Objective: To test the feasibility of a randomized trial of home blood pressure monitoring paired with a remote lifestyle intervention vs. home blood pressure monitoring alone vs. control in individuals with a hypertensive disorder of pregnancy in the first year postpartum. Design: Single-blinded randomized clinical trial Setting: Two tertiary hospitals and a community organization Population: Overweight and obese individuals with a hypertensive disorder of pregnancy and without pre-pregnancy hypertension or diabetes. Methods: We assessed the feasibility of recruitment and retention of 150 participants to study completion at one-year postpartum with randomization 1:1:1 into each arm. Secondary aims were to test effects of the interventions on weight, blood pressure and self-efficacy. Results: Over 23 months, we enrolled 148 of 400 eligible, screened individuals (37%); 28% Black or Other race, and mean pre-pregnancy BMI of 33.4±6.7 kg/m2. In total, 129 (87%) participants completed the one-year postpartum study visit. Overall, 22% of participants developed stage 2 hypertension [≥140/90 mmHg or on anti-hypertensive medications] by one-year postpartum. Individuals in the lifestyle intervention arm had a greater, non-significant decrease in mean arterial pressure (MAP) compared to individuals in the HBPM alone and control arm [mean change in MAP (95%CI) -3.7(-6.5, -0.9), -0.5(-1.5, 2.6), -1.0(-4.1, 2.2) mmHg], respectively. There were no differences in weight or self-efficacy by study arms. Conclusion: In this pilot, randomized trial, we demonstrate feasibility of HBPM paired with a lifestyle intervention in the first year postpartum. We detected high rates of ongoing hypertension emphasizing the need for effective interventions in this population.

Urban pluvial flooding caused by extreme rainfall has been increasing globally, thus exacerbating loss of life and damage to property. Accurate and updated real-time forecasts are critical needs for urban flooding response and defense. Big data has opened new avenues for inundation depth prediction in complex urban settings. In this study, a new method for pluvial flood classification was proposed for an inundation depth change index (IDCI) by dividing floods into three types: pluvial persistent floods (PPFs), pluvial normal floods (PNFs) and pluvial flash floods (PFFs). Prediction models are identified for the three flood types using data from a network of sensors (109 rainfall stations and 80 flood water depth stations) in Shenzhen, China. The results show that backpropagation neural networks (BPNNs) and long short-term memory (LSTM) exhibit good performance in depth prediction but are not significantly different from one another. In addition, PPFs require a longer rainfall sequence to obtain a better forecast. The Nash-Sutcliffe efficiency (NSE) of the depth prediction results at all stations is 0.86. The prospects for generalizing this approach and its usage are discussed.

Will the Ockenden report lead to change in how we consent in Obstetrics?Authored by Dr Finnuala BurnsLuton and Dunstable Hospital, Lewsey Rd, Luton LU4 0DZFinnuala.burns@nhs.net07508018794With the Ockenden report finally published, obstetric negligence is back in the headlines. One of the main concerns in the report was the trusts refusal to grant women’s wishes for Caesarean section and their desire to keep caesarean section rates low. These are the same issues raised in the Montgomery case in 2015. Nadine Montgomery successfully sued for medical negligence after her baby suffered severe hypoxic ischaemic encephalopathy following a shoulder dystocia. She had diabetes and the baby was large for gestational age, given these risk factors it was considered she should have been offered caesarean section, and that if she had, she would have opted for caesarean and the injury would not have occurred.This case clarified in law the appropriate standard for informed consent. Her obstetrician had stated in court that although the patient had asked if there would be any problems with the baby being big, she did not discuss shoulder dystocia and caesarean section, because if she did that with everyone, everyone would request Caesarean. This was not accepted as justification by the court which stated that the patient should have been informed of the risks and benefits or vaginal delivery and offered alternative delivery options. This has led to an overhaul in how we consent women in certain situations, most obviously in those found to have large for gestational age babies, but in other groups (e.g. low risk women) change has been less overt. With the issue of women being refused Caesareans presenting itself again do obstetricians need more clarity on when to offer Caesarean section?I think there are two key issues that need to be clarified, to whom are Obstetricians discussing risks of vaginal delivery with and when should these discussions be taking place. Addressing the issue of “who”, low risk women are not routinely offered a discussion of the risks of vaginal delivery or the option of Caesarean as an alternative. The RCOG states that “Doctors will not recommend a caesarean section unless it is necessary for medical reasons.”However, the standard of consent is not whether Caesarean is “necessary” from a doctor’s perspective, but instead if the risks posed by vaginal delivery would be great enough that “A reasonable person in the patient’s position would be likely to attach significance to the risk”. This level of risk was reached in Montgomery but not in other cases such as Mrs A v East Kent Hospitals University NHS Foundation Trust, where the risk was the same as background risk. This may support not routinely discussing caesarean section with low-risk women, but when a low-risk woman requests a caesarean the position is clear ”For women requesting a CS, if after discussion and offer of support a vaginal birth is still not an acceptable option, offer a planned CS” . Essentially this creates a situation where women already aware of some of the risks are being provided with appropriate information and given choice, while the most vulnerable women who may not be aware of the risks are not. Is this unjust?The second issue of “when” is more complicated. Antenatal counselling is common practice and easily done, but this is more difficult when the patient is in labour. Labour management is extremely dynamic with constantly evolving and sometimes unpredictable risks with limited staff and theatre availability. It is relatively common for a woman with a low-risk pregnancy who has never previously raised the issue to request a Caesarean in labour where there is no medical indication to perform one. These women have capacity and a right to autonomy and Ockenden affirms that their wishes should be respected. However, this can be extremely difficult for an obstetrician with limited resources. Is it appropriate to take a woman with no medical indication for a caesarean to theatre, when this could delay an emergency caesarean to prevent harm to another woman or a baby? Do they have a risk or regret? Guidance around maternal requests caesareans in labour would be useful and may provide support for resources to be increased to be able to accommodate this safely.Similarly, women who were low risk at the onset of labour frequently develop risk factors as the labour progresses (e.g. the presence of meconium or infection). In the concluding statements of the Montgomery ruling, it is stated that the doctor should offer the pros and cons of each delivery option in “any case where either the mother or the child is at heightened risk from a vaginal delivery”. Therefore, although it may not be unreasonable that they have not had delivery options discussed antenatally, as their risks increase in labour, should they be discussed and offered Caesarean at this point? There is no evidence for example to support Caesarean for meconium alone, but the risk is higher than the background risk. Difficulties with resources aside, would this be seen as clinicians offering treatments due to legal considerations rather than in the patient’s best interests.Thankfully Caesarean section rates are no longer to be used to measure a unit’s performance, as this is clearly a hurdle to supporting a women’s choice for Caesarean Section. However further clarification is needed in regard to when this choice is to be overtly offered. As the cases above clearly demonstrate if the doctor is no longer to decide at what level of risk to offer caesarean, and a patient’s belief that a risk was significant enough they should have been offered one is not supported in court, who is it that is deciding? With a lack of guidance is a situation where a judge is required to give clarification on whether a risk was significant after the fact, appropriate for a high-pressure emergency specialty?No acknowledgements. No conflicts of interests. No other contribution to Authorship. No ethics approval needed . No funding.

Background. Factors related to an adverse evolution in COVID19 infection are needed for proper decision making. We try to identify factors related to hospitalization, ICU admission, and mortality related to the infection. Methods. Retrospective cohort study of patients with SARS-CoV-2 infection from March 1st 2020 to January 9th 2022. The sample was randomly divided into two subsamples, for the purposes of derivation and validation of the prediction rule, until omicron variant appearance and afterwards, respectively. Data collected for this study included sociodemographic data, baseline comorbidities and treatments, and other background data. Multivariable logistic regression models using Lasso logistic regression were used . Results. In the multivariable models, older age, male, peripheral vascular disease, heart failure, heart disease, cerebrovascular, dementia, liver, kidney, diabetes, hemiplegia, interstitial pulmonary disease, cystic fibrosis, malignant tumors, as well as diuretics and the chronic systemic use of steroids were common predictive factors of death. Similar predictors, except liver disease, plus arterial hypertension, were also related to adverse evolution. Similar predictors to the previous, including liver disease, plus dyslipidemia, inflammatory bowel disease, respiratory diseases, and the basal prescription of NSAIDs, heparin, bronchodilators, or immunosuppressants were related to hospital admission. All risk scores developed had AUCs from 0.79 (hospital admission) to 0.94 (death) in the validation in the omicron sample. Conclusions. We propose three risk scales for adverse outcomes and hospital admission easy to calculate and with high predictive capacity, which also work with the current omicron variant, which can help manage patients in primary, emergency, and hospital care.

We consider an initial boundary value problem for a class of anisotropic parabolic Ni-Serrin type equations with nonstandard nonlinearity in a bounded smooth domain with homogeneous Dirichlet boundary condition. Because the nonlinear perturbation leads to difficulties (it does not have a definite sign) in obtaining a priori estimates in the energy method, we had to modify the Tartar method significantly. Under suitable assumptions, we obtain the global existence, decay, and extinction of solutions.

Background: Aortic complications, such as aortic tears and dissections, during cannulation must be managed urgently and often require hypothermic circulatory arrest. We report a unique management strategy to repair an aortic tear without dissection by modifying a Dacron ascending aortic graft with side-arm to serve both as a patch for the aortic tear and inflow for the bypass circuit. Case Presentation: A 32-year-old female patient undergoing reoperative cardiac surgery suffered an unexpected aortic tear during cannulation for cardiopulmonary bypass. After promptly transitioning to femoral cannulation and hypothermic circulatory arrest, the tear was repaired by utilizing a physician-modified ascending aortic graft with side-arm, in which the surrounding skirt of the side-arm was cut from the circumferential graft to patch the defect. The patient was rewarmed with the side-arm serving as arterial inflow for the bypass circuit, and the remainder of the operation proceeded without complication. Conclusion: This type of aortic repair for aortic tears without dissection can offer the patient the benefit of avoiding multiple aortotomies in a weakened aorta, reducing circulatory arrest time, and re-establishing a central cannulation strategy for cardiopulmonary bypass, consequently reducing the likelihood of distal limb ischemia.

Objectives: With an aged population, cardiac surgery in oncologic patients is no longer uncommon. The use of postcardiotomy extracorporeal life support has increased, but its utility in oncologic patients is not clear. This study aims to define the role of postcardiotomy extracorporeal life support in patients with malignancy. Methods: The Extracorporeal Life Support Organization registry was queried for patients older than 18 years with an International Classification of Diseases codes of hematologic and solid malignancy over the last decade (2010-2019). Among them, patients who underwent cardiac surgery or transcatheter valve intervention were selected. Outcomes and clinical data including types of procedure and cancer subtypes were analyzed. Results: One hundred and sixty-two patients met inclusion criteria: 17 pulmonary support, 119 cardiac support, and 26 extracorporeal cardiopulmonary resuscitation. Sixty-two patients (38.3%) survived to discharge. Low survival was seen with hematologic (35.5%), soft tissue (25.0%) and breast malignancies (15.4%) though none of them were statistically significant. Coronary artery bypass grafting (n=56) and surgical valve procedure (n=54) were dominant types of procedures with a survival of 44.6% and 33.3%, respectively. Ventricular assist device procedure (n=48) and cardiac transplant (n=21) were also commonly performed with a survival of 37.5% and 33.3%, respectively. Conclusions: Postcardiotomy extracorporeal life support in patients with malignancy was associated with a low but acceptable survival rate given the high mortality with postcardiotomy extracorporeal life support in the general population. The impact of a cancer diagnosis appeared to be small, but gathering a detailed history of cardiotoxic treatments could be crucial.

Background: Coronary artery aneurysms are reported in 1.5 to 4.9 percent of the population receiving coronary angiography. Whether there is coronary stenosis or atrial fibrillation, it might result in an acute coronary syndrome. Case presentation: The patient was in his usual health when he began to experience pain while watching television an hour before his visit to the emergency department . The patient, a smoker with a history of hypertension, presented at our hospital with significant retrosternal chest pain. A CT angiography of the coronary arteries revealed a large RCA aneurysm thrombus-laden aneurysm. He was given 324 mg aspirin, 400 mcg Nitro-glycerin, 80 mg Atorvastatin, and a Heparin infusion immediately. An emergency RCA bypass grafting procedure was performed after a cardiothoracic surgical team assessed the patient. Conclusion: Coronary artery aneurysm is an infrequent disorder that can appear in a variety of ways. Before any further therapy, it should be thoroughly evaluated.

This letter is in response to the case report by Kuzmin et al. entitled “Left atrial appendage occlusion device causing coronary obstruction: A word of caution” , published in November 2020 issue of Journal of Cardiac Surgery. The report describes a circumflex lesion occurring following mitral valve (MV) repair, tricuspid valve repair, and left atrial appendage closure (LAAO) using AtriClip device. The authors concluded that LAAO is a safe procedure, but in the setting of a concomitant MV surgery LAAO may be a contributor to the reported event. Circumflex coronary artery occlusion or impingement during MV repair is well described in the literature. On the reported two-dimensional cine, the position of the stenosis is typical of mitral repair induced injury. A ring suture can gather and compress tissue adjacent to the coronary creating stenosis without a discrete ligation. It is also true that vigorous traction on the LAA without due attention to distortion of the adjacent circumflex might be capable of creating compression or accordioning of the vessel. To mitigate this, the clip should be placed at the true base of the appendage. A residual pouch carries as much or more risk as not attempting to close the appendage at all. The authors’ recommendation to place the clip more distally will inevitably lead to incomplete closures. In conclusion, the reported event was more likely due to a mitral stitch, the path of which is not directly visualized after it breaches the endocardium.

The Clinical Genome Resource Consortium (ClinGen) recommends MaxEntScan (MES) model to predict effects of LDLR splice variants. We developed “MaxSpliZer”, a software tool to automate implementation of MES and validated it using ClinVar and UK-Biobank (UKBB) data. We tested concordance of MaxSpliZer predictions with ClinVar classifications of pathogenicity of variants in LDLR and FBN1 with potential effect on splicing. We also annotated LDLR splice variants in 200,618 UKBB participants, categorizing them using MaxSpliZer as deleterious (n=90) and non-deleterious (n=7,404). Low-density lipoprotein cholesterol (LDL-C) levels were compared in these two groups after adjustment for lipid lowering medication use. MaxSpliZer prediction was concordant with the ClinVar classification in 96% of LDLR variants and 98% of FBN1 variants. In the UKBB, splice variants predicted as deleterious by MaxSpliZer had higher LDL-C than non-deleterious splice variants (158.7±47.4 vs. 146.0±34.8mg/dL, p-value = 0.014). Compared to manual curation time of 12±7 min per variant, MaxSpliZer took 0.52±0.11 min for single entries and 1.5 s per variant for biobank-scale data. MaxSpliZer, a software tool that implements MES based on the ClinGen guideline, can accurately classify splice variants in a rapid automated fashion.

Recent reports indiciate that the prevelance of food allergy is increasing, but accurate estimates remain a challenge due to cross-reactivity and limited use of precise diagnostic methods. Component-resolved diagnostics (CRD), in which sensitization to individual molecular components of whole food allergen extracts is measured, is emerging as a promising tool for evaluation of sensitization profiles. In this systematic review, we summarized estimates of prevalence of sensitization to food allergen components in the general population in Europe. We searched seven databases with no restrictions on publication date or language. Two reviewers independently screened the literature and appraised the risk of bias in the included studies. From 4,776 de-duplicated records, five studies, with low to moderate overall risk of bias, were included and narratively synthesized. Forty-six components from 18 foods were investigated. Overall, the prevalence of sensitization was low, particularly for major allergens, and non-existent for 10 components (0% [95% CI 0-0.8]). The highest prevalence was seen for PR-10 proteins, such as Cor a 1.04 (13.6% [95% CI 10.9-16.9]). There were not enough studies to discern regional differences or perfom meta-analysis, highlighting the need for more population-representative studies in order to elucidate patterns of sensitization to food allergen components in Europe.

In receptors of solid organ transplant, calcineurin inhibitors has become a pillar of immunosuppressive treatment. Several case reports have shown hypertrophic and dilated cardiomyopathy as a side effect of tacrolimus. We present the case of a woman receptor of a kidney transplant who developed hypertrophic cardiomyopathy due to Tacrolimus.

Cerulean or blue-dot cataracts is a rare entity caracterised by the presence of early onset bilateral cataracts with concentric layers of bluish-white opacities. Visual acuity is usually well preserved and rarely necessitates cataract extraction before adult life.

Independence is fundamental to the reliability of auditors’ reports. Third parties believe that there is no need for external auditors without independence. Audit failures of well-known and listed companies frequently occur in China. It has essential research value to abstract the factors of the audited supplier and discuss factors that affect the independence of the audit from the perspective of the audit purchaser. This article takes the case of Kangmei Pharmaceutical’s audit failure in 2019 and uses the A-share listed companies’ data on the Shenzhen Stock Exchange from 2010 to 2018 to construct an audit independence model to test the purchaser factors that affect audit independence empirically. The study finds that under other conditions unchanged, the degree of Social Attention and the performance of Corporate Social Responsibility (CSR) significantly affect the independence of auditing. The level of Corporate Internal Governance has no noticeable impact on Audit Independence. However, the level of Corporate Internal Governance and Social Attention plays a significant intermediary effect in the path of Corporate Social Responsibility affecting audit independence. This article introduces legal risk as an external shock to further study the role of intermediary effects. Further research finds that when a company has legal risks, it will negatively obscure the relationship between corporate social responsibility and audit independence by wearing the cloak of social responsibility to achieve self-interested goals. The research results show that auditing the buyer’s attributes is one of the critical factors affecting the independence of external audits. In order to protect the legitimate interests of enterprises and external audit institutions, regulatory authorities can improve Audit Independence by strengthening the guidance of the internal construction of enterprises, encouraging traditional evaluation agencies to rate enterprises regularly, and rationally guiding enterprises to perform social responsibilities.

NTCPD, α-Thalassemia and CSS are three hereditary diseases associated with autosome. Especially, NTCPD and CSS are rarely reported in children. However, the co-occurrence of the three hereditary diseases occurred in a child, and presented complex and diverse genotypes and phenotypes, which has never been described.

Omphalolith is a rare and underdiagnosed entity due to the accumulation of sebum and keratin in the umbilicus. It usually occurs in the elderly with deep and narrow umbilicus. Early recognition of omphalolith is important to prevent complications, unnecessary investigations and anxiety. We report herein two new cases of omphalolith.

We report the case of a 65-year-old woman who presented to our hospital with a complaint of abdominal pain due to undigested mochi, which was resolved by snare cutting.

This paper is concerned with the Cauchy problem for the nonlinear fourth-order Schrödinger equation on R^{n}, with the nonlinearity of Hartree-type (| ·|^{-γ}∗|u|^{2} )u .It is shown that a global solution exists for initial data in the spaces L^{p} (p < 2) under somesuitable conditions on γ, n and p. The solution is established by using a data-decomposition argument, two kinds of generalized Strichartz estimates and a interpolation theorem.

In this paper, we are concerned with the non-relativistic limit of a class of computable approximation models for radiation hydrodynamics. The models consist of the compressible Euler equations coupled with moment closure approximations to the radiative transfer equation. They are first-order partial differential equations with source terms. As hyperbolic relaxation systems, they are showed to satisfy the structural stability condition proposed by W.-A. Yong (1999). Base on this, we verify the non-relativistic limit by combining an energy method with a formal asymptotic analysis.

Non covalent biliproteins are found in a growing number of living organisms and even in viruses, such as SARS-CoV-2. Unlike the well described covalent biliproteins, such as the phytochromes, they present a vast structural and functional diversity, and often with limited experimental information. A very important tool (and sometimes the only one available) to study these systems is the UV-Vis spectrum, which is modulated both by conformational changes of the biliverdin chromophore and specific interactions with the apoprotein. In this work we present a theoretical study of the microscopic determinants of the UV-Vis spectrum of these compounds through the use of hybrid QM(TD-DFT)/MM techniques and molecular dynamics simulations. Comparing our results with existing experimental data, we prove that it is possible to predict spectroscopic properties, such as relative position and intensity ratio of main bands, with affordable methods, and to provide a microscopic explanation of them. This systematic information can be very useful for the study of described biliproteins or for those yet unknown.

Quantitative structure-activity relationship (QSAR) studies on a series of 2-phenylindole derivatives as anticancer drugs were performed to choice the important molecular descriptor which is responsible for their anticancer activity (expressed as pIC50)). The geometry optimizations were performed on the structures using Gaussian 09W software with the density functional B3LYP and 6-311G(d,p) basis sets . Dragon 5.4 software was used to calculate molecular descriptors, and the genetic algorithm (GA) procedure and backward regression were used to proper selection of the most relevant descriptors. Different chemometric tools including the backward multiple linear regression (BW- MLR) and backpropagation-artificial artificial neural network (BP-ANN) were carried out to design QSAR models. The squared correlation coefficient (R2) and the Root Mean Squared Error (RMSE) values of the GA-MLR model were calculated to be 0.2843 and 0.7001 respectively. The BP-ANN model was the most powerful, with the square of predictive correlation coefficient R2pred, root mean square error (RMSE), and absolute average deviation (AAD) which was equal to 0.9416, 0.0238, and 0.0099, respectively. The external validation criteria (Q2F1, Q2F2, Q2F3, and concordance correlation coefficient were applied to assay predictive efficiency of QSAR model derived by BP-ANN method. The results derived from the BP-ANN indicated that the anticancer activity of 2-phenylindole derivatives depends strongly on 3D descriptors namely Radial Distribution Function (RDF) descriptors and 3D-molecular geometry of the studied compounds play an important role for these activities. Thus, it could be useful in the design of new 2-phenylindole derivatives having anticancer potency.

In this paper, we analyze the spatial location of the eavesdropper on the secrecy performance of free-space optical communication systems over Fischer--Snedecor F-distribution fading channel. As a key feature, we investigate the impact of the eavesdropper's location within the range of the beam divergence angle, which is more in line with practical engineering applications. The possible position of the eavesdropper is comprehensively assumed with horizontal and vertical components within the beam divergence angle. To this end, the lower-band secrecy outage probability, asymptotic solutions of SOP at high signal-to-noise-ratio, and the strictly positive secrecy capacity are obtained in closed-form, which are corroborated by exact Monte Carlo simulations respectively.

The integration of an ingestible dosage form with sensing, actuation and drug delivery capabilities can enable a broad range of surgical-free diagnostic and treatment strategies. However, the gastrointestinal (GI) tract is a highly constrained and complex luminal construct that fundamentally limits the size of an ingestible system. Recent advancements in mesoscale magnetic crawlers have demonstrated the ability to effectively traverse complex and confined systems by leveraging magnetic fields to induce contraction and bending-based locomotion. However, the integration of functional components (e.g., electronics) in the proposed ingestible system remains fundamentally challenging. Here, we demonstrate the creation of a centralized compartment in a magnetic robot by imparting localized flexibility (MR-LF). The centralized compartment enables MR-LF to be readily integrated with modular functional components and payloads, such as commercial off-the-shelf electronics and medication, while preserving its bidirectionality in an ingestible form factor. We demonstrate the ability of MR-LF to incorporate electronics, perform drug delivery, guide continuum devices such as catheters, and navigate air-water environments in confined lumens. The MR-LF enables functional integration to create a highly-integrated ingestible system that can ultimately address a broad range of unmet clinical needs.  Keywords: Ingestible electronics; ingestible robots; soft robots; magnetic robots; magnetic crawlers; drug delivery.  Corresponding author email:   yong.kong@utah.edu    

(This is an unedited version of what I had originally Handwritten in High School.)Perceived by common sense, time is a causal loop-based sequence of events. In such cognitive definition, the universe ceases to be a mere block of space-time. Rather, it becomes an ether of space-memory. Memories of - or say, from - the future, are what we call imagination; those of the past we call reflections. We all know and have futures we can recall and pasts we can imagine. This article thus sides with such a unidirectional mode of experience.Phenomenal beings, that is, the beings of sentient extants are difficult if at all possible, to infer by proxy. The subjectivity factor quickly infinitizes and randomizes the experiential data set such that the subject themselves, let alone an external party can define an experience. I may be forgiven for pending phenomenality, at least in this treatment, in my assessment of non-linear horology. A key factor in this escape is the entropic kinetics of biological systems which, through random in detail, take specific paths, in this case, ‘directions’ that cannot be compromised. If a compromise is forced, life ends; and there is no longer use of time without the existence of the property, the quality of liveliness -or life.***Time is a scalar cognitive quantity with units of memory. Objective experiences include both inanimates and humans. (Humans subjectively experience only when conscious of causal acts.) Hence it is possible to separate the concept of time from vector-hood, as others have succeeded by supposing the emergence of direction to memorized events, from cause to effect. This task is formidable inside the vehicle of biology. Other sentience-worthy systems namely computers and perhaps aliens might experience reality independent of vectorial spatial temporality. This work aims to satisfy the conditions necessary for an asymmetric time from the perspective of quantum thermodynamics and horological metaphysics. From these specifics, generalizations of events can be reached that does away with the persistently stubborn illusion of illusions – time.***On the ultra-microscopic scale, everything is a fluctuation or vibration, from the most basic ‘thing’ that is a vacuum to super-things like biophysical structures. The strings of life are vectors. Their vibrations do not go forward or backward in time. Instead, they traverse a scalar world, the magnitude of their existing properties (which to sentients is analogous to acts) not the direction, matters. Lacking the variable t as in Newtonian mechanics, concepts of momentum, speed, and velocity are nullified. To explain the changes of quantum events – in this case vibrating strings – we need a vector-free definition of time, a new theory of experience and events that is not at par with statistical interpretations of entropy and the Schrodinger wave function. It follows that macroscales, like their fellow fundamental versions, can exhibit an asymmetrical reality. This is the promise of linear time chambers.***NLTCs emulate the quantum realm in the exhibition of reality. The chambers recreate the states, vibrations -  the fundamental events of the universe for commonsensible and interactable extants with their acts. Thus, a reworking of sequential biochemistry is necessitated.  This fosters wave chemistry instead of the common, and as it turns out, the slow, linear molecular chemistry.To accelerate biological function or recess it, biomechanics is embodied into the more versatile domain of statistical physics such that biologies do what strings do. This presents a possibility to apparently (concerning one second a per second reality) slower or faster (and anywhere in between) experiential data progress. Such effect is referred to by computer theorists as exponential time. Thus NLTCs take advantage of the time scales available to complex embodied software and those necessary for quantum mechanics namely, plank time and higher dimensions or ‘micro-times’ to ‘realize’ asymmetric experiences.Each slot of the chamber may be toggled to any of the available time types.  The experiencer is protected from time dilation expansion and contraction after effects. Just as a emote fast plays scenes of your worst movies on command, rewinds, pauses, and so forth. The chamber controller navigates reality unidirectionally. Each individual’s world in the many worlds of multiverse existence is accessible. Here. One is not stuck in a dead-end path of a certain reality path, rather access frames of choice, not those of causality – even the inescapable luck factor that guides unidirectional existence, Time travel by experience, not travel. Does the illusion remain?Some applications of NLTCs:·        Skiptime·        Accelerate Time·        Time Retard·        Time Remote·        Good Old Days + Brighter Tomorrow, Lived Now·        Given a choice, would you rather revisit the past than go into the future?·        If you could choose the speed of time, what would it be?