This study investigates the pollution factors present in the water of the Al-Shatrah Stream, focusing on identifying the health risks associated with these factors. To achieve this objective, the researcher employed the Canadian Water Quality Index (CWQI) as a tool for classifying and examining the impact of spatial and seasonal variations on pollution levels. The study analyzed nine indicators, including physical and chemical parameters such as temperature, turbidity, pH, total dissolved solids, total suspended solids, chlorides, sulfates, and alkalinity. Additionally, a bacteriological analysis was conducted to assess the presence of fecal coliform bacteria at three sites along the stream during the months of February and July. The researcher employed statistical analysis to calculate the arithmetic mean and standard deviation of the measured values, both temporally and spatially. Variations between sites were assessed using analysis of variance (ANOVA), and the least significant difference test was applied at a significance level of 0.05 for all indicators. The findings from the Canadian Water Quality Index (CWQI) analysis are concerning, as they indicate that the water quality of the Al-Shatrah Stream is subpar and unsuitable for human consumption. The CWQI equation, a widely accepted and reliable method for assessing water quality, has classified the sampled sites along the stream as having poor water quality.

Background:Chronic endometritis is a persistent and localized inflammation of the endometrium. Clinically, antibiotics are used to treat CE, but there is a lack of optimal treatment protocols. Objectives:To evaluate the effectiveness and safety of different regimens for the treatment of chronic endometritis using a network meta-analysis. Search Strategy:A computerized search was conducted across multiple databases, including PubMed, Embase, Cochrane Library, Web of Science, Wanfang, VIP, CBM, and CNKI, for all clinical studies on antibiotics or antibiotic combinations for the treatment of chronic endometritis. The search covered studies published from January 1, 2019, to September 6, 2024. Selection Criteria:Following the independent screening of the literature by two evaluators, data extraction and risk of bias assessment were performed. Data Collection and Analysis:A network meta-analysis was carried out using Stata 14.0 software, and ranking and funnel plots were generated. Main Results:A total of five studies involving 887 patients were included. Four treatment regimens were assessed: Doxycycline; Doxycycline and Dydrogesterone; Levofloxacin and Tinidazole; Doxycycline and Prednisone acetate. The network meta-analysis revealed that Levofloxacin and Tinidazole were the most effective in terms of overall efficacy, while Doxycycline and Prednisone acetate demonstrated the best outcomes in terms of pregnancy and miscarriage rates. Conclusions:All four drug regimens show good clinical efficacy for treating chronic endometritis, with Levofloxacin and Tinidazole being the most effective. Treatment choices should be individualized based on patient-specific needs. However, due to the limited number of included studies and small sample sizes, further large-scale, high-quality clinical trials are necessary to validate these findings.

Background: ATP7B encodes a copper-transporting adenosine triphosphatase that maintains intracellular copper ion homeostasis by transporting excess copper ions from the cell into the bile. The main objective of this study was to investigate the relationship between ATP7B and various cancers, to reveal its potential role in cancer progression, modulation of the tumour immune microenvironment. To provide comprehensive insights into the relationship between this gene (ATP7B) and cancer by understanding the associated pathological mechanisms. We expect to explore its potential as a prognostic biomarker for cancer and propose new insights for immunotherapy strategies for cancer. Methods: The potential function of ATP7B in multiple cancers was investigated using information from The Cancer Genome Atlas (TCGA), Genotype-Tissue Expression (GTEx), Tumor Immune Estimation Resource version 2 (TIMER 2.0), Kyoto Encyclopedia of Genes and Genomes (KEGG), and Human Protein Atlas (HPA). Variations in ATP7B expression, mutations, DNA methylation, immunohistochemistry, survival, pathological stage, immune cell infiltration, drug response and single-cell biological functioning condition were examined. Results: A wide variety of cancer types showed high levels of ATP7B expression. In the majority of malignancies, the presence of ATP7B expression in tumor tissues has been associated with better overall survival and disease-free survival rates. Cases of UCEC and BLCA with altered ATP7B have improved prognoses. Most tumors had higher levels of DNA methylation. ATP7B was linked to numerous immune cells, genes, and tumor immunity in several cancers. ATP7B expression levels correlate with suppression of the tumour immune microenvironment; this is demonstrated by a negative correlation with CD8+ T cell infiltration in various malignancies. ATP7B-overexpressing patients with immune checkpoint inhibitors have a better prognosis. Conclusions: Our research provides a thorough understanding of ATP7B’s oncogenic function in various tumor types. Our findings imply that ATP7B may be a biomarker for the prognosis of cancer patients. Better prognosis for tumour patients will be achieved through the use of immune checkpoint inhibitors and by interfering with ATP7B expression levels which brings new insights into tumour therapy.

Butyrylcholinesterase Deficiency in a Chinese Female Linked to Heterozygous Variants of the Butyrylcholinesterase Deficiency Gene: A Case ReportYanyue Zhang1, Limin Wang1, Feng Dong2*1Department of clinical Laboratory, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua Municipal Central Hospital Medical Group, Jinhua, China2Department of clinical Laboratory, Jinhua Maternal and Child Health Hospital, Jinhua Municipal Central Hospital Medical Group, Jinhua, China* Corresponding author:Feng Dong, 3476952717@qq.com

This paper introduces a dimensional metric for the concept of pure light speed, a theoretical construct at the foundation of the Knot of Light framework. Unlike the conventional constant speed of light , the pure light speed represents the maximum resonance propagation speed within a unified topological structure. The paper presents proposed mathematical forms of , along with interpretations and dimensional implications.

This paper introduces a generalized dimensional energy equation derived from the Knot of Light theoretical framework. By extending Einstein’s mass-energy equivalence into a multi-dimensional context, we propose the formulation , where both mass and light speed are modulated according to dimensional topology. The model incorporates rhythm-based scaling and phase-dependent transformations, offering a new language to describe energy distribution across layered dimensional fields. This equation serves as the foundational entry in The Knot of Light Equation Series, bridging relativistic physics with topological dimensionality and initiating a structural redefinition of energy in extended space.

A decomposition of D^_i (n) based on Dyck paths is introduced. In conjunction with lattice path enumeration results from [1], this leads to an expression for A014495(n) involving the Catalan Numbers.

The number of individuals with disabilities, such as those with deafness, blindness, and paralysis, is increasing annually, as well as the elderly population. Both groups deserve the right to live independently. This paper introduces a multimodal home automation system that allows users to control household devices autonomously using hand gestures, eye tracking, and voice commands. The solution is customizable to individual preferences and operates on Raspberry Pi 4 through Python. The system is customizable to user needs and operates on a Raspberry Pi 4 using Python. Testing with elderly individuals and people with disabilities at Wahat El Farah Association (El Koura, Lebanon) showed promising results. The system offers a reliable and accessible solution for independent living through adaptable control methods.

Introduction Chronic inflammation poses a significant public health risk, linking to conditions such as cardiovascular disease, diabetes, arthritis, cancer, and adverse reproductive outcomes. In Rwanda, women of reproductive age face health challenges related to nutritional status, infectious diseases, and socioeconomic disparities, potentially contributing to systemic inflammation. However, data on the prevalence of inflammation in this group remain limited. This study evaluates the prevalence and predictors of inflammation, using serum C-reactive protein (CRP) and alpha-1-acid glycoprotein (AGP) data from the 2019-2020 Rwanda Demographic and Health Survey (RDHS). Methods We analyzed secondary data from the RDHS, focusing on women aged 15-49 years, excluding pregnant, breastfeeding, or HIV-positive individuals, resulting in a sample of 2,755 women. We performed Pearson’s chi-squared tests for categorical variables and logistic regression models to assess factors associated with elevated levels of CRP, AGP or both. Results Obese women exhibited significantly higher levels of AGP (aOR 2.4) and CRP (aOR 3.4). Overweight women also had elevated CRP (aOR 1.5). Moderate anaemia linked to increased CRP (aOR 2.8) and AGP (aOR 2.3), while severe anaemia had a higher association with AGP (aOR 5.0). Malaria infection correlated with elevated AGP (aOR 3.9) and CRP (aOR 5.0). Contraceptive pill use was associated with higher CRP levels (aOR 2.3), whereas implants showed lower odds of elevated biomarkers (aOR 0.6). Conclusion Obesity, anaemia, malaria, and contraceptive use are key predictors of elevated inflammatory biomarkers among Rwandan women. Addressing these factors through targeted interventions could mitigate chronic inflammation and related health risks. Further research on the interplay between inflammation and contraceptive choices is needed.

This article deploys the axiomatic method to re-express the political programme set out in Recep Tayyip Erdoğan's Daha Adil Bir Dünya Mümkün (English: A Fairer World Is Possible; hereafter cited in Turkish) within the formal language of Alpay Algebra. Erdoğan's headline claim-encapsulated in the dictum "The world is bigger than five"-is recast, together with four companion principles on cooperation, conscience, equity and hope, as an explicit axiom scheme governing ideology fields. Three theorems follow. First, a maximal "Fair World Field" necessarily exists; second, any fragmented global order must either expand toward that field or disintegrate; third, the limiting order is unique and Lyapunov-stable under a suitably defined time-evolution operator. The proofs exploit chain-completeness, Zorn's Lemma and a novel pseudometric on ideological distance, and are reproduced stepby-step in an online appendix for full replicability. Substantively, the model supplies a transparent logical scaffold for Turkish calls to enlarge the UN Security Council, demonstrates why representational reform is structurally indispensable for long-term legitimacy, and exemplifies how abstract mathematics can illuminate concrete debates on global governance, international law and normative political theory.

The development of sustainable electrodes through biomass valorization requires innovative strategies to overcome the limitations of conventional manufacturing processes. This study demonstrates a facile yet effective green fabrication route, without corrosive reagents or complex treatments, for high-performance supercapacitors using carbonized balsa wood monoliths (CW) as self-supported electrodes. Mechanistic investigations reveal that Cu/CuO/Cu₂O heterojunctions were formed within CW through the single-step impregnation-carbonization process. Capitalizing on the innate hierarchical porosity of balsa wood, the optimized electrode (BSC-4Cu) achieves an exceptional specific capacitance of 1164 F g⁻¹ at 100 mA g⁻¹ (9314 F cm-2). The corresponding symmetric supercapacitor delivers 154 Wh kg⁻¹ energy density at 180 W kg⁻¹, maintaining 93% capacitance retention after 10,000 cycles, surpassing commercial supercapacitors (1-10 Wh kg⁻¹) and approach lithium-ion batteries (150-200 Wh kg⁻¹). This work establishes an eco-conscious protocol for transforming fast-growing biomass into high-value energy storage devices, emphasizing simultaneous performance excellence and sustainable manufacturing principles.

Diabetic cardiomyopathy (DCM) results from prolonged impairment of cardiac gluco-lipid metabolism in diabetes leading to increased mitochondrial dysfunction, oxidative stress, inflammation, cardiac remodeling, and heart failure. The cardiometabolomes involved are used as diagnostic, prognostic, and treatment biomarkers complimentary to the imaging technologies such as echocardiography. However, the imaging readouts can only belatedly detect structural cardiac malfunctions. Artificial Intelligence (AI) is a novel tool in healthcare technology that is currently partially applied to DCM staging, following digitization of the imaging data readouts but not to the cardiometabolites data, which suffer lower sensitivity, specificity and accuracy, despite their advantage in sub-clinical disease diagnosis. We searched online databases for articles published in English between 2020 and 2024 on DCM using appropriate search words. The mean values of global pooled data on glycosylated hemoglobin (HBA1c), Brain-type Natriuretic Peptide (BNP), cardiac Troponin I (cTnI) were determined by Bayesian hierarchical meta-regression models and the Area-Under-the-Curves that were calculated from the constructed Receiver Operating Characteristic curves at 70% sensitivity were used to predict the specificity of the metabolites sensing compared to the standard reference, respectively. The HBA1c, BNP and cTnI predictions were 92%, 80% and 40%, respectively, compared to the standard DCM diagnostic criteria. These figures can be up-scaled, digitized, and digitilized in AI empowered algorithms to predict DCM pathogenesis at the sub-clinical stage. Though diagnostically inferior to the commonly used imaging techniques, AI can be plugged into cardiometabolome sensing to mitigate the development of DM at pre-clinical stage.

Background and Purpose The operational characteristics of dose-escalation design in phase I studies have been studied using simulations, however, there is limited analysis regarding their effects on the results of clinical trials. Experimental Approach We collected the data of 394 clinical trials involving dose-escalation studies for anticancer drugs submitted to the Pharmaceuticals and Medical Devices Agency (PMDA) between 2013 and 2022. We used these data and published papers and analysed outcomes such as enrolment and drug development. Key Results We indentified model-based designs (e.g. Bayesian logistic regression model) and rule-based designs (e.g. classical 3 + 3) as the two primary designs. The median number of dose-limiting toxicity (DLT)-evaluated patients was higher for model-based designs than rule-based designs. The proportion of rule-based designs was higher in Japanese trials and that of model-based designs was higher in multiregional clinical trials (MRCTs). The determined recommended phase Ⅱ dose (RP2D) was consistent with the approved dose in all trials (13/13) involving model-based designs and in 84.0% (21/25) of trials involving rule-based designs. The proportion of progression to the next study phase was 50.0% (61/122) for rule-based designs and 56.3% (36/64) for model-based designs. Similar trends in these outcomes were observed when MRCTs and Japanese trials were examined separately. Conclusion and Implications Model-based designs might require more DLT-evaluated patients; however, they might have different operational capabilities compared with rule-based designs, such as selecting an RP2D consistent with the approved dose. The results might help in choosing the optimal dose-escalation methods in future phase I trials.

Title: A Case of Pulmonary Abscess Masked by Chronic Lymphocytic LeukemiaPrimary and Corresponding AuthorManila Jindal, MDAssociate Director, Department of Medicine

Basal cell carcinoma of temporal bone masquerading as necrotising otitis externa -- A case report

Deep vein thrombosis after knee arthroplasty for hemophilia A: a case report and review of the literature

XiSort is introduced as a deterministic, reproducible sorting algorithm for floating-point sequences, grounded in rigorous mathematical principles. I formalize the sorting metric minimized by XiSort, including a curved variant, and demonstrate that XiSort can be viewed as minimizing the entropy or disorder of a sequence. Leveraging the IEEE-754 total ordering relation, XiSort imposes a complete order on all floating-point values (including ±0 and NaNs), and uses information-theoretic tie-breaking to guarantee a unique sorted output. I integrate XiSort into the Alpay Algebra symbolic framework, showing that the algorithm's recursive structure, monotonic convergence, and idempotence (sorting identity) can be encoded and verified symbolically. Within Alpay Algebra, XiSort is represented as a recursive operator that preserves the closure of the state space and exhibits a convergence property under a suitable monotonic potential function. I also detail XiSort's algorithmic design and performance. Empirical results on both real-world datasets and large-scale Gaussian random data confirm that XiSort achieves competitive throughput inmemory and in external memory (out-of-core) contexts while providing bit-for-bit reproducibility. I report timing results (e.g. sorting 10 8 doubleprecision values in about 12 seconds in-memory, and 100 GB of data at ∼100 MB/s on SSD storage) alongside use cases in scientific computing and high-frequency finance. The results highlight XiSort's practical value for reproducible numerical workflows and large-scale data pipelines, ensuring consistent ordering and stable behavior across platforms and runs.

Aim To analyze geographical variation in use of glucose-lowering drugs (GLDs) for type-2 diabetes (T2DM) in Denmark. Methods We included all adults who filled a prescription for a non-insulin GLD indicated for T2DM from 2010 to 2023 in Denmark. Stratified by each of the five regions, we calculated the annual incidence rate, the annual prevalence proportion, and the total volume of dispensed GLDs from 2010 to 2023. We calculated the proportion of incident prescriptions for GLDs that was issued by different prescriber types and characterized non-insulin GLD users in each region in 2023. Finally, we analyzed variation at the municipal level. Results Totally, data from 478,118 adults were included. In all regions, general practitioners were the main prescribers of GLDs. There were minor regional differences in the use of GLDs with a predominant and increasing use of metformin, accelerating use of SGLT-2is and GLP-1RAs, and declining use of SUs over time. There were some differences in characteristics of GLD users across regions with a slightly higher prevalence of diabetes-related complications and larger involvement of hospital physicians in the Capital Region compared to the other regions. We identified four municipality clusters that differed marginally in the prescribing pattern of non-insulin GLD. Conclusion The small differences in use of GLDs indicate equal access to GLDs across Denmark. Differences at the municipal level calls for future studies to investigate if these reflect differences in clinical practice or differences in T2DM populations.

Stochastic earthquake-tsunami models (SETMs) are widely used to simulate hypothetical tsunamis and their variability. Different SETMs can produce tsunamis with substantially different statistical properties, and to understand their biases, SETMs should be tested against tsunamis generated by multiple real earthquakes. However, few studies have attempted this. This study tests three SETMs from the 2018 Australian Probabilistic Tsunami Hazard Assessment by comparison with fourteen earthquake-tsunamis observed at tide gauges in southeast and west Australia. The SETMs vary in complexity from a simple uniform slip model with deterministic rupture area (FAUS), a uniform slip model with variable rupture area (VAUS), and a heterogeneous slip model (HS). For all historical events, sixty scenarios with similar earthquake location and magnitude are sampled from each SETM, and modelled at tide gauges for sixty hours post-earthquake to represent the SETM tsunami distribution. The best fitting SETM scenarios often agree with observations better than tsunamis modelled using published source inversions. However, some observations are not well modelled by one or more SETMs. The tsunami size distribution varies between the SETMs, with FAUS failing to envelope the observed tsunami size much more often. FAUS also tends to underestimate the observations, particularly for larger tsunamis. The VAUS and HS SETMs perform much better, with HS typically producing larger tsunamis than VAUS, but also failing to envelope the observations more often. The relative performance of each SETM is similar if the tsunami size is analysed over the full simulation, or just for early arriving waves, or late waves.

A document by Moshe Segal. Click on the document to view its contents.

We rigorously formalize anterolateral algebra and embed its structure within the framework of algebraic spectral theory. This provides a natural generalization of algebraic analogy, difference, and transformation using the language of spectral varieties and logic vector flows. We develop precise definitions, theorems, and examples to demonstrate this framework, and conclude with an explicit recipe for the spectral analysis of anterolateral algebraic systems.

The lateral and capsular divisions of the central amygdala (CeLC) is a key region involved in the processing of emotional-affective dimensions of pain. In the spino-parabrachio-amygdaloid pain pathway, the CeLC receives nociceptive information from calcitonin gene-related peptide (CGRP) neurons in the parabrachial nucleus. Recent evidence indicates that glutamate delta receptor 1 (GluD1) regulates this projection in mice. GluD1 is an atypical ionotropic glutamate receptor that largely functions as a synaptogenic molecule involved in the formation and maintenance of synapses. Despite its strong cellular expression, little is known about the subsynaptic localization of GluD1 and its potential interaction with CGRP terminals in CeLC neurons. To address this issue, we used single and double immuno-electron microscopy techniques in rodents and monkeys. In both species, CGRP-positive (CGRP+) terminals formed symmetric and asymmetric synapses with dendrites, symmetric synapses with soma, and less commonly, asymmetric synapses with spines. Approximately 80% of CGRP+ terminals forming clear symmetric synapses expressed vGluT2 immunoreactivity and none were immunoreactive for GABA, confirming the glutamatergic nature of this projection and suggesting that some PB-CGRP terminals may modulate transmission to the CeLC in a peptidergic manner. GluD1 was expressed in the core of symmetric axo-dendritic and axo-somatic synapses and peri-synaptic to asymmetric synapses. These findings show that the ascending CGRP+PB-CeLC projection mediates its effects through a heterogenous population of terminals that display strong synaptic relationships with GluD1 in both mice and monkeys.

Alpha-synuclein is a 140 aa neuronal protein pathologically and genetically linked to Parkinson’s disease (PD). In PD, the major protein modification of alpha-synuclein is phosphorylation at serine 129. Alpha-synuclein is also phosphorylated at low levels under physiological conditions but its regulation and role are still largely unknown. Mounting evidence suggests a role for the gut-brain axis in CNS homeostasis, and therefore we set out to examine the regulation of alpha-synuclein phosphorylation in enteric neurons under physiological conditions. To this end, primary cultures of rat enteric nervous system (ENS) and enteric neurons, which both express alpha-synuclein, were either depolarized or treated with forskolin and analyzed by western blot. We found that membrane depolarization and forskolin induced alpha-synuclein phosphorylation via a Ca2+-calmodulin-dependent protein kinases and cAMP/exchange protein directly activated by cyclic AMP (EPAC) signaling pathway, respectively. Both pathways converged on Polo-like kinase 2 (PLK2) to phosphorylate alpha-synuclein. PLK 2 inhibition increased the amount of alpha-synuclein secretion while reducing its intracellular phosphorylation level in both cytoplasmic and membranous fraction. To investigate alpha-synuclein phosphorylation in the ENS further, specimens of human colon were analyzed to show that the distribution of phosphorylated alpha-synuclein in the ENS was highly variable and that the amount of soluble phosphorylated alpha-synuclein did not differ between PD and controls subjects. Our study is the first to show that alpha-synuclein phosphorylation can be physiologically regulated in enteric neurons, providing a basis to unravel the physiological functions of alpha-synuclein and its phosphorylation in the ENS.

Title: Primary Renal Carcinoid Tumor Presenting as Uncontrolled Flank Pain and Cerebral Metastasis in an Elderly Patient: A Rare Case Report and Review of Literature