Increased intracranial pressure (ICP) is a life-threatening complication frequently observed in patients with traumatic brain injury (TBI). Despite its critical impact, effective and non-invasive methods for early detection remain scarce. This study aimed to evaluate early detection strategies for ICP and identify key risk factors to improve patient outcomes. Patients and methods: A descriptive study was conducted on 215 adult TBI patients from October 2023 to October 2024. Data were collected from electronic medical records, Glasgow Coma Scale (GCS) scores, and Glasgow Outcome Scale (GOS) assessments. Statistical methods included Chi-square tests, Pearson correlations, ANOVA, and logistic regression. Results: A demonstrated significant negative correlation between ICP and GCS components—eye-opening, motor, and verbal responses—both at admission and during symptom progression (p < .01). Elevated ICP was positively associated with longer hospital stays and higher medical costs (p < .01). Changes in respiratory rate, a component of Cushing’s reflex, were significantly linked to ICP (p < .05), while other vital signs, such as pulse rate and blood pressure, were predictive of mortality and GOS outcomes. Logistic regression yielded moderate predictive accuracy for ICP detection, with an AUC of 0.74 (95% CI: 0.54–0.93). Conclusion: GCS and respiratory rate are critical indicators for early ICP detection, but the predictive model’s performance highlights the need for further refinement. Future research should explore additional variables, such as oxygen saturation, and incorporate advanced monitoring techniques to enhance predictive accuracy. Keywords: Cushing’s reflex, Early detection,  Glasgow Coma Scale,  increased intracranial pressure, Risk factors, Traumatic brain injury

Objectives We compared the utility of 2009 and 2023 FIGO stage system in our center with endometrial carcinoma. Methods A total of 172 patients between 2015 and 2020 diagnosed with endometrial carcinoma in our center was included in this study. Molecular classification subtypes were classified using DNA sequencing and immunohistochemostry. The clinical characteristics and patients prognosis were analyzed. Results Of the 172 patients, 10 patients were classified to the POLE-EDM group, 30 patients to the MMR-D group, 106 patients to the NSMP group, and 26 patients to the p53abn group. Stage migration from FIGO2009 to FIGO2023 occurred in 27.3% of the patients (47/172). Among the 47 patients, upstaging from stage I to stage II was observed in 43 patients. The transition from stage III to the early stage occurred in only two patients. All patients were downstaged from III to IA3. Subsequently, from FIGO2023 to FIGO2023m, 9 patients had stage IAm disease. Downstaging to stage IAm was observed in 7 patients due to the presence of POLE mutation. In addition, 14 patients had stage IICm disease using FIGO 2023m. 8 patients were upstaged to stage IIC m due to the presence of p53 abnormality, while 6 patients already exhibited stage IIC disease based on the FIGO2023 classification, without molecular classfication. Patients with endometrial cancer with POLE-EDM had the best prognosis in terms of RFS and OS; those with MMR-D and NSMP exhibited intermediate prognosis, with no significant difference between the two groups; and those with p53abn had the worst prognosis. Conclusions Molecular classifier is a useful tool for classifying endometrial carcinoma and determining prognosis. FIGO2023m showed great advantage in predict prognostic in all stages.

Background: Postoperative pulmonary complications (PPCs) are common following head and neck surgeries (HNS) leading to longer hospital stays and significant morbidity and mortality. Current PPC risk prediction models developed for general surgery patients underperform for HNS. This study validates an existing model and extends it for HNS patients. Methods: Using the NSQIP-ACS database (2018-19), we validated the Gupta model, developed on the same database (2007-08). Later, we recalibrated and updated the model with additional predictors relevant for HNS, followed by internal-external validation. The model performance was evaluated by scaled Brier score and Nagelkerke’s R 2. The discrimination ability was measured by C-statistic (AUC) and calibration was assessed by calibration slope. Results: After extension and validation, the updated model achieved improved performance, with a Brier score of 0.0234 and R 2 of 0.1435. C-statistic rose to 0.822 (95% CI: 0.785–0.858), and the calibration slope increased to 0.979. Conclusion: The updated model showed better performance, discrimination, and calibration in predicting PPC in HNS patients compared to the original model.

E-learning systems are used to increase the educational back- ground of students. E-learning systems are very popular nowa- days which is important to monitor and evaluate student per- formance by delivering interactive content and personalized learning targeting student learning. This research highlights various data mining algorithms that can be used to identify user interactions, trends, and patterns to recommend per- sonalized content for E-learning systems. The content can be changed through translations and summarizations across different media to maintain high student interest. Personal- ized learning increases the student’s satisfaction by increas- ing the student’s behavior toward learning. Then, this re- search aims to provide personalized learning content using a weightage (value-based) mechanism. Finally, this research proposes a model that could help to create an intelligent E- learning system using the mechanism. Then, it can be used to generate personalized content recommendations accord- ing to user performance ratings that help to recommend the content output. This is aimed at improving student engage- ment and user experience towards the content. As a result of developing this system, a 73.99% accuracy value was gen- Abbreviations: E-learning, Electronic learning. ∗Equally contributing authors. erated in initial training and a 63.16% accuracy value was generated in initial testing. Then, an 85.58% accuracy value was given after retraining the model, and a 78.90% accu- racy value was given after retesting the model. Further, the content of the E-learning will be arranged according to the SCORM standard.

Aims: Both substance use and mental illness commonly onset during adolescence or young adulthood, and rates of substance use in young people with mental illness are disproportionately high. This baseline data paper from a clinical trial testing an integrated early intervention for substance use and mental health problems aims to 1) describe the characteristics of participants enrolled; and 2) compare young people with a current and without a lifetime diagnosis of Substance Use Disorder (SUD) in terms of psychiatric symptoms, functioning, and substance use. Methods: Seventy-nine participants aged 12-25 years with high prevalence mental illness (e.g., depression, anxiety) and substance use seeking mental healthcare were recruited from headspace primary mental health centres in North-Western Melbourne. At baseline, they completed self-report and interview measures of psychiatric diagnoses and symptoms, functioning, and substance use. We compared those with a current (n=51) and without a lifetime (n=21) SUD on these measures. Results: Youth with an SUD endorsed more severe depressive and anxiety symptoms, and lower quality of life and role functioning than those who used substances without a lifetime SUD. They also had more alcohol-related problems and higher frequency cannabis use, and higher risk scores for alcohol, tobacco, cannabis, cocaine, amphetamine-type stimulants, and hallucinogen use. There were no group differences in social and occupational functioning or subjectively-rated sleep quality. Conclusions: Findings highlight the need for early identification and integrated care models within youth mental health services to address the high prevalence and impact of problematic substance use, potentially reducing adverse effects of co-occurring SUD and mental illness on youth development and functioning.

In this research, we explore a high-precision numerical method for non-smooth differential equations (NSDEs). Generally speaking, NSDEs can be comprehensively categorized into three main types, namely, the continuous piecewise smooth variety, the discontinuous piecewise smooth type, and the infinite derivative type. When addressing non-smooth issues of the infinite derivative type, conventional approaches typically resort to adaptive quadrature strategies, which consequently entail a substantial computational burden. With the intention of resolving this issue, we present a fractional interpolation method (FIM) that is founded on the fractional Taylor series. This particular method principally takes advantage of the distinctive characteristic that fractional interpolation is associated with infinite derivatives. Unlike conventional methods, the FIM can directly interpolate infinite derivative points without relying on an adaptive quadrature strategy, thus bringing a significant improvement in computational efficiency. Through rigorous non-smooth numerical experiments, we have demonstrated its superior performance compared to conventional high-order numerical methods and MATLAB’s built-in functions. We further confirm the practical applicability of the proposed method by applying it to piecewise smooth systems, such as dry friction systems and binary airfoil systems with free-play. This application effectively demonstrates its potency in analyzing the dynamic responses solutions of non-smooth systems.

In this work, a forward-backward time fractional heat equation is introduced for the first time. A non-overlapping domain decomposition procedure with a finite difference scheme is used to solve the underlying problem in one-dimension. According to the nature of forward and backward property, the physical domain is divided into two separate subdomians. Time discretization of the fractional time derivative is performed by a defferential operator namely V1 method and the second order central difference scheme is employed to deal with the spatial derivative. In addition, a matrix form for the discretized equation is obtained. Furthermore, the convergence and stability of the proposed method is investigated. Finally, some numerical examples are presented to demonstrate the effectiveness of the proposed method.

Seed dispersal by animals in cycads is assumed to be rare and unimportant. We conducted a literature review of seed dispersal by animals in species of the family Zamiaceae. We found 71 reports of animal dispersal in Zamiaceae, mostly by birds and mammals species of small to medium size; but only six studies of seed dispersal in natural populations of Zamia species. We also conducted a study of primary and secondary seed dispersal by animals in Zamia manicata in Colombia. We used camera traps for recording animal interactions with female cones with mature seeds; and a seed marking experiment to explore the movement of seeds away from the immediate vicinity of the parental plant after cone disintegration. For Z. manicata, we observed a potential primary seed disperser, Baryphthengus martii, a medium-sized bird of the Momotidae family. We also registered a 6% of seeds initially dispersed by gravity moved away from the parental plant more than 10 meters of distance. These results and other recent evidence suggest that animal dispersal events might play an important role for the population ecology of species in the Zamiaceae family.

Cancer is a fatal genetic disease involving unregulated cell growth and proliferation with varying underlying complexities including immune evasion, treatment resistance, and recurrence, and optimized treatment is required for proper cure. Molecular studies have revealed that tumors are extremely heterogeneous in nature, leading to the complexity of cancer development, which is ultimately linked to its genetic machinery. It would require effective targeting of dysregulated molecular mechanisms involving growth factors, regulatory proteins, cell adhesion molecules, and molecules of immune system mainly driven by alterations in tumor suppressor genes and oncogenes that may vary among different cancer types. Importantly, patients with the same type of cancer respond differently to available cancer treatments, indicating the need for patient-specific treatment options. Thus, in-depth genomic studies of patients’ tumors are needed to fully understand the determinants of cancer initiation and progression for effective targeted therapy. Precision oncology has evolved as a form of cancer therapy focused on genetic profiling of tumors to identify molecular alterations involved in cancer manifestation for tailored individualized treatment of the disease. Accordingly, there have been great developments in the formulation and production of anticancer agents in recent years owing to advances in molecular technologies enabling precise targeting of oncogenic pathways involved in disease progression. This article aims to briefly explain the foundations and frontiers of precision oncology in the context of advancements in the tools and techniques associated with the process to assess its scope and importance in realizing the intended goals.

Objective: This study aims to determine the frequency of ovarian involvement in patients aged 50 years and younger, investigate the associated factors, and, unlike other studies in the literature, investigate the role of the systemic immune-inflammatory index (SII) in ovarian involvement. Material and Methods: Patients aged 50 years and younger with endometrial cancer between 1992 and 2022 were included in the study. Patients were examined in two groups: patients with adnexal involvement (ovarian metastasis and synchronous ovarian cancer) and patients without adnexal involvement. Clinicopathological parameters that can be used to predict adnexal involvement were analyzed in both groups. Complete blood count parameters (platelet, leukocyte, lymphocyte, neutrophil) were analyzed from the preoperative patients. To evaluate inflammatory indices, PLR (platelet/lymphocyte), NLR (neutrophil/lymphocyte) and SII (neutrophil x platelet/lymphocyte) were calculated. A two-group analysis was performed between the groups by determining the cut-off value for the statistically significant parameters. Results: A total of 205 patients were included in the study, and histopathological ovarian metastasis was detected in 5.9% (n=12), synchronous ovarian tumor was detected in 2.4% (n=5). In the univariate analysis, non-endometrioid histological type, increased grade, advanced stage disease, myometrial invasion depth, LVSI, cervical stromal invasion, lymph node metastasis and omental involvement indicate an increased risk for ovarian involvement (p>0.005). However, in the regression analysis (Table 2) only the stage of the disease, cervical stromal invasion, metastatic pelvic lymph node and omental involvement were found to be independent risk factors for ovarian involvement (p<0.001). Preoperative laboratory values of the patients were examined and a statistically significant difference was found in neutrophil count, NLR percentage and SII (p<0.005). In the group with ovarian involvement, median SII was 1201.62 (±631.95), higher than the group without ovarian involvement (p= 0.023). In the ROC analysis, the best cut-off points were 70% sensitivity, 76% specificity and 992.58 cut-off value (AUC=.726) for SII.When the patients were grouped according to the cut-off value of 992, ovarian involvement was significantly more common in the presence of high SII (p<0.005). Conclusion: Due to the adverse effects of early menopause on women’s health, an ovarian preservation approach for endometrial cancer was brought to the agenda. This study shows that ovarian involvement is rare in patients younger than 45 years of age, with low grade, superficial myometrial invasion, no cervical stromal involvement, no LVSI, and no intraoperative extrauterine spread. In these patients, ovarian-sparing surgery should be considered an option, and SII can be used as an index to be considered in patient selection.

In ESORICS’16, Xu et al. introduced a new notion called delegatable proofs of storage (delegatable POS, DPOS), which strikes a balance between privately verifiable POS (PriPOS) and publicly verifiable POS (PubPOS). Their scheme offers efficiency similar to PriPOS while allowing third-party auditors to verify file integrity, with auditors being revocable and replaceable, thus approximating PubPOS. Later in 2018, Yang et al. enhanced the scheme with data dynamic and privacy-preserving features. However, the scheme’s design is intricate, introduces new hardness assumptions, and has the potential for improved computational efficiency. Our work explores the connections between PriPOS and DPOS, proposing a generic construction that could construct DPOS schemes directly from PriPOS ones. Our generic construction removes the need for new designs or additional assumptions, retains PriPOS’s efficiency, and avoids the overhead of re-downloading files. We formally prove the security of our generic construction and showcase it by instantiating a DPOS scheme based on a classical PriPOS scheme, which concretely shows key advantages. The proposed scheme uses standard primitives like pseudo-random functions, avoids costly pairings, and optimizes computational and communication costs. Furthermore, our generic construction seamlessly accommodates the extension of DPOS schemes to incorporate advanced features. Specifically, we enhance the base DPOS scheme with random masks to achieve a privacy-preserving DPOS scheme and integrate Index Management Tree (IMT) to develop a dynamic DPOS scheme, which reduces update complexity to O ( log n ) .

Objective: Cesarean delivery rates are increasing worldwide, while operative vaginal delivery rates continue to decline. It was evaluated that the use of operative vaginal delivery may help to perform vaginal delivery safely and prevent cesarean section in stage II of labor performed for various maternal or fetal indications, reducing cesarean section rates. Design: A retrospective study. Setting: Department of Obstetrics and Gynecology, Turkish Ministry of Health Elazığ Fethi Sekin City Hospital Population: Patients who had operative delivery and 121 patients who had spontaneus vaginal delivery between 2019-2023. Methods: 75 patients who had operative delivery at Elazığ Fethi Sekin City Hospital between 2019 and 2023 were compared with 121 pregnant women who had spontaneous vaginal delivery as a control group. Singleton deliveries after 37 weeks of gestation and patients with no history of maternal complications were included in the study. Multiple pregnancies or cases with a history of maternal complications were excluded. Main Outcome Measures : Demographic data (age, gravida, parity), maternal characteristics (BMI, gestational week), fetal and neonatal parameters (fetal birth weight, Apgar scores, fetal pH) and postnatal outcomes (NICU requirement, presence of complications) were obtained retrospectively and compared. Result: Gravida and parity values were found to be significantly lower in the study group. There was no significant difference between the groups in terms of gestational week. The first minute Apgar scores of the infants in the study group were significantly lower than those in the control group. The mean fetal pH was significantly lower in the study group and the NICU requirement was higher in this group. Conclusion: The high rate of operative delivery in the first pregnancy may indicate that maternal-fetal adaptation complicates the delivery process.

Herein, genes chsG, chsA, chs5 and chs2 were overexpressed in M. purpureus M183 to evaluate their diverse impacts on the cell growth, Monascus pigments (MPs) and citrinin biosynthesis. The results showed that overexpression of chsG exhibited the most profound effects, notably reducing extracellular MPs production by 59.42%, while upregulating mycelial MPs levels by 73.27% and citrinin production by 34.14%. Morphological analysis indicated a significant decrease in the length of mycelium of M. purpureus M183 following the overexpression of these chs genes. Furthermore, the surfaces of the mycelium pellets of these mutants displayed a more flocculent and roughened appearance during SBF compared to M183. Notably, M. purpureus oe: chsG distinguished itself by displaying conspicuously bolder mycelia, denser cell wall and darker cytoplasm. RT-qPCR results revealed the chsG mRNA level increased by an impressive 11.9-fold in M. purpureus oe: chsG, and individual overexpression of the genes chs5 and chsA triggered notable elevations in the chsG mRNA level. Comparative transcriptome analysis uncovered profound alterations in the expression patterns of genes associated with biosynthetic pathways of MPs, citrinin, metabolism of fatty acids and amino acids, and morphological regulation and growth including the chitin and ergosterol biosynthetic pathways, MAPK signal pathway, global transcription factors and peroxisomes.

Background: Hereditary angioedema(HEA) is a life-threatening disease characterized by bradykinin-associated angioedema attacks. Pulmonary artery stiffness (PAS) evaluates the structural and functional dynamics of the pulmonary vasculature and is pivotal in the development of pulmonary arterial hypertension. In this study, we aimed to evaluate PAS in patients with HEA by echocardiagraphic method during the attack and non-attack periods. Method: A total of 34 patients with HEA who presented to outpatient clinic during attack and non-attack periods and 20 controls consisting of healthy volunteers were included in the study.Systolic and diastolic functions, tissue doppler imaging and pulmoner flow paramaters were evaluated in the patient and control groups. Results: In the statistical comparison of echocardiographic parameters between the patient and control groups, the myocardial performance index (MPI) values were significantly higher in the HEA group compared to the control group (p = 0.007).The PAS values and other echocardiographic variables showed no statistically significant differences between HEA patients and controls, nor between attack and non-attack data in HEA patients (p>0.05). Conclusion: In our study, no statistically significant difference was found in the evaluation of PAS between HEA and the control group and also when the attack and non-attack periods were compared in the HEA group, and PAS evaluation is needed in larger patient groups. MPI was found to be higher in the patient group compared to the control group and may be a harbinger of cardiovascular diseases that will develop in the HEA group.MPI may be used in the HEA group in terms of cardiac effects in follow-up.

Background: Artificial Intelligence (AI) technologies could potentially change many aspects of clinical practice. While Allergen Immunotherapy (AIT) can change the course of allergic diseases providing relief of symptoms that extend for many years after treatment completion, it can also bring uncertainty to patients, who turn to readily available resources such as ChatGPT-4 to address these doubts. The aim of this study was to use validated tools to evaluate the information provided by ChatGPT-4 regarding AIT in terms of quality, reliability and readability. Methods: In accordance with AIT clinical guidelines, 24 questions were selected and introduced in ChatGPT-4. Answers were evaluated by a panel of allergists, using validated tools DISCERN, JAMA Benchmark and Flesch Reading Ease Score and Grade Level. Results: Questions were sorted into 6 categories. ChatGPT provided bad quality information according to DISCERN medians scores in the “Definition”, “Standardization and Efficacy”, and “Safety and Adverse Reactions” categories. It provided insufficient information according to JAMA Benchmark across all categories. Finally, ChatGPT-4 answers required a “college graduate” level of education to be understood as they were very difficult to read. Conclusions: ChatGPT-4 exhibits potential as a valuable complement to healthcare; however, it requires further refinement. The information it provides should be approached with caution regarding its quality, as significant details may be omitted or may not be fully comprehensible. Artificial intelligence models continue to evolve, and medical professionals should participate in this process, given that AI impacts various aspects of life, including health, to ensure the availability of optimal information.

A corner stone of Physics is the Energy Conservation principle which states that the Energy is always conserved and that the Energy, embedded in the whole Universe, cannot disappear or be created from nothing. This should imply that the Total amount of the Energy, which is embedded in the whole Universe, must be a constant value. However, Humans are not able to devise means or experiments which will provide the exact amount of the Energy embedded in the whole Universe, which implies that Humans are not able to devise means or experiments which will conclude, with complete validity, that the amount of the Energy embedded in the whole Universe, can be indeed represented by a constant value. Moreover, the fact, that the nowadays Science of Physics does agree that in addition to the Detectable Energy, the Universe embeds a very large amount of undetectable, or Dark Energy, (about 70% of the estimated Total Energy which is estimated to be embedded in the whole Universe is estimated to be Dark Energy), might further imply, that Humans cannot evaluate the actual amount of the Total Energy embedded in the Universe, which might further support the assumption, that Humans cannot prove, that all the Energy embedded in the Universe, is indeed conserved. The above implies that Humans are not able to provide a proof for the Energy Conservation Principle, which means, that the Energy Conservation Principle is presented only as an axiom, and no discussion was yet provided as to the extent of validity that Humans can attribute to the Energy Conservation Principle, even though, it is a corner stone of the nowadays Science of Physics. Thus, in view of the above, this paper tries to examine the extent of the validity that Humans can attribute, to the Energy Conservation Principle. Initially, this paper tries to explore, if the evaluation of the amount of Energy, only in certain specific Energy components, in the Universe, will result in the evaluations of the same Energy amounts, by all Human evaluators, or, if separate Human evaluators might arrive at different results, relating to the Total Energy Content, of these certain several specific Energy components, which they evaluated. Thus, in view of the above, this paper provides arguments that two separate Humans, evaluating the Total Energy Content of certain several specific Energy components, in the Universe, might arrive at different results, relating to this Total Energy Content, of these several specific Energy components, which they evaluated. The arguments mentioned above, relating to the possibility that two separate Humans, evaluating the Total Energy Content of certain several specific Energy components, in the Universe, might arrive at different results, relating to this Total Energy Content, of these several specific Energy components, which they evaluated, appear also in an additional paper, by the author of this paper, titled: "A discussion related to the Energy Relativity and its Implications" (4). However, in order to emphasize the possibility, that evaluations of Energy amounts by Humans might be also relative, to the Human which executed that evaluation of this Energy amount, the additional paper, mentioned above, did not elaborated on the limitations, that also exist, in the arguments that two separate Humans, evaluating the Total Energy Content of certain several specific Energy components, in the Universe, might arrive at different results, relating to this Total Energy Content, of these several specific Energy components, which they evaluated. Thus, this paper presents also these limitations which further emphasizes the conclusion, presented also in the additional paper, mentioned above, that, although Energy evaluations by Humans might be sometimes relative to the specific Human evaluating that Energy, The Energy Conservation Principle should be recognized as a valid principle when it relates to Energy conservation related to what Humans detect in any specific Inertial Frame of Reference. And, although Humans cannot provide a complete proof for the Energy Conservation Principle, as related to the whole Universe, Humans should still attribute validity to the Energy Conservation Principle, also as related to the whole Universe, because it is a very significant corner stone of the nowadays Science of Physics, but should recognized that this validity is attributed to this principle only as an axiom, without being able to prove it. An important factor, in the arguments, presented in this paper, and the additional paper mentioned above, relating to the possibility that two separate Humans, evaluating the Total Energy Content of certain several specific Energy components, in the Universe, might arrive at different results, relating to this Total Energy Content, of these several specific Energy components, which they evaluated, is the following: The nowadays Science of Physics recognizes only one velocity as absolute, non-relative velocity. This velocity is the velocity of Light in vacuum, which is also recognized as the maximum velocity that Humans can attribute to a moving body. All other velocities are recognized, by the nowadays Science of Physics, as non-absolute or as relative velocities, and this implies, as this paper presents, that Humans might be in situations, in which, their evaluations of the Kinetic Energies, which should be attributed to moving bodies, might turn to be wrong evaluations.

Seed and pollen dispersal plays a crucial role in species persistence by shaping populations on a large scale. However, empirical studies linking small-scale dispersal to large-scale patterns are scarce. We analysed the reproductive ecology of Staudtia kamerunensis (Myristicaceae), a tree species widespread in Central Africa, with the aim of linking its reproductive ecology to its large-scale population dynamics, characterised by a range expansion in the Congo Basin. We investigated gene flow and dispersal using parentage analyses and fine-scale spatial genetic structure in two landscape types, a closed-canopy forest and a forest-savanna mosaic. We found a deficit in regeneration despite fair seed production in the closed-canopy forest. Staudtia kamerunensis is a self-compatible monoecious species (8% selfed progeny), although the decay of inbreeding with age highlights inbreeding depression. Pollen dispersal (dp = 580 m) was more extensive than seed dispersal in the closed-canopy forest, where we detected a significant fine-scale spatial genetic structure (Sp = 0.0083), while gene flow was more extensive in the fragmented forest. The median diameter for reproduction was dbh50 = 58 cm whereas trees reproduce efficiently from 40 cm. This study provides insight into the reproductive ecology and dispersal of S. kamerunensis, revealing patterns that are consistent with previous studies on its population dynamics. Our results also provide insights to maintain healthy populations. We recommend a minimum cutting diameter of 60 cm or regulation to maintain at least 50% of the original reproductive potential after logging operation to preserve the reproductive potential of natural populations.

Ternary hybrid nanofluid have been revealed to possess a wide range of application disciplines reaching from biomedical engineering, detection of cancer, over or photovoltaic panels and cells, nuclear power plant engineering, to the automobile industry, smart cells and and eventually to heat exchange systems. Inspired by the recent developments in nanotechnology and in particular the high potential ability of use of such nanofluids in practical problems, this paper deals with the flow of a three phase nanofluid of MWCNT-Au/Ag nanoparticles dispersed in blood in the presence of a bidirectional stretching sheet. The model derived in this study yields a set of linked nonlinear PDEs, which are first transformed into dimensionless ODEs. From these ODEs we get a dataset with the help of MATHEMATICA environment, then solved using AI-based technique utilizing Levenberg Marquardt Feedforward Algorithm. In this work, flow characteristics under varying physical parameters have been studied and analyzed and the boundary layer phenomena has been investigated. In detail horizontal, vertical velocity profiles as well as temperature distribution are analyzed. The findings reveal that as the stretching ratio of the surface coincide with increasing the vertical velocity as the surface has thinned in this direction minimizing resistance to the fluid flow.

Abstract: Grassland phenology has a significant impact on the carbon balance of terrestrial ecosystems. However, the response of vegetation phenology to seasonal climate remains unclear. This study analyzes the response mechanisms of grassland phenology in China to seasonal climate, altitude, slope, and slope aspect from 2001 to 2019 using methods such as the Geodetector. The results are as follows: (1)The average start of season (SOS) was 172 days, showing an advancing trend at a rate of 0.2 days per year. The average end of season (EOS) was 258 days, showing a delaying trend at a rate of 0.35 days per year. (2)Temperature shows an accumulative effect on SOS, with an extended pre-season period expanding the region where temperature and SOS are negatively correlated. The influence of evapotranspiration and precipitation on SOS varies by season, with both factors generally showing a negative correlation with SOS. Seasonal temperature, precipitation, and evapotranspiration all positively correlate with EOS. (3)The response of SOS to altitude and slope shows a nonlinear trend. Below 4,000 meters, the delay rate of SOS is 1.85 days per kilometer; above 4,000 meters, the delay rate increases to 13.91 days per kilometer. When the slope is below 25°, SOS shows no significant change, but above 25°, SOS is significantly delayed. EOS advances with altitude at a rate of 0.1 days per kilometer. (4)The interaction between climate and terrain has a much lower impact on EOS than on SOS. Evapotranspiration-altitude interaction predominantly influences SOS, while precipitation-altitude interaction primarily drives EOS changes.This study provides a scientific basis for research on terrestrial ecosystem carbon cycling.

The purchase and sale of agricultural tractors are strongly influenced by supply and demand dynamics, making accurate forecasting essential for optimising these transactions. This study presents a novel hybrid methodology that integrates Long Short-Term Memory (LSTM) neural networks with Teaching-Learning-Based Optimisation (TLBO) to enhance decision-making in tractor sales forecasting. The proposed approach leverages TLBO to dynamically optimise critical LSTM hyperparameters, such as the number of layers, neurons, and learning rate, thereby reducing manual intervention and improving model adaptability. Using time series data from January 1961 to December 2020, the hybrid model was trained and evaluated, achieving significant improvements in predictive accuracy compared to standalone LSTM models. The results highlight the potential of this methodology for complex forecasting tasks, providing a scalable framework for decision-making in agricultural markets. Additionally, the versatility of the proposed approach makes it applicable to various domains requiring precise time series predictions.

Epilepsy is one of the five major neuropsychiatric disorders worldwide, primarily due to its high disability and mortality rates. Antiseizure medications (ASMs) are the first-line treatment for primary epilepsy. Levetiracetam (LEV), a broad-spectrum second ASM, has been approved for the treatment of focal seizures, as well as adjunctive therapy for myoclonic seizures and primary generalized tonic-clonic seizures. LEV stands out for its favorable tolerability and fewer side effects. However, therapeutic drug monitoring to establish safe and effective approaches for LEV personalized treatment in some certain populations such as newborns, children, pregnant women, patients with hepatic or renal impairment where adequate safety and pharmacokinetic data is lacking. In this review, we summarized the pharmacokinetic characteristics of LEV in different populations, aiming to provide up-to-date guidance for clinical medication. In adults with epilepsy, pharmacokinetic parameters and dosing regimens align with those of healthy adults. Conversely, newborns and young children with epilepsy may require higher doses compared to adult patients. For elderly patients, it is advisable to adjust the dosage based on their creatinine clearance considering the decline in renal function. In cases of isolated hepatic impairment, dose alteration may not be required; close renal function monitoring is recommended for patients with hepatorenal syndrome. Dose adjustments for patients experiencing renal insufficiency should be based on their creatinine clearance. Notably, both pregnancy status and body weight significantly influence LEV clearance. Understanding the pharmacokinetic profile of LEV across different patient groups aids in optimizing its use, ensuring safety and efficacy in clinical practice.

Abstract: Pulse field ablation (PFA) is a novel technique for treating atrial fibrillation (AF), but its use in patients with mechanical mitral valves (mMV) is limited due to concerns about catheter entrapment and interference with efficacy. We report the first successful use of PFA in a patient with an mMV, with acute pulmonary vein isolation (PVI) confirmed by pre- and post-procedural voltage mapping. This case demonstrates the feasibility and safety of PFA in this high-risk population.

In the context of a finite undirected graph D( V,E) and a non-empty subset σ⊆ V, the graph generated by switching D by σ is denoted as D σ ( V , E ′ ) . This graph is acquired from D by summing up all non-edges that connect σ to the vertices V− σ and terminating all edges that connect σ and its complement V− σ. We record D v for σ={ v}, and the associated switching is known as vertex switching. Nevertheless, we refer to this as | σ|-vertex switching. It is reported as 2-vertex switching when | σ|=2. A two-cyclic graph contains exactly two cycles in it. Any two vertices in a connected graph are linked together by a path. In this article, we provide neccessary and sufficient requirements for D σ , the switching of D at σ={ e,f} to be connected and two cyclic graph when ef∈ E( D).

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