Abstract: This work defines an effective memory horizon \( T_{\rm mem} \) for a class of non-Markovian cosmologies based on the Infinite Transformation Principle (ITP), and shows how \( T_{\rm mem} \) can be inferred from late time expansion and growth data. The key ingredient is a causal kernel that ties the present Hubble rate to the integrated history of internal energy and structure. From this kernel one can extract a characteristic timescale over which past states remain dynamically relevant. A combination of \( H(z) \) measurements, large scale structure growth constraints, and two bin ITP fits is used to constrain the delay parameter that controls the memory kernel and to map it into \( T_{\rm mem} \). In representative fits the present universe behaves as if its dynamics retains memory over effective timescales of order \( T_{\rm mem}\sim 50 \)–\( 80 \)~Gyr, several times larger than the standard \( 13.8 \)~Gyr age, without implying a literal birth time at \( t=-T_{\rm mem} \). The memory horizon is best interpreted as an operational measure of how far back the present expansion is correlated with its own past, not as a revised estimate of the age of the universe. Robustness tests with different kernel families and priors on the delay parameter show that current \( H(z)+f\sigma_8(z) \) data strongly disfavour short delay, effectively Markovian behaviour and favour a long memory regime with a conservative lower bound corresponding to several Hubble times. The picture that emerges is compatible with cyclical cosmologies in which late-time observables can carry accumulated memory from earlier phases, while remaining consistent with the empirical success of \( \Lambda \)CDM at low redshift.

Abstract: Coastal regions concentrate livestock and fisheries activities that generate large volumes of organic residues, often managed inadequately and contributing to nutrient loading, soil degradation, and marine pollution. At the same time, these territories face increasing pressure to decarbonise energy systems and restore degraded soils under climate change. This article proposes a process-oriented conceptual framework for the integrated valorisation of livestock and fisheries residues through hydrogen-centred energy recovery and biochar-based soil regeneration, with a focus on coastal regions of Colombia. The framework integrates biological and thermochemical conversion pathways, including anaerobic digestion, fermentation, gasification, and pyrolysis, within a unified system boundary that treats organic residues as secondary resources rather than environmental burdens. Hydrogen is conceptualised as a short-term energy carrier, while biochar is positioned as a key co-product enabling long-term carbon stabilisation and soil regeneration. By explicitly integrating material and energy flows, territorial scale considerations, and governance dimensions, the proposed framework provides a process-level basis for designing decentralised residue-to-energy and soil-regeneration systems capable of delivering simultaneous benefits in renewable energy supply, waste management, soil restoration, and climate mitigation in environmentally vulnerable coastal regions.

Abstract: Sodium-glucose cotransporter 2 (SGLT2) inhibitors, widely used in the treatment of type 2 diabetes, have recently emerged as potential anticancer agents due to their effects on tumor metabolism and growth signaling pathways. This article presents a viewpoint on the growing body of preclinical evidence linking SGLT2 inhibition to antitumor activity, including reduced glucose uptake, AMPK activation, mTOR suppression, and cell cycle arrest. Agents such as canagliflozin, dapagliflozin, and empagliflozin have demonstrated efficacy across various cancer models, though clinical validation remains limited. We propose that SGLT2 inhibitors may offer a promising therapeutic strategy in metabolically active tumors, especially when guided by molecular profiling. While further research is needed, these findings support reconsidering the oncologic relevance of this drug class within a personalized medicine framework.

Abstract: Background The optimal treatment for unresectable intrahepatic cholangiocarcinoma (iCCA) remains uncertain. Hepatic arterial infusion chemotherapy (HAIC) aims to increase local drug concentration and tumor response. Methods Following PRISMA 2020 guidelines and PROSPERO registration (CRD420251128740), we searched major databases up to March 2025. Included: observational comparative studies of HAIC (alone or with immunotherapy) vs. systemic therapy in unresectable iCCA. Outcomes: OS, PFS, ORR/DCR, grade 3–4 AEs. Pooled estimates used random-effects REML with Hartung–Knapp adjustment. Results Thirteen observational studies (~1,200 patients; no RCTs) were included. HAIC significantly improved tumor response (ORR/DCR RR 2.74 and 1.25, 95% CIs 1.91–3.92 and 1.04–1.50) with non-significant trends favoring HAIC for survival (OS HR 0.66, 95% CI 0.28–1.54; PFS HR 0.59, 95% CI 0.30–1.15). Severe toxicity was comparable (RR 0.79, 95% CI 0.10–6.20; exploratory, k=2). Heterogeneity low (I² ≤1%). Conclusions This observational meta-analysis suggests HAIC is associated with superior tumor response and non-significant survival trends without excess severe toxicity versus systemic therapy in unresectable iCCA. These hypothesis-generating findings require confirmation by randomized trials.

Abstract: The concept of sustainability has evolved far beyond its initial environmental foundations, expanding into a multidimensional framework that integrates multinational policies, multicultural values, and multigenerational knowledge, but there is a paucity of bottom up or grass roots research. This paper is a narrative of oral history intersects supported by rigorous documentation including military records, census data, genealogical records, and scholarship extending over four centuries . By synthesizing individual lived experiences with systemic goals, such as those outlined by the United Nations Sustainable Development Goals (SDGs) [1], a more nuanced understanding of resilience and adaptation emerges. The analysis of recent scholarship indicates that sustainability is a dynamic, narrative - driven process that requires an in- depth understanding of the spatial and temporal consequences of global shifts, ranging from climate catastrophes to the translocal flows of capital and people [2] . This paper uses oral history to show the adaptation of a multigeneration, multicultural “ordinary” family in North America to the social, political, economic, and technological challenges faced over 400 years with a focus on sustainability.

Abstract: Based on a unified non-perturbative quantum gravity framework, this paper systematically elaborates on the cross-scale universality of the quantum gravitational correction term containing a logarithmic term. At the microscale of black hole singularities, it dynamically resolves the singularity through a repulsive potential and ensures information conservation; at the macroscale of black hole gravitational fields and galaxies, it maintains the high-speed revolution of stars and the flatness of rotation curves through additional gravity, eliminating the need for assumptions such as dark matter or black hole spin fitting parameters. With quantum vortices (statistical average topological structures of microscopic particles) and nested AdS/CFT duality as the physical core, the framework derives a modified gravitational potential with a logarithmic term: \( Φ(r)=-\frac{GM}{r}-\frac{kG_h M^2 (ln⁡r+1)}{r} \). Among them, the logarithmic term ln⁡r is the core of realizing the cross-scale effect of “repulsion at short distances and attraction at long distances”. Through predicting black hole shadows (Sgr A*, M87*) consistent with EHT observations without introducing additional free parameters (e.g., spin); calculating the “periastron” velocities of high-speed stars (S4714, S62) orbiting black holes; fitting galaxy rotation curve data (Milky Way, Andromeda Galaxy, NGC2974); and further analyzing the mathematical asymptotic behavior of dark matter halos, multiple cross-scale verifications (spanning nearly 30 orders of magnitude from black hole singularities to galaxies) prove that the framework has high consistency with observations in both strong gravitational fields (black holes) and weak gravitational fields (galaxies). It achieves the first unified description of gravity from the microscale to the macroscale, providing observable and reproducible empirical support for quantum gravity theory.

Abstract: Background: U.S. hospitals have increasingly affiliated with multi-hospital chains, raising questions about whether consolidation yields operational efficiencies or primarily reflects integration costs and market power. Evidence on the dynamic financial response to chain entry—especially in recent years—remains limited.Objective: To estimate dynamic association in hospital financial margins around sustained chain joining using a staggered-adoption-robust event-study design.Methods: We analyzed a RAND-processed HCRIS hospital panel (2014–2023). Dynamic effects were estimated using the Sun & Abraham interaction-weighted event-study estimator with hospital and year fixed effects and hospital-clustered standard errors. We implemented two baseline rules (“has2014” and “entry”) and examined total, operating, and cash-flow margins. To reduce ratio outliers, margins were cleaned using year-specific denominator screening and hard caps for extreme values (|margin|>500%), then winsorized within year (p1/p99) for main analyses. Depending on outcome and baseline rule, models used approximately 13,000–24,000 hospital-year observations, covering ~2,600–2,900 hospitals and roughly 600 sustained chain joins. Robustness checks included a balanced-panel restriction, a treated-only stacked specification, placebo assignment among never-treated hospitals, and ownership-stratified estimates.Results: Lead coefficients were generally small, but cash-flow margins exhibited a statistically detectable negative lead at t = −4 in both baseline rules (p≈0.03), while other leads were typically indistinguishable from zero. Post-entry effects were modest and imprecise across outcomes. Total margins showed near-zero contemporaneous changes at t=0 and small negative estimates in years 1–3 that attenuated by year 4. Operating and cash-flow margins displayed small post-entry declines around t=2 (≈1 percentage point in magnitude; p≈0.06–0.09). Robustness checks (balanced panel, stacked design, placebo) broadly supported a null or weak-transient pattern. Ownership stratification suggested modest longer-run improvements for nonprofit hospitals in later post years (e.g., t=4: +3.7 percentage points; p=0.045), while for-profit estimates were mixed and imprecise.Conclusions: Over 2014–2023, sustained chain joining was not associated with consistent, sustained improvements in hospital financial margins on average. Observed changes were small, often imprecise, and in some outcomes suggest modest short-run declines consistent with integration costs. Continued monitoring with longer post-entry windows and additional outcomes is warranted.

Abstract: This paper introduces a data-driven anomaly detection framework designed to enhance the safety and reliability of lithium-ion battery packs deployed in large-scale electric transport systems. Leveraging principal component analysis (PCA) and cumulative sum (CUSUM) control charts, the method monitors mean-based residuals of voltage and temperature across cell groups to detect early-stage faults such as internal short circuits, sensor failures, and thermal irregularities. Experimental validation using real-world data from a battery-electric locomotive demonstrates the system’s ability to identify anomalies with deviations as low as 4mV and 0.15°C while maintaining a falsepositive rate below 3%. The approach reduces detection time by 56% and missed anomalies by 60% compared to conventional thresholding methods. By integrating real-time fault diagnosis into battery management systems, this work contributes directly to the advancement of safe, durable, and sustainable battery manufacturing and energy storage deployment in heavy-duty electric mobility.

Abstract: Psychologists and economists have employed mean national IQ as a human capital variable to characterize a nation’s potential for economic growth. While previous studies consistently show a high positive correlation between a nation’s average IQ and its wealth, there is disagreement regarding the reason behind this relationship. Some believe high IQs facilitate economic growth while others believe wealth explains why IQs vary across nations. To address this uncertainty, this study analyzes retrospective observations across time within a wealth-equated sample of underdeveloped nations. The correlation between the level of economic growth experienced by the nations sampled and their average IQ across five decades was r = .74 (R² = .548). Statistical tests demonstrate that high IQ nations displayed significantly more growth and that nations experiencing more growth had higher IQs. These results support the use of average national IQ as a human capital variable and demonstrate its causative role in economic growth.

Abstract: Older patients with unresectable locally advanced non-small cell lung cancer (NSCLC) frequently receive concurrent chemoradiotherapy (CCRT) with daily low-dose carboplatin; however, real-world data on its efficacy, safety, and prognostic factors remain limited. We aimed to retrospectively evaluate the clinical outcomes of this regimen and examined whether systemic inflammation-based indices predict prognosis in this setting. We reviewed 52 consecutive patients with locally advanced NSCLC treated with first-line CCRT using daily low-dose carboplatin at three Japanese institutions between April 2007 and December 2019. The median progression-free survival (PFS) and overall survival (OS) were 11.5 and 40.1 months, respectively. Twenty patients received durvalumab as maintenance therapy. In the overall cohort, multivariate analysis identified the Glasgow Prognostic Score (GPS) as an independent predictor of PFS. A GPS of 0–1 was also associated with a significantly longer OS in univariate analysis. CCRT with daily low-dose carboplatin provided durable disease control with acceptable toxicity in older patients with unresectable stage II/III NSCLC. The GPS appears to be a simple marker for PFS in this population and may aid in pretreatment risk stratification alongside histology and consolidation strategies.

Abstract: Introduction: Healthcare workers experience high rates of job-related stress and burnout, contributing to a substantial burden of mental and emotional health conditions. Exposure to natural environments is associated with improved mental health outcomes. However, for healthcare workers, the effects of nature in the workplace have been underexplored. This analysis reports the health effects of gaining a window view of nature among a sample of healthcare workers.Methods: In November 2023, a rehabilitation hospital moved its primary location from a midsize [redacted for anonymous review] city to a nearby area surrounded by woodlands. Employees completed surveys on work environment, job satisfaction and burnout, and health-related outcomes prior to the move, four weeks after the move, and one year after the move.Results: In difference-in-differences models controlling for gender, age, and change in job category, participants who gained a window view of a natural environment had greater odds of experiencing improvements in their reported satisfaction of their window view (OR=8.05, p=0.02). However, no statistically-significant improvements were reported for outcomes relating to job satisfaction, stress, burnout, or mental health associated with the change in window view. Conclusions: Although participants gaining window views of nature reported increases in window view satisfaction, we found no changes to job-related or health-related outcomes either at the first followup or one year after the move associated with gaining a window view of nature. Greater doses of nature in workplace environments, or different kinds of strategies, may be necessary to promote mental health among healthcare workers.

Abstract: Chimeric antigen receptor (CAR) T-cell therapy is an effective treatment for hematologic malignancies. However, it is limited by high costs, risk of severe toxicities such as cytokine release syndrome and neurotoxicity, and heterogeneous patient responses. Current therapy monitoring depends largely on subjective symptom assessment, routine laboratory tests, and basic vital signs, without real-time, quantitative evaluation of CAR T-cell expansion or activation in clinical practice. This lack of timely immune monitoring hampers individualized care and contributes to increased treatment costs. To address this need, we present a proof-of-concept, label-free Rapid Optical Imaging (ROI) biosensor with automated machine learning analysis for direct quantification of functional CAR T-cells from whole blood. This microfluidic platform integrates leukocyte separation, capture, and detection on a single chip, thereby eliminating centrifugation, staining, and operator-dependent interpretation. For validation, 50 μL whole blood samples spiked with Jurkat cells expressing a CD19 CAR underwent red blood cell depletion by agglutination and microfiltration. The leukocyte-enriched fraction was then incubated on a sensor chip functionalized with recombinant CD19 protein. Captured CAR T-cells were imaged by bright-field microscopy and automatically enumerated using a machine learning algorithm. A calibration curve was established across clinically relevant concentrations (1–1,000 cells/mL), with results validated against fluorescence microscopy and flow cytometry. This ROI biosensor enables rapid, quantitative, and label-free CAR T-cell detection from whole blood without specialized equipment or infrastructure. With further development, it could provide a cost-effective point-of-care tool for real-time immune monitoring and improved clinical management of patients receiving CAR T-cell therapy.

Abstract: Digital Twin (DT) technology has become a critical component of smart city evolution, providing real-time analytics, predictive modelling, and operational efficiency enhancements. The goal of this paper is to explore the opportunities and barriers for a city-wide data exchange platform to establish the principles for a Federated DT (FDT) development to serve the integration of sector-specific DT applications to create a cohesive urban intelligence framework. The paper investigates the topic of federated data exchange in a smart city context and how interoperability among the use cases of DTs can be achieved. Two system architectures for a Data Exchange Platform have been explored, including layered and composable FDT approaches. The composable architecture has been chosen for the platform implementation to ensure interoperability, scalability, and security in real-time data exchange. The composable architecture is essentially a microservices-driven framework with self-contained components that have clear functionalities and provides the greatest flexibility for future development of the FDT Data Exchange Platform. By employing a range of microservices, the composable architecture can ensure modularity, scalability, and flexibility, making it easier to manage, update, and extend the platform to accommodate additional DTs for evolving city needs, urban management and decision-making. However, this comes at the cost of increased issues around security and governance of interfaces. The platform has been tested by 5 DTs designed by 4 Universities located in Birmingham, UK and Ulsan, South Korea. For the design of the platform, nine common elements have been identified as “building blocks” analysing the DT use cases in a sandbox environment called the Diatomic Azure DT Development Platform. These common building blocks are 3D Visualisation, Asset Management, Predictive Analytics, Artificial Intelligence, Machine Learning, Authorisation Methods, Access Control, API, and Sensors. These building blocks have been later validated by the use cases presented by 8 SMEs developing DTs. The initial results confirm that the identified building blocks are sufficient for the development of DTs to create a generic city-wide data exchange platform. These results provide insights for DT adoption by de-risking investment and targeted resources required for smart city development. The scope of this paper is limited with smart city applications but the proposed FDT system architecture should be applicable to any domain.

Abstract: Rice husk ash is a valuable material produced from the thermal processing of rice husks, which generate over 100 million tonnes of waste annually worldwide. This review examines the production methods, chemical and physical properties, applications, and challenges associated with rice husk ash utilization across various industries. The production methods analyzed include uncontrolled burning, controlled combustion, fluidized bed combustion, gasification, and pyrolysis. Processing conditions, particularly combustion temperature, significantly influence the final properties of rice husk ash. The optimal temperature range of 500-700°C produces ash with predominantly amorphous silica content ranging from 80 to 95 percent, which provides excellent pozzolanic reactivity. The study evaluates key applications in construction, where rice husk ash serves as a supplementary cementitious material that enhances concrete strength and durability at replacement levels of 10-20 percent. Additional applications include high-purity silica extraction, ceramic manufacturing, environmental remediation through wastewater treatment and heavy metal adsorption, and soil amendment for agricultural improvement. Emerging applications in nanotechnology and advanced materials demonstrate the expanding scope of rice husk ash utilization. The environmental benefits are substantial, including agricultural waste reduction, lower carbon dioxide emissions compared to conventional cement production, and contribution to circular economy principles. However, several barriers limit widespread adoption. These include high variability in ash quality depending on rice variety and processing conditions, absence of standardized production protocols, limited infrastructure in rice-producing regions, and insufficient regulatory frameworks. Current research trends show increasing focus on geopolymer concrete, digital fabrication applications, and high-value silica products. Successful implementation requires coordinated efforts to develop quality standards, optimize processing technologies, establish efficient supply chains, and create supportive policies. Future research should prioritize process optimization for consistent quality, development of application-specific standards, exploration of high-value nanotechnology applications, and comprehensive techno-economic assessments to guide industrial adoption.

Abstract: Greenhouse gas (GHG) emissions from sanitary waste (SW) are not usually quantified in institutional inventories, which limits the ability to assess its management and associated carbon footprint. This study establishes emission factors (EF) for SW generated in a higher education institution (HEI), focusing on toilet paper. In 2022, 19 sanitary waste sources were monitored, obtaining a per capita generation of 3.02 g person⁻¹ day⁻¹ and an annual total of 356.87 kg of SW. Samples were characterized through proximate and elemental analyses, applying stoichiometric calculations for two disposal-site degradation pathways: Aerobic: 310 kg CO₂e t⁻¹, Anaerobic: 5,990 kg CO₂e t⁻¹. The weighted emission for the SW mixture was 1,124 kg CO₂e t⁻¹. Based on an estimated annual mass of 1.12 t yr⁻¹, emissions ranged from 0.35 to 6.71 t CO₂e yr⁻¹ depending on the scenario, here emissions could be reduced by over 90% when aerobic degradation or controlled methane capture predominates. The results suggest that separating SW at its point of generation and ensuring that it undergoes aerobic or energy-recovery treatment processes can limit its contribution to institutional GHG inventories. Having material-specific EF enables quantitative comparison among management strategies and guides continuous-improvement decisions.

Abstract: Lead is a toxic heavy metal associated with significant health risks, particularly in children, due to its neurotoxic effects and lack of a safe exposure threshold. This study presents a comprehensive analysis of blood lead levels (BLLs) in children under 18 years, utilizing data from Georgia's national early disease detection program collected between 2020 and 2023. The dataset includes over 32,000 children, providing a robust foundation for evaluating temporal trends and regional disparities in lead exposure. A nationwide decline in elevated BLLs was observed during the study period, with an overall mean BLL of 3.56 µg/dL; however, substantial regional variations persist, with Adjara (mean BLL 5.27 µg/dL, 11.7% with BLL ≥10 µg/dL) and Guria (mean BLL 5.01 µg/dL, 8.3% with BLL ≥10 µg/dL) reporting the highest levels. These findings under-score the critical need for targeted, region-specific environmental health interventions and policies to address persistent lead exposure risks. This analysis contributes valua-ble epidemiological insights into childhood lead exposure in Georgia, informing future public health strategies and resource allocation.

Abstract:

Purpose: This study aimed to evaluate the effects of different exogenous reagents on the propagation efficiency of Acorus tatarinowii rhizome cuttings, thereby providing a reference for its asexual reproduction and contributing to the large-scale cultivation of this species. Methods: Wild Acorus tatarinowii rhizomes excavated from mountainous areas were used as experimental material. Rhizome cuttings were treated by dipping in solutions of gibberellic acid (GA3) at 50, 100, 200, 300, and 400 mg·L^-1; naphthaleneacetic acid (NAA) at 50, 100, 200, 300, and 400 mg·L^-1; indole-3-acetic acid (IAA) at 10, 20, 50, 100, and 200 mg·L^-1; and potassium indole-3-butyrate (IBA-K) at 10, 20, 50, 100, and 200 mg·L^-1. Distilled water (CK) served as the control. After treatment, emergence rate, rooting rate, number of fibrous roots, number of root tips, root length, plant height, number of leaves, and width of the second simple leaf were recorded to evaluate the effects of these exogenous reagents on asexual rhizome cutting propagation of Acorus tatarinowii. Results: Compared with the control, all exogenous reagents enhanced cutting performance to varying degrees. Treatment Tr19 (IBA-K at 100 mg·L^-1) yielded the highest emergence rate (74%), followed by Tr14 (IAA at 100 mg·L^-1) with an emergence rate of 68%. The best rooting rate was observed under Tr14 (IAA at 100 mg·L^-1), which reached 68%. Tr12 (IAA at 20 mg·L^-1) produced the greatest plant height (27.20 cm), followed by 24.39 cm under Tr13 (IAA at 50 mg·L^-1). The highest average number of leaves was recorded under Tr14 (IAA at 100 mg·L^-1) and Tr2 (GA3 at 100 mg·L^-1), at 7.07 and 6.53 leaves per plant, respectively. Leaf width of the second simple leaf was greatest under Tr16 (IBA-K at 10 mg·L^-1), at 0.61 cm. All four reagents exhibited similar effects on fibrous root number, root tip number, and root length, with growth traits under these treatments significantly superior to the control; optimal performance for these root traits occurred under Tr11 (IAA at 10 mg·L^-1) and Tr14 (IAA at 100 mg·L^-1). Correlation analysis showed strong positive relationships among leaf number, width of the second simple leaf, fibrous root number, root tip number, and root length; a strong correlation was also observed between rooting rate and emergence rate. Conclusion: The application of exogenous reagents of suitable types and concentrations, particularly IAA at 100 mg·L^-1 and IBA-K at 100 mg·L^-1, significantly enhanced the emergence rate, rooting rate, and subsequent growth performance of Acorus tatarinowii rhizome cuttings. These findings provide practical implications and reliable technical support for efficient asexual propagation and large-scale cultivation of Acorus tatarinowii.

Abstract: Large-scale mapping of forest canopy height (FCH) is crucial for accurately understanding ecosystem succession and forest carbon sinks. Recently, three high-resolution FCH products have been released, including global forest canopy height (GFCH), NNGI_FCH_China (NNGI_FCH), and ETH_GlobalCanopyHeight (ETH_GCH). This study provides a detailed assessment of these FCH products across China from forest area, spatial consistency, and overall accuracy using forest inventory, CLCD and field measurement data. The results showed that NNGI_FCH had the smallest relative error of 13.9% and achieved better estimates of forest area in all regions but the north and northeast regions. GFCH had the highest spatial consistency of 71.2% nationwide, followed by NNGI_FCH (69.7%), which performed slightly better than GFCH in the east and northwest regions. ETH_GCH exhibited the lowest spatial consistency of 35.6% and remained below 50% across all regions except the northeast and south regions. ETH_GCH demonstrated the highest overall accuracy across the country, with R2 and RMSE of 0.56 and 4.40 m, followed by NNGI_FCH (R2=0.48, RMSE=4.14 m) and GFCH (R2=0.48, RMSE=4.15 m). Validation results of ETH_GCH were relatively stable in different regions of China, while those of NNGI_FCH varied more but still outperformed GFCH. This study offers valuable insights by evaluating large-scale FCH products, which will be a key basis for in-depth studies on the utilization and improvement of future FCH mapping.

Abstract: Background: Atrial fibrillation (AF) is a prevalent arrhythmia closely associated with cardiometabolic disorders and systemic inflammation. Epicardial adipose tissue (EAT), located in direct contact with the atrial myocardium, has emerged as a biologically active tissue involved in atrial remodeling through inflammatory, fibrotic, and electrophysiological mechanisms. The objective of this review is to summarize current translational and clinical evidence on the role of EAT in AF pathophysiology and to discuss its implications for diagnostic assessment, interventional management, and cardiometabolic therapeutic strategies. Methods: A narrative review of experimental, translational, and clinical studies was conducted using major biomedical databases. The literature was evaluated with a focus on mechanisms linking EAT to atrial remodeling, noninvasive imaging techniques for EAT characterization, echocardiographic and electroanatomical markers of atrial disease, outcomes of catheter ablation strategies, and pharmacological interventions targeting metabolic and inflammatory pathways. Results:The available evidence indicates that increased EAT volume and altered inflammatory activity are associated with atrial fibrosis, conduction abnormalities, and impaired atrial function, contributing to AF initiation and persistence. Multimodality imaging, including cardiac computed tomography and cardiac magnetic resonance, enables quantitative and qualitative assessment of EAT and supports clinical phenotyping. Clinical studies report an association between higher EAT burden and increased AF recurrence after pulmonary vein isolation, particularly in patients with persistent AF. Emerging cardiometabolic therapies, such as glucagon-like peptide-1 receptor agonists and dual GIP/GLP-1 agonists, have been shown to reduce EAT volume and inflammatory markers, although direct evidence linking these interventions to improved AF outcomes remains limited. Conclusions: EAT represents a relevant pathophysiological interface between metabolic disease and AF with potential clinical implications. Incorporating EAT assessment into routine evaluation may enhance risk stratification and support personalized AF management. Further prospective studies are required to define its role as a therapeutic target in clinical practice.

Abstract: In this study investigates the effectiveness of combining interleukin-2 (IL-2) with highly-active antiretroviral therapy (HAART) in the control of HIV replication. A mathematical model of the immune system was developed to examine the dynamics of immune recovery when IL-2 is administered alongside HAART. Analytical methods, including direction and stability of Hopf bifurcation analysis, were employed to assess the stability of the endemic equilibrium, and comprehensive numerical simulations were conducted to validate the theoretical results. Central manifold theory is applied to established the direction and stability of Hopf bifurcation periodic solution. From this study we find subcritical Hopf bifurcation in the system. The findings from the optimal control problem indicate that optimal therapy involving IL-2 and HAART enhances treatment efficacy, reduces adverse side effects, and improves cost-effectiveness. This research contributes to a deeper understanding of the role of IL-2 in HIV treatment and highlights its potential in advancing therapeutic strategies.