A peak enhancement of frequency response of waveguide integrated silicon-based germanium avalanche photodetector

Avalanche photodetectors(APDs) featuring an avalanche multiplication region are vital for reaching high sensitivity and responsivity in optical transceivers. Waveguide-coupled Ge-on-Si separate absorption, charge, and multiplication(SACM)APDs are popular due to their straightforward fabrication process, low optical propagation loss, and high detection sensitivity in optical communications. This paper introduces a lateral SACM Ge-on-Si APD on a silicon-on-insulator(SOI) wafer, featuring a 10 μm-long, 0.5 μm-wide Ge layer at 1310 nm on a standard 8-inch silicon photonics platform. The dark current measures approximately 38.6 μA at-21 V, indicating a breakdown voltage greater than-21 V for the device. The APDs exhibit a unitgain responsivity of 0.5 A/W at-10 V. At-15 V, their responsivity reaches 2.98 and 2.91 A/W with input powers of-10 and-25 dBm, respectively. The device's 3-dB bandwidth is 15 GHz with an input power of-15 dBm and a gain is 11.68. Experimental results show a peak in impedance at high bias voltages, attributed to inductor and capacitor(LC) circuit resonance, enhancing frequency response. Furthermore, 20 Gbps eye diagrams at-21 V and-9 dBm input power reveal signal to noise ratio(SNRs) of 5.30. This lateral SACM APD, compatible with the stand complementary metal oxide semiconductor(CMOS) process,shows that utilizing the peaking effect at low optical power increases bandwidth.

A Temporary Frequency Response Strategy Using a Voltage Source-Based PermanentMagnet Synchronous Generator and Energy Storage Systems

Energy storage systems(ESS)and permanent magnet synchronous generators(PMSG)are speculated to be able to exhibit frequency regulation capabilities by adding differential and proportional control loops with different control objectives.The available PMSG kinetic energy and charging/discharging capacities of the ESS were restricted.To improve the inertia response and frequency control capability,we propose a short-term frequency support strategy for the ESS and PMSG.To this end,the weights were embedded in the control loops to adjust the participation of the differential and proportional controls based on the system frequency excursion.The effectiveness of the proposed control strategy was verified using PSCAD/EMTDC.The simulations revealed that the proposed strategy could improve the maximum rate of change of the frequency nadir and maximum frequency excursion.Therefore,it provides a promising solution of ancillary services for frequency regulation of PMSG and ESS.

Dynamic Response of Foundations during Startup of High-Frequency Tunnel Equipment

The specialized equipment utilized in long-line tunnel engineering is evolving towards large-scale,multifunctional,and complex orientations.The vibration caused by the high-frequency units during regular operation is supported by the foundation of the units,and the magnitude of vibration and the operating frequency fluctuate in different engineering contexts,leading to variations in the dynamic response of the foundation.The high-frequency units yield significantly diverse outcomes under different startup conditions and times,resulting in failure to meet operational requirements,influencing the normal function of the tunnel,and causing harm to the foundation structure,personnel,and property in severe cases.This article formulates a finite element numerical computation model for solid elements using three-dimensional elastic body theory and integrates field measurements to substantiate and ascertain the crucial parameter configurations of the finite element model.By proposing a comprehensive startup timing function for high-frequency dynamic machines under different startup conditions,simulating the frequency andmagnitude variations during the startup process,and suggesting functions for changes in frequency and magnitude,a simulated startup schedule function for high-frequency machines is created through coupling.Taking into account the selection of the transient dynamic analysis step length,the dynamic response results for the lower dynamic foundation during its fundamental frequency crossing process are obtained.The validation checks if the structural magnitude surpasses the safety threshold during the critical phase of unit startup traversing the structural resonance region.The design recommendations for high-frequency units’dynamic foundations are provided,taking into account the startup process of the machine and ensuring the safe operation of the tunnel.

Capacitive energy storage from single pore to porous electrode identified by frequency response analysis

Rate capability,peak power,and energy density are of vital importance for the capacitive energy storage(CES)of electrochemical energy devices.The frequency response analysis(FRA)is regarded as an efficient tool in studying the CES.In the present work,a bi-scale impedance transmission line model(TLM)is firstly developed for a single pore to a porous electrode.Not only the TLM of the single pore is reparameterized but also the particle packing compactness is defined in the bi-scale.Subsequently,the CES properties are identified by FRA,focused on rate capability vs.characteristic frequency,peak power vs.equivalent series resistance,and energy density vs.low frequency limiting capacitance for a single pore to a porous electrode.Based on these relationships,the CES properties are numerically simulated and theoretically predicted for a single pore to a porous electrode in terms of intra-particle pore length,intra-particle pore diameter,inter-particle pore diameter,electrolyte conductivity,interfacial capacitance&exponent factor,electrode thickness,electrode apparent surface area,and particle packing compactness.Finally,the experimental diagnosis of four supercapacitors(SCs)with different electrode thicknesses is conducted for validating the bi-scale TLM and gaining an insight into the CES properties for a porous electrode to a single pore.The calculating results suggest,to some extent,the inter-particle pore plays a more critical role than the intra-particle pore in the CES properties such as the rate capability and the peak power density for a single pore to a porous electrode.Hence,in order to design a better porous electrode,more attention should be given to the inter-particle pore.

A Selective‑Response Hypersensitive Bio‑Inspired Strain Sensor Enabled by Hysteresis Effect and Parallel Through‑Slits Structures

Flexible strain sensors are promising in sensing minuscule mechanical signals,and thereby widely used in various advanced fields.However,the effective integration of hypersensitivity and highly selective response into one flexible strain sensor remains a huge challenge.Herein,inspired by the hysteresis strategy of the scorpion slit receptor,a bio-inspired flexible strain sensor(BFSS)with parallel through-slit arrays is designed and fabricated.Specifically,BFSS consists of conductive monolayer graphene and viscoelastic styrene–isoprene–styrene block copolymer.Under the synergistic effect of the bio-inspired slit structures and flexible viscoelastic materials,BFSS can achieve both hypersensitivity and highly selective frequency response.Remarkably,the BFSS exhibits a high gage factor of 657.36,and a precise identification of vibration frequencies at a resolution of 0.2 Hz through undergoing different morphological changes to high-frequency vibration and low-frequency vibration.Moreover,the BFSS possesses a wide frequency detection range(103 Hz)and stable durability(1000 cycles).It can sense and recognize vibration signals with different characteristics,including the frequency,amplitude,and waveform.This work,which turns the hysteresis effect into a"treasure,"can provide new design ideas for sensors for potential applications including human–computer interaction and health monitoring of mechanical equipment.

Smartphone-based bridge frequency identification using vehicle contact-point response

Bridge frequency(BF)identification using the vehicle scanning method has attracted considerable attention during the last two decades.However,most previous studies have adopted unrealistic vehicle models,thus finding limited practical applications.This study proposes a smartphone-based BF identification method that uses the contact-point acceleration response of a four degree-of-freedom vehicle model.The said response can be inferred from the vehicle body response measured by a smartphone.For realizing practical applications,this method is incorporated into a self-developed smartphone app to obtain data smoothly and identify BFs in a timely manner.Numerical and experimental investigations are performed to verify the effectiveness of the proposed method.In particular,the robustness of this method is investigated numerically against various factors,including the vehicle speed,bridge span,road roughness,and bridge type.Furthermore,laboratory calibration tests are performed to investigate the accuracy of the smartphone gyroscope in measuring the angular velocity,where anomalous data are detected and eliminated.Laboratory experiment results for a simply supported bridge indicate that the proposed method can be used to identify the first two BFs with acceptable accuracy.

Tool Condition Monitoring Based on Nonlinear Output Frequency Response Functions and Multivariate Control Chart

Tool condition monitoring(TCM)is a key technology for intelligent manufacturing.The objective is to monitor the tool operation status and detect tool breakage so that the tool can be changed in time to avoid significant damage to workpieces and reduce manufacturing costs.Recently,an innovative TCM approach based on sensor data modelling and model frequency analysis has been proposed.Different from traditional signal feature-based monitoring,the data from sensors are utilized to build a dynamic process model.Then,the nonlinear output frequency response functions,a concept which extends the linear system frequency response function to the nonlinear case,over the frequency range of the tooth passing frequency of the machining process are extracted to reveal tool health conditions.In order to extend the novel sensor data modelling and model frequency analysis to unsupervised condition monitoring of cutting tools,in the present study,a multivariate control chart is proposed for TCM based on the frequency domain properties of machining processes derived from the innovative sensor data modelling and model frequency analysis.The feature dimension is reduced by principal component analysis first.Then the moving average strategy is exploited to generate monitoring variables and overcome the effects of noises.The milling experiments of titanium alloys are conducted to verify the effectiveness of the proposed approach in detecting excessive flank wear of solid carbide end mills.The results demonstrate the advantages of the new approach over conventional TCM techniques and its potential in industrial applications.

High-Precision Doppler Frequency Estimation Based Positioning Using OTFS Modulations by Red and Blue Frequency Shift Discriminator

Orthogonal Time Frequency and Space(OTFS) modulation is expected to provide high-speed and ultra-reliable communications for emerging mobile applications, including low-orbit satellite communications. Using the Doppler frequency for positioning is a promising research direction on communication and navigation integration. To tackle the high Doppler frequency and low signal-to-noise ratio(SNR) in satellite communication, this paper proposes a Red and Blue Frequency Shift Discriminator(RBFSD) based on the pseudo-noise(PN) sequence.The paper derives that the cross-correlation function on the Doppler domain exhibits the characteristic of a Sinc function. Therefore, it applies modulation onto the Delay-Doppler domain using PN sequence and adjusts Doppler frequency estimation by red-shifting or blue-shifting. Simulation results show that the performance of Doppler frequency estimation is close to the Cramér-Rao Lower Bound when the SNR is greater than -15dB. The proposed algorithm is about 1/D times less complex than the existing PN pilot sequence algorithm, where D is the resolution of the fractional Doppler.

A theory for three-dimensional response of micropolar plates

Through combined applications of the transfer-matrix method and asymptotic expansion technique,we formulate a theory to predict the three-dimensional response of micropolar plates.No ad hoc assumptions regarding through-thickness assumptions of the field variables are made,and the governing equations are two-dimensional,with the displacements and microrotations of the mid-plane as the unknowns.Once the deformation of the mid-plane is solved,a three-dimensional micropolar elastic field within the plate is generated,which is exact up to the second order except in the boundary region close to the plate edge.As an illustrative example,the bending of a clamped infinitely long plate caused by a uniformly distributed transverse force is analyzed and discussed in detail.

Computed tomography radiomic features and clinical factors predicting the response to first transarterial chemoembolization in intermediate-stage hepatocellular carcinoma

Background:According to clinical practice guidelines,transarterial chemoembolization(TACE)is the standard treatment modality for patients with intermediate-stage hepatocellular carcinoma(HCC).Early prediction of treatment response can help patients choose a reasonable treatment plan.This study aimed to investigate the value of the radiomic-clinical model in predicting the efficacy of the first TACE treatment for HCC to prolong patient survival.Methods:A total of 164 patients with HCC who underwent the first TACE from January 2017 to September 2021 were analyzed.The tumor response was assessed by modified response evaluation criteria in solid tumors(mRECIST),and the response of the first TACE to each session and its correlation with overall survival were evaluated.The radiomic signatures associated with the treatment response were identified by the least absolute shrinkage and selection operator(LASSO),and four machine learning models were built with different types of regions of interest(ROIs)(tumor and corresponding tissues)and the model with the best performance was selected.The predictive performance was assessed with receiver operating characteristic(ROC)curves and calibration curves.Results:Of all the models,the random forest(RF)model with peritumor(+10 mm)radiomic signatures had the best performance[area under ROC curve(AUC)=0.964 in the training cohort,AUC=0.949 in the validation cohort].The RF model was used to calculate the radiomic score(Rad-score),and the optimal cutoff value(0.34)was calculated according to the Youden’s index.Patients were then divided into a high-risk group(Rad-score>0.34)and a low-risk group(Rad-score≤0.34),and a nomogram model was successfully established to predict treatment response.The predicted treatment response also allowed for significant discrimination of Kaplan-Meier curves.Multivariate Cox regression identified six independent prognostic factors for overall survival,including male[hazard ratio(HR)=0.500,95%confidence interval(CI):0.260–0.962,P=0.038],alpha-fetoprotein(HR=1.003,95%CI:1.002–1.004,P<0.001),alanine aminotransferase(HR=1.003,95%CI:1.001–1.005,P=0.025),performance status(HR=2.400,95%CI:1.200–4.800,P=0.013),the number of TACE sessions(HR=0.870,95%CI:0.780–0.970,P=0.012)and Rad-score(HR=3.480,95%CI:1.416–8.552,P=0.007).Conclusions:The radiomic signatures and clinical factors can be well-used to predict the response of HCC patients to the first TACE and may help identify the patients most likely to benefit from TACE.

Coherent optical frequency transfer via 972-km fiber link

We demonstrate coherent optical frequency dissemination over a distance of 972 km by cascading two spans where the phase noise is passively compensated for.Instead of employing a phase discriminator and a phase locking loop in the conventional active phase control scheme,the passive phase noise cancellation is realized by feeding double-trip beat-note frequency to the driver of the acoustic optical modulator at the local site.This passive scheme exhibits fine robustness and reliability,making it suitable for long-distance and noisy fiber links.An optical regeneration station is used in the link for signal amplification and cascaded transmission.The phase noise cancellation and transfer instability of the 972-km link is investigated,and transfer instability of 1.1×10^(-19)at 10^(4)s is achieved.This work provides a promising method for realizing optical frequency distribution over thousands of kilometers by using fiber links.

Probiotics: Shaping the gut immunological responses

Probiotics are live microorganisms exerting beneficial effects on the host’s health when administered in adequate amounts.Among the most popular and adequately studied probiotics are bacteria from the families Lactobacillaceae,Bifidobacteriaceae and yeasts.Most of them have been shown,both in vitro and in vivo studies of intestinal inflammation models,to provide favorable results by means of improving the gut microbiota composition,promoting the wound healing process and shaping the immunological responses.Chronic intestinal conditions,such as inflammatory bowel diseases(IBD),are characterized by an imbalance in microbiota composition,with decreased diversity,and by relapsing and persisting inflammation,which may lead to mucosal damage.Although the results of the clinical studies investigating the effect of probiotics on patients with IBD are still controversial,it is without doubt that these microorganisms and their metabolites,now named postbiotics,have a positive influence on both the host’s microbiota and the immune system,and ultimately alter the topical tissue microenvironment.This influence is achieved through three axes:(1)By dis-placement of potential pathogens via competitive exclusion;(2)by offering protection to the host through the secretion of various defensive mediators;and(3)by supplying the host with essential nutrients.We will analyze and discuss almost all the in vitro and in vivo studies of the past 2 years dealing with the possible favorable effects of certain probiotic genus on gut immunological responses,highlighting which species are the most beneficial against intestinal inflammation.

Inflammation: Complexity and significance of cellular and molecular responses

Inflammation is a multifaceted cellular and molecular response triggered by injury,infection,or various pathological conditions.Serving as a protective defense mechanism,the inflammatory response involves clinical signs like redness,swelling,pain,and increased body temperature.Immune cells,notably neutrophils and macrophages,play key roles in orchestrating this response.The delicate balance between proinflammatory and anti-inflammatory mediators,including cytokines and chemokines,regulates the inflammatory cascade.While acute inflammation is crucial for tissue repair,chronic inflammation may indicate an imbalance,contributing to conditions like autoimmune diseases.Understanding these mechanisms is vital for developing therapeutic strategies and managing chronic diseases.

Thermo-hydro-poro-mechanical responses of a reservoir-induced landslide tracked by high-resolution fiber optic sensing nerves

Thermo-poro-mechanical responses along sliding zone/surface have been extensively studied.However,it has not been recognized that the potential contribution of other crucial engineering geological interfaces beyond the slip surface to progressive failure.Here,we aim to investigate the subsurface multiphysics of reservoir landslides under two extreme hydrologic conditions(i.e.wet and dry),particularly within sliding masses.Based on ultra-weak fiber Bragg grating(UWFBG)technology,we employ specialpurpose fiber optic sensing cables that can be implanted into boreholes as“nerves of the Earth”to collect data on soil temperature,water content,pore water pressure,and strain.The Xinpu landslide in the middle reach of the Three Gorges Reservoir Area in China was selected as a case study to establish a paradigm for in situ thermo-hydro-poro-mechanical monitoring.These UWFBG-based sensing cables were vertically buried in a 31 m-deep borehole at the foot of the landslide,with a resolution of 1 m except for the pressure sensor.We reported field measurements covering the period 2021 and 2022 and produced the spatiotemporal profiles throughout the borehole.Results show that wet years are more likely to motivate landslide motions than dry years.The annual thermally active layer of the landslide has a critical depth of roughly 9 m and might move downward in warmer years.The dynamic groundwater table is located at depths of 9e15 m,where the peaked strain undergoes a periodical response of leap and withdrawal to annual hydrometeorological cycles.These interface behaviors may support the interpretation of the contribution of reservoir regulation to slope stability,allowing us to correlate them to local damage events and potential global destabilization.This paper also offers a natural framework for interpreting thermo-hydro-poro-mechanical signatures from creeping reservoir bank slopes,which may form the basis for a landslide monitoring and early warning system.

Effects of Rosa roxburghii&edible fungus fermentation broth on immune response and gut microbiota in immunosuppressed mice

With the rise of probiotics fermentation in food industry,fermented foods have attracted worldwide attention.In this study,protective effects of Rosa roxburghii&edible fungus fermentation broth(REFB)on immune function and gut health in Cyclophosphamide induced immunosuppressed mice were investigated.Results showed that REFB could improve the immune organ index,and promote the proliferation and differentiation of splenic T lymphocytes.In addition,it attenuated intestinal mucosal damage and improved intestinal cellular immunity.REFB administration also up-regulated the expression of IL-4,INF-γ,TNF-α,T-bet and GATA-3 mRNA in small intestine.Furthermore,administration of REFB modulated gut microbiota composition and increased the relative abundance of beneficial genus,such as Bacteroides.It also increased the production of fecal short-chain fatty acids.These indicate that REFB has the potential to improve immunity,alleviate intestinal injury and regulate gut microbiota in immunosuppressed mice.

Time-domain dynamic constitutive model suitable for mucky soil site seismic response

Soil nonlinear behavior displays noticeable effects on the site seismic response.This study proposes a new functional expression of the skeleton curve to replace the hyperbolic skeleton curve.By integrating shear modulus and combining the dynamic skeleton curve and the damping degradation coefficient,the constitutive equation of the logarithmic dynamic skeleton can be obtained,which considers the damping effect in a soil dynamics problem.Based on the finite difference method and the multi-transmitting boundary condition,a 1D site seismic response analysis program called Soilresp1D has been developed herein and used to analyze the time-domain seismic response in three types of sites.At the same time,this study also provides numerical simulation results based on the hyperbolic constitutive model and the equivalent linear method.The results verify the rationality of the new soil dynamic constitutive model.It can analyze the mucky soil site nonlinear seismic response,reflecting the deformation characteristics and damping effect of the silty soil.The hysteresis loop area is more extensive,and the residual strain is evident.

Computed tomography-based nomogram of Siewert type Ⅱ/Ⅲ adenocarcinoma of esophagogastric junction to predict response to docetaxel, oxaliplatin and S-1

BACKGROUND Neoadjuvant chemotherapy(NAC)has become the standard care for advanced adenocarcinoma of esophagogastric junction(AEG),although a part of the patients cannot benefit from NAC.There are no models based on baseline computed tomography(CT)to predict response of Siewert type II or III AEG to NAC with docetaxel,oxaliplatin and S-1(DOS).AIM To develop a CT-based nomogram to predict response of Siewert type II/III AEG to NAC with DOS.METHODS One hundred and twenty-eight consecutive patients with confirmed Siewert type II/III AEG underwent CT before and after three cycles of NAC with DOS,and were randomly and consecutively assigned to the training cohort(TC)(n=94)and the validation cohort(VC)(n=34).Therapeutic effect was assessed by disease-control rate and progressive disease according to the Response Evaluation Criteria in Solid Tumors(version 1.1)criteria.Possible prognostic factors associated with responses after DOS treatment including Siewert classification,gross tumor volume(GTV),and cT and cN stages were evaluated using pretherapeutic CT data in addition to sex and age.Univariate and multivariate analyses of CT and clinical features in the TC were performed to determine independent factors associated with response to DOS.A nomogram was established based on independent factors to predict the response.The predictive performance of the nomogram was evaluated by Concordance index(C-index),calibration and receiver operating characteristics curve in the TC and VC.RESULTS Univariate analysis showed that Siewert type(52/55 vs 29/39,P=0.005),pretherapeutic cT stage(57/62 vs 24/32,P=0.028),GTV(47.3±27.4 vs 73.2±54.3,P=0.040)were significantly associated with response to DOS in the TC.Multivariate analysis of the TC also showed that the pretherapeutic cT stage,GTV and Siewert type were independent predictive factors related to response to DOS(odds ratio=4.631,1.027 and 7.639,respectively;all P<0.05).The nomogram developed with these independent factors showed an excellent performance to predict response to DOS in the TC and VC(C-index:0.838 and 0.824),with area under the receiver operating characteristic curve of 0.838 and 0.824,respectively.The calibration curves showed that the practical and predicted response to DOS effectively coincided.CONCLUSION A novel nomogram developed with pretherapeutic cT stage,GTV and Siewert type predicted the response of Siewert type II/III AEG to NAC with DOS.

Radiofrequency ablation combined with transcatheter arterial chemoembolization for recurrent liver cancer

BACKGROUND The recurrence rate of liver cancer after surgery is high.Radiofrequency ablation(RFA)combined with transcatheter arterial chemoembolization(TACE)is an effective treatment for liver cancer;however,its efficacy in recurrent liver cancer remains unclear.AIM To investigate the clinical effect of TACE combined with RFA in the treatment of recurrent liver cancer.METHODS Ninety patients with recurrent liver cancer were divided into 2 groups according to treatment plan:Control(RFA alone);and experimental[TACE combined with RFA(TACE+RFA)].The incidence of increased alanine aminotransferase levels,complications,and other indices were compared between the two groups before and after the procedures.RESULTS One month after the procedures,the short-term efficacy rate and Karnofsky Performance Status scores of the experimental group were significantly higher than those of the control group(P<0.05).Alpha-fetoprotein(AFP)and total bilirubin levels were lower than those in the control group(P<0.05);The overall response rate was 82.22%and 66.67%in the experimental and control groups,respectively;The disease control rate was 93.33%and 82.22%in the experimental and control groups,respectively,the differences are statistically significant(P<0.05).And there were no statistical differences in complications between the two groups(P>0.05).CONCLUSION TACE+RFA was effective for the treatment of recurrent liver cancer and significantly reduced AFP levels and improved various indices of liver function.

Ultrafast dynamics of femtosecond laser-induced high spatial frequency periodic structures on silicon surfaces

Femtosecond laser-induced periodic surface structures(LIPSS)have been extensively studied over the past few decades.In particular,the period and groove width of high-spatial-frequency LIPSS(HSFL)is much smaller than the diffraction limit,making it a useful method for efficient nanomanufacturing.However,compared with the low-spatial-frequency LIPSS(LSFL),the structure size of the HSFL is smaller,and it is more easily submerged.Therefore,the formation mechanism of HSFL is complex and has always been a research hotspot in this field.In this study,regular LSFL with a period of 760 nm was fabricated in advance on a silicon surface with two-beam interference using an 800 nm,50 fs femtosecond laser.The ultrafast dynamics of HSFL formation on the silicon surface of prefabricated LSFL under single femtosecond laser pulse irradiation were observed and analyzed for the first time using collinear pump-probe imaging method.In general,the evolution of the surface structure undergoes five sequential stages:the LSFL begins to split,becomes uniform HSFL,degenerates into an irregular LSFL,undergoes secondary splitting into a weakly uniform HSFL,and evolves into an irregular LSFL or is submerged.The results indicate that the local enhancement of the submerged nanocavity,or the nanoplasma,in the prefabricated LSFL ridge led to the splitting of the LSFL,and the thermodynamic effect drove the homogenization of the splitting LSFL,which evolved into HSFL.

Envita’s Precision Cancer Care: 35-Fold Improvement in Response Rates

New clinical approaches are imperative beyond the widely adopted National Comprehensive Cancer Network (NCCN) guidelines, utilized by prominent cancer institutions. Cancer is the leading cause of death among individuals younger than 85 years within the United States. Despite significant technological advances, including the expenditure of hundreds of billions, treatment outcomes and overall survival have not notably improved for most types of advanced cancer over the last several decades. Over the past 24 years, Envita Medical Centers has pioneered a unique form of personalized treatment approach for late-stage and refractory cancer patients, introducing groundbreaking innovations in the field. Our integrated algorithm utilizes advanced genomics, transcriptomics, and highly tailored immunotherapy, resulting in remarkable outcome improvements. This study presents Envita’s innovative personalized treatment algorithms and examines the response outcomes of 199 late-stage cancer patients treated at Envita Medical Centers over a two-year period. Compared to standard of care and palliative chemotherapy, Envita’s treatment demonstrated a remarkable 35-fold improvement in overall response rates (Figure 1). Moreover, 88% of the patients, the majority presenting with Stage 3 or 4 cancer, experienced a 43-fold improvement in quality of life with minimal side effects, as compared to standard of care chemotherapy and palliative care. This revolutionary success is attributed to Envita’s personalized therapeutic algorithms, which incorporate customized immunotherapy. Envita’s precision care approach has also achieved a 100% better response rate compared to over 65 global chemotherapy clinical trials with more than 2700 patients. The results from this study suggest that a wider utilization of Envita’s personalized approach can significantly benefit patients with late-stage and refractory cancer.