On traceable iterated line graph and hamiltonian path index

Xiong and Liu[21]gave a characterization of the graphs G for which the n-iterated line graph L^(n)(G)is hamiltonian,for n≥2.In this paper,we study the existence of a hamiltonian path in L^(n)(G),and give a characterization of G for which L^(n)(G)has a hamiltonian path.As applications,we use this characterization to give several upper bounds on the hamiltonian path index of a graph.

Fluorinated semi-interpenetrating polymer networks for enhancing the mechanical performance and storage stability of polymer-bonded explosives by controlling curing and phase separation rates

Herein, the effect of fluoropolymer binders on the properties of polymer-bonded explosives(PBXs) was comprehensively investigated. To this end, fluorinated semi-interpenetrating polymer networks(semiIPNs) were prepared using different catalyst amounts(denoted as F23-CLF-30-D). The involved curing and phase separation processes were monitored using Fourier-transform infrared spectroscopy, differential scanning calorimetry, a haze meter and a rheometer. Curing rate constant and activation energy were calculated using a theoretical model and numerical method, respectively. Results revealed that owing to its co-continuous micro-phase separation structure, the F23-CLF-30-D3 semi-IPN exhibited considerably higher tensile strength and elongation at break than pure fluororubber F2314 and the F23-CLF-30-D0 semi-IPN because the phase separation and curing rates matched in the initial stage of curing.An arc Brazilian test revealed that F23-CLF-30-D-based composites used as mock materials for PBXs exhibited excellent mechanical performance and storage stability. Thus, the matched curing and phase separation rates play a crucial role during the fabrication of high-performance semi-IPNs;these factors can be feasibly controlled using an appropriate catalyst amount.

INTERFACE BEHAVIOR AND DECAY RATES OF COMPRESSIBLE NAVIER-STOKES SYSTEM WITH DENSITY-DEPENDENT VISCOSITY AND A VACUUM

In this paper,we study the one-dimensional motion of viscous gas near a vacuum,with the gas connecting to a vacuum state with a jump in density.The interface behavior,the pointwise decay rates of the density function and the expanding rates of the interface are obtained with the viscosity coefficientμ(ρ)=ρ^(α)for any 0<α<1;this includes the timeweighted boundedness from below and above.The smoothness of the solution is discussed.Moreover,we construct a class of self-similar classical solutions which exhibit some interesting properties,such as optimal estimates.The present paper extends the results in[Luo T,Xin Z P,Yang T.SIAM J Math Anal,2000,31(6):1175-1191]to the jump boundary conditions case with density-dependent viscosity.

Genetic and Agronomic Parameter Estimates of Growth, Yield and Related Traits of Maize (Zea mays L.) under Different Rates of Nitrogen Fertilization

This study evaluated the genetic and agronomic parameter estimates of maize under different nitrogen rates. The trial was established at the Njala Agricultural Research Centre experimental site during 2021 and 2022 in a split block design with three maize varieties (IWCD2, 2009EVDT, and DMR-ESR-Yellow) and seven nitrogen (0, 30, 60, 90, 120, 150 and 180 kg∙N∙ha−1) rates. Findings showed that cob diameter and anthesis silking time (ASI) had intermediate heritability, ASI had high genetic advance, ASI and grain yield had high genotypic coefficient of variation (GCV), while traits with high phenotypic coefficient of variation (PCV) were plant height, ASI, grain yield, number of kernel per cob, number of kernel rows, ear length, and ear height. The PCV values were higher than GCV, indicating the influence of the environment in the studied traits. Nitrogen rates and variety significantly (p < 0.05) influenced grain yield production. Mean grain yields and economic parameter estimates increased with increasing nitrogen rates, with the 30 and 180 kg∙N∙ha−1 plots exhibiting the lowest and highest grain yields of 1238 kg∙ha−1 and 2098 kg∙ha−1, respectively. Variety and nitrogen effects on partial factor productivity (PFPN), agronomic efficiency (AEN), net returns (NR), value cost ratio (VCR) and marginal return (MR) indicated that these parameters were significantly affected (p < 0.05) by these factors. The highest PFPN (41.3 kg grain kg−1∙N) and AEN (29.4 kg grain kg−1∙N) were obtained in the 30 kg∙N∙ha−1 plots, while the highest VCR (2.8) and MR (SLL 1.8 SLL−1 spent on N) were obtained in the 180 kg∙N∙ha−1. The significant influence of variety and nitrogen on traits suggests that increasing yields and maximizing profits require use of appropriate nitrogen fertilization and improved farming practices that could be exploited for increased productivity of maize.

Dynamic interactive bitwise meta-holography with ultra-high computational and display frame rates

Interactive holography offers unmatched levels of immersion and user engagement in the field of future display.Despite of the substantial progress has been made in dynamic meta-holography,the realization of real-time,highly smooth interactive holography remains a significant challenge due to the computational and display frame rate limitations.In this study,we introduced a dynamic interactive bitwise meta-holography with ultra-high computational and display frame rates.To our knowledge,this is the first reported practical dynamic interactive metasurface holographic system.We spa-tially divided the metasurface device into multiple distinct channels,each projecting a reconstructed sub-pattern.The switching states of these channels were mapped to bitwise operations on a set of bit values,which avoids complex holo-gram computations,enabling an ultra-high computational frame rate.Our approach achieves a computational frame rate of 800 kHz and a display frame rate of 23 kHz on a low-power Raspberry Pi computational platform.According to this methodology,we demonstrated an interactive dynamic holographic Tetris game system that allows interactive gameplay,color display,and on-the-fly hologram creation.Our technology presents an inspiration for advanced dynamic meta-holography,which is promising for a broad range of applications including advanced human-computer interaction,real-time 3D visualization,and next-generation virtual and augmented reality systems.

Spalling characteristics of high-temperature treated granitic rock at different strain rates

The dynamic spalling characteristics of rock are important for stability analysis in rock engineering.This paper presented an experimental investigation on the dynamic spalling characteristics of granite with different temperatures and strain rates.A series of dynamic spalling tests with different impact velocities were conducted on thermally treated granite at different temperatures.The dynamic spalling strengths of granite with different temperatures and strain rates were determined.A model was proposed to correlate the dynamic spalling strength of granite,high temperature and strain rate.The results show that the spalling strength of granite decreases with increasing temperature.Moreover,the spalling strength of granite with a higher strain rate is larger than that with a lower strain rate.The proposed model can describe the relationship among dynamic spalling strength of granite,high temperature and strain rate.

Comparison of microwave- and thermal-assisted rock fragmentation methods at different temperatures and loading rates

Understanding the effects of microwave irradiation and thermal treatment on the dynamic compression and fragmentation properties of rocks is essential to quantify energy consumption in rock engineering.In this study,Fangshan granite(FG)specimens were exposed to microwave irradiation and heat treatment.The damage of FG specimens induced by these two methods was compared using X-ray CT scanning and ultrasonic wave method.The temperatures of FG after microwave irradiation and thermal treatment were effectively evaluated using a newly proposed technique.A novelty method for precisely determining the geometric features of fragments is developed to estimate the fragmentation energy.Thus,the dynamic uniaxial compressive strength(UCS),the dynamic fragmentation characteristics,and the fragmentation energy of FG after these two pretreatment methods can be reasonably compared.The noticeable distinction of loading rate effect on the dynamic UCS of FG between these two pretreatment methods is first observed.A relationship is established between the dynamic UCS and the damage induced by microwave irradiation and heat treatment.Moreover,fragmentation energy fan analysis is introduced to accurately compare the fragmentation properties of FG after two pretreatment methods in dynamic compression tests.

Success of susceptibility-guided eradication of Helicobacter pylori in a region with high secondary clarithromycin and levofloxacin resistance rates

BACKGROUND Resistance to clarithromycin(CLA)and levofloxacin(LFX)of Helicobacter pylori(H.pylori)is increasing in severity,and successful eradication is essential.Presently,the eradication success rate has greatly declined,leaving a large number of patients with previous treatment histories.AIM To investigate secondary resistance rates,explore risk factors for antibiotic resistance,and assess the efficacy of susceptibility-guided therapy.METHODS We recruited 154 subjects positive for Urea Breath Test who attended The First Affiliated Hospital of China Medical University between July 2022 and April 2023.Participants underwent a string test after an overnight fast.The gastric juice was obtained and transferred to vials containing storage solution.Subsequently,DNA extraction and the specific DNA amplification were performed using quantitative polymerase chain reaction(qPCR).Demographic information was also analyzed as part of the study.Based on these results,the participants were administered susceptibility-guided treatment.Efficacy was compared with that of the empiric treatment group.RESULTS A total of 132 individuals tested positive for the H.pylori ureA gene by qPCR technique.CLA resistance rate reached a high level of 82.6%(n=109),LFX resistance rate was 69.7%(n=92)and dual resistance was 62.1%(n=82).Gastric symptoms[odds ratio(OR)=2.782;95%confidence interval(95%CI):1.076-7.194;P=0.035]and rural residence(OR=5.152;95%CI:1.407-18.861;P=0.013)were independent risk factors for secondary resistance to CLA and LFX,respectively.A total of 102 and 100 individuals received susceptibility-guided therapies and empiric treatment,respectively.The antibiotic susceptibility-guided treatment and empiric treatment groups achieved successful eradication rates of 75.5%(77/102)and 59.0%(59/411)by the intention-to-treat(ITT)analysis and 90.6%(77/85)and 70.2%(59/84)by the per-protocol(PP)analysis,respectively.The eradication rates of these two treatment strategies were significantly different in both ITT(P=0.001)and PP(P=0.012)analyses.CONCLUSION H.pylori presented high secondary resistance rates to CLA and LFX.For patients with previous treatment failures,treatments should be guided by antibiotic susceptibility tests or regional antibiotic resistance profile.

Gas Exchange Rates of Texas Persimmon (Diospyros texana) in Central Texas Woodlands

Diospyros texana (Texas persimmon) is a secondary species in most Juniperus ashei/Quercus fusiformis woodlands in central Texas. It has high density, but plants are mostly in the community understory. Light response curves at ambient and elevated levels of CO2 and temperature were measured for D. texana. The Anet (photosynthetic rate) increased significantly as both light level and CO2 levels increased but not temperature. The Amax (maximum photosynthetic rate) of D. texana in full sun at elevated levels of CO2 was increased for all treatments. Stomatal conductance increased with levels of CO2 but only if the interaction was removed from the model. Intercellular levels of CO2 increased with both temperature and CO2 treatments as did water use efficiency (WUE). Furthermore, light saturation (Lsat) increased with CO2 treatments and light compensation (Lcp) increased with temperature. The dark respiration (Rd) increased with both temperature and CO2 treatments. Markov population models suggested D. texana populations would remain ecologically similar in the future. However, sub-canopy light levels and herbivory should be considered when examining population projections. For example, Juniperus ashei juveniles are not recruited into any canopy unless there are high light levels. Herbivory reduces the success of Quercus juveniles from reaching the canopy. These factors do not seem to be a problem for D. texana juveniles which would allow them to reach the canopy without need of a high light gap and are not prevented by herbivory. Thus, Juniperus/Quercus woodlands will change in the future to woodlands with D. texana a more common species.

Rates, predictors, and causes of readmission after transcatheter aortic valve replacement in patients with chronic kidney disease

BACKGROUND Transcatheter aortic valve replacement(TAVR)is a revolutionary procedure for severe aortic stenosis.The coexistence of chronic kidney disease(CKD)and TAVR introduces a challenge that significantly impacts patient outcomes.AIM To define readmission rates,predictors,and causes after TAVR procedure in CKD stage 1-4 patients.METHODS We used the national readmission database 2018 and 2020 to look into readmission rates,causes and predictors after TAVR procedure in patients with CKD stage 1-4.RESULTS Out of 24758 who underwent TAVR and had CKD,7892(32.4%)patients were readmitted within 90 days,and had higher adjusted odds of being females(adjusted odds ratio:1.17,95%CI:1.02-1.31,P=0.02)with longer length of hospital stay>6 days,and more comorbidities including but not limited to diabetes mellitus,anemia,and congestive heart failure(CHF).CONCLUSION Most common causes of readmission included CHF(18.0%),sepsis,and complete atrioventricular block.Controlling readmission predictors with very close followup is warranted to prevent such high rate of readmission.

Comparison of the precision of glacier flow rates derived from offset-tracking using Sentinel-2 and Landsat-8/9 imagery

Offset-tracking is an essential method for deriving glacier flow rates using optical imagery.Sentinel-2(S2)and Landsat-8/9(L8/9)are popular optical satellites or constellations for polar studies,offering high spatial resolution with relatively short revisit time,wide swath width,and free accessibility.To evaluate and compare the precision of offset-tracking results yielded with these two kinds of data,in this study S2 and L8/9 imagery observed in Petermann Glacier in Greenland,Karakoram in High-Mountains Asia,and Amery Ice Shelf in the Antarctic are analyzed.Outliers and various systematic error sources in the offset-tracking results including orbital and strip errors were analyzed and eliminated at the pre-process stage.Precision at the off-glacier(bare rock)region was evaluated by presuming that no deformation occurred;then for both glacierized and the off-glacier regions,precision of velocity time series was evaluated based on error propagation theory.The least squares method based on connected components was used to solve flow rates time series based on multi-pair images offset-tracking.The results indicated that S2 achieved slightly higher precision than L8/9 in terms of both single-pair derived displacements and least square solved daily flow rates time series.Generally,the RMSE of daily velocity is 26%lower for S2 than L8/9.Moreover,S2 provided higher temporal resolution for monitoring glacier flow rates.

High-rate metal-free MXene microsupercapacitors on paper substrates

MXene is a promising energy storage material for miniaturized microbatteries and microsupercapacitors(MSCs).Despite its superior electrochemical performance,only a few studies have reported MXene-based ultrahigh-rate(>1000 mV s^(−1))on-paper MSCs,mainly due to the reduced electrical conductance of MXene films deposited on paper.Herein,ultrahigh-rate metal-free on-paper MSCs based on heterogeneous MXene/poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate)(PEDOT:PSS)-stack electrodes are fabricated through the combination of direct ink writing and femtosecond laser scribing.With a footprint area of only 20 mm^(2),the on-paper MSCs exhibit excellent high-rate capacitive behavior with an areal capacitance of 5.7 mF cm^(−2)and long cycle life(>95%capacitance retention after 10,000 cycles)at a high scan rate of 1000 mV s^(−1),outperforming most of the present on-paper MSCs.Furthermore,the heterogeneous MXene/PEDOT:PSS electrodes can interconnect individual MSCs into metal-free on-paper MSC arrays,which can also be simultaneously charged/discharged at 1000 mV s^(−1),showing scalable capacitive performance.The heterogeneous MXene/PEDOT:PSS stacks are a promising electrode structure for on-paper MSCs to serve as ultrafast miniaturized energy storage components for emerging paper electronics.

Macroinvertebrate Community Index (MCI) and Quantitative Macroinvertebrate Community Index (QMCI) Analysis: A Comparative Study between Le Afe and Mulivaifagatoloa Rivers, Upolu Island, Samoa

The diversity of Samoa’s freshwater macroinvertebrates remains largely unexplored, with past studies focusing on specific species without comprehensive cataloguing. This research evaluated the health of Upolu Island’s rural rivers through macroinvertebrate analysis, particularly in the Le Afe and Mulivaifagatoloa Rivers. Collaborating with Samoa’s Water Resources Division in the Ministry of Natural Resources and Environment (MNRE), three sites along each river were sampled, representing a gradient from pristine to anthropogenically impacted areas. A total of 2953 macroinvertebrates were collected and classified into five categories using established identification keys. The Macroinvertebrate Community Index (MCI) and Quantitative Macroinvertebrate Community Index (QMCI) were applied for analysis. The results showed no clear pattern of pollutant-sensitive species prevalence or decline in less disturbed rivers. High MCI scores with low QMCI values indicated numerous low-scoring species, while the opposite suggested a richness of high-scoring taxa. Although MCI and QMCI are tools for monitoring freshwater health, this study lays the groundwork for future research to categorize Samoan macroinvertebrates and assign tolerance scores based on their presence in varying river conditions. .

The effects of deformation parameters and cooling rates on the aging behavior of AZ80+0.4%Ce

The extruded AZ80+0.4%Ce magnesium alloy was twisted in the temperature range of 300-380℃by using a Gleeble 3500 thermal simulation test machine with a torsion unit.The deformed cylindrical specimens were cooled at a cooling rate of 10℃/s or 0.1℃/s,respectively,and aged at 170℃.The microstructure analysis results showed that the grain size decreased with increasing specimen radial position from center(SRPC),and that the strong initial basal texture of the extruded magnesium alloy was weakened.Both continuous and discontinuous dynamic recrystallization mechanisms were involved in contributing to the grain refinement for all specimens investigated.And a novel extension twinning induced dynamic recrystallization mechanism was proposed for specimen deformed at 300℃.For the specimens deformed at 300℃and 340℃followed by a slow cooling rate(0.1℃/s),precipitates of various shapes(β-Mg_(17)Al_(12)),with the dominant precipitates being on the grains boundaries,appeared on the surface section.For specimen deformed at 380℃,lamellar precipitates(LPS)in the interiors of the grains were predominant.After aging,the LPS still dominated for specimens twisted at 380℃;however,the LPS gradually decreased with decreasing deformation temperatures from 380℃to 300℃.Dynamically precipitatedβ,especially those decorating the grain boundaries,changed the competition pictures for the LPS and precipitates of other shapes after aging.Interestingly,LPS dominated the areas for the center section of the specimens after aging regardless of deformation temperatures.Low temperature deformation with high SRPC followed by rapid cooling rate increased the micro hardness of the alloy after aging due to refined grain,reduced precipitates size,decreased lamellar spacing as well as strain hardening.

Enhancing Autonomy Capability in Regional Power Grids:A Strategic Planning Approach with Multiple Autonomous Evaluation Indexes

After the integration of large-scale DistributedGeneration(DG)into the distribution network,the randomness and volatility of its output result in a reduction of spatiotemporal alignment between power generation and demand in the distribution network,exacerbating the phenomenon of wind and solar power wastage.As a novel power system model,the fundamental concept of Regional Autonomous Power Grids(RAPGs)is to achieve localized management and energy autonomy,thereby facilitating the effective consumption of DGs.Therefore,this paper proposes a distributed resource planning strategy that enhances the autonomy capabilities of regional power grids by considering multiple evaluation indexes for autonomy.First,a regional Energy Storage(ES)configuration strategy is proposed.This strategy can select a suitable reference value for the upper limit of ES configuration based on the regional load andDGoutput to maximize the elimination of source load deviations in the region as the upper limit constraint of ES capacity.Then,a control strategy for regional ES is proposed,the charging and discharging reference line of ES is set,and multiple autonomy and economic indexes are used as objective functions to select different proportions of ES to control the distributed resources of the regional power grid and establish evaluation indexes of the internal regional generation and load power ratio,the proportion of power supply matching hours,new energy consumption rate and tie line power imbalance outside the region to evaluate changes in the regional autonomy capabilities.The final simulation results showthat in the real regional grid example,the planning method in the planning year in the region of the overall power supply matching hour ratio and new energy consumption rate increased by 3.9%and 4.8%on average,and the power imbalance of the tie line decreased by 7.8%on average.The proposed planning approach enables the maximization of regional autonomy while effectively smoothing the fluctuation of power exchange between the regional grid and the higher-level grid.This presents a rational and effective planning solution for the regional grid,facilitating the coordinated development between the region and the distribution network.

The variation in basal channels and basal melt rates of Pine Island Ice Shelf

In recent years,there has been a significant acceleration in the thinning,calving and retreat of the Pine Island Ice Shelf(PIIS).The basal channels,results of enhanced basal melting,have the potential to significantly impact the stability of the PIIS.In this study,we used a variety of remote sensing data,including Landsat,REMA DEM,ICESat-1 and ICESat-2 satellite altimetry observations,and Ice Bridge airborne measurements,to study the spatiotemporal changes in the basal channels from 2003 to 2020 and basal melt rate from 2010 to 2017 of the PIIS under the Eulerian framework.We found that the basal channels are highly developed in the PIIS,with a total length exceeding 450 km.Most of the basal channels are ocean-sourced or groundingline-sourced basal channels,caused by the rapid melting under the ice shelf or near the groundingline.A raised seabed prevented warm water intrusion into the eastern branch of the PIIS,resulting in a lower basal melt rate in that area.In contrast,a deepsea trough facilitates warm seawater into the mainstream and the western branch of the PIIS,resulting in a higher basal melt rate in the main-stream,and the surface elevation changes above the basal channels of the mainstream and western branch are more significant.The El Ni?o event in 2015–2016 possibly slowed down the basal melting of the PIIS by modulating wind field,surface sea temperature and depth seawater temperature.Ocean and atmospheric changes were driven by El Ni?o,which can further explain and confirm the changes in the basal melting of the PIIS.

Erosion Rates in Dam Catchments in Jordan—Effects of Topography, Geology, and Urbanizations

Erosion as a natural process produces soils, which are very important natural resources for the fest land plant- and animal kingdoms. Loss of the soil cover reduces agricultural production, biodiversity, and the role of soil as a filter for infiltrating water to replenish the groundwater. It also threatens the food supplies. The knowledge of erosion rates of rocks and terrains is important for developing proactive measures to protect soils from erosion and loss. In this study, erosion rates of catchment areas were calculated based on dams’ catchment extensions and the sediment loads transported by flood flows into dams’ lakes. The study results show that the chemically, via floodwater, transported quantities of materials are negligible compared to the solid materials transported by the water. It calculates erosion rates ranging from 0.013 to 0.212 mm/yr (13 - 212 m/106 yr) for the different catchment areas. Erosion rates in Jordan are, generally, higher than those calculated for the different parts of the world ranging from 2.5 to 60 m/106 yr. This fact can be explained by the very steep topography, calcareous rock cover of the catchment areas and the barren rock exposures.

Comparative analysis of breast and lung cancer survival rates and clinical trial enrollments among rural and urban patients in Georgia

Objectives:Rural patients have poor cancer outcomes and clinical trial(CT)enrollment compared to urban patients due to attitudinal,awareness,and healthcare access differential.Knowledge of cancer survival disparities and CT enrollment is important for designing interventions and innovative approaches to address the stated barriers.The study explores the potential disparities in cancer survival rates and clinical trial enrollments in rural and urban breast and lung cancer patients.Our hypotheses are that for both cancer types,urban cancer patients will have longer 5-year survival rates and higher enrollment rates in clinical trials than those in rural counties.Methods:We compared breast and lung cancer patients’survival rates and enrollment ratios in clinical trials between rural(RUCC 4-9)and urban counties in Georgia at a Comprehensive Cancer Center(CCC).To assess these differences,we carried out a series of independent samples t-tests and Chi-Square tests.Results:The outcomes indicate comparable 5-year survival rates across rural and urban counties for breast and lung cancer patients,failing to substantiate our hypothesis.While clinical trial enrollment rates demonstrated a significant difference between breast and lung cancer patients at CCC,no significant variation was observed based on rural or urban classification.Conclusion:These findings underscore the need for further research into the representation of rural patients with diverse cancer types at CCC and other cancer centers.Further,the findings have considerable implications for the initiation of positive social change to improve CT participation and reduce cancer survival disparities.

Assessment of Water Quality in High-Pressure Peruvian Anthropic Sectors of Lake Titicaca Using a Calibrated Index

The world’s lakes are in the process of degradation, with loss of water quality as a result of anthropic influences. This research aimed to evaluate water quality in high-pressure Peruvian anthropic sectors of Lake Titicaca using a calibrated index. The study considered ten important bays with influence from urban sectors. In each bay, surface waters were monitored for six years, considering physical, chemical and microbiological parameters. Water quality was assessed using the NSF Water Quality Index (NSF-WQI) and the one calibrated for Lake Titicaca (WQIT). Comparing the efficiency of these two indices, the WQIT showed a variation from moderately polluted bays to bad quality bays, such as Desaguadero and Yunguyo. These two bays were classified as hypereutrophic, therefore, the uses attributable to this condition are only irrigation and energy production. Applying the NSF-WQI, the results were not able to identify this significative difference, as all bays were classified as moderate quality waters. This result indicates that the WQIT calibration was adequate, as it allows inferring and estimating the water quality of Lake Titicaca with greater precision. According to Peru’s water quality standard for category 4, established for the conservation of the country’s lakes, the parameters that exceeded the standard values were PO4-P (0.035 mg∙L−1) and BOD5 (5 mg∙L−1) in all bays, and TC (1000 MPN mL−1) in Yunguyo bay. These high values indicate eutrophication processes, one of the main problems in the study area. The WQIT calibrated for Lake Titicaca can be used as an efficient tool to assess water quality in high Andean lentic waterbodies in South America.

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.