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Although the future is mentioned frequently in overarching aims and visions, and it is a major drive in the daily work of archaeological heritage managers and indeed heritage professionals more generally, it remains unclear precisely how an overall commitment to the future can best inform specific heritage practices. It seems that most archaeologists and other heritage professionals cannot easily express how they conceive of the future they work for, and how their work will impact on that future. The future tends to remain implicit in daily practice which operates in a continuing, rolling present. The authors argue that this needs to change because present-day heritage management may be much less beneficial for the future than we commonly expect.

With increasing rates of survival throughout the past several years, stroke remains one of the leading causes of adult disability. Following the onset of stroke, spontaneous mechanisms of recovery at the cellular, molecular, and systems levels ensue. The degree of spontaneous recovery is generally incomplete and variable among individuals. Typically, the best recovery outcomes entail the restitution of function in injured but surviving neural matter. An assortment of restorative therapies exists or is under development with the goal of potentiating restitution of function in damaged areas or in nearby ipsilesional regions by fostering neuroplastic changes, which often rely on mechanisms similar to those observed during spontaneous recovery. Advancements in stroke rehabilitation depend on the elucidation of both spontaneous and therapeutic-driven mechanisms of recovery. Further, the implementation of neural biomarkers in research and clinical settings will enable a multimodal approach to probing brain state and predicting the extent of post-stroke functional recovery. This review will discuss spontaneous and therapeutic-induced mechanisms driving post-stroke functional recovery while underscoring several potential restorative therapies and biomarkers.

The United States has a trust responsibility to provide services to American Indians and Alaska Native (AI/AN) persons. However, a long-standing history of underfunding of the Indian Health Service (IHS) has led to significant challenges in providing services. Twentieth century laws, including the Snyder Act, Transfer Act, Indian Self-Determination and Education Assistance Act, and Indian Health Care Improvement Act (IHCIA) have had an effect on the way health services are provided. IHCIA was reauthorized as part of the Patient Protection and Affordable Care Act (ACA). Several provisions in ACA allow for potential improvements in access to services for AI/AN populations and are described herein. Although policy developments have been promising, IHS underfunding must be resolved to ensure improved AI/AN health.

Past: In the early twentieth century, forestry was one of the most important sectors in Norway and an agitated discussion about the perceived decline of forest resources due to over-exploitation was ongoing. To base the discussion on facts, the young state of Norway established Landsskogtakseringen – the world’s first National Forest Inventory (NFI). Field work started in 1919 and was carried out by county. Trees were recorded on 10 m wide strips with 1–5 km interspaces. Site quality and land cover categories were recorded along each strip. Results for the first county were published in 1920, and by 1930 most forests below the coniferous tree line were inventoried. The 2nd to 5th inventories followed in the years 1937–1986. As of 1954, temporary sample plot clusters on a 3 km × 3 km grid were used as sampling units. Present: The current NFI grid was implemented in the 6th NFI from 1986 to 1993, when permanent plots on a 3 km × 3 km grid were established below the coniferous tree line. As of the 7th inventory in 1994, the NFI is continuous, and 1/5 of the plots are measured annually. All trees with a diameter ≥ 5 cm are recorded on circular, 250 m2 plots. The NFI grid was expanded in 2005 to cover alpine regions with 3 km × 9 km and 9 km × 9 km grids. In 2012, the NFI grid within forest reserves was doubled along the cardinal directions. Clustered temporary plots are used periodically to facilitate county-level estimates. As of today, more than 120 variables are recorded in the NFI including bilberry cover, drainage status, deadwood, and forest health. Landuse changes are monitored and trees outside forests are recorded. Future: Considerable research efforts towards the integration of remote sensing technologies enable the publication of the Norwegian Forest Resource Map since 2015, which is also used for small area estimation at the municipality level. On the analysis side, capacity and software for long term growth and yield prognosis are being developed. Furthermore, we foresee the inclusion of further variables for monitoring ecosystem services, and an increasing demand for mapped information. The relatively simple NFI design has proven to be a robust choice for satisfying steadily increasing information needs and concurrently providing consistent time series.

Background: Depression affects approximately 5.7% of adults worldwide, and around one-third of these individuals develop treatment-resistant depression (TRD). Intravenous (IV) ketamine and esketamine (administered IV or intranasally (IN)) are novel treatment options for TRD; however, only IN esketamine currently holds FDA approval. Objectives: Compare the acute effectiveness of IV ketamine with esketamine (IV or IN) in adults with TRD. Design: Mantel–Haenszel random-effects meta-analysis of head-to-head studies. Response and remission at study end point were co-primary outcomes, expressed as odds ratios (ORs) with 95% confidence intervals (CIs). Subgroup and sensitivity analyses explored the impact of diagnosis, study type, and publication format; heterogeneity was quantified with I2. Data sources and methods: MEDLINE, Embase, Cochrane, APA Psycinfo, and Scopus were searched from inception through 19 March 2025. Eligible studies enrolled adults with unipolar or bipolar depression directly comparing IV ketamine with esketamine and reporting response or remission. Results: Screening 1089 records identified eight studies (n = 978). Seven observational studies (n = 915) comparing IV ketamine with IN esketamine were included in the meta-analysis, while one randomized controlled trial (RCT) comparing IV formulations was summarized qualitatively. Pooled response from six studies gave OR = 1.26 (95% CI, 0.92–1.71; p = 0.15) and remission from seven studies gave OR = 1.31 (95% CI, 0.93–1.86; p = 0.12), both nonsignificantly favoring IV ketamine with negligible heterogeneity (I2 = 0%). Sensitivity analyses excluding bipolar depression or abstract-only reports yielded similar effect estimates, reinforcing the robustness of the findings. Evidence across three studies for faster onset with IV ketamine ranged from significant in one study to modest trends in two. Conclusion: Based on the currently available comparative evidence, which is almost entirely observational, IV ketamine and IN esketamine show comparable acute response and remission rates, though IV ketamine may act faster. Large head-to-head RCTs are needed to confirm these findings. Trial registration: The study protocol was prospectively registered on the Open Science Framework (OSF) at https://osf.io/5jzev. Plain language summary Intravenous ketamine versus esketamine for adults with treatment-resistant depression Why this review matters About one in three people with depression still feel unwell after trying at least two antidepressants, a condition called treatment-resistant depression (TRD). Two recent treatment options include intravenous (IV) ketamine and esketamine, but it remains unclear which is more effective. What we set out to do We searched five large medical databases up to March 2025 and found eight studies comparing IV ketamine with esketamine for TRD. Seven studies, covering 915 participants, tested IV ketamine against intranasal (IN) esketamine; one smaller trial (n=63) compared both drugs by IV drip. Key findings When the seven similar studies were analyzed, IV ketamine and IN esketamine both helped people feel better at about the same rate, and neither proved clearly superior; the odds of improvement slightly favored IV ketamine, but the difference was not statistically significant. Three studies reported that mood lifted sooner with IV ketamine, sometimes after only two or three infusions, whereas the IN esketamine spray usually required more sessions. Both treatments caused short-lived side effects such as temporary rises in blood pressure or feelings of disconnection, and these effects were generally mild to moderate and rarely led to stopping treatment. Because most included studies were not randomized, the certainty of these comparisons is limited. What this means for patients and clinicians During the first four to eight sessions, IV ketamine and IN esketamine appear equally likely to ease depression symptoms. IV infusions may work faster, but the IN spray avoids needles and is FDA approved for TRD. The choice should consider how quickly relief is needed, comfort with IV access, clinic resources, and insurance coverage. Larger, randomized, high-quality studies that track patients for long-term are required to confirm these findings and to show how long the benefits last.

Stroke, resulting from limited blood flow to the brain, is one of the most important causes of morbidity and mortality worldwide. Stroke is classified as ischemic, due to lack of blood flow, or hemorrhagic, due to bleeding. Because 87 % of strokes are classified as ischemic, this type will be the predominant focus of this review. Except for thrombolytic therapy, there is no established treatment to reduce the neurological deficits caused by ischemic stroke. Therefore, it is necessary to develop new therapeutic strategies designed to improve neurological functions after ischemic stroke. Recently, therapies to enhance neurogenesis after ischemic stroke have been investigated. However, these approaches have not led to successful clinical outcomes. This review addresses the pathophysiology of stroke, neurogenesis after stroke, and how to stimulate these processes based on the current literature. Finally, ongoing clinical trials to improve neurological functions after stroke by enhancing neurogenesis are discussed in this review.

This study’s primary objective is to investigate the Jeffery–Hamel model and entropy generation on the Magnetohydrodynamic (MHD) flow of second-grade hybrid nanofluid across stretchable converging and diverging channels. Silver (Ag) and ferroferric oxide (Fe 3 O 4 ) are nanoparticles, using blood as the base fluid. The controlling nonlinear coupled Partial Differential Equations (PDEs) are transformed into Ordinary Differential Equations (ODEs) with similarity transformations and then solved using the Homotopy Perturbation Method (HPM) and shooting technique (Runge–Kutta fourth order) in the MAPLE software. The Homotopy Perturbation Method (HPM) is compared to the Numerical Method (NM), and the results are more accurate and reliable. The effects of velocity, temperature, entropy production, and the Bejan number on physical parameters like a magnetic field, Reynolds number, magnetic field, porosity, and the Brinkman number are discussed through graphs and tables. The heat transfer and skin friction coefficients are also studied and portrayed as graphs. The velocity profile increases for second-grade hybrid nanofluid across stretchable converging and diverging channels as the magnetic field parameter increase. The velocity profile decreases as Deborah’s number increases for the converging channel. As Deborah’s number increases, the velocity profile increases for the diverging channels. The magnetic field and volume fraction increase as the skin friction and Nusselt number increase for second-grade hybrid nanofluid across stretchable converging and diverging channels. This theoretical model, which incorporates MHD with blood flow, is essential for biomedical applications, magnetic resonance imaging (MRI), particularly radiofrequency ablation (RFA), tumour treatment, and cancer therapy. Graphical abstract

This article aims to discuss the Graetz problem for the Casson fluid model under the influence of prescribed heat flux in a circular duct. For this purpose, we employed the separation of variables and the principle of superposition methods to obtain the solution to the problem. The resulting boundary value problem is numerically tackled with MATLAB function bvp4c. The impact of the Brinkman number is also taken into account. Results are presented graphically to show how the prescribed heat flux affects fully developed temperature, average temperature, wall temperature, and the local Nusselt number in the presence of the Casson parameter and viscous dissipation. The analysis reveals that the local Nusselt number is higher for the negative Brinkman number and lower for the positive Brinkman number as compared to the no dissipation function. Moreover, the Casson parameter enhances the local Nusselt number. The findings of this investigation may be beneficial in the improvement of several types of thermal apparatus.