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Background Neoadjuvant immune checkpoint inhibitors (ICIs) have improved survival outcomes compared with chemotherapy in resectable non-small cell lung cancer (NSCLC). However, the impact of actionable genomic alterations (AGAs) on the efficacy of neoadjuvant ICIs remains unclear. We report the influence of AGAs on treatment failure (TF) in patients with resectable NSCLC treated with neoadjuvant ICIs.Methods Tumor molecular profiles were obtained from patients with stage I–IIIA resectable NSCLC (American Joint Committee on Cancer seventh edition) treated with either neoadjuvant nivolumab (N, n=23) or nivolumab+ipilimumab (NI, n=21) followed by surgery in a previously reported phase-2 randomized study (NCT03158129). TF was defined as any progression of primary lung cancer after neoadjuvant ICI therapy in patients without surgery, radiographic and/or biopsy-proven primary lung cancer recurrence after surgery, or death from possibly treatment-related complications or from primary lung cancer since randomization. Tumors with AGAs (n=12) were compared with tumors without AGAs and non-profiled squamous cell carcinomas (non-AGAs+NP SCC, n=20).Results With a median follow-up of 60.2 months, the overall TF rate was 34.1% (15/44). Tumor molecular profiling was retrospectively obtained in 47.7% (21/44) of patients and select AGAs were identified in 12 patients: 5 epidermal growth factor receptor (EGFR), 2 KRAS, 1 ERBB2, and 1 BRAF mutations, 2 anaplastic lymphoma kinase (ALK) and 1 RET fusions. The median time to TF in patients with AGAs was 24.7 months (95% CI: 12.6 to 40.4), compared with not reached (95% CI: not evaluable (NE)–NE) in the non-AGAs+NP SCC group. The TF risk was higher in AGAs (HR: 5.51, 95% CI: 1.68 to 18.1), and lower in former/current smokers (HR: 0.24, 95% CI: 0.08 to 0.75). The odds of major pathological response were 4.71 (95% CI: 0.49 to 45.2) times higher in the non-AGAs+NP SCC group, and the median percentage of residual viable tumor was 72.5% in AGAs compared with 33.0% in non-AGS+NP SCC tumors.Conclusions Patients with NSCLC harboring select AGAs, including EGFR and ALK alterations, have a higher risk for TF, shorter median time to TF, and diminished pathological regression after neoadjuvant ICIs. The suboptimal efficacy of neoadjuvant chemotherapy-sparing, ICI-based regimens in this patient subset underscores the importance of tumor molecular testing prior to initiation of neoadjuvant ICI therapy in patients with resectable NSCLC.

Abstract While we recognize the prognostic importance of clinicopathological measures and circulating tumor DNA (ctDNA), the independent contribution of quantitative image markers to prognosis in non-small cell lung cancer (NSCLC) remains underexplored. In our multi-institutional study of 394 NSCLC patients, we utilize pre-treatment computed tomography (CT) and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) to establish a habitat imaging framework for assessing regional heterogeneity within individual tumors. This framework identifies three PET/CT subtypes, which maintain prognostic value after adjusting for clinicopathologic risk factors including tumor volume. Additionally, these subtypes complement ctDNA in predicting disease recurrence. Radiogenomics analysis unveil the molecular underpinnings of these imaging subtypes, highlighting downregulation in interferon alpha and gamma pathways in the high-risk subtype. In summary, our study demonstrates that these habitat imaging subtypes effectively stratify NSCLC patients based on their risk levels for disease recurrence after initial curative surgery or radiotherapy, providing valuable insights for personalized treatment approaches.

Toxic metals in water systems pose a global health risk. Thus, multifunctional water monitoring and treatment materials are indispensable. Nickel ions, a frequent heavy metal pollutant, affect ecosystem function. However, developing affordable, functional materials for efficient heavy metal removal remains problematic. This study investigates the utilization of Al2O3@g-C3N4 (AlCN) nanosorbent for adsorbing Ni (II) ions from aqueous solutions. The physicochemical analyses verify the creation of an AlCN nanosorbent with a mean size of 31.25 nm crystals and a specific surface area of 58 m2/g. Batch adsorption experiments were conducted to examine the impact of pH, initial Ni (II) concentration, and adsorbent dose on the efficiency of Ni (II) removal using the synthesized (AlCN) nanosorbent. Adding Al2O3 to g-C3N4 nanosheets increased the adsorption capacity to a maximum of 410 mg/g under ideal conditions, as demonstrated by the results. Ni (II) ions adsorption kinetics on AlCN nanosorbents follow the pseudo-second-order kinetic model with an R2 value of 0.99, surpassing the Elovich pseudo-first model. The adsorption isotherm results show that the Langmuir model fits the experimental data better than the Freundlich and Temkin models, indicating a monolayer adsorption process for the AlCN nanosorbent. In addition, the AlCN exhibited multi-elemental adsorption ability and good recyclability. These findings can nominate the fabricated composite as a candidate for water treatment.

Abstract In this work, a novel isatin-Schiff base L2 had been synthesized through a simple reaction between isatin and 2-amino-5-methylthio-1,3,4-thiadiazole. The produced Schiff base L2 was then subjected to a hydrothermal reaction with cerium chloride to produce the cerium (III)-Schiff base complex C2. Several spectroscopic methods, including mass spectra, FT-IR, elemental analysis, UV–vis, 13C-NMR, 1H-NMR, Thermogravimetric Analysis, HR-TEM, and FE-SEM/EDX, were used to completely characterize the produced L2 and C2. A computer simulation was performed using the MOE software program to find out the probable biological resistance of studied compounds against the proteins in some types of bacteria or fungi. To investigate the interaction between the ligand and its complex, we conducted molecular docking simulations using the molecular operating environment (MOE). The docking simulation findings revealed that the complex displayed greater efficacy and demonstrated a stronger affinity for Avr2 effector protein from the fungal plant pathogen Fusarium oxysporum (code 5OD4) than the original ligand. The antibacterial activity of the ligand and its Ce3+ complex were applied in vitro tests against different microorganism. The study showed that the complex was found to be more effective than the ligand.

Elimination of heavy metals from contaminated water systems is of prime distress due to their capacity to prompt toxic impact on the flora and fauna. The usage of innovative nano-engineered materials predominantly opens up smart prospects for the treatment of persistent heavy metal adulterated water resources. This study presents an ultrasonic-assisted sol-gel production of Ru@Co3O4@g-C3N4 nanostructure that was utilized to remove Cu+2 and Cd+2 ions from aqueous solutions. The X-ray diffraction investigation revealed the development of RuO2, Co2O3 and g-C3N4 phases, and the relevant elemental composition was verified by the photoelectron spectroscopy and EDX. The dispersion of the metal oxides within the nitride sheets was evidenced by scanning and transmission electron microscopy. The initial metal ions concentration, pH, and contact time effects were investigated through batch experiments. The adsorption isotherm models matched the Langmuir isotherm well, whereas the kinetics model data perfectly fitted the pseudo-second-order model. The maximum adsorption capacities of Cu+2 and Cd+2 ions on the nanocomposite Ru@Co3O4@g-C3N4 were 696.9 and 564.5 mg/g, respectively. A mechanism based on a viable covalent type of bonding developed by the delocalized -conjugated electrons of the triazine ring and functional groups were efficiently involved in the metal ions anchoring and ultimate elimination. Thus, the suitability of the Ru@Co3O4@g-C3N4 nanocomposite for eradicating heavy metals, including Cu+2 and Cd+2, was established.

Background: COVID-19 (Coronavirus Disease 2019) vaccinations are a critical control measure for the coronavirus pandemic that began in 2019. Several COVID-19 vaccines have been developed, and their effectiveness will almost certainly vary. Objective: This study aimed to assess how effective two doses of the Pfizer and Oxford-AstraZeneca vaccines were in preventing SARS‐CoV‐2 infection six months after administration. Methods: This is a retrospective cohort study of adult individuals from the Jazan Region of Saudi Arabia who received their second dose of the COVID-19 vaccine [Pfizer and Oxford-AstraZeneca (ASZ)] between April and June 2021. The monitoring and follow-up period continued until the end of January 2022. Data were retrieved from the Health Electronic Surveillance Network and National Vaccination Records. Logistic regression was performed to assess the risk of COVID-19 infection among the vaccinated subjects. Results: This study included randomly enrolled 4458 participants in Jazan who received two doses of the COVID-19 vaccine during the research period. The majority of them received the Pfizer vaccine (3136/4458; 70.3%), while the remaining received the ASZ vaccine (1322/4458; 29.7%). The study participants’ mean age was 59.7 years, with a male-to-female ratio of 1.9:1.0 (2920:1538). The results showed that the Pfizer and ASZ vaccines’ protection against infection decreased from 93.2% and 90.2%, respectively, during the first three months, to 68.5% and 68.1% after a six-month interval. In the current study population, being Saudi Arabian, younger as well as having longer intervals between vaccines or crossing a 6-month period after the second vaccine dose were factors linked to higher rates of breakthrough infections. Conclusion: Our findings revealed variations in the efficacy of different COVID-19 vaccine types against COVID-19 breakthrough infections. The Pfizer (mRNA-based) vaccine was found to be relatively more effective than the ASZ (DNA-based) vaccine.

Abstract Background Antiphospholipid syndrome (APS) is one of the most frequent forms of acquired thrombophilia and is associated with an increased risk of stroke, heart attack, pulmonary embolism, and miscarriage in young women. Thirty to 40% of systemic lupus erythematosus (SLE) patients have associated APS. Patients with SLE often have abnormal plasma lipid concentrations. The study aimed to assess the prevalence of thromboembolic insults in SLE patients, with or without APS, and its correlation with disease activity and dyslipidemia. This study included one hundred three patients, seventy-five of whom had SLE without associated APS and twenty-eight had SLE associated with APS. Results Vascular affection, neurological affection, and abortion were significantly higher in SLE patients associated with APS than SLE patients without APS (39.3% vs 6.7%, 46.4% vs 14.7%, 28.6% vs 5.3%, respectively; P < 0.001). Thromboembolic insults were present in 20% of SLE patients without APS, and those patients with thromboembolism demonstrated significantly higher SLEDAI (median = 15 vs 10, P < 0.001) and TG (median = 27.5 vs 18.2, P = 0.007), respectively, than other patients of the same group. The SLEDAI score was significantly higher in SLE patients associated with APS than in SLE patients without APS (P < 0.001). Serum cholesterol and low-density lipoprotein (LDL) were significantly higher in SLE patients associated with APS (93.8 ± 25.3 mg/dl) than in SLE patients without APS (82.3 ± 19.6 mg/dl, P = 0.018; 50 ± 15.9 mg/dl, P = 0.048, respectively). Conclusions SLE patients are at significantly high risk for accelerated atherosclerosis, thromboembolism, and pregnancy loss which is multifactorial. Active disease should be well controlled. Lupus patients should be screened for aPL antibodies, and positive cases must be treated according to international guidelines. All patients with SLE should undergo lipid profile screening, and any abnormalities should be managed promptly.

Immune checkpoint inhibitors with or without chemotherapy are now standard of care for non-small cell lung cancer. However, the benefits of combination vs sequential therapy have not been fully explored. Here, the authors analysed 1,133 patient records and show combination therapy showed increased protection against early progression, but similar overall survival.

Introduction: MET amplification is a known resistance mechanism to EGFR tyrosine kinase inhibitor (TKI) treatment in EGFR-mutant NSCLC. Dual EGFR-MET inhibition has been reported with success in overcoming such resistance and inducing clinical benefit. Resistance mechanisms to dual EGFR-MET inhibition require further investigation and characterization. Methods: Patients with NSCLC with both MET amplification and EGFR mutation who have received crizotinib, capmatinib, savolitinib, or tepotinib plus osimertinib (OSI) after progression on OSI at MD Anderson Cancer Center were included in this study. Molecular profiling was completed by means of fluorescence in situ hybridization (FISH) and next-generation sequencing (NGS). Radiological response was assessed on the basis of Response Evaluation Criteria in Solid Tumors version 1.1. Results: From March 2016 to March 2022, 23 treatments with dual MET inhibitor and osi were identified with a total of 20 patients included. Three patients received capmatinib plus OSI after progression on crizotinib plus OSI. Median age was 64 (38–89) years old and 75% were female. MET amplification was detected by FISH in 14 patients in the tissue, NGS in 10 patients, and circulating tumor DNA in three patients. Median MET gene copy number was 13.6 (6.4–20). Overall response rate was 34.8% (eight of 23). In assessable patients, tumor shrinkage was observed in 82.4% (14 of 17). Median time on treatment was 27 months. Two of three patients responded to capmatinib plus OSI after progression on crizotinib plus OSI. Dual EGFR-MET inhibition was overall well tolerated. Two patients on crizotinib plus OSI and one pt on capmatinib plus OSI discontinued therapy due to pneumonitis. One pt discontinued crizotinib plus OSI due to gastrointestinal toxicity. Six patients were still on double TKI treatment. At disease progression to dual EGFR-MET inhibition, FISH and NGS on tumor and plasma were completed in six patients. Notable resistance mechanisms observed include acquired MET D1246H (n = 1), acquired EGFR C797S (n = 2), FGFR2 fusion (n = 1, concurrent with C797S), and EGFR G796S (n = 1, concurrent with C797S). Four patients lost MET amplification. Conclusions: Dual EGFR and MET inhibition yielded high clinical response rate after progression on OSI. Resistance mechanisms to EGFR-MET double TKI inhibition include MET secondary mutation, EGFR secondary mutation, or loss of MET amplification.

Background Up to 20% of patients with non-small cell lung cancer (NSCLC) develop brain metastasis (BM), for which the current standard of care is radiation therapy with or without surgery. There are no prospective data on the safety of stereotactic radiosurgery (SRS) concurrent with immune checkpoint inhibitor therapy for BM. This is the safety cohort of the phase I/II investigator-initiated trial of SRS with nivolumab and ipilimumab for patients with BM from NSCLC.Patients and methods This single-institution study included patients with NSCLC with active BM amenable to SRS. Brain SRS and systemic therapy with nivolumab and ipilimumab were delivered concurrently (within 7 days). The endpoints were safety and 4-month intracranial progression-free survival (PFS).Results Thirteen patients were enrolled in the safety cohort, 10 of whom were evaluable for dose-limiting toxicities (DLTs). Median follow-up was 23 months (range 9.7–24.3 months). The median interval between systemic therapy and radiation therapy was 3 days. Only one patient had a DLT; hence, predefined stopping criteria were not met. In addition to the patient with DLT, three patients had treatment-related grade ≥3 adverse events, including elevated liver function tests, fatigue, nausea, adrenal insufficiency, and myocarditis. One patient had a confirmed influenza infection 7 months after initiation of protocol treatment (outside the DLT assessment window), leading to pneumonia and subsequent death from hemophagocytic lymphohistiocytosis. The estimated 4-month intracranial PFS rate was 70.7%.Conclusion Concurrent brain SRS with nivolumab/ipilimumab was safe for patients with active NSCLC BM. Preliminary analyses of treatment efficacy were encouraging for intracranial treatment response.

Summary: Background: Only around 20–30% of patients with non-small-cell lung cancer (NCSLC) have durable benefit from immune-checkpoint inhibitors. Although tissue-based biomarkers (eg, PD-L1) are limited by suboptimal performance, tissue availability, and tumour heterogeneity, radiographic images might holistically capture the underlying cancer biology. We aimed to investigate the application of deep learning on chest CT scans to derive an imaging signature of response to immune checkpoint inhibitors and evaluate its added value in the clinical context. Methods: In this retrospective modelling study, 976 patients with metastatic, EGFR/ALK negative NSCLC treated with immune checkpoint inhibitors at MD Anderson and Stanford were enrolled from Jan 1, 2014, to Feb 29, 2020. We built and tested an ensemble deep learning model on pretreatment CTs (Deep-CT) to predict overall survival and progression-free survival after treatment with immune checkpoint inhibitors. We also evaluated the added predictive value of the Deep-CT model in the context of existing clinicopathological and radiological metrics. Findings: Our Deep-CT model demonstrated robust stratification of patient survival of the MD Anderson testing set, which was validated in the external Stanford set. The performance of the Deep-CT model remained significant on subgroup analyses stratified by PD-L1, histology, age, sex, and race. In univariate analysis, Deep-CT outperformed the conventional risk factors, including histology, smoking status, and PD-L1 expression, and remained an independent predictor after multivariate adjustment. Integrating the Deep-CT model with conventional risk factors demonstrated significantly improved prediction performance, with overall survival C-index increases from 0·70 (clinical model) to 0·75 (composite model) during testing. On the other hand, the deep learning risk scores correlated with some radiomics features, but radiomics alone could not reach the performance level of deep learning, indicating that the deep learning model effectively captured additional imaging patterns beyond known radiomics features. Interpretation: This proof-of-concept study shows that automated profiling of radiographic scans through deep learning can provide orthogonal information independent of existing clinicopathological biomarkers, bringing the goal of precision immunotherapy for patients with NSCLC closer. Funding: National Institutes of Health, Mark Foundation Damon Runyon Foundation Physician Scientist Award, MD Anderson Strategic Initiative Development Program, MD Anderson Lung Moon Shot Program, Andrea Mugnaini, and Edward L C Smith.

Background: Problem-based learning is widely recognized for its ability to foster active learning and critical thinking in medical education. However, creating effective problem-based learning scenarios demands a high level of expertise. Leveraging the natural language capabilities of ChatGPT, educators can now receive assistance in designing engaging anatomy problem-based learnings. Objective: This paper aims to provide a comprehensive guide on collaborating with ChatGPT to generate ideas, develop content, and create supporting materials for anatomy problem-based learning scenarios. Material and methods: Our methodology involved an analysis of literature on problem-based learning best practices and experimentation on content creation using ChatGPT. The outputs were refined based on valuable feedback obtained from both educators and students. Results: This guide emphasizes crucial aspects such as defining clear learning objectives, ensuring academic rigour, and aligning the problem-based learning scenarios with the curriculum. By harnessing ChatGPT's conversational abilities, educators can collaboratively co-create problem-based learning scenarios that are engaging and effective. Conclusion: This human-artificial intelligence collaborative approach to anatomy problem-based learning design underscores the importance of maintaining oversight over the content generated by ChatGPT. Further research is necessary to quantify the impact of ChatGPT as a supplementary resource. Purposeful integration of ChatGPT, in alignment with pedagogical goals, has the potential to enhance engagement and learning outcomes, particularly for digitally native students. [ABSTRACT FROM AUTHOR]

The paranasal sinuses are hollowed, air-filled cavities surrounding the nasal cavity. Many pathological processes affect the sinuses, but inflammatory conditions are the commonest, even in asymptomatic patients who undergo head imaging for other indications showing one or more abnormalities of the sinuses. Our research aims to determine the prevalence of incidental paranasal sinuses abnormalities seen among patients who undergo head CT scanning. In addition, it provides baseline information for further investigations required. The study was designed to evaluate all patients who underwent head CT scanning for any reason unrelated to paranasal sinuses abnormalities. 1849 cases were selected and retrospectively analyzed from the elective and emergency CT in the last nine months, from August 2020 to April 2021. In order to meet the inclusion criteria, indications for imaging must not be sinus-related. The study was conducted on 1849 cases who had undergone head CT scans for pathology, 1204 (65%) were male and 645 (35%) were female. Abnormalities of the sinuses were found in about 617 (33%) of all patients, with a higher rate in males (22.23%) than females (11.14%). In addition, these abnormalities were found in younger patients at a higher rate than in middle and old ages 19.74%, 7.19%, and 6.44%, respectively. Our findings revealed that the prevalence of paranasal sinuses abnormalities in asymptomatic Saudi patients was high (33%). Most of the affected sinuses were the maxillary. The male patients were more affected than females in all findings.

Background: Adherence to behavioral respiratory hygiene practices is essential in preventing the transmission of COVID-19, especially given the appearance of new variants of the COVID-19 virus. This study estimated the pre- and post-vaccination levels of adherence to COVID-19 preventive behavioral measures among vaccinated people. Methods: This cross-sectional study assessed the sociodemographics and preventive behavioral measures, and pre- and post-vaccination data, via a questionnaire. Paired t-tests and Chi-squared tests were used to assess the variation in adherence levels. Results: Of the 480 participants, 57.9% were male, and 30.4% were aged between 30 and 39 years of age. After vaccination, there was a statistically significant decline in adherence to all the assessed behavioral protective measures (p < 0.05). Being 50 years old or older, female, a healthcare worker, and a smoker were associated with higher adherence levels compared with other groups in the same categories. Conclusions: A change in the behavior of the community members regarding COVID-19 after receiving the vaccination and a reduction in adherence to respiratory hygiene practices was observed. This indicates the importance of raising awareness about the possibility of reinfection with COVID-19 despite the vaccination, and the importance of behavioral respiratory hygiene for the prevention and control of COVID-19.

In this study, a V@TiO2 nanocomposite is examined for its ability to eliminate carcinogenic Rhodamine (Rh-B) dye from an aqueous medium. A simple ultrasonic method was used to produce the nanosorbent. In addition, V@TiO2 was characterized using various techniques, including XRD, HRTEM, XPS, and FTIR. Batch mode studies were used to study the removal of Rh-B dye. In the presence of pH 9, the V@TiO2 nanocomposite was able to remove Rh-B dye to its maximum extent. A correlation regression of 0.95 indicated that the Langmuir model was a better fit for dye adsorption. Moreover, the maximum adsorption capacity of the V@TiO2 nanocomposite was determined to be 158.8 mg/g. According to the thermodynamic parameters, dye adsorption followed a pseudo-first-order model. Based on the results of the study, a V@TiO2 nanocomposite can be reused for dye removal using ethanol.

This report investigates the elimination of hazardous Rhodamine B dye (RhB) from an aqueous medium utilizing MgTiO3@g-C3N4 nanohybrids manufactured using a facile method. The nanohybrid MgTiO3@g-C3N4 was generated using an ultrasonic approach in the alcoholic solvent. Various techniques, including HRTEM, EDX, XRD, BET, and FTIR, were employed to describe the fabricated MgTiO3@g-C3N4 nanohybrids. RhB elimination was investigated utilizing batch mode studies, and the maximum removal was attained at pH 7.0. The RhB adsorption process is more consistent with the Langmuir isotherm model. The highest adsorption capacity of MgTiO3@g-C3N4 nanohybrids for RhB was determined to be 232 mg/g. The dye adsorption followed a pseudo-second-order model, and the parameters calculated indicated that the kinetic adsorption process was spontaneous. Using ethanol and water, the reusability of the nanomaterial was investigated, and based on the results; it can be concluded that the MgTiO3@g-C3N4 nanohybrids are easily regenerated for dye removal. The removal mechanism for the removal of RhB dye into MgTiO3@g-C3N4 nanohybrids was also investigated.

Background Non-small cell lung cancer (NSCLC) patients bearing targetable oncogene alterations typically derive limited benefit from immune checkpoint blockade (ICB), which has been attributed to low tumor mutation burden (TMB) and/or PD-L1 levels. We investigated oncogene-specific differences in these markers and clinical outcome.Methods Three cohorts of NSCLC patients with oncogene alterations (n=4189 total) were analyzed. Two clinical cohorts of advanced NSCLC patients treated with ICB monotherapy [MD Anderson (MDACC; n=172) and Flatiron Health-Foundation Medicine Clinico-Genomic Database (CGDB; n=894 patients)] were analyzed for clinical outcome. The FMI biomarker cohort (n=4017) was used to assess the association of oncogene alterations with TMB and PD-L1 expression.Results High PD-L1 expression (PD-L1 ≥50%) rate was 19%–20% in classic EGFR, EGFR exon 20 and HER2-mutant tumors, and 34%–55% in tumors with ALK, BRAF V600E, ROS1, RET, or MET alterations. Compared with KRAS-mutant tumors, BRAF non-V600E group had higher TMB (9.6 vs KRAS 7.8 mutations/Mb, p=0.003), while all other oncogene groups had lower TMB (p

In this study, four new Secnidazole metal complexes have been synthesized through the reaction of Secnidazole drug with AuCl3, PtCl2, PdCl2, AgNO3 salts. The structures of the synthesized complexes were elucidated using elemental analysis, molar conductivity, thermal analysis, IR, 1H-NMR and UV-Vis spectroscopy. The spectroscopic results confirm that Secnidazole drug act as a bidentate ligand, coordinated to the metal ion with N3 of the imidazole ring and oxygen atom of OH group. The antimicrobial data revealed that the complexes possess a better antibacterial activity against most of the selected bacteria species than the free drug. In addition, the cytotoxic data showed that Ag-complex possesses a potent anticancer activity against MCF-7 cell line. The docking data showed that the synthesized complexes displayed a good and effective binding model against breast cancer protein (3hb5) which was confirmed by the low values of binding energy and multiple H-bonds.

Bismuth oxyiodide (BiOI) is a targeted material for its relative safety and photocatalytic activity under visible light. In this study, a successful simple and energy-saving route was applied to prepare BiOI through a sonochemical process at room temperature. The characterization of the prepared BiOI was conducted by physical means. The transmission electron microscope (TEM) image showed that the BiOI comprises nanoparticles of about 20 nm. Also, the surface area of the BiOI was found to be 34.03 m2 g−1 with an energy gap of 1.835 eV. The adsorption and photocatalytic capacities of the BiOI were examined for the indigo carmine dye (IC) as a model water-pollutant via the batch experiment methodology. The solution parameters were optimized, including pH, contact time, IC concentration, and temperature. Worth mentioning that an adsorption capacity of 185 mg·g−1 was obtained from 100 mg L−1 IC solution at 25 °C within 60 min as an equilibrium time. In addition, the BiOI showed a high degradation efficiency towards IC under tungsten lamb (80 W), where 93% was removed within 180 min, and the complete degradation was accomplished in 240 min. The fabricated BiOI nanoparticles completely mineralized the IC under artificial visible light, as indicated by the total organic carbon analysis.

This study explores the electronic properties of (C2H7N4O)2BiCl5 using the density functional theory (DFT) method, which was compared with the experimental data. The band structure of the compound indicated that it is a direct semiconductor with a band gap energy of 3.54 eV, which was comparable with the value (3.20 eV) obtained experimentally from the UV–vis spectroscopy. The density of state study showed that the conduction band was formed mainly by Bi 6p, C 2p, and N 2p states, while the valence band was formed mainly by Cl 2p, O 2p, and N 2p states. Hirshfeld surface analysis and enrichment ratio (E) were further used to investigate and quantify the intermolecular interactions within the compound. These studies established that the most important role in the stability of the structure of this crystalline material was provided by hydrogen bonding and π–π stacking interactions. The crystalline morphology of the compound was determined using BFDH simulation, based on the single-crystal structure result. Furthermore, Fourier transform infrared spectroscopy (FTIR) was used to study the vibrational modes of carbamoyl-ganidinium cations. The charge transfer process within the anionic chains of [BiCl5]∝, studied using photoluminescence spectroscopy, resulted in a broad emission band with two positions of maxima centered at 336 and 358 nm. This work offers a good understanding of the optical, structural, as well as the electrical properties of (C2H7N4O)2BiCl5, which are necessary in its applications in areas such as multifunctional magnetic, optoelectronic, and photonic systems.

Purpose The receptor tyrosine kinase rearranged during transfection (RET) can be oncogenically activated by gene fusions or point mutations. Multikinase inhibitors such as cabozantinib, lenvatinib and vandetanib have demonstrated activity in RET-dependent malignancies, and selective RET inhibitors (Selpercatinib and Pralsetinib) are in clinical trials. However, the responsiveness of RET-dependent malignancies to immune checkpoint inhibitors (ICIs) is unknown. We compared the time to treatment discontinuation (TTD) for ICI versus non-ICI therapy in patients with malignancies harbouring activating RET mutations or fusions (RET+).Methods A retrospective review of all RET+ patients who were referred to the phase I clinical trials programme at the University of Texas MD Anderson Cancer Center was conducted. TTD was estimated using Kaplan-Meier analysis. Multivariate analysis using the Cox proportional hazard model was performed to identify independent risk factors of treatment discontinuation.Results Of 70 patients who received systemic therapy for RET+ malignancies, 20 (28.6%) received ICI and 50 (71.4%) received non-ICI therapy. Non-ICI therapy was associated with decreased risk for treatment discontinuation compared with ICI in the overall population (HR=0.31; 95% CI 0.16–0.62; p=0.000834) and in patients with RET point mutations (HR=0.13; 95% CI 0.04–0.45; p=0.00134). In patients with RET fusions, non-ICI therapy was associated with a non-statistically significant decreased risk of treatment discontinuation (HR=0.59; 95% CI 0.25–1.4; p=0.24). ICI therapy and a diagnosis other than medullary thyroid cancer (MTC) were independent risk factors for treatment discontinuation.Conclusion Our study supports the prioritisation of non-ICI over ICI therapy in patients with RET+ tumours.

Introduction: Headache disorders are one of the most prevalent global public-health problems that require placing high demand on health-care Services. Since it is one of the most frequent complaints in clinical practice worldwide, it causes a considerable burden in terms of the social cost. The study aimed to give a guide for the decision on the utilization of computed tomography (CT) in the diagnostic workup and identify if patients require neurological imaging (CT) for proper diagnosis or not. Material s and Methods: The study was carried out in the Radiology Department in King Khalid Hospital, Al Kharj, Saudi Arabia from October 15, 2016, to February 15, 2017. A retrospective record-based study conducted using the documented CT reports in the files of patients whom were referred to the radiology department complaining of any type of a headache. Results: The data included 210 patients 51% were males and 49% were females. The patients were distributed into age groups; the mean age was 38.46 standard deviation ± 13.56. Among Saudi population, the etiology of headache was varying; the most prevalent type of headache was tension headache 25.71% of the total headache patients followed by cluster 25.24% and the migraine with the lowest proportionality. The majority of the patients' headache pain was mild 60%. Moreover, the CT reports for most of the patients were normal. Spearman Correlation test was used to see if there is a significance in using the CT for any patient who comes with symptoms including headache, and the results have shown that there is no association and clinical significance in using the CT for patients with headache without suspecting other clinical condition (P = 0.177). Conclusion: Headache disorders must be on the public-health agenda. Tension, migraine, and cluster-type headaches represent the majority of primary headaches. Statistically no significance or need to obtain CT if there are no life-threatening conditions expected or trauma presented.

BACKGROUND AND OBJECTIVES: Visceral leishmaniasis (VL) is a life-threatening infection caused by Leishmania species. In Sudan, VL is caused by L donovani. Most drugs used to treat VL, especially pentavalent antimony compounds (sodium stibogluconate, SSG), are potentially hepatotoxic. A number of fatal catastrophes happened because patients with VL-hepatitis B/C coinfection were indiscriminately treated with SSG in settings where VL and viral hepatitis coexist. This study aimed to study biochemical and hematological parameters of patients with VL-hepatitis B/C coinfections with the aim to modify treatment protocols to reduce coinfection-added morbidity and mortality. DESIGN AND SETTINGS: This was a prospective analytical, hospital-based, and case-controlled study. The study was done at Kassab Hospital and Professor Elhassan Centre for tropical medicine during the period of February 2008 to April 2013. MATERIALS AND METHODS: Following informed consent by the participants, 78 parasitologically confirmed VL patients with either hepatitis B or C or both and 528 sex- and age-unmatched VL patients without hepatitis B/C coinfection (control group) were enrolled sequentially. Diagnosis of hepatitis B or C was made using immunochromatographic test kits and confirmed by an enzyme-linked immunosorbent assay. RESULTS: VL patients with hepatitis B/C coinfections had significantly increased levels of AST, ALT, and total bilirubin compared to the control group (P=.0001 for all), with significantly decreased levels of albumin and platelets counts (P=.0029 for both). CONCLUSION: VL-hepatitis B/C coinfections are an emerging entity that needs anti-leishmanial treatment modification. Alternative treatments like paromomycin and amphotericin B (AmBisome) could be reserved for these patients.