telmisartan + amlodipine (Micamlo BP / Onduarp / Micamlo AP)

Fabrication of a Bi-doped WO3/CFA nanocomposite for efficient photocatalytic degradation of ciprofloxacin (CIP) under visible light.

Diako Palesa P, Adeiga Opeoluwa I OI, Eswaran Prabakaran P, Pillay Kriveshini K

In this study, the synthesis of a novel bismuth-doped tungsten oxide decorated on coal fly ash (Bi-doped WO3/CFA) nanocomposite for the photocatalytic degradation of ciprofloxacin (CIP) in water was investigated. A Bi-doped WO3/CFA nanocomposite was prepared by the hydrothermal deposition of Bi-doped WO3 nanoparticles onto activated coal fly ash (CFA). Structural and morphological study of the synthesized materials was characterized using a variety of analytical techniques, which include Fourier transform infrared (FT-IR) spectroscopy, X-ray diffraction (XRD), scanning electron microscopy-energy dispersive X-ray spectroscopy (SEM-EDS) and transmission electron microscopy (TEM), BET surface area analysis, UV-vis diffuse reflectance spectroscopy (UV-DRS), zeta potential, and photoluminescence (PL). Short rod-shaped nanoparticles were successfully synthesized. A combination of the rod-shaped nanoparticles with spherical activated CFA was observed for the nanocomposite. The results showed that the nanoparticles and the nanocomposite had definite crystallinity. Tauc plot was used to calculate the band gap energies of the Bi-doped WO3/CFA nanocomposite (1.52 eV). The BET surface area of raw CFA, activated CFA, Bi-doped WO3 NPs, and the Bi-doped WO3/CFA nanocomposite was found to be 6.279 m2 g-1, 6.791 m2 g-1, 50.101 m2 g-1, and 29.452 m2 g-1, respectively. A catalyst-free environment, Bi-doped WO3 NPs, and a Bi-doped WO3/CFA nanocomposite were used for the photocatalytic degradation of CIP under visible light for 0-120 min. The nanocomposite showed better degradation of CIP than the catalyst-free environment and NPs, and this is because of its low band gap and the stability of the nanocomposite. Since the nanocomposite is a stable photocatalyst due to the synergy between Bi, WO3, and the activated CFA, it also showed an increased photocatalytic activity due to the dopant (Bi), the binary photocatalyst (WO3/CFA) and a lower band gap. A catalyst loading of 40 mg Bi-doped WO3/CFA nanocomposite and 5 ppm ciprofloxacin were optimized to obtain photocatalytic degradation of 74% under visible light irradiation for 0-120 minutes. The application was conducted varying parameters like concentration, dosage and pH, and the results indicated that the optimal conditions for the degradation of CIP (74% after 120 min) comprised a catalyst loading of 30 mg, a pH of 7 and a concentration of 5 ppm.

Ageism Goes Both Ways: Bi-Directionally Tracing Absence and Construction in Bioethics and Pediatrics.

Ramzan Rakhshanda R, S Weaver Meaghann M

Spotting the vulnerable: Preoperative risk stratification in non-metastatic colorectal cancer patients aged 80 years and older.

Liu Hsin-Yi HY, Chen Chi-Ling CL, Liang Jin-Tung JT, Huang John J et al.

While colorectal cancer (CRC) surgery is well established in the broader older population, patients aged ≥ 80 years experience a steep rise in frailty, functional dependency, and failure-to-rescue rates. Identifying simple, clinically relevant preoperative indicators may improve risk stratification and guide patient-centered surgical decision-making. We retrospectively analyzed 449 patients aged ≥80 years who underwent curative surgery for non-metastatic CRC. Barthel Index (BI) and body mass index (BMI) were evaluated as predictors of one-year mortality. A prognostic nomogram incorporating age, BI, and BMI was constructed. Patients were stratified into low-, medium-, and high-risk groups based on model scores. Performance of the nomogram was assessed with discrimination, calibration, and decision curve analysis. Overall 1-year mortality was 11.6% (n = 52). BI (OR: 0.963, p < 0.001) and BMI (OR: 0.877, p = 0.023) emerged as independent predictors. The nomogram achieved an AUC of 0.746 in the derivation cohort and 0.724 in the validation cohort. High-risk patients exhibited significantly higher major complication rates (17.9% vs. 4.1%, p < 0.001), higher 1-year mortality (22.7% vs. 5.3%, p < 0.001), and inferior overall survival (adjusted HR: 2.112, 95% CI: 1.480-3.013, p < 0.001) compared with low-risk patients. A nomogram combining age, BI and BMI reliably stratifies postoperative vulnerability and 1-year mortality in patients aged ≥80 years, supporting targeted prehabilitation and surgical shared decision-making.

HLA-DPB1 TCE mismatch vector differentially affects HCT outcomes in 10/10 and ≤9/10 HLA matched patients in the UK.

Turner Thomas R TR, Cambridge Charlotte A CA, Lucas Jonathan A M JAM, French Albert J E AJE et al.

Understanding permissive and beneficial HLA mismatches is a primary area of hematopoietic cell transplant (HCT) research. HLA-DPB1 is well studied in this context, due to its separation from HLA-A∼DQB1 by a recombination hot-spot. The primary study aim was to retrospectively assess the clinical impact of using the latest iteration of the HLA-DPB1 T cell epitope model (TCEv3) for selecting HLA-DPB1 mismatched donors in a UK cohort. The results were also compared to the previous, TCEv2 model. We used the TCEv3 model to assign core and non-core permissive mismatches, to a cohort of 1743 UK volunteer unrelated donor HCTs for malignant diseases between 1996 and 2020. We considered HLA-DPB1 mismatch vector (graft versus host (GvH), host versus graft (HvG), and bi-directional (Bi-D)) across TCE groups, and existing HLA-A∼DQB1 mismatching. In 10/10 HLA matched patients, Bi-D HLA-DPB1 non-core permissive/non-permissive mismatches were associated with significantly worse 5-year overall survival, transplant related mortality, progression-free survival, chronic graft versus host disease (GvHD) and GvHD-free, relapse-free survival (GRFS) compared to HLA-DPB1 matched/permissively mismatched patients. In ≤9/10 HLA matched patients, both Bi-D and HLA-DPB1 matched/permissive mismatches were associated with similarly poor survival, while HvG HLA-DPB1 mismatches reduced mortality and improved GRFS. Overall risk of grades 2-4 acute GvHD (aGvHD) increased with the presence of GvH HLA-DPB1 mismatches and HLA-A∼DQB1 mismatching. Assessing mismatch vector revealed that some canonical non-permissive HLA-DPB1 mismatches are equivalent to an HLA-DPB1 match/permissive mismatch and can be beneficial. Similarly, some canonical permissive mismatches and, surprisingly, HLA-DPB1 matching in an already mismatched setting were detrimental. Bi-D HLA-DPB1 mismatched patients consistently had the poorest outcomes. This UK first, multicenter study shifts our understanding of HLA-DPB1 permissibility in UK HCT, with potential to improve patient survival and quality of life post-HCT through alternative donor selection.