On The Expected Values of Distribution of the Sample Range of Order Statistics from the Geometric Distribution

The expected values of the distribution of the sample range of order statistics from the geometric distribution are presented. For n up to 10, algebraic expressions for the expected values are obtained. Using the algebraic expressions, expected values based on the p and n values can be easily computed

Nivolumab Efficacy and Safety in Cancer Patients with Renal Dysfunction

Aim: Immune checkpoint inhibitors have transformed cancer treatment; however, clinical trials often exclude patients with renal dysfunction. This study aimed to evaluate the efficacy and safety of nivolumab in this population, addressing the limited available data. Methods: A retrospective cross-sectional study was conducted on patients with baseline renal dysfunction who received nivolumab between 2018 and 2023. The safety and efficacy endpoints, including immune-related adverse events (irAEs), treatment response, and progression-free survival. Results: Fifty patients with various malignancies were included, with 30% experiencing manageable worsening of renal function. Approximately 51% of patients experienced no irAEs, whereas 8% experienced grade 3 or 4 adverse events. The treatment discontinuation rate due to adverse effects was 2%. Significantly, 68% of patients showed treatment benefits, with a median progression-free survival of 450 days. Conclusion: Nivolumab is effective and safe for patients with renal dysfunction, with comparable outcomes to those without renal impairment. Despite the occurrence of IrAEs, they were manageable, and we observed benefits in long-term progression-free survival

Mapping artificial intelligence adoption in hepatology practice and research: challenges and opportunities in MENA region

BackgroundArtificial intelligence (AI) is increasingly relevant to hepatology, yet real-world adoption in the Middle East and North Africa (MENA) is uncertain. We assessed awareness, use, perceived value, barriers, and policy priorities among hepatology clinicians in the region.MethodsA cross-sectional online survey targeted hepatologists and gastroenterologists across 17 MENA countries. The survey assessed clinical and research applications of AI, perceived benefits, clinical and research use, barriers, ethical considerations, and institutional readiness. Descriptive statistics and thematic analysis were performed.ResultsOf 285 invited professionals, 236 completed the survey (response rate: 82.8%). While 73.2% recognized the transformative potential of AI, only 14.4% used AI tools daily, primarily for imaging analysis and disease prediction. AI tools were used in research by 39.8% of respondents, mainly for data analysis, manuscript writing assistance, and predictive modeling. Major barriers included inadequate training (60.6%), limited AI tool access (53%), and insufficient infrastructure (53%). Ethical concerns focused on data privacy, diagnostic accuracy, and over-reliance on automation. Despite these challenges, 70.3% expressed strong interest in AI training., and 43.6% anticipating routine clinical integration within 1–3 years.ConclusionMENA hepatologists are optimistic about AI but report limited routine use and substantial readiness gaps. Priorities include scalable training, interoperable infrastructure and standards, clear governance with human-in-the-loop safeguards, and region-specific validation to enable safe, equitable implementation

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

PRECIPITATION CONDITIONS OF CHEVREUL'S SALT FROM SYNTHETIC AQUEOUS CuSO4 SOLUTIONS

In this study, synthetic aqueous CuSO4 solution was prepared at various concentrations. Chevreul's salt was precipitated by passing SO2 through these solutions. Chevreul's salt, a mixed valence copper sulfite, Cu2SO3CuSO32H2O, was characterized by XRD and SEM. The effects of parameters such as initial solution concentration, SO2 feeding rate, reaction time, and initial solution pH on precipitation of Chevreul's salt were investigated. 2n factorial experimental design and orthogonal central composite design methods in the precipitation experiments were used. It was observed that the effective parameters on the precipitation of Chevreul's salt were initial solution concentration, SO2 feeding rate, and initial solution pH. The optimum conditions obtained for maximum copper precipitation were: initial solution concentration 1.14M, SO2 feeding rate 329.35L.h.-1, reaction time 25min, and initial solution pH 8.5. Constant parameters chosen at the initial stage of the reaction were: temperature 62C, stirring speed 600rpm, and reaction pH 3 (Calban et al., 2006). Under these optimum conditions, the percentage of precipitated copper from synthetic aqueous CuSO4 solutions was 99.95

EVALUATION OF LEACHING CONDITIONS FOR DISSOLUTION OF PYRITE IN CHLORINE-SATURATED WATER

The optimum leaching conditions for the dissolution of pyrite in water saturated with chlorine gas were investigated. Reaction temperature, solid-to-liquid ratio, reaction time, and particle size were selected as the leaching parameters. 2n factorial experimental design and orthogonal central-composite design methods were used. A mechanical stirring speed of 500rpm and chlorine gas-flow rate of 1379mL/minute were chosen as the fixed parameters in all experiments. The degrees of effectiveness from high to low were found to be, in respective order, the particle size, the reaction temperature, the solid-to-liquid ratio, and leaching time. A reaction temperature of 30 degrees C, solid-to-liquid ratio of 0.167g/mL, particle size of 150-212m, and reaction time of 360 minutes were found to be the optimum leaching conditions. The dissolution yield of iron from pyrite was 98.4% under optimal leaching conditions