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A Fermatean fuzzy set (FFS) is a reliable method for representing uncertainty in “multi-criteria decision-making” (MCDM). This research seeks to examine the topological properties of FFSs and to establish the notion of “Fermatean fuzzy topology” (FFT). An FFT is the generalisation of existing fuzzy topologies. Several aspects of FFT are examined and various novel concepts are proposed, which include Fermatean fuzzy $\alpha$-continuity between FFTSs and Fermatean fuzzy connectedness. To deal multiple challenges in sustainable supply chain management, a Fermatean fuzzy “combinative distance-based assessment” (CODAS) method was developed. The proposed FF CODAS technique involves various key features for MCDM. Firstly, a known reputation vector or equal expert weights is determined based on the reputation, experience and qualifications of the experts. Secondly, the Fermatean fuzzy direct rating approach is used to establish the relative relevance of criteria based on the expert group’s evaluation preferences. Thirdly, the Fermatean fuzzy CODAS approach is used to construct alternative orderings based on their assessment scores. Finally, an application is developed to show the benefit of the suggested supplier selection approach. Additionally, the symmetry of an optimal decision in application is carried out by a comparison analysis of the suggested models with some existing models. Full article

Programmed death-ligand (PD-L) 1 and 2 are ligands of programmed cell death 1 (PD-1) receptor. They are members of the B7/CD28 ligand-receptor family and the most investigated inhibitory immune checkpoints at present. PD-L1 is the main effector in PD-1-reliant immunosuppression, as the PD-1/PD-L pathway is a key regulator for T-cell activation. Activation of T-cells warrants the upregulation of PD-1 and production of cytokines which also upregulate PD-L1 expression, creating a positive feedback mechanism that has an important role in the prevention of tissue destruction and development of autoimmunity. In the context of inadequate immune response, the prolonged antigen stimulation leads to chronic PD-1 upregulation and T-cell exhaustion. In lung cancer patients, PD-L1 expression levels have been of special interest since patients with non-small cell lung cancer (NSCLC) demonstrate higher levels of expression and tend to respond more favorably to the evolving PD-1 and PD-L1 inhibitors. The Food and Drug Administration (FDA) has approved the PD-1 inhibitor, pembrolizumab, alone as front-line single-agent therapy instead of chemotherapy in patients with NSCLC and PD-L1 ≥1% expression and chemoimmunotherapy regimens are available for lower stage disease. The National Comprehensive Cancer Network (NCCN) guidelines also delineate treatment by low and high expression of PD-L1 in NSCLC. Thus, studying PD-L1 overexpression levels in the different histological subtypes of lung cancer can affect our approach to treating these patients. There is an evolving role of immunotherapy in the other sub-types of lung cancer, especially small cell lung cancer (SCLC). In addition, within the NSCLC category, squamous cell carcinomas and non-G12C KRAS mutant NSCLC have no specific targetable therapies to date. Therefore, assessment of the PD-L1 expression level among these subtypes of lung cancer is required, since lung cancer is one of the few malignances wherein PD-L1 expression levels is so crucial in determining the role of immunotherapy. In this study, we compared PD-L1 expression in lung cancer according to the histological subtype of the tumor. Full article