Subsidies for energy efficiency and alternative energy adoption programs: case study from Egypt taxi recycling program

This thesis was developed to call in question the conventional perception that energy subsidies, especially in the service sector, are necessarily barriers to the adoption of improved technology. It provides a case study for an innovative program that supported energy efficiency and the adoption of alternative energy in the transportation sector and relied in part on subsidy savings. The program-Egypt\u27s Taxi Recycling Program-was not only successful in reaching the targeted population effectively, but also lifted some of the fuel subsidies burden off the government budget. Cost Benefit Analysis (CBA) and Soft System Methodology (SSM) were applied to analyze the distribution of benefits from the Taxi Recycling program. The CBA was applied to define the main costs and benefits drawn by the two key stakeholders- the Egyptian Government and taxi owners participating in the program. The SSM was applied to have more detailed understanding of the role and the power of the stakeholders involved; in order to evaluate the performance of the stakeholders. The study findings indicated that the program has an overall positive impact on the different stakeholders involved. Since it was structured as a Public-Private-Partnership, the program offered significant opportunities to the private sector participating companies, either by stimulating vehicles sales and loan demands that would have not otherwise occurred, or by facilitating the communication channels among the different stakeholders involved. The program encountered some challenges that directly and indirectly affected the stakeholders involved. The taxi owners, however, had been the most influenced by the program\u27s challenges. The challenges included: the advertising firm being unable to fulfill its commitments; the maintenance services and maintenance costs; the waiting periods for getting the new cars; the quality of the cars that were sold; and the adoption of natural gas as an alternative fuel. Nonetheless, the program had overall positive social impacts. Through applying CBA from the government perspective, we concluded that the benefits encountered from the program implementation far exceed the costs incurred by the government. Upon reaching the program target of changing around 40,000 old taxi vehicles operating in Greater Cairo Region, the program would save more than LE 380 million annually from the fuel subsidies assigned funds. As for the environmental impacts, the Taxi Recycling program has been divided into eleven separate projects called Certified Project Activities (CPAs); with an average of 4,576 recycled taxi vehicles per CPA. The preliminary assessment, based on CAPMAS\u27s 2010 estimation of the costs associated with CO2 emissions\u27 negative environmental impacts, showed that the new vehicles would result in annual average environmental benefits of 2.080 million US dollars per each Taxi-Recycling-CPA. In addition, these saved emissions represent potential government revenue if the government was able to sell the reduced emissions under the Clean Development Mechanism

Hematological Indices in Chronic Kidney Disease Patients and The Effect of Hemodialysis on These Indices

Background: Chronic kidney disease (CKD) is a major health issue that affects people all over the globe. Hematological problems are connected to varying grades of CKD. Objective: To study the relationship between chronic kidney disease and hematological indices, and to study the effect of hemodialysis on these parameters. Subjects and Methods: At Internal Medicine, Faculty of Medicine, Zagazig University, Sharkia, Egypt. we conducted this cross-sectional study in addition to the Nephrology Unit of El-Sahel teaching hospital from May 2019 to February 2020 on 165 subjects categorized into three groups with each group of 55 subjects. Group I included normal healthy persons. Group II involved chronic kidney disease patients not on hemodialysis (NDD-CKD) while Group III included patients on maintenance hemodialysis (DD-CKD). All participants' histories were gathered, with particular attention paid to demographic data and the co-morbid medical conditions as diabetes mellitus and hypertension. Full clinical examination was done including local and systemic examinations. In addition, a complete blood count, urea, and creatinine levels were measured. Results: There is a significant association between CKD and changes in RBCs indices with a significant effect of hemodialysis on these changes. A decrease in the mean platelet count in diseased groups compared with normal ones was revealed. We also found differences between the 3 groups according to WBCs indices with significant changes between the 3 groups in TLC. Conclusion: CKD impacts all hematological parameters and hemodialysis also influence all these parameters

Human Islet Response to Selected Type 1 Diabetes-Associated Bacteria: A Transcriptome-Based Study

Type 1 diabetes (T1D) is a chronic autoimmune disease that results from destruction of pancreatic β-cells. T1D subjects were recently shown to harbor distinct intestinal microbiome profiles. Based on these findings, the role of gut bacteria in T1D is being intensively investigated. The mechanism connecting intestinal microbial homeostasis with the development of T1D is unknown. Specific gut bacteria such as Bacteroides dorei (BD) and Ruminococcus gnavus (RG) show markedly increased abundance prior to the development of autoimmunity. One hypothesis is that these bacteria might traverse the damaged gut barrier, and their constituents elicit a response from human islets that causes metabolic abnormalities and inflammation. We have tested this hypothesis by exposing human islets to BD and RG in vitro, after which RNA-Seq analysis was performed. The bacteria altered expression of many islet genes. The commonly upregulated genes by these bacteria were cytokines, chemokines and enzymes, suggesting a significant effect of gut bacteria on islet antimicrobial and biosynthetic pathways. Additionally, each bacteria displayed a unique set of differentially expressed genes (DEGs). Ingenuity pathway analysis of DEGs revealed that top activated pathways and diseases included TREM1 signaling and inflammatory response, illustrating the ability of bacteria to induce islet inflammation. The increased levels of selected factors were confirmed using immunoblotting and ELISA methods. Our data demonstrate that islets produce a complex anti-bacterial response. The response includes both symbiotic and pathogenic aspects. Both oxidative damage and leukocyte recruitment factors were prominent, which could induce beta cell damage and subsequent autoimmunity

Evaluation of the preoperative administration of sildenafil on operative and early postoperative outcome after mitral valve replacement in patients with pulmonary hypertension

Background: Mitral valve diseases are commonly associated with pulmonary hypertension. The aim of this study was to evaluate the effect of preoperative administration of sildenafil on the outcome after mitral valve replacement in patients with pulmonary hypertension. Methods: This prospective randomized study was carried out on 67 patients who had a mitral valve replacement and associated high systolic pulmonary artery pressure more than 50 mmHg. Patients were randomized into three groups: group A (n= 20) received preoperative sildenafil for one week, group B (n=22) received sildenafil for one month, and group C (n= 25) did not receive sildenafil. All patients had transthoracic echocardiography preoperatively, one week and one month postoperatively. Results: There was no difference in preoperative and operative variables among groups. Dobutamine support was required in 15 patients (60%) in group C vs. 6 patients (30%) in group A and 5 patients (22.5%) in group B (p= 0.012). Duration of mechanical ventilation was significantly longer in group C (389.2 ± 48.79 minutes) compared to group A and B (295.5 ± 17.01 and 281.4 ± 39.44 minutes, respectively, p<0.001). ICU stay was longer in group C (61.72 ± 13.69 hours) compared to groups A and B (53.55 ± 14.49 and 45.64 ± 13.43 hours, respectively, p=0001). The hospital stay was longer in group C (8.0 ± 1.80 days) compared to group A and B (6.05 ± 0.94 and 6.27 ± 1.24 days, respectively; p< 0.001). The transthoracic echocardiographic study one month after the operation showed that pulmonary artery systolic pressure significantly lower in groups A and B (28.30 ± 3.3 and 28.2 ± 4.98 mmHg, respectively) compared to group C (43.12 ± 4.99 mmHg) (p <0.001). There was no statistically significant difference between groups A and B regarding PASP after five days  (p= 0.287) or one month (p= 0.939). Conclusion: We found that preoperative administration of oral sildenafil in patients with pulmonary hypertension undergoing mitral valve replacement may reduce pulmonary hypertension postoperatively. We could not find a difference in the administration of sildenafil for either one week or one month preoperatively

Optimizing diagnostic imaging data using LI-RADS and the Likert scale in patients with hepatocellular carcinoma

Purpose: The study aimed to compare the diagnostic performance of the Liver Imaging Reporting and Data System (LI-RADS), which incorporates fixed criteria, and the Likert scale (LS), which mainly depends on an overall impression in liver lesion diagnosis. Material and methods: Diagnostic data of 110 hepatic nodules in 103 high-risk patients for hepatocellular carcinoma (HCC) were included. Data including diameter, arterial hyperenhancement, washout, and capsule were reviewed by 2 readers using LI-RADS and LS (range, score 1-5). Inter-reader agreement (IRA), intraclass agreement (ICA), and diagnostic performance were determined by Fleiss, Cohen's k, and logistic regression, respectively. Results: There were 53 triphasic enhanced computed tomography (CT) and 50 dynamic magnetic resonance (MR) examinations. Overall, IRA was excellent (k = 0.898). IRA was good for arterial hyperenhancement (k = 0.705), washout (k = 0.763), and capsule (k = 0.771) and excellent for diameter (k = 0.981) and tumour embolus (k = 0.927). Overall, ICA between LI-RADS and LS was fair 0.32; ICA was good for scores of 1 (k = 0.682), fair for scores of 2 (k = 0.36), moderate for scores of 5 (k = 0.52), but no agreement was found for scores of 3 (k = –0.059) and 4 (k = –0.022). LIRADS produced relatively high accuracy (87.3% vs. 80%), relatively low sensitivity (84.3% vs. 98%), and significantly higher specificity (89.83% vs. 64.4%) and positive likelihood ratio (+LR: 8.29 vs. 2.75) compared to LS approach. Conclusions: LI-RADS revealed higher diagnostic accuracy as compared to LS with statistical proof higher specificity and +LR showing its ability to foretell malignancy in high-risk patients. We recommend the practical application of the LI-RADS system in the detection and treatment response monitoring of patients with HCC

Aflatoxin M1 in Milk and some Dairy Products: Level, Effect of Manufature and Public Health Concerns

Aflatoxins (AFs) are toxic and carcinogenic metabolites produced by a variety of fungi. Aflatoxin M1 (AFM1) is the major carcinogenic type frequently found in milk and dairy products, thus posing a significant impact on human health. The current study was undertaken to examine milk and some dairy products for contamination with AFM1 in local markets, Sharkia Governorate, Egypt, as well as the effect of manufacture. A total of 75 samples (15, each) of raw milk, pasteurized milk, yoghurt, processed cheese and Domiati cheese were randomly collected. AFM1 was detected in 27 (36%) out of the examined samples in which the level of AFM1 exceeded the limits (0 ng/L, kg) allowed by Egyptian regulation but only 6 (8%) samples exceeded the limits (50 ng/L, kg) allowed by European Commission regulation. Levels of AFM1 contamination in the examined milk and dairy products with mean values of 35.68 ± 10.90, 45.83 ± 7.80, 7.57 ± 1.92, 24.53 ± 3.91 and 42 ± 4.93 ng/L, kg in raw milk, pasteurized milk, yoghurt, processed cheese and Domiati cheese, respectively, were detected. The level of AFM1 decreased after yoghurt manufactur, while, cheese manufacture showed concentration of AFM1 in curd than those in cheese milk. During refrigeration storage of yoghurt, the mean AFM1 toxin decreased after one, two, three, seven days, respectively, then nearly similar level from seven days to fourteen days of storage. In conclusion, widespread presence of AFM1 in raw milk and some dairy products were considered to be possible hazards for public health especially children therefore, continuous monitoring of AFM1 level in commonly marketed raw milk and dairy products in Sharkia markets should be regularly done. Manufacture and storage had little effect on AFM1 content in milk and dairy products, therefore, new or modern technologies for detoxification of milk should be further studied

Colonic delivery of indometacin loaded PGA-co-PDL microparticles coated with Eudragit L100-55 from fast disintegrating tablets

The aim of this work was to investigate the efficient targeting and delivery of indometacin (IND), as a model anti-inflammatory drug to the colon for treatment of inflammatory bowel disease. We prepared fast disintegrating tablets (FDT) containing IND encapsulated within poly(glycerol-adipate-co-ɷ-pentadecalactone), PGA-co-PDL, microparticles and coated with Eudragit L100-55 at different ratios (1:1.5, 1:1, 1:0.5). Microparticles encapsulated with IND were prepared using an o/w single emulsion solvent evaporation technique and coated with Eudragit L-100-55 via spray drying. The produced coated microparticles (PGA-co-PDL-IND/Eudragit) were formulated into optimised FTD using a single station press. The loading, in vitro release, permeability and transport of IND from PGA-co-PDL-IND/Eudragit microparticles was studied in Caco-2 cell lines. IND was efficiently encapsulated (570.15 ± 4.2 μg/mg) within the PGA-co-PDL microparticles. In vitro release of PGA-co-PDL-IND/Eudragit microparticles (1:1.5) showed significantly (p < 0.05, ANOVA/Tukey) lower release of IND 13.70 ± 1.6 and 56.46 ± 3.8% compared with 1:1 (89.61 ± 2.5, 80.13 ± 2.6%) and 1:0.5 (39.46 ± 0.9 & 43.38 ± 3.12) after 3 and 43 h at pH 5.5 and 6.8, respectively. The permeability and transport studies indicated IND released from PGA-co-PDL-IND/Eudragit microparticles had a lower permeability coefficient of 13.95 ± 0.68 × 10−6cm/s compared to free IND 23.06 ± 3.56 × 10−6cm/s. These results indicate the possibility of targeting anti-inflammatory drugs to the colon using FDTs containing microparticles coated with Eudragit

Patient safety in developing countries: retrospective estimation of scale and nature of harm to patients in hospital

OBJECTIVE: To assess the frequency and nature of adverse events to patients in selected hospitals in developing or transitional economies. DESIGN: Retrospective medical record review of hospital admissions during 2005 in eight countries. SETTING: Ministries of Health of Egypt, Jordan, Kenya, Morocco, Tunisia, Sudan, South Africa and Yemen; the World Health Organisation (WHO) Eastern Mediterranean and African Regions (EMRO and AFRO), and WHO Patient Safety. PARTICIPANTS: Convenience sample of 26 hospitals from which 15,548 patient records were randomly sampled. MAIN OUTCOME MEASURES: Two stage screening. Initial screening based on 18 explicit criteria. Records that screened positive were then reviewed by a senior physician for determination of adverse event, its preventability, and the resulting disability. RESULTS: Of the 15,548 records reviewed, 8.2% showed at least one adverse event, with a range of 2.5% to 18.4% per country. Of these events, 83% were judged to be preventable, while about 30% were associated with death of the patient. About 34% adverse events were from therapeutic errors in relatively non-complex clinical situations. Inadequate training and supervision of clinical staff or the failure to follow policies or protocols contributed to most events. CONCLUSIONS: Unsafe patient care represents a serious and considerable danger to patients in the hospitals that were studied, and hence should be a high priority public health problem. Many other developing and transitional economies will probably share similar rates of harm and similar contributory factors. The convenience sampling of hospitals might limit the interpretation of results, but the identified adverse event rates show an estimate that should stimulate and facilitate the urgent institution of appropriate remedial action and also to trigger more research. Prevention of these adverse events will be complex and involves improving basic clinical processes and does not simply depend on the provision of more resources

Calpain signaling: from biology to therapeutic opportunities in neurodegenerative disorders

Neurodegenerative disorders represent a major and growing healthcare challenge globally. Among the numerous molecular pathways implicated in their pathogenesis, calpain signaling has emerged as a crucial player in neuronal dysfunction and cell death. Calpain is a family of calcium-dependent cysteine proteases that is involved in many biological processes, such as signal transduction, cytoskeleton remodeling, and protein turnover. Dysregulation of calpain activation and activity has been associated with several neurodegenerative diseases, including Alzheimer’s, Parkinson’s, and Huntington’s diseases. Understanding the intricate structure of calpains is crucial for unraveling their roles in cellular physiology and their implications in pathology. In addition, the identification of diverse abnormalities in both humans and other animal models with deficiencies in calpain highlights the significant progress made in understanding calpain biology. In this comprehensive review, we delve into the recent roles attributed to calpains and provide an overview of the mechanisms that govern their activity during the progression of neurodegenerative diseases. The possibility of utilizing calpain inhibition as a potential therapeutic approach for treating neuronal dysfunctions in neurodegenerative disorders would be an area of interest in future calpain research

Novel gold nanoparticles coated with somatostatin as a potential delivery system for targeting somatostatin receptors

Targeting of G-protein coupled receptors (GPCRs) like somatostatin-14 (SST-14) could have a potential interest in delivery of anti-cancer agents to tumor cells. Attachment of SST to different nano-carriers e.g., polymeric nanoparticles is limited due to the difficulty of interaction between SST itself and those nano-carriers. Furthermore, the instability problems associated with the final formulation. Attaching of SST to gold nanoparticles (AuNPs) using the positive and negative charge of SST and citrate-AuNPs could be considered a new technique to get stable non-aggregated AuNPs coated with SST. Different analyses techniques have been performed to proof the principle of coating between AuNPs and SST. Furthermore, cellular uptake study on HCC-1809 cell lines has been investigated to show the ability of AuNPs coated SST to enter the cells via SST receptors. Dynamic light scattering (DLS) indicated a successful coating of SST on the MUA-AuNPs surface. Furthermore, all the performed analysis including DLS, SDS-PAGE and UV-VIS absorption spectra indicated a successful coating of AuNPs with SST. Cellular uptake study on HCC-1806 cell lines showed that the number of AuNPs-SST per cell is significantly higher compared to citrate-AuNPs when quantified using inductively coupled plasma spectroscopy. Moreover, the binding of AuNPs-SST to cells can be suppressed by addition of antagonist, indicating that the binding of AuNPs-SST to cells is due to receptor-specific binding. In conclusion, AuNPs could be attached to SST via adsorption to get stable AuNPs coated SST. This new formulation has a potential to target SST receptors localized in many normal and tumor cells