Major depression and disease activity among systemic lupus erythematosus Egyptian females

AbstractAim of the workThe aim of this study was to identify the relationship between disease activity in SLE Egyptian females and the presence, severity and pattern of major depression in these patients.Patients and methodsThe study sample included 100 female patients; fifty SLE patients and fifty healthy adults with matching age serving as control. Patients were assessed using Beck Inventory Score for the presence of major depression, SLEDAI to determine disease activity, SLICC/ACR damage index and HAQ score for functional disability.ResultsThe majority of patients had symptoms of major depression 32/50 (64%) based on Beck Inventory Score while in controls only 16/50 (36%) had major depression. The most common depressive symptoms in SLE patients were: Guilty feeling (92%), Self-dislike (91.6%), Self-criticalness (90.4%), Crying spells (87.5%), Loss of pleasure (83.3%), Change in appetite (83.3%), Agitation (82.8%) and Pessimism (82%). Patients with major depression presented a trend toward having greater severity of SLE disease activity compared with those without major depression (p=0.04). The presence of major depression was significantly associated with functional disability measured by HAQ score (p=0.01). The patients with major depression did not differ significantly from patients without major depression regarding their steroid dosage (p=0.55), SLICC/ACR damage score (p=0.16) and disease duration (p=0.69) but differed significantly as regards Beck Hopelessness Scale (p<0.0001) and suicidal ideation score (p=0.009).ConclusionMajor depression was highly presented in Egyptian SLE patients (64%); its severity was associated with disease activity, but not with steroid administration, cumulative damage or disease duration

Effects of computer-supported collaboration script and incomplete concept maps on web design skills in an online design-based learning environment

Web design skills are an important component of media literacy. The aim of our study was to promote university students’ web design skills through online design-based learning (DBL). Combined in a 2x2-factorial design, two types of scaffolding were implemented in an online DBL environment to support the students through their effort to design, build, modify, and publish web sites on processes and outcomes measures, namely collaboration scripts and incomplete concept maps. The results showed that both treatments had positive effects on collaborative (content-related discourse quality, collaboration skills, and quality of published web sites) and individual (domain-specific knowledge and skills related to the design and building of websites) learning outcomes. There was synergism between the two scaffolds in that the combination of the collaboration script and incomplete concept maps produced the most positive results. To be effective, online DBL thus needs to be enhanced by appropriate scaffolds, and both collaboration scripts and incomplete concept maps are effective examples

Evaluating Egypt\u27s renewable energy and energy subsidies policies.

Egypt and the Middle East region as a whole have the lowest domestic prices worldwide for primary energy and electricity which has resulted in an economic disincentive for investments in renewable energy leading to an underestimation of the true potential of renewable energy due to the absence of commercial incentives for investors. In order to unleash the renewable energy potential in Egypt, it is crucial to reconsider the domestic pricing framework, energy subsidies and restructuring the energy market where the economic advantages of renewable energy become clear. In 2008, the New and Renewable Authority (NREA) announced its goal of reaching a 20 % share of renewable energy in Egypt’s overall energy mix for electricity generation, an estimated 7200 MW. Today, almost a decade after setting this ambitious goal, the installed capacity of renewable energy in Egypt has reached a mere 550 MW. This research evaluates the development of Egypt’s renewable energy sector and its regulatory policies and draws lessons from the examples of other countries and the policies they adopted to foster the developed of the renewable energy sector. The transition to a wide adoption of renewable energy in Egypt would be slow, if left entirely to market forces due to the considerably high cost of electricity generated from renewable energy sources especially when compared to conventional generation which is heavily subsided by the government. The Egyptian government has a key role to play in order to accelerate the process by implementing the required policies to encourage renewable energy deployment on both the supply-side and demand-side. As Egypt starts to liberalize its energy market by removing energy subsidies to ease the pressure on the national budget, the research reviews Egypt’s energy subsidy systems and highlights the failures and successes of countries which have undergone a similar transition and concludes with recommendations for Egypt’s energy reality. The Egyptian government has taken the first steps in the right direction by gradually removing the energy subsidies and launching the Feed-in Tariff scheme thus allowing the private sector to develop renewable energy projects. It is recommended for Egypt to adopt a pricing scheme based on the actual incurred cost as it will eliminate inefficiencies and support the transition to renewable energy. In addition, the adoption of cash transfers instead of subsidies will result in a decrease in the over subsidies bill while increasing the efficient targeting of the poor

EXPLORING THE EFFECT OF CHRONIC INFLAMMATION ON RESPONSE TO IMMUNE CHECKPOINT INHIBITORS IN CANCER

Precision medicine has allowed for the development of monoclonal antibodies that unmask the anti-tumor immune response. These agents have provided some patients durable clinical benefit. However, PD-1 and PD-L1 inhibitor therapies are effective in a small group (10-20%) of non-small cell lung cancer (NSCLC) patients when used as single-agent therapy. The approved companion diagnostic is expression of the immune cell surface molecule, programmed death ligand 1 (PD-L1), on tumors measured by immunohistochemistry (IHC). Studies in tumor biology and immune surveillance dictate that PD-1 inhibitor efficacy should depend on the level of PD-L1 expression; however, the literature has not followed with convincing evidence. The limitations of this test include timing of tissue acquisition, tumor heterogeneity, and timing of therapy relative to the expression of PD-L1. In addition, the requirement of analyzing tumor tissue biopsy samples from a patient is cumbersome. Thus, a peripheral blood biomarker that predicts efficacy of PD-1/PD-L1 inhibition would be optimal for precise and cost-effective treatment. A history of chronic inflammatory diseases may be advantageous for a cancer patient who is treated with PD-1/PD-L1 inhibitors and may allow them to then mobilize a swift immune response to tumor cells. Specific biological components of this persistent inflammation may predict PD-1 inhibitor response. We have taken a novel approach to leverage national healthcare claims data that couples patient history with response to therapy. We have identified potential peripheral blood biomarkers of response to PD-1/PD-L1 inhibitors using a combination of healthcare outcomes and molecular markers that correlate with therapeutic efficacy

Immune Checkpoint Inhibition and the Prevalence of Autoimmune Disorders Among Patients with Lung and Renal Cancer

PURPOSE: Immune checkpoint inhibition reactivates the immune response against cancer cells in multiple tissue types and has been shown to induce durable responses. However, for patients with autoimmune disorders, their conditions can worsen with this reactivation. We sought to identify, among patients with lung and renal cancer, how many harbor a comorbid autoimmune condition and may be at risk of worsening their condition while on immune checkpoint inhibitors such as nivolumab and pembrolizumab. METHODS: An administrative health care claims database, Truven MarketScan, was used to identify patients diagnosed with lung and renal cancer from 2010 to 2013. We assessed patients for diagnosis of autoimmune diseases 1 year prior to or after diagnosis of cancer using International Classification of Diseases, Ninth Revision codes for 41 autoimmune diseases. Baseline characteristics and other comorbid conditions were recorded. RESULTS: More than 25% of patients with both lung and renal cancer had a comorbid autoimmune condition between 2010 and 2013 and were more likely to be women, older, and have more baseline comorbidities. CONCLUSIONS: This population presents a dilemma to physicians when deciding to treat with immune checkpoint inhibitors and risk immune-related adverse events. Future evaluation of real-world use of immune checkpoint inhibitors in patients with cancer with autoimmune diseases will be needed

Chaotic behavior of a discrete dynamical systems with complex parameter

In this paper, we present the equivalent system of complex logistic equation. We study some dynamic properties such as xed points and their asymptotic stability, Lyapunov ex-ponents, chaos and bifurcation. Numerical results which conrm the theoretical analysis are presented

The structural behavior of higher-strength concrete

Call number: LD2668 .T4 1984 R43Master of Scienc

Power Rayleigh Distribution for Fitting Total Deaths of Covid-19 in Egypt

The Rayleigh distribution incorporate the lifetime of an object or a service time. In this paper, a new model, called, Power Rayleigh distribution (PR) is submitted for specifying the confirmed total deaths of Corona virus (Covid-19) in Egypt. Statistical and reliability properties of the PR distribution such as survival function, failure rate function, mean residual life, order statistic and extreme value distribution are deduced and studied. Maximum likelihood method is used to evaluate the unknown parameters. Simulation Schemes are introduced. Finally, two sets of real-life data are construed and observed that the new model can provide a best fit to water runoff data and the total deaths of Covid-19 data than other well-known distributions

NANOEMULSION AS A NOVEL OPHTHALMIC DELIVERY SYSTEM FOR ACETAZOLAMIDE

Objective: The aim of this work was to formulate the antiglaucoma drug acetazolamide as ocular nanoemulsion of high therapeutic efficacy and prolonged effect. Methods: Eighteen nanoemulsion formulaions consisting of different oils, surfactants and cosurfactants at various ratios and constant water content (39%) were prepared based on their constructed pseudoternary-phase diagrams. According to the In vitro release studies, three nanoemulsions which exhibited fast drug release were used to prepare acetazolamide nanoemulsions with higher water content (59%). The six nanoemulsions at either water content (39 or 59%) were evaluated for their physicochemical properties and ex- vivo corneal permeability. In addition, Draize rabbit eye irritation test was performed. Moreover, biological evaluation of acetazolamide nanoemulsions for their intraocular pressure lowering activity on glaucomatous albino rabbits was carried out. Results: Isopropyl myristate nanoemulsion prepared with cremophor EL and transcutol P exhibited the fastest drug release among all isopropyl myristate nanoemulsions. Oleic acid nanoemulsion prepared with mixture of tween 80 and cremophor EL as surfactants together with transcutol P showed the fastest drug release among other oleic acid nanoemulsion formulae. Similar results were also observed for peanut oil nanoemulsions. The above mentioned formulations either at 39% or 59% water content showed acceptable physicochemical properties and higher acetazolamide permeability coefficient through goat corneas than that reported for the free drug. They also were non irritant to rabbit eye. Therapeutic efficacy testing revealed that peanut oil nanoemulsion at 39% water content showed better and prolonged intraocular pressure lowering effect relative to either commercial brinzolamide eye drops (Azopt®) or the commercial oral acetazolamide tablet (Cidamex®). Conclusion: Acetazolamide was successfully formulated in nanoemulsion form which revealed high therapeutic efficacy in treatment of glaucoma together with a prolonged effect