Computational modeling of nanodrug-induced effects on cardiac electromechanics

This work generally aims to promote the use of computational models for predicting side effects of nanodrugs under development, as a means to speed up the cycle of drug development, with potential savings on testing, and reduction in the need for animal or human testing. The specific objective of this thesis has been to accurately model a single ventricular contraction-relaxation cycle, and monitor the effects induced by nanodrugs on the electro-mechano-physiology of the left and right ventricles. Nanodrug interaction with ion channels located on cardiac cell membranes, such as those for sodium, potassium and calcium, can distort an electrical wave propagating through the tissue and can affect cardiac macroscale functions. In this study, a material model after Holzapfel and Ogden was developed to account for the anisotropic hyperelastic behavior of cardiac tissue, which was implemented on the open source software library Chaste. A coupled drug-electro-mechano-physiological system was then set up, also on Chaste, where a nanodrug effect was introduced into the cellular structure (nanoscale) as an ion channel inhibitor, and its influence then solved for, with respect to resulting electro-mechanical ventricular behaviors. Using quantifiable biomarkers, these effects were compared to the literature and clinical data. In this work we identified the following main results. Nanodrugs causing sodium channel blockage were found to produce the anticipated delays in electro-mechanics. Our study further predicted additional effects on LV twisting and LV & RV strain. On the other hand, nanodrugs causing potassium and calcium channel blockage revealed that cardiac mechanics is less responsive to mild alterations in electrophysiology, than electrophysiology is to ionic changes. Nonetheless, it is important to quantify these changes, as even a very small deviation from normal could accumulate over multiple cardiac cycles, and lead to adverse consequences on cardiac health in the long term

Developing A High-performance Liquid Chromatography Method for Simultaneous Determination of Loratadine and its Metabolite Desloratadine in Human Plasma

Background: Allergic diseases are considered as the major burden on public health with increased prevalence globally. Histamine H1-receptor antagonists are the foremost commonly used drugs in the treatment of allergic disorders. The target drug in this study, loratadine, belongs to this class of drugs and its biometabolite desloratadine which is also a non-sedating H1 receptor antagonist with anti-histaminic activity being 2.5 to 4 times greater than loratadine. This study aimed to develop and validate a novel isocratic Reversed-phase High-Performance Liquid Chromatography (RP-HPLC) method for rapid and simultaneous separation and determination of loratadine and its metabolite, desloratadine in human plasma. Methods: The drug extraction method from plasma was based on protein precipitation technique. The separation was carried out on a Thermo Scientific BDS Hypersil C18 column (5μm, 250 x 4.60 mm) in a mobile phase of MeOH: 0.025M KH2PO4 adjusted to pH 3.50 using orthophosphoric acid (85: 15, v/v) at an ambient temperature. The flow rate was maintained at 1 mL/min and maximum absorption was measured using the PDA detector at 248 nm. Results: The retention times of loratadine and desloratadine in plasma samples were recorded to be 4.10 and 5.08 minutes, respectively, indicating a short analysis time. Limits of detection were found to be 1.80 and 1.97 ng/mL for loratadine and desloratadine, respectively, showing a high degree of sensitivity of the method. The method was then validated according to FDA guidelines for the determination of the two analytes in human plasma. Conclusion: The results obtained indicate that the proposed method is rapid, sensitive in the nanogram range, accurate, selective, robust and reproducible compared to other reported methods

Financial Inclusion and Extreme Poverty in the MENA Region: A Gap Analysis Approach

Eradicating extreme poverty remains one of the most significant and challenging Sustainable Development Goals (SDGs) in the Middle East and North African (MENA) region. The latest World Bank statistics from 2018 show that extreme poverty in MENA increased from 2.6% to 5% between 2013 and 2015. MENA ranks third among developing regions for extreme poverty, and fell short of halving extreme poverty by 2015 – the target established by the United Nations’ Millennium Development Goals, the precursor to the SDGs. Using system General Method of Moments dynamic panel estimation methodology on annual data for 11 MENA countries and 23 emerging markets (EMs) over the period 1990 – 2017, this study begins by estimating the impact of financial inclusion – using measures of access and usage – on the eradication of extreme poverty by 2030, the first goal of the SDGs. The results of the study indicate that, on one hand, financial access measures have a positive, statistically significant impact on reducing extreme poverty for the full sample as well as the MENA region. On the other hand, financial usage measures are only statistically significant in reducing extreme poverty for the full sample, but not for the MENA region. The second part of the study employs a gap analysis against four poverty targets—0%, 1.5%, 3%, and 5%—and shows that no MENA country and few EM countries will be able to close the extreme poverty gap and reach the target of 0% by 2030 by depending solely on improvements in financial access. These targets are based on the two benchmarks set by the World Bank and the UN, with intermediaries to capture error and give a fuller picture of what is possible. However, if improvements in financial inclusion alone can bring every EM and MENA country except Djibouti and Romania to bring the most accessible target of reducing global extreme poverty to no more than 5% by 2030. Policy considerations can be directed towards developing and promoting the infrastructure needed for the widespread delivery and usage of financial services, especially for the MENA and EM countries lagging behind the extreme poverty target. Special attention should be paid to the support of digital financial inclusion for its ability to help individuals cope with shocks without reducing consumption. Delivery and usage of financial technology is predicted to magnify the impact of financial inclusion on poverty reduction both directly – as shown in this paper – and indirectly – through channels related to other SDGs. Additionally, governments in the MENA region must take data quality and availability more seriously if they expect to reverse the acceleration of extreme poverty in the digital age

Financial Inclusion and Extreme Poverty in the MENA Region: A Gap Analysis Approach

Eradicating extreme poverty remains one of the most significant and challenging Sustainable Development Goals (SDGs) in the Middle East and North African (MENA) region. The latest World Bank statistics from 2018 show that extreme poverty in MENA increased from 2.6% to 5% between 2013 and 2015. MENA ranks third among developing regions for extreme poverty, and fell short of halving extreme poverty by 2015 – the target established by the United Nations’ Millennium Development Goals, the precursor to the SDGs. Using system General Method of Moments dynamic panel estimation methodology on annual data for 11 MENA countries and 23 emerging markets (EMs) over the period 1990 – 2017, this study begins by estimating the impact of financial inclusion – using measures of access and usage – on the eradication of extreme poverty by 2030, the first goal of the SDGs. The results of the study indicate that, on one hand, financial access measures have a positive, statistically significant impact on reducing extreme poverty for the full sample as well as the MENA region. On the other hand, financial usage measures are only statistically significant in reducing extreme poverty for the full sample, but not for the MENA region. The second part of the study employs a gap analysis against four poverty targets—0%, 1.5%, 3%, and 5%—and shows that no MENA country and few EM countries will be able to close the extreme poverty gap and reach the target of 0% by 2030 by depending solely on improvements in financial access. These targets are based on the two benchmarks set by the World Bank and the UN, with intermediaries to capture error and give a fuller picture of what is possible. However, if improvements in financial inclusion alone can bring every EM and MENA country except Djibouti and Romania to bring the most accessible target of reducing global extreme poverty to no more than 5% by 2030. Policy considerations can be directed towards developing and promoting the infrastructure needed for the widespread delivery and usage of financial services, especially for the MENA and EM countries lagging behind the extreme poverty target. Special attention should be paid to the support of digital financial inclusion for its ability to help individuals cope with shocks without reducing consumption. Delivery and usage of financial technology is predicted to magnify the impact of financial inclusion on poverty reduction both directly – as shown in this paper – and indirectly – through channels related to other SDGs. Additionally, governments in the MENA region must take data quality and availability more seriously if they expect to reverse the acceleration of extreme poverty in the digital age

Beyond the Digital Dividends: Fintect and Extreme Poverty in the Middle East and Africa

This study analyzes the impact of the proliferation of Financial Technology (FinTech) on the achievability of the Sustainable Development Goals (SDGs) with respect to extreme poverty by 2030. The study uses system General Method of Moments (GMM) dynamic panel estimation methodology on annual data for 12 MENA and 45 SSA countries in addition to 70 emerging markets and developing economies from outside the two regions over the period from 2004 until the latest available data in 2018. Three different measures characterize FinTech adoption: the number of mobile cellular subscriptions per 100 people, the number of fixed broadband subscriptions per 100 people, the percentage of people in the population who use the internet. The preliminary results of the study indicate that FinTech measures have a positive statistically significant impact on reducing extreme poverty for the full sample as well as the MENA and the SSA regions. The second part of the study employs a gap analysis against four poverty targets — United Nations’ 0%, World Bank’s 5%, and two intermediaries of 1.5% and 3% to capture all possibilities. The results of the gap analysis suggest that the situation in the MENA region is more promising than the SSA region where improvements in FinTech along will bring extreme poverty below 5% in all MENA countries with the exception of Yemen and Djibouti. For the SSA region, only 4 out of the 45 countries; Gabon, Cabo Verde, Seychelles, and Mauritius are able to close the extreme poverty target of 5%. The paper concludes that poverty alleviation goes beyond digital dividends and identifies human capital accumulation and improvement in governance as the prerequisites for realizing the potential of FinTech and its contribution to the efforts of eradicating extreme poverty within a policy framework to achieve the SDGs in both the MENA and SSA regions

The edge environment in Cairo: An approach to reading the social pattern language of the Middle Eastern built environment

AbstractThis paper introduces a new concept that might help in reading both social life and urban process, showing how they are interlocked in a way that clarifies ideologies and their implications for the physical form of the city. This reading is capable of envisioning and analysing the relationship between the cohesive social pattern language of traditional built environment and its physical expression, relying on a new reflective and exploratory concept, the edge environment. This illuminates the relationship between the values hidden beneath the physical edges of spatial morphology in Middle Eastern urban contexts like Cairo, and allows those values to be understood in terms of modern ideologies relating to the human community. The concept of edge environment might help in the design education particularly in conservation and up-grading processes, as an analytical tool and as a design method by careful interventions at edges by fine tuning of the edge environment

Towards Patient-oriented Design: A Case of the Egyptian Private Outpatient Clinics

In this paper, outpatient clinics’ systems are addressed and their common issues were discussed. As a case study, the private clinics in Egypt are used, and a designed service solution was synthesized. In the case study, the system and application was mainly physician-oriented rather than patient-oriented. With such physician-oriented systems alongside with the current design approaches, waiting times and appointment scheduling are two critical issues. Therefore, in this study, a design thinking approach was implemented to address these design problems for patients and clinic staffs. Based on that analysis, a design application solution called “YourClinic” was developed to support online booking and consultation. This study provides design features and functions to improve the quality of communication between patients and clinic staffs, reduce waiting time, and develop schedules for patients and staffs in order to move towards a patient-oriented clinic service

Toxic effects of formalin-treated cadaver on medical students, staff members, and workers in the Alexandria Faculty of Medicine

Background: Formaldehyde can be toxic, allergenic and carcinogenic. Evaporation of formaldehyde from formalin-treated cadavers in the anatomy dissection rooms can produce high exposure. This study was conducted to assess acute and chronic toxic effects of formalin-treated cadavers on medical students, staff members, and workers at the Anatomy department in the Alexandria Faculty of Medicine (AFM).Methods: A cross sectional approach was adopted to investigate medical students (n = 454). Staff members and workers at the Anatomy department (n = 16), and unexposed staff members and workers in the AFM (n = 19) were included in the study. Medical students filled self-administered predesigned questionnaire. Formalin-exposed and unexposed staff members filled a questionnaire and a Complete Blood Count was done for them.Results: The most frequently reported symptoms by medical students were unpleasant smell (91.2%), itching in the eyes (81.3%), and excessive lacrimation (76.1%). Majority of them reported duration of relief within one hour (>80%), and more than two thirds reported wearing laboratory coats and hand gloves. Formalin-exposed staff reported symptoms of skin disorders as drying (75%), eczema (68.8%), and allergic contact dermatitis (87.5%), besides, eye irritation (68.8%), respiratory tract irritation (93.8%), and workrelated bronchial asthma (53.3%). The mean RBCs and platelets counts were significantly lower among formalin-exposed staff (4.08 ± 0.65 106/ul and 237,375 ± 71745.73/ul respectively) compared with unexposed staff (4.95 ± 0.50 106/ul and 280473.68 ± 54456.27/ul respectively). WBCs count was abnormal (low or high) among formalin-exposed staff members (6.2%, and 18.8% respectively), while all unexposed staff had normal WBCs counts.Conclusion: The research highlighted the irritating action of formalin on medical students, and chronic toxic effects on staff members. This necessitates re-evaluation of the concentration of formalin, proper ventilation and assessment of working practices in the dissecting rooms at the Anatomy department

Investigating the factors of selecting audit clients: Evidence from an emerging market

This study investigates the insights and criteria audit partners use to select prospective clients in an emerging market. We use questionnaires to solicit responses from a sample of auditors at the partner/manager level in Big and non-Big 4 audit firms with international affiliations in an emerging economy. Descriptive statistical tools including the chi-square test and multiple logistic regression analysis are used for the analysis. This study finds that auditor reputation enhancement and corporate governance effectiveness are significantly associated with the acceptance of listed companies and that the higher financial reporting quality of listed companies and the need to promote audit and assurance services are significant factors affecting such decisions. Audit firms tend to select parents or subsidiaries because of the expected effective audits and reduced misstatement and litigation risks and audit firm industry expertise is needed to mitigate expected client risks to significantly affect the selection of clients with prior-year audit qualifications. Fraud is significantly associated with the selection of clients with prior violations reported by government monitoring bodies. This study is among the few empirical studies in emerging economies that provide insights from practicing auditors on a set of comprehensive attributes that affect the selection of audit clients. The findings have implications for audit partners and firms, auditees, and the audit profession in selecting clients that fit the firm’s and profession’s vision of audit branding and reputatio

An urban code in traditional Middle Eastern contexts: The edge environment as a central theme for reading the social pattern language of historic sites

This article discusses a new concept that may help professionals and specialists read the “urban code” of Middle Eastern traditional contexts that was developed from the mix of social aspect and spatial morphology, illustrating how these elements are interconnected in a way that highlights the values and qualities and their reflections on the physicality of the city. This urban code envisions and analyses the relevance of the social pattern language of the traditional context to its urban manifestation, leaning on the “edge environment” as a new generative concept. It outlines the relationship between the ideologies buried underneath the walls of the spatial form of traditional built environment such as Cairo and sheds light on those ideologies in a way that helps us read them within the context of modern values pertained to the sense of community. The notion of the edge environment may contribute to design education restoration, preservation, and upgrading processes as design toolkit that employs careful interventions by fine-tuning the edge environment