The clinical response to natalizumab in patients with multiple sclerosis (MS) may be significantly influenced by genetic variation. Mutations in genes related to the drug’s mechanism of action or the pathological milieu of MS can contribute substantially to interindividual differences in treatment outcomes. This review aims to provide an overview of previous studies that have examined genetic polymorphisms associated with the clinical efficacy of natalizumab. A systematic literature search was conducted across the PubMed, Google Scholar, and ResearchGate databases using targeted keywords relevant to the subject matter. Several genetic loci were found to be linked to natalizumab responsiveness, including the integrin subunit alpha 4 (ITGA4

Traffic loading and environmental factors are among the most serious variables that cause the spoilage of flexible pavements and lead to a decrease in their design life. The objective of this study is to investigate the influence of axle load raise and the change in resilient modulus on the flexible pavement design life. Locally, Highway geometric design code for Iraqi building code has assign certain admissible maximum load limits per every axle truck type that should not be overrun. In this paper nine different axle truck loads (8, 9, 10, 11, 12, 13, 14, 15, and 16) tons, single axle with dual tire and, and two different resilient moduli of asphalt pavement were chosen. The evaluation was carried out assuming high temperature to represent

When the flange of a reinforced concrete spandrel beam is in tension, current design codes and specifications enable a portion of the bonded flexure tension reinforcement to be distributed over an effective flange width. The flexural behavior of the RC L-shaped spandrel beam when reinforcement is laterally displaced in the tension flange is investigated experimentally and numerically in this work. Numerical analysis utilizing the finite element method is performed on discretized flanged beam models validated using experimentally verified L-shaped beam specimens to achieve study objectives. A parametric study was carried out to evaluate the influence of various factors on the beam’s flexure behavior. Results showed that

 Background: The normal decline in systolic blood pressure during recovery phase of treadmill exercise dose not occur in most patients with coronary artery disease, in others recovery values systolic blood pressure may even exceed the peak exercise value. Objectives: Treadmill exercise test parameters indicating the presence and extent of coronary artery disease have traditionally included such as exercise duration, blood pressure and ST-segment response to exercise. The three –minute systolic blood pressure ratio is another important indicator of presence and significance of coronary artery disease is useful and obtainable measure that can be applied in all patients who are undergoing stress testing for evaluation of suspected is

Bacterial toxins are considered to be virulence factors due to the fact that they interfere with the normal processes of the host cell in which they are found. The interplay between the infectious processes of bacteria and the immune system is what causes this impact. In this discussion, we are going to focus on bacterial toxins that act in the extracellular environment, especially on those that impair the activity of macrophages and neutrophils. These toxins are of particular interest since they may be found in a wide variety of bacteria. We will be concentrating our efforts, in particular, on the toxins that are generated by Gram-positive and Gram-negative bacteria. These toxins are able to interact with and have an effect on the many dif