Systemic lupus erythematosus (SLE) is an autoimmune disease with polymorphic expression. B cells have an essential contribution in immune system activation via the production of different cytokines and functioning as potent antigen-presenting cells. Therefore, a drug that particularly targets B cells may represent an ideal therapeutic approach for SLE. Rituximab (RTX), an anti-CD20 monoclonal antibody causing transient B-cell depletion, has been used to manage SLE. This study aims to assess Rituximab effects on lupus nephritis (LN) patients when added to conventional immunosuppressants. Twenty four patients, 15-32 years old, with class III/IV/V LN were involved in this study. All were on steroids before lupus nephritis occurrence. They were given rituximab induction therapy and mycophenolate mofetil (MMF) maintenance therapy. RTX was indicated for refractory and relapsing SLE. Several investigations done before and after RTX treatment and in the last follow up (done one year after starting Rituximab). Those included protein in urine, serum creatinine, double stranded DNA, C3, C4, and Estimated Glomerular Filtration Rate (eGFR). Proteinuria decreased significantly after RTX treatment and in the last measurement (P=0.01 and P=0.001, respectively). Serum creatinine significantly decreased only in the last measurement (P=0.02). Double stranded DNA decreased remarkably after treatment (P=0.01) with a further decrease in the last measurement (P=0.006). C3 and C4 increased after treatment but the increase was significant only for C3 (P=0.002) and this increase continues till the last measurement (P=0.0006). Active urine sediments found in fifteen patients and disappeared after RTX treatment. Rituximab can be promising in treating lupus nephritis when used along with traditional immunosuppressants. It can reduce disease activity and improve renal function in such patients.
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Sub-threshold operation has received a lot of attention in limited performance applications.However, energy optimization of sub-threshold circuits should be performed with the concern of the performance limitation of such circuit. In this paper, a dual size design is proposed for energy minimization of sub-threshold CMOS circuits. The optimal downsizing factor is determined and assigned for some gates on the off-critical paths to minimize the energy at the maximum allowable performance. This assignment is performed using the proposed slack based genetic algorithm which is a heuristic-mixed evolutionary algorithm. Some gates are heuristically assigned to the original and the downsized design based on their slack time determined by static tim
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When we talk about the foresight in films, it is necessary to talk about dreams because foresight represents one of its distinct types. The Precognitive vision has become a possible material in dealing with as subjects in the film industry that adopt these ideas with their philosophical and scientific orientations, because they represent the imagination that predictors are specialized with. It can be invested through the introduction of a vision of another kind to achieve its goals and ambitions in the film industry and in particular the huge institutions of production as in Hollywood. The cinema works in the light of those concepts of production which found the prognostic dream (the foresight) as a distinctive genre in its films,
Th
Planning of cities show great attention on streets planning as one of the most structural component foundations for cities, that providing many functional needs and connect parts of the city each other, and work as a commercial and services activities centers. Instead of this highly focused on distributing streets with different streets types such as economical and trading and housing streets. This concerned was only on the dimensions and scales of different types of vehicles and their movement. When scale and dimension and movement of mans were as a second priority in designing and planning streets. Which came's first for traditional streets. The research try to submit some designs guides for planners that contribute in re conce
... Show MoreIn the last decades, using mineral admixture in concrete became very necessary to improve concrete properties and reduce CO2 emissions associated with the cement production process. Subsequently, more sustainable concrete can be obtained. Ternary blended cement containing two different types of mineral admixture can achieve ambitious steps in this trend. In this research, the synergic effects of mineral admixtures in ternary blended cement and its effects on concrete fresh properties, strength, durability, and efficiency factors of mineral admixture in ternary blended cement, were reviewed. The main conclusion reached after reviewing many literature pieces is that the concrete with ternary blended cement
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The problem of the paper focused on the role of the learning organization in the crisis management strategy, and the extent of the actual interest in both the learning organization and the crisis management and aimed at diagnosing and analyzing that and surrounding questions. The Statistical Package for the Social Sciences (SPSS) program was used to calculate the results and the correlation coefficient between the two main variables. The methodology was descriptive and analytical. The case study was followed by a questionnaire that was distributed to a sample of 31 teachers. The paper adopted a seven-dimensional model of systemic thinking that encourages questioning, empowerment, provision of advanced technologies, and strategic lea
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Background: Patients requiring renal biopsies have various glomerular diseases according to their demographic characteristics.
Objective: To study types of glomerular disease among adult Iraqi patients in a single center in Baghdad/Iraq
Material and Methods: A total of 120 native kidney biopsies were studied. All biopsies were adequate and were processed for Light Microscopy.
The age range of the study patients was 17-67 years, with a mean of 38.5 years. The mean follow up period was 28 weeks (4-52 weeks)
Indication for biopsy included: Nephrotic syndrome (N=72; 60%), Asymptomatic proteinuria (N=21; 17.5%), acute nephritic presentation (N=17; 14.16%), asymptomatic haematuria (N=10; 8.33%).
Results: Primary glomerulonephrit