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.
Kinematics is the mechanics branch which dealswith the movement of the bodies without taking the force into account. In robots, the forward kinematics and inverse kinematics are important in determining the position and orientation of the end-effector to perform multi-tasks. This paper presented the inverse kinematics analysis for a 5 DOF robotic arm using the robotics toolbox of MATLAB and the Denavit-Hartenberg (D-H) parameters were used to represent the links and joints of the robotic arm. A geometric approach was used in the inverse kinematics solution to determine the joints angles of the robotic arm and the path of the robotic arm was divided into successive lines to accomplish the required tasks of the robotic arm.Therefore, this
... Show MoreA ‘locking-bolt’ demountable shear connector (LBDSC) is proposed to facilitate the deconstruction and reuse of steel-concrete composite structures, in line with achieving a more sustainable construction design paradigm. The LBDSC is comprised of a grout-filled steel tube and a geometrically compatible partially threaded bolt. The latter has a geometry that ‘locks’ the bolt in compatible holes predrilled on the steel flange and eliminates initial slip and construction tolerance issues. The structural behaviour of the LBDSC is evaluated through nine pushout tests using a horizontal test setup. The effects of the tube thickness, strength of concrete slab, and strength of infilled grout on the shear resistance, initial stiffness, and du
... Show MoreAbstract
This research aims to design a multi-objective mathematical model to assess the project quality based on three criteria: time, cost and performance. This model has been applied in one of the major projects formations of the Saad Public Company which enables to completion the project on time at an additional cost that would be within the estimated budget with a satisfactory level of the performance which match with consumer requirements. The problem of research is to ensure that the project is completed with the required quality Is subject to constraints, such as time, cost and performance, so this requires prioritizing multiple goals. The project
... Show MoreThere is a growing interest in studying the effects of arthritis on a person's work productivity using a growing variety of outcome indicators.
To develop a valid and reliable shortened version of the Workplace Activity Limitation Scale 12 (WALS‐12) for assessing work productivity limitations in rheumatoid arthritis (RA) patients.
A cross‐sectional study involving 277 RA patients was conducted. An exploratory factor analysis on WALS‐12 was used for item reduction on the first sample. Then confirmatory factor ana
The importance of this research is due to its importance goals, Which are about the attempt of researchers to investigate the probability of depending on businesses, environments to transform organizations, performance in away that enhance the leading role of organizations in their environments , and through views of a number of the staff working in the foundation of technical institutes in Mosul. .
After deciding the methodology of the study that ,in one hand ,performs the goals of the study , and achieving a suitable theoretical framework to present the concepts of businesses, environments and the leadin
... Show MoreThe present study is an attempt to throw light on the nature of the US policy regarding the Middle East region as portrayed by AI-Sabah, Al-Mashriq and Tariq Al-Shaab papers over a period of three months from 1st of July to 30th of September 2013.
In writing this study, a number of goals have been set by the researcher. These goals may include but in no way limited to the nature of the US image as carried by the above three papers, the nature of the topics tackled by them and the nature of the Arab countries which received more and extensive coverage than others.
A qualitative research approach is proposed for the study. This approach has allowed the researcher to arrive at definite answers for the possible questions rais
... Show Moreבמחקר הזה ניתחנו מספר נאומים של שמעון פרס, אנחנו התמקדנו בהשפעה והשכנוע אצל שמעון פרס ואיך הוא יכול להעביר את המסרים של נאומיו בסגנון פרגמטי כדי להגיע ללבו של הציבור.
גם כן, התמקדנו בסגנון הפוליטי שהוא חושב כי התחום הזה צריך להיות ברור מול הציבור וגם כן מול דעת הקהל הבינלאומי מתוך השימוש במונחים בעלי השפעה ושכנוע להגיע למטרות המבוקשות.
במלים אחרות, שמעון פרס, לעתים, מתמקד בשפה מליצית ויעמוד הרב
... Show MoreIn addition to being a novel medication in treating obesity and type 2 diabetes mellitus, tirzepatide is currently being studied to assess its effectiveness and safety on various health parameters, specifically with an emphasis on the neurological field, including sleep medicine and neurodegenerative conditions. In this perspective, we highlight the recent FDA approval of tirzepatide’s use for the treatment of obstructive sleep apnea, with recommendations for future research to extend use in children and adolescents.
The Target costing is an important modern techniques strategic managerial accounting.which is been shown active adoption to changes in contemporary business environments Inaddition,they had been adopted by the units as aresult of the growth in the strategic approach in the man agement..the goal of using target costing is to build and strengthen competitive abilities of economic units thvough introducing appropriate ways to decrease cost and improving quality of product The hypothesis reflects interest in achieving the goal of the research,ie.research question,The hypothesis use target costing to assist economic units to decrease cost and in the manner that leads to competitive advantages while surviving and flourishing in current busines
... Show MoreThe aim of t his p aper is t o const ruct t he (k,r)-caps in t he p rojective 3-sp ace PG(3,p ) over Galois field GF(4). We found t hat t he maximum comp let e (k,2)-cap which is called an ovaloid, exist s in PG(3,4) when k = 13. Moreover t he maximum (k,3)-cap s, (k,4)-cap s and (k,5)-caps.