Covalent modification of protein by drugs may disrupt self-tolerance, leading to lymphocyte activation. Until now, determination of the threshold required for this process has not been possible. Therefore, we performed quantitative mass spectrometric analyses to define the epitopes formed in tolerant and hypersensitive patients taking the β-lactam antibiotic piperacillin and the threshold required for T cell activation. A hydrolyzed piperacillin hapten was detected on four lysine residues of human serum albumin (HSA) isolated from tolerant patients. The level of modified Lys541 ranged from 2.6 to 4.8%. Analysis of plasma from hypersensitive patients revealed the same pattern and levels of modification 1–10 d after the commencement of therapy. Piperacillin-responsive skin-homing CD4+ clones expressing an array of Vβ receptors were activated in a dose-, time-, and processing-dependent manner; analysis of incubation medium revealed that 2.6% of Lys541 in HSA was modified when T cells were activated. Piperacillin–HSA conjugates that had levels and epitopes identical to those detected in patients were shown to selectively stimulate additional CD4+ clones, which expressed a more restricted Vβ repertoire. To conclude, the levels of piperacillin–HSA modification that activated T cells are equivalent to the ones formed in hypersensitive and tolerant patients, which indicates that threshold levels of drug Ag are formed in all patients. Thus, the propensity to develop hypersensitivity is dependent on other factors, such as the presence of T cells within an individual’s repertoire that can be activated with the β-lactam hapten and/or an imbalance in immune regulation.
Sickle cell disease (SCD) is a hereditary ailment that can cause severe pain and suffering to people who are affected. However, with continued investment in research and treatment options, we can make progress towards improving the lives of those with SCD. Over 40% of patients experience painful vaso-occlusive crises (VOCs), so we must work towards finding solutions and providing support for those living with this condition, These episodes, a hallmark of SCD, significantly contribute to morbidity, mortality, and a diminished quality of life, while also incurring substantial healthcare costs. Chronic pain particularly affects older adolescents and adults with SCD, with over half reporting daily discomfort. Opioid-based analgesics, though sti
... Show MoreThe service system has become a necessity of life in modern cities to be the most basic necessities of modern humans, they constitute a major base, which is based on the sustainability of life in the city and a standard measured through the degree of well-being and progress of civilized peoples and their interaction with the surrounding environment, making the services sector as a need not be an option, whenever the cities widened in population and space whenever provision of services and upgrading the quality and quantity more pressing, which made the subject of the services takes the biggest area of the trends and thinking of urban planners and those who in charge of drawing the cities policies. Consideri
... Show MoreThis paper aims to explain the effect of the taxes policy including direct & indirect taxes on supporting the domestic Investment in Iraq. This could help the official planners for drawing the future policies that help provoking (istumlating) the domestic investment in Iraq the quantitative analysis approach was adopted using regression model. The results showed the significance of the effects of both direct & indirect taxes policies on domestic as a simple correlation coefficient ( r ) of ( 0.6 ) , ( 0.64 ) respectively.
This study attempts to test the possibility of developing organizational performance in Zain Telecom by adapting the philosophy and concept of Organizational Identification and its dimensions, the most important of which are (Organizational Identification, organizational loyalty, organizational affiliation).To achieve the goal, the research relied on the questionnaire method, which is one of the methods of collecting information in field studies.
The current research aims to evaluate the level of inclusive leadership within the General Secretariat for the Council of Ministers, and its role in achieving integration in work through the need to improve relationships between different administrative levels, facilitate participation, expression of opinions, and belonging to the organization. In order to achieve the research objective, the descriptive analytical statistical method was chosen using the SPSS V.25 programs, with various statistical methods and measures, including mean, standard deviation, variance coefficient, relative importance, and simple regression, through a questionnaire tool for data collection. The research community included the leadership in the sample of resear
... Show MoreThe purpose of this study is to assess the performance of government units (Iraqi hospitals) by trying to determine the possibility of the current governmental accounting system to provide information on the performance reports of government units. In order to improve the efficiency of hospital resources management, the services provided by the hospital should be subject to performance measurement and evaluation The importance of the health sector in the provision of services, in order to raise the efficiency of the performance of services provided by government units has reached the researcher a set of conclusions, the most important
- The financial reports produced by the accounting s
This study focuses on the basics of cultivation and production of the Wheat Crop in
Wasit Province ; in order to reveal the reality of the geographical distribution of its cultivation
and production.
Wheat is the most important field crops cultivated in Wasit province, as it has vast
possibilities for expansion in growing and production, in which agriculture conducted in a
year and left in other , then changing this method would increase cultivated area of it to nearly
doubled, as well as the possibility of increasing average yields in Donam by using improved
seeds, fertilizer, with the availability of water lever machines, especially wheat is grown in
areas of rivers abutment.
The study showed the spread of th
Native speakers of English from different parts of the world have different accents,but the differences of accents are mainly the result of differences in the sound of vowels and consonants . The actual use of all these sounds in combination leads the speaker to produce a number of segments which only appear on the production level and realized on the perceptual one . RP pronunciation represents the teachable variety in all Iraqi universities because it is the most acceptable and understandable accent all over the world and not only in South East London ..The structure of the English syllable in RP pronunciation is influenced by the appearance of certain allophones especially aspiration and glottalization which ch
... Show MoreThis work evaluates the economic feasibility of various production scenarios for the Zubair reservoir in the Kifl oil field using cash flow and net present value (NPV) calculations. The Kifl field is an exploratory field that has not yet been developed or assessed economically. The first well was drilled in 1960, and three other wells were later drilled to assess the oil accumulation, so in this research, Different production scenarios were evaluated economically. These scenarios were proposed based on the reservoir model of the Zubair formation in the field. The research methodology used QUE$TOR software to estimate capital expenditures (CapEx) and operating expenditures (OpEx) based on field-level data, production prof
... Show MoreObjective: Assessment of health problems and identify demographical information to elderly. Methodology:
it is a descriptive study, data were collected by the researchers depended on the direct interview with the
elderly by using the study instrument (questionnaire) as well as review the records of the geriatric.
Results: The majority of study sample (66%) were males and (24.3%) were within age group (70-74) years,
(44.7%) were widows, and (41.7%) did not read and write. This study applied the international classification
of diseases(short-table) in (11) items, which stated that most of the elderly were complaining from
health problems: debility of hearing (80.65%), eczema or allergies (69.35%), debility of vision (66.9