Diabetic nephropathy (DN) is the foremost cause of end-stage renal disease. Early detection of DN can spare diabetic patients of severe complications. This study aimed to evaluate the diagnostic value of red cell distribution width (RDW) and neutrophil-lymphocyte ratio (NLR) in the detection of DN in patients with type 2 diabetes mellitus (T2DM). This cross-sectional study included a total of 130 patients with T2DM, already diagnosed with T2DM. The albumin creatinine ratio (ACR) in urine samples was calculated for each patient, according to which patients were divided into two groups: with evidence of DN when ACR ? 30 mg/g, and those with no evidence of DN when ACR < 30 mg/g. According to multivariate analysis, each of disease duration (OR = 4.43, 95% CI = 1.68-11.68, p = 0.003), HbA1c (OR = 6.4, 95% CI = 2.32-17.65, p < 0.001) and NLR (OR = 13.75, 95% CI = 1.68-11.68, p < 0.001) were independent predictors for DN. Using the receiver operating characteristic (ROC) curve to evaluate the diagnostic value of NLR revealed that the AUC was 0.736 (95% CI = 0.635-0.837), p < 0.001. The sensitivity and specificity of the test at the cut-off value of NLR = 3.35 was 69% and 89%, respectively. These data indicate that NLR is a simple non-expensive test that can be used regularly to investigate diabetic patients for the development of DN. Red cell distribution width (RDW), on the other hand, had no diagnostic value in this regard.
Primary and secondary response loss , often mediated by the development of anti-drug antibodies (ADAs), limit treatment efficacy. Therapeutic drug monitoring (TDM) is important in optimizing infliximab therapy by correlating drug level with clinical outcomes. This study aimed to find the relationship between infliximab level, ADA presence, and clinical activity in Iraqi Crohn's disease (CD) patients. This cross-sectional study included adult Crohn's disease patients receiving maintenance infliximab (IFX) treatment. Data on demographics and clinical characteristics were collected. Infliximab level and ADA were measured using ELISA. Forty-three patients were included. Patients in remission had significantly higher infliximab levels and lower
... Show MoreThe research aims to how to deal with certain situation to ensure the continuous competitive excellence of business market under the situation of covid-19, especially how to deal with major challenges, identifying the capabilities of tourism industry, investigating the ability of tourism agencies to resist the dynamic change of both internal as well as external environment to ensure their sustainability.
The important here as the paper notice, is how to be efficient and trying to find solutions in order to grow and survive through choosing certain strategies that aligned the critical issues.
Thus to achieve this level, many scenarios planed that could adopt in case of such pande
... Show MoreThis study aims to deeply analyze the character of serial killers in Thomas Harris’ novels and focuses on his novel Red Dragon. The Study searches in these complex and deep characters through the use of Erich Fromm's concepts about the destructive nature of the human psyche and what are the factors affecting serial killers in all social psychological, and biological aspects. This study Concluded: Thomas Harris portrayed the characters of serial killers in a professional and complex and made the reader go on a contemplative journey in the mind and soul of the serial killer, thus reaching the climax of artistic perfection.
Solar tracking systems used are to increase the efficiency of the solar cells have attracted the attention of
researchers recently due to the fact that the attention has been directed to the renewable energy sources. Solar tracking systems are of two types, Maximum Power Point Tracking (MPPT) and sun path tracking. Both types are studied briefly in this paper and a simple low cost sun path tracking system is designed using simple commercially available component. Measurements have been made for comparison between fixed and tracking system. The results have shown that the tracking system is effective in the sense of relatively high output power increase and low cost.
This study investigated the bioethanol production from green algae Chlorella vulgaris depending on its carbohydrate-enriched biomass. Four different phosphorous concentrations were employed to stimulate bioethanol production from Chlorella vulgaris. The impact of various phosphorous values on Chlorella vulgaris growth rate as well as primary product (carbohydrate) were evaluated. High performance liquid chromatography was utilized in this work. The stationary phase was identified as day 14, 12, 10 and 6 in treatments 6, 4, 2 and g/L, respectively. The findings suggest that the treatment without phosphorous addition had the highest record of carbohydrate content (22.64% dry weight) as well as the highest bioethanol yield (20.66% dry weight).
... Show MoreThe widespread use of the Internet of things (IoT) in different aspects of an individual’s life like banking, wireless intelligent devices and smartphones has led to new security and performance challenges under restricted resources. The Elliptic Curve Digital Signature Algorithm (ECDSA) is the most suitable choice for the environments due to the smaller size of the encryption key and changeable security related parameters. However, major performance metrics such as area, power, latency and throughput are still customisable and based on the design requirements of the device.
The present paper puts forward an enhancement for the throughput performance metric by p
... Show MoreThe world and the business environment are constantly witnessing many economic changes that have led to the expansion of the business' volume due to mergers and the increase in an investments volume and the complexity of business and the transformation of some systems, which was reflected on the size of the risk and uncertainty which led to necessity of a presence of transparent and objective accounting information In the way that reflects the financial performance of the economic units to be available to all users of that information, therefore, The need for the existence of indicators for transparency in the disclosure of accounting information that these units adhere to. Standards & Poor's indicators, which included items
... Show MoreResults showed high efficiency of the predator Chrysoperla carnea (Stephens) to attack and consume nymphal instars and adults of cabbage aphid, Brevicoryne brassicae (L.).The total average of the nymphal instars consumed by the larval stage of predator were 308.67, 285.9, 198.77, 154.7 for 1st ,2nd ,3rd ,4th nymphal instars respectively .While it was 110,107.9 for apterae and alatae respectively . Also, predation efficiency increases with the progress of the larval instars up to the third (last) which was the most voracious .The 1st instar nymph consumed by the larvae of the predator were 47,80,181.67 nymphs ,with predation rate of 14.71% , 23.75% and 50.13% for 1st ,2nd and 3rd larval instars
The research aimed to prepare a psychological counseling program for the coaches of the Sports Care Center in the gymnasium, and to learn about the impact of the psychological counseling program in reducing irrational ideas and causal attribution of the coaches of the Sports Talent Care Center in the gymnasium, to assume that there are statistically significant differences between the results of the tribal and posttests of the research group Experimental in the scale of irrational ideas, and there are statistically significant differences between the results of the tribal and posttests of the experimental research group in the scale of the causal attribution scale, The experimental approach was adopted by designing one experimental
... Show MoreAbstract\
The value chain analysis is main tools to achieve effective and efficient cost management; it requires a depth and comprehensive understanding for all internal and external activities associated with creating value. Supply chain as apart of value chain, that means managing it in active and efficient can achieve great results when adopting a comprehensive and integrated performance for these two chains activities. The research aims to identify possible ways to integrate the performance of value and supply chains of the sample" Kufa-cement plant" and determine the effect of this integration in enhancing customer value. The research arrival that logical and integrated analysis of value and supply chains helps
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