Striking enhancement at the site of radiation for nivolumab-induced Stevens-Johnson syndrome

Stevens-Johnson syndrome is a rare adverse cutaneous drug reaction characterized by epidermal detachment of <10% body surface area with an average mortality rate of 1-5%. The mechanism of SJS is not fully understood. Nivolumab is a monoclonal antibody directed against programmed cell death-1 protein (PD-1), a receptor with immune checkpoint inhibitory and antineoplastic activities. We present a case of SJS in a patient being treated with anti-PD-1 therapy nivolumab for metastatic squamous cell carcinoma of the oropharynx. This case is unusual because of the severe accentuation with striking enhancement at his prior radiation site and in the cutaneous region with heavier tumor burden from his metastatic disease. This reaction may give insight to the underlying pathophysiology of SJS, suggesting that immune checkpoint inhibitors can activate T-cells to target keratinocytes and that external factors may be involved in creating distinct epitopes for T-cell recognition. We hope this case adds to the body of knowledge in the pathogenesis of Stevens-Johnson syndrome and cutaneous adverse events seen with checkpoint inhibitors

Educational Dimension of Woman's Character in the Narration's of Prophets as Stated in the Holy Qur'an

The Holy Qur'an has addressed the needs of women and their status in a way never done before in any other religious text. Woman's exalted position in Islam is due, primarily, to her role as a child rearer. It is she who is considered the "first madrasah" (first school) by Islam, and it is from her that children will learn about their responsibility as future 'standard bearers' of Islam and society. The research examines stories and biographies of women in the Qur'an, narrated by various prophets (peace be upon them) through the ages. These stories have been drawn from sound Islamic sources. not the doubtful narrations of Israelite scriptures, showing, through their life stories, women's attitude nature, some positive and others negative. This provides an authentic and comprehensive view of Muslim women from the Qur'anic perspective. It puts forward an educational model for women to realize their true role in the challenging times in which we live. By studying the attitudes and dispositions of women in the Holy Qur'an and the Sunna of the Prophet Muhammad (peace and blessings be upon him) the research illustrates the merits. morals and role of women as educators in the family, as well as society. It also shows the extent to which a Muslim women can harm or benefit each member of her family. The study also shows the scope of educational techniques in the Holy Qur'an and their impact on the attitudes and character of women. It delineates the educational role of women and the features of women's character through investigation of previous religions and comparison with those in Islam. In this way, we can become more acquainted with the characteristics of women, her tasks, rights, duties and the type of work suited to her outside the family

Generating Individual Patient Preferences for the Treatment of Osteoarthritis Using Adaptive Choice-Based Conjoint (ACBC) Analysis.

INTRODUCTION: To explore how adaptive choice-based conjoint (ACBC) analysis could contribute to shared decision-making in the treatment of individual patients with osteoarthritis (OA). METHODS: In-depth case study of three individuals randomly selected from patients with OA participating in an ACBC analysis exercise. Eleven members of a research users' group participated in developing an ACBC task on medication preferences for OA. Individual medication priorities are illustrated by the detailed analysis of ACBC output from three randomly selected patients from the main sample. RESULTS: The case study analysis illustrates individual preferences. Participant 1's priority was avoidance of the four high-risk side effects of medication, which accounted for 90% of the importance of all attributes, while the remaining attributes (expected benefit; way of taking medication; frequency; availability) accounted only for 10% of the total influence. Participant 3 was similar to participant 1 but would accept a high risk of one of the side effects if the medication were available by prescription. In contrast, participant 2's priority was the avoidance of Internet purchase of medication; this attribute (availability) accounted for 52% of the importance of all attributes. CONCLUSIONS: Individual patients have preferences that likely lead to different medication choices. ACBC has the potential as a tool for physicians to identify individual patient preferences as a practical basis for concordant prescribing for OA in clinical practice. Future research needs to establish whether accurate knowledge of individual patient preferences for treatment attributes and levels translates into concordant behavior in clinical practice

Immunomodulatory effect of anise (Pimpinella anisum) in BALB/c mice

Purpose: The aim of this work was to investigate the effect of anise decoction consumption on lymphocytes activity, complete blood count (CBC) and nitric oxide (NO) production in BALB/c mice.Methods: BALB/c mice were given anise tea instead of drinking water and the effect on selected immune parameters was analyzed after 1 and 2 weeks of treatment.Results: Cell activity of anise treated mice was significantly higher than control group at week 2 as revealed by mixed lymphocyte reaction (MLR2. The spleen cells of anise treated mice showed a significant higher lymphocyte proliferative response to in vitro challenge with phytohaemagglutinin (PHA).compared to controls at week two of treatment. The increase in mouse foot thickness as indicator of delayed type of hypersensitivity (DTH) was less in anise treated mice compared to control group. Nitric oxide production by peritoneal macrophages in response to activation with lipopolysaccharides (LPS) was reduced by anise treatment after 1 and 2 weeks of treatment andno significant changes in CD4 and CD8 were noticed either at week 1 or 2 of treatment.Conclusion: This study provides preclinical evidence that anise possesses immunomodulatory activity when administered orally in mice and selectively activates cell-mediated immune mechanismsKeywords: Immunomodulatory, Anise, Traditional medicin

Validating HCS and SIDRA Software for Estimating Delay at Signalized Intersections in Jordan

The main objective of this research was to validate the Highway Capacity Software (HCS) and the Signalized and Unsignalized Intersection Design and Research Aid (SIDRA) Software which are widely used for estimating delay at signalized intersections in Jordan. Fifty four hours of data from eighteen legs at five signalized intersections were collected from Irbid city; the second largest city in Jordan. Traffic volumes and control delay were measured during peak and off-peak periods using video cameras. Data on geometric design elements, signal timings and phasings and vehicular speeds were measured through a field survey. The results of the analysis indicated that both models can be improved significantly by calibrating the basic saturation flow rate or bus PCE factor. However, the best improvement was obtained by calibrating both the basic saturation flow rate and the bus PCE factor simultaneously. It was also found that the two software are good predictors for control delay at signalized intersections in Jordan after calibration. However, SIDRA was found to be better than HCS 2000

Coping Strategies of Jordanian Adolescents With Cancer: An Interpretive Phenomenological Analysis Study

Interpretive phenomenological analysis methodology was used to explore coping strategies used by hospitalized Jordanian adolescents with cancer. In-depth face-to-face interviews were conducted with 10 Jordanian adolescents, aged 13 to18 years, who were receiving chemotherapy for cancer. During treatment, participants were confronted with physical, psychosocial, and emotional distresses resulting from the disease process, the treatment, and its associated side-effects. To cope with the impact of their illness, participants utilized 4 coping strategies: "Strengthening spiritual convictions," "Being optimistic and rebuilding hope," "Enhancing appearance," and "Finding self again." The findings of this study can assist health team members to promote positive psychological care to Arab Muslim adolescents with cancer in a supportive and therapeutic treatment environment

Calculation of magnetic anisotropy energy in SmCo5

SmCo5 is an important hard magnetic material, due to its large magnetic anisotropy energy (MAE). We have studied the magnetic properties of SmCo5 using density functional theory (DFT) calculations where the Sm f-bands, which are difficult to include in DFT calculations, have been treated within the LDA+U formalism. The large MAE comes mostly from the Sm f-shell anisotropy, stemming from an interplay between the crystal field and the spin-orbit coupling. We found that both are of similar strengths, unlike some other Sm compounds, leading to a partial quenching of the orbital moment (f-states cannot be described as either pure lattice harmonics or pure complex harmonics), an optimal situation for enhanced MAE. A smaller portion of the MAE can be associated with the Co-d band anisotropy, related to the peak in the density of states at the Fermi energy. Our result for the MAE of SmCo5, 21.6 meV/f.u., agrees reasonably with the experimental value of 13-16 meV/f.u., and the calculated magnetic moment (including the orbital component) of 9.4 mu_B agrees with the experimental value of 8.9 mu_B.Comment: Submitted to Phys. Rev.