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Biologic agents are increasingly being used to treat adult patients with systemic lupus erythematosus (SLE). However, the available data on biologic agents' use in childhood-onset SLE (cSLE) remains limited. To collate available evidence related to the efficacy and safety of using biologic agents in cSLE. The study followed the PRISMA checklist for reporting the data and conducted a thorough search using PubMed, Cochrane Library, and Scopus from January 2005 to August 2023. Only articles meeting specific criteria were included, focusing on cSLE, the use of biologic agents, and having outcome measures at six- and 12-month follow-ups for safety and efficacy. Case reports were excluded, and four independent reviewers screened the articles for accuracy, with a fifth reviewer resolving any discrepancies that arose to achieve a consensus. The final selection included 18 studies with a total of 593 patients treated with biologic agents for severe and/ or refractory cSLE. The most common indication for using biologic agents was lupus nephritis. Rituximab was used in 12 studies, while belimumab was used in six studies. The studies evaluated the efficacy of biologic agents based on SLE disease activity scores, laboratory parameter improvements, and reduced corticosteroid dosage. Positive outcomes were reported, with improvements in renal, hematologic, and immunologic parameters along with mild adverse effects, mostly related to mild infections and infusion reactions. Belimumab and rituximab have shown promise as potential treatments for severe and refractory cSLE cases, leading to decreased disease activity and complete or partial remission in many patients with an acceptable safety profile. However, further research is needed to better understand their benefits and potential risks in these patients. Key Points • This review emphasizes the lack of sufficient randomized controlled trials exploring the use of biologics in childhood systemic lupus erythematosus (cSLE). • Treatment plans for cSLE are being derived from those used for adult systemic lupus erythematosus. • According to current evidence, belimumab and rituximab can be potential treatment options for refractory and severe cases of cSLE. • Additional studies are required to reach more definitive conclusions. [ABSTRACT FROM AUTHOR]

Building ventilation is mandatory to provide occupants with comfort space. This ventilated air is considered as a waste of energy because the fresh air will enter the room at higher or lower temperature than the room temperature in summer and winter seasons. Moreover, as much as the temperature of fresh air is reduced, lower cooling load is needed. This will lead to reduce the capacity and the power consumption of HVAC system. Normally, energy recovery is used for this purpose. On the other hand, an additional cooling method (evaporative cooling unit) can be added to the exhaust air stream from the energy recovery to reduce its temperature and correspondingly reduce the fresh air temperature. In this research, a model of Energy Recovery with Exhaust air Evaporative Cooling (EREEC) in ventilation is built to test the thermal performance theoretically and experimentally in Mediterranean climate. The results indicated a superior saving due to using EREEC. The inlet temperature is reduced by 2.2 °C at ambient temperature of 24.4 °C and by 7.5 °C at highest ambient temperature of 35.7 °C. Additionally, simulation results show that the base cooling load can be reduced up to 13.38%. Moreover, the Payback Period of EREEC from annual energy saving occurred is around 8 years. [ABSTRACT FROM AUTHOR]

Energy is a crucial element for prosperity and improving the standard of living. Fossil fuels are not an everlasting source of energy. However, the sun is the only eternally sustainable source of energy. In this the present study, feasibility and reliability analyses of a PV grid-connected system are conducted in Mediterranean climate. MATLAB is used to model the energy system and examine its technical and economic performances. Life Cycle Cost (LCC) and Payback Period (PbP) criterion are also used to determine the optimum system design. The present study shows that incorporating an optimum system of solar PV with a grid system (oriented at 26° from the horizontal) is feasible in Mediterranean region. It can reduce 6,075 kWh (83.7%) from the annual electricity bill. Moreover, LCC over a 30-year period is found to be US$ 19,524 while the PbP for the initial investment is 5.88 years. Furthermore, carbon dioxide emissions, associated with thermal power plants generated electricity, are expected to reduce by about 3.6 Tons annually. Thus, to move toward energy independence and energy security, favorable policies and incentives should be set to accelerate the use of such energy systems. [ABSTRACT FROM AUTHOR]

Abstract: Thermal Energy Storage (TES) technology based on the use of Phase Change Materials (PCM) has recently raised an important practical interest. This is mainly due to the high-energy storage density during phase change within a very narrow temperature range. To give an illustrative example, eighty times more heat is required to melt certain amount of ice at 0 °C than to heat up 1 °C the same amount of water. In this paper, novel cooling unit using PCM called Indirect Evaporative and Storage Unit (IESU) has been designed, modeled and simulated through over the year. Moreover IESU has been optimized from technical and economic point of view for residential application in Mediterranean climate. Cooling systems with heat storage have attracted an increasing attention over the past decades. However, studies of IESU haven''t been found in open literature. [Copyright &y& Elsevier]

Abstract: Window design, especially glazing choices, is a critical factor for determining the effectiveness of passive solar design. Windows are like a knife has two side; one is useful and the other is harmful. In this paper the effects of windows’U-value, window orientation and windows size on annual heating and cooling energy demand is studied considering the both energy and investment costs. The study has been performed for three different climate zones; Amman, Aqaba and Berlin. Four types of windows have been studied; single glazed, double glazed L, double glazed H and triple glazed. The results show that heating load is highly sensitive to windows size and type as compared with cooling load. Also, it is shown that with a well-optimized glazed window energy saving can be reached up to 21%, 20% and 24% for Amman, Aqaba and Berlin, respectively. [Copyright &y& Elsevier]

Abstract: Thermal, environment and economic impact of Trombe wall system for residential building in Mediterranean region will be studied in this paper. Moreover, optimum size of this system will be determined by using Life Cycle Cost (LCC) criterion. This will lead to develop an approach for designing the most economic residential building in Mediterranean region. Hour-by-hour energy computer simulations were run with TRNSYS program to analyze the performance of Trombe wall. Then, a complete economical equations of LCC have been built and optimized for variable Trombe wall area ratio as a function of economic and thermal parameters. The optimum Trombe wall area ratio from thermal and economical point of view is 37%. This optimum ratio has reduced LCC by 2.4%. Moreover, about 445kg CO2 will be reduced annually. [Copyright &y& Elsevier]

Abstract: Jordan heavily relies on imported oil and gas for meeting its energy need as the same time the construction sector consumed more than half of the total electricity consumption in Jordan in 2008. In order to provide the occupants with thermal comfort at least cost, applying energy saving measures into early design stage can be significant to achieve this goal. This paper discusses an assessment of best orientation of the building, windows size, thermal insulation thickness from energetic, economic and environmental point of view for typical residential building located in Mediterranean region. The results show that about 27.59% of annual energy consumption can be saved by choosing best orientation, optimum size of windows and shading device, and optimum insulation thickness. The Life Cycle Cost (LCC) is reduced by 11.94%. The specific energy consumption per square meter is 64kWh/m2 a. [Copyright &y& Elsevier]

The lean manufacturing approach plays a vital role in reducing waste and enhancing productivity in the production environment and service setups. Lean manufacturing-based techniques might be employed in evaluating the efficiencies of different rooms in emergency departments (EDs) and hospitals. A lean thinking approach may be used in testing the usage of the existing facilities planned and constructed for patients' use. In the present study, the management principles of lean manufacturing-based methodology have been used to test the usage of the ED services. Two vital rooms of the ED viz. rapid response trauma (RR-Trauma) and rapid response medical (RR-Medical) are studied in terms of crowding and bed occupancy. Using the concept of takt time (TT), an individual department's efficiency and relative efficiency have been calculated to judge the effectiveness of the ED services. A case of a governmental, non-profit and teaching hospital in the southern region of Saudi Arabia has been studied to see the effect of staffed bed redistribution based on lean manufacturing concept. It has been revealed that ED is facing crowding and frequent critical ambulance diversion problems which require a management intervention to go for staffed bed redistribution to accommodate all of the patients' arrivals. Furthermore, the optimal allocation of resources is essentially be achieved to enhance the efficiency and effectiveness of ED rooms. Based on the lean manufacturing concept, the acceptable TT and efficiency for ED rooms are recommended. [ABSTRACT FROM AUTHOR]

Lean thinking approach plays a vital role in reducing waste and enhancing productivity in production environment and service setups. Lean thinking approach may be employed in cutting down the patients' waiting time in emergency departments and hospitals. Also, lean thinking approach may be used in testing the usage of the existing facilities planned and constructed for customers' use. In the present study, lean manufacturing approach has been used to test the usage of the emergency department's services. Four vital sections of the hospital emergency department viz. Male Treatment Room (MTR), Female Treatment Room (FTR), Male Observation Room (MOR), and Female Observation Room (FOR), are studied in terms of bed occupancy. Using the concept of takt time, an individual department efficiency and relative efficiency have been calculated to find the waiting time of customers intending to use the emergency services. A case of a governmental, non-profit and teaching hospital in the southern region of Saudi Arabia has been used to present the methodology based on lean manufacturing approach systematically. In conclusion, the present study revealed that extra equipped beds have been used in these four rooms in the emergency department that can be allocated to the other crowding witnessed rooms of the same department. [ABSTRACT FROM AUTHOR]