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Abstract The study was conducted in Mosul city, northern Iraq to obtain a local isolate of the algal, Fragellaria vaucheria (Bacillariophycophyta) . Maximum biomass (58 mg/l) was obtained after seven days of incubation. The ratio of precipitated biosilica in the cellular walls ranged between 30 to 35 % of the dry weight of the biomass. The amount of biosilica increased with progress of incubation period. The infra red spectrum test showed the high purity of isolated silica. The protein content increased with increase of algal growth and reached 125 mg/l after fifteenth days of incubation, Maximum lipid content (198 mg/l) was obtained after eleven days of incubation. Generally final pH value was higher than the initial one. The algal Fragellaria vaucheria have a wide pH range and the optimum pH for growth was 7.6 .

Purpose – This study aims to explore the enhancement of mechanical properties in epoxy resin composites through the incorporation of graphene nanoparticles, focusing on their impact and wear resistance. It investigates the role of graphene, both treated and untreated, as a reinforcing agent in composites, highlighting the significance of nanoparticle dispersion and surfactant treatment in optimizing mechanical performance. Design/methodology/approach – Employing a novel dispersion technique using a drawing brush, this research contrasts with traditional methods by examining the effects of graphene nanoparticle concentrations treated with surfactants – Polyvinylpyrrolidone (PVP) and Sulphonated Naphthalene Formaldehyde (SNF) – on the mechanical properties of epoxy resin composites. The methodology includes conducting a series of impact and wear tests to assess the influence of graphene reinforcement on the composites' performance. Findings – The findings reveal a marked enhancement in the composites impact resistance and energy absorption capabilities, which escalate with an increase in graphene content. Additionally, the study demonstrates a significant improvement in wear resistance, attributed to the superior mechanical properties, robust interface adhesion and effective dispersion of graphene. The use of surfactants for graphene treatment is identified as a crucial factor in these advancements, offering profound insights into the development of advanced composite materials for diverse industrial uses. Originality/value – This study introduces a unique dispersion technique for graphene in epoxy composites, setting it apart from conventional methods. By focusing on the critical role of surfactant treatment in enhancing the mechanical properties of graphene-reinforced composites, it provides a novel insight into the optimization of impact and wear resistance.

Introduction: Participation in daily life occupations of personal and community meaning is an important component of health and recovery from mental illness. Limitations in participation were found to be a hallmark of serious mental illness (SMI). Still, previous research has mainly focused on objective dimensions of participation, largely neglecting the subjective aspects that hold particular relevance for health outcomes. Next, participation was addressed by specific diagnoses, approach which is divergent from the recovery model, a transdiagnostic approach and clinical practice. Hence, further research into participation is warranted to broaden our understanding. Objectives: We investigated objective and subjective patterns of participation across a range of SMI diagnoses to delineate differences, and to identify personal and illness-related factors associated with participation dimensions. Methods: A secondary analysis of cross-sectional studies (N=14). The analysis included data from 489 men (40.7%) and women (59.3%) diagnosed with one of 4 SMI conditions: psychotic, affective (AD), post-traumatic (PTSD) or personality (PD) disorders. The participants were aged 18 to 60 (M=34.41; SD=10.9) and were in contact with intensive mental health services. All participants completed the Adult Subjective Assessment of Participation (ASAP), which comprised participation intensity, diversity, satisfaction and enjoyment, and standard evaluations of cognitive functioning, symptom severity, and functional capacity. Z-scores were calculated for independent variables to enable comparison. Demographic and illness-related (IR) information was also collected. Results: Frequency of participation was found to be significantly different between diagnostic groups, but not participation diversity, enjoyment and satisfaction. Participation diversity was altered by range of demographic variables (5.26

As a novel corrosion inhibitor, ionic liquid has garnered a growing amount of interest. Different electrodes, such as carbon steel, stainless steel, aluminium, copper, magnesium, and others; different electrolytes, such as hydrochloric acid, sulfuric acid, nitric acid, and seawater; different condition operations at different temperatures and tribological properties; and various techniques, such as weight loss (WL), potentiodynamic polarization (PDP), and electro impedance spectroscopy (EIS), have been investigated. Due to the large number of cations and anions, this conventional laboratory study may not be completed anytime soon. Therefore, IL as a corrosion inhibitor must be investigated further. The purpose of this study is to conduct a more comprehensive analysis of IL as a corrosion inhibitor in 1 M HCl immersion on carbon steel using the group contribution method. Cations and anions were divided into 29 functional groups (FG) of cations and 17 functional groups (FG) of anions using 74 IL and 760 WL data points collected from various studies. Training and test set results have R2 values of 0.639 and AARD values of 14.9%; validation set results have R2 values of 0.319 and AARD values of 14.4%; and the overall data point evaluation has R2 values of 0.324 and AARD values of 14.3%.

Resin-based composites used in dentistry often possess undesirable characteristics. This study investigated the effect of two different nano-additive materials, namely aluminum oxide (Al2O3) and titanium dioxide (TiO2), on the mechanical, wear, and water sorption/solubility behavior of a commercial restorative composite used in dental treatments (Nexcomp Flow A2). The results showed that dental materials containing the introduced nano-fillers have a higher wear resistance than their neat counterparts. Correspondingly, the average diametral tensile strength values were improved from a value of 14.6 MPa to values of 26.6 MPa and 50.8 MPa when reinforced with TiO2 and Al2O3, respectively. It has been found that there is a significant relationship between the improvements in wear resistance and tensile strength due to the addition of nano-additives. Further, the water sorption/solubility of the pure composite was lower by 60% after introducing 1% wt. Al2O3 and by more than 80% when 1%wt. TiO2 was the reinforcement additive. Scanning electron microscope images of the tested samples on worn and unworn surfaces showed that the nano-additives helped carry the load subjected to the surface. After introducing nano-additives into the matrix, surface degradation, which may occur due to water uptake, was suppressed.

Metal oxide-based adsorbents are quite in for wastewater treatment because of their selectivity, stable structure and very low solubility in aqueous systems. To explore the adsorption of methylene blue (MB), Mn3O4-Bi2O3 adsorbents were made using a wet-impregnation technique with various concentrations of Mn3O4. The presence of Mn3O4 contents on the surface of monoclinic Bi2O3 was confirmed through representative scanning electron micrographs. The diffractions pertaining to cubic Mn3O4 and monoclinic Bi2O3 were noticed in the XRD pattern of 5% Mn3O4-Bi2O3 which confirm the composite nature of the adsorbent. XPS analysis revealed the existance of Bi 4f, Bi 4d, Bi 4p, Bi4s, and Mn 2p core levels in Mn3O4-Bi2O3. The adsorption study divulged highest efficiency (∼95% and qe = ∼1.4 mgg-1) of 5% Mn3O4-Bi2O3 composite among other contestants in removing 30 ppm MB at 28 ° C, pH 7 and 250 rpm. In addition to the determination of adsorption ability, the effect of preliminary dye concentration (5, 10, 20, and 30 ppm) and contact time (0.5–6 h) on the removal efficiency of prepared adsorbents were also monitored. The adsorption data from the batch experiments were evaluated using the Langmuir, Freundlich, Temkin, and Dubinin-Radushkevich-Kaganer (DRK) adsorption isotherms and pseudo 1st and 2nd-order kinetic models. The fitting of adsorption isotherms and kinetic models revealed the formation of adsorbate’s monolayer on the surface of adsorbents through the process of chemisorption. Through FTIR measurement, the MB adsorption onto the effective adsorbent (5% Mn3O4-Bi2O3) was also confirmed. Moreover, TGA analysis showed ∼1.5% weight loss by 5% Mn3O4-Bi2O3 before MB adsorption whereas ∼2.6% weight loss was noticed after dye adsorption onto the adsorbent. The antifungal activity was evaluated against the fungi A. solani and M. fructicola using the agar well diffusion technique. The 5% Mn3O4-Bi2O3 composites have exceptional antifungal characteristics compared to Bi2O3 and Mn3O4, with zone inhibition values of 58.6 and 53.9 mm, respectively.

Heterojunctions have proven to be effective catalysts for removing organic pollutants and heavy metals from wastewater. The following study is also about the formation of 2D heterojunction tellurium-doped zinc oxide composite with sulfur-doped graphitic carbon nitride (Te-ZnO@S-g-C3N4) by adopting a low-cost, simple, and ecofriendly coprecipitation technique. Thiourea was calcined to prepare S-g-C3N4 using the thermal degradation method. The characterization of synthesized photocatalysts was carried out by using SEM-EDX, FTIR, and XRD. The results obtained showed that the incorporation of tellurium caused an alteration in the wurtzite structure of ZnO. SEM-EDX analysis validated the purity of the synthesized samples due to the absence of any additional peaks. The decrease in the bandgap was also noted by the formation of composites. Using methylene blue as a reference dye, the UV-vis spectrophotometer was utilized to calculate the absorbance for photocatalytic degradation behavior. As a result of tellurium doping into the ZnO lattice, photocatalytic oxidation/reduction was improved, according to the results. 3Te-ZnO NPs showed the best degradation rate among dopant series, while an excellent overall degradation rate was noted by fabricated composite 3Te-ZnO@40S-g-C3N4. The best doped ZnO and composites were also used as sorbents for the abstraction of heavy metal (Cr(VI)) from water via adsorption. A definite rise in the removal efficiency percentage of chromium ions was observed by using these sorbents. The overall photo degradation rate and adsorption behavior noted were in ZnO

Human activities are becoming more complex and widespread, particularly the use of metal-based materials in everyday life and industry, resulting in increased corrosion that occurs and inhibits the process. Metal corrosion can be slowed by coating the metal with a corrosion inhibitor. Over the last decade, research into ionic liquids (ILs) as corrosion inhibitors has grown at an exponential rate. Metals are effectively inhibited by several cation ILs namely imidazolium, phosphonium, pyridazinium, benzimidazole, pyridinium, and others. ILs-based corrosion inhibitors are used to protect common metals such as carbon steel, copper, magnesium, stainless steel, and zinc. However, IL-based corrosion inhibitors are still used infrequently in industry. As a result, the purpose of this review paper is to demonstrate everything from research to the commercialization process in the industrialized world. The review paper goes into detail about the different types of ILs used as corrosion inhibitors; the mechanism of corrosion inhibition in immobilized fluids; the impact of turbulence on corrosion; the price of ILs in the future; the eco-friendly (the greenness) of ILs as corrosion inhibitors; and the industrial commercialization of ILs.

Does pure consciousness exist without being hooked to a physical mechanism (e.g. human body)? Can such claim be proven logically? The magnitude of asking this sort of question is similar to asking: Is it logical that matter exists out of the total void? The answer to both questions is yes. The aim of this paper is to show that, the existence of pure consciousness is a logical state, it is not energy, and it exists timelessly and can be experienced beyond the physical body. Furthermore, we show that pure consciousness (the soul) is a virtual junction on the metaphysical virtual net where each junction incorporates a set of cords of consciousness. The set can be limited, unlimited or uncountable. Cords of consciousness is treated as brain neural patterns and as such the brain can easily be manipulated by an external device which may transmit neural patterns in order to generate artificial scenes. A computation example was provided to elaborate the neural patterns and cords of consciousness. Finally, we discuss the opportunity rather than the possibility to visit the metaphysical virtual space. In that sense, if it is possible, should we grab the opportunity and expend our science beyond physics, into the metaphysics?

This short paper is to provide answer to the question what is there outside the Universe? If the Universe is expending, what does it expend into? An answer was provided, the universe is expanding into its complementary universe. If that is so, then what the complementary universe is? A new perception is provided that matter exist as a logical state. What is the logical state creating matter? This question is being answered by the relationship between the universe and its complementary universe satisfying the equilibrium equation that total matter of both universes, the inner universe (our universe) and the complementary universe (everything which is not the inner universe e.g. the outside universe), collapse into zero, i.e. no matter. Furthermore, the existence of matter out of void is a logical state resulted from the void existence.

Objective: Coronary artery disease (CAD) is one of the leading causes of death and disability worldwide. Amongst the Middle East countries, Saudi Arabia is facing rapid progressive urbanization by the adoption of a westernized lifestyle and food habits, which contribute to the rising burden of CAD. We aim to evaluate the awareness and prevalence of CAD risk factors among Saudi adults. Methods: This was a cross-sectional study conducted between January and March 2020. Data were collected through an online survey using a self-administered questionnaire. Data assessed on socio-demographic variables, family history of CAD, knowledge of risk factors, symptoms, and complications of CAD. Results data were entered and analyzed using IBM SPSS statistics, version 25. All comparisons were considered significant at P < 0.05. Results: A total of 311 subjects (48.6% men and 51.4% women) included, and most of the participants were between 18 and 25 years. A majority of the participants did not hear about CAD (82%) and unaware of any risk factors (26.4%), symptoms (25.1%), and complications (72.7%) of CAD. The prevalence of a family history of CAD (9.3%), overweight/obesity (58.6%), physical inactivity (79.1%), and smoking (24.1%) observed considerably high among the participants. Conclusion: The present study reveals that a significantly low level of awareness and a high prevalence of CAD risk factors found among Saudi adults. Therefore, the awareness program is needed at the public level to increase the knowledge of CAD risk factors so that persons with high risk for future CAD can be prevented.

It is usual practice to optimize the various processing parameters in order to achieve well-organized and lucrative process conditions. For the creation of tungsten carbide/silicon nitride/AA2219 composites, sintering temperature, sintering pressure, dwelling time, and heating rate all must be optimized. Design of experiments and analysis of variance were employed to assess the factors’ contributions to density as well as microhardness response variables. It was decided to test the admixed powders and Vickers hardness tester, optical microscope, and Archimedes-based density testing to evaluate the sintered compacts. The optimum spark plasma sintering factors were a temperature of 500°C, a pressure of 30 MPa, a dwelling time of 8 minutes, and a heat rate of 160 °C/min, resulting in an extreme density of 2.71 g/cm3 and a maximum microhardness of 38.61 HV (0.38 GPa).

In this research the influence of using waste Poly Ethylene Terephthalate on the mechanical and rheological properties of wood flour filled PP composites has been studied. PET contents varied from 10-33 wt%. Mechanical properties were characterized by tensile testing, while their fracture resistance was determined by impact measurements. The melt rheological behavior of the composites was also studied by a rheometer in the oscillatory mode and dynamic rheological properties such as complex viscosity, storage modulus, loss modulus and damping factor were evaluated at190°C. The results showed that stiffness increases by adding waste Poly Ethylene Terephthalate. PET when added in low concentrations, caused tensile strength to be lower than that of PP composites filled with pure wood flour. Increasing the concentration of waste PET, led to composites with higher amount of tensile strength. The samples containing waste PET had higher complex viscosity and storage modulus than composite without PET. Likewise, it was observed that the damping factor in the PP/Wood composite decreased by incorporating waste PET to the compositions. Key words: waste polyethylene terephthalate, polypropylene, wood flour, mechanical properties, rheological behavior

This study investigates the impact of different surfactants and dispersion techniques on the friction and wear behavior of WS2 and MoS2 nanoparticles additives in a Polyalphaolefin (PAO) base oil under boundary lubrication conditions. The nanoparticles were dispersed using Oleic acid (OA) and Polyvinylpyrrolidone (PVP) to investigate their impact on particle agglomeration. The size distribution of the dispersed nanoparticles in PAO was measured by dynamic light scattering. The nanoparticles treated using PVP resulted in the most stable particle size. Friction studies showed that nanoparticle agglomeration reduction and the homogeneity of the suspension did not significantly impact the friction reduction behavior of the lubricant. Reciprocating wear experiments showed that, for our test conditions, both WS2 and MoS2 nano additives exhibited maximum wear depth reduction (45%) when using the PVP surface treatment compared to base oil. The wear results confirmed the significance of minimizing agglomeration and promoting high dispersion in promoting favorable wear resistance under boundary lubricant conditions. Analysis of the wear surfaces showed that a tribofilm formation was the primary wear reduction mechanism for WS2 particles treated by PVP while, in the case of MoS2 treated by PVP, the mechanism was load sharing via particles rolling and/or sliding at the interface.

Introduction: Episiotomy is a medical intervention in delivery which is still one of the most common surgical procedures. Topical phenytoin cream possesses analgesic, anti-bacterial and anti-inflammation effects as well as accelerating tissue healing. Hence, the present study aimed to compare the effect of topical phenytoin cream with betadine solution on pain reduction of episiotomy incision. Methods: In this double-blind clinical trial, 120 primiparous women with episiotomy that were referred to Al-Zahra Medical Center of Tabriz in 2010 were randomly allocated to phenytoin or betadine groups (60 in each group). Pain assessment was determine and compared using visual analog scale (VAS) in the first 24-hours and then in the 10th day after delivery. Data analysis performed using chi-square, independent t-student and repeated measurements ANOVA tests. Results: The mean pain intensity in the first 24-hours postpartum was 4.39 ± 1.11 in phenytoin group and in betadine group it was 7.11 ± 1.48 (p < 0.001). In the tenth day after delivery, mean pain intensity in phenytoin and betadine groups was 0.72 ± 1.04 and 3.45 ± 2.00 respectively (p < 0.001). Conclusion: The results showed that local phenytoin is effective on reducing the pain of episiotomy wound and can be replaced with betadine.

In this paper the author proposes a new qualitative method for building conceptual frameworks for phenomena that are linked to multidisciplinary bodies of knowledge. First, he redefines the key terms of concept, conceptual framework , and conceptual framework analysis . Concept has some components that define it. A conceptual framework is defined as a network or a “plane” of linked concepts. Conceptual framework analysis offers a procedure of theorization for building conceptual frameworks based on grounded theory method. The advantages of conceptual framework analysis are its flexibility , its capacity for modification , and its emphasis on understanding instead of prediction.

Background: Prompt diagnosis of bacteremia in the emergency department (ED) is of utmost importance. Nevertheless, the average time to first clinical laboratory finding range from 1 to 3 days. Alongside a myriad of scoring systems for occult bacteremia prediction, efforts for applying artificial intelligence (AI) in this realm are still preliminary. In the current study we combined an AI algorithm with a Natural Language Processing (NLP) algorithm that would potentially increase the yield extracted from clinical ED data., Methods: This study involved adult patients who visited our emergency department and at least one blood culture was taken to rule out bacteremia. Using both tabular and free text data, we built an ensemble model that leverages XGBoost for structured data, and logistic regression (LR) on a word-analysis technique called bag-of-words (BOW) Term Frequency-Inverse Document Frequency (TF-IDF), for textual data. All algorithms were designed in order to predict the risk for bacteremia with ED patients whose blood cultures were sent to the laboratory., Results: The study cohort comprised 94,482 individuals, of whom 52% were males. The prevalence of bacteremia in the entire cohort was 9.7%. The model trained on the tabular data yielded an area under the curve (AUC) of 73.7% for XGBoost, while the LR that was trained on the free text achieved an AUC of 71.3%. After checking a range of weights, the best combination was for 55% weight on the XGBoost prediction and 45% weight on the LR prediction. The final model prediction yielded an AUC of 75.6%., Conclusion: Harnessing artificial intelligence to the task of bacteremia surveillance in the ED settings by a combination of both free text and tabular data analysis improved predictive performance compared to using tabular data alone. We recommend that future AI applications based on our findings should be assimilated into the clinical routines of ED physicians., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Cystatin C (CyC), a secreted cysteine protease inhibitor, has unclear biological functions. Many patients exhibit elevated plasma CyC levels, particularly during glucocorticoid (GC) treatment. This study links GCs with CyC's systemic regulation by utilizing genome-wide association and structural equation modeling to determine CyC production genetics in the UK Biobank. Both CyC production and a polygenic score (PGS) capturing predisposition to CyC production were associated with increased all-cause and cancer-specific mortality. We found that the GC receptor directly targets CyC, leading to GC-responsive CyC secretion in macrophages and cancer cells. CyC-knockout tumors displayed significantly reduced growth and diminished recruitment of TREM2+ macrophages, which have been connected to cancer immunotherapy failure. Furthermore, the CyC-production PGS predicted checkpoint immunotherapy failure in 685 patients with metastatic cancer from combined clinical trial cohorts. In conclusion, CyC may act as a GC effector pathway via TREM2+ macrophage recruitment and may be a potential target for combination cancer immunotherapy., Competing Interests: The authors declare no competing interests., (© 2023.)

Introduction: Cardiovascular (CV) disease is the leading cause of death among women in the United States, making CV risk screening and management a women's health priority. Objectives were to elicit barriers and facilitators to CV risk identification and reduction among women veterans, and iteratively cocreate clinical tools to identify CV risk factors and promote goal-setting for lifestyle changes., Methods: We conducted three exploratory focus groups with 21 Veterans Health Administration primary care team members and piloted patient CV screeners with brief interviews with 19 patients from two Veterans Health Administration women's clinics to inform toolkit development. We then conducted two focus groups and one interview for feedback from a total of 12 staff on the proposed toolkit components. Transcripts were summarized, and a matrix analysis was used to synthesize qualitative findings., Results: Provider-identified barriers included difficulties disseminating CV information in clinic, limited patient knowledge, and lack of organized resources for provider communication and available referrals. Women's complex health needs were notable challenges to CV risk reduction. Facilitators included having a single place to track patient CV risks (e.g., an electronic template note), a patient screening worksheet, and aids to complete referrals. Patient-identified barriers included difficulties balancing health, finances, and physical and mental health concerns. Facilitators included resources for accountability and gender-specific information about CV risks and complications. Providers requested easy, accessible tools in the electronic record with gender-specific CV data and resources linked. Patients requested lifestyle change supports, including trustworthy sources vetted by providers., Conclusions: Iteratively eliciting end-users' perspectives is critical to developing user-friendly, clinically relevant tools. CV risk reduction among women veterans will require multilevel tools and resources that meet providers' and women's needs., (Published by Elsevier Inc.)

Background: Evidence-Based Quality Improvement (EBQI) is a systematic, multilevel approach to implementing research evidence into clinical settings. Little is known about EBQI effectiveness in the context of Practice-Based Research Networks (PBRNs), which are themselves designed to foster practice-based change. We evaluated EBQI implementation in a PBRN setting to determine the extent to which the PBRN infrastructure added value., Methods: We conducted a four-site cluster randomized trial of an EBQI approach to tailoring an evidence-based gender awareness curriculum in the VA Women’s Health PBRN (WH-PBRN). After curriculum implementation, site teams identified impacts of the WH-PBRN context on EBQI processes using qualitative methods, including a formal review of project call minutes, post-project debriefing calls, and structured site team input. WH-PBRN site feedback was mapped to the Replicating Effective Programs implementation phases: pre-condition, pre-implementation, implementation, and maintenance/evolution., Results: The pre-condition phase benefited from the existing WH-PBRN research-clinician relationships to facilitate stakeholder engagement and build project buy-in at local sites. During pre-implementation, differences across WH-PBRN sites offered variations in local tailoring of EBQI elements. The WH-PBRN Coordinating Center helped resolve process complexities stemming from local resource differences and the sharing of mid-project adaptations during implementation. Local efforts were amplified in the maintenance phase by WH-PBRN dissemination of findings., Conclusions: The PBRN strengthened multi-site EBQI activities across all implementation phases., Implications: PBRNs contribute to the uptake of evidence into everyday practice, and may serve as an important component of the future implementation of evidence-based initiatives. Level of evidence: V., (Published by Elsevier Inc.)

Acute graft-versus-host disease (GvHD) is a severe adverse event after stem cell transplantation. Bone marrow-derived mesenchymal stromal cells (BM-MSCs) have been used to treat GvHD, but decidual stromal cells (DSCs) isolated from term fetal membrane have advantages compared with BM-MSCs, including increased allosuppression, unlimited supply, and high expression of integrins. We introduced the use of DSCs in patients with steroid refractory aGvHD. In this study, we investigated factors of importance in the reduction of alloreactivity by DSCs. We found that DSCs need to have cell-cell contact in order to mediate suppression in mixed lymphocyte reactions (MLRs). This contact dependency is consistent with an increased frequency of CD4(+)CD25(high)FOXP3(+) regulatory T cells (Tregs) and an augmented intensity of CD25 expression in CD4(+) T cells. Blocking of the activity of indoleamine-2,3-dioxygenase (IDO), prostaglandin E2, PD-L1, and IFN-γ impaired the antiproliferative ability of the DSCs in MLRs. Neutralization of IDO also reduced the frequency of Tregs. In contrast to BM-MSCs, pretreatment of DSCs with high concentrations of IFN-γ (100 U/mL) reduced their ability to suppress alloreactivity, but stimulation of DSCs with MLR supernatants containing low levels of IFN-γ had no effect on the suppressive capacity in MLR. To conclude, DSCs differ in several aspects from MSCs and need to be close to alloreactive lymphocytes to mediate a suppressive effect and increase the frequency of Tregs. Thus, DSCs may not only use paracrine factors for systemic immunosuppression, but also more specifically target T cells locally in affected tissues.