Deferasirox (DFX) monotherapy is effective for reducing myocardial and liver iron concentrations (LIC), although some patients may require intensive chelation for a limited duration. HYPERION, an open-label single-arm prospective phase 2 study, evaluated combination DFX-deferoxamine (DFO) in patients with severe transfusional myocardial siderosis (myocardial [m] T2* 5-<10 ms; left ventricular ejection fraction [LVEF] ≥56%) followed by optional switch to DFX monotherapy when achieving mT2* >10 ms. Mean dose was 30.5 mg/kg per day DFX and 36.3 mg/kg per day DFO on a 5-day regimen. Geometric mean mT2* ratios (Gmeanmonth12/24/Gmeanbaseline) were 1.09 and 1.30, respectively, increasing from 7.2 ms at baseline (n = 60) to 7.7 ms at 12 (n = 52) and 9.5 ms at 24 months (n = 36). Patients (17 of 60; 28.3%) achieved mT2* ≥10 ms and ≥10% increase from baseline at month 24; 15 switched to monotherapy during the study based on favorable mT2*. LIC decreased substantially from a baseline of 33.4 to 12.8 mg Fe/g dry weight at month 24 (-52%). LVEF remained stable with no new arrhythmias/cardiac failure. Five patients discontinued with mT2* <5 ms and 1 died (suspected central nervous system infection). Safety was consistent with established monotherapies. Results show clinically meaningful improvements in mT2* in about one-third of patients remaining on treatment at month 24, alongside rapid decreases in LIC in this heavily iron-overloaded, difficult-to-treat population. Combination therapy may be useful when rapid LIC reduction is required, regardless of myocardial iron overload. This trial was registered at www.clinicaltrials.gov as #NCT01254227.

The driving patterns in developing countries, especially in metropolitan cities, are significantly different from those in developed countries or less-populated cities. However, most of the vehicles driven in these cities are tested using driving cycles that do not match those special driving characteristics, typically resulting in an underestimation or overestimation of the emission rates. In this study, a first driving cycle of passenger cars with gasoline engines is proposed for Greater Cairo, Egypt, based on a very large and diverse dataset of high-resolution onboard measurements, recorded using 87 cars driven in 10 distinctive areas in Greater Cairo. Two global driving cycles have been developed based on the commonly used K-means and the newly suggested K-medoids clustering techniques. The developed cycle based on the K-medoids algorithm, which was found more representative of the collected data, is a time series of speed, ~1500 s, covering a distance of ~5.4 km, with an average speed of 12.480 km/h, where 16.3% of the total duration spent in the idling mode. The superiority of the developed cycle over two commonly used cycles, namely the American transient FTP-75 cycle and the European modal ECE cycle, in terms of estimated fuel consumption and emission rates, is reported.

The driving patterns in developing countries, especially in metropolitan cities, are significantly different from those in developed countries or less-populated cities. However, most of the vehicles driven in these cities are tested using driving cycles that do not match those special driving characteristics, typically resulting in an underestimation or overestimation of the emission rates. In this study, a first driving cycle of passenger cars with gasoline engines is proposed for Greater Cairo, Egypt, based on a very large and diverse dataset of high-resolution onboard measurements, recorded using 87 cars driven in 10 distinctive areas in Greater Cairo. Two global driving cycles have been developed based on the commonly used K-means and the newly suggested K-medoids clustering techniques. The developed cycle based on the K-medoids algorithm, which was found more representative of the collected data, is a time series of speed, $\sim$1500 s, covering a distance of $\sim$5.4 km, with an average speed of 12.480 km/h, where 16.3% of the total duration spent in the idling mode. The superiority of the developed cycle over two commonly used cycles, namely the American transient FTP-75 cycle and the European modal ECE cycle, in terms of estimated fuel consumption and emission rates, is reported.

Captivity to the travel mode is a phenomenon of urban transport in developing countries. Mode choice behavior in cities of the developing countries is constrained and dictated by such reality that many travelers are not always enjoying the freedom of selecting the desired mode of travel. The objective of the paper is to examine mode captivities and the underlying reasons with application on Grater Cairo, utilizing two surveys carried out as part of the latest transport study finalized in 2003; home interview and revealed preference surveys. The paper starts by grouping and discussing mode choice and mode captivity in developing countries cities as related to the different factors. Then, based on the surveys results, mode captive travelers are identified and their socio-economic and trip characteristics within the two samples are examined. The considered modes are formal transit common bus, informal shared taxi, metro and private car. Next, the reasons of "choice" and "non-choice" of modes are investigated in detail. Finally, a logit model is calibrated to examine mode choice elasticities/cross elasticities of captive travelers. This facilitates investigating the sensitivity of mode choice probabilities for captive travelers to changes in transport system variables, such as mainly travel time and travel cost. The paper ends with concluding remarks and suggestions for further work.