Background: One way to target polypharmacy and inappropriate medication in hemodialysis (HD) patients is with medication deprescribing. Objective: To assess the impact of implementing a pharmacist-led deprescribing program on medication adherence among HD patients. Method: A prospective interventional, one-group pretest-posttest-only design study was conducted at a hemodialysis center in Wasit Governorate, Iraq. Medication reconciliation followed by medication review based on the deprescribing program was done for all eligible patients, and the patients were monitored for three months for any possible complications. Results: Two hundred and seventy patients were screened for eligibility. Only one hundred and eighteen were enrolled in the deprescribing program. The median age was 51.5 years, 56.8% were males, and hypertension was the most common etiology for their chronic kidney disease (CKD); 78% had comorbidities. After deprescription, there was a significant reduction in the number of medications from 6.0 to 4.0 and a reduction in the number of pills from 7.0 to 5.0. Medication adherence accessed using the Arabic version of Morisky, Green, and Levine’s (MGL) adherence scale also had a significant reduction from 2.0 to 1.0. Conclusion: A pharmacist-led deprescribing program is a successful strategy for decreasing the number of medications and daily pills prescribed while simultaneously improving hemodialysis patients' adherence to their regimens without compromising the patient’s safety.
<p>Photovoltaic (PV) systems are becoming increasingly popular; however, arc faults on the direct current (DC) side are becoming more widespread as a result of the effects of aging as well as the trend toward higher DC voltage levels, posing severe risk to human safety and system stability. The parallel arc faults present higher level of current as compared with the series arc faults, making it more difficult to spot the series arc. In this paper and for the aim of condition monitoring, the features of a DC series arc fault are analyzed by analysing the arc features, performing model’s simulation in PSCAD, and carrying out experimental studies. Various arc models are simulated and investigated; for low current arcs, the heur
... Show MoreTransport is a problem and one of the most important mathematical methods that help in making the right decision for the transfer of goods from sources of supply to demand centers and the lowest possible costs, In this research, the mathematical model of the three-dimensional transport problem in which the transport of goods is not homogeneous was constructed. The simplex programming method was used to solve the problem of transporting the three food products (rice, oil, paste) from warehouses to the student areas in Baghdad, This model proved its efficiency in reducing the total transport costs of the three products. After the model was solved in (Winqsb) program, the results showed that the total cost of transportation is (269,
... Show MoreAbstract The avulsion of the flexor digitorum profundus, also known as the jersey finger, is a well-known injury that can be treated surgically. It has been classified into four types, among them type IV which involves tendon avulsion from an associated bony fragment with subsequent retraction to the palm or proximal interphalangeal joint is very rare. We present a case of type IV injury in a 45-year-old man with a pulling-on injury. The repair followed a pull-out technique (reinserting the tendon into the avulsed fragment); the entire reduction was tied over a button on the dorsal aspect of the nail and was augmented with a volar plate. The case was reported due to its rarity. We found that early surgical management of this problem greatly
... Show MoreThe development of low profile gamma-ray detectors has encouraged the production of small field of view (SFOV) hand-held imaging devices for use at the patient bedside and in operating theatres. Early development of these SFOV cameras was focussed on a single modality—gamma ray imaging. Recently, a hybrid system—gamma plus optical imaging—has been developed. This combination of optical and gamma cameras enables high spatial resolution multi-modal imaging, giving a superimposed scintigraphic and optical image. Hybrid imaging offers new possibilities for assisting clinicians and surgeons in localising the site of uptake in procedures such as sentinel node detection. The hybrid camera concept can be extended to a multimodal detec
... Show MoreIn this paper, the botnet detection problem is defined as a feature selection problem and the genetic algorithm (GA) is used to search for the best significant combination of features from the entire search space of set of features. Furthermore, the Decision Tree (DT) classifier is used as an objective function to direct the ability of the proposed GA to locate the combination of features that can correctly classify the activities into normal traffics and botnet attacks. Two datasets namely the UNSW-NB15 and the Canadian Institute for Cybersecurity Intrusion Detection System 2017 (CICIDS2017), are used as evaluation datasets. The results reveal that the proposed DT-aware GA can effectively find the relevant features from
... Show MoreIn this paper, the botnet detection problem is defined as a feature selection problem and the genetic algorithm (GA) is used to search for the best significant combination of features from the entire search space of set of features. Furthermore, the Decision Tree (DT) classifier is used as an objective function to direct the ability of the proposed GA to locate the combination of features that can correctly classify the activities into normal traffics and botnet attacks. Two datasets namely the UNSW-NB15 and the Canadian Institute for Cybersecurity Intrusion Detection System 2017 (CICIDS2017), are used as evaluation datasets. The results reveal that the proposed DT-aware GA can effectively find the relevant
... Show MoreIn the early 1990s, as the beginning of the new unilateral leadership of global power by the United States, a new climate of rivalry emerged between revolutionary jihad and national jihad. Al-Qaeda has played on both sides to promote its agenda in support of global jihad. The veteran Afghan warriors returned to the Arab world after the play against the Soviet army "infidel" in Afghanistan after the Soviet invasion of Afghanistan in 1979 and until the disintegration of the Soviet Union in 1990. The Arab world is looking for roles to attract international forces seeking to implement specific projects that need a combat tool . Al-Qaeda has tried to exploit national conflicts and the emergence of sectarian political streams in the Middle Eas
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