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.
Thermomechanical analysis (TMA) and differential scanning calorimetry (DSC) are used to investigate the effect of molding and annealing of polyester on the behavior of thermal expansion and crystallization since these factors play role in the reprocessing or recycling of the polymer. The dynamic mode of the TMA provides enhanced characterization information about the polyester since it separates the transitions into reversible and irreversible signals, and also reveals the progress of the amorphous regions as the polyester loses strength with the increasing temperature approaching melting. Slow cooling after annealing brings crystallization that may be attributed to molecular chain straightening due to orientation.
Case Report.
To present a case of a previous complicated mandibular orthognathic surgery that aimed to setback the mandible in a female cleft lip and palate (CLP) patient, which led to bone necrosis on one side with subsequent severe mandibular deviation and facial asymmetry. We additionally reviewed the previous reports of similar complications, the pathophysiology and the factors that could lead to this dreadful result.
A 27-year-old female patient presented with a severe dentofacial deformity secondary to a complicated bilateral sagittal spli
The purpose of this paper is to model and forecast the white oil during the period (2012-2019) using volatility GARCH-class. After showing that squared returns of white oil have a significant long memory in the volatility, the return series based on fractional GARCH models are estimated and forecasted for the mean and volatility by quasi maximum likelihood QML as a traditional method. While the competition includes machine learning approaches using Support Vector Regression (SVR). Results showed that the best appropriate model among many other models to forecast the volatility, depending on the lowest value of Akaike information criterion and Schwartz information criterion, also the parameters must be significant. In addition, the residuals
... Show MoreDeep learning has recently received a lot of attention as a feasible solution to a variety of artificial intelligence difficulties. Convolutional neural networks (CNNs) outperform other deep learning architectures in the application of object identification and recognition when compared to other machine learning methods. Speech recognition, pattern analysis, and image identification, all benefit from deep neural networks. When performing image operations on noisy images, such as fog removal or low light enhancement, image processing methods such as filtering or image enhancement are required. The study shows the effect of using Multi-scale deep learning Context Aggregation Network CAN on Bilateral Filtering Approximation (BFA) for d
... Show MoreThis study examines experimentally the performance of a horizontal triple concentric tube heat exchanger TCTHE made of copper metal using water as cooling fluid and oil-40 as hot fluid. Hot fluid enters the inner annular tube of the TCTHE in a direction at a temperature of 50, 60 and 70 oC and a flow rate of 20 l/hr. On the other hand, the cooling fluid enters the inner tube and the outer annular tube in the reverse direction (counter current flow) at a temperature of 25 oC and flow rates of 10, 15, 20, 25, 30 and 35 l/hr. The TCTHE is composed of three copper tubes with outer diameters of 34.925 mm, 22.25 mm, and 9.525 mm, and thicknesses of 1.27 mm, 1.143 mm, and 0.762 mm, respectively. TCTHE tube's length was 670
... Show MoreIn every country in the world, there are a number of amputees who have been exposed to some accidents that led to the loss of their upper limbs. The aim of this study is to suggest a system for real-time classification of five classes of shoulder girdle motions for high-level upper limb amputees using a pattern recognition system. In the suggested system, the wavelet transform was utilized for feature extraction, and the extreme learning machine was used as a classifier. The system was tested on four intact-limbed subjects and one amputee, with eight channels involving five electromyography channels and three-axis accelerometer sensor. The study shows that the suggested pattern recognition system has the ability to classify the sho
... Show MoreDuring COVID-19, wearing a mask was globally mandated in various workplaces, departments, and offices. New deep learning convolutional neural network (CNN) based classifications were proposed to increase the validation accuracy of face mask detection. This work introduces a face mask model that is able to recognize whether a person is wearing mask or not. The proposed model has two stages to detect and recognize the face mask; at the first stage, the Haar cascade detector is used to detect the face, while at the second stage, the proposed CNN model is used as a classification model that is built from scratch. The experiment was applied on masked faces (MAFA) dataset with images of 160x160 pixels size and RGB color. The model achieve
... Show MoreThe search included a comparison between two etchands for etch CR-39 nuclear track detector, by the calculation of bulk etch rate (Vb) which is one of the track etching parameters, by two measuring methods (thichness and change mass). The first type, is the solution prepared from solving NaOH in Ethanol (NaOH/Ethanol) by varied normalities under temperature(55˚C)and etching time (30 min) then comparated with the second type the solution prepared from solving NaOH in water (NaOH/Water) by varied normalities with (70˚C) and etching time (60 min) . All detectors were irradiated with (5.48 Mev) α-Particles from an 241Am source in during (10 min). The results that Vb would increase with the increase of
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