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.
Software Defined Network (SDN) is a new technology that separate the control plane from the data plane. SDN provides a choice in automation and programmability faster than traditional network. It supports the Quality of Service (QoS) for video surveillance application. One of most significant issues in video surveillance is how to find the best path for routing the packets between the source (IP cameras) and destination (monitoring center). The video surveillance system requires fast transmission and reliable delivery and high QoS. To improve the QoS and to achieve the optimal path, the SDN architecture is used in this paper. In addition, different routing algorithms are used with different steps. First, we eva
... Show MoreDistributed Denial of Service (DDoS) attacks on Web-based services have grown in both number and sophistication with the rise of advanced wireless technology and modern computing paradigms. Detecting these attacks in the sea of communication packets is very important. There were a lot of DDoS attacks that were directed at the network and transport layers at first. During the past few years, attackers have changed their strategies to try to get into the application layer. The application layer attacks could be more harmful and stealthier because the attack traffic and the normal traffic flows cannot be told apart. Distributed attacks are hard to fight because they can affect real computing resources as well as network bandwidth. DDoS attacks
... Show MoreLet R be a 2-torision free prime ring and ?, ?? Aut(R). Furthermore, G: R×R?R is a symmetric generalized (?, ?)-Biderivation associated with a nonzero (?, ?)-Biderivation D. In this paper some certain identities are presented satisfying by the traces of G and D on an ideal of R which forces R to be commutative
This research dealt with highlighting the images of marriage through the modern means of communication and the legal ruling for it. Dowry even be knotted on them; because they are then one of the parties to the contract and contracted in one contract, and this is prohibited by law and law and common sense.
It turns out that it is permissible to advertise marriage through the Internet in accordance with the rules and standards that preserve values and morals and safeguard dignity and chastity. The acts in Islamic law are vested with intentions. If intentions are true, then the act is true, and Internet marriage is what falls under this order.<
... Show MoreRecent years have witnessed an increase in the use of composite coatings for numerous applications, including aerospace, aircraft, and maritime vessels. These materials owe this popularity surge to the superior strength, weight, stiffness, and electrical insulation they exhibit over conventional substances, such as metals. The growing demand for such materials is accompanied by the inevitable need for fast, accurate, and affordable nondestructive testing techniques to reveal any possible defects within the coatings or any defects under coating. However, typical nondestructive testing (NDT) techniques such as ultrasonic testing (UT), infrared thermography (IRT), eddy current testing (ECT), and laser shearography (LS) have failed to p
... Show MoreA new modified differential evolution algorithm DE-BEA, is proposed to improve the reliability of the standard DE/current-to-rand/1/bin by implementing a new mutation scheme inspired by the bacterial evolutionary algorithm (BEA). The crossover and the selection schemes of the DE method are also modified to fit the new DE-BEA mechanism. The new scheme diversifies the population by applying to all the individuals a segment based scheme that generates multiple copies (clones) from each individual one-by-one and applies the BEA segment-wise mechanism. These new steps are embedded in the DE/current-to-rand/bin scheme. The performance of the new algorithm has been compared with several DE variants over eighteen benchmark functions including sever
... Show Moreplanning is among the most significant in the field of robotics research. As it is linked to finding a safe and efficient route in a cluttered environment for wheeled mobile robots and is considered a significant prerequisite for any such mobile robot project to be a success. This paper proposes the optimal path planning of the wheeled mobile robot with collision avoidance by using an algorithm called grey wolf optimization (GWO) as a method for finding the shortest and safe. The research goals in this study for identify the best path while taking into account the effect of the number of obstacles and design parameters on performance for the algorithm to find the best path. The simulations are run in the MATLAB environment to test the
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Eriobotrya japonica Lindl., named as loquat, is a subtropical fruit tree of the family Rosaceae which is well known medical plant originated in Japan and China. Loquat portions, like leaves, peels and fruits have been shown to possess various health usefulnesses. In Chinese classical medicine, it is vastly utilized in many illnesses, like gastroenteric disorders, diabetes mellitus, pulmonary inflammatory diseases and chronic bronchitis. Loquat plant contain many active constituents, such as flavonoids, carotenoids, vitamins, polyphenolic compounds, other that have many biological effects like anti-tumor, anti-diabetic, anti-inflammatory, anti-mutagenic, antioxidant, antiviral, antitussive, hepatoprotective and hypoli
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