Acute decompensated heart failure (ADHF) is a leading cause of hospital admission and many factors are known to precipitate decompensation. We aimed to assess the decompensating factors of heart failure and the management of patients admitted to the emergency department (ED). A total of 107 patients were examined, all diagnosed with ADHF in the ED of the Baghdad Teaching Hospital, from June 2017 to December 2017, and presenting with decom¬pensation (pulmonary oedema, peripheral oedema, and fatigue). The mean patient age was 62.5 ± 9.8 years (range: 43–85 years); the majority of them were in their 7th decade (37.4%), and men were slightly more than women. Hy¬pertension was the most commonly associated comorbidity (68.2%), followed by diabetes mellitus (57.9%), coronary artery disease (51.4%), dyslipidaemia (37.4%), arrhythmia (28%), and chronic obstructive pulmonary disease / asthma (23.4%). The most common presentation was pulmonary oedema (88.8%) followed by peripheral oedema (61.7%), and fatigue (26.2%). Uncontrolled hypertension was the most common precipitating condition for decompen¬sation (58.9%), followed by infection (39.3%), acute coronary syndrome (31.8%), arrhythmia (27.1%), non-compliance (11.2%), and anaemia (2.8%). The majority of the admitted patients were managed with intravenously-administered (i.v.) diuretics (92.5%) that may have been combined with oxygen therapy (63.6%), antibiotics (58.9%), β-blockers (50.5%), nitroglycerin (40.2%), i.v. fluids (38.3%), and/or digoxin (19.6%).
In the construction of buildings usually, problems occur because of the causes of change orders. The main causer of change orders is the owners, consultants, and contractors. These changes lead to conflicts among them which result in influencing building projects. Therefore, it is necessary to analyze the causes of change orders to reduce them and facilitate management. This paper determines the most critical factors that cause change orders from a different point of view, a consulting owner and a contractor, and a study of the reality of the management of change orders when constructing public buildings. The method employed in this research is a field survey using interviews with experts working in the construction of p
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In this work, a novel technique to obtain an accurate solutions to nonlinear form by multi-step combination with Laplace-variational approach (MSLVIM) is introduced. Compared with the traditional approach for variational it overcome all difficulties and enable to provide us more an accurate solutions with extended of the convergence region as well as covering to larger intervals which providing us a continuous representation of approximate analytic solution and it give more better information of the solution over the whole time interval. This technique is more easier for obtaining the general Lagrange multiplier with reduces the time and calculations. It converges rapidly to exact formula with simply computable terms wit
... Show MoreA three-stage learning algorithm for deep multilayer perceptron (DMLP) with effective weight initialisation based on sparse auto-encoder is proposed in this paper, which aims to overcome difficulties in training deep neural networks with limited training data in high-dimensional feature space. At the first stage, unsupervised learning is adopted using sparse auto-encoder to obtain the initial weights of the feature extraction layers of the DMLP. At the second stage, error back-propagation is used to train the DMLP by fixing the weights obtained at the first stage for its feature extraction layers. At the third stage, all the weights of the DMLP obtained at the second stage are refined by error back-propagation. Network structures an
... Show MoreThis paper presents a cognition path planning with control algorithm design for a nonholonomic wheeled mobile robot based on Particle Swarm Optimization (PSO) algorithm. The aim of this work is to propose the circular roadmap (CRM) method to plan and generate optimal path with free navigation as well as to propose a nonlinear MIMO-PID-MENN controller in order to track the wheeled mobile robot on the reference path. The PSO is used to find an online tune the control parameters of the proposed controller to get the best torques actions for the wheeled mobile robot. The numerical simulation results based on the Matlab package show that the proposed structure has a precise and highly accurate distance of the generated refere
... Show MoreIn this research, the focus was placed on estimating the parameters of the Hypoexponential distribution function using the maximum likelihood method and genetic algorithm. More than one standard, including MSE, has been adopted for comparison by Using the simulation method
shoulder joint by preparing special exercises for the youth-category wrestling, and through the researchers' follow-up to the wrestling game and their work in the field of rehabilitation and physical therapy, noticing that most of the wrestling players suffer from the shoulder joint pain despite their visit to the specialist doctor and take Treatment, so the researchers saw to study this problem and restore the recovery of the injured through special exercises and a suitable qualification program for the shoulder joint muscles, the goal of research in preparing special exercises and knowing its effect on the rehabilitation of the background muscle of the shoulder for the youth wrestling category. The researchers assumed that there are stati
... Show MoreA discussion about the repercussions of the exchange rate on the behavior of stock markets became one of the basic principles of financial economics. The Istanbul Stock Exchange , considered one of the fastest financial markets growing in the region, driven by solid economic activity, for a diversified economy which classified as one of the the fastest growing economies in the world. However, the aforementioned market witnessed sharp fluctuations in the past few months, coinciding with the continuous fluctuations in the exchange rate of the Turkish lira, posing a serious challenge to the economic and investment environment in a c
... Show MoreThis research aims to identify the factors effecting the investigation of insurance fraud from the perspective of the National Insurance Company employees, by analyzing the study variables and make recommendations on how to enhance the company and employees performance, and to achieve the objectives of the study and test hypotheses a questionnaire was designed after referring to the international standards and the 1969 Iraqi punishment law, and it was answered by 20 employees that were approved for the purposes of this research and analysis.
The study found that lack of employee training was a strong factor, while the supervisory staff and operational procedures was a weak one.
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... Show MoreThe existence of succession system has appeared in Arab Islamic state after the death of the prophet Mohammed (peace be upon God and peace), So there was caliphate, then the Umayyad dynasty in Syria , until 132 AH , the date o the emergence of the Abbasid state adopted a system ministry formally , hafs bin sulaiman ( Abu salamah Khallal ) was the first minister emerged on the political scene. He was killed at the time of the first Abbasid caliph , Abu Albbas , incest 132-136 who had put Khalid bin barmak as a minister instead of Hafs bin Sulaiman . During the reign of AL-Mansur 136-158 , there was an importance and a place for the ministry , despite of AL-Mansur strength personality that covered on his ministers personalities
... Show Moreيهدف البحث إلى التعرف على The research aims to identify the effect ofاثر التركيب العمري للسكان على الناتج المحلي الإجمالي في العراق وتحديد الفئات العمرية من أطفال ومنتجين أي من هم في سن العمل والمسنين لأهمية ذلك لإغراض التخطيط الاقتصادي.إنeffectofeee age structure of the population on GDP in Iraq and determine the age groups of children and any of the producers wham are of working age and the elderly of the importance for the purposes of economic planning. نسبة الفئة العمرية Proportion of the age group (00- -4 4سنوات اقتربت من
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