Abstract Background: The novel coronavirus 2 (SARS?CoV?2) pandemic is a pulmonary disease, which leads to cardiac, hematologic, and renal complications. Anticoagulants are used for COVID-19 infected patients because the infection increases the risk of thrombosis. The world health organization (WHO), recommend prophylaxis dose of anticoagulants: (Enoxaparin or unfractionated Heparin for hospitalized patients with COVID-19 disease. This has created an urgent need to identify effective medications for COVID-19 prevention and treatment. The value of COVID-19 treatments is affected by cost-effectiveness analysis (CEA) to inform relative value and how to best maximize social welfare through evidence-based pricing decisions. Objective: compare the clinical outcome and the costs of two anticoagulants (heparin and (enoxaparin)) used to treat hospitalized patients with COVID-19 infection. Patients and method: The study was a retrospective review of medical records of adult, non-pregnant, COVID-19 infected hospitalized patients who had baseline and last outcome measurements at Alamal Epidemiology Center, Al-Najaf city from (Augast 2020 to June 2021). The outcome measures included D-dimer, length of stay (LOS), and mortality rate. Only the cost of the medical treatment was considered in the analysis. The pharmacoeconomics analysis was done in three different cost-effectiveness analysis methods. Microsoft Excel spreadsheet and Statistical Package for the Social Sciences software (SPSS), was used to conduct statistical analysis. Kaplan Meier test was used to compare the mortality rate. T-TEST was used to compare the outcomes of the two groups. Results and discussion: two groups were compared, the first group consists of 72 patients who received heparin, and the second group consists of 72 patients who received enoxaparin. COVID-19 infected patients had a higher abnormal average D-dimer (2534.675 ng/dl). No significant differences between both genders with regards to the basal average D-dimer (males= 2649.95 ng/dl, females= 2374.1mg/dl, P-value>0.05). There was a significant difference between patient's ages 60 years and patients <60. (3177.33 ng/dl, 1763.06 ng/dl, P-value <0.05). It seems that, higher D-dimer levels were associated with a higher mortality rate (died=3166.263 ng/dl, survived= 1729.94 ng/dl, P-value <0.05). Heparin was more effective in decreasing D-dimer levels than enoxaparin which inversely increased the D-dimer levels (-24.4 ng/dl/day, +154.701 ng/dl/day, P-value <0.05). Additionally, heparin was more effective in increasing the survival rate compared to enoxaparin (55% vs, 35%, P-value<0.05). Heparin was associated with a longer duration of stay in hospital than enoxaparin but with no significant difference (13.7 days, 12.3 days, P-value >0.05). Concerning the cost, treatment with heparin cost less than enoxaparin (2.08 U.S $, 9.44 U.S $)/per patient/per day. Conclusion: Originator heparin was a more cost-effective anticoagulant therapy compared to originator enoxaparin, it was associated with a lower cost and better effect, treatment with Heparin resulted in positive INB= 11.3, where a positive result means that heparin is more cost-effective than Enoxaparin. All three methods of pharmacoeconomic analysis decide that heparin was more cost-effective than enoxaparin in treating COVID-19 infected patients.
A particle swarm optimization algorithm and neural network like self-tuning PID controller for CSTR system is presented. The scheme of the discrete-time PID control structure is based on neural network and tuned the parameters of the PID controller by using a particle swarm optimization PSO technique as a simple and fast training algorithm. The proposed method has advantage that it is not necessary to use a combined structure of identification and decision because it used PSO. Simulation results show the effectiveness of the proposed adaptive PID neural control algorithm in terms of minimum tracking error and smoothness control signal obtained for non-linear dynamical CSTR system.
Graphite coated electrodes (GCE) based on molecularly imprinted polymers were fabricated for the selective potentiometric determination of Glibenclamide (Glb). The molecularly imprinted (MIP) and nonimprinted (NIP) polymers were synthesized by radical bulk polymerization using (Glb.) as a template, acrylic acid (AA) and acrylamide (AAm) as monomers, ethylene glycol dimethacrylate (EGDMA) as a cross-linker and benzoyl peroxide (BPO) as an initiator. The imprinted membranes and the non-imprinted membranes were prepared using dioctyl phthalate (DOP) and Dibutylphthalate (DBP) as plasticizers in PVC matrix. The membranes were coated on graphite electrodes. The MIP electrodes using (AA) and (AAm) showed a near nernstian response with slopes o
... Show MoreConstructed wetlands (CWs) are simple low-cost wastewater treatment units that use natural process to improve the effluent water quality and make it possible for its reuse.in this study used the horizontal flow system for the tertiary treatment of wastewater effluent from secondary basins at Al-Rustamiya wastewater treatment plant / old project / Baghdad / Iraq. the Phragmites Australis plant was used for wastewater treatment and the horizontal subsurface flow system was applied. the experimental study was carried out in February 2020 to October 2020. the parameters were monitored for a period of five weeks, Concentration-based average removal efficiencies for HSSF-CW were COD,53% [NO
Abstract
The problem of missing data represents a major obstacle before researchers in the process of data analysis in different fields since , this problem is a recurrent one in all fields of study including social , medical , astronomical and clinical experiments .
The presence of such a problem within the data to be studied may influence negatively on the analysis and it may lead to misleading conclusions , together with the fact that these conclusions that result from a great bias caused by that problem in spite of the efficiency of wavelet methods but they are also affected by the missing of data , in addition to the impact of the problem of miss of accuracy estimation
... Show MoreThe kindergarten teacher play a role in fixing the children behavior so she must plant the value and the habits that make a positive behavior and accepted by the society so the teacher must know all the right educational psychological styles to fix the children behavior and make them accepted psychologically and socially so the problem of the research start from knowing the relation between the methods of dealing with the kindergarten’s teachers and the non right behavior appearance for the kindergarten children. The current research aims to measure the negative behavior appearance of the children of kindergarten and distinguish it according to (sex and levels) and to distinguish the most using styles by the teachers of kinderg
... Show MoreThe complexity and partially defined nature of jet grouting make it hard to predict the performance of grouted piles. So the trials of cement injection at a location with similar soil properties as the erecting site are necessary to assess the performance of the grouted piles. Nevertheless, instead of executing trial-injected piles at the pilot site, which wastes money, time, and effort, the laboratory cement injection devices are essential alternatives for evaluating soil injection ability. This study assesses the performance of a low-pressure laboratory grouting device by improving loose sandy soil injected using binders formed of Silica Fume (SF) as a chemical admixture (10% of Ordinary Portland Cement OPC mass) to di
... Show MoreThis project sought to fabricate a flexible gas sensor based on a short functionalized multi-walled carbon nanotubes (f-MWCNTs) network for nitrogen dioxide gas detection. The network was prepared by filtration from the suspension (FFS) method and modified by coating with a layer of polypyrrole conductive polymer (PPy) prepared by the oxidative chemical polymerization to improve the properties of the network. The structural, optical, and morphological properties of the f-MWCNTs and f-MWCNTs/PPy network were studied using X-ray diffraction (XRD), Fourie-transform infrared (FTIR), with an AFM (atomic force microscopy). XRD proved that the structure of f-MWCNTs is unaffected by the synthesis procedure. The FTIR spectra verified the existence o
... Show MoreThe behavior of AC conductivity (σac), loss tangent (tan δ), and relative permittivity (ε′) for composites of PVC-P/graphite electrode waste (GEW) was investigated, and a qualitative explanation was provided as a function of PVC-P weight fractions (0, 5, 10, 15, 20, and 25) wt. percent, temperature (30-90) °C, and frequency (100Hz-2MHz). The behaviors of the composites' ac. conductivity and impedance as a frequency function and temperature have been examined. The permittivity was shown to rise with increasing temperature (Tg). The relative permittivity increased as the GEW filler concentration increased and was highest in the low-frequency range; nevertheless decreased as the frequency increased.
This paper presents a hybrid genetic algorithm (hGA) for optimizing the maximum likelihood function ln(L(phi(1),theta(1)))of the mixed model ARMA(1,1). The presented hybrid genetic algorithm (hGA) couples two processes: the canonical genetic algorithm (cGA) composed of three main steps: selection, local recombination and mutation, with the local search algorithm represent by steepest descent algorithm (sDA) which is defined by three basic parameters: frequency, probability, and number of local search iterations. The experimental design is based on simulating the cGA, hGA, and sDA algorithms with different values of model parameters, and sample size(n). The study contains comparison among these algorithms depending on MSE value. One can conc
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