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.
The efficiency evaluation of the railway lines performance is done through a set of indicators and criteria, the most important are transport density, the productivity of enrollee, passenger vehicle production, the productivity of freight wagon, and the productivity of locomotives. This study includes an attempt to calculate the most important of these indicators which transport density index from productivity during the four indicators, using artificial neural network technology. Two neural networks software are used in this study, (Simulnet) and (Neuframe), the results of second program has been adopted. Training results and test to the neural network data used in the study, which are obtained from the international in
... Show MoreThe efforts embedded in this paper have been devoted to designing, preparing, and testing warm mix asphalt (WMA) mixtures and comparing their behavior against traditional hot mix asphalt mixtures. For WMA preparation, the Sasobit wax additive has been added to a 40/50 asphalt binder with a concentration of 3%. An experimental evaluation has been performed by conducting the Marshall together with volumetric properties, indirect tensile strength, and wheel tracking tests to acquire the tensile strength ratio (TSR), retained stability index (RSI), and rut depth. It was found that the gained benefit of reduction in mixing and compaction temperatures was reversely associated with a noticeable decline in Marshall properties and moisture s
... Show MoreBiodiesel production process was attracted more attention recently due to the surplus quantity of glycerol (G) as a byproduct from the process. Glycerol Utilization must take in to consideration to fix this issue also, to ensure biodiesel industry sustainability. Highly amount of Glycerol converted to more benefit material Glycerol carbonate (GC) was one of the most allurement compound derived from glycerol by transesterification of glycerol with dimethyl carbonate (DMC). Various parameters have highly impact on transesterification was investigated like catalyst loading (1-5) %wt., molar ratio of DMC: glycerol (5:1 – 1:1), reaction time (30 - 150) min and temperature (40 – 80) ᴼC. The Optimum glycerol carbonate yie
... Show MoreThis paper proposes an on-line adaptive digital Proportional Integral Derivative (PID) control algorithm based on Field Programmable Gate Array (FPGA) for Proton Exchange Membrane Fuel Cell (PEMFC) Model. This research aims to design and implement Neural Network like a digital PID using FPGA in order to generate the best value of the hydrogen partial pressure action (PH2) to control the stack terminal output voltage of the (PEMFC) model during a variable load current applied. The on-line Particle Swarm Optimization (PSO) algorithm is used for finding and tuning the optimal value of the digital PID-NN controller (kp, ki, and kd) parameters that improve the dynamic behavior of the closed-loop digital control fue
... Show MoreDenture bases are fabricated routinely using Poly(methyl methacrylate) (PMMA) acrylic resin. Yet, it is commonly known for its major drawbacks such as insufficient strength and ductility. The purpose of this study was to improve the performance of PMMA acrylic resin as a denture base material by reinforcement with surface treated lithium disilicate glass ceramic powder. The ceramic powder was prepared by grinding and sieving IPS e.max CAD MT blocks. Then, the powder was surface treated with an organosilane coupling agent (TMSPM) and added to PMMA in amount of 1%, 3%, 5% and 7% by weight. Characterizations of the powder was done by particle size analysis, XRD and FTIR. Transverse strength, Impact strength, Shore D hardness and surface roughn
... Show MoreThe problem of Bi-level programming is to reduce or maximize the function of the target by having another target function within the constraints. This problem has received a great deal of attention in the programming community due to the proliferation of applications and the use of evolutionary algorithms in addressing this kind of problem. Two non-linear bi-level programming methods are used in this paper. The goal is to achieve the optimal solution through the simulation method using the Monte Carlo method using different small and large sample sizes. The research reached the Branch Bound algorithm was preferred in solving the problem of non-linear two-level programming this is because the results were better.
In the last few decades, growing interest has been shown in the development of new solar selective coatings based on transition metal nitride and/or oxinitride for solar absorbing applications. Solar thermal collectors are well thought out to be the most effective process of converting and harvesting solar radiation. In this investigation, Cu/TiON/CrO2 multilayered solar selective absorber coatings have been coated onto Al substrates using the dip-coating process followed by an annealing process at (400, 450, 500, 550, and 600 °C. The XRD analysis showed excellent crystalline quality for the prepared thin films along with enhanced surface features as proved by FESEM images, and the grains are in the range of (27–81) nm. The optical in
... Show MoreThe DC electrical conductivity properties of Ge60Se40-xTex alloy with x = 0, 5, 10, 15 and 20). The samples were formed in the form of discs with the thickness of 0.25–0.30 cm and the diameter of 1.5 cm. Samples were pressed under a pressure of 6 tons per cm2 , using a ton hydraulic press. They were prepared after being pressed using a ton hydraulic press using a hydraulic press. Melting point technology use to preper the samples. Continuous electrical conductivity properties were recorded from room temperature to 475 K. Experimental data indicates that glass containing 15% Te has the highest electrical conductivity allowing maximum current through the sample compared to Lu with other samples. Therefore, it is found that the DC co
... Show MoreGrapes and grape seeds are important samples employed for environmental medical studies . The air of this work was to identify and concentration calculation of the elements in grapes fruit and thier seeds by using X-Ray fluoresces technique (XRF) . Samples were collected from Abo Ghraib of Baghdad city ,the grape seeds were obtained from those samples . Both samples were taken under experimental procedure to obtain the sample which were ready for analysis . The samples were then submitted to experimental conditions using a radiation source and then samples were applied for counting analysis shows the elements Na , Mg , Al , Si , P , S , Cl , K , Ca , and Sr as major components of the samples. Fe , Sr , I , Ba and V were
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