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 comparison between the resistance capacity of a single pile excited by two opposite rotary machines embedded in dry and saturated sandy soil was considered experimentally. A small-scale physical model was manufactured to accomplish the experimental work in the laboratory. The physical model consists of: two small motors supplied with eccentric mass 0·012 kg and eccentric distance 20 mm representing the two opposite rotary machines, an aluminum shaft with 20 mm in diameter as the pile, and a steel plate with dimensions of (160 × 160 × 20 mm) as a pile cap. The experimental work was achieved taking the following parameters into consideration, pile embedment depth ratio (L/d; length to diameter) and operating freq
... Show MoreKurdistan power system is expanded along years ago. The electrical power is transmitted through long transmission lines. The main problem of transmission lines is active and reactive power losses. It is important to solve this issue, unless, the most of electrical energy will lost over transmission system. In this study, High Voltage Direct Current links/bipolar connection were connected in a power system to reduce the power losses. The 132kV, 50 Hz, 36 buses Kurdistan power system is used as a study case. The load flow analysis was implemented by using ETAP.16 program in which Newton-Raphson method for three cases. The results show that the losses are reduced after inserted HVDC links.
This paper presents a novel inverse kinematics solution for robotic arm based on artificial neural network (ANN) architecture. The motion of robotic arm is controlled by the kinematics of ANN. A new artificial neural network approach for inverse kinematics is proposed. The novelty of the proposed ANN is the inclusion of the feedback of current joint angles configuration of robotic arm as well as the desired position and orientation in the input pattern of neural network, while the traditional ANN has only the desired position and orientation of the end effector in the input pattern of neural network. In this paper, a six DOF Denso robotic arm with a gripper is controlled by ANN. The comprehensive experimental results proved the appl
... Show MoreLarge language models (LLMs) are a rapidly evolving class of artificial intelligence with significant potential in clinical healthcare. Despite accelerating adoption, rigorous systematic evidence on clinical utility, patient safety, and implementation feasibility remains fragmented. To systematically review LLM applications across clinical domains, evaluate performance with appropriate contextual caveats, characterize implementation barriers, and identify ethical and regulatory considerations. Scientific databases were searched from January 2020 to January 2025. Studies evaluating transformer-based LLMs (≥10M parameters) in clinical settings were eligible. Data were independently double-extracted; quality was assessed using QUADAS-2, RE-A
... Show MoreThis paper reports an experimental study regarding the influence of vertical oscillations on the natural convection heat transfer from a vertical channel. An experimental set-up was constructed and calibrated; the vertical channel was tested in atmosphere at 25o
C. The channel-to-ambient temperature difference was varied with the power supply to the electrical heater ranging between
15W to 70W divided into five levels. Data sets were measured under different operating condition from a test rig under six vibrating velocities (VVs) levels ranging from (5-30 m/s) in addition to the stationary state. The results show that the maximum heat transfer enhancement factor (E) occurs at Rayleigh number (Ra=2.328×103 ) and vibrational Reynol
أن الثورة الرقمية أصبحت اليوم واقع حتمي نعيشه من حيث القت بظلالها على مختلف جوانب الحياة، ولم يخل المسرح من هذا التأثير وخاصة في ظهور ملامح ما بعد الحداثة بكل ما تحملهُ من رؤى فكرية وفلسفية وجمالية، مع ذلك التطور التكنولوجي في هذا السياق يسعى المسرحيون والمخرجون والممثلون الى تأسيس علاقات فاعلة مع شبكات الانترنيت والوسائط الرقمية مما ظهر العديد من المواقع المهتمة بالمسرح. من هنا ظهرت اهمية الربط بين الث
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