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 centers of cities and historical quarter are exposed to a severe threat to the values of the physical and legal urban environment as a result of the value deterioration and the emergence, emergence and spread of new values on the intellectual and urban context, which generates the loss of the urban environment for its spatio-temporal continuity, flexibility, adaptation and continuity, and thus urban obsolescence, Hence the problem of the research in “the lack of comprehensiveness of studies on the phenomenon of urban obsolescence and its impact on the decline in the values of the quality of the built environment in historic
... Show MoreThe present work focuses on the experimental implementation of one of the fiber optical sensors, the optical glass fiber built on surface Plasmon resonance. A type of optical glass fiber was used in this work, single-mode no-core fiber with pre-tapering diameter: (125.1 μm) and (125.3 μm), respectively. The taper method can be tested by measuring the output power of the optical fiber before and after chemical etching to show the difference in cladding diameter due to the effect of hydrofluoric acid with increasing time for the taper process. The optical glass fiber sensor can be fabricated using the taper method to reduce the cladding diameter of the fibers to (83.12 µm, 64.37 µm, and 52.45 µm) for single-mode fibers using Hydrofluoric
... Show MoreThis paper reports a comprehensive study on the behavior of concavely curved soffit reinforced concrete (RC) beams strengthened in flexure with carbon fiber-reinforced polymer (CFRP) composites under static loading. The main objective of this paper is to explore the effect of surface concavity on the bond performance of externally bonded wet layup CFRP sheets and laminates. An experimental program consisting of flexural strengthening of 24 RC beams with concavely curved soffits was carried out. All specimens were simply supported RC beams tested under three-point bending. Of the 24 beams, 6 beams were flat soffit RC beams, and the remainder were fabricated with concavely curved soffits with a degree of curvature that is ranging from 5 mm/m
... Show MoreA Raman spectroscopy method was optimised to examine the chemical changes of aspirin tablets after interaction with helium temperatures. Several aspirin tablets were exposed to plasma-assisted desorption ionisation flame for different times (10, 30, 50, 60, 180 and 300s) and then analysed by Raman spectroscopy using optimal conditions. The changes in chemistry between exposed and fresh (without exposure to plasma) tablets were compared. The vibrational peaks of the aspirin molecule in the Raman spectrum were identified by checking the peak position. The results showed clear spectra with increases in intensity of vibrational peaks until 30s, whereas no spectra were measured for the exposed tablets to plasma flame after 50s. It can, the
... Show MoreDeep learning (DL) plays a significant role in several tasks, especially classification and prediction. Classification tasks can be efficiently achieved via convolutional neural networks (CNN) with a huge dataset, while recurrent neural networks (RNN) can perform prediction tasks due to their ability to remember time series data. In this paper, three models have been proposed to certify the evaluation track for classification and prediction tasks associated with four datasets (two for each task). These models are CNN and RNN, which include two models (Long Short Term Memory (LSTM)) and GRU (Gated Recurrent Unit). Each model is employed to work consequently over the two mentioned tasks to draw a road map of deep learning mod
... Show MoreThe control of prostheses and their complexities is one of the greatest challenges limiting wide amputees’ use of upper limb prostheses. The main challenges include the difficulty of extracting signals for controlling the prostheses, limited number of degrees of freedom (DoF), and cost-prohibitive for complex controlling systems. In this study, a real-time hybrid control system, based on electromyography (EMG) and voice commands (VC) is designed to render the prosthesis more dexterous with the ability to accomplish amputee’s daily activities proficiently. The voice and EMG systems were combined in three proposed hybrid strategies, each strategy had different number of movements depending on the combination protocol between voic
... Show MoreThe economical and highly performed anode material is the critical factor affecting the efficiency of electro-oxidation toward organics. The present study aimed to detect the best conditions to prepare Mn-Co oxide composite anode for the electro-oxidation of phenol. Deposition of Mn-Co oxide onto graphite substrate was investigated at 25, 30, and 35 mA/cm2 to detect the best conditions for deposition. The structure and the crystal size of the Mn-Co oxide composite electrode were examined by using an X-Ray diffractometer (XRD), the morphological properties of the prepared electrode were studied by scanning electron microscopy (SEM) and Atomic force microscopy (AFM) techniques, and the chemical composition of the various
... Show MoreIn this paper, we will illustrate a gamma regression model assuming that the dependent variable (Y) is a gamma distribution and that it's mean ( ) is related through a linear predictor with link function which is identity link function g(μ) = μ. It also contains the shape parameter which is not constant and depends on the linear predictor and with link function which is the log link and we will estimate the parameters of gamma regression by using two estimation methods which are The Maximum Likelihood and the Bayesian and a comparison between these methods by using the standard comparison of average squares of error (MSE), where the two methods were applied to real da
... Show MoreIn this work, an explicit formula for a class of Bi-Bazilevic univalent functions involving differential operator is given, as well as the determination of upper bounds for the general Taylor-Maclaurin coefficient of a functions belong to this class, are established Faber polynomials are used as a coordinated system to study the geometry of the manifold of coefficients for these functions. Also determining bounds for the first two coefficients of such functions.
In certain cases, our initial estimates improve some of the coefficient bounds and link them to earlier thoughtful results that are published earlier.