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.
In this article, we design an optimal neural network based on new LM training algorithm. The traditional algorithm of LM required high memory, storage and computational overhead because of it required the updated of Hessian approximations in each iteration. The suggested design implemented to converts the original problem into a minimization problem using feed forward type to solve non-linear 3D - PDEs. Also, optimal design is obtained by computing the parameters of learning with highly precise. Examples are provided to portray the efficiency and applicability of this technique. Comparisons with other designs are also conducted to demonstrate the accuracy of the proposed design.
This paper presents a hybrid energy resources (HER) system consisting of solar PV, storage, and utility grid. It is a challenge in real time to extract maximum power point (MPP) from the PV solar under variations of the irradiance strength. This work addresses challenges in identifying global MPP, dynamic algorithm behavior, tracking speed, adaptability to changing conditions, and accuracy. Shallow Neural Networks using the deep learning NARMA-L2 controller have been proposed. It is modeled to predict the reference voltage under different irradiance. The dynamic PV solar and nonlinearity have been trained to track the maximum power drawn from the PV solar systems in real time.
Moreover, the proposed controller i
... Show MoreThe dynamic behavior of laced reinforced concrete (LRC) T‐beams could give high‐energy absorption capabilities without significantly affecting the cost, which was offered through a combination of high strength and ductile response. In this paper, LRC T‐beams, composed of inclined continuous reinforcement on each side of the beam, were investigated to maintain high deformations as predicted in blast resistance. The beams were tested under four‐point loading to create pure bending zones and obtain the ultimate flexural capacities. Transverse reinforcement using lacing reinforcement and conventional vertical stirrups were compared in terms of deformation, strain, and toughness changes of the tes
In this paper, an adaptive active disturbance rejection control is newly designed for precise angular steering position tracking of the uncertain and nonlinear SBW system with time delay communications. The proposed adaptive active disturbance rejection control comprises the following two elements: (1) An adaptive extended state observer and (2) an adaptive state error feedback controller. The adaptive extended state observer with adaptive gains is employed for estimating the unmeasured velocity, acceleration, and compound disturbance which consists of system parameter uncertainties, nonlinearities, exterior disturbances, and time delay in which the observer gains are dynamically adjusted based on the estimation error to enhance est
... Show MoreThe control of an aerial flexible joint robot (FJR) manipulator system with underactuation is a difficult task due to unavoidable factors, including, coupling, underactuation, nonlinearities, unmodeled uncertainties, and unpredictable external disturbances. To mitigate those issues, a new robust fixed-time sliding mode control (FxTSMC) is proposed by using a fixed-time sliding mode observer (FxTSMO) for the trajectory tracking problem of the FJR attached to the drones system. First, the underactuated FJR is comprehensively modeled and converted to a canonical model by employing two state transformations for ease of the control design. Then, based on the availability of the measured states, a cascaded FxTSMO (CFxTSMO) is constructed to estim
... Show MoreScleral acrylic resin is widely used to synthesize ocular prosthesis. However, the properties of this material change over time, thus requiring the prosthesis to be refabricated. Many studies were conducted to improve these properties by reinforcing this material with nanoparticles. This study aims to evaluate the effect of silver nanoparticle powder on the mechanical properties (transverse flexural strength, impact strength, shear bond strength, surface microhardness, and surface roughness) of scleral acrylic resin used for ocular prostheses. Two concentrations were selected from the pilot study and evaluated for their effects on scleral acrylic resin properties. According to the pilot study, 0.01 and 0.02wt% AgNPs powder improved
... Show MoreLabor movement is considered important in Britain because it is an international phenomenon of the feudal system and one of the flowerings of the era of the capitalist machine. At the beginning of the 18th century, the world witnessed a change and progress in many aspects of the industrial fields such as the different means of production .this era is called the industrial revolution which especially appeared in Britain and extended to other areas of the world .it leads to many changes in Europe and participated in different economic, political and cultural and social fields. and it has a very important role in progress and development but its disadvantage is that it is exploited by the capitalists to achieve their special rights .in othe
... Show MoreThe aim of the research was to identify On the effect of the learning-by-play strategy on learning some handball skills among second-stage female students,Comparing the results of students' performance before and after implementing the learning by playing strategy,Providing development proposals for teaching handball skills in light of the research results.,I dependresearcherCurriculumexperimentalIn research procedures as an appropriate approach to achieving research objectives,For two groups, one experimental and the other control,Community of female studentsSecondFor the academic year 2024-2025, consisting of (4Female people (numbering)151) StudentChosen.Research sample30 female students from Section (B) were selected and (4) fe
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