Warfarin dosing is challenging due to a multitude of factors affecting its pharmacokinetics (PK) and pharmacodynamics (PD). A novel personalised dosing algorithm predicated on a warfarin PK/PD model and incorporating CYP2C9 and VKORC1 genotype information has been developed for children. The present prospective, observational study aimed to compare the model with conventional weight-based dosing. The study involved two groups of children post-cardiac surgery: Group 1 were warfarin naïve, in whom loading and maintenance doses were estimated using the model over a 6-month duration and compared to historical case-matched controls. Group 2 were already established on maintenance therapy and randomised into a crossover study comparing the model with conventional maintenance dosing, over a 12-month period. Five patients enrolled in Group 1. Compared to the control group, the median time to achieve the first therapeutic INR was longer (5 vs. 2 days), to stable anticoagulation was shorter (29.0 vs. 96.5 days), to over-anticoagulation was longer (15.0 vs. 4.0 days). In addition, median percentage of INRs within the target range (%ITR) and percentage of time in therapeutic range (%TTR) was higher; 70% versus 47.4% and 83.4% versus 62.3%, respectively. Group 2 included 26 patients. No significant differences in INR control were found between model and conventional dosing phases; mean %ITR was 68.82% versus 67.9% (
The expressive speech in the art of acting is considered to be the leading action for thinking and the interior interaction of the individual, in the organization of his relationship with the elements of the environment and its content, and the more acquired the individual's performance today skills in organizing and export of his conflicts and natural occasions , whenever , becomes more adaptable and an interpreted physically and acoustically inside pluralities in personalities, suited to the modern age. This research has addressed a range of topics related to expressive speech in the art of acting, since the first chapter included a systematic framework of the research, represented by the problem , the importance and aims of research t
... Show MoreThis research was aimed to study the pollen morphology for the genus Pterocephalus(Vaill) from Dipsacaceae family in Iraq, and to utilize these feathers in isolating the species as valuable taxonomic traits for enriching Iraqi flora. The study included characteristics of the type, shape, size, sculpturing and apertures, as well as determining the full dimensions using light microscopy as well as numerical analysis of this species and draw polygonal shapes and denderogram convergence between species. The results of the study of pollen and polygonal forms showed significant differences in the characteristics at the level of each species, which helps to identification the genus species, as it was found that the pollen was a tricolp
... Show MoreHere, we found an estimation of best approximation of unbounded functions which satisfied weighted Lipschitz condition with respect to convex polynomial by means of weighted Totik-Ditzian modulus of continuity
The aim of this research is to study the modern Spanish writings on the biography of Prophet Mohamed (PBUH), which gave the glorious biography its due by objective study and analysis with a scholarly approach, unlike the old Spanish and European oriental writings with its biased approach. In the past, Spanish and European writings on Prophet Mohamed were influenced by religious extremism and did not do any justiceto Prophet Mohamed. But this has changed in the modern times, and modern writing on the Prophet biography is based on objective analysis and reliance on original sources instead of the sources of the churches which were full of hate and wicked intentions to eliminate Islam.The research came to the conclusion that the modern Span
... Show MoreThe researcher tried to concentrate on the field study included many houses for the sake of documenting it by pictures and schemes with its history using the available data that had got from elderly whereas the rest of heritage will document in other research , in God willing .
The research confined on the studying of examples heritage houses which was some of them had built at the end of 19th century AD but, other of them had built on the beginning of 20th century . In spite of considering these buildings are important and as a sign to architect art of Jubba but, there is never full studying written about them in Western city .
The importance of this study lies on documenting sides of environmental and climatic progress which Iraq
This paper deals with testing defected model piles in the soil in order to study their behavior. In this respect, the results of model pile tests are discussed either geotechnically or structurally according to the type of failure. Two parameters were studied in order to evaluate the general behavior of defective piles. These parameters include the defect location and the defect type for floating and end bearing pile. The results of the experimental work indicated that the critical case for floating pile is seen to be when the defect of (5%) at the first third of the pile length at which the decrease in the bearing capacity is about (21%), while the decrease in the bearing capacity is found to be (14%) and (10%), when
... Show MoreHuman resources are considered as strategic fortune for being the main driver of the development wheel in the society, and the field of education and learning is one of the main pillars of this fortune for its great effect in the process of economic and social progress of individuals. I was the subject of education to the concerns of many countries, as adopted national policies . And regional support and the reduction of constraints, so came our study (education hub for human development) to identify the role of education in human development and to identify the obstacles facing the education process and the extent of its impacts negatively on the process of human development also contribute to the knowledge of school enrollment and the
... Show MoreBlood lipids are important mediators of host defense during the acute phase of innate immunity. Parasites may induce significant changes in lipid parameters, as has been shown in vitro study where substitution of serum by lipid/cholesterol in medium and in experimental models (in vivo). Thus changes in lipid profile occur in patients that having active infections with most of the parasites. Toxoplasma cannot synthesize cholesterol and depends upon acquisition of low density lipoprotein (LDL)-derived from the host cell, via endocytosis mediated by the LDL receptor or the LDL receptor-related protein.The present study is conducted to evaluate the changes in lipid profile in T. gondii infected women.A total of patients included 87 aborted wom
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Debate is a teaching strategy in nursing education that enhances students' critical thinking. Although debate can be an effective teaching strategy, it is not without limitations. This article discusses the advantages and disadvantages of debate as a teaching strategy in nursing. Also, evaluating debates and choosing topics are highlighted.