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% (
This paper explores the feminist voices in Monica Ali’s novel Brick Lane, focusing on the character development of Nazneen as she evolves from a compliant, dependent wife into a self-reliant, empowered individual. The analysis highlights how Nazneen’s journey toward financial independence through her sewing work plays a critical role in her personal transformation. The paper also examines the impact of female support networks on her empowerment, alongside the cultural obstacles she encounters as an immigrant woman living in London. Using feminist theory, this study discusses the complex interplay between culture, gender, and identity, emphasizing the multifaceted nature of women’s empowerment in a diverse cultural setting. Brick Lane
... Show MoreGas Lasers are important tools that are used in variety purposes, for their low and (cw) output power. The aim of this study was to prepare a way to calculate an optimum stimulated emission cross-section in a gas laser containing a mixture of Xenon and Neon by (30%-70%). The process was a theoretical study of each gas in separate in terms of their physical properties as an active medium. The results of these calculations are logic and more convenient than other mixtures used before
The present study identifies the linguistic means used to realize hyperbole in poetry as a rhetorical device that makes readers experience the beauty of poetic language. To achieve the aim of the study, a model of analysis in accordance with Spitzbardt (1963), Norrick (1982), and McCarthy & Carter (2004) is used. The analysis of data under investigation reveals that hyperbole is a crucial aid used by poets to portrait the real world as imaginative. In conclusion, poets prefer using lexico-grammatical repertoires than lexico-grammatical configurations. Keywords
Terrorist crime is considered a serious act that outweighs all other crimes in terms of impact and result, because it has a wide range on societies, and it also contains a great thing of danger represented in its purpose, and here describing terrorism as a crime is a description that does not give the full right to this behavior or that it It abbreviates it and does not show its actual reality, given that terrorism contains several different crimes and the roles of its contributors, and these roles are necessary to reach the result or the end. In which each episode is complementary to the other, it is not a single act, but rather several joint and complex actions that in turn all lead to the result, and the agreement in the terrorist pro
... Show MoreAt the end of 2019, a new form of Coronavirus (later dubbed COVID-19) emerged in China and quickly spread to other regions of the globe. Despite the virus’s unique and unknown characteristics, it is a widely distributed infectious illness. Finding the geographical distribution of the virus transmission is therefore critical for epidemiologists and governments in order to respond to the illness epidemic rapidly and effectively. Understanding the dynamics of COVID-19’s spatial distribution can help to understand the pandemic’s scope and effects, as well as decision-making, planning, and community action aimed at preventing transmission. The main focus of this study is to investigate the geographic patterns of COVID-19 disseminat
... Show MoreIn this paper we generalize some of the results due to Bell and Mason on a near-ring N admitting a derivation D , and we will show that the body of evidence on prime near-rings with derivations have the behavior of the ring. Our purpose in this work is to explore further this ring like behavior. Also, we show that under appropriate additional hypothesis a near-ring must be a commutative ring.