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 study is concerned with organizational learning and its impact on total quality management in the education sector. Organizational learning is a process that provides the educational sector with the ability to adapt and respond rapidly to developments and changes in a better way according to its main dimensions (Mental Models, Personal Mastery, Team Learning, Shared Vision, System Thinking) by adopting the philosophy of Total Quality Management (TQM) in accordance with its basic dimensions (leadership, customer satisfaction, participation of workers, continuous improvement, training and education). The main purpose of this study is to know (the impact of the Senge model of organizational learni
... Show MoreOrganizational learning is one of the most important means of human resource development in organizations, but most of the organizations, especially public ones do not realize the importance of organizational learning enough, and estimated his role accurately in building intellectual capital, the resource competitive importantly for organizations of the third millennium and who suffers is other end of lack of understanding of its meaning and how to prove its presence and measured in public organizations, so there is the need for this research, which aims to investigate the effect of organizational learning its processes (knowledge acquisition, Information transfer, Interpreting the information, Organizational me
... Show MoreThe Quality function deployment (QFD) tool is an important tool of total quality management because its a link between two important parts customer and production process of the product, using advanced House of quality, which contributed to provide more details about improving the product before it had a vision for the future of the product be improved. Also the identification of the two competitors (Alwazeer , Altouri) bases on the survey of retailers which they identified five competitors products (Alwazeer , Altouri , Ferry , Jif , Dina)for the product (Zahi). Then House of quality to product (Zahi) has been developed By using a Kano Model to classify of customer's requirements for the
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quality issue is the only issue the interesting in recent years of the last century, but also came out of sync with the other issue is the issue of environment, Where they have become represent two sides of one currency, challenges faced by the world and raised by the environmental problems have made industrial organizations pay great attention to the environment by improving their environmental performance, and that's where the oil industry is one of the most dangerous industries, influential and damaging to the environment due to the organizations move away from oil for adoption The application of EMS then a tool to improve environmental performance has been chosen sam
... Show MoreObjecte The study aims to test the effect of using the appropriate quantitative method of demand forecasting in improving the performance of supply chain of the aviation fuel product ( The study sample), One of the products of the Doura refinery (The study site), By testing a set of quantitative methods of demand forecasting using forecasting error measurements, and choosing the least faulty, most accurate and reliable method and adept it in the building chain.
Is the study of problem through a starting with the fol
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the current research aims at analyzing the efficiency of the private university teaching that recently expanded after 2003 ,;besides , the commitment of the private colleges ,definitely Al-Maamun and Al-Mansour colleges with strategy of the ministry of higher education and scientific research. This could be done through many indications that measure the efficiency of the private university teaching , including ( the indication of the efficiency of using human resources and efficiency in using the materialistic indications. But the human efficiency in these colleges , including the sample of the research ( Maamun
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The issues related to foreign trade is a broad field for discussions and captures the interest of economists for their contribution to the process of economic development in the economies of the countries, especially developing ones. The imports of goods and services in foreign trade constitute an important part of the local by which the economy gets goods and services that the economy cannot produce because of the incompetent base of production. Further, the demand function of imports occupied a good deal of the attention of researchers in the field of international economics for which agricultural imports constitute an important part. The reason for the interest in the subject is due to its im
... Show MoreColorectal cancer is a malignant condition that can arise from multiple causative factors. It ranks second, behind lung cancer, as a leading cause of cancer-related deaths worldwide. Extensive research has been conducted to unravel the genetic underpinnings and molecular mechanisms underlying the development of colorectal cancer (CRC). However, epigenetic modifications of histones at the DNA level have become significantly involved in several malignant diseases such as CRC. Hence, this research sought to assess, for the first time locally, the immunoexpression of HDAC-1 and 3 in a group of colorectal patients. Additionally, we explored potential correlations between the expression of HDAC-1, 3 and VEGF. This retrospective study enco
... Show MoreOne of the most important features of American foreign activity during the second half of the 19th century was the encouragement of sending Protestant missionary missions to all countries around the world. The mission of these missions was facilitated by the weakened state of the Ottoman Empire, the increasing influence of European countries, and their interference in its internal affairs. Despite the Ottoman efforts to counter the activities of these missions, the American missionary missions adopted a well-planned strategy that suited the conditions of the region, aimed at achieving their goals through direct and indirect methods, including intervention in the field of education. These missions gave great importance to educational aspects
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The study was conducted in Baghdad and aimed to:
The impact of moving the educational activities in the conservation of literary
texts and the development of literary taste in the fifth grade students moral "by
verifying the validity of hypotheses Elsafreeten following forms:
The first hypothesis:
- There are no differences in women with statistical significance between means
of scores of students three experimental groups, the experimental group first
used upstream activities in the teaching material of literature and texts, the
second experimental group used the activities of building in the teaching
material itself and the experimental group the third use activities concluding
taught the same