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% (
Due to the increase in the number of the satellite channels which resulted from the satellite broadcasting, the demand for the television drama production has increased dramatically, and there has been a significant competitive market, which encouraged the producers to adopt many carrots among them the inclusion of TV series large scenes whose main purpose is to show the volume of the production in the series, let alone achieving the dramatic function. The researcher called this type of scenes (the productive scenes), a name which has not been used before. The researcher studied these scenes and determined his research subject under the title (the production scenes in the TV series) where the research problem has been determined through
... Show MoreThe roots of international relations: peace or war: A critical review A great debate has taken place about international relations between scholars concerning peace and War .The concept of root is matched with that of exception. And the importance of the research lies in the ensuing results in the report about the legitimacy of war and the space it holds, so if the origin of international relation is war .the obstacles against it are going to decrease .and if the origin lies in peace then the dimension of its legitimacy will narrow. key words: international relation –peace-war. Résumé : L’Origine des relations internationales : guerre ou paix : révisions critiques L’origine des relations internationales entre guerre et paix, a s
... Show MoreThe problem of internal sulfate attack in concrete is widespread in Iraq and neighboring countries.This is because of the high sulfate content usually present in sand and gravel used in it. In the present study the total effective sulfate in concrete was used to calculate the optimum SO3 content. Regression models were developed based on linear regression analysis to predict the optimum SO3 content usually referred as (O.G.C) in concrete. The data is separated to 155 for the development of the models and 37 for checking the models. Eight models were built for 28-days age. Then a late age (greater than 28-days) model was developed based on the predicted optimum SO3 content of 28-days and late age. Eight developed models were built for all
... Show MoreFish are regarded as a crucial indicator of alterations in the aquatic environment due to their position at the apex of the food chain. Monitoring these alterations is crucial for identifying modifications in the aquatic ecosystem. The principal elements influencing fish health are temperature, pH, dissolved oxygen, salinity, pesticide contamination, microplastics, and algal presence. These elements substantially influence fish health regarding development, reproduction, respiration, oxygen stress, and the internal enzymes associated with digesting and other metabolic functions. Alterations in global environmental conditions and anthropogenic pollutants result in modifications to fish populations, their lives, and their behavior and
... Show MoreThe study aimed to identify the self- compassion of the students as well as to identify the differences in the self- compassion according to the variables: sex - the academic specialization - Study level, the sample of the study of (200) students distributed equally by sex (male - female) Specialization (Scientific - Human) compassion. The results showed that there were no differences in the self- compassion according to the variables: gender, academic specialization, and Study level. In light of these results, the researcher Number of the recommendations and proposals
Nathaniel Hawthorne is famous for his psychological and moral themes. He is also famous for using symbolism in presenting his poignant themes of sin and its consequences. This research paper studies the use of symbols in Hawthorne's The House of Seven gables as an example of his general use of symbolism in his novels. The general pattern of Hawthorne's symbolism is that he presents one major symbol that embodies the main idea, and supports it with a number of minor symbols that develop and elucidate it. In The House of the Seven Gables, the major symbol is the house itself, which stands for corruption, evil, and the injustice of the past. This symbol is supported by such secondary symbols as the heart, the fountain, the
... Show MoreAlthough severe epistaxis is uncommon, it is serious. The systematic endoscopic nasal examination is an essential step in identifying the bleeding point and aiding electrocauterization. Currently, the S-point, which is located in the superior part of the nasal septum behind the septal body and corresponding to the axilla of the middle concha, is identified in about 30% of cases with severe epistaxis. Cauterization of this point has an excellent rate of controlling the bleeding and preventing its recurrence. We aimed to highlight the significance of the S-point in the management of severe cases of epistaxis.
Demography or population studies or demography is the science that is based on the different characteristics of the population scientific study, and represent a population studies principled way to understand the population of society, in addition to verification of the population in a given area determine the reason for the increase or decrease this number from the previous statistical As these studies estimate future trends for the occurrence of demographic change in terms of birth, death and migration That the registration of deaths of paramount importance narrated that way can the demographic reality of the population analysis, and coverage of the health authorities' needs and enable government institutions of decision-making
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This research aims to highlight the Cooperate Governance concept and determine its accounting dimensions, especially what has connected with development the management accountant role concerning the nature, scope and its location in the organizational structure in the companies as to be complied with implementing the cooperate governance principles and mechanisms in the modern businesses environment. This research has focus on clear shortage in the management accountant role in the companies, regarding to implement the governance mechanisms, especially his role to provide the information and consultations to the internal & external parties (stakeholders) . This
... Show MoreThis study aimed to measure digital stress among students at the University of Baghdad and to identify differences in digital stress based on gender (male–female), academic level (first–fourth year), and field of study (scientific–humanities). The study sample consisted of 200 students from the University of Baghdad. The "Digital Stress" scale, developed by the researcher specifically for this study, was applied, and the descriptive-analytical method was adopted. After administering the scale and analyzing the results using appropriate statistical methods, the findings indicated that university students experience a high level of digital stress, while no statistically significant differences were found in digital stress accord
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