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% (
Gestational Diabetes Mellitus (GDM) is the most common metabolic disorder that found during gestation and is define as hyperglycemia of variable severity with onset or first recognition during gestation that does not clearly characterize any form of the preexisting diabetes (American Diabetes Association [1]). It affects approximately 16.5% of pregnancies worldwide (Plows, et al.[2]). The placenta is an organ that connects the mother and her fetus during pregnancy (Gul, et al.[3]). In the placenta, glucose can be transformed into glycogen for storage by either glycogen synthase or using glycogenin as a prime. However, the function of glycogen deposition stays a matter of debate, it may be the source of fuel for placenta itself or the storag
... Show MoreThe research presented the tagged (aesthetic and expressive characteristics in the works of Jean Dubuffet), so the research objective was: to know the aesthetic and expressive characteristics in the works of (Jean Dubuffet), and the research included four chapters. The aim of the research, the limits of the research, and the definition of terms. The second chapter included four topics. The first topic presented the aesthetic essence and style, while the second topic dealt with expressionism: approaches in concept and meaning.
While the third topic was preoccupied with presenting the aesthetic and expressiveness in the drawings of modernity and beyond, while the fourth topic dealt with: Jean Dubuffet and the experience of raw art. Th
The basic concepts of some near open subgraphs, near rough, near exact and near fuzzy graphs are introduced and sufficiently illustrated. The Gm-closure space induced by closure operators is used to generalize the basic rough graph concepts. We introduce the near exactness and near roughness by applying the near concepts to make more accuracy for definability of graphs. We give a new definition for a membership function to find near interior, near boundary and near exterior vertices. Moreover, proved results, examples and counter examples are provided. The Gm-closure structure which suggested in this paper opens up the way for applying rich amount of topological facts and methods in the process of granular computing.
This research aims to clarify the principles governing the exploration and utilization of outer space, emphasizing the role of international law, particularly international criminal law, in addressing crimes committed beyond Earth whether aboard spacecraft, the International Space Station, or in outer space generally. It examines relevant international treaties governing outer space activities, evaluates their strengths and ambiguities, and highlights deficiencies in their provisions. Furthermore, the study analyzes traditional principles of state criminal jurisdiction territoriality, nationality, universality, and protection and assesses their applicability to offenses committed in outer space.
Rapid development has achieved in treating tumor to stop malignant cell growth and metastasis in the past decade. Numerous researches have emerged to increase potency and efficacy with novel methods for drug delivery. The main objective of this literature review was to illustrate the impact of current new targeting methods to other previous delivering systems to select the most appropriate method in cancer therapy. This review first gave a brief summary of cancer structure and highlighted the main roles of targeting systems. Different types of delivering systems have been addressed in this literature review with focusing on the latest carrier derived from malarial protein. The remarkable advantages and main limitations of the later
... Show MoreThis paper aims to prove an existence theorem for Voltera-type equation in a generalized G- metric space, called the -metric space, where the fixed-point theorem in - metric space is discussed and its application. First, a new contraction of Hardy-Rogess type is presented and also then fixed point theorem is established for these contractions in the setup of -metric spaces. As application, an existence result for Voltera integral equation is obtained.
Shifting Sand of English in Iraq language Policy and Planning
Targeted research to study variations formalism in the paintings of the scratch -linear , and through surveys carried out by the researcher , found and to his knowledge that the study did not address the researchers before, this researcher found rationale in the study of plates scratch and identify variations of design in it. , Which included the first chapter of the research problem in question the following: What morphological variations in the paintings of the scratch -linear ?In order to reach solutions to this problem and to achieve results so research aims to identify the characteristics of the scratch for paintings , and design fundamentals and relationships , which are identified by the researcher Balentajat completed in all of I
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