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% (
Global warming has had considerable effects on vital ecosystems, which has also been caused by increased temperatures and CO2 that follow changes in different abiotic factors, which poses threats to mangrove forests environment. This research was conducted to examine the physiological and morphological characteristics of the Rhizophora apiculata mangrove regarding higher air temperature for the variety of tree species that respond to climate change. Seedlings were cultivated for three months in regulated growth chambers with three varying temperatures of 38°C, 21°C under CO2 at 450 ppm, and ambient CO2 concentration i.e., 450 ± 20 ppm under average temperature at 28°C as the control condition
... Show MoreThere were two types of plows used widely in agricultural fields in the country. The first plow was moldboard plow, while the second one was chisel plow. There were large numbers of Iraqi farmers that used chisel plow for such farming practices. Researchers found that moldboard plows gave the highest rate of carbon dioxide emission. They observed that that with chisel plows they got the lowest carbon dioxide emission. Chisel plow saved energy as compared to moldboard plow and the cost of using the chisel plows was less than the moldboard plows. Chisel plow decreased carbon dioxide emissions from the soil and improve soil properties. The benefits of using chisel plows were more than using moldboard plows.
Infection of the gastric mucosa with Helicobacter pylori is strongly associated with chronic gastritis, peptic ulcer and gastric cancer. Helicobacter pylori virulence factors include a variety of proteins that are involved in its pathogenesis, such as VacA and CagA. Another group of virulence factors is clearly important for colonization of H.pylori in the gastric mucosa. These include urease, motility factors (flagellin), and Superoxide dismutase (SOD). Because of this organism's microaerophilic nature and the increased levels of reactive oxygen in the infected host, we expect that other factors involved in the response to oxidative stress are likely to be required for virulence. Superoxide dismutase is a near
... Show MoreTafsir, ‘interpretation’ is one of the most important sciences the Muslims need. Because Allah, Almighty, revealed the Qur’an to be a way of life for the Muslims in which the healing of what is in the chest, including their goodness and their peasant. Allah says:
“O people, an admonition has indeed come to you from your Lord and a healing for what is in the hearts; and a guidance and a mercy for the believers.”
In order to achieve the goal for which God revealed the Quran must be understood and managed verses:” This is a Book that We have revealed to you abounding in good, that they may ponder over its verses, and that those who have understanding may be mindful.”
The Prophet (PBUH) and his companions understood t
The hero traditionally has such admirable traits as courage, fortitude,
chivalry and patriotism. In the literary works, the hero is the leading
character and the pivot around which all the characters and the events
revolve. The characteristics of the hero usually reflect the cultural values
of his time. Because, in each age, Man's attitudes towards himself and the
world change, different images of the hero emerge.
In Greek Mythology, the hero is frequently favoured by the gods;
therefore, he is himself semi-divine. The Greek hero is of princely birth
and is endowed with good physique, exceptional strength, skill in
athletics and battle, energy and eloquence, like Odysseus who is the hero
of the Odyssey, long
Summary:
We are aware that we cannot reach a correct level of understanding of the Arabic language without using the Quran as our main source in our research. Since the word of the Quran that put an end to all words which kneeled before it all the phrases that lead to the showcasing of the Arabic language in its best self.
Arab scientist realized this truth and gave all their attention to the singular and created from it an important subject for their research in the origins of the language and the science behind. Thus, since they dealt with the structure and studied the significance of the context through the use of vocabulary. Therefore, researching Islamic words or the “surat” mentioned in the Qur’an was necessar
Tourism is a human phenomenon and economic and social activity. It represents an effective forces in the life of the individuals and state alike. As any other economic and human activity has appositive and negative results.
So there is a necessary to planning and activate this sector to get the most possible advantage.
Tourism has special importance out of its effect on the structure and performance of national economy. It can be regarded a dynamic activity with mutual effect include all the economic activities within and out the state. Tourism is affected and affect the production con summing , joineries , communication , ports ,hotel , restaurants ,internal and
... Show Moreان الرأسمالية ليست بناءً هندسياً يتم انتظامه وفقاً للنظريات الهندسية والمعادلات الرياضية والفنون المعمارية، لأنها ببساطة نظاماً اجتماعياً يقوم على تشكيلة اقتصادية معينة، والأخيرة تقوم على مستوى معين لتطور قوى الانتاج (التكنولوجيا) والذي يقوم عليه مستوىً معين لعلاقات الإنتاج، ويقوم على التشكيلة الاقتصادية/ نمط الإنتاج نظاماً سياسياً، هو جزء من البناء الفوقي، ولأنها نظاماً اجتماعياً بالمواصفات انفة
... Show MoreThe current research aims through its chapters to verify the relationship and impact of strategic leadership as an independent variable in the marketing performance as a respondent variable, in a leap cement plant, and try to come up with a set of recommendations that contribute to enhancing the practice and adoption of the two variables in the organization under discussion. And based on the importance of the research topic to the community, and to the researched organization and its members, the analytical and analytical approach was adopted in the completion of this research, and the research community included a leap cement plant in Anbar Governorate, while the research sample was represented by (department heads, and people o
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