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% (
ABSTRACTBackground Subclinical hypothyroidism is mild thyroid hormone deficiency, defined by elevation of serum thyroid-stimulating hormone concentration despite a normal free T3, free T4 level, can be distinguished by clinical and circumstantial observations from other conditions that cause this constellation of laboratory findings. The aim is to find the prevalence, anthropologic, and metabolic changes associate subclinical hypothyroidism(SH) in adult patients presented to obesity research and therapy unit (ORTU Objective: To find the prevalence of subclinical hypothyroidism (SH) in adult obese patients presented to obesity research and therapy unit (ORTU) in AL-Kindy College of medicine and to describe the anthropologic and metabolic
... Show MoreThe mind map represents a system to solve problems including design problems, because it depends on employing the complex and purposeful mental activity, which starts from a desire based on the search and investigation in order to reach integrated results of scientific thinking, utilizing the objective view of the scientific and practical aspects from various angles. This visual system can develop thinking and shorten the retrieval time of the previous information in order to employ it in the solution finding system, that it evokes past experiences and relates them to current situations, then enables the user to choose a suitable solution for the problems. This visual, educational and circulatory means, at the same time, has speci
... Show MoreSub-threshold operation has received a lot of attention in limited performance applications.However, energy optimization of sub-threshold circuits should be performed with the concern of the performance limitation of such circuit. In this paper, a dual size design is proposed for energy minimization of sub-threshold CMOS circuits. The optimal downsizing factor is determined and assigned for some gates on the off-critical paths to minimize the energy at the maximum allowable performance. This assignment is performed using the proposed slack based genetic algorithm which is a heuristic-mixed evolutionary algorithm. Some gates are heuristically assigned to the original and the downsized design based on their slack time determined by static tim
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The current study was conducted to assess the effect of advancing age on total serum IgE level in asthmatic patients. To this purpose, 90 asthmatic patients and 30 healthy individuals ( control group ) were enrolled. Asthmatic patients were categorized into four groups. Group A consisted of asthmatic patients (9) whose age was more than 20 and up to 30 y. Group B contained asthmatics (13) of age more than 30 and up to 40 y. Group C comprised those (23) of more than 40 and up to 50 y. Group D consisted asthmatic patients (45) of age more than 50 y. Total serum IgE level significantly changed in group D patients when compared with those of
Kurdish language multifunctional morphemes indicate the different functional morphological, syntactical, and semantic tasks of the morphemes. The present study discusses the multifunctional task of the Morpheme Le in Kurdish Language. The Morpheme Le has marginally been included in other studies, yet up to the present times, there has not been a research inclusively dedicated to thoroughly discuss and clarify its multifunctional aspects. The present study is divided into two chapters: Chapter one discusses the theoretical aspect of chapter two that is entirely concerned with the practical aspect of the morpheme Le. The first part of chapter one sheds light on the morphological aspect of the morpheme while part two discusses
... Show MoreThis study has evaluated the humoral immune response in Golden Hamsters experimentally infected with Leishmania donovani along (4) times of follow up (15, 30, 60, 90) days after infection. Indirect haemagglutination test was used to determine the antibody titer through the various stages of the study. Also the progress of the infection was studied depending on some of the visceral changes caused by the parasite, like weight of liver, length & weight of spleen & the count of Leishmania parasites in spleen were measured. Results has shown that there was an increase in antibody titer & the maximum value was recorded at the 4th day of follow up (90 days after infection) as well as that there was an increase in the length of the spleen, weight
... Show MoreNumerous regions in the city of Baghdad experience the congestion and traffic problems. Due to the religious and economic significance, Al-Kadhimiya city (inside the metropolitan range of Baghdad) was chosen as study area. The data gathering stage was separated into two branches: the questionnaire method which is utilized to estimate the traffic volumes for the chosen roads and field data collection method which included video recording and manual counting for the volumes entering the selected signal intersections. The stage of analysis and evaluation for the seventeen urban roads, one highway, and three intersections was performed by HCS-2000 software.The presented work plots a system for assessing the level of service
... Show MoreAfter the year 2003, Iraq went through multiple waves of violence and at different levels on the security, intellectual, political and social levels. Behind that stood several motives and incentives to enable violence that represented the first axis of research, the most important of which was the political motives that circulated an atmosphere that politics against society and transformed power into a field of political brutality against the individual and the group at once. There are also cultural, intellectual, media and economic motives such as weak cultural independence, poverty, marginalization, unemployment and want, and the absence of a media discourse that rejects violence but incites it, on the other ha
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Cutting forces are important factors for determining machine serviceability and product quality. Factors such as speed feed, depth of cut and tool noise radius affect on surface roughness and cutting forces in turning operation. The artificial neural network model was used to predict cutting forces with related to inputs including cutting speed (m/min), feed rate (mm/rev), depth of cut (mm) and work piece hardness (Map). The outputs of the ANN model are the machined cutting force parameters, the neural network showed that all (outputs) of all components of the processing force cutting force FT (N), feed force FA (N) and radial force FR (N) perfect accordance with the experimental data. Twenty-five samp
... Show MoreObjective(s):To evaluate the quality of life among secondary and to find out the relationship between students'quality of life and their socio-demographic characteristics of age, gender, residence, marital status, father's and mother's education, and family financial status in Kirkuk City. Methodology: A cross-sectional study is conducted on (100) studentwho are boys and girls aged(13 to 24) years old. These subjects are studying at secondary schools in Kirkuk City.The study is carried out at secondary schools in Kirkuk City from 7th July 7th 2014 to May 7th 2015. A questionnaire is constructed for the purpose