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% (
In this study water quality index (WQI) was calculated to classify the flowing water in the Tigris River in Baghdad city. GIS was used to develop colored water quality maps indicating the classification of the river for drinking water purposes. Water quality parameters including: Turbidity, pH, Alkalinity, Total hardness, Calcium, Magnesium, Iron, Chloride, Sulfate, Nitrite, Nitrate, Ammonia, Orthophosphate and Total dissolved solids were used for WQI determination. These parameters were recorded at the intakes of the WTPs in Baghdad for the period 2004 to 2011. The results from the annual average WQI analysis classified the Tigris River very poor to polluted at the north of Baghdad (Alkarkh WTP) while it was very poor to very polluted in t
... Show MoreBackground: Moral distress, as one of the most important issues in the nursing profession, can negatively affect the healthcare system Objectives: To examine the effect of moral distress on decision making. Methodology: A descriptive cross-sectional study a non-probability sampling method was used and a total sample collected was (126) ICU nurses Result: Moral distress among ICUs nurses were moderate and decision making was good Conclusion: Although nurses in ICUs perceive good decision making but suffered from moderate MD which affected their decision making. MD is still an important issue that nurses may face in ICUs Conclusion: Although nurses in ICUs perceive good decision making but suffered from moderate MD which affected the
... Show MoreThe concept of aesthetics is one of the postmodern propositions, and it is one of the branches of philosophy that examines beauty, its standards and theories, and it is a holistic concept that includes several concepts, including the beautiful, the ugly, and the sublime.
The concept of aesthetics dealt with several studies in general (and in the field of architecture in particular), and the problem of aesthetics is in the blurring of the relationship between aesthetics and architectural criticism, based on the research hypothesis which states that there is a relationship between aesthetics and architectural criticism. The importance of the research in accommodating aesthetic standards and bases of evaluation that increases the possi
Elastic magnetic electron scattering form factors in Ca-41 have been investigated. 1f7/2 subshell has been adopted as a model space with one neutron, and Millinar, Baymann and Zamick 1f7/2 model space effective interaction (F7MBZ) has been used as a model space effective interaction to generate the model space vectors for the M1, M3, M5, M7, and total form factors. Discarded space (core and higher configuration orbits) have been included through the first order perturbation theory to couple the partice-hole pair of excitation with 2ћω excitation energy in the calculation of the form factors and regarding the realistic interaction density dependence M3Y as a core polarization interaction with five sets of modern fitting parameters. Fina
... Show MoreAmpullary carcinomas are uncommon malignant tumours of the digestive system, they usually are adenocarcinomas presenting histologically as three types: intestinal, pancreaticobiliary and mixed. β-catenin is a multifunctional protein involved in physiological homoeostasis and intracellular adhesion. Abnormal nuclear accumulation of β-catenin has been described in many malignancies such as colon, breast, liver and others. The relationships between the immunohistochemical expression of β-catenin and the subtype, the grade and the stage of ampullary carcinoma are studied.
In this work, substantial evidence was obtained for ligand reduction in cerium tetrakis acac complexes. Also, this ligand reduction of a negatively charged ligand proved to depend far less on the nature central metal than neutral ligands does. It is supposed that in Mz(acac)z complexes the charge is distributed evenly over the whole molecule. In this work these complexes were prepared and characterized by IR and CHN analysis to indicate the purities of these complexes. The electrochemistry techniques were shown as obtained for ligand reduction. This research was carried out at School of Chemistry and Molecular Science, Sussex University, U.K.