Background: One way to target polypharmacy and inappropriate medication in hemodialysis (HD) patients is with medication deprescribing. Objective: To assess the impact of implementing a pharmacist-led deprescribing program on medication adherence among HD patients. Method: A prospective interventional, one-group pretest-posttest-only design study was conducted at a hemodialysis center in Wasit Governorate, Iraq. Medication reconciliation followed by medication review based on the deprescribing program was done for all eligible patients, and the patients were monitored for three months for any possible complications. Results: Two hundred and seventy patients were screened for eligibility. Only one hundred and eighteen were enrolled in the deprescribing program. The median age was 51.5 years, 56.8% were males, and hypertension was the most common etiology for their chronic kidney disease (CKD); 78% had comorbidities. After deprescription, there was a significant reduction in the number of medications from 6.0 to 4.0 and a reduction in the number of pills from 7.0 to 5.0. Medication adherence accessed using the Arabic version of Morisky, Green, and Levine’s (MGL) adherence scale also had a significant reduction from 2.0 to 1.0. Conclusion: A pharmacist-led deprescribing program is a successful strategy for decreasing the number of medications and daily pills prescribed while simultaneously improving hemodialysis patients' adherence to their regimens without compromising the patient’s safety.
One of the most significant elements influencing weather, climate, and the environment is vegetation cover. Normalized Difference Vegetation Index (NDVI) and Normalized Difference Built-up Index (NDBI) over the years 2019–2022 were estimated based on four Landsat 8 TIRS’s images covering Duhok City. Using the radiative transfer model, the city's land surface temperature (LST) during the next four years was calculated. The aim of this study is to compute the temperature at the land's surface (LST) from the years 2019-2022 and understand the link, between LST, NDVI, and NDBI and the capability for mapping by LANDSAT-8 TIRS's. The findings revealed that the NDBI and the NDVI had the strongest correlation with the
... Show MoreIn the present study, an attempt has been made to experimentally investigate the flexural performance of ten simply supported reinforced concrete gable roof beams, including solid control specimen (i.e., without openings) and nine beams with web openings of different dimensions and configurations. The nine beams with openings have identical reinforcement details. All beams were monotonically loaded to failure under mid-span loading. The main variables were the number of the created openings, the total area of the created openings, and the inclination angle of the posts between openings. Of interest is the load-carrying capacity, cracking resistance and propagation, deformability, failure mode, and strain development that represent the behav
... Show MoreThis work describes the enhancement of phenol red decolorization through immobilizing of laccase in chitosan and enzyme recycling. Commercial laccase from white rot fungus, Trametesversicolor (Tvlac), was immobilizedin to freshly prepared chitosan beads by using glutaraldehyde as a cross linker. Characterization of prepared chitosan was confirmed by FTIR and scanning electron microscope (SEM). Tvlac (46.2 U/mL) immobilized into chitosan beads at 0.8 % glutaraldehyde (v/v) within 24 hrs. Synthetic (HBT) and natural (vanillin) mediators were used to enhance dye decolorizoation. It was found that 89 % of phenol red was decolorized by chitosan beads within 180 min. in the absence of enzyme and mediator, while decolorization percenta
... Show MoreIn this work, p-n junctions were fabricated from highly-pure nanostructured NiO and TiO2 thin films deposited on glass substrates by dc reactive magnetron sputtering technique. The structural characterization showed that the prepared multilayer NiO/TiO2 thin film structures were highly pure as no traces for other compounds than NiO and TiO2 were observed. It was found that the absorption of NiO-on-TiO2 structure is higher than that of the TiO2-on-NiO. Also, the NiO/TiO2 heterojunctions exhibit typical electrical characteristics, higher ideality factor and better spectral responsivity when compared to those fabricated from the same materials by the same technique and with larger particle size and lower structural purity.
Well integrity is a vital feature that should be upheld into the lifespan of the well, and one constituent of which casing, necessity to be capable to endure all the interior and outside loads. The casing, through its two basic essentials: casing design and casing depth adjustment, are fundamental to a unique wellbore that plays an important role in well integrity. Casing set depths are determined based on fracturing pressure and pore pressure in the well and can usually be obtained from well-specific information. Based on the analyzes using the improved techniques in this study, the following special proposition can be projected: The selection of the first class and materials must be done correctly and accurately in accordance with
... Show MoreTitanium oxide nanoparticles-modified smectite (SMC-nTiO2) as a low-cost adsorbent was investigated for the removal of Rhodamine B (RhB) from aqueous solutions. The adsorbents (SMC and SMC-nTiO2) were characterized by scanning electron microscopy, Fourier transforms infrared spectroscopy, and energy-dispersive X-ray spectroscopy. The effects of various parameters like contact time, adsorbent weight, pH, and temperatures were examined. Three kinetic equations (pseudo-first-order (PFO), pseudo-second-order (PSO), and intra-particle diffusion) were used to evaluate the experimental kinetic of the data and the results showed that the adsorption process is in line with the PSO kinetic model. Adsorption equilibrium isotherms were modeled using La
... Show MoreCoconut milk is considered as a natural drink that enhances the immunity and it is enriched by calcium, iron, magnesium and vitamin (C) and it is also safe drink for kids and bacterial anti-oxdant, and it may be used in the natural juices instead of the whole milk (cow milk) which is added to some juices. This study aimed to determine the nutritrnal value and the sensory evaluation properties of the natural orange juice enriched by canned coconut milk &nb
... Show MoreThe Schiff base (E)-2-(((2-(1H-benzo[d]imidazol-2-yl) phenyl) imino) methyl)-4-methylphenol (Lb) ligand with some metals(II) ion such as; Co, Cu, Cd, and Hg, were synthesis and characterized by the mass and 1 HNMR spectrometry for ligand Schiff base, the fourier-transform infrared spectroscop (FTIR), UV- visible and the flame atomic absorption (AA) spectrum, the CHN analysis, and the chlorine content, in addition to measuring the magnetic sensitivity of the complexes. All the complexes had octahedral geometry. The bioactivity activity for compounds against; Rhizopodium, Staphylococcus aureus, and Escherichia coli showed different efficacy towards these microorganisms