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% (
The research aims to how to deal with certain situation to ensure the continuous competitive excellence of business market under the situation of covid-19, especially how to deal with major challenges, identifying the capabilities of tourism industry, investigating the ability of tourism agencies to resist the dynamic change of both internal as well as external environment to ensure their sustainability.
The important here as the paper notice, is how to be efficient and trying to find solutions in order to grow and survive through choosing certain strategies that aligned the critical issues.
Thus to achieve this level, many scenarios planed that could adopt in case of such pande
... Show MoreThe goal of current research is to identify the difficulties in the application of modern physics in the middle schools of the province of Baghdad schools from the perspective of teachers of physics trends, sample search of (127) teachers, Karkh Third Directorate, and use Researcher questionnaire data collection tool after applying it to teachers who have experience (5) years and more after confirmation of the validity and reliability of the scale (the tool) researcher has used the averages for the purpose of interpreting the results. the results showed that the difficulties have been in the order following: (difficulties related educational environment of modern trends of teaching, curriculum-related dif
... Show MoreService companies always working to increase their competitiveness and efficiency of the survival, growth and development in the present and the future, including insurance companies, so as to increase competition, especially after the emergence of the civil companies dramatically after 2003, has become the goal of recent studies carried out by the organizations is the human capital, because its success and excellence and achievement its objectives depends on the human, and this does not mean that the other components are not important, but also rely on the rights which has increased interest in the search for the way in which they can guide the behaviors and values and their own language in line with the organization's strategy an
... Show MoreBanks represents financial institutions that influence the economy of any country and their evolution and development is the need to seek all states , communities, maintain and control a guarantee of the beneficiaries investors and to promote confidence, so the specialized organizations trying to set principles and rules must be adhered to and are Basel (II) of the necessary effects to be introduced and work on their application. Banks exposed by various risks one of them operational risks that have multiple effects on the activity of the institution itself, as well as the national economy, so this study was to find out what those effects and to find solutions and appropriate proposals to avoid Iraqi banks from the effects of risk,
... Show MoreBackground: The demand for esthetic orthodontic appliances is increasing; so the esthetic orthodontic archwires were introduced. Among them, Teflon and Epoxy coated stainless steel archwires. The amount of force available from the archwire depends on the structural properties and susceptibility to corrosion. All metallic alloys are changed during immersion in artificial saliva, chlorhexidine mouthwash andtoothpaste, but their behaviors differ from one type to another. They corrode at different rates, which lead to decrease the amount of force applied to the teeth. This in vitro study was designed to evaluate the corrosion pits in stainless steel archwires coated with Teflon and with Epoxy in dry and after immersion in artificial saliva, chl
... Show MoreThe digital communication of a product of communication and information revolution. It is characterized by accurate and comprehensive in its services and its effects, which brought changes in the structure of many communities and their organizational structures. They have significant impacts on the social systems and social relations, especially in the Arab societies, which are the focus of the globalized Western media, for many reasons: economical, political , cultural and social.
According to this perception, the Arab identity has become in an encounter with big challenges by the globalized media of trade and the media, which aims to achieve greater profits because of identity and its importance to the communities. This occurs par
The current research aims to identify the effectiveness of a computerized program in developing mathematical skills among the first cycle students in basic education schools in the Sultanate of Oman. The two researchers used the quasi-experimental approach on an intentional sample consisting of (40) male and female students at Al Kawakeb School for Basic Education (1-4). Two of the basic fourth-grade classes and then randomly distributing them into two groups, one is experimental (20) male and female students who followed the computerized interactive program, and the other is (20) male and female students followed the traditional way. On the other hand, its reliability has reached (0.81), and the results of the research have concluded th
... Show MoreThe aim of the research is to identify the role of public relations in promoting tourism by the Palestinian tourism and travel companies in Gaza from the public relations officer’s point of view in those companies.
The researcher used the descriptive analytical method as the most appropriate for such studies and implemented the questionnaire as a tool to obtain the required data from the respondents.
The Researcher reached several conclusions:
1- There is a low percentage of women working in the field of public relations in Palestinian tourism establishments in the Gaza Strip, where the percentage did not exceed 5%.
2- The interpersonal communication counted as one of the elements of integra
This study aimed to examine the effects of electronic training to improve the skills of designing electronic courses for teachers of Arabic language in the colleges of education in Iraq. The descriptive approach is applied and the sample included 145 teachers of Arabic who were selected randomly from the colleges of education in Iraq. Moreover, the results reflected that e-training is effective in improving the skills related to designing online educational courses for teachers of Arabic in the colleges of education in Iraq. Besides, there was no difference between the mean of the respondents' responses to the total score of the tool on the role of electronic training to develop the skills related to electronic courses designing for teacher
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