BackgroundEstablishment of thromboembolism prevention remains a challenge despite the widespread consensus that thromboprophylaxis safely reduces patient morbidity and mortality. Dabigatran is a nonvitamin K antagonist oral anticoagulant (NOAC) which reduces the risk of thromboembolism. Proper dosing is important to achieve the maximum prophylactic benefit with a maintained safety profile.ObjectiveTo evaluate the appropriateness of dabigatran dosing for stroke and systemic embolism prevention in patients with nonvalvular atrial fibrillation (NVAF).MethodsThis is a retrospective cohort study of adults with NVAF. The data were collected from the electronic filing system of the hospital. Patients receiving dabigatran therapy were divided into two treatment groups according to the dose of dabigatran received. The indications for dabigatran as an oral direct anticoagulant, including age, risk of bleeding, creatinine clearance (CrCl), were collected. Appropriateness of dose reduction included any of the following factors: HAS-BLED score >2 points, age ≥75 years, or CrCl of 30–50 mL/min. The two groups were evaluated according to dose appropriateness.ResultsDabigatran dose of 110 mg was found to be inappropriately low in a large number of patients (31.3%). Multivariate regression analysis showed significant association of age and dose appropriateness (p < 0.001).ConclusionThis study revealed inappropriate prescription of reduced doses of dabigatran in a large number of patients. Age was identified as the main driving factor for underdosing. Physicians’ and pharmacists’ awareness regarding this type of high-risk medication should be improved to ensure appropriate and safe use of this commonly used drug.

L IMITING the consumption of high-calorie foods and juices of many consumers in different ages to avoid many diseases such as diabetes, obesity, tooth decay, heart diseases, and arteriosclerosis, is an important issue and challenge for nutritionists and the food industry. Therefore, the aim of this study was to produce a low-calorie pomegranate juice by replacing sucrose with sucralose at different levels. Five low-calorie pomegranate juice formulae were prepared mainly from pomegranate pulp then sweetened using sucrose and replaced with sucralose (Su) (25, 50, 75, and 100%) and evaluated for the physicochemical and sensory properties of the resultant juice during storage period for 6 months at ambient temperature. The obtained results showed that the increase in the replacing levels of the sucralose led to a decrease in the total carbohydrate content and total calories. The results concluded that the use of sucralose as a replacement for sucrose at a level of 50% recorded a high score of sensory evaluation in terms of taste and general acceptance, compared with all the other treatments after 6 months of storage at room temperature. Sensory characteristics indicated that the low calories pomegranate juice had good color, taste, mouth-feel during storage periods.

Ultra high performance-Fiber reinforced concrete (UHP-FRC) is a newly developed building material that has major advantages in terms of high strain ability and high compressive and tensile strength, which is useful for strengthening or repairing concrete members. Web openings are usually constructed in simple reinforced concrete (RC) beams in the shear zones that occasionally demand the crossing of water or sewage pipes and utility cables to accommodate the utility. The presence of opening has a remarkable effect on the ultimate strength of (RC) beams and the beams failed due to shear . This research analyzes numerically simple RC beams with opening strengthening using a UHP-FRC plate. Through the computer program ABAQUS, a numerical study focusing on the nonlinear analysis of finite elements was carried out. The FEM was verified using the experimental studies simple RC beam with/without openings were cast and tested. The UHP-FRC plates were used on both sides of the RC beam around the opening. The numerical study was carried out to investigate the impacts of using UHP-FRC plates with five different thicknesses (10, 20, 30, 40 and 50) mm with constant width 100mm and three different plates with width (50,70 and100) mm with constant thickness 20mm. The result showed that the use of plates thickness from 10 to 20 mm increased the ultimate loads about 52.99% to 62.81%, the use of plates thickness from 30up to 50 mm could not provide any enhancement in the ultimate loads, and the use of plates with different width from 50 up to 100 mm increased the ultimate loads about 23.91% to 62.81%. Overall, the strengthening technique using UHP-FRC plate of RC beam with the opening significantly enhance the ultimate load, ductility and shear strength.

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