Background Patients with implanted cardiac devices constitute a growing segment of contemporary health practice. Nurses have a unique role providing care in hospitals, long-term health care, education and psychological support to these patients. Aim To assess critical care nurses' knowledge and practice regarding implantable cardiac devices. Research design A descriptive exploratory design used the following research questions: (a) What is the nurses' knowledge level regarding implantable cardiac devices? (b) How do nurses manage patients with implantable cardiac devices? Setting At selected critical and coronary care units in Egypt. Sample A convenience sample of 40 nurses with a minimum 1 year of experience was included in the study. Tools for data collection: Tool 1: background data that included gender, age, educational level, area of work and years of experience. Tool 2: questionnaire to assess nurses' knowledge regarding implantable cardiac devices. Tool 3: implantable cardiac devices observational checklist to assess nurses' practice when caring for patients who are being fitted with implantable cardiac devices. Results The current findings revealed that nurses have low knowledge and practice scores and no significant correlations existed between gender, age, years of experience, and their level of knowledge and practice, except negative correlation which existed between practice and years of experience regarding implantable cardiac devices. Conclusion Critical care nurses have inadequate knowledge and practice regarding implantable cardiac devices. Recommendations Replication of this study on a larger probability sample from the different geographical locations of the Arab Republic of Egypt and further research to explore why nurses do not have the knowledge or skills regarding implantable cardiac devices.

Construction industry is one of the most influential motivators of a national economy. The success of construction projects is indispensable to sustain a robust economy. Completion time is important for construction projects, nevertheless project multifaceted objectives, sophisticated nature, inherent uncertainties, and risks are success impediments and can cause time overrun. Stochastic models and simulation scheduling techniques are developed to predict the risk and uncertainty effects on construction projects’ duration. The objective of this research is to develop models that predict the activity durations based on actual data from similar projects. The study introduces comprehensive statistical regression models using historical data of about 84,000 activities in Egypt, Kuwait, and Saudi Arabia. The activities encompass engineering, procurement and construction (EPC) activities for most disciplines of construction projects. The regression models can be utilized to predict more reliably the activities’ duration.

Introduction Autophagy is well known as one of the biogenic responses against various stresses, which possesses the benefi cial roles for survival, but little is known about the dynamics and its signifi cance during the septic condition. We hypothesized that autophagy is induced during the septic condition, and contributes to protect from tissue damage which subsequently leads to organ dysfunction. We confi rm whether the autophagic process is accelerated or sustained in an acute phase of sepsis and we also determine its physiological role. Methods Sepsis was induced by cecal ligation and puncture (CLP) in mice. We examined the kinetics of autophagosome and auto lysosome formation which may explain the status of autophagy by western blotting, immunohistochemistry, and electron microscopy. To investigate a precise role of autophagy in CLP-induced sepsis, chloroquine, an autophagy inhibitor, was administered to the CLP-operated mice, and blood chemistry, pathology of the liver and survival were evaluated. Results Autophagy demonstrated by the ratio of LC3-II/LC3-I was induced over the time course up to 24 hours after CLP. The ratio was particularly increased in the liver, heart and spleen. Autophagosome formation became maximal at 6 hours and declined by 24 hours after CLP. Autolysosome formation as evaluated by both fusion of GFP-LC3 dots with LAMP1 immunohistochemistry and electron microscopy was also increased after the procedure. Furthermore, inhibition of autophagy by chloroquine during the CLP procedure resulted in elevation of serum AST levels, and signifi cantly increased mortality in mice. Conclusion Autophagy was induced in several organs over the time course of the CLP sepsis model and then the process was gradually completed to degradation of the components. Our data suggest autophagy plays a protective role in organ dysfunction in sepsis. P2Reversible depressive eff ect of TNFα on a model of isolated perfused rat heart BV Nguyen Introduction Acute myocardial depression in septic shock is common [1]. Myocardial depression is mediated by circulating depressant substances, which until now have been incompletely characterized [2].The aim of our study was to observe the eff ects of TNFα on the model of perfused rat heart. Methods After profound anesthesia with pentothal, the Wistar rats were killed by exsanguination. After sternotomy, the heart was taken and connected to the Langendorf column. The apex of the heart was hooked to a strength sensor. Biopac student laboratory software was used to record and analyse heart contractions. Contractions were recorded every 5 minutes during periods of 20 minutes. Control measurements were fi rst recorded. We measured four parameters: heart rate, contraction force, speeds of contraction and relaxation for control, during TNFα (20 ng/ml) exposure and after removal of TNFα. We express the variations of parameters as percentage of the control ± SEM. A paired t test was used to compare heart rate, contraction amplitude, speeds of contraction and relaxation with TNFα and ...

Introduction: Non invasive positive pressure ventilation (NIPPV) is the first line treatment for hypercapnic acute respiratory failure (ARF) secondary to COPD exacerbation in selected patients. Limited data exist supporting the use of fiberoptic bronchoscopy (FOB) during this clinical setting. The aim of this study is to assess the role of FOB during NIPPV in patients with decompensated COPD acute exacerbation.Methods: This study is a randomized prospective case control pilot study carried out on 50 patients -admitted to critical care units at Alexandria University Hospital, Egypt -suffering from hypercapnic ARF secondary to COPD exacerbation with Kelly Matthay Score from 2 to 4. All patients received NIPPV. Patients were divided randomly into 2 equal groups: group I (cases) (25 patients) was subjected to additional intervention of early FOB during the first 6-12 h from admission while group II (control) (25 patients) received the conventional treatment and NIPPV only. Outcome parameters measured were changes in ABG data, duration of NIPPV, rate of its success, ICU stay and mortality as well as the safety of FOB and possible complications.Results: No significant difference was detected between the 2 groups regarding the baseline characteristics. No serious complications happened from FOB, and Oxygen desaturation happened in 4/ 25 patients (16%), Tachycardia in 2/25 patients (8%). In group I, 23 patients (92%) were successfully weaned from NIPPV versus 16 patients (64%) in group II (p = 0.037). Total duration of NIP-PV was 28.52 h in group I versus 56.25 h in group II (p = 0.001). Length of ICU stay was 4.84 days in group I versus 8.68 days in group II (p = 0.001). Only 1 patient died in group I versus 3 patients in group II (p = 0.609).Conclusion: The early application of FOB during NIPPV in patients with ARF due to COPD exacerbation was shown to be safe. Significant improvement in the outcome of patients who underwent FOB was noticed in terms of improved ABG data, shorter duration of NIPPV, higher percentage of success and shorter ICU stay while no significant difference was detected in mortality.

Nowadays, the construction sector industry energizes all other industries to diversify their service areas, nonetheless this sector needs to keep leading with technological developments. Following the adoption of Building Information Modeling technology (BIM), the construction projects has become more controlled and coordinated, which has contributed to improve productivity rates and to rationalize resources usage. This research is studied the developments in construction, especially technologies that adopt artificial intelligence (AI) with BIM technology such as machine learning, Augmented Reality techniques (AR), digital assistants, robots, automatic planning, scheduling, and optimization. These techniques can be used during design and construction stages to improve collaborative processes that have become a cornerstone of BIM technologies, as well as financial control and scheduling. Through using BIM, the construction industry can adopt AI technologies like autonomous systems and rely on machine learning in project management to access AI-based project self-management.

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