Search results for: renal failure

Authors: Shah S. M. A., Aftab U.

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It is imperative in today’s world to get a real time information about different emergency situation occurred in the environment. Helicopters are mostly used to access places which are hard to access in emergencies like earthquake, floods, bridge failure or in any other disasters conditions. Use of helicopters are considered more costly to properly collect the data. Therefore a new technique has been introduced in this research to promptly collect data using drones. The drone designed in this research is based on trial and error experimental work with objective to construct an economical drone. Locally available material have been used for this purpose. And a mobile camera were also attached to prepare video during the flight. It was found that within very limited resources the result were quite successful.

Keywords: UAV, real time, camera, disasters

Procedia PDF Downloads 218

Authors: Alexander Zotov, Ilkin Osmanov, Emil Sakharov, Oleg Shelest, Aleksander Troitskiy, Robert Khabazov

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Objective: Thoracoscopic surgical ablation of atrial fibrillation (AF) includes two technologies in performing of operation. 1st strategy used is the AtriCure device (bipolar, nonirrigated, non clamping), 2nd strategy is- the Medtronic device (bipolar, irrigated, clamping). The study presents a comparative analysis of clinical outcomes of two strategies in thoracoscopic ablation of AF using AtriCure vs. Medtronic devices. Methods: In 2 center study, 123 patients underwent thoracoscopic ablation of AF for the period from 2016 to 2020. Patients were divided into two groups. The first group is represented by patients who applied the AtriCure device (N=63), and the second group is - the Medtronic device (N=60), respectively. Patients were comparable in age, gender, and initial severity of the condition. Among the patients, in group 1 were 65% males with a median age of 57 years, while in group 2 – 75% and 60 years, respectively. Group 1 included patients with paroxysmal form -14,3%, persistent form - 68,3%, long-standing persistent form – 17,5%, group 2 – 13,3%, 13,3% and 73,3% respectively. Median ejection fraction and indexed left atrial volume amounted in group 1 – 63% and 40,6 ml/m2, in group 2 - 56% and 40,5 ml/m2. In addition, group 1 consisted of 39,7% patients with chronic heart failure (NYHA Class II) and 4,8% with chronic heart failure (NYHA Class III), when in group 2 – 45% and 6,7%, respectively. Follow-up consisted of laboratory tests, chest Х-ray, ECG, 24-hour Holter monitor, and cardiopulmonary exercise test. Duration of freedom from AF, distant mortality rate, and prevalence of cerebrovascular events were compared between the two groups. Results: Exit block was achieved in all patients. According to the Clavien-Dindo classification of surgical complications fraction of adverse events was 14,3% and 16,7% (1st group and 2nd group, respectively). Mean follow-up period in the 1st group was 50,4 (31,8; 64,8) months, in 2nd group - 30,5 (14,1; 37,5) months (P=0,0001). In group 1 - total freedom of AF was in 73,3% of patients, among which 25% had additional antiarrhythmic drugs (AADs) therapy or catheter ablation (CA), in group 2 – 90% and 18,3%, respectively (for total freedom of AF P<0,02). At follow-up, the distant mortality rate in the 1st group was – 4,8%, and in the 2nd – no fatal events. Prevalence of cerebrovascular events was higher in the 1st group than in the 2nd (6,7% vs. 1,7% respectively). Conclusions: Despite the relatively shorter follow-up of the 2nd group in the study, applying the strategy using the Medtronic device showed quite encouraging results. Further research is needed to evaluate the effectiveness of this strategy in the long-term period.

Keywords: atrial fibrillation, clamping, ablation, thoracoscopic surgery

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Authors: Mariem Meddeb Sidhom, Souhayel Hedfi, Rjaibia Houda, Mehdi Dridi, Mohamed Ali Yousfi, Sâadia Gargouri

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Considering the important increase in costs of caspofungin treatments and ahead the evolution of its indication, pharmacy department was prompted to realize a review of the adequacy of prescriptions in the medical intensive care units (ICU). A retrospective observational study was conducted in Tunis military hospital concerning ICU prescriptions of caspofungin from 2008 until 2013. A pharmacist had returned to the patient’s medical records to collect data and to the microbiology department for parasitological results. The adequacy of prescriptions was evaluated by a pharmacist and an infectiologist parasitologist, referring to predefined scale of criteria resuming the indications of the marketing authorization (MA) and grade AI-AII of the guidelines of the Infectious Diseases Society of America (IDSA). Sixty two ICU patients have been treated with caspofungin during the period of study; however, 8 files were lost. Thus, 54 patients were included in the study having received 55 prescriptions of caspofungin. Males were a majority with 64.8% of the population. Mean age was 51 years. Caspofungin was indicated in accordance with the IDSA recommendations in 43.6% of the cases. The most case of non respect to the guidelines was the indication of caspofungin as empirical treatment in non neutropenic patients. Caspofungin was utilized as a first line treatment in 9 cases where it was possible to give fluconazole first, as germs were fluconazole- sensitive. Caspofungin was indicated in 2 patients with good renal function and in which nor amphotericin B, liposomal ampho B neither itraconazole had been previously used, as indicates the MA. The posology of caspofungin was respected in all prescriptions with a loading dose of 70 mg in the first day and a maintenance dose of 50 mg daily. Seven patients had received a daily dose of 70 mg, the recommended dose for people weighing more than 80 Kg. Caspofungin prescriptions are far to be adequately done. There is a clear need of optimization in indicating this molecule and that must be done in collaboration between the pharmacy department, the ICUs and parasitology department.

Keywords: caspofungin, prescription, intensive care units, marketing authorization, Tunisian hospital cohort

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Authors: Apurv Kulkarni, Shreyas Badave, B. Rajiv

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Non-parametric reliability technique is useful for assessment of reliability of systems for which failure rates are not available. This is useful when detection of malfunctioning of any component is the key purpose during ongoing operation of the system. The main purpose of the Heat Exchanger Cycle discussed in this paper is to provide hot water at a constant temperature for longer periods of time. In such a cycle, certain components play a crucial role and this paper presents an effective way to predict the malfunctioning of the components by determination of system reliability. The method discussed in the paper is feasible and this is clarified with the help of various test cases.

Keywords: heat exchanger cycle, k-statistics, PID controller, system reliability

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Authors: Kamil Ganaev, Elina Vlasova, Andrei Shiryaev, Renat Akchurin

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De novo atrial fibrillation (AF) after coronary artery bypass grafting (CABG) is a common complication. To date, there are no data on the possible effect of diffuse lesions of coronary arteries on the incidence of postoperative AF complications. Methods. Patients operated on-pump under hypothermic conditions during the calendar year (2020) were studied. Inclusion criteria - isolated CABG and achievement of complete myocardial revascularization. Patients with a history of AF moderate and severe valve dysfunction, hormonal thyroid pathology, initial CHF(Congestive heart failure), as well as patients with developed perioperative complications (IM, acute heart failure, massive blood loss) and deceased were excluded. Thus 227 patients were included; mean age 65±9 years; 69% were men. 89% of patients had a 3-vessel lesion of the coronary artery; the remainder had a 2-vessel lesion. Mean LV size: 3.9±0.3 cm, indexed LV volume: 29.4±5.3 mL/m2. Two groups were considered: D (n=98), patients with diffuse coronary heart disease, and L (n=129), patients with local coronary heart disease. Clinical and demographic characteristics in the groups were comparable. Rhythm assessment: continuous bedside ECG monitoring up to 5 days; ECG CT at 5-7 days after CABG; daily routine ECG registration. Follow-up period - postoperative hospital period. Results. The Median follow-up period was 9 (7;11) days. POFP (Postoperative atrial fibrillation) was detected in 61/227 (27%) patients: 34/98 (35%) in group D versus 27/129 (21%) in group L; p<0.05. Moreover, the values of revascularization index in groups D and L (3.9±0.7 and 3.8±0.5, respectively) were equal, and the mean time Cardiopulmonary bypass (CPB) (107±27 and 80±13min), as well as the mean ischemic time (67±17 and 55±11min) were significantly longer in group D (p<0.05). However, a separate analysis of these parameters in patients with and without developed AF did not reveal any significant differences in group D (CPB time 99±21.2 min, ischemic time 63±12.2 min), or in group L (CPB time 88±13.1 min, ischemic time 58.7±13.2 min). Conclusion. With the diffuse nature of coronary lesions, the incidence of AF in the hospital period after isolated CABG definitely increases. To better understand the role of severe coronary atherosclerosis in the development of POAF, it is necessary to distinguish the influence of organic features of atrial and ventricular myocardium (as a consequence of chronic coronary disease) from the features of surgical correction in diffuse coronary lesions.

Keywords: atrial fibrillation, diffuse coronary artery disease, coronary artery bypass grafting, local coronary artery disease

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Authors: Said Ghalem

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Honey is primarily composed of sugars: glucose and fructose. Depending honey, it's either fructose or glucose predominates. More the fructose concentration and the less the glycemic index (GI) is high. Thus, changes in the insulin response shows a decrease of the amount of insulin secreted at an increased fructose honey. Honey is also a compound that can reduce the lipid in the blood. Several studies on animals, but which remain to be checked in humans, have shown that the honey can have interesting effects when combined with other molecules: associated with Metformin (a medicine taken by diabetics), it shows the benefits and effects of diabetes preserves the tissue; associated ginger, it increases the antioxidant activity and thus avoids neurologic complications, neuropathic. Molecular modeling techniques are widely used in chemistry, biology, and the pharmaceutical industry. Most of the currently existing drugs target enzymes. Inhibition of DPP-4 is an important approach in the treatment of type 2 diabetes. We have chosen for the inhibition of DPP-4 the following molecules: Linagliptin (BI1356), Sitagliptin (Januvia), Vildagliptin, Saxagliptin, Alogliptin, and Metformin (Glucophage), that are involved in the disease management of type 2 diabetes and added to honey. For this, we used software Molecular Operating Environment. A Wistar rat study was initiated in our laboratory with a well-studied protocol; after sacrifice, according to international standards and respect for the animal This theoretical approach predicts the mode of interaction of a ligand with its target. The honey can have interesting effects when combined with other molecules, it shows the benefits and effects of honey preserves the tissue, it increases the antioxidant activity, and thus avoids neurologic complications, neuropathic or macrovascular. The organs, especially the kidneys of Wistar, shows that the parameters to renal function let us conclude that damages caused by diabetes are slightly perceptible than those observed without the addition of a high concentration of fructose honey.

Keywords: honey, molecular modeling, DPP4 enzyme, metformin

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Authors: Denys Sebov, Viktoriia Korotaieva, Kateryna Markina

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The clinical advantage of the multipill combination drugs administration (polypill-strategy) over single-component drugs (monopill-strategy) has been established in patients with comorbid arterial hypertension, heart failure, chronic coronary syndrome, diabetes. It was found that polypill-strategy provides better treatment adherence in 33.4% of the patients. It was proven a significant decrease in systolic and diastolic blood pressure, as well as a decrease in dispersion index due to the stability of the blood pressure profile in patients with the polypill-strategy treatment.

Keywords: polypill, artetial hypertension, cardiovascular disease, compliance

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Authors: Rukia Yosuf

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Diabetes is a national healthcare crisis related to both macrovascular and microvascular complications. We hypothesized that higher levels of physical activity are associated with lower total and visceral fat mass, lower systolic blood pressure, and increased insulin sensitivity. Participant inclusion criteria: 21-50 years old, BMI ≥ 30 kg/m2, hemoglobin A1C 5.7-6.4, fasting glucose 100-125 mg/dL, and HOMA IR ≥ 2.5. Exclusion criteria: history of diabetes, hypertension, HIV, renal disease, hearing loss, alcoholic intake over four drinks daily, use of organic nitrates or PDE5 inhibitors, and decreased cardiac function. Total physical activity was measured using accelerometers, body composition using DXA, and insulin resistance via fsIVGTT. Clinical and biochemical cardiometabolic risk factors, blood pressure and heart rate were obtained using a calibrated sphygmomanometer. Anthropometric measures, fasting glucose, insulin, lipid profile, C-reactive protein, and BMP were analyzed using standard procedures. Within our study, we found correlations between levels of physical activity in a heterogeneous group of prediabetic adults. Patients with more physical activity had a higher degree of insulin sensitivity, lower blood pressure, total visceral adipose tissue, and overall lower total mass. Total physical activity levels showed small, but significant correlations with systolic blood pressure, visceral fat, lean mass and insulin sensitivity. After normalizing for the race, age, and gender using multiple regression, these associations were no longer significant considering our small sample size. More research into prediabetes will decrease the population of diabetics overall. In the future, we could increase sample size and conduct cross sectional and longitudinal studies in various populations with prediabetes.

Keywords: diabetes, kidney disease, nephrology, prediabetes

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Authors: Sidra Suleman, Maliha Suleman, Jinesh Shah

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Maxillary canines play a crucial role in occlusion and aesthetics. Successful management of impacted canines requires early identification and intervention to prevent complications such as resorption of adjacent teeth and cystic changes. Although removal of the deciduous canine can encourage normal eruption of its successor, this is not always successful. Some patients may require surgical exposure and bonding of a gold chain to mobilise and align the canine, which can take up to 3 years. As this procedure has various risks, patients need to be appropriately consented to. Failure of such treatment commonly occurs due to inadequate anchorage or failure of the gold chain attachment, but in some cases, this is due to ankylosis. Aim: The aim of this study was to determine the incidence of ankylosis of unerupted maxillary ectopic canines following surgical exposure and orthodontic alignment at the Maxillofacial and Orthodontic Department, Royal Stoke University Hospital (RSUH), United Kingdom. Methodology: Patients treated from January 1, 2017, to December 31, 2019, were retrospectively studied. Electronic records with post-treatment follow-up at 3-6 months and 12-15 months were extracted and analysed. Patients were excluded based on three criteria, non-compliance with orthodontic treatment post-surgery, presence of canine transposition, and external orthodontic treatment. Sample: Overall, 159 suitable patients were selected from the 171 patients identified. Surgical exposure and gold chain bonding was carried out for a total of 206 maxillary canines, with the pattern of impaction being 159 (77.2 %) palatal, 46 (22.3%) buccal, and 1 (0.49%) in line of the arch. The sample consisted of 57 (35.8%) males and 102 (64.2%) females between the age range of 10 to 32 years, with the mean age being 15 years. The procedures were carried out under general anaesthesia for all but three patients, with two cases being repeats. Closed exposure was carried out for 189 (91.7%) canines. Results: The incidence of ankylosis from this study was 0.97%. In total, two patients had upper left canine ankylosis, which was identified at their 12-15 months orthodontic follow-up. Both patients were males, one having closed exposure at age 15 and the other having open exposure at age 19. Conclusions: Although this data shows that there is a low risk of ankylosis (0.97%), it highlights the difficulty in predicting which patients may be affected, and thus, a thorough pre-treatment assessment and careful observation during treatment is necessary. Future studies involving larger cohorts are warranted to further analyse factors affecting outcomes.

Keywords: ankylosis, ectopic, maxillary canines, orthodontics

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Authors: Navid P Roodaki, Rochelle Abila, Daisy Evangeline Garcia

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Background and Objective: Respiratory Distress Syndrome (RDS) among premature infants is a major causes of neonatal death. The use of Continuous Positive Airway Pressure (CPAP) has become a standard of care for preterm newborns with RDS hence cost-effective innovations are needed. This study compared a novel low-cost Bubble CPAP (bCPAP) device to ventilator driven CPAP in the treatment of RDS. Methods: This is a single-blind, randomized controlled trial done on May 2022 to October 2022 in a Level III Neonatal Intensive Care Unit in the Philippines. Preterm newborns (<36 weeks) with RDS were randomized to receive Vayu bCPAP device or Ventilator-derived CPAP. Arterial Blood Gases, Oxygen Saturation, administration of surfactant, and CPAP failure rates were measured. Results: Seventy preterm newborns were included. No differences were observed between the Ventilator driven CPAP and Vayu bCPAP on the PaO2 (97.51mmHg vs 97.37mmHg), So2 (97.08% vs 95.60%) levels, amount of surfactant administered between groups. There were no observed differences in CPAP failure rates between Vayu bPCAP (x̄ 3.23 days) and ventilator-driven CPAP (x̄ 2.98 days). However, a significant difference was noted on the CO2 level (40.32mmHg vs 50.70mmHg), which was higher among those hooked to Ventilator-driven CPAP (p 0.004). Conclusion: This study has shown that the novel low-cost bubble CPAP (Vayu bCPAP) can be used as an efficacious alternate non invasive oxygen therapy among preterm neonates with RDS, although the CO2 levels were higher among those hooked to ventilator driven CPAP, other outcome parameters measured showed that both devices are comparable. Recommendation: A multi-center or national study to account for geographic region, which may alter the outcomes of patients connected to different ventilatory support. Cost comparison between devices is also suggested. A mixed-method research assessing the experiences of health care professionals in assembling and utilizing the gadget is a second consideration.

Keywords: bubble CPAP, ventilator-derived CPAP; infant, premature, respiratory distress syndrome

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Authors: Amit R. Bhende, G. K. Awari

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Remaining useful life (RUL) prediction is one of key technologies to realize prognostics and health management that is being widely applied in many industrial systems to ensure high system availability over their life cycles. The present work proposes a data-driven method of RUL prediction based on multiple health state assessment for rolling element bearings. Bearing degradation data at three different conditions from run to failure is used. A RUL prediction model is separately built in each condition. Feed forward back propagation neural network models are developed for prediction modeling.

Keywords: bearing degradation data, remaining useful life (RUL), back propagation, prognosis

Procedia PDF Downloads 417

Authors: Imen Asma Mbarek, Alexis Rusinek, Etienne Petit, Guy Sutter, Gautier List

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Over the past two decades, the automotive, aerospace and army industries have been paying an increasing attention to Finite Elements (FE) numerical simulations of the fracture process of their structures. Thanks to the numerical simulations, it is nowadays possible to analyze several problems involving costly and dangerous extreme loadings safely and at a reduced cost such as blast or ballistic impact problems. The present paper is concerned with ballistic impact and perforation problems involving ductile fracture of thin armor steel targets. The target fracture process depends usually on various parameters: the projectile nose shape, the target thickness and its mechanical properties as well as the impact conditions (friction, oblique/normal impact...). In this work, the investigations are concerned with the normal impact of a conical head-shaped projectile on thin armor steel targets. The main aim is to establish a comparative study of four fracture criteria that are commonly used in the fracture process simulations of structures subjected to extreme loadings such as ballistic impact and perforation. Usually, the damage initiation results from a complex physical process that occurs at the micromechanical scale. On a macro scale and according to the following fracture models, the variables on which the fracture depends are mainly the stress triaxiality ƞ, the strain rate, temperature T, and eventually the Lode angle parameter Ɵ. The four failure criteria are: the critical strain to failure model, the Johnson-Cook model, the Wierzbicki model and the Modified Hosford-Coulomb model MHC. Using the SEM, the observations of the fracture facies of tension specimen and of armor steel targets impacted at low and high incident velocities show that the fracture of the specimens is a ductile fracture. The failure mode of the targets is petalling with crack propagation and the fracture facies are covered with micro-cavities. The parameters of each ductile fracture model have been identified for three armor steels and the applicability of each criterion was evaluated using experimental investigations coupled to numerical simulations. Two loading paths were investigated in this study, under a wide range of strain rates. Namely, quasi-static and intermediate uniaxial tension and quasi-static and dynamic double shear testing allow covering various values of stress triaxiality ƞ and of the Lode angle parameter Ɵ. All experiments were conducted on three different armor steel specimen under quasi-static strain rates ranging from 10-4 to 10-1 1/s and at three different temperatures ranging from 297K to 500K, allowing drawing the influence of temperature on the fracture process. Intermediate tension testing was coupled to dynamic double shear experiments conducted on the Hopkinson tube device, allowing to spot the effect of high strain rate on the damage evolution and the crack propagation. The aforementioned fracture criteria are implemented into the FE code ABAQUS via VUMAT subroutine and they were coupled to suitable constitutive relations allow having reliable results of ballistic impact problems simulation. The calibration of the four damage criteria as well as a concise evaluation of the applicability of each criterion are detailed in this work.

Keywords: armor steels, ballistic impact, damage criteria, ductile fracture, SEM

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Authors: Atefeh Abdollahi, Maryam Bahreini, Babak Choobi Anzali, Fatemeh Rasooli

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Introduction: Triage becomes the main part of organization of care in Emergency department (ED)s. It is used to describe the sorting of patients for treatment priority in ED. The accurate triage of injured patients has reduced fatalities and improved resource usage. Besides, the nurses’ knowledge and skill are important factors in triage decision-making. The ability to define an appropriate triage level and their need for intervention is crucial to guide to a safe and effective emergency care. Methods: This is a prospective cross-sectional study designed for emergency nurses working in four public university hospitals. Five triage workshops have been conducted every three months for emergency nurses based on a standard triage Emergency Severity Index (ESI) IV slide set - approved by Iranian Ministry of Health. Most influential items on triage performance were discussed through brainstorming in workshops which then, were peer reviewed by five emergency physicians and two head registered nurses expert panel. These factors that might distract nurse’ attention from proper decisions included patients’ past medical diseases, the natural tricks of triage and system failure. After permission had been taken, emergency nurses participated in the study and were given the structured questionnaire. Data were analysed by SPSS 21.0. Results: 92 emergency nurses enrolled in the study. 30 % of nurses reported the past history of chronic disease as the most influential confounding factor to ascertain triage level, other important factors were the history of prior admission, past history of myocardial infarction and heart failure to be 20, 17 and 11 %, respectively. Regarding the concept of difficulties in triage practice, 54.3 % reported that the discussion with patients and family members was difficult and 8.7 % declared that it is hard to stay in a single triage room whole day. Among the participants, 45.7 and 26.1 % evaluated the triage workshops as moderately and highly effective, respectively. 56.5 % reported overcrowding as the most important system-based difficulty. Nurses were mainly doubtful to differentiate between the triage levels 2 and 3 according to the ESI VI system. No significant correlation was found between the work record of nurses in triage and the uncertainty in determining the triage level and difficulties. Conclusion: The work record of nurses hardly seemed to be effective on the triage problems and issues. To correct the deficits, training workshops should be carried out, followed by continuous refresher training and supportive supervision.

Keywords: assessment, education, nurse, triage

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Authors: Onur Ozveri, Korkut Karabag, Cagri Keles

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It is an important issue that the occurring of production downtime and repair costs when machines fail in the machine intensive production industries. In the case of failure of more than one machine at the same time, which machines will have the priority to repair, how to determine the optimal repair time should be allotted for this machines and how to plan the resources needed to repair are the key issues. In recent years, Business Process Management (BPM) technique, bring effective solutions to different problems in business. The main feature of this technique is that it can improve the way the job done by examining in detail the works of interest. In the industries, maintenance and repair works are operating as a process and when a breakdown occurs, it is known that the repair work is carried out in a series of process. Maintenance main-process and repair sub-process are evaluated with process management technique, so it is thought that structure could bring a solution. For this reason, in an international manufacturing company, this issue discussed and has tried to develop a proposal for a solution. The purpose of this study is the implementation of maintenance and repair works which is integrated with process management technique and at the end of implementation, analyzing the maintenance related parameters like quality, cost, time, safety and spare part. The international firm that carried out the application operates in a free region in Turkey and its core business area is producing original equipment technologies, vehicle electrical construction, electronics, safety and thermal systems for the world's leading light and heavy vehicle manufacturers. In the firm primarily, a project team has been established. The team dealt with the current maintenance process again, and it has been revised again by the process management techniques. Repair process which is sub-process of maintenance process has been discussed again. In the improved processes, the ABC equipment classification technique was used to decide which machine or machines will be given priority in case of failure. This technique is a prioritization method of malfunctioned machine based on the effect of the production, product quality, maintenance costs and job security. Improved maintenance and repair processes have been implemented in the company for three months, and the obtained data were compared with the previous year data. In conclusion, breakdown maintenance was found to occur in a shorter time, with lower cost and lower spare parts inventory.

Keywords: ABC equipment classification, business process management (BPM), maintenance, repair performance

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Authors: Gunnar Oskarsson, Gudjon Helgi Egilsson

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Due to globalization, small and medium-sized enterprises (SME) increasingly offer their products and services in foreign markets. The main reasons are either to compensate for a decreased market share in their home market or to exploit opportunities in foreign markets, which are becoming less distant and better accessible than before. International markets are particularly important for companies located in a small economy and offering specialized products. Although more accessible, entering international markets is both expensive and difficult. In order to select the most appropriate markets, it is, therefore, important to gain an insight into the factors that have an impact on success, or potential failure. Although there has been a reasonable volume of research into the theory of internationalization, there is still a need to gain further understanding of the decision-making process of SMEs in small economies and the most important characteristics that distinguish between success and failure. The main objective of this research is to enhance knowledge on the internationalization of SMEs, including the drivers for the decision to internationalize, and the most important factors contributing to success in their internationalization activities. A qualitative approach was found to be most appropriate for this kind of research, with the objective of gaining a deeper understanding and discovering factors which impact a company’s decision-making and potential success. In-depth interviews were conducted with 14 companies in different industries located in Iceland, a country extensively dependent on export revenues. The interviews revealed several factors as drivers of internationalization and, not surprisingly, the most frequently mentioned source of motivation was that the local market is inadequate to maintain a sustainable operation. Good networking relationships were seen as a particular priority for potential success, searching for new markets was mainly carried out through the internet, although sales exhibitions and sales trips were also considered important. When it comes to the final decision as to whether a market should be considered for further analysis, economy, labor cost, legal environment, and cultural barriers were the most common factors to be weighted. The ultimate answer to successful internationalization, however, is largely dependent on a coordinated and experienced management team. The main contribution of this research is offering an insight into factors affecting decision-making in the internationalization process of SMEs, based on the opinion and experience of managers of SMEs in a small economy.

Keywords: internationalization, success factors, small and medium-sized enterprises (SMEs), drivers, decision making

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Authors: C. C .D. Kulathilake, M. Jayatilake, T. Takahashi

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The myocardium is composed of specialized muscle which relies mainly on fatty acid and sugar metabolism and it is widely contribute to the heart functioning. The changes of the cardiac energy-producing system during heart failure have been proved using autoradiography techniques. This study focused on evaluating sugar and fatty acid metabolism in myocardium as cardiac energy getting system using heart-accumulated radiopharmaceuticals. Two sets of autoradiographs of heart cross sections of Lewis male rats were analyzed and the time- accumulation curve obtained with use of the MATLAB image processing software to evaluate fatty acid and sugar metabolic functions.

Keywords: autoradiographs, fatty acid, radiopharmaceuticals, sugar

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Authors: Ezekiel Mwangi, Stephen Kimani, Agnes Mindila

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Usability is one of the key factors that determine the success or failure of any WebGIS (technology normally applied on the internet to analyze and present spatial data on the Internet). However, not all the usability attributes have the same impact on usability. It is, therefore, necessary to prioritize WebGIS usability elements and determine the ones that are more crucial to the success of the WebGIS. This research aims to identify the main elements of WebGIS usability, investigate the order of importance and priority of the usability elements of WebGIS, and propose a WebGIS development framework that incorporates the prioritization of the usability elements. This will be achieved through a literature review. The outcome of this research will help usability specialists and WebGIS developers in determining specific usability elements that should be accorded more emphasis during the design and development of WebGIS.

Keywords: framework, prioritization, usability, WebGIS

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Authors: Naif Mohsen Alharbi

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This paper present failure occurred on flexible coupling installed at oil anf gas operation. Also it presents maintenance ideas implemented on the flexible coupling installed to transmit high torque from gearbox to pump. Basically, the machine train is including steam turbine which drives the pump and there is gearbox located in between for speed reduction. investigation are identifying the root causes, solving and developing the technology designs or bad actor. This report provides the study intentionally for continues operation optimization, utilize the advanced opportunity and implement a improvement. Objective: The main objectives of the investigation are identifying the root causes, solving and developing the technology designs or bad actor. Ultimately, fulfilling the operation productivity, also ensuring better technology, quality and design by solutions. This report provides the study intentionally for continues operation optimization, utilize the advanced opportunity and implemet improvement. Method: The method used in this project was a very focused root cause analysis procedure that incorporated engineering analysis and measurements. The analysis method extensively covers the measuring of the complete coupling dimensions. Including the membranes thickness, hubs, bore diameter and total length, dismantle flexible coupling to diagnose how deep the coupling has been affected. Also, defining failure modes, so that the causes could be identified and verified. Moreover, Vibration analysis and metallurgy test. Lastly applying several solutions by advanced tools (will be mentioned in detail). Results and observation: Design capacity: Coupling capacity is an inadequate to fulfil 100% of operating conditions. Therefore, design modification of service factor to be at least 2.07 is crucial to address this issue and prevent recurrence of similar scenario, especially for the new upgrading project. Discharge fluctuation: High torque flexible coupling encountered during the operation. Therefore, discharge valve behaviour, tuning, set point and general conditions revaluated and modified subsequently, it can be used as baseline for upcoming Coupling design project. Metallurgy test: Material of flexible coupling membrane (discs) tested at the lab, for a detailed metallurgical investigation, better material grade has been selected for our operating conditions,

Keywords: high speed machine, reliabilty, flexible coupling, rotating equipment

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Authors: Amin Tarzi

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The government of the Islamic Republic of Afghanistan was expected to keep the Taliban insurgents at bay after the departure of North Atlantic Treaty Organization (NATO)-led forces in 2021, especially given the two decades of effort to establish security forces to safeguard Western-backed governing institutions. This articles reviews the reasons for the failure of the much larger and better-equipped Afghan National Security Forces (ANSF) to stop the Taliban from taking over the Afghan capital of Kabul in a few days and analyzes the often-forgotten dimension of strategic calculations in this dialogue—namely the societal dimension. In this article, the author argues that this is one of the primary reasons that the ANSF and the Afghan government collapsed.

Keywords: societal warfare, Afghanistan, NATO, Taliban, military strategy

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Authors: Priya Jaswal, Vivek, S. K. Sinha

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One of the most important and complicated factors influencing the functional performance of unpaved roads is traffic loading. The complexity of traffic loading is caused by the variable magnitude and frequency of load, which causes unpaved roads to fail prematurely. Unpaved roads are low-volume roads, and as peri-urbanization increases, unpaved roads act as a means to boost the rural economy. This has also increased traffic on unpaved roads, intensifying the issue of settlement, rutting, and fatigue failure. This is a major concern for unpaved roads built on poor subgrade soil, as excessive rutting caused by heavy loads can cause driver discomfort, vehicle damage, and an increase in maintenance costs. Some researchers discovered that when a consistent static load is exerted as opposed to a rapidly changing load, the rate of deformation of unpaved roads increases. Previously, some of the most common methods for overcoming the problem of rutting and fatigue failure included chemical stabilisation, fibre reinforcement, and so on. However, due to their high cost, engineers' attention has shifted to geotextiles which are used as reinforcement in unpaved roads. Geotextiles perform the function of filtration, lateral confinement of base material, vertical restraint of subgrade soil, and the tension membrane effect. The use of geotextiles in unpaved roads increases the strength of unpaved roads and is an economically viable method because it reduces the required aggregate thickness, which would need less earthwork, and is thus recommended for unpaved road applications. The majority of geotextiles used previously were polymeric, but with a growing awareness of sustainable development to preserve the environment, researchers' focus has shifted to natural fibres. Coir is one such natural fibre that possesses the advantage of having a higher tensile strength than other bast fibres, being eco-friendly, low in cost, and biodegradable. However, various researchers have discovered that the surface of coir fibre is covered with various impurities, voids, and cracks, which act as a plane of weakness and limit the potential application of coir geotextiles. To overcome this limitation, chemical surface modification of coir geotextiles is widely accepted by researchers because it improves the mechanical properties of coir geotextiles. The current paper reviews the effect of using treated coir geotextiles as reinforcement on the load-deformation behaviour of a two-layered unpaved road model.

Keywords: coir, geotextile, treated, unpaved

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Authors: K. Vandenboer, L. Dolphen, A. Bezuijen

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Backward erosion piping is an important failure mechanism for water-retaining structures, a phenomenon that results in the formation of shallow pipes at the interface of a sandy or silty foundation and a cohesive cover layer. This paper studies the effect of two soil types on backward erosion piping; both in case of a homogeneous sand layer, and in a vertically layered sand sample, where the pipe is forced to subsequently grow through the different layers. Two configurations with vertical sand layers are tested; they both result in wider pipes and higher critical gradients, thereby making this an interesting topic in research on measures to prevent backward erosion piping failures.

Keywords: backward erosion piping, embankments, physical modeling, sand

Procedia PDF Downloads 375

Authors: Qian Zhao, Shi-Qi Liu, Bo Guo, Zhi-Jun Cheng, Xiao-Yue Wu

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Cold standby redundancy is considered to be an effective mechanism for improving system reliability and is widely used in industrial engineering. However, because of the complexity of the reliability structure, there is little literature studying on the residual life of cold standby system consisting of complex components. In this paper, a simulation method is presented to predict the residual life of k-out-of-n cold standby system. In practical cases, failure information of a system is either unknown, partly unknown or completely known. Our proposed method is designed to deal with the three scenarios, respectively. Differences between the procedures are analyzed. Finally, numerical examples are used to validate the proposed simulation method.

Keywords: cold standby system, k-out-of-n, residual life, simulation sampling

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Authors: Rebeca V. Tholen, Elaine Bundy

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Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving an LT. Methods: The HRAR Scale is a predictive tool designed to determine the severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients. (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients, and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving a LT. Methods: The HRAR Scale is a predictive tool designed to determine severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients.

Keywords: alcoholism, liver transplant, quality improvement, substance abuse

Procedia PDF Downloads 100

Authors: Jesús Ulloa

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The creation, rise, and consolidation of far right-wing, ultranationalist, and eurosceptic parties in Europe after the Second World War pose a real threat towards the disintegration of the European Union. Starting more than thirty years ago with Jean-Marie Le Pen's FN and Margaret Thatcher's policies, to Marine Le Pen's current FN and anti-immigration proposals along with Nigel Farage's UKIP and their intentions to leave the European Union, the progress of right-wing parties should be noted, taking into account that they may have very important differences within their postures but that they also reach common ground in certain areas. The actual disintegration of the EU would represent an enormous failure of the new liberal world order. Through this essay, the roots of this political parties will be analyzed and the conclusion of whether the disintegration may become a reality or if the principles of cooperation and unity will prevail will be answered.

Keywords: eurosceptic, ultarnationalist, right-wing, European Union

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Authors: Sanchir Erdenebayar, Namuuntsetseg Oyunbaatar

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Objectives: Peritoneal dialysis treatment is one of the important forms of kidney replacement therapy, and it has recently developed instantly in Mongolia for the past five years. Currently, more than 120 patients undergo peritoneal dialysis nationwide. These patients lack nutritional education, which predisposes them to protein deficiency and further impairs their quality of life. However, there is no study which is conducted among those about their dietary in Mongolia. Therefore, integrated nutrition information and educating them about dietary patterns to follow are urgently needed for PD patients. Methods: A cross-sectional study was carried out on 45 patients aged between 18 and 60 years who were undergoing CAPD at the biggest Medvic dialysis center in Ulaanbaatar. The knowledge of nutrition and food intake is assessed by interview based on a validated questionnaire prepared from KDIGO guidelines, semi-FFQ and a 24-hour dietary recall method. In addition, a biochemical blood test that includes total protein, albumin, calcium, phosphorus, potassium, and hemoglobin is used for an assessment of the patient’s current nutritional status. Results: Knowledge of nutritional status for CAPD was great, with 21.4% of patients and 78.65% having poor nutrition knowledge. The rate of mild to moderate malnutrition was 48.8% among research participants. Serum albumin was 38.4 ± 4.7 g/L, and total protein was 67.3±7.5g/l. Patients met 62.5± 26.5% of their daily intake nutritional requirement for calories and 72±40% of their nutritional requirement for protein. All patients’ energy intake was significantly /1328±304kcal/ lower than the energy requirement (2124±378kcal). Only 14.2% met the recommended dietary protein intake recommended to them of greater than 1.2 g/kg. Conclusions: As was established before, nutritional education has a vital positive impact on the health and nutritional status of peritoneal dialysis patients. The results of this study show that nutritional education programs are not enough adequate in peritoneal dialysis patients. There is a crucial priority to establish nutritional educational programs and guidelines for PD patients in Mongolia.

Keywords: renal diet, peritoneal dialysis, nutrition education, CKD diet

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Authors: MUSAWIRA IFTIKHAR

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The field of membrane materials is the most dynamic due to the constantly evolving requirements advancement of materials, to address challenges such as biocompatibility, protein-bound uremic toxins, blood coagulation, auto-immune responses, oxidative stress, and poor clearance of uremic toxins. Hemodialysis is a membrane filtration processes that is currently necessary for daily living of the patients with ESRD. Tens of millions of people with ESRD have benefited from hemodialysis over the past 60–70 years, both in terms of safeguarding life and a longer lifespan. Beyond challenges associated with the efficiency and separative properties of the membranes, ensuring hemocompatibility, or the safe circulation of blood outside the body for four hours every two days, remains a persistent challenge. This review explores the ongoing field of metal–Organic Frameworks (MOFs) and their applications in hemodialysis, offering a comprehensive examination of various MOFs employed to address challenges inherent in traditional hemodialysis methodologies. this This review included includes the experimental work done with various MOFs as a filler such as UiO-66, HKUST-1, MIL-101, and ZIF-8, which together lead to improved adsorption capacities for a range of uremic toxins and proteins. Furthermore, this review highlights how effectively MOF-based hemodialysis membranes remove a variety of uremic toxins, including p-cresol, urea, creatinine, and indoxyl sulfate and potential filler choices for the future. Future research efforts should focus on refining synthesis techniques, enhancing toxin selectivity, and investigating the long-term durability of MOF-based membranes. With these considerations, MOFs emerge as transformative materials in the quest to develop advanced and efficient hemodialysis technologies, holding the promise to significantly enhance patient outcomes and redefine the landscape of renal therapy.

Keywords: membrane, hemodailysis, metal organic frameworks, seperation, protein adsorbtion

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Authors: Dong Jiang

Abstract:

Turnout is the essential equipment on the railway, which also belongs to one of the strongest demanded infrastructural facilities of railway on account of the more seriously frog rail failures. In cooperation with Germany Company (DB Systemtechnik AG), our research team focuses on the quantitative analysis about the frog rails to predict their lifetimes. Moreover, the suggestions for the timely and effective maintenances are made to improve the economy of the frog rails. The lifetime of the frog rail depends strongly on the internal damage of the running surface until the breakages occur. On the basis of Hertzian theory of the contact mechanics, the dynamic loads of the running surface are calculated in form of the contact pressures on the running surface and the equivalent tensile stress inside the running surface. According to material mechanics, the strength of the frog rail is determined quantitatively in form of the Stress-cycle (S-N) curve. Under the interaction between the dynamic loads and the strength, the internal damage of the running surface is calculated by means of the linear damage hypothesis of the Miner’s rule. The emergence of the first Breakage on the running surface is to be defined as the failure criterion that the damage degree equals 1.0. From the microscopic perspective, the running surface of the frog rail is divided into numerous segments for the detailed analysis. The internal damage of the segment grows slowly in the beginning and disproportionately quickly in the end until the emergence of the breakage. From the macroscopic perspective, the internal damage of the running surface develops simply always linear along the lifetime. With this linear growth of the internal damages, the lifetime of the frog rail could be predicted simply through the immediate introduction of the slope of the linearity. However, the superficial abrasion plays an essential role in the results of the internal damages from the both perspectives. The influences of the superficial abrasion on the lifetime are described in form of the abrasion rate. It has two contradictory effects. On the one hand, the insufficient abrasion rate causes the concentration of the damage accumulation on the same position below the running surface to accelerate the rail failure. On the other hand, the excessive abrasion rate advances the disappearance of the head hardened surface of the frog rail to result in the untimely breakage on the surface. Thus, the relationship between the abrasion rate and the lifetime is subdivided into an initial phase of the increased lifetime and a subsequent phase of the more rapid decreasing lifetime with the continuous growth of the abrasion rate. Through the compensation of these two effects, the critical abrasion rate is discussed to reach the optimal lifetime.

Keywords: breakage, critical abrasion rate, frog rail, internal damage, optimal lifetime

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Authors: Andreas Rudisch, Ralf Lampert, Andreas Kolbitsch

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It is a well-known fact among the engineering community that earthquakes with comparatively low magnitudes can cause serious damage to nonstructural components (NSCs) of buildings, even when the supporting structure performs relatively well. Past research works focused mainly on NSCs of nuclear power plants and industrial plants. Particular attention should also be given to architectural façade elements of old masonry buildings (e.g. ornamental figures, balustrades, vases), which are very vulnerable under seismic excitation. Large numbers of these historical nonstructural components (HiNSCs) can be found in highly frequented historical city centers and in the event of failure, they pose a significant danger to persons. In order to estimate the vulnerability of acceleration sensitive HiNSCs, the peak horizontal floor acceleration (PHFA) is used. The PHFA depends on the dynamic characteristics of the building, the ground excitation, and induced nonlinearities. Consequently, the PHFA can not be generalized as a simple function of height. In the present research work, an extensive case study was conducted to investigate the influence of induced nonlinearity on the PHFA for old masonry buildings. Probabilistic nonlinear FE time-history analyses considering three different hazard levels were performed. A set of eighteen synthetically generated ground motions was used as input to the structure models. An elastoplastic macro-model (multiPlas) for nonlinear homogenized continuum FE-calculation was calibrated to multiple scales and applied, taking specific failure mechanisms of masonry into account. The macro-model was calibrated according to the results of specific laboratory and cyclic in situ shear tests. The nonlinear macro-model is based on the concept of multi-surface rate-independent plasticity. Material damage or crack formation are detected by reducing the initial strength after failure due to shear or tensile stress. As a result, shear forces can only be transmitted to a limited extent by friction when the cracking begins. The tensile strength is reduced to zero. The first goal of the calibration was the consistency of the load-displacement curves between experiment and simulation. The calibrated macro-model matches well with regard to the initial stiffness and the maximum horizontal load. Another goal was the correct reproduction of the observed crack image and the plastic strain activities. Again the macro-model proved to work well in this case and shows very good correlation. The results of the case study show that there is significant scatter in the absolute distribution of the PHFA between the applied ground excitations. An absolute distribution along the normalized building height was determined in the framework of probability theory. It can be observed that the extent of nonlinear behavior varies for the three hazard levels. Due to the detailed scope of the present research work, a robust comparison with code-recommendations and simplified PHFA distributions are possible. The chosen methodology offers a chance to determine the distribution of PHFA along the building height of old masonry structures. This permits a proper hazard assessment of HiNSCs under seismic loads.

Keywords: nonlinear macro-model, nonstructural components, time-history analysis, unreinforced masonry

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Authors: Lisandro Blas, Héctor Tamanini

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From earliest 90 to now, no many companies or organization can “really” implement a knowledge management (KM) system that works (no only viewed from a measurement model, but in this continuity). Which are the reasons of that? Some of the reason maybe could be embedded in how KM is demanded (usefulness, priority, experts, a definition of KM) vs the importance and resources that the organizations afford (budget, responsible of a specific area of KM, intangibility). Many organizations “claim” the importance of Knowledge Management but thhese demands are not reflecting these claims in their future actions. With another’s tools or managements ideas the organizations put the economics and human resources to work. Why it´s not occur in KM? This paper tray to explain some of this reasons and tray to deal with this situations through a survey done in 2011 for a IAPG (Argentinean Institute from Oil & Gas) Congress.

Keywords: knowledge management into organizations, new perspectives, failure in implementation, claim

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Authors: Mohamed Mamdouh Al-Banna, Warda Youssef Mohamed Morsy, Hanaa Ali El-Feky, Ashraf Hussein Abdelmohsen

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Background: The mechanically ventilated patients need a special nursing care with continuous closed observation. The patients’ body mass index may affect their prognosis or outcomes. Aim of the study: to investigate the relationship between BMI and selected outcomes of critically ill mechanically ventilated patients. Research Design: A descriptive correlational research design was utilized Research questions: a) what is the BMI profile of mechanically ventilated patients admitted to critical care units over a period of six months? b) What is the relationship between body mass index and frequency of organ dysfunction, length of ICU stay, weaning from mechanical ventilation, and the mortality rate among adult critically ill mechanically ventilated patients? Setting: different intensive care units of Cairo University Hospitals. Sample: A convenience sample of 30 mechanically ventilated patients for at least 72 hours. Tools of data collection: Three tools were utilized to collect data pertinent to the current study: tool 1: patients’ sociodemographic and medical data sheet, tool 2: BURNS Wean Assessment Program (BWAP) checklist, tool 3: Sequential organ failure assessment (SOFA score) sheet. Results: The majority of the studied sample (77%) was males, and (26.7 %) of the studied sample were in the age group of 18-28 years old, and (26.7 %) were in the age group of 40-50 years old. Moreover, two thirds (66.7%) of the studied sample were within normal BMI. No significant statistical relationship between BMI category and ICU length of stay or the mortality rate among the studied sample, (X² = 11.31, P value = 0.79), (X² = 0.15, P value = 0.928) respectively. No significant statistical relationship between BMI category and the weaning trials from mechanical ventilation among the studied sample, (X² = 0.15, P value = 0.928). No significant statistical relationship was found between BMI category and the occurrence of organ dysfunction among the studied sample, (X² = 2.54, P value = 0.637). Conclusion: No relationship between the BMI categories and the selected patients’ outcomes (weaning from MV, length of ICU stay, occurrence of organ dysfunction, mortality rate). Recommendations: Replication of this study on a larger sample from different geographical locations in Arab Republic of Egypt, conducting farther studies to assess the effect of the quality of nursing care on the mechanically ventilated patients’ outcomes.

Keywords: mechanical ventilation, body mass index, outcomes of mechanically ventilated patient, organ failure

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