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Background: Burn is bodily injury resulting from exposure to heat, electricity, or some radiations, marked by varying degrees of skin destruction and hyper anemia often with the formation of watery blisters Aim of study: to assess Nurses' Knowledge, Practice and, Attitude, Regarding Burn Injury Management. Subjects and methods: Descriptive study. The study was conducted at three hospitals (Beni-Suef general hospital, Minia general hospital and, Minia university hospital)first and second hospital affiliated to ministry of health, the third one affiliated to ministry of higher education. Forty nurses where included in the current study sample. Three tools of data collection were used to carry out this study namely, tool 1): Structured Self-Administered Questionnaire that include two parts; part 1): demographic characteristics, and part 2): nurse's knowledge, Tool П-: Nurses’ observational checklists procedure, and Tool IП: Structured nurse's attitude scales. Results: majority of the studied nurses (82.5%) had unsatisfactory knowledge, and, (100%) had unsatisfactory practices and negative attitude regarding burn injury management. Conclusion and recommendations: Most of nurses had shortage knowledge level, poor practice and, negative attitude due to lack of educational program, lack of training and, no update to nurse's performances so, the current study recommended that importance of Provide continuous education and update for nurses regarding evidence based nursing practices about burn patients and, provide sufficient supplies and equipment from hospital administration for nurses to perform their practice in a high quality, safe and in efficient way

AIM: This was a prospective double-blinded randomized comparative study. Several authors have reported the efficacy of platelets derivatives for spinal union. However, the use of PRP and PRF for bone fusion with TLIF has not been fully explored. METHODS: Standard open TLIF surgery was performed on 80 patients, randomized in three groups, TLIF and local bone were used in 40 patients (control group) and TLIF, local bone, and PRP were used in 20 patients (PRP group) and PRF was used in 20 patients (PRF group). Radiological parameters were assessed by X-ray after 3 months post-operative to evaluate the position of the screws and cage migration and by CT scans at 6 months and 12 months postoperatively. Patients, surgeons, and post-surgical analysis were blinded. RESULTS: VAS scores for lower back pain and leg pain were statistically significant between the three groups preoperatively. The VAS scores of back pain improved after 12 months and were statistically significant (p < 0.001) and the VAS score of leg pain improved compared with preoperatively in the three groups during the 6- and 12-month follow-up postoperatively, however, the three groups, VAS scores for leg pain were not significantly different. After 1-year follow-up, significantly more patients achieved definite fusion, when implanted platelets derivatives compared with the control group, but with no significance regarding fusion rates. CONCLUSION: We advocated using platelet derivative as a fusion enhancer modality which is cost and time saving. It appears to be a complementary step that ensures better outcome for the patients.

Early diagnosis is considered important for medical images of breast cancer, the rate of recovery and safety of affected women can be improved. It is also assisting doctors in their daily work by creating algorithms and software to analyze the medical images that can identify early signs of breast cancer. This review presents a comparison has been done in term of accuracy among many techniques used for detecting breast cancer in medical images. Furthermore, this work describes the imaging process, and analyze the advantages and disadvantages of the used techniques for mammography and ultrasound medical images. K-means clustering algorithm has been specifically used to analyze the medical image along with other techniques. The results of the K-means clustering algorithm are discussed and evaluated to show the capacity of this technique in the diagnosis of breast cancer and its reliability to identify a malignant from a benign tumor.

This research aims to study marine nature and identify its artistic and aesthetic characteristics, and then adapt those values ​​to serve the elements of designing women's evening wear, as well as make use of the features of this nature in creating decorative designs that are implemented in the style of free drawing on women's evening costumes. This is to open new horizons in designing women's evening wear, as well as contribute to the establishment of small projects based on the art of free hand drawing, which reduces unemployment and raises the national economy. In order to achieve the objectives of the research, the researcher relied on both the descriptive and analytical approach that dealt with describing the marine nature in order to identify its components and characteristics and then analyze it, and the applied study which consists in creating designs and decorations inspired by this nature. The sample of the study consisted of a group of referees of specialists in the field of clothing and textiles from among the faculty members who numbered (10), and a group of female consumers whose ages ranged from 25 to 40 years and their number (55). The research tools included a questionnaire assessing the decorations executed on the fabrics. In the style of free drawing for specialists and consumers, and a questionnaire evaluating the proposed designs for specialists and consumers. The results concluded with the creation of decorations and designs for evening clothes inspired by the marine nature, which were accepted by professionals and consumers, and the decoration was carried out in a free-drawing style, as well as the designs were analyzed and the materials and color groups were determined. The statistical results also showed that there are statistically significant differences between the proposed designs according to the opinions of specialists and consumers, and in light of the results of the study several recommendations were made, including the intensification of studies with various objectives in the field of fashion design by taking advantage of the marine nature, and adapting marine materials to produce accessories and jewelry used As complements to the marine-inspired designs.

Struetural features resulting from the interaction of a turbulent jet issuing transversely into a uniform stream are deseribed with the help of flow visualization. Jets to erossflow velocity ratios have been investigated with primary goal of introducing a new experimental technique to study characteristics of jets in crossflow. The technique introduced in this study called image digitizing technique. It is based on capturing series of images using a high speed digital camera then processing the obtained images. Accordingly, a new definition for the average image has been introduced and applied. The obtained conclusions are; Image digitizing technique, provided and used in this study, is a reliable and inexpensive technique. The new method of averaging is more deseriptive for jet characteristics. Jet characteristics, e.g. eonccntration distribution, jet centerline, jet boundaries, .. CIH, can be studied using image digitizing technique. Roll-up shear layer vortiees are obtained, which can help in explaining their role in the entrainment mechanism.

Introduction: Survivors of torture have high rates of mental health problems and can experience a sequela of physical effects with the most common being persistent pain. Similar to survivors of torture, persons that are incarcerated have high rates of mental health problems, persistent pain and pain-related disability.The purpose of this study is to assess the effect of an interdisciplinary group treatment approach, involving psychotherapy and physiotherapy, with survivors of torture whom are incarcerated in a prison in Kurdistan, Iraq. Methods: A parallel group study design was used to compare a treatment group (n=11) and a wait-list control group (n=16). The treatment group participated in an interdisciplinary treatment service for a total of 10 weekly group sessions for each discipline.The primary outcome measures were symptoms of nociplastic pain, anxiety, depression, and PTSD. Secondary outcome measures evaluated physical functioning, sleep quality, and general self-efficacy. Results: A statistically significant reduction in outcome measure scores was seen in all symptoms measured immediately post-treatment. Discussion and Conclusion: These findings suggest that a culturally and contextually appropriate interdisciplinary group treatment intervention for survivors of torture in a prison could be effective for short-term reductions in symptoms of anxiety, depression, PTSD, persistent pain, and function. The study has limitations including a small sample size, lack of long-term outcome measures, and an inability to isolate effect of each component of care. The study does demonstrate the feasibility of implementing research that follows international research standards and practices within under-researched settings and post-conflict areas.

The project selection problem has attracted significant attention among construction project participants. Typically, a contractor can execute one or more projects from available projects. This study introduces a new strategy to help contractors in evaluating and selecting suitable construction projects. The new strategy is based on identifying multiple criteria that affect construction projects as well as developing and using a model that supports decision based on the analytic hierarchy process. Furthermore, a fuzzy risk analysis model is proposed to analyze and quantify some of the identified criteria to help contractors select minimally risky projects. Market conditions, financial resources, project conditions, time delays, and cost overruns are five identified criteria that control the selection. Through identifying 70 subsidiary factors, the effects and importance of the first three criteria were determined through a field survey, while time delay and cost overrun criteria were analyzed and quantified through the risk analysis model. The new strategy was applied on a real case study comprising two HVAC system projects in the construction industry (project 1 in Egypt and project 2 in Saudi Arabia). Criteria and causes that yield different effects on the new strategy to support contractor decision and selection control are discussed in detail. Risk factors were ranked according to their importance, and their effects on both time and cost were clarified. The results obtained from the investigated case study showed 55.5% support for project 2, and only 44.5% support for project 1. This strategy is applicable to other case studies in different countries with different projects, criteria, and execution activities.

The Ihram and its clothes is the first of the actions that the disciple of Hajj or Umrah does. And many of the rulings are related to this Ihram. A woman can wear whatever she wants from black or green or other colors, except imitating the men in their clothes. Also, she is not allowed to wear the (Niqab and gloves) during the Ihram .The God Almighty did not specify the women in a garment like a man, he must wear (Izar and Robe). The climate of the holy city of Makkah is not hidden from us, and the role of heat, which completely controls the nature of the weather in it, becomes clear . It is crucial to have sustainable designs that fulfill the functional requirements of Ihram Women Clothes . Given the importance of this topic, the researchers did not find a specialized study that dealt with the Ihram Women Clothes to find solutions to the problems she faces while performing the rituals of Hajj and Umrah. This study aimed to producing sustainable designs for the Ihram women clothes to conform the functional requirements . And get to know the opinions of specialists towards the designs implemented for the Ihram women clothes conform to the functional requirements . Also, knowing the opinions of female consumers towards the designs implemented for the Ihram women clothing to be compatible with functional performance .The researchers followed the descriptive and analytical approach, in addition to the applied study, through designing and implementing samples for sustainable designs for the Ihram women clothing , fulfilling the functional requirements .The research sample includes the research sample consisted of (162) women, divided into (97) women, who answered the opinion poll . Which varied their nationalities between (Egypt, Saudi Arabia, Yemen, Hadramout, Pakistan) and the number (65) consumed to know their views towards the implemented designs .The results showed that specialists and consumers agree that Design No. 2 is the best in achieving functional and environmental aspects (sustainability). The study presented a recommendation to conduct more research to experiment the designs during the Hajj season and to actually measure the extent to which it fulfills the functional requirements of women .

Background: Breast cancer related lymphedema represents a major complication of breast cancer treatment, impacting the quality of life of breast cancer survivors. Patients with lymphedema need to conduct lifelong self care activities to control the progression of swelling, manage lymphedema-associated symptom burden, and minimize long term negative outcomes. Aim: This study aimed to assess knowledge and self care practices of women with breast cancer related lymphedema. Study design: A descriptive study design was utilized to conduct this study. Setting: This study was conducted in the outpatient breast clinic at Oncology Center and Nuclear Medicine, affiliated to Ain Shams University Hospitals. Subjects: A purposive sample of 50 women newly diagnosed with breast cancer related lymphedema, post mastectomy, and treated with radiotherapy. Data collection tools: A structured interview questionnaire for women with breast cancer related lymphedema, and self care practices questionnaire. Results: The mean age of the studied women was 47.71±7.16, and about one fifth of them had satisfactory level of total knowledge regarding breast cancer related lymphedema, also; the minority of them had adequate level of total lymphedema self care practices. Moreover there is statistically significant difference between the self care practices of the studied women and their educational level. Conclusion: The majority of the studied women had unsatisfactory knowledge regarding breast cancer related lymphedema, and almost of them had inadequate lymphedema self care practices. Recommendations: Educational programs about lymphedema and risk reduction methods after the breast surgery are strongly needed. Also, continuous in service educational programs should be held for all the health care team working in breast cancer units. In addition, further researches are recommended to assess barriers to self care among patients with breast cancer related lymphedema.

Background: Subcutaneous enoxaparin administration often causes problems such as pain; bruise and hematoma at the injection sites. In terms of these problems, cold application has been found to have various therapeutic benefits as relieve pain by produce localized anesthetic effect and controls bleeding by causing vasoconstriction. Aim of the study: To investigate the effect of cold application on local problems among patients receiving subcutaneous enoxaparin. Design: Self controlled trial design was utilized. Setting: The study was carried out in general surgery department, orthopedic surgery department, and chest Intensive Care Unit at Beni-seuf University Hospital. Study subjects: A purposive sample of 60 patients was included in the study. Data collection tools: Data were obtained through Patient assessment tool, Bruising Category Scale, Visual Analogue Scale for pain and Hematoma Formation Scale. Results: All studied patients had pain and more than half developed bruise at injection site when they received enoxaparin without cold application but more than three quarter of studied patients had pain and less than one quarter developed bruise when they received injection with cold application. Meanwhile, the majority of the studied patient did not develop hematoma whether cold applied at injection site or not. Conclusion: The pre-injection cold application at enoxaparin injection site was effective in reducing the occurrence of pain and bruising. Moreover, there was statistically significant relation between the patients’ pain intensity, the size of bruising and their demographic characteristics; age and gender. Recommendations: Cold application should be included in standard protocol for the administration of SC enoxaparin and providing on-going and regular in-service educational programs about it for nurses.

Background: The rise of Primary Percutaneous Coronary Intervention (PPCI) procedure as an option for treating Coronary Artery Diseases demands addressing a variety of concerns in the recovery period and afterward including fasting the Ramadan month in the countries with the prevailing Muslim population. Therefore this study aims to assess the ability and the safety of fasting among patients who underwent PPCI within two specified periods.Method: This study was a prospective observational study with a sample size of 200 consecutive patients that have been divided into two groups based on the duration of their last PCI for an attack of Acute Myocardial Infarction (AMI). The patients were admitted to the Causality Department of the Surgical Specialty Hospital-Cardiac Center, Erbil/Iraq. The studied data have been analyzed using the Statistical Package for Social Science version 25 (SPSS), and a P-value of ≤0.05 was considered statistically significant.Results: The proportion of fasting and non-fasting patients showed a significant association with the duration of their last PCI procedure with a P-value of 0.001 as 14% in Group I (patients with less than 6 weeks duration post-PCI) successfully fasted the month while it was 54% in Group II (Patients with more than 6 weeks duration post PCI). Among our findings, there were significant associations with P-values of 0.001 between post-PCI symptoms and Ramadan fasting. In regards to NYHA classifications assessment, Group I had a higher proportion of patients classified as Class III and Class IV compared to Group II with a significant P-value of 0.001 with proportions of class III classification in Group I of 14.3% among fasting, 17.1% among non-fasting, and 58.3% among those who could not continue their fasting while in Group II, the proportions showed 3.7% among fasting, 6.7% among non-fasting, and 0% among those who could not continue their fasting.Conclusion: We discourage fasting among patients who have undergone Percutaneous Coronary Intervention within the first 6 weeks, as well as patients who have NYHA class III and above as they are highly liable for deterioration and can not continue their fasting.

Context: Hepatocellular carcinoma (HCC) is considered one of the most challenging tumors with high incidence, prevalence, and mortality rates. Radiofrequency Ablation (RFA) is one of the emerging therapeutic modalities used for the minimally invasive treatment in the management of early-stage HCC. Aim: This study aimed to assess the effect of self-care guidelines on quality of life for patients with Hepatocellular Carcinoma undergoing Radio Frequency Ablation. Methods: A quasi-experimental design was used to achieve the aim of this study. This study was conducted at the Interventional Radiology Unit, affiliated to Ain Shams University Hospital, on a purposive sample of 50 patients with hepatocellular carcinoma; 25 randomly allocated to the study group, and 25 allocated to the control group. A structured interview questionnaire for patients with hepatocellular carcinoma undergoing radiofrequency ablation was used to collect the study data. It comprises three parts: Sociodemographic characteristic, assessment of patients' medical health, and knowledge about HCC and RFA. The second tool was the quality of life of cancer survivors questionnaire (pre /posttest), and finally, a patient-reported self-care practices assessment checklist (pre /posttests). Results: There were statistically significant differences between the study and control groups regarding their total knowledge about hepatocellular carcinoma and radiofrequency ablation therapy pre and post-implementation of self-care guidelines. There were highly statistically significant differences between both groups regarding the total quality of life, pre and post-implementation of self-care guidelines. In addition, there were highly statistically significant differences regarding total self-care practice, pre, and post-implementation of self-care guidelines. A positive correlation was revealed between total knowledge with total self-care practice and total quality of life (pre/posttest). Also, a significant correlation was revealed between the total quality of life and self-care practices post self-care guidelines implementation at (p

Background: Intensive Care Unit Acquired Muscle Weakness (ICU-AW) is one of the most important complications occurs in the ICU. ICU-AW is a multifactorial syndrome characterized by generalized muscle weakness. Critical care nurses (CCNs) have an important role in the prevention of ICU-AW through increase mobility and applying of range of motion. Design: A descriptive exploratory design was utilized to achieve aim of this study. Aim: This study aimed to assess factors contributing to acquired muscle weakness among critical ill patients. Setting: the study was carried out in intensive care units of Beni–Suef University Hospital. Subjects: A Purposive sample of seventy five patients admitted in the previous mentioned setting. Tools of data collection were consisted of Patient assessment tool, muscle strength scale and indicators to incidence of ICU-AW and factors contributing to ICU-AW assessment tool. Results: revealed that more than half of the studied patients had ICU-AW. The majority of studied patients who had muscle weakness were older than the Non ICU-AW patients. Application of positioning and range of motion exercises were not done in the ICU-AW patients. Administration of corticosteroid and incidence of malnutrition was higher in the ICU-AW patients than the Non ICU-AW patients. There were no statistically significant relation between incidence of ICU-AW and gender, admission medical diagnosis, administration of parenteral nutrition and application of positioning and walking exercises. Conclusion: More than half of studied patients developed ICU-AW. The contributing factors of ICU-AW are patient age, WBCs level, not applying range of motion and chair sitting exercise to ICU patients, administration of corticosteroid and malnutrition. Recommendations: Further researches are recommended to study extensively the effect of nutritional status on incidence of ICU-AW. Also, examine the incidence of ICU-AW in sedated and unconscious patients.

Background: Non-Hodgkin's lymphoma patients undergoing chemotherapy have symptoms that continue to place a significant burden and preventing them from living normally. This requires non-hodgkin's lymphoma patients to engage in a range of self-management actions. The aim of this study was to assess the effect of self-management guidelines on chemotherapy associated symptoms among non-Hodgkin lymphoma patients. Design: A quasi experimental design. Setting: the study was conducted at the hematology unit in Ain Shams University Hospital. Subjects: A purposive sample of 76 adult patients. Data collection tools: Three tools were used in this study, structured interview questionnaire for the non-hodgkin's lymphoma patients undergoing chemotherapy, self-care practices questionnaire, and symptoms experience tools. Results: Regarding total level knowledge, 28.9% of the studied patients had satisfactory level of total knowledge pre implementation of self-management guidelines which improved to 65.8% with a highly significant difference post implementation of self-management guidelines (P≤ 0.001). While 26.3% of the studied patients had satisfactory level of total self-care practices pre implementation of self-management guidelines which improved to 57.9% with a highly significant difference post implementation of self-management guidelines (P≤ 0.001). There was a significant improvement on patients` symptoms experience post implementation of self management guidelines. Conclusion: The implementation of self-management guidelines for patients with non-Hodgkin's lymphoma undergoing chemotherapy has a statistically significant positive effect on their knowledge, self-care practice and associated symptoms which support the stated hypothesis. Recommendation: This study recommends the importance of developing tailored self-management programs for fatigue, nausea, vomiting and oral mucositis to understand and promote chemotherapy associated symptoms self-management in patients with non-hodgkin's lymphoma disease.

Background: Hospital acquired anemia (HAA) is one of the most common intensive care unit (ICU) acquired complications that associated with poor outcomes, increase morbidity and mortality for critically ill patients. Factors contribute to its development include profound loss of RBCs or insufficient RBCs production. Aim of the study: to assess factors contributing to HAA among critical ill patients. Design: A descriptive exploratory design was utilized. Setting: The study was carried in Beni –Suief university hospital inside the critical care units which include; general ICU, cardio care unit (CCU) and chest ICU. Study subjects: purposive sample of 75newly admitted adult critically ill patients to the above mentioned sitting was included in the study. Data collection tools: Data were obtained through patients assessment tool, factors contributing to HAA and indicators of HAA tool. Results: reveals that, nearly one third of studied patients their age were more than or equal fifty years. As regard to gender, the results revealed that, more than half of them were males, nearly one third of anemic patients had HAA in the 5th day from admission to hospital. As well more than three quarter of anemic patients were under feeding and more than one third of them had sepsis, in addition to mean amount of blood loss for anemic patients exceed amount of blood loss for non anemic patients. Conclusion: More than half of studied patients developed HAA during their ICU stay. Even, non-anemic patients were subjected to a decline in their Hb level. As well as, there were statistically significant relation between nutrition deficiency, sepsis, blood loss in ICU and drugs increase RBCs loss factors and occurrence of HAA. Also there were insignificant relation between demographic characteristic of studied patients, their diagnosis on admission to hospital, hemodilution, drugs affect RBCs production and occurrence of HAA. Recommendations: Designing in-service training and educational program for nurses about blood conversation strategies especially prevention of blood loss associated invasive procedure and phlebotomy practice.

Objectives:Patients with impaired renal functions have a variable risk of morbidity and mortality in cardiovascular surgery. Poor outcome was reported among patients who underwent valve surgery. Current study is presumed to compare the early outcomes of patients having different degrees of impaired renal functions and undergoing mitral valve replacement surgery. Methods:135 patients were admitted into the three highly specialized centers in Cairo and Ismailia–Egypt between Dec.2018 and Jan.2020 Preoperative, intraoperative and early post-operative data were recorded. Impairment may present as one of these strata: early reversible (G1-2 included strata 1 & 2 kidney disease patients), moderate G3-4 included strata 3 & 4 kidney disease patients) or advanced irreversible renal damage. (The 5th stratum or G5-KD included end stage renal disease patients undergoing 4-hour hemodialysis sessions, three times a week, with bicarbonate dialysate). We correlated outcome among each stratum with cardiac and renal functions in that stratum. Results:The more is the impairment of renal functions at any peri- operative stage, the longer is the need for prolonged mechanical ventilation and the longer is the hospital stay. We found that levels of serum creatinine were significantly increased postoperatively Also, the more is the reversibility of the renal impairment, even by renal dialysis, the much better is the outcome (P=.0019). We also found insignificant difference between different strata of irreversible renal impairment in the early outcome of the prosthetic mitral valve replacement surgery. The early reversible damage can be repaired peri-operatively. Conclusions:Prosthetic mitral valve replacement among patients with different degrees of impaired renal functions is not only feasible but also it does not seem to add any more deterioration into renal function. Prolonged mechanical ventilation and hospital stay are the only drawbacks of irreversibly impaired renal damage by dialysis or renal transplant.

Governments around the world have issued movement restrictions and quarantine to combat the SARS-CoV-2 (COVID-19) pandemic. However, the Swedish government has not implemented such measures but rather depended on individual responsibility. An important question regarding the extent to which individuals have been encouraged to trust in and be satisfied with government strategies and adopt personal health measures, such as social isolation, remains unanswered. This study aims to examine the direct effects of trust in the government and risk perception on self-efficacy. Most importantly, this study intends to explore whether satisfaction with government measures augments the relationships between trust in the government and self-efficacy and between risk perception and self-efficacy. Thus, we test our suggested hypotheses using survey data obtained from 403 Swedish citizens living in Sweden, and as predicted, the findings indicate that trust in the government and risk perception positively impact individual self-efficacy. Additionally, the findings reveal that satisfaction with government measures strengthens this relationship; more precisely, the impact of trust in the government and risk perception under a high level of individual satisfaction with government measures is much more positive than that under a low level of satisfaction. In practice, a focus on implementing successful policies or strategies and excellent individual self-efficacy are required to halt the pandemic, and the findings indicate that combining strictly attentive and adaptive individual strategies with government strategies can minimize the spread of infection.

The public’s actions will likely have a significant effect on the course of the coronavirus disease (COVID-19) pandemic. Human behavior is conditioned and shaped by information and perceptions of people. This study investigated the impact of risk perception on trust in government and self-efficacy. It examined whether the use of social media helps people adopt preventative actions during the pandemic. To test this hypothesis, data were gathered from 512 individuals (students and academicians) who were based in Malaysia during COVID-19. Our results suggested that risk perception had a significant effect on trust in government and self-efficacy. Moreover, these correlations were stronger when social media was used as a source for gathering information on COVID-19, and in some cases it even helped the user avoid being exposed to the virus. This study assessed the relationship between risk perception and the awareness gained from using social media during the pandemic and also highlighted how social media usage influences trust in government and self-efficacy.

The Multi-mode Resource Constrained Project Scheduling Problem is characterized by a set of tasks, resources and an objective function. All tasks of a project must be organized carefully taking into account precedence relations, the mode in which they are performed and availability of resources at all times. At present, around 71% of the projects related to the software industry are renegotiated or canceled causing negative impacts on both, social and economic areas. Among the root causes of these failures, deficiencies in planning processes and a lack of tools to help generate quasi-optimal project schedules are found. This kind of problem can be presented as an optimization problem subjected to two groups of restrictions: precedence relations and resource constraints. This paper aims at proposing a new Estimation of Distribution Algorithm applied for the resolution of the Multi-mode Resource Constrained Project Scheduling Problem. In particular, this algorithm is based on Factorized Distribution Algorithm in which the precedence relations of the problem are represented by the factorization. A comprehensive computational experiment is described, performed on a set of benchmark instances of the well-known Project Scheduling Problem Library (PSPLIB) in its Multi-mode variant. The results show that the proposed algorithm can find similar or sometimes even shorter makespans than others reported in bibliography.

Museums are important tools to preserve human tradition and history, particularly in traditional fashion. The museum is one of the most important sources available in the local environment to save this traditional fashion from extinction. Research studies have confirmed the effectiveness of virtual museums in the educational process for students and visitors. Previously, few could experience museums only in person. The technological advances of the twentieth century have led to a communication and information revolution. Museums have benefitted from this by expanding and diversifying the ways they present collections; which has attracted the attention of visitors. Virtual museums linked to physical ones have appeared. Study Query: What is the possibility of designing and building a virtual museum on the web (internet) of traditional fashion in Saudi Arabia? What is the efficiency of a virtual museum to give visitors knowledge about traditional fashion in Saudi Arabia? What is the direction of visitors to develop cultural awareness of traditional fashion through the virtual museum? The objective : to develop awareness of Saudi women's traditional fashion for a portion of Saudi society. This can be done by collecting and presenting this fashion in a virtual museum. The researcher will design the virtual museum on the internet. The following aims emerged from this: Designing and building a virtual museum on the internet of traditional fashion in Saudi Arabia. Measuring the efficiency of the virtual museum to give visitors knowledge about traditional fashion in Saudi Arabia. Identifying the direction of visitors to develop the cultural awareness of traditional fashion through the virtual museum. Maintaining some aspects of traditional heritage, especially in traditional fashion. research importance the virtual museum contributes to defining and preserving several pieces of traditional Saudi clothing. This contribution revitalises tourism in the Kingdom of Saudi Arabia, which is sought by the Antiquities Authority. Tourism, by establishing private museums, especially of traditional clothing, will keep it from extinction. The virtual museum could serve as the Nucleuses to studies by serving specialised educational institutions study of traditional costumes. Methodology: The descriptive approach was followed by analysing and characterising models of traditional women's fashion in Saudi Arabia. The pilot curriculum constructed and implemented a virtual museum of traditional costumes in Saudi Arabia. Later, it was applied to a group of visitors, identifying their knowledge of the museum and verifying his duties through application before and after.Research results showed there were no statistically significant differences in the mean scores of visitors in awareness for Saudi women's traditional fashion before visiting the virtual museum. There were differences in the awareness of Saudi women's traditional fashion for a sample of Saudi society before and after visiting the virtual museum at the level of 0.001 to after visiting the virtual museum. There were no statistically significant differences in the direction of visitors to develop cultural awareness of traditional fashion through the virtual museum after visiting.

The time and costs associated with HVAC system installation are significant percentages of the total time and cost of construction projects. Furthermore, these systems affect many of the other construction activities. They are complicated, and their installations face many risks, which may lead to time and cost overruns for the project. Therefore, more attention should be paid to how these systems are installed in construction projects. The main objective of this study was to identify the main activities associated with HVAC system installation in construction projects, as well as the risk factors that affect them. Other objectives included conducting an analysis and assessment of the effects of these risk factors on time and cost objectives. Multi-stage field surveys were used in this study. The major risk sources were qualified in terms of their severity, probability of occurrences, and impacts on time and cost objectives. Three activities associated with HVAC system installation were identified: (a) air distribution duct work, (b) chilled water distribution pipe work, and (c) HVAC equipment installation. Fifty-five risk factors that affect each specific activity and that are common to all activities were also identified and categorized into four groups. Two agreement analysis tests and a full statistical analysis were conducted. A high degree of agreement between all partners was obtained. The time and cost percentages of the three activities were determined. A detailed discussion and analysis indicated that approximately 50% of the key risks belonged to common risks that affected all activities, while the most important risky activity was chilled water distribution pipe work. Furthermore, the analysis emphasized that the number of risk factors increased as the expected duration of the activity increased; however, this relationship did not exist in the case of cost. Ultimately, the obtained results indicate that the expected time and cost overruns caused by the effects of risk factors on HVAC system delivery are approximately 10–20% and 5–10%, respectively.

Simulation has a well-known history in the military, nuclear power, and aviation. It is also a recommended teaching and learning strategy supported by several landmark studies. Although in the past 20 years simulation has become more integrated into the education of nurses and physicians, it has not been as well integrated into the development of skills for practicing nurses. This article will provide an overview of simulation techniques and uses and review of selected simulation research. Despite recommendations for using simulation and growing integration of simulation into education, we still lack empirical evidence of its impact on patient outcomes. Our discussion provides a review of the current uses of simulation in the nursing practice environment with several exemplars and offers recommendations to develop a simulation program.

Background Ischemic heart disease (IHD) is a common cause of death, which encourages us to improve continuously the techniques adopted for coronary artery bypass grafting (CABG). Still the most commonly used graft is saphenous vein harvested by different techniques. Methods This prospective randomized study included 60 patients with IHD in need of CABG classified into two equal groups: group A (saphenous vein harvesting with conventional technique) and group B (saphenous vein harvesting with lens assisted bridging technique [LABT]). We compared the two groups in terms of preoperative, intraoperative and postoperative data then we statistically analysed the findings. Results Our study showed that LABT had significantly less pain, less infection, more cosmetic, less hospital stay with more patient satisfaction and without any additional costs. Conclusions Our study showed that lens assisted bridging vein harvesting was a good substitute for conventional technique.

The research’s issue lie in the inability of the students of Clothing and textiles department at King Abdul-Aziz University, to draw and design Fashion accessories such as footwear, Due to the concentration of fashion design curriculums in Saudi Universities on the clothes drawing and designing .Objectives : Prepare a module using multimedia to develop the students skills to design footwear.Study the scientific basis of the educational process to achieve the objectives of the module in skills development.Measuring the effectiveness of the module using multimedia on students knowledge in footwear designing, by studying the statistical differences before and after performing the module on the research sample (students). Measuring the effectiveness of the module using multimedia on students skills in footwear designing, by studying the statistical differences before and after performing the module on the research sample (students). Enriching the fashion design curriculum (CLT-416), college of home economics, King Abdul-Aziz University, through the footwear designing module.Research Significance: Manifesting the role of educational organizations in developing the skills of the students, including King Abdul-Aziz University.Prepare students who can deal with the technological development in fashion design field.This research considered to be a new addition in the field of Educational using multimedia, and can be used to prepare other new educational curriculums.This research provide an idea about establishing a footwear design curriculum, followed by establishing different majors in the same field, and then apply it in local industry.Research Methodology: The research adopted the empirical approach to establish the module in developing the students skills in Footwear drawing and designing.

IT Service Management System is an application to implement and manage Information Technology Infrastructure Library (ITIL) best practices framework. This framework aims to align the IT services with the business needs by insuring the quality of services provided to business. This IT service Management system links people, processes and technology within the Central Bank of Sudan as the main site of the project. The Central Bank of Sudan is the main bank that governs Sudan's banks rules and regulations. The bank was formed in 1960 with headquarters located in the Khartoum capital of Sudan in addition to eighteen (18) branches spread throughout the country. The Information Technology Administration within the Central Bank of Sudan manage and operate the IT infrastructure that host and support all systems that used internally and for external banks. The objective of this study focused on finding IT service management system that can support international IT service management platform that can apply ITIL standard processes like Incident Management, Service Request Management, Problem Management, Change Request Management, Configuration Management Database and Knowledge Management. The methodology used in this system is the Rapid Application Development (RAD), a condensed development process that produces a high quality system with low investment costs. The proposed system went through to alpha, beta and acceptability tests by IT development team first and second line of support agents to ensure proper module functionality with favorable results. The study concluded in align services provided by the Information system department with business need through manageable and controllable standard. As a recommendation, the system should be implemented at the Central Bank of Sudan. More integrations and benchmarking must be done to ensure modules functionalities and higher security. The system can be the first step to take ISO20000 certificate as it covers many of IS020000 requirements

Desiccant systems have found applications in a very large variety of industrial and daily usage products including the new HVAC installations. The dehumidifier is one of the essential parts of those systems, which severely affects the whole system performance. This paper theoretically and experimentally studies the performance of the cross flow dehumidifier, which has been less studied than the counter flow dehumidifier, although it is more applicable in practice. Channel gauze structured packing was used in the dehumidifier and a LiCl aqueous solution was used as the liquid desiccant. The humidity reduction and dehumidifier effectiveness were adopted as the dehumidifier performance indices. The effects of the dehumidifier inlet parameters, including inlet air and desiccant flow rates, inlet air and desiccant temperature, inlet desiccant concentration and inlet air humidity ratio, on the two indices were investigated. The characteristics of the dehumidifier performance agreed well with the other studies reported in the open literature.

Introduction: Cerebrovascular Background: Critical care nurses are expertly trained to care for critically ill patients; however, many critical care nurses feel inadequately prepared to provide end of life care to patients in the intensive care unit. The nurses attribute this to lack of support and training on end-of-life care. The study aim was to assess effect of self-learning package (SLP) on critical care nurses' performance regarding care for end of life patient. Methods, Design: To achieve this aim a quasi-experimental design was utilized. Subjects and setting: A convenient sample of 60 nurses was selected from surgical, medical and neurological ICU of Ain-Shams university hospitals. Study results: Regarding demographic characteristics. This study revealed that, 58.3% of the studied subjects were less than 30 years, 83.3% were female, 75.0% were diploma nurses, 46.7% of them had ten or more years of experience, and 81.7% had no training related to end of life care. Regarding knowledge and practice 15.0% & 23.3% respectively of the study subjects had satisfactory knowledge and practice related to care for end of life patient in pre phase, 80.0% & 81.7 % respectively in post implementation of self-learning package and 60.0% &45% had a satisfactory knowledge and practice in follow up phase. While regarding attitude, positive attitude was 5%, 80% and 55% respectively in pre, post and follow up phases Conclusion: The current study concluded that there was highly statistically significant increase of total score of nurses' knowledge, practice and total score of nurse’s attitude pre/post, pre/follow up and post/ follow up phases of SLP implementation. there was statistically significant positive effect for SLP on nurses' knowledge, practice and attitude. Recommendations; conduction of further researches in end of life care to enrich, improve, & update nurse's knowledge, practice and attitude. Periodic in-services education program regarding end of life care and self-learning package to be performed for patients are recommended.

Reduction of energy consumption is a major concern in vapor compression cooling systems, especially in areas with very hot weather conditions. In hot weather conditions, performance of these systems decrease sharply and electrical power consumption increases considerably. Evaporative condensers enhance the heat rejection process by using the cooling effect of evaporation and therefore improve energy-usage efficiency. This paper presents an extensive review of the state of the art of evaporative condensers used in residential cooling systems: refrigeration, air-conditioning, and heat pump systems. The paper primarily concentrates on the energy consumption of residential cooling systems worldwide and its related problems. In addition, the paper covers the operation principles of evaporative-condensers, theory of heat rejection, and water evaporation rate. Finally, comparison between different types of condensers is presented. It is found that by using evaporative-cooled condenser instead of air-cooled condenser, the power consumption can be reduced up to 58% and the coefficient of performance can be improved by about 113.4% with systems of different cooling capacities ranging from 3 to 3000 kW.

Scientific knowledge has advanced to enable the development of inhaled insulin. It is a form of diabetes medication administered via the pulmonary system that studies have shown to be efficacious in the treatment of both type 1 and type 2 diabetes. Inhaled insulin is a new, safe means to deliver insulin that may increase patient compliance with insulin therapy, helping them to achieve optimal glycemic control and possibly reducing their risk of developing cardiovascular complications. However, diabetes is a chronic illness requiring lifetime intervention. Empowering patients with the knowledge of the diabetes disease process may give them the confidence to be more autonomous in managing their diabetes. HIIP gives nurse practitioners a new option that may improve their patients’ acceptance of insulin therapy, and improve glycemic control.

Context: Exercise interventions are the cornerstone of cardiac rehabilitation. The exercise program consists of respiratory physiotherapy, neck and shoulder exercises, walking, and cycling. The purpose is preventing respiratory complications, neck and shoulder pain, and increasing the physical functional level. Aim: of this study is to evaluate the effect of applying nursing exercise protocol on hemodynamics and functional capacity among post-cardiac surgery patients. Methods: Quasi-experimental research design utilized in the current study. A purposive sample including 60 male and female patients, classified equally into two equal groups; study group (n= 30) and control group (n= 30), collected through 14 months. This study carried out in the inpatient cardiac surgery department and the outpatient cardiac clinic of Cardiothoracic Surgery Hospital at New Minia City. Four tools utilized in collecting data; named Health Assessment Record; Six Minute Walk Distance Test; Modified Medical Research Council Scale (MMRC) for measuring dyspnea; and Nursing Educational Protocol Checklist. Results: Current study findings displayed an improvement of total distance walked among study group compared to control group, it also showed highly statistically significant differences between both groups related to total distance walked after 12th-week post-discharge documented by p-value (0.000). Conclusion: The current study findings concluded that the nursing educational protocol in the form of deep breathing, incentive spirometer; coughing and early ambulation induces a significant improvement in hemodynamic variables and six minute walk distance recommending that hospitals should implement nursing educational protocol as a routine hospital policy among all cardiac surgical patients in all age groups.

Aim of The study to assess the mothers’ knowledge about breast Feeding, bottle Feeding and weaning of their Infants. This study was carried out in all MCH centers at Minia city. Descriptive research design was used to meet the aim of study. A convenient sample included 1000 mothers who were attending MCH centers.A structured interview sheet was developed by the researcher based on review of relevant literature. It included 2 parts: Part I; included sociodemographic characteristics of the mother and child, Part II; included items related to mothers’ knowledge about breast feeding, bottle feeding, and weaning. There were highly statistical significant differences between total knowledge of mother about breast feeding and all her socio-demographic characteristics. There was a positive relationship between maternal education and increased knowledge about infant feeding. Conclusion of this study illustrated that there is a relationship between knowledge of mother about breast feeding, bottle feeding ,and weaning and her socio-demographic characteristics and that there is a relationship between the education of mother with her knowledge about pattern of breast feeding, bottle feeding, and weaning and that there is a relationship between the occupation of mother and knowledge about exclusive breast feeding, duration of exclusive breast feeding. The study recommended that there is a dire need to arrange for health education program sessions for mothers with main emphasis on importance of colostrum’s feeding, exclusive breast feeding & suitable age of starting and complete weaning.

Background and objective: The goal of this study was to determine the association of complete left bundle branch block (LBBB), site , severity & risk factors of coronary artery disease (CAD). Complete Left bundle branch block increases the risk of cardiac mortality, and prognosis is primarily determined by the underlying CAD. Because the presence of complete LBBB makes the noninvasive identification of CAD less informative, patients with complete LBBB often are referred for coronary angiography to assess the presence and severity of CAD. Methods: A total of 150 consecutive patients with complete LBBB admitted to the coronary care unit were enrolled from the age of 27 to 81 years with the mean age of 59.32 ± 10.5. Male 84 (56%), Female (44%). History, basal investigations echocardiography and virology screen were performed. Coronary angiography has been done for all patients for different reasons of presentation. Results: Critical CAD 70 (46.7%), Left ventricular systolic dysfunction (LVSD) 50 (33.3%). Hypertension found in 83 (55.3%), diabetes mellitus (DM) in 44 (30%), DM& left ventricular systolic dysfunction(LVSD) were more associated with critical CAD. Conclusion: In our study complete LBBB was more common among hypertensive patients. In DM patients was associated with severe CAD. With Left anterior descending artery being the most common artery involved.

The aim of research is to study Capital increase Through the issuance of new common stock (IPO) , And through the stock dividend And the study impact of Capital increase on the stock prices In the stock market . Problem of the research represented in extent impact of Capital increase on the stock prices in the Iraq stock Exchange ? to achieve this objective has been tested three main hypotheses, the first hypothesis that " There are significant impact of Capital increase Through the issuance of new common stock on the stock prices for the surveyed companies " . The second hypothesis is that " There are significant impact of Capital increase Through the stock dividend on the stock prices for the surveyed companies " . Third hypothesis that that " The impact of the capital increase through the stock dividend greater than the impact of the capital increase through the issuance of new stock on the stock prices for the surveyed companies " . To test the hypotheses of the research Data were analyzed using statistical program (SPSS) and using (T-Test) , The research sample included 13 companies Listed in the Iraq Stock Exchange , During the period from November 2013 until June 2015 , 6 companies increased their capital through issuance of new common stock (IPO) , While 6 companies increased their capital through stock dividend , The research has reached into number of conclusions, The most important that the Test results showed presence the impact of Capital increase Through the issuance of new common stock on the stock prices for the surveyed companies , This corresponds with the first main hypothesis . Also the Test results showed presence the impact of Capital increase Through the stock dividend on the stock prices for the surveyed companies, This corresponds with the second main hypothesis . Also the Test results showed the impact of the capital increase through the stock dividend not greater than the impact of the capital increase through the issuance of new stock on the stock prices for the surveyed companies , This not corresponds with the Third main hypothesis .The Researcher was presented a set of recommendations, the most important that companies management must try not to over-reliance In funding to increase capital through the issuance of new stock (IPO) Because Investors are regarded as bad news about the financial situation of the company is reflected negatively on the wealth of the owners .

Background and aim: Patients' satisfaction has been used as a significant indicator of quality services provided by health care personnel. Consequently, the most important predictor of patients, overall satisfaction with hospital care is particularly related to their satisfaction with nursing care. Because nurses comprise the majority of health care providers. The aim of the current study is to assess the patients‘ satisfaction toward nursing care provided in medical and surgical units in Mosul city hospitals. Materials and method: A descriptive study represented in a purposive sample consisted of 1000 patients, the study was carried out at three different hospitals include Ibn Sina, Al Jumhory and Al Salam teaching hospitals. The study was conducted at medical and surgical Units; the data were collected through the use of constructing a questionnaire which consists of two parts, demographic characteristics and patients' satisfaction toward nursing care. Content validity was determined by presenting the questionnaire to a panel of 17 experts. The data were analyzed through the application of descriptive statisticas and inferential statistical analysis. Results: Results of the current study revealed that more than half of patients were male 569(56.9%). The most of patients was married 785(78.5%).The majority of patients were from rural 562(56.2%), additionally, the male more satisfied than female and surgical patients‘ satisfaction more than medical patients. the old age satisfaction more than another age groups, such as the lower level education high satisfied, the married patients more satisfied from other, the unemployed patients more satisfaction, the patients had not previous hospitalization more satisfaction. The patients are more satisfaction toward nursing skills from other domains. While there were a statistical significant difference between patient satisfaction toward nursing care provided and patients characteristics. Conclusion: The current study concluded that patients were satisfied to nursing care Recommendation: the study recommended that further studies should be conducted concerning patients satisfaction with nursing care provided in all hospitals. Keywords: Patients satisfaction, Assessment, Nursing care.

Natural gas plays an important role as an alternative fuel for gasoline and diesel engines. It has a promising future especially with the world crisis in fuel and the lower prices of natural gas compared to the prices of gasoline and diesel fuels. It can be used as a sole fuel in spark ignition engines because it has nearly similar properties as gasoline, but in diesel engines it is used as a main fuel while the diesel fuel is injected to the combustion chamber as a pilot fuel to be an ignition source. This paper investigates the performance of a small dual fuel engine where a single cylinder, four stroke water cooled diesel engine is converted to run on a dual fuel of diesel and compressed natural gas (CNG). An exhaust gas recycling system is used to introduce two ratios of EGR (Exhaust gas recirculation) to the engine. Effects of percentage of natural gas content and EGR ratio on engine performance and emissions are investigated for different engine loads. Based on the obtained experimental results, it can be concluded that the total reduction in engine thermal efficiency increases as the ratio of the used natural gas increases. A maximum reduction of about 5 % in engine efficiency is recorded when 80% of diesel fuel is replaced by natural gas to deliver the same engine power. Also, NOx emissions are decreased while CO is increased with utilization of EGR. Ozet: Dogal gaz benzinli ve dizel motorlar icin alternatif bir yakit olarak onemli bir role sahiptir. Ozellikle yakitlar konusunda dunyada yasanan krizle birlikte ve benzin ile dizel yakitlarinin fiyatlariyla karsilastirildiginda ucuz fiyatiyla umut vadeden bir gelecege sahiptir. Benzinli motorlarda tek basina yakit olarak kullanilabilir cunku benzin ile benzer ozelliklere sahiptir fakat dizel motorlarinda dizel yakit atesleyici on yakit olarak kullanilirken CNG ana yakit olarak kullanilabilir. Bu makale, tek silindirli, dort zamanli su sogutmali dizel motorunun dizel yakit ve sikistirilmis dogal gazin (CNG) birlikte yakit olarak kullanilabildigi bir motora donusturuldugu durum icin kucuk bir cift yakitli motorun performansini incelemektedir. Motora EGR’nin (Egzoz gazi resirkulasyonu) iki oranini uygulamak icin bir egzoz gazi resirkulasyon sistemi kullanilmistir. Farkli motor yukleri icin dogal gaz iceriginin farkli yuzdelerinin ve EGR oranlarinin motor performansina ve egzoz emisyonlarina etkileri incelenmistir. Elde edilen deneysel sonuclar temelinde kullanilan dogal gaz orani arttikca motor termal verimindeki azalmanin arttigi sonucuna varilabilir. Ayni motor gucunu saglamak icin dizel yakitin %80’i dogal gaz ile yer degistirildiginde maksimum %5 motor verimi azalmasi kaydedilmistir. Ayrica EGR kullanildiginda NOx emisyonlari azalirken CO artmaktadir.

Background: Invasive ventilation is a common practice in intensive care units (ICUs). Once a patient is intubated, maintenance of the endotracheal tube placement is essential. When the ETT is not secured effectively, even basic nursing management can cause tube slippage which is a major factor in causing airway trauma. Aim of the study: This study was aimed at comparing the effectiveness of three endotracheal tube securement techniques (Twill, Adhesive and Simple bow) on endotracheal tube slippage, external jugular venous pressure measurement, oral mucosa and facial skin integrity, pain intensity and on patient satisfaction after the fixation method. Subjects and methods: A randomized clinical trial was conducted at the intensive care units in Ain Shams University Specialized Hospital. It included a sample of 90 patients, randomly allocated to the three equal groups: Twill, Adhesive and Simple bow groups, 30 subjects for each. The tools used for data collection included demographic and clinical data sheet, the time profile of ETT fixation method sheet and scales for endotracheal tube (ETT) slippage, external jugular venous pressure (EJVP) measurement, oral assessment guide (OAG) for oral mucosa, Facial Skin Integrity, pain intensity and patient satisfaction procedure scale. The study maneuvers were applied according to the group. Results: Both ETT slippage and EJVP were measured at 15, 30, 60 and 120 min post fixation method. At 120 min, 73% of patients in the Twill group had no slippage compared to Simple bow (50%) and (36%) in Adhesive groups. However, at 30 min post fixation method 90% of patients in the Twill group had normal EJVP measurement compared to Simple bow and Adhesive groups (70% and 57%, respectively), with a statistically significant difference between the three groups. At 60 min, only 10% of patients in the Twill group had high EJVP compared to Simple bow (37%) and Adhesive groups (47%) with a statistically significant difference among them. As well, at 120 min post fixation method, most patients in the Twill group (97%) had normal EJVP measurement, compared to the Adhesive (60%) and Simple bow (57%) groups. Oral mucosa and facial skin integrity assessment was done for all patients in the three study groups at 2, 6, 12, and at 24 h post fixation method. For oral mucosa at 24 h post fixation method, 80% of patients in the Twill group had healthy oral mucosa compared to Simple bow and Adhesive groups (47% and 37%, respectively), with a statistically significant difference between the three groups (P = 0.07). For facial skin integrity, at 6 h, no one of patients in the Twill and Simple bow groups had severe facial skin reaction compared to patients in the Adhesive group (7%) and the difference was statistically significant, (P = 0.01). As well, a statistically significant difference was revealed among the three groups, at 12 and 24 h post fixation method, (P = 0.04 and 0.02, respectively). The Twill technique had the shortest time taken for application and removal of securement method than other groups. Additionally, the Twill group had the lowest scores of pain at all three assessment times (5, 10 and 20 min), whereas those in the Adhesive group had the highest scores. All these differences were statistically significant, (P