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Diagnostic accuracy of ePOS score in predicting DNR labeling after ICU admission:A prospective observational study(ePOS-DNR)

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Journal of Intensive Medicine 2024年第2期4卷 216-221页

作者： Omar E.ramadan ahmed F.Mady Mohammed A.Al-Odat ahmed N.Balshi ahmed W.Aletreby Taisy J.Stephen Sheena R.Diolaso Jennifer Q.Gano Waleed Th.Aletreby Department of Critical Care King Saud Medical CityRiyadhSaudi Arabia Anesthesia Department Faculty of MedicineAin Shams UniversityCairoEgypt Anesthesia Department Faculty of MedicineTanta UniversityTantaEgypt Faculty of Medicine Alexandria UniversityAlexandriaEgypt Nursing Department King Saud Medical CityRiyadhSaudi Arabia

Background Resuscitation can sometimes be futile and making a do-not-resuscitate(DNR)decision is in the best interest of the patient.The electronic poor outcome screening(ePOS)score was developed to predict 6-month poor outcomes of critically ill patients.We explored the diagnostic accuracy of the ePOS score in predicting DNR decisions in the intensive care unit(ICU).Methods This study was conducted at the ICU of a tertiary referral hospital in Saudi Arabia between March and May 2023.Prospectively,we calculated ePOS scores for all eligible consecutive admissions after 48 h in the ICU and recorded the DNR orders.The ability of the score to predict DNR was explored using logistic regression.Youden's ideal cut-off value was calculated using the DeLong method,and different diagnostic accuracy measures were generated with corresponding 95%confidence intervals(CIs).Results We enrolled 857 patients,125 received a DNR order and 732 did not.The average ePOS score of DNR and non-DNR patients was 28.2±10.7 and 15.2±9.7,respectively.ePOS score,as a predictor of DNR order,had an area under receiver operator characteristic(AUROC)curve of 81.8%(95%CI:79.0 to 84.3,P17 was associated with a sensitivity of 87.2(95%CI:80.0 to 92.5,P17 may help guide clinical decisions to withhold or commence resuscitative measures.

关键词： Do-not-resuscitate(DNR) Resuscitation Intensive care unit(ICU) Diagnostic accuracy Sensitivity Specificity

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Laser Surface Hardening of Tool Steels—Experimental and Numerical Analysis

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Journal of Surface Engineered Materials and Advanced Technology 2013年第2期3卷 146-153页

作者： Abdel-Monem El-Batahgy ramadan ahmed ramadan Abdel-Rahman Moussa Manufacturing Technology Department Central Metallurgical R & D Institute Cairo Egypt Mechanical Engineering Department Faculty of Engineering Helwan University Helwan Egypt. Spare Parts Sector Egyptian Iron and Steel Company Helwan Egypt

This research work is focused on both experimental and numerical analysis of laser surface hardening of AISI M2 high speed tool steel. Experimental analysis aims at clarifying effect of different laser processing parameters on properties and performance of laser surface treated specimens. Numerical analysis is concerned with analytical approaches that provide efficient tools for estimation of surface temperature, surface hardness and hardened depth as a function of laser surface hardening parameters. Results indicated that optimization of laser processing parameters including laser power, laser spot size and processing speed combination is of considerable importance for achieving maximum surface hardness and deepest hardened zone. In this concern, higher laser power, larger spot size and lower processing speed are more efficient. Hardened zone with 1.25 mm depth and 996 HV surface hardness was obtained using 1800 W laser power, 4 mm laser spot size and 0.5 m/min laser processing speed. The obtained maximum hardness of laser surface treated specimen is 23% higher than that of conventionally heat treated specimen. This in turn has resulted in 30% increase in wear resistance of laser surface treated specimen. Numerical analysis has been carried out for calculation of temperature gradient and cooling rate based on Ashby and Easterling equations. Then, surface hardness and hardened depth have been numerically estimated based on available Design-Expert software. Numerical results indicated that cooling rate of laser surface treated specimen is high enough to be beyond the nose of the CCT diagram of the used steel that in turn resulted in a hard/martensitic structure. Numerically estimated values of surface temperature, surface hardness and hardened depth as a function of laser processing parameters are in a good agreement with experimental results. Laser processing charts indicating expected values of surface temperature, surface hardness and hardened depth as a function of different wider range of laser processing par

关键词： High Speed Tool Steels Laser Surface Hardening Ashby and Easterling Heat Transfer Equations Design Expert Software Laser Processing Charts

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Patterns of liver profile disturbance in patients with COVID-19

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World Journal of Clinical Cases 2022年第7期10卷 2063-2071页

作者： Hend Ibrahim Shousha ahmed ramadan Rania Lithy Mohamed El-Kassas Department of Endemic Medicine Faculty of MedicineCairo UniversityCairo 12556Egypt Department of Endemic Medicine Faculty of MedicineHelwan UniversityCairo 11795Egypt

Fever and cough are the most common clinical symptoms of coronavirus disease 2019(COVID-19),but complications(such as pneumonia,respiratory distress syndrome,and multiorgan failure)can occur in people with additional comorbidities.COVID-19 may be a new cause of liver disease,as liver profile disturbance is one of the most common findings among patients.The molecular mechanism underlying this phenomenon,however,is still unknown.In this paper,we review the most current research on the patterns of change in liver profile among patients with COVID-19,the possible explanation for these findings,and the relation to pre-existing liver disease in these patients.

关键词： Liver functions COVID-19 Liver profile Alanine transaminase aspartate transaminase Bilirubin

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Dissolved gas analysis and dissipation factor measurement of mineral oil-based nanofluids under thermal and electrical faults

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High Voltage 2023年第3期8卷 455-465页

作者： ahmed Maher Diaa-Eldin A.Mansour Khaled Helal ramadan A.A.Abd El Aal Department of Electrical Engineering Faculty of EngineeringPort-Said UniversityPort-SaidEgypt Department of Electrical Power Engineering Faculty of EngineeringEgypt-Japan University of Science and Technology(E-JUST)New Borg El-Arab CityAlexandriaEgypt Department of Electrical Power and Machines Engineering Faculty of EngineeringTanta UniversityTantaEgypt

Mineral oil is the most frequent insulating liquid used in oil-immersed transformers for electrical insulation and heat dissipation.However,oil-based nanofluids are becoming more popular in scientific research as they have proved to have better dielectric and thermal characteristics.When applying these nanofluids into actual transformers,they would be exposed to thermal and electrical stresses.Thus,The aim of the authors is to investigate the generation pattern of dissolved gases in nanofluids under thermal and electrical faults and to assess the applicability of traditional Dissolved Gas Analysis(DGA)techniques if oil-based nanofluids are used in transformers.Oil-based nanofluid samples were prepared using a magnetic stirrer and an ultrasonic homogeniser and then subjected to simulated thermal and electrical faults in the laboratory using properly sealed test cells.Three types of metal oxides,Silicon dioxide,Titanium dioxide,and Aluminium oxide nanoparticles,have been used to prepare nanofluids with 0.02 g/L and 0.04 g/L concentrations.The gases released and dissolved into oil due to the simulated faults were analysed and compared to traditional mineral oil as a benchmark.The dielectric dissipation factor was obtained and analysed for all samples.According to the findings,the presence and concentration of nanoparticles were shown to influence the amount of gases produced.As a result,this research is crucial in guaranteeing that traditional DGA techniques can be employed in transformers that use oil-based nanofluids.

关键词： electrical thermal dioxide

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Some aspects affecting the response of RC compartment structures subjected to internal blast loads

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Earthquake Engineering and Engineering Vibration 2022年第1期21卷 135-148页

作者： Osman M.O.ramadan M.Galal El Sherbiny ahmed M.Khalil Faculty of Engineering Cairo UniversityCairo 12411Egypt Higher Technological Institute(HTI)at 10th of ramadan City Sharqia 13658Egypt Structural Engineering and Construction Management Department Faculty of Engineering&TechnologyFutureUniversity in Egypt-FUECairo 16383Egypt

Protective compartments are typically used to protect some specific structures from internal explosions,such as industrial buildings that contain devices that may explode in certain circumstances.This research investigates how the response of reinforced concrete(RC)compartment structures subjected to internal blast loads are affected by the following aspects:introduction of material nonlinearity in the analysis,reinforcement ratio,and aspect ratio of the compartment.To achieve this goal,a calibrated and sophisticated FE numerical model is introduced,and a parametric study for the intended aspects is carried out.A discussion of the results and conclusions are offered,which show the role of each aspect in the dynamic performance of the compartment structures.The main conclusions are as follows:introduction of material nonlinearity in this type of analysis and for these structures is very important and significant in obtaining accurate outputs that are similar to actual behavior;the reinforcement ratio has a significant effect on the response and its effect varies depending on the thickness of the compartment;in general,increasing the reinforcement ratio enhances the behavior and reduces the stresses in the compartment;and the aspect ratio of the compartment does not show a clear pattern on the response of such structures under internal blast loads.

关键词： blast loads protective structures nonlinear analysis explicit dynamic analysis

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Friction and wear of sand-contaminated lubricated sliding

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Friction 2018年第4期6卷 457-463页

作者： Mohamed ahmed ramadan Faculty of Engineering at Helwan Helwan University

This paper reports a test investigation of friction and wear responses from sand contaminated lubricated sliding. The influence of sand contaminants on wear and friction is characterized. Analyses are completed utilizing segments of piston ring sliding against the cylinder liner. Paraffin oil, with and without sand contaminants, is utilized. The effects of the concentration and particle size of sand are examined. Based on the observations in the present work, we found that friction and wear increase with sand concentration in the lube. Solid proposals ought to be considered, in order to enlighten the general population on the importance of changing a car engine's oil filter regularly.

关键词：滑动摩擦汽车发动机滤油器

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Could ketamine be the answer to treating treatment-resistant major depressive disorder?

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General Psychiatry 2020年第5期33卷 296-300页

作者： Abdullah Mohammed ramadan Islam ahmed Mansour Psychiatry Mansoura University Faculty of MedicineMansouraEgypt

Major depressive disorder(MDD)is a common,serious,debilitating condition affecting 350 million people worldwide,which remains to be unsatisfactorily treated with 53%of patients still complaining of symptoms after completing their courses with the correct dosage.Ketamine,which was approved by the Food and Drug Administration in 2019,is a potential treatment option for those recalcitrant cases.The mechanism of ketamine is not fully understood,but as type it is classified as an N-methyl-D-aspartate(NMDA)glutamate receptor antagonist,and can be given intravenously,intranasally and orally.It is used to treat treatment-resistant depression,depression associated with suicidal ideation,mood and anxiety disorders and depressions associated with either type of bipolar disorder.Although ketamine is considered relatively safe,several side effects have been reported with the major ones being psychiatric in the form of worsening mood,anxiety and agitation;psychotomimetic in the form of dissociation,perceptual disturbance and abnormal sensations;cardiovascular in the form of increased blood pressure and increased heart rate;and neurological in the form of headache and dizziness.Ketamine is still not approved worldwide for usage in patients with treatment-resistant MDD,but if it is approved sometime in the future with relatively fewer side effects,it is expected to significantly save millions of dollars spent yearly on patients with treatment-resistant depression and that will lift this major burden off the shoulders of healthcare professionals.This study was designed to measure the effects of ketamine,an NMDA receptor antagonist,on patients with treatment-resistant MDD and to analyse the concept that makes it different and relatively safer than other major antidepressants like selective serotonin reuptake inhibitors,monoamine oxidase inhibitors and TCAs(tricyclic antidepressants).

关键词： ketamine dosage sensation

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Are climate change and mental health correlated?

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General Psychiatry 2021年第6期34卷 49-57页

作者： Abdullah Mohammed Hassan ramadan ahmed G Ataallah Department of Psychiatry Mansoura University Faculty of MedicineMansouraEgypt

Climate change is one of the biggest challenges of our time and is likely to affect human beings in substantial ways.Recently,researchers started paying more attention to the changes in climate and their subsequent impact on the social,environmental and economic determinants of health,and the role they play in causing or exacerbating mental health problems.The effects of climate change-related events on mental well-being could be classified into direct and indirect effects.The direct effects of climate change mostly occur after acute weather events and include post-traumatic stress disorder,anxiety,substance abuse disorder,depression and even suicidal ideation.The indirect effects include economic losses,displacement and forced migration,competition over scarce resources and collective violence.The risk factors for developing those mental health issues include young age,female gender,low socioeconomic status,loss or injury of a loved one,being a member of immigrant groups or indigenous people,pre-existing mental illness and inadequate social support.However,in some individuals,especially those undisturbed by any directly observable effects of climate change,abstract awareness and acknowledgement of the ongoing climate crisis can induce negative emotions that can be intense enough to cause mental health illness.Coping strategies should be provided to the affected communities to protect their mental health from collapse in the face of climate disasters.Awareness of the mental health impacts of climate change should be raised,especially in the high-risk groups.Social and global attention to the climate crisis and its detrimental effects on mental health are crucial.This paper was written with the aim of trying to understand the currently,scientifically proven impact of climate change-related disasters on mental health and understanding the different methods of solving the problem at the corporate level,by trying to decrease greenhouse gas emissions to zero,and at the individual level by learning how to cope with the

关键词： mostly collective likely

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Improved Control in Single Phase Inverter Grid-Tied PV System Using Modified PQ Theory

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Intelligent Automation & Soft Computing 2023年第8期37卷 2441-2457页

作者： Nur Fairuz Mohamed Yusof Dahaman Ishak Muhammad Ammirrul Atiqi Mohd Zainuri Muhammad Najwan Hamidi Zuhair Muhammed Alaas Mohamed Mostafa ramadan ahmed Faculty of Electrical Engineering&Technology Universiti Malaysia Perlis02600ArauMalaysia School of Electrical&Electronic Engineering Universiti Sains Malaysia14300Nibong TebalMalaysia Department of Electrical Electronic and Systems EngineeringFaculty of Engineering and Built EnvironmentUniversiti Kebangsaan MalaysiaSelangor43600Malaysia School of Engineering Jazan UniversityJazanSaudi Arabia Faculty of Technology and Education Helwan UniversityCairoEgypt

Grid-connected reactive-load compensation and harmonic control are becoming a central topic as photovoltaic(PV)grid-connected systems diversified.This research aims to produce a high-performance inverter with a fast dynamic response for accurate reference tracking and a low total har-monic distortion(THD)even under nonlinear load applications by improving its control scheme.The proposed system is expected to operate in both stand-alone mode and grid-connected mode.In stand-alone mode,the proposed controller supplies power to critical loads,alternatively during grid-connected mode provide excess energy to the utility.A modified variable step incremental conductance(VS-InCond)algorithm is designed to extract maximum power from PV.Whereas the proposed inverter controller is achieved by using a modified PQ theory with double-band hysteresis current controller(PQ-DBHCC)to produce a reference current based on a decomposition of a single-phase load current.The nonlinear rectifier loads often create significant distortion in the output voltage of single-phase inverters,due to excessive current harmonics in the grid.Therefore,the proposed method generates a close-loop reference current for the switching scheme,hence,minimizing the inverter voltage distortion caused by the excessive grid current harmonics.The simulation findings suggest the proposed control technique can effectively yield more than 97%of power conversion efficiency while suppressing the grid current THD by less than 2%and maintaining the unity power factor at the grid side.The efficacy of the proposed controller is simulated using MATLAB/Simulink.

关键词： Hysteresis current controller incremental conductance nonlinear load PQ theory single-phase inverter

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ANFIS-based Sensor Fusion System of Sit-to-stand for Elderly People Assistive Device Protocols

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International Journal of Automation and computing 2013年第5期10卷 405-413页

作者： Omar Salah ahmed A.ramadan Salvatore Sessa ahmed Abo Ismail Makasatsu Fujie Atsuo Takanishi Egypt-Japan University of Science and Technology New Borg-El-Arab City Faculty of Engineering Tanta University Faculty of Science and Engineering Waseda University

This paper describes the analysis and design of an assistive device for elderly people under development at the EgyptJapan University of Science and Technology（E-JUST） named E-JUST assistive device（EJAD）.Several experiments were carried out using a motion capture system（VICON） and inertial sensors to identify the human posture during the sit-to-stand motion.The EJAD uses only two inertial measurement units（IMUs） fused through an adaptive neuro-fuzzy inference systems（ANFIS） algorithm to imitate the real motion of the caregiver.The EJAD consists of two main parts,a robot arm and an active walker.The robot arm is a 2-degree-of-freedom（2-DOF） planar manipulator.In addition,a back support with a passive joint is used to support the patient s back.The IMUs on the leg and trunk of the patient are used to compensate for and adapt to the EJAD system motion depending on the obtained patient posture.The ANFIS algorithm is used to train the fuzzy system that converts the IMUs signals to the right posture of the patient.A control scheme is proposed to control the system motion based on practical measurements taken from the experiments.A computer simulation showed a relatively good performance of the EJAD in assisting the patient.

关键词： Adaptive neuro-fuzzy inference systems（ANFIS） sensor fusion assistive technologies sit-to-stand motion analysis inertial measurement units

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