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In a typical home water network, water pipes connecting faucets to the central water heater are long. This will lead to a large amount of water being trapped inside the water network and exposed to environmental conditions. Further, in the summer, this trapped water also heats up to an uncomfortable high temperature. Users typically waste this water by letting it flow down the drain until water at a comfortable temperature arrives. Continuous circulation has been proposed but it consumes a significant amount of energy. In this paper, a new approach to saving trapped water is proposed. It enables the circulation of hot as well as cold water. This is achieved via the introduction of a new component called the back box which is installed inside the home water network. This back box enables the circulation of water in a direction against the line pressure. The experimental and simulation results show the viability and effectiveness of the new approach. A significant amount of water can be saved as confirmed by the obtained results.

Importance: Despite the improvement of treatment modalities and technical aspects, recurrence following hernia repair remains one of the main problems for the surgical community. More specifically, previous Cochrane Systematic Review and large database studies compared Lichtenstein repairs. However, none of the relevant published reports were representative of the Saudi population. Objective: This study's objective was to investigate the overall and gender-specific prevalence of recurrences in patients who had undergone Lichtenstein mesh repair of primary inguinal hernia (IH) in the KFHU Centre. Design: This is a retrospective record review study conducted between January 2000 and December 2014. Setting: The study was conducted at a single center located in Saudi Arabia, at King Fahed Hospital University KFHU center. Participants: Adults (≥18 years of age), with IH, operated at KFHU using standard Lichtenstein open mesh repair, and had minimum follow-up of 2 years were included in the study. Laparoscopically operated cases, recurrent and emergently operated cases were excluded from the study. Main Outcome (s) and Measure (s): Data were collected by records review and included sociodemographic characteristics (age, gender, and family history), hernia type and location, risk factors (body mass index [BMI], smoking, comorbidities, etc.), recurrence and other complications (pain, wound hematoma and seroma, infection, etc.). Results: We report a recurrence rate of 1.3% following Liechtenstein mesh repair at our center. As for patient-related factors that were found to be significantly associated with the recurrence of an IH were older age, higher BMI, the existence of hypertension, chronic cough and diabetes, in addition to smoking and lifting heavy objects. Conclusion: We have identified several likely factors associated with higher recurrence after hernia repair. A comparison of the rates of recurrence and complications between different procedures should, therefore, be an important topic to address in future studies.

Background: Recently, new studies have shown that the prevalence of osteoporosis and related fractures has been increased among young females. This study aimed at finding out the association between dietary intake and bone mineral density (BMD) among university Saudi female students at Imam Abdulrahman Bin Faisal University.Methods: A cross sectional study was carried out on 104 females’ students aged 18-24 years taken randomly from Rakkah campus. Dual X-ray absorptiometry was used to evaluate BMD and body composition. A complete and valid questionnaire was used to collect the required information about socio-economic status, lifestyle, body measurements, health history data, and food habits as well as food frequency questionnaire was also used. The results were statically analyzed (SPSS, 2015 V, 23) and descriptive statistics Chi-square test and independent samples t- test were used for the statistical analysis.Results: The results demonstrated that the majority (65%) of students have normal body mass index (18.5-24.9 kg/m2), 58% normal BMD (>-1.0 SD) and 42% have low BMD. Among the low BMD students, 4% having osteoporosis (

Solar chimney or Trombe wall has been studied numerically and analytically. Analytical results available in the literature overestimate air flow rate by 46–97%. While insulated walls are used in the experiments, there might still be loss from the chimney walls, which is not usually considered in the available analytical models. It is found that the overestimation of air flow rate can be reduced to 3–14% by including heat losses from the glass and wall side of the chimney in the analytical model. The presently developed numerical model is validated against experimental data from literature. The conditions within which the analytical solution can give good approximate results regarding the air volume flow rate have been identified and discussed. We found that the analytical method simulates solar chimneys well for gap widths of up to 0.3 m and incident radiation above 500 W/m2. The present numerical results revealed that the optimum value of chimney gap width that maximizes the induced flow through the chimney is 0.3 m.

Introduction Insights in the adaptation of cardiac output (CO) and peripheral systemic vascular resistance in normal pregnancy may aid in identifying women with deviant adaptation. These women are thought to be at risk for hypertensive related complications during pregnancy. Objectives First, to describe the pattern of CO and peripheral resistance changes in normotensive singleton pregnancies. Second, to explore the adaptation of these variables in pregnancies complicated by hypertension, pre-eclampsia and/or foetal growth restriction. Methods We performed a meta-analysis of systematically reviewed literature on CO and peripheral resistance throughout normotensive and complicated pregnancies, using PubMed (NCBI) and Embase (Ovid) databases. Only studies reporting measurements during pregnancy and non-pregnant reference values were included. Pooled mean differences between pregnant and non-pregnant women were calculated for predefined intervals of gestational age using a random-effects model. Results In total, 92 studies were included in this meta-analysis. In uncomplicated pregnancies, CO progressively increased from the first weeks on. After peaking in the early third trimester (+1.47 L/min, over 30% increase as compared to the non-pregnant reference group), CO declined slightly until term. Next to that, peripheral resistance decreased progressively until early third trimester (−316 dyn · s · cm−5, −24% as compared to the non-pregnant group), after which it increased a little. In the first trimester of complicated pregnancies, an augmented increase in CO was observed (+1.36 L/min versus +0.73 L/min in the uncomplicated pregnancies, p Discussion During normal pregnancy, CO increases and peripheral resistance decreases by 30% and 24% respectively, reaching their maximum measure in the second half of pregnancy. Deviant hemodynamic adaptations showing an initial augmented increase with a cross-over to a low cardiac output might identify pregnancies that will be complicated by hypertension and/or growth restriction.

Multiphase flow meters (MPFMs) are being widely employed in the oil and gas industry for a higher rate test frequency in the producing wells and for continuous production monitoring. But after the installation and before it provides services, a MPFM experiences a lengthy process that is comprised of meter calibration, settings configuration and wellhead sampling for liquid density checking. To accomplish this process is often challenging in offshore fields due to the adverse weather conditions and the high costs of offshore activities. That has hindered the MPFM commissioning activities in many Aramco offshore fields and consequently affected the testing requirements. A MPFM is an intelligent metering device which is very sensitive to the fluid's PVT properties, fluids densities, H2S and CO2 contents. A typical calibration of a MPFM in Aramco offshore fields often requires taking fluid samples from each individual well for the fluid density check and determination of mass attenuation of oil due to the fluid density variations in a field. An offshore MPFM often covers the testing requirements for all 6 to 8 producers on a platform. Hence this method always takes a long time to take wellhead fluid samples for completing the calibration process of a single MPFM, and tends to lag far behind their planned commissioning schedule. In 2013, thirty seven new MPFM were installed in 37 different platforms covering more than 122 wells in one Aramco field. A commissioning and calibration campaign was launched early this year with a different approach after carefully analyzing the PVT properties of the produced fluids. In this approach the typical calibration work was first performed on 3 wells, and then the same settings and parameters were copied and uploaded as a batch to those remaining MPFMs covering other 119 wells in this field. This method significantly reduced the time for marine boat support. Furthermore, those 119 wells are being remotely flow tested in a batch via Supervisory Control and Data Acquisition (SCADA) to verify if any further adjustment is required. Due to H2S and CO2free in the produced fluids, and the almost constant liquid densities throughout the area in this field, the accuracy of the MPFM measurement can't be compromised by taking this process. The paper describes a new method that significantly reduced the total time for the 37 MPFM calibration and commissioning jobs and saved the costs.

Water is the most valuable natural resource after air without which a man cannot survive. The growing demand is forcing fresh water beyond natural replenishment rates. This nictitates finding water conservation opportunities. We recognize that there is significant cold water wastage at public places as users try to find a proper setting of the mechanical water mixer. There is in need of a smart system that can handle the demand of water and simultaneously serve the users with water at a constant and comfortable temperature as well as regulated pressure. In this paper, a smart centralized water mixing system has been proposed that provides water to users at a reasonable temperature and flow rate. This will help in eliminating mechanical mixing and use of manual valves. The proposed system is designed using different sensors and controllers in such a way that it is easy to install and it also overcomes the drawbacks of the present system with enhanced features and proper quality of service. The fixed ratio system and the proposed systems are simulated using the tools provide by Matlab. The obtained results show that with the integration of Wireless Sensor Network (WSN) and a control system with the conventional physical system, we can serve users with water at the desired temperature and flow rate. The proposed system provides significant water and energy conservation on top of improved quality of service to users.

Previously dentists focused on repair and maintenance of function. However, the emphasis of many patients and dentists is now on esthetics. Often there is a need for the disciplines of orthodontics, periodontics, restorative dentistry, and maxillofacial surgery to work together in order to achieve optimum results. Currently the sequencing planning process begins with esthetics and then function, structure, and ultimately biology.

We report five fetuses and a child from three families who shared a phenotype comprising cerebral ventriculomegaly and echogenic kidneys with histopathological findings of congenital nephrosis. The presenting features were greatly elevated maternal serum alpha-fetoprotein (MSAFP) or amniotic fluid alpha-fetoprotein (AFAFP) levels or abnormalities visualized on ultrasound scan during the second trimester of pregnancy. Exome sequencing revealed deleterious sequence variants in Crumbs, Drosophila, Homolog of, 2 (CRB2) consistent with autosomal-recessive inheritance. Two fetuses with cerebral ventriculomegaly and renal microcysts were compound heterozygotes for p.Asn800Lys and p.Trp759Ter, one fetus with renal microcysts was a compound heterozygote for p.Glu643Ala and p.Asn800Lys, and one child with cerebral ventriculomegaly, periventricular heterotopias, echogenic kidneys, and renal failure was homozygous for p.Arg633Trp in CRB2. Examination of the kidneys in one fetus showed tubular cysts at the corticomedullary junction and diffuse effacement of the epithelial foot processes and microvillous transformation of the renal podocytes, findings that were similar to those reported in congenital nephrotic syndrome, Finnish type, that is caused by mutations in nephrin (NPHS1). Loss of function for crb2b and nphs1 in Danio rerio were previously shown to result in loss of the slit diaphragms of the podocytes, leading to the hypothesis that nephrosis develops from an inability to develop a functional glomerular barrier. We conclude that the phenotype associated with CRB2 mutations is pleiotropic and that the condition is an important consideration in the evaluation of high MSAFP/AFAFP where a renal cause is suspected.

We present cases of 3 children diagnosed with the same genetic condition, Gitelman syndrome, at different stages using various genetic methods: panel testing, targeted single gene sequencing, and exome sequencing. We discuss the advantages and disadvantages of each method and review the potential of genomic sequencing for early disease detection.

X-ray Photoelectron Spectroscopy (XPS) was used to investigate the growth of thin oxide layers obtained by dry oxidation on ( 011 ) germanium substrates. The heat treatments were carried out, in-situ, at T =380°C under various values of air pressure. The quantitative analysis of the XPS spectra suggests the growth of non uniform oxide layers. An apparent thickness of the oxide film was defined as function of the fraction of the oxidized surface and of the actual thickness of the oxide islands. The results show a quasi linear dependence of the apparent thickness versus the air pressure.

Background: During cardiopulmonary resuscitation, family members are usually pushed out of the resuscitation room. However, growing literature implies that family presence during resuscitation could be beneficial. Some health organizations worldwide such as American Heart Association and the Resuscitation Council in the UK supports family-witnessed resuscitation (FWR) and urge hospitals to develop policies to ease this process. The opinions on FWR vary widely among various cultures, and some hospitals are not applying such polices yet. This is the first study which explores the Saudi family members' opinion for family witness resuscitation in adult critical care setting. Objectives: To investigate whether patient's next of kin would like to have been present in the resuscitation room during attempted cardiopulmonary resuscitation (CPR) of their relative and their experience or knowledge of what is involved in CPR. Subjects and Methods: A retrospective, descriptive telephone survey of families of patients who had admitted in critical cares areas from January 2016 to June 2016. A family presence survey was developed to determine the desires, beliefs, and concerns about FWR. Results: Out of the 235 respondents, 143 (60.9%) wanted to be present in the room of their loved one just before death while CPR was going on. One hundred and eighty-two (77.4%) of the respondents believed that the family members should be with their loved one before death. More than half, i.e., 141 (60.0%) of the respondents believed that their presence might have eased the suffering of the deceased. One hundred and fifty-seven (66.8%) of the family members thought that their presence with the deceased in their last moments could have helped their sorrows and sadness. Conclusion: Most relatives of patients requiring CPR would like to be offered the possibility of being in the resuscitation room; this could have several benefits, so this study suggests that institutions should consider establishing programs of witnessed cardiopulmonary resuscitation for family members.

Scatter directionality of incident ultrasound beam depends on scatter size relative to the wavelength. If they comparable then complex scattering pattern is expected. There are anatomic sites where structural variety could include this scenario like kidney tissue or muscle fibers. This paper introduces a novel approach to constructing angular scatter images.

Purpose: The first medical physics Master's program in the Arabian Gulf region was started in 2002 at King Fahd University of Petroleum & Minerals (KFUPM), Dhahran, Saudi Arabia. Methods: After consulting with national and international representatives from the AAPM, IOMP, the University of Wisconsin‐Madison and King Faisal Specialist Hospital and Research Center (KFSHRC) we constructed a versatile and rigorous curriculum. The program requires the completion of 7 core courses, 7 required labs, a minimum of 3 elective courses, a research project, a four‐month clinical rotation and passing and a comprehensive examination. The success of the program required very close collaboration with national hospitals such as King Fahad Specialist Hospital in Dammam (KFSH‐D), KFSHRC, and Riyadh Military Hospital. We cemented the collaboration with a formal agreement between KFUPM and KFSH‐D, whereby the clinical medical physicists are actively involved in teaching lectures and labs, evaluating students’ performance and co‐supervising their clinical rotation and research projects. In order to prepare our graduates for their medical physics careers, we emphasize innovative learning methods such as students centered learning, execution of course projects, experiential learning and acquiring research skills and tools such as Monte Carlo simulations.Results: Our graduates have succeeded in securing clinical positions in some of the best hospitals in the region and achieved high employer satisfaction. Some students have gone to pursue their PhD's in North America and Europe. Many of our students succeeded in publishing their projects in international journals and international conferences. One of our students was instrumental in obtaining a USpatent(USPatent # 785298) for an innovative x‐ray tube design. Conclusions: We have achieved national recognition through the excellence of our graduates. In order to maintain high education quality standards and achieve international recognition, we are presently working to acquire IAEA approval and CAMPEP accreditation.

X-ray Photoelectron Spectroscopy (XPS) has been used to investigate the oxidation of (011) Ge substrates. The sample surfaces were CP4-etched, then annealed in situ, at different temperatures, for various durations. Dry and wet atmospheres were used. The oxidation rate during the early stage was increased by the presence of moisture in the atmosphere. A simple model was used to define and determine an apparent thickness of the oxide film from XPS measurements. The time dependence of the apparent thickness is consistent with a partial coverage of the surface by oxide islands. The growth kinetics of the oxide islands obeys a nearly cubic law.