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Renal transplantation is the definitive treatment for patients with end-stage renal disease (ESRD). It is associated with better quality of life and patient survival. Nevertheless, these benefits come with rising concerns about weight gain and metabolic abnormalities, which adversely impact transplant outcomes. The objective of this study is to estimate the incidence of weight gain in the first year post-renal transplant in addition to the assessment of potential risk factors and the resulting outcome of the graft. We conducted a single-center retrospective cohort study of all 295 patients who underwent kidney transplantation at King Abdulaziz Medical City (KAMC) between January 2016 and December 2019. Clinical and laboratory variables were collected from electronic records. Continuous variables were reported as mean ± standard deviation. Comparison between groups was assessed by unpaired t-test or Mann-Whitney U test while follow-up data were compared using paired t-test and repeated measures ANOVA. Association between the potential risk factors and the weight gain was assessed by means of binary logistic regression analysis. Significant weight gain was observed in 161 (54.6%) patients. Females were 119 (40.30%) of the cohort. The mean age was 45.3±15.1 years. The prevalence of diabetes was 234 (79.6%), while hypertensives constituted 77 (26.3%). The comparison between patients who gained weight significantly and patients with stable weight showed a numerical higher prevalence of female gender in patients who had more weight gain (44.1% vs. 35.8%), higher diabetes, higher rate of a living donor, and statistically significant lower dialysis duration before transplant. Other clinical and laboratory variables were comparable between the two groups. Our study showed a high incidence of clinically significant weight gain among patients post-renal transplantation. Patients with lower dialysis duration, a living kidney donor and those who are obese at baseline were at higher risk of gaining weight. Patients who underwent kidney transplantation should be monitored closely for weight gain and further studies are needed to determine the risk factors and appropriate interventions.

Patients with certain inflammatory skin diseases have multiple risk factors for venous thromboembolism (VTE). The objective of the study was to determine whether atopic dermatitis (AD), psoriasis, pemphigus, pemphigoid and/or hidradenitis is associated with VTE in US adults. Data were analyzed from the 2002–2012 Nationwide Inpatient Sample, a representative cohort of US hospitalizations ( N  = 72,512,581 adults, including 1,389,292 with VTE). In multivariable logistic regression models including age, sex, insurance, household income and race/ethnicity, hospitalization for AD (adjusted odds ratio [95% confidence intervals] 1.22 [1.17–1.27]), pemphigus (1.96 [1.68–2.28]) and pemphigoid (1.64 [1.47–1.83]) was associated with VTE. These associations remained significant in virtually all patient subsets, including males and females, different age groups and those with and without long-term corticosteroid use. In particular, AD, pemphigus and pemphigoid were each associated with DVT and PE. VTE was associated with increased inpatient length of stay, cost of care and mortality across all the inflammatory skin diseases. HS and psoriasis were not consistently associated with VTE. AD, pemphigus and pemphigoid and some subsets of patients with HS were associated with higher odds of hospitalization for VTE. Patients with these inflammatory skin diseases may benefit from increased screening and prevention of VTE.

The adoption of laparoscopic surgery has significantly transformed surgical practice. However, mastering these techniques requires specialized training. In Saudi Arabia, the level of proficiency in laparoscopic skills among General Surgery (GS) trainees is not well-documented. This study aims to assess GS residents' satisfaction with their laparoscopic training, self-appraise their proficiency, and objectively evaluate their skills using the Fundamentals of Laparoscopic Surgery (FLS) test. This cross-sectional study, approved by the Institutional Review Board and funded by Alfaisal University, took place between October 2021 and May 2023. It involved a two-part approach: an online survey and objective FLS testing. The survey, distributed to GS residents in seven government hospitals in Riyadh, captured self-reported satisfaction and subjective proficiency data. Subsequently, residents who volunteered for FLS testing were objectively assessed using standardized criteria. Of 195 residents, 70 (36%) responded to the survey. Satisfaction with academic teaching and hands-on training in laparoscopic surgery was low (24% and 44%, respectively), while 62% were satisfied with case volume. Self-assessed proficiency was higher for basic skills than for advanced skills like extra-corporeal and intracorporeal knotting. Only a third had been exposed to laparoscopic trainers, and 14.3% had FLS certification prior. Fourteen residents participated in FLS testing, revealing a 36% failure rate in task completion. Prior simulation practice or laparoscopic training certification significantly improved performance (p<0.001), reflected by achieving higher scores and passing FLS proficiency scores. Despite satisfaction with exposure to laparoscopic surgeries, the study highlights a considerable gap in satisfaction and proficiency among GS residents in Saudi Arabia, particularly in advanced laparoscopic skills. The positive impact of simulation-based practice and laparoscopic training certification underscores the need for structured training programs. Addressing these gaps, through integrating comprehensive simulation-based programs and promoting laparoscopic skill certification, is crucial for enhancing surgical education and training outcomes.

This manuscript investigates the utilization of waste heat from automobiles, such as exhaust gas and engine coolant water, to run a lithium bromide water Absorption Cooling System (ACS). This study proposed adding a secondary heat exchanger located between the primary heat exchanger and generator. It takes heat from engine coolant water to reduce thermal load on the generator and to enhance the Coefficient of Performance (COP) of the system. The effect of concentration solution, primary heat exchanger effectiveness, and the temperature of main component (generator, condenser, evaporator and absorber) are studied. The results show a COP of 0.79 with a cooling capacity of 5 kW at generator, condenser, evaporator, and absorber temperatures of (90, 40, 10, and 35), respectively. The COP increases as the evaporator temperature increases, and it decreases as the condenser and absorber temperature increases. Also, any increase in the heat exchanger effectiveness will be led to increase the COP. The results show that the addition of a secondary heat exchanger led to reduce the load on the generator by 4% to 7%, and that depends on the operating conditions and the system. In addition, the results examine a significant reduction in CO 2 emissions by 1.58 kg/hr. These findings point out to a substantial possibility for lowering thermal emissions and increasing energy efficiency, and that provides a long-term way to use waste energy in automobiles.

Radial turbines play a vital role in turbochargers and compact power systems, where efficiency and size optimization are crucial. However, the combined aerodynamic effects of key rotor geometric features–namely blade angle distribution, thickness profile, and blade count–have not been comprehensively examined. This work presents a unified CFD-based methodology to assess how coordinated changes in these parameters influence turbine performance. A validated numerical model of a reference rotor was employed to systematically vary each design factor and evaluate its impact on efficiency and reduced mass flow. The investigation demonstrates that carefully optimized geometric adjustments can enhance flow uniformity, minimize secondary losses, and improve overall energy conversion. The study establishes clear performance trends supported by detailed flow-field analysis and provides design-oriented correlations that can guide future optimization of radial turbine rotors for high-efficiency operation.

This case report discusses the management of a 46-year-old male patient with autosomal dominant polycystic kidney disease and a high body mass index, who underwent a semi-simultaneous procedure involving hand-assisted laparoscopic bilateral nephrectomy to alleviate severe abdominal symptoms and prepare for a kidney transplantation, all using the same incision. This is the first reported occurrence of such a procedure in Saudi Arabia. Post-operatively, the patient made a successful recovery with excellent kidney function and no complications.

Background Exposure to political violence, which pervades many parts of the Middle East and Northern African (MENA) region, is a key potential factor behind the rising rates of risky behaviors among youth, such as drug use, alcohol use, and sexual activity. Theory and empirical work on youth elsewhere suggests that individual characteristics, mental health, and youths’ future orientation play a role in such behaviors. It is possible that political violence impacts behavior in part through its effects on these factors, in particular mental health. However, very little is known about the determinants of youth risk behavior in the region. Understanding the determinants will help MENA countries to deal with emerging public health threats as well as risks to youth health and well-being resulting from engagement in risky behavior. We examined determinants of risky behavior among Palestinian youth in the West Bank and East Jerusalem. Methods We employed structural equation modeling using a 2014 nationally representative data from the Palestinian Youth Health Risk Study to examine the factors associated with engagement of youth ages 18–24 ( N  = 1449) in risky behaviors. Results Personal experience of political violence was the strongest direct predictor of engagement in interpersonal violence ( β  = 0.21, p  = 0.00) and substance use ( β  = 0.21, p  = 0.00). With respect to indirect effects, global distress mediates the impact of witnessing and vicariously experiencing violence on the three outcomes. However, no association was found between personally experiencing political violence and global distress. The study also identified several individual characteristics, such as religiosity, that may be protective against risky behavior. Females are less likely to engage in risky behavior than males, despite experiencing higher levels of global distress. Conclusions The study is the first to use population-based data to test the effects of exposure to political violence on key risky health behaviors of Palestinian youth, a population facing protracted conflict and hardship for which solutions remain elusive. The findings suggest the need for customized interventions to target male and female Palestinians at an early age to develop their coping skills in dealing with violence and distress. Trial registration Not applicable.

This paper for the first time improved a Robust Multi-Output machine learning regression model for seismic hazard zoning of Turkey, Iraq and Iran using constructed 3-D shear-wave velocity ( V s), seismic tomography dataset model for the crust and uppermost mantle beneath the study area. The focus of this paper’s opportunity is to develop a scientific framework leveraging machine learning that will ultimately provide the rapid and more complete characterization of earthquake properties. This work can be targeted at improving the seismic hazard zones system ability to detect and associate seismic signals, or at estimating other seismic characteristics (crust acceleration and crust energy) while traditionally, methods cannot monitor the earthquakes system. This work has derived some physical equations for extraction of many variables as inputs for our developed machine learning model based on a reliable understanding of the tomography data to physical variables by preparing huge dataset from different physical conditions of crust. We have extracted the velocity values of the shear waves from the original NETCDF file, which contains the S velocity values for every one km of the depths of the crust for the study area from one km down to the uppermost mantle beneath the Middle East. For the first time, this study calculated new seismic hazard parameter called Peak Crust Acceleration (PCA) for seismic hazard analysis by considering the transmitted initial seismic energy through the Earth’s crust layers from hypocenter. All machine learning algorithms in this study wrote in python language using anaconda platform the open-source Individual Edition (Distribution).

Purpose The prevalence of metabolic syndrome (MetS) increases in parallel with the increasing incidence of obesity. Hence, bariatric surgery is potentially curative in obese patients with MetS. We aim to measure the effect of bariatric surgery as well as the potential factors leading to MetS resolution in the Saudi population. Methods A retrospective review of three tertiary care centers in Saudi Arabia was done. We identified 386 patients who have MetS and underwent bariatric surgery during the period between January 2016 and December 2018. After exclusion of patients with insufficient follow-up, data from 275 patients was analyzed. MetS diagnosis, persistence, and resolution were determined using the International Diabetes Federation consensus worldwide definition. Results MetS resolution was achieved in 78%, 79%, 73%, and 82% at 1, 2, 3, and 4 years after bariatric surgery, respectively. Accumulatively, 80% achieved MetS resolution with an average follow-up period of two and a half years. Patients who experienced resolution had younger age, lower BMI, lower systolic blood pressure, lower triglycerides, lower fasting plasma glucose, and lower HbA1c preoperatively in addition to a higher percentage of excess weight loss after bariatric surgery when compared to those who had persistence of MetS. Conclusion More than three fourths of patients with MetS achieved resolution after bariatric surgery. Certain patient characteristics, such as young age and higher excess weight loss postoperatively, were associated with a higher chance of MetS resolution. Graphical abstract

This study aims to accurately predict abrasion resistance, measured through the Los Angeles (LA) abrasion test, and modulus of elasticity, assessed using the Micro-Deval Abrasion (MDA) test, to support structural integrity and efficient material use in construction projects. We applied multi-output machine learning models—specifically Linear Regression (LR), Huber, RANSAC, and Support Vector Regression (SVR)—to predict LA and MDA values based on primary input parameters, including Uniaxial Compression Strength (UCS), Point Load Index (PLI), Schmidt Hammer Rebound (Sh_h), and Ultrasonic Pulse Velocity (UPV). The experimental work involved assessing model performance using metrics such as Mean Absolute Error (MAE), R-squared (R2), and Mean Squared Error (MSE). Linear Regression demonstrated superior predictive accuracy, achieving 94% for R2 with an MAE of 0.21 and MSE of 0.09 for LA predictions and 92% for R2 with an MAE of 0.24 and MSE of 0.11 for MDA predictions. These results underscore the potential of machine learning techniques in accurately predicting critical material properties, offering engineers reliable tools for optimizing material selection and structural design. This research contributes to the advancement of construction practices, promoting the development of durable and efficient infrastructure.