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A major current focus of refrigeration and air conditioning research is energy usage and environmental impact. The ejector-based refrigeration system is a technology that, it is hoped, can save power while using environment-friendly refrigerants to reduce any adverse effects on nature. The reduction of compressor dependency is the first and essential aim of this study; the second is to demonstrate the replacement of R134a with the new refrigerant R1234yf in motor vehicle air conditioning systems, establishing the benefits of employing R1234yf in conjunction with a Hybrid Air Conditioning System. In such a system the engine's exhaust gases are used to operate the ejector. A numerical model has been developed which estimates the ejector entrainment ratio at a specified spindle and primary nozzle exit position. A theoretical model using energy and exergy analysis illustrates the impact of hybrid systems on performance under different operating conditions (i.e., engine exhaust, ambient air, and evaporator temperatures). At a specified exhaust temperature, a detailed comparison has been conducted between a current air-conditioning system with R134a and the hybrid system with R1234yf. It was found that the R1234yf hybrid system reduced compressor energy consumption by 44.43% and operating exhaust heat levels by 12.79%. The COP was increased by 41.42%, while the exergetic efficiency was reduced from 37.14% to 13.85%. Cooling capacity dropped by 12.73%. The hybrid air-conditioning system based on R1234yf demonstrated tremendous potential for improving vehicle air-conditioning system efficiency.

S. securidaca seeds are reported to treat a variety of diseases; they contain multiple antidiabetic constituents and are widely used as anti-hyperglycemic, antibacterial, as well as anti-hyperlipidemic agents. The present work aimed to propose tablet formulations containing extracts of S. securidaca seeds in an attempt to obtain antibacterial and anti-hyperglycemic formulations with a more efficient oral hypoglycemic impact, limited side effects, and higher patient compliance for the first time, resulting in multiple benefits. Tablet formulations were created by encapsulating granules from S. securidaca seed extracts with varying concentrations of sodium starch glycolate as a super-disintegrant (0–3%). The final formulations were examined for weight variation, solubility, hardness, water content, disintegration time, friability, drug content (trigonelline and diosgenin), and in vitro drug release. The S. securidaca tablet formulations completed the weight test because the percentage deviation in the personal tablet weight and mechanical resistance from the mean were identified to be within the average range. In accordance with the results, formulations containing diosgenin as well as trigonelline as a super-disintegrant were identified as the ideal formulations. The amount of the active substance released from the tablet (S. securidaca seed extract formulation) was consistent throughout the results with the standard methods recommended by the FDA (94.05%) for diosgenin and 87.25% for trigonelline after 45 min. The acceptable limit, according to the FDA, is not more than (N.L.T.) 80% after 45 min for phase #1. The present study aimed to obtain an optimized formula for S. securidaca extract tablets that met the requirements of a good pharmaceutical preparation according to the United States Pharmacopeia (USP) and National Formulary (NF). This has important implications for the development of novel, effective treatments and significantly advances the development of natural medicine. Our findings are expected to be of interest to researchers, clinicians, and other experts in this field of study. Based on these findings, it can be inferred that the formulation of S. securidaca seed extracts with appropriate and compatible herbal dosage forms has fewer side effects and is more effective than traditional treatments.

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused a highly challenging and threatening situation worldwide. SARS-CoV-2 patients develop various clinical symptoms. The olfactory and taste dysfunctions are potential neurological manifestations among SARS-CoV-2 patients; however, their relationship with blood groups has rarely been investigated. This study aimed to investigate the prevalence of chemosensitive neurological disorders of smell and taste and their association with blood groups in SARS-CoV-2 patients. The present cross-sectional study was performed in the Department of Pathology, and Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. A well-structured, self-administered questionnaire was designed and distributed through social media platforms. A total of 922 Saudi and non-Saudi adults aged 18 years or older participated in the study. Out of 922 participants, the number of people who had anosmia was 309 (33.5%), 211 (22.9%) had hyposmia, and 45 (4.8%) had dysosmia. Moreover, 180 (19.52%) had ageusia, 47 (5.1%) and 293 (31.8%) had hypogeusia and dysgeusia, respectively. Among all the participants, 565 (61.27%) had smell-related disorders and 520 (56.39%) participants had taste-related clinical symptoms. The occurrence of anosmia and ageusia was relatively high among females compared to males (p = 0.024). The prevalence of smell-related disorders was 25.0% (230) and taste-related disorders was 23.21% (214) among the study participants with blood group O compared to all other blood group (A, B, and AB) participants who have smell allied disorders 30.69% (283), and taste allied disorders 27.98% (258). The prevalence of chemosensitive neurological disorders involving impaired smell and taste was higher in SARS-CoV-2 patients. These clinical symptoms were common among the participants with blood group type O compared to all other ABO blood group types. The role of certain demographic characteristics was consistent throughout multiple studies, notably with female gender and young adults.

The negative effects of leishmanicidal medications are numerous, and drug resistance to all of them has been observed. As a result, new medication development and the identification of novel therapeutic targets are critical. Leishmania major trypanothione reductase (Lm-TR), a NADPH-dependent flavoprotein oxidoreductase critical for thiol metabolism, is required for parasite viability. Since it lowers trypanothione, a chemical required by Leishmania's tryparedoxin/tryparedoxin peroxidase system to neutralise hydrogen peroxide (H2O2) produced by host macrophages during infection, this enzyme is essential for parasite survival in the host. Because it is not found in the mammalian host, this enzyme is a promising target for novel anti-leishmania medicines. A three-dimensional model of Lm-TR was created using I-TASSER server. Virtual screening of about 5000 sigma aldrich compounds, acquired from the ZINC database, was carried out using Autodock vina tool. Top ten compounds were tabulated based on binding affinity. The molecules with the ids ZINC04245710 and ZINC03869768 had the highest binding affinities of -11.4 and -11.2 kcal/mol, respectively. These compounds had the maximum binding affinity and the appropriate amount of hydrogen bonds. These molecules may be able to efficiently block the activity of the target enzyme (Lm-TR) and so serve as novel agents to combat cutaneous leishmaniasis. In search for new anti-Leishmania medications that are more effective and less cytotoxic, these molecules may provide a good starting point for a hit-to-lead procedure.

Haney Alsleem,1 Abdulrahman Tajaldeen,1 Abdulrahman Almutairi,2 Hussain Almohiy,3 Ebtisam Aldaais,1 Rayan Albattat,2 Mousa Alsleem,4 Elfatih Abuelhia,1 Osama Abdalla Mabrouk Kheiralla,1 Ahmed Alqahtani,5 Salem Alghamdi,6 Rowa Aljondi,6 Renad Alharbi7 1Department of Radiological Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2Medical Imaging Department, King Fahad Specialist Hospital, Dammam, Saudi Arabia; 3Radiological Sciences, King Khalid University, Abha, Saudi Arabia; 4College of Dentistry, King Faisal University, Alahsa, Saudi Arabia; 5Radiology Department, King Saud Medical City, Riyadh, Saudi Arabia; 6Department of Applied Radiologic Technology, University of Jeddah, Jeddah, Saudi Arabia; 7Department of Radiology, Specialized Medical Complex, Jeddah, Saudi ArabiaCorrespondence: Haney Alsleem, Email hsleem@iau.edu.saBackground: Iterative reconstruction algorithm (IR) techniques were developed to maintain a lower radiation dose for patients as much as possible while achieving the required image quality and medical benefits. The main purpose of the current research was to assess the level and usage extent of IR techniques in computed tomographic (CT) scan exams. Also, the obligation of practitioners in several hospitals in Saudi Arabia to implement IR in CT exams was assessed.Material and Methodology: The recent research was based on two studies: data collection and a survey study. Data on the CT scan examinations were retrospectively collected from CT scanners. The survey was conducted using a questionnaire to evaluate radiographers’ and radiologists’ perceptions about IR and their practices with IR techniques. The statistical analysis results were performed to measure the usage strength level of IR methods.Results and Discussions: The IR strength level of 50% was selected for nearly 80% of different CT examinations and patients of different ages and weights. About 46% of the participants had not learned about IR methods during their college studies, and 54% had not received formal training in applying IR techniques. Only 32% of the participants had adequate experience with IR. Half of the participants were not involved in the updating process of the CT protocol.Conclusion: The results indicate that the majority of radiographer and radiologist at four different hospitals in Saudi Arabia have no explicit or understandable knowledge of selecting IR strength levels during the CT examination of patients. There is a need for more training in IR applications for both radiologists and radiographers. Training sessions were suggested to support radiographers and radiologists to efficiently utilize IR techniques to optimize image quality. Further studies are required to adjust CT exam protocols effectively to utilize the IR technique.Keywords: computed tomography, CT, filter back projection, FBP, iterative reconstruction algorithms, IR, as low as reasonably achievable, ALARA

Vancomycin is commonly used to treat methicillin-resistant staphylococcal infections in neonates. Consensus on its ideal dosing in neonates has not been achieved. Model-based dosing recently has evolved as an important tool to optimize vancomycin initial dosing. The aim of this is to evaluate a population pharmacokinetic model-based approach in achieving the vancomycin therapeutic target of an AUCAn Excel calculator was developed using a previously published population pharmacokinetic model in neonates. It was evaluated using retrospectively retrieved data. For each patient, the initial empiric dose was calculated using the proposed Excel model and the most widely used neonatal dosing references. The probability of achieving the target AUCThis analysis included 225 neonates. The probability of achieving the target AUCThese innovative personalized dosing calculators are promising to improve vancomycin initial dosing in neonates and are easily applicable in routine practices.

CDK1 (cyclin dependent kinase 1) is a key regulator of the cell cycle and is frequently dysregulated in cancer, making it a promising target for anticancer therapy. Securigera securidaca L. (S. securidaca) seeds, traditionally used in folk medicine for various ailments including cancer, were examined for their potential as CDK1/Cks2 inhibitors using in silico approaches. A total of 14 phytocompounds was identified in the GC/MS chromatogram, with gingerone being the most abundant at 25.67% and hippeastrine the least at 2%. Major constituents of the essential extract, including gingerol, eugenol, α-curcumene, and gingerol, showed high values and made up 52% of the total content of the volatile extract. Molecular docking and ADMET studies suggested that hippeastrine and naringenin are potential hit candidates against CDK1, exhibiting good drug-like properties and molecular interactions with desirable pharmacokinetic and toxicological characteristics close to dinaciclib. Furthermore, molecular dynamics (MD) simulations showed that both compounds exhibited stable conformations inside the binding site over the 100 ns MD simulation, suggesting they may stabilize the protein structure by reducing the flexibility of the CDK1 backbone. Additionally, MM-PBSA calculations further supported the stability of hippeastrine and naringenin in CDK1 complexes. Overall, these findings suggest that hippeastrine and naringenin are potential hit candidates for CDK1 inhibition, providing valuable insight into their binding and stability within the active site of CDK1. Further investigation of these compounds with in vitro and in vivo assays is warranted to assess their potential as CDK1 inhibitors for cancer therapy.

Background: Obstructive sleep apnea could affect the quality of life of patients with excessive daytime sleep and memory impairment and is linked with hypertension. It is diagnosed using specific criteria and treated mainly by maintaining continuous positive airway pressure (CPAP). This survey analysis aimed to evaluate the knowledge level of medical students at Qassim University about obstructive sleep apnea syndrome. Methodology: A cross-sectional study was conducted among medical students at Qassim University, Qassim, Saudi Arabia, during 2019-2020 academic year. Data was collected using a validated and pretested questionnaire. Results: A total of 438 students participated in this study. The average score of students was 5.54 ± 3.915 out of 15, which was considered unsatisfactory. The age group of 24 to 26 year-old had the highest average score of 7.38 ± 3.199 (p-value < 0.001). Also, female students had a significantly higher score of 6.55 ± 3.684 as compared to male students (p-value < 0.001). Furthermore, students who had previously heard about the disease had significantly higher scores (7.11 ± 3.173, p-value < 0.001). Students affected by obstructive sleep apnea also had significantly higher scores (7.69 ± 3.281) compared with those who did not have the disease (p-value = 0.025). Conclusion: The level of knowledge of medical students towards obstructive sleep apnea was unsatisfactory and requires improvement. Further studies are needed in other areas in Saudi Arabia.

Network function virtualization (NFV) and software-defined networking (SDN) are two technologies that have emerged to reduce capital and operational costs, and to simplify network management. In this paper, we propose an SDN-based system that provisions virtual network functions (VNFs) to minimize round trip time (RTT) delay and synchronization delay requirements. Our system uses graphic-theoretic approaches to place newly requested VNFs including four centrality functions - betweenness, degree, closeness, and Katz. The system performance is evaluated using two random graph topologies representing the physical and logical structures. The impact of increasing the number of deployed VNFs is considered. The results indicate that the degree and Katz selection methods mostly provide the minimum RTT for physical networks, whereas the betweenness selection provides minimum RTT values for logical networks. Moreover, the closeness selection method provides the best synchronization delay for both logical and physical networks.

A detailed heat transfer numerical study of a three-dimensional impinging jet on a roughened isothermal surface is presented and is investigated from flow physics vantage point under the influence of different parameters. The effects of the Reynolds number, roughness location, and roughness dimension on the flow physics and heat transfer parameters are studied. Additionally, the relations between average heat transfer coefficient (AHTC) and flow physics including pressure, wall shear and flow vortices with thermodynamic nonequilibrium are offered. This paper studies the effect of varying both location and dimension of the roughness element which took the shape of square cross-sectional continuous ribs to deliver a favorable trade-off between total pressure loss and heat transfer rate. The roughness element was tested for three different radial locations (R/D) = 1, 1.5, and 2 and at each location its height (i.e., width) (e) was changed from 0.25 to 1 mm in incremental steps of 0.25. The study used a jet angle (α) of 90 deg, jet-to-target distance (H/D = 6), and Re ranges from 10,000 to 50,000, where H is the vertical distance between the target plate and jet exit. The results show that the AHTC can be significantly affected by changing the geometry and dimensions of the roughness element. This variation can be either an augmentation of, or decrease in, the (HTC) when compared with the baseline case. An enhancement of 12.9% in the AHTC was achieved by using optimal location and dimensions of the roughness element at specific Reynolds number. However, a diminution between 10% and 30% in (AHTC) was attained by the use of rib height e = 1 mm at Re = 50k. The variation of both rib location and height showed better contribution in increasing heat transfer for low-range Reynolds numbers.

The results of an experimental study to evaluate the characteristics of R-407C thermofluid during condensation in a helically coiled copper tube heat exchanger are presented. The effects of saturation temperature (Tsat), and mass and heat fluxes of refrigerant R-407C on thermal performance and pressure drop were determined. The relationship between the refrigerant wall subcooling and heat transfer coefficients was also investigated. This paper reports the effect of the temperature of the water used as cooling medium on the heat transfer rate of condensing R-407C. The study was conducted with mass flux of R-407C in the range of 100&ndash, 450 kg/m2s, mass flux of the coolant water in the range of 500&ndash, 5000 kg/m2s and Tsat of 31 &deg, C, 35 &deg, C, and 39 &deg, C. Compared with a straight smooth tube, the use of the helical coiled (helicoidal) tube increased the condensation rate with a corresponding pressure drop that depended on the value of Tsat of the refrigerant and temperature of the coolant.

In this work, the performance of a two-shaft industrial gas turbine engine inspired by SGT-750, one of best technology at Siemens, is analyzed thermodynamically and economically. The modelling and analyzing process for the proposed system was executed through a software package called IPSEpro and validated with manufacturers’ published data. Exergy analysis, based thermodynamics laws with mass conservation, provides valuable information about locations, magnitudes and types of wastes energy in the thermal systems. Exergoeconomic analysis, the amalgamation of exergy with economics, is useful tool to appraise the gas turbine engine cost-effectiveness. The Specific Exergy Costing method is selected in exergoeconomic evaluation because it is the most widely used reported in the literature and provides reliable results. The performance of a gas turbine engine was investigated for different load variation and climatic conditions. The result shows that the main source of irreversibilities take place in the combustion chamber, compressor and high-pressure turbine, respectively, which constitute to about 96 % of total exergy destruction. The exergetic efficiency and exergy loss rate of the proposed system are about 38.4% and 11.8% respectively. The combustion chamber has the highest value of cost (1312.9 $/h) among other components and the source losses may attribute to the component performance. The production cost of the gas turbine engine based on exergoeconomic evaluation is 12.1 US$/GJ.

For economic benefits and efficient management of resources, organizations are increasingly moving towards the paradigm of “cloud computing” by which they are allowed on-demand delivery of hardware, software and data as services. However, there are many security challenges which are particularly exacerbated by the multitenancy and virtualization features of cloud computing that allow sharing of resources among potentially untrusted tenants in access controlled cloud datacenters. This can result in increased risk of data leakage. To address this risk vulnerability, we propose an efficient risk-aware virtual resource assignment mechanism for clouds multitenant environment. In particular, we introduce the notion of sensitivity in datacenters and the objective is to minimize the risk of data leakage. In addition, the risk should not exceed in high sensitivity datacenters in comparison to low sensitivity datacenters. We present three assignment heuristics and compare their relative performance.

To determine the optimal scanning protocols of dual energy computed tomography angiography (DECTA) in terms of radiation dose and image quality assessment at different keV levels, and compare it with conventional computed tomography angiography (CTA) in patients treated with peripheral arterial stents.Twenty-nine patients with previous stent placement in peripheral arteries were evaluated with DECTA. Images were reconstructed with virtual monochromatic spectral imaging (VMS) at 65, 68, 70 and 72 keV and adaptive statistical iterative reconstruction (ASIR) at 50% compared with CTA. Image quality comprising image noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were assessed, and radiation dose was compared. Effects of different type of peripheral arterial stents on image quality were also evaluated. Fifty-six uniquely identified stents that were located in common iliac arteries (CIA), external iliac arteries (EIA) and superficial femoral arteries (SFA) were evaluated.Within subjects, the results showed that DECTA images (VMS) had less noise than the CTA images for CIA, EIA and SFA stents, with the lowest noise at 72 keV. Also, the VMS images had greater SNR than the CTA images for the EIA stents (P0.05); and the VMS images had greater CNR than the CTA images for CIA, EIA, and SFA stents (P0.001). Also, on CT attenuation, VMS continued to outperform CTA, but to a lesser extent. Between subjects, average VMS noise varied significantly with the type of the stent used (P=0.025) for CIA stents. Radiation dose was highly significant between DECTA and conventional CTA scans (6.98We conclude that an optimal scanning protocol consisting of 72 keV and 50% ASIR leads to better image quality for DECTA in peripheral arterial stenting when compared to conventional CTA.

The emergence of cloud computing infrastructure and Semantic Web technologies has created unprecedented opportunities for composing large-scale business processes and workflow-based applications that span multiple organizational domains. A key challenge related to composition of such multi-organizational business processes and workflows is posed by the security and access control policies of the underlying organizational domains. In this paper, we propose a framework for verifying secure composability of distributed workflows in an autonomous multi-domain environment. The objective of workflow composability verification is to ensure that all the users or processes executing the designated workflow tasks conform to the time-dependent security policy specifications of all collaborating domains. A key aspect of such verification is to determine the time-dependent schedulability of distributed workflows, assumed to be invoked on a recurrent basis. We use a two-step approach for verifying secure workflow composability. In the first step, a distributed workflow is decomposed into domain-specific projected workflows and is verified for conformance with the respective domain's security and access control policy. In the second step, the cross-domain dependencies amongst the workflow tasks performed by different collaborating domains are verified.

Background: Saudi Center of Health care facilities accreditation launched the update stagnated of medication management and use for hospital pharmacy. The MOH pharmacy plan to accredit all hospital pharmacies and highly demand consultation visit. The clinical pharmacist required to visit hospitals to improve the services and get the accreditation. Objective: The goal of this study to explore the value of clinical pharmacist consultation visit with emphasis on medication safety (MS) and pharmacy research (PR) at Ministry of Health hospitals in Riyadh, Saudi Arabia. Methods: It is a twelve months cohort study of a regular visit to three major hospitals as public, pediatrics with maternity and emergency specialties at Riyadh region. The performance assessment used based on Saudi hospital pharmacy standards, MOH pharmacy strategic plan, and the 6-points Likert assessment scale system before the study and by the end of the study. Results: The total number of finished projects were twenty projects divided between ME (nine projects) and PR (eleven projects).The improvements range changes in ME from 16.7% to 100% with average positive improvement 37.04%. In the PR the improvements range changes were 33.3% to 100% with average positive changes was 39.4%.The highest score of the projects of ME was ISMPassessment medication safety for hospitals and ISMP-assessment anticoagulation medication safety for hospitals. The maximum score of the projects of PR was the patient satisfaction of ambulatory pharmacy services at three hospitals. Conclusion: The pharmacist showed the practical high impact on the medication safety and pharmacy research in Riyadh city, Saudi Arabia. The quality and quantity consultation visit with regular evaluation is required for continuous to keep pharmacy improvement at all hospital. Key words: Outcomes, Clinical Pharmacist, Hospital Pharmacy, Ministry of Health, Saudi Arabia.

This paper investigates the effects of the mist fractions on heat transfer characteristics applied on a rotating U-channel with inclined ribs at an angle of 45°. This study has been conducted on five different mist percentages from 1 to 5 with a 1% increment at each step, and all of the cases have been investigated for Reynolds number values of 5000, 10000, 25000 and 40000. The numerical results obtained from the application of RNG k-e turbulence model with enhanced-wall function were in good agreement with the experimental data of the smooth and ribbed channels both with and without mist addition. Results also demonstrated a 300% increase in the flow temperature difference and a noticeable increase in Nusselt number at each bend region and at the downstream of the leading edge around 25% and 110% respectively, at high mist fraction (5%); when compared with the case where only air was used. With %5 mist addition, the convective efficiency also reaches approximately 69%.

In this study, an investigation of a vortex chamber was carried out to gain a full understanding of the nature of the vortex flow and the cooling capability inside the chamber. The paper discusses the effects on flow and heat transfer rates when the inside surface of the vortex chamber was roughened by adding flow turbulators to its wall. The turbulators took the shape of a rib with a square cross-section, the dimension of which varied between 0.25 mm and 2.00 mm. The paper also presents the results of a comparative investigation of jet impingement and vortex cooling on a concave wall using different parameters, such as the total pressure loss coefficient, Nusselt number and thermal performance factor, to evaluate the cooling effectiveness and flow dynamics. Furthermore, the entropy generation in swirl flow with the roughened wall was assessed over a wide range of Reynolds numbers. In this study, an investigation of a vortex chamber was carried out to gain a full understanding of the nature of the vortex flow and the cooling capability inside the chamber. The paper discusses the effects on flow and heat transfer rates when the inside surface of the vortex chamber was roughened by adding flow turbulators to its wall. The turbulators took the shape of a rib with a square cross-section, the dimension of which varied between 0.25 mm and 2.00 mm. The paper also presents the results of a comparative investigation of jet impingement and vortex cooling on a concave wall using different parameters, such as the total pressure loss coefficient, Nusselt number and thermal performance factor, to evaluate the cooling effectiveness and flow dynamics. Furthermore, the entropy generation in swirl flow with the roughened wall was assessed over a wide range of Reynolds numbers. The results show that surface roughness considerably influences the velocity distribution, heat transfer patterns and pressure drop in the vortex chamber. The highest thermal performance factor takes place at rib heights of 0.25 mm and 0.50 mm with a low Re number. Further increase in rib height has an adverse impact on thermal performance. At a Reynolds number lower than 50,000, it is highly recommended to use roughened vortex cooling to obtain the best thermal performance.

This review is aiming to discuss the Risk factor for hyponatremia. The present review was conducted by searching in Medline, Embase, Web of Science, Science Direct, BMJ journal and Google Scholar for, researches, review articles and reports, published over the past years. Books published on Risk factor for hyponatremia. If several studies had similar findings, we randomly selected one or two to avoid repetitive results. On the basis of findings and results this review found Diabetes mellitus was identified as an independent risk factor for hyponatremia and hypomagnesemia, whereas hypertension was associated with hypokalemia. Diuretics were independently associated with several electrolyte disorders: thiazide diuretics (hyponatremia). The frequency of hyponatremia (Na+ ≪134 mEq/L) was 29.9% among OXC-treated patients and 13.5% among CBZ-treated patients (p < 0.0001). Hyponatremia (Na+ ≪128 mEq/L) was severe: 12.4% of OXC-treated patients and 2.8% of CBZ-treated patients (p < 0.001). Advanced age was a risk factor for hyponatremia. Keywords: Risk factor, hyponatremia.

Background: DKA is the leading cause of mortality among pediatric age and young adults with T1D, responsible for almost 50% of all fatalities in diabetic patients younger than 24 years of age. Goals of DKA management include optimization of volume status, hyperglycemia and ketoacidosis, electrolyte abnormalities, and potential precipitating factors. Methodology: we conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 1987, through February 2017. The following search terms were used: ketoacidosis, management of diabetic ketoacidosis, type I diabetic patients’ emergency complication, fluid replacement in DKA, insulin therapy approach. Aim: in this review, we aim at evaluating the various ways of approaching patients who suffer from type-one diabetes during ketoacidosis and keto-acidotic coma. We will try to understand the triggers and pathophysiology behind this condition, and explore ways to prevent them. Conclusion: prompt diagnoses, aggressive treatment, and education of patient and their care providers about prevention strategies must be implemented. Also, more studies are required in the area of preventing health complications due to these types of diseases to effectively manage DKA in the future.

This paper presents the numerical investigations of the injection of mist into an unconfined cooling steam jet to analyze the effects on the corresponding heat transfer characteristics. The infusion of mist into an confined cooling steam jet demonstrates a remarkable improvement in the heat transfer specifications as described in numerous previous studies. Therefore, the current research contributes to the knowledge by focusing on the uniformity configurations of the injected second phase to the unconfined regions and the influence of the surrounding environment on the mist injected. Several variables govern the physical model of the mist concentration and jet to plate distance, which is included in three-dimensional incompressible Navier-Stokes flow with the discrete phase model for the multiphase flow regime. The simulation was conducted over a range of common working Reynolds numbers. The results show that controlling the uniformity of the injected mist will redefine the cooling characteristics. The accumulated mist near the edge leads to the heat transfer enhancement at H/D = 2, 4, and 6. The surrounding environment had a significant influence on the droplet behavior at H/D = 8, thus causing a heat transfer reduction of 8%. The droplet Stock number can determine the droplet performance on the target wall and introducing mist generates a third heat transfer peak that results in an average increase of 38% for 1% mist.

A comprehensive model of cogeneration plant for electrical power and water desalination has been developed based on energetic and exergetic analyses using real operational data. The power side is a combined cycle power plant (CCPP), while the desalination side is a multi-effect thermal vapour compression plant coupled with a conventional multi-effect plant (ME-TVC-MED). IPSEpro software was utilized to model the process, which shows good agreement with the manufacturer's data and published research. The thermodynamic properties of saline water were obtained from the latest published data in the literature. The performance of the cogeneration plant was examined for different ambient temperatures, pressure ratios, loads, feed water temperatures, number of effects and entrainment ratios. The results show that gas turbine engines produce the highest level of useful work in the system at around 34% of the total fuel input. At the same time, they constitute a major source of irreversibility, which accounts for 84% of the total exergy destruction in the plant, while the lowest source of irreversibility is in the steam turbine of 3.3% due to the type of working fluid and reheating system. In the ME-TVC-MED desalination unit, the highest source of irreversibilities occurs in the effects and in the thermo-compressor. The first two effects in the ME-TVC parallel section were responsible for about 40.6% of the total effect exergy destruction, which constitutes the highest value among all the effects. Operating the system at full load while reducing ambient temperature, and increasing pressure ratio and feed water temperature, were strongly recommended in order to improve the plant's performance; while increasing the number of effects is always preferable with low entrainment ratio for high cogeneration plant performance and capacity.

Energetic and exergetic analyses are conducted using operating data for Sabiya, a combined cycle power plant (CCPP) with an advanced triple pressure reheat heat recovery steam generator (HRSG). Furthermore, a sensitivity analysis is carried out on the HRSG using a recent approach to differentiate between the sources of irreversibility. The proposed system was modelled using the IPSEpro software and further validated by the manufacturer’s data. The performance of the Sabiya CCPP was examined for different climatic conditions, pressure ratios, pinch point temperatures, high-pressure steam, and condenser pressure values. The results confirmed that 60.9% of the total exergy destruction occurs in the combustion chamber, which constitutes the main source of irreversibilities within a system. The exergy destruction was significantly affected by both the pressure ratio and the high-pressure steam, where the relation between them was seen to be inversely proportional. The high-pressure stage contributes about 50% of the exergy destruction within the HRSG compared to other stages and the reheat system, due to the high temperature difference between the streams and the large number of components, which leads to high energy loss to the surroundings. Numerous possibilities for improving the CCPP’s performance are introduced, based on the obtained results.