BackgroundThe students’ perception of the learning environment is an important aspect for evaluation and improvement of the educational program. The College of Medicine at King Saud University (KSU) reformed its curriculum in 2009 from a traditional to a system-oriented hybrid curriculum.ObjectiveThe objective of the present study was to determine the perception of the second batch (reformed curriculum) of medical graduates about the educational environment at the College of Medicine, KSU, using the Dundee Ready Education Environment Measure (DREEM) scale.MethodsThe fifth year medical students were asked to evaluate the educational program after graduation in May 2014. The questionnaire was distributed to the graduate students electronically. The DREEM questionnaire consisted of 50 items based on Likert’s scale; and five domains, namely, students’ perceptions of learning, perceptions of teachers, academic self-perceptions, perceptions of atmosphere, and social self-perceptions. Data were analyzed using SPSS.ResultsA total of 62 students participated in the study. The score for students’ perception of learning among medical students ranged from 2.93 to 3.64 (overall mean score: 40.17). The score for students’ perception of teachers ranged from 2.85 to 4.01 (overall mean score: 33.35). The score for students’ academic self-perceptions ranged from 3.15 to 4.06 (overall mean score: 28.4). The score for students’ perception of atmosphere ranged from 2.27 to 3.91 (overall mean score: 41.32). The score for students’ social self-perceptions ranged from 2.85 to 4.33 (overall mean score: 24.33). The general perceptions of the students in all five sub-scales were positive.ConclusionThe overall student’s perception about the educational environment was satisfactory. This study was important to evaluate the students’ perception of the learning environment among medical graduates of the reformed curriculum and provided guidance on areas of improvement in the curriculum.

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Patient: Male, 16-year-old Final Diagnosis: Splenic epidermoid cyst Symptoms: Abdominal asymmetry • abdominal distention • decreased oral intake Medication: — Clinical Procedure: Open splenectomy Specialty: Surgery Objective: Rare coexistence of disease or pathology Background: Splenic epidermoid cysts rarely occur and the majority of cases are discovered incidentally. However, large cysts can present with symptoms due to mass effect. Splenectomy is the treatment indicated for most splenic cysts and definitive diagnosis can only be made after histopathological examination. Case Report: A 16-year-old boy was referred to the general surgery clinic from a local hospital with a history of abdominal asymmetry, distention, decreased oral intake, and early satiety. Abdominal computed tomography (CT) was performed and revealed a large splenic mass measuring 18.4×14×17.4 cm with multiple mural calcifications at the rim. The mass was displacing the stomach, jejunal loops, pancreas, left kidney, and transverse colon. Preoperative biopsy was not possible because a parasitic cyst was suspected; therefore, splenectomy was performed through midline laparotomy. The patient recovered well, with no complications except for transient reactive thrombocytosis. Histopathology was reported as benign epithelial cysts, with the most likely diagnosis being a splenic epidermoid cyst. Subsequently, the patient was followed up at the surgery clinic. During the last outpatient visit, the patient exhibited good recovery with no problems. Conclusions: Large splenic epidermoid cysts are rare, particularly in the pediatric population. Nonspecific clinical and radiological findings are hurdles to an accurate diagnosis. Preoperative diagnosis is crucial to determine the type of intervention. However, a final diagnosis can only be made after histopathological examination.

This paper presents an energy management peer-to-peer (P2P) and peer-to-grid (P2G) trading strategy for power sharing between prosumers with grid-connected photovoltaic/wind turbine/battery storage systems. The optimal results are obtained using the “Fmincon” solver due to its ability to solve large-scale optimization problems. Two prosumers sectors are considered in this study that is the residential and commercial. The results show that for the residential consumer side, the load is satisfied by the energy from the grid, its own renewable energy system (RES), and the energy from the commercial consumer side RES during the first off-peak period (00:00 AM to 05:00 AM). During the peak pricing period (17:00 PM to 22:00 PM), the load is satisfied by the residential consumer’s battery and the commercial consumer’s battery, and no energy is bought from the grid due to the high price. Furthermore, 37.69% and 39.40% cost savings for residential and commercial, respectively, and a reduction of the bill by $42.26/day and $42.97154/day, respectively, are recorded. Significant grid energy savings for the developed P2P/P2G trading for prosumers and maximum daily cost savings are achieved compared to existing cases such as P2G only and P2P only. Finally, the residential consumer can achieve a greenhouse gases (GHG) emissions reduction of 141.88 kgCO2-eq and 176.99 kgCO2-eq net savings, while the commercial consumer can achieve 122.34 kgCO2-eq GHG emissions mitigation and 196.53 kgCO2-eq net savings.

the same long-term results. The surgical approach is chosen by patient characteristics and lesion localization. Central tumors with vascular involvement or biliary structures will be favored by enucleation.