Search results for: Adwan Alanazi

Authors: Sultan Alanazi, Adwan Alanazi

Abstract:

Social applications consist of powerful tools that allow people to connect and interact with each other. However, its negative use cannot be ignored. Cyberbullying is a new and serious Internet problem. Cyberbullying is one of the most common risks for teenagers to go online. More than half of young people report that they do not tell their parents when this will occur, which can have significant physiological consequences. Cyberbullying involves the deliberate use of digital media on the Internet to convey false or embarrassing information about others. Therefore, this article provides a way to detect cyber-bullying in social media applications for parents. The purpose of our work is to develop an architectural model for identifying and measuring the state of Cyberbullying faced by children on social media applications. For parents, this will be a good tool for monitoring their children without invading their privacy. Finally, some interesting open-ended questions were raised, suggesting promising ideas for starting new research in this new field.

Keywords: cyberbullying, cyber bullying, internet crimes, social media security, E-crimes

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Authors: Adel S. El-Azab, Alaa A. M. Abdel-Aziz, Ibrahim A. Al-Suwaidan, Amer M. Alanazi

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A novel series of 2,3,6-trisubstitute quinazolinone were designed, synthesized, and evaluated for their in-vitro antitumor activity. 3 (Benzylideneamino)-6-chloro-2-p-tolylquinazolin-4(3H)-One, 2-[(4-oxo-3-phenethyl-3,4-dihydroquinazolin-2-yl)thio]-N-(3,4;5-trimethoxyphenyl) acetamide and 3-(3-benzyl-6-methyl-4-oxo-3, 4-dihydroquinazolin-2-ylthio)-N-(3,4,5-trimethoxyphenyl) propanamide have shown amazing broad spectrum antitumor activity with mean GI50; 15.8, 3.16, and 7.4 μM respectively compared to known Quinazoline Derivatives antitumor drug 5-FU mean GI50=22.6 μM.

Keywords: quinazoline derivatives, in vitro antitumor, synthesis, 5-FU, NCI

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Authors: Elsayed A. M. Shokr, A. Alhazemi, T. Naser, Talal A. Zuhair, Adel A. Zuhair, Ahmed N. Alshamary, Thamer A. Alanazi, Hosam A. Alanazi

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The main threats to human health from heavy metals are associated with exposure to Pb, Cd, Cu, Mo, Zn, Ni, Mn Co and Cr. is mainly via intake of drinking water being the most important source in most populations. These metals have been extensively studied and their effects on human health regularly reviewed by international bodies such as the WHO. Heavy metals have been used by humans for thousands of years. Although several adverse health effects of heavy metals have been known for a long time, exposure to heavy metals continues, and is even increasing in some parts of the world, in particular in less developed countries, though emissions have declined in most developed countries over the last 100 years. A strong relationship between contaminated drinking water with heavy metals from some of the stations of water shopping in Hail, KSA and chronic diseases such as renal failure, liver cirrhosis, and chronic anemia has been identified in this study. These diseases are apparently related to contaminant drinking water with heavy metals such as Pb, Cd, Cu, Mo, Zn, Ni, Mn Co and Cr. Renal failure is related to contaminate drinking water with lead and cadmium, liver cirrhosis to copper and molybdenum, and chronic anemia to copper and cadmium. Recent data indicate that adverse health effects of cadmium exposure may occur at lower exposure levels than previously anticipated, primarily in the form of kidney damage but possibly also bone effects and fractures. The general population is primarily exposed to mercury via drinking water being a major source of methyl mercury exposure, and dental amalgam. During the last century lead, cadmium, zinc, iron and arsenic is mainly via intake of drinking water being the most important source in most populations. Long-term exposure to lead, cadmium, zinc, iron and arsenic in drinking-water is mainly related to primarily in the form of kidney damage. Studies of these diseases suggest that abnormal incidence in specific areas is related to toxic materials in the groundwater and thereby led to the contamination of drinking water in these areas.

Keywords: heavy metals, liver functions, kidney functions and chronic renal failure, hail, renal, water

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Authors: Somaya Adwan, Rasha Majed, Lamya'a Majed, Hamzah Arof

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In order to produce images with whole body parts, X-ray of different portions of the body parts is assembled using image stitching methods. A new method for image stitching that exploits mutually feature based method and direct based method to identify and merge pairs of X-ray medical images is presented in this paper. The performance of the proposed method based on this hybrid approach is investigated in this paper. The ability of the proposed method to stitch and merge the overlapping pairs of images is demonstrated. Our proposed method display comparable if not superior performance to other feature based methods that are mentioned in the literature on the standard databases. These results are promising and demonstrate the potential of the proposed method for further development to tackle more advanced stitching problems.

Keywords: image stitching, direct based method, panoramic image, X-ray

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Authors: Ali Khwaldeh, Nimer Adwan

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In this paper, a method for constructing a controlled balanced Boolean function satisfying the criterion of a Strictly Avalanche Criteria (SAC) effect is proposed. The proposed method is based on the use of three orthogonal nonlinear components which is unlike the high-order SAC functions. So, the generator synthesized by the proposed method has separate sets of control and information inputs. The proposed method proves its simplicity and the implementation ability. The proposed method allows synthesizing a SAC function generator with fixed control and information inputs. This ensures greater efficiency of the built-in oscillator compared to high-order SAC functions that can be used as a generator. Accordingly, the method is completely formalized and implemented as a software product.

Keywords: boolean function, controlled balanced boolean function, strictly avalanche criteria, orthogonal nonlinear

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Authors: Sami Adwan, Alaa Alhaj Ismail, Claudia Girardone

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This paper examines the changes in the value relevance of book value of equity and net income of financial firms over the crisis period. It also examines how these changes vary with three variables, namely, fair value exposure, ownership concentration, and regulatory capital ratios. Using a sample of financial firms operating in the European Economic Area over 2005-2011, our findings suggest that the value relevance of book value of equity increases while that of net income decreases during the financial crisis. We find that more exposure to fair value accounting mitigates the impact of the crisis on the value relevance of book value of equity and net income. We also find that more concentrated ownership appears to have a mitigating impact on the changes in the value relevance of both book value of equity and net income in times of financial crisis. Finally, we find evidence that the level of regulatory capital ratios tends to have an attenuating effect on the changes in the value relevance of net income (but not book value of equity) in times of financial crisis.

Keywords: value relevance, financial crisis, financial firms, fair value, ownership concentration, regulatory capital

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Authors: Fahad Alanazi, Andrew Jones

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Digital forensics seeks to achieve the successful investigation of digital crimes through obtaining acceptable evidence from digital devices that can be presented in a court of law. Thus, the digital forensics investigation is normally performed through a number of phases in order to achieve the required level of accuracy in the investigation processes. Since 1984 there have been a number of models and frameworks developed to support the digital investigation processes. In this paper, we review a number of the investigation processes that have been produced throughout the years and introduce a proposed digital forensic model which is based on the scope of the Saudi Arabia investigation process. The proposed model has been integrated with existing models for the investigation processes and produced a new phase to deal with a situation where there is initially insufficient evidence.

Keywords: digital forensics, process, metadata, Traceback, Sauid Arabia

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Authors: Mohammed Saad Alanazi

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Satisfaction of travelers with services provided in the airports is a sign of competitiveness and the corporate image of the airport. This study conducted a systematic literature review of recent studies published after 2017 regarding the factors that positively influence travelers’ satisfaction and encourage them to report positive reviews online. This study found variations among the studies found. They used several research methodologies, and datasets and focused on different airports, yet, they commonly categorized airport services into seven categories that should receive high intention because their qualities were found increasing review rate and positivity. It was found that studies targeting travelers’ satisfaction and intention of revisiting tended to use primary sources of data (survey); meanwhile, studies concerned positivity and negativity of comments towards airport services often used online reviews provided by travelers.

Keywords: business Intelligence, airport service quality, passenger satisfaction, thorough analysis

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Authors: Saud Eid Alanazi

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The study aimed at recognizing the obstacles of applying of Electronic Administration (e-administration), which refers to any of a number of mechanisms which convert what in a traditional office are paper processes into electronic processes, with the goal being to create a paperless office and improve productivity and performance at the University of Tabuk from its Academic Leaders' Perspectives. The sample of the study consisted of (98) members from deans, vice deans and head of departments from different specialization, gender and position. For achieving the aim of the study, a questionnaire was developed including (45) items distributed into three domains (administrative, human and technical obstacles) . By using appropriate statistical methods to analyze the information, the results indicated that the administrative obstacles domain came in the first rank with a high degree, and the human and technical obstacles came at the second rank with a moderate degree. The study also showed that there were no statistically significant differences attributed to the variables of the members (specialization, gender and position).

Keywords: administration, electronic administration, obstacles, technology, universities

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Authors: Mohammaad Afzal Khan, Ghazi Abdulmalik Ashoor , Fatimah Alanazi, Talal Shamma, Abdullah Altuhami, Hala Abdalrahman Ahmed, Abdullah Mohammed Assiri, Dieter Clemens Broering

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Microvascular injuries during inflammation are key causes of transplant malfunctioning and permanent failure, which play a major role in the development of chronic rejection of the transplanted organ. Inflammation-induced microvascular loss is a promising area to investigate the decisive roles of regulatory and effector responses. The present study was designed to investigate the impact of IL-10 on immunotolerance, in particular, the microenvironment of the allograft during rejection. Here, we investigated the effects of IL-10 blockade/ reconstitution and serially monitored regulatory T cells (Tregs), graft microvasculature, and airway epithelium in rejecting airway transplants. We demonstrated that the blocking/reconstitution of IL-10 significantly modulates CD4+FOXP3+ Tregs, microvasculature, and airway epithelium during rejection. Our findings further highlighted that blockade of IL-10 upregulated proinflammatory cytokines, IL-2, IL-1β, IFN-γ, IL-15, and IL-23, but suppressed IL-5 secretion during rejection; however, reconstitution of IL-10 significantly upregulated CD4+FOXP3+ Tregs, tissue oxygenation/blood flow and airway repair. Collectively, these findings demonstrate a potential reparative modulation of IL-10 during microvascular and epithelial repair, which could provide a vital therapeutic window to rejecting transplants in clinical practice.

Keywords: interleukin -10, regulatory T cells, allograft rejection, immunotolerance

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Authors: Almutasim Billa A. Alanazi, Hal S. Tharp

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Safe performance and efficient energy consumption are essential factors for designing a control system. This paper presents a reinforcement learning (RL) model that can be applied to control applications to improve safety and reduce energy consumption. As hardware constraints and environmental disturbances are imprecise and unpredictable, conventional control methods may not always be effective in optimizing control designs. However, RL has demonstrated its value in several artificial intelligence (AI) applications, especially in the field of control systems. The proposed model intelligently monitors a system's success by observing the rewards from the environment, with positive rewards counting as a success when the controlled reference is within the desired operating zone. Thus, the model can determine whether the system is safe to continue operating based on the designer/user specifications, which can be adjusted as needed. Additionally, the controller keeps track of energy consumption to improve energy efficiency by enabling the idle mode when the controlled reference is within the desired operating zone, thus reducing the system energy consumption during the controlling operation. Water temperature control for a hydroponic system is taken as a case study for the RL model, adjusting the variance of disturbances to show the model’s robustness and efficiency. On average, the model showed safety improvement by up to 15% and energy efficiency improvements by 35%- 40% compared to a traditional RL model.

Keywords: control system, hydroponics, machine learning, reinforcement learning

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Authors: Mohammed Alanazi, Dimitrios Tsagdis

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Established Business Excellence Models (BEMs), like the Malcolm Baldrige National Quality Award (MBNQA) model and the European Foundation for Quality Management (EFQM) model, have been adopted by firms all over the world. They exist alongside more recent country-specific BEMs; e.g. the Australian, Canadian, China, New Zealand, Singapore, and Taiwan quality awards that although not as widespread as MBNQA and EFQM have nonetheless strong national followings. Regardless of any differences in their following or prestige, the emergence and development of all BEMs have been shaped both by their local context (e.g. underlying socio-economic dynamics) as well as by global best practices. Besides such similarities, that render them into objects (i.e. models) of the same class (i.e. BEMs), BEMs exhibit non-trivial differences in their criteria, relations, and emphasis. Given the evolution of BEMs (e.g. the MBNQA underwent seven evolutions since its inception in 1987 while the EFQM five since 1993), it is unsurprising that comparative studies of their validity are few and far in between. This poses challenges for practitioners and policy makers alike; as it is not always clear which BEM is to be preferred or better fitting to a particular context. Especially, in contexts that differ substantially from the original context of BEM development. This paper aims to fill this gap by presenting a research design and measurement model for comparing BEMs using quantitative methods (e.g. structural equations). Three BEMs will be focused upon in particular for illustration purposes; the MBNQA, the EFQM, and the King Abdul Aziz Quality Award (KAQA) model. They have been selected so to reflect the two established and widely spread traditions as well as a more recent context-specific arrival promising a better fit.

Keywords: Baldrige, business excellence, European Foundation for Quality Management, Structural Equation Model, total quality management

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Authors: Osamah S. Alanazi, Mohammad G. Kotbi, Mohammed O. AlFadil

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While renewable energy technology is developing in Saudi Arabia, and the ambitious 2030 vision encourages the shift towards more efficient and clean energy usage. The research on the application of geothermal resources in residential use for the Saudi Arabian context will contribute towards a more sustainable environment. This paper is a part of an ongoing master's thesis, which its main goal is to investigate the possibility of achieving a zero-carbon house in Riyadh by applying a ground-coupled system into a current sustainable house that uses a grid-tied solar system. The current house was built and designed by King Saud University for the 2018 middle east solar decathlon competition. However, it failed to reach zero-carbon operation due to the high cooling demand. This study will redesign and validate the house using Revit and Carriers Hourly Analysis 'HAP' software with the use of ordinary least square 'OLS' regression. After that, a ground source ventilation system will be designed using the 'GCV Tool' to reduce cooling loads. After the application of the ground source system, the new electrical loads will be compared with the current house. Finally, a simple economic analysis that includes the cost of applying a ground source system will be reported. The findings of this study will indicate the possibility and feasibility of reaching a zero-carbon house in Riyadh, Saudi Arabia, using a ground-coupled ventilation system. While cooling in the residential sector is the dominant energy consumer in the Gulf region, this work will certainly help in moving towards using renewable sources to meet those demands. This paper will be limited to highlight the literature review, the methodology of the research, and the expected outcome.

Keywords: renewable energy, zero-carbon houses, sustainable buildings, geothermal energy, solar PV, GCV Tool

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Authors: Raeed Alanazi

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Introduction: Nursing students have a crucial role to play in the inhibition of infectious diseases and, therefore, must be trained in infection control and prevention modules prior to entering clinical settings. Simulations have been found to have a positive impact on infection control skills and the use of standard precautions. Aim: The purpose of this study was to use the four sources of self-efficacy in explaining the level of clinical self-efficacy and adherence to infection control practices in Saudi nursing students during simulation practice. Method: A cross-sectional design with convenience sampling was used. This study was conducted in all Saudi nursing schools, with a total number of 197 students participated in this study. Three scales were used simulation self- efficacy Scale (SSES), the four sources of self-efficacy scale (SSES), and Compliance with Standard Precautions Scale (CSPS). Multiple linear regression was used to test the use of the four sources of self-efficacy (SSES) in explaining level of clinical self-efficacy and adherence to infection control in nursing students. Results: The vicarious experience subscale (p =.044) was statistically significant. The regression model indicated that for every one unit increase in vicarious experience (observation and reflection in simulation), the participants’ adherence to infection control increased by .13 units (β =.22, t = 2.03, p =.044). In addition, the regression model indicated that for every one unit increase in education level, the participants’ adherence to infection control increased by 1.82 units (beta=.34= 3.64, p <.001). Also, the mastery experience subscale (p <.001) and vicarious experience subscale (p = .020) were shared significant associations with clinical self-efficacy. Conclusion: The findings of this research support the idea that simulation-based learning can be a valuable teaching-learning method to help nursing students develop clinical competence, which is essential in providing quality and safe nursing care.

Keywords: simulation-based learning, clinical self-efficacy, infection control, nursing students

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Authors: Sarah Saad Alamer, Shujon Mohammed Alazzam, Amjad Khater Alanazi, Mohamed Ahmed Sankari, Jana Sameer Sendy, Saleh Al-Khaldi, Khaled Allam, Amani Badawi

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Background: Self-medication is defined as the selection of medicines by individuals to treat self-diagnosed. There are a lot of concerns about the safety of long-term use of nonprescription ophthalmic drugs, which may lead to a variety of serious ocular complications. Topical steroids can produce severe eye-threatening complications, including the elevation of intraocular pressure (IOP) with possible development of glaucoma and infrequent optic nerve damage. In recent times, many OTC ophthalmic preparations have been possible without a prescription. Objective: In our study, we aimed to determine the prevalence of self-medication ocular topical steroid practice and associated factors among adult ophthalmic patients attending King Saud medical city. Methods: This study was conducted as a cross-sectional study, targeting participants aged 18 years old or above who had used topical steroids eye drops to determine the prevalence of self-medication ocular topical steroid practice and associated factors among adult patients attending ophthalmology clinic in King Saud Medical City (KSMC) in the central region. Results: A total of 308 responses, 92(29.8%) were using ocular topical, 58(18.8%) with prescription, 5(1.6%) without prescription, 29(9.4%) with and without prescription while 216(70.1%) did not use it. The frequency of using ocular topical steroids without a prescription among participants was 11(12%) once and 33 (35%) many times. 26(28.3%) were having complication, mostly 11(12.4%) eye infection, 8(9%) Glaucoma, 6 (6.7%) Cataracts. Reasons for self-medication ocular topical steroid practice among participants were 14 (15.2%) repeated symptoms, 11(15.2%) had heard an advice from a friend, 11 (15.2%) thought they had enough knowledge. Conclusion: Our study reveals that, even though detecting a high level of knowledge and acceptable practices and attitudes among participants, the incidence of self-medication with steroid eye drops was observed. This practice is mainly due to participants having repeated symptoms and thinking they have enough knowledge. Increasing the education level of patients on self-medication steroid eye drops practice and it is associated complications would help reduce the incidence of self-medication steroid eye drops practice.

Keywords: self-medication, ophthalmic medicine, steroid eye drop, over the counter

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Authors: Adel S. Alanazi

Abstract:

The transition of a student with a disability from school to work is the most crucial phase while moving from the stage of adolescence into early adulthood. In this process, young individuals face various difficulties and challenges in order to accomplish the next venture of life successfully. In this respect, this paper aims to examine the challenges encountered by the individuals with intellectual disabilities in transition to work in Saudi Arabia. For this purpose, this study has undertaken a qualitative research-based methodology; wherein interpretivist philosophy has been followed along with inductive approach and exploratory research design. The data for the research has been gathered with the help of semi-structured interviews, whose findings are analysed with the help of thematic analysis. Semi-structured interviews were conducted with parents of persons with intellectual disabilities, officials, supervisors and specialists of two vocational rehabilitation centres providing training to intellectually disabled students, in addition to that, directors of companies and websites in hiring those individuals. The total number of respondents for the interview was 15. The purposive sampling method was used to select the respondents for the interview. This sampling method is a non-probability sampling method which draws respondents from a known population and allows flexibility and suitability in selecting the participants for the study. The findings gathered from the interview revealed that the lack of awareness among their parents regarding the rights of their children who are intellectually disabled; the lack of adequate communication and coordination between various entities; concerns regarding their training and subsequent employment are the key difficulties experienced by the individuals with intellectual disabilities. Training in programmes such as bookbinding, carpentry, computing, agriculture, electricity and telephone exchange operations were involved as key training programmes. The findings of this study also revealed that information technology and media were playing a significant role in smoothing the transition to employment of individuals with intellectual disabilities. Furthermore, religious and cultural attitudes have been identified to be restricted for people with such disabilities in seeking advantages from job opportunities. On the basis of these findings, it can be implied that the information gathered through this study will serve to be highly beneficial for Saudi Arabian schools/ rehabilitation centres for individuals with intellectual disability to facilitate them in overcoming the problems they encounter during the transition to work.

Keywords: intellectual disability, transition services, rehabilitation centre, employment

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Authors: Shujon Mohammed Alazzam, Sarah Saad Alamer, Omar Hassan Kasule, Lama Suliman Aleid, Mohammad Abdulaziz Alakeel, Boshra Mosleh Alanazi, Abdullah Abdulelah Altowairqi, Yahya Ali Al-Asiri

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Background: Interventional radiology (IR) is a specialized field within radiology that diagnose and treat several conditions through a minimally invasive surgical procedure that involves the use of various radiological techniques. In the last few years, the role of IR has expanded to include a variety of organ systems which have been led to an increase in demand for these Specialties. The level of knowledge regarding IR is relatively low in general. In this study, we aimed to investigate the perceptions of interventional radiology (IR) as a specialty among medical students and medical interns in Riyadh, Saudi Arabia. Methodology: This study was a cross section. The target population is medical students in January 2023 in Riyadh city, KSA. We used the questionnaire for face-to-face interviews with voluntary participants to assess their knowledge of Interventional radiology. Permission was taken from participants to use their information. Assuring them that the data in this study was used only for scientific purposes. Results: According to the inclusion criteria, a total of 314 students participated in the study. (49%) of the participants were in the preclinical years, and (51%) were in the clinical years. The findings indicate more than half of the students think that they had good information about IR (58%), while (42%) reported that they had poor information and knowledge about IR. Only (28%) of students were planning to take an elective and radiology rotation, (and 27%) said they would consider a career in IR. (73%) of the participants who would not consider a career in IR, the highest reasons in order were due to "I do not find it interesting" (45%), then "Radiation exposure" (14%). Around half (48%) thought that an IRs must complete a residency training program in both radiology and surgery, and just (36%) of the students believe that an IRs must finish training in radiology. Our data show the procedures performed by IRs that (66%) lower limb angioplasty and stenting (58%) Cardiac angioplasty or stenting. (68%) of the students were familiar with angioplasty. When asked about the source of exposure to angioplasty, the majority (46%) were from a cardiologist, (and 16%) were from the interventional radiologist. Regarding IR career prospects, (78%) of the students believe that IRs have good career prospects. In conclusion, our findings reveal that the perception and exposure to IR among medical students and interns are generally poor. This has a direct influence on the student's decision regarding IR as a career path. Recommendations to attract medical students and promote IR as a career should be increased knowledge among medical students and future physicians through early exposure to IR, and this will promote the specialty's growth; also, involvement of the Saudi Interventional Radiology Society and Radiological Society of Saudi Arabia is essential.

Keywords: knowledge, medical students, perceptions, radiology, interventional radiology, Saudi Arabia

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Authors: Mohammad Afzal Khan, Fatimah Alanazi, Hala Abdalrahman Ahmed, Talal Shamma, Kilian Kelly, Mohammed A. Hammad, Abdullah O. Alawad, Abdullah Mohammed Assiri, Dieter Clemens Broering

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Lung transplantation is a life-saving surgical replacement of diseased lungs in patients with end-stage respiratory malfunctions. Despite the remarkable short-term recovery, long-term lung survival continues to face several significant challenges, including chronic rejection and severe toxic side-effects due to global immunosuppression. Stem cell-based immunotherapy has been recognized as a crucial immunoregulatory regimen in various preclinical and clinical studies. Despite initial therapeutic outcomes, conventional stem cells face key limitations. The Cymerus™ manufacturing facilitates the production of a virtually limitless supply of consistent human induced pluripotent stem cell (iPSC)-derived mesenchymal stem cells, which could play a key role in selective immunosuppression and graft repair during rejection. Here, we demonstrated the impact of iPSC-derived human MSCs on the development of immune-tolerance and long-term graft survival in mouse orthotopic airway allografts. BALB/c→C57BL/6 allografts were reconstituted with iPSC-derived MSCs (2 million/transplant/ at d0), and allografts were examined for regulatory T cells (Tregs), oxygenation, microvascular blood flow, airway epithelium and collagen deposition during rejection. We demonstrated that iPSC-derived MSC treatment leads to significant increase in tissue expression of hTSG-6 protein, followed by an upregulation of mouse Tregs and IL-5, IL-10, IL-15 cytokines, which augments graft microvascular blood flow and oxygenation, and thereby maintained a healthy airway epithelium and prevented the subepithelial deposition of collagen at d90 post-transplantation. Collectively, these data confirmed that iPSC-derived MSC-mediated immunosuppression has potential to establish immune-tolerance and rescue allograft from sustained hypoxic/ischemic phase and subsequently limits long-term airway epithelial injury and collagen progression, which therapeutically warrant a study of Cymerus iPSC-derived MSCs as a potential management option for immunosuppression in transplant recipients.

Keywords: stem cell therapy, immunotolerance, regulatory T cells, hypoxia and ischemia, microvasculature

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Authors: Sami Alanazi

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Teamwork practices have been recognized as a significant strategy to improve patient safety, quality of care, and staff and patient satisfaction in healthcare settings, particularly within the emergency department (ED). The EDs depend heavily on teams of interdisciplinary healthcare staff to carry out their operational goals and core business of providing care to the serious illness and injured. The ED is also recognized as a high-risk area in relation to service demand and the potential for human error. Few studies have considered the perceptions and experiences of the ED staff (physicians, nurses, allied health professionals, and administration staff) about the practice of teamwork, especially in Saudi Arabia (SA), and no studies have been conducted to explore the practices of teamwork in the EDs. Aim: To explore the practices of teamwork from the perspectives and experiences of staff (physicians, nurses, allied health professionals, and administration staff) when interacting with each other in the admission areas in the ED of a public hospital in the Northern Border region of SA. Method: A qualitative case study design was utilized, drawing on two methods for the data collection, comprising of semi-structured interviews (n=22) with physicians (6), nurses (10), allied health professionals (3), and administrative members (3) working in the ED of a hospital in the Northern Border region of SA. The second method is non-participant direct observation. All data were analyzed using thematic analysis. Findings: The main themes that emerged from the analysis were as follows: the meaningful of teamwork, reasons of teamwork, the ED environmental factors, the organizational factors, the value of communication, leadership, teamwork skills in the ED, team members' behaviors, multicultural teamwork, and patients and families behaviors theme. Discussion: Working in the ED environment played a major role in affecting work performance as well as team dynamics. However, Communication, time management, fast-paced performance, multitasking, motivation, leadership, and stress management were highlighted by the participants as fundamental skills that have a major impact on team members and patients in the ED. It was found that the behaviors of the team members impacted the team dynamics as well as ED health services. Behaviors such as disputes among team members, conflict, cooperation, uncooperative members, neglect, and emotions of the members. Besides that, the behaviors of the patients and their accompanies had a direct impact on the team and the quality of the services. In addition, the differences in the cultures have separated the team members and created undesirable gaps such the gender segregation, national origin discrimination, and similarity and different in interests. Conclusion: Effective teamwork, in the context of the emergency department, was recognized as an essential element to obtain the quality of care as well as improve staff satisfaction.

Keywords: teamwork, barrier, facilitator, emergencydepartment

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Authors: Dahna Alkahtani, Faryal Suraya, Fadah Alanazi

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Background: Buccal mucosal graft for urethral augmentation has surpassed other grafting options, and is now considered the standard of choice for substitution Urethroplasty. The graft has gained its popularity due to its excellent short and long-term results, easy harvesting as well as its ability in withstanding wet environments. However, although Buccal mucosal grafts are an excellent option, it is not free of complications, potential intraoral complications are bleeding, pain, swelling, injury to the nerve resulting in numbness, lip deviation or retraction. Objectives: The current study aims to evaluate the intraoral complications of buccal mucosa grafts harvested from one cheek, and used in Augmentation Urethroplasty. Methodology: The study was conducted retrospectively using the medical records of patients who underwent open augmentation urethroplasty with a buccal mucosa graft at King Khalid University Hospital, Saudi Arabia. Data collection of demographics included the type of graft used, presence or absence of strictures and its etiological factors. Pre-operative and post-operative evaluations were carried out on the subjects including the medical history, physical examination, uroflowmetry, retrograde urethrography, voiding cystourethrography and urine cultures were also noted. Further, the quality of life and complications of the procedure including the presence or occurrence of bleeding within 3-days post-procedure, the severity of pain, oral swelling after grafting, length of return to normal daily diet, painful surgical site, intake of painkillers, presence or absence of speech disturbance, numbness in the cheeks and lips were documented. Results: Thirty-two male subjects with ages ranging from 15 years to 72 years were included in the current study. Following the procedure, a hundred percent of the subjects returned to their normal daily diet by the sixth postoperative day. Further, the majority of the patients reported experiencing mild pain accounting for 61.3%, and 90.3% of the subjects reported using painkillers to control the pain. Surgical wound Pain was reportedly more common at the perineal site as 48.4% of the subjects experienced it; on the other hand, 41.9% of the patients experienced pain in the oral mucosa. The presence of speech disorders, as assessed through medical history, was found to be present in 3.2% of patients. The presence of numbness in the cheeks and lips was found in 3.2% of patients. Other complications such as parotid duct injury, delayed wound healing, non-healing wound and suture granuloma were rare as 90.3% of the subjects denied experiencing any of them, there were nonetheless reports of parotid duct injury by 6.5% of the patients, and non-healing wound by the 3.2% of patients. Conclusion: Buccal Mucosa Graft in Augmentation Urethroplasty is an ideal source of allograft, although not entirely painless; it is considerably safe with minimal intra-oral complication and undetectable strain on the patients’ quality of life.

Keywords: augmentation, buccal, graft, oral

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