Search results for: systemic approach

Authors: Husham Bayazed

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Purpose of Presentation: The eye is one of a few sites in the body with immune privilege (IP). However, this IP is relatively easily bypassed in the face of sufficient strong local or systemic immunological responses. As immune responses are crucial elements of the repair response, the eye has developed distinct mechanisms to deliver immune responses to injury in the avascular regions of the eye. This presentation may cover and provide an overview of the mechanisms that dictate immune cell trafficking to the local ocular microenvironment in response to different autoimmune and inflammatory-mediated diseases. Recent Findings: Literature reviews declare that immune responses and inflammation play a key role in a diverse range of eye diseases. In recent years, our understanding of ocular immune responses has widely spread in ocular surface inflammation, uveitis, age-related macular degeneration (AMD), glaucoma, transplantation rejection, and other ocular diseases. It is becoming increasingly clear that multiple seemingly unrelated diseases involve immune responses with common themes in their ocular pathogenesis. Recent studies are focusing on elucidating the pathogenesis of ocular inflammatory disease to identify new targets for immunotherapy that will not only improve efficacy but also minimize adverse effects from traditional therapy. Summary: While IP was believed to protect the eye from day-to-day inflammatory insults, however, it is relatively easily breached in the face of different strong local or systemic immunological and inflammatory responses. Therefore, the ocular immune response encapsulates the full range of classical and non-classical immune responses and demonstrates many features which are reflected in other tissues, but eye tissues, by modifying these responses, may reveal unexpected and novel findings which are relevant to immune responses generally. This may have therapeutic potential for new targeting immunotherapy, restoring immune tolerance in ocular autoimmune and inflammatory diseases, and preventing rejection such as stem cells, currently being considered for treatment of worldwide blinding diseases such as AMD.

Keywords: ocular diseases, immunology, immune privilege, immunotherapy

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Authors: Nadia Ben Youssef, Aicha Bouzid

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Gradient estimation is one of the most fundamental tasks in the field of image processing in general, and more particularly for color images since that the research in color image gradient remains limited. The widely used gradient method is Di Zenzo’s gradient operator, which is based on the measure of squared local contrast of color images. The proposed gradient mechanism, presented in this paper, is based on the principle of the Di Zenzo’s approach using quaternion representation. This edge detector is compared to a marginal approach based on multiscale product of wavelet transform and another vector approach based on quaternion convolution and vector gradient approach. The experimental results indicate that the proposed color gradient operator outperforms marginal approach, however, it is less efficient then the second vector approach.

Keywords: gradient, edge detection, color image, quaternion

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Authors: Sebastian Del Corral Winder, Kiriana Sanchez, Mixalis Poulakis, Samantha Gray

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This paper seeks to explore White privilege and Whiteness. Being White in the U.S. is often perceived as the norm and it brings significant social, economic, educational, and health privileges that often are hidden in social interactions. One quality of Whiteness has been its invisibility given its intrinsic impact on the system, which becomes only visible when paying close attention to White identity and culture and during cross-cultural interactions. The cross-cultural interaction provides an emphasis on differences between the participants and people of color are often viewed as “the other.” These interactions may promote an increased opportunity for discrimination and negative stereotypes against a person of color. Given the recent increase of violence against culturally diverse groups, there has been an increased sense of otherness and division in the country. Furthermore, the accent prestige theory has found that individuals who speak English with a foreign accent are perceived as less educated, competent, friendly, and trustworthy by White individuals in the United States. Using the consensual qualitative research (CQR) methodology, this study explored the cross-cultural dyad from the White individual’s perspective focusing on the psychotherapeutic relationship. The participants were presented with an audio recording of a conversation between a psychotherapist with a Hispanic accent and a patient with an American English accent. Then, the participants completed an interview regarding their perceptions of race, culture, and cross-cultural interactions. The preliminary results suggested that the Hispanic accent alone was enough for the participants to assign stereotypical ethnic and cultural characteristics to the individual with the Hispanic accent. Given the quality of the responses, the authors completed a secondary analysis to explore Whiteness and White privilege in more depth. Participants were found to be on a continuum in their understanding and acknowledgment of systemic racism; while some participants listed examples of inequality, other participants noted: “all people are treated equally.” Most participants noted their feelings of discomfort in discussing topics of cultural diversity and systemic racism by fearing to “say the ‘wrong thing.” Most participants placed the responsibility of discussing cultural differences with the person of color, which has been observed to create further alienation and otherness for culturally diverse individuals. The results indicate the importance of examining racial and cultural biases from White individuals to promote an anti-racist stance. The results emphasize the need for greater systemic changes in education, policies, and individual awareness regarding cultural identity. The results suggest the importance for White individuals to take ownership of their own cultural biases in order to promote equity and engage in cultural humility in a multicultural world. Future research should continue exploring the role of White ethnic identity and education as they appear to moderate White individuals’ attitudes and beliefs regarding other races and cultures.

Keywords: culture, qualitative research, whiteness, white privilege

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Authors: Eunice Tan

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The purpose of this presentation is to look at an alternative to the approach and methodologies of working with a child with special needs. The strength-based approach to education embodies a paradigm shift. It is a strategy to move away from a deficit-based methodology which inadvertently may lead to an extensive list of things that the child cannot do or is unable to do. Today, many parents of individuals with special needs are focused on the individual’s deficits rather than on his or her strengths. Even when parents recognise and identify their child’s savant strengths to be valuable and wish to develop their abilities, they face the challenge that there are insufficient programs committed to supporting the development and improvement of such abilities. What is a strength-based approach in education? A strength-based approach in education focuses on students' positive qualities and contributions to class instead of the skills and abilities they may not have. Many schools are focused on the child’s special educational needs rather than the whole child. Parents interviewed have said that they have to engage external tutors to help hone in on their child’s interests and strengths. The strength-based approach to writing statements encourages educators to find out: • What a child can do • What a child can do when he or she is given educational support • Learning more about children with special needs and their strengths and talents will broaden our understanding of how we can help them with language acquisition, social skills, as well as self-help and independence skills.

Keywords: special needs, strengths, and talents, alternative educational approach, strength based approach

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Authors: Gamze Dogan Birer

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Women’s shelters provide service to women who had been subjected to physical, psychological, economical, and sexual violence. It is proposed that adopting a trauma-informed approach in these shelters would contribute to the ‘woman-defined’ success of the service. This includes reshaping the physical qualities of the shelter, contacts, and interventions that women face during their stay in a way that accepts and addresses their traumatic experiences. It is stated in this paper that the trauma-informed approach has commonalities with the basic psychological needs that are proposed by self-determination theory. Therefore, it is proposed that self-determination theory can be used as a theoretical background for trauma-informed approach

Keywords: self determination theory, trauma informed approach, violence against women, women's shelters

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Authors: Katie E. Jennings

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The interactions between family dynamics and environmental factors with mental health vulnerability in individuals are well known and are a theme for on-going research and debate. The impact upon mental health issues and forensic issues on family dynamics, experience, and emotional wellbeing cannot be over-Emphasised. For forensic patients with diagnosed mental disorders, these relationships and environments may have also been functionally linked to the development and maintenance of those disorders; with significant adverse childhood experiences being a common feature of many Patient’s histories. Mental health hospitals remove the patient from their home environments and provide treatment outside of these relationships and often outside of the home area. There is, therefore, a major focus on Services ensuring that patients are able to build and maintain relationships with family and friends, requiring services to involve families in Patients' care and treatment wherever possible. There are standards set by Government and clinical bodies that require absolute demonstration of the inclusion of family and friends in all aspects of the care and treatment of forensic patients. For some patients and family members, this push to take on a “role” in care can be unhelpful, extremely stressful, and has constant implications for the potential delicate reparation of relationships. Based on work undertaken for over 20 years in forensic mental health settings, this paper explores the positive psychology approach to a dimensional model to family inclusion in mental health care that learns from family court work and allows for the maintenance of relationships to be at both proximal and Distil levels; to prevent the replication of abuse, decrease the need for falsehoods and assist the recovery of all. The model is based on allowing families to choose to not be involved or be involved in different ways if this is seen to be more helpful. It also allows patients to choose the level of potential involvement that they would find helpful, and for this to be reviewed at a timeframe agreed by all parties, rather than when the next survey is due or the patient has a significant care meeting. This paper is significant as there is a lack of research to support services to use a positive psychology approach to work in this area, the assumption that being asked to be involved must be positive for all seems naïve at best for this patient group. Work relating to the psychology of family can significantly contribute to the development of knowledge in this area. The development of a dimensional model will support choice within families and assist in the development of more honest and open relationships.

Keywords: family dynamics, forensic, mental disorder, positive psychology

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Authors: Saeed Delara, Kendra MacKay

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Varying methodologies are considered for pile design for both Russian and Western approaches. Although both approaches rely on toe and side frictional resistances, different calculation methods are proposed to estimate pile capacity. The Western approach relies on compactness (internal friction angle) of soil for cohesionless soils and undrained shear strength for cohesive soils. The Russian approach relies on grain size for cohesionless soils and liquidity index for cohesive soils. Though most recommended methods in the Western approaches are relatively simple methods to predict pile settlement, the Russian approach provides a detailed method to estimate single pile and pile group settlement. Details to calculate pile axial capacity and settlement using the Russian and Western approaches are discussed and compared against field test results.

Keywords: pile capacity, pile settlement, Russian approach, western approach

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Authors: Keshari Shrestha, Philip Vatterott

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Introduction: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal drug-related syndrome. DRESS classically presents with a diffuse maculopapular rash, fevers, and eosinophilia more than three weeks after drug exposure. DRESS can present with multi-organ involvement, with liver damage being the most common and severe. Pulmonary involvement is a less common manifestation and is associated with poor clinical outcomes. Chest imaging is often nonspecific, and symptoms can range from mild cough to acute respiratory distress syndrome (ARDS) . This is a case of a 49-year-old female with a history of recent clostridium difficile colitis status post treatment with oral vancomycin who presented with rash, acute liver and kidney failure, as well as diffuse nodular alveolar lung opacities concerning for DRESS syndrome with multi-organ involvement. Clinical Course: This patient initially presented to an outside hospital with clostridium difficile colitis, acute liver injury, and acute kidney injury. She developed a desquamating maculopapular rash in the setting of recent oral vancomycin, meloxicam, and furosemide initiation. She was hospitalized on two additional occasions with worsening altered mental status, liver injury, and acute kidney injury and was initiated on intermittent hemodialysis. Notably, she was found to have systemic eosinophilia (4100 cells/microliter) several weeks prior. She was transferred to this institution for further management where she was found to have encephalopathy, jaundice, lower extremity edema, and diffuse bilateral rhonchorous breath sounds on pulmonary examination. The patient was started on methylprednisolone for suspected DRESS syndrome. She underwent an evaluation for alternative causes of her organ failure. Her workup included a negative infectious, autoimmune, metabolic, toxic, and malignant work-up. Abdominal computed tomography (CT) and ultrasound were remarkable for evidence of hepatic steatosis and possible cirrhotic morphology. Additionally, a chest CT demonstrated diffuse and symmetric nodular alveolar lung opacities with peripheral sparing not consistent with acute respiratory distress syndrome or edema. Ultimately, her condition continued to decline, and she required intubation on several occasions. On hospital day 25 she succumbed to distributive shock in the setting of probable sepsis and multi-organ failure. Discussion: DRESS syndrome occurs in 1 in 1,000 to 10,000 patients with a mortality rate of around 10%. Anti-convulsant, anti-bacterial, anti-viral, and sulfonamide drugs are the most common drugs implicated in the development of DRESS syndrome; however, the list of offending agents is extensive . The diagnosis of DRESS syndrome is made after excluding other causes of disease such as infectious and autoimmune etiologies. The RegiSCAR scoring system is used to diagnose DRESS syndrome with 2-3 points indicating possible disease, 4-5 probable disease, and >5 definite disease. This patient scored a 7 on the RegiSCAR scale for eosinophilia, rash, organ involvement, and exclusion of other causes (infectious and autoimmune). While the pharmacologic trigger in this case is unknown, it is speculated to be caused by vancomycin, meloxicam, or furosemide due to the favorable timeline of initiation. Despite aggressive treatment, DRESS syndrome can often be fatal. Because of this, early diagnosis and treatment of patients with suspected DRESS syndrome is imperative.

Keywords: drug reaction with eosinophilia and systemic symptoms, multi-organ failure, pulmonary involvement, renal failure

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Authors: A. Luft, S. Bremen, N. Balc

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The task of flexibility planning and design, just like factory planning, for example, is to create the long-term systemic framework that constitutes the restriction for short-term operational management. This is a strategic challenge since, due to the decision defect character of the underlying flexibility problem, multiple types of flexibility need to be considered over the course of various scenarios, production programs, and production system configurations. In this context, an evaluation model has been developed that integrates both conventional and additive resources on a basic task level and allows the quantification of flexibility enhancement in terms of mix and volume flexibility, complexity reduction, and machine capacity. The model helps companies to decide in early decision-making processes about the potential gains of implementing additive manufacturing technologies on a strategic level. For companies, it is essential to consider both additive and conventional manufacturing beyond pure unit costs. It is necessary to achieve an integrative view of manufacturing that incorporates both additive and conventional manufacturing resources and quantifies their potential with regard to flexibility and manufacturing complexity. This also requires a structured process for the strategic production systems design that spans the design of various scenarios and allows for multi-dimensional and comparative analysis. A respective guideline for the planning of additive resources on a strategic level is being laid out in this paper.

Keywords: additive manufacturing, production system design, flexibility enhancement, strategic guideline

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Authors: Hsiang-Wen Tang, Cheng-Ying Lo

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In this study, the static behavior of super elliptical Winkler plate is analyzed by applying the double side approach method. The lack of information about super elliptical Winkler plates is the motivation of this study and we use the double side approach method to solve this problem because of its superior ability on efficiently treating problems with complex boundary shape. The double side approach method has the advantages of high accuracy, easy calculation procedure and less calculation load required. Most important of all, it can give the error bound of the approximate solution. The numerical results not only show that the double side approach method works well on this problem but also provide us the knowledge of static behavior of super elliptical Winkler plate in practical use.

Keywords: super elliptical winkler plate, double side approach method, error bound, mechanic

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Authors: Mouhoubi Nedjima, Sassi Boudemagh Souad

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In this paper, we will try to demonstrate the importance of the project approach in the urban to deal with uncertainty, the importance of the involvement of all stakeholders in the urban project process and that the absence of an actor can lead to project failure but also the importance of the urban project management. These points are handled through the following questions: Does the urban adhere to the theory of complexity? Does the project approach bring hope and solution to make urban planning "sustainable"? How converging visions of actors for the same project? Is the management of urban project the solution to support the urban project approach?

Keywords: strategic planning, project, urban project stakeholders, management

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Authors: S. S. Patil, R. M. Mhetre, S. V. Patil

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Lisinopril is an angiotensin converting enzyme inhibitor used in the treatment of hypertension and heart failure in prophylactic treatment after myocardial infarction and in diabetic nephropathy. However, it is very poorly absorbed from gastro-intestinal tract. Intranasal administration is an ideal alternative to the parenteral route for systemic drug delivery. Formulating multiparticulate system with mucoadhesive polymers provide a significant increase in the nasal residence time. The aim of the present approach was to overcome the drawbacks of the conventional dosage forms of lisinopril by formulating intranasal microspheres with Carbopol 974P NF and HPMC K4 M along with film forming polymer ethyl cellulose.The microspheres were prepared by emulsion solvent evaporation method. The prepared microspheres were characterized for encapsulation efficiency, drug loading, particle size, and surface morphology, degree of swelling, ex vivo mucoadhesion, drug release, ex vivo diffusion studies. All formulations has shown entrapment efficiency between 80 to more than 95%, mucoadhesion was more than 80 % and drug release up to 90 %. Ex vivo studies revealed tht the improved bioavailability of drug compared to oral drug administration. Both in vitro and in vivo studies conclude that combination of Carbopol and HPMC based microspheres shown better results than single carbopol based microspheres for the delivery of lisinopril.

Keywords: microspheres, lisinopril, nasal delivery, solvent evaporation method

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Authors: Joris Zufferey, Roderick John Lawrence

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This paper provides an overview of the state of the art about the positive health impacts of exposure to natural outdoor environments. It presents the results of a “review of reviews” in terms of empirical evidence and identifies some key questions. Finally, the authors stress the need to develop more interdisciplinary and systemic contributions. This synthesis of empirical research has been done as part of the EU- FP7 PHENOTYPE research project.

Keywords: Exposure, environment, phenotype, salutogenic effects

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Authors: Abdelhadi Adel, Kadri Ouahab

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This paper proposes an improved approach based on MAS Architecture and Heuristic Algorithm for systematic maintenance to minimize makespan. We have implemented a problem-solving approach for optimizing the processing time, methods based on metaheuristics. The proposed approach is inspired by the behavior of the human body. This hybridization is between a multi-agent system and inspirations of the human body, especially genetics. The effectiveness of our approach has been demonstrated repeatedly in this paper. To solve such a complex problem, we proposed an approach which we have used advanced operators such as uniform crossover set and single point mutation. The proposed approach is applied to three preventive maintenance policies. These policies are intended to maximize the availability or to maintain a minimum level of reliability during the production chain. The results show that our algorithm outperforms existing algorithms. We assumed that the machines might be unavailable periodically during the production scheduling.

Keywords: multi-agent systems, emergence, genetic algorithm, makespan, systematic maintenance, scheduling, hybrid flow shop scheduling

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Authors: Ahmad Alwosheel, Ahmed Alqaraawi

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This work proposes a new speaker segmentation approach for two speakers. It is an online approach that does not require a prior information about speaker models. It has two phases, a conventional approach such as unsupervised BIC-based is utilized in the first phase to detect speaker changes and train a Neural Network, while in the second phase, the output trained parameters from the Neural Network are used to predict next incoming audio stream. Using this approach, a comparable accuracy to similar BIC-based approaches is achieved with a significant improvement in terms of computation time.

Keywords: artificial neural network, diarization, speaker indexing, speaker segmentation

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Authors: Prakash Singh

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The focus of this paper is on the impact of internal organizational factors on the inappropriate job performance and behaviour of employees. The Buffalo City Metropolitan Municipality (BCMM) in South Africa has been experiencing inappropriate job behaviour and performance of some of its workers. They include misappropriation of resources, maladministration, mismanagement, lack of service delivery, fraud, and corruption. Since many workers in this organization have various levels of formal education, such practices are not expected, because the structural-functionalist assumption is that formal education is a solution to societal challenges. Since inappropriate job behaviour and performance continue to be reported in spite of the formal education of BCMM workers, this study seeks to investigate how the two phenomena co-exist. It thus seeks to put into perspective the paradoxical co-existence of formal education with inappropriate job behaviour and performance, by focusing on the BCMM as a case-study. For data collection, this study used the mixed method approach; that is, a combination of qualitative and quantitative methods. The findings revealed structural, systemic and human impediments to labour productivity in the organization. By and large, the unquestioning acceptance of the assumption that the skills shortage is responsible for inappropriate workers’ job performance and behaviour is discredited by the evidence of skilled personnel who exercise their responsibilities in a manner that undermines their occupational requirements. Therefore, this exploratory study affirms that the narrow conception of skills, that privileges job-specific capabilities, is not enough for cultivating a workforce with appropriate job behaviour and performance practices.

Keywords: inappropriate job behaviour, labour productivity, mismanagement, skills shortage

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Authors: Zehra Sultan

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The study is based on the task-based language teaching approach which is found to be very effective in the EFL/ESL classroom. This approach engages learners to acquire the usage of authentic language skills by interacting with the real world through sequence of pedagogical tasks. The use of technology enhances the effectiveness of this approach. This study throws light on the historical background of TBLT and its efficacy in the EFL/ESL classroom. In addition, this study precisely talks about the implementation of this approach in the General Foundation Programme of Muscat College, Oman. It furnishes the list of the pedagogical tasks embedded in the language curriculum of General Foundation Programme (GFP) which are skillfully allied to the College Graduate Attributes. Moreover, the study also discusses the challenges pertaining to this approach from the point of view of teachers, students, and its classroom application. Additionally, the operational success of this methodology is gauged through formative assessments of the GFP, which is apparent in the students’ progress.

Keywords: task-based language teaching, authentic language, communicative approach, real world activities, ESL/EFL activities

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Authors: Lavinia B. Dulla

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The exploration study of the fuzzy regression approach attempts to present that fuzzy regression can be used as a possible alternative to classical regression. It likewise seeks to assess the differences and characteristics of simple linear regression and fuzzy regression using the width of prediction interval, mean absolute deviation, and variance of residuals. Based on the simple linear regression model, the fuzzy regression approach is worth considering as an alternative to simple linear regression when the sample size is between 10 and 20. As the sample size increases, the fuzzy regression approach is not applicable to use since the assumption regarding large sample size is already operating within the framework of simple linear regression. Nonetheless, it can be suggested for a practical alternative when decisions often have to be made on the basis of small data.

Keywords: fuzzy regression approach, minimum fuzziness criterion, interval regression, prediction interval

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Authors: M. Brandt, A. Peniak, J. Makarovič, P. Rafajdus

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This paper deals with a novel approach of power transformers diagnostics. This approach identifies the exact location and the range of a fault in the transformer and helps to reduce operation costs related to handling of the faulty transformer, its disassembly and repair. The advantage of the approach is a possibility to simulate healthy transformer and also all faults, which can occur in transformer during its operation without its disassembling, which is very expensive in practice. The approach is based on creating frequency dependent impedance of the transformer by sweep frequency response analysis measurements and by 3D FE parametrical modeling of the fault in the transformer. The parameters of the 3D FE model are the position and the range of the axial short circuit. Then, by comparing the frequency dependent impedances of the parametrical models with the measured ones, the location and the range of the fault is identified. The approach was tested on a real transformer and showed high coincidence between the real fault and the simulated one.

Keywords: transformer, parametrical model of transformer, fault, sweep frequency response analysis, finite element method

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Authors: Fariha Asif

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The main purpose of this study was to investigate the effectiveness of eclectic approach in teaching of communicative functions. The objectives of the study were to get the information about the use of communicative functions through eclectic approach and to point out the most effective way of teaching functional communication and social interaction with the help of communicative activities through eclectic approach. The next step was to select sample from the selected population. As the research was descriptive so a questionnaire was developed on the basis of hypothesis and distributed to different selected schools of Lahore, Pakistan. Then data was tabulated, analyzed and interpreted through computer by finding percentages of different responses given by teachers to see the results. It was concluded that eclectic approach is effective in teaching communicative functions and communicative functions are better when taught through eclectic approach and communicative activities are more appropriate way of teaching communicative functions. It was found those teachers who were qualified in ELT gave better opinions as compare to those who did not have this degree. Techniques like presentations, dialogues and roleplay proved to be effective for teaching functional communication through communicative activities and also motivate the students not only in learning rules but also in using them to communicate with others.

Keywords: methodology, functions, teaching, ESP

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Authors: Mengjie Liu

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This essay aims at responding to the Kant arguments on how to fit the self-caused subject into the deterministic object which follows the natural laws. This essay mainly adopts the approach abstracted from Fichte’s “Wissenshaftslehre” (Doctrine of Science) to picture a possible solution to the conciliation of Kantian dualism. The Fichte approach is based on the unity of the theoretical and practical reason, which can be understood as a philosophical abstraction from ordinary experience combining both subject and object. This essay will discuss the general Kantian dualism problem and Fichte’s unity approach in the first part. Then the essay will elaborate on the achievement of this unity of the subject and object through Fichte’s “the I posits itself” process in the second section. The following third section is related to the ethical unity of subject and object based on the Fichte approach. The essay will also discuss the limitation of Fichte’s approach from two perspectives: (1) the theoretical possibility of the existence of the pure I and (2) Schelling’s statement that the Absolute I is a result rather than the originating act. This essay demonstrates a possible approach to unifying the subject and object supported by Fichte’s “Absolute I” and ethical theories and also points out the limitations of Fichte’s theories.

Keywords: Fichte, identity, Kantian dualism, Wissenshaftslehre

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Authors: Soumaya Mrabet, Taieb Ach, Imen Akkari, Amira Atig, Neirouz Ghannouchi, Koussay Ach, Elhem Ben Jazia

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Introduction: Celiac disease (CD) is an immune-mediated small intestinal disorder that occurs in genetically susceptible people. It is significantly associated with other autoimmune disorders represented mainly by type 1 diabetes and autoimmune dysthyroidism. The aim of our study is to determine the prevalence and the type of the various autoimmune diseases associated with CD in adult patients. Material and methods: This is a retrospective study including patients diagnosed with CD, explored in Internal Medicine, Gastroenterology and Endocrinology and Diabetology Departments of the Farhat Hached University Hospital, between January 2005 and January 2016. The diagnosis of CD was confirmed by serological tests and duodenal biopsy. The screening of autoimmune diseases was based on physical examination, biological and serological tests. Results: Sixty five patients with a female predominance were included, 48women (73.8%) and 17 men (26.2%). The mean age was 31.8 years (17-75). A family history of CD or other autoimmune diseases was present in 5 and 10 patients respectively. Clinical presentation of CD was made by recurrent abdominal pain in 49 cases, diarrhea in 29 cases, bloating in 17 cases, constipation in 25 cases and vomiting in 8 cases. Autoimmune diseases associated with CD were found in 30 cases (46.1%): type 1 diabetes in 15 patients attested by the positivity of anti-GAD antibodies in 11 cases and anti-IA2 in 4 cases, Hashimoto thyroiditis in 8 cases confirmed by the positivity of anti-TPO antibodies, Addison's disease in 2 patients, Anemia of Biermer in 2 patients, autoimmune hepatitis, Systemic erythematosus lupus, Gougerot Sjögren syndrome, rheumatoid arthritis, Vitiligo and antiphospholipid syndrome in one patient each. CD was associated with more than one autoimmune disease defining multiple autoimmune syndrome in 2 female patients. The first patient had Basedow disease, Addison disease and type 1 diabetes. The second patient had systemic erythematosus lupus and Gougerot Sjögren syndrome. Conclusion: In our study autoimmune diseases were associated with CD in 46.1% of cases and were dominated by diabetes and dysthroidism. After establishing the diagnosis of CD the search of associated autoimmune diseases is necessary in order to avoid any therapeutic delay which can alter the prognosis of the patient.

Keywords: association, autoimmune thyroiditis, celiac disease, diabetes

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Authors: Emad Matar Alotaibi

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In line with other Arabic countries, Saudi Arabia is currently undergoing large scale school reform in response to key factors brought about by globalization. While there is a growing body of research exploring these systemic changes in urban environments, there is very little published research regarding rural schools. In fact, rural schools are still under-examined globally comparing to their urban and suburban counterparts over a range of reform dimensions. In Saudi Arabia, there are around 1128 rural areas that contain about 3200 schools. Several challenges face rural schools, especially in relation to recruitment, retention, and professional development opportunities for teachers and school leaders. However, there is very little in depth research which explores these issues “on the ground”. The aim of this research is fill this knowledge gap and explore teachers’ and leaders’ perceptions and experiences of working in rural schools in KSA. In Saudi Arabia, there is a growing body of research into school leadership. However, there is very little published research specifically exploring rural schools. By using an in-depth case study approach and adopting an analytical framework based on the interlinking concepts of leadership practices, culture, and CPD, this study offers and significant and original contribution to knowledge in this area. This study also will adopt a qualitative multiple case studies, which is going to employ semi-structured interviews, focus groups, and documentary analysis.

Keywords: leadership practice, school culture, continuing professional development, rural school

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Authors: Ahmad Khoirul Umam

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This paper investigates the role of vested interests and its impacts on anti-corruption agenda in Indonesia following the collapse of authoritarian regime in 1998. A pervasive and rampant corruption has been believed as the main cause of the state economy’s fragility. Hence, anti-corruption measures were implemented by applying democratization and market liberalization since the establishment of a consolidated democracy which go hand in hand with a liberal market economy is convinced to be an efficacious prescription for effective anti-corruption. The reform movement has also mandated the establishment of the independent, neutral and professional special anti-corruption agency namely Corruption Eradication Commission (KPK) to more intensify the fight against the systemic corruption. This paper will examine whether these anti-corruption measures have been effective to combat corruption, and investigate to what extend have the anti-corruption efforts, especially those conducted by KPK, been impeded by the emergence of a nexus of vested interests as the side-effect of democratization and market liberalization. Based on interviews with key stakeholders from KPK, other law enforcement agencies, government, prominent scholars, journalists and NGOs in Indonesia, it is found that since the overthrow of Soeharto, anti-corruption movement in the country have become more active and serious. After gradually winning the hearth of people, KPK successfully touched the untouchable corruption perpetrators who were previously protected by political immunity, legal protection and bureaucratic barriers. However, these changes have not necessarily reduced systemic and structural corruption practices. Ironically, intensive and devastating counterattacks were frequently posed by the alignment of business actors, elites of political parties, government, and also law enforcement agencies by hijacking state’s instruments to make KPK deflated, powerless, and surrender. This paper concludes that attempts of democratization, market liberalization and the establishment of anti-corruption agency may have helped Indonesia to reduce corruption. However, it is still difficult to imply that such anti-corruption measures have fostered the more effective anti-corruption works in the newly democratized and weakly regulated liberal economic system.

Keywords: vested interests, democratization, market liberalization, anti-corruption, Indonesia

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Authors: Ranya Elkhayat

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This paper aims at offering a futures study for higher education in the Middle East. Paying special attention to the negative impacts of neoliberalism, the paper will demonstrate how higher education is now commodified, corporatized and how arts and humanities are eschewed in favor of science and technology. This conceptual paper argues against the neoliberal agenda and aims at providing an alternative exemplified in the Capabilities Approach with special reference to Martha Nussbaum’s theory. The paper is divided into four main parts: the current state of higher education under neoliberal values, a prediction of the conditions of higher education in the near future, the future of higher education using the theoretical framework of the Capabilities Approach, and finally, some areas of concern regarding the approach. The implications of the study demonstrate that Nussbaum’s Capabilities Approach will ensure that the values of education are preserved while avoiding the pitfalls of neoliberalism.

Keywords: capabilities approach, education future, higher education, MENA

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Authors: Sukumar Namineni, Tracy O'Connor, Ulrich Kalinke, Percy Knolle, Mathias Heikenwaelder

Abstract:

The liver is one of the pivotal organs in vertebrate animals, serving a multitude of functions such as metabolism, detoxification and protein synthesis and including a predominant role in innate immunity. The innate immune mechanisms pertaining to liver in controlling viral infections have largely been attributed to the Kupffer cells, the locally resident macrophages. However, all the cells of liver are equipped with innate immune functions including, in particular, the hepatocytes. Hence, our aim in this study was to elucidate the innate immune contribution of hepatocytes in viral clearance using mice lacking Ikkβ specifically in the hepatocytes, termed IkkβΔᴴᵉᵖ mice. Blockade of Ikkβ activation in IkkβΔᴴᵉᵖ mice affects the downstream signaling of canonical NF-κB signaling by preventing the nuclear translocation of NF-κB, an important step required for the initiation of innate immune responses. Interestingly, infection of IkkβΔᴴᵉᵖ mice with lymphocytic choriomeningitis virus (LCMV) led to strongly increased hepatic viral titers – mainly confined in clusters of infected hepatocytes. This was due to reduced interferon stimulated gene (ISG) expression during the onset of infection and a reduced CD8+ T-cell-mediated response. Decreased ISG production correlated with increased liver LCMV protein and LCMV in isolated hepatocytes from IkkβΔᴴᵉᵖ mice. A similar phenotype was found in LCMV-infected mice lacking interferon signaling in hepatocytes (IFNARΔᴴᵉᵖ) suggesting a link between NFkB and interferon signaling in hepatocytes. We also observed a failure of interferon-mediated inhibition of HBV replication in HepaRG cells treated with NF-kB inhibitors corroborating our initial findings with LCMV infections. Collectively, these results clearly highlight a previously unknown and influential role of hepatocytes in the induction of innate immune responses leading to viral clearance during a systemic viral infection with LCMV-WE.

Keywords: CD8+ T cell responses, innate immune mechanisms in the liver, interferon signaling, interferon stimulated genes, NF-kB signaling, viral clearance

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Authors: Zoe Wong

Abstract:

The purpose of this paper is to develop a framework for internet education. This framework uses the personalized learning approach for everyone who can freely develop their qualifications & careers. The key components of the framework includes students, teachers, assessments and infrastructure. It allows remove the challenges and limitations of the current educational system and allows learners' to cope with progressing learning materials.

Keywords: internet education, personalized approach, information technology, framework

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Authors: Irfan Abdulrahman Sheth, Sohil Pothiawala

Abstract:

Dermatomyositis is an idiopathic inflammatory myopathy, traditionally characterized by a progressive, symmetrical proximal muscle weakness and pathognomonic or characteristic cutaneous manifestations. We report a case of a 60-year old Chinese female who was referred from polyclinic for allergic rash over the body after applying hair dye 3 weeks ago. It was associated with puffiness of face, shortness of breath and hoarse voice since last 2 weeks with decrease effort tolerance. She also complained of dysphagia/ myalgia with progressive weakness of proximal muscles and palpitations. She denied chest pain, loss of appetite, weight loss, orthopnea or fever. She had stable vital signs and appeared cushingoid. She was noted to have rash over the scalp/ face and ecchymosis over the right arm with puffiness of face and periorbital oedema. There was symmetrical muscle weakness and other neurological examination was normal. Initial impression was of allergic reaction and underlying nephrotic syndrome and Cushing’s syndrome from TCM use. Diagnostic tests showed high Creatinine kinase (CK) of 1463 u/l, CK–MB of 18.7 ug/l and Troponin –T of 0.09 ug/l. The Full blood count and renal panel was normal. EMG showed inflammatory myositis. Patient was managed by rheumatologist and discharged on oral prednisolone with methotrexate/ ergocalciferol capsule and calcium carb, vitamin D tablets and outpatient follow up. In some patients, cutaneous disease exists in the absence of objective evidence of muscle inflammation. Management of dermatomyositis begins with careful investigation for the presence of muscle disease or of additional systemic involvement, particularly of the pulmonary, cardiac or gastrointestinal systems, and for the possibility of an accompanying malignancy. Muscle disease and systemic involvement can be refractory and may require multiple sequential therapeutic interventions or, at times, combinations of therapies. Thus, we want to highlight to the physicians that the cutaneous disease of dermatomyositis should not be confused with allergic reaction. It can be particularly challenging to diagnose. Early recognition aids appropriate management of this group of patients.

Keywords: dermatomyositis, myopathy, allergy, cutaneous disease

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Authors: Janneth Gonzalez, Andrés Pinzon Velasco, Maria Angarita

Abstract:

Astrocytes play an important role in various processes in the brain, including pathological conditions such as neurodegenerative diseases. Recent studies have shown that the increase in saturated fatty acids such as palmitic acid (PA) triggers pro-inflammatorypathways in the brain. The use of synthetic neurosteroids such as tibolone has demonstrated neuro-protective mechanisms. However, broad studies with a systemic point of view on the neurodegenerative role of PA and the neuro-protective mechanisms of tibolone are lacking. In this study, we performed the integration of multi-omic data (transcriptome and proteome) into a human astrocyte genomic scale metabolic model to study the astrocytic response during palmitate treatment. We evaluated metabolic fluxes in three scenarios (healthy, induced inflammation by PA, and tibolone treatment under PA inflammation). We also applied a control theory approach to identify those reactions that exert more control in the astrocytic system. Our results suggest that PA generates a modulation of central and secondary metabolism, showing a switch in energy source use through inhibition of folate cycle and fatty acid β‐oxidation and upregulation of ketone bodies formation. We found 25 metabolic switches under PA‐mediated cellular regulation, 9 of which were critical only in the inflammatory scenario but not in the protective tibolone one. Within these reactions, inhibitory, total, and directional coupling profiles were key findings, playing a fundamental role in the (de)regulation of metabolic pathways that may increase neurotoxicity and represent potential treatment targets. Finally, the overall framework of our approach facilitates the understanding of complex metabolic regulation, and it can be used for in silico exploration of the mechanisms of astrocytic cell regulation, directing a more complex future experimental work in neurodegenerative diseases.

Keywords: astrocytes, data integration, palmitic acid, computational model, multi-omics

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Authors: M. Shaheed Hartley

Abstract:

There has been increasing pressure on education researchers and practitioners at higher education institutions to focus on the development of South Africa’s rural and peri-urban communities and improving their quality of life. Many tertiary institutions are obliged to review their outreach interventions in schools. To ensure that the support provided to schools is still relevant, a systemic evaluation of science educator needs is central to this process. These prioritised needs will serve as guide not only for the outreach projects of tertiary institutions, but also to service providers in general so that the process of addressing educators needs become coordinated, organised and delivered in a systemic manner. This paper describes one area of a broader needs assessment exercise to collect data regarding the needs of educators in a district of 45 secondary schools in the Western Cape Province of South Africa. This research focuses on the needs and challenges faced by science educators at these schools as articulated by the relevant stakeholders. The objectives of this investigation are two-fold: (1) to create a data base that will capture the needs and challenges identified by science educators of the selected secondary schools; and (2) to develop a needs profile for each of the participating secondary schools that will serve as a strategic asset to be shared with the various service providers as part of a community of practice whose core business is to support science educators and science education at large. The data was collected by a means of a needs assessment questionnaire (NAQ) which was developed in both actual and preferred versions. An open-ended questionnaire was also administered which allowed teachers to express their views. The categories of the questionnaire were predetermined by participating researchers, educators and education department officials. Group interviews were also held with the science teachers at each of the schools. An analysis of the data revealed important trends in terms of science educator needs and identified schools that can be clustered around priority needs, logistic reasoning and educator profiles. The needs database also provides opportunity for the community of practice to strategise and coordinate their interventions.

Keywords: needs assessment, science and mathematics education, evaluation, teaching and learning, South Africa

Procedia PDF Downloads 162