Systemic Hypoxia Biomarkers in Asymptomatic Simple Non- Alcoholic Hepatosteatosis

The high prevalence of the risk factors for Non-Alcoholic Fatty Liver Disease (NAFLD) made it one of the most common non- communicable diseases with high morbidity, nationally and worldwide. Early pathogenic implication of cellular hypoxia in Asymptomatic Simple Non-Alcoholic Isolated Hepatosteatosis (ANIHS) was investigated in this cross-sectional study and correlated changes in systemic hypoxia biomarkers with body mass index (BMI) in apparently healthy ANIHS participants with normal liver enzymes and size. We enrolled 180 adult consented volunteering Saudi participants in the period from January 1 to June 1, 2019. They comprised of normal lean healthy controls (n = 40; BMI = 18.5-25) and ANIHS participants (n 140) that were subdivided as overweight (n = 64; BMI = 25.1 – 30) and obese (n = 76; BMI >30 - <40). Male/female ratio was 1:1 and age range was 24 – 50 years (37.0 ± 7.85) without significant differences among groups. The cellular hypoxia biomarkers; lactate, pyruvate, lactate: pyruvate (L/P) ratio & hypoxia inducible factor (HIF)-1α were estimated in fasting plasma. Lactate was significantly higher in obese ANIHS compared to each of overweight ANSHS participants and controls. Pyruvate was significantly lowest in overweight ANIHS followed by obese ANIHS participants - compared to highest level in controls. L/P ratio was highest in obese ANIHS followed by overweight ANIHS participants, compared to controls. HIF-1α was more than 3- folds higher in obese ANIHS participants compared to healthy controls, with a mild increase in overweight ANIHS participants. Pyruvate and the ratio were significantly connected to steatosis, whereas lactate and HIF-1α were significantly connected to both BMI and hepatosteatosis. Cellular hypoxic changes may be implicated in pathogenesis of ANIHS. Plasma HIF-1α level reflects the correlation between BMI and occurrence/progression of ANIHS. Cellular hypoxia with responsive increases in HIF-1α could be prognostically good provided that it correlates a cytoprotective functional transcriptional respons

State of the art of information systems failure managements

Information systems (IS) play a vital role in our daily life. They collect, store, organize and distribute data in structured and organized ways to improve people's daily activities in the most efficient and effective manner. To achieve that, functions and structures are mixed together in a dynamic way to construct an information system with sophisticated capabilities beyond sending emails and publishing data online. Consequently, enterprises and government departments allocate huge financial and human resources for the development of interconnected information systems. However, failures in information systems projects have been growing in the last few years despite their massive allocated resources. That means any IS projects that do not meet their objectives and goal have gone beyond budget or not completed within the agreed time. While there are several factors triggering these failures, this research aims to investigate and address the key factors that are responsible for failure within information systems in various regions, The work conducted includes identifying different role of information systems components, comparing two important information systems success/failure models namely DeLone and Mclean model and ITPOSMO model, and summarising critical success/factors for information systems from various regions. The research findings can be used for developing an framework for effectively managing Information System

A framework for the development of learning management systems for higher education institutions in the Kingdom of Saudi Arabia

This study focuses on a framework for the development of the Learning Management System (LMS) in the Kingdom of Saudi Arabia (KSA) higher education institutes (HEIs) from information systems (IS) perspective, using the Technology Acceptance Model (TAM) and Design Reality Gap (ITPOSMO) model. The research methodology consists of six stages which adopts the paradigm of pragmatism and the research design of mixed-methods. A case study design is used to investigate the implementation of LMS in the Al-Imam Mohamed bin Saud Islamic University. The quantitative part was designed to investigate the attitude of users towards the usefulness of the LMS and to assess the acceptance level of LMS among university users. The qualitative part was designed to explore the gap between the proposed implementation of the LMS and reality. The survey received valid responses from 129 academic and 1548 student. A semistructured interviews with 21 participants. The sample was achieved via a purposive sampling technique. The quantitative data was analysed using descriptive statistical analysis and correlation coefficient. The qualitative data were analysed using a thematic analysis approach. The study identifies the barriers influencing effective LMS in KSA HEIs as 1) technology barriers (lack of IT infrastructure, incomplete functionalities and lack of integration); 2) human barriers (lack of knowledge of the importance of elearning, lack of expertise and competencies); and 3) organisation barriers (organisational preparedness, unclear of requirements, lack of training, resistance and financial constraints). The contribution of this research includes a new model derived from the ITPOSMO model and TAM to investigate LMS in the context of real circumstances, and the physical environment that exists in KSA HEIs. The research focus is more on meso level while encompassing first and third levels as reference for better understanding (Richter et al., 2009). The results lead to developing a framework for the development of LMS in KSA HEIs.Manufacturin

A proposed Vision for the Leadership of Education Institutions on Gifted Caring in Light of Participative Leadership

The study aims to identify the status of gifted caring in education institutions in the Kingdom of Saudi Arabia (KSA). It also attempts to identify the degree of practice by the two heads of participative leadership from the perspective of supervisors in the management of gifted caring. Thus, the study eventually aims to provide a proposed vision for education institutions of gifted caring in light of participative leadership. The study adopted the descriptive survey approach together with the descriptive-analytical method. The study sample involved (102) supervisors. The population comprised all male and female supervisors working for the ministry of education in KSA whose number amounted to (206) supervisors in addition to all ministry circulars related to gifted caring and all relevant studies that tackled education institution leadership in light of the precipitative type. The researchers designed a questionnaire of four dimensions which included (31) items. The study's foremost results revealed that the administration leadership status ranked “medium.” As for the practice of the two heads of the gifted, caring leadership, it also ranked “medium” for all domains, which are: management duties, authorization, human relations, and finally, media and communication domains. The researchers also proposed a vision for the leadership of educational institutions for gifted caring in light of participative leadership by designing an integrated model for the issue. The researchers also put down specific steps to be followed in applying the vision. The study concludes with numerous recommendations and suggestion

Critical success factors for improving learning management systems diffusion in KSA HEIs: an ISM approach

Higher educational institutes (HEIs) are managing their resources by using learning management systems (LMS) which facilitate the learning processes. This paper aims to develop the relationships among success factors typically found in the technology, as well as the human and organisational aspects using an interpretive structural modelling (ISM) approach for LMS diffusion in HEIs in the Kingdom of Saudi Arabia (KSA). The success factors possessing a higher driving power in the ISM approach need to be prioritised as many other dependent variables are affected by them. Success factors emerging with high dependence contribute to facilitating the implementation of LMS. A key finding of the modelling is that clearly defined information technology (IT) policies along with appropriate technology infrastructure are significant factors for facilitating the technology aspect of LMS implementation. Additionally, the strengthening and standardisation of IT education resources, level of computer skills, proper training programmes for staff to deliver knowledge to users as well as a high level of human competencies are significant factors for facilitating the human aspect of LMS implementation. Moreover, the support of top management is a very significant factor for improving the organisational aspect of LMS. To ensure successful LMS implementation, KSA HEIs should focus on effective learning environments, facilitate education activities, top management involvement and increased interaction between pedagogy and technology. Understanding user characteristics and online needs is essential to ensure that barriers are overcome, ensuring successful and continued LMS implementation. Further, in this research, the relationship models among the identified success factors in terms of technology, human and organisational have not been statistically validated. However, it has been suggested that future research may be targeted to develop the initial model through ISM for success factors for improving LMS implementation and then testing it using Structural equation modeling (SEM)

Liver morbidity among haemodialysis patients negative for manifest HBV and HCV : A hospital-based study in an endemic area

Background: End-stage renal disease (ESRD) is an increasing health problem worldwide.  Older age, diabetes mellitus and hypertension, acute kidney damage are among some of the factors that play a role in ESRD. This study aims at exploring liver morbidity (LM) among Egyptian hemodialysis (HD) patients.  Methods: The study included 142 patients free from overt hepatitis B virus (HBV) or  hepatitis C virus (HCV); their data were retrieved from files and all were clinically assessed and tested for liver functions, serological markers and viremia of HCV and HBV. Results: Of 142 eligible HD patients, two seroconverted to overt HCV, and five showed occult HCV. According to the laboratory and ultrasonography (US) data, three patterns of LM were found in 62 (43.7%), non-alcoholic fatty liver disease (NAFLD) in 30 (48.4%), liver fibrosis in 19 (30.6%), and hepatitis in 13 (21%). The mean durations of renal impairment (7.6 ± 5.91), hemodialysis (9 ± 6.1269), and total dialysis sessions (976.26 ± 683.69) were significantly higher in patients with LM compared to others (6.78 ± 4.82, 5.38 ± 3.69, and 699.4 ± 467.1). Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) levels were elevated in 14 (22.6%) and 13 (21%) of patients with LM. However, the ROC curve revealed ALT and AST cut-off points of 16.5 and 25.5 IU/L to discriminate LM. Conclusion: LM is common among EDRD patients undergoing hemodialysis despite the low levels of ALT and AST. The use of the US and the new lower levels of ALT and AST could improve the screening approach of LM

Effects of modifying the electrode placement and pulse width on cognitive side effects with unilateral ECT: A pilot randomised controlled study with computational modelling

Background: The electrode placement and pulse width for electroconvulsive therapy (ECT) are important treatment parameters associated with ECT related retrograde memory side-effects. Modification of these parameters with right unilateral (RUL) ECT may have utility for further reducing these side-effects. Objective: This study explored use of the frontoparietal (FP) placement for reducing retrograde memory side effects with ECT. We hypothesised that superior retrograde memory outcomes would occur with FP compared to temporoparietal (TP) placement and with ultrabrief (UB: 0.3 ms) compared to brief pulse (BP: 1.0 ms) width ECT. Methods: In this randomised cross-over, double-blinded study, participants received a single treatment of BP TP, BP FP, UB TP and UB FP ECT. Neuropsychological testing was conducted prior to and immediately following each treatment. Computational modelling was conducted to explore associations between E-fields in regions-of-interest associated with memory. Results: Nine participants completed the study. The FP placement was not superior to TP for retrograde memory outcomes. For both electrode placements UB pulse width was associated with significantly better visual retrograde memory compared to BP (p <.05). With TP ECT, higher E-fields in regions-of-interest were significantly associated with greater visual retrograde memory side-effects (hippocampi: r = −0.77, p =.04; inferior frontal gyri: r = −0.92, p <.01; middle frontal gyri: r = −0.84, p =.02). Conclusions: Modification of pulse-width had greater effects than electrode placement for reducing retrograde memory side-effects with RUL ECT. Preliminary findings suggested that higher E-fields may be associated with greater cognitive side-effects with ECT

Deep Learning to Construct Computational Head Models for Modelling Electroconvulsive Therapy

Electroconvulsive therapy (ECT) is a neuromodulatory technique used widely for treatment of various psychiatric diseases such as Alzheimer’s and epilepsy. It includes the application of a large dose of electric current for short periods of time through attached electrodes on the scalp. However, there are some concerns related to electric field (EF) distribution in the brain and the potential for cognitive side effects. These concerns can be investigated thoroughly using computational modelling via the finite element (FE) method. To construct FE head models for simulating ECT stimulation, segmentation of magnetic resonance image (MRI) head scans is essential. This segmentation can be performed manually, which is laborious and time-consuming, or automatically. Various automatic segmentation approaches have been utilized to segment MRI head scans, including intensity-based techniques and deep learning techniques. In particular, convolutional neural networks (CNN), a subfield of deep learning, are considered as state-of-the-art owing to their outstanding performance. In this research, 2D U-Net and 3D U-Net CNN architectures were employed to rapidly segment seven MRI head scans into not only cerebrospinal fluid (CSF), grey matter (GM) and white matter (WM) as most studies performed but to include skin, skull tissues. This in turn will accelerate the process of construction of FE head models for simulating ECT. Two experiments were conducted using 2D U-Net, where in experiment 1, all the extracted slices from each head scan were used for training and testing, while experiment 2 involved only mid-slices. Additionally, two experiments were carried out using 3D U-Net with different patch sizes, 64 × 64 × 64 (experiment 3) and 128 × 128 × 128 (experiment 4). Inverse frequency class weighting was also used as an additional run for each experiment. The segmentation performance was evaluated in terms of intersection over union (IOU). In general, higher IOU scores were obtained for experiment 2 and experiment 4. The process of 3D segmentation (experiment 4) took only several seconds compared with previous approaches, which would take few hours. Predicted outputs from experiment 4 were used to construct FE models to simulate ECT. Various electrode montages were modelled on the scalp of each constructed head model, and EF magnitudes in various brain regions under ECT were compared against the corresponding manually-segmented head models. Larger EF magnitudes (10-25%) were exhibited in the automatically-segmented head models of four subjects, while weaker EFs (5-7%) were exhibited in the other three subjects compared with manual segmentation. These errors could be improved by increasing the training dataset to more than seven head scans, enhancing the segmentation accuracy for more accurate simulation of ECT

Do audited firms have better access to credit?: Evidence from emerging countries

AbstractThis study aims to examine the relationship of having financial statements audited by external auditors and access to bank credit, using data from the Business Environment and Enterprise Performance Survey (BEEPS). Among firms having credit access, this research further analyses the impacts of auditing financial statements on loan value, loan rate, and loan term (duration) by applying the Heckman two-step models with sample selection. Results show that firms with audited financial statements have better formal credit access than their counterparts. Among these, audited firms obtain bigger loan value, have lower loan rates and shorter borrowing duration, as compared to non-audited firms. Results are robust when applying the Propensity Score Matching

Natural history and consequences of food sensitisation: results from two birth cohort studies

© 2016 Dr. Shatha Ahmed AlduraywishThe prevalence of allergic diseases is increasing worldwide, particularly in Australia and other “westernised” countries. More recently, evidence suggests a second wave of the “allergy epidemic”, with an increase in the prevalence of food allergies. Despite intense research in this area, there are numerous questions concerning the potential risk factors for the development of allergic diseases. It has been shown that sensitisation to aeroallergens is strongly associated with allergy progression. However the associations between food sensitisation and the development of allergic conditions remain unclear. Therefore, my doctoral work has investigated the natural history of food sensitisation from infancy up to adolescence in an allergy high-risk cohort. I have also investigated the associations between early life food sensitisation and subsequent probable food allergy, asthma, allergic rhinitis and lung function during later childhood and adolescence. Data from an Australian allergy high-risk cohort (Melbourne Atopy Cohort Study (MACS)), and a German population-based cohort (Influence of Life-style related factors on the development of the Immune System and Allergies in East and West Germany PLUS the influence of traffic emissions and genetics (LISAplus)), were used to address the aims of this thesis. MACS recruited 620 infants with a family history of allergic disease prior to birth. The infants were followed from birth up to 18 years and skin prick test (SPT) was conducted at 6, 12 and 24 months, 12 and 18 years. LISAplus recruited 3,097 neonates from four German cities: Munich, Leipzig, Wesel and Bad Honnef. The participants were followed from birth up to 15 years and serum specific IgE was measured at age 2, 6, 10 and 15 years. In both cohorts, multiple surveys, that assessed the occurrence of allergic disease, were distributed throughout the follow-up period. Using these data along with sensitisation data, this thesis has contributed knowledge to address the following issues: Natural History of food sensitisation from infancy up to 18 years A better understanding of the natural history of food sensitisation provides insight, from a public health perspective, to appreciate the likely subsequent burden of food allergy and other allergic diseases over the life course. Longitudinal data on the natural history of food sensitisation beyond early childhood are scarce. Using MACS data, the prevalence of food sensitisation was found to be highest in infancy and declined after the age of 12 months. In the first two years of life, egg white was the most common food sensitisation followed by peanut and cow’s milk while peanut was the most prevalent food allergen at 18 years. Boys with eczema had the highest prevalences of egg and milk sensitisation throughout the follow-ups. A small proportion of children developed late onset food sensitisation (after the age of 2 years) which was unlikely to be clinically relevant. Consequences of early life food sensitisation Longitudinal birth cohort studies with prospective collection of data are the most appropriate design to evaluate the temporal association between early life food sensitisation and development of probable food allergy, asthma, allergic rhinitis and lung function during later childhood and adolescence. An association between food sensitisation at 12 months and the presence of adolescent food sensitisation and probable food allergy was noted in MACS, with sensitisation to more than one food allergen being the strongest predictor. I also demonstrated that early life sensitisation to food without concurrent aeroallergen sensitisation was associated with increased risk of asthma and allergic rhinitis during later childhood (i.e. 10-12 years) in both the MACS and LISAplus studies. Stronger associations were observed for co-sensitisation to both food and aeroallergen. However, only co-sensitisation to both food and aeroallergens in early life was found to be associated with asthma and allergic rhinitis at 18 years in MACS. These findings support the concept of an “atopic march”, in which early life food sensitisation progresses to later asthma and allergic rhinitis. Moreover, I have demonstrated evidence that sensitisation to food allergens only at 6 or 12 months in MACS was associated with reduced FEV1 in adolescence. Most of the observed effect was a direct association, although early life asthma but not aeroallergen sensitisation mediated these associations in part. However, these associations need to be confirmed in population-based studies as sensitisation was not assessed in the first year of life in the LISAplus study. In conclusion, the results I present in this thesis increase our knowledge of the relationship between food sensitisation and allergic disease. Additionally, they suggest that further efforts to prevent the development of food sensitisation, and hence the progression from food sensitisation to food allergy, asthma, allergic rhinitis and lung function impairment should be explored