Middle East Institute Research Articles

Gender disparities among speakers at major spine conferences

PurposeTo examine ten-year trends in gender representation in speaking roles at major spine conferences. Background contextMedical conferences play an important role in career opportunities. There is little analysis on gender representation of major spine conferences despite several studies demonstrating gender disparities within spine surgery. Study DesignObservational study. SampleA total of 20,181 abstract speakers across 10 years of academic conferences for six spine societies. Outcome MeasuresPercent of female abstract presenters. Materials and MethodsWe collated the annual meeting programs of six major spine conferences (North American Spine Society (NASS), Scoliosis Research Society (SRS), International Meeting on Advanced Spine Techniques (IMAST), Global Spine Congress (GSC), American Association of Neurological Surgeons/Congress of Neurological Surgeons (AANS/CNS) Spine Summit, and the Cervical Spine Research Society (CSRS)) dating from 2013 to 2022. Departmental websites, society webpages, or personal social media were identified for images or the use of gendered pronouns in order to determine speaker gender for each speaker type. All categorical variables were compared using Pearson chi-square analysis. ResultsWomen constituted 1,816 (9.0%) of all 20,181 identified conference speakers. Female representation was highest at NASS (N=680, 12.2%) but lowest at CSRS (6.6%) and GSC (7.1%). Spine Summit (7.4%), IMAST (9.92%), and GSC (9.87%) demonstrated the largest annual percent increases in female representation. Institutions in Middle East and Africa (1.4%), and Central and South America (1.8%) supported the lowest percent of female speakers. Women were significantly less likely to be speakers or moderators/course faculty than to be podium abstract presenters (p<.001). The percent of women as invited speakers (10.4% vs. 5.5%, p=.001) and moderators (11.4% vs. 3.7%, p<.001) increased significantly over the study period, with annual increases of 8.8% and 20.8%, respectively, from 2013 to 2022 (p<.001). ConclusionsWhile academic spine societies have made significant progress in promoting gender representation, especially among invited speakers and session moderators, women continue to be underrepresented compared to the percent of women in orthopedic surgery and neurosurgery.

Beyond the Frame: Toward a Collection-Level Redescription of the Colbert Held Archive

ABSTRACT This article argues for the collection-level redescription of the Middle East Institute's Colbert Held Archive, a collection consisting of more than 18,000 color Kodachrome slides of photographs taken by Held throughout his time in the region as a diplomat and geographic field researcher. After discussing the importance of the collection and its possible uses for researchers in the field, this article details how any description of the archives should contextualize the American presence in the Arabian Peninsula during the photographer's time in the region. Arguing that the archives places a dual emphasis on geography and ethnography (the concerted combination of which might be called geo-ethnography), the author argues that the archives would be best served by a collection-level, rather than an item-level, redescription. The article draws from academic literature on reparative description, the More Product, Less Process (MPLP) approach, and Total Cost of Stewardship to suggest that this path forward is the most feasible and meaningful step that can be taken by a small special library to contextualize Held's work and his photographs.

Diversification and performance of microfinance institutions: does Islamic microfinance model matter?

Purpose The aim of this study is to investigate the effect of income and geographic diversification on the double bottom line of microfinance institutions (MFIs) in Middle East and North Africa (MENA) countries where conventional and Islamic MFIs coexist. The idea is to explore whether diversification impacts MFIs' financial performance and outreach differ for Islamic microfinance. Design/methodology/approach The authors test the effect of diversification and business models of MFIs on their performance and poverty outreach. The authors’ data set is an unbalanced panel sample of 81 (Islamic and conventional) MFIs in MENA countries covering 1999–2018, comprising 743 MFI-year observations. Findings The authors find that increasing income diversification in microfinance and focusing on rural areas decreases the financial performance of MFIs in MENA countries. Islamic MFIs benefit from income diversification by increasing their financial performance. The results provide evidence of a nonlinear relationship between income diversification and the financial performance of MFIs. Although conventional MFIs improve their depth of outreach by diversifying their income, Islamic MFIs have a lower breadth of outreach because they show a higher degree of income diversification. Practical implications This research contributes to the ongoing debate of whether MFIs should focus on or diversify their services to Islamic microfinance. Therefore, the findings of this study are practically crucial for MFIs' stakeholders to understand the contribution of diversification strategies in improving the Islamic MFIs to achieve both financial and social objectives. Originality/value To the best of the authors’ knowledge, it is the first research that addresses the impact of diversification strategies in Islamic microfinance. Additionally, using a panel data set of conventional and Islamic MFIs in MENA countries spanning 1999–2018, this study provides empirical evidence on the diversification versus focus issue from the microfinance industry and the subset of Islamic microfinance.

Iran‐Africa Relations under Raisi: Salvaging Ties with the Continent

The Muslim WorldEarly View Article Iran-Africa Relations under Raisi: Salvaging Ties with the Continent Eric Lob, Corresponding Author Eric Lob [email protected] Florida International UniversitySearch for more papers by this author Eric Lob, Corresponding Author Eric Lob [email protected] Florida International UniversitySearch for more papers by this author First published: 26 February 2023 https://doi.org/10.1111/muwo.12464 1 A shorter version of this article was previously and originally published as the following article: Eric Lob, “Iran-Africa Relations under Raisi: Salvaging Ties with the Continent,” Middle East Institute, (April 11, 2022), https://bit.ly/3T9PbKf. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

Middle East Authors' Contribution to the Journal of Arthroplasty's Publications in the Past 20 years (2000-2020).

BackgroundThis study aimed to evaluate the Middle East (ME) countries' contribution to the Journal of Arthroplasty (JOA)’s publications in the past 20 years.MethodsAll articles published in JOA from 2000 to 2020 were evaluated for the contribution prevalence of ME countries’ authors, which were divided into category I, if all the authors were affiliated to ME institutions, and category II, if at least one coauthor affiliated to ME institutions was listed in the articles with other international authors.ResultsA total of 7837 original articles were evaluated. Authors affiliated with ME institutions contributed to 144 (1.8%) articles (148 individual country contributions) from ten (62.5%) out of a total of 16 ME countries. Sixty-eight articles (47.2%) were classified as category I; cooperation between different ME institutes (The authors were from two different ME countries.) was reported in two (1.4%) articles. The top five contributing countries were Egypt, Iran, Israel, Saudi Arabia, and Turkey, contributing 89.2% of the total articles published by ME institutions. Out of the 144 articles, 80 (55.6%) articles were published between 2016 and 2020, 37 (25.7%) articles between 2011 and 2015, and 29 (20.1%) articles between 2000 and 2010. There was a 15.7% mean annual growth in the percentage of ME articles.ConclusionAlthough there was an increasing trend in the contributions of ME countries' authors to JOA publications over the past 20 years, the overall contribution is still low; moreover, the cooperation between ME institutions is minimal.

Comorbidities and Negative Prognostic Factors in Lebanese Patients Presenting with Acute Decompensated Heart Failure with Preserved Ejection Fraction: A Multicenter Retrospective Study

Background: Congestive heart failure is responsible for repeated hospital admissions. It is classified into three types: (1) Heart Failure with reduced ejection fraction, (2) Heart failure with mid-range ejection fraction, and (3) Heart failure with preserved ejection fraction (HFpEF). It is essential to describe the risk factors of HFpEF patients' profiles as targeting them is crucial for management. Aim: Our retrospective study aims to identify the clinical and echocardiographic characteristics associated with HFpEF and its mortality among hospitalized patients with acute decompensated heart failure. Methods: 390 patients of all age groups presenting with acute heart failure decompensation at Mount Lebanon Hospital (MLH) and Middle East Institute of Health (MEIH, Bsalim) were recruited retrospectively between January 2014 and December 2016. We included 133 cases of HFpEF and collected data on each case including: baseline characteristics and comorbidities, electrocardiograms, laboratory studies, and echocardiographic parameters. Results: The 133 Lebanese patients having HFpEF were elderly (76 ± 10 years), with predominantly female gender (56%). Hypertension (87.96%) and diabetes (53.38%) were the most frequently reported comorbidities. The overall in-hospital mortality was 4.5%. Data was compared between living and deceased patients and the frequency of valvular heart disease (p=0.005) and chronic kidney disease (p=0.018) was significantly higher among deceased patients. Right ventricular (RV) dilation on echocardiography was significantly correlated with mortality. Elevated troponin, increased creatinine, hypochloremia, hyponatremia, and anemia were all lab markers associated with increased mortality (p&lt;0.05). Conclusion: Patients with HFpEF represent 43.5% of all decompensated HF cases, with chronic kidney disease, valvular heart diseases, anemia and troponinemia, being the predominant risk factors for adverse clinical outcomes. HFpEF remains an enormous burden on cardiologists for appropriate evaluation, triage, and management.

Comparaison entre Stump Cylinder et moule personnalisé, effet de la forme de l’applicateur sur la distribution de dose

PurposeThe purpose of this study was to compare the efficacy of two applicators used in high dose rate vaginal brachytherapy. The first is the Stump Cylinder used in the “brachycenter” department at the Middle East Institute of Health in Lebanon and the second is the custom mold used in the radiotherapy department at Tenon Hospital in France. Materials and methodA comparison of the clinical target volume and the doses received by the rectum and bladder was performed in order to determine the best method of treatment and to optimize the dose distribution. 95 patients were treated in both departments. ResultsThe average values of the D95% dose received by the CTV were respectively 89.43% for the Stump Cylinder and 110.16% for the custom mold. The conformity index was 0.84 for the Stump Cylinder while it was 0.97 for the custom mold, which ensures a better dose distribution. For the rectum, the maximum dose D2cc taken by volume was 71.23% for the Stump Cylinder and 79.51% for the custom mold. The bladder was better protected with Stump Cylinder with a D2cc value of 65.81% against 94.88% for the custom mold. ConclusionThe underdosing obtained using the Stump Cylinder was due to the shape of upper part of the cylinder which was not conform with the shape of the vaginal vault in women. A better protection of the organs at risk was observed with the Stump Cylinder since the dose taken by the rectum and bladder using a custom mold can reach the tolerance limits.

Genomic Features ofVibrio parahaemolyticusfrom Lebanon and Comparison to Globally Diverse Strains by Whole-Genome Sequencing

Gastroenteritis is a disease that can be caused by virulent strains of Vibrio parahaemolyticus in humans upon the consumption of contaminated seafood. In summer 2017, a sudden increase in the number of patients suffering from gastroenteritis due to a V. parahaemolyticus infection was observed at the Middle East Institute of Health University Hospital in Lebanon. The aim of this study was to analyze the isolates recovered from stool specimens, and to compare them using different phenotypic assays, genomic profiling techniques, and whole-genome sequencing, to achieve a better understanding of the current V. parahaemolyticus strains available in Lebanon. Virulence potential was analyzed based on the detection of the hemolysins: thermostable direct hemolysin (tdh), thermostable direct hemolysin-related hemolysin (trh), and thermolabile hemolysin (tlh). Resistance was determined by testing antibiotic susceptibility and performing PCR assays for β-lactamases and quinolone resistance determinants. Genetic relatedness was verified by multilocus sequence typing, pulsed-field gel electrophoresis, and whole genome-based single nucleotide polymorphism analysis. All of the isolates had the tdh+, trh-, group-specific PCR+ genotype, which is a characteristic of the O3:K6 pandemic clone. The isolates were resistant to ampicillin (100%), ceftazidime (86%), ticarcillin (14%), and amikacin (14%), belonged to the sequence type ST3, and had very similar phylogenetic fingerprints. The isolates undertaken in this study exhibited almost identical resistance, virulence, and phylogenetic patterns, confirming an outbreak linked to the spread of the pandemic O3:K6 serotype in the country.

Nipple sparing mastectomy in breast cancer: extended indications. The Middle East Institute of Health experience

Introduction:Nipple-sparing mastectomy (NSM) is offered as a surgical treatment for breast cancer. It preserves the skin overlying the breast and the nipple areola complex. In this study, we review our experience with NSM, performed for both early and advanced breast cancer patients.

The impact of gender matching between donor and recipient on the outcome of kidney transplant patients: A retrospective study.

The influence of donor and recipient gender on patients postkidney transplant (KT) is still controversial, and literature data do not present unanimous conclusions. We were concerned with the gender impact on the outcome of kidney transplantation at the level of acute rejection (AR), graft function represented by serum creatinine level, delayed graft function (DGF), graft survival, and infection rate. The impact of gender matching between donors and recipients was studied in 299 KT recipients performed in the Transplantation Unit, Middle East Institute of Health, Bsalim, Lebanon, between November 1998 and September 2014. The patients were divided into the following groups: Group I (131 patients, male donor to male recipient), Group II (55 patients, male donor to female recipient), Group III (88 patients, female donor to male recipient), and Group IV (25 patients, female donor to female recipient). AR and DGF were not statistically different among the four groups. Moreover, all groups showed excellent graft survival with no statistical difference. Interestingly, human leukocyte antigen AB-DR matching (P < 0.001) and sensitization were statistically different among the four groups (P = 0.05). The number of patients with infections was statistically significantly lower in Group I (35.4%) and Group III (37.5%) (P = 0.35). Most importantly, graft function, represented by serum creatinine, showed a statistically significant difference among the four groups (P <0.004), with Group II (male to female) and Group IV (female to female) showing the best improvement in five-year survival. However, Group III (female to male) had the worst posttransplant graft function. These results revealed that gender impacts graft function, and Group II, male donor to female recipient, had the best 5-year graft function. This emphasizes that gender should be regarded as a determinant for the success of kidney transplantation.

Crowned dens syndrome: a case report followed by an update on differential diagnosis and treatment

Introduction Crowned dens syndrome (CDS) is a rare clinical presentation of chondrocalcinosis or calcium pyrophosphate crystal deposition (CPPD) disease, characterized by fever, neck pain and stiffness, associated with increased biological markers of inflammation. Diagnosis is made mainly via imaging, and the best modality remains the magnetic resonance imaging (MRI) of the neck showing calcification and calcium pyrophosphate crystals deposition around the odontoid process (1). The aim of this report is to increase awareness of this rare and ill-known clinical tableau and to review its complications and the latest modalities of its diagnosis and treatment. Clinical case: An 83-year-old female patient presented to the emergency department (ED) of the Middle East Institute of Health (MEIH) with severe acute onset neck stiffness and pain of 10/10 intensity, radiating to the submandibular area and reaching the occipital part of the head, associated with nausea and 2 episodes of chills one day prior to presentation. Patient denied any recent history of trauma or surgery of the head and neck. Physical exam at that time was only remarkable for marked limitation of neck motion, and positive Kernig and Brudzinski signs. No skin changes, facial sinuses tenderness, cervical lymphadenopathies or neck swellings were noted. Vital signs at ED were within normal range except for a low grade fever. Laboratory work-up upon presentation showed hyperleukocytosis (WBC = 14000/mm3) with left shift and a C-reactive protein (CRP) of 189 mg/L (0-5 mg/L). Chest X-Ray only showed degenerative osteoarthritis of the thoracic spinal vertebrae. CT-scan of the brain without IV contrast done urgently showed no acute changes. As Clinical and biological features were suggestive of acute meningitis, cultures were taken including blood, urine and CSF fluid from lumbar puncture. The patient was admitted to the hospital for IV antibiotic treatment with a large spectrum carbapenem and close observation. On next 2 days, the patient continued to develop low grade fever with a fluctuating pattern, and levofloxacin and amikacin shots were added for maximal bacterial coverage. Urine and blood culture yielded positive for Escherichia Coli only resistant to penicillin. CSF fluid analysis and culture was unremarkable. So, the patient continued to receive IV antibiotics for urinary tract infection and bacteremia. And although the cultures were sensitive to the antibiotics given, the patient continued to suffer from fever, headache, neck stiffness with minimal improvement and response to IV acetaminophen. Laboratory markers continued to increase and CRP reached 325. The patient then underwent a series of imaging and laboratory tests to determine the cause of fever, including CT-scan of the chest, abdomen and pelvis with IV contrast, widal, wright, Rose Bengal, stool analysis, stool culture, clostridium difficile toxins, transthoracic and transesophageal cardiac ultrasound that were all negative. Finally, neck MRI was done to rule out spondylodiscitis or a cervical abscess and showed evidence of osteoarthritis on multiple cervical spinal levels, calcification of the odontoid process of C2, and thickening of the synovium and posterior ligaments (Fig C – D). Those results were compatible with a CT-scan of the neck then done and was in favor of a corona of calcification around the odontoid process suggesting a crowned dens syndrome (Fig A – B). The patient was put on colchicine therapy, and started to improve slowly, then corticosteroids were added and yielded a faster improvement. The C-reactive protein finally started to drop until reaching 23 mg/L upon the discharge. The patient was finally discharged on NSAIDs and colchicine. And after 1 month, the patient was seen in an outpatient setting where she reported dramatic improvement of her symptoms.

Bibliometric analysis of global migration health research in peer-reviewed literature (2000\u20132016)

BackgroundThe health of migrants has become an important issue in global health and foreign policy. Assessing the current status of research activity and identifying gaps in global migration health (GMH) is an important step in mapping the evidence-base and on advocating health needs of migrants and mobile populations. The aim of this study was to analyze globally published peer-reviewed literature in GMH.MethodsA bibliometric analysis methodology was used. The Scopus database was used to retrieve documents in peer-reviewed journals in GMH for the study period from 2000 to 2016. A group of experts in GMH developed the needed keywords and validated the final search strategy.ResultsThe number of retrieved documents was 21,457. Approximately one third (6878; 32.1%) of the retrieved documents were published in the last three years of the study period. In total, 5451 (25.4%) documents were about refugees and asylum seekers, while 1328 (6.2%) were about migrant workers, 440 (2.1%) were about international students, 679 (3.2%) were about victims of human trafficking/smuggling, 26 (0.1%) were about patients’ mobility across international borders, and the remaining documents were about unspecified categories of migrants. The majority of the retrieved documents (10,086; 47.0%) were in psychosocial and mental health domain, while 2945 (13.7%) documents were in infectious diseases, 6819 (31.8%) documents were in health policy and systems, 2759 (12.8%) documents were in maternal and reproductive health, and 1918 (8.9%) were in non-communicable diseases. The contribution of authors and institutions in Asian countries, Latin America, Africa, Middle East, and Eastern European countries was low. Literature in GMH represents the perspectives of high-income migrant destination countries.ConclusionOur heat map of research output shows that despite the ever-growing prominence of human mobility across the globe, and Sustainable Development Goals of leaving no one behind, research output on migrants’ health is not consistent with the global migration pattern. A stronger evidence base is needed to enable authorities to make evidence-informed decisions on migration health policy and practice. Research collaboration and networks should be encouraged to prioritize research in GMH.

Sejarah Nalar Diplomasi Politik Indonesia di Kawasan Timur Tengah

The historiography of Indonesian political diplomacy in the Middle-East regions faces obstacles from the researchers themselves. The perspective contradictions are compounded by sorting data and sources. The appearance of Indonesian political diplomacy in the Middle East regions according to the Middle East researchers and academics themselves seems to be gloomy and lethargic, because they demand more than what Indonesia has achieved and done. Indonesia is considered not too interested in contributing to the recovery of conflict countries and the acceleration of the transition to democratic values. According to the other researchers who are not based on the Middle East institutions, the appearance of Indonesian political diplomacy in the Middle East is quite positive and slightly vague. Unlike the case with the version that came out directly from the Government of the Republic of Indonesia about their achievements and performance in building diplomatic relations with related countries in the Middle East. Some achievements are recorded annually and submitted to the public in their annual reports. The constraints in historical writing can be overcome by the historical reasoning approach which tries to examine reason, thought and awareness, and which not only focuses on historical facts and events themselves. This approach is able to map the narrative contestation and discourse ideology, and find solutions to the problems.

Evolution and Outcome of Eight Patients Undergoing Treatment of Gastroesophageal Disease by Esophyx

Background: Gastroesophageal reflux disease (GERD) is arguably the most common disease encountered by the gastroenterologist. It is mainly caused by defects in the lower esophageal sphincter (LES) that induces spontaneous transient LES relaxations (tLESRs). This is a chronic condition with typical and atypical, sometimes troublesome manifestations requiring long term treatment. Anti-reflux surgery is an alternative option. The TIF (transoral incisionless fundoplication) procedure by offering some advantages over surgery could be recommended for patients whose symptoms recur upon discontinuation of the medications. This study intended to assess the safety and efficacy of TIF for treating GERD. Methods: A prospective trial was conducted at Lebanese Hospital Geitaoui University Medical Center and Middle East Institute of Health in Lebanon, on 8 patients, age 28-55 years, with chronic GERD, symptoms (>5 years), undergoing EsophyX procedure and followed for 1 year after their procedure. Information concerning the patients was gathered using an international questionnaire (GERD-HRQL, Health Related Quality of Life questionnaire) filled by the treating physician. Results: When compared to scores before TIF and without medications, the GERD-HRQL scores were significantly reduced one year after the procedure. Regurgitation experienced was reduced to 62.5% compared to 75% while patients were off PPI. Symptoms free (GERD-HRQL score ≤ 12) achieving complete cessation of medications, were reported by 25% of patients. Overall 37.5% of patients were satisfied, 12.5% neutral, and 50% less satisfied with their results.

Epidemiology of Helicobacter pylori Infection among Symptomatic Patients, Correlation with Endoscopic Findings and it’s Association with Type II Diabetes Mellitus

Background: Helicobacter pylori (H. pylori) is an important global pathogen infecting approximately 50% of the world’s population. This study was undertaken in order to estimate the prevalence of Helicobacter pylori infections among symptomatic patients in Lebanese Hospital Geitaoui University Medical Center (HLG-CHU) and Middle East Institute of Health (MEIH), to investigate the associated risk factors, the endoscopic findings and its association with type 2 diabetes. Method: This is an observational analytic case-control study, carried out over a period of 6 months, from January 2016 till June 2016, including all patients complaining of upper gastrointestinal (GI) symptoms. The patients (n=226) were enrolled following same protocol in both the hospitals. All subjects completed a validated questionnaire and underwent upper GI endoscopy. The histo-pathological diagnosis of H. pylori infection in biopsy specimen was done using the modified Giemsa stain. H. Pylori prevalence and associated factors were analysed by Students t-test, Chisquare test and Fisher exact test. Statistical analysis was performed using the statistical program SPSS version 22. Results: The overall prevalence was 38.9% with no difference between sexes. There was no association with age, residential region, alcohol and caffeine use and smoking. Low level of education and non-steroidal anti-inflammatory (NSAIDs) use were the only significant factors. Bloating, nausea and early satiety were significant predictors of H. pylori infection. The most commonly identified endoscopic finding was gastritis (78.3%), only duodenitis and oesophagitis were significantly associated with H. pylori. Prevalence of H. pylori was 38.8% and 39%, respectively, in patients with diabetes and having no diabetes. Conclusion: H. Pylori prevalence was found to be high. Individuals who had low educational level and NSAIDs consumers, were under higher risk of infection than others. H. pylori infection appears not to be associated with diabetes.

Institutional transformation and the origins of world income distribution

This paper presents an attempt to quantify institutional changes and examine the respective effects of de jure and de facto political institutions on the path of long-run economic growth and development for a large panel of countries in the period 1810–2000. Using factor analysis, latent indices of de jure and de facto political institutions are constructed by exploiting several existing institutional datasets. The empirical evidence consistently suggests that societies with more extractive political institutions in Latin America, South Asia, Middle East and Eastern Europe have achieved systematically slower long-run economic growth and failed to catch-up with the West. The evidence confirms the primacy of de facto institutional differences over de jure institutions in causing differential growth and development outcomes over time. It also explains why highly concentrated political power and extractive political regimes inhibited the path of economic growth by setting persistent barriers to the engagement in collective action. In the long run, institutional differences account for up to two thirds of within-country development path and up to 83% of between-country development gaps.

Uncertainties of “in vivo” Dosimetry Using Semiconductors

The purpose of the present study is to evaluate the uncertainties of in vivo dosimetry measured with diode detectors for conformal radiation therapy techniques in order to define appropriate tolerance levels for pelvis and breast treatment in MEIH (Middle East Institute of Health). The present work is carried out on 30-472 and 30-473 diode detectors irradiated by 4 and 15MV photon beams of a medical linear accelerator Synergy from ELEKTA. Dose computation is performed with Pinnacle 7.4 k treatment planning system. First, an estimation of the uncertainties in a simple geometric case, using a water-equivalent solid phantom is done. Secondly, each treatment parameter such as field size, beam angle, beam modifiers and source-skin distance is evaluated in order to simulate the conformal radiation treatments used in the present institution for the main anatomical sites. Interpretation of entrance dose in-vivo measurements requires the determination of appropriate tolerance levels. Indeed, the authors found that the 5% action level proposed in the literature underestimates the uncertainties in the treatment process. A method for the evaluation of tolerance/action levels related to the different anatomical sites is developed. By the end of the present study the authors have developed an integrated monitoring system that offers accurate information about the dose received by patients.

10. Nipple sparing mastectomy in breast cancer: Extended indications, the Middle East Institute of Health experience

Background: Nipple-sparing mastectomy (NSM) is one of the procedures offered as part of the surgical treatment for breast cancer. It involves a mastectomy with preservation of the skin involving the breast and the nipple areola complex. Immediate reconstruction, with a tissue expander was performed for a more favorable cosmetic outcome. This study reviews our experience with NSM, performed for patients with early and advanced breast cancer.

Employee sexual harassment policies and Kuwait transnational higher education

Transnational higher education providers based in the West are increasingly partnering with newer institutions in the Middle East. The present study investigates the extent to which workplace sexual harassment prevention policies are prevalent across the Western universities’ home country campuses and their partner institutions in Kuwait. Policies were collected from Kuwait and their foreign partner institutions’ websites followed up by e-mailed and telephoned requests. The policies were coded for characteristics such as procedures for investigation of sexual harassment complaints, training for sexual harassment prevention, sanctions, etc. Results suggest that foreign partner schools appear more likely to make policies available (58%) than campuses based in Kuwait (40%). The foreign institutions’ policies tend to have more of the prevention characteristics than those for Kuwait schools. Development of workplace sexual harassment policies is becoming essential for human resources management in the Middle East as the workforce grows in gender diversity.

The Arab Spring and the Indian Urdu Press

63 Journal of South Asian and Middle Eastern Studies Vol. XXXVI, No.1, Fall 2012 The Arab Spring and the Indian Urdu Press Mohamed Muddassir Quamar* The Arab world is going through a kind of churning for more than one year. Several social, economic, cultural and political factors including corruption, unemployment and bad governance have been cited as the underlying reasons for this unrest.1 The changes might not result in shortterm political stability or long-term ushering in of democracy to the Arab countries. While the outcome remains uncertain, rulers and governments in the region have to become more accountable, have to pave way for reforms or face being overthrown. The developments in the region began after the self-immolation of Tunisian street vendor Muhammad Bouazizi in December 2010. It triggered a massive protest against the Tunisian President Zine El Abidine Ben Ali. The “Jasmine Revolution”, as it was termed by many, had a domino effect on other countries and is collectively known as the Arab Spring.2 The events were widely covered by Arab, regional and international media. How was Arab Spring reflected in the Urdu media in India, where there lives the third largest Muslim population in the world after Indonesia and Pakistan?3 Historically, India has strong political, economic, cultural and *Md Muddassir Quamar is a Doctoral Candidate at the Centre for West Asian Studies, School of International Studies, Jawaharlal Nehru University, New Delhi, India. 1 Sean Foley, “The Arab Awakening and the New Disorder of Hope”, Occasional Paper, Middle East Institute, New Delhi, October 3, 2011, http://mei.org.in/front/cms/ publicationsDetail.php?id=MzA3&cid=Ng==. 2 There are criticisms over the expression Arab Spring. For example see, Rami G. Khouri, “Drop the Orientalist term “Arab Spring””, August 17, 2011, http://www.dailystar.com.lb/ Article.aspx?id=146410#axzz1v74UhBNx. 3 “The Future of the Global Muslim Population: An Interactive Feature, Sortable Data Tables: Muslim Population by Country”, The PEW Forum on Religion & Public Life, January 2011, http://features.pewforum.org/muslim-population/. 64 energy relations with the region.4 The presence of an estimated six million Indian expatriate population in the region makes it strategically very important for India. Seen in this wider context this research looks at the Urdu press in India and their coverage and responses to the “Arab Spring”. Urdu Media in India The Muslim-Urdu linkage is highly debated within India.5 Many leaders see this as the communalization of language and culture and periodically warn against such tendencies.6 According to the preliminary 2011 census figures, India’s Muslim population stands at 150 million and that of Urdu speaking population at 55 million.7 In other words, Urdu is not the lingua franca of every Muslim in India. At the same time, it is necessary to recognize that over time, especially since the partition of the sub-continent, popular perceptions about the linkage has strengthened. While it is not the exclusive language of the Indian Muslims, a significant majority of Urduspeaking population are Muslims. This Urdu speaking population is spread all over the country from Kashmir in the North to Tamil Nadu in the South and from Assam in the East to Gujarat in the West. The nature and extent of influence of this population upon India’s policy is debatable but political developments in the Middle East generate considerable interest, attention and at times protest from the Muslim community. India’s policy towards the Arab world as well as towards the three non-Arab countries of the region, namely, Iran, Israel and Turkey, are widely debated within the community. Therefore, the Urdu press can be seen as one of the most important medium of expression for the Indian Muslim population. There are more than a dozen major national and regional Urdu dailies/periodicals published from different parts of the country. These newspapers in comparison to other regional language dailies devote more attention to the developments in the Middle East. The Arab Spring has also been 4 For details see, S. Maqbul Ahmad, Indo-Arab Relations: An Account of India”s Relations with the Arab World from Ancient up to Modern Times (New Delhi: ICCR, 1969); and Prithvi Ram...