SummaryThere is a need for cellular biomarkers to differentiate patients with sepsis from those with the non-infectious systemic inflammatory response syndrome (SIRS). In this double-blind study we determined whether the expression of known (CD11a/b/c, CD62L) and putative adhesion molecules [CD64, CD97 and epidermal growth factor (EGF)-like molecule containing mucin-like hormone receptor (EMR2)] on blood neutrophils could serve as useful biomarkers of infection and of non-infectious SIRS in critically ill patients. We studied 103 patients with SIRS, 83 of whom had sepsis, and 50 healthy normal subjects, using flow cytometry to characterize neutrophils phenotypically in whole blood samples. Patients with SIRS had an increased prevalence of neutrophils expressing CD11c, CD64 and EMR2 in comparison with healthy subjects (P < 0Á001), but normal expression of CD11a, CD11b, CD62L and CD97. An increase in the percentage of neutrophils bearing CD11c was associated with sepsis, EMR2 with SIRS and CD64 with sepsis and SIRS. Neutrophils expressing CD11c had the highest sensitivity (81%) and specificity (80%) for the detection of sepsis, and there was an association between the percentage of neutrophils expressing EMR2 and the extent of organ failure (P < 0Á05). Contrary to other reports, we did not observe an abnormal expression of CD11b or CD62L on neutrophils from patients with SIRS, and suggest that this discrepancy is due to differences in cell processing protocols. We propose that blood neutrophils expressing CD11c and EMR2 be considered as potential biomarkers for sepsis and SIRS, respectively.

In the 21st century, the way of learning has changed based on sophisticated technology. The use of technology tools is a basic necessity in today's education. In the meantime, interactive games are one of the most famous and effective technology tools in teaching and learning. Interactive games have been used to facilitate learning of reading skills. There is a need to pay attention to reading skills to improve and encourage Literacy Numeracy Screening (LINUS) students to engage and be responsible for their own learning. Many studies have shown that interactive games are capable of helping students improve their reading skills. However, researchers found that the existing interactive games do not emphasize on reading skills. In addition, the games have failed to sustain students' attention in learning because they are not empowered with gaming elements for learning purpose. These issues indirectly have limited active participation of students. The purpose of this paper is to identify slow learners' difficulties in reading literacy and develop Reading Literacy Interactive Games by incorporating the relevant pedagogical elements namely 5 Gaming Elements for Effective e-Learning by Kapp which listed 5 principles which engage learners into subject learning. The research method focuses on following stages: requirement analysis, design and development including alpha testing by validation from expert and beta testing which is user acceptances test to support efficiency and effectiveness of the courseware for further improvement. The result from the alpha and beta testing indicates a positive feedback on Reading Literacy Interactive Games (RLIG).

The technology-based learning process is able to influence pupils on learning and teaching, especially the use of interactive games can transform the way learning of problematic learners in reading skills. Although interactive games are said to be very effective in learning but there are still many technical and implementation shortcomings on remedial education students which identified as slow learners. This paper focuses on technical and implementation issues which restrict the effective integration of Reading Literacy Interactive Games (RLIG) in learning of reading skill among slow learners. The aim of this study is to investigate the critical issues and develop the effective RLIG in order to fulfill the slow learners’ needs. Therefore, a need-analysis was conducted to investigate the issues of technical and implementation of RLIG among slow learners. The findings revealed that there are many technical and implementation issues that restricted slow learners from adapting RLIG in the process of teaching and learning. The findings of this research can assist educators to improve the development of RLIG by incorporating relevant pedagogical approaches and game-based features in the development process