bluuebunny/crossref_metadata_2025 huggingface dataset:
MicroRNA-181a* targets nanog in a subpopulation of CD34+ cells isolated from peripheral blood
Authors: Emara Mohamed , Mintz Paul , Sætrom Pal , Reebye Vikash , Lundbæk Marie B , Nicholls Joanna P , Habib Nagy A , Haoudi Abdelali
Published: October 2012

Background and Objectives:
Hematopoietic stem cells (HSC) are the most widely studied and characterized adult stem cells, which play an essential role in sustaining the formation of blood and immune system. The ease of their manipulation, the lack of serious ethical issues, and, in the autologous setting, the absence of their immunogenicity, have made them an attractive tool for developing stem cell-based therapies. Exploiting the properties of HSC by microRNA (miRNA) profiling offers an attractive approach to identify new regulators of stem cell fate. Although numerous miRNA have been screened from hematopoietic stem cells (HSC), the targets corresponding to many of these miRNA have not yet been fully elucidated. Therefore the objective of this study is to generate a miRNA profile from a subpopulation of adherent CD34+ HSC isolated from G- colony-stimulating factor mobilized peripheral blood aiming to understand the role of selected miRNA in regulating HSC stemness.

Methods:
CD34+ cells from patients' blood were isolated using a CD34+ isolation kit (Miltenyi Biotec) according to the manufacturer's protocol. miRNA profiling of adherent and nonadherent CD34+ cells was done using TaqMan Array MicroRNA Cards. Nanog expression levels was tested using a dual-luciferase reporter construct for miR-181a* or its mutant variant and Nanog 3′ UTR mRNA.

Results:
In this study, we have identified eight clusters of miRNA that were differentially expressed in an adherent subpopulation of CD34+ stem cells. Further analysis of one of the clusters by bioinformatics revealed that a miRNA, miR-181a*, which is highly expressed in the adherent CD34+ cells, affects the expression levels of Nanog, a stem cell surrogate marker. We show specifically by reporter assay and mutational analysis that miR-181a* targets a seedless 3′ compensatory site in the 3′UTR of Nanog and affects gene expression. We demonstrate that inhibiting miR-181a* upregulates the Nanog expression level, in addition to an increase in alkaline phosphatase activity.

Conclusions:
In conclusion, our results highlight a new stem cell-related target for the miR-181 family and show that miR-181a* directly targets Nanog in a subpopulation of CD34+ stem cells suggesting a possible role of miR-181a* in regulation of adherent CD34+ HSC cells stemness.
Challenges of reliability testing in Qatar: Patient willingness for participation by mail or in person in a novel research instrument in Doha, Qatar.
Authors: Khidir Amal , Elnashar Maha , Abdelrahim Huda , Hammoud Maya , Asad Humna , Fetters Michael
Published: October 2012

Background:
Novel survey instrument development requires reliability testing, but limited information informs the preferred approach in Qatar. The testing of survey characteristics of the Multi-Cultural Assessment Inventory-Qatar (MAI-Q), a novel multicultural assessment tool in Arabic, English, Hindi and Urdu, provided the opportunity to investigate survey distribution procedures.

Objective:
To determine willingness to participate, and response rates during survey reliability testing by mail and in person.

Methodology:
To examine participation preferences and rates, patients were recruited through HMC and six primary health centers. When recruited, subjects could choose to take the MAI-Q a second time for the reliability testing in person or by mail. Subjects were either scheduled for follow-up in-person, or were sent the survey in a prepaid, preaddressed envelope.

Results:
Among 387 subjects who initially took the survey, 177 (46%) declined taking the survey a second time for reliability testing. Of 210 subjects who agreed to take the survey a second time for reliability testing, 145/210 (69%) chose mail, and 65/210 (31%) were offered and chose in person follow-up. Actual follow-up to complete reliability testing was only 29/145 (21%) by post but 40/65 (63%) in person.

Conclusion:
These findings reveal challenges researchers face when developing and distributing surveys in Qatar. Nearly half of subjects initially recruited were not willing to participate in follow-up testing. Among those agreeing to follow-up testing, the majority chose mail, but only a fifth of them returned instruments. The majority of subjects who chose in person follow up completed testing. These data inform researchers about the tough choices for developing and conducting surveys in Qatar.
Clinical Research activity in Qatar and the WHO Eastern Mediterranean region: A quantitative analysis.
Authors: Ali Raghib , Bener Abdul Bari
Published: October 2012

Background and Objectives:
Clinical research has led to some of the most important advances in improving human health including the discovery of important risk factors for heart disease, diabetes and cancer as well as treatments for common diseases which have led to unprecedented increases in life expectancy. Unfortunately despite having nearly 600 million people, the Eastern Mediterranean region (EMR) is one of the most underdeveloped parts of the world in terms of clinical research (3.1 clinical studies per million people versus a global average of 19 per million.) However, this overall figure masks important differences between the 22 countries of the EMR and our objective was to quantify clinical research activity in Qatar and other countries of the EMR.

Methods:
We used data from clinicaltrials.gov (a registry of publicly and privately supported clinical studies of human participants) which lists all clinical research studies being conducted in every country. We quantified clinical research activity by dividing the number of studies in each country by its population to get the metric number of clinical studies per million people.

Results:
Qatar had the second highest clinical research activity in the EMR at 18 studies / million people. There was a very wide variation in the number of studies ranging from 36 / million people (Lebanon) to 0 studies / million people (Somalia) with the average across the region being 3.1. Full results are shown in Table 1.

Conclusion:
Qatar's level of clinical research activity was far above the average for the region and almost reaches the global average. This is a remarkable achievement considering that clinical research only began in Qatar a few years ago. Given Qatar's commitment to, and funding for, clinical research it is likely that Qatar will become the regional leader in clinical research in the near future.
Design of new high resolution quadratic time-frequency distributions for monitoring newborn health outcomes
Authors: Ben Jabeur Taoufik , Boashash Boualem
Published: October 2012

Background:
In order to monitor the health of new borns , high performance sensors are placed on the body to record information from different organs: nervous system (EEG signals), heartbeat and fetal movement (accelerometer signals). As the received data are non-stationary signals, Quadratic Time-frequency distributions (QTFDs) are often used to represent the energy, temporal and spectral characteristics of these signals. The suitable QTFD should conserve a high resolution and removes the cross-terms artifacts given by inner- and outer- terms. The inner-terms artifacts are observed in mono-component signals. Due to the Quadratic form of the QTFD, outer-terms are added to inner-terms if the signal contains more than one component.

Recent QTFDs such as Wigner-Ville distribution, Spectrogram, B distribution, Modified B-Distribution, Choi-Williams, focus on the elimination of outer-terms whereas few works dealt with the inner-terms artifacts.

Objectives:
This work aims at designing a new kernel that takes into account the presence of both inner-terms and outer-terms artifacts. The proposed QTFD should remove these artifacts while maintaining a high resolution.

Methods:
A theoretical analysis of the localization of the inner-terms is given. Based on this analysis, we propose first a new kernel that removes the inner-terms for mono-component signal. Multicomponent signals are also considered, in which case we extend the proposed kernel in order to take into account the presence of the outer-terms.

Results and conclusion:
The resulting TFDs are compared with other methods using several examples of mono-component and multi-component signals. Some real data representing EEG signals and fetal movement are also used. The different simulations indicate that the proposed TFDs are more efficient to the existing ones, leading to potential significant improvement in newborn health outcomes.

This work is supported by Qatar National Research Fund, NPRP project No 09-626-2-243
Liver image segmentation from CT data
Authors: Dakua Sarada Prasad , Abi-Nahed Julien
Published: October 2012

Background & Objectives
Despite its long track record, segmentation in medical image computing still remains an active field of research, largely due to the complexities of in-vivo anatomical structures. We present a novel segmentation algorithm based on chaotic theory; the preliminary results show the potential of the technique.

Methods:
Henri Poincare first developed (later revisited by Lorentz) this chaotic model by observing a significant deviation in output through his "three-body-system" when the input is varied even slightly. This theory can be applied to image segmentation ensuring deterministic convergence by keeping initial conditions constant. The scenario is analogous to "iron particles moving randomly in a cell and a strong magnet is suddenly placed on its center". Though the process is chaotic, now it becomes periodic and is easy to solve. The probability of a particle to reach the magnet can be found by solving the magnetostatic version of Laplacian equation. The image is treated as a graph; a seed point is placed both on foreground and background individually and the node potentials are calculated in each case. The label map is built by considering the maximum of two probabilities at a node. Finally, gradient operation on the label map determines the coordinates that carry nonzero value as the desired contour coordinates.

Results:
The qualitative results shown in Fig. 1 reflect the method accuracy when compared to the ground-truth data. The liver CT datasets are collected from MICCAI 2007 workshop. For a single image, it takes nearly 3 sec to complete the operation on a system with 2GB RAM core2duo processor.

Conclusions:
This paper has presented a fast and simple graph-based segmentation algorithm based on chaotic theory which is deterministic and time efficient. In future, we intend to explore its behavior on different subjects and modalities as well.
Uropathogens from Qatari type 2 diabetics with asymptomatic bacteriuria: Antibiotic sensitivity, virulence factors and phylogenetic groups of isolated Escherichia coli
Authors: Afifi Nahla , Al-Thani Asma , Ewis Soliman , Abu Abdullah Asmaa , Albardawil Haneen , Yasin Heba , Rouban Wazeera
Published: October 2012

The urinary tract infections (UTIs) are among the most common bacterial infections in diabetic patients, especially asymptomatic bacteriuria. The aim of this study is to investigate the causative organisms of ABU in type 2 diabetic patients, the phylogenetic grouping and the antibiotic sensitivity pattern of the causative organism in order to determine the drug of choice to cure ASB in diabetics. One hundred & sixty eight men were recruited from attendants of the out-patients clinics at the Army Force Medical Unit in Qatar and were divided into two groups; Group 1 (130 type 2 diabetics) and Group 2 (38 non-diabetic subjects). We found that 20% of diabetic patients had ASB and Escherichia coli was the most prevalent pathogen (92.31%). Genotypic study showed that the most prevalent E. coli groups responsible for UTI belonged to group A and B2 (33.3% for each group). Moreover , Nitrofurantoin was the most sensitive antibiotic for the groups B2, B1 ,D (100%) and 75% for group A. Phenotypic study by SEM showed that there is variation in the diameter. The B1 group had the largest width and length (L= 2.391 ± 0.483)(W=622.667 ± 51.215) while group D was the shortest (L=1.876 ± 0.247) and group A had the lowest width (W=580.21 ± 44.93). Further comparison of virulence factors with symptomatic diabetics is required to determine why ASB lacked symptoms in spite of the presence of virulent genes.
Automated feature detection on ECG waveforms
Authors: Palliyali Abdul Jaleel , Tafreshi Reza , Mohsin Nasreen , Tafreshi Leyla
Published: October 2012

This work presents the development of an algorithm for analyzing ECG waveforms. The identification of the various waveforms on an ECG is the first and most crucial step in any automated analysis. The algorithm developed is capable of detecting all important waveforms. These include the Q,R,S,R' and S' waves, J and ST points and onset and offset of P and T waves. The various techniques utilized in their detection include adaptive thresholding, parabolic curve fitting, modified derivatives and temporal coherence.

After detecting the waveforms, various measurements are obtained from the points detected. These include the polarity of the waveforms, the ST elevation, morphology of ST segment, QRS width and T wave morphologies. These measurements can easily be utilized for diagnosing the ECG for various abnormalities.

The developed detection and measurement algorithm stands out from previous works in a number of ways. It is comprehensive and capable of detecting all the important ECG waveforms. It works well even on atypical ECG beats with secondary R' and S' waves. The adaptive thresholding approach minimizes the dependence on fixed hard thresholds. The synchronous behavior of ECG recordings across leads is exploited to improve accuracy.

The performance of the algorithm was validated on 40 sample 12-lead ECG data of two minutes each. To validate performance on abnormal ECG waveforms, 20 datasets from patients diagnosed for myocardial infarction (MI) were included. An overall detection accuracy of 98.5% was obtained.
Primary coronary intervention for myocardial infarction in Qatar: First nationwide program
Authors: Yacoub Magdi , Gehani Abdurrazzak , Bonow Robert , Al Suwaidi Jassim , Al Tamimi Omar , Al Nabti Rahman , Arafa Salah , Abou-Ghazala Tarek , Al Qahtani Awad , Arabi Abdul Rahman
Published: October 2012

We have designed the first nationwide primary percutaneous coronary intervention (PPCI) program for ST elevation myocardial infarction (STEMI) in Qatar. Guidelines emphasize the door to balloon time (DBT) which should not exceed 90 minutes. This interval reflects the efficiency of the hospital system in the rapid recognition and transfer of the STEMI patient to the catheterization laboratory for PPCI. Although DBT is clearly important and is in the forefront of planning for the wide PPCI program, it is not the only important time interval. Myocardial necrosis begins before the patient arrives to the hospital and even before first medical contact, so time is of the essence. Therefore, our primary PCI program includes a nationwide awareness program for the population and for health care professionals to reduce the pre-hospital delay. We have also taken steps to improve the pre-hospital diagnosis of STEMI. In addition to equipping all ambulances to perform 12-lead ECGs we will establish advanced wireless transmission of the ECG to our heart center and to the smart phone of the consultant on-call for the PPCI service. This will ensure that the patient is transferred directly to the cath lab without unnecessary delay in the emergency rooms. A single phone-call system allows the first medic making the diagnosis to activate the PPCI team. The emergency medical system is acquiring capability to track the exact position of each ambulance using GPS technology to give an accurate estimate of the time needed to arrive to the patient or to the hospital. We also plan for medical helicopter evacuation from far or inaccessible areas. A comprehensive research database is being established to enable specific pioneering research projects and clinical trials, either as a single center or in collaboration with other regional or international centers. The PPCI program is a collaborative effort between the HMC and the QCRC. Qatar will be the first country in the world to have a unified nationwide PPCI program. This program is a model that may be adopted regionally and in developing countries to improve outcomes of patients with STEMI.
Influence of sedentary lifestyle on body weight in Qatari school children
Authors: Alkhateib Mahmoud Abdallah , Al-Zoghbi Mohammed , Saleh Mohammed , Qutba Hamda
Published: October 2012

Background & Objectives:
School children among the most vulnerable groups that pass critical periods of physical, mental, and developmental growth are in need of special nutrition and health care. Little is known about the nutritional status of school children in Qatar. The aim of the present investigation is to determine the anthropometrics measurements (height, weight and body mass index) of Qatari school children, comparing the study results with the international reference population and to determine the relationship between obesity and lifestyle.

Methods:
Study was conducted on a sample from Qatari school children. A representative sample (1500 children) were selected between the ages of 6-12 from 23 schools using multistage cluster random sample, while 200 cases from each age group were targeted as primary sampling unit. Data about number of physical education classes, hours of physical activity per week, and information about the sedentary life style were obtained by utilizing a standardized self-administered questionnaire.

Results:
The current results showed that the percentage of body weight for Qatari children were significantly higher than the reference values while their body height percentage were significantly lower than the reference. Using the WHO (2007) classification of BMI for children, 8%, 16% and 23% of studied children had thinness, overweight and obesity, respectively. The majority of children (55.1%) spent more than 2 hours daily watching TV, surfing the internet or playing electronic games, 25.8% didn't report any kind of physical activity and 48.8% had physical activity less than one hour/day.
The current study showed that there is a significant relationship between children's physical activity and prevalence of overweight and obesity.

Conclusions:
The current work looks at school children in Qatar to create a more complete picture of the current state of health and help to determine how lifestyle and environmental changes can be mitigated as a causal factor of obesity and therefore lifelong poor health.
Predictors of in-hospital mortality among Middle Eastern Arab and South Asian patients hospitalized with atrial fibrillation: Analysis from a 20-year registry in Qatar (1991-2010)
Authors: Salam Amar M , AlBinali Hajar A , Al-Mulla Abdul Wahid , Singh Rajvir , Al Suwaidi Jassim
Published: October 2012

Objectives:
Although predictors of mortality have been identified in major atrial fibrillation (AF) clinical trials, most of the data were limited to studies in the developed world and included mainly Caucasian patients. The aim of this study is to identify predictors of mortality in Middle Eastern Arab and South Asian patients hospitalized with AF in a real-world population in a Middle Eastern country.

Methods:
Retrospective analysis of prospective registry of all patients hospitalized with AF in Qatar from 1991 through 2010 was made. Ethnicity, clinical characteristics and co-morbidities were analyzed in relation to mortality.

Results:
During the 20 year period; 2857 Arabs and 548 Asians were hospitalized for AF. There were 138 deaths among Arabs and 14 among Asians (4.8% versus 2.6%, p= 0.02). Multivariate analysis of predictors of in-hospital mortality identified chronic renal impairment and acute coronary syndromes as independent predictors of poor outcome among patients hospitalized with AF whereas ethnicity was not [Table].

Conclusions:
In this region, the risk of in-hospital mortality for patients hospitalized with AF remains increased in patients who have chronic renal impairment or acute coronary syndromes irrespective of ethnicity. Patients at high risk may benefit from aggressive monitoring and intervention in order to reduce mortality.
Determining the significance of observed mutations in ovarian tumors using a random expectation model
Authors: Halabi Najeeb , Malek Joel , Rafii Arash
Published: October 2012

Background and Objectives:
Recent next generation sequencing studies of different cancers reveal a varied spectrum of mutations with patients having dozens to hundreds of mutations with little overlap in mutations between different patients. A difficult problem is to understand which of the observed mutations contribute to tumorigenesis. While several approaches have been used to determine significantly mutated genes, these approaches do not calculate random expectation mutation frequencies. Here, we develop a simulation of random mutagenesis and compare observed mutation frequencies (Fo) to random expectation frequencies (Fr) to identify genes that are likely to be selected for or against in tumors.

Methods:
Our random simulation method, implemented in Matlab, applies a different mutation probability for A or T bases, G or C bases and CpG repeats. Mutation simulation was done on Agilent's 50 Mb exon library. Mutations are reported on a gene level. Each simulation was run for 100 trials with each trial consisting of 316 repeats. The 100 trials enables calculation of standard deviations for random mutation frequencies. We also carried out a bootstrap analysis of observed data to estimate standard deviations of observed mutations. We calculated differences between Fo and Fr using ratio and rank comparisons.

Results:
We applied our approach to ovarian cancer data reported by the The Cancer Genome Atlas in 2011. We found a significant difference between observed mutations and random expectation mutations. Random mutations correlate well with the length of a gene (R2=0.54 for one trial) while almost no correlation is seen with observed mutations (R2=0.11). We also found one set of genes that is mutated at higher frequencies than expected while another set of genes is mutated at lower frequencies than expected.

Conclusions:
Our simulated mutagenesis method is a novel approach to determining significance of observed mutations in cancer. Application of this model to ovarian cancer data shows a significant discrepancy between expected and observed mutations possibly indicating that most observed gene mutations are selected for. In addition, our approach reveals specific genes that may be implicated in tumorigenesis. These genes are good candidates for further study.
The outcomes of sleeve gastrectomy for treatment of morbidly obese adolescents in Hamad General Hospital
Authors: Al Kuwari Mohammed , Gagner Michel , Sargsyan Davit , Bashah Moataz , Rizwan Mohammed
Published: October 2012

Introduction:
Obesity is a global problem affecting adolescents and teens with profound psychological and medical sequelae. The role of bariatric surgery in adolescents remains controversial. The aim of the study is to report our results with sleeve gastrectomy in this population.

Goal of study:
To study the efficacy of sleeve gastrectomy as a treatment for obese adolescents in terms of weight loss, comorbidity resolution and safety of procedure.

Methods:
Retrospective review of our records of all patients under the age of 19 who underwent laparoscopic sleeve gastrectomy in Hamad General Hospital in the years 2010-2012. Variables studied included; age, BMI, preoperative and postoperative weight, sex, comorbidities, length of stay, operative time, and early or late onset complications.

Results:
Out of 700 patients from our institute, 37 patients (5%) were adolescents. 45% males N=17 and 55% females N=20. Mean age was 17 ±1.5. Mean length of stay was 3.6 ±0.8. Mean operative time was 64 ±17 minute. Mean preoperative weight 141 ±27 kgs (200-94.) Mean BMI 51±8.8 kg/m2 (72-35). With regard to comorbidities, one person had obstructive sleep apnea and reported resolution. Mean follow up was 8 months (17-1), mean post op BMI 38 ±11.8 kg/m2 (23-70), mean excess weight loss -28% (4-45%). Mortality 0%. Morbidity 0%.

Conclusion:
Laparoscopic sleeve gastrectomy is a safe option for treatment of obese adolescents. It is particularly effective in this particular group with satisfactory safety profile and adequate weight loss. However, longer follow up is needed to evaluate the long term effects of the surgery.
Secular trends in cardiovascular comorbidities, etiologies and related mortality among Middle Eastern Arab and South Asian patients hospitalized with atrial fibrillation: A 20-year experience from Qatar (1991-2010)
Authors: Salam Amar M , AlBinali Hajar , Al-Mulla Abdul Wahid , Singh Rajvir , Al Suwaidi Jassim
Published: October 2012

Objectives:
Little is known about the ethnic variability in trends of the etiologies of atrial fibrillation (AF) and related mortality. This was examined in this study in patients hospitalized with AF in a real-world population in a Middle Eastern country.

Methods:
Retrospective analysis of prospective registry of all patients hospitalized with AF in Qatar from 1991 through 2010 was made. Rates and trends of clinical characteristics, cardiac comorbidities and in-hospital mortality were analyzed according to ethnicity.

Results:
During the 20-year period; 2857 Arabs and 548 Asians were hospitalized for AF. Arabs were 9 years older and more likely to have hypertension, diabetes mellitus, chronic renal impairment and dyslipidemia compared to Asians. Valvular heart disease and acute coronary syndromes were more common among Asians while congestive heart failure was more common in Arabs. Overall in-hospital mortality was lower for Asians compared to Arabs while stroke rates were comparable [Table1].

There was an increase in the prevalence of diabetes mellitus and hypertension in both groups in the latter years of the study period but, more so in Arabs when compared to patients hospitalized in the earlier years. Associated valvular heart disease was trending lower in both groups while ischemic heart disease prevalence was trending higher with no significant differences between the two groups. Rheumatic heart disease was statistically trending lower in prevalence; however it remained more prevalent among Asian patients over the study period. There were no significant differences in mortality trends over the study period between the two groups [Table 2].

Conclusions:
The current study is the first ever report of comparative ethnic trends in etiologies and outcome of AF among Middle Eastern Arab and South Asian patients over a 20-year period. The current study underscores the need to study differences in atrial fibrillation among various ethnicities.
Does supraspinal fatigue limit repeated sprint ability?
Authors: Girard Olivier , Bishop David J , Racinais Sébastien
Published: October 2012

Background and Objectives:
Most previous explanations of fatigue during repeated sprint exercise have focused on muscular factors associated with cellular mechanisms. At present, the nature of the neural adjustments and the extent to which corticospinal responsiveness is altered after the completion of repeated sprint exercise are yet to be elucidated. This study was undertaken to test the hypothesis that, in addition to the large peripheral fatigue, supraspinal factors would contribute substantially to neuromuscular adjustments of the quadriceps muscle in response to a repeated sprint cycling exercise.

Methods:
Twelve active individuals performed 10 x 6-s 'all out' sprints on a cycle ergometer (recovery= 30 s), followed 6 min latter by 5 x 6-s sprints (recovery= 30 s). Surface electromyographic activity was continuously recorded during the exercise. In addition, transcranial magnetic and electrical femoral nerve stimulations during brief (5-s) and sustained (30-s) isometric contractions of the knee extensors were performed before and 3 min post-exercise.

Results:
Peak power output and vastus lateralis root mean square activity decreased across sprint repetitions (P <0.001). These decrements were significantly (r= 0.89; P <0.001) correlated. Maximal strength of the knee extensors decreased during brief and sustained contractions (∼11% and 9%, respectively; P <0.001). Cortical voluntary activation values (∼90%), motor evoked potential amplitude and silent period duration responses measured during briefs contractions were unaltered. While cortical voluntary activation declined (P <0.01) during the sustained maximal contraction in both test sessions, larger reductions occurred (P <0.05) after exercise. Lastly, resting twitch amplitude in response to both femoral nerve and cortical stimulation was largely reduced (>40%, P <0.001) following exercise.

Conclusion:
The novel findings provided by motor cortex stimulation are that exercise induced reductions in cortical voluntary activation were seen in sustained, but not brief, maximal isometric contractions of the knee extensors. This, along with the lack of corticospinal responsiveness impairment from pre- to post-exercise, indicates that supraspinal processes do not necessarily limit repeated sprint ability. Rather, fatigue exhibited by the quadriceps when cycling sprints are repeated resides within the muscle itself, due to limitations in energy supply and/or the intramuscular accumulation of metabolic by-products.
Curcumin protects against hydrogen peroxide-induced oxidative stress and cellular injury in human embryonic kidney cells
Authors: Munusamy Shankar , Fadul Amna , Al-Ismail Muna
Published: October 2012

Background and Objectives:
Oxidative stress plays a major role in the pathogenesis of various diseases including renal injury. Curcumin has been shown to exert antioxidant activity in various experimental models. Thus, the objectives of this study are to standardize and establish an in vitro model of hydrogen peroxide (H₂O₂)-induced renal cell injury using human embryonic kidney cells (HEK293), and to evaluate the cytoprotective role and antioxidant properties of curcumin against the established in vitro model.

Methods:
HEK293 cells were incubated at 37°C with different concentrations of H₂O₂ (ranging from 100 µM to 100 mM) over 15-45 minutes. Cell viability was assessed by trypan blue exclusion assay using a hemocytometer to select an optimal concentration of H₂O₂ for our study. Cells were then divided into four different groups: control, H₂O₂-treated, curcumin-treated, and curcumin + H₂O₂ treated. The cytoprotective role and antioxidant properties of curcumin were assessed by measuring cell viability and superoxide dismutase (SOD) activity (using native gel electrophoresis) respectively.

Results:
Compared to the control, 2.5 mM H₂O₂ treatment in HEK293 cells caused a significant decrease in cell viability (98.55% vs. 68.8% respectively; P value <0.05), and loss of SOD activity. Interestingly, cells pretreated with curcumin were protected from H₂O₂-induced cell injury (83.15% vs. 68.8% cell viability in H₂O₂ treated group) and showed an active SOD band, similar to that of control.

Conclusions:
Curcumin acts as an antioxidant and protects HEK293 cells against H₂O₂-induced cellular injury. Further investigations are required to establish the potential therapeutic role of curcumin in kidney diseases.
The State of Qatar's national perinatal mortality rate during 2011 is comparable with selected high income countries: A PEARL study analysis
Authors: Rahman Sajjad ur , Nimeri Nuha , El Tinay Sarrah , El Ansari Walid , Tamano Emirah A , Al Rifai Hilal , Al Tamimi Halima , Salameh Khalil , Shaddad Afaf , Tahir Mohammad , Bener Abdulbari
Published: October 2012

Background and Objectives:
Perinatal mortality, a combination of stillbirths and early neonatal mortality (day 0-6 of life), is a very strong indicator to assess healthcare during the perinatal period. Our study aims to prospectively determine Qatar's perinatal mortality rate (PMR) during 2011, analyze trends from 1990 to 2011 and compare the findings with recent data from selected high income countries.

Methods:
A PEARL study (perinatal neonatal outcomes research study in the Arabian Gulf), a joint collaborative research project between Hamad Medical Corporation, Qatar and the University of Gloucestershire, United Kingdom, is a prospective national perinatal epidemiologic study funded by Qatar National Research Fund. The study aims at quantifying maternal, neonatal and perinatal mortality, morbidities and their correlates by establishing a national neonatal perinatal registry for Qatar called Q-Peri-Reg. The data on live births, stillbirths and early neonatal mortality were collected from all public and private maternity units in Qatar during 2011 and compared with Qatar's historic perinatal mortality data (1990-2010) ascertained from maternity and neonatal unit databases of the Women's Hospital and annual reports of HMC. We used ICD-10 definitions both for reporting and comparison with selected high income countries (data from World Health Statistics 2011 and European Perinatal Health Report 2008).

Results:
The total births during the study period were 20,725 (live births 20,583 and 142 stillbirths) and perinatal deaths 198 (fetal deaths 142 and early neonatal deaths 56) giving a PMR of 9.55, ENMR 2.7 and SBR of 6.85 for reporting and 4.76 for international comparison. The trend of risk ratio (RR) between 1990 and 2011 was significantly down (p= 0.016). This significant improvement in PMR (RR 0.72, 95% CI 0.58-0.89, p= 0.002) since 1990 (13.2) was more marked in ENMR (p <0.001) than SBR (p=0.019). The stillbirths constituted 55% of PMR in 1990 and 71.72% in 2011. The comparable PMR from selected high income countries was between 6 and 10.

Conclusion:
Qatar's 2011 PMR, ENMR and SBR are comparable to selected high income countries. Though there is a significant improvement in perinatal mortality in Qatar since 1990, further improvement is possible by designing well-targeted research-based health system improvement strategies.
Qatar's maternal survival and health status during 2011: A PEARL study analysis
Authors: Rahman Sajjad ur , Al Tamimi Halima , Tamano Emirah , Ahmed Badreldeen , Mohsin Najat , Al Taher Faten , Aboo Backer Naseera , Abdul Rahman Shamsa , Al Rifai Hilal , El Ansari Walid , Naji Lamaan
Published: October 2012

Background and Objectives:
The millennium development goals (MDG 5) mandate a three quarters reduction in maternal mortality ratio (MMR) by 2015. Hence, universal access to reproductive health and improvement in maternal survival remains the prime focus of all global health strategies and plans of action. Our study aims to analyze Qatar's performance in achieving MDG 5 by 2011.

Methodology:
A PEARL study (perinatal neonatal outcomes research study in the Arabian Gulf) is Qatar's prospective national perinatal epidemiologic study funded by Qatar National Research Fund. The study is a joint collaborative research project between Hamad Medical Corporation, Qatar and the University of Gloucestershire, United Kingdom. The project is establishing Qatar's national neonatal perinatal registry called Q-Peri-Reg which will quantify maternal, neonatal and perinatal outcomes and their correlates. Data on maternal health indicators and mortality was collected from all public and private maternity facilities during 2011.

Results:
During 2011, the total deliveries were 20,314 (normal vaginal 15,076 (74.22%) and caesarean sections 5238 (25.78%). 99.45% of deliveries were attended by a trained birth attendant in a maternity facility while 0.55% (n= 114) took place out of hospital. 100% of the mothers had made at least one antenatal visit. The total births were 20,725 (20,583 live births and 142 stillbirths). 100% of the births were examined by a pediatrician and entered in a national birth register. Qatar's MMR was 9.85 (n 2) as compared to global MMR of 260, Australia 8, UK 12 and USA 24.

Conclusion:
Qatar has achieved its target MDG 5 well before 2015. Qatar's 2011 MMR is comparable to most high income countries. Qatar's reproductive health system provides a unique model to study the correlates and associations of maternal survival which can form the basis of global health systems improvement strategies.
Vitamin D and inflammation in the prevention of type 2 diabetes: Public health relevance
Authors: Al-Thani Mohamed H. , Al Thani Al Anoud M. , Sadoun Eman , Badawi Alaa
Published: October 2012

Background and Objectives:
Type 2 diabetes mellitus (T2DM) is a major health problem in Qatar. The prevalence of T2DM in the adult population of Qatar is approximately 16% (twice that in the USA) and the country is ranked sixth in the world for diabetes prevalence. The number of cases of childhood diabetes in Qatar has doubled in ten years. The rapid rise of T2DM cases is thought to be due, in part, to genetic factors that interact with lifestyle factors including, but not limited to, poor nutrition, lack of physical activity and obesity. Recent evidence suggests that lack of vitamin D and inflammation may also play a role.

Methods:
We examined the current knowledge from literature linking T2DM to the chronic low-grade inflammation and the possible role of vitamin D in attenuating the inflammatory factors and, thereby, preventing T2DM.

Results:
Low-grade inflammation resulting from imbalances in the innate immune system has been associated with an array of chronic disorders that predispose to the later development of T2DM (e.g., obesity, metabolic syndrome, and insulin resistance). As a result, inflammation may contribute to the pathogenesis of T2DM. Therefore, attenuation of this inflammatory response via modulating the innate immune system could lead to improved insulin sensitivity and delayed disease onset. Dietary supplementation with vitamin D, may present a novel strategy toward the prevention and control of T2DM at the population level due to its anti-inflammatory and antioxidant properties.

Conclusion:
The concept that vitamin D, via attenuating inflammation, could be employed as a novel preventative measure for T2DM, is evaluated in the context of its relevance to healthcare and public health practices. Overall, to reduce the disease risk and burden at the population level, preventative strategies can be developed to include vitamin D supplementation into the traditional intervention protocols (e.g., exercise, life-style modification, etc.).
Virtualization of exercise: An innovative ankle exercise paradigm based on virtual reality for improving balance in diabetes
Authors: Najafi Bijan , Grewal Gurtej , Sayeed Rashad , Schwenk Michael , Menzies Robert , Talal Talal K. , Armstrong David G.
Published: October 2012

Background:
People with diabetes-related peripheral neuropathy (DPN) frequently suffer from concomitant postural instability that can lead to falls, fractures, depression, anxiety, and decreased quality of life. Exercise has been demonstrated to be effective in improving balance. However, high demands of conventional balance programs might overtax DPN patients' ability to perform exercises correctly. This might in turn reduce motivation or increase risk of diabetic foot ulcers. In addition, conventional training regimes do not incorporate visual feedback, which is of key importance for compensating the impaired proprioceptive feedback due to DPN. In this study, we examined the effectiveness of an innovative ankle exercise program based on virtual reality for improving postural control among DPN patients.

Methods:
A novel ankle reaching exercise program was developed based on virtual reality and body worn sensors. Twenty-nine eligible DPN subjects (Age:57±10 years; BMI: 55.9±11.1 kg/m2) were asked to perform a set of point-to-point ankle reaching tasks while receiving real-time video game style feedback from ankle joint motion. The ankle motion in medial-lateral and anterior-posterior was measured using a set of wearable sensors attached to the subject's shank. To evaluate the benefit of this paradigm for improving postural control, a validated technology based on body worn sensors was used to examine balance at baseline and after training. Postural control was quantified by measuring the area of center of mass sway (COM) and reciprocal compensatory index (RCI).

Results:
Our findings revealed a significant reduction in COM post-training in average by 16% (p= 0.03). A negative correlation (r= -0.46; p< 0.05) was observed between baseline COM and the magnitude of COM reduction post-training suggesting a larger exercise benefit for those who have higher postural control deficit. A similar association was observed between neuropathy severity and magnitude of exercise benefit. In addition, a significant improvement was observed in RCI in average by 11.3% (p< 0.005).

Conclusions:
The current research has implemented a novel balance training paradigm that provides real-time visual feedback from ankle joint motion in order to incorporate joint proprioception in balance training. Our findings support that motor learning based on real-time feedback from ankle joint motion is effective in improving postural stability among DPN patients.
Utility of vitamins in the prevention of type 2 diabetes mellitus and its complications: A public health perspective
Authors: Sadoun Eman , Garcia-Bailo Bibiana , Arora Paul , Da Costa Laura , Al Thani Mohamed H. , Al Thani Al Anoud M. , El-Sohemy Ahmed , Badawi Alaa
Published: October 2012

Background and Objectives:
The incidence of type 2 diabetes mellitus (T2DM) is increasing worldwide, and certain sub-populations appear especially vulnerable to developing the disease. In Qatar, the prevalence of T2DM in the adult population is approximately twice that in the USA. Qatar is ranked sixth in the world for diabetes prevalence. Risk of disease in the country is increasing with an apparent doubling of incidence in children from 1997 to 2007. To reduce T2DM risk and progression, preventative strategies need to be implemented on a population-wide scale with minimal cost and effort and without adverse effect. Our objective was to examine the utility of micronutrients in the prevention of type 2 diabetes and its complications and to evaluate the pathway(s) through which these dietary factors exert their effect.

Methods:
We searched the available literature linking oxidation, inflammatory signaling pathways, and micronutrient intake to T2DM.

Results:
The rise of T2DM rates is thought to be due, in part, to genetic factors that interact with lifestyle factors including, but not limited to, poor nutrition, lack of physical activity and obesity. However, chronic low-grade inflammation resulting from oxidative stress and imbalances in the innate immune system has been also linked to the pathogenesis of T2DM. Reducing inflammation via modulation of oxidative stress and the innate immune response could lead to a status of improved insulin sensitivity and delayed disease onset. Dietary supplementation with anti-inflammatory and antioxidant micronutrients might present a feasible strategy toward the prevention of T2DM at the population level, particularly in vulnerable sub-populations.

Conclusion:
Several lines of evidence support the concept of employing micronutrients as a preventative measure for T2DM via attenuating inflammation and modulating oxidative stress. This approach may be introduced as part of a population-based strategy to curb the rising incidence of T2DM in Qatar and facilitate developing public health policies and actions for disease prevention and control.
The potential public health risk estimates associated with infections by Escherichia coli pathotypes, Salmonella and Campylobacter spp., in Qatar
Authors: Sultan Ali , Stipetic Korana , Hoarau-Vechot Jessica , Duhamel Gerald , McDonough Patrick , Chang Yung-Fu , Mohammed Hussni
Published: October 2012

Background and Objectives:
A major challenge to global health initiatives is food safety. In the USA it is estimated that 76 million foodborne illnesses occur each year causing 300,000 hospitalizations and 5,000 deaths. Escherichia coli O157:H7, Campylobacter and Salmonella enterica are among the leading causes of these illnesses including inflammatory bowel disease (IBD) with severe sequelae. The severity of illness is in part attributable to the virulent factors encoded by genes present in individual pathogens. Data on the risk associated with infection by foodborne bacterial pathogens in Qatar and the complement of virulent factors in these pathogens is lacking. Cost-effective intervention strategies rely on accurate microbial risk assessment (MRA) of the adverse consequences of exposure and infection with specific pathogens (dose-response relationships), but also according to the complement of virulent factors present in each agent. We carried out molecular studies to investigate the profile of virulent genes of three major foodborne bacterial pathogens isolated from humans in Qatar in support of developing accurate MRA.

Methods:
Multiplex polymerase chain reactions (PCR) test and PCR restriction fragment length polymorphism were used to examine E. coli O157:H7 isolates for virulent factors. PCR amplification was used to screen C. jejuni and C. coli for the presence of cytolethal distending toxin (cdt) subtypes (cdtA, cdtB, and cdtC).

Results:
E. coli isolates had a number of virulent factors in common. The enterotoxigenic E. coli (ETEC) pathotypes were detected in human samples at a rate of 40%, while Shiga-toxin producing E. coli (STEC) pathotype was detected at a much lesser rate. The attaching and effacing E. coli (AEEC) pathotype which included several serotypes (O26, O45, O103, O111, O121 and O145) causing illnesses in 2010 were detected at a rate of 60%. The cdtB gene was detected in 82% and 30% of the C. jejuni and C. coli isolates, respectively. The majority of Salmonella enterica isolates expressed cdtB gene.

Conclusions:
The data indicate that infection by foodborne bacterial pathogens are common causes of gastroenteritis in Qatar. Implementation of cost-effective control measures for these important foodborne pathogens require intervention strategies that take into account MRA within the context of Qatar.