bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk assessment of four major bacterial foodborne pathogens associated with preharvest food security in Qatar
Authors: Mohammed Hussni , Stipetic Korana , Hoarau-Vechot Jessica , Duhamel Gerald , McDonough Patrick , Chang Yung-Fu , Sultan Ali
Published: October 2012

Background and Objectives:
Foodborne illness is a major hindrance to health advancement around the world and has been identified as a high priority in the Qatar National Food Security Program (QNFSP) master plan. Increased risk of illnesses is worsened by the ease of travel around the world, by an increase in global food and animal commodities trade, and by continued movement of large populations across vast areas. Qatar is one of the few countries in the world where factors exacerbating the risk of foodborne diseases intersect. Although it is estimated that up to 30% of the population in industrialized countries suffer from foodborne diseases, data in Qatar are lacking. We investigated the epidemiology and ecology of four of the top ten high risk foodborne pathogens at the preharvest level in Qatar, so that cost-effective strategies can be developed to mitigate the associated risk and protect human health. The pathogens are Salmonella spp., Escherichia coli, Campylobacter spp., and Listeria monocytogenes.

Methods:
An epidemiological study was carried out to address the objectives. Samples and data were collected from dairy operations and processing plants. All samples were screened for these pathogens using a combination of culture enrichment and real-time polymerase chain reaction (PCR) diagnostic approach. Molecular studies were carried out to identify toxins associated with virulence of these pathogens. Data on risk factors hypothesized to pose risks of human exposure and infection were analyzed for their significance.

Results:
All four pathogens were detected in samples collected from animal production units and processing plants with varying levels of occurrence. Although non-O157:H7 Shiga-toxin producing E. coli serogroups had the highest rate of occurrence (58%), E. coli O157:H7 were detected at a rate of 6%. Salmonella and Campylobacter spp. were detected at a much higher rate than expected. A higher percentage of the recovered pathogens were confirmed to have a toxin gene.

Conclusions:
Our data confirm the existence of a significant threat to the safety of the food supply system from these pathogens at the preharvest level. There is a need for innovative intervention strategies to mitigate risk of infection and eliminate adverse consequences.
Quantification of physical activity as a function of offloading modality in patients with diabetic foot ulcers - A randomized cohort study
Authors: Najafi Bijan , Bharara Manish , Grewal Gurtej , Menzies Robert , Talal Talal K. , Zirie Mahmoud , Armstrong David G.
Published: October 2012

Background:
Management of physical activity in patients with diabetic foot disease is poorly understood. There is paucity of data, more specifically evidence from a randomized study investigating the levels and profiles of physical activity in this population. This study explores the quantification of physical activity as a function of offloading modality in patients with diabetic foot ulcers.

Method:
Thirty eligible subjects with non-infected, non-ischemic, plantar neuropathic foot ulcers were studied. Participants were randomized to one of two off-loading modalities; removable cast walker (RCW) or instant total contact cast (iTCC). Outcomes were assessed at wound healing or at 12 weeks, whichever came first. Primary outcome measures included duration of wound healing and dosage of activity. Spontaneous daily physical activity was monitored using an unobtrusive wearable sensor incorporated in a comfortable shirt and carried by participants for 48 hours. Activity was quantified by percentage of each main posture (sitting, standing, lying, and walking), total number of steps, longest episode of walking, number and duration of postural transition (sit-to-stand) per day.

Results:
No significant difference was observed for between group BMI and age indicating appropriate randomization. A higher proportion of patients were healed by iTCC (p=0.03). Results suggest that patients in RCW group have in average 12% higher number of steps per day than iTCC group. On the same note, the longest continues walking episode per day was 27% longer in RCW group. RCW group had higher number of postural transition per day in average by 33%. Interestingly a relatively high correlation was observed between the number of postural transition and duration of wound healing (r=0.6, p<0.001). No significant difference was observed for other measured activities.

Conclusions:
This study for the first time demonstrated the detailed profiles of physical activity between the two treatment groups. These data may help in addressing the missing gaps in clinically dosing physical activity for the target population for better wound healing outcomes. The group treated with RCW were more active than iTCC group which may indicate the lack of adherence in RCW group in wearing the prescribed footwear during everyday condition.
PEGylated interferon alfa-2a induces complete hematologic and molecular responses with low toxicity in essential thrombocythemia
Authors: Yassin Mohamed Abdeldaem , Aldewik Nader Izzaldin , Elayoubi Hanadi Rafii
Published: October 2012

Background:
Essential thrombocythemia (ET) is a myeloproliferative neoplasm (MPN) marked by a risk of thrombotic and hemorrhagic complications, and by a long-term risk of evolution to myelofibrosis (MF), and acute leukemia (AL).

Methods:
Inclusion criteria: ET diagnosed as per WHO classification 2008, age 18 to 45 year.

Exclusion criteria: (hepatic and renal dysfunction, history of psychiatric disorder, in particular depression, autoimmune hepatitis, severe cardiac dysfunction, known hypersensitivity to IFN. Complete hematologic response (CR) as per ELN guidelines and molecular response (MR) was defined as 'complete' when JAK2V617F became undetectable with the technique used (i.e., V617F <1%), 'partial' when >50% decrease of baseline V617F was obtained, and 'minor' when V617F decrease was between 20% and 49%. After inclusion, Pegasys was started subcutaneously at 50 microgram weekly for 4 weeks then 135 microgramg/week from week 5.

Results:
Baseline characteristics of the patients are age 19-44 years, 16 males and 24 females. Five patients had a history of major thrombotic events. All the patients responded to Pegasys at the 12-month evaluation including 35 hematologic CRs (94.6%), and 5 PRs (5.4%). Cumulative incidences of hematologic CRs and PRs showed that 100% of responses were achieved within 12 months.

After the first year, V617F continued to decrease without evidence of plateau, the proportion of mutant JAK2 being always similar or lower in the last sample compared with the previous one. None of the responding patients experienced an increase of V617F during follow-up. Median V617F was 58% at 12 months (P <0.001).

Hematologic response was achieved in all patients within 2 months and were sustained beyond the first year. Toxicities included musculoskeletal pain in 6 patients, skin toxicity in 4, and GI symptoms in 2, none of the toxicity exceeds WHO Grade 2.

Conclusion:
PEGylated interferon alfa-2a is an effective and promising treatment for ET reducing the vascular risk and preventing evolution to MF, MDS, and AL. With low toxicity profiles and good hematological and molecular responses, percentage of V617F appears to be a good tool to monitor minimal residual disease and to evaluate treatment efficacy. However, further studies are needed to confirm these results.
Pediatric pneumococcal immunization programs and associated changes in antibiotic utilization: A systematic review
Authors: Wilby Kyle John , Werry Denise
Published: October 2012

Background and Objectives:
Antimicrobial stewardship is rapidly becoming very popular throughout the Middle East and abroad. Immunization programs, as a form of disease prevention, may reduce utilization of antimicrobials by decreasing incidence of disease requiring treatment. This may be especially important in children, as exposure to antimicrobials has been associated with chronic diseases such as asthma. The objective of this review is to summarize and evaluate the literature pertaining to antimicrobial utilization with respect to implementation of pneumococcal immunization programs or within clinical studies assessing vaccine effectiveness.

Methods:
A literature search was performed using the search terms: vaccine; immunization; antimicrobial; antibiotic; and pneumococcal in MEDLINE (1948-August 2012), EMBASE (1980-August 2012), International Pharmaceutical Abstracts (1970-August 2012), Google, and Google Scholar. Articles were limited to those describing pediatric populations. Identified clinical or epidemiological studies were included if antimicrobial utilization was listed as a reported outcome.

Results:
Five articles (two randomized controlled trials and three epidemiological studies) were identified and included in the review. All studies reported decreased antibiotic use associated with initiation of immunization programs or increased uptake of available vaccines. Epidemiological studies showing population-wide decreases reflected the results observed from short-term randomized controlled trials. Antibiotic reductions ranged from 5-10% in randomized controlled trials and up to relative reductions of approximately 40% in epidemiological studies.

Conclusions:
These findings suggest that pneumococcal immunization programs may reduce antibiotic utilization in pediatric populations. As such, vaccination status queries and updates should become part of routine care for patients in medical centers and in the community. Future research is needed to determine if these results are similar in adult recipients of the pneumococcal vaccine, such as the elderly. Pneumococcal vaccination programs could be considered part of nationally and internationally recommended strategies to reduce utilization of antibiotics in pediatric patients.
Optimal reference selection for genome assembly using the minimum description length principle
Authors: Wajid Bilal , Serpedin Erchin , Qaraqe Marwa , Nounou Hazem , Nounou Mohamed , Chouchane Lotfi , Mohamed Nady
Published: October 2012

Background and Objectives:
Reference assisted assembly requires the use of a reference sequence, as a model, to assist in the assembly of novel genomes. The standard method for identifying the best reference sequence for the assembly of a novel genome aims at counting the number of reads of the novel genome that align to the reference sequences and then choosing the reference sequence which has the highest number of reads aligning to it. This work explores the use of minimum description length (MDL) principle and its two variants, the two-part MDL and sophisticated MDL, in identifying the optimal reference sequence for genome assembly.

Methods:
The relevance of MDL to genome assembly can be realized by understanding that genome assembly is an inference problem where the task at hand is to infer the novel genome from read data obtained from sequencing. The task of MDL is to identify the model that best describes the data and within comparative assembly framework the same meaning applies to finding the reference sequences that best describe the set of reads. This work explores the potential of three variants of MDL: two-part MDL, sophisticated MDL and minimax regret for the selection of the optimal reference sequence for comparative assembly.

Results:
The proposed scheme based on sophisticated MDL has been shown to work successfully for the four possible set of mutations: SNPs, insertions, inversions and deletions. The proposed scheme chooses the reference sequence which has the smaller number of SNPs, insertions and deletions. The MDL scheme is able to detect all inversions and rectify them.

Conclusions:
The work compared the MDL scheme with the standard method of counting the number of reads that align to the reference sequence, and found that though the standard method is a necessary condition for finding the optimal sequence, it is not the sufficient condition. Therefore, the proposed MDL scheme encompassed within itself the standard method of: counting the number of reads, by defining it in an inverted fashion as counting the number of reads that did not align to the reference sequence.
Obstetric determinants of neonatal mortality in the State of Qatar: A PEARL study analysis
Authors: Rahman Sajjad ur , Al-Tamimi Halima , Tamano Emirah , Ahmed Badreldeen , Mohsin Najat , Al Tahir Faten , Aboo Backer Naseera , Naji Lamaan , Abdul Rahman Shamsa , Sharara Hussein , Al Sakka Mariam , Al Rifai Hilal , El Ansari Walid
Published: October 2012

Background and Objectives:
The State of Qatar has achieved maternal, neonatal and perinatal survival rates which are comparable to many high income countries, both from the West and East. Our study aims to analyze obstetric determinants of Qatar's neonatal mortality rate (NMR) during 2011.

Methodology:
A PEARL study (Perinatal Neonatal Outcomes Research Study in the Arabian Gulf), a joint collaborative research project between Hamad Medical Corporation (HMC), Qatar, and University of Gloucestershire, United Kingdom, is Qatar's prospective national perinatal epidemiological study funded by Qatar National Research Fund. The study is quantifying maternal, neonatal and perinatal mortality, morbidities and their correlates by establishing a national neonatal perinatal registry for Qatar called Q-Peri-Reg. Data on live births and neonatal mortality was collected from all public and private maternity facilities in Qatar during 2011. Data on obstetric determinants was ascertained from maternal obstetric record on predesigned performas. Univariate and multivariate regression analysis was done using Epi Info and SPSS-20.

Results:
Qatar's NMR during 2011 was 4.9. The relative risk of neonatal mortality was higher and statistically significant with caesarean section delivery (p= 0.003), emergency caesarean section (p <0.001), breech delivery (p <0.001), previous abortion (p= 0.009), previous preterm birth (p= 0.002), and lack of antenatal care (p <0.001). 94% of mothers had antenatal care and 25% of deliveries were by caesarean section. Maternal and paternal age, gravidity, parity, previous stillbirths, maternal BMI at delivery and duration of rupture of membranes did not have any statistically significant correlation with neonatal mortality (Table 1).

Conclusion:
High level of antenatal care in Qatar appears to have contributed significantly to its improved neonatal survival rates. The high levels of emergency caesarean sections and their association with increased neonatal mortality needs further research.
Molecular genetic approach to the diagnosis of a clinically equivocal retinopathy
Authors: Chini Vasiliki , Stambouli Danai , Nedelea Florina Mihaela , Filipescu George Alexandru , Mina Diana , El-Shanti Hatem , Kambouris Marios
Published: October 2012

Background and Objectives:
A pregnant female requested prenatal diagnosis for a congenital and complex eye disease segregating in her family. The three-generation pedigree of Romanian ethnic origin was suggestive of an X-linked inheritance, due to exclusively affected males and no father-to-son transmission. Affected individuals had bilateral optic nerve atrophy, microphthalmia, nystagmus, leukocoria, cataract, retinal detachment, eye tumors reported as retinoblastomas, moderate mental and motor retardation, and seizures. All efforts to obtain the detailed medical records of affected individuals were fruitless.

Methods:
The disease locus was mapped utilizing 78 microsatellite markers that span the X-chromosome at ~2 Mb intervals, followed by candidate genes analysis and mutations detection by Sanger sequencing.

Results:
Affected individuals share an ~10 Mb region between DXS1056 and GATA160B08 at Xp11.23-11.4. Candidate genes in this linkage interval included BCOR and NDP. Mutation screening identified a c.267C>A p.F89L mutation in the NPD gene in all affected individuals, previously described in a single unrelated Dutch family and speculated as causing Norrie disease.

Conclusions:
In retrospect, clinical symptomatology fits the Norrie disease phenotype. The reported retinoblastomas were most likely pseudogliomas characteristic of Norrie disease. Detection of the c.C267A p.F89L mutation in a second unrelated family confirms the pathogenic nature of the mutation for Norrie disease.

Utilization of gene mapping through linkage analyses and candidate gene screening previously utilized exclusively for research applications, were applied at a diagnostic setting and were essential in deciphering the offending molecular defect and diagnosing a disease which due to lack of medical records and poor and misleading clinical history would have no chance of being diagnosed correctly. Clinical diagnosis and mutation identification were essential prerequisites for providing proper genetic counseling and prenatal diagnosis in this family.
Inferring nonlinear and sparse gene regulatory networks
Authors: Noor Amina , Serpedin Erchin , Nounou Hazem , Nounou Mohamed , Qaraqe Marwa
Published: October 2012

Background and Objectives:
Gene regulatory networks model the interactions among the genes and provide a decision rule describing activation and repression of each gene via various proteins. In order to be able to capture the complex gene interactions efficiently, it is imperative to develop algorithms that model the nonlinear interactions among the genes. This work considers the problem of inferring gene regulatory networks using time series data. A nonlinear model is assumed for the gene expression profiles, whereas the microarray data follows a linear Gaussian model.

Methods:
A particle filter based approach is proposed to estimate the gene expression profiles and the parameters are estimated online using the Kalman filter. In order to capture the inherent sparsity of gene networks, a least squares shrinkage selection operator (LASSO) based regression and model selection algorithm is proposed.

Results:
The performance of the aforementioned algorithm is rigorously evaluated for synthetic as well as real biological data sets arising from Drosophila melanogaster time series gene expression profiles. The results are contrasted with those reported in the literature. The performance of the proposed algorithm is compared with the extended Kalman filter (EKF) algorithm using mean square error (MSE) as the fidelity criterion. The proposed algorithm is observed to outperform the EKF in the scenarios considered.

Conclusions:
This work considered the problem of modeling and learning of gene regulatory networks using a nonlinear dynamical model. This represents a quite general modeling set-up. The gene network is modeled using a state space approach, and particle filtering is used for state estimation. The parameters regulating the interaction among genes are supplied by an online Kalman filter. Since the parameter vector is sparse, LASSO identifies the subset of these parameters pertaining to the relevant system coefficients. Extensive performance evaluations demonstrate that the proposed particle filter based approach outperforms EKF in terms of MSE.
Improving patient's outcome through an advanced postgraduate medical education program for injured patients in Qatar
Authors: Peralta Ruben , Parchani A. , Zarour A. , Al-Thani H. , Latifi R.
Published: October 2012

Background and Objectives:
Trauma is the leading cause of death among the young population in the Middle East, including Qatar. A significant number of trauma and injured patients will require sophisticated critical care services and a disproportionately high level of hospital resources are centered within critical care units.

The introduction of an advanced ACGME structured Trauma & Critical Care (TCC) Fellowship Program at the Hamad General Hospital (HGH) in Doha, Qatar will improve patient safety and outcomes, medical care and professional satisfaction.

Methods:
A review of the clinical impact of the TCC Fellowship Program in the trauma service at HGH, the only tertiary and national trauma center in Qatar, was conducted after the second year of implementation to evaluate the healthcare delivery to the severely injured patients, using tools from the ICU resource, evaluation, and patient outcomes rating tool (ICU Report)®.

Results:
Since the implementation of the TCC Fellowship Program in 2008, structured educational and training curriculum have been implemented for physicians assigned to the trauma service at the HGH. Nine fellows have successfully completed the program and graduated. A 40% decrease of intra-hospital mortality has been observed in our trauma service. Three fellows have been promoted to consultant level and six to critical care teaching staff, enhancing staff satisfaction and the overall score of our trauma ICU.

Conclusions:
Advanced postgraduate medical education and training program in trauma and critical care medicine have significantly contributed to patient safety and outcome of critically injured patients in Qatar and have enhanced the overall performance of our trauma service and staff satisfaction. The fellowship program is expanding to other disciplines, and is enrolling national and international candidates in emergency medicine and anesthesia in our institution and is impacting healthcare delivery of the complex cases of injured patients in the country.
Molecular epidemiology of human papillomavirus among Arab women in Qatar
Authors: Elmi Asha , Bansal Devendra , Al-Thani Asma , Al-Ansari Afaf , Mohamed Nady , Sultan Ali
Published: October 2012

Objectives:
Human papillomavirus (HPV) is the most commonly known sexually transmitted agent. To date, few reports are available on the distribution of most prevalent and variant types of HPV in Arab women. Therefore, the aim of this study is to determine the age-specific distribution of HPV types among Arab women being subjected to routine pap smear tests in the State of Qatar.

Methods:
1100 pap smears have been collected in ThinPrep vials (BD SurePath™) from Arab women seeking routine gynecological care at the Women's Hospital, Hamad Medical Corporation (HMC) in Doha, Qatar. All the samples were transported to the laboratory in an icebox container. Viral DNA from ThinPrep samples was extracted by QIAamp MinElute virus spin kit according to manufacturer's instructions and was screened for HPV DNA by real-time PCR using L1 HPV specific (GP5+/6+) primers. The type-specific distribution of the viruses was determined by HPV high and low risk typing RT-PCR kits (Sacace Biotechnology, Italy) and PCR-based sequencing. Real-time PCR amplification was carried out in ABI 7500 real-time PCR (Applied Biosystems).

Results:
Based on the collected data, HPV DNA was detected in 125 women (11.36%), and 15 different HPV genotypes were detected, comprising high-risk and low-risk genotypes. The prevalence of HPV infection was seen in 54.5% Qatari and 45.5% non-Qatari women. With regard to age, 33.5% of all HPVs were found in women 30-39 years of age, 24.8% in women 40-49 years of age, 15.8% in women 50-59 years of age, 5.5% in women over 60 years and 20.4% in women less than 30 years old.

Implications and Impact:
The study shows that the prevalence of HPV infection in Arab women in Qatar is among the highest in the Arab world compared with previous reports. However, more extensive population-based studies should be undertaken before implementing HPV vaccination.
Fetal and perinatal determinants of neonatal mortality in the State of Qatar: A PEARL study analysis
Authors: Rahman Sajjad ur , Nimeri Nuha , El Tinay Sarrah , Al Rifai Hilal , Omar Fahmi , Said Amani , Abughalwa Mahmoud , Said Azzam , El Ansari Walid , Tahir Mohammad
Published: October 2012

Background and Objective:
The State of Qatar has achieved maternal, neonatal and perinatal survival rates which are comparable to many high income countries, both from the West and East. Our study aims to analyze fetal and perinatal determinants of Qatar's neonatal mortality rate (NMR) during 2011.

Methodology:
A PEARL Study (Perinatal Neonatal Outcomes Research Study in the Arabian Gulf), a joint collaborative research project between Hamad Medical Corporation (HMC) Qatar and University of Gloucestershire United Kingdom, is Qatar's prospective national perinatal epidemiological Study funded by Qatar National Research Fund. The study is quantifying maternal, neonatal and perinatal mortality, morbidities and their correlates by establishing a national neonatal perinatal registry for Qatar called Q-Peri-Reg. Data on live births and neonatal mortality were collected from all public and private maternity facilities in Qatar during 2011. Data on fetal and perinatal determinants was ascertained from maternal obstetric and delivery room record on predesigned performas. Univariate and multivariate regression analysis was done using Epi Info and SPSS-20.

Results:
Qatar's NMR during 2011 was 4.9. The incidence of low birth weight in Qatar is 11% and the incidence of preterm deliveries 10.7%. 10% of the babies required delivery room resuscitation.
The relative risk of neonatal mortality was higher and statistically significant with fetal growth (p<0.001), fetal weight at birth (p<0.001), fetal gestation at birth (p<0.001), APGAR score at 1 and 5 minute (p<0.001) and the need for delivery room resuscitation (p<0.001). The RR of neonatal mortality increased (Table 1) with decreasing birth weight (p<0.001) and gestational age (p<0.001).

Conclusion:
Further improvement in Qatar's neonatal mortality is possible by addressing the high incidence of low birth weight and preterm deliveries. Better maternal nutrition, improved antenatal care, birth spacing and best obstetric and neonatal practices at delivery are likely to be most helpful.
Ethnic and gender differences in skin auto-fluorescence
Authors: Mook-Kanamori Marjonneke J , McKeon Cindy , Takiddin Ahmed H , Zirie Mahmoud A , Al-Homse Hala , Al-Obaidli Amina , Al-Mahmoud Khouloud A S , Rowe Jillian , Gerbi Wafaa , Chidiac Omar , Kader Sara A , Al Muftah Wadha , El-Din Selim Mohammed M , Suhre Karsten , Mook-Kanamori Dennis O
Published: October 2012

Background:
The AGE reader is a non-invasive device that measures tissue accumulation of advanced glycation endproducts (AGEs) through skin auto-fluorescence (AF) and gives prediction of cardiovascular risk. For the risk prediction, the AGE reader uses a single reference curve, for both females and males, obtained from Caucasian subjects. Based on these reference curves, clinical cut-offs for a low, medium and high AF have been made. This study examines whether these reference values can be used for ethnic populations seen in Qatar. Furthermore, we assess whether gender and smoking affect skin AF in this particular population.

Methods:
Skin AF was measured in 200 Arabs, 99 South Asians and 35 Filipinos. Using multivariate linear regression analysis and adjusting for the covariates age and the presence of type 2 diabetes, we assessed whether ethnicity, smoking and gender were associated with skin AF.

Results:
The Arabs and the Filipinos had a significant higher skin AF then the South Asian population (0.272 (95% CI: 0.138, 0.406), p <0.001 and 0.354 (95% CI: 0.147- 0.561), p=0.001 respectively). This is equivalent to a horizontal shift of 14.6% and 19.0%, respectively. Also, skin AF was significantly higher in women compared to men (0.432 (95% CI: 0.307, 0.558), p <0.001). Smoking was positively associated with skin AF (0.21 (95% CI: -0.01, 0.41), p=0.056), with an increasing effect of number of pack-years smoked on AF (p=0.024).

Conclusions:
The results of this study suggest that the existing reference values should be expanded for ethnicity, gender and smoking. These results also indicate that the use of the AGE reader in clinical settings should be used with caution, since the clinical cut-off points are dependent on various factors such as ethnicity that still need to be studied in greater detail.
Endothelial dysfunction in morbidily obese young Qataris
Authors: Orie Nelson , Bakhamis Aysha , Al-Jaber Mashael , Al-Emadi Mohamed , Rida Samer , Alsayrafi Mohammed , Mohamed-Ali Vidya
Published: October 2012

Background & objectives:
The prevalence of metabolic syndrome (MetS), including obesity, dyslipidemia, hyperglycemia and hypertension, associated with an increased predisposition to cardiovascular disease (CVD), is especially high in the Middle East, primarily amongst young Qataris. Both insulin resistance and endothelial dysfunction have been proposed to contribute to the pathogenesis of CVD in obese patients. Recent reports have shown that abdominal adipose tissue depot-specific differences impact on endothelial vasomotor function, with the visceral/omental environment considered more pathogenic. It is, however, unclear how severe the effect would be on a relatively young obese population. This study investigated endothelium-dependent relaxation of small arteries embedded in two adipose tissue depots, the sub-cutaneous and the omental.

Methods:
Arteries were isolated from omental (OM) and subcutaneous (SC) adipose tissues collected from consented Qatari patients undergoing bariatric surgery for weight reduction. The arteries (ID ~251 µM for SC and ~ 262 µM for OM) were cut into segments (~2 mm) and mounted on a dual wire Myograph (510A) for measurement of isometric tension. Cumulative concentration-response curves were constructed for acetylcholine (1- 10000 nM, the classical endothelium-dependent relaxant) in the absence or presence of Nω-Nitro-L-arginine methyl ester (L-NAME,100 µM, nitric oxide synthase inhibitor) on initial tone generated with noradrenaline (5 µM). Relaxation to sodium nitroprusside (SNP) and prostaglandin E2 were also recorded.

Results:
The mean age of the patients was 32 years, their blood glucose 5.6 mmol/L, Insulin 19.3 µU/ml , the index of insulin sensitivity/resistance (HOMA) 5.5 and body mass index 43.4 Kg/m2.
Relaxation to Ach was significantly attenuated in OM vessels (Emax 51±9 %) compared with SC vessels (Emax 79±6 %, p<0.05) from same patients. The Ach response was further reduced in the presence of L-NAME. In contrast, the relaxation to SNP and PGE2 were greater in OM vessels compared with the SC vessels.

Conclusions:
These results demonstrate adipose tissue depot-specific differences in the impact of obesity on endothelial function in morbidly obese, insulin resistant, young Qataris, with a marked reduction in endothelium NO-dependent relaxation in the OM compared with SC vessels. The reversibility of this lesion by weight loss are yet to be ascertained.
Early detection of peripheral neuropathy by examining virtual perception of lower extremity join position
Authors: Najafi Bijan , Grewal Gurtej , Sayeed Rashad , Menzies Robert , Talal Talal , Lavery Lawrence , Zirie Mahmoud , Armstrong David
Published: October 2012

Background:
Diabetic peripheral neuropathy (DPN) is one of the most common complications of diabetes that affects nerve functions and may occur in 25% of patients with 10 or more years of diabetes and up to 50% with 20 years of diabetes. Patients with DPN experience a high incidence of injuries while walking and have a low level of perceived safety. In certain cases the impaired judgment - mainly due to impaired proprioceptive feedback - can cause obstacle collision leading to falls and injuries. The subtle early findings that are indicative of postural instability are difficult to accurately assess from a clinical examination, and gait laboratory assessment is not currently available or practical. Thus, unfortunately, many patients that are "at risk for falls" are undiagnosed.

Objectives:
An innovative virtual obstacle crossing (VOC) paradigm using wearable sensors was developed in attempts to detect lower extremity nerve damage due to DPN.
Methods: Sixty-eight participants including diabetes with no, moderate and severe neuropathy and aged-matched healthy controls were recruited. Severity of neuropathy was quantified using vibratory perception threshold (VPT) values. The ability of perception of lower extremity was quantified by measuring the rate of obstacle crossing success (OCS), reaction time (TR), and foot position while crossing a series of virtual obstacles with various heights.

Results:
Results suggest VOC test allows separating between groups. All proposed parameters were significantly deteriorated by increasing neuropath severity (p<0.05). Results also suggest a significant correlation between TR and VPT values (r=0.5, p<10-5). Finally, results suggest a significant deterioration in balance due to diabetes, irrespective of neuropath severity (p<0.05).

Conclusions:
The results proposed the benefit of virtual obstacle crossing as an objective method for detecting peripheral neuropathy at an early stage. This is based on the reasoning that lower extremity proprioception decreases with increasing nerve damage. The increased reaction time, decreased OCS, and increased sway of the DPN patients in this study suggests their decreased proprioception, and, therefore, increased peripheral nerve damage. Further studies should be addressed to compare VOC with other standard methods to confirm whether VOC can detect DPN earlier than current methods.
Congenital and genetic disorders in the Sultanate of Oman: Genetic service needs assessment
Authors: Rajab Anna
Published: October 2012

Background and Objectives:
In the past 40 years Oman has witnessed remarkable social and economic growth, which is best reflected in the well-organized and efficient healthcare system. It has been anticipated that a change in disease pattern would be brought about by improvement in the quality of life, comprehensive healthcare facilities and successful control of communicable diseases. Although genetic and congenital disorders are increasingly observed in medical practice, there were no convincing available data to support these observations. The study was performed over the years 2010-2012 in order to assess the population needs for genetic services.

Methods:
A population-based study was conducted with detailed assessment and interviews of more than 3000 Omani mothers. Randomization was performed by counting the number of nationals in each geographical area and places of residence, and interviewing one mother per 600 Omani nationals in all geographic locations throughout the country. The collected data were verified with available hospital records and reports and analyzed.

Results and Conclusions
The population-based study revealed that 10% of Omani mothers reported congenital and genetic disorders causing morbidity in their offspring. Congenital disorders with mental disability accounted for over half of the reported morbidity, and a third of these reports had familiar recurrence. Morbidity and mortality from congenital and genetic causes that have been derived from this study reflect the situation in traditional Muslim community with high rate of inbreeding where communicable diseases were successfully controlled, and prevention measures are still in a preparatory phase.

The current study confirmed that congenital and genetic conditions are the major contributors to childhood morbidity and mortality, and handicap prevalence in the Sultanate of Oman, indicating the need to prioritize future healthcare and planning, in view of their significant financial, social and research relevance.
Genome-wide association study of prostate cancer in Arab populations: Identification of three genomic regions with multiple consecutive prostate cancer susceptibility loci
Authors: Shan Jingxuan , Al-Rumaihi Khalid , Rabah Danny , Al-Bozom Issam , Al-Said Sami , Farhat Karim , Dsouza Shoba P , Aigha Idil I , Kizhakayil Dhanya , Chouchane Lotfi
Published: October 2012

Background:
Prostate cancer is the most common malignancy in many industrialized countries and the second cause of cancer-related death in Europe and the United States. The incidence of the disease has been increasing in Arab populations. Large databases focused on genetic susceptibility to prostate cancer have been accumulated from population studies of different ancestries, including Europeans and African-Americans. Arab populations, however, have been only rarely studied. Genetic susceptibility to prostate cancer differs significantly across ethnicities. It would be of interest to identify the common alleles associated with prostate cancer risk in Arab population.

Methods:
With Affymetrix Genome-Wide Human SNP Array 6.0, we conducted a genome-wide association study (GWAS) in which 534,781 single nucleotide polymorphisms (SNPs) were genotyped in a Tunisian cohort of 92 cases with prostate cancer and 131 age-matched controls. Then we extended the study to evaluate promising associations of 11 SNPs, identified by GWAS, in a cohort of individuals of Arab ancestry living in Qatar and Saudi Arabia (155 cases and 182 controls) using TaqMan® SNP Genotyping Assays.

Results:
We identified 3 consecutive regions significantly associated with prostate cancer risk on chromosome 9, 17 and 22, including 18 SNPs (P=8.52×10-5 to P=2.18×10-6) in the Tunisian population. Three previous reported common loci associated with prostate cancer at 17q21 containing STAT3 gene in the Caucasian population were confirmed. Two novel chromosomal regions associated with prostate cancer contain candidate susceptibility genes: SMARCA2, LOC646851and SUN2 were revealed.

Conclusion:
Our findings, identifying novel GWAS prostate cancer susceptibilty loci, indicate that prostate cancer genetic risk factors could be ethnic specific.
Application of PCC and M-FISH assays to detect biomarkers-and stage specificity-of cancer of different origins and to improve cancer therapy regimens
Authors: Darroudi Firouz , Long Michael
Published: October 2012

Background:
Cytogenetics of solid tumors in general is negatively affected by culturing artifacts such as preferential clonal expansion and introduction of chromosomal rearrangements, thus making it difficult to discriminate between primary changes and secondary events. Considering that chromosomal instability is a hallmark of cancer even at the precursor cancer level, it is of a great importance to devise a method of comprehensive chromosome analysis of cancer and cancer precursor cells that can bypass culturing problems as much as possible and that can provide informative karyograms of primary tumors at non-mitosis stages of the cell cycle.

Consequently, we have developed a novel approach using chemically induced premature chromosome condensation (PCC) method and combined it with the technique of whole genome chromosome painting assay (M-FISH), in which chromosomal constitution of cancer cells could be detected independent of mitosis and without culture artifact within just three hours after receiving the biopsies.

Objectives:
1. To perform karyotype analysis; 2. To define stage specificity; 3. To detect hall-mark(s) of cancer of different origins; 4. To improve therapy regimen by elucidating sensitivity of tumors and patients' lymphocytes to radiation and/or cytostatic drugs.

Methods:
Chemically-induced PCC method was applied on primary tumors (such as, cervical-, head and neck-, breast- and prostate-cancer) to generate metaphases. Afterwards, these preparations underwent M-FISH.

Results:
This unique/novel combined assay can give for the first time the possibility to assess genetic instability by detecting spontaneously occurring chromosomal instability (structural and numerical) in different types of primary tumors, as well as adjacent normal cells. It may open up the possibility to detect biomarker(s) for specific type of tumors, that can be used as screening tests. Furthermore, the sensitivity of specific types of tumors as well as patient's normal lymphocytes to cytostatic drugs and/or radiation can be determined.

Conclusion:
The unique combined state of the art assay we developed can lead to detect biomarker(s) for specific type of cancer. Moreover, for the first time therapy regimen can be individually designed based upon detecting tumors as well as patient's lymphocytes sensitivity.
Cultural aspect of pedestrian injuries amongst expat workers in Qatar: An opportunity for an injury prevention program
Authors: Latifi Rifat , El-Menyar Ayman , Al Thani Hassan , Zarour Ahmad , Abdulrahman Husham , Parchani Ashok , Tuma Mazin , Consunji Rafael , Peralta Ruben
Published: October 2012

Background:
In the State of Qatar, the majority of workers are expatriates from different ethnicity and culture. Most of them are liable to pedestrian motor vehicle crashes (MVC). We sought to understand the anatomy, time and date of injuries amongst expat workers in relation to their country of origin, culture and traditions.

Methods:
Retrospective analysis of prospectively collected data obtained from trauma registry was done. Analysis includes all traffic related pedestrian injuries admitted to the trauma surgery service at Hamad General Hospital, the only level I trauma center in Qatar, between January 2009 and December 2011. Demographics, time and season of injuries, ISS, type of injuries, anatomical body parts injured, ethanol intake, hospital length of stay, length of ICU stay, and mortality were analyzed.

Results:
Of the 4997 injured patients admitted to the section of trauma, 603 (12.1%) were pedestrians [(non-Arab (75%), Arabs (17%) and nationals (8%)]. The mean age was 31.8±17 years with 93% males. The mean ISS was higher in those who were injured on Friday and Saturday (16±10 and 15±10; p=0.32) in comparison to the week days. Moreover, mean ISS was also relatively high in those who got injured during the winter season (15.2±11) compared to other months (13.5±10). Head injury (45%) was the most common injury followed by injury of the lower limbs (37%), upper limbs (24%), ribs (22%), pelvic area (20%), lung (17%), spleen (10%), liver (7%) and kidney (4%). Alcohol intake was highest amongst expatriate workers from Nepal and Sri Lanka. The median hospital length of stay was 7 (range 1-312) days, TICU stay was 4 (range 1-150) days and ventilator days was 2 (range 1-36) days. The overall mortality was 11.6 % (83% non-Arabs, 9% Arab non-Qataris and 8% Qataris; p=0.08).

Conclusion:
Majority of the pedestrian injuries involved expatriate workers with poor socio-economic status and cultural barrier in communication. Injury severity was higher in winter season particularly during weekends. These injuries pose economic burden to the healthcare system of the country and thus need urgent injury prevention measures such as education and awareness campaigns among expat workers in Qatar.
Investigating poly (ADP-ribose) polymerase-1 (PARP-1) activation in obesity associated DNA damage and pro-inflammatory senescence
Authors: Abdesselem Houari Boumediene , Madani Aisha , Mazloum Nayef
Published: October 2012

Obesity has increased at an alarming rate over the past three decades. It is likely to be caused by increased caloric intake combined with genetic predisposing factors and is a major risk factor for type 2 diabetes (T2D) and cardiovascular disorders. Obesity is linked to chronic inflammation, which was proposed as a cause for insulin resistance and T2D. However, the molecular mechanism of obesity driven T2D still lacks knowledge and thus is inaccessible to therapeutic intervention. In our research, we are exploring the molecular mechanism underpinning this association and aims to identify novel therapeutic targets for the rapidly growing population of obese individuals living with diabetes. The obese state creates a microenvironment within the adipose tissue that is susceptible to the accumulation of reactive oxygen species (ROS). Accumulated ROS causes oxidation of macromolecules such as DNA. Oxidative DNA damage encompasses a variety of DNA lesions such as DNA single-strand breaks (SSBs) and DNA double-strand breaks (DSBs) including non-telomeric and telomeric DSBs. Broken or dysfunctional telomeres have been hypothesized as a cause of cellular senescence, a state of irreversible cell cycle arrest observed in aging illnesses and even in obesity with accumulation of senescent adipocytes. A major player in detecting and defending against accumulation of oxidative DNA damage is PARP-1. PARP-1 activation has been shown to be associated to diabetes and obesity. We are exploring the role of PARP-1 in ROS-induced senescent and inflamed adipocytes by using a combination of biochemical, molecular and cell biological assays in primary human and mice adipocytes treated with hydrogen peroxide (H₂O₂) as a source of ROS.
Public attitudes towards participation in Biobank Qatar
Authors: Nasrella Eman , Clark Brian
Published: October 2012

Background and Objectives:
Biobank Qatar is a research enabling infrastructure requiring members of the Qatari public to donate health and lifestyle information coupled to biological samples to enable research towards better prevention, diagnosis and treatment of diseases common in Qatar.

Building a biobank depends on the willing participation of the public. Recruitment of participants requires insight into public knowledge of biobanking, public willingness and an understanding of motivators and the barriers. This study reports public opinion in Qatar and aids the communication campaign that facilitates recruitment.

Methods:
A qualitative survey was undertaken, by means of recorded structured interviews, with 100 members of the Qatari public including Qatari nationals and long-term expatriate residents (resident for more than 5 years).

Results:
Qatari nationals believe that Biobank Qatar raises Qatar's international profile. Volunteering is seen as a charitable act, compatible with Islam, to help future generations. Long term residents buy-in less to the benefits to Qatar.

Qatari nationals assume confidentiality due to trust in their government. Long-term residents fear their information might be used against them (e.g. in the work place). Fear of infection through contaminated equipment was raised. There is lack of understanding on the process of donating blood. Questions arose over the biobank location, proximity to workplaces and how accessible it would be. Participants suggested commitments with families and employers as potential barriers.

The public favor communication using a range of media. Participants particularly suggested raising awareness through gatherings and social events. Some participants volunteered to "spread the message" amongst social groups by acting as "biobank champions".

Conclusions:
Although limited by scale, scope and composition of the sample, this study provides a way-finder for public opinion related to biobanking for biomedical research. The public support Biobank Qatar, even with limited knowledge of our work. Qatari nationals were particularly supportive and are motivated by national pride, progress and making personal contributions to a healthier future for future generations. This study is useful in guiding our communications and recruitment plans and will be the basis for further sociological studies of the Qatari public and their support for biomedical research.