bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of underlying coronary artery disease on the presentation symptoms and in-hospital outcome of patients with atrial fibrillation
Authors: Salam Amar
Published: November 2013

Objectives: Underlying coronary artery disease (CAD) is an established risk factor for the development of Atrial Fibrillation (AF). How underlying CAD affects symptoms and outcome of patients presenting with AF remains unknown. The aim of the current study was to evaluate how patients with established CAD as evidenced by a history of old myocardial infarction (OMI) differ in symptoms and outcome when hospitalized with AF in a real-world population. Methods: Retrospective analysis of prospective registry of all patients hospitalized with AF in Qatar from 1991 through 2010 was made. Patients were divided into two groups according to history of OMI on presentation. Clinical characteristics, symptoms of presentation and outcome were analyzed. Results: During the 20-years period, 3850 patients were hospitalized for AF; 417 (10.8%) had OMI on presentation while 3433 (89.2%) had no OMI. OMI patients were 11 years older, had more prevalence of hypertension, diabetes mellitus, dyslipidemia, chronic kidney disease and had lower mean left ventricular ejection fraction on echocardiography (all, P value =0.001). Patients with OMI were significantly less likely to present with palpitations (25.7% versus 47.1%) and more likely to present with shortness of breath (36.9% vs. 26.7%) and chest pain (21.3% vs. 10.5%) compared to non-OMI patients (all, P value =0.001) [table]. The in-hospital mortality rate was significantly higher in patients with OMI (8.6% versus 3.6%; P value =0.001). Conclusions: Our study demonstrates that underlying CAD significantly affects the presentation symptoms and outcome of AF patients.
Collagen I: A potential therapeutic target for prostate cancer
Authors: Sadoun Eman
Published: November 2013

Prostate cancer is the second most common malignancy in men worldwide. Advanced age is the greatest risk factor for prostate cancer in humans. Many studies have examined the influence of age on prostate cells. It has been noted that ageing alters both stromal and epithelial aged prostate cells' secretory profile, which is characterized by increased expression of inflammatory mediators, such as CXC chemokines. This has been attributed to a "senescent secretary phenotype" and is thought to contribute to both benign and malignant prostate diseases onset. However, much less is known as to how age affects the prostate matrix and its subsequent interactions with resident cells. Prostate matrix is primarily comprised of collagen I. Young and aged collagen differ in several physical parameters including decreased density, greater fragmentation, and increased disorganization in aged relative to young collagen I. The aim of this proposal is to investigate the underlying mechanisms that alter the local prostate environment in relation to the collagen matrix regulation of cancer cell behavior: both function and secretion. However, collagen matrices derived from prostate glands are not yet feasible and studies of the effect of aged mouse tissues on the behavior of human cancer cells are limited by the lack of compatible murine hosts, as immunodeficient mice do not live past middle age. Consequently, we will use young and aged collagen I obtained from young and aged mouse tail tendons and polymerized into a 3 dimensional (3D) matrix - a known simulation of aged collagen in vitro. We propose that aged 3D collagen I, relative to that of young collagen I, influences prostate cancer cells to decrease the expression of integrins that mediate cellular invasion. At the same time, we propose that aged collagen I increases the ability of prostate cancer cells to secrete chemokines that promote angiogenesis in the tumor microenvironment. We will utilize 3 human prostate cancer cell lines (LNCaP, LNCaPC4-2, and VCaP) that will be examined for the relative function of differentially expressed adhesion molecules during invasion through young and aged 3D collagen I. We will also examine the secretory profile of chemokines known to induce an invasive prostate cancer phenotype. This aged collagen I matrix will specifically elucidate cell-matrix interactions that can uncover potential therapeutic targets in prostate cancer.
Barriers to decision making in cancer multidisciplinary teams: Analysis of cancer decision-making in two surgical specialities
Authors: Jalil Rozh
Published: November 2013

Introduction: Multidisciplinary teams (MDTs) in cancer care have been instituted for almost 20 years. The rationale for MDT-driven care is that bringing together cancer specialists from a range of disciplines allows holistic and unbiased review of treatment options and optimisation of treatment pathways for patients. Multidisciplinary teams are becoming the standard practice in managing cancer patients in the world. The Multidisciplinary team (MDT) is defined as a "group of people of different healthcare disciplines, which meets together at a given time (whether physically in one place, or by video or teleconferencing) to discuss a given patient and who are each able to contribute independently to the diagnostic and treatment decisions about the patient". These teams meet regularly, review investigation results and discuss best available, evidence based treatment options for cancer patients. In the UK, there is a quality assurance program for the function and structure of the MDTs; however there no agreed way to assess the process and the ability of decision making of such teams. This study investigated the factors hampering decision-making in cancer MDT meetings. Methods: All available MDT decision outcomes of cancer patients discussed between February to December 2012 of both Urology and Colorectal surgery were reviewed. MDT decisions and reasons for cases with no decision reached were analysed. Results: MDT discussion outcome of 2035 cancer cases were reviewed (19 Urology MDT meetings, n=1126, 50 Colorectal MDT meetings, n=909). 9.5 %( n=107) of Urology and 6.4 %( n=58) of colorectal cases had no decision reached. Main reasons were: unavailability of histopathological results (47.7%(n=51) of urology and 24.1%(n=14) of Colorectal cases); unavailability of radiological investigation results (43.9%(n=47) of Urology and 43.1%(n=25) of Colorectal cases); unavailability of an Oncologist in the meeting(3.7%(n=4) of Urology and 5.2%(n=3) of Colorectal cases). Discussion: This study uncovers the main barriers that MDTs face in decision-making. Assessing the efficacy of a MDT could be made by its capability to formulate a decision plan for all the cases discussed. Tackling these barriers would result in a more cost-effective process, enhance decision-making and thus enhance cancer care.
Estimating the prevalence of injecting drug use in the Middle East and North Africa
Authors: Mumtaz Ghina
Published: November 2013

Background and objective The Middle East and North Africa (MENA) is home to the world's largest producer of opioids, as well as to major drug trade routes. Over 80% of the global supply of heroin is produced in Afghanistan, and over 75% of this is trafficked through Iran and Pakistan. The increased availability and purity of inexpensive heroin in MENA appears to have led to a subsequent rise in injecting drug use. The objective of this sub-study was to estimate the proportion and number of people who inject drugs (PWID) in MENA, as part of a larger study of HIV epidemiology among PWID in this region. Methods This was a systematic review of literature following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Sources of data included PubMed, Embase, regional databases, conference abstracts, as well as a large body of country-level reports. A generic "drug use" search of these databases was performed. Data on PWID population size estimates in the 23 MENA countries were extracted from relevant studies. Estimates were weighted by adult population size. When more than one such estimate was available per country, we used their mean. Adult population size was extracted from the United Nations World Population Database. Results After screening 4,985 citations, we extracted 121 and 105 measures on the number and proportion of PWID, respectively. We estimated that there are 0.6-1 million PWID in MENA. Pakistan, Iran, and Egypt have the largest number, with an average of about 210,000, 180,000 and 89,000 PWID, respectively. The weighted mean prevalence of injecting drug use was estimated at 0.23 per 100 adults (range 0.03-0.50%), and was highest in Iran (0.43%). Studies of sub-national populations showed geographical heterogeneity in the proportion of PWID. Data on the prevalence of female PWID were scarce. Overall, the mean proportion of females among PWID in included studies was 3.6% (range: 0-35%). Conclusion The mean prevalence of injecting drug use in MENA (23 in every 1000 adults) is comparable with global figures which range from 0.06% in South Asia to 1.50% in Eastern Europe. The prevalence of injecting drug use varied between MENA countries, being higher in the eastern part of the region; and appeared to be heavily concentrated among men. With recent evidence suggesting emerging HIV epidemics among PWID in several MENA countries, these findings take on additional importance. There is an urgent need to scale up harm reduction services for the nearly one million individuals who form this vulnerable population group in MENA.
Using whole exome sequencing as a molecular diagnostic tool to identify disease-causing mutations in consanguineous families in Qatar
Authors: Fahiminiya Somayyeh
Published: November 2013

Background: Whole exome sequencing (WES), which focuses on sequencing of protein-coding regions of human genome, has greatly improved the identification of causal mutations for diverse human genetic disorders in the past four years. We applied WES as a molecular diagnostic tool to identify disease-causing mutations in consanguineous families displaying autosomal recessive (AR) disorders in Qatar. AR diseases are usually severe and rare that occurs with higher rate in consanguineous families. In Qatar, like other Middle East countries, consanguineous marriage and endogamy are common (54%) that results in a higher incidence of several/new AR disorders where many of these disorders are yet to be defined and their causative genes are to be discovered. In order to decrease the overall socio-economic burden of such diseases in the society and development of specific testing tools that will be helpful with the molecular diagnosis, parental testing, carrier identification, and informed genetic counseling, we must first discover the causative genes of these recessive disorders. Methods: All of the experimental (whole exome library preparation, capturing and sequencing) and bioinformatics analyses were performed according to our well-established protocols at Genome Quebec Innovation Center, Montreal, Canada. Results: We performed WES on several consanguineous families, with one or more affected children, where the result of initial molecular screening of known or potential candidate genes was negative. Because of unaffected status of parents and their consanguinity, the mode of inheritance was considered to be autosomal recessive. We also tested de novo and X-linked mode of inheritance in families with one or only male affected child. Based on these assumptions, we identified the definitive damaging mutations for Hypophosphatemic rickets; Hurler syndrome; Glycogen storage disease; Dubowitz-like syndrome; Seckel syndrome; Geleophysic dysplasia; Limb-girdle muscular dystrophy; Multiple Fractures; Metachromatic Leukodystrophy; Immunodeficiency and Juvenile onset cataract. In addition, several candidate genes were identified in families with mental retardation (n=3); CNS anomaly (n=1); eye anomalies (n= 26); peripheral neuropathy (n=7); axonal peripheral neuropathy (n=3) and oro-facio-digital syndrome (n=2), that have been considered for functional follow-up investigations and further characterizations. Conclusion: Our study highlights the importance of using WES as molecular diagnostic approach for discovery pathogenic gene mutations compared to traditional molecular genetic testing. We showed that the WES was successful to identify causal mutations underlying phenotypically complex disorders in ~46% of our patients. The results of this study will help to establish population-specific diagnostic panels, and improve clinical diagnosis and patient management in the country.
Identification Of Genes Involved In The Growth Of Pancreatic Cancer Cells In The Rat Liver Of Nude Rats
Authors: Adwan Hassan
Published: November 2013

Purpose: Owing to aggressiveness and chemo-resistance, pancreatic ductal adeno-carcinoma (PDAC) is characterised by a poor prognosis. At the advanced stage, which is characterised by metastasis into adjacent organs, especially the liver, all systemic treatment approaches have failed, so far. To address this disease spe¬cific dilemma we aimed to establish animal models, which mimic liver metastasis of PDAC and to identify the underlying genes. Methods: From a panel of sixteen pancreatic cancer cell lines, two human (Suit2-007 and Suit2-013) and a rat (ASML) cell line were selected for their property to grow in the liver of male RNU rats and mimic liver metastasis of PDAC. By serial transplantation the take rate was improved until they showed reliable and reproducible growth as orthotopic xenografts. For better monitoring of metastatic tumor growth in vivo, all three pancreatic cancer cell lines were stably transfected with eGFP and luciferase marker genes. In addition, the mRNA expression profile of 13 human PDAC cell lines was analyzed by BeadChip array analysis. Results: Three orthotopic xenograft models, which form liver metastasis of PDAC, were successfully established in male RNU rats following intra-portal implantation.The models vary in their aggressiveness and macroscopic growth. The Bead Chip array analysis showed that only 33 genes and 5 signalling pathways were identified as significantly associated with the ability of the cell lines to grow initially and/or consistently in rat liver. Only a minority of these genes (osteopontin, matrix metalloproteinase-1 and insulin-like growth factor 1) has been intensively studied and shown to be closely related to cancer progression. The function of the remaining 30 genes ranges from moderate to poorly investigated, and their function in cancer progression is still unclear. Conclusions: The ensuing three pancreatic cancer liver metastasis models vary in their aggressiveness and macroscopic growth. They will be used for preclinical evaluation of new therapeutic approaches aiming at the genes identified.
Whole genome polymorphism analysis and responsiveness of melanoma to TIL therapy
Authors: Sommariva Michele
Published: November 2013

Adoptive cell transfer therapy (ACT) holds a highly promising treatment for metastatic melanoma patients. ACT involves the ex vivo expansion of autologous antitumor reactive tumor infiltrating lymphocytes and their reinfusion into lymphodepleted patients, accompanied by IL-2 administration. ACT demonstrates objective clinical responsiveness in 40-50% patients, including 10-21% complete responses. However, the mechanisms underlying the observed inter-individual variability in response to this type of therapy are not well understood. We applied whole genome-wide association study (GWAS) using Illumina OmniQuad 1M SNP bead array and expanded the SNP coverage to 33M by imputation against International HapMap and 1,000 genomes data sets. The analysis was performed in 208 TIL or PBMC samples undergone adoptive therapy or high does IL-2 therapy at the Surgery Branch, NCI. Comparisons between patients experiencing a complete responder (CR, n=30) versus those suffering progression of disease (PD, n=108) excluding the reminder partial responder patients identified 140 independent association SNPs which covers 14 functional known genes at a threshold p-value < 1 x 10-5. Within the chromosomal crossover range (1000Kb); we observed possible association with 405 annotated genes. The strongest signal was rs11587096, rs4506458 on chromosome 1 and rs7894773, rs7070986 at chromosome 10. Several genes at those loci had known immunological function. Those include TLR5, MIA3, TAF1A, DUSP10, DISP1, HHIPL2, MAF177B and EIF3a, FAM45A, SFXN4, GRK5, RGS10, TIAL1, BAG3, INPPF5 AND SEC23IP on chromosome 1 and 10 respectively. In particular, comparisons between patients experiencing a complete response (CR) versus those suffering progression of disease (NR) identified a polymorphism in the region flanking the exon 2 of the G protein-coupled receptor kinase 5 (GRK5) gene as one the most statistically significant polymorphism. GRK5 can exert immunomodulatory function by promoting the desensitization of chemokine receptors, modulating NFkB signaling and promoting the Wnt signaling, a pathway involved in the development of particular CD8+ T lymphocytes. Possible functional impact of the significant SNP on Chr 10 at transcript level was further validated by analyzing encoded gene exons using Fluidigm technology. In conclusion, we have identified different loci associated with clinic outcome by GWAS study suggesting that genetic predisposition is one of the important component determine immune responsiveness.
Investigating PARP-1 function in ROS-induced pro-inflammatory senescence of pre-adipocytes
Authors: Abdesselem Houari
Published: November 2013

Obesity has increased at an alarming rate over the past three decades. It is likely caused by increased caloric intake combined with genetic predisposing factors and is a major risk factor for type 2 diabetes (T2D). Obesity is linked to chronic inflammation, which was proposed as a cause for insulin resistance and T2D. The obese state creates a microenvironment within the adipose tissue that is susceptible to accumulation of reactive oxygen species (ROS). Accumulated ROS leads to DNA damage and activation of DNA damage response. When DNA is severely damaged and can't be repaired, the cell undergoes senescence, an irreversible cell cycle arrest. Senescence has been linked to aging illnesses and even to obesity with accumulation of senescent pre-adipocytes. A major player in detecting and defending against oxidative stress is PARP-1. PARP-1 activation has been shown to be associated to melanoma senescence, inflammation, obesity and diabetes. The role of PARP-1 in ROS-induced senescence and inflammation of pre-adipocytes has not yet been investigated. Therefore, to study PARP-1 function in pre-adipocytes senescence, we generated and characterized an in vitro experimental model for cellular senescence in primary human and mice pre-adipocytes using hydrogen peroxide (H2O2) as a source of ROS. Our preliminary data shows PARP-1 induction in ROS-treated pre-adipocytes. We are currently using this senescence model to characterize the function of PARP-1 by using gene-silencing approaches.
Towards cell level protein interaction in multivariate bioimages
Authors: Khan Adnan
Published: November 2013

Recently, new bioimaging techniques have been proposed to visualize the interaction of several proteins within individual cells. Such techniques could provide the key to understanding complex biological systems such as the protein interactions involved in cancer. Currently, there is a strong urge for sophisticated analytical methods to extract molecular signatures of diseases (such as cancer) in order to not only understand the biological processes behind cancer development but also to aid us in early diagnosis and appropriate treatment. We propose a paradigm for mining of molecular signatures in multivariate bioimages. In contrast to the traditional pixel-level analysis approaches, which ignore cellular structures as units that can be crucial when analyzing cancerous cells, our method incorporates cell-level analysis. We use this framework to perform cell level protein-protein interaction analysis to visualize cellular heterogeneity at a molecular level.
Preliminary results and clinical relevance of next generation sequencing in hypertrophic cardiomyopathy patients in Qatar
Authors: Alshafai Kholoud
Published: November 2013

Title: Preliminary Results and Clinical Relevance of Next Generation Sequencing in Hypertrophic Cardiomyopathy Patients in Qatar. Kholoud Al-Shafai 1, Despina Sanoudou 1,2, Paul Barton 3 , Lama Shuayb 1 , Emmeleia Nana 2 , Pothitos Pitychoutis 2 , Rachel Buchan 3 , Roddy Walsh 3 , Stuart Cook 3, Magdi Yacoub 1,3, Mohammed Alhashemi 4 1 Qatar Cardiovascular Research Center (QCRC), Qatar Foundation, Doha, Qatar, 2 Department of Pharmacology, Medical School, University of Athens ,Greece, 3National Heart & Lung Institute, Imperial College London, London, UK. 4Cardiac OPD and Rehabilitation, Heart Hospital, Doha, Qatar. Hypertrophic cardiomyopathy (HCM) is the most common inherited heart muscle disease with a prevalence of 1 in 500 in the general population. HCM exhibits a remarkable clinical and genetic heterogeneity, with over 30 genes being implicated so far. However, the full spectrum of genes and mutations leading to HCM remains to be discovered to help the understanding of genotype-phenotype relationship and its clinical implications. Next generation sequencing (NGS) technologies are powerful tools to study these issues. Here, we utilized NGS technologies to sequence the exomes of over 170 genes including all known HCM genes. Preliminary results of seventeen HCM patients recruited at the Heart Hospital-Qatar is presented, with particular reference to the clinical implications of NGS in early disease detection, diagnosis and disease management. Different previously known HCM disease-causing genetic variants were detected, within sarcomeric genes including TNNI3, MYBPC3, MYL3 and MYH7. Patients carrying those variants were offered genetic counseling and advised for clinical and genetic screening of relatives, leading to the early detection of HCM in a 13 years old boy, coupled with efforts to detect genotype-positive phenotype-negative relatives. Of particular interest are genetic variants found within PRKAG2, NEXN that have not been previously described in HCM and need to be further assessed and screened in relatives. In addition, two genetic variants were detected in SOS1 and RAF1 that were previously related to Noonan Syndrome leading to the diagnosis of Noonan syndrome variants in these patients with cardiac hypertrophy associated phenotype. This is an ongoing program which is expected to yield further valuable information which could influence the management in these patients.
High-throughput screening technology for anti‐diabetic drug discovery based on adiponectin receptors
Authors: Aouida Mustapha
Published: November 2013

The anti‐diabetic and insulin‐sensitizing effects of adiponectin, a hormone secreted by adipose tissue, are mediated by its molecular interactions with the plasma membrane receptors AdipoR1 and AdipoR2. Adiponectin occurs in several molecular forms and each of these forms has a specific signaling outcome that also depends on the relative abundance of the two receptors. The complex interactions between adiponectin and its receptors are poorly understood. A detailed characterization of how adiponectin interacts with its receptors and, in turn, how these receptors transmit specific downstream signals is critical for the development of meaningful therapeutic interventions for a wide spectrum of metabolic disorders (including type 2 diabetes, obesity, and inflammatory bowel disease) and cancers (of the breast, colon and prostate), all of which are known to be associated with adiponectin function. Here, we report a Saccharomyces cerevisiae based method for investigating agonist-AdipoR interactions that is amenable for high-throughput scale-up and can be used to study both AdipoRs separately. Agonist-AdipoR1 interactions are detected using a split firefly luciferase assay based on reconstitution of firefly luciferase (Luc) activity due to juxtaposition of its N- and C-terminal fragments, NLuc and CLuc, by ligand induced interaction of the chimeric proteins CLuc-AdipoR1 and APPL1-NLuc (adaptor protein containing pleckstrin homology domain, phosphotyrosine binding domain and leucine zipper motif 1-NLuc) in a S. cerevisiae strain lacking the yeast homolog of AdipoRs (Izh2p). The assay monitors the earliest known step in the adiponectin-AdipoR anti-diabetic signaling cascade. We demonstrate that reconstituted Luc activity can be detected in colonies or cells using a CCD camera and quantified in cell suspensions using a microplate reader. AdipoR1-APPL1 interaction occurs in absence of ligand but can be stimulated specifically by agonists such as adiponectin and the tobacco protein osmotin that was shown to have AdipoR-dependent adiponectin-like biological activity in mammalian cells. To further validate this assay, we have modeled the three dimensional structures of receptor-ligand complexes of membrane-embedded AdipoR1 with cyclic peptides derived from osmotin or osmotin-like plant proteins. We demonstrate that the calculated AdipoR1-peptide binding energies correlate with the peptides' ability to behave as AdipoR1 agonists in the split luciferase assay. Further, we demonstrate agonist-AdipoR dependent activation of protein kinase A (PKA) signaling and AMP activated protein kinase (AMPK) phosphorylation in S. cerevisiae, which are homologous to important mammalian adiponectin-AdipoR1 signaling pathways. This system promises to be an effective tool for the identification of novel pharmaceutically active AdipoR agonists and should facilitate the development of therapeutic inventions targeting adiponectin and/or AdipoR physiology.
Endothelial cells provide a niche for placental hematopoietic stem/progenitor cell expansion through broad transcriptomic modification
Authors: Raynaud Christophe
Published: November 2013

Umbilical cord blood (UCB) is an attractive source of hematopoietic stem cells (HSCs). However, the number of HSCs in UCB is limited, and attempts to amplify them in vitro remain inefficient. Several publications have documented amplification of hematopoietic stem/progenitor cells (HSPCs) on endothelial or mesenchymal cells, but the lack of homogeneity in culture conditions and HSC definition impairs direct comparison of these results. We investigated the ability of different feeder layers, mesenchymal progenitors (MPs) and endothelial cells (ECs), to amplify hematopoietic stem/progenitor cells. Placental derived HSPCs (defined as Lin-CD45-/dimCD34+CD38-CD90+) were maintained on a confluent feeder layers and the number of cells and their marker expression were monitored over 21 days. Although both types of feeder layers supported hematopoietic expansion, only endothelial cells triggered amplification of Lin-CD45-/dimCD34+CD38-CD90+ cells, which peaked at 14 days. The amplified cells differentiated into all cell lineages, as attested by in vitro colony-forming assays, and where capable of engraftment and multi-lineage differentiation in sub lethally irradiated mice. Mesenchymal progenitors promoted amplification of CD38+ cells, previously defined as precursors with more limited differentiation potential. A competitive assay demonstrated that hematopoietic stem/progenitor cells had a preference for interacting with endothelial cells in vitro. Cytokine and transcriptomic analysis of both feeder cell types identified differences in gene expression that correlated with propensity of ECs and MPs to support hematopoietic cell amplification and differentiation respectively. Finally, we used RNA sequenencing of endothelial cells and HSPCs to uncover relevant networks illustrating the complex interaction between endothelial and HSPCs leading to stem/progenitor cell expansion.
A retrospective study examining climatic influence on the respiratory health of Qatar residents
Authors: critchley kim
Published: November 2013

There are obvious and well known links between air quality and acute respiratory illnesses that are common in Qatar and other Middle Eastern countries. For example, recent studies have documented a number of respiratory problems associated with inhalation of dust during dry, windy periods. In Qatar, exposure to dust and sand are anecdotally associated with a variety of respiratory issues including asthma and chronic obstructive pulmonary disease (COPD). These illnesses may be brought about by physical damage caused by the particles themselves, or by microorganisms that can be associated with these particles. In this study we will examine the relationship between different climatic variables, daily airborne particulate matter, and hospital admissions for respiratory problems over an eight month period to establish possible relationships. The results of the study will shed light on the importance of weather phenomena, particularly windy conditions, in impacting respiratory health in Qatar. These data are particularly important as respiratory problems are expected to increase as climate change results in hotter, drier conditions over the next few decades.
Lipid biomarkers in the identification of halal/haram products
Authors: Latiff Aishah
Published: November 2013

Plant oils, marine and animal fats are major components of the human diet and they are economically important for many exporting countries. Triacylglycerols (TAG) are the major fat components in human diet. Food consumed by Muslims must be HALAL. Food products with a HALAL designation do not only relate to meat, but also include canned, processed and frozen foods, organic foods, bakery products, pastry and beverages, because of the potential use of animal derived (including porcine) products. Two main objectives of this study are; to differentiate lipid profiles in lard, marine and plant oils and to detect lard contamination in food and commercial cooking oils. This method achieved comprehensive TAGs characterization and differentiation in several oil standards and commercial products. These results were obtained from a single analysis on the Dual-cell Linear Ion Trap Mass Spectrometer using protocols which employs full scan MS, wide band activation with MS2, data-dependent CID (collision induces dissociation) with MS3, all from a single injection. The fatty acid composition of each TAG is easily assigned from the loss of specific neutral fatty acids either in MS (APCI mode) or from similar losses in the CID MS/MS spectra. Therefore, this method could be used as a rapid screening method for TAG profiles. A number of unique TAGs were found in animal and plant oils and three unique TAGs were found in lard oil;these TAGs may be employed in lard detection or adulteration in foods or oil as illustrated in this study. Such an approach may be useful in the determination of halal or haram food products. Finally, preliminary work is also presented regarding the utility of phospholipids contained in plant, marine, and animal fats as additional unique markers for the presence of specific individual oils; especially those from porcine products.
Analyzing the health burden from road trauma in Qatar: Which indicators are best?
Authors: Consunji Rafael
Published: November 2013

The adverse health outcomes, road traffic injuries [RTI's] and deaths, that result from motor vehcile crashes [MVC's] in Qatar have been measured and evaluated. Improvements in this field have been noted; citing improvements in numerous ways using a variety of tools. Deaths are most commonly used with measures of non-fatal outcomes of MVC's rare. The number of MVC's causing injury, number of traffic violations and citations issued and MVC rates per 10,000 vehicles have been applied. The use of the size of the general population as a measure fo RTI exposure or risk is common. Incorporating the highly diverse and changing character of Qatar's population and the even higher differences in road risk exposure between sub-populations must be done. Furhermore, analyses of the differential risk for each of the different RTI mechanisms experienced by the different road users [i.e. rollover vs pedestrian-vehicle collision or driver vs passenger vs pedestrian] must be performed. All of the parameters have been reviewed and analyzed. The tools and parameters best suited to evaluating the health burden from RTI's in Qatar will be presented.
Design Of A New Wavelet-Based Preprocessing Stage For Improved Time-Frequency Detection Of Fetal Movements
Authors: Ben Jabeur Taoufik
Published: November 2013

Design of a new Wavelet-based preprocessing stage for improved time-frequency detection of fetal movements Dr. Taoufik Ben Jabeur and Pr. Boualem Boashash Department of Electrical Engineering, Qatar University Background: Improving Newborn Health Outcomes can be achieved by monitoring Fetal Movement (FetMov) activity which relates directly to the fetus well-being. Several methods exist to record these Fetal movement (FetMov) signals including active (Ultrasounds) and passive ways (accelerometer). Ultrasound is an accurate measurement but expensive and intrusive; for these reasons, capturing FetMov through accelerometer sensors is a preferred option as it is low cost and nonintrusive. In this approach, different sensors are placed on the abdomen of the pregnant woman. Each sensor produces a FetMov signal. The recorded FetMov signals have been shown to be noisy and non-stationary signals containing several artifacts. Thus, a pre-processing stage is required to reduce the noise and eliminate the artifacts. Objectives: This work aims at designing a new pre-processing stage for improving FetMov detection by applying Wavelet de-noising algorithm followed by a threshold given by Kurtosis parameter. Methods: The new method is based on a Wavelet de-noising algorithm followed by a high pass filter to reduce some artifacts. A threshold given by Kurtosis parameter is used in the elimination of the artifacts. Results and conclusion: Simulation results show that the proposed pre-processing stage allows to reduce the noise and to eliminate more than 70% of the artifacts. Few artifacts are still present in the FetMov signals. As the FetMov signal is non-stationary, we use a Time Frequency Matched filter detector (TFMF) based on QTFDs to detect FetMov from these artifacts. The proposed preprocessing stage combined with TFMF detector improves significantly the performance of the detection of the FetMov signal leading to possible improvements in health outcomes for the fetus. Keywords: Fetal movement; Wavelet; Time frequency Matched Filter; Quadratic Time Frequency Distribution.
Regional Differences In The Association Between Hiv And Hsv-2 Prevalence: Implications For Hiv Epidemic Potential
Authors: Kouyoumjian Silva P.
Published: November 2013

ABSTRACT Background and Objective HIV and herpes simplex virus type-2 (HSV-2) are sexually transmitted infections, with HSV-2 being nearly 10 times as infectious as HIV. HSV-2 prevalence has been established as an objective biomarker and a proxy measure of sexual risk behavior. HIV epidemics appear to be emerging in the Middle East and North Africa (MENA) region, but the time course and future size of these epidemics are still unknown. We assessed HIV epidemic potential across regions using the association between HSV-2 and HIV prevalence, and based on a global systematic review of HIV and HSV-2 prevalence and meta-analyses. Methods Sources of data were PubMed and Embase databases, and country-level reports. Data on the prevalence of HIV (PHIV) and of HSV-2 (PHSV2) in the same population were extracted from eligible studies. Our analysis included all population groups except adolescents and injecting drug users, where the dominant mode of HIV transmission was not sexual. Studies with sample sizes of less than 50 were excluded. Odds ratios were calculated as (PHSV2/ (1- PHSV2)) / (PHIV/ (1- PHIV)), and relative risks as (PHSV2/ PHIV). Meta-analyses were conducted incorporating the inverse variance method and using a random-effects model to pool summary estimates of odds ratios and relative risks in different geographical regions. Results The meta-analysis included 662 study measures with a total population of 590,220 individuals from 67 countries. The pooled odds ratio of HSV-2 prevalence relative to HIV prevalence was low in Sub-Saharan Africa, Asia, and North America/West Europe, 6.0 (95% CI 5.5-6.5), 10.4 (95% CI 9.2- 11.8), and 13.0 (95% CI 9.9- 17.8), respectively. We found high odds ratios in East Europe 73.6 (95% CI 32.8-165.5), MENA 38.0 (95% CI 15.2-95.0), and Latin America 30.4 (95% CI 22.4-41.4). The pooled estimates of relative risks followed the same pattern as the odds ratios across all regions. Discussion The small odds ratios in sub-Saharan Africa, Asia, and North America/West Europe suggest established HIV epidemics that have likely reached saturation. Meanwhile, the large odds ratios in MENA, East Europe, and Latin America, suggest emerging HIV epidemics that have not yet reached their epidemic potential. These results corroborate recent data about the trend of HIV epidemics in these regions. The findings are of concern for MENA as they suggest that the HIV epidemics are likely to grow within this decade and the next one. HIV response in MENA needs to be expanded through bio-behavioral surveillance, voluntary counseling, testing, and treatment services, and focus on HIV prevention.
Benign paroxysmal positional vertigo: Early diagnosis and treatment by physical maneuver in the emergency department
Authors: Irfan Furqan
Published: November 2013

Benign paroxysmal positional vertigo is the most common form of vertigo seen in emergency departments. Typically these patients complain of the room spinning associated with certain head movements, nausea and vomiting. This condition can be diagnosed by taking a good history and performing a Dix-Hallpike manoeuvre. BPPV can be successfully treated by physical manoeuvres such as Epley, modified Epley, Semont et al. This condition does not require any investigation. Most ED physicians would normally treat BPPV sufferers with medications such as antihistamines and benzodiazepines, without offering any physical manoeuvre. Herein, we present five cases of benign paroxysmal positional vertigo that were diagnosed with Dix-Hallpike manoeuvre and successfully treated by modified Epley manoeuvre by an emergency physician. Early diagnosis and treatment by modified Epley manoeuvre may prevent unnecessary investigations such as blood tests, CT scans and a prolonged stay in the hospital. It is a useful manoeuvre that usually works within an hour and should be more widely utilized in emergency departments. There are no significant complications associated with this treatment.
Characterization Of The Cellular, Biofilm And Pathogenic Properties Of Candida And Trichosporon Patient Samples Isolated At Hamad Medical Corporation
Authors: Finkel Jonathan
Published: November 2013

Deep tissue fungal infections cause over 30% mortality and add over $2.6 billion to healthcare costs in the United States alone [1,2]. In Qatar, fungal infections occur in up to 16% of all patience's suffering from continuous ambulatory peritoneal dialysis [3]. Implanted medical devices such as artificial joints, catheters and artificial heart valves are associated with elevated rates of fungal bloodstream infections. One of the predominant causes of fungal infections is its ability to grow as a biofilm on these device surfaces [4,5]. Fungal infections are of particular concern to diabetic patients; a condition of great concern in Middle East, with diabetic rates higher then 30% in many Gulf countries [6]. The development and use of the antifungal echinocandins, which effectively treats the most prevalent pathogenic fungi C. albicans, has resulted in other less known fungi emerging as pathogenic sources of infection. With a diverse population of patients, Qatari hospitals have encountered increasing rates of infections from echinocandins resistant pathogenic fungi including Trichosporon spp., and Candida spp. (personal communications). In collaboration with Dr. Saad Taj Aldeen at Hamad Medical Center, I have received a large number of patient isolates that represent a variety of fungal species from a myriad of infection sites. Little is known about many of these different pathogenic fungi. Our specific research objectives were to better characterize this diverse collection of pathogenic fungi to enhance our understanding of the similarities and differences in biofilm formation of these fungi. In vitro biofilm formation assays have been performed and the results highlight unique differences that may explain the different rates of infections observed in the clinical setting. Understanding the different and similar mechanisms used by various fungi to form biofilms will aid in the identification of the pathogen in a host and help determine the most effective treatment. In addition, this information will provide a foundational understanding of biofilm formation and aid in the development of simple assays to support the development of novel therapies.
What type of exercise for metabolic syndrome?
Authors: kilani Hashem
Published: November 2013

The metabolic syndrome is a clustered syndrome characterized by five major abnormalities: cardiovascular risk factors, including elevated blood pressure, dyslipidemia, impaired glycemic control, and abdominal obesity. Although, this syndrome is reaching an epidemic spread in parallel to obesity, the incidence of the metabolic syndrome is expected to continue to rise, enabling the exercise prescription to contribute to optimal treatment at the socioeconomic scale. Exercise training reduces several of the symptoms of the syndrome, but the exercise modality and intensity that yields the maximal beneficial adaptations is controversial. The optimal level of physical training needed to prevent and treat the metabolic syndrome and its associated cardiovascular abnormalities remains undefined. A combination of frequency, intensity, and duration of chronic exercise is responsible for producing a training effect. The interaction of these factors shall provide the required stimulus. This paper will emphasize the adequate dose of exercise needed for most disorders.
Emerging role for colorectal cancer screening in Qatar
Authors: John Anil
Published: November 2013

Introduction Colorectal cancer (CRC) is increasing in incidence in several Asian countries but screening programs are lacking. In Qatar, ,we embarked on a pilot study for Colo-Rectal Cancer (CRC) screening based at 3 primary health centers among subjects with average risk for colorectal cancer. Aim To devise a national screening program for the early detection of colonic cancer among persons at average risk for Colorectal cancer (CRC) ,based on the outcome of our pilot study Methods All subjects aged 40-74 years at average risk for CRC ie that is individuals without history of polyps or documented cancer or inflammatory bowel disease in the past and absent family history are included. They are subjected to screening by immunochemical fecal occult blood testing at the primary health centers. Subjects positive for stool occult blood undergo total colonoscopy at the tertiary care hospital. Cancers and polyps picked up are documented and subjected to appropriate investigations and therapy Results A total number of 1242 healthy subjects at average risk for CRC, between ages of 40-74 years underwent stool occult blood testing by immunochemical fecal occult test. 57 (4.5%)were found to be positive and referred for colonoscopy. Of the 57 eligible persons, invited for colonoscopy, 32(56.4%) underwent the procedure , of whom 7 had polyps and 5 patients had cancer or advanced adenoma. Conclusions Cancers and adenomatous polyps which are treatable and curable can be successfully picked up by primary care level screening programs. Relevance, feasibility and cost effectiveness of such screening programs in Middle East has to be confirmed by community based programmatic screening studies in our region
The Impact Of Viral Evolution And Frequency Of Variant Epitopes On Primary And Memory Hiv-1-Specific Cd8+ T Cell Responses
Authors: Melhem Nada
Published: November 2013

It is not clear if HIV-1 variants lose the ability to prime naïve CD8+ cytotoxic T lymphocytes (CTL) during progressive, untreated infection. Answering this question is important for developing immunotherapeutic approaches for enhanced control of residual HIV-1 infection in persons on combination antiretroviral therapy (cART). We therefore conducted a comprehensive longitudinal analysis of viral evolution and its impact on primary and memory CD8+ T cell responses pre-seroconversion (SC), post-SC, and during cART. We report the emergence of variant sequences in Gag, Env, and Nef at early (0-3 yr) and late (3.3-7.8 yr) times following SC, and after ART (>8 yr). Memory T cell responses targeting autologous virus variants reached a nadir by 8 yr post-SC along with the development of AIDS. This was followed by a transient enhancement of anti-HIV-1 CTL responses upon initiation of cART. The frequency of epitope variants was clearly associated with the breadth but not the magnitude of memory T cell responses. Our study reveals that the immune system retained its capacity to induce broad and high magnitude, primary T cell responses to late variants in pre-SC T cells, comparable to primary anti-HIV-1 responses induced in T cells from HIV-1 uninfected persons. Consequently, despite evolutionary changes in HIV-1, CD8+ T cells can still be primed to viral variants. Hence, vaccination against late, mutated epitopes could be successful in enhancing primary reactivity of T cells for control of the residual reservoir of HIV-1 in persons on ART.
Coronary artery bypass graft patients in Qatar: Possibly the youngest with the highest incidence of diabetes in the world
Authors: Carr Cornelia
Published: November 2013

Coronary Artery Disease in Qatar: Coronary artery bypass graft (CABG) - population possibly the youngest with the highest incidence of diabetes in the world. CS Carr, M Abdulsamad, AM Alkhulaifi Objective: Coronary artery disease is a potentially life-threatening condition. At the Heart Hospital we have an internationally established surgical database to collect data on our cardiac surgical patients. We studied our isolated CABG patients in terms of demographics, rate of diabetes, left ventricular function, and percentage of glycosylated haemoglobin (marker of blood sugar control). Methods: Data were collected from isolated CABG patients (September 2011 until March 2013) at the new Heart Centre in Qatar. Data were derived from theatre logs, the 'Dendrite' surgical database and the Hospital Information System, A standard statistical package was used for analysis. Results: There were 314 patients who underwent isolated CABG within the 18 month study period. 287 (91%) were male; the average age was 55.87 years (55 mean, 58 mode, 55 median). 188 (60%) patients were of Indian Subcontinent origin with the overall ethnicity represented in table 1. Table 1: Distribution of ethnic origin of the CABG patients. 213 patients had a diagnosis of diabetes mellitus (68% of the CABG patients). The glycosylated haemoglobin (HbA1C) was measured in 88% (275 out of 314 patients) of the CABG patients (213 of the diabetic patients). The average value was 7.66 (normal value <6%). The range of values for our patients is shown in figure 1. Figure 1: Distribution of HbA1c for the diabetic patients. The ejection fractions for the patients are divided into good, moderate and poor. The proportions of each group are shown in figure 2. Figure 2: Pie chart representation of the distribution of pre-operative ejection fractions of the CABG patients. Conclusions: Our CABG population appears to be very young (compared to the European Association of Cardiothoracic Surgeons, EACTS, 2010 data book, data for 29 countries). Our rate of diabetes is extremely high at 68% and has extremely variable sugar control. Mass screening for diabetes and early tight control may have a considerable impact on our general population in terms of long term health and financial burden on the health services.