QS Highlights: Heat Waves in Qatar

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EXERCISE COULD HELP WIN THE OBESITY FIGHT A CLOSER LOOK AT HEART MUSCLE CELLS MAY OFFER NEW TREATMENTS FOR CHRONIC DISEASES P.2

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THE RISE OF

HEAT WAVES IN QATAR CHILDREN AND ELDERLY PEOPLE MAY BE PARTICULARLY AT RISK P.8

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PRINTING HEARTS FROM SEAWEED

SEAWEEDS AND 3D PRINTING MAY BE THE FUTURE OF HEART VALVE REPLACEMENT P.7

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ON THE BENEFITS OF SLEEP

WORKING THE GRAVEYARD SHIFT COULD LEAD TO AN EARLY GRAVE P.8

Qatar Medical Journal (QMJ) • • •

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Qatar’s leading medical journal Established in 1992 Over 30 issues with over 600 research articles and conference proceedings published to date Includes a variety of research articles, review articles and case reports

Journal of Emergency Medicine, Trauma and Acute Care (JEMTAC) • •

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Established in 2012 A platform for the discussion of all topics related to emergency trauma and acute care Over 200 research articles and conference proceedings published

, Hamad Medical Corporation s journals are published on QScience.com, Hamad Bin Khalifa University Press’s open access, academic, peerreviewed publishing platform.

http://www.qscience.com/

QScience.com offers a unique and collaborative research environment for academics and scientists in Qatar and the rest of the world.

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CONTENTS

Exercise could help win the obesity fight

7

Printing hearts from seaweed

Editor’s Note

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Hamad Bin Khalifa University Press, Education City, Student Centre, P.O. Box: 5825, Doha, Qatar Email: hbkupcomms@hbku.edu.qa Phone: +974 4454 0960, +974 4454 2433 | Nature Research The Campus – 4 Crinan Street – London, N1 9XY, UK Email: partnerships@nature.com Web: www.nature.com

SCIENCE.COM IS an open access, peer-reviewed publishing platform from Hamad bin Khalifa University Press (HBKU Press) in Qatar. The portal offers a portfolio of different journals that showcase a flurry of research and reviews from the natural and social sciences.

As part of its continuous effort to support open access publishing and advance the communication of scientific knowledge worldwide, Nature Research partnered with QScience. com to offer QScience Highlights, a regularly updated website that features research published across the different QScience journals. The website offers research highlights that describe the findings and implications of original research papers and reviews in a way that is accessible to a wider array of audiences from different fields, backgrounds and disciplines.

Launched in December 2014, the website has offered over a hundred articles, covering topics that range from cardiology and clinical studies to feminism and education to readers from all over the world.

This supplement is meant to offer readers a glimpse into the diversity that Qscience Highlights boasts, by showcasing a selection of ten of the online portal’s most prominent research highlights. We hope that the next pages will provide readers and potential authors with an idea of the width and breadth of topics that QScience.com offers, including how it helps bring science to readers worldwide.

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qs cience.com / May 2017

Between obstacles and opportunities for exercise, most Arabs still do not get enough physical activity.

The future of heart valve replacements may lie in a combination of seaweeds and 3D printing.

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Bringing equality to healthcare in Qatar

Data gathered from surveys suggest that Qataris and non-Qataris are enjoying the same level of healthcare in Qatar.

4

Foreseeing crop growth

A new model can help predict the best growing spots for a crop that can be used for biofuel.

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Working the graveyard shift could lead to an early grave.

A recent review makes some recommendations for changes to save lives.

Sweat is more than just “cool”

A review on the most prevalent type of sweat gland in the human body reveals that there is more to them than first meets the eye.

On the benefits of sleep

8

The rising danger of Heat waves

Heat waves are expected to increase in Qatar over the next five years, increasing susceptibility to several diseases.

10 Examining Qatar’s history in folk medicine

An openaccess digital repository offers researchers a glimpse into Qatar’s history of folk medicine.

12 The reactive heart

Researchers look to heart muscle cells to understand what makes the heart tick

Birds preying on lizards in Qatar

Researchers are hoping they can study shrikes hunting lizards in Qatar to boost efforts for conservation of rare species.

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EP IDEMIOL O G Y

EXERCISE COULD HELP WIN THE OBESITY FIGHT

O

besity is a growing healthcare problem worldwide, and especially throughout the Middle East. The fast adoption of a Western lifestyle, among other factors, has led to reduced physical activity and an increase in the consumption of sugars and saturated fats.

The World Health Organization recommends that healthy adults should have at least 150 minutes of moderate exercise per week. But recent studies found only 40% of men and 27% of women in the Gulf Cooperation Council countries reported being physically active for that amount of time. In Qatar, nearly half of 18- to 19-year-olds have

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insufficient levels of physical activity, and this rate increases substantially with age.

Epidemiologists Kathleen Benjamin and Tam Truong Donnelly of the University of Calgary in Qatar reviewed the relevant literature in order to identify the factors that promote physical activity among Arab adults, and those that act as barriers to it1.

They searched several large databases for relevant English-language studies, using keywords and phrases such as “physical activity,” “exercise,” “Middle East,” “challenges,” and “enablers,” and found 47 articles, and then eliminated 32 of these, because they did not include data on Arab

adults, or because they did not focus on the barriers and facilitators of physical activity.

From their review of the remaining 14 articles, Benjamin and Donnelly find that the two most commonly reported barriers to physical exercise were lack of time, largely due to competing factors such as household chores, childcare, and extra office care, and the presence of health conditions such as heart disease, osteoarthritis and asthma. Other participants reported lack of interest or motivation, fear of injury, and excessive internet usage as major barriers to physical activity.

Some of the reported barriers are related Advertiser retains sole responsibility for content

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Between obstacles and opportunities for exercise, most Arabs still do not get enough physical activity.

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Sweat is more than just “cool” incidence of breast cancer has been steadily increasing over the past 24 years, with women diagnosed at more advanced stages, even though it is highly treatable if detected early.

A study found that very few Arab women are aware of, or participate in, regular breast cancer screening activities.

“Developing educational materials and communicating it to the public require culturally sensitive and socially appropriate language that is understandable and accessible to both Arab women and men,” says lead researcher Tam Truong Donnelly.

to cultural and social norms. Traditionally, women in some Muslim-majority countries need to be accompanied by a male relative when outdoors. This, together with their expected role in the home and the traditional dress many wear in public to preserve their modesty, further reduces Arab women’s opportunities for exercise. Other major reasons for lack of activity included the lack of appropriate facilities, and the hot weather in the region.

Some of the reported barriers are related to cultural and social norms.

The most common facilitators of physical activity were the presence of a health condition or heath scare, such as a heart attack, which motivated people to become more active. Religion was also cited as another major facilitator, with several people contending that the Quran also encourages physical activity.

1. Benjamin, K. & Donnelly, T. T. Barriers and facilitators influencing the physical activity of Arabic adults: a literature review. Avicenna 2013, 1 (2013).

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qatar has one of the highest rates of heart

attacks and strokes among young people in the world, but public health strategies could have a major impact on reducing them, suggest researchers.

By reviewing 774 patients admitted to hospital with heart attacks or strokes, they found that 40% were overweight and a further 30% were obese.

Many of them had diabetes, hypertension, high cholesterol, and/ or were smokers.

“Both Qatari nationals and expatriates should adopt healthier lifestyles to reduce the prevalence of these risk factors,” says Paul Christos, the lead researcher.

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in the arab world, the

A review on the most prevalent type of sweat gland in the human body reveals that there is more to them than first meets the eye.

Sweat glands in the skin may have more functions than previously thought. for years, sweat glands

were thought to be primarily involved in the regulation of body temperature. The eccrine gland is the most prevalent sweat gland in the human body, producing sweat in response to heat and exercise, but also in response to emotional stimuli such as fear, anxiety and pain. As sweat evaporates from the skin’s surface, the body’s temperature cools.

Weill Cornell Medical College in Qatar physiologist Douglas Bovell says, in a review published in Global Local Health Science, that recent research shows these glands have other important functions as well1.

Eccrine glands were found, for example, to add to the skin’s defence mechanisms by producing an antimicrobial peptide called dermcidin, which restricts bacterial growth on the skin.

New sites have also been identified on sweat glands that can be used to limit or block sweat gland secretion. “This may prove useful in helping people who suffer from hyperhidrosis,” a disorder that presents with excessive sweating, “or in creating commercial opportunities for new and more effective antiperspirants,” says Bovell.

Another study found that a

group of athletes who produce sweat with a higher than normal salt content — known as “salty sweaters” — had a defective chloride channel in their eccrine glands. Further research is needed to find out whether modern sports clothes designed to wick away sweat also remove beneficial antimicrobial components from the skin, adds Bovell.

Most recently, stem cells present in eccrine sweat glands were found to play an important role in renewing epithelial cells of the skin in response to wounds. More research could reveal ways to make use of these stem cells to create new sweat glands in burn victims and to improve wound healing in diabetes patients, for example.

“Further research into eccrine sweat gland function would provide a better understanding of its role, along with other skin appendages, in maintaining the skin throughout our life and in disease conditions as well as in understanding thermoregulation in greater detail,” says Bovell.

1. Bovell, D. The human eccrine

sweat gland: structure, function and disorders. Glob. Local Health Sci. 2015, 5 (2015).

qs cience.com / May 2017

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MEDIC INE

BRINGING EQUALITY TO HEALTHCARE IN QATAR Data gathered from surveys suggest that Qataris and non-Qataris are enjoying the same level of healthcare in Qatar.

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new study published online in the Journal of Local and Global Health Perspectives examines key performance indicators in the Qatari healthcare system to determine how it is coping with the demands of a sharp population increase1.

The population of Qatar rose sharply between 2004 and 2010, from 745,000 to

AGR ICULT URE

Foreseeing crop growth

Researchers draw up a model that can help predict the best growing spots for a crop that can be used for biofuel.

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nearly 1.7 million, because of the massive influx of nonQataris, and this has led to a decline in the number of healthcare professionals per capita and in hospital bed capacity.

Orsida Gjebrea of the Supreme Council of Health in Doha and colleagues from the Dubai Health Authority mined data from two national health surveys conducted in 2006 and 2010, to obtain responses from more than 8,000 individuals in total, and analysed them for information regarding access to, use of, and satisfaction with the healthcare system.

Qatar’s rapid development has led to a sharp increase in its population, but the healthcare system has managed to keep up with the rise in demand.

CAMELINA SATIVA,

as average annual rainfall and temperature1.

Argentina occupies a vast area of South America and has a variety of climates, largely determined by the Andean mountain range, which forms a natural border to the west, and the Atlantic ocean, to the east.

The model demonstrates that large areas are suitable for cultivating Camelina sativa, mostly in the northeast of the country, while the southern

commonly known

as gold of pleasure or false flax, is a flowering plant of the mustard family, which is native to the Mediterranean and central Asia. It is used to make biofuel for the aviation industry, reducing emissions of greenhouse gases

by more than 80% compared to petroleum kerosene. It is also rich in omega-3 oils so could be a suitable food source.

In order to look for potential growing areas for the crop in Argentina, Silvia Falasca of the Water and Climate Institute in Buenos Aires and her colleagues analysed climate data from meteorological stations throughout the country between 1981 and 2010, focusing especially on variables such

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C A I A I M A GE / R O B E R T D A LY/GE T T Y I M A GE S

The researchers studied nationals and non-nationals, including blue collar workers. Data for non-nationals living in collective accommodation was not available.

The researchers found that the nonQatari respondents were more likely to be married and have smaller households than the Qataris. They not only reported having a better health status, but also tended to be healthier, with fewer chronic conditions.

They found no difference between these two groups in access to healthcare, with approximately two thirds of each reporting that they usually go to one particular doctor’s office, clinic, or heath centre.

Qataris were, however, significantly more likely to report having a private hospital as their usual source of healthcare, and were also more likely to have inpatient or outpatient care in the two years the surveys were conducted. But the non-Qatari respondents were more than twice as likely to report full satisfaction with the healthcare they received.

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parts of Argentina are less suitable or not suitable at all.

Several areas, located in the eastern region of the Chaco and Formosa provinces, the western region of Corrientes, the northern and central regions of Entre Ríos, and the central and eastern regions of Buenos Aires, have optimal conditions — they receive at least 350 mm of rainfall, and have average temperatures greater than 10 °C between mid-August and

98%

of respondents reported that they had received the appropriate healthcare when they needed it.

Camelina sativa was originally grown as oilseed, but is increasing becoming attractive as a biofuel.

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Overall 98% of respondents reported that they had received the appropriate healthcare when they needed it.

This contrasts with previous studies of immigrants in the USA and Europe, who typically face significant barriers to healthcare, and this is likely because many of the non-Qataris are highly educated high income professionals.

“The latest available data suggests that blue collar workers experience similar levels of satisfaction with healthcare as non-Qatari households,” says Gjebrea, “and according to the Supreme Council of Health 2013 annual report of workers residing in collective accommodation, those with lower incomes were slightly more satisfied than the rest.”

1. Hussin, A. H., Ali, F. M. H., Reka, H., Gjebrea, O. Tracking access, utilization and health system responsiveness to inform evidence-based healthcare policy: the case of Qatar. J. Local Global Health Perspect.2015, 2 (2015).

mid-December, the time of year during which Camelina sativa growth occurs.

The model also enabled the researchers to determine which of these areas are best suited for cultivating the crop for use as a food source, and where it would best be grown to harvest biofuel.

To determine this, the researchers made sure that the production of biofuel in these areas would not be competing with the production of food crops.

The team contend that the same modelling approach can be used in other regions of the world as well to determine areas where Camelina sativa, which could offer new income models in rural areas.

1. Falasca, S. L., del Fresno, M. C. & Waldman, C. Developing an agro-climatic zoning model to determine potential growing areas for Camelina sativa in Argentina. QScience Connect 2014, 4 (2014).

qs cience.com / May 2017

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BIRDS PREYING ON LIZARDS IN QATAR Researchers are hoping they can study shrikes hunting lizards in Qatar to boost efforts for conservation of rare species.

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a collaborative study of an international

team of researchers provides the first evidence that shrike birds prey on lizards in Qatar1.

Shrikes are passerine birds belonging to the genus Lanius, which behave similarly to birds of prey. Unlike raptors, however, shrikes do not have the strong talons needed for tearing up flesh. They overcome this by impaling their prey with sharp objects such as barbed wire, cacti, and thorns. This serves to immobilize and kill their prey, and aids feeding and storage of food. It also advertises territory ownership to other shrikes as well as the male’s prowess to potential mates.

There are 29 shrike species worldwide, many of which prey on invertebrates, but some of the larger species, such as L. meridionalis, the only species resident in Qatar, hunt a wide variety of vertebrates, including amphibians, reptiles, other birds and small

mammals, including bats.

A team of scientists from Qatar, Spain, Romania and France started in 2011 a preliminary inventory of lizards in Qatar and identified 21 different lizard species.

While performing their field work near Al Jassasiya in north-eastern Qatar, they found a live male Hadhramaut sand lizard (Mesalina adramitana) freshly impaled on a palm tree, approximately one-and-ahalf metres above the ground.

Although the researchers did not see the event directly, the presence of shrikes in nearby shrubs, together with the method of impalement, strongly suggests that the shrikes preyed on the lizard.

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EN V IRONMEN T

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Cusps

Normal Valve

B IO T ECHNOL O G Y

Printing hearts from seaweed

The future of heart valve replacements may lie in a combination of seaweeds and 3D printing.

Shrikes do not have talons for hunting, but they overcome this limitation by using the environment to impale their prey.

Reports of shrikes preying on amphibians and reptiles come most often from North America and Europe. This is the first time this predatory behaviour has been reported in Qatar, and the authors also believe that theirs is the first report of this lizard species being hunted by shrikes.

The researchers note that others have also found other rare and elusive skink lizards in the same condition, impaled on plants, or found their scattered body parts in kestrel pellets. They therefore suggest that searching for animals hunted by shrikes could be a useful way of keeping an inventory of rare and elusive species, and that this may help them to estimate how shrike predation affects vulnerable lizard communities in Qatar.

1. Cogălniceanu, D, et al. Shrike predation on the lizard Mesalina adramitana in Qatar; a review of reported reptile and amphibian prey. QScience Connect 2015,1 (2015).

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C

ardiac surgeons sometimes use an extract from brown seaweed, called alginate, to treat heart failure. It is injected into heart muscle, acting like a scaffold, to give the muscle a chance to rebuild itself. Alginate is a carbohydrate made of sugar molecules bound to each other. It has been found to be an attractive bioscaffolding material because it does not invite the formation of potentially life-threatening blood clots.

Tissue engineer Albert Liberski from Sidra Medical and Research Center in Qatar reviewed the latest developments in 3D printing as a potential tool for constructing heart valves from alginate1.

Heart valves are currently replaced with one of two kinds of valves.

Manufactured mechanical valves are long lasting but require lifelong use of drugs that prevent the blood from clotting. Tissue valves do not require the use of these drugs, but they degrade over time and must be replaced every five to seven years.

Researchers are investigating the use of biodegradable scaffolding materials to construct heart valves upon which human cells can grow

and remodel the structure, resulting in a functional valve that’s able to grow with the patient. Alginate-based scaffolds are an attractive option for this purpose. Researchers are studying various techniques that might be used to build these alginate scaffolds.

“3D printing is advantageous since it enables the adjustment of the shape of the valve to the individual needs of patients,” says Liberski. But the technique is still in its infancy, he explains. One team of researchers used 3D printing to make a valve using alginate, but its resolution was low, the process slow, and the valve was not functional. The team also found problems incorporating the cells into the valve that would later grow and form tissue.

Liberski’s team managed to overcome some of the previous limitations by fabricating a functional valve in only ten minutes with cells incorporated properly into its structure. “This puts alginate-based heart valve tissue engineering on ‘fast track’,” he says.

This new approach demonstrated that 3D printing should be considered as part of a complementary process in constructing heart valves rather than a singular superior one, Liberski writes in his paper published in QScience Connect. Research in this area is limited and so there is much room for further investigation.

One area that tissue engineers need to keep their eye on, he says, is developments in 3D printing happening outside the academic world, “otherwise they might purchase a 3D printer for 20,000 Euros while another [open source] 4,000 Euro printer could do a similar job.” Also, Chinese artist Li Hongbo developed a platform that allows the transfer of 2D layers into 3D objects. “He very likely has no idea about tissue engineering, but he helped solve one of the current challenges of our field; namely efficiently colonizing objects with cells,” explains Liberski. “Inspiration spikes often from beyond the expert’s domain,” he says. “Therefore the scientist needs to open up to the public, not only to educate them but also to shamelessly harvest ideas from them.”

1. Liberski, A. R. Three-dimensional

printing of alginate: from seaweeds to heart valve scaffolds. QScience Connect 2016, 3 (2016).

qs cience.com / May 2017

7

On the benefits of sleep

Working the graveyard shift could lead to an early grave. A recent review makes some recommendations for changes to save lives.

T

he American author Edgar Allen Poe famously loathed it, referring to it as “little slices of death”, but we now know that sleep plays an important role in physical and mental health.

It is well known that sleep

deprivation can significantly affect cognitive functions such as attention and memory. More recently, sleep disturbances have been linked to a wide variety of conditions, from psychiatric disorders such as depression to neurodegenerative diseases such as Alzheimer’s and Parkinson’s.

Disruptions of the biological clock of the body may be a risk factor for several diseases.

Disruptions in the circadian rhythm, or the “biological clock” of the body, are also associated with increased risk of cancer, heart disease, and metabolic disorders. The incidence of these conditions is increasing around the world, and a growing body of evidence links this to urbanisation, unbalanced diets and the emergence of the so-called “24-hour society”, in which many do shift work.

A recent review by Dietrich Büsselberg of the Weill-Cornell Medical School in Qatar and his team summarises this evidence, in order to help understand exactly how they are linked, and

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PH YS IOL O G Y

THE RISING DANGER OF

HEAT WAVES

Heat waves are expected to increase in Qatar over the next five years, increasing susceptibility to several diseases.

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a new computerized climate model suggests that the significant majority of children and elderly people in Qatar will be exposed to high levels of hazardous heat wave events in the next five years1.

Heat waves, defined as extended periods of unusually high temperatures, are well known to have adverse effects on human health and well being. These events do not just cause discomfort and inconvenience,

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DE SER T S UN / B A L A N M A DH AVA N / ALAMY STOCK PHOTO

ME T EOROL O G Y

Advertisement Feature develop ways and policies to reverse the trend.

People who work nights are exposed to artificial light, and this significantly affects the expression of “clock genes” that synchronize body functions to the day–night cycle. Research shows that clock genes play important roles in controlling cell division and suppressing tumour growth, as well as in regulating cardiovascular and metabolic function.

While researchers are still unsure how disrupted circadian rhythms might contribute to the development of these diseases, it seems clear that long-term shift

“More long-term studies on humans—including groups experiencing regular night shifts—are needed to firmly link different diseases to conditions which disturb the circadian rhythm.” work poses major health risks.

Büsselberg and his colleagues make a number of recommendations for reducing these risks. They suggest, for example, that employers consider reducing the number of

shift rotations, and increasing the time between shift changes. They also suggest that night shift workers do everything they can to ensure they get good quality sleep—such as avoiding coffee and physical exertion before sleep, wearing eye masks and ear plugs—and that they have regular health checks.

“More long-term studies on humans—including groups

80%

of the general population could be exposed to hazardous heat wave events at least once in the next five years.

A 2003 heat wave is estimated to have caused more than

but can exacerbate severe cardiac and respiratory diseases such as asthma.

Heat waves are a major cause of fatality, and have significant negative impacts on agriculture, the economy and environment. The one that occurred in the summer of 2003, for example, is now considered to be the worst natural disaster of that year in the world. It was responsible for more than 70,000 deaths throughout Europe, and is estimated to have cost more than US$13 billion in economic loss.

Heat waves have been on the rise all around the world, with dire health effects.

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70,000 deaths throughout Europe, and over US$13 billion in economic loss.

experiencing regular night shifts—are needed to firmly link different diseases to conditions which disturb the circadian rhythm,” says Büsselberg.

“We are planning to have a closer look at how melatonin, the hormone which is released during the night, modulates intracellular calcium concentration, and how this could possibly relate to the induction of cancer.”

1. Shanmugam, V., Wafi, A., Al-Taweel, N. & Büsselberg, D. Disruption of circadian rhythm increases the risk of cancer, metabolic syndrome and cardiovascular disease. J. Local Global Health Sci. 2013, 3 (2013).

Summers in Qatar are prone to high temperatures, and a survey of school children there showed children had a prevalence of several respiratory diseases. This prompted Yasir Mohieldeen of the Qatar Environment and Energy Research Institute and his colleagues to launch a study of heat waves in the Gulf state.

They used land surface temperature images obtained from remotely-sensed thermal data, combined with meteorological data, and integrated data about other important factors such as land use and air pollution to generate a predictive model of frequency, intensity and duration of heat waves in Qatar.

The model, which is based on daily meteorological data from 2000 to 2012, suggests that at least 87% of Qatari infants under 4 years of age, as well as more than 86% of elderly people and 80% of the general population could be exposed to hazardous heat wave events at least once in the next five years.

According to the model, heat waves are most likely to occur in Qatar’s northern coastal region, largely because of increased humidity and temperature as a result of air pollution from expansion of the oil and gas industries. In urban areas, such as the Qatari capital Doha, the heat waves will likely be due to increased carbon dioxide emissions from cars, the generation of electricity and heat from air conditioning units which are widespread across the country.

1. Zine El Abidine, E. M., Mohieldeen, Y. E., Mohamed, A. A., Modawi, O. & Al-Sulaiti, M. H. Heat wave hazard modelling: Qatar case study.

QScience Connect 2014, 9 (2014).

qs cience.com / May 2017

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A LT ERN AT I V E MEDIC INE

EXAMINING Q ATAR’S HISTORY IN FOLK MEDICINE An open-access digital repository offers researchers a glimpse into Qatar’s history of folk medicine.

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ocuments obtained by the Qatar Unified Imaging Project, which go back as early as the 11th century up until the modern day, are allowing researchers to explore the region’s culture of traditional medicine1.

The project, funded by the Qatar National Research Fund, digitizes primary sources of information related to Qatar’s history, culture and traditions.

Researchers from Virginia Commonwealth University Qatar investigated the works available in the project’s collection to explore the culture of traditional medicine in the region.

The medical heritage of the Arab region was derived from a variety of sources. “The Arabs were exposed to Greek culture long before Islam and in the process learned the theories and practicum of healing,” write the researchers in their paper, published in the journal Avicenna. The Phoenicians played a role in transmitting 12th century Greek texts on medicine through the ports of the Near and Far East. Migratory Bedouin tribes traversing the desert, merchants trading along the ‘incense route’ and seamen arriving in ports all influenced the region with transnational healing practices. Christian missionaries introduced ‘Western-based’ medicine to the Gulf.

“The precursor of modern chemistry, alchemy, experienced a renaissance in the Arab world when the Arabs became expert chemists, and the art of pharmacology emerged into the Middle Ages,” the researchers write. Many of their texts were destroyed, however, during the Mongol invasion in the 13th Century.

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A variety of traditional healing methods have been used over the centuries. Cupping, or hijama, was described in the writings of the 11th Century Persian scholar Avicenna, as a means to remove blood impurities.

“Specific botanical elixirs and foods prescribed to patients included hijama treatments, and were carefully coordinated with the lunar calendar and planetary movements,” write the researchers.

Cautery was also central to surgical practice in Arabia and was recommended

by Avicenna.

“Folk medicine practiced in Qatar is a microcosm of the practices and beliefs of the Arabian world from which it emanates,” write the researchers. “The methodologies correlate with the needs of the people and the materials that are readily available.”

Medical herbs and plants, for example, are used to treat a variety of conditions.

The desert gourd ‘colocynthis’ is used as a purgative and diuretic to treat intestinal parasites, gonorrhoea and diabetes.

Camel grass, or Cymbopogon schoenanthus, is used to treat colic, kidney stones and rheumatism. And desert truffles, or terfeziaceae, are used to treat eye disease. Additionally, waters are used to heal wounds and skin diseases, and sands are used to treat rheumatism and joint aches.

The researchers found that in modern days, Qataris resort to herbal therapies first among all other available alternative treatments. Cupping is also used for rheumatism, headaches, back pain and toothaches. Cauterization is predominantly used when modern treatments fail, for hepatitis, sciatica, sterility and rheumatism. Qur’anic therapy, which involves the recitation of verses, protective amulets and dissolving written verses in water for ingestion, is sometimes resorted to in order to treat conditions thought to result from ‘the evil eye’. Orthopaedic therapy and massage are other forms of traditional therapy often used in Qatar.

“Medical heritage figures prominently into the historical documentation of Qatar in the 20th Century, and reflects the historical contributions of the Arabs to the development of chemistry and pharmacology, as well as the transnational influences that have affected Qatar’s health care systems over time,” write the researchers.

The team conclude their study with a list of primary source collections for the study of Arabian and related folk medicine.

1. Moe, T., Al Obaidly, F. A., Al Khoder, R. & Schmid, D. Folk medicine and integrative healing in West Asia: Analysis of historical and modern practice and perceptions. Avicenna (2014).

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qs cience.com / May 2017

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C A RDIOL O G Y

THE REACTIVE HEART

Researchers look to heart muscle cells to understand what makes the heart tick. researcHers are taKing a closer look at the

actual heart muscle cells that are responsible for pumping blood around the body, hoping to unlock new treatments for some of the most widespread chronic diseases.

Your heart is a mechanical organ that beats more than 100,000 times per day. Far from being a simple pump under exclusive control of the autonomic nervous system, the heart itself can detect changes in the demands placed upon it, and adjust its actions accordingly on a beat-by-beat basis.

This auto-regulation is possible, in part, thanks to mechanically-sensitive proteins embedded in the membranes of heart muscle cells, including stretch-activated ion channels (SACs) that respond to membrane deformations to alter the flow of electrical charges across the membrane.

SACs were first identified about 30 years ago in heart muscle cells isolated from

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chick embryos. Although they probably mediate the heart’s mechanical sensitivity, researchers have yet to identify them in the main heart chambers of mammals and have little understanding of how they work.

A recent review, published in Global Cardiology Science & Practice, summarizes what is known about heart SACs and potential future developments that may have clinical relevance1.

“A lot remains to be discovered in this exciting field,” says senior author Rémi Peyronnet, from Imperial College London, United Kingdom. “We still don’t know what tensions are present where in a cell, or exactly what activates the channels in vivo.”

Researchers have identified a number of molecules that exhibit the appropriate electrophysiological properties of SACs, with transient receptor potential (TRP)

channels, which are widely expressed in several organs, being among the most likely candidates.

Several TRP channels are found in the heart. For example, antibody staining experiments in rat heart muscle cells show that the distribution of TRPC6 is consistent with a role in sensing membrane stretching.

Some studies further demonstrate that it is sensitive to mechanical forces, but others provide conflicting results regarding both its sensitivity and its distribution.

Other candidates include several different types of potassium channels. One of these is TREK-1, which is regulated by membrane deformation and stretch, as well as other types of stimuli. Another is a channel called KATP, which exhibits mechanical sensitivity and is expressed in the heart after infarction and other diseases.

Stretch-activated channels are implicated in a wide range of diseases, including depression and muscular dystrophy, says Peyronnet. “[They] are obvious therapeutic targets. Channel- and organ-specific inhibitors may be of significant utility for improving patient conditions, and [some of these] are already under investigation.”

1. Christos, P. J. et al. Prevention during the epidemiologic shift to chronic illness: a case control study of risk factors associated with cardiovascular disease in Qatar. J. Local Global Health Perspect.

2013, 4 (2013).

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SEBASTIAN K AULITZKI / AL AMY

The heart is constantly regulating its pulse rate by small changes in proteins present in the muscle cells

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