Haemoprocessor: A Portable Platform Using Rapid Acoustically Driven Plasma Separation Validated by Infrared Spectroscopy for Point-of-Care Diagnostics.

The identification of biomarkers from blood plasma is at the heart of many diagnostic tests. These tests often need to be conducted frequently and quickly, but the logistics of sample collection and processing not only delays the test result, but also puts a strain on the healthcare system due to the sheer volume of tests that need to be performed. The advent of microfluidics has made the processing of samples quick and reliable, with little or no skill required on the user's part. However, while several microfluidic devices have been demonstrated for plasma separation, none of them have validated the chemical integrity of the sample post-process. Here, we present Haemoprocessor: a portable, robust, open-fluidic system that utilizes Travelling Surface Acoustic Waves (TSAW) with the expression of overtones to separate plasma from 20× diluted human blood within a span of 2 min to achieve 98% RBC removal. The plasma and red blood cell separation quality/integrity was validated through Attenuated Total Reflection Fourier Transform Infrared (ATR-FTIR) spectroscopy and multivariate analyses to ascertain device performance and reproducibility when compared to centrifugation (the prevailing gold-standard for plasma separation). Principal Component Analysis (PCA) showed a remarkable separation of 92.21% between RBCs and plasma components obtained through both centrifugation and Haemoprocessor methods. Moreover, a close association between plasma isolates acquired by both approaches in PCA validated the potential of the proposed system as an eminent cell enrichment and plasma separation platform. Thus, compared to contemporary acoustic devices, this system combines the ease of operation, low sample requirement of an open system, the versatility of a SAW device using harmonics, and portability.

Trends and risk factors of hyperglycemia and diabetes among Kuwaiti adults: National Nutrition Surveillance Data from 2002 to 2009.

BACKGROUND: Current prevalence estimates for diabetes in Arabian Gulf countries are some of the world's highest, yet regional trends and contributing factors are poorly documented. The present study was designed to determine temporal changes in the prevalence of impaired fasting glucose (IFG) and diabetes and associated factors in Kuwaiti adults. METHODS: Data analysis from the nationally representative cross-sectional Kuwait National Nutrition Surveillance System. 2745 males and 3611 females, aged 20-69 years, attending registration for employment or pensions and Hajj Pilgrimage health check-ups or accompanying children for immunizations from 2002 through 2009 were participated. Socio-demographic and lifestyle information, height and weight, and blood samples were collected. RESULTS: During the 8 years (2002-09), prevalences of IFG in males and females decreased by 7.4% and 6.8% and of diabetes by 9.8% and 8.9% in males and females, respectively. Linear regression for blood glucose level with time, adjusted for age, BMI, blood cholesterol and education level, showed a greater decrease in males than females (1.12 vs 0.93 mmol/L); males also showed an increase in 2002-2003 followed by a marked decrease in 2006-2007 while females showed a significant decrease in 2008-2009. Both males and females showed the largest decrease in the 2nd half of the study accounting for the majority of the overall decrease (1.13 mmol/L for males and 0.87 mmol/l for females for the 4 years). Compared with 2002-03, the OR for IFG in males decreased with time, and becoming significantly lower (OR=0.32; 95% CI: 0.21-0.49) for 2008-09. In females, the OR for IFG decreased significantly with time, except in 2006-07. Similarly, the OR for diabetes in males decreased to 0.34 (95% CI: 0.24-0.49) and in females to 0.33 (95% CI: 0.22-0.50) in 2008-09. For both genders, age and BMI were independently positively associated with IFG and diabetes, while education levels and smoking were negatively associated with IFG and diabetes. No significant association was found for either hypercholesterolemia or exercise in either gender. CONCLUSION: Continued monitoring of blood glucose is needed to see if negative trends observed in 2008-2009 endure and further research of contributing factors is required for development of targeted intervention strategies.

Trends and risk factors of hypercholesterolemia among Kuwaiti adults: National Nutrition Surveillance Data from 1998 to 2009.

OBJECTIVE: To determine temporal changes in hypercholesterolemia prevalence and associated factors in Kuwaiti adults. DESIGN: Analysis of nationally representative cross-sectional population survey data from the Kuwait National Nutrition Surveillance. METHODS: A total of 15,110 men and 17,701 women, aged 20-69 years, registered for employment or pensions, Hajj Pilgrimage health checkups, or were parents accompanying their children for immunization from 1998 through 2009. Sociodemographic and lifestyle information, height and weight, and blood samples were collected. RESULTS: Hypercholesterolemia (HC; serum cholesterol ≥5.20 mmol/L) prevalence increased within the time period until 2006-2007 (men, 56.0%; women, 53.6%), except for 2002-2003, and then declined significantly in both men (33.7%) and women (30.6%). Linear and logistic regression adjusted for age, education level, and body mass index (BMI) also showed a significant upward temporal trend for total cholesterol and prevalence of moderate and high HC (except for high HC in men) until 2004-2007 followed by a significant downward trend in 2008-2009 in both men and women. For both genders, age, BMI, education level, and presence of diabetes were significantly independently associated with high HC, whereas only age and BMI were associated with moderate HC. Female smokers, compared with non-smokers, had significantly higher odds ratios for both moderate and high HC. Current exercise or fruit and vegetable intake showed no significant association for either gender. CONCLUSION: Continued monitoring of serum cholesterol is needed to see if the negative trend observed in 2008-2009 endures and further research of contributing factors is required for the development of targeted intervention strategies.

Secular trends and risk factors of overweight and obesity among Kuwaiti adults: National Nutrition Surveillance System data from 1998 to 2009.

OBJECTIVE: To determine trends in prevalence of overweight and obesity in Kuwaiti adults, and to examine their association with selected sociodemographic and lifestyle factors. DESIGN: Analysis of cross-sectional population survey data from the Kuwait National Nutrition Surveillance System. SETTING: Social and health facilities in Kuwait. SUBJECTS: Males (n 17 491) and females (n 21 120) aged 20-69 years attending registration for employment or pensions, or Hajj Pilgrimage health check-ups, or parents accompanying their children for immunization 1998 through 2009. Sociodemographic, lifestyle and anthropometric data were collected. RESULTS: Prevalence of BMI ≥ 25 kg/m2 rose from 61·8 % and 59·3 % in females and males respectively, peaked in 2004-2005 (81·4 % and 79·2 %) and fell slightly in 2008-2009 (77·3 % and 77·4 %). Obesity prevalence in females exceeded males for all years and age groups; by 2009, it had increased by 11·3 % in males and 14·6 % in females. Overweight and obesity prevalences in both genders increased until 2004-2005 but fell thereafter, with significant falls for females in 2008-2009. Logistic and linear regression analyses confirmed these temporal changes for both prevalence and BMI in both genders. The odds of obesity increased with age until the fifth decade for both genders and then declined significantly for males. Education level was negatively associated with obesity prevalence in females, while participation in leisure-time exercise was negatively associated with obesity prevalence in males. CONCLUSIONS: Although the combined prevalence of overweight and obesity (BMI ≥ 25 kg/m2) seemed to decrease from 2005 to 2009 among Kuwaiti adults, further research to clarify the identified confounders and continued monitoring are needed to confirm the decrease observed.

Kuwaiti mothers' perception of their preschool children's weight status.

OBJECTIVES: To examine the accuracy of mothers' perceptions of their children's weight status, factors associated with their perceptions, and their plans for controlling their children's weights. METHOD: Four hundred eighty-two overweight Kuwaiti preschool children and their mothers were selected from a sample of 2329 from the Kuwait Nutrition Surveillance System from September 2003 to June 2004. Heights and weights were measured for the children and their mothers to identify their weight status. Mothers were interviewed using a questionnaire to assess their perceptions and plans for their children's weights. RESULTS: Mothers of overweight children (97%), male children (88.4%), and children without a family history of obesity (89%) showed significantly incorrect perception of their children's weight. Interestingly, the age of the child, the mother's education level, the mother's working status, and the mother's body mass index did not significantly contribute to correct perception of weight status. However, two-thirds of mothers had a plan to control their children's weight. The child's age, the body mass index of mother and child, the family history of obesity, and a correct perception of a child's weight by the mother were significantly associated with a plan for weight control. CONCLUSION: A majority of Kuwaiti mothers were unable to correctly perceive their children's weight status, especially for their male, overweight children. Two-thirds of the mothers had a plan to control their weight if the children become obese. The child's age, the child and mother's body weight, and the mother's correct perception mainly affected the selection of the plan.

Age- and gender-specific smoothed waist circumference percentiles for Kuwaiti adolescents.

OBJECTIVE: To ascertain abdominal obesity prevalence (waist circumference, WC) in adolescents and to develop smoothed WC percentile charts for Kuwaiti adolescents for public health use. SUBJECTS AND METHODS: A cross-sectional study of 4,219 healthy Kuwaiti male and female secondary school students between the ages of 11-19 years was examined. Adolescents were drawn from all geographical regions of the country, as part of the Kuwait Nutrition Surveillance Program (KNSP). The KNSP consists of yearly data collections of variables, including weights, heights, and WCs and several sociodemographic variables. LMS regression was used to develop smoothed WC percentile curves. The final percentile curves presented are the result of smoothing three age-specific curves, termed lambda (L), mu (M), and sigma (S) for each gender. RESULTS: Between 5.9 and 12.8% of females and 8.0-30.3% males had WC values > or = 90th percentile. Moreover, the mean WC of males was consistently higher than those of females at each age and the percent of adolescents who exceed the 90th percentile increased with age in males, but not in females. CONCLUSION: Mean WC was higher in males than in females at every age. In most cases, two to three times greater percentages of males, compared to females, equaled or exceeded the 90th percentile, a value frequently associated with higher cardiovascular risk. These results indicate the urgent need to reduce abdominal obesity, an important indicator of the metabolic syndrome, in Kuwaiti adolescents.

Weight loss attempts among Kuwaiti adults attending the Central Medical Nutrition Clinic.

OBJECTIVES: To investigate the reasons for attempting to lose weight and identify weight loss perception and characteristics. METHODS: A cross-sectional survey of a sample of 526 Kuwaiti adults was carried out at the Central Medical Nutrition Clinic, Kuwait, from August to December 2003. Heights and weights were measured and body mass index (BMI) was calculated and classified according to WHO grades of obesity. A structured questionnaire used for collecting data was analyzed using SPSS version 12.0. RESULTS: Of the 526 subjects, the most commonly cited reasons for attempting to lose weight were to avoid health problems (n = 248, 47.1%) followed by improving personal appearance (n = 141, 26.8%). The weight loss perceptions of 263 (50%) of the subjects were within the accepted range (2-5 kg/month); 321 (61.0%)had previously attempted to lose weight, among them 147 (45.8%) followed the advice of doctors and dieticians. The major reason mentioned for stopping the previous dietary regime was inability to resist sweets and traditional foods (n = 99, 31.0%) followed by dissatisfaction with the dietary outcome (n = 79, 24.8%). CONCLUSION: The study confirms an awareness of the health risks of obesity,but an inability among the dieters to maintain a weight loss program. Hence, behavioral management techniques may be necessary to develop nutritional education approaches and effective weight management strategies.