Factors affecting antihypertensive medications adherence among hypertensive patients in Saudi Arabia

Hypertension is a health problem that has increasing prevalence worldwide. Antihypertensive medications are the key for achieving controlled blood pressure. Little is known about predictors of antihypertensive medications adherence in Saudi Arabia. This is a cross-sectional study of 308 participants from a general hospital in Jeddah city, Saudi Arabia conducted between July 2013 and February 2014. Out of the 308 participants, the results showed that 27.9% were classified as perfect adherents and 72.1% were classified as non-perfect adherents to antihypertensive medications. Significant predictors of non-perfect antihypertensive medications in this study were having non-formal education (p=0.031, OR=2.3, 95%CI = [1.82-5]), reporting a poor relationship with physicians (p=0.004, OR=2.25, 95%CI= [1.29-3.9]), and having no co-morbidities (p=0.048, OR=1.86, 95%CI [1.00-3.46]). The outcome of this study highlights the need for policies and interventions that enhance the level of formal education at a population level and improve physician-patient relationships in health care settings.

The Sorcerer II expedition: Intellectual property and biodiscovery

This article considers the significance of a leading marine biodiscovery initiative. In March 2004, Dr. J. Craig Venter announced the official launch of the Sorcerer II Expedition, a scientific expedition of discovery, which would survey marine and terrestrial microbial populations. The Expedition has the potential to uncover tens of thousands of new microbial species and tens of millions of new genes. Venter has disavowed that the Sorcerer II Expedition has any commercial ambitions. However, some have viewed the Sorcerer II Expedition with suspicion. Various civil society groups have accused the Expedition of engaging in 'biopiracy'. This article investigates the Convention on Biological Diversity 1992 and other relevant international treaties, various national and regional regimes to govern access to genetic resources, and benefit-sharing agreements. It considers the intersection of intellectual property law, contract law, environmental law, and international law in this field. This article provides a blueprint for a nationally consistent scheme for access to genetic resources, and a model for future international developments.

Using genetic algorithm in profile-based assignment of applications to virtual machines for greener data centers

The increase in data center dependent services has made energy optimization of data centers one of the most exigent challenges in today's Information Age. The necessity of green and energy-efficient measures is very high for reducing carbon footprint and exorbitant energy costs. However, inefficient application management of data centers results in high energy consumption and low resource utilization efficiency. Unfortunately, in most cases, deploying an energy-efficient application management solution inevitably degrades the resource utilization efficiency of the data centers. To address this problem, a Penalty-based Genetic Algorithm (GA) is presented in this paper to solve a defined profile-based application assignment problem whilst maintaining a trade-off between the power consumption performance and resource utilization performance. Case studies show that the penalty-based GA is highly scalable and provides 16% to 32% better solutions than a greedy algorithm.

Pioneering use of narrative method in a first-year law course to provide an authentic, inquiry-based entry into the discipline of law

Law is saturated with stories. People tell their stories to lawyers; lawyers tell their client's stories to courts; and legislators develop regulation to respond to their constituent's stories of injustice or inequality. My approach to first-year legal education respects this narrative tradition. Both my curriculum design and assessment scheme in the compulsory first-year subject Australian Legal System deploy narrative methodology as the central teaching and learning device. Throughout the course, students work on resolving the problems of four hypothetical clients. Like a murder mystery, pieces of the puzzle come together as students learn more about legal institutions and the texts they produce, the process of legal research, the analysis and interpretation of primary legal sources, the steps in legal problem-solving, the genre conventions of legal writing style, the practical skills and ethical dimensions of professional practice, and critical inquiry into the normative underpinnings and impacts of the law. The assessment scheme mirrors this design. In their portfolio-based assignment, for example, students devise their own client profile, research the client's legal position and prepare a memorandum of advice.

Evaluation of a skin self examination attitude scale using an item response theory model approach

Introduction The Skin Self-Examination Attitude Scale (SSEAS) is a brief measure that allows for the assessment of attitudes in relation to skin self-examination. This study evaluated the psychometric properties of the SSEAS using Item Response Theory (IRT) methods in a large sample of men ≥ 50 years in Queensland, Australia. Methods A sample of 831 men (420 intervention and 411 control) completed a telephone assessment at the 13-month follow-up of a randomized-controlled trial of a video-based intervention to improve skin self-examination (SSE) behaviour. Descriptive statistics (mean, standard deviation, item–total correlations, and Cronbach’s alpha) were compiled and difficulty parameters were computed with Winsteps using the polytomous Rasch Rating Scale Model (RRSM). An item person (Wright) map of the SSEAS was examined for content coverage and item targeting. Results The SSEAS have good psychometric properties including good internal consistency (Cronbach’s alpha = 0.80), fit with the model and no evidence for differential item functioning (DIF) due to experimental trial grouping was detected. Conclusions The present study confirms the SSEA scale as a brief, useful and reliable tool for assessing attitudes towards skin self-examination in a population of men 50 years or older in Queensland, Australia. The 8-item scale shows unidimensionality, allowing levels of SSE attitude, and the item difficulties, to be ranked on a single continuous scale. In terms of clinical practice, it is very important to assess skin cancer self-examination attitude to identify people who may need a more extensive intervention to allow early detection of skin cancer.

On robust face recognition via sparse coding: The good, the bad and the ugly

In the field of face recognition, sparse representation (SR) has received considerable attention during the past few years, with a focus on holistic descriptors in closed-set identification applications. The underlying assumption in such SR-based methods is that each class in the gallery has sufficient samples and the query lies on the subspace spanned by the gallery of the same class. Unfortunately, such an assumption is easily violated in the face verification scenario, where the task is to determine if two faces (where one or both have not been seen before) belong to the same person. In this study, the authors propose an alternative approach to SR-based face verification, where SR encoding is performed on local image patches rather than the entire face. The obtained sparse signals are pooled via averaging to form multiple region descriptors, which then form an overall face descriptor. Owing to the deliberate loss of spatial relations within each region (caused by averaging), the resulting descriptor is robust to misalignment and various image deformations. Within the proposed framework, they evaluate several SR encoding techniques: l1-minimisation, Sparse Autoencoder Neural Network (SANN) and an implicit probabilistic technique based on Gaussian mixture models. Thorough experiments on AR, FERET, exYaleB, BANCA and ChokePoint datasets show that the local SR approach obtains considerably better and more robust performance than several previous state-of-the-art holistic SR methods, on both the traditional closed-set identification task and the more applicable face verification task. The experiments also show that l1-minimisation-based encoding has a considerably higher computational cost when compared with SANN-based and probabilistic encoding, but leads to higher recognition rates.

How talk and interaction unfold in a digitally enabled preschool classroom

The use of mobile digital devices, such as laptops and tablets, has implications for how teachers interact with young students within the institutional context of educational settings. This article examines language and participation in a digitally enabled preschool classroom as students engage with teachers and peers. Ethnomethodology, conversation analysis and membership categorization analysis are used to explicate video-recorded episodes of students (aged 3-5 years) interacting while using a laptop and a tablet. Attending to the sequential organization (when, how) and the context relevance (where) of talk and interaction, analysis shows how the intersection of interactions involving the teacher, students and digital devices, shape the ways that talk and interactions unfold. Analysis found that the teacher-student interactions were jointly arranged around a participation framework that included: 1) the teacher’s embodied action that mobilizes an accompanying action by a student, 2) allocation of turn-taking and participation while using a digital device and, 3) the affordances of the digital device in relation to the participants’ social organization. In this way, it is possible to understand not just what a digital device is or does, but the affordances of what it makes possible in constituting teachers’ and students’ social and learning relationships.

An analytical study revisiting debate on interpretation of Article 38 of the Statute of International Court of Justice

Article 38(1) of the Statute of International Court of Justice (hereinafter ICJ) is today generally seen as a direction to the significant sources of international law, which the world court must consider in resolving disputes; however, the list is not exhaustive nor encompasses all the formal and material sources of the international legal system. Article 38 of the Statute of ICJ was written ninety years ago in a different world, a question is under debate in many states, whether or not sources mentioned in Article 38 of the statute are compatible with needs of 21st century ? In recent decade, many new actors come on the stage which have transformed international law and now it is not only governs relations among states but also covers many International Organizations. Article 38(2) does refer to the other possible sources but does not define them. Moreover, law is a set of rules that citizens must follow to regulate peace and order in society. These laws are binding on both the individual and the state on a domestic and international level. Do states regard this particular rule as a rule of international law? The modern legal system of states is in the form of a specified and well organized set of rules, regulating affairs of different organs of a state. States also need a body of rules for their intercourse with each other. These sets of rules among states are called “International Law.” This article examines international law, its foundation and sources. It considers whether international conventions and treaties can be the only way states can considerably create international law, or there is a need for clarity about the sources of international law. Article is divided into two parts, the first one deals with sources of international law discussed in Article 38 of the statute of International Court of Justice whereas the second one discusses the material and formal sources of law, which still need reorganization as sources of law.

Comparative proteomics of uropathogenic Escherichia coli during growth in human urine identify UCA-like (UCL) fimbriae as an adherence factor involved in biofilm formation and binding to uroepithelial cells

Uropathogenic Escherichia coli (UPEC) are the primary cause of urinary tract infection (UTI) in humans. For the successful colonisation of the human urinary tract, UPEC employ a diverse collection of secreted or surface-exposed virulence factors including toxins, iron acquisition systems and adhesins. In this study, a comparative proteomic approach was utilised to define the UPEC pan and core surface proteome following growth in pooled human urine. Identified proteins were investigated for subcellular origin, prevalence and homology to characterised virulence factors. Fourteen core surface proteins were identified, as well as eleven iron uptake receptor proteins and four distinct fimbrial types, including type 1, P, F1C/S and a previously uncharacterised fimbrial type, designated UCA-like (UCL) fimbriae in this study. These pathogenicity island (PAI)-associated fimbriae are related to UCA fimbriae of Proteus mirabilis, associated with UPEC and exclusively found in members of the E. coli B2 and D phylogroup. We further demonstrated that UCL fimbriae promote significant biofilm formation on abiotic surfaces and mediate specific attachment to exfoliated human uroepithelial cells. Combined, this study has defined the surface proteomic profiles and core surface proteome of UPEC during growth in human urine and identified a new type of fimbriae that may contribute to UTI.

Mary Robinson's declaration of climate justice: Climate change, human rights and fossil fuel divestment

In her biography, Everybody Matters: My Life Giving Voice, Mary Robinson explained how she became interested in the topic of human rights and climate change, after hearing testimony from African farmers, with Archbishop Desmond Tutu.

G-protein beta3 subunit gene (GNB3) variant in causation of essential hypertension

-Essential hypertensives display enhanced signal transduction through pertussis toxin-sensitive G proteins. The T allele of a C825T variant in exon 10 of the G protein beta3 subunit gene (GNB3) induces formation of a splice variant (Gbeta3-s) with enhanced activity. The T allele of GNB3 was shown recently to be associated with hypertension in unselected German patients (frequency=0.31 versus 0.25 in control). To confirm and extend this finding in a different setting, we performed an association study in Australian white hypertensives. This involved an extensively examined cohort of 110 hypertensives, each of whom were the offspring of 2 hypertensive parents, and 189 normotensives whose parents were both normotensive beyond age 50 years. Genotyping was performed by polymerase chain reaction and digestion with BseDI, which either cut (C allele) or did not cut (T allele) the 268-bp polymerase chain reaction product. T allele frequency in the hypertensive group was 0.43 compared with 0.25 in the normotensive group (chi2=22; P=0.00002; odds ratio=2.3; 95% CI=1.7 to 3.3). The T allele tracked with higher pretreatment blood pressure: diastolic=105+/-7, 109+/-16, and 128+/-28 mm Hg (mean+/-SD) for CC, CT, and TT, respectively (P=0.001 by 1-way ANOVA). Blood pressures were higher in female hypertensives with a T allele (P=0.006 for systolic and 0.0003 for diastolic by ANOVA) than they were in male hypertensives. In conclusion, the present study of a group with strong family history supports a role for a genetically determined, physiologically active splice variant of the G protein beta3 subunit gene in the causation of essential hypertension.

Enterprise system investments for competitive advantage: An empirical study of Swiss SMEs

Previous research identifies various reasons companies invest in information technology (IT), often as a means to generate value. To add to the discussion of IT value generation, this study investigates investments in enterprise software systems that support business processes. Managers of more than 500 Swiss small and medium-sized enterprises (SMEs) responded to a survey regarding the levels of their IT investment in enterprise software systems and the perceived utility of those investments. The authors use logistic and ordinary least squares regression to examine whether IT investments in two business processes affect SMEs' performance and competitive advantage. Using cluster analysis, they also develop a firm typology with four distinct groups that differ in their investments in enterprise software systems. These findings offer key implications for both research and managerial practice.

Carbon dioxide emissions in the short run: The rate and sources of economic growth matter

This paper investigates the short-run effects of economic growth on carbon dioxide emissions from the combustion of fossil fuels and the manufacture of cement for 189 countries over the period 1961-2010. Contrary to what has previously been reported, we conclude that there is no strong evidence that the emissions-income elasticity is larger during individual years of economic expansion as compared to recession. Significant evidence of asymmetry emerges when effects over longer periods are considered. We find that economic growth tends to increase emissions not only in the same year, but also in subsequent years. Delayed effects - especially noticeable in the road transport sector - mean that emissions tend to grow more quickly after booms and more slowly after recessions. Emissions are more sensitive to fluctuations in industrial value added than agricultural value added, with services being an intermediate case. On the expenditure side, growth in consumption and growth in investment have similar implications for national emissions. External shocks have a relatively large emissions impact, and the short-run emissions-income elasticity does not appear to decline as incomes increase. Economic growth and emissions have been more tightly linked in fossil-fuel rich countries.

A combination of local inflammation and central memory T cells potentiates immunotherapy in the skin

Adoptive T cell therapy uses the specificity of the adaptive immune system to target cancer and virally infected cells. Yet the mechanism and means by which to enhance T cell function are incompletely described, especially in the skin. In this study, we use a murine model of immunotherapy to optimize cell-mediated immunity in the skin. We show that in vitro - derived central but not effector memory-like T cells bring about rapid regression of skin-expressing cognate Ag as a transgene in keratinocytes. Local inflammation induced by the TLR7 receptor agonist imiquimod subtly yet reproducibly decreases time to skin graft rejection elicited by central but not effector memory T cells in an immunodeficient mouse model. Local CCL4, a chemokine liberated by TLR7 agonism, similarly enhances central memory T cell function. In this model, IL-2 facilitates the development in vivo of effector function from central memory but not effector memory T cells. In a model of T cell tolerogenesis, we further show that adoptively transferred central but not effector memory T cells can give rise to successful cutaneous immunity, which is dependent on a local inflammatory cue in the target tissue at the time of adoptive T cell transfer. Thus, adoptive T cell therapy efficacy can be enhanced if CD8+ T cells with a central memory T cell phenotype are transferred, and IL-2 is present with contemporaneous local inflammation. Copyright © 2012 by The American Association of Immunologists, Inc.