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  • 201.
    Jacobsson, Josefin A.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Sällman Almén, Markus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Benedict, Christian
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Hedberg, Lilia A.
    Michaëlsson, Karl
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Brooks, Samantha
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Kullberg, Joel
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Radiology.
    Axelsson, Tomas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular Medicine.
    Johansson, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Radiology.
    Ahlström, Håkan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Radiology, Oncology and Radiation Science, Radiology.
    Fredriksson, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Schiöth, Helgi B.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Functional Pharmacology.
    Detailed Analysis of Variants in FTO in Association with Body Composition in a Cohort of 70-Year-Olds Suggests a Weakened Effect among Elderly2011In: PLOS ONE, E-ISSN 1932-6203, Vol. 6, no 5, p. e20158-Article in journal (Refereed)
    Abstract [en]

    Background

     The rs9939609 single-nucleotide polymorphism (SNP) in the fat mass and obesity (FTO) gene has previously been associated with higher BMI levels in children and young adults. In contrast, this association was not found in elderly men. BMI is a measure of overweight in relation to the individuals' height, but offers no insight into the regional body fat composition or distribution.

    Objective

    To examine whether the FTO gene is associated with overweight and body composition-related phenotypes rather than BMI, we measured waist circumference, total fat mass, trunk fat mass, leg fat mass, visceral and subcutaneous adipose tissue, and daily energy intake in 985 humans (493 women) at the age of 70 years. In total, 733 SNPs located in the FTO gene were genotyped in order to examine whether rs9939609 alone or the other SNPs, or their combinations, are linked to obesity-related measures in elderly humans.

    Design

    Cross-sectional analysis of the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) cohort.

    Results

     Neither a single SNP, such as rs9939609, nor a SNP combination was significantly linked to overweight, body composition-related measures, or daily energy intake in elderly humans. Of note, these observations hold both among men and women.

    Conclusions

    Due to the diversity of measurements included in the study, our findings strengthen the view that the effect of FTO on body composition appears to be less profound in later life compared to younger ages and that this is seemingly independent of gender.

  • 202.
    Jallow, Amadou
    et al.
    Sunnfjord Apotek, Forde, Norway..
    Ljunggren, Gunnar
    Stockholm Cty Council, Publ Healthcare Serv Comm Adm, Box 6909, SE-10239 Stockholm, Sweden.;Karolinska Inst, Dept Learning Informat Management & Eth, Med Management Ctr, Berzelius Vag 3, SE-17177 Stockholm, Sweden..
    Wandell, Per
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med, Huddinge, Sweden..
    Wahlstrom, Lars
    Karolinska Inst, Ctr Psychiat Res, Stockholm, Sweden..
    Carlsson, Axel C.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med, Huddinge, Sweden..
    HIV-infection and psychiatric illnesses: A double edged sword that threatens the vision of a contained epidemic The Greater Stockholm HIV Cohort Study2017In: Journal of Infection, ISSN 0163-4453, E-ISSN 1532-2742, Vol. 74, no 1, p. 22-28Article in journal (Refereed)
    Abstract [en]

    Context: The Greater Stockholm HIV Cohort Study is an initiative to provide longitudinal information regarding the health of people living with HIV. Objective: Our aim was to explore the prevalence of HIV and its association with psychiatric co-morbidities. Design, setting and participants: All patients with a recorded diagnosis of HIV ( any position of the ICD-10 codes B20-B24) were identified during the period 2007-2014 and related to the total population in Stockholm by January 1, 2015, N = 2.21 million. The age at diagnosis, gender, and first occurrence of an HIV diagnosis was recorded. Analyses were done by age and gender. Prevalence of psychiatric co-morbidities amongst HIV patients were recorded. Main outcome measures: Age-adjusted odds ratios with 95% confidence intervals were calculated with logistic regression for prevalent psychiatric co-morbidities in HIV infected individuals compared to the prevalence in the general population. Results: The total prevalence of HIV was 0.16%; females 0.10% (n Z 1134) and males 0.21% (n Z 2448). HIV-infected people were more frequently diagnosed with psychiatric illnesses and drug abuse. In females and males with HIV-diagnosis respectively, drug dependence disorder was 7.5 (7.76% vs 1.04%) and 5.1 (10.17% vs 1.98%) times higher, psychotic disorders were 6.3 (2.65% vs 0.42%) and 2.9 (1.43% vs 0.49%) times higher, bipolar disorder was 2.5 (1.41% vs 0.57%) and 3 (1.02% vs 0.34%) times higher, depression diagnosis was 1.5 (8.47% vs 5.82%) and 3.4 (10.17% vs 2.97%) higher, trauma-related disorder was 1.5 (6.00% vs 4.10%) respectively 2.9 (4.45% vs 1.56%) times higher, anxiety disorder was 1.2 (6.88% vs 5.72%) and 2.2 (6.54% vs 2.93%) times higher than in their non-infected peers. Conclusion: Despite effective ART, many individuals with HIV have an impaired mental health and a history of drug abuse that may threaten the vision of a contained epidemic. (C) 2016 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  • 203.
    Jangland, Eva
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Education in Nursing.
    Kitson, Alison
    Univ Adelaide, Sch Nursing, Adelaide, SA 5005, Australia;Australia Green Templeton Coll, Cent Adelaide Local Hlth Network, Adelaide, SA, Australia;Univ Oxford, Oxford OX1 2JD, England.
    Muntlin Athlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. School of Nursing, University of Adelaide, South Australia, Australia.
    Patients with acute abdominal pain describe their experiences of fundamental care across the acute care episode: a multi-stage qualitative case study2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, no 4, p. 791-801Article in journal (Refereed)
    Abstract [en]

    AIM: To explore how patients with acute abdominal pain describe their experiences of fundamental care across the acute care episode.

    BACKGROUND: Acute abdominal pain is one of the most common conditions to present in the acute care setting. Little is known about how patients' fundamental care needs are managed from presentation to post discharge.

    DESIGN: A multi-stage qualitative case study using the Fundamentals of Care framework as the overarching theoretical and explanatory mechanism.

    METHODS: Repeated reflective interviews were conducted with five adult patients over a 6-month period in 2013 at a university hospital in Sweden. The interviews (n = 14) were analysed using directed content analysis.

    RESULTS: Patients' experiences across the acute care episode are presented as five patient narratives and synthesized into five descriptions of the entire hospital journey. The patients talked about the fundamentals of care and had vivid accounts of what they meant to them. The experiences of each of the patients were influenced by the extent to which they felt engaged with the health professionals. The ability to engage or build a rapport was identified as a central component across the fundamental care elements, but it varied in visibility.

    CONCLUSION: Consistent pain management, comfort, timely and accurate information, choice and dignity and relationships were identified as essential fundamental care needs of patients experiencing acute abdominal pain regardless of setting, diagnosis, or demographic variables. These were variously achieved and the patients' narratives raised areas for improvement in several areas.

  • 204. Jayasinghe, Saroj
    et al.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Salihovic, Samira
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab. MTM Research Centre, School of Science and Technology, Örebro University, Örebro, Sweden.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Lind, P. Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    DDT and its metabolites could contribute to the aetiology of chronic kidney disease of unknown aetiology (CKDu) and more studies are a priority2019In: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 649, p. 1638-1639Article in journal (Refereed)
  • 205. Jayasinghe, Saroj
    et al.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Salihovic, Samira
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Lind, P. Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    High serum levels of p,p'-DDE are associated with an accelerated decline in GFR during 10 years follow-up.2018In: Science of the Total Environment, ISSN 0048-9697, E-ISSN 1879-1026, Vol. 644, p. 371-374Article in journal (Refereed)
    Abstract [en]

    Over the past 20 years, the global incidence of chronic kidney disease (CKD) has been increasing and organochlorine pesticides (such as DDT) is a suspected etiological factor. The present study examines the associations between low level background exposure to p,p'-DDE (1-dichloro-2,2-bis (p-chlorophenyl) ethylene), the main DDT metabolite, and kidney function during a 10-year follow-up. Data was analysed from the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study (n = 1016, 50% women, all aged 70 years). Serum levels of p,p'-DDE was measured by gas chromatography coupled to high-resolution mass spectrometry (GC/HRMS) at baseline (i.e. age of 70 years). Glomerular filtration rate (GFR) was estimated using serum creatinine and cystatin C at 70, 75 and 80 years of age. A significant decline in GFR was seen during the 10-year follow-up (-24 ml/min/1.73 m2, p < 0.0001). A significant negative interaction was seen between baseline p,p'-DDE levels and change in GFR over time (p < 0.0001) following adjustment for sex, systolic blood pressure, diabetes, BMI, smoking and education level at age 70. Subjects with the lowest levels of p,p'-DDE levels at age 70 showed the lowest decline in GFR over 10 years, while subjects with the highest p,p'-DDE levels showed the greatest decline. Baseline levels of p,p'-DDE were related to an accelerated reduction in GFR over 10 years suggesting a nephrotoxic effect of DDT/p,p'-DDE. These findings support a potential role for DDT in the epidemic of CKD of unknown etiology (CKDu) in agricultural communities of Sri Lanka and Central America where DDT was previously used.

  • 206.
    Jeffs, Lianne
    et al.
    Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada.
    Muntlin Athlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. School of Nursing, University of Adelaide, Australia.
    Needleman, Jack
    UCLA Fielding School of Public Health / Department of Health Policy and Management, USA.
    Jackson, Debra
    Oxford Brookes University/Department of Nursing,Faculty of Health and Life Sciences, UK.
    Kitson, Alison
    School of Nursing, University of Adelaide, Australia; Centre for Evidence based Practice South Australia, School of Nursing, The University of Adelaide, Australia;Green Templeton College, University of Oxford, United Kingdom .
    Building the Foundation to Generate a Fundamental Care Standardized Data Set2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 11-12, p. 2481-2488Article in journal (Refereed)
    Abstract [en]

    Considerable transformation is occurring in healthcare globally with organizations focusing on achieving the quadruple aim of improving the experience of care, the health of populations, and the experience of providing care while reducing per capita costs of health care. In response, health care organizations are employing performance measurement and quality improvement methods to achieve the quadruple aim. Despite the plethora of measures available to health managers, there is no standardized data set and virtually no indicators reflecting how patients actually experience the delivery of fundamental care, such as nutrition, hydration, mobility, respect, education, and psychosocial support. Given the linkages of fundamental care to safety and quality metrics, efforts to build the evidence base and knowledge that captures the impact of enacting fundamental care across the health care continuum and lifespan should include generating a routinely collected data set of relevant measures. This paper provides an overview of the current state of performance measurement, key trends, and a methodological approach to leverage in efforts to generate a standardized data set for fundamental care.

  • 207.
    Jiang, Jiyang
    et al.
    Univ New South Wales, Sch Psychiat, Ctr Hlth Brain Ageing, Sydney, NSW, Australia.
    Thalamuthu, Anbupalam
    Univ New South Wales, Sch Psychiat, Ctr Hlth Brain Ageing, Sydney, NSW, Australia.
    Ho, Jennifer E.
    Massachusetts Gen Hosp, Cardiovasc Res Ctr, Boston, MA 02114 USA;Massachusetts Gen Hosp, Dept Med, Div Cardiol, Boston, MA 02114 USA.
    Mahajan, Anubha
    Univ Oxford, Wellcome Trust Ctr Human Genet, Oxford, England.
    Ek, Weronica E
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Medicinsk genetik och genomik. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Brown, David A.
    St Vincents Hosp, St Vincents Ctr Appl Med Res, Darlinghurst, NSW, Australia;Westmead Inst Med Res, Inst Clin Pathol & Med Res, Westmead, NSW, Australia;Westmead Hosp, Westmead, NSW, Australia.
    Breit, Samuel N.
    St Vincents Hosp, St Vincents Ctr Appl Med Res, Darlinghurst, NSW, Australia.
    Wang, Thomas J.
    Vanderbilt Univ, Dept Med, Div Cardiol, Nashville, TN USA.
    Gyllensten, Ulf B.
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Medicinsk genetik och genomik.
    Chen, Ming-Huei
    NHLBI, Populat Sci Branch, NIH, Framingham, MA USA;Framingham Heart Dis Epidemiol Study, Framingham, MA USA.
    Enroth, Stefan
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Medicinsk genetik och genomik.
    Januzzi, James L., Jr.
    Massachusetts Gen Hosp, Dept Med, Div Cardiol, Boston, MA 02114 USA.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Armstrong, Nicola J.
    Univ New South Wales, Sch Psychiat, Ctr Hlth Brain Ageing, Sydney, NSW, Australia;Murdoch Univ, Math & Stat, Perth, WA, Australia.
    Kwok, John B.
    Neurosci Res Australia, Randwick, NSW, Australia;Univ New South Wales, Sch Med Sci, Sydney, NSW, Australia.
    Schofield, Peter R.
    Neurosci Res Australia, Randwick, NSW, Australia;Univ New South Wales, Sch Med Sci, Sydney, NSW, Australia.
    Wen, Wei
    Univ New South Wales, Sch Psychiat, Ctr Hlth Brain Ageing, Sydney, NSW, Australia;Prince Wales Hosp, Neuropsychiat Inst, Randwick, NSW, Australia.
    Trollor, Julian N.
    Univ New South Wales, Sch Psychiat, Ctr Hlth Brain Ageing, Sydney, NSW, Australia;Univ New South Wales, Sch Psychiat, Dept Dev Disabil Neuropsychiat, Sydney, NSW, Australia.
    Johansson, Åsa
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Medicinsk genetik och genomik.
    Morris, Andrew P.
    Univ Oxford, Wellcome Trust Ctr Human Genet, Oxford, England;Univ Liverpool, Dept Biostat, Liverpool, Merseyside, England.
    Vasan, Ramachandran S.
    Boston Univ, Sch Med, Dept Med, Sect Prevent Med, Boston, MA 02118 USA;Boston Univ, Sch Med, Dept Med, Epidemiol Sect, Boston, MA 02118 USA;Boston Univ, Sch Med, Dept Med, Cardiol Sect, Boston, MA 02118 USA;Boston Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA USA;Natl Heart Lung & Blood Inst, Boston, MA USA;Boston Univ, Framingham Heart Study, Boston, MA 02215 USA.
    Sachdev, Perminder S.
    Univ New South Wales, Sch Psychiat, Ctr Hlth Brain Ageing, Sydney, NSW, Australia;Prince Wales Hosp, Neuropsychiat Inst, Randwick, NSW, Australia.
    Mather, Karen A.
    Univ New South Wales, Sch Psychiat, Ctr Hlth Brain Ageing, Sydney, NSW, Australia.
    A Meta-Analysis of Genome-Wide Association Studies of Growth Differentiation Factor-15 Concentration in Blood2018In: Frontiers in Genetics, E-ISSN 1664-8021, Vol. 9, article id 97Article in journal (Refereed)
    Abstract [en]

    Blood levels of growth differentiation factor-15 (GDF-15), also known as macrophage inhibitory cytokine-1 (MIC-1), have been associated with various pathological processes and diseases, including cardiovascular disease and cancer. Prior studies suggest genetic factors play a role in regulating blood MIC-1/GDF-15 concentration. In the current study, we conducted the largest genome-wide association study (GWAS) to date using a sample of similar to 5,400 community-based Caucasian participants, to determine the genetic variants associated with MIC-1/GDF-15 blood concentration. Conditional and joint (COJO), gene-based association, and gene-set enrichment analyses were also carried out to identify novel loci, genes, and pathways. Consistent with prior results, a locus on chromosome 19, which includes nine single nucleotide polymorphisms (SNPs) (top SNP, rs888663, p = 1.690 x 10(-35)), was significantly associated with blood MIC-1/GDF-15 concentration, and explained 21.47% of its variance. COJO analysis showed evidence for two independent signals within this locus. Gene-based analysis confirmed the chromosome 19 locus association and in addition, a putative locus on chromosome 1. Gene-set enrichment analyses showed that the "COPI-mediated anterograde transport" gene-set was associated with MIC-1/GDF15 blood concentration with marginal significance after FDR correction (p = 0.067). In conclusion, a locus on chromosome 19 was associated with MIC-1/GDF-15 blood concentration with genome-wide significance, with evidence for a new locus (chromosome 1). Future studies using independent cohorts are needed to confirm the observed associations especially for the chromosomes 1 locus, and to further investigate and identify the causal SNPs that contribute to MIC-1/GDF-15 levels.

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  • 208.
    Jiang, Xia
    et al.
    Harvard TH Chan Sch Publ Hlth, Program Genet Epidemiol & Stat Genet, Dept Epidemiol, 677 Huntington Ave, Boston, MA USA.;Karolinska Inst, Inst Environm Med, Unit Cardiovasc Epidemiol, Nobels Vagen 13, S-17177 Stockholm, Sweden..
    O'Reilly, Paul F.
    Kings Coll London, Inst Psychiat, Dept Social Genet & Dev Psychiat, De Crespigny Pk, London SE5 8AF, England..
    Aschard, Hugues
    Harvard TH Chan Sch Publ Hlth, Program Genet Epidemiol & Stat Genet, Dept Epidemiol, 677 Huntington Ave, Boston, MA USA.;Inst Pasteur, Ctr Bioinformat Biostat & Biol Integrat C3BI, F-75724 Paris, France..
    Hsu, Yi-Hsiang
    Hebrew SeniorLife, Inst Aging Res, 1200 Ctr St, Boston, MA 02131 USA.;Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA 02115 USA.;Harvard Med Sch, Boston, MA 02115 USA.;Broad Inst Harvard & Massachusetts Inst Technol, Boston, MA 02142 USA..
    Richards, J. Brent
    Dept Med, 3755 Cote Ste Catherine Rd,Suite H-413, Montreal, PQ H3T 1E2, Canada.;Dept Human Genet, 3755 Cote Ste Catherine Rd,Suite H-413, Montreal, PQ H3T 1E2, Canada.;Dept Epidemiol, 3755 Cote Ste Catherine Rd,Suite H-413, Montreal, PQ H3T 1E2, Canada.;Dept Biostat, 3755 Cote Ste Catherine Rd,Suite H-413, Montreal, PQ H3T 1E2, Canada..
    Dupuis, Josee
    Boston Univ, Dept Biostat, Sch Publ Hlth, Crosstown Ctr, 801 Massachusetts Ave,3rd Floor, Boston, MA 02118 USA.;Framingham Heart Dis Epidemiol Study, 73 Mt Wayte Ave, Framingham, MA 01702 USA..
    Ingelsson, Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Stanford Univ, Sch Med, Div Cardiovasc Med, Dept Med, Stanford, USA.
    Karasik, David
    Hebrew SeniorLife, Inst Aging Res, 1200 Ctr St, Boston, MA 02131 USA..
    Pilz, Stefan
    Med Univ Graz, Div Endocrinol & Diabetol, Dept Internal Med, Auenbruggerpl 15, A-8036 Graz, Austria..
    Berry, Diane
    UCL, Populat Policy & Practice, Inst Child Hlth, Great Ormond St, London WC1E 6BT, England..
    Kestenbaum, Bryan
    Kidney Res Inst, Div Nephrol, 325 Ninth Ave, Seattle, WA 98104 USA..
    Zheng, Jusheng
    Univ Cambridge, MRC Epidemiol Unit, Sch Clin Med, Cambridge Biomed Campus, Cambridge CB2 0QQ, England..
    Luan, Jianan
    Univ Cambridge, MRC Epidemiol Unit, Sch Clin Med, Cambridge Biomed Campus, Cambridge CB2 0QQ, England..
    Sofianopoulou, Eleni
    Univ Cambridge, Strangeways Res Lab, Dept Publ Hlth & Primary Care, Worts Causeway, Cambridge CB1 8RN, England..
    Streeten, Elizabeth A.
    Univ Maryland, Genet & Personalized Med Program, Sch Med, Howard Hall Room 567, Baltimore, MD 21201 USA..
    Albanes, Demetrius
    NCI, Metabol Epidemiol Branch, Div Canc Epidemiol & Genet, NIH, 9609 Med Ctr Dr, Bethesda, MD 20892 USA..
    Lutsey, Pamela L.
    Univ Minnesota, Sch Publ Hlth, Div Epidemiol & Community Hlth, 1300S 2nd St,Suite 300, Minneapolis, MN 55454 USA..
    Yao, Lu
    Univ Minnesota, Sch Publ Hlth, Div Epidemiol & Community Hlth, 1300S 2nd St,Suite 300, Minneapolis, MN 55454 USA..
    Tang, Weihong
    Univ Minnesota, Sch Publ Hlth, Div Epidemiol & Community Hlth, 1300S 2nd St,Suite 300, Minneapolis, MN 55454 USA..
    Econs, Michael J.
    Indiana Univ, Dept Med, Endocrinol, 1120W Michigan St, Indianapolis, IN 46202 USA..
    Wallaschofski, Henri
    Univ Med Greifswald, Inst Clin Chem & Lab Med, D-17489 Greifswald, Germany.;DZHK German Ctr Cardiovasc Res, Partner Site, D-13316 Greifswald, Germany..
    Voelzke, Henry
    DZHK German Ctr Cardiovasc Res, Partner Site, D-13316 Greifswald, Germany.;Univ Med Greifswald, Inst Community Med, SHIP Klinisch Epidemiol Forsch, Walther Rathenau Str 48, D-17475 Greifswald, Germany..
    Zhou, Ang
    Univ South Australia, Ctr Populat Hlth Res, Sansom Inst Hlth Res, Adelaide, SA 5001, Australia..
    Power, Chris
    UCL, Populat Policy & Practice, Inst Child Hlth, Great Ormond St, London WC1E 6BT, England..
    McCarthy, Mark I.
    Univ Oxford, Churchill Hosp, Oxford Ctr Diabet Endocrinol & Metab, Old Rd, Oxford OX3 7LJ, England.;Univ Oxford, Wellcome Ctr Human Genet, Roosevelt Dr, Oxford OX3 7BN, England.;Churchill Hosp, Oxford NIHR Biomed Res Ctr, Old Rd, Oxford OX3 7LJ, England..
    Michos, Erin D.
    Johns Hopkins Sch Med, Ciccarone Ctr Prevent Heart Dis, Div Cardiol, Baltimore, MD 21287 USA.;Johns Hopkins Bloomberg Sch Publ Hlth, Dept Epidemiol, Baltimore, MD 21205 USA..
    Boerwinkle, Eric
    Univ Texas Hlth Sci Ctr Houston, Ctr Human Genet, Houston, TX 77030 USA..
    Weinstein, Stephanie J.
    NCI, Metabol Epidemiol Branch, Div Canc Epidemiol & Genet, NIH, 9609 Med Ctr Dr, Bethesda, MD 20892 USA..
    Freedman, Neal D.
    NCI, Metabol Epidemiol Branch, Div Canc Epidemiol & Genet, NIH, 9609 Med Ctr Dr, Bethesda, MD 20892 USA..
    Huang, Wen-Yi
    NCI, Occupat & Environm Epidemiol Branch, Div Canc Epidemiol & Genet, NIH, 9609 Med Ctr Dr, Bethesda, MD 20892 USA..
    Van Schoor, Natasja M.
    Vrije Univ Amsterdam Med Ctr, Dept Epidemiol & Biostat, Amsterdam Publ Hlth Res Inst, Boelelaan 1089a, NL-1081 HV Amsterdam, Netherlands..
    van der Velde, Nathalie
    Erasmus MC, Dept Epidemiol, Postbus 2040, NL-3000 CA Rotterdam, Netherlands.;AMC, Internal Med, Dept Geriatr, POB 22700, NL-1100 DE Amsterdam, Netherlands..
    de Groot, Lisette C. P. G. M.
    Wageningen Univ, Dept Human Nutr, POB 176700, NL-700 AA Wageningen, Netherlands..
    Enneman, Anke
    Erasmus MC, Dept Epidemiol, Postbus 2040, NL-3000 CA Rotterdam, Netherlands..
    Cupples, L. Adrienne
    Boston Univ, Dept Biostat, Sch Publ Hlth, Crosstown Ctr, 801 Massachusetts Ave,3rd Floor, Boston, MA 02118 USA.;Framingham Heart Dis Epidemiol Study, 73 Mt Wayte Ave, Framingham, MA 01702 USA..
    Booth, Sarah L.
    Tufts Univ, Vitamin K Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, 711 Washington St, Boston, MA 02111 USA..
    Vasan, Ramachandran S.
    Framingham Heart Dis Epidemiol Study, 73 Mt Wayte Ave, Framingham, MA 01702 USA..
    Liu, Ching-Ti
    Boston Univ, Dept Biostat, Sch Publ Hlth, Crosstown Ctr, 801 Massachusetts Ave,3rd Floor, Boston, MA 02118 USA..
    Zhou, Yanhua
    Boston Univ, Dept Biostat, Sch Publ Hlth, Crosstown Ctr, 801 Massachusetts Ave,3rd Floor, Boston, MA 02118 USA..
    Ripatti, Samuli
    Univ Helsinki, Stat & Translat Genet, Biomedicum, Tukholmankatu 8, Helsinki 2U, Finland..
    Ohlsson, Claes
    Univ Gothenburg, Dept Internal Med & Clin Nutr, Vita Straket 11, S-41345 Gothenburg, Sweden..
    Vandenput, Liesbeth
    Univ Gothenburg, Dept Internal Med & Clin Nutr, Vita Straket 11, S-41345 Gothenburg, Sweden..
    Lorentzon, Mattias
    Univ Gothenburg, Dept Geriatr Med, S-43180 Molndal, Sweden.;Sahlgrens Univ Hosp, S-43180 Molndal, Sweden..
    Eriksson, Johan G.
    Univ Helsinki, Dept Gen Practice & Primary Hlth Care, POB 20,Tukholmankatu 8 B, FIN-00014 Helsinki, Finland.;Univ Helsinki, Helsinki Univ Hosp, POB 20,Tukholmankatu 8 B, FIN-00014 Helsinki, Finland.;Univ Helsinki, Folkhalsan Res Ctr, POB 2000014, Helsinki, Finland..
    Shea, M. Kyla
    Tufts Univ, Vitamin K Lab, Jean Mayer USDA Human Nutr Res Ctr Aging, 711 Washington St, Boston, MA 02111 USA..
    Houston, Denise K.
    Wake Forest Sch Med, Sticht Ctr Healthy Aging & Alzheimers Prevent, Med Ctr Blvd, Winston Salem, NC 27157 USA..
    Kritchevsky, Stephen B.
    Wake Forest Sch Med, Sticht Ctr Healthy Aging & Alzheimers Prevent, Med Ctr Blvd, Winston Salem, NC 27157 USA..
    Liu, Yongmei
    Wake Forest Sch Med, Div Publ Hlth Sci, Dept Epidemiol & Prevent, Med Ctr Blvd, Winston Salem, NC 27157 USA..
    Lohman, Kurt K.
    Wake Forest Sch Med, Div Publ Hlth Sci, Dept Biostat Sci, Med Ctr Blvd, Winston Salem, NC 27157 USA..
    Ferrucci, Luigi
    NIA, Longitudinal Studies Sect, Intramural Res Program, NIH, Baltimore, MD 21225 USA..
    Peacock, Munro
    Indiana Univ, Dept Med, Endocrinol, 1120W Michigan St, Indianapolis, IN 46202 USA..
    Gieger, Christian
    German Res Ctr Environm Hlth, Mol Epidemiol, AME, Ingolstadter Landstr 1, D-85764 Neuherberg, Germany..
    Beekman, Marian
    Leiden Univ, Mol Epidemiol, Med Ctr, Einthovenweg 20, NL-2333 ZC Leiden, Netherlands..
    Slagboom, Eline
    Leiden Univ, Mol Epidemiol, Med Ctr, Einthovenweg 20, NL-2333 ZC Leiden, Netherlands..
    Deelen, Joris
    Leiden Univ, Mol Epidemiol, Med Ctr, Einthovenweg 20, NL-2333 ZC Leiden, Netherlands.;Max Planck Inst Biol Ageing, Joseph Stelzmann Str 9b, D-50931 Cologne, Germany..
    van Heemst, Diana
    Leiden Univ, Gerontol & Geriatr, Med Ctr, Albinusdreef 2, NL-2333 ZA Leiden, Netherlands..
    Kleber, Marcus E.
    Heidelberg Univ, Med Fac Mannheim, Dept Med Nephrol Hypertensiol Rheumatol Endocrino, Theodor Kutzer Ufer1, D-68167 Mannheim, Germany..
    Maerz, Winfried
    Heidelberg Univ, Med Fac Mannheim, Dept Med Nephrol Hypertensiol Rheumatol Endocrino, Theodor Kutzer Ufer1, D-68167 Mannheim, Germany.;Med Univ Graz, Clin Inst Med & Chem Lab Diagnost, Auenbruggerpl 15, A-8036 Graz, Austria.;SYNLAB Holding Deutschland GmbH, Gubener Str 39, D-86156 Augsburg, Germany..
    de Boer, Ian H.
    Univ Washington, Div Nephrol, 325 Ninth Ave, Washington, DC 98104 USA.;Univ Washington, Kidney Res Inst, 325 Ninth Ave, Washington, DC 98104 USA..
    Wood, Alexis C.
    ARS, USDA, Childrens Nutr Res Ctr, 1100 Bates Ave, Houston, TX 77071 USA..
    Rotter, Jerome I.
    Harbor UCLA Med Ctr, Inst Translat Genom & Populat Sci, Los Angeles Biomed Res Inst, Torrance, CA 90502 USA.;Harbor UCLA Med Ctr, Dept Pediat, Torrance, CA 90502 USA..
    Rich, Stephen S.
    Univ Virginia, Dept Publ Hlth Sci, Charlottesville, VA 22908 USA.;Univ Virginia, Ctr Publ Hlth Genom, Charlottesville, VA 22908 USA..
    Robinson-Cohen, Cassianne
    Vanderbilt Univ, Div Nephrol, Dept Med, Med Ctr, 1161 21st Ave S, Nashville, TN 37232 USA..
    den Heijer, Martin
    Erasmus MC, Dept Internal Med, Postbus 2040, NL-3000 CA Rotterdam, Netherlands..
    Jarvelin, Marjo-Riitta
    Imperial Coll London, Epidemiol & Biostat Sch Publ Hlth, 156 Norfolk Pl,St Marys Campus, London W2 1PG, England.;Univ Oulu, Fac Med, Ctr Life Course Hlth Res, Oulu 90014, Finland.;Univ Oulu, Bioctr Oulu, POB 5000,Aapistie 5A, FI-90014 Oulu, Finland.;Oulu Univ Hosp, Unit Primary Care, Kajaanintie 50 POB 20,90029 OYS, FI-90220 Oulu, Finland..
    Cavadino, Alana
    UCL, Populat Policy & Practice, Inst Child Hlth, Great Ormond St, London WC1E 6BT, England.;Queen Mary Univ London, Ctr Environm & Prevent Med, Wolfson Inst Prevent Med, Barts & London Sch Med & Dent, Charterhouse Sq, London EC1M 6BQ, England..
    Joshi, Peter K.
    Univ Edinburgh, Usher Inst Populat Hlth Sci & Informat, Ctr Global Hlth Res, Teviot Pl, Edinburgh EH8 9AG, Midlothian, Scotland..
    Wilson, James F.
    Univ Edinburgh, Usher Inst Populat Hlth Sci & Informat, Ctr Global Hlth Res, Teviot Pl, Edinburgh EH8 9AG, Midlothian, Scotland.;Univ Edinburgh, MRC Inst Genet Mol Med, Western Gen Hosp, MRC Human Genet Unit, Edinburgh EH4 2XU, Midlothian, Scotland..
    Hayward, Caroline
    Univ Edinburgh, MRC Inst Genet Mol Med, Western Gen Hosp, MRC Human Genet Unit, Edinburgh EH4 2XU, Midlothian, Scotland..
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Michaëlsson, Karl
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Orthopaedics.
    Trompet, Stella
    Leiden Univ, Gerontol & Geriatr, Med Ctr, Albinusdreef 2, NL-2333 ZA Leiden, Netherlands.;Leiden Univ, Dept Cardiol, Med Ctr, Albinusdreef 2, NL-2333 ZA Leiden, Netherlands..
    Zillikens, M. Carola
    Erasmus MC, Dept Internal Med, Postbus 2040, NL-3000 CA Rotterdam, Netherlands..
    Uitterlinden, Andre G.
    Erasmus MC, Dept Epidemiol, Postbus 2040, NL-3000 CA Rotterdam, Netherlands.;Erasmus MC, Dept Internal Med, Postbus 2040, NL-3000 CA Rotterdam, Netherlands..
    Rivadeneira, Fernando
    Erasmus MC, Dept Epidemiol, Postbus 2040, NL-3000 CA Rotterdam, Netherlands.;Erasmus MC, Dept Internal Med, Postbus 2040, NL-3000 CA Rotterdam, Netherlands..
    Broer, Linda
    Erasmus MC, Dept Internal Med, Postbus 2040, NL-3000 CA Rotterdam, Netherlands..
    Zgaga, Lina
    Univ Dublin, Trinity Coll Dublin, Dept Publ Hlth & Primary Care, Inst Populat Hlth, D02 PN40, Dublin 24, Ireland..
    Campbell, Harry
    Univ Edinburgh, Usher Inst Populat Hlth Sci & Informat, Ctr Global Hlth Res, Teviot Pl, Edinburgh EH8 9AG, Midlothian, Scotland.;Univ Edinburgh, Western Gen Hosp, Inst Genet & Mol Med, Edinburgh EH4 2XU, Midlothian, Scotland..
    Theodoratou, Evropi
    Univ Edinburgh, Usher Inst Populat Hlth Sci & Informat, Ctr Global Hlth Res, Teviot Pl, Edinburgh EH8 9AG, Midlothian, Scotland.;Univ Edinburgh, Western Gen Hosp, Inst Genet & Mol Med, Edinburgh EH4 2XU, Midlothian, Scotland..
    Farrington, Susan M.
    Univ Edinburgh, Western Gen Hosp, Inst Genet & Mol Med, Edinburgh EH4 2XU, Midlothian, Scotland..
    Timofeeva, Maria
    Univ Edinburgh, Western Gen Hosp, Inst Genet & Mol Med, Edinburgh EH4 2XU, Midlothian, Scotland..
    Dunlop, Malcolm G.
    Univ Edinburgh, Western Gen Hosp, Inst Genet & Mol Med, Edinburgh EH4 2XU, Midlothian, Scotland..
    Valdes, Ana M.
    Kings Coll London, Dept Twin Res & Genet Epidemiol, St Thomas Campus,Westminster Bridge Rd, London SE1 7EH, England.;Univ Nottingham, Sch Med, City Hosp, Hucknall Rd, Nottingham NG5 1PB, England..
    Tikkanen, Emmi
    Univ Helsinki, FIMM Inst Mol Med Finland, POB 20, FI-00014 Helsinki, Finland..
    Lehtimaki, Terho
    Fimlab Labs, Dept Clin Chem, Tampere 33520, Finland.;Univ Tampere, Dept Clin Chem, Finnish Cardiovasc Res Ctr Tampere, Fac Med & Life Sci, Tampere 33014, Finland..
    Lyytikainen, Leo-Pekka
    Fimlab Labs, Dept Clin Chem, Tampere 33520, Finland.;Univ Tampere, Dept Clin Chem, Finnish Cardiovasc Res Ctr Tampere, Fac Med & Life Sci, Tampere 33014, Finland..
    Kahonen, Mika
    Tampere Univ Hosp, Dept Clin Physiol, Tampere 33521, Finland.;Univ Tampere, Dept Clin Physiol, Finnish Cardiovasc Res Ctr Tampere, Fac Med & Life Sci, Tampere 33014, Finland..
    Raitakari, Olli T.
    Turku Univ Hosp, Dept Clin Physiol & Nucl Med, Turku 20521, Finland.;Univ Turku, Res Ctr Appl & Prevent Cardiovasc Med, Turku 20014, Finland..
    Mikkila, Vera
    Acad Finland, Hakaniemenranta 6,POB 131, FI-00531 Helsinki, Finland..
    Ikram, M. Arfan
    Erasmus MC, Dept Epidemiol, Postbus 2040, NL-3000 CA Rotterdam, Netherlands..
    Sattar, Naveed
    BHF Glasgow Cardiovasc Res Ctr, Fac Med, Univ Ave, Glasgow G12 8QQ, Lanark, Scotland..
    Jukema, J. Wouter
    Leiden Univ, Dept Cardiol, Med Ctr, Albinusdreef 2, NL-2333 ZA Leiden, Netherlands.;Leiden Univ, Einthoven Lab Expt Vasc Med, Med Ctr, Albinusdreef 2, NL-2333 ZA Leiden, Netherlands..
    Wareham, Nicholas J.
    Univ Cambridge, MRC Epidemiol Unit, Sch Clin Med, Cambridge Biomed Campus, Cambridge CB2 0QQ, England..
    Langenberg, Claudia
    Univ Cambridge, MRC Epidemiol Unit, Sch Clin Med, Cambridge Biomed Campus, Cambridge CB2 0QQ, England..
    Forouhi, Nita G.
    Univ Cambridge, MRC Epidemiol Unit, Sch Clin Med, Cambridge Biomed Campus, Cambridge CB2 0QQ, England..
    Gundersen, Thomas E.
    Vitas AS, Gaustadaleen 21, N-0349 Oslo, Norway..
    Khaw, Kay-Tee
    Univ Cambridge, Strangeways Res Lab, Dept Publ Hlth & Primary Care, Worts Causeway, Cambridge CB1 8RN, England..
    Butterworth, Adam S.
    Univ Cambridge, Strangeways Res Lab, Dept Publ Hlth & Primary Care, Worts Causeway, Cambridge CB1 8RN, England..
    Danesh, John
    Univ Cambridge, Strangeways Res Lab, Dept Publ Hlth & Primary Care, Worts Causeway, Cambridge CB1 8RN, England.;Wellcome Trust Sanger Inst, Wellcome Genome Campus, Cambridge CB10 1SA, England..
    Spector, Timothy
    Kings Coll London, Dept Twin Res & Genet Epidemiol, St Thomas Campus,Westminster Bridge Rd, London SE1 7EH, England..
    Wang, Thomas J.
    Vanderbilt Heart & Vasc Inst, Div Cardiovasc Med, 2220 Pierce Ave 383 Preston Res Bldg, Nashville, TN 37232 USA..
    Hypponen, Elina
    UCL, Populat Policy & Practice, Inst Child Hlth, Great Ormond St, London WC1E 6BT, England.;Univ South Australia, Ctr Populat Hlth Res, Sansom Inst Hlth Res, Adelaide, SA 5001, Australia..
    Kraft, Peter
    Harvard TH Chan Sch Publ Hlth, Program Genet Epidemiol & Stat Genet, Dept Epidemiol, 677 Huntington Ave, Boston, MA USA..
    Kiel, Douglas P.
    Hebrew SeniorLife, Inst Aging Res, 1200 Ctr St, Boston, MA 02131 USA.;Beth Israel Deaconess Med Ctr, Dept Med, Boston, MA 02115 USA.;Harvard Med Sch, Boston, MA 02115 USA.;Broad Inst Harvard & Massachusetts Inst Technol, Boston, MA 02142 USA..
    Genome-wide association study in 79,366 European-ancestry individuals informs the genetic architecture of 25-hydroxyvitamin D levels2018In: Nature Communications, E-ISSN 2041-1723, Vol. 9, article id 260Article in journal (Refereed)
    Abstract [en]

    Vitamin D is a steroid hormone precursor that is associated with a range of human traits and diseases. Previous GWAS of serum 25-hydroxyvitamin D concentrations have identified four genome-wide significant loci (GC, NADSYN1/DHCR7, CYP2R1, CYP24A1). In this study, we expand the previous SUNLIGHT Consortium GWAS discovery sample size from 16,125 to 79,366 (all European descent). This larger GWAS yields two additional loci harboring genome-wide significant variants (P = 4.7×10−9 at rs8018720 in SEC23A, and P = 1.9×10−14 at rs10745742 in AMDHD1). The overall estimate of heritability of 25-hydroxyvitamin D serum concentrations attributable to GWAS common SNPs is 7.5%, with statistically significant loci explaining 38% of this total. Further investigation identifies signal enrichment in immune and hematopoietic tissues, and clustering with autoimmune diseases in cell-type-specific analysis. Larger studies are required to identify additional common SNPs, and to explore the role of rare or structural variants and gene–gene interactions in the heritability of circulating 25-hydroxyvitamin D levels.

  • 209.
    Jobs, Elisabeth
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Risérus, Ulf
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Ingelsson, Erik
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Sundström, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
    Jobs, Magnus
    University of Dalarna.
    Nerpin, Elisabet
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Iggman, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Basu, Samar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Oxidative Stress and Inflammation.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Lars, Lind
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Serum cathepsin S is associated with decreased insulin sensitivity and the development of diabetes type 2 in a community-based cohort of elderly men2013In: Diabetes Care, ISSN 0149-5992, E-ISSN 1935-5548, Vol. 36, no 1, p. 163-165Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    To investigate associations between serum cathepsin S, impaired insulin sensitivity, defective insulin secretion, and diabetes risk in a community-based sample of elderly men without diabetes.

    RESEARCH DESIGN AND METHODS:

    Serum cathepsin S, insulin sensitivity (euglycemic-hyperinsulinemic clamp), and insulin secretion (early insulin response during an oral glucose tolerance test) were measured in 905 participants of the Uppsala Longitudinal Study of Adult Men (mean age, 71 years). Thirty participants developed diabetes during 6 years of follow-up.

    RESULTS:

    After adjustment for age, anthropometric variables, and inflammatory markers, higher cathepsin S was associated with decreased insulin sensitivity (regression coefficient per SD increase -0.09 [95% CI -0.14 to -0.04], P = 0.001), but no association with early insulin response was found. Moreover, higher cathepsin S was associated with a higher risk for developing diabetes (odds ratio per SD increase 1.48 [1.08-2.01], P = 0.01).

    CONCLUSIONS:

    Cathepsin S activity appears to be involved in the early dysregulation of glucose and insulin metabolism.

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    et al.
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    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Medicinsk genetik och genomik.
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    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
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    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Medicinsk genetik och genomik. Uppsala University, Science for Life Laboratory, SciLifeLab.
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    Polašek, Ozren
    Wilson, James F
    Directional dominance on stature and cognition in diverse human populations2015In: Nature, ISSN 0028-0836, E-ISSN 1476-4687, Vol. 523, no 7561, p. 459-462Article in journal (Refereed)
    Abstract [en]

    Homozygosity has long been associated with rare, often devastating, Mendelian disorders, and Darwin was one of the first to recognize that inbreeding reduces evolutionary fitness. However, the effect of the more distant parental relatedness that is common in modern human populations is less well understood. Genomic data now allow us to investigate the effects of homozygosity on traits of public health importance by observing contiguous homozygous segments (runs of homozygosity), which are inferred to be homozygous along their complete length. Given the low levels of genome-wide homozygosity prevalent in most human populations, information is required on very large numbers of people to provide sufficient power. Here we use runs of homozygosity to study 16 health-related quantitative traits in 354,224 individuals from 102 cohorts, and find statistically significant associations between summed runs of homozygosity and four complex traits: height, forced expiratory lung volume in one second, general cognitive ability and educational attainment (P < 1 × 10(-300), 2.1 × 10(-6), 2.5 × 10(-10) and 1.8 × 10(-10), respectively). In each case, increased homozygosity was associated with decreased trait value, equivalent to the offspring of first cousins being 1.2 cm shorter and having 10 months' less education. Similar effect sizes were found across four continental groups and populations with different degrees of genome-wide homozygosity, providing evidence that homozygosity, rather than confounding, directly contributes to phenotypic variance. Contrary to earlier reports in substantially smaller samples, no evidence was seen of an influence of genome-wide homozygosity on blood pressure and low density lipoprotein cholesterol, or ten other cardio-metabolic traits. Since directional dominance is predicted for traits under directional evolutionary selection, this study provides evidence that increased stature and cognitive function have been positively selected in human evolution, whereas many important risk factors for late-onset complex diseases may not have been.

  • 211.
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    Univ Regensburg, Inst Epidemiol & Prevent Med, Dept Genet Epidemiol, D-93053 Regensburg, Germany..
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    Washington Univ, Sch Med, Dept Genet, Div Stat Genom, St Louis, MO 63108 USA..
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    Univ N Carolina, Dept Epidemiol, Chapel Hill, NC 27599 USA..
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    Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02118 USA..
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    Univ N Carolina, Dept Epidemiol, Chapel Hill, NC 27599 USA..
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    Washington Univ, Sch Med, Dept Genet, Div Stat Genom, St Louis, MO 63108 USA..
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    Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02118 USA..
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    Washington Univ, Sch Med, Dept Genet, Div Stat Genom, St Louis, MO 63108 USA..
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    St Georges Univ London, Populat Hlth Res Inst, London SW17 0RE, England.;TransMed Syst Inc, Cupertino, CA 95014 USA..
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    Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02118 USA.;Johns Hopkins Bloomberg Sch Publ Hlth, Dept Biostat, Baltimore, MD USA..
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    Univ Copenhagen, Fac Hlth & Med Sci, Sect Metab Genet, Novo Nordisk Fdn Ctr Basic Metab Res, Copenhagen, Denmark.;Steno Diabet Ctr, Gentofte, Denmark..
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    NHLBI Framingham Heart Study, Framingham, MA 01702 USA.;Brigham & Womens Hosp, Div Prevent Med, 75 Francis St, Boston, MA 02115 USA.;Harvard Med Sch, Boston, MA USA..
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    NHLBI Framingham Heart Study, Framingham, MA 01702 USA.;Boston Univ, Sch Med, Dept Neurol, Boston, MA 02118 USA..
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    Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02118 USA..
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    Framingham Heart Dis Epidemiol Study, NIH, Natl Heart Lung & Blood Inst, Populat Sci Branch, Framingham, MA USA..
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    CHU Vaudois, Inst Social & Prevent Med IUMSP, Lausanne, Switzerland.;Univ Lausanne, Dept Computat Biol, Lausanne, Switzerland.;Swiss Inst Bioinformat, CH-1015 Lausanne, Switzerland..
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    Univ Oxford, Wellcome Trust Ctr Human Genet, Oxford OX3 7BN, England..
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    Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02118 USA..
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    Albert Einstein Coll Med, Dept Epidemiol & Populat Hlth, Bronx, NY 10467 USA..
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    Brigham & Womens Hosp, Div Prevent Med, 75 Francis St, Boston, MA 02115 USA.;Harvard Med Sch, Boston, MA USA.;Lund Univ, Dept Clin Sci, Genet & Mol Epidemiol Unit, SE-20502 Malmo, Sweden.;Harvard T H Chan Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA..
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    Icahn Sch Med Mt Sinai, Charles Bronfman Inst Personalized Med, New York, NY 10029 USA.;Icahn Sch Med Mt Sinai, Genet Obes & Related Metab Traits Program, New York, NY USA..
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    Erasmus Univ, Med Ctr, Dept Epidemiol, Genet Epidemiol Unit, NL-3015 GE Rotterdam, Netherlands..
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    Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA..
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    Univ Lille, CNRS, Inst Pasteur Lille, EGID,UMR 8199, Lille, France..
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    Univ Michigan, Internal Med Nephrol, Ann Arbor, MI USA.;Univ Michigan, Dept Biostat, Ann Arbor, MI 48109 USA.;Univ Michigan, Ctr Stat Genet, Ann Arbor, MI 48109 USA..
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    Univ Western Australia, Ctr Genet Origins Hlth & Dis, Crawley 6009, Australia..
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    Univ Milan, Dept Hlth Sci, Via A Di Rudini 8, I-20142 Milan, Italy..
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    Univ Washington, Dept Biostat, Seattle, WA 98195 USA..
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    CHU Vaudois, Inst Social & Prevent Med IUMSP, Lausanne, Switzerland.;Univ Lausanne, Dept Computat Biol, Lausanne, Switzerland.;Swiss Inst Bioinformat, CH-1015 Lausanne, Switzerland..
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    Erasmus MC, Dept Epidemiol, Rotterdam, Netherlands.;Dokuz Eylul Univ, Dept Psychiat, Izmir, Turkey..
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    Univ Gothenburg, Sahlgrenska Acad, Dept Internal Med & Clin Nutr, Ctr Bone & Arthrit Res,Inst Med, Gothenburg, Sweden..
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    Univ Tartu, Estonian Genome Ctr, EE-51010 Tartu, Estonia..
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    Univ Regensburg, Inst Epidemiol & Prevent Med, Dept Genet Epidemiol, D-93053 Regensburg, Germany.;Univ Hosp Regensburg, Dept Nephrol, Regensburg, Germany..
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    Univ Copenhagen, Fac Hlth & Med Sci, Sect Metab Genet, Novo Nordisk Fdn Ctr Basic Metab Res, Copenhagen, Denmark..
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    Univ Oxford, Wellcome Trust Ctr Human Genet, Oxford OX3 7BN, England.;Univ Oxford, Churchill Hosp, Oxford Ctr Diabet Endocrinol & Metab, Oxford OX3 7LJ, England..
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    Harvard T H Chan Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA.;Natl Univ Singapore, Saw Swee Hock Sch Publ Hlth, Epidemiol Domain, Singapore 117549, Singapore..
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    Framingham Heart Dis Epidemiol Study, NIH, Natl Heart Lung & Blood Inst, Populat Sci Branch, Framingham, MA USA.;Univ Edinburgh, Inst Genet & Mol Med, MRC Human Genet Unit, Edinburgh, Midlothian, Scotland..
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    Univ Michigan, Dept Biostat, Ann Arbor, MI 48109 USA.;Univ Michigan, Ctr Stat Genet, Ann Arbor, MI 48109 USA..
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    Queen Mary Univ London, Barts & London Sch Med & Dent, William Harvey Res Inst, London, England..
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    Natl Inst Hlth & Welfare, Dept Hlth, FI-00271 Helsinki, Finland..
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    Heidelberg Univ, Med Fac Mannheim, Dept Med 5, Mannheim, Germany..
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    Kuopio Res Inst Exercise Med, Kuopio, Finland..
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    Univ Essex, ISER, Colchester CO4 3SQ, Essex, England.;UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England..
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    Univ Hawaii, Canc Ctr, Epidemiol Program, Honolulu, HI 96813 USA..
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    German Res Ctr Environm Hlth, Helmholtz Zentrum Munchen, Inst Genet Epidemiol, D-85764 Neuherberg, Germany.;Ludwig Maximilians Univ Munchen, Univ Hosp Grosshadern, Dept Med 1, D-81377 Munich, Germany.;DZHK German Ctr Cardiovasc Res, Partner Site Munich Heart Alliance, Munich, Germany..
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    Univ Edinburgh, Inst Genet & Mol Med, MRC Human Genet Unit, Edinburgh, Midlothian, Scotland..
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    Univ Laval, Fac Med, Dept Kinesiol, Quebec City G1V 0A6, PQ, Canada.;Univ Laval, Inst Nutr & Funct Foods, Quebec City G1V 0A6, PQ, Canada..
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    Univ Tartu, Estonian Genome Ctr, EE-51010 Tartu, Estonia.;Univ Tartu, Inst Mol & Cell Biol, Dept Biotechnol, EE-51010 Tartu, Estonia..
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    Dept Social & Hlth Care, Helsinki, Finland..
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    Iceland Heart Assoc, Kopavogur, Iceland.;Univ Iceland, Fac Med, Reykjavik, Iceland..
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    Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA..
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    Univ Eastern Finland, Inst Clin Med, Dept Med, Kuopio 70210, Finland..
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    Karolinska Inst, Dept Med Solna, Cardiovasc Med Unit, Stockholm, Sweden.;Karolinska Univ Hosp Solna, Ctr Mol Med, Stockholm, Sweden..
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    Univ Groningen, Univ Med Ctr Groningen, Dept Cardiol, Groningen, Netherlands..
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    Vrije Univ, Dept Biol Psychol, Amsterdam, Netherlands.;Radboud Univ Nijmegen, Behav Sci Inst, Nijmegen, Netherlands..
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    Univ Edinburgh, Inst Genet & Mol Med, MRC Human Genet Unit, Edinburgh, Midlothian, Scotland..
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    Univ N Carolina, Dept Genet, Chapel Hill, NC 27599 USA..
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    Univ Lille, CNRS, Inst Pasteur Lille, EGID,UMR 8199, Lille, France..
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    Imper Coll London, Sch Publ Hlth, Dept Epidemiol & Biostat, London, England.;Ealing Hosp NHS Trust, Cardiol, Southall, Middx, England..
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    Univ Cambridge, Sch Clin Med, Inst Metab Sci, MRC Epidemiol Unit, Cambridge CB2 0QQ, England..
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    Univ Regensburg, Inst Epidemiol & Prevent Med, Dept Genet Epidemiol, D-93053 Regensburg, Germany..
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    Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, 1124 Columbia St, Seattle, WA 98104 USA..
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    Univ Michigan, Dept Biostat, Ann Arbor, MI 48109 USA.;Univ Michigan, Ctr Stat Genet, Ann Arbor, MI 48109 USA..
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    Univ N Carolina, Gillings Sch Global Publ Hlth, Dept Nutr, Chapel Hill, NC 27599 USA..
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    Imper Coll London, Sch Publ Hlth, Dept Epidemiol & Biostat, London, England.;Ealing Hosp NHS Trust, Cardiol, Southall, Middx, England..
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    Imper Coll London, Sch Publ Hlth, Dept Epidemiol & Biostat, London, England.;Ealing Hosp NHS Trust, Cardiol, Southall, Middx, England..
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    Univ Med Ctr Groningen, Univ Groningen, Dept Med, Groningen, Netherlands..
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    Univ Washington, Dept Biostat, Seattle, WA 98195 USA.;Univ Washington, Dept Med, Cardiovasc Hlth Res Unit, Seattle, WA 98101 USA..
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    Busselton Populat Med Res Inst, Nedlands, WA 6009, Australia.;Sir Charles Gairdner Hosp, PathWest Lab Med WA, Nedlands, WA 6009, Australia.;Univ Western Australia, Sch Pathol, 35 Stirling Hwy, Crawley, WA 6009, Australia.;Univ Western Australia, Laboraty Med, 35 Stirling Hwy, Crawley, WA 6009, Australia..
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    Cedars Sinai Med Ctr, Diabet & Obes Res Inst, Los Angeles, CA 90048 USA..
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    Univ Milan, Dept Hlth Sci, Via A Di Rudini 8, I-20142 Milan, Italy..
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    Univ Coll Cork, Dept Pharmacol & Therapeut, Cork, Ireland..
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    Rutgers State Univ, Dept Genet, Piscataway, NJ 08854 USA.;Rutgers State Univ, Dept Stat & Biostat, Piscataway, NJ 08854 USA..
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    Univ Texas Rio Grande Valley, South Texas Diabet & Obes Inst, Brownsville, TX USA..
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    UMC Utrecht, Dept Vasc Surg, Div Surg Specialties, Utrecht, Netherlands..
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    Heidelberg Univ, Med Fac Mannheim, Dept Med 5, Mannheim, Germany..
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    UMC Utrecht, Div Heart & Lungs, Dept Cardiol, Lab Expt Cardiol, Utrecht, Netherlands..
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    Iceland Heart Assoc, Kopavogur, Iceland..
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    Univ Gothenburg, Sahlgrenska Acad, Dept Internal Med & Clin Nutr, Ctr Bone & Arthrit Res,Inst Med, Gothenburg, Sweden..
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    Univ Tartu, Estonian Genome Ctr, EE-51010 Tartu, Estonia.;Boston Childrens Hosp, Div Endocrinol, Boston, MA 02115 USA.;Boston Childrens Hosp, Div Genet, Boston, MA 02115 USA.;Boston Childrens Hosp, Ctr Basic & Translat Obes Res, Boston, MA 02115 USA.;Broad Inst Harvard, Cambridge, MA 02142 USA..
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    Univ Glasgow, Robertson Ctr Biostat, Glasgow, Lanark, Scotland..
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    Univ West Indies, Trop Med Res Inst, Trop Metab Res Unit, Mona JMAAW15, Jamaica, NY USA..
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    Heidelberg Univ, Med Fac Mannheim, Dept Med 5, Mannheim, Germany..
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    Umea Univ, Sect Nutr Res, Dept Publ Hlth & Clin Med, Umea, Sweden..
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    St Georges Univ London, Populat Hlth Res Inst, London SW17 0RE, England..
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    Natl Inst Aging, NIH, Lab Epidemiol Demog & Biometry, Bethesda, MD USA..
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    Kuopio Res Inst Exercise Med, Kuopio, Finland..
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    Univ Edinburgh, Inst Genet & Mol Med, MRC Human Genet Unit, Edinburgh, Midlothian, Scotland..
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    Washington Univ, Sch Med, Dept Psychiat, St Louis, MO 63110 USA..
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    Natl Human Genome Res Inst, NIH, Div Genom Med, Bethesda, MD 20892 USA..
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    Univ Aberdeen, Inst Med Sci, Foresterhill, Aberdeen AB25 2ZD, Scotland.;Univ Edinburgh, Ctr Genom & Expt Med, Generat Scotland, Edinburgh, Midlothian, Scotland..
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    Univ Copenhagen, Fac Hlth & Med Sci, Sect Metab Genet, Novo Nordisk Fdn Ctr Basic Metab Res, Copenhagen, Denmark..
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    Univ Trondheim Hosp, St Olav Hosp, Trondheim, Norway..
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    Univ Med Greifswald, Interfac Inst Genet & Funct Genom, Greifswald, Germany..
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    Vrije Univ, Dept Biol Psychol, Amsterdam, Netherlands..
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    Wellcome Trust Sanger Inst, Dept Human Genet, Cambridge, England..
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    Univ Western Australia, Sch Med & Pharmacol, 25 Stirling Hwy, Crawley, WA 6009, Australia.;Sir Charles Gairdner Hosp, Dept Cardiovasc Med, Nedlands, WA 6009, Australia..
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    Tampere Univ Hosp, Dept Pediat, Tampere 33521, Finland.;Univ Tampere, Fac Med & Life Sci, Dept Pediat, Tampere 33014, Finland..
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    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab. Stanford Univ, Sch Med, Dept Med, Div Cardiovasc Med, Stanford, CA 94305 USA.
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    Busselton Populat Med Res Inst, Nedlands, WA 6009, Australia.;Univ Western Australia, Sch Med & Pharmacol, 25 Stirling Hwy, Crawley, WA 6009, Australia.;Sir Charles Gairdner Hosp, Dept Pulm Physiol & Sleep Med, Nedlands, WA 6009, Australia..
    Jansson, John-Olov
    Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Dept Physiol, Gothenburg, Sweden..
    Jarvelin, Marjo-Riitta
    Imperial Coll London, Sch Publ Hlth, MRC PHE Ctr Environm & Hlth, Dept Epidemiol & Biostat, Norfolk Pl, London, England.;Univ Oulu, Fac Med, Ctr Life Course Epidemiol, POB 5000, FI-90014 Oulu, Finland.;Univ Oulu, Bioctr Oulu, Oulu, Finland.;Oulu Univ Hosp, Unit Primary Care, Kajaanintie 50,POB 20, FI-90220 Oulu, Finland..
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    Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA..
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    Steno Diabet Ctr, Gentofte, Denmark..
    Juonala, Markus
    Univ Turku, Dept Med, Turku 20520, Finland.;Turku Univ Hosp, Div Med, Turku 20521, Finland..
    Kahonen, Mika
    Tampere Univ Hosp, Dept Clin Physiol, Tampere 33521, Finland.;Univ Tampere, Fac Med & Life Sci, Dept Clin Physiol, Tampere 33014, Finland..
    Karlsson, Magnus
    Lund Univ, Skane Univ Hosp, Dept Orthoped & Clin Sci, Clin & Mol Osteoporosis Res Unit, Malmo, Sweden..
    Koistinen, Heikki A.
    Natl Inst Hlth & Welfare, Dept Hlth, FI-00271 Helsinki, Finland.;Univ Helsinki, Endocrinol, Dept Med, FI-00029 Helsinki, Finland.;Univ Helsinki, Endocrinol, Abdominal Ctr, FI-00029 Helsinki, Finland.;Univ Helsinki, Cent Hosp, FI-00029 Helsinki, Finland.;Minerva Fdn, Biomed 2U, FI-00290 Helsinki, Finland..
    Kolcic, Ivana
    Univ Split, Fac Med, Dept Publ Hlth, Split, Croatia..
    Kolovou, Genovefa
    Onassis Cardiac Surg Ctr, Dept Cardiol, Athens, Greece..
    Kooperberg, Charles
    Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, 1124 Columbia St, Seattle, WA 98104 USA..
    Kramer, Bernhard K.
    Heidelberg Univ, Med Fac Mannheim, Dept Med 5, Mannheim, Germany..
    Kuusisto, Johanna
    Univ Eastern Finland, Dept Med, Kuopio 70210, Finland.;Kuopio Univ Hosp, Kuopio 70210, Finland..
    Kvaloy, Kirsti
    Norwegian Univ Sci & Technol, Dept Publ Hlth & Nursing, HUNT Res Ctr, N-7600 Levanger, Norway..
    Lakka, Timo A.
    Kuopio Res Inst Exercise Med, Kuopio, Finland.;Univ Eastern Finland, Inst Biomed Physiol, Kuopio, Finland..
    Langenberg, Claudia
    Univ Cambridge, Sch Clin Med, Inst Metab Sci, MRC Epidemiol Unit, Cambridge CB2 0QQ, England..
    Launer, Lenore J.
    Natl Inst Aging, NIH, Lab Epidemiol Demog & Biometry, Bethesda, MD USA..
    Leander, Karin
    Karolinska Inst, Inst Environm Med, Unit Cardiovasc Epidemiol, Stockholm, Sweden..
    Lee, Nanette R.
    Univ San Carlos, Off Populat Studies Fdn Inc, Cebu 6000, Philippines.;Univ San Carlos, Dept Anthropol Sociol & Hist, Cebu 6000, Philippines..
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Lindgren, Cecilia M.
    Univ Oxford, Wellcome Trust Ctr Human Genet, Oxford OX3 7BN, England.;Univ Oxford, Big Data Inst, Li Ka Shing Ctr Hlth Informat & Discovery, Oxford OX3 7BN, England. Res Ctr Prevent & Hlth, Copenhagen, Denmark..
    Linneberg, Allan
    Minerva Fdn, Biomed 2U, FI-00290 Helsinki, Finland.;Rigshosp, Dept Clin Expt Res, Glostrup, Denmark.;Univ Copenhagen, Fac Hlth & Med Sci, Dept Clin Med, Copenhagen, Denmark..
    Lobbens, Stephane
    Univ Lille, CNRS, Inst Pasteur Lille, EGID,UMR 8199, Lille, France..
    Loh, Marie
    Imper Coll London, Sch Publ Hlth, Dept Epidemiol & Biostat, London, England.;ASTAR, Agcy Sci Technol & Res, Translat Lab Genet Med TLGM, 8A Biomed Grove,Immunos Level 5, Singapore 138648, Singapore..
    Lorentzon, Mattias
    Univ Gothenburg, Sahlgrenska Acad, Dept Internal Med & Clin Nutr, Ctr Bone & Arthrit Res,Inst Med, Gothenburg, Sweden..
    Luben, Robert
    Univ Cambridge, Dept Publ Hlth & Primary Care, Cambridge, England..
    Lubke, Gitta
    Univ Notre Dame, Dept Psychol, Notre Dame, IN 46556 USA..
    Ludolph-Donislawski, Anja
    German Res Ctr Environm Hlth, Helmholtz Zentrum Munchen, Inst Genet Epidemiol, D-85764 Neuherberg, Germany.;Ludwig Maximilians Univ Munchen, Chair Genet Epidemiol, Inst Med Informat Biometry & Epidemiol, D-81377 Munich, Germany..
    Lupoli, Sara
    Univ Milan, Dept Hlth Sci, Via A Di Rudini 8, I-20142 Milan, Italy..
    Madden, Pamela A. F.
    Washington Univ, Sch Med, Dept Psychiat, St Louis, MO 63110 USA..
    Mannikko, Reija
    Kuopio Res Inst Exercise Med, Kuopio, Finland..
    Marques-Vidal, Pedro
    Lausanne Univ Hosp CHUV, Dept Med Internal Med, Lausanne, Switzerland..
    Martin, Nicholas G.
    QIMR Berghofer Med Res Inst, Genet Epidemiol, Brisbane, Qld 4029, Australia..
    McKenzie, Colin A.
    Univ West Indies, Trop Med Res Inst, Trop Metab Res Unit, Mona JMAAW15, Jamaica, NY USA..
    McKnight, Barbara
    Univ Washington, Dept Biostat, Seattle, WA 98195 USA.;Univ Washington, Dept Med, Cardiovasc Hlth Res Unit, Seattle, WA 98101 USA.;Fred Hutchinson Canc Res Ctr, Program Biostat & Biomath, Seattle, WA 98109 USA..
    Mellstrom, Dan
    Univ Gothenburg, Sahlgrenska Acad, Dept Internal Med & Clin Nutr, Ctr Bone & Arthrit Res,Inst Med, Gothenburg, Sweden..
    Menni, Cristina
    Kings Coll London, Dept Twin Res & Genet Epidemiol, London, England..
    Montgomery, Grant W.
    QIMR Berghofer Med Res Inst, Mol Epidemiol, Brisbane, Qld 4029, Australia..
    Musk, A. W. (Bill)
    Busselton Populat Med Res Inst, Nedlands, WA 6009, Australia.;Univ Western Australia, Sch Populat Hlth, 35 Stirling Hwy, Crawley, WA 6009, Australia.;Sir Charles Gairdner Hosp, Dept Resp Med, Nedlands, WA 6009, Australia..
    Narisu, Narisu
    Natl Human Genome Res Inst, Med Genom & Metab Genet Branch, NIH, Bethesda, MD 20892 USA..
    Nauck, Matthias
    Univ Med Greifswald, Inst Clin Chem, Greifswald, Germany.;Univ Med Greifswald, Lab Med, Greifswald, Germany..
    Nolte, Ilja M.
    Univ Groningen, Univ Med Ctr Groningen, Dept Epidemiol, Groningen, Netherlands..
    Oldehinkel, Albertine J.
    Univ Groningen, Univ Med Ctr Groningen, Interdisciplinary Ctr Psychopathol & Emot Regulat, Groningen, Netherlands..
    Olden, Matthias
    Univ Regensburg, Inst Epidemiol & Prevent Med, Dept Genet Epidemiol, D-93053 Regensburg, Germany..
    Ong, Ken K.
    Univ Cambridge, Sch Clin Med, Inst Metab Sci, MRC Epidemiol Unit, Cambridge CB2 0QQ, England..
    Padmanabhan, Sandosh
    Univ Aberdeen, Inst Med Sci, Foresterhill, Aberdeen AB25 2ZD, Scotland.;Univ Glasgow, BHF Glasgow CardiovascRes Ctr, Inst Cardiovasc & Med Sci, Glasgow, Lanark, Scotland..
    Peyser, Patricia A.
    Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA..
    Pisinger, Charlotta
    Glostrup Cty Hosp, Res Ctr Prevent & Hlth, Glostrup, Denmark.;Univ Copenhagen, Fac Hlth Sci, Dept Publ Hlth, Copenhagen, Denmark..
    Porteous, David J.
    Univ Edinburgh, Ctr Genom & Expt Med, Generat Scotland, Edinburgh, Midlothian, Scotland.;Univ Edinburgh, Inst Genet & Mol Med, Ctr Genom & Expt Med, Edinburgh, Midlothian, Scotland..
    Raitakari, Olli T.
    Turku Univ Hosp, Dept Clin Physiol & Nucl Med, Turku 20521, Finland.;Univ Turku, Res Ctr Appl & Prevent Cardiovasc Med, Turku 20520, Finland..
    Rankinen, Tuomo
    Pennington Biomed Res Ctr, Human Genom Lab, 6400 Perkins Rd, Baton Rouge, LA 70808 USA..
    Rao, D. C.
    Washington Univ, Sch Med, Div Biostat, St Louis, MO 63110 USA.;Washington Univ, Sch Med, Dept Psychiat, St Louis, MO 63110 USA.;Washington Univ, Sch Med, Dept Med, St Louis, MO 63110 USA..
    Rasmussen-Torvik, Laura J.
    Northwestern Univ, Feinberg Sch Med, Dept Prevent Med, Chicago, IL 60611 USA..
    Rawal, Rajesh
    German Res Ctr Environm Hlth, Helmholtz Zentrum Munchen, Res Unit Mol Epidemiol, D-85764 Neuherberg, Germany.;German Res Ctr Environm Hlth, Helmholtz Zentrum Munchen, Inst Epidemiol 2, D-85764 Neuherberg, Germany..
    Rice, Treva
    Washington Univ, Sch Med, Div Biostat, St Louis, MO 63110 USA.;Univ Eastern Finland, Dept Med, Kuopio 70210, Finland.;Kuopio Univ Hosp, Kuopio 70210, Finland..
    Ridker, Paul M.
    Brigham & Womens Hosp, Div Prevent Med, 75 Francis St, Boston, MA 02115 USA.;Harvard Med Sch, Boston, MA USA.;Brigham & Womens Hosp, Div Cardiol, Boston, MA 02115 USA..
    Rose, Lynda M.
    Brigham & Womens Hosp, Div Prevent Med, 75 Francis St, Boston, MA 02115 USA.;Harvard Med Sch, Boston, MA USA..
    Bien, Stephanie A.
    Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, 1124 Columbia St, Seattle, WA 98104 USA..
    Rudan, Igor
    Univ Edinburgh, Usher Inst Populat Hlth Sci & Informat, Edinburgh, Midlothian, Scotland..
    Sanna, Serena
    Cittadella Univ Monserrato, CNR, IRGB, I-09042 Monserrato, Italy..
    Sarzynski, Mark A.
    Pennington Biomed Res Ctr, Human Genom Lab, 6400 Perkins Rd, Baton Rouge, LA 70808 USA..
    Sattar, Naveed
    BHF Glasgow Cardiovasc Res Ctr, Fac Med, Glasgow, Lanark, Scotland..
    Savonen, Kai
    Kuopio Res Inst Exercise Med, Kuopio, Finland..
    Schlessinger, David
    Natl Inst Aging, NIH, Lab Genet, Baltimore, MD USA..
    Scholtens, Salome
    Univ Groningen, Univ Med Ctr Groningen, Dept Epidemiol, Groningen, Netherlands..
    Schurmann, Claudia
    Icahn Sch Med Mt Sinai, Charles Bronfman Inst Personalized Med, New York, NY 10029 USA.;Icahn Sch Med Mt Sinai, Genet Obes & Related Metab Traits Program, New York, NY USA..
    Scott, Robert A.
    Univ Cambridge, Sch Clin Med, Inst Metab Sci, MRC Epidemiol Unit, Cambridge CB2 0QQ, England..
    Sennblad, Bengt
    Karolinska Inst, Dept Med Solna, Cardiovasc Med Unit, Stockholm, Sweden.;Karolinska Univ Hosp Solna, Ctr Mol Med, Stockholm, Sweden.;Karolinska Inst, Sci Life Lab, Stockholm, Sweden..
    Siemelink, Marten A.
    UMC Utrecht, Div Heart & Lungs, Dept Cardiol, Lab Expt Cardiol, Utrecht, Netherlands..
    Silbernagel, Gunther
    Med Univ Graz, Dept Internal Med, Div Angiol, Graz, Austria..
    Slagboom, P. Eline
    Leiden Univ, Dept Mol Epidemiol, Med Ctr, Leiden, Netherlands..
    Snieder, Harold
    Univ Groningen, Univ Med Ctr Groningen, Dept Epidemiol, Groningen, Netherlands..
    Staessen, Jan A.
    Univ Leuven, Dept Cardiovasc Sci, Res Unit Hypertens & Cardiovasc Epidemiol, Campus Sint Rafael,Kapucijnenvoer 35, Leuven, Belgium.;Maastricht Univ, R&D VitaK Grp, Brains Unlimited Bldg,Oxfordlaan 55, Maastricht, Netherlands..
    Stott, David J.
    Univ Glasgow, Inst Cardiovasc & Med Sci, Fac Med, Glasgow, Lanark, Scotland..
    Swertz, Morris A.
    Univ Groningen, Univ Med Ctr Groningen, Dept Genet, Groningen, Netherlands..
    Swift, Amy J.
    Natl Human Genome Res Inst, Med Genom & Metab Genet Branch, NIH, Bethesda, MD 20892 USA..
    Taylor, Kent D.
    Univ Calif Los Angeles, Med Ctr, Los Angeles Biomed Res Inst Harbor, Ctr Translat Genom & Populat Sci, Torrance, CA USA.;Univ Calif Los Angeles, Dept Pediat, Los Angeles, CA USA..
    Tayo, Bamidele O.
    Loyola Univ Chicago, Stritch Sch Med, Dept Publ Hlth Sci, Maywood, IL 61053 USA..
    Thorand, Barbara
    German Res Ctr Environm Hlth, Helmholtz Zentrum Munchen, Inst Epidemiol 2, D-85764 Neuherberg, Germany.;German Ctr Diabet Res, D-85764 Neuherberg, Germany..
    Thuillier, Dorothee
    Univ Lille, CNRS, Inst Pasteur Lille, EGID,UMR 8199, Lille, France..
    Tuomilehto, Jaakko
    Dasman Diabet Inst, Res Div, Kuwait, Kuwait.;Danube Univ Krems, Dept Neurosci & Prevent Med, Krems 3500, Austria. Natl Inst Hlth & Welf, Chron Dis Prevent Unit, Helsinki, Finland.;King Abdulaziz Univ, Saudi Diabet Res Grp, Jeddah, Saudi Arabia..
    Uitterlinden, Andre G.
    Erasmus MC, Dept Epidemiol, Rotterdam, Netherlands.;Erasmus MC, Dept Internal Med, Rotterdam, Netherlands..
    Vandenput, Liesbeth
    Univ Gothenburg, Sahlgrenska Acad, Dept Internal Med & Clin Nutr, Ctr Bone & Arthrit Res,Inst Med, Gothenburg, Sweden..
    Vohl, Marie-Claude
    Univ Laval, Inst Nutr & Funct Foods, Quebec City G1V 0A6, PQ, Canada.;Univ Laval, Sch Nutr, Laval, PQ, Canada..
    Volzke, Henry
    Univ Med Greifswald, Inst Community Med, Greifswald, Germany..
    Vonk, Judith M.
    Univ Groningen, Univ Med Ctr Groningen, Dept Epidemiol, Groningen, Netherlands..
    Waeber, Gerard
    Lausanne Univ Hosp CHUV, Dept Med Internal Med, Lausanne, Switzerland..
    Waldenberger, Melanie
    German Res Ctr Environm Hlth, Helmholtz Zentrum Munchen, Res Unit Mol Epidemiol, D-85764 Neuherberg, Germany.;German Res Ctr Environm Hlth, Helmholtz Zentrum Munchen, Inst Epidemiol 2, D-85764 Neuherberg, Germany..
    Westendorp, R. G. J.
    Univ Copenhagen, Dept Publ Hlth, DK-1014 Copenhagen, Denmark.;Univ Copenhagen, Ctr Healthy Aging, DK-1014 Copenhagen, Denmark..
    Wild, Sarah
    Univ Edinburgh, Usher Inst Populat Hlth Sci & Informat, Edinburgh, Midlothian, Scotland..
    Willemsen, Gonneke
    Vrije Univ, Dept Biol Psychol, Amsterdam, Netherlands..
    Wolffenbuttel, Bruce H. R.
    Univ Groningen, Univ Med Ctr Groningen, Dept Endocrinol, Groningen, Netherlands..
    Wong, Andrew
    UCL, MRC Unit Lifelong Hlth & Ageing, 33 Bedford Pl, London WC1B 5JU, England..
    Wright, Alan F.
    Univ Edinburgh, Inst Genet & Mol Med, MRC Human Genet Unit, Edinburgh, Midlothian, Scotland..
    Zhao, Wei
    Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA..
    Zillikens, M. Carola
    Erasmus MC, Dept Internal Med, Rotterdam, Netherlands..
    Baldassarre, Damiano
    Univ Milan, Dipartimento Sci Farmacolog & Biomol, Milan, Italy.;IRCCS, Ctr Cardiolog Monzino, Milan, Italy..
    Balkau, Beverley
    INSERM, U 1018, F-94807 Villejuif, France..
    Bandinelli, Stefania
    Azienda USL Toscana Ctr, Geriatr Unit, Florence, Italy..
    Boger, Carsten A.
    Univ Hosp Regensburg, Dept Nephrol, Regensburg, Germany..
    Boomsma, Dorret I.
    Vrije Univ, Dept Biol Psychol, Amsterdam, Netherlands..
    Bouchard, Claude
    Pennington Biomed Res Ctr, Human Genom Lab, 6400 Perkins Rd, Baton Rouge, LA 70808 USA..
    Bruinenberg, Marcel
    Lifelines Cohort Study, POB 30001, NL-9700 RB Groningen, Netherlands..
    Chasman, Daniel I.
    Brigham & Womens Hosp, Div Prevent Med, 75 Francis St, Boston, MA 02115 USA.;Harvard Med Sch, Boston, MA USA.;Brigham & Womens Hosp, Div Genet, 75 Francis St, Boston, MA 02115 USA..
    Chen, Yii-Der Ida
    Univ Calif Los Angeles, Los Angeles BioMed Res Inst, Inst Translat Genom & Populat Sci, Torrance, CA 90502 USA.;Univ Calif Los Angeles, Dept Pediat Harbor, Torrance, CA 90502 USA..
    Chines, Peter S.
    Natl Human Genome Res Inst, Med Genom & Metab Genet Branch, NIH, Bethesda, MD 20892 USA..
    Cooper, Richard S.
    Loyola Univ Chicago, Stritch Sch Med, Dept Publ Hlth Sci, Maywood, IL 61053 USA..
    Cucca, Francesco
    Cittadella Univ Monserrato, CNR, IRGB, I-09042 Monserrato, Italy.;Univ Sassari, Dipartimento Sci Biomed, Sassari, Italy..
    Cusi, Daniele
    Sanipedia Srl, Bresso, Milano, Italy.;Inst Biomed Technol Natl Ctr Res Segrate, Milan, Italy..
    de Faire, Ulf
    Karolinska Inst, Inst Environm Med, Unit Cardiovasc Epidemiol, Stockholm, Sweden..
    Ferrucci, Luigi
    Natl Inst Aging, Translat Gerontol Branch, Baltimore, MD USA..
    Franks, Paul W.
    Lund Univ, Dept Clin Sci, Genet & Mol Epidemiol Unit, SE-20502 Malmo, Sweden.;Harvard T H Chan Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA.;Umea Univ, Dept Publ Hlth & Clin Med, Umea, Sweden..
    Froguel, Philippe
    Univ Lille, CNRS, Inst Pasteur Lille, EGID,UMR 8199, Lille, France.;Imperial Coll London, Dept Genom Common Dis, London, England..
    Gordon-Larsen, Penny
    Univ N Carolina, Gillings Sch Global Publ Hlth, Dept Nutr, Chapel Hill, NC 27599 USA.;Univ N Carolina, Carolina Populat Ctr, Chapel Hill, NC 27516 USA..
    Grabe, Hans-Jorgen
    Univ Med Greifswald, Dept Psychiat & Psychotherapy, Greifswald, Germany.;German Ctr Neurodegenerat Dis DZNE, Rostock & Greifswald Site, Greifswald, Germany..
    Gudnason, Vilmundur
    Iceland Heart Assoc, Kopavogur, Iceland.;Univ Iceland, Fac Med, Reykjavik, Iceland..
    Haiman, Christopher A.
    Univ Southern Calif, Norris Comprehens Canc Ctr, Keck Sch Med, Dept Prevent Med, Los Angeles, CA 90089 USA..
    Hayward, Caroline
    Univ Edinburgh, Inst Genet & Mol Med, MRC Human Genet Unit, Edinburgh, Midlothian, Scotland.;Univ Edinburgh, Ctr Genom & Expt Med, Generat Scotland, Edinburgh, Midlothian, Scotland..
    Hveem, Kristian
    Norwegian Univ Sci & Technol, Dept Publ Hlth & Nursing, HUNT Res Ctr, N-7600 Levanger, Norway..
    Johnson, Andrew D.
    Framingham Heart Dis Epidemiol Study, NIH, Natl Heart Lung & Blood Inst, Populat Sci Branch, Framingham, MA USA..
    Jukema, Wouter
    Leiden Univ, Dept Cardiol, Med Ctr, Leiden, Netherlands.;Durrer Ctr Cardiogenet Res, Amsterdam, Netherlands.;Interuniv Cardiol Inst Netherlands, Utrecht, Netherlands..
    Kardia, Sharon L. R.
    Univ Michigan, Sch Publ Hlth, Dept Epidemiol, Ann Arbor, MI 48109 USA..
    Kivimaki, Mika
    UCL, Dept Epidemiol & Publ Hlth, London WC1E 6BT, England..
    Kooner, Jaspal S.
    Ealing Hosp NHS Trust, Cardiol, Southall, Middx, England.;Imperial Coll Healthcare NHS Trust, London, England.;Imperial Coll London, Hammersmith Hosp, Fac Med, Natl Heart & Lung Inst, Hammersmith Campus, London, England..
    Kuh, Diana
    UCL, MRC Unit Lifelong Hlth & Ageing, 33 Bedford Pl, London WC1B 5JU, England..
    Laakso, Markku
    Univ Eastern Finland, Dept Med, Kuopio 70210, Finland.;Kuopio Univ Hosp, Kuopio 70210, Finland..
    Lehtimaki, Terho
    Fimlab Labs, Dept Clin Chem, Tampere 33520, Finland.;Univ Tampere, Fac Med & Life Sci, Dept Clin Chem, Tampere 33014, Finland..
    Le Marchand, Loic
    Univ Hawaii, Canc Ctr, Epidemiol Program, Honolulu, HI 96813 USA..
    Marz, Winfried
    Synlab Serv GmbH, Synlab Acad, Mannheim, Germany.;Med Univ Graz, Clin Inst Med, Graz, Austria.;Med Univ Graz, Chem Lab Diagnost, Graz, Austria..
    McCarthy, Mark I.
    Univ Oxford, Wellcome Trust Ctr Human Genet, Oxford OX3 7BN, England.;Univ Oxford, Churchill Hosp, Oxford Ctr Diabet Endocrinol & Metab, Oxford OX3 7LJ, England.;Churchill Hosp, Biomed Res Ctr, Oxford Natl Inst Hlth Res NIHR, Oxford, England..
    Metspalu, Andres
    Univ Tartu, Estonian Genome Ctr, EE-51010 Tartu, Estonia..
    Morris, Andrew P.
    Univ Oxford, Wellcome Trust Ctr Human Genet, Oxford OX3 7BN, England.;Univ Liverpool, Dept Biostat, Liverpool L69 3GL, Merseyside, England..
    Ohlsson, Claes
    Univ Gothenburg, Sahlgrenska Acad, Dept Internal Med & Clin Nutr, Ctr Bone & Arthrit Res,Inst Med, Gothenburg, Sweden..
    Palmer, Lyle J.
    Univ Adelaide, Sch Publ Hlth, Adelaide, SA 5005, Australia..
    Pasterkamp, Gerard
    UMC Utrecht, Div Heart & Lungs, Dept Cardiol, Lab Expt Cardiol, Utrecht, Netherlands.;UMC Utrecht, Div Labs & Pharm, Lab Clin Chem & Hematol, Utrecht, Netherlands..
    Pedersen, Oluf
    Univ Copenhagen, Fac Hlth & Med Sci, Sect Metab Genet, Novo Nordisk Fdn Ctr Basic Metab Res, Copenhagen, Denmark..
    Peters, Annette
    German Res Ctr Environm Hlth, Helmholtz Zentrum Munchen, Inst Epidemiol 2, D-85764 Neuherberg, Germany.;German Ctr Diabet Res, D-85764 Neuherberg, Germany..
    Peters, Ulrike
    Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, 1124 Columbia St, Seattle, WA 98104 USA..
    Polasek, Ozren
    Univ Edinburgh, Usher Inst Populat Hlth Sci & Informat, Edinburgh, Midlothian, Scotland.;Univ Split, Fac Med, Dept Publ Hlth, Split, Croatia..
    Psaty, Bruce M.
    Univ Washington, Dept Med, Seattle, WA 98195 USA.;Univ Washington, Dept Epidemiol, Seattle, WA 98101 USA.;Grp Hlth Cooperat Puget Sound, Grp Hlth Res Inst, Seattle, WA 98101 USA..
    Qi, Lu
    Harvard T H Chan Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA.;Tulane Univ, Sch Publ Hlth & Trop Med, Dept Epidemiol, New Orleans, LA 70118 USA..
    Rauramaa, Rainer
    Kuopio Res Inst Exercise Med, Kuopio, Finland..
    Smith, Blair H.
    Kuopio Univ Hosp, Dept Clin Physiol & Nucl Med, Kuopio, Finland. Univ Dundee, Ninewells Hosp, Div Populat Hlth Sci, Dundee DD2 4RB, Scotland. Univ Dundee, Med Sch, Dundee DD2 4RB, Scotland..
    Sorensen, Thorkild I. A.
    Univ Copenhagen, Fac Hlth & Med Sci, Sect Metab Genet, Novo Nordisk Fdn Ctr Basic Metab Res, Copenhagen, Denmark.;Bispebjerg & Frederiksberg Hosp, Dept Clin Epidemiol, Copenhagen, Denmark.;Univ Bristol, MRC Integrat Epidemiol Unit, Bristol, Avon, England..
    Strauch, Konstantin
    German Res Ctr Environm Hlth, Helmholtz Zentrum Munchen, Inst Genet Epidemiol, D-85764 Neuherberg, Germany.;Ludwig Maximilians Univ Munchen, Chair Genet Epidemiol, Inst Med Informat Biometry & Epidemiol, D-81377 Munich, Germany..
    Tiemeier, Henning
    Erasmus MC, Dept Psychiat, Rotterdam, Netherlands..
    Tremoli, Elena
    Univ Milan, Dipartimento Sci Farmacolog & Biomol, Milan, Italy.;IRCCS, Ctr Cardiolog Monzino, Milan, Italy..
    Van der Harst, Pim
    Univ N Carolina, Dept Genet, Chapel Hill, NC 27599 USA.;Univ Groningen, Univ Med Ctr Groningen, Dept Genet, Groningen, Netherlands.;ICIN Netherlands Heart Inst, Durrer Ctr Cardiogenet Res, Utrecht, Netherlands..
    Vestergaard, Henrik
    Univ Copenhagen, Fac Hlth & Med Sci, Sect Metab Genet, Novo Nordisk Fdn Ctr Basic Metab Res, Copenhagen, Denmark.;Steno Diabet Ctr, Gentofte, Denmark..
    Vollenweider, Peter
    Lausanne Univ Hosp CHUV, Dept Med Internal Med, Lausanne, Switzerland..
    Wareham, Nicholas J.
    Univ Cambridge, Sch Clin Med, Inst Metab Sci, MRC Epidemiol Unit, Cambridge CB2 0QQ, England..
    Weir, David R.
    Univ Michigan, Inst Social Res, Survey Res Ctr, Ann Arbor, MI 48109 USA..
    Whitfield, John B.
    QIMR Berghofer Med Res Inst, Genet Epidemiol, Brisbane, Qld 4029, Australia..
    Wilson, James F.
    Univ Edinburgh, Inst Genet & Mol Med, MRC Human Genet Unit, Edinburgh, Midlothian, Scotland.;Univ Edinburgh, Usher Inst Populat Hlth Sci & Informat, Edinburgh, Midlothian, Scotland..
    Tyrrell, Jessica
    Univ Exeter, Med Sch, Genet Complex Traits, RILD Bldg, Exeter EX2 5DW, Devon, England.;Univ Exeter, European Ctr Environm & Human Hlth, Med Sch, Truro TR1 3HD, England..
    Frayling, Timothy M.
    Univ Exeter, Med Sch, Genet Complex Traits, Exeter EX1 2LU, Devon, England..
    Barroso, Ines
    Wellcome Trust Sanger Inst, Cambridge, England.;Addenbrookes Hosp, Inst Metab Sci, NIHR Cambridge Biomed Res Ctr, Box 289,Level 4, Cambridge CB2 OQQ, England.;Univ Cambridge, Addenbrookes Hosp, Metab Res Labs, Inst Metab Sci, Level 4,Box 289, Cambridge CB2 OQQ, England..
    Boehnke, Michael
    Univ Michigan, Dept Biostat, Ann Arbor, MI 48109 USA.;Univ Michigan, Ctr Stat Genet, Ann Arbor, MI 48109 USA..
    Deloukas, Panagiotis
    Queen Mary Univ London, Barts & London Sch Med & Dent, William Harvey Res Inst, London, England.;Wellcome Trust Sanger Inst, Cambridge, England.;King Abdulaziz Univ, PACER HD, Jeddah, Saudi Arabia..
    Fox, Caroline S.
    NHLBI Framingham Heart Study, Framingham, MA 01702 USA..
    Hirschhorn, Joel N.
    Boston Childrens Hosp, Div Endocrinol, Boston, MA 02115 USA.;Boston Childrens Hosp, Div Genet, Boston, MA 02115 USA.;Boston Childrens Hosp, Ctr Basic & Translat Obes Res, Boston, MA 02115 USA.;Broad Inst Harvard, Cambridge, MA 02142 USA.;Harvard Med Sch, Dept Genet, Boston, MA 02115 USA..
    Hunter, David J.
    Harvard T H Chan Sch Publ Hlth, Dept Nutr, Boston, MA 02115 USA.;Broad Inst Harvard, Cambridge, MA 02142 USA.;Harvard T H Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA.;Brigham & Womens Hosp, Dept Med, Channing Div Network Med, 75 Francis St, Boston, MA 02115 USA.;Harvard Med Sch, Boston, MA 02115 USA..
    Spector, Tim D.
    Kings Coll London, Dept Twin Res & Genet Epidemiol, London, England..
    Strachan, David P.
    St Georges Univ London, Populat Hlth Res Inst, London SW17 0RE, England.;St Georges Univ London, Div Populat Hlth Sci & Educ, London SW17 0RE, England..
    van Duijn, Cornelia M.
    Erasmus Univ, Med Ctr, Dept Epidemiol, Genet Epidemiol Unit, NL-3015 GE Rotterdam, Netherlands.;Netherlands Consortium Healthy Aging, Netherlands Genom Initiat, Leiden, Netherlands.;Ctr Med Syst Biol, Leiden, Netherlands..
    Heid, Iris M.
    Univ Regensburg, Inst Epidemiol & Prevent Med, Dept Genet Epidemiol, D-93053 Regensburg, Germany.;German Res Ctr Environm Hlth, Helmholtz Zentrum Munchen, Inst Genet Epidemiol, D-85764 Neuherberg, Germany..
    Mohlke, Karen L.
    Univ N Carolina, Dept Genet, Chapel Hill, NC 27599 USA..
    Marchini, Jonathan
    Univ Oxford, Dept Stat, Oxford, England..
    Loos, Ruth J. F.
    Icahn Sch Med Mt Sinai, Charles Bronfman Inst Personalized Med, New York, NY 10029 USA.;Icahn Sch Med Mt Sinai, Genet Obes & Related Metab Traits Program, New York, NY USA.;Univ Cambridge, Sch Clin Med, Inst Metab Sci, MRC Epidemiol Unit, Cambridge CB2 0QQ, England.;Mt Sinai Sch Med, New York, NY 10029 USA.;Icahn Sch Med Mt Sinai, Mindich Child Hlth & Dev Inst, New York, NY 10029 USA..
    Kilpelainen, Tuomas O.
    Univ Copenhagen, Fac Hlth & Med Sci, Sect Metab Genet, Novo Nordisk Fdn Ctr Basic Metab Res, Copenhagen, Denmark.;Univ Cambridge, Sch Clin Med, Inst Metab Sci, MRC Epidemiol Unit, Cambridge CB2 0QQ, England.;Icahn Sch Med Mt Sinai, Dept Prevent Med, New York, NY 10029 USA..
    Liu, Ching-Ti
    Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02118 USA..
    Borecki, Ingrid B.
    Washington Univ, Sch Med, Dept Genet, Div Stat Genom, St Louis, MO 63108 USA..
    North, Kari E.
    Univ N Carolina, Dept Epidemiol, Chapel Hill, NC 27599 USA..
    Cupples, L. Adrienne
    Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02118 USA.;NHLBI Framingham Heart Study, Framingham, MA 01702 USA..
    Genome-wide meta-analysis of 241,258 adults accounting for smoking behaviour identifies novel loci for obesity traits2017In: Nature Communications, E-ISSN 2041-1723, Vol. 8, article id 14977Article in journal (Refereed)
    Abstract [en]

    Few genome-wide association studies (GWAS) account for environmental exposures, like smoking, potentially impacting the overall trait variance when investigating the genetic contribution to obesity-related traits. Here, we use GWAS data from 51,080 current smokers and 190,178 nonsmokers (87% European descent) to identify loci influencing BMI and central adiposity, measured as waist circumference and waist-to-hip ratio both adjusted for BMI. We identify 23 novel genetic loci, and 9 loci with convincing evidence of gene-smoking interaction (GxSMK) on obesity-related traits. We show consistent direction of effect for all identified loci and significance for 18 novel and for 5 interaction loci in an independent study sample. These loci highlight novel biological functions, including response to oxidative stress, addictive behaviour, and regulatory functions emphasizing the importance of accounting for environment in genetic analyses. Our results suggest that tobacco smoking may alter the genetic susceptibility to overall adiposity and body fat distribution.

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  • 212.
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    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Massachusetts Gen Hosp, Dept Emergency Med, Boston, MA USA.
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    Massachusetts Gen Hosp, Dept Emergency Med, Boston, MA USA.
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    Geneva Univ Hosp, Dept Radiol, Geneva, Switzerland.
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    Massachusetts Gen Hosp, Dept Med, Boston, MA USA.
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    Massachusetts Gen Hosp, Dept Emergency Med, Boston, MA USA.
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    Brigham & Womens Hosp, Dept Neurol, Boston, MA USA.
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    Massachusetts Gen Hosp, Dept Emergency Med, Boston, MA USA.
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    Massachusetts Gen Hosp, Dept Neurol, Boston, MA USA.
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    Massachusetts Gen Hosp, Dept Neurol, Boston, MA USA.
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    Massachusetts Gen Hosp, Dept Neurol, Boston, MA USA.
    Goldstein, Joshua
    Massachusetts Gen Hosp, Dept Emergency Med, Boston, MA USA.
    Implementation of a rapid, protocol based TIA management pathway2018In: Western Journal of Emergency Medicine, ISSN 1936-900X, E-ISSN 1936-9018, Vol. 19, no 2, p. 216-223Article, review/survey (Refereed)
    Abstract [en]

    Introduction: Our goal was to assess whether use of a standardized clinical protocol improves efficiency for patients who present to the emergency department (ED) with symptoms of transient ischemic attack (TIA).

    Methods: We performed a structured, retrospective, cohort study at a large, urban, tertiary care academic center. In July 2012 this hospital implemented a standardized protocol for patients with suspected TIA. The protocol selected high-risk patients for admission and low/intermediate-risk patients to an ED observation unit for workup. Recommended workup included brain imaging, vascular imaging, cardiac monitoring, and observation. Patients were included if clinical providers determined the need for workup for TIA. We included consecutive patients presenting during a six-month period prior to protocol implementation, and those presenting between 6-12 months after implementation. Outcomes included ED length of stay (LOS), hospital LOS, use of neuroimaging, and 90-day risk of stroke or TIA.

    Results: From 01/2012 to 06/2012, 130 patients were evaluated for TIA symptoms in the ED, and from 01/2013 to 06/2013, 150 patients. The final diagnosis was TIA or stroke in 45% before vs. 41% after (p=0.18). Following the intervention, the inpatient admission rate decreased from 62% to 24% (p<0.001), median ED LOS decreased by 1.2 hours (5.7 to 4.9 hours, p=0.027), and median total hospital LOS from 29.4 hours to 23.1 hours (p=0.019). The proportion of patients receiving head computed tomography (CT) went from 68% to 58% (p=0.087); brain magnetic resonance (MR) imaging from 83% to 88%, (p=0.44) neck CT angiography from 32% to 22% (p=0.039); and neck MR angiography from 61% to 72% (p=0.046). Ninety-day stroke or recurrent TIA among those with final diagnosis of TIA was 3% for both periods.

    Conclusion: Implementation of a TIA protocol significantly reduced ED LOS and total hospital LOS.

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  • 213. Kaisdotter Andersson, Annika
    et al.
    Kron, Josefin
    Karolinska institutet.
    Castren, Maaret
    Karolinska institutet.
    Muntlin Athlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. School of Nursing, University of Adelaide.
    Hök, Bertil
    Wiklund, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Assessment of the breath alcohol concentration in emergency care patients with different level of consciousness2015In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, E-ISSN 1757-7241, Vol. 23, no 1, article id 11Article in journal (Refereed)
    Abstract [en]

    Background

    Many patients seeking emergency care are under the influence of alcohol, which in many cases implies a differential diagnostic problem. For this reason early objective alcohol screening is of importance not to falsely assign the medical condition to intake of alcohol and thus secure a correct medical assessment.

    Objective

    At two emergency departments, demonstrate the feasibility of accurate breath alcohol testing in emergency patients with different levels of cooperation.

    Method

    Assessment of the correlation and ratio between the venous blood alcohol concentration (BAC) and the breath alcohol concentration (BrAC) measured in adult emergency care patients. The BrAC was measured with a breathalyzer prototype based on infrared spectroscopy, which uses the partial pressure of carbon dioxide (pCO2) in the exhaled air as a quality indicator.

    Result

    Eighty-eight patients enrolled (mean 45 years, 53 men, 35 women) performed 201 breath tests in total. For 51% of the patients intoxication from alcohol or tablets was considered to be the main reason for seeking medical care. Twenty-seven percent of the patients were found to have a BAC of <0.04 mg/g. With use of a common conversion factor of 2100:1 between BAC and BrAC an increased agreement with BAC was found when the level of pCO2 was used to estimate the end-expiratory BrAC (underestimation of 6%, r = 0.94), as compared to the BrAC measured in the expired breath (underestimation of 26%, r = 0.94). Performance of a forced or a non-forced expiration was not found to have a significant effect (p = 0.09) on the bias between the BAC and the BrAC estimated with use of the level of CO2. A variation corresponding to a BAC of 0.3 mg/g was found between two sequential breath tests, which is not considered to be of clinical significance.

    Conclusion

    With use of the expired pCO2 as a quality marker the BrAC can be reliably assessed in emergency care patients regardless of their cooperation, and type and length of the expiration.

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  • 214.
    Kassebaum, Nicholas J.
    et al.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Arora, Megha
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Barber, Ryan M.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Bhutta, Zulfigar A.
    Ctr Excellence Women & Child Hlth, Karachi, Pakistan.;Ctr Global Child Hlth, Toronto, ON, Canada..
    Carter, Austin
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Casey, Daniel C.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Charlson, Fiona J.
    Inst Hlth Metr & Evaluat, Seattle, WA USA.;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia.;Queensland Ctr Mental Hlth Res, Brisbane, Qld, Australia..
    Coates, Matthew M.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Coggeshall, Megan
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Cornaby, Leslie
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Dandona, Lalit
    Inst Hlth Metr & Evaluat, Seattle, WA USA.;Publ Hlth Fdn India, New Delhi, India..
    Dicker, Daniel J.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Erskine, Holly E.
    Inst Hlth Metr & Evaluat, Seattle, WA USA.;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia.;Queensland Ctr Mental Hlth Res, Brisbane, Qld, Australia..
    Ferrari, Alize J.
    Inst Hlth Metr & Evaluat, Seattle, WA USA.;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia.;Queensland Ctr Mental Hlth Res, Brisbane, Qld, Australia..
    Fitzmaurice, Christina
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Foreman, Kyle
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Forouzanfar, Mohammad H.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Fullman, Nancy
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Gething, Peter W.
    Univ Oxford, Dept Zool, Oxford, England..
    Goldberg, Ellen M.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Graetz, Nicholas
    Haagsma, Juanita A.
    Inst Hlth Metr & Evaluat, Seattle, WA USA.;Univ Med Ctr, Dept Publ Hlth, Erasmus MC, Rotterdam, Netherlands..
    Johnson, Catherine
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Kemmer, Laura
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Khalil, Ibrahim A.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Kinfu, Yohannes
    Inst Hlth Metr & Evaluat, Seattle, WA USA.;Univ Canberra, Fac Hlth, Ctr Res Action Publ Hlth, Canberra, ACT, Australia..
    Kutz, Michael J.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Kyu, Hmwe H.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Leung, Janni
    Inst Hlth Metr & Evaluat, Seattle, WA USA.;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia.;Queensland Ctr Mental Hlth Res, Brisbane, Qld, Australia..
    Liang, Xiaofeng
    Chinese Ctr Dis Control & Prevent, Beijing, Peoples R China..
    Lim, Stephen S.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Lozano, Rafael
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Mensah, George A.
    NHLBI, NIH, Ctr Translat Res & Implementat Sci, Bldg 10, Bethesda, MD 20892 USA..
    Mikesell, Joe
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Mokdad, Ali H.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Mooney, Meghan D.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Naghavi, Mohsen
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Nguyen, Grant
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Nsoesie, Elaine
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Pigott, David M.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Pinho, Christine
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Rankin, Zane
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Reinig, Nikolas
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Salomon, Joshua A.
    Inst Hlth Metr & Evaluat, Seattle, WA USA.;Harvard Univ, Dept Global Hlth & Populat, Boston, MA 02115 USA..
    Sandar, Logan
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Smith, Alison
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Sorensen, Reed J. D.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Stanaway, Jeffrey
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Steiner, Caitlyn
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Teeple, Stephanie
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Thomas, Bernadette A.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Troeger, Chris
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    VanderZanden, Amelia
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Wagner, Joseph A.
    Inst Hlth Metr & Evaluat, Seattle, WA USA.;Natl Inst Occupat Safety & Hlth, Washington, DC USA..
    Wanga, Valentine
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Whiteford, Harvey A.
    Inst Hlth Metr & Evaluat, Seattle, WA USA.;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia.;Queensland Ctr Mental Hlth Res, Brisbane, Qld, Australia..
    Zhou, Maigeng
    Inst Hlth Metr & Evaluat, Seattle, WA USA.;Natl Ctr Chron & Noncommunicable Dis Control & Pr, Beijing, Peoples R China..
    Zoeckler, Leo
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Abajobir, Amanuel Alemu
    Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia..
    Abate, Kalkidan Hassen
    Jimma Univ, Jimma, Ethiopia..
    Abbafati, Cristiana
    Univ Roma La Sapienza, Rome, Italy..
    Abbas, Kaja M.
    Virginia Tech, Blacksburg, VA USA..
    Abd-Allah, Foad
    Cairo Univ, Dept Neurol, Cairo, Egypt..
    Abraham, Biju
    NM SM Govt Coll, Kalpetta, Kerala, India..
    Abubakar, Ibrahim
    Inst Global Hlth, London, England..
    Abu-Raddad, Laith J.
    Weill Cornell Med Coll Qatar, Infect Dis Epidemiol Grp, Doha, Qatar.;Birzeit Univ, Inst Community & Publ Hlth, Ramallah, Israel..
    Abu-Rmeileh, Niveen M. E.
    Birzeit Univ, Inst Community & Publ Hlth, Ramallah, Israel..
    Achoki, Tom
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Ackerman, Ilana N.
    Monash Univ, Dept Epidemiol & Prevent Med, Sch Publ Hlth & Prevent Med, Melbourne, Vic, Australia..
    Adebiyi, Akindele Olupelumi
    Univ Ibadan, Coll Med, Ibadan, Nigeria.;Univ Coll Hosp, Ibadan, Nigeria..
    Adedeji, Isaac Akinkunmi
    Olabisi Onabanjo Univ, Ago Iwoye, Nigeria..
    Adsuar, Jose C.
    Univ Extremadura, Caceres, Spain..
    Afanvi, Kossivi Agbelenko
    Direct Dist Sanitaire Haho, Notse, Togo.;Univ Lome, Fac Sci Sante, Lome, Togo..
    Afshin, Ashkan
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Agardh, Emilie Elisabet
    Inst Publ Hlth Sci, Stockholm, Sweden..
    Agarwal, Arnav
    Univ Toronto, Toronto, ON, Canada.;McMaster Univ, Hamilton, ON, Canada..
    Kumar, Sanjay
    Ahmed, Muktar Beshir
    Jimma Univ, Jimma, Ethiopia..
    Kiadaliri, Aliasghar Ahmad
    Lund Univ, Dept Clin Sci Lund, Orthoped, Clin Epidemiol Unit, Lund, Sweden.;Kerman Univ Med Sci, Inst Futures Studies Hlth, Hlth Serv Management Res Ctr, Kerman, Iran..
    Ahmadieh, Hamid
    Shahid Beheshti Univ Med Sci, Ophthalm Res Ctr, Tehran, Iran.;Labbafinejad Med Ctr, Dept Ophthalmol, Tehran, Iran..
    Akseer, Nadia
    Ctr Global Child Hlth, Toronto, ON, Canada.;Dalla Lana Sch Publ Hlth, Toronto, ON, Canada..
    Al-Aly, Ziyad
    Washington Univ, St Louis, MO USA..
    Alam, Khurshid
    Murdoch Childrens Res Inst, Melbourne, Vic, Australia.;Univ Melbourne, Melbourne, Vic, Australia.;Univ Sydney, Sydney, NSW, Australia..
    Alam, Noore K. M.
    Univ Queensland, Brisbane, Qld, Australia.;Queensland Hlth, Herston, Qld, Australia..
    Aldhahri, Saleh Fahed
    King Saud Univ, Riyadh, Saudi Arabia.;King Fahad Med City, Riyadh, Saudi Arabia..
    Alegretti, Miguel Angel
    Fac Med, Dept Prevent & Social Med, Montevideo, Uruguay..
    Aleman, Alicia V.
    Sch Med, Montevideo, Uruguay..
    Alemu, Zewdie Aderaw
    Debre Markos Univ, Debre Markos, Ethiopia..
    Alexander, Lily T.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Raghib, Ali
    Univ Oxford, Oxford, England..
    Alkerwi, Ala'a
    LIH, Strassen, Luxembourg..
    Alla, Francois
    Univ Lorraine, Sch Publ Hlth, Nancy, France..
    Allebeck, Peter
    Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden..
    Alsharif, Ubai
    Charite, Berlin, Germany..
    Altirkawi, Khalid A.
    King Saud Univ, Riyadh, Saudi Arabia..
    Martin, Elena Alvarez
    Minist Hlth Social Policy & Equal, Spanish Observ Drugs, Govt Delegat Natl Plan Drugs, Madrid, Spain..
    Alvis-Guzman, Nelson
    Univ Cartagena, Cartagena Indias, Colombia..
    Amare, Azmeraw T.
    Univ Adelaide, Sch Med, Adelaide, SA, Australia.;Bahir Dar Univ, Coll Med & Hlth Sci, Bahir Dar, Ethiopia..
    Amberbir, Alemayehu
    Dignitas Int, Zomba, Malawi..
    Amegah, Adeladza Kofi
    Univ Cape Coast, Cape Coast, Ghana.;Natl Hosp, Abuja, Nigeria..
    Amini, Heresh
    Kurdistan Univ Med Sci, Environm Hlth Res Ctr, Sanandaj, Iran.;Swiss Trop & Publ Hlth Inst, Dept Epidemiol & Publ Hlth, Basel, Switzerland.;Univ Basel, Basel, Switzerland..
    Ammar, Walid
    Minist Publ Hlth, Beirut, Lebanon..
    Amrock, Stephen Marc
    Oregon Hlth & Sci Univ, Portland, OR 97201 USA..
    Anderson, Gregory M.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Anderson, Benjamin O.
    Univ Washington, Seattle, WA 98195 USA..
    Antonio, Carl Abelardo T.
    Univ Philippines, Dept Hlth Policy & Adm, Coll Publ Hlth, Manila, Philippines. Uppsala Univ, Dept Med Sci, Uppsala, Sweden..
    Anwari, Palwasha
    Self Employed, Kabul, Afghanistan..
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Dalarna Univ, Falun, Sweden..
    Arsenijevic, Valentina S. Arsic
    Univ Belgrade, Inst Microbiol & Immunol, Sch Med, Belgrade, Serbia.;Univ Children Hosp, Belgrade, Serbia..
    Artaman, Al
    Univ Manitoba, Winnipeg, MB, Canada..
    Asayesh, Hamid
    Qom Univ Med Sci, Sch Paramed, Dept Emergency Med, Qom, Iran..
    Asghar, Rana Jawad
    South Asian Publ Hlth Forum, Islamabad, Pakistan..
    Avokpaho, Euripide Frinel G. Arthur
    Inst Rech Clin Benin, Cotonou, Benin.;Lab dEtud & Rech Action Sante LERAS Afr, Parakou, Benin..
    Awasthi, Ashish
    Sanjay Gandhi Postgrad Inst Med Sci, Lucknow, Uttar Pradesh, India..
    Quintanilla, Beatriz Paulina Ayala
    Trobe Univ, Judith Lumley Ctr Mother, Infant & Family Hlth Res, Melbourne, Vic, Australia.;Peruvian Natl Inst Hlth, Lima, Peru..
    Azzopardi, Peter
    Murdoch Childrens Res Inst, Melbourne, Vic, Australia.;Dept Paediat, Melbourne, Vic, Australia.;South Australian Hlth & Med Res Inst, Wardliparingga Aboriginal Res Unit, Adelaide, SA, Australia..
    Bacha, Umar
    Univ Management & Technol, Sch Hlth Sci, Lahore, Pakistan..
    Badawi, Alaa
    Fac Med, Dept Nutrit Sci, Toronto, ON, Canada.;Publ Hlth Agcy Canada, Toronto, ON, Canada..
    Balakrishnan, Kalpana
    Sri Ramachandra Univ, Dept Environm Hlth Engn, Chennai, Tamil Nadu, India..
    Banerjee, Amitava
    Farr Inst Hlth Informat Res, London, England..
    Barac, Aleksandra
    Univ Belgrade, Fac Med, Belgrade, Serbia..
    Barker-Collo, Suzanne L.
    Univ Auckland, Sch Psychol, Auckland, New Zealand..
    Barnighausen, Till
    Harvard Univ, Harvard T H Chan Sch Publ Hlth, Boston, MA 02115 USA.;Africa Hlth Res Inst, Mtubatuba, South Africa.;Heidelberg Univ, Inst Publ Hlth, Heidelberg, Germany..
    Barregard, Lars
    Univ Gothenburg, Dept Occupat & Environm Hlth, Gothenburg, Sweden..
    Barrero, Lope H.
    Pontificia Univ Javeriana, Sch Engn, Dept Ind Engn, Bogota, Colombia..
    Basu, Sanjay
    Stanford Univ, Stanford, CA 94305 USA..
    Bayou, Tigist Assefa
    Mekelle Univ, Mekelle, Ethiopia..
    Beardsley, Justin
    Univ Oxford, Ho Chi Minh City, Oxford, Vietnam..
    Bedi, Neeraj
    Coll Publ Hlth & Trop Med, Jazan, Saudi Arabia..
    Beghi, Ettore
    IRCCS Ist Ric Farmacol Mario Negri, Milan, Italy..
    Bell, Brent
    Bell, Michelle L.
    Yale Univ, New Haven, CT USA..
    Benjet, Corina
    Natl Inst Psychiat Ramon Fuente, Mexico City, DF, Mexico..
    Bennett, Derrick A.
    Univ Oxford, Oxford, England..
    Bensenor, Isabela M.
    Univ Sao Paulo, Sao Paulo, Brazil..
    Berhane, Adugnaw
    Debre Berhane Univ, Debre Berhan, Ethiopia..
    Bernabe, Eduardo
    Kings Coll London, London, England..
    Betsu, Balem Demtsu
    Mekelle Univ, Mekelle, Ethiopia..
    Beyene, Addisu Shunu
    Haramaya Univ, Harar, Ethiopia..
    Bhala, Neeraj
    Queen Elizabeth Hosp Birmingham, Birmingham, W Midlands, England.;Univ Otago Med Sch, Wellington, New Zealand..
    Bhansali, Anil
    Postgrad Inst Med Educ & Res, Chandigarh, India..
    Bhatt, Samir
    Imperial Coll London, London, England..
    Biadgilign, Sibhatu
    Independent Publ Hlth Consultants, Addis Ababa, Ethiopia..
    Bienhofff, Kelly
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Bikbov, Boris
    Acad Shumakov Fed Res Ctr Transplantol & Artifici, Dept Nephrol Issues Transplanted Kidney, Moscow, Russia..
    Bin Abdulhak, Aref A.
    Univ Iowa Hosp & Clin, Iowa City, IA 52242 USA..
    Bisanzio, Donal
    Univ Oxford, Nuffield Dept Med, Oxford, England..
    Bjertness, Espen
    Univ Oslo, Dept Community Med, Oslo, Norway..
    Blore, Jed D.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Borschmann, Rohan
    Murdoch Childrens Res Inst, Melbourne, Vic, Australia.;Univ Melbourne, Melbourne, Vic, Australia..
    Boufous, Soufiane
    Transport & Rd Safety TARS Res, Kensington, NSW, Australia..
    Bourne, Rupert R. A.
    Anglia Ruskin Univ, Vision Eye Res Unit, Cambridge, England..
    Brainin, Michael
    Danube Univ Krems, Krems, Austria..
    Brazinova, Alexandra
    Trnava Univ, Fac Hlth Sci & Social Work, Dept Publ Hlth, Trnava, Slovakia.;Int Neurotrauma Res Org, Vienna, Austria..
    Breitborde, Nicholas J. K.
    Ohio State Univ, Columbus, OH 43210 USA. German Canc Res Ctr, Heidelberg, Germany..
    Brugha, Traolach S.
    Univ Leicester, Leicester, Leics, England..
    Buchbinder, Rachelle
    Monash Univ, Dept Epidemiol & Prevent Med, Sch Publ Hlth & Prevent Med, Melbourne, Vic, Australia.;Cabrini Inst, Monash Dept Clin Epidemiol, Melbourne, Vic, Australia..
    Buckle, Geoffrey Colin
    Univ Calif San Francisco, San Francisco, CA USA..
    Butt, Zahid A.
    Shifa Trust Eye Hosp, Rawalpindi, Pakistan..
    Calabria, Bianca
    Australian Natl Univ, Natl Ctr Epidemiol & Populat Hlth, Canberra, ACT, Australia.;Univ New S Wales, Kensington, NSW, Australia..
    Campos-Nonato, Ismael Ricardo
    Harvard Univ, Harvard T H Chan Sch Publ Hlth, Boston, MA 02115 USA.;Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Campuzano, Julio Cesar
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Carabin, Helene
    Univ Oklahoma Hlth Sci Ctr, Dept Biostat & Epidemiol, Oklahoma City, OK USA..
    Carapetis, Jonathan R.
    Univ Western Australia, Telethon Kids Inst, Princess Margaret Hosp Children, Subiaco, WA, Australia..
    Cardenas, Rosario
    Metropolitan Autonomous Univ, Mexico City, DF, Mexico..
    Carrero, Juan Jesus
    Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden..
    Castaneda-Orjuela, Carlos A.
    Colombian Natl Hlth Observ, Inst Nacl Salud, Bogota, Colombia.;Univ Nacl Colombia, Epidemiol & Publ Hlth Evaluat Grp, Dept Publ Hlth, Bogota, Colombia..
    Rivas, Jacqueline Castillo
    Caja Costarricense Seguro Social, San Jose, Costa Rica.;Univ Costa Rica, San Pedro, Montes De Oca, Costa Rica..
    Catala-Lopez, Ferran
    Univ Valencia, Dept Med, INCLIVA Hlth Res Inst & CIBERSAM, Valencia, Spain.;Ottawa Hosp Res Inst, Clin Epidemiol Program, Ottawa, ON, Canada..
    Cavalleri, Fiorella
    Fac Med, Montevideo, Uruguay..
    Chang, Jung-Chen
    Natl Taiwan Univ, Sch Nursing, Coll Med, Taipei, Taiwan..
    Chiang, Peggy Pei-Chia
    Clin Governance Unit, Gold Coast Hlth, Southport, Qld, Australia..
    Chibalabala, Mirriam
    Crowd Watch Afr, Lusaka, Zambia..
    Chibueze, Chioma Ezinne
    Natl Ctr Child Hlth & Dev, Tokyo, Japan..
    Chisumpa, Vesper Hichilombwe
    Univ Zambia, Lusaka, Zambia.;Univ Witwatersrand, Johannesburg, South Africa..
    Choi, Jee-Young Jasmine
    Seoul Natl Univ Med Lib, Seoul, South Korea..
    Choudhury, Lincoln
    World Bank, New Delhi, India..
    Christensen, Hanne
    Bispebjerg Hosp, Copenhagen, Denmark..
    Ciobanu, Liliana G.
    Univ Adelaide, Adelaide, SA, Australia..
    Colistro, Valentina
    Univ Republica, Montevideo, Uruguay.;Ministerio Salud Publ, Montevideo, Uruguay..
    Colomar, Mercedes
    UNICEM, Montevideo, Uruguay..
    Colquhoun, Samantha M.
    Murdoch Childrens Res Inst, Melbourne, Vic, Australia..
    Cortinovis, Monica
    IRCCS Ist Ric Farmacol Mario Negri, Milan, Italy..
    Crump, John A.
    Univ Otago, Ctr Int Hlth, Dunedin Sch Med, Dunedin, New Zealand..
    Damasceno, Albertino
    Eduardo Mondlane Univ, Fac Med, Maputo, Mozambique..
    Dandona, Rakhi
    Publ Hlth Fdn India, New Delhi, India..
    Dargan, Paul I.
    Guys & St Thomas NHS Fdn Trust, London, England..
    Das Neves, Jose
    Univ Porto, Inst Invest Inovacao Sande I3S, Oporto, Portugal.;Univ Porto, INEB Inst Engn Biomed, Oporto, Portugal..
    Davey, Gail
    Wellcome Trust Brighton Sussex Ctr Global Hlth Re, Brighton, E Sussex, England..
    Davis, Adrian C.
    Publ Hlth England, London, England..
    De Leo, Diego
    Griffith Univ, Brisbane, Qld, Australia..
    Degenhardt, Louisa
    Natl Drug & Alcohol Res Ctr, Kensington, NSW, Australia..
    Del Gobbo, Liana C.
    Stanford Univ, Stanford, CA 94305 USA..
    Derrett, Sarah
    Univ Otago, Injury Prevent Res Unit, Dept Prevent & Social Med, Dunedin Sch Med, Dunedin, New Zealand..
    Des Jarlais, Don C.
    Mt Sinai Beth Israel, New York, NY USA.;Icahn Sch Med Mt Sinai, New York, NY USA..
    Deveber, Gabrielle A.
    Hosp Sick Children, Toronto, ON, Canada..
    Dharmaratne, Samath D.
    Univ Peradeniya, Dept Community Med, Fac Med, Peradeniya, Sri Lanka..
    Dhillon, Preet K.
    Publ Hlth Fdn India, Gurgaon, India.;Publ Hlth Fdn India, Gurgaon, India..
    Ding, Eric L.
    Harvard Univ, Harvard T H Chan Sch Publ Hlth, Boston, MA 02115 USA..
    Doyle, Kerrie E.
    RMIT Univ, Bundoora, Vic, Australia..
    Driscoll, Tim R.
    Sydney Sch Publ Hlth, Sydney, NSW, Australia..
    Duan, Leilei
    Natl Ctr Chron & Noncommunicable Dis Control & Pr, Beijing, Peoples R China..
    Dubey, Manisha
    Int Inst Populat Sci, Mumbai, Maharashtra, India..
    Duncan, Bruce Bartholow
    Univ Fed Rio Grande do Sul, Porto Alegre, RS, Brazil.;Univ N Carolina, Chapel Hill, NC USA..
    Ebrahimi, Hedyeh
    Endocrinol & Metab Populat Sci Inst, Non Communicable Dis Res Ctr, Tehran, Iran.;Shariati Hosp, Digest Dis Res Inst, Liver & Pancreaticobiliary Dis Res Ctr, Tehran, Iran..
    Ellenbogen, Richard G.
    Harborview UW Med, Seattle, WA USA..
    Elyazar, Iqbal
    Eijkman Oxford Clin Res Unit, Jakarta, Indonesia..
    Endries, Aman Yesuf
    Arba Minch Univ, Arba Minch, Ethiopia..
    Ermakov, Sergey Petrovich
    Russian Acad Sci, Inst Social & Econ Studies Populat, Moscow, Russia.;Russian Federat, Fed Res Inst Hlth Org & Informat, Minist Hlth, Moscow, Russia..
    Eshrati, Babak
    Minist Hlth & Med Educ, Tehran, Iran.;Arak Univ Med Sci, Arak, Iran..
    Esteghamati, Alireza
    Endocrinol & Metab Populat Sci Inst, Non Communicable Dis Res Ctr, Tehran, Iran..
    Estep, Kara
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Fahimi, Saman
    Digest Dis Res Inst, Tehran, Iran..
    Farid, Talha A.
    Univ Louisville, Louisville, KY 40292 USA..
    Sa Farinha, Carla Sofia e
    DGS Directorate Gen Hlth, Lisbon, Portugal.;Univ Aberta, Lisbon, Portugal..
    Faro, Andre
    Univ Fed Sergipe, Aracaju, Brazil..
    Farvid, Maryam S.
    Harvard Univ, Harvard T H Chan Sch Publ Hlth, Boston, MA 02115 USA.;Massachusetts Gen Hosp, Mongan Inst Hlth Policy, Harvard MGH Ctr Genom, Vulnerable Populat & Hlth Disparities, Boston, MA USA..
    Farzadfar, Farshad
    Endocrinol & Metab Populat Sci Inst, Non Communicable Dis Res Ctr, Tehran, Iran..
    Feigin, Valery L.
    Natl Inst Stroke & Appl Neurosci, Auckland, New Zealand..
    Fereshtehnejad, Seyed-Mohammad
    Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Stockholm, Sweden..
    Fernandes, Jefferson G.
    Inst Educ & Sci, German Hosp Oswaldo Cruz, Sao Paulo, Brazil..
    Fernandes, Joao C.
    Queen Mary Univ London, William Harvey Res Inst, Barts & London Sch Med Dent, Ctr Expt Med Rheumatol, London, England..
    Fischer, Florian
    Univ Bielefeld, Bielefeld, Germany..
    Fitchett, Joseph R. A.
    Harvard Univ, Boston, MA 02115 USA..
    Foigt, Nataliya
    Acad Med Sci, Inst Gerontol, Kiev, Ukraine..
    Fowkes, F. Gerry R.
    Univ Edinburgh, Edinburgh, Midlothian, Scotland..
    Franklin, Richard C.
    James Cook Univ, Townsville, Qld, Australia..
    Friedman, Joseph
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Frostad, Joseph
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Furst, Thomas
    Swiss Trop & Publ Hlth Inst, Dept Epidemiol & Publ Hlth, Basel, Switzerland.;Univ Basel, Basel, Switzerland.;Imperial Coll London, Dept Infect Dis Epidemiol, London, England..
    Futran, Neal D.
    Univ Washington, Seattle, WA 98195 USA..
    Gabbe, Belinda
    Monash Univ, Dept Epidemiol & Prevent Med, Sch Publ Hlth & Prevent Med, Melbourne, Vic, Australia..
    Gankpe, Fortune Gbetoho
    Lab dEtud & Rech Action Sante LERAS Afr, Parakou, Benin.;CHU Hassan II, Fes, Morocco..
    Garcia-Basteiro, Alberto L.
    Manh Hlth Res Ctr, Manhica, Mozambique.;Barcelona Inst Global Hlth, Barcelona, Spain..
    Gebrehiwot, Tsegaye Tewelde
    Jimma Univ, Jimma, Ethiopia..
    Gebremedhin, Amanuel Tesfay
    Jimma Univ, Jimma, Ethiopia.;Univ Munich, Munich, Germany..
    Geleijnse, Johanna M.
    Wageningen Univ, Div Human Nutr, Wageningen, Netherlands..
    Gibney, Katherine B.
    Univ Melbourne, Peter Doherty Inst Infect & Immun, Melbourne, Vic, Australia.;Royal Melbourne Hosp, Melbourne, Vic, Australia..
    Gillum, Richard F.
    Howard Univ, Coll Med, Washington, DC USA..
    Ginawi, Ibrahim Abdelmageem Mohamed
    Univ Hail, Coll Med, Hail, Saudi Arabia..
    Giref, Ababi Zergaw
    Univ Children Hosp, Belgrade, Serbia.;Univ Addis Ababa, Addis Ababa, Ethiopia..
    Giroud, Maurice
    Univ Hosp Dijon, Dijon, France..
    Gishu, Melkamu Dedefo
    Haramaya Univ, Dire Dawa, Ethiopia.;Kersa Hlth & Demog Surveillance Syst, Harar, Ethiopia..
    Godwin, William W.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Gomez-Dantes, Hector
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Gona, Philimon
    Univ Massachusetts, Boston, MA USA..
    Goodridge, Amador
    Inst Invest Cient Serv Alta Tecnol, INDICASAT AIP, Ciudad Del Saber, Panama..
    Gopalani, Sameer Vali
    Govt Federated States Micronesia, Dept Hlth & Social Affairs, Palikir, Micronesia..
    Gotay, Carolyn C.
    Univ British Columbia, Vancouver, BC, Canada..
    Goto, Atsushi
    Div Epidemiol, Ctr Publ Hlth Sci, Tokyo, Japan..
    Gouda, Hebe N.
    Univ Queensland, Brisbane, Qld, Australia..
    Guo, Yuming
    Univ Queensland, Brisbane, Qld, Australia..
    Gupta, Rahul
    West Virginia Bur Publ Hlth, Charleston, WV USA..
    Gupta, Rajeev
    Eternal Heart Care Ctr & Res Inst, Jaipur, Rajasthan, India..
    Gupta, Vipin
    Univ Delhi, Dept Anthropol, Delhi, India..
    Gutierrez, Reyna A.
    Natl Inst Psychiat Ramon Fuente, Mexico City, DF, Mexico..
    Hafezi-Nejad, Nima
    Endocrinol & Metab Populat Sci Inst, Non Communicable Dis Res Ctr, Tehran, Iran..
    Haile, Demewoz
    Univ Addis Ababa, Addis Ababa, Ethiopia..
    Hailu, Alemayehu Desalegne
    Univ Addis Ababa, Sch Publ Hlth, Addis Ababa, Ethiopia.;Univ Bergen, Bergen, Norway..
    Hailu, Gessessew Bugssa
    Mekelle Univ, Mekelle, Ethiopia.;Kilte Awlaelo Hlth & Demog Surveillance Syst, Mekelle, Ethiopia..
    Halasa, Yara A.
    Brandeis Univ, Waltham, MA USA..
    Ribhi, Randah
    Hamadeh,
    Hamidi, Samer
    Hamdan Bin Mohammed Smart Univ, Dubai, U Arab Emirates..
    Hammami, Mouhanad
    Wayne Cty Dept Hlth & Human Serv, Detroit, MI USA..
    Handal, Alexis J.
    Univ New Mexico, Albuquerque, NM USA..
    Hankey, Graeme J.
    Inst Hlth Metr & Evaluat, Seattle, WA USA.;Univ Western Australia, Sch Med & Pharmacol, Perth, WA, Australia.;Harry Perkins Inst Med Res, Nedlands, WA, Australia.;Western Australian Neurosci Res Inst, Nedlands, WA, Australia..
    Harb, Hilda L.
    Minist Publ Hlth, Beirut, Lebanon..
    Harikrishnan, Sivadasanpillai
    Sree Chitra Tirunal Inst Med Sci & Technol, Trivandrum, Kerala, India..
    Haro, Josep Maria
    Parc Sanitari Sant Joan Deu CIBERSAM, Barcelona, Spain.;Univ Barcelona, Barcelona, Spain..
    Hassanvand, Mohammad Sadegh
    Inst Environm Res, Ctr Air Pollut Res, Tehran, Iran..
    Hassen, Tahir Ahmed
    Haramaya Univ, Harar, Ethiopia..
    Havmoeller, Rasmus
    Karolinska Inst, Stockholm, Sweden..
    Hay, Roderick J.
    Kings Coll London, London, England.;Int Fdn Dermatol, London, England..
    Hedayati, Mohammad T.
    Mazandaran Univ Med Sci, Sch Med, Dept Med Mycol & Parasitol, Sari, Iran..
    Heredia-Pi, Ileana Beatriz
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Heydarpour, Pouria
    Multiple Sclerosis Res Ctr Neurosci Inst, Tehran, Iran..
    Hoek, Hans W.
    Univ Med Ctr Groningen, Dept Psychiat, Groningen, Netherlands.;Columbia Univ, Dept Epidemiol, Mailman Sch Publ Hlth, New York, NY USA..
    Hoffman, Daniel J.
    Rutgers State Univ, New Brunswick, NJ USA..
    Horino, Masako
    Nevada Div Publ & Behav Hlth, Dept Hlth & Human Serv, Carson City, NV USA..
    Horita, Nobuyuki
    Yokohama City Univ, Dept Pulmonol, Grad Sch Med, Yokohama, Kanagawa, Japan..
    Hosgood, H. Dean
    Albert Einstein Coll Med, Bronx, NY USA..
    Hoy, Damian G.
    Publ Hlth Div, Pacific Community, Noumea, New Caledonia..
    Hsairi, Mohamed
    Salah Azaiz Inst, Dept Epidemiol, Tunis, Tunisia..
    Huang, Hsiang
    Cambridge Hlth Alliance, Cambridge, MA USA..
    Huang, John J.
    Yale Univ, New Haven, CT USA..
    Iburg, Kim Moesgaard
    Aarhus Univ, Aarhus, Denmark..
    Idrisov, Bulat T.
    Boston Univ, Boston Med Ctr, Boston, MA USA..
    Innos, Kaire
    Natl Inst Hlth Dev, Tallinn, Estonia..
    Inoue, Manami
    Natl Canc Ctr, Tokyo, Japan.;Univ Tokyo, Grad Sch Med, Tokyo, Japan..
    Jacobsen, Kathryn H.
    George Mason Univ, Dept Global & Community Hlth, Fairfax, VA 22030 USA..
    Jauregui, Alejandra
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Jayatilleke, Achala Upendra
    Postgrad Inst Med, Colombo, Sri Lanka.;Inst Violence & Injury Prevent, Colombo, Sri Lanka..
    Jeemon, Panniyammakal
    Ctr Control Chron Condit, New Delhi, India.;Ctr Control Chron Condit, Gurgaon, India.;Ctr Chron Dis Control, New Delhi, India..
    Jha, Vivekanand
    Univ Oxford, Oxford, England.;George Inst Global Hlth India, New Delhi, India..
    Jiang, Guohong
    Tianjin Ctr Dis Control & Prevent, Tianjin, Tianjin, Peoples R China..
    Jiang, Ying
    Univ Occupat & Environm Hlth, Inst Ind Ecol Sci, Dept Hlth Dev, Kitakyushu, Fukuoka, Japan..
    Jibat, Tariku
    Wageningen Univ, Wageningen, Netherlands.;Univ Addis Ababa, Addis Ababa, Ethiopia..
    Jimenez-Corona, Aida
    Inst Ophthalmol Conde Valencia, Dept Ocular Epidemiol & Visual Hlth, Mexico City, DF, Mexico.;Gen Directorate Epidemiol, Minist Hlth, Mexico City, DF, Mexico..
    Jin, Ye
    Natl Ctr Chron & Noncommunicable Dis Control & Pr, Beijing, Peoples R China..
    Jonas, Jost B.
    Heidelberg Univ, Med Fac Mannheim, Dept Ophthalmol, Mannheim, Germany..
    Kabir, Zubair
    Univ Coll Cork, Cork, Ireland..
    Kajungu, Dan K.
    Sante Stat Analyt Res Inst, Kampala, Uganda.;Mildmay Uganda, Kampala, Uganda..
    Kalkonde, Yogeshwar
    Action & Res Community Hlth, Soc Educ, Gadchiroli, India..
    Kamal, Ritul
    CSIR Indian Inst Toxicol Res, Lucknow, Uttar Pradesh, India..
    Kan, Haidong
    Fudan Univ, Shanghai, Peoples R China..
    Kandel, Amit
    SUNY Buffalo, Buffalo, NY USA..
    Karch, Andre
    Helmholtz Ctr Infect Res, Epidemiol & Stat Methods Res Grp, Braunschweig, Germany.;German Ctr Infect Res, Hannover Braunschweig Site, Hannover, Germany..
    Karema, Corine Kakizi
    Swiss Trop & Publ Hlth Inst, Basel, Switzerland.;Qual & Equity Hlth Care, Kigali, Rwanda..
    Karimkhani, Chante
    Case Western Univ Hosp, Cleveland, OH USA..
    Kasaeian, Amir
    Endocrinol & Metab Populat Sci Inst, Non Communicable Dis Res Ctr, Tehran, Iran.;Hematol Oncol & Stem Cell Transplantat Res Ctr, Tehran, Iran..
    Katibeh, Marzieh
    Shahid Beheshti Univ Med Sci, Ophthalm Epidemiol Res Ctr, Tehran, Iran..
    Kaul, Anil
    Oklahoma State Univ, Tulsa, OK USA..
    Kawakami, Norito
    Univ Tokyo, Sch Publ Hlth, Tokyo, Japan..
    Kazi, Dhruv S.
    Univ Calif San Francisco, San Francisco, CA 94143 USA..
    Keiyoro, Peter Njenga
    Inst Trop & Infect Dis, Nairobi, Kenya.;Sch Continuing & Distance Educ, Nairobi, Kenya..
    Kemp, Andrew Haddon
    Univ Sydney, Sydney, NSW, Australia.;Swansea Univ, Swansea, W Glam, Wales..
    Kengne, Andre Pascal
    South African Med Res Council, Cape Town, South Africa.;Univ Cape Town, Cape Town, South Africa..
    Keren, Andre
    Assuta Hosp, Assuta Hashalom, Tel Aviv, Israel..
    Kesavachandran, Chandrasekharan Nair
    CSIR Indian Inst Toxicol Res, Lucknow, Uttar Pradesh, India..
    Khader, Yousef Saleh
    Jordan Univ Sci & Technol, Irbid, Jordan..
    Khan, Abdur Rahman
    Univ Louisville, Louisville, KY 40292 USA..
    Khan, Ejaz Ahmad
    Hlth Serv Acad, Islamabad, Pakistan..
    Khang, Young-Ho
    Seoul Natl Univ, Coll Med, Seoul, South Korea..
    Khoja, Tawfik Ahmed Muthafer
    Execut Board Hlth Minist Council Cooperat Council, Riyadh, Saudi Arabia..
    Khubchandani, Jagdish
    Ball State Univ, Muncie, IN 47306 USA..
    Kieling, Christian
    Univ Fed Rio Grande do Sul, Porto Alegre, RS, Brazil.;Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil..
    Kim, Cho-il
    Korea Hlth Ind Dev Inst, Cheongju, South Korea..
    Kim, Daniel
    Northeastern Univ, Dept Hlth Sci, Boston, MA USA..
    Kim, Yun Jin
    Southern Univ Coll, Skudai, Malaysia..
    Kissoon, Niranjan
    Univ British Columbia, Vancouver, BC, Canada..
    Kivipelto, Miia
    Karolinska Inst, Aging Res Ctr, Stockholm, Sweden..
    Knibbs, Luke D.
    Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia..
    Knudsen, Ann Kristin
    Univ Bergen, Dept Global Publ Hlth & Primary Care, Bergen, Norway.;Ctr Dis Burden, Oslo, Norway..
    Kokubo, Yoshihiro
    Natl Cerebral & Cardiovasc Ctr, Dept Prevent Cardiol, Suita, Osaka, Japan..
    Kolte, Dhaval
    Brown Univ, Div Cardiol, Providence, RI USA..
    Kopec, Jacek A.
    Univ British Columbia, Vancouver, BC, Canada..
    Koul, Parvaiz A.
    Sherikashmir Inst Med Sci, Srinagar, Jammu & Kashmir, India..
    Koyanagi, Ai
    Parc Sanitari Sant Joan Deu CIBERSAM, Res Dev Unit, Barcelona, Spain..
    Defo, Barthelemy Kuate
    Univ Montreal, Dept Demog, Montreal, PQ, Canada.;Univ Montreal, Publ Hlth Res Inst, Montreal, PQ, Canada.;Univ Montreal, Dept Social & Prevent Med, Sch Publ Hlth, Montreal, PQ, Canada..
    Kuchenbecker, Ricardo S.
    Univ Fed Rio Grande do Sul, Grad Studies Epidemiol, Porto Alegre, RS, Brazil..
    Bicer, Burcu Kucuk
    Hacettepe Univ, Inst Publ Hlth, Ankara, Turkey..
    Kuipers, Ernst J.
    Univ Med Ctr Rotterdam, Erasmus MC, Rotterdam, Netherlands..
    Kumar, G. Anil
    Publ Hlth Fdn India, New Delhi, India..
    Kwan, Gene F.
    Boston Univ, Sch Med, Boston, MA USA..
    Lalloo, Ratilal
    Univ Queensland, Sch Dent, Brisbane, Qld, Australia..
    Lallukka, Tea
    Work Org, Work Disabil Prevent, Finnish Inst Occupat Hlth, Helsinki, Finland.;Univ Helsinki, Dept Publ Hlth, Fac Med, Helsinki, Finland..
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Latif, Asma Abdul
    Lahore Coll Women Univ, Dept Zool, Lahore, Pakistan..
    Lavados, Pablo M.
    Univ Desarrollo, Clin Alemana, Serv Neurol, Santiago, Chile..
    Lawrynowicz, Alicia Elena Beatriz
    Inst Nacl Epidemiol Dr Juan H Jara, Mar Del Plata, Argentina..
    Leasher, Janet L.
    Nova SE Univ, Coll Optometry, Ft Lauderdale, Ft Lauderdale, FL USA..
    Leigh, James
    Univ Sydney, Sydney, NSW, Australia..
    Leung, Ricky
    SUNY Albany, Albany, NY USA..
    Li, Yichong
    Natl Ctr Chron & Noncommunicable Dis Control & Pr, Beijing, Peoples R China.;San Francisco VA Med Ctr, San Francisco, CA USA..
    Li, Yongmei
    Lipshultz, Steven E.
    Wayne State Univ, Sch Med, Detroit, MI USA.;Childrens Hosp Michigan, Detroit, MI 48201 USA..
    Liu, Patrick Y.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Liu, Yang
    Emory Univ, Atlanta, GA USA..
    Lloyd, Belinda K.
    Monash Univ, Eastern Hlth Clin Sch, Melbourne, Vic, Australia.;Turning Point, Eastern Hlth, Melbourne, Vic, Australia..
    Logroscino, Giancarlo
    Univ Bari, Bari, Italy..
    Looker, Katharine J.
    Univ Bristol, Bristol, Avon, England..
    Lotufo, Paulo A.
    Univ Sao Paulo, Sao Paulo, Brazil..
    Lucas, Robyn M.
    Australian Natl Univ, Natl Ctr Epidemiol & Populat Hlth, Canberra, ACT, Australia..
    Lunevicius, Raimundas
    Aintree Univ, Hosp Natl Hlth Serv Fdn Trust, Liverpool, Merseyside, England.;Univ Liverpool, Sch Med, Liverpool, Merseyside, England..
    Lyons, Ronan A.
    Farr Inst, Swansea, W Glam, Wales..
    El Razek, Hassan Magdy Abd
    Mansoura Fac Med, Mansoura, Egypt. Social Secur Org Res Inst, Tehran, Iran..
    Mandavi, Mandi
    Majdan, Marek
    Trnava Univ, Fac Hlth Sci & Social Work, Dept Publ Hlth, Trnava, Slovakia..
    Majeed, Azeem
    Imperial Coll London, London, England..
    Malekzadeh, Reza
    Digest Dis Res Inst, Tehran, Iran..
    Malta, Deborah Carvalho
    Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil..
    Marcenes, Wagner
    Kings Coll London, Div Populat & Patient Hlth, Inst Dent, London, England..
    Martinez-Raga, Jose
    Univ Valencia, Univ Hosp Doctor Peset, Valencia, Spain.;CEU Cardenal Herrera Univ, Valencia, Spain..
    Masiye, Felix
    Inst Hlth Metr & Evaluat, Seattle, WA USA.;Univ Zambia, Lusaka, Zambia..
    Mason-Jones, Amanda J.
    Univ York, Dept Hlth Sci, York, N Yorkshire, England..
    Matzopoulos, Richard
    South African Med Res Council, Cape Town, South Africa.;Univ Cape Town, Sch Publ Hlth & Family Med, Cape Town, South Africa..
    Mayosi, Bongani M.
    Univ Cape Town, Cape Town, South Africa..
    McGrath, John J.
    Univ Queensland, Brisbane, Qld, Australia..
    Mckee, Martin
    Erasmus Univ, Inst Hlth Policy & Management, Rotterdam, Netherlands.;London Sch Hyg Trop Med, London, England..
    Meaney, Peter A.
    Univ Penn, Perelman Sch Med, Philadelphia, PA USA.;Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA..
    Mehari, Alem
    Howard Univ, Coll Med, Washington, DC USA..
    Melaku, Yohannes Adama
    Univ Adelaide, Sch Med, Adelaide, SA, Australia.;Mekelle Univ, Sch Publ Hlth, Mekelle, Ethiopia..
    Memiah, Peter
    Univ Florida, Pensacola, FL USA..
    Memish, Ziad A.
    Saudi Minist Hlth, Riyadh, Saudi Arabia.;Alfaisal Univ, Coll Med, Riyadh, Saudi Arabia..
    Mendoza, Walter
    United Nations Populat Fund, Lima, Peru..
    Meretoja, Atte
    Dept Med, Melbourne, Vic, Australia.;Helsinki Univ Hosp, Dept Neurol, Helsinki, Finland..
    Meretoja, Tuomo J.
    Univ Helsinki, Helsinki, Finland.;Helsinki Univ Hosp, Breast Surg Unit, Ctr Comprehens Canc, Helsinki, Finland..
    Mesfin, Yonatan Moges
    Haramaya Univ, Harar, Ethiopia..
    Mhimbira, Francis Apolinary
    Ifakara Hlth Inst, Bagamoyo, Tanzania..
    Miller, Ted R.
    Pacific Inst Res Evaluat, Calverton, MD USA.;Curtin Univ, Ctr Populat Hlth, Perth, WA, Australia..
    Mills, Edward J.
    Univ Ottawa, Ottawa, ON, Canada..
    Mirarefin, Mojde
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Mirrakhimov, Erkin M.
    Kyrgyz State Med Acad, Bishkek, Kyrgyzstan.;Natl Ctr Cardiol & Internal Dis, Bishkek, Kyrgyzstan..
    Mitchell, Philip B.
    Univ New S Wales, Kensington, NSW, Australia..
    Mock, Charles N.
    Harborview Injury Prevent & Res Ctr, Seattle, WA USA..
    Mohammad, Karzan Abdulmuhsin
    Univ Salahaddin, Erbil, Iraq..
    Mohammadi, Alireza
    Baqiyatallah Univ Med Sci, Neurosci Res Ctr, Tehran, Iran..
    Mohammed, Shafiu
    Heidelberg Univ, Inst Publ Hlth, Heidelberg, Germany.;Ahmadu Bello Univ, Hlth Syst & Policy Res Unit, Zaria, Nigeria..
    Monasta, Lorenzo
    IRCCS Burlo Garofolo, Inst Maternal & Child Hlth, Trieste, Italy..
    Montanez Hernandez, Julio Cesar
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Montico, Marcella
    IRCCS Burlo Garofolo, Inst Maternal & Child Hlth, Trieste, Italy..
    Moradi-Lakeh, Maziar
    Inst Hlth Metr & Evaluat, Seattle, WA USA.;Iran Univ Med Sci, Dept Community Med, Gastrointestinal & Liver Dis Res Ctr, Prevent Med & Publ Hlth Res Ctr, Tehran, Iran..
    Mori, Rintaro
    Natl Ctr Child Hlth & Dev, Tokyo, Japan..
    Mueller, Ulrich O.
    Fed Inst Populat Res, Wiesbaden, Germany..
    Mumford, John Everett
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Murdoch, Michele E.
    West Herts Hosp NHS Trust, Watford, England..
    Murthy, Gudlavalleti Venkata Satyanarayana
    London Sch Hyg Trop Med, London, England.;Indian Inst Publ Hlth, Gurgaon, India..
    Nachega, Jean B.
    Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA USA.;Univ Stellenbosch, Cape Town, South Africa.;Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Baltimore, MD USA..
    Naheed, Aliya
    Int Ctr Diarrhoeal Dis Res, Dhaka, Bangladesh..
    Naldi, Luigi
    Azienda Osped Papa Giovanni XXIII, Bergamo, Italy..
    Nangia, Vinay
    Suraj Eye Inst, Nagpur, Maharashtra, India..
    Newton, John N.
    Publ Hlth England, London, England..
    Ng, Marie
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Ngalesoni, Frida Namnyak
    Minist Hlth & Social Welf, Dar Es Salaam, Tanzania..
    Le Nguyen, Quyen
    Duy Tan Univ, Inst Global Hlth Innovat, Da Nang, Vietnam..
    Nisar, Muhammad Imran
    Aga Khan Univ, Karachi, Pakistan..
    Pete, Patrick Martial Nkamedjie
    Inst Res, Socioecon Dev & Commun, Yaounde, Cameroon..
    Nolla, Joan M.
    Hosp Univ Bellvitge, Lhospitalet De Llobregat, Spain..
    Norheim, Ole F.
    Univ Bergen, Bergen, Norway..
    Norman, Rosana E.
    Queensland Univ Technol, Inst Hlth & Biomed Innovat, Brisbane, Qld, Australia..
    Norrving, Bo
    Lund Univ, Skane Univ Hosp, Dept Clin Sci Lund, Lund, Sweden..
    Obermeyer, Carla Makhlouf
    Amer Univ Beirut, Ctr Res Populat & Hlth, Fac Hlth Sci, Beirut, Lebanon..
    Ogbo, Felix Akpojene
    Univ Western Sydney, Ctr Hlth Res, Sydney, NSW, Australia..
    Oh, In-Hwan
    Kyung Hee Univ, Sch Med, Dept Prevent Med, Seoul, South Korea..
    Oladimeji, Olanrewaju
    Human Sci Res Council, Durban, South Africa.;Univ KwaZulu Natal, Durban, South Africa..
    Olivares, Pedro R.
    Univ Autonoma Chile, Talca, Chile..
    Olusanya, Bolajoko Olubukunola
    Ctr Healthy Start Initiat, Lagos, Nigeria..
    Olusanya, Jacob Olusegun
    Ctr Healthy Start Initiat, Lagos, Nigeria..
    Oren, Eyal
    Univ Arizona, Tucson, AZ USA..
    Ortiz, Alberto
    IIS Fdn Jimenez Diaz UAM, Madrid, Spain..
    Ota, Erika
    Lukes Int Univ, Tokyo, Japan..
    Oyekale, Abayomi Samuel
    Hypertens NorthWest Univ, Mafikeng, South Africa..
    Pa, Mahesh
    JSS Univ, JSS Med Coll, Mysore, Karnataka, India..
    Park, Eun-Kee
    Kosin Univ, Dept Med Human & Social Med, Coll Med, Busan, South Korea..
    Parsaeian, Mahboubeh
    Endocrinol & Metab Populat Sci Inst, Non Communicable Dis Res Ctr, Tehran, Iran.;Sch Publ Hlth, Dept Epidemiol & Biostat, Tehran, Iran..
    Patten, Scott B.
    Univ Calgary, Dept Community Hlth Sci, Calgary, AB, Canada..
    Patton, George C.
    Murdoch Childrens Res Inst, Melbourne, Vic, Australia..
    Pedro, Joao Mario
    Univ Porto, EPI Unit Inst Publ Hlth, Oporto, Portugal.;Hlth Res Ctr Angola, Caxito, Angola..
    Pereira, David M.
    Univ Porto, REQUIMTE LAQV, Lab Farm, Dept Quim,Fac Farm, Oporto, Portugal..
    Perico, Norberto
    IRCCS Ist Ric Farmacol Mario Negri, Bergamo, Italy..
    Pesudovs, Konrad
    Flinders Univ S Australia, Adelaide, SA, Australia..
    Petzold, Max
    Univ Gothenburg, Hlth Metr Unit, Gothenburg, Sweden.;Univ Witwatersrand, Johannesburg, South Africa..
    Phillips, Michael Robert
    Emory Univ, Atlanta, GA USA.;Shanghai Jiao Tong Univ, Sch Med, Shanghai, Peoples R China..
    Piel, Frederic B.
    Imperial Coll London, Dept Epidemiol & Biostat, London, England..
    Pillay, Julian David
    Durban Univ Technol, Durban, South Africa..
    Pishgar, Farhad
    Endocrinol & Metab Populat Sci Inst, Non Communicable Dis Res Ctr, Tehran, Iran.;Urooncol Res Ctr, Tehran, Iran..
    Plass, Dietrich
    Exposure Assessment & Environm Hlth Indicators, German Environm Agcy, Berlin, Germany..
    Polinder, Suzanne
    Erasmus MC, Dept Publ Hlth, Rotterdam, Netherlands..
    Popova, Svetlana
    Ctr Addict & Mental Hlth, Toronto, ON, Canada..
    Poulton, Richie G.
    Univ Otago, Dunedin, New Zealand..
    Pourmalek, Farshad
    Univ British Columbia, Vancouver, BC, Canada..
    Prasad, Noela M.
    Fred Hollows Fdn, Sydney, NSW, Australia.;Ctr Eye Res Australia, Melbourne, Vic, Australia..
    Qorbani, Mostafa
    Alborz Univ Med Sci, Sch Med, Dept Community Med, Karaj, Iran..
    Rabiee, Rynaz H. S.
    Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden..
    Radfar, Amir
    AT Still Univ, Kirksville, MO USA..
    Rafay, Anwar
    Contech Sch Publ Hlth, Lahore, Pakistan..
    Rahimi, Kazem
    Univ Oxford, Oxford, England..
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    Sina Trauma & Surg Res Ctr, Tehran, Iran..
    Rahman, Mahfuzar
    Int Inst Populat Sci, Mumbai, Maharashtra, India.;Res & Evaluat Div, BRAC, Dhaka, Bangladesh..
    Rahman, Mohammad Hifz Ur
    Rahman, Sajjad Ur
    Hamad Med Corp, Doha, Qatar..
    Rai, Dheeraj
    Univ Bristol, Bristol, Avon, England..
    Rai, Rajesh Kumar
    Soc Hlth & Demog Surveillance, Suri, India..
    Rajsic, Sasa
    UMIT, ERAWEB Program, Hall In Tirol, Austria..
    Raju, Murugesan
    Univ Missouri, Columbia, MO USA..
    Ram, Usha
    Int Inst Populat Sci, Mumbai, Maharashtra, India..
    Ranganathan, Kavitha
    Univ Michigan Hlth Syst, Ann Arbor, MI USA..
    Refaat, Amany H.
    Walden Univ, Minneapolis, MN USA.;Suez Canal Univ, Ismailia, Egypt..
    Reitsma, Marissa B.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Remuzzi, Giuseppe
    Azienda Osped Papa Giovanni XXIII, Bergamo, Italy.;IRCCS Ist Ric Farmacol Mario Negri, Bergamo, Italy.;Univ Milan, Dept Biomed & Clin Sci Sacco L, Milan, Italy..
    Resnikoff, Serge
    Brien Holden Vision Inst, Kensington, NSW, Australia..
    Reynolds, Alex
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Ribeiro, Antonio L.
    Univ Fed Minas Gerais, Hosp Clin, Belo Horizonte, MG, Brazil..
    Ricci, Stefano
    UO Neurol USL Umbria 1, Citta Di Castello, Italy..
    Roba, Hirbo Shore
    Haramaya Univ, Coll Hlth & Med Sci, Harar, Ethiopia.;Haramaya Univ, Coll Hlth & Med Sci, Dawa, Ethiopia..
    Rojas-Rueda, David
    Inst Salud Global Barcelona, Barcelona, Spain..
    Ronfani, Luca
    IRCCS Burlo Garofolo, Inst Maternal & Child Hlth, Trieste, Italy..
    Roshandel, Gholamreza
    Digest Dis Res Inst, Tehran, Iran.;Golestan Univ Med Sci, Golestan Res Ctr Gastroenterol & Hepatol, Gorgan, Iran..
    Roth, Gregory A.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Roy, Ambuj
    All India Inst Med Sci, New Delhi, India..
    Sackey, Ben Benasco
    World Hlth Org, Accra, Ghana..
    Sagar, Rajesh
    All India Inst Med Sci, New Delhi, India..
    Sanabria, Juan R.
    Marshall Univ, Edwards Sch Med J, Huntington, WV USA.;Case Western Reserve Univ, Cleveland, OH USA..
    Dolores Sanchez-Nino, Maria
    IIS Fdn Jimenez Diaz, Madrid, Spain..
    Santos, Itamar S.
    Univ Sao Paulo, Dept Internal Med, Sao Paulo, Brazil..
    Santos, Joao Vasco
    Univ Porto, Oporto, Portugal..
    Sarmiento-Suarez, Rodrigo
    Univ Ciencias Aplicadas Ambient, Bogota, Colombia..
    Sartorius, Benn
    Univ KwaZulu Natal, Durban, South Africa..
    Satpathy, Maheswar
    All India Inst Med Sci, New Delhi, India..
    Savic, Miloje
    Norwegian Inst Publ Hlth, Oslo, Norway..
    Sawhney, Monika
    Marshall Univ, Huntington, WV USA..
    Schmidt, Maria Ines
    Univ Fed Rio Grande do Sul, Porto Alegre, RS, Brazil..
    Schneider, Ione J. C.
    Univ Fed Santa Catarina, Florianopolis, SC, Brazil..
    Schutte, Aletta E.
    HART, Mafikeng, South Africa.;South African Med Res Council, Potchefstroom, South Africa..
    Schwebel, David C.
    Univ Alabama Birmingham, Birmingham, AL USA..
    Seedat, Soraya
    Univ Stellenbosch, Cape Town, South Africa..
    Sepanlou, Sadaf G.
    Digest Dis Res Inst, Tehran, Iran..
    Servan-Mori, Edson E.
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Shahraz, Saeid
    Tufts Med Ctr, Boston, MA USA..
    Shaikh, Masood Ali
    Independent Consultant, Karachi, Pakistan..
    Sharma, Rajesh
    Indian Inst Technol Ropar, Rupnagar, India..
    She, Jun
    Zhongshan Hosp, Dept Pulm Med, Shanghai, Peoples R China..
    Sheikhbahaei, Sara
    Endocrinol & Metab Populat Sci Inst, Non Communicable Dis Res Ctr, Tehran, Iran..
    Shen, Jiabin
    Ohio State Univ, Coll Med, Columbus, OH 43210 USA.;Res Inst, Nationwide Childrens Hosp, Columbus, OH USA..
    Sheth, Kevin N.
    Yale Univ, Sch Med, New Haven, CT USA..
    Shibuya, Kenji
    Univ Tokyo, Tokyo, Japan..
    Shigematsu, Mika
    Natl Inst Infect Dis, Tokyo, Japan.;Sandia Natl Labs, Albuquerque, NM USA..
    Shin, Min-Jeong
    Korea Univ, Dept Publ Hlth Sci, Grad Sch, Seoul, South Korea..
    Shin, Rahman
    Work Org, Work Disabil Prevent, Finnish Inst Occupat Hlth, Helsinki, Finland..
    Sigfusdottir, Inga Dora
    Reykjavik Univ, Reykjavik, Iceland..
    Santos Silva, Diego Augusto
    Univ Fed Santa Catarina, Florianopolis, SC, Brazil..
    Silverberg, Jonathan I.
    Northwestern Univ, Feinberg Sch Med, Chicago, IL USA..
    Simard, Edgar P.
    Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA USA..
    Singh, Abhishek
    Int Inst Populat Sci, Mumbai, Maharashtra, India..
    Singh, Jasvinder A.
    Univ Alabama Birmingham, Birmingham, AL USA..
    Singh, Prashant Kumar
    Inst Human Dev, New Delhi, India..
    Skirbekk, Vegard
    Columbia Univ, New York, NY USA.;Norwegian Inst Publ Hlth, Oslo, Norway..
    Skogen, Jens Christoffer
    Norwegian Inst Publ Hlth, Dept Hlth Promot, Oslo, Norway.;Alcohol & Drug Res Western Norway, Stavanger, Norway..
    Soljak, Michael
    Imperial Coll London, London, England..
    Soreide, Kjetil
    Stavanger Univ Hosp, Stavanger, Norway..
    Sreeramareddy, Chandrashekhar T.
    Int Med Univ, Dept Community Med, Kuala Lumpur, Malaysia..
    Stathopoulou, Vasiliki
    Attikon Univ Hosp, Athens, Greece..
    Steel, Nicholas
    Publ Hlth England, London, England.;Univ Anglia, Norwich, Norfolk, England..
    Stein, Dan J.
    Univ Cape Town, Dept Psychiat, Cape Town, South Africa.;S African MRC, Unit Anxiety Stress Dis, Cape Town, South Africa..
    Stein, Murray B.
    Univ Calif San Diego, San Diego, CA USA..
    Steiner, Timothy J.
    Imperial Coll London, Div Brain Sci, London, England.;Norwegian Univ Sci & Technol, Dept Neurosci, Trondheim, Norway..
    Stovner, Lars Jacob
    Norwegian Univ Sci & Technol, Dept Neurosci, Trondheim, Norway.;St Olays Hosp, Norwegian Advisory Unit Headache, Trondheim, Norway..
    Stranges, Saverio
    LIH, Strassen, Luxembourg..
    Stroumpoulis, Konstantinos
    Alexandra Gen Hosp Athens, Athens, Greece.;Ctr Hosp Publ Cotentin, Cherbourg, France..
    Sunguya, Bruno F.
    Muhimbili Univ Hlth & Allied Sci, Dar Es Salaam, Tanzania..
    Sur, Patrick J.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Swaminathan, Soumya
    Indian Council Med Res, New Delhi, India..
    Sykes, Bryan L.
    Univ Calif Irvine, Dept Criminol Law & Soc Sociol & Publ Hlth, Irvine, CA USA..
    Szoeke, Cassandra E. I.
    Inst Hlth & Ageing, Melbourne, Vic, Australia..
    Tabares-Seisdedos, Rafael
    Univ Valencia, Dept Med, INCLIVA Hlth Res Inst & CIBERSAM, Valencia, Spain..
    Landon, Nikhil
    Tanne, David
    Chaim Sheba Med Ctr, Tel Hashomer, Israel.;Tel Aviv Univ, Tel Aviv, Israel..
    Tavakkoli, Mohammad
    New York Med Coll, Valhalla, NY USA..
    Taye, Bineyam
    Colgate Univ, Dept Biol, Hamilton, NY USA..
    Taylor, Hugh R.
    Univ Melbourne, Melbourne, Vic, Australia..
    Ao, Braden J. Te
    Auckland Univ Technol, Auckland, New Zealand..
    Tegegne, Teketo Kassaw
    Debre Markos Univ, Debre Markos, Ethiopia..
    Tekle, Dejen Yemane
    Mekelle Univ, Mekelle, Ethiopia..
    Terkawi, Abdullah Sulieman
    Dept Anesthesiol, Riyadh, Saudi Arabia.;Univ Virginia, Dept Anesthesiol, Charlottesville, VA USA.;Cleveland Clin, Outcomes Res Consortium, Cleveland, OH USA..
    Tessema, Gizachew Assefa
    Univ Adelaide, Adelaide, SA, Australia.;Univ Gondar, Gondar, Ethiopia..
    Thakur, J. S.
    Post Grad Inst Med Educ & Res, Sch Publ Hlth, Chandigarh, India..
    Thomson, Alan J.
    Adapt Knowledge Management, Victoria, BC, Canada..
    Thorne-Lyman, Andrew L.
    Harvard Univ, Dept Nutr, Boston, MA 02115 USA.;WorldFish, George Town, Malaysia..
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    Monash Univ, Dept Med, Sch Clin Sci Monash Hlth, Melbourne, Vic, Australia..
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    New York Univ, Nelson Inst Environm Med, Sch Med, Tuxedo Pk, NY USA..
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    Natl Ctr Child Hlth & Dev, Tokyo, Japan..
    Tonelli, Marcello
    Univ Calgary, Calgary, AB, Canada..
    Topor-Madry, Roman
    Jagiellonian Univ Med Coll, Inst Publ Hlth, Fac Hlth Sci, Krakow, Poland.;Wroclaw Med Univ, Fac Hlth Sci, Wroclaw, Poland..
    Topouzis, Fotis
    Aristotle Univ Thessaloniki, Thessaloniki, Greece..
    Tran, Bach Xuan
    Johns Hopkins Univ, Baltimore, MD USA.;Hanoi Med Univ, Hanoi, Vietnam..
    Dimbuene, Zacharie Tsala
    Univ Kinshasa, Fac Econ & Management, Dept Populat Sci & Dev, Kinshasa, Congo.;African Populat & Hlth Res Ctr, Nairobi, Kenya..
    Tsilimbaris, Miltiadis
    Univ Crete, Dept Med, Iraklion, Greece..
    Tura, Abera Kenay
    Haramaya Univ, Dire Dawa, Ethiopia.;Univ Groningen, Groningen, Netherlands..
    Tuzcu, Emin Murat
    Cleveland Clin, Cleveland, OH USA..
    Tyrovolas, Stefanos
    Univ Barcelona, Parc Sanitari Sant Joan Deu, Fundacio Sant Joan Deu, CIBERSAM, Barcelona, Spain..
    Ukwaja, Kingsley N.
    Fed Teaching Hosp, Dept Internal Med, Abakaliki, Nigeria..
    Undurraga, Eduardo A.
    Brandeis Univ, Waltham, MA USA..
    Uneke, Chigozie Jesse
    Ebonyi State Univ, Abakaliki, Nigeria..
    Uthman, Olalekan A.
    Univ Warwick, Warwick Med Sch, Coventry, W Midlands, England..
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    Natl Inst Publ Hlth & Environm, Bilthoven, Netherlands..
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    Maastricht Univ Med Ctr, Maastricht, Netherlands..
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    UKK Inst Hlth Promot Res, Tampere, Finland..
    Vasconcelos, Ana Maria Nogales
    Univ Brasilia, Brasilia, DF, Brazil..
    Venketasubramanian, Narayanaswamy
    Raffles Hosp, Raffles Neurosci Ctr, Singapore, Singapore..
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    Univ Bologna, Bologna, Italy..
    Vlassov, Vasiliy Victorovich
    Natl Res Univ Higher Sch Econ, Moscow, Russia..
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    Inst Hlth Metr & Evaluat, Seattle, WA USA.;Univ Bergen, Dept Global Publ Hlth & Primary Care, Bergen, Norway.;Ctr Dis Burden, Oslo, Norway..
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    Harvard Univ, Harvard T H Chan Sch Publ Hlth, Boston, MA 02115 USA..
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    VA Med Ctr, Washington, DC USA.;Georgetown Univ, Dept Neurol, Washington, DC USA..
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    Natl Ctr Chron & Noncommunicable Dis Control & Pr, Beijing, Peoples R China..
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    McGill Univ, Montreal, PQ, Canada..
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    Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden.;Canc Registry Norway, Inst Populat Based Canc Res, Dept Res, Oslo, Norway.;Univ Tromso, Arct Univ Norway, Dept Community Med, Fac Hlth Sci, Tromso, Norway.;Genet Epidemiol Grp, Folkhalsan Res Ctr, Helsinki, Finland..
    Weintraub, Robert G.
    Murdoch Childrens Res Inst, Melbourne, Vic, Australia.;Royal Childrens Hosp, Melbourne, Vic, Australia..
    Werdecker, Andrea
    Competence Ctr Mortal Follow Up German Natl Cohor, Wiesbaden, Germany..
    WestermaM, Ronny
    Fed Inst Populat Res, Wiesbaden, Germany.;German Natl Cohort Consortium, Heidelberg, Germany..
    Wijeratne, Tissa
    Univ Melbourne, Melbourne, Vic, Australia.;Western Hlth, Footscray, Vic, Australia..
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    Wayne State Univ, Sch Med, Detroit, MI USA.;Childrens Hosp Michigan, Detroit, MI USA..
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    Univ Nottingham, Ctr Evidence based Dermatol, Nottingham, England..
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    South African Med Res Council, Cape Town, South Africa.;Univ Stellenbosch, Cape Town, South Africa..
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    Univ Gondar, Inst Publ Hlth, Dept Epidemiol & Biostat, Gondar, Ethiopia..
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    Kings Coll London, Div Hlth & Social Care Res, London, England.;Guys St Thomas NHS Fdn Trust & Kings Coll London, Natl Inst Hlth Res Comprehens Biomed Res Ctr, London, England..
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    Seoul Natl Univ, Grad Sch Publ Hlth, Seoul, South Korea..
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    Nanjing Univ, Jinling Hosp, Dept Neurol, Sch Med, Nanjing, Peoples R China..
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    Int Inst Populat Sci, Mumbai, Maharashtra, India..
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    Univ KwaZulu Natal, Sch Nursing & Publ Hlth, Discipline Publ Hlth Med, Durban, South Africa..
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    Duke Kunshan Univ, Global Hlth Res Ctr, Kunshan, Peoples R China..
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    Northwestern Univ, Dept Prevent Med, Chicago, IL USA..
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    Univ Tehran Med Sci, Tehran, Iran..
    Ye, Pengpeng
    Yip, Paul
    Univ Hong Kong, Social Work & Social Adm Dept, Hong Kong, Peoples R China.;Univ Hong Kong, Hong Kong Jockey Club Ctr Suicide Res & Prevent, Hong Kong, Peoples R China..
    Yonemoto, Naohiro
    Kyoto Univ, Sch Publ Hlth, Dept Biostat, Kyoto, Japan..
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    Korea Univ, Dept Prevent Med, Coll Med, Seoul, South Korea..
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    Jackson State Univ, Jackson, MS USA..
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    Wuhan Univ, Dept Epidemiol & Biostat, Sch Publ Hlth, Wuhan, Peoples R China.;Wuhan Univ, Global Hlth Inst, Wuhan, Peoples R China..
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    Univ Hosp, Setif, Algeria..
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    Mansoura Univ, Fac Med, Mansoura, Egypt..
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    Leibniz Inst Prevent Res & Epidemiol, Bremen, Germany..
    Zodpey, Sanjay
    Publ Hlth Fdn India, Gurgaon, India.;Publ Hlth Fdn India, Gurgaon, India..
    Zonies, David
    Oregon Hlth & Sci Univ, Portland, OR 97201 USA..
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    Red Cross War Mem Childrens Hosp, Cape Town, South Africa..
    Vos, Theo
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Lopez, Alan D.
    Inst Hlth Metr & Evaluat, Seattle, WA USA.;Melbourne Sch Populat & Global Hlth, Melbourne, Vic, Australia..
    Murray, Christopher J. L.
    Inst Hlth Metr & Evaluat, Seattle, WA USA..
    Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 20152016In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 388, no 10053, p. 1603-1658Article in journal (Refereed)
    Abstract [en]

    Background Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development. Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2015. We calculated DALYs by summing years of life lost (YLLs) and years of life lived with disability (YLDs) for each geography, age group, sex, and year. We estimated HALE using the Sullivan method, which draws from age-specific death rates and YLDs per capita. We then assessed how observed levels of DALYs and HALE differed from expected trends calculated with the Socio-demographic Index (SDI), a composite indicator constructed from measures of income per capita, average years of schooling, and total fertility rate. Findings Total global DALYs remained largely unchanged from 1990 to 2015, with decreases in communicable, neonatal, maternal, and nutritional (Group 1) disease DALYs off set by increased DALYs due to non-communicable diseases (NCDs). Much of this epidemiological transition was caused by changes in population growth and ageing, but it was accelerated by widespread improvements in SDI that also correlated strongly with the increasing importance of NCDs. Both total DALYs and age-standardised DALY rates due to most Group 1 causes significantly decreased by 2015, and although total burden climbed for the majority of NCDs, age-standardised DALY rates due to NCDs declined. Nonetheless, age-standardised DALY rates due to several high-burden NCDs (including osteoarthritis, drug use disorders, depression, diabetes, congenital birth defects, and skin, oral, and sense organ diseases) either increased or remained unchanged, leading to increases in their relative ranking in many geographies. From 2005 to 2015, HALE at birth increased by an average of 2.9 years (95% uncertainty interval 2.9-3.0) for men and 3.5 years (3.4-3.7) for women, while HALE at age 65 years improved by 0.85 years (0.78-0.92) and 1.2 years (1.1-1.3), respectively. Rising SDI was associated with consistently higher HALE and a somewhat smaller proportion of life spent with functional health loss; however, rising SDI was related to increases in total disability. Many countries and territories in central America and eastern sub-Saharan Africa had increasingly lower rates of disease burden than expected given their SDI. At the same time, a subset of geographies recorded a growing gap between observed and expected levels of DALYs, a trend driven mainly by rising burden due to war, interpersonal violence, and various NCDs. Interpretation Health is improving globally, but this means more populations are spending more time with functional health loss, an absolute expansion of morbidity. The proportion of life spent in ill health decreases somewhat with increasing SDI, a relative compression of morbidity, which supports continued efforts to elevate personal income, improve education, and limit fertility. Our analysis of DALYs and HALE and their relationship to SDI represents a robust framework on which to benchmark geography-specific health performance and SDG progress. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform financial and research investments, prevention efforts, health policies, and health system improvement initiatives for all countries along the development continuum.

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    Kassebaum, Nicholas J.
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Aga Khan Univ, Ctr Excellence Women & Child Hlth, Karachi, Pakistan.;Hosp Sick Children, Ctr Global Child Hlth, Toronto, ON, Canada..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA.;Publ Hlth Fdn India, New Delhi, India..
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    Univ Oxford, Dept Zool, Oxford, England..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Univ Canberra, Fac Hlth, Ctr Res & Act Publ Hlth, Canberra, ACT, Australia..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA.;London Sch Hyg & Trop Med, Dept Infect Dis Epidemiol, London, England..
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    Chinese Ctr Dis Control & Prevent, Beijing, Peoples R China..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA.;Univ Melbourne, Melbourne Sch Populat & Global Hlth, Melbourne, Vic, Australia..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Pinho, Christine
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Salomon, Joshua A.
    Steiner, Caitlyn
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Univ Ibadan, Coll Med, Ibadan, Nigeria.;Univ Coll Hosp, Ibadan, Nigeria..
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    Olabisi Onabanjo Univ, Ago Iwoye, Nigeria..
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    Univ Ibadan, Ibadan, Nigeria.;Publ Hlth Promot Alliance, Osogbo, Nigeria..
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    Assoc Ivoirienne Bien Etre Familial, Abidjan, Cote Ivoire..
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    Direct Dist Sanitaire Haho, Notse, Togo.;Univ Lome, Fac Sci Sante, Lome, Togo..
    Agarwal, Arnav
    Univ Toronto, Toronto, ON, Canada.;McMaster Univ, Hamilton, ON, Canada..
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    Lund Univ, Clin Epidemiol Unit, Orthoped, Dept Clin Sci Lund, Lund, Sweden.;Kerman Univ Med Sci, Inst Futures Studies Hlth, Hlth Serv Management Res Ctr, Kerman, Iran..
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    Univ Pittsburgh, Med Ctr, Mckeesport, PA USA..
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    Univ Alabama Birmingham, Dept Epidemiol, Birmingham, AL USA. Univ Alabama Birmingham, Birmingham, AL USA..
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    Hosp Sick Children, Ctr Global Child Hlth, Toronto, ON, Canada.;Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada..
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    Washington Univ, St Louis, MO USA..
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    Univ Melbourne, Childrens Res Inst, Melbourne, Vic, Australia.;Univ Melbourne, Melbourne, Vic, Australia.;Univ Sydney, Sydney, NSW, Australia..
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    Queensland Hlth, Herston, Qld, Australia..
    Alasfoor, Deena
    Minist Hlth, Al Khuwair, Oman..
    Aldhahri, Saleh Fahed
    King Saud Univ, Riyadh, Saudi Arabia. King Fahad Med City, Dept Anesthesiol, Riyadh, Saudi Arabia.;King Fahad Med City, Riyadh, Saudi Arabia..
    Aldridge, Robert William
    Alhabib, Samia
    King Abdullah Bin Abdulaziz Univ Hosp, Riyadh, Saudi Arabia..
    Ali, Raghib
    Univ Oxford, Oxford, England..
    Alkerwi, Ala'a
    Luxembourg Inst Hlth, Strassen, Luxembourg..
    Alla, Francois
    Univ Lorraine, Sch Publ Hlth, Nancy, France..
    Al-Raddadi, Rajaa
    Minist Hlth, Jeddah, Saudi Arabia..
    Alsharif, Ubai
    Charite, Berlin, Germany..
    Martin, Elena Alvarez
    Minist Hlth Social Policy & Equal, Govt Delegat Natl Plan Drugs, Spanish Observ Drugs, Madrid, Spain..
    Alvis-Guzman, Nelson
    Univ Cartagena, Cartagena De Indias, Colombia..
    Amare, Azmeraw T.
    Univ Adelaide, Sch Med, Adelaide, SA, Australia.;Bahir Dar Univ, Coll Med & Hlth Sci, Bahir Dar, Ethiopia. Bahir Dar Univ, Bahir Dar, Ethiopia..
    Amberbir, Alemayehu
    Dignitas Int, Zomba, Malawi..
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    Univ Cape Coast, Cape Coast, Ghana..
    Ammar, Walid
    Minist Publ Hlth, Beirut, Lebanon..
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    Oregon Hlth & Sci Univ, Portland, OR 97201 USA..
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    Aalborg Univ, Fac Med, Dept Hlth Sci & Technol, Ctr Sensory Motor Interact, Aalborg, Denmark..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Rose Fdn Haiti, Portau Au Prince, Haiti..
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    Univ Philippines, Coll Publ Hlth, Dept Hlth Policy & Adm, Manila, Philippines..
    Aregay, Atsede Fantahun
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Dalarna Univ, Falun, Sweden..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Univ Belgrade, Sch Med, Inst Microbiol & Immunol, Belgrade, Serbia.;Univ Childrens Hosp, Belgrade, Serbia..
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    Qom Univ Med Sci, Sch Paramed, Dept Emergency Med, Qom, Iran..
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    Taipei Med Univ, Grad Inst Biomed Informat, Taipei, Taiwan..
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    Inst Rech Clin Benin, Cotonou, Benin.;LERAS Afrique, Parakou, Benin..
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    Academician VI Shumakov Fed Res Ctr Transplantol, Dept Nephrol Issues Transplanted Kidney, Moscow, Russia..
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    Univ Iowa Hosp & Clin, Iowa City, IA 52242 USA..
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    Yale Univ, New Haven, CT USA.;Univ S Florida, Tampa, FL USA..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Univ Oxford, Nuffield Dept Med, Oxford, England..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Danube Univ Krems, Krems, Austria..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Ciobanu, Liliana G.
    Univ Adelaide, Adelaide, SA, Australia..
    Cirillo, Massimo
    Coates, Matthew M.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Univ Melbourne, Childrens Res Inst, Melbourne, Vic, Australia.;Univ Melbourne, Melbourne, Vic, Australia..
    Cooper, Cyrus
    Univ Oxford, NIHR Musculoskeletal Biomed Res Ctr, Oxford, England..
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    Publ Hlth Fdn India, New Delhi, India..
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    Univ Oxford, Nuffield Dept Med, Oxford, England..
    Jarlais, Don C. Des
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Dubey, Manisha
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    Univ Washington, Harborview Injury Prevent & Res Ctr, Seattle, WA USA..
    Ellingsen, Christian Lycke
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    Univ Philippines, Coll Publ Hlth, Manila, Philippines.;Dept Hlth, Manila, Philippines..
    Farid, Talha A.
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    Univ Bielefeld, Bielefeld, Germany. Acad Med Sci, Inst Gerontol, Kiev, Ukraine..
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Franca, Elisabeth Barboza
    Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil..
    Franklin, Richard C.
    James Cook Univ, Townsville, Qld, Australia..
    Fraser, Maya S.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Friedman, Joseph
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Pullman, Nancy
    Furst, Thomas
    Univ Basel, Basel, Switzerland..
    Futran, Neal D.
    Univ Washington, Seattle, WA USA..
    Gambashidze, Ketevan
    Natl Ctr Dis Control & Publ Hlth, Tbilisi, Rep of Georgia..
    Gamkrelidze, Amiran
    Gebre, Teshome
    Task Force Global Hlth, Decatur, GA USA..
    Gebrehiwot, Tsegaye Tewelde
    Gebremedhin, Amanuel Tesfay
    Ludwig Maximilians Univ Munchen, Munich, Germany..
    Gebremedhin, Mengistu
    Gebru, Alemseged Aregay
    Kilte Awlaelo Hlth & Demog Surveillance Syst, Mekelle, Ethiopia..
    Geleijnse, Johanna M.
    Wageningen Univ, Div Human Nutr, Wageningen, Netherlands..
    Gibney, Katherine B.
    Univ Melbourne, Peter Doherty Inst Infect & Immun, Melbourne, Vic, Australia.;Royal Melbourne Hosp, Melbourne, Vic, Australia..
    Giref, Ababi Zergaw
    Giroud, Maurice
    Univ Hosp Dijon, Dijon, France..
    Gishu, Melkamu Dedefo
    Glaser, Elizabeth
    Goenka, Shifalika
    Publ Hlth Fdn India, New Delhi, India..
    Gomez-Dantes, Hector
    Gona, Philimon
    Goodridge, Amador
    Gopalani, Sameer Vali
    Goto, Atsushi
    Graetz, Nicholas
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Gugnani, Harish Chander
    Guo, Yuming
    Gupta, Rahul
    Gupta, Rajeev
    Gupta, Vipin
    Hafezi-Nejad, Nima
    Hailu, Alemayehu Desalegne
    Hailu, Gessessew Bugssa
    Kilte Awlaelo Hlth & Demog Surveillance Syst, Mekelle, Ethiopia..
    Hamadeh, Randah Ribhi
    Hamidi, Samer
    Hancock, Jamie
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Handal, Alexis J.
    Hankey, Graeme J.
    Harb, Hilda L.
    Minist Publ Hlth, Beirut, Lebanon..
    Harikrishnan, Sivadasanpillai
    Harun, Kimani M.
    Univ Washington, Seattle, WA USA..
    Havmoeller, Rasmus
    Hoek, Hans W.
    Horino, Masako
    Horita, Nobuyuki
    Hosgood, H. Dean
    Hoy, Damian G.
    Htet, Aung Soe
    Hu, Guoqing
    Huang, Hsiang
    Huang, John J.
    Yale Univ, New Haven, CT USA..
    Huybrechts, Inge
    Huynh, Chantal
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Iannarone, Marissa
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Iburg, Kim Moesgaard
    Idrisov, Bulat T.
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    Javanbakht, Mehdi
    Jayatilleke, Achala Upendra
    Jee, Sun Ha
    Jeemon, Panniyammakal
    Publ Hlth Fdn India, Ctr Control Chron Condit, New Delhi, India..
    Jha, Vivekanand
    Univ Oxford, Oxford, England..
    Jiang, Guohong
    Jiang, Ying
    Jibat, Tariku
    Wageningen Univ, Wageningen, Netherlands..
    Jonas, Jost B.
    Kabir, Zubair
    Kamal, Ritul
    Kan, Haidong
    Karch, Andre
    Karletsos, Dimitris
    Kasaeian, Amir
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    Kayibanda, Jeanne Francoise
    Kazanjan, Konstantin
    Natl Ctr Dis Control & Publ Hlth, Tbilisi, Rep of Georgia..
    Kazi, Dhruv S.
    Keiyoro, Peter Njenga
    Kemmer, Laura
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Kemp, Andrew Haddon
    Univ Sydney, Sydney, NSW, Australia..
    Kengne, Andre Pascal
    Keren, Andre
    Kereselidze, Maia
    Natl Ctr Dis Control & Publ Hlth, Tbilisi, Rep of Georgia..
    Kesavachandran, Chandrasekharan Nair
    Khader, Yousef Saleh
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    Natl Ctr Dis Control & Publ Hlth, Tbilisi, Rep of Georgia..
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    Khubchandani, Jagdish
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    Defo, Barthelemy Kuate
    Bicer, Burcu Kucuk
    Kudom, Andreas A.
    Univ Cape Coast, Cape Coast, Ghana..
    Kulikoff, Xie Rachel
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Kulkarni, Chanda
    Kumar, G. Anil
    Publ Hlth Fdn India, New Delhi, India..
    Kutz, Michael J.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Lal, Dharmesh Kumar
    Lalloo, Ratilal
    Lam, Hilton
    Lamadrid-Figueroa, Hector
    Lan, Qing
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Laryea, Dennis Odai
    Leigh, James
    Univ Sydney, Sydney, NSW, Australia..
    Leung, Ricky
    Li, Yichong
    Li, Yongmei
    Lipshultz, Steven E.
    Liu, Patrick Y.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Liu, Shiwei
    Chinese Ctr Dis Control & Prevent, Natl Ctr Chron & Noncommun Dis Control & Prevent, Beijing, Peoples R China..
    Liu, Yang
    Chinese Ctr Dis Control & Prevent, Natl Ctr Chron & Noncommun Dis Control & Prevent, Beijing, Peoples R China..
    Lloyd, Belinda K.
    Lotufo, Paulo A.
    Lunevicius, Raimundas
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    Marcenes, Wagner
    Margolis, David Joel
    Marquez, Neal
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Masiye, Felix
    Marzan, Melvin Barrientos
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    Mazorodze, Tasara T.
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    Mehndiratta, Man Mohan
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    Mekonnen, Alemayehu B.
    Univ Sydney, Sydney, NSW, Australia..
    Melaku, Yohannes Adama
    Univ Adelaide, Sch Med, Adelaide, SA, Australia..
    Memish, Ziad A.
    Mendoza, Walter
    Meretoja, Atte
    Univ Melbourne, Dept Med, Melbourne, Vic, Australia. Univ Melbourne, Inst Hlth & Ageing, Melbourne, Vic, Australia..
    Meretoja, Tuomo J.
    Mhimbira, Francis Apolinary
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    Mirarefin, Mojde
    Misganaw, Awoke
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Ibrahim, Norlinah Mohamed
    Mohammad, Karzan Abdulmuhsin
    Mohammadi, Alireza
    Mohammed, Shafiu
    Heidelberg Univ, Inst Publ Hlth, Heidelberg, Germany..
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    Monasta, Lorenzo
    Monis, Jonathan De la Cruz
    Hernandez, Julio Cesar Montanez
    Montero, Pablo
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    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
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    Moradi-Lakeh, Maziar
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Morawska, Lidia
    Mori, Rintaro
    Mueller, Ulrich
    Murthy, Gudlavalleti Venkata Satyanarayana
    London Sch Hyg & Trop Med, London, England..
    Murthy, Srinivas
    Nachega, Jean B.
    Naheed, Aliya
    Naldi, Luigi
    Nand, Devina
    Nangia, Vinay
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    Neupane, Subas
    Newton, John N.
    Ng, Marie
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Ngalesoni, Frida Namnyak
    Nguhiu, Peter
    Nguyen, Grant
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Le Nguyen, Quyen
    Nisar, Muhammad Imran
    Aga Khan Univ, Karachi, Pakistan..
    Nomura, Marika
    Norheim, Ole F.
    Norman, Rosana E.
    Nyakarahuka, Luke
    Obermeyer, Carla Makhlouf
    Ogbo, Felix Akpojene
    Oh, In-Hwan
    Ojelabi, Foluke Adetola
    Univ Ibadan, Ibadan, Nigeria..
    Olivares, Pedro R.
    Olusanya, Bolajoko Olubukunola
    Olusanya, Jacob Olusegun
    Opio, John Nelson
    Oren, Eyal
    Ota, Erika
    Oyekale, Abayomi Samuel
    Pa, Mahesh
    Pain, Amanda
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Papantoniou, Nikolaos
    Park, Eun-Kee
    Park, Hye-Youn
    Caicedo, Angel J. Paternina
    Patten, Scott B.
    Paul, Vinod K.
    Pereira, David M.
    Perico, Norberto
    Pesudovs, Konrad
    Petzold, Max
    Phillips, Michael Robert
    Pillay, Julian David
    Pishgar, Farhad
    Polinder, Suzanne
    Pope, Daniel
    Pourmalek, Farshad
    Qorbani, Mostafa
    Rafay, Anwar
    Rahimi, Kazem
    Univ Oxford, Oxford, England..
    Rahimi-Movaghar, Vafa
    Rahman, Mahfuzar
    Rahman, Mohammad Hifz Ur
    Rahman, Sajjad Ur
    Rai, Rajesh Kumar
    Ram, Usha
    Ranabhat, Chhabi Lal
    Rangaswamy, Thara
    Rao, Paturi Vishnupriya
    Refaat, Amany H.
    Remuzzi, Giuseppe
    Global, regional, and national levels of maternal mortality, 1990-2015: a systematic analysis for the Global Burden of Disease Study 20152016In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 388, no 10053, p. 1775-1812Article in journal (Refereed)
    Abstract [en]

    Background In transitioning from the Millennium Development Goal to the Sustainable Development Goal era, it is imperative to comprehensively assess progress toward reducing maternal mortality to identify areas of success, remaining challenges, and frame policy discussions. We aimed to quantify maternal mortality throughout the world by underlying cause and age from 1990 to 2015. Methods We estimated maternal mortality at the global, regional, and national levels from 1990 to 2015 for ages 10-54 years by systematically compiling and processing all available data sources from 186 of 195 countries and territories, 11 of which were analysed at the subnational level. We quantified eight underlying causes of maternal death and four timing categories, improving estimation methods since GBD 2013 for adult all-cause mortality, HIV-related maternal mortality, and late maternal death. Secondary analyses then allowed systematic examination of drivers of trends, including the relation between maternal mortality and coverage of specific reproductive health-care services as well as assessment of observed versus expected maternal mortality as a function of Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Findings Only ten countries achieved MDG 5, but 122 of 195 countries have already met SDG 3.1. Geographical disparities widened between 1990 and 2015 and, in 2015, 24 countries still had a maternal mortality ratio greater than 400. The proportion of all maternal deaths occurring in the bottom two SDI quintiles, where haemorrhage is the dominant cause of maternal death, increased from roughly 68% in 1990 to more than 80% in 2015. The middle SDI quintile improved the most from 1990 to 2015, but also has the most complicated causal profile. Maternal mortality in the highest SDI quintile is mostly due to other direct maternal disorders, indirect maternal disorders, and abortion, ectopic pregnancy, and/or miscarriage. Historical patterns suggest achievement of SDG 3.1 will require 91% coverage of one antenatal care visit, 78% of four antenatal care visits, 81% of in-facility delivery, and 87% of skilled birth attendance. Interpretation Several challenges to improving reproductive health lie ahead in the SDG era. Countries should establish or renew systems for collection and timely dissemination of health data; expand coverage and improve quality of family planning services, including access to contraception and safe abortion to address high adolescent fertility; invest in improving health system capacity, including coverage of routine reproductive health care and of more advanced obstetric care-including EmOC; adapt health systems and data collection systems to monitor and reverse the increase in indirect, other direct, and late maternal deaths, especially in high SDI locations; and examine their own performance with respect to their SDI level, using that information to formulate strategies to improve performance and ensure optimum reproductive health of their population.

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    Schöttker, Ben
    Schwebel, David C
    Scott, James G
    Sepanlou, Sadaf G
    Shaheen, Amira
    Shaikh, Masood Ali
    She, June
    Shiri, Rahman
    Shiue, Ivy
    Sigfusdottir, Inga Dora
    Singh, Jasvinder
    Slipakit, Naris
    Smith, Alison
    Sreeramareddy, Chandrashekhar
    Stanaway, Jeffrey D
    Stein, Dan J
    Steiner, Caitlyn
    Sufiyan, Muawiyyah Babale
    Swaminathan, Soumya
    Tabarés-Seisdedos, Rafael
    Tabb, Karen M
    Tadese, Fentaw
    Tavakkoli, Mohammad
    Taye, Bineyam
    Teeple, Stephanie
    Tegegne, Teketo Kassaw
    Temam Shifa, Girma
    Terkawi, Adbullah Sulieman
    Thomas, Bernadette
    Thomson, Alan J
    Tobe-Gai, Ruoyan
    Tonelli, Marcello
    Tran, Bach Xuan
    Troeger, Christopher
    Ukwaja, Kingsley N
    Uthman, Olalekan
    Vasankari, Tommi
    Venketasubramanian, Narayanaswamy
    Vlassov, Vasiliy Victorovich
    Weiderpass, Elisabete
    Weintraub, Robert
    Gebrehiwot, Solomon Weldemariam
    Westerman, Ronny
    Williams, Hywel C
    Wolfe, Charles D A
    Woodbrook, Rachel
    Yano, Yuichiro
    Yonemoto, Naohiro
    Yoon, Seok-Jun
    Younis, Mustafa Z
    Yu, Chuanhua
    Zaki, Maysaa El Sayed
    Zegeye, Elias Asfaw
    Zuhlke, Liesl Joanna
    Murray, Christopher J L
    Vos, Theo
    Child and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study2017In: JAMA pediatrics, ISSN 2168-6203, E-ISSN 2168-6211, Vol. 171, no 6, p. 573-592Article in journal (Refereed)
    Abstract [en]

    Importance: Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health.

    Objective: To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion.

    Evidence Review: Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss.

    Findings: Global child and adolescent mortality decreased from 14.18 million (95% uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95% UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75%) in 2015 than was the case in 1990 (61%). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3% (95% UI, 3.1%-5.6%) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long-term sequelae of conditions present at birth (eg, neonatal disorders, congenital birth defects, and hemoglobinopathies) and complications of a variety of infections and nutritional deficiencies. Anemia, developmental intellectual disability, hearing loss, epilepsy, and vision loss are important contributors to childhood disability that can arise from multiple causes. Maternal and reproductive health remains a key cause of disease burden in adolescent females, especially in lower-SDI countries. In low-SDI countries, mortality is the primary driver of health loss for children and adolescents, whereas disability predominates in higher-SDI locations; the specific pattern of epidemiological transition varies across diseases and injuries.

    Conclusions and Relevance: Consistent international attention and investment have led to sustained improvements in causes of health loss among children and adolescents in many countries, although progress has been uneven. The persistence of infectious diseases in some countries, coupled with ongoing epidemiologic transition to injuries and noncommunicable diseases, require all countries to carefully evaluate and implement appropriate strategies to maximize the health of their children and adolescents and for the international community to carefully consider which elements of child and adolescent health should be monitored.

  • 217. Khalili, Payam
    et al.
    Sundström, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Franklin, Stanley S.
    Jendle, Johan
    Lundin, Fredrik
    Jungner, Ingmar
    Nilsson, Peter M.
    Combined effects of brachial pulse pressure and sialic acid for risk of cardiovascular events during 40 years of follow-up in 37 843 individuals2012In: Journal of Hypertension, ISSN 0263-6352, E-ISSN 1473-5598, Vol. 30, no 9, p. 1718-1724Article in journal (Refereed)
    Abstract [en]

    Objective: Pulse pressure (PP) is a risk marker for cardiovascular disease (CVD) in individuals 50 years and older. Inflammation is suggested to influence atherosclerosis, but could also increase PP. We aimed to examine the combined effects of PP and the inflammatory marker sialic acid, and their independent roles on CVD risk. Methods: From a population-based study in Sweden between 1962 and 1965, 18 429 men and 19 414 women at the age of 50 or older were selected and followed for first CVD event until 2005. We investigated the biological interactions between sialic acid and PP. The associations of PP and sialic acid with risk of CVD were calculated by using Cox proportional hazards model. Adjustments were made for conventional risk factors, mean arterial pressure (MAP) and socioeconomic status. Results: The mean age was 59.5 (SD 6.5) years and the number of incident CVD events in men and women were 3641 and 3227, respectively. No biological interaction was seen between PP and sialic acid. In men, the adjusted hazard ratio for PP was 0.92 [95% confidence interval (CI) 0.88-0.96, P < 0.0001) for 1 SD of PP, and 1.09 (95% CI 1.05-1.13, P < 0.0001) for 1 SD of sialic acid. In women, the corresponding figures were 1.02 (95% CI 0.97-1.07, P = 0.48) and 1.09 (95% CI 1.05-1.13, P < 0.0001). Conclusions: Sialic acid but not PP was an independent risk factor for CVD. The risk induced by PP is highly affected by MAP. This suggests that both estimated arterial stiffness and inflammation contribute through different pathways to risk of CVD.

  • 218. Khan, Tauseef A.
    et al.
    Shah, Tina
    Prieto, David
    Zhang, Weili
    Price, Jackie
    Fowkes, Gerald R.
    Cooper, Jackie
    Talmud, Philippa J.
    Humphries, Steve E.
    Sundström, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Hubacek, Jaroslav A.
    Ebrahim, Shah
    Lawlor, Debbie A.
    Ben-Shlomo, Yoav
    Abdollahi, Mohammad R.
    Slooter, Arjen J. C.
    Szolnoki, Zoltan
    Sandhu, Manjinder
    Wareham, Nicholas
    Frikke-Schmidt, Ruth
    Tybjaerg-Hansen, Anne
    Fillenbaum, Gerda
    Heijmans, Bastiaan T.
    Katsuya, Tomohiro
    Gromadzka, Grazyna
    Singleton, Andrew
    Ferrucci, Luigi
    Hardy, John
    Worrall, Bradford
    Rich, Stephen S.
    Matarin, Mar
    Whittaker, John
    Gaunt, Tom R.
    Whincup, Peter
    Morris, Richard
    Deanfield, John
    Donald, Ann
    Smith, George Davey
    Kivimaki, Mika
    Kumari, Meena
    Smeeth, Liam
    Khaw, Kay-Tee
    Nalls, Michael
    Meschia, James
    Sun, Kai
    Hui, Rutai
    Day, Ian
    Hingorani, Aroon D.
    Casas, Juan P.
    Apolipoprotein E genotype, cardiovascular biomarkers and risk of stroke: Systematic review and meta-analysis of 14 015 stroke cases and pooled analysis of primary biomarker data from up to 60 883 individuals2013In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 42, no 2, p. 475-492Article in journal (Refereed)
    Abstract [en]

    Background At the APOE gene, encoding apolipoprotein E, genotypes of the epsilon 2/epsilon 3/epsilon 4 alleles associated with higher LDL-cholesterol (LDL-C) levels are also associated with higher coronary risk. However, the association of APOE genotype with other cardiovascular biomarkers and risk of ischaemic stroke is less clear. We evaluated the association of APOE genotype with risk of ischaemic stroke and assessed whether the observed effect was consistent with the effects of APOE genotype on LDL-C or other lipids and biomarkers of cardiovascular risk. Methods We conducted a systematic review of published and unpublished studies reporting on APOE genotype and ischaemic stroke. We pooled 41 studies (with a total of 9027 cases and 61 730 controls) using a Bayesian meta-analysis to calculate the odds ratios (ORs) for ischaemic stroke with APOE genotype. To better evaluate potential mechanisms for any observed effect, we also conducted a pooled analysis of primary data using 16 studies (up to 60 883 individuals) of European ancestry. We evaluated the association of APOE genotype with lipids, other circulating biomarkers of cardiovascular risk and carotid intima-media thickness (C-IMT). Results The ORs for association of APOE genotypes with ischaemic stroke were: 1.09 (95% credible intervals (CrI): 0.84-1.43) for epsilon 2/epsilon 2; 0.85 (95% CrI: 0.78-0.92) for epsilon 2/epsilon 3; 1.05 (95% CrI: 0.89-1.24) for epsilon 2/epsilon 4; 1.05 (95% CrI: 0.99-1.12) for epsilon 3/epsilon 4; and 1.12 (95% CrI: 0.94-1.33) for epsilon 4/epsilon 4 using the epsilon 3/epsilon 3 genotype as the reference group. A regression analysis that investigated the effect of LDL-C (using APOE as the instrument) on ischaemic stroke showed a positive dose-response association with an OR of 1.33 (95% CrI: 1.17, 1.52) per 1 mmol/l increase in LDL-C. In the separate pooled analysis, APOE genotype was linearly and positively associated with levels of LDL-C (P-trend: 2 x 10(-152)), apolipoprotein B (P-trend: 8.7 x 10(-06)) and C-IMT (P-trend: 0.001), and negatively and linearly associated with apolipoprotein E (P-trend: 6 x 10(-26)) and HDL-C (P-trend: 1.6 x 10(-12)). Associations with lipoprotein(a), C-reactive protein and triglycerides were non-linear. Conclusions In people of European ancestry, APOE genotype showed a positive dose-response association with LDL-C, C-IMT and ischaemic stroke. However, the association of APOE epsilon 2/epsilon 2 genotype with ischaemic stroke requires further investigation. This cross-domain concordance supports a causal role of LDL-C on ischaemic stroke.

  • 219.
    Khoddam, Homeira
    et al.
    Iran University of Medical Sciences, Iran.
    Mehrdad, Neda
    Tehran University of Medical Sciences, Iran.
    Peyrovi, Hamid
    Iran University of Medical Sciences, Iran.
    Kitson, Alison
    School of Nursing, University of Adelaide, Australia; Centre for Evidence based Practice South Australia, School of Nursing, The University of Adelaide, Australia;Green Templeton College, University of Oxford, United Kingdom .
    Schultz, Timothy
    School of Nursing, Faculty of Health Sciences, the University of Adelaide, Australia.
    Muntlin Athlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. School of Nursing, University of Adelaide.
    Knowledge translation in health care: a concept analysis2014In: Medical Journal of the Islamic Republic of Iran, ISSN 1016-1430, E-ISSN 2251-6840, Vol. 28, article id 98Article in journal (Refereed)
    Abstract [en]

    Background:

    Although knowledge translation is one of the most widely used concepts in health and medicalliterature, there is a sense of ambiguity and confusion over its definition. The aim of this paper is to clarify thecharacteristics of KT. This will assist the theoretical development of it and shape its implementation into thehealth care system

    Methods:

    Walker and Avant’s framework was used to analyze the concept and the related literature publishedbetween 2000 and 2010 was reviewed. A total of 112 papers were analyzed.

    Results:

    Review of the literature showed that "KT is a process" and "implementing refined knowledge into aparticipatory context through a set of challenging activities" are the characteristics of KT. Moreover, to occursuccessfully, KT needssome necessary antecedents like an integrated source of knowledge, a receptive context,and preparedness. The main consequence of successful process is a change in four fields of healthcare, i.e. quali-ty of patient care, professional practice, health system, and community. In addition, this study revealed someempirical referents which are helpful to evaluate the process.

    Conclusion:

    By aiming to portray a clear picture of KT, we highlighted its attributes, antecedents, conse-quences and empiricalreferents. Identifying the characteristics of this concept may resolve the existing ambigui-ties in its definition and boundaries thereby facilitate distinction from similar concepts. In addition, these find-ings can be used as a knowledge infrastructure fordeveloping the KT-related models, theories, or tools.

  • 220. Kilpeläinen, Tuomas O
    et al.
    Carli, Jayne F Martin
    Skowronski, Alicja A
    Sun, Qi
    Kriebel, Jennifer
    Feitosa, Mary F
    Hedman, Åsa K
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Drong, Alexander W
    Hayes, James E
    Zhao, Jinghua
    Pers, Tune H
    Schick, Ursula
    Grarup, Niels
    Kutalik, Zoltán
    Trompet, Stella
    Mangino, Massimo
    Kristiansson, Kati
    Beekman, Marian
    Lyytikäinen, Leo-Pekka
    Eriksson, Joel
    Henneman, Peter
    Lahti, Jari
    Tanaka, Toshiko
    Luan, Jian'an
    Greco M, Fabiola Del
    Pasko, Dorota
    Renström, Frida
    Willems, Sara M
    Mahajan, Anubha
    Rose, Lynda M
    Guo, Xiuqing
    Liu, Yongmei
    Kleber, Marcus E
    Pérusse, Louis
    Gaunt, Tom
    Ahluwalia, Tarunveer S
    Ju Sung, Yun
    Ramos, Yolande F
    Amin, Najaf
    Amuzu, Antoinette
    Barroso, Inês
    Bellis, Claire
    Blangero, John
    Buckley, Brendan M
    Böhringer, Stefan
    I Chen, Yii-Der
    de Craen, Anton J N
    Crosslin, David R
    Dale, Caroline E
    Dastani, Zari
    Day, Felix R
    Deelen, Joris
    Delgado, Graciela E
    Demirkan, Ayse
    Finucane, Francis M
    Ford, Ian
    Garcia, Melissa E
    Gieger, Christian
    Gustafsson, Stefan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Hallmans, Göran
    Hankinson, Susan E
    Havulinna, Aki S
    Herder, Christian
    Hernandez, Dena
    Hicks, Andrew A
    Hunter, David J
    Illig, Thomas
    Ingelsson, Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Ioan-Facsinay, Andreea
    Jansson, John-Olov
    Jenny, Nancy S
    Jørgensen, Marit E
    Jørgensen, Torben
    Karlsson, Magnus
    Koenig, Wolfgang
    Kraft, Peter
    Kwekkeboom, Joanneke
    Laatikainen, Tiina
    Ladwig, Karl-Heinz
    LeDuc, Charles A
    Lowe, Gordon
    Lu, Yingchang
    Marques-Vidal, Pedro
    Meisinger, Christa
    Menni, Cristina
    Morris, Andrew P
    Myers, Richard H
    Männistö, Satu
    Nalls, Mike A
    Paternoster, Lavinia
    Peters, Annette
    Pradhan, Aruna D
    Rankinen, Tuomo
    Rasmussen-Torvik, Laura J
    Rathmann, Wolfgang
    Rice, Treva K
    Brent Richards, J
    Ridker, Paul M
    Sattar, Naveed
    Savage, David B
    Söderberg, Stefan
    Timpson, Nicholas J
    Vandenput, Liesbeth
    van Heemst, Diana
    Uh, Hae-Won
    Vohl, Marie-Claude
    Walker, Mark
    Wichmann, Heinz-Erich
    Widén, Elisabeth
    Wood, Andrew R
    Yao, Jie
    Zeller, Tanja
    Zhang, Yiying
    Meulenbelt, Ingrid
    Kloppenburg, Margreet
    Astrup, Arne
    Sørensen, Thorkild I A
    Sarzynski, Mark A
    Rao, D C
    Jousilahti, Pekka
    Vartiainen, Erkki
    Hofman, Albert
    Rivadeneira, Fernando
    Uitterlinden, André G
    Kajantie, Eero
    Osmond, Clive
    Palotie, Aarno
    Eriksson, Johan G
    Heliövaara, Markku
    Knekt, Paul B
    Koskinen, Seppo
    Jula, Antti
    Perola, Markus
    Huupponen, Risto K
    Viikari, Jorma S
    Kähönen, Mika
    Lehtimäki, Terho
    Raitakari, Olli T
    Mellström, Dan
    Lorentzon, Mattias
    Casas, Juan P
    Bandinelli, Stefanie
    März, Winfried
    Isaacs, Aaron
    van Dijk, Ko W
    van Duijn, Cornelia M
    Harris, Tamara B
    Bouchard, Claude
    Allison, Matthew A
    Chasman, Daniel I
    Ohlsson, Claes
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Scott, Robert A
    Langenberg, Claudia
    Wareham, Nicholas J
    Ferrucci, Luigi
    Frayling, Timothy M
    Pramstaller, Peter P
    Borecki, Ingrid B
    Waterworth, Dawn M
    Bergmann, Sven
    Waeber, Gérard
    Vollenweider, Peter
    Vestergaard, Henrik
    Hansen, Torben
    Pedersen, Oluf
    Hu, Frank B
    Eline Slagboom, P
    Grallert, Harald
    Spector, Tim D
    Jukema, J W
    Klein, Robert J
    Schadt, Erik E
    Franks, Paul W
    Lindgren, Cecilia M
    Leibel, Rudolph L
    Loos, Ruth J F
    Genome-wide meta-analysis uncovers novel loci influencing circulating leptin levels2016In: Nature Communications, E-ISSN 2041-1723, Vol. 7, article id 10494Article in journal (Refereed)
    Abstract [en]

    Leptin is an adipocyte-secreted hormone, the circulating levels of which correlate closely with overall adiposity. Although rare mutations in the leptin (LEP) gene are well known to cause leptin deficiency and severe obesity, no common loci regulating circulating leptin levels have been uncovered. Therefore, we performed a genome-wide association study (GWAS) of circulating leptin levels from 32,161 individuals and followed up loci reaching P<10(-6) in 19,979 additional individuals. We identify five loci robustly associated (P<5 × 10(-8)) with leptin levels in/near LEP, SLC32A1, GCKR, CCNL1 and FTO. Although the association of the FTO obesity locus with leptin levels is abolished by adjustment for BMI, associations of the four other loci are independent of adiposity. The GCKR locus was found associated with multiple metabolic traits in previous GWAS and the CCNL1 locus with birth weight. Knockdown experiments in mouse adipose tissue explants show convincing evidence for adipogenin, a regulator of adipocyte differentiation, as the novel causal gene in the SLC32A1 locus influencing leptin levels. Our findings provide novel insights into the regulation of leptin production by adipose tissue and open new avenues for examining the influence of variation in leptin levels on adiposity and metabolic health.

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  • 221.
    Kitson, Alison
    et al.
    School of Nursing, University of Adelaide, Australia; Centre for Evidence based Practice South Australia, School of Nursing, The University of Adelaide, Australia;Green Templeton College, University of Oxford, United Kingdom .
    Dow, Clare
    Institute of Health and Wellbeing, University of Glasgow, United Kingdom.
    Calabrese, Joseph D
    University College London, United Kingdom.
    Locock, Louise
    Health Experiences Research Group, Dept Primary Care Health Sciences, University of Oxford, United Kingdom; National Institute for Health Research, Biomedical Research Centre, Oxford, United Kingdom.
    Muntlin Athlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Stroke survivors’ experiences of the fundamentals of care: A qualitative analysis2013In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 3, p. 392-403Article in journal (Refereed)
    Abstract [en]

    Background

    Managing the fundamentals of care (e.g. elimination, personal hygiene, eating,) needs to be more explicitly addressed within the patient-centred care discourse. It is not possible to investigate issues of patient dignity and respect without acknowledging these basic physical needs. While the literature on caring for people with a stroke is extensive, no studies to date have described stroke survivors’ experiences of all of these fundamentals during the in-hospital phase of their care.

    Design

    Secondary analysis of qualitative data grounded in interpretative phenomenology Participants and settings: Fifteen stroke survivors with in-hospital experiences from multiple healthcare settings and healthcare professionals across the United Kingdom were included.

    Method

    A secondary thematic analysis of primary narrative interview data from stroke survivors.

    Results

    Survivors of strokes have vivid and often distressing recollections of their experiences of the fundamentals of care. For every description of a physical need (elimination, eating and drinking, personal hygiene) there where lucid accounts of the psychosocial and emotional impact (humiliation, distress, lack of dignity, recovery, confidence). Linked to the somatic and emotional dimensions were narratives around the relationship between the patient and the carer (nurse, doctor, allied health professional). Positive recollections of the fundamentals of care were less evident than more distressing experiences. Consistent features of positive experiences included: stroke survivors describing how the physical, psychosocial and relational dimensions of care were integrated and coordinated around their particular need. They reported feeling involved in setting achievable targets to regain control of their bodily functions and regain a sense of personal integrity and sense of self. Sociological constructs such as biographical disruption and loss of self were found to be relevant to stroke survivors’ experiences. Indeed, such constructs may be more linked to the disruption of such fundamental activities rather than the experience of the illness itself.

    Conclusions

    We recommend more practical and integrated approaches be taken around understanding and meeting the physical, psychosocial and relational needs of patients in hospital which could lead to more patient-centred care experiences. These three dimensions need to co-exist in every care episode. More exploration is required to identify the common fundamentals of care needs of patients regardless of illness experience.

  • 222.
    Kitson, Alison
    et al.
    School of Nursing, University of Adelaide, Australia; Centre for Evidence based Practice South Australia, School of Nursing, The University of Adelaide, Australia;Green Templeton College, University of Oxford, United Kingdom .
    Muntlin Athlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Development and preliminary testing of a framework to evaluate patients' experiences of the fundamentals of care: a secondary analysis of three stroke survivor narratives.2013In: Nursing Research and Practice, ISSN 2090-1429, E-ISSN 2090-1437, Vol. 2013, p. 572437-Article in journal (Refereed)
    Abstract [en]

    Aim. To develop and test a framework describing the interrelationship of three key dimensions (physical, psychosocial, and relational) in the provision of the fundamentals of care to patients. Background. There are few conceptual frameworks to help healthcare staff, particularly nurses, know how to provide direct care around fundamental needs such as eating, drinking, and going to the toilet. Design. Deductive development of a conceptual framework and qualitative analysis of secondary interview data. Method. Framework development followed by a secondary in-depth analysis of primary narrative interview data from three stroke survivors. Results. Using the physical, psychosocial and relational dimensions to develop a conceptual framework, it was possible to identify a number of "archetypes" or scenarios that could explain stroke survivors' positive experiences of their care. Factors contributing to suboptimal care were also identified. Conclusions. This way of thinking about how the fundamentals of care are experienced by patients may help to elucidate the complex processes involved around providing high quality fundamentals of care. This analysis illustrates the multiple dimensions at play. However, more systematic investigation is required with further refining and testing with wider healthcare user groups. The framework has potential to be used as a predictive, evaluative, and explanatory tool.

  • 223.
    Kitson, Alison
    et al.
    School of Nursing, University of Adelaide, Australia; Centre for Evidence based Practice South Australia, School of Nursing, The University of Adelaide, Australia;Green Templeton College, University of Oxford, United Kingdom .
    Muntlin Athlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. School of Nursing, University of Adelaide.
    Conroy, Tiffany
    School of Nursing, University of Adelaide, Australia.
    Anything but basic: Nursing’s challenge in meeting patients' fundamental care needs2014In: Journal of Nursing Scholarship, ISSN 1527-6546, E-ISSN 1547-5069, Vol. 46, no 5, p. 331-339Article in journal (Refereed)
    Abstract [en]

    Purpose

    Nursing has not explored the fundamental aspects of patient care in a systematic, conceptually coherent, scientific way, and this has created a number of ongoing challenges.

    Organizing Construct

    Each challenge is identified and addressed in the form of a proposition, with evidence provided to support the arguments put forward and defend the proposed actions.

    Findings

    The challenges include: the need for an integrated way of thinking about the fundamentals of care from a conceptual, methodological, and practical perspective; the ongoing and unresolved tension in nursing practice between a depersonalized and mechanistic approach (termed a “task and time” driven culture) and the need for consistency around understanding and managing the dynamics of the nurse–patient relationship or encounter (termed a “thinking and linking” approach); and the need for a systematic approach to the fundamentals or basics of care that combines the physical, psychosocial, and relational dimensions of the care encounter within the wider context of the care environment. Pragmatic and practical frameworks are needed to ensure that the basic physical and psychosocial needs of patients are embedded not only in the practice but also in the thinking, reflection, and assessment processes of the nurse.

    Conclusions

    Nursing's challenge to meet patients’ basic or fundamental needs is complex. Developing a knowledge base will include identifying researchable questions, using rigorous methodologies, ensuring the relational dimensions are not lost, and ensuring the new knowledge is applied in practice. This requires collaboration on an international scale to achieve improvements in care.

    Clinical Relevance

    To work collaboratively to generate, test, and implement meaningful ways of capturing nursing practice around basic or fundamental care in order to ensure more integrated, holistic patient care nursing practices.

  • 224.
    Kitson, Alison
    et al.
    School of Nursing, University of Adelaide, Australia; Centre for Evidence based Practice South Australia, School of Nursing, The University of Adelaide, Australia;Green Templeton College, University of Oxford, United Kingdom .
    Muntlin Athlin, Åsa
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. School of Nursing, University of Adelaide.
    Elliott, Janice
    School of Nursing, University of Adelaide, Australia.
    Cant, Megan
    School of Nursing, University of Adelaide, Australia.
    What’s my line?: A narrative review and synthesis of the literature on Registered Nurses' communication behaviours between shifts2014In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 70, no 6, p. 1228-1242Article, review/survey (Refereed)
    Abstract [en]

    Aim

    To describe, appraise and synthesize the seminal and empirical literature around Registered Nurses' communication behaviours between shifts in acute hospital settings.

    Background

    Effective communication between shifts (at nursing handover) is acknowledged as a prerequisite to safe and high-quality patient-centred care. However, gaps and inconsistencies continue to prevail.

    Design

    Narrative review and synthesis.

    Data sources

    The electronic databases PubMED, CINAHL and Scopus were used.

    Review methods

    English language, peer-reviewed papers published between 1970–April 2012 were considered for review. Criteria included Registered Nurses' communication during handovers in adult hospital settings.

    Results

    Twenty-nine papers were reviewed. The research lacks a clear conceptual framework to define the core purposes of Nurses' communication behaviours between shifts. Seven themes were identified: overall purpose; report givers and receivers; seeing the whole picture; teaching and education; language; patient-centred care; and social cohesion. Two main communication processes are required – one articulating the whole picture and the other detailing information about patients.

    Conclusion

    This area of research is challenged by lack of consistency in terminology and methodological rigour. While recent research has confirmed the findings from the seminal work, it has not been able to elaborate on some of the key challenges to refine the knowledge base. A more integrated approach is required to understand the complex process of improving nursing communication behaviours, particularly around the nursing handover. A neglected area of study is the role of the unit lead in determining the communication standards of the whole nursing team.

  • 225.
    Klint, Helén
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Lejonklou, Margareta H.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Karimullina, Elina
    University of California, Irvine, Department of Developmental and Cell Biology, Irvine, CA 92697, USA.
    Rönn, Monika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Lind, P. Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Brittebo, Eva
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Low-dose exposure to bisphenol A in combination with fructose increases expression of genes regulating angiogenesis and vascular tone in juvenile Fischer 344 rat cardiac tissue2017In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 122, no 1, p. 20-27Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Epidemiological studies report associations between exposure to the high-volume chemical and endocrine disruptor bisphenol A (BPA) and cardiovascular disorders, but there is a lack of experimental studies addressing the mechanisms of action of BPA on the cardiovascular system. In the present study, effects on markers for cardiovascular function of exposure to BPA and fructose in vivo in rat cardiac tissues, and of BPA exposure in human cardiomyocytes in vitro, were investigated.

    MATERIALS: Juvenile female Fischer 344 rats were exposed to 5, 50, and 500 μg BPA/kg bodyweight/day in their drinking water from 5 to 15 weeks of age, in combination with 5% fructose. Further, cultured human cardiomyocytes were exposed to 10 nM BPA to 1 × 10(4) nM BPA for six hours. Expression of markers for cardiovascular function and BPA target receptors was investigated using qRT-PCR.

    RESULTS: Exposure to 5 μg BPA/kg bodyweight/day plus fructose increased mRNA expression of Vegf, Vegfr2, eNos, and Ace1 in rat heart. Exposure of human cardiomyocytes to 1 × 10(4) nM BPA increased mRNA expression of eNOS and ACE1, as well as IL-8 and NFκβ known to regulate inflammatory response.

    CONCLUSIONS: . Low-dose exposure of juvenile rats to BPA and fructose induced up-regulation of expression of genes controlling angiogenesis and vascular tone in cardiac tissues. The observed effects of BPA in rat heart were in line with our present and previous studies of BPA in human endothelial cells and cardiomyocytes. These findings may aid in understanding the mechanisms of the association between BPA exposure and cardiovascular disorders reported in epidemiological studies.

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  • 226. Knowles, Joshua W.
    et al.
    Xie, Weijia
    Zhang, Zhongyang
    Chennemsetty, Indumathi
    Assimes, Themistocles L.
    Paananen, Jussi
    Hansson, Ola
    Pankow, James
    Goodarzi, Mark O.
    Carcamo-Orive, Ivan
    Morris, Andrew P.
    Chen, Yii-Der I.
    Maekinen, Ville-Petteri
    Ganna, Andrea
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Mahajan, Anubha
    Guo, Xiuqing
    Abbasi, Fahim
    Greenawalt, Danielle M.
    Lum, Pek
    Molony, Cliona
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Lindgren, Cecilia
    Raffel, Leslie J.
    Tsao, Philip S.
    Schadt, Eric E.
    Rotter, Jerome I.
    Sinaiko, Alan
    Reaven, Gerald
    Yang, Xia
    Hsiung, Chao A.
    Groop, Leif
    Cordell, Heather J.
    Laakso, Markku
    Hao, Ke
    Ingelsson, Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Frayling, Timothy M.
    Weedon, Michael N.
    Walker, Mark
    Quertermous, Thomas
    Identification and validation of N-acetyltransferase 2 as an insulin sensitivity gene2015In: Journal of Clinical Investigation, ISSN 0021-9738, E-ISSN 1558-8238, Vol. 125, no 4, p. 1739-1751Article in journal (Refereed)
    Abstract [en]

    Decreased insulin sensitivity, also referred to as insulin resistance (IR), is a fundamental abnormality in patients with type 2 diabetes and a risk factor for cardiovascular disease. While IR predisposition is heritable, the genetic basis remains largely unknown. The GENEticS of Insulin Sensitivity consortium conducted a genome-wide association study (GWAS) for direct measures of insulin sensitivity, such as euglycemic clamp or insulin suppression test, in 2,764 European individuals, with replication in an additional 2,860 individuals. The presence of a nonsynonymous variant of N-acetyltransferase 2 (NAT2) [rs1208 (803A>G, K268R)] was strongly associated with decreased insulin sensitivity that was independent of BMI. The rs1208 "A" allele was nominally associated with IR-related traits, including increased fasting glucose, hemoglobin A1C, total and LDL cholesterol, triglycerides, and coronary artery disease. NAT2 acetylates arylamine and hydrazine drugs and carcinogens, but predicted acetylator NAT2 phenotypes were not associated with insulin sensitivity. In a murine adipocyte cell line, silencing of NAT2 ortholog Nat1 decreased insulin-mediated glucose uptake, increased basal and isoproterenol-stimulated lipolysis, and decreased adipocyte differentiation, while Nat1 overexpression produced opposite effects. Nat1-deficient mice had elevations in fasting blood glucose, insulin, and triglycerides and decreased insulin sensitivity, as measured by glucose and insulin tolerance tests, with intermediate effects in Nat1 heterozygote mice. Our results support a role for NAT2 in insulin sensitivity.

  • 227.
    Kuhlmann, Antje
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Olafsdottir, Inga Sif
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Sundström, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Janson, Christer
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
    Association of biomarkers of inflammation and cell adhesion with lung function in the elderly: a population-based study2013In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 13, p. 82-Article in journal (Refereed)
    Abstract [en]

    Background: Low lung function is associated with increased morbidity and mortality. It is therefore of interest to identify biomarkers that are associated with impaired lung function. The aim of the study was to analyse associations of biomarkers and combinations of biomarkers with lung function in an elderly general population. Methods: Lung function (FEV1 and FVC) and a panel of 15 inflammatory markers from blood samples were analysed in 888 subjects aged 70 years. Biomarkers included cytokines, chemokines, adhesion molecules, C-reactive protein (CRP) and leukocyte count. Results: Leukocyte count and CRP were independently associated with FEV1 after adjustments for other inflammatory markers, sex, BMI, current smoking and pack-years of smoking. In a similar model, leukocyte count and vascular cell adhesion protein 1 (VCAM-1) were the biomarkers that were significantly associated with FVC. Subjects that had both leukocyte count and CRP in the lowest tertile had a FEV1 that was 9% of predicted higher than subjects with leukocyte count and CRP in the highest tertile (103 +/- 16 vs. 94 +/- 21% of predicted, p=0.0002) (mean +/- SD). A difference of 8% of predicted in FVC was found between subjects with leukocyte count and VCAM-1 in the lowest and highest tertiles, respectively (106 +/- 18 vs. 98 +/- 19% of predicted, p=0.002). Conclusion: Leucocyte count, CRP and VCAM-1 were found to relate to poorer lung function. A dose related association was found for the combination leukocyte count and CRP towards FEV1 and leukocyte and VCAM-1 towards FVC. This indicates that combination of two biomarkers yielded more information than assessing them one by one when analysing the association between systemic inflammation and lung function.

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  • 228.
    Kumar, Jitender
    et al.
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.
    Ingelsson, Erik
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Fall, Tove
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.
    No Evidence of a Causal Relationship between Plasma Homocysteine and Type 2 Diabetes: A Mendelian Randomization Study2015In: Frontiers in Cardiovascular Medicine, E-ISSN 2297-055X, Vol. 2, article id 11Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Several observational studies have shown an association between increased circulating homocysteine and risk of type 2 diabetes (T2D). We aimed to assess whether this relation is causal using genetic data from large populations of individuals of European descent.

    METHODS: We investigated the association between homocysteine concentrations and blood glucose, plasma insulin, T2D in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) cohort (n = 1,016). A score of five previously published single nucleotide polymorphisms (SNPs) from genes involved in homocysteine metabolism were utilized as genetic instrument for homocysteine concentrations. The effect estimate of this genetic score with T2D was determined using results from the DIAbetes Genetics Replication And Meta-analysis (DIAGRAM) consortium (including 34,840 cases and 114,981 controls). Further, the effects of the genetic score with fasting glucose and insulin were determined using results from the Meta-Analyses of Glucose and Insulin-related traits Consortium (MAGIC) (up to 38,238 non-diabetic participants).

    RESULTS: The genetic score provided a strong instrument for homocysteine concentrations (P = 2.7 × 10(-143), F = 650). In the PIVUS cohort, we found an association of homocysteine with fasting insulin [β = 0.056 (95% CI 0.021, 0.090), P = 0.001], but not with incident diabetes. We did not find any evidence of a causal effect of homocysteine on fasting glucose, fasting insulin, or T2D (P > 0.05 for all analyses) when using data from DIAGRAM or MAGIC studies.

    CONCLUSION: No evidence of a causal relationship of levels of plasma homocysteine with fasting glucose, fasting insulin, or T2D was observed.

  • 229.
    Kumar, Jitender
    et al.
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Salihovic, Samira
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    van Bavel, Bert
    MTM Research Centre, School of Science and Technology, Örebro University, Örebro, Sweden.
    Ingelsson, Erik
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.
    Lind, P. Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Persistent organic pollutants and liver dysfunction biomarkers in a population-based human sample of men and women2014In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 134, no SI, p. 251-256Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND OBJECTIVE: Persistent organic pollutants (POPs) are stable organic compounds generated through different industrial activities. Liver is involved in the metabolism of POPs, and hence exposure to POPs may interfere with liver function. Although a few studies have shown adverse effects of POPs on liver function, large-scale studies involving humans are lacking. We performed this large population-based cross-sectional study to assess the associations between different POPs and liver dysfunction biomarkers.

    METHODS: A total of 992 individuals (all aged 70 years, 50% males) were recruited as part of Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) cohort. The total toxic equivalency (TEQ) value was calculated for seven mono-ortho and two non-ortho substituted polychlorinated biphenyls (PCBs) and octachloro-p-dibenzodioxin (OCDD) to assess their toxicological effects. The association of TEQ values, summary measures of 16 PCBs (sum of PCBs) and three organochlorine pesticides (sum of OC pesticides) with liver dysfunction biomarkers (bilirubin; alkaline phosphatase, ALP; alanine aminotransferase, ALT; and gamma-glutamyltransferase, GGT) was analyzed utilizing linear regression analysis.

    RESULTS: The mono-ortho PCB TEQ values were found to be significantly positively associated with bilirubin (β=0.71, P=0.008), while sum of OC pesticide concentrations was negatively associated with ALP (β=-0.02, P=0.002) after adjusting for various potential confounders. When analyzed individually, a number of different POPs were associated with ALP, ALT and bilirubin. No such association with GGT was observed.

    CONCLUSION: Various POPs including PCBs, OCDD and pesticides were associated with the liver dysfunction biomarkers bilirubin, ALT and ALP, suggesting adverse effects on liver function from these environmental pollutants.

  • 230.
    Kumar, Jitender
    et al.
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.
    Lind, Monica P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Salihovic, Samira
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    van Bavel, Bert
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Ingelsson, Erik
    Uppsala University, Science for Life Laboratory, SciLifeLab. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.
    Influence of persistent organic pollutants on oxidative stress in population-based samples2014In: Chemosphere, ISSN 0045-6535, E-ISSN 1879-1298, Vol. 114, p. 303-309Article in journal (Refereed)
    Abstract [en]

    Persistent organic pollutants (POPs) are a large group of chemicals widely used and produced in various industrial applications. Many cell culture/animal studies have shown that POPs can induce oxidative stress. Since such data is lacking in humans, we conducted a large population-based study to analyze associations between POPs and oxidative stress markers. We measured following POPs; 16 polychlorinated biphenyls (PCBs), 5 organochlorine (OC) pesticides, octachlorinated dibenzo-p-dioxin, and polybrominated diphenyl ether 47, and oxidative stress markers; homocysteine, reduced [GSH] and oxidized glutathione [GSSG], glutathione ratio [GSSG/GSH], total glutathione, oxidized low-density lipoprotein [ox-LDL], ox-LDL antibodies, conjugated dienes, baseline conjugated dienes of LDL, and total anti-oxidative capacity in plasma samples collected from 992 70-year old individuals (50% women) from the population-based Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) cohort. Linear regression analyses were performed to study the associations between oxidative stress markers and summary measures of POPs including the total toxic equivalence (TEQ), sums of PCBs and BC pesticides (main exposures) while adjusting for potential confounders. In multivariable-adjusted analyses, sum of PCBs showed strong associations with ox-LDL (beta = 0.94; P = 2.9 * 10(-6)). Further, sum of PCBs showed association with glutathione-related markers (GSSG: beta = 0.01; P = 6.0 *10(-7); GSSG/GSH: beta = 0.002; P = 9.7 * 10(-10)), although in reverse direction. Other summary measures did not show any significant association with these markers. In our study of elderly individuals from the general population, we show that plasma levels of POPs are associated with markers of increased oxidative stress thereby suggesting that even low dose background exposure to POPs may be involved in oxidative stress.

  • 231.
    Kumar, Jitender
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Lind, Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Salihovic, Samira
    van Bavel, Bert
    Ingelsson, Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Persistent Organic Pollutants and Inflammatory Markers in a Cross-Sectional Study of Elderly Swedish People: The PIVUS Cohort2014In: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 122, no 9, p. 977-983Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Persistent organic pollutants (POPs) are compounds that are generated through various industrial activities and released in the surrounding environment. Different animal studies have shown effects of different POPs on various inflammatory markers. OBJECTIVE: Because very few studies have been conducted in humans, we assessed the associations between different POPs and inflammatory markers in a large population-based sample of elderly men and women (all 70 years of age) from Sweden. METHODS: This cross-sectional study investigated the concentrations of several polychlorinated biphenyls (PCBs), organochlorine pesticides, polychlorinated dibenzo-p-dioxin, and brominated diphenyl ether congeners and their association with a number of inflammatory markers [vascular cell adhesion molecule 1 (VCAM-1), intercellular adhesion molecule 1 (ICAM-1), E-selectin, C-reactive protein (CRP), total leucocyte count, tumor necrosis factor alpha (TNF-alpha), monocyte chemotactic protein 1 (MCP-1), and interleukin 6 (IL-6)] in 992 individuals. These individuals were recruited from the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) cohort. We used a total toxic equivalency (TEQ) value that measures toxicological effects with the relative potencies of various POPs. RESULTS: Following adjustment for potential confounders, the TEQ value (driven mainly by PCB-126) was significantly associated with levels of ICAM-1 (p < 10(-5)). A similar trend was also observed between sum of PCBs and VCAM-1 (p < 0.001). No significant associations were observed between levels of POPs and other inflammatory markers. CONCLUSIONS: TEQ values were associated with levels of ICAM-1, to a lesser degree also with VCAM-1, but not with CRP and several other inflammatory markers. These findings suggest an activation of vascular adhesion molecules by POPs, and particularly by PCB-126.

  • 232.
    Kumar, Jitender
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Lind, P. Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Salihovic, Samira
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    van Bavel, Bert
    Ekdahl, Kristina Nilsson
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical Immunology.
    Nilsson, Bo
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Ingelsson, Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Influence of persistent organic pollutants on the complement system in a population-based human sample2014In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 71, p. 94-100Article in journal (Refereed)
    Abstract [en]

    Background: Persistent organic pollutants (POPS) are toxic compounds generated through various industrial activities and have adverse effects on human health. Studies performed in cell cultures and animals have revealed that POPs can alter immune-system functioning. The complement system is part of innate immune system that helps to clear pathogens from the body. We performed a large-scale population-based study to find out associations between summary measures of different POPs and different complement system markers. Methods: In this cross-sectional study, 16 polychlorinated biphenyls (PCBs), 3 organochlorine (OC) pesticides, octachloro-p-dibenzodioxin, and 2,2',4,4'-tetrabromodiphenyl ether (BDE-47) were analyzed for their association with levels of protein complement 3 (C3), 3a (C3a), 4 (C4) and C3a/C3 ratio. A total of 992 individuals (all aged 70 years, 50% females) were recruited from the Prospective Investigation of the Vasculature in Uppsala Seniors cohort. Regression analysis adjusting for a variety of confounders was performed to study the associations of different POP exposures (total toxic equivalency value or TEQ and sum of 16 PCBs) with protein complements. Results: The TEQ values were found to be positively associated with C3a (beta = 0.07, 95% CI = 0.017-0.131, p = 0.01) and C3a/C3 ratio (beta = 0.07, 95% Cl = 0.015-0.126, p = 0.01) taking possible confounders into account. The association observed was mainly driven by PCB-126. Conclusion: In this study involving 992 elderly individuals from the general population, we showed that POPs, mainly PCB-126, were associated with levels of complement system markers indicating that the association of these toxic compounds with downstream disease could be mediated by activation of immune system.

  • 233.
    La Merrill, M A
    et al.
    Department of Environmental Toxicology, University of California, Davis, CA, USA.
    Lind, P. Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Salihovic, Samira
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab. MTM Research Centre, School of Science and Technology, Örebro University, Örebro, Sweden, and Norwegian Institute for Water Research, NIVA, Oslo, Norway.
    van Bavel, B
    MTM Research Centre, School of Science and Technology, Örebro University, Örebro, Sweden, and Norwegian Institute for Water Research, NIVA, Oslo, Norway.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    The association between p,p'-DDE levels and left ventricular mass is mainly mediated by obesity2018In: Environmental Research, ISSN 0013-9351, E-ISSN 1096-0953, Vol. 160, p. 541-546, article id S0013-9351(17)31176-3Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND OBJECTIVES: The pesticide metabolite p,p'-DDE has been associated with left ventricular (LV) mass and known risk factors for LV hypertrophy in humans and in experimental models. We hypothesized that the associations of p,p'-DDE with LV hypertrophy risk factors, namely elevated glucose, adiposity and hypertension, mediate the association of p,p'-DDE with LV mass.

    METHODS: p,p'-DDE was measured in plasma from 70-year-old subjects (n = 988) of the Prospective Study of the Vasculature in Uppsala Seniors (PIVUS). When these subjects were 70-, 75- and 80- years old, LV characteristics were measured by echocardiography, while fasting glucose, body mass index (BMI) and blood pressure were assessed with standard clinical techniques.

    RESULTS: We found that p,p'-DDE levels were associated with increased fasting glucose, BMI, hypertension and LV mass in separate models adjusted for sex. Structural equation modeling revealed that the association between p,p'-DDE and LV mass was almost entirely mediated by BMI (70%), and also by hypertension (19%).

    CONCLUSION: The obesogenic effect of p,p'-DDE is a major determinant responsible for the association of p,p'-DDE with LV mass.

  • 234.
    Lampa, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Bornefalk Hermansson, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Uppsala Clinical Research Center (UCR).
    Lind, P. Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Atherosclerosis in Humans and the Association to Environmental Contaminant MixturesManuscript (preprint) (Other academic)
  • 235.
    Lampa, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Bornefalk-Hermansson, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Lind, P. Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Mixture Effects of Multiple Environmental Contaminants on the Metabolic Syndrome in a Human Population-based SampleManuscript (preprint) (Other academic)
  • 236.
    Lampa, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Bornefalk-Hermansson, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Lind, P Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Mixture Effects of Multiple Environmental Contaminants on the Metabolic Syndrome in a Human Population-based SampleManuscript (preprint) (Other academic)
  • 237.
    Lampa, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Bornefalk Hermansson, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Salihovic, Samira
    van Bavel, Bert
    Lind, P. Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    An investigation of the co-variation in circulating levels of a large number of environmental contaminants2012In: Journal of Exposure Science and Environmental Epidemiology, ISSN 1559-0631, E-ISSN 1559-064X, Vol. 22, no 5, p. 476-482Article in journal (Refereed)
    Abstract [en]

    We are daily exposed to many different environmental contaminants. Mixtures of these contaminants could act together to induce more pronounced effects than the sum of the individual contaminants. To evaluate the effects of such mixtures, it is of importance to assess the co-variance amongst the contaminants. Thirty-seven environmental contaminants representing different classes were measured in blood samples from 1016 individuals aged 70 years. Hierarchical cluster analysis and principal component analysis were used to assess the co-variation among the contaminants. Within each identified cluster, possible marker contaminants were sought for. We validated our findings using data from the National Health and Nutrition Examination Survey (NHANES) 2003--2004 study. Two large clusters could be identified, one representing low/medium chlorinated polychlorinated biphenyls (PCBs) (<= 6 chlorine atoms), as well as two pesticides and one representing medium/high chlorinated PCBs (>= 6 chlorine atoms). PCBs 118 and 153 could be used as markers for the low/medium chlorinated cluster and PCBs 170 and 209 could be used as markers for the medium/high chlorinated cluster. This pattern was similar to data from the NHANES study. Apart from the PCBs, little co-variation was seen among the contaminants. Thus, a large number of chemicals have to be measured to adequately identify mixtures of environmental contaminants.

  • 238.
    Lampa, Erik
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Lind, Monica P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Bornefalk-Hermansson, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Disciplinary Domain of Medicine and Pharmacy, research centers etc., Uppsala Clinical Research Center (UCR).
    The identification of complex interactions in epidemiology and toxicology: a simulation study of Boosted Regression Trees2014In: Environmental Health, E-ISSN 1476-069X, Vol. 13, p. 57-Article in journal (Refereed)
    Abstract [en]

    Background: There is a need to evaluate complex interaction effects on human health, such as those induced by mixtures of environmental contaminants. The usual approach is to formulate an additive statistical model and check for departures using product terms between the variables of interest. In this paper, we present an approach to search for interaction effects among several variables using boosted regression trees. Methods: We simulate a continuous outcome from real data on 27 environmental contaminants, some of which are correlated, and test the method's ability to uncover the simulated interactions. The simulated outcome contains one four-way interaction, one non-linear effect and one interaction between a continuous variable and a binary variable. Four scenarios reflecting different strengths of association are simulated. We illustrate the method using real data. Results: The method succeeded in identifying the true interactions in all scenarios except where the association was weakest. Some spurious interactions were also found, however. The method was also capable to identify interactions in the real data set. Conclusions: We conclude that boosted regression trees can be used to uncover complex interaction effects in epidemiological studies.

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  • 239.
    Larsen, Michael D.
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Cars, Thomas
    Hallas, Jesper
    A MiniReview of the Use of Hospital-based Databases in Observational Inpatient Studies of Drugs2013In: Basic & Clinical Pharmacology & Toxicology, ISSN 1742-7835, E-ISSN 1742-7843, Vol. 112, no 1, p. 13-18Article, review/survey (Refereed)
    Abstract [en]

    The majority of pharmacoepidemiological data resources are based on data generated in primary health care. Although inpatient data resources have existed since the 1960s, inpatient pharmacoepidemiological studies are relatively scarce. The objectives of this MiniReview were to describe pharmacoepidemiological studies in hospital settings and the underlying databases to provide an overview of research questions addressed by such databases. The studies were retrieved by chain searching. We included pharmacoepidemiological studies in hospital settings containing data on inpatient drug use. Twelve inpatient databases in Asia, the United States and Europe were found. Most databases were automatically collected from claims data or generated from electronic medical records. The contents of the databases varied as well as the potential for linkage with other data sources such as laboratory and outpatient data. Twenty studies were selected and discussed to illustrate the diversity of inpatient pharmacoepidemiological studies. Hospital-based databases had mainly been used for drug utilization studies and research in adverse drug reactions. Five studies within comparative effectiveness were found. The number of pharmacoepidemiological studies in inpatient settings was low compared with studies from primary healthcare settings. These resources may be under-utilized.

  • 240. Larsen, Michael D.
    et al.
    Cars, Thomas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Hallas, Jesper
    A Review of the Use of Hospital-Based Databases in Observational Inpatient Studies of Drugs2012In: Pharmacoepidemiology and Drug Safety, ISSN 1053-8569, E-ISSN 1099-1557, Vol. 21, p. 48-48Article in journal (Other academic)
  • 241.
    Larsson, Anders
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Ridefelt, Peter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Melhus, Håkan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Reference intervals for parathyroid hormone for 70-year-old males and females: exclusion of individuals from the reference interval based on sex, calcium, diabetes, cardiovascular diseases or reduced kidney function has limited effects on the interval2015In: Annals of Clinical Biochemistry, ISSN 0004-5632, E-ISSN 1758-1001, Vol. 52, no 1, p. 39-43Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: A problem when producing reference intervals for elderly individuals is that they often suffer from a number of diseases and they are most often on medication. If all such persons are excluded, there is a risk that the residual subgroup may not be representative of the population, we therefore wanted to compare the effects different exclusion criteria has on the reference intervals.

    METHODS: We measured parathyroid hormone (PTH), calcium, albumin and cystatin C in a cohort of 70-year-old males and females (n = 1003). Reference intervals for PTH for males and females were calculated for the entire population and after exclusion of persons with calcium >2.60 mmol/L, calcium >2.51 mmol/L, diabetes, reduced glomerular filtration rate (GFR), and cardiovascular diseases.

    RESULTS: The calculated PTH reference interval 16 (CI 14-17) to 94 (CI 87-101) ng/L. Exclusion of study subjects resulted in smaller reference sample groups, but the reference limits remained within the 90% confidence intervals of the original reference limits. The selections thus had a very limited effect on the calculated reference interval for PTH.

    CONCLUSIONS: Exclusion of elderly individuals with high calcium concentrations, diabetes, reduced GFR or cardiovascular disease has little effect on the reference interval for PTH. It is better not to exclude these individuals, as it will provide a broader base for the reference interval.

  • 242.
    Larsson, Anders
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Stridsberg, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemical endocrinology.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Reference values for fasting insulin in 75 year old females and males2013In: Clinical Biochemistry, ISSN 0009-9120, E-ISSN 1873-2933, Vol. 46, no 12, p. 1125-1127Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES:

    Reference intervals for insulin are often based on fairly small study groups with unknown body mass index (BMI). They are also much younger than most patients seeking care. These values are not optimal for elderly patients, as many biological markers change over time and adequate reference intervals are important for correct clinical decisions.

    DESIGN AND METHODS:

    We studied fasting insulin (f-insulin) values in a cohort of 698 75-year old non-diabetic males and females. The 2.5th and 97.5th percentiles for all individuals, males and females were calculated according to the recommendations of the International Federation of Clinical Chemistry on the statistical treatment of reference intervals.

    RESULTS:

    There was a strong positive correlation between BMI and f-insulin, which led to the calculation of separate reference intervals for individuals with BMI ≤30.

    CONCLUSIONS:

    The reference interval for f-insulin for all study subjects was 1.74-18.27mIU/L and for individuals with BMI ≤30 (n=574) the reference interval was 1.66-15.05mIU/L.

  • 243. Lee, Duk-Hee
    et al.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Jacobs, David R., Jr.
    Salihovic, Samira
    van Bavel, Bert
    Lind, Monica P.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Does Mortality Risk of Cigarette Smoking Depend on Serum Concentrations of Persistent Organic Pollutants?: Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) Study2014In: PLOS ONE, E-ISSN 1932-6203, Vol. 9, no 5, p. e95937-Article in journal (Refereed)
    Abstract [en]

    Cigarette smoking is an important cause of preventable death globally, but associations between smoking and mortality vary substantially across country and calendar time. Although methodological biases have been discussed, it is biologically plausible that persistent organic pollutants (POPs) like polychlorinated biphenyls (PCBs) and organochlorine (OC) pesticides can affect this association. This study was performed to evaluate if associations of cigarette smoking with mortality were modified by serum concentrations of PCBs and OC pesticides. We evaluated cigarette smoking in 111 total deaths among 986 men and women aged 70 years in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) with mean follow-up for 7.7 years. The association between cigarette smoking and total mortality depended on serum concentration of PCBs and OC pesticides (P value for interaction = 0.02). Among participants in the highest tertile of the serum POPs summary score, former and current smokers had 3.7 (95% CI, 1.5-9.3) and 6.4 (95% CI, 2.3-17.7) times higher mortality hazard, respectively, than never smokers. In contrast, the association between cigarette smoking and total mortality among participants in the lowest tertile of the serum POPs summary score was much weaker and statistically nonsignificant. The strong smoking-mortality association observed among elderly people with high POPs was mainly driven by low risk of mortality among never smokers with high POPs. As smoking is increasing in many low-income and middle-income countries and POPs contamination is a continuing problem in these areas, the interactions between these two important health-related issues should be considered in future research.

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  • 244.
    Lee, Duk-Hee
    et al.
    Kyungpook Natl Univ, Sch Med, Dept Prevent Med, Daegu, South Korea.;Kyungpook Natl Univ, Dept Biomed Sci, Plus KNU Biomed Convergence Program BK21, Daegu, South Korea..
    Lind, P. Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Jacobs, David R., Jr.
    Univ Minnesota, Sch Publ Hlth, Div Epidemiol & Community Hlth, Minneapolis, MN USA..
    Salihovic, Samira
    Univ Orebro, Sch Sci & Technol, MTM Res Ctr, SE-70182 Orebro, Sweden..
    van Bavel, Bert
    Univ Orebro, Sch Sci & Technol, MTM Res Ctr, SE-70182 Orebro, Sweden..
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Association between background exposure to organochlorine pesticides and the risk of cognitive impairment: A prospective study that accounts for weight change2016In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 89-90, p. 179-184Article in journal (Refereed)
    Abstract [en]

    Background: Background exposure to organochlorine (OC) pesticides was recently linked to cognitive impairment and dementia in cross-sectional and case-control studies. This prospective study was performed to evaluate if OC pesticides at baseline are associated with the future risk of cognitive impairment in elderly, with particular focus on weight change. Methods: Plasma concentrations of 3 OC pesticides (p,p'-DDE, trans-nonachlor, and hexachlorobenzene) were measured among 989 men and women aged 70 years in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS). Cognitive impairment was validated by reviewing medical records. During the ten year follow-up, cognitive impairment was developed in 75 subjects. When weight change from age 70 to 75 was considered in analyses, elderly with incident cases before age 75 were excluded to keep the prospective perspective, leaving 795 study subjects and 44 incident cases. Results: The summary measure of 3 OC pesticides predicted the development of cognitive impairment after adjusting for covariates, including weight change. Compared to subjects with OC pesticides <25th percentile, adjusted hazard ratios (HRs) in those with 25th-<75th and >= 75th percentiles were 3.5 (95% confidence interval: 1.5-8.5) and 3.2 (1.1-7.6), respectively (P-trend = 0.04). Among 506 subjects who maintained or gained body weight, adjusted HRs were 6.9 and 11.6 (1.4-92.6) among the elderly in the 25th-<75th and >= 75th percentiles compared to <25th percentile (P-trend < 0.01). Conclusions: This prospective study demonstrates that background exposure to OC pesticides are linked to the risk of developing cognitive impairment in elderly. The role of the chronic exposure to low dose OC pesticides in the development of dementia should be further evaluated in other populations.

  • 245. Lee, Duk-Hee
    et al.
    Lind, P. Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Jacobs, David R., Jr.
    Salihovic, Samira
    van Bavel, Bert
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Background exposure to persistent organic pollutants predicts stroke in the elderly2012In: Environment International, ISSN 0160-4120, E-ISSN 1873-6750, Vol. 47, p. 115-120Article in journal (Refereed)
    Abstract [en]

    Background exposure to persistent organic pollutants (POPs), lipophilic xenobiotics that accumulate mainly in adipose tissue, has recently emerged as a new risk factor for cardiovascular diseases. This prospective study was performed to evaluate if plasma concentrations of selected POPs predict incident stroke among the elderly. Twenty-one POPs (including 16 polychlorinated biphenyl (PCB) congeners, 3 organochlorine (OC) pesticides, 1 brominated diphenyl ether (BDE), and 1 dioxin) were measured in plasma collected at baseline in 898 participants aged 70 years of the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS). Stroke diagnosis was validated by hospital records. During the five year follow-up, 35 subjects developed hospital-treated stroke. After adjusting for known stroke risk factors, most PCBs with 4, 5, or 6 chlorine atoms, p,p'-DDE, trans-nonachlor, and octachlorodibenzo-p-dioxin significantly predicted the risk of stroke. Across quartiles of summary measures of PCBs and OC pesticides, the adjusted ORs were 1.0, 0.8 (95% confidence interval: 0.2-2.5), 1.2 (0.4-3.4), and 2.1 (0.7-6.2) for PCBs and 1.0, 1.2 (0.3-4.2), 2.3 (0.7-6.9), and 3.0 (1.0-9.4) for OC pesticides (P for trend = 0.11 and 0.03, respectively). The adjusted ORs among participants >= 90th percentile of the summary measures were 5.5 (1.7-18.1) for PCBs and 4.0 (1.1-14.6) for OC pesticides; corresponding ORs for those >= 95th percentile were 7.8 (2.1-29.6) and 9.5 (2.3-38.9). Background exposure to POPs may play an important role in development or progression of stroke in the elderly.

  • 246.
    Lee, Duk-Hee
    et al.
    Kyungpook Natl Univ, Sch Med, Dept Prevent Med, Daegu, South Korea.
    Porta, Miquel
    Univ Autonoma Barcelona, Sch Med, Hosp del Mar, Inst Med Res IMIM, Barcelona, Spain.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Lind, P. Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Jacobs, David R
    Univ Minnesota, Sch Publ Hlth, Div Epidemiol & Community Hlth, Minneapolis, MN USA.
    Neurotoxic chemicals in adipose tissue: A role in puzzling findings on obesity and dementia2018In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 90, no 4, p. 176-182Article in journal (Refereed)
    Abstract [en]

    Midlife obesity is associated with increased risk of dementia, whereas late-life obesity is commonly associated with a lower risk of dementia. Although methodologic issues are often discussed in this apparent risk reversal, chronic exposure to low-dose organochlorine pesticides (OCPs), an emerging risk factor for dementia in general populations, may contribute to a direct explanation for these differences. OCPs are strong lipophilic chemicals with very long half-lives (several years), primarily stored in adipose tissue and very slowly released and metabolized over years. As serum concentrations of neurotoxic OCPs strongly correlate with brain OCPs (r = 0.95), any condition enhancing the release of OCPs from the adipose tissue into circulation would increase the risk of dementia. Increased release of OCPs from adipose tissue typically occurs in (1) dysfunctional adipocytes accompanied by uncontrolled lipolysis and (2) weight loss. Weight gain may help sequester circulating OCPs in adipose tissue. As obesity is the most common reason that adipocytes become dysfunctional, midlife obesity can increase dementia risk through the chronic release of OCPs into circulation. However, late-life obesity potentially decreases dementia risk because weight loss after midlife will increase the release of OCPs while weight gain may actually decrease the release. These countervailing forces may underlie paradoxical associations with dementia of obesity in midlife vs late life which is influenced by weight change after midlife. This hypothesis should be tested in future experimental and human studies on obesity and dementia.

  • 247.
    Lejonklou, Margareta Halin
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Dunder, Linda
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Bladin, Emelie
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Pettersson, Vendela
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Rönn, Monika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Waldén, Tomas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Cell Biology.
    Lind, P. Monica
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine.
    Effects of Low-Dose Developmental Bisphenol A Exposure on Metabolic Parameters and Gene Expression in Male and Female Fischer 344 Rat Offspring.2017In: Journal of Environmental Health Perspectives, ISSN 0091-6765, E-ISSN 1552-9924, Vol. 125, no 6, article id 067018Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Bisphenol A (BPA) is an endocrine-disrupting chemical that may contribute to development of obesity and metabolic disorders. Humans are constantly exposed to low concentrations of BPA, and studies support that the developmental period is particularly sensitive.

    OBJECTIVES: The aim was to investigate the effects of low-dose developmental BPA exposure on metabolic parameters in male and female Fischer 344 (F344) rat offspring.

    METHODS: Pregnant F344 rats were exposed to BPA via their drinking water, corresponding to (BPA0.5; ) or (BPA50; ), from gestational day (GD) 3.5 until postnatal day (PND) 22, and controls were given vehicle (). Body weight (BW), adipose tissue, liver (weight, histology, and gene expression), heart weight, and lipid profile were investigated in the 5-wk-old offspring.

    RESULTS: Males and females exhibited differential susceptibility to the different doses of BPA. Developmental BPA exposure increased plasma triglyceride levels ( compared with , females BPA50 ; compared with , males BPA0.5 ) in F344 rat offspring compared with controls. BPA exposure also increased adipocyte cell density by 122% in inguinal white adipose tissue (iWAT) of female offspring exposed to BPA0.5 compared with controls ( number of adipocytes/HPF compared with number of adipocytes/HPF; ) and by 123% in BPA0.5 females compared with BPA50 animals ( number of adipocytes/high power field (HPF) compared with number of adipocytes/HPF; ). In iWAT of male offspring, adipocyte cell density was increased by 129% in BPA50-exposed animals compared with BPA0.5-exposed animals ( number of adipocytes/HPF compared with number of adipocytes/HPF; ). Furthermore, the expression of genes involved in lipid and adipocyte homeostasis was significantly different between exposed animals and controls depending on the tissue, dose, and sex.

    CONCLUSIONS: Developmental exposure to of BPA, which is 8-10 times lower than the current preliminary EFSA (European Food Safety Authority) tolerable daily intake (TDI) of and is within the range of environmentally relevant levels, was associated with sex-specific differences in the expression of genes in adipose tissue plasma triglyceride levels in males and adipocyte cell density in females when F344 rat offspring of dams exposed to BPA at were compared with the offspring of unexposed controls.

  • 248.
    Liao, Ximing
    et al.
    Goethe Univ Frankfurt, Dept Neurol, Frankfurt, Germany..
    Norata, Giuseppe D.
    Univ Milan, Dipartimento Sci Farmacol & Biomol, I-20122 Milan, Italy.;Bassini Hosp, SISA Ctr Study Atherosclerosis, Cinisello Balsamo, Italy..
    Polak, Joseph F.
    Tufts Univ, Sch Med, Tufts Med Ctr, Boston, MA 02111 USA..
    Stehouwer, Coen D. A.
    Maastricht Univ, Dept Internal Med, Med Ctr, NL-6200 MD Maastricht, Netherlands.;Maastricht Univ, Cardiovasc Res Inst Maastricht CARIM, Med Ctr, NL-6200 MD Maastricht, Netherlands..
    Catapano, Alberico
    IRCSS Multimed, Milan, Italy.;Univ Milan, Dept Pharmacol & Biomol Sci, I-20122 Milan, Italy..
    Rundek, Tatjana
    Univ Miami, Miller Sch Med, Dept Neurol, Coral Gables, FL 33124 USA..
    Ezhov, Marat
    Cardiol Res Ctr, Atherosclerosis Dept, Moscow, Russia..
    Sander, Dirk
    Benedictus Hosp Tutzing & Feldafing, Dept Neurol, Feldafing, Germany.;Tech Univ Munich, Dept Neurol, D-80290 Munich, Germany..
    Thompson, Simon G.
    Univ Cambridge, Dept Publ Hlth & Primary Care, Sch Clin Med, Cambridge CB2 1TN, England..
    Lorenz, Matthias W.
    Goethe Univ Frankfurt, Dept Neurol, Frankfurt, Germany..
    Balakhonova, Tatyana
    Cardiol Res Ctr 2, Ultrasound Vasc Lab, Moscow, Russia..
    Safarova, Maya
    Cardiol Res Ctr, Atherosclerosis Dept, Moscow, Russia..
    Grigore, Liliana
    Bassini Hosp, SISA Ctr Study Atherosclerosis, Cinisello Balsamo, Italy..
    Empana, Jean-Philippe
    Univ Paris 05, Sorbonne Paris Cite, Paris Cardiovasc Res Ctr PARCC, Paris, France..
    Lin, Hung-Ju
    Natl Taiwan Univ Hosp, Dept Internal Med, Taipei, Taiwan..
    McLachlan, Stela
    Univ Edinburgh, Ctr Populat Hlth Sci, Edinburgh EH8 9YL, Midlothian, Scotland..
    Bokemark, Lena
    Gothenburg Univ, Wallenberg Lab Cardiovasc Res, Inst Medicin, Dept Mol & Clin Med,Sahlgrenska Acad, S-41124 Gothenburg, Sweden..
    Ronkainen, Kimmo
    Univ Eastern Finland, Inst Publ Hlth & Clin Nutr, Kuopio, Finland..
    Schminke, Ulf
    Greifswald Univ Clin, Dept Neurol, Greifswald, Germany..
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala Univ, Dept Med, Uppsala, Sweden..
    Willeit, Peter
    Univ Cambridge, Dept Publ Hlth & Primary Care, Sch Clin Med, Cambridge CB2 1TN, England.;Med Univ Innsbruck, Dept Neurol, Innsbruck, Austria..
    Yanez, David N.
    Univ Washington, Dept Biostat, Seattle, WA 98195 USA..
    Steinmetz, Helmuth
    Goethe Univ Frankfurt, Dept Neurol, Frankfurt, Germany..
    Poppert, Holger
    Tech Univ Munich, Dept Neurol, D-80290 Munich, Germany..
    Desvarieux, Moise
    Columbia Univ, Dept Epidemiol, Mailman Sch Publ Hlth, New York, NY USA..
    Ikram, M. Arfan
    Erasmus Univ, Med Ctr, Dept Epidemiol, Rotterdam, Netherlands.;Erasmus Univ, Med Ctr, Dept Neurol, Rotterdam, Netherlands.;Erasmus Univ, Med Ctr, Dept Radiol, Rotterdam, Netherlands..
    Johnsen, Stein Harald
    Univ Tromso, Dept Clin Med, N-9001 Tromso, Norway.;Univ Hosp Northern Norway, Dept Neurol, Tromso, Norway..
    Iglseder, Bernhard
    Parcelsus Med Univ, Salzburg, Austria.;Gemeinnutzige Salzburger Landeskliniken Betriebse, Christian Doppler Klin, Dept Geriatr Med, Salzburg, Austria..
    Friera, Alfonsa
    Univ Autonoma Madrid, Dept Radiol, Hosp Univ Princesa, E-28049 Madrid, Spain..
    Xie, Wuxiang
    Capital Med Univ, Dept Epidemiol, Beijing Inst Heart Lung & Blood Vessel Dis, Beijing Anzhen Hosp, Beijing, Peoples R China..
    Plichart, Matthieu
    Hop Broca, AP HP, Paris, France..
    Su, Ta-Chen
    Natl Taiwan Univ Hosp, Dept Internal Med, Taipei, Taiwan..
    Srinivasan, Sathanur R.
    Tulane Univ, Sch Publ Hlth & Trop Med, Ctr Cardiovasc Hlth, Dept Epidemiol,Biochem, New Orleans, LA USA..
    Schmidt, Caroline
    Gothenburg Univ, Wallenberg Lab Cardiovasc Res, Inst Medicin, Dept Mol & Clin Med,Sahlgrenska Acad, S-41124 Gothenburg, Sweden..
    Tuomainen, Tomi-Pekka
    Univ Eastern Finland, Inst Publ Hlth & Clin Nutr, Kuopio, Finland..
    Volzke, Henry
    SHIP Clin Epidemiol Res, Inst Community Med, Greifswald, Germany..
    Nijpels, Giel
    Vrije Univ Amsterdam, Med Ctr, Dept Gen Practice, Amsterdam, Netherlands.;Vrije Univ Amsterdam, Med Ctr, EMGO Inst Hlth & Care Res, Amsterdam, Netherlands.;Univ Autonoma Madrid, Dept Internal Med, Hosp Univ Princesa, E-28049 Madrid, Spain..
    Willeit, Johann
    Med Univ Innsbruck, Dept Neurol, Innsbruck, Austria..
    Franco, Oscar H.
    Erasmus Univ, Med Ctr, Dept Epidemiol, Rotterdam, Netherlands..
    Suarez, Carmen
    Zhao, Dong
    Capital Med Univ, Dept Epidemiol, Beijing Inst Heart Lung & Blood Vessel Dis, Beijing Anzhen Hosp, Beijing, Peoples R China..
    Ducimetiere, Pierre
    Univ Paris 11, Le Kremlin Bicetre, France..
    Chien, Kuo-Liong
    Natl Taiwan Univ, Inst Epidemiol & Prevent Med, Coll Publ Hlth, Taipei, Taiwan..
    Robertson, Christine
    Univ Edinburgh, Ctr Populat Hlth Sci, Edinburgh EH8 9YL, Midlothian, Scotland..
    Bergstrom, Goran
    Gothenburg Univ, Wallenberg Lab Cardiovasc Res, Inst Medicin, Dept Mol & Clin Med,Sahlgrenska Acad, S-41124 Gothenburg, Sweden..
    Kauhanen, Jussi
    Univ Eastern Finland, Inst Publ Hlth & Clin Nutr, Kuopio, Finland..
    Dorr, Marcus
    Univ Med Greifswald, Dept Internal Med B, Greifswald, Germany.;Partner Site Greifswald, German Ctr Cardiovasc Res DZHK, Greifswald, Germany..
    Dekker, Jaqueline M.
    Univ Med Ctr, Dept Epidemiol & Biostat, Amsterdam, Netherlands..
    Kiechl, Stefan
    Med Univ Innsbruck, Dept Neurol, Innsbruck, Austria..
    Sitzer, Matthias
    Goethe Univ Frankfurt, Dept Neurol, Frankfurt, Germany.;Klinikum Herford, Dept Neurol, Herford, Germany..
    Bickel, Horst
    Tech Univ Munich, Dept Psychiat & Psychotherapy, D-80290 Munich, Germany..
    Sacco, Ralph L.
    Univ Miami, Miller Sch Med, Dept Neurol, Coral Gables, FL 33124 USA..
    Hofman, Albert
    Erasmus Univ, Med Ctr, Dept Epidemiol, Rotterdam, Netherlands..
    Mathiesen, Ellisiv B.
    Univ Tromso, Dept Clin Med, N-9001 Tromso, Norway.;Univ Hosp Northern Norway, Dept Neurol, Tromso, Norway..
    Gabriel, Rafael
    Hosp Univ La Paz, Inst Invest IdiPAZ, Madrid, Spain..
    Liu, Jing
    Capital Med Univ, Dept Epidemiol, Beijing Inst Heart Lung & Blood Vessel Dis, Beijing Anzhen Hosp, Beijing, Peoples R China..
    Berenson, Gerald
    Tulane Univ, Sch Med, Dept Med, Pediat,Biochem,Epidemiol, 1430 Tulane Ave, New Orleans, LA 70112 USA.;Tulane Univ, Sch Publ Hlth & Trop Med, New Orleans, LA USA..
    Kavousi, Maryam
    Erasmus MC, Dept Epidemiol & Biostat, Rotterdam, Netherlands..
    Price, Jackie F.
    Univ Edinburgh, Ctr Populat Hlth Sci, Edinburgh EH8 9YL, Midlothian, Scotland..
    Normative values for carotid intima media thickness and its progression: Are they transferrable outside of their cohort of origin?2016In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 23, no 11, p. 1165-1173Article in journal (Refereed)
    Abstract [en]

    Background The clinical use of carotid intima media thickness (cIMT) requires normal values, which may be subject to variation of geographical factors, ethnicity or measurement details. The influence of these factors has rarely been studied. The aim of this study was to determine whether normative cIMT values and their association with event risk are generalizable across populations. Design Meta-analysis of individual participant data. Method From 22 general population cohorts from Europe, North America and Asia we selected subjects free of cardiovascular disease. Percentiles of cIMT and cIMT progression were assessed separately for every cohort. Cox proportional hazards models for vascular events were used to estimate hazard ratios for cIMT in each cohort. The estimates were pooled across Europe, North America and Asia, with random effects meta-analysis. The influence of geography, ethnicity and ultrasound protocols on cIMT values and on the hazard ratios was examined by meta-regression. Results Geographical factors, ethnicity and the ultrasound protocol had influence neither on the percentiles of cIMT and its progression, nor on the hazard ratios of cIMT for vascular events. Heterogeneity for percentiles of cIMT and cIMT progression was too large to create meaningful normative values. Conclusions The distribution of cIMT values is too heterogeneous to define universal or regional population reference values. CIMT values vary widely between different studies regardless of ethnicity, geographic location and ultrasound protocol. Prediction of vascular events with cIMT values was more consistent across all cohorts, ethnicities and regions.

  • 249.
    Lim, Stephen S.
    et al.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Allen, Kate
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Bhutta, Zulficiar A.
    Aga Khan Univ, Ctr Excellence Women & Child Hlth, Karachi, Pakistan.;Hosp Sick Children, Ctr Global Child Hlth, Toronto, ON, Canada..
    Dandona, Lalit
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA.;Publ Hlth Fdn India, New Delhi, India..
    Forouzanfar, Mohammad H.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Fullman, Nancy
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Gething, Peter W.
    Univ Oxford, Dept Zool, Oxford, England..
    Goldberg, Ellen M.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Hay, Simon I.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Holmberg, Mollie
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Kinfu, Yohannes
    Univ Canberra, Fac Hlth, Ctr Res & Act Publ Hlth, Canberra, ACT, Australia..
    Kutz, Michael J.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Larson, Heidi J.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA.;London Sch Hyg & Trop Med, Dept Infect Dis Epidemiol, London, England..
    Liang, Xiaofeng
    Chinese Ctr Dis Control & Prevent, Beijing, Peoples R China..
    Lopez, Alan D.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA.;Univ Melbourne, Melbourne Sch Populat & Global Hlth, Melbourne, Vic, Australia..
    Lozano, Rafael
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    McNellan, Claire R.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Mokdad, Ali H.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Mooney, Meghan D.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Naghavi, Mohsen
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Olsen, Helen E.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Pigott, David M.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Salomon, Joshua A.
    Harvard Univ, Dept Global Hlth & Populat, Harvard TH Chan Sch Publ Hlth, Boston, MA 02115 USA..
    Vos, Theo
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Wang, Haidong
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Abajobir, Amanuel Alemu
    Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia..
    Abate, Kalkidan Hassen
    Jimma Univ, Jimma, Ethiopia..
    Abbafati, Cristiana
    Univ Roma La Sapienza, Rome, Italy..
    Abbas, Kaja M.
    Virginia Tech, Blacksburg, VA USA..
    Abd-Allah, Foad
    Cairo Univ, Dept Neurol, Cairo, Egypt..
    Abdulle, Abdishakur M.
    New York Univ Abu Dhabi, Abu Dhabi, U Arab Emirates..
    Abraham, Biju
    NMSM Govt Coll Kalpetta, Kalpetta, Kerala, India..
    Abubakar, Ibrahim
    UCL, Inst Global Hlth, London, England..
    Abu-Raddad, Laith J.
    Weill Cornell Med Coll Qatar, Infect Dis Epidemiol Grp, Doha, Qatar..
    Abu-Rmeileh, Niveen M. E.
    Birzeit Univ, Inst Community & Publ Hlth, Ramallah, Israel..
    Abyu, Gebre Yitayih
    Mekelle Univ, Mekelle, Ethiopia..
    Achoki, Tom
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Adebiyi, Akindele Olupelumi
    Univ Ibadan, Coll Med, Ibadan, Nigeria.;Univ Coll Hosp, Ibadan, Nigeria..
    Adedeji, Isaac Akinkunmi
    Olabisi Onabanjo Univ, Ago Iwoye, Nigeria..
    Afanvi, Kossivi Agbelenko
    Direct Dist Sanitaire Haho, Notse, Togo.;Univ Lome, Fac Sci Sante, Lome, Togo..
    Afshin, Ashkan
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA.;Tufts Univ, Friedman Sch Nutr Sci & Policy, Boston, MA 02111 USA..
    Agarwal, Arnav
    McMaster Univ, Hamilton, ON, Canada..
    Agrawal, Anurag
    CSIR Inst Genom & Integrat Biol, Delhi, India.;Baylor Coll Med, Dept Internal Med, Houston, TX 77030 USA..
    Kiadaliri, Aliasghar Ahmad
    Ahmadieh, Hamid
    Ahmed, Kedir Yimam
    Debre Markos Univ, Debre Markos, Ethiopia..
    Akanda, Ali Shafqat
    Univ Rhode Isl, Kingston, RI 02881 USA..
    Akinyemi, Rufus Olusola
    Univ Ibadan, Ibadan, Nigeria.;Newcastle Univ, Newcastle Upon Tyne, Tyne & Wear, England..
    Akinyemiju, Tomi F.
    Akseer, Nadia
    Hosp Sick Children, Ctr Global Child Hlth, Toronto, ON, Canada..
    Al-Aly, Ziyad
    Washington Univ, St Louis, MO USA..
    Alam, Khurshid
    Univ Melbourne, Murdoch Childrens Res Inst, Melbourne, Vic, Australia.;Univ Melbourne, Melbourne, Vic, Australia..
    Alam, Uzma
    Int Ctr Humanitarian Affairs, Nairobi, Kenya..
    Alasfoor, Deena
    AlBuhairan, Fadia S.
    Aldhahri, Saleh Fahed
    King Saud Univ, Riyadh, Saudi Arabia..
    Dge, Robert William Aldr.
    UCL, Inst Global Hlth, London, England.;UCL, Ctr Publ Hlth Data Sci, Inst Hlth Informat, London, England.;UCL, Farr Inst Hlth Informat Res, London, England..
    Alemu, Zewdie Aderaw
    Debre Markos Univ, Debre Markos, Ethiopia..
    Ali, Raghib
    Univ Oxford, Oxford, England..
    Alkerwi, Ala'a
    Luxembourg Inst Hlth, Strassen, Luxembourg..
    Alkhateeb, Mohammad A. B.
    King Saud Univ, King Khalid Univ Hosp, Riyadh, Saudi Arabia..
    Alla, Francois
    Univ Lorraine, Sch Publ Hlth, Nancy, France..
    Allebeck, Peter
    Allen, Christine
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Al-Raddadi, Rajaa
    Minist Hlth, Jeddah, Saudi Arabia..
    Altirkawi, Khalid A.
    King Saud Univ, Riyadh, Saudi Arabia..
    Martin, Elena Alvarez
    Govt Madrid, Madrid, Spain..
    Alvis-Guzman, Nelson
    Univ Cartagena, Cartagena, Colombia..
    Amare, Azmeraw T.
    Univ Adelaide, Sch Med, Adelaide, SA, Australia.;Bahir Dar Univ, Coll Med & Hlth Sci, Bahir Dar, Ethiopia..
    Amberbir, Alemayehu
    Dignitas Int, Zomba, Malawi..
    Amegah, Adeladza Kofi
    Univ Cape Coast, Cape Coast, Ghana..
    Amini, Heresh
    Kurdistan Univ Med Sci, Environm Hlth Res Ctr, Sanandaj, Iran.;Swiss Trop & Publ Hlth Inst, Dept Epidemiol & Publ Hlth, Basel, Switzerland..
    Ammar, Walid
    Amrock, Stephen Marc
    Oregon Hlth & Sci Univ, Portland, OR 97201 USA..
    Andersen, Hjalte H.
    Aalborg Univ, Fac Med, Dept Hlth Sci & Technol, Ctr Sensory Motor Interact, Aalborg, Denmark..
    Anderson, Benjamin O.
    Univ Washington, Seattle, WA 98121 USA..
    Anderson, Gregory M.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Antonio, Carl Abelardo T.
    Univ Philippines Manila, Coll Publ Hlth, Dept Hlth Policy & Adm, Manila, Philippines..
    Anwari, Palwasha
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Dalarna Univ, Falun, Sweden..
    Artaman, Al
    Univ Manitoba, Winnipeg, MB, Canada..
    Asayesh, Hamid
    Qom Univ Med Sci, Sch Paramed, Dept Emergency Med, Qom, Iran..
    Asghar, Rana Jawad
    South Asian Publ Hlth Forum, Islamabad, Pakistan..
    Atique, Suleman
    Taipei Med Univ, Grad Inst Biomed Informat, Taipei, Taiwan..
    Avokpaho, Euripide Frinel G. Arthur
    Inst Rech Clin Benin, Cotonou, Benin.;LERAS Afrique, Parakou, Benin..
    Awasthi, Ashish
    Sanjay Gandhi Postgrad Inst Med Sci, Lucknow, Uttar Pradesh, India..
    Quintanilla, Beatriz Paulina Ayala
    La Trobe Univ, Judith Lumley Ctr Mother Infant & Family Hlth Res, Melbourne, Vic, Australia.;Peruvian Natl Inst Hlth, Lima, Peru..
    Azzopardi, Peter
    Univ Melbourne, Dept Paediat, Melbourne, Vic, Australia.;Univ Melbourne, Murdoch Childrens Res Inst, Melbourne, Vic, Australia.;South Australian Hlth & Med Res Inst, Wardliparingga Aboriginal Res Unit, Adelaide, SA, Australia.;Burnet Inst, Ctr Int Hlth, Melbourne, Vic, Australia..
    Bacha, Umar
    Univ Management & Technol, Sch Hlth Sci, Lahore, Pakistan..
    Badawi, Alaa
    Publ Hlth Agcy Canada, Toronto, ON, Canada..
    Balakrishnan, Kalpana
    Sri Ramachandra Univ, Dept Environm Hlth Engn, Chennai, Tamil Nadu, India..
    Banerjee, Amitava
    UCL, Farr Inst Hlth Informat Res, London, England..
    Barac, Aleksandra
    Univ Belgrade, Fac Med, Belgrade, Serbia..
    Barber, Ryan
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Barker-Collo, Suzanne L.
    Univ Auckland, Sch Psychol, Auckland, New Zealand..
    Barnighausen, Till
    Harvard Univ, Harvard TH Chan Sch Publ Hlth, Boston, MA 02115 USA.;Africa Hlth Res Inst, Mtubatuba, South Africa.;Heidelberg Univ, Inst Publ Hlth, Heidelberg, Germany..
    Barrero, Lope H.
    Pontificia Univ Javeriana, Sch Engn, Dept Ind Engn, Bogota, Colombia..
    Barrientos-Gutierrez, Tonatiuh
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Basu, Sanjay
    Stanford Univ, Stanford, CA 94305 USA..
    Bayou, Tigist Assefa
    Mekelle Univ, Mekelle, Ethiopia..
    Bazargan-Hejazi, Shahrzad
    Charles R Drew Univ Med & Sci, Coll Med, 1621 E 120th St, Los Angeles, CA 90059 USA.;Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA.;Kermanshah Univ Med Sci, Kermanshah, Iran..
    Beardsley, Justin
    Univ Oxford, Ho Chi Minh City, Vietnam..
    Bedi, Neeraj
    Coll Publ Hlth & Trop Med, Jazan, Saudi Arabia..
    Beghi, Ettore
    IRCCS Ist Ric Farmacol Mario Negri, Milan, Italy..
    Bejot, Yannick
    Univ Burgundy, Univ Hosp & Med Sch Dijon, Dijon, France..
    Bell, Michelle L.
    Yale Univ, Sch Med, New Haven, CT USA..
    Bello, Aminu K.
    Univ Alberta, Edmonton, AB, Canada..
    Bennett, Derrick A.
    Univ Oxford, Oxford, England..
    Bensenor, Isabela M.
    Univ Sao Paulo, Sao Paulo, Brazil..
    Benzian, Habib
    UCL, Dept Epidemiol & Publ Hlth, London, England.;NYU, Coll Dent, Dept Epidemiol & Hlth Promot, New York, NY USA..
    Berhane, Adugnaw
    Debre Berhane Univ, Debre Berhan, Ethiopia..
    Bernabe, Eduardo
    Kings Coll London, London, England..
    Bernal, Oscar Alberto
    Univ Andes, Bogota, Colombia. Haramaya Univ, Coll Hlth & Med Sci, Harar, Ethiopia..
    Betsu, Balem Demtsu
    Mekelle Univ, Mekelle, Ethiopia..
    Beyene, Addisu Shunu
    Haramaya Univ, Harar, Ethiopia..
    Bhala, Neeraj
    Queen Elizabeth Hosp Birmingham, Birmingham, W Midlands, England.;Univ Otago, Sch Med, Wellington, New Zealand..
    Bhatt, Samir
    Imperial Coll, London, England..
    Biadgilign, Sibhatu
    Bienhoff, Kelly A.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Bikbov, Boris
    Academician VI Shumakov Fed Res Ctr Transplantol, Issues Transplanted Kidney, Dept Nephrol, Moscow, Russia..
    Binagwaho, Agnes
    Harvard Univ, Harvard Med Sch, Dept Global Hlth & Social Med, Boston, MA 02115 USA.;Dartmouth Coll, Dept Pediat, Hanover, NH 03755 USA.;Dartmouth Coll, Dartmouth Inst Hlth Policy & Clin Practice, Geisel Sch Med, Hanover, NH 03755 USA.;Univ Global Hlth Equ, Kigali, Rwanda..
    Bisanzio, Donal
    Univ Oxford, Nuffield Dept Med, Oxford, England..
    Bjertness, Espen
    Univ Oslo, Dept Community Med, Oslo, Norway..
    Blore, Jed
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Bourne, Rupert R. A.
    Anglia Ruskin Univ, Vis Eye Res Unit, Cambridge, England..
    Brainin, Michael
    Danube Univ Krems, Krems, Austria..
    Brauer, Michael
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA.;Univ British Columbia, Vancouver, BC, Canada..
    Brazinova, Alexandra
    Trnava Univ, Dept Publ Hlth, Fac Hlth Sci & Social Work, Trnava, Slovakia.;Int Neurotrauma Res Org, Vienna, Austria..
    Breitborde, Nicholas J. K.
    Ohio State Univ, Coll Med, Columbus, OH 43210 USA..
    Broday, David M.
    Technion, Haifa, Israel..
    Brugha, Traolach S.
    Univ Leicester, Leicester, Leics, England..
    Buchbinder, Rachelle
    Cabrini Inst, Monash Dept Clin Epidemiol, Melbourne, Vic, Australia.;Monash Univ, Dept Epidemiol & Prevent Med, Melbourne, Vic, Australia..
    Butt, Zahid A.
    Al Shifa Trust Eye Hosp, Rawalpindi, Pakistan..
    Cahill, Leah E.
    Harvard Univ, Harvard TH Chan Sch Publ Hlth, Boston, MA 02115 USA.;Dalhousie Univ, Halifax, NS, Canada..
    Campos-Nonato, Ismael Ricardo
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico.;Harvard Univ, Harvard TH Chan Sch Publ Hlth, Boston, MA 02115 USA..
    Campuzano, Julio Cesar
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Carabin, Helene
    Univ Oklahoma, Hlth Sci Ctr, Dept Biostat & Epidemiol, Oklahoma City, OK USA..
    Cardenas, Rosario
    Metropolitan Autonomous Univ, Mexico City, DF, Mexico..
    Carrero, Juan Jesus
    Carter, Austin
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Casey, Daniel
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Caso, Valeria
    Univ Perugia, Stroke Unit, Perugia, Italy..
    Castaneda-Orjuela, Carlos A.
    Inst Nacl Salud, Colombian Natl Hlth Observ, Bogota, Colombia.;Univ Nacl Colombia, Dept Publ Hlth, Epidemiol & Publ Hlth Evaluat Grp, Bogota, Colombia..
    Rivas, Jacqueline Castillo
    Caja Costarricense Seguro Social, San Jose, Costa Rica.;Univ Costa Rica, San Pedro, Montes De Oca, Costa Rica..
    Catala-Lopez, Ferran
    Cavalleri, Fiorella
    Cecilio, Pedro
    Chang, Hsing-Yi
    Chang, Jung-Chen
    Charlson, Fiona J.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA.;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia..
    Che, Xuan
    Chen, Alan Zian
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Chiang, Peggy Pei-Chia
    Chibalabala, Mirriam
    Chisumpa, Vesper Hichilombwe
    Choi, Jee-Young Jasmine
    Chowdhury, Rajiv
    Christensen, Hanne
    Ciobanu, Liliana G.
    Univ Adelaide, Adelaide, SA, Australia..
    Cirillo, Massimo
    Coates, Matthew M.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Coggeshall, Megan
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Cohen, Aaron J.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Cooke, Graham S.
    Cooper, Cyrus
    Univ Oxford, NIHR Musculoskeletal Biomed Res Ctr, Oxford, England..
    Cooper, Leslie Trumbull
    Cowie, Benjamin C.
    Univ Melbourne, Peter Doherty Inst Infect & Immun, Melbourne, Vic, Australia..
    Crump, John A.
    Damtew, Solomon Abrha
    Dandona, Rakhi
    Publ Hlth Fdn India, New Delhi, India..
    Dargan, Paul I.
    das Neves, Jose
    Davis, Adrian C.
    Davletov, Kairat
    de Castro, E. Filipa
    De Leo, Diego
    Degenhardt, Louisa
    Del Gobbo, Liana C.
    Stanford Univ, Stanford, CA 94305 USA..
    Deribe, Kebede
    Derrett, Sarah
    Jarlais, Don C. Des
    Deshpande, Aniruddha
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    deVeber, Gabrielle A.
    Hosp Sick Children, Ctr Global Child Hlth, Toronto, ON, Canada..
    Dey, Subhojit
    Dharmaratne, Samath D.
    Dhillon, Preet K.
    Ding, Eric L.
    Harvard Univ, Harvard TH Chan Sch Publ Hlth, Boston, MA 02115 USA..
    Dorsey, E. Ray
    Doyle, Kerrie E.
    Driscoll, Tim R.
    Duan, Leilei
    Chinese Ctr Dis Control & Prevent, Natl Ctr Chron & Noncommun Dis Control & Prevent, Beijing, Peoples R China..
    Dubey, Manisha
    Duncan, Bruce Bartholow
    Ebrahimi, Hedyeh
    Endries, Aman Yesuf
    Ermakov, Sergey Petrovich
    Erskine, Holly E.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA.;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia..
    Eshrati, Babak
    Esteghamati, Alireza
    Fahimi, Saman
    Farid, Talha A.
    Farinha, Carla Sofia e Sa
    Faro, Andre
    Farvid, Maryam S.
    Harvard Univ, Harvard TH Chan Sch Publ Hlth, Boston, MA 02115 USA..
    Farzadfar, Farshad
    Feigin, Valery L.
    Felicio, Manuela Mendonca
    Fereshtehnejad, Seyed-Mohammad
    Fernandes, Jefferson G.
    Fernandes, Joao C.
    Ferrari, Alize J.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA.;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia..
    Fischer, Florian
    Fitchett, Joseph R. A.
    Harvard Univ, Boston, MA 02115 USA..
    Fitzmaurice, Christina
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Foigt, Nataliya
    Foreman, Kyle
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Fowkes, F. Gerry R.
    Franca, Elisabeth Barboza
    Franklin, Richard C.
    Fraser, Maya
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Friedman, Joseph
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Frostad, Joseph
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Furst, Thomas
    Swiss Trop & Publ Hlth Inst, Dept Epidemiol & Publ Hlth, Basel, Switzerland..
    Gabbe, Belinda
    Monash Univ, Sch Publ Hlth & Prevent Med, Melbourne, Vic, Australia..
    Garcia-Basteiro, Alberto L.
    Gebre, Teshome
    Gebrehiwot, Tsegaye Tewelde
    Jimma Univ, Jimma, Ethiopia..
    Gebremedhin, Amanuel Tesfay
    Jimma Univ, Jimma, Ethiopia..
    Gebru, Alemseged Aregay
    Mekelle Univ, Mekelle, Ethiopia..
    Gessner, Bradford D.
    Gillum, Richard F.
    Ginawi, Ibrahim Abdelmageem Mohamed
    Giref, Ababi Zergaw
    Giroud, Maurice
    Gishu, Melkamu Dedefo
    Godwin, William
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Gona, Philimon
    Goodridge, Amador
    Gopalani, Sameer Vali
    Gotay, Carolyn C.
    Univ British Columbia, Vancouver, BC, Canada..
    Goto, Atsushi
    Gouda, Hebe N.
    Univ Queensland, Brisbane, Qld, Australia..
    Graetz, Nicholas
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Greenwell, Karen Fern
    Griswold, Max
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Guo, Yuming
    Univ Queensland, Brisbane, Qld, Australia..
    Gupta, Rahul
    Gupta, Rajeev
    Gupta, Vipin
    Gutierrez, Reyna A.
    Gyawali, Bishal
    Haagsma, Juanita A.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Haakenstad, Annie
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA.;Harvard Univ, Harvard TH Chan Sch Publ Hlth, Boston, MA 02115 USA..
    Hafezi-Nejad, Nima
    Haile, Demewoz
    Hailu, Gessessew Bugssa
    Mekelle Univ, Mekelle, Ethiopia..
    Halasa, Yara A.
    Hamadeh, Randah Ribhi
    Hamidi, Samer
    Hammami, Mouhanad
    Hankey, Graeme J.
    Harb, Hilda L.
    Minist Publ Hlth, Beirut, Lebanon..
    Haro, Josep Maria
    Hassanvand, Mohammad Sadegh
    Havmoeller, Rasmus
    Heredia-Pi, Ileana Beatriz
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Hoek, Hans W.
    Horino, Masako
    Horita, Nobuyuki
    Hosgood, H. Dean
    Hoy, Damian G.
    Htet, Aung Soe
    Univ Oslo, Oslo, Norway..
    Hu, Guoqing
    Huang, Hsiang
    Iburg, Kim Moesgaard
    Idrisov, Bulat T.
    Inoue, Manami
    Islami, Farhad
    Jacobs, Troy A.
    Jacobsen, Kathryn H.
    Jahanmehr, Nader
    Jakovljevic, Mihajlo B.
    James, Peter
    Harvard Univ, Dept Epidemiol, Boston, MA 02115 USA.;Harvard Univ, Channing Div Network Med, Brigham & Womens Hosp, Harvard Med Sch, Boston, MA 02115 USA..
    Jansen, Henrica A. F. M.
    Javanbakht, Mehdi
    Jayatilleke, Achala Upendra
    Jee, Sun Ha
    Jeemon, Panniyammakal
    Publ Hlth Fdn India, Ctr Control Chron Condit, New Delhi, India..
    Jha, Vivekanand
    Univ Oxford, Oxford, England..
    Jiang, Ying
    Jibat, Tariku
    Jin, Ye
    Chinese Ctr Dis Control & Prevent, Natl Ctr Chron & Noncommun Dis Control & Prevent, Beijing, Peoples R China..
    Jonas, Jost B.
    Kabir, Zubair
    Kalkonde, Yogeshwar
    Kamal, Ritul
    Kan, Haidong
    Kandel, Amit
    Karch, Andre
    Karema, Corine Kakizi
    Swiss Trop & Publ Hlth Inst, Basel, Switzerland..
    KarimIchani, Chante
    Karunapema, Palitha
    Kasaeian, Amir
    Kassebaum, Nicholas J.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Kaul, Anil
    Kawakami, Norito
    Kayibanda, Jeanne Francoise
    Keiyoro, Peter Njenga
    Kemmer, Laura
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Kemp, Andrew Haddon
    Kengne, Andre Pascal
    Keren, Andre
    Kesavachandran, Chandrasekharan Nair
    Khader, Yousef Saleh
    Khan, Abdur Rahman
    Khan, Ejaz Ahmad
    Khan, Gulfaraz
    Khang, Young-Ho
    Khoja, Tawfik Ahmed Muthafer
    Khosravi, Ardeshir
    Khubchandani, Jagdish
    Kieling, Christian
    Kim, Cho-il
    Kim, Daniel
    Kim, Sungroul
    Kim, Yun Jin
    Kimokoti, Ruth W.
    Kissoon, Niranjan
    Univ British Columbia, Vancouver, BC, Canada..
    Kivipelto, Miia
    Knibbs, Luke D.
    Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia..
    Kokubo, Yoshihiro
    Kolte, Dhaval
    Kosen, Soewarta
    Kotsakis, Georgios A.
    Univ Washington, Sch Dent, Seattle, WA 98121 USA..
    Koul, Parvaiz A.
    Koyanagi, Ai
    Kravchenko, Michael
    Krueger, Hans
    Univ British Columbia, Sch Populat & Publ Hlth, Vancouver, BC, Canada..
    Defo, Barthelemy Kuate
    Kuchenbecker, Ricardo S.
    Kuipers, Ernst J.
    Kulikoff, Xie Rachel
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Kulkarni, Veena S.
    Kumar, G. Anil
    Publ Hlth Fdn India, New Delhi, India..
    Kwan, Gene F.
    Kyu, Hmwe H.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Lal, Aparna
    Lal, Dharmesh Kumar
    Lalloo, Ratilal
    Univ Queensland, Sch Dent, Brisbane, Qld, Australia..
    Lam, Hilton
    Lan, Qing
    Langan, Sinead M.
    London Sch Hyg & Trop Med, London, England..
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Laryea, Dennis Odai
    Latif, Asma Abdul
    Leasher, Janet L.
    Leigh, James
    Leinsalu, Mall
    Leung, Janni
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA.;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia..
    Leung, Ricky
    Levi, Miriam
    Li, Yichong
    Li, Yongmei
    Lind, Margaret
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Linn, Shai
    Lipshultz, Steven E.
    Liu, Patrick Y.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Liu, Shiwei
    Chinese Ctr Dis Control & Prevent, Natl Ctr Chron & Noncommun Dis Control & Prevent, Beijing, Peoples R China..
    Liu, Yang
    Chinese Ctr Dis Control & Prevent, Natl Ctr Chron & Noncommun Dis Control & Prevent, Beijing, Peoples R China..
    Lloyd, Belinda K.
    Lo, Loon-Tzian
    Logroscino, Giancarlo
    Lotufo, Paulo A.
    Univ Sao Paulo, Sao Paulo, Brazil..
    Lucas, Robyn M.
    Lunevicius, Raimundas
    Abd El Razek, Mohammed Magdy
    Magis-Rodriguez, Carlos
    Mandavi, Mandi
    Majdan, Marek
    Trnava Univ, Dept Publ Hlth, Fac Hlth Sci & Social Work, Trnava, Slovakia..
    Majeed, Azeem
    Malekzadeh, Reza
    Malta, Deborah Carvalho
    Mapoma, Chabila C.
    Margolis, David Joel
    Martin, Randall V.
    Dalhousie Univ, Halifax, NS, Canada..
    Martinez-Raga, Jose
    Masiye, Felix
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Mason-Jones, Amanda J.
    Massano, Joao
    Matzopoulos, Richard
    Mayosi, Bongani M.
    McGrath, John J.
    Univ Queensland, Brisbane, Qld, Australia..
    McKee, Martin
    London Sch Hyg & Trop Med, London, England..
    Meaney, Peter A.
    Mehari, Alem
    Mekonnen, Alemayehu B.
    Melaku, Yohannes Adama
    Mekelle Univ, Sch Publ Hlth, Mekelle, Ethiopia.;Univ Adelaide, Sch Med, Adelaide, SA, Australia..
    Memiah, Peter
    Memish, Ziad A.
    Mendoza, Walter
    Mensink, Gert B. M.
    Meretoja, Atte
    Univ Melbourne, Dept Med, Melbourne, Vic, Australia..
    Meretoja, Tuomo J.
    Mesfin, Yonatan Moges
    Haramaya Univ, Harar, Ethiopia..
    Mhimbira, Francis Apolinary
    Micha, Renata
    Tufts Univ, Friedman Sch Nutr Sci & Policy, Boston, MA 02111 USA..
    Miller, Ted R.
    Mills, Edward J.
    Mirarefin, Mojde
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Misganaw, Awoke
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Mitchell, Philip B.
    Mock, Charles N.
    Univ Washington, Harborview Injury Prevent & Res Ctr, Seattle, WA 98121 USA..
    Mohammadi, Alireza
    Mohammed, Shafiu
    Heidelberg Univ, Inst Publ Hlth, Heidelberg, Germany..
    Monasta, Lorenzo
    Monis, Jonathan de la Cruz
    Hernandez, Julio Cesar Montanez
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Montico, Marcella
    Moradi-Lakeh, Maziar
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Morawska, Lidia
    Mori, Rintaro
    Mueller, Ulrich O.
    Murdoch, Michele E.
    Murimira, Brighton
    Murray, Joseph
    Murthy, Gudlavalleti Venkata Satyanarayana
    London Sch Hyg & Trop Med, London, England..
    Murthy, Srinivas
    Univ British Columbia, Vancouver, BC, Canada..
    Musa, Kamarul Imran
    Nachega, Jean B.
    Nagel, Gabriele
    Naidoo, Kovin S.
    Naldi, Luigi
    Nangia, Vinay
    Neal, Bruce
    Nejjari, Chakib
    Newton, Charles R.
    Newton, John N.
    Ngalesoni, Frida Namnyak
    Nguhiu, Peter
    Nguyen, Grant
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Nguyen, Quyen Le
    Nisar, Muhammad Imran
    Aga Khan Univ, Karachi, Pakistan..
    Pete, Patrick Martial Nkamedjie
    Nolte, Sandra
    Nomura, Marika
    Norheim, Ole F.
    Norrving, Bo
    Obermeyer, Carla Makhlouf
    Ogbo, Felix Akpojene
    Oh, In-Hwan
    Oladimeji, Olanrewaju
    Olivares, Pedro R.
    Olusanya, Bolajoko Olubukunola
    Olusanya, Jacob Olusegun
    Opio, John Nelson
    Oren, Eyal
    Ortiz, Alberto
    Osborne, Richard H.
    Ota, Erika
    Owolabi, Mayowa O.
    Univ Ibadan, Dept Med, Ibadan, Nigeria..
    Mahesh, P. A.
    Park, Eun-Kee
    Park, Hye-Youn
    Parry, Charles D.
    Parsaeian, Mahboubeh
    Patel, Tejas
    Patel, Vikram
    London Sch Hyg & Trop Med, Ctr Global Mental Hlth, London, England..
    Caicedo, Angel J. Paternina
    Univ Cartagena, Cartagena, Colombia..
    Patil, Snehal T.
    Patten, Scott B.
    Patton, George C.
    Univ Melbourne, Murdoch Childrens Res Inst, Melbourne, Vic, Australia..
    Paudel, Deepak
    Pedro, Joao Mario
    Pereira, David M.
    Perico, Norberto
    Pesudovs, Konrad
    Petzold, Max
    Phillips, Michael Robert
    Piel, Frederic B.
    Pillay, Julian David
    Pinho, Christine
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Pishgar, Farhad
    Polinder, Suzanne
    Poulton, Richie G.
    Pourmalek, Farshad
    Univ British Columbia, Vancouver, BC, Canada..
    Qorbani, Mostafa
    Rabiee, Rynaz H. S.
    Radfar, Amir
    Rahimi-Movaghar, Vafa
    Rahman, Mahfuzar
    Rahman, Mohammad Hifz Ur
    Rahman, Sajjad Ur
    Rai, Rajesh Kumar
    Rajsic, Sasa
    Raju, Murugesan
    Ram, Usha
    Rana, Saleem M.
    Ranabhat, Chhabi Lal
    Ranganathan, Kavitha
    Rao, Puja C.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Refaat, Amany H.
    Reitsma, Marissa B.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Remuzzi, Giuseppe
    Resnikoff, Serge
    Ribeiro, Antonio L.
    Blancas, Maria Jesus Rios
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Rolm, Hirbo Shore
    Roberts, Bayard
    London Sch Hyg & Trop Med, London, England..
    Rodriguez, Mina
    Rojas-Rueda, David
    Ronfani, Luca
    Roshandel, Gholamreza
    Roth, Gregory A.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Rothenbacher, Dietrich
    Roy, Ambuj
    Roy, Nobhojit
    Sackey, Ben Benasco
    Sagar, Rajesh
    Saleh, Muhammad Muhammad
    Sanabria, Juan R.
    Santomauro, Damian F.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA.;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia..
    Santos, Itamar S.
    Univ Sao Paulo, Dept Internal Med, Sao Paulo, Brazil..
    Sarmiento-Suarez, Rodrigo
    Sartorius, Benn
    Satpathy, Maheswar
    Savic, Miloje
    Sawhney, Monika
    Sawyer, Susan M.
    Univ Melbourne, Dept Pediat, Melbourne, Vic, Australia..
    Schmidhuber, Josef
    Schmidt, Maria Ines
    Schneider, Ione J. C.
    Schutte, Aletta E.
    Schwebel, David C.
    Seedat, Soraya
    Sepanlou, Sadaf G.
    Servan-Mori, Edson E.
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Shackelford, Katya
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Shaheen, Amira
    Shaikh, Masood Ali
    Levy, Teresa Shamah
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Sharma, Rajesh
    She, Jun
    Sheikhbahaei, Sara
    Shen, Jiabin
    Sheth, Kevin N.
    Shey, Muki
    Shi, Peilin
    Tufts Univ, Boston, MA 02111 USA..
    Shibuya, Kenji
    Shigematsu, Mika
    Shin, Min-Jeong
    Shiri, Rahman
    Shishani, Kawkab
    Shiue, Ivy
    Sigfusdottir, Inga Dora
    Silpakit, Naris
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Silva, Diego Augusto Santos
    Silverberg, Jonathan I.
    Simard, Edgar P.
    Sindi, Shireen
    Singh, Abhishek
    Singh, Gitanjali M.
    Tufts Univ, Boston, MA 02111 USA..
    Singh, Jasvinder A.
    Singh, Om Prakash
    Singh, Prashant Kumar
    Skirbekk, Vegard
    Sligar, Amber
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Soneji, Samir
    Dartmouth Coll, Hanover, NH 03755 USA..
    Soreide, Kjetil
    Sorensen, Reed J. D.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Soriano, Joan B.
    Soshnikov, Sergey
    Sposato, Luciano A.
    Sreeramareddy, Chandrashekhar T.
    Stahl, Hans-Christian
    Stanaway, Jeffrey D.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Stathopoulou, Vasiliki
    Steckling, Nadine
    Steel, Nicholas
    Stein, Dan J.
    Steiner, Caitlyn
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Stockl, Heidi
    London Sch Hyg & Trop Med, London, England..
    Stranges, Saverio
    Strong, Mark
    Sun, Jiandong
    Sunguya, Bruno F.
    Sur, Patrick
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Swaminathan, Soumya
    Sykes, Bryan L.
    Szoeke, Cassandra E. I.
    Univ Melbourne, Inst Hlth & Ageing, Melbourne, Vic, Australia..
    Tabares-Seisdedos, Rafael
    Tabb, Karen M.
    Talongwa, Roberto Tchio
    Tarawneh, Mohammed Rasoul
    Tavakkoli, Mohammad
    Taye, Bineyam
    Taylor, Hugh R.
    Univ Melbourne, Melbourne, Vic, Australia..
    Tedla, Bemnet Amare
    Tefera, Worku
    Tegegne, Teketo Kassaw
    Debre Markos Univ, Debre Markos, Ethiopia..
    Tekle, Dejen Yemane
    Mekelle Univ, Mekelle, Ethiopia..
    Shifa, Girma Temam
    Terkawi, Abdullah Sulieman
    Tessema, Gizachew Assefa
    Univ Adelaide, Adelaide, SA, Australia..
    Thakur, J. S.
    Thomson, Alan J.
    Thorne-Lyman, Andrew L.
    Harvard Univ, Dept Nutr, Harvard TH Chan Sch Publ Hlth, Boston, MA 02115 USA..
    Thrift, Amanda G.
    Monash Univ, Dept Med, Sch Clin Sci, Monash Hlth, Melbourne, Vic, Australia..
    Thurston, George D.
    Tillmann, Taavi
    UCL, Dept Epidemiol & Publ Hlth, London, England..
    Tobe-Gai, Ruoyan
    Tonelli, Marcelo
    Topor-Madry, Roman
    Topouzis, Fotis
    Tran, Bach Xuan
    Dimbuene, Zacharie Tsala
    Tura, Abera Kenay
    Tuzcu, Emin Murat
    Tyrovolas, Stefanos
    Ukwaja, Kingsley Nnanna
    Undurraga, Eduardo A.
    Uneke, Chigozie Jesse
    Uthman, Olalekan A.
    van Donkelaar, Aaron
    Dalhousie Univ, Dept Phys & Atmospher Sci, Halifax, NS, Canada..
    Varakin, Yuri Y.
    Vasankari, Tommi
    Vasconcelos, Ana Maria Nogales
    Veerman, J. Lennert
    Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia..
    Venketasubramanian, Narayanaswamy
    Verma, Raj Kumar
    Violante, Francesco S.
    Vlassov, Vasiliy Victorovich
    Volkow, Patricia
    Vollset, Stein Emil
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Wagner, Gregory R.
    Harvard Univ, Harvard TH Chan Sch Publ Hlth, Boston, MA 02115 USA..
    Wallin, Mitchell T.
    Wang, Linhong
    Chinese Ctr Dis Control & Prevent, Natl Ctr Chron & Noncommun Dis Control & Prevent, Beijing, Peoples R China..
    Wanga, Valentine
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Watkins, David A.
    Univ Washington, Seattle, WA 98121 USA..
    Weichenthal, Scott
    Weiderpass, Elisabete
    Weintraub, Robert G.
    Univ Melbourne, Murdoch Childrens Res Inst, Melbourne, Vic, Australia.;Univ Melbourne, Melbourne, Vic, Australia..
    Weiss, Daniel J.
    Univ Oxford, Oxford, England..
    Werdecker, Andrea
    Westerman, Ronny
    Whiteford, Harvey A.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA.;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia..
    Wilkinson, James D.
    Wiysonge, Charles Shey
    Wolfe, Charles D. A.
    Kings Coll London, Div Hlth & Social Care Res, London, England..
    Wolfe, Ingrid
    Kings Coll London, London, England..
    Won, Sungho
    Woolf, Anthony D.
    Workie, Shimelash Bitew
    Wubshet, Mamo
    Xu, Gelin
    Yadav, Ajit Kumar
    Yakob, Bereket
    Yalew, Ayalnesh Zemene
    Mekelle Univ, Mekelle, Ethiopia..
    Yan, Lijing L.
    Yano, Yuichiro
    Yaseri, Mehdi
    Ye, Pengpeng
    Chinese Ctr Dis Control & Prevent, Natl Ctr Chron & Noncommun Dis Control & Prevent, Beijing, Peoples R China..
    Yip, Paul
    Univ Hong Kong, Social Work & Social Adm Dept, Hong Kong, Hong Kong, Peoples R China.;Univ Hong Kong, Hong Kong Jockey Club Ctr Suicide Res & Prevent, Hong Kong, Hong Kong, Peoples R China..
    Yonemoto, Naohiro
    Kyoto Univ, Sch Publ Hlth, Dept Biostat, Kyoto, Japan..
    Yoon, Seok-Jun
    Younis, Mustafa Z.
    Jackson State Univ, Jackson, MS USA..
    Yu, Chuanhua
    Zaidi, Zoubida
    Zaki, Maysaa El Sayed
    Zambrana-Torrelio, Carlos
    Zapata, Tomas
    Zegeye, Elias Asfaw
    Ethiopian Publ Hlth Inst, Addis Ababa, Ethiopia..
    Zhao, Yi
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Zhou, Maigeng
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA.;Chinese Ctr Dis Control & Prevent, Natl Ctr Chron & Noncommun Dis Control & Prevent, Beijing, Peoples R China..
    Zodpey, Sanjay
    Zonies, David
    Oregon Hlth & Sci Univ, Portland, OR 97201 USA..
    Murray, Christopher J. L.
    Univ Washington, Inst Hlth Metr & Evaluat, 2301 5th Ave,Suite 600, Seattle, WA 98121 USA..
    Measuring the health-related Sustainable Development Goals in 188 countries: a baseline analysis from the Global Burden of Disease Study 20152016In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 388, no 10053, p. 1813-1850Article in journal (Refereed)
    Abstract [en]

    Background

    In September, 2015, the UN General Assembly established the Sustainable Development Goals (SDGs). The SDGs specify 17 universal goals, 169 targets, and 230 indicators leading up to 2030. We provide an analysis of 33 health-related SDG indicators based on the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015).

    Methods

    We applied statistical methods to systematically compiled data to estimate the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. We rescaled each indicator on a scale from 0 (worst observed value between 1990 and 2015) to 100 (best observed). Indices representing all 33 health-related SDG indicators (health-related SDG index), health-related SDG indicators included in the Millennium Development Goals (MDG index), and health-related indicators not included in the MDGs (non-MDG index) were computed as the geometric mean of the rescaled indicators by SDG target. We used spline regressions to examine the relations between the Socio-demographic Index (SDI, a summary measure based on average income per person, educational attainment, and total fertility rate) and each of the health-related SDG indicators and indices.

    Findings

    In 2015, the median health-related SDG index was 59.3 (95% uncertainty interval 56.8-61.8) and varied widely by country, ranging from 85.5 (84.2-86.5) in Iceland to 20.4 (15.4-24.9) in Central African Republic. SDI was a good predictor of the health-related SDG index (r(2) = 0.88) and the MDG index (r(2) = 0.2), whereas the non-MDG index had a weaker relation with SDI (r(2) = 0.79). Between 2000 and 2015, the health-related SDG index improved by a median of 7.9 (IQR 5.0-10.4), and gains on the MDG index (a median change of 10.0 [6.7-13.1]) exceeded that of the non-MDG index (a median change of 5.5 [2.1-8.9]). Since 2000, pronounced progress occurred for indicators such as met need with modern contraception, under-5 mortality, and neonatal mortality, as well as the indicator for universal health coverage tracer interventions. Moderate improvements were found for indicators such as HIV and tuberculosis incidence, minimal changes for hepatitis B incidence took place, and childhood overweight considerably worsened.

    Interpretation

    GBD provides an independent, comparable avenue for monitoring progress towards the health-related SDGs. Our analysis not only highlights the importance of income, education, and fertility as drivers of health improvement but also emphasises that investments in these areas alone will not be sufficient. Although considerable progress on the health-related MDG indicators has been made, these gains will need to be sustained and, in many cases, accelerated to achieve the ambitious SDG targets. The minimal improvement in or worsening of health-related indicators beyond the MDGs highlight the need for additional resources to effectively address the expanded scope of the health-related SDGs.

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    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    A combined test of acetylcholine-mediated vasodilation of both the forearm resistance vessels and the radial artery2013In: Clinical Physiology and Functional Imaging, ISSN 1475-0961, E-ISSN 1475-097X, Vol. 33, no 3, p. 206-210Article in journal (Refereed)
    Abstract [en]

    Objective To evaluate a new combined test of endothelium-dependent vasodilation (EDV) in the forearm resistance vessel and the radial artery. Methods Acetylcholine (ACh) and sodium nitroprusside (SNP) infusion in the brachial artery were used to simultaneous evaluate EDV and endothelium-independent vasodilation (EIDV) in forearm resistance vessels (plethysmography) and in the radial artery (ultrasound) in 76 healthy subjects. Brachial artery ultrasound was used to assess flow-mediated vasodilation (FMD). Results Acetylcholine induced a 4 center dot 5% (median value, P=0 center dot 0010) increase in the radial artery diameter, while SNP induced a 31 center dot 2% increase in diameter (P<0 center dot 0001). While no increase in radial artery blood flow was induced by ACh (P=0 center dot 69), an increase by 181% in radial blood flow was induced by SNP (P<0 center dot 0001). When relating the radial artery diameter data to FMD, the change in radial artery diameter induced by ACh was significantly correlated with FMD (r=0 center dot 35, P=0 center dot 013). No such relationship was seen for the diameter change induced by SNP (r=0 center dot 03, P=0 center dot 81). When relating the radial artery blood flow data to EDV and EIDV, the change in radial artery blood flow induced by ACh was significantly correlated with EDV in an inverse fashion (r=0 center dot 42, P=0 center dot 0032). No such relationship was seen for the blood flow change induced by SNP when related to EIDV (r=0 center dot 07, P=0 center dot 63). Conclusion Simultaneous measurements of blood flow in forearm vessels by plethysmography and in the radial artery by ultrasound during ACh infusion is a new way to assess EDV in both resistance and conduit arteries during one investigation.

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