135 results on '"Rehm C"'
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2. Validating self-reported food expenditures against food store and eating-out receipts
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Tang, W, Aggarwal, A, Liu, Z, Acheson, M, Rehm, C D, Moudon, A V, and Drewnowski, A
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- 2016
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3. Socio-demographic correlates and trends in low-calorie sweetener use among adults in the United States from 1999 to 2008
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Drewnowski, A and Rehm, C D
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- 2015
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4. The relation of potassium and sodium intakes to diet cost among US adults
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Drewnowski, A, Rehm, C D, Maillot, M, and Monsivais, P
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- 2015
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5. Short-Course Raltegravir Intensification Does Not Reduce Persistent Low-Level Viremia in Patients with HIV-1 Suppression during Receipt of Combination Antiretroviral Therapy
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McMahon, D., Jones, J., Wiegand, A., Gange, S. J., Kearney, M., Palmer, S., McNulty, S., Metcalf, J. A., Acosta, E., Rehm, C., Coffin, J. M., Mellors, J. W., and Maldarelli, F.
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- 2010
6. Treatment Intensification Does Not Reduce Residual HIV-1 Viremia in Patients on Highly Active Antiretroviral Therapy
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Dinoso, J. B., Kim, S. Y., Wiegand, A. M., Palmer, S. E., Gange, S. J., Cranmer, L., O'Shea, A., Callender, M., Spivak, A., Brennan, T., Kearney, M. F., Proschan, M. A., Mican, J. M., Rehm, C. A., Mellors, J. W., Siliciano, R. F., Maldarelli, F., and Coffin, J. M.
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- 2009
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7. Phase space optimisation of the USANS instrument Kookaburra at the ANSTO OPAL reactor
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Freund, A.K. and Rehm, C.
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- 2011
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8. Gene Expression Profiles in Hepatitis C Virus (HCV) and HIV Coinfection: Class Prediction Analyses before Treatment Predict the Outcome of Anti-HCV Therapy among HIV-Coinfected Persons
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Lempicki, R. A., Polis, M. A., Yang, J., McLaughlin, M., Koratich, C., Huang, D. W., Fullmer, B., Wu, L., Rehm, C. A., Masur, H., Lane, H. C., Sherman, K. E., Fauci, A. S., and Kottilil, S.
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- 2006
9. The geographic distribution of obesity by census tract among 59 767 insured adults in King County, WA
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Drewnowski, A, Rehm, C D, and Arterburn, D
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- 2014
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10. A new dynamical diffraction-based technique of residual stress measurements in thin films
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Agamalian, M., Iolin, E., Kaiser, H., Rehm, C., and Werner, S.A.
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- 2002
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11. Trends in Vitamin C Consumption in the United States
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Rehm, C., Dekker, M., and Boileau, T.
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- 2020
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12. A very low intensity ion beam detector system.
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Zinkann, G. P., Clifft, B. E., Nolen, J. A., Pardo, R. C., Rehm, C. E., and Shen, W. Q.
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- 1999
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13. White Potatoes Are among the Most Affordable Sources of Potassium in the American Diet
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Drewnowski, A. and Rehm, C.
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- 2011
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14. A VERSATILE AUTOMATED SYSTEM FOR THE SPECTROPHOTOMETRIC ANALYSIS OF SINGLE TABLETS.
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Rehm, C. R., Urbanyi, T., and Slone, T. J.
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- 1968
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15. Arterial roads and area socioeconomic status are predictors of fast food restaurant density in King County, WA
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Streichert Laura C, Rehm Colin D, Moudon Anne V, Hurvitz Philip M, and Drewnowski Adam
- Subjects
Nutritional diseases. Deficiency diseases ,RC620-627 ,Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Fast food restaurants reportedly target specific populations by locating in lower-income and in minority neighborhoods. Physical proximity to fast food restaurants has been associated with higher obesity rates. Objective To examine possible associations, at the census tract level, between area demographics, arterial road density, and fast food restaurant density in King County, WA, USA. Methods Data on median household incomes, property values, and race/ethnicity were obtained from King County and from US Census data. Fast food restaurant addresses were obtained from Public Health-Seattle & King County and were geocoded. Fast food density was expressed per tract unit area and per capita. Arterial road density was a measure of vehicular and pedestrian access. Multivariate logistic regression models containing both socioeconomic status and road density were used in data analyses. Results Over one half (53.1%) of King County census tracts had at least one fast food restaurant. Mean network distance from dwelling units to a fast food restaurant countywide was 1.40 km, and 1.07 km for census tracts containing at least one fast food restaurant. Fast food restaurant density was significantly associated in regression models with low median household income (p < 0.001) and high arterial road density (p < 0.001) but not with percent of residents who were nonwhite. Conclusion No significant association was observed between census tract minority status and fast food density in King County. Although restaurant density was linked to low household incomes, that effect was attenuated by arterial road density. Fast food restaurants in King County are more likely to be located in lower income neighborhoods and higher traffic areas.
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- 2009
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16. Oxidation reactions of indapamide. A novel route to the indole derivative, N-(3-sulfamyl-4-chlorobenzamido)-2-methylindole.
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O'Hare, M. J., Tan, E., Rehm, C., Grebow, P., Loev, B., and Neiss, E.
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- 1983
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17. Effect of crystal shape on neutron rocking curves of perfect single crystals designed for ultra-small-angle scattering experiments.
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Freund, A K and Rehm, C
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- 2014
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18. ChemInform Abstract: Improved Preparation of 3,4-Dimethoxythiophene (V).
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MERZ, A. and REHM, C.
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- 1997
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19. Flux Gain for Next-Generation Neutron-Scattering Instruments Resulting From Improved Supermirror Performance
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Rehm, C
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- 2001
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20. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017
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Stanaway, Jeffrey D., Afshin, Ashkan, Gakidou, Emmanuela, Lim, Stephen S., Abate, Degu, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abbasi, Nooshin, Abbastabar, Hedayat, Abd-Allah, Foad, Abdela, Jemal, Abdelalim, Ahmed, Abdollahpour, Ibrahim, Abdulkader, Rizwan Suliankatchi, Abebe, Molla, Abebe, Zegeye, Abera, Semaw F., Abil, Olifan Zewdie, Abraha, Haftom Niguse, Abrham, Aklilu Roba, Abu-Raddad, Laith Jamal, Abu-Rmeileh, Niveen ME, Accrombessi, Manfred Mario Kokou, Acharya, Dilaram, Acharya, Pawan, Adamu, Abdu A., Adane, Akilew Awoke, Adebayo, Oladimeji M., Adedoyin, Rufus Adesoji, Adekanmbi, Victor, Ademi, Zanfina, Adetokunboh, Olatunji O., Adib, Mina G., Admasie, Amha, Adsuar, Jose C., Afanvi, Kossivi Agbelenko, Afarideh, Mohsen, Agarwal, Gina, Aggarwal, Anju, Aghayan, Sargis Aghasi, Agrawal, Anurag, Agrawal, Sutapa, Ahmadi, Alireza, Ahmadi, Mehdi, Ahmadieh, Hamid, Ahmed, Muktar Beshir, Aichour, Amani Nidhal, Aichour, Ibtihel, Aichour, Miloud Taki Eddine, Akbari, Mohammad Esmaeil, Akinyemiju, Tomi, Akseer, Nadia, Al-Aly, Ziyad, Al-Eyadhy, Ayman, Al-Mekhlafi, Hesham M., Alahdab, Fares, Alam, Khurshid, Alam, Samiah, Alam, Tahiya, Alashi, Alaa, Alavian, Seyed Moayed, Alene, Kefyalew Addis, Ali, Komal, Ali, Syed Mustafa, Alijanzadeh, Mehran, Alizadeh-Navaei, Reza, Aljunid, Syed Mohamed, Alkerwi, Ala'a, Alla, François, Alsharif, Ubai, Altirkawi, Khalid, Alvis-Guzman, Nelson, Amare, Azmeraw T., Ammar, Walid, Anber, Nahla Hamed, Anderson, Jason A., Andrei, Catalina Liliana, Androudi, Sofia, Animut, Megbaru Debalkie, Anjomshoa, Mina, Ansha, Mustafa Geleto, Antó, Josep M., Antonio, Carl Abelardo T., Anwari, Palwasha, Appiah, Lambert Tetteh, Appiah, Seth Christopher Yaw, Arabloo, Jalal, Aremu, Olatunde, Ärnlöv, Johan, Artaman, Al, Aryal, Krishna K., Asayesh, Hamid, Ataro, Zerihun, Ausloos, Marcel, Avokpaho, Euripide F.G.A., Awasthi, Ashish, Ayala Quintanilla, Beatriz Paulina, Ayer, Rakesh, Ayuk, Tambe B., Azzopardi, Peter S., Babazadeh, Arefeh, Badali, Hamid, Badawi, Alaa, Balakrishnan, Kalpana, Bali, Ayele Geleto, Ball, Kylie, Ballew, Shoshana H., Banach, Maciej, Banoub, Joseph Adel Mattar, Barac, Aleksandra, Barker-Collo, Suzanne Lyn, Bärnighausen, Till Winfried, Barrero, Lope H., Basu, Sanjay, Baune, Bernhard T., Bazargan-Hejazi, Shahrzad, Bedi, Neeraj, Beghi, Ettore, Behzadifar, Masoud, Behzadifar, Meysam, Béjot, Yannick, Bekele, Bayu Begashaw, Bekru, Eyasu Tamru, Belay, Ezra, Belay, Yihalem Abebe, Bell, Michelle L., Bello, Aminu K., Bennett, Derrick A., Bensenor, Isabela M., Bergeron, Gilles, Berhane, Adugnaw, Bernabe, Eduardo, Bernstein, Robert S., Beuran, Mircea, Beyranvand, Tina, Bhala, Neeraj, Bhalla, Ashish, Bhattarai, Suraj, Bhutta, Zulfiqar A., Biadgo, Belete, Bijani, Ali, Bikbov, Boris, Bilano, Ver, Bililign, Nigus, Bin Sayeed, Muhammad Shahdaat, Bisanzio, Donal, Biswas, Tuhin, Bjørge, Tone, Blacker, Brigette F., Bleyer, Archie, Borschmann, Rohan, Bou-Orm, Ibrahim R., Boufous, Soufiane, Bourne, Rupert, Brady, Oliver J., Brauer, Michael, Brazinova, Alexandra, Breitborde, Nicholas J.K., Brenner, Hermann, Briko, Andrey Nikolaevich, Britton, Gabrielle, Brugha, Traolach, Buchbinder, Rachelle, Burnett, Richard T., Busse, Reinhard, Butt, Zahid A., Cahill, Leah E., Cahuana-Hurtado, Lucero, Campos-Nonato, Ismael R., Cárdenas, Rosario, Carreras, Giulia, Carrero, Juan J., Carvalho, Félix, Castañeda-Orjuela, Carlos A., Castillo Rivas, Jacqueline, Castro, Franz, Catalá-López, Ferrán, Causey, Kate, Cercy, Kelly M., Cerin, Ester, Chaiah, Yazan, Chang, Hsing Yi, Chang, Jung Chen, Chang, Kai Lan, Charlson, Fiona J., Chattopadhyay, Aparajita, Chattu, Vijay Kumar, Chee, Miao Li, Cheng, Ching Yu, Chew, Adrienne, Chiang, Peggy Pei Chia, Chimed-Ochir, Odgerel, Chin, Ken Lee, Chitheer, Abdulaal, Choi, Jee Young J., Chowdhury, Rajiv, Christensen, Hanne, Christopher, Devasahayam J., Chung, Sheng Chia, Cicuttini, Flavia M., Cirillo, Massimo, Cohen, Aaron J., Collado-Mateo, Daniel, Cooper, Cyrus, Cooper, Owen R., Coresh, Josef, Cornaby, Leslie, Cortesi, Paolo Angelo, Cortinovis, Monica, Costa, Megan, Cousin, Ewerton, Criqui, Michael H., Cromwell, Elizabeth A., Cundiff, David K., Daba, Alemneh Kabeta, Dachew, Berihun Assefa, Dadi, Abel Fekadu, Damasceno, Albertino Antonio Moura, Dandona, Lalit, Dandona, Rakhi, Darby, Sarah C., Dargan, Paul I., Daryani, Ahmad, Das Gupta, Rajat, Das Neves, José, Dasa, Tamirat Tesfaye, Dash, Aditya Prasad, Davitoiu, Dragos Virgil, Davletov, Kairat, De la Cruz-Góngora, Vanessa, De La Hoz, Fernando Pio, De Leo, Diego, De Neve, Jan Walter, Degenhardt, Louisa, Deiparine, Selina, Dellavalle, Robert P., Demoz, Gebre Teklemariam, Denova-Gutiérrez, Edgar, Deribe, Kebede, Dervenis, Nikolaos, Deshpande, Aniruddha, Des Jarlais, Don C., Dessie, Getenet Ayalew, Deveber, Gabrielle Aline, Dey, Subhojit, Dharmaratne, Samath Dhamminda, Dhimal, Meghnath, Dinberu, Mesfin Tadese, Ding, Eric L., Diro, Helen Derara, Djalalinia, Shirin, Do, Huyen Phuc, Dokova, Klara, Doku, David Teye, Doyle, Kerrie E., Driscoll, Tim R., Dubey, Manisha, Dubljanin, Eleonora, Duken, Eyasu Ejeta, Duncan, Bruce B., Duraes, Andre R., Ebert, Natalie, Ebrahimi, Hedyeh, Ebrahimpour, Soheil, Edvardsson, David, Effiong, Andem, Eggen, Anne Elise, El Bcheraoui, Charbel, El-Khatib, Ziad, Elyazar, Iqbal Rf, Enayati, Ahmadali, Endries, Aman Yesuf, Er, Benjamin, Erskine, Holly E., Eskandarieh, Sharareh, Esteghamati, Alireza, Estep, Kara, Fakhim, Hamed, Faramarzi, Mahbobeh, Fareed, Mohammad, Farid, Talha A., Farinha, Carla Sofia E.sá, Farioli, Andrea, Faro, Andre, Farvid, Maryam S., Farzaei, Mohammad Hosein, Fatima, Batool, Fay, Kairsten A., Fazaeli, Ali Akbar, Feigin, Valery L., Feigl, Andrea B., Fereshtehnejad, Seyed Mohammad, Fernandes, Eduarda, Fernandes, Joao C., Ferrara, Giannina, Ferrari, Alize J., Ferreira, Manuela L., Filip, Irina, Finger, Jonas David, Fischer, Florian, Foigt, Nataliya A., Foreman, Kyle J., Fukumoto, Takeshi, Fullman, Nancy, Fürst, Thomas, Furtado, João M., Futran, Neal D., Gall, Seana, Gallus, Silvano, Gamkrelidze, Amiran, Ganji, Morsaleh, Garcia-Basteiro, Alberto L., Gardner, William M., Gebre, Abadi Kahsu, Gebremedhin, Amanuel Tesfay, Gebremichael, Teklu Gebrehiwo, Gelano, Tilayie Feto, Geleijnse, Johanna M., Geramo, Yilma Chisha Dea, Gething, Peter W., Gezae, Kebede Embaye, Ghadimi, Reza, Ghadiri, Keyghobad, Ghasemi Falavarjani, Khalil, Ghasemi-Kasman, Maryam, Ghimire, Mamata, Ghosh, Rakesh, Ghoshal, Aloke Gopal, Giampaoli, Simona, Gill, Paramjit Singh, Gill, Tiffany K., Gillum, Richard F., Ginawi, Ibrahim Abdelmageed, Giussani, Giorgia, Gnedovskaya, Elena V., Godwin, William W., Goli, Srinivas, Gómez-Dantés, Hector, Gona, Philimon N., Gopalani, Sameer Vali, Goulart, Alessandra C., Grada, Ayman, Grams, Morgan E., Grosso, Giuseppe, Gugnani, Harish Chander, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Tanush, Gutiérrez, Reyna Alma, Gutiérrez-Torres, Daniela S., Haagsma, Juanita A., Habtewold, Tesfa Dejenie, Hachinski, Vladimir, Hafezi-Nejad, Nima, Hagos, Tekleberhan B., Hailegiyorgis, Tewodros Tesfa, Hailu, Gessessew Bugssa, Haj-Mirzaian, Arvin, Haj-Mirzaian, Arya, Hamadeh, Randah R., Hamidi, Samer, Handal, Alexis J., Hankey, Graeme J., Hao, Yuantao, Harb, Hilda L., Harikrishnan, Sivadasanpillai, Haro, Josep Maria, Hassankhani, Hadi, Hassen, Hamid Yimam, Havmoeller, Rasmus, Hawley, Caitlin N., Hay, Simon I., Hedayatizadeh-Omran, Akbar, Heibati, Behzad, Heidari, Behnam, Heidari, Mohsen, Hendrie, Delia, Henok, Andualem, Heredia-Pi, Ileana, Herteliu, Claudiu, Heydarpour, Fatemeh, Heydarpour, Sousan, Hibstu, Desalegn T., Higazi, Tarig B., Hilawe, Esayas Haregot, Hoek, Hans W., Hoffman, Howard J., Hole, Michael K., Homaie Rad, Enayatollah, Hoogar, Praveen, Hosgood, H. Dean, Hosseini, Seyed Mostafa, Hosseinzadeh, Mehdi, Hostiuc, Mihaela, Hostiuc, Sorin, Hoy, Damian G., Hsairi, Mohamed, Hsiao, Thomas, Hu, Guoqing, Hu, Howard, Huang, John J., Hussen, Mamusha Aman, Huynh, Chantal K., Iburg, Kim Moesgaard, Ikeda, Nayu, Ilesanmi, Olayinka Stephen, Iqbal, Usman, Irvani, Seyed Sina Naghibi, Irvine, Caleb Mackay Salpeter, Islam, Sheikh Mohammed Shariful, Islami, Farhad, Jackson, Maria D., Jacobsen, Kathryn H., Jahangiry, Leila, Jahanmehr, Nader, Jain, Sudhir Kumar, Jakovljevic, Mihajlo, James, Spencer L., Jassal, Simerjot K., Jayatilleke, Achala Upendra, Jeemon, Panniyammakal, Jha, Ravi Prakash, Jha, Vivekanand, Ji, John S., Jonas, Jost B., Jonnagaddala, Jitendra, Jorjoran Shushtari, Zahra, Joshi, Ankur, Jozwiak, Jacek Jerzy, Jürisson, Mikk, Kabir, Zubair, Kahsay, Amaha, Kalani, Rizwan, Kanchan, Tanuj, Kant, Surya, Kar, Chittaranjan, Karami, Manoochehr, Karami Matin, Behzad, Karch, André, Karema, Corine, Karimi, Narges, Karimi, Seyed M., Kasaeian, Amir, Kassa, Dessalegn H., Kassa, Getachew Mullu, Kassa, Tesfaye Dessale, Kassebaum, Nicholas J., Katikireddi, Srinivasa Vittal, Kaul, Anil, Kawakami, Norito, Kazemi, Zhila, Karyani, Ali Kazemi, Kefale, Adane Teshome, Keiyoro, Peter Njenga, Kemp, Grant Rodgers, Kengne, Andre Pascal, Keren, Andre, Kesavachandran, Chandrasekharan Nair, Khader, Yousef Saleh, Khafaei, Behzad, Khafaie, Morteza Abdullatif, Khajavi, Alireza, Khalid, Nauman, Khalil, Ibrahim A., Khan, Gulfaraz, Khan, Muhammad Shahzeb, Khan, Muhammad Ali, Khang, Young Ho, Khater, Mona M., Khazaei, Mohammad, Khazaie, Habibolah, Khoja, Abdullah T., Khosravi, Ardeshir, Khosravi, Mohammad Hossein, Kiadaliri, Aliasghar A., Kiirithio, Daniel N., Kim, Cho Il, Kim, Daniel, Kim, Young Eun, Kim, Yun Jin, Kimokoti, Ruth W., Kinfu, Yohannes, Kisa, Adnan, Kissimova-Skarbek, Katarzyna, Kivimäki, Mika, Knibbs, Luke D., Knudsen, Ann Kristin Skrindo, Kochhar, Sonali, Kokubo, Yoshihiro, Kolola, Tufa, Kopec, Jacek A., Kosen, Soewarta, Koul, Parvaiz A., Koyanagi, Ai, Kravchenko, Michael A., Krishan, Kewal, Krohn, Kristopher J., Kromhout, Hans, Kuate Defo, Barthelemy, Kucuk Bicer, Burcu, Kumar, G. Anil, Kumar, Manasi, Kuzin, Igor, Kyu, Hmwe Hmwe, Lachat, Carl, Lad, Deepesh P., Lad, Sheetal D., Lafranconi, Alessandra, Lalloo, Ratilal, Lallukka, Tea, Lami, Faris Hasan, Lang, Justin J., Lansingh, Van C., Larson, Samantha Leigh, Latifi, Arman, Lazarus, Jeffrey V., Lee, Paul H., Leigh, James, Leili, Mostafa, Leshargie, Cheru Tesema, Leung, Janni, Levi, Miriam, Lewycka, Sonia, Li, Shanshan, Li, Yichong, Liang, Juan, Liang, Xiaofeng, Liao, Yu, Liben, Misgan Legesse, Lim, Lee Ling, Linn, Shai, Liu, Shiwei, Lodha, Rakesh, Logroscino, Giancarlo, Lopez, Alan D., Lorkowski, Stefan, Lotufo, Paulo A., Lozano, Rafael, Lucas, Tim C.D., Lunevicius, Raimundas, Ma, Stefan, Macarayan, Erlyn Rachelle King, Machado, Ísis Eloah, Madotto, Fabiana, Mai, Hue Thi, Majdan, Marek, Majdzadeh, Reza, Majeed, Azeem, Malekzadeh, Reza, Malta, Deborah Carvalho, Mamun, Abdullah A., Manda, Ana Laura, Manguerra, Helena, Mansournia, Mohammad Ali, Mantovani, Lorenzo Giovanni, Maravilla, Joemer C., Marcenes, Wagner, Marks, Ashley, Martin, Randall V., Martins, Sheila C.O., Martins-Melo, Francisco Rogerlândio, März, Winfried, Marzan, Melvin B., Massenburg, Benjamin Ballard, Mathur, Manu Raj, Mathur, Prashant, Matsushita, Kunihiro, Maulik, Pallab K., Mazidi, Mohsen, McAlinden, Colm, McGrath, John J., McKee, Martin, Mehrotra, Ravi, Mehta, Kala M., Mehta, Varshil, Meier, Toni, Mekonnen, Fantahun Ayenew, Melaku, Yohannes A., Melese, Addisu, Melku, Mulugeta, Memiah, Peter T.N., Memish, Ziad A., Mendoza, Walter, Mengistu, Desalegn Tadese, Mensah, George A., Mensink, Gert B.M., Mereta, Seid Tiku, Meretoja, Atte, Meretoja, Tuomo J., Mestrovic, Tomislav, Mezgebe, Haftay Berhane, Miazgowski, Bartosz, Miazgowski, Tomasz, Millear, Anoushka I., Miller, Ted R., Miller-Petrie, Molly Katherine, Mini, G. K., Mirarefin, Mojde, Mirica, Andreea, Mirrakhimov, Erkin M., Misganaw, Awoke Temesgen, Mitiku, Habtamu, Moazen, Babak, Mohajer, Bahram, Mohammad, Karzan Abdulmuhsin, Mohammadi, Moslem, Mohammadifard, Noushin, Mohammadnia-Afrouzi, Mousa, Mohammed, Shafiu, Mohebi, Farnam, Mokdad, Ali H., Molokhia, Mariam, Momeniha, Fatemeh, Monasta, Lorenzo, Moodley, Yoshan, Moradi, Ghobad, Moradi-Lakeh, Maziar, Moradinazar, Mehdi, Moraga, Paula, Morawska, Lidia, Morgado-Da-Costa, Joana, Morrison, Shane Douglas, Moschos, Marilita M., Mouodi, Simin, Mousavi, Seyyed Meysam, Mozaffarian, Dariush, Mruts, Kalayu Brhane, Muche, Achenef Asmamaw, Muchie, Kindie Fentahun, Mueller, Ulrich Otto, Muhammed, Oumer Sada, Mukhopadhyay, Satinath, Muller, Kate, Musa, Kamarul Imran, Mustafa, Ghulam, Nabhan, Ashraf F., Naghavi, Mohsen, Naheed, Aliya, Nahvijou, Azin, Naik, Gurudatta, Naik, Nitish, Najafi, Farid, Nangia, Vinay, Nansseu, Jobert Richie, Nascimento, Bruno Ramos, Neal, Bruce, Neamati, Nahid, Negoi, Ionut, Negoi, Ruxandra Irina, Neupane, Subas, Newton, Charles Richard James, Ngunjiri, Josephine W., Nguyen, Anh Quynh, Nguyen, Grant, Nguyen, Ha Thu, Nguyen, Huong Lan Thi, Nguyen, Huong Thanh, Nguyen, Minh, Nguyen, Nam Ba, Nichols, Emma, Nie, Jing, Ningrum, Dina Nur Anggraini, Nirayo, Yirga Legesse, Nishi, Nobuo, Nixon, Molly R., Nojomi, Marzieh, Nomura, Shuhei, Norheim, Ole F., Noroozi, Mehdi, Norrving, Bo, Noubiap, Jean Jacques, Nouri, Hamid Reza, Nourollahpour Shiadeh, Malihe, Nowroozi, Mohammad Reza, Nsoesie, Elaine O., Nyasulu, Peter S., Obermeyer, Carla M., Odell, Christopher M., Ofori-Asenso, Richard, Ogbo, Felix Akpojene, Oh, In Hwan, Oladimeji, Olanrewaju, Olagunju, Andrew T., Olagunju, Tinuke O., Olivares, Pedro R., Olsen, Helen Elizabeth, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Ong, Kanyin L., Ong, Sok King, Oren, Eyal, Orpana, Heather M., Ortiz, Alberto, Ota, Erika, Otstavnov, Stanislav S., Øverland, Simon, Owolabi, Mayowa Ojo, P A, Mahesh, Pacella, Rosana, Pakhare, Abhijit P., Pakpour, Amir H., Pana, Adrian, Panda-Jonas, Songhomitra, Park, Eun Kee, Parry, Charles D.H., Parsian, Hadi, Patel, Shanti, Pati, Sanghamitra, Patil, Snehal T., Patle, Ajay, Patton, George C., Paudel, Deepak, Paulson, Katherine R., Paz Ballesteros, Wayra Citlali, Pearce, Neil, Pereira, Alexandre, Pereira, David M., Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Pham, Hai Quang, Phillips, Michael R., Pillay, Julian David, Piradov, Michael A., Pirsaheb, Meghdad, Pischon, Tobias, Pishgar, Farhad, Plana-Ripoll, Oleguer, Plass, Dietrich, Polinder, Suzanne, Polkinghorne, Kevan R., Postma, Maarten J., Poulton, Richie, Pourshams, Akram, Poustchi, Hossein, Prabhakaran, Dorairaj, Prakash, Swayam, Prasad, Narayan, Purcell, Caroline A., Purwar, Manorama B., Qorbani, Mostafa, Radfar, Amir, Rafay, Anwar, Rafiei, Alireza, Rahim, Fakher, Rahimi, Zohreh, Rahimi-Movaghar, Afarin, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz ur, Rahman, Muhammad Aziz, Rai, Rajesh Kumar, Rajati, Fatemeh, Rajsic, Sasa, Raju, Sree Bhushan, Ram, Usha, Ranabhat, Chhabi Lal, Ranjan, Prabhat, Rath, Goura Kishor, Rawaf, David Laith, Rawaf, Salman, Reddy, K. 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Bililign, Nigu, Bin Sayeed, Muhammad Shahdaat, Bisanzio, Donal, Biswas, Tuhin, Bjørge, Tone, Blacker, Brigette F, Bleyer, Archie, Borschmann, Rohan, Bou-Orm, Ibrahim R, Boufous, Soufiane, Bourne, Rupert, Brady, Oliver J, Brauer, Michael, Brazinova, Alexandra, Breitborde, Nicholas J K, Brenner, Hermann, Briko, Andrey Nikolaevich, Britton, Gabrielle, Brugha, Traolach, Buchbinder, Rachelle, Burnett, Richard T, Busse, Reinhard, Butt, Zahid A, Cahill, Leah E, Cahuana-Hurtado, Lucero, Campos-Nonato, Ismael R, Cárdenas, Rosario, Carreras, Giulia, Carrero, Juan J, Carvalho, Félix, Castañeda-Orjuela, Carlos A, Castillo Rivas, Jacqueline, Castro, Franz, Catalá-López, Ferrán, Causey, Kate, Cercy, Kelly M, Cerin, Ester, Chaiah, Yazan, Chang, Hsing-Yi, Chang, Jung-Chen, Chang, Kai-Lan, Charlson, Fiona J, Chattopadhyay, Aparajita, Chattu, Vijay Kumar, Chee, Miao Li, Cheng, Ching-Yu, Chew, Adrienne, Chiang, Peggy Pei-Chia, Chimed-Ochir, Odgerel, Chin, Ken Lee, Chitheer, Abdulaal, Choi, Jee-Young J, Chowdhury, Rajiv, Christensen, Hanne, Christopher, Devasahayam J, Chung, Sheng-Chia, Cicuttini, Flavia M, Cirillo, Massimo, Cohen, Aaron J, Collado-Mateo, Daniel, Cooper, Cyru, Cooper, Owen R, Coresh, Josef, Cornaby, Leslie, Cortesi, Paolo Angelo, Cortinovis, Monica, Costa, Megan, Cousin, Ewerton, Criqui, Michael H, Cromwell, Elizabeth A, Cundiff, David K, Daba, Alemneh Kabeta, Dachew, Berihun Assefa, Dadi, Abel Fekadu, Damasceno, Albertino Antonio Moura, Dandona, Lalit, Dandona, Rakhi, Darby, Sarah C, Dargan, Paul I, Daryani, Ahmad, Das Gupta, Rajat, Das Neves, José, Dasa, Tamirat Tesfaye, Dash, Aditya Prasad, Davitoiu, Dragos Virgil, Davletov, Kairat, De la Cruz-Góngora, Vanessa, De La Hoz, Fernando Pio, De Leo, Diego, De Neve, Jan-Walter, Degenhardt, Louisa, Deiparine, Selina, Dellavalle, Robert P, Demoz, Gebre Teklemariam, Denova-Gutiérrez, Edgar, Deribe, Kebede, Dervenis, Nikolao, Deshpande, Aniruddha, Des Jarlais, Don C, Dessie, Getenet Ayalew, Deveber, Gabrielle Aline, Dey, Subhojit, Dharmaratne, Samath Dhamminda, Dhimal, Meghnath, Dinberu, Mesfin Tadese, Ding, Eric L, Diro, Helen Derara, Djalalinia, Shirin, Do, Huyen Phuc, Dokova, Klara, Doku, David Teye, Doyle, Kerrie E, Driscoll, Tim R, Dubey, Manisha, Dubljanin, Eleonora, Duken, Eyasu Ejeta, Duncan, Bruce B, Duraes, Andre R, Ebert, Natalie, Ebrahimi, Hedyeh, Ebrahimpour, Soheil, Edvardsson, David, Effiong, Andem, Eggen, Anne Elise, El Bcheraoui, Charbel, El-Khatib, Ziad, Elyazar, Iqbal Rf, Enayati, Ahmadali, Endries, Aman Yesuf, Er, Benjamin, Erskine, Holly E, Eskandarieh, Sharareh, Esteghamati, Alireza, Estep, Kara, Fakhim, Hamed, Faramarzi, Mahbobeh, Fareed, Mohammad, Farid, Talha A, Farinha, Carla Sofia E sá, Farioli, Andrea, Faro, Andre, Farvid, Maryam S, Farzaei, Mohammad Hosein, Fatima, Batool, Fay, Kairsten A, Fazaeli, Ali Akbar, Feigin, Valery L, Feigl, Andrea B, Fereshtehnejad, Seyed-Mohammad, Fernandes, Eduarda, Fernandes, Joao C, Ferrara, Giannina, Ferrari, Alize J, Ferreira, Manuela L, Filip, Irina, Finger, Jonas David, Fischer, Florian, Foigt, Nataliya A, Foreman, Kyle J, Fukumoto, Takeshi, Fullman, Nancy, Fürst, Thoma, Furtado, João M, Futran, Neal D, Gall, Seana, Gallus, Silvano, Gamkrelidze, Amiran, Ganji, Morsaleh, Garcia-Basteiro, Alberto L, Gardner, William M, Gebre, Abadi Kahsu, Gebremedhin, Amanuel Tesfay, Gebremichael, Teklu Gebrehiwo, Gelano, Tilayie Feto, Geleijnse, Johanna M, Geramo, Yilma Chisha Dea, Gething, Peter W, Gezae, Kebede Embaye, Ghadimi, Reza, Ghadiri, Keyghobad, Ghasemi Falavarjani, Khalil, Ghasemi-Kasman, Maryam, Ghimire, Mamata, Ghosh, Rakesh, Ghoshal, Aloke Gopal, Giampaoli, Simona, Gill, Paramjit Singh, Gill, Tiffany K, Gillum, Richard F, Ginawi, Ibrahim Abdelmageed, Giussani, Giorgia, Gnedovskaya, Elena V, Godwin, William W, Goli, Sriniva, Gómez-Dantés, Hector, Gona, Philimon N, Gopalani, Sameer Vali, Goulart, Alessandra C, Grada, Ayman, Grams, Morgan E, Grosso, Giuseppe, Gugnani, Harish Chander, Guo, Yuming, Gupta, Rahul, Gupta, Rajeev, Gupta, Tanush, Gutiérrez, Reyna Alma, Gutiérrez-Torres, Daniela S, Haagsma, Juanita A, Habtewold, Tesfa Dejenie, Hachinski, Vladimir, Hafezi-Nejad, Nima, Hagos, Tekleberhan B, Hailegiyorgis, Tewodros Tesfa, Hailu, Gessessew Bugssa, Haj-Mirzaian, Arvin, Haj-Mirzaian, Arya, Hamadeh, Randah R, Hamidi, Samer, Handal, Alexis J, Hankey, Graeme J, Hao, Yuantao, Harb, Hilda L, Harikrishnan, Sivadasanpillai, Haro, Josep Maria, Hassankhani, Hadi, Hassen, Hamid Yimam, Havmoeller, Rasmu, Hawley, Caitlin N, Hay, Simon I, Hedayatizadeh-Omran, Akbar, Heibati, Behzad, Heidari, Behnam, Heidari, Mohsen, Hendrie, Delia, Henok, Andualem, Heredia-Pi, Ileana, Herteliu, Claudiu, Heydarpour, Fatemeh, Heydarpour, Sousan, Hibstu, Desalegn T, Higazi, Tarig B, Hilawe, Esayas Haregot, Hoek, Hans W, Hoffman, Howard J, Hole, Michael K, Homaie Rad, Enayatollah, Hoogar, Praveen, Hosgood, H Dean, Hosseini, Seyed Mostafa, Hosseinzadeh, Mehdi, Hostiuc, Mihaela, Hostiuc, Sorin, Hoy, Damian G, Hsairi, Mohamed, 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Martin, Randall V, Martins, Sheila C O, Martins-Melo, Francisco Rogerlândio, März, Winfried, Marzan, Melvin B, Massenburg, Benjamin Ballard, Mathur, Manu Raj, Mathur, Prashant, Matsushita, Kunihiro, Maulik, Pallab K, Mazidi, Mohsen, McAlinden, Colm, McGrath, John J, McKee, Martin, Mehrotra, Ravi, Mehta, Kala M, Mehta, Varshil, Meier, Toni, Mekonnen, Fantahun Ayenew, Melaku, Yohannes A, Melese, Addisu, Melku, Mulugeta, Memiah, Peter T N, Memish, Ziad A, Mendoza, Walter, Mengistu, Desalegn Tadese, Mensah, George A, Mensink, Gert B M, Mereta, Seid Tiku, Meretoja, Atte, Meretoja, Tuomo J, Mestrovic, Tomislav, Mezgebe, Haftay Berhane, Miazgowski, Bartosz, Miazgowski, Tomasz, Millear, Anoushka I, Miller, Ted R, Miller-Petrie, Molly Katherine, Mini, G.K., Mirarefin, Mojde, Mirica, Andreea, Mirrakhimov, Erkin M, Misganaw, Awoke Temesgen, Mitiku, Habtamu, Moazen, Babak, Mohajer, Bahram, Mohammad, Karzan Abdulmuhsin, Mohammadi, Moslem, Mohammadifard, Noushin, Mohammadnia-Afrouzi, Mousa, Mohammed, Shafiu, Mohebi, Farnam, Mokdad, Ali H, Molokhia, Mariam, Momeniha, Fatemeh, Monasta, Lorenzo, Moodley, Yoshan, Moradi, Ghobad, Moradi-Lakeh, Maziar, Moradinazar, Mehdi, Moraga, Paula, Morawska, Lidia, Morgado-Da-Costa, Joana, Morrison, Shane Dougla, Moschos, Marilita M, Mouodi, Simin, Mousavi, Seyyed Meysam, Mozaffarian, Dariush, Mruts, Kalayu Brhane, Muche, Achenef Asmamaw, Muchie, Kindie Fentahun, Mueller, Ulrich Otto, Muhammed, Oumer Sada, Mukhopadhyay, Satinath, Muller, Kate, Musa, Kamarul Imran, Mustafa, Ghulam, Nabhan, Ashraf F, Naghavi, Mohsen, Naheed, Aliya, Nahvijou, Azin, Naik, Gurudatta, Naik, Nitish, Najafi, Farid, Nangia, Vinay, Nansseu, Jobert Richie, Nascimento, Bruno Ramo, Neal, Bruce, Neamati, Nahid, Negoi, Ionut, Negoi, Ruxandra Irina, Neupane, Suba, Newton, Charles Richard Jame, Ngunjiri, Josephine W, Nguyen, Anh Quynh, Nguyen, Grant, Nguyen, Ha Thu, Nguyen, Huong Lan Thi, Nguyen, Huong Thanh, Nguyen, Minh, Nguyen, Nam Ba, Nichols, Emma, Nie, Jing, Ningrum, Dina Nur Anggraini, Nirayo, Yirga Legesse, Nishi, Nobuo, Nixon, Molly R, Nojomi, Marzieh, Nomura, Shuhei, Norheim, Ole F, Noroozi, Mehdi, Norrving, Bo, Noubiap, Jean Jacque, Nouri, Hamid Reza, Nourollahpour Shiadeh, Malihe, Nowroozi, Mohammad Reza, Nsoesie, Elaine O, Nyasulu, Peter S, Obermeyer, Carla M, Odell, Christopher M, Ofori-Asenso, Richard, Ogbo, Felix Akpojene, Oh, In-Hwan, Oladimeji, Olanrewaju, Olagunju, Andrew T, Olagunju, Tinuke O, Olivares, Pedro R, Olsen, Helen Elizabeth, Olusanya, Bolajoko Olubukunola, Olusanya, Jacob Olusegun, Ong, Kanyin L, Ong, Sok King, Oren, Eyal, Orpana, Heather M, Ortiz, Alberto, Ota, Erika, Otstavnov, Stanislav S, Øverland, Simon, Owolabi, Mayowa Ojo, P A, Mahesh, Pacella, Rosana, Pakhare, Abhijit P, Pakpour, Amir H, Pana, Adrian, Panda-Jonas, Songhomitra, Park, Eun-Kee, Parry, Charles D H, Parsian, Hadi, Patel, Shanti, Pati, Sanghamitra, Patil, Snehal T, Patle, Ajay, Patton, George C, Paudel, Deepak, Paulson, Katherine R, Paz Ballesteros, Wayra Citlali, Pearce, Neil, Pereira, Alexandre, Pereira, David M, Perico, Norberto, Pesudovs, Konrad, Petzold, Max, Pham, Hai Quang, Phillips, Michael R, Pillay, Julian David, Piradov, Michael A, Pirsaheb, Meghdad, Pischon, Tobia, Pishgar, Farhad, Plana-Ripoll, Oleguer, Plass, Dietrich, Polinder, Suzanne, Polkinghorne, Kevan R, Postma, Maarten J, Poulton, Richie, Pourshams, Akram, Poustchi, Hossein, Prabhakaran, Dorairaj, Prakash, Swayam, Prasad, Narayan, Purcell, Caroline A, Purwar, Manorama B, Qorbani, Mostafa, Radfar, Amir, Rafay, Anwar, Rafiei, Alireza, Rahim, Fakher, Rahimi, Zohreh, Rahimi-Movaghar, Afarin, Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz ur, Rahman, Muhammad Aziz, Rai, Rajesh Kumar, Rajati, Fatemeh, Rajsic, Sasa, Raju, Sree Bhushan, Ram, Usha, Ranabhat, Chhabi Lal, Ranjan, Prabhat, Rath, Goura Kishor, Rawaf, David Laith, Rawaf, Salman, Reddy, K Srinath, Rehm, Colin D, Rehm, Jürgen, Reiner, Robert C, Reitsma, Marissa B, Remuzzi, Giuseppe, Renzaho, Andre M 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Sardana, Mayank, Sarker, Abdur Razzaque, Sarmiento-Suárez, Rodrigo, Sarrafzadegan, Nizal, Sartorius, Benn, Sarvi, Shahabeddin, Sathian, Brijesh, Satpathy, Maheswar, Sawant, Arundhati R, Sawhney, Monika, Saylan, Mete, Sayyah, Mehdi, Schaeffner, Elke, Schmidt, Maria Inê, Schneider, Ione J C, Schöttker, Ben, Schutte, Aletta Elisabeth, Schwebel, David C, Schwendicke, Falk, Scott, James G, Seedat, Soraya, Sekerija, Mario, Sepanlou, Sadaf G, Serre, Marc L, Serván-Mori, Edson, Seyedmousavi, Seyedmojtaba, Shabaninejad, Hosein, Shaddick, Gavin, Shafieesabet, Azadeh, Shahbazi, Mehdi, Shaheen, Amira A, Shaikh, Masood Ali, Shamah Levy, Teresa, Shams-Beyranvand, Mehran, Shamsi, Mohammadbagher, Sharafi, Heidar, Sharafi, Kiomar, Sharif, Mehdi, Sharif-Alhoseini, Mahdi, Sharifi, Hamid, Sharma, Jayendra, Sharma, Meenakshi, Sharma, Rajesh, She, Jun, Sheikh, Aziz, Shi, Peilin, Shibuya, Kenji, Shiferaw, Mekonnen Sisay, Shigematsu, Mika, Shin, Min-Jeong, Shiri, Rahman, Shirkoohi, Reza, Shiue, Ivy, 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Ebrahim M, Yip, Paul, Yisma, Engida, Yonemoto, Naohiro, Yoon, Seok-Jun, Yotebieng, Marcel, Younis, Mustafa Z, Yousefifard, Mahmoud, Yu, Chuanhua, Zaidi, Zoubida, Zaman, Sojib Bin, Zamani, Mohammad, Zavala-Arciniega, Lui, Zhang, Anthony Lin, Zhang, Hao, Zhang, Kai, Zhou, Maigeng, Zimsen, Stephanie R M, Zodpey, Sanjay, and Murray, Christopher J L
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Science & Technology ,GBD, risks ,risk factors ,comparative risk assesment ,Dalys ,Medicine (all) ,CHOLESTEROL ,BLOOD-PRESSURE ,11 Medical And Health Sciences ,ILLNESS ,TRENDS ,humanities ,Medicine, General & Internal ,TOBACCO CONTROL ,General & Internal Medicine ,parasitic diseases ,Medicine and Health Sciences ,CARDIOVASCULAR-DISEASES ,TRIAL ,Human medicine ,Life Sciences & Biomedicine ,METAANALYSIS - Abstract
Background The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk–outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk–outcome pairs, and new data on risk exposure levels and risk– outcome associations. Methods We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk–outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings In 2017, 34·1 million (95% uncertainty interval [UI] 33·3–35·0) deaths and 1·21 billion (1·14–1·28) DALYs were attributable to GBD risk factors. Globally, 61·0% (59·6–62·4) of deaths and 48·3% (46·3–50·2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10·4 million (9·39–11·5) deaths and 218 million (198–237) DALYs, followed by smoking (7·10 million [6·83–7·37] deaths and 182 million [173–193] DALYs), high fasting plasma glucose (6·53 million [5·23–8·23] deaths and 171 million [144–201] DALYs), high body-mass index (BMI; 4·72 million [2·99–6·70] deaths and 148 million [98·6–202] DALYs), and short gestation for birthweight (1·43 million [1·36–1·51] deaths and 139 million [131–147] DALYs). In total, risk-attributable DALYs declined by 4·9% (3·3–6·5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23·5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18·6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Lancet 2018; 392: 1923–94 *Collaborators listed at the end of the paper Correspondence to: Prof Christopher J L Murray, Institute for Health Metrics and Evalution, Seattle, WA 98121, USA cjlm@uw.edu Global Health Metrics 1924 www.thelancet.com Vol 392 November 10, 2018 Interpretation By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning.
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- 2018
21. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016
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L, Mapoma, C, Martin, R, Martinez-Raga, J, Martins-Melo, F, Mathur, M, Matsushita, K, Matzopoulos, R, Mazidi, M, Mcalinden, C, Mcgrath, J, Mehata, S, Mehndiratta, M, Meier, T, Melaku, Y, Memiah, P, Memish, Z, Mendoza, W, Mengesha, M, Mensah, G, Mensink, G, Mereta, S, Meretoja, A, Meretoja, T, Mezgebe, H, Micha, R, Millear, A, Miller, T, Minnig, S, Mirarefin, M, Mirrakhimov, E, Misganaw, A, Mishra, S, Mohammad, K, Mohammed, K, Mohammed, S, Mohamed Ibrahim, N, Mohan, M, Mokdad, A, Monasta, L, Montañez Hernandez, J, Montico, M, Moradi-Lakeh, M, Moraga, P, Morawska, L, Morrison, S, Mountjoy-Venning, C, Mueller, U, Mullany, E, Muller, K, Murthy, G, Musa, K, Naghavi, M, Naheed, A, Nangia, V, Natarajan, G, Negoi, I, Negoi, R, Nguyen, C, Nguyen, G, Nguyen, M, Nguyen, Q, Nguyen, T, Nichols, E, Ningrum, D, Nomura, M, Nong, V, Norheim, O, Norrving, B, Noubiap, J, Obermeyer, C, Ogbo, F, Oh, I, Oladimeji, O, Olagunju, A, Olagunju, T, Olivares, P, Olsen, H, Olusanya, B, Olusanya, J, Opio, J, Oren, 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Rahimi-Movaghar, Vafa, Rahman, Mahfuzar, Rahman, Mohammad Hifz Ur, Rahman, Muhammad Aziz, Rai, Rajesh Kumar, Rajsic, Sasa, Ram, Usha, Rawaf, Salman, Rehm, Colin D., Rehm, Jürgen, Reiner, Robert C., Reitsma, Marissa B., Reynales-Shigematsu, Luz Myriam, Remuzzi, Giuseppe, Renzaho, Andre M.N., Resnikoff, Serge, Rezaei, Satar, Ribeiro, Antonio L., Rivera, Juan A., Roba, Kedir Teji, Rojas-Rueda, David, Roman, Yesenia, Room, Robin, Roshandel, Gholamreza, Roth, Gregory A., Rothenbacher, Dietrich, Rubagotti, Enrico, Rushton, Lesley, Sadat, Nafi, Safdarian, Mahdi, Safi, Sare, Safiri, Saeid, Sahathevan, Ramesh, Salama, Joseph, Salomon, Joshua A., Samy, Abdallah M., Sanabria, Juan Ramon, Sanchez-Niño, Maria Dolore, Sánchez-Pimienta, Tania G., Santomauro, Damian, Santos, Itamar S., Santric Milicevic, Milena M., Sartorius, Benn, Satpathy, Maheswar, Sawhney, Monika, Saxena, Sonia, Schaeffner, Elke, Schmidt, Maria Inê, Schneider, Ione J.C., Schutte, Aletta E., Schwebel, David C., Schwendicke, Falk, Seedat, Soraya, Sepanlou, Sadaf G., Serdar, Berrin, Servan-Mori, Edson E., Shaddick, Gavin, Shaheen, Amira, Shahraz, Saeid, Shaikh, Masood Ali, Shamah Levy, Teresa, Shamsipour, Mansour, Shamsizadeh, Morteza, Shariful Islam, Sheikh Mohammed, Sharma, Jayendra, Sharma, Rajesh, She, Jun, Shen, Jiabin, Shi, Peilin, Shibuya, Kenji, Shields, Chloe, Shiferaw, Mekonnen Sisay, Shigematsu, Mika, Shin, Min-Jeong, Shiri, Rahman, Shirkoohi, Reza, Shishani, Kawkab, Shoman, Haitham, Shrime, Mark G., Sigfusdottir, Inga Dora, Silva, Diego Augusto Santo, Silva, João Pedro, Silveira, Dayane Gabriele Alve, Singh, Jasvinder A., Singh, Virendra, Sinha, Dhirendra Narain, Skiadaresi, Eirini, Slepak, Erica Leigh, Smith, David L., Smith, Mari, Sobaih, Badr H.A., Sobngwi, Eugene, Soneji, Samir, Sorensen, Reed J.D., Sposato, Luciano A., Sreeramareddy, Chandrashekhar T., Srinivasan, Vinay, Steel, Nichola, Stein, Dan J., Steiner, Caitlyn, Steinke, Sabine, Stokes, Mark Andrew, Strub, Bryan, Subart, Michelle, Sufiyan, Muawiyyah Babale, Suliankatchi, Rizwan Abdulkader, Sur, Patrick J., Swaminathan, Soumya, Sykes, Bryan L., Szoeke, Cassandra E.I., Tabarés-Seisdedos, Rafael, Tadakamadla, Santosh Kumar, Takahashi, Ken, Takala, Jukka S., Tandon, Nikhil, Tanner, Marcel, Tarekegn, Yihunie L., Tavakkoli, Mohammad, Tegegne, Teketo Kassaw, Tehrani-Banihashemi, Arash, Terkawi, Abdullah Sulieman, Tesssema, Belay, Thakur, J.S., Thamsuwan, Ornwipa, Thankappan, Kavumpurathu Raman, Theis, Andrew M., Thomas, Matthew Lloyd, Thomson, Alan J., Thrift, Amanda G., Tillmann, Taavi, Tobe-Gai, Ruoyan, Tobollik, Myriam, Tollanes, Mette C., Tonelli, Marcello, Topor-Madry, Roman, Torre, Anna, Tortajada, Miguel, Touvier, Mathilde, Tran, Bach Xuan, Truelsen, Thoma, Tuem, Kald Beshir, Tuzcu, Emin Murat, Tyrovolas, Stefano, Ukwaja, Kingsley Nnanna, Uneke, Chigozie Jesse, Updike, Rachel, Uthman, Olalekan A., Van Boven, Job F.M., Van Donkelaar, Aaron, Varughese, Santosh, Vasankari, Tommi, Veerman, Lennert J., Venkateswaran, Vidhya, Venketasubramanian, Narayanaswamy, Violante, Francesco S., Vladimirov, Sergey K., Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Vos, Theo, Wadilo, Fiseha, Wakayo, Tolassa, Wallin, Mitchell T., Wang, Yuan-Pang, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G., Weiss, Daniel J., Werdecker, Andrea, Westerman, Ronny, Whiteford, Harvey A., Wiysonge, Charles Shey, Woldeyes, Belete Getahun, Wolfe, Charles D.A., Woodbrook, Rachel, Workicho, Abdulhalik, Wulf Hanson, Sarah, Xavier, Deni, Xu, Gelin, Yadgir, Simon, Yakob, Bereket, Yan, Lijing L., Yaseri, Mehdi, Yimam, Hassen Hamid, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Yotebieng, Marcel, Younis, Mustafa Z., Zaidi, Zoubida, El Sayed Zaki, Maysaa, Zavala-Arciniega, Lui, Zhang, Xueying, Zimsen, Stephanie Raman M., Zipkin, Ben, Zodpey, Sanjay, Lim, Stephen S., and Murray, Christopher J.L.
- Subjects
Líkamsþyngdarstuðull ,Dánarmein ,Heilsufar ,Dánartíðni ,Birthweight ,Fæðingarþyngd ,Börn ,HEALTH-RISKS ,Pregnancy ,EPIDEMIOLOGY ,Psychology ,Meðganga ,Children ,Konur ,Body mass index ,PRECAUTIONARY PRINCIPLE ,Public health ,Global burden of disease/statistics and numerical data ,Medicine (all) ,Smoking ,COST ,Men ,11 Medical And Health Sciences ,Health policy ,Háþrýstingur ,Sálfræði ,World health ,Hypertension ,Lýðheilsa ,Reykingar ,Life Sciences & Biomedicine ,COUNTRIES ,Quality of life ,DEATHS ,Lífsgæði ,Health risk assessment ,Medicine, General & Internal ,Heilbrigðisvísindi ,General & Internal Medicine ,Heilbrigðisstefna ,Women ,Mortality ,Áhættugreining ,CHINESE POPULATION ,OBESITY PREVENTION ,Science & Technology ,HYPERTENSION ,MORTALITY ,Malnutrition ,Næringarskortur ,Karlar ,Cause of death/trends ,RA - Abstract
Correction in: LANCET Volume: 390 Issue: 10104 Pages: 1736-1736 Published: OCT 14 2017 ; LANCET Volume: 390 Issue: 10106 Pages: E38-E38 Published: OCT 28 2017., Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined. Findings Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124.1 million DALYs [95% UI 111.2 million to 137.0 million]), high systolic blood pressure (122.2 million DALYs [110.3 million to 133.3 million], and low birthweight and short gestation (83.0 million DALYs [78.3 million to 87.7 million]), and for women, were high systolic blood pressure (89.9 million DALYs [80.9 million to 98.2 million]), high body-mass index (64.8 million DALYs [44.4 million to 87.6 million]), and high fasting plasma glucose (63.8 million DALYs [53.2 million to 76.3 million]). In 2016 in 113 countries, the leading risk factor in terms of attributable DALYs was a metabolic risk factor. Smoking remained among the leading five risk factors for DALYs for 109 countries, while low birthweight and short gestation was the leading risk factor for DALYs in 38 countries, particularly in sub-Saharan Africa and South Asia. In terms of important drivers of change in trends of burden attributable to risk factors, between 2006 and 2016 exposure to risks explains an 9.3% (6.9-11.6) decline in deaths and a 10.8% (8.3-13.1) decrease in DALYs at the global level, while population ageing accounts for 14.9% (12.7-17.5) of deaths and 6.2% (3.9-8.7) of DALYs, and population growth for 12.4% (10.1-14.9) of deaths and 12.4% (10.1-14.9) of DALYs. The largest contribution of trends in risk exposure to disease burden is seen between ages 1 year and 4 years, where a decline of 27.3% (24.9-29.7) of the change in DALYs between 2006 and 2016 can be attributed to declines in exposure to risks. Interpretation Increasingly detailed understanding of the trends in risk exposure and the RRs for each risk-outcome pair provide insights into both the magnitude of health loss attributable to risks and how modification of risk exposure has contributed to health trends. Metabolic risks warrant particular policy attention, due to their large contribution to global disease burden, increasing trends, and variable patterns across countries at the same level of development. GBD 2016 findings show that, while it has huge potential to improve health, risk modification has played a relatively small part in the past decade., The Bill & Melinda Gates Foundation, Bloomberg Philanthropies.
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- 2017
22. Epidemiological cut-off values for non-O1/ non-O139 Vibrio cholerae disc diffusion data generated by standardised methods.
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Smith P, Le Devendec L, Jouy E, Larvor E, Lesne J, Kirschner AKT, Rehm C, Leopold M, Pleininger S, Heger F, Jäckel C, Göllner C, Nekat J, Hammerl JA, and Baron S
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- Animals, Microbial Sensitivity Tests veterinary, Ciprofloxacin, Trimethoprim, Anti-Bacterial Agents pharmacology, Vibrio cholerae
- Abstract
This work generates the data needed to set epidemiological cut-off values for disc-diffusion zone measurements of Vibrio cholerae. The susceptibility of 147 European isolates of non-O1/non-O139 V. cholerae to 19 antibiotics was established using a standardised disc diffusion method which specified incubation of Mueller Hinton agar plates at 35°C. Epidemiological cut-off values were calculated by analysis of the zone size data with the statistically based normalised resistance interpretation method. Cut-off values for 17 agents were calculated by analysis of the aggregated data from all 4 laboratories participating in this study. The cut-off values calculated were ≥18 mm for amoxicillin/clavulanate, ≥18 mm for amikacin, ≥19 mm for ampicillin, ≥27 mm for cefepime, ≥31 mm for cefotaxime, ≥24 mm for ceftazidime, ≥24 mm for chloramphenicol, ≥31 mm for ciprofloxacin, ≥16 mm for erythromycin, ≥ 27 mm for florfenicol, ≥16 mm for gentamicin, ≥23 mm for imipenem, ≥25 mm for meropenem, ≥29 mm for nalidixic acid, ≥28 mm for norfloxacin, ≥13 mm for streptomycin and ≥23 mm for tetracycline. For the other 2 agents the data from 1 laboratory was excluded from the censored aggregation because the data from that laboratory was considered excessively imprecise. The cut-off values for these 2 agents calculated for the aggregation of the data from 3 laboratories were ≥23 mm for trimethoprim and ≥24 mm for trimethoprim/sulfamethoxazole. These zone size data will be submitted to the Clinical Laboratory Standards Institute (CLSI) and European Committee for Antimicrobial Susceptibility Testing (EUCAST) for their consideration in setting international consensus epidemiological cut-off values for non O1/non-O139 V. cholerae.
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- 2023
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23. Vibrio cholerae-An emerging pathogen in Austrian bathing waters?
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Rehm C, Kolm C, Pleininger S, Heger F, Indra A, Reischer GH, Farnleitner AAH, and Kirschner AKT
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- Humans, Austria epidemiology, Ecosystem, Vibrio cholerae, Cholera epidemiology
- Abstract
Vibrio cholerae, an important human pathogen, is naturally occurring in specific aquatic ecosystems. With very few exceptions, only the cholera-toxigenic strains belonging to the serogroups O1 and O139 are responsible for severe cholera outbreaks with epidemic or pandemic potential. All other nontoxigenic, non-O1/non-O139 V. cholerae (NTVC) strains may cause various other diseases, such as mild to severe infections of the ears, of the gastrointestinal and urinary tracts as well as wound and bloodstream infections. Older, immunocompromised people and patients with specific preconditions have an elevated risk. In recent years, worldwide reports demonstrated that NTVC infections are on the rise, caused amongst others by elevated water temperatures due to global warming.The aim of this review is to summarize the knowledge gained during the past two decades on V. cholerae infections and its occurrence in bathing waters in Austria, with a special focus on the lake Neusiedler See. We investigated whether NTVC infections have increased and which specific environmental conditions favor the occurrence of NTVC. We present an overview of state of the art methods that are currently available for clinical and environmental diagnostics. A preliminary public health risk assessment concerning NTVC infections related to the Neusiedler See was established. In order to raise awareness of healthcare professionals for NTVC infections, typical symptoms, possible treatment options and the antibiotic resistance status of Austrian NTVC isolates are discussed., (© 2023. The Author(s).)
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- 2023
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24. Shear influence on colloidal cluster growth: a SANS and USANS study.
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Muzny C, de Campo L, Sokolova A, Garvey CJ, Rehm C, and Hanley H
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This study examines the time evolution of silica/water clusters where the formation of a gel network from unitary silica particles is interrupted by a simple Couette shear field. The aim is to enable the general understanding of this simple system by examining the microscopic basis for the changes in viscosity by providing structural inputs from small-angle scattering for a simple theoretical model. The experimental system is an 8.3 nm particle silica solution (Ludox) where the gelation has been initiated by lowering the pH in a Couette cell providing a constant shear rate of 250 s
-1 . A unified small-angle neutron scattering (SANS) and ultra-small-angle neutron scattering (USANS) procedure is described to measure the scattered intensity in a wavevector range of 3 × 10-4 ≤ q (nm-1 ) ≤ 3.1 × 10-1 , probing structural changes over a broad range of length scales from the nanometre to the micrometre. Scattering data provide a new means of better understanding the behaviour of colloidal clusters when subjected to an external applied shear over a continuous time sequence after gel initiation; a fit of the time-dependent scattered intensity leads to an estimation of the cluster's effective volume fraction and size as a function of time. A reductionist theoretical basis is described to predict the time-dependent viscosity behaviour of the sheared colloidal suspension gel-initiated cluster growth from the volume fraction of the clusters., (© Chris Muzny et al. 2023.)- Published
- 2023
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25. Immune reconstitution inflammatory syndrome drives emergence of HIV drug resistance from multiple anatomic compartments in a person living with HIV.
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Lisco A, Lange C, Manion M, Kuriakose S, Dewar R, Gorelick RJ, Huik K, Yu Q, Hammoud DA, Smith BR, Muranski P, Rehm C, Sherman BT, Sykes C, Lindo N, Ye P, Bricker KM, Keele BF, Fennessey CM, Maldarelli F, and Sereti I
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- Male, Humans, Middle Aged, Brain, Central Nervous System, Immune Reconstitution Inflammatory Syndrome drug therapy, Immune Reconstitution Inflammatory Syndrome etiology, Leukoencephalopathy, Progressive Multifocal drug therapy, Leukoencephalopathy, Progressive Multifocal etiology, HIV Infections
- Abstract
Reservoirs of HIV maintained in anatomic compartments during antiretroviral therapy prevent HIV eradication. However, mechanisms driving their persistence and interventions to control them remain elusive. Here we report the presence of an inducible HIV reservoir within antigen-specific CD4
+ T cells in the central nervous system of a 59-year-old male with progressive multifocal leukoencephalopathy immune reconstitution inflammatory syndrome (PML-IRIS). HIV production during PML-IRIS was suppressed by modulating inflammation with corticosteroids; selection of HIV drug resistance caused subsequent breakthrough viremia. Therefore, inflammation can influence the composition, distribution and induction of HIV reservoirs, warranting it as a key consideration for developing effective HIV remission strategies., (© 2023. The Author(s), under exclusive licence to Springer Nature America, Inc.)- Published
- 2023
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26. First report on the occurrence of Vibrio cholerae nonO1/nonO139 in natural and artificial lakes and ponds in Serbia: Evidence for a long-distance transfer of strains and the presence of Vibrio paracholerae.
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Rehm C, Lippert K, Indra A, Kolarević S, Kračun-Kolarević M, Leopold M, Steinbacher S, Schachner I, Campostrini L, Risslegger A, Farnleitner AH, Kolm C, and Kirschner AKT
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- Humans, Lakes, Serbia epidemiology, Ponds, Water, Vibrio cholerae genetics
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Vibrio cholerae are natural inhabitants of specific aquatic environments. Strains not belonging to serogroups O1 and O139 are usually unable to produce cholera toxin and cause cholera. However, non-toxigenic V. cholerae (NTVC) are able to cause a variety of mild-to-severe human infections (via seafood consumption or recreational activities). The number of unreported cases is considered substantial, as NTVC infections are not notifiable and physicians are mostly unaware of this pathogen. In the northern hemisphere, NTVC infections have been reported to increase due to global warming. In Eastern Europe, climatic and geological conditions favour the existence of inland water-bodies harbouring NTVC. We thus investigated the occurrence of NTVC in nine Serbian natural and artificial lakes and ponds, many of them used for fishing and bathing. With the exception of one highly saline lake, all investigated water-bodies harboured NTVC, ranging from 5.4 × 10
1 to 1.86 × 104 CFU and 4.5 × 102 to 5.6 × 106 genomic units per 100 ml. The maximum values observed were in the range of bathing waters in other countries, where infections have been reported. Interestingly, 7 out of 39 fully sequenced presumptive V. cholerae isolates were assigned as V. paracholerae, a recently described sister species of V. cholerae. Some clones and sublineages of both V. cholerae and V. paracholerae were shared by different environments indicating an exchange of strains over long distances. Important pathogenicity factors such as hlyA, toxR, and ompU were present in both species. Seasonal monitoring of ponds/lakes used for recreation in Serbia is thus recommended to be prepared for potential occurrence of infections promoted by climate change-induced rise in water temperatures., (© 2022 The Authors. Environmental Microbiology Reports published by Applied Microbiology International and John Wiley & Sons Ltd.)- Published
- 2023
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27. Delays in Continuous Glucose Monitoring Device Initiation: A Single Center Experience and a Call to Change.
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Modzelewski KL, Murati J, Charoenngam N, Rehm C, and Steenkamp DW
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- Adult, Blood Glucose Self-Monitoring, Glycated Hemoglobin analysis, Humans, Retrospective Studies, Blood Glucose, Diabetes Mellitus, Type 1
- Abstract
Background: Continuous glucose monitoring (CGM) has been increasingly shown to be beneficial in patients with both types 1 and 2 diabetes using insulin. Despite this, challenges remain in obtaining coverage for these devices. We sought to define the process of initiation of CGM and better understand factors associated with successful initiation. Methods: A single-center retrospective cohort study of 271 patients seen over a 3-year period from 2017 to 2020 in the adult endocrinology clinic at Boston Medical Center who were prescribed CGM was performed. The primary outcome was time to CGM initiation. Secondary outcomes included factors associated with initiation and continued use of CGMs and glycemic control. Results: Obtaining CGM through pharmacy benefit was significantly faster than through durable medical equipment companies (78 days vs. 152 days, P < 0.0001). Factors associated with initiation of CGM were younger age, private insurance, and education with a clinical diabetes educator. Identifying as black or Hispanic was significantly associated with decreased initiation of CGM. Glycemic control as represented by hemoglobin A1c improved in patients initiated on CGM from 9.06% to 8.22% ( P < 0.001). Conclusion: Prescribing CGM as a pharmacy benefit significantly reduces the time to initiation, but on average, still takes several months, delaying potentially life-saving care for patients living with diabetes. Barriers to CGM initiation must be addressed to ensure timely delivery of optimal care to our patients.
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- 2022
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28. Structure evolution of nanodiamond aggregates: a SANS and USANS study.
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Kabir II, Osborn JC, Lu W, Mata JP, Rehm C, Yeoh GH, and Ersez T
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Ultra-small-angle neutron scattering (USANS) and small-angle neutron scattering (SANS) measurements, covering length scales from micrometres to nanometres, were made to investigate the structure of nanodiamonds (NDs) and their suspensions. These nanodiamonds were produced by two different techniques, namely by the detonation method and by the laser ablation of a carbon-hydro-carbon mixture. The (U)SANS results indicated the presence of structures four orders of magnitude larger than the dimensions of a single ND particle, consisting of aggregations of ND particles. This aggregation of the ND particles was studied by employing the contrast variation technique. Two different solvents, namely H
2 O and dimethyl sulfoxide (and their deuterated counterparts), were used to understand the role of hydrogen in the shape and size of the aggregates. The analysis of experimental data from SANS measurements also reveals the ND particles to have an ellipsoidal structure. Using a defined shape model and the SANS contrast variation technique, it was possible to characterize the non-diamond outer shell of the particles and determine the outer layer thickness. This clarification of the structure of the NDs will allow better preparation of suspensions/samples for various applications. Understanding the structure of NDs at multiple length scales also provides crucial knowledge of particle-particle interaction and its effect on the aggregation structures., (© Imrana I. Kabir et al. 2022.)- Published
- 2022
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29. Safety and immunogenicity of an investigational quadrivalent meningococcal tetanus toxoid conjugate vaccine (MenACYW-TT) co-administered with routine pediatric vaccines in infants and toddlers: A Phase II study.
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Cornish MJ, Hedrick JA, Gabrielsen AA, Johnson AD, Miriam Pina L, Rehm C, Pan J, Neveu D, Da Costa X, Jordanov E, and Dhingra MS
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- Antibodies, Bacterial, Child, Child, Preschool, Humans, Infant, Tetanus Toxoid, Vaccines, Combined, Vaccines, Conjugate, Meningococcal Infections prevention & control, Meningococcal Vaccines
- Abstract
Background: The MenACYW-TT conjugate vaccine is approved for prevention of invasive meningococcal disease (IMD) as a single dose in individuals ≥2 years of age in the United States and ≥12 months in EU and some other countries. This Phase II study evaluated the safety and immunogenicity of this vaccine and of concomitant pediatric vaccines in infants/toddlers (6 weeks-15 months of age)., Methods: Five schedules of the MenACYW-TT conjugate vaccine were evaluated in the United States: 2, 4, 6, and 12 months; 2, 4, 6, and 15 months; 2, 4, and 12 months; 6 and 12 months; and 12 months alone. Routine pediatric vaccines (DTaP-IPV/Hib, PCV7/PCV13, MMR, and varicella) were administered per approved schedules. Proportions of participants with serum bactericidal antibodyassay with human complement (hSBA) titers ≥1:4 and ≥1:8, SBA with baby rabbit complement (rSBA) titers ≥1:8 and ≥1:128, and immune responses against concomitant vaccines were determined., Results: Tenderness and irritability were the most frequent solicited injection site and systemic reactions. Similar proportions of participants achieved an hSBA titer ≥1:8 for all four serogroups regardless of whether 2 or 3 doses were administered in the first year of life. Following a second-year dose, 91-100% of participants achieved the threshold for all 4 serogroups in all schedules regardless of the number of doses in the first year of life. Similar responses were seen with rSBA. Immunogenicity and safety profile of concomitant vaccines was similar whether the MenACYW-TT conjugate vaccine was administered or not., Conclusion: MenACYW-TT conjugate vaccine administered with pediatric vaccines is safe and immunogenic regardless of the schedule and does not affect the immunogenicity or safety of the concomitant vaccines., Clinical Trial Registry: NCT01049035., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: CR, JP, DN, EJ, and MSD currently are, and LMP and XDC were employees of Sanofi Pasteur at the time the study was conducted and hold stock options in Sanofi Pasteur., Inc. MC, JH, AG, and AJ received a grant to carry out the research at their respective study sites., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)
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- 2022
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30. Evaluation of a Paper-Based Checklist versus an Electronic Handover Tool Based on the Situation Background Assessment Recommendation (SBAR) Concept in Patients after Surgery for Congenital Heart Disease.
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Rehm C, Zoller R, Schenk A, Müller N, Strassberger-Nerschbach N, Zenker S, and Schindler E
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(1) Background: we compare a new SBAR based electronic handover tool versus a paper-based checklist for handover in a pediatric intensive care unit (PICU). (2) Methods: this is a randomized, observational study of 40 electronic vs. 40 paper checklist handovers after pediatric cardiac surgery, with a 48 items checklist for comparison of reporting frequencies and notification of disturbances and noise. PICU staff satisfaction was evaluated by a 12-item questionnaire. (3) Results: in 14 out of 40 cases, there were problems with data processing (incomplete or no data processing). Some item groups (e.g., hemodynamics) were consistently reported at higher frequencies than other groups. Items not specifically asked for did not get reported. Some items, automatically processed in the SBAR handover page, did not get reported. Many handovers suffered a noisy and distracting atmosphere. There was no difference in staff satisfaction between the two handover approaches. Nurses were highly unsatisfied with the general approach by which the handover was performed. (4) Conclusions: human error appears to be a main factor for unreliable data processing. Software is still too complicated, and multitasking is a stressful and error prone event. Handover is a complex task with many factors required for a successful completion.
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- 2021
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31. Safety, immunogenicity, and efficacy of a Clostridioides difficile toxoid vaccine candidate: a phase 3 multicentre, observer-blind, randomised, controlled trial.
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de Bruyn G, Gordon DL, Steiner T, Tambyah P, Cosgrove C, Martens M, Bassily E, Chan ES, Patel D, Chen J, Torre-Cisneros J, Fernando De Magalhães Francesconi C, Gesser R, Jeanfreau R, Launay O, Laot T, Morfin-Otero R, Oviedo-Orta E, Park YS, Piazza FM, Rehm C, Rivas E, Self S, and Gurunathan S
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- Aged, Aged, 80 and over, Bacterial Vaccines adverse effects, Female, Humans, Immunization Schedule, Male, Middle Aged, Bacterial Vaccines immunology, Clostridioides difficile, Clostridium Infections prevention & control
- Abstract
Background: In the absence of a licensed vaccine, Clostridioides (formerly Clostridium) difficile infection represents a substantial health burden. The aim of this study was to evaluate the efficacy, immunogenicity, and safety of a toxoid vaccine candidate., Methods: We did a phase 3 multicentre, observer-blind, randomised, controlled trial at 326 hospitals, clinics, and clinical research centres in 27 countries in the USA, Canada, Latin America, Europe, and the Asia-Pacific region. We included adults aged 50 years or older who were considered to be at an increased risk of C difficile infection because they had previously had two hospital stays (each ≥24 h in duration) and had received systemic antibiotics in the previous 12 months (risk stratum 1), or because they were anticipating being admitted to hospital for 72 h or more for elective surgery within 60 days of enrolment (risk stratum 2). Eligible participants were stratified by geographical region and the two risk strata, and randomly assigned (2:1), with a fixed block size of three, to receive either a C difficile toxoid vaccine candidate, containing toxoids A and B (C difficile vaccine candidate group), or a placebo vaccine (placebo group). Participants, investigators, and personnel responsible for collecting safety data and analysing blood and stool samples were masked to group assignment. Personnel responsible for study product preparation and administration were not masked to group assignment. One dose (0·5 mL) of C difficile vaccine candidate or placebo vaccine was administered intramuscularly on days 0, 7, and 30. The primary outcome was the efficacy of the vaccine in preventing symptomatic C difficile infection, defined as having three or more loose stools in a period of 24 h or less, loose stools for 24 h or more, and a PCR-positive test for C difficile toxin B in a loose stool sample, within 3 years after the final vaccine dose. The primary outcome was measured in the modified intention-to-treat population (ie, all participants who received at least one injection of the assigned vaccine). The safety of the vaccine was assessed in the safety analysis set (ie, all participants who had received at least one injection, analysed according to the product received). This study is registered with WHO/ICTRP, number U111-1127-7162, and ClinicalTrials.gov, number NCT01887912, and has been terminated., Findings: Between July 30, 2013, and Nov 17, 2017, we enrolled and randomly assigned 9302 participants to the C difficile vaccine candidate group (n=6201) or to the placebo group (n=3101). 6173 (99·5%) participants in the C difficile vaccine candidate group and 3085 (99·5%) participants in the placebo group received at least one dose of the vaccine. The study was terminated after the first planned interim analysis because of futility. In the C difficile vaccine candidate group, 34 C difficile infections were reported over 11 697·2 person-years at risk (0·29 infections per 100 person-years [95% CI 0·20-0·41]) compared with 16 C difficile infections over 5789·4 person-years at risk in the placebo group (0·28 infections per 100 person-years [0·16-0·45]), indicating a vaccine efficacy of -5·2% (95% CI -104·1 to 43·5). In the C difficile vaccine candidate group, 2847 (46·6%) of 6113 participants reported an adverse event within 30 days of injection compared with 1282 (41·9%) of 3057 participants in the placebo group. The proportion of participants who had an adverse event leading to study discontinuation was 4·8% in both groups (296 participants in the C difficile vaccine candidate group and 146 participants in the placebo group). 1662 (27·2%) participants in the C difficile vaccine candidate group reported at least one serious adverse event compared with 851 (27·8%) participants in the placebo group., Interpretation: In adults at risk for C difficile infection, a bivalent C difficile toxoid vaccine did not prevent C difficile infection. Since the C difficile vaccine candidate met the criteria for futility, the study was terminated and clinical development of this vaccine candidate was stopped., Funding: Sanofi Pasteur., (Copyright © 2021 Elsevier Ltd. All rights reserved.)
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- 2021
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32. Engineering Aptazyme Switches for Conditional Gene Expression in Mammalian Cells Utilizing an In Vivo Screening Approach.
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Rehm C, Klauser B, Finke M, and Hartig JS
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- Animals, Computers, Molecular, Gene Library, Genes, Reporter, Ligands, Mammals genetics, Nucleic Acid Conformation, Plasmids genetics, RNA metabolism, Substrate Specificity, Aptamers, Nucleotide genetics, Biosensing Techniques methods, Genetic Engineering methods, RNA genetics, RNA, Catalytic genetics, Riboswitch genetics
- Abstract
Artificial RNA switches are an emerging class of genetic controllers suitable for synthetic biology applications. Aptazymes are fusions composed of an aptamer domain and a self-cleaving ribozyme. The utilization of aptazymes for conditional gene expression displays several advantages over employing conventional transcription factor-based techniques as aptazymes require minimal genomic space, fulfill their function without the need of protein cofactors and most importantly are reprogrammable with respect to ligand selectivity and the RNA function to be regulated. Technologies that enable the generation of aptazymes to defined input ligands are of interest for the construction of biocomputing devices and biosensing applications. In this chapter we present a method that facilitates the in vivo screening of randomized pools of aptazymes in mammalian cells.
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- 2021
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33. Prolonged Posttreatment Virologic Control and Complete Seroreversion After Advanced Human Immunodeficiency Virus-1 Infection.
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Uruena A, Cassetti I, Kashyap N, Deleage C, Estes JD, Trindade C, Hammoud DA, Burbelo PD, Natarajan V, Dewar R, Imamichi H, Ward AJ, Poole A, Ober A, Rehm C, Jones S, Liang CJ, Chun TW, Nath A, Lane HC, Smith BR, Connors M, and Migueles SA
- Abstract
Background: Possible human immunodeficiency virus (HIV)-1 clearance has rarely been reported. In this study, we describe a unique case of an HIV-positive, combination antiretroviral therapy (cART)-experienced woman with prior acquired immunodeficiency syndrome (AIDS) who has not experienced viral rebound for over 12 years since discontinuing cART., Methods: Leukapheresis, colonoscopy, and lymph node excision were performed for detailed examination of virologic (including HIV reservoir) and immunologic features. Comparisons were made with chronically infected patients and healthy controls., Results: No HIV-specific antibodies were detected in serum. Plasma HIV ribonucleic acid (RNA) levels were <0.2 copies/mL, and, except for low-frequency HIV deoxyribonucleic acid (DNA)
+ cells in lymph node tissue (1 copy/3 × 106 cells), HIV antigen could not be detected by quantitative virus outgrowth (<0.0025 infectious units/106 CD4+ T cells) or by most measurements of HIV RNA or DNA in blood, lymph node, or gut-associated mononuclear cells. Human immunodeficiency virus-specific T-cell responses were detectable but low. Brain imaging revealed a prior biopsy site and persistent white matter disease since 1996. Human immunodeficiency virus DNA+ cells in the 1996 brain biopsy specimen confirmed her identity and initial HIV diagnosis., Conclusions: This represents the first report of complete seroreversion, prolonged posttreatment virus suppression, a profoundly small HIV reservoir, and persistent HIV-specific T cells in an adult with prior AIDS., (Published by Oxford University Press on behalf of Infectious Diseases Society of America 2020.)- Published
- 2020
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34. Consumption of 100% Orange Juice in Relation to Flavonoid Intakes and Diet Quality Among US Children and Adults: Analyses of NHANES 2013-16 Data.
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Maillot M, Vieux F, Rehm C, and Drewnowski A
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This study explored consumption patterns of 100% orange juice by socio-demographics among US children and adults. Dietary intakes data for 15,983 persons aged >2 y came from the nationally representative National Health and Nutrition Examination Survey (NHANES 2013-2016). The What We Eat in America nutrient composition database was merged with the USDA Expanded Flavonoid Database to assess flavonoid intakes. Diet quality measures were the Healthy Eating Index (HEI-2015) and Nutrient Rich Food (NRF9.3) Index. Orange juice consumption accounted for a mean of 14 kcal/d and varied with age, incomes, and race/ethnicity. Orange juice consumption was associated with higher intakes of bioactive flavonoids, lower added sugars, and higher-quality diets overall. Diets of consumers were higher in vitamin C, potassium, calcium, vitamin D (adults), flavanones, and total flavonoids (children) as compared to non-consumers. Consumers had significantly higher HEI-2015 and NRF9.3 scores and lower body mass index values (adults). However, only 15.9% of the NHANES sample consumed any orange juice at all; of these 11.8% had <1 serving/day and only 3.4% had 1 serving/day or more., (Copyright © 2020 Maillot, Vieux, Rehm and Drewnowski.)
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- 2020
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35. Dynamic Shifts in the HIV Proviral Landscape During Long Term Combination Antiretroviral Therapy: Implications for Persistence and Control of HIV Infections.
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Anderson EM, Simonetti FR, Gorelick RJ, Hill S, Gouzoulis MA, Bell J, Rehm C, Pérez L, Boritz E, Wu X, Wells D, Hughes SH, Rao V, Coffin JM, Kearney MF, and Maldarelli F
- Subjects
- Antiretroviral Therapy, Highly Active, CD4-Positive T-Lymphocytes virology, Cell Cycle Proteins genetics, DNA, Viral blood, DNA, Viral genetics, Defective Viruses genetics, Genes, gag, HIV Long Terminal Repeat, HIV-1 drug effects, Humans, Immunologic Memory, Multiplex Polymerase Chain Reaction, Proviruses genetics, T-Lymphocyte Subsets immunology, T-Lymphocyte Subsets virology, Time Factors, Treatment Outcome, Viral Load, Anti-HIV Agents therapeutic use, HIV Infections drug therapy, HIV Infections virology, HIV-1 genetics, HIV-1 isolation & purification, Leukocytes, Mononuclear virology, Proviruses isolation & purification
- Abstract
Combination antiretroviral therapy (cART) controls but does not eradicate HIV infection; HIV persistence is the principal obstacle to curing infections. The proportion of defective proviruses increases during cART, but the dynamics of this process are not well understood, and a quantitative analysis of how the proviral landscape is reshaped after cART is initiated is critical to understanding how HIV persists. Here, we studied longitudinal samples from HIV infected individuals undergoing long term cART using multiplexed Droplet Digital PCR (ddPCR) approaches to quantify the proportion of deleted proviruses in lymphocytes. In most individuals undergoing cART, HIV proviruses that contain gag are lost more quickly than those that lack gag . Increases in the fraction of gag -deleted proviruses occurred only after 1-2 years of therapy, suggesting that the immune system, and/or toxicity of viral re-activation helps to gradually shape the proviral landscape. After 10-15 years on therapy, there were as many as 3.5-5 times more proviruses in which gag was deleted or highly defective than those containing intact gag . We developed a provirus-specific ddPCR approach to quantify individual clones. Investigation of a clone of cells containing a deleted HIV provirus integrated in the HORMAD2 gene revealed that the cells underwent a massive expansion shortly after cART was initiated until the clone, which was primarily in effector memory cells, dominated the population of proviruses for over 6 years. The expansion of this HIV-infected clone had substantial effects on the overall proviral population., Competing Interests: The authors declare no conflict of interest.
- Published
- 2020
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36. Cardiometabolic disease costs associated with suboptimal diet in the United States: A cost analysis based on a microsimulation model.
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Jardim TV, Mozaffarian D, Abrahams-Gessel S, Sy S, Lee Y, Liu J, Huang Y, Rehm C, Wilde P, Micha R, and Gaziano TA
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- Adult, Aged, Aged, 80 and over, Cardiovascular Diseases epidemiology, Cost of Illness, Diabetes Mellitus, Type 2 complications, Female, Humans, Male, Middle Aged, United States, Diabetes Mellitus, Type 2 epidemiology, Diet economics, Medicare economics, Nutrition Surveys statistics & numerical data
- Abstract
Background: Poor diet is a leading risk factor for cardiometabolic disease (CMD) in the United States, but its economic costs are unknown. We sought to estimate the cost associated with suboptimal diet in the US., Methods and Findings: A validated microsimulation model (Cardiovascular Disease Policy Model for Risk, Events, Detection, Interventions, Costs, and Trends [CVD PREDICT]) was used to estimate annual cardiovascular disease (fatal and nonfatal myocardial infarction, angina, and stroke) and type 2 diabetes costs associated with suboptimal intake of 10 food groups (fruits, vegetables, nuts/seeds, whole grains, unprocessed red meats, processed meats, sugar-sweetened beverages, polyunsaturated fats, seafood omega-3 fats, sodium). A representative US population sample of individuals aged 35-85 years was created using weighted sampling from National Health And Nutrition Examination Surveys (NHANES) 2009-2012 cycles. Estimates were stratified by cost type (acute, chronic, drug), sex, age, race, education, BMI, and health insurance. Annual diet-related CMD costs were $301/person (95% CI $287-$316). This translates to $50.4 billion in CMD costs (18.2% of total) for the whole population, of which 84.3% are attributed to acute care ($42.6 billion). The largest annual per capita costs are attributed to low consumption of nuts/seeds ($81; 95% CI $74-$86) and seafood omega-3 fats ($76; 95% CI $70-$83), and the lowest are attributed to high consumption of red meat ($3; 95% CI $2.8-$3.5) and polyunsaturated fats ($20; 95% CI $19-$22). Individual costs are highest for men ($380), those aged ≥65 years ($408), blacks ($320), the less educated ($392), and those with Medicare ($481) or dual-eligible ($536) insurance coverage. A limitation of our study is that dietary intake data were assessed from 24-hour dietary recall, which may not fully capture a diet over a person's life span and is subject to measurement errors., Conclusions: Suboptimal diet of 10 dietary factors accounts for 18.2% of all ischemic heart disease, stroke, and type 2 diabetes costs in the US, highlighting that timely implementation of diet policies could address these health and economic burdens., Competing Interests: I have read the journal's policy and the authors of this manuscript have the following competing interests: YH, JL, YL, PW, TAG, DM, and RM report grants from NIH during the conduct of the study. RM is PI of a research grant from Unilever on an investigator-initiated project to assess the effects of omega-6 fatty acid biomarkers on diabetes and heart disease. TAG reports research funding from Novartis unrelated to the submitted work; and all outside the submitted work, personal fees for consulting from the World Health Organization and Amgen. CR has consulted for the Dairy Management Institute, Unilever, Nestle, PepsiCo, and the Bell Institute (General Mills), all outside of the submitted work. In addition, RM reports personal fees from the World Bank and Bunge, and DM reports research funding from the National Institutes of Health and the Gates Foundation; and, all outside the submitted work, personal fees for ad hoc consulting from GOED, Nutrition Impact, Bunge, Indigo Agriculture, Amarin, Acasti Pharma, Cleveland Clinic Foundation, America’s Test Kitchen, and Danone; scientific advisory board, DayTwo, Elysium Health, Filtricine, and Omada Health; and chapter royalties from UpToDate. This work was performed this investigation as part of the Food Policy Review and Intervention Cost Effectiveness (Food-PRICE) Study.
- Published
- 2019
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37. No evidence of ongoing HIV replication or compartmentalization in tissues during combination antiretroviral therapy: Implications for HIV eradication.
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Bozzi G, Simonetti FR, Watters SA, Anderson EM, Gouzoulis M, Kearney MF, Rote P, Lange C, Shao W, Gorelick R, Fullmer B, Kumar S, Wank S, Hewitt S, Kleiner DE, Hattori J, Bale MJ, Hill S, Bell J, Rehm C, Grossman Z, Yarchoan R, Uldrick T, and Maldarelli F
- Subjects
- Adolescent, Adult, Anti-HIV Agents pharmacology, Anti-HIV Agents therapeutic use, Antiretroviral Therapy, Highly Active, Child, Female, HIV classification, HIV drug effects, HIV genetics, HIV Infections drug therapy, Humans, Male, Organ Specificity, Phylogeny, RNA, Viral, Sequence Analysis, DNA, Young Adult, HIV physiology, HIV Infections virology, Virus Replication drug effects
- Abstract
HIV persistence during combination antiretroviral therapy (cART) is the principal obstacle to cure. Mechanisms responsible for persistence remain uncertain; infections may be maintained by persistence and clonal expansion of infected cells or by ongoing replication in anatomic locations with poor antiretroviral penetration. These mechanisms require different strategies for eradication, and determining their contributions to HIV persistence is essential. We used phylogenetic approaches to investigate, at the DNA level, HIV populations in blood, lymphoid, and other infected tissues obtained at colonoscopy or autopsy in individuals who were on cART for 8 to 16 years. We found no evidence of ongoing replication or compartmentalization of HIV; we did detect clonal expansion of infected cells that were present before cART. Long-term persistence, and not ongoing replication, is primarily responsible for maintaining HIV. HIV-infected cells present when cART is initiated represent the only identifiable source of persistence and is the appropriate focus for eradication., (Copyright © 2019 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution NonCommercial License 4.0 (CC BY-NC).)
- Published
- 2019
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38. Designing Optimal Breakfast for the United States Using Linear Programming and the NHANES 2011-2014 Database: A Study from the International Breakfast Research Initiative (IBRI).
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Vieux F, Maillot M, D Rehm C, and Drewnowski A
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- Adolescent, Adult, Child, Child, Preschool, Databases, Factual, Feeding Behavior, Female, Humans, Male, Nutrition Surveys, Recommended Dietary Allowances, United States, Young Adult, Breakfast, Energy Intake, Nutritive Value, Programming, Linear
- Abstract
The quality of dietary patterns can be optimized using a mathematical technique known as linear programming (LP). LP methods have rarely been applied to individual meals. The present LP models optimized the breakfast meal for those participants in the nationally representative National Health and Nutrition Examination Survey 2011-2014 who ate breakfast ( n = 11,565). The Nutrient Rich Food Index (NRF9.3) was a measure of diet quality. Breakfasts in the bottom tertile of NRF9.3 scores (T1) were LP-modeled to meet nutrient requirements without deviating too much from current eating habits. Separate LP models were run for children and for adults. The LP-modeled breakfasts resembled the existing ones in the top tertile of NRF9.3 scores (T3), but were more nutrient-rich. Favoring fruit, cereals, and dairy, the LP-modeled breakfasts had less meat, added sugars and fats, but more whole fruit and 100% juices, more whole grains, and more milk and yogurt. LP modeling methods can build on existing dietary patterns to construct food-based dietary guidelines and identify individual meals and/or snacks that need improvement.
- Published
- 2019
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39. Evolution of the Interfacial Structure of a Catalyst Ink with the Quality of the Dispersing Solvent: A Contrast Variation Small-Angle and Ultrasmall-Angle Neutron Scattering Investigation.
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Balu R, Choudhury NR, Mata JP, de Campo L, Rehm C, Hill AJ, and Dutta NK
- Abstract
The electrocatalyst layer (ECL) of the proton-exchange membrane fuel cell (PEMFC) is commonly fabricated from colloidal catalyst ink containing carbon-supported catalyst nanoparticles (NPs), ionomer stabilizer, and dispersion medium (DM). The structure, stability, and aggregate size distribution of fuel cell catalyst ink are critically dependent on the quality of DM. However, understanding of the influence of the quality of DM on the hierarchical structure of the ECL is lacking. This work presents a systematic investigation of the effects of reducing alcohol content in isopropyl alcohol/water (IPA/H
2 O) binary mixtures as DM on the structural evolution of water-rich (green) catalyst ink using contrast-variation small-angle and ultrasmall-angle neutron scattering techniques. Both qualitative and quantitative information are extracted from the data to obtain information about the size, structure, and organization of the catalyst ink using different model functions fit to the experimental data. The catalyst ink prepared using 70% IPA (commonly employed in industry and extensively reported in the literature) is shown to consist of randomly distributed globular carbon aggregates (mean radius of gyration of ∼178.9 nm) stabilized by an ionomer mass fractal shell (thickness of ∼13.0 nm), which is dispersed in the matrix of rodlike (∼1.3 nm radius and ∼35.0 nm length) negatively surface-charged ionomer NPs. These well characterized baseline data are then compared and contrasted with DM formulations of lower IPA content. A sequential reduction in IPA content of DM shows a progressive increase in the ionomer NP radius and electrostatic repulsion, concomitantly with the decrease in the carbon aggregate size and ionomer shell thickness of the catalyst ink. Therefore, the changes in the interfacial structure via adjustments of the DM composition can be used as a controlling parameter to tailor the hierarchical structure of the colloidal fuel cell catalyst ink and to further optimize the performance of the ECL.- Published
- 2019
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40. Micron-scale restructuring of gelling silica subjected to shear.
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de Campo L, Garvey CJ, Muzny CD, Rehm C, and Hanley HJM
- Abstract
Hypothesis/objective: We examine the time dependent viscometric behavior of a well-defined system of gelling colloidal silica and how this behavior may be understood from a simple theoretical model which incorporates the microstructure of the gel. The ultra-small angle neutron scattering (USANS) technique is used to interrogate structure during the gelation process., Experiments: The investigations focused on a system where both particles and interactions are well-defined: 7 nm silica particle acid-treated aqueous solution subjected to a constant applied shear in Couette geometry. Ultra-small angle neutron scattering (USANS) time-dependent scattering intensities were measured at wave vectors, q, in the range, 1.0 × 10
-3 ≤ q/nm ≤ 7.3 × 10-2 coupled with viscosity data recorded simultaneously. The interpretation of the USANS scattering data is reliant on an isotropic sample. This assumption has been investigated, over a limited range of scattering vectors, using more suitable small angle neutron scattering (SANS) instrumentation with a restricted q-range., Findings: The first recorded direct kinetic measurements of the micron-scale structure in a gelling system. A critical micro-structural feature of the intensity-viscosity time behavior of a gelling colloid subjected to a shear is the cluster size. A viscosity/intensity coupling observed at the time of a viscosity maximum that corresponds to a time-dependent critical stress and speculated to be independent of the wave vector over a wide q-range., (Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.)- Published
- 2019
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41. Cost-effectiveness of financial incentives and disincentives for improving food purchases and health through the US Supplemental Nutrition Assistance Program (SNAP): A microsimulation study.
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Mozaffarian D, Liu J, Sy S, Huang Y, Rehm C, Lee Y, Wilde P, Abrahams-Gessel S, de Souza Veiga Jardim T, Gaziano T, and Micha R
- Subjects
- Adult, Aged, Aged, 80 and over, Cardiovascular Diseases economics, Cardiovascular Diseases prevention & control, Computer Simulation, Cost Savings statistics & numerical data, Cost-Benefit Analysis, Diet, Healthy economics, Female, Health Behavior, Health Policy, Humans, Male, Middle Aged, Nutrition Surveys, Quality-Adjusted Life Years, United States, Beverages economics, Choice Behavior, Food economics, Food Assistance economics, Government Programs economics, Health Care Costs statistics & numerical data, Motivation
- Abstract
Background: The Supplemental Nutrition Assistance Program (SNAP) provides approximately US$70 billion annually to support food purchases by low-income households, supporting approximately 1 in 7 Americans. In the 2018 Farm Bill, potential SNAP revisions to improve diets and health could include financial incentives, disincentives, or restrictions for certain foods. However, the overall and comparative impacts on health outcomes and costs are not established. We aimed to estimate the health impact, program and healthcare costs, and cost-effectiveness of food incentives, disincentives, or restrictions in SNAP., Methods and Findings: We used a validated microsimulation model (CVD-PREDICT), populated with national data on adult SNAP participants from the National Health and Nutrition Examination Survey (NHANES) 2009-2014, policy effects from SNAP pilots and food pricing meta-analyses, diet-disease effects from meta-analyses, and policy, food, and healthcare costs from published literature to estimate the overall and comparative impacts of 3 dietary policy interventions: (1) a 30% incentive for fruits and vegetables (F&V), (2) a 30% F&V incentive with a restriction of sugar-sweetened beverages (SSBs), and (3) a broader incentive/disincentive program for multiple foods that also preserves choice (SNAP-plus), combining 30% incentives for F&V, nuts, whole grains, fish, and plant-based oils and 30% disincentives for SSBs, junk food, and processed meats. Among approximately 14.5 million adults on SNAP at baseline with mean age 52 years, our simulation estimates that the F&V incentive over 5 years would prevent 38,782 cardiovascular disease (CVD) events, gain 18,928 quality-adjusted life years (QALYs), and save $1.21 billion in healthcare costs. Adding SSB restriction increased gains to 93,933 CVD events prevented, 45,864 QALYs gained, and $4.33 billion saved. For SNAP-plus, corresponding gains were 116,875 CVD events prevented, 56,056 QALYs gained, and $5.28 billion saved. Over a lifetime, the F&V incentive would prevent approximately 303,900 CVD events, gain 649,000 QALYs, and save $6.77 billion in healthcare costs. Adding SSB restriction increased gains to approximately 797,900 CVD events prevented, 2.11 million QALYs gained, and $39.16 billion in healthcare costs saved. For SNAP-plus, corresponding gains were approximately 940,000 CVD events prevented, 2.47 million QALYs gained, and $41.93 billion saved. From a societal perspective (including programmatic costs but excluding food subsidy costs as an intra-societal transfer), all 3 scenarios were cost-saving. From a government affordability perspective (i.e., incorporating food subsidy costs, including for children and young adults for whom no health gains were modeled), the F&V incentive was of low cost-effectiveness at 5 years (incremental cost-effectiveness ratio: $548,053/QALY) but achieved cost-effectiveness ($66,525/QALY) over a lifetime. Adding SSB restriction, the intervention was cost-effective at 10 years ($68,857/QALY) and very cost-effective at 20 years ($26,435/QALY) and over a lifetime ($5,216/QALY). The combined incentive/disincentive program produced the largest health gains and reduced both healthcare and food costs, with net cost-savings of $10.16 billion at 5 years and $63.33 billion over a lifetime. Results were consistent in probabilistic sensitivity analyses: for example, from a societal perspective, 1,000 of 1,000 iterations (100%) were cost-saving for all 3 interventions. Due to the nature of simulation studies, the findings cannot prove the health and cost impacts of national SNAP interventions., Conclusions: Leveraging healthier eating through SNAP could generate substantial health benefits and be cost-effective or cost-saving. A combined food incentive/disincentive program appears most effective and may be most attractive to policy-makers., Competing Interests: I have read the journal's policy and the authors of this manuscript have the following competing interests: RM reports research funding from Unilever and personal fees from the World Bank and Bunge; and DM personal fees from Amarin, Acasti Pharma, GOED, DSM, Nutrition Impact, Pollock Communications, Bunge, Indigo Agriculture, America’s Test Kitchen, and UpToDate; all outside the submitted work.
- Published
- 2018
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42. Early Presence of HIV-1 Subtype C in Washington, D.C.
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Grossman Z, Rico SV, Cone K, Shao W, Rehm C, Jones S, Bozzi G, Dean S, Dewar R, Rehman T, Purdy J, Hadigan C, Pau AK, and Maldarelli F
- Subjects
- Child, District of Columbia epidemiology, Female, HIV Infections transmission, HIV-1 isolation & purification, Humans, Infant, Newborn, Infectious Disease Transmission, Vertical, Molecular Epidemiology, Pregnancy, Genotype, HIV Infections epidemiology, HIV Infections virology, HIV-1 classification, HIV-1 genetics
- Abstract
The presence of non-B HIV subtypes in the USA has been documented during the epidemic, although the timing of early introductions of different subtypes remains uncertain. Subtype C, the most common HIV variant worldwide, was first reported in the USA in 1996-97, after subtype C had expanded greatly in sub-Saharan Africa. In this study, we report a patient with subtype C infection acquired by mother-to-child transmission, born in the USA in 1990 to a Washington, D.C. resident who never traveled outside the USA, demonstrating that subtype C was present in the USA much earlier. Comparative analysis of the sequence from this patient and subtype C sequences in the USA and elsewhere suggest multiple independent introductions of this subtype into the USA have taken place, many of which are traced to sub-Saharan or East Africa. These data indicate subtype C HIV was already present in the USA years earlier than previously reported, and during the early period of subtype C expansion.
- Published
- 2018
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43. Structural evolution of photocrosslinked silk fibroin and silk fibroin-based hybrid hydrogels: A small angle and ultra-small angle scattering investigation.
- Author
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Whittaker JL, Balu R, Knott R, de Campo L, Mata JP, Rehm C, Hill AJ, Dutta NK, and Roy Choudhury N
- Subjects
- Animals, Bombyx, Cross-Linking Reagents chemistry, Fibroins chemistry, Hydrogels chemistry, Polyvinyls chemistry, Scattering, Small Angle, X-Ray Diffraction
- Abstract
Regenerated Bombyx mori silk fibroin (RSF) is a widely recognized protein for biomedical applications; however, its hierarchical gel structure is poorly understood. In this paper, the hierarchical structure of photocrosslinked RSF and RSF-based hybrid hydrogel systems: (i) RSF/Rec1-resilin and (ii) RSF/poly(N-vinylcaprolactam (PVCL) is reported for the first time using small-angle scattering (SAS) techniques. The structure of RSF in dilute to concentrated solution to fabricated hydrogels were characterized using small angle X-ray scattering (SAXS), small angle neutron scattering (SANS) and ultra-small angle neutron scattering (USANS) techniques. The RSF hydrogel exhibited three distinctive structural characteristics: (i) a Porod region in the length scale of 2 to 3nm due to hydrophobic domains (containing β-sheets) which exhibits sharp interfaces with the amorphous matrix of the hydrogel and the solvent, (ii) a Guinier region in the length scale of 4 to 20nm due to hydrophilic domains (containing turns and random coil), and (iii) a Porod-like region in the length scale of few micrometers due to water pores/channels exhibiting fractal-like characteristics. Addition of Rec1-resilin or PVCL to RSF and subsequent crosslinking systematically increased the nanoscale size of hydrophobic and hydrophilic domains, whereas decreased the homogeneity of pore size distribution in the microscale. The presented results have implications on the fundamental understanding of the structure-property relationship of RSF-based hydrogels., (Copyright © 2018. Published by Elsevier B.V.)
- Published
- 2018
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44. Virion incorporation of integrin α4β7 facilitates HIV-1 infection and intestinal homing.
- Author
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Guzzo C, Ichikawa D, Park C, Phillips D, Liu Q, Zhang P, Kwon A, Miao H, Lu J, Rehm C, Arthos J, Cicala C, Cohen MS, Fauci AS, Kehrl JH, and Lusso P
- Abstract
The intestinal mucosa is a key anatomical site for HIV-1 replication and CD4
+ T cell depletion. Accordingly, in vivo treatment with an antibody to the gut-homing integrin α4β7 was shown to reduce viral transmission, delay disease progression, and induce persistent virus control in macaques challenged with simian immunodeficiency virus (SIV). We show that integrin α4β7 is efficiently incorporated into the envelope of HIV-1 virions. Incorporated α4β7 is functionally active as it binds mucosal addressin cell adhesion molecule-1 (MAdCAM-1), promoting HIV-1 capture by and infection of MAdCAM-expressing cells, which in turn mediate trans-infection of bystander cells. Functional α4β7 is present in circulating virions from HIV-infected patients and SIV-infected macaques, with peak levels during the early stages of infection. In vivo homing experiments documented selective and specific uptake of α4β7+ HIV-1 virions by high endothelial venules in the intestinal mucosa. These results extend the paradigm of tissue homing to a retrovirus and are relevant for the pathogenesis, treatment, and prevention of HIV-1 infection., (Copyright © 2017, American Association for the Advancement of Science.)- Published
- 2017
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45. Insights into Free Volume Variations across Ion-Exchange Membranes upon Mixed Solvents Uptake by Small and Ultrasmall Angle Neutron Scattering.
- Author
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Allioux FM, Garvey CJ, Rehm C, Tardy BL, Dagastine RR, Hodgson PD, Kong L, and Dumée LF
- Abstract
Ion-exchange membranes are composite separation materials increasingly used in a variety of electro-membranes and electrochemical processes. Although promising for solvent reclamation, to date, their main applications are limited to aqueous environments due to physicochemical and microstructural changes of the materials upon exposure to nonaqueous and mixed solvents solutions, affecting long-term stability and separation performance. In the present work, the structural changes of commercial and novel hybrid ion-exchange membranes in mixed methanol/water and ethanol/water solutions are assessed for the first time using ultra- and small-angle neutron scattering techniques. The interface between the ion-exchange functional layer and the mechanical support of the membranes is evaluated in the ultralow-q region, while a broad solvent-dependent peak at the mid-q region was correlated to the microstructural properties which are related to the free volume across the ion-exchange domains and to the materials electrical and nanoscale mechanical properties. The results of this study may offer new opportunities toward the development of an efficient separation process using ion-exchange membranes for the purification of fermentation broths toward biofuel generation.
- Published
- 2017
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46. Structural Evolution of Wormlike Micellar Fluids Formed by Erucyl Amidopropyl Betaine with Oil, Salts, and Surfactants.
- Author
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McCoy TM, Valiakhmetova A, Pottage MJ, Garvey CJ, Campo L, Rehm C, Kuryashov DA, and Tabor RF
- Abstract
Solutions of extended, flexible cylindrical micelles, often known as wormlike micelles, have great potential as the base for viscoelastic complex fluids in oil recovery, drilling, and lubrication. Here, we study the morphology and nanostructural characteristics of a model wormlike micellar fluid formed from erucyl amidopropyl betaine (EAPB) in water as a function of a diverse range of additives relevant to complex fluid formulation. The wormlike micellar dispersions are extremely oleo-responsive, with even as little as 0.1% hydrocarbon oil causing a significant disruption of the network and a decrease in zero-shear viscosity of around 100-fold. Simple salts have little effect on the local structure of the wormlike micelles but result in the formation of fractal networks at larger length scales, whereas even tiny amounts of small organic species such as phenol can cause unexpected phase transitions. When forming mixtures with other surfactants, a vast array of self-assembled structures are formed, from spheres to ellipsoids, lamellae, and vesicles, offering the ultimate sensitivity in designing formulations with specific nanostructural characteristics.
- Published
- 2016
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47. Transmitted HIV Drug Resistance Is High and Longstanding in Metropolitan Washington, DC.
- Author
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Kassaye SG, Grossman Z, Balamane M, Johnston-White B, Liu C, Kumar P, Young M, Sneller MC, Sereti I, Dewar R, Rehm C, Meyer W 3rd, Shafer R, Katzenstein D, and Maldarelli F
- Subjects
- Adult, Anti-HIV Agents therapeutic use, Bayes Theorem, District of Columbia epidemiology, Female, HIV Infections drug therapy, Humans, Male, Phylogeny, Retrospective Studies, Anti-HIV Agents pharmacology, Drug Resistance, Viral genetics, HIV Infections epidemiology, HIV Infections virology, HIV-1 classification, HIV-1 drug effects, HIV-1 genetics
- Abstract
Background: Washington, DC, has 2.5% human immunodeficiency virus (HIV) prevalence, 3.9% among African Americans. Antiretrovirals (ARTs) are the cornerstone for treatment and prevention. Monitoring changes in transmitted drug resistance (TDR) is critical for effective HIV care., Methods: HIV genotype data for individuals enrolled in research studies in metropolitan Washington, D.C., were used to identify TDR using the World Health Organization mutation list [Bennett DE, Camacho RJ, Otelea D, et al. Drug resistance mutations for surveillance of transmitted HIV-1 drug-resistance: 2009 update. PloS One 2009; 4:e4724]. HIV phylogenies were reconstructed using maximum likelihood and Bayesian methods. HIV transmission clusters were supported by 1000 bootstrap values >0.70 and posterior probability >0.95 of having a common ancestor., Results: Among 710 individuals enrolled in 1994-2013, the median age was 38.6 years, 46.2% were female, and 53.3% were African-American. TDR was 22.5% among 566 treatment-naive individuals; 15.8% had nucleoside/nucleotide reverse transcriptase inhibitor (NRTI) resistance, 9.8% had nonnucleoside reverse-transcriptase inhibitor (NNRTI) resistance, and 4.2% had protease inhibitor (PI) resistance. Single class TDR was 10.0%, 5.1%, and 1.6% to NRTIs, NNRTIs, and PIs. Dual TDR to PI and NRTI was seen in 1.6%, NRTI and NNRTI in 3.4%, and triple class TDR in 0.9%. TDR frequency decreased from 1994-2006 (27.1%) to 2007-2013 (19.4%; P = .02). Only 6/79 (7.6%) individuals within transmission clusters had evidence of TDR., Discussions: We identified high prevalence of TDR among HIV-infected individuals in metropolitan Washington, DC, regardless of gender. Active surveillance for TDR is needed to guide ART usage and analyses of risk group contributions to HIV transmission and resistance., (© The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.)
- Published
- 2016
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48. Polymeric Ionic Liquid Nanoparticle Emulsions as a Corrosion Inhibitor in Anticorrosion Coatings.
- Author
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Taghavikish M, Subianto S, Dutta NK, de Campo L, Mata JP, Rehm C, and Choudhury NR
- Abstract
In this contribution, we report the facile preparation of cross-linked polymerizable ionic liquid (PIL)-based nanoparticles via thiol-ene photopolymerization in a miniemulsion. The synthesized PIL nanoparticles with a diameter of about 200 nm were fully characterized with regard to their chemical structures, morphologies, and properties using different techniques, such as Fourier transform infrared spectroscopy, thermogravimetric analysis, scanning electron microscopy, and transmission electron microscopy. To gain an in-depth understanding of the physical and morphological structures of the PIL nanoparticles in an emulsion, small-angle neutron scattering and ultra-small-angle neutron scattering were used. Neutron scattering studies revealed valuable information regarding the formation of cylindrical ionic micelles in the spherical nanoparticles, which is a unique property of this system. Furthermore, the PIL nanoparticle emulsion was utilized as an inhibitor in a self-assembled nanophase particle (SNAP) coating. The corrosion protection ability of the resultant coating was examined using potentiodynamic polarization and electrochemical impedance spectroscopy. The results show that the PIL nanoparticle emulsion in the SNAP coating acts as an inhibitor of corrosion and is promising for fabricating advanced coatings with improved barrier function and corrosion protection., Competing Interests: The authors declare no competing financial interest.
- Published
- 2016
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49. The use of low-calorie sweeteners is associated with self-reported prior intent to lose weight in a representative sample of US adults.
- Author
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Drewnowski A and Rehm CD
- Subjects
- Adult, Body Mass Index, Cross-Sectional Studies, Energy Intake, Female, Humans, Intention, Logistic Models, Male, Mental Recall, Middle Aged, Multivariate Analysis, Nutrition Surveys, Prevalence, Retrospective Studies, Self Report, United States, Beverages, Non-Nutritive Sweeteners administration & dosage, Obesity epidemiology, Weight Loss
- Abstract
Background: Low-calorie sweeteners (LCSs) are said to be a risk factor for obesity and diabetes. Reverse causality may be an alternative explanation., Methods: Data on LCS use, from a single 24-h dietary recall, for a representative sample of 22 231 adults were obtained from 5 cycles of the National Health and Nutrition Examination Survey (1999-2008 NHANES). Retrospective data on intent to lose or maintain weight during the prior 12-months and 10-year weight history were obtained from the weight history questionnaire. Objectively measured heights and weights were obtained from the examination. Primary analyses evaluated the association between intent to lose/maintain weight and use of LCSs and specific LCS product types using survey-weighted generalized linear models. We further evaluated whether body mass index (BMI) may mediate the association between weight loss intent and use of LCSs. The association between 10-year weight history and current LCS use was evaluated using restricted cubic splines., Results: In cross-sectional analyses, LCS use was associated with a higher prevalence of obesity and diabetes. Adults who tried to lose weight during the previous 12 months were more likely to consume LCS beverages (prevalence ratio=1.64, 95% confidence interval (CI) 1.54-1.75), tabletop LCS (prevalence ratio=1.68, 95% CI 1.47-1.91) and LCS foods (prevalence ratio=1.93, 95% CI 1.60-2.33) as compared with those who did not. In mediation analyses, BMI only partially mediated the association between weight control history and the use of LCS beverages, tabletop LCS, but not LCS foods. Current LCS use was further associated with a history of prior weight change (for example, weight loss and gain)., Conclusions: LCS use was associated with self-reported intent to lose weight during the previous 12 months. This association was only partially mediated by differences in BMI. Any inference of causality between attempts at weight control and LCS use is tempered by the cross-sectional nature of these data and retrospective self-reports of prior weight loss/maintenance intent.
- Published
- 2016
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50. Investigation of a Quadruplex-Forming Repeat Sequence Highly Enriched in Xanthomonas and Nostoc sp.
- Author
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Rehm C, Wurmthaler LA, Li Y, Frickey T, and Hartig JS
- Subjects
- Gene Expression Profiling, Genome, Bacterial, Open Reading Frames, Microsatellite Repeats, Nostoc genetics, Xanthomonas genetics
- Abstract
In prokaryotes simple sequence repeats (SSRs) with unit sizes of 1-5 nucleotides (nt) are causative for phase and antigenic variation. Although an increased abundance of heptameric repeats was noticed in bacteria, reports about SSRs of 6-9 nt are rare. In particular G-rich repeat sequences with the propensity to fold into G-quadruplex (G4) structures have received little attention. In silico analysis of prokaryotic genomes show putative G4 forming sequences to be abundant. This report focuses on a surprisingly enriched G-rich repeat of the type GGGNATC in Xanthomonas and cyanobacteria such as Nostoc. We studied in detail the genomes of Xanthomonas campestris pv. campestris ATCC 33913 (Xcc), Xanthomonas axonopodis pv. citri str. 306 (Xac), and Nostoc sp. strain PCC7120 (Ana). In all three organisms repeats are spread all over the genome with an over-representation in non-coding regions. Extensive variation of the number of repetitive units was observed with repeat numbers ranging from two up to 26 units. However a clear preference for four units was detected. The strong bias for four units coincides with the requirement of four consecutive G-tracts for G4 formation. Evidence for G4 formation of the consensus repeat sequences was found in biophysical studies utilizing CD spectroscopy. The G-rich repeats are preferably located between aligned open reading frames (ORFs) and are under-represented in coding regions or between divergent ORFs. The G-rich repeats are preferentially located within a distance of 50 bp upstream of an ORF on the anti-sense strand or within 50 bp from the stop codon on the sense strand. Analysis of whole transcriptome sequence data showed that the majority of repeat sequences are transcribed. The genetic loci in the vicinity of repeat regions show increased genomic stability. In conclusion, we introduce and characterize a special class of highly abundant and wide-spread quadruplex-forming repeat sequences in bacteria.
- Published
- 2015
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