Author: "Andrea Gazzinelli" / Topic: medicine - Searchworks@Jio Institute Digital Library Search Results

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1. Prevalence of metabolic syndrome in a rural area of Brazil

Author: Gustavo Velásquez-Meléndez, Andrea Gazzinelli, Rodrigo Côrrea-Oliveira, Adriano Marçal Pimenta, and Gilberto Kac
Subjects: Metabolic syndrome X, Hypertension, Obesity, Body mass index, Rural population, Brazil, Medicine
Abstract: CONTEXT AND OBJECTIVE: Metabolic syndrome (MS) is recognized worldwide as an important public health concern. However, little information is available for rural populations in Brazil. The aim was to determine the prevalence and risk factors associated with MS in a rural village in Brazil in 2004. DESIGN AND SETTING: Cross-sectional population-based study, in Virgem das Graças, a rural community in the Jequitinhonha Valley, State of Minas Gerais. METHODS: MS was the dependent variable, defined as any three of these risk factors: arterial hypertension, high glucose or triglyceride concentrations, low high-density lipoprotein cholesterol and abdominal obesity. MS prevalence, according to selected socioeconomic and demographic variables (age, skin color, marital status, schooling and smoking habits), was determined in 251 subjects aged 20-88 years. Multivariate logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals. RESULTS: MS prevalence was 21.6% (7.7% for men and 33.6% for women); the age-adjusted prevalence was 19.0%. The highest prevalences were observed for women > 60 years of age (52.9%) and women with body mass index (BMI) > 25 kg/m² (64%). Age, sex and BMI were associated risk factors for MS, while skin color was only significantly associated with MS for women. The models were adjusted for age, smoking habits, marital status, skin color and schooling. CONCLUSIONS: BMI and age were independently associated factors for MS in this rural community. These findings provide important evidence on the prevalence of MS as a public health problem, particularly for women and overweight individuals.
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2. Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

Author: Maryam Sharafkhah, Emanuel Zitt, Majid Ezzati, Luxia Zhang, Young-Ho Khang, Ellina Rakhimova, Kairit Mikkel, Tiina Vlasoff, Eruke E. Egbagbe, Sidsel Graff-Iversen, Ilona Nenko, Magdalena Klimek, Mathilde Savy, Sanjib Kumar Sharma, Alfonso Siani, Luís Lopes, Vanina Bongard, Gregor Jurak, Jacqueline F. Price, Christina-Paulina Lambrinou, Maria Lc Iurilli, Rainford J. Wilks, Bontha V. Babu, Fereidoun Azizi, Harunobu Nakamura, Marialaura Bonaccio, Angela Döring, Zhenyu Zhang, Naser Ahmadi, Jolanta Słowikowska-Hilczer, Ana Paula Carlos Cândido, Clive Osmond, Thirunavukkarasu Sathish, Robert J. Adams, Themistoklis Tzotzas, Reina Engle-Stone, Atul Trivedi, Shoichiro Tsugane, Niels Møller, Jorge Bezerra, Dénes Molnár, Muhammad Fadhli Mohd Yusoff, Badreya Al-Lahou, J. Jaime Miranda, Bahram Mohajer, Sigmund A. Anderssen, Lital Keinan Boker, Eero Kajantie, Martin Gulliford, Maties Torrent, Sumit Bharadwaj, Toshiharu Ninomiya, Zbigniew Gaciong, Nayu Ikeda, Li Juan Wu, Adrian Richter, Licia Iacoviello, Marc J. Gunter, Wenbin Wei, Norsyamlina Che Abdul Rahim, Eman Aly, Ambady Ramachandran, Nils Lehmann, Soile E. Puhakka, Giovanni Veronesi, Hongsheng Bi, Eiji Oda, Jia Li Duan, Per Tynelius, José María Huerta, Janne Schurmann Tolstrup, Rodrigo M. Carrillo-Larco, Rosangela Fernandes Lucena Batista, Victoria E Soto-Rojas, Hanno Ulmer, Shukri F. Mohamed, Anthony Kafatos, Suyeon Park, Mohsen Ibrahim, Hamed Pouraram, Bin Zhou, May Soe Aung, Lars Bo Andersen, Erfan Ghasemi, René Charles Sylva, Himanshu K. Chaturvedi, Luc Dauchet, Ahmad Ali Zainuddin, Angela Chetrit, Dan Zhu, Valérie Deschamps, Ko Ko Zaw, Peter Vollenweider, Tomas Vega, Yves Martin-Prével, Mahfuzar Rahman, Dorja Vočanec, Roman Topor-Madry, Vinay Nangia, Herculina S. Kruger, Asher Fawwad, Emily Sonestedt, Elena Pahomova, Aleksander Giwercman, Elżbieta Dziankowska-Zaborszczyk, Cecilia Björkelund, Tatjana Hejgaard, Maria Puiu, Maria Benedetta Donati, Andrew Wong, Carlos P. Boissonnet, Santosh K. Bhargava, Patrick Kolsteren, Dermot O'Reilly, Bahareh Kheiri, Wolfgang Kratzer, Susanne R. de Rooij, H. Bas Bueno-de-Mesquita, Günther Fink, José R. Banegas, Michele Monroy-Valle, Drude Molbo, Mahmudur Rahman, Hynek Pikhart, Rafael N. Pichardo, Massimo Salvetti, Hui Cai, Sarah Filippi, Georg Posch, Hung-Kwan So, Yonghua Hu, Katsuyasu Kouda, Joana Carvalho, Gailute Bernotiene, Hannu Uusitalo, Thein Thein Htay, Felix Kaducu, Maigeng Zhou, Lars Ängquist, Thi Tuyet-Hanh Tran, Charles Lunogelo, Michel Joffres, Sabina Zambon, Ronald D. Gregor, Vayia Rarra, Seyed Mohammad Hashemi-Shahri, Loreto Santa Marina, Galina Obreja, Rudolf Kaaks, Aya Mostafa, Maria do Carmo Franco, Beata Gurzkowska, Chien-Jen Chen, Marie Moitry, Nizal Sarrafzadegan, Xiangjun Wang, Diego Giulliano Destro Christofaro, Imperia Brajkovich, Fangfang Chen, Francesco Panza, Ling Yang, Holly E. Syddall, Cecily Kelleher, Michael Tornaritis, Ningli Wang, Lutgarde Thijs, Marjolein Visser, Angelika Schaffrath Rosario, María José Tormo, Jostein Steene-Johannessen, Norbert Amougou, Emmanuella Magriplis, Mar Alvarez-Pedrerol, Jingli Gao, Stig E. Bojesen, Giuseppe Grosso, Seongjun Ha, Lauren Lissner, Mikhail Benet, Anastasia Markaki, Sanjay Rampal, Antônio Augusto Moura da Silva, Maria Lorenza Muiesan, Angelique Chan, Yvonne T. van der Schouw, Annamari Lundqvist, Philippe Amouyel, Kristyna Zejglicova, Charalambos Hadjigeorgiou, João Breda, Jørgen Meisfjord, Fatima Zahra Laamiri, Carl Lachat, Kai-Uwe Saum, Vilma Irazola, Leng Huat Foo, Óscar Lopes, Dickman Gareta, Flavio Nervi, Imre Janszky, Ruzena Kubinova, Terho Lehtimäki, Mario V. Capanzana, Moyses Szklo, Ramfis Nieto-Martínez, Viswanathan Mohan, Shuohua Chen, Arvind Pandey, Luigi Palmieri, Roya Kelishadi, Srinivasan Kannan, Jie Mi, Robert Beaglehole, Liliana Dacica, Jyrki K. Virtanen, Mohan Deepa, Peter Ueda, Isti Ilmiati Fujiati, Hermann Pohlabeln, Morten Sodemann, Jytte Halkjær, Zbigniew Kułaga, Sophie Visvikis-Siest, Farshad Farzadfar, Mohsen Azimi-Nezhad, Henry Völzke, Karolina Milkowska, Zahra Mohammadi, Belgin Ünal, Magda Gasull, George S. Stergiou, Marshall K. Tulloch-Reid, Seppo Koskinen, James E. Bennett, Marcela González-Gross, Virginija Dulskiene, Idris Guessous, Assembekov Batyrbek, Kamarul Imran Musa, Jeannette Lee, Josep Redon, Bihungum Bista, Luisa M Macieira, Johan Sundström, Andres Metspalu, Lariane M Ono, Flora A. Ukoli, Salar Rahimikazerooni, Andrea Gualtieri, Trevor S. Ferguson, Félicité Tchibindat, Eliza Cinteza, Ha Tp Do, Tajana Zeljkovic Vrkic, Tuyen D Le, Alison J. Hayes, Abdul Basit, Chandini Nekkantti, Teresa Norat, Eunice Ugel, Gulmira Aitmurzaeva, Mariachiara Di Cesare, Abdul Hamid Zargar, Vincenzo Solfrizzi, Garry L. Jennings, Aline Meirhaeghe, Kaare Christensen, Päivi Mäki, Xu Lin, Ali Esmaeili, Joanna Baran, Aneta Grajda, Renata Cifkova, Alexandre C. Pereira, Martin Bobak, Iuliia A Rusakova, Keiu Nelis, Damian K Francis, Guansheng Ma, Axel C. Carlsson, Alejandro Diaz, Alireza Ansari-Moghaddam, N Capkova, Zumin Shi, Maria Turley, Imelda A. Agdeppa, Helena I. S. Nogueira, Marcia Scazufca, Katharina Maruszczak, Natascia Rinaldo, Paulo A. Lotufo, Nuno Lunet, Thor Aspelund, Caroline H.D. Fall, Antonio Cabrera de León, Ahmad Faudzi Yusoff, Holger Theobald, Beatriz D'Agord Schaan, Pedro Marques-Vidal, William A. Neal, Mihai Gafencu, Tandi E. Matsha, Ana B. Crujeiras, Ahmad Reza Dorosty, Alain Morejon, Weili Yan, Dominique Hange, Bekbolat Zholdin, Frédéric Gottrand, Jorge Mota, Jana Námešná, Stevo Popovic, Louise Eriksen, Line Lund Kårhus, Cihangir Erem, Juergen Breckenkamp, Mathilde Kersting, Yi Song, Martin McKee, Aleksandra Gomula, Rafaela Rosário, Enzo Manzato, S. Goya Wannamethee, Sounnia Mediene Benchekor, Azim Nejatizadeh, Krishna Kumar Aryal, Juan P. González-Rivas, Vedrana Sember, Stephen T. McGarvey, Jukka T. Salonen, Patrick Pasquet, Patricia Varona-Pérez, Amelia C. Crampin, Ramin Heshmat, Violeta Iotova, Juvenal Soares Dias-da-Costa, Oye Gureje, Aletta E. Schutte, João Luiz Bastos, Anelise Reis Gaya, Konrad Jamrozik, Dalia Luksiene, Amina Barkat, Maria Paula Santos, José Camolas, Azli Baharudin, Diego Vanuzzo, Doris Stöckl, Rosalynn Siantar, Jouko Saramies, Albertino Damasceno, Davood Khalili, Simona Bo, Martina Müller-Nurasyid, Dominique Cottel, Markku Peltonen, Fikru Tullu, Ana Isabel Rito, Angélica Ochoa-Avilés, Annette J. Dobson, Christopher T. Cowell, Charumathi Sabanayagam, Rildo de Souza Wanderley Júnior, Oanh T. H. Trinh, Farahnaz Joukar, Mostafa K. Mohamed, Mostafa Qorbani, Jeongseon Kim, Helmut Schröder, Machi Suka, Natasja M. van Schoor, Jussi Kauhanen, Teresa Haugsgjerd, Goodarz Danaei, M. Fernanda Lima-Costa, Yong Tao, Elisabetta L. Romeo, Grazyna Jasienska, Victor Guillermo Sequera, Kazem Mohammad, Yanina Zócalo, Fernanda Cunha Soares, Jianfeng Wu, Mohammad Esmaeel Motlagh, María Elena Díaz-Sánchez, Monika Zuziak, Eldridge Ferrer, Anette Varbo, Leila Beltrami Moreira, Jeremy M. Jacobs, Kenneth James, Elena Sacchini, Pascal Bovet, Mahboubeh Parsaeian, Tania Lopez, Ya Xing Wang, Wojciech Drygas, Jody C Miller, Svetlana A. Shalnova, Maria Elisa Zapata, Chung T Nguyen, Nimmathota Arlappa, Edwige Landais, Thorkild I. A. Sørensen, Jeannette Klimont, Amirabbas Momenan, Erik J. Timmermans, Mari-Liis Tammesoo, Jost B. Jonas, Stefania Toselli, Maria Teresa Anselmo Olinto, Bahman Cheraghian, Kouamelan Doua, Esteban Carmuega, Marjeta Mišigoj-Duraković, Bo Werner, M. Arfan Ikram, Breige A. McNulty, Christa Meisinger, Clara Homs, Namuna Shrestha, Alina Kerimkulova, Youcef Laid, Claes Ohlsson, Alicia Matijasevich, Alison J Price, Ala'a Alkerwi, Kristine H. Allin, Lorenza Pilotto, Mohannad Al Nsour, Ingunn Holden Bergh, Marianna Noale, Heba Fouad, Vilnis Dzerve, Novie O. Younger-Coleman, Peter Willeit, Andrea R. V. R. Horimoto, Freda Pitakaka, Habiba Ben Romdhane, Savvas C. Savva, Rajeev Gupta, Jennifer Servais, Cristina Padez, Sarah P. Garnett, Maria del Cristo Rodriguez-Perez, Michala Lustigová, Tien Yin Wong, Rosa Haghshenas, Jonathan Giovannelli, Christina Howitt, Marleen E. Hendriks, Fadia AlBuhairan, Huashuai Chen, Gretchen A Stevens, Luís B. Sardinha, David Goltzman, Jenny M. Kindblom, Karina Mary de Paiva, Yousef Khader, Eric Monterrubio-Flores, Rajendra Pradeepa, Yi-Ting Lin, Martin Neovius, Juan Francisco Miquel, Ellis Owusu-Dabo, Anil Poudyal, Marzieh Katibeh, Tanja Stocks, Veronica Mocanu, Ulla Roggenbuck, Robespierre Ribeiro, Gabriele Eiben, Mary Simon, Christine Cameron, Hamid Hakimi, Kamel Ajlouni, Jakub Stokwiszewski, Iulia Jurca Simina, Pietro Amedeo Modesti, Frederick C. W. Wu, Peter Kristensen, Charles Mondo, Felix Gutzwiller, Mariana Sbaraini, Martijn Huisman, Betina H. Thuesen, Queenie Chan, Antonisamy Belavendra, Artur Mazur, Ulf Ekelund, Laura A. Rodríguez-Villamizar, Marcos André Moura-dos-Santos, Jean Ferrières, Farhad Zamani, Shina Avi, Yves Kameli, Luis Paulo Gomes Mascarenhas, Aluísio J D Barros, Thomas Meinertz Dantoft, Hossein Poustchi, Farid Najafi, Giovanni de Gaetano, Azaliia M Tuliakova, Vera Lanska, Tint Swe Latt, Matthias Bopp, Abbas Rezaianzadeh, Rod Jackson, Johan Van der Heyden, Reecha Sofat, Koen Van Herck, Allan G. Hill, Con Burns, Emanuela Pettenuzzo, Ming-Dong Wang, Stela McLachlan, Ulrike Gehring, Ranko Stevanovic, Nagalla Balakrishna, Lekhraj Rampal, Marjolijn C. E. Bragt, Saeid Eslami, Napoleón Pérez-Farinós, G. K. Mini, Viktoria Anna Kovacs, Rosemarie Martin, Nahla Hwalla, Wei Zheng, Hoang Van Minh, Edward D Janus, Laetitia Huiart, Farhad Pourfarzi, Sudha Ramachandra Rao, Fred Paccaud, Marcia Makdisse, Aye Aye Sein, Enrique Gutiérrez-González, Yang Yang, Anneke Blokstra, Henrike Galenkamp, Jaume Marrugat, Nazan Yardim, Wan Nazaimoon Wan Mohamud, Jesús Ibarluzea, Julio Zuñiga Cisneros, Laura Lauria, Argyro Karakosta, Dragana P Jovic, Jun Hata, Elio Riboli, Piotr Bandosz, Xun Tang, Parvina Mukhtorova, Jean Dallongeville, Jean-Bernard Ruidavets, Anne Tjønneland, Guillermo Frontera, Rahul Malhotra, Thomas Ferrao, Aleksandra Piwońska, Dusan Grafnetter, Mette Rasmussen, Daniel Weghuber, Sherali Rakhmatulloev, Martine Vrijheid, Johann Willeit, Motahareh Kheradmand, Małgorzata Mossakowska, Lechaba Tshepo, Dongfeng Gu, Hyeon Chang Kim, Vilmundur Gudnason, Maria Forsner, Peter Bjerregaard, Leon A. Simons, Rachael McLean, Japhet Killewo, Ramón Suárez-Medina, Y Nikitin, Eng Joo Tan, Jean Claude Mbanya, Aroor Bhagyalaxmi, Renata Kuciene, Kairat Davletov, Jose Eugenio Lozano, Afshin Ostovar, Niloofar Peykari, Guy De Backer, Soheir H Ahmed, Nicholas J. Wareham, Sai Yin Ho, Constanta Huidumac Petrescu, Maria Hassapidou, Iris Pigeot, Myriam Galfo, Susana Cararo Confortin, Blanca Sandra Ruiz-Betancourt, W. M. Monique Verschuren, Catterina Ferreccio, Fabio Galvano, Leila Houti, Daniel Bia, Annika Rosengren, Marcin Rutkowski, Biruta Velika, Joana Araújo, Fernando Rigo, Angela Spinelli, Scott B. McLean, Shirin Djalalinia, Marie Kunešová, Boban Mugoša, Sania Nishtar, Mangesh S. Pednekar, Shahla AlDhukair, Helle-Mai Loit, Antonis Zampelas, Altan Onat, Maciej Banach, Shohreh Naderimagham, Hajer Aounallah-Skhiri, Maja Bæksgaard Jørgensen, Yin Guo, Ewelina Czenczek-Lewandowska, Parasmani Dasgupta, Elvis Oa Wambiya, Inge Huybrechts, Raimund Erbel, Jari Jokelainen, Ana P. Ortiz, Stefan Kiechl, Emmanuel Cohen, Caleb Ochimana, Shynar Abdrakhmanova, Laura Censi, Iqbal Bata, Geetha R Menon, Snehalatha Chamukuttan, Pedro Plans-Rubio, Domenico Palli, Ana Azevedo, Slawomir Koziel, Benoît Salanave, Parinaz Mehdipour, Shu Ti Chiou, Lela Sturua, Lubica Ticha, Felipe Vogt Cureau, Jin Soo Moon, Ming-Hui Zhao, Urho M. Kujala, Nathalie Michels, Ertugrul Celikcan, Jaakko Tuomilehto, Judith Benedics, Tobias F. Rinke de Wit, Agnès Le Port, Reza Homayounfar, Andrea Rodriguez-Martinez, Tai Hing Lam, Yn-Tz Sung, Jürgen König, Kodavanti Mallikharjuna Rao, Hazzaa M. Al-Hazzaa, Karen Morgan, Bogdan Wojtyniak, Cynthia M. Pérez, Ilse Khouw, Manoli Garcia-de-la-Hera, Dong Wook Shin, Genc Burazeri, Ausra Petrauskiene, Charles Sossa Jérome, Kenisha Russell Jonsson, José Boggia, Daniela Galeone, Alice Bonilla-Vargas, Han Cg Kemper, Rahman Shiri, Stefaan Demarest, Else Karin Grøholt, San-Lin You, Adelheid Weber, Juha Auvinen, Aida Pilav, Sibel Gogen, Suzanne N Morin, Wan Mohamad Wan Bebakar, Viviane Cunha Cardoso, Kavumpurathu Raman Thankappan, Hana Zamrazilová, Frank Claessens, Karien Stronks, Helen Gonçalves, Tahir Aris, Luis Revilla, Sérgio Viana Peixoto, Zhamilya Battakova, Jing Liu, Eliza Markidou Ioannidou, Leticia Hernandez Cadena, Priscilla Duboz, Sandjaja, Tiina Laatikainen, Rafel Ramos, Sareh Eghtesad, Judith Simons, Orn Olafsson, E. Shyong Tai, Louise A. Baur, Nihal Thomas, Aung Soe Htet, Bente Sparboe-Nilsen, Paul Elliott, Soon-Woo Park, Angel R. Gonzalez, Ying-Wei Wang, Rob M. van Dam, Ryutaro Ohtsuka, Ludmila Sevcikova, Suhaila Abdul Ghaffar, Lynell V Maniego, Fariborz Mansour-Ghanaei, Maria Dorobantu, Giovanni Viegi, Xiaoguang Yang, Honor Bixby, Prakash C. Gupta, Ofra Kalter-Leibovici, Eugene Sobngwi, Ričardas Radišauskas, Jurate Medzioniene, Roy A Wong-McClure, Kim F. Michaelsen, Antonia Trichopoulou, Tania Tello, Francesco Branca, Johanna Gunnlaugsdottir, Els Clays, Wei-Yen Lim, Suzanne C. Ho, Toomas Veidebaum, Rebecca Goldsmith, Margot González-León, Matthias Nauck, Alibek Mereke, Marta Buoncristiano, Jakob Tarp, Rosalba Rojas-Martínez, Maya Tanrygulyyeva, Reza Malekzadeh, Abdonas Tamosiunas, Dimitrios Poulimeneas, Pedro Ordunez, Isabelle Herter-Aeberli, Khanh Le Nguyen Bao, Anne Juolevi, Vassilis Zafiropulos, Emanuela Gualdi-Russo, Jordi Sunyer, Manu Raj, Chaoqiang Jiang, Sofia Malyutina, Efthymios Kapantais, Maria Lazo-Porras, Maung Maung Than Htike, Michael Hobbs, Ranjit Mohan Anjana, Merike Liivak, Johan G. Eriksson, Margarita Samoutian, Andreia N. Pizarro, Mohammed Rasoul Tarawneh, Jean Woo, Kaspar Staub, Maria Teresa Menzano, Mojtaba Farjam, Adroaldo Cesar Araujo Gaya, Mohammad El-khateeb, Zulfiqar A Bhutta, Mukharram M. Bikbov, Hsien-Ho Lin, Oscar Noboa, Thomas Waldhör, Garry Brian, Simona Costanzo, Frank Tanser, Nor Azwany Yaacob, Michelle Cilia, Ivo Rakovac, Bill Stavreski, Ioannis Pagkalos, Ivan Pećin, Carlo M. Barbagallo, Abla M. Sibai, Yuna He, Matsuda Fumihiko, Bharathi Viswanathan, Ali Reza Safarpour, Wei Cheng Lo, Abdullatif Husseini, Jiang He, Liv Elin Torheim, Nipa Rojroongwasinkul, Aicha Soumare, Astrid Petersmann, Tomasz Grodzicki, Davide Noto, Panayiotis K. Yiallouros, Kelias P. Msyamboza, William R. Tebar, Yingfeng Zheng, Eha Nurk, Bhawesh Koirala, Ana Jelakovic, Suhad Bahijri, Freja B Kampmann, Qi Sheng You, Marika Ferrari, María-Elena González-Villalpando, Aline Wagner, Olfa Saidi, Anwar Batieha, Eduardo Capuano, Coimbatore Subramaniam Shanthirani, Dong Wook Kim, Albina A Fakhretdinova, Tom Wilsgaard, Maria Avdicova, Moesijanti Soekatri, Chiara Donfrancesco, Salim Mohanna, Paola Russo, Uruwan Yamborisut, Rafael dos Santos Henrique, Martin Nankap, Allan Linneberg, Khairil Si-Ramlee, Kirsten Mehlig, Christina Mavrogianni, Raluca Pop, Lèlita Santos, Graziella Bruno, Valentina Peterkova, Iná S. Santos, Georg Lappas, Alberto Palloni, Malay K. Mridha, Andrzej Pajak, Marta García-Solano, Stefaan De Henauw, Daniel Ferrante, Rute Santos, Anders Grøntved, Lucjan Szponar, Mihaela Vladulescu, Chien-An Sun, Jan A. Staessen, Paula Duarte de Oliveira, Norazizah Ibrahim Wong, Maria Nordendahl, Elaine M. Dennison, Jeonghee Lee, Diego Salmerón, Ida Maria Schmidt, Gao Pei, Noushin Mohammadifard, Igor Spiroski, Fernando Rodríguez-Artalejo, Xu Ma, Elin Pettersen Sørgjerd, Valéria Regecová, Cláudia S. Minderico, Johanna A. Otero, Jamila Abubakar Garba, Vesselka Duleva, Rui Ornelas, Ilpo Huhtaniemi, Cesar G. Victora, Lijuan Liu, Rody G. Sy, Mahmood Moosazadeh, Ali Ahmadi, Antonio Pedro Graça, Natalia Nowak-Szczepanska, Miao Li Chee, Michael Sjöström, Charles Agyemang, Shiqi Zhen, Xiu-Hua Guo, Pawel Kurjata, Jardena J. Puder, Mehrdad Azmin, Neil Murphy, Kaosar Afsana, Alireza Sadjadi, Johanna M. Geleijnse, Prashant Mathur, Elysée Claude Bika Lele, Raphael Mendes Ritti-Dias, Yannis Manios, Majid Shirani, Rosemary B. Duda, Liis Nelis, Jurate Klumbiene, Zhengming Chen, Wichai Aekplakorn, Alun Evans, Andrzej Wiecek, Lars Lind, Denise Eldemire-Shearer, Bernardo L. Horta, Macia Enguerran, Seyed Rasoul Zakavi, Daniel Fernández-Bergés, Kumiko Ohara, Ursula Kiechl-Kohlendorfer, Hermann Brenner, Przemyslaw Slusarczyk, Espen Bjertness, Jutta Stieber, Augusto Di Castelnuovo, Joel G. R. Roy, Aryeh D. Stein, Ruth Frikke-Schmidt, Vera Musil, Amaneh Shayanrad, Marcel Goldberg, Ramon O. Jimenez, Mohammad Reza Fattahi, Jolanda Hyska, Amir Houshang Mehrparvar, Elin Kolle, Mohamed Bamoshmoosh, Michelle Holdsworth, Felipe F. Casanueva, Børge G. Nordestgaard, Niels Wedderkopp, Eva Corpeleijn, Elias F. Gudmundsson, Antonio Mistretta, Daniel Lemogoum, Larissa Pruner Marques, Slavica Sović, Olli T. Raitakari, Marco Aurélio Peres, Alexandra Cucu, Gregorio Varela-Moreiras, Janine Clarke, Andrea Gazzinelli, Mieczysław Litwin, Sara Schramm, Xenophon Theodoridis, Harshpal Singh Sachdev, Mohammad Reza Mirjalili, Dimitrios Papandreou, Peter T. Katzmarzyk, Benjamin Acosta-Cazares, Ben Schöttker, Prabhdeep Kaur, Norlaila Mustafa, Shariq Rashid Masoodi, Sadaf G. Sepanlou, Adolfo Rubinstein, Francis Delpeuch, Julianne Williams, Abbas Dehghan, Leanne M. Riley, Heloisa Bettiol, Gabriele Nagel, Ellisiv B. Mathiesen, Ekaterina Stoyanova, Alisha N. Wade, Zhamyila Usupova, Arnaud Chiolero, Oonagh Markey, Jacqueline Ramke, Elena Bogova, Niveen M E Abu-Rmeileh, Nguyen D Nguyen, Tomasz Zdrojewski, Marjo-Riitta Järvelin, Jose Sanchez-Abanto, Rômulo Araújo Fernandes, Lourdes Ribas-Barba, Nalan Uysal, Mohamad Hasnan Ahmad, Krista Fischer, Maria Wany Louzada Strufaldi, Ramiro Guerrero, Farnam Mohebi, Tran Quoc Bao, Flávio Danni Fuchs, Salim Berkinbayev, Enisa Kujundzic, Sari Voutilainen, Farzad Hadaegh, Robert Lundqvist, Saeid Safiri, Iraj Mohebbi, George Luiz Lins Machado-Coelho, Annette Peters, Gonzalo Valdivia, Magdalena Korzycka, Rajiv T Erasmus, Masanori Iwasaki, Charmaine A. Duante, Sheikh Mohammed Shariful Islam, Quang Ngoc La, Ricky Eddie, Petra Rust, Daniela Rodrigues, Dirk De Bacquer, Karen Sparrenberger, Agneta Sjöberg, Thet Thet Mu, Katarzyna Dereń, Cora L. Craig, Jorge Motta, Janina Petkeviciene, Boyd Swinburn, Paibul Suriyawongpaisal, Visnja Djordjic, Ramón Alberto Rascón-Pacheco, Pradeep Joshi, Daan Kromhout, Marius B. Bjertness, Stefano Marventano, Juel Jarani, Alireza Khosravi, Eva Martos, David De Ridder, Lizzy M. Brewster, Nico Dragano, Liam Smeeth, Kenji Shibuya, Emma Ruiz Moreno, Hashem Jaddou, Grzegorz Sobek, Dimitrios Trichopoulos, Marvin Cervantes-Loaiza, Abu Am Hanif, Elaine M. Murtagh, Carlos A. Aguilar-Salinas, Graziella D'Arrigo, Kyungwon Oh, Heiner Boeing, Regina Heidinger-Felso, André Luiz Sena Guimarães, Balkish M. Naidu, Avula Laxmaiah, Ana M. B. Menezes, Marie Eliasen, Francesco Pistelli, Yuan He, Dusko Bjelica, José A. Casajús, Guang Ning, Lutgart Braeckman, Dirk Vanderschueren, Jochanan Stessman, Ivana Radic, Yi Zeng, Hans Concin, Damaskini Valvi, Sari Hantunen, Catherine Kyobutungi, Diego Augusto Santos Silva, Wenhua Zhao, Sok King Ong, Anne W. Taylor, Iraj Nabipour, Justyna Godos, Cyrus Cooper, Mattias Johansson, Samuel C. Dumith, Magdalena Muc, Sabine Schipf, Idowu O Senbanjo, Jim Mann, Rajaa Al-Raddadi, Yih Chung Tham, Kay-Tee Khaw, Joseph Cacciottolo, Ana Henriques, Sahar Saeedi Moghaddam, Reza Mohammadpourhodki, Bernhard O. Boehm, Songhomitra Panda-Jonas, Iveta Pudule, Elisabete Ramos, Lacramioara Aurelia Brinduse, Paul H. Lee, Terence W O'Neill, Javad Aghazadeh-Attari, Margus Punab, Bojan Jelaković, Camilla T. Damsgaard, Takafumi Ishida, Ekaterina Chikova-Iscener, Mirjam M. Heinen, Tazeen H. Jafar, Semánová Csilla, Constance Schultsz, Santiago F. Gomez, Raija Korpelainen, Edward W. Gregg, Laura Gutierrez, Pierre Traissac, Victor M. Herrera, Aristides M. 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Cyril and Methodius University, University of Leuven, Lamprecht und Stamm Sozialforschung und Beratung AG, Bonn University, National Institute of Public Health - National Institute of Hygiene, Kalina Malina Kindergarten, The Jikei University School of Medicine, Fu Jen Catholic University, National Statistical Office, Scientific Research Institute of Maternal and Child Health, University of Lincoln, Central University of Kerala, Amsterdam Public Health Research Institute, Health Service of Murcia, Institut d’Investigacio Sanitaria Illes Balears, University of Bologna, Hellenic Health Foundation, Government Medical College, Sefako Makgatho Health Science University, Addis Ababa University, Universidad Centro-Occidental Lisandro Alvarado, Meharry Medical College, Dokuz Eylul University, University of Tampere Tays Eye Center, Sabiha Gokcen Ilkokulu, Polytechnic Institute of Porto, Icahn School of Medicine at Mount Sinai, Universidad CEU San Pablo, University Miguel Hernandez, Vrije Universiteit Amsterdam, Sunflower Nursery School, North Karelia Center for Public Health, University of the Witwatersrand, Medical University of Vienna, Cork Institute of Technology, Institute for Medical Research, Xinjiang Medical University, Shanghai Educational Development Co. Ltd, Orebro University, University of London, Universitas Indonesia, Institute of Food and Nutrition Development of Ministry of Agriculture and Rural Affairs, Children’s Hospital of Fudan University, University of Cyprus, Niigata University, International Medical University, Iran University of Medical Sciences, Center for Diabetes and Endocrine Care, Peking University First Hospital, Jiangsu Provincial Center for Disease Control and Prevention, Sun Yat-sen University, West Kazakhstan Medical University, Inner Mongolia Medical University, University of Ghana, Maria Lc Iurilli , Bin Zhou , James E Bennett , Rodrigo M Carrillo-Larco , Marisa K Sophiea , Andrea Rodriguez-Martinez , Honor Bixby , Bethlehem D Solomon , Cristina Taddei , Goodarz Danaei , Mariachiara Di Cesare , Gretchen A Stevens , Leanne M Riley , Stefan Savin , Melanie J Cowan , Pascal Bovet , Albertino Damasceno , Adela Chirita-Emandi , Alison J Hayes , Nayu Ikeda , Rod T Jackson , Young-Ho Khang , Avula Laxmaiah , Jing Liu , J Jaime Miranda , Olfa Saidi , Sylvain Sebert , Maroje Sorić , Gregor Starc , Edward W Gregg , Leandra Abarca-Gómez , Ziad A Abdeen , Shynar Abdrakhmanova , Suhaila Abdul Ghaffar , Hanan F Abdul Rahim , Niveen M Abu-Rmeileh , Jamila Abubakar Garba , Benjamin Acosta-Cazares , Robert J Adams , Wichai Aekplakorn , Kaosar Afsana , Shoaib Afzal , Imelda A Agdeppa , Javad Aghazadeh-Attari , Carlos A Aguilar-Salinas , Charles Agyemang , Mohamad Hasnan Ahmad , Noor Ani Ahmad , Ali Ahmadi , Naser Ahmadi , Soheir H Ahmed , Wolfgang Ahrens , Gulmira Aitmurzaeva , Kamel Ajlouni , Hazzaa M Al-Hazzaa , Badreya Al-Lahou , Rajaa Al-Raddadi , Monira Alarouj , Fadia AlBuhairan , Shahla AlDhukair , Mohamed M Ali , Abdullah Alkandari , Ala'a Alkerwi , Kristine Allin , Mar Alvarez-Pedrerol , Eman Aly , Deepak N Amarapurkar , Parisa Amiri , Norbert Amougou , Philippe Amouyel , Lars Bo Andersen , Sigmund A Anderssen , Lars Ängquist , Ranjit Mohan Anjana , Alireza Ansari-Moghaddam , Hajer Aounallah-Skhiri , Joana Araújo , Inger Ariansen , Tahir Aris , Raphael E Arku , Nimmathota Arlappa , Krishna K Aryal , Thor Aspelund , Felix K Assah , Maria Cecília F Assunção , May Soe Aung , Juha Auvinen , Mária Avdicová , Shina Avi , Ana Azevedo , Mohsen Azimi-Nezhad , Fereidoun Azizi , Mehrdad Azmin , Bontha V Babu , Maja Bæksgaard Jørgensen , Azli Baharudin , Suhad Bahijri , Jennifer L Baker , Nagalla Balakrishna , Mohamed Bamoshmoosh , Maciej Banach , Piotr Bandosz , José R Banegas , Joanna Baran , Barbagallo CM, Alberto Barceló , Amina Barkat , Aluisio Jd Barros , Mauro Virgílio Gomes Barros , Abdul Basit , Joao Luiz D Bastos , Iqbal Bata , Anwar M Batieha , Rosangela L Batista , Zhamilya Battakova , Assembekov Batyrbek , Louise A Baur , Robert Beaglehole , Silvia Bel-Serrat , Antonisamy Belavendra , Habiba Ben Romdhane , Judith Benedics , Mikhail Benet , Ingunn Holden Bergh , Salim Berkinbayev , Antonio Bernabe-Ortiz , Gailute Bernotiene , Heloísa Bettiol , Jorge Bezerra , Aroor Bhagyalaxmi , Sumit Bharadwaj , Santosh K Bhargava , Zulfiqar A Bhutta , Hongsheng Bi , Yufang Bi , Daniel Bia , Elysée Claude Bika Lele, Mukharram M Bikbov , Bihungum Bista , Dusko J Bjelica , Peter Bjerregaard , Espen Bjertness , Marius B Bjertness , Cecilia Björkelund , Katia V Bloch , Anneke Blokstra , Simona Bo , Martin Bobak , Lynne M Boddy , Bernhard O Boehm , Heiner Boeing , Jose G Boggia , Elena Bogova , Carlos P Boissonnet , Stig E Bojesen , Marialaura Bonaccio , Vanina Bongard , Alice Bonilla-Vargas , Matthias Bopp , Herman Borghs , Lien Braeckevelt , Lutgart Braeckman , Marjolijn Ce Bragt , Imperia Brajkovich , Francesco Branca , Juergen Breckenkamp , João Breda , Hermann Brenner , Lizzy M Brewster , Garry R Brian , Lacramioara Brinduse , Sinead Brophy , Graziella Bruno , H Bas Bueno-de-Mesquita , Anna Bugge , Marta Buoncristiano , Genc Burazeri , Con Burns , Antonio Cabrera de León , Joseph Cacciottolo , Hui Cai , Tilema Cama , Christine Cameron , José Camolas , Günay Can , Ana Paula C Cândido , Felicia Cañete , Mario V Capanzana , Nadežda Capková , Eduardo Capuano , Vincenzo Capuano , Marloes Cardol , Viviane C Cardoso , Axel C Carlsson , Esteban Carmuega , Joana Carvalho , José A Casajús , Felipe F Casanueva , Ertugrul Celikcan , Laura Censi , Marvin Cervantes-Loaiza , Juraci A Cesar , Snehalatha Chamukuttan , Angelique W Chan , Queenie Chan , Himanshu K Chaturvedi , Nish Chaturvedi , Norsyamlina Che Abdul Rahim , Miao Li Chee , Chien-Jen Chen , Fangfang Chen , Huashuai Chen , Shuohua Chen , Zhengming Chen , Ching-Yu Cheng , Bahman Cheraghian , Angela Chetrit , Ekaterina Chikova-Iscener , Arnaud Chiolero , Shu-Ti Chiou , María-Dolores Chirlaque , Belong Cho , Kaare Christensen , Diego G Christofaro , Jerzy Chudek , Renata Cifkova , Michelle Cilia , Eliza Cinteza , Frank Claessens , Janine Clarke , Els Clays , Emmanuel Cohen , Hans Concin , Susana C Confortin , Cyrus Cooper , Tara C Coppinger , Eva Corpeleijn , Simona Costanzo , Dominique Cottel , Chris Cowell , Cora L Craig , Amelia C Crampin , Ana B Crujeiras , Semánová Csilla , Alexandra M Cucu , Liufu Cui , Felipe V Cureau , Ewelina Czenczek-Lewandowska , Graziella D'Arrigo , Eleonora d'Orsi , Liliana Dacica , María Ángeles Dal Re Saavedra , Jean Dallongeville , Camilla T Damsgaard , Rachel Dankner , Thomas M Dantoft , Parasmani Dasgupta , Saeed Dastgiri , Luc Dauchet , Kairat Davletov , Guy De Backer , Dirk De Bacquer , Giovanni de Gaetano , Stefaan De Henauw , Paula Duarte de Oliveira , David De Ridder , Karin De Ridder , Susanne R de Rooij , Delphine De Smedt , Mohan Deepa , Alexander D Deev , Vincent Jr DeGennaro , Abbas Dehghan , Hélène Delisle , Francis Delpeuch , Stefaan Demarest , Elaine Dennison , Katarzyna Dereń , Valérie Deschamps , Meghnath Dhimal , Augusto F Di Castelnuovo , Juvenal Soares Dias-da-Costa , María Elena Díaz-Sánchez , Alejandro Diaz , Zivka Dika , Shirin Djalalinia , Visnja Djordjic , Ha Tp Do , Annette J Dobson , Maria Benedetta Donati , Chiara Donfrancesco , Silvana P Donoso , Angela Döring , Maria Dorobantu , Ahmad Reza Dorosty , Kouamelan Doua , Nico Dragano , Wojciech Drygas , Jia Li Duan , Charmaine A Duante , Priscilla Duboz , Rosemary B Duda , Vesselka Duleva , Virginija Dulskiene , Samuel C Dumith , Anar Dushpanova , Vilnis Dzerve , Elzbieta Dziankowska-Zaborszczyk , Ricky Eddie , Ebrahim Eftekhar , Eruke E Egbagbe , Robert Eggertsen , Sareh Eghtesad , Gabriele Eiben , Ulf Ekelund , Mohammad El-Khateeb , Jalila El Ati , Denise Eldemire-Shearer , Marie Eliasen , Paul Elliott , Reina Engle-Stone , Macia Enguerran , Rajiv T Erasmus , Raimund Erbel , Cihangir Erem , Louise Eriksen , Johan G Eriksson , Jorge Escobedo-de la Peña , Saeid Eslami , Ali Esmaeili , Alun Evans , David Faeh , Albina A Fakhretdinova , Caroline H Fall , Elnaz Faramarzi , Mojtaba Farjam , Victoria Farrugia Sant'Angelo , Farshad Farzadfar , Mohammad Reza Fattahi , Asher Fawwad , Francisco J Felix-Redondo , Trevor S Ferguson , Romulo A Fernandes , Daniel Fernández-Bergés , Daniel Ferrante , Thomas Ferrao , Marika Ferrari , Marco M Ferrario , Catterina Ferreccio , Eldridge Ferrer , Jean Ferrieres , Thamara Hubler Figueiró , Anna Fijalkowska , Günther Fink , Krista Fischer , Leng Huat Foo , Maria Forsner , Heba M Fouad , Damian K Francis , Maria do Carmo Franco , Ruth Frikke-Schmidt , Guillermo Frontera , Flavio D Fuchs , Sandra C Fuchs , Isti I Fujiati , Yuki Fujita , Matsuda Fumihiko , Takuro Furusawa , Zbigniew Gaciong , Mihai Gafencu , Andrzej Galbarczyk , Henrike Galenkamp , Daniela Galeone , Myriam Galfo , Fabio Galvano , Jingli Gao , Manoli Garcia-de-la-Hera , Marta García-Solano , Dickman Gareta , Sarah P Garnett , Jean-Michel Gaspoz , Magda Gasull , Adroaldo Cesar Araujo Gaya , Anelise Reis Gaya , Andrea Gazzinelli , Ulrike Gehring , Harald Geiger , Johanna M Geleijnse , Ali Ghanbari , Erfan Ghasemi , Oana-Florentina Gheorghe-Fronea , Simona Giampaoli , Francesco Gianfagna , Tiffany K Gill , Jonathan Giovannelli , Glen Gironella , Aleksander Giwercman , Konstantinos Gkiouras , Justyna Godos , Sibel Gogen , Marcel Goldberg , Rebecca A Goldsmith , David Goltzman , Santiago F Gómez , Aleksandra Gomula , Bruna Goncalves Cordeiro da Silva , Helen Gonçalves , David A Gonzalez-Chica , Marcela Gonzalez-Gross , Margot González-Leon , Juan P González-Rivas , Clicerio González-Villalpando , María-Elena González-Villalpando , Angel R Gonzalez , Frederic Gottrand , Antonio Pedro Graça , Sidsel Graff-Iversen , Dušan Grafnetter , Aneta Grajda , Maria G Grammatikopoulou , Ronald D Gregor , Tomasz Grodzicki , Else Karin Grøholt , Anders Grøntved , Giuseppe Grosso , Gabriella Gruden , Dongfeng Gu , Emanuela Gualdi-Russo , Pilar Guallar-Castillón , Andrea Gualtieri , Elias F Gudmundsson , Vilmundur Gudnason , Ramiro Guerrero , Idris Guessous , Andre L Guimaraes , Martin C Gulliford , Johanna Gunnlaugsdottir , Marc J Gunter , Xiu-Hua Guo , Yin Guo , Prakash C Gupta , Rajeev Gupta , Oye Gureje , Beata Gurzkowska , Enrique Gutiérrez-González , Laura Gutierrez , Felix Gutzwiller , Seongjun Ha , Farzad Hadaegh , Charalambos A Hadjigeorgiou , Rosa Haghshenas , Hamid Hakimi , Jytte Halkjær , Ian R Hambleton , Behrooz Hamzeh , Dominique Hange , Abu Am Hanif , Sari Hantunen , Jie Hao , Rachakulla Hari Kumar , Seyed Mohammad Hashemi-Shahri , Maria Hassapidou , Jun Hata , Teresa Haugsgjerd , Jiang He , Yuan He , Yuna He , Regina Heidinger-Felso , Mirjam Heinen , Tatjana Hejgaard , Marleen Elisabeth Hendriks , Rafael Dos Santos Henrique , Ana Henriques , Leticia Hernandez Cadena , Sauli Herrala , Victor M Herrera , Isabelle Herter-Aeberli , Ramin Heshmat , Allan G Hill , Sai Yin Ho , Suzanne C Ho , Michael Hobbs , Michelle Holdsworth , Reza Homayounfar , Clara Homs , Wilma M Hopman , Andrea Rvr Horimoto , Claudia M Hormiga , Bernardo L Horta , Leila Houti , Christina Howitt , Thein Thein Htay , Aung Soe Htet , Maung Maung Than Htike , Yonghua Hu , José María Huerta , Ilpo Tapani Huhtaniemi , Laetitia Huiart , Constanta Huidumac Petrescu , Martijn Huisman , Abdullatif Husseini , Chinh Nguyen Huu , Inge Huybrechts , Nahla Hwalla , Jolanda Hyska , Licia Iacoviello , Jesús M Ibarluzea , Mohsen M Ibrahim , Norazizah Ibrahim Wong , M Arfan Ikram , Violeta Iotova , Vilma E Irazola , Takafumi Ishida , Muhammad Islam , Sheikh Mohammed Shariful Islam , Masanori Iwasaki , Jeremy M Jacobs , Hashem Y Jaddou , Tazeen Jafar , Kenneth James , Kazi M Jamil , Konrad Jamrozik , Imre Janszky , Edward Janus , Juel Jarani , Marjo-Riitta Jarvelin , Grazyna Jasienska , Ana Jelakovic , Bojan Jelakovic , Garry Jennings , Anjani Kumar Jha , Chao Qiang Jiang , Ramon O Jimenez , Karl-Heinz Jöckel , Michel Joffres , Mattias Johansson , Jari J Jokelainen , Jost B Jonas , Jitendra Jonnagaddala , Torben Jørgensen , Pradeep Joshi , Farahnaz Joukar , Dragana P Jovic , Jacek J Jóźwiak , Anne Juolevi , Gregor Jurak , Iulia Jurca Simina , Vesna Juresa , Rudolf Kaaks , Felix O Kaducu , Anthony Kafatos , Eero O Kajantie , Zhanna Kalmatayeva , Ofra Kalter-Leibovici , Yves Kameli , Freja B Kampmann , Kodanda R Kanala , Srinivasan Kannan , Efthymios Kapantais , Argyro Karakosta , Line L Kårhus , Khem B Karki , Marzieh Katibeh , Joanne Katz , Peter T Katzmarzyk , Jussi Kauhanen , Prabhdeep Kaur , Maryam Kavousi , Gyulli M Kazakbaeva , Ulrich Keil , Lital Keinan Boker , Sirkka Keinänen-Kiukaanniemi , Roya Kelishadi , Cecily Kelleher , Han Cg Kemper , Andre P Kengne , Maryam Keramati , Alina Kerimkulova , Mathilde Kersting , Timothy Key , Yousef Saleh Khader , Davood Khalili , Kay-Tee Khaw , Bahareh Kheiri , Motahareh Kheradmand , Alireza Khosravi , Ilse Msl Khouw , Ursula Kiechl-Kohlendorfer , Stefan Kiechl , Japhet Killewo , Dong Wook Kim , Hyeon Chang Kim , Jeongseon Kim , Jenny M Kindblom , Heidi Klakk , Magdalena Klimek , Jeannette Klimont , Jurate Klumbiene , Michael Knoflach , Bhawesh Koirala , Elin Kolle , Patrick Kolsteren , Jürgen König , Raija Korpelainen , Paul Korrovits , Magdalena Korzycka , Jelena Kos , Seppo Koskinen , Katsuyasu Kouda , Viktoria A Kovacs , Sudhir Kowlessur , Slawomir Koziel , Jana Kratenova , Wolfgang Kratzer , Susi Kriemler , Peter Lund Kristensen , Steinar Krokstad , Daan Kromhout , Herculina S Kruger , Ruzena Kubinova , Renata Kuciene , Urho M Kujala , Enisa Kujundzic , Zbigniew Kulaga , R Krishna Kumar , Marie Kunešová , Pawel Kurjata , Yadlapalli S Kusuma , Kari Kuulasmaa , Catherine Kyobutungi , Quang Ngoc La , Fatima Zahra Laamiri , Tiina Laatikainen , Carl Lachat , Youcef Laid , Tai Hing Lam , Christina-Paulina Lambrinou , Edwige Landais , Vera Lanska , Georg Lappas , Bagher Larijani , Tint Swe Latt , Laura Lauria , Maria Lazo-Porras , Gwenaëlle Le Coroller , Khanh Le Nguyen Bao , Agnès Le Port , Tuyen D Le , Jeannette Lee , Jeonghee Lee , Paul H Lee , Nils Lehmann , Terho Lehtimäki , Daniel Lemogoum , Naomi S Levitt , Yanping Li , Merike Liivak , Christa L Lilly , Wei-Yen Lim , M Fernanda Lima-Costa , Hsien-Ho Lin , Xu Lin , Yi-Ting Lin , Lars Lind , Allan Linneberg , Lauren Lissner , Mieczyslaw Litwin , Lijuan Liu , Wei-Cheng Lo , Helle-Mai Loit , Khuong Quynh Long , Luis Lopes , Oscar Lopes , Esther Lopez-Garcia , Tania Lopez , Paulo A Lotufo , José Eugenio Lozano , Janice L Lukrafka , Dalia Luksiene , Annamari Lundqvist , Robert Lundqvist , Nuno Lunet , Charles Lunogelo , Michala Lustigová , Edyta Łuszczki , Guansheng Ma , Jun Ma , Xu Ma , George Ll Machado-Coelho , Aristides M Machado-Rodrigues , Luisa M Macieira , Ahmed A Madar , Stefania Maggi , Dianna J Magliano , Sara Magnacca , Emmanuella Magriplis , Gowri Mahasampath , Bernard Maire , Marjeta Majer , Marcia Makdisse , Päivi Mäki , Fatemeh Malekzadeh , Reza Malekzadeh , Rahul Malhotra , Kodavanti Mallikharjuna Rao , Sofia K Malyutina , Lynell V Maniego , Yannis Manios , Jim I Mann , Fariborz Mansour-Ghanaei , Enzo Manzato , Paula Margozzini , Anastasia Markaki , Oonagh Markey , Eliza Markidou Ioannidou , Pedro Marques-Vidal , Larissa Pruner Marques , Jaume Marrugat , Yves Martin-Prevel , Rosemarie Martin , Reynaldo Martorell , Eva Martos , Katharina Maruszczak , Stefano Marventano , Luis P Mascarenhas , Shariq R Masoodi , Ellisiv B Mathiesen , Prashant Mathur , Alicia Matijasevich , Tandi E Matsha , Christina Mavrogianni , Artur Mazur , Jean Claude N Mbanya , Shelly R McFarlane , Stephen T McGarvey , Martin McKee , Stela McLachlan , Rachael M McLean , Scott B McLean , Breige A McNulty , Sounnia Mediene Benchekor , Jurate Medzioniene , Parinaz Mehdipour , Kirsten Mehlig , Amir Houshang Mehrparvar , Aline Meirhaeghe , Jørgen Meisfjord , Christa Meisinger , Ana Maria B Menezes , Geetha R Menon , Gert Bm Mensink , Maria Teresa Menzano , Alibek Mereke , Indrapal I Meshram , Andres Metspalu , Haakon E Meyer , Jie Mi , Kim F Michaelsen , Nathalie Michels , Kairit Mikkel , Karolina Milkowska , Jody C Miller , Cláudia S Minderico , G K Mini , Juan Francisco Miquel , Mohammad Reza Mirjalili , Daphne Mirkopoulou , Erkin Mirrakhimov , Marjeta Mišigoj-Durakovic , Antonio Mistretta , Veronica Mocanu , Pietro A Modesti , Sahar Saeedi Moghaddam , Bahram Mohajer , Mostafa K Mohamed , Shukri F Mohamed , Kazem Mohammad , Zahra Mohammadi , Noushin Mohammadifard , Reza Mohammadpourhodki , Viswanathan Mohan , Salim Mohanna , Muhammad Fadhli Mohd Yusoff , Iraj Mohebbi , Farnam Mohebi , Marie Moitry , Drude Molbo , Line T Møllehave , Niels C Møller , Dénes Molnár , Amirabbas Momenan , Charles K Mondo , Michele Monroy-Valle , Eric Monterrubio-Flores , Kotsedi Daniel K Monyeki , Jin Soo Moon , Mahmood Moosazadeh , Leila B Moreira , Alain Morejon , Luis A Moreno , Karen Morgan , Suzanne N Morin , Erik Lykke Mortensen , George Moschonis , Malgorzata Mossakowska , Aya Mostafa , Anabela Mota-Pinto , Jorge Mota , Mohammad Esmaeel Motlagh , Jorge Motta , Marcos André Moura-Dos-Santos , Malay K Mridha , Kelias P Msyamboza , Thet Thet Mu , Magdalena Muc , Boban Mugoša , Maria L Muiesan , Parvina Mukhtorova , Martina Müller-Nurasyid , Neil Murphy , Jaakko Mursu , Elaine M Murtagh , Kamarul Imran Musa , Sanja Music Milanovic , Vera Musil , Norlaila Mustafa , Iraj Nabipour , Shohreh Naderimagham , Gabriele Nagel , Balkish M Naidu , Farid Najafi , Harunobu Nakamura , Jana Námešná , Ei Ei K Nang , Vinay B Nangia , Martin Nankap , Sameer Narake , Paola Nardone , Matthias Nauck , William A Neal , Azim Nejatizadeh , Chandini Nekkantti , Keiu Nelis , Liis Nelis , Ilona Nenko , Martin Neovius , Flavio Nervi , Chung T Nguyen , Nguyen D Nguyen , Quang Ngoc Nguyen , Ramfis E Nieto-Martínez , Yury P Nikitin , Guang Ning , Toshiharu Ninomiya , Sania Nishtar , Marianna Noale , Oscar A Noboa , Helena Nogueira , Teresa Norat , Maria Nordendahl , Børge G Nordestgaard , Davide Noto , Natalia Nowak-Szczepanska , Mohannad Al Nsour , Irfan Nuhoglu , Eha Nurk , Terence W O'Neill , Dermot O'Reilly , Galina Obreja , Caleb Ochimana , Angélica M Ochoa-Avilés , Eiji Oda , Kyungwon Oh , Kumiko Ohara , Claes Ohlsson , Ryutaro Ohtsuka , Örn Olafsson , Maria Teresa A Olinto , Isabel O Oliveira , Mohd Azahadi Omar , Altan Onat , Sok King Ong , Lariane M Ono , Pedro Ordunez , Rui Ornelas , Ana P Ortiz , Pedro J Ortiz , Merete Osler , Clive Osmond , Sergej M Ostojic , Afshin Ostovar , Johanna A Otero , Kim Overvad , Ellis Owusu-Dabo , Fred Michel Paccaud , Cristina Padez , Ioannis Pagkalos , Elena Pahomova , Karina Mary de Paiva , Andrzej Pajak , Domenico Palli , Alberto Palloni , Luigi Palmieri , Wen-Harn Pan , Songhomitra Panda-Jonas , Arvind Pandey , Francesco Panza , Dimitrios Papandreou , Soon-Woo Park , Suyeon Park , Winsome R Parnell , Mahboubeh Parsaeian , Ionela M Pascanu , Patrick Pasquet , Nikhil D Patel , Ivan Pecin , Mangesh S Pednekar , Nasheeta Peer , Gao Pei , Sergio Viana Peixoto , Markku Peltonen , Alexandre C Pereira , Marco A Peres , Napoleón Pérez-Farinós , Cynthia M Pérez , Valentina Peterkova , Annette Peters , Astrid Petersmann , Janina Petkeviciene , Ausra Petrauskiene , Emanuela Pettenuzzo , Niloofar Peykari , Son Thai Pham , Rafael N Pichardo , Daniela Pierannunzio , Iris Pigeot , Hynek Pikhart , Aida Pilav , Lorenza Pilotto , Francesco Pistelli , Freda Pitakaka , Aleksandra Piwonska , Andreia N Pizarro , Pedro Plans-Rubió , Bee Koon Poh , Hermann Pohlabeln , Raluca M Pop , Stevo R Popovic , Miquel Porta , Georg Posch , Anil Poudyal , Dimitrios Poulimeneas , Hamed Pouraram , Farhad Pourfarzi , Akram Pourshams , Hossein Poustchi , Rajendra Pradeepa , Alison J Price , Jacqueline F Price , Rui Providencia , Jardena J Puder , Iveta Pudule , Soile E Puhakka , Maria Puiu , Margus Punab , Radwan F Qasrawi , Mostafa Qorbani , Tran Quoc Bao , Ivana Radic , Ricardas Radisauskas , Salar Rahimikazerooni , Mahfuzar Rahman , Mahmudur Rahman , Olli Raitakari , Manu Raj , Ellina Rakhimova , Sherali Rakhmatulloev , Ivo Rakovac , Sudha Ramachandra Rao , Ambady Ramachandran , Jacqueline Ramke , Elisabete Ramos , Rafel Ramos , Lekhraj Rampal , Sanjay Rampal , Vayia Rarra , Ramon A Rascon-Pacheco , Mette Rasmussen , Cassiano Ricardo Rech , Josep Redon , Paul Ferdinand M Reganit , Valéria Regecová , Luis Revilla , Abbas Rezaianzadeh , Lourdes Ribas-Barba , Robespierre Ribeiro , Elio Riboli , Adrian Richter , Fernando Rigo , Natascia Rinaldo , Tobias F Rinke de Wit , Ana Rito , Raphael M Ritti-Dias , Juan A Rivera , Cynthia Robitaille , Romana Roccaldo , Daniela Rodrigues , Fernando Rodríguez-Artalejo , María Del Cristo Rodriguez-Perez , Laura A Rodríguez-Villamizar , Ulla Roggenbuck , Rosalba Rojas-Martinez , Nipa Rojroongwasinkul , Dora Romaguera , Elisabetta L Romeo , Rafaela V Rosario , Annika Rosengren , Ian Rouse , Joel Gr Roy , Adolfo Rubinstein , Frank J Rühli , Jean-Bernard Ruidavets , Blanca Sandra Ruiz-Betancourt , Maria Ruiz-Castell , Emma Ruiz Moreno , Iuliia A Rusakova , Kenisha Russell Jonsson , Paola Russo , Petra Rust , Marcin Rutkowski , Charumathi Sabanayagam , Elena Sacchini , Harshpal S Sachdev , Alireza Sadjadi , Ali Reza Safarpour , Saeid Safiri , Nader Saki , Benoit Salanave , Eduardo Salazar Martinez , Diego Salmerón , Veikko Salomaa , Jukka T Salonen , Massimo Salvetti , Margarita Samoutian , Jose Sánchez-Abanto , Sandjaja , Susana Sans , Loreto Santa Marina , Diana A Santos , Ina S Santos , Lèlita C Santos , Maria Paula Santos , Osvaldo Santos , Rute Santos , Sara Santos Sanz , Jouko L Saramies , Luis B Sardinha , Nizal Sarrafzadegan , Thirunavukkarasu Sathish , Kai-Uwe Saum , Savvas Savva , Mathilde Savy , Norie Sawada , Mariana Sbaraini , Marcia Scazufca , Beatriz D Schaan , Angelika Schaffrath Rosario , Herman Schargrodsky , Anja Schienkiewitz , Sabine Schipf , Carsten O Schmidt , Ida Maria Schmidt , Peter Schnohr , Ben Schöttker , Sara Schramm , Stine Schramm , Helmut Schröder , Constance Schultsz , Aletta E Schutte , Aye Aye Sein , Rusidah Selamat , Vedrana Sember , Abhijit Sen , Idowu O Senbanjo , Sadaf G Sepanlou , Victor Sequera , Luis Serra-Majem , Jennifer Servais , Ludmila Ševcíková , Svetlana A Shalnova , Teresa Shamah-Levy , Morteza Shamshirgaran , Coimbatore Subramaniam Shanthirani , Maryam Sharafkhah , Sanjib K Sharma , Jonathan E Shaw , Amaneh Shayanrad , Ali Akbar Shayesteh , Lela Shengelia , Zumin Shi , Kenji Shibuya , Hana Shimizu-Furusawa , Dong Wook Shin , Majid Shirani , Rahman Shiri , Namuna Shrestha , Khairil Si-Ramlee , Alfonso Siani , Rosalynn Siantar , Abla M Sibai , Antonio M Silva , Diego Augusto Santos Silva , Mary Simon , Judith Simons , Leon A Simons , Agneta Sjöberg , Michael Sjöström , Gry Skodje , Jolanta Slowikowska-Hilczer , Przemyslaw Slusarczyk , Liam Smeeth , Hung-Kwan So , Fernanda Cunha Soares , Grzegorz Sobek , Eugène Sobngwi , Morten Sodemann , Stefan Söderberg , Moesijanti Ye Soekatri , Agustinus Soemantri , Reecha Sofat , Vincenzo Solfrizzi , Mohammad Hossein Somi , Emily Sonestedt , Yi Song , Thorkild Ia Sørensen , Elin P Sørgjerd , Charles Sossa Jérome , Victoria E Soto-Rojas , Aïcha Soumaré , Slavica Sovic , Bente Sparboe-Nilsen , Karen Sparrenberger , Angela Spinelli , Igor Spiroski , Jan A Staessen , Hanspeter Stamm , Maria G Stathopoulou , Kaspar Staub , Bill Stavreski , Jostein Steene-Johannessen , Peter Stehle , Aryeh D Stein , George S Stergiou , Jochanan Stessman , Ranko Stevanovic , Jutta Stieber , Doris Stöckl , Tanja Stocks , Jakub Stokwiszewski , Ekaterina Stoyanova , Gareth Stratton , Karien Stronks , Maria Wany Strufaldi , Lela Sturua , Ramón Suárez-Medina , Machi Suka , Chien-An Sun , Johan Sundström , Yn-Tz Sung , Jordi Sunyer , Paibul Suriyawongpaisal , Boyd A Swinburn , Rody G Sy , Holly E Syddall , René Charles Sylva , Moyses Szklo , Lucjan Szponar , E Shyong Tai , Mari-Liis Tammesoo , Abdonas Tamosiunas , Eng Joo Tan , Xun Tang , Maya Tanrygulyyeva , Frank Tanser , Yong Tao , Mohammed Rasoul Tarawneh , Jakob Tarp , Carolina B Tarqui-Mamani , Radka Taxová Braunerová , Anne Taylor , Julie Taylor , Félicité Tchibindat , William R Tebar , Grethe S Tell , Tania Tello , Yih Chung Tham , K R Thankappan , Holger Theobald , Xenophon Theodoridis , Lutgarde Thijs , Nihal Thomas , Betina H Thuesen , Lubica Tichá , Erik J Timmermans , Anne Tjonneland , Hanna K Tolonen , Janne S Tolstrup , Murat Topbas , Roman Topór-Madry , Liv Elin Torheim , María José Tormo , Michael J Tornaritis , Maties Torrent , Laura Torres-Collado , Stefania Toselli , Giota Touloumi , Pierre Traissac , Thi Tuyet-Hanh Tran , Dimitrios Trichopoulos , Antonia Trichopoulou , Oanh Th Trinh , Atul Trivedi , Lechaba Tshepo , Maria Tsigga , Shoichiro Tsugane , Azaliia M Tuliakova , Marshall K Tulloch-Reid , Fikru Tullu , Tomi-Pekka Tuomainen , Jaakko Tuomilehto , Maria L Turley , Gilad Twig , Per Tynelius , Themistoklis Tzotzas , Christophe Tzourio , Peter Ueda , Eunice Ugel , Flora Am Ukoli , Hanno Ulmer , Belgin Unal , Zhamyila Usupova , Hannu Mt Uusitalo , Nalan Uysal , Justina Vaitkeviciute , Gonzalo Valdivia , Susana Vale , Damaskini Valvi , Rob M van Dam , Johan Van der Heyden , Yvonne T van der Schouw , Koen Van Herck , Hoang Van Minh , Natasja M 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Weghuber , Wenbin Wei , Aneta Weres , Bo Werner , Peter H Whincup , Kurt Widhalm , Indah S Widyahening , Andrzej Wiecek , Rainford J Wilks , Johann Willeit , Peter Willeit , Julianne Williams , Tom Wilsgaard , Bogdan Wojtyniak , Roy A Wong-McClure , Andrew Wong , Jyh Eiin Wong , Tien Yin Wong , Jean Woo , Mark Woodward , Frederick C Wu , Jianfeng Wu , Li Juan Wu , Shouling Wu , Haiquan Xu , Liang Xu , Nor Azwany Yaacob , Uruwan Yamborisut , Weili Yan , Ling Yang , Xiaoguang Yang , Yang Yang , Nazan Yardim , Mehdi Yaseri , Tabara Yasuharu , Xingwang Ye , Panayiotis K Yiallouros , Moein Yoosefi , Akihiro Yoshihara , Qi Sheng You , San-Lin You , Novie O Younger-Coleman , Safiah Md Yusof , Ahmad Faudzi Yusoff , Luciana Zaccagni , Vassilis Zafiropulos , Ahmad A Zainuddin , Seyed Rasoul Zakavi , Farhad Zamani , Sabina Zambon , Antonis Zampelas , Hana Zamrazilová , Maria Elisa Zapata , Abdul Hamid Zargar , Ko Ko Zaw , Tomasz Zdrojewski , Kristyna Zejglicova , Tajana Zeljkovic Vrkic , Yi Zeng 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Claude N, McFarlane, Shelly R, McGarvey, Stephen T, McKee, Martin, McLachlan, Stela, McLean, Rachael M, McLean, Scott B, McNulty, Breige A, Benchekor, Sounnia Mediene, Medzioniene, Jurate, Mehdipour, Parinaz, Mehlig, Kirsten, Mehrparvar, Amir Houshang, Meirhaeghe, Aline, Meisfjord, Jørgen, Meisinger, Christa, Menezes, Ana Maria B, Menon, Geetha R, Mensink, Gert BM, Menzano, Maria Teresa, Mereke, Alibek, Meshram, Indrapal I, Metspalu, Andre, Meyer, Haakon E, Mi, Jie, Michaelsen, Kim F, Michels, Nathalie, Mikkel, Kairit, Milkowska, Karolina, Miller, Jody C, Minderico, Cláudia S, Mini, GK, Miquel, Juan Francisco, Mirjalili, Mohammad Reza, Mirkopoulou, Daphne, Mirrakhimov, Erkin, Mišigoj-Durakovic, Marjeta, Mistretta, Antonio, Mocanu, Veronica, Modesti, Pietro A, Moghaddam, Sahar Saeedi, Mohajer, Bahram, Mohamed, Mostafa K, Mohamed, Shukri F, Mohammad, Kazem, Mohammadi, Zahra, Mohammadifard, Noushin, Mohammadpourhodki, Reza, Mohan, Viswanathan, Mohanna, Salim, Yusoff, Muhammad Fadhli Mohd, Mohebbi, Iraj, Mohebi, Farnam, Moitry, Marie, Molbo, Drude, Møllehave, Line T, Møller, Niels C, Molnár, Déne, Momenan, Amirabba, Mondo, Charles K, Monroy-Valle, Michele, Monterrubio-Flores, Eric, Monyeki, Kotsedi Daniel K, Moon, Jin Soo, Moosazadeh, Mahmood, Moreira, Leila B, Morejon, Alain, Moreno, Luis A, Morgan, Karen, Morin, Suzanne N, Mortensen, Erik Lykke, Moschonis, George, Mossakowska, Malgorzata, Mostafa, Aya, Mota-Pinto, Anabela, Mota, Jorge, Motlagh, Mohammad Esmaeel, Motta, Jorge, Moura-dos-Santos, Marcos André, Mridha, Malay K, Msyamboza, Kelias P, Mu, Thet Thet, Muc, Magdalena, Mugoša, Boban, Muiesan, Maria L, Mukhtorova, Parvina, Müller-Nurasyid, Martina, Murphy, Neil, Mursu, Jaakko, Murtagh, Elaine M, Musa, Kamarul Imran, Milanovic, Sanja Music, Musil, Vera, Mustafa, Norlaila, Nabipour, Iraj, Naderimagham, Shohreh, Nagel, Gabriele, Naidu, Balkish M, Najafi, Farid, Nakamura, Harunobu, Námešná, Jana, Ei K Nang, Ei, Nangia, Vinay B, Nankap, Martin, Narake, Sameer, Nardone, Paola, Nauck, Matthia, Neal, William A, Nejatizadeh, Azim, Nekkantti, Chandini, Nelis, Keiu, Nelis, Lii, Nenko, Ilona, Neovius, Martin, Nervi, Flavio, Nguyen, Chung T, Nguyen, Nguyen D, Nguyen, Quang Ngoc, Nieto-Martínez, Ramfis E, Nikitin, Yury P, Ning, Guang, Ninomiya, Toshiharu, Nishtar, Sania, Noale, Marianna, Noboa, Oscar A, Nogueira, Helena, Norat, Teresa, Nordendahl, Maria, Nordestgaard, Børge G, Noto, Davide, Nowak-Szczepanska, Natalia, Al Nsour, Mohannad, Nuhoglu, Irfan, Nurk, Eha, O'Neill, Terence W, O'Reilly, Dermot, Obreja, Galina, Ochimana, Caleb, Ochoa-Avilés, Angélica M, Oda, Eiji, Oh, Kyungwon, Ohara, Kumiko, Ohlsson, Clae, Ohtsuka, Ryutaro, Olafsson, Örn, Olinto, Maria Teresa A, Oliveira, Isabel O, Omar, Mohd Azahadi, Onat, Altan, Ong, Sok King, Ono, Lariane M, Ordunez, Pedro, Ornelas, Rui, Ortiz, Ana P, Ortiz, Pedro J, Osler, Merete, Osmond, Clive, Ostojic, Sergej M, Ostovar, Afshin, Otero, Johanna A, Overvad, Kim, Owusu-Dabo, Elli, Paccaud, Fred Michel, Padez, 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Poudyal, Anil, Poulimeneas, Dimitrio, Pouraram, Hamed, Pourfarzi, Farhad, Pourshams, Akram, Poustchi, Hossein, Pradeepa, Rajendra, Price, Alison J, Price, Jacqueline F, Providencia, Rui, Puder, Jardena J, Pudule, Iveta, Puhakka, Soile E, Puiu, Maria, Punab, Margu, Qasrawi, Radwan F, Qorbani, Mostafa, Bao, Tran Quoc, Radic, Ivana, Radisauskas, Ricarda, Rahimikazerooni, Salar, Rahman, Mahfuzar, Rahman, Mahmudur, Raitakari, Olli, Raj, Manu, Rakhimova, Ellina, Rakhmatulloev, Sherali, Rakovac, Ivo, Rao, Sudha Ramachandra, Ramachandran, Ambady, Ramke, Jacqueline, Ramos, Elisabete, Ramos, Rafel, Rampal, Lekhraj, Rampal, Sanjay, Rarra, Vayia, Rascon-Pacheco, Ramon A, Rasmussen, Mette, Rech, Cassiano Ricardo, Redon, Josep, Reganit, Paul Ferdinand M, Regecová, Valéria, Revilla, Lui, Rezaianzadeh, Abba, Ribas-Barba, Lourde, Ribeiro, Robespierre, Riboli, Elio, Richter, Adrian, Rigo, Fernando, Rinaldo, Natascia, de Wit, Tobias F Rinke, Rito, Ana, Ritti-Dias, Raphael M, Rivera, Juan A, Robitaille, Cynthia, Roccaldo, Romana, Rodrigues, Daniela, Rodríguez-Artalejo, Fernando, del Cristo Rodriguez-Perez, María, Rodríguez-Villamizar, Laura A, Roggenbuck, Ulla, Rojas-Martinez, Rosalba, Rojroongwasinkul, Nipa, Romaguera, Dora, Romeo, Elisabetta L, Rosario, Rafaela V, Rosengren, Annika, Rouse, Ian, Roy, Joel GR, Rubinstein, Adolfo, Rühli, Frank J, Ruidavets, Jean-Bernard, Ruiz-Betancourt, Blanca Sandra, Ruiz-Castell, Maria, Moreno, Emma Ruiz, Rusakova, Iuliia A, Jonsson, Kenisha Russell, Russo, Paola, Rust, Petra, Rutkowski, Marcin, Sabanayagam, Charumathi, Sacchini, Elena, Sachdev, Harshpal S, Sadjadi, Alireza, Safarpour, Ali Reza, Safiri, Saeid, Saki, Nader, Salanave, Benoit, Martinez, Eduardo Salazar, Salmerón, Diego, Salomaa, Veikko, Salonen, Jukka T, Salvetti, Massimo, Samoutian, Margarita, Sánchez-Abanto, Jose, Sandjaja, null, Sans, Susana, Marina, Loreto Santa, Santos, Diana A, Santos, Ina S, Santos, Lèlita C, Santos, Maria Paula, Santos, Osvaldo, Santos, Rute, Sanz, Sara Santo, Saramies, Jouko L, Sardinha, Luis B, Sarrafzadegan, Nizal, Sathish, Thirunavukkarasu, Saum, Kai-Uwe, Savva, Savva, Savy, Mathilde, Sawada, Norie, Sbaraini, Mariana, Scazufca, Marcia, Schaan, Beatriz D, Rosario, Angelika Schaffrath, Schargrodsky, Herman, Schienkiewitz, Anja, Schipf, Sabine, Schmidt, Carsten O, Schmidt, Ida Maria, Schnohr, Peter, Schöttker, Ben, Schramm, Sara, Schramm, Stine, Schröder, Helmut, Schultsz, Constance, Schutte, Aletta E, Sein, Aye Aye, Selamat, Rusidah, Sember, Vedrana, Sen, Abhijit, Senbanjo, Idowu O, Sepanlou, Sadaf G, Sequera, Victor, Serra-Majem, Lui, Servais, Jennifer, Ševcíková, Ludmila, Shalnova, Svetlana A, Shamah-Levy, Teresa, Shamshirgaran, Morteza, Shanthirani, Coimbatore Subramaniam, Sharafkhah, Maryam, Sharma, Sanjib K, Shaw, Jonathan E, Shayanrad, Amaneh, Shayesteh, Ali Akbar, Shengelia, Lela, Shi, Zumin, Shibuya, Kenji, Shimizu-Furusawa, Hana, Shin, Dong Wook, Shirani, Majid, Shiri, Rahman, Shrestha, Namuna, Si-Ramlee, Khairil, Siani, Alfonso, Siantar, Rosalynn, Sibai, Abla M, Silva, Antonio M, Silva, Diego Augusto Santo, Simon, Mary, Simons, Judith, Simons, Leon A, Sjöberg, Agneta, Sjöström, Michael, Skodje, Gry, Slowikowska-Hilczer, Jolanta, Slusarczyk, Przemyslaw, Smeeth, Liam, So, Hung-Kwan, Soares, Fernanda Cunha, Sobek, Grzegorz, Sobngwi, Eugène, Sodemann, Morten, Söderberg, Stefan, Soekatri, Moesijanti YE, Soemantri, Agustinu, Sofat, Reecha, Solfrizzi, Vincenzo, Somi, Mohammad Hossein, Sonestedt, Emily, Song, Yi, Sørensen, Thorkild IA, Sørgjerd, Elin P, Jérome, Charles Sossa, Soto-Rojas, Victoria E, Soumaré, Aïcha, Sovic, Slavica, Sparboe-Nilsen, Bente, Sparrenberger, Karen, Spinelli, Angela, Spiroski, Igor, Staessen, Jan A, Stamm, Hanspeter, Stathopoulou, Maria G, Staub, Kaspar, Stavreski, Bill, Steene-Johannessen, Jostein, Stehle, Peter, Stein, Aryeh D, Stergiou, George S, Stessman, Jochanan, Stevanovic, Ranko, Stieber, Jutta, Stöckl, Dori, Stocks, Tanja, Stokwiszewski, Jakub, Stoyanova, Ekaterina, Stratton, Gareth, Stronks, Karien, Strufaldi, Maria Wany, Sturua, Lela, Suárez-Medina, Ramón, Suka, Machi, Sun, Chien-An, Sundström, Johan, Sung, Yn-Tz, Sunyer, Jordi, Suriyawongpaisal, Paibul, Swinburn, Boyd A, Sy, Rody G, Syddall, Holly E, Sylva, René Charle, Szklo, Moyse, Szponar, Lucjan, Tai, E Shyong, Tammesoo, Mari-Lii, Tamosiunas, Abdona, Tan, Eng Joo, Tang, Xun, Tanrygulyyeva, Maya, Tanser, Frank, Tao, Yong, Tarawneh, Mohammed Rasoul, Tarp, Jakob, Tarqui-Mamani, Carolina B, Braunerová, Radka Taxová, Taylor, Anne, Taylor, Julie, Tchibindat, Félicité, Tebar, William R, Tell, Grethe S, Tello, Tania, Tham, Yih Chung, Thankappan, KR, Theobald, Holger, Theodoridis, Xenophon, Thijs, Lutgarde, Thomas, Nihal, Thuesen, Betina H, Tichá, Lubica, Timmermans, Erik J, Tjonneland, Anne, Tolonen, Hanna K, Tolstrup, Janne S, Topbas, Murat, Topór-Madry, Roman, Torheim, Liv Elin, Tormo, María José, Tornaritis, Michael J, Torrent, Matie, Torres-Collado, Laura, Toselli, Stefania, Touloumi, Giota, Traissac, Pierre, Tran, Thi Tuyet-Hanh, Trichopoulos, Dimitrio, Trichopoulou, Antonia, Trinh, Oanh TH, Trivedi, Atul, Tshepo, Lechaba, Tsigga, Maria, Tsugane, Shoichiro, Tuliakova, Azaliia M, Tulloch-Reid, Marshall K, Tullu, Fikru, Tuomainen, Tomi-Pekka, Tuomilehto, Jaakko, Turley, Maria L, Twig, Gilad, Tynelius, Per, Tzotzas, Themistokli, Tzourio, Christophe, Ueda, Peter, Ugel, Eunice, Ukoli, Flora AM, Ulmer, Hanno, Unal, Belgin, Usupova, Zhamyila, Uusitalo, Hannu MT, Uysal, Nalan, Vaitkeviciute, Justina, Valdivia, Gonzalo, Vale, Susana, Valvi, Damaskini, van Dam, Rob M, Van der Heyden, Johan, van der Schouw, Yvonne T, Van Herck, Koen, Van Minh, Hoang, Van Schoor, Natasja M, van Valkengoed, Irene GM, Vanderschueren, Dirk, Vanuzzo, Diego, Varbo, Anette, Varela-Moreiras, Gregorio, Varona-Pérez, Patricia, Vasan, Senthil K, Vega, Toma, Veidebaum, Tooma, Velasquez-Melendez, Gustavo, Velika, Biruta, Veronesi, Giovanni, Verschuren, WM Monique, Victora, Cesar G, Viegi, Giovanni, Viet, Lucie, Villalpando, Salvador, Vineis, Paolo, Vioque, Jesu, Virtanen, Jyrki K, Visser, Marjolein, Visvikis-Siest, Sophie, Viswanathan, Bharathi, Vladulescu, Mihaela, Vlasoff, Tiina, Vocanec, Dorja, Vollenweider, Peter, Völzke, Henry, Voutilainen, Ari, Voutilainen, Sari, Vrijheid, Martine, Vrijkotte, Tanja GM, Wade, Alisha N, Wagner, Aline, Waldhör, Thoma, Walton, Janette, Wambiya, Elvis OA, Bebakar, Wan Mohamad Wan, Mohamud, Wan Nazaimoon Wan, de Souza Wanderley Júnior, Rildo, Wang, Ming-Dong, Wang, Ningli, Wang, Qian, Wang, Xiangjun, Wang, Ya Xing, Wang, Ying-Wei, Wannamethee, S Goya, Wareham, Nichola, Weber, Adelheid, Wedderkopp, Niel, Weerasekera, Deepa, Weghuber, Daniel, Wei, Wenbin, Weres, Aneta, Werner, Bo, Whincup, Peter H, Widhalm, Kurt, Widyahening, Indah S, Wiecek, Andrzej, Wilks, Rainford J, Willeit, Johann, Willeit, Peter, Williams, Julianne, Wilsgaard, Tom, Wojtyniak, Bogdan, Wong-McClure, Roy A, Wong, Andrew, Wong, Jyh Eiin, Wong, Tien Yin, Woo, Jean, Woodward, Mark, Wu, Frederick C, Wu, Jianfeng, Wu, Li Juan, Wu, Shouling, Xu, Haiquan, Xu, Liang, Yaacob, Nor Azwany, Yamborisut, Uruwan, Yan, Weili, Yang, Ling, Yang, Xiaoguang, Yang, Yang, Yardim, Nazan, Yaseri, Mehdi, Yasuharu, Tabara, Ye, Xingwang, Yiallouros, Panayiotis K, Yoosefi, Moein, Yoshihara, Akihiro, You, Qi Sheng, You, San-Lin, Younger-Coleman, Novie O, Md Yusof, Safiah, Yusoff, Ahmad Faudzi, Zaccagni, Luciana, Zafiropulos, Vassili, Zainuddin, Ahmad A, Zakavi, Seyed Rasoul, Zamani, Farhad, Zambon, Sabina, Zampelas, Antoni, Zamrazilová, Hana, Zapata, Maria Elisa, Zargar, Abdul Hamid, Ko Zaw, Ko, Zdrojewski, Tomasz, Zejglicova, Kristyna, Vrkic, Tajana Zeljkovic, Zeng, Yi, Zhang, Luxia, Zhang, Zhen-Yu, Zhao, Dong, Zhao, Ming-Hui, Zhao, Wenhua, Zhen, Shiqi, Zheng, Wei, Zheng, Yingfeng, Zholdin, Bekbolat, Zhou, Maigeng, Zhu, Dan, Zins, Marie, Zitt, Emanuel, Zocalo, Yanina, Cisneros, Julio Zuñiga, Zuziak, Monika, Ezzati, Majid, Filippi, Sarah, Cohortes épidémiologiques en population (CONSTANCES), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay-Université Paris Cité (UPCité), Université Paris Cité (UPCité), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-Institut Agro - Montpellier SupAgro, and Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)
Subjects: Population -- Health aspects, Leanness, Baixo peso/Underweight, none, Double burden, alipainoisuus, tulotaso, global health, systematic analysis, Sedentary behaviors, RC1200, Prospective associations, 0302 clinical medicine, underweight, nälänhätä, Biology (General), skin and connective tissue diseases, Children, ComputingMilieux_MISCELLANEOUS, Body mass index, Human Nutrition & Health, education.field_of_study, Humane Voeding & Gezondheid, ylipaino, General Medicine, kansainvälinen vertailu, 3. Good health, World health, Medicine, A100 Pre-clinical Medicine, Population distribution, medicine.medical_specialty, QH301-705.5, Science, Socio-culturale, Nursing, Social sciences, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Thinness, SDG 3 - Good Health and Well-being, BMI, epidemiology, obesity, None, Humans, Obesidade/Obesity, SDG 2 - Zero Hunger, education, VLAG, US adults, Omvårdnad, body mass index, malnutrition, obesity, underweight, nutritional and metabolic diseases, medicine.disease, terveellisyys, Obesity, Faculdade de Ciências Sociais, Body Mass Index, Prevalence, Risk Factors, General Biochemistry, WIAS, lihavuus, RA, Demography, N.A, double burden, Settore MED/09 - Medicina Interna, alueelliset erot, Nutrition and Disease, Animal Nutrition, [SDV]Life Sciences [q-bio], Medizin, 030204 cardiovascular system & hematology, 0601 Biochemistry and Cell Biology, Change distribution of body mass index, RA0421, Voeding en Ziekte, Epidemiology, Medicine and Health Sciences, Global health, Índice de massa corporal/Body Mass Index, 030212 general & internal medicine, Underweight, painoindeksi, 2. Zero hunger, General Neuroscience, aliravitsemus, elintarvikkeet, health, Public Health, Global Health, Social Medicine and Epidemiology, Diervoeding, 3142 Public health care science, environmental and occupational health, purl.org/pe-repo/ocde/ford#3.01.03 [https], Chinese adults, pooled analysis, medicine.symptom, Diet quality, B120 Physiology, Research Article, trends, purl.org/pe-repo/ocde/ford#1.06.03 [https], prevalence, Population, Mothers, Genetics and Molecular Biology, 3121 Internal medicine, medicine, Life Science, ddc:610, 3125 Otorhinolaryngology, ophthalmology, kehonkoostumus, Nutrition, Australian adults, General Immunology and Microbiology, purl.org/pe-repo/ocde/ford#3.01.04 [https], Ciências sociais, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, Malnutrition, Epidemiology and Global Health, sense organs, Estilos de Vida e Impacto na Saúde
Abstract: From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions., Wellcome Trust, Medical Research Council, peer-reviewed
Published: 2021

3. Construção e validação de instrumento para avaliação da qualidade dos programas de controle de infecção

Author: Bráulio Roberto Gonçalves Marinho Couto, André Luiz Silva Alvim, and Andrea Gazzinelli
Subjects: medicine.medical_specialty, Pesquisa sobre serviços de saúde, Psychometrics, media_common.quotation_subject, Health Personnel, RT1-120, Infecção hospitalar, Infection control, Nursing, Estudio de validación, Likert scale, 03 medical and health sciences, 0302 clinical medicine, Infección hospitalaria, Cronbach's alpha, Cross infection, Estudos de validação, Content validity, medicine, Humans, Health services research, Quality (business), Medical physics, 030212 general & internal medicine, Reliability (statistics), media_common, 030505 public health, Reproducibility of Results, Validation study, General Medicine, Investigación sobre servicios de salud, Test (assessment), Control de infecciones, 0305 other medical science, Psychology, Controle de infecções
Abstract: Objective: To build and validate an instrument to assess hospital infection control programs. Method: Methodological study that was developed in seven stages. The instrument items were categorized into the structure, process and result components. 10 expert judges participated, who evaluated the psychometric properties and validated the content using the Likert scale. The pre-test was carried out with 98 health professionals, from April to July 2018. For reliability analysis, Cronbach's alpha test was used. Results: Regarding the content validity index, the score made by expert judges ranged from 0.777 to 1.00, with mean of 0.902 (± 0.076). The Cronbach's alpha test showed good internal consistency of the items (0.82). Conclusion: An instrument to assess hospital infection control programs was developed and validated, which showed good reliability and can be efficiently used at national level. RESUMEN Objetivo: Construir y validar un instrumento para evaluar los programas de control de infecciones hospitalarias. Método: Estudio metodológico desarrollado en siete etapas. Los ítems del instrumento se clasificaron en componentes de estructura, proceso y resultado. Participaron 10 jueces expertos, quienes evaluaron las propiedades psicométricas y validaron el contenido utilizando la escala Likert. La prueba previa se llevó a cabo con 98 profesionales de la salud, de enero a marzo de 2018. Para el análisis de confiabilidad, se utilizó la prueba alfa de Cronbach. Resultados: En cuanto al índice de validez de contenido, la calificación realizada por jueces expertos varió de 0.777 a 1.00, con un promedio de 0.902 (± 0.076). La prueba alfa de Cronbach mostró una buena consistencia interna de los ítems (0,82). Conclusión: Se desarrolló y validó un instrumento para evaluar los programas de control de infecciones hospitalarias, que mostró una buena fiabilidad y se puede utilizar de manera eficiente a nivel nacional. RESUMO Objetivo: Construir e validar um instrumento de avaliação dos programas de controle de infecção hospitalar. Método: Estudo metodológico que foi desenvolvido em sete etapas. Os itens do instrumento foram categorizados nos componentes de estrutura, processo e resultado. Participaram 10 juízes especialistas que avaliaram as propriedades psicométricas e validaram o conteúdo através da escala de Likert. O pré-teste foi realizado com 98 profissionais de saúde, no período de abril a julho de 2018. Para análise de confiabilidade utilizou-se o teste alfa de Cronbach. Resultados: Em relação ao índice de validade de conteúdo, a pontuação feita pelos juízes especialistas variou de 0,777 a 1,00, com média de 0,902 (±0,076). O teste alfa de Cronbach evidenciou boa consistência interna dos itens (0,82). Conclusão: Foi elaborado e validado instrumento de avaliação dos programas de controle de infecção hospitalar, que apresentou boa confiabilidade, podendo ser utilizado de forma eficiente em nível nacional.
Published: 2021

4. Author response: Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight

Author: Zahra Mohammadi, Abdul Basit, Helena I. S. Nogueira, Soile E. Puhakka, Hongsheng Bi, Ari Voutilainen, Davood Khalili, Bin Zhou, Dermot O'Reilly, Natascia Rinaldo, Paulo A. Lotufo, Bahareh Kheiri, Thein Thein Htay, Simona Giampaoli, Goodarz Danaei, M. Fernanda Lima-Costa, Simona Bo, Peter Schnohr, Jerzy Chudek, Francesco Panza, Ling Yang, Katia Vergetti Bloch, Vincenzo Capuano, Holly E. Syddall, Dong Zhao, Indah Suci Widyahening, Maria Lorenza Muiesan, Leng Huat Foo, Mohsen Azimi-Nezhad, Merete Osler, Laura Torres-Collado, Manu Raj, Adroaldo Cesar Araujo Gaya, Susi Kriemler, Ali Akbar Shayesteh, Aneta Grajda, Anette Varbo, Kazem Mohammad, Leila Beltrami Moreira, Shu Ti Chiou, Iuliia A Rusakova, Jyh Eiin Wong, Torben Jørgensen, Lela Sturua, Lubica Ticha, Hamid Hakimi, Hazzaa M. Al-Hazzaa, Yanina Zócalo, Freda Pitakaka, Savvas C. Savva, Rajeev Gupta, Jennifer Servais, Marie Kunešová, Johanna M. Geleijnse, Elysée Claude Bika Lele, Yannis Manios, Jorge Escobedo-de la Peña, Yufang Bi, Chinh Nguyen Huu, Sibel Gogen, Viviane Cunha Cardoso, Kristine H. Allin, Ana Azevedo, Line Tang Møllehave, Vincent Jr DeGennaro, Novie O. Younger-Coleman, Gretchen A Stevens, Dickman Gareta, Holger Theobald, Anja Schienkiewitz, Bekbolat Zholdin, Janice Luisa Lukrafka, Adela Chirita-Emandi, Ulla Roggenbuck, Kenisha Russell Jonsson, Robespierre Ribeiro, Gabriele Eiben, Eero Kajantie, Sounnia Mediene Benchekor, Fariborz Mansour-Ghanaei, Mary Simon, Prakash C. Gupta, Mohammad Esmaeel Motlagh, Emanuela Gualdi-Russo, María Elena Díaz-Sánchez, Pilar Guallar-Castillón, Bee Koon Poh, Cristina Padez, Azaliia M Tuliakova, Sarah P. Garnett, William R. Tebar, Yingfeng Zheng, Suhad Bahijri, Christina Mavrogianni, Mihaela Vladulescu, Jan A. Staessen, Paula Duarte de Oliveira, Rui Ornelas, Michael Sjöström, Charles Agyemang, Slawomir Koziel, Shohreh Naderimagham, Jari Jokelainen, Stephen T. McGarvey, Patrick Pasquet, Farnam Mohebi, Nader Saki, Aida Pilav, Azim Nejatizadeh, Marianna Noale, Habiba Ben Romdhane, Luís B. Sardinha, Laura Lauria, Jun Hata, Kodanda R Kanala, Gert B. M. Mensink, Nils Lehmann, Elio Riboli, Carolina Tarqui-Mamani, Rodrigo M. Carrillo-Larco, Rosangela Fernandes Lucena Batista, Victoria E Soto-Rojas, Luis Serra-Majem, Martina Müller-Nurasyid, Felipe Vogt Cureau, Lekhraj Rampal, Zhamilya Battakova, Ludmila Sevcikova, Suhaila Abdul Ghaffar, Fikru Tullu, Aung Soe Htet, Angel R. Gonzalez, Annette J. Dobson, Kavumpurathu Raman Thankappan, Hélène Delisle, Francisco J. Félix-Redondo, Ramón Suárez-Medina, Annika Rosengren, Sania Nishtar, Tanja G. M. Vrijkotte, Wolfgang Ahrens, Osvaldo Santos, Maria Cecília Formoso Assunção, Kazi M. Jamil, Stefano Marventano, Wenbin Wei, Norsyamlina Che Abdul Rahim, Shukri F. Mohamed, Bente Sparboe-Nilsen, Soon-Woo Park, Ana Isabel Rito, David Goltzman, W. M. Monique Verschuren, Catterina Ferreccio, Marta Buoncristiano, Ramón Alberto Rascón-Pacheco, Pradeep Joshi, Edward D Janus, Laetitia Huiart, Ala'a Alkerwi, Lorenza Pilotto, Mohannad Al Nsour, Daan Kromhout, Marius B. Bjertness, Oanh T. H. Trinh, Nico Dragano, Angélica Ochoa-Avilés, Ingunn Holden Bergh, Yuki Fujita, Juraci Almeida Cesar, Hajer Aounallah-Skhiri, Maria Dorobantu, Jordi Sunyer, Wolfgang Kratzer, Susanne R. de Rooij, Drude Molbo, Rebecca Goldsmith, Jean Woo, Mohammad El-khateeb, Tiffany K. Gill, Nish Chaturvedi, Benjamin Acosta-Cazares, Erik Lykke Mortensen, Nikhil D. Patel, Francesco Pistelli, Yuan He, Ivana Radic, Yi Zeng, Ilse Khouw, Reynaldo Martorell, Ching-Yu Cheng, Stine Schramm, Hana Shimizu-Furusawa, Jacek Jóźwiak, Radwan Qasrawi, Isti Ilmiati Fujiati, Charles Sossa Jérome, Ben Schöttker, Mikhail Benet, Anastasia Markaki, Christopher T. Cowell, Bharathi Viswanathan, Renata Kuciene, Jose Eugenio Lozano, Pedro J Ortiz, Delphine De Smedt, Elaine M. Murtagh, Kamel Ajlouni, Carlos A. Aguilar-Salinas, Graziella D'Arrigo, Xiangjun Wang, Lars Lind, Macia Enguerran, Marjeta Mišigoj-Duraković, Bo Werner, Jean-Michel Gaspoz, Kyungwon Oh, Seyed Rasoul Zakavi, Daniel Fernández-Bergés, Felix Kaducu, Ramon O. Jimenez, Jonathan E. Shaw, Nipa Rojroongwasinkul, Aicha Soumare, Astrid Petersmann, Tomasz Grodzicki, Parvina Mukhtorova, Eha Nurk, Bhawesh Koirala, Óscar Lopes, Ana Jelakovic, Karolina Milkowska, Magda Gasull, Regina Heidinger-Felso, Marcela González-Gross, Belong Cho, Daphne Mirkopoulou, Salvador Villalpando, Tran Quoc Bao, José Boggia, Daniela Galeone, Josep Redon, Matthias Bopp, Abbas Rezaianzadeh, Dusko Bjelica, Amir Houshang Mehrparvar, Felipe F. Casanueva, Khairil Si-Ramlee, Soheir H Ahmed, Maria Nordendahl, Luciana Zaccagni, Mahboubeh Parsaeian, Rod Jackson, Jorge Motta, Keiu Nelis, Fernando Rigo, Andrzej Pajak, Christa Meisinger, Clara Homs, Namuna Shrestha, Mar Alvarez-Pedrerol, Xun Tang, Johann Willeit, Motahareh Kheradmand, Jean Dallongeville, Jean-Bernard Ruidavets, Anne Tjønneland, Diana A. Santos, Lynne M. Boddy, Jie Hao, David Alejandro González-Chica, Elin Kolle, Jingli Gao, Małgorzata Mossakowska, Isabel O. Oliveira, Giuseppe Grosso, Seongjun Ha, Olfa Saidi, Albina A Fakhretdinova, Oye Gureje, Raluca Pop, Iulia Jurca Simina, Nuno Lunet, Maria Forsner, Peter Bjerregaard, Rachael McLean, Antonio Cabrera de León, Guy De Backer, José A. Casajús, Guang Ning, Emmanuella Magriplis, Laura Censi, Graziella Bruno, Valentina Peterkova, Angelique Chan, Yvonne T. van der Schouw, Charalambos Hadjigeorgiou, Anjani Kumar Jha, Toomas Veidebaum, Thamara Hubler Figueiró, Jana Kratenova, Michelle Cilia, Ivo Rakovac, Bill Stavreski, Ya Xing Wang, Oscar Noboa, Romana Roccaldo, Sara Magnacca, Johan Sundström, Peter Stehle, Tania Lopez, Francis Delpeuch, Julianne Williams, Ellisiv B. Mathiesen, Leanne M. Riley, Claudia M. Hormiga, Joanne Katz, Ekaterina Stoyanova, Heloisa Bettiol, Gabriele Nagel, Alireza Khosravi, Lars Bo Andersen, João Breda, Jørgen Meisfjord, Ahmad Faudzi Yusoff, Marjeta Majer, Robert Beaglehole, Caleb Ochimana, Shynar Abdrakhmanova, George S. Stergiou, Blanca Sandra Ruiz-Betancourt, Leon A. Simons, Eng Joo Tan, Victoria Farrugia Sant'Angelo, Gry Skodje, Maryam Keramati, Liv Elin Torheim, Seppo Koskinen, Assembekov Batyrbek, Jaakko Tuomilehto, Marjo-Riitta Järvelin, Ming-Hui Zhao, Krista Fischer, Tobias F. Rinke de Wit, Agnès Le Port, Reza Homayounfar, James E. Bennett, Yuna He, Matsuda Fumihiko, Qi Sheng You, Angela Spinelli, Scott B. McLean, Shirin Djalalinia, Thet Thet Mu, Yves Martin-Prével, Rafael N. Pichardo, Gailute Bernotiene, Pietro Amedeo Modesti, Frederick C. W. Wu, Chandini Nekkantti, Daniela Rodrigues, Tandi E. Matsha, Mihai Gafencu, Xingwang Ye, Salar Rahimikazerooni, Trevor S. Ferguson, Christophe Tzourio, Marie Zins, Fernando Rodríguez-Artalejo, Xu Ma, Elin Pettersen Sørgjerd, Lourdes Ribas-Barba, Nalan Uysal, Salim Berkinbayev, Enisa Kujundzic, Sari Voutilainen, Iraj Mohebbi, Heiner Boeing, Jorge Mota, Jana Námešná, Maria Tsigga, Zivka Dika, Gulmira Aitmurzaeva, Xu Lin, Valéria Regecová, Herman Schargrodsky, Stevo Popovic, Amelia C. Crampin, Hannu Uusitalo, André Luiz Sena Guimarães, Ali Esmaeili, Catherine Kyobutungi, Virginija Dulskiene, Diego Augusto Santos Silva, David De Ridder, Lizzy M. Brewster, Hashem Jaddou, Eunice Ugel, José Camolas, Azli Baharudin, Idris Guessous, Sok King Ong, Tabara Yasuharu, Ali Ghanbari, Anne W. Taylor, Iraj Nabipour, Justyna Godos, Cyrus Cooper, Bruna Gonçalves Cordeiro da Silva, Gonzalo Valdivia, Gyulli M. Kazakbaeva, Takuro Furusawa, Pawel Kurjata, Diego Vanuzzo, Marvin Cervantes-Loaiza, Karen Morgan, Mostafa Qorbani, Rute Santos, Marika Ferrari, Diego Salmerón, Ida Maria Schmidt, Gao Pei, Abu Am Hanif, Balkish M. Naidu, Maria Wany Louzada Strufaldi, Moesijanti Soekatri, Marcia Scazufca, Katharina Maruszczak, Jacqueline Ramke, Elvis Oa Wambiya, Kairit Mikkel, Napoleón Pérez-Farinós, Natalia Nowak-Szczepanska, Miao Li Chee, Jose Sanchez-Abanto, Rajaa Al-Raddadi, Michel Joffres, Vayia Rarra, Ningli Wang, Charmaine A. Duante, Sheikh Mohammed Shariful Islam, Manoli Garcia-de-la-Hera, Weili Yan, Dong Wook Shin, Rômulo Araújo Fernandes, Ilona Nenko, Sanjib Kumar Sharma, Alfonso Siani, Indrapal I. Meshram, Imelda A. Agdeppa, Ei Ei K. Nang, Ian Rouse, Avula Laxmaiah, Ana M. B. Menezes, Yih Chung Tham, Ebrahim Eftekhar, María José Tormo, Felicia Cañete, Marie Eliasen, Lutgart Braeckman, Dirk Vanderschueren, Genc Burazeri, Kari Kuulasmaa, Jesús Vioque, Marisa K. Sophiea, Agneta Sjöberg, Katarzyna Dereń, Albertino Damasceno, Jochanan Stessman, Stig E. Bojesen, Aline Meirhaeghe, Else Karin Grøholt, Flávio Danni Fuchs, Robert Lundqvist, Frédéric Gottrand, Jeongseon Kim, Helmut Schröder, Joanna Baran, Karina Mary de Paiva, Yousef Khader, Eric Monterrubio-Flores, Aneta Weres, Hans Concin, Damaskini Valvi, Sari Hantunen, Machi Suka, Elena Sacchini, Norbert Amougou, Ursula Kiechl-Kohlendorfer, Edwige Landais, Viktoria Anna Kovacs, Rosemarie Martin, Kenneth James, Amaneh Shayanrad, Grethe S. Tell, Norazizah Ibrahim Wong, Vedrana Sember, Anelise Reis Gaya, Konrad Jamrozik, Thorkild I. A. Sørensen, Martin Neovius, Urho M. Kujala, Nathalie Michels, Marcel Goldberg, Alexandra Cucu, Liliana Dacica, Adelheid Weber, Hermann Pohlabeln, Sandjaja, Jukka T. Salonen, Patricia Varona-Pérez, Tiina Laatikainen, Jolanta Słowikowska-Hilczer, Ana Paula Carlos Cândido, Julie Taylor, Anabela Mota-Pinto, Cora L. Craig, Teresa Shamah-Levy, María Dolores Chirlaque, Mohd Azahadi Omar, Dominique Cottel, Charumathi Sabanayagam, Andrea Gazzinelli, Mieczysław Litwin, Sadaf G. Sepanlou, Adolfo Rubinstein, Abbas Dehghan, Rildo de Souza Wanderley Júnior, Wenhua Zhao, Aleksandra Piwońska, Yong Tao, Bontha V. Babu, Marc J. Gunter, Harunobu Nakamura, Wojciech Drygas, Eiji Oda, Jia Li Duan, Stefan Söderberg, Anthony Kafatos, Lynell V Maniego, Els Clays, Wei-Yen Lim, Marshall K. Tulloch-Reid, Mariachiara Di Cesare, Mattias Johansson, Simona Costanzo, Margot González-León, Matthias Nauck, Henry Völzke, George Luiz Lins Machado-Coelho, Annette Peters, Rajiv T Erasmus, Juan Francisco Miquel, Andrea Gualtieri, Abdul Hamid Zargar, Kaare Christensen, Peter Willeit, Tanja Stocks, Christine Cameron, Samuel C. Dumith, Janina Petkeviciene, Boyd Swinburn, Magdalena Muc, Sabine Schipf, Tajana Zeljkovic Vrkic, Martin Bobak, Damian K Francis, Veronica Mocanu, Karien Stronks, Antonisamy Belavendra, Artur Mazur, Nagalla Balakrishna, Jardena J. Puder, Mehrdad Azmin, Shelly R. McFarlane, Sara Santos Sanz, Yang Yang, Anneke Blokstra, Rafel Ramos, Ertugrul Celikcan, Jody C Miller, Jesús Ibarluzea, Svetlana A. Shalnova, Maria Elisa Zapata, Guansheng Ma, Fereidoun Azizi, Beatriz D'Agord Schaan, Pedro Marques-Vidal, William A. Neal, Ana B. Crujeiras, Zhenyu Zhang, Naser Ahmadi, Abdullatif Husseini, Alun Evans, Jiang He, Edyta Łuszczki, Maria G. Stathopoulou, Alibek Mereke, Mari-Liis Tammesoo, Axel C. Carlsson, Helen Gonçalves, Idowu O Senbanjo, Jim Mann, Rajendra Pradeepa, Juel Jarani, Eva Martos, Eugene Sobngwi, Themistoklis Tzotzas, Vassilis Zafiropulos, Reina Engle-Stone, Atul Trivedi, Hui Cai, Sarah Filippi, Georg Posch, Galina Obreja, Cecily Kelleher, Sareh Eghtesad, Chung T Nguyen, Kay-Tee Khaw, Joseph Cacciottolo, Ana Henriques, Yi-Ting Lin, Anil Poudyal, Liam Smeeth, Kenji Shibuya, Emma Ruiz Moreno, Annamari Lundqvist, Thor Aspelund, Caroline H.D. Fall, Philippe Amouyel, Kristyna Zejglicova, Argyro Karakosta, Piotr Bandosz, Juvenal Soares Dias-da-Costa, Maria Lazo-Porras, Maung Maung Than Htike, Dalia Luksiene, Jutta Stieber, Augusto Di Castelnuovo, Aryeh D. Stein, Lechaba Tshepo, Judith Benedics, Aletta E. Schutte, Jürgen König, Magdalena Korzycka, Grzegorz Sobek, Dimitrios Trichopoulos, Tai Hing Lam, Yn-Tz Sung, Masanori Iwasaki, Elias F. Gudmundsson, Antonio Mistretta, Daniel Lemogoum, Nimmathota Arlappa, Isabelle Herter-Aeberli, Khanh Le Nguyen Bao, Shoichiro Tsugane, Kaosar Afsana, Alireza Sadjadi, Myriam Galfo, Jean Claude Mbanya, Bernardo L. Horta, Marleen E. Hendriks, M. Arfan Ikram, Fadia AlBuhairan, Huashuai Chen, Marzieh Katibeh, Sidsel Graff-Iversen, Sahar Saeedi Moghaddam, Larissa Pruner Marques, Louise Eriksen, Aleksandra Gomula, Ricky Eddie, Maciej Banach, Jost B. Jonas, Andrea R. V. R. Horimoto, Slavica Sović, Charles Mondo, Felix Gutzwiller, Mariana Sbaraini, Aye Aye Sein, Henrike Galenkamp, Jaume Marrugat, Nazan Yardim, Cecilia Björkelund, Luigi Palmieri, Roya Kelishadi, Jie Mi, Nahla Hwalla, Jing Liu, Davide Noto, Panayiotis K. Yiallouros, Kelias P. Msyamboza, Judith Simons, Sofia Malyutina, Michele Monroy-Valle, Andres Metspalu, Lariane M Ono, Rafaela Rosário, Flora A. Ukoli, Efthymios Kapantais, Enzo Manzato, S. Goya Wannamethee, Alison J Price, Gregorio Varela-Moreiras, Ali Reza Safarpour, Erfan Ghasemi, Janine Clarke, René Charles Sylva, Wan Nazaimoon Wan Mohamud, Zhamyila Usupova, Chaoqiang Jiang, Julio Zuñiga Cisneros, Freja B Kampmann, Wei Cheng Lo, Reza Mohammadpourhodki, Kaspar Staub, Mojtaba Farjam, Vincenzo Solfrizzi, Garry L. Jennings, Fabio Galvano, Monika Zuziak, Karin De Ridder, Lucie Viet, Anna Bugge, Mehdi Yaseri, Safiah Md Yusof, Sandra C. Fuchs, Emmanuel Cohen, Snehalatha Chamukuttan, Maria Ruiz-Castell, Karen Sparrenberger, Pedro Plans-Rubio, Wei Zheng, Eldridge Ferrer, Martijn Huisman, Maria Hassapidou, Iris Pigeot, Jakub Stokwiszewski, Domenico Palli, Ewelina Czenczek-Lewandowska, Ramiro Guerrero, Farzad Hadaegh, Han Cg Kemper, Saeid Safiri, Ivan Pećin, Arnaud Chiolero, Niels Møller, Jorge Bezerra, Ulrike Gehring, Iná S. Santos, Dénes Molnár, Muhammad Fadhli Mohd Yusoff, Marie Moitry, Nizal Sarrafzadegan, Jacqueline F. Price, Ranko Stevanovic, Sai Yin Ho, Georg Lappas, Alberto Palloni, Malay K. Mridha, Elaine M. Dennison, Jeonghee Lee, Saeid Eslami, Rahman Shiri, Japhet Killewo, Juergen Breckenkamp, Mathilde Kersting, Y Nikitin, Iqbal Bata, Geetha R Menon, Maria Avdicova, Sanjay Rampal, Antônio Augusto Moura da Silva, Kirsten Mehlig, Chien-An Sun, Ramin Heshmat, Violeta Iotova, Stefaan Demarest, Mette Rasmussen, Dirk De Bacquer, San-Lin You, Suzanne N Morin, Martin Gulliford, Maties Torrent, Luc Dauchet, Fred Paccaud, Paibul Suriyawongpaisal, Sherali Rakhmatulloev, Hyeon Chang Kim, Markku Peltonen, Ruth Frikke-Schmidt, Vera Musil, Ahmad Ali Zainuddin, Angela Chetrit, Dan Zhu, Gowri Mahasampath, Ulrich Keil, Sérgio Viana Peixoto, Haiquan Xu, Helle-Mai Loit, Valérie Deschamps, Ilpo Huhtaniemi, Lijuan Liu, Marialaura Bonaccio, Altan Onat, Rody G. Sy, José María Huerta, Ko Ko Zaw, Akihiro Yoshihara, Peter Ueda, Belgin Ünal, Rachel Dankner, Andrzej Wiecek, Eman Aly, Ruzena Kubinova, Justina Vaitkeviciute, Hanna Tolonen, Priscilla Duboz, Orn Olafsson, Yin Guo, Chiara Donfrancesco, Salim Mohanna, Dusan Grafnetter, Daniel Weghuber, Ali Ahmadi, Rosemary B. Duda, E. Shyong Tai, Louise A. Baur, Nihal Thomas, Prabhdeep Kaur, Norlaila Mustafa, Shariq Rashid Masoodi, Liis Nelis, Badreya Al-Lahou, J. Jaime Miranda, Lèlita Santos, Aroor Bhagyalaxmi, Mohamed Bamoshmoosh, Børge G. Nordestgaard, Jeannette Lee, Ahmad Reza Dorosty, Alain Morejon, Ying-Wei Wang, Jakob Tarp, Rosalba Rojas-Martínez, Luxia Zhang, Bahram Mohajer, Maja Bæksgaard Jørgensen, Jurate Klumbiene, Zhengming Chen, Ambady Ramachandran, Andrea Rodriguez-Martinez, Alisha N. Wade, Suyeon Park, Janne Schurmann Tolstrup, Lucjan Szponar, Krishna Kumar Aryal, Tahir Aris, Mahfuzar Rahman, Dorja Vočanec, Juan P. González-Rivas, Rob M. van Dam, Daniel Bia, Oonagh Markey, Ryutaro Ohtsuka, Kumiko Ohara, Ričardas Radišauskas, Jurate Medzioniene, Tiina Vlasoff, Tania Tello, Suzanne C. Ho, Kodavanti Mallikharjuna Rao, May Soe Aung, Vesselka Duleva, Michael Hobbs, Lutgarde Thijs, Marjolein Visser, Parasmani Dasgupta, Inge Huybrechts, Raimund Erbel, Alice Bonilla-Vargas, Hermann Brenner, Mohammad Reza Fattahi, Jolanda Hyska, Roman Topor-Madry, Ranjit Mohan Anjana, Merike Liivak, Eruke E. Egbagbe, Mathilde Savy, Herculina S. Kruger, Neil Murphy, Vinay Nangia, Cesar G. Victora, Mostafa K. Mohamed, H. Bas Bueno-de-Mesquita, Gabriella Gruden, Marcos André Moura-dos-Santos, Mohammed Rasoul Tarawneh, Maria Teresa Menzano, Francesco Branca, Abdonas Tamosiunas, Elena Bogova, Niveen M E Abu-Rmeileh, Maroje Sorić, Aleksander Giwercman, Elżbieta Dziankowska-Zaborszczyk, Tatjana Hejgaard, Yves Kameli, Margarita Samoutian, Andreia N. Pizarro, Jin Soo Moon, Frank Claessens, Zulfiqar A Bhutta, Frank Tanser, Nor Azwany Yaacob, Vanina Bongard, Gregor Jurak, Johan G. Eriksson, Christina-Paulina Lambrinou, Hanspeter Stamm, Kim Overvad, Yanping Li, Carsten Oliver Schmidt, Thomas Meinertz Dantoft, Wichai Aekplakorn, Anwar Batieha, Eduardo Capuano, Teresa Haugsgjerd, Jeremy M. Jacobs, Paola Russo, Nguyen D Nguyen, Luis Revilla, Hossein Poustchi, Farid Najafi, Giovanni de Gaetano, Wan Mohamad Wan Bebakar, Paul Elliott, Denise Eldemire-Shearer, Angela Döring, Giovanni Viegi, Xiaoguang Yang, María-Elena González-Villalpando, Maria Puiu, Maria Benedetta Donati, Andrew Wong, Tomasz Zdrojewski, Carlos P. Boissonnet, Mohamad Hasnan Ahmad, Mahmudur Rahman, Günther Fink, Marcia Makdisse, Dragana P Jovic, Aline Wagner, Coimbatore Subramaniam Shanthirani, Pascal Bovet, Dong Wook Kim, Tom Wilsgaard, Anders Grøntved, Thirunavukkarasu Sathish, Antonia Trichopoulou, Noushin Mohammadifard, Igor Spiroski, Natasja M. van Schoor, Cláudia S. Minderico, Betina H. Thuesen, Queenie Chan, Ulf Ekelund, Laura A. Rodríguez-Villamizar, Line Lund Kårhus, Cihangir Erem, Amina Barkat, Maria Paula Santos, Fernanda Cunha Soares, Constanta Huidumac Petrescu, Allan G. Hill, Honor Bixby, Benoît Salanave, Joana Carvalho, Maigeng Zhou, Ofra Kalter-Leibovici, Roy A Wong-McClure, Kim F. Michaelsen, Doris Stöckl, Rosalynn Siantar, Jouko Saramies, José R. Banegas, Quang Ngoc La, Uruwan Yamborisut, Parinaz Mehdipour, Farhad Pourfarzi, Sudha Ramachandra Rao, Katsuyasu Kouda, Chien-Jen Chen, Rafael dos Santos Henrique, Martin Nankap, Allan Linneberg, Ronald D. Gregor, Rudolf Kaaks, Maria do Carmo Franco, Marta García-Solano, Beata Gurzkowska, Bahman Cheraghian, Stefaan De Henauw, Daniel Ferrante, Johanna A. Otero, Jamila Abubakar Garba, Antonio Pedro Graça, Sumit Bharadwaj, Shiqi Zhen, Xiu-Hua Guo, Prashant Mathur, Raphael Mendes Ritti-Dias, Kouamelan Doua, Esteban Carmuega, Majid Shirani, Przemyslaw Slusarczyk, Petra Rust, Visnja Djordjic, Farahnaz Joukar, Johanna Gunnlaugsdottir, Leila Houti, Nayu Ikeda, Imperia Brajkovich, Amirabbas Momenan, Erik J. Timmermans, Marcin Rutkowski, Biruta Velika, Joana Araújo, Jostein Steene-Johannessen, Christa L. Lilly, Per Tynelius, Michael Tornaritis, Anne Juolevi, Fatima Zahra Laamiri, Carl Lachat, Kai-Uwe Saum, Espen Bjertness, Ana P. Ortiz, Joel G. R. Roy, Himanshu K. Chaturvedi, Michelle Holdsworth, Niels Wedderkopp, Johan Van der Heyden, Mukharram M. Bikbov, Hsien-Ho Lin, Eva Corpeleijn, Harshpal Singh Sachdev, Mohammad Reza Mirjalili, Maria del Cristo Rodriguez-Perez, Michala Lustigová, Tuyen D Le, Teresa Norat, Hana Zamrazilová, Garry Brian, Tien Yin Wong, Rosa Haghshenas, Clive Osmond, Diego Giulliano Destro Christofaro, Mahmood Moosazadeh, Vilma Irazola, Olli T. Raitakari, Marco Aurélio Peres, Terho Lehtimäki, Shuohua Chen, Dimitrios Papandreou, Robert J. Adams, Sigmund A. Anderssen, Peter T. Katzmarzyk, Luisa M Macieira, Félicité Tchibindat, Lital Keinan Boker, Toshiharu Ninomiya, Morten Sodemann, Jytte Halkjær, Zbigniew Kułaga, Sophie Visvikis-Siest, Farshad Farzadfar, N Capkova, Zumin Shi, Maria Turley, Zbigniew Gaciong, Giovanni Veronesi, Martin McKee, Veikko Salomaa, Gilad Twig, Elisabetta L. Romeo, Peter Kristensen, Grazyna Jasienska, Victor Guillermo Sequera, Mario V. Capanzana, Con Burns, Emanuela Pettenuzzo, Ming-Dong Wang, Jonathan Giovannelli, Stela McLachlan, Ellis Owusu-Dabo, Stefania Toselli, Maria Teresa Anselmo Olinto, Senthil K Vasan, Sara Schramm, Xenophon Theodoridis, Moyses Szklo, Ramfis Nieto-Martínez, Viswanathan Mohan, Guillermo Frontera, Rahul Malhotra, Thomas Ferrao, Dongfeng Gu, Tomas Vega, Hynek Pikhart, Päivi Mäki, Heba Fouad, Vilnis Dzerve, Christina Howitt, Seyed Mohammad Hashemi-Shahri, Jenny M. Kindblom, Marjolijn C. E. Bragt, G. K. Mini, Qian Wang, Liufu Cui, Andrzej Galbarczyk, Sylvain Sebert, Vilmundur Gudnason, Loreto Santa Marina, Kairat Davletov, Afshin Ostovar, Niloofar Peykari, Nicholas J. Wareham, Wilma M. Hopman, Karl-Heinz Jöckel, Jussi Kauhanen, Breige A. McNulty, Alina Kerimkulova, Youcef Laid, Claes Ohlsson, Stefan Kiechl, Alicia Matijasevich, Boban Mugoša, Srinivasan Kannan, Jyrki K. Virtanen, Mohan Deepa, Mangesh S. Pednekar, Shahla AlDhukair, Cynthia M. Pérez, Vera Lanska, Tint Swe Latt, Dominique Hange, João Luiz Bastos, Eliza Markidou Ioannidou, Leticia Hernandez Cadena, Maya Tanrygulyyeva, Reza Malekzadeh, Dimitrios Poulimeneas, Pedro Ordunez, Thomas Waldhör, Ioannis Pagkalos, Carlo M. Barbagallo, Abla M. Sibai, Peter Vollenweider, Asher Fawwad, Emily Sonestedt, Elena Pahomova, Santosh K. Bhargava, Patrick Kolsteren, Aya Mostafa, Fangfang Chen, Flavio Nervi, Imre Janszky, Arvind Pandey, Renata Cifkova, Alexandre C. Pereira, Alejandro Diaz, Alireza Ansari-Moghaddam, Rachakulla Hari Kumar, Jaakko Mursu, Luis A. Moreno, Glen Gironella, Jelena Kos, Tilema Cama, Haakon E. Meyer, Jun Ma, Raphael E. Arku, Ziad Abdeen, Rusidah Selamat, Dianna J. Magliano, Jitendra Jonnagaddala, Konstantinos Gkiouras, Paul Korrovits, Paola Nardone, Paolo Vineis, Kotsedi D Monyeki, Khuong Quynh Long, Alberto Barceló, Camilla T. Damsgaard, Constance Schultsz, Frank J Rühli, Santiago F. Gomez, Tara Coppinger, Muhammad Islam, Pierre Traissac, Eleonora d'Orsi, Irfan Nuhoglu, Rui Providência, Bernard Maire, Leandra Abarca-Gómez, Sinead Brophy, Daniela Pierannunzio, Cristina Taddei, Wen-Harn Pan, Gregor Starc, Abdullah Alkandari, Saeed Dastgiri, Lien Braeckevelt, Gustavo Velasquez-Melendez, Sudhir Kowlessur, Bagher Larijani, Cynthia Robitaille, Mohamed M. Ali, Steiner Krokstad, Noor Ani Ahmad, Anar Dushpanova, Agustinus Soemantri, Susana Sans, Ionela Pascanu, Gwenaëlle Le Coroller, Inger Ariansen, Abhijit Sen, Sergej M. Ostojic, Silvana Donoso, Felix K. Assah, Juan A Rivera, Peter H. Whincup, Oana-Florentina Gheorghe-Fronea, Hanan F. Abdul Rahim, Yadlapalli S. Kusuma, Michael Knoflach, Moein Yoosefi, Cassiano Ricardo Rech, Paul Ferdinand M. Reganit, Tomi-Pekka Tuomainen, Francesco Gianfagna, Stefania Maggi, Mohammad Hossein Somi, Behrooz Hamzeh, Bethlehem D. Solomon, Herman Borghs, Zhanna Kalmatayeva, Heidi Klakk, Akram Pourshams, Naomi S. Levitt, Miquel Porta, Vesna Jureša, Alexander D. Deev, Son Thai Pham, Paula Margozzini, Silvia Bel-Serrat, Dora Romaguera, Monira Alarouj, Winsome R. Parnell, Marloes Cardol, David Faeh, Antonio Bernabe-Ortiz, Giota Touloumi, Maryam Kavousi, Sanja Musić Milanović, Jalila El Ati, Sauli Herrala, Liang Xu, Sirkka Keinänen-Kiukaanniemi, Ian Hambleton, Stefan Savin, Andre Pascal Kengne, R. Krishna Kumar, Kurt Widhalm, Marco M Ferrario, Parisa Amiri, Yi Song, Jianfeng Wu, Jeannette Klimont, Jean Ferrières, Farhad Zamani, Shina Avi, Luis Paulo Gomes Mascarenhas, Aluísio J D Barros, Reecha Sofat, Koen Van Herck, Hoang Van Minh, Enrique Gutiérrez-González, Martine Vrijheid, Susana Cararo Confortin, Antonis Zampelas, Bogdan Wojtyniak, Ausra Petrauskiene, Juha Auvinen, Maryam Sharafkhah, Emanuel Zitt, Majid Ezzati, Young-Ho Khang, Ellina Rakhimova, Magdalena Klimek, Luís Lopes, Erkin M. Mirrakhimov, Maria Lc Iurilli, Günay Can, Mark Woodward, Esther Lopez-Garcia, Mauro Virgílio Gomes de Barros, Ahmed A. Madar, Rainford J. Wilks, Shoaib Afzal, Melanie J. Cowan, Gareth Stratton, Eduardo Salazar Martinez, Sameer Narake, Norie Sawada, Li Juan Wu, Adrian Richter, Licia Iacoviello, Hanno Ulmer, Deepak Amarapurkar, Mohsen Ibrahim, Hamed Pouraram, Massimo Salvetti, Hung-Kwan So, Yonghua Hu, Lars Ängquist, Thi Tuyet-Hanh Tran, Charles Lunogelo, Sabina Zambon, Angelika Schaffrath Rosario, Lauren Lissner, Kamarul Imran Musa, Deepa Weerasekera, Bihungum Bista, Takafumi Ishida, Ekaterina Chikova-Iscener, Mirjam M. Heinen, Tazeen H. Jafar, Semánová Csilla, Raija Korpelainen, Edward W. Gregg, Laura Gutierrez, Victor M. Herrera, Aristides M. Machado-Rodrigues, Fatemeh Malekzadeh, Shouling Wu, Jennifer L. Baker, Clicerio González-Villalpando, Irene G. M. van Valkengoed, Anna Fijałkowska, Meghnath Dhimal, Murat Topbaş, George Moschonis, Robert Eggertsen, Quang Ngoc Nguyen, Janette Walton, Elnaz Faramarzi, Nasheeta Peer, Radka Taxová Braunerová, Harald Geiger, Morteza Shamshirgaran, Lela Shengelia, María Ángeles Dal Re Saavedra, Khem Bahadur Karki, Timothy J. Key, Maria G. Grammatikopoulou, Susana Vale, Bernhard O. Boehm, Songhomitra Panda-Jonas, Iveta Pudule, Elisabete Ramos, Lacramioara Aurelia Brinduse, Paul H. Lee, Terence W O'Neill, Javad Aghazadeh-Attari, Margus Punab, Bojan Jelaković, Eliza Cinteza, Ha Tp Do, and Alison J. Hayes
Subjects: education.field_of_study, business.industry, Population, Distribution (economics), medicine.disease, Obesity, Geography, medicine, Underweight, medicine.symptom, education, business, Body mass index, Demography
Published: 2020

5. Trends in cardiometabolic risk factors in the Americas between 1980 and 2014: A pooled analysis of population-based surveys

Author: J Jaime Miranda, Rodrigo M Carrillo-Larco, Catterina Ferreccio, Ian R Hambleton, Paulo A Lotufo, Ramfis Nieto-MartSínez, Bin Zhou, James Bentham, Honor Bixby, Kaveh Hajifathalian, Yuan Lu, Cristina Taddei, Leandra Abarca-Gómez, Benjamin Acosta-Cazares, Carlos A Aguilar-Salinas, Dolores S Andrade, Maria Cecília F Assunção, Alberto Barceló, Aluisio JD Barros, Mauro VG Barros, Joao Luiz D Bastos, Iqbal Bata, Rosangela L Batista, Mikhail Benet, Antonio Bernabe-Ortiz, Heloísa Bettiol, Daniel Bia, Katia V Bloch, Jose G Boggia, Carlos P Boissonnet, Imperia Brajkovich, Lizzy M Brewster, Christine Cameron, Ana Paula C Cândido, Felicia Cañete, Viviane C Cardoso, Esteban Carmuega, Juraci A Cesar, Queenie Chan, Diego G Christofaro, Janine Clarke, Susana C Confortin, Cora L Craig, Felipe V Cureau, Juvenal Soares Dias-da-Costa, Alejandro Diaz, Silvana C Donoso, Eleonora d'Orsi, Paula Duarte de Oliveira, Samuel C Dumith, Denise Eldemire-Shearer, Paul Elliott, Jorge Escobedo-de la Peña, Trevor S Ferguson, Romulo A Fernandes, Daniel Ferrante, Damian K Francis, Flavio D Fuchs, Sandra C Fuchs, Andrea Gazzinelli, David Goltzman, Helen Gonçalves, Bruna Goncalves Cordeiro da Silva, Angel R Gonzalez, David A Gonzalez-Chica, Margot González-Leon, Juan P González-Rivas, Clicerio González-Villalpando, María-Elena González-Villalpando, Mariano Gorbea Bonet, Ronald D Gregor, Ramiro Guerrero, Andre L Guimaraes, Martin C Gulliford, Laura Gutierrez, Leticia Hernandez Cadena, Victor M Herrera, Wilma M Hopman, Andrea RVR Horimoto, Claudia M Hormiga, Bernardo L Horta, Christina Howitt, Vilma E Irazola, Kenneth James, Ramon O Jimenez, Santa Magaly Jiménez-Acosta, Michel Joffres, Patrick Kolsteren, Orlando Landrove, Maria Lazo-Porras, Christa L Lilly, M Fernanada Lima-Costa, Tania Lopez, George LL Machado-Coelho, Aristides M Machado-Rodrigues, Marcia Makdisse, Paula Margozzini, Larissa Pruner Marques, Reynaldo Martorell, Luis Mascarenhas, Alicia Matijasevich, Anselmo J Mc Donald Posso, Shelly R McFarlane, Scott B McLean, Ana Maria B Menezes, Juan Francisco Miquel, Michele Monroy-Valle, Eric A Monterrubio, Eric Monterubio Flores, Leila B Moreira, Alain Morejon, Suzanne N Morin, Jorge Motta, William A Neal, Flavio Nervi, Ramfis E Nieto-Martínez, Oscar A Noboa, Angélica M Ochoa-Avilés, Maria Teresa Olinto Anselmo, Isabel O Oliveira, Lariane M Ono, Pedro Ordunez, Ana Paula C Ortiz, Pedro J Ortiz, Johanna A Otero, Alberto Palloni, Sergio Viana Peixoto, Alexandre C Pereira, Marco A Peres, Cynthia M Pérez, Rafael N Pichardo, Daniel A Rangel Reina, Ramon A Rascon-Pacheco, Luis Revilla, Robespierre Ribeiro, Raphael M Ritti-Dias, Juan A Rivera, Cynthia Robitaille, Laura A Rodríguez-Villamizar, Rosalba Rojas-Martinez, Joel GR Roy, Adolfo Rubinstein, Blanca Sandra Ruiz-Betancourt, Eduardo Salazar Martinez, Jose Sánchez-Abanto, Ina S Santos, Diego Augusto Santos Silva, Mariana Sbaraini, Marcia Scazufca, Beatriz D Schaan, Herman Schargrodsky, Victor Sequera, Jennifer Servais, Antonio M Silva, Victoria E Soto-Rojas, Karen Sparrenberger, Aryeh D Stein, Ramón Suárez-Medina, Moyses Szklo, William R Tebar, Tania Tello, Marshall K Tulloch-Reid, Peter Ueda, Eunice Ugel, Gonzalo Valdivia, Gustavo Velasquez-Melendez, Roosmarijn Verstraeten, Cesar G Victora, Rildo S Wanderley Jr, Ming-Dong Wang, Rainford J Wilks, Roy A Wong-McClure, Novie O Younger-Coleman, Maria Elisa Zapata, Yanina Zocalo, Julio Zuñiga Cisneros, Goodarz Danaei, Gretchen A Stevens, Leanne M Riley, Majid Ezzati, Mariachiara Di Cesare, Universidad Peruana Cayetano Heredia, Imperial College London, Pontificia Universidad Catolica de Chile, University of the West Indies, Universidade de São Paulo (USP), Miami Veterans Affairs Healthcare System, University of Kent, Cleveland Clinic, Yale University, Caja Costarricense de Seguro Social, Instituto Mexicano Del Seguro Social, Instituto Nacional de Ciencias Medicas y Nutricion, Universidad de Cuenca, Federal University of Pelotas, Pan American Health Organization, University of Pernambuco, Dalhousie University, Federal University of Maranhao, CAFAM University Foundation, University Medical Science, Universidad de la Republica, Centro de Educacion Medica e Investigaciones Clinicas, University of Amsterdam, Canadian Fitness and Lifestyle Research Institute, Universidade Federal de Juiz de Fora, Universidade Estadual Paulista (UNESP), Universidade Federal de Santa Catarina (UFSC), University of Montreal, Universidade Do Vale Do Rio Dos Sinos, National Council of Scientific and Technical Research, Ministry of Health, Instituto Nacional de Salud Publica, Hospital de Clinicas de Porto Alegre, Universidade Federal Do Rio Grande Do sul, McGill University, Andes Clinic of Cardio-Metabolic Studies, Epidemiology and Microbiology, Universidad Icesi, State University of Montes Claros, King's College London, Institute for Clinical Effectiveness and Health Policy, National Institute of Public Health, Universidad Autonoma de Bucaramanga, Kingston General Hospital, Heart Institute, Fundacion Oftalmologica de Santander, Simon Fraser University, Institute of Tropical Medicine, Ministerio de Salud Publica, Harvard TH Chan School of Public Health, West Virginia University, Oswaldo Cruz Foundation Rene Rachou Research Institute, Universidade Federal de Ouro Preto, Hospital Israelita Albert Einstein, Emory University, Gorgas Memorial Institute of Health Studies, Statistics Canada, Gorgas Memorial Institute of Public Health, University of Vale Do Rio Dos Sinos, University of Puerto Rico Medical Sciences Campus, University of Wisconsin-Madison, Minas Gerais State Secretariat for Health, Universidade Nove de Julho, Public Health Agency of Canada, Universidad Industrial de Santander, National Institute of Health, Hospital Italiano de Buenos Aires, Universidad Centro-Occidental Lisandro Alvarado, Epidemiology and Microbiology Institute, Universidade Federal de Minas Gerais (UFMG), World Health Organization, Middlesex University, and Wellcome Trust
Subjects: AWARENESS, Latin Americans, 030231 tropical medicine, Population, 1117 Public Health and Health Services, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, NCD Risk Factor Collaboration (NCD-RisC)—Americas Working Group, Medicine, 030212 general & internal medicine, education, Public, Environmental & Occupational Health, Cardiometabolic risk, education.field_of_study, Science & Technology, HYPERTENSION, business.industry, 1. No poverty, LATIN-AMERICA, General Medicine, Anthropometry, medicine.disease, Obesity, PREVALENCE, 3. Good health, Blood pressure, Pooled analysis, WORLDWIDE TRENDS, OBESITY, business, Life Sciences & Biomedicine, purl.org/pe-repo/ocde/ford#3.02.18 [http], 0605 Microbiology, Demography
Abstract: Made available in DSpace on 2022-04-28T19:28:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-01-01 National Cancer Institute National Institute of Mental Health National Heart, Lung, and Blood Institute Fogarty International Center Alliance for Health Policy and Systems Research Medical Research Council Background Describing the prevalence and trends of cardiometabolic risk factors that are associated with noncommunicable diseases (NCDs) is crucial for monitoring progress, planning prevention, and providing evidence to support policy efforts. We aimed to analyse the transition in body-mass index (BMI), obesity, blood pressure, raised blood pressure, and diabetes in the Americas, between 1980 and 2014. Methods We did a pooled analysis of population-based studies with data on anthropometric measurements, biomarkers for diabetes, and blood pressure from adults aged 18 years or older. A Bayesian model was used to estimate trends in BMI, raised blood pressure (systolic blood pressure =140 mm Hg or diastolic blood pressure =90 mm Hg), and diabetes (fasting plasma glucose =7.0 mmol/L, history of diabetes, or diabetes treatment) from 1980 to 2014, in 37 countries and six subregions of the Americas. Findings 389 population-based surveys from the Americas were available. Comparing prevalence estimates from 2014 with those of 1980, in the non-English speaking Caribbean subregion, the prevalence of obesity increased from 3.9% (95% CI 2.2-6.3) in 1980, to 18.6% (14.3-23.3) in 2014, in men; and from 12.2% (8.2-17.0) in 1980, to 30.5% (25.7-35.5) in 2014, in women. The English-speaking Caribbean subregion had the largest increase in the prevalence of diabetes, from 5.2% (2.1-10.4) in men and 6.4% (2.6-10.4) in women in 1980, to 11.1% (6.4-17.3) in men and 13.6% (8.2-21.0) in women in 2014). Conversely, the prevalence of raised blood pressure has decreased in all subregions; the largest decrease was found in North America from 27.6% (22.3-33.2) in men and 19.9% (15.8-24.4) in women in 1980, to 15.5% (11.1-20.9) in men and 10.7% (7.7-14.5) in women in 2014. Interpretation Despite the generally high prevalence of cardiometabolic risk factors across the Americas, estimates also showed a high level of heterogeneity in the transition between countries. The increasing prevalence of obesity and diabetes observed over time requires appropriate measures to deal with these public health challenges. Our results support a diversification of health interventions across subregions and countries. Universidad Peruana Cayetano Heredia Imperial College London Pontificia Universidad Catolica de Chile University of the West Indies University of Sao Paulo Miami Veterans Affairs Healthcare System University of Kent Cleveland Clinic Yale University Caja Costarricense de Seguro Social Instituto Mexicano Del Seguro Social Instituto Nacional de Ciencias Medicas y Nutricion Universidad de Cuenca Federal University of Pelotas Pan American Health Organization University of Pernambuco Dalhousie University Federal University of Maranhao CAFAM University Foundation University Medical Science Universidad de la Republica Centro de Educacion Medica e Investigaciones Clinicas University of Amsterdam Canadian Fitness and Lifestyle Research Institute Universidade Federal de Juiz de Fora Universidade Estadual Paulista Universidade Federal de Santa Catarina University of Montreal Universidade Do Vale Do Rio Dos Sinos National Council of Scientific and Technical Research Ministry of Health Instituto Nacional de Salud Publica Federal University of Sao Paulo Hospital de Clinicas de Porto Alegre Universidade Federal Do Rio Grande Do sul McGill University Andes Clinic of Cardio-Metabolic Studies National Institute of Hygiene Epidemiology and Microbiology Universidad Icesi State University of Montes Claros King's College London Institute for Clinical Effectiveness and Health Policy National Institute of Public Health Universidad Autonoma de Bucaramanga Kingston General Hospital Heart Institute Fundacion Oftalmologica de Santander Simon Fraser University Institute of Tropical Medicine Ministerio de Salud Publica Harvard TH Chan School of Public Health West Virginia University Oswaldo Cruz Foundation Rene Rachou Research Institute Universidade Federal de Ouro Preto Hospital Israelita Albert Einstein Emory University Gorgas Memorial Institute of Health Studies Statistics Canada Gorgas Memorial Institute of Public Health University of Vale Do Rio Dos Sinos University of Puerto Rico Medical Sciences Campus University of Wisconsin-Madison Minas Gerais State Secretariat for Health Universidade Nove de Julho Public Health Agency of Canada Universidad Industrial de Santander National Institute of Health University of Sao Paulo Clinics Hospital Hospital Italiano de Buenos Aires Federal University of Santa Catarina Universidad Centro-Occidental Lisandro Alvarado Epidemiology and Microbiology Institute Universidade Federal de Minas Gerais World Health Organization Middlesex University Universidade Estadual Paulista National Cancer Institute: 1P20CA217231 National Institute of Mental Health: 1U19MH098780 National Heart, Lung, and Blood Institute: 1UM1HL134590 National Heart, Lung, and Blood Institute: 5U01HL114180 Fogarty International Center: D71TW010877 National Heart, Lung, and Blood Institute: HHSN268200900033C Alliance for Health Policy and Systems Research: HQHSR1206660 Medical Research Council: MR/P008984/1 Medical Research Council: MR/P02386X/1 Medical Research Council: MR/P024408/1 Fogarty International Center: R21TW009982
Published: 2020

6. Fatores associados à doença renal crônica: inquérito epidemiológico da Pesquisa Nacional de Saúde

Author: Lilian Kelen de Aguiar, Rogério Ruscitto do Prado, Andrea Gazzinelli, and Deborah Carvalho Malta
Subjects: Fatores de Risco, medicine.medical_specialty, Epidemiology, renal insufficiency, Insuficiência Renal Crônica, 03 medical and health sciences, 0302 clinical medicine, Medicine, 030212 general & internal medicine, Self report, Doença Crônica, National health, Gynecology, 030505 public health, Life style, business.industry, lcsh:Public aspects of medicine, Brasil, chronic. chronic disease. risk factors. health surveys. health planning. brazil, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, General Medicine, Inquérito Epidemiológico, Planejamento em Saúde, 0305 other medical science, business
Abstract: RESUMO: Objetivos: Identificar a prevalência da doença renal crônica (DRC) autorreferida no Brasil e caracterizar os fatores associados a essa enfermidade. Métodos: Trata-se de um inquérito epidemiológico de base domiciliar, a Pesquisa Nacional de Saúde (PNS) realizada em 2013. O desfecho analisado foi a prevalência de DRC. Os grupos de variáveis explicativas foram: características sociodemográficas, estilos de vida, doenças crônicas autorreferidas, antropometria e avaliação de saúde. Foram estimadas as prevalências de DRC e os respectivos intervalos de confiança de 95% e foram realizados a análise univariada e o modelo de regressão logística múltipla, permanecendo as variáveis estatisticamente significativas (p < 0,05). Resultados: Observou-se que 1,42% (intervalo de confiança de 95% - IC95% 1,33 - 1,52) dos 60.202 entrevistados referiram ser portadores de DRC. O odds ratio (OR) aumentou com a idade, sendo 2,68 entre os idosos com 65 anos ou mais (IC95% 1,75 - 4,09). Apresentaram chance maior de DRC: possuir planos de saúde, com OR = 1,51 (IC95% 1,28 - 1,78), tabagismo, hipertensão, colesterol elevado e autoavaliação de saúde ruim, com OR = 1,75 (IC95% 1,45 - 2,12), OR = 1,20 (IC95% 1,02 - 1,42), OR = 1,83 (IC95% 1,56 - 2,15), OR = 4,70 (IC95% 3,75 - 5,88), respectivamente. Conclusões: A prevalência de DRC foi maior em idade mais avançada, baixa escolaridade, possuir plano de saúde, tabagismo, hipertensão, hipercolesterolemia e avaliação regular ou ruim do estado de saúde. O conhecimento da prevalência da DRC e dos fatores de risco e de proteção são essenciais para prevenção da doença e para subsidiar as políticas públicas de saúde.
Published: 2020

7. Tuberculosis in the homeless population: performance of primary health care professionals

Author: Rodrigo Pinheiro Fernandes de Queiroga, Andrea Gazzinelli, and Lenilde Duarte de Sá
Subjects: Gerontology, Family health, lcsh:RT1-120, education.field_of_study, Tuberculosis, lcsh:Nursing, Avaliação de Programas e Projetos de Saúde, Population, Evaluative research, medicine.disease, Pessoas em Situação de Rua, Atenção Primária à Saúde, Medical Terminology, Homeless population, medicine, Tuberculose, Christian ministry, Tuberculosis control, education, Psychology, Reliability (statistics), Medical Assisting and Transcription
Abstract: Objective: to analyze the actions to control tuberculosis in the homeless population. Methods: this is an evaluative research that had the participation of 171 family health strategy professionals. An instrument addressing aspects of tuberculosis care for homeless people was used in the study. The performance of professionals was analyzed through the evaluation of variables extracted from an exploratory factor and reliability analyses. Results: in the factor 1, on actions to control tuberculosis in the homeless population, the variables were classified as incipient and partially satisfactory; in the factor 2, on the support that the teams should receive to direct tuberculosis control actions in the homeless population, the variables were classified as unsatisfactory and incipient. Conclusion: the actions to control tuberculosis in the homeless population do not consider the specificities of this population, contrary to the recommendations of the Ministry of Health. Objetivo: analisar as ações para o controle da tuberculose na população em situação de rua. Métodos: trata-se de uma pesquisa avaliativa que contou com a participação de 171 profissionais da estratégia saúde da família. Utilizou-se um instrumento que aborda aspectos da assistência à tuberculose para pessoas em situação de rua. A análise de desempenho ocorreu mediante avaliação das variáveis extraídas da análise fatorial exploratória e de confiabilidade. Resultados: no fator 1, ações para o controle da tuberculose na população em situação de rua, as variáveis foram classificadas como incipientes e parcialmente satisfatórias; no fator 2, apoio que as equipes devem receber para direcionar as ações de controle da tuberculose na população em situação de rua, as variáveis foram classificadas como insatisfatórias e incipientes. Conclusão: as ações para o controle da tuberculose na população em situação de rua não consideram as especificidades dessa população, contrariando as recomendações do Ministério da Saúde.
Published: 2018

8. Public engagement for the conduct of a controlled human infection study testing vaccines against Necator americanus (hookworm) in areas of active hookworm transmission in Brazil

Author: Luciene Barra Ribeiro, Andréa Gazzinelli, Helton da Costa Santiago, Jacqueline Araújo Fiuza, Lucas Lobato, Rodrigo Correa de Oliveira, and Maria Flávia Gazzinelli Bethony
Subjects: Medicine, Science
Published: 2024

9. Improving the understanding of schistosomiasis among adolescents in endemic areas in Brazil: A comparison of educational methods

Author: Andrea Gazzinelli, David Diemert, Leonardo Ferreira Matoso, Maria Flávia Gazzinelli, Gisele Nepomuceno de Andrade, and Lucas Lobato
Subjects: Male, Health Knowledge, Attitudes, Practice, Educational measurement, medicine.medical_specialty, Adolescent, media_common.quotation_subject, education, 030231 tropical medicine, Schistosomiasis, Article, 03 medical and health sciences, 0302 clinical medicine, McNemar's test, Surveys and Questionnaires, Intervention (counseling), Pedagogy, Humans, Medicine, Conversation, Child, Students, Health Education, Practical implications, media_common, 030505 public health, Educational method, business.industry, Teaching, Videotape Recording, General Medicine, medicine.disease, Family medicine, Female, Health education, Educational Measurement, 0305 other medical science, business, Brazil
Abstract: Objective To evaluate the effectiveness of two teaching strategies, both guided by the concept of dialogicity, on adolescents’ knowledge about schistosomiasis and adherence to diagnostic fecal testing. Methods Two teaching strategies related to schistosomiasis were developed, an educational video and group conversation, which were tested in two groups of students aged 10–15 years old. Before and after the intervention, a questionnaire was applied to assess participants' knowledge about schistosomiasis and, after the intervention, two fecal samples were requested from each participant. Comparisons were performed by paired t- and McNemar tests. Results Both strategies resulted in statistically significant improvements in knowledge between the pre- and post-tests. Students who watched the video had a higher return rate of fecal samples and percentage of correct questionnaire answers, mainly on questions about schistosomiasis infection. Conclusion Teaching strategies based on dialogue favored the construction of concepts about schistosomiasis that can influence the adoption of positives attitudes related to health. Practical implications Using teaching strategies based on the concept of dialogicity can favor the increase of knowledge of school age children about schistosomiasis and can influence behavioral change related to health.
Published: 2016

10. Genetic determinants of cardiometabolic risk factors in rural families in Brazil

Author: Angel Martinez-Perez, José Manuel Soria, Miriam S. Dutra, Gustavo Velasquez-Melendez, Rodrigo Correa-Oliveira, Andrea Gazzinelli, and Geórgia das Graças Pena
Subjects: 0301 basic medicine, medicine.medical_specialty, Waist, business.industry, 030105 genetics & heredity, Heritability, Anthropometry, medicine.disease, 03 medical and health sciences, 030104 developmental biology, Endocrinology, Blood pressure, Anthropology, Internal medicine, Cohort, Genetics, medicine, Anatomy, Metabolic syndrome, business, Body mass index, Ecology, Evolution, Behavior and Systematics, Cohort study, Demography
Abstract: Objectives: The purpose of this study was to estimate the heritability of genetic and environmental correlations between cardiometabolic risk factors in extended pedigrees. Methods: The Jequitinhonha Community Family Study Cohort (JCFSC) consists of individuals aged ≥18 years living in rural villages. Family pedigrees were constructed of the cohort. The following data were collected: demographic and socioeconomic status, lifestyle variables, anthropometrics, and lipid traits. Results: The JCFSC consists of 931 individuals distributed into 69 pedigrees with 4,907 members in total. The heritabilities were 0.47 for total cholesterol (TC), 0.44 for triglycerides (TG) and 0.42 for high-density lipoprotein cholesterol (HDLc), 0.49 for metabolic syndrome, approximately 0.60 for anthropometric traits and 0.30 for blood pressure/hypertension. Significant genetic correlations (ρg) were found mainly between TG and TC (ρg = 0.58) and hypertension and TG (ρg = 0.52). Systolic blood pressure (SBP) was correlated with TG (ρg = 0.39) and HDLc (ρg = −0.30). Diastolic blood pressures correlated with TG (ρg=0.56) and TC (ρg=0.30). Genetic correlations were also found between anthropometric traits, including: body mass index (BMI) and TG (ρg=0.34), waist circumference (WC) and TG (ρg=0.42), and WC and HDLc (ρg=-0.33). Household effects were found for HDLc (c2= 0.19), SBP (c2 = 0.14) and Hypertension (c2= 0.14). Conclusions: To some phenotypes, including lipids, hypertension, blood pressure, and anthropometric traits, genetic contribution is important in the determination of cardiometabolic risk factors. This study provides a foundation for future studies. These will mainly focus on rare variants that could describe the genetic mechanisms influencing cardiometabolic risk
Published: 2016

11. Association between sociodemographic and health factors and the practice of walking in a rural area

Author: Paula Gonçalves Bicalho, Tatiane Géa-Horta, Gustavo Velasquez-Melendez, Andrea Gazzinelli, and Alexandra Dias Moreira
Subjects: Caminhada, 030505 public health, business.industry, Zona rural, Health Policy, lcsh:Public aspects of medicine, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Walking, Rural areas, Motor activity, 03 medical and health sciences, 0302 clinical medicine, Atividade motora, Medicine, 030212 general & internal medicine, 0305 other medical science, business, Humanities
Abstract: Resumo A prática regular da caminhada contribui para melhor qualidade de vida, reduzindo riscos para doenças cardiovasculares. O objetivo deste artigo é verificar a associação entre fatores sociodemográficos e de saúde relacionados à prática de caminhada de adultos no contexto rural brasileiro. Estudo transversal com 567 adultos. A variável desfecho foi a prática regular de caminhada (≥ 150 minutos/semana) e as de exposição foram as sociodemográficas, antropométricas, clinico laboratoriais e autopercepção de saúde. As análises foram realizadas pelo teste do qui-quadrado e regressão de Poisson, considerando p ≤ 0,05. Apenas 34,7% da população pratica a caminhada de forma regular. O sexo feminino (RP 0,84; IC95% 0,78–0,89), a idade entre 31-45 anos (RP 1,11; IC95% 1,02–1,22 para comparação entre pessoas de 18-30 anos) e a autopercepção de saúde ruim/regular (RP 0,90; IC95% 0,84–0,97 para a comparação entre pessoas com autopercepção excelente/boa) permaneceram independentemente associadas à prática regular de caminhada. A idade entre 31-45 anos e o sexo masculino foram positivamente associados à caminhada e a percepção de saúde regular/ruim apresentou associação negativa. Esses achados podem sugerir que as políticas públicas de incentivo a atividade física nas áreas urbanas podem ser aplicadas também nas rurais. Abstract The regular practice of walking can contribute to a better quality of life, reducing the risk of cardiovascular disease. Objective: To assess the association between sociodemographic and health factors related to adult practice of walking in the Brazilian rural context. Methods: Cross-sectional study of 567 adults. The outcome variable was the regular practice of walking (≥150 minutes per week) and the explanatory variables were sociodemographic factors, anthropometric measures, laboratory tests and self-perceived health. The chi-square test and Poisson regression were used in analysis, considering p ≤ 0.05. Results: Only 34.7% of the population practices walking regularly. Women (PR 0.84, 95% CI 0.78-0.89), age of 31-45 years (OR 1.11, 95% CI 1.02-1.22, comparing to 18-30 years), and self-perception of poor/fair health (OR 0.90, 95% CI 0.84-0.97 comparing to people with great/good health) remained independently associated with regular practice of walking. Conclusion Age between 31 and 45 years and males were positively associated with walking and the perception of poor/fair health had negative association. These findings may suggest that public policies to encourage physical activity in urban areas should also be applied to rural areas.
Published: 2018

12. Schistosoma mansoni reinfection: Analysis of risk factors by classification and regression tree (CART) modeling

Author: Renato M. Assunção, Helmut Kloos, Jeffrey M. Bethony, Gisele Nepomuceno de Andrade, Bráulio M. Veloso, Leonardo Ferreira Matoso, Andrea Gazzinelli, Roberta Oliveira-Prado, and Rodrigo Correa-Oliveira
Subjects: 0301 basic medicine, Male, Schistosoma Mansoni, Decision Analysis, lcsh:Medicine, Social Sciences, Geographical locations, Families, 0302 clinical medicine, Sociology, Risk Factors, Epidemiology, Medicine and Health Sciences, Schistosomiasis, Geography, Medical, lcsh:Science, Child, Children, Multidisciplinary, Schools, biology, Epidemiological Factors, Waterborne diseases, Pollution, 3. Good health, Praziquantel, Infectious Diseases, Helminth Infections, Child, Preschool, Schistosoma, Engineering and Technology, Female, Schistosoma mansoni, Management Engineering, Brazil, medicine.drug, Research Article, Neglected Tropical Diseases, medicine.medical_specialty, Environmental Engineering, Adolescent, Infectious Disease Control, 030231 tropical medicine, Research and Analysis Methods, Education, 03 medical and health sciences, Environmental health, Helminths, parasitic diseases, medicine, Parasitic Diseases, Animals, Humans, Risk factor, Socioeconomic status, Models, Statistical, lcsh:R, Decision Trees, Water Pollution, Organisms, Biology and Life Sciences, South America, medicine.disease, biology.organism_classification, Tropical Diseases, Invertebrates, Schistosomiasis mansoni, 030104 developmental biology, Socioeconomic Factors, Age Groups, People and Places, lcsh:Q, Population Groupings
Abstract: Praziquantel (PZQ) is an effective chemotherapy for schistosomiasis mansoni and a mainstay for its control and potential elimination. However, it does not prevent against reinfection, which can occur rapidly in areas with active transmission. A guide to ranking the risk factors for Schistosoma mansoni reinfection would greatly contribute to prioritizing resources and focusing prevention and control measures to prevent rapid reinfection. The objective of the current study was to explore the relationship among the socioeconomic, demographic, and epidemiological factors that can influence reinfection by S. mansoni one year after successful treatment with PZQ in school-aged children in Northeastern Minas Gerais state Brazil. Parasitological, socioeconomic, demographic, and water contact information were surveyed in 506 S. mansoni-infected individuals, aged 6 to 15 years, resident in these endemic areas. Eligible individuals were treated with PZQ until they were determined to be negative by the absence of S. mansoni eggs in the feces on two consecutive days of Kato-Katz fecal thick smear. These individuals were surveyed again 12 months from the date of successful treatment with PZQ. A classification and regression tree modeling (CART) was then used to explore the relationship between socioeconomic, demographic, and epidemiological variables and their reinfection status. The most important risk factor identified for S. mansoni reinfection was their “heavy” infection at baseline. Additional analyses, excluding heavy infection status, showed that lower socioeconomic status and a lower level of education of the household head were also most important risk factors for S. mansoni reinfection. Our results provide an important contribution toward the control and possible elimination of schistosomiasis by identifying three major risk factors that can be used for targeted treatment and monitoring of reinfection. We suggest that control measures that target heavily infected children in the most economically disadvantaged households would be most beneficial to maintain the success of mass chemotherapy campaigns.
Published: 2017

13. Knowledge and willingness to participate in research: a descriptive study of volunteers in a clinical trial

Author: Maria Flávia Gazzinelli, Lucas Lobato, Amanda Nathale Soares, and Andrea Gazzinelli
Subjects: medicine.medical_specialty, media_common.quotation_subject, Alternative medicine, lcsh:Medicine, Convenience sample, Ensaio Clínico, Consentimiento Informado, Consentimento Livre e Esclarecido, Research Ethics, Ética em Pesquisa, Nursing, Informed consent, medicine, Research information, media_common, Informed Consent, lcsh:Public aspects of medicine, lcsh:R, Public Health, Environmental and Occupational Health, Ética en Investigación, lcsh:RA1-1270, Clinical Trial, Ensayo Clínico, Clinical trial, Family medicine, Personal Autonomy, Autonomía Personal, Descriptive research, Psychology, Autonomy, Autonomia Pessoal
Abstract: O objetivo deste estudo é avaliar o conhecimento sobre as informações do Termo de Consentimento Livre e Esclarecido (TCLE) e a voluntariedade de participantes de um ensaio clínico. Trata-se de um estudo quantitativo, descritivo, transversal, realizado em novembro de 2011 com participantes de um ensaio clínico realizado em Americaninhas, no Nordeste de Minas Gerais, Brasil. Amostra por conveniência, com 143 adultos de 18 a 45 anos, de ambos os sexos. Utilizou-se um questionário estruturado, aplicado uma semana após a assinatura do TCLE. A maioria dos participantes do ensaio clínico assinou o TCLE sem o conhecimento suficiente das informações da pesquisa, e sofreu influência em sua decisão de participar do ensaio clínico. Concluímos que a assinatura do TCLE não garante a expressão da autonomia de todos os participantes de pesquisa clínica. The aim of this study was to evaluate volunteers’ knowledge of the information on the free informed consent form and their willingness to participate in a clinical trial. This was a quantitative, descriptive, cross-sectional study conducted in November 2011 with subjects from a clinical trial in Americaninhas, northeast Minas Gerais State, Brazil. A convenience sample included 143 adults of both sexes, 18 to 45 years of age. A structured questionnaire was applied one week after signing the free informed consent form. Most participants signed the free informed consent without sufficient knowledge of the research information and were influenced in their decision to participate in the trial. The authors conclude that signing the free informed consent form fails to express all participants’ autonomy in clinical trials. El objetivo de este estudio es evaluar el conocimiento acerca de la información del Formulario de Consentimiento Informado y la disposición de los participantes para un ensayo clínico. Se trata de un análisis cuantitativo, descriptivo, de corte transversal, realizado en noviembre de 2011 con participantes de un ensayo clínico en Americaninhas, llevado a cabo en el nordeste de Minas Gerais, Brasil. Se trata de una muestra de conveniencia: 148 adultos entre 18 y 45 años, de ambos sexos. Se utilizó un cuestionario estructurado, cumplimentado una semana después de firmar el Formulario de Consentimiento Informado. La mayoría de los participantes del ensayo firmó el formulario de consentimiento informado sin un conocimiento suficiente de la investigación y fue influenciado en su decisión de participar en el ensayo clínico. Se concluye que la firma del formulario de consentimiento informado no garantiza la expresión de la autonomía de todos los participantes en la investigación clínica.
Published: 2014

14. Effective anthelmintic therapy of residents living in endemic area of high prevalence for Hookworm and Schistosoma mansoni infections enhances the levels of allergy risk factor anti-Der p1 IgE

Author: Márcio Sobreira Silva Araújo, Andrea Gazzinelli, Sabrina S. Campolina, Andréa Teixeira-Carvalho, Humberto Ferreira de Oliveira Quites, Rodrigo Correa-Oliveira, Olindo Assis Martins-Filho, Leonardo Ferreira Matoso, and Tércia Maria Ribeiro Lima Rezende
Subjects: education.field_of_study, Allergy, High prevalence, biology, business.industry, Immunology, Population, Anti-Der p1 IgE, medicine.disease, Immunoglobulin E, Allergic disorders, Article, Allergy risk factors, parasitic diseases, medicine, biology.protein, Eosinophilia, Helminths, Anthelmintic, medicine.symptom, Risk factor, education, business, medicine.drug
Abstract: In this work were investigated the relationship between Hookworm/Schistosoma mansoni infections and allergy related risk factors in two endemic areas with distinct prevalence of infections and co-infection. The intensity of infections, eosinophilia, allergy risk factors, infections status and anti-Der p1 IgE levels before and 2 years (population 1) and 3 years (population 2) after anthelmintic treatment, were evaluated. It was observed that the population with lower prevalence and intensity of infection (population 2) had lower eosinophils counts (>600/mm3) and higher animal contact than the population with higher parasites intensity (population 1). After anthelmintic treatment the intensity of S. mansoni single infection decreased, but no changes were observed in Hookworm and co-infected individuals. The anthelmintic treatment also enhanced anti-Der p1 IgE optical density in ELISA on the subgroups that became negative for helminth infection regardless of their previous infection condition in population 1. Facing that, we evaluated the anti-Der p1 IgE reactivity index, and the ratio (after/before treatment) was significantly higher in patients co-infected before treatment. On the other hand, no association between anti-Der p1 IgE reactivity index and the intensity of infections were observed. In conclusion, effective anthelmintic therapy of subjects from endemic areas with high prevalence of Hookworm and S. mansoni infections enhances anti-Der p1 IgE levels.
Published: 2013

15. Integration of Primary Health Care of a small Brazilian city in the health care network

Author: Ed Wilson Vieira and Andrea Gazzinelli
Subjects: education.field_of_study, medicine.medical_specialty, Health (social science), Data collection, Operationalization, Sociology and Political Science, business.industry, Health Policy, Public health, Population, Scientific literature, External validity, integration of systems, evaluation of health services, primary care, health care, Health care, medicine, Operations management, Business, education, Socioeconomic status
Abstract: Introduction: integration of health care has been an important challenge in the provision of health care. Brazilian studies, however, have yet to evaluate it objectively and only large cities have been addressed. Therefore, this study’s objective was to objectively measure the degree of integration of Primary Health Care PHC in a small Brazilian city in the health care network. Methods: initially, to quantitatively operationalize the concept of integration, a structured evaluation matrix with 25 indicators was developed based on the scientific literature and technical recommendations, with evaluation parameters scored from 0 to 3. All the physicians and nurses of the public health facilities of a small city in the State of Minas Gerais, Brazil were invited to answer a structured questionnaire based on this evaluation matrix. Additionally, all the cases of individuals who had been referred for specialized exams and to medical specialists waiting to get an appointment during the study period, were analyzed. After data collection, each indicator was scored based on the parameters established in the matrix. The ratio between the total score obtained and the total score expected 75 points multiplied by 10 was considered to determine the degree of integration of the PHC in the health care network. The degree of integration was classified and analyzed on a continuous scale, from very little integration score 0.00-1.24 to perfect integration 8.75-10.00. Results: the results reveal there is poor coordination of care, along with problems concerning the organization of the flow of patients to provide appropriate health care, with weak instruments to promote integration and important barriers to the access of specialized care, limiting the integration of PHC within the health care network. The average score per indicator was very low 1.16 and the total score obtained for the matrix was only 28, meaning there was a degree of integration of 3.73, which is evidence of a poor level of integration of PHC into the health care network. Discussion: the limited integration of PHC into the health care network exposes the fragmentation of the care provided to the population of a small city that is linked to the Brazilian Public Health System Sistema Unico de Saude - SUS. In Brazil, there are more than 5,000 small towns with approximately 70 million total inhabitants. Most of these towns face political, geographical and socioeconomic conditions, which, along with the insufficient supply of specialized services, impose additional barriers to the integration of care, worsening a situation of already poor integration. Limitations: this study’s external validity represents a limitation, though the evaluation matrix developed here may contribute to the improvement of integration in many other cities with similar characteristics. Suggestions for future research: by listing several indicators that indicate actions for better integration in a single instrument, the evaluation matrix makes it possible to carry out systematic assessments of integration in municipal health systems. This methodology needs to be replicated in the future in cities of different sizes and contexts, and the level of relative importance of each indicator should be verified.
Published: 2018

16. Longitudinal analysis of antigen specific response in individuals with Schistosoma mansoni infection in an endemic area of Minas Gerais, Brazil

Author: Ricardo Toshio Fujiwara, Andrea Gazzinelli, Philip T. LoVerde, Mery Natali Silva Abreu, Helmut Kloos, Leonardo Ferreira Matoso, Rodrigo Correa-Oliveira, and Roberta Oliveira-Prado
Subjects: Male, Immunoglobulin E, Immunoglobulin G, Serology, 0302 clinical medicine, Seroepidemiologic Studies, Schistosomiasis, Longitudinal Studies, Child, Aged, 80 and over, 0303 health sciences, biology, Neglected Diseases, General Medicine, Schistosoma mansoni, Middle Aged, 3. Good health, Infectious Diseases, Female, IgE, Disease Susceptibility, Antibody, Longitudinal study, Brazil, Adult, Adolescent, 030231 tropical medicine, Antibodies, Helminth, 03 medical and health sciences, Young Adult, Antigen, parasitic diseases, medicine, Animals, Humans, 030304 developmental biology, Aged, IgG4, fungi, Public Health, Environmental and Occupational Health, Original Articles, medicine.disease, biology.organism_classification, Virology, Schistosomiasis mansoni, Antigens, Helminth, Immunology, biology.protein, Parasitology, Biomarkers, Immunoepidemiology
Abstract: Background Immunoepidemiologic studies have shown a relationship between IgE and IgG4 antibodies with age and with resistance and susceptibility to infection. It is believed that the IgE and IgG4 responses to soluble egg antigen (SEA) can be used for serological analysis of infection and post-treatment status. This study aimed to evaluate the association between Schistosoma mansoni infection and anti-SEA IgG4 and IgE reactivities, and determine whether these reactivities could be used as biomarkers of infection. Methods Between 2001 and 2009, a longitudinal study was performed in which parasitologic and blood specimens and socioeconomic and water-contact information were collected from 127 individuals. All patients positive for S. mansoni infection were treated. Results Schistosomiasis prevalence and the geometric mean of the egg count in 2001 were 59% and 61.05, respectively, decreasing to 26.8% and 8.78 in 2009. IgG4 anti-SEA reactivity in infected individuals was significantly higher than that in uninfected individuals at all time points. Analysis of receiver-operating characteristic (ROC) area showed that the IgG4 anti-SEA antibodies were able to predict infection by S. mansoni at each time point. Conclusion IgG4 anti-SEA reactivity can be used as a biomarker for immune monitoring of the presence of infection with S. mansoni in endemic areas.
Published: 2013

17. Association of a NOD2 Gene Polymorphism and T-Helper 17 Cells With Presumed Ocular Toxoplasmosis

Author: Ariane G. Cruz, Wesley R. Campos, Humberto F. Quites, Miriam S. Dutra, Ricardo Guerra Peixe, Nancy E. Miller, Andrea Gazzinelli, Alba Lucínia Peixoto-Rangel, Lis Ribeiro do Valle Antonelli, Lilian M. G. Bahia-Oliveira, Ricardo T. Gazzinelli, Samantha Ribeiro Béla, Jenefer M. Blackwell, Michaela Fakiola, and Anna C. Higino-Rocha
Subjects: Adult, CD4-Positive T-Lymphocytes, Interleukin 2, Nod2 Signaling Adaptor Protein, Biology, Polymorphism, Single Nucleotide, Immunophenotyping, Cohort Studies, Major Articles and Brief Reports, Immune system, Aldesleukin, medicine, Humans, Immunology and Allergy, Toxoplasmosis, Ocular, Alleles, Cell Proliferation, Interleukin-17, Chorioretinitis, Toxoplasma gondii, Interleukin, T-Lymphocytes, Helper-Inducer, Th1 Cells, medicine.disease, biology.organism_classification, Virology, Toxoplasmosis, Phenotype, Infectious Diseases, Haplotypes, Immunology, Cytokines, Th17 Cells, Interleukin 17, Brazil, medicine.drug
Abstract: Retinochoroiditis manifests in patients infected with Toxoplasma gondii. Here, we assessed 30 sibships and 89 parent/case trios of presumed ocular toxoplasmosis (POT) to evaluate associations with polymorphisms in the NOD2 gene. Three haplotype-tagging single-nucleotide polymorphisms (tag-SNPs) within the NOD2 gene were genotyped. The family-based association test showed that the tag-SNP rs3135499 is associated with retinochoroiditis (P = .039). We then characterized the cellular immune response of 59 cases of POT and 4 cases of active ocular toxoplasmosis (AOT). We found no differences in levels of interferon γ (IFN-γ) and interleukin 2 produced by T-helper 1 cells when comparing patients with AOT or POT to asymptomatic individuals. Unexpectedly, we found an increased interleukin 17A (IL-17A) production in patients with POT or OAT. In patients with POT or AOT, the main cellular source of IL-17A was CD4(+)CD45RO(+)T-bet(-)IFN-γ(-) T-helper 17 cells. Altogether, our results suggest that NOD2 influences the production of IL-17A by CD4(+) T lymphocytes and might contribute to the development of ocular toxoplasmosis.
Published: 2012

18. Avaliação das ações de controle da esquistossomose na Estratégia de Saúde da Família em municípios do Vale do Jequitinhonha em Minas Gerais

Author: Leonardo Ferreira Matoso, Andrea Gazzinelli, Mery Natali Silva Abreu, and Humberto Ferreira de Oliveira Quites
Subjects: Diagnostic methods, Health services administration, Esquistossomose mansoni, Epidemiology, 030231 tropical medicine, Estratégia Saúde da Família, 03 medical and health sciences, 0302 clinical medicine, Nursing, Schistosomiasis control, Saúde pública, Family Health Strategy, Doenças negligenciadas, Medicine, Family health, Government, Public health, 030505 public health, Health professionals, business.industry, lcsh:Public aspects of medicine, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, General Medicine, Administração de serviços de saúde, Schistosomiasis mansoni, Neglected diseases, Controle de doenças transmissíveis, Health education, Observational study, Communicable disease control, 0305 other medical science, business, Health department
Abstract: RESUMO: Estudo observacional que analisa a qualidade das ações de diagnóstico, tratamento e controle da esquistossomose na Estratégia Saúde da Família (ESF) em área endêmica. Foram utilizados questionários estruturados em 97 profissionais de saúde da ESF e em secretários municipais de saúde de 25 municípios pertencentes à Gerência Regional de Saúde de Pedra Azul, Minas Gerais. Foram utilizados os Modelos de Variáveis Latentes para definir um escore a fim de avaliar a qualidade da proposta. Os resultados mostraram que 57,8% das equipes da ESF realizam suas ações de maneira insatisfatória ou crítica. Os profissionais não realizam ações efetivas para controle da infecção e 8,1% não utilizam o método diagnóstico preconizado pelo governo. As estratégias de vigilância e controle ainda são incipientes. Da mesma forma, os profissionais não receberam treinamento adequado para o desenvolvimento das ações de prevenção e controle da esquistossomose. Falta material educativo para o desempenho das atividades de educação em saúde, sendo que as equipes da ESF realizam atividades educativas nas escolas em 48% dos municípios. Menos da metade dos profissionais entrevistados conhecia o Programa de Controle da Esquistossomose (PCE). É necessário integrar as práticas do PCE à ESF, além de buscar um adequado suporte da gestão municipal por meio de pactuações e do controle social. ABSTRACT: Observational study that examined the quality of the preventive actions for schistosomiasis control in the Brazilian Family Health Strategy (FHS) in an endemic area. Structured questionnaires were used to interview 97 health professionals of the FHS and the Secretary of Health of 25 municipalities belonging to the State Health Department of Pedra Azul, Minas Gerais, Brazil. Models of latent variables were used to define a score to evaluate the quality of the process. The results showed that 57.8% of the FHS teams' actions were unsatisfactory or critical. The professionals did not perform effective activities for the control of the infection and 8.1% did not use the diagnostic methods required by the government. Similarly, the professionals did not receive adequate training for the development of schistosomiasis prevention and control. There was a lack of educational materials to carry out health education activities, and the FHS teams conducted educational activities in only 48% of the schools of municipalities. Less than half of the professionals interviewed knew about the Schistosomiasis Control Program. We concluded that it is necessary to integrate this Program's practices to the FHS, and seek a suitable support of municipal management through pacts and social control.
Published: 2016

19. Anthropometric changes and their effects on cardiometabolic risk factors in rural populations in Brazil

Author: Mark Anthony Beinner, Tatiane Géa-Horta, Mariana Santos Felisbino Mendes, Gustavo Velasquez-Melendez, and Andrea Gazzinelli
Subjects: Male, Rural Population, Circunferência da Cintura, Physiology, Hemodynamics, Blood Pressure, 030204 cardiovascular system & hematology, Body Mass Index, chemistry.chemical_compound, 0302 clinical medicine, High-density lipoprotein, Risk Factors, Medicine, Longitudinal Studies, Anthropometry, Health Policy, lcsh:Public aspects of medicine, Middle Aged, Lipids, Cardiovascular diseases, Cardiovascular Diseases, Low-density lipoprotein, Rural population, Female, Waist Circumference, 0305 other medical science, Brazil, Adult, Adolescent, Índice de Massa Corporal, 03 medical and health sciences, Young Adult, Humans, População rural, Aged, Doenças cardiovasculares, 030505 public health, business.industry, Cholesterol, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Blood pressure, chemistry, Multivariate Analysis, Linear Models, business, Body mass index, Lipoprotein, Antropometria
Abstract: This article aims to evaluate associations between anthropometric changes in five years with lipid and blood pressure levels in Brazilian rural population. This longitudinal study evaluated 387 individuals aged 18 to 75 residents of two rural communities. Demographic, lifestyle, anthropometric, biochemical and hemodynamic characteristics were assessed in 2004 and repeated in 2009. Multivariate linear regression was used. Positive change in BMI was associated with increased diastolic blood pressure (DBP) (β = 0.07; 95%CI: 0.03-0.11), low-density lipoprotein (LDL-C) (increase of 0.01% to 10%: β = 0.08; 95%CI: 0.02-0.14, more than 10% increase: β = 0.09; 95%CI: 0.01-0.16) and low density lipoprotein/high density lipoprotein cholesterol ratio (LDL-C/HDL-C) (increase of 0.01% to 10%: β = 0.15; 95%CI: 0.06-0.25, more than 10% increase: β = 0.14; 95%CI: 0.02-0.25). Our results showed no association between positive changes in WC and lipid levels increase, only with blood pressure levels increase (SBP: β = 0.06; CI95%:0.02-0.10; DBP: β = 0.09; CI95%: 0.04;0.13). Positive changes in BMI are independent predictors of increased lipid and blood pressure levels and positive changes in WC of increased blood pressure. Resumo O objetivo deste artigo foi avaliar associação entre as mudanças antropométricas, em cinco anos de estudo, com os níveis lipídicos e pressóricos em populações rurais brasileiras. Estudo longitudinal, que avaliou 387 indivíduos, entre 18 e 75 anos, residentes em duas comunidades rurais. Características demográficas, de estilo de vida, antropométricas, bioquímicas e hemodinâmicas foram coletadas em 2004 e repetidas em 2009. Utilizou-se a regressão linear. Mudanças positivas do IMC foram associadas com aumento da pressão arterial diastólica (PAD) (β = 0,07; IC95%: 0,03-0,11), lipoproteína de baixa densidade (LDL-C) (aumento de 0,01% a 10%: β = 0,08; IC95%: 0,02-0,14; aumento de mais de 10%: β = 0,09; IC95%: 0,01-0,16) e razão lipoproteína de baixa densidade/lipoproteína de alta densidade (LDL-C/HDL-C) (aumento de 0,01 a 10%: β = 0,15; IC95%: 0,06-0,25; aumento de mais de 10% β = 0,14; IC95%: 0,02-0,25). Não se observou associação entre mudanças positivas na CC e aumento de níveis lipídicos, apenas com aumento da pressão arterial (PAS: β = 0,06; IC95%: 0,02-0,10; PAD: β = 0,09; IC95%: 0,04-0,13). Mudanças positivas no IMC são preditoras independentes para aumento de níveis lipídicos e pressóricos e mudanças positivas na CC para aumento de níveis pressóricos.
Published: 2016

20. Prevalência da síndrome metabólica e seus fatores associados em área rural de Minas Gerais (MG, Brasil)

Author: Adriano Marçal Pimenta, Andrea Gazzinelli, and Gustavo Velasquez-Melendez
Subjects: Gynecology, medicine.medical_specialty, Síndrome x metabólica, business.industry, Health Policy, Public Health, Environmental and Occupational Health, Resistência à insulina, Consumo de bebidas alcoólicas, Inflamação, Obesidade, Medicine, business, Rural population, População rural
Abstract: OBJETIVO: Estimar a prevalência da síndrome metabólica (SM) e seus fatores associados em área rural de Minas Gerais. METODOLOGIA: Trata-se de um estudo transversal, de base populacional, conduzido nas comunidades rurais de Virgem das Graças e Caju, Vale do Jequitinhonha, Minas Gerais. Foram coletas informações sobre características demográficas, do estilo de vida, antropométricas, bioquímicas e hemodinâmicas de 534 participantes adultos. A SM foi definida segundo critérios estabelecidos pela National Cholesterol Education Program - Adult Treatment Panel III. Associações independentes entre as covariáveis e a SM foram avaliadas usando-se a regressão multivariada de Poisson com variâncias robustas. O nível de significância estatística foi estabelecido em 5,0%. RESULTADOS: A SM estava presente em 14,9% dos participantes. O sexo feminino, a obesidade, a inflamação crônica subclínica, a resistência à insulina, a idade e o consumo moderado de bebida alcoólica permaneceram independentemente associados à SM. CONCLUSÕES: Na população rural estudada, a SM era problema de Saúde Pública, associada a fatores modificáveis. Portanto, medidas preventivas primárias poderiam ser usadas para diminuir a prevalência deste agravo e o seu impacto na saúde das pessoas.
Published: 2011

21. Behavioral disorders and low quality of life in children and adolescents with chronic kidney disease

Author: Ana Cristina Simões e Silva, Cristiane S. Dias, Mônica Ribeiro Canhestro, Humberto Correa, Carla Cristina D. Melo, Andrea Gazzinelli, José Maria Penido Silva, Renata Cristiane Marciano, Cristina M. Bouissou Soares, José Silvério Santos Diniz, Eduardo A. Oliveira, and Eleonora Moreira Lima
Subjects: Male, Nephrology, medicine.medical_specialty, Pediatrics, Adolescent, medicine.medical_treatment, Life quality, Child Behavior Disorders, Statistics, Nonparametric, Quality of life, Surveys and Questionnaires, Internal medicine, medicine, Humans, Child, Dialysis, business.industry, Mental Disorders, Strengths and Difficulties Questionnaire, Odds ratio, medicine.disease, humanities, Cross-Sectional Studies, Logistic Models, Socioeconomic Factors, Pediatrics, Perinatology and Child Health, Quality of Life, Kidney Failure, Chronic, Female, business, Pediatric population, Kidney disease
Abstract: Recent years has seen an increasing interest in the quality of life (QOL) of children with chronic kidney disease (CKD). The objective of this cross-sectional study was to investigate the prevalence of behavioral disorders and to assess the health-related QOL (HRQOL) in 136 patients with CKD. To estimate the prevalence of behavior disorders and analyze HRQOL, we used the Strengths and Difficulties Questionnaire (SDQ) and Pediatric Inventory of Quality of Life (PedsQL) Core Scales as assessment tools for both the patients and caregivers. When compared to healthy controls, the CKD group had significantly lower scores in almost all PedsQL domains. After adjustment, only absence of religion/other religions remained significantly associated with a lower global HRQOL score [odds ratio (OR) 6.2, P = 0.009]. Among the parents, two factors remained significantly associated with a lower global HRQOL score: patients’ age >10 years (OR 5.4, P = 0.033) and absence of religion/other religions (OR 3.2, P = 0.038). The CKD group demonstrated a higher proportion of behavioral and emotional disorders in all SDQ domains. There was a negative correlation between the presence of behavior and emotional disorders and HRQOL score (r = −0.552, P < 0.001). Our findings suggest the importance of evaluating behavioral and social repercussions of CKD in order to improve the life quality of this pediatric population.
Published: 2010

22. Accessibility to and utilisation of schistosomiasis-related health services in a rural area of state of Minas Gerais, Brazil

Author: Leonardo Ferreira Matoso, Helmut Kloos, Dener Carlos dos Reis, Kellen Rosa Coelho, Andrea Gazzinelli, Humberto Ferreira de Oliveira Quites, and Charles H. King
Subjects: Adult, Male, Rural Population, Microbiology (medical), Veterinary medicine, medicine.medical_specialty, lcsh:Arctic medicine. Tropical medicine, Adolescent, lcsh:RC955-962, lcsh:QR1-502, Schistosomiasis, Health Services Accessibility, lcsh:Microbiology, Schistosomicides, Young Adult, Health services, Schistosomiasis control, Primary health, schistosomiasis, Health care, Prevalence, medicine, health-seeking behaviour, Humans, Child, Socioeconomics, Aged, Aged, 80 and over, Primary Health Care, business.industry, Public health, Infant, Middle Aged, medicine.disease, Disease control, Schistosomiasis mansoni, spatial, Socioeconomic Factors, Child, Preschool, Health Care Surveys, access to health care, Female, Rural area, business, Brazil
Abstract: The objective of the present paper was to compare accessibility and utilisation of schistosomiasis diagnostic and treatment services in a small village and the surrounding rural area in northern part of the state of Minas Gerais Brazil. The study included 1,228 individuals: 935 central village residents and 293 rural residents of Sao Pedro do Jequitinhonha. Schistosoma mansoni infection rates were significantly higher in the central village than in the rural area during a survey in 2007 (44.3% and 23.5%, respectively) and during the 2002 schistosomiasis case-finding campaign (33.1% and 26.5%, respectively) (p < 0.001). However, during the 2002-2006 period, only 23.7% of the villagers and 27% of the rural residents obtained tests on their own from health centres, hospitals and private clinics in various nearby towns. In 2007, 63% of the villagers and 70.5% of the rural residents reported never having received treatment for schistosomiasis. This paper reveals considerable variation in the accessibility and utilisation of schistosomiasis-related health services between the central village and the rural area. A combination of low utilisation rates between 2002-2006 and persistently high S. mansoni infection rates suggest that the schistosomiasis control program must be more rapidly incorporated into the primary health services.
Published: 2010

23. Eosinophil activation status, cytokines and liver fibrosis in Schistosoma mansoni infected patients

Author: Andrea Gazzinelli, Olindo Assis Martins-Filho, Denise da Silveira-Lemos, Lúcia Fraga Alves Oliveira, Rodrigo Correa-Oliveira, Lorena Júnia de Souza, Matheus Fernandes Costa-Silva, Leonardo Ferreira Matoso, and Andréa Teixeira-Carvalho
Subjects: Adult, Liver Cirrhosis, Male, Pathology, medicine.medical_specialty, Adolescent, Veterinary (miscellaneous), medicine.medical_treatment, Schistosomiasis, Antigens, CD, HLA Antigens, Eosinophil activation, medicine, Animals, Humans, IL-2 receptor, Cells, Cultured, Cluster of differentiation, biology, CD23, CD28, Schistosoma mansoni, Middle Aged, respiratory system, Flow Cytometry, medicine.disease, biology.organism_classification, Schistosomiasis mansoni, Eosinophils, Infectious Diseases, Cytokine, Insect Science, Immunology, Cytokines, Female, Parasitology
Abstract: We have been investigating whether human eosinophils play an important role in schistosomiasis mansoni morbidity. Our main focus has been on the activation-related cell surface markers (CD23/CD69/CD25/HLA-DR/CD28/CD80) and the detection of TNF-alpha, IL-4 and IL-5 in peripheral blood eosinophils from chronic Schistosoma mansoni-infected patients. Our studies compare both, intestinal (INT) and individuals with periportal fibrosis (FIB). Our major findings, point to distinct profile of activation-related surface markers on eosinophils as the hallmark of disease morbidity during chronic S. mansoni infection. Up-regulation of several activation-related markers was observed on eosinophils from FIB group, but not INT, which include early activation markers, such as CD69 and CD23. INT displayed a distinct profile, with up-regulation of molecules related to the late activation (CD25, HLA-DR, CD28 and CD80). These results suggest that some immunoregulatory events may take place controlling the early eosinophil activation in the INT group. Higher levels of eosinophil-derived cytokines were observed in FIB, regardless the antigen stimulation in vitro. A mixed cytokine pattern, characterized by positive correlation between TNF-alpha, IL-4 and IL-5 was observed in both INT and FIB. However, lack of correlation between the cytokine expression and the eosinophil activation status points out that even those FIB patients presenting minor increment on eosinophil activation displayed higher levels of cytokine-positive eosinophils. Indeed, the positive association between lymphocyte-derived IL-10 and the eosinophils cytokine profile was observed exclusively in INT further emphasize our hypothesis that immunoregulatory events take place controlling disease morbidity in human schistosomiasis. The impaired IL-10-driven immunoregulatory function may play an important role on the establishment of pathology in patients bearing periportal fibrosis.
Published: 2008

24. The use of spatial tools in the study of Schistosoma mansoni and its intermediate host snails in Brazil: a brief review

Author: Andrea Gazzinelli and Helmut Kloos
Subjects: Health (social science), Geographic information system, Geography, Planning and Development, Medicine (miscellaneous), Biomphalaria, lcsh:G1-922, Schistosomiasis, law.invention, schistosomiasis, Biomphalaria spp., geographical information system, mapping, Brazil, law, medicine, Animals, Environmental planning, biology, Ecology, business.industry, Health Policy, Intermediate host, Schistosoma mansoni, medicine.disease, biology.organism_classification, Schistosomiasis mansoni, Transmission (mechanics), Population Surveillance, Geographic Information Systems, business, Brazil, lcsh:Geography (General), Maps as Topic
Abstract: The rapidly increasing number of spatial studies and the complexity of schistosomiasis transmission dynamics in Brazil indicate that surveillance and control programmes can benefit from the spatial approach, not only in areas susceptible to the introduction and establishment of new transmission foci but also in areas experiencing declines in schistosomiasis transmission. Several additional areas amenable to, or requiring, spatial research are identified. This paper reviews spatial studies of schistosomiasis in Brazil with a focus on the application of spatial tools in epidemiological, disease ecological, control and several additional areas in schistosomiasis research.
Published: 2007

25. Ageing and Toll-like receptor expression by innate immune cells in chronic human schistosomiasis

Author: Ana Maria Caetano Faria, Rodrigo Correa-Oliveira, V Moura, Olindo Assis Martins-Filho, Iramaya Rodrigues Caldas, Fabiano Comin, Elaine Speziali, and Andrea Gazzinelli
Subjects: Adult, Aging, Translational Studies, Adolescent, Endemic Diseases, T cell, Immunology, Population, Helminthiasis, Schistosomiasis, Biology, Monocytes, Natural killer cell, Immune system, medicine, Humans, Immunology and Allergy, education, Aged, Aged, 80 and over, Toll-like receptor, education.field_of_study, Innate immune system, Toll-Like Receptors, Dendritic Cells, Middle Aged, medicine.disease, CD56 Antigen, Schistosomiasis mansoni, Up-Regulation, Killer Cells, Natural, Cross-Sectional Studies, medicine.anatomical_structure, Chronic Disease, Female, Brazil
Abstract: Summary There has been no systematic study of the immune response of individuals aged over 60 years living in Schistosomiasis mansoni-endemic areas, although senescence is reportedly associated with susceptibility to infection and progressive decline in immune function. We have shown previously, in two endemic areas in Minas Gerais, Brazil, that the frequency of individuals aged over 60 years with chronic schistosomiasis is no longer negligible. Moreover, several elderly individuals who have always lived in these endemic areas stay protected from infection. An important question for studies of ageing and disease control in developing countries is which differences in the immunological profile of these negatively tested (non-infected) individuals can account for their resistance to either infection or reinfection. We show, in the present study, that non-infected (negative) elderly individuals develop innate immune mechanisms of protection that replace the age-associated decline in T cell function. Non-infected elderly individuals from endemic areas of schistosome infection present an increase in the frequency of the natural killer (NK) CD56low subset of NK cells expressing Toll-like receptors (TLR)-1, -2, -3 and -4 as determined by flow cytometry analysis. In addition, the proportion of dendritic cells expressing TLR-1 is elevated as well as the frequency of monocytes expressing TLR-1 and -4. These results suggest that TLR expression by cells of the innate immune system may be related to the negative status of infection in some elderly individuals who are constantly exposed to S. mansoni. Developing mechanisms of protection from infection may represent a biomarker for healthy ageing in this population.
Published: 2007

26. THE WAITING TIME FOR SPECIALIZED MEDICAL CONSULTATIONS IN A SMALL MUNICIPALITY OF MINAS GERAIS, BRAZIL

Author: Thais Moreira Nascimento Lima, Ed Wilson Vieira, and Andrea Gazzinelli
Subjects: Waiting time, medicine.medical_specialty, Descriptive statistics, Otorhinolaryngology, media_common.quotation_subject, medicine, Specialty, Medical emergency, Art, Primary care, medicine.disease, Cartography, media_common
Abstract: Objective: to evaluate the waiting time for specialized medical consultations in a small municipality, far from large urban centers, and located in an economically undeveloped region in Minas Gerais State, Brazil. Method: this was a case study with a descriptive approach that followed and analyzed in a six months period (July 2011 to January 2012), 152 referrals of patients to specialized medical consultations not offered in the municipality. The referrals were analyzed with regard to referencing and consultation scheduling using a structured instrument for data collection. A descriptive analysis was performed and the average number of waiting days was compared between variables of interest. Results: the majority of referrals (74.3%) were to specialists forwarded by primary care physicians. Requests for the first consultation represented 88.8% of referrals, and their main demand went to otorhinolaryngology (36.3%). The average waiting time for the first consultation, regardless of the specialty, was 244 days (standard deviation = 193, median = 198), ranging from six to 559 days. Only 3.7% of patients waited three months or less, and another 5.2% waited three to six months. At the end of the six months of the study period, 91.1% of the followed patients were still waiting for the specialized consultation. All the fulfilled consultations were in services located in the State capital, 700 km away. Conclusion: the access to specialized consultation is fragile, with long waiting time, directly affecting the integrality of care.
Published: 2015

27. Socioeconomic determinants of schistosomiasis in a poor rural area in Brazil

Author: Gustavo Velasquez-Melendez, Rodrigo Correa-Oliveira, Andrea Gazzinelli, Sara Crawford, Helmut Kloos, and Philip T. LoVerde
Subjects: education.field_of_study, Cross-sectional study, Veterinary (miscellaneous), Population, Socioeconomic development, Schistosomiasis, medicine.disease, Head of Household, Infectious Diseases, Geography, Environmental protection, Insect Science, Environmental health, medicine, Parasitology, Residence, Rural area, education, Socioeconomic status
Abstract: The objective of this paper is to identify and quantify socioeconomic determinants of Schistosoma mansoni infection in the rural area of Virgem das Gracas in Minas Gerais State of Brazil. A cross-sectional study was carried out to examine the prevalence and intensity of schistosomiasis in relation to socioeconomic characteristics of the households. Log-binomial regression analysis was used to examine the data on both the household and individual levels, analyzing the prevalence ratios for the association of schistosomiasis and socioeconomic variables related to the head of the household. Multiple comparisons through mixed effect modeling were used to examine the relationship between intensity of infection (geometric mean egg counts) and different levels of socioeconomic variables, respectively. In the univariate analysis, place of residence, number of persons per room, and lack of motorized transport were associated with schistosomiasis at the household level and age and unsafe water contact at the individual level. Age, unsafe water contact, number of persons per room, household possessions and lack of education of head of household remained significant predictors of schistosomiasis in the multivariable analysis. Only age was significantly associated with intensity of infection of individuals. It is concluded that widespread poverty, the rural environment, and weak socioeconomic differentiation that result in intense contact with infective water appear to minimize the protective effect of piped water supply and other socioeconomic parameters on schistosomiasis found in other studies. The potential role of socioeconomic development in conjunction with schistosomiasis control is described and areas for further studies are identified.
Published: 2006

28. Cytokine Production Associated with Periportal Fibrosis during Chronic Schistosomiasis Mansoni in Humans

Author: Rodrigo Correa-Oliveira, Alda Maria Soares Silveira, Andrea Gazzinelli, Olindo Assis Martins-Filho, Giovanni Gazzinelli, Luiz Cosme Cotta Malaquias, Philip T. LoVerde, E. Moreno, L. F. Alves Oliveira, and P. Martins Leite
Subjects: Adult, Liver Cirrhosis, Male, Adolescent, Liver Diseases, Parasitic, medicine.medical_treatment, Immunology, Helminthiasis, Schistosomiasis, Biology, Lymphocyte Activation, Microbiology, Peripheral blood mononuclear cell, Antigen, Transforming Growth Factor beta, Fibrosis, medicine, Animals, Humans, Parasite Egg Count, Cells, Cultured, Aged, Aged, 80 and over, Host Response and Inflammation, Interleukin-13, Schistosoma mansoni, Odds ratio, Middle Aged, medicine.disease, Schistosomiasis mansoni, Portal System, Infectious Diseases, Cytokine, Chronic Disease, Leukocytes, Mononuclear, Cytokines, Female, Parasitology, Tumor necrosis factor alpha
Abstract: Volunteers living in an area where schistosomiasis mansoni is endemic were subjected to ultrasound examination and classified into groups according to the levels of fibrosis diagnosed, namely, absence of indications of fibrosis (group 0), incipient fibrosis (group 1), and moderate/severe fibrosis (group 2). Peripheral blood mononuclear cells (PBMC) collected from the volunteers were stimulated with soluble antigens from adult schistosomes or from schistosome eggs, and the production of the cytokines gamma interferon, tumor necrosis factor alpha, transforming growth factor β (TGF-β), interleukin-4 (IL-4), IL-10, and IL-13 was determined. Potential associations of the level of fibrosis with age, sex, intensity of infection, and cytokine production were investigated between the three groups. Univariate analysis identified associations of age (>50), gender (male), and absence of eggs/g of feces with moderate/severe fibrosis and an association of intensity of infection (>100 eggs) with incipient fibrosis. When cytokine production in PBMC cultures stimulated by soluble egg antigens was categorized as low or high, significant differences in the distribution of IL-13 levels were established between groups 0 and 2. No significant differences were detected between the groups in the cytokines produced by PBMC cultures stimulated with soluble antigens from adult schistosomes. When all variables were tested in multivariate analyses, only IL-13 was strongly associated with fibrosis (odds ratio = 5.8; 95% confidence interval [CI] = 1.1 to 30.5). While high levels of TGF-β appeared to be associated with protection against fibrosis, the strength of the association was low.
Published: 2006

29. Combined methods for the study of water contact behavior in a rural schistosomiasis-endemic area in Brazil

Author: Gustavo Velasquez-Melendez, Andrea Gazzinelli, Wesley Rodrigues Pereira, Julio Cézar Alves Paixão Rodrigues, Helmut Kloos, Rodrigo Corrêa Oliveira, and Philip T. LoVerde
Subjects: Adult, Male, Adolescent, Endemic Diseases, Veterinary (miscellaneous), Population, Water supply, Fresh Water, Schistosomiasis, Rural Health, Sex Factors, Water Supply, Environmental protection, Environmental health, medicine, Animals, Humans, Risk factor, Child, education, Aged, Laundering, Aged, 80 and over, education.field_of_study, Land use, business.industry, Age Factors, Water, Baths, Middle Aged, medicine.disease, Health Surveys, Schistosomiasis mansoni, Infectious Diseases, Geography, Child, Preschool, Insect Science, Female, Parasitology, Water quality, Rural area, Risk assessment, business, Brazil
Abstract: A new combined methodology consisting of direct observation and two types of interviews (internal and external interviews) was evaluated for use in exposure risk assessment in schistosomiasis. Specific objectives were to determine its usefulness in achieving equitable coverage of gendered exposure risk and its efficiency in identifying water contact behavior in a rural area in Brazil with different settlement patterns, land use and domestic water supplies. Of the 2476 water contacts recorded, 1223 (49.4%) were identified by direct observation, 946 (38.2%) by internal interviews and 307 (12.4%) by external interviews. Significantly longer mean durations of contacts were recorded for females and greater mean percentage of body surface exposed for males (P0.01), reflecting differences in gendered water contact activities. Direct observation identified slightly more male contacts, external interviews significantly more male contacts (P0.006), and internal interviews moderately more female contacts. The three methods recorded mean numbers of contacts and mean TBM (total body minutes) per person, declining with age. Significant differences were found between the three methods in regard to frequency and/or intensity of washing clothes, fetching water, washing utensils, washing multiple parts of the body, and bathing. The three methods also recorded differentially frequencies and exposure intensities in the three study communities, among different age groups, by gender and for individual study members. These activity-, locality-, age/gender- and person-specific patterns reflect the relative efficiency and complementarity of the three methods in settlements with different land use, access to streams and water supplies.
Published: 2006

30. Comparative clinical and ultrasound study of egg-negative and egg-positive individuals from Schistosoma mansoni low morbidity endemic areas, and hospitalized patients with hepatosplenic disease

Author: Andrea Gazzinelli, Alda Maria Soares Silveira, Lucia Alves de Oliveira Fraga, Rodrigo Correa-Oliveira, Jeffrey M. Bethony, Telcia V B Magalhães, Giovanni Gazzinelli, Aluízio Prata, Iramaya Rodrigues Caldas, Maria Carolina B Alvarez, Philip T. LoVerde, and F. C. Lima E Silva
Subjects: Adult, Liver Cirrhosis, Male, Microbiology (medical), Pathology, medicine.medical_specialty, lcsh:Arctic medicine. Tropical medicine, Adolescent, Endemic Diseases, Liver Diseases, Parasitic, lcsh:RC955-962, RC955-962, Schistosomiasis, Physical examination, Severity of Illness Index, Feces, Schistosomicides, Periportal fibrosis, Fibrosis, Arctic medicine. Tropical medicine, medicine, Animals, Humans, Child, Parasite Egg Count, Aged, Splenic Diseases, Ultrasonography, biology, medicine.diagnostic_test, Portal Vein, Stool test, business.industry, Echogenicity, Middle Aged, biology.organism_classification, medicine.disease, Oxamniquine, Schistosomiasis mansoni, Infectious Diseases, medicine.anatomical_structure, Case-Control Studies, Abdomen, Female, Parasitology, Schistosoma mansoni, business, medicine.drug
Abstract: Two hundred and twenty three subjects from a Schistosoma mansoni low morbidity endemic area and nine hospitalized hepatosplenic patients were submitted to stool test and clinical examination and abdomen ultrasound assessments. According to stool examination and ultrasound results, they were grouped as follows: G1 - 63 Schistosoma mansoni egg-negative individuals; G2 - 141 egg-positive patients and without evidence of periportal fibrosis; G3 - 19 egg-positive patients with periportal echogenicity (3-6mm); and G4 - 9 hepatosplenic patients with periportal echogenicity (> 6mm). Hepatomegaly detected by physical examination of the abdomen evaluated in the midclavicular line was verified in G1, G2 and G3, respectively, in 11.1, 12.1 and 26.3%. In G1, G2 and G3, periportal thickening occurred only in schistosomal patients (8.5%). Mild pathological alterations in patients that cannot yet be detected by clinical examination were detectable in the liver by ultrasound and can be due to fibrosis. The degree of mild periportal fibrosis was diminished in 57.9% of patients 12 months after treatment of schistosomiasis with oxamniquine. At ultrasonography, the mean liver left lobe measurement of G3 was larger than that of G1, and that of G4 larger than that of G1 and G2. The mean size of the spleen of G4 was significantly larger than that of the other three groups, and that of G3 larger than that of G1 and G2.
Published: 2005

31. Human schistosomiasis mansoni: intensity of infection differentially affects the production of interleukin-10, interferon-γ and interleukin-13 by soluble egg antigen or adult worm antigen stimulated cultures

Author: Maria Carolina B Alvarez, Jeffrey M. Bethony, Rodrigo Correa-Oliveira, Claudia Carvalho-Queiroz, Andrea Gazzinelli, Giovanni Gazzinelli, Francisco C Lima-Silva, Aluízio Prata, Alda Maria Soares Silveira, Philip T. LoVerde, and L. F. Alves-Oliveira
Subjects: Adult, Endemic Diseases, Severity of Illness Index, Interferon-gamma, Antigen, medicine, Animals, Humans, Interferon gamma, Cells, Cultured, Eggs per gram, Interleukin-13, biology, Age Factors, Public Health, Environmental and Occupational Health, Interleukin, Schistosoma mansoni, General Medicine, T helper cell, biology.organism_classification, Schistosomiasis mansoni, Interleukin-10, Interleukin 10, Infectious Diseases, medicine.anatomical_structure, Antigens, Helminth, Immunology, Interleukin 13, Leukocytes, Mononuclear, Parasitology, Disease Susceptibility, Brazil, medicine.drug
Abstract: The effect of the intensity of infection (eggs per gram faeces, epg) on the production of interferon-gamma (INF-gamma), interleukin (IL)-10 and IL-13 by peripheral blood mononuclear cells (PBMCs) from individuals living in a Schistosoma mansoni-endemic area was evaluated. In vitro stimulation of PBMCs with soluble egg antigen (SEA) resulted in significantly higher secretion levels of IFN-gamma in egg-negative individuals compared with those with an intensity of infection of more than 100 epg. In contrast, the egg-positive group produced significantly higher amounts of IL-10. Levels of IL-13 did not differ significantly between egg-positive and egg-negative groups. These findings suggest that IL-10 is an important cytokine in the control of the T helper cell (Th) type 1 responses during human S. mansoni infection, shifting the immune response from Th0 in egg-negative individuals from an endemic area to a Th2 polarization in chronic infected individuals.
Published: 2004

32. Exposure to Schistosoma mansoni infection in a rural area in Brazil. Part III: household aggregation of water-contact behaviour

Author: Rodrigo Correa-Oliveira, Philip T. LoVerde, Simon Brooker, Jeffrey M. Bethony, Jeff T. Williams, Andrea Gazzinelli, Maria Flávia Gazzinelli, and Helmut Kloos
Subjects: Adult, Male, Adolescent, Bathing, Health Behavior, Population, Schistosomiasis, Rural Health, Risk Factors, Water Supply, Environmental protection, Environmental health, Activities of Daily Living, medicine, Humans, Child, education, Socioeconomic status, Aged, Schistosoma, Aged, 80 and over, Analysis of Variance, education.field_of_study, biology, Age Factors, Public Health, Environmental and Occupational Health, Infant, Environmental Exposure, Middle Aged, biology.organism_classification, medicine.disease, Schistosomiasis mansoni, Infectious Diseases, Geography, Child, Preschool, Regression Analysis, Female, Parasitology, Residence, Schistosoma mansoni, Rural area, Brazil
Abstract: Much research points to the importance of the household in the study of water-borne diseases such as schistosomiasis. An important aspect of the household is the clustering of domestic activities associated with water collection, storage and usage. Such activities can result in the sharing of water-contact sites and water-contact behaviour, which expose household members to similar risks of infection. In previous studies, we determined that shared residence accounted for 28% of the variance in Schistosoma faecal egg excretion rates. We now quantify the effect of shared residence on the variation in water-related health behaviours. We found that shared residence accounted for 30% of the variation in total water contacts per week. It also accounted for a large proportion of the variation in individual water-contact behaviour: e.g. agricultural contacts (63%), washing limbs (56%) or bathing (41%). These results implicate the household as an important composite measure of the complex relationships between socioeconomic, environmental and behavioural factors that influence water-contact behaviour and, therefore, the transmission of schistosomiasis. Our results also support a focus on the household in the implementation of schistosomiasis prevention and control efforts.
Published: 2004

33. Transmission of Helicobacter pylori infection in families of preschool-aged children from Minas Gerais, Brazil

Author: Renata de Magalhães Queiroz, Dulciene M.M. Queiroz, Jeffrey M. Bethony, Gifone A. Rocha, Rodrigo Correa-Oliveira, Ana Carolina Dias Bocewicz, Luciana Diniz Silva, Adriana Santos, Andrea Gazzinelli, and Andreia Maria Camargos Rocha
Subjects: Pediatrics, medicine.medical_specialty, education.field_of_study, business.industry, Cost effectiveness, Offspring, media_common.quotation_subject, Population, Public Health, Environmental and Occupational Health, Fertility, Odds ratio, Infant mortality, Infectious Diseases, Epidemiology, Medicine, Parasitology, Risk factor, business, education, Demography, media_common
Abstract: We evaluated the role of the family in the transmission of Helicobacter pylori infection in preschool-aged children from a rural district in the State of Minas Gerais, Brazil. Sixty-six families (66 index children, 63 mothers, 60 fathers and 134 siblings), defined as at least one parent living in the same household with at least one offspring up to 8 years old, were studied. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by logistic regression controlling for age, gender, number of children in household and H. pylori status of the father, mother and siblings. The prevalence of the infection was 69.7% (469 of 673) and it increased with age (P < 0.001). Positive mothers were a strong and independent risk factor for infection (OR 22.70; 95% CI 2.31-223.21). Positive siblings were also positively associated with infection (OR 1.81; 95% CI 1.01-3.30).
Published: 2003

34. The interdiction of disease: a cultural construction of schistosomiasis in an endemic area in Minas Gerais, Brazil

Author: Luiz Alberto Oliveira Gonçalves, Regiane Veloso Santos, Maria Flávia Gazzinelli, and Andrea Gazzinelli
Subjects: media_common.quotation_subject, Esquistossomose, lcsh:Medicine, Schistosomiasis, Disease, Educação Ambiental, Perception, Educação em Saúde, medicine, Socioeconomics, Health Education, media_common, lcsh:Public aspects of medicine, lcsh:R, Public Health, Environmental and Occupational Health, Endemic area, lcsh:RA1-1270, Interdiction, medicine.disease, Geography, Environmental Education, Program development, Health education, Rural area
Abstract: Desenvolvido em uma área endêmica em esquistossomose, zona rural de Minas Gerais, Brasil, este estudo pretendeu analisar a relação entre um Programa de Educação Ambiental e Saúde, e a postura dos sujeitos frente aos ambientes e à doença. O programa de educação implementado, destinou-se a professores e alunos da escola estadual do lugarejo de Boa União. Pautou-se em um importante dispositivo diferencial com relação aos programas mais usuais neste campo educacional, ao buscar uma perspectiva não puramente instrumental e cognitiva de conhecimento da realidade e da doença, mas uma abordagem na qual os sujeitos são levados a indagar e investigar juntos as suas percepções da realidade, dos ambientes e da doença. Ficou demonstrado que é a partir do conhecimento e reflexão acerca da experiência dos sujeitos com os ambientes e com a doença, experiência entendida aqui como campo onde se entrecruzam representações e práticas, aspectos objetivos e subjetivos, o racional e o empírico, que se obtém o confronto e ruptura cognitivos indispensáveis a uma mudança de postura dos sujeitos. This study was conducted in a rural area endemic for schistosomiasis in Minas Gerais, Brazil. The objective was to determine the relationship between an environmental and health education program for schistosomiasis, implemented for teachers and students from the state secondary school in the village of Boa União, and the subsequent actions of its participants in regards to the environment and the illness. An important difference in this program is its perspective that it is not merely the implementation of instrumental and cognitive knowledge of the environment and illness, but an approach in which subjects are asked to question and investigate their perception of reality, the environment, and the illness. The study demonstrated that a change in attitude could occur from reflection on one's experience in relation to both the environment and diseases endemic it.
Published: 2002

35. Decline in infection-related morbidities following drug-mediated reductions in the intensity of Schistosoma infection: A systematic review and meta-analysis

Author: David Bertsch, Gisele Nepomuceno de Andrade, Charles H. King, and Andrea Gazzinelli
Subjects: 0301 basic medicine, Pathology and Laboratory Medicine, Praziquantel, Mathematical and Statistical Techniques, 0302 clinical medicine, Medicine and Health Sciences, Schistosomiasis, Anthelmintics, Proteinuria, biology, Pharmaceutics, lcsh:Public aspects of medicine, 3. Good health, Diarrhea, Infectious Diseases, Helminth Infections, Meta-analysis, Physical Sciences, Schistosoma, medicine.symptom, Statistics (Mathematics), Research Article, Neglected Tropical Diseases, Hepatomegaly, medicine.drug, medicine.medical_specialty, lcsh:Arctic medicine. Tropical medicine, lcsh:RC955-962, 030231 tropical medicine, Gastroenterology and Hepatology, Research and Analysis Methods, 03 medical and health sciences, Signs and Symptoms, Drug Therapy, Diagnostic Medicine, Helminths, Internal medicine, Parasitic Diseases, medicine, Animals, Chemotherapy, Humans, Statistical Methods, Disease burden, business.industry, Organisms, Public Health, Environmental and Occupational Health, Biology and Life Sciences, lcsh:RA1-1270, Odds ratio, Tropical Diseases, medicine.disease, biology.organism_classification, Invertebrates, Fibrosis, Health Care, 030104 developmental biology, Immunology, Health Statistics, Morbidity, business, Mathematics, Meta-Analysis, Developmental Biology
Abstract: Background Since 1984, WHO has endorsed drug treatment to reduce Schistosoma infection and its consequent morbidity. Cross-sectional studies suggest pre-treatment correlation between infection intensity and risk for Schistosoma-related pathology. However, evidence also suggests that post-treatment reduction in intensity may not reverse morbidity because some morbidities occur at all levels of infection, and some reflect permanent tissue damage. The aim of this project was to systematically review evidence on drug-based control of schistosomiasis and to develop a quantitative estimate of the impact of post-treatment reductions in infection intensity on prevalence of infection-associated morbidity. Methodology/Principal findings This review was registered at inception with PROSPERO (CRD42015026080). Studies that evaluated morbidity before and after treatment were identified by online searches and searches of private archives. Post-treatment odds ratios or standardized mean differences were calculated for each outcome, and these were correlated to treatment-related egg count reduction ratios (ERRs) by meta-regression. A greater ERR correlated with greater reduction in odds of most morbidities. Random effects meta-analysis was used to derive summary estimates: after treatment of S. mansoni and S. japonicum, left-sided hepatomegaly was reduced by 54%, right-sided hepatomegaly by 47%, splenomegaly by 37%, periportal fibrosis by 52%, diarrhea by 53%, and blood in stools by 75%. For S. haematobium, hematuria was reduced by 92%, proteinuria by 90%, bladder lesions by 86%, and upper urinary tract lesions by 72%. There were no consistent changes in portal dilation or hemoglobin levels. In sub-group analysis, age, infection status, region, parasite species, and interval to follow-up were associated with meaningful differences in outcome. Conclusion/Significance While there are challenges to implementing therapy for schistosomiasis, and praziquantel therapy is not fully curative, reductions in egg output are significantly correlated with decreased morbidity and can be used to project diminution in disease burden when contemplating more aggressive strategies to minimize infection intensity., Author summary Schistosomiasis is the disease caused by infection with Schistosoma parasitic flukes. Depending on the infecting species, chronic Schistosoma infection can cause a variety of pathologies including liver and spleen enlargement, fibrosis and hypertension of the portal vein of the liver, or bladder ulceration and deformities and kidney blockage. Infection can also cause anemia, diarrhea, abdominal pain, and decreased physical fitness. In our study, we quantified the reductions in prevalence of infection-related morbidities among populations with Schistosoma infection, as achieved by giving one or more drug treatments. We systematically reviewed 71 available reports of Schistosoma-related morbidity reduction and determined, based on a meta-analysis of the primary data, that the odds of persisting morbidity progressively decrease when greater post-treatment reductions in parasite burden are achieved, as reflected by reduced egg counts in standard diagnostic testing. This suggests that repeated or more effective anti-parasite drug treatment will be a valuable tool for greater reduction of Schistosoma-related patient morbidities in affected areas.
Published: 2017

36. Serological screening of the Schistosoma mansoni adult worm proteome

Author: Andrea Gazzinelli, Guilherme Oliveira, Jonas Perales, Rosiane A. Silva-Pereira, Rodrigo Correa-Oliveira, Paola R. Patrocínio, André Teixeira-Ferreira, Franco H. Falcone, and Fernanda Ludolf
Subjects: Adult, Male, Proteomics, lcsh:Arctic medicine. Tropical medicine, Proteome, lcsh:RC955-962, Immunoblotting, Immunology, Antibodies, Helminth, Gene Expression, Context (language use), Schistosomiasis, Biochemistry, Mass Spectrometry, Serology, Young Adult, Antigen, Molecular Cell Biology, medicine, Animals, Humans, Electrophoresis, Gel, Two-Dimensional, Biology, Immunity to Infections, Spectrometric Identification of Proteins, biology, lcsh:Public aspects of medicine, Public Health, Environmental and Occupational Health, Immunity, Proteins, lcsh:RA1-1270, Schistosoma mansoni, biology.organism_classification, medicine.disease, Virology, Recombinant Proteins, Infectious Diseases, Antigens, Helminth, biology.protein, Female, Reticulocalbin 1, Antibody, Research Article
Abstract: Background New interventions tools are a priority for schistosomiasis control and elimination, as the disease is still highly prevalent. The identification of proteins associated with active infection and protective immune response may constitute the basis for the development of a successful vaccine and could also indicate new diagnostic candidates. In this context, post-genomic technologies have been progressing, resulting in a more rational discovery of new biomarkers of resistance and antigens for diagnosis. Methodology/Principal Findings Two-dimensional electrophoresed Schistosoma mansoni adult worm protein extracts were probed with pooled sera of infected and non-infected (naturally resistant) individuals from a S. mansoni endemic area. A total of 47 different immunoreactive proteins were identified by mass spectrometry. Although the different pooled sera shared most of the immunoreactive protein spots, nine protein spots reacted exclusively with the serum pool of infected individuals, which correspond to annexin, major egg antigen, troponin T, filamin, disulphide-isomerase ER-60 precursor, actin and reticulocalbin. One protein spot, corresponding to eukaryotic translation elongation factor, reacted exclusively with the pooled sera of non-infected individuals living in the endemic area. Western blotting of two selected recombinant proteins, major egg antigen and hemoglobinase, showed a similar recognition pattern of that of the native protein. Concluding/Significance Using a serological proteome analysis, a group of antigens related to the different infection status of the endemic area residents was identified and may be related to susceptibility or resistance to infection., Author Summary Despite intensive efforts towards disease control, schistosomiasis is still highly prevalent in most endemic countries. Although effective treatment is available and widely used, it does not prevent reinfection, as it could be achieved with the use of a vaccine. Efforts to control and eradicate schistosomiasis rely on praziquantel, the only drug available for treatment. Therefore, the identification of antigens that can induce protective immunity is highly desirable, as well as the need for more sensitive assays, useful to detect low intensity infections and treatment follow-up. The occurrence of natural resistance in schistosome endemic areas suggests that there is protective immunity. However, the mechanisms involved in protection, or the proteins that induce this protective immunity, are not yet known. These proteins, once identified, may constitute the basis for a successful vaccine. In this study, we compared the profile of reactive proteins to the serum antibodies of infected and non-infected individuals residing in a schistosomiasis endemic area using two-dimensional western blotting. The association of proteomic and serological screening methodologies enabled the identification of immunogenic proteins of the parasite, which could be an informative source for the development of vaccines and new diagnostic assays. In this manuscript we describe the discovery of potential candidate proteins for subsequent testing as protective or diagnostic antigens.
Published: 2013

37. Microgeographical patterns of schistosomiasis and water contact behavior; examples from Africa and Brazil

Author: Andrea Gazzinelli, Helmut Kloos, and Paul Van Zuyle
Subjects: Microbiology (medical), Male, Kenya, Time Factors, lcsh:Arctic medicine. Tropical medicine, Adolescent, lcsh:RC955-962, lcsh:QR1-502, Water supply, Spatial Behavior, Context (language use), Schistosomiasis, lcsh:Microbiology, law.invention, law, Environmental protection, Water Supply, water contact behavior, schistosomiasis, medicine, Prevalence, Animals, Humans, Socioeconomics, Child, Socioeconomic status, Contact behavior, business.industry, Water, medicine.disease, Geography, Transmission (mechanics), Child, Preschool, Africa, Female, geographical aspects, Egypt, Water quality, business, Brazil, Information Systems, Statistical Distributions
Abstract: This paper examines the results of spatial (microgeographical) water contact/schistosomiasis studies in two African (Egyptian and Kenyan) and one Brazilian communities. All three studies used traditional cartographic and statistical methods but one of them employed also GIS (geographical information systems) tools. The advantage of GIS and their potential role in schistosomiasis control are briefly described. The three cases revealed considerable variation in the spatial distribution of water contact, transmission parameters and infection levels at the household and individual levels. All studies showed considerable variation in the prevalence and intensity of infection between households. They also show a variable influence of distance on water contact behavior associated with type of activity, age, sex, socioeconomic level, perception of water quality, season and availability of water in the home. Water contact behavior and schistosomiasis were evaluated in the Brazilian village of Nova Uniao within the context of water sharing between household and age/sex groups. Recommendations are made for further spatial studies on the transmission and control of schistosomiasis.
Published: 1998

38. Transmission of Human Papilloma virus among couples

Author: Agnaldo Lopes da Silva Filho, Andréa Gazzinelli Dantés, Carlos Eduardo Gazzinelli Cruz, Eduardo Batista Cândido, and Soraya Moukhaiber Zhour
Subjects: Papillomaviridae, sexually transmited diseases, pathogenicity, Medicine
Abstract: Introduction: Among the sexually transmitted diseases, the highest world incidence is infection by the human papillomavirus (HPV). It affects 65% of men and 80% of women. At the moment, it is only the viral infection associated with development of cancer. Objective: To review the aspects related to the transmission of the HPV in men and women, collecting studies that analyze their transmission among couples, comparing the correlation between the partners and the transmission rates among different sites. Methods: The study was designed based upon literature review, using medical search tools like Pubmed/Medline, with the keywords: “Human Papillomavirus”; and combinations, “Human Papillomavirus” and “couples,” “HPV infection in men,” “transmission of papilloma virus.” The studies selected were those that included HPV detection through HPV-DNA. Results: The concomitance of at least one viral genotype between genders showed great variation from 2.63 to 100%, the latter being specifically related to high-grade and consistency in HIV-positive groups. Conclusion: Men play a decisive role in this mechanism, both as a transmitter and as a carrier, thus they should also be the focus of HPV vaccination and treatment policies
Published: 2022

39. Transtornos mentais e qualidade de vida em crianças e adolescentes com doença renal crônica e em seus cuidadores

Author: Renata Cristiane Marciano, José Silvério Santos Diniz, Eduardo A. Oliveira, Carla Cristina D. Melo, Eleonora Moreira Lima, Cristiane S. Dias, Andrea Gazzinelli Oliveira, Humberto Correa, José Maria Penido Silva, Mônica Ribeiro Canhestro, and Cristina M. Bouissou Soares
Subjects: Gerontology, diálise, business.industry, MEDLINE, General Medicine, Disease, urologic and male genital diseases, medicine.disease, Mental health, pediatria, Quality of life (healthcare), qualidade de vida, Life expectancy, Medicine, transplante de rim, business, Social effects, insuficiência renal crônica, Pediatric population, Kidney disease
Abstract: A melhoria da atenção médica resultou em um aumento da sobrevida de pacientes pediátricos com doença renal crônica (DRC). Entretanto, as repercussões clínicas e as consequências do tratamento são inúmeras. O objetivo deste estudo foi a realização de uma revisão desta temática, incluindo estudos publicados desde 1980 até a atualidade, que abordam também a influência de outras doenças crônicas na população pediátrica. Foram revisadas as repercussões clínicas e as alterações neurológicas e neurocognitivas da DRC que podem influenciar na saúde mental e qualidade de vida destes pacientes. Estudaram-se também os efeitos emocionais e sociais da DRC e a sua influência na adesão à terapêutica e controle clínico nas diferentes modalidades de tratamento conservador, dialítico e transplante. Observa-se um comprometimento da qualidade de vida e da saúde mental desses pacientes. A compreensão das repercussões psicossociais e a tentativa de minimizá-las amenizam o impacto da doença renal no paciente. Esse cuidado mais adequado, completo e humanizado pode resultar na melhora da adesão e do controle clínico.
Published: 2010

40. Schistosoma mansoni Stomatin like protein-2 is located in the tegument and induces partial protection against challenge infection

Author: Leonardo P. Farias, Henrique K. Roffato, Rodrigo Correa-Oliveira, Patricia S. Coulson, Cibele A. Tararam, Fernanda C. Cardoso, Patricia A. Miyasato, Toshie Kawano, Luciana C. C. Leite, Bogar O. Montoya, R. Alan Wilson, Sergio C. Oliveira, and Andrea Gazzinelli
Subjects: lcsh:Arctic medicine. Tropical medicine, lcsh:RC955-962, Helminth protein, Immunology, Antibodies, Helminth, Schistosomiasis, Immunoglobulin G, Interferon-gamma, Mice, Immune system, Western blot, medicine, Animals, Humans, Cloning, Molecular, Molecular Biology, Infectious Diseases/Helminth Infections, Organelles, biology, medicine.diagnostic_test, Tumor Necrosis Factor-alpha, lcsh:Public aspects of medicine, Vaccination, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Viral tegument, Helminth Proteins, Schistosoma mansoni, Sequence Analysis, DNA, medicine.disease, biology.organism_classification, Virology, Schistosomiasis mansoni, Immunoglobulin A, Mice, Inbred C57BL, Infectious Diseases, Antigens, Helminth, biology.protein, Leukocytes, Mononuclear, Female, Antibody, Research Article, Biotechnology
Abstract: Background Schistosomiasis affects more than 200 million individuals worldwide, with a further 650 million living at risk of infection, constituting a severe health problem in developing countries. Even though an effective treatment exists, it does not prevent re-infection, and the development of an effective vaccine still remains the most desirable means of control for this disease. Methodology/Principal Findings Herein, we report the cloning and characterization of a S. mansoni Stomatin-like protein 2 (SmStoLP-2). In silico analysis predicts three putative sites for palmitoylation (Cys11, Cys61 and Cys330), which could contribute to protein membrane association; and a putative mitochondrial targeting sequence, similar to that described for human Stomatin-like protein 2 (HuSLP-2). The protein was detected by Western blot with comparable levels in all stages across the parasite life cycle. Fractionation by differential centrifugation of schistosome tegument suggested that SmStoLP-2 displays a dual targeting to the tegument membranes and mitochondria; additionally, immunolocalization experiments confirm its localization in the tegument of the adult worms and, more importantly, in 7-day-old schistosomula. Analysis of the antibody isotype profile to rSmStoLP-2 in the sera of patients living in endemic areas for schistosomiasis revealed that IgG1, IgG2, IgG3 and IgA antibodies were predominant in sera of individuals resistant to reinfection as compared to those susceptible. Next, immunization of mice with rSmStoLP-2 engendered a 30%–32% reduction in adult worm burden. Protective immunity in mice was associated with specific anti-rSmStoLP-2 IgG1 and IgG2a antibodies and elevated production of IFN-γ and TNF-α, while no IL-4 production was detected, suggesting a Th1-predominant immune response. Conclusions/Significance Data presented here demonstrate that SmStoLP-2 is a novel tegument protein located in the host-parasite interface. It is recognized by different subclasses of antibodies in patients resistant and susceptible to reinfection and, based on the data from murine studies, shows protective potential against schistosomiasis. These results indicate that SmStoLP-2 could be useful in a combination vaccine., Author Summary Schistosomiasis is a parasitic disease causing serious chronic morbidity in tropical countries. Together with the publication of the transcriptome database, a series of new vaccine candidates were proposed based on their functional classification. However, the prediction of vaccine candidates from sequence information or even by proteomics or microarrays data is somewhat speculative and there remains the considerable task of functional analysis of each new gene/protein. In this study, we present the characterization of one of these molecules, a stomatin like protein 2 (SmStoLP-2). Sequence analysis predicts signals that could contribute to protein membrane association and mitochondrial targeting, which was confirmed by differential extractions of schistosome tegument membranes and mitochondria. Additionally, confocal microscope analysis showed SmStoLP-2 present in the tegument of 7-day-old schistosomula and adult worms. Studies in patients living in endemic areas for schistosomiasis revealed high levels of IgG1, IgG2, IgG3 and IgA anti-SmStoLP-2 antibodies in individuals resistant to reinfection. Recombinant SmStoLP-2 protein, when used as vaccine, induced significant levels of protection in mice. This reduction in worm burden was associated with a typical Th1-type immune response. These results indicate that SmStoLP-2 could be useful in association with other antigens for the composition of a vaccine against schistosomiasis.
Published: 2010

41. Fatores associados à resistência à insulina em populações rurais

Author: Gustavo Velasquez-Melendez, Andrea Gazzinelli, and Larissa Loures Mendes
Subjects: Gerontology, obesidade, Multivariate analysis, resistência à insulina, business.industry, Cross-sectional study, Endocrinology, Diabetes and Metabolism, Insulin, medicine.medical_treatment, composição corporal, população rural, General Medicine, Anthropometry, Overweight, medicine.disease, Obesity, Insulin resistance, Sobrepeso, Medicine, Young adult, medicine.symptom, business, Demography
Abstract: O objetivo deste estudo foi avaliar a associação dos indicadores antropométricos, de composição corporal, bioquímicos e hemodinâmicos com a resistência à insulina em duas comunidades rurais. A amostra foi constituída por indivíduos com idade maior ou igual a 18 anos de ambos os sexos. Foram excluídos os diabéticos e as mulheres grávidas. A coleta de dados incluiu variáveis demográficas, de estilo de vida, hemodinâmicas, antropométricas e bioquímicas. Dos 567 participantes, 50,4% eram homens e 49,6%, mulheres. A maioria das pessoas tinha a cor de pele não-branca (75,7%), vivia com seus cônjuges (69,3%) e possuía baixo nível educacional. Neste trabalho, 17,4% das pessoas apresentavam sobrepeso e 5,5%, obesidade. Pela análise multivariada observou-se que, nos indivíduos adultos, não-diabéticos, com baixo nível socioeconômico e educacional, os fatores associados à resistência à insulina foram o sobrepeso e a obesidade, o aumento da razão cintura/quadril, a proteína C-reativa e a cor de pele.
Published: 2009

42. Schistosoma mansoni infection in a rural area of the Jequitinhonha Valley, Minas Gerais, Brazil: analysis of exposure risk

Author: Wesley Rodrigues Pereira, Philip T. LoVerde, Rodrigo Correa-Oliveira, Andrea Gazzinelli, Leonardo Ferreira Matoso, Jorge Gustavo Velásquez-Meléndez, Helmut Kloos, Sara Crawford, Ricardo Toshio Fujiwara, and Guilherme Grossi Lopes Cançado
Subjects: Adult, Male, Risk, Rural Population, medicine.medical_specialty, Veterinary medicine, Adolescent, Veterinary (miscellaneous), Prevalence, Helminthiasis, Antibodies, Helminth, Immunoglobulin E, Article, Leukocyte Count, Antibody Specificity, Risk Factors, Epidemiology, medicine, Animals, Humans, Risk factor, Child, Parasite Egg Count, biology, business.industry, Water, Environmental exposure, Environmental Exposure, Schistosoma mansoni, Middle Aged, medicine.disease, biology.organism_classification, Increased IgE level, Schistosomiasis mansoni, Eosinophils, Infectious Diseases, Insect Science, Immunology, biology.protein, Parasitology, Female, business, Brazil
Abstract: This study examines the relative contribution of age-specific total IgE levels, eosinophils and water contact behavior to the prevalence and intensity (geometric mean egg counts) of Schistosoma mansoni infection in the poor rural population of Virgem das Graças in northern Minas Gerais State. In bivariate analysis, age was strongly correlated with both prevalence and intensity of infection, while eosinophil levels with prevalence only (p
Published: 2008

43. Effect of Chemotherapy with Praziquantel on the Production of Cytokines and Morbidity Associated with Schistosomiasis Mansoni▿

Author: Alda Maria Soares Silveira, Andrea Gazzinelli, Rodrigo Correa-Oliveira, L. F. Alves-Oliveira, Andréa Teixeira-Carvalho, Giovanni Gazzinelli, P. Martins-Leite, and Luiz Cosme Cotta Malaquias
Subjects: Adult, Male, Adolescent, medicine.medical_treatment, Helminthiasis, Schistosomiasis, Clinical Therapeutics, Praziquantel, Interferon-gamma, Young Adult, Fibrosis, Transforming Growth Factor beta, medicine, Animals, Humans, Pharmacology (medical), Interferon gamma, Aged, Ultrasonography, Pharmacology, Aged, 80 and over, Anthelmintics, Chemotherapy, Interleukin-13, biology, Middle Aged, medicine.disease, biology.organism_classification, Schistosomiasis mansoni, Interleukin-10, Infectious Diseases, Cytokine, Immunology, Leukocytes, Mononuclear, Cytokines, Female, Schistosoma mansoni, Interleukin-4, Brazil, medicine.drug
Abstract: The objective of the present study was to test the hypothesis that treatment of schistosomiasis mansoni with praziquantel can alter significantly the immune response of patients and generate a reversal of the level of fibrosis. Peripheral blood mononuclear cell (PBMC) samples were collected from, and abdominal ultrasound examinations conducted on, volunteers infected withSchistosoma mansoniand living in an area where the disease is endemic, both prior to and one year after treatment with praziquantel. Subjects were classified into groups according to the level of pathology (i.e., absent, incipient, moderate, or severe fibrosis). PBMCs were stimulated with schistosome soluble egg antigens (SEA), and the levels of production of the cytokines gamma interferon (IFN-γ), tumor necrosis factor alpha, transforming growth factor β, and interleukin-4 (IL-4), IL-10, and IL-13 were determined. The chemotherapy was effective in reducing morbidity, particularly for individuals presenting with severe fibrosis. When levels of cytokine production in posttreatment PBMC cultures stimulated by SEA were categorized as low or high, significant differences in the distribution of IL-13 levels between groups presenting with or not presenting with fibrosis were established. Comparison of pre- and posttreatment SEA-induced cytokine levels in individuals who had experienced no change in the grade of fibrosis following chemotherapy revealed that the level of IFN-γ decreased in subjects with fibrosis whereas that of IL-10 decreased in individuals with and without fibrosis. The data suggest that chemotherapy is effective in reducing the morbidity of the disease and that the level of IL-13 may be a useful indicator of the persistence of fibrosis following treatment.
Published: 2008

44. Associação entre obesidade central, triglicerídeos e hipertensão arterial em uma área rural do Brasil

Author: Andrea Gazzinelli, Gilberto Kac, Gustavo Velasquez-Melendez, Adriano Marçal Pimenta, and Rodrigo Correa-Oliveira
Subjects: obesidade, obesity, Waist, business.industry, dislipidemias, população rural, Odds ratio, medicine.disease, Logistic regression, Obesity, Confidence interval, Blood pressure, Hypertension, medicine, epidemiology, rural population, medicine.symptom, epidemiologia, Cardiology and Cardiovascular Medicine, business, dyslipidemias, Dyslipidemia, Abdominal obesity, Demography, Hipertensão
Abstract: FUNDAMENTO: A hipertensão, importante problema de saúde pública, representa uma das principais causas de morbidade em todo o mundo. OBJETIVO: Estimar a prevalência da hipertensão arterial e seus fatores de risco em uma comunidade rural do nordeste do estado de Minas Gerais, Brasil. MÉTODOS: Estudo transversal realizado em 2004, em Virgem das Graças, comunidade rural localizada no Vale do Jequitinhonha. A amostra era composta por 287 indivíduos, com idades entre 18 e 88 anos. Hipertensão foi definida segundo os critérios da Joint National Committee (pressão arterial sistólica > 140 mmHg e/ou pressão arterial diastólica > 90 mmHg): indivíduos que já usavam medicamentos anti-hipertensivos também foram considerados hipertensos. Usou-se a análise bivariada para testar a relação entre as variáveis independentes e hipertensão, e a regressão logística para ajustar fatores de confusão e identificar interações. A força de associação foi mensurada usando-se odds ratio (OR) e seus intervalos de confiança de 95% [IC (95%)]. RESULTADOS: A prevalência bruta da hipertensão foi de 47,0% [IC (95%): 41,1 - 53,0], a prevalência ajustada por idade foi de 43,2% [IC (95%): 35,7 - 50,7], enquanto a prevalência ajustada por escolaridade foi de 44,1% [IC (95%): 43,9 - 44,3]. De acordo com a análise multivariada, observou-se que idade, triglicerídeos, circunferência da cintura e sexo eram fatores de risco independentes associados à hipertensão. CONCLUSÃO: Os achados fornecem evidências importantes de que a hipertensão é um problema de saúde pública associado à dislipidemia e à obesidade abdominal, na área rural de Minas Gerais. BACKGROUND: Hypertension represents a serious public health problem and is one of the most frequent causes of morbidity around the world. OBJECTIVE: To estimate the prevalence of hypertension and its risk factors in a rural community located in the north-eastern state of Minas Gerais, Brazil. METHODS: A cross-sectional study was carried out in 2004 in the Virgem das Graças Village, a rural community located the Jequitinhonha Valley. The sample consisted of 287 males and females aged between 18 to 88 years. Hypertension was defined according to Joint National Committee criteria (systolic blood pressure > 140 mmHg and/or diastolic blood pressure > 90 mmHg): subjects already receiving anti-hypertensive treatment were considered to be hypertensive. Bivariate analysis was performed to test the relationship between the independent variables and hypertension. Logistic regression was used to adjust for confounding and to identify interactions. The strength of association was measured using Odds Ratio (OR) and its 95% confidence intervals [CI (95%)]. RESULTS: The crude prevalence of hypertension was 47.0% [CI (95%): 41.1 - 53.0], the age-standardized prevalence was 43.2% [CI (95%): 35.7 - 50.7], while the schooling-standardized prevalence was 44.1% [CI (95%): 43.9 - 44.3]. Age, triglycerides, waist circumference and sex were found to be independent risk factors for hypertension according to multivariate analysis. CONCLUSION: The findings provide important evidence concerning the hypertension as a public health problem and its association with dyslipidemia and abdominal obesity in the rural area of Minas Gerais.
Published: 2008

45. Distúrbios metabólicos e adiposidade em uma população rural

Author: Gilberto Kac, Daniele Augsuta dos Santos Silva, Gustavo Velasquez-Melendez, Andrea Gazzinelli, Mariana Santos Felisbino-Mendes, and Adriano Marçal Pimenta
Subjects: medicine.medical_specialty, business.industry, Adiposidade, Endocrinology, Diabetes and Metabolism, Adipose tissue, General Medicine, Overweight, Carbohydrate metabolism, medicine.disease, Obesity, Hiperglicemia, Blood pressure, Endocrinology, Internal medicine, Sobrepeso, Dislipidemia, medicine, Analysis of variance, medicine.symptom, business, Body mass index, Dyslipidemia, População rural, Hipertensão
Abstract: O objetivo deste estudo transversal foi investigar a prevalência de sobrepeso e adiposidade central (AC) e suas relações com alterações no metabolismo de lipídeos, glicose e níveis pressóricos em uma amostra de 287 indivíduos adultos residentes em uma comunidade rural do Estado de Minas Gerais. Foram realizadas comparações de médias dos indicadores metabólicos: lipoproteínas, glicose e níveis pressóricos, segundo categorias de sobrepeso e AC, usando análise de variância e teste de Tukey. A prevalência de sobrepeso foi de 24,8% (37,4% no sexo feminino; 11,5% no sexo masculino). A AC esteve presente em 28,1% das pessoas (50,3% no sexo feminino; 4,3% no sexo masculino). Indivíduos com AC apresentaram maiores valores médios de pressão arterial (HA), colesterol total, LDL, triglicérides e glicemia de jejum; e menores valores médios de HDL. Foram verificadas associações entre AC e HA, dislipidemia e hiperglicemia. Associações significativas entre sobrepeso e HA, dislipidemia e hiperglicemia também foram evidenciadas. Esses resultados confirmam o potencial efeito das alterações na composição corporal, principalmente em nível central, sobre o metabolismo lipídico e de glicose, e também sobre o aumento dos níveis pressóricos em populações da área rural.
Published: 2008

46. Popular beliefs about the infectivity of water among school children in two hyperendemic schistosomiasis areas of Brazil

Author: Maria Flávia Gazzinelli, Rita de Cássia Marques, Helmut Kloos, Dener Carlos dos Reis, and Andrea Gazzinelli
Subjects: Male, Sociology of scientific knowledge, Health Knowledge, Attitudes, Practice, Adolescent, Endemic Diseases, Veterinary (miscellaneous), media_common.quotation_subject, Schistosomiasis, Article, Environmental protection, Perception, Intervention (counseling), Common knowledge, Medicine, Humans, Quality (business), Socioeconomics, Child, media_common, business.industry, Water, medicine.disease, Contaminated water, Infectious Diseases, Insect Science, Parasitology, Health education, Female, business, Brazil
Abstract: This article examines changing common knowledge of elementary school children to scientific knowledge related to the relationship between water characteristics and the transmission of schistosomiasis through health education. A review of the literature and two case studies from rural elementary schools in Brazil show how the prevailing concept of dirty and polluted water, which has operated as an epistemological obstacle for acquiring scientific knowledge, may be related to symbolic thought and cultural parameters. Through an educational intervention not commonly applied to health programs involving elementary school students in two schistosomiasis-endemic rural communities in Brazil this paper describes the difficulties researchers encountered in changing the prevailing perception that very dirty and polluted water provides optimal conditions for schistosome transmission, to the scientifically accepted view that transmission occurs most often in visually clean, although fecally contaminated water. This conceptual difficulty may be largely explained in terms of the symbolism involved in clean and dirty water and the life-giving quality of water. Based on our results, we recommend that knowledge about water-related beliefs and concepts among school children should be considered in school-based health education programs in areas of endemic schistosomiasis and possibly other intestinal infections.
Published: 2007

47. Socioeconomic studies of schistosomiasis in Brazil: a review

Author: Helmut Kloos, Rodrigo Correa-Oliveira, Márcia Christina Caetano de Souza, Andrea Gazzinelli, and Humberto Ferreira de Oliveira Quites
Subjects: Rural Population, Urban Population, Veterinary (miscellaneous), Psychological intervention, Schistosomiasis, Decentralization, Article, Multidisciplinary approach, Risk Factors, Environmental health, Health care, medicine, Humans, Socioeconomic status, business.industry, medicine.disease, Infectious Diseases, Geography, Socioeconomic Factors, Agriculture, Insect Science, Parasitology, Rural area, business, Brazil
Abstract: This review finds considerable evidence that socioeconomic status has significantly influenced the transmission, spread and treatment of schistosomiasis in Brazil. High infection rates persist among both the rural and urban poor. Rural living, poor housing and water supplies and low educational level were major factors in schistosomiasis occurrence among agricultural populations. In urban areas, prevailing living conditions in shantytowns and labor migrations from and periodic return movements to rural areas were predictive of schistosomiasis. The risk of the establishment of new transmission foci exists in both rural and urban areas, conferred by and affecting poorer people. Associations between schistosomiasis and socioeconomic parameters, persisting inequities in health services accessibility, prevailing health impacts of schistosomiasis, and the ongoing decentralization of health services point to opportunities and strategies for focused interventions aimed at promoting health-enhancing behavior and living conditions and improving access to health care. The authors call for multidisciplinary studies to better examine the complexities of the socioeconomic environment in relation to schistosomiasis and for economic programs to reduce prevailing socioeconomic inequalities.
Published: 2007

48. Cytokines, chemokine receptors, CD4+CD25HIGH+ T-cells and clinical forms of human schistosomiasis

Author: Denise da Silveira-Lemos, Alda Maria Soares Silveira, Giovanni Gazzinelli, Vanessa Peruhype-Magalhães, Olindo Assis Martins-Filho, Andréa Teixeira-Carvalho, Rodrigo Correa-Oliveira, Luiz Cosme Cotta Malaquias, Lúcia Fraga Alves Oliveira, and Andrea Gazzinelli
Subjects: Adult, CD4-Positive T-Lymphocytes, Male, Adolescent, Veterinary (miscellaneous), medicine.medical_treatment, Schistosomiasis, Biology, CXCR3, CXCR4, Chemokine receptor, Immune system, Antigen, medicine, Humans, Child, Cells, Cultured, Aged, Interleukin-2 Receptor alpha Subunit, Middle Aged, medicine.disease, Flow Cytometry, Infectious Diseases, Cytokine, Insect Science, Immunology, Cytokines, Parasitology, Female, Receptors, Chemokine, CD8
Abstract: Previous studies have demonstrated that distinct immune response profiles can be correlated with the development/maintenance of different clinical forms of human schistosomiasis. We have previously shown that individuals with the more severe clinical forms of the disease such as those presenting different levels of fibrosis or with the hepatosplenic (HS) clinical form of the disease show significantly different immune response when compared with those with the intestinal clinical form (INT). To better understand the immune mechanisms associated with the clinical form of the schistosomiasis, in this study, we present the results of the evaluation, at a single cell level, of the cytokine patterns as well as the chemokine receptors expression by T-cell subsets after in vitro short-term stimulation with soluble egg antigens as well as the ex vivo frequency analysis of putative regulatory CD4+CD25HIGH+ T-cell subset in the peripheral blood mononuclear cells. We observed an increase on IL-4+, IL-5+ and IL-10+ cells both in the CD4+ and CD8+ lymphocytes in INT and a significant decrease on the number of IL-4+, IL-5+ and IL-10+ T-lymphocytes for HS. However, patients with detectable fibrosis presented decrease on IL-10+ (both CD4+ and CD8+ lymphocytes) and basal levels of IL-4 and IL-5. These data suggested that although INT group is under the influence of an effective immunoregulated immune response, mainly due to the high percentage of IL-10+ cells, it presents a mixed type (Type1/Type-2) immune profile. Moreover, the chemokine receptors expression demonstrated that CXCR3 and CXCR4 by CD4+ T-cells in INT may dictate the selective profile of IL-10 associated with the immunomodulatory events in human schistosomiasis. Additionally, the ex vivo analysis also suggests that higher levels of CD4+CD25HIGH+ T-cells may play a role in controlling morbidity in chronic human schistosomiasis. Taken together, these data suggest a major role of IL-10-producing CXCR4+ CD4+ T-cell subset for the asymptomatic outcome of the disease.
Published: 2007

49. The impact of two education methods on knowledge of schistosomiasis transmission and prevention among schoolchildren in a rural community in northern Minas Gerais, Brazil

Author: Andrea Gazzinelli, Helmut Kloos, Maria Flávia Gazzinelli, Gustavo Velasquez-Melendez, Dener Carlos dos Reis, and Izabela Rocha Dutra
Subjects: Microbiology (medical), Gerontology, Male, Rural Population, Health Knowledge, Attitudes, Practice, lcsh:Arctic medicine. Tropical medicine, Adolescent, lcsh:RC955-962, Population, Psychological intervention, lcsh:QR1-502, Developing country, Schistosomiasis, lcsh:Microbiology, law.invention, law, Risk Factors, Social representation, Environmental health, Surveys and Questionnaires, schistosomiasis, medicine, Prevalence, health education, Humans, education, Child, education.field_of_study, business.industry, medicine.disease, Transmission (mechanics), evaluation models, Health education, Female, Rural area, business, Brazil
Abstract: The objective of this study was to analyse the effect of using two health education approaches on knowledge of transmission and prevention of schistosomiasis of school children living in a rural endemic area in the state of Minas Gerais, Brazil. The 87 children participating in the study were divided into three groups based on gender, age and presence or absence of Schistosoma mansoni infection. In the first group the social representation model and illness experience was used. In the second group, we used the cognitive model based on the transmission of information. The third group, the control group, did not receive any information related to schistosomiasis. Ten meetings were held with all three groups that received a pre-test prior to the beginning of the educational intervention and a post-test after the completion of the program. The results showed that knowledge levels in Group 1 increased significantly during the program in regard to transmission (p = 0.038) and prevention (p = 0.001) of schistosomiasis. Groups 2 and 3 did not show significant increase in knowledge between the two tests. These results indicate that health education models need to consider social representation and illness experience besides scientific knowledge in order to increase knowledge of schistosomiasis transmission and prevention.
Published: 2006

50. The spatial distribution of Schistosoma mansoni infection before and after chemotherapy in the Jequitinhonha Valley in Brazil

Author: Jeffrey M. Bethony, Allen Hightower, Rodrigo Correa-Oliveira, Wesley Rodrigues Pereira, Andrea Gazzinelli, Philip T. LoVerde, João Paulo Amaral Haddad, and Helmut Kloos
Subjects: Microbiology (medical), Adult, Male, Veterinary medicine, lcsh:Arctic medicine. Tropical medicine, Adolescent, lcsh:RC955-962, exposure risk, medicine.medical_treatment, lcsh:QR1-502, Schistosomiasis, Biology, Spatial distribution, Immunoglobulin E, chemotherapy, Albendazole, lcsh:Microbiology, Praziquantel, Feces, nursing, Low exposure, medicine, Parasite Egg Count, Animals, Humans, IgE antibodies, Child, Anthelmintics, Chemotherapy, Water, chistosomiasis, Schistosoma mansoni, medicine.disease, biology.organism_classification, Schistosomiasis mansoni, spatial clustering, Child, Preschool, Immunology, biology.protein, Female, Rural area, Brazil
Abstract: Schistosomiasis prevalence and egg counts remained low one year after chemotherapy in most households in a hyperendemic rural area in northern Minas Gerais but several distinct spatial patterns could be observed in relation to IgE levels and to a lesser extent to exposure risk (TBM) and type of water supply. An inverse relationship between pre-treatment household prevalence and egg counts on the one hand and post-treatment IgE levels on the other were noted in two of the five communities. Low exposure risk was associated with the low pre-treatment infection rates in the central village but did not contribute to the decline of infection rates after chemotherapy in the study area, as indicated by the significant increase in water contact during the posttreatment period (p < 0.0001). Distance between households and the streams and socioeconomic factors were also unimportant in predicting the spatial distribution of infection. These results are consistent with the production and antiparasitic effect of high levels of IgE in Schistosoma mansoni infection.
Published: 2006

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