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1. Developing empathy in healthcare professions students: protocol of a mixed-methods non-controlled longitudinal intervention study

Author: Andre Matthias Müller, Nicola Siew Pei Ngiam, Michael Dunn, Dujeepa D. Samarasekera, Benjamin Yen Seow Goh, Charlene En Hui Goh, Ann Toh, Jeannette Lee, Wai-Ping Yau, Lydia Siew Tang Lau, and Paul John Gallagher
Subjects: interdisciplinary instruction, healthcare education, psycho-social competencies, healthcare professionalism, compassion, Medicine (General), R5-920
Abstract: Despite the necessary focus on clinical skills and knowledge during the tertiary education of healthcare professionals, the literature highlights the importance of developing psycho-social competencies. Empathy, a cognitive-behavioral attribute linked to various benefits for patients and healthcare professionals, is one such competency. Pedagogical approaches to successfully develop empathy in tertiary healthcare students are available. However, these approaches are often integrated piecemeal throughout the tertiary education journey. Research on a more empathy-focused curriculum is scarce. This manuscript describes the design of a study that aims to examine the effects of a more empathy-focused curriculum on empathy in tertiary healthcare profession students in Singapore. Freshmen dentistry, medicine, nursing, and pharmacy students enrolled in a novel curriculum with a strong empathy focus will be recruited for the study and followed for the program’s extent. Mixed-methods data collection at various time points will be conducted. Quantitative data will be collected on cognitive-behavioral empathy, intentions to provide empathic care, and engagement in courses of the curriculum. Qualitative data on perceptions of patient care and empathy in relation to relevant courses of the curriculum will be collected to provide context for quantitative findings. Ethics approval was granted by the Departmental Ethics Review Committee of the Saw Swee Hock School of Public Health, National University of Singapore (Ethics ID: SSHSPH-214).
Published: 2024
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2. Validation of remote anthropometric measurements in a rural randomized pediatric clinical trial in primary care settings

Author: E Zhang, Ann M. Davis, Elizabeth Yakes Jimenez, Brittany Lancaster, Monica Serrano-Gonzalez, Di Chang, Jeannette Lee, Jin-Shei Lai, Lee Pyles, Timothy VanWagoner, and Paul Darden
Subjects: Medicine, Science
Abstract: Abstract Rural children are more at risk for childhood obesity but may have difficulty participating in pediatric weight management clinical trials if in-person visits are required. Remote assessment of height and weight observed via videoconferencing may provide a solution by improving the accuracy of self-reported data. This study aims to validate a low-cost, scalable video-assisted protocol for remote height and weight measurements in children and caregivers. Families were provided with low-cost digital scales and tape measures and a standardized protocol for remote measurements. Thirty-three caregiver and child (6–11 years old) dyads completed remote (at home) height and weight measurements while being observed by research staff via videoconferencing, as well as in-person measurements with research staff. We compared the overall and absolute mean differences in child and caregiver weight, height, body mass index (BMI), and child BMI adjusted Z-score (BMIaz) between remote and in-person measurements using paired samples t-tests and one sample t-tests, respectively. Bland–Altman plots were used to estimate the limits of agreement (LOA) and assess systematic bias. Simple regression models were used to examine associations between measurement discrepancies and sociodemographic factors and number of days between measurements. Overall mean differences in child and caregiver weight, height, BMI, and child BMIaz were not significantly different between remote and in-person measurements. LOAs were − 2.1 and 1.7 kg for child weight, − 5.2 and 4.0 cm for child height, − 1.5 and 1.7 kg/m2 for child BMI, − 0.4 and 0.5 SD for child BMIaz, − 3.0 and 2.8 kg for caregiver weight, − 2.9 and 3.9 cm for caregiver height, and − 2.1 and 1.6 kg/m2 for caregiver BMI. Absolute mean differences were significantly different between the two approaches for all measurements. Child and caregiver age were each significantly associated with differences between remote and in-person caregiver height measurements; there were no significant associations with other measurement discrepancies. Remotely observed weight and height measurements using non-research grade equipment may be a feasible and valid approach for pediatric clinical trials in rural communities. However, researchers should carefully evaluate their measurement precision requirements and intervention effect size to determine whether remote height and weight measurements suit their studies. Trial registration: ClinicalTrials.gov NCT04142034 (29/10/2019).
Published: 2024
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3. Pragmatic, randomized, blinded trial to shorten pharmacologic treatment of newborns with neonatal opioid withdrawal syndrome (NOWS)

Author: Adam Czynski, Abbot Laptook, Abhik Das, Brian Smith, Alan Simon, Rachel Greenberg, Robert Annett, Jeannette Lee, Jessica Snowden, Claudia Pedroza, Barry Lester, Barry Eggleston, Drew Bremer, and Elisabeth McGowan
Subjects: Weaning, Neonatal, Opioid, Withdrawal, NOWS, Morphine, Medicine (General), R5-920
Abstract: Abstract Background The incidence of maternal opioid use in the USA has increased substantially since 2000. As a consequence of opioid use during pregnancy, the incidence of neonatal opioid withdrawal syndrome (NOWS) has increased fivefold between 2002 and 2012. Pharmacological therapy is indicated when signs of NOWS cannot be controlled, and the objective of pharmacological therapy is to control NOWS signs. Once pharmacologic therapy has started, there is great variability in strategies to wean infants. An important rationale for studying weaning of pharmacological treatment for NOWS is that weaning represents the longest time interval of drug treatment. Stopping medications too early may not completely treat NOWS symptoms. Methods This will be a pragmatic, randomized, blinded trial of opioid weaning to determine whether more rapid weaning, compared to slow wean, will reduce the number of days of opioid treatment in infants receiving morphine or methadone as the primary treatment for NOWS. Discussion The proposed study is a pragmatic trial to determine whether a rapid-weaning intervention reduces the number of days of opioid treatment, compared to a slow-weaning intervention, and we powered the proposed study to detect a 2-day difference in the length of treatment. Hospitals will be able to use either morphine or methadone with the knowledge that we may find a positive treatment effect for both, one, or neither drugs. Trial registration NCT04214834. Registered January 2, 2020.
Published: 2023
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4. Improving pediatric COVID-19 vaccine uptake using an mHealth tool (MoVeUp): study protocol for a randomized, controlled trial

Author: Russell J. McCulloh, Paul M. Darden, Jessica Snowden, Songthip Ounpraseuth, Jeannette Lee, Martina Clarke, Sophia R. Newcomer, Linda Fu, DeAnn Hubberd, Jaime Baldner, Maryam Garza, and Ellen Kerns
Subjects: Vaccination, Vaccine hesitancy, Vaccine confidence, mHealth, Mobile health, COVID-19, Medicine (General), R5-920
Abstract: Abstract Background Coronavirus disease 2019 (COVID-19) vaccines demonstrate excellent effectiveness against infection, severe disease, and death. However, pediatric COVID-19 vaccination rates lag among individuals from rural and other medically underserved communities. The research objective of the current protocol is to determine the effectiveness of a vaccine communication mobile health (mHealth) application (app) on parental decisions to vaccinate their children against COVID-19. Methods Custodial parents/caregivers with ≥ 1 child eligible for COVID-19 vaccination who have not yet received the vaccine will be randomized to download one of two mHealth apps. The intervention app will address logistical and motivational barriers to pediatric COVID-19 vaccination. Participants will receive eight weekly push notifications followed by two monthly push notifications (cues to action) regarding vaccinating their child. Through branching logic, users will access customized content based on their locality, degree of rurality-urbanicity, primary language (English/Spanish), race/ethnicity, and child’s age to address COVID-19 vaccine knowledge and confidence gaps. The control app will provide push notifications and information on general pediatric health and infection prevention and mitigation strategies based on recommendations from the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC). The primary outcome is the proportion of children who complete COVID-19 vaccination series. Secondary outcomes include the proportion of children who receive ≥ 1 dose of COVID-19 vaccine and changes in parent/caregiver scores from baseline to immediately post-intervention on the modified WHO SAGE Vaccine Hesitancy Scale adapted for the COVID-19 vaccine. Discussion The COVID-19 pandemic inflicts disproportionate harm on individuals from underserved communities, including those in rural settings. Maximizing vaccine uptake in these communities will decrease infection rates, severe illness, and death. Given that most US families from these communities use smart phones, mHealth interventions hold the promise of broad uptake. Bundling multiple mHealth vaccine uptake interventions into a single app may maximize the impact of deploying such a tool to increase COVID-19 vaccination. The new knowledge to be gained from this study will directly inform future efforts to increase COVID-19 vaccination rates across diverse settings and provide an evidentiary base for app-based vaccine communication tools that can be adapted to future vaccine-deployment efforts. Clinical trials registration ClinicalTrials.gov NCT05386355 . Registered on May 23, 2022.
Published: 2022
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5. Correction: Improving pediatric COVID-19 vaccine uptake using an mHealth tool (MoVeUp): study protocol for a randomized, controlled trial

Author: Russell J. McCulloh, Paul M. Darden, Jessica Snowden, Songthip Ounpraseuth, Jeannette Lee, Martina Clarke, Sophia R. Newcomer, Linda Fu, DeAnn Hubberd, Jaime Baldner, Maryam Garza, and Ellen Kerns
Subjects: Medicine (General), R5-920
Published: 2024
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6. Measuring and controlling medical record abstraction (MRA) error rates in an observational study

Author: Maryam Y. Garza, Tremaine Williams, Sahiti Myneni, Susan H. Fenton, Songthip Ounpraseuth, Zhuopei Hu, Jeannette Lee, Jessica Snowden, Meredith N. Zozus, Anita C. Walden, Alan E. Simon, Barbara McClaskey, Sarah G. Sanders, Sandra S. Beauman, Sara R. Ford, Lacy Malloch, Amy Wilson, Lori A. Devlin, and Leslie W. Young
Subjects: Medical record abstraction, Data quality, Clinical research, Clinical data management, Data collection, Medicine (General), R5-920
Abstract: Abstract Background Studies have shown that data collection by medical record abstraction (MRA) is a significant source of error in clinical research studies relying on secondary use data. Yet, the quality of data collected using MRA is seldom assessed. We employed a novel, theory-based framework for data quality assurance and quality control of MRA. The objective of this work is to determine the potential impact of formalized MRA training and continuous quality control (QC) processes on data quality over time. Methods We conducted a retrospective analysis of QC data collected during a cross-sectional medical record review of mother-infant dyads with Neonatal Opioid Withdrawal Syndrome. A confidence interval approach was used to calculate crude (Wald’s method) and adjusted (generalized estimating equation) error rates over time. We calculated error rates using the number of errors divided by total fields (“all-field” error rate) and populated fields (“populated-field” error rate) as the denominators, to provide both an optimistic and a conservative measurement, respectively. Results On average, the ACT NOW CE Study maintained an error rate between 1% (optimistic) and 3% (conservative). Additionally, we observed a decrease of 0.51 percentage points with each additional QC Event conducted. Conclusions Formalized MRA training and continuous QC resulted in lower error rates than have been found in previous literature and a decrease in error rates over time. This study newly demonstrates the importance of continuous process controls for MRA within the context of a multi-site clinical research study.
Published: 2022
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7. Eating, Sleeping, Consoling for Neonatal Opioid Withdrawal (ESC-NOW): a Function-Based Assessment and Management Approach study protocol for a multi-center, stepped-wedge randomized controlled trial

Author: Leslie W. Young, Songthip Ounpraseuth, Stephanie L. Merhar, Alan E. Simon, Abhik Das, Rachel G. Greenberg, Rosemary D. Higgins, Jeannette Lee, Brenda B. Poindexter, P. Brian Smith, Michele Walsh, Jessica Snowden, Lori A. Devlin, and for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network and the NIH Environmental influences on Child Health Outcomes (ECHO) Program Institutional Development Awards States Pediatric Clinical Trials Network
Subjects: Medicine (General), R5-920
Published: 2022
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8. Compression Therapy for HIV-Associated Kaposi Sarcoma Leg Lymphedema: Results of the Kenyan Improvised Compression for Kaposi Sarcoma Randomized Controlled Trial

Author: Aileen Y. Chang, Rakhi Karwa, Haji Odhiambo, Phelix Were, Sara L. Fletcher, Edith C. Tonui, Michael A. Kohn, Jeannette Lee, Di Chang, Shelly Lensing, Diana Flora Namaemba, Naftali Busakhala, Samson K. Kiprono, Toby Maurer, Suzanne Goodrich, and Sonak D. Pastakia
Subjects: Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: PURPOSEEvaluate the effectiveness of compression while receiving chemotherapy compared with chemotherapy alone in the treatment of HIV-associated Kaposi sarcoma (KS) lymphedema.METHODSA randomized controlled trial was conducted in a single oncology clinic in western Kenya (NCT03404297). A computer-generated randomization schedule was used to allocate treatment arms. Randomized block design was used for stratification by lymphedema stage. Participants were HIV positive adults age ≥ 18 years on antiretroviral therapy with biopsy-proven KS associated with leg lymphedema and being initiated on chemotherapy. The intervention was 10 weeks of weekly clinic-based application of two-component paste compression bandages. The primary outcome was change in the Lower Extremity Lymphedema Index (LELI) score from week 0 to week 14. The secondary outcomes were change in the Lymphedema Quality of Life measure (LYMQOL) and change in the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 score from week 0 to week 14. Blinded outcome assessments were conducted.RESULTSOf 30 participants randomly assigned, 25 eligible patients (chemotherapy [control], n = 13; compression plus chemotherapy [intervention], n = 12) returned at week 14. Change in LELI, LYMQOL, and EORTC QLQ-C30 scores between week 14 and week 0 did not significantly differ by arm. The mean (standard deviation) change in LELI score was –25.9 (34.6) for the control arm compared with –13.3 (29.5) for the intervention arm, P = .340. The difference (95% CI) in the change in LELI score was –12.6 (–39.3 to 14.1).CONCLUSIONFuture studies evaluating a 14-week change in LELI for KS lymphedema should assume a standard deviation of approximately 30. Lessons learned from this pilot trial should inform the development of a larger, multicenter trial to evaluate the effectiveness of compression for KS lymphedema.
Published: 2022
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9. Pre-vaccination prevalence of anogenital and oral human papillomavirus in young HIV-infected men who have sex with men

Author: Jessica A. Kahn, Marvin Belzer, Xiaofei Chi, Jeannette Lee, Aditya H. Gaur, Kenneth Mayer, Jaime Martinez, Donna C. Futterman, Elizabeth A. Stier, Mary E. Paul, Elizabeth Y. Chiao, Daniel Reirden, Steven E. Goldstone, Ana P. Ortiz Martinez, Edward R. Cachay, Luis F. Barroso, Maria Da Costa, Craig M. Wilson, and Joel M. Palefsky
Subjects: Infectious and parasitic diseases, RC109-216
Abstract: The aims of this study were to: 1) determine prevalence of anogenital and oral HPV, 2) determine concordance between HPV at anal, perianal, scrotal/penile, and oral sites; and 3) describe factors associated with anogenital HPV types targeted by the 9-valent vaccine. Data were collected from 2012 to 2015 among men who have sex with men 18–26 years of age enrolled in a vaccine trial (N = 145). Penile/scrotal, perianal, anal, and oral samples were tested for 61 HPV types. Logistic regression was used to identify factors associated with types in the 9-valent vaccine. Participants’ mean age was 23.0 years, 55.2% were African-American, and 26.2% were Hispanic; 93% had anal, 40% penile, and 6% oral HPV. Among those with anogenital infection, 18% had HPV16. Concordance was low between anogenital and oral sites. Factors independently associated with a 9-valent vaccine-type HPV were: race (African-American vs. White, OR=2.67, 95% CI=1.11–6.42), current smoking (yes vs. no, OR=2.37, 95% CI=1.03–5.48), and number of recent receptive anal sex partners (2+ vs. 0, OR=3.47, 95% CI=1.16–10.4). Most MSM were not infected with HPV16 or HPV18, suggesting that they may still benefit from HPV vaccination, but anogenital HPV was very common, highlighting the importance of vaccinating men before sexual initiation. Clinical trial number: NCT01209325 Keywords: Adolescents, Clinical trials, Men who have sex with men, Vaccine, Human papillomavirus, HIV
Published: 2019
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10. Factors associated with diabetes-related distress over time among patients with T2DM in a tertiary hospital in Singapore

Author: Maudrene L. Tan, Chuen S. Tan, Konstadina Griva, Yung S. Lee, Jeannette Lee, E. S. Tai, Eric Y. Khoo, and Hwee-Lin Wee
Subjects: Diabetes-related distress, Diabetes, Longitudinal, Excessive daytime sleepiness, Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract: Abstract Background Persistent diabetes-related distress (DRD) is experienced by patients with Type 2 Diabetes Mellitus. Knowing factors associated with persistent DRD will aid clinicians in prioritising interventions efforts. Methods A total of 216 patients were recruited from a tertiary hospital in Singapore, an Asian city state, and followed for 1.5 years (2011–2014). Data was collected by self-completed questionnaires assessing DRD (measured by the Problem Areas in Diabetes score) and other psychosocial aspects such as social support, presenteeism, depression, health-related quality of life (HRQoL) and excessive daytime sleepiness (EDS) at three time points. Clinical data (body-mass-index and glycated haemoglobin) was obtained from medical records. Change score was calculated for each clinical and psychosocial variable to capture changes in these variables from baseline. Generalized Linear Model with Generalized Estimating Equation method was used to assess whether baseline and change scores in clinical and psychosocial are associated with DRD over time. Results Complete data was available for 73 patients, with mean age 44 (SD 12.5) years and 67% males. Persistent DRD was experienced by 21% of the patients. In the final model, baseline HRQoL (OR = 0.56, p
Published: 2017
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11. Challenges in cancer self-management of patients with limited English proficiency

Author: Fang-Yu Chou, Lily Y Kuang, Jeannette Lee, Grace J Yoo, and Lei-Chun Fung
Subjects: Cancer, Chinese-American, limited English proficiency, self-management, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282, Nursing, RT1-120
Abstract: Objective: This paper summarizes the barriers and challenges in cancer care reported from a validation project of a self-management intervention handbook from Chinese-American cancer patients with limited English proficiency (LEP). Methods: Seven health-care providers (HCPs) and 16 Chinese-American cancer survivors with LEP were invited to validate a self-management intervention handbook through networking sampling method. Bilingual versions were developed and validated using the repeated translation process. Online and paper-based survey and interview were conducted to collect information on the perception of barriers and experiences on cancer care. Data were analyzed by the content analysis method. Results: The HCPs reported a bilingual self-management handbook which is useful and feasible for patient self-management. The challenges in giving cancer care to LEP patients included: patients do not engage in discussion, different cultural health beliefs, unable to speak to patients in their primary language, and patients are less likely to discuss emotional and social challenges during treatments. The common barriers and experiences during cancer care included: limited understanding about treatment/medication and side effects, language barriers such as unable to communicate to make the decision, unable to understand information related to resources and do not know what questions to ask, and do not know what to expect during their cancer treatment. Conclusions: The current findings highlight the need of cancer self-management support for culturally diverse LEP cancer patients. Further research can include applying the supportive intervention to all LEP cancer patients.
Published: 2016
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12. Preliminary validation of a health-related quality of life symptom index for persons treated or actively monitored for anal HSIL (AMC –A02, -A03)

Author: Thomas M. Atkinson, PhD, Joel Palefsky, MD, J. Michael Berry, MD, Stephen Goldstone, MD, Andrew Webb, Rebecca Levine, MD, Timothy J. Wilkin, MD, MPH, Gary Bucher, MD, David Cella, PhD, Jeannette Lee, PhD, Jeff Taylor, Yuelin Li, PhD, and Jack Burkhalter, PhD
Subjects: Infectious and parasitic diseases, RC109-216
Abstract: Background: Precancerous anal high-grade squamous intraepithelial lesions (HSIL) and its associated treatments have the potential to reduce health-related quality of life (HRQoL) in impacted individuals. The ANCHOR (ANal Cancer HSIL Outcomes Research) trial aims to determine whether treating anal HSIL, versus active monitoring, is effective in reducing incidence of anal cancer in HIV-infected individuals. The present study sought to establish preliminary psychometric evidence of the 25-item ANCHOR Health-Related Symptom Inventory (A-HRSI). Methods: Eligible ANCHOR participants recruited within two-weeks post-treatment or randomization to active surveillance completed the A-HRSI and well-established legacy HRQoL measures (i.e., Functional Assessment of Cancer Therapy – General [FACT-G] and MD Anderson Symptom Inventory [MDASI]) via telephone. Construct validity was assessed using an exploratory factor analysis (EFA). Pearson correlations were then calculated between summed items within the resulting A-HRSI latent factors and legacy measure outcome subscales to establish convergent and divergent validity. Results: 200 participants were enrolled. EFA provided initial confirmation that the A-HRSI items are best represented by the proposed broad three-factor structure (e.g., physical symptoms, physical impacts, psychological symptoms). These three factors had fair to moderate Pearson correlations with FACT-G Total and MDASI Symptom Severity and Interference subscales. Conclusions: Preliminary psychometric evidence exists to support the construct validity of the A-HRSI, indicating this measure can capture disease- and treatment-related physical and psychological symptoms and physical impacts. Clinical responsiveness and Spanish-translation of this measure will be completed prior to ultimately deploying this measure in the ANCHOR trial to facilitate participant reporting of their HRQoL to inform clinical decision-making.
Published: 2018
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13. Epicardial and visceral adipose tissue in relation to subclinical atherosclerosis in a Chinese population.

Author: Nang Ei Ei Khaing, Tai E Shyong, Jeannette Lee, Cinnie Yentia Soekojo, Alvin Ng, and Rob M Van Dam
Subjects: Medicine, Science
Abstract: Body fatness is associated with risk of coronary heart disease and it has been postulated that epicardial adipose tissue (EAT) may have a particularly detrimental effect because of its localized toxic effects. We therefore aimed to examine the association between EAT and coronary artery calcification and compared this with associations for visceral adipose tissue (VAT) and other regional fat depots.We conducted a cross-sectional study of 487 Chinese participants aged 50 years old and above, living in Singapore. Participants, free from known diabetes mellitus and coronary heart diseases, completed interviews, a health screening to evaluate obesity and cardiovascular disease risk factors, and computed tomography scans of the abdomen and coronary arteries. Associations between regional fat depots and subclinical atherosclerosis defined as CAC> = 100 were determined by multiple logistic regression analysis.Epicardial adipose tissue (EAT) was highly correlated with visceral adipose tissue (VAT) (Pearson r = 0.72) and trunk fat mass (r = 0.66). The age and sex-adjusted odd ratio (OR) (in 1-SD increase) of subclinical atherosclerosis was 1.28 (1.01-1.61) for EAT and 1.40 (1.04-1.88) for VAT. These associations were weaker and non-significant after adjusting for markers of dyslipidemia and hyperglycemia. Total body fat, subcutaneous abdominal fat, and leg, arm and trunk fat mass were not significantly associated with atherosclerosis.VAT and EAT showed similar associations with coronary artery calcification and the associations could be mediated by traditional risk factors in this ethnic Chinese population.
Published: 2018
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14. Is Coffee Consumption associated with Age-related Macular Degeneration and Diabetic Retinopathy?

Author: Neelam Kumari, Xiang Li, Wan-Ling Wong, E Shyong Tai, Jeannette Lee, Rob M van Dam, and Tien-Yin Wong
Subjects: negative results, Coffee, caffeine, age-related macular degeneration, diabetic retinopathy, Biology (General), QH301-705.5
Abstract: Introduction Coffee is among the most widely consumed beverages in the world. Several epidemiological studies have evaluated the association between coffee consumption and risk of systemic diseases; however, there is paucity of data in relation to coffee consumption and risk of eye diseases. This study aims to examine the relationship between coffee consumption and risk of age-related macular degeneration (AMD) and diabetic retinopathy (DR) in multiethnic population of Singapore. Materials and MethodsWe analyzed the data from 4121 study participants from the Singapore Prospective Study Program to examine the relationship of coffee to prevalence of AMD and DR. A standardized questionnaire that included information about the habitual amount of coffee consumed was completed by all study participants. Presence and severity of AMD and DR was assessed on fundus photographs using the Mutiethnic Study of Atherosclerosis Grading Protocol. ResultsThe prevalence of AMD and DR in our population was 5.4% and 32.0%, respectively. A positive history of coffee consumption was present in 77.5% of AMD population and 76.1% of DR population with majority of participants consuming 1-2 cups of coffee daily. No statistically significant association was observed between coffee consumption and odds of AMD or DR after adjusting for confounding factors [AMD: Odds Ratio (OR) = 1.27, Confidence Interval (CI) = 0.88-1.83, p = 0.20; DR: OR = 1.36, CI = 0.69-2.69, p = 0.37). ConclusionThis epidemiological study of a large multiethnic population data set do not support the hypothesis that habitual intake of coffee and caffeine is associated with an altered risk of AMD and DR among Asians.
Published: 2014

15. Association of Television Viewing Time with Body Composition and Calcified Subclinical Atherosclerosis in Singapore Chinese.

Author: Ei Ei Khaing Nang, Rob M van Dam, Chuen Seng Tan, Falk Mueller-Riemenschneider, Yi Ting Lim, Kai Zhi Ong, Siqing Ee, Jeannette Lee, and E Shyong Tai
Subjects: Medicine, Science
Abstract: Sedentary behavior such as television viewing may be an independent risk factor for coronary heart disease. However, few studies have assessed the impact of television viewing time on coronary artery calcification and it remains unclear how body fat contributes to this relationship. The aim of this study is to evaluate the association between television viewing time and subclinical atherosclerosis and whether effects on visceral or subcutaneous fat may mediate any associations observed.This was a cross-sectional study of 398 Chinese participants (192 men and 206 women) from Singapore prospective study. Participants were free from known cardiovascular diseases and underwent interview, health screening, computed tomography scans of coronary arteries and abdomen. Spearman's correlation was used to test the correlation between television viewing time, physical activity, body composition and abdominal fat distribution. The association between television viewing time and subclinical atherosclerosis was assessed by multiple logistic regression analysis.In men, television viewing time was significantly correlated with higher body fat mass index, percent body fat, subcutaneous and visceral fat. These associations were in the same direction, but weaker and not statistically significant in women. Television viewing time (hours/day) was associated with subclinical atherosclerosis in men (odds ratio: 1.41, 95% CI: 1.03-1.93) but no significant association was observed in women (odds ratio: 0.88, 95% CI: 0.59-1.31) after adjusting for potential socio-demographic and lifestyle confounders. Further adjustments for biological factors did not affect these associations.Television viewing time was associated with greater adiposity and higher subcutaneous and visceral fat in men. TV viewing time was also associated with subclinical atherosclerosis in men and the potential mechanisms underlying this association require further investigation.
Published: 2015
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16. Psychometric Properties of the Problem Areas in Diabetes (PAID) Instrument in Singapore.

Author: Kavita Venkataraman, Luor Shyuan Maudrene Tan, Dianne Carrol Tan Bautista, Konstadina Griva, Yasmin Laura Marie Zuniga, Mohamed Amir, Yung Seng Lee, Jeannette Lee, E Shyong Tai, Eric Yin Hao Khoo, and Hwee Lin Wee
Subjects: Medicine, Science
Abstract: Emotional distress is an important dimension in diabetes, and several instruments have been developed to measure this aspect. The Problem Areas in Diabetes (PAID) scale is one such instrument which has demonstrated validity and reliability in Western populations, but its psychometric properties in Asian populations have not been examined.This was a secondary analysis of data from patients with Type 2 diabetes mellitus recruited through convenience sampling from a diabetes specialist outpatient clinic in Singapore. The following psychometric properties were assessed: Construct validity through confirmatory factor analysis (CFA) and Rasch analysis, concurrent validity through correlation with related scales (Kessler Psychological Distress Scale, Diabetes Health Profile-psychological distress, Audit of Diabetes Dependent Quality of Life), reliability through assessment of internal consistency and floor and ceiling effects, and sensitivity by estimating effect sizes for known clinical and social functioning groups.203 patients with mean age of 45±12 years were analysed. None of the previously published model structures achieved a good fit on CFA. On Rasch analysis, four items showed poor fit and were removed. The abridged 16-item PAID mapped to a single latent trait, with a high degree of internal consistency (Cronbach ɑ 0.95), but significant floor effect (24.6% scoring at floor). Both 20-item and 16-item PAID scores were moderately correlated with scores of related scales, and sensitive to differences in clinical and social functioning groups, with large effect sizes for glycemic control and diabetes related complications, nephropathy and neuropathy.The abridged 16-item PAID measures a single latent trait of emotional distress due to diabetes whereas the 20-item PAID appears to measures more than one latent trait. However, both the 16-item and 20-item PAID versions are valid, reliable and sensitive for use among Singaporean patients with diabetes.
Published: 2015
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17. Viral Profiling Identifies Multiple Subtypes of Kaposi’s Sarcoma

Author: Mina C. Hosseinipour, Kristen M. Sweet, Jie Xiong, Dan Namarika, Albert Mwafongo, Michael Nyirenda, Loreen Chiwoko, Deborah Kamwendo, Irving Hoffman, Jeannette Lee, Sam Phiri, Wolfgang Vahrson, Blossom Damania, and Dirk P. Dittmer
Subjects: Microbiology, QR1-502
Abstract: ABSTRACT Kaposi’s sarcoma (KS), caused by KS-associated herpesvirus (KSHV), is the most common cancer among HIV-infected patients in Malawi and in the United States today. In Malawi, KSHV is endemic. We conducted a cross-sectional study of patients with HIV infection and KS with no history of chemo- or antiretroviral therapy (ART). Seventy patients were enrolled. Eighty-one percent had T1 (advanced) KS. Median CD4 and HIV RNA levels were 181 cells/mm3 and 138,641 copies/ml, respectively. We had complete information and suitable plasma and biopsy samples for 66 patients. For 59/66 (89%) patients, a detectable KSHV load was found in plasma (median, 2,291 copies/ml; interquartile range [IQR], 741 to 5,623). We utilized a novel KSHV real-time quantitative PCR (qPCR) array with multiple primers per open reading frame to examine KSHV transcription. Seventeen samples exhibited only minimal levels of KSHV mRNAs, presumably due to the limited number of infected cells. For all other biopsy samples, the viral latency locus (LANA, vCyc, vFLIP, kaposin, and microRNAs [miRNAs]) was transcribed abundantly, as was K15 mRNA. We could identify two subtypes of treatment-naive KS: lesions that transcribed viral RNAs across the length of the viral genome and lesions that displayed only limited transcription restricted to the latency locus. This finding demonstrates for the first time the existence of multiple subtypes of KS lesions in HIV- and KS-treatment naive patients. IMPORTANCE KS is the leading cancer in people infected with HIV worldwide and is causally linked to KSHV infection. Using viral transcription profiling, we have demonstrated the existence of multiple subtypes of KS lesions for the first time in HIV- and KS-treatment-naive patients. A substantial number of lesions transcribe mRNAs which encode the viral kinases and hence could be targeted by the antiviral drugs ganciclovir or AZT in addition to chemotherapy.
Published: 2014
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18. Associations between disease awareness and health-related quality of life in a multi-ethnic Asian population.

Author: Kavita Venkataraman, ChinMeng Khoo, Hwee Lin Wee, Chuen Seng Tan, Stefan Ma, Derrick Heng, Jeannette Lee, E Shyong Tai, and Julian Thumboo
Subjects: Medicine, Science
Abstract: Health related quality of life (HRQoL) is an important dimension of individuals' well-being, and especially in chronic diseases like diabetes and hypertension. The objective of this study was to evaluate the contributions of disease process, comorbidities, medication or awareness of the disease to HRQoL in diabetes mellitus, hypertension and dyslipidemia.This was a cross-sectional study of 3514 respondents from the general community in Singapore, assessed for HRQoL, disease and comorbid conditions through self-report, clinical and laboratory investigations. HRQoL was assessed using SF-36 health survey version 2. For each condition, participants were categorized as having 1) no disease, 2) undiagnosed, 3) diagnosed, not taking medication, and 4) diagnosed, taking medication. Analysis used one-way ANOVA and multiple linear regression.Diagnosed disease was associated with lower physical health component summary (PCS) scores across all three conditions. After adjustment for comorbidities, this association remained significant only for those not on medication in diabetes (-2.7±1.2 points, p = 0.03) and dyslipidemia (-1.3±0.4 points, p = 0.003). Diagnosed hypertension (no medication -2.6±0.9 points, p = 0.002; medication -1.4±0.5 points, p = 0.004) and dyslipidemia (no medication -0.9±0.4 points, p = 0.03; medication -1.9±0.5 points, p
Published: 2014
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19. Establishing the thematic framework for a diabetes-specific health-related quality of life item bank for use in an english-speaking asian population.

Author: Odelia Koh, Jeannette Lee, Maudrene L S Tan, E-Shyong Tai, Ce Jin Foo, Kok Joon Chong, Su-Yen Goh, Yong Mong Bee, Julian Thumboo, Yin-Bun Cheung, Avjeet Singh, and Hwee-Lin Wee
Subjects: Medicine, Science
Abstract: To establish a thematic framework for a Diabetes Mellitus (DM)-specific health-related quality of life (HRQoL) item bank by identifying important HRQoL themes and content gaps in existing DM-specific HRQoL measures and determining whether Patient-Reported Outcomes Measurement Information System (PROMIS) item banks are useful as a starting point.English-speaking Type 2 DM patients were recruited from an outpatient specialist clinic in Singapore. Thematic analysis was performed through open coding and axial coding. Items from four existing DM-specific measures and PROMIS Version 1.0 and 2.0 item banks were compared with identified themes and sub-themes.42 patients participated (25 men and 17 women; 28 Chinese, 4 Malay, 8 Indians, 2 other ethnicities). Median age was 53.70 years (IQR45.82-56.97) and the median disease duration was 11.13 (SD9.77) years. 10 subthemes (neutral emotions, coping emotions, empowered to help others, support from family, spend more time with family, relationships, financial burden on family, improved relationship, social support and religion/spirituality) were not covered by existing DM-specific measures. PROMIS covered 5 of 6 themes, 15 of 30 subthemes and 19 of 35 codes identified. Emotional distress (frustration, fear and anxiety) was most frequently mentioned (200 times).We had developed a thematic framework for assessing DM-specific HRQoL in a multi-ethnic Asian population, identified new items that needed to be written and confirmed that PROMIS was a useful starting point. We hope that better understanding and measurement of HRQoL of Asian DM patients will translate to better quality of care for them.
Published: 2014
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20. New measure of insulin sensitivity predicts cardiovascular disease better than HOMA estimated insulin resistance.

Author: Kavita Venkataraman, Chin Meng Khoo, Melvin K S Leow, Eric Y H Khoo, Anburaj V Isaac, Vitali Zagorodnov, Suresh A Sadananthan, Sendhil S Velan, Yap Seng Chong, Peter Gluckman, Jeannette Lee, Agus Salim, E Shyong Tai, and Yung Seng Lee
Subjects: Medicine, Science
Abstract: ContextAccurate assessment of insulin sensitivity may better identify individuals at increased risk of cardio-metabolic diseases.ObjectivesTo examine whether a combination of anthropometric, biochemical and imaging measures can better estimate insulin sensitivity index (ISI) and provide improved prediction of cardio-metabolic risk, in comparison to HOMA-IR.Design and participantsHealthy male volunteers (96 Chinese, 80 Malay, 77 Indian), 21 to 40 years, body mass index 18-30 kg/m(2). Predicted ISI (ISI-cal) was generated using 45 randomly selected Chinese through stepwise multiple linear regression, and validated in the rest using non-parametric correlation (Kendall's tau τ). In an independent longitudinal cohort, ISI-cal and HOMA-IR were compared for prediction of diabetes and cardiovascular disease (CVD), using ROC curves.SettingThe study was conducted in a university academic medical centre.Outcome measuresISI measured by hyperinsulinemic euglycemic glucose clamp, along with anthropometric measurements, biochemical assessment and imaging; incident diabetes and CVD.ResultsA combination of fasting insulin, serum triglycerides and waist-to-hip ratio (WHR) provided the best estimate of clamp-derived ISI (adjusted R(2) 0.58 versus 0.32 HOMA-IR). In an independent cohort, ROC areas under the curve were 0.77±0.02 ISI-cal versus 0.76±0.02 HOMA-IR (p>0.05) for incident diabetes, and 0.74±0.03 ISI-cal versus 0.61±0.03 HOMA-IR (pConclusionsTriglycerides and WHR, combined with fasting insulin levels, provide a better estimate of current insulin resistance state and improved identification of individuals with future risk of CVD, compared to HOMA-IR. This may be useful for estimating insulin sensitivity and cardio-metabolic risk in clinical and epidemiological settings.
Published: 2013
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21. Are C-reactive protein associated genetic variants associated with serum levels and retinal markers of microvascular pathology in Asian populations from Singapore?

Author: Rajkumar Dorajoo, Ruoying Li, Mohammad Kamran Ikram, Jianjun Liu, Philippe Froguel, Jeannette Lee, Xueling Sim, Rick Twee-Hee Ong, Wan Ting Tay, Chen Peng, Terri L Young, Alexandra I F Blakemore, Ching Yu Cheng, Tin Aung, Paul Mitchell, Jie Jin Wang, Caroline C Klaver, Eric Boerwinkle, Ronald Klein, David S Siscovick, Richard A Jensen, Vilmundur Gudnason, Albert Vernon Smith, Yik Ying Teo, Tien Yin Wong, E-Shyong Tai, Chew-Kiat Heng, and Yechiel Friedlander
Subjects: Medicine, Science
Abstract: C-reactive protein (CRP) levels are associated with cardiovascular disease and systemic inflammation. We assessed whether CRP-associated loci were associated with serum CRP and retinal markers of microvascular disease, in Asian populations.Genome-wide association analysis (GWAS) for serum CRP was performed in East-Asian Chinese (N = 2,434) and Malays (N = 2,542) and South-Asian Indians (N = 2,538) from Singapore. Leveraging on GWAS data, we assessed, in silico, association levels among the Singaporean datasets for 22 recently identified CRP-associated loci. At loci where directional inconsistencies were observed, quantification of inter-ethnic linkage disequilibrium (LD) difference was determined. Next, we assessed association for a variant at CRP and retinal vessel traits [central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE)] in a total of 24,132 subjects of East-Asian, South-Asian and European ancestry.Serum CRP was associated with SNPs in/near APOE, CRP, HNF1A and LEPR (p-values ≤4.7×10(-8)) after meta-analysis of Singaporean populations. Using a candidate-SNP approach, we further replicated SNPs at 4 additional loci that had been recently identified to be associated with serum CRP (IL6R, GCKR, IL6 and IL1F10) (p-values ≤0.009), in the Singaporean datasets. SNPs from these 8 loci explained 4.05% of variance in serum CRP. Two SNPs (rs2847281 and rs6901250) were detected to be significant (p-value ≤0.036) but with opposite effect directions in the Singaporean populations as compared to original European studies. At these loci we did not detect significant inter-population LD differences. We further did not observe a significant association between CRP variant and CRVE or CRAE levels after meta-analysis of all Singaporean and European datasets (p-value >0.058).Common variants associated with serum CRP, first detected in primarily European studies, are also associated with CRP levels in East-Asian and South-Asian populations. We did not find a causal link between CRP and retinal measures of microvascular disease.
Published: 2013
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22. Human T cell leukemia virus reactivation with progression of adult T-cell leukemia-lymphoma.

Author: Lee Ratner, William Harrington, Xuan Feng, Christian Grant, Steve Jacobson, Ariela Noy, Joseph Sparano, Jeannette Lee, Richard Ambinder, Nancy Campbell, Michael Lairmore, and AIDS Malignancy Consortium
Subjects: Medicine, Science
Abstract: BackgroundHuman T-cell leukemia virus-associated adult T-cell leukemia-lymphoma (ATLL) has a very poor prognosis, despite trials of a variety of different treatment regimens. Virus expression has been reported to be limited or absent when ATLL is diagnosed, and this has suggested that secondary genetic or epigenetic changes are important in disease pathogenesis.Methods and findingsWe prospectively investigated combination chemotherapy followed by antiretroviral therapy for this disorder. Nineteen patients were prospectively enrolled between 2002 and 2006 at five medical centers in a phase II clinical trial of infusional chemotherapy with etoposide, doxorubicin, and vincristine, daily prednisone, and bolus cyclophosphamide (EPOCH) given for two to six cycles until maximal clinical response, and followed by antiviral therapy with daily zidovudine, lamivudine, and alpha interferon-2a for up to one year. Seven patients were on study for less than one month due to progressive disease or chemotherapy toxicity. Eleven patients achieved an objective response with median duration of response of thirteen months, and two complete remissions. During chemotherapy induction, viral RNA expression increased (median 190-fold), and virus replication occurred, coincident with development of disease progression.ConclusionsEPOCH chemotherapy followed by antiretroviral therapy is an active therapeutic regimen for adult T-cell leukemia-lymphoma, but viral reactivation during induction chemotherapy may contribute to treatment failure. Alternative therapies are sorely needed in this disease that simultaneously prevent virus expression, and are cytocidal for malignant cells.
Published: 2009
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23. Acme Attractions

Author: Don Letts, Jeannette Lee
Published: 2021

24. Comparing Medical Record Abstraction (MRA) Error Rates in an Observational Study to Pooled Rates Identified in the Data Quality Literature

Author: Maryam Y. Garza, Tremaine B. Williams, Songthip Ounpraseuth, Zhuopei Hu, Jeannette Lee, Jessica Snowden, Anita C. Walden, Alan E. Simon, Lori A. Devlin, Leslie W. Young, and Meredith N. Zozus
Abstract: Background: Medical record abstraction (MRA) is a commonly used method for data collection in clinical research, but is prone to error, and the influence of quality control (QC) measures is seldom and inconsistently assessed during the course of a study. We employed a novel, standardized MRA-QC framework as part of an ongoing observational study in an effort to control MRA error rates. In order to assess the effectiveness of our framework, we compared our error rates against traditional MRA studies that had not reported using formalized MRA-QC methods. Thus, the objective of this study was to compare the MRA error rates derived from the literature with the error rates found in a study using MRA as the sole method of data collection that employed an MRA-QC framework. Methods: Using a moderator meta-analysis employed with Q-test, the MRA error rates from the meta-analysis of the literature were compared with the error rate from a recent study that implemented formalized MRA training and continuous QC processes. Results: The MRA process for data acquisition in clinical research was associated with both high and highly variable error rates (70 – 2,784 errors per 10,000 fields). Error rates for the study using our MRA-QC framework were between 1.04% (optimistic, all-field rate) and 2.57% (conservative, populated-field rate) (or 104 – 257 errors per 10,000 fields), 4.00 – 5.53 percentage points less than the observed rate from the literature (pConclusions: Review of the literature indicated that the accuracy associated with MRA varied widely across studies. However, our results demonstrate that, with appropriate training and continuous QC, MRA error rates can be significantly controlled during the course of a clinical research study.
Published: 2023
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25. Error Rates of Data Processing Methods in Clinical Research: A Systematic Review and Meta-Analysis

Author: Maryam Y. Garza, Tremaine Williams, Songthip Ounpraseuth, Zhuopei Hu, Jeannette Lee, Jessica Snowden, Anita C. Walden, Alan E. Simon, Lori A. Devlin, Leslie W. Young, and Meredith N. Zozus
Abstract: Background: Over the last 30 years, empirical assessments of data accuracy in clinical research have been reported in the literature. Although there have been articles summarizing results reported in multiple papers, there has been little synthesis of these results. Further, although notable exceptions exist, little evidence has been obtained regarding the relative accuracy of different data processing methods. Methods: A systematic review of the literature was performed to identify clinical research studies that evaluated the quality of data obtained from data processing methods typically used in clinical research (e.g., medical record abstraction, optical scanning, single-data entry, and double-data entry). A total of 93 papers meeting our inclusion criteria were categorized according to their data processing methods. Quantitative information on data accuracy was abstracted from the articles and pooled. Meta-analysis of single proportions based on an inverse variance method and generalized linear mixed model approach of studies from the literature were used to derive an overall estimate of error rates across data processing methods for comparison. Results: Review of the literature indicated that the accuracy associated with data processing methods varies widely, with error rates ranging from 2 errors per 10,000 fields to 2,784errors per 10,000 fields. The medical record abstraction process for data acquisition in clinical research was associated with both high and highly variable error rates, with a variability of 3 orders of magnitude in accuracy (70 – 2,784 errors per 10,000 fields). Error rates for data processed with optical methods were comparable to data processed using single-data entry (2 – 358 vs. 4 – 650 per 10,000 fields, respectively). In comparison, double-data entry was associated with the lowest error rates (4 – 33 per 10,000 fields). Conclusions: Data processing and cleaning methods may explain a significant amount of the variability in data accuracy.
Published: 2023
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26. Internships before and during COVID-19: experiences and perceptions of undergraduate interns and supervisors

Author: Dana Wai Shin Chow, Suganthi Narayanasamy, Jeannette Lee, Raymond Boon Tar Lim, Cecilia Woon Chien Teng, and Chee Hsiang Liow
Subjects: medicine.medical_specialty, Medical education, ComputingMilieux_THECOMPUTINGPROFESSION, Coronavirus disease 2019 (COVID-19), media_common.quotation_subject, Public health, Soft skills, Education, Work (electrical), Originality, Internship, Perception, medicine, Technical skills, Life-span and Life-course Studies, Psychology, media_common
Abstract: PurposeThe COVID-19 pandemic has brought about a contingent shift to remote working and learning worldwide. However, little is known regarding the impact of this shift on internships. Moreover, much of the available literature studies on internships are focused largely on perceptions by students, less so by supervisors. This paper describes the impact of COVID-19 on public health (PH) internships and examines interns' and supervisors' perspectives on their experiences in internships before and during the pandemic.Design/methodology/approachA cross-sectional study design was conducted on two cohorts of undergraduate students and their supervisors in Singapore. Participants were surveyed using questionnaires with both close-ended and open-ended questions about various aspects of the internship experience. Data were triangulated from these surveys and module evaluation reports, and analyzed quantitatively and qualitatively.FindingsCOVID-19 disrupted internships significantly, with a reduction in the number of placements offered and necessary changes to the internship scope. Overall, the internship experience has been positive. Supervisors and e-interns reported high levels of satisfaction and documented learning gains such as the development of technical skills and soft skills unique to remote work.Originality/valueThe study findings fill current gaps in the literature on supervisor perceptions and internship experiences during COVID-19. Recommendations are proposed to optimize e-internships, a potentially authentic workplace in the post-COVID era.
Published: 2021
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27. Improving pediatric COVID-19 vaccine uptake using an mHealth tool (MoVeUP): a randomized, controlled trial

Author: Russell James McCulloh, Paul Darden, Jessica Snowden, Songthip Ounpraseuth, Jeannette Lee, Martina Clarke, Sophia R Newcomer, Linda Fu, DeAnn Hubberd, Jaime Baldner, Maryam Garza, and Ellen Kerns
Abstract: Background: Coronavirus disease 2019 (COVID-19) vaccines demonstrate excellent effectiveness against infection, severe disease, and death. However, pediatric COVID-19 vaccination rates lag among individuals from rural and other medically underserved communities. The research objective of the current protocol is to determine the effectiveness of a vaccine communication mobile health (mHealth) application (app) on parental decisions to vaccinate their children against COVID-19. Methods: Custodial parents/caregivers with ≥1 child eligible for COVID-19 vaccination who have not yet received the vaccine will be randomized to download one of two mHealth apps. The intervention app will address logistical and motivational barriers to pediatric COVID-19 vaccination. Participants will receive eight weekly push notifications followed by two monthly push notifications (cues to action) regarding vaccinating their child. Through branching logic, users will access customized content based on their locality, degree of rurality-urbanicity, primary language (English/Spanish), race/ethnicity, and child’s age to address COVID-19 vaccine knowledge and confidence gaps. The control app will provide push notifications and information on general pediatric health and infection prevention and mitigation strategies based on recommendations from the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC). The primary outcome is the proportion of children who complete COVID-19 vaccination series. Secondary outcomes include the proportion of children who receive ≥1 dose of COVID-19 vaccine and changes in parent/caregiver scores from baseline to immediately post-intervention on the modified WHO SAGE Vaccine Hesitancy Scale adapted for the COVID-19 vaccine. Discussion: The COVID-19 pandemic inflicts disproportionate harm on individuals from underserved communities, including those in rural settings. Maximizing vaccine uptake in these communities will decrease infection rates, severe illness, and death. Given that most US families from these communities use smart phones, mHealth interventions hold the promise of broad uptake. Bundling multiple mHealth vaccine-uptake interventions into a single app may maximize the impact of deploying such a tool to increase COVID-19 vaccination. The new knowledge to be gained from this study will directly inform future efforts to increase COVID-19 vaccination rates across diverse settings and provide an evidentiary base for app-based vaccine communication tools that can be adapted to future vaccine-deployment efforts. Clinical Trials Registration: Name of the registry: clinicaltrials.gov Trial registration number: NCT05386355 Date of registration: May 23, 2022 URL of trial registry record: https://clinicaltrials.gov/ct2/show/NCT05386355
Published: 2022
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28. Quality Assurance in Clinical Trials Requiring Radiotherapy in sub-Saharan Africa

Author: Lilie L. Lin, Ntokozo Ndlovu, Jessica Lowenstein, Meg Wirth, Jeannette Lee, Elizabeth A. Stier, Madhur Garg, Jeffrey Kotzen, Webster Kadzatsa, Joel Palefsky, Susan E. Krown, and Mark H. Einstein
Subjects: Cancer Research, Radiation, Oncology, Radiology, Nuclear Medicine and imaging
Abstract: Given the increasing availability of radiotherapy in sub-Saharan Africa, clinical trials that include radiotherapy are likely to grow. Ensuring appropriate delivery of radiotherapy through rigorous quality assurance is an important component of clinical trial execution. We reviewed the process for credentialing radiotherapy sites and radiotherapy quality assurance through the Imaging and Radiation Oncology Core (IROC) Houston Quality Assurance Center for AMC-081, a multicenter study of cisplatin and radiotherapy for women with locally advanced cervical cancer living with HIV, conducted by the AIDS Malignancy Consortium at 2 sites in South Africa and Zimbabwe.Women living with HIV with newly diagnosed stage IB2, IIA (4 cm), IIB-IVA cervical carcinoma (per 2009 FIGO) were enrolled on AMC-081. They received 3D conformal external-beam radiotherapy (EBRT) to the pelvis (41.4-45 Gy) using a linear accelerator, high dose rate brachytherapy (6-9 Gy to point A with each fraction and up to 4 fractions), and concurrent weekly cisplatin (40 mg/mAll of the 38 women enrolled on AMC-081 received +/- 5% of the protocol-specified prescribed dose of EBRT. Geometry of brachytherapy applicator placement was scored as per protocol in all implants. Doses to points A and B, ICRU bladder, or ICRU rectum required correction by IROC in50% of the implants. In the final evaluation, 58% of participants (n=22) were treated per protocol, 40% (n=15) had minor protocol deviations, and 3% (n=1) had major protocol deviations. No records were received within 60 days of treatment completion as requested in the protocol.Major radiotherapy deviations were low, but timely submission of radiotherapy data did not occur. Future studies, especially those that include specialized radiotherapy techniques such as stereotactic or intensity-modulated radiotherapy, will require pathways to ensure timely and adequate quality assurance.
Published: 2022

29. Informatics Infrastructure in a Rural Pediatric Clinical Trials Network: Matching Specific Clinical Research Needs with Best Practices and Industry Guidelines

Author: Melody Greer, Maryam Y. Garza, Jeannette Lee, Fred Prior, Lawrence Tarbox, Jeff Tobler, Anita Walden, Meredith Nahm Zozus, and Jessica Snowden
Subjects: History, Polymers and Plastics, Pharmacology (medical), General Medicine, Business and International Management, Industrial and Manufacturing Engineering
Published: 2022
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30. 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. 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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. 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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. Machado-Rodrigues, Fatemeh Malekzadeh, Shouling Wu, Jennifer L. Baker, Clicerio González-Villalpando, Eleonora d'Orsi, Irene G. M. van Valkengoed, Anna Fijałkowska, Wen-Harn Pan, Gregor Starc, Meghnath Dhimal, Murat Topbaş, George Moschonis, Robert Eggertsen, Abdullah Alkandari, Quang Ngoc Nguyen, Janette Walton, Elnaz Faramarzi, Saeed Dastgiri, Lien Braeckevelt, Nasheeta Peer, Radka Taxová Braunerová, Mohamed M. Ali, Steiner Krokstad, Harald Geiger, Morteza Shamshirgaran, Lela Shengelia, María Ángeles Dal Re Saavedra, Silvana Donoso, Khem Bahadur Karki, Timothy J. Key, Maria G. Grammatikopoulou, Susana Vale, Felix K. Assah, Juan A Rivera, Peter H. Whincup, Oana-Florentina Gheorghe-Fronea, Cassiano Ricardo Rech, Paul Ferdinand M. Reganit, Rachakulla Hari Kumar, Jaakko Mursu, Luis A. Moreno, Glen Gironella, Jelena Kos, Tilema Cama, Haakon E. Meyer, Jun Ma, Raphael E. Arku, Ziad Abdeen, Dianna J. Magliano, Jitendra Jonnagaddala, Konstantinos Gkiouras, Paola Nardone, Alberto Barceló, Tomi-Pekka Tuomainen, Francesco Gianfagna, Stefania Maggi, Mohammad Hossein Somi, Behrooz Hamzeh, Miquel Porta, Vesna Jureša, Alexander D. Deev, David Faeh, Antonio Bernabe-Ortiz, Sirkka Keinänen-Kiukaanniemi, Ian Hambleton, Stefan Savin, Andre Pascal Kengne, R. Krishna Kumar, Kurt Widhalm, Marco M Ferrario, Parisa Amiri, Anjani Kumar Jha, Thamara Hubler Figueiró, Jana Kratenova, Claudia M. Hormiga, Maria Tsigga, Zivka Dika, Indrapal I. Meshram, Ei Ei K. Nang, Ian Rouse, Rusidah Selamat, Paul Korrovits, Grethe S. Tell, Julie Taylor, Anabela Mota-Pinto, Paolo Vineis, Kotsedi D Monyeki, Khuong Quynh Long, Frank J Rühli, Shelly R. McFarlane, Sara Santos Sanz, Edyta Łuszczki, Maria G. Stathopoulou, Tara Coppinger, Karin De Ridder, Lucie Viet, Anna Bugge, Mehdi Yaseri, Safiah Md Yusof, Sandra C. Fuchs, Muhammad Islam, Irfan Nuhoglu, Rui Providência, Bernard Maire, Leandra Abarca-Gómez, Sinead Brophy, Maria Ruiz-Castell, Daniela Pierannunzio, Cristina Taddei, Gowri Mahasampath, Gustavo Velasquez-Melendez, Hanna Tolonen, Sudhir Kowlessur, Bagher Larijani, Laura Torres-Collado, Susi Kriemler, Ali Akbar Shayesteh, Cynthia Robitaille, Jorge Escobedo-de la Peña, Yufang Bi, Chinh Nguyen Huu, Line Tang Møllehave, Vincent Jr DeGennaro, Noor Ani Ahmad, Anar Dushpanova, Agustinus Soemantri, Susana Sans, Ionela Pascanu, Gwenaëlle Le Coroller, Inger Ariansen, Kodanda R Kanala, Gert B. M. Mensink, Abhijit Sen, Sergej M. Ostojic, Hanan F. Abdul Rahim, Hélène Delisle, Francisco J. Félix-Redondo, Yadlapalli S. Kusuma, Michael Knoflach, Moein Yoosefi, Tanja G. M. Vrijkotte, Wolfgang Ahrens, Osvaldo Santos, Bethlehem D. Solomon, Erik Lykke Mortensen, Nikhil D. Patel, Reynaldo Martorell, Ching-Yu Cheng, Stine Schramm, Hana Shimizu-Furusawa, Jacek Jóźwiak, Radwan Qasrawi, Herman Borghs, Zhanna Kalmatayeva, Heidi Klakk, Akram Pourshams, Naomi S. Levitt, Son Thai Pham, Simona Giampaoli, Dong Zhao, Indah Suci Widyahening, Merete Osler, Paula Margozzini, Silvia Bel-Serrat, Dora Romaguera, Monira Alarouj, Winsome R. Parnell, Marloes Cardol, Giota Touloumi, Janice Luisa Lukrafka, Adela Chirita-Emandi, Maryam Kavousi, Sanja Musić Milanović, Jean-Michel Gaspoz, Jalila El Ati, Sauli Herrala, Liang Xu, Pilar Guallar-Castillón, Bee Koon Poh, Luis Serra-Majem, Jonathan E. Shaw, Belong Cho, Daphne Mirkopoulou, Salvador Villalpando, Yuki Fujita, Tiffany K. Gill, Nish Chaturvedi, Erkin M. Mirrakhimov, Günay Can, Mark Woodward, Esther Lopez-Garcia, Mauro Virgílio Gomes de Barros, Ahmed A. Madar, Shoaib Afzal, Melanie J. Cowan, Gareth Stratton, Eduardo Salazar Martinez, Sameer Narake, Norie Sawada, Deepak Amarapurkar, Deepa Weerasekera, Diana A. Santos, Marjeta Majer, Herman Schargrodsky, Bruna Gonçalves Cordeiro da Silva, Ebrahim Eftekhar, Jesús Vioque, Marisa K. Sophiea, Teresa Shamah-Levy, María Dolores Chirlaque, Mohd Azahadi Omar, Stefan Söderberg, Isabel O. Oliveira, Joanne Katz, Xingwang Ye, Christophe Tzourio, Marie Zins, Aneta Weres, Ulrich Keil, Haiquan Xu, Akihiro Yoshihara, Rachel Dankner, Gabriella Gruden, Maroje Sorić, Hanspeter Stamm, Kim Overvad, Yanping Li, Carsten Oliver Schmidt, Christa L. Lilly, Veikko Salomaa, Gilad Twig, Senthil K Vasan, Qian Wang, Liufu Cui, Andrzej Galbarczyk, Sylvain Sebert, Wilma M. Hopman, Karl-Heinz Jöckel, Ari Voutilainen, Peter Schnohr, Jerzy Chudek, Katia Vergetti Bloch, Vincenzo Capuano, Jyh Eiin Wong, Torben Jørgensen, Anja Schienkiewitz, Nader Saki, Carolina Tarqui-Mamani, Maria Cecília Formoso Assunção, Kazi M. Jamil, Juraci Almeida Cesar, Pedro J Ortiz, Delphine De Smedt, Luciana Zaccagni, Lynne M. Boddy, Jie Hao, David Alejandro González-Chica, Romana Roccaldo, Sara Magnacca, Peter Stehle, Victoria Farrugia Sant'Angelo, Gry Skodje, Maryam Keramati, Tabara Yasuharu, Ali Ghanbari, Gyulli M. Kazakbaeva, Takuro Furusawa, Felicia Cañete, Kari Kuulasmaa, Justina Vaitkeviciute, (NCD-RisC), NCD Risk Factor Collaboration, Imperial College London, Harvard T.H. Chan School of Public Health, Middlesex University [London], Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Montpellier Interdisciplinary center on Sustainable Agri-food systems (Social and nutritional sciences) (UMR MoISA), Centre de Coopération Internationale en Recherche Agronomique pour le Développement (Cirad)-Institut de Recherche pour le Développement (IRD)-Centre International de Hautes Etudes Agronomiques Méditerranéennes - Institut Agronomique Méditerranéen de Montpellier (CIHEAM-IAMM), Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Centre International de Hautes Études Agronomiques Méditerranéennes (CIHEAM)-Institut national d’études supérieures agronomiques de Montpellier (Montpellier SupAgro), 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)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Interactions Gène-Environnement en Physiopathologie Cardio-Vasculaire (IGE-PCV), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Wellcome TrustEuropean Commission, Clinical Developmental Psychology, APH - Mental Health, Sociology, The Social Context of Aging (SoCA), Nutrition and Health, Iurilli, Maria LC [0000-0003-0409-1635], Zhou, Bin [0000-0002-1741-8628], Ezzati, Majid [0000-0002-2109-8081], Apollo - University of Cambridge Repository, Epidemiology and Data Science, APH - Aging & Later Life, APH - Societal Participation & Health, Public and occupational health, APH - Health Behaviors & Chronic Diseases, VU University medical center, APH 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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 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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 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, 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 , 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, Luxia Zhang , Zhen-Yu Zhang , Dong Zhao , Ming-Hui Zhao , Wenhua Zhao , Shiqi Zhen , Wei Zheng , Yingfeng Zheng , Bekbolat Zholdin , Maigeng Zhou , Dan Zhu , Marie Zins , Emanuel Zitt , Yanina Zocalo , Julio Zuñiga Cisneros , Monika Zuziak , Majid Ezzati , Sarah Filippi, Epidemiology, Iurilli, Maria LC, Zhou, Bin, Bennett, James E, Carrillo-Larco, Rodrigo M, Sophiea, Marisa K, Rodriguez-Martinez, Andrea, Bixby, Honor, Solomon, Bethlehem D, Taddei, Cristina, Danaei, Goodarz, Di Cesare, Mariachiara, Stevens, Gretchen A, Riley, Leanne M, Savin, Stefan, Cowan, Melanie J, Bovet, Pascal, Damasceno, Albertino, Chirita-Emandi, Adela, Hayes, Alison J, Ikeda, Nayu, Jackson, Rod T, Khang, Young-Ho, Laxmaiah, Avula, Liu, Jing, Miranda, J Jaime, Saidi, Olfa, Sebert, Sylvain, Sorić, Maroje, Starc, Gregor, Gregg, Edward W, Abarca-Gómez, Leandra, Abdeen, Ziad A, Abdrakhmanova, Shynar, Ghaffar, Suhaila Abdul, Rahim, Hanan F Abdul, Abu-Rmeileh, Niveen M, Garba, Jamila Abubakar, Acosta-Cazares, 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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, 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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
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31. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants

Author: Zhou, Bin Carrillo-Larco, Rodrigo M. Danaei, Goodarz Riley, Leanne M. Paciorek, Christopher J. Stevens, Gretchen A. and Gregg, Edward W. Bennett, James E. Solomon, Bethlehem and Singleton, Rosie K. Sophiea, Marisa K. Iurilli, Maria L. C. and Lhoste, Victor P. F. Cowan, Melanie J. Savin, Stefan and Woodward, Mark Balanova, Yulia Cifkova, Renata Damasceno, Albertino Elliott, Paul Farzadfar, Farshad He, Jiang and Ikeda, Nayu Kengne, Andre P. Khang, Young-Ho Kim, Hyeon Chang Laxmaiah, Avula Lin, Hsien-Ho Margozzini Maira, Paula and Miranda, J. Jaime Neuhauser, Hannelore Sundstrom, Johan and Varghese, Cherian Widyahening, Indah S. Zdrojewski, Tomasz and Ezzati, Majid Abarca-Gomez, Leandra Abdeen, Ziad A. Rahim, Hanan F. Abdul Abu-Rmeileh, Niveen M. Acosta-Cazares, Benjamin and Adams, Robert J. Aekplakorn, Wichai Afsana, Kaosar and Afzal, Shoaib Agdeppa, Imelda A. Aghazadeh-Attari, Javad and Aguilar-Salinas, Carlos A. Agyemang, Charles Ahmad, Noor Ani and Ahmadi, Ali Ahmadi, Naser Ahmadi, Nastaran Ahmadizar, Fariba and Ahmed, Soheir H. Ahrens, Wolfgang Ajlouni, Kamel and Al-Raddadi, Rajaa Alarouj, Monira AlBuhairan, Fadia and AlDhukair, Shahla Ali, Mohamed M. Alkandari, Abdullah and Alkerwi, Ala'a Allin, Kristine Aly, Eman Amarapurkar, Deepak N. Amougou, Norbert Amouyel, Philippe Andersen, Lars Bo and Anderssen, Sigmund A. Anjana, Ranjit Mohan Ansari-Moghaddam, Alireza Ansong, Daniel Aounallah-Skhiri, Hajer Araujo, Joana and Ariansen, Inger Aris, Tahir Arku, Raphael E. Arlappa, Nimmathota Aryal, Krishna K. Aspelund, Thor Assah, Felix K. and Assuncao, Maria Cecilia F. Auvinen, Juha Avdicova, Maria and Azevedo, Ana Azimi-Nezhad, Mohsen Azizi, Fereidoun Azmin, Mehrdad Babu, Bontha V. Bahijri, Suhad Balakrishna, Nagalla and Balanova, Yulia Bamoshmoosh, Mohamed Banach, Maciej and Banadinovic, Maja Bandosz, Piotr Banegas, Jose R. Baran, Joanna Barbagallo, Carlo M. Barcelo, Alberto Barkat, Amina and Barreto, Marta Barros, Aluisio J. D. Gomes Barros, Mauro Virgilio Bartosiewicz, Anna Basit, Abdul Bastos, Joao Luiz D. Bata, Iqbal Batieha, Anwar M. Batyrbek, Assembekov and Baur, Louise A. Beaglehole, Robert Belavendra, Antonisamy and Ben Romdhane, Habiba Benet, Mikhail Bennett, James E. and Benson, Lowell S. Berkinbayev, Salim Bernabe-Ortiz, Antonio and Bettiol, Heloisa Bezerra, Jorge Bhagyalaxmi, Aroor Bhargava, Santosh K. Bia, Daniel Biasch, Katia Lele, Elysee Claude Bika Bikbov, Mukharram M. Bista, Bihungum Bjerregaard, Peter and Bjertness, Espen Bjertness, Marius B. Bjorkelund, Cecilia and Bloch, Katia V. Blokstra, Anneke Bo, Simona Bobak, Martin Boeing, Heiner Boggia, Jose G. Boissonnet, Carlos P. and Bojesen, Stig E. Bongard, Vanina Bonilla-Vargas, Alice and Bopp, Matthias Borghs, Herman Bovet, Pascal Boyer, Christopher B. Braeckman, Lutgart Brajkovich, Imperia and Branca, Francesco Breckenkamp, Juergen Brenner, Hermann and Brewster, Lizzy M. Briceno, Yajaira Brito, Miguel Bruno, Graziella Bueno-de-Mesquita, H. Bas Bueno, Gloria Bugge, Anna Burns, Con Bursztyn, Michael Cabrera de Leon, Antonio and Cacciottolo, Joseph Cameron, Christine Can, Gunay and Candido, Ana Paula C. Capanzana, Mario V. Capkova, Nadezda and Capuano, Eduardo Capuano, Vincenzo Cardoso, Viviane C. and Carlsson, Axel C. Carvalho, Joana Casanueva, Felipe F. and Censi, Laura Cervantes-Loaiza, Marvin Chadjigeorgiou, Charalambos A. Chamukuttan, Snehalatha Chan, Angelique W. and Chan, Queenie Chaturvedi, Himanshu K. Chaturvedi, Nish Chee, Miao Li Chen, Chien-Jen Chen, Fangfang Chen, Huashuai and Chen, Shuohua Chen, Zhengming Cheng, Ching-Yu Cheraghian, Bahman Dekkaki, Imane Cherkaoui Chetrit, Angela Chien, Kuo-Liong Chiolero, Arnaud Chiou, Shu-Ti Chirita-Emandi, Adela Chirlaque, Maria-Dolores Cho, Belong Christensen, Kaare Christofaro, Diego G. Chudek, Jerzy Cifkova, Renata and Cinteza, Eliza Claessens, Frank Clarke, Janine Clays, Els Cohen, Emmanuel Concin, Hans Cooper, Cyrus and Coppinger, Tara C. Costanzo, Simona Cottel, Dominique and Cowell, Chris Craig, Cora L. Crampin, Amelia C. Crujeiras, Ana B. Cruz, Juan J. Csilla, Semanova Cui, Liufu Cureau, Felipe V. Cuschieri, Sarah D'Arrigo, Graziella d'Orsi, Eleonora Dallongeville, Jean Damasceno, Albertino Danaei, Goodarz Dankner, Rachel Dantoft, Thomas M. Dauchet, Luc and Davletov, Kairat De Backer, Guy De Bacquer, Dirk De Curtis, Amalia de Gaetano, Giovanni De Henauw, Stefaan de Oliveira, Paula Duarte De Ridder, David De Smedt, Delphine Deepa, Mohan Deev, Alexander D. DeGennaro, Vincent Jr Delisle, Helene Demarest, Stefaan Dennison, Elaine Deschamps, Valerie and Dhimal, Meghnath Di Castelnuovo, Augusto F. Dias-da-Costa, Juvenal Soares Diaz, Alejandro Dickerson, Ty T. Dika, Zivka and Djalalinia, Shirin Do, Ha T. P. Dobson, Annette J. and Donfrancesco, Chiara Donoso, Silvana P. Doering, Angela and Dorobantu, Maria Doerr, Marcus Doua, Kouamelan Dragano, Nico and Drygas, Wojciech Duante, Charmaine A. Duboz, Priscilla and Duda, Rosemary B. Dulskiene, Virginija Dushpanova, Anar and Dzakula, Aleksandar Dzerve, Vilnis Dziankowska-Zaborszczyk, Elzbieta Eddie, Ricky Eftekhar, Ebrahim Eggertsen, Robert and Eghtesad, Sareh Eiben, Gabriele Ekelund, Ulf El-Khateeb, Mohammad El Ati, Jalila Eldemire-Shearer, Denise Eliasen, Marie Elliott, Paul Elosua, Roberto Erasmus, Rajiv T. and Erbel, Raimund Erem, Cihangir Eriksen, Louise Eriksson, Johan G. Escobedo-de la Pena, Jorge Eslami, Saeid Esmaeili, Ali Evans, Alun Faeh, David Fakhretdinova, Albina A. and Fall, Caroline H. Faramarzi, Elnaz Farjam, Mojtaba and Farzadfar, Farshad Fattahi, Mohammad Reza Fawwad, Asher and Felix-Redondo, Francisco J. Felix, Stephan B. Ferguson, Trevor S. Fernandes, Romulo A. Fernandez-Berges, Daniel Ferrante, Daniel Ferrao, Thomas Ferrari, Marika Ferrario, Marco M. and Ferreccio, Catterina Ferreira, Haroldo S. Ferrer, Eldridge and Ferrieres, Jean Figueiro, Thamara Hubler Fink, Gunther and Fischer, Krista Foo, Leng Huat Forsner, Maria Fouad, Heba M. and Francis, Damian K. Franco, Maria do Carmo Frikke-Schmidt, Ruth Frontera, Guillermo Fuchs, Flavio D. Fuchs, Sandra C. and Fujita, Yuki Fumihiko, Matsuda Furdela, Viktoriya Furer, Ariel Furusawa, Takuro Gaciong, Zbigniew Galbarczyk, Andrzej and Galenkamp, Henrike Galvano, Fabio Gao, Jingli Gao, Pei and Garcia-de-la-Hera, Manoli Garcia, Pablo Gareta, Dickman and Garnett, Sarah P. Gaspoz, Jean-Michel Gasull, Magda and Gazzinelli, Andrea Gehring, Ulrike Geleijnse, Johanna M. and George, Ronnie Ghanbari, Ali Ghasemi, Erfan Gheorghe-Fronea, Oana-Florentina Ghimire, Anup Gialluisi, Alessandro and Giampaoli, Simona Gieger, Christian Gill, Tiffany K. and Giovannelli, Jonathan Gironella, Glen Giwercman, Aleksander and Gkiouras, Konstantinos Goldberg, Marcel Goldsmith, Rebecca A. and Gomez, Luis F. Gomula, Aleksandra Cordeiro da Silva, Bruna Goncalves Goncalves, Helen Goncalves, Mauer Gonzalez-Chica, David A. Gonzalez-Gross, Marcela Gonzalez-Rivas, Juan P. and Gonzalez-Villalpando, Clicerio Gonzalez-Villalpando, Maria-Elena and Gonzalez, Angel R. Bonet Gorbea, Mariano Gottrand, Frederic and Graff-Iversen, Sidsel Grafnetter, Dusan Grajda, Aneta and Grammatikopoulou, Maria G. Gregor, Ronald D. Grodzicki, Tomasz and Grosso, Giuseppe Gruden, Gabriella Gu, Dongfeng Guan, Ong Peng Gudmundsson, Elias F. Gudnason, Vilmundur Guerrero, Ramiro Guessous, Idris Guimaraes, Andre L. Gulliford, Martin C. Gunnlaugsdottir, Johanna Gunter, Marc J. Gupta, Prakash C. Gupta, Rajeev Gureje, Oye Gurzkowska, Beata and Gutierrez, Laura Gutzwiller, Felix Ha, Seongjun Hadaegh, Farzad Haghshenas, Rosa Hakimi, Hamid Halkjaer, Jytte and Hambleton, Ian R. Hamzeh, Behrooz Hange, Dominique Hanif, Abu A. M. Hantunen, Sari Hao, Jie Hardman, Carla Meneses and Kumar, Rachakulla Hari Hashemi-Shahri, Seyed Mohammad Hata, Jun and Haugsgjerd, Teresa Hayes, Alison J. He, Jiang He, Yuna and Heier, Margit Hendriks, Marleen Elisabeth Henrique, Rafael dos Santos Henriques, Ana Cadena, Leticia Hernandez Herrala, Sauli Heshmat, Ramin Hill, Allan G. Ho, Sai Yin Ho, Suzanne C. Hobbs, Michael Holdsworth, Michelle Homayounfar, Reza Dinc, Gonul Horasan Horimoto, Andrea R. V. R. Hormiga, Claudia M. Horta, Bernardo L. Houti, Leila Howitt, Christina and Htay, Thein Thein Htet, Aung Soe Htike, Maung Maung Than and Hu, Yonghua Huerta, Jose Maria Huhtaniemi, Ilpo Tapani and Huiart, Laetitia Huisman, Martijn Husseini, Abdullatif S. and Huybrechts, Inge Hwalla, Nahla Iacoviello, Licia Iannone, Anna G. Ibrahim, Mohsen M. Wong, Norazizah Ibrahim Ikeda, Nayu Ikram, M. Arfan Iotova, Violeta Irazola, Vilma E. and Ishida, Takafumi Isiguzo, Godsent C. Islam, Muhammad Islam, Sheikh Mohammed Shariful Iwasaki, Masanori Jackson, Rod T. and Jacobs, Jeremy M. Jaddou, Hashem Y. Jafar, Tazeen James, Kenneth Jamrozik, Konrad Janszky, Imre Janus, Edward and Jarvelin, Marjo-Riitta Jasienska, Grazyna Jelakovic, Ana and Jelakovic, Bojan Jennings, Garry Jha, Anjani Kumar Jiang, Chao Qiang Jimenez, Ramon O. Joeckel, Karl-Heinz Joffres, Michel Johansson, Mattias Jokelainen, Jari J. Jonas, Jost B. and Jorgensen, Torben Joshi, Pradeep Joukar, Farahnaz and Jozwiak, Jacek Juolevi, Anne Jurak, Gregor Juresa, Vesna and Kaaks, Rudolf Kafatos, Anthony Kajantie, Eero O. and Kalmatayeva, Zhanna Kalpourtzi, Natasa Kalter-Leibovici, Ofra and Kampmann, Freja B. Kannan, Srinivasan Karaglani, Eva and Karhus, Line L. Karki, Khem B. Katibeh, Marzieh Katz, Joanne and Kauhanen, Jussi Kaur, Prabhdeep Kavousi, Maryam and Kazakbaeva, Gyulli M. Keil, Ulrich Boker, Lital Keinan and Keinanen-Kiukaanniemi, Sirkka Kelishadi, Roya Kemper, Han C. G. and Kengne, Andre P. Keramati, Maryam Kerimkulova, Alina and Kersting, Mathilde Key, Timothy Khader, Yousef Saleh and Khalili, Davood Khang, Young-Ho Khaw, Kay-Tee Kheiri, Bahareh Kheradmand, Motahareh Khosravi, Alireza and Kiechl-Kohlendorfer, Ursula Kiechl, Stefan Killewo, Japhet and Kim, Dong Wook Kim, Hyeon Chang Kim, Jeongseon Klakk, Heidi and Klimek, Magdalena Klumbiene, Jurate Knoflach, Michael and Kolle, Elin Kolsteren, Patrick Kontto, Jukka P. Korpelainen, Raija Korrovits, Paul Kos, Jelena Koskinen, Seppo Kouda, Katsuyasu Kowlessur, Sudhir Koziel, Slawomir Kratenova, Jana and Kriaucioniene, Vilma Kristensen, Peter Lund Krokstad, Steiner Kromhout, Daan Kruger, Herculina S. Kubinova, Ruzena and Kuciene, Renata Kujala, Urho M. Kulaga, Zbigniew Kumar, R. Krishna Kurjata, Pawel Kusuma, Yadlapalli S. Kutsenko, Vladimir Kuulasmaa, Kari Kyobutungi, Catherine Laatikainen, Tiina Lachat, Carl Laid, Youcef Lam, Tai Hing Landrove, Orlando Lanska, Vera Lappas, Georg Larijani, Bagher and Latt, Tint Swe Laxmaiah, Avula Le Coroller, Gwenaelle Khanh Le Nguyen Bao Le, Tuyen D. Lee, Jeannette Lee, Jeonghee and Lehmann, Nils Lehtimaki, Terho Lemogoum, Daniel Levitt, Naomi S. Li, Yanping Lilly, Christa L. Lim, Wei-Yen and Lima-Costa, M. Fernanda Lin, Hsien-Ho Lin, Xu Lin, Yi-Ting and Lind, Lars Lingam, Vijaya Linneberg, Allan Lissner, Lauren Litwin, Mieczyslaw Lo, Wei-Cheng Loit, Helle-Mai and Lopez-Garcia, Esther Lopez, Tania Lotufo, Paulo A. Lozano, Jose Eugenio Lovrencic, Iva Lukacevic Lukrafka, Janice L. and Luksiene, Dalia Lundqvist, Annamari Lundqvist, Robert Lunet, Nuno Lustigova, Michala Luszczki, Edyta Ma, Guansheng and Ma, Jun Machado-Coelho, George L. L. Machado-Rodrigues, Aristides M. Macia, Enguerran Macieira, Luisa M. Madar, Ahmed A. Maggi, Stefania Magliano, Dianna J. Magriplis, Emmanuella Mahasampath, Gowri Maire, Bernard Majer, Marjeta and Makdisse, Marcia Malekzadeh, Fatemeh Malekzadeh, Reza and Malhotra, Rahul Mallikharjuna, Kodavanti Malyutina, Sofia K. and Maniego, Lynell V. Manios, Yannis Mann, Jim I. and Mansour-Ghanaei, Fariborz Manzato, Enzo Marcil, Anie and Margozzini, Paula Marild, Staffan B. Glavic, Mihalea Marinovic and Marques-Vidal, Pedro Marques, Larissa Pruner Marrugat, Jaume and Martorell, Reynaldo Mascarenhas, Luis P. Matasin, Marija and Mathiesen, Ellisiv B. Mathur, Prashant Matijasevich, Alicia and Matlosz, Piotr Matsha, Tandi E. Mavrogianni, Christina and Mbanya, Jean Claude N. Mc Donald Posso, Anselmo J. McFarlane, Shelly R. McGarvey, Stephen T. McLachlan, Stela McLean, Rachael M. McLean, Scott B. McNulty, Breige A. Benchekor, Sounnia Mediene Medzioniene, Jurate Mehdipour, Parinaz and Mehlig, Kirsten Mehrparvar, Amir Houshang Meirhaeghe, Aline and Meisinger, Christa Mendoza Montano, Carlos Menezes, Ana Maria B. and Menon, Geetha R. Mereke, Alibek Meshram, Indrapal I. and Metspalu, Andres Meyer, Haakon E. Mi, Jie Michels, Nathalie and Mikkel, Kairit Milkowska, Karolina Miller, Jody C. and Minderico, Claudia S. Mini, G. K. Miranda, J. Jaime and Mirjalili, Mohammad Reza Mirrakhimov, Erkin Misigoj-Durakovic, Marjeta Modesti, Pietro A. Moghaddam, Sahar Saeedi Mohajer, Bahram Mohamed, Mostafa K. Mohamed, Shukri F. Mohammad, Kazem Mohammadi, Mohammad Reza Mohammadi, Zahra and Mohammadifard, Noushin Mohammadpourhodki, Reza Mohan, Viswanathan Mohanna, Salim Yusoff, Muhammad Fadhli Mohd and Mohebbi, Iraj Mohebi, Farnam Moitry, Marie Mollehave, Line T. Molnar, Denes Momenan, Amirabbas Mondo, Charles K. and Monterrubio-Flores, Eric Monyeki, Kotsedi Daniel K. Moon, Jin Soo Moosazadeh, Mahmood Moreira, Leila B. Morejon, Alain and Moreno, Luis A. Morgan, Karen Moschonis, George Mossakowska, Malgorzata Mostafa, Aya Mostafavi, Seyed-Ali Mota, Jorge and Motlagh, Mohammad Esmaeel Motta, Jorge Andre Moura-dos-Santos, Marcos Mridha, Malay K. Msyamboza, Kelias P. Mu, Thet Thet and Muhihi, Alfa J. Muiesan, Maria L. Muller-Nurasyid, Martina and Murphy, Neil Mursu, Jaakko Musa, Kamarul Imran and Milanovic, Sanja Music Musil, Vera Mustafa, Norlaila and Nabipour, Iraj Naderimagham, Shohreh Nagel, Gabriele Naidu, Balkish M. Najafi, Farid Nakamura, Harunobu Namesna, Jana and Nang, Ei Ei K. Nangia, Vinay B. Narake, Sameer Ndiaye, Ndeye Coumba Neal, William A. Nejatizadeh, Azim Nenko, Ilona and Neovius, Martin Neuhauser, Hannelore K. Nguyen, Chung T. and Nguyen, Nguyen D. Nguyen, Quang V. Quang Ngoc Nguyen and Nieto-Martinez, Ramfis E. Niiranen, Teemu J. Nikitin, Yury P. and Ninomiya, Toshiharu Nishtar, Sania Njelekela, Marina A. and Noale, Marianna Noboa, Oscar A. Noorbala, Ahmad Ali Norat, Teresa Nordendahl, Maria Nordestgaard, Borge G. Noto, Davide and Nowak-Szczepanska, Natalia Al Nsour, Mohannad Nunes, Baltazar O'Neill, Terence W. O'Reilly, Dermot Ochimana, Caleb Oda, Eiji Odili, Augustine N. Oh, Kyungwon Ohara, Kumiko Ohtsuka, Ryutaro Olie, Valerie Olinto, Maria Teresa A. Oliveira, Isabel O. Omar, Mohd Azahadi Onat, Altan and Ong, Sok King Ono, Lariane M. Ordunez, Pedro Ornelas, Rui and Ortiz, Pedro J. Osmond, Clive Ostojic, Sergej M. and Ostovar, Afshin Otero, Johanna A. Overvad, Kim Owusu-Dabo, Ellis Paccaud, Fred Michel Padez, Cristina Pahomova, Elena and de Paiva, Karina Mary Pajak, Andrzej Palli, Domenico and Palmieri, Luigi Pan, Wen-Harn Panda-Jonas, Songhomitra and Panza, Francesco Paoli, Mariela Papandreou, Dimitrios Park, Soon-Woo Park, Suyeon Parnell, Winsome R. Parsaeian, Mahboubeh Pasquet, Patrick Patel, Nikhil D. Pavlyshyn, Halyna Pecin, Ivan Pednekar, Mangesh S. Pedro, Joao M. and Peer, Nasheeta Peixoto, Sergio Viana Peltonen, Markku and Pereira, Alexandre C. Peres, Karen G. D. A. Peres, Marco A. and Peters, Annette Petkeviciene, Janina Peykari, Niloofar Son Thai Pham Pichardo, Rafael N. Pigeot, Iris Pikhart, Hynek and Pilav, Aida Pilotto, Lorenza Pitakaka, Freda Piwonska, Aleksandra Pizarro, Andreia N. Plans-Rubio, Pedro Polasek, Ozren Porta, Miquel Poudyal, Anil Pourfarzi, Farhad and Pourshams, Akram Poustchi, Hossein Pradeepa, Rajendra Price, Alison J. Price, Jacqueline F. Providencia, Rui Puhakka, Soile E. Puiu, Maria Punab, Margus Qasrawi, Radwan F. and Qorbani, Mostafa Queiroz, Daniel Tran Quoc Bao Radic, Ivana and Radisauskas, Ricardas Rahimikazerooni, Salar Rahman, Mahfuzar Raitakari, Olli Raj, Manu Rakhimova, Ellina M. and Rao, Sudha Ramachandra Ramachandran, Ambady Ramos, Elisabete and Rampal, Lekhraj Rampal, Sanjay Rangel Reina, Daniel A. and Rarra, Vayia Rech, Cassiano Ricardo Redon, Josep Reganit, Paul Ferdinand M. Regecova, Valeria Revilla, Luis and Rezaianzadeh, Abbas Ribeiro, Robespierre Riboli, Elio and Richter, Adrian Rigo, Fernando de Wit, Tobias F. Rinke and Ritti-Dias, Raphael M. Robitaille, Cynthia Rodriguez-Artalejo, Fernando del Cristo Rodriguez-Perez, Maria Rodriguez-Villamizar, Laura A. Roggenbuck, Ulla Rojas-Martinez, Rosalba Romaguera, Dora Romeo, Elisabetta L. Rosengren, Annika Roy, Joel G. R. and Rubinstein, Adolfo Ruidavets, Jean-Bernard Sandra Ruiz-Betancourt, Blanca Ruiz-Castell, Maria Rusakova, Iuliia A. and Russo, Paola Rutkowski, Marcin Sabanayagam, Charumathi and Sabbaghi, Hamideh Sachdev, Harshpal S. Sadjadi, Alireza and Safarpour, Ali Reza Safi, Sare Safiri, Saeid Saidi, Olfa and Sakarya, Sibel Saki, Nader Salanave, Benoit Salazar Martinez, Eduardo Salmeron, Diego Salomaa, Veikko Salonen, Jukka T. Salvetti, Massimo Sanchez-Abanto, Jose Sans, Susana and Santos, Diana A. Santos, Ina S. Santos, Lelita C. and Santos, Maria Paula Santos, Rute Saramies, Jouko L. and Sardinha, Luis B. Sarganas, Giselle Sarrafzadegan, Nizal and Sathish, Thirunavukkarasu Saum, Kai-Uwe Savva, Savvas and Sawada, Norie Sbaraini, Mariana Scazufca, Marcia Schaan, Beatriz D. Schargrodsky, Herman Schipf, Sabine Schmidt, Carsten O. Schnohr, Peter Schoettker, Ben Schramm, Sara and Schultsz, Constance Schutte, Aletta E. Sebert, Sylvain Sein, Aye Aye Sen, Abhijit Senbanjo, Idowu O. Sepanlou, Sadaf G. and Servais, Jennifer Shalnova, Svetlana A. Shamah-Levy, Teresa and Shamshirgaran, Morteza Shanthirani, Coimbatore Subramaniam and Sharafkhah, Maryam Sharma, Sanjib K. Shaw, Jonathan E. and Shayanrad, Amaneh Shayesteh, Ali Akbar Shi, Zumin Shibuya, Kenji Shimizu-Furusawa, Hana Shin, Dong Wook Shirani, Majid and Shiri, Rahman Shrestha, Namuna Si-Ramlee, Khairil Siani, Alfonso Siantar, Rosalynn Sibai, Abla M. de Moura Silva, Caroline Ramos Santos Silva, Diego Augusto Simon, Mary and Simons, Judith Simons, Leon A. Sjostrom, Michael and Slowikowska-Hilczer, Jolanta Slusarczyk, Przemyslaw Smeeth, Liam and So, Hung-Kwan Soares, Fernanda Cunha Sobngwi, Eugene and Soderberg, Stefan Soemantri, Agustinus Sofat, Reecha and Solfrizzi, Vincenzo Somi, Mohammad Hossein Sonestedt, Emily and Song, Yi Sorensen, Thorkild I. A. Sorgjerd, Elin P. Soric, Maroje Jerome, Charles Sossa Soumare, Aicha Sparboe-Nilsen, Bente Sparrenberger, Karen Staessen, Jan A. Starc, Gregor and Stavreski, Bill Steene-Johannessen, Jostein Stehle, Peter and Stein, Aryeh D. Stergiou, George S. Stessman, Jochanan and Stieber, Jutta Stoeckl, Doris Stocks, Tanja Stokwiszewski, Jakub Stronks, Karien Strufaldi, Maria Wany Suka, Machi and Sun, Chien-An Sundstrom, Johan Sung, Yn-Tz Suriyawongpaisal, Paibul Sy, Rody G. Syddall, Holly E. Sylva, Rene Charles and Szklo, Moyses Tai, E. Shyong Tammesoo, Mari-Liis Tamosiunas, Abdonas Tan, Eng Joo Tang, Xun Tanser, Frank Tao, Yong and Tarawneh, Mohammed Rasoul Tarqui-Mamani, Carolina B. Taylor, Anne Taylor, Julie Tebar, William R. Tell, Grethe S. and Tello, Tania Tham, Yih Chung Thankappan, K. R. Theobald, Holger Theodoridis, Xenophon Thijs, Lutgarde Thinggaard, Mikael Thomas, Nihal Thorand, Barbara Thuesen, Betina H. and Timmermans, Erik J. Tjandrarini, Dwi H. Tjonneland, Anne and Toft, Ulla Tolonen, Hanna K. Tolstrup, Janne S. Topbas, Murat Topor-Madry, Roman Jose Tormo, Maria Tornaritis, Michael J. Torrent, Maties Torres-Collado, Laura Touloumi, Giota Traissac, Pierre Triantafyllou, Areti Trichopoulos, Dimitrios Trichopoulou, Antonia Trinh, Oanh T. H. Trivedi, Atul Tshepo, Lechaba Tsugane, Shoichiro Tuliakova, Azaliia M. Tulloch-Reid, Marshall K. Tullu, Fikru Tuomainen, Tomi-Pekka Tuomilehto, Jaakko Turley, Maria L. Twig, Gilad and Tynelius, Per Tzourio, Christophe Ueda, Peter Ugel, Eunice Ulmer, Hanno Uusitalo, Hannu M. T. Valdivia, Gonzalo and Valvi, Damaskini van Dam, Rob M. van den Born, Bert-Jan and Van der Heyden, Johan van der Schouw, Yvonne T. Van Herck, Koen and Hoang Van Minh Van Schoor, Natasja M. van Valkengoed, Irene G. M. van Zutphen, Elisabeth M. Vanderschueren, Dirk and Vanuzzo, Diego Varbo, Anette Vasan, Senthil K. Vega, Tomas and Veidebaum, Toomas Velasquez-Melendez, Gustavo Veronesi, Giovanni Verschuren, W. M. Monique Verstraeten, Roosmarijn and Victora, Cesar G. Viet, Lucie Villalpando, Salvador Vineis, Paolo Vioque, Jesus Virtanen, Jyrki K. Visvikis-Siest, Sophie Viswanathan, Bharathi Vlasoff, Tiina Vollenweider, Peter Voutilainen, Ari Wade, Alisha N. Walton, Janette and Wambiya, Elvis O. A. Bebakar, Wan Mohamad Wan Mohamud, Wan Nazaimoon Wan Wanderley Junior, Rildo de Souza Wang, Ming-Dong and Wang, Ningli Wang, Qian Wang, Xiangjun Wang, Ya Xing and Wang, Ying-Wei Wannamethee, S. Goya Wareham, Nicholas Wei, Wenbin Weres, Aneta Werner, Bo Whincup, Peter H. and Widhalm, Kurt Widyahening, Indah S. Wiecek, Andrzej Wilks, Rainford J. Willeit, Johann Willeit, Peter Williams, Emmanuel A. Wilsgaard, Tom Wojtyniak, Bogdan Wong-McClure, Roy A. Wong, Andrew Wong, Tien Yin Woo, Jean Woodward, Mark Wu, Frederick C. Wu, Shouling Wyszynska, Justyna and Xu, Haiquan Xu, Liang Yaacob, Nor Azwany Yan, Weili and Yang, Ling Yang, Xiaoguang Yang, Yang Yasuharu, Tabara and Ye, Xingwang Yiallouros, Panayiotis K. Yoosefi, Moein and Yoshihara, Akihiro You, San-Lin Younger-Coleman, Novie O. and Yusoff, Ahmad Faudzi Zainuddin, Ahmad A. Zakavi, Seyed Rasoul and Zamani, Farhad Zambon, Sabina Zampelas, Antonis Elisa Zapata, Maria Zaw, Ko Ko Zdrojewski, Tomasz Zejglicova, Kristyna Vrkic, Tajana Zeljkovic Zeng, Yi Zhang, Luxia and Zhang, Zhen-Yu Zhao, Dong Zhao, Ming-Hui Zhen, Shiqi and Zheng, Yingfeng Zholdin, Bekbolat Zhu, Dan Zins, Marie and Zitt, Emanuel Zocalo, Yanina Zoghlami, Nada Zuniga Cisneros, Julio NCD Risk Factor Collaboration
Abstract: Background Hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods We used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings The number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings. Copyright (C) 2021 World Health Organization; licensee Elsevier.
Published: 2021

32. 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. 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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
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33. Serum acylcarnitines and amino acids and risk of type 2 diabetes in a multiethnic Asian population

Author: Samuel H Gunther, Chin Meng Khoo, Xueling Sim, Jean-Paul Kovalik, Jeannette Lee, Rob M. van Dam, E-Shyong Tai, and Jianhong Ching
Subjects: Male, medicine.medical_specialty, Diabetes risk, Asia, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Phenylalanine, Type 2 diabetes, Lower risk, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Risk Factors, Internal medicine, Diabetes mellitus, Carnitine, medicine, Humans, Prospective Studies, Amino Acids, Prospective cohort study, 030304 developmental biology, 0303 health sciences, Singapore, business.industry, Genetics/Genomes/Proteomics/Metabolomics, medicine.disease, Endocrinology, chemistry, Diabetes Mellitus, Type 2, Cohort, risk predictors, Female, Glycated hemoglobin, type 2 diabetes, business
Abstract: IntroductionWe evaluated whether concentrations of serum acylcarnitines and amino acids are associated with risk of type 2 diabetes and can improve predictive diabetes models in an Asian population.Research design and methodsWe used data from 3313 male and female participants from the Singapore Prospective Study Program cohort who were diabetes-free at baseline. The average age at baseline was 48.0 years (SD: 11.9 years), and participants were of Chinese, Malay, and Indian ethnicity. Diabetes cases were identified through self-reported physician diagnosis, fasting glucose and glycated hemoglobin concentrations, and linkage to national disease registries. We measured fasting serum concentrations of 45 acylcarnitines and 14 amino acids. The association between metabolites and incident diabetes was modeled using Cox proportional hazards regression with adjustment for age, sex, ethnicity, height, and parental history of diabetes, and correction for multiple testing. Metabolites were added to the Atherosclerosis Risk in Communities (ARIC) predictive diabetes risk model to assess whether they could increase the area under the receiver operating characteristic curve (AUC).ResultsParticipants were followed up for an average of 8.4 years (SD: 2.1 years), during which time 314 developed diabetes. Branched-chain amino acids (HR: 1.477 per SD; 95% CI 1.325 to 1.647) and the alanine to glycine ratio (HR: 1.572; 95% CI 1.426 to 1.733) were most strongly associated with diabetes risk. Additionally, the acylcarnitines C4 and C16-OH, and the amino acids alanine, combined glutamate/glutamine, ornithine, phenylalanine, proline, and tyrosine were significantly associated with higher diabetes risk, and the acylcarnitine C8-DC and amino acids glycine and serine with lower risk. Adding selected metabolites to the ARIC model resulted in a significant increase in AUC from 0.836 to 0.846.ConclusionsWe identified acylcarnitines and amino acids associated with risk of type 2 diabetes in an Asian population. A subset of these modestly improved the prediction of diabetes when added to an established diabetes risk model.
Published: 2020

34. An Integrative Approach to Needs Assessment and Curriculum Development of the First Public Health Major in Singapore

Author: Gina Junna Goh, Raymond Boon Tar Lim, Jeannette Lee, Cecilia Woon Chien Teng, Julian Azfar, and Diane Bun
Subjects: medicine.medical_specialty, Higher education, curriculum, major, 03 medical and health sciences, 0302 clinical medicine, Political science, Internship, Curriculum development, medicine, ComputingMilieux_COMPUTERSANDEDUCATION, Humans, Capstone, 030212 general & internal medicine, Curriculum, Accreditation, Singapore, Medical education, undergraduate, education, ComputingMilieux_THECOMPUTINGPROFESSION, pedagogy, Curriculum, Instruction, and Pedagogy, business.industry, 030503 health policy & services, Public health, lcsh:Public aspects of medicine, public health, Australia, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, United Kingdom, Needs assessment, Hong Kong, 0305 other medical science, business, Needs Assessment
Abstract: Although public health undergraduate education is increasingly popular in the West, studies describing the needs assessment and curriculum development of public health undergraduate education programs are lacking in the Asia Pacific. The objective of this study was to describe the needs assessment and curriculum development of a second major in public health for undergraduates in the National University of Singapore, the first in Singapore. We used the integrated framework for curriculum development in higher education, which consisted of five stages. In Stage 1, the environment was assessed on the need for a new curriculum. Externally, there was a demand for public health workforce in Singapore based on a review of reports from the Ministry of Health and the job portals. Internally, there was a demand from existing students of the university, along with support from the faculty to offer a new curriculum. There was no university in Singapore offering an undergraduate major program in public health. In Stage 2, competencies to be developed were identified from public health job descriptions using job portals, the needs of public health stakeholders, and competencies listed in the public health curriculum accreditation frameworks such as the Council on Education for Public Health. In Stage 3, based on data triangulation, the curriculum was designed as a second major that is offered to all students of the university from year 2 onward. Students have to complete a total of 12 modules, of which 6 are core and 6 are elective. The capstone module is a 320-h internship module where students will be attached to public health–related agencies, organizations, or non-governmental organizations. Our curriculum is generally aligned with undergraduate public health programs in other established universities in the United States of America, United Kingdom, Australia, and Hong Kong. In Stage 4, various pedagogical strategies were identified for the core modules. We are currently at Stage 5 where implementation, monitoring, and evaluation are still being carried out. We hope that the lessons learnt will serve to inform other universities in the Asia Pacific that are considering implementing such programs and broadening their offerings in public health education.
Published: 2020
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35. Initial Development and Content Validation of a Health-Related Symptom Index for Persons either Treated or Monitored for Anal High-Grade Squamous Intraepithelial Lesions

Author: Jack E. Burkhalter, Thomas M. Atkinson, J. Berry-Lawhorn, Stephen Goldstone, Mark H. Einstein, Timothy J. Wilkin, Jeannette Lee, David Cella, Joel M. Palefsky, Erica I. Lubetkin, Jeff Taylor, Nicholas Sheon, Andrew Webb, Susan M. Holland, Madeline Rogers, Elyse Shuk, and Rebecca Levine
Subjects: business.industry, Health Policy, Public Health, Environmental and Occupational Health, Cognition, medicine.disease, High-Grade Squamous Intraepithelial Lesions, Comprehension, 03 medical and health sciences, 0302 clinical medicine, Quality of life, 030220 oncology & carcinogenesis, Content validity, Medicine, Anal cancer, 030212 general & internal medicine, Cognitive interview, business, Qualitative research, Clinical psychology
Abstract: Background Anal cancer, caused by oncogenic types of human papillomavirus, is a growing problem in the United States. A key focus of anal cancer prevention has been screening for and treating precancerous high-grade squamous intraepithelial anal lesions (HSILs). Objectives To develop a health-related symptom index for HSIL using qualitative techniques because anal HSIL and its treatment may have a negative impact on health-related quality of life (HRQOL), and no HRQOL measure specific to this condition and treatment currently exists. Methods Expert consultation was used to guide one-on-one concept elicitation interviews with participants to identify HRQOL aspects they attribute to their anal HSIL and its treatment. This resulted in a draft instrument, which was administered to an independent participant sample, where cognitive interview techniques assessed comprehension. Results Eighteen anal HSIL-related concepts were identified by the expert panel. Across the 41 concept elicitation interviews, 23 items representing physical symptoms, physical impacts, and psychological symptoms were identified to comprise the initial measure, which was then evaluated during three rounds of cognitive interviews (n = 45). Several questionnaire aspects were refined on the basis of participant input, with three additional items added per expert/participant recommendation. One item was removed because of poor comprehension, resulting in a 25-item measure. Conclusions Using state-of-the-art qualitative methodology, we have established the content validity of this new instrument, the ANCHOR Anal HSIL Health-Related Symptom Index. Quantitative validation efforts are currently underway. The participant-driven process of developing this tool will facilitate a participant-centered evaluation of the impact on morbidity for treatment of anal HSIL or observation without treatment.
Published: 2018
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36. A Healthy Asian A Posteriori Dietary Pattern Correlates with A Priori Dietary Patterns and Is Associated with Cardiovascular Disease Risk Factors in a Multiethnic Asian Population

Author: Jeannette Lee, Salome A. Rebello, Rob M. van Dam, E. Shyong Tai, and Clare Whitton
Subjects: Adult, Male, 0301 basic medicine, China, Waist, Mediterranean diet, Dietary Approaches To Stop Hypertension, Cross-sectional study, Health Behavior, India, Medicine (miscellaneous), Blood lipids, Diet, Mediterranean, Body Mass Index, Cohort Studies, Food group, 03 medical and health sciences, Asian People, Risk Factors, Humans, Medicine, Triglycerides, 030109 nutrition & dietetics, Nutrition and Dietetics, business.industry, Malaysia, Feeding Behavior, Middle Aged, medicine.disease, Obesity, Cholesterol, Cross-Sectional Studies, Cardiovascular Diseases, Female, Diet, Healthy, business, Body mass index, Demography, Cohort study
Abstract: Background Healthful dietary patterns are associated with cardiovascular disease risk factors in Western populations. However, a consistent healthful dietary pattern across major Asian ethnic groups has yet to be identified. Objective We aimed to identify a posteriori dietary patterns for Chinese, Malay, and Indian ethnic groups in an urban Asian setting, compare these with a priori dietary patterns, and ascertain associations with cardiovascular disease risk factors including hypertension, obesity, and abnormal blood lipid concentrations. Methods We used cross-sectional data from 8433 Singapore residents (aged 21-94 y) from the Multi-Ethnic Cohort study of Chinese, Malay, and Indian ethnicity. Food consumption was assessed using a validated 169-item food-frequency questionnaire. With the use of 28 food groups, dietary patterns were derived by principal component analysis, and their association with cardiovascular disease risk factors was assessed using multiple linear regression. Associations between derived patterns and a priori patterns (aHEI-2010-Alternative Healthy Eating Index-2010, aMED-alternate Mediterranean Diet, and DASH-Dietary Approaches to Stop Hypertension) were assessed, and the magnitude of associations with risk factors compared. Results We identified a "healthy" dietary pattern, similar across ethnic groups, and characterized by high intakes of whole grains, fruit, dairy, vegetables, and unsaturated cooking oil and low intakes of Western fast foods, sugar-sweetened beverages, poultry, processed meat, and flavored rice. This "healthy" pattern was inversely associated with body mass index (BMI; in kg/m2) (-0.26 per 1 SD of the pattern score; 95% CI: -0.36, -0.16), waist circumference (-0.57 cm; 95% CI: -0.82, -0.32), total cholesterol (-0.070 mmol/L; 95% CI: -0.091, -0.048), LDL cholesterol (-0.054 mmol/L; 95% CI: -0.074, -0.035), and fasting triglycerides (-0.22 mmol/L; 95% CI: -0.04, -0.004) and directly associated with HDL cholesterol (0.013 mmol/L; 95% CI: 0.006, 0.021). Generally, "healthy" pattern associations were at least as strong as a priori pattern associations with cardiovascular disease risk factors. Conclusion A healthful dietary pattern that correlated well with a priori patterns and was associated with lower BMI, serum LDL cholesterol, total cholesterol, and fasting triglyceride concentrations was identified across 3 major Asian ethnic groups.
Published: 2018
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37. Oncology Section EDGE Task Force on Cancer: A Systematic Review of Clinical Measures for Pain

Author: Shana E. Harrington, Laura Gilchrist, Jeannette Lee, Frances L. Westlake, and Alicia Baker
Subjects: 030203 arthritis & rheumatology, medicine.medical_specialty, Oncology (nursing), business.industry, Task force, Rehabilitation, Cancer, Physical Therapy, Sports Therapy and Rehabilitation, Edge (geometry), medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Oncology, Section (archaeology), Medicine, Medical physics, business, 030217 neurology & neurosurgery
Published: 2018
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38. Determinants of poor sleep quality in elderly patients with diabetes mellitus, hyperlipidemia and hypertension in Singapore

Author: Brenda L. H. Sim, Joanne Hui Min Quah, Jeannette Lee, and Grace Shu Hui Chiang
Subjects: Male, Sleep Wake Disorders, medicine.medical_specialty, Multivariate analysis, 030232 urology & nephrology, Hyperlipidemias, Pittsburgh Sleep Quality Index, 03 medical and health sciences, 0302 clinical medicine, Quality of life, Risk Factors, Surveys and Questionnaires, Diabetes mellitus, Internal medicine, Hyperlipidemia, Prevalence, medicine, Humans, Nocturia, Care Planning, Aged, Aged, 80 and over, Response rate (survey), Singapore, business.industry, Research, Public Health, Environmental and Occupational Health, medicine.disease, Confidence interval, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Hypertension, Female, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract: AimThe objective of this study was to assess determinants of poor sleep quality which is an under-diagnosed and under-treated problem in elderly patients with diabetes mellitus, hyperlipidemia and hypertension.BackgroundPoor sleep quality is linked to decreased quality of life, increased morbidity and mortality. Poor sleep quality is common in the elderly population with associated cardiometabolic risk factors such as diabetes, hyperlipidemia and hypertension.MethodsThis is a cross-sectional study undertaken in the primary healthcare setting (Singhealth Polyclinics-Outram) in Singapore. Singaporeans aged 65 years and above who had at least one of the three cardiometabolic risk factors (diabetes, hypertension and hyperlipidemia) were identified. Responders’ sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire and were divided into those with good quality sleep and those with poor quality sleep, based on the PSQI score. Information on demographics, co-morbidities and lifestyle practices were collected. Descriptive and multivariate analyses of determinants of poor sleep were determined.FindingsThere were 199 responders (response rate 88.1%). Nocturia (adjusted prevalence rate ratio 1.54, 95% confidence interval 1.06–2.26) was found to be associated with an increased risk of poor sleep quality in elderly patients with diabetes mellitus, hypertension and hyperlipidaemia. Nocturia, a prevalent problem in the Asian elderly population, has been found to be associated with poor sleep quality in our study. Hence, it is imperative to identify and treat patients with nocturia to improve sleep quality among them.
Published: 2018
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39. Acme Attractions

Author: Don Letts, Jeannette Lee, Don Letts, and Jeannette Lee
Abstract: Acme Attractions tells the story of a place, and its people, that found themselves at the heart of one of the country's great cultural moments. While living and working through a now-legendary period of the capital's history, Don Letts and Jeannette Lee found themselves simultaneously experiencing the pleasures and pitfalls of youth while witnessing the birth and heady, early excitement of punk. Their story, told here through a conversation that is warm, intelligent and compelling, touches on the revolutionary feelings of that time, as fashion, politics, music and art were all re-made in real time and, as we now know, things would never be the same again.
Published: 2021

40. Treatment of Breast Cancer–Related Lymphedema Using Negative Pressure Massage: A Pilot Randomized Controlled Trial

Author: Betty Smoot, Kimberly S. Topp, Riikka Lampinen, Jeannette Lee, Christine Miaskowski, Janella Leano, Lisa Brinker, and Judy Mastick
Subjects: 030506 rehabilitation, medicine.medical_specialty, Breast Cancer Lymphedema, Pilot Projects, Physical Therapy, Sports Therapy and Rehabilitation, law.invention, Disability Evaluation, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Manual lymphatic drainage, Randomized controlled trial, law, Dash, medicine, Humans, Single-Blind Method, Aged, Massage, business.industry, Rehabilitation, Middle Aged, medicine.disease, Confidence interval, Lymphedema, Physical therapy, Female, 0305 other medical science, business, 030217 neurology & neurosurgery
Abstract: Objective To evaluate the efficacy of negative pressure massage treatment (NPMT) compared with manual lymphatic drainage (MLD) in women with chronic breast cancer–related lymphedema (LE). We hypothesized that NPMT would result in greater improvements in LE and upper limb function. Design Pilot single-blinded randomized controlled trial. Setting Health sciences university. Participants Of 64 women screened, 28 met eligibility requirements (ie, >18y of age; completed active treatment for breast cancer; had unilateral arm LE for ≥1y; were not receiving LE care; had stable LE) and were randomized to the NPMT (n=15) and control groups (n=13). Interventions The intervention group received NPMT and the control group received MLD; both received twelve 60-minute sessions over 4-6 weeks. Main Outcome Measures Bioimpedance (lymphedema index [L-Dex] units]), limb volume (mL) calculated from limb circumference, and Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH) score. Results Outcomes were analyzed for 28 women. Compared to the MLD group, the NPMT group demonstrated greater improvement with a large effect size in L-Dex scores (P=.001; standardized mean difference [SMD]=−1.15; 95% confidence interval, −1.96 to −0.35) and interlimb volume differences (P=.038; SMD=−0.83; 95% confidence interval, −1.60 to −0.05). Differences in DASH scores were not statistically significant (P=.067). Conclusions Compared to MLD, treatment with NPMT resulted in greater improvement in L-Dex scores and interlimb volume differences in women with a duration of unilateral upper limb LE of >1 year. Our findings need to be confirmed in a larger randomized controlled trial.
Published: 2021
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41. Oncology Section EDGE Task Force on Urogenital Cancer Outcomes: Clinical Measures of Lymphedema—A Systematic Review

Author: Jeannette Lee, Joy C. Cohn, Hannah Geyer, and Mary Insana Fisher
Subjects: medicine.medical_specialty, Oncology (nursing), Task force, business.industry, Rehabilitation, Physical Therapy, Sports Therapy and Rehabilitation, medicine.disease, Surgery, 03 medical and health sciences, 0302 clinical medicine, Lymphedema, Oncology, Urogenital cancer, 030220 oncology & carcinogenesis, medicine, Physical therapy, Limb volume, 030212 general & internal medicine, Urogenital neoplasm, business
Published: 2017
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42. Factors associated with diabetes-related distress over time among patients with T2DM in a tertiary hospital in Singapore

Author: E-Shyong Tai, Yung Seng Lee, Eric Yin Hao Khoo, Chuen Seng Tan, Hwee Lin Wee, Konstadina Griva, Jeannette Lee, and Maudrene L. S. Tan
Subjects: Adult, Male, Self-Assessment, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Population, Excessive daytime sleepiness, 030209 endocrinology & metabolism, lcsh:Diseases of the endocrine glands. Clinical endocrinology, Diabetes Complications, Tertiary Care Centers, 03 medical and health sciences, Social support, 0302 clinical medicine, Quality of life, Internal medicine, Humans, Medicine, Longitudinal Studies, 030212 general & internal medicine, education, Psychiatry, Generalized estimating equation, Singapore, education.field_of_study, Diabetes-related distress, lcsh:RC648-665, business.industry, Medical record, Diabetes, General Medicine, Middle Aged, Distress, Diabetes Mellitus, Type 2, Linear Models, Longitudinal, Female, medicine.symptom, business, Psychosocial, Research Article
Abstract: Background Persistent diabetes-related distress (DRD) is experienced by patients with Type 2 Diabetes Mellitus. Knowing factors associated with persistent DRD will aid clinicians in prioritising interventions efforts. Methods A total of 216 patients were recruited from a tertiary hospital in Singapore, an Asian city state, and followed for 1.5 years (2011–2014). Data was collected by self-completed questionnaires assessing DRD (measured by the Problem Areas in Diabetes score) and other psychosocial aspects such as social support, presenteeism, depression, health-related quality of life (HRQoL) and excessive daytime sleepiness (EDS) at three time points. Clinical data (body-mass-index and glycated haemoglobin) was obtained from medical records. Change score was calculated for each clinical and psychosocial variable to capture changes in these variables from baseline. Generalized Linear Model with Generalized Estimating Equation method was used to assess whether baseline and change scores in clinical and psychosocial are associated with DRD over time. Results Complete data was available for 73 patients, with mean age 44 (SD 12.5) years and 67% males. Persistent DRD was experienced by 21% of the patients. In the final model, baseline HRQoL (OR = 0.56, p
Published: 2017
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43. Genome-wide association meta-analyses and fine-mapping elucidate pathways influencing albuminuria

Author: Tobias Hermle, Holger Kirsten, Karsten B. Sieber, Aiko P. J. de Vries, Su Chi Lim, Peter Kovacs, Charumathi Sabanayagam, Carl D. Langefeld, Bernhard K. Krämer, Kent D. Taylor, Janine F. Felix, Belen Ponte, Markus Loeffler, Mary F. Feitosa, Kai-Uwe Eckardt, Jianjun Liu, Katalin Dittrich, Charlene A. Wong, Uwe Völker, Adriana M. Hung, Thomas Meitinger, Anubha Mahajan, Anselm Hoppmann, Erik Ingelsson, Martin H. de Borst, Oscar H. Franco, Niek Verweij, Kai-Uwe Saum, Vilmundur Gudnason, Bram P. Prins, Carsten A. Böger, Terho Lehtimäki, Andrew A. Hicks, Todd L. Edwards, Olivier Devuyst, Peter P. Pramstaller, Katrin Horn, Leslie A. Lange, Johanne Tremblay, Jin-Fang Chai, Sahar Ghasemi, Kjell Nikus, Tanja Poulain, Massimiliano Cocca, Anna Köttgen, Eric Boerwinkle, Barry I. Freedman, Miao-Ling Chee, Man Li, Stephan J. L. Bakker, Tamara B. Harris, Albert V. Smith, Ton J. Rabelink, Dennis O. Mook-Kanamori, Iris M. Heid, Jasmin Divers, Chaolong Wang, Kathleen A. Ryan, Pavel Hamet, Silke Szymczak, Shih-Jen Hwang, Hauke Thomsen, Rainer Rettig, Ayush Giri, Fernando Rivadeneira, Leo-Pekka Lyytikäinen, Cristian Pattaro, Andrej Teren, Valencia Hui Xian Foo, Myriam Rheinberger, Audrey Y. Chu, Barbara McMullen, Franziska Grundner-Culemann, Masayuki Yasuda, Murielle Bochud, Martin Gögele, Anke Tönjes, Jeannette Lee, Adrienne Tin, Kevin Ho, Konstantin Strauch, Josef Coresh, Renée de Mutsert, Sandra Freitag-Wolf, Gardar Sveinbjornsson, Yizhe Xu, Katalin Susztak, Tien Yin Wong, Mary L. Biggs, Isleifur Olafsson, Qiong Yang, Antje Körner, Chengxiang Qiu, E-Shyong Tai, Martina Müller-Nurasyid, Ben Schöttker, Jeffrey O' Connell, Mengmeng Chen, Daniel F. Gudbjartsson, Dermot F. Reilly, Vincent W. V. Jaddoe, Damia Noce, Pim van der Harst, Sanaz Sedaghat, Chiea Chuen Khor, Adam S. Butterworth, Mathias Gorski, Robert J. Carroll, James G. Wilson, Johan Ärnlöv, Christa Meisinger, Kenneth Rice, Bettina Jung, Christian M. Shaffer, Unnur Thorsteinsdottir, Matthias Nauck, Shreeram Akilesh, Mika Kähönen, Johanna Jakobsdottir, Melanie Waldenberger, Ralph Burkhardt, Daniela Baptista, John Danesh, Benjamin B. Sun, Karlhans Endlich, Holly Kramer, Frauke Degenhardt, Wolfgang Lieb, Kari Stefansson, Joachim Thiery, Lars Lind, Nicholette D. Palmer, Sarah A. Pendergrass, Suzanne Vogelezang, Peter J. van der Most, Afshin Parsa, Markus Scholz, Florian Kronenberg, Joseph C. Maranville, Laura M. Raffield, Hermann Brenner, Wieland Kiess, Anna I. Podgornaia, Yuan Shi, Tanguy Corre, Miao-Li Chee, Deborah Mascalzoni, Bamidele O. Tayo, Navya Shilpa Josyula, Ching-Yu Cheng, Lea Gerstner, Nisha Bansal, Jerome I. Rotter, Alexander Teumer, Vilmantas Giedraitis, Raymond Noordam, Ron T. Gansevoort, Lihua Wang, Andrew P. Morris, Bruce M. Psaty, Boting Ning, Zhi Yu, Christian Fuchsberger, Matthias Wuttke, Heiko Runz, Annette Peters, Yih Chung Tham, James P. Cook, Yong Li, Chris H. L. Thio, Hilma Holm, Alessandro De Grandi, Jonathan Marten, André G. Uitterlinden, Andre Franke, Nicholas Y. Q. Tan, Otis D. Wilson, Georg Ehret, Cecilia M. Lindgren, Josyf C. Mychaleckyj, Wolfgang Koenig, Harold Snieder, Michael Stumvoll, Kozeta Miliku, M. Arfan Ikram, Teresa Nutile, Læknadeild (HÍ), Faculty of Medicine (UI), School of Health Sciences (UI), Heilbrigðisvísindasvið (HÍ), Háskóli Íslands, University of Iceland, Teumer, Alexander [0000-0002-8309-094X], Li, Yong [0000-0003-2651-8791], Wuttke, Matthias [0000-0003-3420-5082], Giri, Ayush [0000-0002-7786-4670], Qiu, Chengxiang [0000-0002-6346-8669], Kirsten, Holger [0000-0002-3126-7950], Tin, Adrienne [0000-0002-4207-5866], Feitosa, Mary F. [0000-0002-0933-2410], Chai, Jin-Fang [0000-0003-3770-1137], Cocca, Massimiliano [0000-0002-1127-7596], Gorski, Mathias [0000-0002-9103-5860], Horn, Katrin [0000-0002-5307-6936], Li, Man [0000-0002-3839-0281], Marten, Jonathan [0000-0001-6916-2014], van der Most, Peter J. [0000-0001-8450-3518], Burkhardt, Ralph [0000-0003-1924-1202], Coresh, Josef [0000-0002-4598-0669], de Borst, Martin H. [0000-0002-4127-8733], Ehret, Georg [0000-0002-5730-0675], Endlich, Karlhans [0000-0001-6052-6061], Felix, Janine F. [0000-0002-9801-5774], Franke, Andre [0000-0003-1530-5811], Freedman, Barry I. [0000-0003-0275-5530], Freitag-Wolf, Sandra [0000-0002-1069-7740], Giedraitis, Vilmantas [0000-0003-3423-2021], Grundner-Culemann, Franziska [0000-0001-9649-281X], Gudnason, Vilmundur [0000-0001-5696-0084], Hicks, Andrew A. [0000-0001-6320-0411], Ikram, M. Arfan [0000-0003-0372-8585], Ingelsson, Erik [0000-0003-2256-6972], Jaddoe, Vincent W. V. [0000-0003-2939-0041], Josyula, Navya Shilpa [0000-0003-2782-8812], Khor, Chiea-Chuen [0000-0002-1128-4729], Koenig, Wolfgang [0000-0002-2064-9603], Kovacs, Peter [0000-0002-0290-5423], Kronenberg, Florian [0000-0003-2229-1120], Lindgren, Cecilia M. [0000-0002-4903-9374], Liu, Jianjun [0000-0002-3255-3019], Lyytikäinen, Leo-Pekka [0000-0002-7200-5455], Mahajan, Anubha [0000-0001-5585-3420], Mascalzoni, Deborah [0000-0003-4156-1464], Miliku, Kozeta [0000-0002-9614-7191], Müller-Nurasyid, Martina [0000-0003-3793-5910], Mychaleckyj, Josyf C. [0000-0003-2595-0005], Palmer, Nicholette D. [0000-0001-8883-2511], Poulain, Tanja [0000-0003-3825-5829], Raffield, Laura M. [0000-0002-7892-193X], Rice, Kenneth M. [0000-0002-3071-7278], Rivadeneira, Fernando [0000-0001-9435-9441], Sabanayagam, Charumathi [0000-0002-4042-4719], Smith, Albert V. [0000-0003-1942-5845], Sun, Benjamin B. [0000-0001-6347-2281], Szymczak, Silke [0000-0002-8897-9035], Taylor, Kent D. [0000-0002-2756-4370], Thio, Chris H. L. [0000-0003-2623-7172], Uitterlinden, André G. [0000-0002-7276-3387], van der Harst, Pim [0000-0002-2713-686X], Verweij, Niek [0000-0002-4303-7685], Völker, Uwe [0000-0002-5689-3448], Wang, Chaolong [0000-0003-3945-1012], Yang, Qiong [0000-0002-3658-1375], Devuyst, Olivier [0000-0003-3744-4767], Edwards, Todd L. [0000-0003-4318-6119], Ho, Kevin [0000-0002-3054-8697], Morris, Andrew P. [0000-0002-6805-6014], Pendergrass, Sarah A. [0000-0002-0565-6522], Rotter, Jerome I. [0000-0001-7191-1723], Stefansson, Kari [0000-0003-1676-864X], Susztak, Katalin [0000-0002-1005-3726], Scholz, Markus [0000-0002-4059-1779], Butterworth, Adam S. [0000-0002-6915-9015], Hung, Adriana M. [0000-0002-3203-1608], Pattaro, Cristian [0000-0002-4119-0109], Köttgen, Anna [0000-0002-4671-3714], Apollo - University of Cambridge Repository, Groningen Institute for Organ Transplantation (GIOT), Lifestyle Medicine (LM), Groningen Kidney Center (GKC), Cardiovascular Centre (CVC), Life Course Epidemiology (LCE), Epidemiology, Erasmus MC other, Pediatrics, Internal Medicine, Feitosa, Mary F [0000-0002-0933-2410], van der Most, Peter J [0000-0001-8450-3518], de Borst, Martin H [0000-0002-4127-8733], Felix, Janine F [0000-0002-9801-5774], Freedman, Barry I [0000-0003-0275-5530], Hicks, Andrew A [0000-0001-6320-0411], Ikram, M Arfan [0000-0003-0372-8585], Jaddoe, Vincent WV [0000-0003-2939-0041], Lindgren, Cecilia M [0000-0002-4903-9374], Mychaleckyj, Josyf C [0000-0003-2595-0005], Palmer, Nicholette D [0000-0001-8883-2511], Raffield, Laura M [0000-0002-7892-193X], Rice, Kenneth M [0000-0002-3071-7278], Smith, Albert V [0000-0003-1942-5845], Sun, Benjamin B [0000-0001-6347-2281], Taylor, Kent D [0000-0002-2756-4370], Thio, Chris HL [0000-0003-2623-7172], Uitterlinden, André G [0000-0002-7276-3387], Edwards, Todd L [0000-0003-4318-6119], Morris, Andrew P [0000-0002-6805-6014], Pendergrass, Sarah A [0000-0002-0565-6522], Rotter, Jerome I [0000-0001-7191-1723], Butterworth, Adam S [0000-0002-6915-9015], and Hung, Adriana M [0000-0002-3203-1608]
Subjects: 0301 basic medicine, Drosophila melanogaster/genetics, Diabetes Mellitus/genetics, LD SCORE REGRESSION, 030232 urology & nephrology, 45/43, General Physics and Astronomy, Genome-wide association study, BLOOD-PRESSURE, Bioinformatics, GLOMERULAR-FILTRATION-RATE, Genome-wide association studies, Diabetes mellitus genetics, 0302 clinical medicine, Creatinine/urine, Risk Factors, Genome-wide, Phenomics, lcsh:Science, ddc:616, Regulation of gene expression, RISK, Gene knockdown, Kidney diseases, Multidisciplinary, HERITABILITY, Albuminuria/genetics, article, Chromosome Mapping, Kidney disease, ddc, 3. Good health, Drosophila melanogaster, Creatinine, Nýrnasjúkdómar, 692/4022/1585, Slit diaphragm, Medical genetics, medicine.symptom, Erfðarannsóknir, Medical Genetics, medicine.medical_specialty, Science, 631/208/205/2138, 610 Medicine & health, Biology, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, Meta-Analysis as Topic, 360 Social problems & social services, Diabetes Mellitus, medicine, Animals, Humans, Albuminuria, Genetic Predisposition to Disease, ddc:610, EXCRETION RATE, CARDIOVASCULAR EVENTS, Genetic association, Medicinsk genetik, TRANS-EQTLS, KIDNEY-DISEASE, General Chemistry, 030104 developmental biology, Gene Expression Regulation, Genetic Loci, COLLABORATIVE METAANALYSIS, lcsh:Q, Genome-Wide Association Study
Abstract: Publisher's version (útgefin grein)., Increased levels of the urinary albumin-to-creatinine ratio (UACR) are associated with higher risk of kidney disease progression and cardiovascular events, but underlying mechanisms are incompletely understood. Here, we conduct trans-ethnic (n = 564,257) and European-ancestry specific meta-analyses of genome-wide association studies of UACR, including ancestry- and diabetes-specific analyses, and identify 68 UACR-associated loci. Genetic correlation analyses and risk score associations in an independent electronic medical records database (n = 192,868) reveal connections with proteinuria, hyperlipidemia, gout, and hypertension. Fine-mapping and trans-Omics analyses with gene expression in 47 tissues and plasma protein levels implicate genes potentially operating through differential expression in kidney (including TGFB1, MUC1, PRKCI, and OAF), and allow coupling of UACR associations to altered plasma OAF concentrations. Knockdown of OAF and PRKCI orthologs in Drosophila nephrocytes reduces albumin endocytosis. Silencing fly PRKCI further impairs slit diaphragm formation. These results generate a priority list of genes and pathways for translational research to reduce albuminuria., Competing interests: Karsten B. Sieber is full-time employee of GlaxoSmithKline. Gardar Sveinbjornsson, Daniel F. Gudbjartsson, Hilma Holm, Unnur Thorsteinsdottir and Kari Stefansson are full-time employees of deCODE genetics, Amgen Inc. John Danesh is member of the Novartis Cardiovascular and Metabolic Advisory Board, received grant support from Novartis. Oscar H. Franco works in ErasmusAGE, a center for aging research across the life course funded by Nestlé Nutrition (Nestec Ltd.), Metagenics Inc., and AXA. Wolfgang Koenig received modest consultation fees for advisory board meetings from Amgen, DalCor, Kowa, Novartis, Pfizer and Sanofi, and modest personal fees for lectures from Amgen, AstraZeneca, Novartis, Pfizer and Sanofi. Anna I. Podgornaia and Dermot F. Reilly are employees of Merck Sharp Dohme Corp., Whitehouse Station, NJ, USA. Kevin Ho disclosed a research and financial relationship with Sanofi-Genzyme. Bruce M. Psaty serves on the DSMB of a clinical trial funded by the manufacturer (Zoll LifeCor) and on the Steering Committee of the Yale Open Data Access Project funded by Johnson & Johnson. Markus Scholz: Consultancy of and grant support from Merck Serono not related to this project. Adam S. Butterworth received grants from MSD, Pfizer, Novartis, Biogen and Bioverativ and personal fees from Novartis. Anna Köttgen received grant support from Gruenenthal not related to this project. The other authors declare no competing interests.
Published: 2019
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44. Voluntary community service in medical school: A qualitative study on student leaders’ motivations, experiences, and outcomes

Author: Jeannette Lee, Alvona Zi Hui Loh, Julia Shi Yu Tan, and Gerald Choon-Huat Koh
Subjects: Students, Medical, Medical psychology, 020205 medical informatics, media_common.quotation_subject, Decision Making, education, MEDLINE, Medically Underserved Area, Empathy, 02 engineering and technology, Leadership, Education, Interviews as Topic, 03 medical and health sciences, 0302 clinical medicine, 0202 electrical engineering, electronic engineering, information engineering, Humans, Community Health Services, 030212 general & internal medicine, Qualitative Research, Schools, Medical, media_common, Singapore, Social Responsibility, Medical education, business.industry, Communication, General Medicine, Personal development, Thematic analysis, Psychology, business, Social responsibility, Qualitative research
Abstract: Background: Participation in community service within underprivileged communities among medical students is associated with numerous positive outcomes, such as promoting empathy, enhancing leadership qualities, and fostering civic and social responsibility. We conducted a qualitative study to understand the experiences, motivations and student-reported outcomes on personal growth, when medical students in a developed Asian country participate in local and overseas community services. Methods: We recruited medical students from Yong Loo Lin School of Medicine (YLLSOM), National University of Singapore, who were leaders of a community service project organized in medical school. Twelve one-to-one interviews were held for the participants from 6 to 8 January 2013. Interviews were audio-recorded and transcribed into free-flow text. Thematic analysis was performed independently by three researchers. Results: Motivations to participate in community service include past-positive community service experience and present motivations such as compassion, self-discovery etc. Students reported higher empathy levels, improved communication, organization, decision-making, interpersonal, and leadership skills. The degree of influence on academic work and residency choice were varied. Conclusion: Community service in medical school enriches medical students by bringing about improved self-reported outcomes, leadership skills, and interpersonal skills. It has some bearing on residency choice and academic work.
Published: 2016
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45. Epicardial and visceral adipose tissue in relation to subclinical atherosclerosis in a Chinese population

Author: Rob M. van Dam, Alvin Choong Meng Ng, Nang Ei Ei Khaing, Tai E. Shyong, Cinnie Yentia Soekojo, and Jeannette Lee
Subjects: Male, Adipose tissue, lcsh:Medicine, Blood Pressure, 030204 cardiovascular system & hematology, Biochemistry, Vascular Medicine, Diagnostic Radiology, Fats, 0302 clinical medicine, Risk Factors, Medicine and Health Sciences, Odds Ratio, Coronary Heart Disease, lcsh:Science, Tomography, Coronary Arteries, education.field_of_study, Singapore, Multidisciplinary, Radiology and Imaging, Arteries, Middle Aged, Lipids, Coronary Vessels, medicine.anatomical_structure, Cholesterol, Adipose Tissue, Cardiology, Female, Anatomy, Pericardium, Research Article, medicine.medical_specialty, Imaging Techniques, Population, 030209 endocrinology & metabolism, Neuroimaging, Intra-Abdominal Fat, Research and Analysis Methods, 03 medical and health sciences, Asian People, Diagnostic Medicine, Internal medicine, Diabetes mellitus, medicine, Humans, education, Aged, business.industry, lcsh:R, nutritional and metabolic diseases, Biology and Life Sciences, Odds ratio, medicine.disease, Atherosclerosis, Obesity, Subcutaneous Fat, Abdominal, Computed Axial Tomography, Coronary arteries, Biological Tissue, Cross-Sectional Studies, Cardiovascular Anatomy, Abdomen, Blood Vessels, lcsh:Q, Calcium, business, Tomography, X-Ray Computed, Dyslipidemia, Neuroscience
Abstract: Background Body fatness is associated with risk of coronary heart disease and it has been postulated that epicardial adipose tissue (EAT) may have a particularly detrimental effect because of its localized toxic effects. We therefore aimed to examine the association between EAT and coronary artery calcification and compared this with associations for visceral adipose tissue (VAT) and other regional fat depots. Methods We conducted a cross-sectional study of 487 Chinese participants aged 50 years old and above, living in Singapore. Participants, free from known diabetes mellitus and coronary heart diseases, completed interviews, a health screening to evaluate obesity and cardiovascular disease risk factors, and computed tomography scans of the abdomen and coronary arteries. Associations between regional fat depots and subclinical atherosclerosis defined as CAC> = 100 were determined by multiple logistic regression analysis. Results Epicardial adipose tissue (EAT) was highly correlated with visceral adipose tissue (VAT) (Pearson r = 0.72) and trunk fat mass (r = 0.66). The age and sex-adjusted odd ratio (OR) (in 1-SD increase) of subclinical atherosclerosis was 1.28 (1.01-1.61) for EAT and 1.40 (1.04-1.88) for VAT. These associations were weaker and non-significant after adjusting for markers of dyslipidemia and hyperglycemia. Total body fat, subcutaneous abdominal fat, and leg, arm and trunk fat mass were not significantly associated with atherosclerosis. Conclusion VAT and EAT showed similar associations with coronary artery calcification and the associations could be mediated by traditional risk factors in this ethnic Chinese population.
Published: 2018

46. Cohort Profile: The Singapore Multi-Ethnic Cohort (MEC) study

Author: Kee Seng Chia, Jeannette Lee, Rob M. van Dam, Kristin Hui Xian Tan, Linda Wei Lin Tan, Xueling Sim, and E. Shyong Tai
Subjects: 0301 basic medicine, Gerontology, Epidemiology, business.industry, Ethnic group, MEDLINE, 030209 endocrinology & metabolism, General Medicine, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Cohort, Medicine, business
Published: 2018

47. Diagnosis of Diabetes Mellitus Using HbA1c in Asians: Relationship Between HbA1c and Retinopathy in a Multiethnic Asian Population

Author: Su Chi Lim, Charumathi Sabanayagam, E. Shyong Tai, Ching-Yu Cheng, Ecosse L. Lamoureux, Derrick Heng, Tien Yin Wong, Agus Salim, Weng Kit Lye, Stefan Ma, Maudrene L. S. Tan, Ah Chuan Thai, M. Kamran Ikram, Subramaniam Tavintharan, Jeannette Lee, and Eric Yin Hao Khoo
Subjects: Adult, Male, medicine.medical_specialty, Cross-sectional study, Endocrinology, Diabetes and Metabolism, Clinical Biochemistry, Population, Ethnic group, Context (language use), Sensitivity and Specificity, Biochemistry, Endocrinology, Asian People, Ophthalmology, Diabetes mellitus, Positive predicative value, Internal medicine, Diabetes Mellitus, Ethnicity, Prevalence, medicine, Humans, education, Aged, Aged, 80 and over, Glycated Hemoglobin, Singapore, education.field_of_study, Diabetic Retinopathy, business.industry, Biochemistry (medical), Diabetic retinopathy, Middle Aged, medicine.disease, Cross-Sectional Studies, Female, business, Retinopathy
Abstract: Hemoglobin A1c (HbA1c) ≥ 6.5% (47.5 mmol/mol) has recently been included as a criterion for the diagnosis of diabetes mellitus. It is unclear whether this criterion is appropriate in Asians.To examine the relationship between HbA1c and diabetes-specific moderate retinopathy in Asian ethnic groups.Four independent population-based cross-sectional studies (2004-2011) in Singapore representing the three major Asian ethnic groups (n = 13 170 adults aged ≥ 25 y: Chinese, 5834; Malays, 3596; and Indians, 3740).Moderate retinopathy was assessed from digital retinal photographs and defined as a level43 using the Early Treatment Diabetic Retinopathy Study (ETDRS) scale. Sensitivity, specificity, positive and negative predictive values, and the area under the receiver operating characteristic curve for detecting moderate retinopathy were compared across ethnic groups at different HbA1c cut-points.HbA1c levels were higher in Indians and Malays compared to Chinese (P.001). The prevalence of moderate retinopathy below HbA1c6.5% was1% in all ethnic groups. At HbA1c ≥ 6.5%, the sensitivity for detecting moderate retinopathy was lower in Chinese subjects compared to Indians and Malays (75.8 vs 86.0 and 85.3%), but specificity (89.7 vs 71.9 and 76.3%) was higher; however, positive predictive value and negative predictive value were similar among Chinese, Indians, and Malays (10.5, 12.3, 12.4%; and 99.6, 99.1, 99.2%, respectively). The AUCs were similar across all three ethnic groups (0.861, 0.851, and 0.853).Our study supports the use of HbA1c for diagnosing diabetes in Asians. Despite some interethnic variation in the relationship of HbA1c and retinopathy, a cut-point of 6.5% performs reasonably well in the three major Asian ethnic groups.
Published: 2015
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48. Oncology Section EDGE Task Force on Breast Cancer Outcomes: A Systematic Review of Outcome Measures for Functional Mobility

Author: Jeannette Lee, Lucinda Pfalzer, Hannah Geyer, Claire C. Davies, Mary Insana Fisher, and Genevieve Colon
Subjects: medicine.medical_specialty, Psychometrics, Oncology (nursing), Task force, business.industry, Rehabilitation, Outcome measures, Cancer, Physical Therapy, Sports Therapy and Rehabilitation, medicine.disease, Functional Independence Measure, Breast cancer, Oncology, Rating scale, Survivorship curve, Physical therapy, Medicine, business
Abstract: Background: Breast cancer treatments in women with breast cancer often result in physical impairments that lead to activity limitations and participation restrictions. These limitations and restrictions manifest in impaired functional mobility skills that may impact survivorship. Thus, evaluation of functional mobility is an important part of survivorship care. Purpose: To identify functional mobility outcome measures that possess strong psychometric properties and are clinically useful for examination of women treated for breast cancer. Methods: Multiple electronic databases were searched for articles published after 1995. Studies were included if they reported psychometric properties, used clinically feasible methods, were performed on adults, and published in the English language. Each outcome measure was independently evaluated and rated by two reviewers. A single Cancer EDGE Task Force Outcome Measure Rating Form was completed for each category of functional mobility, and a recommendation was made using the 4-point Cancer EDGE Task Force Rating Scale. Results: Of the original 819 articles found, 211 were included in this review. A total of 11 measures are recommended for clinical use: the Timed Up and Go; the 2-Minute, 6-Minute, and 12-Minute Walk Tests; 10-Meter Walk; 5 Times Sit to Stand; Short Performance Physical Battery; Physical Battery for Patients with Cancer; Functional Independence Measure (FIM); Assessment of Life Habits; and Activity Measure for Post-acute Care. Conclusions: Many tools are available to assess upper extremity and overall functional mobility skills in women treated for breast cancer. There are currently no tools recommended that assess community participation.
Published: 2015
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49. Anchorage suffers 'major' damage after 7.0-magnitude earthquake

Author: Falsey, Jeannette Lee, Berman, Mark, and Fritz, Angela
Subjects: Alaska Earthquake, 2018, Earthquakes -- Alaska, Earthquake damage -- Alaska, Automobiles, Engineers, General interest, News, opinion and commentary
Abstract: Byline: Jeannette Lee Falsey, Mark Berman and Angela FritzANCHORAGE, Alaska - Chris Riekena was driving with his 7-year-old son when the road beneath their car began to shake.Riekena, an engineer [...]
Published: 2018

50. [0] 'Major' damage after magnitude-7 earthquake in Alaska

Author: Falsey, Jeannette Lee, Berman, Mark, and Fritz, Angela
Subjects: Earthquakes -- Forecasts and trends -- Alaska, Natural disaster damage -- Forecasts and trends -- Economic aspects, Automobiles, Engineers, Market trend/market analysis, General interest, News, opinion and commentary
Abstract: Byline: Jeannette Lee Falsey, Mark Berman and Angela FritzANCHORAGE, Alaska - Chris Riekena was driving with his 7-year-old son when the road beneath their car began to shake.Riekena, an engineer [...]
Published: 2018

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