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  • 101.
    Florvall, Gösta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Basu, Samar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Helmersson, Johanna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Microalbuminuria measured by three different methods, blood pressure and cardiovascular risk factors in elderly Swedish males2008In: Analytical chemistry insights, ISSN 1177-3901, Vol. 3, p. 69-74Article in journal (Refereed)
    Abstract [en]

    Microalbuminuria is associated with hypertension and is a strong risk factor for subsequent chronic disease, both renal and coronary heart disease (CHD), Presently there are several methods available for measurement of microalbuminuria. The aim of this study was to evaluate if the three different methods gave similar information or if one of the assays were superior to the others. Blood pressure, infl ammatory markers and cardiovascular mortality and morbidity were correlated with urine albumin analysed with a point-of-care testing (POCT) instrument, nephelometric determination of albumin and albumin/creatinine ratio in elderly males. The study population consisted of 103 diabetic and 603 nondiabetic males (age 77 years) in a cross-sectional study. We analyzed urine albumin with a HemoCue® Urine Albumin POCT instrument and a ProSpec® nephelometer and albumin/creatinine ratio. There were strong correlations between both systolic and diastolic blood pressure and all three urine albumin methods (p < 0.0001). There were also signifi cant correlations between the different urine albumin measurements and serum amyloid A component, high-sensitivity C-reactive protein and interleukin-6. The three different urine albumin methods studied provided similar information in relation to cardiovascular disease. There was a strong correlation between systolic and diastolic blood pressure and microalbuminuria in both the whole study population and in nondiabetic males emphasizing the role of hypertension in glomerular damage. The good correlation between the studied urine albumin measurements show that all three methods can be used for monitoring urine albumin excretion.

  • 102.
    Florvall, Gösta
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Basu, Samar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Apolipoprotein A1 Is a Stronger Prognostic Marker Than Are HDL and LDL Cholesterol for Cardiovascular Disease and Mortality in Elderly Men2006In: The journals of gerontology. Series A, Biological sciences and medical sciences, ISSN 1079-5006, E-ISSN 1758-535X, Vol. 61, no 12, p. 1262-1266Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to compare apolipoprotein A1 (ApoA1) and B (ApoB) with high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) as markers for cardiovascular mortality and morbidity in elderly men. We analyzed serum ApoA1, ApoB, total cholesterol, HDL-C, and LDL-C in a group of 77-year-old men (n = 785). The results were correlated with data from the Swedish cause of death registry. Receiver-operating characteristic curves showed that, of the studied serum markers, ApoA1 was the best predictor for ischemic heart disease mortality (area under the curve = 0.724, 95% confidence interval, 0.691-0.755). There were also significant correlations between the apolipoproteins and other known risk markers for cardiovascular disease such as triglycerides, high-sensitivity C-reactive protein (hsCRP), and cystatin C. Serum ApoA1 is a better risk marker than are ApoB, ApoB/ApoA1 ratio, HDL-C, and LDL-C for cardiovascular disease and mortality in elderly men.

  • 103.
    Forouzanfar, Mohammad H.
    et al.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Afshin, Ashkan
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Alexander, Lily T.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Anderson, H. Ross
    St Georges Univ London, Populat Hlth Res Inst, London, England..
    Bhutta, Zulficiar A.
    Aga Khan Univ, Ctr Excellence Women & Child Hlth, Karachi, Pakistan.;Hosp Sick Children, Ctr Global Child Hlth, Toronto, ON, Canada..
    Biryukov, Stan
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Brauer, Michael
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Burnett, Richard
    Hlth Canada, Ottawa, ON, Canada..
    Cercy, Kelly
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Charlson, Fiona J.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA.;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia.;Queensland Ctr Mental Hlth Res, Brisbane, Qld, Australia..
    Cohen, Aaron J.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA.;Hlth Effects Inst, Boston, MA USA..
    Dandona, Lalit
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA.;Publ Hlth Fdn India, New Delhi, India..
    Estep, Kara
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Ferrari, Alize J.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA.;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia.;Queensland Ctr Mental Hlth Res, Brisbane, Qld, Australia..
    Frostad, Joseph J.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Fullman, Nancy
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Gething, Peter W.
    Univ Oxford, Dept Zool, Oxford, England..
    Godwin, William W.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Griswold, Max
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Kinfu, Yohannes
    Univ Canberra, Fac Hlth, Ctr Res & Act Publ Hlth, Canberra, ACT, Australia..
    Kyu, Hmwe H.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Larson, Heidi J.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA.;London Sch Hyg & Trop Med, Dept Infect Dis Epidemiol, London, England..
    Liang, Xiaofeng
    Chinese Ctr Dis Control & Prevent, Beijing, Peoples R China..
    Lim, Stephen S.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Liu, Patrick Y.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Lopez, Alan D.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA.;Univ Melbourne, Melbourne Sch Populat & Global Hlth, Melbourne, Vic, Australia..
    Lozano, Rafael
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA.;Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Marczak, Laurie
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Mensah, George A.
    NHLBI, Ctr Translat Res & Implementat Sci, NIH, Bldg 10, Bethesda, MD 20892 USA..
    Mokdad, Ali H.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Moradi-Lakeh, Maziar
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA.;Iran Univ Med Sci, Dept Community Med, Gastrointestinal & Liver Dis Res Ctr, Prevent Med & Publ Hlth Res Ctr, Tehran, Iran..
    Naghavi, Mohsen
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Neal, Bruce
    George Inst Global Hlth, Sydney, NSW, Australia.;Univ Sydney, Sydney, NSW, Australia.;Royal Prince Alfred Hosp, Sydney, NSW, Australia.;Imperial Coll London, London, England..
    Reitsma, Marissa B.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Roth, Gregory A.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Salomon, Joshua A.
    Harvard Univ, Dept Global Hlth & Populat, Boston, MA 02115 USA..
    Sur, Patrick J.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Vos, Theo
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Wagner, Joseph A.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Wang, Haidong
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Zhao, Yi
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Zhou, Maigeng
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA.;Chinese Ctr Dis Control & Prevent, Ctr Chron & Noncommunicable Dis Control & Prevent, Beijing, Peoples R China..
    Aasvang, Gunn Marit
    Norwegian Inst Publ Hlth, Oslo, Norway..
    Abajobir, Amanuel Alemu
    Abate, Kalkidan Hassen
    Jimma Univ, Jimma, Ethiopia..
    Abbafati, Cristiana
    Univ Roma La Sapienza, Rome, Italy..
    Abbas, Kaja M.
    Virginia Tech, Blacksburg, VA USA..
    Abd-Allah, Foad
    Cairo Univ, Dept Neurol, Cairo, Egypt..
    Abdulle, Abdishakur M.
    New York Univ Abu Dhabi, Abu Dhabi, U Arab Emirates..
    Abera, Semaw Ferede
    Mekelle Univ, Sch Publ Hlth, Coll Hlth Sci, Mekelle, Ethiopia.;Kilte Awlaelohlth & Demog Surveillance Site, Mekelle, Ethiopia.;Univ Hohenheim, Food Secur & Inst Biol Chem & Nutr, Stuttgart, Germany..
    Abraham, Biju
    NM SM Govt Coll Kalpetta, Kalpetta, Kerala, India..
    Abu-Raddad, Laith J.
    Weill Cornell Med Coll Qatar, Infect Dis Epidemiol Grp, Doha, Qatar..
    Abyu, Gebre Yitayih
    Mekelle Univ, Mekelle, Ethiopia..
    Adebiyi, Akindele Olupelumi
    Univ Ibadan, Coll Med, Ibadan, Nigeria.;Univ Coll Hosp, Ibadan, Nigeria..
    Adedeji, Isaac Akinkunmi
    Olabisi Onabanjo Univ, Ago Iwoye, Nigeria..
    Ademi, Zanfina
    Univ Melbourne, Melbourne, Vic, Australia. Natl Inst Publ Hlth, Natl Council Sci & Technol, Cuernavaca, Morelos, Mexico.;Univ Basel, Basel, Switzerland..
    Adou, Arsene Kouablan
    Assoc Ivoirienne Bien Etre Familial, Abidjan, Cote Ivoire..
    Adsuar, Jose C.
    Univ Extremadura, Caceres, Spain..
    Agardh, Emilie Elisabet
    Inst Publ Hlth Sci, Stockholm, Sweden..
    Agarwal, Arnav
    Univ Toronto, Toronto, ON, Canada.;McMaster Univ, Hamilton, ON, Canada..
    Agrawal, Anurag
    CSIR Inst Genom & Integrat Biol, Delhi, India.;Baylor Coll Med, Dept Internal Med, Houston, TX 77030 USA..
    Kiadaliri, Aliasghar Ahmad
    Lund Univ, Clin Epidemiol Unit, Dept Clin Sci Lund, Orthoped, Lund, Sweden.;Kerman Univ Med Sci, Inst Futures Studies Hlth, Hlth Serv Management Res Ctr, Kerman, Iran..
    Ajala, Oluremi N.
    Harvard Univ, Harvard TH Chan Sch Publ Hlth, Boston, MA 02115 USA.;Univ Pittsburgh, Med Ctr, Mckeesport, PA USA..
    Akinyemiju, Tomi F.
    Univ Alabama Birmingham, Dept Epidemiol, Birmingham, AL USA..
    Al-Aly, Ziyad
    Washington Univ, St Louis, MO USA..
    Alam, Khurshid
    Univ Melbourne, Murdoch Childrens Res Inst, Melbourne, Vic, Australia.;Univ Melbourne, Melbourne, Vic, Australia. Natl Inst Publ Hlth, Natl Council Sci & Technol, Cuernavaca, Morelos, Mexico.;Univ Sydney, Sydney, NSW, Australia..
    Alam, Noore K. M.
    Univ Queensland, Brisbane, Qld, Australia.;Queensland Hlth, Herston, Qld, Australia..
    Aldhahri, Saleh Fahed
    King Saud Univ, Riyadh, Saudi Arabia.;King Fahad Med City, Dept Anesthesiol, Riyadh, Saudi Arabia.;King Fahad Med City, Riyadh, Saudi Arabia..
    Aldridge, Robert William
    UCL, Ctr Publ Hlth Data Sci, Inst Hlth Informat, London, England..
    Alemu, Zewdie Aderaw
    Debre Markos Univ, Debre Markos, Ethiopia..
    Ali, Raghib
    Univ Oxford, Oxford, England..
    Alkerwi, Ala'a
    Luxembourg Inst Hlth LIH, Strassen, Luxembourg..
    Alla, Francois
    Univ Lorraine, Sch Publ Hlth, Nancy, France..
    Allebeck, Peter
    Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden..
    Alsharif, Ubai
    Charite, Berlin, Germany..
    Altirkawi, Khalid A.
    King Saud Univ, Riyadh, Saudi Arabia..
    Alvarez Martin, Elena
    Govt Delegat Natl Plan Drugs, Minist Hlth, Spanish Observ Drugs, Social Policy & Equal, Madrid, Spain..
    Alvis-Guzman, Nelson
    Univ Cartagena, Cartagena De Indias, Colombia..
    Amare, Azmeraw T.
    Univ Adelaide, Sch Med, Adelaide, SA, Australia.;Bahir Dar Univ, Coll Med & Hlth Sci, Bahir Dar, Ethiopia..
    Amberbir, Alemayehu
    Dignitas Int, Zomba, Malawi..
    Amegah, Adeladza Kofi
    Univ Cape Coast, Cape Coast, Ghana..
    Amini, Heresh
    Kurdistan Univ Med Sci, Environm Hlth Res Ctr, Sanandaj, Iran.;Swiss Trop & Publ Hlth Inst, Dept Epidemiol & Publ Hlth, Basel, Switzerland..
    Ammar, Walid
    Minist Publ Hlth, Beirut, Lebanon..
    Amrock, Stephen Marc
    Oregon Hlth & Sci Univ, Portland, OR 97201 USA..
    Andersen, Hjalte H.
    Aalborg Univ, Fac Med, Dept Hlth Sci & Technol, Ctr Sensory Motor Interact, Aalborg, Denmark..
    Anderson, Benjamin O.
    Univ Washington, Seattle, WA 98195 USA..
    Antonio, Carl Abelardo T.
    Univ Philippines Manila, Dept Hlth Policy & Adm, Coll Publ Hlth, Manila, Philippines..
    Anwar, Palwasha
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Dalarna Univ, Falun, Sweden. Univ Manitoba, Winnipeg, MB, Canada..
    Artaman, Al
    Asayesh, Hamid
    Qom Univ Med Sci, Sch Paramed, Dept Emergency Med, Qom, Iran..
    Asghar, Rana Jawad
    South Asian Publ Hlth Forum, Islamabad, Pakistan..
    Assadi, Reza
    Mashhad Univ Med Sci, Mashhad, Iran..
    Atique, Suleman
    Taipei Med Univ, Grad Inst Biomed Informat, Taipei, Taiwan..
    Avokpaho, Euripide Frinel G. Arthur
    Inst Rech Clin Benin, Cotonou, Benin.;Lab Etud & Rech Act Sante LERAS Afrique, Parakou, Benin..
    Awasthi, Ashish
    Sanjay Gandhi Postgrad Inst Med Sci, Lucknow, Uttar Pradesh, India..
    Quintanilla, Beatriz Paulina Ayala
    La Trobe Univ, Judith Lumley Ctr Mother Infant & Family Hlth Res, Melbourne, Vic, Australia.;Peruvian Natl Inst Hlth, Lima, Peru..
    Azzopardi, Peter
    Univ Melbourne, Dept Paediat, Melbourne, Vic, Australia.;Univ Melbourne, Murdoch Childrens Res Inst, Melbourne, Vic, Australia.;South Australian Hlth & Med Res Inst, Wardliparingga Aboriginal Res Unit, Adelaide, SA, Australia..
    Bacha, Umar
    Univ Management & Technol, Sch Hlth Sci, Lahore, Pakistan..
    Badawi, Alaa
    Univ Toronto, Dept Nutr Sci, Fac Med, Toronto, ON, Canada.;Publ Hlth Agcy Canada, Toronto, ON, Canada..
    Bahit, Maria C.
    INECO Neurociencias, Rosario, Santa Fe, Argentina..
    Balakrishnan, Kalpana
    Sri Ramachandra Univ, Dept Environm Hlth Engn, Madras, Tamil Nadu, India..
    Barac, Aleksandra
    Univ Belgrade, Fac Med, Belgrade, Serbia..
    Barber, Ryan M.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Barker-Collo, Suzanne L.
    Univ Auckland, Sch Psychol, Auckland, New Zealand..
    Baernighausen, Till
    Harvard Univ, Harvard TH Chan Sch Publ Hlth, Boston, MA 02115 USA.;Africa Hlth Res Inst, Mtubatuba, South Africa.;Heidelberg Univ, Inst Publ Hlth, Heidelberg, Germany..
    Barquera, Simon
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Barregard, Lars
    Univ Gothenburg, Dept Occupat & Environm Hlth, Gothenburg, Sweden..
    Barrero, Lope H.
    Pontificia Univ Javeriana, Sch Engn, Dept Ind Engn, Bogota, Colombia..
    Basu, Sanjay
    Stanford Univ, Stanford, CA 94305 USA..
    Bans, Carolina
    Bazargan-Hejazi, Shahrzad
    Charles R Drew Univ Med & Sci, Coll Med, 1621 E 120th St, Los Angeles, CA 90059 USA.;Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA.;Kermanshah Univ Med Sci, Kermanshah, Iran..
    Beardsley, Justin
    Univ Oxford, Ho Chi Minh City, Vietnam..
    Bedi, Neeraj
    Coll Publ Hlth & Trop Med, Jazan, Saudi Arabia..
    Beghi, Ettore
    IRCCS Ist Ric Farmacol Mario Negri, Milan, Italy..
    Bell, Michelle L.
    Yale Univ, New Haven, CT USA..
    Bello, Aminu K.
    Univ Alberta, Edmonton, AB, Canada..
    Bennett, Derrick A.
    Univ Oxford, Oxford, England..
    Bensenor, Isabela M.
    Univ Sao Paulo, Sao Paulo, Brazil..
    Berhane, Adugnaw
    Debre Berhane Univ, Debre Berhan, Ethiopia..
    Bernabe, Eduardo
    Kings Coll London, London, England. Haramaya Univ, Coll Hlth & Med Sci, Harar, Ethiopia..
    Betsu, Balem Demtsu
    Mekelle Univ, Mekelle, Ethiopia..
    Beyene, Addisu Shunu
    Haramaya Univ, Harar, Ethiopia..
    Bhala, Neeraj
    Queen Elizabeth Hosp Birmingham, Birmingham, W Midlands, England.;Univ Otago, Sch Med, Wellington, New Zealand..
    Bhansali, Anil
    Postgrad Inst Med Educ & Res, Chandigarh, India..
    Bhatt, Samir
    Imperial Coll London, Dept Infect Dis Epidemiol, London, England..
    Biadgilign, Sibhatu
    Independent Publ Hlth Consultants, Addis Ababa, Ethiopia..
    Bikbov, Boris
    Acad VI Shumakov Fed Res Ctr Transplantol & Artif, Dept Nephrol Issues Transplanted Kidney, Moscow, Russia..
    Bisanzio, Donal
    Univ Oxford, Nuffield Dept Med, Oxford, England..
    Bjertness, Espen
    Univ Oslo, Dept Community Med, Oslo, Norway..
    Blore, Jed D.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Borschmann, Rohan
    Univ Melbourne, Murdoch Childrens Res Inst, Melbourne, Vic, Australia.;Univ Melbourne, Melbourne, Vic, Australia. Natl Inst Publ Hlth, Natl Council Sci & Technol, Cuernavaca, Morelos, Mexico..
    Boufous, Soufiane
    Univ New South Wales, Transport & Rd Safety TARS Res, Kensington, NSW, Australia..
    Bourne, Rupert R. A.
    Anglia Ruskin Univ, Vis & Eye Res Unit, Cambridge, England..
    Brainin, Michael
    Danube Univers Krems, Krems, Austria..
    Brazinova, Alexandra
    Trnava Univ, Dept Publ Hlth, Fac Hlth Sci & Social Work, Trnava, Slovakia.;Int Neurotrauma Res Org, Vienna, Austria..
    Breitborde, Nicholas J. K.
    Ohio State Univ, Columbus, OH 43210 USA..
    Brenner, Hermann
    German Canc Res Ctr, Heidelberg, Germany..
    Broday, David M.
    Technion, Haifa, Israel..
    Brugha, Traolach S.
    Univ Leicester, Leicester, Leics, England..
    Brunekreef, Bert
    Univ Utrecht, Inst Risk Assessment Sci, Utrecht, Netherlands..
    Butt, Zahid A.
    Al Shifa Trust Eye Hosp, Rawalpindi, Pakistan..
    Cahill, Leah E.
    Harvard Univ, Harvard TH Chan Sch Publ Hlth, Boston, MA 02115 USA.;Dalhousie Univ, Halifax, NS, Canada..
    Calabria, Bianca
    Univ New South Wales, Kensington, NSW, Australia.;Australian Natl Univ, Natl Ctr Epidemiol & Populat Hlth, Canberra, ACT, Australia..
    Ricardo Campos-Nonato, Ismael
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico.;Harvard Univ, Harvard TH Chan Sch Publ Hlth, Boston, MA 02115 USA..
    Cardenas, Rosario
    Metropolitan Autonomous Univ, Mexico City, DF, Mexico..
    Carpenter, David
    Univ Albany, Rensselaer, NY USA..
    Casey, Daniel C.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Castaneda-Oquela, Carlos A.
    Colombian Natl Hlth Observ, Inst Nacl Salud, Bogota, Colombia.;Univ Nacl Colombia, Dept Publ Hlth, Epidemiol & Publ Hlth Evaluat Grp, Bogota, Colombia..
    Castillo Rivas, Jacqueline
    Caja Costarricense Seguro Social, San Jose, Costa Rica.;Univ Costa Rica, San Pedro, Montes De Oca, Costa Rica..
    Estanislao Castro, Ruben
    Univ Diego Portales, Santiago, Chile..
    Catala-Lopez, Ferran
    Univ Valencia, Dept Med, INCLIVA Hlth Res Inst, Valencia, Spain.;CIBERSAM, Valencia, Spain.;Ottawa Hosp, Res Inst, Clin Epidemiol Program, Ottawa, ON, Canada. Natl Taiwan Univ, Coll Med, Sch Nursing, Taipei, Taiwan..
    Chang, Jung-Chen
    Chiang, Peggy Pei-Chia
    Gold Coast Hlth, Clin Governance Unit, Southport, Qld, Australia..
    Chibalabala, Mirriam
    Crowd Watch Africa, Lusaka, Zambia..
    Chimed-Ochir, Odgerel
    Univ Occupat & Environm Hlth, Dept Environm Epidemiol, Kitakyushu, Fukuoka, Japan..
    Chisumpa, Vesper Hichilombwe
    Univ Zambia, Lusaka, Zambia.;Univ Witwatersrand, Johannesburg, South Africa..
    Chitheer, Abdulaal A.
    Minist Hlth, Baghdad, Iraq..
    Choi, Jee-Young Jasmine
    Seoul Natl Univ, Med Lib, Seoul, South Korea..
    Christensen, Hanne
    Bispebjerg Hosp, Copenhagen, Denmark..
    Christopher, Devasahayam Jesudas
    Christian Med Coll & Hosp, Vellore, Tamil Nadu, India..
    Ciobanu, Liliana G.
    Univ Adelaide, Adelaide, SA, Australia..
    Coates, Matthew M.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Colquhoun, Samantha M.
    Univ Melbourne, Murdoch Childrens Res Inst, Melbourne, Vic, Australia.;Univ Melbourne, Melbourne, Vic, Australia. Natl Inst Publ Hlth, Natl Council Sci & Technol, Cuernavaca, Morelos, Mexico..
    Cooper, Leslie Trumbull
    Mayo Clin, Jacksonville, FL 32224 USA. Mario Negri Inst Pharmacol Res, Milan, Italy..
    Cooperrider, Kimberly
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Cornaby, Leslie
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Cortinovis, Monica
    Crump, John A.
    Univ Otago, Ctr Int Hlth, Dunedin Sch Med, Dunedin, New Zealand..
    Cuevas-Nasu, Lucia
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Damasceno, Albertino
    Eduardo Mondlane Univ, Fac Med, Maputo, Mozambique..
    Dandona, Rakhi
    Publ Hlth Fdn India, New Delhi, India..
    Darby, Sarah C.
    Univ Oxford, Clin Trial Serv Unit, Oxford, England..
    Dargan, Paul I.
    Guys & St Thomas NHS Fdn Trust, London, England..
    das Neves, Jose
    Univ Porto, Inst Invest & Inovacao Saude i3S, Oporto, Portugal.;Univ Porto, INEB Inst Engn Biomed, Oporto, Portugal..
    Davis, Adrian C.
    Publ Hlth England, London, England..
    Davletov, Kairat
    Kazakh Natl Med Univ, Sch Publ Hlth, Alma Ata, Kazakhstan..
    Filipa de Castro, E.
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    De la Cruz-Gongora, Vanessa
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    De Leo, Diego
    Griffith Univ, Brisbane, Qld, Australia..
    Degenhardt, Louisa
    Univ New South Wales, Natl Drug & Alcohol Res Ctr, Kensington, NSW, Australia..
    Del Gobbo, Liana C.
    Stanford Univ, Stanford, CA 94305 USA..
    del Pozo-Cruz, Borja
    Univ Auckland, Auckland, New Zealand..
    Dellavalle, Robert P.
    Univ Colorado, Sch Med, Aurora, CO USA.;Colorado Sch Publ Hlth, Aurora, CO USA..
    Deribew, Amare
    Univ Oxford, Nuffield Dept Med, Oxford, England.;KEMRI Wellcome Trust Res Programme, Kilifi, Kenya..
    Des Jarlais, Don C.
    Mt Sinai Beth Israel, New York, NY USA.;Icahn Sch Med Mt Sinai, New York, NY 10029 USA..
    Dharmaratne, Samath D.
    Univ Peradeniya, Fac Med, Dept Community Med, Peradeniya, Sri Lanka..
    Dhillon, Preet K.
    Publ Hlth Fdn India, Gurgaon, India.;Publ Hlth Fdn India, Gurgaon, India..
    Diaz-Tome, Cesar
    Hosp Santa Creu & Sant Pau, Barcelona, Spain..
    Dicker, Daniel
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Ding, Eric L.
    Harvard Univ, Harvard TH Chan Sch Publ Hlth, Boston, MA 02115 USA..
    Dorsey, E. Ray
    Univ Rochester, Med Ctr, Rochester, NY 14642 USA..
    Doyle, Kerrie E.
    RMIT Univ, Bundoora, Vic, Australia..
    Driscoll, Tim R.
    Univ Sydney, Sydney Sch Publ Hlth, Sydney, NSW, Australia..
    Duan, Leilei
    Chinese Ctr Dis Control & Prevent, Ctr Chron & Noncommunicable Dis Control & Prevent, Beijing, Peoples R China..
    Dubey, Manisha
    Int Inst Populat Sci, Bombay, Maharashtra, India..
    Duncan, Bruce Bartholow
    Univ Fed Rio Grande do Sul, Porto Alegre, RS, Brazil.;Univ Nouth Carolina, Chapel Hill, NC USA..
    Elyazar, Iqbal
    Eijkman Oxford Clin Res Unit, Jakarta, Indonesia..
    Endries, Aman Yesuf
    Arba Minch Univ, Arba Minch, Ethiopia..
    Ermakov, Sergey Petrovich
    Russian Acad Sci, Inst Social & Econ Studies Populat, Moscow, Russia.;Minist Hlth Russian Federat, Fed Res Inst Hlth Org & Informat, Moscow, Russia..
    Erskine, Holly E.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA.;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia.;Queensland Ctr Mental Hlth Res, Brisbane, Qld, Australia..
    Eshrati, Babak
    Minist Hlth & Med Educ, Tehran, Iran.;Arak Univ Med Sci, Arak, Iran..
    Esteghamati, Alireza
    Univ Tehran Med Sci, Endocrinol & Metab Populat Sci Inst, Tehran, Iran..
    Fahimi, Saman
    Univ Tehran Med Sci, Digest Dis Res Inst, Tehran, Iran..
    Aquino Faraon, Emerito Jose
    Univ Philippines Manila, Coll Publ Hlth, Manila, Philippines.;Dept Hlth, Manila, Philippines..
    Farid, Talha A.
    Univ Louisville, Louisville, KY USA..
    Sofia E Sa Farinha, Carla
    DGS Directorate Gen Hlth, Lisbon, Portugal.;Univ Aberta, Lisbon, Portugal..
    Faro, Andre
    Univ Fed Sergipe, Aracaju, Brazil..
    Farvid, Maryam S.
    Harvard Univ, Harvard TH Chan Sch Publ Hlth, Boston, MA 02115 USA.;Massachusetts Gen Hosp, Mongan Inst Hlth Policy, Harvard MGH Ctr Genom Vulnerable Populat & Hlth D, Boston, MA 02114 USA..
    Farzadfar, Farshad
    Univ Tehran Med Sci, Noncommunicable Dis Res Ctr, Tehran, Iran..
    Feigin, Valery L.
    Auckland Univ Technol, Natl Inst Stroke & Appl Neurosci, Auckland, New Zealand..
    Fereshtehnejad, Seyed-Mohammad
    Karolinska Inst, Dept Neurobiol, Care Sci & Soc NVS, Stockholm, Sweden..
    Fernandes, Jefferson G.
    German Hosp Oswaldo Cruz, Inst Educ & Sci, Sao Paulo, Brazil..
    Fischer, Florian
    Univ Bielefeld, Bielefeld, Germany..
    Fitchett, Joseph R. A.
    Harvard Univ, Boston, MA 02115 USA..
    Fleming, Tom
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Foigt, Nataliya
    Acad Med Sci, Inst Gerontol, Kiev, Ukraine..
    Foreman, Kyle
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Fowkes, F. Gerry R.
    Univ Edinburgh, Edinburgh, Midlothian, Scotland..
    Franklin, Richard C.
    James Cook Univ, Townsville, Qld, Australia..
    Fuerst, Thomas
    Univ Basel, Basel, Switzerland.;Swiss Trop & Publ Hlth Inst, Dept Epidemiol & Publ Hlth, Basel, Switzerland..
    Futran, Neal D.
    Univ Washington, Seattle, WA 98195 USA..
    Gakidou, Emmanuela
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Garcia-Basteiro, Alberto L.
    Manhica Hlth Res Ctr, Manhica, Mozambique.;Barcelona Inst Global Hlth, Barcelona, Spain..
    Gebrehiwot, Tsegaye Tewelde
    Jimma Univ, Jimma, Ethiopia..
    Gebremedhin, Amanuel Tesfay
    Jimma Univ, Jimma, Ethiopia.;Univ Munich, Munich, Germany..
    Geleijnse, Johanna M.
    Wageningen Univ, Div Human Nutr, Wageningen, Netherlands..
    Gessner, Bradford D.
    Agence Med Prevent, Paris, France..
    Giref, Ababi Zergaw
    Univ Addis Ababa, Addis Ababa, Ethiopia..
    Giroud, Maurice
    Univ Hosp Dijon, Dijon, France. Haramaya Univ, Coll Hlth & Med Sci, Dire Dawa, Ethiopia..
    Gishu, Melkamu Dedefo
    Haramaya Univ, Dire Dawa, Ethiopia.;Kersa Hlth & Demog Surveillance Syst, Harar, Ethiopia..
    Goenka, Shifalika
    Publ Hlth Fdn India, New Delhi, India..
    Carmen Gomez-Cabrera, Mari
    Univ Valencia, Valencia, Spain.;INCLIVA Biomed Res Inst, Valencia, Spain..
    Gomez-Dantes, Hector
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Gona, Philimon
    Univ Massachusetts, Boston, MA 02125 USA..
    Goodridge, Amador
    Inst Invest Cient & Servicios Alta Tecnol INDICAS, Ciudad Del Saber, Panama..
    Gopalani, Sameer Vali
    Govt Federated States Micronesia, Dept Hlth & Social Affairs, Palikir, Micronesia..
    Gotay, Carolyn C.
    Univ British Columbia, Vancouver, BC, Canada..
    Goto, Atsushi
    Natl Canc Ctr, Div Epidemiol, Ctr Publ Hlth Sci, Tokyo, Japan..
    Gouda, Hebe N.
    Univ Queensland, Brisbane, Qld, Australia..
    Gugnani, Harish Chander
    St James Sch Med, Dept Microbiol, The Quarter, Anguilla, Scotland.;St James Sch Med, Dept Epidemiol & Biostat, The Quarter, Anguilla, Scotland. West Virginia Bur Publ Hlth, Charleston, WV USA. Eternal Heart Care Ctr & Res Inst, Jaipur, Rajasthan, India..
    Guillemin, Francis
    Univ Lorraine, Sch Publ Hlth, Nancy, France..
    Guo, Yuming
    Univ Queensland, Brisbane, Qld, Australia..
    Gupta, Rahul
    Gupta, Rajeev
    Gutierrez, Reyna A.
    Natl Inst Psychiat Ramon Fuente, Mexico City, DF, Mexico..
    Haagsma, Juanita A.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA.;Univ Med Ctr, Erasmus MC, Dept Publ Hlth, Rotterdam, Netherlands..
    Hafezi-Nejad, Nima
    Univ Tehran Med Sci, Endocrinol & Metab Populat Sci Inst, Tehran, Iran..
    Haile, Demewoz
    Univ Addis Ababa, Addis Ababa, Ethiopia..
    Hailu, Gessessew Bugssa
    Mekelle Univ, Mekelle, Ethiopia.;Kilte Awlaelo Hlth & Demog Surveillance Syst, Mekelle, Ethiopia..
    Halasa, Yara A.
    Brandeis Univ, Waltham, MA USA..
    Hamadeh, Randah Ribhi
    Arabian Gulf Univ, Manama, Bahrain..
    Hamidi, Samer
    Hamdan Bin Mohammed Smart Univ, Dubai, U Arab Emirates..
    Handal, Alexis J.
    Univ New Mexico, Albuquerque, NM 87131 USA..
    Hankey, Graeme J.
    Univ Western Australia, Sch Med & Pharmacol, Perth, WA, Australia.;Harry Perkins Inst Med Res, Nedlands, WA, Australia.;Western Australian Neurosci Res Inst, Nedlands, WA, Australia..
    Hao, Yuantao
    Sun Yat Sen Univ, Sch Publ Hlth, Guangzhou, Guangdong, Peoples R China..
    Harb, Hilda L.
    Harikrishnan, Sivadasanpillai
    Sree Chitra Tirunal Inst Med Sci & Technol, Trivandrum, Kerala, India..
    Maria Haro, Josep
    Parc Sanitari Sant Joan Deu CIBERSAM, St Boi De Llobregat, Barcelona, Spain.;Univ Barcelona, Barcelona, Spain..
    Hassanvand, Mohammad Sadegh
    Univ Tehran Med Sci, Ctr Air Pollut Res, Inst Environm Res, Tehran, Iran..
    Hassen, Tahir Ahmed
    Haramaya Univ, Harar, Ethiopia..
    Havmoeller, Rasmus
    Karolinska Inst, Stockholm, Sweden..
    Beatriz Heredia-Pi, Ileana
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Francisco Hernandez-Llanes, Norberto
    Comis Nacl Adicc, Mexico City, DF, Mexico..
    Heydarpour, Pouria
    Univ Tehran Med Sci, Multiple Sclerosis Res Ctr, Neurosci Inst, Tehran, Iran..
    Hoek, Hans W.
    Univ Groningen, Univ Med Ctr Groningen, Dept Psychiat, Groningen, Netherlands.;Columbia Univ, Dept Epidemiol, Mailman Sch Publ Hlth, New York, NY USA..
    Hoffman, Howard J.
    Natl Inst Deafness & Other Commun Disorders, Epidemiol & Stat Program, NIH, Bethesda, MD USA..
    Horino, Masako
    Dept Hlth & Human Serv, Nevada Div Publ & Behav Hlth, Carson City, NV USA..
    Horita, Nobuyuki
    Yokohama City Univ, Dept Pulmonol, Grad Sch Med, Yokohama, Kanagawa, Japan..
    Hosgood, H. Dean
    Albert Einstein Coll Med, Bronx, NY 10467 USA..
    Hoy, Damian G.
    Pacific Community, Publ Hlth Div, Noumea, New Caledonia..
    Hsairi, Mohamed
    Salah Azaiz Inst, Dept Epidemiol, Tunis, Tunisia..
    Htet, Aung Soe
    Univ Oslo, Oslo, Norway.;Minist Hlth, Int Relat Div, Nay Pyi Taw, Myanmar..
    Hu, Guoqing
    Cent S Univ, Sch Publ Hlth, Dept Epidemiol & Hlth Stat, Changsha, Hunan, Peoples R China..
    Huang, John J.
    Husseini, Abdullatif
    Birzeit Univ, Birzeit, Israel..
    Hutchings, Sally J.
    Imperial Coll London, London, England..
    Huybrechts, Inge
    Int Agcy Res Canc IARC, Lyon, France.;Univ Ghent, Ghent, Belgium..
    Iburg, Kim Moesgaard
    Aarhus Univ, Aarhus, Denmark..
    Idrisov, Bulat T.
    Boston Univ, Boston Med Ctr, Boston, MA 02215 USA..
    Ileanu, Bogdan Vasile
    Bucharest Univ Econ Studies, Bucharest, Romania..
    Inoue, Manami
    Natl Canc Ctr, Tokyo, Japan.;Univ Tokyo, Grad Sch Med, Tokyo, Japan..
    Jacobs, Troy A.
    HIDN, USAID Global Hlth Bur, MCH Div, Washington, DC USA..
    Jacobsen, Kathryn H.
    George Mason Univ, Dept Global & Community Hlth, Fairfax, VA USA..
    Jahanmehr, Nader
    Shahid Beheshti Univ Med Sci, Sch Publ Hlth, Tehran, Iran..
    Jakovljevic, Mihajlo B.
    Univ Kragujevac, Fac Med Sci, Kragujevac, Serbia..
    Jansen, Henrica A. F. M.
    UNFPA Asia & Pacific Reg Off, Bangkok, Thailand..
    Jassal, Simerjot K.
    Univ Calif San Diego, VA San Diego, San Diego, CA 92103 USA..
    Javanbakht, Mehdi
    Univ Aberdeen, Aberdeen, Scotland..
    Jayatilleke, Achala Upendra
    Postgrad Inst Med, Colombo, Sri Lanka.;Inst Violence & Injury Prevent, Colombo, Sri Lanka..
    Jee, Sun Ha
    Yonsei Univ, Grad Sch Publ Hlth, Seoul, South Korea..
    Jeemon, Panniyammakal
    Publ Hlth Fdn India, Ctr Control Chron Condit, New Delhi, India.;Publ Hlth Fdn India, Ctr Control Chron Condit, Gurgaon, India.;Ctr Chron Dis Control, New Delhi, India..
    Jha, Vivekanand
    Univ Oxford, Oxford, England.;George Inst Global Hlth India, New Delhi, India..
    Jiang, Ying
    Univ Occupat & Environm Hlth, Dept Hlth Dev, Inst Ind Ecol Sci, Kitakyushu, Fukuoka, Japan..
    Jibat, Tariku
    Wageningen Univ, Wageningen, Netherlands.;Univ Addis Ababa, Addis Ababa, Ethiopia.;Univ Addis Ababa, Debre Zeit, Ethiopia..
    Jin, Ye
    Chinese Ctr Dis Control & Prevent, Ctr Chron & Noncommunicable Dis Control & Prevent, Beijing, Peoples R China..
    Johnson, Catherine O.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Jonas, Jost B.
    Heidelberg Univ, Med Fac Mannheim, Dept Ophthalmol, Mannheim, Germany..
    Kabir, Zubair
    Univ Coll Cork, Cork, Ireland..
    Kalkonde, Yogeshwar
    Soc Educ Act & Res Community Hlth, Gadchiroli, India..
    Kamal, Ritul
    CSIR Indian Inst Toxicol Res, Lucknow, Uttar Pradesh, India..
    Kan, Haidong
    Fudan Univ, Shanghai, Peoples R China..
    Karch, Andre
    Helmholtz Ctr Infect Res, Epidemiol & Stat Methods Res Grp, Braunschweig, Germany.;German Ctr Infect Res, Hannover Braunschweig Site, Braunschweig, Germany..
    Karema, Corine Kakizi
    Swiss Trop & Publ Hlth Inst, Basel, Switzerland.;Qual & Equity Hlth Care, Kigali, Rwanda..
    Karimkhani, Chante
    Case Western Univ Hosp, Cleveland, OH USA..
    Kasaeian, Amir
    Univ Tehran Med Sci, Noncommunicable Dis Res Ctr, Tehran, Iran.;Univ Tehran Med Sci, Hematol Oncol & Stem Cell Transplantat Res Ctr, Tehran, Iran..
    Kaul, Anil
    Oklahoma State Univ, Tulsa, OK USA..
    Kawakami, Norito
    Univ Tokyo, Sch Publ Hlth, Tokyo, Japan..
    Kazi, Dhruv S.
    Univ Calif San Francisco, San Francisco, CA 94143 USA..
    Keiyoro, Peter Njenga
    Inst Trop & Infect Dis, Nairobi, Kenya.;Sch Continuing & Distance Educ, Nairobi, Kenya..
    Kemp, Andrew Haddon
    Univ Sydney, Sydney, NSW, Australia.;Swansea Univ, Swansea, W Glam, Wales..
    Kengne, Andre Pascal
    South African Med Researcil, Cape Town, South Africa.;Univ Cape Town, Cape Town, South Africa..
    Keren, Andre
    Assuta Hosp, Assuta Hashalom, Tel Aviv, Israel..
    Kesavachandran, Chandrasekharan Nair
    Khader, Yousef Saleh
    Jordan Univ Sci & Technol, Irbid, Jordan..
    Khan, Abdur Rahman
    Univ Louisville, Louisville, KY USA..
    Khan, Ejaz Ahmad
    Hlth Serv Acad, Islamabad, Pakistan..
    Khan, Gulfaraz
    United Arab Emirates Univ, Coll Med & Hlth Sci, Dept Microbiol & Immunol, Al Ain, U Arab Emirates..
    Khang, Young-Ho
    Seoul Natl Univ, Coll Med, Seoul, South Korea..
    Khatibzadeh, Shahab
    Harvard Univ, Harvard TH Chan Sch Publ Hlth, Boston, MA 02115 USA..
    Khera, Sahil
    New York Med Coll, Valhalla, NY 10595 USA..
    Khoja, Tawfik Ahmed Muthafer
    Execut Board Hlth Ministers Council Cooperat Coun, Riyadh, Saudi Arabia..
    Khubchandani, Jagdish
    Ball State Univ, Muncie, IN 47306 USA..
    Kieling, Christian
    Univ Fed Rio Grande do Sul, Porto Alegre, RS, Brazil.;Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil. Korea Hlth Ind Dev Inst, Cheongju, South Korea..
    Kim, Cho-il
    Kim, Daniel
    Northeastern Univ, Dept Hlth Sci, Boston, MA 02115 USA..
    Kimokoti, Ruth W.
    Simmons Coll, Boston, MA 02115 USA..
    Kissoon, Niranjan
    Univ British Columbia, Vancouver, BC, Canada..
    Kivipelto, Miia
    Karolinska Inst, Aging Res Ctr, Stockholm, Sweden..
    Knibbs, Luke D.
    Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia..
    Kokubo, Yoshihiro
    Natl Cerebral & Cardiovasc Ctr, Dept Prevent Cardiol, Suita, Osaka, Japan..
    Kopec, Jacek A.
    Univ British Columbia, Vancouver, BC, Canada..
    Koul, Parvaiz A.
    Sherikashmir Inst Med Sci, Srinagar, Jammu & Kashmir, India..
    Koyanagi, Ai
    Parc Sanitari St Joan Deu CIBERSAM, Res & Dev Unit, Barcelona, Spain..
    Kravchenko, Michael
    Res Ctr Neurol, Moscow, Russia..
    Kromhout, Hans
    Univ Utrecht, Inst Risk Assessment Sci, Utrecht, Netherlands..
    Krueger, Hans
    Univ British Columbia, Sch Populat & Publ Hlth, Vancouver, BC, Canada..
    Ku, Tiffany
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Defo, Barthelemy Kuate
    Univ Montreal, Dept Demog, Montreal, PQ, Canada.;Univ Montreal, Publ Hlth Res Inst, Montreal, PQ, Canada.;Univ Montreal, Dept Social & Prevent Med, Sch Publ Hlth, Montreal, PQ, Canada..
    Kuchenbecker, Ricardo S.
    Univ Fed Rio Grande do Sul, Graduat Studies Epidemiol, Porto Alegre, RS, Brazil..
    Bicer, Burcu Kucuk
    Hacettepe Univ, Inst Publ Hlth, Ankara, Turkey..
    Kuipers, Ernst J.
    Univ Med Ctr Rotterdam, Erasmus MC, Rotterdam, Netherlands..
    Kumar, G. Anil
    Publ Hlth Fdn India, New Delhi, India..
    Kwan, Gene F.
    Boston Univ, Sch Med, Boston, MA 02118 USA..
    Lal, Dharmesh Kumar
    Publ Hlth Fdn India, Gurgaon, India.;Publ Hlth Fdn India, Gurgaon, India..
    Lalloo, Ratilal
    Univ Queensland, Sch Dent, Brisbane, Qld, Australia..
    Lallukka, Tea
    Finnish Inst Occupat Hlth, Work Disabil Prevent, Work Org, Helsinki, Finland.;Univ Helsinki, Dept Publ Hlth, Fac Med, Helsinki, Finland..
    Lan, Qing
    NCI, Rockville, MD USA..
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Latif, Asma Abdul
    Women Univ, Lahore Coll, Dept Zool, Lahore, Pakistan..
    Beatriz Lawrynowicz, Alicia Elena
    Inst Nacl Epidemiol Dr Juan H Jara, Mar Del Plata, Buenos Aires, Argentina..
    Leasher, Janet L.
    Nova Southeastern Univ, Coll Optometry, Ft Lauderdale, FL 33314 USA..
    Leigh, James
    Univ Sydney, Sydney, NSW, Australia..
    Leung, Janni
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA.;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia.;Queensland Ctr Mental Hlth Res, Brisbane, Qld, Australia..
    Levi, Miriam
    Tuscany Reg Ctr Occupat Injuries & Dis, Florence, Italy..
    Li, Xiaohong
    Natl Ctr Birth Defects Monitoring China, Chengdu, Peoples R China..
    Li, Yichong
    Chinese Ctr Dis Control & Prevent, Ctr Chron & Noncommunicable Dis Control & Prevent, Beijing, Peoples R China..
    Liang, Juan
    Sichuan Univ, West China Univ Hosp 2, Natl Off Maternal & Child Hlth Surveillance, Chengdu, Peoples R China..
    Liu, Shiwei
    Chinese Ctr Dis Control & Prevent, Ctr Chron & Noncommunicable Dis Control & Prevent, Beijing, Peoples R China..
    Lloyd, Belinda K.
    Monash Univ, Eastern Hlth Clin Sch, Fitzroy, Vic, Australia.;Eastern Hlth, Turning Point, Melbourne, Vic, Australia..
    Logroscino, Giancarlo
    Univ Bari, Bari, Italy..
    Lotufo, Paulo A.
    Univ Sao Paulo, Sao Paulo, Brazil..
    Lunevicius, Raimundas
    Aintree Univ, Hosp Natl Hlth Serv Fdn Trust, Liverpool, Merseyside, England.;Univ Liverpool, Sch Med, Liverpool, Merseyside, England..
    Maclntyre, Michael
    Mahdavi, Mandi
    Social Secur Org Res Inst, Tehran, Iran.;Erasmus Univ, Inst Hlth Policy & Management, Rotterdam, Netherlands..
    Majdan, Marek
    Trnava Univ, Dept Publ Hlth, Fac Hlth Sci & Social Work, Trnava, Slovakia..
    Majeed, Azeem
    Imperial Coll London, London, England..
    Malekzadeh, Reza
    Univ Tehran Med Sci, Digest Dis Res Inst, Tehran, Iran..
    Malta, Deborah Carvalho
    Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil..
    Manamo, Wondimu Ayele Ayele
    Univ Addis Ababa, Addis Ababa, Ethiopia..
    Mapoma, Chabila C.
    Univ Zambia, Lusaka, Zambia..
    Marcenes, Wagner
    Kings Coll London, Inst Dent, Div Populat & Patient Hlth, London, England..
    Martin, Randall V.
    Dalhousie Univ, Halifax, NS, Canada..
    Martinez-Raga, Jose
    Univ Valencia, Univ Hosp Doctor Peset, Valencia, Spain.;CEU Cardenal Herrera Univ, Moncada, Valencia, Spain..
    Masiye, Felix
    Univ Zambia, Lusaka, Zambia..
    Matsushita, Kunihiro
    Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Baltimore, MD USA..
    Matzopoulos, Richard
    South African Med Researcil, Cape Town, South Africa.;Univ Cape Town, Sch Publ Hlth & Family Med, Cape Town, South Africa..
    Mayosi, Bongani M.
    McGrath, John J.
    Univ Queensland, Brisbane, Qld, Australia..
    McKee, Martin
    London Sch Hyg & Trop Med, London, England..
    Meaney, Peter A.
    Univ Penn, Perelman Sch Med, Philadelphia, PA 19104 USA.;Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA..
    Medina, Catalina
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Mehari, Alem
    Howard Univ, Coll Med, Washington, DC 20059 USA..
    Mena-Rodriguez, Fabiola
    Mekonnen, Alemayehu B.
    Univ Sydney, Sydney, NSW, Australia.;Univ Gondar, Gondar, Ethiopia..
    Melaku, Yohannes Adama
    Mekelle Univ, Sch Publ Hlth, Mekelle, Ethiopia.;Univ Adelaide, Sch Med, Adelaide, SA, Australia..
    Memish, Ziad A.
    Saudi Minist Hlth, Riyadh, Saudi Arabia.;Alfaisal Univ, Coll Med, Riyadh, Saudi Arabia..
    Mendoza, Walter
    United Nations Populat Fund, Lima, Peru..
    Mensink, Gert B. M.
    Robert Koch Inst, Berlin, Germany..
    Meretoja, Atte
    Univ Melbourne, Dept Med, Melbourne, Vic, Australia.;Helsinki Univ Hosp, Dept Neurol, Helsinki, Finland..
    Meretoja, Tuomo J.
    Univ Helsinki, Helsinki, Finland.;Helsinki Univ Hosp, Ctr Comprehens Canc, Breast Surg Unit, Helsinki, Finland..
    Mesfin, Yonatan Moges
    Haramaya Univ, Harar, Ethiopia..
    Mhimbira, Francis Apolinary
    Ifakara Hlth Inst, Bagamoyo, Tanzania..
    Miller, Ted R.
    Pacific Inst Res & Evaluat, Calverton, MD USA.;Curtin Univ, Ctr Populat Hlth, Perth, WA, Australia..
    Mills, Edward J.
    Univ Ottawa, Ottawa, ON, Canada..
    Mirarefin, Mojde
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Misganaw, Awoke
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Mock, Charles N.
    Univ Washington, Harborview Injury Prevent & Res Ctr, Seattle, WA 98195 USA..
    Mohammadi, Alireza
    Baqiyatallah Univ Med Sci, Neurosci Res Ctr, Tehran, Iran..
    Mohammed, Shafiu
    Heidelberg Univ, Inst Publ Hlth, Heidelberg, Germany.;Ahmadu Bello Univ, Hlth Syst & Policy Res Unit, Zaria, Nigeria..
    Mola, Glen Liddell D.
    Univ Papua New Guinea, Boroko, Papua N Guinea..
    Monasta, Lorenzo
    IRCCS Burlo Garofolo, Inst Maternal & Child Hlth, Trieste, Italy..
    Montanez Hernandez, Julio Cesar
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Montico, Marcella
    IRCCS Burlo Garofolo, Inst Maternal & Child Hlth, Trieste, Italy..
    Morawska, Lidia
    Queensland Univ Technol, Int Lab Air Qual & Hlth, Brisbane, Qld, Australia..
    Mori, Rintaro
    Natl Ctr Child Hlth & Dev, Tokyo, Japan..
    Mozaffarian, Dariush
    Tufts Univ, Friedman Sch Nutr Sci & Policy, Boston, MA 02111 USA..
    Mueller, Ulrich O.
    Fed Inst Populat Res, Wiesbaden, Germany..
    Mullany, Erin
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Mumford, John Everett
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Murthy, Gudlavalleti Venkata Satyanarayana
    London Sch Hyg & Trop Med, London, England.;Publ Hlth Fdn India, Indian Inst Publ Hlth, Gurgaon, India..
    Nachega, Jean B.
    Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Baltimore, MD USA.;Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA USA.;Univ Stellenbosch, Cape Town, South Africa..
    Naheed, Aliya
    Int Ctr Diarrhoeal Dis Res, Bangladesh Icddr B, Dhaka, Bangladesh..
    Nangia, Vinay
    Suraj Eye Inst, Nagpur, Maharashtra, India..
    Nassiri, Nariman
    Wayne State Univ, Sch Med, Detroit, MI USA..
    Newton, John N.
    Publ Hlth England, London, England..
    Ng, Marie
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Nguyen, Quyen Le
    Nisar, Muhammad Imran
    Aga Khan Univ, Karachi, Pakistan..
    Pete, Patrick Martial Nkamedjie
    Inst Res Socioecon Dev & Commun, Yaounde, Cameroon..
    Norheim, Ole F.
    Univ Bergen, Bergen, Norway..
    Norman, Rosana E.
    Queensland Univ Technol, Inst Hlth & Biomed Innovat, Brisbane, Qld, Australia..
    Norrving, Bo
    Skane Univ Hosp, Dept Clin Sci Lund, Dept Clin Sci, Lund, Sweden..
    Nyakarahuka, Luke
    Makerere Univ, Kampala, Uganda..
    Obermeyer, Carla Makhlouf
    Amer Univ Beirut, Fac Hlth Sci, Ctr Res Populat & Hlth, Beirut, Lebanon..
    Ogbo, Felix Akpojene
    Univ Western Sydney, Ctr Hlth Res, Sydney, NSW, Australia. Kyung Hee Univ, Sch Med, Dept Prevent Med, Seoul, South Korea..
    Oh, In-Hwan
    Oladimeji, Olanrewaju
    Human Sci Res Council, Durban, South Africa.;Univ KwaZulu Natal, Durban, South Africa. Univ Autonoma Chile, Talca, Chile..
    Olivares, Pedro R.
    Olsen, Helen
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Olusanya, Bolajoko Olubukunola
    Ctr Hlth Start Initiat, Lagos, Nigeria..
    Olusanya, Jacob Olusegun
    Ctr Hlth Start Initiat, Lagos, Nigeria..
    Opio, John Nelson
    Lira Municipal Council, Lira Dist Local Govt, Lira, Uganda..
    Oren, Eyal
    Univ Arizona, Tucson, AZ USA..
    Orozco, Ricardo
    Natl Inst Psychiat Ramon Fuente, Mexico City, DF, Mexico..
    Ortiz, Alberto
    II S Fdn Jimenez Diaz UAM, Madrid, Spain..
    Ota, Erika
    St Lukes Int Univ, Tokyo, Japan..
    Mahesh, P. A.
    JSS Univ, JSS Med Coll, Mysore, Karnataka, India. Kosin Univ, Coll Med, Dept Med Human & Social Med, Busan, South Korea..
    Pana, Adrian
    Bucharest Univ Econ Studies, Bucharest, Romania..
    Park, Eun-Kee
    Parry, Charles D.
    South African Med Researcil, Alcohol Tobacco & Other Drug Res Unit, Cape Town, South Africa.;Univ Stellenbosch, Dept Psychiat, Cape Town, South Africa.;South African Med Res Council, Alcohol Tobacco & Other Drug Res Unit, Potchefstroom, South Africa..
    Parsaeian, Mahboubeh
    Univ Tehran Med Sci, Noncommunicable Dis Res Ctr, Tehran, Iran.;Univ Tehran Med Sci, Dept Epidemiol & Biostat, Sch Publ Hlth, Tehran, Iran..
    Patel, Tejas
    Mt Sinai Hlth Syst, New York, NY USA..
    Caicedo, Angel J. Paternina
    Univ Pittsburgh, Publ Hlth Dynam Lab, Pittsburgh, PA USA.;Univ Cartagena, Cartagena, Colombia..
    Patil, Snehal T.
    Deemed Univ, Krishan Inst Med Sci, Sch Dent Sci, Karad, India..
    Patten, Scott B.
    Univ Calgary, Dept Community Hlth Sci, Calgary, AB, Canada..
    Patton, George C.
    Univ Melbourne, Dept Paediat, Melbourne, Vic, Australia.;Univ Melbourne, Murdoch Childrens Res Inst, Melbourne, Vic, Australia..
    Pearce, Neil
    London Sch Hyg & Trop Med, London, England..
    Pereira, David M.
    Univ Porto, Fac Farm, Dept Quim, REQUIMTE LAQV,Lab Farmacognosia, Oporto, Portugal..
    Perico, Norberto
    IRCCS Ist Ric Farmacol Mario Negri, Bergamo, Italy..
    Pesudovs, Konrad
    Flinders Univ S Australia, Adelaide, SA, Australia..
    Petzold, Max
    Univ Gothenburg, Hlth Metr Unit, Gothenburg, Sweden.;Univ Witwatersrand, Johannesburg, South Africa..
    Phillips, Michael Robert
    Shanghai Jiao Tong Univ, Sch Med, Shanghai, Peoples R China.;Emory Univ, Atlanta, GA 30322 USA..
    Piel, Frederic B.
    Imperial Coll London, Dept Epidemiol & Biostat, Sch Publ Hlth, London, England..
    Pillay, Julian David
    Durban Univ Technol, Durban, South Africa..
    Plass, Dietrich
    German Environm Agcy, Exposure Assessment & Environm Hlth Indicators, Berlin, Germany..
    Polinder, Suzanne
    Erasmus Univ, Med Ctr, Dept Publ Hlth, Rotterdam, Netherlands..
    Pond, Constance D.
    Univ Newcastle, Callaghan, NSW, Australia..
    Pope, C. Arden
    Brigham Young Univ, Provo, UT 84602 USA..
    Pope, Daniel
    Univ Liverpool, Dept Publ Hlth & Policy, Liverpool, Merseyside, England..
    Popova, Svetlana
    Univ Toronto, Ctr Addict & Mental Hlth, Toronto, ON, Canada..
    Poulton, Richie G.
    Univ Otago, Dunedin, New Zealand..
    Pourmalek, Farshad
    Univ British Columbia, Vancouver, BC, Canada..
    Prasad, Noela M.
    Fred Hollows Fdn, Sydney, NSW, Australia.;Ctr Eye Res Australia, Melbourne, Vic, Australia..
    Qorbani, Mostafa
    Alborz Univ Med Sci, Dept Community Med, Karaj, Iran..
    Rabiee, Rynaz H. S.
    Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden..
    Radfar, Amir
    AT Still Univ, Kirksville, MO USA..
    Rafay, Anwar
    Contech Sch Publ Hlth, Lahore, Pakistan..
    Rahimi-Movaghar, Vafa
    Univ Tehran Med Sci, Sina Trauma & Surg Res Ctr, Tehran, Iran..
    Rahman, Mahfuzar
    BRAC, Res & Evaluat Div, Dhaka, Bangladesh..
    Rahman, Mohammad Hifz Ur
    Int Inst Populat Sci, Bombay, Maharashtra, India..
    Rahman, Sajjad Ur
    Hamad Med Corp, Doha, Qatar..
    Rai, Rajesh Kumar
    Soc Hlth & Demog Surveillance, Suri, India..
    Rajsic, Sasa
    Univ Hlth Sci Med Informat & Technol, ERAWEB Program, Hall In Tirol, Australia..
    Raju, Murugesan
    Univ Missouri, Columbia, MO USA..
    Ram, Usha
    Int Inst Populat Sci, Bombay, Maharashtra, India..
    Rana, Saleem M.
    Contech Sch Publ Hlth, Lahore, Pakistan.;Contech Int Hlth Consultants, Lahore, Pakistan..
    Ranganathan, Kavitha
    Univ Michigan Hlth Syst, Ann Arbor, MI USA..
    Rao, Puja
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Razo Garcia, Christian Aspacia
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Refaat, Amany H.
    Walden Univ, Minneapolis, MN USA.;Suez Canal Univ, Ismailia, Egypt..
    Rehm, Colin D.
    Montefiore Med Ctr, 111 E 210th St, Bronx, NY 10467 USA..
    Rehm, Jurgen
    Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada.;Ctr Addict & Mental Hlth, Toronto, ON, Canada..
    Reinig, Nikolas
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Remuzzi, Giuseppe
    IRCCS Ist Ric Farmacol Mario Negri, Bergamo, Italy.;Azienda Osped Papa Giovanni XXIII, Bergamo, Italy.;Univ Milan, Dept Biomed & Clin Sci L Sacco, Milan, Italy..
    Resnikoff, Serge
    Univ New South Wales, Brien Holden Vision Inst, Kensington, NSW, Australia..
    Ribeiro, Antonio L.
    Univ Fed Minas Gerais, Hosp Clin, Belo Horizonte, MG, Brazil..
    Rivera, Juan A.
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Rolm, Hirbo Shore
    Rodriguez, Anna
    Imperial Coll London, Dept Epidemiol & Biostat, Sch Publ Hlth, London, England.;Lincoln Univ, Sch Psychol, Lincoln, England..
    Rodriguez-Ramirez, Sonia
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Rojas-Rueda, David
    Inst Salud Global Barcelona, Barcelona, Spain..
    Roman, Yesenia
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Ronfani, Luca
    IRCCS Burlo Garofolo, Inst Maternal & Child Hlth, Trieste, Italy..
    Roshandel, Gholamreza
    Univ Tehran Med Sci, Digest Dis Res Inst, Tehran, Iran.;Golestan Univ Med Sci, Golestan Res Ctr Gastroenterol & Hepatol, Gorgan, Iran..
    Rothenbacher, Dietrich
    Univ Ulm, Inst Epidemiol & Med Biometry, Ulm, Germany..
    Roy, Ambuj
    All India Inst Med Sci, New Delhi, India..
    Saleh, Muhammad Muhammad
    Dev Res & Projects Ctr, Abuja, Nigeria..
    Sanabria, Juan R.
    Marshall Univ, J Edwards Sch Med, Huntington, WV USA. Case Western Reserve Univ, Cleveland, OH 44106 USA..
    Dolores Sanchez-Nino, Maria
    II S Fdn Jimenez Diaz, Madrid, Spain..
    Sanchez-Pimienta, Tania G.
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Sandar, Logan
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Santomauro, Damian F.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA.;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia.;Queensland Ctr Mental Hlth Res, Brisbane, Qld, Australia..
    Santos, Itamar S.
    Univ Sao Paulo, Dept Internal Med, Sao Paulo, Brazil..
    Sarmiento-Suarez, Rodrigo
    Univ Ciencias Aplicadas & Ambient, Bogota, Colombia..
    Sartorius, Benn
    Univ KwaZulu Natal, Durban, South Africa. Univ Autonoma Chile, Talca, Chile..
    Satpathy, Maheswar
    All India Inst Med Sci, New Delhi, India..
    Savic, Miloje
    Norwegian Inst Publ Hlth, Oslo, Norway..
    Sawhney, Monika
    Marshall Univ, Huntington, WV USA..
    Schmidhuber, Josef
    Food & Agr Org, Global Perspect Studies Unit, Rome, Italy..
    Schmidt, Maria Ines
    Univ Fed Rio Grande do Sul, Porto Alegre, RS, Brazil..
    Schneider, Ione J. C.
    Univ Fed Santa Catarina, Florianopolis, SC, Brazil..
    Schoettker, Ben
    German Canc Res Ctr, Heidelberg, Germany.;FOM Univ, Inst Hlth Care & Social Sci, Essen, Germany..
    Schutte, Aletta E.
    North West Univ, Hypertens Africa Res Team HART, Potchefstroom, South Africa.;South African Med Res Council, Potchefstroom, South Africa..
    Schwebel, David C.
    Univ Alabama Birmingham, Birmingham, AL USA..
    Scott, James G.
    Univ Queensland, Clin Res Ctr, Brisbane, Qld, Australia..
    Seedat, Soraya
    Univ Stellenbosch, Cape Town, South Africa..
    Sepanlou, Sadaf G.
    Univ Tehran Med Sci, Digest Dis Res Inst, Tehran, Iran..
    Servan-Mori, Edson E.
    Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico..
    Shaheen, Amira
    Shahraz, Saeid
    An Najah Univ, Dept Publ Hlth, Nablus, Israel..
    Shaikh, Masood Ali
    Tufts Med Ctr, Boston, MA USA.;Independent Consultant, Karachi, Pakistan..
    Levy, Teresa Shamah
    Sharma, Rajesh
    Indian Inst Technol Ropar, Rupnagar, India..
    She, Jun
    Fudan Univ, Dept Pulm Med, Zhongshan Hosp, Shanghai, Peoples R China..
    Sheikhbahaei, Sara
    Univ Tehran Med Sci, Endocrinol & Metab Populat Sci Inst, Tehran, Iran..
    Shen, Jiabin
    Ohio State Univ, Coll Med, Columbus, OH 43210 USA.;Nationwide Childrens Hosp, Res Inst, Columbus, OH USA..
    Sheth, Kevin N.
    Yale Univ, Sch Med, New Haven, CT USA..
    Shi, Peilin
    Tufts Univ, Boston, MA 02111 USA..
    Shibuya, Kenji
    Univ Tokyo, Tokyo, Japan..
    Shigematsu, Mika
    Natl Inst Infect Dis, Tokyo, Japan.;Sandia Natl Labs, Albuquerque, NM USA. Korea Univ, Dept Publ Hlth Sci, Grad Sch, Seoul, South Korea. Korea Univ, Dept Prevent Med, Coll Med, Seoul, South Korea..
    Shin, Min-Jeong
    Shiri, Rahman
    Finnish Inst Occupat Hlth, Work Disabil Prevent, Work Org, Helsinki, Finland..
    Shishani, Kawkab
    Washington State Univ, Spokane, WA USA..
    Shiue, Ivy
    Univ Edinburgh, Alzheimer Scotland Dementia Res Ctr, Edinburgh, Midlothian, Scotland.;Northumbria Univ, Fac Hlth & Life Sci, Newcastle Upon Tyne, Tyne & Wear, England..
    Shrime, Mark G.
    Harvard Univ, Harvard Med Sch, Boston, MA 02115 USA..
    Sigfusdottir, Inga Dora
    Reykjavik Univ, Reykjavik, Iceland..
    Silva, Diego Augusto Santos
    Alves Silveira, Dayane Gabriele
    Univ Brasilia, Brasilia, DF, Brazil..
    Silverberg, Jonathan I.
    Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA..
    Simard, Edgar P.
    Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA..
    Sindi, Shireen
    Karolinska Inst, Stockholm, Sweden..
    Singh, Abhishek
    Int Inst Populat Sci, Bombay, Maharashtra, India..
    Singh, Jasvinder A.
    Univ Alabama Birmingham, Birmingham, AL USA..
    Singh, Prashant Kumar
    Inst Human Dev, New Delhi, India..
    Slepak, Erica Leigh
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Soljak, Michael
    Imperial Coll London, London, England..
    Soneji, Samir
    Dartmouth Coll, Hanover, NH 03755 USA..
    Sorensen, Reed J. D.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Sposato, Luciano A.
    Western Univ, Dept Clin Neurol Sci, London, ON, Canada..
    Sreeramareddy, Chandrashekhar T.
    Int Med Univ, Dept Community Med, Kuala Lumpur, Malaysia..
    Stathopoulou, Vasiliki
    Attikon Univ Hosp, Athens, Greece..
    Steckling, Nadine
    Univ Hosp Munich, Inst & Outpatient Clin Occupat Social & Environm, Munich, Germany..
    Steel, Nicholas
    Publ Hlth England, London, England.;Univ East Anglia, Norwich, Norfolk, England..
    Stein, Dan J.
    Univ Cape Town, Dept Psychiat, Cape Town, South Africa.;South African Med Res Council Unit Anxiety & Stre, Cape Town, South Africa..
    Stein, Murray B.
    Univ Calif San Diego, San Diego, CA 92103 USA..
    Stockl, Heidi
    London Sch Hyg & Trop Med, London, England..
    Stranges, Saverio
    Luxembourg Inst Hlth, Strassen, Luxembourg..
    Stroumpoulis, Konstantinos
    Alexandra Gen Hosp Athens, Athens, Greece.;Ctr Hosp Publ Cotentin, Cherbourg, France..
    Sunguya, Bruno F.
    Muhimbili Univ Hlth & Allied Sci, Dar Es Salaam, Tanzania..
    Swaminathan, Soumya
    Indian Council Med Res, New Delhi, India..
    Sykes, Bryan L.
    Univ Calif Irvine, Dept Criminol, Irvine, CA USA.;Univ Calif Irvine, Dept Law & Soc, Irvine, CA USA.;Univ Calif Irvine, Dept Sociol, Irvine, CA USA.;Univ Calif Irvine, Dept Publ Hlth, Irvine, CA USA..
    Szoeke, Cassandra E. I.
    Univ Melbourne, Inst Hlth & Ageing, Melbourne, Vic, Australia..
    Tabares-Seisdedos, Rafael
    Univ Valencia, Dept Med, INCLIVA Hlth Res Inst, Valencia, Spain.;CIBERSAM, Valencia, Spain..
    Takahashi, Ken
    Univ Occupat & Environm Hlth, Inst Ind Ecol Sci, Dept Environm Epidemiol, Kitakyushu, Fukuoka, Japan..
    Talongwa, Roberto Tchio
    MINSANTE, Minist Hlth, Yaounde, Cameroon..
    Landon, Nikhil
    Tanne, David
    Chaim Sheba Med Ctr, Tel Hashomer, Israel.;Tel Aviv Univ, Tel Aviv, Israel..
    Tavakkoli, Mohammad
    Taye, Belaynew Wasie
    Bahir Dar Univ, Bahir Dar, Ethiopia..
    Taylor, Hugh R.
    Univ Melbourne, Melbourne, Vic, Australia. Natl Inst Publ Hlth, Natl Council Sci & Technol, Cuernavaca, Morelos, Mexico..
    Tedla, Bemnet Amare
    Univ Gondar, Gondar, Ethiopia.;James Cook Univ, Cairns, Qld, Australia..
    Tefera, Worku Mekonnen
    Univ Addis Ababa, Coll Hlth Sci, Sch Publ Hlth, Addis Ababa, Ethiopia..
    Tegegne, Teketo Kassaw
    Debre Markos Univ, Debre Markos, Ethiopia..
    Tekle, Dejen Yemane
    Mekelle Univ, Mekelle, Ethiopia..
    Terkawi, Abdullah Sulieman
    King Fahad Med City, Dept Anesthesiol, Riyadh, Saudi Arabia.;Univ Virginia, Dept Anesthesiol, Charlottesville, VA USA.;Cleveland Clin, Outcomes Res Consortium, Cleveland, OH 44106 USA..
    Thakur, J. S.
    Post Grad Inst Med Educ & Res, Sch Publ Hlth, Chandigarh, India. Univ Bath, Bath, Avon, England..
    Thomas, Bernadette A.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Thomas, Matthew Lloyd
    Thomson, Alan J.
    Adapt Knowledge Management, Victoria, BC, Canada..
    Thorne-Lyman, Andrew L.
    Harvard Univ, Dept Nutr, Boston, MA 02115 USA.;WorldFish, George Town, Malaysia..
    Thrift, Amanda G.
    Monash Univ, Sch Clin Sci Monash Hlth, Dept Med, Melbourne, Vic, Australia..
    Thurston, George D.
    New York Univ, Sch Med, Nelson Inst Environm Med, Tuxedo Pk, NY USA..
    Tillmann, Taavi
    UCL, Dept Epidemiol & Publ Hlth, London, England..
    Tobe-Gai, Ruoyan
    Natl Ctr Child Hlth & Dev, Tokyo, Japan..
    Tobollik, Myriam
    German Environm Agcy, Berlin, Germany..
    Topor-Madry, Roman
    Jagiellonian Univ, Coll Med, Fac Hlth Sci, Inst Publ Hlth, Krakow, Poland.;Wroclaw Med Univ, Fac Hlth Sci, Wroclaw, Poland..
    Topouzis, Fotis
    Aristotle Univ Thessaloniki, Thessaloniki, Greece..
    Towbin, Jeffrey Allen
    Le Bonheur Childrens Hosp, Memphis, TN USA.;Univ Tennessee, Hlth Sci Ctr, Memphis, TN USA.;St Jude Childrens Res Hosp, 332 N Lauderdale St, Memphis, TN 38105 USA..
    Tran, Bach Xuan
    Dimbuene, Zacharie Tsala
    Univ Kinshasa, Fac Econ & Management, Dept Populat Sci & Dev, Kinshasa, Congo.;African Populat & Hlth Res Ctr, Nairobi, Kenya..
    Tsilimparis, Nikolaos
    Univ Heart Ctr Hamburg, Hamburg, Germany..
    Tura, Abera Kenay
    Haramaya Univ, Dire Dawa, Ethiopia.;Univ Groningen, Groningen, Netherlands..
    Tuzcu, Emin Murat
    Cleveland Clin, Cleveland, OH 44106 USA..
    Tyrovolas, Stefanos
    Univ Barcelona, CIBERSAM, Fundacio St Joan De Deu, Parc Sanitari Sant Joan De Deu, Barcelona, Spain..
    Ukwaja, Kingsley N.
    Fed Teaching Hosp, Dept Internal Med, Abakaliki, Nigeria..
    Undurraga, Eduardo A.
    Brandeis Univ, Waltham, MA USA..
    Uneke, Chigozie Jesse
    Ebonyi State Univ, Abakaliki, Nigeria..
    Uthman, Olalekan A.
    Univ Warwick, Warwick Med Sch, Coventry, W Midlands, England..
    van Donkelaar, Aaron
    Dalhousie Univ, Dept Phys & Atmospher Sci, Halifax, NS, Canada..
    van Os, Jim
    Maastricht Univ, Med Ctr, Maastricht, Netherlands..
    Varakin, Yuri Y.
    Res Ctr Neurol, Moscow, Russia..
    Vasankari, Tommi
    UKK Inst Hlth Promot Res, Tampere, Finland..
    Veerman, J. Lennert
    Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia..
    Venketasubramanian, Narayanaswamy
    Raffles Hosp, Raffles Neurosci Ctr, Singapore, Singapore..
    Violante, Francesco S.
    Univ Bologna, Bologna, Italy..
    Vollset, Stein Emil
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA.;Norwegian Inst Publ Hlth, Ctr Dis Burden, Oslo, Norway.;Univ Bergen, Dept Global Publ Hlth & Primary Care, Bergen, Norway..
    Wagner, Gregory R.
    Harvard Univ, Harvard TH Chan Sch Publ Hlth, Boston, MA 02115 USA.;Natl Inst Occupat Safety & Hlth, Washington, DC USA..
    Waller, Stephen G.
    Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA..
    Wang, JianLi
    Univ Calgary, Calgary, AB, Canada..
    Wang, Linhong
    Chinese Ctr Dis Control & Prevent, Ctr Chron & Noncommunicable Dis Control & Prevent, Beijing, Peoples R China..
    Wang, Yanping
    Natl Off Maternal & Child Hlth Surveillance, Chengdu, Peoples R China..
    Weichenthal, Scott
    McGill Univ, Montreal, PQ, Canada..
    Weiderpass, Elisabete
    Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden.;Inst Populat Based Canc Res, Dept Res, Canc Registry Norway, Oslo, Norway.;Arctic Univ Norway, Univ Tromso, Fac Hlth Sci, Dept Community Med, Tromso, Norway.;Folkhalsan Res Ctr, Genet Epidemiol Grp, Helsinki, Finland..
    Weintraub, Robert G.
    Univ Melbourne, Murdoch Childrens Res Inst, Melbourne, Vic, Australia.;Univ Melbourne, Melbourne, Vic, Australia. Natl Inst Publ Hlth, Natl Council Sci & Technol, Cuernavaca, Morelos, Mexico.;Royal Childrens Hosp, Melbourne, Vic, Australia..
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    Fed Inst Populat Res, Competence Ctr Mortal Follow Up German Natl Cohor, Wiesbaden, Germany..
    Westerman, Ronny
    Fed Inst Populat Res, Wiesbaden, Germany.;German Natl Cohort Consortium, Heidelberg, Germany..
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    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA.;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia.;Queensland Ctr Mental Hlth Res, Brisbane, Qld, Australia..
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    Western Hlth, Footscray, Vic, Australia. Guys & St Thomas NHS Fdn Trust, Comprehens Biomed Res Ctr, Natl Inst Hlth Res, London, England. Kings Coll London, London, England..
    Wiysonge, Charles Shey
    South African Med Researcil, Cape Town, South Africa.;Univ Stellenbosch, Cape Town, South Africa..
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    Kings Coll London, Div Hlth & Social Care Res, London, England..
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    Seoul Natl Univ, Grad Sch Publ Hlth, Seoul, South Korea..
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    Royal Cornwall Hosp, Truro, England..
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    St Pauls Hosp, Millennium Med Coll, Addis Ababa, Ethiopia..
    Xavier, Denis
    St Johns Med Coll & Res Inst, Bangalore, Karnataka, India..
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    Nanjing Univ, Sch Med, Jinling Hosp, Dept Neurol, Nanjing, Jiangsu, Peoples R China..
    Yadav, Ajit Kumar
    Int Inst Populat Sci, Bombay, Maharashtra, India..
    Yakob, Bereket
    Univ KwaZulu Natal, Sch Nursing & Publ Hlth, Discipline Publ Hlth Med, Durban, South Africa..
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    Mekelle Univ, Mekelle, Ethiopia..
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    Northwestern Univ, Dept Prevent Med, Chicago, IL 60611 USA..
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    Univ Tehran Med Sci, Tehran, Iran.;Shahid Beheshti Univ Med Sci, Ophthalm Res Ctr, Tehran, Iran..
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    Chinese Ctr Dis Control & Prevent, Ctr Chron & Noncommunicable Dis Control & Prevent, Beijing, Peoples R China..
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    Univ Hong Kong, Social Work & Social Adm Dept, Hong Kong, Hong Kong, Peoples R China.;Univ Hong Kong, Hong Kong Jockey Club Ctr Suicide Res & Prevent, Hong Kong, Hong Kong, Peoples R China..
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    Kyoto Univ, Sch Publ Hlth, Dept Biostat, Kyoto, Japan..
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    Younis, Mustafa Z.
    Jackson State Univ, Jackson, MS USA..
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    Wuhan Univ, Dept Epidemiol & Biostat, Sch Publ Hlth, Wuhan, Peoples R China.;Wuhan Univ, Global Hlth Inst, Wuhan, Peoples R China..
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    Univ Hosp, Setif, Algeria..
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    Mansoura Univ, Fac Med, Mansoura, Egypt..
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    Natl Off MCH Surveillance China, Chengdu, Peoples R China..
    Zipkin, Ben
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Zodpey, Sanjay
    Publ Hlth Fdn India, Gurgaon, India.;Publ Hlth Fdn India, Gurgaon, India..
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    Red Cross War Mem Childrens Hosp, Cape Town, South Africa..
    Murray, Christopher J. L.
    Inst Hlth Metr & Evaluat, Seattle, WA 98121 USA..
    Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 20152016In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 388, no 10053, p. 1659-1724Article in journal (Refereed)
    Abstract [en]

    Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors-the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57.8% (95% CI 56.6-58.8) of global deaths and 41.2% (39.8-42.8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211.8 million [192.7 million to 231.1 million] global DALYs), smoking (148.6 million [134.2 million to 163.1 million]), high fasting plasma glucose (143.1 million [125.1 million to 163.5 million]), high BMI (120.1 million [83.8 million to 158.4 million]), childhood undernutrition (113.3 million [103.9 million to 123.4 million]), ambient particulate matter (103.1 million [90.8 million to 115.1 million]), high total cholesterol (88.7 million [74.6 million to 105.7 million]), household air pollution (85.6 million [66.7 million to 106.1 million]), alcohol use (85.0 million [77.2 million to 93.0 million]), and diets high in sodium (83.0 million [49.3 million to 127.5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Copyright (C) The Author(s). Published by Elsevier Ltd.

  • 104. Forouzanfar, Mohammad H
    et al.
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    Brauer, Michael
    Burnett, Richard
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    Wagner, Joseph
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    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
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    Murray, Christopher J
    Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.2015In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 386, no 10010, p. 2287-2323Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the first of a series of annual updates of the GBD. Risk factor quantification, particularly of modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention. The GBD 2013 provides a timely opportunity to update the comparative risk assessment with new data for exposure, relative risks, and evidence on the appropriate counterfactual risk distribution.

    METHODS: Attributable deaths, years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) have been estimated for 79 risks or clusters of risks using the GBD 2010 methods. Risk-outcome pairs meeting explicit evidence criteria were assessed for 188 countries for the period 1990-2013 by age and sex using three inputs: risk exposure, relative risks, and the theoretical minimum risk exposure level (TMREL). Risks are organised into a hierarchy with blocks of behavioural, environmental and occupational, and metabolic risks at the first level of the hierarchy. The next level in the hierarchy includes nine clusters of related risks and two individual risks, with more detail provided at levels 3 and 4 of the hierarchy. Compared with GBD 2010, six new risk factors have been added: handwashing practices, occupational exposure to trichloroethylene, childhood wasting, childhood stunting, unsafe sex, and low glomerular filtration rate. For most risks, data for exposure were synthesised with a Bayesian meta-regression method, DisMod-MR 2.0, or spatial-temporal Gaussian process regression. Relative risks were based on meta-regressions of published cohort and intervention studies. Attributable burden for clusters of risks and all risks combined took into account evidence on the mediation of some risks such as high body-mass index (BMI) through other risks such as high systolic blood pressure and high cholesterol.

    FINDINGS: All risks combined account for 57·2% (95% uncertainty interval [UI] 55·8-58·5) of deaths and 41·6% (40·1-43·0) of DALYs. Risks quantified account for 87·9% (86·5-89·3) of cardiovascular disease DALYs, ranging to a low of 0% for neonatal disorders and neglected tropical diseases and malaria. In terms of global DALYs in 2013, six risks or clusters of risks each caused more than 5% of DALYs: dietary risks accounting for 11·3 million deaths and 241·4 million DALYs, high systolic blood pressure for 10·4 million deaths and 208·1 million DALYs, child and maternal malnutrition for 1·7 million deaths and 176·9 million DALYs, tobacco smoke for 6·1 million deaths and 143·5 million DALYs, air pollution for 5·5 million deaths and 141·5 million DALYs, and high BMI for 4·4 million deaths and 134·0 million DALYs. Risk factor patterns vary across regions and countries and with time. In sub-Saharan Africa, the leading risk factors are child and maternal malnutrition, unsafe sex, and unsafe water, sanitation, and handwashing. In women, in nearly all countries in the Americas, north Africa, and the Middle East, and in many other high-income countries, high BMI is the leading risk factor, with high systolic blood pressure as the leading risk in most of Central and Eastern Europe and south and east Asia. For men, high systolic blood pressure or tobacco use are the leading risks in nearly all high-income countries, in north Africa and the Middle East, Europe, and Asia. For men and women, unsafe sex is the leading risk in a corridor from Kenya to South Africa.

    INTERPRETATION: Behavioural, environmental and occupational, and metabolic risks can explain half of global mortality and more than one-third of global DALYs providing many opportunities for prevention. Of the larger risks, the attributable burden of high BMI has increased in the past 23 years. In view of the prominence of behavioural risk factors, behavioural and social science research on interventions for these risks should be strengthened. Many prevention and primary care policy options are available now to act on key risks.

  • 105. Fox, Caroline S
    et al.
    Matsushita, Kunihiro
    Woodward, Mark
    Bilo, Henk J G
    Chalmers, John
    Heerspink, Hiddo J Lambers
    Lee, Brian J
    Perkins, Robert M
    Rossing, Peter
    Sairenchi, Toshimi
    Tonelli, Marcello
    Vassalotti, Joseph A
    Yamagishi, Kazumasa
    Coresh, Josef
    de Jong, Paul E
    Wen, Chi-Pang
    Nelson, Robert G
    Associations of kidney disease measures with mortality and end-stage renal disease in individuals with and without diabetes: a meta-analysis.2012In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 380, no 9854, p. 1662-73Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Chronic kidney disease is characterised by low estimated glomerular filtration rate (eGFR) and high albuminuria, and is associated with adverse outcomes. Whether these risks are modified by diabetes is unknown.

    METHODS: We did a meta-analysis of studies selected according to Chronic Kidney Disease Prognosis Consortium criteria. Data transfer and analyses were done between March, 2011, and June, 2012. We used Cox proportional hazards models to estimate the hazard ratios (HR) of mortality and end-stage renal disease (ESRD) associated with eGFR and albuminuria in individuals with and without diabetes.

    FINDINGS: We analysed data for 1,024,977 participants (128,505 with diabetes) from 30 general population and high-risk cardiovascular cohorts and 13 chronic kidney disease cohorts. In the combined general population and high-risk cohorts with data for all-cause mortality, 75,306 deaths occurred during a mean follow-up of 8·5 years (SD 5·0). In the 23 studies with data for cardiovascular mortality, 21,237 deaths occurred from cardiovascular disease during a mean follow-up of 9·2 years (SD 4·9). In the general and high-risk cohorts, mortality risks were 1·2-1·9 times higher for participants with diabetes than for those without diabetes across the ranges of eGFR and albumin-to-creatinine ratio (ACR). With fixed eGFR and ACR reference points in the diabetes and no diabetes groups, HR of mortality outcomes according to lower eGFR and higher ACR were much the same in participants with and without diabetes (eg, for all-cause mortality at eGFR 45 mL/min per 1·73 m(2) [vs 95 mL/min per 1·73 m(2)], HR 1·35; 95% CI 1·18-1·55; vs 1·33; 1·19-1·48 and at ACR 30 mg/g [vs 5 mg/g], 1·50; 1·35-1·65 vs 1·52; 1·38-1·67). The overall interactions were not significant. We identified much the same findings for ESRD in the chronic kidney disease cohorts.

    INTERPRETATION: Despite higher risks for mortality and ESRD in diabetes, the relative risks of these outcomes by eGFR and ACR are much the same irrespective of the presence or absence of diabetes, emphasising the importance of kidney disease as a predictor of clinical outcomes.

    FUNDING: US National Kidney Foundation.

  • 106.
    Frithiof, Robert
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Bandert, Anna
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Lipcsey, Miklós
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Hedenstierna laboratory.
    Smekal, David
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Central Venous Line and Dialysis Catheter Position Affects Drug Clearance during Continuous Renal Replacement Therapy in an Animal Model.2019In: ASAIO journal (1992), ISSN 1058-2916, E-ISSN 1538-943X, Vol. 65, no 4, p. 408-413Article in journal (Refereed)
    Abstract [en]

    In intensive care, drugs are commonly administered through central venous catheters (CVC). These catheters and central venous dialysis catheters (CVDC) are often placed in the same vessel for practical reasons. The aim of this experimental study was to investigate if the position of CVC and CVDC influences the elimination of infused drugs, during continuous renal replacement therapy (CRRT). In a randomized, cross-over model, anesthetized piglets received both a CVC and a CVDC in a jugular vein. Another CVDC was placed in a femoral vein for comparison. After baseline measurements, CRRT was performed in either of the CVDC, each CRRT-period separated by another baseline period. Hypotension was induced by peripherally given sodium nitroprusside. In the CVC, both gentamicin and noradrenaline were administered. Noradrenaline was titrated to reach a target blood pressure. When CRRT was performed using the CVDC in the same vessel as the drugs were infused, the plasma concentration of gentamicin was reduced compared with when the infusion and CVDC were in different vessels (5.66 [standard deviation (SD) ± 1.23] vs. 7.76 [SD ± 2.30] mg/L [p = 0.02]). The noradrenaline infusion rate needed to reach the target blood pressure was more than doubled (0.32 [SD ± 0.16] vs. 0.15 [SD ± 0.08] µg/kg/min [p = 0.006]). This experimental study indicates that the removal of drugs is increased if infusion is in close vicinity of the CVDC, during CRRT.

  • 107. Fullman, N
    et al.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Murray, Christopher J L
    Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016.2017In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 390, no 10100, p. 1423-1459Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The UN's Sustainable Development Goals (SDGs) are grounded in the global ambition of "leaving no one behind". Understanding today's gains and gaps for the health-related SDGs is essential for decision makers as they aim to improve the health of populations. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016), we measured 37 of the 50 health-related SDG indicators over the period 1990-2016 for 188 countries, and then on the basis of these past trends, we projected indicators to 2030.

    METHODS: We used standardised GBD 2016 methods to measure 37 health-related indicators from 1990 to 2016, an increase of four indicators since GBD 2015. We substantially revised the universal health coverage (UHC) measure, which focuses on coverage of essential health services, to also represent personal health-care access and quality for several non-communicable diseases. We transformed each indicator on a scale of 0-100, with 0 as the 2·5th percentile estimated between 1990 and 2030, and 100 as the 97·5th percentile during that time. An index representing all 37 health-related SDG indicators was constructed by taking the geometric mean of scaled indicators by target. On the basis of past trends, we produced projections of indicator values, using a weighted average of the indicator and country-specific annualised rates of change from 1990 to 2016 with weights for each annual rate of change based on out-of-sample validity. 24 of the currently measured health-related SDG indicators have defined SDG targets, against which we assessed attainment.

    FINDINGS: Globally, the median health-related SDG index was 56·7 (IQR 31·9-66·8) in 2016 and country-level performance markedly varied, with Singapore (86·8, 95% uncertainty interval 84·6-88·9), Iceland (86·0, 84·1-87·6), and Sweden (85·6, 81·8-87·8) having the highest levels in 2016 and Afghanistan (10·9, 9·6-11·9), the Central African Republic (11·0, 8·8-13·8), and Somalia (11·3, 9·5-13·1) recording the lowest. Between 2000 and 2016, notable improvements in the UHC index were achieved by several countries, including Cambodia, Rwanda, Equatorial Guinea, Laos, Turkey, and China; however, a number of countries, such as Lesotho and the Central African Republic, but also high-income countries, such as the USA, showed minimal gains. Based on projections of past trends, the median number of SDG targets attained in 2030 was five (IQR 2-8) of the 24 defined targets currently measured. Globally, projected target attainment considerably varied by SDG indicator, ranging from more than 60% of countries projected to reach targets for under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria, to less than 5% of countries projected to achieve targets linked to 11 indicator targets, including those for childhood overweight, tuberculosis, and road injury mortality. For several of the health-related SDGs, meeting defined targets hinges upon substantially faster progress than what most countries have achieved in the past.

    INTERPRETATION: GBD 2016 provides an updated and expanded evidence base on where the world currently stands in terms of the health-related SDGs. Our improved measure of UHC offers a basis to monitor the expansion of health services necessary to meet the SDGs. Based on past rates of progress, many places are facing challenges in meeting defined health-related SDG targets, particularly among countries that are the worst off. In view of the early stages of SDG implementation, however, opportunity remains to take actions to accelerate progress, as shown by the catalytic effects of adopting the Millennium Development Goals after 2000. With the SDGs' broader, bolder development agenda, multisectoral commitments and investments are vital to make the health-related SDGs within reach of all populations.

  • 108.
    Fullman, Nancy
    et al.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Yearwood, Jamal
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Abay, Solomon M.
    Addis Ababa Univ, Addis Ababa, Ethiopia.
    Abbafati, Cristiana
    Univ Roma La Sapienza, Rome, Italy.
    Abd-Allah, Foad
    Cairo Univ, Dept Neurol, Cairo, Egypt.
    Abdela, Jemal
    Haramaya Univ, Coll Hlth & Med Sci, Harar, Ethiopia.
    Abdelalim, Ahmed
    Cairo Univ, Dept Neurol, Cairo, Egypt.
    Abebe, Zegeye
    Univ Gondar, Gondar, Ethiopia.
    Abebo, Teshome Abuka
    Hawassa Univ, Coll Med & Hlth Sci, Hawassa, Ethiopia.
    Aboyans, Victor
    Dupuytren Univ Hosp, Limoges, France.
    Abraha, Haftom Niguse
    Mekelle Univ, Mekelle, Ethiopia.
    Abreu, Daisy M. X.
    Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil.
    Abu-Raddad, Laith J.
    Weill Cornell Med Coll Qatar, Infect Dis Epidemiol Grp, Doha, Qatar.
    Adane, Akilew Awoke
    Univ Gondar, Gondar, Ethiopia;Univ Queensland, Brisbane, Qld, Australia.
    Adedoyin, Rufus Adesoji
    Obafemi Awolowo Univ, Dept Med Rehabil, Ife, Nigeria.
    Adetokunboh, Olatunji
    Stellenbosch Univ, Cape Town, South Africa.
    Adhikari, Tara Ballav
    Univ Southern Denmark, Fac Hlth Sci, Unit Hlth Promot Res, Esbjerg, Denmark.
    Afarideh, Mohsen
    Univ Tehran Med Sci, Endocrinol & Metab Res Ctr, Tehran, Iran.
    Afshin, Ashkan
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Agarwal, Gina
    McMaster Univ, Hamilton, ON, Canada;CSIR, Inst Genom & Integrat Biol, Delhi, India;Baylor Coll Med, Dept Internal Med, Houston, TX 77030 USA;Indian Inst Publ Hlth, Gurugram, India;Publ Hlth Fdn India, Gurugram, India.
    Agius, Dominic
    Directorate Hlth Informat & Res, Pieta, Malta;Malta Coll Family Doctors, Gzira, Malta.
    Agrawal, Anurag
    Agrawal, Sutapa
    Kiadaliri, Aliasghar Ahmad
    Lund Univ, Skane Univ Hosp, Dept Clin Sci Lund, Dept Clin Sci Lund,Orthoped,Clin Epidemiol Unit,N, Lund, Sweden.
    Aichour, Miloud Taki Eddine
    High Natl Sch Vet Med, Algiers, Algeria.
    Akibu, Mohammed
    Debere Berhan Univ, Debre Berhan, Ethiopia.
    Akinyemi, Rufus Olusola
    Univ Ibadan, Ibadan, Nigeria;Newcastle Univ, Newcastle Upon Tyne, Tyne & Wear, England.
    Akinyemiju, Tomi F.
    Univ Alabama Birmingham, Dept Epidemiol, Birmingham, AL USA.
    Akseer, Nadia
    Hosp Sick Children, Ctr Global Child Hlth, Toronto, ON, Canada;Univ Toronto, Fac Med, Dalla Lana Sch Publ Hlth, Dept Nutr Sci, Toronto, ON, Canada.
    Al Lami, Faris Hasan
    Baghdad Coll Med, Baghdad, Iraq.
    Alahdab, Fares
    Mayo Clin, Fdn Med Educ & Res, Rochester, MN USA;Syrian Amer Med Soc, Washington, DC USA.
    Al-Aly, Ziyad
    Washington Univ St Louis, St Louis, MO USA.
    Alam, Khurshid
    Univ Western Australia, Sch Populat & Global Hlth, Perth, WA, Australia.
    Alam, Tahiya
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Alasfoor, Deena
    Minist Hlth, Int Relat Div, Al Khuwair, Oman.
    Albittar, Mohammed I.
    Alene, Kefyalew Addis
    Univ Gondar, Inst Publ Hlth, Dept Epidemiol & Biostat, Gondar, Ethiopia;Australian Natl Univ, Res Sch Populat Hlth, Dept Global Hlth, Canberra, ACT, Australia.
    Al-Eyadhy, Ayman
    King Saud Univ, Riyadh, Saudi Arabia;King Faisal Specialist Hosp & Res Ctr, Riyadh, Saudi Arabia.
    Ali, Syed Danish
    Univ London, London, England;SIR Management Consultants, Oxford, England;Inst & Fac Actuaries, Oxford, England.
    Alijanzadeh, Mehran
    Qazvin Univ Med Sci, Qavin, Iran.
    Aljunid, Syed M.
    Kuwait Univ, Fac Publ Hlth, Kuwait, Kuwait;Natl Univ Malaysia, Int Ctr Casemix & Clin Coding, Kuala Lumpur, Malaysia.
    Alkerwi, Ala'a
    Luxembourg Inst Hlth, Strassen, Luxembourg.
    Alla, Francois
    Univ Lorraine, Sch Publ Hlth, Nancy, France.
    Allebeck, Peter
    Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden.
    Allen, Christine
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Alomari, Mahmoud A.
    Jordan Univ Sci & Technol, Fac Appl Med Sci, Dept Rehabil Sci, Div Phys Therapy, Irbid, Jordan.
    Al-Raddadi, Rajaa
    King Abdulaziz Univ, Dept Family & Community Med, Coll Med, Jeddah, Saudi Arabia.
    Alsharif, Ubai
    Charite Univ Med Berlin, Berlin, Germany.
    Altirkawi, Khalid A.
    King Saud Univ, Riyadh, Saudi Arabia.
    Alvis-Guzman, Nelson
    Univ Cartagena, Cartagena De Indias, Colombia.
    Amare, Azmeraw T.
    Bahir Dar Univ, Coll Med & Hlth Sci, Bahir Dar, Ethiopia.
    Amenu, Kebede
    Ammar, Walid
    Minist Publ Hlth, Beirut, Lebanon.
    Amoako, Yaw Ampem
    Komfo Anokye Teaching Hosp, Dept Med, Kumasi, Ghana.
    Anber, Nahla
    Andrei, Catalina Liliana
    Carol Davila Univ Med & Pharm, Bucharest, Romania.
    Androudi, Sofia
    Univ Thessaly, Larisa, Greece.
    Antonio, Carl Abelardo T.
    Univ Philippines Manila, Coll Publ Hlth, Manila, Philippines;Univ Philippines Manila, Coll Publ Hlth, Dept Hlth Policy & Adm, Manila, Philippines.
    Araujo, Valdelaine E. M.
    Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil;Minist Hlth Brazil, Brasilia, DF, Brazil.
    Aremu, Olatunde
    Birmingham City Univ Dept Publ Hlth & Therapies, Birmingham, W Midlands, England.
    Arnlov, Johan
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med & Primary Care, Stockholm, Sweden;Dalama Univ, Sch Hlth & Social Studies, Falun, Sweden.
    Artaman, Al
    Univ Manitoba, Winnipeg, MB, Canada.
    Aryal, Krishna Kumar
    Nepal Hlth Res Council, Kathmandu, Nepal;Univ Oslo, Oslo, Norway.
    Asayesh, Hamid
    Qom Univ Med Sci, Sch Paramed, Dept Emergency Med, Qom, Iran.
    Asfaw, Ephrem Tsegay
    Mekelle Univ, Coll Hlth Sci, Mekelle, Ethiopia;Mekelle Univ, Inst Biomed Sci, Mekelle, Ethiopia.
    Asgedom, Solomon Weldegebreal
    Mekelle Univ, Mekelle, Ethiopia.
    Asghar, Rana Jawad
    South Asian Publ Hlth Forum, Islamabad, Pakistan.
    Ashebir, Mengistu Mitiku
    Mekelle Univ, Sch Publ Hlth, Mekelle, Ethiopia.
    Asseffa, Netsanet Abera
    Atey, Tesfay Mehari
    Atre, Sachin R.
    Johns Hopkins Univ, Johns Hopkins Bloomberg Sch Publ Hlth, Ctr Clin Global Hlth Educ, Baltimore, MD USA;Dr D Y Patil Vidyapeeth Pune, Pune, Maharashtra, India.
    Atteraya, Madhu S.
    Keimyung Univ, Daegu, South Korea.
    Avila-Burgos, Leticia
    Natl Inst Publ Hlth, Cuemavaca, Mexico.
    Avokpaho, Euripide Frinel G. Arthur
    Inst Rech Clin Benin, Cotonou, Benin;Lab Etudes & Rech Act St LERAS Afrique, Parakou, Benin.
    Awasthi, Ashish
    Indian Inst Publ Hlth, Gandhinagar, India.
    Quintanilla, Beatriz Paulina Ayala
    La Trobe Univ, Judith Lumley Ctr Mother Infant & Family Hlth Res, Melbourne, Vic, Australia;Peruvian Natl Inst Hlth, Lima, Peru.
    Ayalew, Animut Alebel
    Debre Markos Univ, Debre Markos, Ethiopia.
    Ayele, Henok Tadesse
    McGill Univ, Dept Epidemiol Biostat & Occupat Hlth, Montreal, PQ, Canada;Dilla Univ, Dilla, Ethiopia.
    Ayer, Rakesh
    Univ Tokyo, Tokyo, Japan.
    Ayuk, Tambe Betrand
    Inst Med Res & Plant Med Studies Cameroon, Yaounde, Cameroon;Univ South Africa, Pretoria, South Africa.
    Azzopardi, Peter
    Burnet Inst, Melbourne, Vic, Australia;Univ Melbourne, Dept Paediat, Melbourne, Vic, Australia;Univ Melbourne, Murdoch Childrens Res Inst, Melbourne, Vic, Australia;South Australian Hlth & Med Res Inst, Wardliparingga Aboriginal Res Unit, Adelaide, SA, Australia.
    Azzopardi-Muscat, Natasha
    Directorate Hlth Informat & Res, Pieta, Malta;Univ Malta, Isl & Small States Inst, Dept Hlth Serv Management, Msida, Malta.
    Babalola, Tesleem Kayode
    Univ Lagos, Dept Community Hlth & Primary Care, Lagos, Nigeria.
    Badali, Hamid
    Invas Fungi Res Ctr, Sari, Iran;Ctr Expertise Mycol Radboudumc CWZ, Nijmegen, Netherlands.
    Badawi, Alaa
    Univ Toronto, Fac Med, Dalla Lana Sch Publ Hlth, Dept Nutr Sci, Toronto, ON, Canada;Publ Hlth Agcy Canada, Toronto, ON, Canada.
    Banach, Maciej
    Med Univ Lodz, Dept Hypertens, Lodz, Poland.
    Banerjee, Amitava
    UCL, Inst Hlth Informat, Farr Inst Hlth Informat Res, London, England.
    Banstola, Amrit
    Publ Hlth Perspect Nepal, Pokhara, Nepal.
    Barber, Ryan M.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Barboza, Miguel A.
    Hosp Dr Rafael A Calderon Guardia, CCSS, San Jose, Costa Rica;Univ Costa Rica, San Pedro, Costa Rica.
    Barker-Collo, Suzanne L.
    Univ Auckland, Sch Psychol, Auckland, New Zealand.
    Baernighausen, Till
    Barquera, Simon
    Natl Inst Publ Hlth, Cuemavaca, Mexico.
    Barrero, Lope H.
    Pontificia Univ Javeriana, Sch Engn, Dept Ind Engn, Bogota, Colombia.
    Bassat, Quique
    Univ Barcelona, Barcelona Inst Global Hlth, Barcelona, Spain;ICREA, Barcelona, Spain.
    Basu, Sanjay
    Stanford Univ, Stanford, CA USA.
    Baune, Bernhard T.
    Univ Adelaide, Sch Med, Discipline Psychiat, Adelaide, SA, Australia.
    Bazargan-Hejazi, Shahrzad
    Charles R Drew Univ Med & Sci, Coll Med, Los Angeles, CA USA;Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA.
    Bedi, Neeraj
    Jazan Univ, Coll Publ Hlth & Trop Med, Jazan, Saudi Arabia.
    Beghi, Ettore
    IRCCS, Ist Ric Farmacol Mario Negri, Milan, Italy.
    Behzadifar, Masoud
    Lorestan Univ Med Sci, Social Determinants Hlth Res Ctr, Khorramabad, Iran;Lorestan Univ Med Sci, Khorramabad, Iran;Iran Univ Med Sci, Hlth Management & Econ Res Ctr, Tehran, Iran.
    Behzadifar, Meysam
    Bekele, Bayu Begashaw
    Univ Gondar, Coll Med & Hlth Sci, Gondar, Ethiopia;Mizan Tepi Univ, Mizan Aman, Ethiopia.
    Belachew, Abate Bekele
    Mekelle Univ, Sch Publ Hlth, Mekelle, Ethiopia.
    Belay, Saba Abraham
    Dr Tewelde Legesse Hlth Sci Coll, Mekelle, Ethiopia.
    Belay, Yihalem Abebe
    Debre Markos Univ, Debre Markos, Ethiopia.
    Bell, Michelle L.
    Yale Univ, New Haven, CT USA.
    Bello, Aminu K.
    Univ Alberta, Edmonton, AB, Canada.
    Bennett, Derrick A.
    Univ Oxford, Nuffield Dept Populat Hlth, Oxford, England.
    Bennett, James R.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Bensenor, Isabela M.
    Univ Sao Paulo, Sao Paulo, Brazil.
    Berhe, Derbew Fikadu
    Mekelle Univ, Sch Pharm, Mekelle, Ethiopia;Univ Groningen, Univ Med Ctr Groningen, Groningen, Netherlands.
    Bernabe, Eduardo
    Kings Coll London, London, England.
    Bernstein, Robert Steven
    Emory Univ, Rollins Sch Publ Hlth, Dept Global Hlth, Atlanta, GA 30322 USA;Univ South Honda, Coll Publ Hlth, Dept Global Hlth, Tampa, FL USA.
    Beuran, Mircea
    Carol Davila Univ Med & Pharm, Bucharest, Romania;Emergency Hosp Bucharest, Bucharest, Romania.
    Bhalla, Ashish
    Postgrad Inst Med Educ & Res, Chandigarh, India.
    Bhatt, Paurvi
    Medtron Philanthropy, Minneapolis, MN USA.
    Bhaumik, Soumyadeep
    Publ Hlth Fdn India, Gurugram, India.
    Bhutta, Zulfiqar A.
    Hosp Sick Children, Ctr Global Child Hlth, Toronto, ON, Canada;Aga Khan Univ, Ctr Excellence Women & Child Hlth, Karachi, Pakistan.
    Biadgo, Belete
    Univ Gondar, Gondar, Ethiopia.
    Bijani, Ali
    Babol Univ Med Sci, Social Determinants Hlth Res Ctr, Hlth Res Inst, Babol Sar, Iran.
    Bikbov, Boris
    IRCCS, Ist Ric Farmacol Mario Negri, Milan, Italy.
    Birungi, Charles
    UCL, London, England.
    Biryukov, Stan
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Bizuneh, Hailemichael
    St Pauls Hosp, Millennium Med Coll, Addis Ababa, Ethiopia;Jigjiga Univ, Jigjiga, Ethiopia.
    Bolliger, Ian W.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Bolt, Kaylin
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Bou-Orm, Ibrahim R.
    Minist Publ Hlth, Beirut, Lebanon.
    Bozorgmehr, Kayvan
    Univ Heidelberg Hosp, Dept Gen Practice & Hlth Serv Res, Heidelberg, Germany.
    Brady, Oliver Jerome
    London Sch Hyg & Trop Med, London, England.
    Brazinova, Alexandra
    Comenius Univ, Inst Epidemiol, Fac Med, Bratislava, Slovakia.
    Breitborde, Nicholas J. K.
    Ohio State Univ, Columbus, OH 43210 USA.
    Brenner, Hermann
    German Canc Res Ctr, Heidelberg, Germany.
    Britton, Gabrielle
    INDICASAT AIP, Panama City, Panama.
    Brugha, Traolach S.
    Univ Leicester, Leicester, Leics, England.
    Butt, Zahid A.
    Al Shifa Trust Eye Hosp, Rawalpindi, Pakistan.
    Cahuana-Hurtado, Lucero
    Natl Inst Publ Hlth, Cuemavaca, Mexico.
    Campos-Nonato, Ismael Ricardo
    Natl Inst Publ Hlth, Cuemavaca, Mexico;Harvard Univ, Harvard T H Chan Sch Publ Hlth, Boston, MA 02115 USA. Africa Hlth Res Inst, Mtubatuba, South Africa.
    Campuzano, Julio Cesar
    Natl Inst Publ Hlth, Cuemavaca, Mexico.
    Car, Josip
    Nanyang Technol Univ, LKCMed, Singapore, Singapore;Imperial Coll London, London, England.
    Car, Mate
    Imperial Coll London, London, England;Minist Hlth Republ Croatia, Zagreb, Croatia.
    Cardenas, Rosario
    Metropolitan Autonomous Univ, Mexico City, DF, Mexico.
    Carrero, Juan Jesus
    Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden;Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med & Primary Care, Stockholm, Sweden.
    Carvalho, Felix
    Univ Porto, Fac Pharm, Porto, Portugal.
    Castaneda-Orjuela, Carlos A.
    Inst Nacl Salud, Colombian Natl Hlth Observ, Bogota, Colombia;Univ Nacl Colombia, Publ Hlth Dept, Epidemiol & Publ Hlth Evaluat Grp, Bogota, Colombia.
    Rivas, Jacqueline Castillo
    Univ Costa Rica, San Pedro, Costa Rica;Caja Costarricense Seguro Social, San Jose, Costa Rica.
    Catala-Lopez, Ferran
    Univ Valencia, INCLIVA Hlth Res Inst, Dept Med, Valencia, Spain;Univ Valencia, CIBERSAM, Dept Med, Valencia, Spain;Ottawa Hosp Res Inst, Clin Epidemiol Program, Ottawa, ON, Canada.
    Cercy, Kelly
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Chalek, Julian
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Chang, Hsing-Yi
    Natl Hlth Res Inst, Zgunan Town, Taiwan;Natl Yang Ming Univ, Taipei, Taiwan.
    Chang, Jung-Chen
    Natl Taiwan Univ, Coll Med, Sch Nursing, Taipei, Taiwan.
    Chattopadhyay, Aparajita
    Int Inst Populat Sci, Mumbai, Maharashtra, India.
    Chaturvedi, Pankaj
    Tata Mem Hosp, Mumbai, Maharashtra, India.
    Chiang, Peggy Pei-Chia
    Gold Coast Hlth, Clin Governance Unit, Southport, Qld, Australia.
    Chisumpa, Vesper Hichilombwe
    Univ Zambia, Lusaka, Zambia;Univ Witwatersrand, Johannesburg, South Africa.
    Choi, Jee-Young J.
    Seoul Natl Univ, Seoul, South Korea;Seoul Natl Univ, Med Lib, Seoul, South Korea.
    Christensen, Hanne
    Bispebjerg Hosp, Copenhagen, Denmark.
    Christopher, Devasahayam Jesudas
    Christian Med Coll & Hosp, Vellore, Tamil Nadu, India.
    Chung, Sheng-Chia
    UCL, Inst Hlth Informat, Farr Inst Hlth Informat Res, London, England.
    Ciobanu, Liliana G.
    Univ Adelaide, Sch Med, Discipline Psychiat, Adelaide, SA, Australia.
    Cirillo, Massimo
    Univ Salerno, Baronissi, Italy.
    Colombara, Danny
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Conti, Sara
    Univ Milano Bicocca, Monza, Italy.
    Cooper, Cyrus
    Univ Oxford, NIHR Musculoskeletal Biomed Res Ctr, Oxford, England;Univ Southampton, MRC Lifecourse Epidemiol Unit, Southampton, Hants, England.
    Cornaby, Leslie
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Cortesi, Paolo Angelo
    Univ Milano Bicocca, Res Ctr Publ Hlth, Monza, Italy.
    Cortinovis, Monica
    IRCCS, Ist Ric Farmacol Mario Negri, Milan, Italy.
    Pereira, Alexandre Costa
    Univ Sao Paulo, Inst Heart, Sao Paulo, Brazil.
    Cousin, Ewerton
    Univ Fed Rio Grande do Sul, Porto Alegre, RS, Brazil.
    Criqui, Michael H.
    Univ Calif San Diego, San Diego, CA 92103 USA.
    Cromwell, Elizabeth A.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Crowe, Christopher Stephen
    Univ Washington, Seattle, WA 98195 USA.
    Crump, John A.
    Univ Otago, Dunedin Sch Med, Ctr Int Hlth, Dunedin, New Zealand.
    Daba, Alemneh Kabeta
    Hawassa Univ, Hawassa, Ethiopia.
    Dachew, Berihun Assefa
    Univ Gondar, Inst Publ Hlth, Gondar, Ethiopia;Univ Queensland, Brisbane, Qld, Australia;Wolaita Sodo Univ, Wolaita Sodo, Ethiopia.
    Dadi, Abel Fekadu
    Univ Gondar, Gondar, Ethiopia;Flinders Univ S Australia, Adelaide, SA, Australia.
    Dandona, Lalit
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA;Publ Hlth Fdn India, Gurugram, India.
    Dandona, Rakhi
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA;Publ Hlth Fdn India, Gurugram, India.
    Dargan, Paul I.
    Guys & St Thomas NHS Fdn Trust, London, England.
    Daryani, Ahmad
    Mazandaran Univ Med Sci, Toxoplasmosis Res Ctr, Sari, Iran.
    Daryani, Maryam
    Mazandaran Univ Med Sci, Sari, Iran.
    Das, Jai
    Aga Khan Univ, Dept Paediat & Child Hlth, Karachi, Pakistan.
    Das, Siddharth Kumar
    KG Med Univ, Lucknow, Uttar Pradesh, India.
    das Neves, Jose
    Univ Porto, INEB Inst Engn Biomed, Porto, Portugal;Univ Porto, Inst Invest & Inovacao Sande I3S, Porto, Portugal.
    Weaver, Nicole Davis
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Davletov, Kairat
    Kazakh Natl Med Univ, Sch Publ Hlth, Alma Ata, Kazakhstan.
    de Courten, Barbora
    Monash Univ, Melbourne, Vic, Australia;Monash Med Ctr, Clayton, Vic, Australia.
    De Leo, Diego
    Griffith Univ, Brisbane, Qld, Australia.
    De Neve, Jan-Walter
    Heidelberg Inst Publ Hlth, Heidelberg, Germany.
    Dellavalle, Robert P.
    Univ Colorado, Sch Med, Aurora, CO USA;Colorado Sch Publ Hlth, Aurora, CO USA.
    Demoz, Gebre
    Addis Ababa Univ, Addis Ababa, Ethiopia;Aksum Univ, Aksum, Ethiopia.
    Deribe, Kebede
    Addis Ababa Univ, Sch Publ Hlth, Addis Ababa, Ethiopia;Brighton & Sussex Med Sch, Brighton, E Sussex, England.
    Des Jarlais, Don C.
    Mt Sinai Beth Israel, New York, NY USA;Icahn Sch Med Mt Sinai, New York, NY 10029 USA.
    Dey, Subhojit
    Indian Inst Publ Hlth, Gurugram, India.
    Dharmaratne, Samath D.
    Univ Peradeniya, Fac Med, Dept Community Med, Peradeniya, Sri Lanka.
    Dhimal, Meghnath
    Govt Nepal, Nepal Hlth Res Council, Kathmandu, Nepal.
    Djalalinia, Shirin
    Minist Hlth & Med Educ, Res & Technol, Tehran, Iran.
    Doku, David Teye
    Univ Cape Coast, Cape Coast, Ghana;Univ Tampere, Tampere, Finland.
    Dolan, Kate
    UNSW, Sydney, NSW, Australia.
    Dorsey, E. Ray
    Univ Rochester, Med Ctr, Rochester, NY 14642 USA.
    Bender dos Santos, Kadine Priscila
    Univ Estado Santa Catarina, Florianopolis, SC, Brazil.
    Doyle, Kerrie E.
    Australian Natl Univ, Res Sch Populat Hlth, Dept Global Hlth, Canberra, ACT, Australia;RMIT Univ, Bundoora, Vic, Australia.
    Driscoll, Tim R.
    Univ Sydney, Sydney Sch Publ Hlth, Sydney, NSW, Australia.
    Dubey, Manisha
    Int Inst Populat Sci, Mumbai, Maharashtra, India.
    Dubljanin, Eleonora
    Univ Belgrade, Inst Microbiol & Immunol, Belgrade, Serbia.
    Duncan, Bruce Bartholow
    Univ Fed Rio Grande do Sul, Porto Alegre, RS, Brazil;Univ N Carolina, Chapel Hill, NC 27515 USA.
    Echko, Michelle
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Edessa, Dumessa
    Haramaya Univ, Harar, Ethiopia.
    Edvardsson, David
    La Trobe Univ, Bundoora, Vic, Australia;Umea Univ, Umea, Sweden.
    Ehrlich, Joshua R.
    Univ Michigan, Ann Arbor, MI 48109 USA.
    Eldrenkamp, Erika
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    El-Khatib, Ziad
    Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden;Harvard Med Sch, Dept Global Hlth & Social Med, Kigali, Rwanda.
    Endres, Matthias
    Charite Univ Med Berlin, Berlin, Germany.
    Endries, Aman Yesuf
    Arba Minch Univ, Arba Minch, Ethiopia.
    Eshrati, Babak
    Minist Hlth & Med Educ, Tehran, Iran;Arak Univ Med Sci, Arak, Iran.
    Eskandarieh, Sharareh
    Multiple Sclerosis Res Ctr, Tehran, Iran.
    Esteghamati, Alireza
    Univ Tehran Med Sci, Endocrinol & Metab Res Ctr, Tehran, Iran.
    Fakhar, Mahdi
    Mazandaran Univ Med Sci, Sch Med, Mol & Cell Biol Res Ctr, Sari, Iran.
    Farag, Tamer
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Faramarzi, Mahbobeh
    Babol Univ Med Sci, Babol Sar, Iran.
    Faraon, Emerito Jose Aquino
    Univ Philippines Manila, Coll Publ Hlth, Manila, Philippines;Univ Philippines Manila, Coll Publ Hlth, Dept Hlth Policy & Adm, Manila, Philippines;Dept Hlth, Manila, Philippines.
    Faro, Andre
    Univ Fed Sergipe, Aracaju, Brazil.
    Farzadfar, Farshad
    Univ Tehran Med Sci, Noncommun Dis Res Ctr, Tehran, Iran.
    Fatusi, Adesegun
    Obafemi Awolowo Univ, Coll Hlth Sci, Dept Community Hlth, Ife, Nigeria.
    Fazeli, Mir Sohail
    Doctor Evidence, Santa Monica, CA USA.
    Feigin, Valery L.
    Auckland Univ Technol, Natl Inst Stroke & Appl Neurosci, Auckland, New Zealand.
    Feigl, Andrea B.
    Harvard Univ, Harvard T H Chan Sch Publ Hlth, Dept Global Hlth & Populat, Boston, MA 02115 USA.
    Fentahun, Netsanet
    Jimma Univ, Inst Hlth, Fac Publ Hlth, Dept Hlth Behav & Soc, Jimma, Ethiopia.
    Fereshtehnejad, Seyed-Mohammad
    Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med & Primary Care, Stockholm, Sweden.
    Fernandes, Eduarda
    Univ Porto, Dept Chem Sci, Porto, Portugal.
    Fernandes, Joao C.
    Catholic Univ Portugal, Fac Biotechnol, CBQF Ctr Biotechnol & Fine Chem Associate Lab, Porto, Portugal.
    Fijabi, Daniel Obadare
    Brandeis Univ, Heller Grad Sch, Waltham, MA USA.
    Filip, Irina
    Kaiser Permanente, Fontana, CA USA.
    Fischer, Florian
    Univ Bielefeld, Sch Publ Hlth, Bielefeld, Germany.
    Fitzmaurice, Christina
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA;Univ Washington, Dept Med, Div Hematol, Seattle, WA 98195 USA;Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA.
    Flaxman, Abraham D.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Flor, Luisa Sorio
    Escola Nacl Sande Publ Sergio Arouca, Rio De Janeiro, Brazil;Univ Fed Espirito Santo, Vitoria, Brazil.
    Foigt, Nataliya
    Acad Med Sci, Inst Gerontol, Kiev, Ukraine. Swiss Trop & Publ Hlth Inst, Dept Epidemiol & Publ Hlth, Basel, Switzerland.
    Foreman, Kyle J.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA;Imperial Coll London, London, England.
    Frostad, Joseph J.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Fuerst, Thomas
    Futran, Neal D.
    Univ Washington, Seattle, WA 98195 USA.
    Gakidou, Emmanuela
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Gallus, Silvano
    IRCCS, Ist Ric Farmacol Mario Negri, Milan, Italy;Univ Fed Santa Catarina, Florian6poliss, Brazil.
    Gambashidze, Ketevan
    Natl Ctr Dis Control & Publ Hlth, Tbilisi, Rep of Georgia.
    Gamkrelidze, Amiran
    Natl Ctr Dis Control & Publ Hlth, Tbilisi, Rep of Georgia.
    Ganji, Morsaleh
    Univ Tehran Med Sci, Endocrinol & Metab Res Ctr, Tehran, Iran.
    Gebre, Abadi Kahsu
    Mekelle Univ, Mekelle, Ethiopia.
    Gebrehiwot, Tsegaye Tewelde
    Jimma Univ, Jimma, Ethiopia.
    Gebremedhin, Amanuel Tesfay
    Jimma Univ, Jimma, Ethiopia;Ludwig Maximilians Univ Munchen, Munich, Germany.
    Gelaw, Yalemzewod Assefa
    Univ Gondar, Inst Publ Hlth, Gondar, Ethiopia;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia.
    Geleijnse, Johanna M.
    Wageningen Univ, Div Human Nutr, Wageningen, Netherlands.
    Geremew, Demeke
    Univ Gondar, Gondar, Ethiopia.
    Gething, Peter W.
    Univ Oxford, Dept Zool, Oxford, England.
    Ghadimi, Reza
    Babol Univ Med Sci, Hlth Res Inst, Babol Sar, Iran;Dept Nutr, Babol Sar, Iran.
    Falavarjani, Khalil Ghasemi
    Ghasemi-Kasman, Maryam
    Babol Univ Med Sci, Babol Sar, Iran.
    Gill, Paramjit Singh
    Univ Warwick, Warwick Med Sch, Coventry, W Midlands, England.
    Giref, Ababi Zergaw
    Addis Ababa Univ, Addis Ababa, Ethiopia.
    Giroud, Maurice
    Univ Hosp Dijon, Dijon, France.
    Gishu, Melkamu Dedefo
    Haramaya Univ, Harar, Ethiopia;Kersa Hlth & Demog Surveillance Syst, Harar, Ethiopia.
    Giussani, Giorgia
    IRCCS, Ist Ric Farmacol Mario Negri, Milan, Italy.
    Godwin, William W.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Goli, Srinivas
    Jawaharlal Nehru Univ, New Delhi, India.
    Gomez-Dantes, Hector
    Natl Inst Publ Hlth, Cuemavaca, Mexico.
    Gona, Philimon N.
    Univ Massachusetts, Boston, MA 02125 USA.
    Goodridge, Amador
    Inst Invest Cient Serv Alta Tecnol INDICASAT AIP, Ciudad Saber, Panama.
    Gopalani, Sameer Vali
    Govt Federated States Micronesia, Dept Hlth & Social Affairs, Palikir, Micronesia.
    Goryakin, Yevgeniy
    Org Econ Cooperat & Dev, Paris, France.
    Goulart, Alessandra Carvalho
    Univ Sao Paulo, Univ Hosp, Ctr Clin, Sao Paulo, Brazil;Univ Sao Paulo, Univ Hosp, Epidemiol Res Ctr, Sao Paulo, Brazil.
    Grada, Ayman
    Boston Univ, Sch Med, Boston, MA 02215 USA.
    Griswold, Max
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Grosso, Giuseppe
    Univ Hosp Policlin Vittorio Emanuele, Catania, Italy;NNEdPro Global Ctr Nutr & Hlth, Cambridge, England.
    Gugnani, Harish Chander
    St James Sch Med, Dept Microbiol, Quarter, Anguilla;St James Sch Med, Dept Epidemiol & Biostat, Quarter, Anguilla.
    Guo, Yuming
    Univ Queensland, Brisbane, Qld, Australia.
    Gupta, Rahul
    West Virginia Bur Publ Hlth, Charleston, WV USA.
    Gupta, Rajeev
    Eternal Heart Care Ctr, Jaipur, Rajasthan, India;Res Inst, Jaipur, Rajasthan, India.
    Gupta, Tanush
    Montefiore Med Ctr, Bronx, NY 10467 USA;Albert Einstein Coll Med, Bronx, NY 10467 USA.
    Gupta, Tarun
    Indian Inst Technol Kanpur, Kanpur, Uttar Pradesh, India.
    Gupta, Vipin
    Univ Delhi, Dept Anthropol, Delhi, India.
    Haagsma, Juanita A.
    Univ Med Ctr Rotterdam, Erasmus MC, Rotterdam, Netherlands.
    Hachinski, Vladimir
    Western Univ, London, ON, Canada.
    Hafezi-Nejad, Nima
    Univ Tehran Med Sci, Endocrinol & Metab Res Ctr, Tehran, Iran.
    Hailu, Gessessew Bugssa
    Mekelle Univ, Mekelle, Ethiopia;Kilte Awlaelo Hlth & Demog Surveillance Syst, Mekelle, Ethiopia.
    Hamadeh, Randah Ribhi
    Arabian Gulf Univ, Manama, Bahrain.
    Hamidi, Samer
    Hamdan Bin Mohammed Smart Univ, Abu Dhabi, U Arab Emirates.
    Hankey, Graeme J.
    Univ Western Australia, Sch Med & Pharmacol, Perth, WA, Australia;Harry Perkins Inst Med Res, Nedlands, WA, Australia;Western Australian Neurosci Res Inst, Nedlands, WA, Australia.
    Harb, Hilda L.
    Harewood, Heather C.
    Eunice Gibson Polyclin, Bridgetown, Barbados.
    Harikrishnan, Sivadasanpillai
    Sree Chitra Tirunal Inst Med Sci & Technol, Trivandrum, Kerala, India.
    Haro, Josep Maria
    Parc Sanitari St Joan Deu CIBERSAM, Barcelona, Spain.
    Hassen, Hamid Yimam
    Mizan Tepi Univ, Mizan Aman, Ethiopia.
    Havmoeller, Rasmus
    Hawley, Caitlin
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Hay, Simon I.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA;Univ Oxford, Li Ka Shing Ctr Hlth Informat & Discovery, Oxford Big Data Inst, Oxford, England.
    He, Jiawei
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Hearps, Stephen J. C.
    Murdoch Childrens Res Hosp, Child Neuropsychol, Parkville, Vic, Australia.
    Hegazy, Mohamed I.
    Cairo Univ, Fac Med, Cairo, Egypt.
    Heibati, Behzad
    Iran Univ Med Sci, Air Pollut Res Ctr, Tehran, Iran.
    Heidari, Mohsen
    Hormozgan Univ Med Sci, Fac Hlth, Bandar Abbas, Iran.
    Hendrie, Delia
    Curtin Univ, Sch Publ Hlth, Perth, WA, Australia.
    Henry, Nathaniel J.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Herrera Ballesteros, Victor Hugo
    Gorgas Mem Inst Studies Hlth, Panama City, Panama;Univ Panama, Panama City, Panama.
    Herteliu, Claudiu
    Bucharest Univ Econ Studies, Dept Stat & Econometr, Bucharest, Romania.
    Hibstu, Desalegn Tsegaw
    Hawassa Univ, Coll Med & Hlth Sci, Hawassa, Ethiopia.
    Hiluf, Molla Kahssay
    Samara Univ, Samara, Ethiopia.
    Hoek, Hans W.
    Univ Groningen, Univ Med Ctr Groningen, Dept Psychiat, Groningen, Netherlands;Columbia Univ, Mailman Sch Publ Hlth, Dept Epidemiol, New York, NY 10027 USA.
    Rad, Enayatollah Homaie
    Guilan Univ Med Sci, Guilan Rd Trauma Res Ctr, Rasht, Iran.
    Horita, Nobuyuki
    Yokohama City Univ, Grad Sch Med, Dept Pulmonol, Yokohama, Kanagawa, Japan.
    Hosgood, H. Dean
    Albert Einstein Coll Med, Bronx, NY 10467 USA.
    Hosseini, Mostafa
    Hosseini, Seyed Reza
    Babol Univ Med Sci, Social Determinants Hlth Res Ctr, Hlth Res Inst, Babol Sar, Iran.
    Hostiuc, Mihaela
    Carol Davila Univ Med & Pharm, Bucharest, Romania.
    Hostiuc, Sorin
    Carol Davila Univ Med & Pharm, Bucharest, Romania.
    Hoy, Damian G.
    Pacific Community, Publ Hlth Div, Noumea, New Caledonia.
    Hsairi, Mohamed
    Salah Azaiz Inst, Dept Epidemiol, Tunis, Tunisia.
    Htet, Aung Soe
    Univ Oslo, Oslo, Norway.
    Hu, Guoqing
    Cent S Univ, Sch Publ Hlth, Dept Epidemiol & Hlth Stat, Changsha, Peoples R China.
    Huang, John J.
    Yale Univ, New Haven, CT USA.
    Iburg, Kim Moesgaard
    Aarhus Univ, Aarhus, Denmark.
    Idris, Fachmi
    Sriwijaya Univ, Palembang, Indonesia;Social Secur Administering Body Hlth, Jakarta, Indonesia.
    Igumbor, Ehimario Uche
    US Ctr Dis Control & Prevent, Pretoria, South Africa;Univ Western Cape, Sch Publ Hlth, Cape Town, South Africa.
    Ikeda, Chad
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Ileanu, Bogdan Vasile
    Bucharest Univ Econ Studies, Bucharest, Romania.
    Ilesanmi, Olayinka S.
    Natl Publ Hlth Inst, Monrovia, CA, Liberia.
    Innos, Kaire
    Natl Inst Hlth Dev, Tallinn, Estonia.
    Irvani, Seyed Sina Naghibi
    Prevent Metab Disorders Res Ctr, Res Inst Endocrine Sci, Tehran, Iran;Shahid Beheshti Univ Med Sci, Tehran, Iran.
    Irvine, Caleb M. S.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Islami, Farhad
    Amer Canc Soc, Surveillance & Hlth Serv Res, Atlanta, GA 30329 USA.
    Jacobs, Troy A.
    USAID Global Hlth Bur, HIDN, MCH Div, Washington, DC USA.
    Jacobsen, Kathryn H.
    George Mason Univ, Dept Global & Community Hlth, Fairfax, VA 22030 USA.
    Jahanmehr, Nader
    Shahid Beheshti Univ Med Sci, Sch Publ Hlth, Tehran, Iran.
    Jain, Rajesh
    Jain Hosp MSS, Kanpur, Uttar Pradesh, India.
    Jain, Sudhir Kumar
    Natl Ctr Dis Control Delhi, Delhi, India.
    Jakovljevic, Mihajlo M.
    Univ Washington, Ctr Hlth Trends & Forecasts, Seattle, WA 98195 USA;Univ Kragujevac, Fac Med Sci, Kragujevac, Serbia.
    Jalu, Moti Tolera
    Haramaya Univ, Harar, Ethiopia;St Pauls Hosp, Millennium Med Coll, Addis Ababa, Ethiopia.
    Jamal, Amr A.
    Javanbakht, Mehdi
    Univ Aberdeen, Aberdeen, Scotland.
    Jayatilleke, Achala Upendra
    Postgrad Inst Med, Colombo, Sri Lanka;Inst Violence & Injury Prevent, Colombo, Sri Lanka.
    Jeemon, Panniyammakal
    Ctr Control Chron Condit, Gurugram, India;Ctr Chron Dis Control, New Delhi, India.
    Jha, Ravi Prakash
    Banaras Hindu Univ, Varanasi, Uttar Pradesh, India.
    Jha, Vivekanand
    Univ Oxford, Oxford, England;George Inst Global Hlth, New Delhi, India.
    Jozwiak, Jacek
    Czestochowa Tech Univ, Inst Hlth & Nutr Sci, Czestochowa, Poland.
    John, Oommen
    George Inst Global Hlth, New Delhi, India.
    Johnson, Sarah Charlotte
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Jonas, Jost B.
    Heidelberg Univ, Med Fac Mannheim, Dept Ophthalmol, Mannheim, Germany.
    Joshua, Vasna
    Indian Council Med Res, Natl Inst Epidemiol, Chennai, Tamil Nadu, India.
    Juerisson, Mikk
    Univ Tartu, Inst Family Med & Publ Hlth, Tartu, Estonia.
    Kabir, Zubair
    Univ Coll Cork, Cork, Ireland.
    Kadel, Rajendra
    London Sch Econ & Polit Sci, London, England.
    Kahsay, Amaha
    Mekelle Univ, Mekelle, Ethiopia.
    Kalani, Rizwan
    Univ Washington, Seattle, WA 98195 USA.
    Kar, Chittaranjan
    SCB Med Coll, Cuttack, Orissa, India.
    Karanikolos, Marina
    European Observ Hlth Syst & Policies, London, England.
    Karch, Andre
    Helmholtz Ctr Infect Res, Epidemiol & Stat Methods Res Grp, Braunschweig, Germany;German Ctr Infect Res, Hannover, Germany.
    Karema, Corine Kakizi
    Swiss Trop & Publ Hlth Inst, Basel, Switzerland. Univ Basel, Basel, Switzerland;Qual & Equity Hlth Care, Kigali, Rwanda.
    Karimi, Seyed M.
    Univ Washington Tacoma, Tacoma, WA USA.
    Kasaeian, Amir
    Univ Tehran Med Sci, Hematol Malignancies Res Ctr, Tehran, Iran;Univ Tehran Med Sci, Hematol Oncol & Stem Cell Transplantat Res Ctr, Tehran, Iran.
    Kassa, Dessalegn Haile
    Debre Markos Univ, Debre Markos, Ethiopia.
    Kassa, Getachew Mullu
    Debre Markos Univ, Debre Markos, Ethiopia.
    Kassa, Tesfaye Dessale
    Mekelle Univ, Mekelle, Ethiopia.
    Kassebaum, Nicholas J.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA;Seattle Childrens Hosp, Dept Anesthesiol & Pain Med, Seattle, WA USA.
    Katikireddi, Srinivasa Vittal
    Univ Glasgow, MRC CSO Social Publ Hlth Sci Unit, Glasgow, Lanark, Scotland.
    Kaul, Anil
    Oklahoma State Univ, Tulsa, OK USA.
    Kawakami, Norito
    Univ Tokyo, Sch Publ Hlth, Tokyo, Japan.
    Kazanjan, Konstantin
    Natl Ctr Dis Control & Publ Hlth, Tbilisi, Rep of Georgia.
    Kebede, Seifu
    Mekelle Univ, Mekelle, Ethiopia.
    Keiyoro, Peter Njenga
    Inst Trop & Infect Dis, Nairobi, Kenya;Sch Continuing & Distance Educ, Nairobi, Kenya.
    Kemp, Grant Rodgers
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Kengne, Andre Pascal
    South African Med Res Council, UKZN Gastrointestinal Canc Res Ctr, Cape Town, South Africa;Univ Cape Town, Fac Hlth Sci, Hatter Inst Cardiovasc Res Africa, Dept Psychiat, Cape Town, South Africa.
    Kereselidze, Maia
    Natl Ctr Dis Control & Publ Hlth, Tbilisi, Rep of Georgia.
    Ketema, Ezra Belay
    Mekelle Univ, Mekelle, Ethiopia.
    Khader, Yousef Saleh
    Jordan Univ Sci & Technol, Dept Community Med Publ Hlth & Family Med, Irbid, Jordan;Jordan Univ Sci & Technol, Fac Appl Med Sci, Dept Rehabil Sci, Div Phys Therapy, Irbid, Jordan.
    Khafaie, Morteza Abdullatif
    Ahvaz Jundishapur Univ Med Sci, Ahwaz, Iran.
    Khajavi, Alireza
    Shahid Beheshti Univ Med Sci, Tehran, Iran.
    Khalil, Ibrahim A.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Khan, Ejaz Ahmad
    Hlth Serv Acad, Islamabad, Pakistan.
    Khan, Gulfaraz
    United Arab Emirates Univ, Coll Med Hlth Sci, Dept Microbiol & Immunol, Al Ain, U Arab Emirates.
    Khan, Md Nuruzzaman
    Univ Newcastle, Newcastle, NSW, Australia;Jatiya Kabi Kazi Nazrul Islam Univ, Mymensingh, Bangladesh.
    Khan, Muhammad Ali
    Univ Alabama Birmingham, Dept Epidemiol, Birmingham, AL USA;Univ Tennessee, Hlth Sci Ctr, Memphis, TN 38163 USA.
    Khanal, Mukti Nath
    Dept Hlth Serv Hlth Management Informat Syst, Kathmandu, Nepal.
    Khang, Young-Ho
    Seoul Natl Univ, Dept Hlth Policy & Management, Coll Hlth Sci, Seoul, South Korea;Seoul Natl Univ, Med Ctr, Inst Hlth Policy & Management, Seoul, South Korea.
    Khater, Mona M.
    Cairo Univ, Fac Med, Cairo, Egypt;Cairo Univ, Cairo, Egypt.
    Khoja, Abdullah Tawfih Abdullah
    Johns Hopkins Univ, Johns Hopkins Bloomberg Sch Publ Hlth, Ctr Clin Global Hlth Educ, Baltimore, MD USA;Mohammed Ibn Saudi Univ, Coll Med, Dept Publ Hlth, Riyadh, Saudi Arabia;Mohammed Ibn Saudi Univ, Coll Med, Dept Family Med, Riyadh, Saudi Arabia.
    Khosravi, Ardeshir
    Univ Tehran Med Sci, Noncommun Dis Res Ctr, Tehran, Iran;Iranian Minist Hlth & Med Educ, Tehran, Iran.
    Khubchandani, Jagdish
    Ball State Univ, Dept Nutr & Hlth Sci, Muncie, IN 47306 USA.
    Kibret, Getiye Dejenu
    Addis Ababa Univ, Coll Vet Med & Agr, Addis Ababa, Ethiopia;Debre Markos Univ, Debre Markos, Ethiopia.
    Kiirithio, Daniel Ngari
    Kenya Revenue Author, Nairobi, Kenya;Synotech Consultants, Nairobi, Kenya.
    Kim, Daniel
    Northeastern Univ, Dept Hlth Sci, Boston, MA 02115 USA.
    Kim, Yun Jin
    Xiamen Univ, Sch Med, Malaysia Campus, Sepang, Malaysia.
    Kimokoti, Ruth W.
    Simmons Coll, Boston, MA 02115 USA.
    Kinfu, Yohannes
    Univ Canberra, Ctr Res & Action Publ Hlth, Canberra, ACT, Australia.
    Kinra, Sanjay
    London Sch Hyg & Trop Med, London, England.
    Kisa, Adnan
    Univ Oslo, Oslo, Norway.
    Kissoon, Niranjan
    Univ British Columbia, Fac Med, Sch Populat & Publ Hlth, Vancouver, BC, Canada.
    Kochhar, Sonali
    Univ Washington, Dept Global Hlth, Seattle, WA 98195 USA;Global Healthcare Consulting, New Delhi, India.
    Kokubo, Yoshihiro
    Natl Cerebral & Cardiovasc Ctr, Dept Prevent Cardiol, Suita, Osaka, Japan.
    Kopec, Jacek A.
    Univ British Columbia, Fac Med, Sch Populat & Publ Hlth, Vancouver, BC, Canada.
    Kosen, Soewarta
    Natl Inst Hlth Res Dev, Ctr Community Empowerment Hlth Policy & Humanitie, Jakarta, Indonesia.
    Koul, Parvaiz A.
    Sher Kashmir Inst Med Sci, Srinagar, Jammu & Kashmir, India.
    Koyanagi, Ai
    Parc Sanitari St Joan Deu CIBERSAM, Res & Dev Unit, Barcelona, Spain.
    Kravchenko, Michael
    Res Ctr Neurol, Moscow, Russia.
    Krishan, Kewal
    Panjab Univ, Chandigarh, India.
    Krohn, Kristopher J.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Defo, Barthelemy Kuate
    Univ Montreal, Sch Publ Hlth, Dept Demog, Montreal, PQ, Canada;Univ Montreal, Sch Publ Hlth, Publ Hlth Res Inst, Montreal, PQ, Canada;Univ Montreal, Sch Publ Hlth, Dept Social & Prevent Med, Montreal, PQ, Canada.
    Kumar, G. Anil
    Publ Hlth Fdn India, Gurugram, India.
    Kumar, Pushpendra
    Int Inst Populat Sci, Mumbai, Maharashtra, India.
    Kutz, Michael
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Kuzin, Igor
    Minist Hlth Ukraine, State Inst Publ Hlth Ctr, Kiev, Ukraine.
    Kyu, Hmwe H.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Lad, Deepesh Pravinkumar
    Postgrad Inst Med Educ & Res, Chandigarh, India.
    Lafranconi, Alessandra
    Univ Milano Bicocca, Monza, Italy.
    Lal, Dharmesh Kumar
    Publ Hlth Fdn India, Gurugram, India.
    Lalloo, Ratilal
    Univ Queensland, Sch Dent, Brisbane, Qld, Australia.
    Lam, Hilton
    NHLBI, Ctr Translat Res & Implementat Sci, Inst Hlth Policy & Dev Studies, Natl Inst Hlth, Manila, Philippines.
    Lan, Qing
    NCI, Rockville, MD USA.
    Lang, Justin J.
    Publ Hlth Agcy Canada, Toronto, ON, Canada;Childrens Hosp, Eastern Ontario Res Inst, Ottawa, ON, Canada.
    Lansingh, Van C.
    Help Me See Inc, New York, NY USA;Inst Mexicano Oftalmol, Queretaro, Mexico.
    Lansky, Sonia
    Univ Fed Minas Gerais, Sch Med, Belo Horizonte, MG, Brazil;Secretaria Municipal Sande, Belo Horizonte, MG, Brazil.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Latifi, Arman
    Maragheh Univ Med Sci, Managerial Epidemiol Res Ctr, Sch Nursing & Midwifery, Dept Publ Hlth, Maragheh, Iran.
    Lazarus, Jeffrey Victor
    Univ Barcelona, Hosp Clin, ISGlobal, Barcelona, Spain;Univ Copenhagen, Rigshosp, CHIP, Copenhagen, Denmark.
    Leasher, Janet L.
    Nova Southeastern Univ, Coll Optometry, Ft Lauderdale, FL 33314 USA.
    Lee, Paul H.
    Hong Kong Polytech Univ, Hong Kong, Hong Kong, Peoples R China.
    Legesse, Yirga
    Mekelle Univ, Mekelle, Ethiopia.
    Leigh, James
    Univ Sydney, Sydney, NSW, Australia.
    Leshargie, Cheru Tesema
    Debre Markos Univ, Debre Markos, Ethiopia.
    Leta, Samson
    Addis Ababa Univ, Addis Ababa, Ethiopia.
    Leung, Janni
    Univ Washington, Seattle, WA 98195 USA;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia.
    Leung, Ricky
    SUNY Albany, Albany, NY 12222 USA.
    Levi, Miriam
    Tuscany Reg Ctr Occupat Injuries & Dis, Florence, Italy.
    Li, Yongmei
    San Francisco VA Med Ctr, San Francisco, CA USA.
    Liang, Juan
    Sichuan Univ, West China Univ Hosp 2, Natl Off Maternal & Child Hlth Surveillance, Chengdu, Sichuan, Peoples R China.
    Liben, Misgan Legesse
    Samara Univ, Samara, Ethiopia.
    Lim, Lee-Ling
    Univ Malaya, Kuala Lumpur, Malaysia;Chinese Univ Hong Kong, Shatin, Hong Kong, Peoples R China.
    Lim, Stephen S.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Lind, Margaret
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Linn, Shai
    Univ Haifa, Haifa, Israel.
    Listl, Stefan
    Heidelberg Univ, Heidelberg, Germany;Radboud Univ Nijmegen Med Ctr, Nijmegen, Netherlands.
    Liu, Patrick Y.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Liu, Shiwei
    Chinese Ctr Dis Control & Prevent, Natl Ctr Chron & Noncommunicable Dis Control & Pr, Beijing, Peoples R China.
    Lodha, Rakesh
    All India Inst Med Sci, New Delhi, India.
    Lopez, Alan D.
    Univ Melbourne, Melbourne Sch Populat & Global Hlth, Melbourne, Vic 3010, Australia.
    Lorch, Scott A.
    Univ Penn, Childrens Hosp Philadelphia, Sch Med, Philadelphia, PA 19104 USA.
    Lorkowski, Stefan
    Friedrich Schiller Univ Jena, Inst Nutr, Jena, Germany;Competence Cluster Nutr & Cardiovasc Hlth NutriCA, Jena, Germany.
    Lotufo, Paulo A.
    Univ Sao Paulo, Sao Paulo, Brazil.
    Lucas, Timothy C. D.
    Univ Oxford, Li Ka Shing Ctr Hlth Informat & Discovery, Oxford Big Data Inst, Oxford, England;Univ Oxford, Nuffield Dept Med, Oxford, England.
    Lunevicius, Raimundas
    Aintree Univ Hosp Natl Hlth Serv Fdn Trust, Liverpool, Merseyside, England;Univ Liverpool, Sch Med, Liverpool, Merseyside, England.
    Lurton, Gregoire
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Lyons, Ronan A.
    Swansea Univ, Farr Inst, Swansea, W Glam, Wales.
    Maalouf, Fadi
    Amer Univ Beirut, Fac Hlth Sci, Ctr Res Populat & Hlth, Dept Psychiat, Beirut, Lebanon.
    Macarayan, Erlyn Rachelle King
    Harvard Univ, Ariadne Labs, Boston, MA 02115 USA.
    Mackay, Mark T.
    Univ Melbourne, Melbourne, Vic 3010, Australia;Royal Childrens Hosp Melbourne, Melbourne, Vic, Australia.
    Maddison, Emilie R.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Madotto, Fabiana
    Univ Milano Bicocca, Monza, Italy.
    Abd El Razek, Hassan Magdy
    Mansoura Fac Med, Mansoura, Egypt;Aswan Univ Hosp, Aswan Fac Med, Aswan, Egypt.
    Abd El Razek, Mohammed Magdy
    Majdan, Marek
    Trnava Univ, Fac Hlth Sci & Social Work, Dept Publ Hlth, Trnava, Slovakia.
    Majdzadeh, Reza
    Univ Tehran Med Sci, Knowledge Utilizat Res Ctr, Tehran, Iran;Univ Tehran Med Sci, Community Based Participatory Res Ctr, Tehran, Iran;Natl Inst Hlth Res, Tehran, Iran.
    Majeed, Azeem
    Imperial Coll London, Dept Primary Care & Publ Hlth, London, England.
    Malekzadeh, Reza
    Univ Tehran Med Sci, Digest Dis Res Inst, Tehran, Iran.
    Malhotra, Rajesh
    All India Inst Med Sci, New Delhi, India.
    Malta, Deborah Carvalho
    Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil.
    Mamun, Abdullah A.
    Univ Queensland, Brisbane, Qld, Australia.
    Manguerra, Helena
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Manhertz, Treh
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Mansournia, Mohammad Ali
    Univ Tehran Med Sci, Dept Epidemiol & Biostat, Tehran, Iran.
    Mantovani, Lorenzo G.
    Univ Milano Bicocca, Monza, Italy.
    Manyazewal, Tsegahun
    Ethiopian Publ Hlth Assoc, Addis Ababa, Ethiopia.
    Mapoma, Chabila C.
    Univ Zambia, Lusaka, Zambia.
    Margono, Christopher
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Martinez-Raga, Jose
    Hosp Univ Doctor Peset, Valencia, Spain;CEU Cardinal Herrera Univ, Moncada, Spain.
    Martins, Sheila Cristina Ouriques
    Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil;Hosp Moinhos Vento, Porto Alegre, RS, Brazil.
    Martins-Melo, Francisco Rogerlandio
    Fed Inst Educ Sci & Technol Ceara, Caucaia, Brazil. Synlab Acad, Mannheim, Germany. Med Univ Graz, Clin Inst Med & Chem Lab Diagnost, Graz, Austria.
    Martopullo, Ira
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Maerz, Winfried
    Massenburg, Benjamin Ballard
    Univ Washington, Dept Surg, Div Plast Surg, Seattle, WA 98195 USA;Harvard Med Sch, Program Global Surg & Social Change, Kigali, Rwanda.
    Mathur, Manu Raj
    Publ Hlth Fdn India, Gurugram, India;UCL, London, England.
    Maulik, Pallab K.
    George Inst Global Hlth India, New Delhi, India;Univ Oxford, George Inst Global Hlth, Oxford, England.
    Mazidi, Mohsen
    Chalmers Univ Technol, Dept Biol & Biol Engn Food & Nutr Sci, Gothenburg, Sweden.
    McAlinden, Colm
    Univ Hosp Bristol NHS Fdn Trust, Bristol, Avon, England;Publ Hlth Wales, Swansea, W Glam, Wales.
    McGrath, John J.
    Univ Queensland, Queensland Brain Inst, Brisbane, Qld, Australia;Aarhus Univ, Aarhus Sch Business & Social Sci, Natl Ctr Register Based Res, Aarhus, Denmark;Queensland Ctr Mental Hlth Res, Pk Ctr Mental Hlth, Wacol, Qld, Australia.
    McKee, Martin
    London Sch Hyg & Trop Med, London, England.
    Mehata, Suresh
    Ipas Nepal, Kathmandu, Nepal.
    Mehrotra, Ravi
    Natl Inst Canc Prevent Res, Noida, India.
    Mehta, Kala M.
    Univ Calif San Francisco, San Francisco, CA 94143 USA.
    Mehta, Varshil
    MGM Med Coll, Navi Mumbai, India.
    Meier, Toni
    Martin Luther Univ Halle Wittenberg, Inst Medizin Epidemiol Biometrie & Informat, Competence Cluster Nutr & Cardiovasc Hlth NutriCA, Saale, Germany.
    Mejia-Rodriguez, Fabiola
    Natl Inst Publ Hlth, Cuemavaca, Mexico.
    Meles, Kidanu Gebremariam
    Mekelle Univ, Coll Hlth Sci, Mekelle, Ethiopia;Mekelle Univ, Sch Publ Hlth, Mekelle, Ethiopia.
    Melku, Mulugeta
    Univ Gondar, Gondar, Ethiopia.
    Memiah, Peter
    Univ West Florida, Pensacola, FL 32514 USA.
    Memish, Ziad A.
    Saudi Minist Hlth, Riyadh, Saudi Arabia;Alfaisal Univ, Coll Med, Riyadh, Saudi Arabia.
    Mendoza, Walter
    United Nations Populat Fund, Lima, Peru.
    Mengiste, Degu Abate
    Haramaya Univ, Harar, Ethiopia.
    Mengistu, Desalegn Tadese
    Mekelle Univ, Coll Hlth Sci, Mekelle, Ethiopia.
    Menota, Bereket Gebremichael
    Addis Ababa Univ, Addis Ababa, Ethiopia.
    Mensah, George A.
    NHLBI, Ctr Translat Res & Implementat Sci, Inst Hlth Policy & Dev Studies, Natl Inst Hlth, Manila, Philippines.
    Meretoja, Atte
    Univ Melbourne, Dept Med, Melbourne, Vic, Australia;Helsinki Univ Hosp, Comprehens Canc Ctr, Dept Neurol, Breast Surg Unit, Helsinki, Finland.
    Meretoja, Tuomo J.
    Univ Helsinki, Fac Med, Finnish Inst Occupat Hlth, Dept Publ Hlth,Work Org,Work Disability Program, Helsinki, Finland.
    Mezgebe, Haftay Berhane
    Mekelle Univ, Mekelle, Ethiopia.
    Miazgowski, Tomasz
    Pomeranian Med Univ, Szczecin, Poland.
    Micha, Renata
    Tufts Univ, Friedman Sch Nutr Sci & Policy, Boston, MA 02111 USA.
    Milam, Robert
    Doctor Evidence, Santa Monica, CA USA.
    Millear, Anoushka
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Miller, Ted R.
    Curtin Univ, Sch Publ Hlth, Perth, WA, Australia;Pacific Inst Res Evaluat, Calverton, MD USA.
    Mini, G. K.
    Sree Chitra Tirunal Inst Med Sci & Technol, Thiruvananthapuram, Kerala, India;Amrita Inst Med Sci, Kochi, India.
    Minnig, Shawn
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Mirica, Andreea
    Bucharest Univ Econ Studies, Bucharest, Romania.
    Mirrakhimov, Erkin M.
    Kyrgyz State Med Acad, Bishkek, Kyrgyzstan;Natl Ctr Cardiol & Internal Dis, Bishkek, Kyrgyzstan.
    Misganaw, Awoke
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Mitchell, Philip B.
    Univ New South Wales, Sch Optometry & Vision Sci, Brien Holden Vision Inst, Kensington, NSW, Australia.
    Mlashu, Fitsum Weldegebreal
    Haramaya Univ, Harar, Ethiopia.
    Moazen, Babak
    Univ Tehran Med Sci, Noncommun Dis Res Ctr, Endocrinol & Metab Res Inst, Tehran, Iran;Heidelberg Univ, Fac Med Mannheim, Inst Publ Hlth, Dept Ophthalmol, Heidelberg, Germany.
    Mohammad, Karzan Abdulmuhsin
    Salahaddin Univ, Erbil, Iraq;Ishik Univ, Erbil, Iraq.
    Mohammadibakhsh, Roghayeh
    Hamedan Univ Med Sci, Hamadan, Iran.
    Mohammed, Ebrahim
    Mekelle Univ, Mekelle, Ethiopia.
    Mohammed, Mohammed A.
    Jigjiga Univ, Jigjiga, Ethiopia;Univ Sydney, Sydney, NSW, Australia.
    Mohammed, Shafiu
    Heidelberg Univ, Inst Publ Hlth, Heidelberg, Germany;Ahmadu Bello Univ, Hlth Syst & Policy Res Unit, Zaria, Nigeria.
    Mokdad, Ali H.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Mola, Glen Liddell D.
    Univ Papua New Guinea, Sch Med & Hlth Sci, Reprod Hlth & ObGyn, Boroko, Papua N Guinea.
    Molokhia, Mariam
    Kings Coll London, London, England.
    Momeniha, Fatemeh
    Iran Univ Med Sci, Sch Publ Hlth, Dept Environm Hlth Engn, Tehran, Iran.
    Monasta, Lorenzo
    IRCCS Burlo Garofolo, Inst Maternal & Child Hlth, Trieste, Italy.
    Montanez Hernandez, Julio Cesar
    Natl Inst Publ Hlth, Cuemavaca, Mexico.
    Moosazadeh, Mahmood
    Mazandaran Univ Med Sci, Hlth Sci Res Ctr, Addict Inst, Sari, Iran.
    Moradi-Lakeh, Maziar
    Iran Univ Med Sci, Dept Community Med, Tehran, Iran;Iran Univ Med Sci, Prevent Med & Publ Hlth Res Ctr, Tehran, Iran;Iran Univ Med Sci, Gastrointestinal & Liver Dis Res Ctr, Tehran, Iran.
    Moraga, Paula
    Univ Lancaster, Lancaster Med Sch, Lancaster, England.
    Morawska, Lidia
    Queensland Univ Technol, Int Lab Air Qual & Hlth, Brisbane, Qld, Australia.
    Velasquez, Ilais Moreno
    Gorgas Mem Inst Hlth Studies, Panama City, Panama.
    Mori, Rintaro
    Natl Ctr Child Hlth & Dev, Tokyo, Japan.
    Morrison, Shane D.
    Univ Washington, Seattle, WA 98195 USA.
    Moses, Mark
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Mousavi, Seyyed Meysam
    Univ Tehran Med Sci, Sch Publ Hlth, Dept Hlth Management & Econ, Tehran, Iran.
    Mueller, Ulrich O.
    Fed Inst Populat Res, Competence Ctr Mortal Follow Up German Natl Cohor, Wiesbaden, Germany.
    Murhekar, Manoj
    ICMR Natl Inst Epidemiol, Chennai, Tamil Nadu, India.
    Murthy, Gudlavalleti Venkata Satyanarayana
    London Sch Hyg & Trop Med, London, England.
    Murthy, Srinivas
    Univ British Columbia, Fac Med, Sch Populat & Publ Hlth, Vancouver, BC, Canada.
    Musa, Jonah
    Univ Jos, Jos, Nigeria;Jos Univ, Teaching Hosp, Jos, Nigeria.
    Musa, Kamarul Imran
    Univ Sci Malaysia, Sch Med Sci, Kubang Kerian, Malaysia.
    Mustafa, Ghulam
    Helping Hands Fdn, Multan, Pakistan;Nishtar Med Univ, Multan, Pakistan.
    Muthupandian, Saravanan
    Mekelle Univ, Coll Hlth Sci, Mekelle, Ethiopia;Mekelle Univ, Inst Biomed Sci, Mekelle, Ethiopia;Mekelle Univ, Dept Med Microbiol, Mekelle, Ethiopia.
    Nagata, Chie
    Natl Ctr Child Hlth & Dev, Tokyo, Japan.
    Nagel, Gabriele
    Ulm Univ, Inst Epidemiol & Med Biometry, Ulm, Germany.
    Naghavi, Mohsen
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Naheed, Aliya
    Int Ctr Diarrhoeal Dis Res, Dhaka, Bangladesh.
    Naik, Gurudatta A.
    Univ Alabama Birmingham, Dept Epidemiol, Birmingham, AL USA.
    Naik, Nitish
    All India Inst Med Sci, New Delhi, India.
    Najafi, Farid
    Kermanshah Univ Med Sci, Sch Publ Hlth, Res Ctr Environm Determinants Hlth, Kermanshah, Iran.
    Naldi, Luigi
    Azienda Osped Papa Giovanni XXIII, Bergamo, Italy.
    Nangia, Vinay
    Suraj Eye Inst, Nagpur, Maharashtra, India.
    Nansseu, Jobert Richie Njingang
    Univ Yaounde, Fac Med & Biomed Sci, Dept Publ Hlth, Yaounde, Cameroon;Minist Publ Hlth, Dept Control Dis Epidem & Pandem, Yaounde, Cameroon.
    Narayan, K. M. Venkat
    Emory Univ, Atlanta, GA 30322 USA.
    Nascimento, Bruno Ramos
    Hosp Univ Ciencias Med, Belo Horizonte, MG, Brazil.
    Negoi, Ionut
    Carol Davila Univ Med & Pharm, Bucharest, Romania;Emergency Hosp Bucharest, Bucharest, Romania.
    Negoi, Ruxandra Irina
    Carol Davila Univ Med & Pharm, Bucharest, Romania.
    Newton, Charles R.
    Univ Oxford, Oxford, England;KEMRI Wellcome Trust, Kilifi, Kenya.
    Ngunjiri, Josephine Wanjiku
    Univ Nairobi, Nairobi, Kenya.
    Nguyen, Grant
    Nguyen, Long
    Nguyen, Trang Huyen
    Nichols, Emma
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Ningrum, Dina Nur Anggraini
    Semarang State Univ, Dept Publ Hlth, Semarang City, Indonesia;Taipei Med Univ, Grad Inst Biomed Informat, Taipei, Taiwan.
    Nolte, Ellen
    London Sch Hyg & Trop Med, European Observ Hlth Syst & Policies, London, England.
    Nong, Vuong Minh
    Norheim, Ole F.
    Univ Bergen, Bergen, Norway.
    Norrving, Bo
    Noubiap, Jean Jacques N.
    Univ Cape Town, Fac Hlth Sci, Hatter Inst Cardiovasc Res Africa, Dept Psychiat, Cape Town, South Africa;Med Diagnost Ctr, Yaounde, Cameroon.
    Nyandwi, Alypio
    Rwanda Minist Hlth, Kigali, Rwanda.
    Obermeyer, Carla Makhlouf
    Amer Univ Beirut, Fac Hlth Sci, Ctr Res Populat & Hlth, Dept Psychiat, Beirut, Lebanon.
    Ofori-Asenso, Richard
    Monash Univ, Melbourne, Vic, Australia.
    Ogbo, Felix Akpojene
    Oh, In-Hwan
    Kyung Hee Univ, Sch Med, Dept Prevent Med, Seoul, South Korea.
    Oladimeji, Olanrewaju
    South Africa & Univ KwaZulu Natal, Human Sci Res Council, Durban, South Africa.
    Olagunju, Andrew Toyin
    Univ Adelaide, Sch Med, Discipline Psychiat, Adelaide, SA, Australia;Univ Lagos, Coll Med, Dept Psychiat, Lagos, Nigeria;Lagos Univ, Teaching Hosp, Dept Psychiat, Lagos, Nigeria.
    Olagunju, Tinuke Oluwasefunmi
    McMaster Univ, Hamilton, ON, Canada;Western Univ, London, ON, Canada.
    Olivares, Pedro R.
    Univ Autonoma Chile, Talca, Chile.
    Vasconcelos de Oliveira, Patricia Pereira
    Minist Hlth Brazil, Brasilia, DF, Brazil.
    Olsen, Helen E.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Olusanya, Bolajoko Olubukunola
    Ctr Healthy Start Initiat, Lagos, Nigeria.
    Olusanya, Jacob Olusegun
    Ctr Healthy Start Initiat, Lagos, Nigeria.
    Ong, Kanyin
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Opio, John Nelson
    Lira Municipal Council, Lira Dist Local Govt, Kampala, Uganda.
    Oren, Eyal
    San Diego State Univ, Grad Sch Publ Hlth, Div Epidemiol & Biostat, San Diego, CA 92182 USA.
    Ortega-Altamirano, Doris V.
    Natl Inst Publ Hlth, Cuemavaca, Mexico.
    Ortiz, Alberto
    UAM, IIS Fdn Jimenez Diaz, Madrid, Spain.
    Ozdemir, Raziye
    Karabuk Univ, Karabuk, Turkey. JSS Univ, JSS Med Coll, Mysore, Karnataka, India.
    Mahesh, P. A.
    Pain, Amanda W.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Palone, Marcos Roberto Tovani
    Univ Sao Paulo, Sao Paulo, Brazil.
    Pana, Adrian
    Bucharest Univ Econ Studies, Bucharest, Romania.
    Panda-Jonas, Songhomitra
    Heidelberg Univ, Fac Med Mannheim, Inst Publ Hlth, Dept Ophthalmol, Heidelberg, Germany.
    Pandian, Jeyaraj D.
    Christian Med Coll Ludhiana, Ludhiana, Punjab, India.
    Park, Eun-Kee
    Kosin Univ, Coll Med, Dept Med Humanities & Social Med, Busan, South Korea.
    Parsian, Hadi
    Babol Univ Med Sci, Babol Sar, Iran.
    Patel, Tejas
    White Plains Hosp, White Plains, NY USA.
    Pati, Sanghamitra
    Publ Hlth Fdn India, Gurugram, India.
    Patil, Snehal T.
    Deemed Univ, Krishan Inst Med Sci, Sch Dent Sci, Karad, India.
    Patle, Ajay
    Minist Hlth Family Welf, Natl Hlth Syst Resource Ctr, New Delhi, India.
    Patton, George C.
    Univ Melbourne, Dept Paediat, Melbourne, Vic, Australia;Univ Melbourne, Murdoch Childrens Res Inst, Melbourne, Vic, Australia.
    Paturi, Vishnupriya Rao
    Diabet Res Soc, Clin Res, Hyderabad, India;DiabetOmics, Portland, OR USA.
    Paudel, Deepak
    UK Dept Int Dev, Lalitpur, Nepal.
    Pedroso, Marcel de Moares
    Fundacao Oswaldo Cruz, Inst Comunicacao & Informacao Cientif & Tecnol Sa, Rio De Janeiro, Brazil.
    Pedroza, Sandra P.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Pereira, David M.
    Univ Porto, Fac Farm, Dept Quim, REQUIMTE,LAQV,Lab Farmacognosia, Porto, Portugal.
    Perico, Norberto
    IRCCS, Ist Ric Farmacol Mario Negri, Milan, Italy.
    Peterson, Hannah
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Petzold, Max
    Univ Witwatersrand, Johannesburg, South Africa;Univ Gothenburg, Hlth Metr Unit, Gothenburg, Sweden.
    Peykari, Niloofar
    Minist Hlth & Med Educ, Tehran, Iran.
    Phillips, Michael Robert
    Emory Univ, Atlanta, GA 30322 USA;Shanghai Jiao Tong Univ, Sch Med, Shanghai, Peoples R China.
    Piel, Frederic B.
    Imperial Coll London, Dept Epidemiol & Biostat, London, England. Imperial Coll London, Dept Infect Dis Epidemiol, London, England.
    Pigott, David M.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Pillay, Julian David
    Durban Univ Technol, Durban, South Africa.
    Piradov, Michael A.
    Res Ctr Neurol, Moscow, Russia.
    Polinder, Suzanne
    Univ Med Ctr Rotterdam, Erasmus MC, Dept Publ Hlth, Rotterdam, Netherlands.
    Pond, Constance D.
    Univ Newcastle, Callaghan, NSW, Australia.
    Postma, Maarten J.
    Univ Groningen, Groningen, Netherlands;Univ Med Ctr Groningen, Groningen, Netherlands.
    Pourmalek, Farshad
    Univ British Columbia, Fac Med, Sch Populat & Publ Hlth, Vancouver, BC, Canada.
    Prakash, Swayam
    Sanjay Gandhi Postgrad Inst Med Sci, Lucknow, Uttar Pradesh, India.
    Prakash, V.
    Charotar Univ Sci & Technol, Anand, Gujarat, India.
    Prasad, Narayan
    Sanjay Gandhi Post Grad Inst Med Sci, Lucknow, Uttar Pradesh, India.
    Prasad, Noela Marie
    Univ Melbourne, Melbourne, Vic 3010, Australia;Fred Hollows Fdn, Melbourne, Vic, Australia.
    Purcell, Caroline
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Qorbani, Mostafa
    Alborz Univ Med Sci, Noncommunicable Dis Res Ctr, Karaj, Iran.
    Quintana, Hedley Knewjen
    Commemorat Gorgas Inst Hlth Studies, Panama City, Panama.
    Radfar, Amir
    AT Still Univ, Kirksville, MO USA.
    Rafay, Anwar
    Contech Int Hlth Consultants, Lahore, Pakistan;Contech Sch Publ Hlth, Lahore, Pakistan.
    Rafiei, Alireza
    Mazandaran Univ Med Sci, Sch Med, Mol & Cell Biol Res Ctr, Sari, Iran.
    Rahimi, Kazem
    Univ Oxford, Oxford, England.
    Rahimi-Movaghar, Afarin
    Univ Tehran Med Sci, Iranian Natl Ctr Addict Studies, Tehran, Iran.
    Rahimi-Movaghar, Vafa
    Univ Tehran Med Sci, Sina Trauma & Surg Res Ctr, Tehran, Iran.
    Rahman, Mahfuzar
    La Trobe Univ, Austin Clin Sch Nursing, Melbourne, Vic, Australia;Univ Melbourne, Melbourne, Vic 3010, Australia;BRAC, Res & Evaluat Div, Dhaka, Bangladesh.
    Rahman, Muhammad Aziz
    Rahman, Sajjad Ur
    Sweidi Hosp, Riyadh, Saudi Arabia.
    Rai, Rajesh Kumar
    Soc Hlth & Demog Surveillance, Sufi, India.
    Raju, Bhushan
    Nizams Inst Med Sci, Hyderabad, India.
    Ram, Usha
    Int Inst Populat Sci, Mumbai, Maharashtra, India.
    Rana, Saleem M.
    Contech Int Hlth Consultants, Lahore, Pakistan;Contech Sch Publ Hlth, Lahore, Pakistan.
    Rankin, Zane
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Rasella, Davide
    Fundacao Oswaldo Cruz, Inst Goncalo Muniz, Salvador, BA, Brazil.
    Rawaf, David Laith
    Imperial Coll London, WHO Collaborating Ctr, London, England;North Hampshire Hosp, Basingstoke, Hants, England;Univ Coll London Hosp, London, England.
    Rawaf, Salman
    Imperial Coll London, London, England.
    Ray, Sarah E.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Aspacia Razo-Garcia, Christian
    Natl Inst Publ Hlth, Cuemavaca, Mexico.
    Reddy, Priscilla
    Human Sci Res Council, Cape Town, South Africa.
    Reiner, Robert C.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Reis, Cesar
    Loma Linda Univ Med Ctr, Loma Linda, CA USA.
    Reitsma, Marissa B.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Remuzzi, Giuseppe
    IRCCS, Ist Ric Farmacol Mario Negri, Milan, Italy;Azienda Sociosanitaria Terr, Bergamo, Italy;Univ Milan, Dept Biomed & Clin Sci L Sacco, Milan, Italy.
    Renzaho, Andre M. N.
    Western Sydney Univ, Ctr Hlth Res, Sydney, NSW, Australia.
    Resnikoff, Serge
    Univ New South Wales, Sch Optometry & Vision Sci, Brien Holden Vision Inst, Kensington, NSW, Australia.
    Rezaei, Satar
    Kermanshah Univ Med Sci, Sch Publ Hlth, Res Ctr Environm Determinants Hlth, Kermanshah, Iran.
    Rezai, Mohammad Sadegh
    Mazandaran Univ Med Sci, Sari, Iran.
    Ribeiro, Antonio L.
    Univ Fed Minas Gerais, Hosp Clin, Belo Horizonte, MG, Brazil.
    Rios Blancas, Maria Jesus
    Natl Inst Publ Hlth, Cuemavaca, Mexico.
    Rivera, Juan A.
    Natl Inst Publ Hlth, Cuemavaca, Mexico.
    Roever, Leonardo
    Univ Fed Uberlandia, Uberlandia, MG, Brazil.
    Ronfani, Luca
    IRCCS Burlo Garofolo, Inst Maternal & Child Hlth, Trieste, Italy.
    Roshandel, Gholamreza
    Univ Tehran Med Sci, Digest Dis Res Inst, Tehran, Iran;Golestan Univ Med Sci, Golestan Res Ctr Gastroenterol & Hepatol, Gorgan, Iran.
    Rostami, Ali
    Babol Univ Med Sci, Sch Med, Infect Dis & Trop Med Res Ctr, Babol Sar, Iran.
    Roth, Gregory A.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Rothenbacher, Dietrich
    Ulm Univ, Inst Epidemiol & Med Biometry, Ulm, Germany.
    Roy, Ambuj
    All India Inst Med Sci, New Delhi, India.
    Roy, Nobhojit
    Karolinska Inst, Dept Publ Hlth Sci, Stockholm, Sweden;HBNI Univ, BARC Hosp, Mumbai, Maharashtra, India.
    Ruhago, George Mugambage
    Muhimbili Univ Hlth & Allied Sci, Dar Es Salaam, Tanzania.
    Sabde, Yogesh Damodar
    Natl Inst Res Environm Hlth, Bhopal, India.
    Sachdev, Perminder S.
    Univ New South Wales, Sch Optometry & Vision Sci, Brien Holden Vision Inst, Kensington, NSW, Australia;Prince Wales Hosp, Randwick, NSW, Australia.
    Sadat, Nafis
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Safdarian, Mahdi
    Univ Tehran Med Sci, Sina Trauma & Surg Res Ctr, Tehran, Iran.
    Safiri, Saeid
    Maragheh Univ Med Sci, Managerial Epidemiol Res Ctr, Sch Nursing & Midwifery, Dept Publ Hlth, Maragheh, Iran.
    Sagar, Rajesh
    All India Inst Med Sci, New Delhi, India.
    Sahebkar, Amirhossein
    Univ Western Australia, Nedlands, WA, Australia;Mashhad Univ Med Sci, Mashhad, Iran.
    Sahraian, Mohammad Ali
    Univ Tehran Med Sci, MS Res Ctr, Neurosci Inst, Tehran, Iran.
    Sajadi, Haniye Sadat
    Univ Tehran Med Sci, Natl Inst Hlth Res, Tehran, Iran.
    Salama, Joseph
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Salamati, Payman
    Univ Tehran Med Sci, Sina Trauma & Surg Res Ctr, Tehran, Iran.
    Saldanha, Raphael de Freitas
    Fiocruz MS, Rio De Janeiro, Brazil.
    Salimzadeh, Hamideh
    Salomon, Joshua A.
    Harvard Univ, Harvard T H Chan Sch Publ Hlth, Dept Global Hlth & Populat, Boston, MA 02115 USA.
    Samy, Abdallah M.
    Ain Shams Univ, Fac Sci, Cairo, Egypt.
    Sanabria, Juan Ramon
    Marshall Univ, Edwards Sch Med, Dept Publ Hlth, Huntington, WV USA;Case Western Reserve Univ, Cleveland, OH 44106 USA.
    Sancheti, Parag K.
    Sancheti Inst Orthopaed Rehabil, Pune, Maharashtra, India.
    Sanchez-Nino, Maria Dolores
    IIS Fdn Jimenez Diaz, Madrid, Spain.
    Santomauro, Damian
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia;Queensland Ctr Mental Hlth Res, Brisbane, Qld, Australia.
    Santos, Itamar S.
    Univ Sao Paulo, Internal Med Dept, Sao Paulo, Brazil.
    Milicevic, Milena M. Santric
    Univ Belgrade, Ctr Sch Publ Hlth & Hlth Management, Belgrade, Serbia;Univ Belgrade, Fac Med, Inst Social Med, Belgrade, Serbia.
    Sarker, Abdur Razzaque
    Int Ctr Diarrhoeal Dis Res, Dhaka, Bangladesh.
    Sarrafzadegan, Nizal
    Univ British Columbia, Fac Med, Sch Populat & Publ Hlth, Vancouver, BC, Canada;Isfahan Cardiovasc Res Inst, Esfahan, Iran.
    Sartorius, Benn
    South African Med Res Council, UKZN Gastrointestinal Canc Res Ctr, Cape Town, South Africa;Univ KwaZulu Natal, Sch Nursing & Publ Hlth, Publ Hlth Med, Durban, South Africa.
    Satpathy, Maheswar
    Utkal Univ, Ctr Adv Study Psychol, Bhubaneswar, India.
    Savic, Miloje
    Norwegian Inst Publ Hlth, Ctr Dis Burden, Oslo, Norway.
    Sawhney, Monika
    Marshall Univ, Edwards Sch Med, Dept Publ Hlth, Huntington, WV USA.
    Saxena, Sonia
    Imperial Coll London, London, England.
    Saylan, Mete I.
    Bayer Turkey, Istanbul, Turkey.
    Schaeffner, Elke
    Charite Univ Med Berlin, Berlin, Germany.
    Schmidhuber, Josef
    Food & Agr Org, Global Perspect Studies, Rome, Italy.
    Schmidt, Maria Ines
    Univ Fed Rio Grande do Sul, Porto Alegre, RS, Brazil.
    Schneider, Ione J. C.
    Univ Fed Santa Catarina, Florian6poliss, Brazil.
    Schumacher, Austin E.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Schutte, Aletta E.
    South African Med Res Council, UKZN Gastrointestinal Canc Res Ctr, Cape Town, South Africa;North West Univ, Hypertens Africa Res Team, Potchefstroom, South Africa.
    Schwebel, David C.
    Univ Alabama Birmingham, Dept Epidemiol, Birmingham, AL USA.
    Schwendicke, Falk
    Charite Univ Med Berlin, Berlin, Germany.
    Sekerija, Mario
    Croatian Inst Publ Hlth, Croatian Natl Canc Registry, Zagreb, Croatia;Univ Zagreb, Sch Publ Hlth Dr Andrija A Tampar, Sch Med, Zagreb, Croatia.
    Sepanlou, Sadaf G.
    Univ Tehran Med Sci, Digest Dis Res Inst, Tehran, Iran.
    Servan-Mori, Edson E.
    Natl Inst Publ Hlth, Cuemavaca, Mexico.
    Shafieesabet, Azadeh
    NYU, Langone Med Ctr, Dept Rehabil Med, New York, NY 10003 USA.
    Shaikh, Masood Ali
    Shakh-Nazarova, Marina
    Natl Ctr Dis Control & Publ Hlth, Tbilisi, Rep of Georgia.
    Shams-Beyranvand, Mehran
    Univ Tehran Med Sci, Endocrinol & Metab Res Ctr, Tehran, Iran.
    Sharafi, Heidar
    Deakin Univ, Middle East Liver Dis Ctr, Inst Phys Activ & Nutr, Burwood, Vic, Australia.
    Sharif-Alhoseini, Mahdi
    Univ Tehran Med Sci, Sina Trauma & Surg Res Ctr, Tehran, Iran.
    Islam, Sheikh Mohammed Shariful
    George Inst Global Hlth, New Delhi, India;Deakin Univ, Middle East Liver Dis Ctr, Inst Phys Activ & Nutr, Burwood, Vic, Australia.
    Sharma, Meenakshi
    Indian Council Med Res, Natl Inst Epidemiol, Chennai, Tamil Nadu, India.
    Sharma, Rajesh
    Delhi Technol Univ, Univ Sch Management & Entrepreneurship, Delhi, India.
    She, Jun
    Fudan Univ, Zhongshan Hosp, Dept Pulm Med, Shanghai, Peoples R China.
    Sheikh, Aziz
    Harvard Med Sch, Kigali, Rwanda.
    Shfare, Mebrahtu Teweldemedhin
    Aksum Univ, Coll Hlth Sci & Referral Hosp, Aksum, Ethiopia.
    Shi, Peilin
    Tufts Univ, Friedman Sch Nutr Sci & Policy, Boston, MA 02111 USA.
    Shields, Chloe
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Shigematsu, Mika
    Natl Inst Infect Dis, Tokyo, Japan.
    Shinohara, Yukito
    Tachikawa Hosp, Tokyo, Japan.
    Shiri, Rahman
    Univ Helsinki, Fac Med, Finnish Inst Occupat Hlth, Dept Publ Hlth,Work Org,Work Disability Program, Helsinki, Finland.
    Shirkoohi, Reza
    Univ Tehran Med Sci, Canc Res Ctr, Tehran, Iran.
    Shiue, Ivy
    Martin Luther Univ Halle Wittenberg, Inst Medizin Epidemiol Biometrie & Informat, Competence Cluster Nutr & Cardiovasc Hlth NutriCA, Saale, Germany;Univ Edinburgh, Alzheimer Scotland Dementia Res Ctr, Edinburgh, Midlothian, Scotland.
    Shrime, Mark G.
    Harvard Med Sch, Kigali, Rwanda.
    Shukla, Sharvari Rahul
    Symbiosis Int Univ, Symbiosis Inst Hlth Sci, Pune, Maharashtra, India;KEM Hosp Res Ctr, Diabet Unit, Pune, Maharashtra, India.
    Siabani, Soraya
    Kermanshah Univ Med Sci, Sch Publ Hlth, Res Ctr Environm Determinants Hlth, Kermanshah, Iran;Univ Technol Sydney, Sydney, NSW, Australia.
    Sigfusdottir, Inga Dora
    Reykjavik Univ, Reykjavik, Iceland.
    Silberberg, Donald H.
    Univ Penn, Philadelphia, PA 19104 USA.
    Santos Silva, Diego Augusto
    Silva, Joao Pedro
    Univ Porto, Fac Pharm, Toxicol Grp, UCIBIO REQUIMTE, Porto, Portugal.
    Alves Silveira, Dayane Gabriele
    Brasilia Univ, Brasilia, DF, Brazil.
    Singh, Jasvinder A.
    Univ Alabama Birmingham, Dept Epidemiol, Birmingham, AL USA.
    Singh, Lavanya
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Singh, Narinder Pal
    Max Hosp, Ghaziabad, India.
    Singh, Virendra
    Asthma Bhawan, Jaipur, Rajasthan, India.
    Sinha, Dhirendra Narain
    Sch Prevent Oncol, Patna, Bihar, India;Natl Inst Canc Prevent, CTC Global Knowledge Hub Smokeless Tobacco, Noida, India.
    Sinke, Abiy Hiruye
    Ethiopian Med Assoc, Addis Ababa, Ethiopia.
    Sisay, Mekonnen
    Haramaya Univ, Harar, Ethiopia.
    Skirbekk, Vegard
    Columbia Univ, New York, NY 10027 USA;Norwegian Inst Publ Hlth, Ctr Dis Burden, Oslo, Norway.
    Sliwa, Karen
    Univ Cape Town, Fac Hlth Sci, Hatter Inst Cardiovasc Res Africa, Dept Psychiat, Cape Town, South Africa.
    Smith, Alison
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Soares Filho, Adauto Martins
    Sobaih, Badr H. A.
    King Khalid Univ Hosp, Riyadh, Saudi Arabia.
    Somai, Melek
    Tunisian Ctr Publ Hlth, Les Berges Du Lac, Tunisia.
    Soneji, Samir
    Dartmouth Coll, Hanover, NH 03755 USA.
    Soofi, Moslem
    Kermanshah Univ Med Sci, Sch Publ Hlth, Res Ctr Environm Determinants Hlth, Kermanshah, Iran.
    Sorensen, Reed J. D.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Soriano, Joan B.
    Inst Invest Hosp Univ Princesa IISP, Madrid, Spain;Univ Autonoma Madrid, Madrid, Spain.
    Soyiri, Ireneous N.
    Univ Edinburgh, Alzheimer Scotland Dementia Res Ctr, Edinburgh, Midlothian, Scotland.
    Sposato, Luciano A.
    Western Univ, Dept Clin Neurol Sci, London, ON, Canada.
    Sreeramareddy, Chandrashekhar T.
    Int Med Univ, Dept Community Med, Kuala Lumpur, Malaysia.
    Srinivasan, Vinay
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Stanaway, Jeffrey D.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Stathopoulou, Vasiliki
    Attikon Univ Hosp, Athens, Greece.
    Steel, Nicholas
    Univ East Anglia, Norwich, Norfolk, England;Publ Hlth England, London, England.
    Stein, Dan J.
    Univ Cape Town, Fac Hlth Sci, Hatter Inst Cardiovasc Res Africa, Dept Psychiat, Cape Town, South Africa;South African Med Res Council, Unit Anxiety & Stress Disorders, Cape Town, South Africa.
    Stokes, Mark Andrew
    Deakin Univ, Middle East Liver Dis Ctr, Inst Phys Activ & Nutr, Burwood, Vic, Australia.
    Sturua, Lela
    Natl Ctr Dis Control & Publ Hlth, Tbilisi, Rep of Georgia.
    Sufiyan, Muawiyyah Babale
    Ahmadu Bello Univ, Hlth Syst & Policy Res Unit, Zaria, Nigeria.
    Suliankatchi, Rizwan Abdulkader
    Minist Hlth, Riyadh, Saudi Arabia.
    Sunguya, Bruno F.
    Sur, Patrick J.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Sykes, Bryan L.
    Univ Calif Irvine, Dept Criminol Law & Soc Sociol & Publ Hlth, Irvine, CA USA.
    Sylaja, P. N.
    Sree Chitra Tirunal Inst Med Sci & Technol, Thiruvananthapuram, Kerala, India.
    Szoeke, Cassandra E. I.
    Univ Melbourne, Inst Hlth & Ageing, Melbourne, Vic 3010, Australia.
    Tabares-Seisdedos, Rafael
    Univ Valencia, INCLIVA Hlth Res Inst, Dept Med, Valencia, Spain;Univ Valencia, CIBERSAM, Dept Med, Valencia, Spain.
    Tadakamadla, Santosh Kumar
    Griffith Univ, Brisbane, Qld, Australia.
    Tadesse, Andualem Henok
    Mizan Tepi Univ, Mizan Teferi, Ethiopia.
    Taffere, Getachew Redae
    Mekelle Univ, Sch Publ Hlth, Mekelle, Ethiopia.
    Tandon, Nikhil
    All India Inst Med Sci, New Delhi, India.
    Tariku, Amare Tariku
    Univ Gondar, Gondar, Ethiopia;Univ Adelaide, Sch Med, Discipline Psychiat, Adelaide, SA, Australia.
    Taveira, Nuno
    Inst Super Ciencias Sande Egas Moniz, Almada, Portugal;Univ Lisbon, Fac Pharm, Lisbon, Portugal.
    Tehrani-Banihashemi, Arash
    Iran Univ Med Sci, Dept Community Med, Tehran, Iran;Iran Univ Med Sci, Prevent Med & Publ Hlth Res Ctr, Tehran, Iran.
    Shifa, Girma Temam
    Addis Ababa Univ, Addis Ababa, Ethiopia;Arba Minch Univ, Arba Minch, Ethiopia.
    Temsah, Mohamad-Hani
    Terkawi, Abdullah Sulieman
    Univ Virginia, Dept Anesthesiol, Charlottesville, VA USA;King Fahad Med City, Dept Anesthesiol, Riyadh, Saudi Arabia;Cleveland Clin, Consortium Cleveland Clin, Cleveland, OH 44106 USA.
    Tesema, Azeb Gebresilassie
    Mekelle Univ, Mekelle, Ethiopia.
    Tesfaye, Dawit Jember
    Hawassa Univ, Coll Med & Hlth Sci, Hawassa, Ethiopia.
    Tessema, Belay
    Univ Gondar, Gondar, Ethiopia.
    Thakur, J. S.
    Post Grad Inst Med Educ & Res, Sch Publ Hlth, Chandigarh, India.
    Thomas, Nihal
    Christian Med Coll & Hosp, Vellore, Tamil Nadu, India.
    Thompson, Matthew J.
    Univ Washington, Seattle, WA 98195 USA.
    Tillmann, Taavi
    UCL, Inst Epidemiol & Hlth, London, England.
    To, Quyen G.
    Queensland Univ Technol, Int Lab Air Qual & Hlth, Brisbane, Qld, Australia.
    Tobe-Gai, Ruoyan
    Natl Ctr Child Hlth & Dev, Tokyo, Japan.
    Tonelli, Marcello
    Univ Calgary, Calgary, AB, Canada.
    Topor-Madry, Roman
    Jagiellonian Univ, Med Coll, Fac Hlth Sci, Inst Publ Hlth, Krakow, Poland;Wroclaw Med Univ, Fac Hlth Sci, Wroclaw, Poland.
    Topouzis, Fotis
    Aristotle Univ Thessaloniki, Thessaloniki, Greece.
    Torre, Anna
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Tortajada, Miguel
    Hosp Univ Doctor Peset, Valencia, Spain;Univ Valencia, Sch Med, Valencia, Spain.
    Tran, Bach Xuan
    Johns Hopkins Univ, Johns Hopkins Bloomberg Sch Publ Hlth, Ctr Clin Global Hlth Educ, Baltimore, MD USA;Med Univ Hanoi, Hanoi, Vietnam.
    Tran, Khanh Bao
    Tripathi, Avnish
    Univ Louisville, Sch Med, Louisville, KY 40292 USA.
    Tripathy, Srikanth Prasad
    Natl Inst Res TB, Chennai, Tamil Nadu, India.
    Troeger, Christopher
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Truelsen, Thomas
    Univ Copenhagen, Rigshosp, Dept Neurol, Copenhagen, Denmark.
    Tsoi, Derrick
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Car, Lorainne Tudor
    Nanyang Technol Univ, LKCMed, Singapore, Singapore;Imperial Coll London, London, England.
    Tuem, Kald Beshir
    Mekelle Univ, Mekelle, Ethiopia.
    Tyrovolas, Stefanos
    Univ Barcelona, CIBERSAM, Fundaci6 Sant de Joan Deu, Parc Sanitari Sant Joan de Deu, Barcelona, Spain.
    Uchendu, Uche S.
    US Dept Vet Affairs, Washington, DC USA.
    Ukwaja, Kingsley Nnanna
    Fed Teaching Hosp, Dept Internal Med, Abakaliki, Nigeria.
    Ullah, Irfan
    Gomal Univ, Gomal Ctr Biochem & Biotechnol, Dera Ismail Khan, Pakistan;Mufti Mehmood Mem Teaching Hosp, Programmat Management Drug Resistant TB Unit, TB Culture Lab, Dera Ismail Khan, Pakistan.
    Updike, Rachel
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Uthman, Olalekan A.
    Univ Warwick, Warwick Med Sch, Coventry, W Midlands, England.
    Uzochukwu, Benjamin S. Chudi
    Univ Nigeria, Enugu Campus, Enugu, Nigeria.
    Ruben Valdez, Pascual
    Sociedad Argentina Med, Buenos Aires, DF, Argentina;Hosp Velez Sarsfield, Buenos Aires, DF, Argentina.
    van Boven, Job F. M.
    Univ Groningen, Groningen, Netherlands.
    Varughese, Santosh
    Christian Med Coll & Hosp, Vellore, Tamil Nadu, India.
    Vasankari, Tommi
    UKK Inst Hlth Promot Res, Tampere, Finland.
    Venketasubramanian, Narayanaswamy
    Raffles Hosp, Raffles Neurosci Ctr, Singapore, Singapore.
    Violante, Francesco S.
    Univ Bologna, Bologna, Italy.
    Vladimirov, Sergey K.
    Fed Res Inst Hlth Org & Informat, Moscow, Russia.
    Vlassov, Vasiliy Victorovich
    Natl Res Univ Higher Sch Econ, Moscow, Russia.
    Vollset, Stein Emil
    Norwegian Inst Publ Hlth, Ctr Dis Burden, Oslo, Norway.
    Vos, Theo
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Wagnew, Fasil
    Debre Markos Univ, Debre Markos, Ethiopia.
    Waheed, Yasir
    Fdn Univ, Islamabad, Pakistan.
    Wallin, Mitchell T.
    VA Med Ctr, Washington, DC USA;Georgetown Univ, Neurol Dept, Washington, DC USA.
    Walson, Judd L.
    Univ Washington, Seattle, WA 98195 USA;Nat Hist Museum, London, England.
    Wang, Yafeng
    Fudan Univ, Zhongshan Hosp, Shanghai, Peoples R China;Xi An Jiao Tong Univ, Affiliated Hosp 1, Xian, Shaanxi, Peoples R China;Univ Sao Paulo, Med Sch, Sao Paulo, SP, Brazil.
    Wang, Yuan-Pang
    Wassie, Molla Mesele
    Univ Gondar, Gondar, Ethiopia;Univ Adelaide, Adelaide, SA, Australia.
    Weaver, Marcia R.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Weiderpass, Elisabete
    Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden;Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Family Med & Primary Care, Stockholm, Sweden;Canc Registry Norway, Inst Populat Based Canc Res, Dept Res, Oslo, Norway;Arctic Univ Norway, Univ Tromso, Fac Hlth Sci, Dept Community Med, Tromso, Norway;Folkhalsan Res Ctr, Genet Epidemiol Grp, Helsinki, Finland.
    Weintraub, Robert G.
    Univ Melbourne, Melbourne, Vic 3010, Australia;Royal Childrens Hosp, Melbourne, Vic, Australia;Murdoch Childrens Res Inst, Melbourne, Vic, Australia.
    Weiss, Jordan
    Univ Penn, Philadelphia, PA 19104 USA.
    Weldegwergs, Kidu Gidey
    Mekelle Univ, Mekelle, Ethiopia.
    Werdecker, Andrea
    Fed Inst Populat Res, Competence Ctr Mortal Follow Up German Natl Cohor, Wiesbaden, Germany.
    West, T. Eoin
    Univ Washington, Seattle, WA 98195 USA.
    Westerman, Ronny
    Fed Inst Populat Res, Competence Ctr Mortal Follow Up German Natl Cohor, Wiesbaden, Germany;German Natl Cohort Consortium, Heidelberg, Germany.
    White, Richard G.
    London Sch Hyg & Trop Med, London, England.
    Whiteford, Harvey A.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA;Univ Queensland, Sch Publ Hlth, Brisbane, Qld, Australia;Queensland Ctr Mental Hlth Res, Brisbane, Qld, Australia.
    Widecka, Justyna
    VitroLive Sp Zoo, Szczecin, Poland.
    Winkler, Andrea Sylvia
    Tech Univ Munich, Klinikum Rechts Isar, Ctr Global Hlth, Dept Neurol, Munich, Germany;Univ Oslo, Ctr Global Hlth, Inst Hlth & Soc, Oslo, Norway.
    Wiysonge, Charles Shey
    Stellenbosch Univ, Cape Town, South Africa;South African Med Res Council, Cape Town, South Africa.
    Wolfe, Charles D. A.
    Kings Coll London, Div Hlth & Social Care Res, London, England;Kings Coll London, London, England;Guys & St Thomas NHS Fdn Trust, Natl Inst Hlth, Res Comprehens Biomed Res Ctr, London, England.
    Wondimkun, Yohanes Ayele
    Haramaya Univ, Harar, Ethiopia.
    Workicho, Abdulhalik
    Jimma Univ, Jimma, Ethiopia;Univ Ghent, Ghent, Belgium.
    Wyper, Grant M. A.
    NHS Natl Serv Scotland, Glasgow, Lanark, Scotland;Univ Strathclyde, Glasgow, Lanark, Scotland.
    Xavier, Denis
    St Johns Med Coll & Res Inst, Bangalore, Karnataka, India.
    Xu, Gelin
    Nanjing Univ, Jinling Hosp, Sch Med, Dept Neurol, Nanjing, Jiangsu, Peoples R China.
    Yan, Lijing L.
    Duke Kunshan Univ, Global Hlth Res Ctr, Kunshan, Peoples R China.
    Yano, Yuichiro
    Northwestern Univ, Dept Prevent Med, Chicago, IL 60611 USA.
    Yaseri, Mehdi
    Shahid Beheshti Univ Med Sci, Ophthalm Res Ctr, Tehran, Iran.
    Yimer, Nigus Bililign
    Woldia Univ, Woldia, Ethiopia.
    Yin, Peng
    Chinese Ctr Dis Control & Prevent, Natl Ctr Chron & Noncommunicable Dis Control & Pr, Beijing, Peoples R China.
    Yip, Paul
    Univ Hong Kong, Hong Kong Jockey Club Ctr Suicide Res & Prevent, Social Work & Social Adm Dept, Hong Kong, Hong Kong, Peoples R China.
    Yirsaw, Biruck Desalegn
    Addis Ababa Univ, Addis Ababa, Ethiopia;Univ South Australia, Mawson Lakes, SA, Australia.
    Yonemoto, Naohiro
    Kyoto Univ, Sch Publ Hlth, Dept Biostat, Kyoto, Japan.
    Yonga, Gerald
    Aga Khan Univ, NCD Res Policy Unit, Nairobi, Kenya.
    Yoon, Seok-Jun
    Korea Univ, Coll Med, Dept Prevent Med, S, Seoul, South Korea.
    Yotebieng, Marcel
    Ohio State Univ, Columbus, OH 43210 USA;Univ Kinshasa, Sch Publ Hlth, Kinshasa, DEM REP CONGO.
    Younis, Mustafa Z.
    Jackson State Univ, Jackson, MS 39217 USA.
    Yu, Chuanhua
    Wuhan Univ, Sch Publ Hlth, Global Hlth Inst, Dept Epidemiol & Biostat, Wuhan, Hubei, Peoples R China.
    Zadnik, Vesna
    Inst Oncol Ljubljana, Epidemiol & Canc Registry, Ljubljana, Slovenia.
    Zaidi, Zoubida
    Univ Hosp Setif, Setif, Algeria.
    Zaki, Maysaa El Sayed
    Mansoura Univ, Fac Med, Mansoura, Egypt.
    Bin Zaman, Sojib
    Int Ctr Diarrhoeal Dis Res, Dhaka, Bangladesh.
    Zamani, Mohammad
    Babol Univ Med Sci, Babol Sar, Iran.
    Zenebe, Zerihun Menlkalew
    Mekelle Univ, Mekelle, Ethiopia.
    Zhou, Maigeng
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA;Chinese Ctr Dis Control & Prevent, Natl Ctr Chron & Noncommunicable Dis Control & Pr, Beijing, Peoples R China.
    Zhu, Jun
    Natl Off MCH Surveillance China, Chengdu, Peoples R China.
    Zimsen, Stephanie R. M.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Zipkin, Ben
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Zodpey, Sanjay
    Publ Hlth Fdn India, Gurugram, India.
    Zuhlke, Liesl Joanna
    Red Cross War Mem Childrens Hosp, Cape Town, South Africa.
    Murray, Christopher J. L.
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Lozano, Rafael
    Univ Washington, Inst Hlth Metr & Evaluat, Seattle, WA 98195 USA.
    Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 20162018In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 391, no 10136, p. 2236-2271Article in journal (Refereed)
    Abstract [en]

    Background: A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016.

    Methods: Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita.

    Findings: In 2016, HAQ Index performance spanned from a high of 97.1 (95% UI 95.8-98.1) in Iceland, followed by 96.6 (94.9-97.9) in Norway and 96.1 (94.5-97.3) in the Netherlands, to values as low as 18.6 (13.1-24.4) in the Central African Republic, 19.0 (14.3-23.7) in Somalia, and 23.4 (20.2-26.8) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91.5 (89.1-936) in Beijing to 48.0 (43.4-53.2) in Tibet (a 43.5-point difference), while India saw a 30.8-point disparity, from 64.8 (59.6-68.8) in Goa to 34.0 (30.3-38.1) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4.8-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20.9-point to 17.0-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17.2-point to 20.4-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries.

    Interpretation: GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle-SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view and subsequent provision of quality health care for all populations.

  • 109. Gakidou, E
    et al.
    Afshin, A
    Abajobir, AA
    Abate, KH
    Abbafati, C
    Abbas, KM
    Abd-Allah, A
    Abdulle, AM
    Abera, F
    Aboyans, v
    Abu-Raddad, LJ
    Abu-Rmeileh, NME
    Abyu, GY
    Ärnlöv, Johan
    Karolinska university; Dalarna University.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Artaman, A
    Aryal, KK
    Asayesh, H
    Zhang, X
    Zimsen, SRM
    Zipkin, B,
    Zodpey, S
    Lim, SS
    Murray, CJL
    Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2016: a systematic analysis for the Global Burden of Disease Study 20162017In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 390, no 10100, p. 1345-1422Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of risk factor exposure and attributable burden of disease. By providing estimates over a long time series, this study can monitor risk exposure trends critical to health surveillance and inform policy debates on the importance of addressing risks in context.

    METHODS: We used the comparative risk assessment framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2016. This study included 481 risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk (RR) and exposure estimates from 22 717 randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources, according to the GBD 2016 source counting methods. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. Finally, we explored four drivers of trends in attributable burden: population growth, population ageing, trends in risk exposure, and all other factors combined.

    FINDINGS: Since 1990, exposure increased significantly for 30 risks, did not change significantly for four risks, and decreased significantly for 31 risks. Among risks that are leading causes of burden of disease, child growth failure and household air pollution showed the most significant declines, while metabolic risks, such as body-mass index and high fasting plasma glucose, showed significant increases. In 2016, at Level 3 of the hierarchy, the three leading risk factors in terms of attributable DALYs at the global level for men were smoking (124·1 million DALYs [95% UI 111·2 million to 137·0 million]), high systolic blood pressure (122·2 million DALYs [110·3 million to 133·3 million], and low birthweight and short gestation (83·0 million DALYs [78·3 million to 87·7 million]), and for women, were high systolic blood pressure (89·9 million DALYs [80·9 million to 98·2 million]), high body-mass index (64·8 million DALYs [44·4 million to 87·6 million]), and high fasting plasma glucose (63·8 million DALYs [53·2 million to 76·3 million]). In 2016 in 113 countries, the leading risk factor in terms of attributable DALYs was a metabolic risk factor. Smoking remained among the leading five risk factors for DALYs for 109 countries, while low birthweight and short gestation was the leading risk factor for DALYs in 38 countries, particularly in sub-Saharan Africa and South Asia. In terms of important drivers of change in trends of burden attributable to risk factors, between 2006 and 2016 exposure to risks explains an 9·3% (6·9-11·6) decline in deaths and a 10·8% (8·3-13·1) decrease in DALYs at the global level, while population ageing accounts for 14·9% (12·7-17·5) of deaths and 6·2% (3·9-8·7) of DALYs, and population growth for 12·4% (10·1-14·9) of deaths and 12·4% (10·1-14·9) of DALYs. The largest contribution of trends in risk exposure to disease burden is seen between ages 1 year and 4 years, where a decline of 27·3% (24·9-29·7) of the change in DALYs between 2006 and 2016 can be attributed to declines in exposure to risks.

    INTERPRETATION: Increasingly detailed understanding of the trends in risk exposure and the RRs for each risk-outcome pair provide insights into both the magnitude of health loss attributable to risks and how modification of risk exposure has contributed to health trends. Metabolic risks warrant particular policy attention, due to their large contribution to global disease burden, increasing trends, and variable patterns across countries at the same level of development. GBD 2016 findings show that, while it has huge potential to improve health, risk modification has played a relatively small part in the past decade.

  • 110.
    Ganna, Andrea
    et al.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Salihovic, Samira
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Sundström, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Broeckling, Corey D
    Proteomics and Metabolomics Facility, Colorado State University, Fort Collins, Colorado, United States of America.
    Hedman, Åsa K
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Magnusson, Patrik K E
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Pedersen, Nancy L
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Siegbahn, Agneta
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Coagulation and inflammation science.
    Zilmer, Mihkel
    Department of Biochemistry, Centre of Excellence for Translational Medicine, University of Tartu, Tartu, Estonia.
    Prenni, Jessica
    Proteomics and Metabolomics Facility, Colorado State University, Fort Collins, Colorado, United States of America.
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Fall, Tove
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.
    Ingelsson, Erik
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology.
    Large-scale Metabolomic Profiling Identifies Novel Biomarkers for Incident Coronary Heart Disease2014In: PLOS Genetics, ISSN 1553-7390, E-ISSN 1553-7404, Vol. 10, no 12, p. e1004801-Article in journal (Refereed)
    Abstract [en]

    Analyses of circulating metabolites in large prospective epidemiological studies could lead to improved prediction and better biological understanding of coronary heart disease (CHD). We performed a mass spectrometry-based non-targeted metabolomics study for association with incident CHD events in 1,028 individuals (131 events; 10 y. median follow-up) with validation in 1,670 individuals (282 events; 3.9 y. median follow-up). Four metabolites were replicated and independent of main cardiovascular risk factors [lysophosphatidylcholine 18∶1 (hazard ratio [HR] per standard deviation [SD] increment = 0.77, P-value<0.001), lysophosphatidylcholine 18∶2 (HR = 0.81, P-value<0.001), monoglyceride 18∶2 (MG 18∶2; HR = 1.18, P-value = 0.011) and sphingomyelin 28∶1 (HR = 0.85, P-value = 0.015)]. Together they contributed to moderate improvements in discrimination and re-classification in addition to traditional risk factors (C-statistic: 0.76 vs. 0.75; NRI: 9.2%). MG 18∶2 was associated with CHD independently of triglycerides. Lysophosphatidylcholines were negatively associated with body mass index, C-reactive protein and with less evidence of subclinical cardiovascular disease in additional 970 participants; a reverse pattern was observed for MG 18∶2. MG 18∶2 showed an enrichment (P-value = 0.002) of significant associations with CHD-associated SNPs (P-value = 1.2×10-7 for association with rs964184 in the ZNF259/APOA5 region) and a weak, but positive causal effect (odds ratio = 1.05 per SD increment in MG 18∶2, P-value = 0.05) on CHD, as suggested by Mendelian randomization analysis. In conclusion, we identified four lipid-related metabolites with evidence for clinical utility, as well as a causal role in CHD development.

  • 111. Garpenstrand, Håkkan
    et al.
    Bergqvist, Michael
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology. Enheten för onkologi.
    Brattström, Daniel
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology. Enheten för onkologi.
    Larsson, Anders
    Department of Medical Sciences. klinisk kemi.
    Oreland, Lars
    Hesselius, Patrik
    Wagenius, Gunnar
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology. Enheten för onkologi.
    Serum semicarbazide-sensitive amine oxidase (SSAO) activity correlates with VEGF in non-small-cell lung cancer patients.2004In: Med Oncol, ISSN 1357-0560, Vol. 21, no 3, p. 241-50Article in journal (Refereed)
  • 112.
    Gordh, Torsten
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Lind, Anne-Li
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Bodolea, Constatin
    Hewitt, Ellen
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Cathepsin S is increased in cerebrospinal fluid from patients with neuropathic pain: A support of the microglia hypothesis in humans2014In: Scandinavian Journal of Pain, ISSN 1877-8860, E-ISSN 1877-8879, Vol. 5, no 3, p. 208-209Article in journal (Refereed)
    Abstract [en]

    Aims: Cathepsin S has been reported to be a biomarker of spinal microglial activation, a process suggested to be involved in the pathophysiology of chronic neuropathic pain. So far this has been shown only in animal experiments. The aim of this study was to investigate the concentrations of cathepsin S in human cerebrospinal fluid (CSF) samples from a well-defined patient cohort suffering from neuropathic pain as compared to controls.

    Methods: CSF samples from patients suffering from chronic neuropathic pain (n = 14) were analyzed for cathepsin S levels using commercial sandwich ELISAs (DY1183, R&D Systems, Minneapolis, MN, USA). Control CSF was sampled from patients undergoing minor urological surgical procedures under spinal anaesthesia (n = 70), having no obvious pain suffering.

    Results: The neuropathic pain group had significantly higher levels of CSF cathepsin S (median 15189 pg/mL, range 3213–40,040), than the control group (median 5911 pg/mL, range 1909–17,188) (p < 0.005, Mann–Whitney U-test).

    Conclusion: The results support the existence of microglial activation in chronic neuropathic pain patients. CSF Cathepsin S may serve as a potential biomarker for this specific mechanism linked to neuropathic pain. In the future, Cathepsin S inhibiting drugs might become a new treatment alternative for neurophatic pain.

  • 113.
    Goscinski, Gunilla
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Lipcsey, Miklós
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Eriksson, Mats B
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Tano, Eva
    Sjölin, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Anti-inflammatory effects of the antibiotics ceftazidime and tobramycin in porcine endotoxin shock: are they really anti-inflammatory? Authors' response.2004In: Crit Care, ISSN 1466-609X, Vol. 8, no 2, p. 141-Article in journal (Other academic)
  • 114.
    Govorov, Igor
    et al.
    Karolinska Institutet, Department of Women's and Children's Health, Stockholm, Sweden.
    Bremme, Katarina
    Karolinska Institutet, Department of Women's and Children's Health, Stockholm, Sweden.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Holmström, Margareta
    Karolinska University Hospital Solna, Department of Medicine, Stockholm, Sweden.
    Komlichenko, Eduard
    Almazov National Medical Research Centre, Institution of Pediatrics and Perinatology, Saint-Petersburg, Russia.
    Chaireti, Roza
    Karolinska Institutet, Department of Molecular Medicine and Surgery, Stockholm, Sweden.
    Mints, Miriam
    Karolinska Institutet, Department of Women's and Children's Health, Stockholm, Sweden.
    Blood inflammatory and endothelial markers in women with von Willebrand disease2019In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 14, no 1, article id e0210544Article in journal (Refereed)
    Abstract [en]

    Introduction: VWD-affected females often experience menorrhagia. Periodical fluctuations of the sex steroids during the menstrual cycle cause changes both in the coagulation and immune system. The aim of the current study was to assess the changes in selected inflammatory and endothelial markers in women with VWD during two phases of the menstrual cycle (follicular and luteal) and to compare it with corresponding data from healthy controls.

    Materials and methods: The study group included 12 VWD-affected females with regular menstrual cycle, with none of them being prescribed hormone treatment. They were not pregnant or breastfeeding. The control group consisted of 102 healthy females, matched for age and BMI.

    Results: Within the VWD group, endostatin was higher during the follicular phase, compared to the luteal phase, although the difference was not significant (p = 0.062). sICAM-1 and IL-6 were higher in VWD-affected females, compared to the controls, sVCAM-1, cathepsin S and sP-selectin were lower (p<0.003 for all cases). The pattern was constant throughout the menstrual cycle.

    Conclusions: Higher levels of endostatin during early follicular phase could potentially predispose women with VWD to the development of heavy menstrual bleeding, due to antiangiogenic properties and ability to suppress several coagulation factors. Lower p-selectin levels in VWD group, compared to controls, may also contribute to the bleeding tendency. Changes in other proteins, involved in angiogenesis are hypothetically related to the formation of angiodysplasia—common complication of VWF deficiency. The latter statement requires confirmation in larger studies.

  • 115. Grams, Morgan E
    et al.
    Sang, Yingying
    Ballew, Shoshana H
    Gansevoort, Ron T
    Kimm, Heejin
    Kovesdy, Csaba P
    Naimark, David
    Oien, Cecilia
    Smith, David H
    Coresh, Josef
    Sarnak, Mark J
    Stengel, Benedicte
    Tonelli, Marcello
    A Meta-analysis of the Association of Estimated GFR, Albuminuria, Age, Race, and Sex With Acute Kidney Injury2015In: American Journal of Kidney Diseases, ISSN 0272-6386, E-ISSN 1523-6838, Vol. 66, no 4, p. 591-601Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Acute kidney injury (AKI) is a serious global public health problem. We aimed to quantify the risk of AKI associated with estimated glomerular filtration rate (eGFR), albuminuria (albumin-creatinine ratio [ACR]), age, sex, and race (African American and white).

    STUDY DESIGN: Collaborative meta-analysis.

    SETTING & POPULATION: 8 general-population cohorts (1,285,049 participants) and 5 chronic kidney disease (CKD) cohorts (79,519 participants).

    SELECTION CRITERIA FOR STUDIES: Available eGFR, ACR, and 50 or more AKI events.

    PREDICTORS: Age, sex, race, eGFR, urine ACR, and interactions.

    OUTCOME: Hospitalized with or for AKI, using Cox proportional hazards models to estimate HRs of AKI and random-effects meta-analysis to pool results.

    RESULTS: 16,480 (1.3%) general-population cohort participants had AKI over a mean follow-up of 4 years; 2,087 (2.6%) CKD participants had AKI over a mean follow-up of 1 year. Lower eGFR and higher ACR were strongly associated with AKI. Compared with eGFR of 80mL/min/1.73m(2), the adjusted HR of AKI at eGFR of 45mL/min/1.73m(2) was 3.35 (95% CI, 2.75-4.07). Compared with ACR of 5mg/g, the risk of AKI at ACR of 300mg/g was 2.73 (95% CI, 2.18-3.43). Older age was associated with higher risk of AKI, but this effect was attenuated with lower eGFR or higher ACR. Male sex was associated with higher risk of AKI, with a slight attenuation in lower eGFR but not in higher ACR. African Americans had higher AKI risk at higher levels of eGFR and most levels of ACR.

    LIMITATIONS: Only 2 general-population cohorts could contribute to analyses by race; AKI identified by diagnostic code.

    CONCLUSIONS: Reduced eGFR and increased ACR are consistent strong risk factors for AKI, whereas associations of AKI with age, sex, and race may be weaker in more advanced stages of CKD.

  • 116. Grenegård, Magnus
    et al.
    Vretenbrant Öberg, Karin
    Nylander, Martina
    Desiléts, Stéphanie
    Lindström, Eva G
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Ramström, Ida
    Ramström, Sofia
    Lindahl, Tomas L
    The ATP-gated P2X1 receptor plays a pivotal role in activation of aspirin-treated platelets by thrombin and epinephrine2008In: Journal of Biological Chemistry, ISSN 0021-9258, E-ISSN 1083-351X, Vol. 283, no 27, p. 18493-18504Article in journal (Refereed)
    Abstract [en]

    Human platelets express protease-activated receptor 1 (PAR1) and PAR4 but limited data indicate for differences in signal transduction. We studied the involvement of PAR1 and PAR4 in the cross-talk between thrombin and epinephrine. The results show that epinephrine acted via alpha(2A)-adrenergic receptors to provoke aggregation, secretion, and Ca(2+) mobilization in aspirin-treated platelets pre-stimulated with subthreshold concentrations of thrombin. Incubating platelets with antibodies against PAR4 or the PAR4-specific inhibitor pepducin P4pal-i1 abolished the aggregation. Furthermore, platelets pre-exposed to the PAR4-activating peptide AYPGKF, but not to the PAR1-activating peptide SFLLRN, were aggregated by epinephrine, whereas both AYPGKF and SFLLRN synergized with epinephrine in the absence of aspirin. The roles of released ATP and ADP were elucidated by using antagonists of the purinergic receptors P2X(1), P2Y(1), and P2Y(12) (i.e. NF449, MRS2159, MRS2179, and cangrelor). Intriguingly, ATP, but not ADP, was required for the epinephrine/thrombin-induced aggregation. In Western blot analysis, a low concentration of AYPGKF, but not SFLLRN, stimulated phosphorylation of Akt on serine 473. Moreover, the phosphatidyl inositide 3-kinase inhibitor LY294002 antagonized the effect of epinephrine combined with thrombin or AYPGKF. Thus, in aspirin-treated platelets, PAR4, but not PAR1, interacts synergistically with alpha(2A)-adrenergic receptors, and the PI3-kinase/Akt pathway is involved in this cross-talk. Furthermore, in PAR4-pretreated platelets, epinephrine caused dense granule secretion, and subsequent signaling from the ATP-gated P2X(1)-receptor and the alpha(2A)-adrenergic receptor induced aggregation. These results suggest a new mechanism that has ATP as a key element and circumvents the action of aspirin on epinephrine-facilitated PAR4-mediated platelet activation.

  • 117. Griswold, MG
    et al.
    Fullman, N
    Hawley, C
    Arian, N
    Zimsen, SRM,
    Tymeson, HD
    Venkateswaran, V
    Tapp, AD
    Forouzanfar, MH
    Salama, JS
    Ärnlöv, Johan
    Karolinska Inst, Dept Neurobiol, Stockholm, Sweden; Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Carrero, JJ
    Carvalho, F
    Yotebieng, M
    Younis, MZ
    Zachariah, G
    Zaidi, Z
    Zamani, M
    Zhang, X
    Zodpey, S
    Mokdad, AH
    Naghavi, M
    Murray, CJL
    Gakidou, E
    Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 20162018In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 392, no 10152, p. 1015-1035Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older.

    METHODS: Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health.

    FINDINGS: Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2·2% (95% uncertainty interval [UI] 1·5-3·0) of age-standardised female deaths and 6·8% (5·8-8·0) of age-standardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3·8% (95% UI 3·2-4·3) of female deaths and 12·2% (10·8-13·6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2·3% (95% UI 2·0-2·6) and male attributable DALYs were 8·9% (7·8-9·9). The three leading causes of attributable deaths in this age group were tuberculosis (1·4% [95% UI 1·0-1·7] of total deaths), road injuries (1·2% [0·7-1·9]), and self-harm (1·1% [0·6-1·5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2-33·3) of total alcohol-attributable female deaths and 18·9% (15·3-22·6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0-0·8) standard drinks per week.

    INTERPRETATION: Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.

    FUNDING: Bill & Melinda Gates Foundation.

  • 118. Grubb, Anders
    et al.
    Horio, Masaru
    Hansson, Lars-Olof
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Björk, Jonas
    Nyman, Ulf
    Flodin, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Bökenkamp, Arend
    Yasuda, Yoshinari
    Blufpand, Hester
    Lindström, Veronica
    Zegers, Ingrid
    Althaus, Harald
    Blirup-Jensen, Søren
    Itoh, Yoshi
    Sjöström, Per
    Nordin, Gunnar
    Christensson, Anders
    Klima, Horst
    Sunde, Kathrin
    Hjort-Christensen, Per
    Armbruster, David
    Ferrero, Carlo
    Generation of a new cystatin C-based estimating equation for glomerular filtration rate by use of 7 assays standardized to the international calibrator2014In: Clinical Chemistry, ISSN 0009-9147, E-ISSN 1530-8561, Vol. 60, no 7, p. 974-986Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Many different cystatin C-based equations exist for estimating glomerular filtration rate. Major reasons for this are the previous lack of an international cystatin C calibrator and the nonequivalence of results from different cystatin C assays.

    METHODS:

    Use of the recently introduced certified reference material, ERM-DA471/IFCC, and further work to achieve high agreement and equivalence of 7 commercially available cystatin C assays allowed a substantial decrease of the CV of the assays, as defined by their performance in an external quality assessment for clinical laboratory investigations. By use of 2 of these assays and a population of 4690 subjects, with large subpopulations of children and Asian and Caucasian adults, with their GFR determined by either renal or plasma inulin clearance or plasma iohexol clearance, we attempted to produce a virtually assay-independent simple cystatin C-based equation for estimation of GFR.

    RESULTS:

    We developed a simple cystatin C-based equation for estimation of GFR comprising only 2 variables, cystatin C concentration and age. No terms for race and sex are required for optimal diagnostic performance. The equation, [Formula: see text] is also biologically oriented, with 1 term for the theoretical renal clearance of small molecules and 1 constant for extrarenal clearance of cystatin C.

    CONCLUSIONS:

    A virtually assay-independent simple cystatin C-based and biologically oriented equation for estimation of GFR, without terms for sex and race, was produced.

  • 119. Gudbjörnsson, B
    et al.
    Christofferson, R
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Surgical Sciences.
    Larsson, Anders
    Department of Medical Sciences. klinisk kemi.
    Synovial concentrations of the angiogenic peptides bFGF and VEGF do not discriminate rheumatoid arthritis from other forms of inflammatory arthritis.2004In: Scand J Clin Lab Invest, ISSN 0036-5513, Vol. 64, no 1, p. 9-15Article in journal (Other scientific)
  • 120. Gustafsson, J.
    et al.
    Jensen-Urstad, K.
    Herlitz-Lindberg, M.
    Moller, S.
    Pettersson, S.
    Gunnarsson, I.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Svenungsson, E.
    Atherosclerosis in systemic lupus erythematosus (SLE) and controls: an analysis of SLE subgroups2014In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 43, no S127, p. 7-8Article in journal (Other academic)
  • 121. Gustafsson, Johanna
    et al.
    Gunnarsson, Iva
    Börjesson, Ola
    Pettersson, Susanne
    Rheumatology Unit, Department of Medicine Karolinska University Hospital, Solna, Sweden.
    Möller, Sonia
    Fei, Guo-Zhong
    Elvin, Kerstin
    Simard, Julia F.
    Hansson, Lars-Olof
    Department of Laboratory Medicine, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden.
    Lundberg, Ingrid E.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Svenungsson, Elisabet
    Predictors of the first cardiovascular event in patients with systemic lupus erythematosus: a prospective cohort study2009In: Arthritis Research & Therapy, ISSN 1478-6354, E-ISSN 1478-6362, Vol. 11, no 6, p. R186-Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION :

    Cardiovascular disease (CVD) is a major cause of premature mortality among Systemic lupus erythematosus (SLE) patients. Many studies have measured and evaluated risk factors for premature subclinical atherosclerosis, but few studies are prospective and few have evaluated risk factors for hard endpoints, i.e. clinically important cardiovascular events (CVE). We investigated the impact of traditional and lupus associated risk factors for the first ever CVE in a longitudinal cohort of SLE patients.

    METHODS :

    A total of 182 SLE patients (mean age 43.9 years) selected to be free of CVE were included. Cardiovascular and autoimmune biomarkers were measured on samples collected after overnight fasting at baseline. Clinical information was collected at baseline and at follow up. End point was the first ever CVE (ischemic heart, cerebrovascular or peripheral vascular disease or death due to CVD). Impact of baseline characteristics/biomarkers on the risk of having a first CVE was evaluated with Cox regression.

    RESULTS :

    Follow up was 99.5% after a mean time of 8.3 years. Twenty-four patients (13%) had a first CVE. In age-adjusted Cox regression, any positive antiphospholipid antibody (aPL), elevated markers of endothelial activation (von Willebrand factor (vWf), soluble vascular cellular adhesion molecule-1 (sVCAM-1)) and fibrinogen predicted CVEs. Of SLE manifestations, arthritis, pleuritis and previous venous occlusion were positively associated with future CVEs while thrombocytopenia was negatively associated. Among traditional risk factors only age and smoking were significant predictors. In a multivariable Cox regression model age, any positive aPL, vWf and absence of thrombocytopenia were all predictors of the first CVE.

    CONCLUSIONS :

    In addition to age, positive aPL, biomarkers indicating increased endothelial cell activity/damage, and absence of thrombocytopenia were independent predictors of CVEs in this prospective study. Our results indicate that activation of the endothelium and the coagulation system are important features in SLE related CVD. Furthermore, we observed that the risk of CVEs seems to differ between subgroups of SLE patients.

  • 122. Gustafsson, Johanna
    et al.
    Jensen-Urstad, Kerstin
    Herlitz-Lindberg, Marie
    Moller, Sonia
    Pettersson, Susanne
    Gunnarsson, Iva
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Svenungsson, Elisabet
    Atherosclerosis In Systemic Lupus Erythematosus (SLE) and Controls, -An Analysis Of SLE Subgroups2013In: Arthritis and Rheumatism, ISSN 0004-3591, E-ISSN 1529-0131, Vol. 65, no Suppl. 10, p. S1243-S1243Article in journal (Other academic)
  • 123. Gustafsson, Johanna
    et al.
    Simard, Julia F
    Gunnarsson, Iva
    Elvin, Kerstin
    Lundberg, Ingrid E
    Hansson, Lars-Olof
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Svenungsson, Elisabet
    Risk factors for cardiovascular mortality in patients with systemic lupus erythematosus, a prospective cohort study2012In: Arthritis Research & Therapy, ISSN 1478-6354, E-ISSN 1478-6362, Vol. 14, no 2, p. R46-Article in journal (Refereed)
    Abstract [en]

    INTRODUCTION:

    Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease. Cardiovascular disease (CVD) is common and a major cause of mortality. Studies on cardiovascular morbidity are abundant, whereas mortality studies focusing on cardiovascular outcomes are scarce. The aim of this study was to investigate causes of death and baseline predictors of overall (OM), non-vascular (N-VM), and specifically cardiovascular (CVM) mortality in SLE, and to evaluate Systematic coronary risk evaluation (SCORE).

    METHODS:

    208 SLE patients were included 1995-1999 and followed up after 12 years. Clinical evaluation, CVD risk factors, and biomarkers were recorded at inclusion. Death certificates and autopsy protocols were collected. Causes of death were divided into CVM (ischemic vascular and general atherosclerotic diseases), N-VM and death due to pulmonary hypertension. Predictors of mortality were investigated using multivariable Cox regression. SCORE and standardized mortality ratio (SMR) were calculated.

    RESULTS:

    During follow-up 42 patients died at mean age of 62 years. SMR 2.4 (CI 1.7-3.0). 48% of deaths were caused by CVM. SCORE underestimated CVM but not to a significant level. Age, high cystatin C levels and established arterial disease were the strongest predictors for all- cause mortality. After adjusting for these in multivariable analyses, only smoking of traditional risk factors, high soluble vascular cell adhesion molecule-1 (sVCAM-1), high sensitivity C-reactive protein (hsCRP), anti-beta2 glycoprotein-1 (abeta2GP1) and any antiphospholipid antibody (aPL) among biomarkers, remained predictive of CVM.

    CONCLUSION:

    With the exception of smoking, traditional risk factors do not capture the main underlying risk factors for CVM in SLE. Rather, cystatin C levels, inflammatory and endothelial markers, and anticardiolipin antibodies (aCL) differentiate patients with favorable versus severe cardiovascular prognosis. Our results suggest that these new biomarkers are useful in evaluating the future risk of cardiovascular mortality in SLE patients.

  • 124. Gustafsson, Johanna T
    et al.
    Herlitz Lindberg, Marie
    Gunnarsson, Iva
    Pettersson, Susanne
    Elvin, Kerstin
    Öhrvik, John
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Jensen-Urstad, Kerstin
    Svenungsson, Elisabet
    Excess atherosclerosis in systemic lupus erythematosus A matter of renal involvement: Case control study of 281 SLE patients and 281 individually matched population controls2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 4, article id e0174572Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Systemic lupus erythematosus (SLE), is a heterogeneous disease which predominantly affects young females (90%). SLE is associated with a shorter life expectancy than in the general population. Standardized mortality ratios (SMR) of 2.4 have been reported, which is comparable to diabetes. In modern societies cardiovascular disease (CVD) is the major cause of premature mortality. Accelerated atherosclerosis is generally assumed to be the underlying cause for SLE related CVD. However, previous studies diverge regarding whether atherosclerosis is more common in SLE than in controls. With this in mind and based on own clinical experience we hypothesized that accelerated atherosclerosis is not a general feature of SLE, but prevails in SLE subgroups.

    METHODS: 281 SLE patients and 281 individually age and sex matched population controls, were investigated clinically. Fasting blood samples and risk factor data were collected. All participants were subject to B-mode ultrasonography of the carotid arteries. Carotid plaque occurrence and mean intima media thickness (mIMT) were recorded. Two SLE subgroups previously described to be at high CVD risk; 1) patients with nephritis and 2) patients with anti-phospholipid antibodies (aPL), and one subgroup reported to be at comparatively lower CVD risk; patients positive for Sjögren´s syndrome antigens A/B (SSA/SSB) antibodies were analyzed separately in comparison with their respective matched controls.

    RESULTS: Median age was 49 (IQR 36-59) years, 93% were females. Manifest CVD; ischemic heart, cerebro- and peripheral vascular disease, prevailed in patients (12% vs. 1%, p<0.0001). Overall plaque prevalence did not differ (20% vs. 16%), but patients had slightly higher mIMT than controls (0.56 vs. 0.53 mm, p<0.0033). After age adjustment plaques, but not mIMT, remained associated with previous CVD events. Therefore we focused further analyses on plaques, a more robust measure of atherosclerosis. Patients with nephritis (40%), but neither aPL (25%) nor SSA/SSB (40%) positive patients, had more plaques than their respective controls (23% vs. 11%, p = 0.008). Notably, patients with nephritis were younger than other SLE patients (45 vs.49 years, p = 0.02). To overcome the confounding effect of age we performed an age-matched nested case-control analysis, which demonstrated that patients with nephritis had twice as often plaques (23%) as both non-nephritis patients (11%, p = 0.038) and controls (12%, p = 0.035).

    CONCLUSIONS: In SLE excess carotid plaques are essentially confined to the SLE subgroup with nephritis. This subgroup had plaques twice as often as age-matched non-nephritis SLE patients and population controls. Non-nephritis SLE patients, including the aPL positive subgroup, which has a high CVD risk, had similar prevalence of plaques as controls. To prevent later CVD events, this novel observation calls for risk factor screening and initiation of anti-atherosclerotic treatment selectively in SLE nephritis patients. Preferably at nephritis onset, which is often at a young age. In a general perspective this study demonstrates the importance to perform careful clinical subgroup analyses when investigating heterogeneous, hitherto not clearly defined, conditions like SLE.

  • 125.
    Hagström, Emil
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Endocrine Surgery. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Ahlström, Tommy
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Endocrine Surgery.
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Melhus, Håkan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical pharmacogenomics and osteoporosis.
    Hellman, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Endocrine Surgery.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Parathyroid hormone and calcium are independently associated with subclinical vascular disease in a community-based cohort2015In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 238, no 2, p. 420-426Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    Diseases with abnormal levels of parathyroid hormone (PTH) and calcium, such as primary and secondary hyperparathyroidism, are associated with an increased risk of cardiovascular morbidity and mortality. However, there is paucity on the association between calcium, PTH and abnormalities in the vascular system in the general population.

    METHODS:

    In the PIVUS study (Prospective Investigation of the Vasculature in Uppsala Seniors), a community based cohort of 70-year old men and women (n = 1016), the associations between s-calcium, p-PTH and endothelial function, arterial stiffness and blood pressures were investigated, adjusting for cardiovascular risk factors and mineral metabolism.

    RESULTS:

    In multivariable linear regression models 1 SD increase in calcium was associated with 1.1 units decrease in the stroke volume/pulse pressure ratio and 0.06 decrease in common carotid artery distensibility (p < 0.001) indicative of increased arterial stiffness. Further, calcium was associated with increasing calculated central pulse pressure with 1.3 mmHg elevation per 1 SD increase in calcium (p < 0.05). 1 SD increase in PTH was associated with 1.9 and 1.0 mmHg increase in intra-arterially measured brachial artery systolic and diastolic blood pressures, respectively (p < 0.01), as well as 1.6 and 0.9 mmHg increase in calculated central systolic and diastolic blood pressures (p < 0.05). PTH was not associated with arterial stiffness, endothelial function or pulse pressure.

    CONCLUSION:

    In a large community-based sample of elderly, calcium was independently associated with increased arterial stiffness, and PTH independently to intra-arterial peripheral and calculated central blood pressures. The findings indicate a possible link between the vasculature and mineral metabolism.

  • 126.
    Hallberg, Pär
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Melhus, Håkan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Hansson, Lars-Olof
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Cystatin C vs creatinine as markers of renal function in patients on digoxin treatment2004In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 109, no 3, p. 247-253Article in journal (Other academic)
    Abstract [en]

    BACKGROUND: The kidney function is a major determinant of the serum concentration of digoxin as this drug is mainly eliminated unchanged through the kidneys. Since digoxin is widely prescribed among the elderly, and the glomerular filtration rate (GFR) declines with age, it is important that the clinician takes the patient's GFR into account when prescribing digoxin. Serum cystatin C has been suggested to be superior to creatinine for estimation of GFR, which may have relevance for the optimization of treatment with digoxin. METHODS: To evaluate which of the two GFR markers serum creatinine and serum cystatin C that best correlates with serum digoxin, we compared the serum levels of digoxin with the serum levels of creatinine and cystatin C in 149 patients on therapeutic drug monitoring of digoxin at our hospital. RESULTS: Overall, there was a stronger correlation between serum digoxin concentrations and cystatin C (p=0.00001) as compared to creatinine (p= 0.00003). Interestingly, of the patients with a serum digoxin concentration > or = 1.5 nmol/L, 29% had a serum creatinine level within normal limits, as compared to 20% with normal cystatin C levels. CONCLUSIONS: In this study, serum cystatin C correlated better to serum digoxin than did serum creatinine. With improved GFR monitoring, digoxin concentrations should be better controlled.

  • 127. Hamad, Rangeen Rafik
    et al.
    Eriksson, Maria J.
    Berg, Elisabeth
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Bremme, Katarina
    Impaired endothelial function and elevated levels of pentraxin 3 in early-onset preeclampsia2012In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 91, no 1, p. 50-56Article in journal (Refereed)
    Abstract [en]

    Objective: To study endothelial function in relation to anti-angiogenic biomarkers and the inflammatory process in preeclampsia.

    Design: Observational study.

    Setting: Data were obtained from pregnant women who were admitted to the obstetrical ward at the Karolinska University Hospital, Solna, Stockholm, Sweden. Population. Thirty-five women with newly developed and untreated preeclampsia and 30 healthy controls.

    Methods: Flow-mediated dilation of the brachial artery, levels of anti-angiogenic and inflammatory markers were measured in plasma during pregnancy and 3-6 months after delivery. Main outcome measures. Flow-mediated dilation of the brachial artery, anti-angiogenic and inflammatory markers.

    Results: Flow-mediated dilation was decreased in the preeclamptic group at inclusion and at follow-up (p<0.05). Pentraxin 3 (PTX3) and ratio of soluble fms-like tyrosine kinase-1 (sFlt-1) to placental growth factor (PlGF) were elevated in women with preeclampsia during pregnancy (p<0.001). Furthermore flow-mediated dilation was lower and the ratio sFlt-1/PlGF and PTX3 were higher in early-onset preeclampsia than late preeclampsia (p=0.018, 0.002 and 0.039). Levels of PTX3 at inclusion correlated inversely with flow-mediated dilation at follow-up both in the preeclampsia and control groups (Spearman, r(s) =-0.47, p=0.02 and r(s) =-0.46, p=0.02 respectively).

    Conclusion: Impaired endothelial function and increased ratio sFlt/PlGF, elevated PTX3 is present in women with preeclampsia and is especially pronounced in women with early-onset preeclampsia.

  • 128.
    Hanslin, Katja
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases.
    Sjölin, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases.
    Skorup, Paul
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases.
    Wilske, Frida
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases.
    Frithiof, Robert
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Castegren, Marcus
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Infectious Diseases.
    Lipcsey, Miklos
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Pre-existing systemic inflammation attenuates bacterial clearance by the liver in porcine abdominal sepsis2016In: Intensive Care Medicine Experimental, ISSN 1646-2335, E-ISSN 2197-425X, Vol. 3, no suppl. 1, p. A620-Article in journal (Refereed)
  • 129.
    Hansson, Jonas
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Internal Medicine.
    Vasan, Ramachandran S.
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Ingelsson, Erik
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Michaëlsson, Karl
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
    Sundström, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Biomarkers of Extracellular Matrix Metabolism (MMP-9 and TIMP-1) and Risk of Stroke, Myocardial Infarction, and Cause-Specific Mortality: Cohort Study2011In: PLoS ONE, ISSN 1932-6203, Vol. 6, no 1, p. e16185-Article in journal (Refereed)
    Abstract [en]

    Objective: Turnover of the extracellular matrix in all solid organs is governed mainly by a balance between the degrading matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs). An altered extracellular matrix metabolism has been implicated in a variety of diseases. We investigated relations of serum levels of MMP-9 and TIMP-1 to mortality risk from an etiological perspective.

    Design: The prospective Uppsala Longitudinal Study of Adult Men (ULSAM) cohort, followed from 1991-1995 for up to 18.1 years. A random population-based sample of 1,082 71-year-old men, no loss to follow-up. Endpoints were all-cause (n = 628), cardiovascular (n = 230), non-cardiovascular (n = 398) and cancer mortality (n = 178), and fatal or non-fatal myocardial infarction (n = 138) or stroke (n = 163).

    Results: Serum MMP-9 and TIMP-1 levels were associated with risk of all-cause mortality (Cox proportional hazard ratio [HR] per standard deviation 1.10, 95% confidence interval [CI] 1.03-1.19; and 1.11, 1.02-1.20; respectively). TIMP-1 levels were mainly related to risks of cardiovascular mortality and stroke (HR per standard deviation 1.22, 95% CI 1.09-1.37; and 1.18, 1.04-1.35; respectively). All relations except those of TIMP-1 to stroke risk were attenuated by adjustment for cardiovascular disease risk factors. Relations in a subsample without cardiovascular disease or cancer were similar to those in the total sample.

    Conclusion: In this community-based cohort of elderly men, serum MMP-9 and TIMP-1 levels were related to mortality risk. An altered extracellular matrix metabolism may be involved in several detrimental pathways, and circulating MMP-9 or TIMP-1 levels may be relevant markers thereof.

  • 130.
    Hansson, Lars-Olof
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Wadström, Jonas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
    Lipcsey, Miklós
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
    Biglarnia, Alireza
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Transplantation Surgery.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Dagens svenska metoder för att mäta njurfunktion måste bli bättre: Rutinformlerna ger osäker diagnostik - stor risk för feldosering av läkemedel2008In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 105, no 10, p. 731-734Article in journal (Refereed)
    Abstract [sv]

    Njurfunktionsmätningar och främst måttet på glomerulär filtrationshastighet (GFR) tillhör våra mest använda laboratorieanalyser.

    Nuvarande metoder och ekvationer för beräkning av glomerulär filtration håller för låg diagnostisk kvalitet och innebär klara risker för felklassificering av njurpatienter och feldosering av läkemedel.

    Nuvarande svenska metoder för att mäta GFR måste förbättras.

    Vi måste förbättra kunskapen om skillnader mellan GFR beräknat i ml/min och i ml/min/ 1,73 m2.

    Det är viktigt att vi i sjukvården har ett enhetligt sätt att rapportera beräknat GFR.

  • 131. Hardt, Uta
    et al.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Gunnarsson, Iva
    Clancy, Robert M
    Petri, Michelle
    Buyon, Jill P
    Silverman, Gregg J
    Svenungsson, Elisabet
    Grönwall, Caroline
    Autoimmune reactivity to malondialdehyde adducts in systemic lupus erythematosus is associated with disease activity and nephritis2018In: Arthritis Research & Therapy, ISSN 1478-6354, E-ISSN 1478-6362, Vol. 20, article id 36Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Immunoglobulin M (IgM) autoreactivity to malondialdehyde (MDA) protein modifications is part of the natural antibody repertoire in health and may have beneficial functions. In contrast, IgG anti-MDA are increased in chronic inflammation and autoimmunity and may instead have pathogenic properties.

    METHODS: Herein, we investigated serum IgG anti-MDA levels by enzyme-linked immunosorbent assay (ELISA) in 398 systemic lupus erythematosus (SLE) patients in the Swedish Karolinska SLE cohort and compared these to findings in 225 US SLE patients from New York University and Johns Hopkins University.

    RESULTS: In two independent cohorts, IgG anti-MDA levels correlated positively with disease activity by the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI; p < 0.0001, Spearman R = 0.3). Meta-analysis found an odds ratio of 2.7 (confidence interval (CI) 1.9-3.9; p < 0.0001) for high anti-MDA IgG levels with active disease (SLEDAI ≥ 6). Furthermore, IgG anti-MDA correlated directly with erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), soluble tumor necrosis factor receptors (sTNFR-1, sTNFR-2), and vascular cell adhesion molecule 1 (VCAM-1) measurements, and inversely with complement factors (C1q, C2, C3, C4). Importantly, IgG anti-MDA levels were significantly elevated in SLE patients with active nephritis (p = 0.0005) and correlated with cystatin C estimated glomerular filtration rate and albuminuria.

    CONCLUSIONS: Elevated IgG anti-MDA in SLE patients was associated with high disease activity, with active lupus nephritis, and with biomarkers of systemic inflammation. This natural antibody reactivity may have potential prognostic utility, and may also actively contribute to pathogenesis.

  • 132.
    Hardt, Uta
    et al.
    Karolinska Inst, Dept Med, Rheumatol Unit, Stockholm, Sweden.;Karolinska Univ Hosp, Stockholm, Sweden..
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Gunnarsson, Iva
    Karolinska Inst, Dept Med, Rheumatol Unit, Stockholm, Sweden.;Karolinska Univ Hosp, Stockholm, Sweden..
    Clancy, Robert M.
    NYU, Sch Med, Dept Med, Div Rheumatol, New York, NY USA..
    Silverman, Gregg J.
    NYU, Sch Med, Dept Med, Div Rheumatol, New York, NY USA..
    Svenungsson, Elisabet
    Karolinska Inst, Dept Med, Rheumatol Unit, Stockholm, Sweden.;Karolinska Univ Hosp, Stockholm, Sweden..
    Gronwall, Caroline
    Karolinska Inst, Dept Med, Rheumatol Unit, Stockholm, Sweden.;Karolinska Univ Hosp, Stockholm, Sweden..
    Autoimmune reactivity to malondialdehyde adducts in SLE is associated with high disease activity2017In: Scandinavian Journal of Immunology, ISSN 0300-9475, E-ISSN 1365-3083, Vol. 86, no 4, p. 330-330Article in journal (Other academic)
  • 133. Harris, Holly
    et al.
    Wolk, Alicja
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Vasson, Marie-Paule
    Basu, Samar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Oxidative Stress and Inflammation.
    Soluble vascular endothelial growth factor receptors 2 (sVEGFR-2) and 3 (sVEGFR-3) and breast cancer risk in the Swedish Mammography Cohort2016In: International Journal of Molecular Epidemiology and Genetics, ISSN 1948-1756, E-ISSN 1948-1756, Vol. 7, no 1, p. 81-86Article in journal (Refereed)
    Abstract [en]

    Vascular endothelial growth factor (VEGF) is a signalling protein that has been established as a contributor to tumor angiogenesis, and expression of VEGF and its soluble receptors (sVEGFR2 and sVEGFR3) have been demonstrated in breast cancer cells. However, no prospective studies have examined the association between prediagnostic sVEGFR levels and breast cancer risk. We conducted a prospective case-control study nested within the Swedish Mammography Cohort examining the association between sVEGFR2 and 3 levels and breast cancer risk. The analysis included 69 incident breast cancer cases diagnosed after blood collection and 719 controls. Logistic regression models were used to calculate odds ratios and 95% confidence intervals. After adjustment for breast cancer risk factors, sVEGFR2 levels were associated with breast cancer risk (OR=1.28; 95% CI=1.06-1.56 per 1000 ng/L increase in concentration) while sVEGFR3 levels were not related to such risk (OR=1.00; 95% CI=0.93-1.07). Our results suggest that sVEGFR2 levels may be positively associated with breast cancer risk, however future studies with larger case groups are necessary to confirm this association.

  • 134. Hay, SI
    et al.
    Abajobir, AA
    Abate, KH
    Abbafati, C
    Abbas, KM
    Abd-Allah, F
    Abdulkader, RS
    Abdulle, AM
    Abebo, TA
    Abera, SF
    Aboyans, V
    Abu-Raddad, LJ
    Ärnlöv, Johan
    Karolinska institute, Dept Neurobiol, Div Family Med & Primary Care, Care Sci & Soc, Stockholm, Sweden; Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden .
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Zaki, MES
    Zegeye, EA
    Zenebe, ZM
    Zhang, X
    Zheng, Y
    Zhou, M
    Zipkin, B
    Zodpey, S
    Zoeckler, L
    Zuhlke, LJ
    Murray, CJL
    Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.2017In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 390, no 10100, p. 1260-1344, article id S0140-6736(17)32130-XArticle in journal (Refereed)
    Abstract [en]

    BACKGROUND: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI).

    METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate.

    FINDINGS: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally.

    INTERPRETATION: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support.

    FUNDING: Bill & Melinda Gates Foundation.

  • 135.
    Helmersson, Johanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition Research.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Vessby, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition Research.
    Basu, Samar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition Research.
    Active smoking and a history of smoking are associated with enhanced prostaglandin F(2alpha), interleukin-6 and F(2)-isoprostane formation in elderly men2005In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 181, no 1, p. 201-207Article in journal (Refereed)
    Abstract [en]

    The underlying mechanisms by which smoking induces cardiovascular diseases are largely unknown. The effect of smoking status on the cyclooxygenase (COX)-mediated inflammatory indicator prostaglandin F(2alpha) (PGF(2alpha)) has never been studied. Associations of cytokines and antioxidants and smoking status, have shown conflicting results. Urinary 15-keto-dihydro-PGF(2alpha) (a major metabolite of PGF(2alpha)), serum interleukin-6 (IL-6) and high sensitivity C-reactive protein (hsCRP), serum amyloid protein A (SAA), urinary 8-iso-PGF(2alpha) (an F(2)-isoprostane, indicator of oxidative stress), and serum alpha-tocopherol were quantified in a population-based sample (n = 642) of 77-year old men without diabetes. Fifty-five men were current smokers and 391 former smokers. Inflammatory indicators were increased in current smokers (15-keto-dihydro-PGF(2alpha), P < 0.001; IL-6, P = 0.01) than non-smokers. 8-iso-PGF(2alpha) was increased (P < 0.01) and alpha-tocopherol reduced (P < 0.001) in current smokers. Further, former smokers had increased formation of 15-keto-dihydro-PGF(2alpha), IL-6 and 8-iso-PGF(2alpha) compared non-smokers. This is the first study to show that smokers have increased PGF(2alpha) formation, thus enhanced COX-mediated inflammation, in addition to elevated levels of cytokines and isoprostanes. Subclinical COX- and cytokine-mediated inflammation and oxidative stress are ongoing processes not only in active smokers but also in former smokers which may contribute to the accelerated atherosclerosis associated with smoking.

  • 136.
    Helmersson, Johanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Ridefelt, Peter
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiovascular epidemiology.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Reference values for 34 frequently used laboratory tests in 80-year-old men and women2016In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 92, p. 97-101Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Reference values are usually based on blood samples from healthy individuals in the age range 20-50 years. Most patients seeking health care are older than this reference population. Many reference intervals are age dependent and there is thus a need to have appropriate reference intervals also for elderly individuals.

    METHODS: We analyzed a group of frequently used laboratory tests in an 80-year-old population (n=531, 266 females and 265 males). The 2.5th and 97.5th percentiles for these markers were calculated according to the International Federation of Clinical Chemistry guidelines on the statistical treatment of reference values.

    RESULTS: Reference values are reported for serum alanine transaminase (ALT), albumin, alkaline phosphatase, pancreatic amylase, apolipoprotein A1, apolipoprotein B, apolipoprotein B/apolipoprotein A1 ratio, aspartate aminotransferase (AST), AST/ALT ratio, bilirubin, calcium, calprotectin, cholesterol, HDL-cholesterol, creatinine kinase (CK), creatinine, creatinine estimated GFR, C-reactive protein, cystatin C, cystatin C estimated GFR, gamma-glutamyltransferase (GGT), iron, iron saturation, lactate dehydrogenase (LDH), magnesium, phosphate, transferrin, triglycerides, urate, urea, zinc, hemoglobin, platelet count and white blood cell count. The upper reference limit for creatinine and urea was significantly increased while the lower limit for iron and albumin was decreased in this elderly population in comparison with the population in the Nordic Reference Interval Project (NORIP).

    CONCLUSIONS: Reference values calculated from the whole population and a subpopulation without cardiovascular disease showed strong concordance. Several of the reference interval limits were outside the 90% confidence interval of NORIP.

  • 137.
    Helmersson, Johanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Vessby, Bengt
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Basu, Samar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Association of type 2 diabetes with cyclooxygenase-mediated inflammation and oxidative stress in an elderly population2004In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 109, no 14, p. 1729-1734Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Involvement of cyclooxygenase (COX)-mediated inflammation in type 2 diabetes has not been studied, and the association between cytokine-mediated inflammation and diabetes is not fully clarified.

    METHODS AND RESULTS: 15-Keto-dihydro-prostaglandin F2alpha (a metabolite of prostaglandin F2alpha and an indicator of COX-mediated inflammation), high-sensitivity C-reactive protein (CRP), serum amyloid protein A (SAA), 8-iso-PGF2alpha (a nonenzymatic, free radical product of arachidonic acid and an indicator of oxidative stress), and alpha-tocopherol were measured in a population-based sample of 77-year-old men (n=765), in which 112 men had type 2 diabetes. The inflammatory indicators were increased in men with diabetes (urinary 15-keto-dihydro-PGF2alpha, P<0.001, CRP and SAA, P<0.05). However, when adjusted for body mass index, waist circumference, or fasting insulin, no association was found between diabetes and CRP or SAA. The oxidative stress indicator 8-iso-PGF2alpha in urine was increased (P<0.01) in men with diabetes. Patients who were newly diagnosed with diabetes (<7 years since diagnosis) had increased urinary 15-keto-dihydro-PGF2alpha and decreased alpha-tocopherol, but 8-iso-PGF2alpha was unaltered.

    CONCLUSIONS: This is the first study to show that type 2 diabetes in elderly men is related to COX-mediated inflammation, reflected by enhanced prostaglandin formation. The high levels of cytokine-mediated acute-phase proteins observed in men with diabetes appear to be related to obesity and increased fasting insulin. The results further suggest that the appearance of chronic inflammation is an early process in the pathogenesis of diabetes, whereas oxidative injury may be a later process, possibly related to inflammation.

  • 138.
    Helmersson, Johanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Vessby, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Basu, Samar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Cyclooxygenase-mediated prostaglandin F2alpha is decreased in an elderly population treated with low-dose aspirin2005In: Prostaglandins, Leukotrienes and Essential Fatty Acids, ISSN 0952-3278, E-ISSN 1532-2823, Vol. 72, no 4, p. 227-233Article in journal (Refereed)
    Abstract [en]

    Low-dose aspirin (acetylsalicylic acid) is used as prophylaxis against cardiovascular diseases. The effect of aspirin on inflammation and oxidative stress, processes known to be involved in cardiovascular diseases, are not fully known. Cyclooxygenase(COX)-mediated inflammatory indicator prostaglandin F2alpha(PGF2alpha (15-keto-dihydro-PGF2alpha), cytokine-mediated inflammatory indicators (interleukin-6, high sensitivity C-reactive protein, serum amyloid A protein), and oxidative stress indicators (8-iso-PGF2alpha, tocopherols) were quantified in men with daily 75 mg of aspirin (n = 175) and control men (n = 464), all of age 77, in a cross-sectional study. Men treated with aspirin had decreased levels of urinary 15-keto-dihydro-PGF2alpha than controls (P < 0.01), independent of possible cardiovascular risk factors. Aspirin-treated men had increased levels of alpha-tocopherol than controls (P<0.05). This is the first study to indicate that low-dose aspirin treatment is associated with decreased levels of PGF2alpha. This observation suggests a possible COX-mediated anti-inflammatory effect of low-dose aspirin, which should be further confirmed by intervention studies.

  • 139.
    Helmersson, Johanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition Research.
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Vessby, Bengt
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition Research.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Alfthan, Georg
    Basu, Samar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition Research.
    Serum selenium predicts levels of F2-isoprostanes and prostaglandin F2alpha in a 27 year follow-up study of Swedish men2005In: Free radical research, ISSN 1071-5762, E-ISSN 1029-2470, Vol. 39, no 7, p. 763-770Article in journal (Refereed)
    Abstract [en]

    Low concentrations of selenium (Se) predict mortality and cardiovascular diseases in some populations. The effect of Se on in vivo indicators of oxidative stress and inflammation, two important features of atherosclerosis, in human populations is largely unexplored. This study investigated the longitudinal association between serum selenium (s-Se) and a golden standard indicator of oxidative stress in vivo (8-iso-prostaglandin F2, a major F2-isoprostane), an indicator of cyclooxygenase (COX)-mediated inflammation (prostaglandin F2), high sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6) and serum amyloid A protein (SAA) in a follow-up study of 27 years. The s-Se was measured in 615 Swedish men at 50 years of age in a health investigation. The status of oxidative stress and inflammation was evaluated in a re-investigation 27 years later by quantification of urinary 8-iso-PGF2 and 15-keto-dihydro- PGF2 (a major metabolite of PGF2) and serum hsCRP, SAA and IL-6. Men in the highest quartile of s-Se at age 50 had decreased levels of 8-iso-PGF2 compared to all lower quartiles   and decreased levels of PGF2 compared to all lower quartiles   at follow-up. These associations were independent of BMI, diabetes, hyperlipidemia, hypertension, smoking, -tocopherol and β-carotene at baseline. The s-Se was not associated with hsCRP, SAA or IL-6 at follow-up. In conclusion, high concentrations of s-Se predict reduced levels of oxidative stress and subclinical COX-mediated (but not cytokine-mediated) inflammation in a male population. The associations between Se, oxidative stress and inflammation, respectively, might be related to the proposed cardiovascular protective property of Se.

  • 140.
    Helmersson-Karlqvist, Johanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Flodin, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Hansson, Lars-Olof
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    The age related association is more pronounced for cystatin C estimated GFR than for creatinine estimated GFR in primary care patients2013In: Clinical Biochemistry, ISSN 0009-9120, E-ISSN 1873-2933, Vol. 46, no 16-17, p. 1761-1763Article in journal (Refereed)
    Abstract [en]

    Objectives

    There is an age associated change in GFR but this association may be influenced by the method used. The aims of the present study were to assess the association between age and cystatin C and creatinine based glomerular filtration rate estimates in primary care patients, and to determine the proportion of patients with clinically important renal impairment.

    Materials and methods

    1552 samples with simultaneous requests for creatinine and cystatin C from 1552 primary care patients in the county of Uppsala, Sweden were analysed. MDRD, CKD-EPI and cystatin C equations were used to calculate glomerular filtration rate (GFR) and the associations between GFR and age were explored.

    Results

    The yearly change in cystatin C estimated GFR was 1.24 mL/min/1.73 m2 while the corresponding decline for creatinine estimated GFR was 0.76 mL/min/1.73 m2 for MDRD and 0.99 mL/min/1.73 m2 for CKD-EPI.

    Conclusions

    The age related association with GFR estimates is smaller for creatinine estimates than for cystatin C estimates. This leads to differences in the number of patients with reduced eGFR detected with the three estimates and the patient treatment will depend on the estimate used. This is not coherent with a good patient care and we thus need to develop new eGFR equations with better agreement between the estimates.

  • 141.
    Helmersson-Karlqvist, Johanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Flodin, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Havelka, Aleksandra Mandic
    Karolinska Univ Hosp, Dept Clin Chem, Stockholm, Sweden.
    Xu, Xiao Yan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    The Roche Immunoturbidimetric Albumin Method on Cobas c 501 Gives Higher Values Than the Abbott and Roche BCP Methods When Analyzing Patient Plasma Samples2016In: Journal of clinical laboratory analysis (Print), ISSN 0887-8013, E-ISSN 1098-2825, Vol. 30, no 5, p. 677-681Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Serum/plasma albumin is an important and widely used laboratory marker and it is important that we measure albumin correctly without bias. We had indications that the immunoturbidimetric method on Cobas c 501 and the bromocresol purple (BCP) method on Architect 16000 differed, so we decided to study these methods more closely.

    METHOD: A total of 1,951 patient requests with albumin measured with both the Architect BCP and Cobas immunoturbidimetric methods were extracted from the laboratory system. A comparison with fresh plasma samples was also performed that included immunoturbidimetric and BCP methods on Cobas c 501 and analysis of the international protein calibrator ERM-DA470k/IFCC.

    RESULTS: The median difference between the Abbott BCP and Roche immunoturbidimetric methods was 3.3 g/l and the Roche method overestimated ERM-DA470k/IFCC by 2.2 g/l. The Roche immunoturbidimetric method gave higher values than the Roche BCP method: y = 1.111x - 0.739, R² = 0.971.

    CONCLUSION: The Roche immunoturbidimetric albumin method gives clearly higher values than the Abbott and Roche BCP methods when analyzing fresh patient samples. The differences between the two methods were similar at normal and low albumin levels.

  • 142.
    Helmersson-Karlqvist, Johanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Karlsson, Bo
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine.
    Fredricsson, Annika
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Gastroenterology/Hepatology.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Evaluation of the Alere D-dimer test for point of care testing2014In: Journal of Thrombosis and Thrombolysis, ISSN 0929-5305, E-ISSN 1573-742X, Vol. 38, no 2, p. 250-252Article in journal (Refereed)
    Abstract [en]

    The primary care regularly sees patients that have symptoms that could be due to thromboembolic diseases. It would be valuable to be able to rule out deep venous thrombosis or pulmonary embolism using Wells score and a negative D-dimer testing already at the primary care unit. This requires a validated D-dimer assay suitable for primary care use. We compared D-dimer results obtained with the new point of care analyzer Alere Triage(®) and the central hospital laboratory STA-R Evolution analyzer from the same patient samples (n = 102). We also calculated the total coefficient of variation (CV) for the Alere method. The two methods showed a good linear correlation (R(2) = 0.977) and a slope of 0.975. CV for the Alere D-dimer method was well below 10 %. The study shows that the Alere D-dimer assay and the central laboratory standard assay show similar results. We suggest that the Alere D-dimer assay could be used in primary care in combination with Wells score to reduce referrals to the emergency unit.

  • 143.
    Helmersson-Karlqvist, Johanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Carlsson, Axel C
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
    Venge, Per
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Sundström, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Ingelsson, Erik
    Lind, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Urinary neutrophil gelatinase-associated lipocalin (NGAL) is associated with mortality in a community-based cohort of older Swedish men2013In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 227, no 2, p. 408-413Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE

    Neutrophil gelatinase-associated lipocalin (NGAL) indicates tubular kidney damage, neutrophil activation and possibly atherogenesis, however the prospective association between urinary NGAL (u-NGAL) and cardiovascular death in the community is not known.

    METHODS

    This study evaluates the association between urinary and serum NGAL and mortality in a Swedish population of 597 men aged 78 years. During the study (median follow-up 8.1 years) 261 men died, 90 of cardiovascular causes.

    RESULTS

    U-NGAL was associated with increased all-cause and cardiovascular mortality (HR 2.0 for quartile 4 vs. quartile 1, 95% CI 1.0-4.0, P < 0.05) in Cox regression models independently of cardiovascular risk factors, CRP and cystatin C estimated glomerular filtration rate (eGFRCysC) but not urinary Albumin (u-Alb). A combination of low eGFRCysC (≤60 mL/min), high u-Alb (≥3 mg/mmol Cr) and high u-NGAL (≥1.19 μg/mmol Cr) was associated with a 9-fold increased cardiovascular mortality (P < 0.001) and a 3-fold increased all-cause mortality (P < 0.001). Serum NGAL was associated with increased all-cause mortality risk independent of other cardiovascular risk factors (HR 1.4 for quartile 4 vs.1, 95% CI 1.0-1.9, P < 0.05) but not after adjustment with CRP, eGFRCysC or u-Alb.

    CONCLUSION

    This community study is the first to show that the tubular kidney biomarker u-NGAL associated with increased cardiovascular and all-cause mortality independent of cardiovascular risk factors and glomerular filtration. Additional research is needed to evaluate the utility of NGAL in clinical practice.

  • 144.
    Helmersson-Karlqvist, Johanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Carlsson, Axel C
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Molecular epidemiology. Uppsala University, Science for Life Laboratory, SciLifeLab.
    Härmä, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Increased urinary cystatin C indicated higher risk of cardiovascular death in a community cohort2014In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 234, no 1, p. 108-113Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Urinary cystatin C (u-CysC) is a new biomarker for acute tubular kidney dysfunction and may also indicate chronic tubular dysfunction. Chronic kidney disease is an important cardiovascular risk factor, however it is not known if u-CysC is a risk marker for cardiovascular death.

    METHODS: The association between u-CysC and cardiovascular mortality was investigated in a Swedish community-based cohort of 604 men aged 78 years. During follow-up (mean 6.7 years), 203 participants died, of which 90 due to cardiovascular causes.

    RESULTS: High u-CysC (>0.029 mg/mmol Cr) was associated with a more than 2-fold risk of cardiovascular death (multivariable hazard ratio for quintile 5 vs. 1: 2.5, 95% CI 1.2-5.2, P < 0.05) in Cox regression models independent of cardiovascular risk factors, glomerular filtration rate (eGFR) and urinary Albumin. Participants with low eGFR (≤60 mL/min), albuminuria (≥3 mg/mmol Cr) and high u-CysC (>0.029 mg/mmol Cr) combined had a significantly higher cardiovascular mortality risk compared to participants with one or two of these biomarkers normal (hazard ratio 15, 95% CI: 6.7-36, P < 0.001, compared to all three biomarkers normal).

    CONCLUSIONS: This study is the first to show that increased concentrations of the tubular kidney biomarker u-CysC indicated risk of cardiovascular death independently of other cardiovascular risk factors, glomerular filtration and albuminuria. Additional research is needed to further establish the usefulness of u-CysC in clinical practice.

  • 145.
    Helmersson-Karlqvist, Johanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Day-to-day variation of urinary NGAL and rational for creatinine correction2013In: Clinical Biochemistry, ISSN 0009-9120, E-ISSN 1873-2933, Vol. 46, no 1-2, p. 70-72Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES:

    Clinical studies evaluating the new tubular biomarker urinary neutrophil gelatinase-associated lipocalin (U-NGAL) in urine increase and there is no consensus whether absolute U-NGAL concentrations or urinary NGAL/creatinine (U-NGAL/Cr) ratios should be used when chronic tubular dysfunction is studied. The aim was to study the biological variation of U-NGAL in healthy subjects and the rational for urinary Creatinine (U-Cr) correction in two different study samples.

    DESIGN AND METHODS:

    To study biological variation of U-NGAL and U-NGAL/Cr ratio and the association between U-NGAL and U-Cr in healthy subjects 13 young males and females (median age 29years) collected morning urine in 10 consecutive days. Additionally, a random subsample of 400 males from a population-based cohort (aged 78years) collecting 24-hour urine during one day was studied.

    RESULTS:

    The calculated biological variation for absolute U-NGAL was 27% and for U-NGAL/Cr ratio 101%. Absolute U-NGAL increased linearly with U-Cr concentration (the theoretical basis for creatinine adjustment) in the older males (R=0.19, P<0.001) and with borderline significance in the young adults (R=0.16, P=0.08). The U-NGAL/Cr ratio was, however, negatively associated with creatinine in the older males (R=-0.14, P<0.01) and in the young adults (R=-0.16, P=0.07) indicating a slight "overadjustment".

    CONCLUSIONS:

    The study provide some support for the use of U-NGAL/Cr ratio but the rather large biological variation and risk of possible overadjustment need to be considered. Both absolute U-NGAL and U-NGAL/Cr ratios should be reported for the estimation of chronic tubular dysfunction.

  • 146.
    Helmersson-Karlqvist, Johanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Ärnlöv, Johan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Geriatrics.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Basu, Samar
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Oxidative Stress and Inflammation.
    Prostaglandin F2α formation is associated with mortality in a Swedish community-based cohort of older males2015In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 36, no 4Article in journal (Refereed)
    Abstract [en]

    Aims

    An increasing number of clinical studies highlight the importance of the inflammatory mediator prostaglandin F2α (PGF). Prostaglandin F2α activity has been suggested to play pivotal roles in the development of cardiovascular diseases and cancer. However, whether systemic PGF concentrations may signal mortality is unknown. The aim was to evaluate in vivo PGF formation, by measuring urinary 15-keto-dihydro-PGF, and mortality risk in a community setting.                     

    Methods and results

    Urinary 15-keto-dihydro-PGF was measured in a Swedish population of 670 men (aged 77–78 years) and the participants were followed up for a median of 9.7 years (383 died, among them 156 of cardiovascular causes and 102 of cancer). In Cox regression models, urinary 15-keto-dihydro-PGF was significantly associated with cardiovascular mortality [multivariate hazard ratio (HR) for 1 SD increase of urinary 15-keto-dihydro-PGF: 1.18; 95% CI:1.04–1.34; P = 0.01) independent of established cardiovascular risk factors including C-reactive protein. Urinary 15-keto-dihydro-PGF was also independently associated with total mortality (multivariate HR for 1 SD increase of urinary 15-keto-dihydro-PGF: 1.11; 95% CI: 1.01–1.21; P = 0.03). The combination of 15-keto-dihydro-PGF concentrations above the median and high serum high-sensitive C-reactive protein (>3 mg/L) was independently associated with a two-fold increased risk of cancer and total mortality (P = 0.02 and P < 0.001, respectively).                     

    Conclusion

    This is the first study to show that the inflammatory mediator PGF was independently associated with mortality and specifically cardiovascular mortality 10 years later. The results are in line with the emerging evidence of the importance of the inflammatory mediator PGF in fatal cardiovascular disease.

  • 147.
    Helmersson-Karlqvist, Johanna
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Åkerfeldt, Torbjörn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Gunningberg, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Leo Swenne, Christine
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Serum MMP-9 and TIMP-1 concentrations and MMP-9 activity during surgery-induced inflammation in humans2012In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 50, no 6, p. 1115-1119Article in journal (Refereed)
    Abstract [en]

     Background: Matrix metalloproteinase 9 (MMP-9) and the endogenous inhibitor to MMP-9, tissue inhibitor of metalloproteinase 1 (TIMP-1), have important roles in tissue remodelling and are implicated in a number of diseases related to inflammation. The time course in activation and formation of MMPs and TIMPs during an inflammatory reaction is not fully known. This study investigates MMP-9 and TIMP-1 concentrations and MMP-9 activity at different time points after major surgery when a state of noticeable inflammation is expected.

    Methods: Serum MMP-9 and TIMP-1 concentrations and MMP-9 activity were analysed preoperatively and 4 and 30 days postoperatively in patients undergoing elective surgery (coronary artery bypass n=21; orthopaedic surgery, n=29).

    Results: Serum TIMP-1 and MMP-9 activity increased significantly 4 days after surgery (p<0.05 and p<0.01, respectively) and decreased again 30 days after surgery (p<0.01, respectively, compared to 4 days after surgery). Serum MMP-9 increased significantly 4 days after surgery (p<0.05) and was still high 30 days after surgery (p<0.01 compared to before surgery). The calculated MMP-9/TIMP-1 ratio was increased 30 days after surgery compared to before surgery (p<0.01).

    Conclusions: The inflammatory state induced by elective surgery is associated with increased TIMP-1 response and MMP-9 activity in serum within a few days which may be of importance for the postoperative heeling process. The further increase in MMP-9 concentrations at day 30 postoperative did not result in increased MMP-9 activity. Serum MMP-9 concentrations or the calculated MMP-9/TIMP-1 ratio do not entirely represent MMP-9 activity during surgery-induced inflammation.

  • 148.
    Herman, Stephanie
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Emami Khoonsari, Payam
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Tolf, Andreas
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurology.
    Steinmetz, Julia
    Zetterberg, Henrik
    Åkerfeldt, Torbjörn
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Jakobsson, Per-Johan
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Spjuth, Ola
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmaceutical Biosciences.
    Burman, Joachim
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurology.
    Kultima, Kim
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Chemistry.
    Integration of magnetic resonance imaging and protein and metabolite CSF measurements to enable early diagnosis of secondary progressive multiple sclerosis.2018In: Theranostics, ISSN 1838-7640, E-ISSN 1838-7640, Vol. 8, no 16, p. 4477-4490Article in journal (Refereed)
    Abstract [en]

    Molecular networks in neurological diseases are complex. Despite this fact, contemporary biomarkers are in most cases interpreted in isolation, leading to a significant loss of information and power. We present an analytical approach to scrutinize and combine information from biomarkers originating from multiple sources with the aim of discovering a condensed set of biomarkers that in combination could distinguish the progressive degenerative phenotype of multiple sclerosis (SPMS) from the relapsing-remitting phenotype (RRMS).

    Methods: Clinical and magnetic resonance imaging (MRI) data were integrated with data from protein and metabolite measurements of cerebrospinal fluid, and a method was developed to sift through all the variables to establish a small set of highly informative measurements. This prospective study included 16 SPMS patients, 30 RRMS patients and 10 controls. Protein concentrations were quantitated with multiplexed fluorescent bead-based immunoassays and ELISA. The metabolome was recorded using liquid chromatography-mass spectrometry. Clinical follow-up data of the SPMS patients were used to assess disease progression and development of disability.

    Results: Eleven variables were in combination able to distinguish SPMS from RRMS patients with high confidence superior to any single measurement. The identified variables consisted of three MRI variables: the size of the spinal cord and the third ventricle and the total number of T1 hypointense lesions; six proteins: galectin-9, monocyte chemoattractant protein-1 (MCP-1), transforming growth factor alpha (TGF-α), tumor necrosis factor alpha (TNF-α), soluble CD40L (sCD40L) and platelet-derived growth factor AA (PDGF-AA); and two metabolites: 20β-dihydrocortisol (20β-DHF) and indolepyruvate. The proteins myelin basic protein (MBP) and macrophage-derived chemokine (MDC), as well as the metabolites 20β-DHF and 5,6-dihydroxyprostaglandin F1a (5,6-DH-PGF1), were identified as potential biomarkers of disability progression.

    Conclusion: Our study demonstrates, in a limited but well-defined and data-rich cohort, the importance and value of combining multiple biomarkers to aid diagnostics and track disease progression.

  • 149.
    Hong, Jaan
    et al.
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology.
    Larsson, Anders
    Department of Medical Sciences.
    Ekdahl, Kristina
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology.
    Elgue, Graciela
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology.
    Larsson, Rolf
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology.
    Nilsson, Bo
    Uppsala University, Medicinska vetenskapsområdet, Faculty of Medicine, Department of Oncology, Radiology and Clinical Immunology.
    Contact between a polymer and whole blood: sequence of events leading to thrombin generation.2001In: J Lab Clin Med, Vol. 138, p. 139-Article in journal (Refereed)
  • 150.
    Hudecova, Miriam
    et al.
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Holte, Jan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
    Moby, Lena
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Olovsson, Matts
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Stridsberg, Mats
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemical endocrinology.
    Larsson, Anders
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Biochemial structure and function.
    Berglund, Lars
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center.
    Berne, Christian
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Endocrinology, Diabetes and Metabolism.
    Sundström Poromaa, Inger
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
    Androgen levels, insulin sensitivity, and early insulin response in women with polycystic ovary syndrome: a long-term follow-up study2011In: Fertility and Sterility, ISSN 0015-0282, E-ISSN 1556-5653, Vol. 95, no 3, p. 1146-1148Article in journal (Refereed)
    Abstract [en]

    Thirty-four women with polycystic ovary syndrome who previously had participated in studies with intravenous glucose tolerance test and hyperinsulinemic, euglycemic clamp between 1987 and 1995 underwent anthropometric, endocrine (T and sex-hormone binding globulin serum concentration), and metabolic (intravenous glucose tolerance test, hyperinsulinemic, euglycemic clamp, and androgens) measurements. Free androgen levels and β-cell function decreased over time in women with polycystic ovary syndrome, but insulin sensitivity remained unaltered.

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