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201. Independent contributions of cognitive functioning and social risk factors to symptoms of ADHD in two Nordic populations-based cohorts

Author: Forssman, Linda, Bohlin, Gunilla, Lundervold, Astri J., Taanila, Anja, Heiervang, Einar, Loo, Sandra, Järvelin, Marjo-Riitta, Smalley, Susan, Moilanen, Irma, Rodriguez, Alina, Forssman, Linda, Bohlin, Gunilla, Lundervold, Astri J., Taanila, Anja, Heiervang, Einar, Loo, Sandra, Järvelin, Marjo-Riitta, Smalley, Susan, Moilanen, Irma, and Rodriguez, Alina
Abstract: This study examined independent contributions of executive functioning (EF), state regulation (SR), and social risk factors to symptom dimensions of attention deficit hyperactivity disorder (ADHD) in two cohorts, which included 221 Norwegian children and 294 Finnish adolescents. Independent contributions of EF and SR were shown in the Norwegian cohort and EF contributed independently in the Finnish cohort. When controlling for each symptom dimension, cognitive functioning and social risk factors were differentially associated with inattention and hyperactivity/impulsivity symptoms. The results show the need to include both social risk factors and cognitive functioning to obtain a better understanding of ADHD symptoms.

202. GWAS on longitudinal growth traits reveals different genetic factors influencing infant, child and adult BMI

Author: Rodriguez, Alina and Rodriguez, Alina
Abstract: Early childhood growth patterns are associated with adult health, yet the genetic factors and the developmental stages involved are not fully understood. Here we combine genome-wide association studies with modelling of longitudinal growth traits to study the genetics of infant and child growth, followed by functional, pathway, genetic correlation, risk score and co-localization analyses to determine how developmental timings, molecular pathways and genetic determinants of these traits overlap with those of adult health. We found a robust overlap between the genetics of child and adult BMI, with variants associated with adult BMI acting as early as 4-6 years old. However, we demonstrated a completely distinct genetic makeup for peak BMI during infancy, influenced by variation at the LEPR/LEPROT locus. These findings suggest that different genetic factors control infant and child BMI. In light of the obesity epidemic, these findings are important to inform the timing and targets of prevention strategies.

203. Antenatal corticosteroid therapy (ACT) and size at birth: A population-based analysis using the Finnish Medical Birth Register

Author: Rodriguez, Alina, Wang, Yingbo, Ali Khan, Anohki, Cartwright, Rufus, Gissler, Mika, Jarvelin, Marjo-Riitta, Rodriguez, Alina, Wang, Yingbo, Ali Khan, Anohki, Cartwright, Rufus, Gissler, Mika, and Jarvelin, Marjo-Riitta
Abstract: Antenatal corticosteroid therapy (ACT) is used clinically to prepare the fetal lung for impending preterm birth, but animal and human studies link corticosteroids to smaller birth size. Whether ACT is associated with birth size is debated; therefore, we assessed differences in birth size in treated versus untreated pregnancies. Methods and findings This observational register-based study used data from the Finnish Medical Birth Register (FMBR) covering all births in Finland (January 1, 2006–December 31, 2010). We used unadjusted and adjusted regression analyses as well as propensity score matching (PSM) to analyze whether birth size differed by ACT exposure. PSM provides a stringent comparison, as subsamples were created matched on baseline and medical characteristics between treated and untreated women. All analyses were stratified by timing of birth. The primary study outcome was birth size: birth weight (BWT), birth length (BL), ponderal index (PI), and head circumference (HC) measured immediately after birth and recorded in the FMBR. Additional analyses explored indicators of neonatal health in relation to ACT exposure and birth size. A total of 278,508 live-born singleton births with ≥24 gestational completed weeks were registered in the FMBR during the 5-year study period. Over 4% of infants were born preterm, and 4,887 women were treated with ACT (1.75%). More than 44% of the exposed infants (n = 2,173) were born at term. First, results of unadjusted regression analyses using the entire sample showed the greatest reductions in BWT as compared to the other analytic methods: very preterm −61.26 g (±SE 24.12, P < 0.01), preterm −232.90 g (±SE 17.24, P < .001), near term −171.50 g (±SE 17.52, P < .001), and at term −101.95 g (±SE 10.89, P < .001). Second, using the entire sample, regression analyses adjusted for baseline and medical conditions showed significant differences in BWT between exposed and unexposed infants: very preterm −61.54 g (±SE 28.62, P < .03)

204. Effects of non-pharmacological interventions on insomnia in patients with tinnitus: a systematic review & meta-analysis.

Author: Laparidou, Despina, Curtis, Ffion, Rodriguez, Alina, Law, Graham, Durrant, Simon, Pierzycki, Robert H., Siriwardena, Niro, Laparidou, Despina, Curtis, Ffion, Rodriguez, Alina, Law, Graham, Durrant, Simon, Pierzycki, Robert H., and Siriwardena, Niro
Abstract: Introduction Tinnitus is the perception of sound (ringing or buzzing) in the absence of external/electrical stimulation. It affects about 10% of people in the United Kingdom, with rates of comorbid sleep problems ranging from 50 to 77%. Our aim was to systematically review the literature relating to the effectiveness of cognitive behavioural therapy (CBT) interventions on insomnia in patients with tinnitus. Methods A systematic literature search of seven scientific databases (Cochrane Library/CENTRAL, PROSPERO, HTA/DARE, Medline, CINAHL, Web of science, ClinicalTrials.gov) was performed, covering literature published up to August 2018. Database searching was supplemented with internet searching and forward/backward citation tracking from systematic reviews and included studies. Studies were considered eligible for inclusion if they involved: adult patients (living at home or in a care setting) with tinnitus; CBT interventions for tinnitus and/or insomnia; any comparator (i.e. usual care, alternative intervention); randomised controlled trials or quasi-randomised controlled trials that reported sleep outcomes. The primary outcome was a mean difference in sleep. The quality of the included studies was assessed according to the Cochrane Risk of Bias assessment tool. Two reviewers independently reviewed title/abstracts initially and then full-text papers, before proceeding with data extractions. Any discrepancies were resolved through discussion, or where required a third reviewer. Results Four studies (427 participants) were included in the meta-analysis. The majority of the interventions were internet-based and targeted tinnitus distress with insomnia reported as a secondary outcome. Sleep management and/or guidance was an additional optional module in three studies. Results demonstrated a significant reduction in insomnia as measured by the insomnia severity index [-3.28; 95% CI=-4.51,-2.05; I2=0%]), which equates to a moderate effect size (0.05). Risk of bias was co

205. The Early Growth Genetics (EGG) and EArly Genetics and Lifecourse Epidemiology (EAGLE) Consortia: design, results and future prospects

Author: Middeldorp, Christel, Felix, Janine, Rodriguez, Alina, Mahajan, Anubha, EArly Genetics Lifecourse Epidemiology (EAGLE) consortium, Early Growth Genetics (EGG) consortium, McCarthy, Mark, Middeldorp, Christel, Felix, Janine, Rodriguez, Alina, Mahajan, Anubha, EArly Genetics Lifecourse Epidemiology (EAGLE) consortium, Early Growth Genetics (EGG) consortium, and McCarthy, Mark
Abstract: The impact of many unfavorable childhood traits or diseases, such as low birth weight and mental disorders, is not limited to childhood and adolescence, as they are also associated with poor outcomes in adulthood, such as cardiovascular disease. Insight into the genetic etiology of childhood and adolescent traits and disorders may therefore provide new perspectives, not only on how to improve wellbeing during childhood, but also how to prevent later adverse outcomes. To achieve the sample sizes required for genetic research, the Early Growth Genetics (EGG) and EArly Genetics and Lifecourse Epidemiology (EAGLE) consortia were established. The majority of the participating cohorts are longitudinal population-based samples, but other cohorts with data on early childhood phenotypes are also involved. Cohorts often have a broad focus and collect(ed) data on various somatic and psychiatric traits as well as environmental factors. Genetic variants have been successfully identified for multiple traits, for example, birth weight, atopic dermatitis, childhood BMI, allergic sensitization, and pubertal growth. Furthermore, the results have shown that genetic factors also partly underlie the association with adult traits. As sample sizes are still increasing, it is expected that future analyses will identify additional variants. This, in combination with the development of innovative statistical methods, will provide detailed insight on the mechanisms underlying the transition from childhood to adult disorders.

206. 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

Author: GBD 2013 Risk Factors Collaborators*, Forouzanfar, Mohammad H, Alexander, Lily, Anderson, H Ross, Bachman, Victoria F, Biryukov, Stan, Brauer, Michael, Burnett, Richard, Casey, Daniel, Coates, Matthew M, Cohen, Aaron, Delwiche, Kristen, Estep, Kara, Frostad, Joseph J, Astha, KC, Kyu, Hmwe H, Moradi-Lakeh, Maziar, Ng, Marie, Slepak, Erica Leigh, Thomas, Bernadette A, Wagner, Joseph, Rodriguez*, Alina, GBD 2013 Risk Factors Collaborators*, Forouzanfar, Mohammad H, Alexander, Lily, Anderson, H Ross, Bachman, Victoria F, Biryukov, Stan, Brauer, Michael, Burnett, Richard, Casey, Daniel, Coates, Matthew M, Cohen, Aaron, Delwiche, Kristen, Estep, Kara, Frostad, Joseph J, Astha, KC, Kyu, Hmwe H, Moradi-Lakeh, Maziar, Ng, Marie, Slepak, Erica Leigh, Thomas, Bernadette A, Wagner, Joseph, and Rodriguez*, Alina
Abstract: Summary Background The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the fi rst of a series of annual updates of the GBD. Risk factor quantifi cation, particularly of modifi able 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 fi rst 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 fi ltration rate. For most risks, data for exposure were synthesised with a Bayesian metaregression 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

207. Smoking prevalence and attributable disease burden in 195 countries and territories, 1990–2015: a systematic analysis from the Global Burden of Disease Study 2015

Author: Reitsma, Marissa B., Fullman, Nancy, Ng, Marie, Salama, Joseph S., Abajobir, Amanuel, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abera, Semaw Ferede, Abraham, Biju, Abyu, Gebre Yitayih, Adebiyi, Akindele Olupelumi, Al-Aly, Ziyad, Aleman, Alicia V., Ali, Raghib, Al Alkerwi, Ala'a, Allebeck, Peter, Al-Raddadi, Rajaa Mohammad, Amare, Azmeraw T., Amberbir, Alemayehu, Ammar, Walid, Amrock, Stephen Marc, Antonio, Carl Abelardo T., Asayesh, Hamid, Atnafu, Niguse Tadela, Azzopardi, Peter, Banerjee, Amitava, Barac, Aleksandra, Barrientos-Gutierrez, Tonatiuh, Basto-Abreu, Ana Cristina, Bazargan-Hejazi, Shahrzad, Bedi, Neeraj, Bell, Brent, Bello, Aminu K., Bensenor, Isabela M., Beyene, Addisu Shunu, Bhala, Neeraj, Biryukov, Stan, Bolt, Kaylin, Brenner, Hermann, Butt, Zahid, Cavalleri, Fiorella, Cercy, Kelly, Chen, Honglei, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G., Colistro, Valentina, Colomar, Mercedes, Cornaby, Leslie, Dai, Xiaochen, Damtew, Solomon Abrha, Dandona, Lalit, Dandona, Rakhi, Dansereau, Emily, Davletov, Kairat, Dayama, Anand, Degfie, Tizta Tilahun, Deribew, Amare, Dharmaratne, Samath D., Dimtsu, Balem Demtsu, Doyle, Kerrie E., Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Estep, Kara, Faraon, Emerito Jose Aquino, Farzadfar, Farshad, Feigin, Valery L., Feigl, Andrea B., Fischer, Florian, Friedman, Joseph, G/hiwot, Tsegaye Tewelde, Gall, Seana L., Gao, Wayne, Gillum, Richard F., Gold, Audra L., Gopalani, Sameer Vali, Gotay, Carolyn C, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Hamadeh, Randah Ribhi, Hankey, Graeme, Harb, Hilda L., Hay, Simon I., Horino, Masako, Horita, Nobuyuki, Hosgood, H. Dean, Husseini, Abdullatif, Ileanu, Bogdan Vasile, Islami, Farhad, Jiang, Guohong, Jiang, Ying, Jonas, Jost B., Kabir, Zubair, Kamal, Ritul, Kasaeian, Amir, Kesavachandran, Chandrasekharan Nair, Khader, Yousef S., Khalil, Ibrahim, Khang, Young-Ho, Khera, Sahil, Khubchandani, Jagdish, Kim, Daniel, Kim, Yun Jin, Kimokoti, Ruth W., Kinfu, Yohannes, Knibbs, Luke D., Kokubo, Yoshihiro, Kolte, Dhaval, Kopec, Jacek, Kosen, Soewarta, Kotsakis, Georgios A., Koul, Parvaiz A., Koyanagi, Ai, Krohn, Kristopher J., Krueger, Hans, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kulkarni, Chanda, Kumar, G. Anil, Leasher, Janet L., Lee, Alexander, Leinsalu, Mall, Li, Tong, Linn, Shai, Liu, Patrick, Liu, Shiwei, Lo, Loon-Tzian, Lopez, Alan D., Ma, Stefan, El Razek, Hassan Magdy Abd, Majeed, Azeem, Malekzadeh, Reza, Malta, Deborah Carvalho, Manamo, Wondimu Ayele, Martinez-Raga, Jose, Mekonnen, Alemayehu Berhane, Mendoza, Walter, Miller, Ted R., Mohammad, Karzan Abdulmuhsin, Morawska, Lidia, Musa, Kamarul Imran, Nagel, Gabriele, Neupane, Sudan Prasad, Nguyen, Quyen, Nguyen, Grant, Oh, In-Hwan, Oyekale, Abayomi Samuel, PA, Mahesh, Pana, Adrian, Park, Eun-Kee, Patil, Snehal T., Patton, George C., Pedro, Joao, Qorbani, Mostafa, Rafay, Anwar, Rahman, Mahfuzar, Rai, Rajesh Kumar, Ram, Usha, Ranabhat, Chhabi Lal, Refaat, Amany H., Reinig, Nickolas, Roba, Hirbo Shore, Rodriguez, Alina, Roman, Yesenia, Roth, Gregory, Roy, Ambuj, Sagar, Rajesh, Salomon, Joshua, Sanabria, Juan, de Souza Santos, Itamar, Sartorius, Benn, Satpathy, Maheswar, Sawhney, Monika, Sawyer, Susan, Saylan, Mete, Schaub, Michael P., Schluger, Neil, Schutte, Aletta Elisabeth, Sepanlou, Sadaf G., Serdar, Berrin, Shaikh, Masood Ali, She, Jun, Shin, Min-Jeong, Shiri, Rahman, Shishani, Kawkab, Shiue, Ivy, Sigfusdottir, Inga Dora, Silverberg, Jonathan I., Singh, Jasvinder, Singh, Virendra, Slepak, Erica Leigh, Soneji, Samir, Soriano, Joan B., Soshnikov, Sergey, Sreeramareddy, Chandrashekhar T, Stein, Dan J., Stranges, Saverio, Subart, Michelle L., Swaminathan, Soumya, Szoeke, Cassandra E. I., Tefera, Worku Mekonnen, Topor-Madry, Roman, Tran, Bach, Tsilimparis, Nikolaos, Tymeson, Hayley, Ukwaja, Kingsley Nnanna, Updike, Rachel, Uthman, Olalekan A., Violante, Francesco Saverio, Vladimirov, Sergey K., Vlassov, Vasiliy, Vollset, Stein Emil, Vos, Theo, Weiderpass, Elisabete, Wen, Chi-Pan, Werdecker, Andrea, Wilson, Shelley, Wubshet, Mamo, Xiao, Lin, Yakob, Bereket, Yano, Yuichiro, Ye, Penpeng, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z., Yu, Chuanhua, Zaidi, Zoubida, El Sayed Zaki, Maysaa, Zhang, Anthony Lin, Zipkin, Ben, Murray, Christopher J. L., Forouzanfar, Mohammad H., Gakidou, Emmanuela, Reitsma, Marissa B., Fullman, Nancy, Ng, Marie, Salama, Joseph S., Abajobir, Amanuel, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abera, Semaw Ferede, Abraham, Biju, Abyu, Gebre Yitayih, Adebiyi, Akindele Olupelumi, Al-Aly, Ziyad, Aleman, Alicia V., Ali, Raghib, Al Alkerwi, Ala'a, Allebeck, Peter, Al-Raddadi, Rajaa Mohammad, Amare, Azmeraw T., Amberbir, Alemayehu, Ammar, Walid, Amrock, Stephen Marc, Antonio, Carl Abelardo T., Asayesh, Hamid, Atnafu, Niguse Tadela, Azzopardi, Peter, Banerjee, Amitava, Barac, Aleksandra, Barrientos-Gutierrez, Tonatiuh, Basto-Abreu, Ana Cristina, Bazargan-Hejazi, Shahrzad, Bedi, Neeraj, Bell, Brent, Bello, Aminu K., Bensenor, Isabela M., Beyene, Addisu Shunu, Bhala, Neeraj, Biryukov, Stan, Bolt, Kaylin, Brenner, Hermann, Butt, Zahid, Cavalleri, Fiorella, Cercy, Kelly, Chen, Honglei, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G., Colistro, Valentina, Colomar, Mercedes, Cornaby, Leslie, Dai, Xiaochen, Damtew, Solomon Abrha, Dandona, Lalit, Dandona, Rakhi, Dansereau, Emily, Davletov, Kairat, Dayama, Anand, Degfie, Tizta Tilahun, Deribew, Amare, Dharmaratne, Samath D., Dimtsu, Balem Demtsu, Doyle, Kerrie E., Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Estep, Kara, Faraon, Emerito Jose Aquino, Farzadfar, Farshad, Feigin, Valery L., Feigl, Andrea B., Fischer, Florian, Friedman, Joseph, G/hiwot, Tsegaye Tewelde, Gall, Seana L., Gao, Wayne, Gillum, Richard F., Gold, Audra L., Gopalani, Sameer Vali, Gotay, Carolyn C, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Hamadeh, Randah Ribhi, Hankey, Graeme, Harb, Hilda L., Hay, Simon I., Horino, Masako, Horita, Nobuyuki, Hosgood, H. Dean, Husseini, Abdullatif, Ileanu, Bogdan Vasile, Islami, Farhad, Jiang, Guohong, Jiang, Ying, Jonas, Jost B., Kabir, Zubair, Kamal, Ritul, Kasaeian, Amir, Kesavachandran, Chandrasekharan Nair, Khader, Yousef S., Khalil, Ibrahim, Khang, Young-Ho, Khera, Sahil, Khubchandani, Jagdish, Kim, Daniel, Kim, Yun Jin, Kimokoti, Ruth W., Kinfu, Yohannes, Knibbs, Luke D., Kokubo, Yoshihiro, Kolte, Dhaval, Kopec, Jacek, Kosen, Soewarta, Kotsakis, Georgios A., Koul, Parvaiz A., Koyanagi, Ai, Krohn, Kristopher J., Krueger, Hans, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kulkarni, Chanda, Kumar, G. Anil, Leasher, Janet L., Lee, Alexander, Leinsalu, Mall, Li, Tong, Linn, Shai, Liu, Patrick, Liu, Shiwei, Lo, Loon-Tzian, Lopez, Alan D., Ma, Stefan, El Razek, Hassan Magdy Abd, Majeed, Azeem, Malekzadeh, Reza, Malta, Deborah Carvalho, Manamo, Wondimu Ayele, Martinez-Raga, Jose, Mekonnen, Alemayehu Berhane, Mendoza, Walter, Miller, Ted R., Mohammad, Karzan Abdulmuhsin, Morawska, Lidia, Musa, Kamarul Imran, Nagel, Gabriele, Neupane, Sudan Prasad, Nguyen, Quyen, Nguyen, Grant, Oh, In-Hwan, Oyekale, Abayomi Samuel, PA, Mahesh, Pana, Adrian, Park, Eun-Kee, Patil, Snehal T., Patton, George C., Pedro, Joao, Qorbani, Mostafa, Rafay, Anwar, Rahman, Mahfuzar, Rai, Rajesh Kumar, Ram, Usha, Ranabhat, Chhabi Lal, Refaat, Amany H., Reinig, Nickolas, Roba, Hirbo Shore, Rodriguez, Alina, Roman, Yesenia, Roth, Gregory, Roy, Ambuj, Sagar, Rajesh, Salomon, Joshua, Sanabria, Juan, de Souza Santos, Itamar, Sartorius, Benn, Satpathy, Maheswar, Sawhney, Monika, Sawyer, Susan, Saylan, Mete, Schaub, Michael P., Schluger, Neil, Schutte, Aletta Elisabeth, Sepanlou, Sadaf G., Serdar, Berrin, Shaikh, Masood Ali, She, Jun, Shin, Min-Jeong, Shiri, Rahman, Shishani, Kawkab, Shiue, Ivy, Sigfusdottir, Inga Dora, Silverberg, Jonathan I., Singh, Jasvinder, Singh, Virendra, Slepak, Erica Leigh, Soneji, Samir, Soriano, Joan B., Soshnikov, Sergey, Sreeramareddy, Chandrashekhar T, Stein, Dan J., Stranges, Saverio, Subart, Michelle L., Swaminathan, Soumya, Szoeke, Cassandra E. I., Tefera, Worku Mekonnen, Topor-Madry, Roman, Tran, Bach, Tsilimparis, Nikolaos, Tymeson, Hayley, Ukwaja, Kingsley Nnanna, Updike, Rachel, Uthman, Olalekan A., Violante, Francesco Saverio, Vladimirov, Sergey K., Vlassov, Vasiliy, Vollset, Stein Emil, Vos, Theo, Weiderpass, Elisabete, Wen, Chi-Pan, Werdecker, Andrea, Wilson, Shelley, Wubshet, Mamo, Xiao, Lin, Yakob, Bereket, Yano, Yuichiro, Ye, Penpeng, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z., Yu, Chuanhua, Zaidi, Zoubida, El Sayed Zaki, Maysaa, Zhang, Anthony Lin, Zipkin, Ben, Murray, Christopher J. L., Forouzanfar, Mohammad H., and Gakidou, Emmanuela
Abstract: Background The scale-up of tobacco control, especially after the adoption of the Framework Convention for Tobacco Control, is a major public health success story. Nonetheless, smoking remains a leading risk for early death and disability worldwide, and therefore continues to require sustained political commitment. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) offers a robust platform through which global, regional, and national progress toward achieving smoking-related targets can be assessed. Methods We synthesised 2818 data sources with spatiotemporal Gaussian process regression and produced estimates of daily smoking prevalence by sex, age group, and year for 195 countries and territories from 1990 to 2015. We analysed 38 risk-outcome pairs to generate estimates of smoking-attributable mortality and disease burden, as measured by disability-adjusted life-years (DALYs). We then performed a cohort analysis of smoking prevalence by birth-year cohort to better understand temporal age patterns in smoking. We also did a decomposition analysis, in which we parsed out changes in all-cause smoking-attributable DALYs due to changes in population growth, population ageing, smoking prevalence, and risk-deleted DALY rates. Finally, we explored results by level of development using the Socio-demographic Index (SDI). Findings Worldwide, the age-standardised prevalence of daily smoking was 25·0% (95% uncertainty interval [UI] 24·2–25·7) for men and 5·4% (5·1–5·7) for women, representing 28·4% (25·8–31·1) and 34·4% (29·4–38·6) reductions, respectively, since 1990. A greater percentage of countries and territories achieved significant annualised rates of decline in smoking prevalence from 1990 to 2005 than in between 2005 and 2015; however, only four countries had significant annualised increases in smoking prevalence between 2005 and 2015 (Congo [Brazzaville] and Azerbaijan for men and Kuwait and Timor-Leste for women). In 2015, 11·5% of global deaths (6·4

208. Slip of the tongue: implications for evolution and language development

Author: Forrester, Gillian S., Rodriguez, Alina, Forrester, Gillian S., and Rodriguez, Alina
Abstract: A prevailing theory regarding the evolution of language implicates a gestural stage prior to the emergence of speech. In support of a transition of human language from a gestural to a vocal system, articulation of the hands and the tongue are underpinned by overlapping left hemisphere dominant neural regions. Behavioral studies demonstrate that human adults perform sympathetic mouth actions in imitative synchrony with manual actions. Additionally, right-handedness for precision manual actions in children has been correlated with the typical development of language, while a lack of hand bias has been associated with psychopathology. It therefore stands to reason that sympathetic mouth actions during fine precision motor action of the hands may be lateralized. We employed a fine-grained behavioral coding paradigm to provide the first investigation of tongue protrusions in typically developing 4-year old children. Tongue protrusions were investigated across a range of cognitive tasks that required varying degrees of manual action: precision motor action, gross motor action and no motor actions. The rate of tongue protrusions was influenced by the motor requirements of the task and tongue protrusions were significantly right-biased for only precision manual motor action (p < .001). From an evolutionary perspective, tongue protrusions can drive new investigations regarding how an early human communication system transitioned from hand to mouth. From a developmental perspective, the present study may serve to reveal patterns of tongue protrusions during the motor development of typically developing children.

209. Guidelines for identification and treatment of individuals with attention deficit/hyperactivity disorder and associated fetal alcohol spectrum disorders based upon expert consensus

Author: Young, Susan, Absoud, Michael, Blackburn, Carolyn, Branney, Polly, Colley, Bill, Farrag, Emad, Fleisher, Susan, Gregory, Ges, Gudjonsson, Gisli H., Kim, Keira, O’Malley, Kieran D., Plant, Moira, Rodriguez, Alina, Ozer, Susan, Takon, Inyang, Woodhouse, Emma, Mukherjee, Raja, Young, Susan, Absoud, Michael, Blackburn, Carolyn, Branney, Polly, Colley, Bill, Farrag, Emad, Fleisher, Susan, Gregory, Ges, Gudjonsson, Gisli H., Kim, Keira, O’Malley, Kieran D., Plant, Moira, Rodriguez, Alina, Ozer, Susan, Takon, Inyang, Woodhouse, Emma, and Mukherjee, Raja
Abstract: BACKGROUND: The association of attention deficit/hyperactivity disorder (ADHD) and fetal alcohol spectrum disorders (FASD) results in a complex constellation of symptoms that complicates the successful diagnosis and treatment of the affected individual. Current literature lacks formal guidelines, randomized control trials, and evidence-based treatment plans for individuals with ADHD and associated FASD. Therefore, a meeting of professional experts was organized with the aim of producing a consensus on identification and treatment guidelines that will aid clinicians in caring for this unique patient population. METHODS: Experts from multiple disciplines in the fields of ADHD and FASD convened in London, United Kingdom, for a meeting hosted by the United Kingdom ADHD Partnership (UKAP; www.UKADHD.com ) in June 2015. The meeting provided the opportunity to address the complexities of ADHD and FASD from different perspectives and included presentations, discussions, and group work. The attendees worked towards producing a consensus for a unified approach to ADHD and associated FASD. RESULTS: The authors successfully came to consensus and produced recommended guidelines with specific regards to identification and assessment, interventions and treatments, and multiagency liaisons and care management, highlighting that a lifespan approach to treatment needs to be adopted by all involved. Included in the guidelines are: 1) unique 'red flags', which when identified in the ADHD population can lead to an accurate associated FASD diagnosis, 2) a treatment decision tree, and 3) recommendations for multiagency care management. CONCLUSIONS: While clinically useful guidelines were achieved, more research is still needed to contribute to the knowledge base about the diagnosis, treatment, and management of those with ADHD and associated FASD.

210. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Author: Rodriguez, Alina and Rodriguez, Alina
Abstract: Background Up-to-date evidence about levels and trends in disease and injury incidence, prevalence, and years lived with disability (YLDs) is an essential input into global, regional, and national health policies. In the Global Burden of Disease Study 2013 (GBD 2013), we estimated these quantities for acute and chronic diseases and injuries for 188 countries between 1990 and 2013. Methods Estimates were calculated for disease and injury incidence, prevalence, and YLDs using GBD 2010 methods with some important refinements. Results for incidence of acute disorders and prevalence of chronic disorders are new additions to the analysis. Key improvements include expansion to the cause and sequelae list, updated systematic reviews, use of detailed injury codes, improvements to the Bayesian meta-regression method (DisMod-MR), and use of severity splits for various causes. An index of data representativeness, showing data availability, was calculated for each cause and impairment during three periods globally and at the country level for 2013. In total, 35 620 distinct sources of data were used and documented to calculated estimates for 301 diseases and injuries and 2337 sequelae. The comorbidity simulation provides estimates for the number of sequelae, concurrently, by individuals by country, year, age, and sex. Disability weights were updated with the addition of new population-based survey data from four countries. Findings Disease and injury were highly prevalent; only a small fraction of individuals had no sequelae. Comorbidity rose substantially with age and in absolute terms from 1990 to 2013. Incidence of acute sequelae were predominantly infectious diseases and short-term injuries, with over 2 billion cases of upper respiratory infections and diarrhoeal disease episodes in 2013, with the notable exception of tooth pain due to permanent caries with more than 200 million incident cases in 2013. Conversely, leading chronic sequelae were largely attributable to non-com

211. Changes in health in England, with analysis by English regions and areas of deprivation, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Author: Newton, John N., Briggs, Adam D. M., Murray, Christopher J. L., Dicker, Daniel, Foreman, Kyle J., Wang, Haidong, Naghavi, Mohsen, Forouzanfar, Mohammad H., Ohno, Summer Lockett, Barber, Ryan M., Vos, Theo, Stanaway, Jeffrey D., Schmidt, Jürgen C, Hughes, Andrew J, Fay, Derek F J, Ecob, Russell, Gresser, Charis, McKee, Martin, Rutter, Harry, Abubakar, Ibrahim, Ali, Raghib, Anderson, H Ross, Banerjee, Amitava, Bennett, Derrick A, Bernabé, Eduardo, Bhui, Kamaldeep S, Biryukov, Stanley M, Bourne, Rupert R, Brayne, Carol E G, Bruce, Nigel G, Brugha, Traolach S, Burch, Michael, Capewell, Simon, Casey, Daniel, Chowdhury, Rajiv, Coates, Matthew M, Cooper, Cyrus, Critchley, Julia A, Dargan, Paul I, Dherani, Mukesh K, Elliott, Paul, Ezzati, Majid, Fenton, Kevin A, Fraser, Maya S, Fürst, Thomas, Greaves, Felix, Green, Mark A, Gunnell, David J, Hannigan, Bernadette M, Hay, Roderick J, Hay, Simon I, Hemingway, Harry, Larson, Heidi J, Looker, Katharine J, Lunevicius, Raimundas, Lyons, Ronan A, Marcenes, Wagner, Mason-Jones, Amanda J, Matthews, Fiona E, Moller, Henrik, Murdoch, Michele E, Newton, Charles R, Pearce, Neil, Piel, Frédéric B, Pope, Daniel, Rahimi, Kazem, Rodriguez, Alina, Scarborough, Peter, Schumacher, Austin E, Shiue, Ivy, Smeeth, Liam, Tedstone, Alison, Valabhji, Jonathan, Williams, Hywel C, Wolfe, Charles D A, Woolf, Anthony D, Davis, Adrian C J, Newton, John N., Briggs, Adam D. M., Murray, Christopher J. L., Dicker, Daniel, Foreman, Kyle J., Wang, Haidong, Naghavi, Mohsen, Forouzanfar, Mohammad H., Ohno, Summer Lockett, Barber, Ryan M., Vos, Theo, Stanaway, Jeffrey D., Schmidt, Jürgen C, Hughes, Andrew J, Fay, Derek F J, Ecob, Russell, Gresser, Charis, McKee, Martin, Rutter, Harry, Abubakar, Ibrahim, Ali, Raghib, Anderson, H Ross, Banerjee, Amitava, Bennett, Derrick A, Bernabé, Eduardo, Bhui, Kamaldeep S, Biryukov, Stanley M, Bourne, Rupert R, Brayne, Carol E G, Bruce, Nigel G, Brugha, Traolach S, Burch, Michael, Capewell, Simon, Casey, Daniel, Chowdhury, Rajiv, Coates, Matthew M, Cooper, Cyrus, Critchley, Julia A, Dargan, Paul I, Dherani, Mukesh K, Elliott, Paul, Ezzati, Majid, Fenton, Kevin A, Fraser, Maya S, Fürst, Thomas, Greaves, Felix, Green, Mark A, Gunnell, David J, Hannigan, Bernadette M, Hay, Roderick J, Hay, Simon I, Hemingway, Harry, Larson, Heidi J, Looker, Katharine J, Lunevicius, Raimundas, Lyons, Ronan A, Marcenes, Wagner, Mason-Jones, Amanda J, Matthews, Fiona E, Moller, Henrik, Murdoch, Michele E, Newton, Charles R, Pearce, Neil, Piel, Frédéric B, Pope, Daniel, Rahimi, Kazem, Rodriguez, Alina, Scarborough, Peter, Schumacher, Austin E, Shiue, Ivy, Smeeth, Liam, Tedstone, Alison, Valabhji, Jonathan, Williams, Hywel C, Wolfe, Charles D A, Woolf, Anthony D, and Davis, Adrian C J
Abstract: Background In the Global Burden of Disease Study 2013 (GBD 2013), knowledge about health and its determinants has been integrated into a comparable framework to inform health policy. Outputs of this analysis are relevant to current policy questions in England and elsewhere, particularly on health inequalities. We use GBD 2013 data on mortality and causes of death, and disease and injury incidence and prevalence to analyse the burden of disease and injury in England as a whole, in English regions, and within each English region by deprivation quintile. We also assess disease and injury burden in England attributable to potentially preventable risk factors. England and the English regions are compared with the remaining constituent countries of the UK and with comparable countries in the European Union (EU) and beyond. Methods We extracted data from the GBD 2013 to compare mortality, causes of death, years of life lost (YLLs), years lived with a disability (YLDs), and disability-adjusted life-years (DALYs) in England, the UK, and 18 other countries (the first 15 EU members [apart from the UK] and Australia, Canada, Norway, and the USA [EU15+]). We extended elements of the analysis to English regions, and subregional areas defined by deprivation quintile (deprivation areas). We used data split by the nine English regions (corresponding to the European boundaries of the Nomenclature for Territorial Statistics level 1 [NUTS 1] regions), and by quintile groups within each English region according to deprivation, thereby making 45 regional deprivation areas. Deprivation quintiles were defined by area of residence ranked at national level by Index of Multiple Deprivation score, 2010. Burden due to various risk factors is described for England using new GBD methodology to estimate independent and overlapping attributable risk for five tiers of behavioural, metabolic, and environmental risk factors. We present results for 306 causes and 2337 sequelae, and 79 risks or risk clu

212. Different risk factors between disruptive behavior disorders and ADHD in Northern Finland birth cohort 1986

Author: Nordstrom, Tanja, Hurtig, Tuula, Rodriguez, Alina, Savolainen, Jukka, Rautio, Arja, Moilanen, Irma, Taanila, Anja, Ebeling, Hanna, Nordstrom, Tanja, Hurtig, Tuula, Rodriguez, Alina, Savolainen, Jukka, Rautio, Arja, Moilanen, Irma, Taanila, Anja, and Ebeling, Hanna
Abstract: Objective: To examine different risk factors between disruptive behavior disorders (DBD) and ADHD or combined DBD and ADHD. Method: The study population was derived from the Northern Finland Birth Cohort 1986. Psychiatric diagnoses were defined from the Schedule for Affective Disorders and Schizophrenia for School-Age Children–Present and Lifetime Version (K-SADS-PL) interview. The study sample was divided into four groups—people with DBD (n = 44), with ADHD (n = 91), with both (n = 72), and without either (n = 250)—to evaluate the different risk factors behind these disorders. Results: After adjusting with possible confounding factors, female gender and paternal admittance to inpatient psychiatric care increased the odds that an adolescent was having DBD. Childhood hyperactivity symptoms increased the odds of having ADHD and childhood hyperactivity symptoms and scholastic impairment increased the odds of having both disorders. Conclusion: Our study indicates DBD and ADHD have clearly different risk factors, and the impact of the paternal factors on DBD should be noted more than has been before.

213. Is prenatal exposure to maternal obesity linked to child mental health?

Author: Bagchi, Debasis, Rodriguez, Alina, Bagchi, Debasis, and Rodriguez, Alina

214. Changes in health in England, with analysis by English regions and areas of deprivation, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Author: Newton, John N., Briggs, Adam D. M., Murray, Christopher J. L., Dicker, Daniel, Foreman, Kyle J., Wang, Haidong, Naghavi, Mohsen, Forouzanfar, Mohammad H., Ohno, Summer Lockett, Barber, Ryan M., Vos, Theo, Stanaway, Jeffrey D., Schmidt, Jürgen C., Hughes, Andrew J., Fay, Derek F. J., Ecob, Russell, Gresser, Charis, McKee, Martin, Rutter, Harry, Abubakar, Ibrahim, Ali, Raghib, Anderson, H. Ross, Banerjee, Amitava, Bennett, Derrick A., Bernabé, Eduardo, Bhui, Kamaldeep S., Biryukov, Stanley M., Bourne, Rupert R., Brayne, Carol E. G., Bruce, Nigel G., Brugha, Traolach S., Burch, Michael, Capewell, Simon, Casey, Daniel, Chowdhury, Rajiv, Coates, Matthew M., Cooper, Cyrus, Critchley, Julia A., Dargan, Paul I., Dherani, Mukesh K., Elliott, Paul, Ezzati, Majid, Fenton, Kevin A., Fraser, Maya S., Fürst, Thomas, Greaves, Felix, Green, Mark A., Gunnell, David J., Hannigan, Bernadette M., Hay, Roderick J., Hay, Simon I., Hemingway, Harry, Larson, Heidi J., Looker, Katharine J., Lunevicius, Raimundas, Lyons, Ronan A., Marcenes, Wagner, Mason-Jones, Amanda J., Matthews, Fiona E., Moller, Henrik, Murdoch, Michele E., Newton, Charles R., Pearce, Neil, Piel, Frédéric B., Pope, Daniel, Rahimi, Kazem, Rodriguez, Alina, Scarborough, Peter, Schumacher, Austin E., Shiue, Ivy, Smeeth, Liam, Tedstone, Alison, Valabhji, Jonathan, Williams, Hywel C., Wolfe, Charles D. A., Woolf, Anthony D., Davis, Adrian C. J., Newton, John N., Briggs, Adam D. M., Murray, Christopher J. L., Dicker, Daniel, Foreman, Kyle J., Wang, Haidong, Naghavi, Mohsen, Forouzanfar, Mohammad H., Ohno, Summer Lockett, Barber, Ryan M., Vos, Theo, Stanaway, Jeffrey D., Schmidt, Jürgen C., Hughes, Andrew J., Fay, Derek F. J., Ecob, Russell, Gresser, Charis, McKee, Martin, Rutter, Harry, Abubakar, Ibrahim, Ali, Raghib, Anderson, H. Ross, Banerjee, Amitava, Bennett, Derrick A., Bernabé, Eduardo, Bhui, Kamaldeep S., Biryukov, Stanley M., Bourne, Rupert R., Brayne, Carol E. G., Bruce, Nigel G., Brugha, Traolach S., Burch, Michael, Capewell, Simon, Casey, Daniel, Chowdhury, Rajiv, Coates, Matthew M., Cooper, Cyrus, Critchley, Julia A., Dargan, Paul I., Dherani, Mukesh K., Elliott, Paul, Ezzati, Majid, Fenton, Kevin A., Fraser, Maya S., Fürst, Thomas, Greaves, Felix, Green, Mark A., Gunnell, David J., Hannigan, Bernadette M., Hay, Roderick J., Hay, Simon I., Hemingway, Harry, Larson, Heidi J., Looker, Katharine J., Lunevicius, Raimundas, Lyons, Ronan A., Marcenes, Wagner, Mason-Jones, Amanda J., Matthews, Fiona E., Moller, Henrik, Murdoch, Michele E., Newton, Charles R., Pearce, Neil, Piel, Frédéric B., Pope, Daniel, Rahimi, Kazem, Rodriguez, Alina, Scarborough, Peter, Schumacher, Austin E., Shiue, Ivy, Smeeth, Liam, Tedstone, Alison, Valabhji, Jonathan, Williams, Hywel C., Wolfe, Charles D. A., Woolf, Anthony D., and Davis, Adrian C. J.
Abstract: In the Global Burden of Disease Study 2013 (GBD 2013), knowledge about health and its determinants has been integrated into a comparable framework to inform health policy. Outputs of this analysis are relevant to current policy questions in England and elsewhere, particularly on health inequalities. We use GBD 2013 data on mortality and causes of death, and disease and injury incidence and prevalence to analyse the burden of disease and injury in England as a whole, in English regions, and within each English region by deprivation quintile. We also assess disease and injury burden in England attributable to potentially preventable risk factors. England and the English regions are compared with the remaining constituent countries of the UK and with comparable countries in the European Union (EU) and beyond.

215. The interplay of variants near LEKR and CCNL1 and social stress in relation to birth size

Author: Wang, Guoying, Ali Khan, Anokhi, Rodriguez, Alina, Sebert, Sylvain, Kaakinen, Marika, Cauchi, Stéphane, Froguel, Philippe, Hartikainen, Anna-Liisa, Pouta, Anneli, Järvelin, Marjo-Riitta, Wang, Guoying, Ali Khan, Anokhi, Rodriguez, Alina, Sebert, Sylvain, Kaakinen, Marika, Cauchi, Stéphane, Froguel, Philippe, Hartikainen, Anna-Liisa, Pouta, Anneli, and Järvelin, Marjo-Riitta
Abstract: Background We previously identified via a genome wide association study variants near LEKR and CCNL1 and in the ADCY5 genes lead to lower birthweight. Here, we study the impact of these variants and social stress during pregnancy, defined as social adversity and neighborhood disparity, on infant birth size. We aimed to determine whether the addition of genetic variance magnified the observed associations. Methodology/Principal Findings We analyzed data from the Northern Finland Birth Cohort 1986 (n = 5369). Social adversity was defined by young maternal age (<20 years), low maternal education (<11 years), and/or single marital status. Neighborhood social disparity was assessed by discrepancy between neighborhoods relative to personal socio-economic status. These variables are indicative of social and socioeconomic stress, but also of biological risk. The adjusted multiple regression analysis showed smaller birth size in both infants of mothers who experienced social adversity (birthweight by −40.4 g, 95%CI −61.4, −19.5; birth length −0.14 cm, 95%CI −0.23, −0.05; head circumference −0.09 cm 95%CI −0.15, −0.02) and neighborhood disparity (birthweight −28.8 g, 95%CI −47.7, −10.0; birth length −0.12 cm, 95%CI −0.20, −0.05). The birthweight-lowering risk allele (SNP rs900400 near LEKR and CCNL1) magnified this association in an additive manner. However, likely due to sample size restriction, this association was not significant for the SNP rs9883204 in ADCY5. Birth size difference due to social stress was greater in the presence of birthweight-lowering alleles. Conclusions/Significance Social adversity, neighborhood disparity, and genetic variants have independent associations with infant birth size in the mutually adjusted analyses. If the newborn carried a risk allele rs900400 near LEKR/CCNL1, the impact of stress on birth size was stronger. These observations give support to the hypothesis that individuals with genetic or other biological risk are more vulnerable to e

216. 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

Author: Forouzanfar, Mohammad H., Alexander, Lily, Anderson, H. Ross, Bachman, Victoria F., Biryukov, Stan, Brauer, Michael, Burnett, Richard, Casey, Daniel, Coates, Matthew M., Cohen, Aaron, Delwiche, Kristen, Estep, Kara, Frostad, Joseph J., KC, Astha, Kyu, Hmwe H., Moradi-Lakeh, Maziar, Ng, Marie, Slepak, Erica Leigh, Thomas, Bernadette A., Wagner, Joseph, Aasvang, Gunn Marit, Abbafati, Cristiana, Ozgoren, Ayse Abbasoglu, Abd-Allah, Foad, Abera, Semaw F., Aboyans, Victor, Abraham, Biju, Abraham, Jerry Puthenpurakal, Abubakar, Ibrahim, Abu-Rmeileh, Niveen M. E., Aburto, Tania C., Achoki, Tom, Adelekan, Ademola, Adofo, Koranteng, Adou, Arsène K., Adsuar, José C., Afshin, Ashkan, Agardh, Emilie E., Al Khabouri, Mazin J., Al Lami, Faris H., Alam, Sayed Saidul, Alasfoor, Deena, Albittar, Mohammed I., Alegretti, Miguel A., Aleman, Alicia V., Alemu, Zewdie A., Alfonso-Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Ali, Mohammed K., Alla, François, Allebeck, Peter, Allen, Peter J., Alsharif, Ubai, Alvarez, Elena, Alvis-Guzman, Nelson, Amankwaa, Adansi A., Amare, Azmeraw T., Ameh, Emmanuel A., Ameli, Omid, Amini, Heresh, Ammar, Walid, Anderson, Benjamin O., Antonio, Carl Abelardo T., Anwari, Palwasha, Cunningham, Solveig Argeseanu, Arnlöv, Johan, Arsenijevic, Valentina S. Arsic, Artaman, Al, Asghar, Rana J., Assadi, Reza, Atkins, Lydia S., Atkinson, Charles, Avila, Marco A., Awuah, Baffour, Badawi, Alaa, Bahit, Maria C., Bakfalouni, Talal, Balakrishnan, Kalpana, Balalla, Shivanthi, Balu, Ravi Kumar, Banerjee, Amitava, Barber, Ryan M., Barker-Collo, Suzanne L., Barquera, Simon, Barregard, Lars, Barrero, Lope H., Barrientos-Gutierrez, Tonatiuh, Basto-Abreu, Ana C., Basu, Arindam, Basu, Sanjay, Basulaiman, Mohammed O., Ruvalcaba, Carolina Batis, Beardsley, Justin, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L., Benjet, Corina, Bennett, Derrick A., Benzian, Habib, Bernabé, Eduardo, Beyene, Tariku J., Bhala, Neeraj, Bhalla, Ashish, Bhutta, Zulfiqar A., Bikbov, Boris, Abdulhak, Aref A. Bin, Blore, Jed D., Blyth, Fiona M., Bohensky, Megan A., Başara, Berrak Bora, Borges, Guilherme, Bornstein, Natan M., Bose, Dipan, Boufous, Soufiane, Bourne, Rupert R., Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J., Brenner, Hermann, Briggs, Adam D. M., Broday, David M., Brooks, Peter M., Bruce, Nigel G., Brugha, Traolach S., Brunekreef, Bert, Buchbinder, Rachelle, Bui, Linh N., Bukhman, Gene, Bulloch, Andrew G., Burch, Michael, Burney, Peter G. J., Campos-Nonato, Ismael R., Campuzano, Julio C., Cantoral, Alejandra J., Caravanos, Jack, Cárdenas, Rosario, Cardis, Elisabeth, Carpenter, David O., Caso, Valeria, Castañeda-Orjuela, Carlos A., Castro, Ruben E., Catalá-López, Ferrán, Cavalleri, Fiorella, Çavlin, Alanur, Chadha, Vineet K., Chang, Jung-chen, Charlson, Fiona J., Chen, Honglei, Chen, Wanqing, Chen, Zhengming, Chiang, Peggy P., Chimed-Ochir, Odgerel, Chowdhury, Rajiv, Christophi, Costas A., Chuang, Ting-Wu, Chugh, Sumeet S., Cirillo, Massimo, Claßen, Thomas K. D., Colistro, Valentina, Colomar, Mercedes, Colquhoun, Samantha M., Contreras, Alejandra G., Cooper, Cyrus, Cooperrider, Kimberly, Cooper, Leslie T., Coresh, Josef, Courville, Karen J., Criqui, Michael H., Cuevas-Nasu, Lucia, Damsere-Derry, James, Danawi, Hadi, Dandona, Lalit, Dandona, Rakhi, Dargan, Paul I., Davis, Adrian, Davitoiu, Dragos V., Dayama, Anand, de Castro, E. Filipa, De la Cruz-Góngora, Vanessa, De Leo, Diego, de Lima, Graça, Degenhardt, Louisa, del Pozo-Cruz, Borja, Dellavalle, Robert P., Deribe, Kebede, Derrett, Sarah, Jarlais, Don C. Des, Dessalegn, Muluken, deVeber, Gabrielle A., Devries, Karen M., Dharmaratne, Samath D., Dherani, Mukesh K., Dicker, Daniel, Ding, Eric L, Dokova, Klara, Dorsey, E. Ray, Driscoll, Tim R., Duan, Leilei, Durrani, Adnan M., Ebel, Beth E., Ellenbogen, Richard G., Elshrek, Yousef M., Endres, Matthias, Ermakov, Sergey P., Erskine, Holly E., Eshrati, Babak, Esteghamati, Alireza, Fahimi, Saman, Faraon, Emerito Jose A., Farzadfar, Farshad, Fay, Derek F. J., Feigin, Valery L., Feigl, Andrea B., Fereshtehnejad, Seyed-Mohammad, Ferrari, Alize J., Ferri, Cleusa P., Flaxman, Abraham D., Fleming, Thomas D., Foigt, Nataliya, Foreman, Kyle J., Paleo, Urbano Fra, Franklin, Richard C., Gabbe, Belinda, Gaffikin, Lynne, Gakidou, Emmanuela, Gamkrelidze, Amiran, Gankpé, Fortuné G., Gansevoort, Ron T., García-Guerra, Francisco A., Gasana, Evariste, Geleijnse, Johanna M., Gessner, Bradford D., Gething, Pete, Gibney, Katherine B., Gillum, Richard F., Ginawi, Ibrahim A. M., Giroud, Maurice, Giussani, Giorgia, Goenka, Shifalika, Goginashvili, Ketevan, Dantes, Hector Gomez, Gona, Philimon, de Cosio, Teresita Gonzalez, González-Castell, Dinorah, Gotay, Carolyn C., Goto, Atsushi, Gouda, Hebe N., Guerrant, Richard L., Gugnani, Harish C., Guillemin, Francis, Gunnell, David, Gupta, Rahul, Gupta, Rajeev, Gutiérrez, Reyna A., Hafezi-Nejad, Nima, Hagan, Holly, Hagstromer, Maria, Halasa, Yara A., Hamadeh, Randah R., Hammami, Mouhanad, Hankey, Graeme J., Hao, Yuantao, Harb, Hilda L., Haregu, Tilahun Nigatu, Haro, Josep Maria, Havmoeller, Rasmus, Hay, Simon I., Hedayati, Mohammad T., Heredia-Pi, Ileana B., Hernandez, Lucia, Heuton, Kyle R., Heydarpour, Pouria, Hijar, Martha, Hoek, Hans W., Hoffman, Howard J., Hornberger, John C., Hosgood, H. Dean, Hoy, Damian G., Hsairi, Mohamed, Hu, Guoqing, Hu, Howard, Huang, Cheng, Huang, John J., Hubbell, Bryan J., Huiart, Laetitia, Husseini, Abdullatif, Iannarone, Marissa L., Iburg, Kim M., Idrisov, Bulat T., Ikeda, Nayu, Innos, Kaire, Inoue, Manami, Islami, Farhad, Ismayilova, Samaya, Jacobsen, Kathryn H., Jansen, Henrica A., Jarvis, Deborah L., Jassal, Simerjot K., Jauregui, Alejandra, Jayaraman, Sudha, Jeemon, Panniyammakal, Jensen, Paul N., Jha, Vivekanand, Jiang, Fan, Jiang, Guohong, Jiang, Ying, Jonas, Jost B., Juel, Knud, Kan, Haidong, Roseline, Sidibe S Kany, Karam, Nadim E., Karch, André, Karema, Corine K., Karthikeyan, Ganesan, Kaul, Anil, Kawakami, Norito, Kazi, Dhruv S., Kemp, Andrew H., Kengne, Andre P., Keren, Andre, Khader, Yousef S., Khalifa, Shams Eldin Ali Hassan, Khan, Ejaz A., Khang, Young-Ho, Khatibzadeh, Shahab, Khonelidze, Irma, Kieling, Christian, Kim, Daniel, Kim, Sungroul, Kim, Yunjin, Kimokoti, Ruth W, Kinfu, Yohannes, Kinge, Jonas M., Kissela, Brett M., Kivipelto, Miia, Knibbs, Luke D., Knudsen, Ann Kristin, Kokubo, Yoshihiro, Kose, M. Rifat, Kosen, Soewarta, Kraemer, Alexander, Kravchenko, Michael, Krishnaswami, Sanjay, Kromhout, Hans, Ku, Tiffany, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kuipers, Ernst J., Kulkarni, Chanda, Kulkarni, Veena S., Kumar, G. Anil, Kwan, Gene F., Lai, Taavi, Balaji, Arjun Lakshmana, Lalloo, Ratilal, Lallukka, Tea, Lam, Hilton, Lan, Qing, Lansingh, Van C., Larson, Heidi J., Larsson, Anders, Laryea, Dennis O., Lavados, Pablo M., Lawrynowicz, Alicia E., Leasher, Janet L., Lee, Jong-Tae, Leigh, James, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Liang, Juan, Liang, Xiaofeng, Lim, Stephen S., Lindsay, M. Patrice, Lipshultz, Steven E., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., Logroscino, Giancarlo, London, Stephanie J., Lopez, Nancy, Lortet-Tieulent, Joannie, Lotufo, Paulo A., Lozano, Rafael, Lunevicius, Raimundas, Ma, Jixiang, Ma, Stefan, Machado, Vasco M. P., MacIntyre, Michael F., Magis-Rodriguez, Carlos, Mahdi, Abbas A., Majdan, Marek, Malekzadeh, Reza, Mangalam, Srikanth, Mapoma, Christopher C., Marape, Marape, Marcenes, Wagner, Margolis, David J, Margono, Christopher, Marks, Guy B., Martin, Randall V., Marzan, Melvin B., Mashal, Mohammad T., Masiye, Felix, Mason-Jones, Amanda J., Matsushita, Kunihiro, Matzopoulos, Richard, Mayosi, Bongani M., Mazorodze, Tasara T., McKay, Abigail C., McKee, Martin, McLain, Abigail, Meaney, Peter A, Medina, Catalina, Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Mekonnen, Wubegzier, Melaku, Yohannes A., Meltzer, Michele, Memish, Ziad A., Mendoza, Walter, Mensah, George A., Meretoja, Atte, Mhimbira, Francis Apolinary, Micha, Renata, Miller, Ted R., Mills, Edward J., Misganaw, Awoke, Mishra, Santosh, Ibrahim, Norlinah Mohamed, Mohammad, Karzan A., Mokdad, Ali H., Mola, Glen L., Monasta, Lorenzo, Hernandez, Julio C. Montañez, Montico, Marcella, Moore, Ami R, Morawska, Lidia, Mori, Rintaro, Moschandreas, Joanna, Moturi, Wilkister N, Mozaffarian, Dariush, Mueller, Ulrich O., Mukaigawara, Mitsuru, Mullany, Erin C., Murthy, Kinnari S., Naghavi, Mohsen, Nahas, Ziad, Naheed, Aliya, Naidoo, Kovin S., Naldi, Luigi, Nand, Devina, Nangia, Vinay, Narayan, KM Venkat, Nash, Denis, Neal, Bruce, Nejjari, Chakib, Neupane, Sudan P., Newton, Charles R., Ngalesoni, Frida N., de Dieu Ngirabega, Jean, Nguyen, Grant, Nguyen, Nhung T., Nieuwenhuijsen, Mark J., Nisar, Muhammad I., Nogueira, José R., Nolla, Joan M., Nolte, Sandra, Norheim, Ole F., Norman, Rosana E., Norrving, Bo, Nyakarahuka, Luke, Oh, In-Hwan, Ohkubo, Takayoshi, Olusanya, Bolajoko O., Omer, Saad B., Opio, John Nelson, Orozco, Ricardo, Pagcatipunan, Rodolfo S., Pain, Amanda W., Pandian, Jeyaraj D., Panelo, Carlo Irwin A., Papachristou, Christina, Park, Eun-Kee, Parry, Charles D., Caicedo, Angel J. Paternina, Patten, Scott B., Paul, Vinod K., Pavlin, Boris I., Pearce, Neil, Pedraza, Lilia S., Pedroza, Andrea, Stokic, Ljiljana Pejin, Pekericli, Ayfer, Pereira, David M., Perez-Padilla, Rogelio, Perez-Ruiz, Fernando, Perico, Norberto, Perry, Samuel A. L., Pervaiz, Aslam, Pesudovs, Konrad, Peterson, Carrie B., Petzold, Max, Phillips, Michael R., Phua, Hwee Pin, Plass, Dietrich, Poenaru, Dan, Polanczyk, Guilherme V., Polinder, Suzanne, Pond, Constance D., Pope, C. Arden, Pope, Daniel, Popova, Svetlana, Pourmalek, Farshad, Powles, John, Prabhakaran, Dorairaj, Prasad, Noela M., Qato, Dima M., Quezada, Amado D., Quistberg, D. Alex A., Racapé, Lionel, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Sajjad Ur, Raju, Murugesan, Rakovac, Ivo, Rana, Saleem M., Rao, Mayuree, Razavi, Homie, Reddy, K. Srinath, Refaat, Amany H., Rehm, Jürgen, Remuzzi, Giuseppe, Ribeiro, Antonio L., Riccio, Patricia M., Richardson, Lee, Riederer, Anne, Robinson, Margaret, Roca, Anna, Rodriguez, Alina, Rojas-Rueda, David, Romieu, Isabelle, Ronfani, Luca, Room, Robin, Roy, Nobhojit, Ruhago, George M., Rushton, Lesley, Sabin, Nsanzimana, Sacco, Ralph L, Saha, Sukanta, Sahathevan, Ramesh, Sahraian, Mohammad Ali, Salomon, Joshua A., Salvo, Deborah, Sampson, Uchechukwu K., Sanabria, Juan R., Sanchez, Luz Maria, Sánchez-Pimienta, Tania G., Sanchez-Riera, Lidia, Sandar, Logan, Santos, Itamar S., Sapkota, Amir, Satpathy, Maheswar, Saunders, James E., Sawhney, Monika, Saylan, Mete I., Scarborough, Peter, Schmidt, Jürgen C., Schneider, Ione J. C., Schöttker, Ben, Schwebel, David C., Scott, James G., Seedat, Soraya, Sepanlou, Sadaf G., Serdar, Berrin, Servan-Mori, Edson E., Shaddick, Gavin, Shahraz, Saeid, Levy, Teresa Shamah, Shangguan, Siyi, She, Jun, Sheikhbahaei, Sara, Shibuya, Kenji, Shin, Hwashin H., Shinohara, Yukito, Shiri, Rahman, Shishani, Kawkab, Shiue, Ivy, Sigfusdottir, Inga D., Silberberg, Donald H., Simard, Edgar P., Sindi, Shireen, Singh, Abhishek, Singh, Gitanjali M., Singh, Jasvinder A., Skirbekk, Vegard, Sliwa, Karen, Soljak, Michael, Soneji, Samir, Søreide, Kjetil, Soshnikov, Sergey, Sposato, Luciano A., Sreeramareddy, Chandrashekhar T., Stapelberg, Nicolas J. C., Stathopoulou, Vasiliki, Steckling, Nadine, Stein, Dan J., Stein, Murray B., Stephens, Natalie, Stöckl, Heidi, Straif, Kurt, Stroumpoulis, Konstantinos, Sturua, Lela, Sunguya, Bruno F., Swaminathan, Soumya, Swaroop, Mamta, Sykes, Bryan L., Tabb, Karen M., Takahashi, Ken, Talongwa, Roberto T., Tandon, Nikhil, Tanne, David, Tanner, Marcel, Tavakkoli, Mohammad, Te Ao, Braden J., Teixeira, Carolina M., Téllez Rojo, Martha M., Terkawi, Abdullah S., Texcalac-Sangrador, José Luis, Thackway, Sarah V., Thomson, Blake, Thorne-Lyman, Andrew L., Thrift, Amanda G., Thurston, George D., Tillmann, Taavi, Tobollik, Myriam, Tonelli, Marcello, Topouzis, Fotis, Towbin, Jeffrey A., Toyoshima, Hideaki, Traebert, Jefferson, Tran, Bach X., Trasande, Leonardo, Trillini, Matias, Trujillo, Ulises, Dimbuene, Zacharie Tsala, Tsilimbaris, Miltiadis, Tuzcu, Emin Murat, Uchendu, Uche S., Ukwaja, Kingsley N., Uzun, Selen B., van de Vijver, Steven, Van Dingenen, Rita, van Gool, Coen H., van Os, Jim, Varakin, Yuri Y., Vasankari, Tommi J., Vasconcelos, Ana Maria N., Vavilala, Monica S., Veerman, Lennert J., Velasquez-Melendez, Gustavo, Venketasubramanian, N., Vijayakumar, Lakshmi, Villalpando, Salvador, Violante, Francesco S., Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Wagner, Gregory R., Waller, Stephen G., Wallin, Mitchell T., Wan, Xia, Wang, Haidong, Wang, JianLi, Wang, Linhong, Wang, Wenzhi, Wang, Yanping, Warouw, Tati S., Watts, Charlotte H., Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G., Werdecker, Andrea, Wessells, K. Ryan, Westerman, Ronny, Whiteford, Harvey A., Wilkinson, James D., Williams, Hywel C., Williams, Thomas N., Woldeyohannes, Solomon M., Wolfe, Charles D. A., Wong, John Q., Woolf, Anthony D., Wright, Jonathan L., Wurtz, Brittany, Xu, Gelin, Yan, Lijing L., Yang, Gonghuan, Yano, Yuichiro, Ye, Pengpeng, Yenesew, Muluken, Yentür, Gökalp K., Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z., Younoussi, Zourkaleini, Yu, Chuanhua, Zaki, Maysaa E., Zhao, Yong, Zheng, Yingfeng, Zhou, Maigeng, Zhu, Jun, Zhu, Shankuan, Zou, Xiaonong, Zunt, Joseph R., Lopez, Alan D., Vos, Theo, Murray, Christopher J., Forouzanfar, Mohammad H., Alexander, Lily, Anderson, H. 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D., Colistro, Valentina, Colomar, Mercedes, Colquhoun, Samantha M., Contreras, Alejandra G., Cooper, Cyrus, Cooperrider, Kimberly, Cooper, Leslie T., Coresh, Josef, Courville, Karen J., Criqui, Michael H., Cuevas-Nasu, Lucia, Damsere-Derry, James, Danawi, Hadi, Dandona, Lalit, Dandona, Rakhi, Dargan, Paul I., Davis, Adrian, Davitoiu, Dragos V., Dayama, Anand, de Castro, E. Filipa, De la Cruz-Góngora, Vanessa, De Leo, Diego, de Lima, Graça, Degenhardt, Louisa, del Pozo-Cruz, Borja, Dellavalle, Robert P., Deribe, Kebede, Derrett, Sarah, Jarlais, Don C. Des, Dessalegn, Muluken, deVeber, Gabrielle A., Devries, Karen M., Dharmaratne, Samath D., Dherani, Mukesh K., Dicker, Daniel, Ding, Eric L, Dokova, Klara, Dorsey, E. Ray, Driscoll, Tim R., Duan, Leilei, Durrani, Adnan M., Ebel, Beth E., Ellenbogen, Richard G., Elshrek, Yousef M., Endres, Matthias, Ermakov, Sergey P., Erskine, Holly E., Eshrati, Babak, Esteghamati, Alireza, Fahimi, Saman, Faraon, Emerito Jose A., Farzadfar, Farshad, Fay, Derek F. J., Feigin, Valery L., Feigl, Andrea B., Fereshtehnejad, Seyed-Mohammad, Ferrari, Alize J., Ferri, Cleusa P., Flaxman, Abraham D., Fleming, Thomas D., Foigt, Nataliya, Foreman, Kyle J., Paleo, Urbano Fra, Franklin, Richard C., Gabbe, Belinda, Gaffikin, Lynne, Gakidou, Emmanuela, Gamkrelidze, Amiran, Gankpé, Fortuné G., Gansevoort, Ron T., García-Guerra, Francisco A., Gasana, Evariste, Geleijnse, Johanna M., Gessner, Bradford D., Gething, Pete, Gibney, Katherine B., Gillum, Richard F., Ginawi, Ibrahim A. M., Giroud, Maurice, Giussani, Giorgia, Goenka, Shifalika, Goginashvili, Ketevan, Dantes, Hector Gomez, Gona, Philimon, de Cosio, Teresita Gonzalez, González-Castell, Dinorah, Gotay, Carolyn C., Goto, Atsushi, Gouda, Hebe N., Guerrant, Richard L., Gugnani, Harish C., Guillemin, Francis, Gunnell, David, Gupta, Rahul, Gupta, Rajeev, Gutiérrez, Reyna A., Hafezi-Nejad, Nima, Hagan, Holly, Hagstromer, Maria, Halasa, Yara A., Hamadeh, Randah R., Hammami, Mouhanad, Hankey, Graeme J., Hao, Yuantao, Harb, Hilda L., Haregu, Tilahun Nigatu, Haro, Josep Maria, Havmoeller, Rasmus, Hay, Simon I., Hedayati, Mohammad T., Heredia-Pi, Ileana B., Hernandez, Lucia, Heuton, Kyle R., Heydarpour, Pouria, Hijar, Martha, Hoek, Hans W., Hoffman, Howard J., Hornberger, John C., Hosgood, H. 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Rifat, Kosen, Soewarta, Kraemer, Alexander, Kravchenko, Michael, Krishnaswami, Sanjay, Kromhout, Hans, Ku, Tiffany, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kuipers, Ernst J., Kulkarni, Chanda, Kulkarni, Veena S., Kumar, G. Anil, Kwan, Gene F., Lai, Taavi, Balaji, Arjun Lakshmana, Lalloo, Ratilal, Lallukka, Tea, Lam, Hilton, Lan, Qing, Lansingh, Van C., Larson, Heidi J., Larsson, Anders, Laryea, Dennis O., Lavados, Pablo M., Lawrynowicz, Alicia E., Leasher, Janet L., Lee, Jong-Tae, Leigh, James, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Liang, Juan, Liang, Xiaofeng, Lim, Stephen S., Lindsay, M. Patrice, Lipshultz, Steven E., Liu, Shiwei, Liu, Yang, Lloyd, Belinda K., Logroscino, Giancarlo, London, Stephanie J., Lopez, Nancy, Lortet-Tieulent, Joannie, Lotufo, Paulo A., Lozano, Rafael, Lunevicius, Raimundas, Ma, Jixiang, Ma, Stefan, Machado, Vasco M. P., MacIntyre, Michael F., Magis-Rodriguez, Carlos, Mahdi, Abbas A., Majdan, Marek, Malekzadeh, Reza, Mangalam, Srikanth, Mapoma, Christopher C., Marape, Marape, Marcenes, Wagner, Margolis, David J, Margono, Christopher, Marks, Guy B., Martin, Randall V., Marzan, Melvin B., Mashal, Mohammad T., Masiye, Felix, Mason-Jones, Amanda J., Matsushita, Kunihiro, Matzopoulos, Richard, Mayosi, Bongani M., Mazorodze, Tasara T., McKay, Abigail C., McKee, Martin, McLain, Abigail, Meaney, Peter A, Medina, Catalina, Mehndiratta, Man Mohan, Mejia-Rodriguez, Fabiola, Mekonnen, Wubegzier, Melaku, Yohannes A., Meltzer, Michele, Memish, Ziad A., Mendoza, Walter, Mensah, George A., Meretoja, Atte, Mhimbira, Francis Apolinary, Micha, Renata, Miller, Ted R., Mills, Edward J., Misganaw, Awoke, Mishra, Santosh, Ibrahim, Norlinah Mohamed, Mohammad, Karzan A., Mokdad, Ali H., Mola, Glen L., Monasta, Lorenzo, Hernandez, Julio C. Montañez, Montico, Marcella, Moore, Ami R, Morawska, Lidia, Mori, Rintaro, Moschandreas, Joanna, Moturi, Wilkister N, Mozaffarian, Dariush, Mueller, Ulrich O., Mukaigawara, Mitsuru, Mullany, Erin C., Murthy, Kinnari S., Naghavi, Mohsen, Nahas, Ziad, Naheed, Aliya, Naidoo, Kovin S., Naldi, Luigi, Nand, Devina, Nangia, Vinay, Narayan, KM Venkat, Nash, Denis, Neal, Bruce, Nejjari, Chakib, Neupane, Sudan P., Newton, Charles R., Ngalesoni, Frida N., de Dieu Ngirabega, Jean, Nguyen, Grant, Nguyen, Nhung T., Nieuwenhuijsen, Mark J., Nisar, Muhammad I., Nogueira, José R., Nolla, Joan M., Nolte, Sandra, Norheim, Ole F., Norman, Rosana E., Norrving, Bo, Nyakarahuka, Luke, Oh, In-Hwan, Ohkubo, Takayoshi, Olusanya, Bolajoko O., Omer, Saad B., Opio, John Nelson, Orozco, Ricardo, Pagcatipunan, Rodolfo S., Pain, Amanda W., Pandian, Jeyaraj D., Panelo, Carlo Irwin A., Papachristou, Christina, Park, Eun-Kee, Parry, Charles D., Caicedo, Angel J. Paternina, Patten, Scott B., Paul, Vinod K., Pavlin, Boris I., Pearce, Neil, Pedraza, Lilia S., Pedroza, Andrea, Stokic, Ljiljana Pejin, Pekericli, Ayfer, Pereira, David M., Perez-Padilla, Rogelio, Perez-Ruiz, Fernando, Perico, Norberto, Perry, Samuel A. L., Pervaiz, Aslam, Pesudovs, Konrad, Peterson, Carrie B., Petzold, Max, Phillips, Michael R., Phua, Hwee Pin, Plass, Dietrich, Poenaru, Dan, Polanczyk, Guilherme V., Polinder, Suzanne, Pond, Constance D., Pope, C. Arden, Pope, Daniel, Popova, Svetlana, Pourmalek, Farshad, Powles, John, Prabhakaran, Dorairaj, Prasad, Noela M., Qato, Dima M., Quezada, Amado D., Quistberg, D. Alex A., Racapé, Lionel, Rafay, Anwar, Rahimi, Kazem, Rahimi-Movaghar, Vafa, Rahman, Sajjad Ur, Raju, Murugesan, Rakovac, Ivo, Rana, Saleem M., Rao, Mayuree, Razavi, Homie, Reddy, K. 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Abstract: Summary Background The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the fi rst of a series of annual updates of the GBD. Risk factor quantifi cation, particularly of modifi able 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 fi rst 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 fi ltration rate. For most risks, data for exposure were synthesised with a Bayesian metaregression 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

217. Women with non-Swedish speaking background and their children: a longitudinal study of uptake of care and maternal and child health

Author: Fabian, Helena, Rådestad, Ingela, Rodriguez, Alina, Waldenström, Ulla, Fabian, Helena, Rådestad, Ingela, Rodriguez, Alina, and Waldenström, Ulla
Abstract: Aim: To study uptake of care at the antenatal and child health clinic (CHC), and maternal and child health up to 5 years after the birth, as reported by mothers with a non-Swedish speaking background (NSB). Methods: A sample of 300 women with a NSB, 175 originated from a poor country and 125 originated from a rich country, were compared with a reference group of 2761 women with a Swedish speaking background. Four postal questionnaires were completed: during pregnancy, and 2 months, 1 year and 5 years after the birth. Results: Mothers with a NSB from a poor country of origin did not differ from the reference group of mothers with a Swedish speaking background regarding number of clinic visits, but they had a lower attendance rate at antenatal and postnatal education classes. Depressive symptoms, parental stress and poor self-rated health were more common in these women, and they reported more psychological and behavioral problems in their 5-year olds. Women with a rich country origin did not differ from the reference group regarding maternal and child health, but had a lower uptake of all out-patient care, except parental classes after the birth. Conclusion: Women originating from a poor country seem to be under great stress during pregnancy and the child's first years.

218. The Strengths and Difficulties Questionnaire in the Nordic countries

Author: Obel, Carsten, Heiervang, Einar, Rodriguez, Alina, Heyerdahl, Sonja, Smedje, Hans, Sourander, Andre, Gudmundsson, Olafur O., Clench-Aas, Jocelyne, Christensen, Else, Heian, Frode, Mathiesen, Kristin S., Magnusson, Pall, Njardvik, Urdur, Koskelainen, Merja, Ronning, John A., Stormark, Kjell Morten, Olsen, Jorn, Obel, Carsten, Heiervang, Einar, Rodriguez, Alina, Heyerdahl, Sonja, Smedje, Hans, Sourander, Andre, Gudmundsson, Olafur O., Clench-Aas, Jocelyne, Christensen, Else, Heian, Frode, Mathiesen, Kristin S., Magnusson, Pall, Njardvik, Urdur, Koskelainen, Merja, Ronning, John A., Stormark, Kjell Morten, and Olsen, Jorn
Abstract: Background: The Strengths and Difficulties Questionnaire (SDQ) has been translated into the different Nordic languages between 1996 and 2003. During the past few years, SDQs have been completed for nearly 100,000 children and adolescents in population-based studies as well as in clinical samples. The largest studies have been performed in Norway and Denmark, and in these countries the diagnostic interview DAWBA has also been used in conjunction with the SDQ. Aims: In addition to a brief overview of past and ongoing SDQ work in Sweden, Finland, Norway, Denmark, and Iceland, we present scale means and standard deviations from selected community studies with comparable age groups, including parental reports for 7, 9 and 11 year-old children and self-reports of 13 and 15 year-olds. Conclusions: The descriptive statistics suggest that the distributions of SDQ scores are very similar across the Nordic countries. Further collaborative efforts in establishing norms and evaluating the validity of the SDQ as a screening instrument are encouraged.

219. Global and national Burden of diseases and injuries among children and adolescents between 1990 and 2013

Author: Kyu, Hmwe H., Pinho, Christine, Wagner, Joseph A., Brown, Jonathan C., Bertozzi-Villa, Amelia, Charlson, Fiona J., Coffeng, Luc Edgar, Dandona, Lalit, Erskine, Holly E., Ferrari, Alize J., Fitzmaurice, Christina, Fleming, Thomas D., Forouzanfar, Mohammad H., Graetz, Nicholas, Guinovart, Caterina, Haagsma, Juanita, Higashi, Hideki, Kassebaum, Nicholas J., Larson, Heidi J., Lim, Stephen S., Mokdad, Ali H., Moradi-Lakeh, Maziar, Odell, Shaun V., Roth, Gregory A., Serina, Peter T., Stanaway, Jeffrey D., Misganaw, Awoke, Whiteford, Harvey A., Wolock, Timothy M., Wulf Hanson, Sarah, Abd-Allah, Foad, Abera, Semaw Ferede, Abu-Raddad, Laith J., AlBuhairan, Fadia S., Amare, Azmeraw T., Antonio, Carl Abelardo T., Artaman, Al, Barker-Collo, Suzanne L., Barrero, Lope H., Benjet, Corina, Bensenor, Isabela M., Bhutta, Zulfiqar A., Bikbov, Boris, Brazinova, Alexandra, Campos-Nonato, Ismael, Castañeda-Orjuela, Carlos A., Catalá-López, Ferrán, Chowdhury, Rajiv, Cooper, Cyrus, Crump, John A., Dandona, Rakhi, Degenhardt, Louisa, Dellavalle, Robert P., Dharmaratne, Samath D., Faraon, Emerito Jose A., Feigin, Valery L., Fürst, Thomas, Geleijnse, Johanna M., Gessner, Bradford D., Gibney, Katherine B., Goto, Atsushi, Gunnell, David, Hankey, Graeme J., Hay, Roderick J., Hornberger, John C., Hosgood, H. Dean, Hu, Guoqing, Jacobsen, Kathryn H., Jayaraman, Sudha P., Jeemon, Panniyammakal, Jonas, Jost B., Karch, André, Kim, Daniel, Kim, Sungroul, Kokubo, Yoshihiro, Kuate Defo, Barthelemy, Kucuk Bicer, Burcu, Kumar, G. Anil, Larsson, Anders, Leasher, Janet L., Leung, Ricky, Li, Yongmei, Lipshultz, Steven E., Lopez, Alan D., Lotufo, Paulo A., Lunevicius, Raimundas, Lyons, Ronan A., Majdan, Marek, Malekzadeh, Reza, Mashal, Taufiq, Mason-Jones, Amanda J., Melaku, Yohannes Adama, Memish, Ziad A., Mendoza, Walter, Miller, Ted R., Mock, Charles N., Murray, Joseph, Nolte, Sandra, Oh, In-Hwan, Olusanya, Bolajoko Olubukunola, Ortblad, Katrina F., Park, Eun-Kee, Paternina Caicedo, Angel J., Patten, Scott B., Patton, George C., Pereira, David M., Perico, Norberto, Piel, Frédéric B., Polinder, Suzanne, Popova, Svetlana, Pourmalek, Farshad, Quistberg, D. Alex, Remuzzi, Giuseppe, Rodriguez, Alina, Rojas-Rueda, David, Rothenbacher, Dietrich, Rothstein, David H., Sanabria, Juan, Santos, Itamar S., Schwebel, David C., Sepanlou, Sadaf G., Shaheen, Amira, Shiri, Rahman, Shiue, Ivy, Skirbekk, Vegard, Sliwa, Karen, Sreeramareddy, Chandrashekhar T., Stein, Dan J., Steiner, Timothy J., Stovner, Lars Jacob, Sykes, Bryan L., Tabb, Karen M., Terkawi, Abdullah Sulieman, Thomson, Alan J., Thorne-Lyman, Andrew L., Towbin, Jeffrey Allen, Ukwaja, Kingsley Nnanna, Vasankari, Tommi, Venketasubramanian, Narayanaswamy, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Weiderpass, Elisabete, Weintraub, Robert G., Werdecker, Andrea, Wilkinson, James D., Woldeyohannes, Solomon Meseret, Wolfe, Charles D. A., Yano, Yuichiro, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z., Yu, Chuanhua, El Sayed Zaki, Maysaa, Naghavi, Mohsen, Murray, Christopher J. L., Vos, Theo, Kyu, Hmwe H., Pinho, Christine, Wagner, Joseph A., Brown, Jonathan C., Bertozzi-Villa, Amelia, Charlson, Fiona J., Coffeng, Luc Edgar, Dandona, Lalit, Erskine, Holly E., Ferrari, Alize J., Fitzmaurice, Christina, Fleming, Thomas D., Forouzanfar, Mohammad H., Graetz, Nicholas, Guinovart, Caterina, Haagsma, Juanita, Higashi, Hideki, Kassebaum, Nicholas J., Larson, Heidi J., Lim, Stephen S., Mokdad, Ali H., Moradi-Lakeh, Maziar, Odell, Shaun V., Roth, Gregory A., Serina, Peter T., Stanaway, Jeffrey D., Misganaw, Awoke, Whiteford, Harvey A., Wolock, Timothy M., Wulf Hanson, Sarah, Abd-Allah, Foad, Abera, Semaw Ferede, Abu-Raddad, Laith J., AlBuhairan, Fadia S., Amare, Azmeraw T., Antonio, Carl Abelardo T., Artaman, Al, Barker-Collo, Suzanne L., Barrero, Lope H., Benjet, Corina, Bensenor, Isabela M., Bhutta, Zulfiqar A., Bikbov, Boris, Brazinova, Alexandra, Campos-Nonato, Ismael, Castañeda-Orjuela, Carlos A., Catalá-López, Ferrán, Chowdhury, Rajiv, Cooper, Cyrus, Crump, John A., Dandona, Rakhi, Degenhardt, Louisa, Dellavalle, Robert P., Dharmaratne, Samath D., Faraon, Emerito Jose A., Feigin, Valery L., Fürst, Thomas, Geleijnse, Johanna M., Gessner, Bradford D., Gibney, Katherine B., Goto, Atsushi, Gunnell, David, Hankey, Graeme J., Hay, Roderick J., Hornberger, John C., Hosgood, H. Dean, Hu, Guoqing, Jacobsen, Kathryn H., Jayaraman, Sudha P., Jeemon, Panniyammakal, Jonas, Jost B., Karch, André, Kim, Daniel, Kim, Sungroul, Kokubo, Yoshihiro, Kuate Defo, Barthelemy, Kucuk Bicer, Burcu, Kumar, G. Anil, Larsson, Anders, Leasher, Janet L., Leung, Ricky, Li, Yongmei, Lipshultz, Steven E., Lopez, Alan D., Lotufo, Paulo A., Lunevicius, Raimundas, Lyons, Ronan A., Majdan, Marek, Malekzadeh, Reza, Mashal, Taufiq, Mason-Jones, Amanda J., Melaku, Yohannes Adama, Memish, Ziad A., Mendoza, Walter, Miller, Ted R., Mock, Charles N., Murray, Joseph, Nolte, Sandra, Oh, In-Hwan, Olusanya, Bolajoko Olubukunola, Ortblad, Katrina F., Park, Eun-Kee, Paternina Caicedo, Angel J., Patten, Scott B., Patton, George C., Pereira, David M., Perico, Norberto, Piel, Frédéric B., Polinder, Suzanne, Popova, Svetlana, Pourmalek, Farshad, Quistberg, D. Alex, Remuzzi, Giuseppe, Rodriguez, Alina, Rojas-Rueda, David, Rothenbacher, Dietrich, Rothstein, David H., Sanabria, Juan, Santos, Itamar S., Schwebel, David C., Sepanlou, Sadaf G., Shaheen, Amira, Shiri, Rahman, Shiue, Ivy, Skirbekk, Vegard, Sliwa, Karen, Sreeramareddy, Chandrashekhar T., Stein, Dan J., Steiner, Timothy J., Stovner, Lars Jacob, Sykes, Bryan L., Tabb, Karen M., Terkawi, Abdullah Sulieman, Thomson, Alan J., Thorne-Lyman, Andrew L., Towbin, Jeffrey Allen, Ukwaja, Kingsley Nnanna, Vasankari, Tommi, Venketasubramanian, Narayanaswamy, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Weiderpass, Elisabete, Weintraub, Robert G., Werdecker, Andrea, Wilkinson, James D., Woldeyohannes, Solomon Meseret, Wolfe, Charles D. A., Yano, Yuichiro, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z., Yu, Chuanhua, El Sayed Zaki, Maysaa, Naghavi, Mohsen, Murray, Christopher J. L., and Vos, Theo
Abstract: Importance The literature focuses on mortality among children younger than 5 years. Comparable information on nonfatal health outcomes among these children and the fatal and nonfatal burden of diseases and injuries among older children and adolescents is scarce. Objective To determine levels and trends in the fatal and nonfatal burden of diseases and injuries among younger children (aged <5 years), older children (aged 5-9 years), and adolescents (aged 10-19 years) between 1990 and 2013 in 188 countries from the Global Burden of Disease (GBD) 2013 study. Evidence Review Data from vital registration, verbal autopsy studies, maternal and child death surveillance, and other sources covering 14 244 site-years (ie, years of cause of death data by geography) from 1980 through 2013 were used to estimate cause-specific mortality. Data from 35 620 epidemiological sources were used to estimate the prevalence of the diseases and sequelae in the GBD 2013 study. Cause-specific mortality for most causes was estimated using the Cause of Death Ensemble Model strategy. For some infectious diseases (eg, HIV infection/AIDS, measles, hepatitis B) where the disease process is complex or the cause of death data were insufficient or unavailable, we used natural history models. For most nonfatal health outcomes, DisMod-MR 2.0, a Bayesian metaregression tool, was used to meta-analyze the epidemiological data to generate prevalence estimates. Findings Of the 7.7 (95% uncertainty interval [UI], 7.4-8.1) million deaths among children and adolescents globally in 2013, 6.28 million occurred among younger children, 0.48 million among older children, and 0.97 million among adolescents. In 2013, the leading causes of death were lower respiratory tract infections among younger children (905 059 deaths; 95% UI, 810 304-998 125), diarrheal diseases among older children (38 325 deaths; 95% UI, 30 365-47 678), and road injuries among adolescents (115 186 deaths; 95% UI, 105 185-124 870). Iron deficiency

220. Common variation near ROBO2 is associated with expressive vocabulary in infancy

Author: St Pourcain, Beate, Cents, Rolieke A. M., Whitehouse, Andrew J. O., Haworth, Claire M. A., Davis, Oliver S. P., O’Reilly, Paul F., Roulstone, Susan, Wren, Yvonne, Ang, Qi W., Velders, Fleur P., Evans, David M., Kemp, John P., Warrington, Nicole M., Miller, Laura, Timpson, Nicholas J., Ring, Susan M., Verhulst, Frank C., Hofman, Albert, Rivadeneira, Fernando, Meaburn, Emma L., Price, Thomas S., Dale, Philip S., Pillas, Demetris, Yliherva, Anneli, Rodriguez, Alina, Golding, Jean, Jaddoe, Vincent W. V., Jarvelin, Marjo-Riitta, Plomin, Robert, Pennell, Craig E., Tiemeier, Henning, Davey Smith, George, St Pourcain, Beate, Cents, Rolieke A. M., Whitehouse, Andrew J. O., Haworth, Claire M. A., Davis, Oliver S. P., O’Reilly, Paul F., Roulstone, Susan, Wren, Yvonne, Ang, Qi W., Velders, Fleur P., Evans, David M., Kemp, John P., Warrington, Nicole M., Miller, Laura, Timpson, Nicholas J., Ring, Susan M., Verhulst, Frank C., Hofman, Albert, Rivadeneira, Fernando, Meaburn, Emma L., Price, Thomas S., Dale, Philip S., Pillas, Demetris, Yliherva, Anneli, Rodriguez, Alina, Golding, Jean, Jaddoe, Vincent W. V., Jarvelin, Marjo-Riitta, Plomin, Robert, Pennell, Craig E., Tiemeier, Henning, and Davey Smith, George
Abstract: Twin studies suggest that expressive vocabulary at ~24 months is modestly heritable. However, the genes influencing this early linguistic phenotype are unknown. Here we conduct a genome-wide screen and follow-up study of expressive vocabulary in toddlers of European descent from up to four studies of the EArly Genetics and Lifecourse Epidemiology consortium, analysing an early (15–18 months, ‘one-word stage’, NTotal=8,889) and a later (24–30 months, ‘two-word stage’, NTotal=10,819) phase of language acquisition. For the early phase, one single-nucleotide polymorphism (rs7642482) at 3p12.3 near ROBO2, encoding a conserved axon-binding receptor, reaches the genome-wide significance level (P=1.3 × 10−8) in the combined sample. This association links language-related common genetic variation in the general population to a potential autism susceptibility locus and a linkage region for dyslexia, speech-sound disorder and reading. The contribution of common genetic influences is, although modest, supported by genome-wide complex trait analysis (meta-GCTA h215–18-months=0.13, meta-GCTA h224–30-months=0.14) and in concordance with additional twin analysis (5,733 pairs of European descent, h224-months=0.20).

221. Concern for privacy in relation to age during physical examination of children: an exploratory study

Author: Hansson, Mats G, Kihlbom, Ulrik, Tuvemo, Torsten, Rodriguez, Alina, Hansson, Mats G, Kihlbom, Ulrik, Tuvemo, Torsten, and Rodriguez, Alina
Abstract: Objectives: To explore whether physicians behave differently regarding ethics and respect for privacydepending on children’s age. We explored whether physician behaviours contributed to childuneasiness.Study design: Observational study of 21 children (0–12 years; 18 boys; mean age 3.2) undergoingevaluation for inguinal hernia. Specific physician-initiated verbal and nonverbal behaviours werecoded from digital video discs of the consultations.Results: Physician intrusiveness (i.e. approaching the child suddenly or in an uninvited way) duringthe physical examination was related to concurrent child uneasiness (r ¼ 0.42, p < 0.06) and lastedthrough the postexamination phase of the consultation (r ¼ 0.52, p < 0.01). Child mood during theexamination strongly predicted postexamination mood (r ¼ 0.69, p < 0.0001). Neither the totalnumber of physician-initiated positive behaviours or privacy-related behaviours was associated withchild age. Negative physician behaviours were strongly related to negative mood in the child(r ¼ 0.72, p < 0.0001) at the close of the consultation.

222. Psychosocial predictors of smoking and exercise during pregnancy

Author: Rodriguez, Alina, Bohlin, G., Lindmark, G., Rodriguez, Alina, Bohlin, G., and Lindmark, G.
Abstract: This study examined health behaviours among nulliparous pregnant Swedish women. Structural equation modelling ( N = 350) was used to predict smoking and exercise at gestational weeks 20 and 32 from psychosocial factors measured in early and mid-pregnancy. Although women altered their lifestyle early in pregnancy, so that by gestational week 20 both smoking and exercise had declined, previous behaviours remained strong and consistent predictors of later behaviours. Hostility and health awareness predicted smoking at both weeks 20 and 32. Smoking at week 32 was also predicted by concurrent perceived stress. Exercise at week 20 was predicted by hostility, social support, stress, and whether or not the pregnancy was planned; and at week 32 only health awareness was significant. Social support had a significant indirect effect on each behaviour, which suggests that social support facilitated compliance with health professionals' recommendations. These results suggest that psychosocial factors previously associated with health outcomes also predict health behaviours throughout pregnancy.

223. Do inattention and hyperactivity symptoms equal scholastic impairment? Evidence from three European cohorts

Author: Rodriguez, Alina, Järvelin, Marjo-Riitta, Obel, Carsten, Taanila, Anja, Miettunen, Jouko, Moilanen, Irma, Henriksen, Tine Brink, Pietiläinen, Katri, Ebeling, Hanna, Kotimaa, Arto J., Linnet, Karen Markussen, Olsen, Jørn, Rodriguez, Alina, Järvelin, Marjo-Riitta, Obel, Carsten, Taanila, Anja, Miettunen, Jouko, Moilanen, Irma, Henriksen, Tine Brink, Pietiläinen, Katri, Ebeling, Hanna, Kotimaa, Arto J., Linnet, Karen Markussen, and Olsen, Jørn
Abstract: Background Attention Deficit/Hyperactivity Disorder (ADHD) affects many children, adolescents, and adults and is associated with a number of impairments. Poor academic performance is related to ADHD in clinical samples. However, it is unclear to what extent core ADHD symptoms and scholastic impairment are related in non-referred school-aged children. Methods Data come from three population-based cohorts from Sweden, Denmark, and Finland, which are part of the Nordic Network on ADHD. The combined sample size was 13,087 children who were studied at ages 7–8 or 10–12 years. Teachers rated children on inattention and hyperactivity symptoms and reported children's scholastic performance on basic skills. Results There was a significant association in all cohorts between core ADHD symptoms and scholastic impairment in reading, writing, and mathematics. Particularly, inattention was related to a two to tenfold increase in scholastic impairment. Prevalence of hyperactivity symptoms was similar across the three cohorts, but inattention was lowest among children from the Finnish cohort, after stratification on living conditions. Conclusion These results extend previous reports of scholastic impairment among children with clinically diagnosed ADHD to non-referred population samples from three European countries. Surveillance policies should be implemented in school systems to catch children in need of behavioral or scholastic support early.

224. Is maternal smoking during pregnancy a risk factor for Hyperkinetic disorder?--findings from a sibling design

Author: Obel, Carsten, Olsen, Jorn, Henriksen, Tine Brink, Rodriguez, Alina, Jarvelin, Marjo-Riitta, Moilanen, Irma, Parner, Erik, Linnet, Karen Markussen, Taanila, Anja, Ebeling, Hanna, Heiervang, Einar, Gissler, Mika, Obel, Carsten, Olsen, Jorn, Henriksen, Tine Brink, Rodriguez, Alina, Jarvelin, Marjo-Riitta, Moilanen, Irma, Parner, Erik, Linnet, Karen Markussen, Taanila, Anja, Ebeling, Hanna, Heiervang, Einar, and Gissler, Mika
Abstract: Background Studies have consistently shown that pregnancy smoking is associated with twice the risk of hyperactivity/inattention problems in the offspring. An association of this magnitude may indicate behavioural difficulties as one of the most important health effects related to smoking during pregnancy. However, social and genetic confounders may fully or partially account for these findings. Methods A cohort including all singletons born in Finland from 1 January 1987 through 31 December 2001 was followed until 1 January 2006 based on linkage of national registers. Data were available for 97% (N = 868 449) of the population. We followed singleton children of smoking and non-smoking mothers until they had an International Classification of Diseases, 10th revision, diagnosis of hyperkinetic disorder (HKD) or to the end of the observation period. We used sibling-matched Cox regression analyses to control for social and genetic confounding. Results We found a much smaller association between exposure to maternal smoking during pregnancy and risk of HKD in children using the sibling-matched analysis [hazards ratio (HR) = 1.20, 95% confidence interval (CI) 0.97–1.49] than was observed in the entire cohort (HR 2.01, 95% CI 1.90–2.12). Conclusions Our findings suggest that the strong association found in previous studies may be due to time-stable familial factors, such as environmental and genetic factors. If smoking is a causal factor, the effect is small and less important than what the previous studies indicate.

225. Associations between pre-pregnancy obesity and asthma symptoms in adolescents

Author: Patel, Swatee P., Rodriguez, Alina, Little, Mark P., Elliott, Paul, Pekkanen, Juha, Hartikainen, Anna-Liisa, Pouta, Anneli, Laitinen, Jaana, Harju, Terttu, Canoy, Dexter, Jarvelin, Marjo-Riitta, Patel, Swatee P., Rodriguez, Alina, Little, Mark P., Elliott, Paul, Pekkanen, Juha, Hartikainen, Anna-Liisa, Pouta, Anneli, Laitinen, Jaana, Harju, Terttu, Canoy, Dexter, and Jarvelin, Marjo-Riitta
Abstract: Background The high prevalence of children's asthma symptoms, worldwide, is unexplained. We examined the relation between maternal pre-pregnancy weight and body mass index (BMI), and asthma symptoms in adolescents. Methods Data from 6945 adolescents born within the Northern Finland Birth Cohort 1986 were used. Prospective antenatal and birth outcome data, including maternal pre-pregnancy weight and BMI, and asthma symptoms in adolescent offspring at age 15–16 years, were employed. Logistic regression analyses were performed to examine the associations between relevant prenatal factors and asthma symptoms during adolescence. Results Current wheeze (within the past year) was reported by 10.6% of adolescents, and physician-diagnosed asthma by 6.0%. High maternal pre-pregnancy BMI was a significant predictor of wheeze in the adolescents (increase per kilogram per square metre unit; 2.7%, 95% CI 0.9 to 4.4 for ever wheeze; 3.5%, 95% CI 1.3 to 5.8 for current wheeze), and adjusting for potential confounders further increased the risk (2.8%, 95% CI 0.5 to 5.1; 4.7%, 95% CI 1.9 to 7.7, respectively). High maternal pre-pregnancy weight, in the top tertile, also significantly increased the odds of current wheeze in the adolescent by 20% (95% CI 4 to 39), and adjusting for potential confounders further increased the risk (OR=1.52, 95% CI 1.19 to 1.95). Results were similar for current asthma. Furthermore, these significant associations were observed only among adolescents without parental history of atopy but not among those with parental history of atopy. Conclusions The association demonstrated here between maternal pre-pregnancy overweight and obesity, and asthma symptoms in adolescents suggests that increase in asthma may be partly related to the rapid rise in obesity in recent years.

226. Maternal adiposity prior to pregnancy is associated with ADHD symptoms in offspring: evidence from three prospective pregnancy cohorts

Author: Rodriguez, Alina, Miettunen, J., Henriksen, T. B., Olsen, J., Obel, C., Taanila, A., Ebeling, H., Linnet, K. M., Moilanen, I., Järvelin, M.-R., Rodriguez, Alina, Miettunen, J., Henriksen, T. B., Olsen, J., Obel, C., Taanila, A., Ebeling, H., Linnet, K. M., Moilanen, I., and Järvelin, M.-R.
Abstract: Objectives: We examine whether pregnancy weight (pre-pregnancy body mass index (BMI) and/or weight gain) is related to core symptoms of attention deficit hyperactivity disorder (ADHD) in school-age offspring. Design: Follow-up of prospective pregnancy cohorts from Sweden, Denmark and Finland within the Nordic Network on ADHD. Methods: Maternal pregnancy and delivery data were collected prospectively. Teachers rated inattention and hyperactivity symptoms in offspring. High scores were defined as at least one core symptom rated as ‘severe’ and two as ‘present’ (approximately 10% of children scored in this range). Logistic regression and latent class analyses were used to examine maternal pregnancy weight in relation to children's ADHD core symptoms. Results: Teacher rated 12 556 school-aged children. Gestational weight gain outside of the Institute of Medicine guidelines was not related to ADHD symptoms (below recommendations: odds ratio (OR): 0.96; 95% confidence interval (CI): 0.81, 1.14; above recommendations: OR: 0.98; 95% CI: 0.82, 1.16). To examine various patterns of pre-pregnancy BMI and weight gain, we used latent class analysis and found significant associations between classes that included pre-pregnancy overweight or obesity and a high ADHD symptom score in offspring, ORs ranged between 1.37 (95% CI: 1.07, 1.75) and 1.89 (95% CI: 1.13, 3.15) adjusted for gestational age, birth weight, weight gain, pregnancy smoking, maternal age, maternal education, child gender, family structure and cohort country of origin. Children of women who were both overweight and gained a large amount of weight during gestation had a 2-fold risk of ADHD symptoms (OR: 2.10, 95% CI: 1.19, 3.72) compared to normal-weight women. Conclusions: We show for the first time that pre-pregnancy BMI is associated with ADHD symptoms in children. Our results are of public health significance if the associations are causal and will then add ADHD symptoms in offspring to the list of deleterious ou

227. Comorbidity of disruptive behavioral disorders and attention-deficit hyperactivity disorder – indicator of severity in problematic behavior?

Author: Nordström, Tanja, Ebeling, Hanna, Hurtig, Tuula, Rodriguez, Alina, Savolainen, Juha, Moilanen, Irma, Taanila, Anja, Nordström, Tanja, Ebeling, Hanna, Hurtig, Tuula, Rodriguez, Alina, Savolainen, Juha, Moilanen, Irma, and Taanila, Anja
Abstract: BACKGROUND: Disruptive behavioral disorders (DBD) and attention-deficit hyperactivity disorder (ADHD) are both characterized by certain patterns of misbehavior among adolescents. AIMS: The aim of this study was to examine how the comorbidity of DBD and ADHD affects in misbehavior among adolescents. METHODS: A total of 158 adolescents aged 16-18 years, from a subsample of the Northern Finland Birth Cohort 1986 (NFBC 1986), were interviewed with the Finnish translation of the semi-structured Schedule for Affective Disorders and Schizophrenia for School-Age Children--Present and Lifetime (K-SADS-PL) in order to obtain DBD, including conduct disorder (CD) and oppositional defiant disorder (ODD), and ADHD diagnoses. The structure of the CD symptoms, obtained from the K-SADS-PL, was compared with the previously formed model about the development of the problematic behavior. The severity of the CD symptoms was compared with adolescents diagnosed with only DBD, only ADHD and with both DBD and ADHD. Also, the associations with other psychiatric disorders diagnosed at age 16 were evaluated. RESULTS: The boys in the study sample were diagnosed with ADHD or with comorbid DBD and ADHD more often than girls. The severity of CD symptoms was statistically significantly associated with the comorbid DBD and ADHD group. The adolescents diagnosed with comorbid DBD and ADHD had an increased risk for anxiety disorders, depressive disorders and substance abuse disorders. CONCLUSIONS: The comorbidity of DBD and ADHD seems to indicate the severity of CD symptoms. CLINICAL IMPLICATIONS: The comorbidity between DBD and ADHD should be considered in clinical practice because it could indicate more serious problematic behavior than pure disorders alone.

228. Infant locomotive development and its association with adult blood pressure

Author: Pillas, Demetris, Kaakinen, Marika, Tzoulaki, Ioanna, Netuveli, Gopalakrishnan, Rodriguez, Alina, Fung, Erik, Tammelin, Tuija H., Blane, David, Millwood, Iona Y., Hardy, Rebecca, Sovio, Ulla, Pouta, Anneli, Hopstock, Laila Arnesdatter, Hartikainen, Anna-Liisa, Laitinen, Jaana, Vaara, Sarianna, Khan, Anokhi Ali, Chong, Raymond, Elliott, Paul, Jarvelin, Marjo-Riitta, Pillas, Demetris, Kaakinen, Marika, Tzoulaki, Ioanna, Netuveli, Gopalakrishnan, Rodriguez, Alina, Fung, Erik, Tammelin, Tuija H., Blane, David, Millwood, Iona Y., Hardy, Rebecca, Sovio, Ulla, Pouta, Anneli, Hopstock, Laila Arnesdatter, Hartikainen, Anna-Liisa, Laitinen, Jaana, Vaara, Sarianna, Khan, Anokhi Ali, Chong, Raymond, Elliott, Paul, and Jarvelin, Marjo-Riitta
Abstract: Evidence from animal models suggests that locomotion and blood pressure share common neurophysiological regulatory systems. As a result of this common regulation, we hypothesized that the development of locomotion in human infants would be associated with blood pressure levels in adulthood. The study sample comprised 4,347 individuals with measures of locomotive and non-locomotive neuromotor development in infancy and adult blood pressure levels within a longitudinal birth cohort study, the Northern Finland Birth Cohort 1966. Later development in all three stages of locomotive development during infancy was associated with higher systolic and diastolic blood pressure levels at age 31. For age of walking without support, 0.34 (95 % CI 0.07 to 0.60)-mm Hg higher SBP and 0.38 (95 % CI 0.15 to 0.62)-mm Hg higher DBP were estimated for each month of later achievement (P = 0.012 for SBP; P = 0.001 for DBP). No association was identified for non-locomotive neuromotor development. Conclusion: These results highlight the positive sequelae of advanced locomotive development during infancy, suggesting that the common regulatory systems between locomotion and blood pressure may influence the development of raised blood pressure over time.

229. Multiple measures of adiposity are associated with mean leukocyte telomere length in the Northern Finland birth cohort 1966

Author: Buxton, Jessica L., Das, Shikta, Rodriguez, Alina, Kaakinen, Marika, Couto Alves, Alexessander, Sebert, Sylvain, Millwood, Iona Y., Laitinen, Jaana, O’Reilly, Paul F., Jarvelin, Marjo-Riitta, Blakemore, Alexandra I. F., Buxton, Jessica L., Das, Shikta, Rodriguez, Alina, Kaakinen, Marika, Couto Alves, Alexessander, Sebert, Sylvain, Millwood, Iona Y., Laitinen, Jaana, O’Reilly, Paul F., Jarvelin, Marjo-Riitta, and Blakemore, Alexandra I. F.
Abstract: Studies of leukocyte telomere length (LTL) and adiposity have produced conflicting results, and the relationship between body mass index (BMI) and telomere length throughout life remains unclear. We therefore tested association of adult LTL measured in 5,598 participants with: i) childhood growth measures (BMI and age at adiposity rebound (AR)); ii) change in BMI from childhood to adulthood and iii) adult BMI, waist-to-hip ratio (WHR), body adiposity index (BAI). Childhood BMI at AR was positively associated with LTL at 31 years in women (P = 0.041). Adult BMI and WHR in both men (P = 0.025 and P = 0.049, respectively) and women (P = 0.029 and P = 0.008, respectively), and BAI in women (P = 0.021) were inversely associated with LTL at 31 years. An increase in standardised BMI between early childhood and adulthood was associated with shorter adult LTL in women (P = 0.008). We show that LTL is inversely associated with multiple measures of adiposity in both men and women. Additionally, BMI increase in women from childhood to adulthood is associated with shorter telomeres at age 31, potentially indicating accelerated biological ageing.

230. The interplay of variants near LEKR and CCNL1 and social stress in relation to birth size

Author: Ali Khan, Anokhi, Rodriguez, Alina, Sebert, Sylvain, Kaakinen, Marika, Cauchi, Stéphane, Froguel, Philippe, Hartikainen, Anna-Liisa, Pouta, Anneli, Järvelin, Marjo-Riitta, Ali Khan, Anokhi, Rodriguez, Alina, Sebert, Sylvain, Kaakinen, Marika, Cauchi, Stéphane, Froguel, Philippe, Hartikainen, Anna-Liisa, Pouta, Anneli, and Järvelin, Marjo-Riitta
Abstract: Background We previously identified via a genome wide association study variants near LEKR and CCNL1 and in the ADCY5 genes lead to lower birthweight. Here, we study the impact of these variants and social stress during pregnancy, defined as social adversity and neighborhood disparity, on infant birth size. We aimed to determine whether the addition of genetic variance magnified the observed associations. Methodology/Principal Findings We analyzed data from the Northern Finland Birth Cohort 1986 (n = 5369). Social adversity was defined by young maternal age (<20 years), low maternal education (<11 years), and/or single marital status. Neighborhood social disparity was assessed by discrepancy between neighborhoods relative to personal socio-economic status. These variables are indicative of social and socioeconomic stress, but also of biological risk. The adjusted multiple regression analysis showed smaller birth size in both infants of mothers who experienced social adversity (birthweight by −40.4 g, 95%CI −61.4, −19.5; birth length −0.14 cm, 95%CI −0.23, −0.05; head circumference −0.09 cm 95%CI −0.15, −0.02) and neighborhood disparity (birthweight −28.8 g, 95%CI −47.7, −10.0; birth length −0.12 cm, 95%CI −0.20, −0.05). The birthweight-lowering risk allele (SNP rs900400 near LEKR and CCNL1) magnified this association in an additive manner. However, likely due to sample size restriction, this association was not significant for the SNP rs9883204 in ADCY5. Birth size difference due to social stress was greater in the presence of birthweight-lowering alleles. Conclusions/Significance Social adversity, neighborhood disparity, and genetic variants have independent associations with infant birth size in the mutually adjusted analyses. If the newborn carried a risk allele rs900400 near LEKR/CCNL1, the impact of stress on birth size was stronger. These observations give support to the hypothesis that individuals with genetic or other biological risk are more vulnerable to e

231. Maternal pre-pregnancy body mass index and offspring attention deficit hyperactivity disorder: a population-based cohort study using a sibling-comparison design

Author: Chen, Qi, Sjolander, Arvid, Langstrom, Niklas, Rodriguez, Alina, Serlachius, Eva, D'Onofrio, Brian M., Lichtenstein, Paul, Larsson, Henrik, Chen, Qi, Sjolander, Arvid, Langstrom, Niklas, Rodriguez, Alina, Serlachius, Eva, D'Onofrio, Brian M., Lichtenstein, Paul, and Larsson, Henrik
Abstract: Background High maternal pre-pregnancy body mass index (BMI) is associated with increased risk of offspring attention deficit hyperactivity disorder (ADHD). However, the role of unmeasured familial confounding for this association remains unclear. Methods We conducted a population-based cohort study via linkage of Swedish national and regional registers to investigate maternal pre-pregnancy BMI (underweight: BMI <18.5; overweight: 25≤ BMI <30; obesity: BMI ≥30) in relation to offspring ADHD. We followed 673 632 individuals born in Sweden between 1992 and 2000, with prospectively collected information on maternal pre-pregnancy BMI, until they received an ADHD diagnosis or ADHD medication, death, emigration or 31 December 2009. Hazard ratios (HRs) were estimated by Cox proportional hazards models. Stratified Cox proportional hazards models were applied to data on full siblings to control for unmeasured familial confounding. Results At the population level, pre-pregnancy overweight/obesity was associated with increased risk of offspring ADHD (HRoverweight = 1.23, 95% CI = 1.18–1.27, P = 0.01; HRobesity = 1.64, 95% CI = 1.57–1.73, P = 0.01), after adjustment for measured covariates. In full sibling comparisons, however, previously observed associations no longer remained (HRoverweight = 0.98, 95% CI = 0.83–1.16, P = 0.82; HRobesity = 1.15, 95% CI = 0.85–1.56, P = 0.38). Conclusions The results suggested that the association between maternal pre-pregnancy overweight/obesity and offspring ADHD could be ascribed to unmeasured familial confounding.

232. Placental size Is associated with mental health in children and adolescents

Author: Khalife, Natasha, Glover, Vivette, Hartikainen, Anna-Liisa, Taanila, Anja, Ebeling, Hanna, Järvelin, Marjo-Riitta, Rodriguez, Alina, Khalife, Natasha, Glover, Vivette, Hartikainen, Anna-Liisa, Taanila, Anja, Ebeling, Hanna, Järvelin, Marjo-Riitta, and Rodriguez, Alina
Abstract: Background The role of the placenta in fetal programming has been recognized as a highly significant, yet often neglected area of study. We investigated placental size in relation to psychopathology, in particular attention deficit hyperactivity disorder (ADHD) symptoms, in children at 8 years of age, and later as adolescents at 16 years. Methodology/Principal Findings Prospective data were obtained from The Northern Finland Birth Cohort (NFBC) 1986. Placental weight, surface area and birth weight were measured according to standard procedures, within 30 minutes after birth. ADHD symptoms, probable psychiatric disturbance, antisocial disorder and neurotic disorder were assessed at 8 years (n = 8101), and ADHD symptoms were assessed again at 16 years (n = 6607), by teachers and parents respectively. We used logistic regression analyses to investigate the association between placental size and mental health outcomes, and controlled for gestational age, birth weight, socio-demographic factors and medical factors, during gestation. There were significant positive associations between placental size (weight, surface area and placental-to-birth-weight ratio) and mental health problems in boys at 8 and 16 years of age. Increased placental weight was linked with overall probable psychiatric disturbance (at 8y, OR = 1.14 [95% CI = 1.04–1.25]), antisocial behavior (at 8 y, OR = 1.14 [95% CI = 1.03–1.27]) and ADHD symptoms (inattention-hyperactivity at 16y, OR = 1.19 [95% CI = 1.02–1.38]). No significant associations were detected among girls. Conclusions/Significance Compensatory placental growth may occur in response to prenatal insults. Such overgrowth may affect fetal development, including brain development, and ultimately contribute to psychopathology.

233. Prevalence of purging at age 16 and associations with negative outcomes among girls in three community-based cohorts

Author: Solmi, Francesca, Sonneville, Kendrin R., Easter, Abigail, Horton, Nicholas J., Crosby, Ross D., Treasure, Janet, Rodriguez, Alina, Jarvelin, Marjo-Ritta, Field, Alison E., Micali, Nadia, Solmi, Francesca, Sonneville, Kendrin R., Easter, Abigail, Horton, Nicholas J., Crosby, Ross D., Treasure, Janet, Rodriguez, Alina, Jarvelin, Marjo-Ritta, Field, Alison E., and Micali, Nadia
Abstract: Background The comorbidity of purging behaviours, such as vomiting, inappropriate use of laxatives, diuretics or slimming medications, has been examined in literature. However, most studies do not include adolescents, individuals who purge in the absence of binge eating, or those purging at subclinical frequency. This study examines the prevalence of purging among 16-year-old girls across three countries and their association with substance use and psychological comorbidity. Methods Data were obtained by questionnaire in 3 population-based cohorts (Avon Longitudinal Study of Parents and Children (ALSPAC), United Kingdom, n = 1,608; Growing Up Today Study (GUTS), USA, n = 3,504; North Finland Birth Cohort (NFBC85/86), Finland, n = 2,306). Multivariate logistic regressions were employed to estimate associations between purging and outcomes. Four models were fit adjusting for binge eating and potential confounders of these associations. Results In ALSPAC, 9.7% of girls reported purging in the 12-months prior to assessment, 7.3% in GUTS, and 3.5% in NFBC. In all 3 cohorts, purging was associated with adverse outcomes such as binge drinking (ALSPAC: odds ratio (OR) = 2.0, 95% confidence interval (CI) = 1.4–2.9; GUTS: OR = 2.5, 95% CI = 1.5–4.0; NFBC: OR = 1.7, 95% CI = 1.0–2.8), drug use (ALSPAC: OR = 2.9, 95% CI = 1.8–4.7; GUTS: OR = 4.5, 95% CI = 2.8–7.3; NFBC: OR = 4.1, 95% CI = 2.6–6.6), depressive symptoms in ALSPAC (OR = 2.2, 95% CI = 1.5–3.1) and GUTS(OR = 3.7, 95% CI = 2.2–6.3), and several psychopathology measures including clinical anxiety/depression in NFBC (OR = 11.2, 95% CI = 3.9, 31.7). Conclusions Results show a higher prevalence of purging behaviours among girls in the United Kingdom compared to those in the United States and Finland. Our findings support evidence highlighting that purging in adolescence is associated with negative outcomes, independent of its frequency and binge eating.

234. Childhood attention-deficit/hyperactivity disorder symptoms are risk factors for obesity and physical inactivity in adolescence

Author: Khalife, Natasha, Kantomaa, Marko, Glover, Vivette, Tammelin, Tuija, Laitinen, Jaana, Ebeling, Hanna, Hurtig, Tuula, Jarvelin, Marjo-Riitta, Rodriguez, Alina, Khalife, Natasha, Kantomaa, Marko, Glover, Vivette, Tammelin, Tuija, Laitinen, Jaana, Ebeling, Hanna, Hurtig, Tuula, Jarvelin, Marjo-Riitta, and Rodriguez, Alina
Abstract: Objective To prospectively investigate the association and directionality between attention-deficit/hyperactivity disorder (ADHD) symptoms and obesity from childhood to adolescence in the general population. We examined whether obesogenic behaviors, namely, physical inactivity and binge eating, underlie the potential ADHD symptom–obesity association. We explored whether childhood conduct disorder (CD) symptoms are related to adolescent obesity/physical inactivity. Method At 7 to 8 years (n = 8,106), teachers reported ADHD and CD symptoms, and parents reported body mass index (BMI) and physically active play. At 16 years (n = 6,934), parents reported ADHD symptoms; adolescents reported physical activity (transformed to metabolic equivalent of task [MET] hours per week) and binge eating; BMI and waist–hip ratio (WHR) were measured via clinical examination. Obesity was defined using the International Obesity Task Force (IOTF) cut-offs for BMI and the 95th percentile cut-off for WHR. Results Childhood ADHD symptoms significantly predicted adolescent obesity, rather than the opposite. Inattention-hyperactivity symptoms at 8 years were associated with indices of obesity at 16 years (obese BMI: odds ratio [OR] = 1.91, 95% confidence interval [CI] = 1.10–3.33; 95th percentile WHR: OR = 1.71, 95% CI = 1.05–2.78), adjusted for gender, baseline BMI, physical activity, family structure change, and maternal education. Child CD symptoms associated with indices of adolescent obesity. Reduced physically active play in childhood predicted adolescent inattention (OR = 1.61, 95% CI = 1.16–2.24). Childhood ADHD and CD symptoms were linked with physical inactivity in adolescence (inattention-hyperactivity; OR = 1.60, 95% CI = 1.20–2.13), but not binge eating. Physical inactivity mediated the associations. Conclusions Children with ADHD or CD symptoms are at increased risk for becoming obese and physically inactive adolescents. Physical activity may be beneficial for both behavior proble
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235. Cognitive functioning and family risk factors in relation to symptom behaviors of ADHD and ODD in adolescents

Author: Forssman, Linda, Eninger, Lilianne, Tillman, Carin M., Rodriguez, Alina, Bohlin, Gunilla, Forssman, Linda, Eninger, Lilianne, Tillman, Carin M., Rodriguez, Alina, and Bohlin, Gunilla
Abstract: Objective: In this study, the authors investigated whether ADHD and oppositional defiant disorder (ODD) behaviors share associations with problems in cognitive functioning and/or family risk factors in adolescence. This was done by examining independent as well as specific associations of cognitive functioning and family risk factors with ADHD and ODD behaviors. Method: A sample of 120 adolescents from the general population was assessed on various cognitive tasks. ADHD and ODD behaviors were measured through parental and teacher ratings based on Diagnostic and Statistical Manual of Mental Disorders (4th edition) criteria. Parents and adolescents provided information regarding measures of family risk factors. Results: The results show that only cognitive functioning was associated with ADHD behaviors, and family risk factors were, independent of cognitive functioning, associated with ODD behaviors. Conclusion: These results suggest that cognitive performance bears a specific significance for ADHD behaviors, whereas family risk factors have specific importance for ODD behaviors.

236. Sleep Duration and Waking Activities in Relation to the National Sleep Foundation’s Recommendations: An Analysis of US Population Sleep Patterns from 2015 to 2017

Author: Mireku, Michael Osei, Rodriguez, Alina, Mireku, Michael Osei, and Rodriguez, Alina
Abstract: The objective was to investigate the association between time spent on waking activities and nonaligned sleep duration in a representative sample of the US population. We analysed time use data from the American Time Use Survey (ATUS), 2015–2017 (N = 31,621). National Sleep Foundation (NSF) age-specific sleep recommendations were used to define recommended (aligned) sleep duration. The balanced, repeated, replicate variance estimation method was applied to the ATUS data to calculate weighted estimates. Less than half of the US population had a sleep duration that mapped onto the NSF recommendations, and alignment was higher on weekdays (45%) than at weekends (33%). The proportion sleeping longer than the recommended duration was higher than those sleeping shorter on both weekdays and weekends (p < 0.001). Time spent on work, personal care, socialising, travel, TV watching, education, and total screen time was associated with nonalignment to the sleep recommendations. In comparison to the appropriate recommended sleep group, those with a too-short sleep duration spent more time on work, travel, socialising, relaxing, and leisure. By contrast, those who slept too long spent relatively less time on each of these activities. The findings indicate that sleep duration among the US population does not map onto the NSF sleep recommendations, mostly because of a higher proportion of long sleepers compared to short sleepers. More time spent on work, travel, and socialising and relaxing activities is strongly associated with an increased risk of nonalignment to NSF sleep duration recommendations.
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237. Effects of Cognitive Behavioural Therapy on insomnia in adults with tinnitus: systematic review and meta-analysis of randomised controlled trials

Author: Curtis, Ffion, Laparidou, Despina, Bridle, Christopher, Law, Graham, Durrant, Simon, Rodriguez, Alina, Pierzycki, Robert, Siriwardena, Niro, Curtis, Ffion, Laparidou, Despina, Bridle, Christopher, Law, Graham, Durrant, Simon, Rodriguez, Alina, Pierzycki, Robert, and Siriwardena, Niro
Abstract: Insomnia is common in patients with tinnitus and negatively affects tinnitus symptoms and quality of life. This systematic review aimed to synthesise evidence of the effectiveness of cognitive behavioural therapy (CBT) based interventions on insomnia in adults with tinnitus. We conducted a comprehensive database search (MEDLINE, CINAHL, Web of Science, CENTRAL, ClinicalTrials.gov and PROSPERO) for published, unpublished and ongoing randomised controlled trials of CBT in adults with tinnitus. Five trials met the inclusion criteria for the systematic review, with four of these providing data for the meta-analysis. This demonstrated a statistically significant reduction in Insomnia Severity Index (a standard diagnostic questionnaire of insomnia used in clinical settings) following CBT (-3.28, 95% CI -4.51, -2.05, P=<0.001). There was no evidence of statistical heterogeneity (I2=0%). Risk of bias was considered low in all categories except blinding of participants, personnel, and/or the assessment of outcomes. Here, for the first time, we demonstrate that CBT based interventions can significantly improve sleep in adults with tinnitus.

238. Prenatal glucocorticoid treatment and later mental health in children and adolescents

Author: Khalife, Natasha, Glover, Vivette, Taanila, Anja, Ebeling, Hanna, Järvelin, Marjo-Riitta, Rodriguez, Alina, Khalife, Natasha, Glover, Vivette, Taanila, Anja, Ebeling, Hanna, Järvelin, Marjo-Riitta, and Rodriguez, Alina
Abstract: Background Animal studies demonstrate a clear link between prenatal exposure to glucocorticoids (GC) and altered offspring brain development. We aim to examine whether prenatal GC exposure programs long-term mental health in humans. Methods Using propensity-score-matching, children prenatally exposed to synthetic glucocorticoids (sGC), n=37, and controls, n=185, were balanced on important confounders related to sGC treatment - gestational age and pre-pregnancy BMI. We also used mixed-effects modeling to analyse the entire cohort – matching each sGC case, n=37, to all possible controls, n=6079, on gestational age and sex. We obtained data from the Northern Finland Birth Cohort 1986 at four waves – pregnancy, birth, 8 and 16 years. Data on pregnancy and birth outcomes came from medical records. Mental health was assessed at 8 years by teachers with the Rutter B2 scale, and at 16 years by parents with the Strengths and Weaknesses of ADHD symptoms and Normal behavior (SWAN) scale and adolescents by the Youth Self-Report (YSR) scale. Results Prenatal sGC treatment was consistently associated with adverse mental health in childhood and adolescence, as shown by both the propensity-score method and mixed-effects model. Using the propensity-score-matched subsample, linear multiple regression showed prenatal sGC was significantly linked with general psychiatric disturbance (B=8.34 [95% CI: .23-16.45]) and inattention (B= .97 [95% CI: .16-1.80]) at 8 years after control for relevant confounders. Similar findings were obtained at 16 years, but did not reach statistical significance. Mediation by birthweight/placental weight was not detected. Conclusions This study is the first to prospectively investigate the long-term associations between prenatal exposure to sGC treatment and mental health in children and adolescents. We report an association between prenatal exposure to sGC and child mental health, supportive of the idea that sGC has a programming effect on the feta

239. Association of ADHD symptoms in adolescence and mortality in Northern Finland Birth Cohort 1986.

Author: Mustonen, Antti, Alakokkare, Anni-Emilia, Scott, James G., Halt, Anu-Helmi, Vuori, Miika, Hurtig, Tuula, Rodriguez, Alina, Miettunen, Jouko, and Niemelä, Solja
Subjects: *COHORT analysis, *ATTENTION-deficit hyperactivity disorder, *FAMILY structure, *ADOLESCENCE, *DISEASE risk factors
Abstract: Diagnosis of attention deficit hyperactive disorder (ADHD) has been associated with increased risk of mortality in large register samples. However, there is less known about the association between symptoms of ADHD in adolescents and risk of mortality in general population samples. The Northern Finland Birth Cohort 1986 (n = 9432 at recruitment in early pregnancy) linked to nationwide register data for deaths was utilized to study the association between parent-rated ADHD symptoms assessed using Strengths and Weaknesses of ADHD symptoms and Normal Behaviors (SWAN) questionnaire and mortality until age 33 years. Cox-regression analysis with hazard ratios (HRs) and 95% confidence intervals (CIs) was used to study the association between SWAN inattentive, hyperactive, and combined symptom scores and risk of death. Sixty-three (0.9%) of the 6685 participants died during the follow-up. Higher SWAN inattentive (crude HR = 2.30, 95% CI 1.46–3.63), SWAN hyperactive (crude HR = 2.43, 95% CI 1.29–4.56), and SWAN combined (crude HR = 2.69, 95% CI 1.57–4.61) scores were associated with increased risk of death. After adjustments for sex, family structure, and lifetime parental psychiatric disorder, these associations persisted. Further adjustment for frequent alcohol intoxication, cannabis, and other substance use in adolescence attenuated these to below statistical significance. These results extend previous findings on the risk of mortality in adolescents who have symptoms of ADHD. Further research with larger samples are needed to determine whether the association between ADHD symptoms and mortality is independent of adolescent substance use. [ABSTRACT FROM AUTHOR]
Published: 2023
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240. A genome-wide association study of total child psychiatric problems scores.

Author: Neumann, Alexander, Nolte, Ilja M., Pappa, Irene, Ahluwalia, Tarunveer S., Pettersson, Erik, Rodriguez, Alina, Whitehouse, Andrew, van Beijsterveldt, Catharina E. M., Benyamin, Beben, Hammerschlag, Anke R., Helmer, Quinta, Karhunen, Ville, Krapohl, Eva, Lu, Yi, van der Most, Peter J., Palviainen, Teemu, St Pourcain, Beate, Seppälä, Ilkka, Suarez, Anna, and Vilor-Tejedor, Natalia
Subjects: *GENOME-wide association studies, *GENETIC variation, *MENTAL illness, *EATING disorders, *SCHOOL children, *GENETIC correlations, *22Q11 deletion syndrome
Abstract: Substantial genetic correlations have been reported across psychiatric disorders and numerous cross-disorder genetic variants have been detected. To identify the genetic variants underlying general psychopathology in childhood, we performed a genome-wide association study using a total psychiatric problem score. We analyzed 6,844,199 common SNPs in 38,418 school-aged children from 20 population-based cohorts participating in the EAGLE consortium. The SNP heritability of total psychiatric problems was 5.4% (SE = 0.01) and two loci reached genome-wide significance: rs10767094 and rs202005905. We also observed an association of SBF2, a gene associated with neuroticism in previous GWAS, with total psychiatric problems. The genetic effects underlying the total score were shared with common psychiatric disorders only (attention-deficit/hyperactivity disorder, anxiety, depression, insomnia) (rG > 0.49), but not with autism or the less common adult disorders (schizophrenia, bipolar disorder, or eating disorders) (rG < 0.01). Importantly, the total psychiatric problem score also showed at least a moderate genetic correlation with intelligence, educational attainment, wellbeing, smoking, and body fat (rG > 0.29). The results suggest that many common genetic variants are associated with childhood psychiatric symptoms and related phenotypes in general instead of with specific symptoms. Further research is needed to establish causality and pleiotropic mechanisms between related traits. [ABSTRACT FROM AUTHOR]
Published: 2022
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241. Deciphering the link and direction between attention-deficit/hyperactivity disorder symptoms and obesity : common behavioural or prenatal pathways?

Author: Khalife, Natasha, Rodriguez, Alina, Jarvelin, Marjo-Riitta, and Glover, Vivette
Subjects: 614
Abstract: Growing evidence suggests an association between attention-deficit/hyperactivity disorder (ADHD) and obesity, although very little is understood about the nature of this link. The aims of this thesis were to examine the following aspects of the ADHD-obesity association: (1) the directionality of the link from childhood to adolescence, (2) behavioural mediators during childhood and adolescence, and (3) prenatal risk factors common for both disorders. Participants were from the Northern Finland Birth Cohort (NFBC) 1986 (N=9479). Data were obtained on pregnancy and birth factors, and child/adolescent mental health, obesity, and lifestyle factors. Regression analyses showed that ADHD symptoms significantly predicted obesity, rather than in the opposite direction, from childhood to adolescence. Mediation analyses examined potential underlying behavioural factors - physical activity and binge-eating, and showed that physical inactivity mediated the longitudinal ADHD symptom-obesity association. Further, there was a bidirectional, longitudinal association between physical inactivity and ADHD symptoms. ADHD and obesity may share common prenatal risk factors, including prenatal exposure to cortisol. This was studied using a quasi-experimental approach by examining the impact of prenatal exposure to synthetic glucocorticoids (sGC). Results from propensity-score and mixed-effects methods showed that prenatal sGC increased the risk for general psychiatric disturbance and inattention symptoms, but not obesity, in childhood. Placental size may represent another common prenatal contributing factor; placental size was positively associated with behaviour problems, including ADHD symptoms, in child and adolescent boys, but was not associated with obesity. This thesis addresses important unexplored aspects of the association between ADHD and obesity, and provides insight into risk factors for both disorders. The direction of the association was driven from ADHD symptoms to obesity, and physical inactivity was a behavioural mediator underlying the link. Although there was no evidence that both disorders share common prenatal risk, prenatal sGC and placental size were positively associated with ADHD symptoms.
Published: 2015
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242. Stress and glucocorticoid treatment during pregnancy, early growth and metabolic outcomes in childhood

Author: Ali Khan, Anokhi, Jarvelin, Marjo-Riitta, and Rodriguez, Alina
Subjects: 614
Abstract: Background: Variation in birth size has been linked to increased risk of a number of disorders later in life, including cardiovascular and metabolic disorders. However, less is known about other parameters of birth size, beyond birth weight, on later health. Moreover, the impact of the biological markers of stress, i.e. glucocorticoids, on various parameters of birth size remains understudied as well as their impact on later metabolic outcomes. Aims and objectives: The aim of this study was to examine the influence of the HPA axis on birth size (birth weight, ponderal index, birth length, head circumference) and subsequent metabolic health in adolescence. The main predictor being exposure to glucocorticoids either administered clinically or inferred as a result of maternal social stress. The genetic environment interplay of birth weight lowering alleles near LEKR and CCNL1 and in ADCY5 was also examined. Methods: Data came from the Northern Finland Birth Cohort (NFBC1986), and the National Finnish Medical Birth Registry (MBR) 2006-2010. Glucocorticoid treatment (sGC) to mature foetal lung in threatened preterm birth, social stress measures, and birth outcomes were obtained from medical records and via maternal report (in NFBC1986) during pregnancy. Data on NFBC1986 children at 16 years included anthropometry, blood pressure, blood sample for DNA, and metabolic outcomes. Results: The systematic literature review showed a dearth of information on the association of sGC on birth size, with the larger studies reporting smaller birth size in infants exposed to sGC. The NFBC1986 cohort showed only 17% (n=58) preterm infants had received sGC due to threatened preterm birth, with an association with smaller birth length of -0.18cm(95%CI -0.26, -0.10), but a larger birth weight of 116g(95%CI 98.9, 133.1) and head circumference of 0.75cm(95%CI 0.7, 0.81). In contrast, in the MBR (5090 exposed subjects) sGC treatment was consistently associated with lower birth weight of -207g(95%CI -220, -195), birth length of -1.26cm(95%CI -1.31, -1.20), head circumference of -0.94cm(95%CI -0.98, -0.90), and ponderal index of -0.91 (95%CI-1.02, -0.81). Maternal social stress during pregnancy and risk allele near LEKR and CCNL1 each was associated with smaller birth size. The association with stress was magnified with lower birth weight of -118g(95%CI -156, -79), birth length of -0.30cm(95%CI -0.46, -0.14), head circumference of -0.23cm(-0.35, -0.11), and ponderal index of -0.47(95%CI -0.67, -0.26) in the presence of risk allele. No robust association was found between maternal social stress during pregnancy and metabolic syndrome at 16 years. There was an association with more adverse lipid profile in particular with apolipoprotein B/A ratio (1.92% increase, 95%CI 0.34, 3.52, by maternal exposure to social stress). Conclusion: Stress and exposure to sGC during pregnancy in addition to genetic risk are related to smaller birth size. In the NFBC1986 there was no evidence of longer term impact of in utero stress exposure on metabolic syndrome in adolescence, though there was a poorer lipid profile noted. To better understand the degree to which the HPA axis plays in foetal programming, maternal and foetal cortisol levels during pregnancy would be beneficial.
Published: 2015
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243. Contribution to the determination of the chemotherapeutic drug G1 in biological fluids

Author: del Valle, Lizette Gil, W/Michael, Daniel Gebru, Rodríguez, Alina Martinez, Peraza, Rolando Tápanes, Ramos, Francisco, and Avila, Jorge Pérez
Published: 1997
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244. A genome-wide association study of total child psychiatric problems scores

Author: Carol A. Wang, Erik Pettersson, Jari Lahti, Irene Pappa, Gail M. Williams, Peter J. van der Most, Olli T. Raitakari, Jackob M. Najman, Henning Tiemeier, Amanda G. Wills, Craig E. Pennell, Terho Lehtimäki, Jouke-Jan Hottenga, Katri Räikkönen, Jakob Stokholm, Tarunveer S. Ahluwalia, Eva Krapohl, Marinus H. van IJzendoorn, Ilkka Seppälä, Christian Hakulinen, John K. Hewitt, Joachim Heinrich, Catharina E. M. van Beijsterveldt, Robert Plomin, Beben Benyamin, Marius Lahti-Pulkkinen, Lærke Sass, Ville Karhunen, Meike Bartels, Beate St Pourcain, Marie Standl, Silvia Alemany, Andrew J. O. Whitehouse, Alexander Neumann, Carla M. T. Tiesler, Gareth E. Davies, Elina Hyppönen, Catharina A. Hartman, Liisa Keltikangas-Järvinen, Ilja M. Nolte, Ang Zhou, Dorret I. Boomsma, Anjali K. Henders, Alina Rodriguez, Klaus Bønnelykke, Christel M. Middeldorp, Hans Bisgaard, Anke R. Hammerschlag, Kaili Rimfeld, Albertine J. Oldehinkel, Teemu Palviainen, Chris Power, Jaakko Kaprio, Tellervo Korhonen, Marian J. Bakermans-Kranenburg, Natalia Vilor-Tejedor, Yi Lu, Quinta Helmer, Anna Suarez, Jordi Sunyer, Harold Snieder, Neumann, Alexander [0000-0001-6653-3203], Ahluwalia, Tarunveer S [0000-0002-7464-3354], Rodriguez, Alina [0000-0003-1209-8802], van der Most, Peter J [0000-0001-8450-3518], Palviainen, Teemu [0000-0002-7847-8384], Kaprio, Jaakko [0000-0002-3716-2455], Lahti-Pulkkinen, Marius [0000-0002-5244-5525], Najman, Jackob M [0000-0001-7079-2080], Tiemeier, Henning [0000-0002-4395-1397], Apollo - University of Cambridge Repository, Life Course Epidemiology (LCE), Interdisciplinary Centre Psychopathology and Emotion regulation (ICPE), Institute for Molecular Medicine Finland, Genetic Epidemiology, University of Helsinki, Developmental Psychology Research Group, Department of Psychology and Logopedics, Helsinki Inequality Initiative (INEQ), Faculty Common Matters (Faculty of Education), Psychosocial factors and health, Medicum, Tellervo Korhonen / Principal Investigator, Department of Public Health, Child and Adolescent Psychiatry / Psychology, Clinical Genetics, Tampere University, Department of Clinical Chemistry, Clinical Medicine, Clinical Child and Family Studies, LEARN! - Child rearing, Biological Psychology, APH - Mental Health, APH - Personalized Medicine, APH - Health Behaviors & Chronic Diseases, APH - Methodology, Neumann, Alexander, Nolte, Ilja M, Pappa, Irene, Ahluwalia, Tarunveer S, Benyamin, Beben, Zhou, Ang, Hyppönen, Elina, and Tiemeier, Henning
Subjects: Bipolar Disorder, Genome-wide association study, Expression, Quality-control, Genome-wide association studies, genome-wide, 0302 clinical medicine, Human genetics, 0303 health sciences, education.field_of_study, Multidisciplinary, Bipolar Disorder/genetics, 1184 Genetics, developmental biology, physiology, Single Nucleotide, Metaanalysis, Neuroticism, 3. Good health, Physical sciences, Eating disorders, psychiatric disorders, Schizophrenia, Genome-Wide Association Study/methods, Anxiety, medicine.symptom, Attention Deficit Disorder with Hyperactivity/genetics, Research Article, medicine.medical_specialty, General psychopathology factor, General Science & Technology, Genetic loci, Population, FOS: Physical sciences, Polymorphism, Single Nucleotide, Age-of-onset, Heritability, 03 medical and health sciences, children, medicine, ADHD, Humans, Genetic Predisposition to Disease, Clinical genetics, Bipolar disorder, Polymorphism, Psychiatry, education, childhood, 030304 developmental biology, Medicine and health sciences, Biology and life sciences, business.industry, Questionnaire, Single nucleotide polymorphisms, medicine.disease, Research and analysis methods, Attention-deficit/hyperactivity disorder, Attention Deficit Disorder with Hyperactivity, Symptoms, Autism, Gene expression, Human medicine, 3111 Biomedicine, business, 030217 neurology & neurosurgery, Model, Genome-Wide Association Study
Abstract: Substantial genetic correlations have been reported across psychiatric disorders and numerous cross-disorder genetic variants have been detected. To identify the genetic variants underlying general psychopathology in childhood, we performed a genome-wide association study using a total psychiatric problem score. We analyzed 6,844,199 common SNPs in 38,418 school-aged children from 20 population-based cohorts participating in the EAGLE consortium. The SNP heritability of total psychiatric problems was 5.4% (SE = 0.01) and two loci reached genome-wide significance: rs10767094 and rs202005905. We also observed an association of SBF2, a gene associated with neuroticism in previous GWAS, with total psychiatric problems. The genetic effects underlying the total score were shared with common psychiatric disorders only (attention-deficit/hyperactivity disorder, anxiety, depression, insomnia) (rG > 0.49), but not with autism or the less common adult disorders (schizophrenia, bipolar disorder, or eating disorders) (rG < 0.01). Importantly, the total psychiatric problem score also showed at least a moderate genetic correlation with intelligence, educational attainment, wellbeing, smoking, and body fat (rG > 0.29). The results suggest that many common genetic variants are associated with childhood psychiatric symptoms and related phenotypes in general instead of with specific symptoms. Further research is needed to establish causality and pleiotropic mechanisms between related traits. The work of H. Tiemeier is further supported by a European Union’s Horizon 2020 research and innovation program (Contract grant number: 633595, DynaHealth) and a NWO-VICI grant (NWO-ZonMW: 016.VICI.170.200). https://www.nwo.nl/ The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Published: 2022
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245. Genetic association study of childhood aggression across raters, instruments, and age

Author: Nicholas G. Martin, S. Alexandra Burt, Louise Arseneault, Fazil Aliev, Luke M. Evans, Hill F. Ip, Beate St Pourcain, Michel G. Nivard, William E. Copeland, Rebecca K. Vinding, Scott Gordon, Koen Bolhuis, Christian J. Hopfer, Gun Peggy Knudsen, Stefan Johansson, Avshalom Caspi, Richard Border, Chandra A. Reynolds, Pål R. Njølstad, Liisa Keltikangas-Järvinen, Dorret I. Boomsma, Klaus Bønnelykke, Teemu Palviainen, Marta Ribasés, Alina Rodriguez, Catharina A. Hartman, Ilkka Seppälä, Christel M. Middeldorp, Rosa Bosch, Jan Haavik, Gail M. Williams, Andrea G. Allegrini, Ruth Ks, John R. B. Perry, Hadi Zafarmand, Chang Jiang, Elizabeth J. Costello, Camiel M. van der Laan, Olli T. Raitakari, Miquel Casas, Isabell Brikell, William G. Iacono, Jaakko Kaprio, John K. Hewitt, Andrew C. Heath, Eero Vuoksimaa, Xiaoran Tong, Gemma Español, Erik A. Ehli, Richie Poulton, Gareth E. Davies, Albertine J. Oldehinkel, Hans Bisgaard, Naomi R. Wray, Ted Reichborn-Kjennerud, Robert Plomin, Michael C. Stallings, Qing Lu, Jackob M. Najman, Daniel E. Adkins, Yi Lu, Harold Snieder, Sally J. Wadsworth, Alexander Neumann, Alexandra Havdahl, Karen Sugden, Kelly L. Klump, Andrew Smolen, Henrik Larsson, Toos C. E. M. van Beijsterveldt, Kenneth Krauter, Tarunveer S. Ahluwalia, Tellervo Korhonen, Andrey A. Shabalin, Joachim Heinrich, Anke R. Hammerschlag, Shelby Marrington, Lærke Sass, Pamela A. F. Madden, Henning Tiemeier, Tanja Vrijkotte, Paul Lichtenstein, Terho Lehtimäki, Ville Karhunen, Cristina Sánchez-Mora, Robin P. Corley, Anna A. E. Vinkhuyzen, Richard J. Rose, Per Magnus, Sabrina Llop, Ilja M. Nolte, S.A. Brown, Christian Hakulinen, Anjali K. Henders, Marie Standl, Silvia Alemany, Gretchen R.B. Saunders, Jouke-Jan Hottenga, Eveline L. de Zeeuw, Meike Bartels, Elisabeth Thiering, José J. Morosoli, Fiona A. Hagenbeek, Laura Pulkki-Råback, Frank C. Verhulst, Martin A. Kennedy, Craig E. Pennell, Eva Krapohl, Kaili Rimfeld, Tetyana Zayats, Lucía Colodro-Conde, Judith B.M. Ensink, André G. Uitterlinden, Natalia Vilor-Tejedor, Felix R. Day, Jennifer R. Harris, George Davey Smith, Qi Chen, Sebastian Lundström, Marjo-Riitta Järvelin, Alyce M. Whipp, Katrina L. Grasby, L. John Horwood, John Pearson, Judy L. Silberg, Paula Rovira, Hermine H. Maes, Carol A. Wang, Roseann E. Peterson, Tamara L. Wall, Andrew J. O. Whitehouse, Maria-Jose Lopez-Espinosa, Najaf Amin, Jess Tyrrell, Danielle M. Dick, Sarah E. Medland, Allison L. Miller, Øyvind Helgeland, Josep Antoni Ramos Quiroga, Joseph M. Boden, Abdullah Mamun, James Scott, María Soler Artigas, Joseph A. Prinz, Lindon J. Eaves, Terrie E. Moffitt, Matt McGue, Jordi Sunyer, Joanna Martin, Tampere University, Clinical Medicine, Department of Clinical Chemistry, Apollo-University Of Cambridge Repository, Ip, Hill F [0000-0003-1991-5019], Sánchez-Mora, Cristina [0000-0003-4211-1107], Nolte, Ilja M [0000-0001-5047-4077], St Pourcain, Beate [0000-0002-4680-3517], Palviainen, Teemu [0000-0002-7847-8384], Colodro-Conde, Lucía [0000-0002-9004-364X], Gordon, Scott [0000-0001-7623-328X], Aliev, Fazil [0000-0001-8357-4699], Karhunen, Ville [0000-0001-6064-1588], Border, Richard [0000-0002-6293-2968], Ahluwalia, Tarunveer S [0000-0002-7464-3354], Day, Felix R [0000-0003-3789-7651], Hottenga, Jouke-Jan [0000-0002-5668-2368], Rimfeld, Kaili [0000-0001-5139-065X], Lu, Yi [0000-0001-9933-3654], Soler Artigas, María [0000-0002-3213-1107], Bosch, Rosa [0000-0002-7596-183X], Ramos Quiroga, Josep Antoni [0000-0003-1622-0350], Neumann, Alexander [0000-0001-6653-3203], Grasby, Katrina [0000-0001-8539-0228], Middeldorp, Christel [0000-0002-6218-0428], Evans, Luke M [0000-0002-7458-1720], Alemany, Silvia [0000-0002-7925-6767], Sass, Lærke [0000-0002-5217-7014], Ruth, Kate [0000-0003-4966-9170], Ehli, Erik A [0000-0002-7865-3015], Hagenbeek, Fiona A [0000-0002-8773-0430], Snieder, Harold [0000-0003-1949-2298], Uitterlinden, André G [0000-0002-7276-3387], Haavik, Jan [0000-0001-7865-2808], Johansson, Stefan [0000-0002-2298-7008], Knudsen, Gun Peggy S [0000-0002-6193-4291], Njolstad, Pal Rasmus [0000-0003-0304-6728], Rodriguez, Alina [0000-0003-1209-8802], Brown, Sandy [0000-0001-8780-0323], Miller, Allison [0000-0003-3816-2251], Keltikangas-Järvinen, Liisa [0000-0002-7977-3852], Havdahl, Alexandra [0000-0002-9268-0423], Perry, John RB [0000-0001-6483-3771], Lehtimäki, Terho [0000-0002-2555-4427], Arseneault, Louise [0000-0002-2938-2191], Boden, Joseph [0000-0003-1502-1608], Pearson, John [0000-0001-5607-4517], Kennedy, Martin [0000-0002-6445-8526], Poulton, Richie [0000-0002-1052-4583], Copeland, William E [0000-0002-1348-7781], Wray, Naomi [0000-0001-7421-3357], Järvelin, Marjo-Riitta [0000-0002-2149-0630], McGue, Matt [0000-0002-5580-1433], Pennell, Craig E [0000-0002-0937-6165], Dick, Danielle M [0000-0002-1636-893X], Martin, Nicholas G [0000-0003-4069-8020], Medland, Sarah E [0000-0003-1382-380X], Kaprio, Jaakko [0000-0002-3716-2455], Tiemeier, Henning [0000-0002-4395-1397], Davey Smith, George [0000-0002-1407-8314], Oldehinkel, Albertine J [0000-0003-3925-3913], Ribasés, Marta [0000-0003-1039-1116], Lichtenstein, Paul [0000-0003-3037-5287], Plomin, Robert [0000-0002-0756-3629], Bartels, Meike [0000-0002-9667-7555], Nivard, Michel G [0000-0003-2015-1888], Boomsma, Dorret I [0000-0002-7099-7972], Apollo - University of Cambridge Repository, Life Course Epidemiology (LCE), Interdisciplinary Centre Psychopathology and Emotion regulation (ICPE), Child and Adolescent Psychiatry / Psychology, Epidemiology, Internal Medicine, Institute for Molecular Medicine Finland, Genetic Epidemiology, Helsinki Institute of Life Science HiLIFE, University of Helsinki, Tellervo Korhonen / Principal Investigator, Cognitive and Brain Aging, Faculty Common Matters (Faculty of Medicine), Medicum, Doctoral Programme in Cognition, Learning, Instruction and Communication, Department of Psychology and Logopedics, Helsinki Inequality Initiative (INEQ), Faculty Common Matters (Faculty of Education), Psychosocial factors and health, Behavioural Sciences, Department of Public Health, Adult Psychiatry, Epidemiology and Data Science, APH - Aging & Later Life, APH - Methodology, ARD - Amsterdam Reproduction and Development, Graduate School, Child Psychiatry, ACS - Pulmonary hypertension & thrombosis, ANS - Cellular & Molecular Mechanisms, ANS - Compulsivity, Impulsivity & Attention, Public and occupational health, APH - Health Behaviors & Chronic Diseases, Institut Català de la Salut, [Ip HF] Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. [van der Laan CM] Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. Netherlands Institute for the Study of Crime and Law Enforcement, Amsterdam, The Netherlands. [Krapohl EML] Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK. [Brikell I] Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. [Sánchez-Mora C, Soler Artigas M, Rovira P, Ribasés M] Servei de Psiquiatria, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain. Unitat de Genètica Psiquiàtrica, Grup de Recerca en Psiquiatria, Salut Mental i Addicció, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Nolte IM] Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. [Bosch R] Servei de Psiquiatria, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain. Servei de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Bellaterra, Spain. [Español G] Servei de Psiquiatria, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Ramos Quiroga JA, Ribasés M] Servei de Psiquiatria, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain. Unitat de Genètica Psiquiàtrica, Grup de Recerca en Psiquiatria, Salut Mental i Addicció, Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. Servei de Psiquiatria i Medicina Legal, Universitat Autònoma de Barcelona, Bellaterra, Spain, Vall d'Hebron Barcelona Hospital Campus, Biological Psychology, APH - Personalized Medicine, APH - Mental Health, Amsterdam Reproduction & Development, Perry, John R B [0000-0001-6483-3771], Ip, Hill F. [0000-0003-1991-5019], Nolte, Ilja M. [0000-0001-5047-4077], Ahluwalia, Tarunveer S. [0000-0002-7464-3354], Day, Felix R. [0000-0003-3789-7651], Evans, Luke M. [0000-0002-7458-1720], Ehli, Erik A. [0000-0002-7865-3015], Hagenbeek, Fiona A. [0000-0002-8773-0430], Uitterlinden, André G. [0000-0002-7276-3387], Knudsen, Gun Peggy S. [0000-0002-6193-4291], Perry, John R. B. [0000-0001-6483-3771], Copeland, William E. [0000-0002-1348-7781], Pennell, Craig E. [0000-0002-0937-6165], Dick, Danielle M. [0000-0002-1636-893X], Martin, Nicholas G. [0000-0003-4069-8020], Medland, Sarah E. [0000-0003-1382-380X], Oldehinkel, Albertine J. [0000-0003-3925-3913], Nivard, Michel G. [0000-0003-2015-1888], and Boomsma, Dorret I. [0000-0002-7099-7972]
Subjects: 0301 basic medicine, DISORDER, 45/43, Genome-wide association study, 3124 Neurology and psychiatry, 0302 clinical medicine, Child, Psychiatry, 0303 health sciences, trastornos mentales [PSIQUIATRÍA Y PSICOLOGÍA], HERITABILITY, Mental Disorders, Cognition, Genomics, Explained variation, Justice and Strong Institutions, Aggression, Psychiatry and Mental health, Meta-analysis, ADOLESCENCE, Child, Preschool, conducta y mecanismos de la conducta::conducta::síntomas conductuales::agresión [PSIQUIATRÍA Y PSICOLOGÍA], 631/208/212, Female, Biological psychiatry, medicine.symptom, Life Sciences & Biomedicine, Investigative Techniques::Genetic Techniques::Genetic Association Studies [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], BEHAVIOR, RC321-571, Childhood aggression, Clinical psychology, SDG 16 - Peace, Adolescent, Mental Disorders [PSYCHIATRY AND PSYCHOLOGY], Neurosciences. Biological psychiatry. Neuropsychiatry, Single-nucleotide polymorphism, Biology, 3121 Internal medicine, Malalties mentals - Aspectes genètics, Genetic correlation, Article, 1117 Public Health and Health Services, Cellular and Molecular Neuroscience, 03 medical and health sciences, 631/477/2811, SDG 3 - Good Health and Well-being, Human behaviour, medicine, SNP, Humans, GENOME-WIDE ASSOCIATION, Biological Psychiatry, Genetic Association Studies, 030304 developmental biology, Genetic association, Retrospective Studies, técnicas de investigación::técnicas genéticas::estudios de asociación genética [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Science & Technology, SDG 16 - Peace, Justice and Strong Institutions, Infant, Behavior and Behavior Mechanisms::Behavior::Behavioral Symptoms::Aggression [PSYCHIATRY AND PSYCHOLOGY], 1103 Clinical Sciences, Agressivitat en els infants, Heritability, 030104 developmental biology, 1701 Psychology, ORIGINS, Research Programm of Donders Centre for Neuroscience, 3111 Biomedicine, TRAJECTORIES, 030217 neurology & neurosurgery, Demography, Genome-Wide Association Study
Abstract: Childhood aggressive behavior (AGG) has a substantial heritability of around 50%. Here we present a genome-wide association meta-analysis (GWAMA) of childhood AGG, in which all phenotype measures across childhood ages from multiple assessors were included. We analyzed phenotype assessments for a total of 328 935 observations from 87 485 children aged between 1.5 and 18 years, while accounting for sample overlap. We also meta-analyzed within subsets of the data, i.e., within rater, instrument and age. SNP-heritability for the overall meta-analysis (AGGoverall) was 3.31% (SE = 0.0038). We found no genome-wide significant SNPs for AGGoverall. The gene-based analysis returned three significant genes: ST3GAL3 (P = 1.6E–06), PCDH7 (P = 2.0E–06), and IPO13 (P = 2.5E–06). All three genes have previously been associated with educational traits. Polygenic scores based on our GWAMA significantly predicted aggression in a holdout sample of children (variance explained = 0.44%) and in retrospectively assessed childhood aggression (variance explained = 0.20%). Genetic correlations (rg) among rater-specific assessment of AGG ranged from rg = 0.46 between self- and teacher-assessment to rg = 0.81 between mother- and teacher-assessment. We obtained moderate-to-strong rgs with selected phenotypes from multiple domains, but hardly with any of the classical biomarkers thought to be associated with AGG. Significant genetic correlations were observed with most psychiatric and psychological traits (range $$\left| {r_g} \right|$$ r g : 0.19–1.00), except for obsessive-compulsive disorder. Aggression had a negative genetic correlation (rg = ~−0.5) with cognitive traits and age at first birth. Aggression was strongly genetically correlated with smoking phenotypes (range $$\left| {r_g} \right|$$ r g : 0.46–0.60). The genetic correlations between aggression and psychiatric disorders were weaker for teacher-reported AGG than for mother- and self-reported AGG. The current GWAMA of childhood aggression provides a powerful tool to interrogate the rater-specific genetic etiology of AGG.
Published: 2021
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246. Childhood Attention-Deficit/Hyperactivity Disorder Symptoms Are Risk Factors for Obesity and Physical Inactivity in Adolescence.

Author: Khalife, Natasha, Kantomaa, Marko, Glover, Vivette, Tammelin, Tuija, Laitinen, Jaana, Ebeling, Hanna, Hurtig, Tuula, Jarvelin, Marjo-Riitta, and Rodriguez, Alina
Subjects: *CHILDREN with attention-deficit hyperactivity disorder, *CHILDHOOD obesity, *ADOLESCENT obesity, *BEHAVIOR disorders in children, *SEDENTARY behavior in children, *SEDENTARY lifestyles
Abstract: Objective: To prospectively investigate the association and directionality between attention-deficit /hyperactivity disorder (ADHD) symptoms and obesity from childhood to adolescence in the general population. We examined whether obesogenic behaviors, namely, physical inactivity and binge eating, underlie the potential ADHD symptom-obesity association. We explored whether childhood conduct disorder (CD) symptoms are related to adolescent obesity/physical inactivity. Method: At 7 to 8 years (n = 8,106), teachers reported ADHD and CD symptoms, and parents reported body mass index (BMI) and physically active play. At 16 years (n = 6,934), parents reported ADHD symptoms; adolescents reported physical activity (transformed to metabolic equivalent of task [MET] hours per week) and binge eating; BMI and waist-hip ratio (WHR) were measured via clinical examination. Obesity was defined using the International Obesity Task Force (IOTF) cut-offs for BMI and the 95th percentile cut-off for WHR. Results: Childhood ADHD symptoms significantly predicted adolescent obesity, rather than the opposite. Inattention-hyperactivity symptoms at 8 years were associated with indices of obesity at 16 years (obese BMI: odds ratio [OR] = 1.91, 95% confidence interval [CI] = 1.10-3.33; 95th percentile WHR: OR = 1.71, 95% CI = 1.05-2.78), adjusted for gender, baseline BMI, physical activity, family structure change, and maternal education. Child CD symptoms associated with indices of adolescent obesity. Reduced physically active play in childhood predicted adolescent inattention (OR = 1.61, 95% CI = 1.16-2.24). Childhood ADHD and CD symptoms were linked with physical inactivity in adolescence (inattention-hyperactivity; OR = 1.60, 95% CI = 1.20-2.13), but not binge eating. Physical inactivity mediated the associations. Conclusions: Children with ADHD or CD symptoms are at increased risk for becoming obese and physically inactive adolescents. Physical activity may be beneficial for both behavior problems and obesity. [ABSTRACT FROM AUTHOR]
Published: 2014
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247. Obesity and co-morbid hypertensive and diabetic disorders in pregnancy and early manifestations of neurodevelopmental adversity in the offspring : Prediction and Prevention of Pre-eclampsia and Intrauterine Growth Restriction (PREDO) Study

Author: Girchenko, Polina, University of Helsinki, Faculty of Medicine, Department of Psychology and Logopedics, Doctoral Programme in Psychology, Learning and Communication, Helsingin yliopisto, lääketieteellinen tiedekunta, Psykologian, oppimisen ja kommunikaation tohtoriohjelma, Helsingfors universitet, medicinska fakulteten, Doktorandprogrammet i psykologi, lärande och kommunikation, Rodriguez, Alina, Räikkönen-Talvitie, Katri, and Lahti, Jari
Subjects: Psychology
Abstract: The prevalence of women entering pregnancy with overweight and obesity is growing worldwide reaching epidemic proportions. Apart from the risks of maternal and fetal morbidity associated with overweight and obesity, excessive weight is also an essential risk factor for diabetic and hypertensive disorders occurring before and during pregnancy. Maternal obesity and co-morbid hypertensive and diabetic disorders affect fetal development and have been linked with compromised neurodevelopment of the offspring; however, previous findings are not entirely consistent. Further, due to high co-morbidity between maternal overweight/obesity and hypertensive and diabetic disorders, it is difficult to disentangle their individual effects on child neurodevelopment. In addition, the mechanisms underlying associations between maternal overweight/obesity and co-morbid disorders and child neurodevelopment remain elusive. This thesis examines the effects of maternal overweight/obesity and co-morbid hypertensive and diabetic disorders on early manifestations of neurodevelopmental adversity and on developmental delay in early childhood. It also examines whether DNA methylation (DNAm) biomarker of gestational age (GA) at birth reflects prenatal exposure to maternal overweight/obesity and co-morbid hypertensive and diabetic disorders, and hence, has a potential to identify individuals at risk for neurodevelopmental adversity already at birth. This thesis capitalizes on the Prediction and Prevention of Pre-eclampsia and Intrauterine Growth Restriction (PREDO) birth cohort comprising 4777 women and their singleton children born in Finland between 2006 and 2010. Data on maternal early pregnancy BMI, pre-pregnancy and gestational hypertension, pre-eclampsia, type 1 diabetes and gestational diabetes mellitus (GDM) were derived from the Finnish Medical Birth Register (MBR). DNAm gestational age (DNAm GA) was calculated using the method based on the methylation profile of 148 selected cytosine-phosphate-guanine (CpG) sites on DNA. Regulatory behavior problems in infancy were measured using Neonatal Perception Inventory (NPI) at the infant’s mean age of 16.9 (SD=7.6) days. Developmental milestones were measured using Ages and Stages Questionnaire (ASQ) Third edition at the child’s mean age of 42.1 (SD=8.2) months. In comparison to the infants born to normal weight mothers, infants born to overweight/obese mothers displayed more regulatory behavior problems and were more likely to display regulatory behavior problems in multiple areas of self-regulation. These effects were independent of the co-morbid hypertensive and diabetic disorders (Study II). Children of overweight and obese mothers were more likely to display more severe and pervasive developmental delay in comparison to the children on normal weight mothers. The effects of maternal overweight and obesity on severity and pervasiveness of developmental delay in early childhood were also independent of the co-morbid hypertensive and diabetic disorders (Study III). Infant regulatory behavior problems partially mediated the association between maternal overweight/obesity and child neurodevelopmental milestones (Study II). Maternal pre-eclampsia was marginally associated with infant regulatory problems in multiple areas of self-regulation in normal weight non-diabetic women, but its effect was not significant in overweight/obese women and/or women with GDM (Study II). Maternal pre-eclampsia increased the odds of more severe and pervasive developmental delay in early childhood, and these effects were lower in the presence of overweight/obesity and diabetic disorders (Study III). GDM was not associated with infant regulatory behavior problems (Study II). The effect of GDM on severity and pervasiveness of developmental delay in early childhood was partially driven by maternal overweight/obesity and/or pre-eclampsia (Study III). Gestational and chronic hypertension were not associated with infant regulatory behavior problems and developmental delay(Studies II and III). Maternal BMI was not associated with variation in DNAm GA (Study IV). Maternal pre-eclampsia was associated with DNAm GA acceleration (Study IV). GDM in index pregnancy was not associated with variation in DNAm GA, however, insulin treated GDM in previous pregnancy was associated with DNAm GA deceleration (Study IV). These study findings suggest that maternal overweight and obesity affect child neurodevelopment independently of the co-morbid hypertensive and diabetic disorders, and that the trajectory of this effect can partially be traced from infant regulatory behavior problems to developmental delay in early childhood. Hence, infant regulatory behavior problems may represent an early manifestation of neurodevelopmental adversity due to prenatal exposure to maternal overweight/obesity. Pre-eclampsia increases the risk of developmental delay in early childhood independently of maternal overweight, obesity and diabetic disorders and its adverse effects on child neurodevelopment have a potential to be detected already at birth by assessing DNAm GA. Adverse effects of gestational diabetes on child neurodevelopment can be partially accounted for by highly co-morbid maternal overweight/ obesity and pre-eclampsia. Efforts aimed at weight management among women of reproductive age and prevention of pre-eclampsia during pregnancy are likely to reduce the burden of neurological morbidity in the future. Yhä useampi hedelmällisessä iässä oleva nainen ympäri maailmaa on ylipainoinen tai lihava. Ylipaino on tärkeä diabeteksen ja verenpainesairauksien riskitekijä sekä yleisesti että raskauden aikana, ja näitä häiriöitä voidaankin kuvata ylipainon ja lihavuuden liitännäissairauksiksi. Aiempien tutkimusten perusteella äidin lihavuus ja nämä liitännäissairaudet vaikuttavat sikiön kehitykseen ja voivat mahdollisesti lisätä lapsen käytös- ja tunnehäiriöiden ja muiden kehityksellisten ongelmien riskiä, mutta nämä aiemmat tulokset ovat osin ristiriidassa keskenään. Lisäksi on vaikeaa arvioida, mikä on yksittäisten riskitekijöiden itsenäinen merkitys lapsen kehityksen kannalta, sillä äidin lihavuus ja ylipaino, diabetes ja verenpainesairaudet esiintyvät usein yhdessä. On myös huomattava, että mekanismit, jotka selittävät äidin ylipainon tai lihavuuden ja sen liitännäissairauksien yhteyttä lapsen kehitykseen ovat edelleen varsin epäselviä. Tässä väitöskirjassa tarkastellaan äidin ylipainon ja lihavuuden sekä diabeteksen ja verenpainehäiriöiden vaikutusta lapsen varhaisiin käytös- ja tunnehäiriöiden ilmentymiin sekä kehitysviivästymiin. Lisäksi väitöskirjassa tarkastellaan vastasyntyneen perimäaineksen epigeneettisiä muutoksia, eli DNA:ssa ennen syntymää tapahtuneita muokkauksia, joiden johdosta emäsjärjestys ei muutu, mutta jotka voivat vaikuttaa solujen toimintaan. Epigeneettisten muutosten osalta selvitetään, ovatko ne yhteydessä äidin raskauden aikaiseen lihavuuteen, ylipainoon ja liitännäissairauksiin. Lisäksi selvitetään, voitaisiinko epigeneettisiä muutoksia tutkimalla auttaa tunnistamaan mahdollisimman varhaisessa vaiheessa ne lapset, joilla on kohonnut kehityksen häiriöiden riski. Väitöskirja on toteutettu osana suomalaista Predo-tutkimusta. Predo (Pre-eklampsian ennustaminen ja ehkäisy) on seurantatutkimus, johon kuuluu 4777 äitiä sekä heidän lastaan, jotka syntyivät Suomessa 2006-2010. Äidin varhaisraskauden painoindeksiä, diabetesta ja verenpainesairauksia koskeva tieto kerättiin Terveyden ja Hyvinvoinnin laitoksen ylläpitämästä kansallisesta Syntyneiden lasten rekisteristä. Epigeneettisten muutosten osalta tarkasteltiin syntymän yhteydessä otettuja napanuoran verinäytteitä, joista on mahdollista tutkia vastasyntyneen soluja. Tutkimuksessa valittiin vastasyntyneen DNA:sta 148 sytosiini-fosfaatti-guaniini-kohtaa, joiden metylaatioaste heijastelee raskauden kestoa, ja näiden kohtien metylaatioastetta tarkasteltiin suhteessa äidin painoon, sairauksiin sekä lapsen kehitykseen. Itsesäätelyvaikeuksia imeväisiässä mitattiin Neonatal Perception Inventory -kyselylomakkeella, jonka vastasyntyneiden äidit täyttivät keskimäärin 17 päivää synnytyksen jälkeen. Kehitysviivästymiä arvioitiin Ages and Stages -kyselylomakkeella, jonka äidit täyttivät lapsen ollessa keskimäärin 42 kuukauden ikäinen. Tutkimuksessa havaittiin, että äidin ylipaino ja lihavuus vaikuttavat lapsen kehitykseen riippumatta liitännäissairauksista eli myös silloin, kun diabeteksen ja verenpainesairauksien vaikutus lapseen on huomioitu. Äidin ylipaino ja lihavuus olivat tutkimuksessa yhteydessä sekä vastasyntyneen varhaisiin itsesäätelyn vaikeuksiin että kehitysviivästymiin varhaislapsuudessa. Tutkimuslöydösten perusteella vastasyntyneen itsesäätelyvaikeudet voivat olla äidin ylipainon ja lihavuuden haittavaikutusten varhainen ilmentymä lapsessa. Tutkimuksessa havaittiin lisäksi, että pre-eklampsia – raskaushäiriö, joka aiheuttaa muun muassa verenpaineen nousua ja jota on kutsuttu Suomessa myös raskausmyrkytykseksi – lisää lapsen varhaisen kehitysviivästymän riskiä riippumatta äidin ylipainosta, lihavuudesta tai diabeteksesta. Tulosten perusteella on mahdollista, että pre-eklampsian haitalliset vaikutukset lapsen kehitykseen voidaan havaita jo varhain tutkimalla vastasyntyneen perimäaineksessa tapahtuneita epigeneettisiä muutoksia. Hedelmällisessä iässä olevien naisten painonhallintaan ja pre-eklampsian ehkäisyyn tähtäävät toimet voisivat vähentää psykiatristen ja neurologisten sairauksien kuormaa tulevaisuudessa.
Published: 2018

248. 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

Author: Yong Zhao, Hadi Danawi, Bach Xuan Tran, Gene Bukhman, Vasiliki Stathopoulou, Taavi Tillmann, Nelson Alvis-Guzman, Yongmei Li, Jerry Puthenpurakal Abraham, Sudan Prasad Neupane, Jack Caravanos, Ben Schöttker, Rafael Lozano, Damian G Hoy, Yoshihiro Kokubo, Nicholas J K Breitborde, Sergey Soshnikov, Yukito Shinohara, Randall V. Martin, Michael Brainin, Fernando Perez-Ruiz, Yingfeng Zheng, Santosh Mishra, Julio Cesar Montañez Hernandez, Michael Phillips, Belinda J. Gabbe, Hebe N. Gouda, Ziad A. Memish, Rupert R A Bourne, Guoqing Hu, Emmanuel A. Ameh, Abigail McLain, Michelle L. Bell, Christopher Margono, Marissa Iannarone, Wilkister N. Moturi, Donald H. Silberberg, Carl Abelardo T. Antonio, Nataliya Foigt, Anand Dayama, Yanping Wang, Amanda J. Mason-Jones, Bolajoko O. Olusanya, Monica S. Vavilala, Katherine B Gibney, David Tanne, Sidibe S Kany Roseline, Marcella Montico, Abhishek Singh, Sarah Derrett, Alireza Esteghamati, Seok Jun Yoon, Corine Karema, Rakhi Dandona, David M. Pereira, Kazem Rahimi, Gitanjali M. Singh, Vivekanand Jha, John Hornberger, Anne M. Riederer, Kathryn H. Jacobsen, Andrea Pedroza, Lily Alexander, Fiona M. Blyth, Tommi Vasankari, Kyle J Foreman, Rana J. Asghar, Tilahun Nigatu Haregu, Yousef Khader, Rafael Alfonso-Cristancho, Suzanne Barker-Collo, Lydia S. Atkins, Simerjot K. Jassal, Mohammad Ali Sahraian, Peter Scarborough, Hans W. Hoek, E. Ray Dorsey, Muluken Dessalegn, David C. Schwebel, Gavin Shaddick, Thomas D. Fleming, Mohammad Tavakkoli, Dorairaj Prabhakaran, Mohammad H. Forouzanfar, Christopher C. Mapoma, Jost B. Jonas, Erin C Mullany, Gene F. Kwan, Johanna M. Geleijnse, Antonio Luiz Pinho Ribeiro, Roberto Tchio Talongwa, Tolesa Bekele, Jed D. Blore, Gunn Marit Aasvang, Philimon Gona, Miguel Angel Alegretti, Babak Eshrati, Mitsuru Mukaigawara, Richard F. Gillum, Odgerel Chimed-Ochir, Ubai Alsharif, Richard C. Franklin, Felix Masiye, Richard T. Burnett, Sanjay Krishnaswami, Martin McKee, John J Huang, Lucía Cuevas-Nasu, Wagner Marcenes, Walid Ammar, Knud Juel, Joseph R. Zunt, Martha M Téllez Rojo, Mamta Swaroop, Noela M Prasad, Azmeraw T. Amare, Tim Driscoll, Michael Kravchenko, Heresh Amini, Amir Sapkota, Theo Vos, Charlotte Watts, Dennis Odai Laryea, D. Alex Quistberg, Justin Beardsley, Cheng Huang, Adnan M. Durrani, Sarah V Thackway, Rita Van Dingenen, Manami Inoue, Martha Híjar, Honglei Chen, Amany H. Refaat, Yichong Li, Vineet K. Chadha, Wenzhi Wang, Louisa Degenhardt, Kingsley N. Ukwaja, Nayu Ikeda, James D. Wilkinson, Linh N Bui, Maria Hagströmer, Gonghuan Yang, Ann Kristin Knudsen, David J. Margolis, Soewarta Kosen, Hans Kromhout, Atsushi Goto, Man Mohan Mehndiratta, Thomas N. Williams, Michael Soljak, Yun Jin Kim, Hideaki Toyoshima, Jeyaraj D Pandian, Borja del Pozo-Cruz, Soufiane Boufous, Ivy Shiue, Anders Larsson, Guilherme V. Polanczyk, John Powles, Yara A. Halasa, Robin Room, Ratilal Lalloo, Carolina Batis Ruvalcaba, Panniyammakal Jeemon, Elisabete Weiderpass, Jürgen Rehm, Ejaz Ahmad Khan, Alicia Aleman, Zacharie Tsala Dimbuene, Elena Alvarez, Rachelle Buchbinder, Randah R. Hamadeh, Bryan Hubbell, Sadaf G. Sepanlou, Farhad Islami, Costas A. Christophi, Heidi Stöckl, Ismael R. Campos-Nonato, Nigel Bruce, Edward J Mills, Samuel A L Perry, Taavi Lai, Baffour Awuah, Mete Saylan, Karen J. Courville, Arindam Basu, Vanessa De la Cruz-Góngora, Teresita González de Cosío, Naohiro Yonemoto, Frida Namnyak Ngalesoni, Muluken Azage Yenesew, Atte Meretoja, Michael Brauer, Cyrus Cooper, Giorgia Giussani, Valentina S. Arsic Arsenijevic, Vasiliy Victorovich Vlassov, André Karch, Leilei Duan, Matthew M Coates, Omid Ameli, Gelin Xu, Matthias Endres, Ganesan Karthikeyan, Ione Jayce Ceola Schneider, Mohamed Hsairi, Palwasha Anwari, Mazin J. Al Khabouri, Dariush Mozaffarian, Juan R. Sanabria, Pablo M. Lavados, Sumeet S. Chugh, Johan Ärnlöv, Ivo Rakovac, Maurice Giroud, Haidong Kan, Ibrahim Abdelmageem Mohamed Ginawi, José Luis Texcalac-Sangrador, Luigi Naldi, Erica Leigh Slepak, Deena Alasfoor, James E. Saunders, Richard Matzopoulos, Talal Bakfalouni, Stein Emil Vollset, Andrea Werdecker, Lennert J. Veerman, Lorenzo Monasta, Henrica A. F. M. Jansen, Reyna A Gutiérrez, Brittany Wurtz, Luz Maria Sanchez, Lijing L. Yan, M. Patrice Lindsay, Michele Meltzer, Sanjay Basu, Steven van de Vijver, Alaa Badawi, Thomas Claßen, Young-Ho Khang, Brett M. Kissela, Jun Zhu, In-Hwan Oh, Fiona J Charlson, Maria Cecilia Bahit, Dinorah González-Castell, Rosario Cárdenas, Dan Poenaru, Sayed Saidul Alam, Mitchell T. Wallin, Harish Chander Gugnani, James Leigh, Ferrán Catalá-López, Lidia Morawska, Jim van Os, Stephanie J. London, Kaire Innos, Isabelle Romieu, Fiorella Cavalleri, Adrian Davis, Hwee Pin Phua, Chakib Nejjari, Héctor Gómez Dantés, Boris I. Pavlin, Karen Sliwa, Lynne Gaffikin, Constance D. Pond, Michael F. MacIntyre, Blake Thomson, Norberto Perico, Ronny Westerman, Samantha M. Colquhoun, Michael H. Criqui, Ana Maria Nogales Vasconcelos, Wubegzier Mekonnen, Bulat Idrisov, Ana Basto-Abreu, Andrew G. M. Bulloch, Jasvinder A. Singh, Vinod K. Paul, Emin Murat Tuzcu, Svetlana Popova, Hmwe H Kyu, Richard L. Guerrant, Mohammed I. Albittar, Srikanth Mangalam, Steven E. Lipshultz, Lela Sturua, Semaw Ferede Abera, Eduardo Bernabé, George D. Thurston, Bruno F. Sunguya, Tiffany Ku, Alejandra G. Contreras, Abdullah Sulieman Terkawi, Charles Atkinson, Ashkan Afshin, Heidi J. Larson, Abdullatif Husseini, Jose C. Adsuar, Reza Assadi, Ademola Lukman Adelekan, Joshua A. Salomon, Yousef M. Elshrek, Gokalp Kadri Yentur, Devina Nand, Narayanaswamy Venketasubramanian, Graça Maria Ferreira De Lima, Maheswar Satpathy, Fotis Topouzis, Traolach S. Brugha, Hywel C Williams, Coen H. Van Gool, Andrew H. Kemp, Awoke Misganaw, Amado D Quezada, Norito Kawakami, Bert Brunekreef, Peter Burney, Tati S. Warouw, Jongmin Lee, Inga Dora Sigfusdottir, Marcel Tanner, Solveig A. Cunningham, Benjamin O. Anderson, Tariku Jibat Beyene, Lars Barregard, Xia Wan, Giuseppe Remuzzi, Bernadette Thomas, Lilia S Pedraza, Massimo Cirillo, Alina Rodriguez, Ricky Leung, Farshad Pourmalek, K. Srinath Reddy, Charles D.A. Wolfe, Ulrich O Mueller, Neeraj Bedi, Al Artaman, Lucia Hernandez, Itamar S. Santos, C. Arden Pope, Norlinah Mohamed Ibrahim, Carlo Irwin A. Panelo, Selen Begüm Uzun, Miltiadis K. Tsilimbaris, Anwar Rafay, Daniel Dicker, Melvin Barrientos Marzan, Sajjad Ur Rahman, Mohammed O. Basulaiman, Edgar P. Simard, Mohammad T Mashal, Maysaa El Sayed Zaki, Shiwei Liu, Don C. Des Jarlais, Bo Norrving, Salvador Villalpando, Miia Kivipelto, Yang Liu, Carolina Maria Teixeira, Catalina Medina, Sudha Jayaraman, Josep Maria Haro, Diego De Leo, Angel J Paternina Caicedo, Abigail C. McKay, Eric L. Ding, Mukesh Dherani, Ljiljana Pejin Stokic, Vinay Nangia, Sukanta Saha, Juan Liang, Elisabeth Cardis, Zourkaleini Younoussi, José R Nogueira, Braden Te Ao, Vasco Manuel Pedro Machado, Lionel Racapé, Ting Wu Chuang, Shahab Khatibzadeh, E Filipa de Castro, Barthelemy Kuate Defo, Ulises Trujillo, Alan D. Lopez, Soraya Seedat, Lope H Barrero, Linhong Wang, Daniel Pope, Alexandra Brazinova, Faris Lami, Valentina Colistro, G Anil Kumar, Derek F J Fay, Haidong Wang, Hwashin H. Shin, Raimundas Lunevicius, Suzanne Polinder, Dietrich Plass, David Rojas-Rueda, Stephen S Lim, Tania G Sánchez-Pimienta, K.M. Venkat Narayan, Yuantao Hao, Jung-Chen Chang, Corina Benjet, Seyed-Mohammad Fereshtehnejad, Luciano A. Sposato, Stan Biryukov, Kunihiro Matsushita, Beth E. Ebel, Cleusa P. Ferri, Soumya Swaminathan, K. Ryan Wessells, Gustavo Velasquez-Melendez, Leslie T. Cooper, David O. Carpenter, Nancy Lopez, Bryan L. Sykes, Sandra Nolte, Murray B. Stein, Paul N. Jensen, Fabiola Mejía-Rodríguez, Xiaonong Zou, Bradford D. Gessner, Dhruv S. Kazi, Dragos Virgil Davitoiu, Alejandra Jáuregui, Pouria Heydarpour, Megan Bohensky, Harvey Whiteford, Berrak Bora Basara, Zhengming Chen, Gregory R. Wagner, Paul I. Dargan, Hermann Brenner, Nima Hafezi-Nejad, John Nelson Opio, Scott Weichenthal, Deborah Salvo, Jun She, Tea Lallukka, Carolyn C. Gotay, Stephen G. Waller, Christian Kieling, Shivanthi Balalla, Valery L. Feigin, Qing Lan, Matias Trillini, Adam D M Briggs, Sungroul Kim, Niveen M E Abu-Rmeileh, Renata Micha, Sergey Petrovich Ermakov, Ole Frithjof Norheim, Zulfiqar A Bhutta, Paul S. F. Yip, Grant Nguyen, Ralph L. Sacco, Biju Abraham, Ken Takahashi, Jixiang Ma, Peter A. Meaney, Ayse Abbasoglu Ozgoren, Kimberly Cooperrider, M Rifat Kose, Shams Eldin Ali Hassan Khalifa, Rasmus Havmoeller, Alize J. Ferrari, Kebede Deribe, Nadim E. Karam, George A. Mensah, Bongani M. Mayosi, Konrad Pesudovs, Joanna Moschandreas, Ziad Nahas, James Damsere-Derry, Nsanzimana Sabin, Tonatiuh Barrientos-Gutiérrez, Ying Jiang, Andre Pascal Kengne, Peter Allebeck, Jonas Minet Kinge, Shankuan Zhu, Guy B. Marks, Daniel C Casey, Marco A Avila, Anna Roca, Lalit Dandona, Ami R. Moore, Adansi A. Amankwaa, David Gunnell, Andre Keren, Yohannes Adama Melaku, Nhung T Nguyen, Anthony D. Woolf, Mayuree Rao, Peter J. Allen, Christina Papachristou, Karzan Abdulmuhsin Mohammad, Ravi Kumar Balu, Marie Ng, Marcello Tonelli, Maziar Moradi-Lakeh, Maigeng Zhou, Emmanuela Gakidou, Mohammed K. Ali, Amanda W Pain, Dan J. Stein, Kawkab Shishani, Fortuné Gbètoho Gankpé, Howard J. Hoffman, James Scott, Nadine Steckling, Samia Alhabib, Deborah Jarvis, Kara Estep, Arsène Kouablan Adou, Ricardo Orozco, Holly Hagan, K. C. Astha, Reza Malekzadeh, Klara Dokova, Aliya Naheed, Ernst J. Kuipers, Valeria Caso, Derrick A Bennett, Andrea B. Feigl, Uche S. Uchendu, Holly E. Erskine, Shireen Sindi, Arjun Lakshmana Balaji, Francesco Saverio Violante, Monika Sawhney, Alejandra Cantoral, Ketevan Goginashvili, Raghib Ali, Fan Jiang, Robert G. Weintraub, Homie Razavi, Myriam Tobollik, Howard Hu, Emerito Jose A. Faraon, Irma Khonelidze, Patricia M. Riccio, Eun-Kee Park, Julio Cesar Campuzano, Ibrahim Abubakar, Jürgen C Schmidt, Konstantinos Stroumpoulis, Aref A. Bin Abdulhak, Graeme J. Hankey, Natan M. Bornstein, Mouhanad Hammami, Lee Richardson, Rintaro Mori, Alanur Çavlin, Ruth W Kimokoti, Samir Soneji, Mark J. Nieuwenhuijsen, John Q. Wong, Joseph Frostad, Tom Achoki, Rahman Shiri, Ashish Bhalla, Kurt Straif, Simon I. Hay, Scott B. Patten, Kalpana Balakrishnan, Awoke Misganaw Temesgen, Chandrashekhar T Sreeramareddy, Ryan M Barber, Rosana E. Norman, JianLi Wang, Siyi Shangguan, Luke Nyakarahuka, Kovin Naidoo, Charles D. H. Parry, Mercedes Colomar, H. Ross Anderson, Carlos Magis-Rodriguez, Joan M. Nolla, Muhammad Imran Nisar, Karen Devries, Andrew L. Thorne-Lyman, Denis Nash, Marape Marape, Rajiv Chowdhury, Dima M. Qato, Luca Ronfani, Nobhojit Roy, Daniel Kim, Yuichiro Yano, Luke D. Knibbs, Margaret Robinson, Hilda L Harb, Rogelio Pérez-Padilla, Janet L Leasher, Jonathan L. Wright, Peter Brooks, Cristiana Abbafati, Belinda K Lloyd, Victor Aboyans, Nikhil Tandon, Charles R. Newton, Simón Barquera, Ted R. Miller, Kinnari S. Murthy, Habib Benzian, Glen Mola, Paulo A. Lotufo, Burcu Kucuk Bicer, Peggy Pei-Chia Chiang, Alexander Kraemer, Solomon Meseret Woldeyohannes, Saman Fahimi, Lesley Rushton, Kim Moesgaard Iburg, Vafa Rahimi-Movaghar, Logan Sandar, Bruce Neal, Teresa Shamah Levy, Karen M. Tabb, Jeffrey A. Towbin, Christopher J L Murray, Ramesh Sahathevan, Aaron Cohen, Chanda Kulkarni, Van C. Lansingh, François Alla, Tasara T. Mazorodze, Murugesan Raju, Saeid Shahraz, Uchechukwu K.A. Sampson, Rajeev Gupta, Neil Pearce, Mustafa Z. Younis, Veena S. Kulkarni, Francisco A García-Guerra, Amanda G. Thrift, Stefan Ma, Samaya Ismayilova, Evariste Gasana, Amitava Banerjee, Aslam Pervaiz, Emilie Agardh, Abraham D. Flaxman, Farshad Farzadfar, Peter W. Gething, Ileana Heredia-Pi, Boris Bikbov, Wanqing Chen, Saad B. Omer, Ruben Castro, Neeraj Bhala, Sara Sheikhbahaei, Hilton Lam, Urbano Fra Paleo, Lidia Sanchez-Riera, Alicia Elena Beatriz Lawrynowicz, Kristen Delwiche, Richard G. Ellenbogen, Max Petzold, Yuri Y Varakin, Guilherme Borges, Guohong Jiang, Francis Guillemin, Kyle R. Heuton, Yohannes Kinfu, Victoria F Bachman, Joseph A Wagner, Carlos A Castañeda-Orjuela, Leonardo Trasande, Abbas Ali Mahdi, Josef Coresh, Chuanhua Yu, Kenji Shibuya, Berrin Serdar, Laetitia Huiart, Xiaofeng Liang, Jean de Dieu Ngirabega, Takayoshi Ohkubo, Natalie Stephens, Francis Apolinary Mhimbira, Jefferson Traebert, Amiran Gamkrelidze, Kjetil Søreide, Samath D Dharmaratne, Robert P. Dellavalle, George Mugambage Ruhago, Lakshmi Vijayakumar, Joannie Lortet-Tieulent, Dipan Bose, Tania C Aburto, Saleem M Rana, Miriam Levi, Mohammad Taghi Hedayati, Rodolfo S Pagcatipunan, Ron T. Gansevoort, H. D. Hosgood, Michael Burch, Mohsen Naghavi, Vegard Skirbekk, Ayfer Pekericli, Walter Mendoza, Pengpeng Ye, Gabrielle deVeber, Ali H. Mokdad, David M. Broday, Koranteng Adofo, Zewdie Aderaw Alemu, Shifalika Goenka, Carrie Beth Peterson, Nicolas J. C. Stapelberg, Edson Serván-Mori, Anil Kaul, Foad Abd-Allah, Marek Majdan, Rahul Gupta, Giancarlo Logroscino, Kardiyoloji, Peterson, Carrie B., Laboratoire de Physique des Solides (LPS), Université Paris-Sud - Paris 11 (UP11)-Centre National de la Recherche Scientifique (CNRS), Wisconsin Division of Public Health, Laboratoire de psychologie sociale et de psychologie cognitive (LAPSCO), Centre National de la Recherche Scientifique (CNRS)-Université Blaise Pascal - Clermont-Ferrand 2 (UBP), Erosion torrentielle neige et avalanches (UR ETGR (ETNA)), Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA), London South Bank University, Metropolitan Police Service, Hong Kong Baptist University (HKBU), Institut für Informatik [München/Munich] (LMU), Ludwig-Maximilians-Universität München (LMU), Neuroépidémiologie Tropicale (NET), Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM)-CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges], CHU Limoges, Insight Centre for Data Analytics [Galway] (INSIGHT), National University of Ireland [Galway] (NUI Galway), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques Nancy, Cancéropôle du Grand Est-Institut National de la Santé et de la Recherche Médicale (INSERM), Karolinska Institute, karolinska institute, Department of Molecular Biosciences, Department of Molecular Biosciences [Oslo], Faculty of Mathematics and Natural Sciences [Oslo], University of Oslo (UiO)-University of Oslo (UiO)-Faculty of Mathematics and Natural Sciences [Oslo], University of Oslo (UiO)-University of Oslo (UiO), Centro de Estudios Avanzados en Zonas Aridas (CEAZA), Ecole Polytechnique Fédérale de Lausanne (EPFL), Regional Genetic Service, St Mary's Hospital, Manchester, Laboratoire d'Ingénierie des Matériaux (LIM), Centre National de la Recherche Scientifique (CNRS), Computer Science Department [Bristol], University of Bristol [Bristol], Universität Mannheim [Mannheim], Lawrence Berkeley National Laboratory [Berkeley] (LBNL), Samsung Research &Development Institute India - Bangalore (Groupe Samsung) (SRI-B), Computational Science and Engineering Department [Daresbury] (STFC), Science & Technologie Facilities Council, Multimedia Research Center (MRC), University of Alberta, Division of Biostatistics (Biostat - MINNEAPOLIS), University of Minnesota [Twin Cities], University of Minnesota System-University of Minnesota System, University of Southampton, Imperial College London, Neurology Department, Ichilov Medical Center, Interactions, transferts, ruptures artistiques et culturels - EA 6301 (InTRu), Université de Tours, Institut Jacques Monod (IJM (UMR_7592)), Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Julius Center for Health Sciences and Primary Care, University Medical Center [Utrecht], Risk Assessment Sciences Institute, Utrecht University [Utrecht], Unité de Biologie Fonctionnelle et Adaptative (BFA (UMR_8251 / U1133)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Respiratory Epidemiology and Public Health, Imperial College London-Royal Brompton Hospital-National Heart and Lung Institute [UK], CIBER de Epidemiología y Salud Pública (CIBERESP), STAR laboratory, Stanford University [Stanford], Unité de recherche Virologie et Immunologie Moléculaires (VIM), Institut National de la Recherche Agronomique (INRA), Tennent Institute of Ophthalmology, National University of Singapore (NUS), Centre de Robotique (CAOR), MINES ParisTech - École nationale supérieure des mines de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL), Multidisciplinary Nanotechnology Centre, Swansea University, Cyprus International Institute for the Environment and Public Health, Harvard School of Public Health, Genomics Research Center, Academia Sinica, Neuro Rehab Services LLP [New Delhi], Department of Signal Theory and Communications (TSC), Univ. Politec. de Catalunya, King‘s College London, Dept. Mat. Engn. De Ma, Sao Carlos, Fed. Univ. Sao Carlos UFSCar, RESPEC (RESPEC), RESPEC, Advanced Laboratories on Embedded Systems [Roma] (ALES), Department of Biology [Miami], University of Miami [Coral Gables], Health Care, Minister Of Labour-Ministry of Labor, Health and Social Affairs, Department of Nephrology, University Medical Center, University of Groningen, Division of Human Nutrition, Wageningen University and Research Centre [Wageningen] (WUR), Spatial Ecology and Epidemiology Group, University of Oxford [Oxford], College of Medicine, University of Hail, Saudi Arabia, Laboratory of Neurologic Diseases, Mario Negri Institute, Milan, Department of Civil Engineering [Hamirpur], National Institute of Technology [Hamirpur], GEMMA — Environmental Engineering and Microbiology Research Group, Department of Hydraulic, Maritime and Environmental Engineering, Universitat Politècnica de Catalunya [Barcelona] (UPC), Department of Biosciences and Nutrition, Karolinska Institutet [Stockholm], Institut National de Recherche et d'Analyse Physico-Chimique (INRAP), Institut National de Recherche et d'Analyse Physico-chimique (Ariana, Tunisie) (INRAP), Franche-Comté Électronique Mécanique, Thermique et Optique - Sciences et Technologies (UMR 6174) (FEMTO-ST), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Université de Technologie de Belfort-Montbeliard (UTBM), Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences [Tehran] (SBUMS), Shahid Beheshti University-Shahid Beheshti University, Center for Applied Medical Research (CIMA), University of Tehran, Secretariat of the Pacific Community, Public Health Division, Sociétés, Acteurs, Gouvernement en Europe (SAGE), Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), College of Precision Instrument and Optoelectronics Engineering, Tianjin University, George Washington University (GW), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Universiteit Gent [Ghent], Washington State University (WSU), Laboratoire de Physique de l'ENS Lyon (Phys-ENS), École normale supérieure - Lyon (ENS Lyon)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Institut de recherche en informatique de Toulouse (IRIT), Université Toulouse 1 Capitole (UT1)-Université Toulouse - Jean Jaurès (UT2J)-Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut National Polytechnique (Toulouse) (Toulouse INP), Université Fédérale Toulouse Midi-Pyrénées, School of Computer Science - China University of Geosciences (China University of Geosciences (East Area)), Centre de Recherche en Automatique de Nancy (CRAN), Université de Lorraine (UL)-Centre National de la Recherche Scientifique (CNRS), Université Catholique de Louvain (UCL), Fachbereich Physik [Berlin], Freie Universität Berlin, Div Cyclotron & Radiopharmaceut Sci (DRDO, INMAS), Univ New Delhi, School of Physics and Astronomy, University of St Andrews [Scotland], University of Cape Town, Department of Neuroscience, Department of Computer Science and Engineering [Daejeon] (Chungnam National University), Lawrence University, Gastroenterology & Hepatology, Tata Research Development and Design Center (TRDDC), TCS Innovation Labs, University of Helsinki, Google Inc [Mountain View], Research at Google, Swedish Defense Research Agency (FOI), Servicio de Neurologia (SANTIAGO - Neurologie), Universidad del Desarrollo, Novartis Pharmaceutical Corporation, Laboratoire de glaciologie et géophysique de l'environnement (LGGE), Observatoire des Sciences de l'Univers de Grenoble [1985-2015] (OSUG [1985-2015]), Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology [2007-2019] (Grenoble INP [2007-2019])-Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology [2007-2019] (Grenoble INP [2007-2019])-Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS), Department of Mechanical and Automation Engineering (CAD Laboratory), The Chinese University of Hong Kong [Hong Kong], Università degli studi di Bari, Department of Health and Human Services, National Institutes of Health [Bethesda] (NIH), Centre d'études et de recherche en informatique et communications (CEDRIC), Ecole Nationale Supérieure d'Informatique pour l'Industrie et l'Entreprise (ENSIIE)-Conservatoire National des Arts et Métiers [CNAM] (CNAM), Heuristique et Diagnostic des Systèmes Complexes [Compiègne] (Heudiasyc), Université de Technologie de Compiègne (UTC)-Centre National de la Recherche Scientifique (CNRS), College of Information and Electrical Engineering [Beijing] (CIEE), China Agricultural University (CAU), Thales Research and Technology [Palaiseau], THALES, Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), Centre d'économie de la Sorbonne (CES), Université Panthéon-Sorbonne (UP1)-Centre National de la Recherche Scientifique (CNRS), Paris School of Economics (PSE), École supérieure du professorat et de l'éducation - Académie de Grenoble [2013-2019] (ESPE Grenoble [2013-2019]), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Department of Mathematics, University of Iowa [Iowa City], College of Medicine, Alfaisal University, Saudi Ministry of Health, Institut national des recherches agricoles du Bénin, Centre de Recherches agricoles du Sud, Departments of Epidemiology and Nutrition, Unit of Human Nutrition, Agricultural University of Athens, Department of Animal Science, Pennsylvania State University (Penn State), Penn State System-Penn State System, University of Virginia, University of Virginia [Charlottesville], Epidemiology and Biostatistics Unit, Institute for Maternal and Child Health - IRCCS ‘‘Burlo Garofolo', Jet Propulsion Laboratory (JPL), NASA-California Institute of Technology (CALTECH), Division of Cardiovascular Medicine and Channing Division of Network Medicine, Brigham and Women's Hospital [Boston], American University of Beirut [Beyrouth] (AUB), Department of Chemistry, Scientific Computing Research Unit, Department of dermatology, Milano University-Azienda Ospedaleria Ospedali Riuniti di Bergamo, Mailman School of Public Health, Columbia University [New York], The Georges Institute for International Health, The University of Sydney, Department of epidemiology and Public Health, Faculty of Medicine, Département Optique (OPT), Université européenne de Bretagne - European University of Brittany (UEB)-Télécom Bretagne-Institut Mines-Télécom [Paris] (IMT), Laboratoire des signaux et systèmes (L2S), Université Paris-Sud - Paris 11 (UP11)-CentraleSupélec-Centre National de la Recherche Scientifique (CNRS), Universitat Pompeu Fabra [Barcelona], Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona]-Catalunya ministerio de salud, Nutriments Lipidiques et Prévention des Maladies Métaboliques, Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université de la Méditerranée - Aix-Marseille 2, Department of Neurology Lunds University Hospital Lund, Unit of Functional Bionanomaterials, School of Biosciences, University of Birmingham [Birmingham], Electrical Engineering and Computer Science Department - Case Western Reserve University, Case Western Reserve University [Cleveland], World Health Organization, Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Nordic School of Public Health, The James Hutton Institute, Horia Hulubei National Institute for Physics and Nuclear Engineering, Department of Pediatrics, University of Washington [Seattle], Institute of Public Health, Department of Physics, Clarendon Laboratory, Center for TeleInFrastruktur (CTIF), Aalborg University [Denmark] (AAU), Physikalisches Institut [Freiburg], Albert-Ludwigs-Universität Freiburg, Savoirs, Textes, Langage (STL) - UMR 8163 (STL), Centre National de la Recherche Scientifique (CNRS)-Université de Lille, Dept.of Computer Science, Indian Institute of Technology Madras (IIT Madras), Istituto Mario Negri Bergamo, Centro Ricerche e Trapianti Villa Camozzi, Universidade Estadual Paulista Júlio de Mesquita Filho [São José do Rio Preto] (UNESP), Laboratoire de Génie Informatique et Ingénierie de Production (LGI2P), IMT - MINES ALES (IMT - MINES ALES), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Institut geològic de Catalunya (IGC), Institut Geològic de Catalunya-IGC, Institut Cochin (IC UM3 (UMR 8104 / U1016)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Physiologie et Génomique des Poissons (LPGP), Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Recherche Agronomique (INRA), Politecnico di Milano [Milan] (POLIMI), Symantec, University of Oviedo, European Microsoft Innovation Center (EMIC), Microsoft Corporation [Redmond, Wash.], Technion - Israel Institute of Technology [Haifa], Laboratoire de Mécanique, Physique et Géosciences (LMPG), Université Le Havre Normandie (ULH), Normandie Université (NU)-Normandie Université (NU), Department of Physics, Cavendish Laboratory, University of Cambridge [UK] (CAM), Laboratoire de Probabilités et Modèles Aléatoires (LPMA), Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7)-Université Pierre et Marie Curie - Paris 6 (UPMC), Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA), Departments of Applied Physics [New Haven], Yale University [New Haven], Center for Mathematical Modeling (CMM), Department of Global Health and Development, London School of Hygiene and Tropical Medicine (LSHTM), University of Occupational and Environmental Health [Kitakyushu] (UEOH), Department of Computer Science and Engineering [New Delhi], Indian Institute of Technology Delhi (IIT Delhi), Institut de Recherche sur les Phénomènes Hors Equilibre (IRPHE), Aix Marseille Université (AMU)-École Centrale de Marseille (ECM)-Centre National de la Recherche Scientifique (CNRS), GlaxoSmithKline, Imperial College London-Clinical Imaging Center, Universidade Federal de Pernambuco [Recife] (UFPE), Maclean Building, Benson Lane, Crowmarsh Gifford, Centre for Ecology and Hydrology, Nanoscience Institute (NEST), Dipartimento di Fisica, Università di Pisa, Aristotle University of Thessaloniki, Laboratory Of Immune Cell Biology (LICB), JRC Institute for Environment and Sustainability (IES), European Commission - Joint Research Centre [Ispra] (JRC), Institute of Human Genetics, Rheinische Friedrich-Wilhelms-Universität Bonn, Laboratorio Nacional de Computação Cientifica [Rio de Janeiro] (LNCC / MCT), Occupational Health Unit, Bologna University Hospital-Sant'Orsola-Malpighi Polyclinic, Royal Institute of Technology [Stockholm] (KTH ), NICTA [Eveleigh], National ICT Australia [Sydney] (NICTA), Division of Solid Mechanics, Lund University [Lund], University of Calgary, BioWare Corp, Manchester Academic Health Sciences Centre, Institut d'Histoire et de Philosophie des Sciences et des Techniques (IHPST), Université Panthéon-Sorbonne (UP1)-Centre National de la Recherche Scientifique (CNRS)-Département d'Etudes Cognitives - ENS Paris (DEC), École normale supérieure - Paris (ENS Paris), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-École normale supérieure - Paris (ENS Paris), Ghent University [Belgium] (UGENT), Imaging Sciences and Biomedical Engineering Division [London], Guy's and St Thomas' Hospital [London]-King‘s College London, Children’s Hospital of Philadelphia (CHOP ), Perelman School of Medicine, University of Pennsylvania [Philadelphia], Laboratoire de recherche en Hydrodynamique, Énergétique et Environnement Atmosphérique (LHEEA), École Centrale de Nantes (ECN)-Centre National de la Recherche Scientifique (CNRS), Institut de Recherche en Génie Civil et Mécanique (GeM), Université de Nantes - Faculté des Sciences et des Techniques, Université de Nantes (UN)-Université de Nantes (UN)-École Centrale de Nantes (ECN)-Centre National de la Recherche Scientifique (CNRS), Department of Physiology, Augusta University - Medical College of Georgia, University System of Georgia (USG)-University System of Georgia (USG), Neurorestoration Group, Wolfson Centre for Age-related Diseases-King‘s College London, Electronic Navigation Research Institute (ENRI), Ministry of Land, Infrastructure, Transport and Tourism, Department of Computer Science [KAIST] (CS), Korea Advanced Institute of Science and Technology (KAIST), Centre for Undergraduate Studies, University of the Punjab, Siemens Corporate Research, Siemens AG [Munich], University of Massachusetts [Boston] (UMass Boston), University of Massachusetts System (UMASS), Department of Materials Science, Sichuan University [Chengdu] (SCU), Natl Engn Res Ctr Vegetables, Key Lab Biol & Genet Improvement Hort Crops N Chi, Beijing Acad Agr & Forestry Sci, University Hospital Puerta de Hierro, Madrid, Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Diderot - Paris 7 (UPD7), MINES ParisTech - École nationale supérieure des mines de Paris-PSL Research University (PSL), Université de Franche-Comté (UFC)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Supérieure de Mécanique et des Microtechniques (ENSMM)-Université de Technologie de Belfort-Montbeliard (UTBM), Shahid Beheshti University of Medical Sciences, École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), MOLTECH-ANJOU (MOLTECH-ANJOU), Université d'Angers (UA)-Centre National de la Recherche Scientifique (CNRS), Universidad de Santiago de Chile [Santiago] (USACH)-Universidad del Desarrollo, Observatoire des Sciences de l'Univers de Grenoble (OSUG), Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Institut polytechnique de Grenoble - Grenoble Institute of Technology (Grenoble INP)-Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut national des sciences de l'Univers (INSU - CNRS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA)-Centre National de la Recherche Scientifique (CNRS), École supérieure du professorat et de l'éducation - Académie de Grenoble (ESPE Grenoble), Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Université Grenoble Alpes (UGA), California Institute of Technology (CALTECH)-NASA, Centre National de la Recherche Scientifique (CNRS)-CentraleSupélec-Université Paris-Sud - Paris 11 (UP11), Université de la Méditerranée - Aix-Marseille 2-Institut National de la Recherche Agronomique (INRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Lille-Centre National de la Recherche Scientifique (CNRS), Institut National de la Recherche Agronomique (INRA)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université Pierre et Marie Curie - Paris 6 (UPMC)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Universidad de Santiago de Chile [Santiago] (USACH), École normale supérieure - Paris (ENS Paris)-École normale supérieure - Paris (ENS Paris), King‘s College London-Wolfson Centre for Age-related Diseases, Sichuan University, Universitat de Barcelona, Interne Geneeskunde, Medische Sociologie, MUMC+: MA Psychiatrie (3), MUMC+: Hersen en Zenuw Centrum (3), Psychiatrie & Neuropsychologie, CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA), Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology [2007-2019] (Grenoble INP [2007-2019])-Institut national des sciences de l'Univers (INSU - CNRS)-Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut polytechnique de Grenoble - Grenoble Institute of Technology [2007-2019] (Grenoble INP [2007-2019])-Institut national des sciences de l'Univers (INSU - CNRS)-Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture (IRSTEA)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry])-Centre National de la Recherche Scientifique (CNRS)-Centre National de la Recherche Scientifique (CNRS), Institut Mines-Télécom [Paris] (IMT)-Télécom Bretagne-Université européenne de Bretagne - European University of Brittany (UEB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Descartes - Paris 5 (UPD5)-Centre National de la Recherche Scientifique (CNRS), Cardiovascular Centre (CVC), Groningen Kidney Center (GKC), RS: MHeNs - R2 - Mental Health, Laboratoire de Physique des Solides ( LPS ), Université Paris-Sud - Paris 11 ( UP11 ) -Centre National de la Recherche Scientifique ( CNRS ), Laboratoire de psychologie sociale et de psychologie cognitive ( LAPSCO ), Université Blaise Pascal - Clermont-Ferrand 2 ( UBP ) -Centre National de la Recherche Scientifique ( CNRS ), Erosion torrentielle neige et avalanches ( UR ETGR ), Institut national de recherche en sciences et technologies pour l'environnement et l'agriculture ( IRSTEA ), Hong Kong Baptist University ( HKBU ), Institut für Informatik [München/Munich] ( LMU ), Ludwig-Maximilians-Universität München, Neuroépidémiologie Tropicale ( NET ), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut Génomique, Environnement, Immunité, Santé, Thérapeutique ( GEIST ), Université de Limoges ( UNILIM ) -Université de Limoges ( UNILIM ), Insight Centre for Data Analytics (National University of Ireland Galway (NUIG)) ( INSIGHT ), Maladies chroniques, santé perçue, et processus d'adaptation ( APEMAC ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Cancéropôle du Grand Est-Institut National de la Santé et de la Recherche Médicale ( INSERM ), University of Oslo ( UiO ) -University of Oslo ( UiO ), Centro de Estudios Avanzados en Zonas Aridas ( CEAZA ), Ecole Polytechnique Fédérale de Lausanne ( EPFL ), Laboratoire d'Ingénierie des Matériaux ( LIM ), Centre National de la Recherche Scientifique ( CNRS ), Lawrence Berkeley National Laboratory [Berkeley] ( LBNL ), Samsung Research &Development Institute India - Bangalore (Groupe Samsung) ( SRI-B ), Computational Science and Engineering Department [Daresbury] ( STFC ), Multimedia Research Center ( MRC ), University of Alberta [Edmonton], Division of Biostatistics ( Biostat - MINNEAPOLIS ), University of Minnesota [Minneapolis], University of Southampton [Southampton], Interactions, transferts, ruptures artistiques et culturels - EA 6301 ( InTRu ), Institut Jacques Monod ( IJM ), Université Paris Diderot - Paris 7 ( UPD7 ) -Centre National de la Recherche Scientifique ( CNRS ), University Medical Center Utrecht, Biologie Fonctionnelle et Adaptative ( BFA ), Imperial College London-Royal Brompton Hospital-National Heart and Lung Institute, Unité de recherche Virologie et Immunologie Moléculaires ( VIM ), Institut National de la Recherche Agronomique ( INRA ), National University of Singapore ( NUS ), Centre de Robotique ( CAOR ), MINES ParisTech - École nationale supérieure des mines de Paris-PSL Research University ( PSL ), Department of Signal Theory and Communications ( TSC ), RESPEC ( RESPEC ), Advanced Laboratories on Embedded Systems [Roma] ( ALES ), Wageningen University and Research Centre [Wageningen] ( WUR ), Universitat Politècnica de Catalunya [Barcelona] ( UPC ), Institut National de Recherche et d'Analyse Physico-Chimique ( INRAP ), Institut National de Recherche et d'Analyse Physico-chimique (INRAP-Tunisie), Franche-Comté Électronique Mécanique, Thermique et Optique - Sciences et Technologies (UMR 6174) ( FEMTO-ST ), Université de Franche-Comté ( UFC ) -Centre National de la Recherche Scientifique ( CNRS ) -Ecole Nationale Supérieure de Mécanique et des Microtechniques ( ENSMM ) -Université de Technologie de Belfort-Montbeliard ( UTBM ), Tehran University, Sociétés, Acteurs, Gouvernement en Europe ( SAGE ), Université de Strasbourg ( UNISTRA ) -Centre National de la Recherche Scientifique ( CNRS ), Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale ( SESSTIM - U912 INSERM - AMU - IRD ), Institut de Recherche pour le Développement ( IRD ) -Aix Marseille Université ( AMU ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Washington State University ( WSU ), Laboratoire de Physique de l'ENS Lyon ( Phys-ENS ), École normale supérieure - Lyon ( ENS Lyon ) -Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique ( CNRS ), Institut des Sciences Chimiques de Rennes ( ISCR ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Ecole Nationale Supérieure de Chimie de Rennes-Institut National des Sciences Appliquées ( INSA ) -Centre National de la Recherche Scientifique ( CNRS ), Institut de recherche en informatique de Toulouse ( IRIT ), Institut National Polytechnique [Toulouse] ( INP ) -Université Toulouse 1 Capitole ( UT1 ) -Université Toulouse - Jean Jaurès ( UT2J ) -Université Toulouse III - Paul Sabatier ( UPS ), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique ( CNRS ), Centre de Recherche en Automatique de Nancy ( CRAN ), Université de Lorraine ( UL ) -Centre National de la Recherche Scientifique ( CNRS ), Université Catholique de Louvain ( UCL ), Freie Universität Berlin [Berlin], Div Cyclotron & Radiopharmaceut Sci ( DRDO, INMAS ), Institut de Physique Nucléaire d'Orsay ( IPNO ), Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de Physique Nucléaire et de Physique des Particules du CNRS ( IN2P3 ) -Centre National de la Recherche Scientifique ( CNRS ), Tata Research Development and Design Center ( TRDDC ), Laboratoire MOLTECH-Anjou [Angers] ( MOLTECH ANJOU ), Université d'Angers ( UA ) -Centre National de la Recherche Scientifique ( CNRS ), University of Helsinki [Helsinki], Swedish Defense Research Agency ( FOI ), Servicio de Neurologia ( SANTIAGO - Neurologie ), Universidad de Santiago de Chile [Santiago] ( USACH ) -Universidad del Desarrollo, Novartis Pharmaceutical Corp., East Hanover NJ 07936, USA, Laboratoire de glaciologie et géophysique de l'environnement ( LGGE ), Observatoire des Sciences de l'Univers de Grenoble ( OSUG ), Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut national des sciences de l'Univers ( INSU - CNRS ) -Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ) -Université Joseph Fourier - Grenoble 1 ( UJF ) -Institut national des sciences de l'Univers ( INSU - CNRS ) -Centre National de la Recherche Scientifique ( CNRS ) -Université Grenoble Alpes ( UGA ) -Centre National de la Recherche Scientifique ( CNRS ), Department of Mechanical and Automation Engineering ( CAD Laboratory ), National Institutes of Health ( NIH ), Centre d'étude et de recherche en informatique et communications ( CEDRIC ), Ecole Nationale Supérieure d'Informatique pour l'Industrie et l'Entreprise ( ENSIIE ) -Conservatoire National des Arts et Métiers [CNAM] ( CNAM ), Heuristique et Diagnostic des Systèmes Complexes [Compiègne] ( Heudiasyc ), Université de Technologie de Compiègne ( UTC ) -Centre National de la Recherche Scientifique ( CNRS ), College of Information and Electrical Engineering [Beijing] ( CIEE ), China Agricultural University ( CAU ), Queen Mary University of London ( QMUL ), Centre d'économie de la Sorbonne ( CES ), Université Panthéon-Sorbonne ( UP1 ) -Centre National de la Recherche Scientifique ( CNRS ), Paris School of Economics ( PSE ), École supérieure du professorat et de l'éducation - Académie de Grenoble ( ESPE Grenoble ), Université Savoie Mont Blanc ( USMB [Université de Savoie] [Université de Chambéry] ) -Université Grenoble Alpes ( UGA ), PennState University [Pennsylvania] ( PSU ), Jet Propulsion Laboratory ( JPL ), NASA-California Institute of Technology ( CALTECH ), American University of Beirut [Beyrouth], The University of Sydney [Sydney], Département Optique ( OPT ), Université européenne de Bretagne ( UEB ) -Télécom Bretagne-Institut Mines-Télécom [Paris], Laboratoire des signaux et systèmes ( L2S ), Université Paris-Sud - Paris 11 ( UP11 ) -CentraleSupélec-Centre National de la Recherche Scientifique ( CNRS ), Center for Research in Environmental Epidemiology ( CREAL ), Université de la Méditerranée - Aix-Marseille 2-Institut National de la Recherche Agronomique ( INRA ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Center for TeleInFrastruktur ( CTIF ), Aalborg University [Denmark] ( AAU ), Savoirs, Textes, Langage (STL) - UMR 8163 ( STL ), Université de Lille-Centre National de la Recherche Scientifique ( CNRS ), Indian Institute of Technology Madras ( IIT Madras ), Universidade Estadual Paulista Júlio de Mesquita ( UNESP ), Laboratoire de Génie Informatique et Ingénierie de Production ( LGI2P ), IMT - Mines Alès Ecole Mines - Télécom ( IMT - MINES ALES ), Institut geològic de Catalunya ( IGC ), Institut Cochin ( UM3 (UMR 8104 / U1016) ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Laboratoire de Physiologie et Génomique des Poissons ( LPGP ), Institut National de la Recherche Agronomique ( INRA ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Politecnico di Milano [Milan], European Microsoft Innovation Center ( EMIC ), Laboratoire de Mécanique, Physique et Géosciences ( LMPG ), Université Le Havre Normandie ( ULH ), Normandie Université ( NU ) -Normandie Université ( NU ), University of Cambridge [UK] ( CAM ), Laboratoire de Probabilités et Modèles Aléatoires ( LPMA ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Paris Diderot - Paris 7 ( UPD7 ) -Centre National de la Recherche Scientifique ( CNRS ), Institut de Génétique et de Biologie Moléculaire et Cellulaire ( IGBMC ), Université de Strasbourg ( UNISTRA ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Center for Mathematical Modeling ( CMM ), Universidad de Santiago de Chile [Santiago] ( USACH ), London School of Hygiene and Tropical Medicine ( LSHTM ), University of Occupational and Environmental Health [Kitakyushu] ( UEOH ), Indian Institute of Technology Delhi ( IIT Delhi ), Institut de Recherche sur les Phénomènes Hors Equilibre ( IRPHE ), Aix Marseille Université ( AMU ) -Ecole Centrale de Marseille ( ECM ) -Centre National de la Recherche Scientifique ( CNRS ), Universidade Federal de Pernambuco [Recife] ( UFPE ), Nanoscience Institute ( NEST ), Laboratory Of Immune Cell Biology ( LICB ), JRC Institute for Environment and Sustainability ( IES ), European Commission - Joint Research Centre [Ispra] ( JRC ), Bonn Universität [Bonn], Laboratorio Nacional de Computação Cientifica [Rio de Janeiro] ( LNCC / MCT ), Royal Institute of Technology [Stockholm] ( KTH ), National ICT Australia [Sydney] ( NICTA ), Institut d'Histoire et de Philosophie des Sciences et des Techniques ( IHPST ), Université Panthéon-Sorbonne ( UP1 ) -Département d'Etudes Cognitives - ENS Paris ( DEC ), École normale supérieure - Paris ( ENS Paris ) -École normale supérieure - Paris ( ENS Paris ) -Centre National de la Recherche Scientifique ( CNRS ), Ghent University [Belgium] ( UGENT ), Children’s Hospital of Philadelphia ( CHOP ), Univeristy of Pennsylvania Medical School, Laboratoire de recherche en Hydrodynamique, Énergétique et Environnement Atmosphérique ( LHEEA ), École Centrale de Nantes ( ECN ) -Centre National de la Recherche Scientifique ( CNRS ), Institut de Recherche en Génie Civil et Mécanique ( GeM ), Université de Nantes ( UN ) -École Centrale de Nantes ( ECN ) -Centre National de la Recherche Scientifique ( CNRS ), Medical College of Georgia, Electronic Navigation Research Institute ( ENRI ), Department of Computer Science [KAIST] ( CS ), Korea Advanced Institute of Science and Technology ( KAIST ), Laboratoire de l'Accélérateur Linéaire ( LAL ), University of Massachusetts [Boston] ( UMass Boston ), Forouzanfar, Mohammad H, Alexander, Lily, Anderson, H. Ro, Bachman, Victoria F, Biryukov, Stan, Brauer, Michael, Burnett, Richard, Casey, Daniel, Coates, Matthew M, Cohen, Aaron, Delwiche, Kristen, Estep, Kara, Frostad, Joseph J, Kc, Astha, Kyu, Hmwe H, Moradi Lakeh, Maziar, Ng, Marie, Slepak, Erica Leigh, Thomas, Bernadette A, Wagner, Joseph, Aasvang, Gunn Marit, Abbafati, Cristiana, Ozgoren, Ayse Abbasoglu, Abd Allah, Foad, Abera, Semaw F, Aboyans, Victor, Abraham, Biju, Abraham, Jerry Puthenpurakal, Abubakar, Ibrahim, Abu Rmeileh, Niveen M. E, Aburto, Tania C, Achoki, Tom, Adelekan, Ademola, Adofo, Koranteng, Adou, Arsène K, Adsuar, José C, Afshin, Ashkan, Agardh, Emilie E, Al Khabouri, Mazin J, Al Lami, Faris H, Alam, Sayed Saidul, Alasfoor, Deena, Albittar, Mohammed I, Alegretti, Miguel A, Aleman, Alicia V, Alemu, Zewdie A, Alfonso Cristancho, Rafael, Alhabib, Samia, Ali, Raghib, Ali, Mohammed K, Alla, Françoi, Allebeck, Peter, Allen, Peter J, Alsharif, Ubai, Alvarez, Elena, Alvis Guzman, Nelson, Amankwaa, Adansi A, Amare, Azmeraw T, Ameh, Emmanuel A, Ameli, Omid, Amini, Heresh, Ammar, Walid, Anderson, Benjamin O, Antonio, Carl Abelardo T, Anwari, Palwasha, Cunningham, Solveig Argeseanu, Arnlöv, Johan, Arsenijevic, Valentina S. Arsic, Artaman, Al, Asghar, Rana J, Assadi, Reza, Atkins, Lydia S, Atkinson, Charle, Avila, Marco A, Awuah, Baffour, Badawi, Alaa, Bahit, Maria C, Bakfalouni, Talal, Balakrishnan, Kalpana, Balalla, Shivanthi, Balu, Ravi Kumar, Banerjee, Amitava, Barber, Ryan M, Barker Collo, Suzanne L, Barquera, Simon, Barregard, Lar, Barrero, Lope H, Barrientos Gutierrez, Tonatiuh, Basto Abreu, Ana C, Basu, Arindam, Basu, Sanjay, Basulaiman, Mohammed O, Ruvalcaba, Carolina Bati, Beardsley, Justin, Bedi, Neeraj, Bekele, Tolesa, Bell, Michelle L, Benjet, Corina, Bennett, Derrick A, Benzian, Habib, Bernabé, Eduardo, Beyene, Tariku J, Bhala, Neeraj, Bhalla, Ashish, Bhutta, Zulfiqar A, Bikbov, Bori, Abdulhak, Aref A. Bin, Blore, Jed D, Blyth, Fiona M, Bohensky, Megan A, Başara, Berrak Bora, Borges, Guilherme, Bornstein, Natan M, Bose, Dipan, Boufous, Soufiane, Bourne, Rupert R, Brainin, Michael, Brazinova, Alexandra, Breitborde, Nicholas J, Brenner, Hermann, Briggs, Adam D. M, Broday, David M, Brooks, Peter M, Bruce, Nigel G, Brugha, Traolach S, Brunekreef, Bert, Buchbinder, Rachelle, Bui, Linh N, Bukhman, Gene, Bulloch, Andrew G, Burch, Michael, Burney, Peter G. J, Campos Nonato, Ismael R, Campuzano, Julio C, Cantoral, Alejandra J, Caravanos, Jack, Cárdenas, Rosario, Cardis, Elisabeth, Carpenter, David O, Caso, Valeria, Castañeda Orjuela, Carlos A, Castro, Ruben E, Catalá López, Ferrán, Cavalleri, Fiorella, Çavlin, Alanur, Chadha, Vineet K, Chang, Jung Chen, Charlson, Fiona J, Chen, Honglei, Chen, Wanqing, Chen, Zhengming, Chiang, Peggy P, Chimed Ochir, Odgerel, Chowdhury, Rajiv, Christophi, Costas A, Chuang, Ting Wu, Chugh, Sumeet S, Cirillo, Massimo, Claßen, Thomas Kd, Colistro, Valentina, Colomar, Mercede, Colquhoun, Samantha M, Contreras, Alejandra G, Cooper, Cyru, Cooperrider, Kimberly, Cooper, Leslie T, Coresh, Josef, Courville, Karen J, Criqui, Michael H, Cuevas Nasu, Lucia, Damsere Derry, Jame, Danawi, Hadi, Dandona, Lalit, Dandona, Rakhi, Dargan, Paul I, Davis, Adrian, Davitoiu, Dragos V, Dayama, Anand, de Castro, E. Filipa, De la Cruz Góngora, Vanessa, De Leo, Diego, de Lima, Graça, Degenhardt, Louisa, Del Pozo Cruz, Borja, Dellavalle, Robert P, Deribe, Kebede, Derrett, Sarah, Jarlais, Don C. De, Dessalegn, Muluken, Deveber, Gabrielle A, Devries, Karen M, Dharmaratne, Samath D, Dherani, Mukesh K, Dicker, Daniel, Ding, Eric L, Dokova, Klara, Dorsey, E. Ray, Driscoll, Tim R, Duan, Leilei, Durrani, Adnan M, Ebel, Beth E, Ellenbogen, Richard G, Elshrek, Yousef M, Endres, Matthia, Ermakov, Sergey P, Erskine, Holly E, Eshrati, Babak, Esteghamati, Alireza, Fahimi, Saman, Faraon, Emerito Jose A, Farzadfar, Farshad, Fay, Derek F. J, Feigin, Valery L, Feigl, Andrea B, Fereshtehnejad, Seyed Mohammad, Ferrari, Alize J, Ferri, Cleusa P, Flaxman, Abraham D, Fleming, Thomas D, Foigt, Nataliya, Foreman, Kyle J, Paleo, Urbano Fra, Franklin, Richard C, Gabbe, Belinda, Gaffikin, Lynne, Gakidou, Emmanuela, Gamkrelidze, Amiran, Gankpé, Fortuné G, Gansevoort, Ron T, García Guerra, Francisco A, Gasana, Evariste, Geleijnse, Johanna M, Gessner, Bradford D, Gething, Pete, Gibney, Katherine B, Gillum, Richard F, Ginawi, Ibrahim A. M, Giroud, Maurice, Giussani, Giorgia, Goenka, Shifalika, Goginashvili, Ketevan, Dantes, Hector Gomez, Gona, Philimon, de Cosio, Teresita Gonzalez, González Castell, Dinorah, Gotay, Carolyn C, Goto, Atsushi, Gouda, Hebe N, Guerrant, Richard L, Gugnani, Harish C, Guillemin, Franci, Gunnell, David, Gupta, Rahul, Gupta, Rajeev, Gutiérrez, Reyna A, Hafezi Nejad, Nima, Hagan, Holly, Hagstromer, Maria, Halasa, Yara A, Hamadeh, Randah R, Hammami, Mouhanad, Hankey, Graeme J, Hao, Yuantao, Harb, Hilda L, Haregu, Tilahun Nigatu, Haro, Josep Maria, Havmoeller, Rasmu, Hay, Simon I, Hedayati, Mohammad T, Heredia Pi, Ileana B, Hernandez, Lucia, Heuton, Kyle R, Heydarpour, Pouria, Hijar, Martha, Hoek, Hans W, Hoffman, Howard J, Hornberger, John C, Hosgood, H. Dean, Hoy, Damian G, Hsairi, Mohamed, Hu, Guoqing, Hu, Howard, Huang, Cheng, Huang, John J, Hubbell, Bryan J, Huiart, Laetitia, Husseini, Abdullatif, Iannarone, Marissa L, Iburg, Kim M, Idrisov, Bulat T, Ikeda, Nayu, Innos, Kaire, Inoue, Manami, Islami, Farhad, Ismayilova, Samaya, Jacobsen, Kathryn H, Jansen, Henrica A, Jarvis, Deborah L, Jassal, Simerjot K, Jauregui, Alejandra, Jayaraman, Sudha, Jeemon, Panniyammakal, Jensen, Paul N, Jha, Vivekanand, Jiang, Fan, Jiang, Guohong, Jiang, Ying, Jonas, Jost B, Juel, Knud, Kan, Haidong, Roseline, Sidibe S. Kany, Karam, Nadim E, Karch, André, Karema, Corine K, Karthikeyan, Ganesan, Kaul, Anil, Kawakami, Norito, Kazi, Dhruv S, Kemp, Andrew H, Kengne, Andre P, Keren, Andre, Khader, Yousef S, Khalifa, Shams Eldin Ali Hassan, Khan, Ejaz A, Khang, Young Ho, Khatibzadeh, Shahab, Khonelidze, Irma, Kieling, Christian, Kim, Daniel, Kim, Sungroul, Kim, Yunjin, Kimokoti, Ruth W, Kinfu, Yohanne, Kinge, Jonas M, Kissela, Brett M, Kivipelto, Miia, Knibbs, Luke D, Knudsen, Ann Kristin, Kokubo, Yoshihiro, Kose, M. Rifat, Kosen, Soewarta, Kraemer, Alexander, Kravchenko, Michael, Krishnaswami, Sanjay, Kromhout, Han, Ku, Tiffany, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kuipers, Ernst J, Kulkarni, Chanda, Kulkarni, Veena S, Kumar, G. Anil, Kwan, Gene F, Lai, Taavi, Balaji, Arjun Lakshmana, Lalloo, Ratilal, Lallukka, Tea, Lam, Hilton, Lan, Qing, Lansingh, Van C, Larson, Heidi J, Larsson, Ander, Laryea, Dennis O, Lavados, Pablo M, Lawrynowicz, Alicia E, Leasher, Janet L, Lee, Jong Tae, Leigh, Jame, Leung, Ricky, Levi, Miriam, Li, Yichong, Li, Yongmei, Liang, Juan, Liang, Xiaofeng, Lim, Stephen S, Lindsay, M. Patrice, Lipshultz, Steven E, Liu, Shiwei, Liu, Yang, Lloyd, Belinda K, Logroscino, Giancarlo, London, Stephanie J, Lopez, Nancy, Lortet Tieulent, Joannie, Lotufo, Paulo A, Lozano, Rafael, Lunevicius, Raimunda, Ma, Jixiang, Ma, Stefan, Machado, Vasco M. P, Macintyre, Michael F, Magis Rodriguez, Carlo, Mahdi, Abbas A, Majdan, Marek, Malekzadeh, Reza, Mangalam, Srikanth, Mapoma, Christopher C, Marape, Marape, Marcenes, Wagner, Margolis, David J, Margono, Christopher, Marks, Guy B, Martin, Randall V, Marzan, Melvin B, Mashal, Mohammad T, Masiye, Felix, Mason Jones, Amanda J, Matsushita, Kunihiro, Matzopoulos, Richard, Mayosi, Bongani M, Mazorodze, Tasara T, Mckay, Abigail C, Mckee, Martin, Mclain, Abigail, Meaney, Peter A, Medina, Catalina, Mehndiratta, Man Mohan, Mejia Rodriguez, Fabiola, Mekonnen, Wubegzier, Melaku, Yohannes A, Meltzer, Michele, Memish, Ziad A, Mendoza, Walter, Mensah, George A, Meretoja, Atte, Mhimbira, Francis Apolinary, Micha, Renata, Miller, Ted R, Mills, Edward J, Misganaw, Awoke, Mishra, Santosh, Ibrahim, Norlinah Mohamed, Mohammad, Karzan A, Mokdad, Ali H, Mola, Glen L, Monasta, Lorenzo, Hernandez, Julio C. Montañez, Montico, Marcella, Moore, Ami R, Morawska, Lidia, Mori, Rintaro, Moschandreas, Joanna, Moturi, Wilkister N, Mozaffarian, Dariush, Mueller, Ulrich O, Mukaigawara, Mitsuru, Mullany, Erin C, Murthy, Kinnari S, Naghavi, Mohsen, Nahas, Ziad, Naheed, Aliya, Naidoo, Kovin S, Naldi, Luigi, Nand, Devina, Nangia, Vinay, Narayan, Km Venkat, Nash, Deni, Neal, Bruce, Nejjari, Chakib, Neupane, Sudan P, Newton, Charles R, Ngalesoni, Frida N, de Dieu Ngirabega, Jean, Nguyen, Grant, Nguyen, Nhung T, Nieuwenhuijsen, Mark J, Nisar, Muhammad I, Nogueira, José R, Nolla, Joan M, Nolte, Sandra, Norheim, Ole F, Norman, Rosana E, Norrving, Bo, Nyakarahuka, Luke, Oh, In Hwan, Ohkubo, Takayoshi, Olusanya, Bolajoko O, Omer, Saad B, Opio, John Nelson, Orozco, Ricardo, Pagcatipunan, Rodolfo S, Pain, Amanda W, Pandian, Jeyaraj D, Panelo, Carlo Irwin A, Papachristou, Christina, Park, Eun Kee, Parry, Charles D, Caicedo, Angel J. Paternina, Patten, Scott B, Paul, Vinod K, Pavlin, Boris I, Pearce, Neil, Pedraza, Lilia S, Pedroza, Andrea, Stokic, Ljiljana Pejin, Pekericli, Ayfer, Pereira, David M, Perez Padilla, Rogelio, Perez Ruiz, Fernando, Perico, Norberto, Perry, Samuel A. L, Pervaiz, Aslam, Pesudovs, Konrad, Peterson, Carrie B, Petzold, Max, Phillips, Michael R, Phua, Hwee Pin, Plass, Dietrich, Poenaru, Dan, Polanczyk, Guilherme V, Polinder, Suzanne, Pond, Constance D, Pope, C. Arden, Pope, Daniel, Popova, Svetlana, Pourmalek, Farshad, Powles, John, Prabhakaran, Dorairaj, Prasad, Noela M, Qato, Dima M, Quezada, Amado D, Quistberg, D. Alex A, Racapé, Lionel, Rafay, Anwar, Rahimi, Kazem, Rahimi Movaghar, Vafa, Rahman, Sajjad Ur, Raju, Murugesan, Rakovac, Ivo, Rana, Saleem M, Rao, Mayuree, Razavi, Homie, Reddy, K. Srinath, Refaat, Amany H, Rehm, Jürgen, Remuzzi, Giuseppe, Ribeiro, Antonio L, Riccio, Patricia M, Richardson, Lee, Riederer, Anne, Robinson, Margaret, Roca, Anna, Rodriguez, Alina, Rojas Rueda, David, Romieu, Isabelle, Ronfani, Luca, Room, Robin, Roy, Nobhojit, Ruhago, George M, Rushton, Lesley, Sabin, Nsanzimana, Sacco, Ralph L, Saha, Sukanta, Sahathevan, Ramesh, Sahraian, Mohammad Ali, Salomon, Joshua A, Salvo, Deborah, Sampson, Uchechukwu K, Sanabria, Juan R, Sanchez, Luz Maria, Sánchez Pimienta, Tania G, Sanchez Riera, Lidia, Sandar, Logan, Santos, Itamar S, Sapkota, Amir, Satpathy, Maheswar, Saunders, James E, Sawhney, Monika, Saylan, Mete I, Scarborough, Peter, Schmidt, Jürgen C, Schneider, Ione J. C, Schöttker, Ben, Schwebel, David C, Scott, James G, Seedat, Soraya, Sepanlou, Sadaf G, Serdar, Berrin, Servan Mori, Edson E, Shaddick, Gavin, Shahraz, Saeid, Levy, Teresa Shamah, Shangguan, Siyi, She, Jun, Sheikhbahaei, Sara, Shibuya, Kenji, Shin, Hwashin H, Shinohara, Yukito, Shiri, Rahman, Shishani, Kawkab, Shiue, Ivy, Sigfusdottir, Inga D, Silberberg, Donald H, Simard, Edgar P, Sindi, Shireen, Singh, Abhishek, Singh, Gitanjali M, Singh, Jasvinder A, Skirbekk, Vegard, Sliwa, Karen, Soljak, Michael, Soneji, Samir, Søreide, Kjetil, Soshnikov, Sergey, Sposato, Luciano A, Sreeramareddy, Chandrashekhar T, Stapelberg, Nicolas J. C, Stathopoulou, Vasiliki, Steckling, Nadine, Stein, Dan J, Stein, Murray B, Stephens, Natalie, Stöckl, Heidi, Straif, Kurt, Stroumpoulis, Konstantino, Sturua, Lela, Sunguya, Bruno F, Swaminathan, Soumya, Swaroop, Mamta, Sykes, Bryan L, Tabb, Karen M, Takahashi, Ken, Talongwa, Roberto T, Tandon, Nikhil, Tanne, David, Tanner, Marcel, Tavakkoli, Mohammad, Te Ao, Braden J, Teixeira, Carolina M, Téllez Rojo, Martha M, Terkawi, Abdullah S, Texcalac Sangrador, José Lui, Thackway, Sarah V, Thomson, Blake, Thorne Lyman, Andrew L, Thrift, Amanda G, Thurston, George D, Tillmann, Taavi, Tobollik, Myriam, Tonelli, Marcello, Topouzis, Foti, Towbin, Jeffrey A, Toyoshima, Hideaki, Traebert, Jefferson, Tran, Bach X, Trasande, Leonardo, Trillini, Matia, Trujillo, Ulise, Dimbuene, Zacharie Tsala, Tsilimbaris, Miltiadi, Tuzcu, Emin Murat, Uchendu, Uche S, Ukwaja, Kingsley N, Uzun, Selen B, van de Vijver, Steven, Van Dingenen, Rita, van Gool, Coen H, van Os, Jim, Varakin, Yuri Y, Vasankari, Tommi J, Vasconcelos, Ana Maria N, Vavilala, Monica S, Veerman, Lennert J, Velasquez Melendez, Gustavo, Venketasubramanian, N, Vijayakumar, Lakshmi, Villalpando, Salvador, Violante, Francesco S, Vlassov, Vasiliy Victorovich, Vollset, Stein Emil, Wagner, Gregory R, Waller, Stephen G, Wallin, Mitchell T, Wan, Xia, Wang, Haidong, Wang, Jianli, Wang, Linhong, Wang, Wenzhi, Wang, Yanping, Warouw, Tati S, Watts, Charlotte H, Weichenthal, Scott, Weiderpass, Elisabete, Weintraub, Robert G, Werdecker, Andrea, Wessells, K. Ryan, Westerman, Ronny, Whiteford, Harvey A, Wilkinson, James D, Williams, Hywel C, Williams, Thomas N, Woldeyohannes, Solomon M, Wolfe, Charles D. A, Wong, John Q, Woolf, Anthony D, Wright, Jonathan L, Wurtz, Brittany, Xu, Gelin, Yan, Lijing L, Yang, Gonghuan, Yano, Yuichiro, Ye, Pengpeng, Yenesew, Muluken, Yentür, Gökalp K, Yip, Paul, Yonemoto, Naohiro, Yoon, Seok Jun, Younis, Mustafa Z, Younoussi, Zourkaleini, Yu, Chuanhua, Zaki, Maysaa E, Zhao, Yong, Zheng, Yingfeng, Zhou, Maigeng, Zhu, Jun, Zhu, Shankuan, Zou, Xiaonong, Zunt, Joseph R, Lopez, Alan D, Vos, Theo, Murray, Christopher J., Cell biology, Epidemiology, Neurosciences, Health Technology Assessment (HTA), Public Health, General practice, Bachman, Victoria F., Coates, Matthew M., Frostad, Joseph J., Astha, K.C., Kyu, Hmwe H., Moradi-Lakeh, Maziar, Thomas, Bernadette A., Abbasoglu Ozgoren, Ayse, Abd-Allah, Foad, Abera, Semaw F., Puthenpurakal Abraham, Jerry, Abu-Rmeileh, Niveen M.E., Aburto, Tania C., Adou, Arsène K., Adsuar, José C., Agardh, Emilie E., Al Khabouri, Mazin J., Al Lami, Faris H., Albittar, Mohammed I., Alegretti, Miguel A., Aleman, Alicia V., Alemu, Zewdie A., Alfonso-Cristancho, Rafael, Ali, Mohammed K., Allen, Peter J., Alvis-Guzman, Nelson, Amankwaa, Adansi A., Amare, Azmeraw T., Ameh, Emmanuel A., Anderson, Benjamin O., Antonio, Carl Abelardo T., Argeseanu Cunningham, Solveig, Arsic Arsenijevic, Valentina S., Asghar, Rana J., Atkins, Lydia S., Avila, Marco A., Bahit, Maria C., Barber, Ryan M., Barker-Collo, Suzanne L., Barrero, Lope H., Barrientos-Gutierrez, Tonatiuh, Basto-Abreu, Ana C., Basulaiman, Mohammed O., Batis Ruvalcaba, Carolina, Bell, Michelle L., Bennett, Derrick A., Beyene, Tariku J., Bhutta, Zulfiqar A., Bin Abdulhak, Aref A., Blore, Jed D., Blyth, Fiona M., Bohensky, Megan A., Bora Başara, Berrak, Bornstein, Natan M., Bourne, Rupert R., Breitborde, Nicholas J., Briggs, Adam D.M., Broday, David M., Brooks, Peter M., Bruce, Nigel G., Brugha, Traolach S., Bui, Linh N., Bulloch, Andrew G., Burney, Peter G.J., Campos-Nonato, Ismael R., Campuzano, Julio C., Cantoral, Alejandra J., Carpenter, David O., Castañeda-Orjuela, Carlos A., Castro, Ruben E., Catalá-López, Ferrán, Chadha, Vineet K., Chang, Jung-Chen, Charlson, Fiona J., Chiang, Peggy P., Chimed-Ochir, Odgerel, Christophi, Costas A., Chuang, Ting-Wu, Chugh, Sumeet S., Claßen, Thomas K.D., Colquhoun, Samantha M., Contreras, Alejandra G., Cooper, Leslie T., Courville, Karen J., Criqui, Michael H., Cuevas-Nasu, Lucia, Damsere-Derry, Jame, Dargan, Paul I., Davitoiu, Dragos V., De Castro, E. Filipa, De La Cruz-Góngora, Vanessa, De Lima, Graça, Del Pozo-Cruz, Borja, Dellavalle, Robert P., Des Jarlais, Don C., Deveber, Gabrielle A., Devries, Karen M., Dharmaratne, Samath D., Dherani, Mukesh K., Ding, Eric L., Driscoll, Tim R., Durrani, Adnan M., Ebel, Beth E., Ellenbogen, Richard G., Elshrek, Yousef M., Ermakov, Sergey P., Erskine, Holly E., Faraon, Emerito Jose A., Fay, Derek F.J., Feigin, Valery L., Feigl, Andrea B., Fereshtehnejad, Seyed-Mohammad, Ferrari, Alize J., Ferri, Cleusa P., Flaxman, Abraham D., Fleming, Thomas D., Foreman, Kyle J., Fra Paleo, Urbano, Franklin, Richard C., Gankpé, Fortuné G., Gansevoort, Ron T., García-Guerra, Francisco A., Geleijnse, Johanna M., Gessner, Bradford D., Gibney, Katherine B., Gillum, Richard F., Ginawi, Ibrahim A.M., Gomez Dantes, Hector, Gonzalez De Cosio, Teresita, González-Castell, Dinorah, Gotay, Carolyn C., Gouda, Hebe N., Guerrant, Richard L., Gugnani, Harish C., Gutiérrez, Reyna A., Hafezi-Nejad, Nima, Halasa, Yara A., Hamadeh, Randah R., Hankey, Graeme J., Harb, Hilda L., Hay, Simon I., Hedayati, Mohammad T., Heredia-Pi, Ileana B., Heuton, Kyle R., Hoek, Hans W., Hoffman, Howard J., Hornberger, John C., Hosgood, H., Hoy, Damian G., Huang, John J., Hubbell, Bryan J., Iannarone, Marissa L., Iburg, Kim M., Idrisov, Bulat T., Jacobsen, Kathryn H., Jansen, Henrica A., Jarvis, Deborah L., Jassal, Simerjot K., Jensen, Paul N., Jonas, Jost B., Kany Roseline, Sidibe S., Karam, Nadim E., Karema, Corine K., Kazi, Dhruv S., Kemp, Andrew H., Kengne, Andre P., Khader, Yousef S., Ali Hassan Khalifa, Shams Eldin, Khan, Ejaz A., Khang, Young-Ho, Kimokoti, Ruth W., Kinge, Jonas M., Kissela, Brett M., Knibbs, Luke D., Kuate Defo, Barthelemy, Kucuk Bicer, Burcu, Kuipers, Ernst J., Kulkarni, Veena S., Kwan, Gene F., Lakshmana Balaji, Arjun, Lansingh, Van C., Larson, Heidi J., Laryea, Dennis O., Lavados, Pablo M., Lawrynowicz, Alicia E., Leasher, Janet L., Lee, Jong-Tae, Lim, Stephen S., Lipshultz, Steven E., Lloyd, Belinda K., London, Stephanie J., Lortet-Tieulent, Joannie, Lotufo, Paulo A., Machado, Vasco M.P., Macintyre, Michael F., Magis-Rodriguez, Carlo, Mahdi, Abbas A., Mapoma, Christopher C., Margolis, David J., Marks, Guy B., Martin, Randall V., Marzan, Melvin B., Mashal, Mohammad T., Mason-Jones, Amanda J., Mayosi, Bongani M., Mazorodze, Tasara T., Mckay, Abigail C., Meaney, Peter A., Mejia-Rodriguez, Fabiola, Melaku, Yohannes A., Memish, Ziad A., Mensah, George A., Apolinary Mhimbira, Franci, Miller, Ted R., Mills, Edward J., Mohamed Ibrahim, Norlinah, Mohammad, Karzan A., Mokdad, Ali H., Mola, Glen L., Montañez Hernandez, Julio C., Moore, Ami R., Moturi, Wilkister N., Mueller, Ulrich O., Mullany, Erin C., Murthy, Kinnari S., Naidoo, Kovin S., Narayan, K.M. Venkat, Neupane, Sudan P., Newton, Charles R., Ngalesoni, Frida N., Ngirabega, Jean De Dieu, Nguyen, Nhung T., Nieuwenhuijsen, Mark J., Nisar, Muhammad I., Nogueira, José R., Nolla, Joan M., Norheim, Ole F., Norman, Rosana E., Oh, In-Hwan, Olusanya, Bolajoko O., Omer, Saad B., Pagcatipunan, Rodolfo S., Pain, Amanda W., Pandian, Jeyaraj D., Panelo, Carlo Irwin A., Park, Eun-Kee, Parry, Charles D., Paternina Caicedo, Angel J., Patten, Scott B., Paul, Vinod K., Pavlin, Boris I., Pedraza, Lilia S., Pejin Stokic, Ljiljana, Pereira, David M., Perez-Padilla, Rogelio, Perez-Ruiz, Fernando, Perry, Samuel A.L., Phillips, Michael R., Polanczyk, Guilherme V., Pond, Constance D., Prasad, Noela M., Qato, Dima M., Quezada, Amado D., Quistberg, D. Alex A., Rahimi-Movaghar, Vafa, Ur Rahman, Sajjad, Rana, Saleem M., Refaat, Amany H., Ribeiro, Antonio L., Riccio, Patricia M., Rojas-Rueda, David, Ruhago, George M., Sacco, Ralph L., Salomon, Joshua A., Sampson, Uchechukwu K., Sanabria, Juan R., Sánchez-Pimienta, Tania G., Sanchez-Riera, Lidia, Santos, Itamar S., Saunders, James E., Saylan, Mete I., Schmidt, Jürgen C., Schneider, Ione J.C., Schwebel, David C., Scott, James G., Sepanlou, Sadaf G., Servan-Mori, Edson E., Shamah Levy, Teresa, Shin, Hwashin H., Sigfusdottir, Inga D., Silberberg, Donald H., Simard, Edgar P., Singh, Gitanjali M., Singh, Jasvinder A., Sposato, Luciano A., Sreeramareddy, Chandrashekhar T., Stapelberg, Nicolas J.C., Stein, Dan J., Stein, Murray B., Sunguya, Bruno F., Sykes, Bryan L., Tabb, Karen M., Talongwa, Roberto T., Te Ao, Braden J., Teixeira, Carolina M., Téllez Rojo, Martha M., Terkawi, Abdullah S., Texcalac-Sangrador, José Lui, Thackway, Sarah V., Thorne-Lyman, Andrew L., Thrift, Amanda G., Thurston, George D., Towbin, Jeffrey A., Tran, Bach X., Tsala Dimbuene, Zacharie, Uchendu, Uche S., Ukwaja, Kingsley N., Uzun, Selen B., Van De Vijver, Steven, Van Gool, Coen H., Van Os, Jim, Varakin, Yuri Y., Vasankari, Tommi J., Vasconcelos, Ana Maria N., Vavilala, Monica S., Veerman, Lennert J., Velasquez-Melendez, Gustavo, Venketasubramanian, N., Violante, Francesco S., Victorovich Vlassov, Vasiliy, Wagner, Gregory R., Waller, Stephen G., Wallin, Mitchell T., Warouw, Tati S., Watts, Charlotte H., Weintraub, Robert G., Whiteford, Harvey A., Wilkinson, James D., Williams, Hywel C., Williams, Thomas N., Woldeyohannes, Solomon M., Wolfe, Charles D.A., Wong, John Q., Woolf, Anthony D., Wright, Jonathan L., Yan, Lijing L., Yentür, Gökalp K., Yoon, Seok-Jun, Younis, Mustafa Z., Zaki, Maysaa E., Zunt, Joseph R., Lopez, Alan D., and Temesgen, A.M.
Subjects: Male, Fine particulate matter, Nutrition and Disease, MESH : Sanitation, Health Behavior, Diseases, MESH: Metabolic Diseases, MESH: Global Health, 030204 cardiovascular system & hematology, MESH: Risk Assessment, Global Health, MESH : Nutritional Status, MESH: Occupational Exposure, 0302 clinical medicine, Unsafe Sex, MESH: Risk Factors, Risk Factors, Voeding en Ziekte, Medicine, Air-pollution, MESH : Female, 030212 general & internal medicine, MESH : Risk Assessment, Sanitation, Wasting, 2. Zero hunger, Factors de risc en les malalties, Medicine (all), [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, Public Health, Global Health, Social Medicine and Epidemiology, General Medicine, MESH : Occupational Diseases, MESH: Nutritional Status, All-cause mortality, MESH : Risk Factors, humanities, Environmental Exposure, Female, Humans, Metabolic Diseases, Nutritional Status, Occupational Diseases, Occupational Exposure, Risk Assessment, Tobacco smoking, 3. Good health, Nutritional Statu, MESH : Occupational Exposure, MESH : Metabolic Diseases, Cohort, medicine.symptom, Risk assessment, Blood-pressure, Human, MESH: Occupational Diseases, Risk factors in diseases, Coronary-heart-disease, MESH : Male, MESH: Health Behavior, MESH: Environmental Exposure, Population health, Body-mass index, 03 medical and health sciences, Household cooking, Cardiovascular-disease, Environmental health, General & Internal Medicine, parasitic diseases, Life Science, MESH: Sanitation, Risk factor, MESH : Health Behavior, VLAG, GBD2013, MESH: Humans, business.industry, Risk Factor, Global Burden of Disease Study, 79 behavioural, environmental and occupational, and metabolic risks, Long-term exposure, MESH : Humans, CAUSE-SPECIFIC MORTALITY, MESH: Male, Metabolic Disease, Occupational Disease, Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi, MALE BRITISH DOCTORS, Years of potential life lost, Relative risk, Malalties, MESH : Global Health, OUTDOOR AIR-POLLUTION, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH : Environmental Exposure, MESH: Female
Abstract: Summary 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 metaregression 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. Funding Bill & Melinda Gates Foundation. Background The Global Burden of Disease, Injuries, and Risk Factor study 2013 (GBD 2013) is the fi rst of a series of annual updates of the GBD. Risk factor quantifi cation, particularly of modifi able 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 fi rst 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 fi ltration rate. For most risks, data for exposure were synthesised with a Bayesian metaregression 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. Funding Bill & Melinda Gates Foundation.
Published: 2015
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249. Deciphering the link and direction between attention-deficit/hyperactivity disorder symptoms and obesity: Common behavioural or prenatal pathways?

Author: Khalife, Natasha, Rodriguez, Alina, Jarvelin, Marjo-Riitta, Glover, Vivette, Nordic Council of Ministers, Academy of Finland, Sigrid Juselius Foundation (Finland), University of Oulu, National Institutes of Health, European Union, and The Swedish Council for Working Life and Social Research (FAS)
Subjects: mental disorders
Abstract: Growing evidence suggests an association between attention-deficit/hyperactivity disorder (ADHD) and obesity, although very little is understood about the nature of this link. The aims of this thesis were to examine the following aspects of the ADHD-obesity association: (1) the directionality of the link from childhood to adolescence, (2) behavioural mediators during childhood and adolescence, and (3) prenatal risk factors common for both disorders. Participants were from the Northern Finland Birth Cohort (NFBC) 1986 (N=9479). Data were obtained on pregnancy and birth factors, and child/adolescent mental health, obesity, and lifestyle factors. Regression analyses showed that ADHD symptoms significantly predicted obesity, rather than in the opposite direction, from childhood to adolescence. Mediation analyses examined potential underlying behavioural factors – physical activity and binge-eating, and showed that physical inactivity mediated the longitudinal ADHD symptom-obesity association. Further, there was a bidirectional, longitudinal association between physical inactivity and ADHD symptoms. ADHD and obesity may share common prenatal risk factors, including prenatal exposure to cortisol. This was studied using a quasi-experimental approach by examining the impact of prenatal exposure to synthetic glucocorticoids (sGC). Results from propensity-score and mixed-effects methods showed that prenatal sGC increased the risk for general psychiatric disturbance and inattention symptoms, but not obesity, in childhood. Placental size may represent another common prenatal contributing factor; placental size was positively associated with behaviour problems, including ADHD symptoms, in child and adolescent boys, but was not associated with obesity. This thesis addresses important unexplored aspects of the association between ADHD and obesity, and provides insight into risk factors for both disorders. The direction of the association was driven from ADHD symptoms to obesity, and physical inactivity was a behavioural mediator underlying the link. Although there was no evidence that both disorders share common prenatal risk, prenatal sGC and placental size were positively associated with ADHD symptoms. Open Access
Published: 2014

250. Stress and glucocorticoid treatment during pregnancy, early growth and metabolic outcomes in childhood

Author: Ali Khan, Anokhi, Jarvelin, Marjo-Riitta, and Rodriguez, Alina
Abstract: Background: Variation in birth size has been linked to increased risk of a number of disorders later in life, including cardiovascular and metabolic disorders. However, less is known about other parameters of birth size, beyond birth weight, on later health. Moreover, the impact of the biological markers of stress, i.e. glucocorticoids, on various parameters of birth size remains understudied as well as their impact on later metabolic outcomes. Aims and objectives: The aim of this study was to examine the influence of the HPA axis on birth size (birth weight, ponderal index, birth length, head circumference) and subsequent metabolic health in adolescence. The main predictor being exposure to glucocorticoids either administered clinically or inferred as a result of maternal social stress. The genetic environment interplay of birth weight lowering alleles near LEKR and CCNL1 and in ADCY5 was also examined. Methods: Data came from the Northern Finland Birth Cohort (NFBC1986), and the National Finnish Medical Birth Registry (MBR) 2006-2010. Glucocorticoid treatment (sGC) to mature foetal lung in threatened preterm birth, social stress measures, and birth outcomes were obtained from medical records and via maternal report (in NFBC1986) during pregnancy. Data on NFBC1986 children at 16 years included anthropometry, blood pressure, blood sample for DNA, and metabolic outcomes. Results: The systematic literature review showed a dearth of information on the association of sGC on birth size, with the larger studies reporting smaller birth size in infants exposed to sGC. The NFBC1986 cohort showed only 17% (n=58) preterm infants had received sGC due to threatened preterm birth, with an association with smaller birth length of -0.18cm(95%CI -0.26, -0.10), but a larger birth weight of 116g(95%CI 98.9, 133.1) and head circumference of 0.75cm(95%CI 0.7, 0.81). In contrast, in the MBR (5090 exposed subjects) sGC treatment was consistently associated with lower birth weight of -207g(95%CI -220, -195), birth length of -1.26cm(95%CI -1.31, -1.20), head circumference of -0.94cm(95%CI -0.98, -0.90), and ponderal index of -0.91 (95%CI-1.02, -0.81). Maternal social stress during pregnancy and risk allele near LEKR and CCNL1 each was associated with smaller birth size. The association with stress was magnified with lower birth weight of -118g(95%CI -156, -79), birth length of -0.30cm(95%CI -0.46, -0.14), head circumference of -0.23cm(-0.35, -0.11), and ponderal index of -0.47(95%CI -0.67, -0.26) in the presence of risk allele. No robust association was found between maternal social stress during pregnancy and metabolic syndrome at 16 years. There was an association with more adverse lipid profile in particular with apolipoprotein B/A ratio (1.92% increase, 95%CI 0.34, 3.52, by maternal exposure to social stress). Conclusion: Stress and exposure to sGC during pregnancy in addition to genetic risk are related to smaller birth size. In the NFBC1986 there was no evidence of longer term impact of in utero stress exposure on metabolic syndrome in adolescence, though there was a poorer lipid profile noted. To better understand the degree to which the HPA axis plays in foetal programming, maternal and foetal cortisol levels during pregnancy would be beneficial. Open Access
Published: 2014

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