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Drawing on fieldwork that incorporates ethnography and archival land research, this dissertation investigates the transformation of land into property in Hawai’i and its continued impact on the development of Hawaiian landscapes and communities contemporarily. On the windward side of the North Shore of O‘ahu, Hawai‘i, residents have been fighting against the threat of commercial and urban development for decades. Through interviews with key community leaders, I describe the origins of the current grassroots anti-development movement that started in the 1970s, when protestors first organized around the protection of Native Hawaiian and non-Indigenous farmers being threatened with eviction to make way for urban development. The colonial and foreign influence on the privatization of property in the 1850s had set into motion legal practices of land dispossession that continue to impact the contemporary land struggles over development on the North Shore today. I demonstrate that the adoption of Western legal attitudes towards the productive capacity of land and property ownership is what has allowed for affluent prospectors to amass large estates over time, resulting in the immense loss of Native Hawaiian-held kuleana properties to powerful developers through processes of anticommoning. With this dissertation, I conduct a novel analysis of the ways in which this legal doctrine is inherently unsuited to address both real and intangible non-Western patterns of property distribution, thereby creating both land and resource insecurities characteristic of a tragedy of the anticommons. In conclusion, I argue that these practices ultimately undermine residents’ decision-making power over the direction of their community and their ability to resist unwanted development interventions in the future.

Background: When developed properly, disease-specific patient reported outcome measures have the potential to measure relevant changes in how a patient feels and functions in the context of a therapeutic trial. The Huntington’s Disease Health Index (HD-HI) is a multifaceted disease-specific patient reported outcome measure (PROM) designed specifically to satisfy previously published FDA guidance for developing PROMs for product development and labeling claims. Objective: In preparation for clinical trials, we examine the validity, reliability, clinical relevance, and patient understanding of the Huntington’s Disease Health Index (HD-HI). Methods: We partnered with 389 people with Huntington’s disease (HD) and caregivers to identify the most relevant questions for the HD-HI. We subsequently utilized two rounds of factor analysis, cognitive interviews with fifteen individuals with HD, and test-retest reliability assessments with 25 individuals with HD to refine, evaluate, and optimize the HD-HI. Lastly, we determined the capability of the HD-HI to differentiate between groups of HD participants with high versus low total functional capacity score, prodromal versus manifest HD, and normal ambulation versus mobility impairment. Results: HD participants identified 13 relevant and unique symptomatic domains to be included as subscales in the HD-HI. All HD-HI subscales had a high level of internal consistency and reliability and were found by participants to have acceptable content, relevance, and usability. The total HD-HI score and each subscale score statistically differentiated between groups of HD participants with high versus low disease burden. Conclusion: Initial evaluation of the HD-HI supports its validity and reliability as a PROM for assessing how individuals with HD feel and function.

Background Outcomes after kidney transplantation (KTx) remain limited by delayed graft function (DGF) and acute rejection. Non-invasive biomarkers may help identify patients at increased risk for these events. We examined the association between the systemic immune-inflammation index (SII), a novel inflammatory biomarker, and outcomes after KTx and evaluated its ability to predict post-transplant prognosis. Patients and methods Adult patients who underwent primary KTx at our institution between 2016-2019 were included. SII was calculated from pre-transplant complete blood counts as the ratio of the neutrophil count to the lymphocyte count multiplied by the platelet count. The cutoff between high and low SII was determined by maximizing the area under the curve. Multivariable logistic and Cox regression were used to identify factors associated with DGF and patient, rejection-free, and graft survival respectively. Results Overall, 378 KTx recipients were included; 224 (59.3%) had high SII. On unadjusted analysis, high SII was associated with reduced odds of DGF, and improved patient and rejection-free survival. After adjustment, high SII was independently associated with improved patient survival alone. Multivariable models incorporating SII performed well for the prediction of DGF (c-statistic=0.755) and patient survival (c-statistic=0.786), though rejection-free survival was more difficult to predict (c-statistic=0.635). Conclusion SII demonstrated limited utility as an independent predictor of outcomes after KTx. However, in combination with other clinically relevant parameters, SII is a useful predictor of post-KTx prognosis. Validation of this novel inflammatory biomarker in a multi-institutional study is needed to further elucidate its practical applications in transplantation.

In an era of broader lung sharing, different-team transplantation (DT, procuring team from nonrecipient center) may streamline procurement logistics; however, safety and cost implications of DT remain unclear. To understand whether DT represents a safe means to reduce lung transplant (LTx) costs, we compared posttransplant outcomes and lung procurement and index hospitalization costs among matched DT and same-team transplantation (ST, procuring team from recipient center) cohorts at a single, high-volume institution. We hypothesized that DT reduces costs without compromising outcomes after LTx.Patients who underwent DT between January 2016 to May 2020 were included. A cohort of patients who underwent ST was matched 1:3 (nearest neighbor) based on recipient age, disease group, lung allocation score, history of previous LTx, and bilateral versus single LTx. Posttransplant outcomes and costs were compared between groups.In total, 23 DT and 69 matched ST recipients were included. Perioperative outcomes and posttransplant survival were similar between groups. Compared with ST, DT was associated with similar lung procurement and index hospitalization costs (DT vs ST, procurement: median $65,991 vs $58,847, P = .16; index hospitalization: median $294,346 vs $322,189, P = .7). On average, procurement costs increased $3263 less per 100 nautical miles for DT versus ST; DT offered cost-savings when travel distances exceeded approximately 363 nautical miles.At our institution, DT and ST were associated with similar post-LTx outcomes; DT offered cost-savings with increasing procurement travel distance. These findings suggest that DT may mitigate logistical and financial burdens of lung procurement; however, further investigation in a multi-institutional cohort is warranted.

Textbook surgical outcome (TO) is a novel composite quality measure in lung transplantation (LTx). Compared to 1-year survival metrics, TO may better differentiate center performance, and motivate improvements in care. To understand the feasibility of implementing this metric, we defined TO in LTx using US national data, and evaluated its ability to predict post-transplant outcomes and differentiate center performance.Adult patients who underwent isolated LTx between 2016 and 2019 were included. TO was defined as freedom from post-transplant length of stay 30 days, 90-day mortality, intubation or extracorporeal membrane oxygenation at 72 h post-transplant, post-transplant ventilator support lasting ≥5 days, postoperative airway dehiscence, inpatient dialysis, pre-discharge acute rejection, and grade 3 primary graft dysfunction at 72 h. Recipient and donor characteristics and post-transplant outcomes were compared between patients who achieved and failed TO.Of 8959 lung transplant recipients, 4664 (52.1%) achieved TO. Patient and graft survival were improved among patients who achieved TO (both log-rank P .0001). Among 62 centers, adjusted rates of TO ranged from 27.0% to 72.4% reflecting a wide variability in center-level performance.TO defined using national data may represent a novel composite metric to guide quality improvement in LTx across US transplant centers.In this study we defined textbook outcome (TO) for lung transplantation (LTx) using US national data. We found that achievement of TO was associated with improved post-transplant survival, and wide variability in center-level LTx performance. These findings suggest that TO could be readily implemented to compare quality of care among US LTx centers.

Background: Hand-sewn anastomosis is a crucial part of aortic reconstruction surgery and significantly affects its outcome. The present study presents a novel, bidirectional surgical needle aimed to improve aortic anastomosis in terms of speed and ease of use. Our objective was to assess the efficacy of the new design in comparison with the conventional needle. Methods: A series of simulations were conducted with COMSOL software in order to perform a fatigue comparative analysis between the new and the conventional needle design. Ease of penetration into a piece of polydimethylsiloxane was evaluated. Lastly, the prototype was tested under in-vitro conditions in comparison with the conventional needle. Results: Based on fatigue analysis, the new needle design improves durability, provided the two tips are equally used. The polytetrafluoroethylene coating improves penetration into the tissue by 7% to 17%, while electropolishing improves penetration up to 19%. When using the novel needle design, the average anastomotic task completion time was significantly reduced by 22% and the overall distance of hand movements was significantly reduced by 20%. Conclusions: The proposed design exhibited a shorter anastomotic time and seems promising in relation to ease of use and simplicity of the anastomotic technique it introduces.

Ex vivo lung perfusion (EVLP) is a novel lung preservation strategy that facilitates the use of marginal allografts; however, it is more expensive than static cold storage (SCS). To understand how preservation method might affect postoperative costs, we compared outcomes and index hospitalization costs among matched EVLP and SCS preserved lung transplant (LTx) recipients at a single, high-volume institution. A total of 22 EVLP and 66 matched SCS LTx recipients were included; SCS grafts were further stratified as either standard-criteria (SCD) or extended-criteria donors (ECD). Median total preservation time was 857, 409, and 438 min for EVLP, SCD, and ECD lungs, respectively (p .0001). EVLP patients had similar perioperative outcomes and posttransplant survival compared to SCS SCD and ECD recipients. Excluding device-specific costs, total direct variable costs were similar among EVLP, SCD, and ECD recipients (median $200,404, vs. $154,709 vs. $168,334, p = .11). The median direct contribution margin was positive for EVLP recipients, and similar to that for SCD and ECD graft recipients (all p .99). These findings demonstrate that the use of EVLP was profitable at an institutional level; however, further investigation is needed to better understand the financial implications of EVLP in facilitating donor pool expansion in an era of broader lung sharing.

Reported pregnancies in women with repaired truncus arteriosus are rare. As a result of improved surgical techniques, more women with conotruncal defects are now reaching reproductive age. Multifactorial inheritance rather than single gene mutation is the causative agent of most congenital heart disease. The environment can play an important and varied role in direct transmission, particularly in incidences where genes predispose a defect. This may be one of the first reported cases discussing a pregnant mother with repaired truncus arteriosus and her fetus, prenatally diagnosed with a concordant truncal defect.

There is an urgent need for therapeutic interventions for desensitization and antibody-mediated rejection (AMR) in sensitized patients with preformed or de novo donor-specific HLA antibodies (DSA). The risk of AMR and allograft loss in sensitized patients is increased due to preformed DSA detected at time of transplant or the reactivation of HLA memory after transplantation, causing acute and chronic AMR. Alternatively, de novo DSA that develops post-transplant due to inadequate immunosuppression and again may lead to acute and chronic AMR or even allograft loss. Circulating antibody, the final product of the humoral immune response, has been the primary target of desensitization and AMR treatment. However, in many cases these protocols fail to achieve efficient removal of all DSA and long-term outcomes of patients with persistent DSA are far worse when compared to non-sensitized patients. We believe that targeting multiple components of humoral immunity will lead to improved outcomes for such patients. In this review, we will briefly discuss conventional desensitization methods targeting antibody or B cell removal and then present a mechanistically designed desensitization regimen targeting plasma cells and the humoral response.

BACKGROUND: Six hours was historically regarded as the limit of acceptable ischemic time for lung allografts. However, broader sharing of donor lungs often necessitates use of allografts with ischemic time >6 hours. We characterized the association between ischemic time ≥8 hours and outcomes after lung transplantation using a contemporary cohort from a high-volume institution. METHODS: Patients who underwent primary isolated bilateral lung transplantation between 1/2016–5/2020 were included. Patients bridged to transplant with extracorporeal membrane oxygenation or mechanical ventilation, and ex-vivo perfusion cases were excluded. Recipients were stratified by total allograft ischemic time

Background: Hand-sewn anastomosis is a crucial part of aortic reconstruction surgery and significantly affects its outcome. The present study presents a novel, bidirectional surgical needle aimed to improve aortic anastomosis in terms of speed and ease of use. Our objective was to assess the efficacy of the new design in comparison with the conventional needle. Methods: A series of simulations were conducted with COMSOL software in order to perform a fatigue comparative analysis between the new and the conventional needle design. Ease of penetration into a piece of polydimethylsiloxane was evaluated. Lastly, the prototype was tested under in-vitro conditions in comparison with the conventional needle. Results: Based on fatigue analysis, the new needle design improves durability, provided the two tips are equally used. The polytetrafluoroethylene coating improves penetration into the tissue by 7% to 17%, while electropolishing improves penetration up to 19%. When using the novel needle design, the average anastomotic task completion time was significantly reduced by 22% and the overall distance of hand movements was significantly reduced by 20%. Conclusions: The proposed design exhibited a shorter anastomotic time and seems promising in relation to ease of use and simplicity of the anastomotic technique it introduces.

In the United States, an overall national decline in organ transplants has accompanied the substantial burden of COVID-19. Amidst significant regional variations in COVID-19, lung transplantation (LTx) remains a critical life-saving operation. Our LTx practice during the early pandemic may provide a blueprint for managing LTx in an era of continued community prevalence. Patients who underwent LTx at our institution between March 1 and May 20, 2020 were included. Recipient, operative, and donor characteristics were compared to those from our program in 2019, and COVID-19 testing practices were evaluated for March, April, and May to understand how our practice adapted to the pandemic. Our program performed 36 LTx, 33% more than the same period in 2019. Recipient, operative, and donor characteristics during COVID-19 were similar to those in 2019. By April 1, all donors and recipients underwent pretransplant COVID-19 testing, all returning negative results. To date, no recipients have developed posttransplant COVID-19. At our institution, pretransplant COVID-19 testing, use of local donor lungs, and avoidance of donors from areas of increased community penetration supported a safe and effective LTx practice during the early COVID-19 pandemic. Continued follow-up is required to ensure the long-term safety of these newly transplanted patients.

Background Patients with broad HLA sensitization have poor access to donor organs, high mortality while waiting for kidney transplant, and inferior graft survival. Although desensitization strategies permit transplantation via lowering of donor-specific antibodies, the B cell-response axis from germinal center activation to plasma cell differentiation remains intact. Methods To investigate targeting the germinal center response and plasma cells as a desensitization strategy, we sensitized maximally MHC-mismatched rhesus pairs with two sequential skin transplants. We administered a proteasome inhibitor (carfilzomib) and costimulation blockade agent (belatacept) to six animals weekly for 1 month; four controls received no treatment. We analyzed blood, lymph node, bone marrow cells, and serum before desensitization, after desensitization, and after kidney transplantation. Results The group receiving carfilzomib and belatacept exhibited significantly reduced levels of donor-specific antibodies (P=0.05) and bone marrow plasma cells (P=0.02) compared with controls, with a trend toward reduced lymph node T follicular helper cells (P=0.06). Compared with controls, carfilzomib- and belatacept-treated animals had significantly prolonged graft survival (P=0.02), and renal biopsy at 1 month showed significantly reduced antibody-mediated rejection scores (P=0.02). However, four of five animals with long-term graft survival showed gradual rebound of donor-specific antibodies and antibody-mediated rejection. Conclusions Desensitization using proteasome inhibition and costimulation blockade reduces bone marrow plasma cells, disorganizes germinal center responses, reduces donor-specific antibody levels, and prolongs allograft survival in highly sensitized nonhuman primates. Most animals experienced antibody-mediated rejection with humoral-response rebound, suggesting desensitization must be maintained after transplantation using ongoing suppression of the B cell response.

Purpose Six hours has historically been regarded as the limit of acceptable ischemic time (IT) for lung allografts. However, smarter sharing of donor lungs often necessitates use of allografts with IT >6 hours. We characterized the association between IT ≥8 hours and outcomes after lung transplantation (LTx) using a contemporary cohort from a high-volume institution. We hypothesized that longer ITs do not predict greater mortality or graft failure. Methods Patients who underwent primary isolated bilateral orthotopic LTx between 1/2016-5/2020 were included. Patients bridged to LTx with ECMO or mechanical ventilation, and ex-vivo perfusion cases were excluded. Recipients were stratified by allograft IT Results Of 358 patients, 95 (26.5%) received IT ≥8h lungs. IT ≥8h recipients were more likely to be male (69.5% vs 54.4%, p=0.01) and have DCD donors (20.0% vs 5.3%, p Conclusion In a modern cohort, use of lung allografts with IT ≥8h was associated with similar perioperative outcomes and post-transplant survival. Further investigation is required to better understand how broader use impacts post-LTx outcomes and the implications for smarter sharing under an evolving national allocation policy.

Made available in DSpace on 2018-11-26T20:04:45Z (GMT). No. of bitstreams: 0 Previous issue date: 2017-12-16 Wellcome Trust AstraZeneca Background Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. Methods We pooled 2416 population-based studies with measurements of height and weight on 128.9 million participants aged 5 years and older, including 31.5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity). Findings Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0.01 kg/m (2) per decade; 95% credible interval -0.42 to 0.39, posterior probability [PP] of the observed decrease being a true decrease= 0.5098) in eastern Europe to an increase of 1.00 kg/m(2) per decade (0.69-1.35, PP> 0.9999) in central Latin America and an increase of 0.95 kg/m (2) per decade (0.64-1.25, PP> 0.9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0.09 kg/m(2) per decade (-0.33 to 0.49, PP= 0.6926) in eastern Europe to an increase of 0.77 kg/m (2) per decade (0.50-1.06, PP> 0.9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0.7% (0.4-1.2) in 1975 to 5.6% (4.8-6.5) in 2016 in girls, and from 0.9% (0.5-1.3) in 1975 to 7.8% (6.7-9.1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9.2% (6.0-12.9) in 1975 to 8.4% (6.8-10.1) in 2016 in girls and from 14.8% (10.4-19.5) in 1975 to 12.4% (10.3-14.5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22.7% (16.7-29.6) among girls and 30.7% (23.5-38.0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44-117) million girls and 117 (70-178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24-89) million girls and 74 (39-125) million boys worldwide were obese. Interpretation The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults. Imperial Coll London, Sch Publ Hlth, London W2 1PG, England Univ Kent, Canterbury, Kent, England Imperial College London, London, England Middlesex Univ, London, England WHO, Geneva, Switzerland Cleveland Clin, Cleveland, OH 44106 USA Yale Univ, New Haven, CT 06520 USA Univ Calif Berkeley, Berkeley, CA USA Victor Babes Univ Med & Pharm Timisoara, Timisoara, Romania Univ Sydney, Sydney, NSW, Australia Johns Hopkins Univ, Baltimore, MD 21218 USA Isfahan Univ Med Sci, Esfahan, Iran South African Med Res Council, Cape Town, South Africa Seoul Natl Univ, Seoul, South Korea Natl Inst Nutr, Secunderabad, India Harvard TH Chan Sch Publ Hlth, Boston, MA USA Peking Univ, Beijing, Peoples R China Univ Peruana Cayetano Heredia, Lima, Peru Ain Shams Univ, Cairo, Egypt Karolinska Inst, Stockholm, Sweden Univ Coimbra, Coimbra, Portugal Univ Putra Malasia, Seri Kembangan, Malaysia Hosp Sick Children, Toronto, ON, Canada Aga Khan Univ, Karachi, Pakistan Caja Costarricense Seguro Social, San Jose, Costa Rica Al Quds Univ, Jerusalem, Palestine Ctr Diabet & Endocrine Care, Bengaluru, India Birzeit Univ, Birzeit, Palestine Inst Mexicano Seguro Social, Mexico City, DF, Mexico Int Rice Res Inst, Los Banos, Philippines Univ Adelaide, Adelaide, SA, Australia Mahidol Univ, Salaya, Nakhon Pathom, Thailand BARC, Dhaka, Bangladesh Inst Nacl Ciencias Med & Nutr Salvador Zubiran, Mexico City, DF, Mexico Univ Amsterdam, Amsterdam, Netherlands Noncommun Dis Res Ctr, Tehran, Iran Leibniz Inst Prevent Res & Epidemiol BIPS, Leipzig, Germany Natl Ctr Diabet Endocrinol, Amman, Jordan Kazakh Natl Med Univ, Alma Ata, Kazakhstan King Saud Univ, Riyadh, Saudi Arabia Kuwait Inst Sci Res, Kuwait, Kuwait Minist Hlth, Riyadh, Saudi Arabia King Abdullah Int Med Res Ctr, Riyadh, Saudi Arabia Univ Malaysia Sabah, Kota Kinabalu, Malaysia Luxembourg Inst Hlth, Luxembourg, Luxembourg ISGlobal Ctr Res Environm Epidemol, Barcelona, Spain WHO, Reg Off Eastern Mediterranean, Cairo, Egypt Bombay Hosp & Med Res Ctr, Bombay, Maharashtra, India Lille Univ & Hosp, Lille, France London Sch Hyg & Trop Med, London, England Western Norway Univ App Sci, Bergen, Norway Norwegian Sch Sport Sci, Oslo, Norway Univ Cuenca, Cuenca, Ecuador Bispebjerg Hosp, Copenhagen, Denmark Frederiksberg Univ Hosp, Copenhagen, Denmark Madras Diabet Res Fdn, Madras, Tamil Nadu, India Natl Inst Publ Hlth, Tunis, Tunisia Univ Porto, Oporto, Portugal Norwegian Inst Publ Hlth, Oslo, Norway Minist Hlth Malaysia, Putrajaya, Malaysia Natl Inst Nutr, Bangalore, Karnataka, India Univ Strasbourg, Strasbourg, France Strasbourg Univ Hosp, Strasbourg, France Nepal Hlth Res Council, Kathmandu, Nepal Univ Iceland, Reykjavik, Iceland Univ Yaounde, Yaounde, Cameroon Univ Fed Pelotas, Pelotas, Brazil Univ Med, Yangon, Myanmar Univ Porto, Med Sch, Oporto, Portugal Shahid Beheshti Univ Med Sci, Tehran, Iran Indian Council Med Res, New Delhi, India King Abdulaziz Univ, Riyadh, Saudi Arabia Univ Sci & Technol, Taizi, Yemen Med Univ Lodz, Lodz, Poland Med Univ Gdansk, Gdansk, Poland Univ Autonoma Madrid, Madrid, Spain Univ Palermo, Palermo, Italy Pan Amer Hlth Org, Washington, DC USA Mohammed V Univ Rabat, Rabat, Morocco Univ Pernambuco, Recife, PE, Brazil Dalhousie Univ, Calgary, AB, Canada Jordan Univ Technol, Amman, Jordan Univ Fed Maranhao, Sao Luis, Brazil Univ Auckland, Auckland, New Zealand Univ Tunis El Manar, El Manar, Tunisia Fed Minist Hlth & Womens Affairs, Vienna, Austria CAFAM Univ Fdn, Bogota, Colombia Imperial Coll London, London, England Lithuanian Univ Hlth Sci, Kaunas, Lithuania Univ Sao Paulo, Sao Paulo, Brazil BJ Med Coll, Pune, Maharashtra, India Chirayu Med Coll, Bhopal, India Sunder Lal Jain Hosp, Delhi, India Shandong Univ Tradit Chinese Med, Shanghai, Peoples R China Shanghai Jiao Tong Univ, Sch Med, Shanghai, Peoples R China Norwegian Inst Publ, Oslo, Norway Ufa Eye Res Inst, Moscow, Russia Univ Montenegro, Montenegro, Mexico Univ Southern Denmark, Lyngby, Denmark Univ Oslo, Oslo, Norway Univ Gothenburg, Gothenburg, Sweden Natl Inst Publ Hlth & Environm, Amsterdam, Netherlands Univ Turin, Turin, Italy UCL, London, England Liverpool John Moores Univ, Liverpool, Merseyside, England Nanyang Technol Univ, Singapore, Singapore German Inst Human Nutr, Hamburg, Germany Univ Republica, Montevideo, Uruguay CEMIC, La Plata, Buenos Aires, Argentina IRCCS Ist Neurol Mediterraneo Neuromed, Naples, Italy Toulouse Univ, Sch Med, Toulouse, France Univ Lausanne, Minist Hlth, Lausanne, Switzerland Flemish Agcy Care & Hlth, Brussels, Belgium Univ Ghent, Ghent, Belgium FrieslandCampina, Amersfoort, Netherlands Univ Cent Venezuela, Caracas, Venezuela Bielefeld Univ, Bielefeld, Germany WHO, Reg Off Europe, Copenhagen, Denmark German Canc Res Ctr, Heidelberg, Germany Fred Hollows Fdn New Zealand, Auckland, New Zealand Carol Davila Univ Med & Pharm, Bucharest, Romania Natl Inst Publ Hlth & Environm, Amersroot, Netherlands Univ Southern Denmark, Copenhagen, Denmark Inst Publ Hlth, Tirana, Albania Cork Inst Technol, Cork, Ireland Univ La Laguna, San Cristobal la Laguna, Spain Univ Malta, Msida, Malta Vanderbilt Univ, 221 Kirkland Hall, Nashville, TN 37235 USA Minist Hlth, Pangai, Tonga Canadian Fitness & Lifestyle Res Inst, Ottawa, ON, Canada Hosp Santa Maria, Lisbon, Portugal Istanbul Univ, Istanbul, Turkey Univ Fed Juiz de Fora, Juiz De Fora, Portugal Food & Nutr Res Inst, Manila, Philippines Santiago de Compostela Univ, Santiago De Compostela, Spain Assoc Calabrese Epatol, Perugia, Italy India Diabet Res Fdn, Delhi, India Duke NUS Med Sch, Singapore, Singapore Natl Inst Med Stat, New Delhi, India Acad Sinica, Taipei, Taiwan Capital Inst Pediat, Beijing, Peoples R China Duke Univ, Durham, NC 27706 USA Kailuan General Hospital, Tangshan, Peoples R China Univ Oxford, Oxford, England Duke NUS MEd Sch, Singapore, Singapore Gertner Inst Epidemiol & Hlth Policy Res, Tel Aviv, Israel Natl Ctr Publ Hlth & Anal, Sofia, Bulgaria Univ Bern, Bern, Switzerland Minist Hlth & Welfare, Taipei, Taiwan Murcia Reg Hlth Council, Murcia, Spain Seoul Natl Univ, Coll Med, Seoul, South Korea Korea Ctr Dis Control & Prevent, Seoul, South Korea Univ Estadual Paulista, Sao Paulo, Brazil Med Univ Silesia, Katowice, Poland Charles Univ Prague, Prague, Czech Republic Katholieke Univ Leuven, Leuven, Belgium Agcy Prevent & Social Med, Vienna, Austria Univ Fed Santa Catarina, Sao Carlos, SP, Brazil Univ Southampton, Southampton, Hants, England Inst Pasteur, Lille, France CIBEROBN, Barcelona, Spain Natl Inst Publ Hlth, Bucharest, Romania Natl Council Res, Rome, Italy Univ Fed Santa Catarin, Sao Carlos, SP, Brazil Eduardo Mondlane Univ, Maputo, Mozambique Univ Copenhagen, Copenhagen, Denmark Res Ctr Prevent & Hlth, Glostrup, Denmark Tabriz Hlth Serv Managemnet Ctr, Tabriz, Iran Lille Univ Hosp, Lille, France Sci Inst Publ Hlth, Brussels, Belgium Madaras Diabet Res Fdn, Chennai, India Natl Res Ctr Prevent Med, Moscow, Russia Erasmus MC, Rotterdam, Netherlands Univ Montreal, Montreal, PQ, Canada Inst Rech Dev, Montpellier, France French Publ Hlth Agcy, St Maurice, France Univ Vale Rio Sino, Sao Leopoldo, Brazil Natl Council Sci & Tech Res, Buenos Aires, DF, Argentina Univ Zagreb, Zagreb, Croatia Univ Tehran Med Sci, Tehran, Iran Natl Inst Nutr, Hanoi, Vietnam Univ Queensland, Brisbane, Qld, Australia Ist Super Sanita, Rome, Italy Helmholtz Zentrum Munchen, Munich, Germany Minist Sante & Lutte Contre Sida, Abidjan, Cote Ivoire Cardinal Wyszynski Inst Cardiol, Warsaw, Poland Beijing Ctr Dis Prevent & Control, Beijing, Peoples R China Univ Latvia, Riga, Latvia Univ Benin, Benin, Nigeria Univ Skovde, Skovde, Sweden Natl Inst Nutr & Food Technol, Tunis, Tunisia Univ Calif Davis, Davis, CA 95616 USA Univ Stellenbosch, Stellenbosch, South Africa Karadeniz Tech Univ, Trabzon, Turkey Univ Southern Copenhagen, Copenhagen, Denmark Natl Inst Hlth & Welfare, Helsinki, Finland Queens Univ Belfast, Belfast, Antrim, North Ireland Univ Zurich, Zurich, Switzerland Primary Health Care, Floriana, Malta Ctr Salud Villanueva Norte, Villanueva De La Serena, Spain Univ West Indies, Mona, Jamaica Hosp Don Benito Villanueva de la Serena, Villanueva De La Serena, Spain Minist Hlth, Buenos Aires, DF, Argentina Council Agr Res & Econ, Rome, Italy Pontificia Univ Catolica Chile, Santiago, Chile Univ Toulouse, Sch Med, Toulouse, France Univ Manchester, Manchester, Lancs, England Univ Tartu, Tartu, Estonia Inst Nacl Salud Publ, Cuernavaca, Morelos, Mexico Univ Sains Malaysia, George Town, Malaysia Umea Univ, Umea, Sweden Dalarna University, Falun, Sweden Univ West Indies, Kingston, Jamaica Univ Fed Sao Paulo, Sao Paulo, Brazil Hosp Univ Son Espases, Palma De Mallorca, Spain Hosp Clin Porto Alegre, Porto Alegre, RS, Brazil Univ Fed Rio Grande do Sul, Rio Grande, Brazil Kindai Univ, Higashiosaka, Osaka, Japan Kyoto Univ, Kyoto, Japan Med Univ Warsaw, Warsaw, Poland Minist Hlth, Rome, Italy Univ Catania, Catania, Italy CIBER Epidemiol & Salud Publ, Barcelona, Spain Univ KwaZulu Natal, Durban, South Africa Geneva Univ Hosp, Geneva, Switzerland Australian Bur Stat, Canberra, ACT, Australia Agcy Prevent & Social Med, Innsbruck, Austria Wageningen Univ, Wageningen, Netherlands Noncommunicable Dis Res Ctr, Shiraz, Iran Univ Insubria, Varese, Italy Lund Univ, Lund, Sweden Minist Hlth, Ankara, Turkey Minist Hlth, Jerusalem, Israel McGill Univ, Montreal, PQ, Canada Andes Clin Cardiometab Studies, Timotes, Venezuela Univ Politecn Madrid, Madrid, Spain Univ Lille 2, Lille, France Minist Hlth, Lisbon, Portugal Inst Clin & Expt Med, Prague, Czech Republic Childrens Mem Hlth Inst, Warsaw, Poland Alexander Technol Educ Inst, Sindos, Greece Dalhousie Univ, Halifax, NS, Canada Jagiellonian Univ, Med Coll, Krakow, Poland Univ Southern Denmark, Odense, Denmark Azienda Osped Univ Policlin Vittorio Emanuele, Catania, Italy Univ Novi Sad, Novi Sad, Serbia Natl Ctr Cardiovasc Dis, Beijing, Peoples R China Univ Ferrara, Ferrara, Italy Singapore Eye Res Inst, Singapore, Singapore Iceland Heart Assoc, Kopavogur, Iceland Univ Icesi, Cali, Colombia Univ Estadual Montes Claros, Montes Claros, Brazil Kings Coll London, London, England Int Agcy Res Canc, Lyon, France Capital Med Univ, Beijing, Peoples R China Healis Sekhsaria Inst Publ Hlth, Navi Mumbai, India Eternal Heart Care Ctr Res Inst, Jaipur, Rajasthan, India Univ Ibadan, Ibadan, Nigeria Childrens Memorial Hlth Inst, Warsaw, Poland Inst Clin Effectiveness & Hlth Policy, Buenos Aires, DF, Argentina Res & Educ Inst Child Hlth, Nicosia, Cyprus Minist Hlth, Seri Begawan, Brunei Danish Canc Soc, Res Ctr, Copenhagen, Denmark Univ West Indies, Bridgetown, Barbados Alexander Technol Educ Inst Thessaloniki, Sindos, Greece Kyushu Univ, Fukuoka, Japan Tulane Univ, New Orleans, LA 70118 USA Univ Pecs, Pecs, Hungary Univ Coll Dublin, Dublin, Ireland Univ Amsterdam, Acad Med Ctr, Amsterdam, Netherlands Natl Inst Publ Hlth, Cuernavaca, Morelos, Mexico Oulu Univ Hosp, SF-90100 Oulu, Finland Univ Autonoma Bucaramanga, Bucaramanga, Colombia Swiss Fed Inst Technol, Zurich, Switzerland Chron Diseases Res Ctr, Tehran, Iran Univ Hong Kong, Hong Kong, Hong Kong, Peoples R China Chinese Univ Hong Kong, Hong Kong, Hong Kong, Peoples R China Univ Western Australia, Perth, WA, Australia Kingston Gen Hosp, Kingston, ON, Canada Heart Inst, Sao Paulo, Brazil Fdn Oftalmol Santander, Floridablanca, Colombia Univ Oran 1, Oran, Algeria Minist Hlth, Naypyitaw, Myanmar Vrije Univ Amsterdam, Med Ctr, Amsterdam, Netherlands Vrije Univ Amsterdam, Amsterdam, Netherlands Amer Univ Beirut, Beirut, Lebanon IRCCS Ist Neurol Mediterraneo Neuromed, Pozzilli, Italy Cardiol Mercato S Severino, Mercato San Severino, Italy Cairo Univ, Giza, Egypt Natl Inst Hlth & Nutr, Tokyo, Japan UHC Zagreb, Zagreb, Croatia Niigata Univ, Niigata, Japan Hadassah Univ, Med Ctr, Jerusalem, Israel Jordan Univ Sci & Technol, Irbid, Jordan Norwegian Univ Sci & Technol, Trondheim, Norway Sports Univ Tirana, Tirana, Albania Univ Zagreb, Sch Med, Zagreb, Croatia Heart Fdn, Fortitude Valley, Australia Natl Hlth Insurance Serv, Seoul, South Korea Guangzhou 12th Hosp, Guangzhou, Guangdong, Peoples R China Natl Inst Hyg Epidemiol & Microbiol, Havana, Cuba Simon Fraser Univ, Burnaby, BC, Canada Heidelberg Univ, Heidelberg, Germany World Hlth Org Country Off, Agra, Uttar Pradesh, India Inst Publ Hlth Serbia, Belgrade, Serbia Czestochowa Tech Univ, Czestochowa, Poland Univ Ljubljana, Ljubljana, Slovenia Univ Crete, Rethimnon, Greece Univ Kebangsaan Malaysia, Bangi, Malaysia Hellen Med Assoc Obes, Athens, Greece Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA Univ Eastern Finland, Joensuu, Finland Natl Inst Epidemiol, Madras, Tamil Nadu, India Ufa Eye Res Inst, Ufa, Russia Univ Munster, Munster, Germany Israel Ctr for Dis Control, Ramat Gan, Israel Oulu Univ Hosp, Oulu, Finland Isfahan Univ Med Sci, Isfahan, Israel Kyrgyz State Med Acad, Bishkek, Kyrgyzstan Res Inst Child Nutr, Dortmund, Germany Natl Ctr Diabetes & Endocrinol, Amman, Jordan Univ Cambridge, Cambridge, England Med Univ Innsbruck, Innsbruck, Austria Muhimbili Univ Hlth & Allied Sci, Dar Es Salaam, Tanzania Natl Canc Ctr, Goyang Si, South Korea Natl Hlh Insurance Serv, Seoul, South Korea Stat Austria, Vienna, Austria BP Koirala Inst Hlth Sci, Dharan, Nepal Inst Trop Med, Antwerp, Belgium Tartu Univ Clin, Tartu, Estonia Natl Inst Pharm & Nutr, Budapest, Hungary Minis Hlth & Qual Life, Port Louis, Mauritius Polish Acad Sci, Anthropol Unit Wroclaw, Wroclaw, Poland Univ Hosp Ulm, Ulm, Germany Univ Groningen, Groningen, Netherlands North West Univ, Potchefstroom, South Africa Natl Inst Publ Hlth, Prague, Czech Republic Univ Jyvaskyla, Jyvaskyla, Finland Amrita Inst Med Sci, Thiruvananthapuram, Kerala, India Inst Endocrinol, Prague, Czech Republic All India Inst Med Sci, New Delhi, India African Populat & Hlth Res Ctr, Nairobi, Kenya Hanoi Univ Publ Hlth, Hanoi, Vietnam Higher Inst Nursing Profess & Tech Hlth Morocco, Rabat, Morocco Natl Inst Publ Hlth Algeria, Algiers, Algeria Minist Salud Publ, Havana, Cuba Sahlgrens Acad, Gothenburg, Sweden Endocrinol & Met Res Ctr, Arak, Iran Indicium Res, Manila, Philippines Food & Agr Org, Rome, Italy Natl Univ Singapore, Singapore, Singapore Tampere Univ Hosp, Tampere, Finland Univ Cape Town, Cape Town, South Africa West Virginia Univ, Morgantown, WV USA Fundacao Oswaldo Cruz, Rene Rachou Res Inst, Belo Horizonte, MG, Brazil Natl Taiwan Univ, Taipei, Taiwan Univ Chinese Acad Sci, Beijing, Peoples R China Uppsala Univ, Uppsala, Sweden Capital Med Univ, Beijing An Zhen Hosp, Beijing, Peoples R China Natl Inst Hlth Dev, Tallinn, Estonia Univ Med Greifswald, Greifswald, Germany Consejeria Sanidad Junta Castilla & Leon, Valladolid, Spain Univ Fed Ouro Pret, Ouro Preto, Brazil Jikei Univ, Sch Med, Tokyo, Japan CNR, Rome, Italy Baker Heart & Diabet Inst, Melbourne, Vic, Australia Agr Univ Athens, Athens, Greece Univ Putra Malaysia, Seri Kembangan, Malaysia Inst Rech Dev, Marseille, France Hosp Israelita Albert Einstein, Sao Paulo, Brazil Shiraz Univ Med Sci, Shiraz, Iran Inst Internal & Prevent Med, Novosibirsk, Russia Harokopio Univ, Kallithea, Greece Univ Otago, Dunedin, New Zealand Univ Padua, Padua, Italy Technol Educ Inst Crete, Iraklion, Greece Loughborough Univ Technol, Loughborough, Leics, England Univ Fed Santa Catarina, Florianopolis, SC, Brazil Lausanne Univ Hosp, Lausanne, Switzerland Inst Hosp Mard Invest Med, Barcelona, Spain Mary Immaculate Coll, Limerick, Ireland Emory Univ, Atlanta, GA 30322 USA Hungarian Soc Sports Med, Budapest, Hungary Sherikashmir Inst Med Sci, Srinagar, Jammu & Kashmir, India UiT Arctic Univ Norway, Tromso, Norway Cape Peninsula Univ Technol, Cape Town, South Africa Univ Rzeszow, Rzeszow, Poland Univ Yaounde I, Yaounde, Cameroon Brown Univ, Providence, RI 02912 USA Univ Edinburgh, Edinburgh, Midlothian, Scotland Stat Canada, Ottawa, ON, Canada Int Med Univ, Kuala Lumpur, Malaysia INSERM, Villejuif, France Helmholtz Zentrum Munchen, Oberschleissheim, Germany Robert Koch Inst, Berlin, Germany Lusofona Univ, Lisbon, Portugal Democritus Univ Greece, Komotini, Greece Grigore T Popa Univ Med & Pharm, Iasi, Romania Univ Firenze, Florence, Italy Hypertens Res Ctr, Esfahan, Iran Mulago Hosp, Kampala, Uganda Univ Limpopo, Polokwane, South Africa Seoul Natl Univ, Childrens Hosp, Seoul, South Korea Univ Fed Rio Grande do Sul, Porto Alegre, RS, Brazil Univ Med Sci, Havana, Cuba Univ Zaragoza, Zaragoza, Spain R CSI Dublin, Dublin, Ireland Int Inst Mol & Cell Biol, Warsaw, Poland Ain Shams University, Cairo, Egypt Ahvaz Jundishapur Univ Med Sci, Ahwaz, Iran Gorgas Memorial Inst Publ Hlth, Panama City, Panama Dept Publ Hlth, Nay Pyi Taw, Myanmar Univ Brescia, Brescia, Italy Helmholtz Zentrum Munchen, Neuherberg, Germany Univ Eastern Finland, Kuopio, Finland Mary Immaculate Coll, Tours, France Bushehr Univ Med Sci, Bushehr, Iran Ulm Univ, Ulm, Germany Inst Publ Hlth, Kuala Lumpur, Malaysia Kobe Univ, Kobe, Hyogo, Japan Banska Bystrica Reg Author Publ Hlth, Banska Bystrica, Slovakia Suraj Eye Inst, Nagpur, Maharashtra, India Helen Keller Int, Yaounde, Cameroon Karolinska Inst, Solna, Sweden Natl Inst Hyg & Epidemiol, Hanoi, Vietnam Univ Pharm & Med Ho Chi Minh City, Ho Chi Minh City, Vietnam Hanoi Med Univ, Hanoi, Vietnam Miami Vet Affairs Healthcare Syst, Miami, FL USA Heartfile, Islamabad, Pakistan Natl Canc Ctr, Tokyo, Japan Eastern Mediterranean Publ Hlth Network, Amman, Jordan State Univ Med & Pharm, Kishinev, Moldova Tachikawa Gen Hosp, Tachikawa, Tokyo, Japan Acad Hosp Paramaribo, Paramaribo, Surinam Univ Vale Rio dos Sinos, Sao Leopoldo, Brazil Natl Food & Nutr Inst, Warsaw, Poland Minist Hlth, Bandar Seri Begawan, Brunei Univ Fed Santa Catarin, Florianopolis, SC, Brazil Univ Madeira, Funchal, Portugal Univ Puerto Rico, San Juan, PR USA MRC Lifecourse Epidemiol Unit, Southampton, Hants, England Aarhus Univ, Aarhus, Denmark Kwame Nkrumah Univ Sci & Technol, Kumasi, Ghana Inst Social & Prevent, Lausanne, Switzerland Canc Prevent & Res Inst, Florence, Italy Univ Wisconsin Madison, Madison, WI USA IRCCS Casa Sollievo Sofferenz, San Giovanni Rotondo, Italy Zayed Univ, Dubai, U Arab Emirates Catholic Univ Daegu, Gyongsan, South Korea Tg Mures Univ Med & Pharm, Targu Mures, Romania Jivandeep Hosp, Surat, India South African Med Res Council, Tygerberg, South Africa Univ Med Ctr Utrecht, Utrecht, Netherlands Fundacao Oswaldo Cruz, Rene Rachou Res Inst, Rio De Janeiro, Brazil Spanish Agcy Consumer Affairs Social Serv & Nutr, Madrid, Spain Univ Puerto Rico, Med Sci Campus, San Juan, PR USA Minist Hlth & Med Educ, Tehran, Iran Vietnam Natl Heart Inst, Hanoi, Vietnam Leibniz Inst Prevent Res & Epidemiol BIPS, Bremen, Germany Univ Sarajevo, Sarajevo, Bosnia & Herceg Cardiovasc Prevent Ctr Udine, Udine, Italy Univ Hosp Pisa, Pisa, Italy Minist Hlth & Med Serv, Honiara, Solomon Islands Publ Hlth Agcy Catalonia, Barcelona, Spain Univ Kebangsaan Malaysia, Kuala Lumpur, Malaysia Univ Montenegro, Podgorica, Montenegro Inst Hosp Mar Invest Med, Barcelona, Spain Agcy Prevent and Social Med, Innsbruck, Austria Digest Oncol Res Ctr, Tehran, Iran Digest Dis Res Inst, Tehran, Iran CHU Vaudois, Lausanne, Switzerland Ctr Dis & Prevent Control, Riga, Latvia Al Quds Univ, Jerusalem, Israel Alborz Univ Med Sci, Karaj, Iran Minist Hlth, Hanoi, Vietnam BRAC, Dhaka, Bangladesh Inst Epidemiol Dis Control & Res, Dhaka, Bangladesh Univ Turku, Turku, Finland India Diabet Res Fdn, Madras, Tamil Nadu, India Univ New South Wales, Sydney, NSW, Australia Inst Univ Invest Atencio Primaria Jordi Gol, Barcelona, Spain Univ Malaya, Kuala Lumpur, Malaysia Univ Valencia, Valencia, Spain Univ Philippines, Quezon City, Philippines Nutr Res Fdn, Barcelona, Spain Minas Gerais State Secretariat Hlth, Belo Horizonte, MG, Brazil Hlth Ctr San Agustin, San AgustIn, Spain PharmAccess Fdn, Amsterdam, Netherlands Natl Inst Hlth Doutor Ricardo Jorge, Lisbon, Portugal Publ Hlth Agcy Canada, Ottawa, ON, Canada Canarian Hlth Serv, Barcelona, Spain Univ Ind Santander, Bucaramanga, Colombia Inst Nacl Salud Publ, Mexico City, DF, Mexico CIBEROBN, Madrid, Spain Gothenburg Univ, Gothenburg, Sweden Fiji Natl Univ, Suva, Fiji CNR, Inst Food Sci, Rome, Italy Sitaram Bhartia Inst Sci & Res, New Delhi, India Univ Tunis El Mana, Tunis, Tunisia Natl Inst Publ Hlth, Mexico City, DF, Mexico Univ Helsinki, Helsinki, Finland Natl Inst Hlth Peru, Lima, Peru Minist Hlth, South Jakarta, Indonesia Catalan Dept Hlth, Barcelona, Spain Publ Hlth Subdelegate Off, Barcelona, Spain Univ Lisbon, Lisbon, Portugal Prevent Med & Publ Hlth, Lisbon, Portugal Univ Sao Paulo, Clin Hosp, Sao Paulo, Brazil South Karelia Social & Hlth Care Dist, Lappeenranta, Finland Isfahan Cardiovasc Res Ctr, Esfahan, Iran Hosp Italiano Buenos Aires, Buenos Aires, DF, Argentina Rigshosp, Copenhagen, Denmark Minist Hlth, Naypyidaw, Myanmar Lagos State Univ, Coll Med, Lagos, Nigeria Univ Las Palmas Gran Canaria, Las Palmas Gran Canaria, Spain Baker Heart and Diabet Inst, Melbourne, Vic, Australia Univ Tokyo, Tokyo, Japan Samsung Med Ctr, Seoul, South Korea Finnish Inst Occupat Hlth, Helsinki, Finland St Vincents Hosp, Melbourne, Vic, Australia Acad Med Ctr Amsterdam, Amsterdam, Netherlands Hlth Polytech Jakarta II Inst, Jakarta, Indonesia Univ Bari, Bari, Italy Inst Reg Sante Publ, Cotonou, Benin Univ Bordeaux, Bordeaux, France Inst Publ Hlth Republ Macedonia, Skopje, Macedonia Univ Leuven, Leuven, Belgium Lamprecht & Stamm Sozialforsch & Beratung AG, Zurich, Switzerland INSERM, Paris, France Univ Bonn, Bonn, Germany Sotiria Hosp, Athens, Greece Natl Inst Publ Hlth, Natl Inst Hyg, Warsaw, Poland Swansea Univ, Swansea, W Glam, Wales Fu Jen Catholic Univ, New Taipei, Taiwan Minist Hlth, Amman, Jordan Natl Inst Hlth, Lima, Peru UNICEF, Yaounde, Cameroon Danish Canc Soc Res Ctr, Copenhagen, Denmark Hlth Serv Murcia, Murcia, Spain Res & Educ Inst, Nicosia, Cyprus IB SALUT Area Salut Menorca, Palma de Mallorca, Spain Univ Bologna, Bologna, Italy Hellen Hlth Fdn, Athens, Greece Univ Pharm & Med Ho Chi Min City, Ho Chi Minh, Vietnam Governm Med Coll, Secunderabad, India Sefako Makgatho Hlth Sci Univ, Kangnung, South Korea Addis Ababa Univ, Addis Ababa, Ethiopia Dasman Diabet Inst, Kuwait, Kuwait Minist Hlth, Thorndon, New Zealand Hellen Med Associat Obes, Athens, Greece Univ Ctr Occidental Lisandro Alvarado, Barquisimeto, Venezuela Meharry Med Coll, Nashville, TN USA Dokuz Eylul Univ, Izmir, Turkey Univ Tampere, Tays Eye Ctr, Tampere, Finland Polytech Inst Porto, Oporto, Portugal Univ Utrecht, Utrecht, Netherlands Amsterdam Publ Hlth Res Inst, Amsterdam, Netherlands Univ Fed Minas Gerais, Belo Horizonte, MG, Brazil Natl Inst Publ Hlth & Environm, Bilthoven, Netherlands Fed Univ Pelota, Pelotas, Brazil Italian Natl Res Council, Rome, Italy Univ Miguel Hernandez, Elche, Spain Minist Hlth, Victoria, Seychelles North Karelian Ctr Publ Hlth, Joensuu, Finland ISGlobal Ctr Res Environm Epidemiol, Barcelona, Spain Univ Witwatersrand, Johannesburg, South Africa Med Univ Vienna, Vienna, Austria Univ Coll Cork, Cork, Ireland Inst Med Res, Kuala Lumpur, Malaysia Xinjiang Med Univ, Urumqi, Peoples R China St Georges Univ London, London, England Univ Indonesia, Depok, Indonesia Natl Inst Hyg, Warsaw, Poland Caja Costarricense Seguro Social, Atenas, Costa Rica Univ Kebangsaan Malaysia, Bangi Selangor, Malaysia Univ New South Wales, Kensington, NSW, Australia Univ Mancheste, Manchester, Lancs, England Shandong Univ Tradit Chinese Med, Jinan, Shandong, Peoples R China Kailuan Gen Hosp, Tangshan, Peoples R China Minist Agr, Inst Food & Dev, Beijing, Peoples R China Fudan Univ, Childrens Hosp, Shanghai, Peoples R China Chinese Ctr Dis Control & Prevent, Beijing, Peoples R China Univ Cyprus, Nicosia, Cyprus Univ Teknol MARA, Shah Alam, Malaysia Capital Med Univ Beijing, An Zhen Hosp, Beijing, Peoples R China West Kazakhstan State Med Univ, Aktobe, Kazakhstan Inner Mongolia Med Univ, Hohhot, Peoples R China Gorgas Mem Inst Publ Hlth, Panama City, Panama Univ Estadual Paulista, Sao Paulo, Brazil