Publications by authors named "Ding Ding"

492 Publications

Decreased nocturnal heart rate variability and potentially related brain regions in arteriosclerotic cerebral small vessel disease.

BMC Neurol 2021 Sep 16;21(1):361. Epub 2021 Sep 16.

Department of Neurology, North Huashan Hospital, Fudan University, No.108 Lu Xiang Road, Shanghai, 201900, China.

Background: To assess heart rate variability (HRV) among patients with arteriosclerotic cerebral small vessel disease (CSVD) by comparing with control subjects, and to determine whether HRV parameters were related to structural alterations in brain regions involved in autonomic regulation among CSVD patients.

Methods: We consecutively recruited subjects aged between 50 and 80 years who visited the Stroke Prevention Clinic of our hospital and have completed brain magnetic resonance imaging examination from September 1, 2018 to August 31, 2019. Polysomnography and synchronous analyses of HRV were then performed in all participants. Multivariable binary logistic regression was used to identify the relationship between HRV parameters and CSVD. Participants were invited to further undergo three-dimensional brain volume scan, and the voxel based morphometry (VBM) analysis was used to identify gray matter atrophy.

Results: Among 109 participants enrolled in this study, 63 were assigned to the arteriosclerotic CSVD group and 46 to the control group. Lower standard deviation of normal-to-normal intervals (SDNN, OR = 0.943, 95% CI 0.903 to 0.985, P = 0.009) and higher ratio of low to high frequency power (LF/HF, OR = 4.372, 95% CI 1.033 to 18.508, P = 0.045) during the sleep period were associated with CSVD, independent of traditional cerebrovascular risk factors and sleep disordered breathing. A number of 24 CSVD patients and 21 controls further underwent three-dimensional brain volume scan and VBM analysis. Based on VBM results, SDNN during the awake time (β = 0.544, 95% CI 0.211 to 0.877, P = 0.001) and the sleep period (β = 0.532, 95% CI 0.202 to 0.862, P = 0.001) were both positively related with gray matter volume within the right inferior frontal gyrus only among CSVD patients.

Conclusions: Decreased nocturnal HRV is associated with arteriosclerotic CSVD independent of traditional cerebrovascular risk factors and sleep disordered breathing. The structural atrophy of some brain regions associated with cardiac autonomic regulation sheds light on the potential relationship.

Trial Registration: Trial registration number: ChiCTR1800017902 . Date of registration: 20 Aug 2018.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12883-021-02388-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8447504PMC
September 2021

Impact of the COVID-19 pandemic on people with epilepsy: Findings from the Brazilian arm of the COV-E study.

Epilepsy Behav 2021 Aug 9;123:108261. Epub 2021 Aug 9.

Oxford Epilepsy Research Group, NIHR Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford OX3 9DU, UK. Electronic address:

The COVID-19 pandemic has had an unprecedented impact on people and healthcare services. The disruption to chronic illnesses, such as epilepsy, may relate to several factors ranging from direct infection to secondary effects from healthcare reorganization and social distancing measures.

Objectives: As part of the COVID-19 and Epilepsy (COV-E) global study, we ascertained the effects of COVID-19 on people with epilepsy in Brazil, based on their perspectives and those of their caregivers. We also evaluated the impact of COVID-19 on the care delivered to people with epilepsy by healthcare workers.

Methods: We designed separate online surveys for people with epilepsy and their caregivers. A further survey for healthcare workers contained additional assessments of changes to working patterns, productivity, and concerns for those with epilepsy under their care. The Brazilian arm of COV-E initially collected data from May to November 2020 during the country's first wave. We also examined national data to identify the Brazilian states with the highest COVID-19 incidence and related mortality. Lastly, we applied this geographic grouping to our data to explore whether local disease burden played a direct role in difficulties faced by people with epilepsy.

Results: Two hundred and forty-one people returned the survey, 20% were individuals with epilepsy (n = 48); 22% were caregivers (n = 53), and 58% were healthcare workers (n = 140). Just under half (43%) of people with epilepsy reported health changes during the pandemic, including worsening seizure control, with specific issues related to stress and impaired mental health. Of respondents prescribed antiseizure medication, 11% reported difficulty taking medication on time due to problems acquiring prescriptions and delayed or canceled medical appointments. Only a small proportion of respondents reported discussing significant epilepsy-related risks in the previous 12 months. Analysis of national COVID-19 data showed a higher disease burden in the states of Sao Paulo and Rio de Janeiro compared to Brazil as a whole. There were, however, no geographic differences observed in survey responses despite variability in the incidence of COVID-19.

Conclusion: Our findings suggest that Brazilians with epilepsy have been adversely affected by COVID-19 by factors beyond infection or mortality. Mental health issues and the importance of optimal communication are critical during these difficult times. Healthcare services need to find nuanced approaches and learn from shared international experiences to provide optimal care for people with epilepsy as the direct burden of COVID-19 improves in some countries. In contrast, others face resurgent waves of the pandemic.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.yebeh.2021.108261DOI Listing
August 2021

Inpatient medical cost of status epilepticus in children: A national-wide, multicenter study from China.

Epilepsy Behav 2021 Aug 26;123:108248. Epub 2021 Aug 26.

Department of Neurology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China. Electronic address:

Objectives: To describe the inpatient medical cost during hospitalization in children with status epilepticus (SE) and identify factors associated with the cost by a nationwide, multicenter study in China.

Materials & Methods: We retrospectively identified pediatric inpatients with SE form Hospital Information System (HIS) of 44 hospitals in 27 provinces in China between 2013 and 2015. Inpatient medical cost and factors associated with the cost were analyzed.

Results: A total of 4041 children diagnosed with SE with inpatient medical cost were enrolled in the present study. The median age at admission was 2.9 (range 0.1-18) years, and 2271 patients were male (56.2%). The median inpatient medical cost of children with SE was $1175.5 (665.1-2320.6). The median inpatient medical cost was $3865.6 (1837.4-8210.4) in children with SRSE and $1048.6 (619.8-1865.4) in those with N-SRSE (p < 0.0001). Children with length of hospital stay (LOS) > 7 showed a much higher inpatient medical cost than those with LOS ≤ 7 day ($2300.7 vs. $767.2, p < 0.0001). Regarding different etiologies, children with acute symptomatic etiology showed the highest median inpatient medical cost of $1681.1 (901.0-3699.6), in which children with central nervous system (CNS) infection reported $2606.0 (1380.0-5016.1) and prolonged febrile seizures (PFS) reported $909.8 (649.3-1322.0). Additionally, children with idiopathic/cryptogenic etiology reported a medical cost of $923.2 (548.9-1534.5). Multiple linear regression analysis of cost-driving factors revealed LOS > 7, examinations, treatment equipment and procedures, and treatment medicines were independently associated with a higher inpatient medical cost (R = 60.91). In addition, PFS and idiopathic/cryptogenic epilepsy etiology were independently associated with a lower cost.

Conclusions: SE in children was a cost intensive disease in China with a median inpatient medical cost of $1175.5. LOS, etiology and examinations, treatment equipment and procedures, and treatment medicines were significantly associated with inpatient medical cost.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.yebeh.2021.108248DOI Listing
August 2021

Anatomic Criteria Determine Resectability in Locally Advanced Pancreatic Cancer.

Ann Surg Oncol 2021 Aug 27. Epub 2021 Aug 27.

Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Background: The introduction of multi-agent chemotherapy and radiation therapy has facilitated potential resection with curative intent in selected locally advanced pancreatic cancer (LAPC) patients with excellent outcomes. Nevertheless, there remains a remarkable lack of consensus on the management of LAPC. We sought to describe the outcomes of patients with LAPC and objectively define the multidisciplinary selection process for operative exploration based on anatomical factors.

Methods: Consecutive patients with LAPC were evaluated for pancreatic surgery in the multidisciplinary clinic of a high-volume institution, between 2013 and 2018. Prospective stratification (LAPC-1, LAPC-2, and LAPC-3), based on the involvement of regional anatomical structures, was performed at the time of presentation prior to the initiation of treatment. Resection rates and patient outcomes were evaluated and correlated with the initial anatomic stratification system.

Results: Overall, 415 patients with LAPC were included in the study, of whom 84 (20%) were successfully resected, with a median overall survival of 35.3 months. The likelihood of operative exploration was associated with the pretreatment anatomic LAPC score, with a resection rate of 49% in patients classified as LAPC-1, 32% in LAPC-2, and 11% in LAPC-3 (p < 0.001). Resected patients with improvement of the LAPC score at the time of exploration had significantly longer median overall survival compared with those with no change or progression of LAPC score (60.7 vs. 29.8 months, p = 0.006).

Conclusions: Selected patients with LAPC can undergo curative-intent surgery with excellent outcomes. The proposed Johns Hopkins anatomic LAPC score provides an objective system to anticipate the probability of eventual surgical resection after induction therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1245/s10434-021-10663-1DOI Listing
August 2021

Addressing the syndemics of physical inactivity and air pollution.

CMAJ 2021 Aug;193(32):E1255-E1256

Sydney School of Public Health (Ding, Elbarbary), Faculty of Medicine and Health, and Charles Perkins Centre (Ding), The University of Sydney, Camperdown, New South Wales, Australia.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1503/cmaj.211282DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8386486PMC
August 2021

Disturbed microbial ecology in Alzheimer's disease: evidence from the gut microbiota and fecal metabolome.

BMC Microbiol 2021 Aug 12;21(1):226. Epub 2021 Aug 12.

Department of Preventive Medicine and Health Education, School of Public Health, Fudan University, Shanghai, 200032, China.

Background: Gut microbiota (GMB) alteration has been reported to influence the Alzheimer's disease (AD) pathogenesis through immune, endocrine, and metabolic pathways. This study aims to investigate metabolic output of the dysbiosis of GMB in AD pathogenesis. In this study, the fecal microbiota and metabolome from 21 AD participants and 44 cognitively normal control participants were measured. Untargeted GMB taxa was analyzed through 16S ribosomal RNA gene profiling based on next-generation sequencing and fecal metabolites were quantified by using ultrahigh performance liquid chromatography-mass spectrometry (UPLC-MS).

Results: Our analysis revealed that AD was characterized by 15 altered gut bacterial genera, of which 46.7% (7/15 general) was significantly associated with a series of metabolite markers. The predicted metabolic profile of altered gut microbial composition included steroid hormone biosynthesis, N-Acyl amino acid metabolism and piperidine metabolism. Moreover, a combination of 2 gut bacterial genera (Faecalibacterium and Pseudomonas) and 4 metabolites (N-Docosahexaenoyl GABA, 19-Oxoandrost-4-ene-3,17-dione, Trigofoenoside F and 22-Angeloylbarringtogenol C) was able to discriminate AD from NC with AUC of 0.955 in these 65 subjects.

Conclusions: These findings demonstrate that gut microbial alterations and related metabolic output changes may be associated with pathogenesis of AD, and suggest that fecal markers might be used as a non-invasive examination to assist screening and diagnosis of AD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12866-021-02286-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8361629PMC
August 2021

Effects of divorce and widowhood on subsequent health behaviours and outcomes in a sample of middle-aged and older Australian adults.

Sci Rep 2021 Aug 2;11(1):15237. Epub 2021 Aug 2.

Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, 6N69 Charles Perkins Centre (D17), Camperdown, NSW, 2006, Australia.

Marital disruption is a common life event with potential health implications. We examined the prospective association of divorce/widowhood with subsequent lifestyles, psychological, and overall health outcomes within short and longer terms using three waves of data from the 45 and Up Study in Australia (T1, 2006-09; T2, 2010; T3, 2012-16). Marital status and health-related outcomes were self-reported using validated questionnaires. Nine outcomes were examined including lifestyles (smoking, drinking, diet and physical activity), psychological outcomes (distress, anxiety and depression) and overall health/quality of life. Logistic regression was adjusted for sociodemographic characteristics and baseline health outcomes. Of the 33,184 participants who were married at T1 (mean age 59.5 ± 9.3 years), after 3.4 years, 2.9% became divorced and 2.4% widowed at T2. Recent divorce was positively associated with smoking, poor quality of life, high psychological distress, anxiety and depression at T2. Similar but weaker associations were observed for widowhood. However, these associations were much attenuated at T3 (5 years from T2). Marital disruption in midlife or at an older age can be detrimental to health, particularly psychological health in the short term. Public awareness of the health consequences of spousal loss should be raised. Resources, including professional support, should be allocated to help individuals navigate these difficult life transitions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41598-021-93210-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328969PMC
August 2021

Physical activity behaviours in adolescence: current evidence and opportunities for intervention.

Lancet 2021 07 21;398(10298):429-442. Epub 2021 Jul 21.

Population and Public Health Sciences, Pennington Biomedical Research Center, Baton Rouge, LA, USA.

Young people aged 10-24 years constitute 24% of the world's population; investing in their health could yield a triple benefit-eg, today, into adulthood, and for the next generation. However, in physical activity research, this life stage is poorly understood, with the evidence dominated by research in younger adolescents (aged 10-14 years), school settings, and high-income countries. Globally, 80% of adolescents are insufficiently active, and many adolescents engage in 2 h or more daily recreational screen time. In this Series paper, we present the most up-to-date global evidence on adolescent physical activity and discuss directions for identifying potential solutions to enhance physical activity in the adolescent population. Adolescent physical inactivity probably contributes to key global health problems, including cardiometabolic and mental health disorders, but the evidence is methodologically weak. Evidence-based solutions focus on three key components of the adolescent physical activity system: supportive schools, the social and digital environment, and multipurpose urban environments. Despite an increasing volume of research focused on adolescents, there are still important knowledge gaps, and efforts to improve adolescent physical activity surveillance, research, intervention implementation, and policy development are urgently needed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/S0140-6736(21)01259-9DOI Listing
July 2021

An evidence-based assessment of the impact of the Olympic Games on population levels of physical activity.

Lancet 2021 07 21;398(10298):456-464. Epub 2021 Jul 21.

Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.

Pre-Olympic Games predictions commonly include an increase in population-based physical activity in the host city, as often stated in the bid, but the post-Olympic Games effects on physical activity have not been summarised. In this Series paper, we aim to do the following: examine mentions of a physical activity legacy in pre-Olympic bid documentation; analyse existing physical activity surveillance data collected before, during, and after the Olympic Games in hosting areas around the world; and evaluate Google Trends data surrounding the London 2012 Olympic Games as a case study of community interest in the topic of exercise during the time of the Olympic Games. Before 2007, little mention of physical activity was made in pre-Olympic Games documentation, but, after that, most documents had targets for population physical activity or sports participation. The synthesis of available surveillance data indicates that there was no change in the prevalence of physical activity or sports participation, except for the 2008 Summer Olympics in Beijing and the 1998 Winter Olympics in Nagano; although, the increase in participation in Nagano might not be attributable to the Olympic Games since there was no change in participation in winter sports. The Google Trends data showed an acute spike in searches with the term "Olympic" immediately associated with the London Olympic Games period and showed a sustained peri-Olympic increase in searches with the term "exercise". By themselves, the Olympic Games have not improved population-wide physical activity but might be an important missed public health opportunity. Such a legacy will require strategic planning and partnerships across the International Olympic Committee and the Olympic, sport, and public health agencies and a thorough evaluation framework implemented throughout the pre-Olympic Games and post-Olympic Games period in the host country.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/S0140-6736(21)01165-XDOI Listing
July 2021

The Effect of Thermal Oxidation on the Photothermal Conversion Property of Tantalum Coatings.

Materials (Basel) 2021 Jul 19;14(14). Epub 2021 Jul 19.

School of Physic and Microelectronics, Hunan University, Changsha 410082, China.

In this study, tantalum coatings are deposited by a plasma spraying method aiming at enhancing the biocompatibility of the titanium implant. Tantalum oxide coatings are gained through the thermal oxidation of tantalum coatings at different temperatures for photothermal therapy. The effect of thermal oxidation on the morphology, composition, and structure of tantalum coatings has been studied. The UV-VIS-NIR spectra results, cancer therapy effect in vitro, and photothermal conversion properties among the tantalum oxide coatings under varied thermal treatment conditions are compared comprehensively. It has been proven that the tantalum coating treated at 200 °C exhibits the most intense NIR adsorption, the highest photothermal conversion effect, and the most excellent photothermal ablation effect in vitro. The results reveal that incomplete oxidation at a low temperature leads to the formation of oxygen vacancies, which narrow the band gap; this promotes its photothermal conversion ability.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ma14144031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303513PMC
July 2021

New staging classification for pancreatic neuroendocrine neoplasms combining TNM stage and WHO grade classification [].

Cancer Lett 2021 Oct 14;518:207-213. Epub 2021 Jul 14.

Department of Biliary-Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China. Electronic address:

AJCC TNM stage and WHO grade (G) are two widely used staging systems to guide clinical management for pancreatic neuroendocrine neoplasms (panNENs), based on clinical staging and pathological grading information, respectively. We proposed to integrate TNM stage and G grade into one staging system (TNMG) and to evaluate its clinical application as a prognostic indicator for panNENs. Accordingly, 5254 patients diagnosed with panNENs were used to evaluate and to validate the applicability of TNMG to panNENs. The predictive accuracy of TNMG system was compared with that of each separate staging/grading system. We found that TNM stage and G grade were independent risk factors for survival in both the Surveillance, Epidemiology, and End Result (SEER) and multicenter series. The interaction effect between TNM stage and G grade was significant. Twelve subgroups combining the TNM stage and G grade were proposed in the TNMG stage, which were classified into five stages TNMG. According to the TNMG staging classification in the SEER series, the estimated median survival for stages I, II, III, IV, and V were 203, 174, 112, 61, and 8 months, respectively. The predictive accuracy of TNMG stage was higher than that of TNM stage and G grade used independently. The TNMG stage classification was more accurate in predicting panNEN patient's prognosis than either the TNM stage or G grade.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.canlet.2021.07.018DOI Listing
October 2021

Physical Activity Promotion and the United Nations Sustainable Development Goals: Building Synergies to Maximize Impact.

J Phys Act Health 2021 Jul 13:1-18. Epub 2021 Jul 13.

Background: Many of the known solutions to the physical inactivity pandemic operate across sectors relevant to the United Nations Sustainable Development Goals (SDGs).

Methods: The authors examined the contribution of physical activity promotion strategies toward achieving the SDGs through a conceptual linkage exercise, a scoping review, and an agent-based model.

Results: Possible benefits of physical activity promotion were identified for 15 of the 17 SDGs, with more robust evidence supporting benefits for SDGs 3 (good health and well-being), 9 (industry, innovation, and infrastructure), 11 (sustainable cities and communities), 13 (climate action), and 16 (peace, justice, and strong institutions). Current evidence supports prioritizing at-scale physical activity-promoting transport and urban design strategies and community-based programs. Expected physical activity gains are greater for low-and middle-income countries. In high-income countries with high car dependency, physical activity promotion strategies may help reduce air pollution and traffic-related deaths, but shifts toward more active forms of travel and recreation, and climate change mitigation, may require complementary policies that disincentivize driving.

Conclusions: The authors call for a synergistic approach to physical activity promotion and SDG achievement, involving multiple sectors beyond health around their goals and values, using physical activity promotion as a lever for a healthier planet.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1123/jpah.2021-0413DOI Listing
July 2021

Reliable Detection of Somatic Mutations for Pancreatic Cancer in Endoscopic Ultrasonography-Guided Fine Needle Aspirates with Next-Generation Sequencing: Implications from a Prospective Cohort Study.

J Gastrointest Surg 2021 Jul 9. Epub 2021 Jul 9.

Department of Surgery, Johns Hopkins University School of Medicine, 600 N. Wolfe St, Baltimore, MD, 21287, USA.

Background Or Purpose: Pancreatic ductal adenocarcinoma (PDAC) is commonly diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). However, the diagnostic adequacy of EUS-FNA is often limited by low cellularity leading to inconclusive results. We aimed to investigate the feasibility and added utility of targeted next-generation sequencing (NGS) on PDAC EUS-FNAs.

Methods: EUS-FNAs were prospectively performed on 59 patients with suspected PDAC (2014-2017) at a high-volume center. FNAs were analyzed for the presence of somatic mutations using NGS to supplement cytopathologic evaluations and were compared to surgical specimens and circulating tumor DNA (ctDNA).

Results: Fifty-nine patients with suspected PDAC were evaluated, and 52 were diagnosed with PDAC on EUS-FNA. Four of the remaining seven patients had inconclusive EUS-FNAs and were ultimately diagnosed with PDAC after surgical resection. Of these 56 cases of PDAC, 48 (85.7%) and 18 (32.1%) harbored a KRAS and/or TP53 mutation on FNA NGS, respectively. Particularly, in the four inconclusive FNA PDAC diagnoses (false negatives), half harbored KRAS mutations on FNA. No KRAS/TP53 mutation was found in remaining three non-PDAC cases. All EUS-FNA detected KRAS mutations were detected in 16 patients that underwent primary tumor NGS (100% concordance), while 75% KRAS concordance was found between FNA and ctDNA NGS.

Conclusion: Targeted NGS can reliably detect KRAS mutations from EUS-FNA samples and exhibits high KRAS mutational concordance with primary tumor and ctDNA. This suggests targeted NGS of EUS-FNA samples may enable preoperative ctDNA prognostication using digital droplet PCR and supplement diagnoses in patients with inconclusive EUS-FNA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11605-021-05078-yDOI Listing
July 2021

Plasma biomarker profiles and the correlation with cognitive function across the clinical spectrum of Alzheimer's disease.

Alzheimers Res Ther 2021 07 5;13(1):123. Epub 2021 Jul 5.

Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Rd, Shanghai, China.

Background: Plasma biomarkers showed a promising value in the disease diagnosis and management of Alzheimer's disease (AD). However, profiles of the biomarkers and the associations with cognition across a spectrum of cognitive stages have seldom been reported.

Methods: We recruited 320 individuals with cognitive impairment and 131 cognitively normal participants from a memory clinic and a community cohort. Participants were classified into 6 groups based on their Clinical Dementia Rating (CDR) scores and clinical diagnosis, including AD, amnestic mild cognitive impairment (aMCI), and normal cognition (NC). A battery of neuropsychological tests was used to assess the global and domain-specific cognition. Plasma Aβ, Aβ, Aβ/Aβ, total tau (t-tau), neurofilament protein light chain (NfL), and phosphorylated tau at threonine 181 (p-tau181) were quantified using the single-molecule array (Simoa) platform.

Results: All the plasma markers (Aβ, Aβ, Aβ/Aβ, t-tau, NfL, p-tau181) showed certain discrepancies among NC, aMCI, and AD groups. The p-tau181 level showed a continuous escalating trend as the CDR scores increased from 0 (NC group) to 3 (severe AD). Compared with other biomarkers, p-tau181 had correlations with broader cognitive domains, covering global cognition (r = -0.536, P < 0.0001), memory (r = -0.481, P < 0.0001), attention (r = -0.437, P < 0.0001), visuospatial function (r = -0.385, P < 0.0001), and language (r = -0.177, P = 0.0003). Among participants with CDR ≥ 1, higher p-tau181 was correlated with worse global cognition (r = -0.301, P < 0.001).

Conclusions: Plasma p-tau181 had correlations with broader cognitive domains, suggesting its potential as a promising clinical-relevant blood-based biomarker.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s13195-021-00864-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8259165PMC
July 2021

The Association of Gut Microbiota with Osteoporosis is Mediated by Amino Acid Metabolism: Multiomics in a Large Cohort.

J Clin Endocrinol Metab 2021 Jul 2. Epub 2021 Jul 2.

Guangdong Provincial Key Laboratory of Food, Nutrition and Health; Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.

Context: Several small studies have suggested that the gut microbiome might influence osteoporosis, but there is little evidence from human metabolomics studies to explain this association.

Objective: This study examined the association of gut microbiome dysbiosis with osteoporosis and explored the potential pathways through which this association occurs using faecal and serum metabolomics.

Methods: We analysed the composition of the gut microbiota by 16S rRNA profiling and bone mineral density (BMD) using dual-energy X-ray absorptiometry in 1776 community-based adults. Targeted metabolomics in faeces (15 categories) and serum (12 categories) were further analysed in 971 participants using ultra-high-performance liquid chromatography coupled to tandem mass spectrometry (UPLC-MS/MS).

Results: This study showed that osteoporosis was related to the beta diversity, taxonomy and functional composition of the gut microbiota. The relative abundance of Actinobacillus, Blautia, Oscillospira, Bacteroides and Phascolarctobacterium was positively associated with osteoporosis. However, Veillonellaceae other, Collinsella and Ruminococcaceae other were inversely associated with the presence of osteoporosis. The association between microbiota biomarkers and osteoporosis was related to levels of peptidases and transcription machinery in microbial function. Faecal and serum metabolomics analyses suggested that tyrosine and tryptophan metabolism and valine, leucine and isoleucine degradation were significantly linked to the identified microbiota biomarkers and to osteoporosis, respectively.

Conclusion: This large population-based study provided robust evidence connecting gut dysbiosis, faecal metabolomics and serum metabolomics with osteoporosis. Our results suggest that gut dysbiosis and amino acid metabolism could be targets for intervention in osteoporosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1210/clinem/dgab492DOI Listing
July 2021

Microstructure and Its Effect on the Magnetic, Magnetocaloric and Magnetostrictive Properties of TbCoFe Glassy Ribbons.

Materials (Basel) 2021 Jun 4;14(11). Epub 2021 Jun 4.

Institute of Materials, Shanghai University, Shanghai 200072, China.

In the present work, the microstructure and its effect on the magnetic, magnetocaloric, and magnetoelastic properties of the TbCoFe melt-spun ribbon were investigated. The ribbon exhibits typical amorphous characteristics in its X-ray diffraction examination and differential scanning calorimetry measurement. However, the magnetic properties of the ribbon indicate that the ribbon is inhomogeneous in the nanoscale, as ascertained by a high-resolution electron microscope. Compared to the TbCo amorphous alloy, the TbCoFe ribbon shows poor magnetocaloric properties but outstanding magnetostriction. A rather high value of reversible magnetostriction up to 788 ppm under 5 T was obtained. The mechanism for the formation of nanoparticles and its effect on the magnetocaloric and magnetostrictive properties were investigated.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/ma14113068DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8199978PMC
June 2021

Supporting active ageing before retirement: a systematic review and meta-analysis of workplace physical activity interventions targeting older employees.

BMJ Open 2021 06 30;11(6):e045818. Epub 2021 Jun 30.

School of Public Health, University of Sydney, Sydney, New South Wales, Australia.

Objective: With the growing representation of older adults in the workforce, the health and fitness of older employees are critical to support active ageing policies. This systematic review aimed to characterise and evaluate the effects on physical activity (PA) and fitness outcomes of workplace PA interventions targeting older employees.

Design: We searched Medline, PreMedline, PsycInfo, CINAHL and the Cochrane Controlled Register of Trials (CENTRAL) for articles published from inception to 17 February 2020. Eligible studies were of any experimental design, included employees aged ≥50 years, had PA as an intervention component and reported PA-related outcomes.

Results: Titles and abstracts of 8168 records were screened, and 18 unique interventions were included (3309 participants). Twelve studies were randomised controlled trials (RCTs). Seven interventions targeted multiple risk factors (n=1640), involving screening for cardiovascular disease risk factors, but had a non-specific description of the PA intervention. Four interventions targeted nutrition and PA (n=1127), and seven (n=235) focused only on PA. Interventions overwhelmingly targeted aerobic PA, compared with only four interventions targeting strength and/or balance (n=106). No studies involved screening for falls/injury risk, and only two interventions targeted employees of low socioeconomic status. Computation of effect sizes (ESs) was only possible in a maximum of three RCTs per outcome. ESs were medium for PA behaviour (ES=0.25 95% CI -0.07 to 0.56), muscle strength (ES=0.27, 95% CI -0.26 to 0.80), cardiorespiratory fitness (ES=0.28, 95% CI -22 to 0.78), flexibility (ES=0.50, 95% CI -0.04 to 1.05) and balance (ES=0.74, 95% CI -0.21 to 1.69). Grading of Recommendations Assessment, Development and Evaluation criteria-rated quality of evidence was 'low' due to high risk of bias, imprecision and inconsistency.

Conclusions: The lack of high-quality effective workplace PA interventions contrasts the importance and urgency to improve the health and fitness in this population. Future interventions should incorporate strength and balance training and screening of falls/injury risk in multi risk factors approaches.

Prospero Registration Number: CRD42018084863. (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=84863).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bmjopen-2020-045818DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8246361PMC
June 2021

Large-scale phenotypic drug screen identifies neuroprotectants in zebrafish and mouse models of retinitis pigmentosa.

Elife 2021 06 29;10. Epub 2021 Jun 29.

Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, United States.

Retinitis pigmentosa (RP) and associated inherited retinal diseases (IRDs) are caused by rod photoreceptor degeneration, necessitating therapeutics promoting rod photoreceptor survival. To address this, we tested compounds for neuroprotective effects in multiple zebrafish and mouse RP models, reasoning drugs effective across species and/or independent of disease mutation may translate better clinically. We first performed a large-scale phenotypic drug screen for compounds promoting rod cell survival in a larval zebrafish model of inducible RP. We tested 2934 compounds, mostly human-approved drugs, across six concentrations, resulting in 113 compounds being identified as hits. Secondary tests of 42 high-priority hits confirmed eleven lead candidates. Leads were then evaluated in a series of mouse RP models in an effort to identify compounds effective across species and RP models, that is, potential pan-disease therapeutics. Nine of 11 leads exhibited neuroprotective effects in mouse primary photoreceptor cultures, and three promoted photoreceptor survival in mouse retinal explants. Both shared and complementary mechanisms of action were implicated across leads. Shared target tests implicated -dependent cell death in our zebrafish RP model. Complementation tests revealed enhanced and additive/synergistic neuroprotective effects of paired drug combinations in mouse photoreceptor cultures and zebrafish, respectively. These results highlight the value of cross-species/multi-model phenotypic drug discovery and suggest combinatorial drug therapies may provide enhanced therapeutic benefits for RP patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7554/eLife.57245DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8425951PMC
June 2021

Poor Odor Identification Predicts Mortality Risk in Older Adults without Neurodegenerative Diseases: The Shanghai Aging Study.

J Am Med Dir Assoc 2021 Jun 19. Epub 2021 Jun 19.

Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jamda.2021.05.026DOI Listing
June 2021

Neuropeptide ACP facilitates lipid oxidation and utilization during long-term flight in locusts.

Elife 2021 06 21;10. Epub 2021 Jun 21.

State Key Laboratory of Integrated Management of Pest Insects and Rodents, Institute of Zoology, Chinese Academy of Sciences, Beijing, China.

Long-term flight depends heavily on intensive energy metabolism in animals; however, the neuroendocrine mechanisms underlying efficient substrate utilization remain elusive. Here, we report that the adipokinetic hormone/corazonin-related peptide (ACP) can facilitate muscle lipid utilization in a famous long-term migratory flighting species, . By peptidomic analysis and RNAi screening, we identified brain-derived ACP as a key flight-related neuropeptide. gene expression increased notably upon sustained flight. CRISPR/Cas9-mediated knockout of gene and ACP receptor gene () significantly abated prolonged flight of locusts. Transcriptomic and metabolomic analyses further revealed that genes and metabolites involved in fatty acid transport and oxidation were notably downregulated in the flight muscle of ACP mutants. Finally, we demonstrated that a fatty-acid-binding protein (FABP) mediated the effects of ACP in regulating muscle lipid metabolism during long-term flight in locusts. Our results elucidated a previously undescribed neuroendocrine mechanism underlying efficient energy utilization associated with long-term flight.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.7554/eLife.65279DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8324298PMC
June 2021

CO Electroreduction to Formate at a Partial Current Density up to 590 mA mg via Micrometer-Scale Lateral Structuring of Bismuth Nanosheets.

Small 2021 Jul 13;17(29):e2100602. Epub 2021 Jun 13.

School of Chemical and Material Engineering, Jiangnan University, Wuxi, 214122, China.

2D bismuth nanosheets are a promising layered material for formate-producing via electrocatalytic CO conversion. However, the commercial interest of bismuth nanosheets in CO electroreduction is still rare due to the undesirable current density for formate at moderate operation potentials (about 200 mA mg ) and harsh synthesis conditions (high temperature and/or high pressure). This work reports the preparation of Bi nanosheets with a lateral size in micrometer-scale via electrochemical cathodic exfoliation in aqueous solution at normal pressure and temperature. As-prepared Bi LNSs (L indicates large lateral size) possess high Faradaic efficiencies over 90% within a broad potential window from -0.44 to -1.10 V versus RHE and a superior partial current density about 590 mA mg for formate in comparison with state-of-the-art results. Structure analysis, electrochemical results, and density functional theory calculations demonstrate that the increasing tensile lattice strain observed in Bi LNSs leads to less overlap of d orbitals and a narrower d-band width, which tuning the intermediate binding energies, and therefore promotes the intrinsic activity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/smll.202100602DOI Listing
July 2021

Sleep Timing and Risk of Dementia Among the Chinese Elderly in an Urban Community: The Shanghai Aging Study.

Front Neurol 2021 29;12:629507. Epub 2021 Apr 29.

Department of Neurology, Memory and Aging Center, Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States.

Growing evidence has suggested a link between poor sleep quality and increased risk of dementia. However, little is known about the association between sleep timing, an important behavior marker of circadian rhythms, and dementia risk in older adults, and whether this is independent of sleep duration or quality. We included data from 1,051 community-dwelling older men and women (aged≥ 60y) without dementia from the Shanghai Aging Study. At baseline, participants reported sleep timing, duration, and quality using the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI). Dementia diagnosis over the following 7.3 years was determined by neurologists using DSM-IV criteria. We used Cox proportional hazards models to examine the association between bedtime (before 9 p.m., after 11 p.m. vs. 9-11 p.m.), rise time (before 6 a.m., after 8 a.m. vs. 6-8 a.m.), and risk of dementia. A total of 238 (22.8%), 675 (64.5%), and 133 (12.7%) participants reported going to bed before 9 p.m., between 9 and 11 p.m., and after 11 p.m., respectively, while 272 (26%), 626 (59.9%), and 148 (14.2%) reported getting up before 6 a.m., between 6 and 8 a.m., and after 8 a.m., respectively. Participants who reported going to bed earlier had a lower education level, were less likely to be smokers, more likely to have hypertension or diabetes, and had longer sleep duration but poorer sleep quality compared to those who reported a later bedtime. We found 47 incidents of dementia among 584 participants followed up over an average of 7.3 years. After adjustment for demographics, education, income, body mass index, depressive symptoms, smoking, alcohol use, physical activity, comorbidities, APOE4 genotype, and baseline MMSE, those with a bedtime of before 9 p.m. were two times more likely to develop dementia [hazard ratio (HR)=2.16 (95%CI: 1.06-4.40)], compared to those going to bed between 9 and 11 p.m. Later bedtime (i.e., after 11 p.m.) showed the opposite but had a non-significant association with dementia risk (HR=0.15, 95%CI: 0.02-1.29). We did not find an association for rise time and risk of dementia. Earlier sleep timing in older adults without dementia was associated with an increased risk of dementia. Future studies should examine the underlying mechanisms of this association and explore the usefulness of sleep timing as a preclinical marker for dementia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fneur.2021.629507DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8116668PMC
April 2021

Does weight loss reduce the incidence of total knee and hip replacement for osteoarthritis?-A prospective cohort study among middle-aged and older adults with overweight or obesity.

Int J Obes (Lond) 2021 08 15;45(8):1696-1704. Epub 2021 May 15.

Sydney School of Public Health, The University of Sydney, Sydney, Australia.

Objective: This study aims to investigate the association between weight change and total knee or hip replacement (TKR or THR) for OA among middle-aged and older adults with overweight or obesity.

Method: Weight data were collected in 2006-2009 and in 2010 from the 45 and Up Study-a population-based cohort aged ≥45 years in New South Wales, Australia. Participants were included if they had a baseline body mass index (BMI) ≥ 25 kg/m and no history of TKR or THR. Weight change was categorised into four groups: >7.5% loss; >5-7.5% loss; stable (≤5% change) and >5% gain. Hospital admission data were linked to identify TKR and THR for OA, and multivariable Cox regression was used to assess risk of TKR and THR.

Results: Of 23,916 participants, 2139 lost >7.5% weight, 1655 lost 5-7.5% weight, and 4430 gained >5% weight. Over 5.2 years, 1009 (4.2%) underwent TKR and 483 (2.0%) THR. Compared to weight-stable, weight loss of >7.5% was associated with reduced risk of TKR after adjusting for age, sex, BMI, socioeconomic and lifestyle factors (hazard ratio 0.69, 95%CI 0.54-0.87), but had no association with THR. Weight loss of 5-7.5% was not associated with altered risk of either TKR or THR. Weight gain was associated with increased risk of THR after adjusting for confounders, but not TKR.

Conclusion: This study suggests that a weight loss target >7.5% is required to reduce the risk of TKR in adults with overweight or obesity. Weight gain should be avoided as it increases the risk of THR.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41366-021-00832-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310800PMC
August 2021

Psychometric Properties of the Chinese Version of the Sarcopenia and Quality of Life, a Quality of Life Questionnaire Specific for Sarcopenia.

Calcif Tissue Int 2021 Oct 15;109(4):415-422. Epub 2021 May 15.

Chemistry, National University of Singapore, No. 21, Lower Kent Ridge Road, Singapore, 119077, Singapore.

A quality of life questionnaire specific to sarcopenia (SarQoL®) was successfully developed. There is a huge demand for translation and validation in Chinese. The aim of this study was to translate the SarQoL® into Chinese and investigate its psychometric properties. The translation and cross-cultural adaptation process recommended by the developers of the initial questionnaire was followed. A total of 159 participants were investigated. The translation process consists of five steps: (1) two bilinguals independently translate initial English to Chinese; (2) synthesize the two translations into one; (3) backward translations; (4) expert committee review and (5) test of the pre-final version. The validation consists of three parts: (1) validity (discriminative power, construct validity); (2) reliability (internal consistency, test-retest reliability) and (3) floor and ceiling effects. There was no difficulty in translation process. Regarding the validity, good discriminant validity {quality of life for sarcopenic subjects [35.56 (29.73-42.70)] vs. non-sarcopenic ones [73.22 (60.09-82.90)], p < 0.001} and consistent construct validity [high correlations (spearman's r) of SarQoL® with generic Short Form-36 version 2 questionnaire (0.250 to 0.824) and EuroQoL-5-Dimension questionnaire (- 0.114 to - 0.823)] were found in SarQoL®. Regarding reliability, high internal consistency (Cronbach's alpha coefficient was 0.867) and excellent test-retest reliability (intraclass coefficient correlation was 0.997, 95% CI 0.994-0.998) were found. No ceiling/floor effect was reflected. A valid SarQoL® questionnaire is now available for Chinese population. It can provide a better understanding of the sarcopenia disease burden and serve as a therapeutic outcome indicator in research.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00223-021-00859-8DOI Listing
October 2021

Light-Intensity Physical Activity and Life Expectancy: National Health and Nutrition Survey.

Am J Prev Med 2021 09 10;61(3):428-433. Epub 2021 May 10.

Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.

Introduction: Quantifying the years of life gained associated with light-intensity physical activity may be important for risk communication in public health. Because no studies have examined the role of light-intensity physical activity in life expectancy, this study aims to quantify the years of life gained from light-intensity physical activity in a population-based U.S.

Sample:

Methods: This study used data from 6,636 participants in the National Health and Nutrition Examination Survey (2003-2006). Analyses were conducted in 2020. Light-intensity physical activity was categorized into low, medium, and high on the basis of tertiles, and survival models were applied to estimate the years of life gained from each light-intensity physical activity group. Analyses were repeated in participants with moderate-to-vigorous physical activity above or below the median.

Results: During a mean follow-up of 11 years and at 55,520 person-years, 994 deaths were recorded. At age 20 years, participants with low, medium, and high light-intensity physical activity had a predicted life expectancy of 53.92 (95% CI=46.66, 61.18), 58.16 (95% CI=52.10, 65.22), and 58.44 (95% CI=51.29, 65.60) years, suggesting significant years of life gained from medium and high levels of light-intensity physical activity of 2.89 (95% CI=0.90, 4.12) and 3.07 (95% CI=0.84, 5.30) years. The corresponding years of life gained at age 45 years and 65 years were 2.51 (95% CI=0.40, 5.47) and 1.52 (95% CI=0.54, 2.50) years for the medium light-intensity physical activity group and 2.66 (95% CI=0.80, 4.52) and 1.62 (95% CI=0.49, 52.75) years for the high light-intensity physical activity group. This association was significant in participants with moderate-to-vigorous physical activity below the median but not for those with moderate-to-vigorous physical activity above the median.

Conclusions: Light-intensity physical activity may extend life expectancy. Given the low prevalence of moderate-to-vigorous physical activity in populations, physical activity promotion efforts may capitalize on emerging evidence on light-intensity physical activity, particularly among the most inactive groups.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.amepre.2021.02.012DOI Listing
September 2021

Developmental trajectories of sleep during childhood and adolescence are related to health in young adulthood.

Acta Paediatr 2021 08 26;110(8):2435-2444. Epub 2021 May 26.

Curtin School of Allied Health, Curtin University, Perth, WA, Australia.

Aim: Sleep behaviour is correlated and causally related to physical and mental health. Limited longitudinal data exist on the associations of poor sleep behaviour in childhood and adolescence with adult health. Parent-reported sleep behaviours from 1993 participants of the Raine Study (at ages 5, 8, 10, 14, 17) were used to determine sleep trajectories (using latent class growth analysis).

Methods: Measures of physical and mental health were compared between sleep trajectories using generalised linear models (at age 20).

Results: Three sleep trajectories were identified as follows: 43% of participants belonged to a trajectory with 'consistently minimal' sleep problems, 49% showed some 'declining' in reporting of sleep problems incidence and 8% had 'persistent' sleep problems. Participants in the 'consistently minimal' trajectory had better physical and mental health outcomes at age 20 compared to those in the 'declining' and 'persistent' trajectories. For example, 'consistently minimal' participants had significantly lower body fat percentage (mean difference: -3.89% (95% CI: -7.41 to -0.38)) and a higher (better) SF-12 mental component score (mean difference: 4.78 (95% CI: 2.35-7.21)) compared to participants in the 'persistent' trajectory.

Conclusion: Poor sleep behaviour across childhood and adolescent years is related to poorer physical and mental health in young adulthood.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/apa.15911DOI Listing
August 2021

Dietary risk versus physical inactivity: a forced comparison with policy implications?

Lancet 2021 May;397(10286):1709-1710

Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia; School of Health Sciences, The University of Sydney, Camperdown, NSW 2006, Australia.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/S0140-6736(21)00801-1DOI Listing
May 2021

Autoimmune Pancreatitis: A Critical Analysis of the Surgical Experience in an Era of Modern Diagnostics.

Pancreas 2021 04;50(4):556-563

From the Department of Surgery.

Objective: The aim of this study was to critically analyze the surgical experience of managing autoimmune pancreatitis (AIP) in an era of modern diagnostics and compare these patients with those who were managed conservatively.

Methods: Two prospectively maintained databases were used to retrospectively identify patients with AIP who were either managed conservatively or underwent pancreatectomy.

Results: Eighty-eight patients were included in the study, of which 56 (63.6%) underwent resection and 32 (36.4%) were managed conservatively. Patients who underwent resection were more likely to present with jaundice (64.3% vs 18.1%, P < 0.001) and weight loss (53.6% vs 15.6%, P = 0.005). The cohort who underwent resection had a significantly higher median carbohydrate antigen 19-9 (40.0 vs 18.6 U/mL, P = 0.034) and was less likely to have elevated immunoglobulin G4 (26.1% vs 50.0%, P < 0.001). The most frequent initial diagnosis in the cohort who underwent resection was ductal adenocarcinoma (82.1%). Nine patients (28.1%) in the conservatively managed cohort experienced AIP relapse compared with 6 patients (10.7%) in the cohort who underwent resection.

Conclusions: The most frequent reason for surgical resection of AIP is concern for malignancy. Carbohydrate antigen 19-9 elevations were more common than immunoglobulin G4 in our cohort, suggesting that this laboratory profile is suboptimal for this population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1097/MPA.0000000000001812DOI Listing
April 2021

Sliding down the risk factor rankings: reasons for and consequences of the dramatic downgrading of physical activity in the Global Burden of Disease 2019.

Br J Sports Med 2021 Apr 29. Epub 2021 Apr 29.

Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1136/bjsports-2021-104064DOI Listing
April 2021
-->