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Ning Z, He S, Liu Q, Ma H, Ma C, Wu J, Ma Y, Zhang Y. Effects of the interaction between cold spells and fine particulate matter on mortality risk in Xining: a case-crossover study at high altitude. Front Public Health 2024; 12:1414945. [PMID: 38813422 PMCID: PMC11133570 DOI: 10.3389/fpubh.2024.1414945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 05/02/2024] [Indexed: 05/31/2024] Open
Abstract
Background With global climate change, the health impacts of cold spells and air pollution caused by PM2.5 are increasingly aggravated, especially in high-altitude areas, which are particularly sensitive. Exploring their interactions is crucial for public health. Methods We collected time-series data on meteorology, air pollution, and various causes of death in Xining. This study employed a time-stratified case-crossover design and conditional logistic regression models to explore the association between cold spells, PM2.5 exposure, and various causes of death, and to assess their interaction. We quantitatively analyzed the interaction using the relative excess odds due to interaction (REOI), attributable proportion due to interaction (AP), and synergy index (S). Moreover, we conducted stratified analyses by average altitude, sex, age, and educational level to identify potential vulnerable groups. Results We found significant associations between cold spells, PM2.5, and various causes of death, with noticeable effects on respiratory disease mortality and COPD mortality. We identified significant synergistic effects (REOI>0, AP > 0, S > 1) between cold spells and PM2.5 on various causes of death, which generally weakened with a stricter definition of cold spells and longer duration. It was estimated that up to 9.56% of non-accidental deaths could be attributed to concurrent exposure to cold spells and high-level PM2.5. High-altitude areas, males, the older adults, and individuals with lower educational levels were more sensitive. The interaction mainly varied among age groups, indicating significant impacts and a synergistic action that increased mortality risk. Conclusion Our study found that in high-altitude areas, exposure to cold spells and PM2.5 significantly increased the mortality risk from specific diseases among the older adults, males, and those with lower educational levels, and there was an interaction between cold spells and PM2.5. The results underscore the importance of reducing these exposures to protect public health.
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Affiliation(s)
- Zhenxu Ning
- Department of Public Health, Faculty of Medicine, Qinghai University, Xining, China
| | - Shuzhen He
- Xining Centre for Disease Control and Prevention, Xining, China
| | - Qiansheng Liu
- Department of Public Health, Faculty of Medicine, Qinghai University, Xining, China
| | - Haibin Ma
- Xining Centre for Disease Control and Prevention, Xining, China
| | - Chunguang Ma
- Xining Centre for Disease Control and Prevention, Xining, China
| | - Jing Wu
- Xining Centre for Disease Control and Prevention, Xining, China
| | - Yanjun Ma
- Qinghai Institute of Health Sciences, Xining, China
| | - Youxia Zhang
- Qinghai Province Cardio Cerebrovascular Disease Specialist Hospital, Xining, China
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Zhang M, Zhu D, Wan Y, He B, Ma L, Li H, Wen X, Huang R, Chen B, Xiong L, Gao F. Using 7.0 T cardiac magnetic resonance to investigate the effect of estradiol on biventricular structure and function of ovariectomized rats exposed to chronic hypobaric hypoxia at high altitude. Arch Biochem Biophys 2022; 725:109294. [DOI: 10.1016/j.abb.2022.109294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 11/02/2022]
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Bortolan L, Savoldelli A, Pellegrini B, Modena R, Sacchi M, Holmberg HC, Supej M. Ski Mountaineering: Perspectives on a Novel Sport to Be Introduced at the 2026 Winter Olympic Games. Front Physiol 2021; 12:737249. [PMID: 34744777 PMCID: PMC8566874 DOI: 10.3389/fphys.2021.737249] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/20/2021] [Indexed: 11/13/2022] Open
Abstract
Ski mountaineering is a rapidly growing winter sport that involves alternately climbing and descending slopes and various racing formats that differ in length and total vertical gain, as well as their distribution of downhill and uphill sections. In recent years, both participation in and media coverage of this sport have increased dramatically, contributing, at least in part, to its inclusion in the 2026 Winter Olympics in Milano-Cortina. Here, our aim has been to briefly describe the major characteristics of ski mountaineering, its physiological and biomechanical demands, equipment, and training/testing, as well as to provide some future perspectives. Despite its popularity, research on this discipline is scarce, but some general characteristics are already emerging. Pronounced aerobic capacity is an important requirement for success, as demonstrated by positive correlations between racing time and maximal oxygen uptake and oxygen uptake at the second ventilatory threshold. Moreover, due to the considerable mechanical work against gravity on demanding uphill terrain, the combined weight of the athlete and equipment is inversely correlated with performance, prompting the development of both lighter and better equipment in recent decades. In ski mountaineering, velocity uphill is achieved primarily by more frequent (rather than longer) strides due primarily to high resistive forces. The use of wearable technologies, designed specifically for analysis in the field (including at elevated altitudes and cold temperatures) and more extensive collaboration between researchers, industrial actors, and coaches/athletes, could further improve the development of this sport.
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Affiliation(s)
- Lorenzo Bortolan
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,CeRiSM, Sport Mountain and Health Research Centre, University of Verona, Rovereto, Italy
| | - Aldo Savoldelli
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,CeRiSM, Sport Mountain and Health Research Centre, University of Verona, Rovereto, Italy
| | - Barbara Pellegrini
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,CeRiSM, Sport Mountain and Health Research Centre, University of Verona, Rovereto, Italy
| | - Roberto Modena
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.,CeRiSM, Sport Mountain and Health Research Centre, University of Verona, Rovereto, Italy
| | | | | | - Matej Supej
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
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Shi YJ, Wang JL, Gao L, Wen DL, Dan Q, Dong Y, Guo YT, Zhao CH, Li TJ, Guo J, Li ZB, Chen YD. Altitude Cardiomyopathy Is Associated With Impaired Stress Electrocardiogram and Increased Circulating Inflammation Makers. Front Physiol 2021; 12:640302. [PMID: 33776794 PMCID: PMC7991828 DOI: 10.3389/fphys.2021.640302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/19/2021] [Indexed: 11/13/2022] Open
Abstract
Many sea-level residents suffer from acute mountain sickness (AMS) when first visiting altitudes above 4,000 m. Exercise tolerance also decreases as altitude increases. We observed exercise capacity at sea level and under a simulated hypobaric hypoxia condition (SHHC) to explore whether the response to exercise intensity represented by physiological variables could predict AMS development in young men. Eighty young men from a military academy underwent a standard treadmill exercise test (TET) and biochemical blood test at sea level, SHHC, and 4,000-m altitude, sequentially, between December 2015 and March 2016. Exercise-related variables and 12-lead electrocardiogram parameters were obtained. Exercise intensity and AMS development were investigated. After exposure to high altitude, the count of white blood cells, alkaline phosphatase and serum albumin were increased (P < 0.05). There were no significant differences in exercise time and metabolic equivalents (METs) between SHHC and high-altitude exposures (7.05 ± 1.02 vs. 7.22 ± 0.96 min, P = 0.235; 9.62 ± 1.11 vs. 9.38 ± 1.12, P = 0.126, respectively). However, these variables were relatively higher at sea level (8.03 ± 0.24 min, P < 0.01; 10.05 ± 0.31, P < 0.01, respectively). Thus, subjects displayed an equivalent exercise tolerance upon acute exposure to high altitude and to SHHC. The trends of cardiovascular hemodynamics during exercise under the three different conditions were similar. However, both systolic blood pressure and the rate-pressure product at every TET stage were higher at high altitude and under the SHHC than at sea level. After acute exposure to high altitude, 19 (23.8%) subjects developed AMS. Multivariate logistic regression analysis showed that METs under the SHHC {odds ratio (OR) 0.355 per unit increment [95% confidence intervals (CI) 0.159-0.793], P = 0.011}, diastolic blood pressure (DBP) at rest under SHHC [OR 0.893 per mmHg (95%CI 0.805-0.991), P = 0.030], and recovery DBP 3 min after exercise at sea level [OR 1.179 per mmHg (95%CI 1.043-1.333), P = 0.008] were independently associated with AMS. The predictive model had an area under the receiver operating characteristic curve of 0.886 (95%CI 0.803-0.969, P < 0.001). Thus, young men have similar exercise tolerance in acute exposure to high altitude and to SHHC. Moreover, AMS can be predicted with superior accuracy using characteristics easily obtainable with TET.
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Affiliation(s)
- Ya-Jun Shi
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jin-Li Wang
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Ling Gao
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Dong-Lin Wen
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Qing Dan
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Ying Dong
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Ya-Tao Guo
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Cheng-Hui Zhao
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Teng-Jing Li
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Jun Guo
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Zong-Bin Li
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yun-Dai Chen
- Department of Cardiology, First Medical Center, Chinese PLA General Hospital, Beijing, China
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Red Cell Distribution Width as a Novel Marker for Different Types of Atrial Fibrillation in Low and High Altitude. Cardiol Res Pract 2019; 2019:6291964. [PMID: 30984423 PMCID: PMC6431478 DOI: 10.1155/2019/6291964] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Accepted: 01/28/2019] [Indexed: 12/16/2022] Open
Abstract
Background Increased red cell distribution width (RDW) can predict the incidence and mortality of cardiovascular diseases. However, there are limited data on the relationship between RDW and altitude and the subtype of atrial fibrillation (AF). We investigated the effects of altitude on RDW in patients with different types of AF. Methods A total of 303 patients with nonvalvular AF were included. Of these, 156 lived in low altitude (77 paroxysmal AF, PAF; 79 persistent AF, PeAF) and 147 in high altitude (77 paroxysmal AF, PAF; 70 persistent AF, PeAF). In these groups, baseline characteristics, complete blood counts, serum biochemistry, and echocardiography were evaluated. Multivariate logistic regression analysis was conducted to determine the independent predictors of AF at the different altitudes. Results In both low and high altitudes, RDW and left atrial diameter (LAD) were higher in AF than control subjects (P < 0.05) and higher in persistent AF than paroxysmal AF (P < 0.05). Compared with any groups (PAF group, PeAF group, or control group) of low-altitude, RDW and LAD were found higher in high-altitude corresponding groups. Multivariate logistic regression analysis demonstrated that RDW, mean corpuscular volume (MCV), and LAD levels independently associated with AF patients in low altitude (RDW, OR 1.687, 95% CI 1.021–2.789; P < 0.05), while in high altitude, RDW, MCV, creatinine (Cr), and LAD were independent predictors for AF patients (RDW, OR 1.755, 95% CI 1.179–2.613; P < 0.05). Conclusion Elevated RDW levels may be an independent risk marker for nonvalvular AF, affected by type of AF and altitude.
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Aguilar M, González-Candia A, Rodríguez J, Carrasco-Pozo C, Cañas D, García-Herrera C, Herrera EA, Castillo RL. Mechanisms of Cardiovascular Protection Associated with Intermittent Hypobaric Hypoxia Exposure in a Rat Model: Role of Oxidative Stress. Int J Mol Sci 2018; 19:ijms19020366. [PMID: 29373484 PMCID: PMC5855588 DOI: 10.3390/ijms19020366] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 01/08/2018] [Accepted: 01/09/2018] [Indexed: 12/25/2022] Open
Abstract
More than 140 million people live and works (in a chronic or intermittent form) above 2500 m worldwide and 35 million live in the Andean Mountains. Furthermore, in Chile, it is estimated that 55,000 persons work in high altitude shifts, where stays at lowlands and interspersed with working stays at highlands. Acute exposure to high altitude has been shown to induce oxidative stress in healthy human lowlanders, due to an increase in free radical formation and a decrease in antioxidant capacity. However, in animal models, intermittent hypoxia (IH) induce preconditioning, like responses and cardioprotection. Here, we aimed to describe in a rat model the responses on cardiac and vascular function to 4 cycles of intermittent hypobaric hypoxia (IHH). Twelve adult Wistar rats were randomly divided into two equal groups, a four-cycle of IHH, and a normobaric hypoxic control. Intermittent hypoxia was induced in a hypobaric chamber in four continuous cycles (1 cycle = 4 days hypoxia + 4 days normoxia), reaching a barometric pressure equivalent to 4600 m of altitude (428 Torr). At the end of the first and fourth cycle, cardiac structural, and functional variables were determined by echocardiography. Thereafter, ex vivo vascular function and biomechanical properties were determined in femoral arteries by wire myography. We further measured cardiac oxidative stress biomarkers (4-Hydroxy-nonenal, HNE; nytrotirosine, NT), reactive oxygen species (ROS) sources (NADPH and mitochondrial), and antioxidant enzymes activity (catalase, CAT; glutathione peroxidase, GPx, and superoxide dismutase, SOD). Our results show a higher ejection and shortening fraction of the left ventricle function by the end of the 4th cycle. Further, femoral vessels showed an improvement of vasodilator capacity and diminished stiffening. Cardiac tissue presented a higher expression of antioxidant enzymes and mitochondrial ROS formation in IHH, as compared with normobaric hypoxic controls. IHH exposure determines a preconditioning effect on the heart and femoral artery, both at structural and functional levels, associated with the induction of antioxidant defence mechanisms. However, mitochondrial ROS generation was increased in cardiac tissue. These findings suggest that initial states of IHH are beneficial for cardiovascular function and protection.
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Affiliation(s)
- Miguel Aguilar
- Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago 7500922, Chile.
| | - Alejandro González-Candia
- Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago 7500922, Chile.
| | - Jorge Rodríguez
- Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago 7500922, Chile.
- Departamento de Kinesiología, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile.
| | - Catalina Carrasco-Pozo
- Discovery Biology, Griffith Institute for Drug Discovery, Griffith University, Brisbane, QLD 4222, Australia.
- Departamento de Nutrición, Facultad de Medicina, Universidad de Chile, Santiago 8380453, Chile.
| | - Daniel Cañas
- Departamento de Ingeniería Mecánica, Facultad de Ingeniería, Universidad de Santiago de Chile, Santiago 9170125, Chile.
| | - Claudio García-Herrera
- Departamento de Ingeniería Mecánica, Facultad de Ingeniería, Universidad de Santiago de Chile, Santiago 9170125, Chile.
| | - Emilio A Herrera
- Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago 7500922, Chile.
- International Center for Andean Studies, Universidad de Chile, Putre, Chile.
| | - Rodrigo L Castillo
- Programa de Fisiopatología, Instituto de Ciencias Biomédicas, Facultad de Medicina, Universidad de Chile, Santiago 7500922, Chile.
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González NF, Anchique CV, Rivas AD. Test de caminata de 6 minutos en pacientes de rehabilitación cardiaca de altitud moderada. REVISTA COLOMBIANA DE CARDIOLOGÍA 2017. [DOI: 10.1016/j.rccar.2017.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Gaston AF, Roca E, Doucende G, Hapkova I, Subirats E, Durand F. Réponses physiologiques à l’exercice en altitude modérée : intérêt de la mesure de la SpO2. Sci Sports 2016. [DOI: 10.1016/j.scispo.2015.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Praz C, Léger B, Kayser B. Energy expenditure of extreme competitive mountaineering skiing. Eur J Appl Physiol 2014; 114:2201-11. [PMID: 24996806 DOI: 10.1007/s00421-014-2939-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 06/13/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE Multi-hour ski mountaineering energy balance may be negative and intake below recommendations. METHODS Athletes on the 'Patrouille des Glaciers' racecourses (17 on course Z, 27 km, +2,113 m; 11 on course A, 26 km, +1,881 m) volunteered. Pre-race measurements included body mass, stature, VO2max, and heart rate (HR) vs VO2 at simulated altitude; race measurements HR, altitude, incline, location, and food and drink intake (A). Energy expenditure (EE) was calculated from altitude corrected HR derived VO2. RESULTS Race time was 5 h 7 min ± 44 min (mean ± SD, Z) and 5 h 51 min ± 53 min (A). Subjects spent 19.2 ± 3.2 MJ (Z), respectively, 22.6 ± 2.9 MJ (A) during the race. Energy deficit was -15.5 ± 3.9 MJ (A); intake covered 20 ± 7 % (A). Overall energy cost of locomotion (EC) was 9.9 ± 1.3 J m(-1) kg(-1) (Z), 8.0 ± 1.0 J m(-1) kg(-1) (A). Uphill EC was 11.7 ± 1 J m(-1) kg(-1) (Z, 13 % slope) and 15.7 ± 2.3 J m(-1) kg(-1) (A, 19 % slope). Race A subjects lost -1.5 ± 1.1 kg, indicating near euhydration. Age, body mass, gear mass, VO2max and EC were significantly correlated with performance; energy deficit was not. CONCLUSIONS Energy expenditure and energy deficit of a multi-hour ski mountaineering race are very high and energy intake is below recommendations.
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Affiliation(s)
- Caroline Praz
- Institute of Sports Sciences and Department of Physiology, Faculty of Biology and Medicine, University of Lausanne, Géopolis, Campus Dorigny, 1015, Lausanne, Switzerland
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Frisancho AR. Developmental functional adaptation to high altitude: review. Am J Hum Biol 2014; 25:151-68. [PMID: 24065360 DOI: 10.1002/ajhb.22367] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2012] [Indexed: 11/12/2022] Open
Abstract
Various approaches have been used to understand the origins of the functional traits that characterize the Andean high-altitude native. Based on the conceptual framework of developmental functional adaptation which postulates that environmental influences during the period of growth and development have long lasting effects that may be expressed during adulthood, we initiated a series of studies addressed at determining the pattern of physical growth and the contribution of growth and development to the attainment of full functional adaptation to high-altitude of low and high altitude natives living under rural and urban conditions. Current research indicate that: (a) the pattern of growth at high altitude due to limited nutritional resources, physical growth in body size is delayed but growth in lung volumes is accelerated because of hypoxic stress); (b) low-altitude male and female urban natives can attain a full functional adaptation to high altitude by exposure to high-altitude hypoxia during the period of growth and development; (c) both experimental studies on animals and comparative human studies indicate that exposure to high altitude during the period of growth and development results in the attainment of a large residual lung volume; (d) this developmentally acquired enlarged residual lung volume and its associated increase in alveolar area when combined with the increased tissue capillarization and moderate increase in red blood cells and hemoglobin concentration contributes to the successful functional adaptation of the Andean high-altitude native to hypoxia; and (e) any specific genetic traits that are related to the successful functional adaptation of Andean high-altitude natives have yet to be identified.
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Affiliation(s)
- A Roberto Frisancho
- Department of Anthropology and Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, 48109-1092
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Frisancho AR. Developmental Functional Adaptation to High Altitude: Review. Am J Hum Biol 2013. [DOI: 10.1002/jhb.22367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
- A. Roberto Frisancho
- Department of Anthropology and Center for Human Growth and Development; University of Michigan; Ann Arbor; Michigan; 48109-1092
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