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Kipkemoi P, Kim HA, Christ B, O'Heir E, Allen J, Austin-Tse C, Baxter S, Brand H, Bryant S, Buser N, de Menil V, Eastman E, Murugasen S, Galvin A, Kombe M, Ngombo A, Mkubwa B, Mwangi P, Kipkoech C, Lovgren A, MacArthur DG, Melly B, Mwangasha K, Martin A, Nkambule LL, Sanchis-Juan A, Singer-Berk M, Talkowski ME, VanNoy G, van der Merwe C, Newton C, O'Donnell-Luria A, Abubakar A, Donald KA, Robinson EB. Phenotype and genetic analysis of data collected within the first year of NeuroDev. Neuron 2023; 111:2800-2810.e5. [PMID: 37463579 DOI: 10.1016/j.neuron.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 01/13/2023] [Accepted: 06/16/2023] [Indexed: 07/20/2023]
Abstract
Genetic association studies have made significant contributions to our understanding of the etiology of neurodevelopmental disorders (NDDs). However, these studies rarely focused on the African continent. The NeuroDev Project aims to address this diversity gap through detailed phenotypic and genetic characterization of children with NDDs from Kenya and South Africa. We present results from NeuroDev's first year of data collection, including phenotype data from 206 cases and clinical genetic analyses of 99 parent-child trios. Most cases met criteria for global developmental delay/intellectual disability (GDD/ID, 80.3%). Approximately half of the children with GDD/ID also met criteria for autism. Analysis of exome-sequencing data identified a pathogenic or likely pathogenic variant in 13 (17%) of the 75 cases from South Africa and 9 (38%) of the 24 cases from Kenya. Data from the trio pilot are publicly available, and the NeuroDev Project will continue to develop resources for the global genetics community.
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Affiliation(s)
- Patricia Kipkemoi
- Neuroscience Unit, KEMRI-Wellcome Trust, Center for Geographic Medicine Research Coast, Kilifi, Kenya; Complex Trait Genetics Department, Center for Neurogenomics and Cognitive Research, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Heesu Ally Kim
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Bjorn Christ
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, 4th Floor ICH Building, Rondebosch, South Africa
| | - Emily O'Heir
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Jake Allen
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Christina Austin-Tse
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | | | - Harrison Brand
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Sam Bryant
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Nick Buser
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Victoria de Menil
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Emma Eastman
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, 4th Floor ICH Building, Rondebosch, South Africa
| | - Serini Murugasen
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, 4th Floor ICH Building, Rondebosch, South Africa
| | - Alice Galvin
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Martha Kombe
- Neuroscience Unit, KEMRI-Wellcome Trust, Center for Geographic Medicine Research Coast, Kilifi, Kenya
| | - Alfred Ngombo
- Neuroscience Unit, KEMRI-Wellcome Trust, Center for Geographic Medicine Research Coast, Kilifi, Kenya
| | - Beatrice Mkubwa
- Neuroscience Unit, KEMRI-Wellcome Trust, Center for Geographic Medicine Research Coast, Kilifi, Kenya
| | - Paul Mwangi
- Neuroscience Unit, KEMRI-Wellcome Trust, Center for Geographic Medicine Research Coast, Kilifi, Kenya
| | - Collins Kipkoech
- Neuroscience Unit, KEMRI-Wellcome Trust, Center for Geographic Medicine Research Coast, Kilifi, Kenya
| | - Alysia Lovgren
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | | | - Brigitte Melly
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, 4th Floor ICH Building, Rondebosch, South Africa
| | - Katini Mwangasha
- Neuroscience Unit, KEMRI-Wellcome Trust, Center for Geographic Medicine Research Coast, Kilifi, Kenya
| | - Alicia Martin
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Lethukuthula L Nkambule
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Alba Sanchis-Juan
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA
| | | | - Michael E Talkowski
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Grace VanNoy
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | | | - Charles Newton
- Neuroscience Unit, KEMRI-Wellcome Trust, Center for Geographic Medicine Research Coast, Kilifi, Kenya; Department of Psychiatry, University of Oxford, London, UK; Institute of Human Development, Aga Khan University, Nairobi, Kenya
| | - Anne O'Donnell-Luria
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA; Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA, USA
| | - Amina Abubakar
- Neuroscience Unit, KEMRI-Wellcome Trust, Center for Geographic Medicine Research Coast, Kilifi, Kenya; Department of Psychiatry, University of Oxford, London, UK; Institute of Human Development, Aga Khan University, Nairobi, Kenya.
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, 4th Floor ICH Building, Rondebosch, South Africa; Neuroscience Institute, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, South Africa.
| | - Elise B Robinson
- The Broad Institute of MIT and Harvard, Cambridge, MA, USA; Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.
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Holtz AM, VanCoillie R, Vansickle EA, Carere DA, Withrow K, Torti E, Juusola J, Millan F, Person R, Guillen Sacoto MJ, Si Y, Wentzensen IM, Pugh J, Vasileiou G, Rieger M, Reis A, Argilli E, Sherr EH, Aldinger KA, Dobyns WB, Brunet T, Hoefele J, Wagner M, Haber B, Kotzaeridou U, Keren B, Heron D, Mignot C, Heide S, Courtin T, Buratti J, Murugasen S, Donald KA, O'Heir E, Moody S, Kim KH, Burton BK, Yoon G, Campo MD, Masser-Frye D, Kozenko M, Parkinson C, Sell SL, Gordon PL, Prokop JW, Karaa A, Bupp C, Raby BA. Heterozygous variants in MYH10 associated with neurodevelopmental disorders and congenital anomalies with evidence for primary cilia-dependent defects in Hedgehog signaling. Genet Med 2022; 24:2065-2078. [PMID: 35980381 PMCID: PMC10765599 DOI: 10.1016/j.gim.2022.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 06/30/2022] [Accepted: 07/01/2022] [Indexed: 10/15/2022] Open
Abstract
PURPOSE Nonmuscle myosin II complexes are master regulators of actin dynamics that play essential roles during embryogenesis with vertebrates possessing 3 nonmuscle myosin II heavy chain genes, MYH9, MYH10, and MYH14. As opposed to MYH9 and MYH14, no recognizable disorder has been associated with MYH10. We sought to define the clinical characteristics and molecular mechanism of a novel autosomal dominant disorder related to MYH10. METHODS An international collaboration identified the patient cohort. CAS9-mediated knockout cell models were used to explore the mechanism of disease pathogenesis. RESULTS We identified a cohort of 16 individuals with heterozygous MYH10 variants presenting with a broad spectrum of neurodevelopmental disorders and variable congenital anomalies that affect most organ systems and were recapitulated in animal models of altered MYH10 activity. Variants were typically de novo missense changes with clustering observed in the motor domain. MYH10 knockout cells showed defects in primary ciliogenesis and reduced ciliary length with impaired Hedgehog signaling. MYH10 variant overexpression produced a dominant-negative effect on ciliary length. CONCLUSION These data presented a novel genetic cause of isolated and syndromic neurodevelopmental disorders related to heterozygous variants in the MYH10 gene with implications for disrupted primary cilia length control and altered Hedgehog signaling in disease pathogenesis.
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Affiliation(s)
- Alexander M Holtz
- Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA.
| | - Rachel VanCoillie
- Medical Genetics, Spectrum Health and Helen DeVos Children's Hospital, Grand Rapids, MI
| | - Elizabeth A Vansickle
- Medical Genetics, Spectrum Health and Helen DeVos Children's Hospital, Grand Rapids, MI
| | | | | | | | | | | | | | | | | | | | - Jada Pugh
- Center for Precision Health Research, National Human Genome Research Institute, Bethesda, MD; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Georgia Vasileiou
- Institute of Human Genetics, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Melissa Rieger
- Institute of Human Genetics, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - André Reis
- Institute of Human Genetics, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Emanuela Argilli
- Brain Development Research Program, Department of Neurology, University of California San Francisco, San Francisco, CA
| | - Elliott H Sherr
- Brain Development Research Program, Department of Neurology, University of California San Francisco, San Francisco, CA
| | - Kimberly A Aldinger
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA; Brotman Baty Institute for Precision Medicine, University of Washington, Seattle, WA
| | - William B Dobyns
- Division of Pediatric Genetics and Metabolism, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Theresa Brunet
- Institute of Human Genetics, Technical University Munich School of Medicine, Munich, Germany; Institute of Neurogenomics, Helmholtz Zentrum München, Neuherberg, Germany
| | - Julia Hoefele
- Institute of Human Genetics, Technical University Munich School of Medicine, Munich, Germany
| | - Matias Wagner
- Institute of Human Genetics, Technical University Munich School of Medicine, Munich, Germany; Institute of Neurogenomics, Helmholtz Zentrum München, Neuherberg, Germany; Division of Pediatric Neurology, Department of Pediatrics, Dr. von Hauner Children's Hospital, LMU University Hospital, Munich, Germany
| | - Benjamin Haber
- Division of Child Neurology and Inherited Metabolic Diseases, Center for Pediatric and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Urania Kotzaeridou
- Division of Child Neurology and Inherited Metabolic Diseases, Center for Pediatric and Adolescent Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Boris Keren
- Department of Genetics, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, Paris, France
| | - Delphine Heron
- Department of Genetics, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, Paris, France
| | - Cyril Mignot
- Department of Genetics, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, Paris, France
| | - Solveig Heide
- Department of Genetics, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, Paris, France
| | - Thomas Courtin
- Department of Genetics, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, Paris, France
| | - Julien Buratti
- Department of Genetics, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, Paris, France
| | - Serini Murugasen
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Rondebosch, South Africa
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Rondebosch, South Africa
| | - Emily O'Heir
- Center for Mendelian Genomics and Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA
| | - Shade Moody
- Division of Child and Adolescent Neurology, The University of Texas Health Science Center, Houston, TX
| | - Katherine H Kim
- Division of Genetics, Birth Defects, and Metabolism, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Barbara K Burton
- Division of Genetics, Birth Defects, and Metabolism, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Grace Yoon
- Division of Clinical and Metabolic Genetics, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Miguel Del Campo
- Division of Dysmorphology & Teratology, Department of Pediatrics, University of California San Diego, San Diego, CA
| | - Diane Masser-Frye
- Division of Genetics/ Dysmorphology, Rady Children's Hospital San Diego, San Diego, CA
| | - Mariya Kozenko
- Division of Genetics, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Christina Parkinson
- Division of Genetics, McMaster Children's Hospital, Hamilton, Ontario, Canada
| | - Susan L Sell
- Department of Pediatrics, Penn State Health Children's Hospital, Hershey, PA
| | - Patricia L Gordon
- Department of Pediatrics, Penn State Health Children's Hospital, Hershey, PA
| | - Jeremy W Prokop
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI
| | - Amel Karaa
- Division of Genetics and Genomics, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Caleb Bupp
- Medical Genetics, Spectrum Health and Helen DeVos Children's Hospital, Grand Rapids, MI.
| | - Benjamin A Raby
- Division of Pulmonary Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
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4
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de Menil V, Hoogenhout M, Kipkemoi P, Kamuya D, Eastman E, Galvin A, Mwangasha K, de Vries J, Kariuki SM, Murugasen S, Mwangi P, Singh I, Stein DJ, Abubakar A, Newton CR, Donald KA, Robinson E. The NeuroDev Study: Phenotypic and Genetic Characterization of Neurodevelopmental Disorders in Kenya and South Africa. Neuron 2019; 101:15-19. [PMID: 30605655 DOI: 10.1016/j.neuron.2018.12.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The NeuroDev study will deeply phenotype cognition, behavior, dysmorphias, and neuromedical traits on an expected cohort of 5,600 Africans (1,800 child cases, 1,800 child controls, and 1,900 parents) and will collect whole blood for exome sequencing and biobanking.
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Affiliation(s)
- Victoria de Menil
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, 75 Ames Street, Cambridge, MA 02142, USA
| | - Michelle Hoogenhout
- Department of Paediatrics & Child Health, 4(th) Floor ICH Building, Red Cross War Memorial Children's Hospital and University of Cape Town, Rondebosch, South Africa
| | - Patricia Kipkemoi
- Neurosciences Unit, Clinical Department, KEMRI-Wellcome Trust Collaborative Research Programme, PO Box 230-80108, Kilifi, Kenya
| | - Dorcas Kamuya
- Department of Health Systems and Research Ethics, KEMRI-Wellcome Trust Collaborative Research Programme, Kilifi, Kenya
| | - Emma Eastman
- Department of Paediatrics & Child Health, 4(th) Floor ICH Building, Red Cross War Memorial Children's Hospital and University of Cape Town, Rondebosch, South Africa
| | - Alice Galvin
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, 75 Ames Street, Cambridge, MA 02142, USA; Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Katini Mwangasha
- Neurosciences Unit, Clinical Department, KEMRI-Wellcome Trust Collaborative Research Programme, PO Box 230-80108, Kilifi, Kenya
| | - Jantina de Vries
- Department of Medicine, University of Cape Town, Observatory, Cape Town 7925, South Africa
| | - Symon M Kariuki
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK; Neurosciences Unit, Clinical Department, KEMRI-Wellcome Trust Collaborative Research Programme, PO Box 230-80108, Kilifi, Kenya
| | - Serini Murugasen
- Department of Paediatrics & Child Health, 4(th) Floor ICH Building, Red Cross War Memorial Children's Hospital and University of Cape Town, Rondebosch, South Africa
| | - Paul Mwangi
- Neurosciences Unit, Clinical Department, KEMRI-Wellcome Trust Collaborative Research Programme, PO Box 230-80108, Kilifi, Kenya
| | - Ilina Singh
- Department of Psychiatry and Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - Dan J Stein
- Department of Psychiatry & Mental Health, and MRC Unit on Risk and Resilience in Mental Disorders, University of Cape Town, J-Block, Groote Schuur Hospital, Observatory, Cape Town, South Africa
| | - Amina Abubakar
- Neurosciences Unit, Clinical Department, KEMRI-Wellcome Trust Collaborative Research Programme, PO Box 230-80108, Kilifi, Kenya.
| | - Charles R Newton
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford OX3 7JX, UK; Neurosciences Unit, Clinical Department, KEMRI-Wellcome Trust Collaborative Research Programme, PO Box 230-80108, Kilifi, Kenya
| | - Kirsten A Donald
- Department of Paediatrics & Child Health, 4(th) Floor ICH Building, Red Cross War Memorial Children's Hospital and University of Cape Town, Rondebosch, South Africa.
| | - Elise Robinson
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, 75 Ames Street, Cambridge, MA 02142, USA; Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; Analytic and Translational Genetics Unit, Massachusetts General Hospital, Richard B. Simches Building, 6(th) Floor, 185 Cambridge Street, Boston, MA 02114, USA.
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5
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Lewington S, Li L, Murugasen S, Hong LS, Yang L, Guo Y, Bian Z, Collins R, Chen J, He H, Wu M, He T, Ren X, Meng J, Peto R, Chen Z. Temporal trends of main reproductive characteristics in ten urban and rural regions of China: the China Kadoorie biobank study of 300 000 women. Int J Epidemiol 2014; 43:1252-62. [PMID: 24639443 PMCID: PMC4121552 DOI: 10.1093/ije/dyu035] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chinese women's reproductive patterns have changed significantly over the past several decades. However, relatively little is known about the pace and characteristics of these changes either overall or by region and socioeconomic status. METHODS We examined the cross-sectional data from the China Kadoorie Biobank cohort study that recruited 300 000 women born between 1930 and 1974 (mean age: 51 years) from 10 socially diverse urban and rural regions of China. Temporal trends in several self-reported reproductive characteristics, and effect modification of these trends by area and education (as a surrogate for socioeconomic status), were examined. RESULTS The overall mean age at menarche was 15.4 (standard deviation 1.9) years, but decreased steadily over the 45 birth cohorts from 16.1 to 14.3 years, except for an anomalous increase of ∼1 year for women exposed to the 1958-61 famine in early adolescence. Similarly large changes were seen for other characteristics: mean parity fell (urban: 4.9 to 1.1; rural: 5.9 to 1.4); mean age at first birth increased (urban: 19.0 to 25.9 years; rural: 18.3 to 23.8 years); and birth spacing increased after 1980 to over 5 years. Breastfeeding declined after 1950 in urban and, after 1980, in rural women; and 68% of urban and 48% of rural women experienced a terminated pregnancy. Mean age at menopause increased from 47.9 to 49.3 years. CONCLUSIONS There have been striking changes in reproductive factors over time and between areas among these Chinese women. Their effects on major chronic diseases should be investigated.
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Affiliation(s)
- Sarah Lewington
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK, School of Public Health, Peking University Health Science Center, Beijing, China, Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China, Chinese National Center for Food Safety Risk Assessment, Beijing, China, Nangang Center for Disease Control, Haerbin, Heilongjiang, China, Jiangsu Centre for Disease Control, Nanjing, Jiangsu, China, Huixian Centre for Disease Control, Huixian, Hennan, China, Gansu Centre for Disease Control, Lanzhou, Gansu, China and Liuzhou Centre for Disease Control, Liuzhou, Guangxi, China
| | - LiMing Li
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK, School of Public Health, Peking University Health Science Center, Beijing, China, Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China, Chinese National Center for Food Safety Risk Assessment, Beijing, China, Nangang Center for Disease Control, Haerbin, Heilongjiang, China, Jiangsu Centre for Disease Control, Nanjing, Jiangsu, China, Huixian Centre for Disease Control, Huixian, Hennan, China, Gansu Centre for Disease Control, Lanzhou, Gansu, China and Liuzhou Centre for Disease Control, Liuzhou, Guangxi, ChinaClinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK, School of Public Health, Peking University Health Science Center, Beijing, China, Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China, Chinese National Center for Food Safety Risk Assessment, Beijing, China, Nangang Center for Disease Control, Haerbin, Heilongjiang, China, Jiangsu Centre for Disease Control, Nanjing, Jiangsu, China, Huixian Centre for Disease Control, Huixian, Hennan, China, Gansu Centre for Disease Control, Lanzhou, Gansu, China and Liuzhou Centre for Disease Control, Liuzhou, Guangxi, China
| | - Serini Murugasen
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK, School of Public Health, Peking University Health Science Center, Beijing, China, Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China, Chinese National Center for Food Safety Risk Assessment, Beijing, China, Nangang Center for Disease Control, Haerbin, Heilongjiang, China, Jiangsu Centre for Disease Control, Nanjing, Jiangsu, China, Huixian Centre for Disease Control, Huixian, Hennan, China, Gansu Centre for Disease Control, Lanzhou, Gansu, China and Liuzhou Centre for Disease Control, Liuzhou, Guangxi, China
| | - Lai-san Hong
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK, School of Public Health, Peking University Health Science Center, Beijing, China, Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China, Chinese National Center for Food Safety Risk Assessment, Beijing, China, Nangang Center for Disease Control, Haerbin, Heilongjiang, China, Jiangsu Centre for Disease Control, Nanjing, Jiangsu, China, Huixian Centre for Disease Control, Huixian, Hennan, China, Gansu Centre for Disease Control, Lanzhou, Gansu, China and Liuzhou Centre for Disease Control, Liuzhou, Guangxi, China
| | - Ling Yang
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK, School of Public Health, Peking University Health Science Center, Beijing, China, Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China, Chinese National Center for Food Safety Risk Assessment, Beijing, China, Nangang Center for Disease Control, Haerbin, Heilongjiang, China, Jiangsu Centre for Disease Control, Nanjing, Jiangsu, China, Huixian Centre for Disease Control, Huixian, Hennan, China, Gansu Centre for Disease Control, Lanzhou, Gansu, China and Liuzhou Centre for Disease Control, Liuzhou, Guangxi, China
| | - Yu Guo
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK, School of Public Health, Peking University Health Science Center, Beijing, China, Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China, Chinese National Center for Food Safety Risk Assessment, Beijing, China, Nangang Center for Disease Control, Haerbin, Heilongjiang, China, Jiangsu Centre for Disease Control, Nanjing, Jiangsu, China, Huixian Centre for Disease Control, Huixian, Hennan, China, Gansu Centre for Disease Control, Lanzhou, Gansu, China and Liuzhou Centre for Disease Control, Liuzhou, Guangxi, China
| | - Zheng Bian
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK, School of Public Health, Peking University Health Science Center, Beijing, China, Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China, Chinese National Center for Food Safety Risk Assessment, Beijing, China, Nangang Center for Disease Control, Haerbin, Heilongjiang, China, Jiangsu Centre for Disease Control, Nanjing, Jiangsu, China, Huixian Centre for Disease Control, Huixian, Hennan, China, Gansu Centre for Disease Control, Lanzhou, Gansu, China and Liuzhou Centre for Disease Control, Liuzhou, Guangxi, China
| | - Rory Collins
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK, School of Public Health, Peking University Health Science Center, Beijing, China, Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China, Chinese National Center for Food Safety Risk Assessment, Beijing, China, Nangang Center for Disease Control, Haerbin, Heilongjiang, China, Jiangsu Centre for Disease Control, Nanjing, Jiangsu, China, Huixian Centre for Disease Control, Huixian, Hennan, China, Gansu Centre for Disease Control, Lanzhou, Gansu, China and Liuzhou Centre for Disease Control, Liuzhou, Guangxi, China
| | - Junshi Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK, School of Public Health, Peking University Health Science Center, Beijing, China, Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China, Chinese National Center for Food Safety Risk Assessment, Beijing, China, Nangang Center for Disease Control, Haerbin, Heilongjiang, China, Jiangsu Centre for Disease Control, Nanjing, Jiangsu, China, Huixian Centre for Disease Control, Huixian, Hennan, China, Gansu Centre for Disease Control, Lanzhou, Gansu, China and Liuzhou Centre for Disease Control, Liuzhou, Guangxi, China
| | - Hui He
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK, School of Public Health, Peking University Health Science Center, Beijing, China, Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China, Chinese National Center for Food Safety Risk Assessment, Beijing, China, Nangang Center for Disease Control, Haerbin, Heilongjiang, China, Jiangsu Centre for Disease Control, Nanjing, Jiangsu, China, Huixian Centre for Disease Control, Huixian, Hennan, China, Gansu Centre for Disease Control, Lanzhou, Gansu, China and Liuzhou Centre for Disease Control, Liuzhou, Guangxi, China
| | - Ming Wu
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK, School of Public Health, Peking University Health Science Center, Beijing, China, Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China, Chinese National Center for Food Safety Risk Assessment, Beijing, China, Nangang Center for Disease Control, Haerbin, Heilongjiang, China, Jiangsu Centre for Disease Control, Nanjing, Jiangsu, China, Huixian Centre for Disease Control, Huixian, Hennan, China, Gansu Centre for Disease Control, Lanzhou, Gansu, China and Liuzhou Centre for Disease Control, Liuzhou, Guangxi, China
| | - Tianyou He
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK, School of Public Health, Peking University Health Science Center, Beijing, China, Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China, Chinese National Center for Food Safety Risk Assessment, Beijing, China, Nangang Center for Disease Control, Haerbin, Heilongjiang, China, Jiangsu Centre for Disease Control, Nanjing, Jiangsu, China, Huixian Centre for Disease Control, Huixian, Hennan, China, Gansu Centre for Disease Control, Lanzhou, Gansu, China and Liuzhou Centre for Disease Control, Liuzhou, Guangxi, China
| | - Xiaolan Ren
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK, School of Public Health, Peking University Health Science Center, Beijing, China, Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China, Chinese National Center for Food Safety Risk Assessment, Beijing, China, Nangang Center for Disease Control, Haerbin, Heilongjiang, China, Jiangsu Centre for Disease Control, Nanjing, Jiangsu, China, Huixian Centre for Disease Control, Huixian, Hennan, China, Gansu Centre for Disease Control, Lanzhou, Gansu, China and Liuzhou Centre for Disease Control, Liuzhou, Guangxi, China
| | - Jinhuai Meng
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK, School of Public Health, Peking University Health Science Center, Beijing, China, Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China, Chinese National Center for Food Safety Risk Assessment, Beijing, China, Nangang Center for Disease Control, Haerbin, Heilongjiang, China, Jiangsu Centre for Disease Control, Nanjing, Jiangsu, China, Huixian Centre for Disease Control, Huixian, Hennan, China, Gansu Centre for Disease Control, Lanzhou, Gansu, China and Liuzhou Centre for Disease Control, Liuzhou, Guangxi, China
| | - Richard Peto
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK, School of Public Health, Peking University Health Science Center, Beijing, China, Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China, Chinese National Center for Food Safety Risk Assessment, Beijing, China, Nangang Center for Disease Control, Haerbin, Heilongjiang, China, Jiangsu Centre for Disease Control, Nanjing, Jiangsu, China, Huixian Centre for Disease Control, Huixian, Hennan, China, Gansu Centre for Disease Control, Lanzhou, Gansu, China and Liuzhou Centre for Disease Control, Liuzhou, Guangxi, China
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, University of Oxford, Oxford, UK, School of Public Health, Peking University Health Science Center, Beijing, China, Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China, Chinese National Center for Food Safety Risk Assessment, Beijing, China, Nangang Center for Disease Control, Haerbin, Heilongjiang, China, Jiangsu Centre for Disease Control, Nanjing, Jiangsu, China, Huixian Centre for Disease Control, Huixian, Hennan, China, Gansu Centre for Disease Control, Lanzhou, Gansu, China and Liuzhou Centre for Disease Control, Liuzhou, Guangxi, China
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