Imperial College London

DrQueenieChan

Faculty of MedicineSchool of Public Health

Senior Research Officer
 
 
 
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Contact

 

+44 (0)20 7594 3311q.chan

 
 
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Location

 

151Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Publication Type
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140 results found

Eriksen R, Gibson R, Aresu M, Heard A, Chan Q, Evangelou E, Gao H, Elliott P, Frost Get al., Gene-diet quality interactions on HbA1c and type 2 diabetes risk: The Airwave Health Monitoring Study, Endocrinology, Diabetes & Metabolism, ISSN: 2398-9238

Introduction: Type 2 Diabetes (T2D) is multi-factorial involving lifestyle, environmental and genetic risk factors. This study aims to investigate the impact of genetic interactions with alcohol and diet quality on glycated haemoglobin A1c (HbA1c) independent of obesity, in a British population.Methods: Cross-sectional study of 14,089 white British participants from Airwave Health Monitoring Study, and a sub-sample of 3,733 participants with dietary data. A T2D genetic risk score (GRS) was constructed and its interactions with diet on HbA1c were assessed.Results: GRS was associated with a higher HbA1c% ( 0.03, p<0.0001) and a higher risk of pre-diabetes (OR 1.09, p<0.0001) and T2D (OR 1.14, p 0.006). The genetic effect on HbA1c% was significantly higher in obese participants ( 1.88, pinteraction 0.03). A high intake of wholegrain attenuated the effect on HbA1c% in high-risk individuals pinteraction 0.04. Conclusion: The genetic effect on HbA1c was almost doubled in obese individuals, compared with those with a healthy weight, and independent of weight there was a modest offset on HbA1c in high-genetic risk individuals consuming a diet high in wholegrain. This supports the importance of a healthy diet high in wholegrains and along with maintaining a healthy weight in controlling HbA1c amongst high genetic risk groups.

Journal article

Yan L, Wen X, Dyer AR, Chen H, Zhou L, Elliott P, Wu Y, Chan Q, Zhao Let al., 2019, Development of equations for converting random-zero to automated oscillometric blood pressure values

<jats:title>Abstract</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>This study aimed to collect data to compare blood pressure values between random-zero sphygmomanometers and automated oscillometric devices and generate equations to convert blood pressure values from one device to the other.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Omron HEM-907, a widely used automated oscillometric device in many epidemiologic surveys and cohort studies, was compared here with random-zero sphygmomanometers. Two hundred and one participants aged 40-79 years (37% men) were enrolled and randomly assigned to one of two groups with blood pressure measurement first taken by automated oscillometric devices or by random-zero sphygmomanometers. The study design enabled comparisons of blood pressure values between random-zero sphygmomanometers and two modes of this automated oscillometric device – automated and manual, and assessment of effects of measurement order on blood pressure values.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Among all participants, mean blood pressure levels were lowest when measured with random-zero sphygmomanometers compared with both modes of automated oscillometric devices. Several variables, including age and gender, were found to contribute to the blood pressure differences between random-zero sphygmomanometers and automated oscillometric devices. Equations were developed using multiple linear regression after taking those variables into account to convert blood pressure values by random-zero sphygmomanometers to automated oscillometric devices.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Equations developed in this study could be used to compare blood pressure values between epidemiologic and clinical studies or i

Journal article

Aljuraiban GS, Gibson R, Oude Griep LM, Okuda N, Steffen LM, Van Horn L, Chan Qet al., 2019, Perspective: The application of a priori diet quality scores to cardiovascular disease risk: A critical evaluation of current scoring systems, Advances in Nutrition, ISSN: 2156-5376

Healthy dietary habits are the cornerstone of cardiovascular disease (CVD) prevention. Numerous researchers have developed diet quality indices to help evaluate and compare diet quality across and within various populations. The availability of these new indices raises questions regarding the best selection relevant to a given population. In this perspective, we critically evaluate a priori–defined dietary indices commonly applied in epidemiological studies of CVD risk and mortality. A systematic literature search identified 59 observational studies that applied a priori–defined diet quality indices to CVD risk factors and/or CVD incidence and/or CVD mortality. Among 31 different indices, these scores were categorized as follows: 1) those based on country-specific dietary patterns, 2) those adapted from distinct dietary guidelines, and 3) novel scores specific to key diet-related factors associated with CVD risk.The strengths and limitations of these indices are described according to index components, calculation methods, and the application of these indices to different population groups. Also, the importance of identifying methodological challenges faced by researchers when applying an index are considered, such as selection and weighting of food groups within a score, since food groups are not necessarily equivalent in their associations with CVD. The lack of absolute cutoff values, emphasis on increasing healthy food without limiting unhealthy food intake, and absence of validation of scores with biomarkers or other objective diet assessment methods further complicate decisions regarding the best indices to use. Future research should address these limitations, consider cross-cultural and other differences between population groups, and identify translational challenges inherent in attempting to apply a relevant diet quality index for use in CVD prevention at a population level.

Journal article

Shi Z, Vu T, Kotthaus S, Harrison RM, Grimmond S, Yue S, Zhu T, Lee J, Han Y, Demuzere M, Dunmore RE, Ren L, Liu D, Wang Y, Wild O, Allan J, Acton WJ, Barlow J, Barratt B, Beddows D, Bloss WJ, Calzolai G, Carruthers D, Carslaw DC, Chan Q, Chatzidiakou L, Chen Y, Crilley L, Coe H, Dai T, Doherty R, Duan F, Fu P, Ge B, Ge M, Guan D, Hamilton JF, He K, Heal M, Heard D, Hewitt CN, Hollaway M, Hu M, Ji D, Jiang X, Jones R, Kalberer M, Kelly FJ, Kramer L, Langford B, Lin C, Lewis AC, Li J, Li W, Liu H, Liu J, Loh M, Lu K, Lucarelli F, Mann G, McFiggans G, Miller MR, Mills G, Monk P, Nemitz E, O'Connor F, Ouyang B, Palmer PI, Percival C, Popoola O, Reeves C, Rickard AR, Shao L, Shi G, Spracklen D, Stevenson D, Sun Y, Sun Z, Tao S, Tong S, Wang Q, Wang W, Wang X, Wang X, Wang Z, Wei L, Whalley L, Wu X, Wu Z, Xie P, Yang F, Zhang Q, Zhang Y, Zhang Y, Zheng Met al., 2019, Introduction to the special issue "In-depth study of air pollution sources and processes within Beijing and its surrounding region (APHH-Beijing)", ATMOSPHERIC CHEMISTRY AND PHYSICS, Vol: 19, Pages: 7519-7546, ISSN: 1680-7316

Journal article

Zhou L, Stamler J, Chan Q, Van Horn L, Daviglus ML, Dyer AR, Miura K, Okuda N, Wu Y, Ueshima H, Elliott P, Zhao L, INTERMAP Research Groupet al., 2019, Salt intake and prevalence of overweight/obesity in Japan, China, the United Kingdom, and the United States: the INTERMAP Study, American Journal of Clinical Nutrition, ISSN: 1938-3207

BACKGROUND: Several studies have reported that dietary salt intake may be an independent risk factor for overweight/obesity, but results from previous studies are controversial, reflecting study limitations such as use of a single spot urine or dietary recall to estimate daily salt intake rather than 24-h urine collections, and population samples from only a single country or center. OBJECTIVE: The aim of this study was to use data from the International Study of Macro-/Micro-nutrients and Blood Pressure (INTERMAP Study) to explore the relation between dietary salt intake estimated from 2 timed 24-h urine collections and body mass index (BMI; in kg/m2) as well as prevalence of overweight/obesity in Japan, China, the United Kingdom, and the United States. METHODS: Data were from a cross-sectional study of 4680 men and women aged 40-59 y in Japan (n = 1145), China (n = 839), the United Kingdom (n = 501), and the United States (n = 2195). General linear models were used to obtain the regression coefficients (β) of salt intake associated with BMI. Multivariable logistic regression models were used to determine the ORs and 95% CIs of overweight/obesity associated with a 1-g/d higher dietary salt intake. RESULTS: After adjustment for potential confounding factors including energy intake, salt intake 1 g/d higher was associated with BMI higher by 0.28 in Japan, 0.10 in China, 0.42 in the United Kingdom, and 0.52 in the United States, all P values < 0.001. Salt intake 1 g/d higher was associated with odds of overweight/obesity 21% higher in Japan, 4% higher in China, 29% higher in the United Kingdom, and 24% higher in the United States, all P values < 0.05. CONCLUSIONS: Salt intake is positively associated with BMI and the prevalence of overweight/obesity in Japan, China, the United Kingdom, and the United States. This association needs to be further confirmed in well-designed prospective studies with re

Journal article

Bixby H, Bentham J, Zhou B, Di Cesare M, Paciorek CJ, Bennett JE, Taddei C, Stevens GA, Rodriguez-Martinez A, Carrillo-Larco RM, Khang Y-H, Soric M, Gregg E, Miranda JJ, Bhutta ZA, Savin S, Sophiea MK, Iurilli MLC, Solomon BD, Cowan MJ, Riley LM, Danaei G, Bovet P, Christa-Emandi A, Hambleton IR, Hayes AJ, Ikeda N, Kengne AP, Laxmaiah A, Li Y, McGarvey ST, Mostafa A, Neovius M, Starc G, Zainuddin AA, Ezzati Met al., 2019, Rising rural body-mass index is the main driver of the global obesity epidemic, Nature, Vol: 569, Pages: 260-264, ISSN: 0028-0836

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities1,2. This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity3,4,5,6. Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017—and more than 80% in some low- and middle-income regions—was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing—and in some countries reversal—of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.

Journal article

Cai Y, Liang L, Barratt B, Kelly F, Hansell A, Tong Z, Lyu B, Chan Q, Xie W, Zhang Det al., Associations between daily air quality and hospitalisations for acute exacerbation of chronic obstructive pulmonary disease in Beijing, 2013-2017, Lancet Planetary Health, ISSN: 2542-5196

Background: Air pollution in Beijing hasbeen improving throughimplementation of the Air Pollution Prevention and Control Action Plan(2013-2017)but the implication for respiratory morbidity hasnot been directly investigated.Methods: Daily city-wide average concentrations of PM10, PM2·5, PMcoarse, NO2, SO2, CO and O3 in 2013-17 were averaged from 35 monitoring stationsacross the city.A generalized additive Poisson time-series model was applied to estimate the relative riskwith 95% confidence interval (CI) on hospitalisationsratesfor acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Beijing.Findings: During 18/January/2013-31/December/2017, 161,613 AECOPD hospitalisationswere recorded.Ambient concentrations of SO2and PM2·5 decreased by 68% and 33% over this five-year period.Relative risk for AECOPD hospitalisation was1·029 (95%CI: 1·023-1·035), 1·028(95%CI:1·021-1·034), 1·018(95%CI:1·013-1·022), 1·036(95%CI:1·028-1·044), 1·019(95%CI:1·013-1·024), 1·024(95%CI:1·018-1·029) and 1·027(95%CI:1·010-1·044) forsame day PM10,PM2·5, PMcoarse, NO2, SO2,COand O3 (warm season) respectivelyper interquartile rangeincrement.Femalesor patients aged ≥65 years were more susceptible.In 2013, there were 12,679 AECOPD casesadvanced by PM2·5pollution over expected rates if daily levels had not exceeded the World Health Organisationtarget, whereas in 2017 the respective figure was 7,377 cases.Interpretation: Increased acuteair pollution episodesweresignificantly associated with increasedhospitalisations for AECOPDin Beijingdespite improvement in overall air quality.Our findings however highlight the importance and effectiveness of stringent air pollution control policieson reducing COPD morbidity and provide rationale

Journal article

Iwahori T, Miura K, Ueshima H, Tanaka-Mizuno S, Chan Q, Arima H, Dyer AR, Elliott P, Stamler J, INTERSALT Research Groupet al., 2019, Urinary sodium-to-potassium ratio and intake of sodium and potassium among men and women from multiethnic general populations: the INTERSALT Study, Hypertension Research, ISSN: 0916-9636

The Na/K ratio may be more strongly related to blood pressure and cardiovascular disease than sodium or potassium. The casual urine Na/K ratio can provide prompt on-site feedback, and with repeated measurements, may provide useful individual estimates of the 24-h ratio. The World Health Organization has published guidelines for sodium and potassium intake, but no generally accepted guideline prevails for the Na/K ratio. We used standardized data on 24 h and casual urinary electrolyte excretion obtained from the INTERSALT Study for 10,065 individuals aged 20-59 years from 32 countries (52 populations). Associations between the casual urinary Na/K ratio and the 24-h sodium and potassium excretion of individuals were assessed by correlation and stratification analyses. The mean 24-h sodium and potassium excretions were 156.0 mmol/24 h and 55.2 mmol/24 h, respectively; the mean 24-h urinary Na/K molar ratio was 3.24. Pearson's correlation coefficients (r) for the casual urinary Na/K ratio with 24-h sodium and potassium excretions were 0.42 and -0.34, respectively, and these were 0.57 and -0.48 for the 24-h ratio. The urinary Na/K ratio predicted a 24-h urine Na excretion of <85 mmol/day (the WHO recommended guidelines) with a sensitivity of 99.7% and 94.0%, specificity of 39.5% and 48.0%, and positive predictive value of 96.3% and 61.1% at the cutoff point of 1 in 24 h and casual urine Na/K ratios, respectively. A urinary Na/K molar ratio <1 may be a useful indicator for adherence to the WHO recommended levels of sodium and, to a lesser extent, the potassium intake across different populations; however, cutoff points for Na/K ratio may be tuned for localization.

Journal article

Wen X, Zhou L, Stamler J, Chan Q, Van Horn L, Daviglus ML, Dyer AR, Elliott P, Ueshima H, Miura K, Okuda N, Wu Y, Zhao Let al., 2019, Agreement between 24-h dietary recalls and 24-h urine collections for estimating sodium intake in China, Japan, UK, USA: the International Study of Macro- and Micro-nutrients and Blood Pressure., J Hypertens, Vol: 37, Pages: 814-819, ISSN: 0263-6352

OBJECTIVE: The present study aims to compare 24-h dietary recalls with 24-h urine collections for the estimation of sodium intake at both population and individual levels in China, Japan, the United Kingdom (UK), and the United States of America (USA), using data from the International Study of Macro- and Micro-nutrients and Blood Pressure (INTERMAP). METHODS: Mean differences between 24-h dietary recalls and 24-h urine collections were calculated for their agreement in estimating sodium intake at the population level; relative and absolute differences as well as misclassification of salt intake groups (salt intake <6, 6-8.9, 9-11.9, 12-14.9, and ≥15 g/day) were used to determine the agreement at the individual level. RESULTS: The mean differences (95% CI) between dietary recalls and urine collections for China, Japan, UK, and USA were -54.0 (-59.8, -48.3), 3.9 (0.6, 7.2), 2.9 (-1.8, 7.6), and -3.5 (-5.8, -1.1) mmol/day, respectively. The proportions of individual relative differences beyond ±40% were 34.3% for China, 16.9% for Japan, 24.2% for UK, and 21.3% for USA; the proportions of individual absolute differences greater than 51.3 mmol/day (3 g salt) were 58.6% for China, 32.8% for Japan, 25.4% for UK, and 31.9% for USA. The rate for misclassification of salt intake groups at individual level for China, Japan, UK, and USA were 71.4, 60.9, 58.7, and 60.0%, respectively. CONCLUSION: The 24-h dietary recalls demonstrate greater agreement with the 24-h urine collections in estimating population sodium intake for Japan, UK, and USA, compared with China. The 24-h dietary recall has poor performance in assessing individual sodium intake in these four countries.

Journal article

Okami Y, Ueshima H, Nakamura Y, Okuda N, Nakagawa H, Sakata K, Saitoh S, Okayama A, Yoshita K, Choudhury SR, Chan Q, Elliott P, Miura K, Stamler J, for the INTERMAP AND INTERLIPID Research Groupset al., 2019, The relationship of dietary cholesterol to serum low density lipoprotein cholesterol and confounding by reverse causality: the INTERLIPID study, Journal of Atherosclerosis and Thrombosis, Vol: 26, Pages: 170-182, ISSN: 1340-3478

im: The positive relationship between dietary cholesterol and serum cholesterol has been questioned by a set of recent cohort studies. This study aimed to investigate how employment status and education years relate to the association between dietary cholesterol and serum low-density lipoprotein cholesterol (LDL-C) in a Japanese population.Methods: A population-based, random sample, cross-sectional study (INTERLIPID) was performed. Among 1,145 Japanese individuals aged 40-59 years, 106 were excluded because of special diets, use of lipid-lowering drugs, hormone replacement, and missing data, leaving 1,039 individuals (533 men and 506 women). Dietary cholesterol was assessed from four 24-h dietary recalls, and LDL-C was measured enzymatically with an auto-analyzer. A standard questionnaire inquired about employment status and education years.Results: In men, a 1 standard deviation (SD) higher dietary cholesterol was associated with 3.16 mg/dL lower serum LDL-C (P=0.009; unadjusted model). After adjustment for covariates, higher serum LDL-C was estimated per 1 SD higher intake of dietary cholesterol in nonemployed men [self-employed, homemakers, farmers, fishermen, and retired employees; β=+9.08, 95% confidence interval (CI)=+0.90-+17.27] and less educated men (β=+4.46, 95% CI=-0.97-+9.90), whereas an inverse association was observed in employed men (β=-3.02, 95% CI=-5.49--0.54) and more educated men (β=-3.66, 95% CI=-6.25--1.07).Conclusions: In men who were nonemployed and less educated, a higher intake of dietary cholesterol was associated with elevated concentrations of serum LDL-C, whereas an inverse association was observed in men who were employed and more educated.

Journal article

Gibson R, Lau C-H, Loo RL, Ebbles T, Chekmeneva E, Dyer A, Miura K, Ueshima H, Zhao L, Elliott P, Daviglus M, Stamler J, Van Horn L, Holmes E, Chan Qet al., American Heart Association's Epidemiology and Prevention/Lifestyle and Cardiometabolic Health 2019 Scientific Sessions, American Heart Association EpiLifestyle

Conference paper

Gibson R, Frost G, Chan Q, Elliott P, Singh D, Eriksen R, Heard A, Vergnaud ACet al., 2018, A cross-sectional investigation into the occupational and socio-demographic characteristics of British police force employees reporting a dietary pattern associated with cardiometabolic risk: Findings from the Airwave Health Monitoring Study, European Journal of Nutrition, Vol: 57, Pages: 2913-2926, ISSN: 0044-264X

PurposeThe aims of this study were to (1) determine the association between diet quality using the Dietary Approaches to Stop Hypertension (DASH) score and cardiometabolic risk in a British working population and (2) identify employee characteristics associated with reporting a poorer quality dietary pattern.MethodsBritish police employees enrolled (2007–2012) into the Airwave Health Monitoring Study (n = 5527) were included for sex-specific cross-sectional analyses. Dietary intakes were measured using 7-day food records. DASH score was calculated to determine diet quality. Logistic regression evaluated associations between (1) diet quality and increased cardiometabolic risk (defined as ≥ 3 risk markers: dyslipidaemia, elevated blood pressure, waist circumference, CRP or HbA1c), and (2) poor diet quality (lowest fifth of DASH score distribution) and employee characteristics.ResultsEmployees recording a poor diet quality had greater odds (OR) of increased cardiometabolic risk independent of established risk factors (demographic, lifestyle and occupational) and BMI: men OR 1.50 (95% CI 1.12–2.00), women: OR 1.84 (95% CI 1.19–2.97) compared to the healthiest diet group. Characteristics associated with reporting a poor quality diet were employment in Scotland vs. England: men OR 1.88 (95% CI 1.53–2.32), women: OR 1.49 (95% CI 1.11–2.00), longer working hours (≥ 49 vs. ≤40 h) men: OR 1.53 (95% CI 1.21–1.92) women: OR 1.53 (95% CI 1.12–2.09). For men, job strain (high vs. low) was associated with reporting a poor diet quality OR 1.66 (95% CI 1.30–2.12).ConclusionsThe general population disparities in diet quality between England and Scotland were reflected in British police employees. The association of longer working hours and job strain with diet quality supports the targeting of workplace nutritional interventions.

Journal article

Takashima N, Ohkubo T, Miura K, Okayama A, Nagako O, Nakagawa H, Saito S, Sakata K, Choudhury SR, Miyagawa N, Chan Q, Zhao L, Elliott P, Ueshima H, Stamler Jet al., 2018, Factors associated with intra-individual visit-to-vist variability in blood pressure in four countries: The INTERMAP Study, Journal of Human Hypertension, ISSN: 0950-9240

Several studies demonstrated that visit-to-visit variability of blood pressure (BP) predicted future events of total death, stroke and cardiovascular disease. Little is known about factors associated with visit-to-visit BP variability in different countries. We recruited participants aged 40–59 years from four countries (Japan, the People’s Republic of China [PRC], the United Kingdom [UK] and the United States [US]). At each study visit, BP was measured twice by trained observers using random zero sphygmomanometers after five minutes resting. We defined visit-to-visit BP variability as variation independent of mean (VIM) by using average systolic BP of 1st and 2nd measurement across four study visits. Data on 4680 men and women were analyzed. Mean ± standard deviation of VIM values among participants in Japan, the PRC, the UK and the US were 5.44 ± 2.88, 6.85 ± 3.49, 5.65 ± 2.81 and 5.84 ± 3.01, respectively; VIM value in the PRC participants was significantly higher. Sensitivity analyses among participants without antihypertensive treatment or past history of cardiovascular disease yielded similar results. Higher VIM value was associated with older age, female gender, lower pulse rate and urinary sodium excretion and use of antihypertensive agents such as angiotensin converting enzyme inhibitors, beta blockers and calcium channel blockers. The difference of visit-to-visit BP variability between PRC and other countries remained significant after adjustment for possible confounding factors. In this large international study across four countries, visit-to-visit BP variability in the PRC was higher than in the other three countries. Reproducibility and mechanisms of these findings remain to be elucidated.

Journal article

Chekmeneva E, Dos Santos Correia G, Gomez Romero M, Stamler J, Chan Q, Elliott P, Nicholson J, Holmes Eet al., 2018, Ultra performance liquid chromatography-high resolution mass spectrometry and direct infusion-high resolution mass spectrometry for combined exploratory and targeted metabolic profiling of human urine, Journal of Proteome Research, Vol: 17, Pages: 3492-3502, ISSN: 1535-3893

The application of metabolic phenotyping to epidemiological studies involving thousands of biofluid samples presents a challenge for the selection of analytical platforms that meet the requirements of high-throughput precision analysis and cost-effectiveness. Here, direct infusion nanoelectrospray (DI-nESI)- was compared to an ultra-performance (UPLC)-high resolution mass spectrometry (HRMS) method for metabolic profiling of an exemplary set of 132 human urine samples from a large epidemiological cohort. Both methods were developed and optimised to allow simultaneous collection of high resolution urinary metabolic profiles and quantitative data for a selected panel of 35 metabolites. The total run time for measuring the sample set in both polarities by UPLC-HRMS was of 5 days compared to 9 hours by DI-nESI-HRMS. To compare the classification ability of the two MS methods we performed exploratory analysis of the full-scan HRMS profiles to detect sex-related differences in biochemical composition. Although metabolite identification is less specific in DI-nESI-HRMS, the significant features responsible for discrimination between sexes were mostly the same in both MS-based platforms. Using the quantitative data we showed that 10 metabolites have strong correlation (Pearson’s r > 0.9 and Passing-Bablok regression slope 0.8-1.3) and good agreement assessed by Bland-Altman plots between UPLC-HRMS and DI-nESI-HRMS and thus, can be measured using a cheaper and less sample- and time-consuming method. Only five metabolites showed weak correlation (Pearson’s r< 0.4) and poor agreement due to the overestimation of the results by DI-nESI-HRMS, and the rest of metabolites showed acceptable correlation between the two methods.

Journal article

Zaid M, Miura K, Okayama A, Nakagawa H, Sakata K, Saitoh S, Okuda N, Yoshita K, Choudhury SR, Rodriguez B, Masaki K, Willcox B, Miyagawa N, Okamura T, Chan Q, Elliott P, Stamler J, Ueshima Het al., 2018, Associations of High-Density Lipoprotein Particle and High-Density Lipoprotein Cholesterol With Alcohol Intake, Smoking, and Body Mass Index - The INTERLIPID Study -, CIRCULATION JOURNAL, Vol: 82, Pages: 2557-+, ISSN: 1346-9843

Journal article

Aljuraiban GS, Stamler J, Chan Q, Van Horn L, Daviglus ML, Elliott P, Oude Griep LM, INTERMAP Research Groupet al., 2018, Relations between dairy product intake and blood pressure: the INTERnational study on MAcro/micronutrients and blood Pressure, Journal of Hypertension, ISSN: 0263-6352

BACKGROUND: Epidemiologic evidence suggests that low-fat dairy consumption may lower risk of hypertension. Dairy products may be distinctly linked to health, because of differences in nutritional composition, but little is known about specific nutrients that contribute to the dairy-blood pressure (BP) association, nor to underlying kidney function. METHODS: We examined cross-sectional associations to BP of dairy product intakes, total and by type, from the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP) including 2694 participants aged 40-59 years from the UK and the USA. Eight BP, four 24-h dietary recalls and two 24-h urine samples were collected during four visits. Linear regression models adjusted for lifestyle/dietary factors to estimate BP differences per 2SD higher intakes of total-and-individual-types of dairy were calculated. RESULTS: Multivariable linear regression coefficients were estimated and pooled. In contrast to total and whole-fat dairy, each 195 g/1000 kcal (2SD) greater low-fat dairy intake was associated with a lower SBP -2.31 mmHg and DBP -2.27 mmHg. Significant associations attenuated with adjustment for dietary phosphorus, calcium, and lactose, but strengthened with urinary calcium adjustment. Stratification by median albumin-creatinine ratio (ACR; high ACR indicates impaired kidney function) showed strong associations between low-fat dairy and BP in participants with low ACR (SBP: -3.66; DBP: -2.15 mmHg), with no association in participants with high ACR. CONCLUSION: Low-fat dairy consumption was associated with lower BP, especially among participants with low ACR. Dairy-rich nutrients including phosphorus and calcium may have contributed to the beneficial associations with BP.

Journal article

Zhou B, Bentham J, Di Cesare M, Bixby HRH, Danaei G, Hajifathalian K, Taddei C, Carrillo-Larco R, Khatibzadeh S, Lugero C, Peykari N, Zhang WZ, Bennett J, Bilano V, Stevens G, Riley L, Cowan M, Chen Z, Hambleton I, Jackson RT, Kengne A-P, Khang Y-H, Laxmaiah A, Liu J, Malekzadeh R, Neuhauser H, Soric M, Starc G, Sundstrom J, Woodward M, Ezzati Met al., 2018, Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: a pooled analysis of 1,018 population-based measurement studies with 88.6 million participants, International Journal of Epidemiology, Vol: 47, Pages: 872-883i, ISSN: 1464-3685

BackgroundChange in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure.MethodsWe pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20–29 years to 70–79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probit-transformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure.ResultsIn 2005–16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the high-income Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association.ConclusionsChange in mean bloo

Journal article

Aljuraiban G, Stamler J, Chan Q, van Horn L, Daviglus M, Elliott P, Oude Griep Let al., Relations between dairy product intake and blood pressure: the INTERMAP study, Journal of Hypertension, ISSN: 0263-6352

Background: epidemiologic evidence suggests that low-fat dairy consumption may lower risk of hypertension. Dairy products may be distinctly linked to health, due to differences in nutritional composition, but little is known about specific nutrients that contribute to the dairy-blood pressure (BP) association, nor to underlying kidney function. Methods: we examined cross-sectional associations to BP of dairy product intakes, total and by type, from the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP) including 2,694 participants aged 40-59 years from the United Kingdom and the United States. Eight BP, four 24-hour dietary recalls and two 24-hour urine samples were collected during four visits. Linear regression models adjusted for lifestyle/dietary factors to estimate BP differences per 2SD higher intakes of total-and-individual-types of dairy were calculated.Results: multivariable linear regression coefficients were estimated and pooled. In contrast to total and whole-fat dairy, each 195 g/1000 kcal (2SD) greater low-fat dairy intake was associated with a lower systolic BP (SBP) -2.31 mmHg and diastolic BP (DBP) -2.27 mmHg. Significant associations attenuated with adjustment for dietary phosphorus, calcium, and lactose, but strengthened with urinary calcium adjustment. Stratification by median albumin-creatinine-ratio (ACR), (high ACR indicates impaired kidney function) showed strong associations between low-fat dairy and BP in participants with low ACR (SBP: -3.66; DBP: -2.15 mmHg), with no association in participants with high ACR. Conclusions: low-fat dairy consumption was associated with lower BP, especially among participants with low ACR. Dairy-rich nutrients including phosphorus and calcium may have contributed to the beneficial associations with BP.

Journal article

Chan Q, The alternative Mediterranean diet score and blood pressure for US participant in the INTERMAP Study, American Society for Nutrition’s inaugural flagship meeting

Conference paper

Eriksen R, Gibson R, Lamb K, McMeel Y, Vergnuad A-C, Aresu M, Spear J, Chan Q, Elliott P, Frost Get al., 2018, Nutrient profiling and adherence to components of the UK national dietary guidelines association with metabolic risk factors for cardiovascular diseases and diabetes: Airwave Health Monitoring Study, British Journal of Nutrition, Vol: 119, Pages: 695-705, ISSN: 1475-2662

CVD is the leading cause of death worldwide. Diet is a key modifiable component in the development of CVD. No official UK diet quality index exists for use in UK nutritional epidemiological studies. The aims of this study are to: (i) develop a diet quality index based on components of UK dietary reference values (DRV) and (ii) determine the association between the index, the existing UK nutrient profile (NP) model and a comprehensive range of cardiometabolic risk markers among a British adult population. A cross-sectional analysis was conducted using data from the Airwave Health Monitoring Study (n 5848). Dietary intake was measured by 7-d food diary and metabolic risk using waist circumference, BMI, blood lipid profile, glycated Hb (HbA1c) and blood pressure measurements. Diet quality was assessed using the novel DRV index and NP model. Associations between diet and cardiometabolic risk were analysed via multivariate linear models and logistic regression. A two-point increase in NP score was associated with total cholesterol (β −0·33 mmol/l, P<0·0001) and HbA1c (β −0·01 %, P<0·0001). A two-point increase in DRV score was associated with waist circumference (β −0·56 cm, P<0·0001), BMI (β −0·15 kg/m2, P<0·0001), total cholesterol (β −0·06 mmol/l, P<0·0001) and HbA1c (β −0·02 %, P=0·002). A one-point increase in DRV score was associated with type 2 diabetes (T2D) (OR 0·94, P=0·01) and obesity (OR 0·95, P<0·0001). The DRV index is associated with overall diet quality and risk factors for CVD and T2D, supporting its application in nutritional epidemiological studies investigating CVD risk in a UK population.

Journal article

Xie W, Zheng F, Evangelou E, Liu O, Yang Z, Chan Q, Elliott P, Wu Yet al., 2018, Blood pressure-lowering drugs and secondary prevention of cardiovascular disease: systematic review and meta-analysis., Journal of Hypertension, Vol: 36, Pages: 1256-1265, ISSN: 0263-6352

OBJECTIVE: To systematically evaluate the efficacy of five commonly used blood pressure-lowering drugs in reducing cardiovascular events among patients with nonacute cardiovascular disease, but without heart failure. METHODS: We searched PubMed, EMBASE, and Cochrane Central Register of Controlled Trials on 18 March 2017. The primary outcome was fatal and nonfatal cardiovascular events, and the secondary outcomes were all-cause death, fatal and nonfatal myocardial infarction, and stroke. Pooled risk ratios and corresponding 95% confidence intervals (CIs) were calculated using Mantel-Haenszel random-effects meta-analyses. RESULTS: Twenty-seven randomized controlled trials with 143 095 participants and a treatment duration of at least 12 months were included in our analyses. Fifteen trials enrolled patients with coronary artery disease, eight enrolled patients with cerebral artery disease, and four enrolled patients with cardiovascular disease. Of the 27 trials, 10 trials only included hypertensive patients. Compared with placebo, angiotensin-converting enzyme inhibitors (ACEIs) (risk ratio 0.85, 95% CI 0.78-0.92), angiotensin receptor blockers (risk ratio 0.92, 95% CI 0.87-0.98), and diuretics (risk ratio 0.77, 95% CI 0.66-0.90) significantly reduced the risk of cardiovascular events. Apart from this, ACEIs significantly reduced all secondary outcomes, calcium channel blockers, and diuretics reduced stroke significantly. No significant difference was found in head-to-head comparisons of each given drug class with any other class. CONCLUSIONS: Although only ACEIs have evidences showing its effect in reducing cardiovascular events and all secondary outcomes, head-to-head comparisons did not provide strong evidence in difference in the effects between these blood pressure-lowering drugs.

Journal article

Stamler J, Chan Q, Daviglus M, Dyer A, van Horn L, Garside D, Miura K, Wu Y, Ueshima H, Zhao L, Elliott Pet al., 2018, Relation of dietary sodium (salt) to blood pressure and Its possible modulation by other dietary factors: the INTERMAP study, Hypertension, Vol: 71, Pages: 631-637, ISSN: 0194-911X

Available data indicate that dietary sodium (as salt) relates directly to blood pressure (BP). Most of these findings are from studies lacking dietary data; hence, it is unclear whether this sodium–BP relationship is modulated by other dietary factors. With control for multiple nondietary factors, but not body mass index, there were direct relations to BP of 24-hour urinary sodium excretion and the urinary sodium/potassium ratio among 4680 men and women 40 to 59 years of age (17 population samples in China, Japan, United Kingdom, and United States) in the INTERMAP (International Study on Macro/Micronutrients and Blood Pressure), and among its 2195 American participants, for example, 2 SD higher 24-hour urinary sodium excretion (118.7 mmol) associated with systolic BP 3.7 mm Hg higher. These sodium–BP relations persisted with control for 13 macronutrients, 12 vitamins, 7 minerals, and 18 amino acids, for both sex, older and younger, blacks, Hispanics, whites, and socioeconomic strata. With control for body mass index, sodium–BP—but not sodium/potassium–BP—relations were attenuated. Normal weight and obese participants manifested significant positive relations to BP of urinary sodium; relations were weaker for overweight people. At lower but not higher levels of 24-hour sodium excretion, potassium intake blunted the sodium–BP relation. The adverse association of dietary sodium with BP is minimally attenuated by other dietary constituents; these findings underscore the importance of reducing salt intake for the prevention and control of prehypertension and hypertension.

Journal article

Harada S, Hirayama A, Chan Q, Kurihara A, Fukai K, Iida M, Kato S, Sugiyama D, Kuwabara K, Takeuchi A, Akiyama M, Okamura T, Ebbels TMD, Elliott P, Tomita M, Sato A, Suzuki C, Sugimoto M, Soga T, Takebayashi Tet al., 2018, Reliability of plasma polar metabolite concentrations in a large-scale cohort study using capillary electrophoresis-mass spectrometry., PLoS ONE, Vol: 13, ISSN: 1932-6203

BACKGROUND: Cohort studies with metabolomics data are becoming more widespread, however, large-scale studies involving 10,000s of participants are still limited, especially in Asian populations. Therefore, we started the Tsuruoka Metabolomics Cohort Study enrolling 11,002 community-dwelling adults in Japan, and using capillary electrophoresis-mass spectrometry (CE-MS) and liquid chromatography-mass spectrometry. The CE-MS method is highly amenable to absolute quantification of polar metabolites, however, its reliability for large-scale measurement is unclear. The aim of this study is to examine reproducibility and validity of large-scale CE-MS measurements. In addition, the study presents absolute concentrations of polar metabolites in human plasma, which can be used in future as reference ranges in a Japanese population. METHODS: Metabolomic profiling of 8,413 fasting plasma samples were completed using CE-MS, and 94 polar metabolites were structurally identified and quantified. Quality control (QC) samples were injected every ten samples and assessed throughout the analysis. Inter- and intra-batch coefficients of variation of QC and participant samples, and technical intraclass correlation coefficients were estimated. Passing-Bablok regression of plasma concentrations by CE-MS on serum concentrations by standard clinical chemistry assays was conducted for creatinine and uric acid. RESULTS AND CONCLUSIONS: In QC samples, coefficient of variation was less than 20% for 64 metabolites, and less than 30% for 80 metabolites out of the 94 metabolites. Inter-batch coefficient of variation was less than 20% for 81 metabolites. Estimated technical intraclass correlation coefficient was above 0.75 for 67 metabolites. The slope of Passing-Bablok regression was estimated as 0.97 (95% confidence interval: 0.95, 0.98) for creatinine and 0.95 (0.92, 0.96) for uric acid. Compared to published data from other large cohort measurement platforms, reproducibility of metabolites common

Journal article

NCD Risk Factor Collaboration NCD-RisC, 2017, Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults., Lancet, Vol: 390, Pages: 2627-2642, ISSN: 0140-6736

BACKGROUND: Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. METHODS: We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity). FINDINGS: Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0·01 kg/m(2) per decade; 95% credible interval -0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m(2) per decade (0·69-1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m(2) per decade (0·64-1·25, PP>0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m(2) per decade (-0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m(2) per decade (0·50-1·06, PP>0·9999) in Polynesia and Micronesia. Tre

Journal article

Kenge AP, Bentham J, Zhou B, Bixby H, Taddei C, Chan Q, Elliott P, Ezzati M, Mbanya JCNet al., 2017, Trends in obesity and diabetes across regions in Africa from 1980 to 2014: an analysis of pooled population-based studies., International Journal of Epidemiology, Vol: 46, Pages: 1421-1432, ISSN: 1464-3685

Background: The 2016 Dar Es Salaam Call to Action on Diabetes and other NCDs advocates national multi-sectoral NCD strategies and action plans based on available data and information from countries of sub-Saharan Africa and beyond. We estimated trends, from 1980 to 2014, in age-standardised mean body mass index (BMI) and diabetes prevalence in these countries in order to assess the co-progression and assist policy formulation.Methods: We pooled data from African and world-wide population-based studies which measured height, weight, and biomarkers to assess diabetes status in adults aged >18 years. A Bayesian hierarchical model was used to estimate trends, by sex, for 200 countries and territories including 53 countries across five African regions, (central, eastern, northern, southern and western) in mean BMI and diabetes prevalence (defined as either fasting plasma glucose of >7.0 mmol/L, history of diabetes diagnosis, or use of insulin or oral glucose control agents). ResultsAfrican data came from 245 population-based surveys (1.2 million participants) for BMI and 76 surveys (182 000 participants) for diabetes prevalence estimates. Countries with the highest number of data sources for BMI were South Africa (n=17), Nigeria (n=15) and Egypt (n=13); and for diabetes estimates, Tanzania (n=8), Tunisia (n=7), Cameroon, Egypt and South Africa (all n=6). The age-standardised mean BMI increased from 21.0 kg/m2 (95% credible interval: 20.3-21.7) to 23.0 kg/m2 (22.7-23.3) in men, and from 21.9 kg/m2 (21.3-22.5) to 24.9 kg/m2 (24.6-25.1) in women. The age-standardised prevalence of diabetes increased from 3.4% (1.5-6.3) to 8.5% (6.5-10.8) in men, and from 4.1% (2.0-7.5) to 8.9 % (6.9-11.2) in women. Estimates in northern and southern regions were mostly higher than the global average; those in central, eastern and western regions were lower than global averages. A positive association (correlation coefficient ≃0.9) was observed between mean BMI and diabetes prevalence

Journal article

Gibson R, Eriksen R, Lamb K, Mcmeel Y, Vergnaud A, Spear J, Aresu M, Chan Q, Elliott P, Frost Get al., 2017, Dietary assessment of British police force employees: a description of diet record coding procedures and cross-sectional evaluation of dietary energy intake reporting (the airwave health monitoring study), BMJ Open, Vol: 7, ISSN: 2044-6055

Objectives: Dietary intake is a key aspect of occupational health. To capture the characteristics of dietary behaviour that is affected by occupational environment that may impact on disease risk, collection of prospective multi-day dietary records are required. The aims of this paper are to: i) the collection of multi day dietary data in the Airwaves health monitoring study, ii) describe the dietarycoding procedures applied and iii) investigate the plausibilityof dietary reporting in this occupational cohort. Design: A dietary coding protocol for this large-scale studywas developed to minimise coding error rate. Participants (n4,412) who completed 7-day food records were included for cross-sectional analyses. Energy intake misreporting wasestimated using the Goldberg method. Multivariate logistic regression models were applied to determine participant characteristics associated with energy intake misreporting. Setting: British police force employees enrolled (2007 to 2012) into the Airwave Health Monitoring Study. Results: The mean code error rate per food diary was3.7% (SD 3.2%). The strongest predictors of energy intake under-reporting were body mass index (BMI) and physical activity. Compared to participants withBMI <25kg/m2, thosewith BMI >30kg/m2 had increased odds of being classified as under-reporting energy intake (men OR 5.20 95%CI 3.92, 6.89; women OR 2.66 95%CI 1.85, 3.83). Men and women in the highest physical activity category compared to the lowest were also more likely to be classified as under-reporting (men OR 3.33 95%CI 2.46, 4.50; women OR 4.34 95%CI 2.91, 6.55). Conclusions: A reproducible dietary record coding procedure has been developed to minimise coding error in complex 7-day diet diaries. The prevalence of energy intake under-reporting is comparable to existingnational UK cohortsand, in agreement with p

Journal article

Pertiwi K, Oude Griep LM, Stamler J, Chan Q, Geleijnse JM, Steffen LM, Rodriguez B, Daviglus ML, Van Horn L, Elliott Pet al., 2017, Relationship of potato consumption, total and by preparation method with blood pressure and body mass index: The International Population Study on Macronutrients and Blood Pressure (INTERMAP) US study, Scientific Sessions on Epidemiology and Prevention, Lifestyle and Cardiometabolic Health of the American Hearth Association, Publisher: American Heart Association, Pages: AP272-AP272, ISSN: 0009-7322

Background: Limited evidence from prospective US cohort studies suggests that higher potato intake is associated with a higher risk of hypertension and obesity. Different preparation methods affect the nutritional composition of potatoes and are related to different dietary choices that may influence associations with blood pressure and body mass index (BMI).Objective: To investigate potato consumption, total and by preparation method, in relation to blood pressure and BMI.Methods: We used cross-sectional data of 2,195 participants aged 40 to 59 in 1996-1997 from the United States samples of the population-based INTERMAP study. During four visits, four in-depth multipass 24-hour dietary recalls and eight blood pressure measurements were collected. Reported potato intakes were categorized as fried and non-fried potatoes, using the USDA food grouping system. Potato intakes (g/1000 kcal) were averaged over four days. Regression coefficients per 2SD higher intake were estimated using multivariate linear regression analyses with adjustments for age, sex, sample, lifestyle and disease factors, and other food groups. To assess influence on the association, diet quality (by Dietary Approaches to Stop Hypertension adherence score), BMI, urinary sodium and potassium were added separately to the previous model.Results: Median intake of total, non-fried, and fried potatoes were 40 g/d, 23 g/d and 8 g/d, respectively. Total and non-fried potato intakes were not associated with blood pressure. The association between fried potatoes and blood pressure varied by sex (P for interaction=0.03).In women, higher fried potato intake (2SD: 20 g/1000 kcal) was associated with a +3.00 mmHg (95%CI: 1.29, 4.71) higher systolic and +1.26 mmHg (95%CI: 0.15, 2.38) higher diastolic blood pressure, which prevailed after additional, but separate, adjustments for BMI, diet quality, urinary sodium and potassium. Potato chips contributed predominantly (79%) to fried potato intake and accounted for the

Conference paper

Kimani C, Kadota A, Miura K, Miyagawa N, Okuda N, Yoshita K, Sakurai M, Okayama A, Nakagawa H, Saitoh S, Sakata K, Rodriguez B, Masaki K, Chan Q, Elliott P, Stamler J, Ueshima Het al., 2017, Lifestyle Factors Related to the Difference in Serum Lipids Between Japanese -Americans in Hawaii and Japanese in Japan: the INTERLIPID Study, Scientific Sessions of the American-Heart-Association on Epidemiology and Prevention/Lifestyle and Cardiometabolic Health, Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0009-7322

Conference paper

Okami Y, Ueshima H, Nakamura Y, Okuda N, Nakagawa H, Sakata K, Saitoh S, Okayama A, Yoshita K, Miyagawa N, Choudhury SR, Chan Q, Elliott P, Stamler J, Miura Ket al., 2017, Reverse Causality of the Relationship Between Dietary Cholesterol and Serum Low Density Lipoprotein Cholesterol Associated With Education and Employment: the INTERLIPID Study, Scientific Sessions of the American-Heart-Association on Epidemiology and Prevention/Lifestyle and Cardiometabolic Health, Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0009-7322

Conference paper

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