The active cohort: a population-based smartphone intervention for health outcomes.

Background: The Clalit Active Cohort Study (CACS) assess the impact of lifestyle factors, particularly physical activity, on short- and long-term health outcomes using real-world data. Launched in January 2021, CACS focuses on Clalit Health Services members with supplemental health insurance who use the Clalit Active smartphone app.

Methods: The study integrates data from the Clalit Active app with electronic health records from CHS, covering primary and secondary care, hospitalizations, medications, laboratory results, and imaging.

Phenome-wide association of physical activity with morbidity and mortality risk in China: A prospective cohort study.

Research in high-income countries has established the health benefits of physical activity (PA), but evidence from low- and middle-income countries, including China, where PA patterns vary from those in high-income countries, remains limited. Moreover, previous research, mainly focused on specific diseases, failing to fully capture the health impacts of PA. We investigated the associations of PA with 425 distinct diseases and 53 causes of death using data from 511,088 participants aged 30-79 years in the China Kadoorie Biobank.

Prospective associations of diabetes with 15 cancers in 2.2 million UK and Chinese adults.

Background: Diabetes has been associated with the risk of numerous cancers but the causal relevance of many of these associations remains unclear.

Methods: We investigated associations between diabetes and risks of 15 cancers using Cox-regression and individual-level data from 2.2 million adults (334,978 incident cancer cases) in three prospective cohorts, UK Biobank (UKB), Million Women Study (MWS), and China Kadoorie Biobank (CKB).

Incorporation of Patient and Public Involvement in Statistical Methodology Research: Summary of Workshop Proceedings.

Patient and Public Involvement (PPI) is well-established in applied health research but remains under utilised in statistical methodology research due to perceived irrelevance and communication challenges. This paper summarises a one-day workshop held in February 2024 in Leicester, organised by the University of Leicester and the NIHR Statistics Group, aimed at addressing barriers to meaningful PPI in statistical methodology. The workshop brought together statisticians and experienced public contributors to discuss strategies, share case studies, and offer practical guidance on conducting effective PPI.

Predictive performance of wearable sensors for mortality risk in older adults: a model development and validation study.

Background: Many adults in high-income countries carry a device capable of measuring physical-activity behaviour. Thus, there is public health need to understand whether such data can enhance prediction of future health outcomes. We aimed to investigate whether device-measured daily-step count and walking cadence improve the prediction of mortality beyond traditional risk-factors.

GDF15 and its receptors as pathways mediating smoking related weight change.

Background: Smokers have lower body weight than non-smokers, while smoking cessation results in weight gain. Understanding the mechanisms involved can help identify potential therapeutic targets to enhance smoking cessation.

Methods: We measured plasma levels of growth/differentiation factor 15 (GDF15), a stress-responsive protein, and its two receptors (proto-oncogene tyrosine-protein kinase receptor Ret [RET], GDNF family receptor alpha-like [GFRAL]) among 3936 Chinese adults (mean BMI 24.

Corrigendum to Associations of reallocating sedentary leisure-time to alternative discretionary movement behaviours with incident cardiometabolic diseases in 0.5 million Chinese adults. The Lancet Regional Health-Western Pacific, Volume 57, 101524.

[This corrects the article DOI: 10.1016/j.lanwpc.

Proteome-Wide Genetic Study in East Asians and Europeans Identified Multiple Therapeutic Targets for Ischemic Stroke.

Background: Analyses of genomic and proteomics data in prospective biobank studies in diverse populations may discover novel or repurposing drug targets for stroke.

Methods: We extracted individual -protein quantitative trait locus for 2923 proteins measured using Olink Explore panel from a genome-wide association study in prospective China Kadoorie Biobank and UK Biobank, both established ≈20 years ago. These -protein quantitative trait loci were used in ancestry-specific 2-sample Mendelian randomization analyses of ischemic stroke (IS) in East Asians (n=22 664 cases) and Europeans (n=62 100 cases).

Causal Relevance of Lp(a) for Coronary Heart Disease and Stroke Types in East Asian and European Ancestry Populations: A Mendelian Randomization Study.

Background: Elevated plasma levels of Lp(a) [lipoprotein(a)] are a causal risk factor for coronary heart disease and stroke in European individuals, but the causal relevance of Lp(a) for different stroke types and in East Asian individuals with different Lp(a) genetic architecture is uncertain.

Methods: We measured plasma levels of Lp(a) in a nested case-control study of 18 174 adults (mean [SD] age, 57 [10] years; 49% female) in the China Kadoorie Biobank (CKB) and performed a genome-wide association analysis to identify genetic variants affecting Lp(a) levels, with replication in ancestry-specific subsets in UK Biobank. We further performed 2-sample Mendelian randomization analyses, associating ancestry-specific Lp(a)-associated instrumental variants derived from CKB or from published data in European individuals with risk of myocardial infarction (n=17 091), ischemic stroke (IS [n=29 233]) and its subtypes, or intracerebral hemorrhage (n=5845) in East Asian and European individuals using available data from CKB and genome-wide association analysis consortia.

Association of Daily Steps with Incident Nonalcoholic Fatty Liver Disease: Evidence from the UK Biobank Cohort.

Purpose: Low physical activity has been shown to be associated with a higher risk of nonalcoholic fatty liver disease (NAFLD). However, the strength and shape of this association are currently uncertain due to a reliance on self-reported physical activity measures. This report aims to investigate the relationship of median daily step count with NAFLD using accelerometer-derived step count from a large prospective cohort study.

Global evaluation of the impact of food fortification with folic acid on rates of schizophrenia.

Background: Low folate status is one of the multiple factors thought to contribute to the development of schizophrenia. As of 2023, over 70 countries have implemented mandatory fortification of foods with folic acid, a public health measure aimed at reducing neural tube defects; however, the impact of such policy on schizophrenia has not been comprehensively investigated.

Method: We assessed the impact of mandatory folic acid fortification on changes in the schizophrenia rates in 194 jurisdictions between 1990 and 2019 using publicly available data.

Associations of reallocating sedentary leisure-time to alternative discretionary movement behaviours with incident cardiometabolic diseases in 0.5 million Chinese adults.

Background: In Chinese adults, there is a considerable burden of sedentary behaviour. This study aimed to estimate the implications of reallocating sedentary leisure-time to non-sedentary behaviours for incident cardiometabolic diseases.

Methods: A prospective cohort study of 462,370 Chinese adults (mean age 51 years; 59% female) who were free from diabetes and cardiovascular diseases at baseline.

Trends in stroke incidence, death, and disability outcomes in a multi-ethnic population: Auckland regional community stroke studies (1981-2022).

Background: Reliable data on trends of stroke incidence and outcomes over time are necessary for assessing the effectiveness of public health and clinical strategies, and for allocating healthcare resources. We assessed the levels and trends in incidence, mortality, early case fatality and disability for stroke in a defined, ethnically mixed population over 40 years.

Methods: To analyse data from five population-based stroke incidence studies in adult residents (age ≥15 years) of the Greater Auckland Region of New Zealand (NZ) (1.

Mendelian randomization identifies proteins involved in neurodegenerative diseases.

Proteins are involved in multiple biological functions. High-throughput technologies have allowed the measurement of thousands of proteins in population biobanks. In this study, we aimed to identify proteins related to Alzheimer's disease, Parkinson's disease, multiple sclerosis and amyotrophic lateral sclerosis by leveraging large-scale genetic and proteomic data.

Comparative studies of 2168 plasma proteins measured by two affinity-based platforms in 4000 Chinese adults.

Proteomics offers unique insights into human biology and drug development, but few studies have directly compared the utility of different proteomics platforms. We measured plasma levels of 2168 proteins in 3976 Chinese adults using both Olink Explore and SomaScan platforms. The correlation of protein levels between platforms was modest (median rho = 0.

Associations of total, domain-specific, and intensity-specific physical activity with all-cause and cause-specific mortality in China: A population-based cohort study.

Background: Evidence of an association between physical activity (PA) and mortality has mainly focused on leisure-time physical activity (LTPA) and moderate-to-vigorous-intensity physical activity (MVPA). We aimed to assess the associations of total, domain-specific, and intensity-specific PA with all-cause and cause-specific mortality.

Methods: We used baseline PA data from the China Kadoorie Biobank, including 482,067 participants aged 30-79 years from 10 areas in China.

Normal-weight obesity subtypes and 10-year risks of major vascular diseases in 0.3 million adults.

Background & Aims: Obesity directly contributes to the progression of cardiovascular disease, but little is known about the association and risk attribution of normal-weight obesity subtypes with the incidence of major vascular events (MVEs) and their subtypes.

Methods: This is a prospective cohort study based on the China Kadoorie Biobank (CKB). A total of 308,071 individuals with no prior vascular diseases or cancer were included at baseline.

Risk prediction of ischemic heart disease using plasma proteomics, conventional risk factors and polygenic scores in Chinese and European adults.

Plasma proteomics could enhance risk prediction for multiple diseases beyond conventional risk factors or polygenic scores (PS). To assess utility of proteomics for risk prediction of ischemic heart disease (IHD) compared with conventional risk factors and PS in Chinese and European populations. A nested case-cohort study measured plasma levels of 2923 proteins using Olink Explore panel in ~ 4000 Chinese adults (1976 incident IHD cases and 2001 sub-cohort controls).

Nepal Family Cohort study: a study protocol.

Introduction: The Nepal Family Cohort study uses a life course epidemiological approach to collect comprehensive data on children's and their parents' environmental, behavioural and metabolic risk factors. These factors can affect the overall development of children to adulthood and the onset of specific diseases. Among the many risk factors, exposure to air pollution and lifestyle factors during childhood may impact lung development and function, leading to the early onset of respiratory diseases.

Proteo-genomic analyses in relatively lean Chinese adults identify proteins and pathways that affect general and central adiposity levels.

Adiposity is an established risk factor for multiple diseases, but the causal relationships of different adiposity types with circulating protein biomarkers have not been systematically investigated. We examine the causal associations of general and central adiposity with 2923 plasma proteins among 3977 Chinese adults (mean BMI = 23.9 kg/m²).

Daily steps are a predictor of, but perhaps not a modifiable risk factor for Parkinson's Disease: findings from the UK Biobank.

Importance: Higher physical activity levels have been suggested as a potential modifiable risk factor for lowering the risk of incident Parkinson's disease (PD). This study uses objective measures of physical activity to investigate the role of reverse causation in the observed association.

Objective: To investigate the association between accelerometer-derived daily step count and incident PD, and to assess the impact of reverse causation on this association.

Demographic disparities in the incidence and case fatality of subarachnoid haemorrhage: an 18-year nationwide study from New Zealand.

Background: Although the incidence and case-fatality of subarachnoid haemorrhage (SAH) vary within countries, few countries have reported nationwide rates, especially for multi-ethnic populations. We assessed the nationwide incidence and case-fatality of SAH in New Zealand (NZ) and explored variations by sex, district, ethnicity and time.

Methods: We used administrative health data from the national hospital discharge and cause-of-death collections to identify hospitalised and fatal non-hospitalised aneurysmal SAHs in NZ between 2001 and 2018.

Measured and genetically predicted protein levels and cardiovascular diseases in UK Biobank and China Kadoorie Biobank.

Several large-scale studies have measured plasma levels of the proteome in individuals with cardiovascular diseases (CVDs). However, since the majority of such proteins are interrelated, it is difficult for observational studies to distinguish which proteins are likely to be of etiological relevance. Here we evaluate whether plasma levels of 2,919 proteins measured in 52,164 UK Biobank participants are associated with incident myocardial infarction, ischemic stroke or heart failure.