Background-Sudden cardiac death (SCD) is a major clinical and public health problem. Methods and ... more Background-Sudden cardiac death (SCD) is a major clinical and public health problem. Methods and Results-United States (US) vital statistics mortality data from 1989 to 1998 were analyzed. SCD is defined as deaths occurring out of the hospital or in the emergency room or as "dead on arrival" with an underlying cause of death reported as a cardiac disease (ICD-9 code 390 to 398, 402, or 404 to 429). Death rates were calculated for residents of the US aged Ն35 years and standardized to the 2000 US population. Of 719 456 cardiac deaths among adults aged Ն35 years in 1998, 456 076 (63%) were defined as SCD. Among decedents aged 35 to 44 years, 74% of cardiac deaths were SCD. Of all SCDs in 1998, coronary heart disease (ICD-9 codes 410 to 414) was the underlying cause on 62% of death certificates. Death rates for SCD increased with age and were higher in men than women, although there was no difference at age Ն85 years. The black population had higher death rates for SCD than white, American Indian/Alaska Native, or Asian/Pacific Islander populations. The Hispanic population had lower death rates for SCD than the non-Hispanic population. From 1989 to 1998, SCD, as the proportion of all cardiac deaths, increased 12.4% (56.3% to 63.9%), and age-adjusted SCD rates declined 11.7% in men and 5.8% in women. During the same time, age-specific death rates for SCD increased 21% among women aged 35 to 44 years. Conclusions-SCD remains an important public health problem in the US. The increase in death rates for SCD among younger women warrants additional investigation.
Journal of the American College of Cardiology, 2004
We sought to determine the annual incidence of sudden cardiac death (SCD) in the general populati... more We sought to determine the annual incidence of sudden cardiac death (SCD) in the general population using a prospective approach. To assess the validity of retrospective surveillance, a simultaneous comparison was made with a death certificate-based method of determining SCD incidence. BACKGROUND Accurate surveillance and characterization of SCD in the general population is likely to significantly facilitate current and future community-based preventive and therapeutic interventions.
Between 1989 and 1998 there was a 21% increase in estimated sudden cardiac death among US women a... more Between 1989 and 1998 there was a 21% increase in estimated sudden cardiac death among US women aged 35 to 44 years. In contrast, the sudden cardiac death rate in age-matched men showed a decreasing trend (-2.8%). Due to under-representation of younger adults in published autopsy series, etiologies of sudden cardiac death merit further investigation. We reviewed autopsy and detailed cardiac pathologic findings in younger women (age 35-44 years) from a 270-patient, 13-year (1984-1996) autopsy series of sudden cardiac death, and performed comparisons with findings in age-matched men. Women aged 35 to 44 years constituted 32% of all women in the series compared to men, who constituted 24% of total men (P =.004 vs women). A presumptive cause of sudden cardiac death could not be determined in 13 women (50%). Among women, 6 cases (22%) had significant coronary artery disease. Findings in others included coronary artery anomalies (n = 3), myocarditis (n = 2), hypertrophic cardiomyopathy (n = 1), coronary artery dissection (n = 1) and accessory pathway (n = 1). In younger men, a presumptive cause of sudden cardiac death remained undetermined in only 24% (P =.025 vs younger women), and coronary artery disease accounted for 40% of cases. In younger women, despite autopsy and detailed cardiac pathologic examination, an attributable cause of sudden cardiac death was not determined in 50% of cases; a 2-fold increase compared to men of the same age. Given the dynamic and multifactorial nature of sudden cardiac death, comprehensive population-based investigations are likely to be necessary to further investigate this unexpected sex-based disparity.
Heart attacks are more prevalent among Hispanics and Blacks than among Whites. Bystanders must be... more Heart attacks are more prevalent among Hispanics and Blacks than among Whites. Bystanders must be able to recognize heart attack symptoms and activate the emergency response system in order to receive time-dependent therapies that increase survival. This study estimated racial/ethnic disparities in awareness of heart attack symptoms in a sample of the US population. We evaluated data from 33,059 adult participants in the 2001 National Health Interview Survey. Respondents indicated their awareness of five heart attack symptoms and the need to call 911 in the presence of such symptoms. Hispanics and Blacks were less likely to recognize each heart attack symptom than were Whites (P<.05). Hispanics (25.6%), people aged 18-24 years (33.6%), men (39.1%), and those with less than a high school education (31.3%) were less likely to recognize all five heart attack symptoms and report that they would call 911 than were Whites (45.8%), Blacks (36.1%), respondents aged 45-64 years (47.7%) an...
Within-person and methodological variability of a given analyte are important elements in determi... more Within-person and methodological variability of a given analyte are important elements in determining whether an individual has altered concentrations of that analyte. We report the short-term (1 month) within-person, between-person, and methodological variability of plasma homocysteine in 20 healthy participants from whom samples were drawn weekly for 4 weeks. The short-term between-person variance was high, whereas within-person and methodological variances were relatively very low, giving a high reliability coefficient (R) for homocysteine (R = 0.94). The long-term (30 months) reliability coefficient was 0.65, but was greatly influenced by an outlier (R = 0.82 with the outlier excluded). The data suggest that an individual's plasma homocysteine concentration is relatively constant over at least 1 month, and a single measurement characterizes the average concentration reasonably well.
Background and Purpose-Rapid and accurate evaluation of stroke subtypes is crucial for optimal tr... more Background and Purpose-Rapid and accurate evaluation of stroke subtypes is crucial for optimal treatment and outcomes. This study assessed factors associated with the likelihood of an "ill-defined" diagnosis for stroke hospitalizations.
Reliable and timely information on the leading causes of death in populations, and how these are ... more Reliable and timely information on the leading causes of death in populations, and how these are changing, is a crucial input into health policy debates. In the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), we aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex. We attempted to identify all available data on causes of death for 187 countries from 1980 to 2010 from vital registration, verbal autopsy, mortality surveillance, censuses, surveys, hospitals, police records, and mortuaries. We assessed data quality for completeness, diagnostic accuracy, missing data, stochastic variations, and probable causes of death. We applied six different modelling strategies to estimate cause-specific mortality trends depending on the strength of the data. For 133 causes and three special aggregates we used the Cause of Death Ensemble model (CODEm) approach, which uses four families of statistical models testing a large set of different models using different permutations of covariates. Model ensembles were developed from these component models. We assessed model performance with rigorous out-of-sample testing of prediction error and the validity of 95% UIs. For 13 causes with low observed numbers of deaths, we developed negative binomial models with plausible covariates. For 27 causes for which death is rare, we modelled the higher level cause in the cause hierarchy of the GBD 2010 and then allocated deaths across component causes proportionately, estimated from all available data in the database. For selected causes (African trypanosomiasis, congenital syphilis, whooping cough, measles, typhoid and parathyroid, leishmaniasis, acute hepatitis E, and HIV/AIDS), we used natural history models based on information on incidence, prevalence, and case-fatality. We separately estimated cause fractions by aetiology for diarrhoea, lower respiratory infections, and meningitis, as well as disaggregations by subcause for chronic kidney disease, maternal disorders, cirrhosis, and liver cancer. For deaths due to collective violence and natural disasters, we used mortality shock regressions. For every cause, we estimated 95% UIs that captured both parameter estimation uncertainty and uncertainty due to model specification where CODEm was used. We constrained cause-specific fractions within every age-sex group to sum to total mortality based on draws from the uncertainty distributions. In 2010, there were 52·8 million deaths globally. At the most aggregate level, communicable, maternal, neonatal, and nutritional causes were 24·9% of deaths worldwide in 2010, down from 15·9 million (34·1%) of 46·5 million in 1990. This decrease was largely due to decreases in mortality from diarrhoeal disease (from 2·5 to 1·4 million), lower respiratory infections (from 3·4 to 2·8 million), neonatal disorders (from 3·1 to 2·2 million), measles (from 0·63 to 0·13 million), and tetanus (from 0·27 to 0·06 million). Deaths from HIV/AIDS increased from 0·30 million in 1990 to 1·5 million in 2010, reaching a peak of 1·7 million in 2006. Malaria mortality also rose by an estimated 19·9% since 1990 to 1·17 million deaths in 2010. Tuberculosis killed 1·2 million people in 2010. Deaths from non-communicable diseases rose by just under 8 million between 1990 and 2010, accounting for two of every three deaths (34·5 million) worldwide by 2010. 8 million people died from cancer in 2010, 38% more than two decades ago; of these, 1·5 million (19%) were from trachea, bronchus, and lung cancer. Ischaemic heart disease and stroke collectively killed 12·9 million people in 2010, or one in four deaths worldwide, compared with one in five in 1990; 1·3 million deaths were due to diabetes, twice as many as in 1990. The fraction of global deaths due to injuries (5·1 million deaths) was marginally higher in 2010 (9·6%) compared with two decades earlier (8·8%). This was driven by a 46% rise in deaths worldwide due to road traffic accidents (1·3 million in 2010) and a rise in deaths from falls. Ischaemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, lung cancer, and HIV/AIDS were the leading causes of death in 2010. Ischaemic heart disease, lower respiratory infections, stroke, diarrhoeal disease, malaria, and HIV/AIDS were the leading causes of years of life lost due to premature mortality (YLLs) in 2010, similar to what was estimated for 1990, except for HIV/AIDS and preterm birth complications. YLLs from lower respiratory infections and diarrhoea decreased by 45-54% since 1990; ischaemic heart disease and stroke YLLs increased by 17-28%. Regional variations in leading causes of death were substantial. Communicable, maternal, neonatal, and nutritional causes still accounted for 76% of premature mortality in sub-Saharan Africa in 2010. Age standardised death rates from some key disorders rose…
Although human studies have failed to reveal an increased risk of clinical cardiovascular disease... more Although human studies have failed to reveal an increased risk of clinical cardiovascular disease in men who undergo vasectomy, the possibility exists that an association may be detectable only after a long followup, or it may be more evident for subclinical than clinical disease. We assessed the association of vasectomy with inflammation and coagulation factors, carotid intimal-medial thickness, carotid plaque, prevalent peripheral arterial disease, and incident coronary heart disease and stroke in the Atherosclerosis Risk in Communities cohort. Included in the study were 3,957 white men 45 to 64 years old who were free of coronary heart disease at the Atherosclerosis Risk in Communities (ARIC) baseline examination in 1987 to 1989. Data on vasectomy was collected at baseline by self-reporting. High resolution B-mode ultrasound was done to assess carotid intimal-medial thickness and carotid plaque. The cohort was followed an average of 9 years for incident cardiovascular events. Average time since vasectomy was 16 years. Approximately 20% of the population had undergone vasectomy 20 years or more ago at baseline. Multivariate analysis showed no association of vasectomy status with inflammation or coagulation factors, peripheral arterial disease, carotid plaque, carotid far wall thickness, incident coronary heart disease or stroke. Associations were unaffected by the time since vasectomy. There is no evidence in this population based sample of men indicating that vasectomy is related to atherosclerosis even after more than 20 years of followup.
Journal of Pharmaceutical and Biomedical Analysis, 2011
In this study, a sensitive and robust ultraperformance liquid chromatography-tandem mass spectrom... more In this study, a sensitive and robust ultraperformance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed, validated, and applied to determine gender-dependent pharmacokinetics of total emodin (aglycone + glucuronide) in male and female Sprague-Dawley rats. The lower limit of quantification for emodin and emodin glucuronide in rat plasma was 39 and 78 ng/ml, with signal-to-noise ratio of ≥10. Precision and accuracy studies showed emodin and emodin glucuronide plasma concentrations well within the 10% range in all studies. Plasma recovery of emodin and emodin glucuronide was always above 86% for low (emodin: 39 ng/ml; glucuronide: 78 ng/ml), 92% for medium (625 ng/ml), and 97% for high (10 000 ng/ml) concentrations. Furthermore, emodin showed more than 95% plasma stability under short-term and long-term storage conditions, as well as after three freeze-thaw cycles in the experiments. The developed and validated analytical method was successfully applied to study the gender-dependent 10-fold higher oral bioavailability of total emodin in male than female rats. The oral bioavailability of emodin and emodin glucuronide was also measured separately and showed a statistically significant gender difference in oral bioavailability of emodin and emodin glucuronide in rats.
Recommendation 5: Develop high throughput strategies to efficiently establish the functional rele... more Recommendation 5: Develop high throughput strategies to efficiently establish the functional relevance of newly discovered genetic information.
Background-Sudden cardiac death (SCD) is a major clinical and public health problem. Methods and ... more Background-Sudden cardiac death (SCD) is a major clinical and public health problem. Methods and Results-United States (US) vital statistics mortality data from 1989 to 1998 were analyzed. SCD is defined as deaths occurring out of the hospital or in the emergency room or as "dead on arrival" with an underlying cause of death reported as a cardiac disease (ICD-9 code 390 to 398, 402, or 404 to 429). Death rates were calculated for residents of the US aged Ն35 years and standardized to the 2000 US population. Of 719 456 cardiac deaths among adults aged Ն35 years in 1998, 456 076 (63%) were defined as SCD. Among decedents aged 35 to 44 years, 74% of cardiac deaths were SCD. Of all SCDs in 1998, coronary heart disease (ICD-9 codes 410 to 414) was the underlying cause on 62% of death certificates. Death rates for SCD increased with age and were higher in men than women, although there was no difference at age Ն85 years. The black population had higher death rates for SCD than white, American Indian/Alaska Native, or Asian/Pacific Islander populations. The Hispanic population had lower death rates for SCD than the non-Hispanic population. From 1989 to 1998, SCD, as the proportion of all cardiac deaths, increased 12.4% (56.3% to 63.9%), and age-adjusted SCD rates declined 11.7% in men and 5.8% in women. During the same time, age-specific death rates for SCD increased 21% among women aged 35 to 44 years. Conclusions-SCD remains an important public health problem in the US. The increase in death rates for SCD among younger women warrants additional investigation.
Journal of the American College of Cardiology, 2004
We sought to determine the annual incidence of sudden cardiac death (SCD) in the general populati... more We sought to determine the annual incidence of sudden cardiac death (SCD) in the general population using a prospective approach. To assess the validity of retrospective surveillance, a simultaneous comparison was made with a death certificate-based method of determining SCD incidence. BACKGROUND Accurate surveillance and characterization of SCD in the general population is likely to significantly facilitate current and future community-based preventive and therapeutic interventions.
Between 1989 and 1998 there was a 21% increase in estimated sudden cardiac death among US women a... more Between 1989 and 1998 there was a 21% increase in estimated sudden cardiac death among US women aged 35 to 44 years. In contrast, the sudden cardiac death rate in age-matched men showed a decreasing trend (-2.8%). Due to under-representation of younger adults in published autopsy series, etiologies of sudden cardiac death merit further investigation. We reviewed autopsy and detailed cardiac pathologic findings in younger women (age 35-44 years) from a 270-patient, 13-year (1984-1996) autopsy series of sudden cardiac death, and performed comparisons with findings in age-matched men. Women aged 35 to 44 years constituted 32% of all women in the series compared to men, who constituted 24% of total men (P =.004 vs women). A presumptive cause of sudden cardiac death could not be determined in 13 women (50%). Among women, 6 cases (22%) had significant coronary artery disease. Findings in others included coronary artery anomalies (n = 3), myocarditis (n = 2), hypertrophic cardiomyopathy (n = 1), coronary artery dissection (n = 1) and accessory pathway (n = 1). In younger men, a presumptive cause of sudden cardiac death remained undetermined in only 24% (P =.025 vs younger women), and coronary artery disease accounted for 40% of cases. In younger women, despite autopsy and detailed cardiac pathologic examination, an attributable cause of sudden cardiac death was not determined in 50% of cases; a 2-fold increase compared to men of the same age. Given the dynamic and multifactorial nature of sudden cardiac death, comprehensive population-based investigations are likely to be necessary to further investigate this unexpected sex-based disparity.
Heart attacks are more prevalent among Hispanics and Blacks than among Whites. Bystanders must be... more Heart attacks are more prevalent among Hispanics and Blacks than among Whites. Bystanders must be able to recognize heart attack symptoms and activate the emergency response system in order to receive time-dependent therapies that increase survival. This study estimated racial/ethnic disparities in awareness of heart attack symptoms in a sample of the US population. We evaluated data from 33,059 adult participants in the 2001 National Health Interview Survey. Respondents indicated their awareness of five heart attack symptoms and the need to call 911 in the presence of such symptoms. Hispanics and Blacks were less likely to recognize each heart attack symptom than were Whites (P<.05). Hispanics (25.6%), people aged 18-24 years (33.6%), men (39.1%), and those with less than a high school education (31.3%) were less likely to recognize all five heart attack symptoms and report that they would call 911 than were Whites (45.8%), Blacks (36.1%), respondents aged 45-64 years (47.7%) an...
Within-person and methodological variability of a given analyte are important elements in determi... more Within-person and methodological variability of a given analyte are important elements in determining whether an individual has altered concentrations of that analyte. We report the short-term (1 month) within-person, between-person, and methodological variability of plasma homocysteine in 20 healthy participants from whom samples were drawn weekly for 4 weeks. The short-term between-person variance was high, whereas within-person and methodological variances were relatively very low, giving a high reliability coefficient (R) for homocysteine (R = 0.94). The long-term (30 months) reliability coefficient was 0.65, but was greatly influenced by an outlier (R = 0.82 with the outlier excluded). The data suggest that an individual's plasma homocysteine concentration is relatively constant over at least 1 month, and a single measurement characterizes the average concentration reasonably well.
Background and Purpose-Rapid and accurate evaluation of stroke subtypes is crucial for optimal tr... more Background and Purpose-Rapid and accurate evaluation of stroke subtypes is crucial for optimal treatment and outcomes. This study assessed factors associated with the likelihood of an "ill-defined" diagnosis for stroke hospitalizations.
Reliable and timely information on the leading causes of death in populations, and how these are ... more Reliable and timely information on the leading causes of death in populations, and how these are changing, is a crucial input into health policy debates. In the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010), we aimed to estimate annual deaths for the world and 21 regions between 1980 and 2010 for 235 causes, with uncertainty intervals (UIs), separately by age and sex. We attempted to identify all available data on causes of death for 187 countries from 1980 to 2010 from vital registration, verbal autopsy, mortality surveillance, censuses, surveys, hospitals, police records, and mortuaries. We assessed data quality for completeness, diagnostic accuracy, missing data, stochastic variations, and probable causes of death. We applied six different modelling strategies to estimate cause-specific mortality trends depending on the strength of the data. For 133 causes and three special aggregates we used the Cause of Death Ensemble model (CODEm) approach, which uses four families of statistical models testing a large set of different models using different permutations of covariates. Model ensembles were developed from these component models. We assessed model performance with rigorous out-of-sample testing of prediction error and the validity of 95% UIs. For 13 causes with low observed numbers of deaths, we developed negative binomial models with plausible covariates. For 27 causes for which death is rare, we modelled the higher level cause in the cause hierarchy of the GBD 2010 and then allocated deaths across component causes proportionately, estimated from all available data in the database. For selected causes (African trypanosomiasis, congenital syphilis, whooping cough, measles, typhoid and parathyroid, leishmaniasis, acute hepatitis E, and HIV/AIDS), we used natural history models based on information on incidence, prevalence, and case-fatality. We separately estimated cause fractions by aetiology for diarrhoea, lower respiratory infections, and meningitis, as well as disaggregations by subcause for chronic kidney disease, maternal disorders, cirrhosis, and liver cancer. For deaths due to collective violence and natural disasters, we used mortality shock regressions. For every cause, we estimated 95% UIs that captured both parameter estimation uncertainty and uncertainty due to model specification where CODEm was used. We constrained cause-specific fractions within every age-sex group to sum to total mortality based on draws from the uncertainty distributions. In 2010, there were 52·8 million deaths globally. At the most aggregate level, communicable, maternal, neonatal, and nutritional causes were 24·9% of deaths worldwide in 2010, down from 15·9 million (34·1%) of 46·5 million in 1990. This decrease was largely due to decreases in mortality from diarrhoeal disease (from 2·5 to 1·4 million), lower respiratory infections (from 3·4 to 2·8 million), neonatal disorders (from 3·1 to 2·2 million), measles (from 0·63 to 0·13 million), and tetanus (from 0·27 to 0·06 million). Deaths from HIV/AIDS increased from 0·30 million in 1990 to 1·5 million in 2010, reaching a peak of 1·7 million in 2006. Malaria mortality also rose by an estimated 19·9% since 1990 to 1·17 million deaths in 2010. Tuberculosis killed 1·2 million people in 2010. Deaths from non-communicable diseases rose by just under 8 million between 1990 and 2010, accounting for two of every three deaths (34·5 million) worldwide by 2010. 8 million people died from cancer in 2010, 38% more than two decades ago; of these, 1·5 million (19%) were from trachea, bronchus, and lung cancer. Ischaemic heart disease and stroke collectively killed 12·9 million people in 2010, or one in four deaths worldwide, compared with one in five in 1990; 1·3 million deaths were due to diabetes, twice as many as in 1990. The fraction of global deaths due to injuries (5·1 million deaths) was marginally higher in 2010 (9·6%) compared with two decades earlier (8·8%). This was driven by a 46% rise in deaths worldwide due to road traffic accidents (1·3 million in 2010) and a rise in deaths from falls. Ischaemic heart disease, stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, lung cancer, and HIV/AIDS were the leading causes of death in 2010. Ischaemic heart disease, lower respiratory infections, stroke, diarrhoeal disease, malaria, and HIV/AIDS were the leading causes of years of life lost due to premature mortality (YLLs) in 2010, similar to what was estimated for 1990, except for HIV/AIDS and preterm birth complications. YLLs from lower respiratory infections and diarrhoea decreased by 45-54% since 1990; ischaemic heart disease and stroke YLLs increased by 17-28%. Regional variations in leading causes of death were substantial. Communicable, maternal, neonatal, and nutritional causes still accounted for 76% of premature mortality in sub-Saharan Africa in 2010. Age standardised death rates from some key disorders rose…
Although human studies have failed to reveal an increased risk of clinical cardiovascular disease... more Although human studies have failed to reveal an increased risk of clinical cardiovascular disease in men who undergo vasectomy, the possibility exists that an association may be detectable only after a long followup, or it may be more evident for subclinical than clinical disease. We assessed the association of vasectomy with inflammation and coagulation factors, carotid intimal-medial thickness, carotid plaque, prevalent peripheral arterial disease, and incident coronary heart disease and stroke in the Atherosclerosis Risk in Communities cohort. Included in the study were 3,957 white men 45 to 64 years old who were free of coronary heart disease at the Atherosclerosis Risk in Communities (ARIC) baseline examination in 1987 to 1989. Data on vasectomy was collected at baseline by self-reporting. High resolution B-mode ultrasound was done to assess carotid intimal-medial thickness and carotid plaque. The cohort was followed an average of 9 years for incident cardiovascular events. Average time since vasectomy was 16 years. Approximately 20% of the population had undergone vasectomy 20 years or more ago at baseline. Multivariate analysis showed no association of vasectomy status with inflammation or coagulation factors, peripheral arterial disease, carotid plaque, carotid far wall thickness, incident coronary heart disease or stroke. Associations were unaffected by the time since vasectomy. There is no evidence in this population based sample of men indicating that vasectomy is related to atherosclerosis even after more than 20 years of followup.
Journal of Pharmaceutical and Biomedical Analysis, 2011
In this study, a sensitive and robust ultraperformance liquid chromatography-tandem mass spectrom... more In this study, a sensitive and robust ultraperformance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method was developed, validated, and applied to determine gender-dependent pharmacokinetics of total emodin (aglycone + glucuronide) in male and female Sprague-Dawley rats. The lower limit of quantification for emodin and emodin glucuronide in rat plasma was 39 and 78 ng/ml, with signal-to-noise ratio of ≥10. Precision and accuracy studies showed emodin and emodin glucuronide plasma concentrations well within the 10% range in all studies. Plasma recovery of emodin and emodin glucuronide was always above 86% for low (emodin: 39 ng/ml; glucuronide: 78 ng/ml), 92% for medium (625 ng/ml), and 97% for high (10 000 ng/ml) concentrations. Furthermore, emodin showed more than 95% plasma stability under short-term and long-term storage conditions, as well as after three freeze-thaw cycles in the experiments. The developed and validated analytical method was successfully applied to study the gender-dependent 10-fold higher oral bioavailability of total emodin in male than female rats. The oral bioavailability of emodin and emodin glucuronide was also measured separately and showed a statistically significant gender difference in oral bioavailability of emodin and emodin glucuronide in rats.
Recommendation 5: Develop high throughput strategies to efficiently establish the functional rele... more Recommendation 5: Develop high throughput strategies to efficiently establish the functional relevance of newly discovered genetic information.
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