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1. Acute diverticulitis in immunocompromised patients: evidence from an international multicenter observational registry (Web-based International Register of Emergency Surgery and Trauma, Wires-T)

Author

Tartaglia, D., Cremonini, C., Annunziata, E., Catena, F., Sartelli, M., Kirkpatrick, A. W., Musetti, S., Strambi, S., Chiarugi, M., Coccolini, F., Salvetti, F., Fugazzola, P., Ceresoli, M., Benedetti, F., Elisa, N. G., Litvin, A., Lostoridis, E., Ahmed, A. Y. Y. M., Manatakis, D., Negoi, I., Ioannidis, O., Uzunoglu, M. Y., Tochie, J. N., Cillara, N., Tomadze, G., Bala, M., Isik, A., Fonseca, V. C., Bellanova, G., Ghannam, W., Yalkin, O., Garcia, F. H., Altintoprak, F., Hadzhiev, D., Chirica, M., Zese, M., Balalis, D., Cui, Y., Luppi, D., Romeo, L., Muratore, A., Lunghi, E. G., Yovtchev, Y., Dimitrov, E., Nikolopoulos, I., Omerovic, M., Zizzo, M., Ugoletti, L., Costa, G., Scalzone, R., Perrone, S., Occhionorelli, S., Nardi, M., Gubbiotti, F., Muhtaroglu, A., Scaramuzzo, R., Corte, H., Yanez, C., Zakaria, A. D., Seretis, C., Gelmini, R., Pappalardo, V., Paratore, F., Sydorchuk, R., Mulita, F., Kara, Y., Toma, E. A., Vailas, M., Sotiropoulou, M., Elbahnasawy, M., Sibilla, M. G., Martines, G., Goksoy, B., Parini, D., Zaghi, C., Podda, M., Osipov, A., Brisinda, G., Gambino, G., Doklestic, L. A. K., Loncar, Z., Micic, D., Lesevic, I., D'Agostino, F., Garzali, I. U., Caicedo, Y., Marcela, L., Marin, P. A. G., Perivoliotis, K., Ntentas, I., Kuptsov, A., Chowdhury, S., Patel, T., Tartaglia, D, Cremonini, C, Annunziata, E, Catena, F, Sartelli, M, Kirkpatrick, A, Musetti, S, Strambi, S, Chiarugi, M, Coccolini, F, Salvetti, F, Fugazzola, P, Ceresoli, M, Benedetti, F, Elisa, N, Litvin, A, Lostoridis, E, Ahmed, A, Manatakis, D, Negoi, I, Ioannidis, O, Uzunoglu, M, Tochie, J, Cillara, N, Tomadze, G, Bala, M, Isik, A, Fonseca, V, Bellanova, G, Ghannam, W, Yalkin, O, Garcia, F, Altintoprak, F, Hadzhiev, D, Chirica, M, Zese, M, Balalis, D, Cui, Y, Luppi, D, Romeo, L, Muratore, A, Lunghi, E, Yovtchev, Y, Dimitrov, E, Nikolopoulos, I, Omerovic, M, Zizzo, M, Ugoletti, L, Costa, G, Scalzone, R, Perrone, S, Occhionorelli, S, Nardi, M, Gubbiotti, F, Muhtaroglu, A, Scaramuzzo, R, Corte, H, Yanez, C, Zakaria, A, Seretis, C, Gelmini, R, Pappalardo, V, Paratore, F, Sydorchuk, R, Mulita, F, Kara, Y, Toma, E, Vailas, M, Sotiropoulou, M, Elbahnasawy, M, Sibilla, M, Martines, G, Goksoy, B, Parini, D, Zaghi, C, Podda, M, Osipov, A, Brisinda, G, Gambino, G, Doklestic, L, Loncar, Z, Micic, D, Lesevic, I, D'Agostino, F, Garzali, I, Caicedo, Y, Marcela, L, Marin, P, Perivoliotis, K, Ntentas, I, Kuptsov, A, Chowdhury, S, and Patel, T

Subjects
Medical therapy, Acute diverticuliti, Gastroenterology, Acute diverticulitis, Surgery, Immunocompromised
Abstract

Background Immunocompromised patients with acute diverticulitis are at increased risk of morbidity and mortality. The aim of this study was to compare clinical presentations, types of treatment, and outcomes between immunocompromised and immunocompetent patients with acute diverticulitis. Methods We compared the data of patients with acute diverticulitis extracted from the Web-based International Registry of Emergency Surgery and Trauma (WIRES-T) from January 2018 to December 2021. First, two groups were identified: medical therapy (A) and surgical therapy (B). Each group was divided into three subgroups: nonimmunocompromised (grade 0), mildly to moderately (grade 1), and severely immunocompromised (grade 2). Results Data from 482 patients were analyzed—229 patients (47.5%) [M:F = 1:1; median age: 60 (24–95) years] in group A and 253 patients (52.5%) [M:F = 1:1; median age: 71 (26–94) years] in group B. There was a significant difference between the two groups in grade distribution: 69.9% versus 38.3% for grade 0, 26.6% versus 51% for grade 1, and 3.5% versus 10.7% for grade 2 (p p = 0.027) was more common in higher grades of immunodeficiency. Patients with grade 2 needed longer hospitalization (p = 0.005). In group B, a similar condition was found in terms of severe sepsis (p = 0.002), quick Sequential Organ Failure Assessment score > 2 (p = 0.0002), and Mannheim Peritonitis Index (p = 0.010). A Hartmann’s procedure is mainly performed in grades 1–2 (p p = 0.047). Mortality was higher in the immunocompromised patients (p = 0.002). Conclusions Immunocompromised patients with acute diverticulitis present with a more severe clinical picture. When surgery is required, immunocompromised patients mainly undergo a Hartmann’s procedure. Postoperative morbidity and mortality are, however, higher in immunocompromised patients, who also require a longer hospital stay.

Published
2023

2. Colorectal neoplastic emergencies in immunocompromised patients: preliminary result from the Web-based International Register of Emergency Surgery and Trauma (WIRES-T trial)

Author

Coccolini F., Mazzoni A., Cremonini C., Cobuccio L., Pucciarelli M., Vetere G., Borelli B., Strambi S., Musetti S., Miccoli M., Cremolini C., Salvetti F., Fugazzola P., Ceresoli M., Elisa N. G., Litvin A., Lostoridis E., Ahmed A. Y. Y. M., Manatakis D., Negoi I., Ioannidis O., Uzunoglu M. Y., Tochie J. N., Cillara N., Tomadze G., Bala M., Isik A., Fonseca V. C., Bellanova G., Ghannam W., Yalkin O., Garcia F. H., Altintoprak F., Hadzhiev D., Chirica M., Zese M., Balalis D., Cui Y., Luppi D., Romeo L., Muratore A., Lunghi E. G., Yovtchev Y., Nikolopoulos I., Omerovic M., Zizzo M., Ugoletti L., Costa G., Scalzone R., Perrone S., Occhionorelli S., Nardi M., Gubbiotti F., Catena F., Muhtaroglu A., Scaramuzzo R., Corte H., Yanez C., Zakaria A. D., Seretis C., Gelmini R., Pappalardo V., Paratore F., Sydorchuk R., Mulita F., Kara Y., Toma E. A., Vailas M., Sotiropoulou M., Benedetti F., Elbahnasawy M., Sibilla M. G., Martines G., Goksoy B., Parini D., Zaghi C., Podda M., Osipov A., Brisinda G., Gambino G., Akhmeteli L., Doklestic K., Loncar Z., Micic D., Lesevic I., D'Agostino F., Garzali I. U., Caicedo Y., Marcela L., Marin P. A. G., Perivoliotis K., Ntentas I., Kuptsov A., Dimitrov E., Chowdhury S., Patel T., Sartelli M., Tartaglia D., Chiarugi M., Coccolini, F, Mazzoni, A, Cremonini, C, Cobuccio, L, Pucciarelli, M, Vetere, G, Borelli, B, Strambi, S, Musetti, S, Miccoli, M, Cremolini, C, Salvetti, F, Fugazzola, P, Ceresoli, M, Elisa, N, Litvin, A, Lostoridis, E, Ahmed, A, Manatakis, D, Negoi, I, Ioannidis, O, Uzunoglu, M, Tochie, J, Cillara, N, Tomadze, G, Bala, M, Isik, A, Fonseca, V, Bellanova, G, Ghannam, W, Yalkin, O, Garcia, F, Altintoprak, F, Hadzhiev, D, Chirica, M, Zese, M, Balalis, D, Cui, Y, Luppi, D, Romeo, L, Muratore, A, Lunghi, E, Yovtchev, Y, Nikolopoulos, I, Omerovic, M, Zizzo, M, Ugoletti, L, Costa, G, Scalzone, R, Perrone, S, Occhionorelli, S, Nardi, M, Gubbiotti, F, Catena, F, Muhtaroglu, A, Scaramuzzo, R, Corte, H, Yanez, C, Zakaria, A, Seretis, C, Gelmini, R, Pappalardo, V, Paratore, F, Sydorchuk, R, Mulita, F, Kara, Y, Toma, E, Vailas, M, Sotiropoulou, M, Benedetti, F, Elbahnasawy, M, Sibilla, M, Martines, G, Goksoy, B, Parini, D, Zaghi, C, Podda, M, Osipov, A, Brisinda, G, Gambino, G, Akhmeteli, L, Doklestic, K, Loncar, Z, Micic, D, Lesevic, I, D'Agostino, F, Garzali, I, Caicedo, Y, Marcela, L, Marin, P, Perivoliotis, K, Ntentas, I, Kuptsov, A, Dimitrov, E, Chowdhury, S, Patel, T, Sartelli, M, Tartaglia, D, and Chiarugi, M

Subjects
Survival, Colon, Emergency, Acute care, Surgery, Morbidity, Mortality, Immunosuppression, Cancer
Abstract

Association of advanced age, neoplastic disease and immunocompromission (IC) may lead to surgical emergencies. Few data exist about this topic. Present study reports the preliminary data from the WIRES-T trial about patients managed for colorectal neoplastic emergencies in immunocompromised patients. The required data were taken from a prospective observational international register. The study was approved by the Ethical Committee with approval n. 17575; ClinicalTrials.gov Identifier: NCT03643718. 839 patients were collected; 753 (80.7%) with mild–moderate IC and 86 (10.3%) with severe. Median age was 71.9 years and 73 years, respectively, in the two groups. The causes of mild–moderate IC were reported such malignancy (753–100%), diabetes (103–13.7%), malnutrition (26–3.5%) and uremia (1–0.1%), while severe IC causes were steroids treatment (14–16.3%); neutropenia (7–8.1%), malignancy on chemotherapy (71–82.6%). Preoperative risk classification were reported as follow: mild–moderate: ASA 1–14 (1.9%); ASA 2–202 (26.8%); ASA 3–341 (45.3%); ASA 4–84 (11.2%); ASA 5–7 (0.9%); severe group: ASA 1-1 patient (1.2%); ASA 2–16 patients (18.6%); ASA 3–41 patients (47.7%); ASA 4–19 patients (22.1%); ASA 5–3 patients (3.5%); lastly, ASA score was unavailable for 105 cases (13.9%) in mild–moderate group and in 6 cases (6.9%) in severe group. All the patients enrolled underwent urgent/emergency surgery Damage control approach with open abdomen was adopted in 18 patients. Mortality was 5.1% and 12.8%, respectively, in mild–moderate and severe groups. Long-term survival data: in mild–moderate disease-free survival (median, IQR) is 28 (10–91) and in severe IC, it is 21 (10–94). Overall survival (median, IQR) is 44 (18–99) and 26 (20–90) in mild–moderate and severe, respectively; the same is for post-progression survival (median, IQR) 29 (16–81) and 28, respectively. Univariate and multivariate analyses showed as the only factor influencing mortality in mild–moderate and severe IC is the ASA score. Colorectal neoplastic emergencies in immunocompromised patients are more frequent in elderly. Sigmoid and right colon are the most involved. Emergency surgery is at higher risk of complication and mortality; however, management in dedicated emergency surgery units is necessary to reduce disease burden and to optimize results by combining oncological and acute care principles. This approach may improve outcomes to obtain clinical advantages for patients like those observed in elective scenario. Lastly, damage control approach seems feasible and safe in selected patients.

Published
2023

4. Correlazioni tra la regolamentazione delle sostanze chimiche (REACH e CLP) e la normativa in materia di tutela dell'ambiente

Author

Zaghi C., Lupi S., and Santoro S.

Subjects
sostanze chimiche, REACH, normativa ambientale
Abstract

E' presentata una rassegna delle innovazioni introdotte nell'Unione Europea in materia di registrazione, valutazione, autorizzazione e restrizione delle sostanze chimiche nonché in materia di classificazione ed etichettatura. Vengono evidenziati i collegamenti tra la normativa europea sulle sostanze chimiche e le altre normative di tutela ambientale, in particolare le connessioni tra i regolamenti REACH e CLP e la normativa relativa al controllo dei pericoli di incidenti rilevanti, alla tutela delle acque, ai prodotti fitosanitari, ai biocidi e ai rifiuti. Inoltre, sono presi in considerazione gli elementi di contatto tra la normativa in materia di sostanze chimiche, le strategie per la promozione degli "acquisti pubblici verdi" (Green Public Procurement - GPP) e le strategie su "produzione e consumo sostenibili" (Sustainable Consumption and Production -SCP).

Published
2014

5. Evaluation of the environmental and health risk of perfluorinated compounds in Italian waters

Author

Marziali L., Polesello S., Valsecchi S., Stefani F., Patrolecco L., Pagnotta R., Zaghi C., and Serrini G.

Subjects
composti perfluorurati, monitoraggio, ecotossicologia
Abstract

A survey of the distribution of perfluorinated carboxylates (from C5 to C10) and sulphonates (C4, C6 and C8) in the main Italian river basins have been carried out in order to get a reliable picture of the polyfluoralkyl substances (PFAS) contamination and possibly to identify the main sources for the aquatic environment. Monitoring campaigns on river Po and its tributaries, on rivers Adige, Tevere, Arno and Brenta basin have been carried out. A survey has been performed also in transitional coastal areas such as river Po Delta and Lagoon of Venice. Chemical plant discharges and drinking waters present in the same basins were also sampled. In order to evaluate the ecological risk associated to this class of compounds we investigated their long term sublethal effects on the genetic and life traits parameters of populations of Chironomus riparius (Diptera, Chironomidae) under a multigenerational test.

Published
2013

15. Surgeons' perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey

Author

Cobianchi, Lorenzo, Piccolo, Daniele, Dal Mas, Francesca, Agnoletti, Vanni, Ansaloni, Luca, Balch, Jeremy, Biffl, Walter, Butturini, Giovanni, Catena, Fausto, Coccolini, Federico, Denicolai, Stefano, De Simone, Belinda, Frigerio, Isabella, Fugazzola, Paola, Marseglia, Gianluigi, Marseglia, Giuseppe Roberto, Martellucci, Jacopo, Modenese, Mirko, Previtali, Pietro, Ruta, Federico, Venturi, Alessandro, Kaafarani, Haytham M, Loftus, Tyler J, Kenneth Lyle Abbott, Abubaker Abdelmalik, Nebyou Seyoum Abebe, Fikri Abu-Zidan, Yousif Abdallah Yousif Adam, Harissou Adamou, Dmitry Mikhailovich Adamovich, Ferdinando Agresta, Antonino Agrusa, Emrah Akin, Mario Alessiani, Henrique Alexandrino, Syed Muhammad Ali, Vasilescu Alin Mihai, Pedro Miguel Almeida, Mohammed Mohammed Al-Shehari, Michele Altomare, Francesco Amico, Michele Ammendola, Jacopo Andreuccetti, Elissavet Anestiadou, Peter Angelos, Alfredo Annicchiarico, Amedeo Antonelli, Daniel Aparicio-Sanchez, Antonella Ardito, Giulio Argenio, Catherine Claude Arvieux, Ingolf Harald Askevold, Boyko Tchavdarov Atanasov, Goran Augustin, Selmy Sabry Awad, Giulia Bacchiocchi, Carlo Bagnoli, Hany Bahouth, Efstratia Baili, Lovenish Bains, Gian Luca Baiocchi, Miklosh Bala, Carmen Balagué, Dimitrios Balalis, Edoardo Baldini, Oussama Baraket, Suman Baral, Mirko Barone, Alberto Gonzãlez Barranquero, Jorge Arturo Barreras, Gary Alan Bass, Zulfu Bayhan, Giovanni Bellanova, Offir Ben-Ishay, Fabrizio Bert, Valentina Bianchi, Helena Biancuzzi, Chiara Bidoli, Raluca Bievel Radulescu, Mark Brian Bignell, Alan Biloslavo, Daniele Bissacco, Roberto Bini, Paolo Boati, Guillaume Boddaert, Branko Bogdanic, Cristina Bombardini, Luigi Bonavina, Luca Bonomo, Andrea Bottari, Konstantinos Bouliaris, Gioia Brachini, Antonio Brillantino, Giuseppe Brisinda, Maloni Mamada Bulanauca, Luis Antonio Buonomo, Jakob Burcharth, Salvatore Buscemi, Francesca Calabretto, Giacomo Calini, Valentin Calu, Fabio Cesare Campanile, Riccardo Campo Dall Orto, Andrea Campos-Serra, Stefano Campostrini, Recayi Capoglu, Joao Miguel Carvas, Marco Cascella, Gianmaria Casoni Pattacini, Valerio Celentano, Danilo Corrado Centonze, Marco Ceresoli, Dimitrios Chatzipetris, Antonella Chessa, Maria Michela Chiarello, Mircea Chirica, Serge Chooklin, Christos Chouliaras, Sharfuddin Chowdhury, Pasquale Cianci, Nicola Cillara, Stefania Cimbanassi, Stefano Piero Bernardo Cioffi, Elif Colak, Enrique Colás Ruiz, Luigi Conti, Alessandro Coppola, Tiago Correia De Sa, Silvia Dantas Costa, Valerio Cozza, Giuseppe Curro', Kirsten Felicia Ann-Sophie Aimee Dabekaussen, Fabrizio D'Acapito, Dimitrios Damaskos, Giancarlo D'Ambrosio, Koray Das, Richard Justin Davies, Andrew Charles De Beaux, Sara Patricia De Lebrusant Fernandez, Alessandro De Luca, Francesca De Stefano, Luca Degrate, Zaza Demetrashvili, Andreas Kyriacou Demetriades, Dzemail Smail Detanac, Agnese Dezi, Giuseppe Di Buono, Isidoro Di Carlo, Pierpaolo Di Lascio, Marcello Di Martino, Salomone Di Saverio, Bogdan Diaconescu, Jose J Diaz, Rigers Dibra, Evgeni Nikolaev Dimitrov, Vincenza Paola Dinuzzi, Sandra Dios-Barbeito, Jehangir Farman Ali Diyani, Agron Dogjani, Maurizio Domanin, Mario D'Oria, Virginia Duran Munoz-Cruzado, Barbora East, Mikael Ekelund, Gerald Takem Ekwen, Adel Hamed Elbaih, Muhammed Elhadi, Natalie Enninghorst, Mairam Ernisova, Juan Pablo Escalera-Antezana, Sofia Esposito, Giuseppe Esposito, Mercedes Estaire, Camilla Nikita Farè, Roser Farre, Francesco Favi, Luca Ferrario, Antonjacopo Ferrario di Tor Vajana, Claudia Filisetti, Francesco Fleres, Vinicius Cordeiro Fonseca, Alexander Forero-Torres, Francesco Forfori, Laura Fortuna, Evangelos Fradelos, Gustavo P Fraga, Pietro Fransvea, Simone Frassini, Giuseppe Frazzetta, Erica Pizzocaro, Maximos Frountzas, Mahir Gachabayov, Rita Galeiras, Alain A Garcia Vazquez, Simone Gargarella, Ibrahim Umar Garzali, Wagih Mommtaz Ghannam, Faiz Najmuddin Ghazi, Lawrence Marshall Gillman, Rossella Gioco, Alessio Giordano, Luca Giordano, Carlo Giove, Giorgio Giraudo, Mario Giuffrida, Michela Giulii Capponi, Emanuel Gois Jr, Carlos Augusto Gomes, Felipe Couto Gomes, Ricardo Alessandro Teixeira Gonsaga, Emre Gonullu, Jacques Goosen, Tatjana Goranovic, Raquel Gracia-Roman, Giorgio Maria Paolo Graziano, Ewen Alexander Griffiths, Tommaso Guagni, Dimitar Bozhidarov Hadzhiev, Muad Gamil Haidar, Hytham K S Hamid, Timothy Craig Hardcastle, Firdaus Hayati, Andrew James Healey, Andreas Hecker, Matthias Hecker, Edgar Fernando Hernandez Garcia, Adrien Montcho Hodonou, Eduardo Cancio Huaman, Martin Huerta, Aini Fahriza Ibrahim, Basil Mohamed Salabeldin Ibrahim, Giuseppe Ietto, Marco Inama, Orestis Ioannidis, Arda Isik, Nizar Ismail, Azzain Mahadi Hamid Ismail, Ruhi Fadzlyana Jailani, Ji Young Jang, Christos Kalfountzos, Sujala Niatarika Rajsain Kalipershad, Emmanouil Kaouras, Lewis Jay Kaplan, Yasin Kara, Evika Karamagioli, Aleksandar Karamarkovia, Ioannis Katsaros, Alfie J Kavalakat, Aristotelis Kechagias, Jakub Kenig, Boris Juli Kessel, Jim S Khan, Vladimir Khokha, Jae Il Kim, Andrew Wallace Kirkpatrick, Roberto Klappenbach, Yoram Kluger, Yoshiro Kobe, Efstratios Kofopoulos Lymperis, Kenneth Yuh Yen Kok, Victor Kong, Dimitris P Korkolis, Georgios Koukoulis, Bojan Kovacevic, Vitor Favali Kruger, Igor A Kryvoruchko, Hayato Kurihara, Akira Kuriyama, Aitor Landaluce-Olavarria, Pierfrancesco Lapolla, Ari Leppäniemi, Leo Licari, Giorgio Lisi, Andrey Litvin, Aintzane Lizarazu, Heura Llaquet Bayo, Varut Lohsiriwat, Claudia Cristina Lopes Moreira, Eftychios Lostoridis, Agustãn Tovar Luna, Davide Luppi, Gustavo Miguel Machain V, Marc Maegele, Daniele Maggiore, Stefano Magnone, Ronald V Maier, Piotr Major, Mallikarjuna Manangi, Andrea Manetti, Baris Mantoglu, Chiara Marafante, Federico Mariani, Athanasios Marinis, Evandro Antonio Sbalcheiro Mariot, Gennaro Martines, Aleix Martinez Perez, Costanza Martino, Pietro Mascagni, Damien Massalou, Maurizio Massaro, Belen Matías-García, Gennaro Mazzarella, Giorgio Mazzarolo, Renato Bessa Melo, Fernando Mendoza-Moreno, Serhat Meric, Jeremy Meyer, Luca Miceli, Nikolaos V Michalopoulos, Flavio Milana, Andrea Mingoli, Tushar S Mishra, Muyed Mohamed, Musab Isam Eldin Abbas Mohamed, Ali Yasen Mohamedahmed, Mohammed Jibreel Suliman Mohammed, Rajashekar Mohan, Ernest E Moore, Dieter Morales-Garcia, Mã Ns Muhrbeck, Francesk Mulita, Sami Mohamed Siddig Mustafa, Edoardo Maria Muttillo, Mukhammad David Naimzada, Pradeep H Navsaria, Ionut Negoi, Luca Nespoli, Christine Nguyen, Melkamu Kibret Nidaw, Giuseppe Nigri, Ioannis Nikolopoulos, Donal Brendan O'Connor, Habeeb Damilola Ogundipe, Cristina Oliveri, Stefano Olmi, Ernest Cun Wang Ong, Luca Orecchia, Aleksei V Osipov, Muhammad Faeid Othman, Marco Pace, Mario Pacilli, Leonardo Pagani, Giuseppe Palomba, Desire' Pantalone, Arpad Panyko, Ciro Paolillo, Mario Virgilio Papa, Dimitrios Papaconstantinou, Maria Papadoliopoulou, Aristeidis Papadopoulos, Davide Papis, Nikolaos Pararas, Jose Gustavo Parreira, Neil Geordie Parry, Francesco Pata, Tapan Patel, Simon Paterson-Brown, Giovanna Pavone, Francesca Pecchini, Veronica Pegoraro, Gianluca Pellino, Maria Pelloni, Andrea Peloso, Eduardo Perea Del Pozo, Rita Goncalves Pereira, Bruno Monteiro Pereira, Aintzane Lizarazu Perez, Silvia Pérez, Teresa Perra, Gennaro Perrone, Antonio Pesce, Lorenzo Petagna, Giovanni Petracca, Vorapong Phupong, Biagio Picardi, Arcangelo Picciariello, Micaela Piccoli, Edoardo Picetti, Emmanouil Pikoulis Pikoulis, Tadeja Pintar, Giovanni Pirozzolo, Francesco Piscioneri, Mauro Podda, Alberto Porcu, Francesca Privitera, Clelia Punzo, Silvia Quaresima, Martha Alexa Quiodettis, Niels Qvist, Razrim Rahim, Filipe Ramalho de Almeida, Rosnelifaizur Bin Ramely, Huseyin Kemal Rasa, Martin Reichert, Alexander Reinisch-Liese, Angela Renne, Camilla Riccetti, Maria Rita Rodriguez-Luna, Daniel Roizblatt, Andrea Romanzi, Luigi Romeo, Francesco Pietro Maria Roscio, Ramely Bin Rosnelifaizur, Stefano Rossi, Andres M Rubiano, Elena Ruiz-Ucar, Boris Evgeniev Sakakushev, Juan Carlos Salamea, Ibrahima Sall, Lasitha Bhagya Samarakoon, Fabrizio Sammartano, Alejandro Sanchez Arteaga, Sergi Sanchez-Cordero, Domenico Pietro Maria Santoanastaso, Massimo Sartelli, Diego Sasia, Norio Sato, Artem Savchuk, Robert Grant Sawyer, Giacomo Scaioli, Dimitrios Schizas, Simone Sebastiani, Barbara Seeliger, Helmut Alfredo Segovia Lohse, Charalampos Seretis, Giacomo Sermonesi, Mario Serradilla-Martin, Vishal G Shelat, Sergei Shlyapnikov, Theodoros Sidiropoulos, Romeo Lages Simoes, Leandro Siragusa, Boonying Siribumrungwong, Mihail Slavchev, Leonardo Solaini, Gabriele Soldini, Andrey Sopuev, Kjetil Soreide, Apostolos Sovatzidis, Philip Frank Stahel, Matt Strickland, Mohamed Arif Hameed Sultan, Ruslan Sydorchuk, Larysa Sydorchuk, Syed Muhammad Ali Muhammad Syed, Luis Tallon-Aguilar, Andrea Marco Tamburini, Nicolò Tamini, Edward C T H Tan, Jih Huei Tan, Antonio Tarasconi, Nicola Tartaglia, Giuseppe Tartaglia, Dario Tartaglia, John Vincent Taylor, Giovanni Domenico Tebala, Michel Teuben, Alexis Theodorou, Matti Tolonen, Giovanni Tomasicchio, Adriana Toro, Beatrice Torre, Tania Triantafyllou, Giuseppe Trigiante Trigiante, Marzia Tripepi, Julio Trostchansky, Konstantinos Tsekouras, Victor Turrado-Rodriguez, Roberta Tutino, Matteo Uccelli, Petar Angelov Uchikov, Bakarne Ugarte-Sierra, Mika Tapani Ukkonen, Michail Vailas, Panteleimon G Vassiliu, Alain Garcia Vazquez, Rita Galeiras Vazquez, George Velmahos, Juan Ezequiel Verde, Juan Manuel Verde, Massimiliano Veroux, Jacopo Viganò, Ramon Vilallonga, Diego Visconti, Alessandro Vittori, Maciej Waledziak, Tongporn Wannatoop, Lukas Werner Widmer, Michael Samuel James Wilson, Sarah Woltz, Ting Hway Wong, Sofia Xenaki, Byungchul Yu, Steven Yule, Sanoop Koshy Zachariah, Georgios Zacharis, Claudia Zaghi, Andee Dzulkarnaen Zakaria, Diego A Zambrano, Nikolaos Zampitis, Biagio Zampogna, Simone Zanghì, Maristella Zantedeschi, Konstantinos Zapsalis, Fabio Zattoni, Monica Zese, Lorenzo, Cobianchi, Daniele, Piccolo, Francesca, Dal Ma, Vanni, Agnoletti, Luca, Ansaloni, Jeremy, Balch, Walter, Biffl, Giovanni, Butturini, Fausto, Catena, Federico, Coccolini, Stefano, Denicolai, Belinda, De Simone, Isabella, Frigerio, Paola, Fugazzola, Gianluigi, Marseglia, Giuseppe Roberto, Marseglia, Jacopo, Martellucci, Mirko, Modenese, Pietro, Previtali, Federico, Ruta, Alessandro, Venturi, Haytham M, Kaafarani, Tyler J, Loftu, Lyle Abbott, Kenneth, Abdelmalik, Abubaker, Seyoum Abebe, Nebyou, Abu-Zidan, Fikri, Abdallah Yousif Adam, Yousif, Adamou, Harissou, Mikhailovich Adamovich, Dmitry, Agresta, Ferdinando, Agrusa, Antonino, Akin, Emrah, Alessiani, Mario, Alexandrino, Henrique, Muhammad Ali, Syed, Alin Mihai, Vasilescu, Miguel Almeida, Pedro, Mohammed Al-Shehari, Mohammed, Altomare, Michele, Amico, Francesco, Ammendola, Michele, Andreuccetti, Jacopo, Anestiadou, Elissavet, Angelos, Peter, Annicchiarico, Alfredo, Antonelli, Amedeo, Aparicio-Sanchez, Daniel, Ardito, Antonella, Argenio, Giulio, Claude Arvieux, Catherine, Harald Askevold, Ingolf, Tchavdarov Atanasov, Boyko, Augustin, Goran, Sabry Awad, Selmy, Bacchiocchi, Giulia, Bagnoli, Carlo, Bahouth, Hany, Baili, Efstratia, Bains, Lovenish, Luca Baiocchi, Gian, Bala, Miklosh, Balagué, Carmen, Balalis, Dimitrio, Baldini, Edoardo, Baraket, Oussama, Baral, Suman, Barone, Mirko, Gonzãlez Barranquero, Alberto, Arturo Barreras, Jorge, Alan Bass, Gary, Bayhan, Zulfu, Bellanova, Giovanni, Ben-Ishay, Offir, Bert, Fabrizio, Bianchi, Valentina, Biancuzzi, Helena, Bidoli, Chiara, Bievel Radulescu, Raluca, Brian Bignell, Mark, Biloslavo, Alan, Bissacco, Daniele, Bini, Roberto, Boati, Paolo, Boddaert, Guillaume, Bogdanic, Branko, Bombardini, Cristina, Bonavina, Luigi, Bonomo, Luca, Bottari, Andrea, Bouliaris, Konstantino, Brachini, Gioia, Brillantino, Antonio, Brisinda, Giuseppe, Mamada Bulanauca, Maloni, Antonio Buonomo, Lui, Burcharth, Jakob, Buscemi, Salvatore, Calabretto, Francesca, Calini, Giacomo, Calu, Valentin, Cesare Campanile, Fabio, Campo Dall Orto, Riccardo, Campos-Serra, Andrea, Campostrini, Stefano, Capoglu, Recayi, Miguel Carvas, Joao, Cascella, Marco, Casoni Pattacini, Gianmaria, Celentano, Valerio, Corrado Centonze, Danilo, Ceresoli, Marco, Chatzipetris, Dimitrio, Chessa, Antonella, Michela Chiarello, Maria, Chirica, Mircea, Chooklin, Serge, Chouliaras, Christo, Chowdhury, Sharfuddin, Cianci, Pasquale, Cillara, Nicola, Cimbanassi, Stefania, Piero Bernardo Cioffi, Stefano, Colak, Elif, Colás Ruiz, Enrique, Conti, Luigi, Coppola, Alessandro, Correia De Sa, Tiago, Dantas Costa, Silvia, Cozza, Valerio, Curro', Giuseppe, Felicia Ann-Sophie Aimee Dabekaussen, Kirsten, D'Acapito, Fabrizio, Damaskos, Dimitrio, D'Ambrosio, Giancarlo, Das, Koray, Justin Davies, Richard, Charles De Beaux, Andrew, Patricia De Lebrusant Fernandez, Sara, De Luca, Alessandro, De Stefano, Francesca, Degrate, Luca, Demetrashvili, Zaza, Kyriacou Demetriades, Andrea, Smail Detanac, Dzemail, Dezi, Agnese, Di Buono, Giuseppe, Di Carlo, Isidoro, Di Lascio, Pierpaolo, Di Martino, Marcello, Di Saverio, Salomone, Diaconescu, Bogdan, J Diaz, Jose, Dibra, Riger, Nikolaev Dimitrov, Evgeni, Paola Dinuzzi, Vincenza, Dios-Barbeito, Sandra, Farman Ali Diyani, Jehangir, Dogjani, Agron, Domanin, Maurizio, D'Oria, Mario, Duran Munoz-Cruzado, Virginia, East, Barbora, Ekelund, Mikael, Takem Ekwen, Gerald, Hamed Elbaih, Adel, Elhadi, Muhammed, Enninghorst, Natalie, Ernisova, Mairam, Pablo Escalera-Antezana, Juan, Esposito, Sofia, Esposito, Giuseppe, Estaire, Mercede, Nikita Farè, Camilla, Farre, Roser, Favi, Francesco, Ferrario, Luca, Ferrario di Tor Vajana, Antonjacopo, Filisetti, Claudia, Fleres, Francesco, Cordeiro Fonseca, Viniciu, Forero-Torres, Alexander, Forfori, Francesco, Fortuna, Laura, Fradelos, Evangelo, P Fraga, Gustavo, Fransvea, Pietro, Frassini, Simone, Frazzetta, Giuseppe, Pizzocaro, Erica, Frountzas, Maximo, Gachabayov, Mahir, Galeiras, Rita, A Garcia Vazquez, Alain, Gargarella, Simone, Umar Garzali, Ibrahim, Mommtaz Ghannam, Wagih, Najmuddin Ghazi, Faiz, Marshall Gillman, Lawrence, Gioco, Rossella, Giordano, Alessio, Giordano, Luca, Giove, Carlo, Giraudo, Giorgio, Giuffrida, Mario, Giulii Capponi, Michela, Gois Jr, Emanuel, Augusto Gomes, Carlo, Couto Gomes, Felipe, Alessandro Teixeira Gonsaga, Ricardo, Gonullu, Emre, Goosen, Jacque, Goranovic, Tatjana, Gracia-Roman, Raquel, Maria Paolo Graziano, Giorgio, Alexander Griffiths, Ewen, Guagni, Tommaso, Bozhidarov Hadzhiev, Dimitar, Gamil Haidar, Muad, S Hamid, Hytham K, Craig Hardcastle, Timothy, Hayati, Firdau, James Healey, Andrew, Hecker, Andrea, Hecker, Matthia, Fernando Hernandez Garcia, Edgar, Montcho Hodonou, Adrien, Cancio Huaman, Eduardo, Huerta, Martin, Fahriza Ibrahim, Aini, Mohamed Salabeldin Ibrahim, Basil, Ietto, Giuseppe, Inama, Marco, Ioannidis, Oresti, Isik, Arda, Ismail, Nizar, Mahadi Hamid Ismail, Azzain, Fadzlyana Jailani, Ruhi, Young Jang, Ji, Kalfountzos, Christo, Niatarika Rajsain Kalipershad, Sujala, Kaouras, Emmanouil, Jay Kaplan, Lewi, Kara, Yasin, Karamagioli, Evika, Karamarkovia, Aleksandar, Katsaros, Ioanni, J Kavalakat, Alfie, Kechagias, Aristoteli, Kenig, Jakub, Juli Kessel, Bori, S Khan, Jim, Khokha, Vladimir, Il Kim, Jae, Wallace Kirkpatrick, Andrew, Klappenbach, Roberto, Kluger, Yoram, Kobe, Yoshiro, Kofopoulos Lymperis, Efstratio, Yuh Yen Kok, Kenneth, Kong, Victor, P Korkolis, Dimitri, Koukoulis, Georgio, Kovacevic, Bojan, Favali Kruger, Vitor, A Kryvoruchko, Igor, Kurihara, Hayato, Kuriyama, Akira, Landaluce-Olavarria, Aitor, Lapolla, Pierfrancesco, Leppäniemi, Ari, Licari, Leo, Lisi, Giorgio, Litvin, Andrey, Lizarazu, Aintzane, Llaquet Bayo, Heura, Lohsiriwat, Varut, Cristina Lopes Moreira, Claudia, Lostoridis, Eftychio, Tovar Luna, Agustãn, Luppi, Davide, V, Gustavo Miguel Machain, Maegele, Marc, Maggiore, Daniele, Magnone, Stefano, V Maier, Ronald, Major, Piotr, Manangi, Mallikarjuna, Manetti, Andrea, Mantoglu, Bari, Marafante, Chiara, Mariani, Federico, Marinis, Athanasio, Antonio Sbalcheiro Mariot, Evandro, Martines, Gennaro, Martinez Perez, Aleix, Martino, Costanza, Mascagni, Pietro, Massalou, Damien, Massaro, Maurizio, Matías-García, Belen, Mazzarella, Gennaro, Mazzarolo, Giorgio, Bessa Melo, Renato, Mendoza-Moreno, Fernando, Meric, Serhat, Meyer, Jeremy, Miceli, Luca, V Michalopoulos, Nikolao, Milana, Flavio, Mingoli, Andrea, S Mishra, Tushar, Mohamed, Muyed, Isam Eldin Abbas Mohamed, Musab, Yasen Mohamedahmed, Ali, Jibreel Suliman Mohammed, Mohammed, Mohan, Rajashekar, E Moore, Ernest, Morales-Garcia, Dieter, Ns Muhrbeck, Mã, Mulita, Francesk, Mohamed Siddig Mustafa, Sami, Maria Muttillo, Edoardo, David Naimzada, Mukhammad, H Navsaria, Pradeep, Negoi, Ionut, Nespoli, Luca, Nguyen, Christine, Kibret Nidaw, Melkamu, Nigri, Giuseppe, Nikolopoulos, Ioanni, Brendan O'Connor, Donal, Damilola Ogundipe, Habeeb, Oliveri, Cristina, Olmi, Stefano, Cun Wang Ong, Ernest, Orecchia, Luca, V Osipov, Aleksei, Faeid Othman, Muhammad, Pace, Marco, Pacilli, Mario, Pagani, Leonardo, Palomba, Giuseppe, Pantalone, Desire', Panyko, Arpad, Paolillo, Ciro, Virgilio Papa, Mario, Papaconstantinou, Dimitrio, Papadoliopoulou, Maria, Papadopoulos, Aristeidi, Papis, Davide, Pararas, Nikolao, Gustavo Parreira, Jose, Geordie Parry, Neil, Pata, Francesco, Patel, Tapan, Paterson-Brown, Simon, Pavone, Giovanna, Pecchini, Francesca, Pegoraro, Veronica, Pellino, Gianluca, Pelloni, Maria, Peloso, Andrea, Perea Del Pozo, Eduardo, Goncalves Pereira, Rita, Monteiro Pereira, Bruno, Lizarazu Perez, Aintzane, Pérez, Silvia, Perra, Teresa, Perrone, Gennaro, Pesce, Antonio, Petagna, Lorenzo, Petracca, Giovanni, Phupong, Vorapong, Picardi, Biagio, Picciariello, Arcangelo, Piccoli, Micaela, Picetti, Edoardo, Pikoulis Pikoulis, Emmanouil, Pintar, Tadeja, Pirozzolo, Giovanni, Piscioneri, Francesco, Podda, Mauro, Porcu, Alberto, Privitera, Francesca, Punzo, Clelia, Quaresima, Silvia, Alexa Quiodettis, Martha, Qvist, Niel, Rahim, Razrim, Ramalho de Almeida, Filipe, Bin Ramely, Rosnelifaizur, Kemal Rasa, Huseyin, Reichert, Martin, Reinisch-Liese, Alexander, Renne, Angela, Riccetti, Camilla, Rita Rodriguez-Luna, Maria, Roizblatt, Daniel, Romanzi, Andrea, Romeo, Luigi, Pietro Maria Roscio, Francesco, Bin Rosnelifaizur, Ramely, Rossi, Stefano, M Rubiano, Andre, Ruiz-Ucar, Elena, Evgeniev Sakakushev, Bori, Carlos Salamea, Juan, Sall, Ibrahima, Bhagya Samarakoon, Lasitha, Sammartano, Fabrizio, Sanchez Arteaga, Alejandro, Sanchez-Cordero, Sergi, Pietro Maria Santoanastaso, Domenico, Sartelli, Massimo, Sasia, Diego, Sato, Norio, Savchuk, Artem, Grant Sawyer, Robert, Scaioli, Giacomo, Schizas, Dimitrio, Sebastiani, Simone, Seeliger, Barbara, Alfredo Segovia Lohse, Helmut, Seretis, Charalampo, Sermonesi, Giacomo, Serradilla-Martin, Mario, G Shelat, Vishal, Shlyapnikov, Sergei, Sidiropoulos, Theodoro, Lages Simoes, Romeo, Siragusa, Leandro, Siribumrungwong, Boonying, Slavchev, Mihail, Solaini, Leonardo, Soldini, Gabriele, Sopuev, Andrey, Soreide, Kjetil, Sovatzidis, Apostolo, Frank Stahel, Philip, Strickland, Matt, Arif Hameed Sultan, Mohamed, Sydorchuk, Ruslan, Sydorchuk, Larysa, Muhammad Ali Muhammad Syed, Syed, Tallon-Aguilar, Lui, Marco Tamburini, Andrea, Tamini, Nicolò, H Tan, Edward C T, Huei Tan, Jih, Tarasconi, Antonio, Tartaglia, Nicola, Tartaglia, Giuseppe, Tartaglia, Dario, Vincent Taylor, John, Domenico Tebala, Giovanni, Teuben, Michel, Theodorou, Alexi, Tolonen, Matti, Tomasicchio, Giovanni, Toro, Adriana, Torre, Beatrice, Triantafyllou, Tania, Trigiante Trigiante, Giuseppe, Tripepi, Marzia, Trostchansky, Julio, Tsekouras, Konstantino, Turrado-Rodriguez, Victor, Tutino, Roberta, Uccelli, Matteo, Angelov Uchikov, Petar, Ugarte-Sierra, Bakarne, Tapani Ukkonen, Mika, Vailas, Michail, G Vassiliu, Panteleimon, Garcia Vazquez, Alain, Galeiras Vazquez, Rita, Velmahos, George, Ezequiel Verde, Juan, Manuel Verde, Juan, Veroux, Massimiliano, Viganò, Jacopo, Vilallonga, Ramon, Visconti, Diego, Vittori, Alessandro, Waledziak, Maciej, Wannatoop, Tongporn, Werner Widmer, Luka, Samuel James Wilson, Michael, Woltz, Sarah, Hway Wong, Ting, Xenaki, Sofia, Yu, Byungchul, Yule, Steven, Koshy Zachariah, Sanoop, Zacharis, Georgio, Zaghi, Claudia, Dzulkarnaen Zakaria, Andee, A Zambrano, Diego, Zampitis, Nikolao, Zampogna, Biagio, Zanghì, Simone, Zantedeschi, Maristella, Zapsalis, Konstantino, Zattoni, Fabio, Zese, Monica, Cobianchi L., Piccolo D., Mas F.D., Agnoletti V., Ansaloni L., Balch J., Biffl W., Butturini G., Catena F., Coccolini F., Denicolai S., De Simone B., Frigerio I., Fugazzola P., Marseglia G., Marseglia G.R., Martellucci J., Modenese M., Previtali P., Ruta F., Venturi A., Kaafarani H.M., Loftus T.J., Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Team Dynamics Study Group, Cobianchi, L, Piccolo, D, Dal Mas, F, Agnoletti, V, Ansaloni, L, Balch, J, Biffl, W, Butturini, G, Catena, F, Coccolini, F, Denicolai, S, De Simone, B, Frigerio, I, Fugazzola, P, Marseglia, G, Martellucci, J, Modenese, M, Previtali, P, Ruta, F, Venturi, A, Kaafarani, H, Loftus, T, Abbott, K, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Adamovich, D, Agresta, F, Agrusa, A, Akin, E, Alessiani, M, Alexandrino, H, Ali, S, Mihai, V, Almeida, P, Al-Shehari, M, Altomare, M, Amico, F, Ammendola, M, Andreuccetti, J, Anestiadou, E, Angelos, P, Annicchiarico, A, Antonelli, A, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Arvieux, C, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bacchiocchi, G, Bagnoli, C, Bahouth, H, Baili, E, Bains, L, Baiocchi, G, Bala, M, Balague, C, Balalis, D, Baldini, E, Baraket, O, Baral, S, Barone, M, Barranquero, A, Barreras, J, Bass, G, Bayhan, Z, Bellanova, G, Ben-Ishay, O, Bert, F, Bianchi, V, Biancuzzi, H, Bidoli, C, Radulescu, R, Bignell, M, Biloslavo, A, Bini, R, Bissacco, D, Boati, P, Boddaert, G, Bogdanic, B, Bombardini, C, Bonavina, L, Bonomo, L, Bottari, A, Bouliaris, K, Brachini, G, Brillantino, A, Brisinda, G, Bulanauca, M, Buonomo, L, Burcharth, J, Buscemi, S, Calabretto, F, Calini, G, Calu, V, Campanile, F, Dall'Orto, R, Campos-Serra, A, Campostrini, S, Capoglu, R, Carvas, J, Cascella, M, Pattacini, G, Celentano, V, Centonze, D, Ceresoli, M, Chatzipetris, D, Chessa, A, Chiarello, M, Chirica, M, Chooklin, S, Chouliaras, C, Chowdhury, S, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colak, E, Ruiz, E, Conti, L, Coppola, A, De Sa, T, Costa, S, Cozza, V, Curro', G, Dabekaussen, K, D'Acapito, F, Damaskos, D, D'Ambrosio, G, Das, K, Davies, R, De Beaux, A, Fernandez, S, De Luca, A, De Stefano, F, Degrate, L, Demetrashvili, Z, Demetriades, A, Detanac, D, Dezi, A, Di Buono, G, Di Carlo, I, Di Lascio, P, Di Martino, M, Di Saverio, S, Diaconescu, B, Diaz, J, Dibra, R, Dimitrov, E, Dinuzzi, V, Dios-Barbeito, S, Diyani, J, Dogjani, A, Domanin, M, D'Oria, M, Munoz-Cruzado, V, East, B, Ekelund, M, Ekwen, G, Elbaih, A, Elhadi, M, Enninghorst, N, Ernisova, M, Escalera-Antezana, J, Esposito, S, Esposito, G, Estaire, M, Fare, C, Farre, R, Favi, F, Ferrario, L, Vajana, A, Filisetti, C, Fleres, F, Fonseca, V, Forero-Torres, A, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Frassini, S, Frazzetta, G, Pizzocaro, E, Frountzas, M, Gachabayov, M, Galeiras, R, Vazquez, A, Gargarella, S, Garzali, I, Ghannam, W, Ghazi, F, Gillman, L, Gioco, R, Giordano, A, Giordano, L, Giove, C, Giraudo, G, Giuffrida, M, Capponi, M, Gois, E, Gomes, C, Gomes, F, Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Gracia-Roman, R, Graziano, G, Griffiths, E, Guagni, T, Hadzhiev, D, Haidar, M, Hamid, H, Hardcastle, T, Hayati, F, Healey, A, Hecker, A, Hecker, M, Garcia, E, Hodonou, A, Huaman, E, Huerta, M, Ibrahim, A, Ibrahim, B, Ietto, G, Inama, M, Ioannidis, O, Isik, A, Ismail, N, Ismail, A, Jailani, R, Jang, J, Kalfountzos, C, Kalipershad, S, Kaouras, E, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Katsaros, I, Kavalakat, A, Kechagias, A, Kenig, J, Kessel, B, Khan, J, Khokha, V, Kim, J, Kirkpatrick, A, Klappenbach, R, Kluger, Y, Kobe, Y, Lymperis, E, Kok, K, Kong, V, Korkolis, D, Koukoulis, G, Kovacevic, B, Kruger, V, Kryvoruchko, I, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Lapolla, P, Leppaniemi, A, Licari, L, Lisi, G, Litvin, A, Lizarazu, A, Bayo, H, Lohsiriwat, V, Moreira, C, Lostoridis, E, Luna, A, Luppi, D, Machain, V, Maegele, M, Maggiore, D, Magnone, S, Maier, R, Major, P, Manangi, M, Manetti, A, Mantoglu, B, Marafante, C, Mariani, F, Marinis, A, Mariot, E, Martines, G, Perez, A, Martino, C, Mascagni, P, Massalou, D, Massaro, M, Matias-Garcia, B, Mazzarella, G, Mazzarolo, G, Melo, R, Mendoza-Moreno, F, Meric, S, Meyer, J, Miceli, L, Michalopoulos, N, Milana, F, Mingoli, A, Mishra, T, Mohamed, M, Mohamedahmed, A, Mohammed, M, Mohan, R, Moore, E, Morales-Garcia, D, Muhrbeck, M, Mulita, F, Mustafa, S, Muttillo, E, Naimzada, M, Navsaria, P, Negoi, I, Nespoli, L, Nguyen, C, Nidaw, M, Nigri, G, Nikolopoulos, I, O'Connor, D, Ogundipe, H, Oliveri, C, Olmi, S, Ong, E, Orecchia, L, Osipov, A, Othman, M, Pace, M, Pacilli, M, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papa, M, Papaconstantinou, D, Papadoliopoulou, M, Papadopoulos, A, Papis, D, Pararas, N, Parreira, J, Parry, N, Pata, F, Patel, T, Paterson-Brown, S, Pavone, G, Pecchini, F, Pegoraro, V, Pellino, G, Pelloni, M, Peloso, A, Del Pozo, E, Pereira, R, Pereira, B, Perez, S, Perra, T, Perrone, G, Pesce, A, Petagna, L, Petracca, G, Phupong, V, Picardi, B, Picciariello, A, Piccoli, M, Picetti, E, Pikoulis, E, Pintar, T, Pirozzolo, G, Piscioneri, F, Podda, M, Porcu, A, Privitera, F, Punzo, C, Quaresima, S, Quiodettis, M, Qvist, N, Rahim, R, de Almeida, F, Ramely, R, Rasa, H, Reichert, M, Reinisch-Liese, A, Renne, A, Riccetti, C, Rodriguez-Luna, M, Roizblatt, D, Romanzi, A, Romeo, L, Roscio, F, Rosnelifaizur, R, Rossi, S, Rubiano, A, Ruiz-Ucar, E, Sakakushev, B, Salamea, J, Sall, I, Samarakoon, L, Sammartano, F, Arteaga, A, Sanchez-Cordero, S, Santoanastaso, D, Sartelli, M, Sasia, D, Sato, N, Savchuk, A, Sawyer, R, Scaioli, G, Schizas, D, Sebastiani, S, Seeliger, B, Lohse, H, Seretis, C, Sermonesi, G, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Sidiropoulos, T, Simoes, R, Siragusa, L, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Sopuev, A, Soreide, K, Sovatzidis, A, Stahel, P, Strickland, M, Sultan, M, Sydorchuk, R, Sydorchuk, L, Syed, S, Tallon-Aguilar, L, Tamburini, A, Tamini, N, Tan, E, Tan, J, Tarasconi, A, Tartaglia, N, Tartaglia, G, Tartaglia, D, Taylor, J, Tebala, G, Teuben, M, Theodorou, A, Tolonen, M, Tomasicchio, G, Toro, A, Torre, B, Triantafyllou, T, Trigiante, G, Tripepi, M, Trostchansky, J, Tsekouras, K, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Uchikov, P, Ugarte-Sierra, B, Ukkonen, M, Vailas, M, Vassiliu, P, Vazquez, R, Velmahos, G, Verde, J, Veroux, M, Vigano, J, Vilallonga, R, Visconti, D, Vittori, A, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Woltz, S, Wong, T, Xenaki, S, Yu, B, Yule, S, Zachariah, S, Zacharis, G, Zaghi, C, Zakaria, A, Zambrano, D, Zampitis, N, Zampogna, B, Zanghi, S, Zantedeschi, M, Zapsalis, K, Zattoni, F, and Zese, M

Subjects
Settore SECS-P/10 - Organizzazione Aziendale, Settore MED/18 - Chirurgia Generale, Artificial intelligence, Settore SECS-P/07 - Economia Aziendale, Decision aid, Emergency Medicine, Decision aids, Surgery, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Trauma and emergency surgery, Clinical decision-making, Survey
Abstract

Background Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons’ knowledge and perception of using AI-based tools in clinical decision-making processes. Methods An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society’s website and Twitter profile. Results 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons' preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust. Discussion The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI.

Published
2023
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16. Time for a paradigm shift in shared decision-making in trauma and emergency surgery? Results from an international survey

Author

Cobianchi, Lorenzo, Dal Mas, Francesca, Agnoletti, Vanni, Ansaloni, Luca, Biffl, Walter, Butturini, Giovanni, Campostrini, Stefano, Catena, Fausto, Denicolai, Stefano, Fugazzola, Paola, Martellucci, Jacopo, Massaro, Maurizio, Previtali, Pietro, Ruta, Federico, Venturi, Alessandro, Woltz, Sarah, Kaafarani, Haytham M., Loftus, Tyler J., Aapoäÿlu, Recayi, Abbott, Kenneth Lyle, Abdelmalik, Abubaker, Abebe, Nebyou Seyoum, Abu-Zidan, Fikri, Adam, Yousif Abdallah Yousif, Adamou, Harissou, Adamovich, Dmitry Mikhailovich, Agresta, Ferdinando, Agrusa, Antonino, Akin, Emrah, Alessiani, Mario, Alexandrino, Henrique, Bidoli, Chiara, Ali, Syed Muhammad, Mihai, Vasilescu Alin, Almeida, Pedro Miguel, Al-Shehari, Mohammed Mohammed, Altomare, Michele, Amico, Francesco, Ammendola, Michele, Andreuccetti, Jacopo, Anestiadou, Elissavet, Annicchiarico, Alfredo, Antonelli, Amedeo, Aparicio-Sanchez, Daniel, Ardito, Antonella, Argenio, Giulio, Arvieux, Catherine Claude, Arvieux, Catherine, Askevold, Ingolf Harald, Atanasov, Boyko Tchavdarov, Augustin, Goran, Awad, Selmy Sabry, Bacchiocchi, Giulia, Bagnoli, Carlo, Bahouth, Hany, Baili, Efstratia, Bains, Lovenish, Baiocchi, Gian Luca, Bala, Miklosh, Balaguà©, Carmen, Balalis, Dimitrios, Baldini, Edoardo, Baraket, Oussama, Baral, Suman, Barone, Mirko, Gonzãlez Barranquero, Alberto, Barreras, Jorge Arturo, Bass, Gary Alan, Bayhan, Zulfu, Bellanova, Giovanni, Ben-Ishay, Offir, Bert, Fabrizio, Bianchi, Valentina, Biancuzzi, Helena, Radulescu, Raluca Bievel, Bignell, Mark Brian, Biloslavo, Alan, Bini, Roberto, Bissacco, Daniele, Boati, Paoll, Boddaert, Guillaume, Bogdanic, Branko, Bombardini, Cristina, Bonavina, Luigi, Bonomo, Luca, Bottari, Andrea, Bouliaris, Konstantinos, Brachini, Gioia, Brillantino, Antonio, Brisinda, Giuseppe, Bulanauca, Maloni Mamada, Buonomo, Luis Antonio, Burcharth, Jakob, Buscemi, Salvatore, Calabretto, Francesca, Calini, Giacomo, Calu, Valentin, Campanile, Fabio Cesare, Campo Dall’Orto, Riccardo, Campos-Serra, Andrea, Carvas, Joao Miguel, Cascella, Marco, Pattacini, Gianmaria Casoni, Celentano, Valerio, Centonze, Danilo Corrado, Ceresoli, Marco, Chatzipetris, Dimitrios, Chessa, Antonella, Chiarello, Maria Michela, Chirica, Mircea, Chooklin, Serge, Chouliaras, Christos, Chowdhury, Sharfuddin, Cianci, Pasquale, Cillara, Nicola, Cimbanassi, Stefania, Cioffi, Stefano Piero Bernardo, Colãis-Ruiz, Enrique, Colak, Elif, Conti, Luigi, Coppola, Alessandro, de Sa, Tiago Correia, Costa, Silvia Dantas, Cozza, Valerio, Curro’, Giuseppe, Dabekaussen, Kirsten Felicia Ann-Sophie Aimee, D’Acapito, Fabrizio, Damaskos, Dimitrios, D’Ambrosio, Giancarlo, Das, Koray, Davies, Richard Justin, de Beaux, Andrew Charles, De Lebrusant Fernandez, Sara Patricia, De Luca, Alessandro, De Simone, Belinda, De Stefano, Francesca, Degrate, Luca, Demetrashvili, Zaza, Demetriades, Andreas Kyriacou, Detanac, Dzemail Smail, Dezi, Agnese, Di Buono, Giuseppe, Carlo, Isidoro-D. I., Di Lascio, Pierpaolo, Di Martino, Marcello, Di Saverio, Salomone, Diaconescu, Bogdan, Diaz, Jose J., Dibra, Rigers, Dimitrov, Evgeni Nikolaev, Dinuzzi, Vincenza Paola, Dios-Barbeito, Sandra, Diyani, Jehangir Farman Ali, Dogjani, Agron, Domanin, Maurizio, D’Oria, Mario, Munoz-Cruzado, Virginia Duran, East, Barbora, Ekelund, Mikael, Ekwen, Gerald Takem, Elbaih, Adel Hamed, Elhadi, Muhammed, Enninghorst, Natalie, Ernisova, Mairam, Escalera-Antezana, Juan Pablo, Esposito, Sofia, Esposito, Giuseppe, Estaire-Gãmez, Mercedes, Farã, Camilla Nikita, Farre, Roser, Favi, Francesco, Ferrario, Luca, Ferrario di Tor Vajana, Antonjacopo, Filisetti, Claudia, Fleres, Francesco, Fonseca, Vinicius Cordeiro, Forero-Torres, Alexander, Forfori, Francesco, Fortuna, Laura, Fradelos, Evangelos, Fraga, Gustavo P., Fransvea, Pietro, Frassini, Simone, Frazzetta, Giuseppe, Frigerio, Isabella, Frountzas, Maximos, Gachabayov, Mahir, Galeiras, Rita, Garcãa, Belen Matãas, Garcia Vazquez, Alain, Gargarella, Simone, Garzali, Ibrahim Umar, Ghannam, Wagih Mommtaz, Ghazi, Faiz Najmuddin, Gillman, Lawrence Marshall, Gioco, Rossella, Giordano, Alessio, Giordano, Luca, Giove, Carlo, Giraudo, Giorgio, Giuffrida, Mario, Capponi, Michela Giulii, Gois, Emanuel, Gomes, Carlos Augusto, Gomes, Felipe Couto, Gonsaga, Ricardo Alessandro Teixeira, Gonullu, Emre, Goosen, Jacques, Goranovic, Tatjana, Gracia-Roman, Raquel, Graziano, Giorgio Maria Paolo, Griffiths, Ewen Alexander, Guagni, Tommaso, Hadzhiev, Dimitar Bozhidarov, Haidar, Muad Gamil, Hamid, Hytham K. S., Hardcastle, Timothy Craig, Hayati, Firdaus, Healey, Andrew James, Hecker, Andreas, Hecker, Matthias, Garcia, Edgar Fernando Hernandez, Hodonou, Adrien Montcho, Huaman, Eduardo cancio, Huerta, Martin, Ibrahim, Aini Fahriza, Ibrahim, Basil Mohamed Salabeldin, Ietto, Giuseppe, Inama, Marco, Ioannidis, Orestis, Isik, Arda, Ismail, Nizar, Ismail, Azzain Mahadi Hamid, Jailani, RUHI Fadzlyana, Jang, Ji Young, Kalfountzos, Christos, Kalipershad, Sujala Niatarika Rajsain, Kaouras, Emmanouil, Kaplan, Lewis Jay, Kara, Yasin, Karamagioli, Evika, Karamarkovia, Aleksandar, Katsaros, Ioannis, Kavalakat, Alfie J., Kechagias, Aristotelis, Kenig, Jakub, Kessel, Boris Juli, Khan, Jim S., Khokha, Vladimir, Kim, Jae Il, Kirkpatrick, Andrew Wallace, Klappenbach, Roberto, Kobe, Yoshiro, Lymperis, Efstratios Kofopoulos, Kok, Kenneth Yuh Yen, Kong, Victor, Korkolis, Dimitris P., Koukoulis, Georgios, Kovacevic, Bojan, Kruger, Vitor Favali, Kryvoruchko, Igor A., Kurihara, Hayato, Kuriyama, Akira, Landaluce-Olavarria, Aitor, Lapolla, Pierfrancesco, Licari, Leo, Lisi, Giorgio, Litvin, Andrey, Lizarazu, Aintzane, Bayo, Heura Llaquet, Lohsiriwat, Varut, Moreira, Claudia Cristina Lopes, Lostoridis, Eftychios, Luna, Agustãn Tovar, Luppi, Davide, Gustavo Miguel Machain, V., Maegele, Marc, Maggiore, Daniele, Magnone, Stefano, Maier, Ronald V., Major, Piotr, Manangi, Mallikarjuna, Manetti, Andrea, Mantoglu, Baris, Marafante, Chiara, Mariani, Federico, Marinis, Athanasios, Mariot, EvandroAntonio Sbalcheiro, Marseglia, Giuseppe Roberto, Martãnez-Pãrez, Aleix, Martines, Gennaro, Perez, Aleix Martinez, Martino, Costanza, Mascagni, Pietro, Massalou, Damien, Matãas-Garcãa, Belãn, Mazzarella, Gennaro, Mazzarolo, Giorgio, Melo, Renato Bessa, Mendoza-Moreno, Fernando, Meric, Serhat, Meyer, Jeremy, Miceli, Luca, Michalopoulos, Nikolaos V., Milana, Flavio, Mingoli, Andrea, Mishra, Tushar S., Mohamed, Muyed, Mohamed, Musab Isam Eldin Abbas, Mohamedahmed, Ali Yasen, Mohammed, Mohammed Jibreel Suliman, Mohan, Rajashekar, Moore, Ernest E., Morales-Garcia, Dieter, Muhrbeck, Mãns, Mulita, Francesk, Mustafa, Sami Mohamed Siddig, Muttillo, Edoardo Maria, Naimzada, Mukhammad David, Navsaria, Pradeep H., Negoi, Ionut, Nespoli, Luca, Nguyen, Christine, Nidaw, Melkamu Kibret, Nigri, Giuseppe, Nikolopoulos, Ioannis, O’Connor, Donal Brendan, Ogundipe, Habeeb Damilola, Oliveri, Cristina, Olmi, Stefano, Ong, Ernest Cun Wang, Orecchia, Luca, Osipov, Aleksei V., Othman, Muhammad Faeid, Pace, Marco, Pacilli, Mario, Pagani, Leonardo, Palomba, Giuseppe, Pantalone, Desire’, Panyko, Arpad, Paolillo, Ciro, Papa, Mario Virgilio, Papaconstantinou, Dimitrios, Papadoliopoulou, Maria, Papadopoulos, Aristeidis, Papis, Davide, Pararas, Nikolaos, Parreira, Jose Gustavo, Parry, Neil Geordie, Pata, Francesco, Patel, Tapan, Paterson-Brown, Simon, Pavone, Giovanna, Pecchini, Francesca, Pellino, Gianluca, Pelloni, Maria, Peloso, Andrea, del Pozo, Eduardo Perea, Pereira, Rita Goncalves, Pereira, Bruno Monteiro, Perez, Aintzane Lizarazu, Perra, Teresa, Perrone, Gennaro, Pesce, Antonio, Petagna, Lorenzo, Petracca, Giovanni, Phupong, Vorapong, Picardi, Biagio, Picciariello, Arcangelo, Piccoli, Micaela, Piccolo, Daniele, Picetti, Edoardo, Pikoulis Pikoulis, Emmanouil, Pintar, Tadeja, Pirozzolo, Giovanni, Piscioneri, Francesco, Podda, Mauro, Porcu, Alberto, Privitera, Francesca, Punzo, Clelia, Quaresima, Silvia, Quiodettis, Martha Alexa, Qvist, Niels, Rahim, Razrim, de Almeida, Filipe Ramalho, Ramely, Rosnelifaizur Bin, Rasa, Huseyin Kemal, Reichert, Martin, Reinisch-Liese, Alexander, Renne, Angela, Riccetti, Camilla, Rodriguez-Luna, Maria Rita, Roizblatt, Daniel, Romanzi, Andrea, Romeo, Luigi, Roscio, Francesco Pietro Maria, Rosnelifaizur, Ramely Bin, Rossi, Stefano, Rubiano, Andres M., Ruiz-Úcar, Elena, Sakakushev, Boris Evgeniev, Salamea, Juan Carlos, Sall, Ibrahima, Samarakoon, Lasitha Bhagya, Sammartano, Fabrizio, Arteaga, Alejandro Sanchez, Sanchez-Cordero, Sergi, Santoanastaso, Domenico Pietro Maria, Sasia, Diego, Sato, Norio, Savchuk, Artem, Sawyer, Robert Grant, Scaioli, Giacomo, Schizas, Dimitrios, Sebastiani, Simone, Seeliger, Barbara, Lohse, Helmut Alfredo Segovia, Seretis, Charalampos, Sermonesi, Giacomo, Serradilla-Martin, Mario, Shelat, Vishal G., Shlyapnikov, Sergei, Sidiropoulos, Theodoros, Simoes, Romeo Lages, Siragusa, Leandro, Siribumrungwong, Boonying, Slavchev, Mihail, Solaini, Leonardo, Soldini, Gabriele, Sopuev, Andrey, Soreide, Kjetil, Sovatzidis, Apostolos, Stahel, Philip Frank, Strickland, Matt, Sultan, Mohamed Arif Hameed, Sydorchuk, Ruslan, Sydorchuk, Larysa, Syed, Syed Muhammad Ali Muhammad, Syed, Ali Muhammad, Tallon-Aguilar, Luis, Tamburini, Andrea Marco, Tamini, Nicolò, Tan, Edward C. T. H., Tan, Jih Huei, Tarasconi, Antonio, Tartaglia, Nicola, Tartaglia, Giuseppe, Tartaglia, Dario, Taylor, John Vincent, Tebala, Giovanni Domenico, Teuben, Michel, Theodorou, Alexis, Tolonen, Matti, Tomasicchio, Giovanni, Toro, Adriana, Torre, Beatrice, Triantafyllou, Tania, Trigiante Trigiante, Giuseppe, Tripepi, Marzia, Trostchansky, Julio, Tsekouras, Konstantinos, Turrado-Rodriguez, Victor, Tutino, Roberta, Uccelli, Matteo, Uchikov, Petar Angelov, Ugarte-Sierra, Bakarne, Ukkonen, Mika Tapani, Vailas, Michail, Vassiliu, Panteleimon G., Vazquez, Alain Garcia, Vazquez, Rita Galeiras, Verde, Juan Ezequiel, Verde, Juan Manuel, Veroux, Massimiliano, Viganò, Jacopo, Vilallonga, Ramon, Visconti, Diego, Vittori, Alessandro, Waledziak, Maciej, Wannatoop, Tongporn, Widmer, Lukas Werner, Wilson, Michael Samuel James, Wong, Ting Hway, Xenaki, Sofia, Byungchul, Yu, Yule, Steven, Zachariah, Sanoop Koshy, Zacharis, Georgios, Zaghi, Claudia, Zakaria, Andee Dzulkarnaen, Zambrano, Diego A., Zampitis, Nikolaos, Zampogna, Biagio, Zanghã, Simone, Zapsalis, Konstantinos, Zattoni, Fabio, Zese, Monica, Farre, Silvia Pãrez, Pegoraro, Veronica, Zantedeschi, Maristella, Reitano, Elisa, Pizzocaro, Erica, Cobianchi, L, Dal Mas, F, Agnoletti, V, Ansaloni, L, Biffl, W, Butturini, G, Campostrini, S, Catena, F, Denicolai, S, Fugazzola, P, Martellucci, J, Massaro, M, Previtali, P, Ruta, F, Venturi, A, Woltz, S, Kaafarani, H, Loftus, T, Aapoaylu, R, Abbott, K, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Adamovich, D, Agresta, F, Agrusa, A, Akin, E, Alessiani, M, Alexandrino, H, Bidoli, C, Ali, S, Mihai, V, Almeida, P, Al-Shehari, M, Altomare, M, Amico, F, Ammendola, M, Andreuccetti, J, Anestiadou, E, Annicchiarico, A, Antonelli, A, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Arvieux, C, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bacchiocchi, G, Bagnoli, C, Bahouth, H, Baili, E, Bains, L, Baiocchi, G, Bala, M, Balaguacopyright, C, Balalis, D, Baldini, E, Baraket, O, Baral, S, Barone, M, Gonzalez Barranquero, A, Barreras, J, Bass, G, Bayhan, Z, Bellanova, G, Ben-Ishay, O, Bert, F, Bianchi, V, Biancuzzi, H, Radulescu, R, Bignell, M, Biloslavo, A, Bini, R, Bissacco, D, Boati, P, Boddaert, G, Bogdanic, B, Bombardini, C, Bonavina, L, Bonomo, L, Bottari, A, Bouliaris, K, Brachini, G, Brillantino, A, Brisinda, G, Bulanauca, M, Buonomo, L, Burcharth, J, Buscemi, S, Calabretto, F, Calini, G, Calu, V, Campanile, F, Campo Dall'Orto, R, Campos-Serra, A, Carvas, J, Cascella, M, Pattacini, G, Celentano, V, Centonze, D, Ceresoli, M, Chatzipetris, D, Chessa, A, Chiarello, M, Chirica, M, Chooklin, S, Chouliaras, C, Chowdhury, S, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colais-Ruiz, E, Colak, E, Conti, L, Coppola, A, de Sa, T, Costa, S, Cozza, V, Curro', G, Dabekaussen, K, D'Acapito, F, Damaskos, D, D'Ambrosio, G, Das, K, Davies, R, de Beaux, A, De Lebrusant Fernandez, S, De Luca, A, De Simone, B, De Stefano, F, Degrate, L, Demetrashvili, Z, Demetriades, A, Detanac, 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Trigiante, G, Tripepi, M, Trostchansky, J, Tsekouras, K, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Uchikov, P, Ugarte-Sierra, B, Ukkonen, M, Vailas, M, Vassiliu, P, Vazquez, A, Vazquez, R, Verde, J, Veroux, M, Vigano, J, Vilallonga, R, Visconti, D, Vittori, A, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Wong, T, Xenaki, S, Yu, B, Yule, S, Zachariah, S, Zacharis, G, Zaghi, C, Zakaria, A, Zambrano, D, Zampitis, N, Zampogna, B, Zangha, S, Zapsalis, K, Zattoni, F, Zese, M, Farre, S, Pegoraro, V, Zantedeschi, M, Reitano, E, Pizzocaro, E, Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), and The Team Dynamics Study Group

Subjects
Settore SECS-P/10 - Organizzazione Aziendale, Settore MED/18 - Chirurgia Generale, Settore SECS-P/07 - Economia Aziendale, Emergency Medicine, Clinical decision-making, Patient-centric care, Shared decision-making, Survey, Trauma and emergency surgery, Surgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Background Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons. Methods Grounding on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society’s website, and shared on the society’s Twitter profile. Results A total of 650 trauma and emergency surgeons from 71 countries in five continents participated in the initiative. Less than half of the surgeons understood SDM, and 30% still saw the value in exclusively engaging multidisciplinary provider teams without involving the patient. Several barriers to effectively partnering with the patient in the decision-making process were identified, such as the lack of time and the need to concentrate on making medical teams work smoothly. Discussion Our investigation underlines how only a minority of trauma and emergency surgeons understand SDM, and perhaps, the value of SDM is not fully accepted in trauma and emergency situations. The inclusion of SDM practices in clinical guidelines may represent the most feasible and advocated solutions.

Published
2023
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17. Aortic balloon occlusion (REBOA) in pelvic ring injuries: preliminary results of the ABO Trauma Registry

Author

Adam Bersztel, Camilla Cremonini, Endre Szarka, Fausto Catena, Maria Grazia Sibilla, Artai Pirouzram, Enrico Cicuttin, Eva-Corina Caragounis, Boris Kessel, Federico Coccolini, Yosuke Matsumura, Lauri Handolin, Viktor A. Reva, Emiliano Gamberini, Per Skoog, Sung Wook Chang, George Oosthuizen, David T. McGreevy, Miklosh Bala, Kristofer F. Nilsson, Yuri Kon, Luca Ansaloni, Vanni Agnoletti, Mariusz Maszkowski, Tongporn Wannatoop, Matteo Tomasoni, Marco Ceresoli, V Manchev, Tokiya Ishida, Mårten Falkenberg, Gad Shaked, Mitra Sadeghi, Massimo Chiarugi, Carlos A. Ordoñez, Paola Fugazzola, Junichi Matsumoto, Peter Hibert-Carius, Thomas Larzon, Dan Hebron, Claudia Zaghi, Koji Idoguchi, Asko Toivola, Tal M. Hörer, Coccolini, F, Ceresoli, M, Mcgreevy, D, Sadeghi, M, Pirouzram, A, Toivola, A, Skoog, P, Idoguchi, K, Kon, Y, Ishida, T, Matsumura, Y, Matsumoto, J, Reva, V, Maszkowski, M, Fugazzola, P, Tomasoni, M, Cicuttin, E, Ansaloni, L, Zaghi, C, Sibilla, M, Cremonini, C, Bersztel, A, Caragounis, E, Falkenberg, M, Handolin, L, Oosthuizen, G, Szarka, E, Manchev, V, Wannatoop, T, Chang, S, Kessel, B, Hebron, D, Shaked, G, Bala, M, Ordonez, C, Hibert-Carius, P, Chiarugi, M, Nilsson, K, Larzon, T, Gamberini, E, Agnoletti, V, Catena, F, and Horer, T

Subjects
Male, Hemodynamics, 0302 clinical medicine, Registries, Aorta, Univariate analysis, education.field_of_study, Trauma Severity Indices, ABO, EVTM, Hemodynamic, International, Morbidity, Mortality, Pelvis, REBOA, Registry, Trauma, Mortality rate, Hydrogen-Ion Concentration, Middle Aged, medicine.anatomical_structure, Blunt trauma, 030220 oncology & carcinogenesis, Female, 030211 gastroenterology & hepatology, Adult, medicine.medical_specialty, Adolescent, Systole, Pelvi, Population, Arterial Occlusive Diseases, Shock, Hemorrhagic, Young Adult, 03 medical and health sciences, medicine.artery, medicine, Humans, International Normalized Ratio, education, business.industry, Balloon Occlusion, Surgery, Blood pressure, business
Abstract

EndoVascular and Hybrid Trauma Management (EVTM) has been recently introduced in the treatment of severe pelvic ring injuries. This multimodal method of hemorrhage management counts on several strategies such as the REBOA (resuscitative endovascular balloon occlusion of the aorta). Few data exist on the use of REBOA in patients with a severely injured pelvic ring. The ABO (aortic balloon occlusion) Trauma Registry is designed to capture data for all trauma patients in hemorrhagic shock where management includes REBOA placement. Among all patients included in the ABO registry, 72 patients presented with severe pelvic injuries and were the population under exam. 66.7% were male. Mean and median ISS were respectively 43 and 41 (SD ± 13). Isolated pelvic injuries were observed in 12 patients (16.7%). Blunt trauma occurred in 68 patients (94.4%), penetrating in 2 (2.8%) and combined in 2 (2.8%). Type of injury: fall from height in 15 patients (23.1%), traffic accident in 49 patients (75.4%), and unspecified impact in 1 patient (1.5%). Femoral access was gained pre-hospital in 1 patient, in emergency room in 43, in operating room in 12 and in angio-suite in 16. REBOA was positioned in zone 1 in 59 patients (81,9%), in zone 2 in 1 (1,4%) and in zone 3 in 12 (16,7%). Aortic occlusion was partial/periodical in 35 patients (48,6%) and total occlusion in 37 patients (51,4%). REBOA associated morbidity rate: 11.1%. Overall mortality rate was 54.2% and early mortality rate (≤ 24 h) was 44.4%. In the univariate analysis, factors related to early mortality (≤ 24 h) are lower pH values (p = 0.03), higher base deficit (p = 0.021), longer INR (p = 0.012), minor increase in systolic blood pressure after the REBOA inflation (p = 0.03) and total aortic occlusion (p = 0.008). None of these values resulted significant in the multivariate analysis. In severe hemodynamically unstable pelvic trauma management, REBOA is a viable option when utilized in experienced centers as a bridge to other treatments; its use might be, however, accompanied with severe-to-lethal complications.

Published
2020
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18. Biomonitoring of chemicals in biota of two wetland protected areas exposed to different levels of environmental impact: results of the 'PREVIENI' project

Author

Guido Perra, Sabrina Tait, Eva Alessi, Alberto Mantovani, Michela Mariottini, Cristiana Guerranti, Augusto De Sanctis, Carlo Zaghi, Donatella Caserta, Monia Renzi, Emiliano Leonida Fanello, Dante Caserta, Silvano Focardi, Cinzia La Rocca, Davide Baroni, Guerranti, C., Perra, G., Alessi, E., Baroni, D., Caserta, D., De Sanctis, A., Fanello, E. L., La Rocca, C., Mariottini, M., Renzi, M., Tait, S., Zaghi, C., Mantovani, A., and Focardi, S. E.

Subjects
Fluorocarbon, 010504 meteorology & atmospheric sciences, Musk xylene, Phenolic compound, Organohalogen compound, Water Pollutant, 010501 environmental sciences, Endocrine Disruptors, 01 natural sciences, Bioindicators, Organohalogen compounds, Perfluorinated compounds, Phenolic compounds, Phthalates, Polycyclic aromatic hydrocarbons, Benzhydryl Compounds, Biota, Caprylates, Europe, Fluorocarbons, Halogenated Diphenyl Ethers, Humans, Italy, Phenols, Phthalic Acids, Polychlorinated Biphenyls, Polycyclic Aromatic Hydrocarbons, Water Pollutants, Chemical, Environmental Monitoring, Wetlands, chemistry.chemical_compound, Polybrominated diphenyl ethers, Polychlorinated Biphenyl, Biomonitoring, Water Pollutants, General Environmental Science, Benzhydryl Compound, education.field_of_study, General Medicine, Pollution, Chemical, Perfluorinated compound, Polycyclic aromatic hydrocarbon, Environmental chemistry, Phthalate, Human, endocrine system, Population, Management, Monitoring, Policy and Law, Galaxolide, bioindicators, organohalogen compounds, perfluorinated compounds, phenolic compounds, phthalates, polycyclic aromatic hydrocarbons, education, Phthalic Acid, Endocrine Disruptor, 0105 earth and related environmental sciences, Phenol, Bioindicator, chemistry, Synthetic musk, Halogenated Diphenyl Ether, Environmental science, Polybrominated Biphenyls, Caprylate
Abstract

The PREVIENI project (funded by the Ministry of Environment) investigated the exposure to endocrine disrupters in samples of human population and environmental biota in Italy. The environmental biomonitoring considered two Italian WWF Oasis, with the aim to compare the presence and effects of endocrine disruptors in organisms from two protected natural areas, respectively, upstream and downstream a chemical emission site. Chemical analysis of pollutants' tissue levels was made on tissues from earthworm, barbell, trout, and coot, selected as bioindicator organisms. The contaminants considered were as follows: the perfluorinated compounds perfuoroctane sulfonate (PFOS) and perfluorooctanoic acid (PFOA), polychlorinated biphenyls (PCBs 58 congeners), polybrominated diphenyl ethers (PBDEs, 13 congeners), polycyclic aromatic hydrocarbons (PAHs, 16 compounds), toxic trace elements, the phthalate di-2-ethylexyl phthalate (DEHP) and its primary metabolite, bisphenol A, synthetic musk compounds (musk xylene, musk ketone, tonalide, and galaxolide), and p-nonylphenol. The analyses showed low concentrations of most pollutants in all species from both areas, compared to available literature; noticeable exceptions were the increases of DEHP's primary metabolite, PBDE, PAHs, Hg, and Pb in barbells, and of PCB and Cd in earthworms from the downstream area. The results showed the presence of endocrine disruptors, including those considered as "non-persistent," in bioindicators from protected areas, albeit at low levels. The results provide a contribution to the evaluation of reference values in biota from Mediterranean Europe and support the relevance of monitoring exposure to pollutants, in particular for freshwater environment, also in protected areas.

Published
2017

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