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2,707 results on '"A, Shapiro"'

1. Failure Mode Effects Analysis of Re-triage of Injured Patients to Receiving High-level Illinois Trauma Centers.

Author

Slocum, John D., Holl, Jane L., Brigode, William M., Voights, Mary Beth, Anstadt, Michael J., Henry, Marion C., Mis, Justin, Fantus, Richard J., Plackett, Timothy P., Markul, Eddie J., Chang, Grace H., Shapiro, Michael B., Siparsky, Nicole, and Stey, Anne M.

Abstract

Objective: This study identified failures in emergency inter-hospital transfer, or re-triage, at high-level trauma centers receiving severely injured patients. Background: The re-triage process averages 4 hours despite the fact timely re-triage within 2 hours mitigates injury-associated mortality. Non-trauma and low-level trauma centers reported that the most critical failures were in finding an accepting high-level trauma center. Critical failures at high-level trauma centers have not been assessed. Methods: This was an observational cross-sectional study at 9 high-level adult trauma centers and 3 high-level pediatric trauma centers. Failure modes effects analysis of the re-triage process was conducted in 4 phases. Phase 1 purposively sampled trauma coordinators, followed by snowball sampling of clinicians, operations, and leadership to ensure representative participation. Phase 2 mapped each re-triage step. Phase 3 identified failures at each step. Phase 4 scored each failure on impact, frequency, and safeguards for detection. Standardized rubrics were used in phase 4 to rate each failure's impact (I), frequency (F), and safeguard for detection (S) to calculate their risk priority number (RPN; IxFxS). Failures were rank-ordered for criticality based on their RPN. Results: A total of 64 trauma coordinators, surgeons, emergency medicine physicians, nurses, operations, and quality managers across 12 high-level trauma centers participated. There were 178 failures identified at adult and pediatric high-level trauma centers. The most critical failures were: (1) insufficiently trained transport staff (RPN = 648), (2) issues transmitting imaging from sending to receiving centers (RPN = 400), and (3) incomplete exchange of clinical information (RPN = 384). Conclusions: The most critical failures were limited transportation and incomplete exchange of clinical, radiologic, and arrival timing information. Further investigation of these failures includes several regions is needed to determine the reproducibility of these findings. [ABSTRACT FROM AUTHOR]

Published
2025
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5. Sexual Violence and Hazardous Drinking: Exploring Associations With PTSD Symptoms and Gender Among Adults With Probable PTSD and Hazardous Drinking.

Author

Short, Nicole A., Shapiro, Mary, Smit, Tanya, McGrew, Shelby J., Zvolensky, Michael J., and Vujanovic, Anka A.

Abstract

Sexual violence is associated with posttraumatic stress disorder (PTSD), but relatively less research has explored whether it is associated with hazardous drinking. PTSD symptoms may indirectly influence the association between sexual violence and hazardous alcohol use. This association may be moderated by gender. The aim of the current study was to cross-sectionally test whether sexual violence is indirectly associated with hazardous drinking through PTSD symptoms and explore whether gender moderates this association. Hypotheses were tested among 631 adults (M age = 38, 56% men, 78.6% White) with probable PTSD and hazardous drinking who completed online self-report surveys. Results indicated sexual violence, compared with other trauma types, was associated with more severe hazardous drinking. There was a significant indirect effect of PTSD symptoms in this association. There was no evidence of a moderating effect of gender. PTSD symptoms may drive hazardous drinking among sexual violence survivors. Results also underscore associations between sexual violence and alcohol use, regardless of gender. Future work should continue to investigate these associations prospectively. [ABSTRACT FROM AUTHOR]

Published
2024
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6. Platelet-Rich Plasma-Induced Remodeling of the Abductor Pollicis Longus Tendon: A Treatment for Tendinopathy in the First Dorsal Compartment of the Wrist.

Author

Dixon, Grant, Shapiro, Mark S., Potter, Steven, Ni, Andrew, Xu, Nasa, Santa Maria, Daniel, and Brady, Christina

Subjects
VIBRATION therapy, WRIST joint, TENDON rupture, TENDON injury healing, DISTAL radius fractures
Abstract

The article discusses the use of platelet-rich plasma (PRP) treatment for tendinopathy in the abductor pollicis longus (APL) tendon in the wrist. It presents a case study of a 59-year-old male with APL tendinosis following a traumatic injury and corticosteroid injection, who experienced significant improvement after PRP treatment. The study challenges the standard care of corticosteroid injections for wrist tendinopathies and suggests PRP as a safe and effective alternative for tendon healing. The authors recommend further research on the efficacy of PRP versus corticosteroid injections for wrist tendinopathies. [Extracted from the article]

Published
2024
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15. Clinical Practice Guidelines to Support Capacity Building in Orthopaedic Surgical Outreach: An International Consensus Building Approach.

Author

Welch, Jessica M., Kamal, Robin N., Kozin, Scott H., Dyer, George S. M., Katarincic, Julia A., Fox, Paige M., and Shapiro, Lauren M.

Abstract

Background: Surgical outreach to low- and middle-income countries (LMICs) by organizations from high-income countries is on the rise to help address the growing burden of conditions warranting surgery. However, concerns remain about the impact and sustainability of such outreach. Leading organizations (e.g., the World Health Organization) advocate for a capacity-building approach to ensure the safety, quality, and sustainability of the local health-care system. Despite this, to our knowledge, no guidelines exist to inform such efforts. We aimed to develop clinical practice guidelines (CPGs) to support capacity-building in orthopaedic surgical outreach utilizing a multistakeholder and international voting panel. Methods: We followed a modified American Academy of Orthopaedic Surgeons (AAOS) CPG development process. We systematically reviewed the existing literature across 7 predefined capacity-building domains (partnership, professional development, governance, community impact, finance, coordination, and culture). A writing panel composed of 6 orthopaedic surgeons with extensive experience in surgical outreach reviewed the existing literature and developed a consensus-based CPG for each domain. We created an international voting panel of orthopaedic surgeons and administrators who have leadership roles in outreach organizations or hospitals with which outreach organizations partner. Members individually reviewed the CPGs and voted to approve or disapprove each guideline. A CPG was considered approved if >80% of panel members voted to approve it. Results: An international voting panel of 14 surgeons and administrators from 6 countries approved all 7 of the CPGs. Each CPG provides recommendations for capacity-building in a specific domain. For example, in the domain of partnership, the CPG recommends the development of a documented plan for ongoing, bidirectional partnership between the outreach organization and the local team. In the domain of professional development, the CPG recommends the development of a needs-based curriculum focused on both surgical and nonsurgical patient care utilizing didactic and hands-on techniques. Conclusions: As orthopaedic surgical outreach grows, best-practice CPGs to inform capacity-building initiatives can help to ensure that resources and efforts are optimized to support the sustainability of care delivery at local sites. These guidelines can be reviewed and updated in the future as evidence that supports capacity-building in LMICs evolves. The global burden of disease warranting surgery is substantial, and morbidity and mortality from otherwise treatable ditions remain disproportionately high in low- and middle-income countries (LMICs)1,2. It is estimated that up to 2 million (about 40%) of injury-related deaths in LMICs could be avoided annually if mortality rates were reduced to the level of those in high-income countries (HICs)3. Despite this, progress toward improved access to safe, timely surgery in resource-poor areas has been slow. Historically, nongovernmental organizations (NGOs) have tried to address unmet surgical needs through short-term outreach trips; however, growing criticism has highlighted the limitations of short-term trips, including limited follow-up, an increased burden on the local workforce, and further depletion of local resources4-6. In light of ongoing concerns, public health priorities have shifted toward models that emphasize long-term capacity-building rather than short-term care delivery. Capacity-building is an approach to health-care development that builds independence through infrastructure development, sustainability, and enhanced problem-solving while taking context into account7,8. [ABSTRACT FROM AUTHOR]

Published
2024
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22. Induction to Methadone 80 mg in the First Week of Treatment of PatientsWho Use Fentanyl: A Case Series From an Outpatient Opioid Treatment Program.

Author

Steiger, Scott, McCuistian, Caravella, Suen, Leslie W., Shapiro, Brad, Tompkins, D. Andrew, and Bazazi, Alexander R.

Abstract

Objectives: Current guidelines for methadone titration may unnecessarily delay reaching effective doses for patients using fentanyl, resulting in an increased risk of ongoing fentanyl use, dissatisfaction with treatment, and early dropout. Development and evaluation of rapid methadone induction protocols may improve treatment for patients using fentanyl. Methods: Retrospective chart review was conducted for patients admitted in 2022 to a single licensed opioid treatment program (OTP) where a rapid induction protocol provides methadone 40 mg on day 1, 60 mg on day 2, and 80 mg on day 3 to patients using fentanyl <65 years old without significant medical comorbidities. The primary feasibility outcome was completion of the protocol, defined by receipt of methadone dose 80 mg or more on treatment day 7. The primary safety outcomes were oversedation, nonfatal overdose, and death. A secondary outcome was retention in treatment at 30 days. Results: Rapid induction was ordered for 93 patients and completed by 65 (70%). Average dose on day 7 for patients who completed was 89 mg (SD 9.5 mg) versus 49 mg (SD 14.0 mg) for those who did not. No episodes of oversedation, nonfatal overdose, or death were observed. At 30 days, 85% of the patients who had the rapid protocol ordered (79/93) were retained, with 88% (57/65) who completed the protocol retained versus 79% (22/28) who did not complete (OR 1.9, 95% CI 0.6--6.2). Conclusions: Rapid induction to methadone 80 mg by day 7 was feasible for outpatients using fentanyl in this study at a single OTP. No significant safety events were identified. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Impact of Diplopia and Ptosis From Lingering Third Nerve Palsy After Treatment of Cerebral Aneurysms.

Author

Shapiro, Jeremy N., Delott, Lindsey B., and Trobe, Jonathan D.

Abstract

Background: Third nerve palsies (TNPs) may not resolve after intervention for intracranial aneurysms that have compressed the nerve. The disability related to this lingering condition has not been assessed with the support of patient self-report. Methods: A single-institutional retrospective study of patients with TNP who had undergone interventions for intracranial aneurysms. We used residual primary-position diplopia, a narrow zone of single binocular vision, and vision-obscuring ptosis to divide TNP recovery into complete, incomplete nondisabling, and incomplete disabling outcomes based on medical record documentation and patient self-report derived from telephonic interviews. Results: In a cohort of 33 patients, 13 (39%) had complete TNP recovery. There were 11 patients (33%) with lingering visual disability from diplopia or ptosis present before ophthalmic interventions. Of the 6 patients who underwent ophthalmic interventions, visual disability was relieved in only 2 patients, leaving 9 patients (27%) with lingering impairment in instrumental activities of daily living. Telephonic interviews of 23 patients (70% of the cohort) confirmed that the outcome criteria we applied were accurate in assessing visual disability in 17 patients (74%). Univariate analysis using the Fisher exact test showed that aneurysmal clipping as a treatment modality was the only clinical feature associated with a favorable TNP outcome. Conclusions: In applying a novel method of assessing disability, this study showed that more than one-quarter of patients undergoing procedures for brain aneurysms had lingering disability from third nerve palsy--associated diplopia or ptosis, despite later ophthalmic interventions. Patient self-report gleaned from telephonic interviews was valuable in largely validating the assessment method derived from medical records and in revealing differences between physician and patient estimation of disability. [ABSTRACT FROM AUTHOR]

Published
2024
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30. Patient Perceptions and Knowledge Surrounding Pregnancy After Heart Transplantation: A Multicenter Study.

Author

DeFilippis, Ersilia M., Donald, Elena M., Hoffman, Karlee, Rosario, Karen Flores, Agarwal, Richa, Shapiro, Hilary, Hong, Kimberly N., Khush, Kiran K., Punnoose, Lynn, and Kittleson, Michelle M.

Abstract

BACKGROUND: More women of childbearing age are surviving after heart transplantation (HT), many of whom have a desire to become pregnant. Limited data exist evaluating patients' perspectives, receipt of counseling, and knowledge surrounding contraception, pregnancy, breastfeeding, and medication safety after HT. METHODS: We conducted a voluntary, confidential, web-based cross-sectional survey of women who were childbearing age (defined as 18-45 years) at the time of HT. Transplants occurred between January 2005 and January 2020. Surveys were conducted across 6 high-volume HT centers in the United States. RESULTS: There were 64 responses from women who were of childbearing age at the time of HT. Twenty-five women (39.1%) were pregnant before HT, and 6 (9.4%) women reported at least 1 pregnancy post-transplant. Fifty-three percent (n=34) reported they did not receive enough information on post-HT pregnancy before listing for HT, and 26% (n=16) did not discuss their ability to become pregnant with their care team before proceeding with HT. Following HT, 44% (n=28) still felt that they had not received enough information regarding pregnancy. The majority of women (n=49, 77%) had discussed contraception to prevent unplanned pregnancy with their transplant team. Twenty percent (n=13) reported that pregnancy was never safe after transplantation based on the information they had received from their transplant providers. CONCLUSIONS: Many women feel they are not receiving adequate counseling with regard to posttransplant reproductive health. This survey highlights an opportunity to improve both provider education and patient communication to better support women with HT desiring posttransplant pregnancy. [ABSTRACT FROM AUTHOR]

Published
2024
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31. Relationship Between Sarcopenia and Intensive Blood Pressure Control Efficacy and Safety: A Secondary Analysis of SPRINT.

Author

Mirzai, Saeid, Persits, Ian, Kazibwe, Richard, Gabani, Mohanad, Seals, Austin, Singleton, Matthew J., Rikhi, Rishi, Chevli, Parag A., Carbone, Salvatore, Tang, W. H. Wilson, Yeboah, Joseph, Williamson, Jeff D., Kitzman, Dalane W., Herrington, David M., and Shapiro, Michael D.

Abstract

BACKGROUND: Sarcopenia and hypertension are independently associated with worse cardiovascular disease (CVD) risk and survival. While individuals with sarcopenia may benefit from intensive blood pressure (BP) control, the increased vulnerability of this population raises concerns for potential harm. This study aimed to evaluate clinical and safety outcomes with intensive (target <120 mm Hg) versus standard (<140 mm Hg) systolic BP targets in older hypertensive adults with sarcopenia compared with nonsarcopenic counterparts in the SPRINT (Systolic Blood Pressure Intervention Trial). METHODS: Sarcopenia was defined using surrogates of the lowest sex-stratified median of the sarcopenia index (serum creatinine/cystatin C×100) for muscle wasting and gait speed =0.8 m/s for muscle weakness. Outcomes included CVD events, all-cause mortality, and serious adverse events. RESULTS: Of 2571 SPRINT participants with sarcopenia index and gait speed data available (aged =75 years), 502 (19.5%) met the criteria for sarcopenia, which was associated with higher risks of CVD events (adjusted hazard ratio, 1.49 [95% CI, 1.15-1.94]; P=0.003) and all-cause mortality (adjusted hazard ratio, 1.46 [95% CI, 1.09-1.94]; P=0.010). In participants with sarcopenia, intensive (versus standard) BP control nearly halved the risk of CVD events (adjusted hazard ratio, 0.57 [95% CI, 0.36-0.88]; P=0.012) without increasing serious adverse events. Similar risk reduction was seen for all-cause mortality in participants with sarcopenia (adjusted hazard ratio, 0.66 [95% CI, 0.41-1.08]; P=0.102), but the effect was only significant in those without chronic kidney disease. CONCLUSIONS: Older hypertensive adults with sarcopenia randomized to intensive BP control experienced a lower risk of CVD without increased adverse events compared with standard BP control. [ABSTRACT FROM AUTHOR]

Published
2024
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32. Lipoprotein(a) and Coronary Plaque in Asymptomatic Individuals: The Miami Heart Study at Baptist Health South Florida.

Author

Mszar, Reed, Cainzos-Achirica, Miguel, Valero-Elizondo, Javier, Lahan, Shubham, Al-Kindi, Sadeer G., Quispe, Renato, Ali, Shozab S., Arias, Lara, Saxena, Anshul, Shah, Svati H., Cury, Ricardo C., Budoff, Matthew J., Blaha, Michael J., Shapiro, Michael D., Sharma, Garima, Santos, Raul D., Blankstein, Ron, Feldman, Theodore, Fialkow, Jonathan, and Nasir, Khurram

Abstract

BACKGROUND: Elevated levels of lipoprotein(a) (Lp(a)) are independently associated with an increased risk of atherosclerotic cardiovascular disease events. However, the mechanisms driving this association are poorly understood. We aimed to evaluate the association between Lp(a) and coronary plaque characteristics in a contemporary US cohort without clinical atherosclerotic cardiovascular disease, undergoing coronary computed tomography angiography, the noninvasive gold standard for the assessment of coronary atherosclerosis. We used baseline data from the Miami Heart Study--a community-based, prospective cohort study--which included asymptomatic adults aged 40 to 65 years evaluated using coronary computed tomography angiography. Those taking any lipid-lowering therapies were excluded. Elevated Lp(a) was defined as =125 nmol/L. Outcomes included any plaque, coronary artery calcium score >0, maximal stenosis =50%, presence of any high-risk plaque feature (positive remodeling, spotty calcification, low-attenuation plaque, napkin ring), and the presence of =2 high-risk plaque features. RESULTS: Among 1795 participants (median age, 52 years; 54.3% women; 49.6% Hispanic), 291 (16.2%) had Lp(a) =125 nmol/L. In unadjusted analyses, individuals with Lp(a) =125 nmol/L had a higher prevalence of all outcomes compared with Lp(a) <125 nmol/L, although differences were only statistically significant for the presence of any coronary plaque and =2 high-risk features. In multivariable models, elevated Lp(a) was independently associated with the presence of any coronary plaque (odds ratio, 1.40, [95% CI, 1.05-1.86]) and with =2 high-risk features (odds ratio, 3.94, [95% CI, 1.82-8.52]), although only 35 participants had this finding. Among participants with a coronary artery calcium score of 0 (n=1200), those with Lp(a) =125 nmol/L had a significantly higher percentage of any plaque compared with those with Lp(a) <125 nmol/L (24.2% versus 14.2%; P<0.001). CONCLUSIONS:' In this contemporary analysis, elevated Lp(a) was independently associated with the presence of coronary plaque. Larger studies are needed to confirm the strong association observed with the presence of multiple high-risk coronary plaque features. [ABSTRACT FROM AUTHOR]

Published
2024
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36. Integration of Total Worker Health® Training for Occupational Health and Safety Professionals With Efforts to Promote Worker Health, Safety, and Well-being in Mexico.

Author

Brown, Carol E., Jaramillo, Diana, Tenney, Liliana, Schwatka, Natalie V., Goering, Madison G., Hernandez, Karely Villarreal, Shapiro, David C., Van Dyke, Mike, Rice, Serena, Barnoya, Joaquin, Avila, Mauricio Hernandez, Reyna, Rebeca Velasco, Rivera Beltran, Ricardo Alonso, Real Orneias, Gabriel Alejandro, Montealegre, Claudia Gorian, and Newman, Lee S.

Published
2024
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45. Stoma-free Survival After Rectal Cancer Resection With Anastomotic Leakage: Development and Validation of a Prediction Model in a Large International Cohort

Author

Nynke G, Greijdanu, Kiedo, Wienholt, Sander, Ubel, Kevin, Talboom, Gerjon, Hannink, Albert, Wolthui, Francisco B, de Lacy, Jérémie H, Lefevre, Michael, Solomon, Matteo, Frasson, Nicolas, Rotholtz, Quentin, Denost, Rodrigo O, Perez, Tsuyoshi, Konishi, Yves, Pani, Martin, Rutegård, Roel, Hompe, Camiel, Rosman, Frans, van Workum, Pieter J, Tani, Wilt, De, H W, Johanne, A Bremers, Andreas J, T Ferenschild, Flori, de Vriendt, Stefanie, D'Hoore, André, Bislenghi, Gabriele, Farguell, Jordi, M Lacy, Antonio, González Atienza, Paula, S van Kessel, Charlotte, Parc, Yann, Voron, Thibault, K Collard, Maxime, Sancho Muriel, Jorge, Cholewa, Hannia, A Mattioni, Laura, Frontali, Alice, W Polle, Sebastiaan, Polat, Fatih, J Obihara, Ndidi, B Vailati, Bruna, Kusters, Miranda, B Tuynmann, Jurriaan, A Hazen, Sanne J, J Grüter, Alexander A, Amano, Takahiro, Fujiwara, Hajime, Salomon, Mario, Ruiz, Hernán, Gonzalez, Ricardo, Estefanía, Diego, Avellaneda, Nicola, Carrie, Augusto, Santillan, Mateo, A Pantoja Pachajoa, Diana, Parodi, Matia, Gielis, Manuel, Binder, Alf-Dorian, Gürtler, Thoma, Riedl, Peter, Badiani, Sarit, Berney, Christophe, Morgan, Matthew, Hollington, Paul, da Silva, Nigel, Nair, Gavin, M Ho, Yiu, Lamparelli, Michael, Kapadia, Raj, M Kroon, Hidde, N Dudi-Venkata, Nagendra, Liu, Jianliang, Sammour, Tarik, Flamey, Nicola, Pattyn, Paul, Chaoui, Ahmed, Vansteenbrugge, Loui, J van den Broek, Nathalie E, Vanclooster, Patrick, de Gheldere, Charle, Pletinckx, Pieter, Defoort, Barbara, Dewulf, Maxime, Slavchev, Mihail, Belev, Nikolay, Atanasov, Boyko, Krastev, Panche, Sokolov, Manol, Maslyankov, Svilen, Gribnev, Petar, Pavlov, Vasil, Ivanov, Tsvetomir, Karamanliev, Martin, Filipov, Emil, Tonchev, Pencho, Aigner, Felix, Mitteregger, Martin, Allmer, Caterina, Seitinger, Gerald, Colucci, Nicola, Buchs, Nicola, Ris, Frédéric, Toso, Christian, Gialamas, Eleftherio, Vuagniaux, Aurélie, Chautems, Roland, Sauvain, Marc-Olivier, Daester, Silvio, von Flüe, Marku, Guenin, Marc-Olivier, Taha-Mehlitz, Stephanie, F Hess, Gabriel, Martínek, Lubomír, Skrovina, Matej, Machackova, Maria, Benčurik, Vladimir, Uluk, Deniz, Pratschke, Johann, S Dittrich, Luca, Guel-Klein, Safak, Perez, Daniel, Grass, Julia-Kristin, Melling, Nathaniel, Mueller, Simone, H Iversen, Lene, D Eriksen, Jacob, Baatrup, Gunnar, Al-Najami, Issam, Bjørsum-Meyer, Thoma, Teras, Jüri, M Teras, Roland, A Monib, Fatma, Eldin Abu Elnga Ahmed, Nagm, Alkady, Eithar, K Ali, Ahmed, Abd Elatti Khedr, Gehan, Samir Abdelaal, Ahmed, M Bassyouni Ashoush, Fouad, Ewedah, Moataz, M Elshennawy, Eslam, Hussein, Mohamed, Fernández-Martínez, Daniel, J García-Flórez, Lui, Fernández-Hevia, María, Suárez-Sánchez, Aida, Del Hoyo Aretxabala, Izaskun, Losada Docampo, Iria, Gómez Zabala, Jesú, Tejedor, Patricia, T Morales Bernaldo de Quirós, Javier, Bodega Quiroga, Ignacio, Navarro-Sánchez, Antonio, Soto Darias, Iván, López Fernández, Cristina, de La Cruz Cuadrado, Cristina, Sánchez-Guillén, Lui, López-Rodríguez-Arias, Francisco, Soler-Silva, Álvaro, Arroyo, Antonio, C Bernal-Sprekelsen, Juan, Á Gómez-Abril, Segundo, Gonzálvez, Paula, T Torres, María, Rubio Sánchez, Teresa, Blanco Antona, Francisco, E Sánchez Lara, Juan, A Alcázar Montero, José, Colás-Ruiz, Enrique, M Tasende-Presedo, Marta, Fernández-Hurtado, Ignacio, A Cifuentes-Ródenas, José, Castro Suárez, Marta, Losada, Manuel, Hernández, Miguel, Alonso, Alfredo, Diéguez, Beatriz, Serralta, Daniel, E Medina Quintana, Rita, M Gil Lopez, Jose, Lima Pinto, Francisca, Nieto-Moreno, Elena, Correa Bonito, Alba, Cerdán Santacruz, Carlo, Bermejo Marcos, Elena, García Septiem, Javier, Calero-Lillo, Aránzazu, Alanez-Saavedra, Javier, Muñoz-Collado, Salvador, López-Lara, Manuel, Labalde Martínez, María, Ferrero Herrero, Eduardo, Javier García Borda, Francisco, García Villar, Óscar, Escartín, Jorge, L Blas, Juan, Ferrer, Rocío, García Egea, Jorge, Rodríguez-Infante, Antonio, Mínguez-Ruiz, Germán, Carreño-Villarreal, Guillermo, Pire-Abaitua, Gerardo, Dziakova, Jana, Sáez-Cazallas Rodríguez, Carlo, J Pizarro Aranda, María, M Muguerza Huguet, José, Borda-Arrizabalaga, Nerea, M Enriquez-Navascués, José, Elorza Echaniz, Garazi, Saralegui Ansorena, Yolanda, Estaire-Gómez, Mercede, Martínez-Pinedo, Carlo, Barbero-Valenzuela, Alejandro, Ruíz-García, Pablo, Kraft, Miquel, J Gómez-Jurado, María, Pellino, Gianluca, Espín-Basany, Eloy, Cotte, Eddy, Panel, Nathalie, Goutard, Claire-Angéline, Deángelis, Nicola, Lauka, Lelde, Shaikh, Shafaque, Osborne, Laura, Ramsay, George, Nichita, Vladimir-Ion, Bhandari, Santosh, Sarmah, Panchali, M Bethune, Rob, M Pringle, Heather C, Massey, Lisa, E Fowler, George, S Hamid, Hytham K, D de Simone, Belinda, Kynaston, Jame, Bradley, Nichola, M Stienstra, Roxane, Gurjar, Shashank, Mukherjee, Tanmoy, Chandio, Ashfaq, Ahmed, Safia, Singh, Baljit, Runau, Francoi, Chaudhri, Sanjay, Siaw, Oliver, Sarveswaran, Janahan, Miu, Victor, Ashmore, Daniel, Darwich, Haitham, Singh-Ranger, Deepak, Singh, Nirbhaibir, Shaban, Mohamed, Gareb, Fahed, Petropolou, Thalia, Polydorou, Adrea, Dattani, Mit, Afzal, Asma, Bavikatte, Akshay, Sebastian, Boby, Ward, Nichola, Mishra, Amitabh, Manatakis, Dimitrio, Agalianos, Christo, Tasis, Nikolao, Antonopoulou, Maria-Ioanna, Karavokyros, Ioanni, Charalabopoulos, Alexandro, Schizas, Dimitrio, Baili, Efstratia, Syllaios, Athanasio, Karydakis, Lysandro, Vailas, Michail, Balalis, Dimitrio, Korkolis, Dimitrio, Plastiras, Ari, Rompou, Aliki, Xenaki, Sofia, Xynos, Evangelo, Chrysos, Emmanuel, Venianaki, Maria, Christodoulidis, Grigorio, Perivoliotis, Konstantino, Tzovaras, George, Baloyiannis, Ioanni, Ho, Man-Fung, Siu-Man Ng, Simon, Wing-Chung Mak, Tony, Futaba, Kaori, Šantak, Goran, Šimleša, Damir, Osić, Jurica, Zukanović, Goran, E Kelly, Michael, O Larkin, John, H McCormick, Paul, J Mehigan, Brian, M Connelly, Tara, Neary, Peter, Ryan, Jessica, Mccullough, Peter, A Al-Juaifari, Maytham, Hammoodi, Hayder, Hashim Abbood, Ali, Calabrò, Marcello, Muratore, Andrea, La Terra, Antonio, Farnesi, Francesca, V Feo, Carlo, Fabbri, Nicolò, Pesce, Antonio, Fazzin, Marta, Roscio, Francesco, Clerici, Federico, Lucchi, Andrea, Vittori, Laura, Agostinelli, Laura, Cristina Ripoli, Maria, Sambucci, Daniele, Porta, Andrea, Sinibaldi, Giovanni, Crescentini, Giacomo, Larcinese, Antonella, Picone, Emanuele, Persiani, Roberto, Biondi, Alberto, Pezzuto, Roberto, Lorenzon, Laura, Rizzo, Gianluca, Coco, Claudio, D'Agostino, Luca, Spinelli, Antonino, M Sacchi, Matteo, Carvello, Michele, Foppa, Caterina, Maroli, Annalisa, M Palini, Gian, Garulli, Gianluca, Zanini, Nicola, Delrio, Paolo, Rega, Daniela, Carbone, Fabio, Aversano, Alessia, Pirozzolo, Giovanni, Recordare, Alfonso, D'Alimonte, Lucrezia, Vignotto, Chiara, Corbellini, Carlo, M Sampietro, Gianluca, Lorusso, Leonardo, A Manzo, Carlo, Ghignone, Federico, Ugolini, Giampaolo, Montroni, Isacco, Pasini, Franceso, Pasini, Francesco, Ballabio, Michele, Bisagni, Pietro, T Armao, Francesca, Longhi, Marco, Ghazouani, Omar, Galleano, Raffaele, Tamini, Nicolò, Oldani, Massimo, Nespoli, Luca, Picciariello, Arcangelo, F Altomare, Donato, Tomasicchio, Giovanni, Lantone, Giuliano, Catena, Fausto, Giuffrida, Mario, Annicchiarico, Alfredo, Perrone, Gennaro, Grossi, Ugo, A Santoro, Giulio, Zanus, Giacomo, Iacomino, Alessandro, Novello, Simone, Passuello, Nicola, Zucchella, Martino, Puca, Lucia, Degiuli, Maurizio, Reddavid, Rossella, Scabini, Stefano, Aprile, Alessandra, Soriero, Domenico, Fioravanti, Emanuela, Rottoli, Matteo, Romano, Angela, Tanzanu, Marta, Belvedere, Angela, M Mariani, Nicolò, P Ceretti, Andrea, Opocher, Enrico, Gallo, Gaetano, Sammarco, Giuseppe, de Paola, Gilda, Pucciarelli, Salvatore, Marchegiani, Francesco, Spolverato, Gaya, Buzzi, Gianluca, Di Saverio, Salomone, Meroni, Paola, Parise, Cristiano, I Bottazzoli, Elisa, Lapolla, Pierfrancesco, Brachini, Gioia, Cirillo, Bruno, Mingoli, Andrea, Sica, Giuseppe, Siragusa, Leandro, Bellato, Vittoria, Cerbo, Daniele, A de Pasqual, Carlo, de Manzoni, Giovanni, A di Cosmo, Maria, H Alrayes, Bourhan M, M Qandeel, Mahmoud W, Bani Hani, Mohammad, Rabadi, Alexander, S El Muhtaseb, Mohammad, Abdeen, Basel, Karmi, Fahed, Žilinskas, Justa, Latkauskas, Tada, Tamelis, Algimanta, Pikūnienė, Ingrida, Šlenfuktas, Vyginta, Poskus, Toma, Kryzauskas, Mariu, Jakubauskas, Mata, Mikalauskas, Sauliu, Jakubauskiene, Lina, Y Hassan, Soha, Altrabulsi, Amani, Abdulwahed, Eman, Ghmagh, Reem, Deeknah, Abdulqudu, Alshareea, Entisar, Elhadi, Muhammed, Abujamra, Saleh, A Msherghi, Ahmed, E Tababa, Osama W, A Majbar, Mohammed, Souadka, Amine, Benkabbou, Amine, Mohsine, Raouf, Echiguer, Sabrillah, Moctezuma-Velázquez, Paulina, Salgado-Nesme, Noel, Vergara-Fernández, Omar, C Sainz-Hernández, Juan, E Alvarez-Bautista, Francisco, D Zakaria, Andee, Zakaria, Zaidi, K Wong, Michael P, Ismail, Razif, F Ibrahim, Aini, N Abdullah, Nik A, Julaihi, Rokayah, Bhat, Sameer, O'Grady, Greg, Bissett, Ian, Lamme, Ba, D Musters, Gijsbert, M Dinaux, Anne, A Grotenhuis, Brechtje, J Aalbers, Ernst J Steller Arend G, M Leeuwenburgh, Marjolein, T Rutten, Harm J, A Burger, Jacobus W, G Bloemen, Johanne, J Ketelaers, Stijn H, Waqar, Usama, Chawla, Tabish, Rauf, Hareem, Rani, Pallavi, K Talsma, Aaldert, Scheurink, Lieke, B van Praagh, Jasper, Segelman, Josefin, Nygren, Jona, Anderin, Kajsa, Tiefenthal, Marit, de Andrés, Beatriz, P Beltrán de Heredia, Juan, Vázquez, Andrea, Gómez, Tania, Golshani, Parisa, Kader, Rawaz, Mohamed, Abudi, Westerterp, Marinke, Marinelli, Andrea, Niemer, Quirine, G Doornebosch, Pascal, Shapiro, Joël, Vermaas, Maarten, R de Graaf, Eelco J, L van Westreenen, Hendrik, Zwakman, Marije, D van Dalsen, Annette, J Vles, Wouter, Nonner, Joost, R Toorenvliet, Boudewijn, J Janssen, Paul T, G Verdaasdonk, Emiel G, J Amelung, Femke, R Bahadoer, Koen C M J Peeters Renu, A Holman, Fabian, Heemskerk, Jeroen, Vosbeek, Noortje, A Leijtens, Jeroen W, M Taverne, Sophie B, M Heijnen, Bob H, El-Massoudi, Youssef, de Groot-van Veen, Irene, Hoff, Christiaan, Jou-Valencia, Daniela, J Consten, Esther C, A Burghgraef, Thij, Geitenbeek, Ritch, L Hulshof, Lorenzo G W, D Slooter, Gerrit, Reudink, Muriël, D Bouvy, Nicole, L Wildeboer, Aurelia C, Verstappen, Sonja, J Pennings, Alexander, van den Hengel, Berber, G Wijma, Allard, de Haan, Jael, F de Nes, Lindsey C, Heesink, Vera, Karsten, Tom, M Heidsma, Charlotte, J Koemans, Willem, T Dekker, Jan-Willem, J van der Zijden, Charlène, Roos, Daphne, Demirkiran, Ahmet, van der Burg, Sjirk, J Oosterling, Steven, J Hoogteijling, Tij, Wiering, Bastiaan, J Smeeing, Diederik P, Havenga, Klaa, Lutfi, Hamid, Tsimogiannis, Konstantino, Sköldberg, Filip, Folkesson, Joakim, den Boer, Frank, G van Schaik, Ted, van Gerven, Pieter, Sietses, Colin, C Hol, Jeroen, G Boerma, Evert-Jan, J Creemers, Davy M, K Schultz, Johanne, Frivold, Tone, Riis, Rolf, Gregussen, Hilde, Busund, Sondre, H Sjo, Ole, Gaard, Maria, Krohn, Nina, L Ersryd, Amanda, Leung, Edmund, Sultan, Hytham, Nabil Hajjaj, Baraa, Jehad Alhisi, Ahmed, E Khader, Ahmed A, Filipa Dias Mendes, Ana, Semião, Miguel, Queiroz Faria, Lui, Azevedo, Constança, M da Costa Devesa, Helena, Fortuna Martins, Sónia, M Rodrigues Jarimba, Aldo, M Ribeiro Marques, Sónia, Marques Ferreira, Rita, Oliveira, António, Ferreira, Cátia, Pereira, Ricardo, M Surlin, Valeriu, M Graure, Giorgiana, D Ramboiu, Stefan Patrascu Sandu, Negoi, Ionut, Ciubotaru, Cezar, Stoica, Bogdan, Tanase, Ioan, M Negoita, Valentina, Florea, Sabrina, Macau, Florin, Vasile, Mihai, Stefanescu, Victor, Dimofte, Gabriel-Mihail, Luncă, Sorinel, Roată, Cristian-Ene, Mușină, Ana-Maria, Garmanova, Tatiana, N Agapov, Mikhail, G Markaryan, Daniil, Eduard, Galliamov, Yanishev, Alexey, Abelevich, Alexander, Bazaev, Andrey, V Rodimov, Sergey, B Filimonov, Victor, A Melnikov, Andrey, A Suchkov, Igor, Drozdov, Evgeniy, N Kostromitskiy, Dmitriy, Sjöström, Olle, Matthiessen, Peter, Baban, Bayar, Gadan, Soran, Dehlaghi Jadid, Kaveh, Staffan, Maria, M Park, Jennifer, Rydbeck, Daniel, Lydrup, Marie-Louise, Buchwald, Pamela, Jutesten, Henrik, Darlin, Lotten, Lindqvist, Ebba, Nilsson, Karl, Larsson, Per-Ander, Jangmalm, Staffan, A Košir, Jurij, Tomažič, Aleš, Grosek, Jan, Košir Božič, Tajda, Zazo, Aya, Zazo, Rama, Fares, Hala, Ayoub, Kusay, Niazi, Ammar, Mansour, Ali, Abbas, Ayman, Tantoura, Mohammad, Hamdan, Alaa, Hassan, Naya, Hasan, Bassam, Saad, Ahmad, Sebai, Amine, Haddad, Ani, Maghrebi, Houcine, Kacem, Montasser, Yalkın, Ömer, Veysi Samsa, Mehmet, Atak, İbrahim, Balci, Bengi, Haberal, Elifcan, Dogan, Lütfi, E Gecim, Ibrahim, Akyol, Cihangir, A Koc, Mehmet, Sivrikoz, Emre, Piyadeoğlu, Deniz, O Avanagh, Dara, Sökmen, Selman, Bişgin, Tayfun, Günenç, Erşan, Güzel, Melek, Leventoğlu, Sezai, Yüksel, Osman, Kozan, Ramazan, Göbüt, Hüseyin, Cengiz, Fevzi, Erdinc, Kemal, Coşgun Acar, Nihan, Kamer, Erdinc, Özgür, İlker, Aydın, Oguzhan, Keskin, Metin, Türker Bulut, Mehmet, B Kulle, Cemil, Kara, Yasin, Sıbıç, Osman, H Özata, İbrahim, Buğra, Dursun, Balık, Emre, Çakır, Murat, Alhardan, Ana, Colak, Elif, B CiftciEngin Aybar, Ahmet, Can Sari, Ahmet, Demirli Atici, Semra, Kaya, Tayfun, Dursun, Ayberk, Calik, Bulent, Faruk Özkan, Ömer, Şeyda Ülgür, Hanife, Düzgün, Özgül, Monson, John, George, Sarah, Woods, Kayla, Al-Eryani, Fatima, Albakry, Rudaina, Coetzee, Emile, Boutall, Adam, Herman, Ayesiga, Warden, Claire, Mugla, Naser, Forgan, Tim, Mia, Imraan, Lambrechts, Anton, Roberto Persiani (ORCID:0000-0002-1537-5097), Alberto Biondi (ORCID:0000-0002-2470-7858), Nynke G, Greijdanu, Kiedo, Wienholt, Sander, Ubel, Kevin, Talboom, Gerjon, Hannink, Albert, Wolthui, Francisco B, de Lacy, Jérémie H, Lefevre, Michael, Solomon, Matteo, Frasson, Nicolas, Rotholtz, Quentin, Denost, Rodrigo O, Perez, Tsuyoshi, Konishi, Yves, Pani, Martin, Rutegård, Roel, Hompe, Camiel, Rosman, Frans, van Workum, Pieter J, Tani, Wilt, De, H W, Johanne, A Bremers, Andreas J, T Ferenschild, Flori, de Vriendt, Stefanie, D'Hoore, André, Bislenghi, Gabriele, Farguell, Jordi, M Lacy, Antonio, González Atienza, Paula, S van Kessel, Charlotte, Parc, Yann, Voron, Thibault, K Collard, Maxime, Sancho Muriel, Jorge, Cholewa, Hannia, A Mattioni, Laura, Frontali, Alice, W Polle, Sebastiaan, Polat, Fatih, J Obihara, Ndidi, B Vailati, Bruna, Kusters, Miranda, B Tuynmann, Jurriaan, A Hazen, Sanne J, J Grüter, Alexander A, Amano, Takahiro, Fujiwara, Hajime, Salomon, Mario, Ruiz, Hernán, Gonzalez, Ricardo, Estefanía, Diego, Avellaneda, Nicola, Carrie, Augusto, Santillan, Mateo, A Pantoja Pachajoa, Diana, Parodi, Matia, Gielis, Manuel, Binder, Alf-Dorian, Gürtler, Thoma, Riedl, Peter, Badiani, Sarit, Berney, Christophe, Morgan, Matthew, Hollington, Paul, da Silva, Nigel, Nair, Gavin, M Ho, Yiu, Lamparelli, Michael, Kapadia, Raj, M Kroon, Hidde, N Dudi-Venkata, Nagendra, Liu, Jianliang, Sammour, Tarik, Flamey, Nicola, Pattyn, Paul, Chaoui, Ahmed, Vansteenbrugge, Loui, J van den Broek, Nathalie E, Vanclooster, Patrick, de Gheldere, Charle, Pletinckx, Pieter, Defoort, Barbara, Dewulf, Maxime, Slavchev, Mihail, Belev, Nikolay, Atanasov, Boyko, Krastev, Panche, Sokolov, Manol, Maslyankov, Svilen, Gribnev, Petar, Pavlov, Vasil, Ivanov, Tsvetomir, Karamanliev, Martin, Filipov, Emil, Tonchev, Pencho, Aigner, Felix, Mitteregger, Martin, Allmer, Caterina, Seitinger, Gerald, Colucci, Nicola, Buchs, Nicola, Ris, Frédéric, Toso, Christian, Gialamas, Eleftherio, Vuagniaux, Aurélie, Chautems, Roland, Sauvain, Marc-Olivier, Daester, Silvio, von Flüe, Marku, Guenin, Marc-Olivier, Taha-Mehlitz, Stephanie, F Hess, Gabriel, Martínek, Lubomír, Skrovina, Matej, Machackova, Maria, Benčurik, Vladimir, Uluk, Deniz, Pratschke, Johann, S Dittrich, Luca, Guel-Klein, Safak, Perez, Daniel, Grass, Julia-Kristin, Melling, Nathaniel, Mueller, Simone, H Iversen, Lene, D Eriksen, Jacob, Baatrup, Gunnar, Al-Najami, Issam, Bjørsum-Meyer, Thoma, Teras, Jüri, M Teras, Roland, A Monib, Fatma, Eldin Abu Elnga Ahmed, Nagm, Alkady, Eithar, K Ali, Ahmed, Abd Elatti Khedr, Gehan, Samir Abdelaal, Ahmed, M Bassyouni Ashoush, Fouad, Ewedah, Moataz, M Elshennawy, 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Bermejo Marcos, Elena, García Septiem, Javier, Calero-Lillo, Aránzazu, Alanez-Saavedra, Javier, Muñoz-Collado, Salvador, López-Lara, Manuel, Labalde Martínez, María, Ferrero Herrero, Eduardo, Javier García Borda, Francisco, García Villar, Óscar, Escartín, Jorge, L Blas, Juan, Ferrer, Rocío, García Egea, Jorge, Rodríguez-Infante, Antonio, Mínguez-Ruiz, Germán, Carreño-Villarreal, Guillermo, Pire-Abaitua, Gerardo, Dziakova, Jana, Sáez-Cazallas Rodríguez, Carlo, J Pizarro Aranda, María, M Muguerza Huguet, José, Borda-Arrizabalaga, Nerea, M Enriquez-Navascués, José, Elorza Echaniz, Garazi, Saralegui Ansorena, Yolanda, Estaire-Gómez, Mercede, Martínez-Pinedo, Carlo, Barbero-Valenzuela, Alejandro, Ruíz-García, Pablo, Kraft, Miquel, J Gómez-Jurado, María, Pellino, Gianluca, Espín-Basany, Eloy, Cotte, Eddy, Panel, Nathalie, Goutard, Claire-Angéline, Deángelis, Nicola, Lauka, Lelde, Shaikh, Shafaque, Osborne, Laura, Ramsay, George, Nichita, Vladimir-Ion, Bhandari, Santosh, Sarmah, Panchali, M 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J, L van Westreenen, Hendrik, Zwakman, Marije, D van Dalsen, Annette, J Vles, Wouter, Nonner, Joost, R Toorenvliet, Boudewijn, J Janssen, Paul T, G Verdaasdonk, Emiel G, J Amelung, Femke, R Bahadoer, Koen C M J Peeters Renu, A Holman, Fabian, Heemskerk, Jeroen, Vosbeek, Noortje, A Leijtens, Jeroen W, M Taverne, Sophie B, M Heijnen, Bob H, El-Massoudi, Youssef, de Groot-van Veen, Irene, Hoff, Christiaan, Jou-Valencia, Daniela, J Consten, Esther C, A Burghgraef, Thij, Geitenbeek, Ritch, L Hulshof, Lorenzo G W, D Slooter, Gerrit, Reudink, Muriël, D Bouvy, Nicole, L Wildeboer, Aurelia C, Verstappen, Sonja, J Pennings, Alexander, van den Hengel, Berber, G Wijma, Allard, de Haan, Jael, F de Nes, Lindsey C, Heesink, Vera, Karsten, Tom, M Heidsma, Charlotte, J Koemans, Willem, T Dekker, Jan-Willem, J van der Zijden, Charlène, Roos, Daphne, Demirkiran, Ahmet, van der Burg, Sjirk, J Oosterling, Steven, J Hoogteijling, Tij, Wiering, Bastiaan, J Smeeing, Diederik P, Havenga, Klaa, Lutfi, Hamid, Tsimogiannis, Konstantino, Sköldberg, Filip, Folkesson, Joakim, den Boer, Frank, G van Schaik, Ted, van Gerven, Pieter, Sietses, Colin, C Hol, Jeroen, G Boerma, Evert-Jan, J Creemers, Davy M, K Schultz, Johanne, Frivold, Tone, Riis, Rolf, Gregussen, Hilde, Busund, Sondre, H Sjo, Ole, Gaard, Maria, Krohn, Nina, L Ersryd, Amanda, Leung, Edmund, Sultan, Hytham, Nabil Hajjaj, Baraa, Jehad Alhisi, Ahmed, E Khader, Ahmed A, Filipa Dias Mendes, Ana, Semião, Miguel, Queiroz Faria, Lui, Azevedo, Constança, M da Costa Devesa, Helena, Fortuna Martins, Sónia, M Rodrigues Jarimba, Aldo, M Ribeiro Marques, Sónia, Marques Ferreira, Rita, Oliveira, António, Ferreira, Cátia, Pereira, Ricardo, M Surlin, Valeriu, M Graure, Giorgiana, D Ramboiu, Stefan Patrascu Sandu, Negoi, Ionut, Ciubotaru, Cezar, Stoica, Bogdan, Tanase, Ioan, M Negoita, Valentina, Florea, Sabrina, Macau, Florin, Vasile, Mihai, Stefanescu, Victor, Dimofte, Gabriel-Mihail, Luncă, Sorinel, Roată, Cristian-Ene, Mușină, Ana-Maria, Garmanova, Tatiana, N Agapov, Mikhail, G Markaryan, Daniil, Eduard, Galliamov, Yanishev, Alexey, Abelevich, Alexander, Bazaev, Andrey, V Rodimov, Sergey, B Filimonov, Victor, A Melnikov, Andrey, A Suchkov, Igor, Drozdov, Evgeniy, N Kostromitskiy, Dmitriy, Sjöström, Olle, Matthiessen, Peter, Baban, Bayar, Gadan, Soran, Dehlaghi Jadid, Kaveh, Staffan, Maria, M Park, Jennifer, Rydbeck, Daniel, Lydrup, Marie-Louise, Buchwald, Pamela, Jutesten, Henrik, Darlin, Lotten, Lindqvist, Ebba, Nilsson, Karl, Larsson, Per-Ander, Jangmalm, Staffan, A Košir, Jurij, Tomažič, Aleš, Grosek, Jan, Košir Božič, Tajda, Zazo, Aya, Zazo, Rama, Fares, Hala, Ayoub, Kusay, Niazi, Ammar, Mansour, Ali, Abbas, Ayman, Tantoura, Mohammad, Hamdan, Alaa, Hassan, Naya, Hasan, Bassam, Saad, Ahmad, Sebai, Amine, Haddad, Ani, Maghrebi, Houcine, Kacem, Montasser, Yalkın, Ömer, Veysi Samsa, Mehmet, Atak, İbrahim, Balci, Bengi, Haberal, Elifcan, Dogan, Lütfi, E Gecim, Ibrahim, Akyol, Cihangir, A Koc, Mehmet, Sivrikoz, Emre, Piyadeoğlu, Deniz, O Avanagh, Dara, Sökmen, Selman, Bişgin, Tayfun, Günenç, Erşan, Güzel, Melek, Leventoğlu, Sezai, Yüksel, Osman, Kozan, Ramazan, Göbüt, Hüseyin, Cengiz, Fevzi, Erdinc, Kemal, Coşgun Acar, Nihan, Kamer, Erdinc, Özgür, İlker, Aydın, Oguzhan, Keskin, Metin, Türker Bulut, Mehmet, B Kulle, Cemil, Kara, Yasin, Sıbıç, Osman, H Özata, İbrahim, Buğra, Dursun, Balık, Emre, Çakır, Murat, Alhardan, Ana, Colak, Elif, B CiftciEngin Aybar, Ahmet, Can Sari, Ahmet, Demirli Atici, Semra, Kaya, Tayfun, Dursun, Ayberk, Calik, Bulent, Faruk Özkan, Ömer, Şeyda Ülgür, Hanife, Düzgün, Özgül, Monson, John, George, Sarah, Woods, Kayla, Al-Eryani, Fatima, Albakry, Rudaina, Coetzee, Emile, Boutall, Adam, Herman, Ayesiga, Warden, Claire, Mugla, Naser, Forgan, Tim, Mia, Imraan, Lambrechts, Anton, Roberto Persiani (ORCID:0000-0002-1537-5097), and Alberto Biondi (ORCID:0000-0002-2470-7858)

Abstract

Objective:To develop and validate a prediction model (STOMA score) for 1-year stoma-free survival in patients with rectal cancer (RC) with anastomotic leakage (AL).Background:AL after RC resection often results in a permanent stoma.Methods:This international retrospective cohort study (TENTACLE-Rectum) encompassed 216 participating centres and included patients who developed AL after RC surgery between 2014 and 2018. Clinically relevant predictors for 1-year stoma-free survival were included in uni and multivariable logistic regression models. The STOMA score was developed and internally validated in a cohort of patients operated between 2014 and 2017, with subsequent temporal validation in a 2018 cohort. The discriminative power and calibration of the models' performance were evaluated.Results:This study included 2499 patients with AL, 1954 in the development cohort and 545 in the validation cohort. Baseline characteristics were comparable. One-year stoma-free survival was 45.0% in the development cohort and 43.7% in the validation cohort. The following predictors were included in the STOMA score: sex, age, American Society of Anestesiologist classification, body mass index, clinical M-disease, neoadjuvant therapy, abdominal and transanal approach, primary defunctioning stoma, multivisceral resection, clinical setting in which AL was diagnosed, postoperative day of AL diagnosis, abdominal contamination, anastomotic defect circumference, bowel wall ischemia, anastomotic fistula, retraction, and reactivation leakage. The STOMA score showed good discrimination and calibration (c-index: 0.71, 95% CI: 0.66-0.76).Conclusions:The STOMA score consists of 18 clinically relevant factors and estimates the individual risk for 1-year stoma-free survival in patients with AL after RC surgery, which may improve patient counseling and give guidance when analyzing the efficacy of different treatment strategies in future studies.

Published
2023

50. Baseline Clinical Factors Are Associated With Risk of Complications in Crohn's Disease: Appraisal of the American Gastroenterological Association Clinical Care Pathway.

Author

Santiago, Priscila, Coelho-Prabhu, Nayantara, Lennon, Ryan, Shumin Rui, Rajauria, Palak, Friton, Jessica, Raffals, Laura E., Deepali, Fnu, Daoud, Nader, Farraye, Francis A., Tuck, Jaclyn, Malik, Talha, Leleiko, Neal S., Shapiro, Jason, Shah, Samir A., Sands, Bruce E., and Ungaro, Ryan C.

Published
2024
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