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1. Role and Importance of Ergonomics in Retrograde Intrarenal Surgery: Outcomes of a Narrative Review

Author: Chloe Shu Hui Ong, Guido Giusti, Vineet Gauhar, Deepak Ragoori, Dmitry Gorelov, Irene Girón-Nanne, Sung Y Cho, Jeremy Yuen-Chun Teoh, Saeed Bin Hamri, Olivier Traxer, Esteban Emiliani, K G Jyothi Swaroop, Bm Zeeshan Hameed, Pradeep Durai, Silvia Proietti, Vinson Ws Chan, Nariman Gadzhiev, Meshari Alshaashaa, Bhaskar K. Somani, Mariela Corrales, and Daniele Castellani
Subjects: medicine.medical_specialty, business.industry, Urologists, Urology, MEDLINE, Human factors and ergonomics, Flexible ureteroscopy, Kidney Calculi, Treatment Outcome, Lithotripsy, Ureteroscopy, medicine, Humans, Medical physics, Narrative review, Ergonomics, Technological advance, business
Abstract: Background: With recent technological advancement, new and improved endoscopic instruments and laser devices have catapulted flexible ureteroscopy (fURS) to the forefront, hence making retrograde i...
Published: 2022
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2. Multicentre study of hospitalised patients with sports- and recreational cycling–related traumatic brain injury in Hong Kong

Author: Kwong-Yui Yam, Fion Wy Lau, Wai-Man Lui, KY Pang, Anson Wong, Calvin H K Mak, Yin Chung Po, Eric Cheung, Danny Tm Chan, Peony Tan, Kwong-Yau Chan, Peter Ym Woo, Bertrand Siu, W. S. Poon, Nancy Ws Law, and Carly Ky Mak
Subjects: medicine.medical_specialty, education.field_of_study, Multivariate analysis, Traumatic brain injury, business.industry, Incidence (epidemiology), Glasgow Outcome Scale, Population, Middle Aged, medicine.disease, Skull fracture, Athletic Injuries, Brain Injuries, Traumatic, Epidemiology, Emergency medicine, medicine, Clinical endpoint, Hong Kong, Humans, Head Protective Devices, education, business, human activities, Retrospective Studies
Abstract: Introduction Cycling is associated with a greater risk of traumatic brain injury (TBI) than other recreational activities. This study aimed to investigate the epidemiology of sports-related TBI in Hong Kong and to examine predictors for recreational cycling-induced intracranial haemorrhage. Methods This retrospective multicentre study included patients diagnosed with sports-related TBI in public hospitals in Hong Kong from 2015 to 2019. Computed tomography scans were reviewed by an independent assessor. The primary endpoint was traumatic intracranial haemorrhage. The secondary endpoint was an unfavourable Glasgow Outcome Scale (GOS) score at discharge from hospital. Results In total, 720 patients were hospitalised with sports-related TBI. The most common sport was cycling (59.2%). The crude incidence of cycling-related TBI was 1.1 per 100 000 population. Cyclists were more likely to exhibit intracranial haemorrhage and an unfavourable GOS score, compared with patients who had TBI because of other sports. Although 47% of cyclists had intracranial haemorrhage, only 15% wore a helmet. In multivariate analysis, significant predictors for intracranial haemorrhage were age ≥60 years, antiplatelet medication, moderate or severe TBI, and skull fracture. Among 426 cyclists, 375 (88%) had mild TBI, and helmet wearing was protective against intracranial haemorrhage, regardless of age, antiplatelet medication intake, and mechanism of injury. Of 426 cyclists, 31 (7.3%) had unfavourable outcomes on discharge from hospital. Conclusions The incidence of sports-related TBI is low in Hong Kong. Although cycling-related head injuries carried greater risks of intracranial haemorrhage and unfavourable outcomes compared with other sports, most cyclists experienced good recovery. Helmet wearing among recreational cyclists with mild TBI was protective against intracranial haemorrhage and skull fracture.
Published: 2021
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3. Imaging Findings of Progressing Rosai–Dorfman Disease of the Breast: a Case Report and Literature Review

Author: KM Kwok, WS Mak, Kck Wong, WP Cheung, LW Lo, and Epy Fung
Subjects: medicine.medical_specialty, business.industry, medicine, Radiology, Nuclear Medicine and imaging, medicine.disease, business, Dermatology, Rosai–Dorfman disease
Published: 2021
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4. Mortality from esophagectomy for esophageal cancer across low, middle, and high-income countries: An international cohort study

Author: Kamarajah, Sk, Nepogodiev, D, Bekele, A, Cecconello, I, Evans, Rpt, Guner, A, Gossage, Ja, Harustiak, T, Hodson, J, Isik, A, Kidane, B, Leon-Takahashi, Am, Mahendran, Ha, Negoi, I, Okonta, Ke, Rosero, G, Sayyed, Rh, Singh, P, Takeda, Fr, van Hillegersberg, R, Vohra, Rs, White, Re, Griffiths, Ea, Alderson, D, Bundred, J, Gossage, J, Jefferies, B, Mckay, S, Mohamed, I, Siaw-Acheampong, K, Vohra, R, Wanigasooriya, K, Whitehouse, T, Gjata, A, Moreno, Ji, Guevara, Cr, Kechagias, A, Gockel, I, Kennedy, A, Da Roit, A, Bagajevas, A, Azagra, Js, Mejia-Fernandez, L, Wijnhoven, Bpl, El Kafsi, J, Sousa, M, Sampaio, As, Blanco, R, Wallner, B, Schneider, Pm, Hsu, Pk, Gananadha, S, Wills, V, Devadas, M, Duong, C, Talbot, M, Hii, Mw, Jacobs, R, Andreollo, Na, Johnston, B, Darling, G, Isaza-Restrepo, A, Arias-Amezquita, F, Raptis, D, Gaedcke, J, Reim, D, Izbicki, J, Egberts, Jh, Dikinis, S, Kjaer, Dw, Larsen, Mh, Achiam, Mp, Saarnio, J, Theodorou, D, Liakakos, T, Korkolis, Dp, Robb, Wb, Collins, C, Murphy, T, Reynolds, J, Tonini, V, Migliore, M, Bonavina, L, Valmasoni, M, Bardini, R, Weindelmayer, J, Terashima, M, Alghunaim, E, Elhadi, M, Medina-Franco, H, Lau, Pc, Heisterkamp, J, Rosman, C, Beban, G, Babor, R, Gordon, A, Rossaak, Ji, Pal, Kmi, Qureshi, Au, Naqi, Sa, Syed, Aa, Barbosa, J, Vicente, Cs, Leite, J, Freire, J, Casaca, R, Costa, Rct, Scurtu, Rr, Mogoanta, Ss, Bolca, C, Constantinoiu, S, Sekhniaidze, D, Bjelovic, M, Jby, So, Gacevski, G, Loureiro, C, Pera, M, Bianchi, A, Moreno, Gm, Fernandez, Jm, Carrera, Mst, Vallve-Bernal, M, Pascual, Mac, Elmahi, S, Halldestam, I, Hedberg, J, Monig, S, Gutknecht, S, Tez, M, Tirnaksiz, Mb, Colak, E, Sevinc, B, Hindmarsh, A, Khan, I, Khoo, D, Byrom, R, Gokhale, J, Wilkerson, P, Jain, P, Chan, D, Robertson, K, Iftikhar, S, Skipworth, R, Forshaw, M, Higgs, S, Nijjar, R, Viswanath, Yks, Turner, P, Dexter, S, Boddy, A, Allum, Wh, Oglesby, S, Cheong, E, Beardsmore, D, Maynard, N, Berrisford, R, Mercer, S, Puigt, S, Melhadot, R, Kelty, C, Underwood, T, Dawas, K, Lewis, W, Al-Bahrani, A, Bryce, G, Thomas, M, Arndt, At, Palazzo, F, Meguid, Ra, Fergusson, J, Beenen, E, Mosse, C, Salim, J, Cheah, S, Wright, T, Cerdeira, Mp, Mcquillan, P, Richardson, M, Liem, H, Spillane, J, Yacob, M, Albadawi, F, Thorpe, T, Dingle, A, Cabalag, C, Loi, K, Fisher, Om, Ward, S, Read, M, Johnson, M, Bassari, R, Bui, H, Sallum, Raa, da Rocha, Jrm, Lopes, Lr, Tercioti, V, Coelho, Jd, Ferrer, Jap, Buduhan, G, Tan, L, Srinathan, S, Shea, P, Yeung, J, Allison, F, Carroll, P, Vargas-Barato, F, Gonzalez, F, Ortega, J, Nino-Torres, L, Beltran-Garcia, Tc, Castilla, L, Pineda, M, Bastidas, A, Gomez-Mayorga, J, Cortes, N, Cetares, C, Caceres, S, Duarte, S, Pazdro, A, Snajdauf, M, Faltova, H, Sevcikova, M, Mortensen, Pb, Katballe, N, Ingemann, T, Morten, B, Kruhlikava, I, Ainswort, Ap, Stilling, Nm, Eckardt, J, Holm, J, Thorsteinsson, M, Siemsen, M, Brandt, B, Nega, B, Teferra, E, Tizazu, A, Kauppila, Jh, Koivukangas, V, Merilainen, S, Gruetzmann, R, Krautz, C, Weber, G, Golcher, H, Emons, G, Azizian, A, Ebeling, M, Niebisch, S, Kreuser, N, Albanese, G, Hesse, J, Volovnik, L, Boecher, U, Reeh, M, Triantafyllou, S, Schizas, D, Michalinos, A, Mpali, E, Mpoura, M, Charalabopoulos, A, Manatakis, Dk, Balalis, D, Bolger, J, Baban, C, Mastrosimone, A, Mcanena, O, Quinn, A, Suilleabhain, Cbo, Hennessy, Mm, Ivanovski, I, Khizer, H, Ravi, N, Donlon, N, Cervellera, M, Vaccari, S, Bianchini, S, Sartarelli, L, Asti, E, Bernardi, D, Merigliano, S, Provenzano, L, Scarpa, M, Saadeh, L, Salmaso, B, De Manzoni, G, Giacopuzzi, S, La Mendola, R, De Pasqual, Ca, Tsubosa, Y, Niihara, M, Irino, T, Makuuchi, R, Ishii, K, Mwachiro, M, Fekadu, A, Odera, A, Mwachiro, E, Alshehab, D, Ahmed, Ha, Shebani, Ao, Elhadi, A, Elnagar, Fa, Elnagar, Hf, Makkai-Popa, St, Wong, Lf, Tan, Yr, Thannimalai, S, Ca, Ho, Pang, Ws, Tan, Jh, Basave, Hnl, Cortes-Gonzalez, R, Lagarde, Sm, van Lanschot, Jjb, Cords, C, Jansen, Wa, Martijnse, I, Matthijsen, R, Bouwense, S, Klarenbeek, B, Verstegen, M, van Workum, F, Ruurda, Jp, van der Sluis, Pc, de Maat, M, Evenett, N, Johnston, P, Patel, R, Maccormick, A, Young, M, Smith, B, Ekwunife, C, Memon, Ah, Shaikh, K, Wajid, A, Khalil, N, Haris, M, Mirza, Zu, Qudus, Sba, Sarwar, Mz, Shehzadi, A, Raza, A, Jhanzaib, Mh, Farmanali, J, Zakir, Z, Shakeel, O, Nasir, I, Khattak, S, Baig, M, Noor, Ma, Ahmed, Hh, Naeem, A, Pinho, Ac, da Silva, R, Bernardes, A, Campos, Jc, Matos, H, Braga, T, Monteiro, C, Ramos, P, Cabral, F, Gomes, Mp, Martins, Pc, Correia, Am, Videira, Jf, Ciuce, C, Drasovean, R, Apostu, R, Paitici, S, Racu, Ae, Obleaga, Cv, Beuran, M, Stoica, B, Ciubotaru, C, Negoita, V, Cordos, I, Birla, Rd, Predescu, D, Hoara, Pa, Tomsa, R, Shneider, V, Agasiev, M, Ganjara, I, Gunjic, D, Veselinovic, M, Babic, T, Chin, Ts, Shabbir, A, Kim, G, Crnjac, A, Samo, H, Del Val, Id, Leturio, S, Ramon, Jm, Dal Cero, M, Rifa, S, Rico, M, Pomar, Ap, Corcoles, Jam, Miravalles, Jlr, Pais, Sa, Turienzo, Sa, Alvarezt, Ls, Alvarez, Ls, Campos, Pv, Rendo, Ag, Garcia, Ss, Santos, Epg, Martinez, Et, Fernandez, Dm, Magadan, Ac, Concepcion, Mv, Diaz, Lc, Rosat, Ra, Perez, Sle, Bailon, Cm, Tinoco, Cc, Bhojwani, Ec, Sanchez, Dp, Ahmed, Me, Dzhendov, T, Lindberg, F, Rutegard, M, Sundbom, M, Mickael, C, Colucci, N, Schnider, A, Er, S, Kurnaz, E, Turkyilmaz, S, Turkyilmaz, A, Yildirim, R, Baki, Be, Akkapulu, N, Karahan, O, Damburaci, N, Hardwickt, R, Safranek, P, Sujendran, V, Bennett, J, Afzal, Z, Shrotri, M, Chan, B, Exarchou, K, Gilbert, T, Amalesh, T, Mukherjee, D, Mukherjee, S, Wiggins, Th, Kennedy, R, Mccain, S, Harris, A, Dobson, G, Davies, N, Wilson, I, Mayo, D, Bennett, D, Young, R, Manby, P, Blencowe, N, Schiller, M, Byrne, B, Mitton, D, Wong, V, Elshaer, A, Cowen, M, Menon, V, Tan, Lc, Mclaughlin, E, Koshy, R, Sharp, C, Brewer, H, Das, N, Cox, M, Al Khyatt, W, Worku, D, Iqbal, R, Walls, L, Mcgregor, R, Fullarton, G, Macdonald, A, Mackay, C, Craig, C, Dwerryhouse, S, Hornby, S, Jaunoo, S, Wadley, M, Baker, C, Saad, M, Kelly, M, Davies, A, Di Maggio, F, Mistry, P, Singhal, R, Tucker, O, Kapoulas, S, Powell-Brett, S, Davis, P, Bromley, G, Watson, L, Verma, R, Ward, J, Shetty, V, Ball, C, Pursnani, K, Sarela, A, Sue, Lh, Mehta, S, Hayden, J, To, N, Palser, T, Hunter, D, Supramaniam, K, Butt, Z, Ahmed, A, Kumar, S, Chaudry, A, Moussa, O, Kordzadeh, A, Lorenzi, B, Wilson, M, Patil, P, Noaman, I, Willem, J, Bouras, G, Evans, R, Singh, M, Warrilow, H, Ahmad, A, Tewari, N, Yanni, F, Couch, J, Theophilidou, E, Reilly, Jj, van Boxel, G, Akbari, K, Zanotti, D, Sgromo, B, Sanders, G, Wheatley, T, Ariyarathenam, A, Reece-Smith, A, Humphreys, L, Choh, C, Carter, N, Knight, B, Pucher, P, Athanasiou, A, Tan, B, Abdulrahman, M, Vickers, J, Akhtar, K, Chaparala, R, Brown, R, Alasmar, Mma, Ackroyd, R, Patel, K, Tamhankar, A, Wyman, A, Walker, R, Grace, B, Abbassi, N, Slim, N, Ioannidi, L, Blackshaw, G, Havard, T, Escofet, X, Powell, A, Owera, A, Rashid, F, Jambulingam, P, Padickakudi, J, Ben-Younes, H, Mccormack, K, Makey, Ia, Karush, Mk, Seder, Cw, Liptay, Mj, Chmielewski, G, Rosato, El, Berger, Ac, Zheng, R, Okolo, E, Singh, A, Scott, Cd, Weyant, Mj, Mitchell, Jd, Moenig, Stefan Paul, Kamarajah S.K., Nepogodiev D., Bekele A., Cecconello I., Evans R.P.T., Guner A., Gossage J.A., Harustiak T., Hodson J., Isik A., Kidane B., Leon-Takahashi A.M., Mahendran H.A., Negoi I., Okonta K.E., Rosero G., Sayyed R.H., Singh P., Takeda F.R., van Hillegersberg R., Vohra R.S., White R.E., Griffiths E.A., Alderson D., Bundred J., Gossage J., Jefferies B., McKay S., Mohamed I., Siaw- Acheampong K., Vohra R., Wanigasooriya K., Whitehouse T., Gjata A., Moreno J.I., Guevara C.R., Kechagias A., Gockel I., Kennedy A., Da Roit A., Bagajevas A., Azagra J.S., Mejia-Fernandez L., Wijnhoven B.P.L., El Kafsi J., Sousa M., Sampaio A.S., Blanco R., Wallner B., Schneider P.M., Hsu P.K., Gananadha S., Wills V., Devadas M., Duong C., Talbot M., Hii M.W., Jacobs R., Andreollo N.A., Johnston B., Darling G., Isaza-Restrepo A., Arias- Amezquita F., Raptis D., Gaedcke J., Reim D., Izbicki J., Egberts J.H., Dikinis S., Kjaer D.W., Larsen M.H., Achiam M.P., Saarnio J., Theodorou D., Liakakos T., Korkolis D.P., Robb W.B., Collins C., Murphy T., Reynolds J., Tonini V., Migliore M., Bonavina L., Valmasoni M., Bardini R., Weindelmayer J., Terashima M., Alghunaim E., Elhadi M., Medina-Franco H., Lau P.C., Heisterkamp J., Rosman C., Beban G., Babor R., Gordon A., Rossaak J.I., Pal K.M.I., Qureshi A.U., Naqi S.A., Syed A.A., Barbosa J., Vicente C.S., Leite J., Freire J., Casaca R., Costa R.C.T., Scurtu R.R., Mogoanta S.S., Bolca C., Constantinoiu S., Sekhniaidze D., Bjelovic M., So J.B.Y., Gacevski G., Loureiro C., Pera M., Bianchi A., Moreno G.M., Martin Fernandez J., Trugeda Carrera M.S., Vallve-Bernal M., Citores Pascual M.A., Elmahi S., Halldestam I., Hedberg J., Monig S., Gutknecht S., Tez M., Tirnaksiz M.B., Colak E., Sevinc B., Hindmarsh A., Khan I., Khoo D., Byrom R., Gokhale J., Wilkerson P., Jain P., Chan D., Robertson K., Iftikhar S., Skipworth R., Forshaw M., Higgs S., Nijjar R., Viswanath Y.K.S., Turner P., Dexter S., Boddy A., Allum W.H., Oglesby S., Cheong E., Beardsmore D., Maynard N., Berrisford R., Mercer S., Puig S., Melhado R., Kelty C., Underwood T., Dawas K., Lewis W., Al-Bahrani A., Bryce G., Thomas M., Arndt A.T., Palazzo F., Meguid R.A., Fergusson J., Beenen E., Mosse C., Salim J., Cheah S., Wright T., Cerdeira M.P., McQuillan P., Richardson M., Liem H., Spillane J., Yacob M., Albadawi F., Thorpe T., Dingle A., Cabalag C., Loi K., Fisher O.M., Ward S., Read M., Johnson M., Bassari R., Bui H., Sallum R.A.A., da Rocha J.R.M., Lopes L.R., Tercioti V., Coelho J.D., Ferrer J.A.P., Buduhan G., Tan L., Srinathan S., Shea P., Yeung J., Allison F., Carroll P., Vargas-Barato F., Gonzalez F., Ortega J., Nino-Torres L., Beltran-Garcia T.C., Castilla L., Pineda M., Bastidas A., Gomez-Mayorga J., Cortes N., Cetares C., Caceres S., Duarte S., Pazdro A., Snajdauf M., Faltova H., Sevcikova M., Mortensen P.B., Katballe N., Ingemann T., Morten B., Kruhlikava I., Ainswort A.P., Stilling N.M., Eckardt J., Holm J., Thorsteinsson M., Siemsen M., Brandt B., Nega B., Teferra E., Tizazu A., Kauppila J.H., Koivukangas V., Merilainen S., Gruetzmann R., Krautz C., Weber G., Golcher H., Emons G., Azizian A., Ebeling M., Niebisch S., Kreuser N., Albanese G., Hesse J., Volovnik L., Boecher U., Reeh M., Triantafyllou S., Schizas D., Michalinos A., Mpali E., Mpoura M., Charalabopoulos A., Manatakis D.K., Balalis D., Bolger J., Baban C., Mastrosimone A., McAnena O., Quinn A., O Suilleabhain C.B., Hennessy M.M., Ivanovski I., Khizer H., Ravi N., Donlon N., Cervellera M., Vaccari S., Bianchini S., Sartarelli L., Asti E., Bernardi D., Merigliano S., Provenzano L., Scarpa M., Saadeh L., Salmaso B., De Manzoni G., Giacopuzzi S., La Mendola R., De Pasqual C.A., Tsubosa Y., Niihara M., Irino T., Makuuchi R., Ishii K., Mwachiro M., Fekadu A., Odera A., Mwachiro E., AlShehab D., Ahmed H.A., Shebani A.O., Elhadi A., Elnagar F.A., Elnagar H.F., Makkai-Popa S.T., Wong L.F., Tan Y.R., Thannimalai S., Ho C.A., Pang W.S., Tan J.H., Basave H.N.L., Cortes-Gonzalez R., Lagarde S.M., van Lanschot J.J.B., Cords C., Jansen W.A., Martijnse I., Matthijsen R., Bouwense S., Klarenbeek B., Verstegen M., van Workum F., Ruurda J.P., van der Sluis P.C., de Maat M., Evenett N., Johnston P., Patel R., MacCormick A., Young M., Smith B., Ekwunife C., Memon A.H., Shaikh K., Wajid A., Khalil N., Haris M., Mirza Z.U., Qudus S.B.A., Sarwar M.Z., Shehzadi A., Raza A., Jhanzaib M.H., Farmanali J., Zakir Z., Shakeel O., Nasir I., Khattak S., Baig M., Noor M.A., Ahmed H.H., Naeem A., Pinho A.C., da Silva R., Bernardes A., Campos J.C., Matos H., Braga T., Monteiro C., Ramos P., Cabral F., Gomes M.P., Martins P.C., Correia A.M., Videira J.F., Ciuce C., Drasovean R., Apostu R., Paitici S., Racu A.E., Obleaga C.V., Beuran M., Stoica B., Ciubotaru C., Negoita V., Cordos I., Birla R.D., Predescu D., Hoara P.A., Tomsa R., Shneider V., Agasiev M., Ganjara I., Gunjic D., Veselinovic M., Babic T., Chin T.S., Shabbir A., Kim G., Crnjac A., Samo H., Diez del Val I., Leturio S., Ramon J.M., Dal Cero M., Rifa S., Rico M., Pagan Pomar A., Martinez Corcoles J.A., Rodicio Miravalles J.L., Pais S.A., Turienzo S.A., Alvarez L.S., Campos P.V., Rendo A.G., Garcia S.S., Santos E.P.G., Martinez E.T., Fernandez D.M., Magadan A.C., Concepcion M.V., Diaz L.C., Rosat R.A., Perez S.L., Bailon C.M., Tinoco C.C., Choolani Bhojwani E., Sanchez D.P., Ahmed M.E., Dzhendov T., Lindberg F., Rutegard M., Sundbom M., Mickael C., Colucci N., Schnider A., Er S., Kurnaz E., Turkyilmaz S., Turkyilmaz A., Yildirim R., Baki B.E., Akkapulu N., Karahan O., Damburaci N., Hardwick R., Safranek P., Sujendran V., Bennett J., Afzal Z., Shrotri M., Chan B., Exarchou K., Gilbert T., Amalesh T., Mukherjee D., Mukherjee S., Wiggins T.H., Kennedy R., McCain S., Harris A., Dobson G., Davies N., Wilson I., Mayo D., Bennett D., Young R., Manby P., Blencowe N., Schiller M., Byrne B., Mitton D., Wong V., Elshaer A., Cowen M., Menon V., Tan L.C., McLaughlin E., Koshy R., Sharp C., Brewer H., Das N., Cox M., Al Khyatt W., Worku D., Iqbal R., Walls L., McGregor R., Fullarton G., Macdonald A., MacKay C., Craig C., Dwerryhouse S., Hornby S., Jaunoo S., Wadley M., Baker C., Saad M., Kelly M., Davies A., Di Maggio F., Mistry P., Singhal R., Tucker O., Kapoulas S., Powell-Brett S., Davis P., Bromley G., Watson L., Verma R., Ward J., Shetty V., Ball C., Pursnani K., Sarela A., Sue L.H., Mehta S., Hayden J., To N., Palser T., Hunter D., Supramaniam K., Butt Z., Ahmed A., Kumar S., Chaudry A., Moussa O., Kordzadeh A., Lorenzi B., Wilson M., Patil P., Noaman I., Willem J., Bouras G., Evans R., Singh M., Warrilow H., Ahmad A., Tewari N., Yanni F., Couch J., Theophilidou E., Reilly J.J., van Boxel G., Akbari K., Zanotti D., Sgromo B., Sanders G., Wheatley T., Ariyarathenam A., Reece-Smith A., Humphreys L., Choh C., Carter N., Knight B., Pucher P., Athanasiou A., Tan B., Abdulrahman M., Vickers J., Akhtar K., Chaparala R., Brown R., Alasmar M.M.A., Ackroyd R., Patel K., Tamhankar A., Wyman A., Walker R., Grace B., Abbassi N., Slim N., Ioannidi L., Blackshaw G., Havard T., Escofet X., Powell A., Owera A., Rashid F., Jambulingam P., Padickakudi J., Ben-Younes H., Mccormack K., Makey I.A., Karush M.K., Seder C.W., Liptay M.J., Chmielewski G., Rosato E.L., Berger A.C., Zheng R., Okolo E., Singh A., Scott C.D., Weyant M.J., Mitchell J.D., and Surgery
Subjects: Male, Esophageal Neoplasms, SURGERY, IMPACT, medicine.medical_treatment, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, FAILURE, Postoperative Period, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Generalized estimating equation, COMPLICATIONS, ddc:617, Anastomosis, Surgical, General Medicine, Middle Aged, Esophageal cancer, Reconstructive and regenerative medicine Radboud Institute for Molecular Life Sciences [Radboudumc 10], HOSPITAL VOLUME, Oncology, Esophagectomy, 030220 oncology & carcinogenesis, Anastomotic leak, Global surgery, Postoperative mortality, Female, Cohort study, Adult, medicine.medical_specialty, Necrosis, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, Esophagus, SDG 3 - Good Health and Well-being, Internal medicine, medicine, Humans, Developing Countries, Aged, business.industry, Developed Countries, Cancer, Odds ratio, GLOBAL BURDEN, RESCUE, medicine.disease, Confidence interval, Surgery, business
Abstract: Background: No evidence currently exists characterising global outcomes following major cancer surgery, including esophageal cancer. Therefore, this study aimed to characterise impact of high income countries (HIC) versus low and middle income countries (LMIC) on the outcomes following esophagectomy for esophageal cancer.Method: This international multi-center prospective study across 137 hospitals in 41 countries included patients who underwent an esophagectomy for esophageal cancer, with 90-day follow-up. The main explanatory variable was country income, defined according to the World Bank Data classification. The primary outcome was 90-day postoperative mortality, and secondary outcomes were composite leaks (anastomotic leak or conduit necrosis) and major complications (Clavien-Dindo Grade III - V). Multivariable generalized estimating equation models were used to produce adjusted odds ratios (ORs) and 95% confidence intervals (CI95%).Results: Between April 2018 to December 2018, 2247 patients were included. Patients from HIC were more significantly older, with higher ASA grade, and more advanced tumors. Patients from LMIC had almost three-fold increase in 90-day mortality, compared to HIC (9.4% vs 3.7%, p < 0.001). On adjusted analysis, LMIC were independently associated with higher 90-day mortality (OR: 2.31, CI95%: 1.17-4.55, p = 0.015). However, LMIC were not independently associated with higher rates of anastomotic leaks (OR: 1.06, CI95%: 0.57-1.99, p = 0.9) or major complications (OR: 0.85, CI95%: 0.54-1.32, p = 0.5), compared to HIC.Conclusion: Resections in LMIC were independently associated with higher 90-day postoperative mortality, likely reflecting a failure to rescue of these patients following esophagectomy, despite similar composite anastomotic leaks and major complication rates to HIC. These findings warrant further research, to identify potential issues and solutions to improve global outcomes following esophagectomy for cancer.
Published: 2021
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5. Beep or alert: evaluating WhatsApp vs pagers for communication between hospital staff

Author: Rehman Alvi, Ummey Hani, Muhammad Ws Baqai, and Noman Shahzad
Subjects: Telemedicine, Teamwork, Staff perceptions, business.product_category, 020205 medical informatics, Leadership and Management, business.industry, Health Policy, media_common.quotation_subject, 02 engineering and technology, medicine.disease, Clinical communication, 03 medical and health sciences, Patient safety, 0302 clinical medicine, 0202 electrical engineering, electronic engineering, information engineering, medicine, 030212 general & internal medicine, Medical emergency, Pager, business, media_common
Abstract: Background/Aims A timely and effective communication system between hospital staff is vital for teamwork, patient safety and optimal clinical outcomes. This study compared staff perceptions of WhatsApp compared to traditional pagers for clinical communication in one of the largest tertiary care hospitals in Pakistan. Methods A questionnaire regarding factors such as the ease of use and reliability of each communication modality was distributed to interns and residents at the Aga Khan University Hospital in Karachi, Pakistan. Descriptive statistics were computed for percentages, frequencies and statistical significance of categorical variables. Results A total of 163 participants completed the survey. Of these, 95.1% preferred WhatsApp for storing information for later reference, 58.6% considered WhatsApp to be faster in terms of response, and 52.1% found WhatsApp easier to use than pagers. However, 60.7% chose pagers as better suited for emergency situations and 92.6% were concerned that WhatsApp could potentially compromise patient data security. Overall, participants preferred the development of a bespoke app for hospital communications instead. Conclusions WhatsApp was regarded as easier to use and more accessible than pagers, but it was not deemed to be compliant with hospital policies. Productive communication could be optimised with the use of a tailor-made app dedicated solely to clinical communication.
Published: 2021
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6. Ultrasound-guided Vacuum-assisted Excision of Papillary Breast Lesions as an Alternative to Surgical Excision: 7-year Experience

Author: Ayh Leung, Epy Fung, CW Wong, KM Kwok, Dhy Cho, WS Mak, CM Chau, Kck Wong, Lkm Wong, and Hon Shing Lam
Subjects: medicine.medical_specialty, Vacuum assisted, business.industry, medicine, Radiology, Nuclear Medicine and imaging, Surgical excision, Radiology, business, Ultrasound guided
Published: 2020
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7. Diagnostic performance of morning serum cortisol as an alternative to short synacthen test for the assessment of adrenal reserve; a retrospective study

Author: Ws Wassif, Rajeev Kumar, and Peter Carr
Subjects: Adult, Male, endocrine system, medicine.medical_specialty, Hydrocortisone, Adrenal disorder, 030209 endocrinology & metabolism, Logistic regression, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Adrenal insufficiency, Humans, Short synacthen test, 030212 general & internal medicine, Aged, Retrospective Studies, Morning, Diagnostic Tests, Routine, business.industry, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Basal (medicine), Cosyntropin, Female, business, hormones, hormone substitutes, and hormone antagonists, Serum cortisol, Adrenal Insufficiency
Abstract: Objective The short synacthen test (SST) is widely used across the UK to assess adrenal reserve. The main objective of our study was to determine the morning serum cortisol level that will predict adrenal insufficiency (AI) thus reducing our reliance on SST. Design This was a single centre retrospective study of 393 SST tests measuring 0 and 60 min cortisol levels after administration of 250 μg of synacthen (synthetic ACTH). Patients and methods All the SST tests for patients suspected of primary or secondary AI between April 2016 and October 2018 were included in this study. We used serum to determine circulating cortisol by a newer generation competitive electrochemiluminescence immunoassay (ECLIA) (Roche Diagnostics). A post-ACTH cortisol response of ≥420 nmol/L at 60 min was considered adequate to rule out AI. The data were analysed to ascertain the relationship between 0 min and 60 min serum cortisol. Results A total of 393 SST results were included in this study. Overall, a total of 332 (84.5%) subjects achieved sufficient serum cortisol level at 60 min, while 61 subjects (15.5%) showed insufficient response. Using the logistic regression, we determined that a morning basal serum cortisol level of ≥354 nmol/L was able to predict normal adrenal function with 100% sensitivity. We were unable to find a lower cut-off value below which SST will not be required. By using this proposed cut-off point, approximately 37% of the SSTs tests could be avoided. Conclusions Basal morning serum cortisol can be safely used as a first step in the evaluation of patients with suspected AI. This will enhance the number of patients being screened for this condition.
Published: 2020
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8. PARASITIC INFECTION IN PREGNANT WOMEN PRESENTED WITH ANEMIA IN FAYOUM GOVERNORATE, EGYPT

Author: AA Abdelsamie, Emh Mèabed, AA Hafez, and WS Deeb
Subjects: medicine.medical_specialty, Obstetrics, Anemia, business.industry, medicine, medicine.disease, business, Parasitic infection
Published: 2020
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9. IMPACT OF PHOTOTHERAPY ON PLATELET COUNT IN NEONATES WITH INDIRECT HYPERBILIRUBINEMIA

Author: NS Hashem, GM Ezzat, AM Abd El Moktader, and WS Mohamed
Subjects: medicine.medical_specialty, business.industry, Internal medicine, medicine, Indirect Hyperbilirubinemia, Platelet, business, Gastroenterology
Published: 2020
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10. Psychiatric comorbidity in individuals at‐risk for psychosis: Relationships with symptoms, cognition and psychosocial functioning

Author: Wai Sau Chung, Suet In Chan, Man Kin Ng, Wai Ching Yan, W.C. Chang, Lai Ming Hui, Ho Ming Lee, Chung Mun Ng, Lap Tak Poon, Hoi Ching Lee, Pui Fai Pang, Sai Yu Lui, Kit Wa Chan, Wai Chung Lam, WS Yeung, Shirley Sanyin Chiu, Kwun Nam Chan, Y C Wong, Lam Wai Choy, Shiu Yin Chong, Kwok Ling Chan, Tak Lam Lo, Charles Wai Hong Chan, Yi Man Mo, Ming Cheuk Wong, Man Wa Siu, and Eric Y.H. Chen
Subjects: Psychosis, medicine.medical_specialty, Comorbidity, 03 medical and health sciences, Cognition, 0302 clinical medicine, medicine, Humans, Prospective Studies, Cognitive skill, Psychiatry, Biological Psychiatry, Psychiatric Status Rating Scales, business.industry, Medical record, At risk mental state, medicine.disease, 030227 psychiatry, Psychosocial Functioning, Psychiatry and Mental health, Psychotic Disorders, Quality of Life, Anxiety, Female, Pshychiatric Mental Health, medicine.symptom, business, Psychosocial, 030217 neurology & neurosurgery, Psychopathology
Abstract: Aim Psychiatric comorbidity frequently occurs with at-risk mental state (ARMS) for psychosis. Its relationships with psychopathology, cognition and functioning, however, remain to be further clarified. We aimed to examine prevalence and correlates of psychiatric comorbidity, and its associations with psychosocial functioning and subjective quality-of-life (QoL) in a representative sample of Chinese ARMS individuals. Methods One hundred ten help-seeking participants aged 15 to 40 years with ARMS were recruited from a specialized early psychosis service in Hong Kong. ARMS status was verified by comprehensive assessment of at-risk mental state (CAARMS). Comorbid Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition non-psychotic psychiatric disorders at baseline were ascertained using diagnostic interview and medical record review. Assessments encompassing symptom profiles, psychosocial functioning, subjective QoL and a brief cognitive battery were conducted. Results Forty-nine (44.5%) ARMS participants were diagnosed as having comorbid non-psychotic psychiatric disorders at baseline, primarily depressive and anxiety disorders. Binary multiple logistic regression analysis revealed that female gender, more severe depressive symptoms, higher suicidality and poorer global cognitive functioning were independently associated with comorbid diagnosis status. ARMS participants with psychiatric comorbidity displayed significantly more limited extended social networks and poorer subjective QoL than those without psychiatric comorbidity. Conclusion Comorbid disorders were frequently observed in Chinese ARMS individuals, and were linked to poorer cognition and higher suicide risk. Our findings underscore a potential critical role of psychiatric comorbidity in determining social functioning and subjective QoL in at-risk individuals. Further longitudinal research is required to clarify trajectories of comorbid disorder status and its prospective impact on clinical and functional outcomes in ARMS populations.
Published: 2020
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11. Statistics of Canine Skin Tumors in Korea during 2005-2018

Author: Choi Ws, Lim Hy, Kim Sh, Seung Bj, Cho Sh, Jung-Hyang Sur, and Bae Mk
Subjects: medicine.medical_specialty, Pathology, General Veterinary, business.industry, medicine, Histopathology, Body region, Skin cancer, Liposarcoma, Lipoma, business, medicine.disease, Skin lesion
Published: 2020
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12. Human microphysiological systems for drug development

Author: Adrian Roth and Mps-Ws Berlin
Subjects: Multidisciplinary, Drug Development, Drug-Related Side Effects and Adverse Reactions, Drug development, business.industry, Lab-On-A-Chip Devices, Antineoplastic Combined Chemotherapy Protocols, Humans, Medicine, Pharmacokinetics, Precision Medicine, Pharmacology, business
Abstract: Organs-on-chips could be used to assess drug efficacy and support personalized medicine
Published: 2021
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13. A global experiment on motivating social distancing during the COVID-19 pandemic

Author: Legate, N, Ngyuen, T-V, Weinstein, N, Moller, A, Legault, L, Vally, Z, Tajchman, Z, Zsido, AN, Zrimsek, M, Chen, Z, Ziano, I, Gialitaki, Z, Ceary, CD, Jang, Y, Lin, Y, Kunisato, Y, Yamada, Y, Xiao, Q, Jiang, X, Du, X, Yao, E, Ryan, WS, Wilson, JP, Cyrus-Lai, W, Jimenez-Leal, W, Law, W, Unanue, W, Collins, WM, Richard, KL, Vranka, M, Ankushev, V, Schei, V, DePaola, C, Lerche, V, Kovic, V, Križanić, V, Kadreva, VH, Adoric, VC, Tran, US, Yeung, SK, Hassan, W, Houston, R, Machin, MA, Lima, TJS, Ostermann, T, Frizzo, T, Sverdrup, TE, House, T, Gill, T, Fedotov, M, Paltrow, T, Jernsäther, T, Rahman, T, Machin, T, Koptjevskaja-Tamm, M, Hostler, TJ, Ishii, T, Szaszi, B, Adamus, S, Suter, L, von Bormann, SM, Habib, S, Studzinska, A, Stojanovska, D, Janssen, SMJ, Stieger, S, Schulenberg, SE, Tatachari, S, Azouaghe, S, Sorokowski, P, Sorokowska, A, Song, X, Morbée, S, Lewis, S, Sinkolova, S, Grigoryev, D, Drexler, SM, Daches, S, Levine, SL, Geniole, SN, Akter, S, Vračar, S, Massoni, S, Costa, S, Zorjan, S, Sarioguz, E, Izquierdo, SM, Tshonda, SS, Alves, SG, Pöntinen, S, Solas, SÁ, Ordoñez-Riaño, S, Očovaj, SB, Onie, S, Lins, S, Biberauer, T, Çoksan, S, Khumkom, S, Sacakli, A, Ruiz-Fernández, S, Geiger, SJ, FatahModares, S, Walczak, RB, Betlehem, R, Vilar, R, Cárcamo, RA, Ross, RM, McCarthy, R, Ballantyne, T, Westgate, EC, Ryan, RM, Gargurevich, R, Afhami, R, Ren, D, Monteiro, RP, Reips, U-D, Reggev, N, Calin-Jageman, RJ, Pourafshari, R, Oliveira, R, Nedelcheva-Datsova, M, Rahal, R-M, Ribeiro, RR, Radtke, T, Searston, R, Jai-ai, R, Habte, R, Zdybek, P, Chen, S-C, Wajanatinapart, P, Maturan, PLG, Perillo, JT, Isager, PM, Kačmár, P, Macapagal, PM, Maniaci, MR, Szwed, P, Hanel, PHP, Forbes, PAG, Arriaga, P, Paris, B, Parashar, N, Papachristopoulos, K, Correa, PS, Kácha, O, Bernardo, M, Campos, O, Bravo, ON, Galindo-Caballero, OJ, Ogbonnaya, CE, Bialobrzeska, O, Kiselnikova, N, Simonovic, N, Cohen, N, Nock, NL, Hernandez, A, Thogersen-Ntoumani, C, Ntoumanis, N, Johannes, N, Albayrak-Aydemir, N, Say, N, Neubauer, AB, Martin, NI, Levy, N, Torunsky, N, Antwerpen, NV, Doren, NV, Sunami, N, Rachev, NR, Majeed, NM, Schmidt, N-D, Nadif, K, Corral-Frías, NS, Ouherrou, N, Abbas, N, Pantazi, M, Lucas, MY, Vasilev, MR, Victoria Ortiz, M, Butt, MM, Kurfalı, M, Kabir, M, Muda, R, Rivera, MDCMCT, Sirota, M, Seehuus, M, Parzuchowski, M, Toro, M, Hricova, M, Maldonado, MA, Rentzelas, P, Vansteenkiste, M, Metz, MA, Marszalek, M, Karekla, M, Mioni, G, Bosma, MJ, Westerlund, M, Vdovic, M, Bialek, M, Silan, MA, Anne, M, Misiak, M, Gugliandolo, MC, Grinberg, M, Capizzi, M, Espinoza Barría, MF, Kurfali, MA, Mensink, MC, Harutyunyan, M, Khosla, M, Dunn, MR, Korbmacher, M, Adamkovič, M, Ribeiro, MFF, Terskova, M, Hruška, M, Martončik, M, Jansen, M, Voracek, M, Čadek, M, Frias-Armenta, M, Kowal, M, Topor, M, Roczniewska, M, Oosterlinck, M, Kohlová, MB, Paruzel-Czachura, M, Sabristov, M, Romanova, M, Papadatou-Pastou, M, Lund, ML, Antoniadi, M, Magrin, ME, Jones, MV, Li, M, Ortiz, MS, Manavalan, M, Muminov, A, Kossowska, M, Friedemann, M, Wielgus, M, van Hooff, MLM, Varella, MAC, Standage, M, Nicolotti, M, Colloff, MF, Bradford, M, Vaughn, LA, Eudave, L, Vieira, L, Lu, JG, Pineda, LMS, Matos, L, Pérez, LC, Lazarevic, LB, Jaremka, LM, Smit, ES, Kushnir, E, Ferguson, LJ, Anton-Boicuk, L, Lins de Holanda Coelho, G, Ahlgren, L, Liga, F, Levitan, CA, Micheli, L, Gunton, L-A, Volz, L, Stojanovska, M, Boucher, L, Samojlenko, L, Delgado, LGJ, Kaliska, L, Beatrix, L, Warmelink, L, Rojas-Berscia, LM, Yu, K, Wylie, K, Wachowicz, J, Desai, K, Barzykowski, K, Kozma, L, Evans, K, Kirgizova, K, Emmanuel Agesin, BB, Koehn, MA, Wolfe, K, Korobova, T, Morris, K, Klevjer, K, van Schie, K, Vezirian, K, Damnjanović, K, Thommesen, KK, Schmidt, K, Filip, K, Staniaszek, K, Grzech, K, Hoyer, K, Moon, K, Khaobunmasiri, S, Rana, K, Janjić, K, Suchow, JW, Kielińska, J, Cruz Vásquez, JE, Chanal, J, Beitner, J, Vargas-Nieto, JC, Roxas, JCT, Taber, J, Urriago-Rayo, J, Pavlacic, JM, Benka, J, Bavolar, J, Soto, JA, Olofsson, JK, Vilsmeier, JK, Messerschmidt, J, Czamanski-Cohen, J, Waterschoot, J, Moss, JD, Boudesseul, J, Lee, JM, Kamburidis, J, Joy-Gaba, JA, Zickfeld, J, Miranda, JF, Verharen, JPH, Hristova, E, Beshears, JE, Djordjevic, JM, Bosch, J, Valentova, JV, Antfolk, J, Berkessel, JB, Schrötter, J, Urban, J, Röer, JP, Norton, JO, Silva, JR, Pickering, JS, Vintr, J, Uttley, J, Kunst, JR, Ndukaihe, ILG, Iyer, A, Vilares, I, Ivanov, A, Ropovik, I, Sula, I, Sarieva, I, Metin-Orta, I, Prusova, I, Pinto, I, Bozdoc, AI, Almeida, IAT, Pit, IL, Dalgar, I, Zakharov, I, Arinze, AI, Ihaya, K, Stephen, ID, Gjoneska, B, Brohmer, H, Flowe, H, Godbersen, H, Kocalar, HE, Hedgebeth, MV, Chuan-Peng, H, Sharifian, M, Manley, H, Akkas, H, Hajdu, N, Azab, H, Kaminski, G, Nilsonne, G, Anjum, G, Travaglino, GA, Feldman, G, Pfuhl, G, Czarnek, G, Marcu, GM, Hofer, G, Banik, G, Adetula, GA, Bijlstra, G, Verbruggen, F, Kung, FYH, Martela, F, Foroni, F, Forest, J, Singer, G, Muchembled, F, Azevedo, F, Mosannenzadeh, F, Marinova, E, Štrukelj, E, Etebari, Z, Bradshaw, EL, Baskin, E, Garcia, EOL, Musser, E, van Steenkiste, IMM, Ahn, ER, Quested, E, Pronizius, E, Jackson, EA, Manunta, E, Agadullina, E, Šakan, D, Dursun, P, Dujols, O, Dubrov, D, Willis, M, Tümer, M, Beaudry, JL, Popović, D, Dunleavy, D, Djamai, I, Krupić, D, Herrera, D, Vega, D, Du, H, Mola, D, Chakarova, D, Davis, WE, Holford, DL, Lewis, DMG, Vaidis, DC, Ozery, DH, Ricaurte, DZ, Storage, D, Sousa, D, Alvarez, DS, Boller, D, Rosa, AD, Dimova, D, Marko, D, Moreau, D, Reeck, C, Correia, RC, Whitt, CM, Lamm, C, Solorzano, CS, von Bastian, CC, Sutherland, CAM, Overkott, C, Aberson, CL, Wang, C, Niemiec, CP, Karashiali, C, Noone, C, Chiu, F, Picciocchi, C, Brownlow, C, Karaarslan, C, Cellini, N, Esteban-Serna, C, Reyna, C, Ferreyra, C, Batres, C, Li, R, Grano, C, Carpentier, J, Tamnes, CK, Fu, CHY, Ishkhanyan, B, Bylinina, L, Jaeger, B, Bundt, C, Allred, TB, Vermote, BJ, Bokkour, A, Bogatyreva, N, Shi, J, Chopik, WJ, Antazo, B, Behzadnia, B, Becker, M, Bayyat, MM, Cocco, B, Chou, W-L, Barkoukis, V, Hubena, B, Žuro, B, Aczel, B, Baklanova, E, Bai, H, Balci, BB, Babinčák, P, Soenens, B, Dixson, BJW, Mokady, A, Kappes, HB, Atari, M, Szala, A, Szabelska, A, Aruta, JJB, Domurat, A, Arinze, NC, Modena, A, Adiguzel, A, Monajem, A, ARABI, KAITEL, Özdoğru, AA, Rothbaum, AO, Torres, AO, Theodoropoulou, A, Skowronek, A, Jurković, AP, Singh, A, Kassianos, AP, Findor, A, Hartanto, A, Landry, AT, Ferreira, A, Santos, AC, De la Rosa-Gomez, A, Gourdon-Kanhukamwe, A, Luxon, AM, Todsen, AL, Karababa, A, Janak, A, Pilato, A, Bran, A, Tullett, AM, Kuzminska, AO, Krafnick, AJ, Urooj, A, Khaoudi, A, Ahmed, A, Groyecka-Bernard, A, Askelund, AD, Adetula, A, Belaus, A, Charyate, AC, Wichman, AL, Stoyanova, A, Greenburgh, A, Thomas, AG, Arvanitis, A, Forscher, PS, Mallik, PR, Coles, NA, Miller, JK, Moshontz, H, Urry, HL, IJzerman, H, Basnight-Brown, DM, Ebersole, CR, Chartier, CR, Buchanan, EM, Primbs, MA, Department of Psychology, Education and Child Studies, Clinical Psychology, Legate, N, Nguyen, T, Weinstein, N, Moller, A, Legault, L, Vally, Z, Tajchman, Z, Zsido, A, Zrimsek, M, Chen, Z, Ziano, I, Gialitaki, Z, Ceary, C, Jang, Y, Lin, Y, Kunisato, Y, Yamada, Y, Xiao, Q, Jiang, X, Du, X, Yao, E, Ryan, W, Wilson, J, Cyrus-Lai, W, Jimenez-Leal, W, Law, W, Unanue, W, Collins, W, Richard, K, Vranka, M, Ankushev, V, Schei, V, Lerche, V, Kovic, V, Krizanic, V, Kadreva, V, Adoric, V, Tran, U, Yeung, S, Hassan, W, Houston, R, Machin, M, Lima, T, Ostermann, T, Frizzo, T, Sverdrup, T, House, T, Gill, T, Fedotov, M, Paltrow, T, Jernsather, T, Rahman, T, Machin, T, Koptjevskaja-Tamm, M, Hostler, T, Ishii, T, Szaszi, B, Adamus, S, Suter, L, von Bormann, S, Habib, S, Studzinska, A, Stojanovska, D, Janssen, S, Stieger, S, Schulenberg, S, Tatachari, S, Azouaghe, S, Sorokowski, P, Sorokowska, A, Song, X, Morbee, S, Lewis, S, Sinkolova, S, Grigoryev, D, Drexler, S, Daches, S, Levine, S, Geniole, S, Akter, S, Vracar, S, Massoni, S, Costa, S, Zorjan, S, Sarioguz, E, Izquierdo, S, Tshonda, S, Alves, S, Pontinen, S, Solas, S, Ordonez-Riano, S, Ocovaj, S, Onie, S, Lins, S, Biberauer, T, Coksan, S, Khumkom, S, Sacakli, A, Ruiz-Fernandez, S, Geiger, S, Modares, S, Walczak, R, Betlehem, R, Vilar, R, Carcamo, R, Ross, R, Mccarthy, R, Ballantyne, T, Westgate, E, Ryan, R, Gargurevich, R, Afhami, R, Ren, D, Monteiro, R, Reips, U, Reggev, N, Calin-Jagema, R, Pourafshari, R, Oliveira, R, Nedelcheva-Datsova, M, Rahal, R, Ribeiro, R, Radtke, T, Searston, R, Jai-ai, R, Habte, R, Zdybek, P, Chen, S, Wajanatinapart, P, Maturan, P, Perillo, J, Isager, P, Kacmar, P, Macapagal, P, Maniaci, M, Szwed, P, Hanel, P, Forbes, P, Arriaga, P, Paris, B, Parashar, N, Papachristopoulos, K, Correa, P, Kacha, O, Bernardo, M, Campos, O, Bravo, O, Galindo-Caballero, O, Ogbonnaya, C, Bialobrzeska, O, Kiselnikova, N, Simonovic, N, Cohen, N, Nock, N, Hernandez, A, Thogersen-Ntouma, C, Ntoumanis, N, Johannes, N, Albayrak-Aydemir, N, Say, N, Neubauer, A, Martin, N, Torunsky, N, van Antwerpen, N, Van Doren, N, Sunami, N, Rachev, N, Majeed, N, Schmidt, N, Nadif, K, Corral-Frias, N, Ouherrou, N, Abbas, N, Pantazi, M, Lucas, M, Vasilev, M, Ortiz, M, Butt, M, Kurfali, M, Kabir, M, Muda, R, Rivera, M, Sirota, M, Seehuus, M, Parzuchowski, M, Toro, M, Hricova, M, Maldonado, M, Rentzelas, P, Vansteenkiste, M, Metz, M, Marszalek, M, Karekla, M, Mioni, G, Bosma, M, Westerlund, M, Vdovic, M, Bialek, M, Silan, M, Anne, M, Misiak, M, Gugliandolo, M, Grinberg, M, Capizzi, M, Barria, M, Mensink, M, Harutyunyan, M, Khosla, M, Dunn, M, Korbmacher, M, Adamkovic, M, Ribeiro, M, Terskova, M, Hruska, M, Martoncik, M, Voracek, M, Cadek, M, Frias-Armenta, M, Kowal, M, Topor, M, Roczniewska, M, Oosterlinck, M, Kohlova, M, Paruzel-Czachura, M, Sabristov, M, Romanova, M, Papadatou-Pastou, M, Lund, M, Antoniadi, M, Magrin, M, Jones, M, Li, M, Manavalan, M, Muminov, A, Kossowska, M, Friedemann, M, Wielgus, M, van Hooff, M, Varella, M, Standage, M, Nicolotti, M, Colloff, M, Bradford, M, Vaughn, L, Eudave, L, Vieira, L, Lu, J, Pineda, L, Matos, L, Perez, L, Lazarevic, L, Jaremka, L, Smit, E, Kushnir, E, Ferguson, L, Anton-Boicuk, L, Coelho, G, Ahlgren, L, Liga, F, Levitan, C, Micheli, L, Gunton, L, Volz, L, Stojanovska, M, Boucher, L, Samojlenko, L, Delgado, L, Kaliska, L, Beatrix, L, Warmelink, L, Rojas-Berscia, L, Yu, K, Wylie, K, Wachowicz, J, Desai, K, Barzykowski, K, Kozma, L, Evans, K, Kirgizova, K, Agesin, B, Koehn, M, Wolfe, K, Korobova, T, Morris, K, Klevjer, K, van Schie, K, Vezirian, K, Damnjanovic, K, Thommesen, K, Schmidt, K, Filip, K, Staniaszek, K, Grzech, K, Hoyer, K, Moon, K, Khaobunmasiri, S, Rana, K, Janjic, K, Suchow, J, Kielinska, J, Vasquez, J, Chanal, J, Beitner, J, Vargas-Nieto, J, Roxas, J, Taber, J, Urriago-Rayo, J, Pavlacic, J, Benka, J, Bavolar, J, Soto, J, Olofsson, J, Vilsmeier, J, Messerschmidt, J, Czamanski-Cohen, J, Waterschoot, J, Moss, J, Boudesseul, J, Lee, J, 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S., Kushnir, E., Wichman, A. L., Ferguson, L. J., Anton-Boicuk, L., De Holanda Coelho, G. L., Ahlgren, L., Liga, F., Levitan, C. A., Micheli, L., Gunton, L. -A., Volz, L., Stojanovska, M., Boucher, L., Samojlenko, L., Delgado, L. G. J., Kaliska, L., Beatrix, L., Warmelink, L., Rojas-Berscia, L. M., Yu, K., Wylie, K., Wachowicz, J., Charyate, A. C., Desai, K., Barzykowski, K., Kozma, L., Evans, K., Kirgizova, K., Belaus, A., Emmanuel Agesin, B. B., Koehn, M. A., Wolfe, K., Korobova, T., Morris, K., Klevjer, K., Van Schie, K., Vezirian, K., Damnjanovic, K., Thommesen, K. K., Schmidt, K., Filip, K., Staniaszek, K., Adetula, A., Grzech, K., Hoyer, K., Moon, K., Khaobunmasiri, S., Rana, K., Janjic, K., Suchow, J. W., Kielinska, J., Cruz Vasquez, J. E., Chanal, J., Beitner, J., Vargas-Nieto, J. C., Roxas, J. C. T., Taber, J., Urriago-Rayo, J., Askelund, A. D., Pavlacic, J. M., Benka, J., Bavolar, J., Soto, J. A., Olofsson, J. K., Vilsmeier, J. K., Messerschmidt, J., Czamanski-Cohen, J., Waterschoot, J., Moss, J. D., Boudesseul, J., Lee, J. M., Kamburidis, J., Joy-Gaba, J. A., Zickfeld, J., Miranda, J. F., Verharen, J. P. H., Hristova, E., Beshears, J. E., Djordjevic, J. M., Bosch, J., Valentova, J. V., Antfolk, J., Berkessel, J. B., Schrotter, J., Urban, J., Roer, J. P., Norton, J. O., Silva, J. R., Pickering, J. S., Vintr, J., Uttley, J., Kunst, J. R., Ndukaihe, I. L. G., Iyer, A., Vilares, I., Ivanov, A., Ropovik, I., Sula, I., Groyecka-Bernard, A., Sarieva, I., Metin-Orta, I., Prusova, I., Pinto, I., Bozdoc, A. I., Almeida, I. A. T., Pit, I. L., Dalgar, I., Zakharov, I., Arinze, A. I., Ihaya, K., Stephen, I. D., Gjoneska, B., Brohmer, H., Flowe, H., Godbersen, H., Kocalar, H. E., Hedgebeth, M. V., Chuan-Peng, H., Sharifian, M., Manley, H., Akkas, H., Hajdu, N., Azab, H., Kaminski, G., Nilsonne, G., Anjum, G., Travaglino, G. A., Feldman, G., Pfuhl, G., Czarnek, G., Marcu, G. M., Hofer, G., Banik, G., Adetula, G. A., Bijlstra, G., Verbruggen, F., Kung, F. Y. H., Martela, F., Foroni, F., Forest, J., Singer, G., Muchembled, F., Azevedo, F., Mosannenzadeh, F., Marinova, E., Strukelj, E., Etebari, Z., Bradshaw, E. L., Baskin, E., Garcia, E. O. L., Musser, E., Van Steenkiste, I. M. M., Ahn, E. R., Quested, E., Pronizius, E., Jackson, E. A., Manunta, E., Agadullina, E., Sakan, D., Dursun, P., Dujols, O., Dubrov, D., Willis, M., Tumer, M., Beaudry, J. L., Popovic, D., Dunleavy, D., Djamai, I., Krupic, D., Herrera, D., Vega, D., Du, H., Mola, D., Chakarova, D., Davis, W. E., Holford, D. L., Lewis, D. M. G., Vaidis, D. C., Ozery, D. H., Ricaurte, D. Z., Storage, D., Sousa, D., Alvarez, D. S., Boller, D., Rosa, A. D., Dimova, D., Marko, D., Moreau, D., Reeck, C., Correia, R. C., Whitt, C. M., Lamm, C., Solorzano, C. S., Von Bastian, C. C., Sutherland, C. A. M., Ebersole, C. R., Overkott, C., Aberson, C. L., Wang, C., Niemiec, C. P., Karashiali, C., Noone, C., Chiu, F., Picciocchi, C., Brownlow, C., Karaarslan, C., Cellini, N., Esteban-Serna, C., Reyna, C., Ferreyra, C., Batres, C., Li, R., Grano, C., Carpentier, J., Tamnes, C. K., Fu, C. H. Y., Ishkhanyan, B., Bylinina, L., Jaeger, B., Bundt, C., Allred, T. B., Vermote, B. J., Bokkour, A., Bogatyreva, N., Shi, J., Chopik, W. J., Antazo, B., Behzadnia, B., Becker, M., Bayyat, M. M., Cocco, B., Ahmed, A., Chou, W. -L., Barkoukis, V., Hubena, B., Khaoudi, A., Zuro, B., Aczel, B., Baklanova, E., Bai, H., Balci, B. B., Babincak, P., Soenens, B., Dixson, B. J. W., Mokady, A., Kappes, H. B., Atari, M., Szala, A., Szabelska, A., Aruta, J. J. B., Domurat, A., Arinze, N. C., Modena, A., Adiguzel, A., Monajem, A., Ait El Arabi, K., Ozdogru, A. A., Rothbaum, A. O., Torres, A. O., Theodoropoulou, A., Skowronek, A., Urooj, A., Jurkovic, A. P., Singh, A., Kassianos, A. P., Findor, A., Hartanto, A., Landry, A. T., Ferreira, A., Santos, A. C., De La Rosa-Gomez, A., Gourdon-Kanhukamwe, A., Luxon, A. M., Todsen, A. L., Karababa, A., Janak, A., Pilato, A., Bran, A., Tullett, A. M., Kuzminska, A. O., Krafnick, A. J., Department of Industrial Engineering and Management, Aalto-yliopisto, Aalto University, Massey, D., Kurfali, Merve A., Collaboration, Psychological Science Accelerator Self-Determination Theory, FdR overig onderzoek, Persuasive Communication (ASCoR, FMG), and Organizational Psychology
Subjects: behavior change, Coronavirus disease 2019 (COVID-19), 230 Affective Neuroscience, INTENTIONS, L400, self-determination theory, Physical Distancing, Social Sciences, Intention, Ciências Sociais::Psicologia [Domínio/Área Científica], FATIGUE, motivation, PARENTAL PROHIBITION, SDG 3 - Good Health and Well-being, Pandemic, Humans, health communication, MESSAGES, Sociology, Pandemics, METAANALYSIS, COVID-19, Behaviour Change and Well-being, Multidisciplinary, business.industry, Social distance, Public relations, Motivation, INTERNALIZATION, business, BEHAVIOR
Abstract: Significance\ud \ud Communicating in ways that motivate engagement in social distancing remains a critical global public health priority during the COVID-19 pandemic. This study tested motivational qualities of messages about social distancing (those that promoted choice and agency vs. those that were forceful and shaming) in 25,718 people in 89 countries. The autonomy-supportive message decreased feelings of defying social distancing recommendations relative to the controlling message, and the controlling message increased controlled motivation, a less effective form of motivation, relative to no message. Message type did not impact intentions to socially distance, but people’s existing motivations were related to intentions. Findings were generalizable across a geographically diverse sample and may inform public health communication strategies in this and future global health emergencies.\ud \ud \ud \ud Abstract\ud \ud Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges.
Published: 2022
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14. Biallelic TMEM260 variants cause truncus arteriosus, with or without renal defects

Author: Pagnamenta, AT, Jackson, A, Perveen, R, Beaman, G, Petts, G, Gupta, A, Hyder, Z, Chung, BH, Kan, AS, Cheung, KW, Kerstjens‐Frederikse, WS, Abbott, KM, Ambrose, JC, Arumugam, P, Bevers, R, Bleda, M, Boardman‐Pretty, F, Boustred, CR, Brittain, H, Caulfield, MJ, Chan, GC, Elgar, G, Fowler, T, Giess, A, Hamblin, A, Henderson, S, Hubbard, TJP, Jackson, R, Jones, LJ, Kasperaviciute, D, Kayikci, M, Kousathanas, A, Lahnstein, L, Leigh, SEA, Leong, IUS, Lopez, JF, Maleady‐Crowe, F, McEntagart, M, Minneci, F, Moutsianas, L, Mueller, M, Murugaesu, N, Need, AC, O′Donovan, P, Odhams, CA, Patch, C, Pereira, MB, Perez‐Gil, D, Pullinger, J, and Rahim, T
Subjects: Heart Defects, Congenital, Heterozygote, medicine.medical_specialty, kidney, renal failure, Genotype, media_common.quotation_subject, Nonsense, Persistent truncus arteriosus, Gastroenterology, Internal medicine, Genetics, medicine, Humans, Missense mutation, Abnormalities, Multiple, Family, Genetic Predisposition to Disease, structural heart defects and renal anomalies syndrome, truncus arteriosus, Alleles, Genetic Association Studies, Genetics (clinical), Exome sequencing, media_common, Kidney, business.industry, Membrane Proteins, medicine.disease, Phenotype, Elevated creatinine, genome sequencing, TMEM260, medicine.anatomical_structure, Amino Acid Substitution, SHDRA, RNA splicing, Kidney Diseases, phenotypic variability, business, exome sequencing
Abstract: Only two families have been reported with biallelic TMEM260 variants segregating with structural heart defects and renal anomalies syndrome (SHDRA). With a combination of genome, exome sequencing and RNA studies, we identified eight individuals from five families with biallelic TMEM260 variants. Variants included one multi-exon deletion, four nonsense/frameshifts, two splicing changes and one missense change. Together with the published cases, analysis of clinical data revealed ventricular septal defects (12/12), mostly secondary to truncus arteriosus (10/12), elevated creatinine levels (6/12), horse-shoe kidneys (1/12) and renal cysts (1/12) in patients. Three pregnancies were terminated on detection of severe congenital anomalies. Six patients died between the ages of 6 weeks and 5 years. Using a range of stringencies, carrier frequency for SHDRA was estimated at 0.0007–0.007 across ancestries. In conclusion, this study confirms the genetic basis of SHDRA, expands its known mutational spectrum and clarifies its clinical features. We demonstrate that SHDRA is a severe condition associated with substantial mortality in early childhood and characterised by congenital cardiac malformations with a variable renal phenotype.
Published: 2022
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15. S48 Lenzilumab efficacy and safety in newly hospitalized Covid-19 subjects: results from the LIVE-AIR phase 3 randomized double-blind placebo-controlled trial

Author: Z Temesgen, CD Burger, J Baker, C Polk, CR Libertin, CF Kelley, VC Marconi, R Orenstein, VM Catterson, WS Aronstein, C Durrant, D Chappell, O Ahmed, G Chappell, and AD Badley
Subjects: Mechanical ventilation, medicine.medical_specialty, education.field_of_study, Randomization, business.industry, medicine.medical_treatment, Population, Placebo-controlled study, medicine.disease, Placebo, Gastroenterology, Respiratory failure, Internal medicine, Coagulopathy, medicine, education, business, Kidney disease
Abstract: BACKGROUNDSevere COVID-19 pneumonia results from a hyperinflammatory immune response (cytokine storm, CS), characterized by GM-CSF mediated activation and trafficking of myeloid cells, leading to elevation of downstream inflammatory chemokines (MCP-1, IL-8, IP-10), cytokines (IL-6, IL-1), and other markers of systemic inflammation (CRP, D-dimer, ferritin). CS leads to fever, hypotension, coagulopathy, respiratory failure, ARDS, and death. Lenzilumab is a novel Humaneered(R) anti-human GM-CSF monoclonal antibody that directly binds GM-CSF and prevents signaling through its receptor. The LIVE-AIR Phase 3 randomized, double-blind, placebo-controlled trial investigated the efficacy and safety of lenzilumab to assess the potential for lenzilumab to improve the likelihood of ventilator-free survival (referred to herein as survival without ventilation, SWOV), beyond standard supportive care, in hospitalized subjects with severe COVID-19. METHODSSubjects with COVID-19 (n=520), [≥]18 years, and [≤]94% oxygen saturation on room air and/or requiring supplemental oxygen, but not invasive mechanical ventilation, were randomized to receive lenzilumab (600 mg, n=261) or placebo (n=259) via three intravenous infusions administered 8 hours apart. Subjects were followed through Day 28 following treatment. RESULTSBaseline demographics were comparable between the two treatment groups: male, 64.7%; mean age, 60.5 years; mean BMI, 32.5 kg/m2; mean CRP, 98.36 mg/L; CRP was
Published: 2021
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16. Author response for 'Changing Pattern of Pediatric Anaphylaxis in Hong Kong, 2010‐2019'

Author: Agnes Sy Leung, G.W.K. Wong, Mike Yw Kwan, Yat Sun Yau, Chi Hang Wong, Polly P. K. Ho, Ting Fan Leung, Gilbert T. Chua, JS Rosa Duque, David Ck Luk, Ann Ws Au, and Rebecca M. Y. Li
Subjects: medicine.medical_specialty, business.industry, medicine, medicine.disease, business, Intensive care medicine, Anaphylaxis
Published: 2021
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17. Elevated sCD40L in Secondary Progressive Multiple Sclerosis in Comparison to Non-progressive Benign and Relapsing Remitting Multiple Sclerosis

Author: Elizabeth A. Mills, Jacob Ws Martens, Qin Wang, Aiya Saad, Qi Wu, Yang Mao-Draayer, Catherine A. Dowling, Jennifer Yang, and Pavani Chilukuri
Subjects: Oncology, medicine.medical_specialty, secondary progressive multiple sclerosis, business.industry, Multiple sclerosis, soluble CD40 ligand, medicine.disease, multiple sclerosis, Relapsing remitting, Internal medicine, Medicine, Secondary progressive multiple sclerosis, relapsing remitting MS, Neurology. Diseases of the nervous system, Original Research Article, RC346-429, business, Benign MS
Abstract: Background: The long-term prognosis of relapsing-remitting multiple sclerosis (RRMS) is usually unfavorable as most patients transition to secondary progressive multiple sclerosis (SPMS) with accumulative disability. A rare form of non-progressive multiple sclerosis (MS) also exists, known as benign MS (BMS or NPMS), which lacks disease progression defined as Expanded Disability Status Scale (EDSS) ≤3 after 15 years of disease onset without treatment. Purpose: Our study aims to identify soluble plasma factors predicting disease progression in multiple sclerosis (MS). Research Design and Study Sample: We utilized Luminex multiplex to analyze plasma levels of 33 soluble factors, comparing 32 SPMS patients to age-, sex-, and disease duration-matched non-progressive BMS patients, as well as to RRMS patients and healthy controls. Results: Plasma levels of EGF, sCD40L, MCP1/CCL2, fractalkine/CX3CL1, IL-13, Eotaxin, TNFβ/LTα, and IL-12p40 were significantly different between the various types of MS. Plasma sCD40L was significantly elevated in SPMS compared to BMS and RRMS. The combination of MCP1/CCL2 and sCD40L discriminated between RRMS and SPMS. MCP1/CCL2 was found to be the most effective classifier between BMS and RRMS, while BMS was most effectively distinguished from SPMS by the combination of sCD40L and IFNγ levels. Conclusions: These differences may facilitate personalized precision medicine and aid in the discovery of new therapeutic targets for disease progression through the improvement of patient stratification.
Published: 2021

18. AGÊNCIAS TRANSFUSIONAIS E BIOSSEGURANÇA EM CONFORMIDADE COM AS NORMAS E LEGISLAÇÕES VIGENTES

Author: Mhs Silva, MC Silva, WS Teles, Renato Cesar Sacchetto Torres, Pccs Junior, Alj Morais, Amms Barros, A Debbo, Marysilvia Ferreira da Costa, and RN Silva
Subjects: business.industry, Immunology and Allergy, Medicine, Diseases of the blood and blood-forming organs, Hematology, RC633-647.5, business, Humanities
Abstract: Introducao A biosseguranca e um conjunto de medidas que busca reduzir os riscos inerentes a uma determinada atividade. Essa area de conhecimento e definida pela Agencia Nacional de Vigilância Sanitaria (Anvisa) como: “condicao de seguranca alcancada por um conjunto de acoes destinadas a prevenir, controlar, reduzir ou eliminar riscos inerentes as atividades que possam comprometer a saude humana, animal e o meio ambiente”. E relevante o entendimento das responsabilidades pertinentes para assegurar a cultura da biosseguranca e sua disseminacao tao quanto a valorizacao presente no ambiente laboratorial, visto que e a partir desta compreensao que surgem as modificacoes corretas nas atitudes, no comportamento e na reorganizacao do processo administrativo. O objetivo deste estudo foi avaliar a implementacao dos procedimentos de biosseguranca laboratorial nas Agencias Transfusionais (AT), os quais contribuirao para proporcionar um ambiente seguro para os funcionarios, clientes. Objetivo Avaliar e analisar os procedimentos de biosseguranca em AT. Material e metodos Foi realizado um estudo transversal com dados retrospectivos e analise dos dados contidos nos roteiros de inspecao da RDC 34/2014, realizados em ATs de uma regiao do nordeste brasileiro. Resultados Na analise realizada a partir dos roteiros de inspecao nas AT observou-se que os residuos biologicos sao depositados nas lixeiras com saco plastico de cor branca com o simbolo de infectante, e os residuos comuns armazenados em saco preto ou azul. Com relacao aos Equipamentos de Protecao Individuais (EPI's), sao disponibilizados e utilizados em todas AT, porem em 02 AT os oculos de protecao individual nao apresentavam boa vedacao periferica e boa adaptacao ao rosto. Ja no que concerne ao chuveiro de emergencia utilizado em acidente que envolvem o lancamento de uma grande quantidade de substâncias quimicas sobre o profissional nenhuma das agencias dispunham conforme tabela. Discussao Portanto, torna-se evidente as praticas de biosseguranca devido as exposicoes a agentes patogenos, superficies sujas com amostras biologicas, equipamentos contaminados, nos quais o profissional pode se contaminar e transferir essa contaminacao para outras pessoas. Dessa forma, faz-se necessario o acesso dos trabalhadores a informacoes sobre os riscos inerentes as suas atividades, alem de ter conhecimento sobre os EPIs e as medidas preventivas e corretivas. Conclusao Dessa forma, destaca-se a importância dos residuos biologicos da coleta sanguinea em ATs, no âmbito dos servicos de saude, e faz-se necessario o conhecimento sobre os conceitos, classicacao e gerenciamento desse tipo de residuo, uma vez que as condicoes de seguranca ambiental e ocupacional sao requisitos imprescindiveis a serem observados por todos os responsaveis pelos estabelecimentos de saude.
Published: 2021

19. A SEVERIDADE E A FREQUÊNCIA DE HEMORRAGIAS NOS PACIENTES COM HEMOFILIA E COM PRESENÇA DE INIBIDORES

Author: Pccs Junior, RN Silva, A Debbo, Alj Morais, Mhs Silva, Amms Barros, MC Silva, Marysilvia Ferreira da Costa, Renato Cesar Sacchetto Torres, and WS Teles
Subjects: business.industry, Immunology and Allergy, Medicine, Diseases of the blood and blood-forming organs, Hematology, RC633-647.5, business, Humanities
Abstract: Introducao Uma das principais manifestacoes clinicas das hemofilias, especialmente as graves, sao os hematomas, principalmente as hemartroses. Elas sao de hemorragias intra-articulares que ocorrem desde os primeiros anos de vida. Estima-se que mais de 80% de todos os casos de hemorragias em portadores de hemofilia grave sejam intra-articulares. Ao longo do tempo, a recorrencia das hemartroses levam a ativacao de enzimas liticas e fibrose, gerando dano articular permanente, o que causa varios niveis de incapacidade fisica. Os demais sangramentos geralmente acontecem em episodios isolados, principalmente apos algum trauma ocorrido. OBJETIVO: O presente estudo teve como objetivo analisar as manifestacoes clinicas da hemofilia dos pacientes atendidos no ambulatorio de uma regiao do nordeste brasileiro. Material e metodos A pesquisa constitui-se de uma analise retrospectiva a partir de informacoes dos prontuarios de pacientes portadores de hemofilia A que foram atendidos no setor ambulatorial em uma regiao do nordeste brasileiro, durante o periodo de janeiro de 2018 a marco de 2020. Resultados Foram avaliados 100 prontuarios de pacientes portadores de hemofilia A atendidos no ambulatorio destes, foram selecionados 17% (17), levando-se em consideracao os pacientes que apresentam aloanticorpos inibidores do fator VIII. Dos pacientes diagnosticados, 18% (3) apresentam inibidores de alta titulacao e, dentre eles, 67% (2) apresentam a forma grave da doenca e 33% (1) apresentam a forma leve; dentre os 82% (14) dos pacientes que apresentam inibidores de baixa titulacao, por sua vez, 64% (9) tem a forma grave da doenca, 21% (3) tem a forma leve e 14% (2) apresentam a forma moderada (grafico 1). Dos sintomas apresentados pelos pacientes que apresentaram inibidores, todos apresentaram hemartrose e hematomas, e entre aqueles que desenvolveram algum tipo de artropatia: 80% (8) eram da forma grave e 20% (2) tinham hemofilia leve; enquanto isso, entre os que sofreram algum sangramento gengival: 60% (6) tinham a forma grave e 40% (4) tinham a leve. Discussao Uma das principais manifestacoes clinicas das hemofilias, especialmente as graves, sao os hematomas, principalmente as hermatroses. Elas sao de hemorragias intra-articulares que ocorrem desde os primeiros anos de vida. Estima-se que mais de 80% de todos os casos de hemorragias em portadores de hemofilia grave sejam intra-articulares. Ao longo do tempo, a recorrencia das hermatroses levam a ativacao de enzimas liticas e fibrose, gerando dano articular permanente, o que causa varios niveis de incapacidade fisica. Os demais sangramentos geralmente acontecem em episodios isolados, principalmente apos algum trauma ocorrido. Conclusao Nesse sentido, esta pesquisa pode ser utilizada como importante ferramenta para que a instituicao obtenha uma melhor compreensao acerca das manifestacoes clinicas dos pacientes portadores de hemofilia A atendidos.
Published: 2021

20. PREVALÊNCIA DA INFECÇÃO PELO VÍRUS DA HEPATITE B EM UM CENTRO DE HEMOTERAPIA DO ESTADO DE SERGIPE

Author: WS Teles, RC Torres, AMMS Barros, RN Silva, MHS Silva, A Debbo, PCCS Junior, ALJ Morais, and MC Silva
Subjects: business.industry, Immunology and Allergy, Medicine, Diseases of the blood and blood-forming organs, Hematology, RC633-647.5, business, Virology
Abstract: A hepatite B é uma enfermidade infecto-contagiosa, cujo agente etiológico é o vírus da hepatite B (VHB), que pode ser adquirido através relações sexuais, de forma perinatal e através de transfusão sanguínea. A Hepatite é encarada como um dos maiores problemas de saúde pública no mundo, caracterizando- se por 02 estágios bem definidos, que se manifestam como enfermidade aguda e crônica. Este estudo objetivou traçar o perfil epidemiológico dos portadores da Hepatite B em um centro de hemoterapia do estado de Sergipe no ano de 2019. Os dados foram coletados em banco de dados informatizado institucional, referentes ao período de janeiro a dezembro de 2019. Observou-se dos 31.316 potenciais doadores, 16,84% (5.274) foram considerados inaptos para a doação, após triagem clínico-laboratorial. Destes 3,05% (795) casos foram positivos para Hepatite B, sendo excluídos e as suas bolsas desprezadas. Prevalência de sorologia positiva foi entre os doadores do sexo masculino, 80,38% (639). Sendo que, 26,67% (212) se encontravam na faixa etária de 30 a 39 anos. Nas mulheres, a maior prevalência foi também na faixa etária entre 30 e 39 anos (55–6,91%). Dentre os indivíduos que apresentaram positividade para o HbsAg, tanto os homens quanto as mulheres, demonstraram uma maior incidência na faixa etária de 18 a 29 anos. Nas pessoas que apresentaram uma positividade para anti-HBc, observou-se uma maior incidência do sexo masculino, sendo uma faixa etária maior acometida dos 30 aos 39 anos. Quanto aos resultados sorológicos, o HBsAg prevaleceu no gênero masculino na faixa etária entre 30 a 49 anos (40%) e no feminino de 18 a 29 anos (8,42%) e o anti-HBc prevaleceu em ambos os gêneros na faixa etária entre 30 a 49 anos, correspondendo a 48,14% no masculino e a 11,28% no feminino. Em relação ao tipo de doação, 51% do total de doações foram de doadores de reposição. Estes dados fortalecem a importância da detecção de anti- HBc na melhoria da qualidade do sangue a ser transfundido, tornando-o mais seguro do ponto de vista. Esta pesquisa poderá servir aos gestores públicos da saúde, a fim de subsidiar o desenvolvimento de estratégias de prevenção, intensificando campanhas de caráter junto à população, visando estabelecer a profilaxia, tratamento e controle de cura de doenças que pode se adquirir por transmissão sanguínea, e dentre elas a Hepatite.
Published: 2021

21. Medical Pulmonary Diseases That Cause Neonatal Respiratory Distress: A Radiological Pictorial Essay

Author: WS Mak, Eyl Kan, WP Cheung, KC Wong, and Cyy Kwong
Subjects: medicine.medical_specialty, business.industry, Radiological weapon, medicine, Neonatal respiratory distress, Radiology, Nuclear Medicine and imaging, Intensive care medicine, business
Published: 2020
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22. Pathological left ventricular hypertrophy and outflow tract obstruction in an infant of a diabetic mother: A case report

Author: Kunle-Olowu Oe, Otaigbe Be, Onyeka Ca, Yeibake Ws, Oremodu T, and Ujuanbi As
Subjects: medicine.medical_specialty, business.industry, Internal medicine, medicine, Cardiology, Outflow, Left ventricular hypertrophy, medicine.disease, business, Pathological
Published: 2020
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23. Transcranial direct current stimulation for improving gross motor function in children with cerebral palsy: A systematic review

Author: Anna Patricia Nicole Diego and Ada Ws Leung
Subjects: 030506 rehabilitation, medicine.medical_specialty, Transcranial direct-current stimulation, business.industry, medicine.medical_treatment, medicine.disease, Motor function, Neuromodulation (medicine), Cerebral palsy, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Occupational Therapy, Functional abilities, Gross motor function, Medicine, 0305 other medical science, business, 030217 neurology & neurosurgery
Abstract: Introduction The functional abilities of children with cerebral palsy are often compromised because of limited motor function. Transcranial direct current stimulation is a neuromodulation tool used as an adjunct to other therapeutic modalities to improve gross motor function. This review aimed to examine the quality of evidence and the effectiveness of transcranial direct current stimulation for improving gross motor function in children with cerebral palsy. Method A systematic review was conducted, and eligible studies were critically appraised for methodological quality. Randomised controlled trials were selected to undergo meta-analysis for assessing the effectiveness of transcranial direct current stimulation on clinical outcomes. Results Eight studies, including seven randomised controlled trials, fitted the inclusion criteria. All the randomised controlled trials were rated ‘moderate’ quality based on the grading of recommendations assessment, development and evaluation (GRADE) system. Using meta-analysis, only cadence, an outcome measure of gait variables, demonstrated efficacy of intervention, mean difference 16.57 (10.88, 22.25); I2 = 0%, P = 0.83. Other gross motor and functional outcomes had either inconsistent mean difference or high heterogeneity. Conclusion Overall, the effectiveness of transcranial direct current stimulation as a treatment in children with cerebral palsy remains unclear, and the findings should be interpreted with caution. The quality of evidence was mostly moderate, and more vigorous research incorporating functional outcomes should be conducted to guide clinical practice.
Published: 2020
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24. University laboratory of biomechanics and sport analytics and engineering in Gdansk as an important science institution

Author: Dancewicz Nosko D, Erdmann Ws, Aschenbrenner P, Urbanski R, and Kowalczyk R
Subjects: Engineering, business.industry, Analytics, Institution (computer science), Engineering ethics, business
Published: 2020
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25. Maize–Cassava Intercropping: An Effort to Increase Food and Feed Security and Incomes in Coastal Lowland Kenya

Author: KK Lewa, WS Chivatsi, RW Muinga, and HM Saha
Subjects: Geography, biology, Agroforestry, business.industry, Silage, Agriculture, Livestock, Intercropping, business, biology.organism_classification, Productivity
Abstract: The study was carried out at the Kenya Agricultural and Livestock Research Organisation (KALRO) Centre at Mtwapa to assess the effect of shade on the productivity of a maize–cassava intercropping s...
Published: 2019
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26. Cholestasis In Infants With Down Syndrome Is Not Due To Extrahepatic Biliary Atresia: A Ten-Year Single Egyptian Centre Experience

Author: Haytham Esmat, Sally T. Mostafa El Sorogy, Hend Abd El Baky, Christine Ws Basanti, Iman H. Draz, Dalia S. Mosallam, Hesham M Abd Elkader, and Magd A. Kotb
Subjects: Pediatrics, medicine.medical_specialty, Down syndrome, Extrahepatic Biliary Atresia, business.industry, Gastroenterology, Jaundice, Hepatology, medicine.disease, Ursodeoxycholic acid, Neonatal hepatitis, 03 medical and health sciences, 0302 clinical medicine, Cholestasis, 030220 oncology & carcinogenesis, Internal medicine, medicine, 030211 gastroenterology & hepatology, medicine.symptom, business, Trisomy, medicine.drug
Abstract: Purpose We aimed to define the clinical presentations, course and outcome of cholestasis in infants with Down syndrome (trisomy 21) who presented to the Pediatric Hepatology Clinic, New Children Hospital, Cairo University, Egypt. Methods Retrospective analysis of data of cohort of infants with Down syndrome and cholestasis who followed up during 2005-2015. Results Among 779 infants with cholestasis who presented during 2005-2015, 61 (7.8%) had Down syndrome. Six dropped out. Among the 55 who followed-up for a mean duration +SD = 12.1 ± 16.7 months, none had extrahepatic biliary atresia (EHBA), 37 (63.3%) had neonatal hepatitis and 18 (32.7%) had non-syndromic paucity of intrahepatic biliary radicals. Fourteen (25.4%) had associated congenital heart disease. Only 35 (63.3%) cleared the jaundice. Twenty-nine (52.7%) received ursodeoxycholic acid (UDCA); of them, 13 cleared the jaundice, one improved, 14 progressed and one died, compared to 22 who cleared the jaundice of the 26 who did not receive UDCA. Only three of those who did not receive UDCA progressed and none died. UDCA carried a 3.4-fold risk of poor prognosis (p= 0.001). UDCA use was associated with more complications (p= 0.016) in those with Down syndrome and cholestasis. Conclusion We did not come across EHBA among neonates and infants with Down syndrome in 10 years. Non-syndromic paucity is associated with favorable outcome in infants with Down syndrome. UDCA use in cholestasis with Down syndrome is associated with poor outcome.
Published: 2019
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27. The role of symptoms and insight in mediating cognition and functioning in first episode psychosis

Author: WS Yeung, Edwin Ho Ming Lee, Karen Pui Kei Chan, Pik Ying Chan, Eunice Yeuk Lai Law, Wing Chung Chang, Christy L.M. Hui, Roger Man Kin Ng, Eric F.C. Cheung, Michael Gar Chung Yiu, Sherry Kit Wa Chan, William Tak-Lam Lo, Edwin P F Pang, Dicky W.S. Chung, Wing King Lee, Alison Wai Fan Lo, Catherine Shiu-yin Chong, and Eric Y.H. Chen
Subjects: Adult, Male, Psychosis, Psychological intervention, 03 medical and health sciences, 0302 clinical medicine, First episode psychosis, medicine, Humans, Cognitive Dysfunction, In patient, Biological Psychiatry, business.industry, Cognition, Awareness, Functional recovery, medicine.disease, 030227 psychiatry, Clinical Practice, Psychiatry and Mental health, Insight into illness, Psychotic Disorders, Schizophrenia, Female, business, 030217 neurology & neurosurgery, Follow-Up Studies, Clinical psychology
Abstract: Achieving functional recovery in patients with psychosis is a challenge in clinical practice. Investigating the complex interplay between cognition, symptoms, insight and functional outcome in first episode psychosis will be crucial to understanding the factors leading to better functioning.In this 12-month prospective follow-up study, we investigated how cognition, clinical symptoms, and insight into illness affected overall functioning in 160 patients with first episode psychosis recruited from the Early Assessment Service for Young People with Psychosis (EASY) in Hong Kong from July 1, 2014 to June 30, 2016. Cognition was assessed at baseline while symptoms, insight, and functioning were assessed at 12-month follow-up. Structural equation modelling was used to examine the direct and indirect relationships between functioning and other latent constructs.Symptoms (negative symptoms and general psychopathology) and insight were shown to be significant mediators between cognition and functioning. The significant direct relationship between cognition and functioning (β = 0.387; p 0.001) became insignificant (β = 0.079; p = 0.578) after including symptoms and insight in the model. Symptoms and insight were significantly associated with cognition (symptoms, β = -0.469; p 0.001; insight, β = -0.372; p 0.001) and predicted functioning (symptoms, β = -0.558; p 0.001; insight, β = -0.264; p 0.01).Symptoms and insight mediated the effects of cognition on functioning. Interventions for improving functioning in patients with first episode psychosis should target not only cognition but also symptoms and insight.
Published: 2019
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28. Comparison between Free Anterolateral Thigh Flap and Free Medial Sural Artery Perforator Flap in Reconstruction of Post Traumatic Soft Tissue Defects of Dorsum of the Foot

Author: Abulezz Ta, Abo Elhassan Ws, Elsayed Gy, and Ali Ae
Subjects: Dorsum, business.industry, medicine.artery, medicine, Soft tissue, General Medicine, Anatomy, Anterolateral thigh, business, Sural arteries, eye diseases, Foot (unit)
Abstract: Background: The objective of this study was to compare the pliability, the function, aesthetic outcome, complications and patient satisfaction between free anterolateral thigh flap and free medial sural artery perforator flap in reconstruction of post traumatic soft tissue defects of dorsum of the foot. Method: The study was conducted on forty patients with post traumatic soft tissue defects of the dorsum of the foot between August 2018 and August 2019. Patients were divided randomly into two groups. In group1 (20 patients), the defects were reconstructed with free anterolateral thigh perforator flap. In group 2 (20 patients), reconstruction was done by free medial sural artery perforator flap. Result: In group 1 (ALT flap), Complete flap survival was achieved in 100% of cases. Thirteen patients required secondary debulking procedures and scar revisions. In group 2 (MSAP Flap), Complete flap survival was achieved in 85% with one flap totally lost and two flaps had distal necrosis. One patient needed scar revision and another patient needed flap advancement. Conclusion: MSAP flap is superior to ALT flap. It has many advantages: it is thin, pliable, fitted to normal footwear, less hairy and there is no need for secondary procedures in most cases.
Published: 2021
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29. Characterisation of in-hospital complications associated with COVID-19 using the ISARIC WHO Clinical Characterisation Protocol UK: a prospective, multicentre cohort study

Author: Thomas M Drake, Aya M Riad, Cameron J Fairfield, Conor Egan, Stephen R Knight, Riinu Pius, Hayley E Hardwick, Lisa Norman, Catherine A Shaw, Kenneth A McLean, A A Roger Thompson, Antonia Ho, Olivia V Swann, Michael Sullivan, Felipe Soares, Karl A Holden, Laura Merson, Daniel Plotkin, Louise Sigfrid, Thushan I de Silva, Michelle Girvan, Clare Jackson, Clark D Russell, Jake Dunning, Tom Solomon, Gail Carson, Piero Olliaro, Jonathan S Nguyen-Van-Tam, Lance Turtle, Annemarie B Docherty, Peter JM Openshaw, J Kenneth Baillie, Ewen M Harrison, Malcolm G Semple, Beatrice Alex, Benjamin Bach, Wendy S Barclay, Debby Bogaert, Meera Chand, Graham S Cooke, Ana da Silva Filipe, Tom Fletcher, Christopher A Green, Julian A Hiscox, Antonia YW Ho, Peter W Horby, Samreen Ijaz, Say Khoo, Paul Klenerman, Andrew Law, Wei Shen Lim, Alexander J Mentzer, Alison M Meynert, Mahdad Noursadeghi, Shona C Moore, Massimo Palmarini, William A Paxton, Georgios Pollakis, Nicholas Price, Andrew Rambaut, David L Robertson, Vanessa Sancho-Shimizu, Janet T Scott, Thushan de Silva, Shiranee Sriskandan, David Stuart, Charlotte Summers, Richard S Tedder, Emma C Thomson, AA Roger Thompson, Ryan S Thwaites, Lance CW Turtle, Rishi K Gupta, Carlo Palmieri, Maria Zambon, Marc-Emmanuel Dumas, Julian Griffin, Zoltan Takats, Kanta Chechi, Petros Andrikopoulos, Anthonia Osagie, Michael Olanipekun, Sonia Liggi, Matthew Lewis, Gonçalo dos Santos Correia, Caroline Sands, Panteleimon Takis, Lynn Maslen, Hayley Hardwick, Chloe Donohue, Fiona Griffiths, Wilna Oosthuyzen, Kenneth A Mclean, Derek Murphy, Jo Dalton, Egle Saviciute, Stephanie Roberts, Janet Harrison, Laura Marsh, Marie Connor, Sophie Halpin, Carrol Gamble, James Lee, Gary Leeming, Murray Wham, Sara Clohisey, Ross Hendry, James Scott-Brown, William Greenhalf, Victoria Shaw, Sarah E McDonald, Seán Keating, Katie A. Ahmed, Jane A Armstrong, Milton Ashworth, Innocent G Asiimwe, Siddharth Bakshi, Samantha L Barlow, Laura Booth, Benjamin Brennan, Katie Bullock, Benjamin WA Catterall, Jordan J Clark, Emily A Clarke, Sarah Cole, Louise Cooper, Helen Cox, Christopher Davis, Oslem Dincarslan, Chris Dunn, Philip Dyer, Angela Elliott, Anthony Evans, Lorna Finch, Lewis WS Fisher, Terry Foster, Isabel Garcia-Dorival, Philip Gunning, Catherine Hartley, Rebecca L Jensen, Christopher B Jones, Trevor R Jones, Shadia Khandaker, Katharine King, Robyn T. Kiy, Chrysa Koukorava, Annette Lake, Suzannah Lant, Diane Latawiec, Lara Lavelle-Langham, Daniella Lefteri, Lauren Lett, Lucia A Livoti, Maria Mancini, Sarah McDonald, Laurence McEvoy, John McLauchlan, Soeren Metelmann, Nahida S Miah, Joanna Middleton, Joyce Mitchell, Ellen G Murphy, Rebekah Penrice-Randal, Jack Pilgrim, Tessa Prince, Will Reynolds, P. Matthew Ridley, Debby Sales, Victoria E Shaw, Rebecca K Shears, Benjamin Small, Krishanthi S Subramaniam, Agnieska Szemiel, Aislynn Taggart, Jolanta Tanianis-Hughes, Jordan Thomas, Erwan Trochu, Libby van Tonder, Eve Wilcock, J. Eunice Zhang, Lisa Flaherty, Nicole Maziere, Emily Cass, Alejandra Doce Carracedo, Nicola Carlucci, Anthony Holmes, Hannah Massey, Lee Murphy, Nicola Wrobel, Sarah McCafferty, Kirstie Morrice, Alan MacLean, Kayode Adeniji, Daniel Agranoff, Ken Agwuh, Dhiraj Ail, Erin L. Aldera, Ana Alegria, Brian Angus, Abdul Ashish, Dougal Atkinson, Shahedal Bari, Gavin Barlow, Stella Barnass, Nicholas Barrett, Christopher Bassford, Sneha Basude, David Baxter, Michael Beadsworth, Jolanta Bernatoniene, John Berridge, Nicola Best, Pieter Bothma, David Chadwick, Robin Brittain-Long, Naomi Bulteel, Tom Burden, Andrew Burtenshaw, Vikki Caruth, Duncan Chambler, Nigel Chee, Jenny Child, Srikanth Chukkambotla, Tom Clark, Paul Collini, Catherine Cosgrove, Jason Cupitt, Maria-Teresa Cutino-Moguel, Paul Dark, Chris Dawson, Samir Dervisevic, Phil Donnison, Sam Douthwaite, Andrew Drummond, Ingrid DuRand, Ahilanadan Dushianthan, Tristan Dyer, Cariad Evans, Chi Eziefula, Chrisopher Fegan, Adam Finn, Duncan Fullerton, Sanjeev Garg, Atul Garg, Effrossyni Gkrania-Klotsas, Jo Godden, Arthur Goldsmith, Clive Graham, Elaine Hardy, Stuart Hartshorn, Daniel Harvey, Peter Havalda, Daniel B Hawcutt, Maria Hobrok, Luke Hodgson, Anil Hormis, Michael Jacobs, Susan Jain, Paul Jennings, Agilan Kaliappan, Vidya Kasipandian, Stephen Kegg, Michael Kelsey, Jason Kendall, Caroline Kerrison, Ian Kerslake, Oliver Koch, Gouri Koduri, George Koshy, Shondipon Laha, Steven Laird, Susan Larkin, Tamas Leiner, Patrick Lillie, James Limb, Vanessa Linnett, Jeff Little, Mark Lyttle, Michael MacMahon, Emily MacNaughton, Ravish Mankregod, Huw Masson, Elijah Matovu, Katherine McCullough, Ruth McEwen, Manjula Meda, Gary Mills, Jane Minton, Mariyam Mirfenderesky, Kavya Mohandas, Quen Mok, James Moon, Elinoor Moore, Patrick Morgan, Craig Morris, Katherine Mortimore, Samuel Moses, Mbiye Mpenge, Rohinton Mulla, Michael Murphy, Megan Nagel, Thapas Nagarajan, Mark Nelson, Lillian Norris, Matthew K. O'Shea, Igor Otahal, Marlies Ostermann, Mark Pais, Selva Panchatsharam, Danai Papakonstantinou, Hassan Paraiso, Brij Patel, Natalie Pattison, Justin Pepperell, Mark Peters, Mandeep Phull, Stefania Pintus, Jagtur Singh Pooni, Frank Post, David Price, Rachel Prout, Nikolas Rae, Henrik Reschreiter, Tim Reynolds, Neil Richardson, Mark Roberts, Devender Roberts, Alistair Rose, Guy Rousseau, Brendan Ryan, Taranprit Saluja, Aarti Shah, Prad Shanmuga, Anil Sharma, Anna Shawcross, Jeremy Sizer, Manu Shankar-Hari, Richard Smith, Catherine Snelson, Nick Spittle, Nikki Staines, Tom Stambach, Richard Stewart, Pradeep Subudhi, Tamas Szakmany, Kate Tatham, Jo Thomas, Chris Thompson, Robert Thompson, Ascanio Tridente, Darell Tupper-Carey, Mary Twagira, Nick Vallotton, Rama Vancheeswaran, Lisa Vincent-Smith, Shico Visuvanathan, Alan Vuylsteke, Sam Waddy, Rachel Wake, Andrew Walden, Ingeborg Welters, Tony Whitehouse, Paul Whittaker, Ashley Whittington, Padmasayee Papineni, Meme Wijesinghe, Martin Williams, Lawrence Wilson, Sarah Sarah, Stephen Winchester, Martin Wiselka, Adam Wolverson, Daniel G Wootton, Andrew Workman, Bryan Yates, Peter Young, investigators, ISARIC4C, Division of Computational and Systems Medicine, Imperial College London, London, SW7 2AZ, UK, Imperial College London - National Heart and Lung Institute, Centre National de la Recherche Scientifique (CNRS), Department of Pathology and Laboratory Medicine, University of California, National Institute for Health Research, and UKRI MRC COVID-19 Rapid Response Call
Subjects: MESH: United Kingdom, Male, Pediatrics, Respiratory Tract Diseases, MESH: Comorbidity, MESH: Hospitalization, Comorbidity, 030204 cardiovascular system & hematology, MESH: World Health Organization, MESH: Clinical Protocols, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: COVID-19, Medicine, Hospital Mortality, Prospective Studies, 030212 general & internal medicine, ISARIC4C investigators, Prospective cohort study, 11 Medical and Health Sciences, MESH: Aged, United Kingdom/epidemiology, Incidence (epidemiology), Clinical Protocols/standards, Age Factors, Articles, General Medicine, MESH: Hospitals, Hospitals, 3. Good health, Hospitalization, Cardiovascular Diseases, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Cohort, COVID-19/complications, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Cohort study, medicine.medical_specialty, MEDLINE, World Health Organization, MESH: Nervous System Diseases, 03 medical and health sciences, General & Internal Medicine, Humans, MESH: SARS-CoV-2, MESH: Hospital Mortality, Survival analysis, Aged, MESH: Age Factors, MESH: Humans, SARS-CoV-2, business.industry, MESH: Cardiovascular Diseases, COVID-19, medicine.disease, MESH: Male, MESH: Prospective Studies, MESH: Respiratory Tract Diseases, Nervous System Diseases, business, Complication, MESH: Female
Abstract: BackgroundCOVID-19 is a multi-system disease and patients who survive may experience in-hospital complications. These complications are likely to have important short and long-term consequences for patients, healthcare utilisation, healthcare system preparedness, and society amidst the ongoing COVID-19 pandemic. Our aim was to characterise the extent and impact of COVID-19 complications, particularly in those who survive using the International Severe Acute Respiratory and emerging Infections Consortium (ISARIC) WHO Clinical Characterisation Protocol UK (CCP-UK).MethodsA multicentre, prospective cohort study in 302 UK healthcare facilities of adults hospitalised with COVID-19 between 17th January and 4th August 2020. Complications were defined as organ specific diagnoses occurring alone or in addition to any hallmarks of COVID-19 illness. Outcomes included death, critical care use, and ability to self-care at hospital discharge. We used multilevel logistic regression and survival models to explore associations between these outcomes and in-hospital complications, age, and pre-existing comorbidities.ResultsOf patients admitted to hospital for management of COVID-19, 49.7% (36 367/73 197) experienced at least one complication. The mean age of our cohort was 71.1 years old (SD 18.7), included more males (56.0%, 41 025/73 ) with 81.0% (59 289/73 197) of patients having at least one comorbidity. Males over 60 were most likely to experience a complication (60 y and over, 54.5% [16 579/30 416] in males and 48.2% [11 707/24 288] in females; Under 60 y, 48.8% [5179/10 609] in males, 36.6% [2814/7689] in females). Renal (24.3%, 17 752/73 197), complex respiratory 18.4% (13 486/73 197), and systemic (16.3%, 11 895/73 197) complications were most frequent. Cardiovascular (12.3%, 8973/73 197), neurological (4.3%, 3115/73 197), and gastrointestinal/liver (0.8%, 7901/73 197) complications were also reported. The presence of any complication was associated with significantly worse survival (adjusted HR 1.74, 95% CI 1.64 to 1.84) and increased admission to critical care (adjusted OR 7.25, 95% CI 6.83 to 7.69). Reduced ability to self-care at discharge was significantly greater in patients who experienced a complication (adjusted OR 2.42, 95% CI 2.31 to 2.54) and was greatest in those who experienced neurological complications (adjusted OR 4.39, 95% CI 3.95 to 4.89). ConclusionsComplications and worse functional outcomes in patients admitted to hospital with COVID-19 are high, even in young, previously healthy individuals. Acute complications are associated with reduced ability to self-care at discharge, with neurological complications being associated with the worst functional outcomes. COVID-19 complications are likely to cause significant strain on health and social care in the coming years. These data will help in the design and provision of services aimed at the post-hospitalisation care of patients with COVID-19.
Published: 2021
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30. Co-infections, secondary infections, and antimicrobial use in patients hospitalised with COVID-19 during the first pandemic wave from the ISARIC WHO CCP-UK study: a multicentre, prospective cohort study

Author: Clark D Russell, Cameron J Fairfield, Thomas M Drake, Lance Turtle, R Andrew Seaton, Dan G Wootton, Louise Sigfrid, Ewen M Harrison, Annemarie B Docherty, Thushan I de Silva, Conor Egan, Riinu Pius, Hayley E Hardwick, Laura Merson, Michelle Girvan, Jake Dunning, Jonathan S Nguyen-Van-Tam, Peter J M Openshaw, J Kenneth Baillie, Malcolm G Semple, Antonia Ho, Peter JM Openshaw, Gail Carson, Beatrice Alex, Benjamin Bach, Wendy S Barclay, Debby Bogaert, Meera Chand, Graham S Cooke, Ana da Silva Filipe, Tom Fletcher, Christopher A Green, Julian A Hiscox, Antonia YW Ho, Peter W Horby, Samreen Ijaz, Say Khoo, Paul Klenerman, Andrew Law, Wei Shen Lim, Alexander J Mentzer, Alison M Meynert, Mahdad Noursadeghi, Shona C Moore, Massimo Palmarini, William A Paxton, Georgios Pollakis, Nicholas Price, Andrew Rambaut, David L Robertson, Vanessa Sancho-Shimizu, Janet T Scott, Thushan de Silva, Tom Solomon, Shiranee Sriskandan, David Stuart, Charlotte Summers, Richard S Tedder, Emma C Thomson, AA Roger Thompson, Ryan S Thwaites, Lance CW Turtle, Rishi K Gupta, Carlo Palmieri, Maria Zambon, Hayley Hardwick, Chloe Donohue, Ruth Lyons, Fiona Griffiths, Wilna Oosthuyzen, Lisa Norman, Stephen R Knight, Kenneth A Mclean, Derek Murphy, Catherine A Shaw, Jo Dalton, Egle Saviciute, Stephanie Roberts, Janet Harrison, Laura Marsh, Marie Connor, Sophie Halpin, Clare Jackson, Carrol Gamble, Gary Leeming, Murray Wham, Sara Clohisey, Ross Hendry, James Scott-Brown, William Greenhalf, Victoria Shaw, Sarah E McDonald, Seán Keating, Katie A. Ahmed, Jane A Armstrong, Milton Ashworth, Innocent G Asiimwe, Siddharth Bakshi, Samantha L Barlow, Laura Booth, Benjamin Brennan, Katie Bullock, Benjamin WA Catterall, Jordan J Clark, Emily A Clarke, Sarah Cole, Louise Cooper, Helen Cox, Christopher Davis, Oslem Dincarslan, Chris Dunn, Philip Dyer, Angela Elliott, Anthony Evans, Lorna Finch, Lewis WS Fisher, Terry Foster, Isabel Garcia-Dorival, Philip Gunning, Catherine Hartley, Rebecca L Jensen, Christopher B Jones, Trevor R Jones, Shadia Khandaker, Katharine King, Robyn T. Kiy, Chrysa Koukorava, Annette Lake, Suzannah Lant, Diane Latawiec, Lara Lavelle-Langham, Daniella Lefteri, Lauren Lett, Lucia A Livoti, Maria Mancini, Sarah McDonald, Laurence McEvoy, John McLauchlan, Soeren Metelmann, Nahida S Miah, Joanna Middleton, Joyce Mitchell, Ellen G Murphy, Rebekah Penrice-Randal, Jack Pilgrim, Tessa Prince, Will Reynolds, P. Matthew Ridley, Debby Sales, Victoria E Shaw, Rebecca K Shears, Benjamin Small, Krishanthi S Subramaniam, Agnieska Szemiel, Aislynn Taggart, Jolanta Tanianis-Hughes, Jordan Thomas, Erwan Trochu, Libby van Tonder, Eve Wilcock, J. Eunice Zhang, Lisa Flaherty, Nicole Maziere, Emily Cass, Alejandra Doce Carracedo, Nicola Carlucci, Anthony Holmes, Hannah Massey, Lee Murphy, Nicola Wrobel, Sarah McCafferty, Kirstie Morrice, Alan MacLean, Kayode Adeniji, Daniel Agranoff, Ken Agwuh, Dhiraj Ail, Erin L. Aldera, Ana Alegria, Brian Angus, Abdul Ashish, Dougal Atkinson, Shahedal Bari, Gavin Barlow, Stella Barnass, Nicholas Barrett, Christopher Bassford, Sneha Basude, David Baxter, Michael Beadsworth, Jolanta Bernatoniene, John Berridge, Nicola Best, Pieter Bothma, David Chadwick, Robin Brittain-Long, Naomi Bulteel, Tom Burden, Andrew Burtenshaw, Vikki Caruth, Duncan Chambler, Nigel Chee, Jenny Child, Srikanth Chukkambotla, Tom Clark, Paul Collini, Catherine Cosgrove, Jason Cupitt, Maria-Teresa Cutino-Moguel, Paul Dark, Chris Dawson, Samir Dervisevic, Phil Donnison, Sam Douthwaite, Ingrid DuRand, Ahilanadan Dushianthan, Tristan Dyer, Cariad Evans, Chi Eziefula, Chrisopher Fegan, Adam Finn, Duncan Fullerton, Sanjeev Garg, Atul Garg, Effrossyni Gkrania-Klotsas, Jo Godden, Arthur Goldsmith, Clive Graham, Elaine Hardy, Stuart Hartshorn, Daniel Harvey, Peter Havalda, Daniel B Hawcutt, Maria Hobrok, Luke Hodgson, Anil Hormis, Michael Jacobs, Susan Jain, Paul Jennings, Agilan Kaliappan, Vidya Kasipandian, Stephen Kegg, Michael Kelsey, Jason Kendall, Caroline Kerrison, Ian Kerslake, Oliver Koch, Gouri Koduri, George Koshy, Shondipon Laha, Steven Laird, Susan Larkin, Tamas Leiner, Patrick Lillie, James Limb, Vanessa Linnett, Jeff Little, Mark Lyttle, Michael MacMahon, Emily MacNaughton, Ravish Mankregod, Huw Masson, Elijah Matovu, Katherine McCullough, Ruth McEwen, Manjula Meda, Gary Mills, Jane Minton, Mariyam Mirfenderesky, Kavya Mohandas, Quen Mok, James Moon, Elinoor Moore, Patrick Morgan, Craig Morris, Katherine Mortimore, Samuel Moses, Mbiye Mpenge, Rohinton Mulla, Michael Murphy, Megan Nagel, Thapas Nagarajan, Mark Nelson, Matthew K. O'Shea, Igor Otahal, Marlies Ostermann, Mark Pais, Selva Panchatsharam, Danai Papakonstantino, Hassan Paraiso, Brij Patel, Natalie Pattison, Justin Pepperell, Mark Peters, Mandeep Phull, Stefania Pintus, Jagtur Singh Pooni, Frank Post, David Price, Rachel Prout, Nikolas Rae, Henrik Reschreiter, Tim Reynolds, Neil Richardson, Mark Roberts, Devender Roberts, Alistair Rose, Guy Rousseau, Brendan Ryan, Taranprit Saluja, Aarti Shah, Prad Shanmuga, Anil Sharma, Anna Shawcross, Jeremy Sizer, Manu Shankar-Hari, Richard Smith, Catherine Snelson, Nick Spittle, Nikki Staines, Tom Stambach, Richard Stewart, Pradeep Subudhi, Tamas Szakmany, Kate Tatham, Jo Thomas, Chris Thompson, Robert Thompson, Ascanio Tridente, Darell Tupper-Carey, Mary Twagira, Andrew Ustianowski, Nick Vallotton, Lisa Vincent-Smith, Shico Visuvanathan, Alan Vuylsteke, Sam Waddy, Rachel Wake, Andrew Walden, Ingeborg Welters, Tony Whitehouse, Paul Whittaker, Ashley Whittington, Padmasayee Papineni, Meme Wijesinghe, Martin Williams, Lawrence Wilson, Sarah Sarah, Stephen Winchester, Martin Wiselka, Adam Wolverson, Daniel G Wootton, Andrew Workman, Bryan Yates, Peter Young, UK Research and Innovation, and UKRI MRC COVID-19 Rapid Response Call
Subjects: Microbiology (medical), BACTERIAL, medicine.medical_specialty, Secondary infection, Psychological intervention, World Health Organization, medicine.disease_cause, Microbiology, Haemophilus influenzae, Virology, Internal medicine, Pandemic, medicine, Humans, Prospective Studies, ISARIC4C investigators, Prospective cohort study, Pandemics, Case report form, Science & Technology, Coinfection, Diagnostic Tests, Routine, business.industry, STEWARDSHIP, COVID-19, Articles, Bacterial Infections, ADULTS, Antimicrobial, United Kingdom, Anti-Bacterial Agents, Infectious Diseases, Staphylococcus aureus, business, Life Sciences & Biomedicine
Abstract: Background: Microbiological characterisation of co-infections and secondary infections in patients with COVID-19 is lacking, and antimicrobial use is high. We aimed to describe microbiologically confirmed co-infections and secondary infections, and antimicrobial use, in patients admitted to hospital with COVID-19. Methods: The International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC) WHO Clinical Characterisation Protocol UK (CCP-UK) study is an ongoing, prospective cohort study recruiting inpatients from 260 hospitals in England, Scotland, and Wales, conducted by the ISARIC Coronavirus Clinical Characterisation Consortium. Patients with a confirmed or clinician-defined high likelihood of SARS-CoV-2 infection were eligible for inclusion in the ISARIC WHO CCP-UK study. For this specific study, we excluded patients with a recorded negative SARS-CoV-2 test result and those without a recorded outcome at 28 days after admission. Demographic, clinical, laboratory, therapeutic, and outcome data were collected using a prespecified case report form. Organisms considered clinically insignificant were excluded. Findings: We analysed data from 48 902 patients admitted to hospital between Feb 6 and June 8, 2020. The median patient age was 74 years (IQR 59–84) and 20 786 (42·6%) of 48 765 patients were female. Microbiological investigations were recorded for 8649 (17·7%) of 48 902 patients, with clinically significant COVID-19-related respiratory or bloodstream culture results recorded for 1107 patients. 762 (70·6%) of 1080 infections were secondary, occurring more than 2 days after hospital admission. Staphylococcus aureus and Haemophilus influenzae were the most common pathogens causing respiratory co-infections (diagnosed ≤2 days after admission), with Enterobacteriaceae and S aureus most common in secondary respiratory infections. Bloodstream infections were most frequently caused by Escherichia coli and S aureus. Among patients with available data, 13 390 (37·0%) of 36 145 had received antimicrobials in the community for this illness episode before hospital admission and 39 258 (85·2%) of 46 061 patients with inpatient antimicrobial data received one or more antimicrobials at some point during their admission (highest for patients in critical care). We identified frequent use of broad-spectrum agents and use of carbapenems rather than carbapenem-sparing alternatives. Interpretation: In patients admitted to hospital with COVID-19, microbiologically confirmed bacterial infections are rare, and more likely to be secondary infections. Gram-negative organisms and S aureus are the predominant pathogens. The frequency and nature of antimicrobial use are concerning, but tractable targets for stewardship interventions exist. Funding: National Institute for Health Research (NIHR), UK Medical Research Council, Wellcome Trust, UK Department for International Development, Bill & Melinda Gates Foundation, EU Platform for European Preparedness Against (Re-)emerging Epidemics, NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at University of Liverpool, and NIHR HPRU in Respiratory Infections at Imperial College London.
Published: 2021
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31. Proxalutamide Reduction of Mortality Rate in Hospitalized COVID-19 Patients Depends on Treatment Duration – an Exploratory Analysis of the Proxa-Rescue AndroCoV Trial

Author: Carlos Gustavo Wambier, Flavio A. Cadegiani, Andy Goren, Jose Enrique M Medeiros, Michael N Correia, Maria Fernanda R Barroco, Renan N Barros, Emilyn O Guerreiro, Rafael X Cunha, Dirce Costa Onety, Luiza Fernanda M Nicolau, Patricia S da Silva, Raquel N Nicolau, Raysa Ws Paulain, Daniel N Fonseca, Ricardo A Zimerman, Karla Cristina P Israel, and Claudia Elizabeth Thompson
Subjects: medicine.medical_specialty, education.field_of_study, Randomization, business.industry, Mortality rate, Population, Placebo, law.invention, Randomized controlled trial, law, Interquartile range, Relative risk, Internal medicine, Number needed to treat, medicine, business, education
Abstract: IntroductionProxalutamide, a second-generation non-steroidal antiandrogen (NSAA), primarily developed for castration-resistant prostate cancer, demonstrated reduction in 28-day mortality rate of 77.7% in hospitalized COVID-19 patients in a double-blind, placebo-controlled, two-arm randomized clinical trial (RCT), through intention-to-treat (ITT) analysis. We observed a high 28-day mortality rate of patients that did not complete the 14-day treatment with proxalutamide, compared to the placebo arm. These differences may raise hypotheses to explain the wide differences between ITT and on-treatment (OT) analysis in terms of efficacy. Despite the inherent limitations of OT analysis, we aimed to respond to unanswered questions regarding the drug efficacy when the 14-day treatment with proxalutamide was complete, and secondarily understand the causality relationship between treatment interruption and mortality rate.MethodsThis is a post-hoc exploratory analysis of a double-blinded, randomized, placebo-controlled, prospective, multicentric, two-arm RCT of 300mg-daily 14-day proxalutamide therapy for hospitalized COVID-19 patients not requiring mechanical ventilation. OT population excluded patients that did not complete the full 14-day course of therapy or died from COVID-19 complications within 24 hours of randomization. The primary outcome was the 28-day COVID-19 mortality rate. Secondary outcomes included median hospital length, 14-day and 28-day alive hospital discharge rate and 28-day all-cause mortality rate of those who discontinued intervention.ResultsIn total, 580 patients completed the 14-day treatment or died during treatment, including 288 patients in the proxalutamide arm and 292 patients in the placebo arm, with similar baseline characteristics between groups. The 28-day COVID-19 mortality rate was 4.2% in the proxalutamide group and 49.0% in the placebo group. The mortality risk ratio (RR) was 0.08 (95% CI, 0.05-0.15), with a number needed to treat (NNT) of 2.2 to prevent death. The median hospital length stay after randomization was 5 days (interquartile range [IQR] = 3 to 7.2 days) in the proxalutamide group and 9 days (IQR = 6 to 15 days) in the placebo group (p ConclusionThe reduction in 28-day all-cause mortality rate with 14-day proxalutamide treatment for hospitalized COVID-19 patients was more significant while on treatment adhesion (92%), compared to the reduction when all patients enrolled in the proxalutamide arm were considered (77.7%). However, the magnitude of statistical significance of the reduction in all-cause mortality and the NNT were similar between the OT and ITT analysis. The apparent high mortality risk rate with early interruption of proxalutamide treatments suggests that strategies for treatment compliance should be reinforced for future RCTs with proxalutamide. (NCT04728802)
Published: 2021
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32. Proxalutamide Improves Lung Injury in Hospitalized COVID-19 Patients – an Analysis of the Radiological Findings of the Proxa-Rescue AndroCoV Trial

Author: Michael N Correia, Luiza Fernanda M Nicolau, Karla Cristina P Israel, Rafael X Cunha, Rnan N Barros, Patricia S da Silva, Emilyn O Guerreiro, Raquel N Nicolau, Raysa Ws Paulain, Daniel N Fonseca, Andy Goren, Carlos Gustavo Wambier, Claudia Elizabeth Thompson, Jose Erique M Medeiros, Flavio A. Cadegiani, Dirce Costa Onety, Ricardo A Zimerman, and Maria Fernanda R Barroco
Subjects: medicine.medical_specialty, Randomization, Lung, medicine.drug_class, business.industry, Lung injury, Entry into host, Antiandrogen, Placebo, law.invention, medicine.anatomical_structure, Randomized controlled trial, law, Radiological weapon, medicine, Radiology, business
Abstract: IntroductionAntiandrogens are candidates against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) due to host cell entry inhibition by the suppression of TMPRSS2. Proxalutamide is a nonsteroidal anti-androgen (NSAA) with strong antagonism on androgen receptor (AR) and angiotensin-converting enzyme 2 (ACE2). Efficacy of proxalutamide was previously demonstrated for early COVID-19 outpatients, and also reduction of deaths in hospitalized COVID-19 patients. Whether radiological changes would follow the improvement in clinical outcomes with proxalutamide is not established. The present post-hoc analysis aims to evaluate whether proxalutamide improves lung injury observed through chest computerized tomography (CT) scans.MethodsThis is a post-hoc analysis of the radiological findings of The Proxa-Rescue AndroCoV Trial with all enrolled patients from the three participating institutions of the city of Manaus, Brazil, that had at least two chest CT scans during hospitalization. The quantification of lung parenchyma involvement was performed by blinded radiologists with expertise in analysis of COVID-19 images. A first chest CT scan was performed upon randomization and a second CT scan was performed approximately five days later, whenever feasible. Improvement rate was the first endpoint, and relative and absolute changes between the first and second CT scans were the second endpoints.ResultsOf the 395 patients initially evaluated, 77 and 169 patients from the proxalutamide and placebo arms, respectively, were included (n=246). Baseline characteristics and percentage of lung parenchyma affected in the baseline chest CT scan were similar between groups. In the second chest CT scan, the percentage of lungs affected (Median – IQR) was 35.0% (25.0-57.5%) in the proxalutamide group versus 67.5% (50.0-80.0%) in the placebo group (p < 0.001). The absolute and relative change between the second and first chest CT scans (Median – IQR) were -15.0 percent points (p.p.) (−30.0 – 0.0p.p.) and -25.0% (−50.0 – 0.0%) in the proxalutamide group, respectively, and +15.0p.p. (0.0 - +30.0p.p.) and +32.7% (0.0 - +80.0%) in the placebo group, respectively (p < 0.001 for both absolute and relative changes). The improvement rate, i.e., the percentage of subjects that had improvement from the first to the second CT scan, was 72.3% in the proxalutamide group and 23.1% in the placebo group (p < 0.0001), with an improvement rate ratio (95%CI) of 3.15 (2.32 – 4.28).ConclusionProxalutamide improves lung opacities in hospitalized COVID-19 patients when compared to placebo. (NCT04728802)
Published: 2021
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33. Changes in in-hospital mortality in the first wave of COVID-19: a multicentre prospective observational cohort study using the WHO Clinical Characterisation Protocol UK

Author: Annemarie B Docherty, Rachel H Mulholland, Nazir I Lone, Christopher P Cheyne, Daniela De Angelis, Karla Diaz-Ordaz, Cara Donegan, Thomas M Drake, Jake Dunning, Sebastian Funk, Marta García-Fiñana, Michelle Girvan, Hayley E Hardwick, Janet Harrison, Antonia Ho, David M Hughes, Ruth H Keogh, Peter D Kirwan, Gary Leeming, Jonathan S Nguyen Van-Tam, Riinu Pius, Clark D Russell, Rebecca G Spencer, Brian DM Tom, Lance Turtle, Peter JM Openshaw, J Kenneth Baillie, Ewen M Harrison, Malcolm G Semple, Gail Carson, Beatrice Alex, Benjamin Bach, Wendy S Barclay, Debby Bogaert, Meera Chand, Graham S Cooke, Ana da Silva Filipe, Tom Fletcher, Christopher A Green, Julian A Hiscox, Antonia YW Ho, Peter W Horby, Samreen Ijaz, Say Khoo, Paul Klenerman, Andrew Law, Wei Shen Lim, Alexander J Mentzer, Laura Merson, Alison M Meynert, Mahdad Noursadeghi, Shona C Moore, Massimo Palmarini, William A Paxton, Georgios Pollakis, Nicholas Price, Andrew Rambaut, David L Robertson, Vanessa Sancho-Shimizu, Janet T Scott, Thushan de Silva, Louise Sigfrid, Tom Solomon, Shiranee Sriskandan, David Stuart, Charlotte Summers, Richard S Tedder, Emma C Thomson, AA Roger Thompson, Ryan S Thwaites, Lance CW Turtle, Rishi K Gupta, Carlo Palmieri, Maria Zambon, Hayley Hardwick, Chloe Donohue, Ruth Lyons, Fiona Griffiths, Wilna Oosthuyzen, Lisa Norman, Cameron J Fairfield, Stephen R Knight, Kenneth A Mclean, Derek Murphy, Catherine A Shaw, Jo Dalton, Egle Saviciute, Stephanie Roberts, Laura Marsh, Marie Connor, Sophie Halpin, Clare Jackson, Carrol Gamble, Murray Wham, Sara Clohisey, Ross Hendry, James Scott-Brown, William Greenhalf, Victoria Shaw, Sarah E McDonald, Seán Keating, Katie A Ahmed, Jane A Armstrong, Milton Ashworth, Innocent G Asiimwe, Siddharth Bakshi, Samantha L Barlow, Laura Booth, Benjamin Brennan, Katie Bullock, Benjamin WA Catterall, Jordan J Clark, Emily A Clarke, Sarah Cole, Louise Cooper, Helen Cox, Christopher Davis, Oslem Dincarslan, Chris Dunn, Philip Dyer, Angela Elliott, Anthony Evans, Lorna Finch, Lewis WS Fisher, Terry Foster, Isabel Garcia-Dorival, Philip Gunning, Catherine Hartley, Rebecca L Jensen, Christopher B Jones, Trevor R Jones, Shadia Khandaker, Katharine King, Robyn T Kiy, Chrysa Koukorava, Annette Lake, Suzannah Lant, Diane Latawiec, Lara Lavelle-Langham, Daniella Lefteri, Lauren Lett, Lucia A Livoti, Maria Mancini, Sarah McDonald, Laurence McEvoy, John McLauchlan, Soeren Metelmann, Nahida S Miah, Joanna Middleton, Joyce Mitchell, Ellen G Murphy, Rebekah Penrice-Randal, Jack Pilgrim, Tessa Prince, Will Reynolds, P. Matthew Ridley, Debby Sales, Victoria E Shaw, Rebecca K Shears, Benjamin Small, Krishanthi S Subramaniam, Agnieska Szemiel, Aislynn Taggart, Jolanta Tanianis-Hughes, Jordan Thomas, Erwan Trochu, Libby van Tonder, Eve Wilcock, J. Eunice Zhang, Lisa Flaherty, Nicole Maziere, Emily Cass, Alejandra Doce Carracedo, Nicola Carlucci, Anthony Holmes, Hannah Massey, Lee Murphy, Nicola Wrobel, Sarah McCafferty, Kirstie Morrice, Alan MacLean, Kayode Adeniji, Daniel Agranoff, Ken Agwuh, Dhiraj Ail, Erin L Aldera, Ana Alegria, Brian Angus, Abdul Ashish, Dougal Atkinson, Shahedal Bari, Gavin Barlow, Stella Barnass, Nicholas Barrett, Christopher Bassford, Sneha Basude, David Baxter, Michael Beadsworth, Jolanta Bernatoniene, John Berridge, Nicola Best, Pieter Bothma, David Chadwick, Robin Brittain-Long, Naomi Bulteel, Tom Burden, Andrew Burtenshaw, Vikki Caruth, Duncan Chambler, Nigel Chee, Jenny Child, Srikanth Chukkambotla, Tom Clark, Paul Collini, Catherine Cosgrove, Jason Cupitt, Maria-Teresa Cutino-Moguel, Paul Dark, Chris Dawson, Samir Dervisevic, Phil Donnison, Sam Douthwaite, Ingrid DuRand, Ahilanadan Dushianthan, Tristan Dyer, Cariad Evans, Chi Eziefula, Chrisopher Fegan, Adam Finn, Duncan Fullerton, Sanjeev Garg, Atul Garg, Effrossyni Gkrania-Klotsas, Jo Godden, Arthur Goldsmith, Clive Graham, Elaine Hardy, Stuart Hartshorn, Daniel Harvey, Peter Havalda, Daniel B Hawcutt, Maria Hobrok, Luke Hodgson, Anil Hormis, Michael Jacobs, Susan Jain, Paul Jennings, Agilan Kaliappan, Vidya Kasipandian, Stephen Kegg, Michael Kelsey, Jason Kendall, Caroline Kerrison, Ian Kerslake, Oliver Koch, Gouri Koduri, George Koshy, Shondipon Laha, Steven Laird, Susan Larkin, Tamas Leiner, Patrick Lillie, James Limb, Vanessa Linnett, Jeff Little, Mark Lyttle, Michael MacMahon, Emily MacNaughton, Ravish Mankregod, Huw Masson, Elijah Matovu, Katherine McCullough, Ruth McEwen, Manjula Meda, Gary Mills, Jane Minton, Mariyam Mirfenderesky, Kavya Mohandas, Quen Mok, James Moon, Elinoor Moore, Patrick Morgan, Craig Morris, Katherine Mortimore, Samuel Moses, Mbiye Mpenge, Rohinton Mulla, Michael Murphy, Megan Nagel, Thapas Nagarajan, Mark Nelson, Matthew K O'Shea, Igor Otahal, Marlies Ostermann, Mark Pais, Selva Panchatsharam, Danai Papakonstantinou, Hassan Paraiso, Brij Patel, Natalie Pattison, Justin Pepperell, Mark Peters, Mandeep Phull, Stefania Pintus, Jagtur Singh Pooni, Frank Post, David Price, Rachel Prout, Nikolas Rae, Henrik Reschreiter, Tim Reynolds, Neil Richardson, Mark Roberts, Devender Roberts, Alistair Rose, Guy Rousseau, Brendan Ryan, Taranprit Saluja, Aarti Shah, Prad Shanmuga, Anil Sharma, Anna Shawcross, Jeremy Sizer, Manu Shankar-Hari, Richard Smith, Catherine Snelson, Nick Spittle, Nikki Staines, Tom Stambach, Richard Stewart, Pradeep Subudhi, Tamas Szakmany, Kate Tatham, Jo Thomas, Chris Thompson, Robert Thompson, Ascanio Tridente, Darell Tupper-Carey, Mary Twagira, Andrew Ustianowski, Nick Vallotton, Lisa Vincent-Smith, Shico Visuvanathan, Alan Vuylsteke, Sam Waddy, Rachel Wake, Andrew Walden, Ingeborg Welters, Tony Whitehouse, Paul Whittaker, Ashley Whittington, Padmasayee Papineni, Meme Wijesinghe, Martin Williams, Lawrence Wilson, Sarah Sarah, Stephen Winchester, Martin Wiselka, Adam Wolverson, Daniel G Wooton, Andrew Workman, Bryan Yates, Peter Young, Kirwan, Peter D [0000-0001-6904-0500], Apollo - University of Cambridge Repository, Imperial College Healthcare NHS Trust- BRC Funding, GlaxoSmithKline Biologicals, National Institute for Health Research, UKRI MRC COVID-19 Rapid Response Call, and UK Research and Innovation
Subjects: Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, World Health Organization, 1117 Public Health and Health Services, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Clinical Protocols, Internal medicine, Severity of illness, Pandemic, Risk of mortality, medicine, Humans, 030212 general & internal medicine, Hospital Mortality, Prospective Studies, Prospective cohort study, ISARIC4C Investigators, Aged, COVID-19/epidemiology, Aged, 80 and over, business.industry, United Kingdom/epidemiology, Mortality rate, Confounding, COVID-19, 1103 Clinical Sciences, Odds ratio, Articles, Middle Aged, United Kingdom, 030228 respiratory system, Female, business, Cohort study, 1199 Other Medical and Health Sciences
Abstract: Background\ud \ud Mortality rates in hospitalised patients with COVID-19 in the UK appeared to decline during the first wave of the pandemic. We aimed to quantify potential drivers of this change and identify groups of patients who remain at high risk of dying in hospital.\ud \ud \ud Methods\ud \ud In this multicentre prospective observational cohort study, the International Severe Acute Respiratory and Emerging Infections Consortium WHO Clinical Characterisation Protocol UK recruited a prospective cohort of patients with COVID-19 admitted to 247 acute hospitals in England, Scotland, and Wales during the first wave of the pandemic (between March 9 and Aug 2, 2020). We included all patients aged 18 years and older with clinical signs and symptoms of COVID-19 or confirmed COVID-19 (by RT-PCR test) from assumed community-acquired infection. We did a three-way decomposition mediation analysis using natural effects models to explore associations between week of admission and in-hospital mortality, adjusting for confounders (demographics, comorbidities, and severity of illness) and quantifying potential mediators (level of respiratory support and steroid treatment). The primary outcome was weekly in-hospital mortality at 28 days, defined as the proportion of patients who had died within 28 days of admission of all patients admitted in the observed week, and it was assessed in all patients with an outcome. This study is registered with the ISRCTN Registry, ISRCTN66726260.\ud \ud \ud Findings\ud \ud Between March 9, and Aug 2, 2020, we recruited 80 713 patients, of whom 63 972 were eligible and included in the study. Unadjusted weekly in-hospital mortality declined from 32·3% (95% CI 31·8–32·7) in March 9 to April 26, 2020, to 16·4% (15·0–17·8) in June 15 to Aug 2, 2020. Reductions in mortality were observed in all age groups, in all ethnic groups, for both sexes, and in patients with and without comorbidities. After adjustment, there was a 32% reduction in the risk of mortality per 7-week period (odds ratio [OR] 0·68 [95% CI 0·65–0·71]). The higher proportions of patients with severe disease and comorbidities earlier in the first wave (March and April) than in June and July accounted for 10·2% of this reduction. The use of respiratory support changed during the first wave, with gradually increased use of non-invasive ventilation over the first wave. Changes in respiratory support and use of steroids accounted for 22·2%, OR 0·95 (0·94–0·95) of the reduction in in-hospital mortality.\ud \ud \ud Interpretation\ud \ud The reduction in in-hospital mortality in patients with COVID-19 during the first wave in the UK was partly accounted for by changes in the case-mix and illness severity. A significant reduction in in-hospital mortality was associated with differences in respiratory support and critical care use, which could partly reflect accrual of clinical knowledge. The remaining improvement in in-hospital mortality is not explained by these factors, and could be associated with changes in community behaviour, inoculum dose, and hospital capacity strain.\ud \ud \ud Funding\ud \ud National Institute for Health Research and the Medical Research Council.
Published: 2021
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34. Risk of adverse outcomes in patients with underlying respiratory conditions admitted to hospital with COVID-19 a national, multicentre prospective cohort study using the ISARIC WHO Clinical Characterisation Protocol UK

Author: Chloe I Bloom, Thomas M Drake, Annemarie B Docherty, Brian J Lipworth, Sebastian L Johnston, Jonathan S Nguyen-Van-Tam, Gail Carson, Jake Dunning, Ewen M Harrison, J Kenneth Baillie, Malcolm G Semple, Paul Cullinan, Peter J M Openshaw, Beatrice Alex, Benjamin Bach, Wendy S Barclay, Debby Bogaert, Meera Chand, Graham S Cooke, Ana da Filipe, Tom Fletcher, Christoper A Green, Julian A Hiscox, Antonia Ying Ho, Peter W Horby, Samreen Ijaz, Saye Khoo, Paul Klenerman, Andrew Law, Wei Shen Lim, Alexander J Mentzer, Laura Merson, Alison M Meynert, Mahdad Noursadeghi, Shona C Moore, Massimo Palmarini, William A Paxton, Georgios Pollakis, Nicholas Price, Andrew Rambaut, David L Robertson, Clark D Russell, Vanessa Sancho-Shimizu, Janet T Scott, Thushan de Silva, Louise Sigfrid, Tom Solomon, Shiranee Sriskandan, David Stuart, Charlotte Summers, Richard S Tedder, Emma C Thomson, AA Roger Thompson, Ryan S Thwaites, Lance CW Turtle, Maria Zambon, Hayley Hardwick, Chloe Donohue, Ruth Lyons, Fiona Griffiths, Wilna Oosthuyzen, Lisa Norman, Riinu Pius, Cameron J Fairfield, Stephen R Knight, Kenneth A Mclean, Derek Murphy, Catherine A Shaw, Jo Dalton, Michelle Girvan, Egle Saviciute, Stephanie Roberts, Janet Harrison, Laura Marsh, Marie Connor, Sophie Halpin, Clare Jackson, Carrol Gamble, Gary Leeming, Murray Wham, Sara Clohisey, Ross Hendry, James Scott-Brown, William Greenhalf, Victoria Shaw, Sara McDonald, Seán Keating, Katie A. Ahmed, Jane A Armstrong, Milton Ashworth, Innocent G Asiimwe, Siddharth Bakshi, Samantha L Barlow, Laura Booth, Benjamin Brennan, Katie Bullock, Benjamin WA Catterall, Jordan J Clark, Emily A Clarke, Sarah Cole, Louise Cooper, Helen Cox, Christopher Davis, Oslem Dincarslan, Chris Dunn, Philip Dyer, Angela Elliott, Anthony Evans, Lorna Finch, Lewis WS Fisher, Terry Foster, Isabel Garcia-Dorival, Philip Gunning, Catherine Hartley, Rebecca L Jensen, Christopher B Jones, Trevor R Jones, Shadia Khandaker, Katharine King, Robyn T. Kiy, Chrysa Koukorava, Annette Lake, Suzannah Lant, Diane Latawiec, Lara Lavelle-Langham, Daniella Lefteri, Lauren Lett, Lucia A Livoti, Maria Mancini, Sarah McDonald, Laurence McEvoy, John McLauchlan, Soeren Metelmann, Nahida S Miah, Joanna Middleton, Joyce Mitchell, Ellen G Murphy, Rebekah Penrice-Randal, Jack Pilgrim, Tessa Prince, Will Reynolds, P. Matthew Ridley, Debby Sales, Victoria E Shaw, Rebecca K Shears, Benjamin Small, Krishanthi S Subramaniam, Agnieska Szemiel, Aislynn Taggart, Jolanta Tanianis-Hughes, Jordan Thomas, Erwan Trochu, Libby van Tonder, Eve Wilcock, J. Eunice Zhang, Lisa Flaherty, Nicole Maziere, Emily Cass, Alejandra Doce Carracedo, Nicola Carlucci, Anthony Holmes, Hannah Massey, Kayode Adeniji, Daniel Agranoff, Ken Agwuh, Dhiraj Ail, Ana Alegria, Brian Angus, Abdul Ashish, Dougal Atkinson, Shahedal Bari, Gavin Barlow, Stella Barnass, Nicholas Barrett, Christopher Bassford, David Baxter, Michael Beadsworth, Jolanta Bernatoniene, John Berridge, Nicola Best, Pieter Bothma, David Brealey, Robin Brittain-Long, Naomi Bulteel, Tom Burden, Andrew Burtenshaw, Vikki Caruth, David Chadwick, Duncan Chambler, Nigel Chee, Jenny Child, Srikanth Chukkambotla, Tom Clark, Paul Collini, Catherine Cosgrove, Jason Cupitt, Maria-Teresa Cutino-Moguel, Paul Dark, Chris Dawson, Samir Dervisevic, Phil Donnison, Sam Douthwaite, Ingrid DuRand, Ahilanadan Dushianthan, Tristan Dyer, Cariad Evans, Chi Eziefula, Chrisopher Fegan, Adam Finn, Duncan Fullerton, Sanjeev Garg, Atul Garg, Effrossyni Gkrania-Klotsas, Jo Godden, Arthur Goldsmith, Clive Graham, Elaine Hardy, Stuart Hartshorn, Daniel Harvey, Peter Havalda, Daniel B Hawcutt, Maria Hobrok, Luke Hodgson, Anil Hormis, Michael Jacobs, Susan Jain, Paul Jennings, Agilan Kaliappan, Vidya Kasipandian, Stephen Kegg, Michael Kelsey, Jason Kendall, Caroline Kerrison, Ian Kerslake, Oliver Koch, Gouri Koduri, George Koshy, Shondipon Laha, Steven Laird, Susan Larkin, Tamas Leiner, Patrick Lillie, James Limb, Vanessa Linnett, Jeff Little, Michael MacMahon, Emily MacNaughton, Ravish Mankregod, Huw Masson, Elijah Matovu, Katherine McCullough, Ruth McEwen, Manjula Meda, Gary Mills, Jane Minton, Mariyam Mirfenderesky, Kavya Mohandas, Quen Mok, James Moon, Elinoor Moore, Patrick Morgan, Craig Morris, Katherine Mortimore, Samuel Moses, Mbiye Mpenge, Rohinton Mulla, Michael Murphy, Megan Nagel, Thapas Nagarajan, Mark Nelson, Igor Otahal, Mark Pais, Selva Panchatsharam, Hassan Paraiso, Brij Patel, Natalie Pattison, Justin Pepperell, Mark Peters, Mandeep Phull, Stefania Pintus, Jagtur Pooni, Frank Post, David Price, Rachel Prout, Nikolas Rae, Henrik Reschreiter, Tim Reynolds, Neil Richardson, Mark Roberts, Devender Roberts, Alistair Rose, Guy Rousseau, Brendan Ryan, Taranprit Saluja, Aarti Shah, Prad Shanmuga, Anil Sharma, Anna Shawcross, Jeremy Sizer, Manu Shankar-Hari, Richard Smith, Catherine Snelson, Nick Spittle, Nikki Staines, Tom Stambach, Richard Stewart, Pradeep Subudhi, Tamas Szakmany, Kate Tatham, Jo Thomas, Chris Thompson, Robert Thompson, Ascanio Tridente, Darell Tupper-Carey, Mary Twagira, Andrew Ustianowski, Nick Vallotton, Lisa Vincent-Smith, Shico Visuvanathan, Alan Vuylsteke, Sam Waddy, Rachel Wake, Andrew Walden, Ingeborg Welters, Tony Whitehouse, Paul Whittaker, Ashley Whittington, Meme Wijesinghe, Martin Williams, Lawrence Wilson, Sarah Wilson, Stephen Winchester, Martin Wiselka, Adam Wolverson, Daniel G Wooton, Andrew Workman, Bryan Yates, Peter Young, National Institute for Health Research, UK Research and Innovation, GlaxoSmithKline Biologicals, UKRI MRC COVID-19 Rapid Response Call, and Medical Research Council (MRC)
Subjects: Pulmonary and Respiratory Medicine, Adult, Male, medicine.medical_specialty, Adolescent, Pulmonary Disease, Chronic Obstructive/complications, Respiratory System, INHALED CORTICOSTEROIDS, World Health Organization, Risk Assessment, 1117 Public Health and Health Services, Cohort Studies, Pulmonary Disease, Chronic Obstructive, Young Adult, Critical Care Medicine, Clinical Protocols, General & Internal Medicine, Internal medicine, medicine, Humans, Hospital Mortality, Prospective Studies, Young adult, Prospective cohort study, Asthma, Science & Technology, business.industry, Public health, ISARIC investigators, Respiratory disease, Asthma/complications, COVID-19, 1103 Clinical Sciences, Odds ratio, Articles, Middle Aged, medicine.disease, United Kingdom, PREVALENCE, Hospitalization, COVID-19/complications, Female, Risk assessment, business, Life Sciences & Biomedicine, Cohort study, 1199 Other Medical and Health Sciences
Abstract: BACKGROUND: Studies of patients admitted to hospital with COVID-19 have found varying mortality outcomes associated with underlying respiratory conditions and inhaled corticosteroid use. Using data from a national, multicentre, prospective cohort, we aimed to characterise people with COVID-19 admitted to hospital with underlying respiratory disease, assess the level of care received, measure in-hospital mortality, and examine the effect of inhaled corticosteroid use. METHODS: We analysed data from the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) WHO Clinical Characterisation Protocol UK (CCP-UK) study. All patients admitted to hospital with COVID-19 across England, Scotland, and Wales between Jan 17 and Aug 3, 2020, were eligible for inclusion in this analysis. Patients with asthma, chronic pulmonary disease, or both, were identified and stratified by age ( FINDINGS: 75 463 patients from 258 participating health-care facilities were included in this analysis: 860 patients younger than 16 years (74 [8·6%] with asthma), 8950 patients aged 16-49 years (1867 [20·9%] with asthma), and 65 653 patients aged 50 years and older (5918 [9·0%] with asthma, 10 266 [15·6%] with chronic pulmonary disease, and 2071 [3·2%] with both asthma and chronic pulmonary disease). Patients with asthma were significantly more likely than those without asthma to receive critical care (patients aged 16-49 years: adjusted odds ratio [OR] 1·20 [95% CI 1·05-1·37]; p=0·0080; patients aged ≥50 years: adjusted OR 1·17 [1·08-1·27]; p INTERPRETATION: Underlying respiratory conditions are common in patients admitted to hospital with COVID-19. Regardless of the severity of symptoms at admission and comorbidities, patients with asthma were more likely, and those with chronic pulmonary disease less likely, to receive critical care than patients without an underlying respiratory condition. In patients aged 16 years and older, severe asthma was associated with increased mortality compared to non-severe asthma. In patients aged 50 years and older, inhaled corticosteroid use in those with asthma was associated with lower mortality than in patients without an underlying respiratory condition; patients with chronic pulmonary disease had significantly increased mortality compared to those with no underlying respiratory condition, regardless of inhaled corticosteroid use. Our results suggest that the use of inhaled corticosteroids, within 2 weeks of admission, improves survival for patients aged 50 years and older with asthma, but not for those with chronic pulmonary disease. FUNDING: National Institute for Health Research, Medical Research Council, NIHR Health Protection Research Units in Emerging and Zoonotic Infections at the University of Liverpool and in Respiratory Infections at Imperial College London in partnership with Public Health England.
Published: 2021
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35. Efficacy of Proxalutamide in Hospitalized COVID-19 Patients: A Randomized, Double-Blind, Placebo-Controlled, Parallel-Design Clinical Trial

Author: Michael N Correia, Raquel N Nicolau, Rafael X Cunha, Ricardo A Zimerman, Emilyn O Guerreiro, Fatima N Mirza, Flavio Renan Pc Alcantara, Dirce Costa Onety, Brenda G Almeida, Angelo M Ribeiro, John McCoy, Gabriel S Ferreira, Jose Enrique M Medeiros, Andy Goren, Raysa Ws Paulain, Renan N Barros, Gerald J Nau, Maria Fernanda R Barroco, Daniel N Fonseca, Luiza Fm Nicolau, Adailson A de Souza, Flavio A. Cadegiani, Carlos Gustavo Wambier, Patricia S da Silva, Alessandra Reis, Marissa Li, Claudia Elizabeth Thompson, Karla Cristina P Israel, Suzyane S do Rosario, and Felipe O de Almeida
Subjects: Clinical trial, Mechanical ventilation, Coronavirus disease 2019 (COVID-19), Interquartile range, business.industry, Mortality rate, medicine.medical_treatment, Anesthesia, Hazard ratio, medicine, Respiratory system, Placebo, business
Abstract: BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectivity is mediated by the androgen-promoted protease, transmembrane protease, serine 2 (TMPRSS2). Previously, we have shown that treatment with proxalutamide, a non-steroidal androgen receptor antagonist, accelerates viral clearance and clinical remission in outpatients with coronavirus disease 2019 (COVID-19) compared to placebo. The effects in hospitalized COVID-19 patients were unknown.MethodsMen and women hospitalized but not requiring mechanical ventilation were randomized (1:1 ratio) to receive 300 mg of proxalutamide per day or placebo for 14 days. The study was conducted at eight sites in the state of Amazonas, Brazil. The primary outcome measure was the clinical status (8-point ordinal scale) at 14-days post-randomization. The primary efficacy endpoint was the 14-day recovery ratio (alive hospital discharge [scores 1, 2]).FindingsA total of 645 patients were randomized (317 received proxalutamide, 328 placebo) and underwent intention-to-treat analysis. The 14-day median ordinal scale score in the proxalutamide group was 1 (interquartile range [IQR]=1–2) versus 7 (IQR=2–8) for placebo, PInterpretationHospitalized COVID-19 patients not requiring mechanical ventilation receiving proxalutamide had a 128% higher recovery rate than those treated with placebo. All-cause mortality was reduced by 77.7% over 28 days. (ClinicalTrials.gov number, NCT04728802).
Published: 2021
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36. Abstracts Reporting of Randomized Controlled Trials in Ten Highest-ranking Nursing Journals: Improvement in the Quality Since CONSORT Extension for Abstracts

Author: Ying Y, Zhang Y, Zhang X, Rn Ws, and Zhang J
Subjects: medicine.medical_specialty, Randomized controlled trial, business.industry, law, media_common.quotation_subject, Medicine, Medical physics, Quality (business), Extension (predicate logic), business, law.invention, media_common, Ranking (information retrieval)
Abstract: Background: When evaluating randomized controlled trials(RCTs), nurses usually refer to the abstracts to make an initial assessment of the results and to determine whether a full-text review is required. Aims: To determine whether the publication of Consolidated Standards of Reporting Trials (CONSORT) for abstracts resulted in an improvement in the abstracts report of nursing RCTs. Methods: This research was a cross-sectional study. Web of Science was searched. 200 RCTs were randomly selected from ten high-impact nursing journals. CONSORT-A checklist was used to assess abstracts. Total score on checklists, comparison on total scores between two periods, and effect factors were analyzed. Results: Mean overall adherence across all abstracts was 8.85±2.18 which significantly improved with the time span. The most poorly reported items were ‘harms’, ‘outcomes in method’, and ‘method of blinding’ which appeared in 0, 8.5% and 16.5% of abstracts, respectively. Recent year of publication(P=0.014), Journal impact factor (P=0.000), multiple center trial (P=0.000), and structured abstract (P=0.008) were associated significantly with a high reporting quality. Conclusions: Although not defined all of abstracts in nursing area, our sample reflect the general trend that there was limited adherence to the CONSORT-A among abstracts in nursing literature. It is necessary to promote and actively apply the CONSORT-A guideline.
Published: 2021
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37. Non-steroidal anti-inflammatory drug use and outcomes of COVID-19 in the ISARIC Clinical Characterisation Protocol UK cohort: a matched, prospective cohort study

Author: Thomas M Drake, Cameron J Fairfield, Riinu Pius, Stephen R Knight, Lisa Norman, Michelle Girvan, Hayley E Hardwick, Annemarie B Docherty, Ryan S Thwaites, Peter J M Openshaw, J Kenneth Baillie, Ewen M Harrison, Malcolm G Semple, Peter JM Openshaw, Gail Carson, Beatrice Alex, Benjamin Bach, Wendy S Barclay, Debby Bogaert, Meera Chand, Graham S Cooke, Ana da Silva Filipe, Thushan de Silva, Jake Dunning, Tom Fletcher, Christopher A Green, Julian A Hiscox, Antonia YW Ho, Peter W Horby, Samreen Ijaz, Say Khoo, Paul Klenerman, Andrew Law, Wei Shen Lim, Alexander J Mentzer, Laura Merson, Alison M Meynert, Shona C Moore, Mahdad Noursadeghi, Massimo Palmarini, William A Paxton, Georgios Pollakis, Nicholas Price, Andrew Rambaut, David L Robertson, Clark D Russell, Vanessa Sancho-Shimizu, Janet T Scott, Louise Sigfrid, Tom Solomon, Shiranee Sriskandan, David Stuart, Charlotte Summers, Richard S Tedder, AA Roger Thompson, Emma C Thomson, Lance CW Turtle, Maria Zambon, Chloe Donohue, Fiona Griffiths, Hayley Hardwick, Ruth Lyons, Wilna Oosthuyzen, Kenneth A Mclean, Derek Murphy, Catherine A Shaw, Marie Connor, Jo Dalton, Carrol Gamble, Sophie Halpin, Janet Harrison, Clare Jackson, Laura Marsh, Stephanie Roberts, Egle Saviciute, Sara Clohisey, Ross Hendry, Gary Leeming, James Scott-Brown, Murray Wham, William Greenhalf, Sara McDonald, Victoria Shaw, Seán Keating, Katie A. Ahmed, Jane A Armstrong, Milton Ashworth, Innocent G Asiimwe, Siddharth Bakshi, Samantha L Barlow, Laura Booth, Benjamin Brennan, Katie Bullock, Nicola Carlucci, Emily Cass, Benjamin WA Catterall, Jordan J Clark, Emily A Clarke, Sarah Cole, Louise Cooper, Helen Cox, Christopher Davis, Oslem Dincarslan, Alejandra Doce Carracedo, Chris Dunn, Philip Dyer, Angela Elliott, Anthony Evans, Lorna Finch, Lewis WS Fisher, Lisa Flaherty, Terry Foster, Isabel Garcia-Dorival, Philip Gunning, Catherine Hartley, Anthony Holmes, Rebecca L Jensen, Christopher B Jones, Trevor R Jones, Shadia Khandaker, Katharine King, Robyn T. Kiy, Chrysa Koukorava, Annette Lake, Suzannah Lant, Diane Latawiec, Lara Lavelle-Langham, Daniella Lefteri, Lauren Lett, Lucia A Livoti, Maria Mancini, Hannah Massey, Nicole Maziere, Sarah McDonald, Laurence McEvoy, John McLauchlan, Soeren Metelmann, Nahida S Miah, Joanna Middleton, Joyce Mitchell, Ellen G Murphy, Rebekah Penrice-Randal, Jack Pilgrim, Tessa Prince, Will Reynolds, P. Matthew Ridley, Debby Sales, Victoria E Shaw, Rebecca K Shears, Benjamin Small, Krishanthi S Subramaniam, Agnieska Szemiel, Aislynn Taggart, Jolanta Tanianis-Hughes, Jordan Thomas, Erwan Trochu, Libby van Tonder, Eve Wilcock, J. Eunice Zhang, Alan MacLean, Sarah McCafferty, Kirstie Morrice, Lee Murphy, Nicola Wrobel, Kayode Adeniji, Daniel Agranoff, Ken Agwuh, Dhiraj Ail, Erin L. Aldera, Ana Alegria, Brian Angus, Abdul Ashish, Dougal Atkinson, Shahedal Bari, Gavin Barlow, Stella Barnass, Nicholas Barrett, Christopher Bassford, Sneha Basude, David Baxter, Michael Beadsworth, Jolanta Bernatoniene, John Berridge, Nicola Best, Pieter Bothma, Robin Brittain-Long, Naomi Bulteel, Tom Burden, Andrew Burtenshaw, Vikki Caruth, David Chadwick, Duncan Chambler, Nigel Chee, Jenny Child, Srikanth Chukkambotla, Tom Clark, Paul Collini, Catherine Cosgrove, Jason Cupitt, Maria-Teresa Cutino-Moguel, Paul Dark, Chris Dawson, Samir Dervisevic, Phil Donnison, Sam Douthwaite, Ingrid DuRand, Ahilanadan Dushianthan, Tristan Dyer, Cariad Evans, Chi Eziefula, Chrisopher Fegan, Adam Finn, Duncan Fullerton, Sanjeev Garg, Atul Garg, Effrossyni Gkrania-Klotsas, Jo Godden, Arthur Goldsmith, Clive Graham, Elaine Hardy, Stuart Hartshorn, Daniel Harvey, Peter Havalda, Daniel B Hawcutt, Maria Hobrok, Luke Hodgson, Anil Hormis, Michael Jacobs, Susan Jain, Paul Jennings, Agilan Kaliappan, Vidya Kasipandian, Stephen Kegg, Michael Kelsey, Jason Kendall, Caroline Kerrison, Ian Kerslake, Oliver Koch, Gouri Koduri, George Koshy, Shondipon Laha, Steven Laird, Susan Larkin, Tamas Leiner, Patrick Lillie, James Limb, Vanessa Linnett, Jeff Little, Mark Lyttle, Michael MacMahon, Emily MacNaughton, Ravish Mankregod, Huw Masson, Elijah Matovu, Katherine McCullough, Ruth McEwen, Manjula Meda, Gary Mills, Jane Minton, Mariyam Mirfenderesky, Kavya Mohandas, Quen Mok, James Moon, Elinoor Moore, Patrick Morgan, Craig Morris, Katherine Mortimore, Samuel Moses, Mbiye Mpenge, Rohinton Mulla, Michael Murphy, Thapas Nagarajan, Megan Nagel, Mark Nelson, Matthew K. O'Shea, Marlies Ostermann, Igor Otahal, Mark Pais, Selva Panchatsharam, Danai Papakonstantinou, Padmasayee Papineni, Hassan Paraiso, Brij Patel, Natalie Pattison, Justin Pepperell, Mark Peters, Mandeep Phull, Stefania Pintus, Frank Post, David Price, Rachel Prout, Nikolas Rae, Henrik Reschreiter, Tim Reynolds, Neil Richardson, Mark Roberts, Devender Roberts, Alistair Rose, Guy Rousseau, Brendan Ryan, Taranprit Saluja, Sarah Sarah, Aarti Shah, Manu Shankar-Hari, Prad Shanmuga, Anil Sharma, Anna Shawcross, Jagtur Singh Pooni, Jeremy Sizer, Richard Smith, Catherine Snelson, Nick Spittle, Nikki Staines, Tom Stambach, Richard Stewart, Pradeep Subudhi, Tamas Szakmany, Kate Tatham, Jo Thomas, Chris Thompson, Robert Thompson, Ascanio Tridente, Darell Tupper-Carey, Mary Twagira, Andrew Ustianowski, Nick Vallotton, Lisa Vincent-Smith, Shico Visuvanathan, Alan Vuylsteke, Sam Waddy, Rachel Wake, Andrew Walden, Ingeborg Welters, Tony Whitehouse, Paul Whittaker, Ashley Whittington, Meme Wijesinghe, Martin Williams, Lawrence Wilson, Stephen Winchester, Martin Wiselka, Adam Wolverson, Daniel G Wooton, Andrew Workman, Bryan Yates, Peter Young, investigators, ISARIC4C, Horby, PW, UKRI MRC COVID-19 Rapid Response Call, National Institute for Health Research, Medical Research Council (MRC), and UK Research and Innovation
Subjects: medicine.medical_specialty, business.industry, Immunology, Acute kidney injury, Articles, medicine.disease, Logistic regression, Rheumatology, Internal medicine, Cohort, Propensity score matching, Epidemiology, medicine, Immunology and Allergy, Medical prescription, business, Prospective cohort study, ISARIC4C Investigators, Cohort study
Abstract: Background Early in the pandemic it was suggested that pre-existing use of non-steroidal anti-inflammatory drugs (NSAIDs) could lead to increased disease severity in patients with COVID-19. NSAIDs are an important analgesic, particularly in those with rheumatological disease, and are widely available to the general public without prescription. Evidence from community studies, administrative data, and small studies of hospitalised patients suggest NSAIDs are not associated with poorer COVID-19 outcomes. We aimed to characterise the safety of NSAIDs and identify whether pre-existing NSAID use was associated with increased severity of COVID-19 disease. Methods This prospective, multicentre cohort study included patients of any age admitted to hospital with a confirmed or highly suspected SARS-CoV-2 infection leading to COVID-19 between Jan 17 and Aug 10, 2020. The primary outcome was in-hospital mortality, and secondary outcomes were disease severity at presentation, admission to critical care, receipt of invasive ventilation, receipt of non-invasive ventilation, use of supplementary oxygen, and acute kidney injury. NSAID use was required to be within the 2 weeks before hospital admission. We used logistic regression to estimate the effects of NSAIDs and adjust for confounding variables. We used propensity score matching to further estimate effects of NSAIDS while accounting for covariate differences in populations. Results Between Jan 17 and Aug 10, 2020, we enrolled 78 674 patients across 255 health-care facilities in England, Scotland, and Wales. 72 179 patients had death outcomes available for matching; 40 406 (56·2%) of 71 915 were men, 31 509 (43·8%) were women. In this cohort, 4211 (5·8%) patients were recorded as taking systemic NSAIDs before admission to hospital. Following propensity score matching, balanced groups of NSAIDs users and NSAIDs non-users were obtained (4205 patients in each group). At hospital admission, we observed no significant differences in severity between exposure groups. After adjusting for explanatory variables, NSAID use was not associated with worse in-hospital mortality (matched OR 0·95, 95% CI 0·84–1·07; p=0·35), critical care admission (1·01, 0·87–1·17; p=0·89), requirement for invasive ventilation (0·96, 0·80–1·17; p=0·69), requirement for non-invasive ventilation (1·12, 0·96–1·32; p=0·14), requirement for oxygen (1·00, 0·89–1·12; p=0·97), or occurrence of acute kidney injury (1·08, 0·92–1·26; p=0·33). Interpretation NSAID use is not associated with higher mortality or increased severity of COVID-19. Policy makers should consider reviewing issued advice around NSAID prescribing and COVID-19 severity. Funding National Institute for Health Research and Medical Research Council.
Published: 2021
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38. NLoed: A Python package for nonlinear optimal experimental design in systems biology

Author: Lu Z, Receno C, Brian Ingalls, Astwood M, Nathan Braniff, Pearce T, and Forrest Ws
Subjects: Source code, Computer science, business.industry, media_common.quotation_subject, Design of experiments, Python (programming language), Modular design, Data type, Workflow, Software, Documentation, Software engineering, business, computer, media_common, computer.programming_language
Abstract: MotivationModelling in systems and synthetic biology relies on accurate parameter estimates and predictions. Accurate model calibration relies, in turn, on data, and on how well-suited the available data is to a particular modelling task. Optimal experimental design (OED) techniques can be used to identify experiments and data collection procedures that will most efficiently contribute to a given modelling objective. However, implementation of OED is limited by currently available software tools that are not well-suited for the diversity of nonlinear models and non-normal data commonly encountered in biological research. Moreover, existing OED tools do not make use of the state-of-the-art numerical tools, resulting in inefficient computation.ResultsHere we present the NLoed software package. NLoed is an open-source Python library providing convenient access to OED methods, with particular emphasis on experimental design for systems biology research. NLoed supports a wide variety of nonlinear, multi-input/output, and dynamic models, and facilitates modelling and design of experiments over a wide variety of data types. To support OED investigations, the NLoed package implements maximum likelihood fitting and diagnostic tools, providing a comprehensive modelling workflow. NLoed offers an accessible, modular, and flexible OED tool-set suited to the wide variety of experimental scenarios encountered in systems biology research. We demonstrate NLOED’s capabilities by applying it to experimental design for characterization of a bacterial optogenetic system.AvailabilityNLoed is available via pip from the PyPi repository; https://pypi.org/project/nloed/. Source code, documentation and examples can be found on Github at https://github.com/ingallslab/NLoed.Contactbingalls@uwaterloo.caSupplementary informationSupplementary materials are available online.
Published: 2021
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39. Modified Multiple Marker Aneuploidy Screening as a Primary Screening Test for Preeclampsia

Author: Rasasakaram E, Gibbons C, Bedford Hm, Mak-Tam E, Rashid S, Meschino Ws, Mei-Dan E, Cuckle H, Huang T, and Priston M
Subjects: Oncology, medicine.medical_specialty, business.industry, Internal medicine, medicine, Aneuploidy, medicine.disease, business, Preeclampsia, Primary screening, Test (assessment)
Abstract: Background: Maternal biochemical markers used in multiple marker aneuploidy screening have been associated with adverse pregnancy outcomes. This study aims to assess if a combination of maternal characteristics and biochemical markers in the first and second trimesters can be used to screen for preeclampsia (PE), gestational hypertension and preterm birth. Methods: This case-control study used information on maternal characteristics and residual blood samples from pregnant women who have undergone multiple marker aneuploidy screening. The median multiple of the median (MoM) of first and second trimester biochemical markers in cases (women with PE, gestational hypertension and preterm birth) and controls were compared. Biochemical markers included pregnancy-associated plasma protein A (PAPP-A), placental growth factor (PlGF), human chorionic gonadotropin (hCG), alpha feto-protein (AFP), unconjugated estriol (uE3) and Inhibin A. Logistic regression analysis was used to estimate screening performance using different marker combinations. Screening performance was defined as detection rate (DR) and false positive rate (FPR). Preterm and early-onset preeclampsia PE were defined as women with PE delivered < 37 and < 34 weeks of gestation.Results: There were 147 pregnancies with PE (81 term, 49 preterm and 17 early-onset), 295 with gestational hypertension, and 166 preterm birth. Compared to controls, PE cases had significantly lower median MoM of PAPP-A (0.77 vs 1.10, pConclusions: Maternal characteristics with first trimester PAPP-A and PlGF measured for aneuploidy screening provided reasonable accuracy in identifying women at risk of developing early onset PE, allowing triage of high-risk women for further investigation and risk-reducing therapy.
Published: 2021
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40. nSiP(System in Package) Platform for various module packaging applications

Author: Jaegil Lee, Lewis In Soo Kang, WS Shin, NamChul Kim, Jay Kim, and Sy Park
Subjects: System in package, Reliability (semiconductor), Stack (abstract data type), Computer science, business.industry, Redistribution layer, Substrate (printing), Routing (electronic design automation), Daisy chain, business, Computer hardware, Line (electrical engineering)
Abstract: nSiP(nepes System in Package) platform technology has been developed and verified as a module concept SiP package which can contain various dies and multi passives by using WLP and fan-out related technologies for various applications. nSiP platform technology has been proven to be enabling less stack up of metal routing layers due to fine 5/5 um line and spaces capabilities and improving the electrical performance. nSiP platform technology is a basic structure based on the fabricated redistribution layer for double side substrate technology, high density and double side mount technology, embedded trace substrate even without conventional PCB substrate technology. The process of nSiP module consists of Pattern process, Surface mounting (SMT) and Encapsulation (& B/E). Pattern process is a main process to fabricate redistribution layer on carrier and all process has been developed and proven with reliability tests. The fabricated redistribution layer has been developed with low Dk/Df dielectric materials. In order to validate, EVT(Engineering Validation Test) vehicle has been designed. nSiP module size which includes Components with 3-die and 65-passvie is $10\times 10\ \ \text{mm}$ with thickness 1 mm. The fabricated redistribution layer consists of 4-metal and 4-passivation layers in daisy chain format for reliability test nSiP platform technology can reduce overall module size down to 31% compared to conventional system in package technology. EMI shielding structure has been developed. Panel Level Package technology will add further benefit of cost competitiveness. Since each customer has their own SiP requirement, nSiP platform technology can be a solution as SiP module for any applications and any structures which can include any functions, like 3D PoP, double side SiP, 5G mmWave package solution and so on.
Published: 2021
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41. Serum EMAP‐II in Young and Older Men During Prolonged Exercise in Temperate and Hot Conditions

Author: James A. McCormick, Melissa D. Côté, Journeay Ws, Glen P. Kenny, and Sean R. Notley
Subjects: Prolonged exercise, business.industry, Genetics, Temperate climate, Physiology, Medicine, business, Molecular Biology, Biochemistry, Biotechnology
Published: 2021
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42. Hong Kong Geriatrics Society and Hong Kong Urological Association consensus on personalised management of male lower urinary tract symptoms in the era of multiple co-morbidities and polypharmacy

Author: Peggy Sk Chu, TK Lo, Sandy Ws Woo, MH Cheung, Clarence Lh Leung, William Kk Wong, and Tony Nh Chan
Subjects: Geriatrics, Polypharmacy, Adult, Male, medicine.medical_specialty, Consensus, Referral, business.industry, Incidence (epidemiology), Incidence, Disease, medicine.disease, Lower Urinary Tract Symptoms, Lower urinary tract symptoms, Medicine, Hong Kong, Humans, Co morbidity, business, Adverse effect, Intensive care medicine
Abstract: Lower urinary tract symptoms (LUTS) are common complaints of adult men. Benign prostatic hyperplasia (BPH) represents the most common underlying cause. As the incidence of BPH increases with age, and pharmacological treatment is a major part of the disease's management, the majority of patients with LUTS are managed by primary care practitioners. There are circumstances in which specialist care by urologists or geriatricians is required, such as failure of medical treatment, adverse effects from medical treatment, or complications from BPH. Referral choices can be confusing to patients and even practitioners in different specialties under such circumstances. There is currently no local consensus about the diagnosis, medical management, or referral mechanism of patients with BPH. A workgroup was formed by members of The Hong Kong Geriatrics Society (HKGS) and the Hong Kong Urological Association (HKUA) to review evidence for the diagnosis and medical treatment of LUTS. A consensus was reached by HKGS and HKUA on an algorithm for the flow of male LUTS care and the use of uroselective alpha blockers, antimuscarinics, beta-3 adrenoceptor agonists, and 5α-reductase inhibitors in the primary care setting. This consensus by HKGS and HKUA provides a new management paradigm of male LUTS.
Published: 2021

43. Association of Anemia with Rehabilitation Outcome for Subacute Geriatric Rehabilitation Patients in a Secondary Hospital in Malaysia

Author: Wee Kooi Cheah, Mann Leon Chin, Huey Ee Chong, and Christopher Ws Chan
Subjects: medicine.medical_specialty, Creatinine, Rehabilitation, Geriatric rehabilitation, business.industry, Barthel index, Anemia, medicine.medical_treatment, Retrospective cohort study, medicine.disease, Rehabilitation outcome, chemistry.chemical_compound, chemistry, Interquartile range, Internal medicine, medicine, business
Abstract: Objective: To evaluate the effect of Anemia on Rehabilitation Outcome for Geriatric Subjects in Taiping Hospital Subacute Geriatric Rehabilitation Ward.Methodology: This was a retrospective study, with 126 subjects to compare the change in modified Barthel Index score of anemic and non anemic subjects.Results: 44% of subjects were anemic and the Mean corpuscular hemoglobin and Mean corpuscular volume for anemic subjects were 85.4pg and 29.8fL. Among anemic subjects 45.5% were Malay, 38.2% were Chinese, 14.5% were Indian and 1% were others. The Median(IQR) Modified Barthel Index (MBI) on admission for anemic subjects and non anemic subjects were insignificantly difference which were 47 (29, 63) and 36 (21, 59) respectively, (p=0.059). The median(IQR) of MBI improvement for non anemic subjects was found to be significantly higher than anemic subjects which were 14 (5, 26) and 8 (1, 18) (p=0.021). Subject with hemoglobin (hb) ≥ 9g/dL were significantly associated with MBI improvement of more than 20, p=0.014. Multiple linear regression revealed a significant linear relationship between age and MBI score improvement (p=0.010). Subjects 10 years younger showed a 3.55 score improvement in MBI.Conclusion: The study suggested that non-anemic subjects showed significant MBI improvement. Our study also suggested judicious transfusion practices to maintain a hemoglobin threshold of 9 g/dL might be able to improve subject’s functional outcome. These results should encourage further research with a larger elderly subject population to provide insights and awareness for the need to correct anemia in rehabilitation subjects.
Published: 2021
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44. Development and validation of the ISARIC 4C deterioration model for adults hospitalised with COVID-19: a prospective cohort study

Author: Rishi K Gupta, Ewen M Harrison, Antonia Ho, Annemarie B Docherty, Stephen R Knight, Maarten van Smeden, Ibrahim Abubakar, Marc Lipman, Matteo Quartagno, Riinu Pius, Iain Buchan, Gail Carson, Thomas M Drake, Jake Dunning, Cameron J Fairfield, Carrol Gamble, Christopher A Green, Sophie Halpin, Hayley E Hardwick, Karl A Holden, Peter W Horby, Clare Jackson, Kenneth A Mclean, Laura Merson, Jonathan S Nguyen-Van-Tam, Lisa Norman, Piero L Olliaro, Mark G Pritchard, Clark D Russell, James Scott-Brown, Catherine A Shaw, Aziz Sheikh, Tom Solomon, Cathie Sudlow, Olivia V Swann, Lance Turtle, Peter J M Openshaw, J Kenneth Baillie, Malcolm G Semple, Mahdad Noursadeghi, Peter JM Openshaw, Beatrice Alex, Benjamin Bach, Wendy S Barclay, Debby Bogaert, Meera Chand, Graham S Cooke, Ana da Silva Filipe, Tom Fletcher, Julian A Hiscox, Antonia Ying Wai Ho, Samreen Ijaz, Saye Khoo, Paul Klenerman, Andrew Law, Wei Shen Lim, Alexander J Mentzer, Alison M Meynert, Shona C Moore, Massimo Palmarini, William A Paxton, Georgios Pollakis, Nicholas Price, Andrew Rambaut, David L Robertson, Vanessa Sancho-Shimizu, Janet T Scott, Thushan de Silva, Louise Sigfrid, Shiranee Sriskandan, David Stuart, Charlotte Summers, Richard S Tedder, Emma C Thomson, AA Roger Thompson, Ryan S Thwaites, Lance CW Turtle, Maria Zambon, Hayley Hardwick, Chloe Donohue, Ruth Lyons, Fiona Griffiths, Wilna Oosthuyzen, Tom M Drake, Stephen Knight, Derek Murphy, Jo Dalton, James Lee, Daniel Plotkin, Michelle Girvan, Scott Mullaney, Claire Petersen, Egle Saviciute, Stephanie Roberts, Janet Harrison, Laura Marsh, Marie Connor, Gary Leeming, Murray Wham, Sara Clohisey, Ross Hendry, William Greenhalf, Victoria Shaw, Sarah McDonald, Seán Keating, Katie A. Ahmed, Jane A Armstrong, Milton Ashworth, Innocent G Asiimwe, Siddharth Bakshi, Samantha L Barlow, Laura Booth, Benjamin Brennan, Katie Bullock, Benjamin WA Catterall, Jordan J Clark, Emily A Clarke, Sarah Cole, Louise Cooper, Helen Cox, Christopher Davis, Oslem Dincarslan, Chris Dunn, Philip Dyer, Angela Elliott, Anthony Evans, Lorna Finch, Lewis WS Fisher, Terry Foster, Isabel Garcia-Dorival, Willliam Greenhalf, Philip Gunning, Catherine Hartley, Rebecca L Jensen, Christopher B Jones, Trevor R Jones, Shadia Khandaker, Katharine King, Robyn T. Kiy, Chrysa Koukorava, Annette Lake, Suzannah Lant, Diane Latawiec, L Lavelle-Langham, Daniella Lefteri, Lauren Lett, Lucia A Livoti, Maria Mancini, Laurence McEvoy, John McLauchlan, Soeren Metelmann, Nahida S Miah, Joanna Middleton, Joyce Mitchell, Ellen G Murphy, Rebekah Penrice-Randal, Jack Pilgrim, Tessa Prince, Will Reynolds, P. Matthew Ridley, Debby Sales, Victoria E Shaw, Rebecca K Shears, Benjamin Small, Krishanthi S Subramaniam, Agnieska Szemiel, Aislynn Taggart, Jolanta Tanianis-Hughes, Jordan Thomas, Erwan Trochu, Libby van Tonder, Eve Wilcock, J. Eunice Zhang, Kayode Adeniji, Daniel Agranoff, Ken Agwuh, Dhiraj Ail, Ana Alegria, Brian Angus, Abdul Ashish, Dougal Atkinson, Shahedal Bari, Gavin Barlow, Stella Barnass, Nicholas Barrett, Christopher Bassford, David Baxter, Michael Beadsworth, Jolanta Bernatoniene, John Berridge, Nicola Best, Pieter Bothma, David Brealey, Robin Brittain-Long, Naomi Bulteel, Tom Burden, Andrew Burtenshaw, Vikki Caruth, David Chadwick, Duncan Chambler, Nigel Chee, Jenny Child, Srikanth Chukkambotla, Tom Clark, Paul Collini, Catherine Cosgrove, Jason Cupitt, Maria-Teresa Cutino-Moguel, Paul Dark, Chris Dawson, Samir Dervisevic, Phil Donnison, Sam Douthwaite, Ingrid DuRand, Ahilanadan Dushianthan, Tristan Dyer, Cariad Evans, Chi Eziefula, Chrisopher Fegan, Adam Finn, Duncan Fullerton, Sanjeev Garg, Atul Garg, Effrossyni Gkrania-Klotsas, Jo Godden, Arthur Goldsmith, Clive Graham, Elaine Hardy, Stuart Hartshorn, Daniel Harvey, Peter Havalda, Daniel B Hawcutt, Maria Hobrok, Luke Hodgson, Anil Hormis, Michael Jacobs, Susan Jain, Paul Jennings, Agilan Kaliappan, Vidya Kasipandian, Stephen Kegg, Michael Kelsey, Jason Kendall, Caroline Kerrison, Ian Kerslake, Oliver Koch, Gouri Koduri, George Koshy, Shondipon Laha, Steven Laird, Susan Larkin, Tamas Leiner, Patrick Lillie, James Limb, Vanessa Linnett, Jeff Little, Michael MacMahon, Emily MacNaughton, Ravish Mankregod, Huw Masson, Elijah Matovu, Katherine McCullough, Ruth McEwen, Manjula Meda, Gary Mills, Jane Minton, Mariyam Mirfenderesky, Kavya Mohandas, Quen Mok, James Moon, Elinoor Moore, Patrick Morgan, Craig Morris, Katherine Mortimore, Samuel Moses, Mbiye Mpenge, Rohinton Mulla, Michael Murphy, Megan Nagel, Thapas Nagarajan, Mark Nelson, Igor Otahal, Mark Pais, Selva Panchatsharam, Hassan Paraiso, Brij Patel, Natalie Pattison, Justin Pepperell, Mark Peters, Mandeep Phull, Stefania Pintus, Jagtur Singh Pooni, Frank Post, David Price, Rachel Prout, Nikolas Rae, Henrik Reschreiter, Tim Reynolds, Neil Richardson, Mark Roberts, Devender Roberts, Alistair Rose, Guy Rousseau, Brendan Ryan, Taranprit Saluja, Aarti Shah, Prad Shanmuga, Anil Sharma, Anna Shawcross, Jeremy Sizer, Manu Shankar-Hari, Richard Smith, Catherine Snelson, Nick Spittle, Nikki Staines, Tom Stambach, Richard Stewart, Pradeep Subudhi, Tamas Szakmany, Kate Tatham, Jo Thomas, Chris Thompson, Robert Thompson, Ascanio Tridente, Darell Tupper-Carey, Mary Twagira, Andrew Ustianowski, Nick Vallotton, Lisa Vincent-Smith, Shico Visuvanathan, Alan Vuylsteke, Sam Waddy, Rachel Wake, Andrew Walden, Ingeborg Welters, Tony Whitehouse, Paul Whittaker, Ashley Whittington, Meme Wijesinghe, Martin Williams, Lawrence Wilson, Sarah Wilson, Stephen Winchester, Martin Wiselka, Adam Wolverson, Daniel G Wooton, Andrew Workman, Bryan Yates, Peter Young, National Institute for Health Research, Commission of the European Communities, Medical Research Council (MRC), UKRI MRC COVID-19 Rapid Response Call, UK Research and Innovation, Gupta, Rishi K [0000-0002-6257-1285], Lipman, Marc [0000-0001-7501-4448], Buchan, Iain [0000-0003-3392-1650], and Apollo - University of Cambridge Repository
Subjects: Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Critical Care, Clinical Decision-Making, MEDLINE, Logistic regression, ResearchInstitutes_Networks_Beacons/humanitarian_conflict_response_institute, Severity of Illness Index, 1117 Public Health and Health Services, 03 medical and health sciences, 0302 clinical medicine, Patient Admission, Clinical Decision Rules, Severity of illness, Medicine, Humans, 030212 general & internal medicine, Hospital Mortality, Prospective Studies, Prospective cohort study, ISARIC4C Investigators, Aged, Aged, 80 and over, Clinical Deterioration, business.industry, SARS-CoV-2, Reproducibility of Results, COVID-19, 1103 Clinical Sciences, Articles, Middle Aged, Medical research, Prognosis, Respiration, Artificial, United Kingdom, Intensive Care Units, Logistic Models, 030228 respiratory system, Preparedness, Emergency medicine, Cohort, Humanitarian and Conflict Response Institute, Female, business, 1199 Other Medical and Health Sciences
Abstract: Background\ud \ud Prognostic models to predict the risk of clinical deterioration in acute COVID-19 cases are urgently required to inform clinical management decisions.\ud \ud \ud Methods\ud \ud We developed and validated a multivariable logistic regression model for in-hospital clinical deterioration (defined as any requirement of ventilatory support or critical care, or death) among consecutively hospitalised adults with highly suspected or confirmed COVID-19 who were prospectively recruited to the International Severe Acute Respiratory and Emerging Infections Consortium Coronavirus Clinical Characterisation Consortium (ISARIC4C) study across 260 hospitals in England, Scotland, and Wales. Candidate predictors that were specified a priori were considered for inclusion in the model on the basis of previous prognostic scores and emerging literature describing routinely measured biomarkers associated with COVID-19 prognosis. We used internal–external cross-validation to evaluate discrimination, calibration, and clinical utility across eight National Health Service (NHS) regions in the development cohort. We further validated the final model in held-out data from an additional NHS region (London).\ud \ud \ud Findings\ud \ud 74 944 participants (recruited between Feb 6 and Aug 26, 2020) were included, of whom 31 924 (43·2%) of 73 948 with available outcomes met the composite clinical deterioration outcome. In internal–external cross-validation in the development cohort of 66 705 participants, the selected model (comprising 11 predictors routinely measured at the point of hospital admission) showed consistent discrimination, calibration, and clinical utility across all eight NHS regions. In held-out data from London (n=8239), the model showed a similarly consistent performance (C-statistic 0·77 [95% CI 0·76 to 0·78]; calibration-in-the-large 0·00 [–0·05 to 0·05]); calibration slope 0·96 [0·91 to 1·01]), and greater net benefit than any other reproducible prognostic model.\ud \ud \ud Interpretation\ud \ud The 4C Deterioration model has strong potential for clinical utility and generalisability to predict clinical deterioration and inform decision making among adults hospitalised with COVID-19.\ud \ud \ud Funding\ud \ud National Institute for Health Research (NIHR), UK Medical Research Council, Wellcome Trust, Department for International Development, Bill & Melinda Gates Foundation, EU Platform for European Preparedness Against (Re-)emerging Epidemics, NIHR Health Protection Research Unit (HPRU) in Emerging and Zoonotic Infections at University of Liverpool, NIHR HPRU in Respiratory Infections at Imperial College London.
Published: 2021
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45. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Author: Nepogodiev, Dmitri, Bhangu, Aneel, Glasbey, James C, Li, Elizabeth, Omar, Omar M, Simoes, Joana FF, Abbott, Tom EF, Alser, Osaid, Arnaud, Alexis P, Bankhead-Kendall, Brittany K, Breen, Kerry A, Cunha, Miguel F, Davidson, Giana H, Di Saverio, Salomone, Gallo, Gaetano, Griffiths, Ewen A, Gujjuri, Rohan R, Hutchinson, Peter J, Kaafarani, Haytham MA, Lederhuber, Hans, Löffler, Markus W, Mashbari, Hassan N, Minaya-Bravo, Ana, Morton, Dion G, Moszkowicz, David, Pata, Francesco, Tsoulfas, George, Venn, Mary L, Cox, Daniel, Roslani, April C, Alakaloko, Felix, de Vries, Jean-Paul PM, Aaraj, Mahmoud A, Abbott, Sarah J, Abdalla, Mutwakil OM, Abdelaal, Ahmed S, Ademuyiwa, Adesoji O, Aherne, Thomas M, Ali, Osman M, Alkadeeki, Ghadah Z, Almeida, Ana C, Alrahawy, Mahmoud M, Ambler, Graeme K, Alameer, Ehab, Andreani, Stefano M, De Andrés-Asenjo, Beatriz, Antonanzas, Leyre Lopez, Aoun, Salah G, Ashoush, Fouad M, Augestad, Knut Magne, Avellana, Rocio B, Ayeni, Funbi A, Ayorinde, John OO, Babu, Bheemanakone H, Baig, Mirza MAS, Bajomo, Oreoluwa M, Baker, Olivia J, Baker, Markus P, Baldwin, Alexander J, Ban, Vin Shen, Baron, Ryan D, Barranquero, Alberto G, Barry, Conor P, DI Bartolomeo, Alessandro, Bass, Gary A, Bath, Michael F, Batjer, H Hunt, Beamish, Andrew J, Belgaumkar, Ajay P, Bence, Matthew N, Benson, Ruth A, Bernal-Sprekelsen, Juan Carlos, Bhama, Anuradha R, Bhavaraju, Avi V, Biffl, Walter L, Blundell, Chris M, Boddy, Alexander P, Borgstein, Alexander BJ, Bosanquet, David C, Bosch, Karen D, Bouhuwaish, Ahmad EM, Bozkurt, Mehmet A, Brathwaite, Collin EM, Brown, Benjamin C, Brown, Oliver D, Brown, Allison K, Buarque, Igor Lima, Bueno-Cañones, Alejandro D, Bulugma, Mustafa R, Burke, Joshua R, Byrne, Matthew HV, Cagigal-Ortega, Elima P, Callcut, Rachael A, DI Candido, Francesca, Canova, Michaela E, Carlos, William J, Caruana, Edward J, Cato, Liam D, Catton, Andrew B, Ceretti, Andrea Pisani, Chase, Thomas JG, Chiara, Francesco Di, Chowdhury, Abeed H, Chung, Eric A, Cicerchia, Pierfranco M, Clough, Ethan CS, Coleman, Natasha L, Collins, Chris G, Collins, Michelle L, Colonna, Emily T, Comini, Lara V, Coughlin, Patrick A, Cruzado, Laura Fernández-Gomez, Davidson, Brian R, Davies, Richard J, Davies, Emma J, Davis, Niall F, Dawson, Brett E, Dean, Benjamin JF, Delgado, Maria Garcia-Conde, Diaz, Jose J, Dickson, Kathryn E, Diez-Alonso, Manuel M, Dixon, Jan R, Doe, Matthew J, Drake, Thomas D, Drake, Frederick T, Duffy, John P, Dunne, Declan FJ, Dunne, Naomi JM, Durán-Muñoz-Cruzado, Virginia M, Durst, Alexander ZE, Eardley, Nicola J, Edwards, John G, Elfallal, Ahmed H, Elfiky, Mahmoud MA, Elliott, Jessie A, Emile, Sameh H, Emslie, Katy M, Endorf, Frederick W, Engel, Jamie L, Enjuto, Diego T, Etchill, Eric W, Evans, Jonathan P, Fahey, Brian A, Faria, Carlos S, Feo, Carlo V, Ferguson, Henry JM, Fernandez, Beatriz Dieguez, Fernandez, Andres Garcia, Fernández, Antonio J, Fernández-Pacheco, Borja Camacho, Fitzgerald, J Edward, Fonsi, Giovanni B, Font, Roser Farré, Fowler, Amy L, Fretwell, Kenneth R, Fructuoso, Lorena Sanchon, Fusai, Giuseppe K, Garcia, Miguel Hernandez, Garcia-Ureña, Miguel Angel, Gill, Charn K, Gisbertz, Suzanne S, Del Giudice, Roberto, Giuffrida, Maria Carmela, Di Giuseppe, Matteo, Gómez, María Fanjul, Guariglia, Claudio A, Hainsworth, Alison J, Hall, Bria J, Hall, James RW, Hammond, John S, Haqqani, Maha H, Harrison, Ewen M, Hazelton, Joshua P, van Heinsbergen, Maarten, Hill, Arnold DK, Hing, Caroline B, Hirji, Sameer A, Ho, Michael WS, Holbrook, Charlotte M, Holme, Thomas J, Hopkins, James C, Hopkinson, David N, Hossain, Fahad S, Hudson, Victoria E, Hughes, Jane L, Hwang, E. Shelley, Ibrahim, Mohamed AH, Isolani, Simone M, Jenkinson, Michael D, Jenny, Hillary E, Jeyaretna, Deva S, Jones, Robert P, Jones, Andrew P, Jonker, Pascal KC, Jönsson, Maria L, Joyce, Doireann P, Kalkwarf, Kyle J, Kamarajah, Sivesh K, El Kassas, Mohamed, Kavanagh, Dara O, Keatley, James M, Khalefa, Mohamed A, Khan, Jim S, Kirmani, Bilal H, Kisiel, Aaron P, Kouris, Spyros Marinos, Kowal, Mikolaj R, Labib, Peter L, Larkin, John O, Lauscher, Johannes C, Leclercq, Wouter KG, Ledesma, Frances SJ, Leite-Moreira, André M, Leung, Elaine YL, Lewis, Sophia E, Lima, Maria João, Lin, Daniel J, Liu, Helen H, Lowery, Aoife J, Lozano, Saida Martel, Luney, Catriona R, Maia, Mariana Magalhães, Mariani, Nicolò M, Marino, Marco V, Marra, Angelo A, Marsh, Christopher L, Martin, Robert CG, McCluney, Simon J, McIntyre, Robert C, Mckay, Siobhan C, McKevitt, Kevin L, Meagher, Ashley D, Mehdi, Mohammad Q, Mehigan, Brian J, Gonzalez-De Miguel, Melania, De Miguel-Ardevines, Maria-Carmen, Mills, Sarah J, Mohan, Helen M, Moir, John AG, Monson, John RT, Monteiro, Joana M, Montella, Maria T, Montesinos, Cristina Soto, Morgom, Marwa M, Moura, Francisco S, Muguerza, Jose M, Murphy, Suzanne H, De Nardi, Paola, Naumann, David N, Neary, Paul C, Neely, David TA, Ng-Kamstra, Joshua S, Ngu, Albert WT, Nguyen, Truong A, Nita, George E, Nunes, Quentin M, Nygaard, Rachel M, O'Meara, Lindsay B, O'Neill, John R, Okafor, Barbara U, Olson, Steven A, Oo, Aung Y, Ormazabal, Pablo Collera, Osorio, Alexander L, Pachl, Max J, Parry, James T, Patel, Panna K, Pérez-Sánchez, Luis E, Pevidal, Ana Nogues, Pezzuto, Anna P, Philp, Matthew M, Pinkney, Thomas D, Pollok, Joerg M, Povey, Meical G, Poza, Alfredo Alonso, Rajgor, Amarkumar D, Rao, Jagan N, Raptis, Dimitri A, Rice, Henry E, Ridgway, Paul F, Rivas, Ana Munoz, Rodriguez-Sanjuan, Juan C, Rogers, Luke J, Da Roit, Anna, Rollett, Rebecca A, Romera, Jose L, Rooney, Siobhan M, Roxo, Vanessa I, Le Roy, Bertrand, Rubio, Eduardo E, Ruiz, Carolina Castro, Ruiz, Manuel Losada, Ryan, Éanna J, Saad, Abdel Rahman, Saeed, Samerah A, Salama, Hiba A, Salamah, Abdulrauf A, Sampietro, Gianluca M, Sarma, Diwakar R, Schaffer, Kathryn B, Schnitzbauer, Andreas A, Scurrah, Rachel J, Serevina, Olivia L, Serralheiro, Pedro A, Sewards, Joseph M, Shackcloth, Michael J, Shaw, Abigail V, Sheel, Andrea RG, Sica, Giuseppe S, De Simone, Veronica, Singh, Aminder A, Singh, Rabindra P, Skelly, Brendan L, Smith, Henry G, Sohail, Amir H, Spalding, Duncan R, Springford, Laurie R, Ssentongo, Anna E, Steinkamp, Pieter J, Stevens, Kent A, Stewart, Grant D, Stylianides, Nicholas A, Sullivan, Tom BB, Taher, Ahmed SA, Tamimy, Muhammad S, Tang, Alethea M, Tebala, Giovanni D, Tejero-Pintor, Francisco J, Thaha, Mohamed A, Thomas, Amy J, De Toma, Giorgio, La Torre, Filippo, Torres, Antonio J, Townshend, David N, Trout, Isobel M, Tucker, Sarah C, Ubhi, Harmony K, Vega, Viviana A, Velmahos, George C, Velopulos, Catherine G, Viswanath, Yirupaiahgari KS, Vivas, Alfredo A, Wade, Ryckie G, Wadley, Martin S, Wall, Joshua JS, Walters, Andrew M, Warren, Oliver J, Weerasinghe, Chamindri K, Wilkin, Richard JW, Williams, Katherine J, Winter, Stuart C, Wormald, Justin CR, Wright, Franklin L, Xyda, Souzana E, Young, Alastair L, Youssef, Mina MG, Yousuf, Farhat B, El Youzouri, Hanan, Zappa, Marco A, Abate, Emmanuele, Abdalaziz, Hossam, Abdelkarim, Mostafa, Abdou, Hossam, Aboelkassem-Ibrahim, Ahmad, Abuown, Ala, Acebes-Garcia, Fernando, Acharya, Metesh, Adamina, Michel, Addae-Boateng, Emmanuel, Aftab, Raiyyan, Agarwal, Arnav, Aguilar, José, Ahmed, Yousra, Aitken, Emma, Al-Azzawi, Marwa, Al-Embideen, Somya, Al-Masri, Mahmoud, Al-Najjar, Hani, Al-Sukaini, Ahmad, Alam, Ruhina, Alderson, Derek, Aliyeva, Zumrud, Aljanadi, Firas, Almasri, Murad, Alonso-Ortuño, Paula, Altintoprak, Fatih, Amira, Gamal, Amjad, Rabbia, Anania, Gabriele, Andabaka, Tatjana, Angelou, Dimitrios, Annamalai, Seethalakshmi, Annessi, Valerio, Anthoney, James, Anwar, Sibtain, Anwer, Mariyah, Aragon-Chamizo, Juan, Ardito, Antonella, Arigoni, Michele, Armao, Teodora, Arminio, Armando, Armstrong, Lara, Arnaud, Alexis, Asaad, Peter, Ashcroft, James, Ashmore, Christopher, Asqalan, Ahmad, Asti, Emanuele, Aubry, Emmanuelle, Aytac, Erman, Ayuso-Herrera, Esther, Baeza, Melody, Bailon-Cuadrado, Martin, Bakmaz, Bernarda, Baldi, Caterina, Baldini, Edoardo, Baldo, Stefano, Ballabio, Michele, Baloyiannis, Ioannis, Baltazar, Gerard, Bàmbina, Fabrizio, Bandiera, Alessandro, Barlow, Emma, Barmasse, Roberto, Barmpagianni, Christina, Baronio, Gianluca, Barra, Fabio, Bartsch, Anne-Marie, Basgaran, Amedra, Basha, Amr, Bashkirova, Varvara, Bastazza, Marco, Baumber, Rachel, Belcher, Elizabeth, Belvedere, Angela, Benítez-Linero, Inmaculada, Bergeat, Damien, Bernasconi, Matteo, Bhalla, Ashish, Bhutiani, Neal, Bianco, Federica, Bisagni, Pietro, Blake, Iain, Blanco-Colino, Ruth, Blazquez-Martin, Alma, Boal, Matthew, Bonavina, Luigi, Bonavina, Giulia, Bond-Smith, Giles, Booth, Karen, Borges, Filipe, Borghi, Felice, Bouchagier, Konstantinos, Bourke, Grainne, Boyle, Emily, Brachini, Gioia, Brain, Jessie, Brar, Amanpreet, Breckles, Lisa, Bretagnol, Frédéric, Brixton, Genevieve, Bruzzaniti, Placido, Bueser, Teofila, Burnside, Nathan, Caballero, Albert, Calcerrada-Alises, Enrique, Callahan, Miriam, Camarero, Enrique, Campagnaro, Tommaso, Campanelli, Michela, Candiani, Massimo, Cantalejo-Diaz, Miguel, Cao, Han, Capelli, Patrizio, Capizzi, Vita, Carcano, Giulio, Carissimi, Francesca, Carlini, Massimo, Carlucci, Michele, Carmichael, Heather, Carrasco, Milagros, Carrillo, Mariana, Carvello, Michele, Casati, Massimiliano, Castoro, Carlo, Catalan, Vanesa, Cavaleiro, Salomé, Cellerino, Paola, Centinaio, Giovanna, Cernei, Cristina, Cerro, Cristina, Cervellera, Maurizio, Chakrabortee, Sohini, Chamberlain, Stephanie, Chan, Jeffrey, Chang, Grace, Chaudhry, Dauod, Chebaro, Alexandre, Chen, David, Chetty, Govind, Chia, Zoe, Chiappini, Ambra, Chiarugi, Massimo, Chidambaram, Swathikan, Chiozza, Matteo, Cholewa, Hanna, Chong, Clara, Choolani-Bhojwani, Ekta, Christoforidis, Dimitri, Chui, Karen, Chung, Choyin, Cirillo, Bruno, Citterio, Davide, Clermidi, Pauline, Coccolini, Federico, Colletti, Gaia, Compagnoni, Bruno, Concepción-Martín, Vanesa, Confalonieri, Marco, Connolly, Hannah, Conso, Christel, Conti, Luigi, Cooper, Zara, Cordera, Fernando, Corral, Javier, Costa, Marta, Costanzi, Andrea, Cotsoglou, Christian, Cozza, Valerio, Cuming, Tamzin, Curtis, Miles, Cuschieri, Joseph, D'Agruma, Michele, D'Andrea, Giancarlo, Daliya, Prita, Dare, Oliver, Darko, Ebenezer, Day, Andrew, Dehal, Ahmed, Dehart, Dustin, Delgado-Oliver, Eduardo, Denning, Max, Desai, Anant, Desender, Liesbeth, Dester, Sara, Díaz-García, Alberto, Diaz-Peña, Patricia, Dousset, Bertrand, Doussot, Alexandre, Duchateau, Nicolas, Duff, Sarah, Dunning, Joel, Duque-Mallen, Victoria, Dziakova, Jana, Egan, Bridget, Egan, Richard, El-Ali, Abess, Elfeki, Hossam, Elhadi, Muhammed, Eljareh, Mohammed, Elkady, Ramy, Elkhafeefi, Fatimah, Elmore, Ugo, Elmoslemany, Tarek, Emmerson, Oliver, Enemosah, Ibrahim, English, Camilla, English, William, Escartin, Jorge, Estaire-Gomez, Mercedes, Evans, Luke, Evans, Jessica, Exley, Rebecca, Fabbri, Nicoló, Falco, Giuseppe, Familiari, Pietro, Fancellu, Alessandro, Farik, Shebani, Farrell, Tony, Fehervari, Matyas, Fell, Adam, Fernandez-Camuñas, Angel, Fernández-Marín, Reyes, Fernández-Martínez, María, Ferrara, Francesco, Ferrari, Guglielmo, Ferrero, Simone, Findlay, Laura, Fiore, Marco, Fiori, Enrico, Flatman, Michael, Flindall, Ian, Flor, Blas, Fontana, Tommaso, Ford, Samuel, Ford, David, Forlani, Stefano, Francone, Elisa, Frattaruolo, Colomba, Frio, Federico, Gagliano, Annalisa, Gagliardi, Filippo, Gahunia, Sukhpreet, Gaino, Francesca, Gala, Tanzeela, Galfrascoli, Elisa, Galimberti, Luca, Gallagher, Phoebe, Galleano, Raffaele, Galván-Pérez, Armando, Gammeri, Emanuele, Ganau, Mario, Garcés-García, Raúl, Garulli, Gianluca, Gascon-Ferrer, Isabel, Gattolin, Andrea, Gaujoux, Sebastien, Gentilli, Sergio, Georgiades, Fanourios, Ghanbari, Amir, Ghosh, Dhruv, Giacometti, Marco, Giblin, Anna-Victoria, Gilbert, Catherine, Giménez, Clara, Giorgakis, Emmanouil, Gipponi, Manuel, Glen, Paul, Goatly, Giles, Gobatti, Davide, Godbole, Chintamani, Gohil, Kajal, Gómez, Marcos, Gomez-Rosado, Juan-Carlos, Gonullu, Emre, Gonzalez-Gonzalez, Enrique, Gordini, Luca, Gracia, Isabel, Gracia-Roche, Carlos, Granieri, Stefano, Green, Susanna, Grivon, Manuela, Grove, Thomas, Guaglio, Marcello, Guaitoli, Eleonora, Guglielmi, Alfredo, Guha, Soumya, Gustavino, Claudio, Habeeb, Amir, Hagger, Robert, Hakmi, Hazim, Halkias, Constantine, Hall, Claire, Hampton, Matthew, Handa, Siddhartha, Hansen, Laura, Haq, Iram, Harky, Amer, Harries, Rhiannon, Harrison, Joseph, Hasan, Raashad, Hawari, Mohammad, Hawkin, Paul, Hebblethwaite, Bethany, Henriques, Susana, Heritage, Emily, Hernandez-Juara, Pilar, Herrero-Lopez, Maria, Hervieux, Erik, Heyd, Bruno, Higgs, Simon, Hitchman, Louise, Ho, Beatrice, Hogan, Aisling, Hölzle, Frank, Hossain, Tanvir, Hurt, Libor, Hutchinson, Peter, Iacob, Giulio, Iannone, Immacolata, Ibrahim, Sherif, Iovino, Domenico, Isik, Arda, Jafarova, Sevda, Jamil, Tahir, Jayaraju, Ullas, Jenner, Edward, Jimenez-Higuera, Elisa, Jimeno, Jaime, Jones, Mark, Judkins, Nicholas, Kalavrezos, Nicholas, Kalidindi, Venugopala, Kalkat, Maninder, Kamal, Mona, Kamphues, Carsten, Kang, Chong, Kara, Yasin, Karam, Edward, Karim, Ahmed, Kashora, Florence, Kearney, David, Khajuria, Apoorva, Khan, Umul, Khan, Azam, Khatri, Chetan, Kinnaman, Gabriel, Kinross, James, Kler, Aaron, Klimopoulos, Serafeim, Kocataş, Ali, Kolias, Angelos, Königsrainer, Alfred, Konsten, Joop, Kontovounisios, Christos, Kourdouli, Amar, Krishnan, Emily, Kristinsson, Sverrir, Kruijff, Schelto, Kudsk-Iversen, Søren, Kufeji, Dorothy, Kugler, Nadav, Kulkarni, Rugved, Kurihara, Hayato, Laface, Letizia, Lakkis, Zaher, Lami, Mariam, Landaluce-Olavarria, Aitor, Lapolla, Pierfrancesco, Lawani, Ismail, Lawday, Samuel, Lázaro, André, Lecolle, Katia, Leventoglu, Sezai, Li, Zoe, Liew, Ignatius, Lisi, Giorgio, Lizzi, Vincenzo, Lo, Terence, Lomiento, Daniele, Longhi, Marco, Lostis, Emilie, Lostoridis, Eftychios, Loubani, Mahmoud, Lowy-Benoliel, Alejandro, Lucianetti, Alessandro, Luke, Louis, Lunevicius, Raimundas, Luraghi, Marco, Lye, George, Mabrouk, Islam, Macchi, Alberto, MacDonald, Luisa, Machairas, Nikolaos, Madonini, Marco, Magowan, Drew, Maisonneuve, Emeline, Majkowska, Agata, Majkowski, Lawrence, Mak, Jason, Malabarba, Stefano, Malerba, Michele, Mannan, Syed, Manson, Joanna, Mansuri, Ahmer, Mantoglu, Baris, Manu, Nichola, Maqsood, Afnan, Marano, Alessandra, Marchbank, Adrian, Marcos-Santos, Pablo, Marrano, Enrico, Martin, Janet, Martin, Emmeline, Martin, Guy, Martin-Albo, Lorena, Martín-Román, Lorena, Martinelli, Fabio, Martínez-dePaz, Fernando, Martinez-German, Antonio, Martinez-Pinedo, Carlos, Martins, Ricardo, Marwan, Hisham, Marzi, Federica, Mathieu, Pierre, Matute-Najarro, Maria-Soledad, Maw, Andrew, Mazingi, Dennis, Mazzaferro, Vincenzo, McCanny, Andrew, McKenzie, Katherine, McLarty, Nicola, McPherson, Iain, Medina, Esther, Mediratta, Saniya, Medone, Marzia, Mehra, Gautam, Mele, Simone, Melero-Cortés, Lidia, Mendoza-Moreno, Fernando, Meneghini, Simona, Mercante, Giuseppe, Merdrignac, Aude, Merola, Stephen, Metallidis, Symeon, Michel, Martin, Migliore, Marco, Mihanovic, Jakov, Miller, Douglas, Mingoli, Andrea, Minto, Gary, Mirabella, Antonello, Misra, Nikhil, Mitrasinovic, Stefan, Miu, Victor, Moawad, Nader, Mochet, Sylvie, Modabber, Ali, Mohammad, Adam, Mohan, Midhun, Moliner-Sánchez, Carmen, Mongelli, Francesco, Monteleone, Michela, Montuori, Mauro, Moore, Rachel, Mora-Guzmán, Ismael, Morales, Xavier, Morales, Dieter, Morelli, Luca, Morelli, Lucia, Morgan, Richard, Morris, Chris, Mortini, Pietro, Mosca, Angelo, Motter, Dema, Moug, Susan, Mukherjee, Samrat, Najdy, Manhal, Nakas, Apostolos, Namazov, Ilgar, Naredla, Pradyumna, Nasef, Emmhamed, Nassa, Heeam, Nath, Rahul, Navarro-Sánchez, Antonio, Nazarian, Scarlet, Negri, Giampiero, Nehra, Deepika, Neil-Dwyer, Jason, Neri, Jacopo, Newton, Katy, Nikaj, Herald, Niquen, Milagros, Nobile, Sara, Nogueiro, Jorge, Ntirenganya, Faustin, Nugent, Michael, Núñez, Jordi, Ocaña, Juan, Okechukwu, Valentine, Oliva-Mompean, Fernando, Oliveira, Ana, Ollat, Didier, Onos, Lavinia, Osagie-Clouard, Liza, Osman, Khabab, Ottolina, Jessica, Ourieff, Jared, Outani, Oumaima, Oyewole, Bankole, Ozben, Volkan, Pacheco-Sanchez, David, Padilla-Valverde, David, Pai, Madhava, Paiella, Salvatore, Paisley, Samuel, Palini, Gianmarco, Palmeri, Matteo, Panahi, Pedram, Parente, Alessandro, Parlanti, Daniele, Parmar, Chetan, Pascual, Angela, Patel, Mahul, Pathak, Abhijit, Patil, Sangram, Pattyn, Piet, Peckham-Cooper, Adam, Pedrazzani, Corrado, Pellino, Gianluca, Peluso, Chiara, Pereira, André, Pereira-Neves, António, Perez-Diaz, MD, Pérez-González, Marta, Pérez-Saborido, Baltasar, Perivoliotis, Konstantinos, Perkins, Clare, Peros, Georgios, Perotto, Ornella, Perra, Teresa, Petrone, Patrizio, Phenix, George, Picazo, Sara, Picon-Rodriguez, Rafael, Piloni, Martina, Pingarrón-Martín, Lorena, Pinotti, Enrico, Pisanu, Adolfo, Pizzini, Paolo, Pockney, Peter, Podda, Mauro, Podolsky, Dina, Poggioli, Gilberto, Pompili, Cecilia, Pontari, Michael, Porcu, Alberto, Potter, Ryan, Price, Claire, Pruvot, François-René, Pujol-Muncunill, Roger, Puppo, Andrea, Quante, Markus, Quintana-Villamandos, Begoña, Qureshi, Ali, Radenkovic, Dejan, Rakvin, Ivan, Ramallo-Solís, Irene, Ramcharan, Sean, Ramos, Diego, Ramos-Bonilla, Antonio, Ramzi, Joussi, Rathinam, Sridhar, Rausa, Emanuele, Ravaioli, Matteo, Ravindran, Sharanya, Raymond, Thomas, Razik, Aisha, Redfern, Jennifer, Reguera-Rosal, Julio, Rela, Mariam, Rey-Biel, Juan, Rey-Valcarcel, Cristina, Ribolla, Marta, Richards, Tomos, Richmond, Michael, Righini, Erminio, Rio-Gomez, Javier, Riyat, Harjoat, Rizvi, Sana, Roberts, Keith, Roberts, Matthew, Robertson, Stuart, Robertson, Ronald, Robin-Valle, Alvaro, Rochon, Melissa, Rojo, Mikel, Rolli, Luigi, Romano, Silvio, Ross, Elizabeth, Ross, Howard, Rossborough, Catherine, Rottoli, Matteo, Ruiz-Grande, Fernando, Ruiz-Martin, Irene, Ruiz-Soriano, María, Ruzzenente, Andrea, Ryska, Ondrej, Saez, Carlos, Sagnotta, Andrea, Sahnan, Kapil, Sahni, Arun, Salim, Ali, Sallam, Ibrahim, Salvia, Roberto, Samadov, Elgun, Sammarco, Giuseppe, Sampaio-Alves, Mafalda, Sánchez-Arteaga, Alejandro, Sanchez-Fuentes, Maria-Nieves, Sanchez-Pelaez, Daniel, Sanchez-Perez, Coral, Sanchez-Rubio, Maria, Sancho-Muriel, Jorge, Sanders, Julie, Santero-Ramirez, Maria-Pilar, Santora, Thomas, Santoro, Antonio, Santos, Irene, Santos-Sousa, Hugo, Sapienza, Paolo, Sartarelli, Lodovico, Sarveswaran, Janahan, Sasia, Diego, Saudemont, Alain, Saudi-Moro, Sef, Saxena, Shobhit, Saxena, Dolly, Sayasneh, Ahmad, Scalabre, Aurelien, Schache, Andrew, Schiavina, Riccardo, Schineis, Christian, Schreckenbach, Teresa, Scorza, Antonella, Scott, Lucy, Seegert, Sara, Seguin-Givelet, Agathe, Senent-Boza, Ana, Seymour, Keith, Shabana, Amanda, Shah, Karishma, Shah, Jigar, Shah, Preena, Shah, Sujay, Shakir, Taner, Shalaby, Mostafa, Shankar, Sushma, Shaw, Richard, Shehata, Sameh, Shenfine, Amy, Sheridan, Kelda, Sherief, Ahmed, Sherief, Mohamed, Sherif, Mohamed, Shinkwin, Michael, Shu, Sebastian, Siaw-Acheampong, Kwabena, Sileri, Pierpaolo, Singh, Abhinav, Singh, Shailendra, Sinha, Sanjay, Sinha, Deepti, Siragusa, Leandro, Sivaprakasam, Rajesh, Sivayoganathan, Sriharan, Smillie, Robert, Smith, Claire, Smith, Andrew, Smith, Christopher, Sochorova, Dana, Soggiu, Fiammetta, Sohrabi, Catrin, Solari, Francesca, Solli, Piergiorgio, Soreide, Kjetil, Spinelli, Antonino, Spoletini, Domenico, Spriano, Giuseppe, Sravanam, Sanskrithi, Ssentongo, Paddy, Stanger, Sophie, Stavroulias, Dionisios, Steel, Ben, Stella, Marco, Stewart, Robbie, Stringer, Sally, Sulen, Nina, Sundar, Sudha, Sundhu, Matthew, Suri, Avni, Syed, Arooj, Szatmary, Peter, Tabiri, Stephen, Tadross, Daniel, Taglietti, Lucio, Tansey, Rosamond, Tartaglia, Dario, Tawheed, Ahmed, Tayeh, Salim, Teles, Tobias, Testa, Valentina, Tewari, Nilanjana, Thoenissen, Philipp, Thomas, Kane, Thomin, Anne, Thrush, Jessica, Tierney, Sean, Tiwari, Abhinav, Toh, Simon, Toledo, Enrique, Tonini, Valeria, Torkington, Jared, Torquati, Alfonso, Torzilli, Guido, Totty, Joshua, Tourountzi, Paraskevi, Tousidonis, Manuel, Townend, Philip, Townsend, Catherine, Trompeter, Alex, Trotta, Francesco, Truant, Stéphanie, Trujillo-Díaz, Jeancarlos, Tsoulfas, Georgios, Turco, Celia, Turrado-Rodriguez, Victor, Turri, Giulia, Tustin, Harry, Tyler, Jayne, Tzedakis, Stylianos, Tzovaras, George, Uittenbogaart, Martine, Ullah, Ramzan, Urban, Shane, Urbani, Alessia, Usai, Antonella, Vaccarella, Gianpaolo, Valdes-Hernandez, Javier, Valsecchi, Luca, Vashisht, Rajiv, Vázquez-Fernández, Andrea, Venn, Mary, Vera-Mansilla, Cristina, Vergari, Roberto, Vescio, Giuseppina, Vidya, Raghavan, Vieira, Paula, Vijay, Vardhini, Vimalachandran, Dale, Violante, Tommaso, Volpe, 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Aloka S D, Al Maadany, Faraj S, De Marchi, Joshua A, Ramos-De la Medina, Antonio, Mithany, Reda H M, Sanchez del Pueblo, Cristina, van Ramshorst, Gabriëlle, De Salas, Maria Marqueta, De Souza, Anthony C, Dolores Del Toro, M, Archer, James E, Odeh, Abdulrahman, Erridge, Simon, Salem, Hosni Khairy, Jones, Gareth P, Gardner, Anne, Tripathi, Shiva S, Gregg, Anne, Jeganathan, Reuben, Siddique, Muhammad Harris, Lombardi, Celestino P, Martin, Benjamin, Leo, Cosimo Alex, Dass, Debashis, Di Franco, Gregorio, Jiao, Long R, Mari, Giulio Maria, Capitan-Morales, Luis-Cristobal, Connelly, Tara M, Alanbuki, Ammar, De Virgilio, Armando, Schilling, Clare, San Miguel Mendez, Carlos, Kulkarni, Gauri, Nizami, Kulsoom, Walsh, Stewart, Dean, Harry, Ruiz-Marin, Miguel, Houston, Rory, Trompetto, Mario, Chrastek, David, Kouritas, Vasileios, Cannoletta, Maria, Rosato, Francesco, Kaushal, Manish V, Costa, Paulo Matos, Elkadi, Hannah H, Johnstone, Jack R, Irvine, Esmee, Alvarez, Maria R, Corbellini, Carlo, Venkatesan, Gowtham S, Mateo-Sierra, Olga, Martínez-Pérez, Carolina, Serrano González, Javier, Hernández Bartolomé, Miguel Ángel, Díaz Pérez, David, Gutiérrez Samaniego, María, Galindo Jara, Pablo, Sharma, Neil, Smart, Neil J, Keller, Deborah S, COVIDsurg Collaborative, [missing], Nepogodiev, Dmitri, Glasbey, James C, Li, Elizabeth, Omar, Omar M, Simoes, Joana FF, Abbott, Tom EF, Alser, Osaid, Arnaud, Alexis P, Bankhead-Kendall, Brittany K, Breen, Kerry A, Cunha, Miguel F, Davidson, Giana H, Di Saverio, Salomone, Gallo, Gaetano, Griffiths, Ewen A, Gujjuri, Rohan R, Hutchinson, Peter J, Kaafarani, Haytham MA, Lederhuber, Han, Löffler, Markus W, Mashbari, Hassan N, Minaya-Bravo, Ana, Morton, Dion G, Moszkowicz, David, Pata, Francesco, Tsoulfas, George, Venn, Mary L, Bhangu, Aneel, Cox, Daniel, Roslani, April C, Alakaloko, Felix, de Vries, Jean-Paul PM, Aaraj, Mahmoud A, Abbott, Sarah J, Abdalla, Mutwakil OM, Abdelaal, Ahmed S, Ademuyiwa, Adesoji O, Aherne, Thomas M, Ali, Osman M, Alkadeeki, Ghadah Z, Almeida, Ana C, Alrahawy, Mahmoud M, Ambler, Graeme K, Alameer, Ehab, Andreani, Stefano M, De Andrés-Asenjo, Beatriz, Antonanzas, Leyre Lopez, Aoun, Salah G, Ashoush, Fouad M, Augestad, Knut Magne, Avellana, Rocio B, Ayeni, Funbi A, Ayorinde, John OO, Babu, Bheemanakone H, Baig, Mirza MAS, Bajomo, Oreoluwa M, Baker, Olivia J, Baker, Markus P, Baldwin, Alexander J, Ban, Vin Shen, Baron, Ryan D, Barranquero, Alberto G, Barry, Conor P, DI Bartolomeo, Alessandro, Bass, Gary A, Bath, Michael F, Batjer, H Hunt, Beamish, Andrew J, Belgaumkar, Ajay P, Bence, Matthew N, Benson, Ruth A, Bernal-Sprekelsen, Juan Carlo, Bhama, Anuradha R, Bhavaraju, Avi V, Biffl, Walter L, Blundell, Chris M, Boddy, Alexander P, Borgstein, Alexander BJ, Bosanquet, David C, Bosch, Karen D, Bouhuwaish, Ahmad EM, Bozkurt, Mehmet A, Brathwaite, Collin EM, Brown, Benjamin C, Brown, Oliver D, Brown, Allison K, Buarque, Igor Lima, Bueno-Cañones, Alejandro D, Bulugma, Mustafa R, Burke, Joshua R, Byrne, Matthew HV, Cagigal-Ortega, Elima P, Callcut, Rachael A, DI Candido, Francesca, Canova, Michaela E, Carlos, William J, Caruana, Edward J, Cato, Liam D, Catton, Andrew B, Ceretti, Andrea Pisani, Chase, Thomas JG, Chiara, Francesco Di, Chowdhury, Abeed H, Chung, Eric A, Cicerchia, Pierfranco M, Clough, Ethan CS, Coleman, Natasha L, Collins, Chris G, Collins, Michelle L, Colonna, Emily T, Comini, Lara V, Connolly, Tara M, Coughlin, Patrick A, Cruzado, Laura Fernández-Gomez, Davidson, Brian R, Davies, Richard J, Davies, Emma J, Davis, Niall F, Dawson, Brett E, Dean, Benjamin JF, Delgado, Maria Garcia-Conde, Diaz, Jose J, Dickson, Kathryn E, Diez-Alonso, Manuel M, Dixon, Jan R, Doe, Matthew J, Drake, Thomas D, Drake, Frederick T, Duffy, John P, Dunne, Declan FJ, Dunne, Naomi JM, Durán-Muñoz-Cruzado, Virginia M, Durst, Alexander ZE, Eardley, Nicola J, Edwards, John G, Elfallal, Ahmed H, Elfiky, Mahmoud MA, Elliott, Jessie A, Emile, Sameh H, Emslie, Katy M, Endorf, Frederick W, Engel, Jamie L, Enjuto, Diego T, Etchill, Eric W, Evans, Jonathan P, Fahey, Brian A, Faria, Carlos S, Feo, Carlo V, Ferguson, Henry JM, Fernandez, Beatriz Dieguez, Fernandez, Andres Garcia, Fernández, Antonio J, Fernández-Pacheco, Borja Camacho, Fitzgerald, J Edward, Fonsi, Giovanni B, Font, Roser Farré, Fowler, Amy L, Franco, Gregorio Di, Fretwell, Kenneth R, Fructuoso, Lorena Sanchon, Fusai, Giuseppe K, Garcia, Miguel Hernandez, Garcia-Ureña, Miguel Angel, Gill, Charn K, Gisbertz, Suzanne S, Del Giudice, Roberto, Giuffrida, Maria Carmela, Di Giuseppe, Matteo, Gómez, María Fanjul, González, Javier Serrano, Guariglia, Claudio A, Hainsworth, Alison J, Hall, Bria J, Hall, James RW, Hammond, John S, Haqqani, Maha H, Harrison, Ewen M, Hazelton, Joshua P, van Heinsbergen, Maarten, Hill, Arnold DK, Hing, Caroline B, Hirji, Sameer A, Ho, Michael WS, Holbrook, Charlotte M, Holme, Thomas J, Hopkins, James C, Hopkinson, David N, Hossain, Fahad S, Hudson, Victoria E, Hughes, Jane L, Hwang, E. Shelley, Ibrahim, Mohamed AH, Isolani, Simone M, Jara, Pablo Galindo, Jenkinson, Michael D, Jenny, Hillary E, Jeyaretna, Deva S, Jones, Robert P, Jones, Andrew P, Jonker, Pascal KC, Jönsson, Maria L, Joyce, Doireann P, Kalkwarf, Kyle J, Kamarajah, Sivesh K, El Kassas, Mohamed, Kavanagh, Dara O, Keatley, James M, Khalefa, Mohamed A, Khan, Jim S, Kirmani, Bilal H, Kisiel, Aaron P, Kouris, Spyros Marino, Kowal, Mikolaj R, Labib, Peter L, Larkin, John O, Lauscher, Johannes C, Leclercq, Wouter KG, Ledesma, Frances SJ, Leite-Moreira, André M, Leung, Elaine YL, Lewis, Sophia E, Lima, Maria João, Lin, Daniel J, Liu, Helen H, Lowery, Aoife J, Lozano, Saida Martel, Luney, Catriona R, Maia, Mariana Magalhãe, Mariani, Nicolò M, Marino, Marco V, Marra, Angelo A, Marsh, Christopher L, Martin, Robert CG, Mccluney, Simon J, Mcintyre, Robert C, Mckay, Siobhan C, Mckevitt, Kevin L, Meagher, Ashley D, Mehdi, Mohammad Q, Mehigan, Brian J, Gonzalez-De Miguel, Melania, De Miguel-Ardevines, Maria-Carmen, Miguel-Mendez, Carlos San, Mills, Sarah J, Mohan, Helen M, Moir, John AG, Monson, John RT, Monteiro, Joana M, Montella, Maria T, Montesinos, Cristina Soto, Morgom, Marwa M, Moura, Francisco S, Muguerza, Jose M, Murphy, Suzanne H, De Nardi, Paola, Naumann, David N, Neary, Paul C, Neely, David TA, Ng-Kamstra, Joshua S, Ngu, Albert WT, Nguyen, Truong A, Nita, George E, Nunes, Quentin M, Nygaard, Rachel M, O'Meara, Lindsay B, O'Neill, John R, Okafor, Barbara U, Olson, Steven A, Oo, Aung Y, Ormazabal, Pablo Collera, Osorio, Alexander L, Pachl, Max J, Parry, James T, Patel, Panna K, Pérez, David Díaz, Pérez, Carolina Martínez, Pérez-Sánchez, Luis E, Pevidal, Ana Nogue, Pezzuto, Anna P, Philp, Matthew M, Pinkney, Thomas D, Pollok, Joerg M, Povey, Meical G, Poza, Alfredo Alonso, Rajgor, Amarkumar D, Rao, Jagan N, Raptis, Dimitri A, Rice, Henry E, Ridgway, Paul F, Rivas, Ana Munoz, Rodriguez-Sanjuan, Juan C, Rogers, Luke J, Da Roit, Anna, Rollett, Rebecca A, Romera, Jose L, Rooney, Siobhan M, Roxo, Vanessa I, Le Roy, Bertrand, Rubio, Eduardo E, Ruiz, Carolina Castro, Ruiz, Manuel Losada, Ryan, Éanna J, Saad, Abdel Rahman, Saeed, Samerah A, Salama, Hiba A, Salamah, Abdulrauf A, Samaniego, María Gutiérrez, Sampietro, Gianluca M, Sarma, Diwakar R, Schaffer, Kathryn B, Schnitzbauer, Andreas A, Scurrah, Rachel J, Serevina, Olivia L, Serralheiro, Pedro A, Sewards, Joseph M, Shackcloth, Michael J, Shaw, Abigail V, Sheel, Andrea RG, Sica, Giuseppe S, De Simone, Veronica, Singh, Aminder A, Singh, Rabindra P, Skelly, Brendan L, Smith, Henry G, Sohail, Amir H, Spalding, Duncan R, Springford, Laurie R, Ssentongo, Anna E, Steinkamp, Pieter J, Stevens, Kent A, Stewart, Grant D, Stylianides, Nicholas A, Sullivan, Tom BB, Taher, Ahmed SA, Tamimy, Muhammad S, Tang, Alethea M, Tebala, Giovanni D, Tejero-Pintor, Francisco J, Thaha, Mohamed A, Thomas, Amy J, De Toma, Giorgio, La Torre, Filippo, Torres, Antonio J, Townshend, David N, Trout, Isobel M, Tucker, Sarah C, Ubhi, Harmony K, Vega, Viviana A, Velmahos, George C, Velopulos, Catherine G, Viswanath, Yirupaiahgari KS, Vivas, Alfredo A, Wade, Ryckie G, Wadley, Martin S, Wall, Joshua JS, Walters, Andrew M, Warren, Oliver J, Weerasinghe, Chamindri K, Wilkin, Richard JW, Williams, Katherine J, Winter, Stuart C, Wormald, Justin CR, Wright, Franklin L, Xyda, Souzana E, Young, Alastair L, Youssef, Mina MG, Yousuf, Farhat B, El Youzouri, Hanan, Zappa, Marco A, Abate, Emmanuele, Abdalaziz, Hossam, Abdelkarim, Mostafa, Abdou, Hossam, Aboelkassem-Ibrahim, Ahmad, Abuown, Ala, Acebes-Garcia, Fernando, Acharya, Metesh, Adamina, Michel, Addae-Boateng, Emmanuel, Aftab, Raiyyan, Agarwal, Arnav, Aguilar, José, Ahmed, Yousra, Aitken, Emma, Al-Azzawi, Marwa, Al-Embideen, Somya, Al-Masri, Mahmoud, Al-Najjar, Hani, Al-Sukaini, Ahmad, Alam, Ruhina, Alderson, Derek, Aliyeva, Zumrud, Aljanadi, Fira, Almasri, Murad, Alonso-Ortuño, Paula, Altintoprak, Fatih, Amira, Gamal, Amjad, Rabbia, Anania, Gabriele, Andabaka, Tatjana, Angelou, Dimitrio, 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Fernando, Martinez-German, Antonio, Martinez-Pinedo, Carlo, Martins, Ricardo, Marwan, Hisham, Marzi, Federica, Mateos-Sierra, Olga, Mathieu, Pierre, Matute-Najarro, Maria-Soledad, Maw, Andrew, Mazingi, Denni, Mazzaferro, Vincenzo, Mccanny, Andrew, Mckenzie, Katherine, Mclarty, Nicola, Mcpherson, Iain, Medina, Esther, Mediratta, Saniya, Medone, Marzia, Mehra, Gautam, Mele, Simone, Melero-Cortés, Lidia, Mendoza-Moreno, Fernando, Meneghini, Simona, Mercante, Giuseppe, Merdrignac, Aude, Merola, Stephen, Metallidis, Symeon, Michel, Martin, Migliore, Marco, Mihanovic, Jakov, Miller, Dougla, Mingoli, Andrea, Minto, Gary, Mirabella, Antonello, Misra, Nikhil, Mitrasinovic, Stefan, Miu, Victor, Moawad, Nader, Mochet, Sylvie, Modabber, Ali, Mohammad, Adam, Mohan, Midhun, Moliner-Sánchez, Carmen, Mongelli, Francesco, Monteleone, Michela, Montuori, Mauro, Moore, Rachel, Mora-Guzmán, Ismael, Morales, Xavier, Morales, Dieter, Morelli, Luca, Morelli, Lucia, Morgan, Richard, Morris, Chri, Mortini, Pietro, Mosca, Angelo, Motter, Dema, Moug, Susan, Mukherjee, Samrat, Najdy, Manhal, Nakas, Apostolo, Namazov, Ilgar, Naredla, Pradyumna, Nasef, Emmhamed, Nassa, Heeam, Nath, Rahul, Navarro-Sánchez, Antonio, Nazarian, Scarlet, Negri, Giampiero, Nehra, Deepika, Neil-Dwyer, Jason, Neri, Jacopo, Newton, Katy, Nikaj, Herald, Niquen, Milagro, Nobile, Sara, Nogueiro, Jorge, Ntirenganya, Faustin, Nugent, Michael, Núñez, Jordi, Ocaña, Juan, Okechukwu, Valentine, Oliva-Mompean, Fernando, Oliveira, Ana, Ollat, Didier, Onos, Lavinia, Osagie-Clouard, Liza, Osman, Khabab, Ottolina, Jessica, Ourieff, Jared, Outani, Oumaima, Oyewole, Bankole, Ozben, Volkan, Pacheco-Sanchez, David, Padilla-Valverde, David, Pai, Madhava, Paiella, Salvatore, Paisley, Samuel, Palini, Gianmarco, Palmeri, Matteo, Panahi, Pedram, Parente, Alessandro, Parlanti, Daniele, Parmar, Chetan, Pascual, Angela, Patel, Mahul, Pathak, Abhijit, Patil, Sangram, Pattyn, Piet, Peckham-Cooper, Adam, Pedrazzani, Corrado, Pellino, Gianluca, 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Tomo, Richmond, Michael, Righini, Erminio, Rio-Gomez, Javier, Riyat, Harjoat, Rizvi, Sana, Roberts, Keith, Roberts, Matthew, Robertson, Stuart, Robertson, Ronald, Robin-Valle, Alvaro, Rochon, Melissa, Rojo, Mikel, Rolli, Luigi, Romano, Silvio, Ross, Elizabeth, Ross, Howard, Rossborough, Catherine, Rottoli, Matteo, Ruiz, Miguel, Ruiz-Grande, Fernando, Ruiz-Martin, Irene, Ruiz-Soriano, María, Ruzzenente, Andrea, Ryska, Ondrej, Saez, Carlo, Sagnotta, Andrea, Sahnan, Kapil, Sahni, Arun, Salim, Ali, Sallam, Ibrahim, Salvia, Roberto, Samadov, Elgun, Sammarco, Giuseppe, Sampaio-Alves, Mafalda, Sánchez-Arteaga, Alejandro, Sanchez-Fuentes, Maria-Nieve, Sanchez-Pelaez, Daniel, Sanchez-Perez, Coral, Sanchez-Rubio, Maria, Sancho-Muriel, Jorge, Sanders, Julie, Santero-Ramirez, Maria-Pilar, Santora, Thoma, Santoro, Antonio, Santos, Irene, Santos-Sousa, Hugo, Sapienza, Paolo, Sartarelli, Lodovico, Sarveswaran, Janahan, Sasia, Diego, Saudemont, Alain, Saudi-Moro, Sef, Saxena, Shobhit, Saxena, Dolly, 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Mendoza-Moreno F., Meneghini S., Mercante G., Merdrignac A., Merola S., Metallidis S., Michel M., Migliore M., Mihanovic J., Miller D., Mingoli A., Minto G., Mirabella A., Misra N., Mitrasinovic S., Miu V., Moawad N., Mochet S., Modabber A., Mohammad A., Mohan M., Moliner-Sanchez C., Mongelli F., Monteleone M., Montuori M., Moore R., Mora-Guzman I., Morales X., Morales D., Morelli L., Morgan R., Morris C., Mortini P., Mosca A., Motter D., Moug S., Mukherjee S., Najdy M., Nakas A., Namazov I., Naredla P., Nasef E., Nassa H., Nath R., Navarro-Sanchez A., Nazarian S., Negri G., Nehra D., Neil-Dwyer J., Neri J., Newton K., Nikaj H., Niquen M., Nobile S., Nogueiro J., Ntirenganya F., Nugent M., Nunez J., Ocana J., Okechukwu V., Oliva-Mompean F., Oliveira A., Ollat D., Onos L., Osagie-Clouard L., Osman K., Ottolina J., Ourieff J., Outani O., Oyewole B., Ozben V., Pacheco-Sanchez D., Padilla-Valverde D., Pai M., Paiella S., Paisley S., Palini G., Palmeri M., Panahi P., Parente A., Parlanti D., Parmar C., Pascual A., Patel M., Pathak A., Patil S., Pattyn P., Peckham-Cooper A., Pedrazzani C., Pellino G., Peluso C., Pereira A., Pereira-Neves A., Perez-Diaz M.D., Perez-Gonzalez M., Perez-Saborido B., Perivoliotis K., Perkins C., Peros G., Perotto O., Perra T., Petrone P., Phenix G., Picazo S., Picon-Rodriguez R., Piloni M., Pingarron-Martin L., Pinotti E., Pisanu A., Pizzini P., Pockney P., Podda M., Podolsky D., Poggioli G., Pompili C., Pontari M., Porcu A., Potter R., Price C., Pruvot F.-R., Pujol-Muncunill R., Puppo A., Quante M., Quintana-Villamandos B., Qureshi A., Radenkovic D., Rakvin I., Ramallo-Solis I., Ramcharan S., Ramos D., Ramos-Bonilla A., Ramzi J., Rathinam S., Rausa E., Ravaioli M., Ravindran S., Raymond T., Razik A., Redfern J., Reguera-Rosal J., Rela M., Rey-Biel J., Rey-Valcarcel C., Ribolla M., Richards T., Richmond M., Righini E., Rio-Gomez J., Riyat H., Rizvi S., Roberts K., Roberts M., Robertson S., Robertson R., Robin-Valle A., Rochon M., Rojo M., Rolli L., Romano S., Ross E., Ross H., Rossborough C., Rottoli M., Ruiz-Grande F., Ruiz-Martin I., Ruiz-Soriano M., Ruzzenente A., Ryska O., Saez C., Sagnotta A., Sahnan K., Sahni A., Salim A., Sallam I., Salvia R., Samadov E., Sammarco G., Sampaio-Alves M., Sanchez-Arteaga A., Sanchez-Fuentes M.-N., Sanchez-Pelaez D., Sanchez-Perez C., Sanchez-Rubio M., Sancho-Muriel J., Sanders J., Santero-Ramirez M.-P., Santora T., Santoro A., Santos I., Santos-Sousa H., Sapienza P., Sartarelli L., Sarveswaran J., Sasia D., Saudemont A., Saudi-Moro S., Saxena S., Saxena D., Sayasneh A., Scalabre A., Schache A., Schiavina R., Schineis C., Schreckenbach T., Scorza A., Scott L., Seegert S., Seguin-Givelet A., Senent-Boza A., Seymour K., Shabana A., Shah K., Shah J., Shah P., Shah S., Shakir T., Shalaby M., Shankar S., Shaw R., Shehata S., Shenfine A., Sheridan K., Sherief A., Sherief M., Sherif M., Shinkwin M., Shu S., Siaw-Acheampong K., Sileri P., Singh A., Singh S., Sinha S., Sinha D., Siragusa L., Sivaprakasam R., Sivayoganathan S., Smillie R., Smith C., Smith A., Sochorova D., Soggiu F., Sohrabi C., Solari F., Solli P., Soreide K., Spinelli A., Spoletini D., Spriano G., Sravanam S., Ssentongo P., Stanger S., Stavroulias D., Steel B., Stella M., Stewart R., Stringer S., Sulen N., Sundar S., Sundhu M., Suri A., Syed A., Szatmary P., Tabiri S., Tadross D., Taglietti L., Tansey R., Tartaglia D., Tawheed A., Tayeh S., Teles T., Testa V., Tewari N., Thoenissen P., Thomas K., Thomin A., Thrush J., Tierney S., Tiwari A., Toh S., Toledo E., Tonini V., Torkington J., Torquati A., Torzilli G., Totty J., Tourountzi P., Tousidonis M., Townend P., Townsend C., Trompeter A., Trotta F., Truant S., Trujillo-Diaz J., Turco C., Turrado-Rodriguez V., Turri G., Tustin H., Tyler J., Tzedakis S., Tzovaras G., Uittenbogaart M., Ullah R., Urban S., Urbani A., Usai A., Vaccarella G., Valdes-Hernandez J., Valsecchi L., Vashisht R., Vazquez-Fernandez A., Venn M., Vera-Mansilla C., Vergari R., Vescio G., Vidya R., Vieira P., Vijay V., Vimalachandran D., Violante T., Volpe A., Vovola F., Vulliamy P., Wall R., Wallwork K., Ward A., Warwick D., Waseem S., Weaver H., Wells F., Wen J., West R., Whitehall E., Wild L., Wilkins A., Williams G., Williams M., Winnand P., Wong K., Worku D., Wright N., Yalamanchili S., Yershov D., Yildiz A., Young R., Yurttas C., Zadegan F., Zafar N., Zakaria R., Zambon M., Zanini N., Zarate A., Zerbib P., Zizzo M., Zmora O., Zonta S., van Berge Henegouwen M.I., van der Plas W.Y., Ali I.A.M., Bakri N.A.C., Bauset J.C.C., Abou Chaar M.K., Marino Cosentino L.M., Gomez Diaz C.J., Garcia Galocha J.L., de Gheldere C.A., Ataide Gomes G.M., Beltran de Heredia J., Blazer III D.G., Nugent III W.C., Ali karar A.A., Borja De Lacy F., Blas Laina J.L., Shane Lester M.J., Liyanage A.S.D., Al Maadany F.S., De Marchi J.A., Ramos-De la Medina A., Mithany R.H.M., Sanchez del Pueblo C., van Ramshorst G.H., De Salas M.M., De Souza A.C., Dolores Del Toro M., Archer J.E., Odeh A., Erridge S., Salem H.K., Jones G.P., Gardner A., Tripathi S.S., Gregg A., Jeganathan R., Siddique M.H., Lombardi C.P., Martin B., Leo C.A., Dass D., Di Franco G., Jiao L.R., Mari G.M., Capitan-Morales L.-C., Connelly T.M., Alanbuki A., De Virgilio A., Schilling C., San Miguel Mendez C., Kulkarni G., Nizami K., Walsh S., Dean H., Ruiz-Marin M., Houston R., Trompetto M., Chrastek D., Kouritas V., Cannoletta M., Rosato F., Kaushal M.V., Costa P.M., Elkadi H.H., Johnstone J.R., Irvine E., Alvarez M.R., Corbellini C., Venkatesan G.S., Mateo-Sierra O., Martinez-Perez C., Serrano Gonzalez J., Hernandez Bartolome M.A., Diaz Perez D., Gutierrez Samaniego M., Galindo Jara P., Sharma N., Smart N.J., Keller D.S., AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Surgery, Graduate School, Almaadany, F. S., Samadov, E., Namazov, I., Jafarova, S., Ramshorst, G. H. V., Pattyn, P., Desender, L., Gheldere, C. A. D., Duchateau, N., Mihanovic, J., Sulen, N., Andabaka, T., Rakvin, I., Bakmaz, B., Smith, H. G., Jonsson, M. L., Kassas, M. E., Tawheed, A., Shehata, S., Ashoush, F. M., Abdelaal, A. S., Elfiky, M. M. A., Emile, S. H., Elfallal, A. H., Elfeki, H., Shalaby, M., Alrahawy, M. M., Sallam, I., Amira, G., Sherief, A., Sherief, M., Lakkis, Z., Doussot, A., Turco, C., Heyd, B., Mathieu, P., Chebaro, A., Lecolle, K., Zerbib, P., Truant, S., Saudemont, A., Pruvot, F. -R., Arnaud, A. P., Bergeat, D., Merdrignac, A., Scalabre, A., Roy, B. L., Perotto, O., Tzedakis, S., Gaujoux, S., Dousset, B., Moszkowicz, D., Bretagnol, F., Hervieux, E., Maisonneuve, E., Clermidi, P., Aubry, E., Thomin, A., Seguin-Givelet, A., Zadegan, F., Conso, C., Ollat, D., Kamphues, C., Lauscher, J. C., Schineis, C., Schnitzbauer, A. A., Thoenissen, P., Youzouri, H. E., Schreckenbach, T., Nguyen, T. A., Modabber, A., Holzle, F., Winnand, P., Konigsrainer, A., Quante, M., Yurttas, C., Loffler, M. W., Klimopoulos, S., Tzovaras, G., Baloyiannis, I., Perivoliotis, K., Lostoridis, E., Tourountzi, P., Marchi, J. A. D., Farrell, T., Davis, N. F., Kearney, D., Larkin, J. O., Mohan, H. M., Mehigan, B. J., Fahey, B. A., Barry, C. P., Elliott, J. A., Bass, G. A., Connelly, T. M., Kavanagh, D. O., Elkady, R., Neary, P. C., Ridgway, P. F., Joyce, D. P., Tierney, S., Boyle, E., Egan, B., Lowery, A. J., Collins, C. G., Hogan, A., Mckevitt, K. L., Ryan, E. J., Fowler, A. L., Aherne, T. M., Nizami, K., Walsh, S., Zmora, O., Kugler, N., Falco, G., Ruiz, C. C., Mele, S., Annessi, V., Ferrari, G., Montella, M. T., Mariani, N. M., Ceretti, A. P., Lomiento, D., Taglietti, L., Giudice, R. D., Compagnoni, B., Dester, S., Granieri, S., Cotsoglou, C., Campagnaro, T., Turri, G., Guglielmi, A., Ruzzenente, A., Pedrazzani, C., Salvia, R., Paiella, S., Nobile, S., Marino, M. 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C., Palini, G., Garulli, G., Ballabio, M., Bisagni, P., Pizzini, P., Gagliano, A., Armao, T., Longhi, M., Madonini, M., Luraghi, M., Galimberti, L., Romano, S., Bastazza, M., Trotta, F., Gipponi, M., Malabarba, S., Centinaio, G., Mochet, S., Usai, A., Grivon, M., Barmasse, R., Sagnotta, A. S., Marino, L. M. P., Galleano, R., Malerba, M., Baldo, S., Ligure, P., Casati, M., Abate, E., Laface, L., Brianza, C., Lizzi, V., Vovola, F., Arminio, A., Vergari, R., Rausa, E., Bianco, F., Lucianetti, A., Guaitoli, E., Pinotti, E., Carissimi, F., Montuori, M., Baronio, G., Campanelli, M., Sica, G. S., Siragusa, L. S., Lapolla, P., Mingoli, A., Toma, G. D., Fiori, E., Torre, F. L., Sapienza, P., Brachini, G., Cirillo, B., Iannone, I., Zambon, M., Chiappini, A., Meneghini, S., Fonsi, G. B., Cicerchia, P. M., Bruzzaniti, P., Santoro, A., Bartolomeo, A. 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J., Roberts, M., Robertson, R., Callcut, R. A., Canova, M. E., Suri, A., Velopulos, C. G., Carmichael, H., Mcintyre, R. C., Wright, F. L., Urban, S., Martin, R. C. G., Bhutiani, N., Diaz, J. J., Abdou, H., O'Meara, L. B., Richmond, M., Almasri, M., Marwan, H., Mehdi, M. Q., Kulkarni, G., Ban, V. S., Aoun, S. G., Batjer, H. H., Bhangu, A., Guided Treatment in Optimal Selected Cancer Patients (GUTS), Robotics and image-guided minimally-invasive surgery (ROBOTICS), and Universidad de Cantabria
Subjects: Male, Emergency Medical Services, Respiratory Tract Diseases, Coronavirus Infections/complications, sars cov2, Settore MED/10 - MALATTIE DELL'APPARATO RESPIRATORIO, 030204 cardiovascular system & hematology, SARS-CoV-2, acute respiratory syndrome, pulmonary complication, 0302 clinical medicine, Postoperative Complications, Retrospective Studie, CONSENSUS DEFINITIONS, Epidemiology, Medicine and Health Sciences, Medicine, Surgery, Postoperative complications, Mortality, COVID-19, 030212 general & internal medicine, Hospital Mortality, Viral, Respiratory Tract Disease, 11 Medical and Health Sciences, Mortality rate, Covid19, Operative/adverse effects, General Medicine, Middle Aged, Elective Surgical Procedures/adverse effects, Operative, Elective Surgical Procedures, Surgical Procedures, Operative, Female, COVID-19. Global surgery. Perioperative SARS-CoV-2 infection. International cohort study, Coronavirus Infections, Human, Cohort study, Surgical Procedures, Operative/adverse effects, Adult, medicine.medical_specialty, Respiratory Tract Diseases/etiology, Pneumonia, Viral, NO, COVIDSurg Collaborative, 03 medical and health sciences, Viral/complications, Betacoronavirus, Young Adult, General & Internal Medicine, Humans, Mortality, Elective surgery, Pandemics, LS7_4, Aged, Retrospective Studies, Surgical Procedures, Betacoronaviru, Elective Surgical Procedure, Pandemic, Coronavirus Infection, Emergency Medical Service, business.industry, No key words available, Postoperative complication, COVID-19, Retrospective cohort study, Odds ratio, Perioperative, Pneumonia, Surgery, Pneumonia, Viral/complications, Postoperative Complication, business
Abstract: The lancet 396(10243), 27-38 (2020). doi:10.1016/S0140-6736(20)31182-X, Published by Elsevier, London [u.a.]
Published: 2020
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46. HEMOGLOBINÚRIA PAROXISTICA NOTURNA E ANEMIA APLÁSTICA – RELATO DE CASO

Author: Marysilvia Ferreira da Costa, A Debbo, WS Teles, Mhss Hosanaphotmailcom, Pccs Junior, MC Silva, Alj Morais, Renato Cesar Sacchetto Torres, RN Silva, and Amms Barros
Subjects: Gynecology, medicine.medical_specialty, business.industry, Immunology and Allergy, Medicine, Diseases of the blood and blood-forming organs, Hematology, RC633-647.5, business
Abstract: Introducao A HPN e um disturbio clonal causado por uma mutacao adquirida no gene PIGA das celulas-tronco hematopoieticas. O gene PIGA, localizado no cromossomo X, codifica uma proteina que e parte integral da formacao da âncora de glicosilfosfatidilinositol (GPI) para proteinas de membrana. Mutacoes no PIGA resultam na perda de todas as proteinas ancoradas no GPI, como a CD59, uma importante proteina reguladora do complemento, na superficie dos eritrocitos. Como consequencia, as celulas ficam suscetiveis a ativacao pelo complemento, levando a hemolise intravascular continua. Objetivo Relatar um caso de Anemia Aplastica, com a associacao a Hemoglobinuria Paroxistica Noturna (HPN), enfatizando os aspectos fisiopatologicos, clinicos, diagnosticos e tratamento. Material e metodos Trata-se de um estudo de carater exploratorio transversal por meio da analise dos prontuarios e resultados de exames. Resultados Paciente feminino de 54 anos, com diagnostico (AA) severa sintomatica (resposta da serie granulocitica e plaquetaria apos o uso de imunossupressor (ciclosporina), apresentando associado a anemia, DHL elevado, aumento da bilirrubina indireta e teste de coombs negativo, com citometria de fluxo positiva HPN, demonstrando que 33% das hemacias apresentam perda total de expressao de CD59 (populacao HPN III). Da mesma forma, 86% dos neutrofilos apresentam perda de expressao CD24 e aerolisina, em 91% dos monocitos apresentam perda de expressao de CD14 e aerolisina. Na ocasiao do tratamento a paciente teve necessidade transfusional (hemacias filtradas) em decorrer da AA. No decorrer do monitoramento apresentou diminuicao das plaquetas associada a astenia, sangramento retal, leucopenia, tendo necessidade transfusional para manter a homeostasia. Foi tratado com ciclosporina pelo quadro da anemia aplastica severa e em seguida foi administrado Eculizumabe em tratamento continuo de periodicidade semanal dentro de quatro semanas (fase de inducao) seguindo de periodo quinzenal apos a quinta semana (fase de manutencao) no tratamento especifico para HPN. Discussao A situacao da paciente e grave por caracteristica propria da doenca base, porem em resposta ao tratamento apresentou melhoras no quadro clinico e na qualidade de vida, obtendo melhoras da anemia sintomatica e amenizando o quadro de dor abdominal e necessidade transfusional, permitindo a paciente retomar as atividades domestica e laborais. Conclusao O conhecimento precoce da doenca (AA) e HPN, beneficiara o paciente no tratamento e na melhoria da qualidade de vida minimizando os riscos de sequelas graves.
Published: 2021
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47. IMPORTÂNCIA DA LAVAGEM DE MÃOS PARA PREVENIR A DISSEMINAÇÃO DA COVID-19

Author: Pccs Junior, Renato Cesar Sacchetto Torres, Alj Morais, Amms Barros, Mhs Silva, A Debbo, MC Silva, WS Teles, RN Silva, and Marysilvia Ferreira da Costa
Subjects: business.industry, Immunology and Allergy, Medicine, Diseases of the blood and blood-forming organs, Hematology, RC633-647.5, business, Humanities, Article
Abstract: Introducao Desde a percepcao do novo coronavirus (SARS-CoV-2), responsavel pela disseminacao do surto descoberto pela primeira vez na cidade de Wuhan, China, em dezembro de 2019, a raca humana tem vivenciado um dificil problema sanitario global, arrodeadas de exatidao no que diz respeito aos caracteres epidemiologicos, sorologicos e sua facilidade de se disseminar. As infeccoes relacionadas a assistencia a saude tem ocorrencia em varias em instituicoes assistenciais de saude, tanto em paises desenvolvidos como subdesenvolvidos, acometendo aproximadamente 1,4 milhoes de pacientes em todo o mundo, resultando em altos numeros morbimortalidade, prolongamento do tempo de internacao, resistencia de microrganismos e obitos. Apresentam diversas causas e tem varias relacoes multifatoriais. A higienizacao das maos retrata a conduta apartada primordial como tatica de minimizacao da incidencia das infeccoes ambulatoriais e hospitalares. Objetivo O objetivo deste estudo foi orientar os profissionais do setor de ambulatorio de um centro de Hemoterapia no periodo de 10 a 26 de fevereiro de 2020, com intuito de melhorar os metodos de limpeza e higienizacao e prevencao acerca da COVID-19. Material e metodos Foi realizado um treinamento teorico atraves do Google Met., que e um servico de comunicacao por video desenvolvido pelo Google. O treinamento foi realizado em cinco modulos com carga horaria 30h com os funcionarios envolvendo o preenchimento do check-list, baseado no manual Seguranca do Paciente em Servicos de Saude, Higienizacao das Maos da Agencia Nacional de Vigilância Sanitaria. Resultados Dos 32 funcionarios que executam suas atividades profissionais no setor de transfusao e ambulatorio que responderam o instrumento de pesquisa, 75% (24) eram do sexo feminino e 25% (08) do sexo masculino. O nivel de formacao academica variou entre os docentes: 9,3% (3) sao Enfermeiros, Farmaceuticos 6,2 (02), Tecnicos de Enfermagem 18,7% (06), Assistente administrativo 15,6% (05), Assistente social 3,1% (01), Psicologa 3,1% (01), Fisioterapeuta 3,1% (01), Dentista 6,2% (02), Estagiarios 34,3% (11). Discussao Neste estudo observou-se que a higienizacao e o uso de luvas associaram-se a uma menor velocidade de contaminacao das maos durante cuidados rotineiros nos setores laboratoriais e no ambulatorio evitando a contaminacao da maioria dos profissionais de saude. Conclusao Esta acao deve ser constantemente desenvolvida na pratica educacional, alem de abordagem aprofundada referente a prevencao e controle de infeccoes como estrategia de promocao da seguranca do paciente.
Published: 2021

48. UK Head and neck cancer surgical capacity during the second wave of the COVID-19 pandemic: Have we learned the lessons? COVIDSurg collaborative

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Pichi, B, Lemma, F, Marino, MV, Bergonzani, M, Varazzani, A, Bussu, F, Perra, T, Piras, A, Porcu, A, Rizzo, D, Campisi, G, Cordova, A, Franza, M, Rinaldi, G, Toia, F, Gianni, A, Giannini, L, Gordini, L, Baldini, E, Conti, L, De Virgilio, A, Ferreli, F, Gaino, F, Mercante, G, Spriano, G, Ansarin, M, Chu, F, De Berardinis, R, Ietrobon, G, Tagliabue, M, Ionna, F, Baietti, A, Maremonti, P, Neri, F, Prucher, G, Ricci, S, Casaril, A, Nama, M, Cotoia, A, Lizzi, V, Vovola, F, Bruzzaniti, P, Familiari, P, Lapolla, P, Marruzzo, G, Mingoli, A, Ribuffo, D, Cipriani, R, Contedini, F, Lauretta, M, Marchetti, C, Melotti, M, Pignatti, M, Pinto, V, Pizzigallo, A, Ricotta, F, Tarsitano, A, Catarzi, L, Consorti, G, Abdulwahed, EA, Alshareea, EA, Biala, MI, Ghmagh, RJ, Ibrahim, AF, Liew, YT, Alvarez, MR, Arrangoiz, R, Cordera, F, Gómez-Pedraza, A, Soulé-Martínez, CE, Becerril, OS, Becerra, GFC, Arkha, Y, Bechri, H, El Ouahabi, A, Oudrhiri, M, Benkabbou, A, Majbar, M, Mohsine, R, Souadka, A, Lageju, N, Schreuder, WH, Hardillo, J, Bree, R, Schweitzer, D, Adeyeye, AA, Enoch, EE, Sholadoye, TSTT, Wuraola, F, Oyelakin, O, Khokhar, MI, Ayub, B, Walędziak, M, Szewczyk, M, Faria, C, Cardoso, P, Castro Silva, J, AlKharashi, E, Jelovac, D, Petrovic, M, Sumrak, S, Asceric, RR, Bojicic, JM, Kovacevic, BM, Krdzic, ID, Milentijevic, MA, Milutinovic, VZ, Stefanovic, ZB, Villacampa, JM, Jiménez Carneros, V, Salazar Carrasco, A, Carabias Hernandez, A, Alonso Lamberti, L, León Ledesma, R, Jiménez Miramón, FJ, Jover Navalón, JM, Garcia Quijada, J, Ramos Rodriguez, J, Valle Rubio, A, Vilaseca, I, Escartin, J, Estaire-Gomez, M, Padilla Valverde, D, Tousidonis, M, Lopez, F, Deandrés-Olabarria, U, Durán-Ballesteros, M, Fernández-Pablos, F, Ibáñez-Aguirre, F, Sanz-Larrainzar, A, Ugarte-Sierra, B, Di Martino, M, Prada, J, Jariod-Ferrer, UM, Landaluce Olavarria, A, Rey-Biel, J, Díaz de Cerio, P, Sánchez Barrueco, A, Lindqvist, EK, Sund, M, Piantanida, R, Giger, R, Hool, S, Müller, SA, Stoeckli, SJ, Simon, C, Toutounji, T, Al assaf, A, Hammed, AM, Hammed, SM, Mahfoud, M, Arikan, A, Yalkin, Ö, İflazoğlu, N, Isik, A, Leventoglu, S, Aydemir, L, Basaran, B, Sen, C, Comert-Ulusan, M, Saracoglu, KT, Saracoglu, A, Mantoglu, B, Kucuk, G, Aygun, N, Baran, E, Tanal, M, Eray Tufan, A, Uludag, M, Gürkan Yetkin, S, Yigit, B, Calik, B, Demirli Atici, S, Kaya, T, Sikakulya, FK, Abdel-Galil, KMAH, Lowe, T, Durrani, AJ, Habeeb, A, Irune, E, Luke, L, Masterson, L, Murphy, SH, Segaren, N, Walker, C, Waseem, S, Jones, TM, Loh, C, Pringle, S, Schache, AG, Shaw, RJ, Stenhouse, J, Armstrong, M, Sood, S, Sutton, D, Thomas, S, Clarke, P, Winter, SC, Hislop, S, Counter, PR, Ghazali, N, Lloyd, C, Prabhu, V, Godden, D, Whitley, S, Butler, C, Nash, R, El-Boghdadly, K, Fry, A, Niziol, R, De, M, Gill, CK, Crank, S, Mace, AD, Ho, M, Mair, M, Kothari, P, Homer, J, Sainuddin, S, Egan, RJ, Kittur, M, Burgess, C, O'Hara, J, Manickavasagam, J, McDonald, C, Burrows, S, Java, KR, Katre, C, Ahmed, A, Siddique, H, King, E, Ramchandani, P, Naredla, PR, Brennan, P, Ringrose, T, Schmidt, F, Mak, JKC, Nankivell, P, Parmar, S, Sharma, N, Douglas, C, McCaul, J, Dhanda, J, Kyzas, P, Vassiliou, L, Kumar, A, Husband, A, Hulbert, J, Ingrams, D, Parkin, R, Varley, I, Gahir, D, George, A, Zakai, D, Bater, M, Surwald, C, Devlin, B, Leonard, CG, Pigadas, N, Snee, D, Singh, RP, Hyde, NC, Paley, M, Cocks, H, Wilson, A, Choi, D, Kerawala, CJ, Riva, F, Dickason, A, Semple, CJ, Schilling, C, Walton, G, Rees-Stoner, O, Scott, N, Nixon, IJ, Tighe, D, Mattine, S, Chu, MMH, Pothula, V, Lee, W, Brown, L, Ganly, I, Alpert, N, Illezeau, CN, Miles, B, Rapp, J, Taioli, E, Azam, MT, Choudhry, AJ, Marx, W, Stein, J, Ying, Y, Gross, ND, Almasri, M, Joshi, R, Kulkarni, G, Marwan, H, Mehdi, M, Sumer, B, Collaborative, COVIDSurg, and Winter, SC
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), delay, medicine.medical_treatment, Comorbidity, SARS‐CoV‐2, surgery, Tertiary Care Centers, Patient referral, COVID‐19, Pandemic, medicine, Humans, Current wave, Pandemics, SARS-CoV-2, business.industry, capacity, pandemic, General surgery, Head and neck cancer, COVID-19, Original Articles, medicine.disease, United Kingdom, Otorhinolaryngologic Surgical Procedures, critical care, Radiation therapy, head and neck cancer, comorbidity, head and neck neoplasms, humans, otorhinolaryngologic surgical procedures, tertiary care centers, Otorhinolaryngology, Head and Neck Neoplasms, Original Article, business, Cancer surgery
Abstract: Objectives: The aim of this study was to evaluate the differences in surgical capacity for head and neck cancer in the UK between the first wave (March‐June 2020) and the current wave (Jan‐Feb 2021) of the COVID‐19 pandemic. Design: REDcap online based survey of hospital capacity. Setting: UK secondary and tertiary hospitals providing head and neck cancer surgery. Participants: One representative per hospital was asked to report the capacity for head and neck cancer surgery in that institution. Main Outcome Measures: The principal measures of interests were new patient referrals, capacity in outpatients, theatres and critical care; therapeutic compromises constituting delay to surgery, de‐escalated surgery and therapeutic migration to non‐surgical primary modality. Results: Data was returned from approximately 95% of UK hospitals with a head and neck cancer surgery specialist service. 50% of UK head and neck cancer patients requiring surgery have significantly compromised treatments during the second wave: 28% delayed, 10% have received radiotherapy‐based treatment instead of surgery and 12% have received de‐escalated surgery. Surgical capacity has been more severely constrained in the second wave (58% of pre‐pandemic level) compared with the first wave (62%) despite the time to prepare. Conclusions: Some hospitals are overwhelmed by COVID‐19 and unable to offer essential cancer surgery, but all have neighbouring hospitals in their region retaining good (or even normal) capacity. It is noteworthy that very few patients have been appropriately re‐directed away from the hospitals most constrained by their burden of COVID‐19. The paucity of an effective central or regional strategic response to this evident mismatch between demand and surgical capacity is to the detriment of our head and neck cancer patients.
Published: 2021

49. Pancreatic Mass Mimicking Neuroendocrine Tumor

Author: Moon Ws, Song Js, Yang Jd, and Ahn Ar
Subjects: Pathology, medicine.medical_specialty, business.industry, medicine, Pancreatic mass, General Medicine, business, medicine.disease
Abstract: A 68-year-old man presented to our hospital for the evaluation of an incidentally detected pancreatic mass. Serum tumor marker levels were within normal limits. On delayed-phase computed tomography, a homogeneous enhancing 1.8 cm-sized hypervascular mass was detected in the pancreatic head (Figure 1). As the radiologic impression was that of a neuroendocrine tumor, the patient underwent pylorus-preserving pancreatoduodectomy. Microscopically, the tumor exhibited typical features of pancreatic solid hamartoma (Figure 2). Pancreatic solid hamartoma is an extremely rare entity that shows components that are present in the normal pancreas with distorted architecture and are considered as malformative lesions. Preoperative diagnosis is difficult because the clinicopathological features of solid hamartoma have not yet been fully clarified. The radiologic findings in this mass were similar to those of a neuroendocrine tumor. All patients with pancreatic hamartomas present with a benign clinical course. Recognition of this entity is desirable to avoid unnecessary extended surgical resection.
Published: 2021
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50. Mapping routine measles vaccination in low- and middle-income countries

Author: Sbarra, AN, Rolfe, S, Nguyen, JQ, Earl, L, Galles, NC, Marks, A, Abbas, KM, Abbasi-Kangevari, M, Abbastabar, H, Abd-Allah, F, Abdelalim, A, Abdollahi, M, Abegaz, KH, Abiy, HAA, Abolhassani, H, Abreu, LG, Abrigo, MRM, Abushouk, AI, Accrombessi, MMK, Adabi, M, Adebayo, OM, Adekanmbi, V, Adetokunboh, OO, Adham, D, Afarideh, M, Aghaali, M, Ahmad, T, Ahmadi, R, Ahmadi, K, Ahmed, MB, Alanezi, FM, Alanzi, TM, Alcalde-Rabanal, JE, Alemnew, BT, Ali, BA, Ali, M, Alijanzadeh, M, Alinia, C, Alipoor, R, Alipour, V, Alizade, H, Aljunid, SM, Almasi, A, Almasi-Hashiani, A, Al-Mekhlafi, HM, Altirkawi, KA, Amare, B, Amini, S, Amini-Rarani, M, Amiri, F, Amit, AML, Amugsi, DA, Ancuceanu, R, Andrei, CL, Anjomshoa, M, Ansari, F, Ansari-Moghaddam, A, Ansha, MG, Antonio, CAT, Antriyandarti, E, Anvari, D, Arabloo, J, Arab-Zozani, M, Aremu, O, Armoon, B, Aryal, KK, Arzani, A, Asadi-Aliabadi, M, Asgari, S, Atafar, Z, Ausloos, M, Awoke, N, Quintanilla, BPA, Ayanore, MA, Aynalem, YA, Azadmehr, A, Azari, S, Babaee, E, Badawi, A, Badiye, AD, Bahrami, MA, Baig, AA, Bakhtiari, A, Balakrishnan, S, Banach, M, Banik, PC, Barac, A, Baradaran-Seyed, Z, Baraki, AG, Basu, S, Bayati, M, Bayou, YT, Bedi, N, Behzadifar, M, Bell, ML, Berbada, DA, Berhe, K, Bhattarai, S, Bhutta, ZA, Bijani, A, Birhanu, M, Bisanzio, D, Biswas, A, Bohlouli, S, Bolla, SR, Borzouei, S, Brady, OJ, Bragazzi, NL, Briko, AN, Briko, NI, Nagaraja, SB, Butt, ZA, Cámera, LA, Campos-Nonato, IR, Car, J, Cárdenas, R, Carvalho, F, Castaldelli-Maia, JM, Castro, F, Chattu, VK, Chehrazi, M, Chin, KL, Chu, D-T, Cook, AJ, Cormier, NM, Cunningham, B, Dahlawi, SMA, Damiani, G, Dandona, R, Dandona, L, Danovaro, MC, Dansereau, E, Daoud, F, Darwesh, AM, Darwish, AH, Das, JK, Weaver, ND, De Neve, J-W, Demeke, FM, Demis, AB, Denova-Gutiérrez, E, Desalew, A, Deshpande, A, Desta, DM, Dharmaratne, SD, Dhungana, GP, Dianatinasab, M, Diaz, D, Dipeolu, IO, Djalalinia, S, Do, HT, Dorostkar, F, Doshmangir, L, Doyle, KE, Dunachie, SJ, Duraes, AR, Kalan, ME, Leylabadlo, HE, Edinur, HA, Effiong, A, Eftekhari, A, El, Sayed, I, El, Sayed, Zaki, M, Elema, TB, Elhabashy, HR, El-Jaafary, SI, Elsharkawy, A, Emamian, MH, Enany, S, Eshrati, B, Eskandari, K, Eskandarieh, S, Esmaeilnejad, S, Esmaeilzadeh, F, Esteghamati, A, Etisso, AE, Farahmand, M, Faraon, EJA, Fareed, M, Faridnia, R, Farioli, A, Farzadfar, F, Fattahi, N, Fazlzadeh, M, Fereshtehnejad, S-M, Fernandes, E, Filip, I, Fischer, F, Foigt, NA, Folayan, MO, Foroutan, M, Fukumoto, T, Fullman, N, Gad, MM, Geberemariyam, BS, Gebrehiwot, TT, Gebrehiwot, AM, Gebremariam, KT, Gebremedhin, KB, Gebremeskel, GG, Gebreslassie, AA, Gedefaw, GA, Gezae, KE, Ghadiri, K, Ghaffari, R, Ghaffarifar, F, Ghajarzadeh, M, Gheshlagh, RG, Ghashghaee, A, Ghiasvand, H, Gholamian, A, Gilani, SA, Gill, PS, Girmay, A, Gomes, NGM, Gopalani, SV, Goulart, BNG, Grada, A, Guimarães, RA, Guo, Y, Gupta, R, Hafezi-Nejad, N, Haj-Mirzaian, A, Handiso, DW, Hanif, A, Haririan, H, Hasaballah, AI, Hasan, MM, Hasanpoor, E, Hasanzadeh, A, Hassanipour, S, Hassankhani, H, Heidari-Soureshjani, R, Henry, NJ, Herteliu, C, Heydarpour, F, Hollerich, GI, Rad, EH, Hoogar, P, Hossain, N, Hosseini, M, Hosseinzadeh, M, Househ, M, Hu, G, Huda, TM, Humayun, A, Ibitoye, SE, Ikilezi, G, Ilesanmi, OS, Ilic, IM, Ilic, MD, Imani-Nasab, MH, Inbaraj, LR, Iqbal, U, Irvani, SSN, Islam, SMS, Islam, MM, Iwu, CJ, Iwu, CCD, Jadidi-Niaragh, F, Jafarinia, M, Jahanmehr, N, Jakovljevic, M, Jalali, A, Jalilian, F, Javidnia, J, Jenabi, E, Jha, V, Ji, JS, John, O, Johnson, KB, Joukar, F, Jozwiak, JJ, Kabir, Z, Kabir, A, Kalani, H, Kalankesh, LR, Kalhor, R, Kamal, Z, Kanchan, T, Kapoor, N, Karami, M, Matin, BK, Karch, A, Karimi, SE, Kayode, GA, Karyani, AK, Keiyoro, PN, Khader, YS, Khafaie, MA, Khammarnia, M, Khan, MS, Khan, EA, Khan, J, Khan, MN, Khatab, K, Khater, MM, Khatib, MN, Khayamzadeh, M, Khazaei, M, Khazaei, S, Khosravi, A, Khubchandani, J, Kianipour, N, Kim, YJ, Kimokoti, RW, Kinyoki, DK, Kisa, A, Kisa, S, Kolola, T, Komaki, H, Kosen, S, Koul, PA, Koyanagi, A, Kraemer, MUG, Krishan, K, Kuate Defo, B, Kumar, M, Kumar, P, Kumar, GA, Kusuma, D, La Vecchia, C, Lacey, B, Lad, SD, Lal, DK, Lam, F, Lami, FH, Lansingh, VC, Larson, HJ, Lasrado, S, Lee, SWH, Lee, PH, LeGrand, KE, Lenjebo, TL, Li, S, Liang, X, Liu, PY, Lopukhov, PD, Machado, DB, Mahasha, PW, Mahdavi, MM, Maheri, M, Mahotra, NB, Maled, V, Maleki, S, Malik, MA, Malta, DC, Mansour-Ghanaei, F, Mansouri, B, Mansourian, M, Mansournia, MA, Martins-Melo, FR, Masaka, A, Mayala, BK, Mehndiratta, MM, Mehri, F, Mehta, KM, Memiah, PTN, Mendoza, W, Menezes, RG, Mengesha, MB, Mengesha, EW, Mestrovic, T, Mihretie, KM, Miller-Petrie, MK, Mills, EJ, Milne, GJ, Mirabi, P, Mirrakhimov, EM, Mirzaei, R, Mirzaei, M, Mirzaei, HR, Mirzaei, H, Mirzaei-Alavijeh, M, Moazen, B, Moghadaszadeh, M, Mohamadi, E, Mohammad, DK, Mohammad, Y, Mohammad, KA, Mohammad Gholi Mezerji, N, Mohammadbeigi, A, Mohammadian-Hafshejani, A, Mohammadpourhodki, R, Mohammed, S, Mohammed, AS, Mohammed, H, Mohebi, F, Mokdad, AH, Monasta, L, Moosavi, MA, Moosazadeh, M, Moradi, G, Moradi, M, Moradi-Joo, M, Moradi-Lakeh, M, Moradzadeh, R, Moraga, P, Mosapour, A, Mouodi, S, Mousavi, SM, Khaneghah, AM, Mueller, UO, Muluneh, AG, Munro, SB, Murray, CJL, Murthy, GVS, Muthupandian, S, Naderi, M, Nagarajan, AJ, Naghavi, M, Nangia, V, Nansseu, JR, Nayak, VC, Nazari, J, Ndwandwe, DE, Negoi, I, Ngunjiri, JW, Nguyen, HLT, Nguyen, CTK, Nguyen, TH, Nigatu, YT, Nikbakhsh, R, Nikfar, S, Nikpoor, AR, Ningrum, DNA, Nnaji, CA, Oh, I-H, Oladnabi, M, Olagunju, AT, Olusanya, JO, Olusanya, BO, Bali, AO, Omer, MO, Onwujekwe, OE, Osgood-Zimmerman, AE, Owolabi, MO, P, A, M, Padubidri, JR, Pakshir, K, Pana, A, Pandey, A, Pando-Robles, V, Pashaei, T, Pasupula, DK, Paternina-Caicedo, AJ, Patton, GC, Pazoki Toroudi, H, Pepito, VCF, Pescarini, JM, Pigott, DM, Pilgrim, T, Pirsaheb, M, Poljak, M, Postma, MJ, Pourjafar, H, Pourmalek, F, Pourmirza, Kalhori, R, Prada, SI, Prakash, S, Quazi Syed, Z, Quintana, H, Rabiee, N, Rabiee, M, Radfar, A, Rafiei, A, Rahim, F, Rajati, F, Rameto, MA, Ramezanzadeh, K, Ranabhat, CL, Rao, SJ, Rasella, D, Rastogi, P, Rathi, P, Rawaf, S, Rawaf, DL, Rawal, L, Rawassizadeh, R, Rawat, R, Renjith, V, Renzaho, AMN, Reshmi, B, Reta, MA, Rezaei, N, Rezai, MS, Rezapour, A, Riahi, SM, Ribeiro, AI, Rickard, J, Rios-Blancas, M, Rios-González, CM, Roever, L, Rostamian, M, Rubino, S, Rwegerera, GM, Saad, AM, Saadatagah, S, Sabour, S, Sadeghi, E, Moghaddam, SS, Saeidi, S, Sagar, R, Sahebkar, A, Sahraian, MA, Sajadi, SM, Salahshoor, MR, Salam, N, Salem, H, Salem, MR, Salomon, JA, Kafil, HS, Sambala, EZ, Samy, AM, Saraswathy, SYI, Sarmiento-Suárez, R, Saroshe, S, Sartorius, B, Sarveazad, A, Sathian, B, Sathish, T, Schaeffer, LE, Schwebel, DC, Senthilkumaran, S, Shabaninejad, H, Shahabi, S, Shaheen, AA, Shaikh, MA, Shalash, AS, Shams-Beyranvand, M, Shamsi, MB, Shamsizadeh, M, Sharafi, K, Sharifi, H, Sheikh, A, Sheikhtaheri, A, Shetty, RS, Shiferaw, WS, Shigematsu, M, Shin, JI, Shirkoohi, R, Siabani, S, Siddiqi, TJ, Silverberg, JIS, Simonetti, B, Singh, JA, Sinha, DN, Sinke, AH, Soheili, A, Sokhan, A, Soltani, S, Soofi, M, Sorrie, MB, Soyiri, IN, Spotin, A, Spurlock, EE, Sreeramareddy, CT, Sudaryanto, A, Sufiyan, MB, Suleria, HAR, Abdulkader, RS, Taherkhani, A, Tapak, L, Taveira, N, Taymoori, P, Tefera, YM, Tehrani-Banihashemi, A, Teklehaimanot, BF, Tekulu, GH, Tesfay, BE, Tessema, ZT, Tessema, B, Thankappan, KR, Tohidinik, HR, Topor-Madry, R, Tovani-Palone, MR, Tran, BX, Uddin, R, Ullah, I, Umeokonkwo, CD, Unnikrishnan, B, Upadhyay, E, Usman, MS, Vaezi, M, Valadan, Tahbaz, S, Valdez, PR, Vasseghian, Y, Veisani, Y, Violante, FS, Vollmer, S, Waheed, Y, Wakefield, J, Wang, Y, Wang, Y-P, Weldesamuel, GT, Werdecker, A, Westerman, R, Wiangkham, T, Wiens, KE, Wiysonge, CS, Woldu, G, Wondafrash, DZ, Wonde, TE, Wu, A-M, Yadollahpour, A, Jabbari, SHY, Yamada, T, Yaya, S, Yazdi-Feyzabadi, V, Yeheyis, TY, Yeshaw, Y, Yilgwan, CS, Yip, P, Yonemoto, N, Younis, MZ, Yousefi, Z, Yousefifard, M, Yousefinezhadi, T, Yu, C, Yusefzadeh, H, Zadey, S, Zahirian, Moghadam, T, Zaki, L, Zaman, SB, Zamani, M, Zamanian, M, Zandian, H, Zangeneh, A, Zarei, F, Zerfu, TA, Zhang, Y, Zhang, Z-J, Zhao, X-JG, Zhou, M, Ziapour, A, Hay, SI, Lim, SS, Mosser, JF, Local Burden of Disease Vaccine Coverage Collaborators, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), HUS Comprehensive Cancer Center, Clinicum, Department of Oncology, Sbarra, Alyssa N., Rolfe, Sam, Nguyen, Jason Q., Earl, Lucas, Ahmed, MB, Mosser, Jonathan F, Collaborators, Local Burden of Disease Vaccine Coverage, Bill & Melinda Gates Foundation, Alexander von Humboldt-Stiftung, Unión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF), Universiti Sains Malaysia (Malasia), Panjab University (India), NIHR - Oxford Biomedical Research Centre (Reino Unido), Australian Research Council, Instituto de Saúde Pública da Universidade do Porto, Local Burden Dis Educ Attainment C, Local Burden of Disease Vaccine Coverage Collaborator, and Violante FS
Subjects: and promotion of well-being, Vacunación Masiva, Internationality, Disease prevention, children under 5 years old, Geographic Mapping, Rural Health, medicine.disease_cause, Cross-reactivity, 0302 clinical medicine, RA0421, Vaccination Refusal, 030212 general & internal medicine, Child, immunity patterns, Pediatric, 0303 health sciences, Public health, Multidisciplinary, biology, Vaccination, Uncertainty, IMMUNIZATION, 3142 Public health care science, environmental and occupational health, COVERAGE, 3. Good health, TIME, 3.4 Vaccines, Child, Preschool, Infectious diseases, A990 Medicine and Dentistry not elsewhere classified, Antibody, Engineering sciences. Technology, AFRICA, General Science & Technology, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), COVID-19, 610 Medicine & health, Global Vaccine Action Plan (GVAP), Local Burden of Disease Vaccine Coverage Collaborators, Article, Vaccine Related, 03 medical and health sciences, measles vaccine, Measels, Low- and middle-income countries, Local burden of disease, Clinical Research, medicine, Humans, Healthcare Disparities, Preschool, PROGRESS, 030304 developmental biology, business.industry, MORTALITY, Developed Countries, Prevention, Comment, Vacunación, Urban Health, Prevention of disease and conditions, Virology, Coronavirus, Good Health and Well Being, Cobertura de Vacunación, biology.protein, Immunization, business, Measles
Abstract: The safe, highly effective measles vaccine has been recommended globally since 1974, yet in 2017 there were more than 17 million cases of measles and 83,400 deaths in children under 5 years old, and more than 99% of both occurred in low- and middle-income countries (LMICs)1–4. Globally comparable, annual, local estimates of routine first-dose measles-containing vaccine (MCV1) coverage are critical for understanding geographically precise immunity patterns, progress towards the targets of the Global Vaccine Action Plan (GVAP), and high-risk areas amid disruptions to vaccination programmes caused by coronavirus disease 2019 (COVID-19)5–8. Here we generated annual estimates of routine childhood MCV1 coverage at 5 × 5-km2 pixel and second administrative levels from 2000 to 2019 in 101 LMICs, quantified geographical inequality and assessed vaccination status by geographical remoteness. After widespread MCV1 gains from 2000 to 2010, coverage regressed in more than half of the districts between 2010 and 2019, leaving many LMICs far from the GVAP goal of 80% coverage in all districts by 2019. MCV1 coverage was lower in rural than in urban locations, although a larger proportion of unvaccinated children overall lived in urban locations; strategies to provide essential vaccination services should address both geographical contexts. These results provide a tool for decision-makers to strengthen routine MCV1 immunization programmes and provide equitable disease protection for all children., Although progress in the coverage of routine measles vaccination in children in low- and middle-income countries was made during 2000–2019, many countries remain far from the goal of 80% coverage in all districts by 2019.
Published: 2021
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