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1. The genomic evolutionary dynamics and global circulation patterns of respiratory syncytial virus.

Author

Langedijk, Annefleur, Vrancken, Bram, Lebbink, Robert, Wilkins, Deidre, Kelly, Elizabeth, Baraldi, Eugenio, Mascareñas de Los Santos, Abiel, Danilenko, Daria, Choi, Eun, Palomino, María, Chi, Hsin, Keller, Christian, Cohen, Robert, Papenburg, Jesse, Pernica, Jeffrey, Greenough, Anne, Richmond, Peter, Martinón-Torres, Federico, Heikkinen, Terho, Stein, Renato, Hosoya, Mitsuaki, Nunes, Marta, Verwey, Charl, Evers, Anouk, Kragten-Tabatabaie, Leyla, Suchard, Marc, Kosakovsky Pond, Sergei, Poletto, Chiara, Colizza, Vittoria, Lemey, Philippe, and Bont, Louis

Subjects
Infant, Child, Humans, Child, Preschool, Respiratory Syncytial Virus Infections, Phylogeny, Respiratory Syncytial Virus, Human, Genomics, Respiratory Tract Infections
Abstract

Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infection in young children and the second leading cause of infant death worldwide. While global circulation has been extensively studied for respiratory viruses such as seasonal influenza, and more recently also in great detail for SARS-CoV-2, a lack of global multi-annual sampling of complete RSV genomes limits our understanding of RSV molecular epidemiology. Here, we capitalise on the genomic surveillance by the INFORM-RSV study and apply phylodynamic approaches to uncover how selection and neutral epidemiological processes shape RSV diversity. Using complete viral genome sequences, we show similar patterns of site-specific diversifying selection among RSVA and RSVB and recover the imprint of non-neutral epidemic processes on their genealogies. Using a phylogeographic approach, we provide evidence for air travel governing the global patterns of RSVA and RSVB spread, which results in a considerable degree of phylogenetic mixing across countries. Our findings highlight the potential of systematic global RSV genomic surveillance for transforming our understanding of global RSV spread.

Published
2024

2. HIV-1-induced cytokines deplete homeostatic innate lymphoid cells and expand TCF7-dependent memory NK cells

Author

Wang, Yetao, Lifshitz, Lawrence, Gellatly, Kyle, Vinton, Carol L, Busman-Sahay, Kathleen, McCauley, Sean, Vangala, Pranitha, Kim, Kyusik, Derr, Alan, Jaiswal, Smita, Kucukural, Alper, McDonel, Patrick, Hunt, Peter W, Greenough, Thomas, Houghton, JeanMarie, Somsouk, Ma, Estes, Jacob D, Brenchley, Jason M, Garber, Manuel, Deeks, Steven G, and Luban, Jeremy

Subjects
Medical Microbiology, Biomedical and Clinical Sciences, Immunology, Sexually Transmitted Infections, Infectious Diseases, Clinical Research, HIV/AIDS, 2.1 Biological and endogenous factors, Aetiology, Inflammatory and immune system, Infection, Good Health and Well Being, Cytokines, Gene Expression Regulation, HIV Infections, HIV-1, Homeostasis, Humans, Immunity, Innate, Immunologic Memory, In Vitro Techniques, Inflammation, Killer Cells, Natural, Lymphocytes, T Cell Transcription Factor 1, Wnt Signaling Pathway, Biochemistry and cell biology
Abstract

Human immunodeficiency virus 1 (HIV-1) infection is associated with heightened inflammation and excess risk of cardiovascular disease, cancer and other complications. These pathologies persist despite antiretroviral therapy. In two independent cohorts, we found that innate lymphoid cells (ILCs) were depleted in the blood and gut of people with HIV-1, even with effective antiretroviral therapy. ILC depletion was associated with neutrophil infiltration of the gut lamina propria, type 1 interferon activation, increased microbial translocation and natural killer (NK) cell skewing towards an inflammatory state, with chromatin structure and phenotype typical of WNT transcription factor TCF7-dependent memory T cells. Cytokines that are elevated during acute HIV-1 infection reproduced the ILC and NK cell abnormalities ex vivo. These results show that inflammatory cytokines associated with HIV-1 infection irreversibly disrupt ILCs. This results in loss of gut epithelial integrity, microbial translocation and memory NK cells with heightened inflammatory potential, and explains the chronic inflammation in people with HIV-1.

Published
2020

3. Cardiovascular Fitness, Cortical Plasticity, and Aging

Author

Colcombe, Stanley J., Kramer, Arthur F., Erickson, Kirk I., Scalf, Paige, McAuley, Edward, Cohen, Neal J., Webb, Andrew, Jerome, Gerry J., Marquez, David X., Elavsky, Steriani, and Greenough, William T.

Published
2004

4. Use of Person-Centered Language Among Scientific Research Focused on Sickle Cell Disease

Author

Emily Sowah, Paul Delgado, M. Tomi Adewumi, Mary C. Greenough, Swapnil Gajjar, Jabraan Pasha, Savannah Nicks, and Micah Hartwell

Subjects
Cross-Sectional Studies, Emergency Medicine, Humans, Pain, Anemia, Sickle Cell, Emergency Service, Hospital, United States, Language
Abstract

Sickle cell disease (SCD) is a lifelong illness affecting many individuals in the United States. Proper management of SCD is imperative, however, the unpredictability of pain crises may lead to frequent emergency department (ED) visits. This SCD feature has led to health-related stigmatization via labels and other terminology within clinical settings, which may be translated through medical research. Thus, it is important for medical literature to adhere to person-centered language (PCL) to diminish such stigmas from transcending into the clinical setting.Our aim was to determine current adherence to PCL related to individuals with SCD in existing literature.This was a cross-sectional design study. Published studies on SCD that used human participants were selected between January 1, 2015 and April 14, 2021. Two investigators performed screening and data procedures in a masked, duplicate fashion, with conflicts and discrepancies resolved via an arbiter. χAfter excluding editorials and commentaries, 200 articles were retained. We found that 186 publications (94%) adhered to PCL. Among articles with non-PCL, labeling occurred in 2 articles (1%) and emotional language implying suffering was identified in 10 articles (5%).Our study suggests a widespread adherence to PCL in recent SCD literature. However, findings suggest a major disconnect between education and practice, as recent publications document the use of non-PCL terminology within EDs. Health care providers should be aware of biases and institutional resources should be allocated toward raising awareness.

Published
2022

5. The impact of COVID-19 on smoking cessation in pregnancy

Author

Nadja Bednarczuk, Emma E. Williams, Gareth Absalom, Judith Olaitan-Salami, and Anne Greenough

Subjects
Adult, Pregnancy Complications, Pregnancy, Smoking, Pediatrics, Perinatology and Child Health, COVID-19, Humans, Obstetrics and Gynecology, Female, Smoking Cessation, Tobacco Use Cessation Devices
Abstract

Objectives A greater proportion of non-pregnant smokers attempted to stop smoking during compared to before the COVID-19 pandemic. The objective of this study was to determine if a greater proportion of pregnant women also attempted to stop smoking during the pandemic rather than before. Methods The use of antenatal smoking cessation services and nicotine replacement therapies (NRT) in pregnant women was audited before (2019–2020) and during the COVID pandemic (2020–2021). Anonymised data from January 2019 to March 2021 were analysed from the Lambeth and Southwark smoking cessation service. Results A total of 252 pregnant women who smoked were referred to their local antenatal smoking cessation service, of which 90 (35.7%) (median age: 31 years [19–52 years]) chose to attend smoking cessation clinics. The COVID-19 pandemic was not associated with an increase in the number of women attending smoking cessation clinics, (2020–2021 n=46 [40.8%] of 110); compared to (2019–2020 n=44 [30.9%] of 142 referred pregnant women pre-pandemic) p=0.061. Eighty-two women utilised NRT to help them stop smoking and the frequency of NRT use did not change during the pandemic (2019–2020 n=39, 2020–2021 n=43; p=0.420). No significant difference in smoking cessation rates between the two periods was observed at either the four-week (p=0.285) or twelve-week follow-up (p=0.829). Conclusions Smoking cessation rates in pregnant women and the demand for antenatal smoking cessation services was unchanged during compared to before the COVID-19 pandemic.

Published
2022

6. Diaphragmatic electromyography during a spontaneous breathing trial to predict extubation failure in preterm infants

Author

Emma E. Williams, Fahad M. S. Arattu Thodika, Imogen Chappelow, Nicole Chapman-Hatchett, Theodore Dassios, and Anne Greenough

Subjects
Electromyography, Diaphragm, Pediatrics, Perinatology and Child Health, Infant, Newborn, Airway Extubation, Infant, Humans, Ventilator Weaning, Infant, Premature
Abstract

Background Premature attempts at extubation and prolonged episodes of ventilatory support in preterm infants have adverse outcomes. The aim of this study was to determine whether measuring the electrical activity of the diaphragm during a spontaneous breathing trial (SBT) could predict extubation failure in preterm infants. Methods When infants were ready for extubation, the electrical activity of the diaphragm was measured by transcutaneous electromyography (EMG) before and during a SBT when the infants were on endotracheal continuous positive airway pressure. Results Forty-eight infants were recruited (median (IQR) gestational age of 27.2 (25.6–30.4) weeks). Three infants did not pass the SBT and 13 failed extubation. The amplitude of the EMG increased during the SBT [2.3 (1.5–4.2) versus 3.5 (2.1–5.3) µV; p Conclusions In all preterm infants, PMA was the strongest predictor of extubation failure; in those born Impact Composite assessments of readiness for extubation may be beneficial in the preterm population. Diaphragmatic electromyography measured by surface electrodes is a non-invasive technique to assess the electrical activity of the diaphragm. Postmenstrual age was the strongest predictor of extubation outcome in preterm infants. The change in diaphragmatic activity during a spontaneous breathing trial in extremely prematurely born infants can predict subsequent extubation failure with moderate sensitivity and specificity.

Published
2022

7. Longitudinal changes in lung function in very prematurely born young people receiving high‐frequency oscillation or conventional ventilation from birth

Author

Alessandra Bisquera, Christopher Harris, Alan Lunt, Sanja Zivanovic, Neil Marlow, Sandy Calvert, Anne Greenough, and Janet L. Peacock

Subjects
Male, Pulmonary and Respiratory Medicine, Adolescent, Forced Expiratory Volume, Vital Capacity, Pediatrics, Perinatology and Child Health, Infant, Newborn, High-Frequency Ventilation, Humans, Lung, Follow-Up Studies
Abstract

To examine changes in lung function over time in extremely prematurely born adolescents.Changes in lung function during adolescence would vary by ventilation mode immediately after birth.Longitudinal follow-up study.Participants from the United Kingdom Oscillation Study who were randomized at birth to high-frequency oscillation (HFO) or conventional ventilation (CV) were assessed at 11-14 years (n = 319) and at 16-19 years (n = 159).Forced expiratory flow (FEF), forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and lung volumes including functional residual capacity (FRC) were reported as z-scores. The diffusion capacity of the lungs for carbon monoxide (DLCO) was measured. Lung function trajectories were compared by mode of ventilation using mixed models. Changes in z-scores were scaled to 5-year average follow-up.There were significant changes in the mean FEF75, FEF50, FEF25, FEV1, FVC, and DLCO z-scores within the CV and HFO cohorts, but no significant differences in the changes between the two groups. The mean FRC z-score increased in both groups, with an average change of greater than one z-score. The mean FEV1/FVC z-score increased significantly in the CV group, but not in the HFO group (difference in slopes: p = 0.02). Across the population, deterioration in lung function was associated with male sex, white ethnicity, lower gestational age at birth, postnatal corticosteroids, oxygen dependency at 36 weeks postmenstrual age, and lower birth weight, but not ventilation mode.There was little evidence that the mode of ventilation affected changes in lung function over time.

Published
2022

8. Work of breathing at different tidal volume targets in newborn infants with congenital diaphragmatic hernia

Author

Rebecca Lee, Katie A. Hunt, Emma E. Williams, Theodore Dassios, and Anne Greenough

Subjects
Cross-Over Studies, Pediatrics, Perinatology and Child Health, Infant, Newborn, Tidal Volume, Humans, Infant, Hernias, Diaphragmatic, Congenital, Respiration, Artificial, Work of Breathing
Abstract

Congenital diaphragmatic hernia (CDH) results in varying degrees of pulmonary hypoplasia. Volume targeted ventilation (VTV) is a lung protective strategy but the optimal target tidal volume in CDH infants has not previously been studied. The aim of this study was to test the hypothesis that low targeted volumes would be better in CDH infants as determined by measuring the work of breathing (WOB) in CDH infants, at three different targeted tidal volumes. A randomised cross-over study was undertaken. Infants were eligible for inclusion in the study after surgical repair of their diaphragmatic defect. Targeted tidal volumes of 4, 5, and 6 ml/kg were each delivered in random order for 20-min periods with 20-min periods of baseline ventilation between. WOB was assessed and measured by using the pressure–time product of the diaphragm (PTPdi). Nine infants with a median gestational age at birth of 38 + 4 (range 36 + 4–40 + 6) weeks and median birth weight 3202 (range 2855–3800) g were studied. The PTPdi was higher at 4 ml/kg than at both 5, p = 0.008, and 6 ml/kg, p = 0.012.Conclusion: VTV of 4 ml/kg demonstrated an increased PTPdi compared to other VTV levels studied and should be avoided in post-surgical CDH infants. What is Known:• Lung injury secondary to mechanical ventilation increases the mortality and morbidity of infants with CDH.• Volume targeted ventilation (VTV) reduces ‘volutrauma’ and ventilator-induced lung injury in other neonatal intensive care populations. What is New:• A randomised cross-over trial was carried out investigating the response to different VTV levels in infants with CDH.• Despite pulmonary hypoplasia being a common finding in CDH, a VTV of 5ml/kg significantly reduced the work of breathing in infants with CDH compared to a lower VTV level.

Published
2022

9. Impact of a Care Bundle on Cost Saving for Noninvasive Respiratory Support for Neonates

Author

Sandeep Shetty, Anne Greenough, Katie Evans, and Anay Kulkarni

Subjects
medicine.medical_specialty, Evidence-based practice, Continuous Positive Airway Pressure, business.industry, medicine.medical_treatment, Infant, Newborn, MEDLINE, General Medicine, medicine.disease_cause, Cost savings, Cost Savings, Pediatrics, Perinatology and Child Health, medicine, Cannula, Humans, Continuous positive airway pressure, Care bundle, Duration (project management), Intensive care medicine, business, Lead (electronics), Nasal cannula, Infant, Premature, Patient Care Bundles, health care economics and organizations
Abstract

Background Neonates often receive noninvasive respiratory support via continuous positive airway pressure (CPAP) or high-flow nasal cannula oxygen (HHFNC). The decision to change from one mode to the other, however, is not evidence based, hence not standardized and does not consider cost implications. Purpose To assess the introduction of a care bundle for the medical and nursing staff in a tertiary medical and surgical neonatal center with regard to any financial savings or adverse outcomes. Methods An education package and written guidelines were used to increase the awareness of the durations for which CPAP and HHFNC Vapotherm (VT) circuits could be used and the costs of the circuits. Results This resulted in a cost saving of £17,000 ($22,254) for the year without adverse outcomes. Implications for practice Introduction of a care bundle involving an education package and written guidelines to increase the awareness of the durations that circuits could be used and the costs of CPAP and HHFNC circuits among the medical and nursing staff can lead to cost savings when incorporated into clinical practice. Implications for research Strategies, particularly during weaning, which involve changing from one form of noninvasive respiratory support to another, need a greater evidence base. Future research should include awareness of the duration different circuits could be used and the cost implications of changes between modes and hence circuits.

Published
2022

10. Nurse Practitioner Follow-Up Care Using Telehealth MMSE

Author

Mary Val Palumbo, Victoria Greenough, Betty Rambur, and Peter W Callas

Subjects
Epidemiology, Health Policy, Aftercare, COVID-19, Mental Status and Dementia Tests, Telemedicine, Psychiatry and Mental health, Cellular and Molecular Neuroscience, Developmental Neuroscience, Humans, Dementia, Neurology (clinical), Geriatrics and Gerontology, Pandemics, Retrospective Studies
Abstract

During the COVID-19 pandemic, many healthcare services moved to telehealth delivery for continuation of care. The Mini Mental Status Examination (MMSE) has been used for follow-up assessment of disease progression and care planning after dementia diagnosis. Carotentuto et al. (2018) found no difference in MMSE scores when repeating a telehealth MMSE two weeks after a face-to-face visit. The purpose of this study was to determine if telehealth cognitive testing (MMSE) is a reliable alternative to traditional face-to-face testing when nurse practitioners are providing follow-up care (every 6 months) for person with dementia and their families.To evaluate MMSE testing administered via telehealth, a retrospective chart review of patients (N = 90) seen between April 2020 and December 2021 was conducted. Those fitting the inclusion criteria of at least two previous face-to-face MMSE assessments, and two MMSE telehealth assessments were analyzed (n = 45). Linear regression calculated the slope for each patient's MMSE score per year to compare the face-to-face and telehealth rates of cognitive decline for each individual. A paired t-test was used to compare MMSE slope for face-to-face and telehealth assessments.Although there was a larger decrease per year in MMSE score across telehealth assessments (during the pandemic) when compared to in-person (-2.7 vs -1.2, respectively), the difference in individual decline was not statistically significant (p = 0.10). There was also no significant difference between MMSE slope of decline in each of the two nurse practitioner providers for in-person testing mean (p = 0.32), telehealth mean (p = 0.34) and difference in slopes (p = 0.27).These preliminary findings indicate that administering the MMSE via telehealth does not result in scores that are markedly different from in-person testing. Therefore, it is reasonable to use telehealth for follow-up dementia care visits when an objective measure of cognitive decline is helpful to guide family caregiving. Telehealth may be a good alternative for patients and family who are unwilling or unable to travel to the clinic due to health concerns, poor weather, long travel time or agitation in a clinic setting, even when the pandemic has ended.

Published
2022

12. Hydrocortisone to Prevent Bronchopulmonary Dysplasia — Not a Silver Bullet

Author

Anne Greenough

Subjects
Hydrocortisone, Management of Technology and Innovation, Infant, Newborn, Humans, General Medicine, Infant, Premature, Article, Bronchopulmonary Dysplasia
Abstract

BACKGROUND: Bronchopulmonary dysplasia is a prevalent complication after extremely preterm birth. Inflammation with mechanical ventilation may contribute to its development. Whether hydrocortisone treatment after the second postnatal week can improve survival without bronchopulmonary dysplasia and without adverse neurodevelopmental effects is unknown. METHODS: We conducted a trial involving infants who had a gestational age of less than 30 weeks and who had been intubated for at least 7 days at 14 to 28 days. Infants were randomly assigned to receive either hydrocortisone (4 mg per kilogram of body weight per day tapered over a period of 10 days) or placebo. Mandatory extubation thresholds were specified. The primary efficacy outcome was survival without moderate or severe bronchopulmonary dysplasia at 36 weeks of postmenstrual age, and the primary safety outcome was survival without moderate or severe neurodevelopmental impairment at 22 to 26 months of corrected age. RESULTS: We enrolled 800 infants (mean [±SD] birth weight, 715±167 g; mean gestational age, 24.9±1.5 weeks). Survival without moderate or severe bronchopulmonary dysplasia at 36 weeks occurred in 66 of 398 infants (16.6%) in the hydrocortisone group and in 53 of 402 (13.2%) in the placebo group (adjusted rate ratio, 1.27; 95% confidence interval [CI], 0.93 to 1.74). Two-year outcomes were known for 91.0% of the infants. Survival without moderate or severe neurodevelopmental impairment occurred in 132 of 358 infants (36.9%) in the hydrocortisone group and in 134 of 359 (37.3%) in the placebo group (adjusted rate ratio, 0.98; 95% CI, 0.81 to 1.18). Hypertension that was treated with medication occurred more frequently with hydrocortisone than with placebo (4.3% vs. 1.0%). Other adverse events were similar in the two groups. CONCLUSIONS: In this trial involving preterm infants, hydrocortisone treatment starting on postnatal day 14 to 28 did not result in substantially higher survival without moderate or severe bronchopulmonary dysplasia than placebo. Survival without moderate or severe neurodevelopmental impairment did not differ substantially between the two groups. (Funded by the National Institutes of Health; ClinicalTrials.gov number, NCT01353313.)

Published
2022

13. Expression of SARS coronavirus 1 spike protein from a herpesviral vector induces innate immune signaling and neutralizing antibody responses

Author

Hyung Suk Oh, Shenghua Zhou, LuCheng Cao, Timothy Dudek, Jenny Wun-Yue Che, Daisuke Watanabe, Fernando Diaz, Thomas C. Greenough, Leisa Mandell, Evelyn A. Kurt-Jones, David M. Knipe, Robert W. Finberg, Gregory J. Babcock, and Changhong Zhou

Subjects
SARS coronavirus, Genetic Vectors, Inflammation, Herpesvirus 1, Human, Herpes simplex virus, Antibodies, Viral, medicine.disease_cause, Article, Cell Line, Cell Fusion, Mice, 03 medical and health sciences, Virology, medicine, Animals, Humans, Vaccines, Virus-Like Particle, Neutralizing antibody, 030304 developmental biology, 0303 health sciences, Cell fusion, Innate immune system, biology, fungi, 030302 biochemistry & molecular biology, Respiratory infection, Viral Vaccines, Antibodies, Neutralizing, Immunity, Innate, Cell biology, Severe acute respiratory syndrome-related coronavirus, Spike Glycoprotein, Coronavirus, biology.protein, Cytokines, medicine.symptom, Signal transduction, Antibody, Signal Transduction
Abstract

SARS coronavirus 1 (SARS-CoV-1) causes a respiratory infection that can lead to acute respiratory distress characterized by inflammation and high levels of cytokines in the lung tissue. In this study we constructed a herpes simplex virus 1 replication-defective mutant vector expressing SARS-CoV-1 spike protein as a potential vaccine vector and to probe the effects of spike protein on host cells. The spike protein expressed from this vector is functional in that it localizes to the surface of infected cells and induces fusion of ACE2-expressing cells. In immunized mice, the recombinant vector induced antibodies that bind to spike protein in an ELISA assay and that show neutralizing activity. The spike protein expressed from this vector can induce the expression of cytokines in an ACE2-independent, MyD88-dependent process. These results argue that the SARS-CoV-1 spike protein intrinsically activates signaling pathways that induce cytokines and contribute directly to the inflammatory process of SARS.

Published
2021

14. The effect of postnatal corticosteroids on growth parameters in infants with bronchopulmonary dysplasia

Author

Theodore Dassios, Mikhaela Mann, Anne Greenough, and Emma E Williams

Subjects
Male, Pediatrics, medicine.medical_specialty, Neonatal intensive care unit, Hydrocortisone, Side effect, medicine.drug_class, Dexamethasone, Child Development, Adrenal Cortex Hormones, Intensive Care Units, Neonatal, medicine, Body Size, Humans, Infant, Very Low Birth Weight, Respiratory function, Growth Disorders, Bronchopulmonary Dysplasia, business.industry, Body Weight, Infant, Newborn, Obstetrics and Gynecology, medicine.disease, Respiration, Artificial, United Kingdom, Bronchopulmonary dysplasia, Pediatrics, Perinatology and Child Health, Intensive Care, Neonatal, Corticosteroid, Female, medicine.symptom, business, Weight gain, medicine.drug
Abstract

Objectives Corticosteroids are administered to ventilator dependent infants with bronchopulmonary dysplasia (BPD) to improve respiratory function and facilitating extubation. Acutely, however, growth impairment can occur as a side effect of such therapy. We aimed to determine the effect of corticosteroids on postnatal growth during the entire neonatal intensive care unit (NICU) admission. Methods A whole population study of extremely preterm infants with BPD was undertaken. Corticosteroid therapy was classified as treatment with dexamethasone or hydrocortisone for a least five consecutive days. Growth was calculated as the difference in weight and head circumference z-score from birth to discharge. Results Six thousand, one hundred and four infants with BPD were included of whom 28.3% received postnatal corticosteroids. Infants receiving corticosteroids were less mature (GA 25.0 vs. 26.3 weeks) and of lower birthweight (0.70 vs. 0.84 kg) than those not receiving treatment. There were no significant differences between those who did and did not receive corticosteroids in weight gain (p=0.61) or head circumference growth (p=0.33) from birth to discharge. Single vs. multiple courses of postnatal corticosteroids did not result in significant differences in weight (p=0.62) or head circumference (p=0.13) growth. Conclusions Postnatal corticosteroid treatment did not affect the longer term growth of preterm infants with BPD.

Published
2021

15. Influence of bronchopulmonary dysplasia on lung function in adolescents who were born extremely prematurely

Author

Christopher Harris, Samuel Morris, Alan Lunt, Janet Peacock, and Anne Greenough

Subjects
Pulmonary and Respiratory Medicine, Young Adult, Adolescent, Spirometry, Pediatrics, Perinatology and Child Health, Infant, Newborn, Infant, Humans, Prospective Studies, Lung, Bronchopulmonary Dysplasia, Follow-Up Studies
Abstract

To assess if a previous diagnosis of bronchopulmonary dysplasia (BPD) was associated with poorer lung function at 16 to 19 years of age, regardless of whether postnatal corticosteroids had been administered.Infants with BPD will have poorer lung function at 16 to 19 years of age.Prospective follow-up study.One hundred and sixty-one participants aged between 16 and 19 years who were born at less than 29 weeks of gestation; 87 had had BPD.Lung function was assessed by spirometry (FEVAt 16 to 19 years, those who had had a diagnosis of BPD had poorer airway function (FEVIn adolescents and young adults born prematurely, those who had BPD had poorer lung function compared to those without, regardless of whether they had received postnatal corticosteroids.

Published
2022

16. Volumetric capnography pre- and post-surfactant during initial resuscitation of premature infants

Author

Anne Greenough, Katie A. Hunt, Emma E Williams, and Theodore Dassios

Subjects
Resuscitation, Birth weight, Infant, Premature, Diseases, Surface-Active Agents, 03 medical and health sciences, 0302 clinical medicine, Pulmonary surfactant, Capnography, Tidal Volume, Humans, Medicine, Respiratory function, Tidal volume, business.industry, Infant, Newborn, Infant, Gestational age, Pulmonary Surfactants, 030208 emergency & critical care medicine, Airway obstruction, medicine.disease, Respiration, Artificial, 030228 respiratory system, Anesthesia, Pediatrics, Perinatology and Child Health, Breathing, business, Infant, Premature
Abstract

Background Volumetric capnography allows for continuous monitoring of expired tidal volume and carbon dioxide. The slope of the alveolar plateau of the capnogram (SIII) could provide information regarding ventilation homogeneity. We aimed to assess the feasibility of measuring SIII during newborn resuscitation and determine if SIII decreased after surfactant indicating ventilation inhomogeneity improvement. Methods Respiratory function traces of preterm infants resuscitated at birth were analysed. Ten capnograms were constructed for each infant: five pre- and post-surfactant. If a plateau was present SIII was calculated by regression analysis. Results Thirty-six infants were included, median gestational age of 28.7 weeks and birth weight of 1055 g. Average time between pre- and post-surfactant was 3.2 min. Three hundred and sixty capnograms (180 pre and post) were evaluated. There was adequate slope in 134 (74.4%) capnograms pre and in 100 (55.6%) capnograms post-surfactant (p = 0.004). Normalised for tidal volume SIII pre-surfactant was 18.89 mmHg and post-surfactant was 24.86 mmHg (p = 0.006). An increase in SIII produced an up-slanting appearance to the plateau indicating regional obstruction. Conclusion It was feasible to evaluate the alveolar plateau pre-surfactant in preterm infants. Ventilation inhomogeneity increased post-surfactant likely due to airway obstruction caused by liquid surfactant present in the airways. Impact Volumetric capnography can be used to assess homogeneity of ventilation by SIII analysis. Ventilation inhomogeneity increased immediately post-surfactant administration during the resuscitation of preterm infants, producing a characteristic up-slanting appearance to the alveolar plateau. The best determinant of alveolar plateau presence in preterm infants was the expired tidal volume.

Published
2021

17. Impact of COVID-19 on Cardiovascular Testing in the United States Versus the Rest of the World

Author

Hirschfeld, Cole B., Shaw, Leslee J., Williams, Michelle C., Lahey, Ryan, Villines, Todd C., Dorbala, Sharmila, Choi, Andrew D., Shah, Nishant R., Bluemke, David A., Berman, Daniel S., Blankstein, Ron, Ferencik, Maros, Narula, Jagat, Winchester, David, Malkovskiy, Eli, Goebel, Benjamin, Randazzo, Michael J., Lopez-Mattei, Juan, Parwani, Purvi, Vitola, Joao V., Cerci, Rodrigo J., Better, Nathan, Raggi, Paolo, Lu, Bin, Sergienko, Vladimir, Sinitsyn, Valentin, Kudo, Takashi, Nørgaard, Bjarne Linde, Maurovich-Horvat, Pál, Cohen, Yosef A., Pascual, Thomas N. B., Pynda, Yaroslav, Dondi, Maurizio, Paez, Diana, Einstein, Andrew J., Cerci, Rodrigo, Hinterleitner, Gerd, Lu, Yao, Morozova, Olga, Xu, Zhuoran, Cohen, Yosef, Randazzo, Michael, Choi, Andrew, Nasery, Mohammad Nawaz, Goda, Artan, Shirka, Ervina, Benlabgaa, Rabie, Bouyoucef, Salah, Medjahedi, Abdelkader, Nailli, Qais, Agolti, Mariela, Aguero, Roberto Nicolas, Alak, Maria del Carmen, Alberguina, Lucia Graciela, Arroñada, Guillermo, Astesiano, Andrea, Astesiano, Alfredo, Norton, Carolina Bas, Benteo, Pablo, Blanco, Juan, Bonelli, Juan Manuel, Bustos, Jose Javier, Cabrejas, Raul, Cachero, Jorge, Campisi, Roxana, Canderoli, Alejandro, Carames, Silvia, Carrascosa, Patrícia, Castro, Ricardo, Cendoya, Oscar, Cognigni, Luciano Martin, Collaud, Carlos, Cortes, Claudia, Courtis, Javier, Cragnolino, Daniel, Daicz, Mariana, De La Vega, Alejandro, De Maria, Silvia Teresa, Del Riego, Horacio, Dettori, Fernando, Deviggiano, Alejandro, Dragonetti, Laura, Embon, Mario, Enriquez, Ruben Emilio, Ensinas, Jorge, Faccio, Fernando, Facello, Adolfo, Garofalo, Diego, Geronazzo, Ricardo, Gonza, Natalia, Gutierrez, Lucas, Guzzo, Miguel Angel, Hasbani, Victor, Huerin, Melina, Jäger, Victor, Lewkowicz, Julio Manuel, Nieves A López De Munaín, Maria, Lotti, Jose Maria, Marquez, Alejandra, Masoli, Osvaldo, Masoli, Osvaldo Horacio, Mastrovito, Edgardo, Mayoraz, Matias, Melado, Graciela Eva, Mele, Anibal, Merani, Maria Fernanda, Meretta, Alejandro Horacio, Molteni, Susana, Montecinos, Marcos, Noguera, Eduardo, Novoa, Carlos, Sueldo, Claudio Pereyra, Ascani, Sebastian Perez, Pollono, Pablo, Pujol, Maria Paula, Radzinschi, Alejandro, Raimondi, Gustavo, Redruello, Marcela, Rodríguez, Marina, Rodríguez, Matías, Romero, Romina Lorena, Acuña, Arturo Romero, Rovaletti, Federico, San Miguel, Lucas, Solari, Lucrecia, Strada, Bruno, Traverso, Sonia, Traverzo, Sonia Simona, Espeche, Maria del Huerto Velazquez, Weihmuller, Juan Sebastian, Wolcan, Juan, Zeffiro, Susana, Sakanyan, Mari, Beuzeville, Scott, Boktor, Raef, Butler, Patrick, Calcott, Jennifer, Carr, Loretta, Chan, Virgil, Chao, Charles, Chong, Woon, Dobson, Mark, Downie, D'Arne, Dwivedi, Girish, Elison, Barry, Engela, Jean, Francis, Roslyn, Gaikwad, Anand, Basavaraj, Ashok Gangasandra, Goodwin, Bruce, Greenough, Robert, Hamilton-Craig, Christian, Hsieh, Victar, Joshi, Subodh, Lederer, Karin, Lee, Kenneth, Lee, Joseph, Magnussen, John, Mai, Nghi, Mander, Gordon, Murton, Fiona, Nandurkar, Dee, Neill, Johanne, O'Rourke, Edward, O'Sullivan, Patricia, Pandos, George, Pathmaraj, Kunthi, Pitman, Alexander, Poulter, Rohan, Premaratne, Manuja, Prior, David, Ridley, Lloyd, Rutherford, Natalie, Salehi, Hamid, Saunders, Connor, Scarlett, Luke, Seneviratne, Sujith, Shetty, Deepa, Shrestha, Ganesh, Shulman, Jonathan, Solanki, Vijay, Stanton, Tony, Stuart, Murch, Stubbs, Michael, Swainson, Ian, Taubman, Kim, Taylor, Andrew, Thomas, Paul, Unger, Steven, Upton, Anthony, Vamadevan, Shankar, Van Gaal, William, Verjans, Johan, Voutnis, Demetrius, Wayne, Victor, Wilson, Peter, Wong, David, Wong, Kirby, Younger, John, Feuchtner, Gudrun, Mirzaei, Siroos, Weiss, Konrad, Maroz-Vadalazhskaya, Natallia, Gheysens, Olivier, Homans, Filip, Moreno-Reyes, Rodrigo, Pasquet, Agnès, Roelants, Veronique, Van De Heyning, Caroline M., Ríos, Raúl Araujo, Soldat-Stankovic, Valentina, Stankovic, Sinisa, Albernaz Siqueira, Maria Helena, Almeida, Augusto, Alves Togni, Paulo Henrique, Andrade, Jose Henrique, Andrade, Luciana, Anselmi, Carlos, Araújo, Roberta, Azevedo, Guilherme, Bezerra, Sabbrina, Biancardi, Rodrigo, Grossman, Gabriel Blacher, Brandão, Simone, Pianta, Diego Bromfman, Carreira, Lara, Castro, Bruno, Chang, Tien, Cunali, Fernando, Cury, Roberto, Dantas, Roberto, de Amorim Fernandes, Fernando, De Lorenzo, Andrea, De Macedo Filho, Robson, Erthal, Fernanda, Fernandes, Fabio, Fernandes, Juliano, De Souza, Thiago Ferreira, Alves, Wilson Furlan, Ghini, Bruno, Goncalves, Luiz, Gottlieb, Ilan, Hadlich, Marcelo, Kameoka, Vinícius, Lima, Ronaldo, Lima, Adna, Lopes, Rafael Willain, Machado e Silva, Ricardo, Magalhães, Tiago, Silva, Fábio Martins, Mastrocola, Luiz Eduardo, Medeiros, Fábio, Meneghetti, José Claudio, Naue, Vania, Naves, Danilo, Nolasco, Roberto, Nomura, Cesar, Oliveira, Joao Bruno, Paixao, Eduardo, De Carvalho, Filipe Penna, Pinto, Ibraim, Possetti, Priscila, Quinta, Mayra, Nogueira Ramos, Rodrigo Rizzo, Rocha, Ricardo, Rodrigues, Alfredo, Rodrigues, Carlos, Romantini, Leila, Sanches, Adelina, Santana, Sara, Sara da Silva, Leonardo, Schvartzman, Paulo, Matushita, Cristina Sebastião, Senra, Tiago, Shiozaki, Afonso, Menezes de Siqueira, Maria Eduarda, Siqueira, Cristiano, Smanio, Paola, Soares, Carlos Eduardo, Junior, José Soares, Bittencourt, Marcio Sommer, Spiro, Bernardo, Mesquita, Cláudio Tinoco, Torreao, Jorge, Torres, Rafael, Uellendahl, Marly, Monte, Guilherme Urpia, Veríssimo, Otávia, Cabeda, Estevan Vieira, Pedras, Felipe Villela, Waltrick, Roberto, Zapparoli, Marcello, Naseer, Hamid, Garcheva-Tsacheva, Marina, Kostadinova, Irena, Theng, Youdaline, Abikhzer, Gad, Barette, Rene, Chow, Benjamin, Dabreo, Dominique, Friedrich, Matthias, Garg, Ria, Hafez, Mohammed Nassoh, Johnson, Chris, Kiess, Marla, Leipsic, Jonathon, Leung, Eugene, Miller, Robert, Oikonomou, Anastasia, Probst, Stephan, Roifman, Idan, Small, Gary, Tandon, Vikas, Trivedi, Adwait, White, James, Zukotynski, Katherine, Canessa, Jose, Muñoz, Gabriel Castro, Concha, Carmen, Hidalgo, Pablo, Lovera, Cesar, Massardo, Teresa, Vargas, Luis Salazar, Abad, Pedro, Arturo, Harold, Ayala, Sandra, Benitez, Luis, Cadena, Alberto, Caicedo, Carlos, Moncayo, Antonio Calderón, Gomez, Sharon, Gutierrez Villamil, Claudia T., Jaimes, Claudia, Londoño, Juan, Londoño Blair, Juan Luis, Pabon, Luz, Pineda, Mauricio, Rojas, Juan Carlos, Ruiz, Diego, Escobar, Manuel Valencia, Vasquez, Andres, Vergel, Damiana, Zuluaga, Alejandro, Gamboa, Isabel Berrocal, Castro, Gabriel, González, Ulises, Baric, Ana, Batinic, Tonci, Franceschi, Maja, Paar, Maja Hrabak, Jukic, Mladen, Medakovic, Petar, Persic, Viktor, Prpic, Marina, Punda, Ante, Batista, Juan Felipe, Gómez Lauchy, Juan Manuel, Gutierrez, Yamile Marcos, Menéndez, Rayner, Peix, Amalia, Rochela, Luis, Panagidis, Christoforos, Petrou, Ioannis, Engelmann, Vaclav, Kaminek, Milan, Kincl, Vladimír, Lang, Otto, Simanek, Milan, Abdulla, Jawdat, Bøttcher, Morten, Christensen, Mette, Gormsen, Lars Christian, Hasbak, Philip, Hess, Søren, Holdgaard, Paw, Johansen, Allan, Kyhl, Kasper, Norgaard, Bjarne Linde, Øvrehus, Kristian Altern, Rønnow Sand, Niels Peter, Steffensen, Rolf, Thomassen, Anders, Zerahn, Bo, Perez, Alfredo, Escorza Velez, Giovanni Alejandro, Velez, Mayra Sanchez, Abdel Aziz, Islam Shawky, Abougabal, Mahasen, Ahmed, Taghreed, Allam, Adel, Asfour, Ahmed, Hassan, Mona, Hassan, Alia, Ibrahim, Ahmed, Kaffas, Sameh, Kandeel, Ahmed, Ali, Mohamed Mandour, Mansy, Ahmad, Maurice, Hany, Nabil, Sherif, Shaaban, Mahmoud, Flores, Ana Camila, Poksi, Anne, Knuuti, Juhani, Kokkonen, Velipekka, Larikka, Martti, Uusitalo, Valtteri, Bailly, Matthieu, Burg, Samuel, Deux, Jean-François, Habouzit, Vincent, Hyafil, Fabien, Lairez, Olivier, Proffit, Franck, Regaieg, Hamza, Sarda-Mantel, Laure, Tacher, Vania, Schneider, Roman P., Ayetey, Harold, Angelidis, George, Archontaki, Aikaterini, Chatziioannou, Sofia, Datseris, Ioannis, Fragkaki, Christina, Georgoulias, Panagiotis, Koukouraki, Sophia, Koutelou, Maria, Kyrozi, Eleni, Repasos, Evangelos, Stavrou, Petros, Valsamaki, Pipitsa, Gonzalez, Carla, Gutierrez, Goleat, Maldonado, Alejandro, Buga, Klara, Garai, Ildiko, Schmidt, Erzsébet, Szilveszter, Balint, Várady, Edit, Banthia, Nilesh, Bhagat, Jinendra Kumar, Bhargava, Rishi, Bhat, Vivek, Bhatia, Mona, Choudhury, Partha, Chowdekar, Vijay Sai, Irodi, Aparna, Jain, Shashank, Joseph, Elizabeth, Kumar, Sukriti, Girijanandan Mahapatra, Prof Dr, Mitra, Deepanjan, Mittal, Bhagwant Rai, Ozair, Ahmad, Patel, Chetan, Patel, Tapan, Patel, Ravi, Patel, Shivani, Saxena, Sudhir, Sengupta, Shantanu, Singh, Santosh, Singh, Bhanupriya, Sood, Ashwani, Verma, Atul, Affandi, Erwin, Alam Edison, Padma Savenadia, Gunawan, Gani, Hapkido, Habusari, Hidayat, Basuki, Huda, Aulia, Mukti, Anggoro Praja, Prawiro, Djoko, Soeriadi, Erwin Affandi, Syawaluddin, Hilman, Albadr, Amjed, Assadi, Majid, Emami, Farshad, Houshmand, Golnaz, Maleki, Majid, Rostami, Maryam Tajik, Zakavi, Seyed Rasoul, Zaid, Eed Abu, Agranovich, Svetlana, Arnson, Yoav, Bar-Shalom, Rachel, Frenkel, Alex, Knafo, Galit, Lugassi, Rachel, Maor Moalem, Israel Shlomo, Mor, Maya, Muskal, Noam, Ranser, Sara, Shalev, Aryeh, Albano, Domenico, Alongi, Pierpaolo, Arnone, Gaspare, Bagatin, Elisa, Baldari, Sergio, Bauckneht, Matteo, Bertelli, Paolo, Bianco, Francesco, Bonfiglioli, Rachele, Boni, Roberto, Bruno, Andrea, Bruno, Isabella, Busnardo, Elena, Califaretti, Elena, Camoni, Luca, Carnevale, Aldo, Casoni, Roberta, Cavallo, Armando Ugo, Cavenaghi, Giorgio, Chierichetti, Franca, Chiocchi, Marcello, Cittanti, Corrado, Colletta, Mauro, Conti, Umberto, Cossu, Alberto, Cuocolo, Alberto, Cuzzocrea, Marco, De Rimini, Maria Luisa, De Vincentis, Giuseppe, Del Giudice, Eleonora, Del Torto, Alberico, Della Tommasina, Veronica, Durmo, Rexhep, Erba, Paola Anna, Evangelista, Laura, Faletti, Riccardo, Faragasso, Evelina, Farsad, Mohsen, Ferro, Paola, Florimonte, Luigia, Frantellizzi, Viviana, Fringuelli, Fabio Massimo, Gatti, Marco, Gaudiano, Angela, Gimelli, Alessia, Giubbini, Raffaele, Giuffrida, Francesca, Ialuna, Salvatore, Laudicella, Riccardo, Leccisotti, Lucia, Leva, Lucia, Liga, Riccardo, Liguori, Carlo, Longo, Giampiero, Maffione, Margherita, Mancini, Maria Elisabetta, Marcassa, Claudio, Milan, Elisa, Nardi, Barbara, Pacella, Sara, Pepe, Giovanna, Pontone, Gianluca, Pulizzi, Sabina, Quartuccio, Natale, Rampin, Lucia, Ricci, Fabrizio, Rossini, Pierluigi, Rubini, Giuseppe, Russo, Vincenzo, Sacchetti, Gian Mauro, Sambuceti, Gianmario, Scarano, Massimo, Sciagrà, Roberto, Sperandio, Massimiliano, Stefanelli, Antonella, Ventroni, Guido, Zoboli, Stefania, Baugh, Dainia, Chambers, Duane, Madu, Ernest, Nunura, Felix, Asano, Hiroshi, Chimura, Chimura Misato, Fujimoto, Shinichiro, Fujisue, Koichiro, Fukunaga, Tomohisa, Fukushima, Yoshimitsu, Fukuyama, Kae, Hashimoto, Jun, Ichikawa, Yasutaka, Iguchi, Nobuo, Imai, Masamichi, Inaki, Anri, Ishimura, Hayato, Isobe, Satoshi, Kadokami, Toshiaki, Kato, Takao, Kumita, Shinichiro, Maruno, Hirotaka, Mataki, Hiroyuki, Miyagawa, Masao, Morimoto, Ryota, Moroi, Masao, Nagamachi, Shigeki, Nakajima, Kenichi, Nakata, Tomoaki, Nakazato, Ryo, Nanasato, Mamoru, Naya, Masanao, Norikane, Takashi, Ohta, Yasutoshi, Okayama, Satoshi, Okizaki, Atsutaka, Otomi, Yoichi, Otsuka, Hideki, Saito, Masaki, Sakata, Sakata Yasushi, Sarai, Masayoshi, Sato, Daisuke, Shiraishi, Shinya, Suwa, Yoshinobu, Takanami, Kentaro, Takehana, Kazuya, Taki, Junichi, Tamaki, Nagara, Taniguchi, Yasuyo, Teragawa, Hiroki, Tomizawa, Nobuo, Tsujita, Kenichi, Umeji, Kyoko, Wakabayashi, Yasushi, Yamada, Shinichiro, Yamazaki, Shinya, Yoneyama, Tatsuya, Rawashdeh, Mohammad, Batyrkhanov, Daultai, Dautov, Tairkhan, Makhdomi, Khalid, Ombati, Kevin, Alkandari, Faridah, Garashi, Masoud, Coie, Tchoyoson Lim, Rajvong, Sonexay, Kalinin, Artem, Kalnina, Marika, Haidar, Mohamad, Komiagiene, Renata, Kviecinskiene, Giedre, Mataciunas, Mindaugas, Vajauskas, Donatas, Picard, Christian, Karim, Noor Khairiah A., Reichmuth, Luise, Samuel, Anthony, Allarakha, Mohammad Aaftaab, Naojee, Ambedhkar Shantaram, Alexanderson-Rosas, Erick, Barragan, Erika, González-Montecinos, Alejandro Becerril, Cabada, Manuel, Rodriguez, Daniel Calderon, Carvajal-Juarez, Isabel, Cortés, Violeta, Cortés, Filiberto, De La Peña, Erasmo, Gama-Moreno, Manlio, González, Luis, Ramírez, Nelsy Gonzalez, Jiménez-Santos, Moisés, Matos, Luis, Monroy, Edgar, Morelos, Martha, Ornelas, Mario, Ortga Ramirez, Jose Alberto, Preciado-Anaya, Andrés, Preciado-Gutiérrez, Óscar Ulises, Barragan, Adriana Puente, Rosales Uvera, Sandra Graciela, Sandoval, Sigelinda, Tomas, Miguel Santaularia, Sierra-Galan, Lilia M., Siu, Silvia, Vallejo, Enrique, Valles, Mario, Faraggi, Marc, Sereegotov, Erdenechimeg, Ilic, Srdja, Ben-Rais, Nozha, Alaoui, Nadia Ismaili, Taleb, Sara, Myo, Khin Pa, Thu, Phyo Si, Ghimire, Ram Kumar, Rajbanshi, Bijoy, Barneveld, Peter, Glaudemans, Andor, Habets, Jesse, Koopmans, Klaas Pieter, Manders, Jeroen, Pool, Stefan, Scholte, Arthur, Scholtens, Asbjørn, Slart, Riemer, Thimister, Paul, Van Asperen, Erik-Jan, Veltman, Niels, Verschure, Derk, Wagenaar, Nils, Edmond, John, Ellis, Chris, Johnson, Kerryanne, Keenan, Ross, Hua, Shaw, Occleshaw, Christopher, Sasse, Alexander, To, Andrew, Van Pelt, Niels, Young, Calum, Cuadra, Teresa, Roque Vanegas, Hector Bladimir, Soli, Idrissa Adamou, Issoufou, Djibrillou Moussa, Ayodele, Tolulope, Madu, Chibuzo, Onimode, Yetunde, Efros-Monsen, Elen, Forsdahl, Signe Helene, Hildre Dimmen, Jenni-Mari, Jørgensen, Arve, Krohn, Isabel, Løvhaugen, Pål, Bråten, Anders Tjellaug, Al Dhuhli, Humoud, Al Kindi, Faiza, Al-Bulushi, Naeema, Jawa, Zabah, Tag, Naima, Afzal, Muhammad Shehzad, Fatima, Shazia, Younis, Muhammad Numair, Riaz, Musab, Saadullah, Mohammad, Herrera, Yariela, Lenturut-Katal, Dora, Vázquez, Manuel Castillo, Ortellado, José, Akhter, Afroza, Cao, Dianbo, Cheung, Stephen, Dai, Xu, Gong, Lianggeng, Han, Dan, Hou, Yang, Li, Caiying, Li, Tao, Li, Dong, Li, Sijin, Liu, Jinkang, Liu, Hui, Ng, Ming Yen, Sun, Kai, Tang, Gongshun, Wang, Jian, Wang, Ximing, Wang, Zhao-Qian, Wang, Yining, Wang, Yifan, Wu, Jiang, Wu, Zhifang, Xia, Liming, Xiao, Jiangxi, Xu, Lei, Yang, Youyou, Yin, Wu, Yu, Jianqun, Yuan, Li, Zhang, Tong, Zhang, Longjiang, Zhang, Yong-Gao, Zhang, Xiaoli, Zhu, Li, Alfaro, Ana, Abrihan, Paz, Barroso, Asela, Cruz, Eric, Gomez, Marie Rhiamar, Magboo, Vincent Peter, Medina, John Michael, Obaldo, Jerry, Pastrana, Davidson, Pawhay, Christian Michael, Quinon, Alvin, Tang, Jeanelle Margareth, Tecson, Bettina, Uson, Kristine Joy, Uy, Mila, Kostkiewicz, Magdalena, Kunikowska, Jolanta, Bettencourt, Nuno, Cantinho, Guilhermina, Ferreira, Antonio, Syed, Ghulam, Arnous, Samer, Atyani, Said, Byrne, Angela, Gleeson, Tadhg, Kerins, David, Meehan, Conor, Murphy, David, Murphy, Mark, Murray, John, O'Brien, Julie, Bang, Ji-In, Bom, Henry, Cho, Sang-Geon, Hong, Chae Moon, Jang, Su Jin, Jeong, Yong Hyu, Kang, Won Jun, Kim, Ji-Young, Lee, Jaetae, Namgung, Chang Kyeong, So, Young, Won, Kyoung Sook, Majstorov, Venjamin, Vavlukis, Marija, Salobir, Barbara Gužic, Štalc, Monika, Benedek, Theodora, Benedek, Imre, Mititelu, Raluca, Stan, Claudiu Adrian, Ansheles, Alexey, Dariy, Olga, Drozdova, Olga, Gagarina, Nina, Gulyaev, Vsevolod Milyevich, Itskovich, Irina, Karalkin, Anatoly, Kokov, Alexander, Migunova, Ekaterina, Pospelov, Viktor, Ryzhkova, Daria, Saifullina, Guzaliya, Sazonova, Svetlana, Shurupova, Irina, Trifonova, Tatjana, Ussov, Wladimir Yurievich, Vakhromeeva, Margarita, Valiullina, Nailya, Zavadovsky, Konstantin, Zhuravlev, Kirill, Alasnag, Mirvat, Okarvi, Subhani, Saranovic, Dragana Sobic, Keng, Felix, Jason See, Jia Hao, Sekar, Ramkumar, Yew, Min Sen, Vondrak, Andrej, Bejai, Shereen, Bennie, George, Bester, Ria, Engelbrecht, Gerrit, Evbuomwan, Osayande, Gongxeka, Harlem, Vuuren, Magritha Jv, Kaplan, Mitchell, Khushica, Purbhoo, Lakhi, Hoosen, Louw, Lizette, Malan, Nico, Milos, Katarina, Modiselle, Moshe, More, Stuart, Naidoo, Mathava, Scholtz, Leonie, Vangu, Mboyo, Aguadé-Bruix, Santiago, Blanco, Isabel, Cabrera, Antonio, Camarero, Alicia, Casáns-Tormo, Irene, Cuellar-Calabria, Hug, Flotats, Albert, Fuentes Cañamero, Maria Eugenia, García, María Elia, Jimenez-Heffernan, Amelia, Leta, Rubén, Diaz, Javier Lopez, Lumbreras, Luis, Marquez-Cabeza, Juan Javier, Martin, Francisco, Martinez de Alegria, Anxo, Medina, Francisco, Canal, Maria Pedrera, Peiro, Virginia, Pubul-Nuñez, Virginia, Rayo Madrid, Juan Ignacio, Rey, Cristina Rodríguez, Perez, Ricardo Ruano, Ruiz, Joaquín, Hernández, Gertrudis Sabatel, Sevilla, Ana, Zeidán, Nahla, Nanayakkara, Damayanthi, Udugama, Chandraguptha, Simonsson, Magnus, Alkadhi, Hatem, Buechel, Ronny Ralf, Burger, Peter, Ceriani, Luca, De Boeck, Bart, Gräni, Christoph, Juillet de Saint Lager Lucas, Alix, Kamani, Christel H., Kawel-Boehm, Nadine, Manka, Robert, Prior, John O., Rominger, Axel, Vallée, Jean-Paul, Khiewvan, Benjapa, Premprabha, Teerapon, Thientunyakit, Tanyaluck, Sellem, Ali, Kir, Kemal Metin, Sayman, Haluk, Sebikali, Mugisha Julius, Muyinda, Zerida, Kmetyuk, Yaroslav, Korol, Pavlo, Mykhalchenko, Olena, Pliatsek, Volodymyr, Satyr, Maryna, Albalooshi, Batool, Ahmed Hassan, Mohamed Ismail, Anderson, Jill, Bedi, Punit, Biggans, Thomas, Bularga, Anda, Bull, Russell, Burgul, Rajesh, Carpenter, John-Paul, Coles, Duncan, Cusack, David, Deshpande, Aparna, Dougan, John, Fairbairn, Timothy, Farrugia, Alexia, Gopalan, Deepa, Gummow, Alistair, Ramkumar, Prasad Guntur, Hamilton, Mark, Harbinson, Mark, Hartley, Thomas, Hudson, Benjamin, Joshi, Nikhil, Kay, Michael, Kelion, Andrew, Khokhar, Azhar, Kitt, Jamie, Lee, Ken, Low, Chen, Mak, Sze Mun, Marousa, Ntouskou, Martin, Jon, Mcalindon, Elisa, Menezes, Leon, Morgan-Hughes, Gareth, Moss, Alastair, Murray, Anthony, Nicol, Edward, Patel, Dilip, Peebles, Charles, Pugliese, Francesca, Luis Rodrigues, Jonathan Carl, Rofe, Christopher, Sabharwal, Nikant, Schofield, Rebecca, Semple, Thomas, Sharma, Naveen, Strouhal, Peter, Subedi, Deepak, Topping, William, Tweed, Katharine, Weir-Mccall, Jonathan, Abbara, Suhny, Abbasi, Taimur, Abbott, Brian, Abohashem, Shady, Abramson, Sandra, Al-Abboud, Tarek, Al-Mallah, Mouaz, Almousalli, Omar, Ananthasubramaniam, Karthikeyan, Kumar, Mohan Ashok, Askew, Jeffrey, Attanasio, Lea, Balmer-Swain, Mallory, Bayer, Richard R., Bernheim, Adam, Bhatti, Sabha, Bieging, Erik, Bloom, Stephen, Blue, Sean, Bluemke, David, Borges, Andressa, Branch, Kelley, Bravo, Paco, Brothers, Jessica, Budoff, Matthew, Bullock-Palmer, Renée, Burandt, Angela, Burke, Floyd W., Bush, Kelvin, Candela, Candace, Capasso, Elizabeth, 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George Kinzfogl, Kircher, Jacqueline, Kirkbride, Rachael, Kontos, Michael, Kottam, Anupama, Krepp, Joseph, Layer, Jay, Lee, Steven H., Leppo, Jeffrey, Lesser, John, Leung, Steve, Lewin, Howard, Litmanovich, Diana, Liu, Yiyan, Magurany, Kathleen, Markowitz, Jeremy, Marn, Amanda, Matis, Stephen E., Mckenna, Michael, Mcrae, Tony, Mendoza, Fernando, Merhige, Michael, Min, David, Moffitt, Chanan, Moncher, Karen, Moore, Warren, Morayati, Shamil, Morris, Michael, Mossa-Basha, Mahmud, Mrsic, Zorana, Murthy, Venkatesh, Nagpal, Prashant, Napier, Kyle, Nelson, Katarina, Nijjar, Prabhjot, Osman, Medhat, Passen, Edward, Patel, Amit, Patil, Pravin, Paul, Ryan, Phillips, Lawrence, Polsani, Venkateshwar, Poludasu, Rajaram, Pomerantz, Brian, Porter, Thomas, Prentice, Ryan, Pursnani, Amit, Rabbat, Mark, Ramamurti, Suresh, Rich, Florence, Luna, Hiram Rivera, Robinson, Austin, Robles, Kim, Rodríguez, Cesar, Rorie, Mark, Rumberger, John, Russell, Raymond, Sabra, Philip, Sadler, Diego, Schemmer, Mary, Schoepf, U. Joseph, Shah, Samir, Shah, Nishant, Shanbhag, Sujata, Sharma, Gaurav, Shayani, Steven, Shirani, Jamshid, Shivaram, Pushpa, Sigman, Steven, Simon, Mitch, Slim, Ahmad, Smith, David, Smith, Alexandra, Soman, Prem, Sood, Aditya, Srichai-Parsia, Monvadi Barbara, Streeter, James, T, Albert, Tawakol, Ahmed, Thomas, Dustin, Thompson, Randall, Torbet, Tara, Trinidad, Desiree, Ullery, Shawn, Unzek, Samuel, Uretsky, Seth, Vallurupalli, Srikanth, Verma, Vikas, Waller, Alfonso, Wang, Ellen, Ward, Parker, Weissman, Gaby, Wesbey, George, White, Kelly, Wolinsky, David, Yost, Sandra, Zgaljardic, Michael, Alonso, Omar, Beretta, Mario, Ferrando, Rodolfo, Kapitan, Miguel, Mut, Fernando, Djuraev, Omoa, Rozikhodjaeva, Gulnora, Le Ngoc, Ha, Mai, Son Hong, Nguyen, Xuan Canh, Hirschfeld, Cole B., Shaw, Leslee J., Williams, Michelle C., Lahey, Ryan, Villines, Todd C., Dorbala, Sharmila, Choi, Andrew D., Shah, Nishant R., Bluemke, David A., Berman, Daniel S., Blankstein, Ron, Ferencik, Maro, Narula, Jagat, Winchester, David, Malkovskiy, Eli, Goebel, Benjamin, Randazzo, Michael J., Lopez-Mattei, Juan, Parwani, Purvi, Vitola, Joao V., Cerci, Rodrigo J., Better, Nathan, Raggi, Paolo, Lu, Bin, Sergienko, Vladimir, Sinitsyn, Valentin, Kudo, Takashi, Nørgaard, Bjarne Linde, Maurovich-Horvat, Pál, Cohen, Yosef A., Pascual, Thomas N. B., Pynda, Yaroslav, Dondi, Maurizio, Paez, Diana, Einstein, Andrew J., Cerci, Rodrigo, Hinterleitner, Gerd, Lu, Yao, Morozova, Olga, Xu, Zhuoran, Cohen, Yosef, Randazzo, Michael, Choi, Andrew, Nasery, Mohammad Nawaz, Goda, Artan, Shirka, Ervina, Benlabgaa, Rabie, Bouyoucef, Salah, Medjahedi, Abdelkader, Nailli, Qai, Agolti, Mariela, Aguero, Roberto Nicola, Alak, Maria del Carmen, Alberguina, Lucia Graciela, Arroñada, Guillermo, Astesiano, Andrea, Astesiano, Alfredo, Norton, Carolina Ba, Benteo, Pablo, Blanco, Juan, Bonelli, Juan Manuel, Bustos, Jose Javier, Cabrejas, Raul, Cachero, Jorge, Campisi, Roxana, Canderoli, Alejandro, Carames, Silvia, Carrascosa, Patrícia, Castro, Ricardo, Cendoya, Oscar, Cognigni, Luciano Martin, Collaud, Carlo, Cortes, Claudia, Courtis, Javier, Cragnolino, Daniel, Daicz, Mariana, De La Vega, Alejandro, De Maria, Silvia Teresa, Del Riego, Horacio, Dettori, Fernando, Deviggiano, Alejandro, Dragonetti, Laura, Embon, Mario, Enriquez, Ruben Emilio, Ensinas, Jorge, Faccio, Fernando, Facello, Adolfo, Garofalo, Diego, Geronazzo, Ricardo, Gonza, Natalia, Gutierrez, Luca, Guzzo, Miguel Angel, Hasbani, Victor, Huerin, Melina, Jäger, Victor, Lewkowicz, Julio Manuel, Nieves A López De Munaín, Maria, Lotti, Jose Maria, Marquez, Alejandra, Masoli, Osvaldo, Masoli, Osvaldo Horacio, Mastrovito, Edgardo, Mayoraz, Matia, Melado, Graciela Eva, Mele, Anibal, Merani, Maria Fernanda, Meretta, Alejandro Horacio, Molteni, Susana, Montecinos, Marco, Noguera, Eduardo, Novoa, Carlo, Sueldo, Claudio Pereyra, Ascani, Sebastian Perez, Pollono, Pablo, Pujol, Maria Paula, Radzinschi, Alejandro, Raimondi, Gustavo, Redruello, Marcela, Rodríguez, Marina, Rodríguez, Matía, Romero, Romina Lorena, Acuña, Arturo Romero, Rovaletti, Federico, San Miguel, Luca, Solari, Lucrecia, Strada, Bruno, Traverso, Sonia, Traverzo, Sonia Simona, Espeche, Maria del Huerto Velazquez, Weihmuller, Juan Sebastian, Wolcan, Juan, Zeffiro, Susana, Sakanyan, Mari, Beuzeville, Scott, Boktor, Raef, Butler, Patrick, Calcott, Jennifer, Carr, Loretta, Chan, Virgil, Chao, Charle, Chong, Woon, Dobson, Mark, Downie, D'Arne, Dwivedi, Girish, Elison, Barry, Engela, Jean, Francis, Roslyn, Gaikwad, Anand, Basavaraj, Ashok Gangasandra, Goodwin, Bruce, Greenough, Robert, Hamilton-Craig, Christian, Hsieh, Victar, Joshi, Subodh, Lederer, Karin, Lee, Kenneth, Lee, Joseph, Magnussen, John, Mai, Nghi, Mander, Gordon, Murton, Fiona, Nandurkar, Dee, Neill, Johanne, O'Rourke, Edward, O'Sullivan, Patricia, Pandos, George, Pathmaraj, Kunthi, Pitman, Alexander, Poulter, Rohan, Premaratne, Manuja, Prior, David, Ridley, Lloyd, Rutherford, Natalie, Salehi, Hamid, Saunders, Connor, Scarlett, Luke, Seneviratne, Sujith, Shetty, Deepa, Shrestha, Ganesh, Shulman, Jonathan, Solanki, Vijay, Stanton, Tony, Stuart, Murch, Stubbs, Michael, Swainson, Ian, Taubman, Kim, Taylor, Andrew, Thomas, Paul, Unger, Steven, Upton, Anthony, Vamadevan, Shankar, Van Gaal, William, Verjans, Johan, Voutnis, Demetriu, Wayne, Victor, Wilson, Peter, Wong, David, Wong, Kirby, Younger, John, Feuchtner, Gudrun, Mirzaei, Siroo, Weiss, Konrad, Maroz-Vadalazhskaya, Natallia, Gheysens, Olivier, Homans, Filip, Moreno-Reyes, Rodrigo, Pasquet, Agnè, Roelants, Veronique, Van De Heyning, Caroline M., Ríos, Raúl Araujo, Soldat-Stankovic, Valentina, Stankovic, Sinisa, Albernaz Siqueira, Maria Helena, Almeida, Augusto, Alves Togni, Paulo Henrique, Andrade, Jose Henrique, Andrade, Luciana, Anselmi, Carlo, Araújo, Roberta, Azevedo, Guilherme, Bezerra, Sabbrina, Biancardi, Rodrigo, Grossman, Gabriel Blacher, Brandão, Simone, Pianta, Diego Bromfman, Carreira, Lara, Castro, Bruno, Chang, Tien, Cunali, Fernando, Cury, Roberto, Dantas, Roberto, de Amorim Fernandes, Fernando, De Lorenzo, Andrea, De Macedo Filho, Robson, Erthal, Fernanda, Fernandes, Fabio, Fernandes, Juliano, De Souza, Thiago Ferreira, Alves, Wilson Furlan, Ghini, Bruno, Goncalves, Luiz, Gottlieb, Ilan, Hadlich, Marcelo, Kameoka, Viníciu, Lima, Ronaldo, Lima, Adna, Lopes, Rafael Willain, Machado e Silva, Ricardo, Magalhães, Tiago, Silva, Fábio Martin, Mastrocola, Luiz Eduardo, Medeiros, Fábio, Meneghetti, José Claudio, Naue, Vania, Naves, Danilo, Nolasco, Roberto, Nomura, Cesar, Oliveira, Joao Bruno, Paixao, Eduardo, De Carvalho, Filipe Penna, Pinto, Ibraim, Possetti, Priscila, Quinta, Mayra, Nogueira Ramos, Rodrigo Rizzo, Rocha, Ricardo, Rodrigues, Alfredo, Rodrigues, Carlo, Romantini, Leila, Sanches, Adelina, Santana, Sara, Sara da Silva, Leonardo, Schvartzman, Paulo, Matushita, Cristina Sebastião, Senra, Tiago, Shiozaki, Afonso, Menezes de Siqueira, Maria Eduarda, Siqueira, Cristiano, Smanio, Paola, Soares, Carlos Eduardo, Junior, José Soare, Bittencourt, Marcio Sommer, Spiro, Bernardo, Mesquita, Cláudio Tinoco, Torreao, Jorge, Torres, Rafael, Uellendahl, Marly, Monte, Guilherme Urpia, Veríssimo, Otávia, Cabeda, Estevan Vieira, Pedras, Felipe Villela, Waltrick, Roberto, Zapparoli, Marcello, Naseer, Hamid, Garcheva-Tsacheva, Marina, Kostadinova, Irena, Theng, Youdaline, Abikhzer, Gad, Barette, Rene, Chow, Benjamin, Dabreo, Dominique, Friedrich, Matthia, Garg, Ria, Hafez, Mohammed Nassoh, Johnson, Chri, Kiess, Marla, Leipsic, Jonathon, Leung, Eugene, Miller, Robert, Oikonomou, Anastasia, Probst, Stephan, Roifman, Idan, Small, Gary, Tandon, Vika, Trivedi, Adwait, White, Jame, Zukotynski, Katherine, Canessa, Jose, Muñoz, Gabriel Castro, Concha, Carmen, Hidalgo, Pablo, Lovera, Cesar, Massardo, Teresa, Vargas, Luis Salazar, Abad, Pedro, Arturo, Harold, Ayala, Sandra, Benitez, Lui, Cadena, Alberto, Caicedo, Carlo, Moncayo, Antonio Calderón, Gomez, Sharon, Gutierrez Villamil, Claudia T., Jaimes, Claudia, Londoño, Juan, Londoño Blair, Juan Lui, Pabon, Luz, Pineda, Mauricio, Rojas, Juan Carlo, Ruiz, Diego, Escobar, Manuel Valencia, Vasquez, Andre, Vergel, Damiana, Zuluaga, Alejandro, Gamboa, Isabel Berrocal, Castro, Gabriel, González, Ulise, Baric, Ana, Batinic, Tonci, Franceschi, Maja, Paar, Maja Hrabak, Jukic, Mladen, Medakovic, Petar, Persic, Viktor, Prpic, Marina, Punda, Ante, Batista, Juan Felipe, Gómez Lauchy, Juan Manuel, Gutierrez, Yamile Marco, Menéndez, Rayner, Peix, Amalia, Rochela, Lui, Panagidis, Christoforo, Petrou, Ioanni, Engelmann, Vaclav, Kaminek, Milan, Kincl, Vladimír, Lang, Otto, Simanek, Milan, Abdulla, Jawdat, Bøttcher, Morten, Christensen, Mette, Gormsen, Lars Christian, Hasbak, Philip, Hess, Søren, Holdgaard, Paw, Johansen, Allan, Kyhl, Kasper, Norgaard, Bjarne Linde, Øvrehus, Kristian Altern, Rønnow Sand, Niels Peter, Steffensen, Rolf, Thomassen, Ander, Zerahn, Bo, Perez, Alfredo, Escorza Velez, Giovanni Alejandro, Velez, Mayra Sanchez, Abdel Aziz, Islam Shawky, Abougabal, Mahasen, Ahmed, Taghreed, Allam, Adel, Asfour, Ahmed, Hassan, Mona, Hassan, Alia, Ibrahim, Ahmed, Kaffas, Sameh, Kandeel, Ahmed, Ali, Mohamed Mandour, Mansy, Ahmad, Maurice, Hany, Nabil, Sherif, Shaaban, Mahmoud, Flores, Ana Camila, Poksi, Anne, Knuuti, Juhani, Kokkonen, Velipekka, Larikka, Martti, Uusitalo, Valtteri, Bailly, Matthieu, Burg, Samuel, Deux, Jean-Françoi, Habouzit, Vincent, Hyafil, Fabien, Lairez, Olivier, Proffit, Franck, Regaieg, Hamza, Sarda-Mantel, Laure, Tacher, Vania, Schneider, Roman P., Ayetey, Harold, Angelidis, George, Archontaki, Aikaterini, Chatziioannou, Sofia, Datseris, Ioanni, Fragkaki, Christina, Georgoulias, Panagioti, Koukouraki, Sophia, Koutelou, Maria, Kyrozi, Eleni, Repasos, Evangelo, Stavrou, Petro, Valsamaki, Pipitsa, Gonzalez, Carla, Gutierrez, Goleat, Maldonado, Alejandro, Buga, Klara, Garai, Ildiko, Schmidt, Erzsébet, Szilveszter, Balint, Várady, Edit, Banthia, Nilesh, Bhagat, Jinendra Kumar, Bhargava, Rishi, Bhat, Vivek, Bhatia, Mona, Choudhury, Partha, Chowdekar, Vijay Sai, Irodi, Aparna, Jain, Shashank, Joseph, Elizabeth, Kumar, Sukriti, Girijanandan Mahapatra, Prof Dr, Mitra, Deepanjan, Mittal, Bhagwant Rai, Ozair, Ahmad, Patel, Chetan, Patel, Tapan, Patel, Ravi, Patel, Shivani, Saxena, Sudhir, Sengupta, Shantanu, Singh, Santosh, Singh, Bhanupriya, Sood, Ashwani, Verma, Atul, Affandi, Erwin, Alam, Edison, Padma, Savenadia, Gunawan, Gani, Hapkido, Habusari, Hidayat, Basuki, Huda, Aulia, Mukti, Anggoro Praja, Prawiro, Djoko, Soeriadi, Erwin Affandi, Syawaluddin, Hilman, Albadr, Amjed, Assadi, Majid, Emami, Farshad, Houshmand, Golnaz, Maleki, Majid, Rostami, Maryam Tajik, Zakavi, Seyed Rasoul, Zaid, Eed Abu, Agranovich, Svetlana, Arnson, Yoav, Bar-Shalom, Rachel, Frenkel, Alex, Knafo, Galit, Lugassi, Rachel, Maor Moalem, Israel Shlomo, Mor, Maya, Muskal, Noam, Ranser, Sara, Shalev, Aryeh, Albano, Domenico, Alongi, Pierpaolo, Arnone, Gaspare, Bagatin, Elisa, Baldari, Sergio, Bauckneht, Matteo, Bertelli, Paolo, Bianco, Francesco, Bonfiglioli, Rachele, Boni, Roberto, Bruno, Andrea, Bruno, Isabella, Busnardo, Elena, Califaretti, Elena, Camoni, Luca, Carnevale, Aldo, Casoni, Roberta, Cavallo, Armando Ugo, Cavenaghi, Giorgio, Chierichetti, Franca, Chiocchi, Marcello, Cittanti, Corrado, Colletta, Mauro, Conti, Umberto, Cossu, Alberto, Cuocolo, Alberto, Cuzzocrea, Marco, De Rimini, Maria Luisa, De Vincentis, Giuseppe, Del Giudice, Eleonora, Del Torto, Alberico, Della Tommasina, Veronica, Durmo, Rexhep, Erba, Paola Anna, Evangelista, Laura, Faletti, Riccardo, Faragasso, Evelina, Farsad, Mohsen, Ferro, Paola, Florimonte, Luigia, Frantellizzi, Viviana, Fringuelli, Fabio Massimo, Gatti, Marco, Gaudiano, Angela, Gimelli, Alessia, Giubbini, Raffaele, Giuffrida, Francesca, Ialuna, Salvatore, Laudicella, Riccardo, Leccisotti, Lucia, Leva, Lucia, Liga, Riccardo, Liguori, Carlo, Longo, Giampiero, Maffione, Margherita, Mancini, Maria Elisabetta, Marcassa, Claudio, Milan, Elisa, Nardi, Barbara, Pacella, Sara, Pepe, Giovanna, Pontone, Gianluca, Pulizzi, Sabina, Quartuccio, Natale, Rampin, Lucia, Ricci, Fabrizio, Rossini, Pierluigi, Rubini, Giuseppe, Russo, Vincenzo, Sacchetti, Gian Mauro, Sambuceti, Gianmario, Scarano, Massimo, Sciagrà, Roberto, Sperandio, Massimiliano, Stefanelli, Antonella, Ventroni, Guido, Zoboli, Stefania, Baugh, Dainia, Chambers, Duane, Madu, Ernest, Nunura, Felix, Asano, Hiroshi, Chimura, Chimura Misato, Fujimoto, Shinichiro, Fujisue, Koichiro, Fukunaga, Tomohisa, Fukushima, Yoshimitsu, Fukuyama, Kae, Hashimoto, Jun, Ichikawa, Yasutaka, Iguchi, Nobuo, Imai, Masamichi, Inaki, Anri, Ishimura, Hayato, Isobe, Satoshi, Kadokami, Toshiaki, Kato, Takao, Kumita, Shinichiro, Maruno, Hirotaka, Mataki, Hiroyuki, Miyagawa, Masao, Morimoto, Ryota, Moroi, Masao, Nagamachi, Shigeki, Nakajima, Kenichi, Nakata, Tomoaki, Nakazato, Ryo, Nanasato, Mamoru, Naya, Masanao, Norikane, Takashi, Ohta, Yasutoshi, Okayama, Satoshi, Okizaki, Atsutaka, Otomi, Yoichi, Otsuka, Hideki, Saito, Masaki, Sakata, Sakata Yasushi, Sarai, Masayoshi, Sato, Daisuke, Shiraishi, Shinya, Suwa, Yoshinobu, Takanami, Kentaro, Takehana, Kazuya, Taki, Junichi, Tamaki, Nagara, Taniguchi, Yasuyo, Teragawa, Hiroki, Tomizawa, Nobuo, Tsujita, Kenichi, Umeji, Kyoko, Wakabayashi, Yasushi, Yamada, Shinichiro, Yamazaki, Shinya, Yoneyama, Tatsuya, Rawashdeh, Mohammad, Batyrkhanov, Daultai, Dautov, Tairkhan, Makhdomi, Khalid, Ombati, Kevin, Alkandari, Faridah, Garashi, Masoud, Coie, Tchoyoson Lim, Rajvong, Sonexay, Kalinin, Artem, Kalnina, Marika, Haidar, Mohamad, Komiagiene, Renata, Kviecinskiene, Giedre, Mataciunas, Mindauga, Vajauskas, Donata, Picard, Christian, Karim, Noor Khairiah A., Reichmuth, Luise, Samuel, Anthony, Allarakha, Mohammad Aaftaab, Naojee, Ambedhkar Shantaram, Alexanderson-Rosas, Erick, Barragan, Erika, González-Montecinos, Alejandro Becerril, Cabada, Manuel, Rodriguez, Daniel Calderon, Carvajal-Juarez, Isabel, Cortés, Violeta, Cortés, Filiberto, De La Peña, Erasmo, Gama-Moreno, Manlio, González, Lui, Ramírez, Nelsy Gonzalez, Jiménez-Santos, Moisé, Matos, Lui, Monroy, Edgar, Morelos, Martha, Ornelas, Mario, Ortga Ramirez, Jose Alberto, Preciado-Anaya, André, Preciado-Gutiérrez, Óscar Ulise, Barragan, Adriana Puente, Rosales Uvera, Sandra Graciela, Sandoval, Sigelinda, Tomas, Miguel Santaularia, Sierra-Galan, Lilia M., Siu, Silvia, Vallejo, Enrique, Valles, Mario, Faraggi, Marc, Sereegotov, Erdenechimeg, Ilic, Srdja, Ben-Rais, Nozha, Alaoui, Nadia Ismaili, Taleb, Sara, Myo, Khin Pa, Thu, Phyo Si, Ghimire, Ram Kumar, Rajbanshi, Bijoy, Barneveld, Peter, Glaudemans, Andor, Habets, Jesse, Koopmans, Klaas Pieter, Manders, Jeroen, Pool, Stefan, Scholte, Arthur, Scholtens, Asbjørn, Slart, Riemer, Thimister, Paul, Van Asperen, Erik-Jan, Veltman, Niel, Verschure, Derk, Wagenaar, Nil, Edmond, John, Ellis, Chri, Johnson, Kerryanne, Keenan, Ro, Hua, Shaw, Occleshaw, Christopher, Sasse, Alexander, To, Andrew, Van Pelt, Niel, Young, Calum, Cuadra, Teresa, Roque Vanegas, Hector Bladimir, Soli, Idrissa Adamou, Issoufou, Djibrillou Moussa, Ayodele, Tolulope, Madu, Chibuzo, Onimode, Yetunde, Efros-Monsen, Elen, Forsdahl, Signe Helene, Hildre Dimmen, Jenni-Mari, Jørgensen, Arve, Krohn, Isabel, Løvhaugen, Pål, Bråten, Anders Tjellaug, Al Dhuhli, Humoud, Al Kindi, Faiza, Al-Bulushi, Naeema, Jawa, Zabah, Tag, Naima, Afzal, Muhammad Shehzad, Fatima, Shazia, Younis, Muhammad Numair, Riaz, Musab, Saadullah, Mohammad, Herrera, Yariela, Lenturut-Katal, Dora, Vázquez, Manuel Castillo, Ortellado, José, Akhter, Afroza, Cao, Dianbo, Cheung, Stephen, Dai, Xu, Gong, Lianggeng, Han, Dan, Hou, Yang, Li, Caiying, Li, Tao, Li, Dong, Li, Sijin, Liu, Jinkang, Liu, Hui, Ng, Ming Yen, Sun, Kai, Tang, Gongshun, Wang, Jian, Wang, Ximing, Wang, Zhao-Qian, Wang, Yining, Wang, Yifan, Wu, Jiang, Wu, Zhifang, Xia, Liming, Xiao, Jiangxi, Xu, Lei, Yang, Youyou, Yin, Wu, Yu, Jianqun, Yuan, Li, Zhang, Tong, Zhang, Longjiang, Zhang, Yong-Gao, Zhang, Xiaoli, Zhu, Li, Alfaro, Ana, Abrihan, Paz, Barroso, Asela, Cruz, Eric, Gomez, Marie Rhiamar, Magboo, Vincent Peter, Medina, John Michael, Obaldo, Jerry, Pastrana, Davidson, Pawhay, Christian Michael, Quinon, Alvin, Tang, Jeanelle Margareth, Tecson, Bettina, Uson, Kristine Joy, Uy, Mila, Kostkiewicz, Magdalena, Kunikowska, Jolanta, Bettencourt, Nuno, Cantinho, Guilhermina, Ferreira, Antonio, Syed, Ghulam, Arnous, Samer, Atyani, Said, Byrne, Angela, Gleeson, Tadhg, Kerins, David, Meehan, Conor, Murphy, David, Murphy, Mark, Murray, John, O'Brien, Julie, Bang, Ji-In, Bom, Henry, Cho, Sang-Geon, Hong, Chae Moon, Jang, Su Jin, Jeong, Yong Hyu, Kang, Won Jun, Kim, Ji-Young, Lee, Jaetae, Namgung, Chang Kyeong, So, Young, Won, Kyoung Sook, Majstorov, Venjamin, Vavlukis, Marija, Salobir, Barbara Gužic, Štalc, Monika, Benedek, Theodora, Benedek, Imre, Mititelu, Raluca, Stan, Claudiu Adrian, Ansheles, Alexey, Dariy, Olga, Drozdova, Olga, Gagarina, Nina, Gulyaev, Vsevolod Milyevich, Itskovich, Irina, Karalkin, Anatoly, Kokov, Alexander, Migunova, Ekaterina, Pospelov, Viktor, Ryzhkova, Daria, Saifullina, Guzaliya, Sazonova, Svetlana, Shurupova, Irina, Trifonova, Tatjana, Ussov, Wladimir Yurievich, Vakhromeeva, Margarita, Valiullina, Nailya, Zavadovsky, Konstantin, Zhuravlev, Kirill, Alasnag, Mirvat, Okarvi, Subhani, Saranovic, Dragana Sobic, Keng, Felix, Jason See, Jia Hao, Sekar, Ramkumar, Yew, Min Sen, Vondrak, Andrej, Bejai, Shereen, Bennie, George, Bester, Ria, Engelbrecht, Gerrit, Evbuomwan, Osayande, Gongxeka, Harlem, Vuuren, Magritha Jv, Kaplan, Mitchell, Khushica, Purbhoo, Lakhi, Hoosen, Louw, Lizette, Malan, Nico, Milos, Katarina, Modiselle, Moshe, More, Stuart, Naidoo, Mathava, Scholtz, Leonie, Vangu, Mboyo, Aguadé-Bruix, Santiago, Blanco, Isabel, Cabrera, Antonio, Camarero, Alicia, Casáns-Tormo, Irene, Cuellar-Calabria, Hug, Flotats, Albert, Fuentes Cañamero, Maria Eugenia, García, María Elia, Jimenez-Heffernan, Amelia, Leta, Rubén, Diaz, Javier Lopez, Lumbreras, Lui, Marquez-Cabeza, Juan Javier, Martin, Francisco, Martinez de Alegria, Anxo, Medina, Francisco, Canal, Maria Pedrera, Peiro, Virginia, Pubul-Nuñez, Virginia, Rayo Madrid, Juan Ignacio, Rey, Cristina Rodríguez, Perez, Ricardo Ruano, Ruiz, Joaquín, Hernández, Gertrudis Sabatel, Sevilla, Ana, Zeidán, Nahla, Nanayakkara, Damayanthi, Udugama, Chandraguptha, Simonsson, Magnu, Alkadhi, Hatem, Buechel, Ronny Ralf, Burger, Peter, Ceriani, Luca, De Boeck, Bart, Gräni, Christoph, Juillet de Saint Lager Lucas, Alix, Kamani, Christel H., Kawel-Boehm, Nadine, Manka, Robert, Prior, John O., Rominger, Axel, Vallée, Jean-Paul, Khiewvan, Benjapa, Premprabha, Teerapon, Thientunyakit, Tanyaluck, Sellem, Ali, Kir, Kemal Metin, Sayman, Haluk, Sebikali, Mugisha Juliu, Muyinda, Zerida, Kmetyuk, Yaroslav, Korol, Pavlo, Mykhalchenko, Olena, Pliatsek, Volodymyr, Satyr, Maryna, Albalooshi, Batool, Ahmed Hassan, Mohamed Ismail, Anderson, Jill, Bedi, Punit, Biggans, Thoma, Bularga, Anda, Bull, Russell, Burgul, Rajesh, Carpenter, John-Paul, Coles, Duncan, Cusack, David, Deshpande, Aparna, Dougan, John, Fairbairn, Timothy, Farrugia, Alexia, Gopalan, Deepa, Gummow, Alistair, Ramkumar, Prasad Guntur, Hamilton, Mark, Harbinson, Mark, Hartley, Thoma, Hudson, Benjamin, Joshi, Nikhil, Kay, Michael, Kelion, Andrew, Khokhar, Azhar, Kitt, Jamie, Lee, Ken, Low, Chen, Mak, Sze Mun, Marousa, Ntouskou, Martin, Jon, Mcalindon, Elisa, Menezes, Leon, Morgan-Hughes, Gareth, Moss, Alastair, Murray, Anthony, Nicol, Edward, Patel, Dilip, Peebles, Charle, Pugliese, Francesca, Luis Rodrigues, Jonathan Carl, Rofe, Christopher, Sabharwal, Nikant, Schofield, Rebecca, Semple, Thoma, Sharma, Naveen, Strouhal, Peter, Subedi, Deepak, Topping, William, Tweed, Katharine, Weir-Mccall, Jonathan, Abbara, Suhny, Abbasi, Taimur, Abbott, Brian, Abohashem, Shady, Abramson, Sandra, Al-Abboud, Tarek, Al-Mallah, Mouaz, Almousalli, Omar, Ananthasubramaniam, Karthikeyan, Kumar, Mohan Ashok, Askew, Jeffrey, Attanasio, Lea, Balmer-Swain, Mallory, Bayer, Richard R., Bernheim, Adam, Bhatti, Sabha, Bieging, Erik, Bloom, Stephen, Blue, Sean, Bluemke, David, Borges, Andressa, Branch, Kelley, Bravo, Paco, Brothers, Jessica, Budoff, Matthew, Bullock-Palmer, Renée, Burandt, Angela, Burke, Floyd W., Bush, Kelvin, Candela, Candace, Capasso, Elizabeth, Cavalcante, Joao, Chang, Donald, Chatterjee, Saurav, Chatzizisis, Yianni, Cheezum, Michael, Chen, Tiffany, Chen, Jennifer, Chen, Marcu, Clarcq, Jame, Cordero, Ayreen, Crim, Matthew, Danciu, Sorin, Decter, Bruce, Dhruva, Nimish, Doherty, Neil, Doukky, Rami, Dunbar, Anjori, Duvall, William, Edwards, Rachael, Esquitin, Kerry, Farah, Husam, Fentanes, Emilio, Fisher, Daniel, Fitzpatrick, Daniel, Foster, Cameron, Fuisz, Tony, Gannon, Michael, Gastner, Lori, Gerson, Myron, Ghoshhajra, Brian, Goldberg, Alan, Goldner, Brian, Gonzalez, Jorge, Gore, Rosco, Gracia-López, Sandra, Hage, Fadi, Haider, Agha, Haider, Sofia, Hamirani, Yasmin, Hassen, Karen, Hatfield, Mallory, Hawkins, Carolyn, Hawthorne, Katie, Heath, Nichola, Hendel, Robert, Hernandez, Phillip, Hill, Gregory, Horgan, Stephen, Huffman, Jeff, Hurwitz, Lynne, Iskandrian, Ami, Janardhanan, Rajesh, Jellis, Christine, Jerome, Scott, Kalra, Dinesh, Kaviratne, Summanther, Kay, Fernando, Kelly, Faith, Khalique, Omar, Kinkhabwala, Mona, Iii, George Kinzfogl, Kircher, Jacqueline, Kirkbride, Rachael, Kontos, Michael, Kottam, Anupama, Krepp, Joseph, Layer, Jay, Lee, Steven H., Leppo, Jeffrey, Lesser, John, Leung, Steve, Lewin, Howard, Litmanovich, Diana, Liu, Yiyan, Magurany, Kathleen, Markowitz, Jeremy, Marn, Amanda, Matis, Stephen E., Mckenna, Michael, Mcrae, Tony, Mendoza, Fernando, Merhige, Michael, Min, David, Moffitt, Chanan, Moncher, Karen, Moore, Warren, Morayati, Shamil, Morris, Michael, Mossa-Basha, Mahmud, Mrsic, Zorana, Murthy, Venkatesh, Nagpal, Prashant, Napier, Kyle, Nelson, Katarina, Nijjar, Prabhjot, Osman, Medhat, Passen, Edward, Patel, Amit, Patil, Pravin, Paul, Ryan, Phillips, Lawrence, Polsani, Venkateshwar, Poludasu, Rajaram, Pomerantz, Brian, Porter, Thoma, Prentice, Ryan, Pursnani, Amit, Rabbat, Mark, Ramamurti, Suresh, Rich, Florence, Luna, Hiram Rivera, Robinson, Austin, Robles, Kim, Rodríguez, Cesar, Rorie, Mark, Rumberger, John, Russell, Raymond, Sabra, Philip, Sadler, Diego, Schemmer, Mary, Schoepf, U. Joseph, Shah, Samir, Shah, Nishant, Shanbhag, Sujata, Sharma, Gaurav, Shayani, Steven, Shirani, Jamshid, Shivaram, Pushpa, Sigman, Steven, Simon, Mitch, Slim, Ahmad, Smith, David, Smith, Alexandra, Soman, Prem, Sood, Aditya, Srichai-Parsia, Monvadi Barbara, Streeter, Jame, T, Albert, Tawakol, Ahmed, Thomas, Dustin, Thompson, Randall, Torbet, Tara, Trinidad, Desiree, Ullery, Shawn, Unzek, Samuel, Uretsky, Seth, Vallurupalli, Srikanth, Verma, Vika, Waller, Alfonso, Wang, Ellen, Ward, Parker, Weissman, Gaby, Wesbey, George, White, Kelly, Wolinsky, David, Yost, Sandra, Zgaljardic, Michael, Alonso, Omar, Beretta, Mario, Ferrando, Rodolfo, Kapitan, Miguel, Mut, Fernando, Djuraev, Omoa, Rozikhodjaeva, Gulnora, Le Ngoc, Ha, Mai, Son Hong, Nguyen, Xuan Canh, Hirschfeld, C, Shaw, L, Williams, M, Lahey, R, Villines, T, Dorbala, S, Choi, A, Shah, N, Bluemke, D, Berman, D, Blankstein, R, Ferencik, M, Narula, J, Winchester, D, Malkovskiy, E, Goebel, B, Randazzo, M, Lopez-Mattei, J, Parwani, P, Vitola, J, Cerci, R, Better, N, Raggi, P, Lu, B, Sergienko, V, Sinitsyn, V, Kudo, T, Nørgaard, B, Maurovich-Horvat, P, Cohen, Y, Pascual, T, Pynda, Y, Dondi, M, Paez, D, Einstein, A, and Erba, P

Subjects
Aging, Coronavirus disease 2019 (COVID-19), Clinical Sciences, coronavirus, Disease, 030204 cardiovascular system & hematology, Cardiorespiratory Medicine and Haematology, Cardiovascular, 030218 nuclear medicine & medical imaging, NO, 03 medical and health sciences, 0302 clinical medicine, COVID-19 Testing, Cardiovascular procedures, Predictive Value of Tests, cardiovascular disease, Clinical Research, Environmental health, INCAPS-COVID Investigators Group, Pandemic, Volume reduction, Medicine, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular imaging, diagnostic cardiovascular procedure, Pandemics, business.industry, SARS-CoV-2, Prevention, COVID-19, Health Services, United States/epidemiology, United States, Invasive coronary angiography, coronaviru, Heart Disease, Good Health and Well Being, MYOCARDIAL-INFARCTION, Cardiovascular System & Hematology, Predictive value of tests, HOSPITAL ADMISSIONS, Cardiology and Cardiovascular Medicine, Early phase, business
Abstract

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-U.S. institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection.

Published
2021

18. International Impact of COVID-19 on the Diagnosis of Heart Disease

Author

Einstein, A. J., Shaw, L. J., Hirschfeld, C., Williams, M. C., Villines, T. C., Better, N., Vitola, J. V., Cerci, R., Dorbala, S., Raggi, P., Choi, A. D., Lu, B., Sinitsyn, V., Sergienko, V., Kudo, T., Norgaard, B. L., Maurovich-Horvat, P., Campisi, R., Milan, E., Louw, L., Allam, A. H., Bhatia, M., Malkovskiy, E., Goebel, B., Cohen, Y., Randazzo, M., Narula, J., Pascual, T. N. B., Pynda, Y., Dondi, M., Gerd Hinterleitner, Paez D., Yao, Lu, Olga, Morozova, Zhuoran, Xu, Juan, Lopez-Mattei, Purvi, Parwani, Mohammad Nawaz Nasery, Artan, Goda, Ervina, Shirka, Rabie, Benlabgaa, Salah, Bouyoucef, Abdelkader, Medjahedi, Qais, Nailli, Mariela, Agolti, Roberto Nicolas Aguero, Maria Del Carmen Alak, Lucia Graciela Alberguina, Guillermo, Arroñada, Andrea, Astesiano, Alfredo, Astesiano, Carolina Bas Norton, Pablo, Benteo, Juan, Blanco, Juan Manuel Bonelli, Jose Javier Bustos, Raul, Cabrejas, Jorge, Cachero, Alejandro, Canderoli, Silvia, Carames, Patrícia, Carrascosa, Ricardo, Castro, Oscar, Cendoya, Luciano Martin Cognigni, Carlos, Collaud, Claudia, Cortes, Javier, Courtis, Daniel, Cragnolino, Mariana, Daicz, Alejandro De La Vega, Silvia Teresa De Maria, Horacio Del Riego, Fernando, Dettori, Alejandro, Deviggiano, Laura, Dragonetti, Mario, Embon, Ruben Emilio Enriquez, Jorge, Ensinas, Fernando, Faccio, Adolfo, Facello, Diego, Garofalo, Ricardo, Geronazzo, Natalia, Gonza, Lucas, Gutierrez, Miguel Angel Guzzo, Victor, Hasbani, Melina, Huerin, Victor, Jäger, Julio Manuel Lewkowicz, Maria Nieves, A López De Munaín, Jose Maria Lotti, Alejandra, Marquez, Osvaldo, Masoli, Edgardo, Mastrovito, Matias, Mayoraz, Graciela Eva Melado, Anibal, Mele, Maria Fernanda Merani, Alejandro Horacio Meretta, Susana, Molteni, Marcos, Montecinos, Eduardo, Noguera, Carlos, Novoa, Claudio Pereyra Sueldo, Sebastian Perez Ascani, Pablo, Pollono, Maria Paula Pujol, Alejandro, Radzinschi, Gustavo, Raimondi, Marcela, Redruello, Marina, Rodríguez, Matías, Rodríguez, Romina Lorena Romero, Arturo Romero Acuña, Federico, Rovaletti, Lucas San Miguel, Lucrecia, Solari, Bruno, Strada, Sonia, Traverso, Sonia Simona Traverzo, Maria Del Huerto Velazquez Espeche, Juan Sebastian Weihmuller, Juan, Wolcan, Susana, Zeffiro, Mari, Sakanyan, Scott, Beuzeville, Raef, Boktor, Patrick, Butler, Jennifer, Calcott, Loretta, Carr, Virgil, Chan, Charles, Chao, Woon, Chong, Mark, Dobson, D'Arne, Downie, Girish, Dwivedi, Barry, Elison, Jean, Engela, Roslyn, Francis, Anand, Gaikwad, Ashok Gangasandra Basavaraj, Bruce, Goodwin, Robert, Greenough, Christian, Hamilton-Craig, Victar, Hsieh, Subodh, Joshi, Karin, Lederer, Kenneth, Lee, Joseph, Lee, John, Magnussen, Nghi, Mai, Gordon, Mander, Fiona, Murton, Dee, Nandurkar, Johanne, Neill, Edward, O'Rourke, Patricia, O'Sullivan, George, Pandos, Kunthi, Pathmaraj, Alexander, Pitman, Rohan, Poulter, Manuja, Premaratne, David, Prior, Lloyd, Ridley, Natalie, Rutherford, Hamid, Salehi, Connor, Saunders, Luke, Scarlett, Sujith, Seneviratne, Deepa, Shetty, Ganesh, Shrestha, Jonathan, Shulman, Vijay, Solanki, Tony, Stanton, Murch, Stuart, Michael, Stubbs, Ian, Swainson, Kim, Taubman, Andrew, Taylor, Paul, Thomas, Steven, Unger, Anthony, Upton, Shankar, Vamadevan, William Van Gaal, Johan, Verjans, Demetrius, Voutnis, Victor, Wayne, Peter, Wilson, David, Wong, Kirby, Wong, John, Younger, Gudrun, Feuchtner, Siroos, Mirzaei, Konrad, Weiss, Natallia, Maroz-Vadalazhskaya, Olivier, Gheysens, Filip, Homans, Rodrigo, Moreno-Reyes, Agnès, Pasquet, Veronique, Roelants, Caroline, M Van De Heyning, Raúl Araujo Ríos, Valentina, Soldat-Stankovic, Sinisa, Stankovic, Maria Helena Albernaz Siqueira, Augusto, Almeida, Paulo Henrique Alves Togni, Jose Henrique Andrade, Luciana, Andrade, Carlos, Anselmi, Roberta, Araújo, Guilherme, Azevedo, Sabbrina, Bezerra, Rodrigo, Biancardi, Gabriel Blacher Grossman, Simone, Brandão, Diego Bromfman Pianta, Lara, Carreira, Bruno, Castro, Tien, Chang, Fernando Cunali Jr, Roberto, Cury, Roberto, Dantas, Fernando de Amorim Fernandes, Andrea De Lorenzo, Robson De Macedo Filho, Fernanda, Erthal, Fabio, Fernandes, Juliano, Fernandes, Thiago Ferreira De Souza, Wilson Furlan Alves, Bruno, Ghini, Luiz, Goncalves, Ilan, Gottlieb, Marcelo, Hadlich, Vinícius, Kameoka, Ronaldo, Lima, Adna, Lima, Rafael Willain Lopes, Ricardo Machado, E Silva, Tiago, Magalhães, Fábio Martins Silva, Luiz Eduardo Mastrocola, Fábio, Medeiros, José Claudio Meneghetti, Vania, Naue, Danilo, Naves, Roberto, Nolasco, Cesar, Nomura, Joao Bruno Oliveira, Eduardo, Paixao, Filipe Penna De Carvalho, Ibraim, Pinto, Priscila, Possetti, Mayra, Quinta, Rodrigo Rizzo Nogueira Ramos, Ricardo, Rocha, Alfredo, Rodrigues, Carlos, Rodrigues, Leila, Romantini, Adelina, Sanches, Sara, Santana, Leonardo Sara da Silva, Paulo, Schvartzman, Cristina Sebastião Matushita, Tiago, Senra, Afonso, Shiozaki, Maria Eduarda Menezes de Siqueira, Cristiano, Siqueira, Paola, Smanio, Carlos Eduardo Soares, José Soares Junior, Marcio Sommer Bittencourt, Bernardo, Spiro, Cláudio Tinoco Mesquita, Jorge, Torreao, Rafael, Torres, Marly, Uellendahl, Guilherme Urpia Monte, Otávia, Veríssimo, Estevan Vieira Cabeda, Felipe Villela Pedras, Roberto, Waltrick, Marcello, Zapparoli, Hamid, Naseer, Marina, Garcheva-Tsacheva, Irena, Kostadinova, Youdaline, Theng, Gad, Abikhzer, Rene, Barette, Benjamin, Chow, Dominique, Dabreo, Matthias, Friedrich, Ria, Garg, Mohammed Nassoh Hafez, Chris, Johnson, Marla, Kiess, Jonathon, Leipsic, Eugene, Leung, Robert, Miller, Anastasia, Oikonomou, Stephan, Probst, Idan, Roifman, Gary, Small, Vikas, Tandon, Adwait, Trivedi, James, White, Katherine, Zukotynski, Jose, Canessa, Gabriel Castro Muñoz, Carmen, Concha, Pablo, Hidalgo, Cesar, Lovera, Teresa, Massardo, Luis Salazar Vargas, Pedro, Abad, Harold, Arturo, Sandra, Ayala, Luis, Benitez, Alberto, Cadena, Carlos, Caicedo, Antonio Calderón Moncayo, Sharon, Gomez, Claudia, T Gutierrez Villamil, Claudia, Jaimes, Juan Luis Londoño Blair, Luz, Pabon, Mauricio, Pineda, Juan Carlos Rojas, Diego, Ruiz, Manuel Valencia Escobar, Andres, Vasquez, Damiana, Vergel, Alejandro, Zuluaga, Isabel Berrocal Gamboa, Gabriel, Castro, Ulises, González, Ana, Baric, Tonci, Batinic, Maja, Franceschi, Maja Hrabak Paar, Mladen, Jukic, Petar, Medakovic, Viktor, Persic, Marina, Prpic, Ante, Punda, Juan Felipe Batista, Juan Manuel Gómez Lauchy, Yamile Marcos Gutierrez, Rayner, Menéndez, Amalia, Peix, Luis, Rochela, Christoforos, Panagidis, Ioannis, Petrou, Vaclav, Engelmann, Milan, Kaminek, Vladimír, Kincl, Otto, Lang, Milan, Simanek, Jawdat, Abdulla, Morten, Bøttcher, Mette, Christensen, Lars Christian Gormsen, Philip, Hasbak, Søren, Hess, Paw, Holdgaard, Allan, Johansen, Kasper, Kyhl, Kristian Altern Øvrehus, Niels Peter Rønnow Sand, Rolf, Steffensen, Anders, Thomassen, Zerahn, Bo, Alfredo, Perez, Giovanni Alejandro Escorza Velez, Mayra Sanchez Velez, Islam Shawky Abdel Aziz, Mahasen, Abougabal, Taghreed, Ahmed, Ahmed, Asfour, Mona, Hassan, Alia, Hassan, Ahmed, Ibrahim, Sameh, Kaffas, Ahmed, Kandeel, Mohamed Mandour Ali, Ahmad, Mansy, Hany, Maurice, Sherif, Nabil, Mahmoud, Shaaban, Ana Camila Flores, Anne, Poksi, Juhani, Knuuti, Velipekka, Kokkonen, Martti, Larikka, Valtteri, Uusitalo, Matthieu, Bailly, Samuel, Burg, Jean-François, Deux, Vincent, Habouzit, Fabien, Hyafil, Olivier, Lairez, Franck, Proffit, Hamza, Regaieg, Laure, Sarda-Mantel, Vania, Tacher, Roman, P Schneider, Harold, Ayetey, George, Angelidis, Aikaterini, Archontaki, Sofia, Chatziioannou, Ioannis, Datseris, Christina, Fragkaki, Panagiotis, Georgoulias, Sophia, Koukouraki, Maria, Koutelou, Eleni, Kyrozi, Evangelos, Repasos, Petros, Stavrou, Pipitsa, Valsamaki, Carla, Gonzalez, Goleat, Gutierrez, Alejandro, Maldonado, Klara, Buga, Ildiko, Garai, Erzsébet, Schmidt, Balint, Szilveszter, Edit, Várady, Nilesh, Banthia, Jinendra Kumar Bhagat, Rishi, Bhargava, Vivek, Bhat, Partha, Choudhury, Vijay Sai Chowdekar, Aparna, Irodi, Shashank, Jain, Elizabeth, Joseph, Sukriti, Kumar, Girijanandan, Mahapatra, Deepanjan, Mitra, Bhagwant Rai Mittal, Ahmad, Ozair, Chetan, Patel, Tapan, Patel, Ravi, Patel, Shivani, Patel, Sudhir, Saxena, Shantanu, Sengupta, Santosh, Singh, Bhanupriya, Singh, Ashwani, Sood, Atul, Verma, Erwin, Affandi, Padma Savenadia Alam, Edison, Edison, Gani, Gunawan, Habusari, Hapkido, Basuki, Hidayat, Aulia, Huda, Anggoro Praja Mukti, Djoko, Prawiro, Erwin Affandi Soeriadi, Hilman, Syawaluddin, Amjed, Albadr, Majid, Assadi, Farshad, Emami, Golnaz, Houshmand, Majid, Maleki, Maryam Tajik Rostami, Seyed Rasoul Zakavi, Eed Abu Zaid, Svetlana, Agranovich, Yoav, Arnson, Rachel, Bar-Shalom, Alex, Frenkel, Galit, Knafo, Rachel, Lugassi, Israel Shlomo Maor Moalem, Maya, Mor, Noam, Muskal, Sara, Ranser, Aryeh, Shalev, Domenico, Albano, Pierpaolo, Alongi, Gaspare, Arnone, Elisa, Bagatin, Sergio, Baldari, Matteo, Bauckneht, Paolo, Bertelli, Francesco, Bianco, Rachele, Bonfiglioli, Roberto, Boni, Andrea, Bruno, Isabella, Bruno, Elena, Busnardo, Elena, Califaretti, Luca, Camoni, Aldo, Carnevale, Roberta, Casoni, Armando Ugo Cavallo, Giorgio, Cavenaghi, Franca, Chierichetti, Marcello, Chiocchi, Corrado, Cittanti, Mauro, Colletta, Umberto, Conti, Alberto, Cossu, Alberto, Cuocolo, Marco, Cuzzocrea, Maria Luisa De Rimini, Giuseppe De Vincentis, Eleonora Del Giudice, Alberico Del Torto, DELLA TOMMASINA, Veronica, Rexhep, Durmo, Erba, PAOLA ANNA, Laura, Evangelista, Riccardo, Faletti, Evelina, Faragasso, Mohsen, Farsad, Paola, Ferro, Luigia, Florimonte, Viviana, Frantellizzi, Fabio Massimo Fringuelli, Marco, Gatti, Angela, Gaudiano, Alessia, Gimelli, Raffaele, Giubbini, Francesca, Giuffrida, Salvatore, Ialuna, Riccardo, Laudicella, Lucia, Leccisotti, Lucia, Leva, Liga, Riccardo, Carlo, Liguori, Giampiero, Longo, Margherita, Maffione, Maria Elisabetta Mancini, Claudio, Marcassa, Barbara, Nardi, Sara, Pacella, Giovanna, Pepe, Gianluca, Pontone, Sabina, Pulizzi, Natale, Quartuccio, Lucia, Rampin, Fabrizio, Ricci, Pierluigi, Rossini, Giuseppe, Rubini, Vincenzo, Russo, Gian Mauro Sacchetti, Gianmario, Sambuceti, Massimo, Scarano, Roberto, Sciagrà, Massimiliano, Sperandio, Antonella, Stefanelli, Guido, Ventroni, Stefania, Zoboli, Dainia, Baugh, Duane, Chambers, Ernest, Madu, Felix, Nunura, Hiroshi, Asano, Chimura Misato Chimura, Shinichiro, Fujimoto, Koichiro, Fujisue, Tomohisa, Fukunaga, Yoshimitsu, Fukushima, Kae, Fukuyama, Jun, Hashimoto, Yasutaka, Ichikawa, Nobuo, Iguchi, Masamichi, Imai, Anri, Inaki, Hayato, Ishimura, Satoshi, Isobe, Toshiaki, Kadokami, Takao, Kato, Shinichiro, Kumita, Hirotaka, Maruno, Hiroyuki, Mataki, Masao, Miyagawa, Ryota, Morimoto, Masao, Moroi, Shigeki, Nagamachi, Kenichi, Nakajima, Tomoaki, Nakata, Ryo, Nakazato, Mamoru, Nanasato, Masanao, Naya, Takashi, Norikane, Yasutoshi, Ohta, Satoshi, Okayama, Atsutaka, Okizaki, Yoichi, Otomi, Hideki, Otsuka, Masaki, Saito, Sakata Yasushi Sakata, Masayoshi, Sarai, Daisuke, Sato, Shinya, Shiraishi, Yoshinobu, Suwa, Kentaro, Takanami, Kazuya, Takehana, Junichi, Taki, Nagara, Tamaki, Yasuyo, Taniguchi, Hiroki, Teragawa, Nobuo, Tomizawa, Kenichi, Tsujita, Kyoko, Umeji, Yasushi, Wakabayashi, Shinichiro, Yamada, Shinya, Yamazaki, Tatsuya, Yoneyama, Mohammad, Rawashdeh, Daultai, Batyrkhanov, Tairkhan, Dautov, Khalid, Makhdomi, Kevin, Ombati, Faridah, Alkandari, Masoud, Garashi, Tchoyoson Lim Coie, Sonexay, Rajvong, Artem, Kalinin, Marika, Kalnina, Mohamad, Haidar, Renata, Komiagiene, Giedre, Kviecinskiene, Mindaugas, Mataciunas, Donatas, Vajauskas, Christian, Picard, Noor Khairiah, A Karim, Luise, Reichmuth, Anthony, Samuel, Mohammad Aaftaab Allarakha, Ambedhkar Shantaram Naojee, Erick, Alexanderson-Rosas, Erika, Barragan, Alejandro Becerril González-Montecinos, Manuel, Cabada, Daniel Calderon Rodriguez, Isabel, Carvajal-Juarez, Violeta, Cortés, Filiberto, Cortés, Erasmo De La Peña, Manlio, Gama-Moreno, Luis, González, Nelsy Gonzalez Ramírez, Moisés, Jiménez-Santos, Luis, Matos, Edgar, Monroy, Martha, Morelos, Mario, Ornelas, Jose Alberto Ortga Ramirez, Andrés, Preciado-Anaya, Óscar Ulises Preciado-Gutiérrez, Adriana Puente Barragan, Sandra Graciela Rosales Uvera, Sigelinda, Sandoval, Miguel Santaularia Tomas, Lilia, M Sierra-Galan, Silvia, Siu, Enrique, Vallejo, Mario, Valles, Marc, Faraggi, Erdenechimeg, Sereegotov, Srdja, Ilic, Nozha, Ben-Rais, Nadia Ismaili Alaoui, Sara, Taleb, Khin Pa Pa Myo, Phyo Si Thu, Ram Kumar Ghimire, Bijoy, Rajbanshi, Peter, Barneveld, Andor, Glaudemans, Jesse, Habets, Klaas Pieter Koopmans, Jeroen, Manders, Stefan, Pool, Arthur, Scholte, Asbjørn, Scholtens, Riemer, Slart, Paul, Thimister, Erik-Jan Van Asperen, Niels, Veltman, Derk, Verschure, Nils, Wagenaar, John, Edmond, Chris, Ellis, Kerryanne, Johnson, Ross, Keenan, Shaw Hua Anthony Kueh, Christopher, Occleshaw, Alexander, Sasse, Andrew, To, Niels Van Pelt, Calum, Young, Teresa, Cuadra, Hector Bladimir Roque Vanegas, Idrissa Adamou Soli, Djibrillou Moussa Issoufou, Tolulope, Ayodele, Chibuzo, Madu, Yetunde, Onimode, Elen, Efros-Monsen, Signe Helene Forsdahl, Jenni-Mari Hildre Dimmen, Arve, Jørgensen, Isabel, Krohn, Pål, Løvhaugen, Anders Tjellaug Bråten, Humoud Al Dhuhli, Faiza Al Kindi, Naeema, Al-Bulushi, Zabah, Jawa, Naima, Tag, Muhammad Shehzad Afzal, Shazia, Fatima, Muhammad Numair Younis, Musab, Riaz, Mohammad, Saadullah, Yariela, Herrera, Dora, Lenturut-Katal, Manuel Castillo Vázquez, José, Ortellado, Afroza, Akhter, Dianbo, Cao, Stephen, Cheung, Dai, Xu, Lianggeng, Gong, Dan, Han, Yang, Hou, Caiying, Li, Tao, Li, Dong, Li, Sijin, Li, Jinkang, Liu, Hui, Liu, Ming Yen Ng, Kai, Sun, Gongshun, Tang, Jian, Wang, Ximing, Wang, Zhao-Qian, Wang, Yining, Wang, Yifan, Wang, Jiang, Wu, Zhifang, Wu, Liming, Xia, Jiangxi, Xiao, Lei, Xu, Youyou, Yang, Yin, Wu, Jianqun, Yu, Yuan, Li, Tong, Zhang, Longjiang, Zhang, Yong-Gao, Zhang, Xiaoli, Zhang, Zhu, Li, Ana, Alfaro, Paz, Abrihan, Asela, Barroso, Eric, Cruz, Marie Rhiamar Gomez, Vincent Peter Magboo, John Michael Medina, Jerry, Obaldo, Davidson, Pastrana, Christian Michael Pawhay, Alvin, Quinon, Jeanelle Margareth Tang, Bettina, Tecson, Kristine Joy Uson, Mila, Uy, Magdalena, Kostkiewicz, Jolanta, Kunikowska, Nuno, Bettencourt, Guilhermina, Cantinho, Antonio, Ferreira, Ghulam, Syed, Samer, Arnous, Said, Atyani, Angela, Byrne, Tadhg, Gleeson, David, Kerins, Conor, Meehan, David, Murphy, Mark, Murphy, John, Murray, Julie, O'Brien, Ji-In, Bang, Henry, Bom, Sang-Geon, Cho, Chae Moon Hong, Su Jin Jang, Yong Hyu Jeong, Won Jun Kang, Ji-Young, Kim, Jaetae, Lee, Chang Kyeong Namgung, Young, So, Kyoung Sook Won, Venjamin, Majstorov, Marija, Vavlukis, Barbara Gužic Salobir, Monika, Štalc, Theodora, Benedek, Imre, Benedek, Raluca, Mititelu, Claudiu Adrian Stan, Alexey, Ansheles, Olga, Dariy, Olga, Drozdova, Nina, Gagarina, Vsevolod Milyevich Gulyaev, Irina, Itskovich, Anatoly, Karalkin, Alexander, Kokov, Ekaterina, Migunova, Viktor, Pospelov, Daria, Ryzhkova, Guzaliya, Saifullina, Svetlana, Sazonova, Irina, Shurupova, Tatjana, Trifonova, Wladimir Yurievich Ussov, Margarita, Vakhromeeva, Nailya, Valiullina, Konstantin, Zavadovsky, Kirill, Zhuravlev, Mirvat, Alasnag, Subhani, Okarvi, Dragana Sobic Saranovic, Felix, Keng, Jia Hao Jason See, Ramkumar, Sekar, Min Sen Yew, Andrej, Vondrak, Shereen, Bejai, George, Bennie, Ria, Bester, Gerrit, Engelbrecht, Osayande, Evbuomwan, Harlem, Gongxeka, Magritha Jv Vuuren, Mitchell, Kaplan, Purbhoo, Khushica, Hoosen, Lakhi, Nico, Malan, Katarina, Milos, Moshe, Modiselle, Stuart, More, Mathava, Naidoo, Leonie, Scholtz, Mboyo, Vangu, Santiago, Aguadé-Bruix, Isabel, Blanco, Antonio, Cabrera, Alicia, Camarero, Irene, Casáns-Tormo, Hug, Cuellar-Calabria, Albert, Flotats, Maria Eugenia Fuentes Cañamero, María Elia García, Amelia, Jimenez-Heffernan, Rubén, Leta, Javier Lopez Diaz, Luis, Lumbreras, Juan Javier Marquez-Cabeza, Francisco, Martin, Anxo Martinez de Alegria, Francisco, Medina, Maria Pedrera Canal, Virginia, Peiro, Virginia, Pubul-Nuñez, Juan Ignacio Rayo Madrid, Cristina Rodríguez Rey, Ricardo Ruano Perez, Joaquín, Ruiz, Gertrudis Sabatel Hernández, Ana, Sevilla, Nahla, Zeidán, Damayanthi, Nanayakkara, Chandraguptha, Udugama, Magnus, Simonsson, Hatem, Alkadhi, Ronny Ralf Buechel, Peter, Burger, Luca, Ceriani, Bart De Boeck, Christoph, Gräni, Alix Juillet de Saint Lager Lucas, Christel, H Kamani, Nadine, Kawel-Boehm, Robert, Manka, John, O Prior, Axel, Rominger, Jean-Paul, Vallée, Benjapa, Khiewvan, Teerapon, Premprabha, Tanyaluck, Thientunyakit, Ali, Sellem, Kemal Metin Kir, Haluk, Sayman, Mugisha Julius Sebikali, Zerida, Muyinda, Yaroslav, Kmetyuk, Pavlo, Korol, Olena, Mykhalchenko, Volodymyr, Pliatsek, Maryna, Satyr, Batool, Albalooshi, Mohamed Ismail Ahmed Hassan, Jill, Anderson, Punit, Bedi, Thomas, Biggans, Anda, Bularga, Russell, Bull, Rajesh, Burgul, John-Paul, Carpenter, Duncan, Coles, David, Cusack, Aparna, Deshpande, John, Dougan, Timothy, Fairbairn, Alexia, Farrugia, Deepa, Gopalan, Alistair, Gummow, Prasad Guntur Ramkumar, Mark, Hamilton, Mark, Harbinson, Thomas, Hartley, Benjamin, Hudson, Nikhil, Joshi, Michael, Kay, Andrew, Kelion, Azhar, Khokhar, Jamie, Kitt, Ken, Lee, Chen, Low, Sze Mun Mak, Ntouskou, Marousa, Jon, Martin, Elisa, Mcalindon, Leon, Menezes, Gareth, Morgan-Hughes, Alastair, Moss, Anthony, Murray, Edward, Nicol, Dilip, Patel, Charles, Peebles, Francesca, Pugliese, Jonathan Carl Luis Rodrigues, Christopher, Rofe, Nikant, Sabharwal, Rebecca, Schofield, Thomas, Semple, Naveen, Sharma, Peter, Strouhal, Deepak, Subedi, William, Topping, Katharine, Tweed, Jonathan, Weir-Mccall, Suhny, Abbara, Taimur, Abbasi, Brian, Abbott, Shady, Abohashem, Sandra, Abramson, Tarek, Al-Abboud, Mouaz, Al-Mallah, Omar, Almousalli, Karthikeyan, Ananthasubramaniam, Mohan Ashok Kumar, Jeffrey, Askew, Lea, Attanasio, Mallory, Balmer-Swain, Richard, R Bayer, Adam, Bernheim, Sabha, Bhatti, Erik, Bieging, Ron, Blankstein, Stephen, Bloom, Sean, Blue, David, Bluemke, Andressa, Borges, Kelley, Branch, Paco, Bravo, Jessica, Brothers, Matthew, Budoff, Renée, Bullock-Palmer, Angela, Burandt, Floyd, W Burke, Kelvin, Bush, Candace, Candela, Elizabeth, Capasso, Joao, Cavalcante, Donald, Chang, Saurav, Chatterjee, Yiannis, Chatzizisis, Michael, Cheezum, Tiffany, Chen, Jennifer, Chen, Marcus, Chen, Andrew, Choi, James, Clarcq, Ayreen, Cordero, Matthew, Crim, Sorin, Danciu, Bruce, Decter, Nimish, Dhruva, Neil, Doherty, Rami, Doukky, Anjori, Dunbar, William, Duvall, Rachael, Edwards, Kerry, Esquitin, Husam, Farah, Emilio, Fentanes, Maros, Ferencik, Daniel, Fisher, Daniel, Fitzpatrick, Cameron, Foster, Tony, Fuisz, Michael, Gannon, Lori, Gastner, Myron, Gerson, Brian, Ghoshhajra, Alan, Goldberg, Brian, Goldner, Jorge, Gonzalez, Rosco, Gore, Sandra, Gracia-López, Fadi, Hage, Agha, Haider, Sofia, Haider, Yasmin, Hamirani, Karen, Hassen, Mallory, Hatfield, Carolyn, Hawkins, Katie, Hawthorne, Nicholas, Heath, Robert, Hendel, Phillip, Hernandez, Gregory, Hill, Stephen, Horgan, Jeff, Huffman, Lynne, Hurwitz, Ami, Iskandrian, Rajesh, Janardhanan, Christine, Jellis, Scott, Jerome, Dinesh, Kalra, Summanther, Kaviratne, Fernando, Kay, Faith, Kelly, Omar, Khalique, Mona, Kinkhabwala, George Kinzfogl Iii, Jacqueline, Kircher, Rachael, Kirkbride, Michael, Kontos, Anupama, Kottam, Joseph, Krepp, Jay, Layer, Steven, H Lee, Jeffrey, Leppo, John, Lesser, Steve, Leung, Howard, Lewin, Diana, Litmanovich, Yiyan, Liu, Kathleen, Magurany, Jeremy, Markowitz, Amanda, Marn, Stephen, E Matis, Michael, Mckenna, Tony, Mcrae, Fernando, Mendoza, Michael, Merhige, David, Min, Chanan, Moffitt, Karen, Moncher, Warren, Moore, Shamil, Morayati, Michael, Morris, Mahmud, Mossa-Basha, Zorana, Mrsic, Venkatesh, Murthy, Prashant, Nagpal, Kyle, Napier, Katarina, Nelson, Prabhjot, Nijjar, Medhat, Osman, Edward, Passen, Amit, Patel, Pravin, Patil, Ryan, Paul, Lawrence, Phillips, Venkateshwar, Polsani, Rajaram, Poludasu, Brian, Pomerantz, Thomas, Porter, Ryan, Prentice, Amit, Pursnani, Mark, Rabbat, Suresh, Ramamurti, Florence, Rich, Hiram Rivera Luna, Austin, Robinson, Kim, Robles, Cesar, Rodríguez, Mark, Rorie, John, Rumberger, Raymond, Russell, Philip, Sabra, Diego, Sadler, Mary, Schemmer, U Joseph Schoepf, Samir, Shah, Nishant, Shah, Sujata, Shanbhag, Gaurav, Sharma, Steven, Shayani, Jamshid, Shirani, Pushpa, Shivaram, Steven, Sigman, Mitch, Simon, Ahmad, Slim, David, Smith, Alexandra, Smith, Prem, Soman, Aditya, Sood, Monvadi Barbara Srichai-Parsia, James, Streeter, Albert, T Ahmed Tawakol, Dustin, Thomas, Randall, Thompson, Tara, Torbet, Desiree, Trinidad, Shawn, Ullery, Samuel, Unzek, Seth, Uretsky, Srikanth, Vallurupalli, Vikas, Verma, Alfonso, Waller, Ellen, Wang, Parker, Ward, Gaby, Weissman, George, Wesbey, Kelly, White, David, Winchester, David, Wolinsky, Sandra, Yost, Michael, Zgaljardic, Omar, Alonso, Mario, Beretta, Rodolfo, Ferrando, Miguel, Kapitan, Fernando, Mut, Omoa, Djuraev, Gulnora, Rozikhodjaeva, Ha Le Ngoc, Son Hong Mai, Xuan Canh Nguyen, Einstein, A. J., Shaw, L. J., Hirschfeld, C., Williams, M. C., Villines, T. C., Better, N., Vitola, J. V., Cerci, R., Dorbala, S., Raggi, P., Choi, A. D., Lu, B., Sinitsyn, V., Sergienko, V., Kudo, T., Norgaard, B. L., Maurovich-Horvat, P., Campisi, R., Milan, E., Louw, L., Allam, A. H., Bhatia, M., Malkovskiy, E., Goebel, B., Cohen, Y., Randazzo, M., Narula, J., Pascual, T. N. B., Pynda, Y., Dondi, M., Paez, D., Cuocolo, A., Einstein, A, Shaw, L, Hirschfeld, C, Williams, M, Villines, T, Better, N, Vitola, J, Cerci, R, Dorbala, S, Raggi, P, Choi, A, Lu, B, Sinitsyn, V, Sergienko, V, Kudo, T, Norgaard, B, Maurovich-Horvat, P, Campisi, R, Milan, E, Louw, L, Allam, A, Bhatia, M, Malkovskiy, E, Goebel, B, Cohen, Y, Randazzo, M, Narula, J, Pascual, T, Pynda, Y, Dondi, M, Paez, D, Pacella, S, and Erba, P

Subjects
INCAPS COVID Investigators Group, Heart disease, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Diagnostic Techniques, Cardiovascular, coronavirus, global health, IAEA, Disease, Telehealth, Cardiorespiratory Medicine and Haematology, 030204 cardiovascular system & hematology, Cardiovascular, 0302 clinical medicine, cardiovascular disease, cardiac testing, COVID-19, diagnostic techniques, cardiovascular, health care surveys, heart diseases, humans, international agencies, Pandemic, Global health, 030212 general & internal medicine, COVID-19 Heart Disease, Cause of death, STATEMENT, Heart Disease, International Agencie, Public Health and Health Services, Biomedical Imaging, Cardiology and Cardiovascular Medicine, Human, medicine.medical_specialty, Heart Diseases, 03 medical and health sciences, Clinical Research, medicine, Humans, Personal protective equipment, Heart Disease - Coronary Heart Disease, business.industry, International Agencies, medicine.disease, the, coronaviru, Diagnostic Techniques, Good Health and Well Being, Clinical research, Cardiovascular System & Hematology, Health Care Survey, Health Care Surveys, Emergency medicine, Global Health, business
Abstract

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. OBJECTIVES The study sought to assess COVID-19`s impact on global cardiovascular diagnostic procedural volumes and safety practices. METHODS The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. RESULTS Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoradc echocardiography decreased by 59%, transesophageat echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p < 0.001 for each procedure). hi multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower-middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and teteheatth. CONCLUSIONS COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19-related changes in care delivery is warranted. (C) 2021 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.

Published
2021

19. Premature infants with patent ductus arteriosus: Postnatal growth according to type of management

Author

Kunal Babla, Kuberan Pushparajah, Theodore Dassios, Ann Hickey, and Anne Greenough

Subjects
Male, Pediatrics, medicine.medical_specialty, Birth weight, Gestational Age, Infant, Premature, Diseases, Conservative Treatment, Weight Gain, neonatal, patent ductus arteriosus, Postoperative Complications, Corrected Gestational Age, Ductus arteriosus, medicine, Humans, ligation, Cardiac Surgical Procedures, Postnatal growth, Ductus Arteriosus, Patent, Growth Disorders, Retrospective Studies, business.industry, prematurity, Infant, Newborn, lcsh:RJ1-570, Infant, Gestational age, lcsh:Pediatrics, Infant, Low Birth Weight, medicine.anatomical_structure, Pediatrics, Perinatology and Child Health, Cohort, Gestation, Female, medicine.symptom, business, Weight gain, Infant, Premature
Abstract

Background: Patent Ductus Arteriosus (PDA) is a common condition, affecting nearly half of infants born before 28 weeks' of gestation, and it has been associated with poor growth. It is not known if different treatment modalities are associated with more profound growth impairment. Our aim was to compare differences in weight gain at 36 weeks' corrected gestational age (CGA) in premature infants that received medical, surgical or conservative management for PDA. Methods: We retrospectively reviewed notes of 208 infants born under 30 weeks' gestation with a diagnosis of PDA. Gestational age (GA) at birth, birth weight z-score, CGA and weight z-score at 36 weeks' CGA were collected. In our cohort, surgical closure was performed in infants who remained symptomatic after medical or conservative management. Results: Ninety-four infants had medical, 56 surgical and 58 conservative management. Surgically managed infants had a lower median (IQR) GA [24.4 (24.0–26.1) weeks'] than medically [25.4 (24.6–26.5) weeks'] or conservatively managed [26.4 (25.4–28.1) weeks', p

Published
2021

20. Untreated obstructive sleep apnea is associated with increased hospitalization from influenza infection

Author

Glen Greenough, Catherine C. Pollack, and Eva M Mok

Subjects
Male, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Cpap adherence, 03 medical and health sciences, 0302 clinical medicine, Immune system, Internal medicine, Influenza, Human, medicine, Humans, Lebanon, Aged, Retrospective Studies, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure, business.industry, Middle Aged, medicine.disease, Sleep in non-human animals, respiratory tract diseases, Hospitalization, Obstructive sleep apnea, Sleep deprivation, 030228 respiratory system, Neurology, Influenza Vaccines, Commentary, Patient Compliance, Female, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery
Abstract

There is evidence that sleep deprivation or diseases such as obstructive sleep apnea (OSA) that lead to sleep disruption may adversely impact immune system functioning. We hypothesized that individuals who have OSA who did not use continuous positive airway pressure (CPAP) would have higher rates of hospitalization and complications from influenza infection than patients with OSA who were adherent to treatment.Medical records of patients at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire who had both OSA and a new, laboratory-confirmed influenza infection between 2016 and 2018 were reviewed for results of polysomnography, CPAP usage, influenza vaccination records, confirmation of influenza infection, and influenza-related hospitalizations and complications.Compared to the patients who were adherent to CPAP, patients who were either conservatively treated without CPAP or who were nonadherent to CPAP therapy had higher odds of hospitalization from influenza infections (odds ratio = 4.7, 95% confidence interval 1.3 to 19.5, P = .01) but no higher odds of complications from influenza. The patients who had untreated sleep apnea had a higher percentage of influenza vaccination for their season of illness (75% of patients) compared to patients who were adherent to CPAP (56% of patients), although the difference in vaccination was not statistically significant.Patients with OSA who did not use CPAP appear to have greater rates of hospitalization from acute influenza infection, despite having a higher trend of influenza vaccination compared to patients who were adherent to CPAP.

Published
2020

21. Mortality after 36 weeks postmenstrual age of extremely preterm infants in neonatal care: The impact of growth impairment and bronchopulmonary dysplasia

Author

Theodore Dassios, Emma Williams, Ann Hickey, Ravindra Bhat, and Anne Greenough

Subjects
Enterocolitis, Necrotizing, Infant, Extremely Premature, Intensive Care Units, Neonatal, Pediatrics, Perinatology and Child Health, Infant, Newborn, Obstetrics and Gynecology, Humans, Infant, Female, Gestational Age, Bronchopulmonary Dysplasia, Retrospective Studies
Abstract

A small group of extremely preterm infants survive to 36 weeks postmenstrual age (PMA), but die before discharge from neonatal care.To investigate which epidemiological and clinical parameters were related to death after 36 weeks PMA in extremely preterm infants.Retrospective whole-population study.All infants born28 weeks of gestation admitted to a neonatal unit in England between 2014 and 2018.Mortality after 36 weeks PMA and before discharge from neonatal care. Bronchopulmonary dysplasia (BPD) defined as any respiratory support at 36 weeks PMA.Death after 36 weeks PMA occurred in 156 of a total of 11.747 included infants (1.3 %) and at a median (IQR) age of 130 (93-164) days. A lower gestational age [Odds Ratio: 0.82, 95 % CI:0.72-0.94, adjusted p = 0.005], lower birth weight z-score [Odds Ratio: 0.45, 95 % CI:0.36-0.56, adjusted p 0.001], greater absolute difference in weight z-score from birth to 36 weeks PMA [Odds Ratio: 0.46, 95 % CI:0.38-0.56, adjusted p 0.001] were independently associated with death after 36 weeks PMA. A diagnosis of BPD [Odds Ratio: 4.57, 95 % CI:2.19-9.54, adjusted p 0.001] and of necrotising enterocolitis requiring surgery [Odds Ratio: 2.81, 95 % CI:1.82-4.34, adjusted p 0.001] were also independently associated with death after 36 weeks PMA.Mortality of extremely preterm infants after 36 weeks postmenstrual age is associated with lower gestational age and more impaired growth. The diagnoses of bronchopulmonary dysplasia and necrotising enterocolitis were associated with a higher risk of death after 36 weeks postmenstrual age and before discharge from neonatal care.

Published
2022

22. Prediction of survival in infants with congenital diaphragmatic hernia and the response to inhaled nitric oxide

Author

Fahad M. S. Arattu Thodika, Svilena Dimitrova, Mahesh Nanjundappa, Mark Davenport, Kypros Nicolaides, Theodore Dassios, and Anne Greenough

Subjects
Hypertension, Pulmonary, Pediatrics, Perinatology and Child Health, Administration, Inhalation, Humans, Infant, Gases, Hernias, Diaphragmatic, Congenital, Nitric Oxide, Retrospective Studies
Abstract

The use of inhaled nitric oxide (iNO) in treating pulmonary hypertension in infants with congenital diaphragmatic hernia (CDH) is controversial. Our aims were to identify factors associated with survival in CDH infants and whether this was influenced by the response to iNO. Results of CDH infants treated in a tertiary surgical and medical perinatal centre in a ten year period (2011–2021) were reviewed. Factors affecting survival were determined. To assess the response to iNO, blood gases prior to and 30 to 60 min after initiation of iNO were analysed and PaO2/FiO2 ratios and oxygenation indices (OI) calculated. One hundred and five infants were admitted with CDH; 46 (43.8%) infants died. The CDH infants who died had a lower median observed to expected lung to head ratio (O/E LHR) (p p 2 (46.7 versus 58.8 mmHg, p 2/FiO2 ratio (49.4 versus 58.8, p = 0.003) improved post iNO initiation. The percentage change in the PaO2/FiO2 ratio post iNO initiation was higher in infants who survived (69.4%) compared to infants who died (10.2%), p = 0.018.Conclusion: The highest OI on day 1 predicted survival. iNO improved oxygenation in certain CDH infants and a positive response was more likely in those who survived. What is Known:• The use of iNO is controversial in infants with CDH with respect to whether it improves survival. What is New:• We have examined predictors of survival in CDH infants including the response to iNO and demonstrated that the highest oxygenation index on day 1 predicted survival (AUCROC =0.908).• Certain infants with CDH responded to iNO and those with a greater response were more likely to survive.

Published
2022

23. The use of neurally-adjusted ventilatory assist (NAVA) for infants with congenital diaphragmatic hernia (CDH)

Author

Grace Poole, Sandeep Shetty, and Anne Greenough

Subjects
Pediatrics, Perinatology and Child Health, Infant, Newborn, Obstetrics and Gynecology, Infant, Humans, Multicenter Studies as Topic, Prospective Studies, Hernias, Diaphragmatic, Congenital, Interactive Ventilatory Support, Respiration, Artificial
Abstract

Objectives Newborns with congenital diaphragmatic hernia (CDH) can have complex respiratory problems which are worsened by ventilatory induced lung injury. Neurally adjusted ventilator assist (NAVA) is a potentially promising ventilation mode for this population, as it can result in improved patient-ventilator interactions and provision of adequate gas exchange at lower airway pressures. Content A literature review was undertaken to provide an overview of NAVA and examine its role in the management of infants with CDH. Summary NAVA in neonates has been used in CDH infants who were stable on ventilatory support or being weaned from mechanical ventilation and was associated with a reduction in the level of respiratory support. Outlook There is, however, limited evidence regarding the efficacy of NAVA in infants with CDH, with only short-term benefits being investigated. A prospective, multicentre study with long term follow-up is required to appropriately assess NAVA in this population.

Published
2022

24. Does closed-loop automated oxygen control reduce the duration of mechanical ventilation? A randomised controlled trial in ventilated preterm infants

Author

Ourania Kaltsogianni, Theodore Dassios, and Anne Greenough

Subjects
Intermittent hypoxemia and hyperoxemia, Closed loop automated oxygen control, Infant, Newborn, Infant, Medicine (miscellaneous), Preterm infants, Hyperoxia, Respiration, Artificial, Oxygen, Mechanical ventilation, Humans, Pharmacology (medical), Hypoxia, Infant, Premature, Bronchopulmonary Dysplasia
Abstract

Background Many preterm infants require supplemental oxygen in the newborn period but experience frequent fluctuations of their oxygen saturation levels. Intermittent episodes of hypoxia or hyperoxia increase the risk of complications. Compliance with achievement of oxygen saturation targets is variable, and the need for frequent adjustments of the inspired oxygen concentration increases workload. Closed-loop automated oxygen control systems (CLAC) improve achievement of oxygen saturation targets and reduce both episodes of hypoxia and hyperoxia and the number of manual adjustments. This study investigates whether CLAC compared with manual oxygen control reduces the duration of mechanical ventilation in preterm infants born at less than 31 weeks of gestation. Methods This randomised controlled trial performed at a single tertiary neonatal unit is recruiting 70 infants born at less than 31 weeks of gestational age and within 48 h of initiation of mechanical ventilation. Infants are randomised to CLAC or manual oxygen control from recruitment until successful extubation. The primary outcome is the duration of mechanical ventilation, and secondary outcomes are the percentage of time spent within target oxygen saturation ranges, the time spent in hypoxia or hyperoxia, the number of manual adjustments required, the number of days on oxygen, the incidence of bronchopulmonary dysplasia and the length and cost of neonatal unit stay. The study is performed following informed parental consent and was approved by the Yorkshire and the Humber-Sheffield Research Ethics Committee (protocol version 1.1, 13 July 2021). Discussion This trial will investigate the effect of CLAC on the duration of mechanical ventilation, which is an important clinical outcome as prolonged mechanical ventilation is associated with important adverse outcomes, such as bronchopulmonary dysplasia. Trial registration ClinicalTrials.Gov NCT05030337. Registered on 17 August 2021

Published
2022

25. Does Duration of Pain at Baseline Influence Longer-term Clinical Outcomes of Low Back Pain Patients Managed on an Evidence-Based Pathway?

Author

Francis Fatoye, Denis Martin, Shaun Wellburn, Cormac Ryan, Andrew Coxon, Sharon Hamilton, Glynis Peat, Greg Atkinson, Charles Greenough, Helen Ridley, Alastair Dickson, Mary-Anne Jess, and Diarmaid Ferguson

Subjects
Male, medicine.medical_specialty, Time Factors, Evidence-based practice, MEDLINE, 03 medical and health sciences, 0302 clinical medicine, Quality of life (healthcare), Surveys and Questionnaires, Outcome Assessment, Health Care, Health care, Humans, Medicine, Orthopedics and Sports Medicine, Longitudinal Studies, 030212 general & internal medicine, Duration (project management), business.industry, Foundation (evidence), Low back pain, Treatment Outcome, England, Quality of Life, Physical therapy, Female, Observational study, Neurology (clinical), medicine.symptom, business, Low Back Pain, 030217 neurology & neurosurgery
Abstract

Study Design. Non-randomised longitudinal observational study. Objective. To evaluate the association between baseline pain duration and medium-to-long term clinical outcomes, in low back pain (LBP) patients enrolled on the North East of England Regional Back Pain and Radicular Pain Pathway (NERBPP). Summary of Background Data. The NERBPP is based upon National Institute for Health and Care Excellence (NICE) guidelines. These guidelines no longer differentiate management of LBP patients based on pain duration. Medium-to-long term data from the NERBPP is lacking. Methods. Between May 2015 and December 2019, 786 and 552 LBP patients from the NERBPP returned 6-month and 12-month follow-up outcome measures, respectively. Outcomes included pain (Numerical rating scale), function (Oswestry Disability Index) and quality-of-life (EuroQol five-dimension, five-level questionnaire), analysed using a series of covariate-adjusted models. Patients were categorized into four groups based upon baseline pain duration

Published
2020

26. Prediction of extubation success using the diaphragmatic electromyograph results in ventilated neonates

Author

Kamal Ali, Anne Greenough, Ian Hunt, Theodore Dassios, and Katie A. Hunt

Subjects
Male, Diaphragm, Diaphragmatic breathing, Gestational Age, Infant, Premature, Diseases, Infant, Newborn, Diseases, 03 medical and health sciences, 0302 clinical medicine, Corrected Gestational Age, 030225 pediatrics, Tidal Volume, Birth Weight, Humans, Medicine, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Tidal volume, Extubation failure, Receiver operating characteristic, Electromyography, business.industry, Infant, Newborn, Obstetrics and Gynecology, Gestational age, Respiration, Artificial, Diaphragm (structural system), Treatment Outcome, ROC Curve, Anesthesia, Pediatrics, Perinatology and Child Health, Airway Extubation, Female, business, Infant, Premature
Abstract

Objectives Extubation failure is common in infants and associated with complications. Methods A prospective study was undertaken of preterm and term born infants. Diaphragm electromyogram (EMG) was measured transcutaneously for 15–60 min prior to extubation. The EMG results were related to tidal volume (Tve) to calculate the neuroventilatory efficiency (NVE). Receiver operating characteristic curves (ROC) were constructed and areas under the ROCs (AUROC) calculated. Results Seventy-two infants, median gestational age 28 (range 23–42) weeks were included; 15 (21%) failed extubation. Infants successfully extubated were more mature at birth (p=0.001), of greater corrected gestational age (CGA) at extubation (p29.6 weeks had the highest combined sensitivity (86%) and specificity (80%) in predicting extubation success. Conclusions Although NVE differed significantly between those who did and did not successfully extubate, CGA was the best predictor of extubation success.

Published
2020

27. Global molecular diversity of RSV – the 'INFORM RSV' study

Author

Robert Cohen, Louis Bont, Monika Bauck, Jesse Papenburg, Robert Jan Lebbink, Terho Heikkinen, Alexey Ruzin, Mitsuaki Hosoya, Federico Martinón-Torres, Marta C. Nunes, Anne Greenough, Peter Richmond, Christiana A. Naaktgeboren, Christian Keller, Michael E Abram, Anouk Evers, Joanne G. Wildenbeest, Mark T. Esser, Marije P. Hennus, Annefleur C Langedijk, David E. Tabor, Marco C. Viveen, Frank E. J. Coenjaerts, Renato T. Stein, Hong Jin, Andrev Tovchigrechko, Jeffrey M. Pernica, Leyla Kragten-Tabatabaie, and Deidre E. Wilkins

Subjects
Male, 0301 basic medicine, Temporal and geographical diversity, medicine.medical_specialty, Genotype, medicine.drug_class, viruses, Genome, Viral, Respiratory Syncytial Virus Infections, Biology, Respiratory syncytial virus, Monoclonal antibody, Antiviral Agents, Genome, Virus, DNA sequencing, lcsh:Infectious and parasitic diseases, Study Protocol, 03 medical and health sciences, 0302 clinical medicine, Molecular level, Medical microbiology, Next generation sequencing, Drug Resistance, Bacterial, medicine, Humans, lcsh:RC109-216, Prospective Studies, 030212 general & internal medicine, Vaccines, Polymorphism, Genetic, Molecular epidemiology, Reverse Transcriptase Polymerase Chain Reaction, Immunization, Passive, Infant, Newborn, Antibodies, Monoclonal, Infant, respiratory system, Virology, 030104 developmental biology, Infectious Diseases, Parasitology, Child, Preschool, Respiratory Syncytial Virus, Human, Female, Monoclonal antibodies
Abstract

Background Respiratory syncytial virus (RSV) is a global cause of severe respiratory morbidity and mortality in infants. While preventive and therapeutic interventions are being developed, including antivirals, vaccines and monoclonal antibodies, little is known about the global molecular epidemiology of RSV. INFORM is a prospective, multicenter, global clinical study performed by ReSViNET to investigate the worldwide molecular diversity of RSV isolates collected from children less than 5 years of age. Methods The INFORM study is performed in 17 countries spanning all inhabited continents and will provide insight into the molecular epidemiology of circulating RSV strains worldwide. Sequencing of > 4000 RSV-positive respiratory samples is planned to detect temporal and geographical molecular patterns on a molecular level over five consecutive years. Additionally, RSV will be cultured from a subset of samples to study the functional implications of specific mutations in the viral genome including viral fitness and susceptibility to different monoclonal antibodies. Discussion The sequencing and functional results will be used to investigate susceptibility and resistance to novel RSV preventive or therapeutic interventions. Finally, a repository of globally collected RSV strains and a database of RSV sequences will be created.

Published
2020

28. Second course of systemic dexamethasone: efficacy and respiratory function changes

Author

Theodore Dassios, Anne Greenough, and Ourania Kaltsogianni

Subjects
Male, business.industry, Respiration, Infant, Newborn, Infant, Obstetrics and Gynecology, Respiration, Artificial, Dexamethasone, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Anesthesia, Pediatrics, Perinatology and Child Health, Airway Extubation, Humans, Medicine, Respiratory function, 030212 general & internal medicine, business, Ventilator Weaning, Infant, Premature, Retrospective Studies, medicine.drug
Abstract

There is a paucity of data concerning the efficacy of a second course of systemic postnatal corticosteroids resulting in a successful extubation of prematurely-born, ventilated infants and its effect on their respiratory function.To determine the efficacy of a second course of systemic dexamethasone in successful extubation of prematurely-born infants and to describe the respiratory function changes that occur following the administration of the second course.Retrospective cohort study of ventilated infants less than 30 weeks of gestation who received a nine-day second course of intravenous dexamethasone in a tertiary neonatal unit. Extubation was deemed successful if the infants were not re-intubated within 72 h of the extubation attempt. We calculated the ventilation perfusion ratio (VFifteen (10 male) infants with a median (IQR) gestational age (GA) of 25.7 (24.7-26.6) weeks and a birth weight of 0.79 (0.67-0.93) kg were studied at a postnatal age of 60 (48-73) days. Fourteen of fifteen infants (93%) were successfully extubated. The VA second course of systemic dexamethasone appears efficient in weaning premature infants off invasive ventilation and is associated with a significant improvement in oxygenation.

Published
2020

29. Proportional assist ventilation (PAV) versus neurally adjusted ventilator assist (NAVA): effect on oxygenation in infants with evolving or established bronchopulmonary dysplasia

Author

Katie A. Hunt, Anne Greenough, and Theodore Dassios

Subjects
Male, medicine.medical_specialty, Oxygenation index, Neurally adjusted ventilator assist, Proportional Assist Ventilation, Internal medicine, Neurally adjusted ventilatory assist, Humans, Medicine, Prospective Studies, Respiratory system, Interactive Ventilatory Support, Bronchopulmonary Dysplasia, Cross-Over Studies, business.industry, Infant, Newborn, Oxygenation, medicine.disease, Oxygen, Treatment Outcome, Bronchopulmonary dysplasia, Proportional assist, Pediatrics, Perinatology and Child Health, Cardiology, Breathing, Female, Original Article, business, Biomarkers, Infant, Premature, Conventional ventilation
Abstract

Both proportional assist ventilation (PAV) and neurally adjusted ventilatory assist (NAVA) provide pressure support synchronised throughout the respiratory cycle proportional to the patient’s respiratory demand. Our aim was to compare the effect of these two modes on oxygenation in infants with evolving or established bronchopulmonary dysplasia. Two-hour periods of PAV and NAVA were delivered in random order to 18 infants born less than 32 weeks of gestation. Quasi oxygenation indices (“OI”) and alveolar-arterial (“A-a”) oxygen gradients at the end of each period on PAV, NAVA and baseline ventilation were calculated using capillary blood samples. The mean “OI” was not significantly different on PAV compared to NAVA (7.8 (standard deviation (SD) 3.2) versus 8.1 (SD 3.4), respectively, p = 0.70, but lower on both than on baseline ventilation (mean baseline “OI” 11.0 (SD 5.0)), p = 0.002, 0.004, respectively). The “A-a” oxygen gradient was higher on PAV and baseline ventilation than on NAVA (20.8 (SD 12.3) and 22.9 (SD 11.8) versus 18.5 (SD 10.8) kPa, p = 0.015, Conclusion: Both NAVA and PAV improved oxygenation compared to conventional ventilation. There was no significant difference in the mean “OI” between the two modes, but the mean “A-a” gradient was better on NAVA.What is Known:• Proportional assist ventilation (PAV) and neurally adjusted ventilatory assist (NAVA) can improve the oxygenation index (OI) in prematurely born infants.• Both PAV and NAVA can provide support proportional to respiratory drive or demand throughout the respiratory cycle.What is New:• In infants with evolving or established BPD, using capillary blood samples, both PAV and NAVA compared to baseline ventilation resulted in improvement in the “OI”, but there was no significant difference in the “OI” on PAV compared to NAVA.• The “alveolar-arterial” oxygen gradient was better on NAVA compared to PAV.

Published
2020

30. Using cluster analysis to describe phenotypical heterogeneity in extremely preterm infants:a retrospective whole-population study

Author

Theodore Dassios, Emma E Williams, Christopher Harris, and Anne Greenough

Subjects
Male, Infant, Extremely Premature, Infant, Newborn, Cluster Analysis, Humans, Infant, Female, Gestational Age, Hemorrhage, General Medicine, Bronchopulmonary Dysplasia, Retrospective Studies
Abstract

ObjectiveTo use cluster analysis to identify discrete phenotypic groups of extremely preterm infants.DesignSecondary analysis of a retrospective whole population study.SettingAll neonatal units in England between 2014 and 2019.ParticipantsInfants live-born at less than 28 weeks of gestation and admitted to a neonatal unit.InterventionsK-means cluster analysis was performed with the gestational age, Apgar score at 5 min and duration of mechanical ventilation as input variables.Primary and secondary outcome measuresBronchopulmonary dysplasia, discharge on home oxygen, intraventricular haemorrhage, death before discharge from neonatal care.ResultsTen thousand one hundred and ninety-seven infants (53% male) were classified into four clusters: Cluster 1 contained infants with intermediate gestation and duration of ventilation and had an intermediate mortality and incidence of bronchopulmonary dysplasia. Cluster 2 contained infants with the highest gestation, a shorter duration of ventilation and the lowest mortality. Cluster 3 contained infants with the lowest Apgar score and highest mortality and incidence of intraventricular haemorrhage. Cluster 4 contained infants with the lowest gestation, longest duration of ventilation and highest incidence of bronchopulmonary dysplasia.ConclusionClinical parameters can classify extremely preterm infants into discrete phenotypic groups with differing subsequent neonatal outcomes.

Published
2022

31. End-tidal carbon dioxide levels during resuscitation and carbon dioxide levels in the immediate neonatal period and intraventricular haemorrhage

Author

Prashanth Bhat, Anne Greenough, Theodore Dassios, Anthony D. Milner, Kentaro Tamura, Ravindra Bhat, Katie A. Hunt, Vadivelam Murthy, Emma E Williams, and Anoop Pahuja

Subjects
Resuscitation, End-tidal carbon dioxide, Gestational Age, Infant, Premature, Diseases, Intensive Care Units, Neonatal, Tidal Volume, Humans, Medicine, Poor correlation, Cerebral Hemorrhage, Monitoring, Physiologic, Retrospective Studies, business.industry, Infant, Newborn, Intraventricular haemorrhage, Gestational age, Carbon Dioxide, End tidal, Delivery suite, Carbon dioxide, Infant, Extremely Low Birth Weight, Infant, Extremely Premature, Anesthesia, Pediatrics, Perinatology and Child Health, Original Article, Blood Gas Analysis, Prematurity, business, Area under the roc curve
Abstract

Abnormal levels of end-tidal carbon dioxide (EtCO2) during resuscitation in the delivery suite are associated with intraventricular haemorrhage (IVH) development. Our aim was to determine whether carbon dioxide (CO2) levels in the first 3 days after birth reflected abnormal EtCO2 levels in the delivery suite, and hence, a prolonged rather than an early insult resulted in IVH. In addition, we determined if greater EtCO2level fluctuations during resuscitation occurred in infants who developed IVH. EtCO2 levels during delivery suite resuscitation and CO2 levels on the neonatal unit were evaluated in 58 infants (median gestational age 27.3 weeks). Delta EtCO2 was the difference between the highest and lowest level of EtCO2. Thirteen infants developed a grade 3–4 IVH (severe group). There were no significant differences in CO2 levels between those who did and did not develop an IVH (or severe IVH) on the NICU. The delta EtCO2 during resuscitation differed between infants with any IVH (6.2 (5.4–7.5) kPa) or no IVH (3.8 (2.7–4.3) kPA) (p < 0.001) after adjusting for differences in gestational age. Delta EtCO2 levels gave an area under the ROC curve of 0.940 for prediction of IVH.Conclusion: The results emphasize the importance of monitoring EtCO2 levels in the delivery suite. What is Known:• Abnormal levels of carbon dioxide (CO2) in the first few days after birth and abnormal end-tidal CO2levels (EtCO2) levels during resuscitation are associated in preterm infants with the risk of developing intraventricular haemorrhage (IVH). What is New:• There were no significant differences in NICU CO2levels between those who developed an IVH or no IVH.• There was a poor correlation between delivery suite ETCO2levels and NICU CO2levels.• Large fluctuations in EtCO2during resuscitation in the delivery suite were highly predictive of IVH development in preterm infants.

Published
2019

32. Chronology and Determinants of Respiratory Function Changes Following Administration of Systemic Postnatal Corticosteroids in Extremely Preterm Infants

Author

Theodore Dassios, Anne Greenough, Ourania Kaltsogianni, Ravindra Bhat, and Ann Hickey

Subjects
Male, Postnatal Care, Birth weight, Gestational Age, Ventilation/perfusion ratio, Dexamethasone, 03 medical and health sciences, Oxygen Consumption, 0302 clinical medicine, Intensive Care Units, Neonatal, 030225 pediatrics, Tidal Volume, medicine, Humans, Respiratory function, 030212 general & internal medicine, Glucocorticoids, Bronchopulmonary Dysplasia, Retrospective Studies, business.industry, Infant, Newborn, Infant, Gestational age, Retrospective cohort study, medicine.disease, Respiration, Artificial, Circadian Rhythm, Postnatal age, Treatment Outcome, Bronchopulmonary dysplasia, Infant, Extremely Premature, Anesthesia, Pediatrics, Perinatology and Child Health, Breathing, Female, business, Follow-Up Studies
Abstract

Objective To describe the effect of systemic corticosteroids administered to treat evolving bronchopulmonary dysplasia on oxygen diffusion and ventilation efficiency. Study design This was a retrospective cohort study of ventilated infants who received a 9-day course of dexamethasone in a tertiary neonatal unit. We calculated the transcutaneous oxygen saturation–to–fraction of inspired oxygen (FiO2) ratio (SFR), the ventilation perfusion ratio (VA/Q), and the ventilation efficiency index (VEI) before, during, and after the course of corticosteroids. The response to corticosteroids was calculated as the difference between the FiO2 percentage before starting steroids and the lowest FiO2 value during the course of steroid treatment. Results Seventy infants (38 males) with a median gestational age (GA) of 25.0 weeks (IQR, 24.3-26.0 weeks) and a median birth weight of 0.70 kg (IQR, 0.63-0.82 kg) were studied at a median postnatal age of 39 days (IQR, 29-48 days). The median SFR before treatment was 1.42 (IQR, 1.19-1.72), and the highest SFR was 2.35 (IQR, 1.87-2.83) after 9 days of treatment. The median VA/Q before treatment was 0.14 (IQR, 0.11-0.18) and was significantly higher at 72 hours after the start of treatment (0.22; IQR, 0.15-0.29; P Conclusions Oxygen diffusion continues to improve throughout the entire duration of a 9-day course of systemically administered corticosteroids in ventilated extremely preterm infants. More immature infants are less responsive to corticosteroids.

Published
2019

34. Inappropriate use of clinical practices in Canada: a systematic review

Author

Janet E. Squires, Danielle Cho-Young, Laura D. Aloisio, Robert Bell, Stephen Bornstein, Susan E. Brien, Simon Decary, Melissa Demery Varin, Mark Dobrow, Carole A. Estabrooks, Ian D. Graham, Megan Greenough, Doris Grinspun, Michael Hillmer, Tanya Horsley, Jiale Hu, Alan Katz, Christina Krause, John Lavis, Wendy Levinson, Adrian Levy, Michelina Mancuso, Steve Morgan, Letitia Nadalin-Penno, Andrew Neuner, Tamara Rader, Wilmer J. Santos, Gary Teare, Joshua Tepper, Amanda Vandyk, Michael Wilson, and Jeremy M. Grimshaw

Subjects
Canada, Overtreatment, Patient Satisfaction, Humans, Inappropriate Prescribing, General Medicine, Medical Overuse, Quality of Health Care
Abstract

Inappropriate health care leads to negative patient experiences, poor health outcomes and inefficient use of resources. We aimed to conduct a systematic review of inappropriately used clinical practices in Canada.We searched multiple bibliometric databases and grey literature to identify inappropriately used clinical practices in Canada between 2007 and 2021. Two team members independently screened citations, extracted data and assessed methodological quality. Findings were synthesized in 2 categories: diagnostics and therapeutics. We reported ranges of proportions of inappropriate use for all practices. Medians and interquartile ranges (IQRs), based on the percentage of patients not receiving recommended practices (underuse) or receiving practices not recommended (overuse), were calculated. All statistics are at the study summary level.We included 174 studies, representing 228 clinical practices and 28 900 762 patients. The median proportion of inappropriate care, as assessed in the studies, was 30.0% (IQR 12.0%-56.6%). Underuse (median 43.9%, IQR 23.8%-66.3%) was more frequent than overuse (median 13.6%, IQR 3.2%-30.7%). The most frequently investigated diagnostics were glycated hemoglobin (underused, range 18.0%-85.7%,We have provided a summary of inappropriately used clinical practices in Canadian health care systems. Our findings can be used to support health care professionals and quality agencies to improve patient care and safety in Canada.

Published
2021

35. Impact of COVID-19 on the imaging diagnosis of cardiac disease in Europe

Author

Williams M. C., Shaw L., Hirschfeld C. B., Maurovich-Horvat P., Norgaard B. L., Pontone G., Jimenez-Heffernan A., Sinitsyn V., Sergienko V., Ansheles A., Bax J. J., Buechel R., Milan E., Slart R. H. J. A., Nicol E., Bucciarelli-Ducci C., Pynda Y., Better N., Cerci R., Dorbala S., Raggi P., Villines T. C., Vitola J., Malkovskiy E., Goebel B., Cohen Y., Randazzo M., Pascual T. N. B., Dondi M., Paez D., Einstein A. J., Nasery M. N., Goda A., Shirka E., Benlabgaa R., Bouyoucef S., Medjahedi A., Nailli Q., Agolti M., Aguero R. N., Del Carmen Alak M., Alberguina L. G., Arronada G., Astesiano A., Norton C. B., Benteo P., Blanco J., Bonelli J. M., Bustos J. J., Cabrejas R., Cachero J., Campisi R., Canderoli A., Carames S., Carrascosa P., Castro R., Cendoya O., Cognigni L. M., Collaud C., Cortes C., Courtis J., Cragnolino D., Daicz M., De La Vega A., De Maria S. T., Del Riego H., Dettori F., Deviggiano A., Dragonetti L., Embon M., Enriquez R. E., Ensinas J., Faccio F., Facello A., Garofalo D., Geronazzo R., Gonza N., Gutierrez L., Guzzo M. A., Hasbani V., Huerin M., Jager V., Lewkowicz J. M., De Munain M. N. A. L., Lotti J. M., Marquez A., Masoli O., Masoli O. H., Mastrovito E., Mayoraz M., Melado G. E., Mele A., Merani M. F., Meretta A. H., Molteni S., Montecinos M., Noguera E., Novoa C., Sueldo C. P., Ascani S. P., Pollono P., Pujol M. P., Radzinschi A., Raimondi G., Redruello M., Rodriguez M., Romero R. L., Acuna A. R., Rovaletti F., Miguel L. S., Solari L., Strada B., Traverso S., Traverzo S. S., Del Huerto Velazquez Espeche M., Weihmuller J. S., Wolcan J., Zeffiro S., Sakanyan M., Beuzeville S., Boktor R., Butler P., Calcott J., Carr L., Chan V., Chao C., Chong W., Dobson M., Downie D., Dwivedi G., Elison B., Engela J., Francis R., Gaikwad A., Basavaraj A. G., Goodwin B., Greenough R., Hamilton-Craig C., Hsieh V., Joshi S., Lederer K., Lee K., Lee J., Magnussen J., Mai N., Mander G., Murton F., Nandurkar D., Neill J., O'Rourke E., O'Sullivan P., Pandos G., Pathmaraj K., Pitman A., Poulter R., Premaratne M., Prior D., Ridley L., Rutherford N., Salehi H., Saunders C., Scarlett L., Seneviratne S., Shetty D., Shrestha G., Shulman J., Solanki V., Stanton T., Stuart M., Stubbs M., Swainson I., Taubman K., Taylor A., Thomas P., Unger S., Upton A., Vamadevan S., Van Gaal W., Verjans J., Voutnis D., Wayne V., Wilson P., Wong D., Wong K., Younger J., Feuchtner G., Mirzaei S., Weiss K., Maroz-Vadalazhskaya N., Gheysens O., Homans F., Moreno-Reyes R., Pasquet A., Roelants V., Van De Heyning C. M., Rios R. A., Soldat-Stankovic V., Stankovic S., Siqueira M. H. A., Almeida A., Togni P. H. A., Andrade J. H., Andrade L., Anselmi C., Araujo R., Azevedo G., Bezerra S., Biancardi R., Grossman G. B., Brandao S., Pianta D. B., Carreira L., Castro B., Chang T., Cunali F., Cury R., Dantas R., De Amorim Fernandes F., De Lorenzo A., De MacEdo Filho R., Erthal F., Fernandes F., Fernandes J., De Souza T. F., Alves W. F., Ghini B., Goncalves L., Gottlieb I., Hadlich M., Kameoka V., Lima R., Lima A., Lopes R. W., E Silva R. M., Magalhaes T., Silva F. M., Mastrocola L. E., Medeiros F., Meneghetti J. C., Naue V., Naves D., Nolasco R., Nomura C., Oliveira J. B., Paixao E., De Carvalho F. P., Pinto I., Possetti P., Quinta M., Ramos R. R. N., Rocha R., Rodrigues A., Rodrigues C., Romantini L., Sanches A., Santana S., Da Silva L. S., Schvartzman P., Matushita C. S., Senra T., Shiozaki A., De Siqueira M. E. M., Siqueira C., Smanio P., Soares C. E., Soares J., Bittencourt M. S., Spiro B., Mesquita C. T., Torreao J., Torres R., Uellendahl M., Monte G. U., Verissimo O., Cabeda E. V., Pedras F. V., Waltrick R., Zapparoli M., Naseer H., Garcheva-Tsacheva M., Kostadinova I., Theng Y., Abikhzer G., Barette R., Chow B., Dabreo D., Friedrich M., Garg R., Hafez M. N., Johnson C., Kiess M., Leipsic J., Leung E., Miller R., Oikonomou A., Probst S., Roifman I., Small G., Tandon V., Trivedi A., White J., Zukotynski K., Canessa J., Munoz G. C., Concha C., Hidalgo P., Lovera C., Massardo T., Vargas L. S., Abad P., Arturo H., Ayala S., Benitez L., Cadena A., Caicedo C., Moncayo A. C., Gomez S., Villamil C. T. G., Jaimes C., Londono J., Blair J. L. L., Pabon L., Pineda M., Rojas J. C., Ruiz D., Escobar M. V., Vasquez A., Vergel D., Zuluaga A., Gamboa I. B., Castro G., Gonzalez U., Baric A., Batinic T., Franceschi M., Hrabak M., Jukic M., Medakovic P., Persic V., Prpic M., Punda A., Batista J. F., Lauchy J. M. G., Gutierrez Y. M., Menendez R., Peix A., Rochela L., Panagidis C., Petrou I., Engelmann V., Kaminek M., Kincl V., Lang O., Simanek M., Abdulla J., Bottcher M., Christensen M., Gormsen L. C., Hasbak P., Hess S., Holdgaard P., Johansen A., Kyhl K., Ovrehus K. A., Sand N. P. R., Steffensen R., Thomassen A., Zerahn B., Perez A., Velez G. A. E., Velez M. S., Aziz I. S. A., Abougabal M., Ahmed T., Allam A., Asfour A., Hassan M., Hassan A., Ibrahim A., Kaffas S., Kandeel A., Ali M. M., Mansy A., Maurice H., Nabil S., Shaaban M., Flores A. C., Poksi A., Knuuti J., Kokkonen V., Larikka M., Uusitalo V., Bailly M., Burg S., Deux J. -F., Habouzit V., Hyafil F., Lairez O., Proffit F., Regaieg H., Sarda-Mantel L., Tacher V., Schneider R. P., Ayetey H., Angelidis G., Archontaki A., Chatziioannou S., Datseris I., Fragkaki C., Georgoulias P., Koukouraki S., Koutelou M., Kyrozi E., Repasos E., Stavrou P., Valsamaki P., Gonzalez C., Gutierrez G., Maldonado A., Buga K., Garai I., Schmidt E., Szilveszter B., Varady E., Banthia N., Bhagat J. K., Bhargava R., Bhat V., Bhatia M., Choudhury P., Chowdekar V. S., Irodi A., Jain S., Joseph E., Kumar S., Mahapatra G., Mitra D., Mittal B. R., Ozair A., Patel C., Patel T., Patel R., Patel S., Saxena S., Sengupta S., Singh S., Singh B., Sood A., Verma A., Affandi E., Alam P. S., Edison E., Gunawan G., Hapkido H., Hidayat B., Huda A., Mukti A. P., Prawiro D., Soeriadi E. A., Syawaluddin H., Albadr A., Assadi M., Emami F., Houshmand G., Maleki M., Rostami M. T., Zakavi S. R., Zaid E. A., Agranovich S., Arnson Y., Bar-Shalom R., Frenkel A., Knafo G., Lugassi R., Moalem I. S. M., Mor M., Muskal N., Ranser S., Shalev A., Albano D., Alongi P., Arnone G., Bagatin E., Baldari S., Bauckneht M., Bertelli P., Bianco F., Bonfiglioli R., Boni R., Bruno A., Bruno I., Busnardo E., Califaretti E., Camoni L., Carnevale A., Casoni R., Cavallo A. U., Cavenaghi G., Chierichetti F., Chiocchi M., Cittanti C., Colletta M., Conti U., Cossu A., Cuocolo A., Cuzzocrea M., De Rimini M. L., De Vincentis G., Del Giudice E., Del Torto A., Della Tommasina V., Durmo R., Erba P. A., Evangelista L., Faletti R., Faragasso E., Farsad M., Ferro P., Florimonte L., Frantellizzi V., Fringuelli F. M., Gatti M., Gaudiano A., Gimelli A., Giubbini R., Giuffrida F., Ialuna S., Laudicella R., Leccisotti L., Leva L., Liga R., Liguori C., Longo G., Maffione M., Mancini M. E., Marcassa C., Nardi B., Pacella S., Pepe G., Pulizzi S., Quartuccio N., Rampin L., Ricci F., Rossini P., Rubini G., Russo V., Sacchetti G. M., Sambuceti G., Scarano M., Sciagra R., Sperandio M., Stefanelli A., Ventroni G., Zoboli S., Baugh D., Chambers D., Madu E., Nunura F., Asano H., Chimura C. M., Fujimoto S., Fujisue K., Fukunaga T., Fukushima Y., Fukuyama K., Hashimoto J., Ichikawa Y., Iguchi N., Imai M., Inaki A., Ishimura H., Isobe S., Kadokami T., Kato T., Kudo T., Kumita S., Maruno H., Mataki H., Miyagawa M., Morimoto R., Moroi M., Nagamachi S., Nakajima K., Nakata T., Nakazato R., Nanasato M., Naya M., Norikane T., Ohta Y., Okayama S., Okizaki A., Otomi Y., Otsuka H., Saito M., Sakata S. Y., Sarai M., Sato D., Shiraishi S., Suwa Y., Takanami K., Takehana K., Taki J., Tamaki N., Taniguchi Y., Teragawa H., Tomizawa N., Tsujita K., Umeji K., Wakabayashi Y., Yamada S., Yamazaki S., Yoneyama T., Rawashdeh M., Batyrkhanov D., Dautov T., Makhdomi K., Ombati K., Alkandari F., Garashi M., Coie T. L., Rajvong S., Kalinin A., Kalnina M., Haidar M., Komiagiene R., Kviecinskiene G., Mataciunas M., Vajauskas D., Picard C., Karim N. K. A., Reichmuth L., Samuel A., Allarakha M. A., Naojee A. S., Alexanderson-Rosas E., Barragan E., Becerril A., Gonzalez-Montecinos, Cabada M., Rodriguez D. C., Carvajal-Juarez I., Cortes V., Cortes F., De La Pena E., Gama-Moreno M., Gonzalez L., Ramirez N. G., Jimenez-Santos M., Matos L., Monroy E., Morelos M., Ornelas M., Ramirez J. A. O., Preciado-Anaya A., Preciado-Gutierrez O. U., Barragan A. P., Uvera S. G. R., Sandoval S., Tomas M. S., Sierra-Galan L. M., Siu S., Vallejo E., Valles M., Faraggi M., Sereegotov E., Ilic S., Ben-Rais N., Alaoui N. I., Taleb S., Myo K. P. P., Thu P. S., Ghimire R. K., Rajbanshi B., Barneveld P., Glaudemans A., Habets J., Koopmans K. P., Manders J., Pool S., Scholte A., Scholtens A., Slart R., Thimister P., Van Asperen E. -J., Veltman N., Verschure D., Wagenaar N., Edmond J., Ellis C., Johnson K., Keenan R., Kueh S. H., Occleshaw C., Sasse A., To A., Van Pelt N., Young C., Cuadra T., Vanegas H. B. R., Soli I. A., Issoufou D. M., Ayodele T., Madu C., Onimode Y., Efros-Monsen E., Forsdahl S. H., Dimmen J. -M. H., Jorgensen A., Krohn I., Lovhaugen P., Braten A. T., Al Dhuhli H., Al Kindi F., Al-Bulushi N., Jawa Z., Tag N., Afzal M. S., Fatima S., Younis M. N., Riaz M., Saadullah M., Herrera Y., Lenturut-Katal D., Vazquez M. C., Ortellado J., Akhter A., Cao D., Cheung S., Dai X., Gong L., Han D., Hou Y., Li C., Li T., Li D., Li S., Liu J., Liu H., Lu B., Ng M. Y., Sun K., Tang G., Wang J., Wang X., Wang Z. -Q., Wang Y., Wu J., Wu Z., Xia L., Xiao J., Xu L., Yang Y., Yin W., Yu J., Yuan L., Zhang T., Zhang L., Zhang Y. -G., Zhang X., Zhu L., Alfaro A., Abrihan P., Barroso A., Cruz E., Gomez M. R., Magboo V. P., Medina J. M., Obaldo J., Pastrana D., Pawhay C. M., Quinon A., Tang J. M., Tecson B., Uson K. J., Uy M., Kostkiewicz M., Kunikowska J., Bettencourt N., Cantinho G., Ferreira A., Syed G., Arnous S., Atyani S., Byrne A., Gleeson T., Kerins D., Meehan C., Murphy D., Murphy M., Murray J., O'Brien J., Bang J. -I., Bom H., Cho S. -G., Hong C. M., Jang S. J., Jeong Y. H., Kang W. J., Kim J. -Y., Namgung C. K., So Y., Won K. S., Majstorov V., Vavlukis M., Salobir B. G., Stalc M., Benedek T., Benedek I., Mititelu R., Stan C. A., Dariy O., Drozdova O., Gagarina N., Gulyaev V. M., Itskovich I., Karalkin A., Kokov A., Migunova E., Pospelov V., Ryzhkova D., Saifullina G., Sazonova S., Shurupova I., Trifonova T., Ussov W. Y., Vakhromeeva M., Valiullina N., Zavadovsky K., Zhuravlev K., Alasnag M., Okarvi S., Saranovic D. S., Keng F., See J. H. J., Sekar R., Yew M. S., Vondrak A., Bejai S., Bennie G., Bester R., Engelbrecht G., Evbuomwan O., Gongxeka H., Vuuren M. J., Kaplan M., Khushica P., Lakhi H., Louw L., Malan N., Milos K., Modiselle M., More S., Naidoo M., Scholtz L., Vangu M., Aguade-Bruix S., Blanco I., Cabrera A., Camarero A., Casans-Tormo I., Cuellar-Calabria H., Flotats A., Canamero M. E. F., Garcia M. E., Leta R., Diaz J. L., Lumbreras L., Marquez-Cabeza J. J., Martin F., De Alegria A. M., Medina F., Canal M. P., Peiro V., Pubul-Nunez V., Madrid J. I. R., Rey C. R., Perez R. R., Ruiz J., Hernandez G. S., Sevilla A., Zeidan N., Nanayakkara D., Udugama C., Simonsson M., Alkadhi H., Buechel R. R., Burger P., Ceriani L., De Boeck B., Grani C., De Saint Lager Lucas A. J., Kamani C. H., Kawel-Boehm N., Manka R., Prior J. O., Rominger A., Vallee J. -P., Khiewvan B., Premprabha T., Thientunyakit T., Sellem A., Kir K. M., Sayman H., Sebikali M. J., Muyinda Z., Kmetyuk Y., Korol P., Mykhalchenko O., Pliatsek V., Satyr M., Albalooshi B., Hassan M. I. 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A, Dougan, J, Fairbairn, T, Farrugia, A, Gopalan, D, Gummow, A, Ramkumar, P, Hamilton, M, Harbinson, M, Hartley, T, Hudson, B, Joshi, N, Kay, M, Kelion, A, Khokhar, A, Kitt, J, Low, C, Mak, S, Marousa, N, Martin, J, Mcalindon, E, Menezes, L, Morgan-Hughes, G, Moss, A, Murray, A, Patel, D, Peebles, C, Pugliese, F, Rodrigues, J, Rofe, C, Sabharwal, N, Schofield, R, Semple, T, Sharma, N, Strouhal, P, Subedi, D, Topping, W, Tweed, K, Weir-Mccall, J, Abbara, S, Abbasi, T, Abbott, B, Abohashem, S, Abramson, S, Al-Abboud, T, Al-Mallah, M, Almousalli, O, Ananthasubramaniam, K, Kumar, M, Askew, J, Attanasio, L, Balmer-Swain, M, Bayer, R, Bernheim, A, Bhatti, S, Bieging, E, Blankstein, R, Bloom, S, Blue, S, Bluemke, D, Borges, A, Branch, K, Bravo, P, Brothers, J, Budoff, M, Bullock-Palmer, R, Burandt, A, Burke, F, Bush, K, Candela, C, Capasso, E, Cavalcante, J, Chang, D, Chatterjee, S, Chatzizisis, Y, Cheezum, M, Chen, T, Chen, J, Chen, M, Choi, A, Clarcq, J, Cordero, A, Crim, M, Danciu, S, Decter, B, Dhruva, N, Doherty, N, Doukky, R, Dunbar, A, Duvall, W, Edwards, R, Esquitin, K, Farah, H, Fentanes, E, Ferencik, M, Fisher, D, Fitzpatrick, D, Foster, C, Fuisz, T, Gannon, M, Gastner, L, Gerson, M, Ghoshhajra, B, Goldberg, A, Goldner, B, Gonzalez, J, Gore, R, Gracia-Lopez, S, Hage, F, Haider, A, Haider, S, Hamirani, Y, Hassen, K, Hatfield, M, Hawkins, C, Hawthorne, K, Heath, N, Hendel, R, Hernandez, P, Hill, G, Horgan, S, Huffman, J, Hurwitz, L, Iskandrian, A, Janardhanan, R, Jellis, C, Jerome, S, Kalra, D, Kaviratne, S, Kay, F, Kelly, F, Khalique, O, Kinkhabwala, M, Iii, G, Kircher, J, Kirkbride, R, Kontos, M, Kottam, A, Krepp, J, Layer, J, Lee, S, Leppo, J, Lesser, J, Leung, S, Lewin, H, Litmanovich, D, Liu, Y, Lopez-Mattei, J, Magurany, K, Markowitz, J, Marn, A, Matis, S, Mckenna, M, Mcrae, T, Mendoza, F, Merhige, M, Min, D, Moffitt, C, Moncher, K, Moore, W, Morayati, S, Morris, M, Mossa-Basha, M, Mrsic, Z, Murthy, V, Nagpal, P, Napier, K, Narula, J, Nelson, K, Nijjar, P, Osman, M, Parwani, P, Passen, E, Patel, A, Patil, P, Paul, R, Phillips, L, Polsani, V, Poludasu, R, Pomerantz, B, Porter, T, Prentice, R, Pursnani, A, Rabbat, M, Ramamurti, S, Rich, F, Luna, H, Robinson, A, Robles, K, Rodriguez, C, Rorie, M, Rumberger, J, Russell, R, Sabra, P, Sadler, D, Schemmer, M, Schoepf, U, Shah, S, Shah, N, Shanbhag, S, Sharma, G, Shayani, S, Shirani, J, Shivaram, P, Sigman, S, Simon, M, Slim, A, Smith, D, Smith, A, Soman, P, Srichai-Parsia, M, Streeter, J, Albert, T, Tawakol, A, Thomas, D, Thompson, R, Torbet, T, Trinidad, D, Ullery, S, Unzek, S, Uretsky, S, Vallurupalli, S, Verma, V, Waller, A, Wang, E, Ward, P, Weissman, G, Wesbey, G, White, K, Winchester, D, Wolinsky, D, Yost, S, Zgaljardic, M, Alonso, O, Beretta, M, Ferrando, R, Kapitan, M, Mut, F, Djuraev, O, Rozikhodjaeva, G, Ngoc, H, Mai, S, Nguyen, X, ​Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE), Translational Immunology Groningen (TRIGR), and Cardiovascular Centre (CVC)

Subjects
INCAPS COVID Investigators Group, cardiac imaging techniques, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, Practice Patterns, Disease, Cardiovascular, coronary artery disease, COVID-19, Cardiac Imaging Techniques, Cardiologists, Europe, Health Care Surveys, Healthcare Disparities, Heart Diseases, Humans, Practice Patterns, Physicians', Predictive Value of Tests, Gross domestic product, Human health, cardiovascular disease, Pandemic, Medicine, cardiovascular imaging, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Interna medicina, cardiac imaging technique, Predictive value of tests, Cardiology and Cardiovascular Medicine, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Infektologija, cardiac disease, Coronavirus disease 2019 (COVID-19), Independent predictor, cardiac imaging, NO, Imaging diagnosis, Diseases of the circulatory (Cardiovascular) system, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Internal Medicine, Physicians', business.industry, BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Infectology, RC666-701, HOSPITALIZATIONS, business, Health Care Delivery, Economics and Global Health Care, Demography
Abstract

ObjectivesWe aimed to explore the impact of the COVID-19 pandemic on cardiac diagnostic testing and practice and to assess its impact in different regions in Europe.MethodsThe online survey organised by the International Atomic Energy Agency Division of Human Health collected information on changes in cardiac imaging procedural volumes between March 2019 and March/April 2020. Data were collected from 909 centres in 108 countries.ResultsCentres in Northern and Southern Europe were more likely to cancel all outpatient activities compared with Western and Eastern Europe. There was a greater reduction in total procedure volumes in Europe compared with the rest of the world in March 2020 (45% vs 41%, p=0.003), with a more marked reduction in Southern Europe (58%), but by April 2020 this was similar in Europe and the rest of the world (69% vs 63%, p=0.261). Regional variations were apparent between imaging modalities, but the largest reductions were in Southern Europe for nearly all modalities. In March 2020, location in Southern Europe was the only independent predictor of the reduction in procedure volume. However, in April 2020, lower gross domestic product and higher COVID-19 deaths were the only independent predictors.ConclusionThe first wave of the COVID-19 pandemic had a significant impact on care of patients with cardiac disease, with substantial regional variations in Europe. This has potential long-term implications for patients and plans are required to enable the diagnosis of non-COVID-19 conditions during the ongoing pandemic.

Published
2021

36. Acute kidney injury in infants with congenital diaphragmatic hernia

Author

Fahad M S, Arattu Thodika, Theodore, Dassios, Akash, Deep, and Anne, Greenough

Subjects
Trachea, Pregnancy, Fetoscopy, Humans, Infant, Female, Gestational Age, Acute Kidney Injury, Hernias, Diaphragmatic, Congenital, Retrospective Studies
Abstract

To assess the incidence of acute kidney injury (AKI) in infants with congenital diaphragmatic hernia (CDH), including those who had fetoscopic endoluminal tracheal occlusion (FETO), and the effect of AKI on mortality and length of stay.Ten-year retrospective review of infants admitted with CDH to a tertiary perinatal centre.Ninety-four infants with median gestational age of 38AKI was present in the majority of infants with CDH and most common in those who had undergone FETO.

Published
2021

37. Lung Protection During Mechanical Ventilation in the Premature Infant

Author

Emma E Williams and Anne Greenough

Subjects
medicine.medical_specialty, medicine.medical_treatment, Lung injury, Positive-Pressure Respiration, medicine, Humans, Respiratory function, Intensive care medicine, Oxygen toxicity, Lung, Mechanical ventilation, Capnography, Respiratory Distress Syndrome, Lung protection, medicine.diagnostic_test, business.industry, Infant, Newborn, Obstetrics and Gynecology, respiratory system, medicine.disease, Respiration, Artificial, respiratory tract diseases, Lung recruitment, Pediatrics, Perinatology and Child Health, Breathing, business, Infant, Premature
Abstract

Mechanical ventilation can be life-saving for the premature infant, but is often injurious to immature and underdeveloped lungs. Lung injury is caused by atelectrauma, oxygen toxicity, and volutrauma. Lung protection must include appropriate lung recruitment starting in the delivery suite and throughout mechanical ventilation. Strategies include open lung ventilation, positive end-expiratory pressure, and volume-targeted ventilation. Respiratory function monitoring, such as capnography and ventilator graphics, provides clinicians with continuous real-time information and an adjunct to optimize lung-protective ventilatory strategies. Further research is needed to assess which lung-protective strategies result in a decrease in long-term respiratory morbidity.

Published
2021

38. Factors affecting the arterial to end-tidal carbon dioxide gradient in ventilated neonates

Author

Emma Williams, Nadja Bednarczuk, Theodore Dassios, and Anne Greenough

Subjects
Oxygen, Physiology, Capnography, Physiology (medical), Biomedical Engineering, Biophysics, Infant, Newborn, Birth Weight, Humans, Infant, Arteries, Carbon Dioxide
Abstract

Objective. To determine factors which influenced the relationship between blood carbon dioxide (pCO2) and end-tidal carbon dioxide (EtCO2) values in ventilated, newborn infants. Furthermore, to assess whether pCO2 levels could be predicted from continuous EtCO2 monitoring. Approach. An observational study of routinely monitored newborn infants requiring mechanical ventilation in the first 28 d after birth was undertaken. Infants received standard clinical care. Daily pCO2 and EtCO2 levels were recorded and the difference (gradient: ∆P-EtCO2) between the pairs were calculated. Ventilatory settings corresponding to the time of each blood gas assessment were noted. End-tidal capnography monitoring was performed using the Microstream sidestream Filterline H set capnograph. Main results. A total of 4697 blood gas results from one hundred and fifty infants were analysed. The infants had a median gestational age of 33.3 (range 22.3–42.0) weeks and birth weight of 1880 (395–5520) grams. Overall, there was moderate correlation between pCO2 and EtCO2 levels (r = 0.65, p < 0.001). The ∆P-EtCO2 for infants born less than 32 weeks of gestation was significantly higher (1.4 kPa) compared to infants born at greater than 32 weeks of gestation (0.8 kPa) (p < 0.001). In infants born at less than 32 completed weeks of gestation, pCO2 levels were independently associated with EtCO2, day after birth, birthweight and fraction of inspired oxygen (FiO2) (model r 2 = 0.52, p < 0.001). Significance. The results of end-tidal capnography monitoring have the potential to predict blood carbon dioxide values within the neonatal population.

Published
2021

39. The use of telecommunication and virtualization among ongoing and discontinued COVID-19 clinical trials: A cross-sectional analysis

Author

Mary C. Greenough, Nicholas B. Sajjadi, Brayden Rucker, Matt Vassar, and Micah Hartwell

Subjects
Cross-Sectional Studies, SARS-CoV-2, Virtualization, Short Communication, Remote Data Collection, Communicable Disease Control, COVID-19, Humans, Pharmacology (medical), Clinical Trials, General Medicine, Pandemics, Telemedicine
Abstract

Importance The COVID-19 pandemic has impacted clinical research due to safety measures such as social distancing and lockdowns. However, developing treatments for COVID-19 relies on conducting clinical trials. Using telemedicine or virtual methods may support ongoing trials and limit the pandemic's impact on clinical research. Objective To examine the use of virtual methods among ongoing and discontinued COVID-19 clinical trials. Design In this cross-sectional analysis, we performed a systematic search of ClinicalTrials.gov for COVID-19 related trials registered since the pandemic began. In masked, duplicate fashion, authors extracted data from included studies, noting whether trialists reported using telecommunication, virtualization, or remote data collection to deliver interventions and monitor outcome measures. The authors also coded the use of virtual methods for recruitment, enrollment, or follow-up visits. Chi-square tests and Kruskal-Wallis tests were used to assess differences in the use of virtual methods between ongoing and discontinued studies and differences between intervention types. Results Our search returned 2549 clinical trials, of which 2383 were included. Of included studies, 2109 (88.5%) were ongoing and 274 (11.5%) were discontinued. Overall, 519 (24.6%) ongoing COVID-19 trials reported using virtual methods for trial conduct and 43 (15.7%) discontinued trials reported using virtual methods. There was a statistically significant difference in the rate of reporting virtual methods between discontinued and ongoing trials (X21 = 27.2, P

Published
2021

40. Cumulative hypoxia, socioeconomic deprivation and neurodevelopmental outcomes in preterm infants

Author

Theodore Dassios, Ourania Kaltsogianni, Poonam Belani, Anusha Arasu, and Anne Greenough

Subjects
Male, Pulmonary and Respiratory Medicine, Child Development, Socioeconomic Factors, Physiology, General Neuroscience, Infant, Newborn, Humans, Infant, Gestational Age, Hypoxia, Infant, Premature, Retrospective Studies
Abstract

Hypoxia can adversely affect cognition, while socioeconomic deprivation has also been associated with impaired neurodevelopment in the newborn. We aimed to assess the impact of hypoxia and socioeconomic deprivation on the neurodevelopmental outcomes of preterm infants.Retrospective cohort study at a tertiary neonatal unit between 2015 and 2018. The motor, cognitive and language domain scores of the Bayley-III assessment were recorded at 24 months of corrected gestational age. The percentage of time with pulse oximetry (SpOA total of 93,767 data points from 80 infants (34 male) with a median (IQR) gestational age of 27.9(25.9-29.0) weeks and a birth weight of 0.94(0.74-1.23) kg were analysed. The median (IQR) motor score [103(91-110)] was significantly related to the median (IQR) time with SpOHypoxia in preterm infants exerted a negative impact on motor function and cognition and conversely, higher educational attainment had a positive impact on cognition and language.

Published
2022

41. Assessment of the fetal lungs in utero

Author

Carla L. Avena-Zampieri, Jana Hutter, Mary Rutherford, Anna Milan, Megan Hall, Alexia Egloff, David F.A. Lloyd, Surabhi Nanda, Anne Greenough, and Lisa Story

Subjects
Lung Diseases, Pregnancy, Prenatal Diagnosis, Infant, Newborn, Humans, Obstetrics and Gynecology, Female, General Medicine, Hernias, Diaphragmatic, Congenital, Lung Volume Measurements, Lung
Abstract

Antenatal diagnosis of abnormal pulmonary development has improved significantly over recent years because of progress in imaging techniques. Two-dimensional ultrasound is the mainstay of investigation of pulmonary pathology during pregnancy, providing good prognostication in conditions such as congenital diaphragmatic hernia; however, it is less validated in other high-risk groups such as those with congenital pulmonary airway malformation or preterm premature rupture of membranes. Three-dimensional assessment of lung volume and size is now possible using ultrasound or magnetic resonance imaging; however, the use of these techniques is still limited because of unpredictable fetal motion, and such tools have also been inadequately validated in high-risk populations other than those with congenital diaphragmatic hernia. The advent of advanced, functional magnetic resonance imaging techniques such as diffusion and T2* imaging, and the development of postprocessing pipelines that facilitate motion correction, have enabled not only more accurate evaluation of pulmonary size, but also assessment of tissue microstructure and perfusion. In the future, fetal magnetic resonance imaging may have an increasing role in the prognostication of pulmonary abnormalities and in monitoring current and future antenatal therapies to enhance lung development. This review aims to examine the current imaging methods available for assessment of antenatal lung development and to outline possible future directions.

Published
2022

42. Differences in clinical and laboratory biomarkers for short and long-term respiratory outcomes in preterm neonates

Author

Anne Greenough, Jonathan M. Davis, Norma Terrin, Janis L. Breeze, Richard B. Parad, Lynette K. Rogers, and Carolyn Salafia

Subjects
Pulmonary and Respiratory Medicine, Vascular Endothelial Growth Factor A, medicine.medical_specialty, Gestational Age, Article, Lipid oxidation, Risk Factors, Internal medicine, Epidemiology, medicine, Humans, Respiratory system, Bronchopulmonary Dysplasia, business.industry, Postmenstrual Age, Infant, Newborn, Infant, medicine.disease, Bronchopulmonary dysplasia, Pediatrics, Perinatology and Child Health, Necrotizing enterocolitis, Biomarker (medicine), Gestation, business, Biomarkers, Infant, Premature
Abstract

Background Pulmonary outcome of premature neonates has focused more on short-term than long-term respiratory morbidities. Objective Describe risk factors/biomarkers associated with short-term (bronchopulmonary dysplasia [BPD]) (supplemental oxygen use at 36 weeks postmenstrual age [PMA]) and longer-term (chronic respiratory morbidity [CRM]) (respiratory related symptoms, medications, medical/emergency visits, hospitalizations at 6-12 months corrected gestational age [CGA]) respiratory outcomes in a longitudinal cohort. Design/methods Neonates born at 24-29-week gestation were prospectively followed to 6-12-month CGA. Associations between clinical and laboratory risk factors/biomarkers of BPD and CRM were explored. Results Of 86 subjects, 94% survived. Outcomes were available for 89% at 36-week PMA (BPD present in 42% of infants) and 72% at 6-12-month CGA (CRM present in 47% of infants). For the 54 infants with known outcomes for both BPD and CRM, diagnoses were discordant in 41%. BPD was associated with lower birthweight and birthweight Z-score for GA, lower Apgar scores, more surfactant doses, higher SNAPPE-II scores, highest Day 1 inspired oxygen concentration, Day 7 oxygen use, prolonged ventilatory support, bacteremia, necrotizing enterocolitis, and treated patent ductus arteriosus. CRM was associated with lower Apgar scores, Day 7 oxygen use and higher urine vascular endothelial growth factor. Patterns of plasma and urine lipid oxidation products differed in the two outcomes. Conclusion In this hypothesis generating and exploratory study, BPD and CRM were associated with different risk factors/biomarker patterns. Concordance between these two outcomes was weak. Strategies for reducing CRM should be studied in cohorts identified by appropriate early risk factors/biomarkers.

Published
2021

43. Selective ferroptosis vulnerability due to familial Alzheimer's disease presenilin mutations

Author

Mark A. Greenough, Darius J. R. Lane, Rachelle Balez, Helena Targa Dias Anastacio, Zhiwen Zeng, Katherine Ganio, Christopher A. McDevitt, Karla Acevedo, Abdel Ali Belaidi, Jari Koistinaho, Lezanne Ooi, Scott Ayton, Ashley I. Bush, and Neuroscience Center

Subjects
MECHANISM, PSEN1, Presenilins, Cell Biology, TAU HYPERPHOSPHORYLATION, MICE LACKING, nervous system diseases, SELENOPROTEIN P, NOTCH, Selenium, CELL-DEATH, Alzheimer Disease, mental disorders, COGNITIVE DECLINE, Mutation, GAMMA-SECRETASE ACTIVITY, Flavin-Adenine Dinucleotide, Presenilin-1, 1182 Biochemistry, cell and molecular biology, Humans, Ferroptosis, BRAIN, Amyloid Precursor Protein Secretases, Molecular Biology
Abstract

Mutations in presenilin 1 and 2 (PS1 and PS2) cause autosomal dominant familial Alzheimer’s disease (FAD). Ferroptosis has been implicated as a mechanism of neurodegeneration in AD since neocortical iron burden predicts Alzheimer’s disease (AD) progression. We found that loss of the presenilins dramatically sensitizes multiple cell types to ferroptosis, but not apoptosis. FAD causal mutations of presenilins similarly sensitizes cells to ferroptosis. The presenilins promote the expression of GPX4, the selenoprotein checkpoint enzyme that blocks ferroptosis by quenching the membrane propagation of lethal hydroperoxyl radicals. Presenilin γ-secretase activity cleaves Notch-1 to signal LRP8 expression, which then controls GPX4 expression by regulating the supply of selenium into the cell since LRP8 is the uptake receptor for selenoprotein P. Selenium uptake is thus disrupted by presenilin FAD mutations, suppressing GPX4 expression. Therefore, presenilin mutations may promote neurodegeneration by derepressing ferroptosis, which has implications for disease-modifying therapeutics.

Published
2021

44. Carbon dioxide monitoring in the newborn infant

Author

Anne Greenough, Theodore Dassios, and Emma Williams

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Resuscitation, Dead space, medicine.medical_treatment, Population, law.invention, Randomized controlled trial, law, Capnography, medicine, Intubation, Humans, education, Intensive care medicine, Monitoring, Physiologic, Mechanical ventilation, education.field_of_study, medicine.diagnostic_test, business.industry, Respiration, Infant, Newborn, Infant, Carbon Dioxide, Respiration, Artificial, Pediatrics, Perinatology and Child Health, Ventilation (architecture), business
Abstract

Carbon dioxide (CO2 ) monitoring is vital during mechanical ventilation of newborn infants, as morbidity increases when CO2 levels are inappropriate. Our aim was to review the uses and limitations of such noninvasive monitoring methods. Colorimetry is primarily utilized during resuscitation to determine whether successful intubation has occurred. False negative and positive results can however lead to delays in detecting tracheal versus esophageal intubation. Transcutaneous carbon dioxide sensors have limited use during resuscitation, but can be utilized to provide continuous trend data during on-going ventilation. End-tidal capnography can provide clinicians with quantitative end-tidal CO2 (EtCO2 ) values and a continuous real-time capnogram waveform trace. These devices are becoming more widely accepted for use in the neonatal population as the new devices are lightweight with minimal additional dead space. Nevertheless, they have been reported to have variable accuracy when compared to arterial CO2 measurements, however, divergence of results may be related to disease severity rather than technological limitations. During resuscitation EtCO2 can be detected by capnography more rapidly than by colorimetry. Furthermore, capnography can be currently utilized in neonatal research settings to determine the physiological dead space and ventilation inhomogeneity, and thus has potential to be beneficial to clinical care. In conclusion, novel modes of noninvasive carbon dioxide monitoring can be safely and reliably utilized in newborn infants during mechanical ventilation. Future randomized trials should aim to address which device provides the most optimal form of monitoring in different clinical contexts.

Published
2021

45. Pulmonary hypertension in infants with bronchopulmonary dysplasia: risk factors, mortality and duration of hospitalisation

Author

Anne Greenough, Mahesh Nanjundappa, Theodore Dassios, Fahad M. S. Arattu Thodika, and Aaron Bell

Subjects
Male, Pediatrics, medicine.medical_specialty, Hypertension, Pulmonary, Risk Factors, Intensive Care Units, Neonatal, London, medicine, Birth Weight, Humans, Hospital Costs, Bronchopulmonary Dysplasia, business.industry, Infant, Newborn, Obstetrics and Gynecology, Gestational age, Infant, Odds ratio, Length of Stay, medicine.disease, Pulmonary hypertension, Respiration, Artificial, Bronchopulmonary dysplasia, Pediatrics, Perinatology and Child Health, Breathing, Gestation, Electronic data, Female, Complication, business, Infant, Premature
Abstract

Objectives Pulmonary hypertension (PH) is a complication of bronchopulmonary dysplasia (BPD) and associated with increased mortality and morbidity. Our aim was to identify, in infants with BPD, the effect of PH on health-care utilisation and health related cost of care. Methods An electronic data recording system was used to identify infants ≤32 weeks of gestation who developed BPD. PH was classified as early (≤28 days after birth) or late (>28 days after birth). Results In the study period, 182 infants developed BPD; 22 (12.1%) developed late PH. Development of late PH was associated with a lower gestational age [24.6 (23.9–26.9) weeks, p=0.001] and a greater need for positive pressure ventilation on day 28 after birth (100%) compared to infants without late PH (51.9%) (odds ratio (OR) 19.5, 95% CI: 2.6–148), p Conclusions Development of late PH was associated with increased mortality, a prolonged duration of stay and higher healthcare cost.

Published
2021

46. Non-invasive carbon dioxide monitoring in the UK: a survey of practice within neonatal intensive care

Author

Theodore Dassios, Emma E Williams, Anne Greenough, Shannon Gunawardana, and Nadja Bednarczuk

Subjects
medicine.medical_specialty, business.industry, Non invasive, Infant, Newborn, Carbon Dioxide, United Kingdom, Anesthesiology and Pain Medicine, Carbon dioxide monitoring, Capnography, Intensive care, Surveys and Questionnaires, medicine, Intensive Care, Neonatal, Intubation, Intratracheal, Humans, Colorimetry, Intensive care medicine, business, Monitoring, Physiologic
Published
2021

47. Influence of antenatal corticosteroids and sex on the mortality and morbidity of extremely prematurely born infants

Author

Theodore Dassios, Anne Greenough, Emma E Williams, and Rebecca Lee

Subjects
Male, Pediatrics, medicine.medical_specialty, Gestational Age, behavioral disciplines and activities, Pregnancy, Adrenal Cortex Hormones, mental disorders, medicine, Humans, Birth Weight, Bronchopulmonary Dysplasia, Cerebral Hemorrhage, business.industry, Infant, Newborn, Obstetrics and Gynecology, Infant, medicine.disease, Intraventricular hemorrhage, Bronchopulmonary dysplasia, Infant, Extremely Premature, Pediatrics, Perinatology and Child Health, Breathing, Female, Morbidity, business
Abstract

To report the effect of antenatal corticosteroids (ANS) on mortality, intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD) and the duration of ventilation according to sex in extremely preterm infants.All extremely preterm infants admitted to any neonatal unit in England between 2014 and 2019.Eleven thousand seven hundred and fourteen infants (54% male) were included with a median (IQR) gestational age of 26 + 1 (24 + 6 - 27 + 1) weeks, birth weight of 809 (670 - 960) grams and birth weight z-score of -0.38 (-0.88 to 0.07). ANS were administered in 10,449 infants (89%); equally in males and females. Infants who received ANS compared to those who did not, had a lower mortality before discharge (18.7 versus 32.3%,Antenatal corticosteroids had a greater beneficial effect in female compared to male extremely prematurely born infants in reducing death before discharge.

Published
2021

48. Nicotine replacement therapy and e-cigarettes in pregnancy and infant respiratory outcomes

Author

Emma E Williams, Anne Greenough, Nadja Bednarczuk, and Theodore Dassios

Subjects
Pediatrics, medicine.medical_specialty, Receptor expression, Electronic Nicotine Delivery Systems, Nicotine, Airway resistance, Respiratory Rate, Pregnancy, medicine, Animals, Humans, Nicotinic Agonists, Respiratory system, Child, Lung, business.industry, Obstetrics and Gynecology, medicine.disease, Nicotine replacement therapy, Tobacco Use Cessation Devices, medicine.anatomical_structure, Pediatrics, Perinatology and Child Health, Gestation, Female, Smoking Cessation, business, medicine.drug
Abstract

Background Nicotine replacement therapy (NRT) and e-cigarettes are recommended to pregnant women who wish to stop smoking. Albeit eliminating other harmful components of cigarettes, those alternatives still expose the developing fetus to nicotine. The lungs may be particularly vulnerable to damage by nicotine as there is widespread nicotinic-acetylcholine receptor expression in the lungs. There is, however, a paucity of information about the effect of NRT and e-cigarette use in pregnancy on infant respiratory outcomes. Aims To explore the effect of NRT and e-cigarettes on the developing lung. Study design A literature search was undertaken to examine the use and safety of nicotine-replacement strategies in pregnancy, with a focus on infant respiratory outcomes. This included experimental studies investigating the effect of isolated “gestational” nicotine on the developing lung. Outcome measures Respiratory outcomes in animal studies and infants. Results Animal studies investigating the effect of gestational nicotine exposure on fetal lung development demonstrated abnormal lung growth; including abnormal airway branching and alveolar development. Consequently, offspring display altered pulmonary mechanics, including both increased respiratory rate and airway resistance. These findings mirror respiratory pathology observed in infants born to smoking mothers. Human trials of NRT and e-cigarette use in pregnancy have not identified adverse perinatal outcomes regarding reduced birthweight or prematurity, but have not considered infant and childhood respiratory outcomes. Conclusions Nicotine can impair fetal lung development, leading to concerns regarding the safety of NRT and e-cigarettes in pregnancy. Studies have yet to explore the impact of these nicotine-containing products on infant respiratory outcomes.

Published
2021

49. Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Author

Dondi, M., Milan, E., Pontone, G., Hirschfeld, C. B., Williams, M., Shaw, L. J., Pynda, Y., Raggi, P., Cerci, R., Vitola, J., Better, N., Villines, T. C., Dorbala, S., Pascual, T. N. B., Giubbini, R., Einstein, A. J., Paez, D., Italy: Domenico Albano, Pierpaolo, Alongi, Gaspare, Arnone, Elisa, Bagatin, Sergio, Baldari, Matteo, Bauckneht, Paolo, Bertelli, Francesco, Bianco, Rachele, Bonfiglioli, Roberto, Boni, Andrea, Bruno, Isabella, Bruno, Elena, Busnardo, Elena, Califaretti, Luca, Camoni, Aldo, Carnevale, Roberta, Casoni, Armando Ugo Cavallo, Giorgio, Cavenaghi, Franca, Chierichetti, Marcello, Chiocchi, Corrado, Cittanti, Mauro, Colletta, Umberto, Conti, Alberto, Cossu, Alberto, Cuocolo, Marco, Cuzzocrea, Maria Luisa De Rimini, Giuseppe De Vincentis, Eleonora Del Giudice, Alberico Del Torto, Veronica Della Tommasina, Rexhep, Durmo, Paola Anna Erba, Laura, Evangelista, Riccardo, Faletti, Evelina, Faragasso, Mohsen, Farsad, Paola, Ferro, Luigia, Florimonte, Viviana, Frantellizzi, Fabio Massimo Fringuelli, Marco, Gatti, Angela, Gaudiano, Alessia, Gimelli, Raffaele, Giubbini, Francesca, Giuffrida, Salvatore, Ialuna, Riccardo, Laudicella, Lucia, Leccisotti, Lucia, Leva, Liga, Riccardo, Carlo, Liguori, Giampiero, Longo, Margherita, Maffione, Maria Elisabetta Mancini, Claudio, Marcassa, Elisa, Milan, Barbara, Nardi, Sara, Pacella, Giovanna, Pepe, Gianluca, Pontone, Sabina, Pulizzi, Natale, Quartuccio, Lucia, Rampin, Fabrizio, Ricci, Pierluigi, Rossini, Giuseppe, Rubini, Vincenzo, Russo, Gian Mauro Sacchetti, Gianmario, Sambuceti, Massimo, Scarano, Roberto, Sciagrà, Massimiliano, Sperandio, Antonella, Stefanelli, Guido, Ventroni, Stefania Zoboli Members from Rest of the World (alphabetically by country and last name) Afghanistan: Mohammad Nawaz Nasery Albania: Artan Goda, Ervina Shirka Algeria: Rabie Benlabgaa, Salah, Bouyoucef, Abdelkader, Medjahedi, Qais Nailli Argentina: Mariela Agolti, Roberto Nicolas Aguero, Maria del Carmen Alak, Lucia Graciela Alberguina, Guillermo, Arroñada, Andrea, Astesiano, Alfredo, Astesiano, Carolina Bas Norton, Pablo, Benteo, Juan, Blanco, Juan Manuel Bonelli, Jose Javier Bustos, Raul, Cabrejas, Jorge, Cachero, Roxana, Campisi, Alejandro, Canderoli, Silvia, Carames, Patrícia, Carrascosa, Ricardo, Castro, Oscar, Cendoya, Luciano Martin Cognigni, Carlos, Collaud, Claudia, Cortes, Javier, Courtis, Daniel, Cragnolino, Mariana, Daicz, Alejandro De La Vega, Silvia Teresa De Maria, Horacio Del Riego, Fernando, Dettori, Alejandro, Deviggiano, Laura, Dragonetti, Mario, Embon, Ruben Emilio Enriquez, Jorge, Ensinas, Fernando, Faccio, Adolfo, Facello, Diego, Garofalo, Ricardo, Geronazzo, Natalia, Gonza, Lucas, Gutierrez, Miguel Angel Guzzo, Victor, Hasbani, Melina, Huerin, Victor, Jäger, Julio Manuel Lewkowicz, Maria Nieves, A López De Munaín, Jose Maria Lotti, Alejandra, Marquez, Osvaldo, Masoli, Osvaldo Horacio Masoli, Edgardo, Mastrovito, Matias, Mayoraz, Graciela Eva Melado, Anibal, Mele, Maria Fernanda Merani, Alejandro Horacio Meretta, Susana, Molteni, Marcos, Montecinos, Eduardo, Noguera, Carlos, Novoa, Claudio Pereyra Sueldo, Sebastian Perez Ascani, Pablo, Pollono, Maria Paula Pujol, Alejandro, Radzinschi, Gustavo, Raimondi, Marcela, Redruello, Marina, Rodríguez, Matías, Rodríguez, Romina Lorena Romero, Arturo Romero Acuña, Federico, Rovaletti, Lucas San Miguel, Lucrecia, Solari, Bruno, Strada, Sonia, Traverso, Sonia Simona Traverzo, Maria del Huerto Velazquez Espeche, Juan Sebastian Weihmuller, Juan, Wolcan, Susana Zeffiro Armenia: Mari Sakanyan Australia: Scott Beuzeville, Raef, Boktor, Patrick, Butler, Jennifer, Calcott, Loretta, Carr, Virgil, Chan, Charles, Chao, Woon, Chong, Mark, Dobson, D'Arne, Downie, Girish, Dwivedi, Barry, Elison, Jean, Engela, Roslyn, Francis, Anand, Gaikwad, Ashok Gangasandra Basavaraj, Bruce, Goodwin, Robert, Greenough, Christian, Hamilton-Craig, Victar, Hsieh, Subodh, Joshi, Karin, Lederer, Kenneth, Lee, Joseph, Lee, John, Magnussen, Nghi, Mai, Gordon, Mander, Fiona, Murton, Dee, Nandurkar, Johanne, Neill, Edward, O'Rourke, Patricia, O'Sullivan, George, Pandos, Kunthi, Pathmaraj, Alexander, Pitman, Rohan, Poulter, Manuja, Premaratne, David, Prior, Lloyd, Ridley, Natalie, Rutherford, Hamid, Salehi, Connor, Saunders, Luke, Scarlett, Sujith, Seneviratne, Deepa, Shetty, Ganesh, Shrestha, Jonathan, Shulman, Vijay, Solanki, Tony, Stanton, Murch, Stuart, Michael, Stubbs, Ian, Swainson, Kim, Taubman, Andrew, Taylor, Paul, Thomas, Steven, Unger, Anthony, Upton, Shankar, Vamadevan, William Van Gaal, Johan, Verjans, Demetrius, Voutnis, Victor, Wayne, Peter, Wilson, David, Wong, Kirby, Wong, John Younger Austria: Gudrun Feuchtner, Siroos, Mirzaei, Konrad Weiss Belarus: Natallia Maroz-Vadalazhskaya Belgium: Olivier Gheysens, Filip, Homans, Rodrigo, Moreno-Reyes, Agnès, Pasquet, Veronique, Roelants, Van De Heyning Bolivia: Raúl Araujo Ríos Bosnia - Herzegovina: Valentina Soldat-Stankovic, Caroline M., Sinisa Stankovic Brazil: Maria Helena Albernaz Siqueira, Augusto, Almeida, Paulo Henrique Alves Togni, Jose Henrique Andrade, Luciana, Andrade, Carlos, Anselmi, Roberta, Araújo, Guilherme, Azevedo, Sabbrina, Bezerra, Rodrigo, Biancardi, Gabriel Blacher Grossman, Simone, Brandão, Diego Bromfman Pianta, Lara, Carreira, Bruno, Castro, Tien, Chang, Fernando Cunali, Jr., Roberto, Cury, Roberto, Dantas, Fernando de Amorim Fernandes, Andrea De Lorenzo, Robson De Macedo Filho, Fernanda, Erthal, Fabio, Fernandes, Juliano, Fernandes, Thiago Ferreira De Souza, Wilson Furlan Alves, Bruno, Ghini, Luiz, Goncalves, Ilan, Gottlieb, Marcelo, Hadlich, Vinícius, Kameoka, Ronaldo, Lima, Adna, Lima, Rafael Willain Lopes, Ricardo Machado, e Silva, Tiago, Magalhães, Fábio Martins Silva, Luiz Eduardo Mastrocola, Fábio, Medeiros, José Claudio Meneghetti, Vania, Naue, Danilo, Naves, Roberto, Nolasco, Cesar, Nomura, Joao Bruno Oliveira, Eduardo, Paixao, Filipe Penna De Carvalho, Ibraim, Pinto, Priscila, Possetti, Mayra, Quinta, Rodrigo Rizzo Nogueira Ramos, Ricardo, Rocha, Alfredo, Rodrigues, Carlos, Rodrigues, Leila, Romantini, Adelina, Sanches, Sara, Santana, Leonardo Sara da Silva, Paulo, Schvartzman, Cristina Sebastião Matushita, Tiago, Senra, Afonso, Shiozaki, Maria Eduarda Menezes de Siqueira, Cristiano, Siqueira, Paola, Smanio, Carlos Eduardo Soares, José Soares Junior, Marcio Sommer Bittencourt, Bernardo, Spiro, Cláudio Tinoco Mesquita, Jorge, Torreao, Rafael, Torres, Marly, Uellendahl, Guilherme Urpia Monte, Otávia, Veríssimo, Estevan Vieira Cabeda, Felipe Villela Pedras, Roberto, Waltrick, Marcello Zapparoli Brunei Darussalam: Hamid Naseer Bulgaria: Marina Garcheva-Tsacheva, Irena Kostadinova Cambodia: Youdaline Theng Canada: Gad Abikhzer, Rene, Barette, Benjamin, Chow, Dominique, Dabreo, Matthias, Friedrich, Ria, Garg, Mohammed Nassoh Hafez, Chris, Johnson, Marla, Kiess, Jonathon, Leipsic, Eugene, Leung, Robert, Miller, Anastasia, Oikonomou, Stephan, Probst, Idan, Roifman, Gary, Small, Vikas, Tandon, Adwait, Trivedi, James, White, Katherine Zukotynski Chile: Jose Canessa, Gabriel Castro Muñoz, Carmen, Concha, Pablo, Hidalgo, Cesar, Lovera, Teresa, Massardo, Luis Salazar Vargas Colombia: Pedro Abad, Harold, Arturo, Sandra, Ayala, Luis, Benitez, Alberto, Cadena, Carlos, Caicedo, Antonio Calderón Moncayo, Sharon, Gomez, Gutierrez Villamil, Claudia T., Claudia, Jaimes, Juan, Londoño, Juan Luis Londoño Blair, Luz, Pabon, Mauricio, Pineda, Juan Carlos Rojas, Diego, Ruiz, Manuel Valencia Escobar, Andres, Vasquez, Damiana, Vergel, Alejandro Zuluaga Costa Rica: Isabel Berrocal Gamboa, Gabriel, Castro, Ulises, González, Croatia: Ana Baric, Tonci, Batinic, Maja, Franceschi, Maja Hrabak Paar, Mladen, Jukic, Petar, Medakovic, Viktor, Persic, Marina, Prpic, Ante Punda Cuba: Juan Felipe Batista, Juan Manuel Gómez Lauchy, Yamile Marcos Gutierrez, Rayner, Menéndez, Amalia, Peix, Luis Rochela Cyprus: Christoforos Panagidis, Ioannis Petrou Czech Republic: Vaclav Engelmann, Milan, Kaminek, Vladimír, Kincl, Otto, Lang, Milan Simanek Denmark: Jawdat Abdulla, Morten, Bøttcher, Mette, Christensen, Lars Christian Gormsen, Philip, Hasbak, Søren, Hess, Paw, Holdgaard, Allan, Johansen, Kasper, Kyhl, Bjarne Linde Norgaard, Kristian Altern Øvrehus, Niels Peter Rønnow Sand, Rolf, Steffensen, Anders, Thomassen, Bo Zerahn Dominican Republic: Alfredo Perez Ecuador: Giovanni Alejandro Escorza Velez, Mayra Sanchez Velez Egypt: Islam Shawky Abdel Aziz, Mahasen, Abougabal, Taghreed, Ahmed, Adel, Allam, Ahmed, Asfour, Mona, Hassan, Alia, Hassan, Ahmed, Ibrahim, Sameh, Kaffas, Ahmed, Kandeel, Mohamed Mandour Ali, Ahmad, Mansy, Hany, Maurice, Sherif, Nabil, Mahmoud Shaaban El Salvador: Ana Camila Flores Estonia: Anne Poksi Finland: Juhani Knuuti, Velipekka, Kokkonen, Martti, Larikka, Valtteri Uusitalo France: Matthieu Bailly, Samuel, Burg, Jean-François, Deux, Vincent, Habouzit, Fabien, Hyafil, Olivier, Lairez, Franck, Proffit, Hamza, Regaieg, Laure, Sarda-Mantel, Schneider Ghana: Harold Ayetey Greece: George Angelidis, Vania Tacher Germany: Roman P., Aikaterini, Archontaki, Sofia, Chatziioannou, Ioannis, Datseris, Christina, Fragkaki, Panagiotis, Georgoulias, Sophia, Koukouraki, Maria, Koutelou, Eleni, Kyrozi, Evangelos, Repasos, Petros, Stavrou, Pipitsa Valsamaki Guatemala: Carla Gonzalez, Goleat Gutierrez Honduras: Alejandro Maldonado Hungary: Klara Buga, Ildiko, Garai, Pál, Maurovich-Horvat, Erzsébet, Schmidt, Balint, Szilveszter, Edit Várady India: Nilesh Banthia, Jinendra Kumar Bhagat, Rishi, Bhargava, Vivek, Bhat, Mona, Bhatia, Partha, Choudhury, Vijay Sai Chowdekar, Aparna, Irodi, Shashank, Jain, Elizabeth, Joseph, Sukriti, Kumar, Prof Dr Girijanandan Mahapatra, Deepanjan, Mitra, Bhagwant Rai Mittal, Ahmad, Ozair, Chetan, Patel, Tapan, Patel, Ravi, Patel, Shivani, Patel, Sudhir, Saxena, Shantanu, Sengupta, Santosh, Singh, Bhanupriya, Singh, Ashwani, Sood, Atul Verma Indonesia: Erwin Affandi, Padma Savenadia Alam, Edison, Edison, Gani, Gunawan, Habusari, Hapkido, Basuki, Hidayat, Aulia, Huda, Anggoro Praja Mukti, Djoko, Prawiro, Erwin Affandi Soeriadi, Hilman Syawaluddin Iraq: Amjed Albadr Islamic Republic of Iran: Majid Assadi, Farshad, Emami, Golnaz, Houshmand, Majid, Maleki, Maryam Tajik Rostami, Seyed Rasoul Zakavi Israel: Eed Abu Zaid, Svetlana, Agranovich, Yoav, Arnson, Rachel, Bar-Shalom, Alex, Frenkel, Galit, Knafo, Rachel, Lugassi, Israel Shlomo Maor Moalem, Maya, Mor, Noam, Muskal, Sara, Ranser, Aryeh Shalev Jamaica: Dainia Baugh, Duane, Chambers, Ernest, Madu, Felix Nunura Japan: Hiroshi Asano, Chimura Misato Chimura, Shinichiro, Fujimoto, Koichiro, Fujisue, Tomohisa, Fukunaga, Yoshimitsu, Fukushima, Kae, Fukuyama, Jun, Hashimoto, Yasutaka, Ichikawa, Nobuo, Iguchi, Masamichi, Imai, Anri, Inaki, Hayato, Ishimura, Satoshi, Isobe, Toshiaki, Kadokami, Takao, Kato, Takashi, Kudo, Shinichiro, Kumita, Hirotaka, Maruno, Hiroyuki, Mataki, Masao, Miyagawa, Ryota, Morimoto, Masao, Moroi, Shigeki, Nagamachi, Kenichi, Nakajima, Tomoaki, Nakata, Ryo, Nakazato, Mamoru, Nanasato, Masanao, Naya, Takashi, Norikane, Yasutoshi, Ohta, Satoshi, Okayama, Atsutaka, Okizaki, Yoichi, Otomi, Hideki, Otsuka, Masaki, Saito, Sakata Yasushi Sakata, Masayoshi, Sarai, Daisuke, Sato, Shinya, Shiraishi, Yoshinobu, Suwa, Kentaro, Takanami, Kazuya, Takehana, Junichi, Taki, Nagara, Tamaki, Yasuyo, Taniguchi, Hiroki, Teragawa, Nobuo, Tomizawa, Kenichi, Tsujita, Kyoko, Umeji, Yasushi, Wakabayashi, Shinichiro, Yamada, Shinya, Yamazaki, Tatsuya Yoneyama Jordan: Mohammad Rawashdeh Kazakhstan: Daultai Batyrkhanov, Tairkhan Dautov Kenya: Khalid Makhdomi, Kevin Ombati Kuwait: Faridah Alkandari, Masoud Garashi Lao People's Democratic Republic: Tchoyoson Lim Coie, Sonexay Rajvong Latvia: Artem Kalinin, Marika Kalnina Lebanon: Mohamad Haidar Lithuania: Renata Komiagiene, Giedre, Kviecinskiene, Mindaugas, Mataciunas, Karim Malta: Luise Reichmuth, Donatas Vajauskas Luxembourg: Christian Picard Malaysia: Noor Khairiah A., Anthony Samuel Mauritius: Mohammad Aaftaab Allarakha, Ambedhkar Shantaram Naojee Mexico: Erick Alexanderson-Rosas, Erika, Barragan, Alejandro Becerril González-Montecinos, Manuel, Cabada, Daniel Calderon Rodriguez, Isabel, Carvajal-Juarez, Violeta, Cortés, Filiberto, Cortés, Erasmo De La Peña, Manlio, Gama-Moreno, Luis, González, Nelsy Gonzalez Ramírez, Moisés, Jiménez-Santos, Luis, Matos, Edgar, Monroy, Martha, Morelos, Mario, Ornelas, Jose Alberto Ortga Ramirez, Andrés, Preciado-Anaya, Óscar Ulises Preciado-Gutiérrez, Adriana Puente Barragan, Sandra Graciela Rosales Uvera, Sigelinda, Sandoval, Miguel Santaularia Tomas, Sierra-Galan, Lilia M., Silvia, Siu, Enrique, Vallejo, Mario Valles Monaco: Marc Faraggi Mongolia: Erdenechimeg Sereegotov Montenegro: Srdja Ilic Morocco: Nozha Ben-Rais, Nadia Ismaili Alaoui, Sara Taleb Myanmar: Khin Pa Pa Myo, Phyo Si Thu Nepal: Ram Kumar Ghimire, Bijoy Rajbanshi Netherlands: Peter Barneveld, Andor, Glaudemans, Jesse, Habets, Klaas Pieter Koopmans, Jeroen, Manders, Stefan, Pool, Arthur, Scholte, Asbjørn, Scholtens, Riemer, Slart, Paul, Thimister, Erik-Jan Van Asperen, Niels, Veltman, Derk, Verschure, Nils Wagenaar New Zealand: John Edmond, Chris, Ellis, Kerryanne, Johnson, Ross, Keenan, Shaw Hua (Anthony) Kueh, Christopher, Occleshaw, Alexander, Sasse, Andrew, To, Niels Van Pelt, Calum Young Nicaragua: Teresa Cuadra, Hector Bladimir Roque Vanegas Niger: Idrissa Adamou Soli, Djibrillou Moussa Issoufou Nigeria: Tolulope Ayodele, Chibuzo, Madu, Yetunde Onimode Norway: Elen Efros-Monsen, Signe Helene Forsdahl, Jenni-Mari Hildre Dimmen, Arve, Jørgensen, Isabel, Krohn, Pål, Løvhaugen, Anders Tjellaug Bråten Oman: Humoud Al Dhuhli, Faiza Al Kindi, Naeema, Al-Bulushi, Zabah, Jawa, Naima Tag Pakistan: Muhammad Shehzad Afzal, Shazia, Fatima, Muhammad Numair Younis, Musab, Riaz, Mohammad Saadullah Panama: Yariela Herrera Papua New Guinea: Dora Lenturut-Katal Paraguay: Manuel Castillo Vázquez, José Ortellado People's Republic of Bangladesh: Afroza Akhter People's Republic of China: Dianbo Cao, Stephen, Cheung, Dai, Xu, Lianggeng, Gong, Dan, Han, Yang, Hou, Caiying, Li, Tao, Li, Dong, Li, Sijin, Li, Jinkang, Liu, Hui, Liu, Bin, Lu, Ming Yen Ng, Kai, Sun, Gongshun, Tang, Jian, Wang, Ximing, Wang, Zhao-Qian, Wang, Yining, Wang, Yifan, Wang, Jiang, Wu, Zhifang, Wu, Liming, Xia, Jiangxi, Xiao, Lei, Xu, Youyou, Yang, Yin, Wu, Jianqun, Yu, Yuan, Li, Tong, Zhang, Longjiang, Zhang, Yong-Gao, Zhang, Xiaoli, Zhang, Li Zhu Peru: Ana Alfaro Philippines: Paz Abrihan, Asela, Barroso, Eric, Cruz, Marie Rhiamar Gomez, Vincent Peter Magboo, John Michael Medina, Jerry, Obaldo, Davidson, Pastrana, Christian Michael Pawhay, Alvin, Quinon, Jeanelle Margareth Tang, Bettina, Tecson, Kristine Joy Uson, Mila Uy Poland: Magdalena Kostkiewicz, Jolanta Kunikowska Portugal: Nuno Bettencourt, Guilhermina, Cantinho, Antonio Ferreira Qatar: Ghulam Syed Republic of Ireland: Samer Arnous, Said, Atyani, Angela, Byrne, Tadhg, Gleeson, David, Kerins, Conor, Meehan, David, Murphy, Mark, Murphy, John, Murray, Julie O'Brien Republic of Korea: Ji-In Bang, Henry, Bom, Sang-Geon, Cho, Chae Moon Hong, Su Jin Jang, Yong Hyu Jeong, Won Jun Kang, Ji-Young, Kim, Jaetae, Lee, Chang Kyeong Namgung, Young, So, Kyoung Sook Won Republic of North Macedonia: Venjamin Majstorov, Marija Vavlukis Republic of Slovenia: Barbara Gužic Salobir, Monika Štalc Romania: Theodora Benedek, Imre, Benedek, Raluca, Mititelu, Claudiu Adrian Stan Russian Federation: Alexey Ansheles, Olga, Dariy, Olga, Drozdova, Nina, Gagarina, Vsevolod Milyevich Gulyaev, Irina, Itskovich, Anatoly, Karalkin, Alexander, Kokov, Ekaterina, Migunova, Viktor, Pospelov, Daria, Ryzhkova, Guzaliya, Saifullina, Svetlana, Sazonova, Vladimir, Sergienko, Irina, Shurupova, Tatjana, Trifonova, Wladimir Yurievich Ussov, Margarita, Vakhromeeva, Nailya, Valiullina, Konstantin, Zavadovsky, Kirill Zhuravlev Saudi Arabia: Mirvat Alasnag, Subhani Okarvi Serbia: Dragana Sobic Saranovic Singapore: Felix Keng, Jia Hao Jason See, Ramkumar, Sekar, Min Sen Yew Slovak Republic: Andrej Vondrak South Africa: Shereen Bejai, George, Bennie, Ria, Bester, Gerrit, Engelbrecht, Osayande, Evbuomwan, Harlem, Gongxeka, Magritha Jv Vuuren, Mitchell, Kaplan, Purbhoo, Khushica, Hoosen, Lakhi, Lizette, Louw, Nico, Malan, Katarina, Milos, Moshe, Modiselle, Stuart, More, Mathava, Naidoo, Leonie, Scholtz, Mboyo Vangu Spain: Santiago Aguadé-Bruix, Isabel, Blanco, Antonio, Cabrera, Alicia, Camarero, Irene, Casáns-Tormo, Hug, Cuellar-Calabria, Albert, Flotats, Maria Eugenia Fuentes Cañamero, María Elia García, Amelia, Jimenez-Heffernan, Rubén, Leta, Javier Lopez Diaz, Luis, Lumbreras, Juan Javier Marquez-Cabeza, Francisco, Martin, Anxo Martinez de Alegria, Francisco, Medina, Maria Pedrera Canal, Virginia, Peiro, Virginia, Pubul-Nuñez, Juan Ignacio Rayo Madrid, Cristina Rodríguez Rey, Ricardo Ruano Perez, Joaquín, Ruiz, Gertrudis Sabatel Hernández, Ana, Sevilla, Nahla Zeidán Sri Lanka: Damayanthi Nanayakkara, Chandraguptha Udugama Sweden: Magnus Simonsson Switzerland: Hatem Alkadhi, Ronny Ralf Buechel, Peter, Burger, Luca, Ceriani, Bart De Boeck, Christoph, Gräni, Alix Juillet de Saint Lager Lucas, Kamani, Christel H., Nadine, Kawel-Boehm, Robert, Manka, Prior, John O., Axel, Rominger, Jean-Paul Vallée Thailand: Benjapa Khiewvan, Teerapon, Premprabha, Tanyaluck Thientunyakit Tunisia: Ali Sellem Turkey: Kemal Metin Kir, Haluk Sayman Uganda: Mugisha Julius Sebikali, Zerida Muyinda Ukraine: Yaroslav Kmetyuk, Pavlo, Korol, Olena, Mykhalchenko, Volodymyr, Pliatsek, Maryna Satyr United Arab Emirates: Batool Albalooshi, Mohamed Ismail Ahmed Hassan United Kingdom: Jill Anderson, Punit, Bedi, Thomas, Biggans, Anda, Bularga, Russell, Bull, Rajesh, Burgul, John-Paul, Carpenter, Duncan, Coles, David, Cusack, Aparna, Deshpande, John, Dougan, Timothy, Fairbairn, Alexia, Farrugia, Deepa, Gopalan, Alistair, Gummow, Prasad Guntur Ramkumar, Mark, Hamilton, Mark, Harbinson, Thomas, Hartley, Benjamin, Hudson, Nikhil, Joshi, Michael, Kay, Andrew, Kelion, Azhar, Khokhar, Jamie, Kitt, Ken, Lee, Chen, Low, Sze Mun Mak, Ntouskou, Marousa, Jon, Martin, Elisa, Mcalindon, Leon, Menezes, Gareth, Morgan-Hughes, Alastair, Moss, Anthony, Murray, Edward, Nicol, Dilip, Patel, Charles, Peebles, Francesca, Pugliese, Jonathan Carl Luis Rodrigues, Christopher, Rofe, Nikant, Sabharwal, Rebecca, Schofield, Thomas, Semple, Naveen, Sharma, Peter, Strouhal, Deepak, Subedi, William, Topping, Katharine, Tweed, Jonathan Weir-Mccall United States of America: Suhny Abbara, Taimur, Abbasi, Brian, Abbott, Shady, Abohashem, Sandra, Abramson, Tarek, Al-Abboud, Mouaz, Al-Mallah, Omar, Almousalli, Karthikeyan, Ananthasubramaniam, Mohan Ashok Kumar, Jeffrey, Askew, Lea, Attanasio, Mallory, Balmer-Swain, Bayer, Richard R., Adam, Bernheim, Sabha, Bhatti, Erik, Bieging, Ron, Blankstein, Stephen, Bloom, Sean, Blue, David, Bluemke, Andressa, Borges, Kelley, Branch, Paco, Bravo, Jessica, Brothers, Matthew, Budoff, Renée, Bullock-Palmer, Angela, Burandt, Burke, Floyd W., Kelvin, Bush, Candace, Candela, Elizabeth, Capasso, Joao, Cavalcante, Donald, Chang, Saurav, Chatterjee, Yiannis, Chatzizisis, Michael, Cheezum, Tiffany, Chen, Jennifer, Chen, Marcus, Chen, Andrew, Choi, James, Clarcq, Ayreen, Cordero, Matthew, Crim, Sorin, Danciu, Bruce, Decter, Nimish, Dhruva, Neil, Doherty, Rami, Doukky, Anjori, Dunbar, William, Duvall, Rachael, Edwards, Kerry, Esquitin, Husam, Farah, Emilio, Fentanes, Maros, Ferencik, Daniel, Fisher, Daniel, Fitzpatrick, Cameron, Foster, Tony, Fuisz, Michael, Gannon, Lori, Gastner, Myron, Gerson, Brian, Ghoshhajra, Alan, Goldberg, Brian, Goldner, Jorge, Gonzalez, Rosco, Gore, Sandra, Gracia-López, Fadi, Hage, Agha, Haider, Sofia, Haider, Yasmin, Hamirani, Karen, Hassen, Mallory, Hatfield, Carolyn, Hawkins, Katie, Hawthorne, Nicholas, Heath, Robert, Hendel, Phillip, Hernandez, Gregory, Hill, Stephen, Horgan, Jeff, Huffman, Lynne, Hurwitz, Ami, Iskandrian, Rajesh, Janardhanan, Christine, Jellis, Scott, Jerome, Dinesh, Kalra, Summanther, Kaviratne, Fernando, Kay, Faith, Kelly, Omar, Khalique, Mona, Kinkhabwala, George Kinzfogl Iii, Jacqueline, Kircher, Rachael, Kirkbride, Michael, Kontos, Anupama, Kottam, Joseph, Krepp, Jay, Layer, Steven, H Lee, Jeffrey, Leppo, John, Lesser, Steve, Leung, Howard, Lewin, Diana, Litmanovich, Yiyan, Liu, Juan, Lopez-Mattei, Kathleen, Magurany, Jeremy, Markowitz, Amanda, Marn, Stephen, E Matis, Michael, Mckenna, Tony, Mcrae, Fernando, Mendoza, Michael, Merhige, David, Min, Chanan, Moffitt, Karen, Moncher, Warren, Moore, Shamil, Morayati, Michael, Morris, Mahmud, Mossa-Basha, Zorana, Mrsic, Venkatesh, Murthy, Prashant, Nagpal, Kyle, Napier, Jagat, Narula, Katarina, Nelson, Prabhjot, Nijjar, Medhat, Osman, Purvi, Parwani, Edward, Passen, Amit, Patel, Pravin, Patil, Ryan, Paul, Lawrence, Phillips, Venkateshwar, Polsani, Rajaram, Poludasu, Brian, Pomerantz, Thomas, Porter, Ryan, Prentice, Amit, Pursnani, Mark, Rabbat, Suresh, Ramamurti, Florence, Rich, Hiram Rivera Luna, Austin, Robinson, Kim, Robles, Cesar, Rodríguez, Mark, Rorie, John, Rumberger, Raymond, Russell, Philip, Sabra, Diego, Sadler, Mary, Schemmer, Joseph Schoepf, U., Samir, Shah, Nishant, Shah, Sujata, Shanbhag, Gaurav, Sharma, Steven, Shayani, Jamshid, Shirani, Pushpa, Shivaram, Steven, Sigman, Mitch, Simon, Ahmad, Slim, David, Smith, Alexandra, Smith, Prem, Soman, Aditya, Sood, Monvadi Barbara Srichai-Parsia, James, Streeter, Albert, T, Ahmed, Tawakol, Dustin, Thomas, Randall, Thompson, Tara, Torbet, Desiree, Trinidad, Shawn, Ullery, Samuel, Unzek, Seth, Uretsky, Srikanth, Vallurupalli, Vikas, Verma, Alfonso, Waller, Ellen, Wang, Parker, Ward, Gaby, Weissman, George, Wesbey, Kelly, White, David, Winchester, David, Wolinsky, Sandra, Yost, Michael Zgaljardic Uruguay: Omar Alonso, Mario, Beretta, Rodolfo, Ferrando, Miguel, Kapitan, Fernando Mut Uzbekistan: Omoa Djuraev, Gulnora Rozikhodjaeva Vietnam: Ha Le Ngoc, Son Hong Mai, and Xuan Canh Nguyen

Subjects
medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Cardiology, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, COVID-19, Cardiac imaging, Cardiovascular disease, Article, cardiac imaging, Healthcare delivery, cardiovascular disease, Intensive care, Surveys and Questionnaires, Health care, Pandemic, medicine, Humans, Pandemics, Protocol (science), business.industry, SARS-CoV-2, Non invasive, Italy, humans, pandemics, surveys and questionnaires, cardiology, Emergency medicine, Cardiology and Cardiovascular Medicine, business
Abstract

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p < 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures.

Published
2021

50. Prognostic value of the oxygenation index to predict survival and timing of surgery in infants with congenital diaphragmatic hernia

Author

Anne Greenough, Gwendolyn Andradi, Kamal Ali, Yew-Wei Tan, Mark Davenport, and Lekshmi Sasidharan

Subjects
medicine.medical_specialty, Oxygenation index, Birth weight, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Statistical significance, Humans, Medicine, Retrospective Studies, Receiver operating characteristic, business.industry, Infant, Newborn, Congenital diaphragmatic hernia, Gestational age, General Medicine, Prognosis, medicine.disease, Surgery, Oxygen, Postnatal age, 030220 oncology & carcinogenesis, Pediatrics, Perinatology and Child Health, Breathing, Blood Gas Analysis, Hernias, Diaphragmatic, Congenital, business
Abstract

To compare the mean oxygenation index on day1 (MOId1) with the best OI on day1 (BOId1) in predicting 30-day mortality in congenital diaphragmatic hernia (CDH). In addition, to determine whether serial OIs in the first 48 h after birth and preoperative OI (PreOp-OI), were associated with optimal timing of surgery, ventilation requirement and hospital stay in infants with CDH.The medical records of infants with antenatally diagnosed CDH during 2009-2015 were retrospectively reviewed. Receiver operator characteristic curves were constructed to identify MOId1 and BOId1 cutoff levels to predict 30-day mortality. In those who underwent surgery, the mean OI on each of the first two days (MOId1, MOId2) and PreOp-OI were correlated using Spearman (rs) with the age at surgery, the duration of ventilation and length of stay. Statistical significance was P 0.05* and 0.001**.Survivors (n = 44) and nonsurvivors (n = 24) were comparable in gestational age, birth weight and defect laterality. Nonsurvivors had higher median BOId1 (15.4 vs 2.9; P 0.01) and MOId1 (48 vs 7.5; p 0.01) than survivors. Mortality was best predicted by two cutoffs [BOId1 6 (sensitivity 92%, specificity 89%); and MOId1 17 (sensitivity 96%, specificity 96%)]. Forty-four infants underwent surgery at a median postnatal age of five (range 2-19) days. MOId1 and MOId2 both correlated significantly with the age at surgery (rs = 0.4**, rs 0.5**) but not ventilation period and length of stay. PreOp-OI correlated significantly with age at surgery, duration of ventilation and length of stay (rs = 0.32*, rs = 0.47**, rs = 0.37*). A PreOp-OI3 was predictive of optimal timing for surgery with improved duration of ventilation (8 vs 22, P = 0.001) and length of stay (26 vs 47, P = 0.004). However, 11/44 (25%) patients would not achieve a PreOp-OI 3 by day 7+ of life and might still require surgery, one of them died.Both MOId1 and BOId1 are highly predictive of mortality in CDH. Oxygenation indices in the first 48 h poorly predicted the timing of surgery. PreOp-OI3 may be a cutoff for optimal timing for surgery in infants for CDH repair.Prognostic Study.Level III.

Published
2019

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