Author: "Rajab, A." / Topic: medicine.disease - Searchworks@Jio Institute Digital Library Search Results

629 results on '"Rajab, A."'

1. COVID-19 infection mortality risk in Iranian patients with type 2 diabetes, hypertension and obesity

Author: Manouchehr Nakhjavani, Nasrin Baiat Paridari, Fatemeh Ghaemi, Soghra Rabizadeh, Alireza Esteghamati, Mahdi Shadnoush, Armin Rajab, and Mostafa Khoshabi
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, COVID-19, Comorbidity, General Medicine, Type 2 diabetes, Iran, medicine.disease, Obesity, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Risk Factors, Internal medicine, Hypertension, Diabetes Mellitus, medicine, Humans, business
Abstract: Diabetes mellitus and hypertension are highly prevalent among patients with severe COVID-19.To study the mortality risk of COVID-19 infection in patients with type 2 diabetes and additive effect of hypertension and obesity in the Iranian population.This was a cross-sectional survey of the national COVID-19 registry from the Iranian Ministry of Health. The medical status of 22 002 patients with COVID-19 between 1 March and 30 April 2020 was analysed.Patients with type 2 diabetes had a higher risk of mortality with an odds ratio (OR) of 1.67 [95% confidence interval (CI): 1.53-1.82, P0.001]. The risk of mortality was also high in patients with diabetes and hypertension, with an odds ratio of 1.76 (95% CI: 1.56-1.99, P0.001). The odds ratio of the risk of mortality in patients with diabetes, hypertension and obesity was 1.87 (95% CI: 1.35-2.58, P0.001).Type 2 diabetes, hypertension and obesity each predict mortality in Iranian patients with COVID-19, and when they are present together, patients have a greater risk of mortality.خطر الوفاة الناجمة عن الإصابة بكوفيد-19 لدى المرضى الإيرانيين المصابين بالنمط 2 من السكري وارتفاع ضغط الدم والسمنة.مهدي شدنوش، صغرا ربيع زاده، علي رضا إستغاماتي، منوشهر ناخجواني، نسرين بيات باريداري، مصطفى خشابي، أرمين رجب، فاطمة غامي.ينتشر داء السكري وارتفاع ضغط الدم انتشارًا كبيرًا بين المرضى المصابين بحالة وخيمة من كوفيد-19.هدفت هذه الدراسة إلى دراسة خطر الوفاة الناجمة عن الإصابة بكوفيد-19 لدى المرضى المصابين بالنمط 2 من السكري، والتأثير الإضافي لارتفاع ضغط الدم والسمنة لدى السكان الإيرانيين.أُجري مسح مقطعي للسجل الوطني الخاص بمرض كوفيد-19 في وزارة الصحة الإيرانية. وجرى تحليل الحالة الطبية لعدد 22002 من المرضى المصابين بكوفيد-19 في الفترة بين 1 مارس/ آذار و30 أبريل/ نيسان 2020.كان المرضى المصابون بالنمط 2 من السكري أكثر عرضة للوفاة بنسبة أرجحية 1.67 [فاصل ثقة 95٪: 1.53–1.82، القيمة الاحتمالية0.001]. وكان خطر الوفاة أيضًا أعلى لدى مرضى السكري وارتفاع ضغط الدم، بنسبة أرجحية 1.76 [فاصل ثقة 95٪: 1.56–1.99، القيمة الاحتمالية0.001). وبلغت نسبة أرجحية خطر الوفاة لدى مرضى السكري وارتفاع ضغط الدم والسمنة 1.87 (فاصل ثقة 95٪: 1.35–2.58، القيمة الاحتمالية0.001).يُنبئ كلٌ من النمط 2 من داء السكري وارتفاع ضغط الدم والسمنة بالوفيات لدى المرضى الإيرانيين المصابين بكوفيد-19، وعندما تترافق تلك الأمراض معًا، يزداد خطر وفاة المرضى.Risque de mortalité lié à l'infection par la COVID-19 chez les patients iraniens souffrant de diabète de type 2, d'hypertension et d'obésité.Le diabète sucré et l'hypertension sont très prévalents chez les patients atteints d'une forme grave de COVID-19.Étudier le risque de mortalité lié à l'infection par la COVID-19 chez les patients atteints de diabète de type 2 et l'effet additif de l'hypertension et de l'obésité dans la population iranienne.Il s'agissait d'une enquête transversale du registre national de la COVID-19 du ministère iranien de la Santé et de l'Éducation médicale. L'état de santé de 22 002 patients atteints de COVID-19 entre le 1Les patients atteints de diabète de type 2 présentaient un risque de mortalité plus élevé avec un odds ratio (OR) de 1,67 [intervalle de confiance (IC) à 95 % : 1,53-1,82, p0,001]. Le risque de mortalité était également plus élevé chez les patients diabétiques et hypertendus, avec un OR de 1,76 (IC à 95 % : 1,56-1,99, p0,001). L'odds ratio du risque de mortalité chez les patients diabétiques, hypertendus et obèses était de 1,87 (IC à 95 % : 1,35-2,58, p0,001).Le diabète de type 2, l'hypertension et l'obésité permettent respectivement de prédire la mortalité chez les patients iraniens atteints de COVID-19, et lorsqu'ils sont présents ensemble, les patients ont un risque de mortalité plus élevé.
Published: 2022

2. Ross Operation in Neonates: A Meta-analysis

Author: Suyog Mokashi, Andres Zorrilla-Vaca, Taufiek Konrad Rajab, Sandeep Sainathan, and Minoo N. Kavarana
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Pediatrics, Heart Valve Diseases, MEDLINE, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Aortic valve replacement, medicine, Humans, Heart Valve Prosthesis Implantation, business.industry, Mortality rate, Incidence (epidemiology), Infant, Newborn, Publication bias, medicine.disease, Confidence interval, Cardiac surgery, Treatment Outcome, 030228 respiratory system, Aortic Valve, Heart Valve Prosthesis, Meta-analysis, Surgery, Cardiology and Cardiovascular Medicine, business
Abstract: Background The Ross operation is the preferred treatment for aortic valve replacement in children. However previous studies indicate that outcomes in neonates are poor. This meta-analysis examines the pooled outcomes of the Ross operation in neonates. Methods Four major databases (PubMed/MEDLINE, EMBASE, Scopus, and ScienceDirect) were searched from inception until May 1, 2020 for studies describing outcomes of the Ross operation in neonates. The primary outcome was early mortality, and secondary outcomes were late mortality and mechanical support. Random-effects models were used to account for possible heterogeneity between studies, and continuity corrections were used to include zero total event trials. Results Eighteen studies comprising outcomes data on 181 neonates were included in the analysis. Meta-analysis showed a pooled early mortality rate of 24% (95% confidence interval, 12%-38%; I2 = 52%, P for heterogeneity = .01). Meta-regression analysis showed that more recently published studies reported significantly worse early mortality (P = .03). The pooled incidence of postoperative mechanical support was 15% (95% confidence interval, 5%-28%; I2 = 28%, P for heterogeneity = .22). No evidence of publication bias was found according to Egger’s test (bias coefficient = 0.21, P = .57). Conclusions The neonatal Ross operation carries a high early mortality rate. The treatment of unrepairable aortic valves in neonates remains an unsolved problem in congenital cardiac surgery.
Published: 2022

3. Pentalogy of Cantrell With a Left Ventricular Diverticulum and Muscular VSD

Author: Morgan Ashley Hill, Jennie H. Kwon, T. Konrad Rajab, and Minoo N. Kavarana
Subjects: Pulmonary and Respiratory Medicine, congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, business.industry, Diaphragmatic breathing, medicine.disease, Diaphragm (structural system), Pentalogy of Cantrell, Abdominal wall, medicine.anatomical_structure, Internal medicine, cardiovascular system, medicine, Cardiology, Pericardium, Surgery, cardiovascular diseases, Cardiology and Cardiovascular Medicine, business, Diverticulum, Tetralogy of Fallot, Congenital disorder
Abstract: Pentalogy of Cantrell (POC) is a rare congenital disorder characterized by defects of the anterior diaphragm, midline supraumbilical abdominal wall, diaphragmatic pericardium, lower sternum, and heart. The low incidence and significant heterogeneity of POC make it difficult for most surgeons to gain consistent experience in treating these congenital heart defects. Here we describe the treatment of a patient with POC, Tetralogy of Fallot, left ventricular (LV) diverticulum, and a muscular ventricular septal defect (VSD). An innovative approach through a left ventricular diverticulotomy was utilized which provided excellent exposure for repair of the muscular VSD.
Published: 2022

4. Role of Therapeutic Drug Monitoring in Medication Safety, Physicians Perception, and Practice

Author: Majed Alfaifi, Theaar Alotaibi, Faisal Alharthi, Saeed Alzahrani, Abdullah Mohammed H. Althomali, Khaled Alhusayni, Fahad Rajab, Sultan Alrubaiei, Ibrahim Dighriri, Shaden Bin Howimel, Abdulrahman Hommadi, Abdulaziz Alkhammash, Rasha Alqahtani, Adel Alharthi, and Ibrahim Mobarki
Subjects: Drug, medicine.diagnostic_test, business.industry, media_common.quotation_subject, medicine.disease, Medication error, Clinical pharmacy, Pharmacotherapy, Therapeutic drug monitoring, Perception, Physician perception, Physician demographics, Medicine, Medical emergency, business, media_common
Abstract: Introduction: Patients admitted to the hospital will receive various drugs, each carrying the risk of error. Medication errors concern our healthcare system, especially considering the relatively high number of patients admitted to hospitals. Assuming that each patient receives at least two medications twice a day, the likelihood of a medication error is considerable. Therefore, therapeutic drug monitoring (TDM) focuses on measuring blood medication levels and plays a crucial role in medication safety. Aims: This study aimed to determine the effect of TDM in ensuring the safety of medications in many Taif hospitals. Also, to enhance the safety and quality of drug use and reflect physician perception and practice regarding TDM. Methodology: A prospective cross-sectional study consisting of questionnaires was conducted to physicians at many of Taif's governmental hospitals between March and May 2021. Questionnaires evaluated three parts: physician demographics, physician perception about TDM, and physician practices regarding TDM. The collected data were processed using the Excel program. Results: More than 80% of the interviewed physicians agreed that TDM is a tool that can guide the clinician to provide effective and safe drug therapy in the individual patient. Approximately 77% agreed that TDM is a team of decision-making groups. Around 25% of physicians performed TDM weekly, 22% monthly, and 10% daily. The medications that participating physicians ordered TDM were digoxin (30%), carbamazepine (21%), and gentamycin (17%). The participants had a limited understanding of the advantages of TDM in terms of drug safety and welfare. Conclusion: The number of actual drug errors occurs in the healthcare systems. Therefore, must establishment of TDM in hospitals. Medical administration and physicians must cooperate with the clinical pharmacist. Also, establish workshops for health practitioners to educate them about the role of TDM and pharmacokinetic laboratories in controlling the therapeutic process.
Published: 2021

5. Urine-derived extracellular vesicle miRNAs as possible biomarkers for and mediators of necrotizing enterocolitis: A proof of concept study

Author: Pamela Mar, Yijie Wang, Rachel Han, Gail E. Besner, Jeffrey D. Galley, and Adrian Rajab
Subjects: Disease, Proof of Concept Study, Article, Sepsis, Transcriptome, Extracellular Vesicles, Mice, 03 medical and health sciences, 0302 clinical medicine, Enterocolitis, Necrotizing, 030225 pediatrics, microRNA, medicine, Extracellular, Animals, Humans, business.industry, Infant, Newborn, General Medicine, Extracellular vesicle, medicine.disease, digestive system diseases, Rats, MicroRNAs, 030220 oncology & carcinogenesis, Pediatrics, Perinatology and Child Health, Necrotizing enterocolitis, Immunology, Surgery, Signal transduction, business, Biomarkers
Abstract: Background Early-stage symptomology of necrotizing enterocolitis (NEC) is similar in presentation to non-NEC sepsis, though the treatment plans differ based on antibiotic administration and withholding of feeds. Improved diagnostics for NEC differentiation would allow clinicians to more rapidly set individual patients on a targeted treatment path. Extracellular vesicle-derived miRNAs, have previously demonstrated efficacy as disease biomarkers. To determine if these miRNAs are differentially-expressed in NEC infants, we performed transcriptomic analysis of urine-derived extracellular vesicle-derived miRNAs. Methods Urine was non-invasively obtained from infants in one of four groups (n ≥ 8) (Medical NEC, Surgical NEC, non-NEC sepsis, and healthy age-matched controls). EV-derived miRNAs were isolated and transcriptomic analysis was performed. Results Multiple miRNAs, including miR-376a, miR-518a-3p and miR-604, were significantly altered when comparing NEC to non-NEC sepsis and healthy controls, and could potentially be used as specific NEC biomarkers. Additionally, Ingenuity Pathway Analysis demonstrated that miRs differentially-expressed in NEC were associated with inflammatory disease and intestinal disease. Signal transduction molecules associated with NEC including TP53 and RPS15, which were also reduced transcriptionally in a rat model of NEC. Conclusion These data indicate that there is a pool of potential urine EV-derived miRNAs that may be validated as NEC biomarkers in the differentiation of NEC from non-NEC sepsis and from age-matched controls. Additionally, signal transduction molecules associated with miRNAs differentially-expressed in human NEC are altered in a murine model of NEC, suggesting potential crossover between murine models of the disease and actual human presentation. Level of Evidence Level III Study of Diagnostic Test.
Published: 2021

6. Adhesion barriers in cardiac surgery: A systematic review of efficacy

Author: Morgan Ashley Hill, William T Head, Namrata Paladugu, Brielle Gerry, Jennie H. Kwon, Taufiek Konrad Rajab, Minoo N. Kavarana, and Emily Brennan
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, Adhesion (medicine), Tissue Adhesions, Adhesion barrier, medicine.disease, Cardiac surgery, Postoperative Complications, Reporting bias, medicine, Humans, Surgery, Cardiac Surgical Procedures, Cardiology and Cardiovascular Medicine, Intensive care medicine, business, Formation rate, Pericardium, Polytetrafluoroethylene
Abstract: BACKGROUND Postoperative pericardial adhesions have been associated with increased morbidity, mortality, and surgical difficulty. Barriers exist to limit adhesion formation, yet little is known about their use in cardiac surgery. The study presented here provides the first major systematic review of adhesion barriers in cardiac surgery. METHODS Scopus and PubMed were assessed on November 20, 2020. Inclusion criteria were clinical studies on human subjects, and exclusion criteria were studies not published in English and case reports. Risk of bias was evaluated with the Cochrane Risk of Bias Tool. Barrier efficacy data was assessed with Excel and GraphPad Prism 5. RESULTS Twenty-five studies were identified with a total of 13 barriers and 2928 patients. Polytetrafluoroethylene (PTFE) was the most frequently evaluated barrier (13 studies, 67% of patients) with adhesion formation rate of 37.31% and standardized tenacity score of 26.50. Several barriers had improved efficacy. In particular, Cova CARD had a standardized tenacity score of 15.00. CONCLUSIONS Overall, the data varied considerably in terms of study design and reporting bias. The amount of data was also limited for the non-PTFE studies. PTFE has historically been effective in preventing adhesions. More recent barriers may be superior, yet the current data is nonconfirmatory. No ideal adhesion barrier currently exists, and future barriers must focus on the requirements unique to operating in and around the heart.
Published: 2021

7. Gain in growth after surgical repair of congenital heart disease among children with Down syndrome

Author: Bana Nasser Agha, Abdulrahman Almazrou, Baraa Tarek Ziad Oubaied, Nazmus Saquib, Juliann Saquib, Jesmin Hossain, Ahmad Mamoun Rajab, and Anas Naser Al Sarraj
Subjects: Heart Defects, Congenital, Male, Pediatrics, medicine.medical_specialty, Down syndrome, Younger age, Heart disease, business.industry, Medical record, Saudi Arabia, Genetic disorder, Infant, Repeated measures design, medicine.disease, Body Height, Body Mass Index, Genetics, medicine, Humans, Analysis of variance, Down Syndrome, Child, business, Body mass index, Genetics (clinical)
Abstract: Down syndrome (DS) is a common genetic disorder among Saudi children, for which limited data is available on growth for those who undergo surgery for congenital heart disease (CHD). We assessed the magnitude of growth over time following surgery and the factors associated with growth change. Eighty-eight children with DS and CHD who underwent surgery between 2009 and 2017 at the tertiary children's hospital in Al-Qassim, Saudi Arabia, were eligible. Information on gender, height, and weight (at surgery, 6 and 12 months), age at surgery, and type of CHD were abstracted from the medical records. Repeated measure analysis of variance (ANOVA) was used for data analysis. The sample's mean age (SD) was 16.2 months (20.1); 47% were male. Height, weight, and body mass index (BMI) increased significantly at both follow-up points. There was a significant interaction between age at surgery, type of heart disease, and time for all three physical indices (p-values0.001). The increase in height, weight, and BMI was significantly greater for children ≤8 months old with acyanotic CHD compared to children8 months with cyanotic CHD. Overall, the gain in growth was greater for the children with DS who had had surgery at a younger age.
Published: 2021

8. Barriers to initiation of insulin therapy in poorly controlled type 2 diabetes based on self-determination theory

Author: Soghra Rabizadeh, Salome Sadat Salehi, Pegah Khaloo, Alireza Esteghamati, Manouchehr Nakhjavani, Armin Rajab, Reza Majdzadeh, Hossein Mirmiranpour, Hamid Alemi, and Assadollah Rajab
Subjects: medicine.medical_specialty, business.industry, Insulin, medicine.medical_treatment, General Medicine, Type 2 diabetes, medicine.disease, Diabetes Mellitus, Type 2, Slow progression, Surveys and Questionnaires, Diabetes mellitus, Internal medicine, Personal Autonomy, Severity of illness, medicine, Humans, Patient Compliance, Intrinsic motivation, Medical prescription, business, Self-determination theory
Abstract: Proper glycaemic control can slow progression of diabetes complications. One of the main causes of poor glycaemic control is delayed initiation of insulin therapy.To explain the reasons for delayed insulin initiation based on a behavioural model using patients' innate psychological needs.We enrolled 151 patients with type 2 diabetes who had indications for insulin therapy. Thirty general practitioners (GPs) were included as care providers. Patients were studied by questionnaires evaluating components of self determination theory, such as competency, relatedness and autonomy. We also evaluated patients' attitudes towards insulin therapy using the Insulin Treatment Appraisal Scale questionnaire. GPs' attitudes towards insulin therapy were assessed with a different questionnaire.Competency of patients was scored as acceptable (14.44/20). Relatedness score was low at around 15.63/30. The findings suggested that the patients' intrinsic motivation was less than their extrinsic motivation (8.41/15 vs 15.03/20). The main barrier to insulin therapy on the patients' side was rejection of severity of illness (67.5%). According to GPs, low compliance (96.7%) was the main cause of delayed insulin prescription.We observed that patients do not have a proper understanding about their illness. Due to the low score of relatedness as a representative of patients and care providers' relationship, we highlight the importance of educating both about insulin therapy and how they can have the most effective relationship in this process.العوائق التي تَُول دون بدء العلاج بالأنسولين لداء السُّكَّري من النمط الثاني الذي لا يمكن ضبطه جيداً استناداً إلى نظرية تقرير المصير.أرمين رجب، بيجا خالو، صغرى رابي زاده، حميد العليمي، سالومي صالحي، رضا مجدزاده، حسين ميرميرانبور، أسد الله رجب، علي رضا إستغاماتي، منوچهر نخجواني.يمكن أن يؤدي ضبط سكر الدم على نحوٍ صحيح إلى إبطاء تفاقم مضاعفات السُّكَّري. ويُعد تأخر بدء العلاج بالأنسولين أحد الأسباب الرئيسية التي تحول دون الضبط الجيد لسكر الدم.هدفت هذه الدراسة إلى شرح أسباب تأخُّر بدء العلاج بالأنسولين بِناءً على نموذج سلوكي يستند إلى احتياجات المرضى النفسية الفطرية.شملت هذه الدراسة 151 مريضاً بالسُّكَّري من النمط الثاني تستدعي حالاتهم العلاج بالأنسولين. وشملت ثلاثين ممارساً عاماً يضطلعون بدور مُقدِّمي خدمات الرعاية. وخضع المرضى للدراسة عن طريق استبيانات لتقييم مكوِّنات نظرية تقرير المصير، مثل الكفاءة والارتباط والاستقلالية. كما أجرينا تقييماً لمواقف المرضى تجاه العلاج بالأنسولين باستخدام استبيان مقياس تقييم العلاج بالأنسولين. وقُيّمَت مواقف الممارسين العامِّين تجاه العلاج بالأنسولين باستخدام استبيان مختلف.حصلت كفاءة المرضى على درجة مقبولة (14.44 / 20)، فيما حصل الارتباط على درجة منخفضة تُقدَّر بنحو 15.63 / 30. وأشارت النتائج إلى أن الدافع الذاتي للمرضى كان أقلَّ من دوافعهم الخارجية (8.41 / 15 مقابل 15.03 / 20). وتَثَّل العائق الرئيسي الذي يحُول دون إقدام المرضى على العلاج بالأنسولين في عدم الاعتراف بشدة المرض (67.5٪). ووَفْقاً للممارسين العامِّين، كان انخفاض الامتثال (96.7٪) السبب الرئيسي لتأخُّر وصف الأنسولين.لاحظنا أن المرضى لا يتمتعون بفهمٍ صحيحٍ لمرضهم. ونظراً لانخفاض درجة الارتباط كممثل للعلاقة بين المرضى ومُقدِّمي خدمات الرعاية، فإننا نُسلّط الضوءَ على أهمية تثقيف كلٍ منهما بشأن العلاج بالأنسولين، وكيف يمكن الوصول إلى أفضل علاقة فعّالة بين الطرفين في إطار هذه العملية.Obstacles face à la mise en place de l’insulinothérapie dans le diabète de type 2 mal contrôlé selon la théorie de l’autodétermination.Un contrôle adéquat de la glycémie permet de ralentir la progression des complications du diabète. Le retard dans la mise en place de l’insulinothérapie constitue l’une des principales causes d’un mauvais contrôle de la glycémie.Expliquer les raisons du retard de la mise en place du traitement par insuline sur la base d’un modèle comportemental fondé sur les besoins psychologiques innés des patients.Nous avons recruté 151 patients atteints de diabète de type 2 pour lesquels l’insulinothérapie était indiquée. Une trentaine de médecins généralistes ont été inclus en qualité de prestataires de soins. L’étude a été menée au moyen de questionnaires évaluant des composantes de la théorie de l’autodétermination, telles que la compétence, l’affiliation et l’autonomie. Nous avons également évalué les attitudes des patients vis-à-vis de l’insulinothérapie à l’aide du questionnaire de l’échelle d’évaluation de l’insulinothérapie (Insulin Treatment Appraisal Scale). Les attitudes des médecins généralistes vis-à-vis de l’insulinothérapie ont été évaluées au moyen d’un questionnaire différent.La compétence des patients a été jugée acceptable (14,44/20). Le score se rapportant à l’affiliation était faible, à environ 15,63/30. Les résultats suggèrent que la motivation intrinsèque des patients était inférieure à leur motivation extrinsèque (8,41/15 contre 15,03/20). Du côté des patients, le rejet de la gravité de la maladie (67,5 %) constituait le principal obstacle à la mise en place de l’insulinothérapie. Selon les médecins généralistes, une faible observance (96,7 %) était la principale cause de retard dans la prescription d’insuline.Nous avons observé que les patients ont une mauvaise compréhension de leur maladie. En raison de la faiblesse du score concernant l’affiliation, en tant qu’élément représentant la relation entre les patients et les prestataires de soins, nous soulignons l’importance d’une meilleure sensibilisation des malades et soignants à l’insulinothérapie et de la manière de mettre en place une relation efficace.
Published: 2020

9. Methicillin-resistant Staphylococcus aureus development in intensive care patients

Author: Saed Enabi, Amjad Chamsi Basha, Mohamed Abdelghafour Ali, Ahmad Mamoun Rajab, Tawfik Mamoun Rajab, Nazmus Saquib, Ahmed Abdelgadir, Saleh Qusai Saleh Ayash, and Abdullah Murhaf Al-Khani
Subjects: medicine.medical_specialty, business.industry, Case-control study, General Medicine, 030204 cardiovascular system & hematology, medicine.disease, medicine.disease_cause, Intensive care unit, Comorbidity, Methicillin-resistant Staphylococcus aureus, law.invention, Sepsis, 03 medical and health sciences, 0302 clinical medicine, Staphylococcus aureus, law, Internal medicine, Intensive care, Hospital-acquired infection, medicine, 030212 general & internal medicine, business
Abstract: Objectives : To determine the factors associated with the development of methicillin-resistant Staphylococcus aureus (MRSA), hospital stay and mortality, and early versus late MRSA infection. Methods : Cases (n=44) were intensive care unit (ICU) patients admitted to King Fahd Specialist Hospital, Al-Qassim, Saudi Arabia between 2015 and 2019 who developed MRSA during their hospital stay. Controls (n=48) were patients from the same place and period who did not develop MRSA. Data were abstracted from hospital records. Results : Admission with sepsis (case: 46% vs. control: 2%, p less than 0.001) and having at least one comorbid condition (case: 95% vs. control: 46%, p less than 0.001) were significantly associated with the development of MRSA. Age (mean ±SD: case: 65±18, control: 64±18, p=0.7) and gender (% male, case: 52%, control: 56%, p=0.70) were not associated with the development of MRSA. Approximately 73% of all MRSA cases developed within the first 2 weeks of admission. Among the early cases, 44% died during their ICU stay; the corresponding percentage among the late cases was 42% (p=0.69). There was no difference between early and late MRSA cases in terms of non-sepsis admissions (50% vs. 67%, p=0.32) or comorbid status (at least one: 97% vs. 92%, p=0.17). Conclusion : Sepsis and comorbid conditions were significant risk factors for MRSA development among hospital patients. Saudi Med J 2020; Vol. 41 (11): 1181-1186 doi: 10.15537/smj.2020.11.25465 How to cite this article: Ali MA, Rajab AM, Al-Khani AM, Ayash SQ, Basha AC, Abdelgadir A, Rajab TM, Enabi S, Saquib N. Methicillin-resistant Staphylococcus aureus development in intensive care patients. A case-control study. Saudi Med J. 2020 Nov;41(11):1181-1186. doi: 10.15537/smj.2020.11.25465.
Published: 2020

10. Immunohistochemical Expression of Retinoblastoma Gene Product and p53 Protein in Transitional Cell Carcinoma of the Urinary Bladder and its Relationship to Different Clinicopathological Parameters

Author: Zina A. Rajab Alhamadani, Alaa Qasim Yahya, and Mohanad Mundher
Subjects: medicine.medical_specialty, Bladder cancer, Urinary bladder, business.industry, Urinary system, medicine.medical_treatment, H&E stain, General Medicine, medicine.disease, Gastroenterology, Cystectomy, Transitional cell carcinoma, medicine.anatomical_structure, Internal medicine, Carcinoma, medicine, Bladder stones, business
Abstract: BACKGROUND: Carcinoma of urinary bladder is one of the most common malignancies worldwide and constitutes a major health problem. Multiple risk factors are associated with this tumor and its prognosis will depend on different clinicopathological parameters. Over expression of P53 protein and mutant Rb gene is associated with more aggressive clinical and histopathological features of the tumor such as advanced stage and higher grade. AIM: The immunohistochemical expression of Rb gene and P53 gene will be assessed through their protein products in transitional cell carcinoma (TCC) of the urinary bladder and then will be correlated with other well-known risk factors and prognostic parameters of bladder TCC, such as grading, tumor size, smoking, alcohol drinking, and family history. METHODS: Patients were recruited from the uro-surgical department/Surgical Subspecialties Teaching Hospital during the period from November 2020 through April 2021. In this study, patients enrolled were those suspected to have bladder carcinoma. The work up included a full history and clinical examination. Surgical samples were taken from the patients for histopathological evaluation; the study’s samples represented either endoscopic cup biopsy, transurethral resection of the tumor, or radical cystectomy. Sections obtained from these samples were stained with the conventional hematoxylin and eosin stain. Then, immunohistochemical staining for P53 and pRB was applied only for patients diagnosed with TCC. RESULTS: The differences between low-grade and high-grade tumors regarding pRb percentage score were statistically significant (p = 0.026), but were not significant regarding the intensity score (p = 0.094). There were significant correlations between tumor stage and both pRb intensity and percentage scores (p = 0.044 and 0.042, respectively). Differences between low-grade and high-grade tumors regarding p53 intensity score were significant (p = 0.022). The differences between low-grade and high-grade tumors regarding p53 percentage score were significant (p = 0.049). The differences between different tumor stages regarding p53 intensity score were significant (p = 0.018). The differences between different tumor stages regarding P53 percentage score were significant (p = 0.019). CONCLUSIONS: Tumor’s grade was found to be correlated with the tumor stage with no correlation with the age, gender, smoking, family history of TCC, history of urinary tract infection, bladder stones, nor the recurrence of the tumor. The pRb intensity and the percentage scores were correlated to each other and to tumor’s grade and stage, except for the pRb intensity which showed no correlation with the tumor’s grade. The P53 intensity and percentage scores were correlated to each other and also to tumor’s grade and stage, so that P53 is over-expressed in tumors with higher grade and stage.
Published: 2021

11. Dietary Pattern, Genomic Stability and Relative Cancer Risk in Asian Food Landscape

Author: Michael Fenech, Razinah Sharif, Nor Fadilah Rajab, and Suzana Shahar
Subjects: Risk, Cancer Research, Medicine (miscellaneous), medicine.disease_cause, Genomic Instability, Genomic Stability, food, Neoplasms, Environmental health, Humans, Medicine, Socioeconomic status, Nutrition and Dietetics, business.industry, Incidence, Cancer, food.cuisine, Dietary pattern, medicine.disease, Diet, Review article, Oncology, Asian food, business, Carcinogenesis, Cancer risk
Abstract: The incidence of cancer globally is increasing, partly due to lifestyle factors. Despite a better understanding of cancer biology and advancement in cancer management and therapies, current strategies in cancer treatment remain costly and cause socioeconomic burden especially in Asian countries. Hence, instead of putting more efforts in searches for new cancer cures, attention has now shifted to understanding how to mitigate cancer risk by modulating lifestyle factors. It has been established that carcinogenesis is multifactorial, and the important detrimental role of oxidative stress, chronic inflammation, and genomic instability is evident. To date, there is no study linking dietary pattern and genomic stability in cancer risk in the Asian food landscape. Thus, this present review article discusses recent literature on dietary pattern and genomic stability and its relationship with cancer risk in Asia.
Published: 2021

12. Native Aortic Root Thrombosis After Norwood Palliation for Hypoplastic Left Heart Syndrome

Author: Taufiek Konrad Rajab and Max B. Mitchell
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, medicine.medical_treatment, Thrombolysis, 030204 cardiovascular system & hematology, medicine.disease, Thrombosis, Surgery, Hypoplastic left heart syndrome, 03 medical and health sciences, Catheter, 0302 clinical medicine, 030228 respiratory system, medicine, Retrograde perfusion, Stage (cooking), Cardiology and Cardiovascular Medicine, business, Complication, Cardiac catheterization
Abstract: Background Norwood palliation for hypoplastic left heart syndrome typically results in retrograde perfusion of the native aortic root. This may predispose to native aortic root thrombosis (NART). Methods Patients who underwent stage 1 Norwood palliation at Children’s Hospital Colorado between 2003 and 2019 were retrospectively reviewed for NART. Additional patients were identified by a systematic literature review. Patient factors, operative details, presentation, diagnostic methods, treatments, and outcomes were analyzed. Results Three patients with NART were identified among 241 patients who had undergone stage 1 Norwood palliation at Children’s Hospital Colorado (mean follow-up, 48 months). A fourth patient identified at Children’s Hospital Colorado had undergone stage 1 palliation elsewhere. The systematic literature review identified 12 additional patients. Among the 16 patients, patients presented with new arrhythmias (38% [n = 6]), evidence of ischemia (31% [n = 5]), incidentally (19% [n = 3]), inability to wean from postoperative support (6% [n = 1]), and cardiac arrest (6% [n = 1). The diagnosis was made by transthoracic echocardiography (TTE) in 50% (n = 8), transesophageal echocardiography in 19% (n = 3), cardiac catheterization in 25% (n = 4), and cardiac computed tomography in 6% (n = 1). Importantly, 44% (n = 7) of patients were missed by TTE and subsequently diagnosed by other methods. Treatment strategies were surgical thrombectomy in 38% (n = 6), anticoagulation alone in 38% (n = 6), direct catheter thrombolysis in 19% (n = 3), and systemic thrombolysis in 6% (n = 1). The rate of mortality or transplant listing was 44% (n = 7). Conclusions NART is an underappreciated complication of Norwood palliation with high mortality. There should be a high index of suspicion for NART in patients after Norwood palliation with an unexplained complicated clinical course. Importantly, NART is frequently missed by TTE.
Published: 2021

13. Topographical patterns of whole-brain structural alterations in association with genetic risk, cerebrospinal fluid, positron emission tomography biomarkers of Alzheimer’s disease, and neuropsychological measures

Author: Subapriya Suppiah, Mazlyfarina Mohamad, Albert Dayor Piersson, and Nor Fadilah Rajab
Subjects: Apolipoprotein E, Oncology, medicine.medical_specialty, biology, medicine.diagnostic_test, business.industry, Tau protein, Neuropsychology, medicine.disease, Temporal lobe, Cerebrospinal fluid, Atrophy, Positron emission tomography, Internal medicine, biology.protein, Medicine, Radiology, Nuclear Medicine and imaging, business, Episodic memory
Abstract: This study aimed at investigating the topographical pattern of whole-brain structural alterations in association with apolipoprotein E e4 (APOE e4), cerebrospinal fluid (CSF) [amyloid-beta 42 (Aβ42), and neurofibrillary tau protein], positron emission tomography (PET) biomarkers [Aβ, tau, and 2-[18F]fluoro-2-deoxy-d-glucose (FDG)], and neuropsychological measures. PubMed, Scopus, Ovid, and Cochrane databases were searched. Risk of bias (using a modified Newcastle–Ottawa Scale) and level of evidence were determined. One hundred and thirty-one studies met the inclusion criteria. APOE e4 effect is exerted on the whole-brain. Still, the medial temporal lobe is the most affected, with moderate evidence observed across the lifespan (except late mid-life) and in the AD continuum. Moderate to strong evidence shows that atrophy of AD-vulnerable regions is associated with reduced CSF Aβ42, increased Aβ- and tau-PET, and increased CSF tau. No association between gray matter changes and FDG-PET measures in healthy late mid-life and older adults. Preliminary findings demonstrate a relationship between hippocampal atrophy and lower episodic memory in early life. Moderate evidence of an association between hippocampal atrophy and lower episodic memory is observed in late mid-life. In contrast, hippocampal atrophy is associated with reduced episodic memory and global cognition in older APOE e4 carriers. Strong evidence suggests that atrophy of the AD vulnerable regions is associated with CSF and PET biomarkers and cognitive measures. These relationships may be potentially helpful in characterizing the preclinical and clinical stages of MCI and AD and predicting AD progression.
Published: 2021

14. Switching of Hashimoto Thyroiditis Into Graves’ Disease: A Case Report and Literature Review

Author: Nour Maksoud, Lubana Wannous, Rajab Maksoud, and Samaher Almousa
Subjects: hashimoto thyroiditis, endocrine system, medicine.medical_specialty, Goiter, endocrine system diseases, Graves' disease, Levothyroxine, Physical examination, Gastroenterology, Lethargy, Thyroid peroxidase, Internal medicine, medicine, autoimmune diseases, biology, medicine.diagnostic_test, business.industry, Thyroid, medicine.disease, graves disease, medicine.anatomical_structure, biology.protein, Medicine, business, Hormone, medicine.drug
Abstract: Background: Hashimoto thyroiditis (HT) and Graves’ disease (GD) are autoimmune inflammatory thyroid disorders. The evolution from GD into HT is the most common scenario while the conversion from HT into GD seems to be less common. Case Presentation: A 20-year-old female patient referred to the endocrinology clinic with a three-month history of fatigue, lethargy, lack of appetite, constipation, menorrhagia, cold intolerance, and 5 kg weight gain in the last two months. Clinical examination showed dry skin, scalp hair loss, and painless hard goiter whereas thyroid ultrasound revealed generalized homogeneous hypoechoic thyroid hypertrophy. Laboratory tests demonstrated increased serum thyroid-stimulating hormone (TSH) 210 µIU/L (normal: 0.25-4.50), decreased free thyroxine (FT4) 0.37 ng/L (normal: 0.8-1.8) and free triiodothyronine (FT3) 1.94 pg/mL (normal: 1.8-4.6), and finally, increased thyroid peroxidase antibodies (anti-TPO) 462 IU/mL (normal: up to 34). Based on observations, HT was diagnosed and thus daily treatment with levothyroxine 75 mcg was started for the patient. Two months later, she referred with symptoms suggestive of hyperthyroidism with reduced TSH levels, which did not improve after levothyroxine cessation, thus more laboratory tests were conducted and revealed decreased TSH levels, increased T3 and T4, and TSH receptor stimulating antibody (TSAb)levels, and increased radioactive iodine uptake at 24 hours. Therefore, the diagnosis of GD was made. Five weeks after treatment, she was in full remission. Conclusion: Although the switch from HT into GD is rare, it can occur at any time during the disease. Nonetheless, early diagnosis and treatment would improve the quality of care.
Published: 2021

15. Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

Author: Stephen R Knight, Catherine A Shaw, Riinu Pius, Thomas M Drake, Lisa Norman, Adesoji O Ademuyiwa, Adewale O Adisa, Maria Lorena Aguilera, Sara W Al-Saqqa, Ibrahim Al-Slaibi, Aneel Bhangu, Bruce M Biccard, Peter Brocklehurst, Ainhoa Costas-Chavarri, Kathryn Chu, Anna Dare, Muhammed Elhadi, Cameron J Fairfield, J Edward Fitzgerald, Dhruv Ghosh, James Glasbey, Mark I. van Berge Henegouwen, J.C. Allen Ingabire, T Peter Kingham, Marie Carmela Lapitan, Ismaïl Lawani, Bettina Lieske, Richard Lilford, Janet Martin, Kenneth A McLean, Rachel Moore, Dion Morton, Dmitri Nepogodiev, Faustin Ntirenganya, Francesco Pata, Thomas Pinkney, Ahmad Uzair Qureshi, Antonio Ramos-De la Medina, Aya Riad, Hosni Khairy Salem, Joana Simões, Richard Spence, Neil Smart, Stephen Tabiri, Hannah Thomas, Thomas G Weiser, Malcolm West, John Whitaker, Ewen M Harrison, Arben Gjata, Maria Marta Modolo, Sebastian King, Erick Chan, Sayeda Nazmun Nahar, Ade Waterman, Dominique Vervoort, Alemayehu Ginbo Bedada, Bernardo De Azevedo, Ana Gabriela Figueiredo, Manol Sokolov, Venerand Barendegere, Gerald Ekwen, Arnav Agarwal, Qinyang Liu, Juan Camilo Correa, Kalisya Luc Malemo, Jacques Bake, Jakov Mihanovic, Kamila Kuncarová, Julius Orhalmi, Hosni Salem, Jyri Teras, Aristotelis Kechagias, Alexis P Arnaud, Judith Lindert, Vasileios Kalles, Maria-Lorena Aguilera-Arevalo, Gustavo Recinos, Zsolt Baranyai, Basant Kumar, Harish Neelamraju Lakshmi, Sanoop Koshy Zachariah, Philip Alexander, Sunil Kumar Venkatappa, C Pramesh, Radhian Amandito, Christina Fleming, Luca Ansaloni, Gianluca Pellino, Ahmed M. Altibi, Ibrahim Nour, Intisar Hamdun, Ali M. Ghellai, Donatas Venskutonis, Tomas Poskus, Justas Zilinskas, Precious Malemia, Yong Yong Tew, Elaine Borg, Sarah Ellul, fatima Zahraa Wafqui, David W Borowski, Anne Sophie van Dalen, Cameron Wells, Harissou Adamou, Adesoji Ademuyiwa, Adewale Adisa, Kjetil Søreide, Sara Al Saqqa, Osaid Alser, Haya Tahboub, Helmut Alfredo Segovia Lohse, Sebastian Shu Yip, Piotr Major, António Sampaio Soares, Matei Razvan Bratu, Andrey Litvin, Armen Vardanyan, JC Allen Ingabire, Ahmad Gudal, Naif Albati, Jovan Juloski, Miran Rems, Sarah Rayne, Stephanie Van Straten, Yoshan Moodley, Irene Ortega Vázquez, Jaime Ruiz-Tovar, Kithsiri Janakantha Senanayake, Sujeewa Priyantha Bandara Thalgaspitiya, Omer Abdelbagi Omer, Anmar Homeida, Yucel Cengiz, Daniel Clerc, Muhammad Alshaar, Hanen Bouaziz, Yuksel Altinel, Matthew Doe, Maryna Freigofer, Ella Teasdale, Rakan Kabariti, Joshua Michael Clements, Stephen Richard Knight, Ahsan Ashfaq, Ijeoma Azodo, Gabriela Wagner, Ivan Trostchansky, Mayaba Maimbo, David Linyama, Helidon Nina, Amanda Zeko, Claudio Gabriel Fermani, Santiago Villalobos, Federico Carballo, Pablo Farina, Sebastian Guckenheimer, Marilla Dickfos, Ankit Ajmera, Chester Chong, Ralph Gourlay, Sikandar Hussaini, Yi Jia Lee, Adeeb Majid, Peter Martin, Rebecca Miles, Owen James Morris, Jamie Phua, William Ridley, Tarunpreet Saluja, Ryan Renxin Tan, Jen Teh, Anna Wells, Bharti Arora, Qaasim Dollie, Debbie Ho, Yanru Ma, Omattage Mahasha Perera, Anthony Truong, Amanda Caroline Dawson, Bryan Lim, Upuli Pahalawatta, Jacqueline Phan, Xiao-Ming Sarah Woon-Shoo-Tong, Andrea Yeoh, Lillian Charman, Andrew Drane, Sharon Laura, Charmaine Chu Wen Lo, Amy Mozes, Rita Poon, Hao Han Tan, Ellen Wall, Prakshi Chopra, Jasmine De Giovanni, Bal Dhital, Brian Draganic, Alexander Duller, Jonathan Gani, Yao Kuan Goh, Jun Young Jeong, Brendan McManus, Prakash Nagappan, Peter Pockney, Anya Rugendyke, Mahsa Sarrami, Stephen Smith, Vanessa Wills, Hsu Ven Wong, Geoffrey Ye, Geoffrey Zhang, Ethan Brooker, Daniel Feng, Bonnie Lau, Carlin Ngai, Sarah Birks, David Gyorki, Jaime Otero de Pablos, Ali Abbosh, Chris Gillespie, Ahmed Mahmoud, Bianca Kwan, Joshua Lawson, Andrea Warwick, Janne Bingham, Andrew J Cockbain, Nagendra Naidu Dudi-Venkata, Jordan Ellaby-Hall, Ben Finlay, Emily Humphries, Jade Pisaniello, Monique Pisaniello, Salma Salih, Tarik Sammour, Haidar Hadri Abd Wahab, April De Silva, Nicola Hayward, Kartik Iyer, Guy Maddern, Gian Andrea Prevost, Naga Annapureddy, Krishna Pranathi Settipalli, Jeremy Yeo, Lucy Hempenstall, Lily Pham, Shaun Purcell, Cherry Talavera, Ashish I Vaska, Gurpreet Chaggar, Phillip Chrapko, Annelise Cocco, Sarah Michelle Crystal Jade Coulter-Nile, Grahame Ctercteko, James French, Houchen Gong, Martijn Gosselink, Thuvarahan Jegathees, Ivan Jin, Michelle Kalachov, Kathryn Kiefhaber, Katherine Lee, Jason Luong, Steven Phan, Henry Pleass, Kelly Veale, Zhi Zeng, Angela Au, Ashe DeBiasio, Idy Deng, Jananee Myooran, Amrita Nair, Peter Stewart, Anton Stift, Lukas Walter Unger, Kerstin Wimmer, Nabila Ahmed, Syed Hasan, Saber Rahman, Margaret O'Shea, Greg Padmore, Adrian Peters, Pietro Perduca, Guenda Pulcina, Nicolas Tinton, Frederic Buxant, Elsa Dabin, Giulia Garofalo, Francis Dossou, Freddy Houehanou Rodrigue Gnangnon, Yacoubou Imorou Souaibou, Pako Motlaleselelo, Omphile Tlhomelang, Igor Lima Buarque, Gustavo Mendonça Ataíde Gomes, Aldo Vieira Barros, Ilia Batashki, Nikolai Damianov, Vladislav Stoyanov, Dragomir Dardanov, Svilen Maslyankov, Plamen Petkov, George Todorov, Evgeni Zhivkov, Aygulya Akisheva, Miguel Angel Castilla Moreno, Geno Genov, Ivelina Ilieva, Tsvetomir Ivanov, Martin Karamanliev, Azhar Khan, Emil Mitkov, Tsanko Yotsov, Boyko Atanasov, Nikolay Belev, Mihail Slavchev, Carlos Nsengiyumva, Elgan Jones, Simon Stock, Steve Kyota, James Brown, Tresor Mabanza K., Lemery Nigo Samuel, Chidi Otuneme, Ngwang Prosper, Franklin Umenze, Marylise Boutros, Natasha Caminsky, Sinziana Dumitra, Richard Garfinkle, Dominique Morency, Ebram Salama, Alexander Banks, Lorenzo Ferri, Haitian He, Amit Katz, Alexander Sender Liberman, Sarkis Meterissian, Allison Pang, Elena Parvez, Usmaan Hameed, Fahima Osman, Sangita Sequeira, Natalie Coburn, Alisha Jaffer, Paul Karanicolas, Matthew Mosseler, Reilly Musselman, Xinyuan Liu, Ching Wan Yip, Juan Sebastian Garces-Otero, Carolina Guzman, Sebastian Sierra, Andres Uribe Valencia, Paulo Andrés Cabrera Rivera, Saul Camelo, Andrea Gonzalez, Alejandro González-Orozco, Manuel Santiago Mosquera Paz, Carlos J- Perez Rivera, Felipe Gonzalez, Andres Isaza-Restrepo, Laura Nino- Torres, Natalia Arias Madrid, Maria Clara Mendoza Arango, Justin Tsandiraki, Damir Jemendžic, Branislav Kocman, Oliver Šuman, Renata Canic, Darko Jurišic, Ivana Karakas, Ana Krizanovic Rupcic, Vlatka Pitlovic, Josip Samardžic, Mario Kopljar, Ivan Bacic, Edgar Domini, Robert Karlo, Danijela Miljanic, Andrea Simic, Mariam Ahmed, Majdi Al Nassrallah, Rabiya Altaf, Talal Amjad, Ruba Eltoum, Heba Haidar, Alhassan Hassan, Omar Khalil, Marwan Qasem, Rommel Ramesh, Gautham Sajith, Maham Wisal, Jan Žatecký, Michele Bujda, Katerina Jirankova, Ales Paclik, Aya Abdallah, Mariam Abdulgawad Almogy, Esraa Ayman El-sawy, Ahmed Moustafa ElFayoumy, Nourhan Elghareeb, Nourhan Ahmed Esmat, Ahmed Fadel, Abdullah Habater, Heba Hamdy, Amr Hefni, Marwa Kamal, Norhan Mohamed Abobakr, Ahmed Sayed, Nancy Shaker, Ehab Taha, Hoda Tharwat, Omar Zakaria, Ibrahem Abdelmotaleb, Ali Al-Dhufri, Hamza S. Al-Himyari, Enas El sheikh, Asmaa Eldmaty, Aya Elkhalawy, Ahmed M.Elkhashen, Kithara Magdy, Safa Mostafa, Habib Doutoum Sadia, Mohamed mahmoud Saleh, Dina Samir, Mohamed Yahia Mohamed Ali, Mahmoud A. Nassar, Samar Abdelhady, Aly Abdelrazek, Israa Abdelsalam, Aya El-Sawy, Eman Essam, Mohamed Gadelkarim, Khaled Ghaly, Mohamed Hassabalnaby, Rana Masarani, Nourhan Mohamed Shaaban, Ahmed Sabry, Menatalla Salem, Nourhan Akram Soliman, Diaaaldin Zahran, Moustafa Ramadan Abou El.soud, Esraa Tarek Badr, Hala Borham, Nehal Elmeslemany, Mohammad Elsayed, Fawzia Elsherif, Sara Eslam, Gehad Gaber, Sondos Ibrahim, Yara Kamh, Abdelrahman Mahmoud, Shimaa gamal Mohamed, Eman Morshedy, Cinderella Omar, Fatima Salem Soliman, Shaza Abdelkawy, Naglaa Abdelmohsen, Mahmoud Abdelshakour, Ahmed Dahy, Norhan Gamal, Mohammed Gamal, Ahmad Hasan, Helal Hetta, Nehad Mousa, Mohamed Omar, Somia Rabie, Mahmoud Saad, Bakeer Saleh, Marwa Sayed Mohamed, Muhammad Shawqi, Heba Abdelhady Mousa, Mostafa Alnoury, Mohamed Elbealawy, Ahmed Elshafey, Muhammad Essam Ibrahim El Desouki Muhammad Ahmed, Mennatullah Ghonaim, Fawzy Hgag, Mohamed Ibrahim, Mahmoud Morsy, Mohamed Reda Loaloa, Ahmed Refaat, Hadeer Samir, Fatma Shahien, Mohamed Sobhy, Fathy Sroor, Esraa Abdellatif, Marina Adel, Amr Abdelghani Afifi, Eman Afifi, Marco Antaky, Amr Dawoud, Naira El Zoghby, Amira El-remaily, Ali Abdelazez Elzanfaly, Ahmed Gadallah, Fatma Alzahraa Gamal, Omar Hashem, Shrouk Medhat Youssef, Aliaa Muhammad Attyah, Malak Munir, Omar Shazly, Esraa Taha, Karim Wilson, Sawsan Adel, Asmaa Ali, Esraa Eid, Esraa Elhelow, Marwa Elmahdy, Bassant Elshatby, Amany Hossam el-din Zakaria, Ahmad Hossny, Eman Ibrahim, Ahmed M.Yonis, Maram Metwalli, Basant Yousry, Esraa Zid, Mina A Yacoub, Ahmed Abdelhakim, Nervana Abouelsoad, Mo'min Alkhatib, Ahmed Ashraf, Alaa Ashraf, Yasmin Elazab, Mahmoud Elfanty, Osama Elkabir, Mai Elsayed, Ahmed Elshimy, Hager Elsobky, John Eskander, Ahmed Gad, Ward Hamsho, Noura Khaled Abdelwahed, Menna Magdy, Dalia Moharam, Abeer Osama, Shereen Ramadan, Radwa Roum, Taqwa Sayed, Tarneem Shehada, Ahmed Mohy Zidan, Khalid Abbas, Amr Ali, Mohamed Attia, Mohamed Balata, Ayman El Nakeeb, Mohamed Ibrahim Elsayed Elewaily, Ahmed Elfallal, Hossam Elfeki, Ahmed Elkhadragy, Sameh Emile, Helmy Ezzat, Hasnaa Hosni, Islam Mansour, Waleed Omar, Gehad Othman, Kareem Sadek, Mostafa Shalaby, Noura Shehab-Eldeen, Rawda Anas khalifa, Helmy Badr, Mostafa Eldeep, Ahmed Eldeep, Amany Eldoseuky mohammed, Salwa Khallaf, Eman Magdy Hegazy, Rokia Mahmoud, Pola Mikhail, Mahmoud Morsi, Sara Mowafy, Dina Raafat, Amina Safy, Marwa Sera, Ahmed shible Sera, Mostafa Salim Mohamed AbdAllah, Muhammad Abdelkader, Abdulrahman Osama Abdou, Ahmedgaber Ahmed, Shireen Gaafar, Fatma Ibrahim negm, Mina Lapic, Ahmed Maher, Hagar Mahmoud, Ahmed Mostafa, Mohamed Samir, Fatma Samy, Nourhan Semeda, Hind I. Shalaby, Alaa El-taweel, Ahmed Galal Elnagar, Ahmed Gamal Hemidan, Mohamed Hussein, Ahmed.A. Kandil, Mf Moawad, Ayat Allah Nasser Hamamah, Mostafa Soliman, Mohamed Abdelkhalek, Noura Abdelmaksoud Tawakel, Ahmed Mohamed Abdelwahed, Alrawy Abdou, Khalid Atallah, Mohammed Yasser Elsherbeny, Eman Emara, Mohamed Hamdy, Omar Hamdy, Amira Haron, Salma Ismail, Islam Hany Metwally, Nihal Mohamed Hamed Elgaml, Ahmed Nassar, Basel Refky, Mirna Sadek, Mahmoud Saleh, Asmaa Yunes, Mai Zakaria, Mohammed Zuhdy, Notila Fayed, Mohammed Mustafa Hassan Mohammed, Sander Kütner, Priit Melnik, Indrek Seire, Toomas Ümarik, Eppu Ainoa, Verner Eerola, Hanna Koppatz, Laura Koskenvuo, Ville Sallinen, Sini Takala, Jevgeni Katunin, Arto Turunen, Niki Christou, Muriel Mathonnet, Vincent Lavoue, Krystel Nyangoh Timoh, Lucie Soulabaille, Romain Lesourd, Aude Merdrignac, Laurent Sulpice, Benoît André, Elodie Chantalat, Charlotte Vaysse, Bertrand Dousset, Sebastien Gaujoux, Gregory Martin, Octavian Clonda, Domantas Juodis, Klaus Kienle, Andras Mravik, Samuel Palmer, Gabor Szabadhegyi, Anita Eseenam Agbeko, Solomon Gyabaah, Frank Enoch Gyamfi, Nuhu Naabo, Atta Owusu senior, Joseph Yorke, Frank Owusu, Francis Abantanga, Theophilus Teddy Kojo Anyomih, Abdul-Jalilu Mohammed Muntaka, Emmanuel Owusu Abem, Mohammed Sheriff, Paul M. Wondoh, Dimitrios Balalis, Dimitrios Korkolis, Georgios Gkiokas, Eirini Pantiora, Theodosios Theodosopoulos, Argyrios Ioannidis, Konstantinos Konstantinidis, Sofia Konstantinidou, Nikolaos Machairas, Anna Paspala, Anastasia Prodromidou, Christos Chouliaras, Konstantinos Papadopoulos, Ioannis Baloyiannis, Ioannis Mamaloudis, George Tzovaras, Ioanna Akrida, Maria-Ioanna Argentou, Stylianos Germanos, Evangelos Iliopoulos, Ioannis Maroulis, George Skroubis, George Theofanis, Christos Chatzakis, Orestis Ioannidis, Lydia Loutzidou, Panagiotis Karathanasis, Nikolaos Michalopoulos, Charalampos Theodoropoulos, Dimitrios Theodorou, Tania Triantafyllou, Zoe Garoufalia, Natasha Hasemaki, Michalis Kontos, Gregory Kouraklis, Stylianos Kykalos, Theodore Liakakos, Eustratia Mpaili, Alexandros Papalampros, Dimitrios Schizas, Athanasios Syllaios, Ekaterini Christina Tampaki, Antonios Tsimpoukelis, Maria Ioanna Antonopoulou, Eirini Deskou, Dimitrios K. Manatakis, Dimitrios Papageorgiou, Menelaos Zoulamoglou, Christos Anthoulakis, Michalis Margaritis, Nikolaos Nikoloudis, Veronica Campo, André Ceballos, Mario-Andrés Flores, Waleska Giron, Donghyun Ko, Gabriel Martinez, Verónica Rivera Lara, Nataly Rueda, Andres Sanchez, Jorge Carlos Guillermo Tejeda Garrido, Alvaro Eduardo Alvarez Rivera, Elvis Benjamin Bamaca Ixcajoc, Lilian Elizabeth Barreda Zelaya, Patricia Chacòn-Herrera, Ligia Margarita Corea Ruiz, Guillermo Echeverria-Davila, Mario Garcia, Danilo García, Edgar Fernando Gutiérrez Mayen, Noriega José, Nery Mazariegos, Diego Méndez, Michael Paniagua Espinoza, David Bardos, Marton Benke, Kristof Illes, Balint András Kokas, Réka Szabó, Akhila Appukuttan, Anjitha Asok, Vijaykumar D.k, Kapil Malik, Praveen Ravishankaran, Ritesh Tapkire, Guru Moorthy, Joyner Abraham, Ramesh Muthuvel, John Alapatt, Abhay Kattepur, Nizamudheen Pareekutty, Mebanshanbor Garod, Caleb Harris, Cliff Wanniang, Ashish Gupta, Deepak Nehra, Sanjeev Parshad, Rajgopal Acharya, Rajendra Badwe, Manish Bhandare, Urvashi Jain, Karishma Kirti, Nita Nair, Shailesh Shrikhande, Purvi Thakkar, Premkumar Anandan, Archana C S, Arun Holenarasipur Narasannaiah, Tejaswi Jagarlamudi, Rashmi M R, Mallikarjuna Manangi, Abhishek Raghavendra, K. Seshagiri Rao, Vinay S, Vinay Sajjan, Aneesh Shenoy, Santhosh Shivashankar Chikkanayakanahalli, Kavya Tharanath, Sushmita V, Peter Adidharma, Raksheeth Agarwal, Phebe Anggita Gultom, Ghafur Rasyid Arifin, Matthew Billy, Zatira Elfizri, Alessa Fahira, Devi Felicia, Triana Hardianti Gunardi, Nadya Johanna, Nadia Rahmadiani Nugrahadi, Sonar Soni Panigoro, Siti Rahmayanti, Retta Catherina Sihotang, Santi Yuanita Brata, Hadi Winoto, Nastaran Barati, Manoochehr Karami, Hamidreza Khorshidi, Homa Naderifar, Mazin A. Abdulla, Maggie Coleman, Ronan J Doherty, Rob Hannon, Brenda Murphy, Aine Stakelum, Des Winter, Lylas Aljohmani, Richard Farnan, Yeshey Seldon, Tanna Tan, Shriya Varghese, Mohammad Alherz, Muaaz Ather, Mohammad Bajilan, Vivien Graziadei, Isobel Pilkington, Omar Quidwai, Paul Ridgway, Haaris Shiwani, Abd al-Rahman Tahir, Eimear Blunnie, Daniel Burke, Niall Kennedy, Kate Macdonagh, Maeve O'Neill, Siobhan Rooney, Giuseppe Falco, Guglielmo Ferrari, Simone Mele, Gabriela Elisa Nita, Lara Ugoletti, Maurizio Zizzo, Gianmaria Confalonieri, Giovanni Pesenti, Fulvio Tagliabue, Gianluca Baronio, Deborah Ongaro, Giacomo Pata, Bruno Compagnoni, Renato Salvadori, Lucio Taglietti, Nicola D'Alessandro, Pierpaolo Di Lascio, Giovanni Pascale, Luca Bortolasi, Tommaso Campagnaro, Massimo Carlini, Giorgio Lisi, Davide Lombardi, Corrado Pedrazzani, Domenico Spoletini, Giulia Turri, Paola Violi, Donato Francesco Altomare, Fabrizio Aquilino, Nicola Musa, Vincenzo Papagni, Arcangelo Picciariello, Leonardo Vincenti, Dario Andreotti, Savino Occhionorelli, Matteo Tondo, Stefano Maria Massimiliano. Basso, Riccardo Cirelli, Marco Enrico Mario Maino, Guglielmo Niccolò Piozzi, Emanuele Picone, Rosa Scaramuzzo, Giovanni Sinibaldi, Alfonso Amendola, Lorenzo Anastasio, Luigi Bucci, Emanuele Caruso, Antonio Castaldi, Sara Di Maso, Vincenza Paola Dinuzzi, Giovanni Esposito, Maria Gaudiello, Mariano Cesare Giglio, Paola Antonella Greco, Gaetano Luglio, Andrea Manfreda, Ester Marra, Federica Mastella, Gianluca Pagano, Roberto Peltrini, Vincenzo Pepe, Michele Sacco, Viviana Sollazzo, Giovanni Spiezio, Ettore Cianchetti, Nunzia Menduni, Michele Maria Carvello, Francesca Di Candido, Antonino Spinelli, Fabio Corsi, Luca Sorrentino, Fabio Marino, Emanuele Luigi Giuseppe Asti, Luigi Bonavina, Emanuele Rausa, Martina Asta, Andrea Belli, Francesco Bianco, Carmela Cervone, Paolo Delrio, Armando Falato, Andrea Fares Bucci, Rita Guarino, Ugo Pace, Daniela Rega, Emilia De Luca, Gaetano Gallo, Giuseppe Sammarco, Giuseppe Sena, Giuseppina Vescio, Letizia Santandrea, Giampaolo Ugolini, Davide Zattoni, Nicola Chetta, Gaetano Logrieco, Serafino Vanella, Gianluca Garulli, Nicola Zanini, Andrea Bondurri, Francesco Cammarata, Francesco Colombo, Diego Foschi, Giulia Maria Beatrice Lamperti, Anna Maffioli, Gianluca Matteo Sampietro, Al'ona Yakushkina, Gloria Zaffaroni, Enrico Cicuttin, Maria Grazia Sibilla, Harmony Impellizzeri, Marco Inama, Gianluigi Moretto, Sylvie Mochet, Elisa Ponte, Antonella Usai, Stefano Mancini, Andrea Sagnotta, Luigi Solinas, Elisa Bolzonaro, Nicolò Tamini, Gianluca Curletti, Raffaele Galleano, Michele Malerba, Sofia Campanella, Gianfranco Cocorullo, Francesco Colli, Paolino De Marco, Nicolò Falco, Tommaso Fontana, Leonel jospin Kamdem Mambou, Antonella La Brocca, Leo Licari, Brenda Randisi, Giovanna Rizzo, Giulia Rotolo, Giuseppe Salamone, Roberta Tutino, Paolina Venturelli, Stefano Malabarba, Alessandro Sgrò, Ivan Vella, Bruno Cirillo, Daniele Crocetti, Giorgio De Toma, Pierfrancesco Lapolla, Andrea Mingoli, Paolo Sapienza, Angela Belvedere, Stefania Bianchini, Margherita Binetti, Arianna Birindelli, Valeria Tonini, Mauro Podda, Fabio Pulighe, Michele De Rosa, Lorenzo Bono, Felice Borghi, Paolo Geretto, Maria Carmela Giuffrida, Corrado Lauro, Alessandra Marano, Luca Pellegrino, Paola Salusso, Diego Sasia, Michela Campanelli, Alberto Realis Luc, Mario Trompetto, Roberto Cardia, Nicola Cillara, Antonio Nicola Giordano, Antonio Costanzo, Mario Alessandro Giovilli, Luca Turati, Silvestro Canonico, Guido Sciaudone, Francesco Selvaggi, Lucio Selvaggi, Nader Albsoul, Ahmad AlBsoul, Ala'a Aldeen Alkhatib, Osama Alsallaq, Justin Z. Amarin, Rami Ayoub, Isam Bsisu, M S El Muhtaseb, Mohammad Jabaiti, Jamal Melhem, Yasmeen Z. Qwaider, Mohammad Hasan Salameh, Ahmad Suleihat, Haya H. Suradi, Mohammad Alammarin, Almoutuz Aljaafreh, Mohammad Bani hani, Zeina Bani hani, Farah Bani Hani, Toqa Fahmawee, Shadi Hamouri, Cyrine Katanani, Ra'fat Tawalbeh, Tamara Tawalbeh, Hassan Zawahrah, Mohamad K. Abou Chaar, Lana Abusalem, Mahmoud Al-Masri, Hani Al-Najjar, Lutfi Barghuthi, Zahra Ahmed, Adnan Maulana, Omar Ngotho, Charbel Kamau, Aruyaru Stanley Mwenda, Fridah Bosire, Elizabeth Mwachiro, Robert Parker, Ian Simel, Kimutai Sylvester, Abdulmunem Ahmed Mustafa Althini, Sofian Elbarouni, Aya Elseed Elbeshina, Ahmed Gwea, Ans Malek, Wedad Albashir Masoud Farag, Abdulwahab Abdalei, Abu Baker Abdel Malik, Areej Abo-khammash, Ma'aly Abuhlaiga, Nour Adnan, Marwa Albaggar, Asma Alfitory, Asma Aljanfi, Fakhruddin Almuzghi, Zohoor Altumei, Fatima Alzabti, Hana Ashoushan, Mohamed Assalhi, Joma Azzubia, Sondos Bnhameida, Malik Delhen, Houssein Elshafei, Hana Elteir, Fatima Esbaga, Abdel Aziz Gobbi, Fatma Hamouda, Hamdan Hilan, Rania Ismail, Fieruz Jebran, Muataz Kasbour, Galia Maderi, Saja Mohammad, Burooj Mohammed, Habib Murtadi, Hamassat Mustafa, Mohamed Rajab, Sarah Trenba, Mariam Wafaa, Eman Al Sagheir, Alabas Almigheerbi, Ahmed Alzahaf, Sumayyah Ghayth Bahroun, Najah Ben Dallah, Mahmoud Elshaibani, Haitem Eswaye, Maha Karar, Samah Omar, Eman Younes, Maha Younes, Dafer Zreeg, Saleh Abujamra, Firas Ashour, Mala Elgammudi, Wesal Omar F. Aljadidi, Enas Saddouh, Randa Sharif, Aya Alabuzidi, AbdulMawlay Alwerfally, Sarra Aribi, Fatma Bibas, Taha Elfaituri, Yasmine Elhajjaji, Ala Khaled, Wegdan Khalil, Tesneem Layas, Enas Soula, Ahmed Tarek, Muad fathi khalleefah Abu hallalah, Hazem Abdelkarem Ahmed, Tagwa Alsharef, Abdulsalam Ali Ben Saoud, Tasnim El Gharmoul, Ahmed Elhadi, Safa Elrais, Abdulhalim Shebani, Heba Zarti, Asaid Zeiton, Marijus Ambrazevicius, Nerijus Kaselis, Migle Stakyte, Oleg Aliosin, Agne Cizauskaite, Sarunas Dailidenas, Vitalijus Eismontas, Migle Kybransiene, Vitalija Nutautiene, Narimantas Samalavicius, Dainius Simcikas, Algirdas Slepavicius, Albinas Tamosiunas, Nerijus Ubartas, Paulius Zeromskas, Saulius Bradulskis, Edvinas Dainius, Juozas Juocas, Egle Kubiliute, Juozas Kutkevicius, Aurimas Opolskis, Audrius Parseliunas, Andrejus Subocius, Egle Virbickaite, Diana Zuikyte, Algirdas Bogusevicius, Kristina Buzaite, Daiva Cepuliene, Ieva Cesleviciene, Vaidotas Cesna, Jolanta Gribauskaite, Povilas Ignatavicius, Mantas Jokubauskas, Monika Liugailaite, Ernest Margelis, Ruta Mazelyte, Lina Pankratjevaite, Matas Pažusis, Agne Rackeviciute, Justina Saladyte, Monika Škimelyte, Vygintas Šlenfuktas, Monika Sudeikyte, Algimantas Tamelis, Tomas Vanagas, Žygimantas Žumbakys, Aivaras Atkociunas, Audrius Dulskas, Justas Kuliavas, Justas Birutis, Sigitas Paškevicius, Mindaugas Šatkauskas, Donatas Danys, Matas Jakubauskas, Lina Jakubauskiene, Marius Kryzauskas, Vytautas Lipnickas, Gabija Makunaite, Fanjandrainy Rasoaherinomenjanahary, Herizo Rasolofonarivo, Luc Hervé Samison, Bitiel Banda, Vanessa Msosa, Ahmad Imran Ahmad Izzuddin, Andre Das, Ying Yee Gan, Tan Shong Sheng, Jia yng Siaw, Mohd Fadliyazid Ab Rahim, Dyg Zahratul Hamrak Abang Jamari, Nurfariza Che Husin, Muhd Yusairi Kamarulzaman, Yi Ping Lim, Nil Amri Mohamed Kamil, Mohd Razeen Mohd Hassan, Saidah Mohd Sahid, Johari Mustafa, Elaine Hui Been Ng, Wan Khamizar Wan Khazim, Ng Chang Ern, P.g. Lingeshan, Syariz Ezuan Sulaiman, Sue Ean Ang, Muhammad Navid Bin Mohamad Sithik, Yih Jeng Cheong, Mahadevan Deva Tata, Law Jia Xian, Aravinthan Kadravello, I-Ern Koh, Li-Yen Ng, Yuki Julius Ng We Yong, Kandasami Palayan, Chi Xuan Sam, Phuah Siow Jin, Jeremy Tan Ern Hwei, Yita Tang, Alvin Zubin Ter, Michael Pak-Kai Wong, Andee Dzulkarnaen Zakaria, Zaidi Zakaria, Fitjerald Henry, Thyivya Kalaiselvan, Muhammad Fairuz Shah Abd Karim, Mohamed Rezal Abdul Aziz, Nora Abdul Aziz, Tak Loon Khong, Peng Choong Lau, Hiong Chin Lim, April Camilla Roslani, Jonathan Chen Ken Seak, Sui-Weng Wong, Lai Fen Wong, Leow Yeen Chin, Mercy Chinemerem Anyanwu, Zachary Busuttil, Thomas Calleja, Kurt Lee Chircop, Ruth Cutajar, Andrew Michael Dimech, Joseph Galea, Kiara Gascon Perai, Ruth Gatt, Lisa Kelman, Elizabeth Micallef, Favour Nwolu, Kim Sammut, Joanna Thompson, Sean Warwicker, Matthew Zammit, Fernando Cordera, Efraín Cruz González, Jorge Sánchez-García, Francisco José Barbosa Camacho, Francisco Javier Barrera López, Carlos Jose Zuloaga Fernandez del Valle, Eric Acosta, Iván Romarico González Espinoza, Perla Moreno, Ana Olivia Cortes-Flores, Clotilde Fuentes Orozco, Alejandro Gonzalez Ojeda, Samantha Corro Díaz González, Laura Martinez, Bonifacio Mosqueda Amador, Armando Novoa, Dennet Arturo Olazo Espejo, Alejandro Jimenez, Federico Lopez Rosales, Elva Gabriela Vanoye, Luis Alberto Garcia Gonzalez, Roberto Carlos Miranda-Ackerman, Manuel Solano-Genesta, Alethia Alvarez-Cano, Hector Hugo Romero-Garza, Heriberto Medina-Franco, Lorelí Mejía-Fernández, Noel Salgado-Nesme, Omar Vergara-Fernandez, Guadalupe Montserrat Gutiérrez-Mota, Francisco Xavier Hernandez Vera, Anabella Llantada Lopez, Gilberto Morgan Villela, Felipe de Jesus Ramirez Padilla, Walezka Tapia Marin, Mónica Martínez Maldonado, Ramses Sánchez Suárez, José Manuel Troche, Chaymae Benyaiche, Oumaima Outani, Souadka Amine, Amine Benkabbou, Anass Mohammed Majbar, Raouf Mohsine, Ali Rafik, Thida Oung, Moe Moe Tin, Philipp Plarre, Anna Alberga, Nina Sluiter, Jurriaan Tuynman, Robin Blok, Didem Cömert, Roel Hompes, Marianne Kalff, Merel Elisabeth Stellingwerf, Pieter Tanis, Mark van Berge Henegouwen, Elise Maria van Praag, Daan Wisselink, Michael Gerhards, Josephine Lopes Cardozo, Emma Westerduin, Joske de Jonge, Aaw van Geloven, Kaz van Schilt, Frank den Boer, Simone Stoots, Stijn Vlek, Jamie Adams, Ibrahim S. Al-Busaidi, Gabrielle Budd, Seung il Choi, Michael Jen Jie Chu, Anurag Ganugapati, Lucy McKinstry, Rebecca Pascoe, Simon Richards, Kenrick Rosser, Annie Stevenson, Rebecca White, Shebani Farik, Jin Kwun, Ahmed Murad, Sarah Cowan, Timothy Hall, Michael Hayton, Laminou Malam Sani, Souleymane Oumarou Garba, Ibrahim Amadou Magagi, Oumarou Habou, Halima Aliyu, Muhammad Daniyan, Tunde T. Sholadoye, Lawal Abdullahi, Lofty-John Anyanwu, Aminu Mohammad Mohammad, Abubakar Bala Muhammad, Abdurrahman Abba Sheshe, Ibrahim Suleiman, Alaba Adesina, Ajibola Awolowo, Clement Onuoha, Omotayo Salami, Ogechukwu Taiwo, Agboola Taiwo, Stephen Kache, Jerry Godfrey Makama, Danjuma Sale, Olajide Abiola, Akinlabi Ajao, Anthony Ajiboye, Amarachukwu Etonyeaku, Julius Olaogun, Ademola Adebanjo, Opeoluwa Adesanya, Michael Olatunji Afolayan, Olanrewaju Balogun, Ayomide Makanjuola, Samuel Nwokocha, Rufus Wale Ojewola, Thomas Olagboyega Olajide, Adewale Aderounmu, Abdul-Rashid Adesunkanmi, Augustine Agbakwuru, Adeleke Akeem Aderogba, Olusegun Isaac Alatise, Olukayode Arowolo, Oladejo Lawal, Tajudeen Mohammed, Chinedu Ndegbu, Olalekan Olasehinde, Funmilola Wuraola, Akinbolaji Akinkuolie, Arinzechukwu Mosanya, Omobolaji Ayandipo, Peter Elemile, Taiwo Akeem Lawal, Samuel Ali SANI, Stephen Garba, Rebecca Hauwa SANI, Samson Olori, Henry Onyebuashi, Ifeanyi Umoke, Adedire Adenuga, Ademola Adeyeye, Olufemi Habeeb, Bashir Lawal, Abdulrasheed Nasir, Eirik Kjus Aahlin, Didrik Kjønås, Elisabeth Myrseth, Jibran Abbasy, Abdul Alvi, Omair Saleem, Asma Afzal, Anam Nazir, Muhammad Farooq, Ayesha Liaqat, Syed Asghar Naqi, Ali Raza, Muzna Sarfraz, Muhammad Sarwar, Muntaha Banglani, Ambreen Munir, Rahmat Sehrish, Bushra Ayub, Raza Sayyed, Amna Altaf, Saima Ayub, Komal Saeed, Bilal Syed, Sana Amir Akbar, Abdul Wahid Anwer, Ruqayya Naheed Khan, Amina Iqbal Khan, Shahid Khattak, Sameen Mohtasham, Muhammad Asad Parvaiz, Aamir Ali Syed, Abdul Basit Ansari, Noman Shahzad, Tanwir Khaliq, Isbah Rashid, Shahzad Hussain Waqar, Hasan Abu Al-saleem, Amjad Abu Alqumboz, Mohammad Alqadi, Adham Amro, Rawan Assa, Eman Awesat, Rawan Ayyad, Mohammed Hammad, Ayat Haymony, Bassel Hijazi, Bara Hmeidat, Rowaa Lahaseh, Aseel Qawasmi, Alaa Rajabi, Mohammed Shehada, Sundus Shkokani, Yasmine Yaghi, Nadine Yaghi, Mohammad AlZohour, Mohammad Farid, Yousef Mahmoud Habes, Wesam Juba, Yanal Nubani, Abdelrahman Rabee, Mohammad Sa'deh, Saeed Abed, Iyad Al basos, Mohammad Alswerki, Dina Ashour, Israa Awad, Samar Diab, Alaa El Jamassi, Sahar El-Kahlout, Somaya Elhout, Ahmed N K Hajjaj, Doaa Hasanain, Baraa Nabil hajjaj, Mohammed Obaid, Eman Saikaly, Ahmed Salhi, Hiba Al-Tammam, Murad Almasri, Muath Baniowda, Doha Beshtawi, Ali Horoub, Rami Misk, Bayan Mohammad, Rami Qasrawi, Tasnim Sholi, Samar Abu-Nimeh, Abrar Abu-srour, Sadi A. Abukhalaf, Samer Adawi, Barah Alsalameh, Kholoud Ayesh, Muawiyah Elqadi, Ahmad Hammouri, Fatima Karim Mustafa, Natalie Marzouqa, Shatha Melhem, Dima Miqdad, Balqees Mohamad, Mhammed Rawhi, Ayman B. Abu Ahammala, Ahmed Abu Ataya, Israa Abu Jayyab, Samar Al-Shwaikh, Othman Alagha, Mohammed Alasttal, Haneen Awadallah, Mahmood Elblbessy, Jehad Fares, Akram Jarbou, Ibtisam Mahfouz, Moath A. Albahnasawi, Asmaa' Abo mahadi, Hasan Abuelhatal, Ayham Abuelqomboz, Abdelrahman Almoqayyad, Abdallah Alwali, Reem Balaawi, Mahmoud Hamouda, Mohammed Humeid, Abdullah Jedyan, Tasneem Mahmoud Abu hamam, Ghadeer Matar, Ali Salem, Tahani Samra, Nureddin Shaheen, Karam Shihada, Ayoob A.Nemer, Mahmoud Abu Al Amrain, Abdulwhhab Abu Alamrain, Najlaa Abu Jamie, Mohammed R. Abu-Rous, Nada Alfarra, Mohammed AlTaweel, Noor Alwhaidi, Ramadan Hamed, Bader Saqqa, Ahmad Shaheen, Dana Aljaber, Loay Aljaberi, Malak Alwaheidi, Assef Jawaada, Hani Khaldi, Rami Qahoush, Jalil Qari, Rana Saadeh, Ahlam Salim, Aseel Yacoub, Abbas Abbas, Rana Abu shua`ib, Baraa Abu Zainah, Mahmoud AbuSirrees, Basheer Babaa, Ola Barhoush, Asef Belal qadomi, Laith Daraghmeh, Reema Haji, Alaa Khatatbeh, Lana Khatib, Salsabeel Qarariah, Yara Quzmar, Khalil Safadi, Roqaya Salameh, Mohammad Hassan, Shifaa Herzallah, Loai Massad, Ahmed Nazzal, Ranin Nazzal, Dennis Escobar, Gustavo Miguel Machain V, Agustin Rodriguez Gonzalez, Jorge Emerson Chachaima Mar, Nathaly Olga Chinchihualpa Paredes, Vicente Cuba, Walter Lopez, Maria Milagros Niquen Jimenez, Nestor Alberto Sanchez Bartra, Olenka Sapallanay Ojeda, Diego Sequeiros, Andrea Toscano Pacheco, María Vergara, Sol Abarca, Rodrigo Alcorta, Giuliano Borda-Luque, Ivan Edward Eusebio Zegarra, Claudia Luján López, Mirella Marrufo, Cinthya Mogrovejo, Andrea Nomura, Yamile Rodríguez Angeles, Maitza Rosario Vidal Meza, Gabriela Zavala, José Neiser Castillo Arrascue, Jomara Caroline Hidrogo Cabrera, José Julio Mariano Larrea vera, Miguel Osorio, Edgar Alcides Ylatoma Díaz, Mark Anthony Fontanilla, Joseph Roy Fuentes, Anna Leah Salazar, Genieve Dominguez, Marc Paul Lopez, Shiela Macalindong, Mark Augustine Onglao, Arjel Ramirez, Marie Dione Sacdalan, Mayou Martin Tampo, Gemma Leonora Uy, Jeremiah Mangahas, Kenneth Yabut, Joannes Paul Cañete, Bernalynn Eris Cansana, Ernes John Castro, Maria Kaiserin Lipana, Manuel Francisco Roxas, Vlu Jean Zara, Maciej Chrol, Paula Franczak, Michal Orlowski, Piotr Budzynski, Andrzej Budzynski, Pawel Bury, Agata Czerwinska, Jadwiga Dworak, Jacek Dziedzic, Michal Kisielewski, Jan Kulawik, Anna Lasek, Piotr Malczak, Marcin Migaczewski, Michal Pedziwiatr, Magdalena Pisarska, Dorota Radkowiak, Mateusz Rubinkiewicz, Anna Rzepa, Tomasz Skoczylas, Maciej Stanek, Katarzyna Truszkiewicz, Mateusz Wierdak, Marek Winiarski, Piotr Zarzycki, Anna Zub-Pokrowiecka, Piotr Kowalewski, Rafal Roszkowski, Maciej Waledziak, Miguel Tomé, Sara Patrocinio, Ines Guerreiro, Filipe Almeida, Xavier de Sousa, Nuno Monteiro, Maria Teresa Costa Santos, Daniela de Oliveira, Marta Lopes Serra, Daniela Morgado, Christian Neves, Ana Carolina Oliveira, Alice Pimentel, Sofia Silva, Márcia Carvalho, Lúcia Carvalho, Joana Magalhães, Leonor Matos, Tânia Monteiro, Carlota Ramos, Vanessa Santos, José Barbosa, Jose Costa-Maia, Vítor Devezas, Ana Fareleira, Cristina Fernandes, Diana Gonçalves, Henrique Mora, Marina Morais, Fabiana Silva de Sousa, Sara Catarino Santos, Ana Logrado, André Tojal, Edgar Amorim, Miguel F. Cunha, Ana Fazenda, João Pedro Melo Neves, Inês Isabel Sampaio da Nóvoa Gomes Miguel, Diogo Veiga, José Azevedo, Hugo Cardoso Louro, Mariana Leite, Maria Bairos Menezes, Bárbara Gama, Diana Brito, Marta Cristina Cruz Martins, André Graça e Magalhães, Ana Catarina Longras, Rita Lourenço, Diana Matos, Luis Castro, Filipa Policarpo, Joana Romano, Cristina Monteiro, Diogo Pinto, Marina Duarte, Sónia Fortuna Martins, Mariline Oliveira, Diogo Galvão, Lisandra Martins, Anaisa Silva, Viorel Taranu, Bárbara Vieira, Jessica Neves, Simone Oliveira, Hugo Ribeiro, Margarida Cinza, Rosa Felix, Arnaldo Machado, Joana Oliveira, Joana Patrício, Rita Pedroso de Lima, Mário Pereira, Miguel Rocha Melo, Cristina Velez, Alberto Abreu da Silva, Mariana Claro, Daniel Costa Santos, Andreia Ferreira, Hugo Capote, Daniela Rosado, Filipa Taré, Oriana Nogueira, Miguel Ângelo, José Miguel Baiao, Andreia Guimarães, João Marques, Miguel Nico Albano, Marta Silva, Ana Valente da Costa, Teresa Vieira Caroço, Sara Almeida Braga, Ines Capunge, Marta Fragoso, João Guimarães, Bruno Pinto, João Ribeiro, Miguel Angel, Guilherme Fialho, Monica Guerrero, Filipa Campos Costa, Diogo Cardoso, Vasco Cardoso, Magda Alves, Inês Estalagem, Tiago Louro, Cláudia Marques, Rita Martelo, Miguel Morgado, Rita Canotilho, Ana Margarida Correia, Pedro Martins, Mariana Peyroteo, João Gomes, Rita Monteiro, Manuela Romano, Daniela Macedo Alves, Rita Peixoto, Catarina Quintela, Maria João Jervis, Débora Melo, André Pacheco, Valter Paixão, Vera Pedro, Joana Pimenta, João Pimenta de Castro, Ana Rocha, Mircea Beuran, Cezar Ciubotaru, Bogdan Diaconescu, Sorin Hostiuc, Ionut Negoi, Bogdan Stoica, NA NA, Evgeny Anokhin, Georgy Kuznetsov, Giorgi Oganezov, Fedor Paramzin, Ekaterina Romanova, Valeryan Rutkovskii, Vasilii Rutkovskii, Mikhail Shushval, Mikhail Zabiyaka, Khasan Dzhumabaev, Valerii Ivanov, Zaman Mamedli, Sergey Achkasov, Artem Balkarov, Elnur Nabiev, Marat Nagudov, Evgeny Rybakov, Karina Saifutdinova, Oleg Sushkov, Lule Joseph, Isaac Ndayishimiye, Ntirenganya Faustin, Alphonse Zeta Mutabazi, Jean Paul Mvukiyehe, Vizir J.P Nsengimana, Carine Uwakunda, Mohammad Monir Abbas, Nouf Akeel, Murad Aljiffry, Kholoud Awaji, Ali Farsi, Ghader Jamjoum, Ahmad Khoja, Ashraf Maghrabi, Nadim Malibary, Mohammed Nassif, Abdulaziz Saleem, Abdullah Sultan, Wail Tashkandi, Hanaa Tashkandi, Nora Trabulsi, Mouhamadou Bachir Ba, Adja Coumba Diallo, Abdourahmane Ndong, Vladica Cuk, Uroš Jankovic, Sharon Zhiling Koh, Frederick Koh, Kuok Chung Lee, Kai Yin Lee, Sean Lee, Wei Qi Leong, Su Ann Lui, Prajwala Prakash, Jan Grosek, Gregor Norcic, Ales Tomazic, Nicolas Fitchat, Robert Jaich, Devorah Wineberg, Modise Zacharia Koto, Daniella Baiocchi, Damian Clarke, Christina Johanna Steenkamp, Sharon Bannister, Adam Boutall, Galya Chinnery, Anna Coccia, Angela Dell, Parveen Karjiker, Christo Kloppers, Nicholas Loxton, Tumi Mabogoane, Francois Malherbe, Eugenio Panieri, Shreya Rayamajhi, Tirsa van Wyngaard, Claire Warden, T E Madiba, Nivashen Pillay, Savannah Brooks, Charlise Kruger, Lisa Hannah Van Der Merwe, Ferhana Gool, Maahir Kariem, Heather Bougard, Nazmie Kariem, Fazlin Noor, Reantha Pillay, Leandi Steynfaardt, Lucía González González, José Miguel Marín Santos, Paula Martín-Borregón, Javier Martínez Caballero, Cristina Nevado García, Pastora Rodriguez Fraga, Gonzalo De Castro Parga, Maria Pilar Fernández Veiga, Lucía Garrido López, Hugo Infante Pino, Irene Lages Cal, Marta López Otero, Manuel Nogueira Sixto, Marta Paniagua García Señorans, Laura Rodríguez Fernández, Alejandro Ruano Poblador, Erika Rufo Crespo, Raquel Sanchez-Santos, Vincenzo Vigorita, Ester Alonso Batanero, Dorisme Asnel, Isabel Cifrian Canales, Elisa Contreras Saiz, Irene De Santiago Alvarez, Tamara Díaz Vico, Sebastian Fernandez Arias, Daniel Fernández Martínez, Carmen García Bernardo, Luis Joaquín García Flórez, Carmen Garcia Gutierrez, Manuel García Munar, Carlos Alberto Márquez Zorrilla Molina, Marta Merayo, José Luis Michi Campos, Maria Moreno Gijon, Jorge L. Otero-Diez, Jose Luis Rodicio Miravalles, Lorena Solar-Garcia, Aida Suárez Sánchez, Nuria Truan, Cristina Alejandre Villalobos, Yurena Caballero Díaz, Marta Jimenez, Dacil Montesdeoca, Antonio Navarro-Sánchez, Victor Vega, Juan Beltrán de Heredia, Zahira Gómez, Carlos Jezieniecki, Ana Patricia Legido Morán, Mario Montes-Manrique, Mario Rodriguez-Lopez, María Ruiz Soriano, Jeancarlos Trujillo Díaz, Andrea Vazquez Fernandez, Nuria Argudo, Miguel Pera, Laia Torrent Jansà, Melody García Domínguez, Ignacio Goded, Marta Roldón Golet, Issa Talal El-Abur, Alejandra Utrilla Fornals, Vanesa Zambrana Campos, Maria Del Mar Aguilar Martinez, Marina Bosch, Luis García-Catalá, Luis Sánchez-Guillén, Eva Artigau, Nuria Gomez Romeu, David Julià Bergkvist, Beatriz Espina Perez, Olga Morató, Carles Olona, Beatriz Diéguez, Alexander Forero-Torres, Manuel Losada, Segundo Gomez-Abril, Paula Gonzálvez, Rosario Martinez, Sergio Navarro Martínez, Carmen Payá-Llorente, Álvaro Pérez Rubio, Sandra Santarrufina Martinez, Juan Carlos Sebastián Tomás, Ramon Trullenque Juan, Alberto Gegúndez Simón, Paloma Maté, Maria Isabel Prieto-Nieto, Ines Rubio-Perez, Aitor Urbieta, Marina Vicario Bravo, David Abelló, Matteo Frasson, Alvaro Garcia-Granero, Alfredo Abad Gurumeta, Ane Abad-Motos, Elena Lucena-de Pablo, Beatriz Nozal, Javier Ripollés-Melchor, Rut Salvachúa, Esther Ferrero, Luis Garcia-Sancho Tellez, Antonio L. Picardo, Jose Alberto Rojo López, Laura Patricia Zorrilla Matilla, Carmen Cagigas Fernandez, Sonia Castanedo Bezanilla, José Estevez Tesouro, Maria Jose Fernandez-Diaz, Juan García Cardo, Marcos Gomez Ruiz, Erik Gonzalez-Tolaretxipi, Jaime Jimeno Fraile, Cristobal Poch, Montserrat Rodriguez-Aguirre, Noemí Troche Pesqueira, Maria Soledad Trugeda-Carrera, Javier de la Torre, Ruth Blanco-Colino, Eloy Espin-Basany, Martin Espinosa-Bravo, Clara Morales Comas, Eduardo Reyes Afonso, Joaquín Rivero Déniz, Christian Siso Raber, Mireia Verdaguer Tremolosa, Pramodh Chandrasinghe, Sumudu Kumarage, Nimeshi Wijekoon Arachchilage, Ahmed Abdalla Ahmed Elkamel, Mohammed A. Adam, Nina Blomme, Anders Thorell, Fredrik Wogensen, Andreas Älgå, Dhirar Ansarei, Fuat Celebioglu, Göran Heinius, Linda Nigard, Emil Pieniowski, Sandra Ahlqvist, Ida Björklund, Andreas Frånberg, Martina Håkansson, Karin Adamo, Oskar Franklin, Malin Sund, Rebecca Wiberg, Yvette Andersson, Abbas Chabok, Maziar Nikberg, Alexander Kugelberg, Claudia Canonica, Dimitrios Christoforidis, Fabrizio Fasolini, Paolo Gaffuri, Mauro Giuliani, Francesco Meani, Sotirios Georgios Popeskou, Silvia Pozza, Wiebke Wandschneider, Lorenz Peterer, Lukas Werner Widmer, Bernd Zimmermann, Panagiotis Bakoleas, Iris Chanousi, Lydia Charalampidou, Lukasz Filip Grochola, Franziska Heid, Sotirios Ntaoulas, Michail Outos, Georgios Peros, Hanna Podolska-Skoczek, Katharina Beate Reinisch, Christian Zielasek, Nicolas Demartines, Jérôme Gilgien, Amaniel Kefleyesus, Pénélope St-Amour, Arnaud Toussaint, Maryam Alhimyar, Bayan Alsaid, Amr Alyafi, Ahmad Alkhaledi, Basel Kouz, Ahmad Omarain, Yusra Al-Sabbagh, Haya Alkhatib, Samer Sara, Ahmad Alhaj, Aghyad Danial, Lama Kadoura, Sarah Maa Albared, Yamen Monawar, Louei Nahas, Barook Abd, Ahmad Saad, Habib Wakkaf, Hatem Bouzaiene, Montassar Ghalleb, Elif Akaydin, Ata Cem Akbaba, Onur Atakul, Ege Baltaci, Sevval Besli, Gökçen Burgu, Ulukan Cenal, Cansu de Muijnck, Hasan Can Demirkaya, Alper Dogruoz, Zeynep Ipek Gezer, Yasemin Gündogdu, Merve Kara, Hasan Kürsad Korkmaz, Gökalp Kagan Kurtoglu, Volkan Ozben, Berk Baris Ozmen, Ahmet Murat Pektas, Eda Kübra Sel, Nilüfer Yenidünya, Fuat Baris Bengur, Berke Mustafa Oral, Tahir Koray Yozgatli, Seymur Abdullayev, Mehmet Emin Gunes, Nuri Alper Sahbaz, Tuba Banaz, Kübra Kargici, Omer Faruk Kuyumcu, Erkan Yanikoglu, Merve Yesilsancak, Duygu Yilmaz, Melik Kagan Aktas, Ahmet Rencuzogullari, Arda Isik, Sezai Leventoglu, Ali Yalçinkaya, Osman Yüksel, Mustafa U Kalayci, Yasin Kara, Inanc Samil Sarici, Alp Akin, Gökçe nur Alemdag, Ekin Arslan, Bahadir Emre Baki, Muhammed Selim Bodur, Adnan Calik, Bahar Candas Altinbas, Irem Cihanyurdu, Oguz Erkul, Burak Gül, Ali Guner, Beyza Köse, Anil Semiz, Sule Sevim, Serkan Tayar, Kadir Tomas, Ozan yavuz Tüfek, Serdar Türkyilmaz, Mehmet Ulusahin, Arif Usta, Reyyan Yildirim, Sertaç Ata Güler, Ozan Can Tatar, Ecenur Varol, Busenur Kirimtay, Muhammed Uysal, Alp Yildiz, Emin Kose, Ahmet Burak Ciftci, Elif Çolak, Huseyin Eraslan, Gultekin Ozan Kucuk, Kürsat Yemez, Herman Lule, Mumbere Bienfait, Emmanuel Bua, Noella Okalany, Maksym Basarab, Oleksii Bielosludtsev, Kateryna Kolhanova, Kateryna Perepelytsia, Kateryna Romanukha, Dmytro Savenkov, Stanislav Siryi, Maksym Tereshchenko, Nezamai Viacheslav, Anton Volovetskyi, Andrey Kebkalo, Yegor Tryliskyy, Volodimir Tyselskiy, Eilidh Bruce, Bing Lun Chow, Emma Iddles, Sarah McGuckin, Nicola Newall, George Ramsay, Parivrudh Sharma, Caitlin Stewart, Jeremy Wong, Abdul Badran, Michael Bath, Fanny Belais, Eman Butt, Kaustuv Joshi, Milan Kapur, Mike Shaw, Adam Townson, Christopher Yee Khang Williams, Timothy Gray, Robert Greig, Mansoor Husain, Elspeth Murray, Ahmed Mustafa, Ashar Asif, Arya Gokul, Max Shah, Mabel Temisanren Akitikori, Alexandros Charalabopoulos, Sophie Davidson, Sinead McNally, Shamil Rupani, Fatema Juma, Sarah Catherine Mills, Laura Muirhead, Kate Sellars, Una Walsh, Oliver Warren, Alice Chambers, Richard Hunt, Stephen Boyce, Hannah Cornwall, Isabel Tol, Eleftherios Orestis Argyriou, Nicola Eardley, Meical Povey, Joanna M S Aithie, Ahmer Irfan, Mari-Claire McGuigan, Robert Starr, Craig Russell Warren, Jess Archibald, Georgia Kirby, Ivan Kisyov, Chun Kheng Khoo, Rachel Lee, Dana Photiou, Rowan Davis, Uday Prasad, P Zichu Yang, Jonathan Bird, Edmund Leung, Virginia Summerour, Chelise Currow, Jianshen Kiam, Gerald Jack Soon Tan, Anitha Muthusami, Ibifunke Pegba-Otemolu, Tomas Urbonas, Joseph Nunoo-Mensah, Edgaras Smolskas, Alex Boddy, Gianpiero Gravante, David Hunter, David Andrew, Amanda Koh, Amari Thompson, Lawrence Adams, Hollie A Clements, Kasun De Silva, Ogbonnia Ekpete, Seraj Haque, Scott Henderson, Bilal Ibrahim, Thummini Jayasinghe, Jennifer Livie, Keir Mailley, Gopikrishnan Nair, Daniel Tan, Caitlin Baggaley, Aleksander Dawidziuk, Bartosz Szyszka, Charlotte Barter, Nirav Gandhi, Karen Hassell, Samantha Hitchin, Jennett Kelsall, Eva Nagy, Ashrafun Nessa, Lisa Whisker, Fady Yanni, Mahmoud Ali, Deeksha Arora, Sunanda Hediwattege, Navam Kumarasinghe, Munir Rathore, Athula Tennakoon, Syed Mustafa Ali Ahmad, Oreoluwa Bajomo, Fahema Nadira, Valerio Celentano, Ewen Griffiths, Rama Santhosh Karri, Jason Kei Chak Mak, Michelle Pipe, Muhammad Iqbal Bhatti, Mohamed Rabie, Connor Boyle, David Hamilton, Aishath Mihuna, James Chean Khun Ng, Gary Nicholson, Agata Oliwa, Robert Pearson, Anna Rose, Shun Qi Yong, Catherine Boereboom, Michael Hanna, Catherine Walter, Thomas Samuel Greensmith, Rachel Mitchell, Eimear Monaghan, James Crawford, Susan Moug, James Blackwell, Hannah Boyd-Carson, Philip Herrod, Omar Al-Allaf, Miriam Beattie, Cameron Bullock, Shivang Burman, Gemma Clark, Nicolas Flamey, Oliver Flannery, Alexander Harding, Ben Kodiatt, Samuel Lawday, Shivani Mahapatra, Navin Mukundu Nagesh, Michael Ng, Dupinderjit Rye, Andrel Yoong, Laura Clark, Chris Deans, Monisha Edirisooriya, Emma Victoria Carrington, Tsz Lun Ernest Wong, Baasil Yusuf, Carla Chamberlain, Kathryn Duke, Elizabeth Kmiotek, Azel Botes, Natalie Condie, Timothy Schrire, Reena Shah, Iolo Thomas-Jones, Charlotte Yates, Natasha Anthony, Edward Matthews, Kapil Sahnan, James Tankel, Sally Tucker, Jasmine Winter Beatty, Paul Ziprin, William Duggan, Anastasia Kantartzi, Shruthi Sridhar, Rachel Alys Khaw, Prakhar Srivastava, Charlotte Underwood, Homero Alves do Canto Brum, Sharat Chopra, Laura Davis, Rebecca Hughes, Joshua Tulley, Justin Alberts, Thomas Athisayaraj, Mojolaoluwa Olugbemi, Kasim Ahmad, Claudia Chan, Gavin Chapman, Hannah Fleming, Benjamin Fox, Julia Grewar, Kate Hulse, Duncan Rutherford, Mackay Sinead, Scott Smith, Doug Speake, Peter G Vaughan-Shaw, Natasha Christodoulides, Simrit Kudhail, Matthew Welch, Syed Muhibullah Husaini, Simon Lambracos, Chikamuche Anyanwu, Rishi Suresh, Jimmy Scott Thomas, Elizabeth Gleeson, Rebecca Platoff, Areeba Saif, Zachary Enumah, Eric Etchill, Alodia Gabre-Kidan, Mitchell Bernstein, Francesco Maria Carrano, Joseph Connors, Patricio Lynn, Marcovalerio Melis, Elliot Newman, Deshka S Foster, Kenneth Perrone, Ashley Titan, Sarwat Ahmad, Andrea Chao M.D. Bafford, Marco Dal Molin, Nader Hanna, Syed Nabeel Zafar, Mark Hemmila, Lena Napolitano, Jane J Wong, Julia Chandler, Lauren Wood, Sherry Wren, Taylor Ottesen, Lucia You, Kristin Yu, María del pilar Arciénega Yañez, Martin Ferreira Fernandes, Daniel González, Santiago Cubas, María Catalina González, Vanessa Zubiaurre, Rodrigo Demolin, Nicolas Giroff, Pablo Sciuto, Maite Campos, Gabriela Rodríguez Cantera, Garg Deepika, Elliot Simuchimba, Anadi Bulaya, Chali Chibuye, Bright Chirengendure, Mary-Rose Kabale, Kizito Kabongo, James Munthali, Oliver Mweso, Francis Pikiti, James Otieno, Log Tung Lai, Brighid Blackman, Sophie Richards, Suren Subramaniam, Rafid Karim, Nathan Kok, Yanni Dion Lee, Shabina Ali, Aanjaneya Sinha, Robert Corrigan, Nicole Barnes, Florence Wong, Grace Dennis, Julia Jedamzik, Emil Phillips, Wivine Piette, Marie Van hentenryck, Houenoukpo Koco, Souliath Lawani, Mamo Woldu Kassa, Tainá Santos Bezerra, Petar Gribnev, Dobromir Dimitrov, Panche Krastev, Sovannarith Oum, Divine Tim Bonghaseh, Maryam Al Farsi, Nourah Alsharqawi, Veronica Acevedo, Andrea Carolina Castillo Barbosa, Felipe Giron, Jimmy Paul Leon Rodriguez, Darko Kucan, Damir Rosko, Neven Barsic, Domagoj Župan, Amgad Hegazi, Vendula Truncíková, Vladimir Fryba, Mostafa Mohamed, Ahmed Sultan, Ahmed Nagi, Abdallah Rashad Temerik, Mohamed Elemam Elshawy, Moustafa Ibrahim Mahmoud, Shrouk Omar, Mohamed Anwar, Tarek Rageh, Aya Elmokadem, Khaled Gaballa, Sandra Teppo, Antti Turunen, Pasi Pengermä, Quentin Ballouhey, Damien Bergeat, Ariane Weyl, Elisabeth Hain, Adam Gyedu, Edwin Yenli, Dorcas Osei-Poku, Vaia-Aliki Rompou, Athanasios Zoikas, Apostolos Gaitanidis, Georgios Koukis, Konstantinos Perivoliotis, Panagiotis Tavlas, Konstantinos Galanos-Demiris, George Zografos, Ioannis Karavokyros, Georgia Xanthopoulou, Eirini Iordanidou, Fernanda Ayau, Allan Garcia, Pekli Damján, Deepender Wason, Ashika B L, Ervandy Rangganata, Prerna Kamath, Donal B O'Connor, Margherita Pinto, Fabrizio Perrone, Francesca Paola Tropeano, Francesca Troilo, Daniela Bossi, Dario Scala, Lucrezia Pulitanò, Marcella Carella, Andrea Pietrabissa, Alice Gori, Giorgio Giraudo, Veronica De Simone, Alfio Alessandro Russo, Bartolomeo Braccio, Raed Al-Taher, Sarah Athamneh, Andrea Parker, Adnan Sawiee, Amina Kattia, Malik Salem, Osama Tababa, Zuhour Shaeeb, Vilius Syminas, Jonas Jurgaitis, Gyte Damuleviciene, Saulius Svagzdys, Narindra Njarasoa Mihaja Razafimanjato, Ling Chieng Loo, Ing Ching Tiong, Wan Farahiyah Wan Muhmad, Harinthiran Vijeyan, Teoh Li Ying, Gabriella Grech, Rodrigo Arrangoiz, Vania Brickelia Jimenez Ley, Daniel Arizpe, Elizabeth Lagunes Lara, Elizabeth Victoria Castro López, Jose Eaazim, Marije Gordinou de Gouberville, Vivian Bastiaenen, Simone Rottier, Fouad Nahab, Maria Yeonhee Ji, Mohammed Seyoji, Callistus Nwachukwu, Okechukwu Emeghara, Sayyid Egbunu Muhammed, Ayodeji Idowu, Olamiposi Sowemimo, Olakayode Ogundoyin, Oluwatosin Akande, Alexander Lott, Maliha Nadeem, Ahsan Ali Laghari, Asif Loya, Hassan Mushtaq, Muhammad Tariq Abdullah, Baseel Abuhilal, Mohammad Atawneh, Hamdan Hamdan, Belal Alhabil, Abedelrahman Srour, Ibrahim Mousa, Luis Da Silva Medina, Katarzyna Bartosiak, Pedro Ferreira, Vítor Francisco, Ricardo Lemos, Luísa Frutuoso, Sara Fernandes, Telma Fonseca, Jorge Pereira, Juan Rachadell, Ana Torre, Filipe Madeira Martins, Ana Cristina Carvalho, Joana Rodrigues Ferreira, Bruno Ribeiro da Silva, Helena Devesa, Ana Vieira, Inês Mónica, Margarida Amaro, Diogo Sousa, Marta Reia, João Louro, Ana Martins, Joaquina Dominguez, Inês Santos, Nuno Miguel Freitas 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Pimenta de Castro J., Rocha A., Beuran M., Ciubotaru C., Diaconescu B., Hostiuc S., Negoi I., Stoica B., NA N.A., Anokhin E., Kuznetsov G., Oganezov G., Paramzin F., Romanova E., Rutkovskii V., Shushval M., Zabiyaka M., Dzhumabaev K., Ivanov V., Mamedli Z., Achkasov S., Balkarov A., Nabiev E., Nagudov M., Rybakov E., Saifutdinova K., Sushkov O., Joseph L., Ndayishimiye I., Faustin N., Mutabazi A.Z., Mvukiyehe J.P., Nsengimana V.J.P., Uwakunda C., Abbas M.M., Akeel N., Aljiffry M., Awaji K., Farsi A., Jamjoum G., Khoja A., Maghrabi A., Malibary N., Nassif M., Saleem A., Sultan A., Tashkandi W., Tashkandi H., Trabulsi N., Ba M.B., Diallo A.C., Ndong A., Cuk V., Jankovic U., Koh S.Z., Koh F., Lee K.C., Lee K.Y., Lee S., Leong W.Q., Lui S.A., Prakash P., Grosek J., Norcic G., Tomazic A., Fitchat N., Jaich R., Wineberg D., Koto M.Z., Baiocchi D., Clarke D., Steenkamp C.J., Bannister S., Boutall A., Chinnery G., Coccia A., Dell A., Karjiker P., Kloppers C., Loxton N., Mabogoane T., Malherbe F., Panieri E., Rayamajhi S., van Wyngaard T., Warden C., Madiba T.E., Pillay N., Brooks S., Kruger C., Van Der Merwe L.H., Gool F., Kariem M., Bougard H., Kariem N., Noor F., Pillay R., Steynfaardt L., Gonzalez Gonzalez L., Marin Santos J.M., Martin-Borregon P., Martinez Caballero J., Nevado Garcia C., Rodriguez Fraga P., De Castro Parga G., Fernandez Veiga M.P., Garrido Lopez L., Infante Pino H., Lages Cal I., Lopez Otero M., Nogueira Sixto M., Paniagua Garcia Senorans M., Rodriguez Fernandez L., Ruano Poblador A., Rufo Crespo E., Sanchez-Santos R., Vigorita V., Alonso Batanero E., Asnel D., Cifrian Canales I., Contreras Saiz E., De Santiago Alvarez I., Diaz Vico T., Fernandez Arias S., Fernandez Martinez D., Garcia Bernardo C., Garcia Florez L.J., Garcia Gutierrez C., Garcia Munar M., Marquez Zorrilla Molina C.A., Merayo M., Michi Campos J.L., Moreno Gijon M., Otero-Diez J.L., Rodicio Miravalles J.L., Solar-Garcia L., Suarez Sanchez A., Truan N., Alejandre Villalobos C., Caballero Diaz Y., Jimenez M., Montesdeoca D., Navarro-Sanchez A., Vega V., Beltran de Heredia J., Gomez Z., Jezieniecki C., Legido Moran A.P., Montes-Manrique M., Rodriguez-Lopez M., Ruiz Soriano M., Trujillo Diaz J., Vazquez Fernandez A., Argudo N., Pera M., Torrent Jansa L., Garcia Dominguez M., Goded I., Roldon Golet M., Talal El-Abur I., Utrilla Fornals A., Zambrana Campos V., Aguilar Martinez M.D.M., Bosch M., Garcia-Catala L., Sanchez-Guillen L., Artigau E., Gomez Romeu N., Julia Bergkvist D., Espina Perez B., Morato O., Olona C., Dieguez B., Forero-Torres A., Losada M., Gomez-Abril S., Gonzalvez P., Martinez R., Navarro Martinez S., Paya-Llorente C., Perez Rubio A., Santarrufina Martinez S., Sebastian Tomas J.C., Trullenque Juan R., Gegundez Simon A., Mate P., Prieto-Nieto M.I., Rubio-Perez I., Urbieta A., Vicario Bravo M., Abello D., Frasson M., Garcia-Granero A., Abad Gurumeta A., Abad-Motos A., Lucena-de Pablo E., Nozal B., Ripolles-Melchor J., Salvachua R., Ferrero E., Garcia-Sancho Tellez L., Picardo A.L., Rojo Lopez J.A., Zorrilla Matilla L.P., Cagigas Fernandez C., Castanedo Bezanilla S., Estevez Tesouro J., Fernandez-Diaz M.J., Garcia Cardo J., Gomez Ruiz M., Gonzalez-Tolaretxipi E., Jimeno Fraile J., Poch C., Rodriguez-Aguirre M., Troche Pesqueira N., Trugeda-Carrera M.S., de la Torre J., Blanco-Colino R., Espin-Basany E., Espinosa-Bravo M., Morales Comas C., Reyes Afonso E., Rivero Deniz J., Siso Raber C., Verdaguer Tremolosa M., Chandrasinghe P., Kumarage S., Wijekoon Arachchilage N., Abdalla Ahmed Elkamel A., A. Adam M., Blomme N., Thorell A., Wogensen F., Alga A., Ansarei D., Celebioglu F., Heinius G., Nigard L., Pieniowski E., Ahlqvist S., Bjorklund I., Franberg A., Hakansson M., Adamo K., Franklin O., Sund M., Wiberg R., Andersson Y., Chabok A., Nikberg M., Kugelberg A., Canonica C., Christoforidis D., Fasolini F., Gaffuri P., Giuliani M., Meani F., Popeskou S.G., Pozza S., Wandschneider W., Peterer L., Widmer L.W., Zimmermann B., Bakoleas P., Chanousi I., Charalampidou L., Grochola L.F., Heid F., Ntaoulas S., Outos M., Peros G., Podolska-Skoczek H., Reinisch K.B., Zielasek C., Demartines N., Gilgien J., Kefleyesus A., St-Amour P., Toussaint A., Alhimyar M., Alsaid B., Alyafi A., Alkhaledi A., Kouz B., Omarain A., Al-Sabbagh Y., Alkhatib H., Sara S., Alhaj A., Danial A., Kadoura L., Maa Albared S., Monawar Y., Nahas L., Abd B., Saad A., Wakkaf H., Bouzaiene H., Ghalleb M., Akaydin E., Akbaba A.C., Atakul O., Baltaci E., Besli S., Burgu G., Cenal U., de Muijnck C., Demirkaya H.C., Dogruoz A., Gezer Z.I., Gundogdu Y., Kara M., Korkmaz H.K., Kurtoglu G.K., Ozben V., Ozmen B.B., Pektas A.M., Sel E.K., Yenidunya N., Bengur F.B., Oral B.M., Yozgatli T.K., Abdullayev S., Gunes M.E., Sahbaz N.A., Banaz T., Kargici K., Kuyumcu O.F., Yanikoglu E., Yesilsancak M., Yilmaz D., Aktas M.K., Rencuzogullari A., Isik A., Leventoglu S., Yalcinkaya A., Yuksel O., Kalayci M.U., Kara Y., Sarici I.S., Akin A., Alemdag G.N., Arslan E., Baki B.E., Bodur M.S., Calik A., Candas Altinbas B., Cihanyurdu I., Erkul O., Gul B., Guner A., Kose B., Semiz A., Sevim S., Tayar S., Tomas K., Tufek O.Y., Turkyilmaz S., Ulusahin M., Usta A., Yildirim R., Guler S.A., Tatar O.C., Varol E., Kirimtay B., Uysal M., Yildiz A., Kose E., Ciftci A.B., Colak E., Eraslan H., Kucuk G.O., Yemez K., Lule H., Bienfait M., Bua E., Okalany N., Basarab M., Bielosludtsev O., Kolhanova K., Perepelytsia K., Romanukha K., Savenkov D., Siryi S., Tereshchenko M., Viacheslav N., Volovetskyi A., Kebkalo A., Tryliskyy Y., Tyselskiy V., Bruce E., Chow B.L., Iddles E., McGuckin S., Newall N., Ramsay G., Sharma P., Stewart C., Wong J., Badran A., Bath M., Belais F., Butt E., Joshi K., Kapur M., Shaw M., Townson A., Williams C.Y.K., Gray T., Greig R., Husain M., Murray E., Mustafa A., Asif A., Gokul A., Shah M., Akitikori M.T., Charalabopoulos A., Davidson S., McNally S., Rupani S., Juma F., Mills S.C., Muirhead L., Sellars K., Walsh U., Warren O., Chambers A., Hunt R., Boyce S., Cornwall H., Tol I., Argyriou E.O., Eardley N., Povey M., Aithie J.M.S., Irfan A., McGuigan M.-C., Starr R., Warren C.R., Archibald J., Kirby G., Kisyov I., Khoo C.K., Lee R., Photiou D., Davis R., Prasad U., Yang P.Z., Bird J., Leung E., Summerour V., Currow C., Kiam J., Tan G.J.S., Muthusami A., Pegba-Otemolu I., Urbonas T., Nunoo-Mensah J., Smolskas E., Boddy A., Gravante G., Hunter D., Andrew D., Koh A., Thompson A., Adams L., Clements H.A., De Silva K., Ekpete O., Haque S., Henderson S., Ibrahim B., Jayasinghe T., Livie J., Mailley K., Nair G., Tan D., Baggaley C., Dawidziuk A., Szyszka B., Barter C., Gandhi N., Hassell K., Hitchin S., Kelsall J., Nagy E., Nessa A., Whisker L., Yanni F., Ali M., Arora D., Hediwattege S., Kumarasinghe N., Rathore M., Tennakoon A., Ali Ahmad S.M., Bajomo O., Nadira F., Celentano V., Griffiths E., Karri R.S., Mak J.K.C., Pipe M., Bhatti M.I., Rabie M., Boyle C., Hamilton D., Mihuna A., Ng J.C.K., Nicholson G., Oliwa A., Pearson R., Rose A., Yong S.Q., Boereboom C., Hanna M., Walter C., Greensmith T.S., Mitchell R., Monaghan E., Crawford J., Moug S., Blackwell J., Boyd-Carson H., Herrod P., Al-Allaf O., Beattie M., Bullock C., Burman S., Clark G., Flamey N., Flannery O., Harding A., Kodiatt B., Lawday S., Mahapatra S., Mukundu Nagesh N., Ng M., Rye D., Yoong A., Clark L., Deans C., Edirisooriya M., Carrington E.V., Wong T.L.E., Yusuf B., Chamberlain C., Duke K., Kmiotek E., Botes A., Condie N., Schrire T., Shah R., Thomas-Jones I., Yates C., Anthony N., Matthews E., Sahnan K., Tankel J., Tucker S., Winter Beatty J., Ziprin P., Duggan W., Kantartzi A., Sridhar S., Khaw R.A., Srivastava P., Underwood C., Alves do Canto Brum H., Chopra S., Davis L., Hughes R., Tulley J., Alberts J., Athisayaraj T., Olugbemi M., Ahmad K., Chan C., Chapman G., Fleming H., Fox B., Grewar J., Hulse K., Rutherford D., Sinead M., Speake D., Vaughan-Shaw P.G., Christodoulides N., Kudhail S., Welch M., Husaini S.M., Lambracos S., Anyanwu C., Suresh R., Thomas J.S., Gleeson E., Platoff R., Saif A., Enumah Z., Etchill E., Gabre-Kidan A., Bernstein M., Carrano F.M., Connors J., Lynn P., Melis M., Newman E., Foster D.S., Perrone K., Titan A., Ahmad S., Bafford A.C.M.D., Dal Molin M., Hanna N., Zafar S.N., Hemmila M., Napolitano L., Wong J.J., Chandler J., Wood L., Wren S., Ottesen T., You L., Yu K., Arcienega Yanez M.D.P., Ferreira Fernandes M., Gonzalez D., Cubas S., Gonzalez M.C., Zubiaurre V., Demolin R., Giroff N., Sciuto P., Campos M., Rodriguez Cantera G., Deepika G., Simuchimba E., Bulaya A., Chibuye C., Chirengendure B., Kabale M.-R., Kabongo K., Munthali J., Mweso O., Pikiti F., Otieno J., Lai L.T., Blackman B., Subramaniam S., Karim R., Kok N., Lee Y.D., Ali S., Sinha A., Corrigan R., Barnes N., Wong F., Dennis G., Jedamzik J., Phillips E., Piette W., Van hentenryck M., Koco H., Lawani S., Kassa M.W., Santos Bezerra T., Gribnev P., Dimitrov D., Krastev P., Oum S., Bonghaseh D.T., Al Farsi M., Alsharqawi N., Acevedo V., Castillo Barbosa A.C., Giron F., Leon Rodriguez J.P., Kucan D., Rosko D., Barsic N., Zupan D., Hegazi A., Truncikova V., Fryba V., Mohamed M., Nagi A., Rashad Temerik A., Elshawy M.E., Mahmoud M.I., Anwar M., Rageh T., Elmokadem A., Gaballa K., Teppo S., Pengerma P., Ballouhey Q., Bergeat D., Weyl A., Hain E., Gyedu A., Yenli E., Osei-Poku D., Rompou V.-A., Zoikas A., Gaitanidis A., Koukis G., Perivoliotis K., Tavlas P., Galanos-Demiris K., Zografos G., Karavokyros I., Xanthopoulou G., Iordanidou E., Ayau F., Garcia A., Damjan P., Wason D., B L A., Rangganata E., Kamath P., O'Connor D.B., Pinto M., Perrone F., Tropeano F.P., Troilo F., Bossi D., Scala D., Pulitano L., Carella M., Pietrabissa A., Gori A., Giraudo G., De Simone V., Russo A.A., Braccio B., Al-Taher R., Athamneh S., Parker A., Sawiee A., Kattia A., Tababa O., Shaeeb Z., Syminas V., Jurgaitis J., Damuleviciene G., Svagzdys S., Razafimanjato N.N.M., Chieng Loo L., Tiong I.C., Wan Muhmad W.F., Vijeyan H., Li Ying T., Grech G., Arrangoiz R., Jimenez Ley V.B., Arizpe D., Lagunes Lara E., Castro Lopez E.V., Eaazim J., Gordinou de Gouberville M., Bastiaenen V., Rottier S., Nahab F., Ji M.Y., Seyoji M., Nwachukwu C., Emeghara O., Muhammed S.E., Idowu A., Sowemimo O., Ogundoyin O., Akande O., Lott A., Nadeem M., Laghari A.A., Loya A., Mushtaq H., Abdullah M.T., Abuhilal B., Atawneh M., Hamdan H., Alhabil B., Srour A., Mousa I., Da Silva Medina L., Bartosiak K., Ferreira P., Francisco V., Lemos R., Frutuoso L., Fernandes S., Fonseca T., Pereira J., Rachadell J., Torre A., Madeira Martins F., Carvalho A.C., Rodrigues Ferreira J., Ribeiro da Silva B., Devesa H., Vieira A., Monica I., Amaro M., Sousa D., Reia M., Louro J., Martins A., Dominguez J., Santos I., Freitas Oliveira N.M., Pereira J.C., Silva-Vaz P., Freire L., Escrevente R., Negoita V.M., Shakhmatov D., Nezerwa Y., Radulovic R., Obery G., Viljoen F., Mendes T., Suarez A., Moncada E., Fernandez-Hevia M., Curtis Martinez C., Gil Garcia J.M., Gonzalez Zunzarren M., Idris T., Eklov K., Grahn O., Amin L., Blomqvist M., Ajani C., Kraus R., Seeger N., Willemin M., Rayya F., Ayash M., Msouti R., Kannas I., Abazid E., Esper A., Slim S., Kavcar A.S., Aytac E., Dural A.C., Ilker A., Eray I.C., Kurnaz E., Altiner S., Tepe M.D., Sahin C., Savli E., Innocent A., Babirye L., Diachenko A., Hordoskiy V., Curry H., Chau C.Y.C., Robertson H., Lennon H., Loi L., Kirkham E., McCann C., Watts D., Gurung B., Wilson M., Tribedi T., Garofalo E., Zahra B., MacDonald S., Daniels I., Ng N., Khosla S., Olivier J., Yue S.Y.P., Suresh G., Wellington J., Lorejo E., Mossaad M., Crutcher M., Alimi M., Baiu I., Abdou H., Conway A., Peck C., Perdomo Perez M.A., Zulu S., Nakazwe M., Knight, S. R., Shaw, C. A., Pius, R., Drake, T. M., Norman, L., Ademuyiwa, A. O., Adisa, A. O., Aguilera, M. L., Al-Saqqa, S. W., Al-Slaibi, I., Bhangu, A., Biccard, B. M., Brocklehurst, P., Costas-Chavarri, A., Chu, K., Dare, A., Elhadi, M., Fairfield, C. J., Fitzgerald, J. E., Ghosh, D., Glasbey, J., van Berge Henegouwen, M. I., Ingabire, J. C. A., Kingham, T. P., Lapitan, M. C., Lawani, I., Lieske, B., Lilford, R., Martin, J., Mclean, K. A., Moore, R., Morton, D., Nepogodiev, D., Ntirenganya, F., Pata, F., Pinkney, T., Qureshi, A. U., Ramos-De la Medina, A., Riad, A., Salem, H. K., Simoes, J., Spence, R., Smart, N., Tabiri, S., Thomas, H., Weiser, T. G., West, M., Whitaker, J., Harrison, E. M., Gjata, A., Modolo, M. M., King, S., Chan, E., Nahar, S. N., Waterman, A., Vervoort, D., Bedada, A. G., De Azevedo, B., Figueiredo, A. G., Sokolov, M., Barendegere, V., Ekwen, G., Agarwal, A., Liu, Q., Camilo Correa, J., Malemo, K. L., Bake, J., Mihanovic, J., Kuncarova, K., Orhalmi, J., Salem, H., Teras, J., Kechagias, A., Arnaud, A. P., Lindert, J., Kalles, V., Aguilera-Arevalo, M. -L., Recinos, G., Baranyai, Z., Kumar, B., Neelamraju Lakshmi, H., Zachariah, S. K., Alexander, P., Kumar Venkatappa, S., Pramesh, C., Amandito, R., Fleming, C., Ansaloni, L., Pellino, G., Altibi, A. M., Nour, I., Hamdun, I., Ghellai, A. M., Venskutonis, D., Poskus, T., Zilinskas, J., Malemia, P., Tew, Y. Y., Borg, E., Ellul, S., Wafqui, F. Z., Borowski, D. W., van Dalen, A. S., Wells, C., Adamou, H., Ademuyiwa, A., Adisa, A., Soreide, K., Al Saqqa, S., Alser, O., Tahboub, H., Segovia Lohse, H. A., Shu Yip, S., Major, P., Sampaio Soares, A., Bratu, M. R., Litvin, A., Vardanyan, A., Allen Ingabire, J. C., Gudal, A., Albati, N., Juloski, J., Rems, M., Rayne, S., Van Straten, S., Moodley, Y., Ortega Vazquez, I., Ruiz-Tovar, J., Senanayake, K. J., Thalgaspitiya, S. P. B., Omer, O. A., Homeida, A., Cengiz, Y., Clerc, D., Alshaar, M., Bouaziz, H., Altinel, Y., Doe, M., Freigofer, M., Teasdale, E., Kabariti, R., Clements, J. M., Ashfaq, A., Azodo, I., Wagner, G., Trostchansky, I., Maimbo, M., Linyama, D., Nina, H., Zeko, A., Fermani, C. G., Villalobos, S., Carballo, F., Farina, P., Guckenheimer, S., Dickfos, M., Ajmera, A., Chong, C., Gourlay, R., Hussaini, S., Lee, Y. J., Majid, A., Martin, P., Miles, R., Morris, O. J., Phua, J., Ridley, W., Saluja, T., Tan, R. R., Teh, J., Wells, A., Arora, B., Dollie, Q., Ho, D., Ma, Y., Perera, O. M., Truong, A., Dawson, A. C., Lim, B., Pahalawatta, U., Phan, J., Woon-Shoo-Tong, X. -M. S., Yeoh, A., Charman, L., Drane, A., Laura, S., Lo, C. C. W., Mozes, A., Poon, R., Tan, H. H., Wall, E., Chopra, P., De Giovanni, J., Dhital, B., Draganic, B., Duller, A., Gani, J., Goh, Y. K., Jeong, J. Y., Mcmanus, B., Nagappan, P., Pockney, P., Rugendyke, A., Sarrami, M., Smith, S., Wills, V., Wong, H. V., Ye, G., Zhang, G., Brooker, E., Feng, D., Lau, B., Ngai, C., Birks, S., Gyorki, D., Otero de Pablos, J., Abbosh, A., Gillespie, C., Mahmoud, A., Kwan, B., Lawson, J., Warwick, A., Bingham, J., Cockbain, A. J., Dudi-Venkata, N. N., Ellaby-Hall, J., Finlay, B., Humphries, E., Pisaniello, J., Pisaniello, M., Salih, S., Sammour, T., Abd Wahab, H. H., De Silva, A., Hayward, N., Iyer, K., Maddern, G., Prevost, G. A., Annapureddy, N., Settipalli, K. P., Yeo, J., Hempenstall, L., Pham, L., Purcell, S., Talavera, C., Vaska, A. I., Chaggar, G., Chrapko, P., Cocco, A., Coulter-Nile, S. M. C. J., Ctercteko, G., French, J., Gong, H., Gosselink, M., Jegathees, T., Jin, I., Kalachov, M., Kiefhaber, K., Lee, K., Luong, J., Phan, S., Pleass, H., Veale, K., Zeng, Z., Au, A., Debiasio, A., Deng, I., Myooran, J., Nair, A., Stewart, P., Stift, A., Unger, L. W., Wimmer, K., Ahmed, N., Hasan, S., Rahman, S., O'Shea, M., Padmore, G., Peters, A., Perduca, P., Pulcina, G., Tinton, N., Buxant, F., Dabin, E., Garofalo, G., Dossou, F., Gnangnon, F. H. R., Imorou Souaibou, Y., Motlaleselelo, P., Tlhomelang, O., Lima Buarque, I., Mendonca Ataide Gomes, G., Vieira Barros, A., Batashki, I., Damianov, N., Stoyanov, V., Dardanov, D., Maslyankov, S., Petkov, P., Todorov, G., Zhivkov, E., Akisheva, A., Castilla Moreno, M. A., Genov, G., Ilieva, I., Ivanov, T., Karamanliev, M., Khan, A., Mitkov, E., Yotsov, T., Atanasov, B., Belev, N., Slavchev, M., Nsengiyumva, C., Jones, E., Stock, S., Kyota, S., Brown, J., Mabanza, K. T., Nigo Samuel, L., Otuneme, C., Prosper, N., Umenze, F., Boutros, M., Caminsky, N., Dumitra, S., Garfinkle, R., Morency, D., Salama, E., Banks, A., Ferri, L., He, H., Katz, A., Liberman, A. S., Meterissian, S., Pang, A., Parvez, E., Hameed, U., Osman, F., Sequeira, S., Coburn, N., Jaffer, A., Karanicolas, P., Mosseler, M., Musselman, R., Liu, X., Yip, C. W., Garces-Otero, J. S., Guzman, C., Sierra, S., Uribe Valencia, A., Cabrera Rivera, P. A., Camelo, S., Gonzalez, A., Gonzalez-Orozco, A., Mosquera Paz, M. S., Perez Rivera, C. J., Gonzalez, F., Isaza-Restrepo, A., Nino- Torres, L., Arias Madrid, N., Mendoza Arango, M. C., Tsandiraki, J., Jemendzic, D., Kocman, B., Suman, O., Canic, R., Jurisic, D., Karakas, I., Krizanovic Rupcic, A., Pitlovic, V., Samardzic, J., Kopljar, M., Bacic, I., Domini, E., Karlo, R., Miljanic, D., Simic, A., Ahmed, M., Al Nassrallah, M., Altaf, R., Amjad, T., Eltoum, R., Haidar, H., Hassan, A., Khalil, O., Qasem, M., Ramesh, R., Sajith, G., Wisal, M., Zatecky, J., Bujda, M., Jirankova, K., Paclik, A., Abdallah, A., Abdulgawad Almogy, M., Ayman El-sawy, E., Elfayoumy, A. M., Elghareeb, N., Esmat, N. 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B., Abu Ataya, A., Abu Jayyab, I., Al-Shwaikh, S., Alagha, O., Alasttal, M., Awadallah, H., Elblbessy, M., Fares, J., Jarbou, A., Mahfouz, I., Albahnasawi, M. A., Abo mahadi, A., Abuelhatal, H., Abuelqomboz, A., Almoqayyad, A., Alwali, A., Balaawi, R., Hamouda, M., Humeid, M., Jedyan, A., Mahmoud Abu hamam, T., Matar, G., Salem, A. L., Samra, T., Shaheen, N., Shihada, K., A. Nemer, A., Abu Al Amrain, M., Abu Alamrain, A., Abu Jamie, N., Abu-Rous, M. R., Alfarra, N., Altaweel, M., Alwhaidi, N., Hamed, R., Saqqa, B., Shaheen, A., Aljaber, D., Aljaberi, L., Alwaheidi, M., Jawaada, A., Khaldi, H., Qahoush, R., Qari, J., Saadeh, R., Salim, A., Yacoub, A., Abbas, A., Abu shua'ib, R., Abu Zainah, B., Abusirrees, M., Babaa, B., Barhoush, O., Belal qadomi, A., Daraghmeh, L., Haji, R., Khatatbeh, A., Khatib, L., Qarariah, S., Quzmar, Y., Safadi, K., Salameh, R., Hassan, M., Herzallah, S., Massad, L., Nazzal, A., Nazzal, R., Escobar, D., Machain V, G. M., Rodriguez Gonzalez, A., Chachaima Mar, J. E., Chinchihualpa Paredes, N. O., Cuba, V., Lopez, W., Niquen Jimenez, M. M., Sanchez Bartra, N. A., Sapallanay Ojeda, O., Sequeiros, D., Toscano Pacheco, A., Vergara, M., Abarca, S., Alcorta, R., Borda-Luque, G., Eusebio Zegarra, I. E., Lujan Lopez, C., Marrufo, M., Mogrovejo, C., Nomura, A., Rodriguez Angeles, Y., Vidal Meza, M. R., Zavala, G., Castillo Arrascue, J. N., Hidrogo Cabrera, J. C., Larrea vera, J. J. M., Osorio, M., Ylatoma Diaz, E. A., Fontanilla, M. A., Fuentes, J. R., Salazar, A. L., Dominguez, G., Lopez, M. P., Macalindong, S., Onglao, M. A., Ramirez, A., Sacdalan, M. D., Tampo, M. M., Uy, G. L., Mangahas, J., Yabut, K., Canete, J. P., Cansana, B. E., Castro, E. J., Lipana, M. K., Roxas, M. F., Zara, V. J., Chrol, M., Franczak, P., Orlowski, M., Budzynski, P., Budzynski, A., Bury, P., Czerwinska, A., Dworak, J., Dziedzic, J., Kisielewski, M., Kulawik, J., Lasek, A., Malczak, P., Migaczewski, M., Pedziwiatr, M., Pisarska, M., Radkowiak, D., Rubinkiewicz, M., Rzepa, A., Skoczylas, T., Stanek, M., Truszkiewicz, K., Wierdak, M., Winiarski, M., Zarzycki, P., Zub-Pokrowiecka, A., Kowalewski, P., Roszkowski, R., Waledziak, M., Tome, M., Patrocinio, S., Guerreiro, I., Almeida, F., de Sousa, X., Monteiro, N., Costa Santos, M. T., de Oliveira, D., Lopes Serra, M., Morgado, D., Neves, C., Oliveira, A. C., Pimentel, A., Silva, S., Carvalho, M., Carvalho, L., Magalhaes, J., Matos, L., Monteiro, T., Ramos, C., Santos, V., Barbosa, J., Costa-Maia, J., Devezas, V., Fareleira, A., Fernandes, C., Goncalves, D., Mora, H., Morais, M., Silva de Sousa, F., Catarino Santos, S., Logrado, A., Tojal, A., Amorim, E., Cunha, M. F., Fazenda, A., Melo Neves, J. P., Sampaio da Novoa Gomes Miguel, I. I., Veiga, D., Azevedo, J., Cardoso Louro, H., Leite, M., Bairos Menezes, M., Gama, B., Brito, D., Cruz Martins, M. C., Graca e Magalhaes, A., Longras, A. C., Lourenco, R., Matos, D., Castro, L., Policarpo, F., Romano, J., Monteiro, C., Pinto, D., Duarte, M., Fortuna Martins, S., Oliveira, M., Galvao, D., Martins, L., Silva, A., Taranu, V., Vieira, B., Neves, J., Oliveira, S., Ribeiro, H., Cinza, M., Felix, R., Machado, A., Oliveira, J., Patricio, J., Pedroso de Lima, R., Pereira, M., Rocha Melo, M., Velez, C., Abreu da Silva, A., Claro, M., Costa Santos, D., Ferreira, A., Capote, H., Rosado, D., Tare, F., Nogueira, O., Angelo, M., Baiao, J. M., Guimaraes, A., Marques, J., Nico Albano, M., Silva, M., Valente da Costa, A., Vieira Caroco, T., Almeida Braga, S., Capunge, I., Fragoso, M., Guimaraes, J., Pinto, B., Ribeiro, J., Angel, M., Fialho, G., Guerrero, M., Campos Costa, F., Cardoso, D., Cardoso, V., Alves, M., Estalagem, I., Louro, T., Marques, C., Martelo, R., Morgado, M., Canotilho, R., Correia, A. M., Martins, P., Peyroteo, M., Gomes, J., Monteiro, R., Romano, M., Alves, D. M., Peixoto, R., Quintela, C., Jervis, M. J., Melo, D., Pacheco, A., Paixao, V., Pedro, V., Pimenta, J., Pimenta de Castro, J., Rocha, A., Beuran, M., Ciubotaru, C., Diaconescu, B., Hostiuc, S., Negoi, I., Stoica, B., Na, N. A., Anokhin, E., Kuznetsov, G., Oganezov, G., Paramzin, F., Romanova, E., Rutkovskii, V., Shushval, M., Zabiyaka, M., Dzhumabaev, K., Ivanov, V., Mamedli, Z., Achkasov, S., Balkarov, A., Nabiev, E., Nagudov, M., Rybakov, E., Saifutdinova, K., Sushkov, O., Joseph, L., Ndayishimiye, I., Faustin, N., Mutabazi, A. Z., Mvukiyehe, J. P., Nsengimana, V. J. P., Uwakunda, C., Abbas, M. M., Akeel, N., Aljiffry, M., Awaji, K., Farsi, A., Jamjoum, G., Khoja, A., Maghrabi, A., Malibary, N., Nassif, M., Saleem, A., Sultan, A., Tashkandi, W., Tashkandi, H., Trabulsi, N., Ba, M. B., Diallo, A. C., Ndong, A., Cuk, V., Jankovic, U., Koh, S. Z., Koh, F., Lee, K. C., Lee, K. Y., Lee, S., Leong, W. Q., Lui, S. A., Prakash, P., Grosek, J., Norcic, G., Tomazic, A., Fitchat, N., Jaich, R., Wineberg, D., Koto, M. Z., Baiocchi, D., Clarke, D., Steenkamp, C. J., Bannister, S., Boutall, A., Chinnery, G., Coccia, A., Dell, A., Karjiker, P., Kloppers, C., Loxton, N., Mabogoane, T., Malherbe, F., Panieri, E., Rayamajhi, S., van Wyngaard, T., Warden, C., Madiba, T. E., Pillay, N., Brooks, S., Kruger, C., Van Der Merwe, L. H., Gool, F., Kariem, M., Bougard, H., Kariem, N., Noor, F., Pillay, R., Steynfaardt, L., Gonzalez Gonzalez, L., Marin Santos, J. M., Martin-Borregon, P., Martinez Caballero, J., Nevado Garcia, C., Rodriguez Fraga, P., De Castro Parga, G., Fernandez Veiga, M. P., Garrido Lopez, L., Infante Pino, H., Lages Cal, I., Lopez Otero, M., Nogueira Sixto, M., Paniagua Garcia Senorans, M., Rodriguez Fernandez, L., Ruano Poblador, A., Rufo Crespo, E., Sanchez-Santos, R., Vigorita, V., Alonso Batanero, E., Asnel, D., Cifrian Canales, I., Contreras Saiz, E., De Santiago Alvarez, I., Diaz Vico, T., Fernandez Arias, S., Fernandez Martinez, D., Garcia Bernardo, C., Garcia Florez, L. J., Garcia Gutierrez, C., Garcia Munar, M., Marquez Zorrilla Molina, C. A., Merayo, M., Michi Campos, J. L., Moreno Gijon, M., Otero-Diez, J. L., Rodicio Miravalles, J. L., Solar-Garcia, L., Suarez Sanchez, A., Truan, N., Alejandre Villalobos, C., Caballero Diaz, Y., Jimenez, M., Montesdeoca, D., Navarro-Sanchez, A., Vega, V., Beltran de Heredia, J., Gomez, Z., Jezieniecki, C., Legido Moran, A. P., Montes-Manrique, M., Rodriguez-Lopez, M., Ruiz Soriano, M., Trujillo Diaz, J., Vazquez Fernandez, A., Argudo, N., Pera, M., Torrent Jansa, L., Garcia Dominguez, M., Goded, I., Roldon Golet, M., Talal El-Abur, I., Utrilla Fornals, A., Zambrana Campos, V., Aguilar Martinez, M. D. M., Bosch, M., Garcia-Catala, L., Sanchez-Guillen, L., Artigau, E., Gomez Romeu, N., Julia Bergkvist, D., Espina Perez, B., Morato, O., Olona, C., Dieguez, B., Forero-Torres, A., Losada, M., Gomez-Abril, S., Gonzalvez, P., Martinez, R., Navarro Martinez, S., Paya-Llorente, C., Perez Rubio, A., Santarrufina Martinez, S., Sebastian Tomas, J. C., Trullenque Juan, R., Gegundez Simon, A., Mate, P., Prieto-Nieto, M. I., Rubio-Perez, I., Urbieta, A., Vicario Bravo, M., Abello, D., Frasson, M., Garcia-Granero, A., Abad Gurumeta, A., Abad-Motos, A., Lucena-de Pablo, E., Nozal, B., Ripolles-Melchor, J., Salvachua, R., Ferrero, E., Garcia-Sancho Tellez, L., Picardo, A. L., Rojo Lopez, J. A., Zorrilla Matilla, L. P., Cagigas Fernandez, C., Castanedo Bezanilla, S., Estevez Tesouro, J., Fernandez-Diaz, M. J., Garcia Cardo, J., Gomez Ruiz, M., Gonzalez-Tolaretxipi, E., Jimeno Fraile, J., Poch, C., Rodriguez-Aguirre, M., Troche Pesqueira, N., Trugeda-Carrera, M. S., de la Torre, J., Blanco-Colino, R., Espin-Basany, E., Espinosa-Bravo, M., Morales Comas, C., Reyes Afonso, E., Rivero Deniz, J., Siso Raber, C., Verdaguer Tremolosa, M., Chandrasinghe, P., Kumarage, S., Wijekoon Arachchilage, N., Abdalla Ahmed Elkamel, A., A. Adam, M., Blomme, N., Thorell, A., Wogensen, F., Alga, A., Ansarei, D., Celebioglu, F., Heinius, G., Nigard, L., Pieniowski, E., Ahlqvist, S., Bjorklund, I., Franberg, A., Hakansson, M., Adamo, K., Franklin, O., Sund, M., Wiberg, R., Andersson, Y., Chabok, A., Nikberg, M., Kugelberg, A., Canonica, C., Christoforidis, D., Fasolini, F., Gaffuri, P., Giuliani, M., Meani, F., Popeskou, S. G., Pozza, S., Wandschneider, W., Peterer, L., Widmer, L. W., Zimmermann, B., Bakoleas, P., Chanousi, I., Charalampidou, L., Grochola, L. F., Heid, F., Ntaoulas, S., Outos, M., Peros, G., Podolska-Skoczek, H., Reinisch, K. B., Zielasek, C., Demartines, N., Gilgien, J., Kefleyesus, A., St-Amour, P., Toussaint, A., Alhimyar, M., Alsaid, B., Alyafi, A., Alkhaledi, A., Kouz, B., Omarain, A., Al-Sabbagh, Y., Alkhatib, H., Sara, S., Alhaj, A., Danial, A., Kadoura, L., Maa Albared, S., Monawar, Y., Nahas, L., Abd, B., Saad, A., Wakkaf, H., Bouzaiene, H., Ghalleb, M., Akaydin, E., Akbaba, A. C., Atakul, O., Baltaci, E., Besli, S., Burgu, G., Cenal, U., de Muijnck, C., Demirkaya, H. C., Dogruoz, A., Gezer, Z. I., Gundogdu, Y., Kara, M., Korkmaz, H. K., Kurtoglu, G. K., Ozben, V., Ozmen, B. B., Pektas, A. M., Sel, E. K., Yenidunya, N., Bengur, F. B., Oral, B. M., Yozgatli, T. K., Abdullayev, S., Gunes, M. E., Sahbaz, N. A., Banaz, T., Kargici, K., Kuyumcu, O. F., Yanikoglu, E., Yesilsancak, M., Yilmaz, D., Aktas, M. K., Rencuzogullari, A., Isik, A., Leventoglu, S., Yalcinkaya, A., Yuksel, O., Kalayci, M. U., Kara, Y., Sarici, I. S., Akin, A., Alemdag, G. N., Arslan, E., Baki, B. E., Bodur, M. S., Calik, A., Candas Altinbas, B., Cihanyurdu, I., Erkul, O., Gul, B., Guner, A., Kose, B., Semiz, A., Sevim, S., Tayar, S., Tomas, K., Tufek, O. Y., Turkyilmaz, S., Ulusahin, M., Usta, A., Yildirim, R., Guler, S. A., Tatar, O. C., Varol, E., Kirimtay, B., Uysal, M., Yildiz, A., Kose, E., Ciftci, A. B., Colak, E., Eraslan, H., Kucuk, G. O., Yemez, K., Lule, H., Bienfait, M., Bua, E., Okalany, N., Basarab, M., Bielosludtsev, O., Kolhanova, K., Perepelytsia, K., Romanukha, K., Savenkov, D., Siryi, S., Tereshchenko, M., Viacheslav, N., Volovetskyi, A., Kebkalo, A., Tryliskyy, Y., Tyselskiy, V., Bruce, E., Chow, B. L., Iddles, E., Mcguckin, S., Newall, N., Ramsay, G., Sharma, P., Stewart, C., Wong, J., Badran, A., Bath, M., Belais, F., Butt, E., Joshi, K., Kapur, M., Shaw, M., Townson, A., Williams, C. Y. K., Gray, T., Greig, R., Husain, M., Murray, E., Mustafa, A., Asif, A., Gokul, A., Shah, M., Akitikori, M. T., Charalabopoulos, A., Davidson, S., Mcnally, S., Rupani, S., Juma, F., Mills, S. C., Muirhead, L., Sellars, K., Walsh, U., Warren, O., Chambers, A., Hunt, R., Boyce, S., Cornwall, H., Tol, I., Argyriou, E. O., Eardley, N., Povey, M., Aithie, J. M. S., Irfan, A., Mcguigan, M. -C., Starr, R., Warren, C. R., Archibald, J., Kirby, G., Kisyov, I., Khoo, C. K., Lee, R., Photiou, D., Davis, R., Prasad, U., Yang, P. Z., Bird, J., Leung, E., Summerour, V., Currow, C., Kiam, J., Tan, G. J. S., Muthusami, A., Pegba-Otemolu, I., Urbonas, T., Nunoo-Mensah, J., Smolskas, E., Boddy, A., Gravante, G., Hunter, D., Andrew, D., Koh, A., Thompson, A., Adams, L., Clements, H. 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S., Mitchell, R., Monaghan, E., Crawford, J., Moug, S., Blackwell, J., Boyd-Carson, H., Herrod, P., Al-Allaf, O., Beattie, M., Bullock, C., Burman, S., Clark, G., Flamey, N., Flannery, O., Harding, A., Kodiatt, B., Lawday, S., Mahapatra, S., Mukundu Nagesh, N., Ng, M., Rye, D., Yoong, A., Clark, L., Deans, C., Edirisooriya, M., Carrington, E. V., Wong, T. L. E., Yusuf, B., Chamberlain, C., Duke, K., Kmiotek, E., Botes, A., Condie, N., Schrire, T., Shah, R., Thomas-Jones, I., Yates, C., Anthony, N., Matthews, E., Sahnan, K., Tankel, J., Tucker, S., Winter Beatty, J., Ziprin, P., Duggan, W., Kantartzi, A., Sridhar, S., Khaw, R. A., Srivastava, P., Underwood, C., Alves do Canto Brum, H., Chopra, S., Davis, L., Hughes, R., Tulley, J., Alberts, J., Athisayaraj, T., Olugbemi, M., Ahmad, K., Chan, C., Chapman, G., Fleming, H., Fox, B., Grewar, J., Hulse, K., Rutherford, D., Sinead, M., Speake, D., Vaughan-Shaw, P. G., Christodoulides, N., Kudhail, S., Welch, M., Husaini, S. 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C., Robertson, H., Lennon, H., Loi, L., Kirkham, E., Mccann, C., Watts, D., Gurung, B., Wilson, M., Tribedi, T., Garofalo, E., Zahra, B., Macdonald, S., Daniels, I., Ng, N., Khosla, S., Olivier, J., Yue, S. Y. P., Suresh, G., Wellington, J., Lorejo, E., Mossaad, M., Crutcher, M., Alimi, M., Baiu, I., Abdou, H., Conway, A., Peck, C., Perdomo Perez, M. A., Zulu, S., Nakazwe, M., Department of Surgery, HUS Abdominal Center, Knight, Stephen R, Shaw, Catherine A, Pius, Riinu, Drake, Thomas M, Norman, Lisa, Ademuyiwa, Adesoji O, Adisa, Adewale O, Aguilera, Maria Lorena, Al-Saqqa, Sara W, Al-Slaibi, Ibrahim, Bhangu, Aneel, Biccard, Bruce M, Brocklehurst, Peter, Costas-Chavarri, Ainhoa, Chu, Kathryn, Dare, Anna, Elhadi, Muhammed, Fairfield, Cameron J, Fitzgerald, J Edward, Ghosh, Dhruv, Glasbey, James, van Berge Henegouwen, Mark I, Ingabire, J C Allen, Kingham, T Peter, Lapitan, Marie Carmela, Lawani, Ismaïl, Lieske, Bettina, Lilford, Richard, Martin, Janet, McLean, Kenneth A, Moore, Rachel, Morton, Dion, Nepogodiev, Dmitri, Ntirenganya, Faustin, Pata, Francesco, Pinkney, Thomas, Qureshi, Ahmad Uzair, Ramos-De la Medina, Antonio, Riad, Aya, Salem, Hosni Khairy, Simões, Joana, Spence, Richard, Smart, Neil, Tabiri, Stephen, Thomas, Hannah, Weiser, Thomas G, West, Malcolm, Whitaker, John, Harrison, Ewen M, Gjata, Arben, Modolo, Maria Marta, 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Jezieniecki, Carlos, Legido Morán, Ana Patricia, Montes-Manrique, Mario, Rodriguez-Lopez, Mario, Ruiz Soriano, María, Trujillo Díaz, Jeancarlos, Vazquez Fernandez, Andrea, Argudo, Nuria, Pera, Miguel, Torrent Jansà, Laia, García Domínguez, Melody, Goded, Ignacio, Roldón Golet, Marta, Talal El-Abur, Issa, Utrilla Fornals, Alejandra, Zambrana Campos, Vanesa, Aguilar Martinez, Maria Del Mar, Bosch, Marina, García-Catalá, Luis, Sánchez-Guillén, Luis, Artigau, Eva, Gomez Romeu, Nuria, Julià Bergkvist, David, Espina Perez, Beatriz, Morató, Olga, Olona, Carles, Diéguez, Beatriz, Forero-Torres, Alexander, Losada, Manuel, Gomez-Abril, Segundo, Gonzálvez, Paula, Martinez, Rosario, Navarro Martínez, Sergio, Payá-Llorente, Carmen, Pérez Rubio, Álvaro, Santarrufina Martinez, Sandra, Sebastián Tomás, Juan Carlos, Trullenque Juan, Ramon, Gegúndez Simón, Alberto, Maté, Paloma, Prieto-Nieto, Maria Isabel, Rubio-Perez, Ines, Urbieta, Aitor, Vicario Bravo, Marina, Abelló, David, Frasson, Matteo, Garcia-Granero, Alvaro, Abad Gurumeta, Alfredo, Abad-Motos, Ane, Lucena-de Pablo, Elena, Nozal, Beatriz, Ripollés-Melchor, Javier, Salvachúa, Rut, Ferrero, Esther, Garcia-Sancho Tellez, Luis, Picardo, Antonio L, Rojo López, Jose Alberto, Zorrilla Matilla, Laura Patricia, Cagigas Fernandez, Carmen, Castanedo Bezanilla, Sonia, Estevez Tesouro, José, Fernandez-Diaz, Maria Jose, García Cardo, Juan, Gomez Ruiz, Marcos, Gonzalez-Tolaretxipi, Erik, Jimeno Fraile, Jaime, Poch, Cristobal, Rodriguez-Aguirre, Montserrat, Troche Pesqueira, Noemí, Trugeda-Carrera, Maria Soledad, de la Torre, Javier, Blanco-Colino, Ruth, Espin-Basany, Eloy, Espinosa-Bravo, Martin, Morales Comas, Clara, Reyes Afonso, Eduardo, Rivero Déniz, Joaquín, Siso Raber, Christian, Verdaguer Tremolosa, Mireia, Chandrasinghe, Pramodh, Kumarage, Sumudu, Wijekoon Arachchilage, Nimeshi, Abdalla Ahmed Elkamel, Ahmed, A Adam, Mohammed, Blomme, Nina, Thorell, Anders, Wogensen, Fredrik, Älgå, Andreas, Ansarei, Dhirar, Celebioglu, Fuat, Heinius, Göran, Nigard, Linda, Pieniowski, Emil, Ahlqvist, Sandra, Björklund, Ida, Frånberg, Andreas, Håkansson, Martina, Adamo, Karin, Franklin, Oskar, Sund, Malin, Wiberg, Rebecca, Andersson, Yvette, Chabok, Abbas, Nikberg, Maziar, Kugelberg, Alexander, Canonica, Claudia, Christoforidis, Dimitrios, Fasolini, Fabrizio, Gaffuri, Paolo, Giuliani, Mauro, Meani, Francesco, Popeskou, Sotirios Georgios, Pozza, Silvia, Wandschneider, Wiebke, Peterer, Lorenz, Widmer, Lukas Werner, Zimmermann, Bernd, Bakoleas, Panagiotis, Chanousi, Iris, Charalampidou, Lydia, Grochola, Lukasz Filip, Heid, Franziska, Ntaoulas, Sotirios, Outos, Michail, Peros, Georgios, Podolska-Skoczek, Hanna, Reinisch, Katharina Beate, Zielasek, Christian, Demartines, Nicolas, Gilgien, Jérôme, Kefleyesus, Amaniel, St-Amour, Pénélope, Toussaint, Arnaud, Alhimyar, Maryam, Alsaid, Bayan, Alyafi, Amr, Alkhaledi, Ahmad, Kouz, Basel, Omarain, Ahmad, Al-Sabbagh, Yusra, Alkhatib, Haya, Sara, Samer, Alhaj, Ahmad, Danial, Aghyad, Kadoura, Lama, Maa Albared, Sarah, Monawar, Yamen, Nahas, Louei, Abd, Barook, Saad, Ahmad, Wakkaf, Habib, Bouzaiene, Hatem, Ghalleb, Montassar, Akaydin, Elif, Akbaba, Ata Cem, Atakul, Onur, Baltaci, Ege, Besli, Sevval, Burgu, Gökçen, Cenal, Ulukan, de Muijnck, Cansu, Demirkaya, Hasan Can, Dogruoz, Alper, Gezer, Zeynep Ipek, Gündogdu, Yasemin, Kara, Merve, Korkmaz, Hasan Kürsad, Kurtoglu, Gökalp Kagan, Ozben, Volkan, Ozmen, Berk Baris, Pektas, Ahmet Murat, Sel, Eda Kübra, Yenidünya, Nilüfer, Bengur, Fuat Baris, Oral, Berke Mustafa, Yozgatli, Tahir Koray, Abdullayev, Seymur, Gunes, Mehmet Emin, Sahbaz, Nuri Alper, Banaz, Tuba, Kargici, Kübra, Kuyumcu, Omer Faruk, Yanikoglu, Erkan, Yesilsancak, Merve, Yilmaz, Duygu, Aktas, Melik Kagan, Rencuzogullari, Ahmet, Isik, Arda, Leventoglu, Sezai, Yalçinkaya, Ali, Yüksel, Osman, Kalayci, Mustafa U, Kara, Yasin, Sarici, Inanc Samil, Akin, Alp, Alemdag, Gökçe Nur, Arslan, Ekin, Baki, Bahadir Emre, Bodur, Muhammed Selim, Calik, Adnan, Candas Altinbas, Bahar, Cihanyurdu, Irem, Erkul, Oguz, Gül, Burak, Guner, Ali, Köse, Beyza, Semiz, Anil, Sevim, Sule, Tayar, Serkan, Tomas, Kadir, Tüfek, Ozan Yavuz, Türkyilmaz, Serdar, Ulusahin, Mehmet, Usta, Arif, Yildirim, Reyyan, Güler, Sertaç Ata, Tatar, Ozan Can, Varol, Ecenur, Kirimtay, Busenur, Uysal, Muhammed, Yildiz, Alp, Kose, Emin, Ciftci, Ahmet Burak, Çolak, Elif, Eraslan, Huseyin, Kucuk, Gultekin Ozan, Yemez, Kürsat, Lule, Herman, Bienfait, Mumbere, Bua, Emmanuel, Okalany, Noella, Basarab, Maksym, Bielosludtsev, Oleksii, Kolhanova, Kateryna, Perepelytsia, Kateryna, Romanukha, Kateryna, Savenkov, Dmytro, Siryi, Stanislav, Tereshchenko, Maksym, Viacheslav, Nezamai, Volovetskyi, Anton, Kebkalo, Andrey, Tryliskyy, Yegor, Tyselskiy, Volodimir, Bruce, Eilidh, Chow, Bing Lun, Iddles, Emma, McGuckin, Sarah, Newall, Nicola, Ramsay, George, Sharma, Parivrudh, Stewart, Caitlin, Wong, Jeremy, Badran, Abdul, Bath, Michael, Belais, Fanny, Butt, Eman, Joshi, Kaustuv, Kapur, Milan, Shaw, Mike, Townson, Adam, Williams, Christopher Yee Khang, Gray, Timothy, Greig, Robert, Husain, Mansoor, Murray, Elspeth, Mustafa, Ahmed, Asif, Ashar, Gokul, Arya, Shah, Max, Akitikori, Mabel Temisanren, Charalabopoulos, Alexandros, Davidson, Sophie, McNally, Sinead, Rupani, Shamil, Juma, Fatema, Mills, Sarah Catherine, Muirhead, Laura, Sellars, Kate, Walsh, Una, Warren, Oliver, Chambers, Alice, Hunt, Richard, Boyce, Stephen, Cornwall, Hannah, Tol, Isabel, Argyriou, Eleftherios Orestis, Eardley, Nicola, Povey, Meical, Aithie, Joanna M S, Irfan, Ahmer, McGuigan, Mari-Claire, Starr, Robert, Warren, Craig Russell, Archibald, Jess, Kirby, Georgia, Kisyov, Ivan, Khoo, Chun Kheng, Lee, Rachel, Photiou, Dana, Davis, Rowan, Prasad, Uday, Yang, P Zichu, Bird, Jonathan, Leung, Edmund, Summerour, Virginia, Currow, Chelise, Kiam, Jianshen, Tan, Gerald Jack Soon, Muthusami, Anitha, Pegba-Otemolu, Ibifunke, Urbonas, Tomas, Nunoo-Mensah, Joseph, Smolskas, Edgaras, Boddy, Alex, Gravante, Gianpiero, Hunter, David, Andrew, David, Koh, Amanda, Thompson, Amari, Adams, Lawrence, Clements, Hollie A, De Silva, Kasun, Ekpete, Ogbonnia, Haque, Seraj, Henderson, Scott, Ibrahim, Bilal, Jayasinghe, Thummini, Livie, Jennifer, Mailley, Keir, Nair, Gopikrishnan, Tan, Daniel, Baggaley, Caitlin, Dawidziuk, Aleksander, Szyszka, Bartosz, Barter, Charlotte, Gandhi, Nirav, Hassell, Karen, Hitchin, Samantha, Kelsall, Jennett, Nagy, Eva, Nessa, Ashrafun, Whisker, Lisa, Yanni, Fady, Ali, Mahmoud, Arora, Deeksha, Hediwattege, Sunanda, Kumarasinghe, Navam, Rathore, Munir, Tennakoon, Athula, Ali Ahmad, Syed Mustafa, Bajomo, Oreoluwa, Nadira, Fahema, Celentano, Valerio, Griffiths, Ewen, Karri, Rama Santhosh, Mak, Jason Kei Chak, Pipe, Michelle, Bhatti, Muhammad Iqbal, Rabie, Mohamed, Boyle, Connor, Hamilton, David, Mihuna, Aishath, Ng, James Chean Khun, Nicholson, Gary, Oliwa, Agata, Pearson, Robert, Rose, Anna, Yong, Shun Qi, Boereboom, Catherine, Hanna, Michael, Walter, Catherine, Greensmith, Thomas Samuel, Mitchell, Rachel, Monaghan, Eimear, Crawford, James, Moug, Susan, Blackwell, James, Boyd-Carson, Hannah, Herrod, Philip, Al-Allaf, Omar, Beattie, Miriam, Bullock, Cameron, Burman, Shivang, Clark, Gemma, Flamey, Nicolas, Flannery, Oliver, Harding, Alexander, Kodiatt, Ben, Lawday, Samuel, Mahapatra, Shivani, Mukundu Nagesh, Navin, Ng, Michael, Rye, Dupinderjit, Yoong, Andrel, Clark, Laura, Deans, Chris, Edirisooriya, Monisha, Carrington, Emma Victoria, Wong, Tsz Lun Ernest, Yusuf, Baasil, Chamberlain, Carla, Duke, Kathryn, Kmiotek, Elizabeth, Botes, Azel, Condie, Natalie, Schrire, Timothy, Shah, Reena, Thomas-Jones, Iolo, Yates, Charlotte, Anthony, Natasha, Matthews, Edward, Sahnan, Kapil, Tankel, James, Tucker, Sally, Winter Beatty, Jasmine, Ziprin, Paul, Duggan, William, Kantartzi, Anastasia, Sridhar, Shruthi, Khaw, Rachel Alys, Srivastava, Prakhar, Underwood, Charlotte, Alves do Canto Brum, Homero, Chopra, Sharat, Davis, Laura, Hughes, Rebecca, Tulley, Joshua, Alberts, Justin, Athisayaraj, Thomas, Olugbemi, Mojolaoluwa, Ahmad, Kasim, Chan, Claudia, Chapman, Gavin, Fleming, Hannah, Fox, Benjamin, Grewar, Julia, Hulse, Kate, Rutherford, Duncan, Sinead, Mackay, Smith, Scott, Speake, Doug, Vaughan-Shaw, Peter G, Christodoulides, Natasha, Kudhail, Simrit, Welch, Matthew, Husaini, Syed Muhibullah, Lambracos, Simon, Anyanwu, Chikamuche, Suresh, Rishi, Thomas, Jimmy Scott, Gleeson, Elizabeth, Platoff, Rebecca, Saif, Areeba, Enumah, Zachary, Etchill, Eric, Gabre-Kidan, Alodia, Bernstein, Mitchell, Carrano, Francesco Maria, Connors, Joseph, Lynn, Patricio, Melis, Marcovalerio, Newman, Elliot, Foster, Deshka S, Perrone, Kenneth, Titan, Ashley, Ahmad, Sarwat, Bafford, Andrea Chao M D, Dal Molin, Marco, Hanna, Nader, Zafar, Syed Nabeel, Hemmila, Mark, Napolitano, Lena, Wong, Jane J, Chandler, Julia, Wood, Lauren, Wren, Sherry, Ottesen, Taylor, You, Lucia, Yu, Kristin, Arciénega Yañez, María Del Pilar, Ferreira Fernandes, Martin, González, Daniel, Cubas, Santiago, González, María Catalina, Zubiaurre, Vanessa, Demolin, Rodrigo, Giroff, Nicolas, Sciuto, Pablo, Campos, Maite, Rodríguez Cantera, Gabriela, Deepika, Garg, Simuchimba, Elliot, Bulaya, Anadi, Chibuye, Chali, Chirengendure, Bright, Kabale, Mary-Rose, Kabongo, Kizito, Munthali, James, Mweso, Oliver, Pikiti, Francis, Otieno, James, Lai, Log Tung, Blackman, Brighid, Richards, Sophie, Subramaniam, Suren, Karim, Rafid, Kok, Nathan, Lee, Yanni Dion, Ali, Shabina, Sinha, Aanjaneya, Corrigan, Robert, Barnes, Nicole, Wong, Florence, Dennis, Grace, Jedamzik, Julia, Phillips, Emil, Piette, Wivine, Van Hentenryck, Marie, Koco, Houenoukpo, Lawani, Souliath, Kassa, Mamo Woldu, Santos Bezerra, Tainá, Gribnev, Petar, Dimitrov, Dobromir, Krastev, Panche, Oum, Sovannarith, Bonghaseh, Divine Tim, Al Farsi, Maryam, Alsharqawi, Nourah, Acevedo, Veronica, Castillo Barbosa, Andrea Carolina, Giron, Felipe, Leon Rodriguez, Jimmy Paul, Kucan, Darko, Rosko, Damir, Barsic, Neven, Župan, Domagoj, Hegazi, Amgad, Truncíková, Vendula, Fryba, Vladimir, Mohamed, Mostafa, Sultan, Ahmed, Nagi, Ahmed, Rashad Temerik, Abdallah, Elshawy, Mohamed Elemam, Mahmoud, Moustafa Ibrahim, Omar, Shrouk, Anwar, Mohamed, Rageh, Tarek, Elmokadem, Aya, Gaballa, Khaled, Teppo, Sandra, Turunen, Antti, Pengermä, Pasi, Ballouhey, Quentin, Bergeat, Damien, Weyl, Ariane, Hain, Elisabeth, Gyedu, Adam, Yenli, Edwin, Osei-Poku, Dorcas, Rompou, Vaia-Aliki, Zoikas, Athanasios, Gaitanidis, Apostolos, Koukis, Georgios, Perivoliotis, Konstantinos, Tavlas, Panagiotis, Galanos-Demiris, Konstantinos, Zografos, George, Karavokyros, Ioannis, Xanthopoulou, Georgia, Iordanidou, Eirini, Ayau, Fernanda, Garcia, Allan, Damján, Pekli, Wason, Deepender, B L, Ashika, Rangganata, Ervandy, Kamath, Prerna, O'Connor, Donal B, Pinto, Margherita, Perrone, Fabrizio, Tropeano, Francesca Paola, Troilo, Francesca, Bossi, Daniela, Scala, Dario, Pulitanò, Lucrezia, Carella, Marcella, Pietrabissa, Andrea, Gori, Alice, Giraudo, Giorgio, De Simone, Veronica, Russo, Alfio Alessandro, Braccio, Bartolomeo, Al-Taher, Raed, Athamneh, Sarah, Parker, Andrea, Sawiee, Adnan, Kattia, Amina, Salem, Malik, Tababa, Osama, Shaeeb, Zuhour, Syminas, Vilius, Jurgaitis, Jonas, Damuleviciene, Gyte, Svagzdys, Saulius, Poskus, Tomas, Razafimanjato, Narindra Njarasoa Mihaja, Chieng Loo, Ling, Tiong, Ing Ching, Wan Muhmad, Wan Farahiyah, Vijeyan, Harinthiran, Li Ying, Teoh, Grech, Gabriella, Arrangoiz, Rodrigo, Jimenez Ley, Vania Brickelia, Arizpe, Daniel, Lagunes Lara, Elizabeth, Castro López, Elizabeth Victoria, Eaazim, Jose, Gordinou de Gouberville, Marije, Bastiaenen, Vivian, Rottier, Simone, Nahab, Fouad, Ji, Maria Yeonhee, Seyoji, Mohammed, Nwachukwu, Callistus, Emeghara, Okechukwu, Muhammed, Sayyid Egbunu, Idowu, Ayodeji, Sowemimo, Olamiposi, Ogundoyin, Olakayode, Akande, Oluwatosin, Lott, Alexander, Nadeem, Maliha, Laghari, Ahsan Ali, Loya, Asif, Mushtaq, Hassan, Abdullah, Muhammad Tariq, Abuhilal, Baseel, Atawneh, Mohammad, Hamdan, Hamdan, Alhabil, Belal, Srour, Abedelrahman, Mousa, Ibrahim, Da Silva Medina, Luis, Bartosiak, Katarzyna, Ferreira, Pedro, Francisco, Vítor, Lemos, Ricardo, Frutuoso, Luísa, Fernandes, Sara, Fonseca, Telma, Pereira, Jorge, Rachadell, Juan, Torre, Ana, Madeira Martins, Filipe, Carvalho, Ana Cristina, Rodrigues Ferreira, Joana, Ribeiro da Silva, Bruno, Devesa, Helena, Vieira, Ana, Mónica, Inês, Amaro, Margarida, Sousa, Diogo, Reia, Marta, Louro, João, Martins, Ana, Dominguez, Joaquina, Santos, Inês, Freitas Oliveira, Nuno Miguel, Pereira, José Carlos, Silva-Vaz, Pedro, Freire, Ligia, Escrevente, Ricardo, Negoita, Valentina Madalina, Shakhmatov, Dmitry, Nezerwa, Yves, Radulovic, Radosav, Obery, Gareth, Viljoen, Francois, Mendes, Tome, Suarez, Antonio, Moncada, Enrique, Fernandez-Hevia, Maria, Curtis Martínez, Carolina, Gil Garcia, Julia Maria, González Zunzarren, Mariana, Idris, Tarig, Eklöv, Karolina, Grahn, Oskar, Amin, Leila, Blomqvist, Malin, Ajani, Costanza, Kraus, Rebecca, Seeger, Nico, Willemin, Melissa, Rayya, Fadi, Ayash, Mohammad, Msouti, Raneem, Kannas, Israa, Abazid, Eias, Esper, Asil, Slim, Skander, Kavcar, Akil Serdar, Aytac, Erman, Dural, Ahmet Cem, Ilker, Ayse, Eray, Ismail Cem, Kurnaz, Eray, Altiner, Saygin, Tepe, Mustafa Deniz, Sahin, Can, Savli, Evrim, Innocent, Aryon, Babirye, Lilian, Diachenko, Andrii, Hordoskiy, Vladislav, Curry, Heather, Chau, Charlene Yat Che, Robertson, Harry, Mahmoud, Arin, Lennon, Hannah, Loi, Lynette, Kirkham, Emily, McCann, Cameron, Watts, Daniel, Gurung, Binay, Wilson, Michael, Tribedi, Thomas, Garofalo, Eleonora, Zahra, Baryab, MacDonald, Scott, Daniels, Ian, Ng, Nathan, Khosla, Shivun, Olivier, James, Yue, Sum Yu Pansy, Suresh, Gayathri, Wellington, Jack, Lorejo, Emmanuel, Mossaad, Mafdi, Crutcher, Madison, Alimi, Marjan, Baiu, Ioana, Abdou, Hossam, Conway, Alison, Peck, Connor, Perdomo Perez, Mauro Andres, Zulu, Stanley, Nakazwe, Mildred, Burger, Sule, Davies, Justine, Donaldson, Rachel, Ede, Chikwendu, Garden, O James, Lesetedi, Chiapo, Mabedi, Charles, Magill, Laura, Makinde Alakaloko, Felix, Makupe, Alex, Monahan, Mark, Mulira, Soloman, Muller, Elmi, Musowoyo, Jospeh, Olory-Togbe, Jean Léon, Roberts, Tracey, Smith, Martin, Tayler, Viki, Windsor, John, Yepez, Raul, Sundar, Sudha, Runigamugabo, Emmy, Verjee, Azmina, Chen, José, Daya, Leonid, El Aroussi, Nouhaila, Farina, Valeria, Gnintedeme Olivier, Tchianze, Gonzales Nacarino, Mauricio, Hammani, Aamr, Honjo, Sarah, Jacobs, Rebecca, Kimura, Hitomi, Nkoronko, Mugisha, Oscullo Yepez, Jasson Javier, Pin Hung, Wei, Raj, Ankit, Romani Pozo, Alina, Rommaneh, Muna, Sassamela Fabiano, Samuel Chimbioputo, Shiroma Gago, Camila Milagros, Srinivas, Abhishekh, Sung, Chia-Yen, Tai, Aswan, Valle Aranda, Yener Cristyell, Venturini, Sara, and Wilguens Lartigue, Jean
Subjects: Pediatrics, Colorectal cancer, IMPACT, Disease, Colorectal Neoplasm, 030204 cardiovascular system & hematology, Cancer, surgery, postoperative mortality, 0302 clinical medicine, Postoperative Complications, Global health, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, General Medicine, DISEASES, Income, cancer surgery, Colorectal Neoplasms, Breast Neoplasm, Cohort study, Human, Adult, Developed Countrie, medicine.medical_specialty, Global surgery, General surgery, International multicentre study, Cancer surgery, Breast Neoplasms, Department of Error, NO, Developing Countrie, 03 medical and health sciences, Breast cancer, Stomach Neoplasms, medicine, Humans, Developing Countries, Neoplasm Staging, business.industry, Developed Countries, Odds ratio, CARE, medicine.disease, 3126 Surgery, anesthesiology, intensive care, radiology, Prospective Studie, Postoperative Complication, business
Abstract: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Background: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit.
Published: 2021

16. Health related quality of life in adults with asthma: a systematic review to identify the values of EQ-5D-5L instrument

Author: Somayeh Afshari, Ali Akbari Sari, Maryam Shiravani, Hosein Ameri, Rajab Ali Daroudi, and Hassan Karami
Subjects: Adult, Pulmonary and Respiratory Medicine, Gerontology, Psychometrics, 03 medical and health sciences, 0302 clinical medicine, immune system diseases, EQ-5D, Surveys and Questionnaires, medicine, Humans, Immunology and Allergy, In patient, 030212 general & internal medicine, Asthma, Health related quality of life, business.industry, Reproducibility of Results, medicine.disease, Preference, respiratory tract diseases, 030228 respiratory system, Pediatrics, Perinatology and Child Health, Quality of Life, business
Abstract: The EQ-5D is the most popular generic preference-based instrument used for asthma patients. This study aims to explore the psychometric properties of the EQ-5D-5L instrument in patients with asthma and identify the EQ-5D-5L scores in these patients.PubMed, Scopus, Web of Science, Google Scholar and CEA Registry were searched with English language from 2009 until April 2020. Retrieved studies were checked against the inclusion criteria. Reference lists of the included articles were also reviewed. The quality of included articles was evaluated using Mitton checklist and the data were extracted by a reviewer and were checked by a second reviewer. Meta-analysis was done to calculate the overall scores based on type of asthma control.A total of 17 articles were included. The EQ-5D-5L scores ranged from 0.45 to 0.93 and the VAS scores ranged from 35.67 to 83.80. The EQ-5D-5L is higher in well-controlled (0.88, 95% CI: 0.81-0.96,Higher score of the EQ-5D-5L was consistent with well-controlled asthma patients and those with lower severity of asthma. The assessment of psychometric properties of the EQ-5D-5L needs further observations.
Published: 2021

17. LDL/apo B ratio predict coronary heart disease in Type 2 diabetes independent of ASCVD risk score: A case-cohort study

Author: Yekta Rahimi, Soghra Rabizadeh, Alireza Esteghamati, Fatemeh Moosaie, Armin Rajab, Jeffrey I. Mechanick, and Manouchehr Nakhjavani
Subjects: Male, medicine.medical_specialty, Apolipoprotein B, Endocrinology, Diabetes and Metabolism, Medicine (miscellaneous), Coronary Disease, 030209 endocrinology & metabolism, Type 2 diabetes, Iran, 030204 cardiovascular system & hematology, Risk Assessment, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Risk Factors, Diabetes mellitus, Internal medicine, Prevalence, medicine, Humans, Risk factor, Aged, Dyslipidemias, Retrospective Studies, Nutrition and Dietetics, Framingham Risk Score, biology, business.industry, nutritional and metabolic diseases, Cholesterol, LDL, Middle Aged, Prognosis, medicine.disease, Glycemic index, Diabetes Mellitus, Type 2, Apolipoprotein B-100, biology.protein, Cardiology, Female, lipids (amino acids, peptides, and proteins), Metabolic syndrome, Cardiology and Cardiovascular Medicine, business, Biomarkers
Abstract: Coronary heart disease (CHD) is a major mortality risk factor in patients with diabetes. LDL cholesterol (LDL-C) is a major risk factor for the development of atherosclerosis. There is one apolipoprotein B (ApoB) molecule in each LDL particle. We aimed to evaluate the predictive value of the LDL-C/ApoB ratio for CHD in patients with type 2 diabetes (T2D).In this case-cohort study (apo)lipoproteins and glycemic indices were measured in 1058 individuals with T2D from February 2002 to March 2019, with a median duration of follow up of 10 years. Of 1058 patients with T2D, coronary heart disease occurred in 242 patients. Increased waist circumference, waist-to-hip ratio, and hemoglobin A1c, low-density lipoprotein cholesterol (LDL-C)/Apolipoprotein B (ApoB) ratio, presence of hypertension and metabolic syndrome, and insulin and statin use were more prevalent among patients with CHD (P 0.001). Logistic regression analysis showed that an LDL-C/ApoB ratio equal or lower than 1.2 could predict CHD independent of ASCVD risk score [adjusted OR:1.841, CI:1.257-2.698, P 0.001] when adjusted for multiple confounders. The atherogenic index of plasma (AIP) did not predict CHD.This study showed that LDL-C/ApoB ratio, but not the atherogenic index of plasma, may be considered as an indicator of CHD independent of the ASCVD risk score in patients with T2D. This finding merits further clarification to optimize preventive strategies for CHD.
Published: 2021

18. Assessment of the relationship between depression and treatment compliance in chronically-ill patients in Jeddah, Saudi Arabia

Author: Somayah Saeed Bawazeer, Joud Jamal Balkhair, Aroub Adel Rajab, and Ameen Almohammadi
Subjects: medicine.medical_specialty, business.industry, Treatment adherence, Pharmaceutical Science, Medication adherence, Disease, Chronic illness, Depression, Medication adherence, Treatment compliance, medicine.disease, Moderate depression, Mild depression, Treatment compliance, Internal medicine, Hyperlipidemia, medicine, Pharmacology (medical), business, Depression (differential diagnoses)
Abstract: Purpose: To find the relationship between depression, treatment adherence and lifestyle changes inchronically-ill patients residing in Jeddah, Saudi Arabia.Methods: A cross-sectional study was conducted. A self-administered questionnaire was used tocollect data from patients of multi-healthcare centers located in Jeddah. The questionnaire aimed tocollect the information regarding patients’ levels of medication compliance, patients’ capacity to copewith the disease and adherence to medication, along with their depression level.Results: Of the overall sample size of 439 patients, 43.1 % were suffering from hypertension, 37.8 %were diabetic and 33.7 % had hyperlipidemia. Besides, total scores of Patient Health Questionnaire-9(PHQ-9) showed that approximately 5 % patients were severely depressed, 8 % had moderately severedepression, 27 % had moderate depression, and 60 % had mild depression. Compliance scale datarevealed that 38 % patients showed low compliance, 51 % showed partial compliance, and 11 %showed high compliance. Also, a significant inverse relationship between depression and compliancescales (rs = -0.221, p = 0.004) was observed.Conclusion: The results show an inverse association between depression and medication adherencein patients with chronic disease in Jeddah. Therefore, clinicians are advised to assess the level ofdepression in chronically-ill patients in order to improve their adherence to medicine.Keywords: Chronic illness, Depression, Medication adherence, Treatment compliance
Published: 2021

19. Assessment of nutritional quality of snacks and beverages sold in university vending machines: a qualitative assessment

Author: Hayder Hasan, Haitham Jahrami, Asma Aljabry, Afra Afra Almashgouni, Leila Cheikh Ismail, Dina Rajab, Reyad S. Obaid, Mariam Aljarwan, Mo'ez Al-Islam E. Faris, Ala'a Al-Bakheit, Moza Alnaqbi, and Alanood Alshehhi
Subjects: 0301 basic medicine, 030109 nutrition & dietetics, Saturated fat, Low calorie, Nutritional status, Nutritional quality, medicine.disease, Obesity, Snack food, Caloric intake, 03 medical and health sciences, 0302 clinical medicine, Environmental health, medicine, Business, Management and Accounting (miscellaneous), Eating behavior, 030212 general & internal medicine, Business, Food Science
Abstract: PurposeVending machines (VMs) provide quick access for snack foods and beverages for students during their study days. These vended foods have been reported to affect the student's nutritional status and contributing to obesity by increasing the caloric intake. This study aimed to evaluate the nutritional value of snacks and beverages provided by VM at the university campuses.Design/methodology/approachA cross-sectional observational study in one large urban university with four campuses was conducted. In total, 55 VMs were found distributed over 50 buildings of the four university campuses. Of the vending slots surveyed, only 57 snacks and beverage food items were found repeated. These items were vended and analyzed using nutrient databases, and their nutritional quality was assessed using nutrient adequacy ratio and nutritional quality score.FindingsMost vended snacks were salty (77%) and sweet (23%). Neither snacks nor beverages were nutrient-dense, and the majority (65%) of snacks and beverages were calorie-dense, with high contents of sugar, sodium and saturated fat; while they were low in vitamins C and A, calcium, iron, sodium, protein and dietary fibers. None of the vended beverages met the low calorie, low sugars and high-fiber criteria.Research limitations/implicationsOne limitation of the current work is represented in the fact that VM snacks and beverages are not fixed throughout the year days, and exposed to continuous changes, depending on the customers' attitudes and economic and financial considerations related to the operating contractor company and the customer students. Thus, a continuous, long-term evaluation is suggested to be conducted for a more representative and reflective evaluation of the nutritional quality of vended snacks and beverages.Practical implicationsPoor nutritional quality has been found for vended foods. Healthier food options should be provided to improve students' dietary intake.Social implicationsAttention has to be directed toward the nutritional quality of VM foods, and how to provide adolescents and young adults with healthy options.Originality/valueThis is the first study conducted in the United Arab Emirates (UAE) and Gulf Cooperation Council countries (GCC) assessing the nutritional value of vending machine foods in university settings.
Published: 2021

20. Machine Learning Application for Predicting Autistic Traits in Toddlers

Author: Khairan Rajab, Arun J. Padmavathy, and Fadi Thabtah
Subjects: Multidisciplinary, business.industry, Process (engineering), Computer science, 010102 general mathematics, Feature selection, computer.file_format, Machine learning, computer.software_genre, medicine.disease, 01 natural sciences, Correlation, Statistical classification, Autism spectrum disorder, medicine, Autism, Artificial intelligence, AdaBoost, 0101 mathematics, business, computer, ID3
Abstract: Preliminary diagnosis of medical conditions, such as autism spectrum disorder (ASD), requires an understanding of the influential traits, for example autistic traits, during the screening process. Therefore, selecting the right attributes is a critical part of model construction in medical applications such as ASD screening, as this directly impacts the accuracy and efficiency of classification. This research investigates different methods for selecting attributes, including Chi-square (CHI), correlation feature set, information gain, Gini index and fast correlated-based filter to identify highly impactful autistic traits using over 1000 data observations of cases and controls related to toddlers. We seek to find the common autistic traits that influence the pre-diagnosis process for ASD obtained by these attribute selection methods from a real autism dataset related to toddlers and their impact on the performance of the screening process. To achieve the aim, an empirical methodology involving the use of three classification algorithms, AdaBoost, k-Nearest Neighbour (kNN) and ID3, has been used to derive models from the various different datasets chosen prior to training according to the considered attribute selection methods. These models are evaluated using evaluation metrics including specificity, sensitivity, accuracy and area under curve. Empirical results using the classification techniques for different attribute sets for the toddlers’ dataset show which influential autistic traits can be utilized by clinicians and diagnosticians to speed up the pre-diagnosis process for ASD and to enhance classification performance. More importantly, we show which attribute selection methods identify the relevant attributes that influence the preliminary process for diagnosis.
Published: 2021

21. Conservative Treatment for Locally Advanced Carcinoma of the Larynx Using Alpha-Crystalline B as a Prognostic Molecular Marker

Author: AbdulRahman N Alghamdi, Rajab Alzahrani, Majed Al-Mourgi, Hanan S. Amin, Ashjan Shami, Wael H. Elsawy, and Amal F. Gharib
Subjects: Larynx, business.industry, Locally advanced, Alpha (ethology), medicine.disease, Conservative treatment, chemistry.chemical_compound, medicine.anatomical_structure, chemistry, Molecular marker, medicine, Carcinoma, Cancer research, business
Published: 2021

22. Heat-related illnesses in a mass gathering event and the necessity for newer diagnostic criteria: a field study

Author: Muhammad Ayub Khan, Wesam Alkassas, Ahmad Mamoun Rajab, Mohsin Zaman, Sara T. Al-Rashood, and Mahmoud Dibas
Subjects: Hot Temperature, Cross-sectional study, Heat Stroke, Health, Toxicology and Mutagenesis, Heat exhaustion, Saudi Arabia, Poison control, 010501 environmental sciences, 01 natural sciences, Occupational safety and health, Hajj, Mass gathering, Injury prevention, medicine, Humans, Environmental Chemistry, 0105 earth and related environmental sciences, Travel, Heat-related illnesses, Data collection, business.industry, Field study, Crowds, General Medicine, medicine.disease, Pollution, HRIs, Cross-Sectional Studies, Medical emergency, business, Research Article
Abstract: Heat-related illnesses (HRIs), mainly heat exhaustion (HE) and heat stroke (HS), are characterized by an elevation of core body temperature. In this study, we aimed to explore the HRIs' types and patient characteristics among a sample taken from various representative in-field points in the Hajj season. A cross-sectional study was conducted in 2018 at 80 data collection points distributed in the field. Data related to demographics, features and risk factors were collected and analyzed from all encountered cases with suspected HRIs. Moreover, we developed a diagnostic tree for HRIs by using the XGBoost model. Out of the 1200 persons encountered during the study period, 231 fulfilled the criteria of HRIs spectrum and were included in this study. Around 6% had HS and 20% had HE. All HS cases (100%) were from outside of Saudi Arabia as compared with 72.5% diagnosed with HE (27.5% were from Saudi Arabia). In addition, 16% were considered as heat-induced muscle spasms, and 7% had limb heat edema. Additionally, most of HRIs cases were reported between 11 am and 1 pm. The HRIs diagnostic tree model gave a diagnostic accuracy of 93.6%. This study highlights the magnitude of HRIs among pilgrims in Hajj and provides a diagnostic tree that can aid in the risk stratification and diagnosis of these patients. We advise the implementation of more educational campaigns to pilgrims regarding preventable measures especially for the vulnerable groups (e.g. from outside Saudi Arabia, those with comorbidities and light-skinned people).
Published: 2021

23. An Improved Machine Learning Technique with Effective Heart Disease Prediction System

Author: Mohammad Tabrez Quasim, Yousef Asiri, Saad Alhuwaimel, Rihem Farkh, Khaled Al jaloud, Asadullah Shaikh, and Khairan Rajab
Subjects: Heart disease, business.industry, Computer science, Prediction system, medicine.disease, Machine learning, computer.software_genre, Computer Science Applications, Biomaterials, Mechanics of Materials, Modeling and Simulation, medicine, Artificial intelligence, Electrical and Electronic Engineering, business, computer
Published: 2021

24. Health providers and irritable bowel syndrome

Author: Aishah Yahya Saeed Qatomah, Khalid Ayidh AlAmri, Wesam Mostafa Edrees, Wafa Yahya Saeed Qatomah, Mohammed Saleh Salem Alammari, Yahya Amer Ahmed Wadani, Sattam Awwadh Almalki, Nashmi Salom Aletesh, and Mohammad Rajab Alkhalaf
Subjects: Abdominal pain, medicine.medical_specialty, Constipation, business.industry, education, Stressor, Workload, Disease, medicine.disease, Diarrhea, Family medicine, Etiology, Medicine, medicine.symptom, business, Irritable bowel syndrome
Abstract: Irritable bowel syndrome (IBS) is the most commonly diagnosed condition, which accounts for the highest number of new referrals to gastroenterology clinics. The disease is characterized by symptoms, including diarrhea, abdominal pain, constipation, or a combination of both constipation and diarrhea, which could be accompanied by discharge of mucus in stool and changes in its appearance. The precise etiology of IBS and its pathophysiology are still unknown. However, it is believed that complex interactions between the hormonal, immune, and nervous systems are responsible for causing it. The prevalence of IBS varies across different regions globally, with the highest prevalence reported in South America (21%) and the lowest in Southeast Asia (7%). This review highlights several factors responsible for contributing to the development of IBS, among which stress was found to be an important factor. The current study observed an association between the increasing prevalence of IBS and stressful and hectic working conditions among healthcare professionals compared to the general public. General practitioners, family physicians, nurses, and dentists are exposed to several stressors due to their workload, resulting in an increased prevalence of IBS among healthcare professionals. Similarly, more stress is experienced by the medical students than the normal population because of the stressful academic environment. The review concludes that IBS is more prevalent among healthcare professionals and students, especially among female workers and students, than male workers and students.
Published: 2021

25. Impact of Fas/Fasl Gene Polymorphisms on Susceptibility Risk and Imatinib Mesylate Treatment Response in Chronic Myeloid Leukaemia Patients

Author: Ravindran Ankathil, Sarina Sulong, Nur Shafawati Ab Rajab, Mohd Ismail Ibrahim, Azlan Husin, Ahmad Aizat Abdul Aziz, Nazihah Mohd Yunus, and Aziati Azwari Annuar
Subjects: 0301 basic medicine, Oncology, Adult, Male, medicine.medical_specialty, Fas Ligand Protein, Adolescent, Genotype, FAS/FASL, Antineoplastic Agents, Lower risk, Fas ligand, resistance, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Polymorphism (computer science), Internal medicine, hemic and lymphatic diseases, imatinib mesylate, Leukemia, Myelogenous, Chronic, BCR-ABL Positive, Medicine, Humans, Genetic Predisposition to Disease, Allele, Child, Promoter Regions, Genetic, Chronic myeloid leukaemia, Aged, Retrospective Studies, Polymorphism, Genetic, business.industry, Malaysia, Cancer, General Medicine, Odds ratio, Middle Aged, medicine.disease, promoter polymorphism, 030104 developmental biology, Imatinib mesylate, Logistic Models, 030220 oncology & carcinogenesis, Female, business, Research Article
Abstract: Background: The FAS mediated apoptosis pathway involving the FAS and FASL genes plays a crucial role in the regulation of apoptotic cell death and imatinib mesylate (IM) mechanism of action. Promoter polymorphisms FAS-670 A>G and FAS-844 T>C which alter the transcriptional activity of these genes may grant a risk to develop cancer and revamp the drug activities towards the cancer cell. We investigated the association of these two polymorphisms with the susceptibility risk and IM treatment response in Malaysian chronic myeloid leukaemia (CML) patients. Methods: This is a retrospective study, which included 93 CML patients and 98 controls. The polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method was used to genotype the FAS and FASL polymorphisms. Data nanlysis was done using SPSS Version 22. The associations of the genotypes with susceptibility risk and IM response in CML patients were assessed by means of logistic regression analysis and deriving odds ratio with 95% CI. Results: We observed a significant association between FASL-844T>C polymorphism and CML susceptibility risk and IM response. Variant C allele and FASL-844 CC variant genotype carriers had significantly higher risk for CML susceptibility (OR 1.756, CI 1.163-2.652, p=0.007 and OR 2.261, CI 1.013-5.047, p=0.047 respectively). Conversely, the heterozygous genotype FASL-844 TC conferred lower risk for CML susceptibility (OR 0.379, CI 0.176-0.816, p=0.013). The heterozygous and homozygous variant genotypes and variant C alleles were found to confer a lower risk for the development of IM resistance with OR 0.129 (95% CI: 0.034-0.489 p=0.003), OR 0.257 (95% CI: 0.081-0.818, p=0.021), and OR 0.486 (95% CI: 0.262-0.899, p=0.021) respectively. We also found that FAS-670 A>G polymorphism was not associated with CML susceptibility risk or IM response. Conclusion: The genetic polymorphism FASL-844 T>C may contribute to the CML susceptibility risk and also IM treatment response in CML patients. Accodringly, it may be useful as a biomarker for predicting CML susceptibility risk and IM resistance.
Published: 2021

26. Immediate Postoperative Insulin Requirements May Predict Metabolic Outcome after Total Pancreatectomy and Islet Autotransplantation

Author: Philip Hart, Kristin Kuntz, Luis F. Lara, Amer Rajab, Sylvester M. Black, W. Kenneth Washburn, Shumei Meng, Kyle Porter, Neha Verma, Jill Buss, and Darwin L. Conwell
Subjects: Adult, Blood Glucose, Male, medicine.medical_specialty, Time Factors, Article Subject, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Islets of Langerhans Transplantation, Urology, Transplantation, Autologous, Diseases of the endocrine glands. Clinical endocrinology, Young Adult, Pancreatectomy, Endocrinology, Interquartile range, Insulin-Secreting Cells, Pancreatitis, Chronic, medicine, Humans, Hypoglycemic Agents, Insulin, Endocrine system, Ohio, Retrospective Studies, geography, geography.geographical_feature_category, business.industry, Retrospective cohort study, Middle Aged, RC648-665, medicine.disease, Islet, Autotransplantation, Treatment Outcome, Pancreatitis, Female, business, Biomarkers, Progressive disease, Research Article
Abstract: Chronic pancreatitis (CP) is a progressive disease that leads to eventual loss of endocrine and exocrine function. Total pancreatectomy and islet autotransplantation (TPIAT) is a treatment option for patients with CP; however, predicting postoperative metabolic outcomes remains elusive. In this single-center retrospective study, we report pre-TPIAT characteristics, beta cell function indices, islet yield, and post-TPIAT glucose management data to further understand their relationship. Islet yield, glucose level, and insulin requirement for 72 hours postoperatively were collected for a total of 13 TPIAT recipients between 9-2013 and 9-2018. In addition, their glucose control and basal insulin requirements at 3, 6, and 12 months post-TPIAT were analyzed. All 13 subjects had normal baseline fasting glucose levels. Median islet yield was 4882 IEq/kg (interquartile range 3412 to 8987). Median postoperative total insulin requirement on day 3 was 0.43 units/kg. Pre-TPIAT baseline glucose, insulin, or c-peptide level did not have a significant correlation with the islet yield. Similarly, there was no correlation between islet yield and insulin requirement at 72-hour postoperatively. However, there was an inverse correlation between the absolute islet yield (IEq) and insulin requirement at 6 months and 12 months following post-TPIAT. Further analysis of the relationship between 72-hour post-op insulin requirement and insulin requirement at discharge, 3, 6, and 12 months showed a positive correlation. Despite the finding of inverse correlation of islet yield with long-term basal insulin requirement, this study was not able to detect a correlation between the preoperative parameters to postoperative short-term or long-term outcome as noted in other studies. The 72-hour postoperative insulin requirement is a helpful postoperative predictor of patients needing long-term insulin management following TPIAT. This observation may identify a high-risk group of patients in need of more intensive diabetes education and insulin treatment prior to hospital discharge.
Published: 2020

27. Racial disparities in the incidence and survival of spinal meningioma

Author: Mahmoud Dibas, Mohammad J Atiah, Saadi Aljundi, Sherief Ghozy, Ahmad Mamoun Rajab, Nazmus Saquib, and Kevin Phan
Subjects: End results, medicine.medical_specialty, Future studies, business.industry, Incidence, Incidence (epidemiology), Large population, Retrospective cohort study, General Medicine, medicine.disease, survival, Meningioma, Internal medicine, Epidemiology, Medicine, Pacific islanders, Original Article, business, race, spinal meningioma
Abstract: Objective: Race is a significant prognostic factor in various cancers, including the breast. Its prognostic association with spinal meningioma has not been established, although the incidence of spinal meningioma varies by race. In this retrospective cohort study, we aimed to investigate the association of race with the incidence and survival of spinal meningioma among a large population sample. Materials and Methods: A comprehensive search was done in the surveillance, epidemiology, and end results database between 2000 and 2016 to identify patients with spinal meningioma. Overall and race-specific incidence were calculated. The effect of race on overall survival among these patients was determined with Kaplan–Meier curve and Cox proportional hazard models. Results: Of 3502 spinal meningioma patients, 82.6% were Caucasian, 7.7% were African-American, 8.8% were Asian/Pacific Islander and 0.7% were American Indian/Alaska Native. The overall age-adjusted incidence was 0.239/100,000; it was highest among Caucasian (0.249) and lowest among American Indian/Alaska Native patients (0.137). There was a race effect in overall survival in the unadjusted analysis with the worst overall survival reported for Caucasian patients, and the best reported for American Indian/Alaska Native patients. However, this relationship was insignificant in the adjusted analysis. Conclusions: Race was not significantly associated with overall survival among these patients. Future studies should use spinal-meningioma-specific survival as outcome to see whether there is a racial difference in survival.
Published: 2020

28. Thyroid neoplasm in Makkah region, Saudi Arabia

Author: Suhail I. Sayed, Omar A. Abu Suliman, Firas R. Abi Sheffah, Rajab Alzahrani, Haddad H. Alkaff, Sherif K. Abdelmonim, Saeed A. Al-Ghamdi, Ameen Z. Alherabi, Mohammad A. Alessa, Fares E. Alghamdi, Bayan O. Besharah, Osama A. Marglani, Deemah H. Bukhari, Anas H. Al-Tammas, John C. Heaphy, and Osama A. Bawazir
Subjects: Adult, Male, Makkah, medicine.medical_specialty, Pediatrics, Time Factors, Future studies, education, Saudi Arabia, 030204 cardiovascular system & hematology, medicine.disease_cause, thyroid, Thyroid carcinoma, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, parasitic diseases, Epidemiology, medicine, Humans, cancer, Thyroid Neoplasms, 030212 general & internal medicine, Thyroid tumors, Thyroid neoplasm, Retrospective Studies, business.industry, Incidence, Thyroid disease, Incidence (epidemiology), Thyroid, Age Factors, General Medicine, Middle Aged, medicine.disease, medicine.anatomical_structure, Head and Neck Neoplasms, Thyroid Cancer, Papillary, Female, Original Article, business, geographic locations, Follow-Up Studies
Abstract: Objectives: To improve our local data and demographics of thyroid neoplasm in Makkah region, Kingdom of Saudi Arabia and provide some basic statistics for future studies in our local community. Methods: A record based retrospective epidemiological study was conducted and included 314 thyroid disease patients who were presented to our centers at Makkah region, Kingdom of Saudi Arabia between December 2009 and December 2019. Results: A descriptive statistical analysis was carried out. The average age was 42.77 years, with a female-to-male ratio of 3:1, and most of the patients were Saudi (77%). Fifty-seven percent of cases were benign, while in malignant cases, 33.4% were papillary thyroid carcinoma. The mean follow-up time was 15.44 months, with excellent compliance in 39.4% of the patients. Conclusion: Thyroid tumors have a leading incidence in head and neck tumors in Makkah, Kingdom of Saudi Arabia, mandating further studies to determine the causes and distribution in other regions of the country.
Published: 2020

29. IMPROVEMENT IN REDOX HOMEOSTASIS AFTER CYTOREDUCTIVE SURGERY IN COLORECTAL ADENOCARCINOMA

Author: Soghra Rabizadeh, Giovanni Tomasello, Niloofar Najafi, Alireza Esteghamati, Manouchehr Nakhjavani, Armin Rajab, Abbas Alibakhshi, Hossein Mirmiranpour, Salome Sadat Salehi, Sadat Salehi,S, Mirmiranpour,H, Rabizadeh,S, Esteghmati,A, Tomasello,G, Alibakhshi,A, Najafi,N, Rajab,A, and Nakhjavani,M
Subjects: Glycation End Products, Advanced, Male, 0301 basic medicine, Aging, Antioxidant, Colorectal cancer, medicine.medical_treatment, medicine.disease_cause, Biochemistry, Gastroenterology, chemistry.chemical_compound, Postoperative Complications, 0302 clinical medicine, Malondialdehyde, Homeostasis, chemistry.chemical_classification, biology, Glutathione peroxidase, Cytoreduction Surgical Procedures, General Medicine, Middle Aged, Catalase, colorectal cancer, colorectal surgery, cytoreductive surgery, redox homeostasis, Lipoproteins, LDL, 030220 oncology & carcinogenesis, Female, Colorectal Neoplasms, Research Article, Adult, medicine.medical_specialty, Article Subject, Adenocarcinoma, Superoxide dismutase, 03 medical and health sciences, Internal medicine, medicine, Humans, Aged, Glutathione Peroxidase, QH573-671, business.industry, Cell Biology, medicine.disease, Oxidative Stress, 030104 developmental biology, chemistry, biology.protein, Cytology, business, Oxidative stress, Lipoprotein
Abstract: Colorectal cancer (CRC) as one the most common cancer type is associated with oxidative stress. Surgery is the only curative modality for early-stage CRC. The aim of this study was to evaluate the oxidative damage biomarkers as well as enzymatic and nonenzymatic antioxidants in patients with CRC before and after tumor resection and in healthy controls. 60 patients with stage I/II colorectal adenocarcinoma and 43 healthy controls were recruited in this study. We measured plasma levels of oxidative damage biomarkers, including advanced oxidation protein products (AOPP), advanced glycation end products (AGEs), malondialdehyde (MDA), and oxidized low-density lipoprotein (ox-LDL) at baseline and after tumor removal. We also evaluated the plasma activity of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) as enzymatic antioxidants and the ferric reducing antioxidant power (FRAP) assay for nonenzymatic antioxidant capacity. Patients with CRC had significantly higher AGE, AOPP, MDA, and ox-LDL and also FRAP levels and higher SOD and GPx and lower CAT activity levels compared to healthy controls (p<0.05). We did not observe any statistically significant correlation between redox biomarkers and the size and stage of the tumor. AGEs (72.49±4.7vs.67.93±8.8,p<0.001), AOPP (137.64±21.9vs.119.08±33.1,p<0.001), MDA (3.56±0.30vs.3.05±0.33,p<0.001), and ox-LDL (19.78±0.97vs.16.94±1.02,p<0.001) concentrations reduced significantly after tumor removal. The largest effect sizes were found in ox-LDL (d=−2.853, 95% CI 2.50-3.19) and MDA (d=−1.617, 95% CI 0.43-0.57). Serum FRAP levels (1097.5±156.7vs.1239.3±290,p<0.001) and CAT (2.34±0.34vs.2.63±0.38,p<0.001), GPx (102.37±6.58vs.108.03±6.95,p<0.001), and SOD (5.13±0.39vs.5.53±0.31,p<0.001) activity levels increased significantly after surgery. The largest effect sizes among antioxidants were seen in SOD (d=1.135, 95% CI 0.46-0.34) and GPx (d=0.836, 95% CI 0.35-0.23). This study indicated that patients with colorectal cancer had higher levels of oxidative stress and antioxidant activity compared to healthy controls. After surgical resection of tumor, we observed a substantial improvement in redox homeostasis.
Published: 2021

30. Advancing male age differentially alters levels and localization patterns of PLCzeta in sperm and testes from different mouse strains

Author: Raed Abu-Dawud, MahaAdel Gumssani, BhaveshV Mistry, Reema B. Abu-Dawas, Kevin Coward, AbdullahM Assiri, FAnthony Lai, Muhammad Rajab, Celine Jones, Nadya Al-Yacoub, Junaid Kashir, Falah Al-Mohanna, and Michail Nomikos
Subjects: Male, phospholipase C zeta, Aging, Urology, Population, Immunoblotting, Fluorescent Antibody Technique, Biology, lcsh:RC870-923, sperm, Calcium in biology, male infertility, Male infertility, Andrology, Mice, Phosphoinositide Phospholipase C, Testis, medicine, Animals, RNA, Messenger, education, oocyte activation, Messenger RNA, education.field_of_study, Phospholipase C, Reverse Transcriptase Polymerase Chain Reaction, Oocyte activation, General Medicine, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, Sperm, Spermatozoa, Mice, Inbred C57BL, Ageing, ageing, fertilization, phospholipase c zeta, Original Article
Abstract: Sperm-specific phospholipase C zeta (PLCζ) initiates intracellular calcium (Ca2+) transients which drive a series of concurrent events collectively termed oocyte activation. Numerous investigations have linked abrogation and absence/reduction of PLCζ with forms of male infertility in humans where oocyte activation fails. However, very few studies have examined potential relationships between PLCζ and advancing male age, both of which are increasingly considered to be major effectors of male fertility. Initial efforts in humans may be hindered by inherent PLCζ variability within the human population, alongside a lack of sufficient controllable repeats. Herein, utilizing immunoblotting, immunofluorescence, and quantitative reverse transcription PCR (qRT-PCR) we examined for the first time PLCζ protein levels and localization patterns in sperm, and PLCζ mRNA levels within testes, from mice at 8 weeks, 12 weeks, 24 weeks, and 36 weeks of age, from two separate strains of mice, C57BL/6 (B6; inbred) and CD1 (outbred). Collectively, advancing male age generally diminished levels and variability of PLCζ protein and mRNA in sperm and testes, respectively, when both strains were examined. Furthermore, advancing male age altered the predominant pattern of PLCζ localization in mouse sperm, with younger mice exhibiting predominantly post-acrosomal, and older mice exhibiting both post-acrosomal and acrosomal populations of PLCζ. However, the specific pattern of such decline in levels of protein and mRNA was strain-specific. Collectively, our results demonstrate a negative relationship between advancing male age and PLCζ levels and localization patterns, indicating that aging male mice from different strains may serve as useful models to investigate PLCζ in cases of male infertility and subfertility in humans.
Published: 2020

31. Role of fine-needle aspiration cytology in evaluating thyroid nodules

Author: Firas R. Abi Sheffah, Sherif K. Abdelmonim, Ameen Z. Alherabi, Suhail I. Sayed, Haddad H. Alkaff, Mohammad A. Alessa, Omar A. Abu Suliman, Ahmed S. Bahaj, Anwar N. Melebari, Anas H. Al-Tammas, Saeed A. Al-Ghamdi, Osama A. Bawazir, Fares E. Alghamdi, Rajab Alzahrani, John C. Heaphy, Syeddah S. Mujtaba, Bashair N. Melebari, and Osama A. Marglani
Subjects: Adult, Male, Thyroid nodules, medicine.medical_specialty, Cytological Techniques, Saudi Arabia, Thyroid Gland, carcinoma, 030204 cardiovascular system & hematology, Sensitivity and Specificity, Tertiary care, thyroid, Tertiary Care Centers, 03 medical and health sciences, 0302 clinical medicine, Predictive Value of Tests, Fine needle aspiration cytology, medicine, Humans, Thyroid Neoplasms, Thyroid Nodule, 030212 general & internal medicine, skin and connective tissue diseases, Endoscopic Ultrasound-Guided Fine Needle Aspiration, Retrospective Studies, business.industry, General surgery, Thyroid, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Aspiration cytology, body regions, medicine.anatomical_structure, FNA, cytology, Referral center, Female, Original Article, Ultrasonography, business
Abstract: Objectives : To evaluate the accuracy and e cacy of ne-needle aspiration cytology (FNAC) in diagnosing thyroid nodules, correlating it with the histopathological findings. Methods : A retrospective evaluation of 314 patients was undertaken at a tertiary referral center of King Abdullah Medical City (KAMC), Makkah, Kingdom of Saudi Arabia, between 2010-2019. Patients who presented with thyroid swellings underwent ultrasonography and FNAC. If indicated, surgery was performed. The FNAC findings were compared to the final histopathological reports. Results : Th e findings for FNAC from our data set of 314 patients showed a sensitivity value of 79.8%, specificity of 82.1%, accuracy of 74.8%, positive predictive value of 74.8%, and negative predictive value of 85.9%. Conclusion : Our study showed that FNAC has high sensitivity and speci city in the initial evaluation of patients with thyroid nodules. When guided by ultrasonography, the accuracy can be markedly improved. Molecular markers once widely available can improve the diagnostic power of FNAC to be no less than the histopathologic evaluation of thyroid tissue. Saudi Med J 2020; Vol. 41 (10): 1098-1103 doi: 10.15537/smj.2020.10.25417 How to cite this article: Ahmed S. Bahaj, Haddad H. Alka, Bashair N. Melebari, Anwar N. Melebari, Suhail I. Sayed, Syeddah S. Mujtaba, Sherif K. Abdelmonim, Saeed A. Alghamdi, Fares E. Alghamdi, Omar A. Abu Suliman, Mohammad A. Alessa, Firas R. Abi Sheffah, Anas H. Al-Tammas, Rajab A. Al-Zahrani, Osama A. Marglani, John C. Heaphy, Osama A. Bawazir, Ameen Z. Alherabi. Role of fine-needle aspiration cytology in evaluating thyroid nodules. A retrospective study from a tertiary care center of Western region, Saudi Arabia. Saudi Med J 2020; Vol. 41 (10): 1098-1103. doi: 10.15537/smj.2020.10.25417
Published: 2020

32. Transplantation in Fontan failure: The final stage

Author: James Jaggers and Taufiek Konrad Rajab
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, Protein losing enteropathy, Arteriovenous malformation, medicine.disease, Surgery, Transplantation, Ventricular assist device, medicine, Extracorporeal membrane oxygenation, Fontan failure, Stage (cooking), business
Published: 2020

33. Gluteal muscles primary hydatid cyst after cortical bone destruction in the sacrum

Author: Kusay Ayoub, Abdelaziz Alibraheem, Shaban Suliman, Ammar Niazi, Yasser Hendawi, Ahmad Al-Mouakeh, Mohammad Karam Abouzied, and Samer Rajab Basha
Subjects: musculoskeletal diseases, Foot drop, medicine.medical_specialty, Sacrum, Gait disorders, A Rare Case Report, 03 medical and health sciences, 0302 clinical medicine, Echinococcosis, parasitic diseases, medicine, Paresthesia, Echinococcus granulosus, Main text, Sciatica, biology, business.industry, General Medicine, Pelvic cavity, medicine.disease, biology.organism_classification, Low back pain, Hydatid disease, Surgery, medicine.anatomical_structure, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, medicine.symptom, Differential diagnosis, business
Abstract: Introduction Hydatid disease is caused by infection of Echinococcus Granulosus. Usually Hydatid Cysts occur in the liver and lungs. Presenting hydatid cysts in bone without hepatic affectation is rare and occurs in 0.5–2% of cases. Hence, this rare case makes the diagnosis difficult for the clinicians and, as a result, misdiagnosis of sacral Echinococcosis is common. Presentation of case The authors report on a 47-year male with primary sacral hydatidosis and 34 years of recurrence. He was admitted with compressive neurological symptoms like tingling pain, numbness, sciatica and foot drop. He has undergone 8 operations and has been treated with Albendazole. He has developed a Sacro-cutaneous fistula. Discussion When assessing sciatica, low back pain or lower limb weakness the pelvic cavity should be examined for hidden disease that might explain the neurological symptoms. Conclusion A missed diagnosis of osseous Hydatidosis could be devastating. Accordingly, the sacral Hydatid cyst must be included as a differential diagnosis for compressive neurological symptoms. In clinical practice, surgery remains the gold standard for treating osseous Hydatidosis., Highlights • The symptoms of osseous echinococcosis are non-specific and widely variable. • Sacral hydatid cyst it should be included in the differential diagnosis of any bone mass caused compressive neurological symptoms. • Treatment of hydatid cyst is primarily surgical, demanding total removal without rupture. • Posterior approach is preferred over anterior due to feasibility of the intervention and decrease of the recurrence rate.
Published: 2020

34. Thyroglossal duct surgery. What is the acceptable recurrence rate?

Author: Ameen Z. Alherabi, Firas R. Abi Sheffah, Anas H. Al-Tammas, Asma A. Alahmadi, Mohannad K. Rajab, Osama A. Bawazir, Abdullah Bawazir, Ibtihal A. Althobaiti, John C. Heaphy, and Osama A. Marglani
Subjects: Male, medicine.medical_specialty, recurrence, Adolescent, Thyroglossal duct, Biopsy, Fine-Needle, Saudi Arabia, lcsh:Medicine, 030204 cardiovascular system & hematology, Brief Communication, Malignancy, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, surgical, Biopsy, medicine, Humans, 030212 general & internal medicine, Child, sistrunk, Retrospective Studies, Duct cyst, medicine.diagnostic_test, business.industry, lcsh:R, Gold standard, Infant, Retrospective cohort study, General Medicine, medicine.disease, Thyroglossal Cyst, thyroglossal duct cyst, Surgery, Fine-needle aspiration, medicine.anatomical_structure, Research centre, Child, Preschool, Surgical Procedures, Operative, Female, business
Abstract: Objectives: To present experiences of different specialties in the treatment of thyroglossal duct cysts (TGDCs) and subsequent complications in multiple centers. Methods: A retrospective cross-sectional study of all cases of TGDC for a period of 11 years from 2008-2019 by different departments from 3 different centers in Jeddah, Kingdom of Saudi Arabia (King Faisal Specialist Hospital and Research Centre, Bakhsh Hospital and International Medical Center). Results: Forty-nine patients were included. The type of surgery performed plays a significant role in recurrence (p less than 0.001). The Sistrunk procedure had a lower recurrence rate (0%) than simple excision (70%) and has showed a significantly long recurrence-free interval (p less than 0.001). Higher recurrence rates are associated with higher postoperative complications (p=0.002). Patients who underwent pre-operative fine needle aspiration did not have any recurrence during the follow-up period. Conclusion: The Sistrunk procedure is the gold standard technique with the highest recurrence-free interval rate. Fine needle aspiration could be recommended as a less invasive procedure to exclude malignancy.
Published: 2020

35. ABNORMAL FINDING OF PAP SMEAR AMONG WOMEN HOSPITAL VISITORS IN CITY OF MOSUL, IRAQ

Author: Thukaa T Yahya, Layla G Saeed, Wasnaa A Elias, and Sanaa Rajab
Subjects: Infertility, Vaginal discharge, medicine.medical_specialty, Intraepithelial neoplasia, Abdominal pain, business.industry, Obstetrics, medicine.disease, 03 medical and health sciences, 0302 clinical medicine, Abnormal PAP Smear, Obstetrics and gynaecology, 030220 oncology & carcinogenesis, Medicine, Abnormal Finding, 030212 general & internal medicine, medicine.symptom, business, Prospective cohort study
Abstract: Objective: The research aims to test the use of the Pap smear screening system to identify precancerous lesions among women in City of Mosul, Iraq. Methods: This prospective study was carried out over 1 year at the Department of Obstetrics and Gynaecology in Mosul Teaching Hospital, city of Mosul, Iraq. We screened 100 sexually active women who were more than 21 years of age. Women with different complaints, including vaginal discharge, blood‑mixed discharge, foul-smelling discharge, postcoital bleeding, intermenstrual bleeding, postmenopausal bleeding, abdominal pain, infertility, and secondary amenorrhea, were included in this study. The glass slides had been sent for cytopathological review to the pathology department. The laboratory results have been reported by the new Bethesda Cervical Cytology Reporting System 2014. The device divided the lesions narrowly into certain negative ones for intraepithelial neoplasia and with epithelial cell abnormalities (ECA) that involve squamous and glandular cells. Upon pap smear, the patient was treated accordingly. Results: The study had enrolled a total of 100 cases. All of these patients had an abnormal Pap smear finding that fell according to TBS-2014 criteria in the category of Epithelial Cell abnormality. We interviewed all patients in Detail by proforma. The data reported were statistically analyzed and were collected following observations and tests. Among the study subject, the most common abnormal findings (68.9%) were negative findings. Inflammatory constitute (15.4), and Atypical squamous cells of undetermined significance (7%) followed by LSIL (5.9) and HSIL (2.9). Conclusion: Pap smear is an effective method for screening for Cervical Lesions Precancerous and cancerous. Nevertheless, a cervical biopsy must be performed which Is gold standard if any epithelial defects are found to be confirmed in cervical cytology.
Published: 2020

36. Nitric oxide and TNF-α are correlates of diabetic retinopathy independent of hs-CRP and HbA1c

Author: Manouchehr Nakhjavani, Soghra Rabizadeh, Alireza Esteghamati, Reihane Qahremani, Armin Rajab, Mohammad Omidi, Pegah Khaloo, Ghasem Farahmand, Firouzeh Heidari, Hossein Mirmiranpour, and Masoume Bitaraf
Subjects: medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, Inflammation, Type 2 diabetes, Nitric Oxide, Gastroenterology, Nitric oxide, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Endocrinology, Internal medicine, Diabetes mellitus, medicine, Humans, Glycated Hemoglobin, Diabetic Retinopathy, Triglyceride, Tumor Necrosis Factor-alpha, business.industry, Type 2 Diabetes Mellitus, Diabetic retinopathy, medicine.disease, C-Reactive Protein, Diabetes Mellitus, Type 2, chemistry, 030220 oncology & carcinogenesis, medicine.symptom, business, Biomarkers, Retinopathy
Abstract: Regarding the role of inflammation in progression of diabetes this study was conducted to investigate the association between inflammatory biomarkers such as nitric oxide (NO), tumor necrosis factor alpha (TNF-α), and high-sensitivity C-reactive protein (hs-CRP) with the chance of existence of diabetic retinopathy and its progression in patients with diabetes. A total of 83 patients with T2DM (Type 2 diabetes mellitus) were divided into three groups of patients with proliferative diabetic retinopathy (PDR), patients with non-proliferative diabetic retinopathy (NPDR) and patients without diabetic retinopathy (NDR) based on ophthalmologic funduscopic examination. Twenty six healthy controls were also enrolled. Blood samples were taken after 12 h of overnight fasting, NO, TNF-α, and hs-CRP were measured. Association of the level of these biomarkers with retinopathy was analyzed. The levels of TNF-α, NO and hs-CRP were higher among patients with diabetic retinopathy. Multinomial Logistic Regression model showed that TNF-α and NO could predict the presence of retinopathy among patients with diabetes when adjusted for hs-CRP, HbA1c, FBS, gender, total cholesterol, triglyceride, HDL, LDL, BMI, and age (respectively OR = 1.76, CI 95% = 1.01–3.02, p = 0.046 and OR = 1.12, CI 95% = 1.05–1.18, p
Published: 2020

37. Substance use disorders in Saudi Arabia: a scoping review

Author: Abdulrahman Almazrou, Nazmus Saquib, Juliann Saquib, and Ahmad Mamoun Rajab
Subjects: medicine.medical_specialty, lcsh:Social pathology. Social and public welfare. Criminology, Substance-Related Disorders, Saudi Arabia, 030508 substance abuse, Comorbidity, Review, Substance use disorder, Severity of Illness Index, lcsh:HV1-9960, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Risk Factors, Medicine, Humans, 030212 general & internal medicine, Social work, business.industry, Health Policy, Public health, lcsh:Public aspects of medicine, lcsh:RA1-1270, medicine.disease, Mental health, Quality, Substance abuse, Psychiatry and Mental health, Health psychology, Cross-Sectional Studies, Scale (social sciences), Family medicine, Case-Control Studies, Family Relations, 0305 other medical science, business, Qualitative research, Primary research
Abstract: BackgroundSubstance use disorders (SUD) are mental health conditions that arise from chronic drug use. There is an increased recognition of this problem in Saudi Arabia.ObjectiveConduct a comprehensive review of published literature on SUD to identify knowledge gaps and to guide future research.MethodsPubMed, Embase and Cochrane databases were searched with suitable keywords for SUD publications up to June 10, 2019. Eligible studies (primary research conducted in Saudi Arabia) were organized into three broad domains: (1) risk (or protective) factors of SUD, (2) perspectives on drug use of people who use drugs, and (3) impact on family. The quality of the included studies was assessed with the Newcastle-Ottawa Scale.ResultsOf the 113 search records, 23 were eligible for analysis (19 cross-sectional and 4 case-control). All studies were conducted in clinical settings; all but two included males only. There were 4 studies about SUD risk factors, 6 studies about the perspectives of people who use drugs, and none about family impact. None of the cross-sectional studies (0%) and 25% of case-control studies were of good quality.ConclusionsThe available studies were few in number, weak in methodology, and poor in quality. Quantitative as well as qualitative studies about SUD are warranted in each domain and should represent both genders.
Published: 2020

38. C-reactive protein in gallbladder diseases: diagnostic and therapeutic insights

Author: Matthew S. Nelson, Mihee L. Choe, Jenna M. B. Addams, Margaret E. Olson, Ibraheem M. Rajab, Daniel Majerczyk, and Lawrence A. Potempa
Subjects: Pathology, medicine.medical_specialty, Gallbladder disease, Inflammation, 02 engineering and technology, Excretion, 03 medical and health sciences, chemistry.chemical_compound, medicine, 030304 developmental biology, 0303 health sciences, biology, Cholesterol, business.industry, Gallbladder, C-reactive protein, General Medicine, Gallstones, 021001 nanoscience & nanotechnology, medicine.disease, Biomarker (cell), medicine.anatomical_structure, chemistry, biology.protein, medicine.symptom, 0210 nano-technology, business
Abstract: The gallbladder is an important component of the hepatobiliary system whose primary function is to aid in digestion of foodstuffs, excretion of drugs and facilitate removal of waste products from the body. The gall bladder is principally a storage organ for bile, chemically modified salts and acids of cholesterol which are synthesized in the liver and which function as surfactants to solubilize fatty substances of limited aqueous solubility. Any disruption in the amount or activity of bile surfactant can lead to an accumulation of insoluble molecular clumps (e.g., gallstones) that deposit in and obstruct fluid movement within the gallbladder, and which can lead to pathological congestion and tissue damage. The natural host defense response to any event that causes tissue damage is to stimulate inflammation, which non-specifically but aggressively reacts to the stimuli so to remove the cause and repair damaged tissues. The C-reactive protein (CRP) is a primarily hepatically produced serum protein whose blood levels increase within 6–10 h of any tissue-damaging event. The extent with which it increases correlates with the level of tissue damage and associated inflammation. CRP levels are reported to be of value in diagnosing acute cholecystitis severity, in predicting the outcome and prognosis of cancer-associated gallbladder resection, and in helping identify cystic structures during emergency laparoscopic cholecystectomies. As an understanding of distinctive CRP structural isoforms is evolving, its role not only as a biomarker but as regulator of both physiologic and pathophysiologic processes of inflammation may be relevant in the understanding of and treatment approaches for gallbladder-associated disease.
Published: 2020

39. Cancerous Inhibitor of Protein Phosphatase 2A as a Molecular Marker for Aggressiveness and Survival in Oral Squamous Cell Carcinoma

Author: Khadiga Ahmed Ismail, Amani A. Alrehaili, Farah Anjum, Wael H. Elsawy, Amal F. Gharib, and Rajab Alzahrani
Subjects: 0301 basic medicine, business.industry, Normal tissue, Protein phosphatase 2, Oral cavity, Malignancy, medicine.disease, Tumor tissue, stomatognathic diseases, 03 medical and health sciences, chemistry.chemical_compound, 030104 developmental biology, 0302 clinical medicine, Oral squamous cell carcinoma, chemistry, Downregulation and upregulation, 030220 oncology & carcinogenesis, Molecular marker, Cancer research, medicine, Original Article, Basal cell, business, Cancerous inhibitor of protein phosphatase 2A
Abstract: Cancerous inhibitor of protein phosphatase 2A (CIP2A) has been identified as one of the most commonly altered proteins in human cancers. It blocks the tumor-suppressive action of protein phosphatase 2A (PP2A) complex and enhances malignancy. Thirty-five patients with squamous cell carcinoma of the oral cavity underwent surgical resection of the tumor. CIP2A was assessed by quantitative real-time PCR in the resected tumor tissues and in their adjacent normal tissues. CIP2A was found to be overexpressed in all oral squamous cell carcinoma (OSCC) specimens in comparison to their surrounding normal tissue. CIP2A overexpression was statistically correlated with poor prognostic feature of the tumor. Thus, a high expression level of CIP2A was associated with shorter survival. In conclusion, CIP2A is upregulated in OSCC, and its overexpression is correlated with aggressiveness of the tumor and poor outcome and survival. It may serve as a prognostic marker of OSCC.
Published: 2020

40. Effectiveness of Solution-based Therapy on Self-Compassion and Reducing Blood Glucose in Elderly Patients with Type 2 Diabetes

Author: Zari Ahmadi, Asadollah Rajab, Biouk Tajeri, and Saeideh Bazzazian
Subjects: medicine.medical_specialty, business.industry, Medicine, Blood sugar, Research article, Type 2 diabetes, business, Intensive care medicine, medicine.disease, Self-compassion
Abstract: Introduction and Objectives: One of the problems of diabetes in the elderly is the likelihood of another condition that makes it more difficult to control blood sugar. This study aimed to investigate the effectiveness of solution-based therapy on self-compassion and blood glucose reduction in elderly patients with type 2 diabetes. Materials and Methods: This quasi-experimental study was conducted based on a pretest-posttest design with a control group and follow-up. The statistical population of the study consisted of 60-75-year-old patients with type 2 diabetes referring to Iranian Diabetes Association treatment centers in Tehran, Iran. A total of 36 patients were selected and randomly assigned into two groups of experimental and control. The data were collected using a self-compassion questionnaire and glycated hemoglobin test (HbA1c). The HbA1c test was also administered two months after the end of the training to follow-up and evaluate the sustainability of the treatment effects. The data were analyzed in SPSS software (version 26) through repeated measure ANOVA. Results: The results showed that the solution-based therapy increased self-compassion in the posttest phase (P
Published: 2020

41. TWO YEARS FOLLOW UP AFTER ERADICATION THERAPY OF PEPTIC ULCER

Author: Ali Esmail Al-Snafi and Hassan K. Rajab
Subjects: medicine.medical_specialty, business.industry, Peptic ulcer, General surgery, medicine, Pharmaceutical Science, medicine.disease, business
Abstract: Objective: This study was performed to detect the recurrence rate for two years after eradication therapy of peptic ulcer. Methods: Sixty-nine patients included in this study in Kirkuk city from January 2004 to January 2005 as 1st year follow up, and 49 patients from January 2005 to January 2006 as second year follow up study. A urea breath test and re-endoscopic examination were carried out to confirm peptic ulcer recurrence. A questionnaire was prepared to take the history of the disease and other relevant data of each patient. Results: The recurrence was occurred in 6 (8.7%) and 8 patients (16.33%) in the 1st and 2nd years after eradication therapy. Highly risk of recurrence was smoking, age below 50 y and stress in 1st year follow up, and stress was the highly risk in the 2nd year follow up. Conclusion: After triple and quadruple therapy of peptic ulcer, the recurrence is low, However, the possibility of H. pylori resistance should be considered.
Published: 2020

42. Ascitic calprotectin for the diagnosis of spontaneous bacterial peritonitis: a systematic review and meta-analysis

Author: Saadi Aljundi, Mohamed Saddik Zaghloul, Ahmed Amir, Mohammad J Atiah, Ahmad Mamoun Rajab, Mahmoud Dibas, and Nazmus Saquib
Subjects: medicine.medical_specialty, Peritonitis, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Spontaneous bacterial peritonitis, Internal medicine, Odds Ratio, Humans, Medicine, Hepatology, Receiver operating characteristic, business.industry, Area under the curve, Publication bias, medicine.disease, Confidence interval, ROC Curve, Area Under Curve, 030220 oncology & carcinogenesis, Meta-analysis, Diagnostic odds ratio, 030211 gastroenterology & hepatology, Calprotectin, business, Leukocyte L1 Antigen Complex
Abstract: Calprotectin is a promising diagnostic biomarker for spontaneous bacterial peritonitis (SBP) among cirrhotic patients, but published studies report a wide variation of its diagnostic accuracy. We systematically searched six databases for eligible studies (i.e., all original studies that reported ascitic calprotectin as a diagnostic marker for SBP in cirrhotic patients), and assessed their quality with the Quality Assessment of Diagnostic Accuracy Studies-2 tool. We calculated the pooled sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR), and diagnostic odds ratio (DOR) using the bivariate mixed-effect model. We constructed the summary receiver operating characteristic and determined the area under the curve (AUC). We registered the study protocol in PROSPERO (CRD42019125476). Our search retrieved 102 studies, of which 10 were included in the analysis. The overall risk of bias of these studies ranged from low to moderate. There was no heterogeneity from the threshold effect (Spearman correlation coefficient = 0.100, P value = 0.770). The pooled estimates [95% confidence intervals (CIs)] for ascitic calprotectin were as follows: sensitivity 0.91 (95% CI: 0.88-0.94), specificity 0.87 (95% CI: 0.68-0.96), PLR 7.18 (95% CI: 2.52-20.43), NLR 0.10 (95% CI: 0.07-0.15), DOR 71.91 (95% CI: 19.42-266.34), and AUC 0.92 (95% CI: 0.90-0.94). The sensitivity analysis did not detect outliers, and the model had a robust goodness of fit. There was no significant publication bias detected (Deeks test of asymmetry, P value = 0.79). Ascitic calprotectin is a promising diagnostic biomarker for SBP in cirrhotic patients.
Published: 2020

43. Cancer commonness in Eastern and Western Libya and effect of the eating way on patients

Author: Agila Amal Rajab
Subjects: medicine.medical_specialty, Cross-sectional study, Obstetrics, business.industry, Stomach, Pharynx, Cancer, medicine.disease, Food related tumors, Bad nutritional habits, Eastern and western Libya, Cross sectional study, High-quality nutrition, medicine.anatomical_structure, Fruits and vegetables, medicine, Family history, business, Colorectal Tumors, Fast foods
Abstract: This work provides a summary on size of food related tumors including pancreas, stomach, liver and colorectal tumors in Eastern and Western Libya from 2005 to 2009; and lung, breast and colorectal cancers at Tobruk Medical Center in 2017, and to recognize the responsibility of bad nutritional habits in growing cancer. A total of 972 cancer cases were analyzed. About, 785 cases (466 males and 319 females) were from Eastern and Western Libya and diagnosed with pancreas, stomach, liver, mouth, pharynx and colorectal cancers .Whereas, 187 cases (40 males and 147 females) were obtained from Tobruk Medical Center and diagnosed with lung, breast and colorectal cancers. A cross sectional study performed on 300 patients with pancreas, stomach, liver, mouth, pharynx and colorectal cancers at Tobruk Medical Center, Al Shefa Clinic and Al Shema Clinic in Tobruk from August 2016 to March 2018. Of 785 patients, there were 382 cases (220 males and 162 females) from Western Libya and 403 cases (246 males and 157 females) from Eastern Libya. About 59.4 % males and 40.6% females were detected with pancreas, stomach, liver, mouth, pharynx and colorectal cancers. Men are just about 18.8 % more expected than women to build up tumors. Approximately 28% males and 20.6% females from Western Libya, while 31.4% males and 20% females from Eastern Libya. Men in Eastern Libya are almost 3.4% more likely than men in Western Libya to develop cancer. While, women in Western Libya are only 0.6 % more likely than women in Eastern Libya to develop cancer. Among interviewed patients, 42% (n = 126) cases commonly consumed fast foods, while 34% (n = 102) cases rarely ate fruits and vegetables, and 24% (n = 72) patients had family history. High-quality nutrition with excellent bodily movements encourages health of patients with cancer.
Published: 2020

44. Knowledge of Breast Cancer and the Practice of Breast Self-Examination in Saudi Women: An Online Survey

Author: Hussam Rajab, Fatimah M Yousef, Ikhlas A. Sindi, Mai Albaik, Aminah Allohaibi, and Ghadeer Joudah
Subjects: medicine.medical_specialty, Higher education, medicine.diagnostic_test, business.industry, Knowledge level, Early detection, Cancer, Retrospective cohort study, Disease, medicine.disease, Breast cancer, Family medicine, medicine, General Pharmacology, Toxicology and Pharmaceutics, business, Breast self-examination
Abstract: Breast cancer is a cancer that spreads all over the world, including Saudi Arabia. Early detection requires awareness and knowledge of possible warning signs and effective methods of examination. The study aimed to evaluate the breast cancer knowledge (risk factors, causes, prevention and treatment) and to assess the Breast Self-Examination (BSE) among women in Saudi Arabia, so as to explore possible correlation between education and knowledge and practice of breast cancer. A total of 697 Saudi women, their ages between 18 and 65 years, their education levels ranged from primary to graduate levels. A custom designed survey was distributed online to assess the knowledge of breast cancer across many domains, the practice of BSE and women’s psychology towards this disease. The study period was from September to December 2019. Almost half of the participants had an overall moderate knowledge level (48.7 ± 17.2%) toward breast cancer. As the education level of the participants increased, knowledge also increased at P
Published: 2020

45. Cytogenetic Investigation of Patients with Infertility, Recurrent Abortions, and Unsuccessful Assisted Reproductive Technologies (ARTs) Referred to Sarem Women's Hospital in Tehran Between 2006 and 2017

Author: Leila Shajareh pour, Eiman Bagherizadeh, Fatemeh Vand Rajab por, Seyede Fahimeh Mousavi, Roghaieh Vahedi, Ensieh Ghadami, Abootaleb Saremi, Atefeh Dokhanchi, Jafar Mehrabi Sisakht, Farkhondeh Behjati, Sarem Fertility, Fatemeh Moghadasi, Kamran Bahadori, and Akram Abdi
Subjects: Infertility, medicine.medical_specialty, Cytogenetic investigation, business.industry, Obstetrics, Medicine, Reproductive technology, business, medicine.disease, The arts, Recurrent Abortions
Published: 2020

46. Knowledge toward diabetes risk factors and complications of diabetes mellitus among adults in Jeddah, Saudi Arabia

Author: Baraa Rajab, Rawan Yaqoub, Ali Alamri, Samah Ahmed, and Anwar Alamri
Subjects: Pediatrics, medicine.medical_specialty, Diabetes risk, business.industry, Diabetes mellitus, Medicine, business, medicine.disease
Published: 2020

47. The use of iris claw intraocular lens in aphakic eyes with inadequate capsular support and in phakic eyes for correction of high refractive errors

Author: Hany A Khairy, Ahmed M Shebl Fayed, Ghada Z Rajab, and Abdel-Khalik I El-Saadany
Subjects: medicine.medical_specialty, Intraocular pressure, Visual acuity, genetic structures, medicine.medical_treatment, Intraocular lens, Phakic intraocular lens, Aphakia, Pupil, Ophthalmology, medicine, business.industry, aphakia, RE1-994, medicine.disease, eye diseases, medicine.anatomical_structure, iris-claw lens, Lens (anatomy), lens subluxation, Vitreous hemorrhage, sense organs, lens dislocation, medicine.symptom, business, phakic intraocular lens
Abstract: Background Iris-claw intraocular lens (IOL) implantation is effective for correction of aphakia in the absence of capsular support. Iris claw phakic IOLs lack potential size-related complications that may occur with other phakic IOLs. Objective The aim of this study was to evaluate the technique, efficacy, and safety of iris claw IOL implantation. Patients and methods Patients with inadequate capsular support underwent aphakic iris-claw IOL implantation using two techniques: anterior chamber and retro-pupillary fixation of iris-claw lens. Phakic iris claw IOLs were implanted for myopic patients with high refractive errors or with thin or suspicious corneas. Eyes were evaluated for uncorrected and corrected distance visual acuity, refraction, intraocular pressure, and any postoperative complications. Results The study included 17 eyes. Group I included 12 eyes that underwent aphakic iris-claw lens implantation. Indications for surgery were surgical aphakia (n=8), lens dislocation (n=1), and lens subluxation (n=3). Eight eyes had pre-pupillary lens implantation and four eyes underwent retro-pupillary implantation. Group II included five eyes that underwent phakic iris-claw lens implantation. The final postoperative unaided visual acuity was 0.13±0.067 in group I and 0.22±0.076 in group, II, whereas the corrected visual acuity was 0.28±0.193 in group I and 0.34±0.114 in group II. The visual acuity improved significantly compared with the preoperative values (P=0.003 and 0.003, respectively, in group I and P=0.041 and 0.042, respectively, in group II). Postoperative complications included corneal edema, intraocular pressure elevation, inflammatory reaction, pupil ovalization, vitreous hemorrhage, and lens disenclavation. Conclusion Aphakic iris-claw IOL implantation is an effective option for visual rehabilitation in eyes with inadequate capsular support. Phakic iris-claw lens implantation is useful for correction of high refractive errors with high efficacy and safety.
Published: 2020

48. Parental socioeconomic status and occupation in relation to childhood obesity

Author: Rahaf Kutbi, Abdulmoein E. Al-Agha, Abeer Almutairi, Hani Alzahrani, Sara Bashlawi, Muath Alghamdi, Ameer Mesawa, Ahmed Almarri, Hanadi Alahdali, Abrar Abdullah, and Fatima Rajab
Subjects: medicine, Relation (history of concept), medicine.disease, Psychology, Socioeconomic status, Childhood obesity, Demography
Published: 2020

49. EVALUATION OF HYBRID VENTILATION EFFICIENCY TO IMPROVE THE INDOOR AIR QUALITY FOR PATIENTS’ ROOMS IN HOSPITALS OF ASWAN CITY

Author: Israa Syed Muhammad Othman, Mohammed Abdul Sami Eid, Ayman Rajab Abdel Radi, and Muhammad Hassan Hassan
Subjects: Patient room, Hybrid ventilation, Indoor air quality, medicine, Environmental science, Medical emergency, medicine.disease
Published: 2020

50. Incidence of avascular necrosis of the head of the femur among sickle cell patients in Albaha region, Kingdom of Saudi Arabia

Author: Saeed Faleh Saeed Alshahrani, Abdulhakam Ahmed, Tahani Rajab Ali Alzahrani, Abdulaziz Khalid Saleh Alghamdi, Asmaa Khalid Hassan Abdelkarim, and Abdullah Nasser H Leslom
Subjects: medicine.medical_specialty, business.industry, Incidence (epidemiology), Avascular necrosis, Disease, medicine.disease, Conservative treatment, High morbidity, Internal medicine, Computerized system, Medicine, Femur, High incidence, business
Abstract: Background: Sickle cell disease (SCD) is an autosomal recessive disorder characterized by the production of abnormal hemoglobin S and is associated with high morbidity and mortality. The current study was aimed to determine the incidence of avascular necrosis (AVN) of the head of the femur in SCD patients in Al-Baha region. Methodology: A retrospective, descriptive cross-sectional study was conducted in the King Fahad Hospital located in Al-Baha region in the Kindom of Saudi Arabia. The patient's data collected were the well organized using a computerized system established in 2017. Results: The study showed a significant relationship between female gender SCD and developing AVN, 25 (56.8%). Among the total subjects, 44 patients were females, while only 19 patients were male. Furthermore, the study also found a strong statistically significant relationship between the incidence of AVN and recurrence. A total of 44 (24.3%) patients developed recurrence after AVN development. In 12.1% of them, the recurrence was in the left hip, while 9.0% had it on the right hip, followed by 4% on both the hip and only 2% has developed it on the left shoulder. Among the total, 97.7% of the study group were treated from AVN by replacement while 2.3% continued on conservative treatment. Conclusion: The incidence of AVN of the head of the femur among 24% of the study patients was considered less than that observed in countries of high incidence including Nigeria with 47% but still this percentage needs attention from health system as the avascular necroses of femur head could affect all aspect of life of the patients and health system economy.
Published: 2020

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