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1. Timely News and Notes for Primary Care Providers from the American Diabetes Association

Author: Max Bingham
Subjects: 0301 basic medicine, Type 1 diabetes, education.field_of_study, Pediatrics, medicine.medical_specialty, Departments, business.industry, Risk of infection, Endocrinology, Diabetes and Metabolism, 030106 microbiology, Population, Confounding, Diabetes is Primary, Type 2 diabetes, medicine.disease, Sepsis, 03 medical and health sciences, Diabetes mellitus, Health care, medicine, Internal Medicine, business, education
Abstract: Increased Risks of Infections in Diabetes According to Carey et al. ( Diabetes Care , doi.org/cjxp), individuals with diabetes, and especially those with type 1 diabetes, likely carry a substantially increased risk for infections in comparison to the general public. The authors say that the risk of infection attributable to diabetes likely represents a considerable burden for both patients and health care systems. They call for research to explore education and management strategies to reduce poor outcomes and point out that diabetes-related infection rates are only likely to go up as diabetes rates increase and the population ages. Notable for its large size, the study tracked infection rates and infection-related hospitalizations and mortality in just over 100,000 individuals with diabetes and just over 200,000 matched control individuals without diabetes in England between 2008 and 2015. The researchers then compared rates between individuals with and without diabetes and also between individuals with type 1 versus type 2 diabetes versus control individuals. Notably, they also adjusted the findings for a range of confounding factors such as smoking, BMI, and age—something that previous studies have not consistently accounted for. Compared to those without diabetes, patients with diabetes had higher rates of infections and hospitalization due to infection. Rate disparities were consistently greater in those with type 1 diabetes than in those with type 2 diabetes compared to control subjects. Bone and joint infections, sepsis, and cellulitis showed the largest disparities between individuals with type 2 diabetes and control subjects, whereas, for those with type 1 diabetes, bone and joint infections, sepsis, and endocarditis showed the greatest disparities versus control subjects. Adjusting for factors such as smoking, age, sex, BMI, and deprivation reportedly did not substantially change the outcomes. “People with diabetes, particularly type 1 diabetes, are at increased risk of serious infection, representing an important population burden,” the authors concluded. …
Published: 2022
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2. Placental Findings in Infants with Hypoxic-Ischemic Encephalopathy: The Importance of the Comparison Group

Author: Katherine Rand, Abbot R. Laptook, Jessica Farrar, Richard Tucker, Fusun Gundogan, and Adrienne Bingham
Subjects: Fetus, medicine.medical_specialty, Placenta Diseases, business.industry, Obstetrics, Placenta, Incidence (epidemiology), Placental Finding, Encephalopathy, Infant, Newborn, Infant, Odds ratio, medicine.disease, Chorioamnionitis, Pregnancy, Case-Control Studies, Hypoxia-Ischemia, Brain, Pediatrics, Perinatology and Child Health, medicine, Humans, Small for gestational age, Gestation, Female, business
Abstract: To determine the effect of 3 distinct comparison groups on associations between placental abnormalities and neonatal hypoxic-ischemic encephalopathy (HIE).This single-center, prospective case-control study of singletons of gestational age ≥36 weeks with predefined criteria for HIE (n = 30) and 3 control groups was conducted from June 2015 to January 2018. The control groups were infants born by repeat cesarean delivery (n = 60), infants born small for gestational age (SGA; n = 80), and infants receiving positive-pressure ventilation (PPV) at birth (n = 70). One pathologist blinded to infant category reviewed placental sections using the Amsterdam Placental Workshop criteria. Logistic regression with group contrasts relative to HIE was used to analyze primary placental pathologies, and ORs with 95% CIs provided effect sizes.The odds of maternal vascular malperfusion were increased among HIE group placentas compared with placentas of the repeat cesarean delivery (OR, 4.50; 95% CI, 1.45-14.00) and PPV (3.88; 1.35-11.16) groups, but not those of the SGA group. The odds of fetal vascular malperfusion were increased in the HIE group compared with the SGA group (OR, 9.75; 95% CI, 1.85-51.51). The odds of acute chorioamnionitis were higher in the HIE group compared only with the repeat cesarean delivery group, reflecting a similar incidence of chorioamnionitis in SGA group and PPV group placentas. The absence of placental findings was lowest in the HIE group (6.7%), followed by the SGA (18.8%), PPV (31.4%), and repeat cesarean delivery (75%) groups.Associations with placental abnormalities among infants with HIE varied based on the specific placental abnormality and the control group. Potentially important associations between placental pathology and HIE may be obscured if control groups are not well designed.
Published: 2022
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3. Revision for Aseptic Loosening of Highly Porous Acetabular Components in Primary Total Hip Arthroplasty: An Analysis of 20,993 Total Hip Replacements

Author: Carl Holder, Stephen E. Graves, Roger Bingham, Sophia Rainbird, and Wayne Hoskins
Subjects: Reoperation, musculoskeletal diseases, medicine.medical_specialty, Arthroplasty, Replacement, Hip, Aseptic loosening, Dentistry, Osteoarthritis, Prosthesis Design, Osseointegration, Femoral head, Highly porous, medicine, Humans, Orthopedics and Sports Medicine, Retrospective Studies, business.industry, Australia, Acetabulum, musculoskeletal system, equipment and supplies, medicine.disease, Prosthesis Failure, surgical procedures, operative, medicine.anatomical_structure, Joint replacement registry, Orthopedic surgery, Hip Prosthesis, Implant, business, Porosity, Follow-Up Studies
Abstract: Background Highly porous-coated titanium acetabular components have a high coefficient of friction and ultraporous surfaces to enhance bone ingrowth and osseointegration in total hip arthroplasty (THA). There have been concerns with the development of early radiolucent lines and aseptic loosening of highly porous acetabular components. It is unclear whether these concerns relate to a specific implant or the entire class. The aim of this study is to compare the revision rates for aseptic loosening of highly porous acetabular combinations in primary THA using data from a large joint replacement registry. Methods Data were retrieved from the Australian Orthopedic Association National Joint Replacement Registry for the study period September 1999 to December 2019. All primary THA procedures recorded and performed for osteoarthritis using the most common combinations for each highly porous acetabular component with highly cross-linked polyethylene and a 32-mm or 36-mm femoral head were included. The primary outcome measure was revision for aseptic loosening of the acetabular component. Results were adjusted for patient age and gender. Results There were 20,993 primary THA procedures performed for osteoarthritis using a highly porous acetabular component across 6 combinations. Relative to the POLARSTEM/R3 (StikTite), the Exeter V40/Tritanium had a significantly higher risk of revision for aseptic loosening of the acetabular component (hazard ratio 0.21, 95% confidence interval 0.06-0.74, P = .014). There was no difference between any other highly porous acetabular component combination and no late revisions for aseptic loosening. Conclusion Highly porous-coated titanium acetabular components have low rates of aseptic loosening with long-term follow-up. A difference between components may exist. Level of Evidence Level III.
Published: 2022
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4. Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition

Author: Todd W. Rice, Carol L. Braunschweig, Liam McKeever, Angela L. Bingham, Jayshil J. Patel, Michele McCall, and Charlene Compher
Subjects: Parenteral Nutrition, medicine.medical_specialty, Nutrition and Dietetics, Critical Care, Nutritional Support, business.industry, Critical Illness, Medicine (miscellaneous), Guideline, Intensive care unit, law.invention, Study heterogeneity, Enteral Nutrition, Parenteral nutrition, Randomized controlled trial, law, medicine, Forest plot, Humans, Clinical significance, Medical prescription, Intensive care medicine, business
Abstract: Background New randomized controlled trials have been conducted since publication of the 2016 ASPEN/SCCM critical care nutrition guideline. This guideline updates recommendations for foundational questions central to critical care nutrition support. Methods The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) process was used to develop and summarize evidence for clinical practice recommendations. Clinical outcomes were assessed for (1) higher vs lower energy dose (2) higher vs lower protein dose (3) exclusive isocaloric PN vs EN (4) supplemental PN (SPN) plus EN vs EN alone (5a) mixed oil lipid injectable emulsions (ILE) vs soybean oil, and (5b) Fish oil (FO) containing ILE vs non-FO ILE. To assess safety, weight based energy intake was plotted against hospital mortality when study heterogeneity precluded meaningful Forest plot inferences. Results Between 1/1/2001 and 07/15/2020, 2,320 citations were identified and data were abstracted from 39 trials, including 20,578 participants. Patients receiving FO had decreased pneumonia rates of uncertain clinical significance. Otherwise, there were no differences for any outcome in any question. Due to lack in certainty regarding harm, the energy prescription recommendation was decreased to 12-25kcal/kg/day. Conclusion No differences in clinical outcomes were identified among numerous nutritional interventions, including higher energy or protein intake, isocaloric PN or EN, supplemental PN, or different ILEs. As more consistent critical care nutrition support data become available, more precise recommendations will be possible. In the meantime, clinical judgment and close monitoring are needed. This paper was approved by the ASPEN Board of Directors. This article is protected by copyright. All rights reserved.
Published: 2022
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5. Prognostic Value of Stress Cardiac Magnetic Resonance in Patients With Known Coronary Artery Disease

Author: Scott Bingham, J. Ronald Mikolich, Dipan J. Shah, Subha V. Raman, Afshin Farzaneh-Far, Victor A. Ferrari, Bobak Heydari, Shuaib M Abdullah, Steve W. Leung, Kevin Steel, Chetan Shenoy, Jeanette Schulz-Menger, Matthias Stuber, W. Patricia Bandettini, Raymond Y. Kwong, Andrew E. Arai, John F. Heitner, Orlando P. Simonetti, Jorge A. Gonzalez, Amit R. Patel, Yin Ge, and Panagiotis Antiochos
Subjects: Male, medicine.medical_specialty, Magnetic Resonance Spectroscopy, Stress testing, Ischemia, Coronary Artery Disease, Risk Assessment, Coronary artery disease, Predictive Value of Tests, Risk Factors, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, cardiovascular diseases, Myocardial infarction, Aged, Unstable angina, business.industry, Middle Aged, Prognosis, medicine.disease, Heart failure, Cohort, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Mace
Abstract: This study sought to determine whether stress cardiac magnetic resonance (CMR) provides clinically relevant risk reclassification in patients with known coronary artery disease (CAD) in a multicenter setting in the United States.Despite improvements in medical therapy and coronary revascularization, patients with previous CAD account for a disproportionately large portion of CV events and pose a challenge for noninvasive stress testing.From the Stress Perfusion Imaging in the United States (SPINS) registry, we identified consecutive patients with documented CAD who were referred to stress CMR for evaluation of myocardial ischemia. The primary outcome was nonfatal myocardial infarction (MI) or cardiovascular (CV) death. Major adverse CV events (MACE) included MI/CV death, hospitalization for heart failure or unstable angina, and late unplanned coronary artery bypass graft. The prognostic association and net reclassification improvement by ischemia for MI/CV death were determined.Out of 755 patients (age 64 ± 11 years, 64% male), we observed 97 MI/CV deaths and 210 MACE over a median follow-up of 5.3 years. Presence of ischemia demonstrated a significant association with MI/CV death (HR: 2.30; 95% CI: 1.54-3.44; P 0.001) and MACE (HR: 2.24 ([95% CI: 1.69-2.95; P0.001). In a multivariate model adjusted for CV risk factors, ischemia maintained strong association with MI/CV death (HR: 1.84; 95% CI: 1.17-2.88; P = 0.008) and MACE (HR: 1.77; 95% CI: 1.31-2.40; P 0.001) and reclassified 95% of patients at intermediate pretest risk (62% to low risk, 33% to high risk) with corresponding changes in the observed event rates of 1.4% and 5.3% per year for low and high post-test risk, respectively.In a multicenter cohort of patients with known CAD, CMR-assessed ischemia was strongly associated with MI/CV death and reclassified patient risk beyond CV risk factors, especially in those considered to be at intermediate risk. Absence of ischemia was associated with a2% annual rate of MI/CV death. (Stress CMR Perfusion Imaging in the United States [SPINS] Study; NCT03192891).
Published: 2022
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6. Exercise is commonly used as a substitute for traditional airway clearance techniques by adults with cystic fibrosis in Australia: a survey

Author: Kathy Stiller, Scott Morrow, Rebecca Chambers, Anne E Holland, Jennifer Bishop, Nathan Ward, Jennifer Corda, Jamie Wood, Margot Green, Amanda Nichols, Jenny Hauser, Andrew Shaw, Kathleen Hall, Ruth Dentice, Brenda M. Button, Jenn Bingham, Hilary Rowe, Rebecca Netluch, Tara Smith, Robyn Cobb, and Danielle Shortall
Subjects: Adult, Male, Airway clearance, medicine.medical_specialty, Clinical effectiveness, Physical Therapy, Sports Therapy and Rehabilitation, Positive expiratory pressure, Cystic fibrosis, cystic fibrosis, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, respiratory therapy, medicine, Humans, 030212 general & internal medicine, Uncategorized, physical therapy modalities, exercise, business.industry, lcsh:RM1-950, Australia, Outcome measures, respiratory system, medicine.disease, Combined Modality Therapy, Weight lifting, Exercise Therapy, respiratory tract diseases, Cross-Sectional Studies, lcsh:Therapeutics. Pharmacology, Physical therapy, Female, business, 030217 neurology & neurosurgery
Abstract: Questions: What airway clearance techniques and exercise regimens are used by adults with cystic fibrosis (CF) in Australia when well or unwell? What proportion of these adults believe that exercise can be used as a substitute for traditional airway clearance techniques, and how have they come to this belief? What type of exercise is used as a substitute for traditional airway clearance techniques? Design: Cross-sectional survey at 13 CF centres in Australia, using a purpose-designed questionnaire. Participants: Six hundred and ninety-two adults with CF completed the questionnaire. Outcome measures: The questionnaire included questions about: the participants' current use of traditional airway clearance techniques and exercise, when well and unwell; and beliefs regarding the use of exercise as a substitute for traditional airway clearance techniques. Results: Coughing, huffing and positive expiratory pressure were the most commonly used airway clearance techniques. Walking, jogging and lifting weights were the most commonly used forms of exercise. Overall, 43% of participants believed that exercise could be used as a substitute for traditional airway clearance techniques, with 44% having substituted exercise for traditional airway clearance techniques in the previous 3 months. Personal experience was the most commonly reported factor influencing participants' beliefs about the use of exercise as a substitute for traditional airway clearance techniques. Conclusion: Exercise is commonly used as a substitute for traditional airway clearance techniques. Physiotherapists should advise patients that whilst there is some research suggesting a possible mechanism for exercise as a form of airway clearance, there are currently no medium-term to long-term data supporting exercise as a stand-alone form of airway clearance. These results suggest that future research to investigate the clinical effectiveness of exercise as a substitute for traditional airway clearance techniques should be a priority. Registration: ACTRN12616000994482. Key words: Cystic fibrosis, Exercise, Physical therapy modalities, Respiratory therapy
Published: 2023
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7. Impact of osteopathic manipulative techniques on the management of dizziness caused by neuro-otologic disorders: Protocol for systematic review and meta-analysis

Author: Susan E. Swogger, Karen T. Snider, Yasir Rehman, Shalini Bhatia, Barbara Senger, Robert Johnston, Jonathan Bingham, and Jonathon Kirsch
Subjects: medicine.medical_specialty, business.industry, CINAHL, PsycINFO, Odds ratio, law.invention, Complementary and alternative medicine, Randomized controlled trial, Quality of life, law, Strictly standardized mean difference, Meta-analysis, Physical therapy, Medicine, Observational study, business
Abstract: Background Osteopathic manipulative treatment (OMT) has been increasingly adopted by osteopathic practitioners to treat dizziness from neuro-otologic disorders. However, no systematic review has investigated effectiveness of OMT on benefit outcomes and harm outcomes associated with OMT for these conditions. The current protocol will provide pooled effect estimates for effectiveness of OMT for neuro-otologic disorders. Methods The following databases will be searched: CINAHL, Embase, Ovid MEDLINE, AMED, Ovid Emcare, PEDro, PubMed, PsycINFO, OSTMED.DR, and CENTRAL. Eligible randomized controlled trials and observational studies published in English will be reviewed. Target outcomes are change in dizziness, frequency of falls, quality of life (QOL), disability, and return to work; harm outcomes are dropouts due to ineffectiveness, adverse effects, and all-cause dropout rates. Studies investigating individual types of OMT techniques will be pooled. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment tool will be used for data synthesis and to assess evidence quality. We will report effect estimates with weighted mean differences or standardized mean difference (SMD) for continuous outcome and odds ratios with 95% confidence intervals for binary outcomes. Discussion Our findings will be of importance to patients and osteopathic practitioners and will identify key areas for future research.
Published: 2021
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8. Resuscitative endovascular balloon occlusion of the aorta management guided by a novel handheld pressure transducer

Author: Jason Bingham, Matthew J. Martin, Daniel Lammers, Torbjorg Holtestaul, Jeffrey A. Conner, Matthew J. Eckert, Jessica Weiss, and Ian F. Jones
Subjects: medicine.medical_specialty, Resuscitation, business.industry, Monitoring system, Critical Care and Intensive Care Medicine, Pressure sensor, Arterial pressure monitoring, Mean difference, Permissive hypotension, Internal medicine, Mean Survival Time, Cardiology, medicine, Arterial line, Surgery, business
Abstract: BACKGROUND Management of noncompressible truncal hemorrhage utilizing REBOA requires arterial pressure monitoring that can be logistically challenging in austere or emergency settings. Novel pressure transducer devices such as the Centurion COMPASS® device (CD) offer an alternative to traditional monitoring systems. We sought to assess the feasibility of maintaining permissive hypotension during intermittent REBOA in a porcine model guided by CD monitoring. METHODS Eight Yorkshire swine underwent 20% hemorrhage with an uncontrolled iliofemoral vascular injury. Time-based intermittent zone 1 REBOA was performed with volume-based resuscitation to maintain permissive hypotension. Proximal MAPs from a carotid arterial line (AL) were obtained and compared to CD readings from the proximal REBOA port. The operator was blinded to AL MAP, and the REBOA was managed with exclusively the CD. RESULTS Mean survival time was 100 (range 41-120) minutes from injury. AL and CD measurements were closely correlated (r = .94, p < .001). Bland-Altman analysis for comparison of clinical measurements demonstrated a mean difference of 6 mmHg (95% CI -22 to 34 mmHg) for all MAPs, with a mean difference of 3 mmHg (95% CI -6 to 12 mmHg) in a clinically relevant MAP
Published: 2021
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9. Orthogonal MET analysis in a population‐representative stage II–III colon cancer cohort: prognostic and potential therapeutic implications

Author: Jacqueline James, Richard H. Wilson, Helen G Coleman, Maurice B Loughrey, Sandra Van Schaeybroeck, Svenja Mende, Victoria Bingham, Manuel Salto-Tellez, Matthew P. Humphries, Stephanie G Craig, Stephen McQuaid, and Amélie Viratham Pulsawatdi
Subjects: Proteomics, Oncology, Cancer Research, medicine.medical_specialty, MET R970C mutation, Colorectal cancer, Population, Context (language use), Internal medicine, Biomarkers, Tumor, Genetics, medicine, Humans, c‐MET IHC protein, education, Research Articles, RC254-282, MET RNA‐ISH, education.field_of_study, business.industry, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, General Medicine, Prognosis, medicine.disease, Immunohistochemistry, Subtyping, Clinical trial, colon cancer, Colonic Neoplasms, Cohort, Molecular Medicine, Biomarker (medicine), MET T992I mutation, business, MET amplification, Research Article
Abstract: Clinical trials for MET inhibitors have demonstrated limited success for their use in colon cancer (CC). However, clinical efficacy may be obscured by a lack of standardisation in MET assessment for patient stratification. In this study, we aimed to determine the molecular context in which MET is deregulated in CC using a series of genomic and proteomic tests to define MET expression and identify patient subgroups that should be considered in future studies with MET‐targeted agents. To this aim, orthogonal expression analysis of MET was conducted in a population‐representative cohort of stage II/III CC patients (n = 240) diagnosed in Northern Ireland from 2004 to 2008. Targeted sequencing was used to determine the relative incidence of MET R970C and MET T992I mutations within the cohort. MET amplification was assessed using dual‐colour dual‐hapten brightfield in situ hybridisation (DDISH). Expression of transcribed MET and c‐MET protein within the cohort was assessed using digital image analysis on MET RNA in situ hybridisation (ISH) and c‐MET immunohistochemistry (IHC) stained slides. We found that less than 2% of the stage II/III CC patient population assessed demonstrated a genetic MET aberration. Determination of a high MET RNA‐ISH/low c‐MET IHC protein subgroup was found to be associated with poor 5‐year cancer‐specific outcomes compared to patients with concordant MET RNA‐ISH and c‐MET IHC protein expression (HR 2.12 [95%CI: 1.27–3.68]). The MET RNA‐ISH/c‐MET IHC protein biomarker paradigm identified in this study demonstrates that subtyping of MET expression may be required to identify MET‐addicted malignancies in CC patients who will truly benefit from MET inhibition., A population representative study looking at the molecular context in which MET is deregulated in colon cancer using a series of genomic and proteomic tests. This study demonstrates the limited number of genetic MET aberrations present in a Northern Irish colon cancer cohort and identifies a cancer‐specific poor prognosis MET RNA/c‐MET protein subgroup that may be amenable to targeted therapy.
Published: 2021
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10. Cost-effectiveness of Single vs Double Debridement and Implant Retention for Acute Periprosthetic Joint Infections in Total Knee Arthroplasty: A Markov Model

Author: Kevin J. Bozic, Joseph K. Antonios, Mark J. Spangehl, Joshua S. Bingham, Adam J. Schwartz, and Henry D. Clarke
Subjects: Orthopedic surgery, medicine.medical_specialty, Debridement and implant retention, business.industry, Cost effectiveness, Mortality rate, medicine.medical_treatment, Total knee arthroplasty, Periprosthetic, Joint infections, Markov model, Surgery, Debridement (dental), Acute periprosthetic joint infection, Medicine, Orthopedics and Sports Medicine, Implant, business, RD701-811, Original Research, Failed total knee arthroplasty
Abstract: Background Periprosthetic joint infection (PJI) is a common cause of revision total knee surgery. Although debridement and implant retention (DAIR) has lower success rates in the chronic setting, it is an accepted treatment of acute PJI, whether postoperatively or with late hematogenous seeding. There are two broad DAIR strategies: single debridement and planned double debridement. The purpose of this study is to evaluate the cost-effectiveness of single vs double DAIR for acute PJI in total knee arthroplasty. Methods A decision tree using single or double DAIR as the treatment strategy for acute PJI was constructed. Quality-adjusted life years and costs associated with the two treatment arms were calculated. Treatment success rates, failure rates, and mortality rates were derived from the literature. Medical costs were derived from both the literature and Medicare data. A cost-effectiveness plane was constructed from multiple Monte Carlo trials. A sensitivity analysis identified parameters most influencing the optimal strategy decision. Results Double DAIR was the optimal treatment strategy both in terms of the health utility state (82% of trials) and medical cost (97% of trials). Strategy tables demonstrated that as long as the success rate of double debridement is 10% or greater than the success rate of a single debridement, the two-stage protocol is cost-effective. Conclusions A double DAIR protocol is more cost-effective than single DAIR from a societal perspective.
Published: 2021
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11. PrEP for key populations: results from the first PrEP demonstration project in the Democratic Republic of the Congo

Author: Chloe A. Teasdale, Elaine J. Abrams, Nadine Mushimebele, Elie Mukinda, Chunhui Wang, Faustin Malele Bazola, William Reidy, Raimi Ewetola, Julie Franks, Halli Olsen, Gaston Djomand, Richted Tenda Mazala, Trista Bingham, and Tania Tchissambou
Subjects: Male, medicine.medical_specialty, Health (social science), Social Psychology, Anti-HIV Agents, Human immunodeficiency virus (HIV), HIV Infections, medicine.disease_cause, Transgender Persons, Adherence assessment, Men who have sex with men, Sexual and Gender Minorities, Pre-exposure prophylaxis, medicine, Humans, Homosexuality, Male, Data abstraction, Sex Workers, business.industry, Public Health, Environmental and Occupational Health, Attendance, Female sex, Family medicine, Healthcare settings, Democratic Republic of the Congo, Female, Pre-Exposure Prophylaxis, business
Abstract: Oral pre-exposure prophylaxis (PrEP) is recommended for persons at substantial risk for HIV, including female sex workers (FSW), men who have sex with men (MSM), people who inject drugs (PWID), and transgender women (TGW). We report on a PrEP demonstration project at seven clinics in the Democratic Republic of the Congo. Routinely collected data were abstracted to assess PrEP uptake, scheduled visit attendance, and self-reported adherence. Between February and May 2018, 469 eligible clients were offered daily oral PrEP; 75.1% accepted: 78.7% FSW, 20.5% MSM, and 0.9% TGW. Two percent also identified as PWID. Attendance was 64.5% at one-month visits; 82.1% at three-month visits; and among 47.7% of clients who initiated PrEP at least six months before data abstraction, 85.8% at six-month visits. Among 66.3% of clients with at least one adherence assessment, 39% self-reported low adherence. Results demonstrate the acceptability of PrEP delivered in healthcare settings serving FSW, MSM, PWID, and TGW.
Published: 2021
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12. The Top 50 Most-Cited Knee Arthroscopy Studies

Author: Kade S. McQuivey, Jordan R. Pollock, Sierra N. Murphy, M. Lane Moore, and Joshua S. Bingham
Subjects: medicine.medical_specialty, business.industry, Clinical study design, Rehabilitation, Public Health, Environmental and Occupational Health, Physical Therapy, Sports Therapy and Rehabilitation, Evidence-based medicine, Country of origin, Citation analysis, Analytics, Family medicine, Health care, medicine, Orthopedics and Sports Medicine, Relevance (information retrieval), Systematic Review, Psychology, business, Cohort study
Abstract: Purpose To objectively identify the 50 most influential studies in knee arthroscopy and provide an analysis of their key characteristics. Methods The Clarivate Analytics Web of Knowledge database was used to gather data and metrics of knee arthroscopy research. The search list was sorted by the number of citations, and articles were included or excluded based on relevance to knee arthroscopy. The information extracted for each article included author name, publication year, country of origin, journal name, article type, and the level of evidence. Results For these 50 studies, the total number of citations was calculated to be 12,168, with an average of 243.4 citations per paper. The most-cited article was cited 1,220 times. The 50 studies included in this analysis were published between 1972 and 2013. All 50 articles were published in English and came from 10 different orthopaedic journals. The United States was responsible for the majority of articles (n = 26); however, many other countries were represented. The most prevalent study designs were case series (n = 20). Conclusions The 50 most influential articles in knee arthroscopy were cited a total of 12,168 times. The study designs most commonly used were case series and cohort studies. This article serves as a reference to direct orthopaedic practitioners to the 50 most influential studies in knee arthroscopy. We hope that these 50 studies and the analysis we provide help health care professionals efficiently assess consensus, trends, and needs within the field. Clinical Relevance This analysis of the 50 most influential studies in knee arthroscopy will provide medical students, residents, fellows, and attending physicians with a comprehensive inventory and citation analysis of the most impactful academic contributions to one of the most important fields within orthopaedic surgery.
Published: 2021
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13. Fibromyalgianess and glucocorticoid persistence among patients with rheumatoid arthritis

Author: Dorothy D. Dunlop, Yvonne C. Lee, Clifton O. Bingham, Beth I Wallace, Tuhina Neogi, Andrew C. Heisler, Meriah N Moore, Jing Song, Lutfiyya N. Muhammad, Daniel J. Clauw, Wendy Marder, Alyssa Wohlfahrt, and Marcy B. Bolster
Subjects: musculoskeletal diseases, medicine.medical_specialty, Fibromyalgia, Logistic regression, Arthritis, Rheumatoid, Rheumatology, Prednisone, Internal medicine, Humans, Medicine, Pharmacology (medical), Glucocorticoids, business.industry, Odds ratio, Clinical Science, medicine.disease, humanities, Confidence interval, Antirheumatic Agents, Rheumatoid arthritis, business, Serostatus, Glucocorticoid, medicine.drug
Abstract: Objectives Over one-third of patients with RA exhibit evidence of fibromyalgianess, which is associated with higher rates of disability and inadequate responsiveness to RA treatment. Patients with RA often remain on glucocorticoids long-term, despite the known risk of dose-dependent morbidity. We undertook this study to examine the relationship between fibromyalgianess and glucocorticoid persistence among RA patients. Methods We followed participants with active RA on oral prednisone for ∼3 months after initiating a new DMARD. Fibromyalgianess was measured using the Fibromyalgia Survey Questionnaire (FSQ), previously shown to correlate with key FM features often superimposed upon RA. Severity of fibromyalgianess was stratified as follows: FSQ 10 high/very high. The association between baseline fibromyalgianess and glucocorticoid persistence, defined as prednisone use at 3-month follow-up visit after DMARD initiation, was assessed using multiple logistic regression adjusted for baseline demographics, RA duration, serostatus and inflammatory activity assessed using swollen joint count and CRP. Results Of the 97 participants on prednisone at baseline, 65% were still taking prednisone at follow-up. Fifty-seven percent of participants with low baseline fibromyalgianess had persistent glucocorticoid use, compared with 84% of participants with high or very high fibromyalgianess. After adjustment for non-inflammatory factors and inflammatory activity, participants with high/very high baseline fibromyalgianess were more likely to be taking prednisone at follow-up relative to those with low fibromyalgianess [odds ratio 4.99 (95% CI 1.20, 20.73)]. Conclusion High fibromyalgianess is associated with persistent glucocorticoid use, independent of inflammatory activity.
Published: 2021
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14. 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 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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., 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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 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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. 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A., Fadel, A., Habater, A., Hamdy, H., Hefni, A., Kamal, M., Mohamed Abobakr, N., Sayed, A., Shaker, N., Taha, E., Tharwat, H., Zakaria, O., Abdelmotaleb, I., Al-Dhufri, A., Al-Himyari, H. S., El sheikh, E., Eldmaty, A., Elkhalawy, A., M. Elkhashen, A., Magdy, K., Mostafa, S., Sadia, H. D., Saleh, M. M., Samir, D., Yahia Mohamed Ali, M., A. Nassar, M., Abdelhady, S., Abdelrazek, A., Abdelsalam, I., El-Sawy, A., Essam, E., Gadelkarim, M., Ghaly, K., Hassabalnaby, M., Masarani, R., Mohamed Shaaban, N., Sabry, A., Salem, M., Soliman, N. A., Zahran, D., Abou, El. soud M. R., Badr, E. T., Borham, H., Elmeslemany, N., Elsayed, M., Elsherif, F., Eslam, S., Gaber, G., Ibrahim, S., Kamh, Y., Mohamed, S. G., Morshedy, E., Omar, C., Salem Soliman, F., Abdelkawy, S., Abdelmohsen, N., Abdelshakour, M., Dahy, A., Gamal, N., Gamal, M., Hasan, A., Hetta, H., Mousa, N., Omar, M., Rabie, S., Saad, M., Saleh, B., Sayed Mohamed, M., Shawqi, M., Abdelhady Mousa, H., Alnoury, M., Elbealawy, M., Elshafey, A., Essam Ibrahim El Desouki Muhammad Ahmed, M., Ghonaim, M., Hgag, F., Ibrahim, M., Morsy, M., Reda Loaloa, M., Refaat, A., Samir, H., Shahien, F., Sobhy, M., Sroor, F., Abdellatif, E., Adel, M., Afifi, A. A., Afifi, E., Antaky, M., Dawoud, A., El Zoghby, N., El-remaily, A., Elzanfaly, A. A., Gadallah, A., Gamal, F. A., Hashem, O., Medhat Youssef, S., Muhammad Attyah, A., Munir, M., Shazly, O., Wilson, K., Adel, S., Ali, A., Eid, E., Elhelow, E., Elmahdy, M., Elshatby, B., Hossam el-din Zakaria, A., Hossny, A., Ibrahim, E., M. 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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. 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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 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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
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15. Lebensrettende Maßnahmen bei Kindern (Paediatric Life Support, PLS)

Author: Patrick Van de Voorde, Dominique Biarent, N. M. Turner, Abel Martinez-Mejias, Robert Bingham, Torsten Lauritsen, O. Brissaud, Florian Hoffmann, Nieves de Lucas, Jana Djakow, Groa Bjork Johannesdottir, and Ian Maconochie
Subjects: Resuscitation, medicine.medical_specialty, Critically ill, business.industry, health care facilities, manpower, and services, medicine.medical_treatment, education, Basic life support, 030208 emergency & critical care medicine, Emergency department, 030204 cardiovascular system & hematology, Advanced life support, 03 medical and health sciences, 0302 clinical medicine, Respiratory failure, Life support, Emergency Medicine, Medicine, Cardiopulmonary resuscitation, business, Intensive care medicine, health care economics and organizations
Abstract: The European Resuscitation Council (ERC) Paediatric Life Support (PLS) guidelines are based on the 2020 International Consensus on Cardiopulmonary Resuscitation Science with Treatment Recommendations of the International Liaison Committee on Resuscitation (ILCOR). This section provides guidelines on the management of critically ill or injured infants, children and adolescents before, during and after respiratory/cardiac arrest.
Published: 2021
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16. Acute or chronic periprosthetic joint infection? Using the ESR ∕ CRP ratio to aid in determining the acuity of periprosthetic joint infections

Author: Kade S. McQuivey, Jack M. Haglin, Joshua S. Bingham, David G. Deckey, Mark J. Spangehl, and Zachary K. Christopher
Subjects: Orthopedic surgery, musculoskeletal diseases, 030222 orthopedics, medicine.medical_specialty, Retrospective review, Joint arthroplasty, business.industry, medicine.medical_treatment, Original Full-Length Article, Area under the curve, Periprosthetic, Surgical Revision, Gold standard (test), Joint infections, Arthroplasty, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, Internal medicine, Medicine, Orthopedics and Sports Medicine, Surgery, 030212 general & internal medicine, business, RD701-811
Abstract: Introduction: The gold standard for determining the duration of periprosthetic joint infection (PJI) is a thorough history. Currently, there are no well-defined objective criteria to determine the duration of PJI, and little evidence exists regarding the ratio between ESR (mm/h) and CRP (mg/L) in joint arthroplasty. This study suggests the ESR / CRP ratio will help differentiate acute from chronic PJI. Methods: Retrospective review of patients with PJI was performed. Inclusion criteria: patients >18 years old who underwent surgical revision for PJI and had documented ESR and CRP values. Subjects were divided into two groups: PJI for greater (chronic) or less than (acute) 4 weeks and the ESR / CRP ratio was compared between them. Receiver-operating characteristic (ROC) curves were evaluated to determine the utility of the ESR / CRP ratio in characterizing the duration of PJI. Results: 147 patients were included in the study (81 acute and 66 chronic). The mean ESR / CRP ratio in acute patients was 0.48 compared to 2.87 in chronic patients (p). The ESR / CRP ROC curve demonstrated an excellent area under the curve (AUC) of 0.899. The ideal cutoff value was 0.96 for ESR / CRP to predict a chronic (>0.96) vs. acute () PJI. The sensitivity at this value was 0.74 (95 % CI 0.62–0.83) and the specificity was 0.90 (95 % CI 0.81–0.94). Conclusions: The ESR / CRP ratio may help determine the duration of PJI in uncertain cases. This metric may give arthroplasty surgeons more confidence in defining the duration of the PJI and therefore aid in treatment selection.
Published: 2021

17. Addressing intraarticular pathology at the time of anteverting periacetabular osteotomy for acetabular retroversion is associated with better short-term patient-reported outcomes

Author: Joseph A. Panos, Claudia N Gutierrez, Joshua S. Bingham, Cody C. Wyles, Robert T. Trousdale, Kristin C. Mara, and Rafael J. Sierra
Subjects: Arthrotomy, musculoskeletal diseases, 030222 orthopedics, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Minimal clinically important difference, medicine.medical_treatment, Arthroscopy, Chondroplasty, 030229 sport sciences, Prom, medicine.disease, Preoperative care, Surgery, 03 medical and health sciences, Femoral head, 0302 clinical medicine, medicine.anatomical_structure, Medicine, AcademicSubjects/MED00960, business, Femoroacetabular impingement, Research Articles
Abstract: Periacetabular osteotomy (PAO) is effective in the management of developmental dysplasia of the hip and femoroacetabular impingement secondary to acetabular retroversion. During anteverting PAO for acetabular retroversion, the need for both labral treatment and femoral head–neck junction osteochondroplasty remains equivocal. Accordingly, this study evaluated patient-reported outcome measures (PROM) and reoperation rates after anteverting PAO with or without intraarticular intervention. Cases of anteverting PAO performed at a single institution between November 2009 and January 2016 were retrospectively reviewed. Patients were divided into three groups: no intervention and intraarticular intervention with arthrotomy or arthroscopy. Subsequently, patients were reclassified by the intraarticular procedure performed at surgery into major (labral repair, femoral head–neck osteochondroplasty) and minor (labral debridement, femoral/acetabular chondroplasty) groups. The cohort was 75% female, median age was 19.5 years and mean body mass index was 25.0 kg/m2. Preoperative to postoperative improvement was compared to minimal clinically important differences (MCID) for eight PROM. Patients receiving major interventions exceeded MCID in a greater proportion of PROM compared to minor and no intervention groups (P
Published: 2021

18. Evaluation of transport-related outcomes for neonatal transport teams with and without physicians

Author: Louis Beaumier, Sumesh Thomas, Jennifer Toye, Thérèse Perrault, Paul Byrne, William Bingham, Michael Narvey, Geneviève Piuze, Akhil Deshpandey, Don Ilodigwe, Avash Singh, Gregory Hansen, Poornima Murthy, Zarin Kalapesi, Krista Jangaard, Joseph Ting, Ernesto Phillips, Kyong-Soon Lee, Michael Marrin, Stephanie Redpath, Anne Tierney, Henry Roukema, Mohamed Abdelmawla, Hilary Whyte, Rebecca Caces, Edith Masse, and Sibasis Daspal
Subjects: 03 medical and health sciences, medicine.medical_specialty, 0302 clinical medicine, business.industry, 030225 pediatrics, Pediatrics, Perinatology and Child Health, Emergency medicine, Medicine, 030212 general & internal medicine, Online Only Original Articles, business, Neonatal transport, 3. Good health
Abstract: Objective The aim of this study was to evaluate if the presence of a physician in the neonatal transport team (NTT) affects transport-related outcomes and procedural success. Design Retrospective cohort study with propensity score matching. Setting Canadian national study. Patients Neonatal transports from nontertiary centres between January 2014 and December 2017. Interventions Comparison of transports conducted by NTTs with physicians (MD Group) and without physicians (noMD Group). Main outcome measures The primary outcome was the change in patient acuity as measured by the transport risk index of physiologic severity (TRIPS) score. Secondary outcomes included mortality within 24 hours of NICU admission, clinical complications during transport, procedural success, and stabilization time. Results Among 9,703 eligible cases, 899 neonatal transports attended by NTTs with physicians were compared to 899 neonatal transports without physicians using propensity score matching. No differences were seen in the improvement of TRIPS score or mortality ≤24 hours of NICU admission. The MD Group had more clinical complications (7.7% versus 5.0%, P=0.02). No differences were seen in success rates of invasive procedures. The MD Group had shorter stabilization times. In multivariable analysis, the MD Group was not a significant predictor for the improvement in TRIPS score after adjustment for covariates. Conclusions Neonatal transports conducted by teams including physicians compared to teams without physicians, did not have higher improvement in TRIPS scores and had similar success rates for procedures. These results provide insights for the planning of the structure and training of specialized interfacility neonatal transport programs.
Published: 2021
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19. Significant Published Articles in 2020 for Pharmacy Nutrition Support Practice

Author: Angela L. Bingham, Sarah V. Cogle, Roland N. Dickerson, M. Petrea Cober, Anne M. Tucker, Todd W. Canada, Vanessa J. Kumpf, and Lingtak Neander Chan
Subjects: 0301 basic medicine, Pharmacology, medicine.medical_specialty, 030109 nutrition & dietetics, business.industry, Pharmacist, Pharmacy, Original Articles, Clinical pharmacy, 03 medical and health sciences, 0302 clinical medicine, Family medicine, Nutrition support, Medicine, Pharmacology (medical), 030212 general & internal medicine, business
Abstract: Purpose: The purpose of this article is to assist the pharmacist engaged in nutrition support therapy in staying current with pertinent literature. Methods: Several clinical pharmacists engaged in nutrition support therapy compiled a list of articles published in 2020 considered important to their clinical practice. The citation list was compiled into a single spreadsheet where the author participants were asked to assess whether the article was considered important to nutrition support pharmacy practice. A culled list of publications was then identified whereby at least 5 out of the 8 author participants considered the paper to be important. Guideline and consensus papers from professional organizations, important to practice but not ranked, were also included. Results: A total of 169 articles were identified; 5 from the primary literature were voted by the group to be of high importance. An additional 17 guidelines, position, recommendation, or consensus papers were also identified. The top-ranked articles from the primary literature were summarized and a narrative regarding its implications to pharmacy nutrition support practice were provided. Conclusion: We recommend that pharmacists engaged in nutrition support therapy be familiar with these articles as it pertains to their practice.
Published: 2021
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20. Utilization of mobile application improves perioperative education and patient satisfaction in general surgery patients

Author: Vance Y. Sohn, Jason Bingham, Christopher W. Marenco, Matthew J. Eckert, Daniel Lammers, and Kaitlin Morte
Subjects: Male, medicine.medical_specialty, 020205 medical informatics, Smart phone, 02 engineering and technology, Text message, 03 medical and health sciences, 0302 clinical medicine, Patient satisfaction, Patient Education as Topic, Surveys and Questionnaires, 0202 electrical engineering, electronic engineering, information engineering, Humans, Medicine, 030212 general & internal medicine, business.industry, Surgical care, General surgery, System usability scale, Usability, General Medicine, Perioperative, Middle Aged, Mobile Applications, Elective Surgical Procedures, Patient Satisfaction, Female, Surgery, Smartphone, business, Patient education
Abstract: Introduction Clear and accurate communication is paramount in delivering high quality surgical care. Through the development of a mobile application, we provided patients with a source of education and instruction throughout the peri-operative period. Methods Patients >18 years old with a smart-phone undergoing elective general surgery procedures were eligible. Patients received perioperative educational materials and text message reminders of time-sensitive events via the application. A System Usability Scale and survey was administered. Results 100 patients were enrolled; 51% completed the survey. The average SUS score was 86, correlating with >90th percentile usability. 86% of patients felt that the application improved their surgical experience, 96% said the application provided essential reminders, and 90% felt that application clarified information. 84% of patients did not identify any inconsistency between the application and surgeon. Conclusion Utilizing patient’s smart phones to aid in perioperative education is feasible and improves patient satisfaction. This application has a high usability score, indicating ease of use.
Published: 2021
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21. Pancreatic INI1-deficient undifferentiated rhabdoid carcinoma achieves complete clinical response on gemcitabine and nab-paclitaxel following immediate progression on FOLFIRINOX: a case report

Author: Smruti Rahalkar, David B. Bingham, George A. Fisher, and Daniel A King
Subjects: 0301 basic medicine, Oncology, medicine.medical_specialty, business.industry, FOLFIRINOX, Gastroenterology, Cancer, Case Report, Combination chemotherapy, medicine.disease, Gemcitabine, 03 medical and health sciences, Regimen, 030104 developmental biology, 0302 clinical medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Internal medicine, Pancreatic cancer, medicine, Carcinoma, business, Pancreas, medicine.drug
Abstract: Introduction INI1-deficient undifferentiated rhabdoid carcinoma is a rare pancreatic carcinoma for which the optimal treatment is unknown. Pancreatic ductal adenocarcinoma, the most common histology of pancreas cancer, is treated with combination chemotherapy in the advanced setting, a strategy supported by strong evidence in well powered studies. In patients with excellent performance status, first-line treatment usually consists of the three-drug regimen FOLFIRINOX, with the combination of gemcitabine with nab-paclitaxel, typically less toxic than the three-drug regimen, reserved for second-line therapy. Given the lack of published reports describing treatment outcomes for patients with rare forms of pancreatic cancer, the same treatment approach used for pancreatic ductal adenocarcinoma is typically employed. Observation This case describes a patient with metastatic pancreatic INI1-deficient undifferentiated rhabdoid carcinoma who was primarily resistant to FOLFIRINOX therapy but who then achieved an immediate, marked and sustained response to gemcitabine with nab-paclitaxel. Conclusion Given the lack of data informing on optimal management of INI1-deficient pancreatic undifferentiated rhabdoid carcinoma, and the exceptional response achieved by gemcitabine with nab-paclitaxel, this case report highlights a surprising and potentially informative anecdote. Additional studies are needed to confirm responses observed in this report which when taken together may strongly influence first-line therapy choice for this rare malignancy. Given the difficult in acquiring sufficient numbers of these rare histologies in any one institution, multi-institution collaboration in studying outcomes of rare pancreatic malignancies is likely essential.
Published: 2021
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22. Conversion of Functional Assessment of Chronic Illness Therapy–Fatigue to Patient‐Reported Outcomes Measurement Information System Fatigue Scores in Two Phase III Baricitinib Rheumatoid Arthritis Trials

Author: David Cella, Carol L Kannowski, Clifton O. Bingham, Amy M. DeLozier, Susan J. Bartlett, and Luna Sun
Subjects: Adult, Male, Patient-Reported Outcomes Measurement Information System, medicine.medical_specialty, Time Factors, Baricitinib, Standard score, Placebo, Arthritis, Rheumatoid, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Predictive Value of Tests, Health Status Indicators, Humans, Janus Kinase Inhibitors, Multicenter Studies as Topic, Medicine, Patient Reported Outcome Measures, Fatigue, Aged, Randomized Controlled Trials as Topic, 030203 arthritis & rheumatology, Sulfonamides, business.industry, Remission Induction, Scoring methods, Middle Aged, medicine.disease, humanities, Clinical trial, Treatment Outcome, Clinical Trials, Phase III as Topic, Purines, Antirheumatic Agents, Rheumatoid arthritis, Chronic Disease, Physical therapy, Azetidines, Pyrazoles, Female, Active treatment, business
Abstract: OBJECTIVE The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) is validated for measuring fatigue in rheumatoid arthritis (RA). However, 10 of 13 FACIT-F items are identified as relevant to patients with RA. The Patient-Reported Outcomes Measurement Information System (PROMIS) uses an item response theory-calibrated T score metric. The PROMIS Fatigue item bank includes the FACIT-F items, enabling score conversion. The performance of converted PROMIS Fatigue scores has not been evaluated in RA populations or clinical trials. Our objective was to assess the performance of converted PROMIS Fatigue scores in 2 RA clinical trials of baricitinib. METHODS Crosswalk tables and pattern-scoring methods converted FACIT-F scores to PROMIS Fatigue for both the 13-item FACIT-F and the 10-item RA-optimized FACIT-F instrument, in 2 RA clinical trials evaluating baricitinib, RA-BEAM, and RA-BEACON. RA-BEAM patients had an inadequate response to methotrexate. RA-BEACON patients had an inadequate response or intolerance to ≥1 tumor necrosis factor inhibitor. Baricitinib was compared to all treatment arms via analysis of covariance on PROMIS Fatigue score conversions. RESULTS Baseline FACIT-F-derived PROMIS Fatigue scores reflected severe fatigue across treatment groups and were similar using different scoring methods. At week 24 in both studies, baricitinib was associated with clinically meaningful improvements in PROMIS Fatigue scores. PROMIS Fatigue scores were consistent for conversion methods and for the 13-item or 10-item FACIT-F. CONCLUSION All 4 conversion methods showed differentiation of active treatment compared with placebo from week 12, supporting the use of the PROMIS Fatigue and converting the 10-item FACIT-F to assess fatigue and demonstrate treatment benefit in RA clinical trials on a standardized metric.
Published: 2021
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23. Association between psychomotor disturbance and treatment outcome in psychotic depression: a STOP-PD II report

Author: Nicholas H. Neufeld, Ellen M. Whyte, Anthony J. Rothschild, Aristotle N. Voineskos, George S. Alexopoulos, Kathleen Bingham, Benoit H. Mulsant, Barnett S. Meyers, Patricia Marino, and Alastair J. Flint
Subjects: Olanzapine, Psychomotor learning, medicine.medical_specialty, Sertraline, business.industry, Psychotic depression, Placebo, Logistic regression, medicine.disease, 030227 psychiatry, law.invention, 03 medical and health sciences, Psychiatry and Mental health, 0302 clinical medicine, Tolerability, Randomized controlled trial, law, Internal medicine, medicine, business, 030217 neurology & neurosurgery, Applied Psychology, medicine.drug
Abstract: BackgroundLittle is known about the relationship between psychomotor disturbance (PMD) and treatment outcome of psychotic depression. This study examined the association between PMD and subsequent remission and relapse of treated psychotic depression.MethodsTwo hundred and sixty-nine men and women aged 18–85 years with an episode of psychotic depression were treated with open-label sertraline plus olanzapine for up to 12 weeks. Participants who remained in remission or near-remission following an 8-week stabilization phase were eligible to participate in a 36-week randomized controlled trial (RCT) that compared the efficacy and tolerability of sertraline plus olanzapine (n = 64) with sertraline plus placebo (n = 62). PMD was measured with the psychiatrist-rated sign-based CORE at acute phase baseline and at RCT baseline. Spearman's correlations and logistic regression analyses were used to analyze the association between CORE total score at acute phase baseline and remission/near-remission and CORE total score at RCT baseline and relapse.ResultsHigher CORE total score at acute phase baseline was associated with lower frequency of remission/near-remission. Higher CORE total score at RCT baseline was associated with higher frequency of relapse, in the RCT sample as a whole, as well as in each of the two randomized groups.ConclusionsPMD is associated with poorer outcome of psychotic depression treated with sertraline plus olanzapine. Future research needs to examine the neurobiology of PMD in psychotic depression in relation to treatment outcome.
Published: 2021
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24. Pediatric timing of epinephrine doses: A systematic review

Author: Richard Aickin, Robert Bingham, Allan DeCaen, Janice A. Tijssen, Yee Hui Mok, Amelia G. Reis, Vinay M. Nadkarni, Yong-Kwang Gene Ong, Yacov Rabi, Patrick Van de Voorde, Laurie J. Morrison, Steve Schexnayder, Ian Maconochie, Peter A. Meaney, Anne-Marie Guerguerian, Dianne L. Atkins, Gabrielle Nuthall, Shinichiro Ohshimo, David Kloeck, Monica E. Kleinman, Carolyn Ziegler, Thomaz Bittencourt Couto, Mary Fran Hazinski, Kee-Chong Ng, and Chih-Hung Wang
Subjects: medicine.medical_specialty, Epinephrine, MEDLINE, 030204 cardiovascular system & hematology, Emergency Nursing, Return of spontaneous circulation, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Hospital discharge, Humans, Medicine, Child, business.industry, Confounding, Infant, 030208 emergency & critical care medicine, Patient Discharge, Emergency medicine, Emergency Medicine, Observational study, Cardiology and Cardiovascular Medicine, business, Out-of-Hospital Cardiac Arrest, medicine.drug
Abstract: Aim To evaluate the optimal timing and doses of epinephrine for Infants and children suffering in-hospital or out-of-hospital cardiac arrest. Methods We searched Medline, EMBASE, and Cochrane Controlled Register of Trials (CENTRAL) for human randomized clinical trials and observational studies including comparative cohorts. Two investigators reviewed relevance of studies, extracted the data, conducted meta-analyses and assessed the risk of bias using the GRADE and CLARITY frameworks. Authors of the eligible studies were contacted to obtain additional data. Critically important outcomes included return of spontaneous circulation, survival to hospital discharge and survival with good neurological outcome. Results We identified 7 observational studies suitable for meta-analysis and no randomized clinical trials. The overall certainty of evidence was very low. For the critically important outcomes, the earlier administration of epinephrine was favorable for both in-hospital and out-of-hospital cardiac arrest. Because of a limited number of eligible studies and the presence of severe confounding factors, we could not determine the optimal interval of epinephrine administration. Conclusions Earlier administration of the first epinephrine dose could be more favorable in non-shockable pediatric cardiac arrest. The optimal interval for epinephrine administration remains unclear.
Published: 2021
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25. Radiation Therapy Adherence Among Patients Experiencing Homelessness

Author: Evan C. Osmundson, Brian Bingham, Sheryl B. Fleisch, Jessica N. Walker, Mahmoud Ahmad, and Benjin D. Facer
Subjects: Male, Cancer Research, medicine.medical_specialty, medicine.medical_treatment, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Neoplasms, Chart review, Radiation oncology, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Clinical efficacy, Radiation, business.industry, Standard treatment, Electronic medical record, Cancer, Middle Aged, medicine.disease, Radiation therapy, Oncology, 030220 oncology & carcinogenesis, Ill-Housed Persons, Emergency medicine, Cohort, Patient Compliance, Female, business
Abstract: Purpose Radiation therapy is a valuable, yet time- and resource-intense therapy. Patients experiencing homelessness (PEH) face many barriers related to the timely receipt of radiation therapy. Owing to a paucity of data regarding cancer treatment and homelessness, clinicians have a limited evidence base when recommending therapy to PEH. This study was performed to evaluate adherence to radiation therapy treatment regimens in PEH with cancer. Methods and Materials The study cohort was primarily derived from the Vanderbilt University Medical Center Homeless Health Services program. Patients in the Homeless Health Services program with radiation oncology visits were identified by query of the electronic medical record. Manual chart review was performed to gather standard treatment parameters and data describing missed appointments. A comparison group of patients not experiencing homelessness (non-PEH) was generated by aggregating appointment data for all other patients receiving similar treatments at Vanderbilt University Medical Center during multiple, consecutive years. Results In the study, 3408 PEH were identified, of whom 48 underwent radiation oncology consultation. Thirty-two were prescribed at least 1 course of radiation therapy, for a total of 54 unique courses. Out of these courses, 34 (62.9%) were completed as prescribed without delay, 12 (22.2%) were completed with delay(s), and 8 (14.8%) were not fully completed. Although the PEH cohort had significantly higher rates of delayed and undelivered fractions, the proportion of delayed or incomplete courses was not significantly different from the comparison group of non-PEH, particularly for courses with 10 or fewer fractions. Reasons for missed appointments for PEH were variable. Conclusions This is the first publication describing adherence to radiation therapy in PEH. Our data suggest that PEH are as likely as non-PEH to complete a course of radiation therapy, albeit with more treatment interruptions. When treatment courses of >10 fractions are expected, PEH may benefit from more hypofractionated regimens, provided they have equivalent clinical efficacy to longer regimens. Documenting reasons for missed appointments will be essential to further understanding the needs of PEH. This study serves as a foundation for further analysis regarding homelessness and radiation therapy.
Published: 2021
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26. 148 Lipid Targeting Post-Stroke—Targeting Who?

Author: K Bingham, J M Barber, and C Micallef
Subjects: Cardiovascular event, Relative risk reduction, Aging, medicine.medical_specialty, Myocardial ischemia, business.industry, Atrial fibrillation, General Medicine, medicine.disease, Melkersson–Rosenthal syndrome, Internal medicine, Post stroke, Cardiology, Medicine, LDL Cholesterol Lipoproteins, Frail elderly, Geriatrics and Gerontology, business
Abstract: Introduction Frailer patients are at high risk of complications from drugs like statins. Other less frail patients may be undertreated. The Treat Stroke to Target trial showed that high risk patients with atherosclerosis and/or ischaemic heart disease (IHD) who were treated to an LDL level of less than 1.8 mmol/L had a 22% relative risk reduction in major cardiovascular events compared to those with a higher target. In our Quality Improvement. Project We estimated the numbers of post-stroke cases who might safely benefit from a targeted, pharmacist led intensive lipid management program. Methods 500 consecutive ischaemic stroke cases with a modified Rankin score (mRS) of 0–3 were identified from the Scottish Stroke Care Audit Database. Those discharged to long term care or dead at the time of data collection were excluded. Data collected was age, evidence of atherosclerosis on vascular imaging, co-morbid IHD, LDL at index admission and between 1 month to 1 year post-stroke, anti-lipid treatment at discharge and up to 1 year post-stroke. Atrial fibrillation patients were included if other risk criteria were met. Results The mean age of the 500 cases was 70. From this group, 297 (60%) met the entry criteria for “Treat to Stroke Target”. 190 (64%) cases had LDL checked post-discharge. 87 cases failed to reach the RCP Stroke Guidance of a 40% reduction in LDL Cholesterol. 66 (22%) of cases had LDL >1.8 mmol/L on most recent check and potentially should have been treated to target. Of the 83 cases excluded due to mRS >3 or significant dependency, 70 cases (84%) were discharged on a statin and importantly 34 (48%) of these died within 1 year of their stroke. Conclusions Based on annual stroke admissions in our health board, around 86–117 high risk patients could benefit from a virtual lipid treatment intensification clinic.
Published: 2021
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27. The Top 50 Most-Cited Shoulder Arthroscopy Studies

Author: Jordan R. Pollock, Joshua S. Bingham, Kade S. McQuivey, and M. Lane Moore
Subjects: Shoulder arthroscopy, medicine.medical_specialty, business.industry, Rehabilitation, Public Health, Environmental and Occupational Health, MEDLINE, Physical Therapy, Sports Therapy and Rehabilitation, Evidence-based medicine, Country of origin, Web of knowledge, Analytics, Family medicine, Sports medicine, medicine, Orthopedics and Sports Medicine, Relevance (information retrieval), Systematic Review, Psychology, business, RC1200-1245, Author name
Abstract: Purpose To determine the 50 most frequently cited studies in the orthopaedic shoulder arthroscopy literature and to conduct a bibliometric analysis of these studies. Methods The Clarivate Analytics Web of Knowledge database was used to gather data and metrics using Boolean queries to capture all possible iterations of shoulder arthroscopy research. The search list was sorted so that articles were organized in descending order based on the number of citations and included or excluded based on relevance to shoulder arthroscopy. The information extracted for each article included author name, publication year, country of origin, journal name, article type, and the level of evidence. Results For these 50 studies, the total number of citations was calculated to be 13,910, with an average of 278.2 citations per paper. The most-cited article was cited 1134 times, whereas the second- and third-most cited articles were cited 920 and 745 times, respectively. All 50 articles were published in English and came from 7 different orthopaedic journals. The United States was responsible for most of the included articles (31), followed by France (9) and Japan (3). Conclusions The majority of the most-cited articles in shoulder arthroscopy are case series and descriptive studies originating from the United States. In addition, more than one half of the top 50 most-cited studies were published after 2004, which suggests that article age may be less important in the accumulation of citations for a rapidly growing field like shoulder arthroscopy. Clinical Relevance The top 50 most-cited studies list will provide researchers, medical students, residents, and fellows with a foundational list of the most important and influential academic contributions to shoulder arthroscopy.
Published: 2021
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28. Estimated Lifetime HIV–Related Medical Costs in the United States

Author: Adrienna Bingham, Evin U. Jacobson, Paul G. Farnham, Nidhi Khurana, and Ram K. Shrestha
Subjects: Microbiology (medical), medicine.medical_specialty, Cost estimate, Opportunistic infection, Cost-Benefit Analysis, HIV Infections, Dermatology, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Health care, Humans, Medicine, 030212 general & internal medicine, health care economics and organizations, Dropout (neural networks), 030505 public health, Cost–benefit analysis, business.industry, Public Health, Environmental and Occupational Health, Health Care Costs, Emergency department, medicine.disease, United States, Infectious Diseases, Cohort, Emergency medicine, 0305 other medical science, business, Cohort study
Abstract: Background Lifetime cost estimates are a useful tool in measuring the economic burden of HIV in the United States. Previous estimation methods need to be updated, given improving antiretroviral therapy regimens and updated costs. Methods We used an updated version of the agent-based model progression and transmission of HIV (PATH) 3.0 to reflect current regimens and costs. We simulated a cohort of those infected in 2015 until the last person had died to track the lifetime costs for treatment of HIV, including HIV health care utilization costs (inpatient, outpatient, opportunistic infection prophylaxis, non-HIV medication, and emergency department), opportunistic infection treatment costs, and testing costs. We assumed a median per-person diagnosis delay of 3 years and a 3% base monthly probability of dropout from care for a base-case scenario. Additionally, we modeled a most favorable scenario (median diagnosis delay of 1 year and 1% base dropout rate) and a least favorable scenario (median diagnosis delay of 5 years and 5% base dropout rate). Results We estimated an average lifetime HIV-related medical cost for a person with HIV of $420,285 (2019 US$) discounted (3%) and $1,079,999 undiscounted for a median 3-year diagnosis delay and 3% base dropout rate. Our discounted cost estimate was $490,045 in our most favorable scenario and $326,411 in our least favorable scenario. Conclusions Lifetime per-person HIV-related medical costs depend on the time from infection to diagnosis and the likelihood of dropping out of care. Our results, which are similar to previous studies, reflect updated antiretroviral therapy regimens and costs for HIV treatment.
Published: 2021
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29. Patients and clinicians define symptom levels and meaningful change for PROMIS pain interference and fatigue in RA using bookmarking

Author: Susan J. Bartlett, Anne Lyddiatt, Clifton O. Bingham, Mary Suzanne Schrandt, Alessandra Butanis, Michelle Jones, Karon F. Cook, Ana Maria Orbai, Vivian P. Bykerk, and Victoria Ruffing
Subjects: Adult, Male, medicine.medical_specialty, Patient-Reported Outcomes Measurement Information System, Pain Interference, Severity of Illness Index, Arthritis, Rheumatoid, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Internal medicine, Humans, Medicine, Pharmacology (medical), Patient Reported Outcome Measures, 030212 general & internal medicine, Fatigue, Aged, Pain Measurement, 030203 arthritis & rheumatology, business.industry, Bookmarking, Lived experience, Perspective (graphical), Middle Aged, Clinical Science, Social engagement, Treatment efficacy, Methotrexate, Treatment Outcome, Antirheumatic Agents, Physical therapy, Female, Symptom Assessment, business
Abstract: Objectives Using patient-reported outcomes to inform clinical decision-making depends on knowing how to interpret scores. Patient-Reported Outcome Measurement Information System® (PROMIS®) instruments are increasingly used in rheumatology research and care, but there is little information available to guide interpretation of scores. We sought to identify thresholds and meaningful change for PROMIS Pain Interference and Fatigue scores from the perspective of RA patients and clinicians. Methods We developed patient vignettes using the PROMIS item banks representing a continuum of Pain Interference and Fatigue levels. During a series of face-to-face ‘bookmarking’ sessions, patients and clinicians identified thresholds for mild, moderate and severe levels of symptoms and identified change deemed meaningful for making treatment decisions. Results In general, patients selected higher cut points to demarcate thresholds than clinicians. Patients and clinicians generally identified changes of 5–10 points as representing meaningful change. The thresholds and meaningful change scores of patients were grounded in their lived experiences having RA, approach to self-management, and the impacts on function, roles and social participation. Conclusion Results offer new information about how both patients and clinicians view RA symptoms and functional impacts. Results suggest that patients and providers may use different strategies to define and interpret RA symptoms, and select different thresholds when describing symptoms as mild, moderate or severe. The magnitude of symptom change selected by patients and clinicians as being clinically meaningful in interpreting treatment efficacy and loss of response may be greater than levels determined by external anchor and statistical methods.
Published: 2021
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30. The role of cell free DNA and liquid biopsies in haematological conditions

Author: Andrew Spencer and Nicholas Bingham
Subjects: medicine.medical_specialty, Pathology, Hematology, Cell-free fetal DNA, Chemistry, Internal medicine, medicine, Liquid biopsy, medicine.disease, Lymphoma
Abstract: Cell free nucleic acids (CFNAs) are nucleic acids released from cells that circulate within bodily fluids. Recent advances in molecular techniques have led the ability to interrogate CFNAs in a clinically meaningful way, for example the identification and assessment of foetal CFNAs in maternal blood, allowing minimally invasive testing for foetal genetic abnormalities. The majority of CFNAs arise from haemopoietic cells, making it a particularly rich source of genetic information in haematological conditions. Furthermore, the innate genetic heterogeneity of haematological malignancies, as epitomised by multiple myeloma, lend itself well to "liquid biopsies". This approach promises to provide a more wholistic assessment of whole disease genetics, especially when contrasted against the current gold-standard of single site tissue biopsies. This review briefly summarises the definitions and physiology of CFNAs, both cell free DNA (cfDNA) and extracellular RNA (exRNA), before exploring the literature surrounding the current and future roles of cfDNA in the haematological malignancies and patient care.
Published: 2022

31. Body mass index and complications following major gastrointestinal surgery

Author: Blanco-Colino R, Lee S, Kamarajah SK, Vasko P, Kuiper SZ, Farina V, Chapman SJ, Drake TM, Gavagna L, Pasquali S, Pata F, Pellino G, de la Rosa-Estadella M, Stellingwerf ME, Stijns RCH, Borrellas A, Golding D, Ngaage M, Van Tol RR, de Groof J, de Wilt H, Bemelman WA, McNamee L, Espin-Basany E, Emre Baki B, Gecim IE, Can Tatar O, Bach S, Bhangu A, Bresges K, Burke J, Claireaux HA, Fearnhead N, Fitzgerald JE, Gallagher S, Glasbey JC, Gundogan B, Harrison EM, Hernon J, Khatri C, Kong CY, Lyons A, Mohan M, Morton D, Pinkney TD, Arezzo A, Foppa C, Morino M, Rubbini M, Selvaggi F, Sensi B, Sica G, Orhalmi J, Naccari P, Sgrò A, Burger BHCM, Fares DA, Spijkerman R, van Elst TR, Wiersema R, Stassen LPS, Rodriguez Garcia R, Özkan BB, Tavuz AI, Demirci ZS, Baki BE, Choi PJ, O'Sullivan H, Salman M, Simioni A, Colombo F, Turati L, Cazzola FE, Gallo G, Perrotta G, Papandrea M, Naccari PM, Menduni N, Rossi E, Chetta N, Romeo F, Giordano F, Randisi B, Curletti G, Kuiper J, Costa A, Marcos Rodrigo A, Sanchez A, Varo Muñoz A, Martinez Rios CE, Aliseda-Jover D, Fernandez Nieto D, Alvarez Reyes I, Dominguez Rodriguez LM, Hernandez Ros MI, Esteban Sinovas O, Bartrina Soler P, Villarejo Campos P, Laguna Román S, Fontanet-Soler S, Raurich-Leandro J, Dominguez-Prieto V, Segura-Sampedro JJ, Alconchel-Gago F, Salazar-García C, Gezen AE, Sahin A, Atasoy H, Yuksek B, Arslan E, Ozmen BB, Sen AY, Erol HI, Ucar E, Aktas MK, Yurdaor SS, Mermer S, Seyhan U, Tosun V, Gunaydin Y, Ekinci ZB, Yazkan Z, Choi J, Yeoh TSL, Jones CS, Venturini S, Saat MI, Loo J, Pike G, Davies SC, Kabariti R, Olivier J, Hurný M, Žebrák R, Machačová A, Schulzová M, Smolák P, Široká M, Palyzová H, Jaroš J, Dušek T, Šimáčková B, Bartoš M, Sotona O, Pös M, Karásek D, Higgins P, Hacking S, Arora E, Coughlan G, Palanivail N, Quill S, Zhang AA, Malak M, Maan DS, Cheema J, Goh AWJ, Shamsul Badrin AK, Guinness F, Howard James N, Neary A, Sebaoui S, Gilroy D, Petrov G, Craven K, MacDonald A, Redmond A, Brennan D, Roche D, O'Dwyer M, Collins P, Edwards S, Doyle J, Tiedt L, Arthurs B, O'Byrne L, Kiely A, Glynn M, Sproule L, Heaney A, Li Hi Shing S, Goh W, Al-Nasser Z, Al-Nasser A, Teh JW, De Boni D, Goldin E, Ciccioli E, Vendramin E, Marchese N, Bruno M, Vinci A, Harder G, Morandi V, Magnoli M, Suppa A, Palmieri A, Martorana M, Sette M, Balagna P, Cruciani C, Corte M, Ciano P, Bagaglini G, Montuori M, Di Benedetto L, Arcudi C, Pezzuto R, Saraceno F, Milana F, Franceschilli M, Rizzi A, Sampietro G, Rampulla V, Bianco F, Boschetti ME, Ghignone F, Bianchini S, Esposto R, Riva L, Riva M, Cannavò M, Arrigo A, Giavarini L, Colombo EM, Trompetto M, Clerico G, Catalano M, Dosa T, El Mabruk M, Barone V, Pallara E, Pasqualoni M, Caudullo G, Mastandrea Bonaviri GN, Muro M, Pistola I, Verardi L, Ferrara D, Gerardi S, Remore LM, Belia F, Del Coco F, Larotonda C, Botrugno EM, Cammarota A, Di Girolami L, Laterza V, Laurino A, Paolo G, Santocchi P, Puccioni C, Truma A, Giardino FR, Giuffrida A, Ripa M, Cautiero R, Patturelli M, Capozzolo A, Selvaggi L, Facchiano A, Milazzo LF, Papazachariou SK, Pattapola V, Anania G, Feo C, Bellinato M, Priani P, Zigiotto D, Troia A, Vable T, Piran G, Targa S, Pulpito S, Tagariello F, Fasano A, Anconelli D, Castiglione F, Tognolo L, Lopez G, Campion A, Tarantino M, Sacco R, Sammarco G, Palmisano S, Giacca M, Rocco I, Bellio G, Favero A, Raimondi P, Pantalone MR, De Nardi P, Notarnicola M, Picciariello A, Licari L, Parinisi Z, Fazzotta S, Ciciliot M, Reggiani L, Mariani F, Aonzo P, Checcacci P, Montanelli P, Guerra F, Skalamera I, Staderini F, Grandi S, Nelli T, de Boer DV, van der Pool AEM, Janssen TL, El-Atmani S, van Verschuer VMT, Poelman M, Dronkers WJ, van Steensel L, Toorenvliet BR, Duinhouwer LE, Vermaas M, Ter Bruggen FFJA, Hogendoorn W, van der Harst E, van Rijckevorsel VAJIM, Bayoumy AB, Lap CR, Gooszen JAH, Abdulrahman N, de Roy van Zuidewijn D, de Groof EJ, Zijlmans JL, van Dalen ASHM, Bos K, Musters GD, Looijen RC, Fliers JM, Oostendorp SE, Mosterd CM, Blonk L, Jurgens J, Ribbink ME, Boom MS, Boersma AM, Hidding E, Schmidt PA, Mensink G, Graus SA, Gastel MDA, Veenker CGH, Van Heumen TM, Slieker FJB, Sedee WJA, Löwensteyn YN, Amelung FJ, de Guerre LEVM, Nota CLMA, Van Dijck WPM, van Wijnbergen JWM, Pronk A, Kip M, van der Zee C, Heiloo S, Muller S, Verboeket B, Oudman TS, Zope S, Gilissen V, Gommers J, Cremers D, Van der Lubbe M, Smet M, Ter Weele K, de Bruin M, Geerlings M, Ter Horst L, Kerimova N, Pesser N, Heesakkers H, de Mees T, de Gooyer JM, Willems L, Gawria L, Bonouvrie D, Harms J, Eggen Y, Hengeveld E, Smeets HJ, Hoffman RPC, Detmers Blom FPN, Van Bruggen D, Steup WH, Gooiker GA, Willems YR, van der Hoeven AC, Vallve-Bernal M, Perez-Gandara B, Perez JL, Caballero Rodriguez E, Perez Febles M, Protti Ruiz GP, Hidalgo Pujol M, Alberti Delgado P, Gil Barrionuevo E, Anabitarte O, Caballero L, Poyato Nuñez FJ, Prado Perez R, de la Portilla de Juan F, Fulgencio Barbarin J, Elorza Echaniz G, Mitxelena Elosegi L, Delgado AT, Marti 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Jenvey C, Kitt H, Slade R, Craig AR, Deall C, Reakes T, Chervenkoff J, Strange E, O'Bryan M, Murkin C, Joshi D, Bergara T, Naqib S, Wylam D, Scotcher SE, Hewitt CM, Stoddart MT, Kerai A, Trist AJ, Cole SJ, Knight CL, Stevens S, Cooper GE, Ingham R, Dobson J, O'Kane A, Moradzadeh J, Duffy A, Henderson C, Ashraf S, McLaughin C, Hoskins TC, Reehal RS, Bookless LR, McLean RC, Stone EJ, Wright EV, Abdikadir HR, Roberts C, Spence O, Srikantharajah M, Ruiz EM, Matthews JH, Gardner E, Hester E, Naran P, Simpson R, Minhas M, Cornish E, Semnani SA, Rojoa D, Radotra A, Eraifej J, Eparh K, Smith DNE, Mistry BD, Hickling SL, Din W, Liu C, Mithrakumar P, Mirdavoudi V, Rashid M, Mcgenity C, Hussain O, Kadicheeni M, Gardner H, Anim-Addo N, Pearce J, Aslanyan A, Ntala C, Sorah T, Parkin J, Alizadeh M, White A, Edozie F, Johnston J, Kahar A, Navayogaarajah V, Carter D, Khonsari P, Burgess A, Patel B, Kong C, Ponweera A, Cody A, Tan Y, Ng AYL, Croall A, Allan C, Ng S, Raghuvir V, Telfer R, Greenhalgh AD, McKerr CN, Edison MA, Patel BA, Dear K, Hardy MR, Williams P, Hassan S, Sajjad U, O'Neill EM, Lopes S, Healy L, Jamal N, Tan S, Lazenby D, Husnoo SB, Beecroft S, Sarvanandan T, Weston C, Bassam N, Rabinthiran S, Hayat U, Ng L, Varma D, Sukkari M, Mian A, Omar A, Kim JW, Sellathurai J, Mahmood J, O'Connell C, Bose R, Heneghan H, Lalor P, Matheson J, Doherty C, Cullen C, Cooper D, Angelov S, Drislane C, Smith ACD, Kreibich A, Palkhi E, Durr A, Lotfallah A, Gold D, Mckean E, Dhanji A, Anilkumar A, Thacoor A, Siddiqui ZH, Lim S, Piquet A, Anderson SM, McCormack DR, Gulati J, Ibrahim A, Murray SE, Walsh SL, McGrath A, Ziprin P, Chua EY, Lou CN, Bloomer J, Paine HR, Osei-Kuffour D, White CJ, Szczap A, Gokani S, Patel K, Malys MK, Reed A, Torlot GE, Cumber EM, Charania A, Ahmad S, Varma N, Cheema H, Austreng L, Petra H, Chaudhary M, Zegeye MI, Cheung F, Coffey D, Heer RS, Singh S, Seager E, Cumming S, Suresh RS, Verma S, Ptacek IB, Gwozdz AM, Yang T, Khetarpal AA, Shumon S, Fung TMP, Leung W, Kwang P, Chew L, Loke W, Curran A, Chan C, McGarrigle C, Mohan K, Cullen S, Wong E, Toale C, Collins D, Keane N, Traynor BP, Shanahan D, Yan A, Jafree DJ, Topham C, Mitrasinovic S, Omara S, Bingham G, Lykoudis PM, Miranda BH, Whitehurst K, Kumaran G, Devabalan Y, Aziz H, Shoa M, Dindyal S, Yates JA, Bernstein I, Rattan G, Coulson R, Stezaker S, Isaac A, Salem M, McBride A, McFarlane H, Yow L, MacDonald J, Bartlett RD, Turaga S, White U, Liew W, Yim N, Ang A, Simpson A, McAuley D, Craig E, Murphy L, Shepherd P, Kee JY, Abdulmajid A, Chung A, Warwick HL, Livesey A, Holton P, Theodoreson MD, Jenkin SL, Turner J, Entwisle JH, Marchal ST, O'Connor S, Blege HK, Aithie JM, Sabine LM, Stewart GE, Jackson S, Kishore A, Lankage CM, Acquaah F, Joyce HL, McKevitt KL, Coffey CJ, Fawaz AS, Dolbec KS, O'Sullivan DA, Geraghty JM, Lim E, Bolton L, FitzPatrick D, Robinson C, Ramtoola T, Collinson S, Grundy L, McEnhill PM, Harbhajan Singh GS, Loughran D, Golding DM, Keeling RE, Williams RP, Whitham RDJ, Yoganathan S, Nachiappan R, Egan RJ, Owasil R, Kwan ML, He A, Goh RW, Bhome R, Wilson H, Teoh PJ, Raji K, Jayakody N, Matthams J, Chong J, Luk CY, Greig RJ, Trail M, Charalambous G, Rocke AS, Gardiner N, Bulley F, Warren N, Brennan E, Fergurson P, Wilson R, Whittingham H, Brown EJ, Khanijau R, Gandhi K, Morris S, Boulton AJ, Chandan N, Barthorpe AE, Maamari R, Sandhu S, McCann M, Higgs L, Balian V, Reeder C, Diaper C, Sale T, Ali H, Archer CH, Clarke AK, Heskin J, Hurst PC, Farmer JD, O'Flynn LD, Doan L, Shuker BA, Stott GD, Vithanage NA, Hoban KA, Nesargikar PN, Kennedy HR, Grossart CM, Tan ESM, Roy CSD, Sim P, Leslie KE, Sim D, Abul MH, Cody N, Tay AY, Woon E, Sng S, Mah J, Robson J, Shakweh E, Wing VC, Mills H, Li MM, Barrow TR, Balaji S, Jordan HEM, Phillips C, Naveed H, Hirani S, Tai A, Ratnakumaran R, Sahathevan A, Shafi AMA, Seedat M, Weaver R, Batho A, Punj R, Selvachandran H, Bhatt N, Botchey S, Khonat Z, Brennan K, Morrison CJ, Devlin E, Linton A, Galloway E, McGarvie S, Ramsay N, McRobbie HD, Whewell H, Dean W, Nelaj S, Eragat M, Mishra A, Kane T, Zuhair M, Wells M, Wilkinson D, Woodcock N, Sun E, Aziz N, Abd Ghaffar MK., Nepogodiev, Dmitri, Rosati, Riccardo, Nepogodiev, D., and Robotics and image-guided minimally-invasive surgery (ROBOTICS)
Subjects: Male, obesity, Multivariate analysis, Gastrointestinal Diseases, IMPACT, Settore MED/18 - CHIRURGIA GENERALE, Body mass index, Body weight, Digestive tract, Gastrointestinal tract, Obesity, Postoperative complications, Gastroenterology, digestive tract, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, Risk Factors, Medicine, Prospective Studies, Prospective cohort study, Aged, Europe, Female, Gastrointestinal Neoplasms, Humans, Middle Aged, Postoperative Complications, Body Mass Index, OUTCOMES, body mass index, body weight, gastrointestinal tract, 030220 oncology & carcinogenesis, Meta-analysis, Urological cancers Radboud Institute for Health Sciences [Radboudumc 15], Cohort, 030211 gastroenterology & hepatology, Cohort study, medicine.medical_specialty, Malignancy, NO, 03 medical and health sciences, SDG 3 - Good Health and Well-being, business.industry, postoperative complications, MORTALITY, medicine.disease, Settore MED/18, Surgery, Postoperative complication, Postoperative Complications, Obesity, Digestive Tract, Gastrointestinal Tract, Body Mass Index, Body Weight, business
Abstract: Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a meta-analysis of all available prospective data.Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien-Dindo Grades III-V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results.Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery for malignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49-2.96, P Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease.
Published: 2018
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32. Shock Index as a Predictor of Massive Transfusion and Emergency Surgery on the Modern Battlefield

Author: Matthew J. Eckert, Jason Bingham, Matthew J. Martin, Daniel Lammers, Christopher W. Marenco, and Kaitlin Morte
Subjects: Adult, Male, medicine.medical_specialty, Burn injury, Population, Shock, Hemorrhagic, Blast injury, Young Adult, 03 medical and health sciences, Injury Severity Score, 0302 clinical medicine, Blunt, Predictive Value of Tests, Risk Factors, Heart rate, medicine, Humans, Blood Transfusion, Registries, Military Medicine, education, Emergency Treatment, Retrospective Studies, education.field_of_study, business.industry, United States Department of Defense, medicine.disease, Triage, United States, Massive transfusion, Blood pressure, Surgical Procedures, Operative, 030220 oncology & carcinogenesis, Emergency medicine, Health Resources, War-Related Injuries, Female, 030211 gastroenterology & hepatology, Surgery, business
Abstract: Shock Index (SI) has been used to predict the need for massive transfusion (MT) and emergency surgical procedures (ESP) in civilian trauma. We hypothesize that SI can reliably identify combat trauma patients that will require MT and ESP when applied to the resource-constrained, combat environment.A retrospective review was performed within the Department of Defense Trauma Registry (2008-2016). SI was calculated using heart rate and systolic blood pressure on arrival to the initial facility with surgical capabilities. A threshold value of 0.8 was used to stratify patients into two groups (Group I, SI 0.8; and Group II, SI ≥ 0.8). The need for MT, ESP, and mortality was compared. Regression analyses were conducted to determine the independent association of SI with MT and ESP.A total of 4008 patients were included. The mean age of the patients was 25.5 y, and the majority were predominately male (98%). Mechanisms of injury were blunt and blast injury (62%), penetrating injury (36.7%), and burn injury (0.5%). Overall, 77% of patients (n = 3070) were stratified to Group I, and 23% of patients (n = 938) were stratified to Group II, by SI. Group II patients had a significantly greater need for MT (8.4% versus 0.4%) and ESP (30.7% versus 6.5%), both P 0.001. Regression analysis controlling for age, gender, Injury Severity Score, and Glasgow Coma Score confirmed that SI ≥ 0.8 was an independent risk factor for both MT and need for ESPs (P 0.001).SI is a significant predictor of the need for MT and ESPs in the military trauma population, representing a simple and potentially potent tool for triage and prediction of resource consumption in the resource-limited, austere setting.
Published: 2020
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33. Incorporating a Trauma-Informed Care Protocol Into Pediatric Trauma Evaluation

Author: Maia S. Rutman, Sarah Bingham, Reto M. Baertschiger, Daniel P. Croitoru, Brendin R. Beaulieu-Jones, Kurt K. Rhynhart, and Marcy Singleton
Subjects: Adult, Diagnostic Imaging, medicine.medical_specialty, Declaration, Psychological intervention, MEDLINE, Injury Severity Score, Trauma Centers, Intervention (counseling), medicine, Humans, Child, Retrospective Studies, business.industry, General Medicine, Emergency department, medicine.disease, Pediatrics, Perinatology and Child Health, Emergency medicine, Emergency Medicine, Anxiety, medicine.symptom, Emergency Service, Hospital, business, Psychosocial, Pediatric trauma
Abstract: Background: Trauma evaluation in the Emergency Department (ED) can be a stressful event for children. With the goal of minimizing pain, anxiety, and unneeded interventions in stable patients, we implemented a Pediatric PAUSE© at our Level 1 Adult/Level 2 Pediatric Trauma Center. The Pediatric PAUSE© is a brief protocol performed after the primary survey, which addresses Pain/Privacy, Anxiety/IV Access, Urinary Catheter/Rectal exam/Genital exam, Support from family or staff, and Explain to patient/Engage with PICU team. The aim was to assess whether performing the PAUSE© interfered with timeliness of emergent imaging in pediatric patients and their disposition. Methods: We identified all patients aged 0-18 years evaluated as trauma activations at our institution after the Pediatric PAUSE© was implemented (10/1/16-3/31/17) as well as two analogous 6-month pre-PAUSE© time periods. Patient demographics, time to imaging studies, and time to ED disposition were analyzed. Findings: One hundred and seventy-two patients met study criteria, with a mean age of 10.9 years and mean Injury Severity Score of 10.6. One hundred fifteen participants (68.5 %) were transferred from other hospitals, and 101 (87.8%) had ≥1 imaging study performed prior to arrival. The Pediatric PAUSE© was performed for 41/163 (25%) study participants. There was no difference in time to first imaging study in participants for whom the PAUSE© was performed (18.4 min vs 15.0 min, p=0.09). Interpretation: The PAUSE© is a practice intervention designed to address the psychosocial needs of pediatric trauma patients and their families to help prevent PTS symptoms. Implementation did not interfere with the timeliness of first imaging in pediatric trauma patients. Funding Statement: The authors state: "No funding to disclose." Declaration of Interests: The authors declare: "No conflicts of interests.' Ethics Approval Statement: The study protocol was approved by the Committee for the Protection of Human Subjects at our institution, granting access to our institution’s existing trauma database and the electronic health records of study patients (Dartmouth College Committee for the Protection of Human Subjections: Study #00030129).
Published: 2020
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34. Association of Dysregulated Central Pain Processing and Response to Disease–Modifying Antirheumatic Drug Therapy in Rheumatoid Arthritis

Author: Clifton O. Bingham, Andrew C. Heisler, Dorothy D. Dunlop, Wendy Marder, Daniel J. Clauw, Alyssa Wohlfahrt, Jing Song, Marcy B. Bolster, Lutfiyya N. Muhammad, Yvonne C. Lee, and Tuhina Neogi
Subjects: Adult, Male, Pain Threshold, medicine.medical_specialty, medicine.medical_treatment, Immunology, Pain, Arthritis, Summation, Logistic regression, Article, Arthritis, Rheumatoid, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Internal medicine, medicine, Humans, Immunology and Allergy, Disease-modifying antirheumatic drug, Aged, Pain Measurement, 030203 arthritis & rheumatology, Central Nervous System Sensitization, business.industry, Odds ratio, Middle Aged, medicine.disease, Confidence interval, Antirheumatic Agents, Rheumatoid arthritis, Female, business, 030217 neurology & neurosurgery, Rheumatism
Abstract: Objective To determine the association between dysregulated central pain processing and treatment response in rheumatoid arthritis (RA). Methods One hundred eighty-two participants with active RA were followed up for 12 weeks after starting a disease-modifying antirheumatic drug (DMARD). To assess central pain processing, participants underwent quantitative sensory testing (QST), including assessment of pressure pain thresholds (PPTs) at the trapezius muscles, temporal summation, and conditioned pain modulation (CPM). QST measures were categorized as high central dysregulation versus low central dysregulation. The association between baseline central dysregulation and treatment response, as defined by the European League Against Rheumatism (EULAR) response criteria, was assessed using multiple logistic regression adjusted for demographic characteristics, RA-related variables, and psychosocial variables. Results A good EULAR response was achieved in fewer participants with high CPM dysregulation than participants with low CPM dysregulation (22.5% versus 40.3%; P = 0.01). A similar trend, though not significant, was noted when central dysregulation was assessed with PPT and temporal summation. The adjusted odds ratios (ORs) for the association between high central dysregulation and good EULAR response were 0.59 for PPTs (95% confidence interval [95% CI] 0.28-1.23), 0.60 for temporal summation (95% CI 0.27-1.34), and 0.40 for CPM (95% CI 0.19-0.83). In a model examining the combined effects of dysregulated temporal summation and CPM, dysregulation of both measures was associated with lower odds of achieving a good EULAR response (OR 0.23 [95% CI 0.07-0.73]). Conclusion Low CPM was significantly associated with lower odds of achieving a good EULAR response, suggesting that inefficient descending inhibitory mechanisms may be a potential treatment target for further study.
Published: 2020
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35. A 7‐week‐old male Golden Retriever with extreme leukocytosis: A case report

Author: Bobbi Conner, Emily Bingham, Amber Vitalo, Michael Schaer, and Jere K. Stern
Subjects: hyperleukocytosis, Medicine (General), medicine.medical_specialty, business.industry, General surgery, Case Report, Golden Retriever, Case Reports, General Medicine, 030204 cardiovascular system & hematology, Blood film, 03 medical and health sciences, pediatric, R5-920, 0302 clinical medicine, 030220 oncology & carcinogenesis, blood film, cytology, Medicine, Leukocytosis, medicine.symptom, business
Abstract: Although neoplasia should be a top concern for extreme leukocytosis in dogs, infectious causes must also be considered to avoid delays in treatment or undue recommendations for humane euthanasia. Blood film review is of paramount importance.
Published: 2020
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36. Optimal Prospective Predictors of Mortality in Austere Environments

Author: Daniel Lammers, Kaitlin Morte, Jason Bingham, Matthew J. Martin, Matthew J. Eckert, Chris Marenco, and Jeffrey R. Conner
Subjects: Adult, Male, Warfare, medicine.medical_specialty, Vital signs, Middle East, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Retrospective Studies, Trauma Severity Indices, Receiver operating characteristic, business.industry, Glasgow Coma Scale, Emergency department, Revised Trauma Score, Relief Work, Shock index, Military Personnel, 030220 oncology & carcinogenesis, Emergency medicine, Wounds and Injuries, Injury Severity Score, Female, 030211 gastroenterology & hepatology, Surgery, Risk assessment, business
Abstract: Background Prospective predictors of trauma-related outcomes have been validated to guide management in low-resource settings. The primary objective of this study was to determine the optimal prospective prediction method for mortality within combat and humanitarian trauma. Materials and methods Retrospective review of the Department of Defense Trauma Registry from 2008 to 2016 was performed for adult patients. Areas under receiver operating characteristic curves (AUROCs) were calculated to assess the predictability of shock index (SI), reverse SI × Glasgow Coma Scale (rSIG), SI × Glasgow Coma Scale (SIG), Revised Trauma Score, and Trauma and Injury Severity Score (TRISS) on mortality at point of injury, arrival in emergency department (ED), and the difference in vital signs between those time points. Results A total of 22,218 patients were included. Overall, 97.1% were male, median age range 25-29 y, Injury Severity Score 9.4 ± 0.07, with predominantly penetrating injuries (58.1%), and mortality of 3.4%. ED vitals yielded higher predictability of mortality for all tests based on higher AUROCs. TRISS and rSIG demonstrated the highest AUROCs (0.955 and 0.923, respectively). The optimal cutoff value for rSIG was 14.1 (sensitivity 89% and specificity 87%). rSIG values Conclusions Initial ED vital signs represented a better predictor of early mortality compared with point of injury vital signs for all predictive tools assessed. TRISS and rSIG proved to be most predictive of mortality. However, of the prospective tools assessed, rSIG may be optimal scoring tool because of its ease of calculation and its increased ability to predict mortality.
Published: 2020
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37. Removal of foreign body airway obstruction: A systematic review of interventions

Author: Vrinda Ohri, Ho Tsun Tang, Aysha Abu Hassan, Keith Couper, Theresa M. Olasveengen, Gavin D. Perkins, Robert Bingham, and Emma Patterson
Subjects: Adult, medicine.medical_specialty, Psychological intervention, MEDLINE, 030204 cardiovascular system & hematology, Emergency Nursing, Cochrane Library, 03 medical and health sciences, 0302 clinical medicine, Bias, Abdominal thrusts, Humans, Medicine, Child, business.industry, 030208 emergency & critical care medicine, Odds ratio, Airway obstruction, Foreign Bodies, medicine.disease, Airway Obstruction, Cross-Sectional Studies, Emergency Medicine, Physical therapy, Observational study, Cardiology and Cardiovascular Medicine, business, Choking, RC
Abstract: Objective\ud To summarise in a systematic review the effectiveness of interventions to treat foreign body airway obstructions (FBAO).\ud \ud Methods\ud We searched MEDLINE, EMBASE, and the Cochrane library from inception on 30th September 2019 for studies that described the effectiveness of interventions to treat FBAO in adults and children.\ud We included randomised controlled trials, observational studies and case series (≥5 cases) that described evidence of benefit. For evidence of harm/complications, we included case reports. Two reviewers independently assessed study eligibility, extracted study data, and assessed risk of bias. Data are summarised in a narrative synthesis. The GRADE system is used to assess evidence certainty.\ud \ud Results\ud We included 69 publications, comprising three cross-sectional studies (557 patients); eight case series (755 patients), and 59 were case reports (64 patients). One paper was included as a case series and cross-sectional study. For all interventions and associated outcomes, evidence certainty was very low. Early removal of FBAO by bystanders was associated with improved neurological survival (odds ratio 6.0, 95% confidence interval 1.5 to 23.4). Identified evidence showed that key interventions (back blows, abdominal thrusts, chest thrusts/compressions, Magill forceps, manual removal of obstructions from the mouth, suction-based airway clearance devices) are effective in relieving FBAO. We identified reports of harm in relation to back blows, abdominal thrusts, chest thrusts/compressions, and blind finger sweeps.\ud \ud Conclusions\ud Key interventions successfully relieve FBAO, but may be associated with important harms. Guidelines for FBAO management should balance the benefits and harms of interventions.
Published: 2020
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38. A minimally invasive periacetabular osteotomy technique: minimizing intraoperative risks

Author: J. D. Witt, Joshua S. Bingham, George Grammatopoulos, and S. Thiagarajah
Subjects: 030222 orthopedics, medicine.medical_specialty, business.industry, medicine.medical_treatment, Technical Tips, 030229 sport sciences, Osteotomy, Neurovascular bundle, Acetabulum, Greater sciatic notch, Posterior column, Surgery, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, medicine, Osteotome, AcademicSubjects/MED00960, Sciatic nerve, business, Pelvis
Abstract: The periacetabular osteotomy (PAO) is an extensive surgical procedure associated with potential risk to the adjacent neurovascular structures. A steep learning curve exists, with surgeon experience an important factor in outcome. Little detail exists of the osteotomies themselves, and how to make them safe and reproducible. This article describes our PAO technique with emphasis on specific safety steps. When performing the posterior column cut, migration of the osteotome beyond the lateral pelvis may lead to damage of the sciatic nerve. The safety features detailed include novel measurement of the posterior column width and the use of specific-width osteotomes to complete this osteotomy. To plan the cut, several computerized tomography-based measurements are taken starting just above the greater sciatic notch and continuing down to the inferior part of the acetabulum. The angle of this cut is determined by acetabular morphology and the width of the posterior column. These posterior column width measurements will determine the width of the osteotomes used to perform the cut with little risk that an osteotome will penetrate too far on the lateral side of the pelvis. To ensure the lateral cortex has been cut completely proximally, an osteotome with pre-measured depths may be used from a medial to a direct lateral trajectory. The senior author has been performing this modified approach since 2010 (n = 530 PAOs) and has witnessed no vascular injuries and no nerve injuries aside from minor lateral femoral cutaneous nerve issues. Utilization of these techniques has prevented any major nerve injury without the need for intraoperative electromyography.
Published: 2020

39. Pediatric Life Support

Author: Robert M. Sutton, Thomaz Bittencourt Couto, Gene Yong-Kwang Ong, Garth Meckler, Nieves de Lucas, Abel Martinez Mejias, Amelia G. Reis, Lynda Knight, Peter T. Morley, O. Brissaud, Vinay M. Nadkarni, Patrick Van de Voorde, Robert Bingham, Barnaby R. Scholefield, Taylor N. McCormick, Ravi R. Thiagarajan, Mary Fran Hazinski, Kee-Chong Ng, N. M. Turner, Dianne L. Atkins, Jerry P. Nolan, Joan S. Roberts, Benny L. Joyner, Kathryn E. Roberts, Kelly D. Kadlec, Alex Moylan, Richard Aickin, Groa Bjork Johannesdottir, Shinchiro Ohshimo, Kevin Nation, Allan R. de Caen, Janice A. Tijssen, Arno Zaritsky, Alexis A. Topjian, Arielle Levy, Tia T Raymond, Anne-Marie Guerguerian, Jana Djakow, Ronald A. Bronicki, Ian Maconochie, Stephen M. Schexnayder, Florian Hoffmann, Torsten Lauritsen, Jonathan P. Duff, Javier J. Lasa, Ryan W. Morgan, Dominique Biarent, Gabrielle Nuthall, Melissa V. Chan, Sarah Tabbutt, and Brian H. Walsh
Subjects: child, Emergency Medical Services, medicine.medical_specialty, Consensus, pediatrics, business.industry, Infant, Emergency Nursing, arrhythmia, cardiopulmonary resuscitation, congenital heart disease, Article, AHA Scientific Statements, Life support, Family medicine, Emergency Medicine, Humans, Medicine, ECMO, Cardiology and Cardiovascular Medicine, business, Emergency Treatment, Out-of-Hospital Cardiac Arrest
Abstract: This 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (CoSTR) for pediatric life support is based on the most extensive evidence evaluation ever performed by the Pediatric Life Support Task Force. Three types of evidence evaluation were used in this review: systematic reviews, scoping reviews, and evidence updates. Per agreement with the evidence evaluation recommendations of the International Liaison Committee on Resuscitation, only systematic reviews could result in a new or revised treatment recommendation. Systematic reviews performed for this 2020 CoSTR for pediatric life support included the topics of sequencing of airway-breaths-compressions versus compressions-airway-breaths in the delivery of pediatric basic life support, the initial timing and dose intervals for epinephrine administration during resuscitation, and the targets for oxygen and carbon dioxide levels in pediatric patients after return of spontaneous circulation. The most controversial topics included the initial timing and dose intervals of epinephrine administration (new treatment recommendations were made) and the administration of fluid for infants and children with septic shock (this latter topic was evaluated by evidence update). All evidence reviews identified the paucity of pediatric data and the need for more research involving resuscitation of infants and children.
Published: 2020
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40. Acetabular Distraction Technique for the Treatment of Chronic Pelvic Discontinuities: Excellent Short-Term Implant Survivorship and Good Clinical Outcomes

Author: Joshua S. Bingham, Daniel J. Berry, Robert T. Trousdale, Matthew P. Abdel, David G. Lewallen, and Jaymeson R. Arthur
Subjects: Male, Reoperation, musculoskeletal diseases, medicine.medical_specialty, Arthroplasty, Replacement, Hip, Survivorship, Prosthesis Design, Osseointegration, Pelvis, 03 medical and health sciences, 0302 clinical medicine, Survivorship curve, Distraction, medicine, Humans, Orthopedics and Sports Medicine, Aged, Retrospective Studies, 030222 orthopedics, business.industry, Acetabulum, Ischium, humanities, Prosthesis Failure, Surgery, medicine.anatomical_structure, Harris Hip Score, Female, Hip Prosthesis, Implant, Complication, business, Follow-Up Studies
Abstract: BACKGROUND Pelvic discontinuity is a challenging complication in revision total hip arthroplasty. One technique that has garnered enthusiasm with limited data is acetabular distraction. Acetabular distraction provides stability via elastic recoil of the pelvis. The aim of this study is to report implant survivorship, radiographic results, clinical outcomes, and complications in the largest independent series of discontinuities treated with acetabular distraction. METHODS We retrospectively identified all revision total hip arthroplasties with a pelvic discontinuity between 2005 and 2017. Of the 162 patients, 31 were treated with distraction. Mean age was 67 years, with 71% female. Mean body mass index was 28 kg/m2, and mean follow-up was 3 years. RESULTS The 2-year survivorship free from revision for aseptic loosening, re-revision for any reason, and reoperation were 97%, 93%, and 87%, respectively. There were 3 re-revisions including 1 for aseptic loosening, 1 conversion to a dual mobility for instability, and 1 two-stage exchange for infection. At last follow-up, 3 acetabular components did not have evidence of osteointegration. Only patients with osteointegration to both the ilium and ischium had evidence of a healed discontinuity. The mean Harris Hip Score improved from 43 preoperatively to 77 postoperatively (P < .0001). The most common complication was a partial sciatic nerve palsy that occurred in 4 patients. CONCLUSION In this series utilizing pelvic distraction, there was excellent 2-year survivorship free from revision for aseptic loosening. Despite several discontinuities persisting, 90% of patients had radiographic evidence of implant osteointegration, and clinical outcomes improved significantly. The most common complication was a partial sciatic nerve palsy. LEVEL OF EVIDENCE IV Case Series.
Published: 2020
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41. Use of viral DNA surrogate markers to study routes of transmission of healthcare-associated pathogens

Author: Jennifer L. Cadnum, Curtis J. Donskey, Annette L. Jencson, Manish Thakur, Brigid Wilson, Jessica Bingham, and Heba Alhmidi
Subjects: Methicillin-Resistant Staphylococcus aureus, Microbiology (medical), Cross Infection, 0303 health sciences, medicine.medical_specialty, Stethoscope, 030306 microbiology, Epidemiology, business.industry, Transmission (medicine), law.invention, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, Healthcare associated, law, DNA, Viral, Emergency medicine, Humans, Medicine, 030212 general & internal medicine, Dna viral, business, Delivery of Health Care, Biomarkers
Abstract: Background:The hands of healthcare personnel are the most important source for transmission of healthcare-associated pathogens. The role of contaminated fomites such as portable equipment, stethoscopes, and clothing of personnel in pathogen transmission is unclear.Objective:To study routes of transmission of cauliflower mosaic virus DNA markers from 31 source patients and from environmental surfaces in their rooms.Design:A 3-month observational cohort study.Setting:A Veterans’ Affairs hospital.Methods:After providing care for source patients, healthcare personnel were observed during interactions with subsequent patients. Putative routes of transmission were identified based on recovery of DNA markers from sites of contact with the patient or environment. To assess plausibility of fomite-mediated transmission, we assessed the frequency of transfer of methicillin-resistant Staphylococcus aureus (MRSA) from the skin of 25 colonized patients via gloved hands versus fomites.Results:Of 145 interactions involving contact with patients and/or the environment, 41 (28.3%) resulted in transfer of 1 or both DNA markers to the patient and/or the environment. The DNA marker applied to patients’ skin and clothing was transferred most frequently by stethoscopes, hands, and portable equipment, whereas the marker applied to environmental surfaces was transferred only by hands and clothing. The percentages of MRSA transfer from the skin of colonized patients via gloved hands, stethoscope diaphragms, and clothing were 52%, 40%, and 48%, respectively.Conclusions:Fomites such as stethoscopes, clothing, and portable equipment may be underappreciated sources of pathogen transmission. Simple interventions such as decontamination of fomites between patients could reduce the risk for transmission.
Published: 2020
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42. Pediatric adjusted reverse shock index multiplied by Glasgow Coma Scale as a prospective predictor for mortality in pediatric trauma

Author: Daniel Lammers, Woo S. Do, Mauricio A. Escobar, Jason Bingham, Christopher W. Marenco, Matthew J. Martin, Jeff Conner, John D. Horton, and Matthew J. Eckert
Subjects: Male, medicine.medical_specialty, Adolescent, Vital signs, Poison control, Critical Care and Intensive Care Medicine, Risk Assessment, Severity of Illness Index, 03 medical and health sciences, Injury Severity Score, 0302 clinical medicine, Severity of illness, Humans, Medicine, Glasgow Coma Scale, Registries, Child, Retrospective Studies, business.industry, Infant, Newborn, Infant, 030208 emergency & critical care medicine, Retrospective cohort study, Odds ratio, medicine.disease, Child, Preschool, Emergency medicine, Wounds and Injuries, Female, Surgery, business, Pediatric trauma
Abstract: INTRODUCTION Shock index and its pediatric adjusted derivative (pediatric age-adjusted shock index [SIPA]) have demonstrated utility as prospective predictors of mortality in adult and pediatric trauma populations. Although basic vital signs provide promise as triage tools, factors such as neurologic status on arrival have profound implications for trauma-related outcomes. Recently, the reverse shock index multiplied by Glasgow Coma Scale (GCS) score (rSIG) has been validated in adult trauma as a tool combining early markers of physiology and neurologic function to predict mortality. This study sought to compare the performance characteristics of rSIG against SIPA as a prospective predictor of mortality in pediatric war zone injuries. METHODS Retrospective review of the Department of Defense Trauma Registry, 2008 to 2016, was performed for all patients younger than 18 years with documented vital signs and GCS on initial arrival to the trauma bay. Optimal age-specific cutoff values were derived for rSIG via the Youden index using receiver operating characteristic analyses. Multivariate logistic regression was performed to validate accuracy in predicting early mortality. RESULTS A total of 2,007 pediatric patients with a median age range of 7 to 12 years, 79% male, average Injury Severity Score of 11.9, and 62.5% sustaining a penetrating injury were included in the analysis. The overall mortality was 7.1%. A total of 874 (43.5%) and 685 patients (34.1%) had elevated SIPA and pediatric rSIG scores, respectively. After adjusting for demographics, mechanism of injury, initial vital signs, and presenting laboratory values, rSIG (odds ratio, 4.054; p = 0.01) was found to be superior to SIPA (odds ratio, 2.742; p < 0.01) as an independent predictor of early mortality. CONCLUSION Reverse shock index multiplied by GCS score more accurately identifies pediatric patients at highest risk of death when compared with SIPA alone, following war zone injuries. These findings may help further refine early risk assessments for patient management and resource allocation in constrained settings. Further validation is necessary to determine applicability to the civilian population. LEVEL OF EVIDENCE Prognostic study, level IV.
Published: 2020
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43. Can a Convolutional Neural Network Classify Knee Osteoarthritis on Plain Radiographs as Accurately as Fellowship-Trained Knee Arthroplasty Surgeons?

Author: Adam J. Schwartz, Mark J. Spangehl, Matthew R. Neville, Henry D. Clarke, Joshua S. Bingham, and David A. Etzioni
Subjects: Adult, musculoskeletal diseases, medicine.medical_specialty, Scoring system, Intraclass correlation, Radiography, medicine.medical_treatment, Osteoarthritis, Poor quality, 03 medical and health sciences, 0302 clinical medicine, Humans, Medicine, Orthopedics and Sports Medicine, Fellowships and Scholarships, Arthroplasty, Replacement, Knee, Retrospective Studies, Surgeons, 030222 orthopedics, business.industry, Osteoarthritis, Knee, musculoskeletal system, medicine.disease, Arthroplasty, United States, Confidence interval, Physical therapy, Plain radiographs, Neural Networks, Computer, business
Abstract: Background Osteoarthritis (OA) is the leading cause of disability among adults in the United States. As the diagnosis is based on the accurate interpretation of knee radiographs, use of a convolutional neural network (CNN) to grade OA severity has the potential to significantly reduce variability. Methods Knee radiographs from consecutive patients presenting to a large academic arthroplasty practice were obtained retrospectively. These images were rated by 4 fellowship-trained knee arthroplasty surgeons using the International Knee Documentation Committee (IKDC) scoring system. The intraclass correlation coefficient (ICC) for surgeons alone and surgeons with a CNN that was trained using 4755 separate images were compared. Results Two hundred eighty-eight posteroanterior flexion knee radiographs (576 knees) were reviewed; 131 knees were removed due to poor quality or prior TKA. Each remaining knee was rated by 4 blinded surgeons for a total of 1780 human knee ratings. The ICC among the 4 surgeons for all possible IKDC grades was 0.703 (95% confidence interval [CI] 0.667-0.737). The ICC for the 4 surgeons and the trained CNN was 0.685 (95% CI 0.65-0.719). For IKDC D vs any other rating, the ICC of the 4 surgeons was 0.713 (95% CI 0.678-0.746), and the ICC of 4 surgeons and CNN was 0.697 (95% CI 0.663-0.73). Conclusions A CNN can identify and classify knee OA as accurately as a fellowship-trained arthroplasty surgeon. This technology has the potential to reduce variability in the diagnosis and treatment of knee OA.
Published: 2020
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44. Impact of Telehealth Interventions on Medication Adherence for Patients With Type 2 Diabetes, Hypertension, and/or Dyslipidemia: A Systematic Review

Author: Yawen Li, Jennifer H. Martin, Jennifer M Bingham, Melissa Black, Armando Silva-Almodóvar, Natalie Toselli, Shawna C. Fox, David R. Axon, and Elizabeth Anderson
Subjects: medicine.medical_specialty, education, Psychological intervention, MEDLINE, Medication adherence, Type 2 diabetes, Telehealth, 030204 cardiovascular system & hematology, Medication Adherence, 03 medical and health sciences, 0302 clinical medicine, Diabetes mellitus, medicine, Humans, Pharmacology (medical), 030212 general & internal medicine, Intensive care medicine, Dyslipidemias, business.industry, medicine.disease, Telemedicine, Diabetes Mellitus, Type 2, Chronic Disease, Hypertension, business, Dyslipidemia
Abstract: Objective: To describe telehealth interventions and determine their effect on medication adherence for patients with type 2 diabetes, hypertension, and/or dyslipidemia. Data Sources: PubMed/MEDLINE, EMBASE, Cochrane, CINAHL Plus, PsycINFO, Academic Search Ultimate, International Pharmaceutical Abstracts, Scopus, Web of Science, WHO Global Index Medicus, association websites, and gray literature were searched from January 1, 1998, to December 31, 2019. Study Selection and Data Extraction: Eligible studies reported eHealth, mobile health, and telehealth interventions for adult patients prescribed medications for chronic condition management (eg, type 2 diabetes, hypertension, and/or dyslipidemia). Studies were required to evaluate medication adherence outcomes (eg, medication possession ratio [MPR], proportion of days covered (PDC)]. Randomized controlled trials, cohort studies, and controlled before-and-after studies were included. Multiple reviewers independently extracted data and evaluated risk of bias. Data Synthesis: Of 8693 studies identified, 13 reported either an MPR or PDC and were included in the systematic review. The systematic review demonstrated that electronic health (eHealth) and telehealth interventions were successful at improving medication adherence, whereas mobile health interventions did not improve medication adherence. Relevance to Patient Care and Clinical Practice: This systematic review highlighted the available research and findings of studies assessing interventions to improve medication nonadherence among patients with type 2 diabetes, hypertension, and/or dyslipidemia. The evaluated findings lend support to the need for targeted medication adherence interventions based on patient population and practice settings. Conclusions: Telehealth modalities include telephonic outreach and specialized tools designed to increase health literacy. eHealth and telehealth medication adherence interventions were associated with improved MPR and/or PDC rates.
Published: 2020
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45. THA for a Fractured Femoral Neck: Comparing the Revision and Dislocation Rates of Standard-head, Large-head, Dual-mobility, and Constrained Liners

Author: Wayne Hoskins, Roger Bingham, Richard de Steiger, Xavier L. Griffin, and Alesha Hatton
Subjects: Male, Reoperation, medicine.medical_specialty, Time Factors, Arthroplasty, Replacement, Hip, medicine.medical_treatment, Prosthesis Design, Risk Assessment, Prosthesis, Femoral Neck Fractures, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Clinical Research, medicine, Hip Dislocation, Humans, Orthopedics and Sports Medicine, Femur, Registries, 030212 general & internal medicine, Aged, Femoral neck, Aged, 80 and over, Fracture Healing, 030222 orthopedics, business.industry, Age Factors, Australia, General Medicine, Middle Aged, Arthroplasty, Acetabulum, Prosthesis Failure, Surgery, Treatment Outcome, medicine.anatomical_structure, Joint replacement registry, Orthopedic surgery, Female, Hip Prosthesis, business
Abstract: THA is a reasonable surgical option for some patients with fragility fractures of the femoral neck, but it has the risk of prosthesis dislocation. The prosthesis combination that reduces the risk of dislocation and the rate of revision surgery is not known.In patients receiving primary THA for a femoral neck fracture, does (1) the rate of all-cause revision or (2) the reason for revision and rate of revision for dislocation differ among THA with a standard head size, large head size, dual mobility (DM), or constrained liner? (3) Is there a difference in the revision risk when patients are stratified by age at the time of surgery?Data were analyzed for 16,692 THAs performed to treat fractures of the femoral neck reported in the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) from January 2008 to December 2018, as this included the first use of DM prostheses. The AOANJRR includes information on more than 98% of arthroplasty procedures performed in Australia. Most patients were female (72%) and the mean age was 74 years ± 11. There were 8582 standard-head prostheses, 5820 large-head prostheses, 1778 DM prostheses, and 512 constrained prostheses identified. The cumulative percent revision (CPR) was determined for all causes as well as CPR for dislocation. The time to the first revision was described using Kaplan-Meier estimates of survivorship, with right censoring for death or closure of the database at the time of analysis. The unadjusted CPR was estimated each year of the first 10 years for standard heads, 10 years for large heads, 8 years for constrained liners, and 7 years for DM prostheses, with 95% confidence intervals using unadjusted pointwise Greenwood estimates. The results were adjusted for age, sex, femoral fixation, and head size where appropriate and were considered by age groups70 and ≥ 70 years.When adjusted for age, sex, femoral fixation and head size, there was no difference in the rate of all-cause revision at 7 years for any of the four groups. There was no difference in the rate of all-cause revision when patients were stratified by70 or ≥ 70 years of age. Dislocation was the most common reason for revision (32%). When analyzing revision for dislocation alone, large-head THA had a lower rate of revision for dislocation compared with standard head (HR 0.6 [95% CI 0.4 to 0.8]; p0.001) and DM prostheses had a lower rate of revision for dislocation than standard head for the first 3 months (HR 0.3 [95% CI 0.1 to 0.7]; p0.004) but not after this time point.The Australian registry shows that there is no difference in the rate of all-cause revision for standard-head, large-head, DM prostheses or constrained liner THA after femoral neck fractures for all patients or for patients stratified into younger than 70 years and at least 70 years of age groups. Dislocation is the most common cause of revision. Large-head prostheses are associated with a lower revision risk for dislocation and DM prostheses have a lower rate of revision for dislocation than standard heads for the first 3 months only. Surgeons treating a femoral neck fracture with THA might consider a large head size if the diameter of the acetabulum will allow it and a DM prosthesis if a large head size is not possible. The age, life expectancy and level of function of patients with femoral neck fractures minimizes the potential long-term consequences of these prostheses. The lack of significant differences in survival between most prosthesis combinations means surgeons should continue to look for factors beyond head size and prosthesis to minimize dislocation and revision surgery.Level III, therapeutic study.
Published: 2020
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46. Early Rate of Revision of Total Hip Arthroplasty Related to Surgical Approach

Author: Wayne Hoskins, Alesha Hatton, Roger Bingham, Richard de Steiger, and Michelle Lorimer
Subjects: Male, Reoperation, medicine.medical_specialty, Arthroplasty, Replacement, Hip, medicine.medical_treatment, Periprosthetic, Osteoarthritis, Body Mass Index, 03 medical and health sciences, Femoral head, 0302 clinical medicine, Risk Factors, medicine, Humans, Orthopedics and Sports Medicine, Registries, 030212 general & internal medicine, Aged, Retrospective Studies, 030222 orthopedics, business.industry, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Arthroplasty, Surgery, medicine.anatomical_structure, Joint replacement registry, Orthopedic surgery, Female, business, Body mass index
Abstract: BACKGROUND: A number of surgical approaches are available for total hip arthroplasty (THA), but there are limited large-volume, multi-surgeon data comparing the rates of early revisions following these approaches. The aim of this study was to compare the rate of revision of primary conventional THA related to surgical approach. METHODS: Data from the Australian Orthopaedic Association National Joint Replacement Registry were analyzed for all patients who had undergone a primary THA for osteoarthritis from January 2015 to December 2018. The primary outcome measure was the cumulative percent revision (CPR) for all causes. Secondary outcome measures were major revision (a revision procedure requiring change of the acetabular and/or femoral component) and revision for specific diagnoses: fracture, component loosening, infection, and dislocation. Age, sex, body mass index (BMI), American Society of Anesthesiologists (ASA) score, femoral head size, and femoral fixation were assessed as potential confounders. RESULTS: There was a total of 122,345 primary conventional THAs for which the surgical approach was recorded in the registry; 65,791 were posterior, 24,468 were lateral, and 32,086 were anterior. There was no difference in the overall CPR among approaches, but the anterior approach was associated with a higher rate of major revisions. There were differences among the approaches with regard to the types of revision. When adjusted for age, sex, ASA score, BMI, femoral head size, and femoral fixation, the anterior approach was associated with a higher rate of femoral complications-i.e., revision for periprosthetic fracture and femoral loosening. There was a lower rate of revision for infection after the anterior approach compared with the posterior approach in the entire period, and compared with the lateral approach in the first 3 months. The posterior approach was associated with a higher rate of revision for dislocation compared with both the anterior and the lateral approach in all time periods. The anterior approach was associated with a lower rate of revision compared with the lateral approach in the first 6 months only. CONCLUSIONS: There was no difference in the overall early CPR among the surgical approaches, but the anterior approach was associated with a higher rate of early major revisions and femoral complications (revisions for periprosthetic fracture and femoral loosening) compared with the posterior and lateral approaches and with a lower rate of dislocation and infection. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Published: 2020
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47. Imaging of Clinically Unrecognized Myocardial Fibrosis in Patients With Suspected Coronary Artery Disease

Author: Scott Bingham, J. Ronald Mikolich, Matthias Stuber, Subha V. Raman, Afshin Farzaneh-Far, John F. Heitner, Orlando P. Simonetti, Jeanette Schulz-Menger, Chetan Shenoy, Victor A. Ferrari, Amit R. Patel, Spins Study Investigators, W. Patricia Bandettini, Shuaib M Abdullah, Raymond Y. Kwong, Steve W. Leung, Kevin Steel, Panagiotis Antiochos, Andrew E. Arai, Dipan J. Shah, Jorge A. Gonzalez, and Yin Ge
Subjects: Male, Cardiac function curve, medicine.medical_specialty, Myocardial Infarction, Myocardial Ischemia, Contrast Media, Gadolinium, Perfusion scanning, Coronary Artery Disease, 030204 cardiovascular system & hematology, Risk Assessment, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Silent Myocardial Infarction, Internal medicine, Humans, Medicine, cardiovascular diseases, 030212 general & internal medicine, Myocardial infarction, Ejection fraction, business.industry, Myocardial Perfusion Imaging, Middle Aged, Image Enhancement, Prognosis, medicine.disease, Outcome and Process Assessment, Health Care, Heart failure, Asymptomatic Diseases, cardiovascular system, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Magnetic Resonance Angiography, Mace
Abstract: Stress cardiac magnetic resonance (CMR) provides accurate assessment of both myocardial infarction (MI) and ischemia.This study aimed to evaluate the incremental prognostic value of unrecognized myocardial infarction (UMI), detected during assessment of coronary artery disease (CAD) by stress CMR, beyond cardiac function and ischemia.In the multicenter SPINS (Stress CMR Perfusion Imaging in the United States) study, 2,349 consecutive patients (63 ± 11 years of age, 53% were male) with suspected CAD were assessed by stress CMR and followed over a median of 5.4 years. UMI was defined as the presence of late gadolinium enhancement consistent with MI in the absence of medical history of MI. This study investigated the association of UMI with all-cause mortality and nonfatal MI (death and/or MI), and major adverse cardiac events (MACE).UMI was detected in 347 patients (14.8%) and clinically recognized myocardial infarction (RMI) in 358 patients (15.2%). Compared with patients with RMI, patients with UMI had a similar burden of cardiovascular risk factors, but significantly lower left ventricular ejection fraction (p 0.001) and lower rates of guideline-directed medical therapies, including aspirin (p 0.001), statin (p 0.001), and beta-blockers (p = 0.002). During follow-up, 328 deaths and/or MIs and 528 MACE occurred. In univariate analysis, UMI and RMI were strongly associated with death and/or MI (UMI: hazard ratio [HR]: 2.15; 95% confidence interval [CI]: 1.63 to 2.83; p 0.001; RMI: HR: 2.45; 95% CI: 1.89 to 3.18) and MACE. Compared with patients with RMI, patients with UMI presented an increased risk for heart failure hospitalization (UMI vs. RMI: HR: 2.60; 95% CI: 1.48 to 4.58; p 0.001). In a multivariate model including ischemia and left ventricular ejection fraction, UMI and RMI maintained robust prognostic association with death and/or MI (UMI: HR: 1.82; 95% CI: 1.37 to 2.42; p 0.001; RMI: HR: 1.54; 95% CI: 1.14 to 2.09) and MACE.In a multicenter cohort of patients with suspected CAD, presence of UMI or RMI portended an equally significant risk for death and/or MI, independently of the presence of ischemia. Compared with RMI patients, those with UMI were less likely to receive guideline-directed medical therapies and presented an increased risk for heart failure hospitalization that warrants further study. (Stress CMR Perfusion Imaging in the United States [SPINS]; NCT03192891).
Published: 2020
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48. Association of Pain Centralization and Patient‐Reported Pain in Active Rheumatoid Arthritis

Author: Dorothy D. Dunlop, Yvonne C. Lee, Clifton O. Bingham, Wendy Marder, Daniel J. Clauw, Jing Song, Alyssa Wohlfahrt, Marcy B. Bolster, Kristine Phillips, Tuhina Neogi, and Andrew C. Heisler
Subjects: Adult, Male, Pain Threshold, medicine.medical_specialty, Arthritis, Summation, Article, Arthritis, Rheumatoid, Rheumatology, Internal medicine, Threshold of pain, medicine, Humans, Patient Reported Outcome Measures, Aged, Pain Measurement, Central Nervous System Sensitization, business.industry, Quantitative sensory testing, Middle Aged, medicine.disease, Arthralgia, Confidence interval, Intensity (physics), Conditioned pain modulation, Rheumatoid arthritis, Linear Models, Female, business
Abstract: Objective Pain is a significant burden for patients with rheumatoid arthritis (RA) despite advancements in treatment. We undertook this study to examine the independent contribution of pain centralization to the pain experience of patients with active RA. Methods A total of 263 RA patients with active disease underwent quantitative sensory testing (QST), including assessment of extraarticular pressure pain thresholds (PPTs), temporal summation (TS), and conditioned pain modulation (CPM). The pain experience was assessed by a pain intensity numeric rating scale and the Patient-Reported Outcomes Measurement Information System pain interference computerized adaptive test. We examined associations between QST measures and pain intensity and pain interference. Multiple linear regression models were adjusted for demographic and clinical variables, including swollen joint count and C-reactive protein level. Results Patients with the lowest PPTs (most central dysregulation) reported higher pain intensity than patients with the highest PPTs (adjusted mean difference 1.02 [95% confidence interval (95% CI) 0.37, 1.67]). Patients with the highest TS (most central dysregulation) had higher pain intensity than those with the lowest TS (adjusted mean difference 1.19 [95% CI 0.54, 1.84]). CPM was not associated with differences in pain intensity. PPT and TS were not associated with pain interference. Patients with the lowest CPM (most centrally dysregulated) had lower pain interference than patients with the highest CPM (adjusted mean difference -2.35 [95% CI -4.25, -0.44]). Conclusion Pain centralization, manifested by low PPTs and high TS, was associated with more intense pain. Clinicians should consider pain centralization as a contributor to pain intensity, independent of inflammation.
Published: 2020
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49. Electronic adherence monitoring identifies severe preschool wheezers who are steroid responsive

Author: Nina Sanghani, Pippa Hall, Andrew Bush, Rachael Moore-Crouch, Louise Fleming, James Cook, Sejal Saglani, Yvonne Bingham, Angela Jamalzadeh, and Asthma UK
Subjects: Male, Respiratory System, atopy, CHILDREN, Pilot Projects, medicine.disease_cause, Pediatrics, Atopy, 0302 clinical medicine, Quality of life, Adrenal Cortex Hormones, Interquartile range, preschool wheeze, KIDS TRACK, adherence, Phenotype, Breath Tests, Exhalation, Child, Preschool, Female, Drug Monitoring, medicine.symptom, Life Sciences & Biomedicine, EXHALED NITRIC-OXIDE, Pulmonary and Respiratory Medicine, medicine.medical_specialty, Subgroup analysis, Inhaled corticosteroids, Nitric Oxide, Medication Adherence, 03 medical and health sciences, 030225 pediatrics, Wheeze, Internal medicine, medicine, Humans, Respiratory Sounds, Science & Technology, business.industry, Infant, Aeroallergen, medicine.disease, Asthma, monitoring, 030228 respiratory system, Pediatrics, Perinatology and Child Health, Exhaled nitric oxide, Quality of Life, 1114 Paediatrics and Reproductive Medicine, ASTHMA CONTROL, inhaled corticosteroids, Electronics, business
Abstract: Little is known about adherence to inhaled corticosteroids (ICS) in preschool children with troublesome wheeze. Children with aeroallergen senitization, or those reporting multiple trigger wheeze (MTW), are more likely to respond to ICS. We hypothesized that adherence to ICS and symptom control are only positively related in atopic children, or those reporting MTW. Patients aged 1 to 5 years with recurrent wheeze prescribed ICS were recruited from a tertiary respiratory clinic. Clinical phenotype and aeroallergen senitization were determined, and adherence assessed using an electronic monitoring device (Smartinhaler). Symptom control (test for respiratory and asthma control in kids [TRACK]), quality of life (PACQLQ), airway inflammation (offline exhaled nitric oxide) were assessed at baseline and follow-up. Forty-eight children (mean age 3.7 years; SD, 1.2) were monitored for a median of 112 (interquartile range [IQR], 91-126) days. At baseline n = 29 reported episodic viral wheeze and n = 19 reported MTW. Twenty-four out of 48 (50%) wheezers had suboptimal ICS adherence (
Published: 2020
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50. Evaluating provider acceptance of pharmacist interventions in the Discharge Companion Program and its association with readmission reduction

Author: Srujitha Marupuru, Jennifer M Bingham, Nicole Scovis, Ann M. Taylor, Terri L. Warholak, and Omar Jamjoom
Subjects: medicine.medical_specialty, Health Personnel, Psychological intervention, Pharmacist, Pharmacology (nursing), Pharmacy, Pharmacists, Affect (psychology), Logistic regression, Patient Readmission, 030226 pharmacology & pharmacy, 03 medical and health sciences, 0302 clinical medicine, Intervention (counseling), Health care, medicine, Humans, 030212 general & internal medicine, Retrospective Studies, Pharmacology, business.industry, Odds ratio, Patient Discharge, Discontinuation, Emergency medicine, business
Abstract: Objective To evaluate provider acceptance of pharmacist interventions within the Discharge Companion Program (DCP) and its association with hospital readmissions. Methods This retrospective record review included patients referred to the DCP between January and October 2018. DCP pharmacists’ interventions were assessed for provider acceptance on follow-up consultation or readmission. A chi-square test assessed the association between provider acceptance, communication modality, and technology used. A logistic regression model assessed the association between readmission risk and variables of interest. An a priori alpha level of 0.05 was used. Results Of the 197 patients referred to the DCP, 102 met inclusion criteria. DCP pharmacists made a total of 271 interventions; 185 (68.7%) required provider action. The most common intervention type was medication addition or discontinuation (n = 74, 40%); the communication mode was between DCP nurses and primary care provider offices or skilled nursing facilities (n = 56, 54.9%); and the preferred technology was the telephone (n = 58, 56.9%). Provider acceptance rate was 30.8% (n = 57) of actionable interventions, although it was not significantly associated with 30-day readmission reductions (P = 0.833) and did not differ significantly when interventions were communicated to other health care professionals (P = 0.53). The specific intervention communication mode (i.e., telephone, facsimile, or both) of pharmacist interventions did not significantly affect provider acceptance (P = 0.133). The overall readmission rate was 22.5% (n = 23), and the only significant predictor of 30-day readmission was the number of comorbidities (odds ratio 1.28 [95% CI 1.03–1.58], P = 0.024). Conclusion Provider acceptance of pharmacists’ interventions did not significantly affect 30-day readmission rates, regardless of communication mode (telephone or facsimile) or technology used. However, the DCP successfully identified numerous medication-related problems. Further study is warranted regarding provider acceptance of pharmacist recommendations on 30-day readmission reduction.
Published: 2020
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