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1. Source control in emergency general surgery: WSES, GAIS, SIS-E, SIS-A guidelines

Author

Federico Coccolini, Massimo Sartelli, Robert Sawyer, Kemal Rasa, Bruno Viaggi, Fikri Abu-Zidan, Kjetil Soreide, Timothy Hardcastle, Deepak Gupta, Cino Bendinelli, Marco Ceresoli, Vishal G. Shelat, Richard ten Broek, Gian Luca Baiocchi, Ernest E. Moore, Ibrahima Sall, Mauro Podda, Luigi Bonavina, Igor A. Kryvoruchko, Philip Stahel, Kenji Inaba, Philippe Montravers, Boris Sakakushev, Gabriele Sganga, Paolo Ballestracci, Manu L. N. G. Malbrain, Jean-Louis Vincent, Manos Pikoulis, Solomon Gurmu Beka, Krstina Doklestic, Massimo Chiarugi, Marco Falcone, Elena Bignami, Viktor Reva, Zaza Demetrashvili, Salomone Di Saverio, Matti Tolonen, Pradeep Navsaria, Miklosh Bala, Zsolt Balogh, Andrey Litvin, Andreas Hecker, Imtiaz Wani, Andreas Fette, Belinda De Simone, Rao Ivatury, Edoardo Picetti, Vladimir Khokha, Edward Tan, Chad Ball, Carlo Tascini, Yunfeng Cui, Raul Coimbra, Michael Kelly, Costanza Martino, Vanni Agnoletti, Marja A. Boermeester, Nicola De’Angelis, Mircea Chirica, Walt L. Biffl, Luca Ansaloni, Yoram Kluger, Fausto Catena, and Andrew W. Kirkpatrick

Subjects
Source control, Emergency, Infections, Abdominal, Surgery, Trauma, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Intra-abdominal infections (IAI) are among the most common global healthcare challenges and they are usually precipitated by disruption to the gastrointestinal (GI) tract. Their successful management typically requires intensive resource utilization, and despite the best therapies, morbidity and mortality remain high. One of the main issues required to appropriately treat IAI that differs from the other etiologies of sepsis is the frequent requirement to provide physical source control. Fortunately, dramatic advances have been made in this aspect of treatment. Historically, source control was left to surgeons only. With new technologies non-surgical less invasive interventional procedures have been introduced. Alternatively, in addition to formal surgery open abdomen techniques have long been proposed as aiding source control in severe intra-abdominal sepsis. It is ironic that while a lack or even delay regarding source control clearly associates with death, it is a concept that remains poorly described. For example, no conclusive definition of source control technique or even adequacy has been universally accepted. Practically, source control involves a complex definition encompassing several factors including the causative event, source of infection bacteria, local bacterial flora, patient condition, and his/her eventual comorbidities. With greater understanding of the systemic pathobiology of sepsis and the profound implications of the human microbiome, adequate source control is no longer only a surgical issue but one that requires a multidisciplinary, multimodality approach. Thus, while any breach in the GI tract must be controlled, source control should also attempt to control the generation and propagation of the systemic biomediators and dysbiotic influences on the microbiome that perpetuate multi-system organ failure and death. Given these increased complexities, the present paper represents the current opinions and recommendations for future research of the World Society of Emergency Surgery, of the Global Alliance for Infections in Surgery of Surgical Infection Society Europe and Surgical Infection Society America regarding the concepts and operational adequacy of source control in intra-abdominal infections.

Published
2023
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2. Physiological stress level and screening for malnutrition as preoperative predictors of postoperative complications in pancreatic surgery: a retrospective study

Author

Igor A. Kryvoruchko, Plamen Staikov, Valeriy V. Boyko, Massimo Sartelli, Yulia V. Ivanova, Andrij Honcharov, Svetlana Gramatiuk, and Karine Sargsyan

Subjects
Neutrophil–lymphocyte ratio, Nutritional risk index, Chronic pancreatitis, Cancer of the pancreas, Surgery, Outcomes, RD1-811
Abstract

Abstract Background Assessment of ‘physiological stress levels’ and ‘nutritional status’ before surgery is important for predicting complications and indirect interventions on the pancreas. The aim of this study was to determine neutrophil–lymphocyte ratio (NLR) and nutritional risk index (NRI) indicators before surgery to predict 90-day complications and mortality in a cohort of patients with complicated chronic pancreatitis and cancer of the head of the pancreas. Methods We evaluated preoperative levels of NLR and NRI among 225 subjects treated at different centres located in three countries. Short-term outcomes included length of hospital stay, postoperative complications, and mortality at 90 days and were appreciated based on NLR and NRI. The level of physiological stress was divided according by the formulas: neutrophil–lymphocyte ratio (NLR) = (neutrophil count, %)/(lymphocyte count, %). The nutritional state of the patients was divided according to the INR: NRI = (1.519 × serum albumin, g/L) + (41.7 × present weight, kg / usual weight, kg)]. Results All patients were operated. An analysis of the operations performed in three institutions demonstrated mortality in chronic pancreatitis and pancreatic pseudocysts in 1.4%, in chronic pancreatitis and the presence of an inflammatory mass mainly in the pancreatic head in 1.2%, and in cancer of the pancreatic head in 5.9%. The mean preoperative NLR was normal in 33.8% of the patients, the mild physiologic stress level was 54.7%, and the moderate was 11.5% before surgery. 10.2% of patients had a normal nutritional status, 20% had mild, 19.6% had moderate, and 50.2% had severe malnutrition. In a univariate analysis, at the cutoff of NLR ≥ 9.5 (AUC = 0.803) and the cutoff of NRI ≤ 98.5 (AUC = 0.801), increasing the risk of complications was observed (hazard ratio, 2.01; 95% CI, 1.247–3.250, p = 0.006), but at the cutoff of NRI ≤ 83.55 (AUC = 0.81), we observed a survival difference in operated patients (hazard ratio, 2.15; 95% CI, 1.334–3.477, p = 0.0025). Conclusions Our study demonstrated that NLR and NRI were predictors of postoperative complications, but only NRI was a predictor of 90-day mortality in patients after surgery.

Published
2023
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3. Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines

Author

Federico Coccolini, Francesco Corradi, Massimo Sartelli, Raul Coimbra, Igor A. Kryvoruchko, Ari Leppaniemi, Krstina Doklestic, Elena Bignami, Giandomenico Biancofiore, Miklosh Bala, Ceresoli Marco, Dimitris Damaskos, Walt L. Biffl, Paola Fugazzola, Domenico Santonastaso, Vanni Agnoletti, Catia Sbarbaro, Mirco Nacoti, Timothy C. Hardcastle, Diego Mariani, Belinda De Simone, Matti Tolonen, Chad Ball, Mauro Podda, Isidoro Di Carlo, Salomone Di Saverio, Pradeep Navsaria, Luigi Bonavina, Fikri Abu-Zidan, Kjetil Soreide, Gustavo P. Fraga, Vanessa Henriques Carvalho, Sergio Faria Batista, Andreas Hecker, Alessandro Cucchetti, Giorgio Ercolani, Dario Tartaglia, Joseph M. Galante, Imtiaz Wani, Hayato Kurihara, Edward Tan, Andrey Litvin, Rita Maria Melotti, Gabriele Sganga, Tamara Zoro, Alessandro Isirdi, Nicola De’Angelis, Dieter G. Weber, Adrien M. Hodonou, Richard tenBroek, Dario Parini, Jim Khan, Giovanni Sbrana, Carlo Coniglio, Antonino Giarratano, Angelo Gratarola, Claudia Zaghi, Oreste Romeo, Michael Kelly, Francesco Forfori, Massimo Chiarugi, Ernest E. Moore, Fausto Catena, and Manu L. N. G. Malbrain

Subjects
Morbidity, Acute, Pain, Treatment, Emergency, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background Non-traumatic emergency general surgery involves a heterogeneous population that may present with several underlying diseases. Timeous emergency surgical treatment should be supplemented with high-quality perioperative care, ideally performed by multidisciplinary teams trained to identify and handle complex postoperative courses. Uncontrolled or poorly controlled acute postoperative pain may result in significant complications. While pain management after elective surgery has been standardized in perioperative pathways, the traditional perioperative treatment of patients undergoing emergency surgery is often a haphazard practice. The present recommended pain management guidelines are for pain management after non-traumatic emergency surgical intervention. It is meant to provide clinicians a list of indications to prescribe the optimal analgesics even in the absence of a multidisciplinary pain team. Material and methods An international expert panel discussed the different issues in subsequent rounds. Four international recognized scientific societies: World Society of Emergency Surgery (WSES), Global Alliance for Infection in Surgery (GAIS), Italian Society of Anesthesia, Analgesia Intensive Care (SIAARTI), and American Association for the Surgery of Trauma (AAST), endorsed the project and approved the final manuscript. Conclusion Dealing with acute postoperative pain in the emergency abdominal surgery setting is complex, requires special attention, and should be multidisciplinary. Several tools are available, and their combination is mandatory whenever is possible. Analgesic approach to the various situations and conditions should be patient based and tailored according to procedure, pathology, age, response, and available expertise. A better understanding of the patho-mechanisms of postoperative pain for short- and long-term outcomes is necessary to improve prophylactic and treatment strategies.

Published
2022
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4. Surgical Antibiotic Prophylaxis: A Proposal for a Global Evidence-Based Bundle

Author

Massimo Sartelli, Federico Coccolini, Francesco M. Labricciosa, AbdelKarim. H. Al Omari, Lovenish Bains, Oussama Baraket, Marco Catarci, Yunfeng Cui, Alberto R. Ferreres, George Gkiokas, Carlos Augusto Gomes, Adrien M. Hodonou, Arda Isik, Andrey Litvin, Varut Lohsiriwat, Vihar Kotecha, Vladimir Khokha, Igor A. Kryvoruchko, Gustavo M. Machain, Donal B. O’Connor, Iyiade Olaoye, Jamal A. K. Al-Omari, Alessandro Pasculli, Patrizio Petrone, Jennifer Rickard, Ibrahima Sall, Robert G. Sawyer, Orlando Téllez-Almenares, Fausto Catena, and Walter Siquini

Subjects
healthcare-associated infections, surgical site infections, surgical antibiotic prophylaxis, bundle, prevention, Therapeutics. Pharmacology, RM1-950
Abstract

In the multimodal strategy context, to implement healthcare-associated infection prevention, bundles are one of the most commonly used methods to adapt guidelines in the local context and transfer best practices into routine clinical care. One of the most important measures to prevent surgical site infections is surgical antibiotic prophylaxis (SAP). This narrative review aims to present a bundle for the correct SAP administration and evaluate the evidence supporting it. Surgical site infection (SSI) prevention guidelines published by the WHO, CDC, NICE, and SHEA/IDSA/APIC/AHA, and the clinical practice guidelines for SAP by ASHP/IDSA/SIS/SHEA, were reviewed. Subsequently, comprehensive searches were also conducted using the PubMed®/MEDLINE and Google Scholar databases, in order to identify further supporting evidence-based documentation. The bundle includes five different measures that may affect proper SAP administration. The measures included may be easily implemented in all hospitals worldwide and are based on minimal drug pharmacokinetics and pharmacodynamics knowledge, which all surgeons should know. Antibiotics for SAP should be prescribed for surgical procedures at high risk for SSIs, such as clean–contaminated and contaminated surgical procedures or for clean surgical procedures where SSIs, even if unlikely, may have devastating consequences, such as in procedures with prosthetic implants. SAP should generally be administered within 60 min before the surgical incision for most antibiotics (including cefazolin). SAP redosing is indicated for surgical procedures exceeding two antibiotic half-lives or for procedures significantly associated with blood loss. In principle, SAP should be discontinued after the surgical procedure. Hospital-based antimicrobial stewardship programmes can optimise the treatment of infections and reduce adverse events associated with antibiotics. In the context of a collaborative and interdisciplinary approach, it is essential to encourage an institutional safety culture in which surgeons are persuaded, rather than compelled, to respect antibiotic prescribing practices. In that context, the proposed bundle contains a set of evidence-based interventions for SAP administration. It is easy to apply, promotes collaboration, and includes measures that can be adequately followed and evaluated in all hospitals worldwide.

Published
2024
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5. A pandemic recap: lessons we have learned

Author

Federico Coccolini, Enrico Cicuttin, Camilla Cremonini, Dario Tartaglia, Bruno Viaggi, Akira Kuriyama, Edoardo Picetti, Chad Ball, Fikri Abu-Zidan, Marco Ceresoli, Bruno Turri, Sumita Jain, Carlo Palombo, Xavier Guirao, Gabriel Rodrigues, Mahir Gachabayov, Fernando Machado, Lostoridis Eftychios, Souha S. Kanj, Isidoro Di Carlo, Salomone Di Saverio, Vladimir Khokha, Andrew Kirkpatrick, Damien Massalou, Francesco Forfori, Francesco Corradi, Samir Delibegovic, Gustavo M. Machain Vega, Massimo Fantoni, Demetrios Demetriades, Garima Kapoor, Yoram Kluger, Shamshul Ansari, Ron Maier, Ari Leppaniemi, Timothy Hardcastle, Andras Vereczkei, Evika Karamagioli, Emmanouil Pikoulis, Mauro Pistello, Boris E. Sakakushev, Pradeep H. Navsaria, Rita Galeiras, Ali I. Yahya, Aleksei V. Osipov, Evgeni Dimitrov, Krstina Doklestić, Michele Pisano, Paolo Malacarne, Paolo Carcoforo, Maria Grazia Sibilla, Igor A. Kryvoruchko, Luigi Bonavina, Jae Il Kim, Vishal G. Shelat, Jacek Czepiel, Emilio Maseda, Sanjay Marwah, Mircea Chirica, Giandomenico Biancofiore, Mauro Podda, Lorenzo Cobianchi, Luca Ansaloni, Paola Fugazzola, Charalampos Seretis, Carlos Augusto Gomez, Fabio Tumietto, Manu Malbrain, Martin Reichert, Goran Augustin, Bruno Amato, Alessandro Puzziello, Andreas Hecker, Angelo Gemignani, Arda Isik, Alessandro Cucchetti, Mirco Nacoti, Doron Kopelman, Cristian Mesina, Wagih Ghannam, Offir Ben-Ishay, Sameer Dhingra, Raul Coimbra, Ernest E. Moore, Yunfeng Cui, Martha A. Quiodettis, Miklosh Bala, Mario Testini, Jose Diaz, Massimo Girardis, Walter L. Biffl, Matthias Hecker, Ibrahima Sall, Ugo Boggi, Gabriele Materazzi, Lorenzo Ghiadoni, Junichi Matsumoto, Wietse P. Zuidema, Rao Ivatury, Mushira A. Enani, Andrey Litvin, Majdi N. Al-Hasan, Zaza Demetrashvili, Oussama Baraket, Carlos A. Ordoñez, Ionut Negoi, Ronald Kiguba, Ziad A. Memish, Mutasim M. Elmangory, Matti Tolonen, Korey Das, Julival Ribeiro, Donal B. O’Connor, Boun Kim Tan, Harry Van Goor, Suman Baral, Belinda De Simone, Davide Corbella, Pietro Brambillasca, Michelangelo Scaglione, Fulvio Basolo, Nicola De’Angelis, Cino Bendinelli, Dieter Weber, Leonardo Pagani, Cinzia Monti, Gianluca Baiocchi, Massimo Chiarugi, Fausto Catena, and Massimo Sartelli

Subjects
Pandemia, International, Thoughts, Reflection, Ethics, Biology, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making.

Published
2021
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6. WSES/GAIS/SIS-E/WSIS/AAST global clinical pathways for patients with intra-abdominal infections

Author

Massimo Sartelli, Federico Coccolini, Yoram Kluger, Ervis Agastra, Fikri M. Abu-Zidan, Ashraf El Sayed Abbas, Luca Ansaloni, Abdulrashid Kayode Adesunkanmi, Boyko Atanasov, Goran Augustin, Miklosh Bala, Oussama Baraket, Suman Baral, Walter L. Biffl, Marja A. Boermeester, Marco Ceresoli, Elisabetta Cerutti, Osvaldo Chiara, Enrico Cicuttin, Massimo Chiarugi, Raul Coimbra, Elif Colak, Daniela Corsi, Francesco Cortese, Yunfeng Cui, Dimitris Damaskos, Nicola de’ Angelis, Samir Delibegovic, Zaza Demetrashvili, Belinda De Simone, Stijn W. de Jonge, Sameer Dhingra, Stefano Di Bella, Francesco Di Marzo, Salomone Di Saverio, Agron Dogjani, Therese M. Duane, Mushira Abdulaziz Enani, Paola Fugazzola, Joseph M. Galante, Mahir Gachabayov, Wagih Ghnnam, George Gkiokas, Carlos Augusto Gomes, Ewen A. Griffiths, Timothy C. Hardcastle, Andreas Hecker, Torsten Herzog, Syed Mohammad Umar Kabir, Aleksandar Karamarkovic, Vladimir Khokha, Peter K. Kim, Jae Il Kim, Andrew W. Kirkpatrick, Victor Kong, Renol M. Koshy, Igor A. Kryvoruchko, Kenji Inaba, Arda Isik, Katia Iskandar, Rao Ivatury, Francesco M. Labricciosa, Yeong Yeh Lee, Ari Leppäniemi, Andrey Litvin, Davide Luppi, Gustavo M. Machain, Ronald V. Maier, Athanasios Marinis, Cristina Marmorale, Sanjay Marwah, Cristian Mesina, Ernest E. Moore, Frederick A. Moore, Ionut Negoi, Iyiade Olaoye, Carlos A. Ordoñez, Mouaqit Ouadii, Andrew B. Peitzman, Gennaro Perrone, Manos Pikoulis, Tadeja Pintar, Giuseppe Pipitone, Mauro Podda, Kemal Raşa, Julival Ribeiro, Gabriel Rodrigues, Ines Rubio-Perez, Ibrahima Sall, Norio Sato, Robert G. Sawyer, Helmut Segovia Lohse, Gabriele Sganga, Vishal G. Shelat, Ian Stephens, Michael Sugrue, Antonio Tarasconi, Joel Noutakdie Tochie, Matti Tolonen, Gia Tomadze, Jan Ulrych, Andras Vereczkei, Bruno Viaggi, Chiara Gurioli, Claudio Casella, Leonardo Pagani, Gian Luca Baiocchi, and Fausto Catena

Subjects
Intra-abdominal infections, Peritonitis, Sepsis, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in hospitals worldwide. The cornerstones of effective treatment of IAIs include early recognition, adequate source control, appropriate antimicrobial therapy, and prompt physiologic stabilization using a critical care environment, combined with an optimal surgical approach. Together, the World Society of Emergency Surgery (WSES), the Global Alliance for Infections in Surgery (GAIS), the Surgical Infection Society-Europe (SIS-E), the World Surgical Infection Society (WSIS), and the American Association for the Surgery of Trauma (AAST) have jointly completed an international multi-society document in order to facilitate clinical management of patients with IAIs worldwide building evidence-based clinical pathways for the most common IAIs. An extensive non-systematic review was conducted using the PubMed and MEDLINE databases, limited to the English language. The resulting information was shared by an international task force from 46 countries with different clinical backgrounds. The aim of the document is to promote global standards of care in IAIs providing guidance to clinicians by describing reasonable approaches to the management of IAIs.

Published
2021
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7. Pancreatic Necrosis Infection as a Determinant of Multiple Organ Failure and Mortality in Acute Pancreatitis

Author

Igor A. Kryvoruchko, Valeriy V. Boyko, Massimo Sartelli, Yulia V. Ivanova, Denys O. Yevtushenko, and Andrij S. Honcharov

Subjects
acute necrotizing pancreatitis, pancreatic infection, treatment, bacterial strains, antibiotics, multiple organ failure, Medicine
Abstract

Several recommendations and data on the treatment of acute necrotizing pancreatitis (ANP) are conflicting and different surgical approaches continue to exist. We conducted a study on 148 patients with ANP, who were divided into two groups: the main group (n = 95) when the tactics of the step-up approach were applied with the principles of the concept of Enhanced Recovery After Surgery (ERAS) in order to determine this approach on effectiveness in reducing complications and 30-day mortality (2017–2022); the comparison group (n = 53) when the same tactic of the treatment was used without ERAS principles (2015–2016). Treatment time for the main group in the intensive care unit was minimized (p ≤ 0.004); it has been shown to reduce the frequency of complications in these patients (p < 0.001) requiring conservative or surgical treatment without general anaesthesia (Clavien-Dindo I-IIIa); no statistically significant differences were observed for the total incidence of Clavien-Dindo IIIb-IVb complications (p > 0.05); the median duration of treatment for patients in the primary group was 23 days, and in the reference group—34 days (p ≤ 0.003). Pancreatic infections have been observed in 92 (62.2%) patients and gram-negative bacteria predominated in the overall pathogen structure with 222 (70.7%) strains. The only evidence of multiple organ failure before (AUC = 0.814) and after surgery (AUC = 0.931) was found to be predictive of mortality. Antibiotic sensitivity of all isolated bacteria better understood local epidemiology and identified the most effective antibiotics when treating patients.

Published
2023
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8. It is time to define an organizational model for the prevention and management of infections along the surgical pathway: a worldwide cross-sectional survey

Author

Massimo Sartelli, Francesco M. Labricciosa, Federico Coccolini, Raul Coimbra, Fikri M. Abu-Zidan, Luca Ansaloni, Majdi N. Al-Hasan, Shamshul Ansari, Philip S. Barie, Miguel Angel Caínzos, Marco Ceresoli, Massimo Chiarugi, Jeffrey A. Claridge, Enrico Cicuttin, Evan Patchen Dellinger, Donald E. Fry, Xavier Guirao, Timothy Craig Hardcastle, Andreas Hecker, Ari K. Leppäniemi, Andrey Litvin, Sanjay Marwah, Emilio Maseda, John E. Mazuski, Ziad Ahmed Memish, Andrew W. Kirkpatrick, Leonardo Pagani, Mauro Podda, Huseyin Kemal Rasa, Boris E. Sakakushev, Robert G. Sawyer, Fabio Tumietto, Yonghong Xiao, Wedad Faraj Aboubreeg, Harissou Adamou, Lali Akhmeteli, Emrah Akin, Maria Grazia Alberio, Felipe Alconchel, Ibrahim Amadou Magagi, Ana Belén Araúz, Giulio Argenio, Boyko C. Atanasov, Semra Demirli Atici, Selmy Sabry Awad, Efstratia Baili, Lovenish Bains, Miklosh Bala, Oussama Baraket, Suman Baral, Vladislav A. Belskii, Moussa Benboubker, Offir Ben-Ishay, Pierpaolo Bordoni, Abdalia Boumédiène, Giuseppe Brisinda, Laura Cavazzuti, Sujith J. Chandy, Maria Michela Chiarello, Nicola Cillara, Guglielmo Clarizia, Maria-Elena Cocuz, Iuliu Gabriel Cocuz, Luigi Conti, Raffaella Coppola, Yunfeng Cui, Jacek Czepiel, Fabrizio D’Acapito, Dimitrios Damaskos, Koray Das, Belinda De Simone, Samir Delibegovic, Zaza Demetrashvili, Dzemail S. Detanac, Sameer Dhingra, Stefano Di Bella, Evgeni N. Dimitrov, Agron Dogjani, Mario D’Oria, Irina Magdalena Dumitru, Mutasim M. Elmangory, Octavian Enciu, Massimo Fantoni, Daniela Filipescu, Francesco Fleres, Domitilla Foghetti, Pietro Fransvea, Mahir Gachabayov, Rita Galeiras, Gianni Gattuso, Wagih M. Ghannam, Valeria Ghisetti, Giorgio Giraudo, Kebebe Bekele Gonfa, Emre Gonullu, Yousif Tag Elsir Y. Hamad, Matthias Hecker, Arda Isik, Nizar Ismail, Azzain Ismail, Sumita Agarwal Jain, Souha S. Kanj, Garima Kapoor, Ilias Karaiskos, Alfie J. Kavalakat, Jakub Kenig, Faryal Khamis, Vladimir Khokha, Ronald Kiguba, Jae Il Kim, Yoshiro Kobe, Kenneth Yuh Yen Kok, Bojan M. Kovacevic, Igor Andreevich Kryvoruchko, Akira Kuriyama, Aitor Landaluce-Olavarria, Konstantinos Lasithiotakis, Varut Lohsiriwat, Eftychios Lostoridis, Davide Luppi, Gustavo Miguel Machain Vega, Marc Maegele, Athanasios Marinis, Gennaro Martines, Aleix Martínez-Pérez, Damien Massalou, Cristian Mesina, Gökhan Metan, María Guadalupe Miranda-Novales, Shyam Kumar Mishra, Mohaned Ibrahim Hussein Mohamed, Ali Yasen Y. Mohamedahmed, Ismael Mora-Guzmán, Francesk Mulita, Ana-Maria Musina, Pradeep H. Navsaria, Ionut Negoi, Gabriela Elisa Nita, Donal B. O’Connor, Carlos Alberto Ordoñez, Desiré Pantalone, Arpád Panyko, Aristeidis Papadopoulos, Nikolaos Pararas, Francesco Pata, Tapan Patel, Gianluca Pellino, Teresa Perra, Gennaro Perrone, Antonio Pesce, Tadeja Pintar, Georgi Ivanov Popivanov, Alberto Porcu, Martha Alexa Quiodettis, Razrim Rahim, Ashrarur Rahman Mitul, Martin Reichert, Miran Rems, Glendee Yolande Reynolds Campbell, Nuno Rocha-Pereira, Gabriel Rodrigues, Gustavo Eduardo Roncancio Villamil, Stefano Rossi, Ibrahima Sall, Hossein Samadi Kafil, Diego Sasia, Jeremiah Seni, Charalampos Seretis, Mario Serradilla-Martín, Vishal G. Shelat, Boonying Siribumrungwong, Mihail Slavchev, Leonardo Solaini, Boun Kim Tan, Antonio Tarasconi, Dario Tartaglia, Elena Adelina Toma, Gia Tomadze, Adriana Toro, Marcos Roberto Tovani-Palone, Harry van Goor, Alin Vasilescu, Andras Vereczkei, Massimiliano Veroux, Sergio Alberto Weckmann, Lukas Werner Widmer, AliIbrahim Yahya, Sanoop K. Zachariah, Andee Dzulkarnaen Zakaria, Nadezhda Zubareva, Wietse P. Zuidema, Isidoro Di Carlo, Francesco Cortese, Gian Luca Baiocchi, Ronald V. Maier, and Fausto Catena

Subjects
Cross-sectional survey, Antimicrobial stewardship, Antibiotic prescribing, Antibiotic resistance, Infection prevention and control, Surgery, RD1-811, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9
Abstract

Abstract Background The objectives of the study were to investigate the organizational characteristics of acute care facilities worldwide in preventing and managing infections in surgery; assess participants’ perception regarding infection prevention and control (IPC) measures, antibiotic prescribing practices, and source control; describe awareness about the global burden of antimicrobial resistance (AMR) and IPC measures; and determine the role of the Coronavirus Disease 2019 pandemic on said awareness. Methods A cross-sectional web-based survey was conducted contacting 1432 health care workers (HCWs) belonging to a mailing list provided by the Global Alliance for Infections in Surgery. The self-administered questionnaire was developed by a multidisciplinary team. The survey was open from May 22, 2021, and June 22, 2021. Three reminders were sent, after 7, 14, and 21 days. Results Three hundred four respondents from 72 countries returned a questionnaire, with an overall response rate of 21.2%. Respectively, 90.4% and 68.8% of participants stated their hospital had a multidisciplinary IPC team or a multidisciplinary antimicrobial stewardship team. Local protocols for antimicrobial therapy of surgical infections and protocols for surgical antibiotic prophylaxis were present in 76.6% and 90.8% of hospitals, respectively. In 23.4% and 24.0% of hospitals no surveillance systems for surgical site infections and no monitoring systems of used antimicrobials were implemented. Patient and family involvement in IPC management was considered to be slightly or not important in their hospital by the majority of respondents (65.1%). Awareness of the global burden of AMR among HCWs was considered very important or important by 54.6% of participants. The COVID-19 pandemic was considered by 80.3% of respondents as a very important or important factor in raising HCWs awareness of the IPC programs in their hospital. Based on the survey results, the authors developed 15 statements for several questions regarding the prevention and management of infections in surgery. The statements may be the starting point for designing future evidence-based recommendations. Conclusion Adequacy of prevention and management of infections in acute care facilities depends on HCWs behaviours and on the organizational characteristics of acute health care facilities to support best practices and promote behavioural change. Patient involvement in the implementation of IPC is still little considered. A debate on how operationalising a fundamental change to IPC, from being solely the HCWs responsibility to one that involves a collaborative relationship between HCWs and patients, should be opened.

Published
2022
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9. Two years later: Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members

Author

Reichert, Martin, Sartelli, Massimo, Weigand, Markus A, Hecker, Matthias, Oppelt, Philip U, Noll, Julia, Askevold, Ingolf H, Liese, Juliane, Padberg, Winfried, Coccolini, Federico, Catena, Fausto, Hecker, Andreas, Adam Peckham-Cooper, Adrian Camacho-Ortiz, Aikaterini T. Mastoraki, Aitor Landaluce-Olavarria, Ajay Kumar Pal, Akira Kuriyama, Alain Chichom-Mefire, Alberto Porcu, Aleix Martínez-Pérez, Aleksandar R. Karamarkovic, Aleksei V. Osipov, Alessandro Coppola, Alessandro Cucchetti, Alessandro Spolini, Alessio Giordano, Alexander Reinisch-Liese, Alfie J. Kavalakat, Alin Vasilescu, Amin Alamin, Amit Gupta, Ana Maria Dascalu, Ana-Maria Musina, Anargyros Bakopoulos, Andee Dzulkarnaen Zakaria, Andras Vereczkei, Andrea Balla, Andrea Bottari, Andreas Baumann, Andreas Fette, Andrey Litvin, Aniella Katharina Reichert, Anna Guariniello, Anna Paspala, Anne-Sophie Schneck, Antonio Brillantino, Antonio Pesce, Arda Isik, Ari Kalevi Leppäniemi, Aristeidis Papadopoulos, Aristotelis Kechagias, Ashraf Yehya Abdalla Mohamed, Ashrarur Rahman Mitul, Athanasios Marinis, Athanasios Syllaios, Baris Mantoglu, Belinda De Simone, Benjamin Stefan Weiss, Bernd Pösentrup, Biagio Picardi, Biagio Zampogna, Boris Eugeniev Sakakushev, Boyko Chavdarov Atanasov, Bruno Nardo, Bulent Calik, Camilla Cremonini, Carlos A. Ordoñez, Charalampos Seretis, Chiara Cascone, Christos Chouliaras, Cino Bendinelli, Claudia Lopes, Claudio Guerci, Clemens Weber, Constantinos Nastos, Cristian Mesina, Damiano Caputo, Damien Massalou, Davide Cavaliere, Deborah A. McNamara, Demetrios Demetriades, Desirè Pantalone, Diego Coletta, Diego Sasia, Diego Visconti, Dieter G. Weber, Diletta Corallino, Dimitrios Chatzipetris, Dimitrios K. Manatakis, Dimitrios Ntourakis, Dimitrios Papaconstantinou, Dimitrios Schizas, Dimosthenis Chrysikos, Dmitry Mikhailovich Adamovich, Doaa Elkafrawy, Dragos Seban, Edgar Fernando Hernandez García, Edoardo Baldini, Edoardo Picetti, Edward C. T. H. Tan, Efstratia Baili, Eftychios Lostoridis, Elena Adelina Toma, Elif Colak, Elisabetta Cerutti, Elmin Steyn, Elmuiz A. Hsabo, Emmanouil Ioannis Kapetanakis, Emmanouil Kaouras, Emmanuel Schneck, Emrah Akin, Emre Gonullu, Enes çelik, Enrico Cicuttin, Enrico Pinotti, Erik Johnsson, Ernest E. Moore, Ervis Agastra, Evgeni Nikolaev Dimitrov, Ewen A. Griffiths, Fabrizio D’Acapito, Federica Saraceno, Felipe Alconchel, Felix Alexander Zeppernick, Fernando Machado Rodríguez, Fikri Abu-Zidan, Francesca Pecchini, Francesco Favi, Francesco Ferrara, Francesco Fleres, Francesco Pata, Francesco Pietro Maria Roscio, Francesk Mulita, Frank J. M. F. Dor, Fredrik Linder, Gabriel Dimofte, Gabriel Rodrigues, Gabriela Nita, Gabriele Sganga, Gennaro Martines, Gennaro Mazzarella, Gennaro Perrone, George Velmahos, Georgios D. Lianos, Gia Tomadze, Gian Luca Baiocchi, Giancarlo D’Ambrosio, Gianluca Pellino, Gianmaria Casoni Pattacini, Giorgio Giraudo, Giorgio Lisi, Giovanni Domenico Tebala, Giovanni Pirozzolo, Giulia Montori, Giulio Argenio, Giuseppe Brisinda, Giuseppe Currò, Giuseppe Giuliani, Giuseppe Palomba, Giuseppe Roscitano, Gökhan Avşar, Goran Augustin, Guglielmo Clarizia, Gustavo M. Machain Vega, Gustavo P. Fraga, Harsheet Sethi, Hazim Abdulnassir Eltyeb, Helmut A. Segovia Lohse, Herald René Segovia Lohse, Hüseyin Bayhan, Hytham K. S. Hamid, Igor A. Kryvoruchko, Immacolata Iannone, Imtiaz Wani, Ioannis I. Lazaridis, Ioannis Katsaros, Ioannis Nikolopoulos, Ionut Negoi, Isabella Reccia, Isidoro Di Carlo, Iyiade Olatunde Olaoye, Jacek Czepiel, Jae Il Kim, Jeremy Meyer, Jesus Manuel Saenz Terrazas, Joel Noutakdie Tochie, Joseph M. Galante, Justin Davies, Kapil Sugand, Kebebe Bekele Gonfa, Kemal Rasa, Kenneth Y. Y. Kok, Konstantinos G. Apostolou, Konstantinos Lasithiotakis, Konstantinos Tsekouras, Kumar Angamuthu, Lali Akhmeteli, Larysa Sydorchuk, Laura Fortuna, Leandro Siragusa, Leonardo Pagani, Leonardo Solaini, Lisa A. Miller, Lovenish Bains, Luca Ansaloni, Luca Ferrario, Luigi Bonavina, Luigi Conti, Luis Antonio Buonomo, Luis Tallon-Aguilar, Lukas Tomczyk, Lukas Werner Widmer, Maciej Walędziak, Mahir Gachabayov, Maloni M. Bulanauca, Manu L. N. G. Malbrain, Marc Maegele, Marco Catarci, Marco Ceresoli, Maria Chiara Ranucci, Maria Ioanna Antonopoulou, Maria Papadoliopoulou, Maria Rosaria Valenti, Maria Sotiropoulou, Mario D’Oria, Mario Serradilla Martín, Markus Hirschburger, Massimiliano Veroux, Massimo Fantoni, Matteo Nardi, Matti Tolonen, Mauro Montuori, Mauro Podda, Maximilian Scheiterle, Maximos Frountzas, Mehmet Sarıkaya, Mehmet Yildirim, Michael Bender, Michail Vailas, Michel Teuben, Michela Campanelli, Michele Ammendola, Michele Malerba, Michele Pisano, Mihaela Pertea, Mihail Slavchev, Mika Ukkonen, Miklosh Bala, Mircea Chirica, Mirko Barone, Mohamed Maher Shaat, Mohammed Jibreel Suliman Mohammed, Mona Awad Akasha Abuelgasim, Monika Gureh, Mouaqit Ouadii, Mujdat Balkan, Mumin Mohamed, Musluh Hakseven, Natalia Velenciuc, Nicola Cillara, Nicola de’Angelis, Nicolò Tamini, Nikolaos J. Zavras, Nikolaos Machairas, Nikolaos Michalopoulos, Nikolaos N. Koliakos, Nikolaos Pararas, Noel E. Donlon, Noushif Medappil, Offir Ben-Ishay, Olmi Stefano, Omar Islam, Ömer Tammo, Orestis Ioannidis, Oscar Aparicio, Oussama Baraket, Pankaj Kumar, Pasquale Cianci, Per Örtenwall, Petar Angelov Uchikov, Philip de Reuver, Philip F. Stahel, Philip S. Barie, Micaela Piccoli, Piotr Major, Pradeep H. Navsaria, Prakash Kumar Sasmal, Raul Coimbra, Razrim Rahim, Recayi Çapoğlu, Renol M. Koshy, Ricardo Alessandro Teixeira Gonsaga, Riccardo Pertile, Rifat Ramadan Mussa Mohamed, Rıza Deryol, Robert G. Sawyer, Roberta Angelico, Roberta Ragozzino, Roberto Bini, Roberto Cammarata, Rosa Scaramuzzo, Rossella Gioco, Ruslan Sydorchuk, Salma Ahmed, Salomone Di Saverio, Sameh Hany Emile, Samir Delibegovic, Sanjay Marwah, Savvas Symeonidis, Scott G. Thomas, Sebahattin Demir, Selmy S. Awad, Semra Demirli Atici, Serge Chooklin, Serhat Meric, Sevcan Sarıkaya, Sharfuddin Chowdhury, Shaza Faycal Mirghani, Sherry M. Wren, Simone Gargarella, Simone Rossi Del Monte, Sofia Esposito, Sofia Xenaki, Soliman Fayez Ghedan Mohamed, Solomon Gurmu Beka, Sorinel Lunca, Spiros G. Delis, Spyridon Dritsas, Stefan Morarasu, Stefano Magnone, Stefano Rossi, Stefanos Bitsianis, Stylianos Kykalos, Suman Baral, Sumita A. Jain, Syed Muhammad Ali, Tadeja Pintar, Tania Triantafyllou, Tarik Delko, Teresa Perra, Theodoros A. Sidiropoulos, Thomas M. Scalea, Tim Oliver Vilz, Timothy Craig Hardcastle, Tongporn Wannatoop, Torsten Herzog, Tushar Subhadarshan Mishra, Ugo Boggi, Valentin Calu, Valentina Tomajer, Vanni Agnoletti, Varut Lohsiriwat, Victor Kong, Virginia Durán Muñoz-Cruzado, Vishal G. Shelat, Vladimir Khokha, Wagih Mommtaz Ghannam, Walter L. Biffl, Wietse Zuidema, Yasin Kara, Yoshiro Kobe, Zaza Demetrashvili, Ziad A. Memish, Zoilo Madrazo, Zsolt J. Balogh, Zulfu Bayhan, Surgery, AMS - Musculoskeletal Health, Other Research, APH - Quality of Care, Reichert, Martin, Sartelli, Massimo, Weigand, Markus A, Hecker, Matthia, Oppelt, Philip U, Noll, Julia, Askevold, Ingolf H, Liese, Juliane, Padberg, Winfried, Coccolini, Federico, Catena, Fausto, Hecker, Andrea, Adam Peckham-Cooper, Adrian Camacho-Ortiz, Aikaterini T. Mastoraki, Aitor Landaluce-Olavarria, Ajay Kumar Pal, Akira Kuriyama, Alain Chichom-Mefire, Alberto Porcu, Aleix Martínez-Pérez, Aleksandar R. Karamarkovic, Aleksei V. Osipov, Alessandro Coppola, Alessandro Cucchetti, Alessandro Spolini, Alessio Giordano, Alexander Reinisch-Liese, Alfie J. Kavalakat, Alin Vasilescu, Amin Alamin, Amit Gupta, Ana Maria Dascalu, Ana-Maria Musina, Anargyros Bakopoulos, Andee Dzulkarnaen Zakaria, Andras Vereczkei, Andrea Balla, Andrea Bottari, Andreas Baumann, Andreas Fette, Andrey Litvin, Aniella Katharina Reichert, Anna Guariniello, Anna Paspala, Anne-Sophie Schneck, Antonio Brillantino, Antonio Pesce, Arda Isik, Ari Kalevi Leppäniemi, Aristeidis Papadopoulos, Aristotelis Kechagias, Ashraf Yehya Abdalla Mohamed, Ashrarur Rahman Mitul, Athanasios Marinis, Athanasios Syllaios, Baris Mantoglu, Belinda De Simone, Benjamin Stefan Weiss, Bernd Pösentrup, Biagio Picardi, Biagio Zampogna, Boris Eugeniev Sakakushev, Boyko Chavdarov Atanasov, Bruno Nardo, Bulent Calik, Camilla Cremonini, Carlos A. Ordoñez, Charalampos Seretis, Chiara Cascone, Christos Chouliaras, Cino Bendinelli, Claudia Lopes, Claudio Guerci, Clemens Weber, Constantinos Nastos, Cristian Mesina, Damiano Caputo, Damien Massalou, Davide Cavaliere, Deborah A. McNamara, Demetrios Demetriades, Desirè Pantalone, Diego Coletta, Diego Sasia, Diego Visconti, Dieter G. Weber, Diletta Corallino, Dimitrios Chatzipetris, Dimitrios K. Manatakis, Dimitrios Ntourakis, Dimitrios Papaconstantinou, Dimitrios Schizas, Dimosthenis Chrysikos, Dmitry Mikhailovich Adamovich, Doaa Elkafrawy, Dragos Seban, Edgar Fernando Hernandez García, Edoardo Baldini, Edoardo Picetti, Edward C. T. H. Tan, Efstratia Baili, Eftychios Lostoridis, Elena Adelina Toma, Elif Colak, Elisabetta Cerutti, Elmin Steyn, Elmuiz A. Hsabo, Emmanouil Ioannis Kapetanakis, Emmanouil Kaouras, Emmanuel Schneck, Emrah Akin, Emre Gonullu, Enes çelik, Enrico Cicuttin, Enrico Pinotti, Erik Johnsson, Ernest E. Moore, Ervis Agastra, Evgeni Nikolaev Dimitrov, Ewen A. Griffiths, Fabrizio D’Acapito, Federica Saraceno, Felipe Alconchel, Felix Alexander Zeppernick, Fernando Machado Rodríguez, Fikri Abu-Zidan, Francesca Pecchini, Francesco Favi, Francesco Ferrara, Francesco Fleres, Francesco Pata, Francesco Pietro Maria Roscio, Francesk Mulita, Frank J. M. F. Dor, Fredrik Linder, Gabriel Dimofte, Gabriel Rodrigues, Gabriela Nita, Gabriele Sganga, Gennaro Martines, Gennaro Mazzarella, Gennaro Perrone, George Velmahos, Georgios D. Lianos, Gia Tomadze, Gian Luca Baiocchi, Giancarlo D’Ambrosio, Gianluca Pellino, Gianmaria Casoni Pattacini, Giorgio Giraudo, Giorgio Lisi, Giovanni Domenico Tebala, Giovanni Pirozzolo, Giulia Montori, Giulio Argenio, Giuseppe Brisinda, Giuseppe Currò, Giuseppe Giuliani, Giuseppe Palomba, Giuseppe Roscitano, Gökhan Avşar, Goran Augustin, Guglielmo Clarizia, Gustavo M. Machain Vega, Gustavo P. Fraga, Harsheet Sethi, Hazim Abdulnassir Eltyeb, Helmut A. Segovia Lohse, Herald René Segovia Lohse, Hüseyin Bayhan, Hytham K. S. Hamid, Igor A. Kryvoruchko, Immacolata Iannone, Imtiaz Wani, Ioannis I. Lazaridis, Ioannis Katsaros, Ioannis Nikolopoulos, Ionut Negoi, Isabella Reccia, Isidoro Di Carlo, Iyiade Olatunde Olaoye, Jacek Czepiel, Jae Il Kim, Jeremy Meyer, Jesus Manuel Saenz Terrazas, Joel Noutakdie Tochie, Joseph M. Galante, Justin Davies, Kapil Sugand, Kebebe Bekele Gonfa, Kemal Rasa, Kenneth Y. Y. Kok, Konstantinos G. Apostolou, Konstantinos Lasithiotakis, Konstantinos Tsekouras, Kumar Angamuthu, Lali Akhmeteli, Larysa Sydorchuk, Laura Fortuna, Leandro Siragusa, Leonardo Pagani, Leonardo Solaini, Lisa A. Miller, Lovenish Bains, Luca Ansaloni, Luca Ferrario, Luigi Bonavina, Luigi Conti, Luis Antonio Buonomo, Luis Tallon-Aguilar, Lukas Tomczyk, Lukas Werner Widmer, Maciej Walędziak, Mahir Gachabayov, Maloni M. Bulanauca, Manu L. N. G. Malbrain, Marc Maegele, Marco Catarci, Marco Ceresoli, Maria Chiara Ranucci, Maria Ioanna Antonopoulou, Maria Papadoliopoulou, Maria Rosaria Valenti, Maria Sotiropoulou, Mario D’Oria, Mario Serradilla Martín, Markus Hirschburger, Massimiliano Veroux, Massimo Fantoni, Matteo Nardi, Matti Tolonen, Mauro Montuori, Mauro Podda, Maximilian Scheiterle, Maximos Frountzas, Mehmet Sarıkaya, Mehmet Yildirim, Michael Bender, Michail Vailas, Michel Teuben, Michela Campanelli, Michele Ammendola, Michele Malerba, Michele Pisano, Mihaela Pertea, Mihail Slavchev, Mika Ukkonen, Miklosh Bala, Mircea Chirica, Mirko Barone, Mohamed Maher Shaat, Mohammed Jibreel Suliman Mohammed, Mona Awad Akasha Abuelgasim, Monika Gureh, Mouaqit Ouadii, Mujdat Balkan, Mumin Mohamed, Musluh Hakseven, Natalia Velenciuc, Nicola Cillara, Nicola de’Angelis, Nicolò Tamini, Nikolaos J. Zavras, Nikolaos Machairas, Nikolaos Michalopoulos, Nikolaos N. Koliakos, Nikolaos Pararas, Noel E. Donlon, Noushif Medappil, Offir Ben-Ishay, Olmi Stefano, Omar Islam, Ömer Tammo, Orestis Ioannidis, Oscar Aparicio, Oussama Baraket, Pankaj Kumar, Pasquale Cianci, Per Örtenwall, Petar Angelov Uchikov, Philip de Reuver, Philip F. Stahel, Philip S. Barie, Micaela Piccoli, Piotr Major, Pradeep H. Navsaria, Prakash Kumar Sasmal, Raul Coimbra, Razrim Rahim, Recayi Çapoğlu, Renol M. Koshy, Ricardo Alessandro Teixeira Gonsaga, Riccardo Pertile, Rifat Ramadan Mussa Mohamed, Rıza Deryol, Robert G. Sawyer, Roberta Angelico, Roberta Ragozzino, Roberto Bini, Roberto Cammarata, Rosa Scaramuzzo, Rossella Gioco, Ruslan Sydorchuk, Salma Ahmed, Salomone Di Saverio, Sameh Hany Emile, Samir Delibegovic, Sanjay Marwah, Savvas Symeonidis, Scott G. Thomas, Sebahattin Demir, Selmy S. Awad, Semra Demirli Atici, Serge Chooklin, Serhat Meric, Sevcan Sarıkaya, Sharfuddin Chowdhury, Shaza Faycal Mirghani, Sherry M. Wren, Simone Gargarella, Simone Rossi Del Monte, Sofia Esposito, Sofia Xenaki, Soliman Fayez Ghedan Mohamed, Solomon Gurmu Beka, Sorinel Lunca, Spiros G. Delis, Spyridon Dritsas, Stefan Morarasu, Stefano Magnone, Stefano Rossi, Stefanos Bitsianis, Stylianos Kykalos, Suman Baral, Sumita A. Jain, Syed Muhammad Ali, Tadeja Pintar, Tania Triantafyllou, Tarik Delko, Teresa Perra, Theodoros A. Sidiropoulos, Thomas M. Scalea, Tim Oliver Vilz, Timothy Craig Hardcastle, Tongporn Wannatoop, Torsten Herzog, Tushar Subhadarshan Mishra, Ugo Boggi, Valentin Calu, Valentina Tomajer, Vanni Agnoletti, Varut Lohsiriwat, Victor Kong, Virginia Durán Muñoz-Cruzado, Vishal G. Shelat, Vladimir Khokha, Wagih Mommtaz Ghannam, Walter L. Biffl, Wietse Zuidema, Yasin Kara, Yoshiro Kobe, Zaza Demetrashvili, Ziad A. Memish, Zoilo Madrazo, Zsolt J. Balogh, Zulfu Bayhan, Reichert, M, Sartelli, M, Weigand, M, Hecker, M, Oppelt, P, Noll, J, Askevold, I, Liese, J, Padberg, W, Coccolini, F, Catena, F, Hecker, A, Peckham-Cooper, A, Camacho-Ortiz, A, Mastoraki, A, Landaluce-Olavarria, A, Pal, A, Kuriyama, A, Chichom-Mefire, A, Porcu, A, Martinez-Perez, A, Karamarkovic, A, Osipov, A, Coppola, A, Cucchetti, A, Spolini, A, Giordano, A, Reinisch-Liese, A, Kavalakat, A, Vasilescu, A, Alamin, A, Gupta, A, Dascalu, A, Musina, A, Bakopoulos, A, Zakaria, A, Vereczkei, A, Balla, A, Bottari, A, Baumann, A, Fette, A, Litvin, A, Reichert, A, Guariniello, A, Paspala, A, Schneck, A, Brillantino, A, Pesce, A, Isik, A, Leppaniemi, A, Papadopoulos, A, Kechagias, A, Mohamed, A, Mitul, A, Marinis, A, Syllaios, A, Mantoglu, B, De Simone, B, Weiss, B, Posentrup, B, Picardi, B, Zampogna, B, Sakakushev, B, Atanasov, B, Nardo, B, Calik, B, Cremonini, C, Ordonez, C, Seretis, C, Cascone, C, Chouliaras, C, Bendinelli, C, Lopes, C, Guerci, C, Weber, C, Nastos, C, Mesina, C, Caputo, D, Massalou, D, Cavaliere, D, Mcnamara, D, Demetriades, D, Pantalone, D, Coletta, D, Sasia, D, Visconti, D, Weber, D, Corallino, D, Chatzipetris, D, Manatakis, D, Ntourakis, D, Papaconstantinou, D, Schizas, D, Chrysikos, D, Adamovich, D, Elkafrawy, D, Seban, D, Garcia, E, Baldini, E, Picetti, E, Tan, E, Baili, E, Lostoridis, E, Toma, E, Colak, E, Cerutti, E, Steyn, E, Hsabo, E, Kapetanakis, E, Kaouras, E, Schneck, E, Akin, E, Gonullu, E, Celik, E, Cicuttin, E, Pinotti, E, Johnsson, E, Moore, E, Agastra, E, Dimitrov, E, Griffiths, E, D'Acapito, F, Saraceno, F, Alconchel, F, Zeppernick, F, Rodriguez, F, Abu-Zidan, F, Pecchini, F, Favi, F, Ferrara, F, Fleres, F, Pata, F, Roscio, F, Mulita, F, Dor, F, Linder, F, Dimofte, G, Rodrigues, G, Nita, G, Sganga, G, Martines, G, Mazzarella, G, Perrone, G, Velmahos, G, Lianos, G, Tomadze, G, Baiocchi, G, D'Ambrosio, G, Pellino, G, Pattacini, G, Giraudo, G, Lisi, G, Tebala, G, Pirozzolo, G, Montori, G, Argenio, G, Brisinda, G, Curro, G, Giuliani, G, Palomba, G, Roscitano, G, Avsar, G, Augustin, G, Clarizia, G, Vega, G, Fraga, G, Sethi, H, Eltyeb, H, Lohse, H, Bayhan, H, Hamid, H, Kryvoruchko, I, Iannone, I, Wani, I, Lazaridis, I, Katsaros, I, Nikolopoulos, I, Negoi, I, Reccia, I, Di Carlo, I, Olaoye, I, Czepiel, J, Kim, J, Meyer, J, Terrazas, J, Tochie, J, Galante, J, Davies, J, Sugand, K, Gonfa, K, Rasa, K, Kok, K, Apostolou, K, Lasithiotakis, K, Tsekouras, K, Angamuthu, K, Akhmeteli, L, Sydorchuk, L, Fortuna, L, Siragusa, L, Pagani, L, Solaini, L, Miller, L, Bains, L, Ansaloni, L, Ferrario, L, Bonavina, L, Conti, L, Buonomo, L, Tallon-Aguilar, L, Tomczyk, L, Widmer, L, Waledziak, M, Gachabayov, M, Bulanauca, M, Malbrain, M, Maegele, M, Catarci, M, Ceresoli, M, Ranucci, M, Antonopoulou, M, Papadoliopoulou, M, Valenti, M, Sotiropoulou, M, D'Oria, M, Martin, M, Hirschburger, M, Veroux, M, Fantoni, M, Nardi, M, Tolonen, M, Montuori, M, Podda, M, Scheiterle, M, Frountzas, M, Sarikaya, M, Yildirim, M, Bender, M, Vailas, M, Teuben, M, Campanelli, M, Ammendola, M, Malerba, M, Pisano, M, Pertea, M, Slavchev, M, Ukkonen, M, Bala, M, Chirica, M, Barone, M, Shaat, M, Mohammed, M, Abuelgasim, M, Gureh, M, Ouadii, M, Balkan, M, Mohamed, M, Hakseven, M, Velenciuc, N, Cillara, N, De'Angelis, N, Tamini, N, Zavras, N, Machairas, N, Michalopoulos, N, Koliakos, N, Pararas, N, Donlon, N, Medappil, N, Ben-Ishay, O, Stefano, O, Islam, O, Tammo, O, Ioannidis, O, Aparicio, O, Baraket, O, Kumar, P, Cianci, P, Ortenwall, P, Uchikov, P, de Reuver, P, Stahel, P, Barie, P, Piccoli, M, Major, P, Navsaria, P, Sasmal, P, Coimbra, R, Rahim, R, Capoglu, R, Koshy, R, Gonsaga, R, Pertile, R, Mohamed, R, Deryol, R, Sawyer, R, Angelico, R, Ragozzino, R, Bini, R, Cammarata, R, Scaramuzzo, R, Gioco, R, Sydorchuk, R, Ahmed, S, Di Saverio, S, Emile, S, Delibegovic, S, Marwah, S, Symeonidis, S, Thomas, S, Demir, S, Awad, S, Atici, S, Chooklin, S, Meric, S, Sarikaya, S, Chowdhury, S, Mirghani, S, Wren, S, Gargarella, S, Del Monte, S, Esposito, S, Xenaki, S, Mohamed, S, Beka, S, Lunca, S, Delis, S, Dritsas, S, Morarasu, S, Magnone, S, Rossi, S, Bitsianis, S, Kykalos, S, Baral, S, Jain, S, Ali, S, Pintar, T, Triantafyllou, T, Delko, T, Perra, T, Sidiropoulos, T, Scalea, T, Vilz, T, Hardcastle, T, Wannatoop, T, Herzog, T, Mishra, T, Boggi, U, Calu, V, Tomajer, V, Agnoletti, V, Lohsiriwat, V, Kong, V, Munoz-Cruzado, V, Shelat, V, Khokha, V, Ghannam, W, Biffl, W, Zuidema, W, Kara, Y, Kobe, Y, Demetrashvili, Z, Memish, Z, Madrazo, Z, Balogh, Z, and Bayhan, Z

Subjects
Cross-Sectional Studie, ddc:610, Capacity, Pandemic, SARS-CoV-2, COVID-19, WSES, Time to intervention, Appendicitis, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Cross-Sectional Studies, Emergency, Quarantine, Emergency Medicine, Emergency surgery, Humans, Surgery, Appendiciti, COVID-19, SARS-CoV-2, Pandemic, Emergency surgery, Emergency, Appendicitis, WSES, Time to intervention, Capacity, Quarantine, Pandemics, Diverticulitis, Human
Abstract

Background The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years.

Published
2022

10. Investigate the Possibility of Using Phosphorescence in Clinical Oncology as an Early Prognostic Test in Detecting Brain Carcinogenesis

Author

Yuriy O. Vinnyk, Igor A. Kryvoruchko, Valeriy V. Boyko, Yulia V. Ivanova, Svetlana Gramatiuk, and Karine Sargsyan

Subjects
Clinical Psychology, Sociology and Political Science, Clinical Biochemistry, Law, Biochemistry, Spectroscopy, Social Sciences (miscellaneous)
Abstract

Phosphorescence is considered one of the non-invasive glioblastoma testing methods based on studying molecular energy and the metabolism of L-tryptophan (Trp) through KP, which provides essential information on regulating immunity and neuronal function. This study aimed to conduct a feasibility study using phosphorescence in clinical oncology as an early prognostic test in detecting Glioblastoma. Materials and Methods. This study was conducted on 1039 patients who were operated on with follow-up between January 1, 2014, and December 1, 2022, and retrospectively evaluated in participating institutions in Ukraine (the Department of Oncology, Radiation Therapy, Oncosurgery, and Palliative Care at the Kharkiv National Medical University). Method of protein phosphorescence detection included two steps. During the first step, of luminol-dependent phosphorescence intensity in serum was carried out after its activation by the light source, according to the spectrofluorimeter method, as follows. At a temperature of 30oC, serum drops were dried for 20 minutes to form a solid film. After that, we put the quartz plate with dried serum in a phosphoroscope of luminescent complex and measured the intensity. With the help of Max-Flux Diffraction Optic Parallel Beam Graded Multilayer Monochromator (Rigaku Americas Corporation) following spectral lines as 297, 313, 334, 365, 404, and 434 nm were distinguished and absorbed by serum film in the form of light quantum. The monochromator exit split width was 0.5 mm. Results and conclusion. Considering the limitations of each of the non-invasive tools currently available, phosphorescence-based diagnostic methods are ideally integrated into the NIGT platform: a non-invasive approach for visualizing a tumor and its main tumor characteristics in the spatial and temporal order. Because trp is present in virtually every cell in the body, these fluorescent and phosphorescent fingerprints can be used to detect cancer in many different organs. Using phosphorescence, it is possible to create predictive models for GBM in both primary and secondary diagnostics. This will assist clinicians in selecting the appropriate treatment option, monitoring treatment, and adapting to the era of patient-centered precision medicine.

Published
2023

11. ADHESIVE OBSTRUCTION OF THE SMALL INTESTINE: FEATURES OF DIAGNOSIS AND TREATMENT IN THE CONTEXT OF MINIMALLY INVASIVE TECHNOLOGIES: review

Author

Oleksandr Olefir and Igor A. Kryvoruchko

Abstract

The review presents a modern view on the features of the course and treatment of adhesions of the small intestine, based on modern epidemiological data, accepted guidelines for the diagnosis and nature of the treatment of different categories of patients. It is noted that adhesive intestinal obstruction is a symptom complex due to violation of the movement of contents through the intestines due to the presence of adhesions in the abdominal cavity after operations and injuries. Attention is drawn to the peculiarities of diagnostics of various forms of the disease, which include the leading clinical symptoms, data of X-ray methods (X-ray and CT of the abdominal cavity), MRI, assessment of various biomarkers, indicators of the severity of the patient's condition. It is noted that at present the primary task in solving this problem is to study several controversial issues in this area. The main provisions of measures for the treatment of adhesive obstruction of the small intestine, based on the principles of non-surgical treatment in a certain category of patients, the use of surgical interventions strictly according to indications, especially in patients who need to perform repeated operations, were highlighted. Among them, special attention is paid to the features of open and minimally invasive surgical interventions. It is emphasized that at present, minimally invasive surgical interventions perform the main tasks of surgical treatment for adhesive ileus of the small intestine and significantly reduce surgical trauma in comparison with "open" methods of treatment, but these interventions have not widespread in the world yet.

Published
2022

12. SURGICAL TREATMENT OF ACUTE SMALL BOWEL OBSTRUCTION: CLINICAL AND LABORATORY PARAMETERS ASSOCIATED WITH STRANGULATION AND EARLY MORTALITY AFTER SURGERY

Author

Igor A. Kryvoruchko, Valeriy V. Boyko, Massimo Sartelli, Federico Coccolini, Fausto Catena, and Olexander S. Olefir

Subjects
General Medicine
Abstract

The aim: The study aimed to evaluate some criteria for preoperative diagnosis of strangulation and significant indicators of the prognosis of short-term outcomes in patients with small bowel obstruction. Materials and methods: The results of the treatment of 123 patients aged 18–70 years with SBO were evaluated. Results: All of these patients underwent emergency surgery, and 22 patients (17.9%) have died. It has been shown that four lab parameters (blood leukocytes, lactate, intestinal fatty acid-binding protein, and C-reactive protein levels) and one instrumental (involving the mesentery of the small intestine, free fluid in the abdomen during CT) with 80% probability or more were associated with the strangulation type of SBO (Λ=0.276, p = 0.000). Three lab indicators (WBC count, serum lactate, and intestinal fatty acid-binding protein levels) and two clinical parameters (abdominal perfusion pressure level and the presence of abdominal sepsis) were associated with early mortality after surgery (Λ=0.626, p = 0.000) with the same probability. Immediate results of the treatment in these patients depended on the development of intra-abdominal complications after surgery (P = 0.024) and the need for early reoperation (P = 0.006) as well as the development of cardiovascular dysfunction (P = 0.000) and respiratory dysfunction (P = 0.000). Conclusions: There were confirmed parameters that were significantly associated with strangulation before surgery and short-term in-hospital mortality with an 80% probability or more. This made it possible to develop new mathematical models for the diagnosis of strangulated bowel obstruction and early postoperative mortality with an accuracy of 84.5% and 84.2%, respectively.

Published
2022

13. Surgeons' perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey

Author

Cobianchi, Lorenzo, Piccolo, Daniele, Dal Mas, Francesca, Agnoletti, Vanni, Ansaloni, Luca, Balch, Jeremy, Biffl, Walter, Butturini, Giovanni, Catena, Fausto, Coccolini, Federico, Denicolai, Stefano, De Simone, Belinda, Frigerio, Isabella, Fugazzola, Paola, Marseglia, Gianluigi, Marseglia, Giuseppe Roberto, Martellucci, Jacopo, Modenese, Mirko, Previtali, Pietro, Ruta, Federico, Venturi, Alessandro, Kaafarani, Haytham M, Loftus, Tyler J, Kenneth Lyle Abbott, Abubaker Abdelmalik, Nebyou Seyoum Abebe, Fikri Abu-Zidan, Yousif Abdallah Yousif Adam, Harissou Adamou, Dmitry Mikhailovich Adamovich, Ferdinando Agresta, Antonino Agrusa, Emrah Akin, Mario Alessiani, Henrique Alexandrino, Syed Muhammad Ali, Vasilescu Alin Mihai, Pedro Miguel Almeida, Mohammed Mohammed Al-Shehari, Michele Altomare, Francesco Amico, Michele Ammendola, Jacopo Andreuccetti, Elissavet Anestiadou, Peter Angelos, Alfredo Annicchiarico, Amedeo Antonelli, Daniel Aparicio-Sanchez, Antonella Ardito, Giulio Argenio, Catherine Claude Arvieux, Ingolf Harald Askevold, Boyko Tchavdarov Atanasov, Goran Augustin, Selmy Sabry Awad, Giulia Bacchiocchi, Carlo Bagnoli, Hany Bahouth, Efstratia Baili, Lovenish Bains, Gian Luca Baiocchi, Miklosh Bala, Carmen Balagué, Dimitrios Balalis, Edoardo Baldini, Oussama Baraket, Suman Baral, Mirko Barone, Alberto Gonzãlez Barranquero, Jorge Arturo Barreras, Gary Alan Bass, Zulfu Bayhan, Giovanni Bellanova, Offir Ben-Ishay, Fabrizio Bert, Valentina Bianchi, Helena Biancuzzi, Chiara Bidoli, Raluca Bievel Radulescu, Mark Brian Bignell, Alan Biloslavo, Daniele Bissacco, Roberto Bini, Paolo Boati, Guillaume Boddaert, Branko Bogdanic, Cristina Bombardini, Luigi Bonavina, Luca Bonomo, Andrea Bottari, Konstantinos Bouliaris, Gioia Brachini, Antonio Brillantino, Giuseppe Brisinda, Maloni Mamada Bulanauca, Luis Antonio Buonomo, Jakob Burcharth, Salvatore Buscemi, Francesca Calabretto, Giacomo Calini, Valentin Calu, Fabio Cesare Campanile, Riccardo Campo Dall Orto, Andrea Campos-Serra, Stefano Campostrini, Recayi Capoglu, Joao Miguel Carvas, Marco Cascella, Gianmaria Casoni Pattacini, Valerio Celentano, Danilo Corrado Centonze, Marco Ceresoli, Dimitrios Chatzipetris, Antonella Chessa, Maria Michela Chiarello, Mircea Chirica, Serge Chooklin, Christos Chouliaras, Sharfuddin Chowdhury, Pasquale Cianci, Nicola Cillara, Stefania Cimbanassi, Stefano Piero Bernardo Cioffi, Elif Colak, Enrique Colás Ruiz, Luigi Conti, Alessandro Coppola, Tiago Correia De Sa, Silvia Dantas Costa, Valerio Cozza, Giuseppe Curro', Kirsten Felicia Ann-Sophie Aimee Dabekaussen, Fabrizio D'Acapito, Dimitrios Damaskos, Giancarlo D'Ambrosio, Koray Das, Richard Justin Davies, Andrew Charles De Beaux, Sara Patricia De Lebrusant Fernandez, Alessandro De Luca, Francesca De Stefano, Luca Degrate, Zaza Demetrashvili, Andreas Kyriacou Demetriades, Dzemail Smail Detanac, Agnese Dezi, Giuseppe Di Buono, Isidoro Di Carlo, Pierpaolo Di Lascio, Marcello Di Martino, Salomone Di Saverio, Bogdan Diaconescu, Jose J Diaz, Rigers Dibra, Evgeni Nikolaev Dimitrov, Vincenza Paola Dinuzzi, Sandra Dios-Barbeito, Jehangir Farman Ali Diyani, Agron Dogjani, Maurizio Domanin, Mario D'Oria, Virginia Duran Munoz-Cruzado, Barbora East, Mikael Ekelund, Gerald Takem Ekwen, Adel Hamed Elbaih, Muhammed Elhadi, Natalie Enninghorst, Mairam Ernisova, Juan Pablo Escalera-Antezana, Sofia Esposito, Giuseppe Esposito, Mercedes Estaire, Camilla Nikita Farè, Roser Farre, Francesco Favi, Luca Ferrario, Antonjacopo Ferrario di Tor Vajana, Claudia Filisetti, Francesco Fleres, Vinicius Cordeiro Fonseca, Alexander Forero-Torres, Francesco Forfori, Laura Fortuna, Evangelos Fradelos, Gustavo P Fraga, Pietro Fransvea, Simone Frassini, Giuseppe Frazzetta, Erica Pizzocaro, Maximos Frountzas, Mahir Gachabayov, Rita Galeiras, Alain A Garcia Vazquez, Simone Gargarella, Ibrahim Umar Garzali, Wagih Mommtaz Ghannam, Faiz Najmuddin Ghazi, Lawrence Marshall Gillman, Rossella Gioco, Alessio Giordano, Luca Giordano, Carlo Giove, Giorgio Giraudo, Mario Giuffrida, Michela Giulii Capponi, Emanuel Gois Jr, Carlos Augusto Gomes, Felipe Couto Gomes, Ricardo Alessandro Teixeira Gonsaga, Emre Gonullu, Jacques Goosen, Tatjana Goranovic, Raquel Gracia-Roman, Giorgio Maria Paolo Graziano, Ewen Alexander Griffiths, Tommaso Guagni, Dimitar Bozhidarov Hadzhiev, Muad Gamil Haidar, Hytham K S Hamid, Timothy Craig Hardcastle, Firdaus Hayati, Andrew James Healey, Andreas Hecker, Matthias Hecker, Edgar Fernando Hernandez Garcia, Adrien Montcho Hodonou, Eduardo Cancio Huaman, Martin Huerta, Aini Fahriza Ibrahim, Basil Mohamed Salabeldin Ibrahim, Giuseppe Ietto, Marco Inama, Orestis Ioannidis, Arda Isik, Nizar Ismail, Azzain Mahadi Hamid Ismail, Ruhi Fadzlyana Jailani, Ji Young Jang, Christos Kalfountzos, Sujala Niatarika Rajsain Kalipershad, Emmanouil Kaouras, Lewis Jay Kaplan, Yasin Kara, Evika Karamagioli, Aleksandar Karamarkovia, Ioannis Katsaros, Alfie J Kavalakat, Aristotelis Kechagias, Jakub Kenig, Boris Juli Kessel, Jim S Khan, Vladimir Khokha, Jae Il Kim, Andrew Wallace Kirkpatrick, Roberto Klappenbach, Yoram Kluger, Yoshiro Kobe, Efstratios Kofopoulos Lymperis, Kenneth Yuh Yen Kok, Victor Kong, Dimitris P Korkolis, Georgios Koukoulis, Bojan Kovacevic, Vitor Favali Kruger, Igor A Kryvoruchko, Hayato Kurihara, Akira Kuriyama, Aitor Landaluce-Olavarria, Pierfrancesco Lapolla, Ari Leppäniemi, Leo Licari, Giorgio Lisi, Andrey Litvin, Aintzane Lizarazu, Heura Llaquet Bayo, Varut Lohsiriwat, Claudia Cristina Lopes Moreira, Eftychios Lostoridis, Agustãn Tovar Luna, Davide Luppi, Gustavo Miguel Machain V, Marc Maegele, Daniele Maggiore, Stefano Magnone, Ronald V Maier, Piotr Major, Mallikarjuna Manangi, Andrea Manetti, Baris Mantoglu, Chiara Marafante, Federico Mariani, Athanasios Marinis, Evandro Antonio Sbalcheiro Mariot, Gennaro Martines, Aleix Martinez Perez, Costanza Martino, Pietro Mascagni, Damien Massalou, Maurizio Massaro, Belen Matías-García, Gennaro Mazzarella, Giorgio Mazzarolo, Renato Bessa Melo, Fernando Mendoza-Moreno, Serhat Meric, Jeremy Meyer, Luca Miceli, Nikolaos V Michalopoulos, Flavio Milana, Andrea Mingoli, Tushar S Mishra, Muyed Mohamed, Musab Isam Eldin Abbas Mohamed, Ali Yasen Mohamedahmed, Mohammed Jibreel Suliman Mohammed, Rajashekar Mohan, Ernest E Moore, Dieter Morales-Garcia, Mã Ns Muhrbeck, Francesk Mulita, Sami Mohamed Siddig Mustafa, Edoardo Maria Muttillo, Mukhammad David Naimzada, Pradeep H Navsaria, Ionut Negoi, Luca Nespoli, Christine Nguyen, Melkamu Kibret Nidaw, Giuseppe Nigri, Ioannis Nikolopoulos, Donal Brendan O'Connor, Habeeb Damilola Ogundipe, Cristina Oliveri, Stefano Olmi, Ernest Cun Wang Ong, Luca Orecchia, Aleksei V Osipov, Muhammad Faeid Othman, Marco Pace, Mario Pacilli, Leonardo Pagani, Giuseppe Palomba, Desire' Pantalone, Arpad Panyko, Ciro Paolillo, Mario Virgilio Papa, Dimitrios Papaconstantinou, Maria Papadoliopoulou, Aristeidis Papadopoulos, Davide Papis, Nikolaos Pararas, Jose Gustavo Parreira, Neil Geordie Parry, Francesco Pata, Tapan Patel, Simon Paterson-Brown, Giovanna Pavone, Francesca Pecchini, Veronica Pegoraro, Gianluca Pellino, Maria Pelloni, Andrea Peloso, Eduardo Perea Del Pozo, Rita Goncalves Pereira, Bruno Monteiro Pereira, Aintzane Lizarazu Perez, Silvia Pérez, Teresa Perra, Gennaro Perrone, Antonio Pesce, Lorenzo Petagna, Giovanni Petracca, Vorapong Phupong, Biagio Picardi, Arcangelo Picciariello, Micaela Piccoli, Edoardo Picetti, Emmanouil Pikoulis Pikoulis, Tadeja Pintar, Giovanni Pirozzolo, Francesco Piscioneri, Mauro Podda, Alberto Porcu, Francesca Privitera, Clelia Punzo, Silvia Quaresima, Martha Alexa Quiodettis, Niels Qvist, Razrim Rahim, Filipe Ramalho de Almeida, Rosnelifaizur Bin Ramely, Huseyin Kemal Rasa, Martin Reichert, Alexander Reinisch-Liese, Angela Renne, Camilla Riccetti, Maria Rita Rodriguez-Luna, Daniel Roizblatt, Andrea Romanzi, Luigi Romeo, Francesco Pietro Maria Roscio, Ramely Bin Rosnelifaizur, Stefano Rossi, Andres M Rubiano, Elena Ruiz-Ucar, Boris Evgeniev Sakakushev, Juan Carlos Salamea, Ibrahima Sall, Lasitha Bhagya Samarakoon, Fabrizio Sammartano, Alejandro Sanchez Arteaga, Sergi Sanchez-Cordero, Domenico Pietro Maria Santoanastaso, Massimo Sartelli, Diego Sasia, Norio Sato, Artem Savchuk, Robert Grant Sawyer, Giacomo Scaioli, Dimitrios Schizas, Simone Sebastiani, Barbara Seeliger, Helmut Alfredo Segovia Lohse, Charalampos Seretis, Giacomo Sermonesi, Mario Serradilla-Martin, Vishal G Shelat, Sergei Shlyapnikov, Theodoros Sidiropoulos, Romeo Lages Simoes, Leandro Siragusa, Boonying Siribumrungwong, Mihail Slavchev, Leonardo Solaini, Gabriele Soldini, Andrey Sopuev, Kjetil Soreide, Apostolos Sovatzidis, Philip Frank Stahel, Matt Strickland, Mohamed Arif Hameed Sultan, Ruslan Sydorchuk, Larysa Sydorchuk, Syed Muhammad Ali Muhammad Syed, Luis Tallon-Aguilar, Andrea Marco Tamburini, Nicolò Tamini, Edward C T H Tan, Jih Huei Tan, Antonio Tarasconi, Nicola Tartaglia, Giuseppe Tartaglia, Dario Tartaglia, John Vincent Taylor, Giovanni Domenico Tebala, Michel Teuben, Alexis Theodorou, Matti Tolonen, Giovanni Tomasicchio, Adriana Toro, Beatrice Torre, Tania Triantafyllou, Giuseppe Trigiante Trigiante, Marzia Tripepi, Julio Trostchansky, Konstantinos Tsekouras, Victor Turrado-Rodriguez, Roberta Tutino, Matteo Uccelli, Petar Angelov Uchikov, Bakarne Ugarte-Sierra, Mika Tapani Ukkonen, Michail Vailas, Panteleimon G Vassiliu, Alain Garcia Vazquez, Rita Galeiras Vazquez, George Velmahos, Juan Ezequiel Verde, Juan Manuel Verde, Massimiliano Veroux, Jacopo Viganò, Ramon Vilallonga, Diego Visconti, Alessandro Vittori, Maciej Waledziak, Tongporn Wannatoop, Lukas Werner Widmer, Michael Samuel James Wilson, Sarah Woltz, Ting Hway Wong, Sofia Xenaki, Byungchul Yu, Steven Yule, Sanoop Koshy Zachariah, Georgios Zacharis, Claudia Zaghi, Andee Dzulkarnaen Zakaria, Diego A Zambrano, Nikolaos Zampitis, Biagio Zampogna, Simone Zanghì, Maristella Zantedeschi, Konstantinos Zapsalis, Fabio Zattoni, Monica Zese, Lorenzo, Cobianchi, Daniele, Piccolo, Francesca, Dal Ma, Vanni, Agnoletti, Luca, Ansaloni, Jeremy, Balch, Walter, Biffl, Giovanni, Butturini, Fausto, Catena, Federico, Coccolini, Stefano, Denicolai, Belinda, De Simone, Isabella, Frigerio, Paola, Fugazzola, Gianluigi, Marseglia, Giuseppe Roberto, Marseglia, Jacopo, Martellucci, Mirko, Modenese, Pietro, Previtali, Federico, Ruta, Alessandro, Venturi, Haytham M, Kaafarani, Tyler J, Loftu, Lyle Abbott, Kenneth, Abdelmalik, Abubaker, Seyoum Abebe, Nebyou, Abu-Zidan, Fikri, Abdallah Yousif Adam, Yousif, Adamou, Harissou, Mikhailovich Adamovich, Dmitry, Agresta, Ferdinando, Agrusa, Antonino, Akin, Emrah, Alessiani, Mario, Alexandrino, Henrique, Muhammad Ali, Syed, Alin Mihai, Vasilescu, Miguel Almeida, Pedro, Mohammed Al-Shehari, Mohammed, Altomare, Michele, Amico, Francesco, Ammendola, Michele, Andreuccetti, Jacopo, Anestiadou, Elissavet, Angelos, Peter, Annicchiarico, Alfredo, Antonelli, Amedeo, Aparicio-Sanchez, Daniel, Ardito, Antonella, Argenio, Giulio, Claude Arvieux, Catherine, Harald Askevold, Ingolf, Tchavdarov Atanasov, Boyko, Augustin, Goran, Sabry Awad, Selmy, Bacchiocchi, Giulia, Bagnoli, Carlo, Bahouth, Hany, Baili, Efstratia, Bains, Lovenish, Luca Baiocchi, Gian, Bala, Miklosh, Balagué, Carmen, Balalis, Dimitrio, Baldini, Edoardo, Baraket, Oussama, Baral, Suman, Barone, Mirko, Gonzãlez Barranquero, Alberto, Arturo Barreras, Jorge, Alan Bass, Gary, Bayhan, Zulfu, Bellanova, Giovanni, Ben-Ishay, Offir, Bert, Fabrizio, Bianchi, Valentina, Biancuzzi, Helena, Bidoli, Chiara, Bievel Radulescu, Raluca, Brian Bignell, Mark, Biloslavo, Alan, Bissacco, Daniele, Bini, Roberto, Boati, Paolo, Boddaert, Guillaume, Bogdanic, Branko, Bombardini, Cristina, Bonavina, Luigi, Bonomo, Luca, Bottari, Andrea, Bouliaris, Konstantino, Brachini, Gioia, Brillantino, Antonio, Brisinda, Giuseppe, Mamada Bulanauca, Maloni, Antonio Buonomo, Lui, Burcharth, Jakob, Buscemi, Salvatore, Calabretto, Francesca, Calini, Giacomo, Calu, Valentin, Cesare Campanile, Fabio, Campo Dall Orto, Riccardo, Campos-Serra, Andrea, Campostrini, Stefano, Capoglu, Recayi, Miguel Carvas, Joao, Cascella, Marco, Casoni Pattacini, Gianmaria, Celentano, Valerio, Corrado Centonze, Danilo, Ceresoli, Marco, Chatzipetris, Dimitrio, Chessa, Antonella, Michela Chiarello, Maria, Chirica, Mircea, Chooklin, Serge, Chouliaras, Christo, Chowdhury, Sharfuddin, Cianci, Pasquale, Cillara, Nicola, Cimbanassi, Stefania, Piero Bernardo Cioffi, Stefano, Colak, Elif, Colás Ruiz, Enrique, Conti, Luigi, Coppola, Alessandro, Correia De Sa, Tiago, Dantas Costa, Silvia, Cozza, Valerio, Curro', Giuseppe, Felicia Ann-Sophie Aimee Dabekaussen, Kirsten, D'Acapito, Fabrizio, Damaskos, Dimitrio, D'Ambrosio, Giancarlo, Das, Koray, Justin Davies, Richard, Charles De Beaux, Andrew, Patricia De Lebrusant Fernandez, Sara, De Luca, Alessandro, De Stefano, Francesca, Degrate, Luca, Demetrashvili, Zaza, Kyriacou Demetriades, Andrea, Smail Detanac, Dzemail, Dezi, Agnese, Di Buono, Giuseppe, Di Carlo, Isidoro, Di Lascio, Pierpaolo, Di Martino, Marcello, Di Saverio, Salomone, Diaconescu, Bogdan, J Diaz, Jose, Dibra, Riger, Nikolaev Dimitrov, Evgeni, Paola Dinuzzi, Vincenza, Dios-Barbeito, Sandra, Farman Ali Diyani, Jehangir, Dogjani, Agron, Domanin, Maurizio, D'Oria, Mario, Duran Munoz-Cruzado, Virginia, East, Barbora, Ekelund, Mikael, Takem Ekwen, Gerald, Hamed Elbaih, Adel, Elhadi, Muhammed, Enninghorst, Natalie, Ernisova, Mairam, Pablo Escalera-Antezana, Juan, Esposito, Sofia, Esposito, Giuseppe, Estaire, Mercede, Nikita Farè, Camilla, Farre, Roser, Favi, Francesco, Ferrario, Luca, Ferrario di Tor Vajana, Antonjacopo, Filisetti, Claudia, Fleres, Francesco, Cordeiro Fonseca, Viniciu, Forero-Torres, Alexander, Forfori, Francesco, Fortuna, Laura, Fradelos, Evangelo, P Fraga, Gustavo, Fransvea, Pietro, Frassini, Simone, Frazzetta, Giuseppe, Pizzocaro, Erica, Frountzas, Maximo, Gachabayov, Mahir, Galeiras, Rita, A Garcia Vazquez, Alain, Gargarella, Simone, Umar Garzali, Ibrahim, Mommtaz Ghannam, Wagih, Najmuddin Ghazi, Faiz, Marshall Gillman, Lawrence, Gioco, Rossella, Giordano, Alessio, Giordano, Luca, Giove, Carlo, Giraudo, Giorgio, Giuffrida, Mario, Giulii Capponi, Michela, Gois Jr, Emanuel, Augusto Gomes, Carlo, Couto Gomes, Felipe, Alessandro Teixeira Gonsaga, Ricardo, Gonullu, Emre, Goosen, Jacque, Goranovic, Tatjana, Gracia-Roman, Raquel, Maria Paolo Graziano, Giorgio, Alexander Griffiths, Ewen, Guagni, Tommaso, Bozhidarov Hadzhiev, Dimitar, Gamil Haidar, Muad, S Hamid, Hytham K, Craig Hardcastle, Timothy, Hayati, Firdau, James Healey, Andrew, Hecker, Andrea, Hecker, Matthia, Fernando Hernandez Garcia, Edgar, Montcho Hodonou, Adrien, Cancio Huaman, Eduardo, Huerta, Martin, Fahriza Ibrahim, Aini, Mohamed Salabeldin Ibrahim, Basil, Ietto, Giuseppe, Inama, Marco, Ioannidis, Oresti, Isik, Arda, Ismail, Nizar, Mahadi Hamid Ismail, Azzain, Fadzlyana Jailani, Ruhi, Young Jang, Ji, Kalfountzos, Christo, Niatarika Rajsain Kalipershad, Sujala, Kaouras, Emmanouil, Jay Kaplan, Lewi, Kara, Yasin, Karamagioli, Evika, Karamarkovia, Aleksandar, Katsaros, Ioanni, J Kavalakat, Alfie, Kechagias, Aristoteli, Kenig, Jakub, Juli Kessel, Bori, S Khan, Jim, Khokha, Vladimir, Il Kim, Jae, Wallace Kirkpatrick, Andrew, Klappenbach, Roberto, Kluger, Yoram, Kobe, Yoshiro, Kofopoulos Lymperis, Efstratio, Yuh Yen Kok, Kenneth, Kong, Victor, P Korkolis, Dimitri, Koukoulis, Georgio, Kovacevic, Bojan, Favali Kruger, Vitor, A Kryvoruchko, Igor, Kurihara, Hayato, Kuriyama, Akira, Landaluce-Olavarria, Aitor, Lapolla, Pierfrancesco, Leppäniemi, Ari, Licari, Leo, Lisi, Giorgio, Litvin, Andrey, Lizarazu, Aintzane, Llaquet Bayo, Heura, Lohsiriwat, Varut, Cristina Lopes Moreira, Claudia, Lostoridis, Eftychio, Tovar Luna, Agustãn, Luppi, Davide, V, Gustavo Miguel Machain, Maegele, Marc, Maggiore, Daniele, Magnone, Stefano, V Maier, Ronald, Major, Piotr, Manangi, Mallikarjuna, Manetti, Andrea, Mantoglu, Bari, Marafante, Chiara, Mariani, Federico, Marinis, Athanasio, Antonio Sbalcheiro Mariot, Evandro, Martines, Gennaro, Martinez Perez, Aleix, Martino, Costanza, Mascagni, Pietro, Massalou, Damien, Massaro, Maurizio, Matías-García, Belen, Mazzarella, Gennaro, Mazzarolo, Giorgio, Bessa Melo, Renato, Mendoza-Moreno, Fernando, Meric, Serhat, Meyer, Jeremy, Miceli, Luca, V Michalopoulos, Nikolao, Milana, Flavio, Mingoli, Andrea, S Mishra, Tushar, Mohamed, Muyed, Isam Eldin Abbas Mohamed, Musab, Yasen Mohamedahmed, Ali, Jibreel Suliman Mohammed, Mohammed, Mohan, Rajashekar, E Moore, Ernest, Morales-Garcia, Dieter, Ns Muhrbeck, Mã, Mulita, Francesk, Mohamed Siddig Mustafa, Sami, Maria Muttillo, Edoardo, David Naimzada, Mukhammad, H Navsaria, Pradeep, Negoi, Ionut, Nespoli, Luca, Nguyen, Christine, Kibret Nidaw, Melkamu, Nigri, Giuseppe, Nikolopoulos, Ioanni, Brendan O'Connor, Donal, Damilola Ogundipe, Habeeb, Oliveri, Cristina, Olmi, Stefano, Cun Wang Ong, Ernest, Orecchia, Luca, V Osipov, Aleksei, Faeid Othman, Muhammad, Pace, Marco, Pacilli, Mario, Pagani, Leonardo, Palomba, Giuseppe, Pantalone, Desire', Panyko, Arpad, Paolillo, Ciro, Virgilio Papa, Mario, Papaconstantinou, Dimitrio, Papadoliopoulou, Maria, Papadopoulos, Aristeidi, Papis, Davide, Pararas, Nikolao, Gustavo Parreira, Jose, Geordie Parry, Neil, Pata, Francesco, Patel, Tapan, Paterson-Brown, Simon, Pavone, Giovanna, Pecchini, Francesca, Pegoraro, Veronica, Pellino, Gianluca, Pelloni, Maria, Peloso, Andrea, Perea Del Pozo, Eduardo, Goncalves Pereira, Rita, Monteiro Pereira, Bruno, Lizarazu Perez, Aintzane, Pérez, Silvia, Perra, Teresa, Perrone, Gennaro, Pesce, Antonio, Petagna, Lorenzo, Petracca, Giovanni, Phupong, Vorapong, Picardi, Biagio, Picciariello, Arcangelo, Piccoli, Micaela, Picetti, Edoardo, Pikoulis Pikoulis, Emmanouil, Pintar, Tadeja, Pirozzolo, Giovanni, Piscioneri, Francesco, Podda, Mauro, Porcu, Alberto, Privitera, Francesca, Punzo, Clelia, Quaresima, Silvia, Alexa Quiodettis, Martha, Qvist, Niel, Rahim, Razrim, Ramalho de Almeida, Filipe, Bin Ramely, Rosnelifaizur, Kemal Rasa, Huseyin, Reichert, Martin, Reinisch-Liese, Alexander, Renne, Angela, Riccetti, Camilla, Rita Rodriguez-Luna, Maria, Roizblatt, Daniel, Romanzi, Andrea, Romeo, Luigi, Pietro Maria Roscio, Francesco, Bin Rosnelifaizur, Ramely, Rossi, Stefano, M Rubiano, Andre, Ruiz-Ucar, Elena, Evgeniev Sakakushev, Bori, Carlos Salamea, Juan, Sall, Ibrahima, Bhagya Samarakoon, Lasitha, Sammartano, Fabrizio, Sanchez Arteaga, Alejandro, Sanchez-Cordero, Sergi, Pietro Maria Santoanastaso, Domenico, Sartelli, Massimo, Sasia, Diego, Sato, Norio, Savchuk, Artem, Grant Sawyer, Robert, Scaioli, Giacomo, Schizas, Dimitrio, Sebastiani, Simone, Seeliger, Barbara, Alfredo Segovia Lohse, Helmut, Seretis, Charalampo, Sermonesi, Giacomo, Serradilla-Martin, Mario, G Shelat, Vishal, Shlyapnikov, Sergei, Sidiropoulos, Theodoro, Lages Simoes, Romeo, Siragusa, Leandro, Siribumrungwong, Boonying, Slavchev, Mihail, Solaini, Leonardo, Soldini, Gabriele, Sopuev, Andrey, Soreide, Kjetil, Sovatzidis, Apostolo, Frank Stahel, Philip, Strickland, Matt, Arif Hameed Sultan, Mohamed, Sydorchuk, Ruslan, Sydorchuk, Larysa, Muhammad Ali Muhammad Syed, Syed, Tallon-Aguilar, Lui, Marco Tamburini, Andrea, Tamini, Nicolò, H Tan, Edward C T, Huei Tan, Jih, Tarasconi, Antonio, Tartaglia, Nicola, Tartaglia, Giuseppe, Tartaglia, Dario, Vincent Taylor, John, Domenico Tebala, Giovanni, Teuben, Michel, Theodorou, Alexi, Tolonen, Matti, Tomasicchio, Giovanni, Toro, Adriana, Torre, Beatrice, Triantafyllou, Tania, Trigiante Trigiante, Giuseppe, Tripepi, Marzia, Trostchansky, Julio, Tsekouras, Konstantino, Turrado-Rodriguez, Victor, Tutino, Roberta, Uccelli, Matteo, Angelov Uchikov, Petar, Ugarte-Sierra, Bakarne, Tapani Ukkonen, Mika, Vailas, Michail, G Vassiliu, Panteleimon, Garcia Vazquez, Alain, Galeiras Vazquez, Rita, Velmahos, George, Ezequiel Verde, Juan, Manuel Verde, Juan, Veroux, Massimiliano, Viganò, Jacopo, Vilallonga, Ramon, Visconti, Diego, Vittori, Alessandro, Waledziak, Maciej, Wannatoop, Tongporn, Werner Widmer, Luka, Samuel James Wilson, Michael, Woltz, Sarah, Hway Wong, Ting, Xenaki, Sofia, Yu, Byungchul, Yule, Steven, Koshy Zachariah, Sanoop, Zacharis, Georgio, Zaghi, Claudia, Dzulkarnaen Zakaria, Andee, A Zambrano, Diego, Zampitis, Nikolao, Zampogna, Biagio, Zanghì, Simone, Zantedeschi, Maristella, Zapsalis, Konstantino, Zattoni, Fabio, Zese, Monica, Cobianchi L., Piccolo D., Mas F.D., Agnoletti V., Ansaloni L., Balch J., Biffl W., Butturini G., Catena F., Coccolini F., Denicolai S., De Simone B., Frigerio I., Fugazzola P., Marseglia G., Marseglia G.R., Martellucci J., Modenese M., Previtali P., Ruta F., Venturi A., Kaafarani H.M., Loftus T.J., Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Team Dynamics Study Group, Cobianchi, L, Piccolo, D, Dal Mas, F, Agnoletti, V, Ansaloni, L, Balch, J, Biffl, W, Butturini, G, Catena, F, Coccolini, F, Denicolai, S, De Simone, B, Frigerio, I, Fugazzola, P, Marseglia, G, Martellucci, J, Modenese, M, Previtali, P, Ruta, F, Venturi, A, Kaafarani, H, Loftus, T, Abbott, K, Abdelmalik, A, Abebe, N, Abu-Zidan, F, Adam, Y, Adamou, H, Adamovich, D, Agresta, F, Agrusa, A, Akin, E, Alessiani, M, Alexandrino, H, Ali, S, Mihai, V, Almeida, P, Al-Shehari, M, Altomare, M, Amico, F, Ammendola, M, Andreuccetti, J, Anestiadou, E, Angelos, P, Annicchiarico, A, Antonelli, A, Aparicio-Sanchez, D, Ardito, A, Argenio, G, Arvieux, C, Askevold, I, Atanasov, B, Augustin, G, Awad, S, Bacchiocchi, G, Bagnoli, C, Bahouth, H, Baili, E, Bains, L, Baiocchi, G, Bala, M, Balague, C, Balalis, D, Baldini, E, Baraket, O, Baral, S, Barone, M, Barranquero, A, Barreras, J, Bass, G, Bayhan, Z, Bellanova, G, Ben-Ishay, O, Bert, F, Bianchi, V, Biancuzzi, H, Bidoli, C, Radulescu, R, Bignell, M, Biloslavo, A, Bini, R, Bissacco, D, Boati, P, Boddaert, G, Bogdanic, B, Bombardini, C, Bonavina, L, Bonomo, L, Bottari, A, Bouliaris, K, Brachini, G, Brillantino, A, Brisinda, G, Bulanauca, M, Buonomo, L, Burcharth, J, Buscemi, S, Calabretto, F, Calini, G, Calu, V, Campanile, F, Dall'Orto, R, Campos-Serra, A, Campostrini, S, Capoglu, R, Carvas, J, Cascella, M, Pattacini, G, Celentano, V, Centonze, D, Ceresoli, M, Chatzipetris, D, Chessa, A, Chiarello, M, Chirica, M, Chooklin, S, Chouliaras, C, Chowdhury, S, Cianci, P, Cillara, N, Cimbanassi, S, Cioffi, S, Colak, E, Ruiz, E, Conti, L, Coppola, A, De Sa, T, Costa, S, Cozza, V, Curro', G, Dabekaussen, K, D'Acapito, F, Damaskos, D, D'Ambrosio, G, Das, K, Davies, R, De Beaux, A, Fernandez, S, De Luca, A, De Stefano, F, Degrate, L, Demetrashvili, Z, Demetriades, A, Detanac, D, Dezi, A, Di Buono, G, Di Carlo, I, Di Lascio, P, Di Martino, M, Di Saverio, S, Diaconescu, B, Diaz, J, Dibra, R, Dimitrov, E, Dinuzzi, V, Dios-Barbeito, S, Diyani, J, Dogjani, A, Domanin, M, D'Oria, M, Munoz-Cruzado, V, East, B, Ekelund, M, Ekwen, G, Elbaih, A, Elhadi, M, Enninghorst, N, Ernisova, M, Escalera-Antezana, J, Esposito, S, Esposito, G, Estaire, M, Fare, C, Farre, R, Favi, F, Ferrario, L, Vajana, A, Filisetti, C, Fleres, F, Fonseca, V, Forero-Torres, A, Forfori, F, Fortuna, L, Fradelos, E, Fraga, G, Fransvea, P, Frassini, S, Frazzetta, G, Pizzocaro, E, Frountzas, M, Gachabayov, M, Galeiras, R, Vazquez, A, Gargarella, S, Garzali, I, Ghannam, W, Ghazi, F, Gillman, L, Gioco, R, Giordano, A, Giordano, L, Giove, C, Giraudo, G, Giuffrida, M, Capponi, M, Gois, E, Gomes, C, Gomes, F, Gonsaga, R, Gonullu, E, Goosen, J, Goranovic, T, Gracia-Roman, R, Graziano, G, Griffiths, E, Guagni, T, Hadzhiev, D, Haidar, M, Hamid, H, Hardcastle, T, Hayati, F, Healey, A, Hecker, A, Hecker, M, Garcia, E, Hodonou, A, Huaman, E, Huerta, M, Ibrahim, A, Ibrahim, B, Ietto, G, Inama, M, Ioannidis, O, Isik, A, Ismail, N, Ismail, A, Jailani, R, Jang, J, Kalfountzos, C, Kalipershad, S, Kaouras, E, Kaplan, L, Kara, Y, Karamagioli, E, Karamarkovia, A, Katsaros, I, Kavalakat, A, Kechagias, A, Kenig, J, Kessel, B, Khan, J, Khokha, V, Kim, J, Kirkpatrick, A, Klappenbach, R, Kluger, Y, Kobe, Y, Lymperis, E, Kok, K, Kong, V, Korkolis, D, Koukoulis, G, Kovacevic, B, Kruger, V, Kryvoruchko, I, Kurihara, H, Kuriyama, A, Landaluce-Olavarria, A, Lapolla, P, Leppaniemi, A, Licari, L, Lisi, G, Litvin, A, Lizarazu, A, Bayo, H, Lohsiriwat, V, Moreira, C, Lostoridis, E, Luna, A, Luppi, D, Machain, V, Maegele, M, Maggiore, D, Magnone, S, Maier, R, Major, P, Manangi, M, Manetti, A, Mantoglu, B, Marafante, C, Mariani, F, Marinis, A, Mariot, E, Martines, G, Perez, A, Martino, C, Mascagni, P, Massalou, D, Massaro, M, Matias-Garcia, B, Mazzarella, G, Mazzarolo, G, Melo, R, Mendoza-Moreno, F, Meric, S, Meyer, J, Miceli, L, Michalopoulos, N, Milana, F, Mingoli, A, Mishra, T, Mohamed, M, Mohamedahmed, A, Mohammed, M, Mohan, R, Moore, E, Morales-Garcia, D, Muhrbeck, M, Mulita, F, Mustafa, S, Muttillo, E, Naimzada, M, Navsaria, P, Negoi, I, Nespoli, L, Nguyen, C, Nidaw, M, Nigri, G, Nikolopoulos, I, O'Connor, D, Ogundipe, H, Oliveri, C, Olmi, S, Ong, E, Orecchia, L, Osipov, A, Othman, M, Pace, M, Pacilli, M, Pagani, L, Palomba, G, Pantalone, D, Panyko, A, Paolillo, C, Papa, M, Papaconstantinou, D, Papadoliopoulou, M, Papadopoulos, A, Papis, D, Pararas, N, Parreira, J, Parry, N, Pata, F, Patel, T, Paterson-Brown, S, Pavone, G, Pecchini, F, Pegoraro, V, Pellino, G, Pelloni, M, Peloso, A, Del Pozo, E, Pereira, R, Pereira, B, Perez, S, Perra, T, Perrone, G, Pesce, A, Petagna, L, Petracca, G, Phupong, V, Picardi, B, Picciariello, A, Piccoli, M, Picetti, E, Pikoulis, E, Pintar, T, Pirozzolo, G, Piscioneri, F, Podda, M, Porcu, A, Privitera, F, Punzo, C, Quaresima, S, Quiodettis, M, Qvist, N, Rahim, R, de Almeida, F, Ramely, R, Rasa, H, Reichert, M, Reinisch-Liese, A, Renne, A, Riccetti, C, Rodriguez-Luna, M, Roizblatt, D, Romanzi, A, Romeo, L, Roscio, F, Rosnelifaizur, R, Rossi, S, Rubiano, A, Ruiz-Ucar, E, Sakakushev, B, Salamea, J, Sall, I, Samarakoon, L, Sammartano, F, Arteaga, A, Sanchez-Cordero, S, Santoanastaso, D, Sartelli, M, Sasia, D, Sato, N, Savchuk, A, Sawyer, R, Scaioli, G, Schizas, D, Sebastiani, S, Seeliger, B, Lohse, H, Seretis, C, Sermonesi, G, Serradilla-Martin, M, Shelat, V, Shlyapnikov, S, Sidiropoulos, T, Simoes, R, Siragusa, L, Siribumrungwong, B, Slavchev, M, Solaini, L, Soldini, G, Sopuev, A, Soreide, K, Sovatzidis, A, Stahel, P, Strickland, M, Sultan, M, Sydorchuk, R, Sydorchuk, L, Syed, S, Tallon-Aguilar, L, Tamburini, A, Tamini, N, Tan, E, Tan, J, Tarasconi, A, Tartaglia, N, Tartaglia, G, Tartaglia, D, Taylor, J, Tebala, G, Teuben, M, Theodorou, A, Tolonen, M, Tomasicchio, G, Toro, A, Torre, B, Triantafyllou, T, Trigiante, G, Tripepi, M, Trostchansky, J, Tsekouras, K, Turrado-Rodriguez, V, Tutino, R, Uccelli, M, Uchikov, P, Ugarte-Sierra, B, Ukkonen, M, Vailas, M, Vassiliu, P, Vazquez, R, Velmahos, G, Verde, J, Veroux, M, Vigano, J, Vilallonga, R, Visconti, D, Vittori, A, Waledziak, M, Wannatoop, T, Widmer, L, Wilson, M, Woltz, S, Wong, T, Xenaki, S, Yu, B, Yule, S, Zachariah, S, Zacharis, G, Zaghi, C, Zakaria, A, Zambrano, D, Zampitis, N, Zampogna, B, Zanghi, S, Zantedeschi, M, Zapsalis, K, Zattoni, F, and Zese, M

Subjects
Settore SECS-P/10 - Organizzazione Aziendale, Settore MED/18 - Chirurgia Generale, Artificial intelligence, Settore SECS-P/07 - Economia Aziendale, Decision aid, Emergency Medicine, Decision aids, Surgery, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Trauma and emergency surgery, Clinical decision-making, Survey
Abstract

Background Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons’ knowledge and perception of using AI-based tools in clinical decision-making processes. Methods An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society’s website and Twitter profile. Results 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons' preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust. Discussion The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI.

Published
2023

14. MtMTP2-Facilitated Zinc Transport Into Intracellular Compartments Is Essential for Nodule Development in Medicago truncatula

Author

Javier León-Mediavilla, Marta Senovilla, Jesús Montiel, Patricia Gil-Díez, Ángela Saez, Igor S. Kryvoruchko, María Reguera, Michael K. Udvardi, Juan Imperial, and Manuel González-Guerrero

Subjects
zinc, cation diffusion facilitator, metal transport protein, symbiotic nitrogen fixation, metal nutrition, nodulation, Plant culture, SB1-1110
Abstract

Zinc (Zn) is an essential nutrient for plants that is involved in almost every biological process. This includes symbiotic nitrogen fixation, a process carried out by endosymbiotic bacteria (rhizobia) living within differentiated plant cells of legume root nodules. Zn transport in nodules involves delivery from the root, via the vasculature, release into the apoplast and uptake into nodule cells. Once in the cytosol, Zn can be used directly by cytosolic proteins or delivered into organelles, including symbiosomes of infected cells, by Zn efflux transporters. Medicago truncatula MtMTP2 (Medtr4g064893) is a nodule-induced Zn-efflux protein that was localized to an intracellular compartment in root epidermal and endodermal cells, as well as in nodule cells. Although the MtMTP2 gene is expressed in roots, shoots, and nodules, mtp2 mutants exhibited growth defects only under symbiotic, nitrogen-fixing conditions. Loss of MtMTP2 function resulted in altered nodule development, defects in bacteroid differentiation, and severe reduction of nitrogenase activity. The results presented here support a role of MtMTP2 in intracellular compartmentation of Zn, which is required for effective symbiotic nitrogen fixation in M. truncatula.

Published
2018
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15. ASSOCIATION OF SCREENING MARKERS OF COAGULATION WITH THE SHORT-TERM OUTCOME IN THE SMALL BOWEL OBSTRUCTION IN ADULTS: A RETROSPECTIVE STUDY

Author

Igor A. Kryvoruchko, Alexander S. Olefir, and Marina S. Antonova

Subjects
Adult, Young Adult, Adolescent, ROC Curve, Sepsis, Lactates, Humans, General Medicine, Middle Aged, Prognosis, Biomarkers, Retrospective Studies
Abstract

The aim: To evaluate the possibility of using screening markers of coagulation to the assessment of severity and predict short-term outcomes in patients with small bowel obstruction. Materials and methods: The study was based on the results of treatment of 71 patients 18-60 years old in 2019-2021. Patients were divided into two groups: in the 1st included those with a positive outcome (90.1%), and in the 2nd those with adverse outcomes (9.9%). Results: Only the laparoscopy approach has been in 12.5%, the laparotomy in 78.9%, and the hybrid in 9.9% of patients. There were no significant differences in screening tests of coagulation function indicators, including D-dimer, fibrinogen, Activated Partial Thromboplastin, International Normalised Ratio levels, and the International Society on Thrombosis and Hemostasis Criteria (ISTHC) score in two groups of patients before surgery. The predictive value of preoperative Sequential Organ Failure Assessment (SOFA) data (AUC = 0.844), serum lactate (AUC = 0.805), and systolic blood pressure (SPB) data (AUC = 0.808) before surgery were significant. The SOFA (AUC = 0.844) and APACHE II scores (AUC = 0.802), serum lactate (AUC = 0.884), D-dimer (AUC = 0.812), Antithrombin (AUC = 0.815), and CRP (AUC = 0.856) levels, SPB (0.856) within the first 72 hours after surgery were also good predictors of short-term outcomes (P = 0.000). Conclusions: It was confirmed that three parameters were predictors of early mortality before surgery, none of them included parameters of coagulation and seven parameters via 72 hours after surgery, which had included some parameters of coagulation.

Published
2022

16. EFFICIENCY OF THE INDICATORS INVESTMENT CALCULATION METHOD IN THE INFORMATION SECURITY SYSTEM OF INFORMATION OBJECTS

Author

Valerii Lakhno, Оlena Kryvoruchko, Vitalii Chubaievskyi, Dmytro Y. Kasatkin, Alyona Desyatko, Andrii Blozva, and Igor A. Kryvoruchko

Subjects
Embryology, education.field_of_study, Mathematical optimization, Process (engineering), Computer science, Simulation modelling, Population, Pareto principle, Context (language use), Information security, Cell Biology, Investment (macroeconomics), Object (computer science), Field (computer science), Information protection policy, Risk analysis (engineering), Modelling methods, Metric (mathematics), Genetic algorithm, Anatomy, Informatization, education, Selection (genetic algorithm), Developmental Biology
Abstract

The article describes the methodology of multi-criteria optimization of costs for the information protection system of the object of informatization. The technique is based on the use of a modified VEGA genetic algorithm. A modified algorithm for solving the MCO problem of parameters of a multi-circuit information protection system of an informatization object is proposed, which makes it possible to substantiate the rational characteristics of the ISS components, taking into account the priority metrics of OBI cybersecurity selected by the expert. In contrast to the existing classical VEGA algorithm, the modified algorithm additionally applies the Pareto principle, as well as a new mechanism for the selection of population specimens. The Pareto principle applies to the best point. At this point, the solution, interpreted as the best, if there is an improvement in one of the cybersecurity metrics, and strictly no worse in another metric (or metrics). The new selection mechanism, in contrast to the traditional one, involves the creation of an intermediate population. The formation of an intermediate population occurs in several stages. At the first stage, the first half of the population is formed based on the metric - the proportion of vulnerabilities of the object of informatization that are eliminated in a timely manner. At the second stage, the second half of the intermediate population is formed based on the metric - the proportion of risks that are unacceptable for the information assets of the informatization object. Further, these parts of the intermediate population are mixed. After mixing, an array of numbers is formed and mixed. At the final stage of selection for crossing, specimens (individuals) will be taken by the number from this array. The numbers are chosen randomly. The effectiveness of this technique has been confirmed by practical results

Published
2021

18. Mosaic translation hypothesis: chimeric polypeptides produced via multiple ribosomal frameshifting as a basis for adaptability

Author

Xavier Roucou, Igor S. Kryvoruchko, Marie A. Brunet, Noujoud Gabed, and Umut Çakır

Subjects
0303 health sciences, Translational frameshift, 030302 biochemistry & molecular biology, Alternative splicing, Reading frame, Translation (biology), Cell Biology, Genome project, Computational biology, Biology, Biochemistry, Fusion protein, 03 medical and health sciences, Open reading frame, Proteome, Molecular Biology, 030304 developmental biology
Abstract

How many different proteins can be produced from a single spliced transcript? Genome annotation projects overlook the coding potential of reading frames other than that of the reference open reading frames (refORFs). Recently, alternative open reading frames (altORFs) and their translational products, alternative proteins, have been shown to carry out important functions in various organisms. AltORFs overlapping refORFs or other altORFs in a different reading frame may be involved in one fundamental mechanism so far overlooked. A few years ago, it was proposed that altORFs may act as building blocks for chimeric (mosaic) polypeptides, which are produced via multiple ribosomal frameshifting events from a single mature transcript. We adopt terminology from that earlier discussion and call this mechanism mosaic translation. This way of extracting and combining genetic information may significantly increase proteome diversity. Thus, we hypothesize that this mechanism may have contributed to the flexibility and adaptability of organisms to a variety of environmental conditions. Specialized ribosomes acting as sensors probably played a central role in this process. Importantly, mosaic translation may be the main source of protein diversity in genomes that lack alternative splicing. The idea of mosaic translation is a testable hypothesis, although its direct demonstration is challenging. Should mosaic translation occur, we would currently highly underestimate the complexity of translation mechanisms and thus the proteome.

Published
2021

22. GmVTL1 is an iron transporter on the symbiosome membrane of soybean with an important role in nitrogen fixation

Author

Ivone Torres-Jerez, Frank Bedon, Penelope M. C. Smith, Igor S. Kryvoruchko, David A. Day, Michael K. Udvardi, Ella M. Brear, and Aleksandr Gavrin

Subjects
biology, Chemistry, fungi, Lotus japonicus, food and beverages, Nitrogenase, biology.organism_classification, Yeast, Rhizobia, Complementation, Symbiosome, Biochemistry, Nitrogen fixation, Bacteria
Abstract

SummaryLegumes establish symbiotic relationships with soil bacteria (rhizobia), housed in nodules on plant roots. The plant supplies carbon substrates and other nutrients to the bacteria in exchange for fixed nitrogen. The exchange occurs across a plant-derived symbiosome membrane (SM), which encloses rhizobia to form a symbiosome. Iron supplied by the plant is crucial for the rhizobial enzyme nitrogenase that catalyses N2 fixation, but the SM iron transporter has not been identified.We use complementation of yeast and plant mutants, real-time PCR, hairy root transformation, microscopy and proteomics to demonstrate the role of soybean GmVTL1 and 2.Both are members of the vacuolar iron transporter family and homologous to Lotus japonicus SEN1 (LjSEN1), previously shown to be essential for N2 fixation. GmVTL1 expression is enhanced in nodule infected cells and both proteins are localised to the SM.GmVTL1 and 2 transport iron in yeast and GmVTL1 restores N2 fixation when expressed in the Ljsen1 mutant.Three GmVTL1 amino acid substitutions that reduce iron transport in yeast also block N2 fixation in Ljsen1 plants.We conclude GmVTL1 is responsible for transport of iron across the SM to bacteroids and plays a crucial role in the N2-fixing symbiosis.

Published
2020

23. GmVTL1a is an iron transporter on the symbiosome membrane of soybean with an important role in nitrogen fixation

Author

Ella M. Brear, David A. Day, Aleksandr Gavrin, Penelope M. C. Smith, Ivone Torres-Jerez, Frank Bedon, Michael K. Udvardi, and Igor S. Kryvoruchko

Subjects
0106 biological sciences, 0301 basic medicine, Physiology, Iron, Lotus japonicus, Plant Science, 01 natural sciences, Rhizobia, 03 medical and health sciences, Nitrogen Fixation, Symbiosis, Plant Proteins, biology, Chemistry, fungi, food and beverages, Nitrogenase, biology.organism_classification, Yeast, Complementation, 030104 developmental biology, Biochemistry, Symbiosome, Nitrogen fixation, Soybeans, Root Nodules, Plant, Bacteria, 010606 plant biology & botany
Abstract

Legumes establish symbiotic relationships with soil bacteria (rhizobia), housed in nodules on roots. The plant supplies carbon substrates and other nutrients to the bacteria in exchange for fixed nitrogen. The exchange occurs across a plant-derived symbiosome membrane (SM), which encloses rhizobia to form a symbiosome. Iron supplied by the plant is crucial for rhizobial enzyme nitrogenase that catalyses nitrogen fixation, but the SM iron transporter has not been identified. We use yeast complementation, real-time PCR and proteomics to study putative soybean (Glycine max) iron transporters GmVTL1a and GmVTL1b and have characterized the role of GmVTL1a using complementation in plant mutants, hairy root transformation and microscopy. GmVTL1a and GmVTL1b are members of the vacuolar iron transporter family and homologous to Lotus japonicus SEN1 (LjSEN1), which is essential for nitrogen fixation. GmVTL1a expression is enhanced in nodule infected cells and both proteins are localized to the SM. GmVTL1a transports iron in yeast and restores nitrogen fixation when expressed in the Ljsen1 mutant. Three GmVTL1a amino acid substitutions that block nitrogen fixation in Ljsen1 plants reduce iron transport in yeast. We conclude GmVTL1a is responsible for transport of iron across the SM to bacteroids and plays a crucial role in the nitrogen-fixing symbiosis.

Published
2020

24. Initiative on #4openScienceStandsForUkraine scientists and students

Author

Björn LDM Brücher, Björn Brembs, Detlef Bartsch, Ronald Przygodzki, Romain-Daniel Gosselin, Marijan Slak Rupnik, Valentin Calu, Christof Birkenmaier, Oliver Hayden, Annette Schmidt, Nelson Elias, Hubert J Stein, Cesar Restrepo, Rainer U Pliquett, Björn Petersen, Arkadiusz Spychalla, David H Nguyen, Lúcio Lara Santos, Amir Szold, Mesut Tez, Franco Roviello, Paolo Macri, Vanya Loroch, Michael A Scherer, Boris Pasche, Karol Polom, Stefan Wesarg, Edouard Matevossian, Bruno Zilberstein, Igor A Kryvoruchko, José M Correia da Costa, Giuseppe Nigri, Volkmar Weissig, Sergio Ralon, Mohammad Kermansaravi, Raúl Oleas, Masaharu Seno, Michael Baum, Jan Voskuil, Yoav Mintz, Stefan Rödiger, Gudrun Schueler, Hartmut Kühn, Paolo Delrio, Grzegorz Wallner, Avraham Rivkind, Pentti Nieminen, David G Armstrong, Martin P Schlegel, Martin Daumer, Vahur Ööpik, Raimund JC Araujo, Jose Florencio F Lapeña, Ray Perkins, Georgios Anogianakis, Jochen Salber, Reshef Tenne, and Ijaz S Jamall

Subjects
General Engineering
Published
2022

25. Biomarker assessment in urgent surgical pathology of the small bowel: case-control analysis of a retrospective database

Author

Igor A. Kryvoruchko, Tetiana O. Briukhanova, Oksana A. Nakonechna, and Olexander S. Olefir

Subjects
General Engineering
Abstract

Background: Small bowel obstruction, mesenteric thrombosis, and strangulated ventral hernia area a challenge in emergency abdominal surgery. This study aimed to evaluate biomarkers of damage to the digestive tract in patients with urgent pathology. Materials and methods: The study involved 71 patients aged 18 to 80 years who were hospitalized in the intensive care unit in the immediate postoperative period. Results: All 71 underwent emergency surgery, 27 with small bowel necrosis. Lactate level area under curve (AUC = 0.964), C-reactive protein (AUC = 0.805) and systolic blood pressure (area under curve, AUC = 0.803) on the context of Sequential Organ Failure Assessment (SOFA) score (AUC = 0.880) showed stratification of patients with complications before surgery. Small bowel necrosis patients revealed an increase in primary thiobarbituric acid (TBA) reactive products (AUC = 0.813) lipid peroxidation products, and a decrease in superoxide dismutase activity (AUC = 0.818) and catalase (AUC = 0.804). Wide variability of intestinal fatty-acid binding protein (I-FABP) from 199.8 to 2189.6 pg/mL were observed in all patients studied, with an AUC = 0.814 in small intestinal necrosis. Conclusion: Surgical pathology of the small intestine due to obstruction of various origina, mesenteric thrombosis, and strangulated ventral hernia pronounced revealed disorders of the antioxidant-prooxidant balance. This was expressed by an increase in lipid peroxidation products, and the level of TBA-reactive products, and the activities of superoxide dismutase (SOD), and catalase. Viewed against the background of an increase in I-FABP above 577 pg/mL, these variables were the most significant indicators of small intestinal necrosis.

Published
2022

26. An Iron-Activated Citrate Transporter, MtMATE67, Is Required for Symbiotic Nitrogen Fixation

Author

Vagner A. Benedito, Catalina I. Pislariu, Michael K. Udvardi, Jin Nakashima, Igor S. Kryvoruchko, Manuel Tejada-Jiménez, Ivone Torres-Jerez, Pratyush Routray, Daniel M. Roberts, Lydia Finney, Manuel González-Guerrero, and Senjuti Sinharoy

Subjects
0106 biological sciences, 0301 basic medicine, Root nodule, Membranes, Transport and Bioenergetics, Physiology, Iron, Plant Science, 01 natural sciences, 03 medical and health sciences, chemistry.chemical_compound, Gene Expression Regulation, Plant, Nitrogen Fixation, Medicago truncatula, Genetics, Citrates, Nicotianamine, Symbiosis, Leghemoglobin, Phylogeny, Plant Proteins, biology, fungi, food and beverages, Nitrogenase, biochemical phenomena, metabolism, and nutrition, Citrate transport, Plants, Genetically Modified, biology.organism_classification, 030104 developmental biology, Symbiosome, chemistry, Biochemistry, Mutation, Nitrogen fixation, Carrier Proteins, Root Nodules, Plant, 010606 plant biology & botany
Abstract

Iron (Fe) is an essential micronutrient for symbiotic nitrogen fixation in legume nodules, where it is required for the activity of bacterial nitrogenase, plant leghemoglobin, respiratory oxidases, and other Fe proteins in both organisms. Fe solubility and transport within and between plant tissues is facilitated by organic chelators, such as nicotianamine and citrate. We have characterized a nodule-specific citrate transporter of the multidrug and toxic compound extrusion family, MtMATE67 of Medicago truncatula The MtMATE67 gene was induced early during nodule development and expressed primarily in the invasion zone of mature nodules. The MtMATE67 protein was localized to the plasma membrane of nodule cells and also the symbiosome membrane surrounding bacteroids in infected cells. In oocytes, MtMATE67 transported citrate out of cells in an Fe-activated manner. Loss of MtMATE67 gene function resulted in accumulation of Fe in the apoplasm of nodule cells and a substantial decrease in symbiotic nitrogen fixation and plant growth. Taken together, the results point to a primary role of MtMATE67 in citrate efflux from nodule cells in response to an Fe signal. This efflux is necessary to ensure Fe(III) solubility and mobility in the apoplasm and uptake into nodule cells. Likewise, MtMATE67-mediated citrate transport into the symbiosome space would increase the solubility and availability of Fe(III) for rhizobial bacteroids.

Published
2017

28. Zn-use efficiency for optimization of symbiotic nitrogenfixation in chickpea (Cicer arietinum L.)

Author

Igor S. Kryvoruchko

Subjects
0106 biological sciences, 0301 basic medicine, chemistry.chemical_classification, biology, Plant Science, biology.organism_classification, 01 natural sciences, Rhizobia, 03 medical and health sciences, 030104 developmental biology, Agronomy, chemistry, Botany, Nitrogen fixation, Essential nutrient, Plant nutrition, 010606 plant biology & botany
Abstract

Zn deficiency is widespread in traditional areas of chickpea cultivation worldwide. It limits chickpea productivity and causes significant losses to the economies of the world?s largest chickpea exporters. This review may be of interest to researchers who would like to contribute to the improvement of chickpea cultivation on Zn-depleted soils in an environmentally sustainable manner, namely via identification of genotypes with superior symbiotic performance under Zn-limited conditions. The primary aim of the current work is to familiarize the readers with the biology and symbiotic characteristics of chickpea, and also to provide the necessary background on Zn as an essential nutrient for symbiotic nitrogen fixation (SNF). Special attention has been paid to the choice of rhizobial strains compatible with chickpea. Strains that can serve as an inoculum for simultaneous analysis of many genetically diverse chickpea lines have been suggested. The genotypes listed in this work can be good starting material for identification of chickpea lineages useful for unraveling the molecular basis of Zn-use efficiency, SNF efficiency, or both.

Published
2017

29. Root Nodule Development in Model Versus Non-canonical Plants

Author

Vagner A. Benedito, Bikash Raul, Kaustav Bandyopadhyay, Igor S. Kryvoruchko, and Senjuti Sinharoy

Subjects
Monophyly, Root nodule, Symbiosis, biology, Evolutionary biology, Mechanism (biology), Lotus japonicus, Nitrogen fixation, biology.organism_classification, Clade, Medicago truncatula
Abstract

Nitrogen-fixing symbiosis is the most successful metabolism-dependent mutualistic symbiosis on earth that influences global nitrogen cycles. Engineering and improvement of this symbiosis is the major avenue towards sustainable agriculture. Root nodule symbiosis (RNS) is restricted to a monophyletic group of angiosperm order. Collectively this group is called nitrogen-fixing symbiosis (NFS) clade. Tremendous multifariousness exists among the infection mechanism, nodule structure, and nitrogen fixation efficiency among nodules. We have gained significant knowledge about the molecular mechanism of RNS in last two decades, using model legumes Medicago truncatula and Lotus japonicus. In this chapter, we present the current status of model legumes used to unveil the molecular mechanisms behind the development of nodules and RNS. We further introduce non-canonical legume species that have been used to expand our understanding of the traits associated with RNS in plants. We have also highlighted the extraordinary variations which came up during the evolution of the RNS. This comparative approach will enable us to identify the variable genetic events that rendered NFS to the RNS clade. In turn, this knowledge will hopefully allow us to carefully engineer it in non-fixing crops.

Published
2019

30. MtSWEET11, a Nodule-Specific Sucrose Transporter of Medicago truncatula

Author

Jeremy D. Murray, Wolf B. Frommer, Vagner A. Benedito, Dian Guan, Catalina I. Pislariu, Davide Sosso, Senjuti Sinharoy, Igor S. Kryvoruchko, Michael K. Udvardi, and Ivone Torres-Jerez

Subjects
0106 biological sciences, 0301 basic medicine, Root nodule, biology, Physiology, fungi, food and beverages, Plant Science, Root hair, Meristem, biology.organism_classification, 01 natural sciences, Medicago truncatula, Rhizobia, 03 medical and health sciences, 030104 developmental biology, Symbiosome, Biochemistry, Genetics, Nitrogen fixation, Rhizobium, 010606 plant biology & botany
Abstract

Optimization of nitrogen fixation by rhizobia in legumes is a key area of research for sustainable agriculture. Symbiotic nitrogen fixation (SNF) occurs in specialized organs called nodules and depends on a steady supply of carbon to both plant and bacterial cells. Here we report the functional characterization of a nodule-specific Suc transporter, MtSWEET11 from Medicago truncatula. MtSWEET11 belongs to a clade of plant SWEET proteins that are capable of transporting Suc and play critical roles in pathogen susceptibility. When expressed in mammalian cells, MtSWEET11 transported sucrose (Suc) but not glucose (Glc). The MtSWEET11 gene was found to be expressed in infected root hair cells, and in the meristem, invasion zone, and vasculature of nodules. Expression of an MtSWEET11-GFP fusion protein in nodules resulted in green fluorescence associated with the plasma membrane of uninfected cells and infection thread and symbiosome membranes of infected cells. Two independent Tnt1-insertion sweet11 mutants were uncompromised in SNF. Therefore, although MtSWEET11 appears to be involved in Suc distribution within nodules, it is not crucial for SNF, probably because other Suc transporters can fulfill its role(s).

Published
2016

31. widgetcon: A website and program for quick conversion among common population genetic data formats

Author

Muhammet Sakiroglu, Igor S. Kryvoruchko, and Mahmut Aydın

Subjects
0106 biological sciences, 0301 basic medicine, Service (systems architecture), Population, Input format, Biology, 010603 evolutionary biology, 01 natural sciences, World Wide Web, 03 medical and health sciences, Resource (project management), Software, Research community, Genetics, education, Ecology, Evolution, Behavior and Systematics, education.field_of_study, Data processing, Internet, business.industry, Genetic data, Computational Biology, 030104 developmental biology, Genetics, Population, business, Biotechnology
Abstract

One of the most tedious steps in genetic data analyses is the reformatting data generated with one program for use with other applications. This conversion is necessary because comprehensive evaluation of the data may be based on different algorithms included in diverse software, each requiring a distinct input format. A platform-independent and freely available program or a web-based tool dedicated to such reformatting can save time and efforts in data processing. Here, we report widgetcon, a website and a program which has been developed to quickly and easily convert among various molecular data formats commonly used in phylogenetic analysis, population genetics, and other fields. The web-based service is available at https://www.widgetcon.net. The program and the website convert the major data formats in four basic steps in less than a minute. The resource will be a useful tool for the research community and can be updated to include more formats and features in the future.

Published
2018

33. Medicago truncatula copper transporter 1 (MtCOPT1) delivers copper for symbiotic nitrogen fixation

Author

Viviana Escudero, Igor S. Kryvoruchko, Marta Senovilla, Isidro Abreu, Michael K. Udvardi, Manuel González-Guerrero, Rosario Castro-Rodríguez, and Juan Imperial

Subjects
0301 basic medicine, Physiology, Plant Science, Saccharomyces cerevisiae, Electron Transport Complex IV, 03 medical and health sciences, Nitrogen Fixation, Medicago truncatula, Nitrogenase, Cytochrome c oxidase, Symbiosis, Gene, Cation Transport Proteins, Copper Transporter 1, Plant Proteins, biology, Chemistry, fungi, Cell Membrane, food and beverages, Biological Transport, Cell Differentiation, biology.organism_classification, Yeast, Apoplast, Complementation, 030104 developmental biology, Phenotype, Biochemistry, Multigene Family, Mutation, Nitrogen fixation, biology.protein, Root Nodules, Plant, Copper
Abstract

Copper is an essential nutrient for symbiotic nitrogen fixation. This element is delivered by the host plant to the nodule, where membrane copper (Cu) transporter would introduce it into the cell to synthesize cupro-proteins. COPT family members in the model legume Medicago truncatula were identified and their expression determined. Yeast complementation assays, confocal microscopy and phenotypical characterization of a Tnt1 insertional mutant line were carried out in the nodule-specific M. truncatula COPT family member. Medicago truncatula genome encodes eight COPT transporters. MtCOPT1 (Medtr4g019870) is the only nodule-specific COPT gene. It is located in the plasma membrane of the differentiation, interzone and early fixation zones. Loss of MtCOPT1 function results in a Cu-mitigated reduction of biomass production when the plant obtains its nitrogen exclusively from symbiotic nitrogen fixation. Mutation of MtCOPT1 results in diminished nitrogenase activity in nodules, likely an indirect effect from the loss of a Cu-dependent function, such as cytochrome oxidase activity in copt1-1 bacteroids. These data are consistent with a model in which MtCOPT1 transports Cu from the apoplast into nodule cells to provide Cu for essential metabolic processes associated with symbiotic nitrogen fixation.

Published
2017

34. Medicago truncatula copper transporter 1 (MtCOPT1) delivers copper for symbiotic nitrogen fixation

Author

Juan Imperial, Rosario Castro-Rodríguez, Viviana Escudero, Igor S. Kryvoruchko, Michael K. Udvardi, Isidro Abreu, Marta Senovilla, and Manuel González-Guerrero

Subjects
biology, fungi, Nitrogenase, chemistry.chemical_element, food and beverages, biology.organism_classification, Copper, Apoplast, Medicago truncatula, Yeast, Complementation, chemistry, Biochemistry, Botany, Nitrogen fixation, Gene
Abstract

Summary• Copper is an essential nutrient for symbiotic nitrogen fixation. This element is delivered by the host plant to the nodule, where membrane copper transporter would introduce it into the cell to synthesize cupro-proteins.• COPT family members in model legumeMedicago truncatulawere identified and their expression determined. Yeast complementation assays, confocal microscopy, and phenotypical characterization of aTnt1insertional mutant line were carried out in the nodule-specificM.truncatulaCOPT family member.•Medicago truncatulagenome encodes eight COPT transporters.MtCOPT1(Medtr4g019870) is the only nodule-specificCOPTgene. It is located in the plasma membrane of the differentiation, interzone and early fixation zones. Loss of MtCOPT1 function results in a copper-mitigated reduction of biomass production when the plant obtains its nitrogen exclusively from symbiotic nitrogen fixation. Mutation ofMtCOPT1results in diminished nitrogenase activity in nodules, likely an indirect effect from the loss of a copper-dependent function, such as cytochrome oxidase activity incopt1-1bacteroids.• These data are consistent with a model in which MtCOPT1 transports copper from the apoplast into nodule cells to provide copper for essential metabolic processes associated with symbiotic nitrogen fixation.

Published
2017
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36. Medicago truncatula Natural Resistance Associated Macrophage Protein1 is required for iron uptake by rhizobia infected nodule cells

Author

Michael K. Udvardi, Rosario Castro-Rodríguez, Juan Imperial, Manuel Tejada-Jiménez, Manuel González-Guerrero, M. Mercedes Lucas, Igor S. Kryvoruchko, Ministerio de Economía y Competitividad (España), and European Research Council

Subjects
0106 biological sciences, Macrophage Protein, Root nodule, Physiology, Iron, Mutant, Plant Science, rhizobia-infected cells, 01 natural sciences, Rhizobia, Apoplast, 03 medical and health sciences, symbiotic nitrogen fixation (SNF), Medicago truncatula, Botany, Genetics, Leghemoglobin, 030304 developmental biology, 0303 health sciences, biology, Agricultura, fungi, Nodule Cells, Nitrogenase, food and beverages, biology.organism_classification, 3. Good health, Biochemistry, Nitrogen fixation, 010606 plant biology & botany
Abstract

30 páginas, 9 figuras, 1 tabla, 13 páginas de explicaciones suplementarias de las figuras, más otras 10 figuras suplementarias, Iron is critical for symbiotic nitrogen fixation (SNF) as a key component of multiple ferroproteins involved in this biological process. In the model legume Medicago truncatula, iron is delivered by the vasculature to the infection/maturation zone (zone II) of the nodule, where it is released to the apoplast. From there, plasma membrane iron transporters move it into rhizobia-containing cells, where iron is used as the cofactor of multiple plant and rhizobial proteins (e.g. plant leghemoglobin and bacterial nitrogenase). MtNramp1 (Medtr3g088460) is the M. truncatula Natural Resistance-Associated Macrophage Protein family member, with the highest expression levels in roots and nodules. Immunolocalization studies indicate that MtNramp1 is mainly targeted to the plasma membrane. A loss-of-function nramp1 mutant exhibited reduced growth compared with the wild type under symbiotic conditions, but not when fertilized with mineral nitrogen. Nitrogenase activity was low in the mutant, whereas exogenous iron and expression of wild-type MtNramp1 in mutant nodules increased nitrogen fixation to normal levels. These data are consistent with a model in which MtNramp1 is the main transporter responsible for apoplastic iron uptake by rhizobia-infected cells in zone II., This work was supported by the Spanish Ministry of Economy and Competitiveness (grant no. AGL–2012–32974 to M.G.-G. and Formación del Personal Investigador fellowship no. BES–2013– 062674 to R.C.-R.), a Marie Curie International Reintegration grant (grant no. IRG–2010–276771 to M.G.-G.), a European Research Council Starting grant (grant no. ERC–2013–StG–335284 to M.G.-G.), and a Ramón y Cajal fellowship (no. RYC–2010–06363 to M.G.-G.)., ACKNOWLEDGMENTS We thank Dr. Alonso Rodríguez-Navarro (Universidad Politécnica deMadrid) for providing plasmid pYPGE15, Dr. David Eide (University of Wisconsin, Madison) for the strain fet3/fet4 and its parental strain, Dr. Benoit Lefebvre (Laboratoire des Interactions Plantes Microorganismes) for the pBI101 vector, Dr. Florian Frugier (Institut des Sciences du Vegétal) for the pFRN vector, Dr. Rosario Haro (Universidad Politécnica de Madrid) for the organelle-specific markers, Dr. Regla Bustos (Instituto Nacional de Investigaciones Agroalimentarias) for the agroinfiltration protocol, Dr. Larry Peterson for the Casparian strip visualization method, and Dr. Tsuyoshi Nakagawa (Shiimane University) for the pGWB vectors.

Published
2015

37. The H+-ATPase HA1 of Medicago truncatula Is Essential for Phosphate Transport and Plant Growth during Arbuscular Mycorrhizal Symbiosis

Author

Franziska Krajinski, Pierre-Emmanuel Courty, Bettina Hause, Daniela Zoeller, Marcel Bucher, Igor S. Kryvoruchko, Philipp Franken, Michael K. Udvardi, Haoqiang Zhang, Nina Gerlach, Daniela Sieh, Max Planck Institute of Molecular Plant Physiology (MPI-MP), Max-Planck-Gesellschaft, University of Basel (Unibas), Leibniz Institute of Vegetable and Ornamental Crops (IVOC), University of Cologne, The Samuel Roberts Noble Foundation, and Leibniz Institute of Plant Biochemistry (IPB)

Subjects
Rhizophagus irregularis, biology, Hypha, [SDV]Life Sciences [q-bio], Mutant, fungi, Wild type, food and beverages, Cell Biology, Plant Science, biology.organism_classification, Medicago truncatula, Apoplast, Cell biology, Periarbuscular membrane, Botany, Host cell cytoplasm, Research Articles
Abstract

A key feature of arbuscular mycorrhizal symbiosis is improved phosphorus nutrition of the host plant via the mycorrhizal pathway, i.e., the fungal uptake of Pi from the soil and its release from arbuscules within root cells. Efficient transport of Pi from the fungus to plant cells is thought to require a proton gradient across the periarbuscular membrane (PAM) that separates fungal arbuscules from the host cell cytoplasm. Previous studies showed that the H+-ATPase gene HA1 is expressed specifically in arbuscule-containing root cells of Medicago truncatula. We isolated a ha1-2 mutant of M. truncatula and found it to be impaired in the development of arbuscules but not in root colonization by Rhizophagus irregularis hyphae. Artificial microRNA silencing of HA1 recapitulated this phenotype, resulting in small and truncated arbuscules. Unlike the wild type, the ha1-2 mutant failed to show a positive growth response to mycorrhizal colonization under Pi-limiting conditions. Uptake experiments confirmed that ha1-2 mutants are unable to take up phosphate via the mycorrhizal pathway. Increased pH in the apoplast of abnormal arbuscule-containing cells of the ha1-2 mutant compared with the wild type suggests that HA1 is crucial for building a proton gradient across the PAM and therefore is indispensible for the transfer of Pi from the fungus to the plant.

Published
2014

40. Keel petal incision: a simple and efficient method for genetic crossing in Medicago truncatula

Author

Senjuti Sinharoy, Michael K. Udvardi, Mark Taylor, Naudin Alexis, Igor S. Kryvoruchko, Vijaykumar Veerappan, Rebecca Dickstein, Khem Kadel, and Ashley Scott

Subjects
0106 biological sciences, Pollination, Stamen, Plant Science, medicine.disease_cause, 01 natural sciences, 03 medical and health sciences, Pollen, Medicago truncatula, Botany, Artificial hybridization, medicine, Genetics, Genetic crossing, 030304 developmental biology, 0303 health sciences, Barrel medic, Ecotype, biology, Bud, fungi, Methodology, food and beverages, biology.organism_classification, Legume, Keel petal, Petal, Keel (bird anatomy), 010606 plant biology & botany, Biotechnology
Abstract

Background Genetic crossing is an essential tool in both forward and reverse genetic approaches to understand the biological functions of genes. For Medicago truncatula (barrel medic) various crossing techniques have been used which differ in the methods used to dissect the female parent’s unopened flower bud to remove immature anthers for prevention of self-pollination. Previously described methods including front, side or back incision methods may damage the flower bud, impeding successful fertilization and/or seed development because they may allow pollen to dislodge and floral organs to desiccate after crossing, all of which diminish the success rates of crossing. Results We report the keel petal incision method for genetic crossing in M. truncatula ecotype R108 and demonstrate successful crosses with two other M. truncatula ecotypes, A17 and A20. In the method presented here, an incision is made along the central line of the keel petal from the bottom 1/3rd of the female parent’s flower bud to its distal end. This allows easy removal of anthers from the flower bud and access for cross-pollination. After pollination, the stigma and the deposited pollen from the male donor are covered by the keel petal, wing petals and standard petal, forming a natural pouch. The pouch prevents dislodging of deposited pollen from the stigma and protects the internal floral organs from drying out, without using cling-film or water-containing chambers to maintain a humid environment. The keel petal incision method showed an approximate 80% success rate in the M. truncatula R108 ecotype and also in other ecotypes including Jemalong A17 and A20. Conclusions Our keel petal incision protocol shows marked improvement over existing methods with respect to the ease of crossing and the percentage of successful crosses. Developed for the M. truncatula R108 ecotype, the protocol has been demonstrated with A17 and A20 ecotypes and is expected to work with other ecotypes. Investigators of varying experience have achieved genetic crosses in M. truncatula using this method.

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