Author: "Jason Chui" - Searchworks@Jio Institute Digital Library Search Results

70 results on '"Jason Chui"'

1. Intraoperative Stimulation Mapping in Neurosurgery for Anesthesiologists, Part 2: The Anesthetic Considerations

Author: Naeema S. Masohood, Gabriel Paquin-Lanthier, Jason Chui, Nancy Lu, Tumul Chowdhury, and Lashmi Venkatraghavan
Subjects: direct electrical stimulation, intraoperative stimulation mapping, awake craniotomy, asleep motor mapping, monitored anesthesia care, neuroanesthesia, Anesthesiology, RD78.3-87.3
Abstract: Intraoperative language and sensorimotor function mapping with direct electrical stimulation allows precise identification of functionally important brain regions. Direct electrical stimulation brain mapping has become the standard of care for the resection of brain lesions near or within eloquent regions with various patient outcome benefits. Intraoperative stimulation mapping (ISM) is commonly performed in an awake patient for language and motor assessments. However, motor mapping under general anesthesia, termed asleep motor mapping, has been increasingly performed over the last two decades for lesions primarily affecting the motor areas of the brain. Both asleep-awake-asleep and monitored anesthesia care have been successfully used for awake craniotomy in modern neuroanesthesia. Each anesthetic agent exerts varying effects on the quality of ISM, especially under general anesthesia. Careful selection of an anesthetic technique is crucial for the successful performance of ISM in both awake and asleep conditions. A comprehensive search was performed on electronic databases such as PubMed, Embase, Cochrane, Scopus, Web of Science, and Google Scholar to identify articles describing anesthesia for awake craniotomy, intraoperative brain mapping, and asleep motor mapping. In the second part of this narrative review, we summarize the effects of different anesthetic regimes and agents on ISM, causes of the failure of awake craniotomy and mapping, and outline the anesthetic considerations for ISM during awake craniotomy and asleep motor mapping.
Published: 2023
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2. Intraoperative Stimulation Mapping in Neurosurgery for Anesthesiologists—Part 1: The Technical Nuances

Author: Naeema S. Masohood, Gabriel Paquin-Lanthier, Jason Chui, Nancy Lu, Tumul Chowdhury, and Lashmi Venkatraghavan
Subjects: direct electrical stimulation, intraoperative stimulation mapping, awake craniotomy, language mapping, motor mapping, Anesthesiology, RD78.3-87.3
Abstract: Brain mapping has evolved tremendously in the past decade, fueled by advances in functional neuroimaging technology in neuro-oncology and epilepsy surgery. Despite this, wide anatomic-functional interindividual variability and intraoperative brain shift continue to challenge neurosurgeons performing surgery within or near eloquent brain regions. As such, intraoperative direct cortical and subcortical stimulation mapping remains the gold standard for localizing eloquent brain regions with precision for a safe and tailored resection. Intraoperative stimulation mapping (ISM) allows for maximizing the extent of resection while minimizing postoperative neurological deficits, resulting in better patient outcomes. Understanding the technical nuances of ISM is imperative for the anesthesiologist to provide better anesthetic management tailored to the surgery and stimulation mapping planned. A comprehensive search was performed on electronic databases to identify articles describing intraoperative cortical and subcortical mapping, language, and motor mapping. In the first part of this narrative review, we summarize the salient technical aspects of ISM and the common neurophysiological tasks assessed intraoperatively relevant to the anesthesiologist.
Published: 2023
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3. Assessing the Sensitivity of Multi-Distance Hyperspectral NIRS to Changes in the Oxidation State of Cytochrome C Oxidase in the Brain

Author: Marianne Suwalski, Leena N. Shoemaker, J. Kevin Shoemaker, Mamadou Diop, John M. Murkin, Jason Chui, Keith St. Lawrence, and Daniel Milej
Subjects: cytochrome c oxidase, hyperspectral NIRS, carotid compression, tissue oxygen saturation, diffuse correlation spectroscopy, blood flow index, Microbiology, QR1-502
Abstract: Near-infrared spectroscopy (NIRS) measurements of tissue oxygen saturation (StO2) are frequently used during vascular and cardiac surgeries as a non-invasive means of assessing brain health; however, signal contamination from extracerebral tissues remains a concern. As an alternative, hyperspectral (hs)NIRS can be used to measure changes in the oxidation state of cytochrome c oxidase (ΔoxCCO), which provides greater sensitivity to the brain given its higher mitochondrial concentration versus the scalp. The purpose of this study was to evaluate the depth sensitivity of the oxCCO signal to changes occurring in the brain and extracerebral tissue components. The oxCCO assessment was conducted using multi-distance hsNIRS (source-detector separations = 1 and 3 cm), and metabolic changes were compared to changes in StO2. Ten participants were monitored using an in-house system combining hsNIRS and diffuse correlation spectroscopy (DCS). Data were acquired during carotid compression (CC) to reduce blood flow and hypercapnia to increase flow. Reducing blood flow by CC resulted in a significant decrease in oxCCO measured at rSD = 3 cm but not at 1 cm. In contrast, significant changes in StO2 were found at both distances. Hypercapnia caused significant increases in StO2 and oxCCO at rSD = 3 cm, but not at 1 cm. Extracerebral contamination resulted in elevated StO2 but not oxCCO after hypercapnia, which was significantly reduced by applying regression analysis. This study demonstrated that oxCCO was less sensitive to extracerebral signals than StO2.
Published: 2022
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4. Propofol Reduces Microelectrode-Recording Artefacts caused by Parkinsonian Tremor during Deep Brain Stimulation

Author: Jason Chui, Rizq Alamri, Frank Bihari, Matthew Hebb, and Lakshmikumar Venkatraghavan
Subjects: a tremor effect, deep brain stimulation, parkinson’s disease, propofol, Anesthesiology, RD78.3-87.3
Abstract: A 51-year-old male with medically refractory Parkinson's disease was scheduled for bilateral deep brain stimulation (DBS). During microelectrode recordings (MERs) of right side DBS, the patient developed severe sustained whole-body tremors causing severe artefacts in MER. The right side DBS electrode was inserted with suboptimal MER. For the creation of left burr hole, propofol infusion at a rate of 20 μg/kg/min, was used and soon after, all tremor activity ceased. Propofol infusion was continued during left side MER. With the absence of tremors, left subthalamic nucleus spike activity was better identified and neurological testing could take place. At 6 months after DBS, the patient’s symptoms had improved significantly without the need for levodopa.
Published: 2018
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5. TUM-VIE: The TUM Stereo Visual-Inertial Event Dataset.

Author: Simon Klenk, Jason Chui, Nikolaus Demmel, and Daniel Cremers
Published: 2021
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6. Event-Based Feature Tracking in Continuous Time with Sliding Window Optimization.

Author: Jason Chui, Simon Klenk, and Daniel Cremers
Published: 2021

7. Effects of blood pressure on brain metabolism during cardiopulmonary bypass

Author: Marianne Suwalski, Daniel Milej, Ajay Rajaram, Mamadou Diop, John Murkin, Jason Chui, and Keith St. Lawrence
Published: 2023

8. How should aerosol generating procedures be defined?

Author: Jason Chui, David SC Hui, and Matthew TV Chan
Subjects: SARS-CoV-2, Humans, Respiratory Aerosols and Droplets, General Medicine, Personal Protective Equipment
Published: 2022

9. A Rare Case of Transient Hemiplegia in a Patient With History of Spinal Cord Reperfusion Syndrome After Anterior Cervical Decompression and Fusion Surgery

Author: Luis E, Mendoza Vasquez and Jason, Chui
Published: 2022

10. Assessment by Multi‐Distance Hyperspectral NIRS of Changes in the Oxidation State of Cytochrome C Oxidase (oxCCO) to Carotid Artery Compressions

Author: Leena Shoemaker, Marianne Suwalski, Daniel Milej, J. K. Shoemaker, Jason Chui, and Keith St. Lawrence
Subjects: Genetics, Molecular Biology, Biochemistry, Biotechnology
Published: 2022

11. A novel approach of using brachial plexus blockade as an experimental model for diagnosis of intraoperative nerve dysfunction with somatosensory evoked potentials: a blinded proof-of-concept study

Author: Shalini Dhir, Greydon Glimore, Jason Chui, Alex Freytag, John M. Murkin, and Max Rachinsky
Subjects: medicine.medical_specialty, Experimental model, business.industry, Diagnostic test, Sensory system, General Medicine, Models, Theoretical, Brachial Plexus Block, Blockade, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology and Pain Medicine, 030202 anesthesiology, Somatosensory evoked potential, Evoked Potentials, Somatosensory, Anesthesia, Anesthesiology, medicine, Humans, Brachial Plexus, Evoked potential, business, Brachial plexus, 030217 neurology & neurosurgery
Abstract: Intraoperative nerve dysfunction has been difficult to investigate because of its rarity and unpredictable occurrence. The diagnostic test attributes of nerve function monitors have not been clearly defined. This proof-of-concept study aimed to assess the feasibility of using brachial plexus blockade (BPB) in awake patients as an experimental model for nerve dysfunction to characterize the diagnostic test attributes of somatosensory evoked potentials (SSEPs).We obtained baseline SSEPs and neurologic function in patients and subsequently placed BPBs (experimental model) to generate progressive states of nerve dysfunction. We monitored SSEP changes (index test) and neurologic symptoms (reference standard) simultaneously during the onset of BPB to determine the temporal relationships and diagnostic test attributes of SSEPs.Brachial plexus blockade produced differential motor and sensory dysfunction that allowed simultaneous clinical and neurophysiologic assessment. One hundred and fifty-seven pairs of multiple data points from 14 patients were included for final analysis. The onset of abnormal SSEP signals almost always preceded the onset of neurologic symptoms. The sensitivities and specificities of SSEP to detect the impairment of power (motor rating score ≤ 4/5), cold sensation, and two-point discrimination were 100% and 67%, 99% and 55%, and 100% and 46%, respectively.This study found that BPB can produce sufficient differential nerve dysfunction to allow adequate evaluation of the diagnostic test attributes of SSEPs as a nerve monitor. The results of this study may stimulate further work on refining intraoperative nerve dysfunction models and diagnostic nerve function monitors.www.clinicaltrials.gov (NCT03409536); registered 24 January 2018.RéSUMé: OBJECTIF: La dysfonction nerveuse peropératoire est difficile à étudier en raison de sa rareté et de son imprévisibilité. Les attributs d’un test diagnostique des moniteurs de la fonction nerveuse n’ont pas été clairement définis. Cette étude de démonstration de faisabilité visait à évaluer la faisabilité de l’utilisation d’un bloc du plexus brachial (BPB) chez des patients éveillés comme modèle expérimental de la dysfonction nerveuse afin de caractériser les attributs de test diagnostique des potentiels évoqués somesthésiques (PES). MéTHODE: Nous avons enregistré les PES et la fonction neurologique de base des patients, puis administré des BPB (modèle expérimental) pour générer des états progressifs de dysfonction nerveuse. Nous avons surveillé simultanément les changements des PES (test pour déterminer l’indicateur) et les symptômes neurologiques (norme de référence) pendant l’évolution du BPB afin de déterminer les relations temporelles et les attributs de test diagnostique des PES. RéSULTATS: Le bloc du plexus brachial a produit une dysfonction motrice et sensorielle différentielle qui nous a permis de procéder à une évaluation clinique et neurophysiologique simultanée. Cent cinquante-sept paires de points de données multiples issues de 14 patients ont été incluses pour l’analyse finale. L’apparition de signaux de PES anormaux a presque toujours précédé l’apparition de symptômes neurologiques. Les sensibilités et les spécificités des PES pour détecter la perte de force (score moteur ≤ 4/5), la sensation de froid et la discrimination à deux points étaient de 100 % et 67 %, 99 % et 55 %, et 100 % et 46 %, respectivement. CONCLUSION: Cette étude a constaté que le bloc du plexus brachial peut produire une dysfonction nerveuse différentielle suffisante pour permettre l’évaluation adéquate des attributs de test diagnostique des PES en tant que moniteur nerveux. Les résultats de cette étude pourraient motiver d’autres travaux sur l’amélioration des modèles de dysfonction nerveuse peropératoire et des moniteurs diagnostiques de la fonction nerveuse. ENREGISTREMENT DE L’éTUDE: www.clinicaltrials.gov (NCT03409536); enregistrée le 24 janvier 2018.
Published: 2021

12. Intraoperative neuromonitoring for scoliosis surgery: is there an end to justify the means?

Author: Alana M. Flexman and Jason Chui
Subjects: medicine.medical_specialty, Anesthesiology and Pain Medicine, business.industry, Anesthesia, Anesthesiology, Pain medicine, Fatty liver, medicine, MEDLINE, General Medicine, medicine.disease, business, Scoliosis surgery
Published: 2021

13. REAL-TIME LEARNING ANALYTICS FOR FACE-TO-FACE LESSONS

Author: Singapore Nanyang Polytechnic, Jason Chui, and Joanne Foo
Subjects: Class (computer programming), Data collection, Multimedia, Computer science, business.industry, Learning analytics, General Medicine, computer.software_genre, Face-to-face, Data visualization, Analytics, Learning Management, Action research, business, computer
Abstract: Even though the use of digital technology and e-learning has grown over the years, most of the time spent in schools around the world is still in face-to-face lessons. Traditional classroom teaching encounters fundamental constraints like the difficulty faced by one educator to track the understanding of a group of learners. Numerous tools exist to help educators but they are mostly detached from the actual teaching and learning materials, and hence necessitate a breaking away from the flow of the lesson to collect, visualize and understand the data collected. In this paper, we present a real-time learning analytics system that can provide both educators and learners with a real-time view of the data collected from learners’ interaction with a mobile-optimized lesson embedded in a learning management system and accessible via mobile phones or computers. Data collection and visualization are automated and achieved with no friction to the flow of the lesson. The educator could use the data to keep track of individual students’ responses, as well as moderate the pace of the whole class. Action research was done on a total of four classes of students to test the benefits of using the real-time learning analytics system. Quantitative sentiment feedback was collected and the number of targeted interventions by the educators was recorded. Targeted interventions are defined as moments when the educator spot a learning gap or misconception and intervene immediately to address the issue. Both categories of data captured showed positive results for the use of real-time learning analytics in the classroom. The system has the potential to be used in any domain as it is domain-neutral and built on open-source technology. Usage of the system does not require much technical know-how, and the lessons created can be easily exported into any major Learning Management Systems (LMSs).
Published: 2020

14. Postoperative hemodynamic management in patients undergoing resection of cerebral arteriovenous malformations: A retrospective study

Author: Bahadur Niazi, Jason Chui, and Lashmi Venkatraghavan
Subjects: Adult, Intracranial Arteriovenous Malformations, Male, medicine.medical_specialty, Hemodynamics, Brain Edema, Postoperative Hemorrhage, Cerebral edema, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Physiology (medical), Humans, Medicine, Cerebral Hemorrhage, Retrospective Studies, Postoperative Care, business.industry, Incidence (epidemiology), Medical record, Arteriovenous malformation, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Surgery, Blood pressure, Neurology, 030220 oncology & carcinogenesis, Arteriovenous Fistula, Female, Neurology (clinical), business, Complication, 030217 neurology & neurosurgery
Abstract: Strict control of blood pressure (BP) has been recommended in patients after surgical resection of cerebral arteriovenous malformations (AVM) to prevent postoperative hyperemic complication. The aim of this study was to review the postoperative hemodynamic management in patients after surgical resection of cerebral AVM and the incidence of postoperative intracranial hemorrhage and/or cerebral edema. After the ethics approval, we retrospectively reviewed the medical records of 207 adult patients who underwent elective surgical resection of cerebral AVM from Jan 2005 to Oct 2016 in a single university hospital. We determined the incidence of postoperative symptomatic intracranial hemorrhage and/or cerebral edema, and reviewed the quality of postoperative BP control during the first 72 h postoperatively. Two hundred and seven patients who underwent cerebral AVM resection were included. The median (IQR) of postoperative maximal systolic BP target was 110 (100–120) mmHg but the range was 90–150 mmHg. Failed hemodynamic control was consistently found in half of the patients during the first 72 h postoperatively. The incidence of postoperative intracranial hemorrhage and/or cerebral edema was 4.4% (9/207 patients). All 9 of these patients experienced a hypertensive event prior to their postoperative hyperemic complication. Two patients required induced hypertension to treat postoperative symptomatic cerebral edema. We concluded that postoperative intracranial hemorrhage and/or cerebral edema is not an uncommon complication after surgical resection of cerebral AVM. Further studies are required to develop a more effective strategy to implement strict BP control in the postoperative period.
Published: 2020

15. Assessing the sensitivity of multi-distance hsNIRS for measuring changes in oxCCO in the brain

Author: Marianne Suwalski, Daniel Milej, Leena N. Shoemaker, J. Kevin Shoemaker, Jason Chui, and Keith St. Lawrence
Abstract: A hybrid multi-distance hyperspectral near-infrared spectroscopy (hsNIRS) and diffuse correlation spectroscopy (DCS) optical system was used to test transient changes in cytochrome c oxidase (oxCCO) in the brain during carotid compressions (CC) and hypercapnia.
Published: 2022

16. Efficacy of perioperative pharmacological and regional pain interventions in adult spine surgery: a network meta-analysis and systematic review of randomised controlled trials

Author: James Zhou, Sandy Bae, Alina Abbasi, Jason Chui, Abdulrahman Alboog, and Katherine S. Esquivel
Subjects: Adult, medicine.medical_specialty, Analgesic, Network Meta-Analysis, Psychological intervention, Internal medicine, Intervention (counseling), Credible interval, medicine, Humans, Pain Measurement, Randomized Controlled Trials as Topic, Analgesics, Pain, Postoperative, Morphine, business.industry, Perioperative, Spine, Analgesics, Opioid, Anesthesiology and Pain Medicine, Pooled variance, Meta-analysis, Drug Therapy, Combination, business, medicine.drug
Abstract: Background Development of a widely accepted standardised analgesic pathway for adult spine surgery has been hampered by the lack of quantitative analysis. We conducted a systematic review and network meta-analysis (NMA) to compare, rank, and grade all pharmacological and regional interventions used in adult spine surgery. Methods A systematic search was performed in January 2021. We performed double study screening, selection, and data extraction. The co-primary outcomes were cumulative morphine consumption (mg) and visual analogue pain score (range 0–10) at postoperative 24 h. An NMA was performed using the Bayesian approach (random effects model). We also ranked and graded all analgesic interventions using the Grading of Recommendations Assessment, Development and Evaluation approach for NMA. Results We screened 5908 studies and included 86 randomised controlled studies, which comprised 6284 participants. Of 20 pharmacological and 10 regional interventions, the most effective intervention was triple-drug therapy, consisting of paracetamol, nonsteroidal anti-inflammatory drugs, and adjunct. The pooled mean reduction in morphine consumption and pain score at postoperative 24 h were –26 (95% credible interval [CrI]: –39 to –12) mg and –2.3 (95% CrI: –3.1 to –1.4), respectively. Double-drug therapy was less effective, but showed moderate morphine reduction in a range of –15 to –17 mg and pain score reduction in a range of –1 to –1.6. Single-agent interventions were largely ineffective. Conclusions Triple-drug therapy is the most effective pain intervention in adult spine surgery with moderate-to-high certainty of evidence. We have also identified a graded analgesic effect, in which analgesic efficacy increased with the number of multimodal drugs used. Systematic review registration PROSPERO (CRD42020171326).
Published: 2021

17. Anesthetic management of complex spine surgery in adult patients

Author: Jason Chui, Sandy Bae, and Abdulrahman Alboog
Subjects: Adult, Blood Loss, Surgical, MEDLINE, Anesthetic management, Outcome (game theory), Neurosurgical Procedures, Patient Positioning, 03 medical and health sciences, 0302 clinical medicine, Spine surgery, Clinical Protocols, Pain control, Blood loss, 030202 anesthesiology, Humans, Pain Management, Medicine, Anesthesia, Enhanced recovery after surgery, Pain, Postoperative, Evidence-Based Medicine, Adult patients, business.industry, Treatment Outcome, Anesthesiology and Pain Medicine, Spinal Diseases, Enhanced Recovery After Surgery, business, 030217 neurology & neurosurgery
Abstract: The aim of this article is to review the evidence regarding the anesthetic management of blood loss, pain control, and position-related complications of adult patients undergoing complex spine procedures.The most recent evidence of the anesthetic management of complex spine surgery was identified with a systematic search and graded. In our review, prophylactic tranexamic acid and optimal prone positioning were shown to be effective blood conservation strategies with minimal risks to the patients. Cell saver was cost-effective in complex surgeries with expected blood loss of greater than 500 ml. As for pain control, most interventions only produced mild analgesic effects, suggesting a multimodal approach is necessary to achieve optimal pain control after spine surgery. Regional techniques and NSAIDs were effective but because of their risks, their usage should be discussed with the surgical team. Further studies are required to assess the effectiveness, cost-effectiveness, and risks associated with combined uses of different analgesic interventions. On the basis of the available evidence, we recommend a combined use of gabapentinoids, ketamine, and opioids to achieve optimal analgesia. Lastly, literature for position-related injuries is heavily relied on case reports and the Anesthesia Closed Claim Study because of their rarity. Therefore, we advocate for a structured team-based approach with checklists to minimize position-related complications.As the number and complexity of spine procedures are being performed worldwide is increasing, we suggested to bundle the aforementioned effective interventions as part of an ERAS spine protocol to improve the patient outcome of spine surgery.
Published: 2019

18. A Pilot Study of a Novel Automated Somatosensory Evoked Potential (SSEP) Monitoring Device for Detection and Prevention of Intraoperative Peripheral Nerve Injury in Total Shoulder Arthroplasty Surgery

Author: Darren S. Drosdowech, Jason Chui, and John M. Murkin
Subjects: Male, medicine.medical_specialty, Intraoperative Neurophysiological Monitoring, medicine.medical_treatment, Pilot Projects, 03 medical and health sciences, 0302 clinical medicine, Peripheral Nerve Injuries, 030202 anesthesiology, Evoked Potentials, Somatosensory, medicine, Humans, Prospective Studies, Intraoperative Complications, Prospective cohort study, Ulnar nerve, Ulnar Nerve, Aged, Aged, 80 and over, Univariate analysis, business.industry, Electroencephalography, Middle Aged, medicine.disease, Arthroplasty, Median nerve, Median Nerve, Surgery, Anesthesiology and Pain Medicine, Peripheral neuropathy, Arthroplasty, Replacement, Shoulder, Somatosensory evoked potential, Peripheral nerve injury, Arm, Female, Radial Nerve, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract: Introduction Peripheral nerve injury is a potentially devastating complication after total shoulder arthroplasty (TSA) surgery. This pilot study aimed to assess the feasibility of using an automated somatosensory evoked potential (SSEP) device to provide a timely alert/intervention to minimize intraoperative nerve insults during TSA surgery. Methods A prospective, single-arm, observational study was conducted in a single university hospital. The attending anesthesiologist monitored the study participants using the EPAD automated SSEP device and an intervention was made if there was an alert during TSA surgery. The median, radial, and ulnar nerve SSEP on the operative arm, as well as the median nerve SSEP of the nonoperative arm were monitored for each patient. All patients were evaluated for postoperative neurological deficits 6 weeks postoperatively. Results In total, 21 patients were consented and were successfully monitored. In total, 4 (19%) patients developed intraoperative abnormal SSEP signal changes in the operative arm, in which 3 were reversible and 1 was irreversible till the end of surgery. Median and radial nerves were mostly involved (3/4 patients). The mean cumulative duration of nerve insult (abnormal SSEP) was 21.7±26.2 minutes. Univariate analysis did not identify predictor of intraoperative nerve insults. No patients demonstrated postoperative peripheral neuropathy at 6 weeks. Conclusions A high incidence (19%) of intraoperative nerve insult was observed in this study demonstrating the feasibility of using an automated SSEP device to provide a timely alert and enable an intervention in order to minimize peripheral nerve injury during TSA. Further randomized studies are warranted.
Published: 2019

19. Automated Nerve Monitoring in Shoulder Arthroplasty: A Prospective Randomized Controlled Study

Author: Moaz B. Y. Chohan, Shalini Dhir, Kenneth J. Faber, George S. Athwal, Maxim Rachinsky, Darren S. Drosdowech, John M. Murkin, and Jason Chui
Subjects: Male, medicine.medical_treatment, law.invention, 03 medical and health sciences, 0302 clinical medicine, Primary outcome, Randomized controlled trial, Peripheral Nerve Injuries, Interquartile range, law, Monitoring, Intraoperative, medicine, Humans, Single-Blind Method, In patient, Prospective Studies, Evoked potential, Aged, business.industry, Significant difference, Nerve injury, Arthroplasty, Anesthesiology and Pain Medicine, Arthroplasty, Replacement, Shoulder, 030220 oncology & carcinogenesis, Anesthesia, Female, medicine.symptom, business, 030217 neurology & neurosurgery
Abstract: Background Evoked potential monitoring is believed to prevent neurologic injury in various surgical settings; however, its clinical effect has not been scrutinized. It was hypothesized that an automated nerve monitor can minimize intraoperative nerve injury and thereby improve clinical outcomes in patients undergoing shoulder arthroplasty. Methods A prospective, blinded, parallel group, superiority design, single-center, randomized controlled study was conducted. Study participants were equally randomized into either the automated nerve-monitored or the blinded monitored groups. The primary outcome was intraoperative nerve injury burden as assessed by the cumulative duration of nerve alerts. Secondary outcomes were neurologic deficits and functional scores of the operative arm, and the quality of life index (Euro Quality of life-5 domain-5 level score) at postoperative weeks 2, 6, and 12. Results From September 2018 to July 2019, 213 patients were screened, of whom 200 were randomized. There was no statistically significant difference in the duration of nerve alerts between the automated nerve-monitored and control groups (median [25th, 75th interquartile range]: 1 [0, 18] and 5 [0, 26.5]; Hodges–Lehman difference [95% CI]: 0 [0 to 1] min; P = 0.526). There were no statistically significant differences in secondary outcomes between groups. However, in the ancillary analysis, there were reductions in neurologic deficits and improvements in quality of life index occurring in both groups over the course of the study period. Conclusions Protection from nerve injury is a shared responsibility between surgeons and anesthesiologists. Although a progressive improvement of clinical outcomes were observed over the course of the study in both groups as a consequence of the real-time feedback provided by the automated nerve monitor, this trial did not demonstrate that automated nerve monitoring by itself changes important clinical outcomes compared with no monitoring. Editor’s Perspective What We Already Know about This Topic What This Article Teaches Us That Is New
Published: 2021

20. Cerebral perfusion and metabolic neuromonitoring during cardiopulmonary bypass

Author: Mamadou Diop, John M. Murkin, Linrui Ray Guo, Keith St. Lawrence, Marianne Suwalski, Lawrence C. M. Yip, Michael W.A. Chu, Jason Chui, Daniel Milej, and Ajay Rajaram
Subjects: medicine.medical_specialty, Mean arterial pressure, business.industry, Hemodynamics, Diffuse correlation spectroscopy, law.invention, surgical procedures, operative, Cerebral blood flow, law, Cardiothoracic surgery, Internal medicine, medicine, Cardiology, Cardiopulmonary bypass, Cerebral perfusion pressure, business, Perfusion, circulatory and respiratory physiology
Abstract: During surgery with cardiopulmonary bypass (CPB), maintaining adequate cerebral blood flow (CBF) is paramount to prevent adverse neurological outcome; tissue damage can occur if CBF reduction is sufficient to impair energy metabolism. Ten adult patients undergoing cardiothoracic surgery with CPB received perfusion and metabolic neuromonitoring using a novel optical system combining diffuse correlation spectroscopy and broadband near-infrared spectroscopy. CPB onset resulted in large increases in CBF and significant drops in mean arterial pressure and metabolism. No changes were observed transitioning off CPB. Real-time assessment of cerebral perfusion and metabolism could alert clinicians to relevant hemodynamic events before brain injury occurs.
Published: 2021

21. Postoperative management after coronary artery bypass graft surgery

Author: John M. Murkin and Jason Chui
Subjects: medicine.medical_specialty, medicine.anatomical_structure, business.industry, Medicine, business, Surgery, Postoperative management, Artery
Abstract: Postoperative management of patients following coronary artery bypass graft surgery is focused on fast-track recovery but can be challenging, and is often characterized by haemodynamic fluctuations that may require inotropic support, fluid compartment shifts, an increased bleeding tendency, and occasional surgical complications that require urgent re-exploration. This chapter focuses primarily on haemodynamic management and the attendant indications for and choices of pharmacological therapy, as well as considering the indications for continuance or initiation of longer-term medications. Other aspects of acute care such as bleeding and coagulopathy, respiratory support and ventilation and weaning protocols, sedation, and pain control are also important to ensure a smooth transition from acute care to hospital discharge.
Published: 2021

22. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study

Author: Dmitri, Nepogodiev, Joana Ff Simoes, Elizabeth, Li, Maria, Picciochi, James, C Glasbey, Glauco, Baiocchi, Ruth, Blanco-Colino, Daoud, Chaudhry, Ehab, Alameer, Kariem, El-Boghdadly, Funmilola, Wuraola, Dhruva, Ghosh, Rohan, R Gujjuri, Ewen, M Harrison, Herman, Lule, Haytham, Kaafarani, Mohammad, Khosravi, Irmgard, Kronberger, Sezai, Leventoğlu, Harvinder, Mann, Kenneth, A Mclean, Mengistu Gebreyohanes Mengesha, Maria Marta Modolo, Faustin, Ntirenganya, Lisa, Norman, Oumaima, Outani, Riinu, Pius, Peter, Pockney, Ahmad Uzair Qureshi, April Camilla Roslani, Sohei, Satoi, Catherine, Shaw, Aneel, Bhangu, Omar, M Omar, Waheed-Ul-Rahman, Ahmed, Leah, Argus, Alasdair, Ball, Edward, P Bywater, Amanpreet, Brar, Brett, E Dawson, Irani, Duran, Muhammed, Elhadi, Conor, S Jones, Sivesh, K Kamarajah, James, M Keatley, Samuel, Lawday, Ella, J Marson, Riinu, Ots, Irène, Santos, Elliott, H Taylor, Isobel, M Trout, Chris, Varghese, Mary, L Venn, William, Xu, Irida, Dajti, Arben, Gjata, Salah Eddine Oussama Kacimi, Luis, Boccalatte, Daniel, Cox, Philip, Townend, Felix, Aigner, Irmgard Elisabeth Kronberger, Elgun, Samadov, Amer, Alderazi, Kamral, Hossain, Greg, Padmore, Gabrielle van Ramshorst, Ismaïl, Lawani, Anis, Cerovac, Samir, Delibegovic, Gustavo Mendonça Ataíde Gomes, Igor Lima Buarque, Muhammad, Gohar, Mihail, Slavchev, Chukwuemeka, Nwegbu, Arnav, Agarwal, Janet, Martin, Joshua, Ng-Kamstra, Maricarmen, Olivos, Wenhui, Lou, Dong-Lin, Ren, Jose Andres Calvache, Carlos, J Perez Rivera, Ana Danic Hadzibegovic, Tomislav, Kopjar, Jakov, Mihanovic, Pablo Mijahil Avilés Jiménez, Nikolaos, Gouvas, Jaroslav, Klat, René, Novysedlák, Nicolas, Amisi, Peter, Christensen, Alaa, El-Hussuna, Sylvia, Batista, Eddy, Lincango-Naranjo, Sameh, Emile, Danilo Alfonso Arévalo Sandoval, Hailu, Dhufera, Samuel, Hailu, Mengistu, G Mengesha, Joonas, H Kauppila, Alexis, P Arnaud, Zaza, Demetrashvili, Markus, Albertsmeier, Hans, Lederhuber, Markus, W Löffler, Daniel Kwesi Acquah, Bernard, Ofori, Stephen, Tabiri, Symeon, Metallidis, Georgios, Tsoulfas, Maria-Lorena, Aguilera-Arevalo, Gustavo, Recinos, Tamás, Mersich, Dániel, Wettstein, Gabriele, Kembuan, Peiman Brouki Milan, Mohammad Hossein Khosravi, Masoud, Mozafari, Ahmed, Hilmi, Helen, Mohan, Oded, Zmora, Gaetano, Gallo, Francesco, Pata, Gianluca, Pellino, Yuki, Fujimoto, Naoto, Kuroda, Mohamad, K Abou Chaar, Faris, Ayasra, Ildar, Fakhradiyev, Intisar Hisham Said Hamdun, Jang, Jin-Young, Mohammad, Jamal, Lina, Karout, Aiste, Gulla, Fanjandrainy, Rasoaherinomenjanahary, Luc Hervé Samison, Iran Irani Durán Sánchez, Diana Samantha Gonzalez, Laura, Martinez, María José Martínez, Alejandra, Nayen, Antonio Ramos-De la Medina, Jade, Nunez, Pueya Rashid Nashidengo, Rakesh, Shah, Ashish Lal Shrestha, Pascal, Jonker, Schelto, Kruijff, Milou, Noltes, Pieter, Steinkamp, Deborah, Wright, Lukman, Abdur-Rahman, Adesoji, Ademuyiwa, Adewale, Adisa, Babatunde, Osinaike, Justina, Seyi-Olajide, Omolara, Williams, Emmanuel, Williams, Sofija, Pejkova, Zainab Al Balushi, Raza, Sayyed, Mustafa Abo Mohsen, Sadi, A Abukhalaf, Moises, Cukier, Hugo, Gomez-Fernandez, Sebastian Shu Yip, Ximena Paola Vasquez Ojeda, Marie Dione Sacdalan, Piotr, Major, José, Azevedo, Miguel, F Cunha, Ahmad, Zarour, Eduard-Alexandru, Bonci, Ionut, Negoi, Sergey, Efetov, Viktor, Kochetkov, Andrey, Litvin, Jc Allen Ingabire, Georges, Bucyibaruta, Ntirenganya, Faustin, Sosthene, Habumuremyi, Alphonsine, Imanishimwe, Haragirimana Jean de Dieu, Emmanuel, Munyaneza, Isaie, Ncogoza, Abdourahmane, Ndong, Dejan, Radenkovic, Min Hoe Chew, Frederick, Koh, James, Ngu, Arpád, Panyko, Uros, Bele, Jurij Aleš Košir, Hassan, Daoud, Ana Maria Minaya Bravo, Umesh, Jayarajah, Dakshitha, Wickramasinghe, Mohammed Elmujtba Adam Essa Adam, Martin, Rutegård, Malin, Sund, Michel, Adamina, Eleftherios, Gialamas, Karoline, Horisberger, Muhammad, Alshaar, Abel, Huang, Varut, Lohsiriwat, Shane, Charles, Haithem, Jlassi, Arda, Isik, Hervé Monka Lekuya, Slava, Kopetskyi, Hayder, Alsaadi, Sattar, Alshryda, Osaid, Alser, Brittany, Bankhead-Kendall, Kerry, Breen, Hassan, Mashbari, Fernando Bonilla Cal, Hamza, Al-Naggar, Mayaba, Maimbo, Dennis, Mazingi, Tom, Abbott, Melika, Akhbari, Ruth, Benson, Shivam, Bhanderi, Bruce, Biccard, Edward, Caruana, Sohini, Chakrabortee, Reema, Chapatwala, Ainhoa, Costas-Chavarri, Andreas, K Demetriades, Anant, Desai, Salomone Di Saverio, Thomas, Drake, John, Edwards, Jonathan, Evans, Marco, Fiore, Samuel, Ford, Christina, Fotopoulou, Alexander, Fowler, Kaori, Futaba, Ian, Ganly, Harelimana Grace James, Ewen, Griffiths, Alessandro, Gronchi, Peter, Hutchinson, Gabriella Yael Hyman, Joseph, Incorvia, Ritu, Jain, Michael, Jenkinson, Tabassum, Khan, Stephen Richard Knight, Angelos, Kolias, Søren, Kudsk-Iversen, Tsun Yu Kwan, Elaine, Leung, Julio, Mayol, Siobhan, Mckay, John, G Meara, Emily, Mills, Susan, Moug, Akshay, Patel, Roberto, Perinotti, Henry, E Rice, Keith, Roberts, Andrew, Schache, Richard, Shaw, Neil, Smart, Matthew, Stephens, Grant, D Stewart, Ella, Teasdale, Peter, Vaughan-Shaw, Raghavan, Vidya, Naomi, Wright, Natalie, Zimmelman, Ervis, Agastra, Dariel, Thereska, Sergio Martin Lucchini, Veronica, Laudani, Carina, Chwat, Ivana Ines Pedraza Salazar, Diana Alejandra Pantoja Pachajoa, Agustin, Duro, José Alfredo Calderón Arancibia, Giuliana, D'Aulerio, Nagendra, Dudi-Venkata, Natasha, Egoroff, Shebani, Farik, Natalie, Lott, Jana-Lee, Moss, Sarah, Rennie, Lorwai, Tan, Uyen Giao Vo, David, Watson, David, Watters, Tim, Bright, Paul, Hollington, Xuanyu, Zhou, Hidde, M Kroon, Anthony, Farfus, John, Barker, Eleanor, Watson, Sean, Stevens, Haider, Latif, Amanda Caroline Dawson, Alwin, Chuan, Vijayaragavan, Muralidharan, Enoch, Wong, Travis, Ackermann, Maurizio, Pacilli, Russell, Hodgson, Alexander, Heriot, Peter, Choong, Wendy, Brown, Surjit, Lidder, Justin, Yeung, Luke, Traeger, Guillermo, Regalo, Ralph, Gourlay, Sarit, Badiani, Cherry, Koh, Soni, Putnis, Fayza, Haider, Ashrarur Rahman Mitul, Niels, Komen, Bert, Dhondt, Serge, Cappeliez, Manon, Pigeolet, Martijn, Schoneveld, Jasper, Stijns, Wouter, Oosterlinck, Nicolas, Flamey, Cyrille, Kpangon, Mouhamed, Agbadebo, Sèmèvo Romaric Tobome, Aldo Vieira Barros, Samuel Aguiar Júnior, Heloisa Galvão do Amaral Campos, Jefferson, Gross, Felipe José Fernandez Coimbra, Luiz Paulo Kowalski, Fabiana, Makdissi, Suely, Nakagawa, Joao Pedreira Duprat Neto, Jose Guilherme Vartanian, Guilherme, Yazbek, Stenio, C Zequi, Ronald, Flumignan, Natalia, Jaworska, Angela, Dell, Harsha, Shanthanna, Abdollah, Behzadi, Carolyn, Nessim, Michelle, Mozel, Pascal, St-Germain, Crispin, Russell, Gary, Groot, Najib, Safieddine, Duminda, Wijeysundera, Antoine, Eskander, Sami, Chadi, Shawn, Mackenzie, Alana, Flexman, Fernando, Heredia, Julio, Villanueva, Sofia, Waissbluth, Roberto, Macchiavello, Mario, I Escudero, Tyare, Fuentes, Ximena, Mimica, Dinimo Bolivar Saenz, Lina, Caicedo, Juan Pablo Alzate, Joaquin, Luna, Nestor Fabian Pedraza Alonso, Camilo Ortiz Silva, Juliana, Rodriguez, Liliana, Silva-Igua, Martha Luz Torres, Lina María Trujillo, Albaro José Nieto Calvache, Julián, Balanta-Melo, Rafael, Figueroa-Casanova, Oscar-Julián, García-Montoya, Carlos Andres Marulanda Toro, Marcela Velez Botero, Maria Clara Mendoza Arango, Eneida Diaz Martinez, Valentina Gutiérrez Perdomo, Emileth, Montenegro, Julia, Rodriguez-Abreu, Dolores, Mejía, Galal, Abouelnagah, Sameh, Shehata, Ahmed Hossam Eldin Fouad Rida, Ramy, A Hassan, Mahmoud, M Saad, Mohamed Reda Loaloa, Badr, Mostafa, Mohamed, Qassem, Mohamed, Fahmy, Hesham, Abozied, Ahmed, Y Azzam, Sherief, Ghozy, Asser, Sallam, Ahmed, Shehta, Mohamed, Abdelkhalek, Rehab, Samaka, Amr, Morsy, Ahmed Elshawadfy Sherif, Abraham, Negussie, Tigist, Fisseha, Kibruyisfaw, Shumbash, Metasebia, Abebe, Seid Mohammed Yasin, Yemisirach Bizuneh Akililu, Abebe, Megersa, Teshome, Tefera, Melatework, Assefa, Bahru, Atnafu, Bereket, Tsegaye, Yoseph Solomon Bezabih, Silamlak, Sisay, Kebebe, Bekele, Moa, Jira, Habtamu, Derilo, Eyueal, Degefa, Anteneh, Tadesse, Melkamu, Nidaw, Elise, Sarjanoja, Sylvie, Testelin, Sophie, Boucher, Lionel, Jouffret, Zaher, Lakkis, Alban Zarzavadjian Le Bian, Luke, Harper, Marc Danguy des Déserts, Benoît, André, Karem, Slim, Romain, Verhaeghe, Andrea, Police, Edouard, Girard, Alexandre, Chebaro, Armande Subayi Nkembi, Laurent, Arnalsteen, Quentin, Ballouhey, Diane, Mege, Clement, Jeandel, Emilie, Duchalais, Pierre-Alban, Bouche, Gilles, Manceau, Célia, Crétolle, Erik, Hervieux, Noémie, Girard, Agathe, Seguin-Givelet, Sebastien, Gaujoux, Belinda De Simone, Matthieu, Boisson, Damien, Bergeat, Fabien, Fredon, Francesco, Nappi, Radwan, Kassir, Aurélien, Scalabre, Federico, Migliorelli, Anne-Cecile, Ezanno, Barbara, Seeliger, Charlotte, Vaysse, Helene, Charbonneau, Vincent, Misrai, Olivier, Abbo, Martina Aida Angeles, Laurent, Brunaud, Ali, Modabber, Sebastian, Wolf, Carsten, Kamphues, Philipp, Höhn, Tim, R Glowka, Alexander Christopher Rokohl, Ulrich, Bork, Georg, Fluegen, Raymund, E Horch, Andrea, Schmedding, Andreas, Schnitzbauer, Helge, Eberbach, Daniel, Schlager, Fritz, Spelsberg, Lena, Keppler, Andreas, Hecker, Susanne, Wolfer, Ulrich, Ronellenfitsch, Christine, Nitschke, Christian, Peiper, Ibrahim, Hakami, Stefan, Welter, Karine, Nikolaieva, Andreas, Roth, Judith, Lindert, Konstantinos, Gousias, Anke, Rissmann, Valerie Catherine Linz, Nuh, Rahbari, Marie-Claire, Rassweiler-Seyfried, Anna Eleonora Gut, Jens, Gempt, Daniel, Reim, Arthur, Wagner, Alexander, M Keppler, Mircea Gabriel Stoleriu, Tim, Saier, Josef, Stadler, Julia Christina Kaiser, Stefan, M Brunner, Karin, Pfister, Jonas, Herzberg, Kai, Nowak, Tobias, Reinhard, Gregor, A Stavrou, Alfred, Königsrainer, Christian, Konrads, Markus, Quante, Simon, Laban, Silke von Pusch, Markus, Hirschburger, Johannes, Doerner, Armin, Wiegering, Ekaterini Christina Tampaki, Alitza Gutiérrez Ruiz, Alejandra, Rodas, Ana Lucía Portilla, Jacqueline, Carrera, Amalia Barrios Duarte, Megan, Lowey, Sabrina, Barillas, Atul, Suroy, Dhaivat, Vaishnav, Raghunandan Gorantlu Chowdappa, Irappa, Madabhavi, Dhananjaya, Bhat, Sunil Kumar Venkatappa, Sumit, Thakar, Kavitha, Jain, Aruna, Kumar, Manoj, Nagar, Tushar, Mishra, Arunkumar, Sekar, Anand, Gupta, Lileswar, Kaman, Madhivanan, Karthigeyan, Manjul, Tripathi, Ashwin, Rammohan, Sudheer Othiyil Vayoth, Anupama, Rajanbabu, Anbukkani, Subbian, Rahul, Gupta, Monish, Raut, Nissi, Evelyn, R Lavanya Kannaiyan, Anil, Matai, Sanjeev, Misra, Vishal, Bhende, Sathish, Muthu, Indranil, Ghosh, Abhishek, Sharma, Ankur, Bajaj, Shiv, Rajan, Gaurav, Agarwal, Pranay, Pawar, Philip, Alexander, M Vijayakumar Vijayakumar, Zeeshan, Hameed, Badareesh, L, Navneet Kumar Chaudhry, Lipika, Baliarsing, Satish, Dharap, Amruta, Kulkarni, Yuvaraja, Thyavihally, Rahul Deo Sharma, S Pramesh, C, Rajesh, Soni, Surya Kumar Dube, Shilpa, Sharma, Harvinder, Singh, Lovenish, Bains, Rahul, Ghodke, Ashwani, Kumar, Vivek, Sodhai, Suvendu, Maji, Somprakas, Basu, Chandrashekhar, Mahakalkar, Ravi, Kannan, Asif, Mehraj, Ranganath, N, Ashish, Phadnis, Yadev, I, Alfie, Kavalakat, Rohin, Mittal, Karthik Chandra Vallam, Hamed, Akhavizadegan, Esmaeil Rezghi Maleki, Naser Yousefzadeh Kandevani, Hilary, Ikele, Catherine, Mcnestry, Christina, Fleming, Stephen, O'Brien, Sami Abd Elwahab, Niall, Davis, Mohsen, Javadpour, Brendan, Mcdonnell, Clare, O Connor, Jarlath, Bolger, Cillian, Clancy, Stefanie, M Croghan, Noel, Donlon, Carolyn, Cullinane, Ben, Creavin, Muheilan, Muheilan, Helen, Earley, Syed Mohammad Umar Kabir, Muhammad, Fahadullah, Éanna, Ryan, Tara, Connelly, Daisuke, Hashimoto, Majdi Ali Alqudah, Amer, Alajalen, Rand, Y Omari, Abdulrahman, Qasem, Yazan, Alawneh, Amer, Ahmad, Omar, Aladawi, Bourhan, Alrayes, Hanan, Haidar, Shatha, Husain, Faisal, Qassem, Adnan, Sumadi, Ala'a Abu Salhiyeh, Balqees Mahmoud Al-Manaseer, Zaid, Alsunna, Hazim, Ra'Ed, Faten Reyad Bani Hamad, Amro, Abuleil, Elmi Ahmed Mohamed Jimaale, Marah, Abu-Mehsen, Noor, Olaywah, Omar, Wafi, Hazim, Ababneh, Luai, Abu-Ismail, Almu'Atasim, Khamees, Ahmad, Alkhatib, Raikhan, Bolatbekova, Mukhtar, Kulimbet, Talgat, Nurgozhin, Timur, Saliev, Baurzhan, Zhussupov, Ydyrys, Almabayev, Dilyara, Kaidarova, Khalil, Tamoos, Ahmed, Aqeelah, Alsnosy Abdullah Khalefa Mohammed, Faraj Al Maadany, Ghadah, Alkadeeki, Milad, Gahwagi, Wafa, Aldressi, Mohamed, Amnaina, Arowa Hassan Abdulrahman Alansari, Akram, Alkaseek, Ghozlan, Yagoub, Anass Ben Amer, Marwa, Salem, Ayman, Almugaddami, Dania, Burgan, Mohammed, Abdelkabir, Khayriyah, Alshareef, Rayet Al Islam Ben Jouira, Ayman, Meelad, Ahmad, Bouhuwaish, Sumayya Essayah Dwaga, Houda, Khalifa, Bushray, Almiqlash, Taha, Suliaman, Mohammed, Alawami, Fras, Elhajdawe, Hajir, Aboazamazem, Ibrahim, Ellojli, Ahmed, Msherghi, Ismail Ali Saleh, Mohammed, Alayan, Marcel Didier Ndayishyigikiye, Akutu, Munyika, Philipp, Plarre, David, W Borowski, Cameron, Wells, Rebecca, Teague, Brodie, Elliott, David, Kieser, Omar, Mohyieldin, Nick, Mcintosh, Cheyaanthan, Haran, Jasmin, King, Jeong, Ha, Matthew James McGuinness, Opeoluwa, Adesanya, Julius, Olaogun, Akinola, Akinmade, Kefas, Bwala, Peter, Agbonrofo, Akinwale, Afolabi, Usang, Usang, Sebastian, Ekenze, Samson, Olori, Taiwo Akeem Lawal, Abiodun, Okunlola, Stephen, Kache, Danjuma, Sale, Lofty-John, Anyanwu, Chukwuma, Okereke, Musliu Adetola Tolani, Venko, Filipce, Lazar, Todorovic, Sotir, Stavridis, John George Massoud, Sareyah, Alsibai, Rizwan, Sultan, Humera Naz Altaf, Abu Bakar Hafeez Bhatti, Shahzad Hussain Waqar, Aliya, Aziz, Asad Ali Kerawala, Lajpat, Rai, Mariyah, Anwer, Aiman, Tariq, Bushra, Ayub, Sami Ullah Niazi, Muhammad Yasir Naseem, Muhammad Zeeshan Sarwar, Muhammad Imran Khokhar, Imdad Ahmad Zahid, Haroon Javaid Majid, Nabila, Talat, Muhammad, Asif, Muhammad Hamid Chaudhary, Umer, Farooq, Siddique, Ahmad, Waleed, Mabood, Syed Imran Bukhari, Muhammad, Tariq, Eesha, Yaqoob, Saad, Javed, Muhammad Usman Malik, Hassan Nawaz Yaqoob, Glenda Marina Falcon Pacheco, Robinson Mas Melendez, Arazzelly Del Pilar Paucar Urbina, Jose Rios Chiuyari, Carlos Eduardo Otiniano Alvarado, Lorena Fuentes Rivera Lau, Giuliano, Borda-Luque, Milagros, Niquen-Jimenez, Claudia, Arias, Sergio, Zegarra, Jenner Betalleluz Pallardel, Regina Amparo Ugarte Oscco, Gian, Mendiola, Yahaira Tatiana Carpio Colmenares, Carlos Shiraishi Zapata, Maria Rosa Ortiz, Filipe Castro Borges, Octavio, Viveiros, Pedro, Serralheiro, Paulo, Santos-Costa, Filipa, Mendes, Miguel Rocha Melo, Paulo, Cardoso, Ana, Soares, Rita Gonçalves Pereira, Nelson, Silva, André, Caiado, Maria Luís Sacras, Pedro, Azevedo, Rui, Almeida-Reis, João, Oliveira, Jorge, Nogueiro, Mafalda, Sampaio-Alves, Luciana Cidade Costa, Catarina, Baía, Ana Cláudia Deus, Rita, Branquinho, André, Marçal, André, Tojal, Silviu Tiberiu Makkai-Popa, Aurel, Mironescu, Florin, Grama, Elena Adelina Toma, Daniela, Filipescu, Nicolae, Bacalbasa, Natalia, Motas, Sebastian, Ionescu, Octav, Ginghina, Radu, Costea, Narcis Octavian Zarnescu, Radu, Drasovean, Mihail-Gabriel, Dimofte, Vlad, Porumb, Mikhail, Kirov, Yegor, Molitvin, Vadim, Pykhteev, Marianna, Raevskaya, Aleksandr, Butyrskii, Mushabab, Alshahrani, Azah, Althumairi, Nasser, Alzerwi, Ahmed Al Ameer, Tariq, Madkhali, Abddulrahman Saleh Almulhim, Salman, Ghazwani, Abdu, Ayoub, Othman, Iskander, Mohammed, Ghunaim, Mohammed, Alharthi, Turki, M Alzaidi, Mohammad, Alyami, Abdulrahman Al Amri, Abdullah, Alfakhri, Amal, Alhefdhi, Sharfuddin, Chowdhury, Thamer, Nouh, Ameen, Alshehri, Abdulrahman, Alzahrani, Yousef, Alalawi, Selmy, Awad, Ibrahima, Konate, Jacques, Tendeng, Nan Zun Teo, Sabra, Aqil, Cristina Barrena López, Ana Sánchez Mozo, Antonio Rodriguez Infante, Patricia Caja Vivancos, Mikel, Prieto, Igor Alberdi San Roman, Laura Gomez Fernandez, Josep Maria Muñoz Vives, Anna, Carreras-Castañer, Berta, Díaz-Feijoo, Ramon, Sieira-Gil, Victor, Turrado-Rodriguez, Anna Sánchez López, Santiago, Sánchez-Cabús, Marta Jimenez Toscano, MªPilar Canals Sin, Saura García Laura, Oriol Martin Sole, Pedro Palazon Bellver, Sonia, Pérez-Bertólez, Jordi, Prat-Ortells, Mireia Riba Martínez, Josep, Rubio-Palau, Xavier, Tarrado, Jorge, Nuñez, Veronica Alonso Mendoza, Coro, Bescós, Eloy, Espin-Basany, Martin, Espinosa-Bravo, Daniel, Gil-Sala, Susana, González-Suárez, Nuria Montferrer Estruch, Lucia Porteiro Mariño, Ana, Rodríguez-Tesouro, Fabian Rojas Portilla, M Pilar Tormos Pérez, Inmaculada, Vives, Unai Garcia De Cortazar, Kiara, Tudela, Aitor, Landaluce-Olavarria, Mercedes Estaire Gómez, Jorge, Almoguera, Bakarne, Ugarte-Sierra, Virginia, Jimenez, Marta, Bertrand, Laura Cárdenas Puiggrós, Olga, Delisau-Puig, Jorge, Garcia-Adamez, David Julià Bergkvist, Eloy, Maldonado-Marcos, Lucia Diego García, Marta Roldón Golet, Iván, Soto-Darias, Aida Cristina Rahy-Martín, Diego, Enjuto, Adolfo, Ramos-Luengo, Juan Delgado Fernandez, Carolina Lugo Duarte, Cristina Ojeda Thies, Lucila, Marquez, Diana Crego Vita, Jana, Dziakova, Jorge Caño Velasco, Olga, Mateo-Sierra, Begoña, Quintana-Villamandos, Cristina Rey Valcarcel, Javier, Rio, Laura Román García de León, Marcello Di Martino, Jorge, Prada, Javier Serrano González, Manuel, Losada, Jose Tomas Castell Gomez, Ramon, Corripio-Sanchez, Alexander, Forero-Torres, José Manuel Morales-Puebla, Hanna, Perez-Chrzanowska, Santiago Valderrabano Gonzalez, Alvaro, Yebes, Ignacio, Zapardiel, Manuel Diez Alonso, Nelson Morales Palacios, Alberto Cabañero Sánchez, Fátima Sánchez Fernández, Alfredo Abad Gurumeta, Ane, Abad-Motos, Fernando, Corella, Javier, Ripollés-Melchor, Rosa, Sanz-Gonzalez, Marta Alcaraz Fuentes, Maria Teresa Fernández Martín, Pablo Calvo Espino, Milagros Carrasco Prats, Antonio-José, Fernández-López, Damián García Escudero, Vanesa Garcia Soria, Jesús Aarón Martínez Alonso, Miguel, Ruiz-Marín, Beatriz Gómez Pérez, Joaquin, Moya-Angeler, Daniel Fernández Martínez, Heura Llaquet Bayo, Enrique, Colás-Ruiz, Susana Bella Romera, M Teresa Gavaldà Pellicé, Misericòrdia Jordà Solé, Enrique Jose Ruiz Velasquez, Bernardo, Núñez, Raul, Jimenez, Jon, Zabaleta, Maria Jose González-Gimeno, Irene Ortega Vázquez, Antonio Perez Ferrer, Rubén, Martín-Láez, Marcelo Moreno Suarez, Miguel Angel Freiria Eiras, Irene, Ramallo-Solís, Juan-Carlos, Gomez-Rosado, Jose Ramon Oliver Guillen, Mar Achalandabaso Boira, Juan Carlos Catalá Bauset, Julio, Domenech, Rafael, Badenes, Juan Carlos Bernal-Sprekelsen, Jorge, Sancho-Muriel, Beatriz De Andrés-Asenjo, Francisco, J Tejero-Pintor, Marc, Vallve-Bernal, Alba Vazquez Melero, Laura Sánchez Blasco, Jorge, Escartin, Victoria Duque Mallén, Selvaratnam, Srishankar, Charitha, Sooriyabandara, Oshan, Basnayake, Nalaka, Gunawansa, Prabuth Dulanjan Weeraddana, Thanusan, Vimalakanthan, Shanthamoorthy, Gishanthan, Pramodh, Chandrasinghe, Marc-Olivier, Sauvain, Ahmad, Ghazal, Yusra, Al-Sabbagh, Turki, Alhassoun, Sara Maa Albared, Antoine, Naem, Hareth, Alnahr, Ghassan, Jisry, Ali, Hammed, Okedi Francis Xaviour, Gaston, Turinawe, Isaac, Mubezi, Franck, K Sikakulya, Andrew, Kakeeto, Wilberforce, M Kabweru, Ronald, Kiweewa, Paul, Matovu, Otolia, Isaac, Mohamed, Mashhour, Amin El Helw, Safeena, Kherani, Awadelkarim, Mohamed, Ferial Mohamed Ali Abbas, Diary, Mohammed, Ehab, Aldlyami, Rakesh, Kundra, Antony Louis Rex Michael, Kareem, S Khalil, Rachel, Dbeis, Shafaque, Shaikh, Jenny, Ferry, Aiman, Jamal, Haleema, Siddique, Rishi, Das, Nikhil, Ponugoti, Pornjittra, Rattanasirivilai, Asma, Sultana, Frances, Mosley, Matthew, Chan, Antony, Bateman, Gareth, Davies-Jones, Fanourios, Georgiades, Navid, Ahmadi, Aman, Coonar, Mariam, Baig, Chetan, Khatri, Arthika, Surendran, Julian, Sonksen, Robert, Sinnerton, Caitlin, Brennan, Gemma, Faulkner, Michael, Greenhalgh, Hannah, Emerson, Kiran, Singisetti, Joshua, Totty, Michael, Wilson, Terence, Lo, Harriet, Corbett, Ijeoma, Okonkwo, Gill, Arbane, Cyrus, Kerawala, Chetan, Parmar, Michael, Bath, Funlayo, Odejinmi, Jayesh, Sagar, Rishi, Talwar, Samuel, Newman, John, Hammond, John, Moir, Natalie, Duric, Tamas, Szakmany, Ahmar Iftikhar Talib, Mina, Youssef, Christopher, Lewis-Lloyd, Mariam, Lami, Khurram, Ayub, Benjamin, Dean, Supriya, Balasubramanya, Sathya, Lakpriya, Luke, Rogers, Paul, Turner, Mark, Maher, Kohila, Sigamoney, Jihène El Kafsi, John, Hardie, David, Johnson, Christin, Henein, Marianne, Hollyman, Ketan, Agarwal, Simon, Powell, Govind Singh Chauhan, Rakesh, Patel, Joel, Gagnier, Heather, Carmichael, Aurora, Kristofor, A Olson, Eric, Etchill, Sameer, Hirji, Matthew, Naunheim, Frederick, Drake, Caroline, Reinke, Anna, Alecci, Dennis, Vaysburg, Jennifer, Rodriquez, Emily, Shih, Vin Shen Ban, Julia, Coleman, Krista, Kaups-Fresno, Emmanouil, Giorgakis, Maggie, Dinome, Neal, Bhutiani, Omar, Alnachoukati, Taylor, Aiken, Thomas, Diehl, Ankush, Gosain, Rishi, Rattan, Muhammad Owais Abdul Ghani, Nensi Melissa Ruzgar, Anna, Liveris, Nina, Glass, Charu, Paranjape, Theresa, Chin, Antonio, Meola, Kristina, Nicholson, John, Squiers, Stephanie, Lueckel, Janani, Reisenauer, Rachael, Callcut, Ahmed, Mansour, Allison, Berndtson, Lucy, Kornblith, Sara, Seegert, Paulo, 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Amanda Lira Dos Santos Leite, Laercio, Pol-Fachin, Tainá Santos Bezerra, Alcimar Lavareda Dos Santos Junior Alcimar, Robson, Amorim, Maria Eduarda Bellotti Leão, João José Corrêa Bergamasco, Cintia Cardoso Pinheiro, Rubem Alves Da Silva Neto, Elaine Francisca De Araújo, Lilian, Guimaraes, Tatiana, Liborio-Kimura, Isabelle Melo da Camara, Victor Ripardo Siqueira, Juan, Rodriguez, Jeancarllo, Silva, Rubem Alves Silva Junior, Cláudio, Cardoso, Andre, Guimaraes, Wislene Sarajane Moreira Alves, Agna Soares Da Silva Menezes, Marcelo, Araujo, Kattiucy, Brito, Josie Marcelle Lira Albuquerque, Jairo Alberto Dussan-Sarria, Andressa, Souza, Andre Ricardo Stüker, Tiago, Bresciani, Luciana Cadore Stefani, Leandro Totti Cavazzola, Tainá, Costa, Matheus, Dasqueve, Gustavo De Bacco Marangon, Otávio Ritter Silveira Martins, Josy, Rodrigues, Guilherme Roloff Cardoso, Brasil Silva Neto, Tilaê, Soares, Aline, Zanella, Lucas Torelly Filippi, Enilde Eloena Guerra, Ricardo Pedrini Cruz, Antonio Nocchi Kalil, Gustavo, Laporte, Moacyr, Salem, Murilo de Lima Brazan, Caio Antonio de Campos Prado, Elaine Christine Dantas Moises, Hilda Satie Suto, Alice Gadotti Yasuda, Ana Carolina Tagliatti Zani, Roberto Cardoso Cardoso Dos Santos, Geraldo, Duarte, Edwaldo Edner Joviliano, Carolina Lourenço Gomes Dos Santos, Silvana Maria Quintana, Edwin, Tamashiro, Fabiana Cardoso Pereira Valera, Marília Veccechi Bijos Zaccaro, Isis, Andreotti, Leonardo, Lima, Wilson Salgado Jr, Alonço da Cunha Viana Júnior, Lana, Moutinho, Cora Pichler de Oliveira, Isabela Trindade Martins, Isabela Vieira Toledo, Marco Antonio Correa Guimaraes-Filho, Rodrigo, Arrivabeno, Claudio Bovolenta Murta, Danniel Frade Said, Jose Pontes Junior, Felipe Guimarães Pugliesi, Paulo, Gregorio, Alessandro, Mariani, Fabio, Minamoto, Juliana Lourenço da Silva, Bruno, Muller, Caio, Zanon, Vladimir, C Carvalho, Ana Lucia Munhoz Lima, Priscila, R Oliveira, Jorge Dos Santos Silva, Mariana Faccini Teixeira, Marco, Kulcsar, Leandro, Matos, Kamilla Schmitz Nunes, Joel Abdala Junior, Emne, Abdallah, Genival Barbosa Carvalho, Igor Correia de Farias, Cassia da Silva, Fabio Fernando Eloi Pinto, Luciana, Facure, André, Godoy, Bruna, Kupper, Fernanda, Leite, Matheus de Melo Lôbo, Henrique, Mantoan, Narimã, Marques, Tomas, Marques, João Paulo Medici, Silvio Melo Torres, Katheryne Merlos Garcia, Rafael Ribeiro Meduna, Ana Carolina Scintini Herbst, Silvana Soares Dos Santos, Bruna Tirapelli Gonçalves, Marcelo, Antonini, Carolina, Brienze, José Francisco Farah, Rodrigo, Gonçalves, Vinicius, Machado, Luis Roberto Nadal, Danilo Nadal Rodrigues, Adrieli, Pansani, Maria Luiza Rocha, Marcelo, Simonsen, Daniela, Tsuchiya, Rafaela, Vasques, Jorge, Amorim, Ana Alyra Carvalho, Rebeca, Correia, Brena Costa Dos Santos, Henrique Jorge Guedes Neto, Luis, Nakano, Mariana, Pereda, Vladimir, Vasconcelos, Jamile Barakat Awada, Guilherme, Gava, Tiago Riuji Ijichi, Nam Jin Kim, Rafael, Nunes, Fabio, Pinto, Thiago Henrique Sigoli Pereira, Gustavo Jardim Volpe, Arthur, Gatti, Caroline, Nardi, Ramon, Oliva, Layze Braz de Oliveira, Herica Emilia Félix de Carvalho, Ivonizete Pires Ribeiro, Gabriel Renan Soares Rodrigues, Álvaro Francisco Lopes de Sousa, Michel, Chebel, Paulo Henrique de Sousa Fernandes, Marcelo Augusto Faria Freitas, Juliano Rodrigues da Cunha, Zeenia, Ather, Dobromir, Dimitrov, Emil, Filipov, Elitsa, Gyokova, Ivelina, Ilieva, Tsvetomir, Ivanov, Martin, Karamanliev, Vasil, Neykov, Boyko, Atanasov, Nikolay, Belev, Paolina, Kamenova, Kaloyan, Tonev, Tsanko, Yotsov, Evguenia, Hristova, Kolyo, Spassov, Tsanko, Tsankov, Dragomir, Dardanov, Petar, Gribnev, Manol, Sokolov, James, Brown, John, Tanyi, Heather, Hurdle, Anthony, Maclean, Michael, Sander, Salim Al Riyami, Krittika, Bali, David, Bigam, Khaled, Dajani, Mehran, Anvari, Rafik, Bolis, David, Choi, Susan, Ellis, Michael, Gupta, Wael, Hanna, Dennis, Hong, Cynthia, Horner, Lea, Luketic, Peter, Moisiuk, Yaron, Shargall, Hilda, Alfaro, Nawar, Alkhamesi, Laura, Allen, Muriel, Brackstone, Eunice, Chan, Davy, Cheng, Jason, Chui, Nelson, Gonzalez, Brent, Lanting, S Danielle MacNeil, Robert, Mayer, Jacob, Mcgee, Mahesh, Nagappa, Nicholas, Power, Agya, Prempeh, Mehdi, Qiabi, Hassan, Razvi, Emil, Schemitsch, Herman, Sehmbi, Ushma, Shah, Yamini, Subramani, Edward, Vasarhelyi, Kelly, Vogt, Homer, Yang, Ali Ghorbani Abdehgah, Saba, Balvardi, Liane, Feldman, Julio Flavio Fiore Jr, Melissa, Hanson, Brent, Hopkins, Pepa, Kaneva, Lawrence, Lee, Julia, Leonard, Jad, Abou-Khalil, Andre, Martel, James, Stevenson, Susan, Lee, Richard, Merchant, Samuel, Avoine, Laurence, Belanger, Mathieu, Belanger, Etienne, Belzile, Anne-Sophie, Blais, Sofia, Boucher-Kovalik, Cindy, Boulanger-Gobeil, Etienne, Cardinal, Pierre-Olivier, Champagne, Jonathan, Cloutier, Simon, Corriveau-Durand, Mathieu, Cote, Maxime, Cote, Mathilde, Côté, Valérie, Courval, Suzanne, Demers, Christine, Desbiens, Mehdi El Ouazzani, Karine, Girard, Ève-Marie, Girard, Karo, Gosselin, Helene, Khuong, Nathalie, 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Philemon, Leung, Andrew, Lindberg, Juan Mata Gutierrez, Kelly, Mayson, Adam, Meneghetti, Drew, Phillips, John, Street, Carolina Carvajal Calderón, Daniel Alejandro Donoso Pizarro, Esteban, Fernández, Ángela, Molero, Nastassja, Mutarello, Jorge Núñez Lucic, Katherine Ochoa Gaete, Catalina Ruiz Lopez, Rina, Sepúlveda, Camila, Ulloa, Mauricio, Barreda, Matias, Dallaserra, Matías Günther Wood, Mauricio Sandoval Tobar, Francisco, Garcia-Huidobro, Jimena, Dona, Carolina Soto Diez, Daniel, Igor, Javier, Mena, José Tomás Reyes, Catalina Arredondo Soto, Jose, Campos, Javier, Gonzalez, Barbara, Rivera, Jaime, Altamirano-Villarroel, David, Cohn, Luis Marin de Amesti, Pedro, Recabal, Camilo, Sandoval, Bruno Catoia Fonseca, Monica, Contador, Andres, Hodali, Camila, Pincheira, Andrea Ramos Mantilla, Claudio Salas Garrido, Janina, Torres, Marco, Valenzuela, Zehua, Chen, Jiankun, Hu, Jin, Tao, Kun, Yang, Yuexin, Zhang, Yuan, Chen, Wang, Cunchuan, Wah, Yang, Xueli, Bai, Tingbo, Liang, Tao, Ma, Ning, Pu, Hanlin, Yin, Camilo, Caicedo, Diego Felipe Tellez Beltran, Alejandro, Escobar, Carolina Perez Granados, Lisbeth Alexandra Urueña Pinzon, Carlos, Bonilla, Diana, Santana, Oscar, Serrano, Andrea, Garcia, Fernando Giron Luque, Nasly, G Patino-Jaramillo, Laura Giselle Contreras Baquero, Nestor Augusto Muñoz Botero, Jhoana Andrea Murillo Castellanos, Andrea Juliana Vega Calvera, Lina, M Acosta Buitrago, Maria Paz Bohórquez-Tarazona, Paulo Andrés Cabrera Rivera, J Felipe Casas, Valeria Cormane Alfaro, Julian, Corso, Bayron, Guerra, Albert Franz Guerrero-Becerra, Akram Kadamani Abiyomaa, Felix Ramon Montes, Manuel Santiago Mosquera Paz, Camilo Andrés Polanía Sandoval, Natalia, Quintana, Carlos Fernando Roman Ortega, Carlos, Santacruz, Manuela, Téllez, Camilo Alejandro Velandia Sánchez, Fernando, Arias-Amézquita, Luis Felipe Cabrera Vargas, Natalia Cortes Murgueitio, Elkin, Escorcia, Kemel Ahmed Ghotme Ghotme, Jorge Luis Gomez-Mayorga, Alvaro Felipe Guerrero Vergel, Gabriel, Herrera-Almario, Eduardo, Londono-Schimmer, Juan, A Mejia, Guillermo, Monsalve, Camilo, Rodriguez, Juan Nicolas Rodriguez Niño, Luis Martín Rodríguez Ortegón, Daniel, Sanabria, Andres, Alvarez, Arnulfo, Andrade, Javier, Ardila-Montealegre, David, Baquero, Edgar Mauricio Barrios Vidales, María Alejandra Caicedo Giraldo, María Camila Carvajal, Maria, Castillo, Maria Carolina Castillo Florez, María Angelica Cendales, Danny Conde Monroy, Henry, Cortes, Mario, Daniel, Jairo De la Peña, Elena Leonor Delgado-Nieto, Hernando, Espitia, Carlos Figueroa Avendaño, Edgar Oswaldo Hernandez Burgos, Andres, Isaza-Restrepo, German, Londono, Margarita Maria Maldonado, Andrea, Montenegro, Juan Carlos Navarro, Jorge, Navarro-Alean, Katherine Parra Abaunza, Eliana, Pulido, Erika, M Ramírez Amaya, Carlos Eduardo Rey Chaves, Natalia Andrea Rivera Rincón, William Mauricio Riveros Castillo, Lizeth Rodriguez Sanchez, Wilson, Rubiano, Maria, Russi, Juan Carlos Sabogal Olarte, Javier Mauricio Salgado Tovar, Maria Juliana Sanchez, David Mauricio Solano Varela, Paula Torres Gomez, Marcial, Trillos, Ana María Vargas Patiño, Felipe, Vargas-Barato, Juan Pablo Villate Leon, María Alejandra Wagner Useche, Jesus, Acosta, Adriana, Almeciga, Luis Becerra Mendez, Rafael Jose Beltran, Ana, Bonilla, Miguel, Buitrago, Marino, Cabrera, Pedro Hernando Calderon Quiroz, Diego, Camacho-Nieto, Carlos Andrés Carvajal Fierro, Sergio Cervera Bonilla, Sandra, Diaz, Helena, Facundo, Jorge, Forero, Mauricio Garcia Mora, Karena Victoria Garcia Tirado, German Fabian Godoy Perez, Felipe, Gonzalez, Oscar, Guevara, Jairo Alonso Hernandez, David Ricardo Herrera Mora, Juan David Lalinde, Carlos, Lehmann, Eduardo Leon Llanos, Byron Eduardo Lopez De Mesa Lopez, Ivan, Mariño, Monica, Medina, Raúl Eduardo Pinilla Morales, Angela, Puerto, Andrea, Quintero-Ortíz, Juliana Rendón Hernández, Elio Fabio Sánchez Cortés, Alvaro Eduardo Sánchez Hernández, Raul, Suarez, Oscar, Suescun, Marco, Vanegas, Rodolfo, Varela, Jorge Luis Velez Bernal, David, Viveros-Carreño, Daniela Camargo Gómez, Angelica, Fletcher, Abel, Merchan, Euler Javier Burbano Luna, Indira, Cujiño, Mauricio Velasquez Galvis, Lina Maria Vergara Galliadi, Orlando Abonia Gonzalez Abonia Gonzalez, Maria Fernanda Acuna Saravia, Roberto, Arroyave, Jose Maria Barreto Angulo, Francisco Javier Bonilla-Escobar, Uriel, Cardona, Ivan Castañeda Giacometto, José Luis Castillo, Diego Fernando Castillo-Cobaleda, Diego Jose Caycedo Garcia, Brenda Marcela Coll Tello, Juan Carlos Dueñas-Ramirez, Oscar Andres Escobar Vidarte, Luis, Figueroa, Herney, Garcia-Perdomo, Alden, Gomez, Laura, Gomez, Alejandro, Gomez, Ana María Grande-Gil, David, Guarin, Natalia, Guzman, Enrique Herrera Castañeda, Marisol, Hinaoui, Anuar Armando Idrobo Escobar, Christian Kammerer Kammerer, Sergio, Leon, Carlos Antonio Llanos Lucero, Angie, López, Alexander Maximiliano Martinez-Blanco, Antonio José Montoya Casella, Ricardo Andres Niño Corredor, Sebastian, Ordoñez, Diego Alfredo Palta Uribe, 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Alvarez, Cesar David Galindo Regino, Angela Maria Giraldo Velasquez, Carlos Enrique Melo Moreno, Jorman, H Tejada, Jesus Hernan Tovar, German Alirio Tovar, Edison Alexander Benavides Hernández, Claudia Milena Orozco-Chamorro, Gustavo Adolfo Angel, Christian Ali Buesaquillo, Victor David Olave Montaño, Andrés, Sánchez-Gómez, Daniela Patricia Escalante Ureche, Jairo Martinez Garrido, Eben-Ezer, Genda, Fabrice, Eboma, Kristina, Bitunjac, Karlo, Grulović, Marijana, Vučković, Goran, Šantak, Emanuel, Borovic, Ana Bosak Versic, Damir, Hasandić, Natasa Poldan Grabar, Suzana Srsen Medancic, Lucija, Brkic, Sara, Cokarić, Petra Pavic Palac, Zeljka, Samac, Josipa, Tomić, Marija, Vrdoljak, Ivan, Bacic, Bernarda, Bakmaz, Nikolina Bratošević Vučičić, Domagoj, Brzic, Samir, Canovic, Emilio, Dijan, Maja Grgec Dragicevic, Robert, Karlo, Suzana, Konjevoda, Petra, Kovačević, Ivan, Kovačić, Frane, Markulić, Luka, Matak, Domagoj, Morović, Gordan, Perišić, Andrea, Simic, Neven, Skitarelić, Matea, Veršić, 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Ioanna, Pozotou, Olga, Stavrinidou, Anneza, Yiallourou, Lukáš, Burda, Michal, Dosoudil, Lubomir, Martinek, Wladyslaw, B Gawel, Milan, Lerch, Matúš, Peteja, Jan, Žatecký, Toman, Daniel, Martin, Formánek, Veronika, Javurkova, Markéta, Kepičová, Nicole, Macečková, Petr, Matousek, Ondrej, Simetka, Petr, Vavra, Karol, Zelenik, Jan, Černý, Sami, Khan, Robert, Lischke, Martin, Přibyl, Temoore, Younus, Yenuksha, Amarasena, Karel, Klíma, Setareh, Pirmorad, Zuzana, Hotová, Aleš, Mladěnka, Nulvin, Bozo, Julie Lykke Harbjerg, Louise, Hviid, Helle, Ø Kristensen, Mira, Mekhael, Mette Fugleberg Nielsen, Laerke, Paulsen, Saija, Sinimäki, Louise Zinck Mogensen, Peter, Bonde, Anders Lyng Ebbehøj, Anne-Sophie, Fenger, Aleksander Fjeld Haugstvedt, Christine Hangaard Hansen, Maria Lovisa Jönsson, Lars, N Jorgensen, Peter-Martin, Krarup, Anne-Louise, Lihn, Christian, Meyhoff, Helena, Otte, Anas Ould Si Amar, Henrik, Palm, Nis, Schlesinger, Henry, Smith, Ida, Tryggedsson, Anne Reiss Axelsen, Jens Kristian Baelum, Mark Bremholm Ellebaek, Signe Bremholm Ellebaek, Anders, Hogh, Maria, Acosta, Yancy, Acosta, Pedro, Baez, Luis Alfredo Betances, Luis Rodolfo Bonilla, Daniel, Cabreja, Wilton Cabrera Cruz, María Mabel Collado Expósito, Aldo, Crespo, Octavio, Cruz-Pineda, Claudio Samuel D'óleo García, Pedro, Díaz, Remberto, Escoto, Jatnna, Figueroa, Luis, Garcia, U Garcia-Dubus Rodriguez, Humberto, Gomez, Adrian, Grullon, Fatherin, Guerrero, Lillian, Guzman, Thelma Rocío Jiménez Mosquea, Engels, Lazala, Ariela, Lopez, Leeany Maletta Francisco, Jhomayri, Mercado, Herisardy, Munoz, Jeffrey, Paulino, Maricely Ambar Perez Fernandez, Rudeily, Reyes, Lilia Rosa Reyes Guilamo, Ruben, Rivas, Claudia Alejandra Rivas Torres, Ada, Rodríguez, Madelin Tamar Rosario Villa, Eleazar, Santana, Joel, Soto, Nassin, Tactuk, Cristina Kristel Tonos Sardiñas, Raul, Ubinas, Jose, Victoria, Aaron, Villegas, Ricardo, Acra-Tolari, Larissa, Beltran, Luis Fernand Betances, Alejandro, Blaubach, Denisse Idalia Campos Mejía, Nathalia, Capellan, María Fernanda Cedeño Bruzual, Saray Cordero Spencer, Gabriella Cuevas Lantigua, Luis De Jesus, Gabriela, Díaz, Pedro Pablo Díaz Vásquez, Karla, Disla, Jesús Antonio Echavarría Uceta, Paola Irina Eusebio Jimenez, Damaris, Fernandez, Marlin Fernandez Camilo, Jiomar Manuel Figueroa Germosen, Maruel, Fortunato, Leyla Gabriel Fernández, Alicia German Dihmes, Héctor, Herrera, Elizabeth Leon Cuevas, Jose Alejandro Mata, Mirian Mateo De La Cruz, Dolores Mejia De la Cruz, Marcos, Mirambeaux, Fabio Ortiz De La Cruz, Henry, Paulino, Gabriela, Pelletier, Merycarla, Pichardo, Rodriguez Pumarol Próspero Enrique, Julio, Rivas, Ann Stephany Sanchez Marmolejos, Roman Santana Santana, Irina Suero Almanzar, María Magdalena Vásquez Sánchez, Nicolás, Campuzano, José Ricardo Negrete Ocampo, Maria, Armas, Alvaro Santiago LeMarie Guerra, Gustavo León Vizcaya, Omar Ahmed Abdelwahab, Ahmed, O Elmehrath, Mohammed Ezzat Mostafa, Gamal, Amira, Ibrahim, Sallam, Mohamed, Sherief, Ahmed, 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Maher, Hosain, Ahmed, Hossam, Hamza Hussein Aly Salama Aly, Mohamed, Ibrahim, Abdelrahman, Ibrahim, Nourhan, Ibrahim, Noha Mohamed Salah Ibrahim Moussa Hamouda, Monica, Iskander, Islam, Khalifa, Mostafa, Kotb, Nada, Mahmoud, Alaa Mahmoud Abo Shabana, Nora, Mamdouh, Maram, Metwalli, Khaled, Metwally, Mahmoud, Moghazy, Moustafa, Mohamed, Mohamed, Mourad, Esraa, Moustafa, Kamilia, Mubarek, Nour Eldin Nader, Ahmed, Nasser, Samaa, Omar, Mostafa Shehata Qatora, Mohamed, Ragab, Marawan, Ragal, Dina, Ramadan, Rana, Ramadan, Sara, Ramadan, John, Romany, Ahmed, Sabry, Yasmeen, Said, Sara, Salamah, Ahmed Mostafa Saleh, Mona Saleh Mesbah Mohamed Elkaffas, Alaa, Salem, Hashem, Salim, Ahmed, Samih, Ahmed Samir Abdelaal, Ahmed, Shaheen, Yassmeen Sharafeldin Mohammed, Abdelrahman, Shehata, Mohamed, Shemeis, Karim, Shenit, Mennatallah, Sheta, Asmaa, Soffar, Yousef, Tanas, Ahmed, Tarek, Nermin, Yehia, Omar Khaled Mohamed Eid, Ammar Yasser Abdulfattah, Ahmed, Elsaghir, Mohamed Fouad Elganainy, Omar Ibrahim Elsayed, Omar, Elmandouh, Omar, Hamam, Mostafa Ahmed Shehata, Areej, A Abdelaziz, Ahmed, M Abbas, Wael Abd El-Ghani, Hossam Aldein, S Abd Elazeem, Mustafa Abd Elsayed, Ahmed Yassien Abd-Elkariem, Shimaa, Abdalla, Mahmoud, Abdel-Aleem, Khaled, Abdelazeem, Mahmoud, Abdelfattah, Mohammed, Abdelhafez, Mohamed, M Abdelkarem, Ali, Abdelraouf, Lamess, Abdullaha, Hossam, Abubeih, Moaiad Eldin Ahmed, Nagm Eldin Abu Elnga Ahmed, Ahmed, Ahmed, Sarah Ahmed Saad, Sherif, Alaa, Ali, Alhussaini, Abdelrahman Ahmed Abdelrahman Ali, Ibrahim, Ali, Wagdi, Ali, Mohamed Ali Mohamed, Mohamed, Ashraf, Muhammad, Bassiouni, Mohamed, G El-Adawy, Mohammad, El-Sharkawi, Hussein, Elkhayat, Khaled, Elmaghraby, Shady, Elsdfy, Mohamed, Elsharkawy, Almoutaz, Eltayeb, Mohamed Esmat Mohamed, Esraa, Essam, Mahmoud, Fahd, Osama, Farouk, Rabea, Gadelkareem, Ahmed, Ghoneim, Mohammed Hamada Takrouney, Ahmed, Hamdan, Abd El-Rahman Hamed, Ahmad, Hasan, Mohamed Abdelghafor Hassanin, Islam, Hawal, Kerollos, Henes, Mohamed Omar Herdan, Helal, F Hetta, Omar, Ibrahem, Mostafa, Ibrahim, Islam, H Ibrahim, Mahmoud, Kamel, Mohamed, Khallaf, Shrouk, M Elghazaly, Abobakr, Mahfouz, Osman, Mahmoud, Wesam, Mahran, Doha, Mahrous, Abadeer, Marsis, Ayman, Mohamed, Aliae Mohamed Hussein, Amr Mohamed Sayed, Mahmoud, M Mohammed, Ahmed, Mokhtar, Fatma, A Monib, Ahmed, Nageeb, Mariam Albatoul Nageh, Mohammed, Nageh, Nehal Gamal Omar, Abdelrahman, Ragab, Abdelrahman, Ramadan, Abdallah Rashad Temerik, Aya, Sabry, Hadeer, Safwat, Omar, Salah, Ahmed Elhussiny Salah Mahmoud, Ahmed, Saleh, Mahmoud, Sallam, Ahmed, Samir, Reem, Sayad, Esraa, Sayed, Ahmed, S Sedik, Mohammed, Shahine, Antonios, Soliman, Wael, Soliman, Mohamed Gamal Taher, Randa, Wanees, Ebrahim Ahmed Yousof, Ahmed, Youssef, Omar Zein Elabedeen, Ahmed Emad Sayed Hassan, Shrouk Abdel Fattah, Ahmed, Abostate, Samar, Ali, Saad Ali Saad Salama, Mohamed, Allam, Ahmed, Alsadek, Ebrahim, Arafa, Ahmed, Barakat, Mohammed El Sherpiny, Gehad, Elbehairy, Mahmoud, Eleisawy, 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David, Walawah, Makafui, Yigah, Safia, Yussif, Nuna, Jiagge, Emmanuel, Nachelleh, Jane, Acquaye, Kwabena, Agbedinu, Fareeda, Agyei, Akosua, Agyemang-Prempeh, Kwabena, Amo-Antwi, Michael, Amoah, George, Amoah, Yaw, A Amoako, Daniel Gyawu Aning, Frank, Ankobea-Kokroe, Dominic Annor Mintah, David, Anyitey-Kokor, Adu, Appiah-Kubi, Joshua, Arthur, Vincent, Ativor, Isaac, Barnor, Yasmine, Braimah, Regina, Darko-Asante, Anthony, Davor, Mohammed Duah Issahalq, Mawutor, Dzogbefia, Tano, Emile, Papa, Fiifi-Yankson, Valerie, Gaveh, Senyo, Gudugbe, Solomon, Gyabaah, Frank Enoch Gyamfi, Adam, Gyedu, Derrick, Gyimah, Bernard, Hammond, Boakye-Yiadom, Jonathan, Yorke, Joseph, Thomas Okpoti Konney, Anna, Konney, Kwasi, Kusi, Ishmael, Kyei, Agbenya, Lovi, Nuhu, Naabo, Boateng, Nimako, Beauty, Nyadu, Obed Ofori Nyarko, Ben Blay Ofosu-Barko, Philip Peprah Oppong, Anita, Osabutey, Martha, Poku, Robert, Sagoe, Abiboye, Yifieyeh, George, Ansong, Adam, Abass, Alhassan, Abdul-Mumin, Theophilus, Adjeso, John Abanga Alatiiga, Munira, Amadu, Nathaniel, Annan, German Azahares Leal, Mohammed, Bukari, Alexis, Buunaaim, Ernest, Cheyuo, Latif Daboo Salifu, Michael, Damah, Malcolm, Dery, Edem Kojo Dzantor, Odoniel Guerra Garcia, Yabasin Iddrisu Baba, Adamu, Issaka, Abdul-Jalilu Mohammed Muntaka, James, Murphy, Yaa Nyarko Agyeman, Wisdom Opoku Amankwaa, Imoro, Osman, Samuel, Pie, Anwar Sadat Seidu, Mohammed, Sheriff, Ana Maria Simono Charadan, Abraham, Titigah, Mundashiru, Yahaya, Musah, Yakubu, Edwin Mwintiereh Ta-Ang Yenli, Ioannis, Grypiotis, Nikolaos, Kiriakopoulos, Georgios, Koliopoulos, Vasilis, Kyvelos, Georgia, Micha, Triada, Papadopoulou, Dimitrios, Balalis, Evangelos, Fradelos, Dimitrios, Korkolis, Nicholas, Alexakis, Kyveli, Angelou, Dimitrios, Haidopoulos, Anastasia, Prodromidou, Alexandros, Rodolakis, Nikolaos, Thomakos, Dimitris, Psychogios, Pantelis, Antonakis, Konstantinos, Bramis, Leonidas, Chardalias, Ioannis, Contis, Nikos, Dafnios, Dionysios, Dellaportas, Papalouka, Dimitra, 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Liolis, Elias, Ioannis, Maroulis, Francesk, Mulita, Kerasia-Maria, Plachouri, Michail, Vailas, Charalampos, Doitsidis, Eva, Filo, Ioanna, Gkalonaki, Eleni, Kogia, Konstantina, Kontopoulou, Magdalini, Mitroudi, Christina, Panteli, Ioannis, Patoulias, Olga Ioulia Semkoglou, Dimitrios, Sfoungaris, Ioannis, Valioulis, Ioannis, Astreidis, Panagiotis, Christidis, Orestis, Ioannidis, Lydia, Loutzidou, Antonis, Mantevas, Konstantinos, Paraskevopoulos, Dimitris, Tatsis, Apostolos, Athanasiadis, Themistoklis, Dagklis, Ioannis, Kalogiannidis, Georgios, Kapetanios, Apostolos, Mamopoulos, Chrysoula, Margioula-Siarkou, Stamatios, Petousis, Ioannis, Tsakiridis, Christos, Anthoulakis, Chrysanthos, Christou, Antonios, Fantakis, Eirini, Iordanidou, Christos, Kaselas, Sousana, Panagiotidou, Vasileios, Papadopoulos, Kyriakos, Papavasiliou, Athanasios, Piachas, Ioannis, Siasios, Ioannis, Spyridakis, Theodoros, Theodoridis, Andreas, Tooulias, Eleftherios, Tsiridis, Maria, Tsopozidi, María, Alemán, Estuardo, Brolo, Ana Lucia Lemus, Jennifer, Greenberg, Krisna Mishel Morales Chew, José Rodrigo Oliva, María Alejandra De León Lima, Ismar Lopez Muralles, Felipe, Solares, Gaby, Ajcip, Claudia, Anton, Jose, Cojulun, Mario-Andrés, Flores, Noriega, José, Carlos Adolfo Marroquín Paiz, Steffanía, Morales, Ramiro, Najera, Eduardo Quiñónez Lorenzana, Pablo, Rivera, Lesly, Rodas, Victor, Santos, Dianne, Sosa, Natalia, Ybarra, José David Pérez Cajti, Carlos, Régil, Walter, A Osorio, Rember Rosales Arriola, Luis-Fernando, Talé-Rosales, Danilo, Herrera, Servio Tulio Torres Rodríguez, Sergio Alejandro Villeda, Joshua, Anicetti, Andrea Michelle Lowey Medina, Javier, Ardebol, Kathia, Barillas, Francis De Leon, Salvador, Recinos, Miguel-Angel, Marroquin-Alpirez, Yessica, Yax, Sophie, Hon, Yuk Ho Liu, Alex Qinyang Liu, Shirley, Liu, Hei Tung Natalie Chiu, Chi Man Tom Chow, Victor, Hau, Ho Wai Ip, Brian, Mak, Chung Ying Mok, Dennis, Ng, Yin Yu Eva Siu, Kiu Fung Wong, Jingya Jane Pu, Yu-Xiong, Su, Kit Ying Au-Yeung, David Yuen Chung Chan, Albert, Chan, Shannon Melissa Chan, Tsz Ching Chang, Tor Wo Chiu, Wang Kei Chiu, Zhexi, He, Man Fung Ho, Kevin Ki Wai Ho, Jacky Yan Kit Ho, Janet Wui Cheung Kung, Cheuk Ho Lam, Rainbow W, H Lau, Samuel Ka Kin Ling, Hon Ting Lok, Tony Wing Chung Mak, Chi-Fai, Ng, Simon, Ng, Kelvin Kwok-Chai Ng, Calvin S, H Ng, Michael Tim Yun Ong, Teresa, Tan, Sui Fan Tang, Jeremy Yuen-Chun Teoh, Anthony, Teoh, Bess Siu Yan Tsui, George Kwok Chu Wong, Randolph, Wong, Kwok Chuen Wong, Chi Hang Yee, Zsuzsanna, Antal, Attila, Kalman, Peter, Voros, Kiarash, Bahrehmand, Timea, Echim, Zoltan, Novak, Tamás, Sztipits, Laszló Ádám Bihari, László, Hidi, Laszlo, Piros, Balazs, Rózsa, Peter, Sotonyi, Lilla, Szatai, György, Herczeg, Bálint, Pordány, Fanni, Tornyi, Kristof, Dede, Tamás, Egyed, György, Saftics, Judit, Kulcsicka-Gut, Zsófia, Sipos, Dezso, Toth, Bhavin, Patel, Hardil, Majmudar, Saptak, Mankad, Sohilkhan, Pathan, Sharathkumarkl, L, Lokesh, Sasatti, Subramanyam, Mahankali, Santhosh Kumar Sampengere Annayappa, Tulika, Agrawal, Premkumar, Anandan, Aditya, Baindur, Manjunath, Bd, Savitha, C, S Anitha, G, Sandeep, Harigond, K Tejeswini, K, Venkatesh, Kesarla, Mallikarjuna, Manangi, B Hareesh, P, Jyothi K, R Ranjan, Athish, Shetty, Santhosh Shivashankar Chikkanayakanahalli, Tanvi, Sunil, Shreya, Syamala, Kavya, Tharanath, Aditya, Atal, Niranjana, Rajagopal, S Srinath, B, Vinod, Nk, L Thirumanikandan, P, Nitu, Mishra, Sushruta, Shrivastava, Rekha, Wadhwani, Reyaz, Ahmad, Zainab Ahmad Haq, Prateek, Behera, Ritika, Dhurwe, Rehan, Haq, Vaibhav, Jain, Anuj, Jain, Sunaina, Karna, Kameshwarachari, Pushpalatha, Sumit, Raj, John Ashutosh Santoshi, Pooja, Singh, Virendra, Verma, Vaishali, Waindeskar, Moorat Singh Yadav, Zaheda, Aziz, Koyel, Chakraborty, Preetam, Chappity, Gurudip, Das, Debajyoti, Datta, Saubhagya Kumar Jena, Madhabananda, Kar, Susanta, Khuntia, Pankaj, Kumar, Ravi, Kumar, Aswathi, Kv, Abhijeet, Mishra, Swastik, Mishra, Yash, Mittal, Dillip, Muduly, 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Somil, Jaiswal, Yashpal, Jaware, Navneet, Kala, Ruchi, Karnatak, Apjit, Kaur, Vijay, Kumar, Manoj, Kumar, Ambrish, Kumar, Upander, Kumar, Amit Kumar Shrivastava, Seema, Mehrotra, Brijesh, Mishra, Anand, Mishra, Namrata, Bal Krishna Ojha, Ahmad, Ozair, Uma Shanker Pal, Amita, Pandey, Nancy, Raja, Pooja, Ramakant, Ashutosh, Roy, Rekha, Sachan, Satyanarayan, Sankhwar, Pushp, Sankhwar, Divya, Sarin, Ayushi, Shukla, Sushil, Singh, Mohit, Singh, Kul Ranjan Singh, Renu, Singh, Uma, Singh, Urmila, Singh, Vandana, Solanki, Abhinav Arun Sonkar, Chhitij, Srivastava, Parijat, Suryawanshi, Vivek, Tewarson, Rajat, Verma, Manju Lata Verma, Awdhesh, Yadav, Gyan, Chand, K M, M Vishvak Chanthar, Dileep, Hoysal, Anjali, Mishra, Nitin, Batra, Arun, Bhatti, Rupali, Chopra, Shakina, David, Tapasya, Dhar, Uma Kant Dutt, Rohini, Dutta, Sumir, Gandhi, Parvez David Haque, B Paul Sudhakar John, Sreejith Kannummal Veetil, Gurvinder, Kaur, Navneet, Kumar, Anil, Luther, Anupam, Mahajan, Amit, Mahajan, Kavita, Mandrelle, Shefin, Mathews, Vishal, Michael, Partho, Mukherjee, Pinki, Pargal, Rajesh, Paul, Anupam, Phillip, Rachel, Phillips, Abhishek, Samuel, Noel, Singh, Inderjot, Singh, Abhijit, Singh, Sarvpreet Singh Grewal, Anusha, Singhania, Selven, Thirumalai, Ashish, Varghese, Joshua, Wesley, Josy, Thomas, Pradeep, Zechariah, Mariam Anjum Ifthikar, Rohan Thomas Mathew, Rohan, Shetty, M Vijayakumar Vijaykumar, Bm Zeeshan Hameed, Sufyan, Ibrahim, Gayathri, Jyothish, Sunil, Krishna, Stanley, Mathew, Arjun Suresh Kumar, Narinder, Singh, Piyush Kumar Sinha, Rachith, Sridhar, Sunny, Agarwal, Srikant, Balasubramaniam, Swati, Chhatrapati, Charulata, Deshpande, Ashni, Dharia, Sarita, Fernandes, Suraj, Gandhi, Mangesh, Gore, Abhilash, Jayakumar, Rameshwar, Mhamane, Anand, Nirgude, Sandesh, Parab, Manish, Patil, Amit, Peswani, Anjana, Sahu, Sarika, Samel, Fagun, Shah, Dipti, Haridas, Vijay, Shetty, Bejoy, Abraham, Varun, Agarwal, Quazi, Ahmad, Ashishkumar, Asari, Mohammad Ismail Attar, Nagaraja Sekhar Ayyalasomayajula, Sutej, Bachawat, Shivani, Bachhav, Vivek, Badhe, Sanjiv, Badhwar, Shubhabrata, Banerjee, Vikas, Basa, Vipul, Bothara, Somnath, Chattopadhyay, Sohin, Chaudhari, Rahul, Chavan, Priyank, Chawathe, Shailja, Dadhich, Anuj, Dalal, Avinash, Date, Mandar, Deshpande, Preetham, Dev, Niren, Dongre, Anirudha, Doshi, Maya, Gade, Shreyash, Gajjar, Mohan, Gawande, Amol, Ghalme, Bhavisha, Ghugare, Ishita, Gupta, Manoj, Jain, Divakar, Jain, Saumya Sekhar Jenasamant, Vaishali, Joshi, Vinay, Joshi, Neha, Kalwadia, Nandkishore, Kapadia, Hari Bipin Radhakrishnan Kattana, Tirathram, Kaushik, Akshat, Kayal, Shama, Kovale, Yogesh, Kulkarni, Abhaya, Kumar, Kranthi, Kumar, Kashmira, Kumawat, Vidyadhar, Lad, Namrata, Maskara, Rajesh, Mistry, Smruti Ranjan Mohanty, Kanchan, Motwani, Manoj, Mulchandani, Mandar, Nadkarni, Sanjay, Pandey, Mrunal, Parab, Dinshaw, Pardiwala, Amrita, Patkar, Neha, Pawar, Abhijit, Pawar, Abhinav, Pednekar, Vishal, Peshattiwar, Harshwardhan, Pokharkar, Ojas, Potdar, 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Reddy Voppuru, Anushri, Soni, Gira, Soni, Junaid, Alam, Dinesh, Bagaria, Minu, Bajpai, Akshay Kumar Bisoi, Arvind, Chaturvedi, Sandeep, Chauhan, Narendra, Choudhary, Rajendra Singh Chouhan, Sunil, Chumber, Kamran, Farooque, Vasubabu, Gudala, Amit, Gupta, Mohit, Joshi, Apoorva, Kabra, Shashank Sharad Kale, Abhinav, Kumar, Subodh, Kumar, Dhruv, Mahajan, Rajesh, Malhotra, P Ramesh Menon, Biplap, Misra, Samarth, Mittal, Rajinder, Parshad, Pratyusha, Priyadarshini, Sushma, Sagar, Pradeep Brijkishor Sharma, Vijay, Sharma, Vivek, Trikha, Mayank, Tyagi, Kuldeep, Bansal, Kalyan, Varma, Anurag, Mishra, Rajdeep, Singh, Rohit, Bhardwaj, Abhishek, Mittal, Sabarirajan, Ponnusamy, Gyan Ranjan Singh, Isha, Tuli, Pramod, Bhor, Sanjay, Dhar, Sachin, Kale, Manisha, Aggarwal, Himani, Gupta, Gurleen, Kaur, Ajinkya, Deshpande, Anup, Gadekar, Tanmay, Jaysingani, Taufiq, Panjwani, Rakesh, Patil, Narendra, Vaidya, Sunil Kumar Vishwakarma, Utkarsha, Wayal, Debnarayan, Dutta, Rajnish, Arora, Mohit, Dhingra, Pankaj Kumar Garg, Farhanul, Huda, Pankaj, Kandwal, Ravi, Kant, Rajkumar Kottayasamy Seenivasagam, Navin, Kumar, Shashank, Kumar, Lokavarapu Manoj Joshua, Radheyshyam, Mittal, Dharma Ram Poonia, Deepak, Rajput, Saravanan, Sadhasivam, Sudhir, Singh, Vivek, Singh, Kshitija, Chandanwale, Melissa, Philip, Vaibhav, Thorat, Yousuf, Choudhury, Devishmita, Das, Mautushi, Das, Subhadra, Goala, Farhana Yasmin Laskar, Parbin, Laskar, Kapil, Malik, Poulome, Mukherjee, Abhishek, Sarkar, S Thoibisana Singha, M Nongalei Singha, Damayanti, Singha, Gowtham, Srungavarapu, Ritesh, Tapkire, Siempui, Tling, Syed Muzamil Ishaq Andrabi, Gowhar Aziz Bhat, Nisar, Chowdri, Robindera, Kour, Fazl, Parray, Raahil, Shah, Zamir Ahmad Shah, Rauf, Wani, Soujanya, Adamala, Ravikanth, Gowder, Siddhi, Hegde, S Mashitha, M, Shreya, Sreeram, Sushil, Ankadavar, Darshan, Bafna, Bharat, Dhanani, Nikhil, Ingle, Piyush, Jadhao, Sinu, Joseph, Swapnil, Kapote, Shirin, Karkada, Parag, Lad, Rajan, Lohia, Suyog, Madje, Venkateshwaran, Narasiman, Meer, Chisthi, Gejoe, George, Harihara, Jothi, Dilber, Pareed, Godwin David, C Mathew, Livingston, Abel, Mansi, Agrawal, Rabindranath, B, Manish, Baldia, Ravi Kishore Barla, Manisha, Beck, Santosh, Benjamin, Jeremy, Bliss, Lisa, Cherian, Sreekar, Devarakonda, Geley, Ete, Arun Jacob Philip George, Amish, Gohil, Deeptiman, James, Mark Ranjan Jesudason, Lallu, Joseph, Treasa, Joseph, Kathir, Joyson, Gomathi, Karnan, Albert, Kota, Pushplata, Kumari, Anitha, Loganathan, Vasanth Mark Samuel, John, Mathew, Senthil, K Nathan, Joby Elizabeth Ninan, Ajay, Philip, R Priyadarshini Priyadarshini, Suganya, S, Habie, Samuel, Gilbert, Samuel, Daniel, Selvaraj, Srujan, Sharma, Suraj, Surendran, D Hariharan, T, Santhosh Kumar Thangaraj, Vinotha, Thomas, Varghese, Thomas, John, K Thomas, S Harish, Y, Manobhiram, Boggavarapu, Murali Krishna Voonna, Marilaeta Cindryani Lolobali, Christopher, Ryalino, Tjokorda Gde Agung Senapathi, Mahadewa, Tjokorda, I Made Gede Widnyana, Dita, Aditianingsih, Aino, Auerkari, Susilo, Chandra, Fachreza Aryo Damara, Mohammad Adya Firmansha Dilmy, Achmad Kemal Harzif, Sidharta Kusuma Manggala, Dedy, Pratama, Affan, Priyambodo, Andi Ade Ramlan, Ratna Farida Soenarto, Adhrie, Sugiarto, Ilham Utama Surya, Tamara, Tango, Aida Rosita Tantri, Raihanita, Zahra, Dedy, Fachrian, Andi, Hasyim, Ade, Susanti, Teddy, Saputra, Erwin, Syarifuddin, Andi Asadul Islam, Hendra, Pajan, Ahmad Hannan Amrullah, Khoirul, Anam, Thirza, Hadipranata, Julius Albert Sugianto, Aidyl, Fitrisyah, Mayang Indah Lestari, Nur Rachmat Lubis, Rizal, Zainal, Zulkifli, Zulkifli, Erick Gamaliel Amba, Warren, Lie, Andika Adiputra Thehumury, Tedy, Apriawan, Yunus Kuntawi Aji, Roidah Taqiyya Zahra Wathoni, Sumadi Lukman Anwar, Teguh, Aryandono, Wirsma Arif Harahap, Juni, Kurniawaty, Djayanti, Sari, Artanto, Wahyono, Yunita, Widyastuti, Akhmad Yun Jufan, Parisa, Arjmand, Mohammad, Etezadpour, Babak, Ganjeifar, Masoumeh, Hosseinpoor, Hassan, Mehrad-Majd, Mohsen, Rajati, Reza, Assadi, Ehsan, Noori, Parisa, Rajaei, Samira, Hajisadeghi, Mohammad, Mehdizadeh, Mina, Soltani, Narges, Alizadeh, Gholamreza Azarnia Azar Nia, Hamid, Heidari, Seyedmohamad Hosseini Zavareh Hosseini Zavareh, Ali Moazami Pour Moazami Pour, Farokh, Savaddar, Mostafa, Vahedian, Hoora, Amouzegar, Mojdeh, Bahadorzadeh, Seyedeh Homa Hemmasi, Ahmad, Kachoie, Ali Karimi Karimi, Sepideh, Miraj, Monireh, Mirzaie, Hossein Mokarami Mokarami, Amrollah, Salimi, Roghayyeh, Ahangari, Ali, Ahmadvand, Ali, Bashiri, Morteza, Borhani, Mohammad, Haidari, Mohammad Taghi Imani Khosroshahi, Shahrokh Jahan Bini, Mohsen, Koosha, Mohammad Kazem Moslemi, Ali, Naghibi, Shahrzad, Tehrani, Zahra, Yazdi, Seyyed Hassan Adeli, Majid, Alborzi, Hamed, Bagheri, Mohsen, Eshraghi, Hassan Fatemi Manesh, Mohammad, Ghomeisi, Seyed Fakhreddin Hejazi, Saeed, Madani, Nima Najafian Motahaver, Samieh, Norouzi, Mahdi Pezeshki Modarres, Ali, Shafiee, Jamshid, Vafaeimanesh, Hossein, Yusefi, Elahe, Hosseini, Pourya, Medhati, 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Marshall, Darya, Musa, Zeeshan, Ahmad, Emmet, Andrews, Bruno Chan Chin, Mark, Corrigan, Amy Edwards Murphy, Niamh, Foley, Padraig, Gardiner, Daniel, Hechtl, Michelle, Hsiao, Mohd Yasser Kayyal, Shane, Killeen, Maria, Lyons, Cathy, Burke, Matt, Hewitt, Marwa, Mohamed, Syeda Farah Nazir, Mei Yee Ng, Nor Azlia Abdul Wahab, Cathy, Monteith, Oladayo, Oduola, Lylas, Aljohmani, Timothy, Nugent, Paula, Corr, Lauren, Crone, Johnathon, Harris, Arnold, Hill, David, Kearney, Robert Anthony Keenan, Deirdre, Nolan, James, Ryan, Mark Philip Hehir, Carmen, Regan, Michael, Geary, Fergal, Malone, Claire, Mccarthy, Donal, B O'Connor, Shane, Considine, Emma, Donohoe, Caroline, Herron, John, Larkin, Thomas Hugh Lynch, Barry, Maguire, Rustom, Manecksha, Andrea Mc Carthy, Katharina, Nagassima, Erica, O'Sullivan, Pat, Rohan, Ryan, Roopnarinesingh, Salloum, Salloum, Thomas, Aherne, Mary, Barry, Gareth John Bowen, Ellen, Boyle, Joseph, Dowdall, Ann, Hanly, Ahmed, Hassanin, Helen, Heneghan, Conor, Hurson, Orlaith, Kelly, Rory, Kennelly, Aoife, Kiernan, Sean, T Martin, Nawar, Masarani, Damian, Mccartan, Enda, W McDermott, Ben, Murphy, Kin Cheung Ng, Nwabundo, Njeze, Aine, O'Neill, Ruth, S Prichard, Ned, Quirke, Ian Sean Reynolds, Des, Winter, Rowan, Casey, Mutaz, Elamin, Amy, Gillis, Dara, Kavanagh, Michael, Kelly, Áine, Mcnamee, Paul, Neary, Patrick, Owens, Akshaya, Ravi, Paul, Ridgway, Paul, Carroll, Chris, Collins, Amenah, Dhannoon, Amy, Fowler, Aisling, Hogan, Aoife, Lowery, Peter, Mcanena, Charlie, Timon, Stewart, Walsh, Wisam, Al-Ramli, Imran, Azeem, Muhammad Usaama Bahadoor, Zsolt, Bodnar, Hassan, Elmusharaf, Faisal Saeed Hassan, Adam, Hingum, Huilun, Huan, Seamus, Jennings, Mohamed Hamed Khalid, Mariya, Kuteva, Syed Nadeem Mujtaba, Shanell, Peeriyah, Hina, Rehman, Muhammad Assam Sarwar, Tony, Shaju, Ian, Stephens, Michael, Sugrue, Joseph, Thomas, Manvydas, Varzgalis, Saqib, Zeeshan, Alisha, Jaffer, Larne, Jones-Whiting, Colin, Peirce, Sean, Johnston, Seantee, Lim, Alwaleed, 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Massimiliano, Gennaro, Lorenzo, Giannini, Marcello, Guaglio, Marco, Guzzo, Andrea, Leva, Alberto, Macchi, Elena, Manzo, Fabio, Martinelli, Ilaria, Mattavelli, Vincenzo Maria Mazzaferro, Francesco, Raspagliesi, Luigi, Rolli, Laura, Sala, Roberto, Salvioni, Mario, Santinami, Silvia, Segattini, Luca, Sorrentino, Carlotta, Zaborra, Alexandre, Anesi, Gianmaria Casoni Pattacini, Mattia Di Bartolomeo, Francesca, Pecchini, Arrigo, Pellacani, Micaela, Piccoli, Federico, Fusini, Andrea, Gattolin, Marco, Migliore, Roberto, Rimonda, Diego, Sasia, Elisabetta, Travaglio, Federica, Brunetti, Marco, Cereda, Marco, Ceresoli, Luca, Cigagna, Cristina, Dell'Oro, Alessandro, Fogliati, Robert, Fruscio, Tommaso, Grassi, Maini Marzia Isabella, Luca Carlo Nespoli, Massimo, Oldani, Sara, Ornaghi, Nicolò, Tamini, Carmine, Antropoli, Antonio, Castaldi, Alessio, Palumbo, Gaia, Altieri, Umberto, Bracale, Francesco, Corcione, Marcello De Luca, Giovanni Domenico De Palma, Maria Michela Di Nuzzo, Ruggero, Lionetti, 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Matteo, Filardo, Marika Sharmayne Milani, Franco, Ragni, Andrea de Manzoni Garberini, Edoardo, Baldini, Diana, Carpaneto, Michele, Cauteruccio, Corrado, Ciatti, Luigi, Conti, Serena, Gattoni, Pietro, Maniscalco, Gerardo, Palmieri, Calogero Puma Pagliarello, Giuseppe, Caristo, Raffaele, Galleano, Michele, Malerba, Marcello, Calabrò, Francesca, Farnesi, Elia Giuseppe Lunghi, Andrea, Muratore, Nicoletta Sveva Pipitone Federico, Joel Reuben Abel, Lorenzo, Andreani, Darienzo, Antonio, Vittorio, Aprile, Riccardo, Balestri, Giacomo, Benettini, Stefano, Berrettini, Luca, Bruschini, Massimo, Chiarugi, Federico, Coccolini, Simone, Colangeli, Camilla, Cremonini, Lodovica Cristofani Mencacci, Iacopo, Dallan, Silvia De Santi, Gregorio Di Franco, Lorena Di Girolami, Giacomo, Fiacchini, Niccolò, Furbetta, Stylianos, Korasidis, Marco, Lucchi, Andrea, Morandi, Luca, Morelli, Serena, Musetti, Carlo Maria Neri, Matteo, Palmeri, Miriana, Picariello, Francesco, Porcelli, Marco, Puccini, Nicolo, Roffi, Erica, Statuti, Dario, Tartaglia, Alberto, Tonelli, Matteo, Vianini, Gianluca, Baronio, Mauro, Montuori, Enrico, Pinotti, Stefano Maria Massimiliano Basso, Federica, Maffeis, Paolo, Ubiali, Lorenzo, Aguzzoli, Saverio, Coiro, Giuseppe, Falco, Vincenzo Dario Mandato, Valentina, Mastrofilippo, Simone, Mele, Caterina, Baldi, Carlo, Corbellini, Gianluca Matteo Sampietro, Massimo, Dugo, Mauro, Garino, Chiara, Marafante, Antonio, Masciandaro, Elisabetta, Moggia, Alessandra, Murgese, Felice Eugenio Agro, Gabriella Teresa Capolupo, Filippo, Carannante, Marco, Caricato, Vincenzo, Denaro, Erica, Mazzotta, Rocco, Papalia, Giuseppe, Pascarella, Alessandro, Strumia, Biagio, Zampogna, Matteo, Cinquepalmi, Marco, Colasanti, Celeste Del Basso, Federica, Falaschi, Nicola, Guglielmo, Roberto Luca Meniconi, Alessandra, Pecoraro, Sofia, Usai, Giacomo, Crescentini, Antonella, Larcinese, Emanuele, Picone, Giovanni, Sinibaldi, Annamaria, Agnes, Salvatore, Agnes, Sergio, Alfieri, Francesco, Belia, Valentina, Bianchi, Giuseppe, Bianco, Alberto, Biondi, Paola, Campennì, Valerio, Cozza, Sabatino, D'Archi, Domenico, D'Ugo, Veronica De Simone, Marta Di Grezia, Sofia Di Lorenzo, Federica, Ferracci, Valeria, Fico, Gianluca, Franceschini, Pietro, Fransvea, Giulio, Gasparini, Luca, Gordini, Antonio La Greca, Francesco, Litta, Celestino Pio Lombardi, Angelo Alessandro Marra, Angelo, Parello, Marco Maria Pascale, Romeo, Patini, Gilda, Pepe, Roberto, Persiani, Caterina, Puccioni, Carlo, Ratto, Fausto, Rosa, Gianmarco, Saponaro, Lorenzo, Scardina, Tedesco, Silvia, Giuseppe, Tropeano, Maria, Benevolo, Daniele, Bugada, Flaminia, Campo, Maria Gabriella Dona, Valentina, Manciocco, Paolo, Marchesi, Riccardo, Mastroianni, Francesco, Mazzola, Silvia, Moretto, Raul, Pellini, Gerardo, Petruzzi, Barbara, Pichi, Giuseppe, Simone, Gabriele, Tuderti, Jacopo, Zocchi, Luigi Marino Cosentino, Andrea, Sagnotta, Roberta, Angelico, Vittoria, Bellato, Michela, Campanelli, Marzia, Franceschilli, Michele, Grande, Giorgio, Lisi, Tommaso Maria Manzia, Lorenzo, Petagna, Bruno, Sensi, Giuseppe, Sica, Leandro, Siragusa, Giuseppe, Tisone, Marco, Assenza, Barbara, Binda, Massimo, Biondi, Gioia, Brachini, Placido, Bruzzaniti, Mauro, Casagrande, Flavia, Ciccarone, Pierfranco Maria Cicerchia, Bruno, Cirillo, Daniele, Crocetti, Giancarlo, D'Ambrosio, Vito, D'Andrea, Francesca De Felice, Giorgio De Toma, Carlo Della Rocca, Giulia, Duranti, Pietro, Familiari, Enrico, Fiori, Giovanni Battista Fonsi, Alessandro, Frati, Stefania La Rocca, Filippo La Torre, Pierfrancesco, Lapolla, Giovanni, Marruzzo, Simona, Meneghini, Andrea, Mingoli, Andrea, Picchetto, Antonella, Polimeni, Diego, Ribuffo, Maurizio, Salvati, Antonio, Santoro, Paolo, Sapienza, Luigi, Simonelli, Valentino, Valentini, Martina, Zambon, Giuseppa, Zancana, Emma, Zuppi, Simone, D'Annunzio, Cosimo De Nunzio, Silvia, Fiorelli, Mohsen, Ibrahim, Chiara, Loffredo, Domenico, Massullo, Cecilia, Menna, Rocco, Monica, Massimiliano, Pelli, Erino Angelo Rendina, Leonardo, Teodonio, Andrea, Tubaro, Giulio, Argenio, Giulio, Accarino, Accarino, Giancarlo, Antonio Nicola Giordano, Luca, Cardinali, Elisa, Sebastiani, Grazia, Travaglini, Erika, Andreatta, Emanuele Luigi Giuseppe Asti, Daniele, Bernardi, Luigi, Bonavina, Caterina, Froiio, Andrea, Lovece, Chiara, Copelli, Alfonso, Manfuso, Pasquale Di Maio, Marco, Giudice, Oreste, Iocca, Rosario, Cennamo, Tommaso, Cornali, Francesco Di Marzo, Cristian, Altana, Francesco, Bussu, Giampiero, Capobianco, Anna Giacomina Carta, Sandro, Ciccarello, Maria Laura Cossu, Pietrina, Cottu, Giacomo De Riu, Salvatore, Dessole, Francesco, Dessole, Salvatora, Dettori, Carlo, Doria, Alessandro, Fancellu, Claudio, F Feo, Giorgio Carlo Ginesu, Giuliana, Giuliani, Marco Giuseppe Iannuccelli, Massimo, Madonia, Roberto, Mancino, Olindo, Massarelli, Gianfranco, Meloni, Fabio, Milia, Andrea, Mulliri, Teresa, Perra, Marco, Petrillo, Antonio, Piras, Franco, Piredda, Francesco, Pisanu, Alberto, Porcu, Davide, Rizzo, Angelino, Sanna, Antonio Mario Scanu, Fabrizio, Scognamillo, Damiano, Soma, Anna Rita Tanca, Alessandro, Tedde, Matteo, Tedde, Luigi Angelo Vaira, Andrea Bartalini Cinughi de Pazzi, Osvaldo Carpineto Samorani, Daniele, Fusario, Luigi, Marano, Gaia, Oldrà, Anna Lisa Pesce, Stefania Angela Piccioni, Luca, Resca, Vincenzo, Ricchiuti, Franco, Roviello, Vinno, Savelli, Alberto, Abrate, Pierpaolo, Bordoni, Lorenzo, Bosio, Guglielmo, Clarizia, Francesco, Fleres, Marco, Franzini, Antonio, Fratto, Pierluigi, Giumelli, Alessandro, Grechi, Alessandro, Longhini, Fabrizio, Lorusso, Elisa, Scarnecchia, Federica, Scolari, Alessandro, Spolini, Vincenzo, Maiuri, Matteo, Papandrea, Arturo, Roncone, Lorenzo, Conti, Andrea, Rizzi, Marco, Rovagnati, Alberto, Brolese, Tommaso, Cai, Francesco Antonio Ciarleglio, Francesca, Dalprà, Gianni, Malossini, Liliana, Mereu, Irene, Tamanini, Saverio, Tateo, Giovanni, Viel, Enrico, Battistella, Paolo Boscolo Rizzo, Cristoforo, Fabbris, Marco, Massani, Giacomo, Spinato, Roberta, Tutino, Ugo, Grossi, Alessandro, Iacomino, Simone, Novello, Maurizio, Romano, Serena, Rossi, Giulio, Santoro, Giacomo, Zanus, Sokol, Trungu, Giada, Aizza, Gabriele, Bellio, Selene, Bogoni, Marina, Bortul, Biagio, Casagranda, Sara, Cortinovis, Nicolò de Manzini, Davide, Drigo, Paola, Germani, Manuela, Mastronardi, Lucia, Paiano, Silvia, Palmisano, Pier Luigi Filosso, Francesco, Guerrera, Matteo, Marro, Mauro, Rinaldi, Enrico, Ruffini, Stefano, Salizzoni, Laura, Bardelli, Mattia, Berselli, Giacomo, Borroni, Eugenio, Cocozza, Matteo, Desio, Bottazzoli, Elisa, Giuseppe, Ietto, Valentina, Iori, Domenico, Iovino, Lorenzo, Livraghi, Valentina, Marchionini, Stefano, Megna, Emma Amal Nahal, Mara, Palumbo, Valeria, Quintodei, Alessandra, Zullo, Lucrezia, D'Alimonte, Giovanni, Pirozzolo, Chiara, Vignotto, Tommaso, Campagnaro, Andrea, Caravati, Simone, Conci, Carlotta De Cristofaro, Gabriele, Gecchele, Tommaso, Giuliani, Jacopo, Graziosi, Alfredo, Guglielmi, Salvatore, Paiella, Corrado, 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Rakotoarisoa, Maharo, Ramifehiarivo, Solonirina Harinarindra Ranaivoson, Hajamihamina Marina Parfaite Randriantsoa, Narindra Njarasoa Mihaja Razafimanjato, Jeannie Ba Razafindrahita, Solofoarimanana, Solofoarimanana, Guillaume Odilon Tsiambanizafy, Rakotonaivo Mamisoa Judicaël, Corinne Eulalie Solo, Tojomamy Herinjaka Ralaizafindraibe, Fanonjomahasoa Safiry Andofenohasina, Hanta, Rasataharifetra, Vanona Barijaona Razafindraibe, Angelin Sablon Herinirina, Andre, Das, Thanga, Ganapathy, Yohesuwary, Gunarasa, Kalyani, Mariapan, Maathichsudhaar, Muniandy, Mohd Firdauss Osman, Mohd Azem Fathi Mohammad Azmi, Jien Yen Soh, Wan Zainira Wan Zain, Andee Dzulkarnaen Zakaria, Zaidi, Zakaria, Kheng Hooi Chan, Firdaus, Hayati, Syamim, Johan, Jin Jiun Mah, Ratha Krishnan Sriram, Sentilnathan, Subramaniam, Nur Shahirah Binti Muhammad Shahimi, Khairul Hazim Hamdan, Mohd Razali Ibrahim, Guhan, Muthkumaran, Ju Ann Tan, Mohana Raj Thanapal, Dayang Anita Abdul Aziz, Mae-Lynn, Bastion, Mohd Hairul Nizam Harun, Farrah-Hani, Imran, Norshamsiah Md Din, Ayesha Mohd Zain, Mushawiahti, Mustapha, Syed, Nabil, Ainal Adlin Naffi, Abd Jabar Nazimi, Roszalina, Ramli, Bee Hong Soon, Pavin, Bal, Joo Qing Cheng, Mohd Rusdi Draman, Ahmad Nazran Fadzli, Sakina, Ghauth, Weipin, Hung, Suniza, Jamaris, Peng Soon Koh, Sivakumar, Krishnasamy, Yeong Sing Lee, Yew Toong Liew, Jeffery Zk Lim, Raymond Chung Siang Lim, Hiong Chin Lim, Siti Farhan Moh Pauzi, Shireen Anne Nah, Ashvin Krishna Nair, Doris Sin Wen Ng, Yuki Julius Ng We Yong, Kamarajan, Ramayah, Rahmah, Saaid, Anand, Sanmugam, Mee Hoong See, Kanesh Kumaran Seevalingam, Neha, Sethi, Srihari, Singaravel, Syeda Nureena Syed Jafer Hussain Zaidi, Chu Yik Tang, Li Ying Teoh, Kian Boon Wong, Ruben, Xavier, Ahmad Shuib Yahaya, Norhafiza, Ab, Rahman, Islah Munjih Ab, Rashid, Mohd Fahmi Abd Aziz, Mohd Norhisham Azmi Abdul Rahman, Nasser Muhammad Amjad, Shahidah Che Alhadi, Faisal, Elagili, Mohd Nazli Kamarulzaman, Azmi Md Nor, Ahmad Faidzal Othman, Mohd Yusof Sainal, Mat Salleh Sarif, Richelle, Chua, Aini Fahriza Ibrahim, Abdul Rauf Bin Ahmad, Yii Ling Lau, Ka Yee Liew, Kandasami, Palayan, Hui Yu Wong, Jasiah, Zakaria, Nor Azimah Abd Aziz, Norazila Abdul Rahim, Noorneza Abdul Rahman, Bahiyah, Abdullah, Mohamed Faizal Bin Sikkandar, Fatin, Firman, Nik Mohd Hazleigh, Intan Kartika Kamarudin, Shahril, Khalid, Mohd Fairudz Mohd Miswan, Akmal Zulayla Mohd Zahid, Norasyikin, Mustafa, Kadhim, Obaid, Mohd Yusoff Bin Yahaya Yahaya, Ahmad Ramzi Yusoff, Predrag, Andrejevic, Jeremy Borg Myatt, Svetlana, Brincat, Clifford, Caruana, Kurt Lee Chircop, Francesca, Chircop, Daniel Mario Chircop, Charles, Cini, Viktoria, Czok, Melanie, Farrugia, Gabriella, Grima, Fatimah Mj Hassan Almukhariq, Esther, Muscat, Darryl, Pisani, Mohsin Hassan Khan Roshan, Nicholas, Schembri, Mohamed, Shoukry, Neville, Spiteri, Gilbert, Tanti, Ziad Aboharp Hasan, Alberto Bazan Soto, Cedillo Rodrìguez Jonathan Rubén, Gustavo Esteban Lugo Zamudio, David Gerardo Miranda Gómez, José Alfredo Pérez Meave, Victor Pinto Angulo, Antonio Rojas Aguilar, Erik Efrain Sosa Duran, Alejandro Vàzquez Perez, Diego, Arroyo, Jose, Corona-Cruz, Hector, Martinez-Said, Heriberto, Medina-Franco, Manuel, Mendez, Teresa Moreno, Y Suárez Ma, Dolores Orta Díaz, Martha Patricia Pérez de León Vázquez, Angélica Azucena Soto Carvajal, Fidel Soto Hernández, Juan Ignacio Stenner, Adriana Valenzuela López, Mauricio Rene Hernandez, Rey Jesus Romero, Aldo Bernal Hernandez, Ana Olivia Cortes-Flores, Carlos Jose Zuloaga Fernandez Del Valle, Carlos Andres Colunga Tinajero, Jaime, Orozco-Perez, Laura Gabriela Peña Balboa, Guillermo, Yanowsky-Reyes, Víctor Hugo Alcalá Torres, Francisco José Barbosa Camacho, Irma Valeria Brancaccio Perez, Miguel Angel Calderon-Llamas, Aldo Camacho Gomez, Edgar-Joaquin, Cortes-Torres, Esteban, Cueva-Martinez, Oscar Durán Anguiano, Isaac Esparza Estrada, Roberto, Fierro-Rizo, Paola Flores Becerril, Clotilde Fuentes Orozco, Miguel García Castillo, Alejandro Gonzalez Ojeda, Ana Sofia Gonzalez Rubio, Erick Alonso González-García de Rojas, Luis Humberto Govea-Camacho, Jose Aldo Guzman Barba, Juan Carlos Ibarrola Peña, César Íñiguez Martínez, Francisco Javier Llamas-Macias, Ruben Eduardo Morán Galaviz, Cesar, Nuño-Escobar, Oscar-Everardo, Olvera-Flores, Jaqueline, Osuna-Rubio, Jose Victor Pérez-Navarro, Rodrigo, Prieto-Aldape, Luis Ricardo Ramirez Gonzalez, Marco Vinicio Ramírez Sánchez, Emilio, Reyes, Olaya Moramay Romero-Limón, Carlos Beas Ruiz-Velasco, José Antonio Sánchez Martínez, Guillermo, Sanchez-Villaseñor, Ismael, Sedano-Portillo, Gabriela Ambriz Gonzalez, Pedro Berrones Moreno Berrones Moreno, Ana Beatriz Calderon Alvarado, José de Jesús Cárdenas Barón, Araceli, Hernández, Francisco Javier León Frutos, Edgard Efren Lozada Hernandez, Eduardo Morales Valencia, Karla Daniela Pérez, Francina, Bolanos-Morales, Julio, Herrera-Zamora, Patricio, Santillan-Doherty, David Omar Arriaga Zavala, Salvador Francisco Campos Campos, Lizette, Carmona, 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Alexander, Borgstein, Suzanne, Gisbertz, Sarah, Mikdad, Mark van Berge Henegouwen, Roel, Bakx, Marc, Besselink, Daniel Hl Lemmers, Anne-Jasmin, Roelofs, Paul van Amstel, Claire van Helsdingen, Ludi, Smeele, Niels, Harlaar, Frederik, Jonker, Sjirk van der Burg, Justin, Y van Oostendorp, Saranda, Ombashi, Tim van der Voort, Martijn van Geldorp, Lisanne, Posma-Bouman, Hans Donald de Boer, Annette, Olieman, Henriette, Smid-Nanninga, Jean-Paul P, M De Vries, Rianne, Hogenbirk, Tyche, Derksen, Josephine, Franken, Steven, Oosterling, Peter, Nolte, Jelle van der List, Ian, Alwayn, Okker, Bijlstra, Andries, Braat, Ruth, Bulder, Michèle de Kok, Robin, Faber, Ben, Goudsmit, Jaap, Hamming, Sven, Mieog, Alexander, Vahrmeijer, Fenna E, M van de Leemkolk, Joost van der Vorst, Jan van Schaik, Merel, Verhagen, Kim, Albers, Larsa, Gawria, Harry Van Goor, Michiel, Warle, Tessa, M van Ginhoven, Charlotte, Viëtor, Evert-Jan, Boerma, Lara, Lallitsch, Donald, Schweitzer, Wouter, Leclercq, Julie, Sijmons, 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Asensio, Luis Asensio Gomez, Diego, Carrion, Nuria, Chavarrias, Alvaro de Arriba, Jose Antonio Gazo Martínez Gazo, Alberto Gegúndez Simón, Juan Gómez Rivas, Natalia Gonzalez Alcolea, Carolina, Gonzalez-Gomez, Sara Gortázar de Las Casas, María Alexandra Heras Garceau, Alicia Hernández Gutierrez, Luis, Lassaletta, Fuad Samir Lopez Fernández, Marta, Mancheño, Blanca, Mateos-Serrano, Isabel Pascual Miguelañez, Maria Fernanda Pedrero Escalas, Julio, Peñarrocha, Yolanda, Perez, Maria Isabel Prieto-Nieto, Teresa Rivera Schmitz, Laura, Rodrigáñez, Ines, Rubio-Perez, Isabel Sanchez Cuadrado, José Ignacio Sánchez Méndez, Jorge Fernando Tone, Carlos Toribio Vazquez, Aitor, Urbieta, Diego Córdova García, Francisca Garcia-Moreno Nisa, Laura, Jiménez, Inmaculada, Lasa, Belen, Matías-García, Fernando, Mendoza-Moreno, Marina Pérez González, Ana Sánchez Gollarte, Alejandro Sanchez Pellejero, Cristina Vera Mansilla, Rafael, Barberá, Lourdes, Montes-Jovellar, Sara Fra Fernández, Nicolas Moreno Mata, Barbara, Algar-Yañez, Gutiérrez, Bérénice, Olga De La Varga-Martínez, Paula, Fernandez-Valdes-Bango, Sandra Maria Gadin-Lopez, José María Martínez-Gómiz, Elena, Nieto-Moreno, Ana, Nieto-Moreno, Montserrat Ocampos Hernandez, Maria Laura Pelegrina-Lopez, Alicia Ruiz Escobar, Elena, Sáez-Ruiz, Beatriz, Vazquez-Rivero, Antonio, Lara, Belén Vielva Del Campo, Fernando Alcaide Matas, Simbad, Costas-Ochoa, José María García Pérez, Elizabeth, Marmol, Paula Troncoso Pereira, Maria Del Pilar Concejo Cutoli, Juan Ramón Gómez López, Juan Carlos Martín Del Olmo, Paloma Guillamot Ruano, Javier Páramo Zunzunegui, Antonio Albarracín Marín Blázquez, Alfonso, Aliaga-Sanchez, Marta María Arroyo Domingo, Miriam Artés Artés, Ana Isabel Avellaneda Camarena, Aida, Blaya, Emny Rochell Bobadilla Romero, Pedro Vicente Fernández-Fernández, Lorena Galindo Iñiguez, Víctor Javier García Porcel, Clara Giménez Francés, Antonio Javier Gomez Poveda, Rebeca Gonzalez Celdran, Francisco Miguel González Valverde, Laura Guillamon Vivancos, Elena, Gurrea-Almela, Alejandra Jara Maquilón, Jose David Jimenez Parra, Abd Al Aziz Lanagrán Torres, Raquel Lax Perez, Carmen Maria Lopez Lopez, Francisco, Machado, Alfonso Marco Garrido, Florencio Manuel Marin Martinez, Victoria Martínez Muñoz, Esther, Medina, Olimpia, Molina, José Manuel Muñoz Camarena, Julian, Onate, Pedro Antonio Parra Baños, Emilio Peña Ros, Enrique, Rubio, Marina Sánchez Robles, Carlos Sanchez Rodriguez, María Valero Soriano, María Teresa Yepes García, Felipe, Alconchel, Andrés Balaguer Román, Valentín, Cayuela, Ana, Conesa, Ana Delegido García, Pedro José Gil Vázquez, Paula Gómez Valles, Francisco, Gómez-Bosch, Vicente, J León-Muñoz, Francisco, Martínez, Alvaro, Navarro-Barrios, Tatiana, Nicolás-López, Pablo Ramirez Romero, Emiliano, Cano-Trigueros, María Concepcion Alonso González, Leticia Gómez Viana, Ana Pastor Zapata, Elisa Contreras Saiz, Tamara Díaz Vico, Maria, Fernandez-Hevia, Luis Joaquín García Flórez, Raquel, Rodríguez-Uria, Sandra, Sanz, Lorena, Solar-Garcia, Aida Suárez Sánchez, Jaume, Gelonch, Dietmar, Reinaldo, Miriam Abdulkarim Polo, Asier, Aguirre, Marta Alomar Bofill, Santiago, Baena, Ashish, Bartakke, Carmen Cabeza Oliver, Marta Castro Suárez, José Andrés Cifuentes Rodenas, Olga Claramonte Bellmunt, Ant Onia Crespí Mir, Anabel De La Llave Serralvo, Mar, Escales, Isabel Rosa Fernández Burgos, Pablo Gandia Gonzalez, Juan Lliteras Jorge, María Cristina Martínez Canto, Javier, Mata, Andreu, Morell, Naila, Pagès, Sara Pérez Palao, Cristian Plaza Valiente, Catalina Ramon Barcelo, Carmen Reyero Fernández, Albert Reyes Claret, Leticia Rodriguez Vaquero, Maialen Saez de Vicuña Salinas, Pilar Santos Cidon, Concepcion, Segura, Aina, Serra, Maria Serra Guivernau, Maria Soler Pedrola, Marta, Tasende, Marta Torrent Lluch, María Inmaculada Valldeperas Hernández, Rosa-Maria, Yañez-Lpez, Andrea, Craus-Miguel, Laura Fernández Vega, Natalia Pujol Cano, Juan José Segura-Sampedro, Laura Colet Oliver, Ivan Dot Pascuet, Mireia, Duart, Isabel Tello Galindo, Eduardo Arrea Salto, Jaume Cámara Cabrera, Marta Camats Terré, Juan Gabriel Castro Ríos, Marta de la Rosa-Estadella, Anna, Fernandez-Colorado, Anna, Gasulla-Rodriguez, Antonio, Gimenez-Gaibar, Elena, Gonzalez, Yeray Maldonado Sotoca, Matilde, Molina-Corbacho, Montserrat Monfort Mira, Josep, Rodoreda, Marta Santos Espí, Arnau Verdaguer Figuerola, Elisa Angela Diego-Alonso, Jaime, López-Sánchez, Luis, Muñoz-Bellvis, Jacobo, Trebol, Borja, Aguinagalde, Cristina Gabriela Alzate Arsuaga, Ainhoa Andres Imaz, Iñigo, Arana, Coro Aranzabal Urrutia, Mikel, Armendariz, Lorena, Arrabal, Iñigo, Augusto, Adolfo, Beguiristain, Laura, Busto, Ainhoa, Cuevas, Itziar De Ariño, Alejandro, Elúa, Leticia, Fernandez, Arantza, Fernandez-Monge, Lander, Gallego, Alba, Garcia, Amaia Garcia Dominguez, Gregorio, Garmendia, Carmen, Grañén, Pelayo Hevia Rodríguez, Maria, Iraola, José Miguel Izquierdo, Aintzane, Lizarazu, Jon Ander Lizarbe, Claudia Cristina Lopes Moreira, Iker, López, Ruth Marquina González, Tania, Pastor, Adrián Recio Ayesa, Ana Paula Riverola Aso, Carballo, Rodríguez, Araceli, Rodrìguez, Maria Inmaculada Ruiz Montesinos, Patricia, Torres, Jose, Undabeitia, Ainara, Villafruela, Maria Barrionuevo Ramos, David, Blanco, Marta, Calderón, Eva Corral Rubio, Angel, Cuadrado-García, Daniela, Cubek, Ignacio, Fariña, Maria Fernandez LLorente, Natalia Flores Amador, Mariana García Virosta, Luis Garcia-Sancho Tellez, Adelina Gonzalez Martinez, María, Hernandez, Rubén Herreros Ruiz-Valdepeñas, Carmen Jimenez Sanchez, Eduardo Llamazares Cobo, María, López, Javier, López-Martin, Teresa Martínez Marivela, Luis Miguel Martinez Parra, Paloma Maté Mate, Paloma, Medrano, Manuel Moriche Carretero, Sara Núñez O'Sullivan, Manuel Ortega Oria de Rueda, María Begoña Pastor Nieto, Clara, Pérez, Antonio, L Picardo, Remedios Revilla Amores, Carmen Rodríguez Haro, Jose Alberto Rojo López, Fatima Sanchez Cabezudo Noguera, Cristina, Sanz, Daniel Serralta de Colsa, Cristina Valor Garcia, Marta Velasco Martinez, Iván Andújar Lara, Aranzazu, Calero-Lillo, Enrique, López-Ruiz, Alberto Díaz García, Alejandro Menéndez Moreno, Luis Eduardo Pérez-Sánchez, Ángela, Pascual, Miguel Adeba García, Marta Alonso Fernández, Javier Alvarez Gama, Roberto, Ballestero, Loreto Berjon De La Vega, Paola Calleja Hermosa, Mariana, Carrillo-Rivas, Alfonso, Casado, Andrea, Cerveró, Bonifacio Cimadevilla Calvo, Patricia Corriols Noval, Paloma de la Dehesa Cueto-Felgueroso, Miren Jasone Diez Zapirain, José Estevez Tesouro, José Antonio Fernández-Dívar Sánchez, Lucia Garcia Alcalde, Juan García Cardo, Tito García Moreno, Daniel, García-López, Belen Garcia-Montesinos Perea, Miren Gonzalez Benito, Rocio, Gonzalez-Aguado, Miguel Ángel Gordo Vega Gordo-Vega, Jose, Gutierrez-Banos, Jaime Jimeno Fraile, Yolanda Jubete Castañeda, Patricia Lopez Gomez, Antonia Jesús López López, David Mato Mañas, Carmelo, Morales-Angulo, Dieter, Morales-Garcia, Sara, Naranjo, Jose Luis Rabago, Jose Manuel Rabanal, Rocio Revuelta Zorrilla, Adriana Reyes Echeverría, Juan Carlos Rodríguez-Sanjuán, Juan Ramón Sanz, Isabel Simal Badiola, Guillermo, Tejón, Enrique Toledo Martínez, Raquel Varea Malo, Begoña, Fadrique, Tania, Funes, Elena González Revilla, Isaias, Alarcón, Daniel Aparicio Sánchez, Pablo Beltran Miranda, Carmen, Cepeda-Franco, María Josefa Cuevas López, Sandra, Dios-Barbeito, Virginia María Durán Muñoz-Cruzado, Carlos Gonzalez De Pedro, Rosa, M Jimenez-Rodriguez, Francisco, Manresa-Manresa, Gabriel, Marin, Cristobalina, Martin-Garcia, Sara, Martínez-Núñez, Juan Manuel Martos Martinez, Lucas, Mengíbar, Felipe Pareja Ciuro, Eduardo Perea Del Pozo, Veronica Pino Diaz, José, Pintor-Tortolero, Claudia, Quintero-Pérez, Maria Luisa Reyes Diaz, Mercedes Rubio Manzanares Dorado, Alejandro Sanchez Arteaga, Ana, Senent-Boza, Luis, Tallon-Aguilar, Jose, Tinoco-Gonzalez, Luis-Cristobal, Capitan-Morales, Juan Cintas Catena, Javier, Valdes-Hernandez, María Del Campo Lavilla, Alina López De Fernández, Miriam Abellan Lucas, Alba Diaz Padillo, Maria Gómez Romero, Linda Grace Puerto Tamayo, El Mostafa El Yaqine Er Raoudi, Melody García Domínguez, María Ángeles Gascón Domínguez, Marta González Pérez, Alba Hernáez Arzoz, Joana San Anton, Cristian, Ruminot, Hander Guillermo Acosta Diaz, Daniella, Laguado, Kristina, Aghababyan, Alba, Jr, Enrique, Artigues, Rocío, Belda, Miguel, Beltran, Jose Ignacio Blanes, Elena Campos Carot, Miriam, Cantos, Laura, Costa, Carolina Ferrer Gomez, José María Gallego Sánchez, Oscar, Gil-Albarova, Juan, Gilabert-Estellés, Emilio Lopez Alcina, Isabel López Sánchez, Severiano Marin Bertolin, Carolina, Martinez-Perez, Antonio Melero Abellán, Claudia Mulas Fernández, Beatriz, Novoa, Ruth, Nuñez, Pablo Renovell Ferrer, Guijarro-Jorge, Ricardo, Carolina Soledad Romero Garcia, Miguel Sanfeliu Giner, Silvia, M West, Enrique, Zapater, Ignacio, Miranda, Ana, Monís, Alejandro Roselló Añón, María José Sangüesa, Jorge Sanz Romera, Marcos, Adrianzén, Maria Barrios Carvajal, Mireia, Bauzá, Ana Benítez Riesco, Jose Antonio Carbonell Lopez, María-Carmen, Fernández-Moreno, Ricardo Gadea Mateo, Francisco, Garcia, Maris Luisa García-Pérez, Luisa Paola Garzon, Ana, Izquierdo, Maria Lapeña Rodríguez, Carlos, León-Espinoza, Fernando, Lopez, Rosa Martí Fernández, Sara Martínez Castro, Berta Monleón López, Isabel Mora Oliver, David, Moro-Valdezate, Ernesto Muñoz Sornosa, Sara Palomares Casasús, Leticia Pérez Santiago, Mara Albert Fort, Reyes, Balanzá, Lorena Bermell Marco, Carla Carratalá Pérez, Claudia Pilar Clemente Tomas, Marta, Córcoles, Jose Ángel Diez Ares, Carlos Domingo Del Pozo, Nuria Estellés Vidagany, Gonzalo, Garrigos, Mar Gimeno Gimeno Vicente, Blanca Alastrue Giner, Segundo, Gomez-Abril, Paloma, Gonzalez, Paula Gonzálvez Guardiola, Guillermo Sebastian Martínez Fernández, Charo Martínez García, Lucía, Martínez-Costa, Luz María Moratalla Charcos, Sergio Navarro Martínez, Carmen, Payá-Llorente, Álvaro Pérez Rubio, Nuria, Peris, Eduardo Picazo Pineda, Jordi Planelles Gómez, Francisco Ripoll Vidal, Andrea, Roca, Enrique, Salmerón-González, Raquel Segura Roselló, Ramon Trullenque Juan, Cristina Verdejo Gimeno, Jose Miguel Zaragozá García, Gema Zomeño Bravo, Marcos Bruna Esteban, Hanna, Cholewa, Milton de Jesus, Matteo, Frasson, Luis Oliver García, Héctor, J Aguado, Antonio Jose Alonso Villalba, Francisco, Ardura, Carmen Elena Badillo Bercebal, María Bedate Núnez, Alvarez-Ramos Begoña Aranzazu, Juan Beltrán de Heredia, Hugo, Bermejo, Juan Berrocal Cuadrado, Maria Bragado González, Juan, Bustamante-Munguira, Raul Calvo Gonzalez, Yolanda, Carrascal, Ana Belén Casas Marcos, María Carmen Cervera, Sergio Chávez Valladares, Ángel Cilleruelo Ramos, Susana, Cortes, Jesús, Crespo-Sanjuán, María, Cuaresma, Luis Antonio Cuellar Martin, Carlos Ferreras García, Alvaro, Fuentes-Martín, Abel, Ganso, Elena García García, Luis, Garcia-Florez, Virginia, Garcia-Virto, Juan, Gatón, Julio Alberto Gobernado Tejedor, Tania Gómez Sanz, Jose Ignacio González Martín, María Begoña Gregorio Crespo, Ana Herranz Arriero, Jose, Herreros, Marta Ibáñez Nieto, César, Infante, Carlos, Jezieniecki, Moises, Juarez, Gregorio de Jesus Labrador Hernandez, Ana Patricia Legido Morán, Ricardo León Fernández, Alejandro, Leon-Andrino, Almudena, Llorente, Maria Lopez Pais, Mauricio Loucel Bellino, Sergio, Martin, Miguel Angel Martin-Ferrero, Gonzalo Martinez Municio, Elvira Mateos Alvarez, José María Matilla, Luis María Merino Peñacoba, Mario, Montes-Manrique, Fernando Natal Álvarez, David, C Noriega, Henar Nuñez Del Barrio, Francisco Javier Ortiz de Solórzano Aurusa, Lucía, Pañeda, Victoria Pascual Escudero, Miguel Pascual Samaniego, Adela, Pereda, Marta Pérez Febles, Laura, Pesquera, Maria, Plata, Emma Puertas Ruiz, Mario, Rodriguez-Lopez, Alejandro Romero de Diego, Ana, Ruano, María Ruiz Soriano, Cristina Sánchez Torralvo, Silvia Santiago Maniega, Bárbara, Segura-Méndez, Clarisa Simon Perez, José, Soro-García, Paula Suárez Mansilla Suárez-Mansilla, Jeancarlos Trujillo Díaz, Mª Esther Valsero Herguedas, Andrea Vazquez Fernandez, Eduardo Velasco García, Ana, Zabalza, Álvaro Zamora Horcajada, Fernando Acebes García, Enrique Asensio Díaz, Martín, Bailón, Alejandro David Bueno Cañones, Alvaro Centeno Velasco, Ekta Choolani Bhojwani, Fernando Labarga Rodríguez, Sara, Mambrilla, Pablo, Marcos-Santos, Toledano, Miguel, David Pacheco Sánchez, Baltasar, Pérez-Saborido, Pilar, Pinto, Katherine, Plua, Javier Sanchez Gonzalez, Vicente, Simo, Rosalía Velasco López, Sandra Veleda Belanche, Fabiola Eugenia Michel Campos, Iciar Muñoz Lindez, Maria, Balluerca, Maite, Camuera, Pablo, Helguera, Imanol, Herrero, Patricia Paunero Vazquez, María, Sánchez-Rubio, Isami, Soeda, María Dolores Arribas Del Amo, Vicente Manuel Borrego Estella, Estefania, Casas, Néstor Castán Villanueva, Daniel Delfau Lafuente, Elena Delgado Blanco, María, Domingo, Ismael Gil Romea, Azucena, Gonzalo, Emilio Lagunas Lostao, Noelia Lete Aguirre, Yaiza Martinez Lahoz, Jesús Víctor Pérez-Tierra Ruiz, Maria Del Mar Soriano, Isabel Valero Lázaro, Esmeralda Carnicer Escusol, Guillermo Pola Bandres, Juan Luis Blas Laina, Beatriz, Cros, Patricio Andrés Freile Pazmiño, David, Garcia-Aguilera, Ana Mejía Casado, Ana, Nogués, Issa Talal El-Abur, Carlos, Yánez, Isabel Gascon Ferrer, Carlos, Gracia-Roche, Ursula María Jariod Ferrer, María Victoria Simón Sanz, Tomas, Uson, Waseem, Ahamed, Sumudu, Jayasinghe, Eranda, Karunadasa, Prathibha, Nelihela, Sujeewa Priyantha Bandara Thalgaspitiya, Dickson, Wickramarathna, Nagenthiram, Harivallavan, Pirashanthan, Nagarasa, Eranga, Perera, Kanapathipillai, Piratheep, Vithranage Srimantha Dewsiri Rodrigo, Meera, Thayalan, Rajendram, Thayaparren, Arulprashanth, Arulanantham, Kanishka De Silva, Gagana, Ganga, Anuja Nadeeshan Kumarasinghe, Mahanada, Udukala, Koculen, Vimaleswaran, Prashanthan, Yogarajah, Ravindri, Jayasinghe, Probhodana, Ranaweera, Mohamed, Rishard, Dharmabandhu, N Samarasekera, Sanjeewa, Seneviratne, Sivasuriya, Sivaganesh, Chamal, Fernando, Nishantha, Mendis, Balasingam, Balagobi, Balasupramaniam, Sathesan, Lanka, Dasanayake, Malitha, Patabendige, Wickramasooriya, Dj, Kugarajh, Ganeshapillai, Sathyamoorthy, Prasanna, Dileepa, Ediriweera, Sumudu, Kumarage, Asanka, Jayawardane, Athula, Kaluarachchi, Pituwala Liyanage Adithya Sirisena, Abubakr, Abubakr, Hozifa, Mohamed, Ismail, Mustafa, Mogahid, Sharfeldein, Samir, Ismail, Reem, Musa, Monira, Sarih, Mussab, Abaker, Eman Adam Abdalla, Mohamad, Abdelbagi, Alsafe, Adlan, Ahmed, Alnaeem, Safa, Atyah, Yasir, Awad, Rsheeda, Dawelbait, Mohamed El Hag, Ibrahim, Elbashir, Sami, Eldirdiri, Samwal, Eldirdiri, Mohammed Eltahier Abdalla Omer, Lana Abdalgadir Ahmed Mohamed, Hiba Hassan Rehmtallah Ahmed, Mohammed Balla Yousif Balla, Abdulmoiz, Aljafari, Abdulmalek, Aljafari, Elsagad, Mohamed, Abdulkader, Mohammad, Abdulkader, Shaar, Mohamed Nafea Shaar, Maab Hussein Yousif Elhafiz, Mohammed Husien Yosif Elhafiz, Abubakr Ali Mohammed Alhassan Humidan, Almigdad, Ali, Hisham, Eljack, Mohamedyasin, Elrashid, Manhal, Ahmed, Albrra, Alhag, Douaa, Ali, Mohammed Ahmed Babikir, Imad, Bakheit, Hytham K, S Hamid, Sami, Mohamed, Walid, Shaban, Nidhal, Siddig, Mohamed, Suliman, Rihab Yasir Abdelmagid, Abubaker, Yassin, Omer, Abbas, Eltahir, Abdelrahim, Muhammed, Ahmed, Mohamed, Elobaid, Adil, Hashim, Ali, Mohamed, Omer, Mohamed, Khalid, Osman, Abdallah, Yousif, Safaa, Abdulaal, Marwa, Elsadig, Mohammed, Hussain, Malaz Amir Ataalmanan, Doha Amir AtaAlmanan, Tebyan Amir AtaAlmanan, Alaa, Elgaili, Maria, Mohamed, Usra, Omara, Alkhansa, Osman, Amna, Osman, Safaa, Saad, Abdelkareem, Ahmed, Ali Adil Ali Karar, Aya, Alhassan, Mohanad, Alsidig, Mohamed, Eljack, Mohammed Ibrahim Mohammed Ali, Awad Kamal Awad Osman, Liena, Mohamed, Samah Ibrahim Omer Mohamed Osman Mohamed Osman, Altayeb, Mohammed, Ayman, Mohammed, Khadija, Muhmmed, Eltahir, Musa, Egbal Sahal Abdelmajed, Khalid Z M, Y Hamid, Omnia M, M Yousif, Mahmoud, Saleh, Osman, Bashir, Yassein, Elhussein, Omar, Madani, Eva, Angenete, Jennifer, Park, Lars, Gillberg, Monir, Jawad, Linas, Pieteris, Yousif, Saeed, Sergej, Safonov, Martin, Spångfors, Henrik, Andersson, Hans, Bahlmann, Karin Björnström Karlsson, Michelle, Chew, Lara, Daham, Lina De Geer, Helen, Didriksson, Gunilla, Gagnö, Carina, Jonsson, Anna, Oscarsson, Pamela, Buchwald, Mathilde, Delorme, Marie-Louise, Lydrup, Shahin, Mohseni, Arvid, Pourlotfi, Souheil, Reda, Kajsa, Anderin, Nina, Blomme, Josefin, Segelman, Malin, Simlund, Anders, Thorell, Fredrik, Wogensen, Daniel, Danielsson, Peter, Elbe, Rebecka, Hultgren, Boel, Hynning, Fredrik, Klevebro, Karin, Lind, Ebba, K Lindqvist, Carl, Montan, Ernesto, Sparrelid, Clara Svenberg Lind, Jeremy, Wales, Andreas, Älgå, Martin, Nordberg, Emil, Pieniowski, Ioannis, Gkekas, Niklas, Löfgren, Karolina, Niska, Robert, Zürner, Silvio, Däster, Otto, Kollmar, Savas, Soysal, Stephanie, Taha-Mehlitz, Athanasios, Tampakis, Dominik Valentin Flury, Marie, Heyne-Pietschmann, Gregor Jan Kocher, Ana, M Calinescu, Barbara, Wildhaber, Markus, Gass, Jürg, Metzger, Andreas, Scheiwiller, Lukas, Briner, Oliver, Dwidar, Steven, Grandjean, Pietro, Ricciardi, Alexandra, Calmels, Christodoulou, Michel, Morena, Antonilli, Dimitrios, Christoforidis, Alessandra, Cristaudi, Jacopo, Galafassi, Maria Luisa Gasparri, Francesco, Mongelli, Martino, Munini, Andrea, Papadia, Sotirios Georgios Popeskou, Alex, Alfieri, Thomas, Bächler, Matteo, Giardini, Christian, Gingert, Laura, Guglielmetti, Inna, Meyer, Tobias, Müller, Daniel, Schöni, Folco, Solimene, Frank, Weidner, Marco, Bueter, Daniel, Gero, Amelie, Müller, Carmen, Portenkirchner, Andreas, Thalheimer, Jeannette, Widmer, Ahmad, Hmaideh, Alaa, Kour, Saleem, Swaes, Omar, Alannaz, Ramez, Aljasem, Ezeddin, Dabbagh, M Wafa Hamoud Alhussein, Amr, Hamza, Mazen, Mohammad, Abd El-Fattah Mouhandes, Mohamad, Shareeda, Mohammad Nour Shashaa, Mousa, Sifat, Sheraa, Tahhan, Rahaf, Toutounji, Mohamed, Abdulrahman, Albaraa, Abdulsalam, Ziad Al Jarad, Hala, Alayyoubi, Dina, Alfarra, Ahmad, Alhamid, Mahmoud, Alnasser, Mulham, Gharib, Ruwaid, Gharib, Obaida, Kabel, Osama, Kherallah, Abdulqader, Klaho, Mohamed Shukri Najjar, Ahmad, Razouk, Joud, Shiekhoni, Wael, Alkhaleel, Amira, Almosa, Mohammad, Aloulou, Maen, Alzaeem, Khaled, Arnaout, Muhamad Zakaria Brimo Alsaman, Mohamad, Estanbouli, Hanadi, Hawa, Ahmad Nbrass Kabawi, Ghina, Maarawi, Yehia, Mashhadany, Sana Shaikh Torab, Waleed, Abd, Tayma Abd Alghafour, Hani, Abdalnour, Nazeeh Al Aktaa, Marwan Al Aliwy, M Maher Al Arje, Tasneem Al Najjar, Ahmad, Al-Mouakeh, Ahmad, Aldakhil, Aos, Alhamid, Hasan, Alhasan, Mohamad Shadi Alkarrash, Jumaa, Alkhamis, Sara, Alshekh, Ahmad Yamen Arnaout, Oula, Azizeh, Mohammed, Dalaleh, Aghyad, Danial, Zain, Douba, Raghad, Ghadri, Mohammad Maen Ghannam, Anas, Ghawi, Luma Haj Kassem, M Yasser Halwani, Shahed, Hamadieh, Mohammad, Hanino, Ala Aldeen Hasan, Haya, Jawish, Nasr Ullah Kabbani, Saadullah, Kabbany, Mohamad, Kadi, Lama, Kadoura, Ahmad Amir Kayali, Ammar, Kayyali, Aya, Kelzia, Amana, Kezze, Abdullah, Khalaf, Maymona, Khayata, Mohammad Nour Kitaz, Mohammad, Kour, Raghad, Makki, Ruqaya, Masri, Joseph, Masri, Noor, Masri, Muhammad, Mazketly, Shiar, Mustafa, Ezzeldin, Nashed, Yaman Qoudra Danial, Hasan, Raslan, Rima, Salem, Mohammed Asaad Salem, Thabet Sayed Bakir, Manaf, Sharabaji, Majd Sheikh Alganameh, Duaa Sheikh Kadro, Joudy, Shurbatji, Mohammad Noor Sultan, Dana, Sultan, Hala, Swied, Bakri Tarras Jarkas, Tayf, Toutounji, Fadi, Ward, Rama, Zazo, Aya, Zazo, Zainab, Zeino, Mohamed, Alaktaa, Wael, Alsado, Hala, Fares, Nouran, Hawa, Hamza, Ibrahim, Abdulmonem, Kawas, Mourad, Niazi, Bayan, Toutounji, Mohammad, Abdow, Mohamad, Ahmad, Tareq, Ahmad, Rawan Al Azhar, Hiba Al Hage Diab, Rahaf Al Mulke, Mohammad, Al-Jadaan, Ahmad, Alhussein, Zahra, Alnajem, Omar, Alneser, Bayan, Alsaid, Elias, Azar, Lubna, Bakr, Ammar, Hamza, Yara, Houdifa, Sami, Jomaa, Samer, Kefo, Hiba, Mardini, Alaa, Mohammad, Fadi, Rayya, Fatima, Razzouk, Mohannad, Saleh, Anwar, Shamandi, Ammar Youzkatli Alkhatib, Omar Abdul Salam, Dany, Ajami, Mohammad, Alhamid, Ahmad, Alkhaledi, Danny, Hadidi, Massa, Jabra, Mamdouh, Kallas, Antoine, Laktine, Joelle, Naem, Naya, Naoum, Ghena Mohammed Fawaz Ashour, Ahmad, Alhouri, Deema, Fallouh, Ahmad, N Mohammad, Ahmad, Rmman, Ali, Slitin, Christine, Tanos, Ibrahim, Wakim, Hanaa, Zahrawi, Majd, Abouassi, Layth, Abouassi, Ayham, Aboutrab, Basel, Ahmad, Ahmad Mustafa Ahmad, Aya, Ahmad, Afaf, Ahmad, Mohamad, Alabras, Mohammad, Albasheer, Ola, Alkasser, Mhd Khaled Alkasser, Ali, Alkhdor, Marah, Azkoul, Mohammad Karam Chaaban, Haya, Deeb, Basel, Jazieh, Basel, Kouz, Youssef, Kozah, Raied, Mohamad, Ammar, Mohammad, Mhd Zied Nasri, Mohammed Mouaz Shebani, Mohammed, Shwin, Alaa, Sommaq, Amal, Youssef, Tala Al Asadi, Suhad, Alkhateb, Rasha Khalil Alsayyad, Roula, Altom, Mhd Amin Alzabibi, Batoul, Bakkar, Hlma, Ismail, Salma Khadem Alsrouji, Sara, Melhem, Mohamad, Sankari, Mosa, Shibani, Noura, Shujaa, Ibrahim, 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Giuseppe Salamone, Francesca Toia, Massimiliano Tripoli, Nepogodiev, D, Rosati, R, Surgery, Medicine and Pharmacy academic/administration, Basic (bio-) Medical Sciences, Surgical clinical sciences, Faculty of Medicine and Pharmacy, Gastroenterology, Medical Oncology, Clinical sciences, Breda, João, ARD - Amsterdam Reproduction and Development, Paediatric Surgery, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, AGEM - Endocrinology, metabolism and nutrition, Graduate School, Tytgat Institute for Liver and Intestinal Research, Laura Alberici, Filippo Antonacci, Alessandro Arena, Angela Belvedere, Fabio Bernagozzi, Paolo Bernante, Pietro Bertoglio, Lorenzo Bianchi, Maria Bisulli, Barbara Bonfanti, Safia Boussedra, Jury Brandolini, Crescenzo Cacciapuoti, Stefano Cardelli, Riccardo Casadei, Matteo Cescon, Alessandro Cipolli, Riccardo Cipriani, Alfredo Conti, Luca Contu, Francesco Costa, Niccolo’ Daddi, Eugenia De Crescenzo, Pierandrea De Iaco, Alessandra De Palma, Massimo Del Gaudio, Anna Nunzia Della Gatta, Giampiero Dolci, Giulia Dondi, Matteo Droghetti, Sergio Nicola Forti Parri, Elena Garelli, Chiara Gelati, Giuliana Germinario, Federico A. Giorgini, Carlo Ingaldi, Elio Jovine, Kenji Kawamukai, Antonio Lanci Lanci, Raffaele Lombardi, Maria Elisa Lozano Miralles, Claudio Marchetti, Michele Masetti, Francesco Minni, Daniele Morezzi, Daniele Parlanti, Alice Pellegrini, Anna Myriam Perrone, Anna paola Pezzuto, Marco Pignatti, Gianluigi Pilu, Valentina Pinto, Gilberto Poggioli, Silvana Bernadetta Puglisi, Diego Raimondo, Matteo Ravaioli, Claudio Ricci, Sara Ricciardi, Francesco Ricotta, Roberta Rizzo, Angela Romano, Matteo Rottoli, Riccardo Schiavina, Renato Seracchioli, Matteo Serenari, Margherita Serra, Piergiorgio Solli, Gioia Sorbi, Mario Taffurelli, Marta Tanzanu, Achille Tarsitano, Marco Tesei, Gabriele Vago, Tommaso Violante, Simone Zanotti, Tommaso Frisoni, leonardo solaini, giorgio ercolani, Fruscio, R, Ornaghi, S, Collaborative, Covidsurg, Collaborative, Globalsurg, Palmisano, Silvia, de Manzini, Nicolo', Žundienė, Laura, Dulskas, Audrius, Kuliavas, Justas, Čekauskas, Albertas, Kielaitė-Gulla, Aistė, Poškus, Tomas, Strupas, Kęstutis, Želvys, Arūnas, COVIDSurg Collaborative, GlobalSurg Collaborative, Department of Surgery, HUS Abdominal Center, Simoes, Jff, Li, E, Picciochi, M, Glasbey, Jc, Baiocchi, G, Blanco-Colino, R, Chaudhry, D, Alameer, E, El-Boghdadly, K, Wuraola, F, Ghosh, D, Gujjuri, Rr, Harrison, Em, Lule, H, Kaafarani, H, Khosravi, M, Kronberger, I, Leventoglu, S, Mann, H, Mclean, Ka, Mengistu, Gm, Modolo, Mm, Ntirenganya, F, Norman, L, Outani, O, Pius, R, Pockney, P, Qureshi, Au, Roslani, Ac, Satoi, S, Shaw, C, Bhangu, A, Omar, Om, Ahmed, Wur, Argus, L, Ball, A, Bywater, Ep, Brar, A, Dawson, Be, Duran, I, Elhadi, M, Jones, C, Kamarajah, Sk, Keatley, Jm, Lawday, S, Marson, Ej, Ots, R, Santos, I, Taylor, Eh, Trout, Im, Varghese, C, Venn, Ml, Xu, W, Dajti, I, Gjata, A, Kacimi, Seo, Boccalatte, L, Cox, D, Townend, P, Aigner, F, Kronberger, Ie, Samadov, E, Alderazi, A, Hossain, K, Padmore, G, van Ramshorst, G, Lawani, I, Cerovac, A, Delibegovic, S, Gomes, Gma, Buarque, Il, Gohar, M, Slavchev, M, Nwegbu, C, Agarwal, A, Martin, J, Ng-Kamstra, J, Olivos, M, Lou, Wh, Ren, Dl, Calvache, Ja, Rivera, Cjp, Hadzibegovic, Ad, Kopjar, T, Mihanovic, J, Jimenez, Pma, Gouvas, N, Klat, J, Novysedlak, R, Amisi, N, Christensen, P, El-Hussuna, A, Batista, S, Lincango-Naranjo, E, Emile, S, Sandoval, Daa, Dhufera, H, Hailu, S, Mengesha, Mg, Kauppila, Jh, Arnaud, Ap, Demetrashvili, Z, Albertsmeier, M, Lederhuber, H, Loffler, Mw, Acquah, Dk, Ofori, B, Tabiri, S, Metallidis, S, Tsoulfas, G, Aguilera-Arevalo, Ml, Recinos, G, Mersich, T, Wettstein, D, Kembuan, G, Milan, Pb, Khosravi, Mh, Mozafari, M, Hilmi, A, Mohan, H, Zmora, O, Gallo, G, Pata, F, Pellino, G, Fujimoto, Y, Kuroda, N, Abou Chaar, Mk, Ayasra, F, Fakhradiyev, I, Hamdun, Ih, Jin-Young, J, Jamal, M, Karout, L, Gulla, A, Rasoaherinomenjanahary, F, Samison, Lh, Sanchez, Iid, Gonzalez, D, Martinez, L, Martinez, Mj, Nayen, A, and Ramos-De la Medina, A
Subjects: Male, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], MULTICENTER, infectious diseases, 0302 clinical medicine, 030202 anesthesiology, Anesthesiology, Cirugía, 80 and over, Prospective Studies, Young adult, Child, Lung, Aged, 80 and over, COVID-19, delay, SARS-CoV-2, surgery, timing, SARS‐CoV‐2 infection, Operative, Child, Preschool, Pneumonia & Influenza, Infection, Cohort study, Human, medicine.medical_specialty, Clinical Sciences, Sars-cov-2, GlobalSurg Collaborative, Settore MED/28 - MALATTIE ODONTOSTOMATOLOGICHE, 03 medical and health sciences, Clinical Research, Biodefense, Correspondence, Humans, PULMONARY COMPLICATIONS, CRIANÇAS EM IDADE PRÉ-ESCOLAR, Aged, Science & Technology, Cirurgia, Prevention, Infant, Odds ratio, Pneumonia, Prospective Studie, Clinical research, Surgery, Human medicine, 610 Medizin und Gesundheit, 1109 Neurosciences, Internationality, Settore MED/29 - CHIRURGIA MAXILLOFACCIALE, Settore MED/18 - CHIRURGIA GENERALE, Adolescent, Adult, Cohort Studies, Female, Middle Aged, Surgical Procedures, Operative, Time, Young Adult, Practice Guidelines as Topic, gastroenterology, Medicine and Health Sciences, 030212 general & internal medicine, Prospective cohort study, Mortality rate, Covid19, Infectious Diseases, Patient Safety, medicine.symptom, 6.4 Surgery, Life Sciences & Biomedicine, 610 Medicine & health, COVID-19, SARS-CoV-2, delay, surgery, timing, Asymptomatic, NO, COVIDSurg Collaborative, Vaccine Related, All institutes and research themes of the Radboud University Medical Center, medicine, Mortalitat, ddc:610, Mortality, Preschool, LS7_4, Surgical Procedures, business.industry, Neurosciences, Evaluation of treatments and therapeutic interventions, 1103 Clinical Sciences, 3126 Surgery, anesthesiology, intensive care, radiology, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Anesthesiology and Pain Medicine, Emerging Infectious Diseases, Good Health and Well Being, Mortalidad, Cohort Studie, business
Abstract: Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay. ispartof: ANAESTHESIA vol:76 issue:6 pages:748-758 ispartof: location:England status: published
Published: 2021

23. Intraoperative neuromonitoring for scoliosis surgery: is there an end to justify the means?

Author: Jason, Chui and Alana M, Flexman
Subjects: Fatty Liver, Mice, Ethanol, Scoliosis, Monitoring, Intraoperative, Animals, Neurosurgical Procedures
Published: 2020

24. Optical monitoring of cerebral perfusion and metabolism in adults during cardiac surgery with cardiopulmonary bypass

Author: Marianne Suwalski, John M. Murkin, Lawrence C. M. Yip, Michael W.A. Chu, Jason Chui, Linrui R Guo, Daniel Milej, Keith St. Lawrence, Ajay Rajaram, and Mamadou Diop
Subjects: medicine.medical_specialty, Mean arterial pressure, 01 natural sciences, Article, law.invention, 010309 optics, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, law, Internal medicine, 0103 physical sciences, medicine, Cardiopulmonary bypass, Cerebral perfusion pressure, Lead (electronics), Stroke, business.industry, medicine.disease, Atomic and Molecular Physics, and Optics, Cardiac surgery, Cerebral blood flow, Cardiology, business, Perfusion, Biotechnology
Abstract: During cardiac surgery with cardiopulmonary bypass (CPB), adequate maintenance of cerebral blood flow (CBF) is vital in preventing postoperative neurological injury – i.e. stroke, delirium, cognitive impairment. Reductions in CBF large enough to impact cerebral energy metabolism can lead to tissue damage and subsequent brain injury. Current methods for neuromonitoring during surgery are limited. This study presents the clinical translation of a hybrid optical neuromonitor for continuous intraoperative monitoring of cerebral perfusion and metabolism in ten patients undergoing non-emergent cardiac surgery with non-pulsatile CPB. The optical system combines broadband near-infrared spectroscopy (B-NIRS) to measure changes in the oxidation state of cytochrome c oxidase (oxCCO) – a direct marker of cellular energy metabolism – and diffuse correlation spectroscopy (DCS) to provide an index of cerebral blood flow (CBFi). As the heart was arrested and the CPB-pump started, increases in CBFi (88.5 ± 125.7%) and significant decreases in oxCCO (−0.5 ± 0.2 µM) were observed; no changes were noted during transitions off CPB. Fifteen hypoperfusion events, defined as large and sustained reductions in CPB-pump flow rate, were identified across all patients and resulted in significant decreases in perfusion and metabolism when mean arterial pressure dropped to 30 mmHg or below. The maximum reduction in cerebral blood flow preceded the corresponding metabolic reduction by 18.2 ± 15.0 s. Optical neuromonitoring provides a safe and non-invasive approach for assessing intraoperative perfusion and metabolism and has potential in guiding patient management to prevent adverse clinical outcomes.
Published: 2020

25. Early Goal-directed Therapy During Endovascular Coiling Procedures Following Aneurysmal Subarachnoid Hemorrhage: A Pilot Prospective Randomized Controlled Study

Author: Sachin Pandey, Christine Dy-Valdez, Ian A. Herrick, Rosemary A. Craen, Mel Boulton, Jason Chui, and Rizq Alamri
Subjects: Adult, Subarachnoid hemorrhage, medicine.medical_treatment, Cardiac index, Pilot Projects, Early goal-directed therapy, law.invention, Cerebral vasospasm, Randomized controlled trial, law, medicine, Humans, Prospective Studies, Stroke, Endovascular coiling, business.industry, Vasospasm, Intracranial Aneurysm, Subarachnoid Hemorrhage, medicine.disease, Anesthesiology and Pain Medicine, Anesthesia, Early Goal-Directed Therapy, Surgery, Neurology (clinical), business
Abstract: Background Maintenance of euvolemia and cerebral perfusion are recommended for the prevention of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (aSAH). We conducted a pilot randomized controlled study to assess the feasibility and efficacy of goal-directed therapy (GDT) to correct fluid and hemodynamic derangements during endovascular coiling in patients with aSAH. Methods This study was conducted between November 2015 and February 2019 at a single tertiary center in Canada. Adult patients with aSAH within 5 days of aneurysm rupture were randomly assigned to receive either GDT or standard therapy during endovascular coiling. The incidence of dehydration at presentation and the efficacy of GDT were evaluated. Results Forty patients were allocated to receive GDT (n=21) or standard therapy (n=19). Sixty percent of all patients were found to have dehydration before the coiling procedure commenced. Compared with standard therapy, GDT reduced the duration of intraoperative hypovolemia (mean difference 37.6 [95% confidence interval, 6.2-37.4] min, P=0.006) and low cardiac index (mean difference 30.7 [95% confidence interval, 9.5-56.9] min, P=0.035). There were no differences between the 2 treatment groups with respect to the incidence of vasospasm, stroke, death, and other complications up to postoperative day 90. Conclusions A high proportion of aSAH patients presented at the coiling procedure with dehydration and a low cardiac output state; these derangements were more likely to be corrected if the GDT algorithm was used. Compared with standard therapy, use of the GDT algorithm resulted in earlier recognition and more consistent treatment of dehydration and hemodynamic derangement during endovascular coiling.
Published: 2019

26. Is Routine Chest X-Ray After Ultrasound-Guided Central Venous Catheter Insertion Choosing Wisely?

Author: Jason Chui, Rasha Saeed, Luke Jakobowski, Daniel Bainbridge, Basem Eldeyasty, Fang Zhu, Wanyu Wang, Ronit Lavi, and Lee-Anne Fochesato
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, education.field_of_study, medicine.diagnostic_test, business.industry, Incidence (epidemiology), medicine.medical_treatment, Population, 030208 emergency & critical care medicine, Retrospective cohort study, Critical Care and Intensive Care Medicine, medicine.disease, Surgery, 03 medical and health sciences, Catheter, 0302 clinical medicine, Pneumothorax, medicine, Left subclavian vein, 030212 general & internal medicine, Cardiology and Cardiovascular Medicine, Chest radiograph, education, business, Central venous catheter
Abstract: Background A routine chest radiograph (CXR) is recommended as a screening test after central venous catheter (CVC) insertion. The goal of this study was to assess the value of a routine postprocedural CXR in the era of ultrasound-guided CVC insertion. Methods This population-based retrospective cohort study was performed to review the records of all adult patients who had a CVC inserted in the operating room in a tertiary institution between July 1, 2008, and December 31, 2015. We determined the incidence of pneumothorax and catheter misplacement after ultrasound-guided CVC insertion. A logistic regression analysis was performed to examine the potential risk factors associated with these complications, and a cost analysis was conducted to evaluate the economic impact. Results Of 18,274 patients who had a CVC inserted, 6,875 patients were included. The overall incidence of pneumothorax and catheter misplacement was 0.33% (95% CI, 0.22-0.5) (23 patients) and 1.91% (95% CI, 1.61-2.26) (131 patients), respectively. The site of catheterization was the major determinant of pneumothorax and catheter misplacement; left subclavian vein catheterization was the site at a higher risk for pneumothorax (OR, 6.69 [95% CI, 2.45-18.28]; P Conclusions This study found that pneumothorax and catheter misplacement after ultrasound-guided CVC insertion were rare, and the costs of a postprocedural CXR were exceedingly high. We concluded that a routine postprocedural CXR is unnecessary and not a wise choice in our setting.
Published: 2018

27. Perioperative Peripheral Nerve Injury After General Anesthesia

Author: Jason Chui, Karen L. Posner, Karen B. Domino, and John M. Murkin
Subjects: medicine.medical_specialty, Time Factors, Intraoperative Neurophysiological Monitoring, Population, Anesthesia, General, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Peripheral Nerve Injuries, Predictive Value of Tests, Risk Factors, 030202 anesthesiology, Malpractice, Humans, Medicine, Peripheral Nerves, Perioperative Period, education, Neurologic Examination, education.field_of_study, business.industry, Incidence, Perioperative, Treatment Outcome, Anesthesiology and Pain Medicine, Anesthesia, Etiology, Neurosurgery, business, Orthopedic Procedures, Brachial plexus, 030217 neurology & neurosurgery, Intraoperative neurophysiological monitoring
Abstract: Perioperative peripheral nerve injury (PNI) is a well-recognized complication of general anesthesia that continues to result in patient disability and malpractice claims. However, the multifactorial etiology of PNI is often not appreciated in malpractice claims given that most PNI is alleged to be due to errors in patient positioning. New advances in monitoring may aid anesthesiologists in the early detection of PNI. This article reviews recent studies of perioperative PNI after general anesthesia and discusses the epidemiology and potential mechanisms of injury and preventive measures. We performed a systematic literature search, reviewed the available evidence, and identified areas for further investigation. We also reviewed perioperative PNI in the Anesthesia Closed Claims Project database for adverse events from 1990 to 2013. The incidence of perioperative PNI after general anesthesia varies considerably depending on the type of surgical procedure, the age and risk factors of the patient population, and whether the detection was made retrospectively or prospectively. Taken together, studies suggest that the incidence in a general population of surgical patients undergoing all types of procedures is
Published: 2018

28. The Trileaflet Mitral Valve

Author: Wendy Tsang, Roberto M. Lang, Robert H. Anderson, and Jason Chui
Subjects: Male, medicine.medical_specialty, Trifoliate left atrioventricular valve, Echocardiography, Three-Dimensional, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Mitral valve, Internal medicine, medicine, Humans, cardiovascular diseases, Atrioventricular Septal Defect, Coronary Artery Bypass, Atrioventricular valve, Disease entity, business.industry, Middle Aged, Obesity, Morbid, medicine.anatomical_structure, cardiovascular system, Cardiology, Mitral Valve, Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery
Abstract: With the advent of 3-dimensional echocardiography, visualization of the mitral valve has greatly improved. Recently, there has been an increase in reporting of a distinct entity called the "trileaflet mitral valve" using 3-dimensional echocardiography. It is controversial whether this is a new entity or an improved visualization of isolated mitral valve clefts or trifoliate left atrioventricular valve in the setting of an atrioventricular septal defect (AVSD) with intact septum. We present a case of a trifoliate valve, interpreting our findings based on a systematic review of previous publication on trileaflet mitral valves, isolated clefts in the mural (posterior) leaflet of the mitral valve, and trifoliate left atrioventricular valves with AVSD and intact septal structures. We describe the latter entity as a left atrioventricular valve because it never achieves the features of a normal mitral valve. We compare the features of isolated clefts of the mural leaflet of the mitral valve with trifoliate left atrioventricular valve found in the setting of AVSDs with intact septal structures to illustrate the current controversy regarding these conditions. In conclusion, our review suggested the reported trileaflet left atrioventricular valves is likely a misnomer because of a lack of consideration of embryologic development and nomenclature, rather than a greater appreciation and identification of a new distinct disease entity.
Published: 2018

29. Propofol Reduces Microelectrode-Recording Artefacts caused by Parkinsonian Tremor during Deep Brain Stimulation

Author: Lakshmikumar Venkatraghavan, Rizq Alamri, Frank Bihari, Matthew O. Hebb, and Jason Chui
Subjects: Levodopa, Deep brain stimulation, parkinson’s disease, medicine.medical_treatment, a tremor effect, Critical Care and Intensive Care Medicine, lcsh:RD78.3-87.3, 03 medical and health sciences, Microelectrode recording, 0302 clinical medicine, Medicine, 030212 general & internal medicine, propofol, business.industry, Left subthalamic nucleus, nervous system diseases, deep brain stimulation, Microelectrode, Anesthesiology and Pain Medicine, nervous system, lcsh:Anesthesiology, Anesthesia, Neurology (clinical), business, Propofol, 030217 neurology & neurosurgery, medicine.drug
Abstract: A 51-year-old male with medically refractory Parkinson's disease was scheduled for bilateral deep brain stimulation (DBS). During microelectrode recordings (MERs) of right side DBS, the patient developed severe sustained whole-body tremors causing severe artefacts in MER. The right side DBS electrode was inserted with suboptimal MER. For the creation of left burr hole, propofol infusion at a rate of 20 μg/kg/min, was used and soon after, all tremor activity ceased. Propofol infusion was continued during left side MER. With the absence of tremors, left subthalamic nucleus spike activity was better identified and neurological testing could take place. At 6 months after DBS, the patient’s symptoms had improved significantly without the need for levodopa.
Published: 2018

30. The Effects of Intraoperative Sedation on Surgical Outcomes of Deep Brain Stimulation Surgery

Author: Rizq Alimiri, Andrew G. Parrent, Jason Chui, and Rosemary A. Craen
Subjects: Male, Deep brain stimulation, medicine.drug_class, Deep Brain Stimulation, medicine.medical_treatment, Sedation, Remifentanil, Severity of Illness Index, behavioral disciplines and activities, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, medicine, Humans, Hypnotics and Sedatives, Dexmedetomidine, Aged, Retrospective Studies, Intraoperative Care, business.industry, Parkinson Disease, General Medicine, Perioperative, Middle Aged, Electrodes, Implanted, Treatment Outcome, nervous system, Neurology, Sedative, Anesthesia, Midazolam, Female, Neurology (clinical), medicine.symptom, Propofol, business, 030217 neurology & neurosurgery, Follow-Up Studies, medicine.drug
Abstract: Background: Intraoperative sedation is often used to facilitate deep brain stimulation (DBS) surgery; however, these sedative agents also suppress microelectrode recordings (MER). To date, there have been no studies that have examined the effects of differing sedatives on surgical outcomes and the success of DBS surgery. Methods: We performed a retrospective study to evaluate the effect of differing sedative agents on postoperative surgical outcomes at 6 months in parkinsonian adult patients who underwent DBS surgery, from January 2004 through December 2014, at one academic center. Surgical outcomes of DBS were evaluated using a simplified Unified Parkinson Diseases Rating Score-III and levodopa dose equivalent reduction at baseline and 6 months postoperatively. Results: We analyzed data from 121 of 124 consecutive parkinsonian patients. Propofol, dexmedetomidine, remifentanil, and midazolam were used individually or in combination. All sedatives were routinely discontinued 20 to 30 minutes before MER, in accordance with our institutional protocol. We found no statistically significant association between the use of individual agent or combination of sedative agents and surgical outcomes at 6 months, the success of DBS, duration of MER, duration of stage 1 procedure, and perioperative complications. Conclusions: Our study showed that the choice of sedative agent was not associated with poor surgical outcomes after DBS surgery using MER and macrostimulation techniques in parkinsonian patients.
Published: 2017

31. Neurosurgery: Functional neurosurgery

Author: Suparna Bharadwaj, Jason Chui, and Christine Dy-Valdez
Subjects: medicine.medical_specialty, business.industry, General surgery, medicine, Neurosurgery, Functional neurosurgery, business
Published: 2019

32. Knowledge and perceptions about perioperative stroke: a cross-sectional survey of patients scheduled for non-neurologic and non-cardiac surgery

Author: Jason Chui, Darreul Sewell, Alana M. Flexman, Lingzhong Meng, Adrian W. Gelb, and Taren Roughead
Subjects: Adult, medicine.medical_specialty, Health Knowledge, Attitudes, Practice, Cross-sectional study, media_common.quotation_subject, MEDLINE, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, 030202 anesthesiology, Interquartile range, Risk Factors, Internal medicine, Anesthesiology, medicine, Humans, Stroke, media_common, Response rate (survey), business.industry, General Medicine, medicine.disease, Anesthesiology and Pain Medicine, Cross-Sectional Studies, Elective Surgical Procedures, Anesthesia, Worry, business, 030217 neurology & neurosurgery, Kidney disease
Abstract: Perioperative stroke is associated with significant morbidity and mortality yet patients may not be aware of their risk or receive appropriate counselling. Our objectives were to 1) compare patient’s perceived vs calculated risk of stroke; 2) determine level of worry; and 3) assess prior discussion about perioperative stroke risk amongst elective patients undergoing non-cardiac, non-neurologic surgery. Over a consecutive four-week period, surveys were distributed at two pre-anesthetic clinics to adult patients scheduled for non-cardiac, non-neurologic surgery. The survey included questions about demographics, perioperative stroke risk factors, patient perception of their quantitative and qualitative stroke risk, level of worry about stroke, and risk discussions. We identified independent predictors of risk underestimation amongst medium- and high-risk patients. Six hundred patients completed the survey (response rate 78%). Of these, 479, 104, and 15 patients were classified as low-, medium-, and high-risk, respectively (with two patients missing this data point). Most medium- (86%) and high-risk (80%) patients did not identify their elevated risk. Amongst medium- and high-risk patients, independent predictors of risk underestimation were lower education and absence of kidney disease. Medium- and high-risk patients were more worried than low-risk patients about perioperative stroke (median [interquartile range] visual analogue scale score 2 [0.5–4] vs 1 [0–2], P = 0.001). Fewer than half of patients had discussed perioperative stroke previously (40%, 23%, and 12% of high-, medium-, and low-risk patients, respectively). Patients at higher risk of stroke frequently underestimate their risk of perioperative stroke. The majority of patients had not discussed perioperative stroke prior to anesthetic consultation.
Published: 2019

33. Identifying barriers to the use of ultrasound in the perioperative period: a survey of southwestern Ontario anesthesiologists

Author: Jason Chui, Daniel Bainbridge, Philip M. Jones, Ahmed F. Hegazy, Ronit Lavi, Homer Yang, and Ramiro Arellano
Subjects: medicine.medical_specialty, medicine.medical_treatment, Neuraxial blockade, Health informatics, Ultrasound guidance, Health administration, 03 medical and health sciences, 0302 clinical medicine, Ultrasound, medicine, Humans, Anesthesia, 030212 general & internal medicine, Point of care ultrasound, Practice Patterns, Physicians', Perioperative Period, Ultrasonography, Interventional, Response rate (survey), Ontario, POCUS, business.industry, lcsh:Public aspects of medicine, 030503 health policy & services, Health Policy, Nursing research, Public health, lcsh:RA1-1270, Perioperative, medicine.disease, Anesthesiologists, Medical emergency, Health Services Research, 0305 other medical science, business, Central venous catheter, Research Article
Abstract: Background Ultrasound (US) can be used for many perioperative procedures, but evidence is lacking as to its frequency of use and barrier of application. The objectives of this survey were to determine i) how often US guidance was used perioperatively for vascular access placement, nerve blocks, and heart and lung assessment, and ii) to identify the barriers and the limitations of using US amongst anesthesiologists in southwestern Ontario. Methods We conducted a web-based survey in over 40 academic or community hospitals at southwestern Ontario. Results Of 266 surveys sent, 66 complete surveys were obtained (response rate of 25%). Most respondents (> 80%) reported that US was commonly used for central venous catheter (CVC) insertion, followed by regional blocks; the uses were less frequent for neuraxial blockade and cardiopulmonary assessment. Most respondents wanted to use US more frequently as part of their practice and felt that they already had adequate US training. However, most respondents (59%) reported limited access to US machines in their working institutes as being the major barrier to incorporating US in their daily practice. Conclusion The most common uses of US in anesthesia practice in southwestern Ontario were for CVC insertion and regional blocks. Most anesthesiologists in southwestern Ontario are interested to incorporate US in their daily practice but most were limited by the lack of US resources. Apparently, only providing knowledge and skills teaching may not be sufficient to further improve the US utilization in our region; a matched administrative effort appears to be the next challenge.
Published: 2019

34. MOHICANS: Mobile Learning Teaching Model for Next Gen Learners

Author: Zhen Zhen Leow, Jason Chui, and Cally Ng
Subjects: Higher education, Elearning, business.industry, Teaching, Mobile learning, Quality dimensions, Educational systems, Higher Education, Design strategies, Mathematics education, ComputingMilieux_COMPUTERSANDEDUCATION, Learning, Teaching model, business, Psychology, Mlearning
Abstract: The proliferation of mobile devices among especially the younger (aka Next Gen) learners has led to a change in expectations when it comes to learning. These learners prefer to learn "on-the-go" and to have the learning contents at their fingertips. However, design strategies for mobile learning are still in nascent development stages. This research builds on existing literature in the field of mobile learning pedagogy to propose a novel teaching model for mobile learning which instructors can use to design their own courses.The research is conducted on 120 identified learners from 2 faculties, School of IT and School of Health Sciences who were undertaking their respective core modules. The participating instructors designed and implemented mobile learning packages in accordance with the proposed teaching model. The authors collected feedback from learners via survey questionnaires on a four-point Likert scale to measure the level of learners’ satisfaction with the mobile learning packages. The authors also examined the module learning outcomes to gauge the level of instructors' satisfaction as well as the competency levels achieved by the learners. Both qualitative data and sentiments collected from survey and classroom observations have been encouraging, showing that the teaching model proposed is effective.
Published: 2019

35. Cardiac Output and Cerebral Blood Flow

Author: Lingzhong Meng, Wugang Hou, Ruquan Han, Jason Chui, and Adrian W. Gelb
Subjects: Cardiac output, business.industry, Cerebral arteries, Blood volume, medicine.disease, Cerebral circulation, Anesthesiology and Pain Medicine, Blood pressure, nervous system, Cerebral blood flow, Heart failure, Anesthesia, cardiovascular system, medicine, Autoregulation, business, circulatory and respiratory physiology
Abstract: Cerebral blood flow (CBF) is rigorously regulated by various powerful mechanisms to safeguard the match between cerebral metabolic demand and supply. The question of how a change in cardiac output (CO) affects CBF is fundamental, because CBF is dependent on constantly receiving a significant proportion of CO. The authors reviewed the studies that investigated the association between CO and CBF in healthy volunteers and patients with chronic heart failure. The overall evidence shows that an alteration in CO, either acutely or chronically, leads to a change in CBF that is independent of other CBF-regulating parameters including blood pressure and carbon dioxide. However, studies on the association between CO and CBF in patients with varying neurologic, medical, and surgical conditions were confounded by methodologic limitations. Given that CBF regulation is multifactorial but the various processes must exert their effects on the cerebral circulation simultaneously, the authors propose a conceptual framework that integrates the various CBF-regulating processes at the level of cerebral arteries/arterioles while still maintaining autoregulation. The clinical implications pertinent to the effect of CO on CBF are discussed. Outcome research relating to the management of CO and CBF in high-risk patients or during high-risk surgeries is needed.
Published: 2015

36. Direct motor evoked potentials and cortical mapping using the NIM® nerve monitoring system: A technical note

Author: Suparna Bharadwaj, Matthew O. Hebb, Faizal A. Haji, and Jason Chui
Subjects: Microsurgery, medicine.medical_treatment, Anesthesia, General, Brain mapping, 03 medical and health sciences, 0302 clinical medicine, Muscle action, Monitoring, Intraoperative, Physiology (medical), medicine, Humans, Neurophysiological Monitoring, Craniotomy, Aged, Paresis, Brain Mapping, business.industry, Motor Cortex, Intravenous Anesthetics, Technical note, Monitoring system, General Medicine, Evoked Potentials, Motor, Gross Total Resection, Electric Stimulation, medicine.anatomical_structure, Neurology, 030220 oncology & carcinogenesis, Anesthesia, Female, Surgery, Neurology (clinical), medicine.symptom, business, Anesthetics, Intravenous, 030217 neurology & neurosurgery, Motor cortex
Abstract: Motor evoked potentials (MEPs) are commonly used to prevent neurological injury when operating in close proximity to the motor cortex or corticospinal pathway. We report a novel application of the NIM® nerve monitoring system (Medtronic@ NIM response 3.0) for intraoperative direct cortical (dc)-MEPs monitoring. A 69-year-old female patient presented with a 4month history of progressive left hemiparesis resulting from a large right sided posterior frontal meningioma that abutted and compressed the motor cortex. Motor cortical mapping and MEPs were indicated. The patient was anesthetized and maintained on total intravenous anesthetics. Compound muscle action potentials (CMAP) of the right upper limb were monitored using the NIM system. After a craniotomy was performed, we first used the Ojemann stimulator (monopolar) for dc-stimulation and then switched to use the monopolar nerve stimulator probe of the NIM system. The CMAP response was successfully elicited using the NIM stimulating probe (pulse width=250s, train frequency=7pulses/s, current=20mA). A gross total resection of the tumor was achieved with intermittent cortical mapping of MEPs. There were no intraoperative complications and the patient's motor function was preserved after the surgery. In this case, we reported the successful use of the NIM nerve monitoring system to elicit dc-MEPs under general anesthesia. The advantages of using this system include a simple set up and application, neurosurgeon familiarity, wide availability and lower cost. dc-MEPs can be achieved using the NIM system. We conclude that the NIM nerve monitoring system is a feasible alternative to standard neurophysiological monitoring systems.
Published: 2017

37. Carotid Endarterectomy

Author: Jason Chui and Ian Herrick
Published: 2018

38. Hemodynamic Management of Patients During Endovascular Treatment of Acute Ischemic Stroke Under Conscious Sedation: A Retrospective Cohort Study

Author: Vitor Mendes Pereira, Jason Chui, Andreu Porta-Sánchez, Pirjo Manninen, Gabriela Alcaraz, Lashmi Venkatraghavan, and Joanna D. Schaafsma
Subjects: Male, Sedation, medicine.medical_treatment, Conscious Sedation, Hemodynamics, Blood Pressure, Revascularization, Brain Ischemia, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, medicine, Humans, Acute ischemic stroke, Aged, Retrospective Studies, Aged, 80 and over, Intraoperative Care, business.industry, Endovascular Procedures, Retrospective cohort study, Anesthesiologists, Stroke, Anesthesiology and Pain Medicine, Blood pressure, Treatment Outcome, Anesthesia, Anesthetic, Surgery, Female, Neurology (clinical), medicine.symptom, business, 030217 neurology & neurosurgery, Cohort study, medicine.drug
Abstract: Anesthetic modality and hemodynamic management during mechanical thrombectomy (MT) for acute ischemic stroke (AIS) are potential contributors to the success of revascularization. The aims of our study were to review the hemodynamic management by anesthesiologists and clinical outcomes in patients undergoing MT under conscious sedation.Retrospective cohort study of patients with anterior circulation AIS from January 2012 to March 2016. Primary outcome was hemodynamic intervention, defined as administration of vasoactive drugs to maintain systolic blood pressure (BP) between 140 and 180 mm Hg. The secondary outcome was poor hemodynamic control, defined as BP outside target for15 minutes despite hemodynamic intervention. We performed regression analysis to determine the predictors of hemodynamic intervention and poor hemodynamic control.A total of 126 patients were included in this study; 92% (116) receiving conscious sedation and 8% (10) no sedation. Upon arrival to the neuroradiology suite, systolic BP was140 mm Hg in 30.2% of the patients and180 mm Hg in 14.3%. Hemodynamic intervention was required in 38.9% of patients; 15.1% for hypotension and 19.8% for hypertension. In the multivariate analysis, systolic BP on hospital admission (odds ratio, 1.02; 95% confidence interval, 1.00-1.04; P=0.019) constituted a predictor for hemodynamic intervention. Poor hemodynamic control occurred in 12.7% of patients, with lower baseline systolic BP being associated with higher risk of intraprocedural hypotension (odds ratio, 0.92; 95% confidence interval, 0.89-0.96; P0.001). In-hospital mortality was 13.6%.Hemodynamic intervention is frequent during MT under conscious sedation. The routine presence of anesthesiologists during MT may be helpful in maintaining hemodynamic stability and allow rapid treatment of emergent complications. An individualized approach with tailored hemodynamic targets is required during management of patients undergoing MT for AIS.
Published: 2018

39. Is Routine Chest X-Ray After Ultrasound-Guided Central Venous Catheter Insertion Choosing Wisely?: A Population-Based Retrospective Study of 6,875 Patients

Author: Jason, Chui, Rasha, Saeed, Luke, Jakobowski, Wanyu, Wang, Basem, Eldeyasty, Fang, Zhu, LeeAnne, Fochesato, Ronit, Lavi, and Daniel, Bainbridge
Subjects: Male, Canada, Catheterization, Central Venous, Incidence, Pneumothorax, Middle Aged, Subclavian Vein, Population Surveillance, Central Venous Catheters, Humans, Female, Radiography, Thoracic, Jugular Veins, Aged, Follow-Up Studies, Retrospective Studies, Ultrasonography
Abstract: A routine chest radiograph (CXR) is recommended as a screening test after central venous catheter (CVC) insertion. The goal of this study was to assess the value of a routine postprocedural CXR in the era of ultrasound-guided CVC insertion.This population-based retrospective cohort study was performed to review the records of all adult patients who had a CVC inserted in the operating room in a tertiary institution between July 1, 2008, and December 31, 2015. We determined the incidence of pneumothorax and catheter misplacement after ultrasound-guided CVC insertion. A logistic regression analysis was performed to examine the potential risk factors associated with these complications, and a cost analysis was conducted to evaluate the economic impact.Of 18,274 patients who had a CVC inserted, 6,875 patients were included. The overall incidence of pneumothorax and catheter misplacement was 0.33% (95% CI, 0.22-0.5) (23 patients) and 1.91% (95% CI, 1.61-2.26) (131 patients), respectively. The site of catheterization was the major determinant of pneumothorax and catheter misplacement; left subclavian vein catheterization was the site at a higher risk for pneumothorax (OR, 6.69 [95% CI, 2.45-18.28]; P .001), and catheterization sites other than the right internal jugular vein were at a higher risk for catheter misplacement. Expenditures on routine postprocedural CXR were US $105,000 to $183,000 per year at our institution.This study found that pneumothorax and catheter misplacement after ultrasound-guided CVC insertion were rare, and the costs of a postprocedural CXR were exceedingly high. We concluded that a routine postprocedural CXR is unnecessary and not a wise choice in our setting.
Published: 2017

40. Cerebrovascular Reactivity to Carbon Dioxide Under Anesthesia

Author: Jason Chui, Pirjo Manninen, Jigesh Mehta, Lashmi Venkatraghavan, and Ramamani Mariappan
Subjects: business.industry, Carbon Dioxide, Neurosurgical Procedures, Sevoflurane, law.invention, Anesthesiology and Pain Medicine, Systematic review, Isoflurane, Randomized controlled trial, law, Cerebrovascular Circulation, Anesthesia, Meta-analysis, Anesthetic, medicine, Humans, Surgery, Neurology (clinical), Propofol, business, Respiratory minute volume, medicine.drug
Abstract: Introduction Controlling the arterial carbon dioxide tension (PaCO2) to reduce the cerebral blood flow (CBF) and the intracranial pressure is a common practice in neuroanesthesia. A change in CBF in response to change in PaCO2 is termed as cerebrovascular reactivity to carbon dioxide (CVR-CO2). Studies have shown that, both inhalational and intravenous anesthetic agents have variable effects on CVR-CO2 and the effect of anesthetic agents on CVR also varies with many physiological and pathologic conditions. The objectives of this review were to evaluate the effect of anesthetic agents on the CVR-CO2 in adults and to determine how this response is modified by other physiological and pathologic factors. Methods We conducted a systematic search of the databases of Medline, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews using related term components for both CVR-CO2 and anesthesia. Our primary outcome of this review was to determine whether the CVR-CO2 is maintained under anesthesia. The other endpoints of this review are to determine the effect of other factors (age, sex, medical comorbidities, and cerebrovascular pathology) on the CVR-CO2 under anesthesia. Because of the methodological heterogeneity in the primary studies, quantitative analysis of the data was not possible, and therefore, we have summarized the data qualitatively. Results Our search strategy yielded 1356 citations. After excluding nonpertinent papers, 38 studies were included for the systematic review. Nineteen randomized controlled trials and 19 observational studies met inclusion criteria and a total of 793 patients were studied. Transcranial Doppler was the most commonly used method for measuring CBF and changing the respiratory rate and/or minute ventilation were the most commonly used method to change the CO2 tension. CVR-CO2 is maintained with both inhalational and intravenous anesthetic agents within the range of concentrations used in clinical anesthesia. At doses leading to a broadly equivalent depth of anesthesia, the reactivity value was highest with isoflurane and the least with propofol. Individual agents differ in their degree of reactivity to hypercapnic and hypocapnic stimuli. CVR-CO2 is impaired in elderly patients when compared with young patients with both sevoflurane and propofol anesthesia. In patients with medical comorbidities, the CVR-CO2 impairment under anesthesia was associated with the severity of the underlying diseases and not the anesthetic agents. Conclusions Our systematic review showed that within the clinical anesthesia concentrations, CVR-CO2 is maintained under both propofol and inhalational agents. However, most of the information available is from non-neurosurgical patients and these studies also suffer from significant methodological heterogeneity. Therefore, we were limited by the amount and the quality of data available for this review.
Published: 2015

41. Anesthesia for awake craniotomy: An update☆

Author: Jason Chui
Subjects: Awake craniotomy, Critical perspective, Anesthesiology and Pain Medicine, business.industry, medicine.medical_treatment, Anesthesia, Medicine, Anesthetic management, Perioperative, business, Critical Care and Intensive Care Medicine, Craniotomy
Abstract: Awake craniotomy has become a common procedure and its application has been continually evolving. Anesthesia for awake craniotomy poses a unique challenge to anesthesiologists. The aims of this article are to review under a critical perspective of the author, the current evidence and application of awake craniotomy and to briefly describe the principles of anesthetic management during this procedure.
Published: 2015

42. Anesthetic Management of Patients Undergoing Intracranial Bypass Procedures

Author: Jason Chui, Pirjo Manninen, Lashmi Venkatraghavan, and Raphael H. Sacho
Subjects: medicine.medical_specialty, Cerebral Revascularization, business.industry, Ischemia, Anesthetic management, medicine.disease, Surgery, Cerebrovascular Disorders, Postoperative Complications, Anesthesiology and Pain Medicine, Cerebral blood flow, Cerebrovascular Circulation, Anesthesia, Anesthetic, medicine, Humans, In patient, cardiovascular diseases, Moyamoya disease, Cerebral perfusion pressure, business, medicine.drug
Abstract: Cerebral revascularization is used to augment or replace cerebral blood flow in patients at risk of developing cerebral ischemia. These include patients with moyamoya disease, occlusive cerebrovascular disease, skull base tumors, and complex aneurysms. Our aim in this review is to provide a comprehensive update of both surgical and anesthetic aspects of cerebral revascularization procedures. The anesthetic concerns for most patients presenting for different types of bypass procedures are similar and include the maintenance of adequate cerebral perfusion to prevent cerebral ischemia. Patients with complex aneurysms and tumors have additional considerations related to the surgical treatment of the underlying pathology.
Published: 2015

43. Impact of Ketamine Use on Adjunctive Analgesic and Sedative Medications in Critically Ill Trauma Patients

Author: Mehrnaz Pajoumand, Kaitlin A. Pruskowski, Sai-Ho Jason Chui, H. Neal Reynolds, and Kelly Harbourt
Subjects: Adult, Male, Time Factors, medicine.drug_class, Sedation, Critical Illness, Population, Piperazines, Fentanyl, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Hypnotics and Sedatives, Pharmacology (medical), Ketamine, 030212 general & internal medicine, Dexmedetomidine, education, Infusions, Intravenous, Retrospective Studies, education.field_of_study, Analgesics, business.industry, 030208 emergency & critical care medicine, Middle Aged, Respiration, Artificial, Drug Utilization, Analgesics, Opioid, Thiazoles, Blunt trauma, Anesthesia, Sedative, Wounds and Injuries, Female, medicine.symptom, Propofol, business, medicine.drug
Abstract: Background Ketamine may be used to manage pain and agitation that is refractory to what are usually considered traditional agents such as fentanyl, propofol, benzodiazepines, and dexmedetomidine; however, literature describing the use of ketamine continuous infusions for this purpose in critically ill trauma patients is limited. Objectives The primary objective of this study was to determine the impact of the initiation of a ketamine continuous infusion on sedative and analgesic use in critically ill trauma patients. Secondary objectives were to identify the patient population in which ketamine was initiated, assess the proportion of time patients were at their goal level of sedation, and determine the dosing patterns of adjunctive sedative agents. Methods This single-center retrospective chart review over a 19-month period included critically ill mechanically ventilated adult trauma patients in whom a ketamine continuous infusion was initiated for management of sedation and agitation. Patients who received ketamine for other indications or by the acute pain management service were not included in this evaluation. Results Thirty-six patients were included in the study. Patients in whom ketamine was initiated tended to be white men with blunt trauma. Overall, the initiation of ketamine was associated with a decrease in the amount of opioids and propofol used and an increase in the amount of ziprasidone and dexmedetomidine needed to achieve the goal Richmond Agitation Sedation Score. When compared with the time period before ketamine initiation, the proportion of time that patients achieved goal sedation was not significantly different after the addition of ketamine. Conclusions Although the use of ketamine in critically ill mechanically ventilated adult trauma patients was associated with decreased opioid use, it was also associated with increased use of dexmedetomidine and ziprasidone to achieve and maintain sedation. Further examination of clinical outcomes associated with these differences in drug use in a larger population of trauma patients is warranted before routine use of ketamine for analgesia and sedation can be recommended.
Published: 2017

44. Anesthesiologists' perception of perioperative stroke risk during non-neurologic and non-cardiac surgery

Author: Alana M. Flexman, Lingzhong Meng, Adrian W. Gelb, Darreul Sewell, and Jason Chui
Subjects: Male, medicine.medical_specialty, Perioperative nursing, Cross-sectional study, media_common.quotation_subject, Pilot Projects, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, 030202 anesthesiology, Risk Factors, Anesthesiology, Perception, Surveys and Questionnaires, Medicine, Humans, Perioperative Period, Perioperative stroke, media_common, business.industry, General Medicine, Perioperative, Surgical procedures, Middle Aged, Anesthesiologists, Stroke, Anesthesiology and Pain Medicine, Cross-Sectional Studies, Anesthesia, Non cardiac surgery, Surgical Procedures, Operative, Female, business, 030217 neurology & neurosurgery
Published: 2017

45. Comparison of propofol and volatile agents for maintenance of anesthesia during elective craniotomy procedures: systematic review and meta-analysis

Author: Ramamani Mariappan, Jigesh Mehta, Pirjo Manninen, Lashmi Venkatraghavan, and Jason Chui
Subjects: Adult, medicine.medical_specialty, medicine.medical_treatment, law.invention, Postoperative Complications, Randomized controlled trial, law, Anesthesiology, medicine, Humans, Cerebral perfusion pressure, Propofol, Craniotomy, Intracranial pressure, business.industry, General Medicine, Surgery, Anesthesiology and Pain Medicine, Elective Surgical Procedures, Anesthesia, Anesthetics, Inhalation, Postoperative Nausea and Vomiting, Anesthetic, medicine.symptom, business, Anesthetics, Intravenous, Postoperative nausea and vomiting, medicine.drug
Abstract: Both propofol and volatile anesthetics are commonly used for maintenance of anesthesia in patients undergoing neurosurgical procedures. The effects of these two classes of drugs on cerebral hemodynamics have been compared in many clinical trials The objectives of this review were to evaluate the cerebral hemodynamic effects, operative conditions, recovery profiles, postoperative complications, and neurological outcomes of propofol-based vs volatile-based anesthesia for craniotomy. MEDLINE®, EMBASE™, Cochrane, and other relevant databases were searched for randomized controlled trials that compared propofol-maintained anesthesia with volatile-maintained anesthesia in adult patients undergoing elective craniotomy. The primary outcome measure was the intraoperative brain relaxation score. Secondary outcome measures included intraoperative cerebral hemodynamics (intracranial pressure [ICP], cerebral perfusion pressure [CPP]), cardiovascular changes, recovery profiles, postoperative complications, and clinical outcomes (neurological morbidity, mortality, quality of life). A meta-analysis was conducted using a random effects model to compare the outcomes of the two anesthetic techniques. Fourteen studies (1,819 patients) met inclusion criteria and were analyzed. Brain relaxation scores were similar between the two groups after dural opening; however, ICP was lower (weighted mean difference of −5.2 mmHg; 95% confidence interval −6.81 to −3.6) and CPP was higher (weighted mean difference of 16.3 mmHg; 95% confidence interval 12.2 to 20.46) in patients receiving propofol-maintained anesthesia. Postoperative complications and recovery profiles were similar between the two groups, except for postoperative nausea and vomiting being less frequent with propofol-maintained anesthesia. There were inadequate data to perform a meta-analysis on clinical outcome. Propofol-maintained and volatile-maintained anesthesia were associated with similar brain relaxation scores, although mean ICP values were lower and CPP values higher with propofol-maintained anesthesia. There are inadequate data to compare clinically significant outcomes such as neurological morbidity or mortality.
Published: 2014

46. Day Surgery Craniotomy for Unruptured Cerebral Aneurysms

Author: Michael Tymianski, Nicolai Goettel, Jason Chui, Lashmi Venkatraghavan, and Pirjo Manninen
Subjects: Adult, Male, medicine.medical_specialty, Modern medicine, medicine.medical_treatment, Neurosurgical Procedures, Perioperative Care, Cohort Studies, Postoperative Complications, Aneurysm, medicine, Humans, Anesthesia, Glasgow Coma Scale, Prospective Studies, Treatment Failure, Intraoperative Complications, Prospective cohort study, Aged, Pain Measurement, Retrospective Studies, Pain, Postoperative, business.industry, Hemodynamics, Intracranial Aneurysm, Retrospective cohort study, Clipping (medicine), Perioperative, Length of Stay, Middle Aged, medicine.disease, Surgery, Hospitalization, Treatment Outcome, Anesthesiology and Pain Medicine, Ambulatory Surgical Procedures, Ambulatory, Female, Neurology (clinical), business, Cohort study
Abstract: Background: Ambulatory day surgery is an evolving specialty in line with demands of modern medicine, health care services, and economics, but its role in neurovascular surgery remains controversial. The purpose of this study was to describe our experience of patients undergoing elective clipping of intact cerebral aneurysms as day surgery. Methods: This retrospective and prospective observational study was carried out as a cohort review of patients who underwent outpatient clipping of an intact intracranial aneurysm at the Toronto Western Hospital, University Health Network, between May 2009 and November 2012. Patients were categorized as success (discharged on the same day) or failure (requiring unplanned postoperative hospital admission) of day surgery. Data included the preoperative assessment of the patient, anesthetic management, postoperative care, and the incidence of perioperative complications. Outcomes were duration of hospital stay, and any problems preventing same-day discharge. Results: During the study period 25 patients aged 54±9 years underwent outpatient aneurysm repair. Seventeen patients (68%) successfully completed day surgery, and 8 patients (32%) were admitted to the hospital after surgery due to perioperative complications. Duration of hospital stay in the failure group ranged from 2 to 18 days. Conclusions: Our data demonstrates that surgical clipping of unruptured cerebral aneurysms may be performed in an outpatient setting. Careful selection of day surgery candidates and postoperative assessment for complications is needed. Further research is needed to identify potential risk factors and to target patient subgroups for successful ambulatory surgery.
Published: 2014

47. A Case of Malignant Cerebral Edema Following Removal of Infected Autologous Cranioplasty Flap

Author: Nancy Chan, Kristopher Langdon, Andrew G. Parrent, David Ramsay, Jason Chui, and Sebastian Borowiec
Subjects: medicine.medical_specialty, Anesthesiology and Pain Medicine, business.industry, medicine.medical_treatment, medicine, Surgery, Neurology (clinical), business, medicine.disease, Cranioplasty, Cerebral edema
Published: 2019

48. The Anesthetic Considerations of Intraoperative Electrocorticography During Epilepsy Surgery

Author: Lashmi Venkatraghavan, Jason Chui, Pirjo H. Manninen, and Taufik A. Valiante
Subjects: Refractory seizures, medicine.medical_specialty, Intraoperative Electrocorticography, Neurosurgical Procedures, Epilepsy, Predictive Value of Tests, Monitoring, Intraoperative, medicine, Humans, Anesthesia, Epilepsy surgery, Electrocorticography, Anesthetics, Brain Mapping, medicine.diagnostic_test, business.industry, Epileptogenic lesion, Brain, Electroencephalography, medicine.disease, Epileptogenic zone, Brain Waves, Surgery, Anesthesiology and Pain Medicine, Anesthetic, business, medicine.drug
Abstract: Epilepsy surgery is a well-established therapeutic intervention for patients with medically refractory seizures. Success of epilepsy surgery depends on the accurate localization and complete removal of the epileptogenic zone. Despite the advances in presurgical localization modalities, electrocorticography is still used in approximately 60% to 70% of the epilepsy centers in North America to guide surgical resection of the epileptogenic lesion and to assess for completeness of surgery. In this review, we discuss the principles and intraoperative use of electrocorticography, the effect of anesthetic drugs on electrocorticography, and the use of pharmacoactivation for intraoperative localization of epileptogenic zone.
Published: 2013

49. Presurgical Evaluation of Patients with Epilepsy

Author: Lashmi Venkatraghavan, Jason Chui, and Pirjo H. Manninen
Subjects: medicine.medical_specialty, Neuroimaging, Neuropsychological Tests, Epilepsy, Text mining, Anesthesiology, Physicians, Preoperative Care, medicine, Humans, Hypnotics and Sedatives, Surgical treatment, Tomography, Emission-Computed, Single-Photon, business.industry, Electroencephalography, medicine.disease, Magnetic Resonance Imaging, Electrodes, Implanted, Surgery, Anesthesiology and Pain Medicine, Positron-Emission Tomography, Refractory epilepsy, Amobarbital, Tomography, X-Ray Computed, business
Abstract: Patients with medically refractory epilepsy when referred for surgical treatment often undergo extensive investigations to determine whether surgical treatment is feasible. Surgical feasibility is determined by identifying the location and number of seizure foci and their relationship to eloquent areas of the brain. Good surgical outcome depends on complete resection of seizure foci without any damage to eloquent brain function. Various noninvasive and invasive techniques are used in the presurgical evaluation of patients with epilepsy that include imaging techniques, electrophysiologic studies, and tests to determine functional areas. Understanding of the principles of seizure localization and of the effects of anesthetic drugs on the various preoperative investigations is essential for patient management. In this review article, we discuss the role of the anesthesiologist in patient management during many of these investigations and the role of anesthetic drugs to aid in the localization of the seizure focus and of determining eloquent brain function.
Published: 2013

50. Acute Decompensated Heart Failure and Cardiogenic Shock

Author: Davy Cheng, Janet Martin, and Jason Chui
Subjects: medicine.medical_specialty, Acute decompensated heart failure, business.industry, Internal medicine, Cardiogenic shock, medicine, Cardiology, medicine.disease, business
Published: 2016

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