Author: "Mee-Hoong See" - Searchworks@Jio Institute Digital Library Search Results

92 results on '"Mee-Hoong See"'

1. Gene expression signature for predicting homologous recombination deficiency in triple-negative breast cancer

Author: Jia-Wern Pan, Zi-Ching Tan, Pei-Sze Ng, Muhammad Mamduh Ahmad Zabidi, Putri Nur Fatin, Jie-Ying Teo, Siti Norhidayu Hasan, Tania Islam, Li-Ying Teoh, Suniza Jamaris, Mee-Hoong See, Cheng-Har Yip, Pathmanathan Rajadurai, Lai-Meng Looi, Nur Aishah Mohd Taib, Oscar M. Rueda, Carlos Caldas, Suet-Feung Chin, Joanna Lim, and Soo-Hwang Teo
Subjects: Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Abstract Triple-negative breast cancers (TNBCs) are a subset of breast cancers that have remained difficult to treat. A proportion of TNBCs arising in non-carriers of BRCA pathogenic variants have genomic features that are similar to BRCA carriers and may also benefit from PARP inhibitor treatment. Using genomic data from 129 TNBC samples from the Malaysian Breast Cancer (MyBrCa) cohort, we developed a gene expression-based machine learning classifier for homologous recombination deficiency (HRD) in TNBCs. The classifier identified samples with HRD mutational signature at an AUROC of 0.93 in MyBrCa validation datasets and 0.84 in TCGA TNBCs. Additionally, the classifier strongly segregated HRD-associated genomic features in TNBCs from TCGA, METABRIC, and ICGC. Thus, our gene expression classifier may identify triple-negative breast cancer patients with homologous recombination deficiency, suggesting an alternative method to identify individuals who may benefit from treatment with PARP inhibitors or platinum chemotherapy.
Published: 2024
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2. Clustering of HR + /HER2− breast cancer in an Asian cohort is driven by immune phenotypes

Author: Jia-Wern Pan, Mohana Ragu, Wei-Qin Chan, Siti Norhidayu Hasan, Tania Islam, Li-Ying Teoh, Suniza Jamaris, Mee-Hoong See, Cheng-Har Yip, Pathmanathan Rajadurai, Lai-Meng Looi, Nur Aishah Mohd Taib, Oscar M. Rueda, Carlos Caldas, Suet-Feung Chin, Joanna Lim, and Soo-Hwang Teo
Subjects: Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Abstract Breast cancer exhibits significant heterogeneity, manifesting in various subtypes that are critical in guiding treatment decisions. This study aimed to investigate the existence of distinct subtypes of breast cancer within the Asian population, by analysing the transcriptomic profiles of 934 breast cancer patients from a Malaysian cohort. Our findings reveal that the HR + /HER2− breast cancer samples display a distinct clustering pattern based on immune phenotypes, rather than conforming to the conventional luminal A-luminal B paradigm previously reported in breast cancers from women of European descent. This suggests that the activation of the immune system may play a more important role in Asian HR + /HER2− breast cancer than has been previously recognized. Analysis of somatic mutations by whole exome sequencing showed that counter-intuitively, the cluster of HR + /HER2− samples exhibiting higher immune scores was associated with lower tumour mutational burden, lower homologous recombination deficiency scores, and fewer copy number aberrations, implicating the involvement of non-canonical tumour immune pathways. Further investigations are warranted to determine the underlying mechanisms of these pathways, with the potential to develop innovative immunotherapeutic approaches tailored to this specific patient population.
Published: 2024
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3. Trends in Presentation, Management, and Survival of Women With Breast Cancer in a Multiethnic, Middle-Income Asian Setting

Author: Sharminii Jaya-Prakason, Yek-Ching Kong, Cheng-Har Yip, Mee-Hoong See, Nur Aishah Taib, Nur Fadhlina Abdul Satar, Suniza Jamaris, Li Ying Teoh, Rose Irnawaty Ibrahim, and Nirmala Bhoo-Pathy
Subjects: Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: PURPOSEGranular data on breast cancer (BC) are pertinent for surveillance, planning, and monitoring of cancer care delivery. We determined the trends in clinical presentation, management, and survival of women with BC in a multiethnic middle-income Asian setting over 15 years.METHODSData of 7,478 Malaysian women newly diagnosed with invasive BC between 2005 and 2019 from three hospital-based cancer registries were included. Trends in demographic, tumor, and treatment characteristics were compared across period 1 (P1): 2005-2009, period 2 (P2): 2010-2014, and period 3 (P3): 2015-2019. Overall survival and net survival were determined.RESULTSMore women in P3 than P1 were older than 60 years at diagnosis. Only a marginal increase in proportion of women with stage I disease was observed (23.7% v 27.2% in P1 and P3, respectively, P = .004). Nonetheless, patients were increasingly presenting with smaller tumors, fewer axillary node involvement, well-differentiated tumors, and hormone receptor expression in recent times. Proportion of women with human epidermal growth factor receptor 2 (HER2)–overexpressed tumors significantly decreased. Among indicated patients, receipt of anticancer therapies was somewhat similar over the calendar periods, except for neoadjuvant chemotherapy and anti-HER2 therapy, where increases in administration were noted. Significant improvements in survival were observed over the 15 years, particularly for HER2-overexpressed BCs.CONCLUSIONAlthough the improvements in BC survival that we have observed validate ongoing cancer control efforts and treatment advances, study findings suggest that more could be done for earlier detection and improved access to effective therapies in our settings.
Published: 2024
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4. Age-specific breast and ovarian cancer risks associated with germline BRCA1 or BRCA2 pathogenic variants – an Asian study of 572 familiesResearch in context

Author: Weang-Kee Ho, Nur Tiara Hassan, Sook-Yee Yoon, Xin Yang, Joanna M.C. Lim, Nur Diana Binte Ishak, Peh Joo Ho, Eldarina A. Wijaya, Patsy Pei-Sze Ng, Craig Luccarini, Jamie Allen, Mei-Chee Tai, Jianbang Chiang, Zewen Zhang, Mee-Hoong See, Meow-Keong Thong, Yin-Ling Woo, Alison M. Dunning, Mikael Hartman, Cheng-Har Yip, Nur Aishah Mohd Taib, Douglas F. Easton, Jingmei Li, Joanne Ngeow, Antonis C. Antoniou, and Soo-Hwang Teo
Subjects: Penetrance, Breast cancer risk, Ovarian cancer risk, BRCA1, BRCA2, Public aspects of medicine, RA1-1270
Abstract: Summary: Background: Clinical management of Asian BRCA1 and BRCA2 pathogenic variants (PV) carriers remains challenging due to imprecise age-specific breast (BC) and ovarian cancer (OC) risks estimates. We aimed to refine these estimates using six multi-ethnic studies in Asia. Methods: Data were collected on 271 BRCA1 and 301 BRCA2 families from Malaysia and Singapore, ascertained through population/hospital-based case-series (88%) and genetic clinics (12%). Age-specific cancer risks were estimated using a modified segregation analysis method, adjusted for ascertainment. Findings: BC and OC relative risks (RRs) varied across age groups for both BRCA1 and BRCA2. The age-specific RR estimates were similar across ethnicities and country of residence. For BRCA1 carriers of Malay, Indian and Chinese ancestry born between 1950 and 1959 in Malaysia, the cumulative risk (95% CI) of BC by age 80 was 40% (36%–44%), 49% (44%–53%) and 55% (51%–60%), respectively. The corresponding estimates for BRCA2 were 29% (26–32%), 36% (33%–40%) and 42% (38%–45%). The corresponding cumulative BC risks for Singapore residents from the same birth cohort, where the underlying population cancer incidences are higher compared to Malaysia, were higher, varying by ancestry group between 57 and 61% for BRCA1, and between 43 and 47% for BRCA2 carriers. The cumulative risk of OC by age 80 was 31% (27–36%) for BRCA1 and 12% (10%–15%) for BRCA2 carriers in Malaysia born between 1950 and 1959; and 42% (34–50%) for BRCA1 and 20% (14–27%) for BRCA2 carriers of the same birth cohort in Singapore. There was evidence of increased BC and OC risks for women from >1960 birth cohorts (p-value = 3.6 × 10−5 for BRCA1 and 0.018 for BRCA2). Interpretation: The absolute age-specific cancer risks of Asian carriers vary depending on the underlying population-specific cancer incidences, and hence should be customised to allow for more accurate cancer risk management. Funding: Wellcome Trust [grant no: v203477/Z/16/Z]; CRUK (PPRPGM-Nov20∖100002).
Published: 2024
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5. Factors associated with alteration of nipple or skin sensation and impact of duration of time following nipple-sparing mastectomy (NSM): an analysis of 460 cases with comparison of conventional versus endoscopic- or robotic-assisted NSM

Author: Hung-Wen Lai, Yi-Lin Chang, Korawan Chandrachamnong, Mee-Hoong See, Hsin-I Huang, Shih-Lung Lin, Dar-Yuan Fang, Shou-Tung Chen, Dar-Ren Chen, Chi Wei Mok, and Fiona Tsui-Fen Cheng
Subjects: Nipple-sparing mastectomy (NSM), Nipple sensation, Skin sensation, Nipple areola complex (NAC), Breast cancer, Conventional nipple-sparing mastectomy (C-NSM), Surgery, RD1-811, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: Abstract Background The current study aims to evaluate the nipple and skin sensation following nipple-sparing mastectomy (NSM) and identify patient-, surgical-, or treatment-related factors affecting nipple or skin sensation in this cohort. Methods Patients who received NSM with postoperative nipple and skin sensation test evaluation at a single institution over the past 10 years were retrospectively retrieved from a prospectively collected breast cancer surgery database. Results A total of 460 NSM procedures were included in this current study, with the mean age of 48.3 ± 9.1. Three-hundred eighty-three (83.3%) patients had breast reconstructions. One-hundred seventy-four (37.8%) received conventional NSM (C-NSM), 195 (42.4%) endoscopic-assisted NSM (E-NSM), and 91 (19.8%) robotic-assisted NSM (R-NSM) procedures. For nipple sensation assessment, 15 (3.3%) were grade 0, 83 (18.2%) grade I, 229 (49.7%) grade II, and 133 (28.9%) grade III (normal sensation), respectively, with mean grade score of 2.1 ± 0.7. The preserved (grade III) nipple sensation rate was 36.2% (63/174) in the C-NSM group, 26.7% (52/195) in the E-NSM group, and 19.7% (18/91) in the R-NSM group (P = 0.06). The “time since surgery to last evaluation” was significantly longer in the C-NSM group (45.6 ± 34 months) or E-NSM group (44.7 ± 35.8 months) as compared to R-NSM group (31.8 ± 16 months, P 60 months vs. ≦ 12 months: nipple odds ratio (OR) = 5.75, P
Published: 2023
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6. 'An Unusual Pattern of Metastasis' Metastatic Malignant Thymoma Presented with Breast Lump: A Case Report and Literature Review

Author: Kah-Seng Khoo, Kavinya Diana T. Nadesalingam, Diana Bee-Lan Ong, Li-Ying Teoh, Mei-Sze Teh, Suniza Jamaris, and Mee-Hoong See
Subjects: Surgery, RD1-811
Abstract: Metastatic lesions to the breast from extramammary malignant neoplasms are rare and reported account for 0.5–6.6% of all breast malignancies. Distant metastasis of thymoma is even rarer, especially to extrathoracic regions. We reported a woman with invasive malignant thymoma postneoadjuvant and resection of the thymoma, who developed breast metastasis 7 years later. Breast imaging showed high-density lesion with no intralesional microcalcifications and no significant axillary lymphadenopathy. Core biopsy and histopathology proved the lesion to be metastatic thymic carcinoma. Despite rarity, breast lumps with underlying extramammary malignancy should raise the suspicious of breast metastasis.
Published: 2023
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7. Discriminatory Ability and Clinical Utility of the AJCC7 and AJCC8 Staging Systems for Breast Cancer in a Middle-Income Setting

Author: Chin-Vern Song, Carla H. van Gils, Cheng-Har Yip, Isabelle Soerjomataram, Nur Aishah Mohd Taib, Mee-Hoong See, Alexander Lim, Nur Fadhlina Abdul Satar, and Nirmala Bhoo-Pathy
Subjects: breast cancer, AJCC7, AJCC8, low- and middle-income countries, prognostic performance, clinical utility, Medicine (General), R5-920
Abstract: (1) Background: Differences in access to biomarker testing and cancer treatment in resource-limited settings may affect the clinical utility of the AJCC8 staging system compared to the anatomical AJCC7 system. (2) Methods: A total of 4151 Malaysian women who were newly diagnosed with breast cancer from 2010 to 2020 were followed-up until December 2021. All patients were staged using the AJCC7 and AJCC8 systems. Overall survival (OS) and relative survival (RS) were determined. Concordance-index was used to compare the discriminatory ability between the two systems. (3) Results: Migration from the AJCC7 to AJCC8 staging system resulted in the downstaging of 1494 (36.0%) patients and the upstaging of 289 (7.0%) patients. Approximately 5% of patients could not be staged using the AJCC8 classification. Five-year OS varied between 97% (Stage IA) and 66% (Stage IIIC) for AJCC7, and 96% (Stage IA) and 60% (Stage IIIC) for AJCC8. Concordance-indexes for predicting OS using the AJCC7 and AJCC8 models were 0.720 (0.694–0.747) and 0.745 (0.716–0.774), and for predicting RS they were 0.692 (0.658–0.728) and 0.710 (0.674–0.748), respectively. (4) Conclusions: Given the comparable discriminatory ability between the two staging systems in predicting the stage-specific survival of women with breast cancer in the current study, the continued use of the AJCC7 staging system in resource-limited settings seems pragmatic and justifiable.
Published: 2023
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8. Psychological distress among elderly surgical patients who had their surgery postponed during the COVID-19 pandemic

Author: Pui San Loh, Sook Hui Chaw, Yi Xian Foong, Dhurgka Ramasamy, Rafdzah Ahmad Zaki, Shanggar Kuppusamy, Teng Aik Ong, Mee Hoong See, and Hui Min Khor
Subjects: Psychological distress, Anxiety, Depression, Elective surgical procedures, Elderly, COVID-19, Surgery, RD1-811
Abstract: Abstract Background Many institutions withheld elective lists and triaged surgeries during the peak of coronavirus disease 2019 (COVID-19) pandemic. As a result, older surgical patients have had to wait for rescheduled dates in a long waitlist. This study aimed to identify the psychological impact in these patients when they returned for surgery. Methods This was a cross-sectional study which included 153 patients aged ≥ 65 years undergoing elective surgery. Trained interviewers recruited and assessed psychological status pre-operatively with two validated questionnaires - Hospital Anxiety and Depression Scale (HADS) and 36-item Short Form Health Survey (SF-36). Specific questions were asked about their postponed surgeries, appetite and fear. Results A total of 36 out of 153 (23.5%) patients had their procedures deferred during the first wave of COVID-19 pandemic. Postponed cases were significantly based on the nature of surgery (p = 0.002), cancer diagnosis (p = 0.006) and surgical specialty (p = 0.023). Median HADS scores were higher for patients who were postponed (2.00 versus 4.00 for anxiety, p = 0.180 and 0.00 versus 1.00 for depression, p = 0.424) although no statistical significance was shown. In the whole study population, anxiety was a significant predictor for depression and vice versa (p
Published: 2022
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9. Association Between Adherence to Clinical Practice Guidelines for Adjuvant Therapy for Breast Cancer and Survival in a Resource-Limited Setting

Author: Chin Vern Song, Cheng-Har Yip, Nur Aishah Mohd Taib, Mee Hoong See, Li Ying Teoh, Evelyn M. Monninkhof, Marniza Saad, Cuno S.P.M. Uiterwaal, and Nirmala Bhoo-Pathy
Subjects: Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract: PURPOSEAddressing unwarranted clinical variation in oncology practices is expected to lead to improved cancer outcomes. Particularly, the application and impact of treatment guidelines on breast cancer outcomes are poorly studied in resource-limited settings. We measured adherence to a set of locally developed adjuvant treatment guidelines in a middle-income setting. Importantly, the impact of guidelines adherence on survival following breast cancer was determined.METHODSData of 3,100 Malaysian women with nonmetastatic breast cancer diagnosed between 2010 and 2017 were analyzed. Adherence to the Malaysian Clinical Practice Guidelines for Management of Breast Cancer second Edition was measured. Outcomes comprised overall survival and event-free survival.RESULTSGuideline adherence for chemotherapy, radiotherapy, hormonal therapy, and targeted therapy were 61.7%, 79.2%, 85.1%, and 26.2%, respectively. Older age was generally associated with lower adherence to guidelines. Compared with patients who were treated according to treatment guidelines, overall survival and event-free survival were substantially lower in patients who were not treated accordingly; hazard ratios for all-cause mortality were 1.69 (95% CI, 1.29 to 2.22), 2.59 (95% CI, 1.76 to 3.81), 3.08 (95% CI, 1.94 to 4.88), and 4.48 (95% CI, 1.98 to 10.13) for chemotherapy, radiotherapy, hormone therapy, and targeted therapy, respectively. Study inferences remain unchanged following sensitivity analyses.CONCLUSIONOur study findings appear to suggest that adherence to treatment guidelines that have been adapted for resource-limited settings may still provide effective guidance in improving breast cancer outcomes.
Published: 2022
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10. Comparison of Clinical Outcomes Between Low- and High-Risk Groups of Early Breast Cancer Patients Treated with Intraoperative Radiotherapy in Addition to External Beam Radiation: A Multi-Centre Prospective Study

Author: J. A. Mosiun, Mee-Hoong See, Li-Ying Teoh, Mahmoud Danaee, Lee-Lee Lai, Char-Hong Ng, Cheng-Har Yip, Mei-Sze Teh, Nur Aishah Md Taib, Anita Bustam, Rozita Abdul Malik, Marniza Saad, Suniza Jamaris, and Ngie-Min Ung
Subjects: Humans, Female, Breast Neoplasms, Surgery, Prospective Studies, Social Group
Abstract: There is a paucity of data on the use of intraoperative radiotherapy (IORT) with low-energy X-rays in Malaysian women with early breast cancer. The aim of this study is to evaluate the clinical, cosmetic, and patient-reported outcomes in low- and high-risk early breast cancer patients treated with breast conserving surgery (BCS) and IORT.Patients suitable for BCS who were treated with IORT between January 2016 and June 2019 from three centres were analysed. They were divided into low-risk and high-risk groups based on the risk of recurrence according to the TARGeted Intraoperative radioTherapy (TARGIT) A and B study criteria. Outcomes of interest included local recurrence, wound complications, and radiation toxicity, with a subset analysed for cosmetic and patient-reported outcomes.Within a median follow-up of 31 months, there were 104 and 211 patients in the low- and high-risk groups, respectively. No significant difference was observed in local recurrence rates (low-risk, 1.0% vs. high-risk, 1.4%; p = 1.000). Both cohorts exhibited low frequencies of severe wound complications ranging between 1.4 and 1.9%. No major radiation toxicities were reported in either group. In the subgroup analysis, low-risk patients had significantly better mean scores in the subscales of inframammary fold and scar. Based on the BREAST-Q patient-reported outcomes questionnaire, seven out of nine parameters were scored similarly between both groups with no significant difference.This study showed that the use of IORT in both low- and high-risk early breast cancers is efficacious and safe with low recurrence rates and an acceptable toxicity profile.
Published: 2022

11. Mindful gratitude journaling: psychological distress, quality of life and suffering in advanced cancer: a randomised controlled trial.

Author: Ting Ting Tan, Maw Pin Tan, Chee Loong Lam, Ee Chin Loh, Capelle, David Paul, Zainuddin, Sheriza Izwa, Bin Ting Ang, Min Ai Lim, Zi Lai, Natalie, Yu Zhen Tung, Hway Ann Yee, Chong Guan Ng, Gwo Fuang Ho, Mee Hoong See, Mei Sze Teh, Lee Lee Lai, Pritam Singh, Ranjit Kaur, Chee Shee Chai, Leh Ching Ng, Diana, and Seng Beng Tan
Published: 2023
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12. Association between pre-existing cardiometabolic comorbidities and the pathological profiles of breast cancer at initial diagnosis: a cross sectional study

Author: Shridevi Subramaniam, Yek-Ching Kong, Cheng-Har Yip, Muthukkumaran Thiagarajan, Jayalakshmi Pailoor, Hafizah Zaharah, Nur Aishah Taib, Mee-Hoong See, Diana Sarfati, and Nirmala Bhoo-Pathy
Subjects: Cancer Research, Oncology
Published: 2023

13. Primary Breast Angiosarcoma: Utilisation of Pre-surgical Magnetic Resonance Imaging (MRI) for Accurate Tumour Characterization and Planning – A Case Report and Literature Review

Author: Marlina Tanty Ramli Hamid, Mee Hoong See, Kartini Rahmat, Cheng Har Yip, Wei Lin Ng, Nazimah Ab Mumin, Xin Ying Cheah, and Wai Yee Chan
Subjects: medicine.medical_specialty, medicine.diagnostic_test, business.industry, medicine.medical_treatment, Magnetic resonance imaging, medicine.disease, Malignancy, Breast cancer, Radiological weapon, Biopsy, Medicine, Radiology, Nuclear Medicine and imaging, Elastography, Radiology, business, Abscess, Mastectomy
Abstract: Background: Primary breast angiosarcoma is a rare malignancy with non-specific clinical and radiological findings. Case Report: A 30-year-old lady presented with left breast pain and lumpiness for over one year. She has had several breast ultrasounds (US) and was treated for acute mastitis and abscess. Subsequently, in view of the rapid growth of the lump and worsening pain, she was re-investigated with US, elastography, digital breast tomosynthesis (DBT) and MRI. MRI raised the suspicion of angiosarcoma. The diagnosis was confirmed after biopsy and she underwent mastectomy. Discussion: Literature review on imaging findings of breast angiosarcoma, especially on MRI, is discussed. MRI features showed heterogeneous low signal intensity on T1 and high signal intensity on T2. Dynamic contrast enhancement (DCE) features included either early enhancement with or without washout in the delayed phase, and some reported central areas of non-enhancement. Conclusion: This case report emphasises on the importance of MRI in clinching the diagnosis of breast angiosarcoma, and hence, should be offered sooner to prevent diagnostic delay.
Published: 2021

14. Abstract P5-03-21: A COMPARISON OF BREAST CANCER SURVIVAL ACROSS DIFFERENT TUMOUR BIOLOGY IN YOUNG WOMEN: A MULTICENTRIC DATABASE STUDY IN KLANG VALLEY, MALAYSIA

Author: Mee Hoong See, Phrabakaran Rajehgopal, Mei Sze Teh, Lee Lee Lai, and Abqariyah Yahya
Subjects: Cancer Research, Oncology
Abstract: Background: OBJECTIVE: This study aims to determine the 5-year overall survival of young breast cancer according to tumour biology in Malaysia. METHODOLOGY: Multicenter retrospective study with convenience sampling method used to recruit the patients. All young women aged 50years and below with breast cancer who underwent surgery/under follow up from 1st January 2014 to 31st December 2017 in Hospital Tengku Ampuan Rahimah (HTAR), Klang, Hospital Selayang and Hospital Putrajaya were in included. Categorical data were analyzed using Chi-Square analysis and Fisher’s Exact Test. 5-year overall survival was calculated using Kaplan Meier. Cox Regression to estimate hazard ratio for mortality in patients with different tumour biology. Recurrence were analysed using Chi-Square analysis. RESULTS: A total of 360 patients were recruited predominantly within 41years to 50years of age (63.9%). The majority of the patients were Malays (66.4%). Most of the patients were in Stage II (39.4%) with a significant number of patients in Stage III and IV (25.0% & 26.4% respectively). 56.1% had tumour biology of Luminal A followed by Triple negative (21.7%), HER2 Enriched (12.2%) and Luminal B (10%). Kaplan Meier analysis showed that the 5-year overall survival was 58.3%. There were no statistical significance across the tumour biology subtypes. Among the tumour biology groups, Triple Negative had the highest probability of survival with 54.5%. CONCLUSION: We observed that Triple Negative had the highest probability of survival at 5years while Luminal B (HER 2 Positive) had the lowest probability. The 5-years overall survival was not statistically significant with accordance to locoregional recurrence rate and in different tumour biology. Keywords: Breast cancer, young women, tumour biology, overall survival, locoregional recurrence Citation Format: Mee Hoong See, Phrabakaran Rajehgopal, Mei Sze Teh, Lee Lee Lai, Abqariyah Yahya. A COMPARISON OF BREAST CANCER SURVIVAL ACROSS DIFFERENT TUMOUR BIOLOGY IN YOUNG WOMEN: A MULTICENTRIC DATABASE STUDY IN KLANG VALLEY, MALAYSIA [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-03-21.
Published: 2023

15. Adverse events following immunization and psychological distress among cancer patients/survivors following vaccination against SARS-CoV-2 infection

Author: Li Ping Wong, Lee Lee Lai, Mee Hoong See, Haridah Alias, Sharifah Faridah Syed Omar, Chong Guan Ng, Gwo Fuang Ho, Teng Aik Ong, Yee Chi Wong, Po Lin Ooi, Jasmin Munchar Elias, Zhijian Hu, and Yulan Lin
Subjects: General Psychology
Abstract: PurposeThis study aims to describe the adverse events following immunization (AEFIs) of SARS-CoV-2 vaccination in cancer patients/survivors associated with their psychological distress.MethodsA cross-sectional study was conducted to assess AEFIs after the receipt of SARS-CoV-2 vaccines in cancer patients/survivors attending a university hospital in Malaysia. Psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS) before and after the first and second doses of COVID-19 vaccine.ResultsA total of 217 complete responses were received. Compared with before vaccination, both HADS Anxiety (HADS-A) and HADS Depression (HADS-D) scores were significantly reduced after the first and second dose of the SARS-CoV-2 vaccine. Most of the participants had mild-or-moderate systemic and local AEFIs, with the most common being pain at the injection site, tiredness, and headache for both the first and second doses of the vaccine. Positive correlations between the total AEFI score and HADS-A (r = 0.309, p r = 0.214, p = 0.001) scores were observed after the first dose of the SARS-CoV-2 vaccine. Similarly, positive associations were observed between the total AEFI score and HADS-A (r = 0.305, p r = 0.235, p ConclusionMild-to-moderate AEFIs found in this study help address vaccine hesitancy in cancer patients/survivors. Receiving the SARS-CoV-2 vaccine had a positive effect on decreasing psychological distress in cancer patients/survivors. High severity of an AEFI was associated with higher anxiety and depressive symptoms.
Published: 2022

16. COVID-19 effects on breast cancer patients: symptom presentation and critical intervals in a Malaysian hospital

Author: Mei-Sze Teh, Mee-Hoong See, Lee-Lee Lai, Abqariyah Yahya, Li-Ying Teoh, and Kartini Rahmat
Subjects: Public Health, Environmental and Occupational Health, Emergency Medicine
Published: 2022

17. External Decanting of Non-COVID-19 Cases in a Hybrid Institutional Health Care Center: A Bed Management Strategy During Surge Capacity

Author: Mohd Idzwan bin Zakaria, Nur Amira binti Abd Malek, and Mee Hoong See
Subjects: SARS-CoV-2, Surge Capacity, Public Health, Environmental and Occupational Health, Humans, Disaster Planning, Health Facilities
Published: 2022

18. Desmoid Type Fibromatosis of the Breast Masquerading as Breast Carcinoma: Value of Dynamic Magnetic Resonance Imaging and Its Correlation

Author: Sze Yong Teoh, Anushya Vijayananthan, Kartini Rahmat, Wei Lin Ng, Marlina Tanty Ramli, Mei Sze Teh, Mee Hoong See, and Pailoor Jayalakshmi
Subjects: medicine.medical_specialty, medicine.diagnostic_test, business.industry, Fibromatosis, Case Report, Magnetic resonance imaging, Desmoid type fibromatosis, medicine.disease, Breast cancer, Radiological weapon, Medicine, Radiology, Stromal tumor, Breast carcinoma, business, Rare disease
Abstract: Desmoid type fibromatosis of the breast is a rare stromal tumor that accounts for
Published: 2021

19. Impact of preoperative magnetic resonance imaging on surgery and eligibility for intraoperative radiotherapy in early breast cancer

Author: Wai Yee Chan, Wai Keong Cheah, Marlina Tanty Ramli Hamid, Mohammad Nazri Md Shah, Farhana Fadzli, Shaleen Kaur, Mee Hoong See, Nur Aishah Mohd Taib, and Kartini Rahmat
Subjects: Multidisciplinary, Humans, Female, Breast Neoplasms, Radiotherapy, Adjuvant, Mastectomy, Segmental, Magnetic Resonance Imaging, Mammography
Abstract: We looked at the usefulness of magnetic resonance imaging (MRI) in decision-making and surgical management of patients selected for intraoperative radiotherapy (IORT). We also compared lesion size measurements in different modalities (ultrasound (US), mammogram (MMG), MRI) against pathological size as the gold standard. 63 patients eligible for IORT based on clinical and imaging criteria over a 34-month period were enrolled. All had MMG and US, while 42 had additional preoperative MRI for locoregional preoperative staging. Imaging findings and pathological size concordances were analysed across the three modalities. MRI changed the surgical management of 5 patients (11.9%) whereby breast-conserving surgery (BCS) and IORT was cancelled due to detection of satellite lesion, tumor size exceeding 30mm and detection of axillary nodal metastases. Ten of 42 patients (23.8%) who underwent preoperative MRI were subjected to additional external beam radiotherapy (EBRT); 7 due to lymphovascular invasion (LVI), 2 due to involved margins, and 1 due to axillary lymph node metastatic carcinoma detected in the surgical specimen. Five of 21 (23.8%) patients without prior MRI were subjected to additional EBRT post-surgery; 3 had LVI and 2 had involved margins. The rest underwent BCS and IORT as planned. MRI and MMG show better imaging-pathological size correlation. Significant increase in the mean ‘waiting time’ were seen in the MRI group (34.1 days) compared to the conventional imaging group (24.4 days). MRI is a useful adjunct to conventional imaging and impacts decision making in IORT. It is also the best imaging modality to determine the actual tumour size.
Published: 2021

20. Psychological distress among elderly surgical patients who had their surgery postponed during the COVID-19 pandemic

Author: Pui San Loh, Sook Hui Chaw, Yi Xian Foong, Dhurgka Ramasamy, Rafdzah Ahmad Zaki, Shanggar Kuppusamy, Teng Aik Ong, Mee Hoong See, and Hui Min Khor
Abstract: Background Many institutions withheld elective lists and triaged surgeries during the peak of coronavirus disease 2019 (COVID-19) pandemic. As a result, older surgical patients have had to wait for rescheduled dates in a long waitlist. This study aimed to identify the psychological impact in these patients when they returned for surgery. Methods This was a cross-sectional study which included 153 patients aged ≥ 65 years undergoing elective surgery. Trained interviewers recruited and assessed psychological status pre-operatively with two validated questionnaires - Hospital Anxiety and Depression Scale (HADS) and 36-item Short Form Health Survey (SF-36). Specific questions were asked about their postponed surgeries, appetite and fear. Results A total of 36 out of 153 (23.5%) patients had their procedures deferred during the first wave of COVID-19 pandemic. Postponed cases were significantly based on the nature of surgery (p = 0.002), cancer diagnosis (p = 0.006) and surgical specialty (p = 0.023). Median HADS scores were higher for patients who were postponed (2.00 versus 4.00 for anxiety, p = 0.180 and 0.00 versus 1.00 for depression, p = 0.424) although no statistical significance was shown. In the whole study population, anxiety was a significant predictor for depression and vice versa (p p = 0.018), female (OR 2.41, p = 0.024), cancer (OR 2.19, p = 0.039) and major surgery (OR 2.39, p = 0.023). Similarly, older patients ≥ 85 years old (OR 10.44, p = 0.003) and female (OR 6.07, p = 0.006) had higher risk for depression. Both anxiety and depression were significant risks for loss of appetite (p = 0.005 and 0.001). Lastly, the fear of disease progression due to rescheduling was more frequent in cancer patients (p = 0.035). Conclusion The mental health and disease burden of older surgical patients should be taken into careful consideration when cases need to be postponed in our healthcare system.
Published: 2021

21. Evaluation of skin dose and skin toxicity in patients undergoing intraoperative radiotherapy for early breast cancer

Author: Suniza Jamaris, Zainor Zaili, Anita Zarina Bustam, Marniza Saad, Jeannie Hsiu Ding Wong, Joanne Aisha Mosiun, Ngie Min Ung, Rozita Abdul Malik, Nur Aishah Taib, and Mee Hoong See
Subjects: local complications, medicine.medical_treatment, IORT, Breast Neoplasms, Mastectomy, Segmental, Breast cancer, Dosimetry, Radiochromic film, medicine, Humans, Radiation Oncology Physics, Radiology, Nuclear Medicine and imaging, External beam radiotherapy, Prospective Studies, Prospective cohort study, Radiation Injuries, Instrumentation, Early breast cancer, Aged, Radiation, integumentary system, business.industry, INTRABEAM system, Skin dose, medicine.disease, skin toxicity, Skin toxicity, Female, Neoplasm Recurrence, Local, business, Nuclear medicine, Intraoperative radiotherapy
Abstract: Purpose This study aims to evaluate in vivo skin dose delivered by intraoperative radiotherapy (IORT) and determine the factors associated with an increased risk of radiation‐induced skin toxicity. Methodology A total of 21 breast cancer patients who underwent breast‐conserving surgery and IORT, either as IORT alone or IORT boost plus external beam radiotherapy (EBRT), were recruited in this prospective study. EBT3 film was calibrated in water and used to measure skin dose during IORT at concentric circles of 5 mm and 40 mm away from the applicator. For patients who also had EBRT, the maximum skin dose was estimated using the radiotherapy treatment planning system. Mid‐term skin toxicities were evaluated at 3 and 6 months post‐IORT. Results The average skin dose at 5 mm and 40 mm away from the applicator was 3.07 ± 0.82 Gy and 0.99 ± 0.28 Gy, respectively. Patients treated with IORT boost plus EBRT received an additional skin dose of 41.07 ± 1.57 Gy from the EBRT component. At 3 months post‐IORT, 86% of patients showed no evidence of skin toxicity. However, the number of patients suffering from skin toxicity increased from 15% to 38% at 6 months post‐IORT. We found no association between the IORT alone or with the IORT boost plus EBRT and skin toxicity. Older age was associated with increased risk of skin toxicities. A mathematical model was derived to predict skin dose. Conclusion EBT3 film is a suitable dosimeter for in vivo skin dosimetry in IORT, providing patient‐specific skin doses. Both IORT alone and IORT boost techniques resulted in similar skin toxicity rates.
Published: 2021

22. Breast cancer hormone receptor testing in Asia: is it time to think again on expected positivity rates and methods of scoring?

Author: Mee Hoong See, Kumar Ganesan, Lai-Meng Looi, Kean-Hooi Teoh, and Anthony Rhodes
Subjects: Adult, Aged, 80 and over, Oncology, medicine.medical_specialty, business.industry, Malaysia, MEDLINE, Breast Neoplasms, Middle Aged, medicine.disease, Pathology and Forensic Medicine, Breast cancer, Receptors, Estrogen, Reference Values, Hormone receptor, Internal medicine, Biomarkers, Tumor, Humans, Medicine, Female, Receptors, Progesterone, business, Aged
Published: 2020

23. Adherence rate and the factors contribute toward the surgical adherence of breast cancer in Malaysia

Author: Tania Islam, Adlinda Alip, Nur Aishah Taib, Mao Li Cheng, Siamala Sinnadurai, Mee Hoong See, and Chong Guan Ng
Subjects: Oncology, medicine.medical_specialty, business.industry, Malaysia, MEDLINE, Breast Neoplasms, medicine.disease, Medication Adherence, Breast cancer, Internal medicine, Internal Medicine, Humans, Medicine, Female, Surgery, business
Published: 2020

24. Significant factors influencing inadvertent hypothermia in pediatric anesthesia

Author: Lucy Chan, Kee-Seong Ng, Lee-Lee Lai, Mee Hoong See, and Sanjay Rampal
Subjects: Male, medicine.medical_specialty, Time Factors, Health Informatics, Hypothermia, Critical Care and Intensive Care Medicine, Body Temperature, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Monitoring, Intraoperative, Anesthesiology, Pediatric surgery, medicine, Coagulopathy, Humans, Anesthesia, Postoperative Period, Prospective Studies, Child, Intraoperative Complications, Prospective cohort study, Monitoring, Physiologic, business.industry, Incidence, Infant, Newborn, Infant, 030208 emergency & critical care medicine, medicine.disease, Operating table, Anesthesiology and Pain Medicine, Child, Preschool, Shivering, Female, medicine.symptom, Skin Temperature, Pediatric anesthesia, business, Body Temperature Regulation
Abstract: Thermal imbalances are very common during surgery. Hypothermia exposes the patient to post-operative shivering, cardiac dysfunction, coagulopathy, bleeding, wound infection, delayed anesthesia recovery, prolonged hospital stay and increased hospitalization cost. There are many factors contributing to intraoperative hypothermia. This is a prospective cohort study conducted through observation and measurement of pediatric surgical patients' temperature. Convenience sampling methods were used in this study. Initial skin temperature and core temperature at 10 min, 30 min,1 h, 2 h, 3 h, 4 h, 5 h, 6 h and at the end of surgery were recorded. Body temperature was monitored from time of transfer to the operating table until recovery and discharge to the respective pediatric ward. The overall incidence of intraoperative hypothermia was still very high at about 46.6% even though active and passive temperature management were carried out during surgery. Patient's age, body weight, duration of surgery, type of surgery, intraoperative blood loss, type of anesthesia and operating room temperature were factors that contributed to intraoperative hypothermia. Hypothermia is common in surgery, especially in major and long duration surgery. Intraoperative hypothermia can be life threatening if it is not handled carefully. Various methods are used before, during and after surgery to maintain a patient's body temperature within the normothermia range. The use of an active warming device like the Bair Hugger® air-forced warming system seems to be a good method for reducing the risk of intraoperative hypothermia and effectively maintaining body temperature for all major and minor surgeries.
Published: 2019

25. Gastrointestinal tract metastasis presenting as intussusception in invasive lobular carcinoma of the breast: A case report

Author: Muhammad Syafiq bin Idris, Joanne Aisha Mosiun, Mee Hoong See, Mei Sze Teh, Li Ying Teoh, and Patricia Ann Chandran
Subjects: medicine.medical_specialty, medicine.medical_treatment, Asymptomatic, Article, Metastasis, 03 medical and health sciences, Breast cancer, 0302 clinical medicine, Gastrointestinal metastasis, Case report, medicine, skin and connective tissue diseases, business.industry, Invasive lobular carcinoma, medicine.disease, Abdominal mass, 030220 oncology & carcinogenesis, Hormonal therapy, 030211 gastroenterology & hepatology, Surgery, Radiology, medicine.symptom, business, human activities, Intussusception, Mastectomy, Invasive Lobular Breast Carcinoma
Abstract: Highlights • Gastrointestinal (GI) tract metastasis in breast cancer is rare and occurs more commonly in invasive lobular carcinoma. • The interval between the index breast cancer and GI tract spread may be as long as 30 years. • 20% of patients with GI tract metastasis are asymptomatic, and detection may rely on physical examination and imaging. • Management follows the principles of treatment in systemic disease in breast cancer, with consideration for surgery in obstruction, perforation or bleeding., Introduction Breast cancer metastasis to the gastrointestinal (GI) tract is rare and occurs more frequently in invasive lobular carcinoma. Patients may be asymptomatic or present with variable vague symptoms that may be mistakenly attributed to side effects of chemotherapy or other benign GI diseases. Treatment follows the principles of systemic disease and includes hormonal therapy, chemotherapy and signal transduction inhibitors, with surgical intervention indicated for complications such as obstruction, perforation and hemorrhage. Presentation of case We present the case of a female patient with a history of invasive lobular breast carcinoma who had undergone mastectomy and axillary dissection, followed by chemoradiotherapy. Over the next nine years, she developed ovarian and bone metastases for which appropriate treatment was provided. A right iliac fossa mass was discovered during routine clinic review, though she remained asymptomatic. Computed tomography scan showed ileocecal intussusception. Histopathological examination of the right hemicolectomy specimen following emergency surgery confirmed metastatic invasive lobular carcinoma to the GI tract. Discussion GI tract metastasis may present 30 years after the primary breast cancer. Up to 20% of patients may be asymptomatic as shown by Montagna et al. When present, symptoms are commonly non-specific and vague. Histological diagnosis is challenging. GI metastasis typically appears as intramural infiltration of the bowel wall by small cells arranged in cords. Conclusion It is important to maintain a suspicion for GI tract metastasis in breast cancer patients who present with abdominal mass or GI symptoms, as this aids in prompt institution of accurate and appropriate management.
Published: 2019

26. A Novel Algorithm for Breast Lesion Detection Using Textons and Local Configuration Pattern Features With Ultrasound Imagery

Author: Sook Sam Leong, Edward J. Ciaccio, Gustavo Ramirez-Gonzalez, U. Rajendra Acharya, Joel En Wei Koh, Kristen M. Meiburger, Ángela Chantre-Astaiza, Anushya Vijayananthan, Caroline Judy Westerhout, Mee Hoong See, Nur Aishah Taib, Kartini Rahmat, N. Arunkumar, and Farhana Fadzli
Subjects: medicine.medical_specialty, General Computer Science, texton, 02 engineering and technology, Lesion, 03 medical and health sciences, Breast cancer screening, Engineering (all), 0302 clinical medicine, Breast cancer, malignant, 0202 electrical engineering, electronic engineering, information engineering, medicine, Mammography, General Materials Science, Segmentation, Breast, image, skin and connective tissue diseases, classifier, medicine.diagnostic_test, ultrasound, business.industry, Texton, Computer Science (all), Ultrasound, General Engineering, medicine.disease, local configuration pattern, Local configuration, 020201 artificial intelligence & image processing, lcsh:Electrical engineering. Electronics. Nuclear engineering, Materials Science (all), Radiology, benign, medicine.symptom, business, lcsh:TK1-9971, 030217 neurology & neurosurgery
Abstract: Breast cancer is the most commonly occurring cancer in women worldwide. While mammography remains the gold standard in breast cancer screening, ultrasound is an important imaging modality for both screening and cancer diagnosis. This paper presents a novel method for the detection of breast lesions in ultrasound images using texton filter banks, local configuration pattern features, and classification, without employing any segmentation technique. The developed method was able to accurately detect and classify breast lesions and achieved an accuracy, sensitivity, specificity, and positive predictive value of 96.1%, 96.5%, 95.3%, and 97.9%, respectively. The paradigm that we describe may, therefore, be useful as an effective tool to detect breast nodules during screening and in whole breast imaging, enabling clinicians to focus on images where a lesion is already known to be present. The developed method may also serve as a component for automatic breast nodule detection, and, when found, for the subsequent classification between lesion type benign versus malignant.
Published: 2019

27. Characterisation of protein-truncating and missense variants in PALB2 in 15 768 women from Malaysia and Singapore

Author: Joanna Lim, Rick A. C. M. Boonen, Milan Sharma, Ern Yu Tan, Craig Luccarini, Su-Ming Tan, Jingmei Li, Douglas F. Easton, Sabine Knaup, Benita Kiat Tee Tan, Soo Hwang Teo, Weang Kee Ho, Alison M. Dunning, Chan Eng Chong, Shivaani Mariapun, Kartini Rahmat, Sara Carvalho, Rob M. van Dam, Mee Hoong See, Eldarina Wijaya, Pei Sze Ng, Caroline Baynes, Swee Ho Lim, Antonis C. Antoniou, Sook-Yee Yoon, Haico van Attikum, Mikael Hartman, Cheng Har Yip, Nur Aishah Taib, Veronique Kiat-Mien Tan, Ng, Pei Sze [0000-0001-5403-2065], Yoon, Sook-Yee [0000-0002-9992-0901], Teo, Soo Hwang [0000-0002-0444-590X], and Apollo - University of Cambridge Repository
Subjects: Male, 0301 basic medicine, PALB2, Population, Breast Neoplasms, Biology, Germline, Mice, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Germline mutation, Genetics, medicine, Animals, Humans, Missense mutation, education, Cancer genetics, Genetics (clinical), genetic predisposition to disease, Singapore, education.field_of_study, Malaysia, medicine.disease, 3. Good health, 030104 developmental biology, 030220 oncology & carcinogenesis, Relative risk, Mutation testing, Female, Fanconi Anemia Complementation Group N Protein, germ-line mutation
Abstract: BackgroundRare protein-truncating variants (PTVs) in partner and localiser of BRCA2 (PALB2) confer increased risk to breast cancer, but relatively few studies have reported the prevalence in South-East Asian populations. Here, we describe the prevalence of rare variants in PALB2 in a population-based study of 7840 breast cancer cases and 7928 healthy Chinese, Malay and Indian women from Malaysia and Singapore, and describe the functional impact of germline missense variants identified in this population.MethodsMutation testing was performed on germline DNA (n=15 768) using targeted sequencing panels. The functional impact of missense variants was tested in mouse embryonic stem cell based functional assays.ResultsPTVs in PALB2 were found in 0.73% of breast cancer patients and 0.14% of healthy individuals (OR=5.44; 95% CI 2.85 to 10.39, pPALB2 were not associated with increased risk of breast cancer. Whereas PTVs were associated with later stage of presentation and higher-grade tumours, no significant association was observed with missense variants in PALB2. However, two novel rare missense variants (p.L1027R and p.G1043V) produced unstable proteins and resulted in a decrease in homologous recombination-mediated repair of DNA double-strand breaks.ConclusionDespite genetic and lifestyle differences between Asian and other populations, the population prevalence of PALB2 PTVs and associated relative risk of breast cancer, are similar to those reported in European populations.
Published: 2021

28. Psychological distress among cancer survivors during implementation of a nationwide Movement Control Order over the COVID-19 pandemic

Author: Li Ping Wong, Peter Seah Keng Tok, Lee-Lee Lai, Haridah Alias, Mahmoud Danaee, Chuo Yew Ting, and Mee Hoong See
Subjects: COVID-19 pandemic, Psychological distress, Anxiety, Hospital Anxiety and Depression Scale, Structural equation modeling, 03 medical and health sciences, 0302 clinical medicine, Cancer Survivors, Neoplasms, Surveys and Questionnaires, Pandemic, Physiological Distress, medicine, Humans, Health belief model, 030212 general & internal medicine, Pandemics, Depression (differential diagnoses), Depression, SARS-CoV-2, business.industry, Nursing research, Malaysia, COVID-19, Distress, Oncology, 030220 oncology & carcinogenesis, Original Article, medicine.symptom, business, Stress, Psychological, Clinical psychology
Abstract: Objectives This study aimed to investigate the psychological distress and its associated factors among cancer survivors in Malaysia during the COVID-19 pandemic. Methods An anonymous Internet-based study was conducted between 23 April and 26 June 2020. During the study period, the country underwent phase 3 and phase 4 of the Movement ControlOrder (MCO), ConditionalMovement ControlOrder (CMCO), and Recovery Movement Control Order (RMCO). Psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS), which is a 14-item self-assessment scale for measuring distress (total HADS score; HADS-T) with two subscales, namely, anxiety (HADS-A) and depression (HADS-D). Perceived threat of infection was measured based on the health belief model. Results From a total of 631 responses received, the proportion of participants with anxiety and depression symptoms (above threshold score of 8 on HADS-A and HADS-D) was 29.0 and 20.9%, respectively. Psychological distress (HADS-T > 16) was reported in 22.3% of the respondents. A total of 16.5% had combined anxiety and depression symptoms. The highest HADS-A (6.10; 95%CI 5.64–6.56), HADS-D (5.61; 95%CI 5.14–6.08), and HADS-T (11.71; 95%CI 10.84–12.58) scores were reported among respondents during phase 4 of the MCO. Partial least square-based structural equation modelling (PLS-SEM) revealed that self-perceived health status, perceived susceptibility, and severity of COVID-19 have the greatest effect, leading to higher HADS-A, HADS-D, and HADS-T scores. Conclusion Heightened psychological distress was evident in cancer survivors particularly during the enforcement of the MCO over COVID-19. Providing support to address cancer survivors’ psychological and emotional needs during the COVID-19 pandemic is essential.
Published: 2021

29. Outcomes of Asian Women Treated With Grisotti Flap Reconstruction for Centrally Located Breast Cancers: 5-Years Single Institutional Experience

Author: Mei Sze Teh, Lee-Lee Lai, Suniza Jamaris, Mee Hoong See, and Li-Ying Teoh
Subjects: medicine.medical_specialty, medicine.medical_treatment, Breast surgery, Mammaplasty, Breast Neoplasms, Mastectomy, Segmental, Breast cancer, medicine, Humans, Prospective Studies, Stage (cooking), Prospective cohort study, Mastectomy, Retrospective Studies, business.industry, Retrospective cohort study, Middle Aged, medicine.disease, Surgery, Oncoplastic Surgery, Treatment Outcome, Female, Neoplasm Recurrence, Local, business
Abstract: Introduction Breast conserving surgeries were previously contraindicated for central breast cancers because of poor cosmetic outcomes of central mastectomy without oncoplastic surgery. Grisotti flap is a breast-conserving surgery incorporating oncoplastic surgery technique for centrally located breast cancers. We present our experience and outcome from Breast Surgery Unit, University Malaya Medical Center. Materials and methods A prospective analysis of 15 patients with central retroareolar breast cancer operated from 2012 to 2018 in University Malaya Medical Center. We assessed postoperative complications, margins, locoregional recurrence, and survival outcome. All patients received postoperative radiotherapy. Patients were followed-up 1 week, 1 month, 3 monthly for 1 year and 6 monthly for 5 years. Results Mean age of patients is 62 years. Mean follow-up is 51 months (15-84 months). All tumors were less than 5 cm (1-2.5 cm). Majority of the patients are stage 1 (6 patients/40%) and stage 2 (8 patients/ 53.3%). 2 patients had surgical site infection resolved with antibiotics. One patient had hematoma. None require reoperation. Tumor margins were clear in all patients. No locoregional recurrence. Overall survival is 100%. All are satisfied with their cosmetic outcomes. Conclusions Grisotti flap is a volume displacement technique, which provides satisfactory cosmetic outcome for centrally located breast cancer. This evolutionary thinking leads us to changes in existing techniques with the purpose of achieving oncological safety while reaching for better esthetic results. Our 5 years' experience in Asian population showed that this technique is oncologically safe with good cosmetic outcomes and could be used selectively. It provides a good alternative in patients who are otherwise subjected for mastectomy. This relatively simple technique is a worthwhile endeavor and should be offered when feasible.
Published: 2021

30. Baseline cardiovascular comorbidities, and the influence on cancer treatment decision-making in women with breast cancer

Author: Alan Fong, Andrea Richard, Kok Han Chee, Mee Hoong See, Nirmala Bhoo-Pathy, Ros Suzanna Bustamam, Shridevi Subramaniam, Yek-Ching Kong, Hafizah Zaharah, Cheng Har Yip, Azura Deniel, Nur Aishah Taib, and Cuno S.P.M. Uiterwaal
Subjects: cardiovascular risk factors, Cancer Research, medicine.medical_specialty, Cardiotoxicity, Framingham Risk Score, business.industry, Research, cardiotoxicity, Cancer, Disease, Odds ratio, medicine.disease, Breast cancer, breast cancer, Oncology, Internal medicine, Diabetes mellitus, medicine, business, Stroke
Abstract: Purpose To measure the baseline prevalence of cardiovascular disease (CVD), its modifiable and non-modifiable risk factors in breast cancer patients, and determine their association with adjuvant treatment decision-making. Method From 2016 to 2017, 2,127 women newly-diagnosed with breast cancer were prospectively recruited. Participants' cardiovascular biomarkers were measured prior to adjuvant treatment decision-making. Clinical data and medical histories were obtained from hospital records. Adjuvant treatment decisions were collated 6-8 months after recruitment. A priori risk of cardiotoxicity was predicted using the Cardiotoxicity Risk Score. Results Mean age was 54 years. Eighty-five patients had pre-existing cardiac diseases and 30 had prior stroke. Baseline prevalence of hypertension was 47.8%. Close to 20% had diabetes mellitus, or were obese. Dyslipidaemia was present in 65.3%. The proportion of women presenting with ≥2 modifiable CVD risk factors at initial cancer diagnosis was substantial, irrespective of age. Significant ethnic variations were observed. Multivariable analyses showed that pre-existing CVD was consistently associated with lower administration of adjuvant breast cancer therapies (odds ratio for chemotherapy: 0.32, 95% confidence interval: 0.17-0.58). However, presence of multiple risk factors of CVD did not appear to influence adjuvant treatment decision-making. In this study, 63.6% of patients were predicted to have high risks of developing cardiotoxicities attributed to a high baseline burden of CVD risk factors and anthracycline administration. Conclusion While recent guidelines recommend routine assessment of cardiovascular comorbidities in cancer patients prior to initiation of anticancer therapies, this study highlights the prevailing gap in knowledge on how such data may be used to optimise cancer treatment decision-making.
Published: 2021

31. 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, 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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, Andrea Carolina Perea Serna, July, Ríos, Gabriel, Ríos-Samper, Juan David Rivera Garcia, Juan Camilo Salcedo Moreno, John, Sandoval, Guillermo Alberto Sarmiento Ramirez, Paola Andrea Tabares Romero, Ricardo, Urzola, Iliana Maria Valdes-Duque, Miguel, Velasquez, Lina Maria Villegas, James, Zapata-Copete, José Omar Zorrilla Lara, Mauricio Zuluaga Zuluaga, Alejandra Echeverri Moreno, Juan Sebastian Figueroa, Adolfo Enrique Gómez Ortiz, Maria Fernanda Gonzalez Mosos, Alejandro, González-Orozco, Juan Jose Jaramillo Roncancio, María Camila Leyva Martínez, Monica, Mosos, Juan Sebastian Ramirez, Henry Andrés Rodríguez, Juan David Saavedra Henao, María Alejandra Torrado Varón, Leidy Natalia Idarraga Ramírez, Lorena, Ocampo, Monica Cardona Marin, Ana Maria Marin Gonzalez, David Alejandro Mejia, Luis Emiro Vanegas, Yicel Alvarez Martinez, Sandra Aruachan Vesga, Dayana Vanessa Baron Fuentes, Alejandra Caballero Salas, Gustavo Antonio Martinez Estrada, Kelly Viloria Campo, Juan Antonio Corralez 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, Vanja, Žufić, Matea, Zuzul, Srdan Ante Anzic, Iva, Carevic, Dubravka Heli Litvic, Duska, Markov-Glavas, Tatjana Savic Jovanovic, Goran, Augustin, Jerko, Biloš, Bojan, Biočina, Vedrana, Biosic, Dino, Bobovec, Iva, Botica, Boris, Bumber, Petra, Čerina, Katarina Duric Vukovic, Hrvoje, Gasparovic, Lucija, Gatin, Kresimir, Grsic, Ika Gugić Radojković, Ivan, Jelčić, Zeljko, Kastelan, Juraj, Kolak, Tomislav, Kulis, Kristian, Kunjko, Marjan, Maric, Marcel Marjanović Kavanagh, Borna, Milicic, Trpimir, Morić, Miram, Pasini, Luka, Penezić, Drago, Prgomet, Ratko, Prstacic, Andreja, Prtorić, Rudolf, Radojković, Ivan, Romić, Tomislav, Sečan, Dora Škrljak Šoša, Juraj, Slipac, Mislav, Tomic, Jurica, Zedelj, Toni, Zekulić, Zoran, Zimak, Mia, Lorencin, Ivica, Luksic, Matija, Mamic, Norberto Miranda Espinsa, Ailén Sánchez Cruz, Stavros, A Antoniou, Michael, Kakas, Yiannis, Panayiotou, Heyam, Almezghwi, Kalbim, Arslan, Hasan, Besim, Ali, Özant, Necdet, Özçay, Georgios, Kokkinos, Panayiotis, Papatheodorou, 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, Abdelmajeed, Mostafa, Abdou, Ahmed Abo Shanab, Aya, Abodeeb, Roger, Aboelkhel, Nour Eldin Abosamak, Amna Abou Bakr, Samar, Aboubakr, Yossof, Abouelnagah, Omar, Aboumadawy, Dina, Adel, Nermeen, Afifi, Sara, Ahmed, Abedelrahman, Ahmed, Mohamed Al Sayed, Abdelrahman, Alberkamy, Mohamed, Aldahma, Ahmed, Ali, Mostafa, Ali, Mohamed Amin Bakr, Alaa, Anter, Doaa, Asal, Fouad, Ashoush, Olfat, Ashraf, Abdel Rahman Ashraf, Rewan, Atta, Salma, Badr, Mohamed, Bahaaeldin, Mostafa, Bastawesy, Sara, Darwish, Rasha El Kharashy, Ziad, Elassar, Seifeldin, Elbadawy, Dina, Elkhity, Alromisaa, Elsaka, Manal, Elsayed, Mostafa Elsayed Elsayed Hewalla, Mohamed, Elshafey, Youssof, Eshac, Fares, Eshac, Amr, Essameldin, Moataz, Ewedah, Yara, Ezz, Mohamed, Farag, Inas, Gadelkarim, Ziyad, Gadelrab, Dina, Gamal, Mira, Ghaly, Nathalie, Girgis, Omar, Gouda, Nancy, H El Goweini, Nour, Hafez, Youssef, Hafez, Abdelkader Hamed Abdin, Rodina, Hanno, Aliaa, Hassanin, Mohamed, Hassanin, Hanan, M Hemead, Abdelrahman, Hemida, 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, Abdelrahman, Elgendy, Rewan, Elhawary, Sherif, Eltregy, Mahmoud, Hamdy, Gehad, Hassan, Aya, Khalifa, Ahmed, Mahmoud, Ahmed Mohamed Altukhy, Kareem, Noah, Yasser, Noureldin, Mostafa, Nowar, Moustafa, Saad, Ahmed Saad Elsaeidy, Khaled Saad Elsaeidy, Hesham, Sabry, Mostafa, Sameh, Ahmed Tarek Said-Elnaby, Mohamed, Zahed, Mohamed, Zahran, Abdelrahman, Zaid, Ahmed Zaki Zoghary, Mohamed, Atef, Ahmed, Mohamed, Mohamed, Youssef, Mahmoud Hossameldin Saad Abdelhamid, Emad, Alazab, Ahmed, K Awad, Amr, Darwesh, Lobna El Fiky, Ibrahim, Elgarhy, Mohamed Adel Nassef, Mahmoud, Shaban, Mahmoud Mohamed Mohamed Shalaby, Abdelrahman, Wahba, Omar Youssif Omar Fouad, Menan, Elsadek, Dalia, Gad, Ahmed, Abdelsamed, Abdulhakeem, Bayomy, Mohamed, Elsalhy, Ahmed, Fahim, Ahmed, Seleim, Eman, Afifi, Fatma Alzahraa Gamal, Mennatullah, Gamal, Omnia, Eldesouky, Mohamed Hatem Elmetwalli Eldwini Eldwini, Mostafa Medhat Fahmy Fahmy, Ahmed, Hussein, Abdallah, Ouf, Omar, Sami, Salem, Shaat, Abdullah Wael Mostafa Khalil Bahi, Abdurhman, Atea, Ibrahim, Gamal, Mohamed El Kassas, Wael, Omar, Ahmed, Tawheed, Saeid, Al-Oribi, Nuran Khaled Aly, Mahmoud, Elfiky, Alaa Eldine Elmaghraby, Abdulrahman, Elrahmany, Motaz, Elsherbeeny, Youssef, Helmy, Ahmed, Nabil, Ahmed Samir Farahat, Mostafa, Soliman, Amr, Wassef, Abdelrahman, Abdelrahman, Seif, Elsaban, Galal, Ghaly, Rana, Hamdy, Hamada, Mondy, Lubna, Abdallah, Abdelrhman Kz Darwish, Mohamed, Rabea, Mohammed, A Azab, Alzhraa Salah Abbas, Marwa, El-Deeb, Mohamed, Fawzy, Maher, Ibraheem, Abdelrahman, Bakry, Sarah, Elnems, Randa, Elsheikh, Mohamed Ibrahim Gbreel, Mahmoud, Hafez, Mohamed, Jammal, Khaled, M Hamam, Abdelrahman, M Makram, Omar Mohamed Makram, Salma, Rabie, Sherine Yousery Askalany, Mokhtar Mohamed Ibrahim Abushanab, Abdulrahman, Eid, Mohammed Refaat Ibrahiem Amin El Ghalid, Ahmed Adel Abdelaty, Elsayed, A Fayad, Asmaa, Radwan, Moataz, Sallam, Ahmad, Shokry, Ahmed Mohamed Farouk, Ahmed, Elfallal, Hossam, Elfeki, Mohamed, Elsaeed, Mahmoud, Elsaid, Amany, 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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 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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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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, 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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, 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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, Pedrazzani, Tommaso, Pollini, Simone, Rattizzato, Andrea, Ruzzenente, Roberto, Salvia, Giulia, Turri, Matilde, Bacchion, Giovanni, Butturini, Andrea, Casaril, Alessandro, Giardino, Harmony, Impellizzeri, Marco, Inama, Frigerio, Isabella, Gianluigi, Moretto, Marco De Zuanni, Enrica, Deiana, Mario, Guglielmo, Alessandro, Broglia, Claudia, Casarini, Caterina Costanza Zingaretti, Marta, Bonaldi, Giovanni, Cesana, Francesco, Mastriale, Stefano, Olmi, Matteo Uccelli Yasuyuki Fukami, Takuya, Saito, Tsuyoshi, Sano, Naoki, Hirai, Kazuyoshi, Hirota, Tetsuya, Kushikata, Tasuku, Oyama, Junichi, Saito, Katsuhiko, Ishibashi, Mizue, Kamiyama, Kyongsuk, Son, Kentaroh, Tarao, Takayuki, Yamada, Toshiya, Shiga, Chisaki, Aze, Yoshihiko, Deguchi, Hirotoshi, Hasegawa, Tatsuki, Hoshino, Yasushi, Innami, Hiroyuki, Inoue, Shingo, Ito, Takeshi, Nomura, Tomomi, Ogihara, Reina, Okada, Takashi, Ouchi, Yuri, Sekiya, Keikoku, Tachibana, Emi, Takano, Masae, Yamamoto, Shuko, Matsuda, Yuka, Matsuki, Kenji, Shigemi, 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Mubaydeen, Husam, Sarayrah, Mohammad Abdel Elah, A Tarawneh, Mohammad Yousef Karasneh, Amany, Zurgan, Mohammad, Alassaf, Sayel, H Alzraikat, Justin, Z Amarin, Ahmed, Hijjawi, Haya, H Suradi, Louay, Y Zaghlol, Ahmad, Abdalah, Ghaida, Abdallah, Ammar Abu Tarieh, Tareq, Abu-Libdeh, Faisal, Abualteen, Murad Al Abdallah, Zakaria Al Bdour, Seif Al Dahabrh, Farah, Al-Kasaji, Zaid Al-Sheikh Ali, Mohammad, Al-Thaher, Tareq, Alnajjar, Mohannad, Alqedrh, Mohammad, Alsaleh, Mohammad, Alzaatreh, Ghandi, Amayreh, Yazeed, Ayasra, Ahmad, Eid, Ibrahim, Ghayada, Khaled Moh'd Ahmed Hasanein, Anas, Hassouneh, Raid, Hijazeen, Majedah, Hmeidan, Ahmed, Khaled, Barihan, Khasawneh, Omar, Kifayeh, Yasser, Lafi, Jasem, Seba, Qusai, Semrin, Fda, Sma, Mohammad, Theab, Haitham, Tumeh, Muna Aba Zaid, Alaa, Abazeed, Bader, Abbad, Osaid, Abbadi, Nizar, Abu-Ishkerih, Malk, Al-Osta, Reham, Al-Zyadat, Bashar Omar Falah Alawneh, Majd, Alhattab, Mohd Mujahed Alkurdieh, Ziad, Awwad, Mohammad, Hammouri, Hamzeh, Hussein, 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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 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Antonio Galindo Nava, Blanca, Santos, Juan Roberto Torres Cisneros, Katya, Bozada-Gutiérrez, Jose Jesus Herrera, Mucio Moreno Portillo, Francisco Pérez López, Mario, Trejo-Avila, Carlos Valenzuela Salazar, Maria Regina Alvarez, Fernando, Cordera, Marco Antonio de la Rosa Abaroa, Antonio, Gómez-Pedraza, Roberto, Hernandez, Antonio, Maffuz-Aziz, José Antonio Posada, Carlos Robles Vidal, Jose-Luis, Beristain-Hernandez, Blas Eduardo Quintero Sada, Nicolás Uxmal Soruco Heredia, Ernesto, Anaya, Ricardo, Arceo-Olaiz, Bernardo Gutiérrez Sougarret, Sonia Lopez Flores, Francisco, J Ochoa Carrillo, Raymundo Alfredo Pérez Uribe, Ludwigvan Adriano Bustamante Silva, Arianne, I Lupián-Angulo, Christian Enrique Soulé Martínez, Francisco César Becerra García, Ernesto Javier Guerrero Casillas, Edgar, Uribe, Nereida Esparza Arias, J Mindy Hernández-Nava, David, Isla-Ortiz, Javier, Melchor-Ruan, Esmeralda Romero Bañuelos, Rosa, Salcedo-Hernández, Diana, Vilar-Compte, Paola Zinser Peniche, Jorge, L Aguilar 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Mendoza Pedraza, Monica Noguez Castillo, Jose Anatolio Resendiz, Oscar Alejandro Sánchez García, Laura Elena Fernandez Rios, Pamela, Frigerio, Iset, Garcia, Gloria Isela Mendoza Frías, Emmanuel, Moreno, Raquel, Quiroga, Alejandra Anzures Mendoza, Arantza Govela Hinojosa, Aldo, Izaguirre, Luis Hdez Miguelena, Jose Manuel Luna Vazquez, Indalecio Barcelata Rodriguez, Raul Ramos Mange, Carlos Reyes Utrera, David Zarate Saenz, Miguel Angel Zavala Gonzalez, Francisco Andrade González, Ludivina, Cortes, David, Roman, Aaron, Sanchez, Radu, Gurghiș, Gheorghe, Rojnoveanu, Marin, Vozian, Petru, Caraja, Gheorghe, Croitor, Roman, Mosneaga, Sarnai, Erdene, Lundeg, Ganbold, Sergelen, Orgoi, Soyombo, Orsoo, Altanchimeg, Sainbayar, Erdene, Sandag, Burmaa, Sanjaa, Rita Ait Benhamou, Abdessamad El Azhari, Bennis, Ghita, Sara, Lhassani, Sidi Mamoun Louraoui, Mounir, Rghioui, Sarra, Saaf, Taha, Gadouali, Iltimass, Gouazar, Moniba, Korch, Ahmed, Letrache, Amina, Louari, Anas, Zamame, Samia, Ousouss, Meryem, 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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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Uros, Bumbasirevic, Zoran, Dzamic, Boris, Kajmaković, Bogomir, Milojevic, Nebojša, Prijović, Marko, Zivkovic, Aleksandar, Lazic, Nebojsa, Mitrovic, Dejan, Stevanovic, Marko, Buta, Ana, Cvetkovic, Igor, Djurisic, Merima, Goran, Zorka, Inic, Andjela, Ivezić, Nikola, Jeftic, Marko, Jevric, Vladimir, Jokic, Milan, Kocic, Zoran, Kozomara, Ivan, Markovic, Srdjan, Nikolic, Nada, Santrac, Nevena, Savković, Igor, Spurnic, Dobrica, Stevic, Dejan, Stojiljkovic, Jovana, Tripkovic, Nikola, Vucic, Milan, Zegarac, Tatjana, Dejanovic, Vladimir, Djukic, Srdjan, Marinković, Miljan, Milanovic, Nemanja, Pijanovic, Milena, Radosavljevic, Predrag, Savic, Dejan, Stojakov, Rastko, Živić, Sinisa, Ducic, Mikan, Lazovic, Jovana, Bojičić, Vladica, Cuk, Jovan, Juloski, Aleksandar, Karamarkovic, Marko, Kenic, Bojan, Kovacevic, Igor, Krdzic, Vladan, Milutinović, Vladimir, Djan, Velicko, Trajkovic, Dragana, Zivkovic, Aleksandar, Đermanović, Danica, Golijanin, Dejan, Lukic, Zoran, Radovanovic, Dragana, Radovanovic, 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Raquel Angulo Artal, Luis, Barbier, Guillermo, García-Operé, Marta, Jiménez-Jiménez, Héctor, Marín, Mikel, Oñate, Luis Antonio Pascua-Gómez, María Alexandra Pesántez Peralta, Ibabe Villalabeitia Ateca, Ladislao Cayetano Paniagua, Joan, Camí, Pablo, Collera, Martínez, David, Carlos Javier Gómez Díaz, Jordi Querolt Coll, M Dolors Rosines Cubells, Cristina Soto Montesinos, Guillermo, Triana, Marina, Xicola, Alfonso, Alias, Albert, Baduell, Mariano, Balaguer-Castro, María Pilar Camacho Carrasco, Marina Cámara Vallejo, Borja Campuzano Bitterling, Guillem, Claret, Francisco, J Cuesta-González, Alberto Di Somma, Joaquim Enseñat Nora, Neus, Fabregas, Ada Ferrer Fuertes, Abel, Ferrés, Cesar, Ginesta, Jose Juan Gonzalez Sanchez, Isabel, Gracia, Jhon Alexander Hoyos Castro, Montsant, Jornet-Gibert, Xavier, Morales, Alejandra, Mosteiro-Cadaval, Leire, Pedrosa, José Poblete Carrizo, Marina, Renau-Cerrillo, Luis Alberto Reyes Figueroa, Pedro Roldan Ramos, Jordi Rumià Arboix, Marta, Sabater-Martos, Josep, M Segur, Thomaz, E Topczewski, Jorge, Torales, Ramon, Torné, Pere, Torner, Ricard, Valero, Marian, Vives-Barquiel, Eulalia, Ballester, Alberto Basterra Rincon, Vitiello, Giulia, Belén Martin Arnau, Marta, Gil, Silvia, Martin, Monica, Serrano-Navidad, Mauricio Agüero Mariño, Núria Casanova Torrequebrada, Berta Fabregó Capdevila, Adrián López Campillo, Gemma, Mancebo, Ester, Miralpeix, Blanca, Montcusí, Marina, Munarriz, Ariadna, Salvadó, Josep, M Sole-Sedeno, Clara Téllez Marquès, Ana Centeno Álvarez, Ruth Lopez Gonzalez, Luisana Riba Combatti, Andrea Sanz Llorente, Miguel Bejarano Serrano, Blanca Capdevila Vilaró, Maria Coronas Soucheiron, Mario Cuesta Argos, Irene de Haro Jorge, Yaiza Galvañ Félix, Luis, García-Aparicio, Rebeca, Leal, Albert Malet Contreras, Irene, Martínez-Padilla, Clara, Massaguer, Ines Moraleda Gudayol, María Elena Muñoz Fernández, Paco, Parri, Cristina Pérez Costoya, Javier, Rojas-Ticona, Leopoldo Tapia Moral, Francisco, Vicario, Francesc Angles Crespo, David Bosch Garcia, Berta, Escudero, Carlos Garcia Cardona, Sergi, Bellmunt-Montoya, Javier de la Torre, Úrsula, Acosta, Iago Alvarez Saez, Eva Andreu Riobello, Fernando Ascanio Gosling, Jose, Bagan, Irene, Brana, Bartomeu, Caimari, Marta Cicuendez López Ocaña, Anna, Conesa, Alba de Pablo García-Cuenca, Natalija, Dediulia, Francesc, Duran-Valles, Jordi Giralt López de Sagredo, Maria Jose Gomez-Jurado, Ernesto, Guerra-Farfan, Juan Sebastian Guillén, María Guisasola Rabés, Viviana Andrea Hernández Angel, Maria Jurado Ruiz, Yuri, Loaiza, Manuel, Lopez, Susana, Manrique, Maria Dolores Mateo Arzo, Joan, Minguell-Monyart, Enric Miret Alomar, Sonia Monreal Clua, Víctor Morales Ariza, Clara Morales Comas, Judith, Murillo, Jose Maria Nieto Rodriguez, Elena Vilardell Ortiz, Jorge, Pamias, Montserrat Pascual Pascual Arellano, Remei Perera Sarri, Aleix Pons Bartroli, Nil, Prat, Alfredo Pueyo Ferrer, Rosa Pujol Pina, Jordi, Raurich-Leandro, Maria José Reche Padilla, Joaquín Rivero Déniz, Natalia, 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Alexia Victoria Paluso Montero, Natalia Pérez Romero, Adriana, Poch, Jaime Rodríguez de Alarcón, Adriana Ruano Campos, Rebeca Ruiz Roman, Patricia Saez Carlin, Cristina Sánchez Del Pueblo, Lidia Sotillo Valenzuela, Armando, Galvan, Miguel Ángel García Ureña, Enrique, González, Manuel Medina Pedrique, Alvaro Robin Valle de Lersundi, Carlos San Miguel, Juan, Aragón-Chamizo, Monica, Ballon, Jose, M Barrio, Beatriz Castro Catalan, Laura Cebolla Rojas, Renan Carlo Colombari, Miguel Cuende Diez, Paula Dujovne Lindenbaum, Oscar, Gil-de-Sagredo, Silvia Kayser Mata, Pablo Lozano Lominchar, Yeniffer Tatiana Moreno Salazar, Angela, Moreno-Gutierrez, Melanie, Morote, Uxue, Murgoitio, Nikolas Palma Caucig, Lucía Polanco Pujol, Alejandro, Prosperi, María Belén Ramírez Senent, Diego Fernando Ruiz Chiriboga, Mercedes, Sanz, Maria, Tudela, María Adrien Lara, Raquel, Alarza, Isabel Alonso Sebastian, Mariano Artés Caselles, Laura, Calles-Sastre, Marcos Casas Sánchez, Aritz Equisoain Azcona, Lucía, 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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 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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, Adham, Salma, Al-Houssami, Maram, Balouli, Yazan, Rahmeh, Simon, Yanni, Sally, Yousef, Aline, Ahmad, Marah, Ali, Abdulrahman, Almjersah, Aya, Almoustafa, Hiba, Dahhan, Bashar Haj Hassan, Alaa, Hamdan, Salah, Hammed, Rawan, Harfoush, Rama, Hasan, Natalie, Jarkas, Moufid, Mahfoud, Ahmed, Moussa, Alaa, Sulaiman, Siba, Suliman, Yu-Ning, Hu, Jun-Neng, Roan, Meng-Ta, Tsai, Yi-Chen, Wang, Thammawat, Parakonthun, Nicha, Srisuworanan, Voraboot, Taweerutchana, Somcharoen, Saeteng, Sophon, Siwachat, Apichat, Tantraworasin, Danielle, Dimsoy, Shane, Khan, Akash, Ramsaroop, Shivanand, Ramsubhagh, Karim, Ayed, Oussama, Baraket, Mohamed Hedi Ghalloussi, Abbassi, Imed, Nahla, Kechiche, Waad, Farhat, Ammar, Houssem, Erdal Birol Bostanci, Volkan, Oter, Erol, Pişkin, Cihangir, Akyol, Sibel, Demirel, Mehmet Ali Koç, Can, Konca, Özge, Yanık, Basak, Bolukbasi, Huseyin, Gobut, Emre, Gülçek, Kerim, Karabulut, Ramazan, Kozan, Farshad, Noori, Elif, Özeller, Can, Şahin, Ali, Yalcinkaya, Mesut, Yavaş, Aydın, Yavuz, Utku, Akgor, Omer, Cennet, Hilmi Anil Dincer, Murat, Gultekin, Nazlı, Orhan, Mustafa, Oruç, Serdar, Culcu, Lütfi, Doğan, Cemil, Yüksel, Alp, Yildiz, Aybala, Yildiz, Perihan, Ekmekçi, Baturay Kansu Kazbek, Ülkü Ceren Köksoy, Deniz Serim Korkmaz, Zeynep Şahan Çetinkaya, Elif Aybeniz Yildirim, Hakan, Yilmaz, Metin, Yığman, Nasuh Utku Dogan, Selen, Doğan, Mehmet, Sakinci, Ozgen, Isik, Murat, Şen, Tuncay, Yılmazlar, Utku, Özgen, Ugur, Sungurtekin, Yener, Aydin, Ilker, Ince, Ali Bilal Ulas, Hüseyin Cahit Yalçın, Mehmet, Kaplan, Tuğba, Kaplan, Elif Tugce Kaplan, Afag, Aghayeva, Bilgi, Baca, Inci, Sahin, Zumrud, Aliyeva, Akif Enes Arikan, Erman, Aytac, Onur, Dülgeroğlu, Volkan, Ozben, Cihan, Uras, Emre, Sivrikoz, Ismail Ahmet Bilgin, Bahadır, Bozkırlı, Güralp Onur Ceyhan, Ismail, Hamzaoglu, Halil, Kara, Tayfun, Karahasanoğlu, Olus, Api, Mehmet, Ceyhan, Aylin Pelin Cil, Telce Aysen Gurbuz, Cumhur, B Lent Urman, Ahmet, Akbas, Yunus Emre Aktimur, Yuksel, Altinel, Fikret, Calikoglu, Serdar, 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Malaz, Abbakar, Vanessa, Badas, Radu, Chirvasuta, Joe, Drybrough, Alexandra, Hamshere, Annabelle, Harrison, Rebecca, Ireson, Nelson, Kamali, Abigail, Lau, Sumant, Luhana, Luisa, Macdonald, Barbara, Ribeiro, Alistair, Savage, Tanisha, Sharma, Paul, Swift, Rachel, Taute, Stephanie, Alford, Chase, Elswick, J Quentin Clemens, John Michael DiBianco, Anna, Faris, Mark, Hemmila, Giulia, I Lane, Lena, Napolitano, Jane, J Wong, Shelly, Abramowicz, Dina, Amin, Steven, Roser, Daniel, Beswick, Elisa, Birnbaum, Khaled, Campa, Carolyn, Chabuz, Brandon, Chapman, Nicole, Christian, Marco Del Chiaro, Adam, Dyas, Anna, Gergen, Anne, Getz, Ana, Gleisner, Ryan, Griffin, Laura, Harmon, Scott, Hirsch, Victoria, Huynh, Juan Pablo Idrovo, Laura, Leonard, Helen, Madsen, Robert, Mcintyre, Robert, Meguid, Kenny, Rodriguez, Richard, Schulick, Christopher, Scott, Lauren, Steward, Camille, Stewart, Malcolm, Su, Sarah, Tevis, Daniel, Thieu, Shane, Urban, Catherine, Velopulos, Jon, Vogel, Thomas, Vogler, Kristen, Vossler, Michael, Weyant, Franklin, Wright, Erika, Bengtson, Mary, Bokenkamp, Hannah, Chacon, W Drew Fielder, Alex, Haynes, Charlotte, Heron, Charles, Hill, Cole, Holan, Hannah, Kay, Brian, Kelley, Sabino, Lara, Kathryn, Mcelhinney, E Charles Osterberg, Sharmila, Paul, Christopher, Riley, Ayane, Rossano, Romil, Shah, Ifeoluwa, Shoyombo, Pooja, Srikanth, Pedro, Teixeira, Marc, Trust, Marian, Williams-Brown, Benjamin, Bigelow, Ijezie, Ikwuezunma, Amit, Jain, Harsha, Malapati, Ivy, Mannoh, Adam, Margalit, Sarah, Rapaport, Srikrishna Vangipuram Suresh, Dominique, Vervoort, Lekha, Yesantharao, Zhang, Bo, Hossam, Abdou, Megan, Anders, Jose, Diaz, Michael, Mazzeffi, Peter, Rock, Salim, Afshar, Andrea, Balthazar, Laura, Carlson, Karen, Carver, Michael, Kurtz, Craig, D McClain, Meena, Nathan, Caleb, Nelson, Nathalie, Roy, Rachel, Saunders, Amir, Taghinia, Vivian, Williams, Allison, Brown, Zara, Cooper, Joshua, Jolissaint, David, Mahvi, Barbara, Okafor, Chandrajit, Raut, Vanessa, Roxo, Ciersten, 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Batko, Anthony, Colon, Sofia, Gabrilovich, Carma, Goldstein, Christina, Gory, Janmejay, Hingu, Brian, Leoce, Anh, Nguyen, Guergana, Panayotova, Ruchi, Ram, Deviney, Rattigan, Jerette, Schultz, Sara, Solar, John, Stein, Grace, Tsui, Elizabeth, Warnack, Apostolos, Gaitanidis, Leon, Naar, Robert, Sinyard, Sophia, Angelides, Laura, Fitzmaurice, Alexander, Himstead, Mehraneh, Jafari, Zeljka, Jutric, Kari, Kansal, Lydia, Kirillova, Isabella, Kuo, Kapila, Patel, Erika Linmey Tay Lasso, Maki, Yamamoto, Maleeha, Ahmad, Steven, Chang, Gary Alan Bass, Benjamin, Braslow, Daniel, Dempsey, Caoimhe, Duffy, Daniel, Holena, Jonathan, Imran, John, Keogh, Cara, Lorenzi, Niels, Martin, Mark, Seamon, Lauren, Huckaby, Katrina, Morgan, Caroline, Rieser, Lauren, Rosenblum, Cindy, Teng, J Michael DiMaio, Mohanad, Hamandi, Mary, Hoffman, Allison, T Lanfear, Michael, Connolly, Benjamin, Hall, Tareq, Kheirbek, Elizabeth, Renaud, Kevin, Behm, Judy, Boughey, Kristin Cardiel Nunez, Sean, Cleary, Mihai, Dumbrava, Travis, Grotz, James, Jakub, Rahul, Kanade, David, Larson, Sherief, Shawki, Dennis, Wigle, Haradeen, Dhillon, Avni, Suri, Leonardo Weber Graeff, Ahmed, Elshabrawy, Grace Ihsiu Todd, Mark, Davies, Yan, Qi, Walter, Biffl, Kathryn, Schaffer, Sarah, Averbach, Terry, Curry, Alexandra, Schwartz, Mary Kathryn Abel, Veronica, Andaya, Kristina, Benirschke, Katherine, Bigay, Marissa, Boeck, Lee-Lynn, Chen, Lee-May, Chen, Huey-Lan, Chern, Amanda, Compadre, Patricia, Conroy, Alexa, Glencer, Patrick, Ha, Barbara Cs Hamilton, Johannes, R Kratz, Rondall, Lane, Rex, H Lee, Brenda, Nunez-Garcia, Richard, O'Donnell, Doruk, Ozgediz, Paul, Park, Ankit, Sarin, Ipsit, Shah, Bonnie, Sheu, Madhulika, Varma, Katherine, Wai, Rosanna, Wustrack, Mary Jue Xu, Melissa, Zimel, Pedro, Escobar, Meredid Maldonado Santiago, Mohammad, Azam, Asad, Choudhry, Eric, Hammond, William, Marx, Jihad, Abbas, Somya, Al-Embideen, Carol, Angel, Bailea, Bobich, Raul, Bosio, Gregory, Georgiadis, Tahir, Jamil, Maria, Kenner, Meghan, Lark, Tamara, Maghathe, Sonia, Masih, Gabriel, Naimy, Kristin, O'Mara-Gardner, Emily, Rady, Roberta, Redfern, Jack, Sample, Joseph, Sferra, Kaitlyn, Sharp, Jessica, Shoemaker, Stephen, Stanek, John, Stengle, Hibba, Sumra, Jeffrey, M Sutton, Faris, Azar, Anne, Fischer, Jaymie, Henry, Lawrence, Lottenberg, Mario, Rueda, Sasha, Thiel, Adel, Bozorgzadeh, John, Kelly, Armando Salim Munoz Abraham, Erin, Scott, Camila, Haro, Andrés, Pouy, Gastón, Acuña, Sofia, Álvarez, Ana Carmen Carbajal, Fabiola, Castedo, Diego, Pereiranuñez, Helena, Sobrero, Josefina, Tarigo, Rafat, Al-Saban, Fatima, Al-Eryani, Siham Al Maqtari, Sahar, Al-Maqtari, Mahmmoud, Abdualqader, Majed, Aeed, Ghadeer Al Sanany, Anwaar Al Dhafif, Buthina Al Jarmozi, Saba, Al-Ameri, Awsan, Al-Dhaheri, Dhyia Alhuq Al-Surimi, Amira, Alakhdury, Sabreen, Alashmali, Zainab, Alattas, Manar, Alduba'Ai, Hamdan, Aldumaini, Wafa, Alhaddad, Abdelrahman, Alharazi, Nawal, Alhemyari, Adnan, Alhumaida, Maniee, Aljabri, Hassan, Almarashi, Zuhoor, Almohanady, Marwa, Alodine, Nooraldin, Alqasemi, Basma, Alqudaimi, Ansam Mohammed Ghaleb Alrobaiee, Mohammed, Alsabri, Radfan, Alsalal, Ramzi, Alsayadi, Musaed, Alsayadi, Reem, Alshaipani, Ebrahim, Alsharabi, Nora, Atiah, Hadeel, Bajjah, Muhib, Esmael, Asma, Ghallab, Rana, Ghannam, Adwa'A, Hamid, Lina, Hashem, Sara, Saif, Shaima, Sayad, Nawras, Shaban, Amatallah Hadi Shamsan, Sarah, Shream, Amal, Shukri, Shahd, Zeid, Nabila, Abdullah, Abdulrahman Faisal Al-Garadi, Ahmed, M Ali Al-Radhi, Norhan, Naji, Shaima'A, Nasser, Areej Taha Al Anaib, Ebrahim, Abdurab, Fadhl Al Muhtadi, Amer, Al-Hebbah, Ahmed, Al-Madhrahi, Shehab, Al-Mahdi, Sakhr Abdulhakeem Al-Maswari, Ayman, Al-Oqabi, Zakarya Abdullah Al-Zaazaai, Karim, Al-Zazay, Ali, Alafif, Asem, Albzzaz, Lina, Alqalisi, Mohammed, Alrezami, Haneen, Alshargabi, Mokhtar, Alshargabi, Hossam, Ghanem, Kareem, Saeed, Rasheed, Shalabi, Fareed, Showqi, Miriam, Maimbo, Catherine, Mkandawire, Mulaya, Mubambe, Theresa, Nkole, Vanessa, Savopoulos, Patricia, Shinondo, Chabwera, Shumba, Penias, Tembo, Shelton, Chivanga, Ngqabutho, Dube, Handsome, Dube, Daniel, Dzinotyiwei, Ronald, Makanda, Moses, Mangena, Partson, Maphosa, Derek, Matsika, Proud, Mawere, Nkosikhona, Moyo, Assel, Moyo, Arnold, Muguwu, Simbarashe, Mungazi, Garikai, Mwale, Gamuchirai, Ndabvonga, Mambote Crispin Olivier Ntoto, Hardlife, Ranganai, Ernesto Sánchez Castillo, Oltah, Tshuma, Grace, Gwini, Vimbai Moyana Muguto, Gilbert, Moyo, Trust, Mushawarima, Tinashe, Shoko, Rorisang, Jamela, Marvellous, Machiri, Eric, Shumba, Antony, Chengahomwe, Yemurai, Bikwa, Maxwell, Chimhina, Jeremy, Marume, Kudzayi, Munanzvi, Precious G, T Mutambanengwe, Federico, Ferrari, Marco, Fontanella, Franco, Odicino, Romano, Vito, Nepogodiev D, Emanuele Cammarata, Sofia Campanella, Daniela Canzonieri, Adriana Cordova, Federico De Michele, Ettore Dinoto, Mara Franza, Leo Licari, Daniele Matta, Domenico Mirabella, Felice Pecoraro, Roberto Pirrello, Pierfrancesco Pugliese, Fernando Rosatti, 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

32. Breast Cancer Polygenic Risk Score and Contralateral Breast Cancer Risk

Author: Iris Kramer, Maartje J. Hooning, Nasim Mavaddat, Michael Hauptmann, Renske Keeman, Ewout W. Steyerberg, Daniele Giardiello, Antonis C. Antoniou, Paul D.P. Pharoah, Sander Canisius, Zumuruda Abu-Ful, Irene L. Andrulis, Hoda Anton-Culver, Kristan J. Aronson, Annelie Augustinsson, Heiko Becher, Matthias W. Beckmann, Sabine Behrens, Javier Benitez, Marina Bermisheva, Natalia V. Bogdanova, Stig E. Bojesen, Manjeet K. Bolla, Bernardo Bonanni, Hiltrud Brauch, Michael Bremer, Sara Y. Brucker, Barbara Burwinkel, Jose E. Castelao, Tsun L. Chan, Jenny Chang-Claude, Stephen J. Chanock, Georgia Chenevix-Trench, Ji-Yeob Choi, Christine L. Clarke, J. Margriet Collée, Fergus J. Couch, Angela Cox, Simon S. Cross, Kamila Czene, Mary B. Daly, Peter Devilee, Thilo Dörk, Isabel dos-Santos-Silva, Alison M. Dunning, Miriam Dwek, Diana M. Eccles, D. Gareth Evans, Peter A. Fasching, Henrik Flyger, Manuela Gago-Dominguez, Montserrat García-Closas, José A. García-Sáenz, Graham G. Giles, David E. Goldgar, Anna González-Neira, Christopher A. Haiman, Niclas Håkansson, Ute Hamann, Mikael Hartman, Bernadette A.M. Heemskerk-Gerritsen, Antoinette Hollestelle, John L. Hopper, Ming-Feng Hou, Anthony Howell, Hidemi Ito, Milena Jakimovska, Anna Jakubowska, Wolfgang Janni, Esther M. John, Audrey Jung, Daehee Kang, C. Marleen Kets, Elza Khusnutdinova, Yon-Dschun Ko, Vessela N. Kristensen, Allison W. Kurian, Ava Kwong, Diether Lambrechts, Loic Le Marchand, Jingmei Li, Annika Lindblom, Jan Lubiński, Arto Mannermaa, Mehdi Manoochehri, Sara Margolin, Keitaro Matsuo, Dimitrios Mavroudis, Alfons Meindl, Roger L. Milne, Anna Marie Mulligan, Taru A. Muranen, Susan L. Neuhausen, Heli Nevanlinna, William G. Newman, Andrew F. Olshan, Janet E. Olson, Håkan Olsson, Tjoung-Won Park-Simon, Julian Peto, Christos Petridis, Dijana Plaseska-Karanfilska, Nadege Presneau, Katri Pylkäs, Paolo Radice, Gad Rennert, Atocha Romero, Rebecca Roylance, Emmanouil Saloustros, Elinor J. Sawyer, Rita K. Schmutzler, Lukas Schwentner, Christopher Scott, Mee-Hoong See, Mitul Shah, Chen-Yang Shen, Xiao-Ou Shu, Sabine Siesling, Susan Slager, Christof Sohn, Melissa C. Southey, John J. Spinelli, Jennifer Stone, William J. Tapper, Maria Tengström, Soo Hwang Teo, Mary Beth Terry, Rob A.E.M. Tollenaar, Ian Tomlinson, Melissa A. Troester, Celine M. Vachon, Chantal van Ongeval, Elke M. van Veen, Robert Winqvist, Alicja Wolk, Wei Zheng, Argyrios Ziogas, Douglas F. Easton, Per Hall, Marjanka K. Schmidt, Anne-Lise Børresen-Dale, Kristine Sahlberg, Lars Ottestad, Rolf Kåresen, Ellen Schlichting, Marit Muri Holmen, Toril Sauer, Vilde Haakensen, Olav Engebråten, Bjørn Naume, Alexander Fosså, Cecile Kiserud, Kristin Reinertsen, Åslaug Helland, Margit Riis, Jürgen Geisler, Grethe Grenaker Alnæs, Christine Clarke, Deborah Marsh, Rodney Scott, Robert Baxter, Desmond Yip, Jane Carpenter, Alison Davis, Nirmala Pathmanathan, Peter Simpson, J. Dinny Graham, Mythily Sachchithananthan, David Amor, Lesley Andrews, Yoland Antill, Rosemary Balleine, Jonathan Beesley, Ian Bennett, Michael Bogwitz, Leon Botes, Meagan Brennan, Melissa Brown, Michael Buckley, Jo Burke, Phyllis Butow, Liz Caldon, Ian Campbell, Deepa Chauhan, Manisha Chauhan, Alice Christian, Paul Cohen, Alison Colley, Ashley Crook, James Cui, Margaret Cummings, Sarah-Jane Dawson, Anna deFazio, Martin Delatycki, Rebecca Dickson, Joanne Dixon, Ted Edkins, Stacey Edwards, Gelareh Farshid, Andrew Fellows, Georgina Fenton, Michael Field, James Flanagan, Peter Fong, Laura Forrest, Stephen Fox, Juliet French, Michael Friedlander, Clara Gaff, Mike Gattas, Peter George, Sian Greening, Marion Harris, Stewart Hart, Nick Hayward, John Hopper, Cass Hoskins, Clare Hunt, Paul James, Mark Jenkins, Alexa Kidd, Judy Kirk, Jessica Koehler, James Kollias, Sunil Lakhani, Mitchell Lawrence, Geoff Lindeman, Lara Lipton, Liz Lobb, Graham Mann, Sue Anne McLachlan, Bettina Meiser, Roger Milne, Sophie Nightingale, Shona O'Connell, Sarah O'Sullivan, David Gallego Ortega, Nick Pachter, Briony Patterson, Amy Pearn, Kelly Phillips, Ellen Pieper, Edwina Rickard, Bridget Robinson, Mona Saleh, Elizabeth Salisbury, Christobel Saunders, Jodi Saunus, Clare Scott, Adrienne Sexton, Andrew Shelling, Melissa Southey, Amanda Spurdle, Jessica Taylor, Renea Taylor, Heather Thorne, Alison Trainer, Kathy Tucker, Jane Visvader, Logan Walker, Rachael Williams, Ingrid Winship, Mary Ann Young, HUS Gynecology and Obstetrics, Department of Obstetrics and Gynecology, University of Helsinki, Medical Oncology, Public Health, Clinical Genetics, TechMed Centre, and Health Technology & Services Research
Subjects: 0301 basic medicine, Oncology, Multifactorial Inheritance, PROGNOSIS, Receptor, ErbB-2, LOCI, Gene Expression, Medical and Health Sciences, Cohort Studies, 0302 clinical medicine, ErbB-2, Neoplasms, Receptors, Genetics (clinical), Progesterone, Cancer, Genetics & Heredity, Genome, Manchester Cancer Research Centre, Confounding, Hazard ratio, 1184 Genetics, developmental biology, physiology, Neoplasms, Second Primary, Biological Sciences, Middle Aged, Prognosis, Primary tumor, Neoadjuvant Therapy, 3. Good health, Women's cancers Radboud Institute for Health Sciences [Radboudumc 17], Second Primary, 030220 oncology & carcinogenesis, contralateral breast cancer, kConFab Investigators, epidemiology, Female, Risk assessment, Receptors, Progesterone, Life Sciences & Biomedicine, Cohort study, Receptor, Human, Adult, medicine.medical_specialty, ABCTB Investigators, Breast Neoplasms, Risk Assessment, White People, Article, NBCS Collaborators, 03 medical and health sciences, Breast cancer, AGE, SDG 3 - Good Health and Well-being, Asian People, Internal medicine, Breast Cancer, parasitic diseases, Genetics, medicine, Adjuvant therapy, Humans, Genetic Predisposition to Disease, Aged, Proportional Hazards Models, Science & Technology, business.industry, Proportional hazards model, Genome, Human, ResearchInstitutes_Networks_Beacons/mcrc, Prevention, 22/2 OA procedure, Estrogen Receptor alpha, medicine.disease, ASSOCIATION ANALYSIS, 030104 developmental biology, polygenic risk score, genetic, business, Genome-Wide Association Study
Abstract: Previous research has shown that polygenic risk scores (PRSs) can be used to stratify women according to their risk of developing primary invasive breast cancer. This study aimed to evaluate the association between a recently validated PRS of 313 germline variants (PRS313) and contralateral breast cancer (CBC) risk. We included 56,068 women of European ancestry diagnosed with first invasive breast cancer from 1990 onward with follow-up from the Breast Cancer Association Consortium. Metachronous CBC risk (N = 1,027) according to the distribution of PRS313 was quantified using Cox regression analyses. We assessed PRS313 interaction with age at first diagnosis, family history, morphology, ER status, PR status, and HER2 status, and (neo)adjuvant therapy. In studies of Asian women, with limited follow-up, CBC risk associated with PRS313 was assessed using logistic regression for 340 women with CBC compared with 12,133 women with unilateral breast cancer. Higher PRS313 was associated with increased CBC risk: hazard ratio per standard deviation (SD) = 1.25 (95%CI = 1.18-1.33) for Europeans, and an OR per SD = 1.15 (95%CI = 1.02-1.29) for Asians. The absolute lifetime risks of CBC, accounting for death as competing risk, were 12.4% for European women at the 10th percentile and 20.5% at the 90th percentile of PRS313. We found no evidence of confounding by or interaction with individual characteristics, characteristics of the primary tumor, or treatment. The C-index for the PRS313 alone was 0.563 (95%CI = 0.547-0.586). In conclusion, PRS313 is an independent factor associated with CBC risk and can be incorporated into CBC risk prediction models to help improve stratification and optimize surveillance and treatment strategies. ispartof: AMERICAN JOURNAL OF HUMAN GENETICS vol:107 issue:5 pages:837-848 ispartof: location:United States status: published
Published: 2020

33. Characterisation of protein-truncating and missense variants in

Author: Pei Sze, Ng, Rick Acm, Boonen, Eldarina, Wijaya, Chan Eng, Chong, Milan, Sharma, Sabine, Knaup, Shivaani, Mariapun, Weang Kee, Ho, Joanna, Lim, Sook-Yee, Yoon, Nur Aishah, Mohd Taib, Mee Hoong, See, Jingmei, Li, Swee Ho, Lim, Ern Yu, Tan, Benita Kiat-Tee, Tan, Su-Ming, Tan, Veronique Kiat-Mien, Tan, Rob Martinus, van Dam, Kartini, Rahmat, Cheng Har, Yip, Sara, Carvalho, Craig, Luccarini, Caroline, Baynes, Alison M, Dunning, Antonis, Antoniou, Haico, van Attikum, Douglas F, Easton, Mikael, Hartman, and Soo Hwang, Teo
Subjects: Male, Mice, Singapore, Malaysia, Animals, Humans, Breast Neoplasms, Female, Genetic Predisposition to Disease, Fanconi Anemia Complementation Group N Protein, Germ-Line Mutation
Abstract: Rare protein-truncating variants (PTVs) in partner and localiser of BRCA2 (Mutation testing was performed on germline DNA (n=15 768) using targeted sequencing panels. The functional impact of missense variants was tested in mouse embryonic stem cell based functional assays.PTVs inDespite genetic and lifestyle differences between Asian and other populations, the population prevalence of
Published: 2020

34. Outcomes after mastectomy with immediate breast reconstruction for breast cancer in a multiethnic, middle-income Asian setting

Author: Keh-Ling Tan, Li-Ying Teoh, Mei Sze Teh, Suniza Jamaris, Lee-Lee Lai, Nirmala Bhoo-Pathy, Siamala Sinnadurai, Mee Hoong See, and Rozita Abdul Malik
Subjects: Adult, medicine.medical_specialty, medicine.medical_treatment, Mammaplasty, Breast Neoplasms, Disease-Free Survival, Time-to-Treatment, Young Adult, Breast cancer, Postoperative Complications, Medicine, Humans, Prospective Studies, Stage (cooking), skin and connective tissue diseases, Mastectomy, Neoplasm Staging, Chemotherapy, business.industry, General surgery, Malaysia, Middle income, Odds ratio, Middle Aged, medicine.disease, Confidence interval, Chemotherapy, Adjuvant, Surgery, Female, Radiotherapy, Adjuvant, Neoplasm Recurrence, Local, business, Breast reconstruction
Abstract: Background Although immediate breast reconstruction is increasingly becoming popular worldwide, evidence from resource-limited settings is scarce. We investigated factors associated with immediate breast reconstruction in a multiethnic, middle-income Asian setting. Short-term surgical complications, timing of initiation of chemotherapy, and survival outcomes were compared between women undergoing mastectomy alone and their counterparts receiving immediate breast reconstruction. Methods This historical cohort study included women who underwent mastectomy after diagnosis with stage 0 to stage IIIa breast cancer from 2011 to 2015 in a tertiary hospital. Multivariable regression analyses were used to assess factors associated with immediate breast reconstruction and to measure clinical outcomes. Result Out of 790 patients with early breast cancer who had undergone mastectomy, only 68 (8.6%) received immediate breast reconstruction. Immediate breast reconstruction was independently associated with younger age at diagnosis, recent calendar years, Chinese ethnicity, higher education level, and invasive ductal carcinomas. Although immediate breast reconstruction was associated with a higher risk of short-term local surgical complications (adjusted odds ratio: 3.58 [95% confidence interval 1.75–7.30]), there were no significant differences in terms of delay in initiation of chemotherapy, 5-year disease-free survival, and 5-year overall survival between both groups in the multivariable analyses. Conclusion Although associated with short-term surgical complications, immediate breast reconstruction after mastectomy does not appear to be associated with delays in initiation of chemotherapy, recurrence, or mortality after breast cancer. These findings are valuable in facilitating shared surgical decision-making, improving access to immediate breast reconstruction, and setting priorities for surgical trainings in middle-income settings.
Published: 2020

35. Psychological distress among cancer survivors during implementation of a nationwide Movement Control Order over the COVID-19 pandemic

Author: Li Ping Wong, Lee Lee Lai, Mee Hoong See, Haridah Alias, Mahmoud Danaee, Chuo Yew Ting, and Peter Seah Keng Tok
Abstract: Purpose: This study aimed to investigate the psychological distress and its associated factors among cancer survivors in Malaysia during the COVID-19 pandemic.Methods: An anonymous Internet-based study was conducted between 23 April and 26 June 2020. During the study period, the country underwent Phase 3 and Phase 4 of the Movement Control Order (MCO), Conditional Movement Control Order (CMCO), and Recovery Movement Control Order (RMCO). Psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS), which is a 14-item self-assessment scale for measuring distress (total HADS score (HADS-T)) with two subscales, namely anxiety (HADS-A) and depression (HADS-D). Results: From a total of 631 responses received, the proportion of participants with abnormal anxiety and depression was 29.0% and 20.9%, respectively. Distress was reported in 23.0% of the respondents. A total of 16.45% had combined abnormal anxiety and depression. The highest HADS-A (6.10; 95% CI 5.64‒6.56), HADS-D (5.61; 95% CI 5.14‒6.08), and HADS-T (11.71; 95% CI 10.84‒12.58) scores were reported among respondents during Phase 4 of the MCO. Partial least squares-based structural equation modelling (PLS-SEM) revealed that self-perceived health status, perceived susceptibility, and severity of COVID-19 have the greatest effect, leading to higher HADS-A, HADS-D, and HADS-T scores. Conclusion: Heightened psychological distress was evident in cancer survivors particularly during the enforcement of the MCO over COVID-19. Providing support to address cancer survivors’ psychological and emotional needs during the COVID-19 pandemic is essential.Implication for cancer survivors: Cancer survivors or their carers should be made aware of the high psychological risk during infectious disease outbreaks and seek timely support.
Published: 2020

36. Oncological safety and postoperative complications in oncoplastic breast surgery among Asian women: A single institutional review

Author: Lee-Lee Lai, Abqariyah Yahya, Alia Hanim Aa, Li Ying Teoh, Mei Sze Teh, Mee Hoong See, Kwan Hoong Ng, and Suniza Jamaris
Subjects: medicine.medical_specialty, medicine.medical_treatment, Breast surgery, Mammaplasty, Breast Neoplasms, Mastectomy, Segmental, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Postoperative Complications, Internal Medicine, Breast-conserving surgery, medicine, Overall survival, Humans, Retrospective Studies, business.industry, General surgery, medicine.disease, Treatment Outcome, Oncology, 030220 oncology & carcinogenesis, Cohort, Surgery, Female, business
Abstract: Oncoplastic breast surgery (OBS) improves margin clearance and produces good esthetic outcome in breast cancer treatment. This study evaluates the complications and outcome of OBS in a multiracial patient cohort. Data of 421 patients between 2011 and 2018 were analyzed. The majority were Malays (41.8%), followed by Chinese (39.7%) and Indians (16.8%). Low local complications were noted, with no significant differences in disease-free survival (P = .927) and overall survival (P = .719) between low and high OBS levels. Shared decision-making in offering OBS for Asian women has potential to become a practical option in breast cancer treatment.
Published: 2020

37. A rare case of persistent large cystic breast tumor mimicking as malignant cystic breast cancer

Author: Mei Sze Teh, Li-Ying Teoh, and Mee Hoong See
Subjects: Pathology, medicine.medical_specialty, Oncology, business.industry, Cystic breast, Rare case, medicine, Cancer, Radiology, Nuclear Medicine and imaging, General Medicine, medicine.disease, business
Published: 2022

38. Breast-conserving surgeryversusmastectomy in young women with breast cancer in Asian settings

Author: Cheng Har Yip, Mikael Hartman, Nur Aishah Taib, Maznah Dahlui, Ern Yu Tan, Mee Hoong See, Ava Kwong, S. Sinnadurai, Nirmala Bhoo-Pathy, and N. Bhoo-Pathy
Subjects: medicine.medical_specialty, business.industry, Obstetrics, medicine.medical_treatment, Hazard ratio, Lumpectomy, General Medicine, 030230 surgery, medicine.disease, Radiation therapy, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, 030220 oncology & carcinogenesis, Propensity score matching, Breast-conserving surgery, medicine, Asian country, business, Mastectomy
Abstract: Background Mastectomy rates among women with early breast cancer in Asia have traditionally been high. This study assessed trends in the surgical management of young women with early-stage breast cancer in Asian settings. Survival in women treated with breast-conserving surgery (BCS; lumpectomy with adjuvant radiotherapy) and those undergoing mastectomy was compared. Methods Young women (aged less than 50 years) newly diagnosed with stage I or II (T1-2 N0-1 M0) breast cancer in four hospitals in Malaysia, Singapore and Hong Kong in 1990-2012 were included. Overall survival (OS) was compared for patients treated by BCS and those who had a mastectomy. Propensity score analysis was used to account for differences in demographic, tumour and treatment characteristics between the groups. Results Some 63·5 per cent of 3536 women underwent mastectomy. Over a 15-year period, only a modest increase in rates of BCS was observed. Although BCS was significantly associated with favourable prognostic features, OS was not significantly different for BCS and mastectomy; the 5-year OS rate was 94·9 (95 per cent c.i. 93·5 to 96·3) and 92·9 (91·7 to 94·1) per cent respectively. Inferences remained unchanged following propensity score analysis (hazard ratio for BCS versus mastectomy: 0·81, 95 per cent c.i. 0·64 to 1·03). Conclusion The prevalence of young women with breast cancer treated by mastectomy remains high in Asian countries. Patients treated with BCS appear to survive as well as those undergoing mastectomy.
Published: 2018

39. Re-Excision Rates in Breast-Conserving Surgery for Invasive Breast Cancer after Neoadjuvant Chemotherapy with and without the Use of a Radiopaque Tissue Transfer and X-ray System

Author: Leyla Akpolat-Basci, Ann-Kathrin Bittner, Cornelia Liedtke, Miltiades Stephanou, Hans-Christian Kolberg, Sarah Wetzig, Yueksel Cubuk, Mee Hoong See, Suniza Jamaris, and Johannes Gerharz
Subjects: Treatment response, medicine.medical_specialty, Chemotherapy, business.industry, medicine.medical_treatment, Medizin, medicine.disease, Tissue transfer, Lesion, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Oncology, 030220 oncology & carcinogenesis, Breast-conserving surgery, medicine, Surgery, 030212 general & internal medicine, Radiology, medicine.symptom, Specimen radiography, business, Re-Excision, Research Article
Abstract: Background: Significant re-excision rates in breast-conserving surgery (BCS) after neoadjuvant systemic chemotherapy may result from difficulties in defining the surgical target particularly in cases with excellent treatment response. Devices allowing an exact topographic localisation of the lesion in the resected tissue could reduce re-excision rates by optimising the intraoperative detection of involved margins. Methods: 80 patients with invasive breast cancer receiving BCS after neoadjuvant chemotherapy were included in this non-randomized case-control study. 40 patients with specimen radiography performed in a standard approach (control group) were compared to 40 patients with use of a radiopaque tissue transfer system (study group). Results: 19/80 (23.75%) patients required re-excision because of involved margins; among those, 14/40 (35%) were in the control group and 5/40 (12.5%) in the study group. The association between the use of the radiopaque tissue transfer system and the lower re-excision rate was statistically significant (p = 0.023). Conclusion: Our analysis provides a rationale for the routine use of a radiopaque tissue transfer system for specimen radiography in BCS after neoadjuvant chemotherapy for invasive breast cancer in order to reduce re-excision rates.
Published: 2019

40. Dosage-dependent reduction of macular pigment optical density in female breast cancer patients receiving tamoxifen adjuvant therapy

Author: Angela Voon Pei Loo, Nur Aishah Taib, Visvaraja Subrayan, Tsung Fei Khang, Mee Hoong See, I-Liang Lim, and Adlinda Alip
Subjects: medicine.medical_specialty, Antineoplastic Agents, Hormonal, genetic structures, Breast Neoplasms, Optical density, Macular Degeneration, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Ophthalmology, Adjuvant therapy, medicine, Macular Pigment, Humans, Macula Lutea, Survival rate, Female breast cancer, Dose-Response Relationship, Drug, business.industry, General Medicine, Middle Aged, Macular degeneration, medicine.disease, eye diseases, Tamoxifen, Cross-Sectional Studies, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, 030221 ophthalmology & optometry, Regression Analysis, Female, Surgery, sense organs, business, medicine.drug
Abstract: It is now increasingly common for breast cancer patients to receive adjuvant tamoxifen therapy for a period of up to 10 years. As survival rate increases, managing tamoxifen ocular toxicities is important for patients' quality of life. Macular pigments in photoreceptor cells protect against free radical damage, which can cause macular degeneration. By reducing macular pigment concentration, tamoxifen may increase the risk of macular degeneration. Here, we compared macular pigment optical density (MPOD) and central macular thickness between breast cancer patients on tamoxifen adjuvant therapy (n = 70), and a control group (n = 72). Multiple regression analysis indicated that MPOD decreases with increasing tamoxifen dosage, up to a threshold of about 20 g, after which MPOD plateaus out. Mean MPOD in the treatment group (mean = 0.40) was significantly lower (p-value = 0.02) compared to the control group (mean = 0.47) for the left eye, and for the right eye (treatment mean = 0.39; control mean = 0.48; p-value = 0.009). No significant difference in mean central macular thickness was found between the treatment and the control group (p-values 0.4). In the control group, MPOD and central macular thickness showed significant correlation (r∼0.30; p-values 0.01) for both eyes. However, in the treatment group, loss of significant correlation was observed in the left eye (r = 0.21; p-value = 0.08). The present results show that MPOD decreases non-linearly as a function of tamoxifen dosage, and highlight the potential of tamoxifen to reduce macular pigment concentration through an unknown mechanism that does not depend on macular thinning solely.
Published: 2018

41. Synergistic effect of hyperforin and paclitaxel on growth inhibition, apoptotic mediator activation in MCF-7 human breast cancer cells

Author: Barathan, Muttiah, primary, Zulpa, Ahmad Khusairy, additional, Mee Hoong, See, additional, Vellasamy, Kumutha Malar, additional, and Vadivelu, Jamuna, additional
Published: 2021
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42. Mindful gratitude journaling: psychological distress, quality of life and suffering in advanced cancer: a randomised controlled trial

Author: Ranjit Kaur Pritam Singh, Chee Loong Lam, Gwo Fuang Ho, Natalie Zi Lai, Min Ai Lim, Bin Ting Ang, Ting Ting Tan, Maw Pin Tan, Diana Leh Ching Ng, Hway Ann Yee, Mee Hoong See, Sheriza Izwa Zainuddin, Chong Guan Ng, Seng Beng Tan, Mei Sze Teh, David Paul Capelle, Chee Shee Chai, Ee Chin Loh, Lee-Lee Lai, and Yu Zhen Tung
Subjects: medicine.medical_specialty, media_common.quotation_subject, Medicine (miscellaneous), Context (language use), Hospital Anxiety and Depression Scale, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Quality of life, law, Gratitude, Medicine, 0501 psychology and cognitive sciences, 030212 general & internal medicine, 050102 behavioral science & comparative psychology, media_common, Oncology (nursing), business.industry, 05 social sciences, General Medicine, Clinical trial, Medical–Surgical Nursing, Journaling file system, Physical therapy, Spiritual care, business
Abstract: ContextNumerous studies have shown that gratitude can reduce stress and improve quality of life.ObjectiveOur study aimed to examine the effect of mindful gratitude journaling on suffering, psychological distress and quality of life of patients with advanced cancer.MethodsWe conducted a parallel-group, blinded, randomised controlled trial at the University of Malaya Medical Centre, Malaysia. Ninety-two adult patients with advanced cancer, and an overall suffering score ≥4/10 based on the Suffering Pictogram were recruited and randomly assigned to either a mindful gratitude journaling group (N=49) or a routine journaling group (N=43).ResultsAfter 1 week, there were significant reductions in the overall suffering score from the baseline in both the intervention group (mean difference in overall suffering score=−2.0, 95% CI=−2.7 to −1.4, t=−6.125, p=0.000) and the control group (mean difference in overall suffering score=−1.6, 95% CI=−2.3 to −0.8, t=−4.106, p=0.037). There were also significant improvements in the total Hospital Anxiety and Depression Scale score (mean difference=−3.4, 95% CI=−5.3 to −1.5, t=−3.525, p=0.000) and the total Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being score (mean difference=7.3, 95% CI=1.5 to 13.1, t=2.460, p=0.014) in the intervention group after 7 days, but not in the control group.ConclusionThe results provide evidence that 7 days of mindful gratitude journaling could positively affect the state of suffering, psychological distress and quality of life of patients with advanced cancer.Trial registration numberThe trial was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN1261800172191) and conducted in accordance with the Declaration of Helsinki.
Published: 2021

43. Low Lifetime Risk of Contralateral Breast Cancer in a Middle-Income Asian Country: Evidence to Guide Post-treatment Surveillance

Author: Cheng Har Yip, Nur Aishah Taib, D. G. R. Evans, Nirmala Bhoo-Pathy, Suniza Jamaris, A. Kiran, and Mee Hoong See
Subjects: Adult, medicine.medical_specialty, medicine.medical_treatment, Breast Neoplasms, Disease, Southeast asian, Risk Assessment, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Internal medicine, Humans, Medicine, Genetic Predisposition to Disease, 030212 general & internal medicine, Family history, Mastectomy, Aged, Aged, 80 and over, Gynecology, business.industry, Age Factors, Malaysia, Cancer, Neoplasms, Second Primary, Middle Aged, medicine.disease, Radiation therapy, 030220 oncology & carcinogenesis, Female, Surgery, Hormone therapy, business, Follow-Up Studies
Abstract: Background: The rate of contralateral risk reducing mastectomy (CRRM) is increasing in the West with controversial evidence of improved survival in early breast cancer patients. Although uptake of CRRM in Asia appears low, the trends may rise and there is currently an urgent need to provide evidence for informed decision making in clinical practice. This study aims to determine the risk of contralateral breast cancer (CBC), and its associated factors in an Asian setting.Method: 2937 newly diagnosed patients with stage I and stage II breast cancer in University Malaya Medical Centre between Jan 1993 to Dec 2012 were included in the study. Multinomial logistic regression analysis allowing death to compete with CBC as a study outcome was used; patients with unilateral breast cancer who were alive were taken as reference. A stepwise backward regression analysis including age at diagnosis, ethnicity, family history of breast cancer, TNM stage, hormonal receptor status, HER2 status, chemotherapy, radiotherapy, and hormone therapy was conducted.Results: Fifty women developed CBC, over a median follow-up of 6 years. The 5-year-, and 10-year cumulative risk of contralateral breast cancer was 1.0% (95% CI: 0.6%-1.4%) and 2.8% (95% CI: 2.0%-3.6%), respectively. Young age at diagnosis of first cancer, positive family history and stage I disease, were independent predictors of CBC. Discussion: The current study suggests that the risk of CBC is very low in a Southeast Asian setting. Any recommendations or practice of CRRM should be reviewed with caution and patients must be counseled appropriately.
Published: 2017

44. Impact of Time Since Last Childbirth on Survival of Women with Premenopausal and Postmenopausal Breast Cancers

Author: Nanthini Balakrishnan, Nirmala Bhoo Pathy, Nanthini Thevi Bhoo Pathy, Cheng Har Yip, Soo-Hwang Teo, Siamala Sinnadurai, Nur Aishah Taib, and Mee Hoong See
Subjects: Adult, Oncology, medicine.medical_specialty, Time Factors, Breast Neoplasms, Disease, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Risk Factors, Internal medicine, Risk of mortality, Humans, Medicine, Childbirth, 030212 general & internal medicine, Reproductive History, Survival rate, Aged, Proportional Hazards Models, business.industry, Proportional hazards model, Hazard ratio, Age Factors, Malaysia, Parturition, Middle Aged, Prognosis, medicine.disease, Postmenopause, Survival Rate, Premenopause, 030220 oncology & carcinogenesis, Female, Surgery, business, Abdominal surgery
Abstract: Reproductive factors are associated with risk of breast cancer, but the association with breast cancer survival is less well known. Previous studies have reported conflicting results on the association between time since last childbirth and breast cancer survival. We determined the association between time since last childbirth (LCB) and survival of women with premenopausal and postmenopausal breast cancers in Malaysia. A historical cohort of 986 premenopausal, and 1123 postmenopausal, parous breast cancer patients diagnosed from 2001 to 2012 in University Malaya Medical Centre were included in the analyses. Time since LCB was categorized into quintiles. Multivariable Cox regression was used to determine whether time since LCB was associated with survival following breast cancer, adjusting for demographic, tumor, and treatment characteristics. Premenopausal breast cancer patients with the most recent childbirth (LCB quintile 1) were younger, more likely to present with unfavorable prognostic profiles and had the lowest 5-year overall survival (OS) (66.9; 95% CI 60.2–73.6%), compared to women with longer duration since LCB (quintile 2 thru 5). In univariable analysis, time since LCB was inversely associated with risk of mortality and the hazard ratio for LCB quintile 2, 3, 4, and 5 versus quintile 1 were 0.53 (95% CI 0.36–0.77), 0.49 (95% CI 0.33–0.75), 0.61 (95% CI 0.43–0.85), and 0.64 (95% CI 0.44–0.93), respectively; P trend = 0.016. However, this association was attenuated substantially following adjustment for age at diagnosis and other prognostic factors. Similarly, postmenopausal breast cancer patients with the most recent childbirth were also more likely to present with unfavorable disease profiles. Compared to postmenopausal breast cancer patients in LCB quintile 1, patients in quintile 5 had a higher risk of mortality. This association was not significant following multivariable adjustment. Time since LCB is not independently associated with survival in premenopausal or postmenopausal breast cancers. The apparent increase in risks of mortality in premenopausal breast cancer patients with a recent childbirth, and postmenopausal patients with longer duration since LCB, appear to be largely explained by their age at diagnosis.
Published: 2017

45. Angular dependence of optical fibre thermoluminescent dosimeters irradiated using kilo- and megavoltage X-rays

Author: Yusoff Mohd Amin, F. Moradi, Mayeen Uddin Khandaker, D.A. Bradley, Mee Hoong See, A. Entezam, Nur Aishah Taib, Ghafour Amouzad Mahdiraji, and Ngie Min Ung
Subjects: Physics, Megavoltage X-rays, Radiation, Dosimeter, 010308 nuclear & particles physics, business.industry, medicine.medical_treatment, Physics::Medical Physics, 01 natural sciences, Thermoluminescence, Imaging phantom, Secondary electrons, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Optics, Absorbed dose, 0103 physical sciences, medicine, Irradiation, business, Beam (structure)
Abstract: Prior investigation of the suitability of optical fibres as thermoluminescent dosimeters for diagnostic and therapeutic radiation beams has not included detailed study of the effect of beam angulation. Present study of such response has made use of optical fibre of cylindrical shape, exposed to 30 kVp photons from an X-ray tube and a 6 MV photon beam from a linear accelerator. The effect of the irradiation medium was also studied, comparing response free-in-air against on-surface and in-depth irradiations through use of solid-water ™ phantom. Standard optical fibre (o =125 µm) shows non-uniform response to beams delivered at different incident angles. Monte Carlo simulation provided support for the experimental results, also obtaining absorbed dose in the fibres. The results of free-in-air condition simulated with mono-energy beam show angle-independent response for photons within the energy range 100–500 keV, while dependency has been observed for beam energies of 500 keV. Experimentally, the angular dependency up to 35% is observed in 30 kVp free-in-air, while in 6 MeV beam, this is reduced to 20%, 10%, and 3% in free-in-air, on phantom surface, and in-depth conditions, respectively. The observations have been justified by considering the range of secondary electrons in the dosimeter and the effect of scattered radiation.
Published: 2017

46. Low Breast Conserving Surgery (BCS) rates in public hospitals in Malaysia: The effect of stage and ethnicity

Author: Mee Hoong See, J. Suniza, Sabariah Sharif, Joanne Aisha Mosiun, M.Y. Abdul Wahab, W.J. Wong, Nur Aishah Taib, D. Lee, Z. Hidayati, and R. Balkis
Subjects: Adult, medicine.medical_specialty, Multivariate analysis, medicine.medical_treatment, Ethnic group, Breast Neoplasms, Mastectomy, Segmental, Health Services Accessibility, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Internal medicine, medicine, Breast-conserving surgery, Ethnicity, Humans, 030212 general & internal medicine, Stage (cooking), Neoadjuvant therapy, Aged, Neoplasm Staging, business.industry, Hospitals, Public, Malaysia, General Medicine, Middle Aged, medicine.disease, Radiation therapy, Cross-Sectional Studies, 030220 oncology & carcinogenesis, Multivariate Analysis, Surgery, Female, business, Mastectomy
Abstract: Introduction Breast-conserving surgery (BCS) with radiation therapy is the procedure of choice for early-stage breast cancer. Survival and locoregional recurrence is non-inferior to mastectomy, with superior cosmetic and psycho-social outcomes. Differing health systems have demonstrated a wide variation in the rate of BCS. Little is known about the rate of BCS and factors influencing its practice in middle resource countries. This study aims to examine the BCS rates in Malaysia and to identify factors influencing its uptake. Methodology This is a multi-centre, cross-sectional study involving the University of Malaya Medical Centre (UMMC), Queen Elizabeth II Hospital (QEH), and Tengku Ampuan Rahimah Hospital (TARH). Patients diagnosed with invasive breast cancer from January 2014 to December 2015 were included, excluding stromal cancers and lymphomas. Univariate and multivariate analyses identified factors influencing BCS. Results A total of 1005 patients were diagnosed with breast cancer in the allocated time frame. Excluding incomplete records and those who did not have surgery, 730 patients were analysed. Overall BCS rate was 32.9%. The BCS rate was highest at QEH (54.1%), followed by UMMC (29.5%), and TARH (17.4%). 16.9% had BCS after neoadjuvant therapy. Factors influencing BCS uptake included age, ethnic group, breast-surgeon led services, AJCC Stage, tumour size, HER-2 expression, and tumour grade. Conclusions The rate of BCS in Malaysia is low. A wide variation of rate exists among the studied hospitals. Younger age, earlier AJCC stage, and the presence of a Breast sub-specialist surgeon, would make it more likely that the patient has her breast conserved.
Published: 2019

47. Is pre-operative axillary ultrasound alone sufficient to determine need for axillary dissection in early breast cancer patients?

Author: Kartini Rahmat, Suniza Jamaris, Tania Islam, Nirmala Bhoo-Pathy, Farhana Fadzli, Nur Aishah Taib, Jazree Jamaluddin, and Mee Hoong See
Subjects: Image-Guided Biopsy, medicine.medical_specialty, Sentinel lymph node, Observational Study, Hilum (biology), Breast Neoplasms, lymph node dissection, surgery, 03 medical and health sciences, breast cancer, 0302 clinical medicine, Predictive Value of Tests, Biopsy, medicine, Humans, 030212 general & internal medicine, Lymph node, Retrospective Studies, Ultrasonography, medicine.diagnostic_test, ultrasound, business.industry, Ultrasound, Malaysia, Axillary Lymph Node Dissection, General Medicine, Odds ratio, Middle Aged, Confidence interval, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Axilla, Lymph Node Excision, Female, axillary node, Radiology, business, Research Article
Abstract: Pre-operative status of axillary lymph node (ALN) in early breast cancer is usually initially assessed by pre-operative ultrasound, followed by ultrasound-guided needle biopsy (UNB) confirmation. Patients with positive nodal status will undergo axillary lymph node dissection (ALND), while those with negative nodal status will have sentinel lymph node biopsy. ALND is associated with higher morbidity than Sentinel lymph node biopsy. The objective of this study is to determine if axillary ultrasound alone without UNB is predictive enough to assign patients to ALND and to identify ultrasound features that are significantly associated with pathologically positive ALN. 383 newly diagnosed primary breast cancer patients between 2012 and 2014, and who had undergone pre-operative axillary ultrasound in University Malaya Medical Centre with a complete histopathology report of the axillary surgery were retrospectively reviewed. ALN was considered positive if it had any of these features: cortical thickening > 3 mm, loss of fatty hilum, hypoechoic solid node, mass-like appearance, round shape and lymph node size > 5 mm. Post-operative histopathological reports were then analyzed for nodal involvement. The overall sensitivity, specificity, and accuracy of pre-operative axillary ultrasound in detecting diseased nodes were 45.5%, 80.7%, and 60.3% respectively. The positive (PPV) and negative predictive values were 76.5% and 51.8%. Round shape, loss of fatty hilum and mass-like appearance had the highest PPVs of 87%, 83% and 81.6% respectively and significant odds ratios (ORs) of 5.22 (95% confidence interval [CI]: 1.52 - 17.86), ORs of 4.77 (95% CI: 2.62 - 8.70) and ORs of 4.26 (95% CI: 2.37 - 7.67) respectively (P-value 3 mm was identified to have low PPV at 69.1%, ORs of 1.71 (95% CI: 0.86 - 3.41, P = .126). There are features on axillary ultrasound that confer high PPV for axillary involvement i.e. round shape, loss of fatty hilum, and mass-like appearance. In a low resource setting, these features may benefit from ALND without further pre-operative biopsies. However, pre-operative UNB for features with low PPV that is, cortical thickness > 3 mm should be considered to obviate the unnecessary morbidity associated with ALND.
Published: 2021

48. Missed Opportunities for Loco-Regional Treatment of Elderly Women with Breast Cancer

Author: Nanthini Balakrishnan, Mee Hoong See, Cheng Har Yip, Nur Aishah Taib, and Nirmala Bhoo-Pathy
Subjects: Oncology, medicine.medical_specialty, Antineoplastic Agents, Hormonal, medicine.medical_treatment, Breast Neoplasms, Comorbidity, Mastectomy, Segmental, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Internal medicine, medicine, Humans, 030212 general & internal medicine, Survival rate, Aged, Neoplasm Staging, Proportional Hazards Models, Proportional hazards model, business.industry, Hazard ratio, Age Factors, Malaysia, Middle Aged, medicine.disease, humanities, Tumor Burden, Survival Rate, Radiation therapy, Logistic Models, Chemotherapy, Adjuvant, 030220 oncology & carcinogenesis, Female, Radiotherapy, Adjuvant, Surgery, Hormone therapy, business, Abdominal surgery
Abstract: Factors associated with surgery, adjuvant radiotherapy, and chemotherapy and whether there were missed opportunities for treatment in elderly patients were determined in an Asian setting. All 5616 patients, diagnosed with breast cancer in University Malaya Medical Centre from 1999 to 2013 were included. In 945 elderly patients (aged 65 years and above), multivariable logistic regression was performed to identify factors associated with treatment, following adjustment for age, ethnicity, tumor, and other treatment characteristics. The impact of lack of treatment on survival of the elderly was assessed while accounting for comorbidities. One in five elderly patients had comorbidities. Compared to younger patients, the elderly had more favorable tumor characteristics, and received less loco-regional treatment and chemotherapy. Within stage I–IIIa elderly breast cancer patients, 10 % did not receive any surgery. These patients were older, more likely to be Malays, have comorbidities, and bigger tumors. In elderlies with indications for adjuvant radiotherapy, no irradiation (30 %) was associated with increasing age, comorbidity, and the absence of systemic therapy. Hormone therapy was optimal, but only 35 % of elderly women with ER negative tumors received chemotherapy. Compared to elderly women who received adequate treatment, those not receiving surgery (adjusted hazard ratio: 2.30, 95 %CI: 1.10–4.79), or radiotherapy (adjusted hazard ratio: 1.56, 95 %CI: 1.10–2.19), were associated with higher mortality. Less than 25 % of the survival discrepancy between elderly women receiving loco-regional treatment and no treatment were attributed to excess comorbidities in untreated patients. While the presence of comorbidities significantly influenced loco-regional treatment decisions in the elderly, it was only able to explain the lower survival rates in untreated patients up to a certain extent, suggesting missed opportunities for treatment.
Published: 2016

49. Abstract P5-08-39: Low risk of contralateral breast cancer rates in Asian women- A case for not recommending contralateral prophylactic mastectomy

Author: Suniza Jamaris, A Yahya, Cheng Har Yip, Nur Aishah Taib, N Bhoo Pathy, Mee Hoong See, and G. H. Tan
Subjects: Gynecology, Cancer Research, medicine.medical_specialty, Proportional hazards model, business.industry, Cancer, Prophylactic Mastectomy, medicine.disease, Southeast asian, Breast cancer, Contralateral Prophylactic Mastectomy, Oncology, Internal medicine, Epidemiology, medicine, Family history, business
Abstract: Introduction The rates of contralateral prophylactic mastectomy (CPM)appears to be higher in the west as compared to the east.1,2There is a suggestion of an improved survival benefit of CPM. 1The trends are increasing in the west and little is known in Asia. In western data a rate of 0.5 to 1% per year is often quoted. However, There is scarcity of epidemiological data on rates of contralateral breast cancer (CBC) in Asia. Known predictors of CBC in the west include high stage at diagnosis, early age at diagnosis, presence of family history, genetic predisposition, time from first diagnosis and hormone receptor status. Little is known in Asia. Population based registries are not available in Malaysia as in many Southeast Asian countries. This study aims to provide CBC rates to provide evidence for informed decision making of CPM in Asians. Method A prospective database of newly diagnosed Stage I and II breastcancer patients diagnosed in University Malaya Medical Centre between 1993 to 2012 were analysed. Data on CBC were obtained from institutional database and medical records. Multivariate analysis used Cox regression was applied to observe for any associations with multiple variables such as age at diagnosis, time from diagnosis, presence of family history, menopausal status, ethnic groups, parity and hormone status. Results A total of 3060 Stage I and II patients were prospectively followed up. 127 (4.2%) women developed contralateral breast cancer.At 5 years, 57 (1.9%) and at 10 years, 100(3.4%) developed CBC. Using a multivariate model, the only independent predictor of developing contralateral breast cancer at 5 years was a positive family history OR 1.97(CI 1.02-3.80). However, at 10 years we found the effect of positive family history diminished OR1.57 (CI 0.94-2.64) and younger women were more likely to develop cancer, those aged 51 to 64 years OR 0.29 (CI 0.11-0.73) , >65 years OR 0.20 (CI 0.07-0.60)compared to those less than 35 years. The other factors in the model were not significant. Discussion There is an increasing rate of CPM at 22% from 9% in the west1. A study in Singapore showed a low CPM rate of 1.25%2 . Although uptake of CPM in Asia has not been reported extensively and appears low, the trends may rise and that evidence is needed to counsel patients on the benefits and harms of CPM if patients request for CPM. Given the lower incidence of breast cancer in Malaysia ie 5% average risk compared to 10% in the west, an urgent need to document the risk of contralateral breast cancer, and this data from a single institution is the first to report this rates in Southeast Asia. Conclusion The data shows that risk of contralateral breast cancer is low in this Southeast Asian country. Any recommendations or practice of CPM should be dealt with extreme caution. References 1. Kauffmann R, Nelson R, Smith D, et al: Improved survival with contralateral prophylactic mastectomy. Abstract in 2014 Society of Surgical Oncology Cancer Symposium. 2. Sim Y, Tan VK, Ho GH, Wong CY, Madhukumar P, Tan BK, Yong WS, Ng YY, OngKW.Contralateral prophylactic mastectomy in an Asian population: a single institution review. Breast. 2014 Feb;23(1):56-62. doi: 10.1016/j.breast.2013.10.008. Epub 2013 Nov 23. Citation Format: Taib NA, See MH, Bhoo Pathy N, Yahya A, Tan GH, Jamaris S, Yip CH. Low risk of contralateral breast cancer rates in Asian women- A case for not recommending contralateral prophylactic mastectomy. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-08-39.
Published: 2016

50. The association between methods of biopsy and survival following breast cancer

Author: Anita Zarina Bustam, Yek-Ching Kong, Michael O'Rorke, Nirmala Bhoo-Pathy, Shridevi Subramaniam, Suniza Jamaris, Lai-Meng Looi, Cheng Har Yip, Kean-Hooi Teoh, Mee Hoong See, Nur Aishah Taib, and N. Bhoo-Pathy
Subjects: medicine.medical_specialty, medicine.diagnostic_test, business.industry, Proportional hazards model, medicine.medical_treatment, Hazard ratio, General Medicine, medicine.disease, Lower risk, Radiation therapy, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, 030220 oncology & carcinogenesis, Biopsy, medicine, Risk of mortality, 030212 general & internal medicine, Radiology, business, Cohort study
Abstract: Percutaneous biopsy in breast cancer has been associated with an increased risk of malignant cell seeding. However, the importance of these observations remains obscure due to lack of corroborating evidence from clinical studies. We determined whether method of biopsy is associated with breast cancer survival. This hospital registry-based cohort study included 3416 non-metastatic breast cancer patients diagnosed from 1993 to 2011 in a tertiary setting. Factors associated with biopsy methods were assessed. Multivariable Cox regression analysis was used to determine the independent prognostic impact of method of biopsy. Overall, 990 patients were diagnosed by core needle biopsy (CNB), 1364 by fine needle aspiration cytology (FNAC), and 1062 by excision biopsy. Excision biopsy was significantly associated with more favorable tumor characteristics. Radiotherapy modified the prognostic impact of biopsy method (Pinteraction < .001). Following multivariable analysis, excision biopsy was consistently associated with lower risk of mortality compared to FNAC in women receiving adjuvant radiotherapy (adjusted hazard ratio: 0.81, 95%CI: 0.66-0.99), but not in those who did not receive adjuvant radiotherapy (adjusted hazard ratio: 0.87, 95%CI: 0.65-1.17). While the risk of mortality was not different between patients undergoing FNAC and CNB when radiotherapy is administered, in the absence of radiotherapy, CNB was associated with higher risk of mortality than FNAC (adjusted hazard ratio: 1.57, 95%CI: 1.16-2.12). Given that our results contradict with findings of previous clinical studies assessing the prognostic impact of method of biopsy in women with breast cancer, further studies are warranted.
Published: 2020

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