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1. Reduced temporal muscle thickness predicts shorter survival in patients undergoing chronic subdural haematoma drainage

Author: Tommi K. Korhonen, Otso Arponen, Moritz Steinruecke, Ilaria Pecorella, Harry Mee, Stefan Yordanov, Edoardo Viaroli, Mathew R. Guilfoyle, Angelos Kolias, Ivan Timofeev, Peter Hutchinson, and Adel Helmy
Subjects: Body composition, Chronic subdural haematoma, Computed tomography, Frailty, Sarcopenia, Diseases of the musculoskeletal system, RC925-935, Human anatomy, QM1-695
Abstract: Abstract Background Chronic subdural haematoma (CSDH) drainage is a common neurosurgical procedure. CSDHs cause excess mortality, which is exacerbated by frailty. Sarcopenia contributes to frailty – its key component, low muscle mass, can be assessed using cross‐sectional imaging. We aimed to examine the prognostic role of temporal muscle thickness (TMT) measured from preoperative computed tomography head scans among patients undergoing surgical CSDH drainage. Methods We retrospectively identified all patients who underwent CSDH drainage within 1 year of February 2019. We measured their mean TMT from preoperative computed tomography scans, tested the reliability of these measurements, and evaluated their prognostic value for postoperative survival. Results One hundred and eighty‐eight (122, 65% males) patients (median age 78 years, IQR 70–85 years) were included. Thirty‐four (18%) patients died within 2 years, and 51 (27%) died at a median follow‐up of 39 months (IQR 34–42 months). Intra‐ and inter‐observer reliability of TMT measurements was good‐to‐excellent (ICC 0.85–0.97, P
Published: 2024
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2. Building resilient surgical systems that can withstand external shocks

Author: Janet Martin, Peter Hutchinson, Adesoji O Ademuyiwa, Kathryn Chu, James C Glasbey, Ismail Lawani, John Meara, Ewen Harrison, Richard Sullivan, Gabriella Hyman, K Srinath Reddy, Laura Martínez, and Anna Dare
Subjects: Medicine (General), R5-920, Infectious and parasitic diseases, RC109-216
Published: 2024
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3. Extended tests for evaluating post-traumatic brain injury deficits in resource-limited settings: methods and pilot study data

Author: Mulugeta Semework, Tsegazeab Laeke, Abenezer Tirsit Aklilu, Abraham Tadele, Yordanos Ashagre, Peter Teklewold, Angelos G. Kolias, Peter Hutchinson, Abel Balcha, Dagnachew Yohannes, and Getaw Worku Hassen
Subjects: traumatic brain injury, TBI assessment, brain injury assessment, TBI tests, LMIC brain injury, Neurology. Diseases of the nervous system, RC346-429
Abstract: IntroductionTraumatic brain injury (TBI) is one of the leading causes of all injury-related deaths and disabilities in the world, especially in low to middle-income countries (LMICs) which also suffer from lower levels of funding for all levels of the health care system for patients suffering from TBI. These patients do not generally get comprehensive diagnostic workup, monitoring, or treatment, and return to work too quickly, often with undiagnosed post-traumatic deficits which in turn can lead to subsequent incidents of physical harm.MethodsHere, we share methods and results from our research project to establish innovative, simple, and scientifically based practices that dramatically leverage technology and validated testing strategies to identify post-TBI deficits quickly and accurately, to circumvent economic realities on the ground in LMICs. We utilized paper tests such as the Montreal cognitive assessment (MoCA), line-bisection, and Bell’s test. Furthermore, we combined modifications of neuroscience computer tasks to aid in assessing peripheral vision, memory, and analytical accuracies. Data from seventy-one subjects (51 patients and 20 controls, 15 females and 56 males) from 4 hospitals in Ethiopia are presented. The traumatic brain injury group consists of 17 mild, 28 moderate, and 8 severe patients (based on the initial Glasgow Comma Score). Controls are age and education-matched subjects (no known history of TBI, brain lesions, or spatial neglect symptoms).ResultsWe found these neurophysiological methods can: 1) be implemented in LMICs and 2) test impairments caused by TBI, which generally affect brain processing speed, memory, and both executive and cognitive controls.DiscussionThe main findings indicate that these examinations can identify several deficits, especially the MoCA test. These tests show great promise to assist in the evaluation of TBI patients and support the establishment of dedicated rehabilitation centers. Our next steps will be expansion of the cohort size and application of the tests to other settings.
Published: 2024
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4. An international, prospective observational study on traumatic brain injury epidemiology study protocol: GEO-TBI: Incidence [version 2; peer review: 2 approved]

Author: David Clark, Tommi Kalevi Korhonen, Sara Venturini, Sujit Gnanakumar, Thomas Bashford, Midhun Mohan, Indira Devi Bhagavatula, Ronnie Baticulon, Rocío Fernández-Méndez, Ignatius Esene, Deepak Gupta, Anthony Figaji, Tsegazeab Laeke, Tariq Khan, David Menon, Michael Martin, Kee B. Park, Wellingson Paiva, Andres M. Rubiano, Jogi V. Pattisapu, Hamisi Shabani, Vijaya Sekhar, Davi Solla, Kachinga Sichizya, Manjul Tripathi, Abenezer Tirsit, Bart Depreitere, Carole Turner, Laura Lippa, Corrado Iaccarino, Gail Rosseau, Andrew Reisner, Rikin Trivedi, Franco Servadei, Angelos Kolias, Vicknes Waran, Peter Hutchinson, and Alexis Joannides
Subjects: epidemiology, global, registry, traumatic brain injury, eng, Medicine
Abstract: Background The epidemiology of traumatic brain injury (TBI) is unclear – it is estimated to affect 27–69 million individuals yearly with the bulk of the TBI burden in low-to-middle income countries (LMICs). Research has highlighted significant between-hospital variability in TBI outcomes following emergency surgery, but the overall incidence and epidemiology of TBI remains unclear. To address this need, we established the Global Epidemiology and Outcomes following Traumatic Brain Injury (GEO-TBI) registry, enabling recording of all TBI cases requiring admission irrespective of surgical treatment. Objective The GEO-TBI: Incidence study aims to describe TBI epidemiology and outcomes according to development indices, and to highlight best practices to facilitate further comparative research. Design Multi-centre, international, registry-based, prospective cohort study. Subjects Any unit managing TBI and participating in the GEO-TBI registry will be eligible to join the study. Each unit will select a 90-day study period. All TBI patients meeting the registry inclusion criteria (neurosurgical/ICU admission or neurosurgical operation) during the selected study period will be included in the GEO-TBI: Incidence. Methods All units will form a study team, that will gain local approval, identify eligible patients and input data. Data will be collected via the secure registry platform and validated after collection. Identifiers may be collected if required for local utility in accordance with the GEO-TBI protocol. Data Data related to initial presentation, interventions and short-term outcomes will be collected in line with the GEO-TBI core dataset, developed following consensus from an iterative survey and feedback process. Patient demographics, injury details, timing and nature of interventions and post-injury care will be collected alongside associated complications. The primary outcome measures for the study will be the Glasgow Outcome at Discharge Scale (GODS) and 14-day mortality. Secondary outcome measures will be mortality and extended Glasgow Outcome Scale (GOSE) at the most recent follow-up timepoint.
Published: 2024
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5. Plasma neurofilament light admission levels and development of axonal pathology in mild traumatic brain injury

Author: Iftakher Hossain, Mehrbod Mohammadian, Henna-Riikka Maanpää, Riikka S. K. Takala, Olli Tenovuo, Mark van Gils, Peter Hutchinson, David K. Menon, Virginia F. Newcombe, Jussi Tallus, Jussi Hirvonen, Timo Roine, Timo Kurki, Kaj Blennow, Henrik Zetterberg, and Jussi P. Posti
Subjects: Neurofilament light protein, Diffusion tensor imaging, Diffusion-weighted magnetic resonance imaging, Neurology. Diseases of the nervous system, RC346-429
Abstract: Abstract Background It is known that blood levels of neurofilament light (NF-L) and diffusion-weighted magnetic resonance imaging (DW-MRI) are both associated with outcome of patients with mild traumatic brain injury (mTBI). Here, we sought to examine the association between admission levels of plasma NF-L and white matter (WM) integrity in post-acute stage DW-MRI in patients with mTBI. Methods Ninety-three patients with mTBI (GCS ≥ 13), blood sample for NF-L within 24 h of admission, and DW-MRI ≥ 90 days post-injury (median = 229) were included. Mean fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were calculated from the skeletonized WM tracts of the whole brain. Outcome was assessed using the Extended Glasgow Outcome Scale (GOSE) at the time of imaging. Patients were divided into CT-positive and -negative, and complete (GOSE = 8) and incomplete recovery (GOSE
Published: 2023
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6. The application of medical ethics in the developing countries – A neurosurgical perspective

Author: Iftakher Hossain, Peter Hutchinson, Khandkar Kawsar, Angelos Kolias, Adriana Libório dos Santos, Ignatius N. Esene, Nqobile Thango, Ronnie Baticulon, Beata Laki, and Ahmed Ammar
Subjects: 1) medical ethics, 2) neurosurgery, 3) surgical innovation, 4) outcome 5) research, Neurology. Diseases of the nervous system, RC346-429
Abstract: Introduction: Neurosurgery is one of the rapidly evolving specialities of medical science, where the neurosurgeons have to provide evidence-based interventions in life threatening conditions maintaining the ethical standards. Research question: This narrative review sheds light on the current hindrances of the ethical aspects of neurosurgical practice in low and middle-income countries (LMICs) and provide some feasible solutions for future. Material and methods: A literature search was conducted using PubMed, Scopus and ISI web of knowledge focused on articles in English with the words “medical ethics” together with the words “neurosurgery”, “ethical practice”, “low and middle-income countries”, “surgical innovation”, “randomized clinical trials” and “outcome” alone or in combination. Results: Due to the lack of neurosurgeons and essential infrastructures in LMICs, the practical application of medical ethics is more complicated in the field of neurosurgery. Main obstacles to conduct preclinical and clinical research in the LMICs are the lack of proper ethics committees, quality data, trained manpower and sufficient research funding. Implementation of randomized clinical trials (RCTs) is also difficult for the neurosurgeons working in LMICs. Discussion and conclusion: To improve the situation, socio-economic development, including educating the citizens of these countries about their rights, functional regulatory bodies like medical and dental councils, teaching the neurosurgeons about the internationally recognized medical ethics, quality control regulations by the ministry of health and welfare, and more funding for the health care sectors are urgently needed. Global collaboration is needed to help the LMICs to provide their patients international but “customized” standard care.
Published: 2024
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7. Cervical spine immobilisation following blunt trauma in pre-hospital and emergency care: A systematic review.

Author: Abdullah Pandor, Munira Essat, Anthea Sutton, Gordon Fuller, Stuart Reid, Jason E Smith, Rachael Fothergill, Dhushy Surendra Kumar, Angelos Kolias, Peter Hutchinson, Gavin D Perkins, Mark H Wilson, and Fiona Lecky
Subjects: Medicine, Science
Abstract: ObjectivesTo assess whether different cervical spine immobilisation strategies (full immobilisation, movement minimisation or no immobilisation), impact neurological and/or other outcomes for patients with suspected cervical spinal injury in the pre-hospital and emergency department setting.DesignSystematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesMEDLINE, EMBASE, CINAHL, Cochrane Library and two research registers were searched until September 2023.Eligibility criteriaAll comparative studies (prospective or retrospective) that examined the potential benefits and/or harms of immobilisation practices during pre-hospital and emergency care of patients with a potential cervical spine injury (pre-imaging) following blunt trauma.Data extraction and synthesisTwo authors independently selected and extracted data. Risk of bias was appraised using the Cochrane ROBINS-I tool for non-randomised studies. Data were synthesised without meta-analysis.ResultsSix observational studies met the inclusion criteria. The methodological quality was variable, with most studies having serious or critical risk of bias. The effect of cervical spine immobilisation practices such as full immobilisation or movement minimisation during pre-hospital and emergency care did not show clear evidence of benefit for the prevention of neurological deterioration, spinal injuries and death compared with no immobilisation. However, increased pain, discomfort and anatomical complications were associated with collar application during immobilisation.ConclusionsDespite the limited evidence, weak designs and limited generalisability, the available data suggest that pre-hospital cervical spine immobilisation (full immobilisation or movement minimisation) was of uncertain value due to the lack of demonstrable benefit and may lead to potential complications and adverse outcomes. High-quality randomised comparative studies are required to address this important question.Trial registrationPROSPERO REGISTRATION Fiona Lecky, Abdullah Pandor, Munira Essat, Anthea Sutton, Carl Marincowitz, Gordon Fuller, Stuart Reid, Jason Smith. A systematic review of cervical spine immobilisation following blunt trauma in pre-hospital and emergency care. PROSPERO 2022 CRD42022349600 Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022349600.
Published: 2024
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8. Exploration of uncertainty of PRx time trends

Author: Erta Beqiri, Michal M. Placek, Ka Hing Chu, Joseph Donnelly, Giada Cucciolini, Virginia Motroni, Claudia A. Smith, Marek Czosnyka, Peter Hutchinson, and Peter Smielewski
Subjects: PRx, Uncertainty, Time-trends, Cerebral autoregulation, Traumatic brain injury, Variability, Neurology. Diseases of the nervous system, RC346-429
Abstract: Introduction: PRx can be used as surrogate measure of Cerebral Autoregulation (CA) in traumatic brain injury (TBI) patients. PRx can provide means for individualising cerebral perfusion pressure (CPP) targets, such as CPPopt. However, a recent Delphi consensus of clinicians concluded that consensus could not be reached on the accuracy, reliability, and validation of any current CA assessment method. Research question: We aimed to quantify the short-term uncertainty of PRx time-trends and to relate this to other physiological measurements. Material and methods: Intracranial pressure (ICP), arterial blood pressure (ABP), end-tidal CO2 (EtCO2) high-resolution recordings of 911 TBI patients were processed with ICM + software. Hourly values of metrics that describe the variability within modalities derived from ABP, ICP and EtCO2, were calculated for the first 24h of neuromonitoring. Generalized additive models were used to describe the time trend of the variability in PRx. Linear correlations were studied for describing the relationship between PRx variability and the other physiological modalities. Results: The time profile of variability of PRx decreases over the first 12h and was higher for average PRx ∼0. Increased variability of PRx was not linearly linked with average ABP, ICP, or CPP. For coherence between slow waves of ABP and ICP >0.7, the variability in PRx decreased (R = −0.47, p
Published: 2024
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9. Consensus-based recommendations for diagnosis and surgical management of cranioplasty and post-traumatic hydrocephalus from a European panel

Author: Corrado Iaccarino, Salvatore Chibbaro, Thomas Sauvigny, Ivan Timofeev, Ismail Zaed, Silvio Franchetti, Harry Mee, Antonio Belli, Andras Buki, Pasquale De Bonis, Andreas K. Demetriades, Bart Depreitere, Kostantinos Fountas, Mario Ganau, Antonino Germanò, Peter Hutchinson, Angelos Kolias, Dirk Lindner, Laura Lippa, Niklas Marklund, Catherine McMahon, Dorothee Mielke, Davide Nasi, Wilco Peul, Maria Antonia Poca, Angelo Pompucci, Jussi P. Posti, Nicoleta-Larisa Serban, Bruno Splavski, Ioan Stefan Florian, Anastasia Tasiou, Gianluigi Zona, and Franco Servadei
Subjects: Cranioplasty, Post-traumatic hydrocephalus, Diagnosis, Surgical strategy, Neurology. Diseases of the nervous system, RC346-429
Abstract: Introduction: Planning cranioplasty (CPL) in patients with suspected or proven post-traumatic hydrocephalus (PTH) poses a significant management challenge due to a lack of clear guidance. Research question: This project aims to create a European document to improve adherence and adapt to local protocols based on available resources and national health systems. Methods: After a thorough non-systematic review, a steering committee (SC) formed a European expert panel (EP) for a two-round questionnaire using the Delphi method. The questionnaire employed a 9-point Likert scale to assess the appropriateness of statements inherent to two sections: ''Diagnostic criteria for PTH'' and ''Surgical strategies for PTH and cranial reconstruction.'' Results: The panel reached a consensus on 29 statements. In the ''Diagnostic criteria for PTH'' section, five statements were deemed ''appropriate'' (consensus 74.2−90.3 %), two were labeled ''inappropriate,'' and seven were marked as ''uncertain.''In the ''Surgical strategies for PTH and cranial reconstruction'' section, four statements were considered ''appropriate'' (consensus 74.2−90.4 %), six were ''inappropriate,'' and five were ''uncertain.'' Discussion and conclusion: Planning a cranioplasty alongside hydrocephalus remains a significant challenge in neurosurgery. Our consensus conference suggests that, in patients with cranial decompression and suspected hydrocephalus, the most suitable diagnostic approach involves a combination of evolving clinical conditions and neuroradiological imaging. The recommended management sequence prioritizes cranial reconstruction, with the option of a ventriculoperitoneal shunt when needed, preferably with a programmable valve. We strongly recommend to adopt local protocols based on expert consensus, such as this, to guide patient care.
Published: 2024
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10. Red solid line: Patterns of terminal loss of cerebrovascular reactivity at the bedside

Author: Erta Beqiri, Marek Czosnyka, Michal M. Placek, Giada Cucciolini, Virginia Motroni, Claudia A. Smith, Peter Hutchinson, and Peter Smielewski
Subjects: Red solid line, PRx, lost vascular reactivity, Intracranial hypertension, Brain hypoperfusion, Neurology. Diseases of the nervous system, RC346-429
Abstract: Introduction: Continuous monitoring of the pressure reactivity index (PRx) provides an estimation of dynamic cerebral autoregulation (CA) at the bedside in traumatic brain injury (TBI) patients. Visualising the time-trend of PRx with a risk bar chart in ICM + software at the bedside allows for better real-time interpretability of the autoregulation status. When PRx>0.3 is sustained for long periods, typically of at least half an hour, the bar shows a pattern called “red solid line” (RSL). RSL was previously described to precede refractory intracranial hypertension and brain death. Research question: We aimed to describe pathophysiological changes in measured signals/parameters during RSL. Material and methods: Observation of time-trends of PRx, intracranial pressure, cerebral perfusion pressure, brain oxygenation and compensatory reserve of TBI patients with RSL. Results: Three pathophysiological patterns were identified: RSL precedes intracranial hypertension, RSL is preceded by intracranial hypertension, or RSL is preceded by brain hypoperfusion. In all cases, RSL was followed by death and the RSL onset was between 1 h and 1 day before the terminal event. Discussion and conclusion: RSL precedes death in intensive care and could represent a marker for terminal clinical deterioration in TBI patients. These findings warrant further investigations in larger cohorts to characterise pathophysiological mechanisms underlying the RSL pattern and whether RSL has a significant relationship with outcome after TBI.
Published: 2024
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11. Blood biomarkers for traumatic brain injury: A narrative review of current evidence

Author: Iftakher Hossain, Niklas Marklund, Endre Czeiter, Peter Hutchinson, and Andras Buki
Subjects: Traumatic brain injury, Blood biomarkers, Diagnostics, Outcome prediction, Neurology. Diseases of the nervous system, RC346-429
Abstract: Introduction: A blood-based biomarker (BBBM) test could help to better stratify patients with traumatic brain injury (TBI), reduce unnecessary imaging, to detect and treat secondary insults, predict outcomes, and monitor treatment effects and quality of care. Research question: What evidence is available for clinical applications of BBBMs in TBI and how to advance this field? Material and methods: This narrative review discusses the potential clinical applications of core BBBMs in TBI. A literature search in PubMed, Scopus, and ISI Web of Knowledge focused on articles in English with the words “traumatic brain injury” together with the words “blood biomarkers”, “diagnostics”, “outcome prediction”, “extracranial injury” and “assay method” alone-, or in combination. Results: Glial fibrillary acidic protein (GFAP) combined with Ubiquitin C-terminal hydrolase-L1(UCH-L1) has received FDA clearance to aid computed tomography (CT)-detection of brain lesions in mild (m) TBI. Application of S100B led to reduction of head CT scans. GFAP may also predict magnetic resonance imaging (MRI) abnormalities in CT-negative cases of TBI. Further, UCH-L1, S100B, Neurofilament light (NF-L), and total tau showed value for predicting mortality or unfavourable outcome. Nevertheless, biomarkers have less role in outcome prediction in mTBI. S100B could serve as a tool in the multimodality monitoring of patients in the neurointensive care unit. Discussion and conclusion: Largescale systematic studies are required to explore the kinetics of BBBMs and their use in multiple clinical groups. Assay development/cross validation should advance the generalizability of those results which implicated GFAP, S100B and NF-L as most promising biomarkers in the diagnostics of TBI.
Published: 2024
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12. Optic nerve sheath diameter measurement using point-of-care ultrasound to assess intracranial pressure of adult patients with traumatic brain injury in resource-limited setting

Author: Melaku Getachew, Mohammednur Abdulahi, Natan Muluberehan, Zeynu Hussen, Amanuel Alemayehu, Tiliksew Abebe, Abdulaziz Hussein, Peter Hutchinson, Angelos Kolias, Mulugeta Semework, Abenezer Tirsit, Tsegazeab Laeke, Abraham Tadela, and Getaw Worku Hassen
Subjects: POCUS, TBI, ONSD, Limited-resource Setting, Surgery, RD1-811, Neurology. Diseases of the nervous system, RC346-429
Abstract: Background: Traumatic brain injury is a disease with high mortality with increased intracranial pressure included in the emergency department. Neuroimaging and intracranial pressure monitoring are limited in resource-limited settings. Optic nerve sheath diameter measurement to assess intracranial pressure indirectly using point-of-care ultrasound is appealing in diagnostics and decision-making. Objectives: We plan to evaluate the utility of point-of-care ultrasound on optic nerve sheath diameter role in traumatic brain injury patients. In these patients, optic nerve sheath diameter measurement was performed immediately postoperatively and 24 h later by trained residents. The procedure was repeated if any change in clinical status was observed. Results: A total of 50 patients were enrolled. Twenty-one patients underwent neurosurgical intervention. Three patients died in hospital. Eighteen patients had optic nerve sheath diameters less than 5 mm, 20 patients had optic nerve sheath diameter between 5 mm and 6 mm, and 12 patients had optic nerve sheath diameter > 6 mm. In 2 patients with changes in clinical condition, the repeat optic nerve sheath diameter assessment showed an increase in optic nerve sheath diameter. Conclusion: Despite limitations, trained health care providers can perform optic nerve sheath diameter. Longer training time and quality assurance are needed to appreciate the impact.
Published: 2023
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13. Posterior cervical foraminotomy versus anterior cervical discectomy for Cervical Brachialgia: the FORVAD RCT

Author: Simon Thomson, Gemma Ainsworth, Senthil Selvanathan, Rachel Kelly, Howard Collier, Ruben Mujica-Mota, Rebecca Talbot, Sarah Tess Brown, Julie Croft, Nikki Rousseau, Ruchi Higham, Yahia Al-Tamimi, Neil Buxton, Nicholas Carleton-Bland, Martin Gledhill, Victoria Halstead, Peter Hutchinson, James Meacock, Nitin Mukerji, Debasish Pal, Armando Vargas-Palacios, Anantharaju Prasad, Martin Wilby, and Deborah Stocken
Subjects: Medical technology, R855-855.5
Abstract: Background Posterior cervical foraminotomy and anterior cervical discectomy are routinely used operations to treat cervical brachialgia, although definitive evidence supporting superiority of either is lacking. Objective The primary objective was to investigate whether or not posterior cervical foraminotomy is superior to anterior cervical discectomy in improving clinical outcome. Design This was a Phase III, unblinded, prospective, United Kingdom multicentre, parallel-group, individually randomised controlled superiority trial comparing posterior cervical foraminotomy with anterior cervical discectomy. A rapid qualitative study was conducted during the close-down phase, involving remote semistructured interviews with trial participants and health-care professionals. Setting National Health Service trusts. Participants Patients with symptomatic unilateral cervical brachialgia for at least 6 weeks. Interventions Participants were randomised to receive posterior cervical foraminotomy or anterior cervical discectomy. Allocation was not blinded to participants, medical staff or trial staff. Health-care use from providing the initial surgical intervention to hospital discharge was measured and valued using national cost data. Main outcome measures The primary outcome measure was clinical outcome, as measured by patient-reported Neck Disability Index score 52 weeks post operation. Secondary outcome measures included complications, reoperations and restricted American Spinal Injury Association score over 6 weeks post operation, and patient-reported Eating Assessment Tool-10 items, Glasgow–Edinburgh Throat Scale, Voice Handicap Index-10 items, PainDETECT and Numerical Rating Scales for neck and upper-limb pain over 52 weeks post operation. Results The target recruitment was 252 participants. Owing to slow accrual, the trial closed after randomising 23 participants from 11 hospitals. The qualitative substudy found that there was support and enthusiasm for the posterior cervical FORaminotomy Versus Anterior cervical Discectomy in the treatment of cervical brachialgia trial and randomised clinical trials in this area. However, clinical equipoise appears to have been an issue for sites and individual surgeons. Randomisation on the day of surgery and processes for screening and approaching participants were also crucial factors in some centres. The median Neck Disability Index scores at baseline (pre surgery) and at 52 weeks was 44.0 (interquartile range 36.0–62.0 weeks) and 25.3 weeks (interquartile range 20.0–42.0 weeks), respectively, in the posterior cervical foraminotomy group (n = 14), and 35.6 weeks (interquartile range 34.0–44.0 weeks) and 45.0 weeks (interquartile range 20.0–57.0 weeks), respectively, in the anterior cervical discectomy group (n = 9). Scores appeared to reduce (i.e. improve) in the posterior cervical foraminotomy group, but not in the anterior cervical discectomy group. The median Eating Assessment Tool-10 items score for swallowing was higher (worse) after anterior cervical discectomy (13.5) than after posterior cervical foraminotomy (0) on day 1, but not at other time points, whereas the median Glasgow–Edinburgh Throat Scale score for globus was higher (worse) after anterior cervical discectomy (15, 7, 6, 6, 2, 2.5) than after posterior cervical foraminotomy (3, 0, 0, 0.5, 0, 0) at all postoperative time points. Five postoperative complications occurred within 6 weeks of surgery, all after anterior cervical discectomy. Neck pain was more severe on day 1 following posterior cervical foraminotomy (Numerical Rating Scale – Neck Pain score 8.5) than at the same time point after anterior cervical discectomy (Numerical Rating Scale – Neck Pain score 7.0). The median health-care costs of providing initial surgical intervention were £2610 for posterior cervical foraminotomy and £4411 for anterior cervical discectomy. Conclusions The data suggest that posterior cervical foraminotomy is associated with better outcomes, fewer complications and lower costs, but the trial recruited slowly and closed early. Consequently, the trial is underpowered and definitive conclusions cannot be drawn. Recruitment was impaired by lack of individual equipoise and by concern about randomising on the day of surgery. A large prospective multicentre trial comparing anterior cervical discectomy and posterior cervical foraminotomy in the treatment of cervical brachialgia is still required. Trial registration This trial is registered as ISRCTN10133661. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 27, No. 21. See the NIHR Journals Library website for further project information. Plain language summary Cervical brachialgia is pain that starts in the neck and passes down into the arm. Although most people with cervical brachialgia recover quickly, in some patients pain persists, and in 15% of patients pain is so severe that they are unable to work. In the posterior cervical FORaminotomy Versus Anterior cervical Discectomy in the treatment of cervical brachialgia trial, we investigated two neck surgeries used to treat this problem: posterior cervical foraminotomy (surgery from the back of the neck) and anterior cervical discectomy (surgery from the front of the neck). This trial aimed to find out if one of them is better than the other at relieving pain and more cost-effective for the National Health Service. We assessed patients’ quality of life 1 year after their surgery and how their pain changed over the course of the year. We also measured the number of complications patients had in the first 6 weeks after their operation. Recruitment was slow and so the trial was stopped early, after only 23 patients from 11 hospitals had been randomly allocated to the two surgery groups. We had planned to recruit 252 participants to the trial; the number of participants we were able to recruit in practice was too small to enable us to determine which surgery is better at relieving pain. To find out why the trial had struggled to recruit, we asked hospital staff and participants about their experiences. We found that hospital staff sometimes struggled to organise everything needed to randomise patients on the day of surgery. Some staff also found it difficult to randomise patients as they had an opinion on which surgery they thought the patient should receive. The data collected in the trial will still be useful to help design future research. Finding out which surgery is better at relieving pain remains important, and the data we have collected will support answering this question in future. Scientific summary Background As people age, degenerative disease affects the intervertebral discs, facet joints and ligamentum flavum in the cervical spine. Consequently, the nerve root foramina may change shape and the nerve roots become compressed, causing a syndrome called cervical radiculopathy. Cervical radiculopathy is characterised by neck pain and cervical brachialgia, with the symptom of pain originating in the neck and radiating down into the upper arm. The reported incidence of cervical brachialgia is 1.79 cases per 1000 per year, with > 110,000 cases of brachialgia annually in the UK. Cervical brachialgia typically affects people aged 40–60 years, with up to 15% of patients unable to work because of the pain. In most patients, brachialgia is self-resolving with conservative management strategies. However, if symptoms persist 6 weeks to 3 months after onset, two of the available surgical techniques used (in the UK) to treat cervical brachialgia are posterior cervical foraminotomy (PCF) and anterior cervical discectomy (ACD). The most common and current standard operation is ACD, approaching from the front of the neck. The procedure is effective, but there is a high incidence of significant, potentially permanent, complications, including dysphagia and hoarse voice, which can be devastating to a patient’s quality of life. Alternatively, PCF can be undertaken from the back of the neck. Unlike ACD, PCF avoids risk to the structures in front of the spine including the carotid artery, sympathetic trunk, recurrent laryngeal nerve, larynx and pharynx, but may result in higher levels of postoperative neck pain and a greater need for revision surgery. Controversy therefore exists over which procedure is superior for the treatment of cervical brachialgia, and the decision on which procedure to use is frequently left to surgeon preference. The posterior cervical FORaminotomy Versus Anterior cervical Discectomy in the treatment of cervical brachialgia (FORVAD) trial aimed to robustly compare the two procedures, with the ambition of providing definitive evidence that would guide surgical decision-making for patients with cervical brachialgia symptoms requiring surgical intervention. Objectives The primary objective of the trial was to determine whether PCF is superior to ACD in terms of improving clinical outcome, as measured by the Neck Disability Index (NDI) at 52 weeks post operation, among patients with persistent cervical brachialgia for whom conservative management has failed. The secondary objectives were comparison of the two surgeries in terms of NDI score, patient-reported neck and upper-limb pain, dysphagia and globus, hoarse voice symptoms, incidence of revision surgery, cost effectiveness over 52 weeks post operation, the extent and severity of a patient’s spinal cord functional impairment, and incidence of surgical complications up to 6 weeks post operation. The exploratory objectives were to explore the impact of variations in the optional surgical components of PCF (open or minimal-access surgery) and ACD (surgery with or without a plate) on NDI and EuroQol-5 Dimensions, three-level version (EQ-5D-3L) scores. Design The FORVAD trial was a UK multicentre, Phase III, parallel-group, superiority, individually randomised controlled trial comparing the clinical effectiveness and cost effectiveness of PCF with those of ACD among patients experiencing symptomatic unilateral cervical brachialgia for at least 6 weeks, with confirmed nerve root compression on magnetic resonance imaging or computerised tomography myelography. Neither participants nor medical or clinical trial staff in the FORVAD trial were blinded to the treatment allocated. The trial incorporated an internal pilot phase to assess the feasibility of trial delivery against prespecified recruitment criteria. Participants were randomised (1 : 1) to receive PCF or ACD via minimisation incorporating a random element, with minimisation factors of centre, duration of upper-limb symptoms and smoking status. Participants were followed up in clinic at day 1 and 6 weeks post operation, and by post at 12, 26, 39 and 52 weeks post operation. The target sample size was 252 participants (126 per trial arm). This number was required to have 90% power to detect the minimum clinically important difference of 10% (5 points) in the change in NDI score at 52 weeks post operation, assuming a between-patient standard deviation of 23 units, two-sided 5% significance level and 10% loss to follow-up. For the analysis of the primary outcome measure, it was intended to use a multilevel linear regression model incorporating random effects with respect to centre, and adjusting for baseline (day 0) NDI score and minimisation factors (duration of upper limb symptoms and smoking status). The statistical analysis plan was amended prior to final analysis of the data to account for the restricted sample size owing to the early closure of the trial and was limited to descriptive summaries. Setting The trial aimed to recruit from 15 NHS hospitals throughout the UK. Participating surgeons were expected to perform both trial procedures and were required to have performed a minimum of 10 of each surgical procedure and to have completed a bespoke training package on the e-brain platform [www.ebrain.net (accessed 25 April 2022)]. Participants Patients were eligible to participate if they had been diagnosed with unilateral cervical brachialgia that had persisted for at least 6 weeks, resultant from single-level nerve entrapment, and conservative management had previously failed. Patients with cervical myelopathy, spinal cord compression or who had previously had cervical spine surgery were excluded. Eligibility waivers were not granted in this trial. Interventions Pre-operative investigations and preparation were as per individual site protocol. Participants received either PCF or ACD. Minimal- and open-access techniques were permitted for PCF. For ACD, the choice of fusion material and the decision to use a plate were left to surgeon discretion. Postoperative care was also as per individual site protocol. Main outcome measures The primary outcome measure was the patient-reported percentage NDI score at 52 weeks post operation. Secondary patient-reported outcomes (collected at baseline; at days 1 and 6; and at 12, 26, 39 and 52 weeks post operation) were collected using the Numerical Rating Scale–Neck Pain (NRS-NP), the Numerical Rating Scale–Arm Pain (NRS-AP), the validated PainDETECT, the Eating Assessment Tool-10 items (EAT-10), the Glasgow–Edinburgh Throat Scale (GETS) and the Voice Handicap Index-10 items (VHI-10) tools. Secondary clinical outcomes included a restricted version of the American Spinal Injury Association (ASIA) assessment scale, intraoperative and postoperative complications, incidence of reoperations within 52 weeks of operation and assessment of hoarse voice from additional voice recordings collected from randomly selected participants using the grade, roughness, breathiness, asthenia and strain scoring system. Exploratory outcomes included whether participants receiving PCF received minimal- or open-access surgery, and whether participants receiving ACD received surgery with or without a plate. Patient-reported outcomes were recorded using the EQ-5D-3L, which, alongside collected health resource use data, informed cost-effectiveness analysis. Results Owing to slower than expected accrual, the trial closed to recruitment after randomising 23 participants, 14 to PCF and 9 to ACD, from 11 sites. Therefore, results from the trial should be interpreted with caution because of the small sample size. The median NDI scores at baseline and 52 weeks were 44.0 [interquartile range (IQR) 36.0–62.0] and 25.3 (IQR 20.0–42.0) in the PCF group, respectively, indicating a reduction (improvement) from baseline. In the ACD group, the median scores at baseline and 52 weeks were 35.6 (IQR 34.0–44.0) and 45.0 (IQR 20.0–57.0), respectively. Unlike the PCF group, NDI scores did not appear to improve from baseline in the ACD group. For the NRS-NP and NRS-AP, there was an initial increase from baseline in neck pain score on day 1 post operation in both groups [median 5.5 (IQR 4.0–8.0) at baseline to 8.5 (IQR 6.0–10.0) at 1 day post operation in the PCF group; median 5.0 (IQR 4.0–7.0) at baseline to 7.0 (IQR 4.0–9.0) at 1 day post operation in the ACD group]. Neck pain decreased after day 1 in both treatment groups; at 52 weeks, the median scores were 4.0 (IQR 2.0–5.0) in the PCF group and 5.0 (IQR 3.0–7.0) in the ACD group. In both groups, arm pain improved on day 1 [median 3.0 (IQR 2.0–8.0) in the PCF group; median 4.0 (IQR 0.5–5.0) in the ACD group] and reached its lowest level 12 weeks post operation [median 3.0 (IQR 2.0–8.0) in the PCF group; median 2.5 (IQR 0.0–5.0) in the ACD group]. Thereafter, arm pain deteriorated (increased), but remained below baseline [median 5.0 (IQR 2.0–7.0) in the PCF group and median 5.0 (IQR 3.0–6.0) in the ACD group at 52 weeks]. PainDETECT category scores fluctuated over the postoperative period in the PCF group, but reduced over time in the ACD group, suggesting that in the ACD group a higher proportion of the participants had developed nociceptive, rather than neuropathic, pain. The ASIA score remained unchanged in both treatment groups over the 6-week assessment period. For the EAT-10 and the VHI-10 outcomes, the ACD group had worse outcomes at day 1 [median EAT-10 scores of 0.0 (IQR 0.0–4.0) in the PCF group and 13.5 (IQR 3.5–16.0) in the ACD group, and median VHI-10 scores of 0.0 (IQR 0.0–2.0) in the PCF group and 2.0 (IQR 0.5–8.5) in the ACD group], after which the two groups are comparable. However, the median GETS score was worse in the ACD group postoperatively, although the IQRs in each treatment group overlap at all time points except day 1. Five postoperative complications were reported in five participants throughout the trial, all occurring in the ACD group. Reported complications included two instances of dysphagia and three ‘other’ complications: ‘wound infection’, ‘urinary retention’ and ‘wound redness stitches overnight’. No serious or unexpected serious complications, deaths or reoperations were reported. The health economics and qualitative study The revised aims of the cost-effectiveness analysis were to describe the costs of the surgical interventions, health-care service use and participant out-of-pocket expenditures, and the productivity costs of losses associated with the surgery and its consequences. Responses to the EQ-5D-3L questionnaire of generic health-related quality of life and the rate of data completion are summarised. All costs are based on 2019/20 prices and are presented without discounting, as the time horizon of the analysis is 52 weeks. The costs of the intervention were heavily influenced by outliers in the PCF group, resulting in mean health-care costs of initial surgery, including devices, operation and hospital stay, of £2745 [95% confidence interval (CI) £2344 to £3147] for the PCF group (n = 12) and £4295 (95% CI £3436 to £5154) for the ACD group (n = 8). The corresponding median costs were £2622 (IQR £2402–2824) for participants undergoing PCF and £4423 (IQR £3849–4821) for participants undergoing ACD. These costs were driven by the time in theatre, which was a mean of 30 minutes (median 45 minutes) shorter for PCF (mean 61 minutes, median 52 minutes, IQR 49–60 minutes) than for ACD (mean 91 minutes, median 100 minutes, IQR 75–109 minutes). Results aggregated up to week 6 are presented owing to high attrition thereafter. The mean costs from the NHS and Personal Social Services perspective were £2716 (95% CI £2345 to £3087) for the PCF group and £4133 (95% CI £3099 to £5167) for the ACD group; the median costs were £2634 (IQR £2444–2741) and £4214 (IQR £3602–4994) for the PCF and ACD groups, respectively. The mean per-patient costs to society were £4608 (95% CI £2514 to £6703) for the PCF group and £5015 (95% CI £2286 to £7743) for the ACD group; the median costs were £4097 (IQR £2448–6591) and £4143 (IQR £4126–4284) for the PCF and ACD groups, respectively. At baseline, severe problems with anxiety and depression were more common, and pain and discomfort according to the EQ-5D-3L classification system was more severe in the PCF group than in the ACD group, resulting in mean utility scores of 0.291 (95% CI 0.07 to 0.51) and 0.595 (95% CI 0.40 to 0.78) for PCF and ACD, respectively. The corresponding median scores were 0.210 (IQR –0.01 to 0.60) and 0.689 (IQR 0.66–0.69). This is likely to have played a role in the larger observed gains from baseline in postoperative EuroQol-5 Dimensions (EQ-5D) scores for participants in the PCF group than in the ACD group [median change at 6 weeks of 0.10 (IQR 0.00–0.13) and 0.02 (IQR –0.03 to 0.06), respectively]. A rapid qualitative study was conducted during trial close-down to understand the experiences of health-care professionals and participants who participated in the FORVAD trial and why recruitment had been challenging, with the aim of informing future research in this area. Semistructured interviews were conducted with 18 health-care professionals (research nurses and surgeons) and two participants who had participated in the FORVAD trial. Interviews explored participants’ experiences of the FORVAD trial and their reasons for taking part, and staff experiences of recruiting to the FORVAD trial and neurosurgery trials in general. Interviews were audio-recorded and transcribed verbatim. Transcripts were analysed using rapid qualitative analysis. There was no single key factor that limited recruitment, and several themes were identified as common to all sites. Surgeons at participating sites supported the trial, and recognised collective clinical equipoise; however, many had preferences for one or the other procedure, linked to their usual practice. Organisation of the trial recruitment pathway varied, with some sites choosing to direct potentially eligible patients to dedicated clinics and other sites taking a more ad hoc approach. In the FORVAD trial, the dedicated clinic approach appeared to contribute to more eligible patients being identified and recruited, although staff at other sites explained that dedicated clinics did not fit easily with their clinical pathways. Randomisation on the day of surgery presented ethical and organisational challenges, and, where possible, should be avoided in future surgical trials. Organisation and implementation of a surgical trial in neurosurgery are complex and present many challenges. Future trials in neurosurgery should identify aspects of the protocol where it is possible to offer flexibility and ensure early multidisciplinary involvement at sites to maximise the effective integration of trial and clinical pathways. Conclusions The data suggest that PCF may be associated with better outcomes, fewer complications and lower cost, but the trial recruited slowly and was closed early. As a consequence, the trial is underpowered and definitive conclusions cannot be drawn. Trial recruitment was impaired by the lack of individual equipoise and concern about randomising on the day of surgery. A large prospective multicentre trial comparing ACD and PCF in the treatment of cervical brachialgia is still required. Trial registration This trial is registered as ISRCTN10133661. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 27, No. 21. See the NIHR Journals Library website for further project information.
Published: 2023
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14. An international, prospective observational study on traumatic brain injury epidemiology study protocol: GEO-TBI: Incidence [version 1; peer review: 2 approved]

Author: David Clark, Tommi Kalevi Korhonen, Sara Venturini, Sujit Gnanakumar, Thomas Bashford, Midhun Mohan, Indira Devi Bhagavatula, Ronnie Baticulon, Rocío Fernández-Méndez, Ignatius Esene, Deepak Gupta, Anthony Figaji, Tsegazeab Laeke, Tariq Khan, David Menon, Michael Martin, Kee B. Park, Wellingson Paiva, Andres M. Rubiano, Jogi V. Pattisapu, Hamisi Shabani, Vijaya Sekhar, Davi Solla, Kachinga Sichizya, Manjul Tripathi, Abenezer Tirsit, Bart Depreitere, Carole Turner, Laura Lippa, Corrado Iaccarino, Gail Rosseau, Andrew Reisner, Rikin Trivedi, Franco Servadei, Angelos Kolias, Vicknes Waran, Peter Hutchinson, and Alexis Joannides
Subjects: epidemiology, global, registry, traumatic brain injury, eng, Medicine
Abstract: Background: The epidemiology of traumatic brain injury (TBI) is unclear – it is estimated to affect 27–69 million individuals yearly with the bulk of the TBI burden in low-to-middle income countries (LMICs). Research has highlighted significant between-hospital variability in TBI outcomes following emergency surgery, but the overall incidence and epidemiology of TBI remains unclear. To address this need, we established the Global Epidemiology and Outcomes following Traumatic Brain Injury (GEO-TBI) registry, enabling recording of all TBI cases requiring admission irrespective of surgical treatment. Objective: The GEO-TBI: Incidence study aims to describe TBI epidemiology and outcomes according to development indices, and to highlight best practices to facilitate further comparative research. Design: Multi-centre, international, registry-based, prospective cohort study. Subjects: Any unit managing TBI and participating in the GEO-TBI registry will be eligible to join the study. Each unit will select a 90-day study period. All TBI patients meeting the registry inclusion criteria (neurosurgical/ICU admission or neurosurgical operation) during the selected study period will be included in the GEO-TBI: Incidence. Methods: All units will form a study team, that will gain local approval, identify eligible patients and input data. Data will be collected via the secure registry platform and validated after collection. Identifiers may be collected if required for local utility in accordance with the GEO-TBI protocol. Data: Data related to initial presentation, interventions and short-term outcomes will be collected in line with the GEO-TBI core dataset, developed following consensus from an iterative survey and feedback process. Patient demographics, injury details, timing and nature of interventions and post-injury care will be collected alongside associated complications. The primary outcome measures for the study will be the Glasgow Outcome at Discharge Scale (GODS) and 14-day mortality. Secondary outcome measures will be mortality and extended Glasgow Outcome Scale (GOSE) at the most recent follow-up timepoint.
Published: 2023
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15. Standardizing Cranioplasty Outcomes Following Stroke or Traumatic Brain Injury: Protocol for the Development of a Core Outcome Set

Author: Harry Mee, Ana M Castaño-Leon, Ivan Timofeev, Amos Adeleye, Indira Devi Bhagavatula, Niklas Marklund, Susanne Muehlschlegel, Katie Bond, Clare Clement, Kirsty Grieve, Nicola Owen, Gemma Whiting, Carole Turner, Andres Mariano Rubiano Escobar, Dhaval Shukla, Maria Paul, Judith Allanson, Valerie Pomeroy, Edoardo Viaroli, Elizabeth Warburton, Adam Wells, Gregory Hawryluk, Adel Helmy, Fahim Anwar, Stephen Honeybul, Peter Hutchinson, and Angelos Kolias
Subjects: Medicine, Computer applications to medicine. Medical informatics, R858-859.7
Abstract: BackgroundCore outcome sets (COSs) are important and necessary as they help standardize reporting in research studies. Cranioplasty following traumatic brain injury (TBI) or stroke is becoming increasingly common, leading to an ever-growing clinical and research interest, especially regarding the optimal material, cost-effectiveness, and timing of cranioplasty concerning neurological recovery and complications. Consequently, heterogeneous reporting of outcomes from such diverse studies has led to limited meta-analysis ability and an ongoing risk of outcome reporting bias. This study aims to define a standardized COS for reporting in all future TBI and stroke cranioplasty studies. ObjectiveThis study has four aims: (1) undertake a systematic review to collate the most current outcome measures used within the cranioplasty literature; (2) undertake a qualitative study to understand better the views of clinicians, patients' relatives, and allied health professionals regarding clinical outcomes following cranioplasty; (3) undertake a Delphi survey as part of the process of gaining consensus for the COS; and (4) finalize consensus through a consensus meeting resulting in the COS. MethodsAn international steering committee has been formed to guide the development of the COS. In addition, recommendations from other clinical initiatives such as COMET (Core Outcomes and Effectiveness Trials) and OMERACT (Outcome Measures in Rheumatology) have been adhered to. Phase 1 is data collection through a systematic review and qualitative study. Phase 2 is the COS development through a Delphi survey and consensus meetings with consensus definitions decided and agreed upon before the Delphi survey begins to avoid bias. ResultsPhase 1 started at the end of 2019, following ethical approval in December 2019, and the project completion date is planned for the end of 2022 or beginning of 2023. ConclusionsThis study should result in a consensus on a COS for cranioplasty, following TBI or stroke, to help standardize outcome reporting for future studies, which can be applied to future research and clinical services, help align future studies, build an increased understanding of cranioplasty and its impact on a patient’s function and recovery, and help standardize the evidence base. International Registered Report Identifier (IRRID)DERR1-10.2196/37442
Published: 2023
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16. Early Versus Late Cranioplasty After Decompressive Craniectomy In Traumatic Brain Injury

Author: Rick Vreeburg, Ranjit Singh, Inge van Erp, Tommi Korrhonen, John Hue, Harry Mee, Ivan Timofeev, Bart Depreitere, Ewout Steyerberg, Godard de Ruiter, Peter Hutchinson, Hester Lingsma, Geoffrey Manley, Andrew Maas, Wilco Peul, Jeroen van Dijck, Jussi Posti, and Thomas van Essen
Subjects: Neurology. Diseases of the nervous system, RC346-429
Published: 2023
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17. Update on the Global Neurotrauma Outcomes Study Spine: An international, multi-centre, prospective cohort study on the injury profile, management and outcomes of traumatic spinal injury

Author: Saniya Mediratta, Stefan Yordanov, Jibin Francis, G. Balamurali, Karol Budohoski, Alexis Joannides, Tariq Khan, Radek Kindl, Michael Martin, Colum Nolan, benezer Tirsit, Sarah Woodrow, Peter Hutchinson, and Rikin Trivedi
Subjects: Neurology. Diseases of the nervous system, RC346-429
Published: 2023
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18. The Development and Current Status of a Global Registry for Traumatic Brain Injury – GEO-TBI

Author: Tommi Korhonen, Alexis Joannides, Sujit Gnanakumar, David Clark, Thomas Bashford, Rikin Trivedi, David Menon, Angelos Kolias, and Peter Hutchinson
Subjects: Neurology. Diseases of the nervous system, RC346-429
Published: 2023
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19. Association of body mass index with outcomes in patients with newly diagnosed atrial fibrillation: GARFIELD-AF

Author: Daniela Poli, Sophie Testa, Corrado Lodigiani, Toon Wei Lim, Kevin Jones, Kangning Chen, Hui Li, Hilary Pinnock, Grzegorz Bilo, Hack-Lyoung Kim, Andrew Murray, Bernard J Gersh, Kurt Huber, Robin Fox, Sarah Davies, James Rogers, Morten Schou, Xin Li, Vira Tseluyko, Sergey Popov, Rajeev Gupta, Grzegorz Opolski, Preeti Pandya, Bronte Ayres, Milan Gupta, Peter Hutchinson, Phil Simmons, Andrew Gallagher, Michel Galinier, Franck Paganelli, Jens Kilian, Adam Blenkhorn, Mohamed Ibrahim, Fernando Lanas, Karen Pieper, Eivind Berge, M Clark, Agneta Andersson, Karim Ladha, Bijoy Sinha, Torstein Hole, Dan Atar, Hywel Jones, R Smith, Andrew Ross, Emmanuel Ellie, Paul Evans, Yong Wang, Hiroshi Ono, Tadashi Nakamura, Paul MacDonald, Stephen Rogers, Igor Sibon, Simon Dobson, David Fitzmaurice, Jiyan Chen, Neil Roberts, Pierre Amarenco, Nigel Hart, Giancarlo Agnelli, Georges Mairesse, Pekka Raatikainen, Oleg Sychov, Yasuyuki Suzuki, Bo Liu, Mathieu Zuber, John French, Yuejin Yang, Myeong-Chan Cho, Julian Thompson, Michael Stokes, John W Eikelboom, Mark Richardson, John Matthews, Will Murdoch, Jean-Philippe Neau, Freek Verheugt, Ajay K Kakkar, Giuseppe Ambrosio, Marcin Gruchała, Keith A A Fox, Sunil Kumar, Ruiping Zhao, Patrick Carroll, Masanori Kaneko, Thanh Phan, Ping Yang, Sung-Won Jang, Claire Jones, Mårten Rosenqvist, Johan Engdahl, Debabrata Roy, John Cairns, Ping Chen, Michael Olsen, Paul Angaran, David Russell, Helena Dominguez, Béla Merkely, Joseph Berlingieri, James Bennett, Hugo ten Cate, Hiroshi Yamaguchi, Masahiro Minamoto, Hiroyuki Oda, Toshihiko Shiraiwa, Jonathan Webster, Yukihiro Koretsune, Kotaro Obunai, R Thompson, Yong Seog Oh, Giuliana Guazzaloca, Giuliana Martini, Marc Bonnefoy, Michael Cox, András Nagy, Kazuki Sato, Richard Davies, Daisuke Ikeda, Susumu Suzuki, Hiroki Teragawa, Koji Matsushita, Ying Guo, Catherine Neden, Mark Pugsley, Simon Cartwright, Polly Jacobs, Xiaoshu Cheng, Daniel Nishijima, Sylvia Haas, Vinay Kumar, Saverio Virdone, Jean-Pierre Bassand, Samuel Z Goldhaber, Shinya Goto, Frank Misselwitz, Alexander G G Turpie, Alison Macleod, Karen Forshaw, Mark Boon, Stephen Miller, Simon Wetherell, Moustafa Moustafa, Gaetano Serviddio, Renato Lopes, Kazuo Takei, Hiroaki Nishioka, Mykola Stanislavchuk, C Ramesh, R Kamath, Stuart J Connolly, Nooshin Bazargani, Kevin Douglas, Werner Hacke, Gloria Kayani, Ali Oto, Hiroshi Watanabe, Walter Hermans, Kazuya Murata, Christian Fielder Camm, Marco Moia, Niraj Sharma, Jaeyoung Kim, Walter Abhayaratna, Andriy Yagensky, Hosen Kiat, Wilhelm Haverkamp, Yang Jiao, Hitoshi Kato, Jindrich Spinar, Daniel Theodoro, Philip Cooke, Paolo Golino, Tetsuro Yoshida, Prakash Chandwani, Christine A'Court, Brian Ramjattan, Torbjørn Øien, Toshiyuki Kobayashi, Richard West, Petr Jansky, Seil Oh, Jan Steffel, Martin van Eickels, Hyung-Wook Park, Nam-Ho Kim, Søren Rasmussen, Kazuo Suzuki, David Colquhoun, Hiroshi Ando, Simon Franklin, Tae-Joon Cha, Sang Cheol Bae, Guosheng Fu, Yoshihiro Saito, Heinz Drexel, Michel Martelet, Joseph Mouallem, Nicolas Delarche, Sylvain Destrac, Neil Macey, Andreas Kopf, Masayuki Nakano, Olga Barbarash, Takeshi Inoue, Taro Minagawa, Weihua Li, John Eikelboom, Hiroshi Kubo, Lars Andersson, D Burns, Andrea Podczeck-Schweighofer, Megumi Okada, Massimo Volpe, Takuma Aoyama, Karsten Mueller, Carlos Astudillo, Hiroshi Takeda, Peter Mayer, Jung Hoon Sung, Dinesh Jain, Jung Han Yoon, Alessandro Capucci, Dongryeol Ryu, Kelvin Wong, Hong Euy Lim, Xiaowei Yan, Yusheng Zhao, Yuehui Yin, YUKIHIRO SETA, Taek Jong Hong, MASAKI SHIMOYAMA, Dayi Hu, Junichi Minami, Yuriy Mostovoy, David Foo, Ramazan Topsakal, Zhi-Cheng Jing, Dipen Shah, Kenichi Yamamoto, David Coulshed, Olivier Piot, Ramón Corbalán, Silva Severi, Waldemar Myszka, Mehmet Birhan Yilmaz, Gi-Byoung Nam, Jun Kim, Harald Darius, Jan-Erik Karlsson, PETER VANDERGOTEN, Nasser Taha, Shuta Toru, Jörn Nielsen, Tsutomu Takagi, Koji Higuchi, Steen Husted, Tomohiro Katsuya, Frank Cools, Iveta Petrova, Songkwan Silaruks, GÜNTER LEHMANN, Frederic Casassus, Bernard Crousillat, Bernard Doucet, Jean-Joseph Muller, Grzegorz Raczak, Kazuyuki Saito, Anders Ostrem, Chi Keong Ching, KUNIHIKO YAMAMOTO, John Camm, Carmine Mazzone, Jaemin Shim, Jadwiga Nessler, Jan Vercammen, Marc Delforge, Chong-Jin Kim, Pierre Nazeyrollas, Louise Lumley, Paul Roome, Helen Stoddart, Mark Rickenbach, Paul Mullen, Noriyuki Nakanishi, Gordon Irvine, Paul Conn, Kurt Lenz, Richard Coates, E Fisher, Warwick Coulson, Jiri Lastuvka, Pablo García Pavía, P Jhittay, Philip Saunders, Peter Bernhardt, Wanwarang Wongcharoen, Kentaro Yamamoto, Hector Lucas Luciardi, Harry Gibbs, Marianne Brodmann, Jørn Dalsgaard Nielsen, Hany Ragy, Matyas Keltai, Jitendra Pal Singh Sawhney, Janina Stepinska, Elizaveta Panchenko, Barry Jacobson, Xavier Viñolas, Pantep Angchaisuksiri, Alex Parkhomenko, Huaiqin Zhang, Shiping Cao, Daowen Wang, Guizhou Tao, Yingmin Chen, Shenghu He, Tongguo Wu, Moshui Chen, Longgen Xiong, Praveen Jadhavm, Raghava Sarma, Govind Kulkarni, Rasesh Atulbhai Pothiwala, Mohanan Padinhare Purayil, Kamaldeep Chawla, Veerappa Annasaheb Kothiwale, Bagirath Raghuraman, Vinod Madan Vijan, Jitendra Sawhney, Ganapathi Bantwal, Aziz Khan, Ramdhan Meena, Manojkumar Chopada, Sunitha Abraham, Vikas Bisne, Govindan Vijayaraghavan, Rajashekhar Durgaprasad, Kartikeya Bhargava, Udigala Madappa Nagamalesh, Rajeeve Kumar Rajput, Seishu Kanamori, Koichiro Kumagai, Yosuke Katsuda, Keiki Yoshida, Fumitoshi Toyota, Yuji Mizuno, Ikuo Misumi, Hiroo Noguchi, Shinichi Ando, Tetsuro Suetsugu, Susumu Adachi, Kei Chiba, Hiroaki Norita, Makoto Tsuruta, Takeshi Koyanagi, Takayuki Higashi, Shiro Azakami, Shinichiro Komaki, Kenshi Kumeda, Takashi Murayama, Jun Matsumura, Yurika Oba, Ryuji Sonoda, Kazuo Goto, Kotaro Minoda, Yoshikuni Haraguchi, Hisakazu Suefuji, Hiroo Miyagi, Tsugihiro Nakamura, Hidekazu Nandate, Ryuji Zaitsu, Yoshihisa Fujiura, Akira Yoshimura, Hiroyuki Numata, Jun Ogawa, Yasuyuki Kamogawa, Kinshiro Murakami, Yutaka Wakasa, Masanori Yamasawa, Hiromitsu Maekawa, Sumihisa Abe, Hajime Kihara, Satoru Tsunoda, Katsumi Saito, Hiroki Tachibana, Ichiro Oba, Takashi Kuwahata, Satoshi Higa, Masamichi Gushiken, Takuma Eto, Hidetoshi Chibana, Kazuaki Fujisawa, Yuhei Shiga, Hirokuni Sumi, Toshihisa Nagatomo, Yoshihiko Atsuchi, Toshiro Nagoshi, Kazuhisa Sanno, Fumihiro Hoshino, Naoto Yokota, Masahiro Kameko, Toshifumi Tabuchi, Munesumi Ishizawa, Yoshitake Fujiura, Taku Seto, Tetsu Iwao, Norio Ishioka, Koichi Oshiro, Keizo Tsuchida, Yutaka Hatori, Motoshi Takeuchi, Hiroto Takezawa, Shinjiro Nagano, Masaaki Iwaki, Yuichiro Nakamura, Naomasa Miyamoto, Toshifumi Taguchi, Ko Ashida, Naoto Yoshizawa, Jun Agata, Seishiro Matsukawa, Osamu Arasaki, Shuji Fukuoka, Hirofumi Murakami, Kazuya Mishima, Yoshiki Hata, Ichiro Sakuma, Ichiro Takamura, Mitsuyuki Akutsu, Toshihide Unoki, Yoshinori Go, Makoto Ikemura, Shoji Morii, Shigeru Marusaki, Hideo Doi, Mitsuru Tanaka, Takaaki Kusumoto, Shigeo Kakinoki, Chiga Ogurusu, Masami Nakatsuka, Yutaka Kitami, Yoichi Nakamura, Hiroshi Oda, Rikimaru Oyama, Masato Ageta, Teruaki Mita, Kazuhiko Nagao, Takafumi Mito, Mitsunori Abe, Masako Fujii, Makoto Okawa, Tsuneo Fujito, Toshiya Taniguchi, Tenei Ko, Mizuho Imamaki, Masahiro Akiyama, Takashi Ueda, Hironori Odakura, Masahiko Inagaki, Yoshiki Katsube, Atsuyuki Nakata, Shinobu Tomimoto, Mitsuhiro Shibuya, Kenichiro Ito, Masahiro Matsuta, Motoyuki Ishiguro, Masamichi Wada, Hiroaki Mukawa, Masato Mizuguchi, Fumio Okuda, Teruaki Kimura, Kuniaki Taga, Masaaki Techigawara, Morio Igarashi, Toshihiko Seo, Shinya Hiramitsu, Hiroaki Hosokawa, Mitsumoto Hoshiai, Michitaka Hibino, Koichi Miyagawa, Hideki Horie, Nobuyoshi Sugishita, Yukio Shiga, Akira Soma, Kazuo Neya, Kunio Akahane, Saori Matsui, Hirofumi Kanda, Shiro Nagasaka, Atsushi Taguchi, Akiko Miyashita, Hiroki Sasaguri, Jin Nariyama, Taketo Hatsuno, Takash Iwase, Kazuya Kawai, Tomobumi Kotani, Tsuyoshi Tsuji, Hirosumi Sakai, Kiyoshi Nishino, Kenichi Ikeda, Kazuo Maeda, Tomohiro Shinozuka, Koichi Kawakami, Hiromichi Kitazumi, Mamoru Hamaoka, Jisho Kojima, Akitoshi Sasaki, Yoshihiro Tsuchiya, Tetsuo Betsuyaku, Masaaki Honda, Koichi Hasegawa, Takao Baba, Kazuaki Mineoi, Toshihiko Koeda, Kunihiko Hirasawa, Toshihide Kumazaki, Akira Nakagomi, Eiji Otaki, Takashi Shindo, Hiroyoshi Hirayama, Chikako Sugimoto, Takashi Yamagishi, Ichiro Mizuguchi, Kazunori Sezaki, Isamu Niwa, Ken Takenaka, Osamu Iiji, Koichi Taya, Hitoshi Kitazawa, Samu Ueda, Hirokazu Kakuda, Takuya Ono, Seizo Oriso, Junya Kamata, Toshihiko Nanke, Itaru Maeda, Yoshifusa Matsuura, Yasuyuki Maruyama, Hajime Horie, Tetsutaro Kito, Hiroshi Asano, Masaichi Nakamura, Takashi Washizuka, Tomoki Yoshida, Masato Sawano, Shinichi Arima, Hidekazu Arai, Hisanori Shinohara, Hiroyuki Takai, Nobufusa Furukawa, Akira Ota, Kenji Aoki, Taku Yamamoto, Takeaki Kasai, Shunji Suzuki, Shu Suzuki, Nitaro Shibata, Masayuki Watanabe, Yosuke Nishihata, Toru Arino, Masaki Okuyama, Tetsushi Wakiyama, Tomoko Kato, Yasuo Sasagawa, Takeshi Tana, Yoshihito Hayashi, Shinichi Hirota, Yukihiko Abe, Hirohide Uchiyama, Shuichi Tohyo, Naoto Hanazono, Seiichi Miyajima, Hisashi Shimono, Yasunobu Shozawa, Yawara Niijima, Osamu Murai, Hideko Inaba, Katsumasa Nomura, Masatsugu Nozoe, Toshiyuki Furukawa, Nobuhisa Ito, Shunichi Nagai, Kiyoharu Sato, Shiro Nakahara, Yujin Shimoyama, Naoko Ohara, Teruhiko Kozuka, Hideaki Okita, Masato Endo, Tsutomu Goto, Makoto Hirose, Emiko Nagata, Toshizumi Mori, Shuichi Seki, Katsuhiro Okamoto, Osamu Moriai, Yoko Emura, Tsuyoshi Fukuda, Haruhiko Date, Shuichi Kawakami, Sho Nagai, Yuya Ueyama, Tetsuro Fudo, Mitsuru Imaizumi, Takuo Ogawa, Shunsuke Take, Hideo Ikeda, Norihiko Sakamoto, Kiyomitsu Ikeoka, Nobuo Wakaki, Masatake Abe, Junji Doiuchi, Tetsuya Kira, Masato Tada, Ken Tsuzaki, Naoya Miura, Yasuaki Fujisawa, Wataru Furumoto, Akinori Fujisawa, Ryosai Nakamura, Hiroyasu Komatsu, Rei Fujiki, Shuichi Kawano, Keijiro Nishizawa, Yoji Kato, Junya Azuma, Kiyoshi Yasui, Toshio Amano, Yasuhiro Sekine, Tatsuo Honzawa, Yuichiro Koshibu, Yasuhide Sakamoto, Shingo Miyaguchi, Kojuro Morishita, Yasuko Samejima, Toyoshi Sasaki, Fumiko Iseki, Hiroshi Kano, Yoichi Takagi, Yoko Onuki Pearce, Takayuki Fukui, Toru Nakayama, Hideaki Kanai, Yoshiyuki Kawano, Tetsuji Ino, Hironori Miyoshi, Yasufumi Miyamoto, Masahito Shigekiyo, Shimato Ono, Yutaka Okamoto, Satoshi Ubukata, Kojiro Kodera, Tatsuo Oriuchi, Naoki Matsumoto, Koichi Inagaki, Atsushi Iseki, Tomohiro Yoshida, Toshihiro Goda, Tsukasa Katsuki, Atsushi Sato, Etsuo Mori, Toshio Tsubokura, Hiroshi Shudo, Shunichi Fujimoto, Yoshiyuki Furukawa, Hiroshi Hosokawa, Jun Narumi, Kiichiro Yamamoto, Masaki Owari, Takuya Inakura, Takafumi Anno, Kazuyuki Shirakawa, Tan Yuyang, Hui Nam Park, Woo-Shik Kim, HyeYoung Lee, Dae Hyeok Kim, Dae-Kyeong Kim, Dong Ju Choi, Hui-Kyung Jeon, Dong-Gu Shin, Sang Weon Park, Hoon Ki Park, Sang-Jin Han, Young Keun On, JaeJin Kwak, Seong Hoon Park, Kee-Sik Kim, Byung Chun Jung, Gyo-Seung Hwang, Sakda Rungaramsin, Peerapat Katekangplu, Porames Khunrong, Thanita Bunyapipat, Pinij Kaewsuwanna, Khanchai Siriwattana, Waraporn Tiyanon, Supalerk Pattanaprichakul, Khanchit Likittanasombat, Doungrat Cholsaringkarl, Warangkana Boonyapisit, Sirichai Cheewatanakornkul, Pisit Hutayanon, Seksan Chawanadelert, Pairoj Chattranukulchai, Boonsert Chatlaong, Yingsak Santanakorn, Khompiya Kanokphatcharakun, Piya Mongkolwongroj, Sasivimon Jai-Aue, Ongkarn Komson, Armagan Altun, Ali Aydinlar, Zeki Ongen, Sadik Acikel, Durmus Yildiray Sahin, Ozcan Yilmaz, Hasan Pekdemir, Mesut Demir, Murat Sucu, Levent Sahiner, Murat Ersanli, Ertugrul Okuyan, Dursun Aras, Florencia Rolandi, Adrian Cesar Ingaramo, Gustavo Alberto Sambadaro, Vanina Fernandez Caputi, Hector Luciardi, Sofia Graciela Berman, Pablo Dragotto, Andres Javier Kleiban, Nestor Centurion, Ricardo Dario Dran, Javier Egido, Matias Jose Fosco, Victor Alfredo Sinisi, Luis Rodolfo Cartasegna, Oscar Gomez Vilamajo, Jose Luis Ramos, Sonia Sassone, Gerardo Zapata, Diego Conde, Guillermo Giacomi, Alberto Alfredo Fernandez, Mario Alberto Berli, Fabian Ferroni, Jefferson Jaber, Luciana Vidal Armaganijan, André Steffens, José Márcio Ribeiro, Marcelo Silveira Teixeira, Paulo Rossi, Leonardo Pires, Daniel Moreira, Luiz Bodanese, Marcelo Westerlund Montera, Jamil Abdalla Saad, Euler Roberto Manenti, Alexandre Negri, Carlos Moncada, Dalton Precoma, Fernando Roquette, Gilmar Reis, Estêvão Lanna Figueiredo, Roberto Vieira Botelho, Helius Carlos Finimundi, Adriano Kochi, Fábio Alban, Rogério Tadeu Tumelero, Lilia Maia, Humberto Montecinos, Martín Larico Gómez, Carlos Conejeros, Patricio Marin Cuevas, Alejandro Forero, Claudio Bugueño Gutiérrez, Juan Aguilar, Sergio Potthoff Cardenas, German Eggers, Cesar Houzvic, Carlos Rey, Germán Arriagada, Gustavo Charme Vilches, Raul Leal Cantu, Ricardo Cabrera Jardines, Nilda Espinola Zavaleta, Enrique Lopez Rosas, Gerardo Pozas, Ernesto Cardona Muñoz, Norberto Matadamas Hernandez, Adolfo Leyva Rendon, Norberto Garcia Hernandez, David Lopez Villezca, Carlos Hernandez Herrera, Rodolfo Gaona Rodriguez, Efrain Villeda Espinosa, David Flores Martinez, Jose Velasco Barcena, Omar Fierro Fierro, Ignacio Rodriguez Briones, Humberto Alvarez Lopez, Rafael Olvera Ruiz, Roxana Reyes Sanchez, Roberto Arriaga Nava, Pedro Fajardo Campos, Mario Benavides Gonzalez, Claus Hagn, Johannes Foechterle, Michael Winkler, Bruno Schneeweiss, Alfons Gegenhuber, Wilfried Lang, Sabine Eichinger-Hasenauer, Peter Kaserer, Josef Sykora, Heribert Rasch, Bernhard Strohmer, Luc Capiau, Geert Vervoort, Bart Wollaert, Geert Hollanders, Dirk Faes, Yohan Balthazar, Olivier Xhaet, Harry Striekwold, John Thoeng, Kurt Hermans, Wim Anné, Ivan Blankoff, Michel Beutels, Stefan Verstraete, Philippe Purnode, Pascal Godart, Tim Boussy, Philippe Desfontaines, Alex Heyse, Joeri Voet, Eva Zidkova, Rudolf Spacek, Vilma Machova, Ondrej Ludka, Josef Olsr, Lubos Kotik, Blazej Racz, Richard Ferkl, Jan Hubac, Ilja Kotik, Zdenek Monhart, Hana Burianova, Ondrej Jerabek, Jana Pisova, Vratislav Dedek, Michaela Honkova, Petr Podrazil, Petr Reichert, Miroslav Novak, Vaclav Durdil, Katarina Plocova, Ulrik Hintze, Næstved Sygehus, Arne Bremmelgaard, John Markenvard, Jan Børger, Jorgen Solgaard, Ebbe Eriksen, Thomas Løkkegaard, Michael Bruun, Jacob Mertz, Joël Ohayon, Yannick Gottwalles, Philippe Loiselet, Mohamed Bassel Koujan, André Marquand, Jean-Pierre Cebron, Maxime Guenoun, Dominique Guedj-Meynier, A G Lokesh, James Kadouch, Pierre-Yves Fournier, Jean-Pierre Huberman, Nestor Lemaire, Gilles Rodier, Xavier Vandamme, Marie Hélène Mahagne, Antoine Mielot, Jean-Baptiste Churet, Vincent Navarre, Frederic Sellem, Gilles Monniot, Jean-Paul Boyes, Désiré Obadia, Etienne Bearez, Jean Philippe Brugnaux, Alain Fedorowsky, Jean-Baptiste Berneau, Frédéric Chemin, Sebastien Schellong, Georg Koeniger, Uwe Gerbaulet, Bernd-Thomas Kellner, Thomas Schaefer, Jan Purr, Enno Eißfeller, Heinz-Dieter Zauzig, Peter Riegel, Christoph Axthelm, Gerd-Ulrich Heinz, Holger Menke, Andreas Pustelnik, Stefan Zutz, Wolfgang Eder, Guenter Rehling, Dirk Glatzel, Norbert Ludwig, Petra Sandow, Henning Wiswedel, Cosmas Wildenauer, Steffen Schoen, Toralf Schwarz, Adyeri Babyesiza, Maximilian Kropp, Hans-Hermann Zimny, Friedhelm Kahl, Andreas Caspar, Sabine Omankowsky, Torsten Laessig, Hermann-Josef Hartmann, Hans-Walter Bindig, Gunter Hergdt, Dietrich Reimer, Joachim Hauk, Holger Michel, Praxis Dres, Werner Erdle, Wilfried Dorsch, Janna Dshabrailov, Karl-Albrecht Rapp, Reinhold Vormann, Thomas Mueller, Uwe Horstmeier, Volker Eissing, Heinz Hey, Heinz Leuchtgens, Volker Lilienweiss, Heiner Mueller, Christian Schubert, Herrmann Lauer, Thomas Buchner, Gunter Brauer, Susanne Kamin, Sylvia Baumbach, Muwafeg Abdel-Qader, Hans-Holger Ebert, Carsten Schwencke, Laszlo Karolyi, Britta Sievers, Jens-Uwe Roehnisch, Andras Vertes, Gabor Szantai, Andras Matoltsy, Nikosz Kanakaridisz, Zoltan Boda, Erno Kis, Balazs Gaszner, Ferenc Juhasz, Gizella Juhasz, Sandor Kancz, Zoltan Laszlo, Zsolt May, Ebrahim Noori, Tamas Habon, Peter Polgar, Gabriella Szalai, Sandor Vangel, Gabriella Engelthaler, Judit Ferenczi, Mihaly Egyutt, Leone Maria Cristina, Eros Tiraferri, Rita Santoro, Teresa Maria Caimi, Maria Tessitori, Roberto Cappelli, Roberto Quintavalla, Franco Cosmi, Raffaele Fanelli, Vincenzo Oriana, Raffaele Reggio, Roberto Santi, Leonardo Pancaldi, Jorge Salerno Uriate, Flavia Lillo, Enrico Maria Pogliani, Michele Accogli, Antonio Mariani, Mauro Feola, Arturo Raisaro, Luciano Fattore, Andrea Mauric, Fabrizio Germini, Luca Tedeschi, Maria Settimi, Sergio Nicoli, Paolo Ricciarini, Antonio Argena, Paolo Ronchini, Claudio Bulla, Filippo Tradati, Maria Grazia Bongiorni, Enrico Salomone, Claudio Tondo, Saverio Iacopino, Andreas Lucassen, Henk Adriaansen, Maarten Bongaerts, Mathijs Pieterse, Johannes Herrman, Pieter Hoogslag, Cees Buiks, Per Anton Sirnes, Erik Gjertsen, Knut Erga, Arne Hallaråker, Gunnar Skjelvan, Beraki Ghezai, Arne Svilaas, Peter Christersson, Svein Høegh Henrichsen, Jan Erik Otterstad, Jan Berg-Johansen, Andrzej Gieroba, Malgorzata Biedrzycka, Michal Ogorek, Beata Wozakowska-Kaplon, Krystyna Loboz-Grudzien, Jerzy Kuzniar, Roman Zaluska, Jaroslaw Hiczkiewicz, Lucyna Swiatkowska-Byczynska, Lech Kucharski, Piotr Minc, Maciej Olszewski, Grzegorz Kania, Malgorzata Krzciuk, Zbigniew Lajkowski, Bozenna Ostrowska-Pomian, Jerzy Lewczuk, Elzbieta Zinka, Agnieszka Karczmarczyk, Malgorzata Chmielnicka-Pruszczynska, Iwona Wozniak-Skowerska, Marek Bronisz, Marcin Ogorek, Grazyna Glanowska, Piotr Ruszkowski, Grzegorz Skonieczny, Ryszard Sciborski, Boguslaw Okopien, Piotr Kukla, Krzysztof Galbas, Krzysztof Cymerman, Jaroslaw Jurowiecki, Pawel Miekus, Stanislaw Mazur, Roman Lysek, Jacek Baszak, Teresa Rusicka-Piekarz, Ewa Domanska, Jozef Lesnik, Gadel Kamalov, Dmitry Belenky, Liudmila Egorova, Alexander Khokhlov, Eduard Yakupov, Dmitry Zateyshchikov, Olga Miller, Evgeniy Mazur, Konstantin Zrazhevskiy, Tatyana Novikova, Yulia Moiseeva, Elena Polkanova, Konstantin Sobolev, Maria Rossovskaya, Yulia Shapovalova, Alla Kolesnikova, Konstantin Nikolaev, Oksana Zemlianskaia, Anna Zateyshchikova, Victor Kostenko, Maria Poltavskaya, Anton Edin, Elena Aleksandrova, Oksana Drapkina, Alexander Vishnevsky, Oleg Nagibovich, Petr Chizhov, Svetlana Rachkova, Mikhail Sergeev, Borys Kurylo, Alexey Ushakov, Pere Alvarez Garcia, Luis Tercedor Sanchez, Salvador Tranche Iparraguirre, Pere Toran Monserrat, Emilio Marquez Contreras, Jordi Isart Rafecas, Juan Motero Carrasco, Casimiro Gomez Pajuelo, Angel Grande Ruiz, Jordi Merce Klein, Ines Monte Collado, Herminia Palacin Piquero, Carles Brotons Cuixart, Esther Fernandez Escobar, Cecilia Corros Vicente, Manuel Vida Gutierrez, Francisco Epelde Gonzalo, Encarnacion Martinez Navarro, Maria Barreda Gonzalez, Jose Iglesias Sanmartin, Mercedes Jimenez Gonzalez, Juan Herreros Melenchon, Tomas Ripoll Vera, Manuel Jimenez Navarro, Maria Vazquez Caamano, Gonzalo Marcos Gomez, Andres Iniguez Romo, Alexander Wirdby, Kerstin Henriksson, Micael Elmersson, Arnor Egilsson, Ulf Börjesson, Gunnar Svärd, Anders Lindh, Lars-Bertil Olsson, Mikael Gustavsson, Lars Benson, Claes Bothin, Ali Hajimirsadeghi, Björn Martinsson, Marianne Ericsson, Åke Ohlsson, Håkan Lindvall, Peter Svensson, Katarina Thörne, Hans Händel, Pyotr Platonov, Fredrik Bernsten, Ingar Timberg, Milita Crisby, Lennart Malmqvist, Jörgen Thulin, Aida Hot-Bjelak, Steen Jensen, Per Stalby, Johann Debrunner, Iurii Rudyk, Oleksandr Karpenko, Svitlana Zhurba, Igor Kraiz, Oleksandr Parkhomenko, Iryna Kupnovytska, Nestor Seredyuk, Oleksiy Ushakov, Olena Koval, Igor Kovalskiy, Yevgeniya Svyshchenko, Susanna Tykhonova, Ivan Fushtey, Naresh Chauhan, Daryl Goodwin, Ramila Patel, Bennett Wong, Alex Cameron, Niranjan Patel, M S Kainth, Gill Pickavance, Joanna McDonnell, Laura Handscombe, Trevor Gooding, Helga Wagner, Catherine Bromham, Shoeb Suryani, Bhupinder Sarai, W Willcock, S Sircar, A Gilliand, Roman Bilas, E Strieder, Anne Wakeman, Graham Kirby, Bhaskhar Vishwanathan, Nigel Bird, John Bisatt, Jennifer Litchfield, Tim Fooks, Richard Kelsall, Neil Paul, Elizabeth Alborough, Michael Aziz, Pete Wilson, Sue Fairhead, Hasan Chowan, Gary Taylor, Dawn Tragen, Matt Parfitt, Claire Seamark, Carolyn Paul, Angus Jefferies, Helen Sharp, Claire Giles, Matthew Bramley, Philip Williams, Jehad Aldegather, William Lumb, Phil Evans, Frances Scouller, Yvette Stipp, Philip Pinney, Paul Wadeson, T Railton, Emyr Davies, Jonathan McClure, Marc Jacobs, Claire Hutton, Keith Butter, Susan Barrow, Helen Little, Ulka Choudhary, Ikram Haq, Paul Ainsworth, Phil Weeks, Jane Eden, Lisa Gibbons, Janet Glencross, K Poland, Conor Mulolland, A Warke, Ian Hodgins, Stephen Vercoe, Jayesh Patel, Amar Ali, Nigel De-Sousa, Mark Danielsen, Purnima Sharma, Sophia Galloway, Charlotte Hawkins, Raife Oliver, Martin Aylward, Mira Pattni, Shahid Ahmad, Catherine Rothwell, Fiaz Choudhary, Sabrina Khalaque, Stephanie Short, Sharon Peters, Amy Butler, Steven Coates, Steve Walton, Diane Shepherd, Toh Wong, Melanie Deacon, David Cornelius, Henry Choi, Jon Sumner, Tim Myhill, Salah Estifanos, Diane Geatch, Justin Wilkinson, Richard Veale, Rob Hirst, Kashif Zaman, Catherine Liley, Rebecca Wastling, Paul McEleny, Andre Beattie, Mike Wong, Chaminda Dooldeniya, Greg Rogers, Rajesh Muvva, Matthew Adam, Nicolas Thomas, Rory Reed, Simon Randfield, Ann Flynn, Andrew Halpin, Louise Lomax, Minnal Nadaph, Iain Munro, Jane Goram, John Shewring, Emma Bowen-Simpkins, Bhuwanendu Singh, Penny Astridge, Philip Thomson, Ron Lehman, Andrei Catanchin, David Eccleston, Peter Blombery, Greg Starmer, Margaret Arstall, Maurits Binnekamp, Astin Lee, Robert Luton, Amritanshu Shekhar Pandey, Stephen Cheung, Rolland Leader, Philippe Beaudry, Félix Ayala-Paredes, John Heath, Germain Poirier, Bradley Schweitzer, Reginald Nadeau, Ripple Dhillon, Tomasz Hruczkowski, Andrea Lavoie, Ratika Parkash, James Cha, Benoit Coutu, Jorge Bonet, Saul Vizel, Sameh Fikry, Ahmed Mowafy, Azza Katta, Mazen Tawfik, Moustafa Nawar, Mohamed Sobhy, Tarek Khairy, Ahmed Abd El-Aziz, Ashraf Reda, Atef Elbahry, Mohamed Setiha, Magdi Elkhadem, Adel El-Etreby, David Kettles, Junaid Bayat, Heidi Siebert, Adrian Horak, Ynez Kelfkens, Riaz Garda, Thayabran Pillay, Michele Guerra, Hendrik Theron, Rikus Louw, Deon Greyling, Pindile Mntla, Siddique Ismail, Fayzal Ahmed, Johannes Engelbrecht, Shambu Maharajh, Veronica Ueckermann, Ghazi Yousef, Munther AlOmairi, Rajan Maruthanayagam, Rupesh Singh, Ahmed Naguib, Amrish Agrawal, Mukesh Nathani, Adel Wassef, Scott Beach, Peter Duffy, Stephen Falkowski, Kevin Ferrick, Miguel Franco, Annette Quick, Vance Wilson, Mark Alberts, Edwin Blumberg, Roddy Canosa, Ted Gutowski, Rodney Ison, Jorge Garcia, Howard Noveck, Pamela Rama, Rajneesh Reddy, Marcus Williams, Keith Ferdinand, Ihsan Haque, Robert Mendelson, Sridevi Pitta, Charles Treasure, Cas Cader, Walter Pharr, Alisha Oropallo, George Platt, Jaspal Gujral, James Welker, Firas Koura, Ajay K. Kakkar, A. John Camm, David A. Fitzmaurice, Keith A.A. Fox, Bernard J. Gersh, Samuel Z. Goldhaber, Lorenzo G. Mantovani, Karen S. Pieper, Alexander G.G. Turpie, Freek W.A. Verheugt, Antonio Carlos PereiraBarretto, Stuart J. Connolly, Jean-Yves Le Heuzey, Jitendra Pal SinghSawhney, Carlos JerjesSánchez Díaz, Hugo Ten Cate, Wael Al Mahmeed, Zhiming Yang Li Xue, A.G. Ravi Shankar, Chiei Takanaka Sen Adachi, Rodolfo AndresAhuad Guerrero, Leonel Adalberto Di Paola, DárioCelestino Sobral Filho, Costantino RobertoFrack Costantini, Weimar Kunz SebbaBarrosodeSouzaem, João David deSouzaNeto, José Carlos MouraJorge, Adalberto MenezesLorga Filho, Carlos Henrique DelCarlo, FernandoAugustoAlves da Costa, Gilson Robertode Araújo, Jose FranciscoKerr Saraiva, João CarlosFerreira Braga, Roberto Álvaro RamosFilho, Cláudio MunhozdaFontoura Tavares, CésarCássio Broilo França, Guido BernardoAranha Rosito, João BatistadeMouraXavierMoraes Junior, Roberto Simõesde Almeida, Ney CarterdoCarmo Borges, LuísGustavo Gomes Ferreira, Benjamin AleckJosehStockins Fernandez, CarlosJerjes Sanchez Diaz, Jesus JaimeIllescas Diaz, Maria GuadalupeRamos Zavala, GuillermoAntonio Llamas Esperón, Manuel delosRios Ibarra, LuisRamon Virgen Carrillo, JuanJose Lopez Prieto, Jose LuisLeiva Pons, Carlos GerardoCantu Brito, EduardoJulianJose Roberto ChuquiureValenzuela, Alberto EstebanBazzoni Ruiz, Oscar MartinLopez Ruiz, Jesus DavidMorales Cerda, Axel De Wolf, Carmela Viitanen, Giovanni Di Minno, Raimondo De Cristofaro, Angelo De Blasio, Maria D'Avino, J.H. Ruiter, Coen van Guldener, P.R. Nierop S.H.K., B.E. Groenemeijer, W. Terpstra, L.V.A. Boersma, Wieslaw Supinski Jaroslaw, Roman Libis Vera Eltishcheva, Maria FernandaLopez Fernandez, Luis MiguelRincon Diaz, Luis FernandoIglesias Alonso, Jose RamonGonzalez Juanatey, Joan Bayo iLlibre, Carlos AlexandreAlmeida Fernandez, Juan JoseMontero Alia, Maria AngelsMoleiro Oliva, Maria delMarRodriguez Alvarez, Maria FeArcocha Torres, Miguel AngelPrieto Diaz, Jan Lindén Centrumkliniken, Juerg H. Beer, Colin Bradshaw Cumberlidge, Daniel Jackson Ben Ward, Nick Hargreaves Ben Frankel, William van Gaal, David O'Donnell, Miranda du Preez, Seif Kamal Abou Seif, Mohamed Gamal El Din, Louis van Zyl, Rehana Loghdey Wessel Oosthuysen, Abdullah Al Naeemi, Ehab M. Esheiba, and W. Michael Kutayli
Subjects: Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Objective While greater body mass index (BMI) is associated with increased risk of developing atrial fibrillation (AF), the impact of BMI on outcomes in newly diagnosed AF is unclear. We examine the influence of BMI on outcomes and whether this is modified by sex and evaluate the effect of non-vitamin K oral anticoagulants (NOACs) in patients with high BMI.Methods GARFIELD-AF is a prospective registry of 52 057 newly diagnosed AF patients. The study population comprised 40 482 participants: 703 underweight (BMI
Published: 2022
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20. Can compliment and complaint data inform the care of individuals with chronic subdural haematoma (cSDH)?

Author: Benjamin Davies, Alexis J Joannides, Peter Hutchinson, Thomas Santarius, Daniel J Stubbs, Rowan M Burnstein, Alexander Komashie, and Katherine Jones
Subjects: Medicine (General), R5-920
Abstract: Objectives To explore the frequency and nature of complaints and compliments reported to Patient Advice and Liaison (PALS) in individuals undergoing surgery for a chronic subdural haematoma (cSDH).Design A retrospective study of PALS user interactions.Subjects Individuals undergoing treatment for cSDH between 2014 and 2019.Methods PALS referrals from patients with cSDH between 2014 and 2019 were identified. Case records were reviewed and data on the frequency, nature and factors leading up to the complaint were extracted and coded according to Healthcare Complaints Analysis Tool (HCAT).Results Out of 531 patients identified, 25 (5%) had a PALS interaction, of which 15 (3%) were complaints and 10 (2%) were compliments. HCAT coding showed 8/15 (53%) of complaints were relationship problems, 6/15 (33%) a management problem and 1/15 (7%) other. Of the relationship problems, 6 (75%) were classed as problems with communication and 2 (25%) as a problem with listening. Of the compliments, 9/10 (90%) related to good clinical quality and 1/10 (10%) to staff–patient relationship. Patients were more likely to register a compliment than family members, who in turn were more likely to register a complaint (p
Published: 2021
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21. ‘Overnight, things changed. Suddenly, we were in it’: a qualitative study exploring how surgical teams mitigated risks of COVID-19

Author: Leila Rooshenas, Jane M Blazeby, David Jayne, Natalie S Blencowe, Anni Skilton, Marcus Jepson, Peter Hutchinson, Sian Cousins, Daisy Elliott, Sangeetha Paramasivan, Jenny L Donovan, Cynthia Ochieng, Martin Birchall, and Kerry NL Avery
Subjects: Medicine
Abstract: Objectives COVID-19 presents a risk of infection and transmission for operating theatre teams. Guidelines to protect patients and staff emerged and changed rapidly based on expert opinion and limited evidence. This paper presents the experiences and innovations developed by international surgical teams during the early stages of the pandemic to attempt to mitigate risk.Design In-depth, semistructured interviews were audio recorded, transcribed and analysed thematically using methods of constant comparison.Participants 43 participants, including surgeons from a range of specialties (primarily general surgery, otolaryngology, neurosurgery, cardiothoracic and ophthalmology), anaesthetists and those in nursing roles.Setting The UK, Italy, Spain, the USA, China and New Zealand between March and May 2020.Results Surgical teams sought to mitigate COVID-19 risks by modifying their current practice with an abundance of strategies and innovations. Communication and teamwork played an integral role in how teams adapted, although participants reflected on the challenges of having to improvise in real time. Uncertainties remained about optimal surgical practice and there were significant tensions where teams were forced to balance what was best for patients while contemplating their own safety.Conclusions The perceptions of risks during a pandemic such as COVID-19 can be complex and context dependent. Management of these risks in surgery must be driven by evidence‐based practice resulting from a pragmatic and novel approach to collation of global evidence. The context of surgery has changed dramatically, and surgical teams have developed a plethora of innovations. There is an urgent need for high-quality evidence to inform surgical practice that optimises the safety of both patients and healthcare professionals as the COVID-19 pandemic unfolds.
Published: 2021
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22. Impact of COVID-19 pandemic on surgical neuro-oncology multi-disciplinary team decision making: a national survey (COVID-CNSMDT Study)

Author: Giles Critchley, Peter Hutchinson, Chittoor Rajaraman, Ola Rominiyi, Michael D Jenkinson, Alexis Joannides, Stuart Smith, Victoria Wykes, Stephen John Price, Puneet Plaha, Fardad Taghizadeh Afshari, Erminia Albanese, Neil U Barua, Huan Wee Chan, Thomas Flannery, Michael TC Poon, Georgios Solomou, Anna Solth, Surash Surash, and Helen Bulbeck
Subjects: Medicine
Published: 2020
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23. Global Perspectives on Task Shifting and Task Sharing in Neurosurgery

Author: Faith C. Robertson, Ignatius N. Esene, Angelos G. Kolias, Tariq Khan, Gail Rosseau, William B. Gormley, Kee B. Park, Marike L.D. Broekman, Jeffrey Rosenfeld, Naci Balak, Ahmed Ammar, Magnus Tisel, Michael Haglund, Timothy Smith, Ivar Mendez, Jannick Brennum, Stephen Honeybul, Akira Matsumara, Severien Muneza, Andres Rubiano, Patrick Kamalo, Graham Fieggen, Basant Misra, Gene Bolles, David Adelson, Robert Dempsey, Peter Hutchinson, Alexandrina Nikova, Osama Ghazala, Elubabor Buno, Shibashish Bhattacharjee, Takahiro Iizuka, Jafri Malin Abdullah, Bipin Chaurasia, Eghosa Morgan, Rodolfo E. Alcedo-Guardia, Lynne Lourdes N. Lucena, Kadir Oktay, Omar Ibrahim AbdAllah, Ahlem Saihi, Gacem Abdeldjalil, Mahi Asmaa, Claudio Yampolsky, Laura P. Saladino, Francisco Mannara, Sonal Sachdev, Benjamin Price, Vincent Joris, Nourou Dine Adeniran Bankole, Edgar M. Carrasco, Mirsad Hodzic, Marcos Wagner de Sousa Porto, Robson Amorim, Igor Lima Maldonado, Bizoza Yves, Gonzalo Suarez, Felipe Constanzo, Johanna Cecilia Valdeblanquez Atencio, Karen Alexa Ruiz Mora, Juan Manuel Rodriguez Gil, Kiriakos Paraskeva, Emrah Egemen, Trevcsor Ngamasata, Jeff Ntalaja, Antoine Beltchika, Glennie Ntsambi, Goertz Mirenge Dunia, Mahmoud M. Taha, Mohamed Arnaout, Ramez Kirollos, Mohamed Kassem, Omar Elwardany, Ahmed Negida, Birhanu Dolango, Mikael Aseged, Alemu Adise Mldie, Tsegazeab Laeke, Abenezer Aklilu, Esayas Adefris, Teemu Luoto, Rezai Jahromi Behnam, Emmanuel De Schlichting, Bougaci Nassim, Pierre Bourdillon, Martin N. Stienen, Stephan Lackermair, Franziska Anna Schmidt, Juergen Konczalla, Adrien Holzgreve, Andre Sagerer, Dieter M. Weinert, Paulette Kumi, Aaron Lawson McLean, James Loan, Julian Cahill, Simon Dockrell, Fardad T. Afshari, Paul May, Alkinoos Athanasiou, Steven Papadopoulos, Edroulfo-Georgios Espinoza, Athanasios Chatzisotiriou, Pavlos Vlachogiannis, Konstantina Karabatsou, Thanasis Paschalis, Christos Tsitsipanis, Gabriel Mauricio Longo Calderan, Ronny Leiva, Harsh Deora, Sreenivas Mukkamala, Dipesh Batra, Arvind Sukumaran, Kanishk Parmar, Anuj Bahl, Amit Agrawal, Nirankar Dev, Nikhil Thakur, Sanjay Behari, Chandrasekhar B.V.K. Yandrapati, Ritesh Bhoot, Pragnesh Bhatt, Uday Bhaumik, Manish Agrawal, Antony Thomas, Harish Chandrappa, Ankit Mathur, Petra Wahjoepramono, Selfy Oswari, Rafid Al-Mahfoudh, Abbas Alnaji, Nidal Abuhadrous, Bakr Abo Jarad, Ibrahim Nour, Or Cohen-Inbar, Roberto Colasanti, Alfredo Conti, Giovanni Raffa, Corrado Castrioto, Matteo M. Baccanelli, Santino Ottavio Tomasi, Matteo Zoli, Andrea Veroni, Andrea Di Cristofori, Luigi Giannachi, Laura Lippa, Donatella Sgubin, Morgan Broggi, Marcello Barbato, Francesco Restelli, Mario Ganau, Graziano Taddei, Hamzeh Albadawi, Mohammed Salameh, Madieyva Gulmira, Muffaq Lashhab, Walid El Gaddafi, Mohammad Altoumi, S.M. Manvinder, Davendran Kanesen, Mario Teo, Prabu Rau Sriram, Sarah Atiqah M. Zamri, Vayara Perumall Vinodh, Moussa Denou, Adyl Melhaoui, Oumaima Outani, Mahjouba Boutarbouch, Armin Gretschel, Pradhumna Yadav, Balgopal Karmacharya, Fatih Incekara, Hugo den Boogert, Buccket Argvoello Lopez, Hassane Ali Amadou, Danjuma Sale, Sanusi Bello, Poluyi Edward, Alvan-Emeka Ukachukwu, Evaristus Nwaribe, Ikechukwu Aniaku, Aliyu Baba Ndajiwo, Olabamidele Ayodele, Gyang Markus Bot, Sunday David Ndubuisu Achebe, Bakht Jamal, Muhammad Tariq, Ghulam Farooq, Danyal Zaman Khan, Ahtesham Khizar, Zahid Hussain, Anisa Nazir, Marco Gonzales-Portillo, Jhosep Silvestre Bautista, Roland A. Torres, Abigail Javier-Lizan, Isagani Jodl G. de los Santos, Jr., Nuno Morais, Lydia Dias, Carolina Noronha, Jovelo Monteiro Silva, Alexandra Seromenho-Santos, Kiril Lozanche, Ionut Negoi, Alexandru Tascu, Danil A. Kozyrev, Dr. Menelas Nkeshimana, Claire Karekezi, Marcel Didier Ndayishyigikiye, Faisal Alabbass, Faisal Farrash, Rawan Alhazmi, Jagos Golubovic, Milan Lepifá, Rosanda Ilifá, Aleksandar Stanimirovifá, Sergio Garcia-Garcia, Carlos A. Rodriguez Arias, Ruth Lau, Juan Delgado-Fernandez, Miguel A. Arraez, C. Fernandez Mateos, Ana M. Castano Leon, Saman Wadanamby, David Bervini, Hamisi K. Shabani, Kriengsak Limpastan, Khalil Ayadi, Altay Sencer, Ali Yalcinkaya, Elif Eren, Recep Basaran, Abdulkerim Gokoglu, Vyval Mykola, Felicita Tayong, Mario Zuccarello, Carolyn Quinsey, Michael C. Dewan, Paul H. Young, Edward Laws, Jack Rock, David B. Kurland, Carrie R. Muh, Eri Dario Delgado Aguilar, Kenneth Burns, Jacob Low, Conor Keogh, Chris Uff, Alfio Spina, and Fayez Alelyani
Subjects: Surgery, RD1-811, Neurology. Diseases of the nervous system, RC346-429
Abstract: Background: Neurosurgical task shifting and task sharing (TS/S), delegating clinical care to non-neurosurgeons, is ongoing in many hospital systems in which neurosurgeons are scarce. Although TS/S can increase access to treatment, it remains highly controversial. This survey investigated perceptions of neurosurgical TS/S to elucidate whether it is a permissible temporary solution to the global workforce deficit. Methods: The survey was distributed to a convenience sample of individuals providing neurosurgical care. A digital survey link was distributed through electronic mailing lists of continental neurosurgical societies and various collectives, conference announcements, and social media platforms (July 2018–January 2019). Data were analyzed by descriptive statistics and univariate regression of Likert Scale scores. Results: Survey respondents represented 105 of 194 World Health Organization member countries (54.1%; 391 respondents, 162 from high-income countries and 229 from low- and middle-income countries [LMICs]). The most agreed on statement was that task sharing is preferred to task shifting. There was broad consensus that both task shifting and task sharing should require competency-based evaluation, standardized training endorsed by governing organizations, and maintenance of certification. When perspectives were stratified by income class, LMICs were significantly more likely to agree that task shifting is professionally disruptive to traditional training, task sharing should be a priority where human resources are scarce, and to call for additional TS/S regulation, such as certification and formal consultation with a neurosurgeon (in person or electronic/telemedicine). Conclusions: Both LMIC and high-income countries agreed that task sharing should be prioritized over task shifting and that additional recommendations and regulations could enhance care. These data invite future discussions on policy and training programs. Key words: Global health, Global neurosurgery, LMIC, Neurotrauma, Task sharing, Task shifting, Workforce
Published: 2020
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24. Task-Shifting and Task-Sharing in Neurosurgery: An International Survey of Current Practices in Low- and Middle-Income Countries

Author: Faith C. Robertson, Ignatius N. Esene, Angelos G. Kolias, Patrick Kamalo, Graham Fieggen, William B. Gormley, Marike L.D. Broekman, Kee B. Park, Jeffrey Rosenfeld, Naci Balak, Ahmed Ammar, Magnus Tisel, Michael Haglund, Timothy Smith, Ivar Mendez, Jannick Brennum, Stephen Honeybul, Akira Matsumara, Severien Muneza, Andres Rubiano, Gail Rosseau, Tariq Khan, Basant Misra, Gene Bolles, David Adelson, Robert Dempsey, Peter Hutchinson, Abenezer Aklilu, Abigail Javier-Lizan, Adil Belhachmi, Ahtesham Khizar, Alexandru Tascu, Ali Yalcinkaya, Aliyu Baba Ndajiwo, Alvan-Emeka Ukacjukwu, Amit Agrawal, Amit Thapa, Ana C.V. Silva, Armin Gretschel, Arvind Sukumaran, Atul Vats, Bakr Abo Jarad, Balgopal Karmacharya, Bipin Chaurasia, Boon Seng Liew, Carlos A. Rodriguez Arias, Claire Karekezi, Cohen-Inbar Or, Danjuma Sale, Davendran Kanesen, Djula Djilvesi, Evarsitus Nwaribe, M. Elhaj Mahmoud, Mian Awais, Sanjay Kumar, Amos O. Adeleye, Manish Agarwal, Menelas Nkeshimana, Sunday David Ndubuisi Achebe, Walid El Gaddafi, Ece Uysal, Eghosa Morgan, Elubabor Buno, Emmanuel Sunday, Esayas Adefris, Fayez Alelyani, Felipe Constanzo, Gabriel Longo, Ghulam Farooq, Goertz Mirenge Dunia, Gyang Markus Bot, Hamisi K. Shabani, Harch Deora, Hassan Almenshawy, Hazem Kuheil, Igor Lima Maldonado, Ionut Negoi, Irfan Yousaf, Jafri Malin Abdullah, Jagos Golubovic, Khalil Ayadi, Kriengsak Limpastan, Luxwell Jokonya, Mirsad Hodzic, Mohamed Kassem, Mohammed Al-Rawi, Muhammad Tariq, Mykola Vyval, Nidal Abuhadrous, Nikolaos Syrmos, Osaid Alser, Paul H. Young, Petra Wahjoepramono, Prabu Rau Sriram, Rafik Ouchetati, Recep Basaran, Ritesh Bhoot, Robson Amorim, Rosanda Iliƒá, Saman Wadanamby, Samuel M. Fetene, Sanjay Behari, Satish Babu, Trung Kien Duong, Tsegazeab Laeke, Ulrick S. Kanmounye, Vladimir Komar, Ipe Vazheeparambil George, Zahid Hussain, Lynne Lourdes N. Lucena, Hugues Brieux Ekouele Mbaki, Ken-Keller Kumwenda, Djvnaba Bah, Ibrahim E. Efe, Dickson Bandoh, Yunus Kuntawi Aji, and Thomas Dakurah
Subjects: Surgery, RD1-811, Neurology. Diseases of the nervous system, RC346-429
Abstract: Background: Because nearly 23,000 more neurosurgeons are needed globally to address 5 million essential neurosurgical cases that go untreated each year, there is an increasing interest in task-shifting and task-sharing (TS/S), delegating neurosurgical tasks to nonspecialists, particularly in low- and middle-income countries (LMICs). This global survey aimed to provide a cross-sectional understanding of the prevalence and structure of current neurosurgical TS/S practices in LMICs. Methods: The survey was distributed to a convenience sample of individuals providing neurosurgical care in LMICs with a Web-based survey link via electronic mailing lists of continental societies and various neurosurgical groups, conference announcements, e-mailing lists, and social media platforms. Country-level data were analyzed by descriptive statistics. Results: The survey yielded 127 responses from 47 LMICs; 20 countries (42.6%) reported ongoing TS/S. Most TS/S procedures involved emergency interventions, the top 3 being burr holes, craniotomy for hematoma evacuation, and external ventricular drain. Most (65.0%) believed that their Ministry of Health does not endorse TS/S (24.0% unsure), and only 11% believed that TS/S training was structured. There were few opportunities for TS/S providers to continue medical education (11.6%) or maintenance of certification (9.4%, or receive remuneration (4.2%). Conclusions: TS/S is ongoing in many LMICs without substantial structure or oversight, which is concerning for patient safety. These data invite future clinical outcomes studies to assess effectiveness and discussions on policy recommendations such as standardized curricula, certification protocols, specialist oversight, and referral networks to increase the level of TS/S care and to continue to increase the specialist workforce. Key words: Capacity, Global health, Global neurosurgery, LMIC, Task-sharing, Task-shifting, Workforce
Published: 2020
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25. The extravasation of contrast as a predictor of cerebral hemorrhagic contusion expansion, poor neurological outcome and mortality after traumatic brain injury: A systematic review and meta-analysis.

Author: Isabella Vargas Baldon, Andre Candeas Amorim, Larissa Marques Santana, Davi J Solla, Angelos Kolias, Peter Hutchinson, Wellingson S Paiva, and Marcos Rosa-Júnior
Subjects: Medicine, Science
Abstract: BACKGROUND:The active extravasation of contrast on CT angiography (CTA) in primary intracerebral hemorrhages (ICH) is recognized as a predictive factor for ICH expansion, unfavorable outcomes and mortality. However, few studies have been conducted on the setting of traumatic brain injury (TBI). PURPOSE:To perform a literature systematic review and meta-analysis of the association of contrast extravasation on cerebral hemorrhagic contusion expansion, neurological outcomes and mortality. DATA SOURCES:The PubMed, Cochrane Library, Medline, Scielo, VHL and IBECS databases up to September 21, 2019, were searched for eligible studies. STUDY SELECTION:A total of 505 individual titles and abstracts were identified and screened. A total of 36 were selected for full text analysis, out of which 4 fulfilled all inclusion and exclusion criteria. DATA ANALYSIS:All 4 studies yielded point estimates suggestive of higher risk for hematoma expansion with contrast extravasation and the summary RR was 5.75 (95%CI 2.74-10.47, p
Published: 2020
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26. Correction: The extravasation of contrast as a predictor of cerebral hemorrhagic contusion expansion, poor neurological outcome and mortality after traumatic brain injury: A systematic review and meta-analysis.

Author: Isabella Vargas Baldon, Andre Candeas Amorim, Larissa Marques Santana, Davi J Solla, Angelos Kolias, Peter Hutchinson, Wellingson S Paiva, and Marcos Rosa-Júnior
Subjects: Medicine, Science
Abstract: [This corrects the article DOI: 10.1371/journal.pone.0235561.].
Published: 2020
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27. A Systematic Review of Neurosurgical Care in Low-Income Countries

Author: Hannah K. Weiss, Roxanna M. Garcia, Jesutofunmi A. Omiye, Dominique Vervoort, Robert Riestenberg, Ketan Yerneni, Nikhil Murthy, Annie B. Wescott, Peter Hutchinson, and Gail Rosseau
Subjects: Surgery, RD1-811, Neurology. Diseases of the nervous system, RC346-429
Abstract: Objective: More than 5 billion individuals lack access to essential surgical care. Neurosurgical care is especially limited in low-income countries (LICs). Studies describing neurosurgical care in LICs are critical for understanding global disparities in access to neurosurgical procedures. To better understand these disparities, we conducted a systematic review of the literature identifying neurosurgical patients in LICs. Methods: MEDLINE (PubMed), Embase (embase.com), and Cochrane Library (Wiley) databases were systematically searched to retrieve studies describing neurosurgical care in LICs as defined by the World Bank Country and Lending Groups income classification. All databases were searched from their inception; no date or language limits were applied. All the articles were blindly reviewed by 2 individuals. Data from eligible studies were extracted and summarized. Results: Of the 4387 citations screened, 154 studies met inclusion criteria. The number of publications substantially increased over the study period, with 49% (n = 76) of studies published in the last 5 years. Twenty-six percent (n = 40) of studies had a first author, and 30% (n = 46) had a senior author, affiliated with a country different from the LIC of study. The most common neurosurgical diagnosis was traumatic brain injury (24%, n = 37), followed by hydrocephalus (26%, n = 40), and neoplastic intracranial mass (10%, n = 16). Of LICs, 43% (n = 15/35) had no published neurosurgical literature. Conclusions: There is a significant deficit in the literature on neurosurgical care in LICs. Efforts must focus on supporting research initiatives in LICs to improve publication bias and understand disparities in access to neurosurgical care in the lowest-resource countries. Key words: Global health, Global neurosurgery, Hydrocephalus, Literature review, Low-income countries, Research, Traumatic brain injury
Published: 2020
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28. A multiplex network approach for the analysis of intracranial pressure and heart rate data in traumatic brain injured patients

Author: Giovanna Maria Dimitri, Shruti Agrawal, Adam Young, Joseph Donnelly, Xiuyun Liu, Peter Smielewski, Peter Hutchinson, Marek Czosnyka, Pietro Lió, and Christina Haubrich
Subjects: Multiplex time series network, Visibility graph, ICP, Applied mathematics. Quantitative methods, T57-57.97
Abstract: Abstract Background We present a multiplex network model for the analysis of Intracranial Pressure (ICP) and Heart Rate (HR) behaviour after severe brain traumatic injuries in pediatric patients. The ICP monitoring is of vital importance for checking life threathening conditions, and understanding the behaviour of these parameters is crucial for a successful intervention of the clinician. Our own observations, exhibit cross-talks interaction events happening between HR and ICP, i.e. transients in which both the ICP and the HR showed an increase of 20% with respect to their baseline value in the window considered. We used a complex event processing methodology, to investigate the relationship between HR and ICP, after traumatic brain injuries (TBI). In particular our goal has been to analyse events of simultaneous increase by HR and ICP (i.e. cross-talks), modelling the two time series as a unique multiplex network system (Lacasa et al., Sci Rep 5:15508-15508, 2014). Methods and data We used a complex network approach based on visibility graphs (Lacasa et al., Sci Rep 5:15508-15508, 2014) to model and study the behaviour of our system and to investigate how and if network topological measures can give information on the possible detection of crosstalks events taking place in the system. Each time series was converted as a layer in a multiplex network. We therefore studied the network structure, focusing on the behaviour of the two time series in the cross-talks events windows detected. We used a dataset of 27 TBI pediatric patients, admitted to Addenbrooke’s Hospital, Cambridge, Pediatric Intensive Care Unit (PICU) between August 2012 and December 2014. Results Following a preliminary statistical exploration of the two time series of ICP and HR, we analysed the multiplex network proposed, focusing on two standard topological network metrics: the mutual interaction, and the average edge overlap (Lacasa et al., Sci Rep 5:15508-15508, 2014). We compared results obtained for these two indicators, considering windows in which a cross talks event between HR and ICP was detected with windows in which cross talks events were not present. The analysis of such metrics gave us interesting insights on the time series behaviour. More specifically we observed an increase in the value of the mutual interaction in the case of cross talk as compared to non cross talk. This seems to suggest that mutual interaction could be a potentially interesting “marker” for cross talks events.
Published: 2017
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29. Suicidal ideation among Métis adult men and women – associated risk and protective factors: findings from a nationally representative survey

Author: Mohan B. Kumar, Melissa Walls, Teresa Janz, Peter Hutchinson, Tara Turner, and Catherine Graham
Subjects: Métis, Aboriginal, Indigenous, suicidal thoughts, suicidality, suicidal behavior, Arctic medicine. Tropical medicine, RC955-962
Abstract: Objective. To determine the prevalence of suicidal ideation among Métis men and women (20–59 years) and identify its associated risk and protective factors using data from the nationally representative Aboriginal Peoples Survey (2006). Study design. Secondary analysis of previously collected data from a nationally representative cross-sectional survey. Results. Across Canada, lifetime suicidal ideation was reported by an estimated 13.3% (or an estimated 34,517 individuals) of the total population of 20-to-59-year-old Métis. Of those who ideated, 46.2% reported a lifetime suicide attempt and 6.0% indicated that they had attempted suicide in the previous 12 months. Prevalence of suicidal ideation was higher among Métis men than in men who did not report Aboriginal identity in examined jurisdictions. Métis women were more likely to report suicidal ideation compared with Métis men (14.9% vs. 11.5%, respectively). Métis women and men had some common associated risk and protective factors such as major depressive episode, history of self-injury, perceived Aboriginal-specific community issues, divorced status, high mobility, self-rated thriving health, high self-esteem and positive coping ability. However, in Métis women alone, heavy frequent drinking, history of foster care experience and lower levels of social support were significant associated risk factors of suicidal ideation. Furthermore, a significant interaction was observed between social support and major depressive episode. Among Métis men, history of ever smoking was the sole unique associated risk factor. Conclusion. The higher prevalence of suicidal ideation among Métis women compared with Métis men and the observed gender differences in associations with some associated risk and protective factors suggest the need for gender-responsive programming to address suicidal ideation.
Published: 2012
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30. Developing the Role of a Health Information Professional in a Clinical Research Setting

Author: Helen M. Seeley, Christine Urquhart, Peter Hutchinson, and John Pickard
Subjects: Bibliography. Library science. Information resources
Abstract: Objective ‐ This paper examines the role of a health information professional in a large multidisciplinary project to improve services for head injury.Methods ‐ An action research approach was taken, with the information professional acting as co‐ordinator. Change management processes were guided by theory and evidence. The health information professional was responsible for an ongoing literature review on knowledge management (clinical and political issues), data collection and analysis (from patient records), collating and comparing data (to help develop standards), and devising appropriate dissemination strategies.Results ‐ Important elements of the health information management role proved to be 1) co‐ordination; 2) setting up mechanisms for collaborative learning through information sharing; and 3) using the theoretical frameworks (identified from the literature review) to help guide implementation. The role that emerged here has some similarities to the informationist role that stresses domain knowledge, continuous learning and working in context (embedding). This project also emphasised the importance of co‐ordination, and the ability to work across traditional library information analysis (research literature discovery and appraisal) and information analysis of patient data sets (the information management role).Conclusion ‐ Experience with this project indicates that health information professionals will need to be prepared to work with patient record data and synthesis of that data, design systems to co‐ordinate patient data collection, as well as critically appraise external evidence.
Published: 2010

31. Mapping traumatic axonal injury using diffusion tensor imaging: correlations with functional outcome.

Author: Virginia Newcombe, Doris Chatfield, Joanne Outtrim, Sarah Vowler, Anne Manktelow, Justin Cross, Daniel Scoffings, Martin Coleman, Peter Hutchinson, Jonathan Coles, T Adrian Carpenter, John Pickard, Guy Williams, and David Menon
Subjects: Medicine, Science
Abstract: Traumatic brain injury is a major cause of morbidity and mortality worldwide. Ameliorating the neurocognitive and physical deficits that accompany traumatic brain injury would be of substantial benefit, but the mechanisms that underlie them are poorly characterized. This study aimed to use diffusion tensor imaging to relate clinical outcome to the burden of white matter injury.Sixty-eight patients, categorized by the Glasgow Outcome Score, underwent magnetic resonance imaging at a median of 11.8 months (range 6.6 months to 3.7 years) years post injury. Control data were obtained from 36 age-matched healthy volunteers. Mean fractional anisotropy, apparent diffusion coefficient (ADC), and eigenvalues were obtained for regions of interest commonly affected in traumatic brain injury. In a subset of patients where conventional magnetic resonance imaging was completely normal, diffusion tensor imaging was able to detect clear abnormalities. Significant trends of increasing ADC with worse outcome were noted in all regions of interest. In the white matter regions of interest worse clinical outcome corresponded with significant trends of decreasing fractional anisotropy.This study found that clinical outcome was related to the burden of white matter injury, quantified by diffusivity parameters late after traumatic brain injury. These differences were seen even in patients with the best outcomes and patients in whom conventional magnetic resonance imaging was normal, suggesting that diffusion tensor imaging can detect subtle injury missed by other techniques. An improved in vivo understanding of the pathology of traumatic brain injury, including its distribution and extent, may enhance outcome evaluation and help to provide a mechanistic basis for deficits that remain unexplained by other approaches.
Published: 2011
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32. Second Footprint of Reports from Low- and Low- to Middle-Income Countries in the Neurosurgical Data: A Study from 2018–2020 Compared with Data from 2015–2017

Author: Delia Cannizzaro, Adrian Safa, Andrea Bisoglio, Alice J.M. Jelmoni, Ismail Zaed, Maria Pia Tropeano, Nathan A. Shlobin, Asra Al Fauzi, Abdul Hafid Bajamal, Tariq Khan, Angelos Kolias, Peter Hutchinson, and Franco Servadei
Subjects: Surgery, Neurology (clinical)
Abstract: In 2019, we highlighted the disparities in scientific production between high-income countries (HICs) and low- to middle-income countries (LMICs) by emphasizing how scientific research was underrepresented in the latter. The present study aimed to investigate research productivity in neurosurgery of low-income countries (LICs) and LMICs for the years 2018-2020 and to compare it with the results of our previous study for 2015-2017.We performed a retrospective bibliometric analysis using PubMed and Scopus databases to record all the reports published in 2018-2020 by investigators affiliated with neurosurgical departments in LICs and LMICs. The attribution of the study to LMICs was based on the presence of either the first author or the majority of authors.Our systematic search identified 486 studies reported by LICs and LMICs for full text examination in 12 journals. These articles represent 4.9% of all published neurosurgical articles, compared with 4.5% in the 2015-2017 study. India remained the country with the highest contribution, with a 17.1% increase in reports. Other countries, such as Nigeria and Philippines, also show an increased percentage of reports (from 0.9% to 3.7% and from 0.6% to 2.1%, respectively).There is growing consensus in the neurosurgical scientific community that the dissemination and analysis of epidemiologic and clinical data from developing countries can provide guidelines and practical suggestions worldwide. However, our study shows that the number of neurosurgical articles published by low-income countries in 2018-2020 remained at approximately 5% of the total, resulting in a negative impact on the process of globalization.
Published: 2022

33. GARFIELD-AF: risk profiles, treatment patterns and 2-year outcomes in patients with atrial fibrillation in Germany, Austria and Switzerland (DACH) compared to 32 countries in other regions worldwide

Author: Sylvia, H, John A, C, Darius, H, Jan, S, Saverio, V, Karen, P, Marianne, B, Sebastian, S, Frank, M, Gloria, K, Kakkar, A, Bassand, J, John Camm, A, Fitzmaurice, D, Fox, K, Gersh, B, Goldhaber, S, Goto, S, Haas, S, Hacke, W, Mantovani, L, Misselwitz, F, Pieper, K, Turpie, A, van Eickels, M, Verheugt, F, Gersh, K, Lucas Luciardi Harry Gibbs, H, Brodmann, M, Cools, F, Carlos Pereira Barretto, A, Connolly, S, Eikelboom, J, Corbalan, R, Jing, Z, Jansky, P, Dalsgaard Nielsen, J, Ragy, H, Raatikainen, P, Le Heuzey, J, Keltai, M, Pal Singh Sawhney, J, Agnelli, G, Ambrosio, G, Koretsune, Y, Jerjes Sánchez Díaz, C, Ten Cate, H, Atar, D, Stepinska, J, Panchenko, E, Wei Lim, T, Jacobson, B, Oh, S, Viñolas, X, Rosenqvist, M, Steffel, J, Angchaisuksiri, P, Oto, A, Parkhomenko, A, Al Mahmeed, W, Hu Kangning Chen, D, Zhao, Y, Zhang, H, Chen, J, Cao, S, Wang, D, Yang, Y, Li, W, Li, H, Yin, Y, Tao, G, Yang, P, Chen, Y, He, S, Wang, Y, Fu, G, Li, X, Wu, T, Cheng, X, Yan, X, Zhao, R, Chen, M, Xiong, L, Chen, P, Jiao, Y, Guo, Y, Xue, L, Yang, Z, Jadhavm Raghava Sarma, P, Kulkarni, G, Chandwani, P, Atulbhai Pothiwala, R, Padinhare Purayil, M, Chawla, K, Annasaheb Kothiwale, V, Raghuraman, B, Madan Vijan, V, Sawhney, J, Bantwal, G, Khan, A, Meena, R, Chopada, M, Abraham, S, Bisne, V, Vijayaraghavan, G, Roy, D, Durgaprasad, R, Ravi Shankar, A, Kumar, S, Jain, D, Bhargava, K, Kumar, V, Madappa Nagamalesh, U, Kumar Rajput, R, Koretsune Seishu Kanamori, Y, Yamamoto, K, Kumagai, K, Katsuda, Y, Yoshida, K, Toyota, F, Mizuno, Y, Misumi, I, Noguchi, H, Ando, S, Suetsugu, T, Minamoto, M, Oda, H, Adachi, S, Chiba, K, Norita, H, Tsuruta, M, Koyanagi, T, Ando, H, Higashi, T, Okada, M, Azakami, S, Komaki, S, Kumeda, K, Murayama, T, Matsumura, J, Oba, Y, Sonoda, R, Goto, K, Minoda, K, Haraguchi, Y, Suefuji, H, Miyagi, H, Kato, H, Nakamura, T, Nandate, H, Zaitsu, R, Fujiura, Y, Yoshimura, A, Numata, H, Ogawa, J, Kamogawa, Y, Murakami, K, Wakasa, Y, Yamasawa, M, Maekawa, H, Abe, S, Kihara, H, Tsunoda, S, Saito, K, Tachibana, H, Oba, I, Kuwahata, T, Higa, S, Gushiken, M, Eto, T, Chibana, H, Fujisawa, K, Shiga, Y, Sumi, H, Nagatomo, T, Atsuchi, Y, Nagoshi, T, Sanno, K, Hoshino, F, Yokota, N, Kameko, M, Tabuchi, T, Ishizawa, M, Ikeda, D, Seto, T, Iwao, T, Ishioka, N, Oshiro, K, Tsuchida, K, Hatori, Y, Takeuchi, M, Takezawa, H, Nagano, S, Iwaki, M, Nakamura, Y, Miyamoto, N, Taguchi, T, Ashida, K, Yoshizawa, N, Agata, J, Matsukawa, S, Arasaki, O, Fukuoka, S, Murakami, H, Mishima, K, Hata, Y, Sakuma, I, Obunai, K, Takamura, I, Akutsu, M, Unoki, T, Go, Y, Ikemura, M, Morii, S, Marusaki, S, Doi, H, Tanaka, M, Kusumoto, T, Kakinoki, S, Ogurusu, C, Murata, K, Shimoyama, M, Nakatsuka, M, Kitami, Y, Oyama, R, Ageta, M, Mita, T, Nagao, K, Mito, T, Minami, J, Abe, M, Fujii, M, Okawa, M, Fujito, T, Taniguchi, T, Ko, T, Kubo, H, Imamaki, M, Akiyama, M, Ueda, T, Odakura, H, Inagaki, M, Katsube, Y, Nakata, A, Tomimoto, S, Shibuya, M, Nakano, M, Ito, K, Matsuta, M, Ishiguro, M, Minagawa, T, 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Ravi Shankar, Sunil Kumar, Dinesh Jain, Kartikeya Bhargava, Vinay Kumar, Udigala Madappa Nagamalesh, Rajeeve Kumar Rajput, Yukihiro Koretsune Seishu Kanamori, Kenichi Yamamoto, Koichiro Kumagai, Yosuke Katsuda, Keiki Yoshida, Fumitoshi Toyota, Yuji Mizuno, Ikuo Misumi, Hiroo Noguchi, Shinichi Ando, Tetsuro Suetsugu, Masahiro Minamoto, Hiroyuki Oda, Susumu Adachi, Kei Chiba, Hiroaki Norita, Makoto Tsuruta, Takeshi Koyanagi, Kunihiko Yamamoto, Hiroshi Ando, Takayuki Higashi, Megumi Okada, Shiro Azakami, Shinichiro Komaki, Kenshi Kumeda, Takashi Murayama, Jun Matsumura, Yurika Oba, Ryuji Sonoda, Kazuo Goto, Kotaro Minoda, Yoshikuni Haraguchi, Hisakazu Suefuji, Hiroo Miyagi, Hitoshi Kato, Tsugihiro Nakamura, Tadashi Nakamura, Hidekazu Nandate, Ryuji Zaitsu, Yoshihisa Fujiura, Akira Yoshimura, Hiroyuki Numata, Jun Ogawa, Yasuyuki Kamogawa, Kinshiro Murakami, Yutaka Wakasa, Masanori Yamasawa, Hiromitsu Maekawa, Sumihisa Abe, Hajime Kihara, Satoru Tsunoda, Katsumi Saito, Hiroki Tachibana, Ichiro Oba, Takashi Kuwahata, Satoshi Higa, Masamichi Gushiken, Takuma Eto, Hidetoshi Chibana, Kazuaki Fujisawa, Yuhei Shiga, Hirokuni Sumi, Toshihisa Nagatomo, Yoshihiko Atsuchi, Toshiro Nagoshi, Kazuhisa Sanno, Fumihiro Hoshino, Naoto Yokota, Masahiro Kameko, Toshifumi Tabuchi, Munesumi Ishizawa, Yoshitake Fujiura, Daisuke Ikeda, Taku Seto, Tetsu Iwao, Norio Ishioka, Koichi Oshiro, Keizo Tsuchida, Yutaka Hatori, Motoshi Takeuchi, Hiroto Takezawa, Shinjiro Nagano, Masaaki Iwaki, Yuichiro Nakamura, Naomasa Miyamoto, Toshifumi Taguchi, Ko Ashida, Naoto Yoshizawa, Jun Agata, Seishiro Matsukawa, Osamu Arasaki, Shuji Fukuoka, Hirofumi Murakami, Kazuya Mishima, Yoshiki Hata, Ichiro Sakuma, Kotaro Obunai, Ichiro Takamura, Mitsuyuki Akutsu, Toshihide Unoki, Yoshinori Go, Makoto Ikemura, Shoji Morii, Shigeru Marusaki, Hideo Doi, Mitsuru Tanaka, Takaaki Kusumoto, Shigeo Kakinoki, Chiga Ogurusu, Kazuya Murata, Masaki Shimoyama, Masami Nakatsuka, Yutaka Kitami, Yoichi Nakamura, Hiroshi Oda, Rikimaru Oyama, Masato Ageta, Teruaki Mita, Kazuhiko Nagao, Takafumi Mito, Junichi Minami, Mitsunori Abe, Masako Fujii, Makoto Okawa, Tsuneo Fujito, Toshiya Taniguchi, Tenei Ko, Hiroshi Kubo, Mizuho Imamaki, Masahiro Akiyama, Takashi Ueda, Hironori Odakura, Masahiko Inagaki, Yoshiki Katsube, Atsuyuki Nakata, Shinobu Tomimoto, Mitsuhiro Shibuya, Masayuki Nakano, Kenichiro Ito, Masahiro Matsuta, Motoyuki Ishiguro, Taro Minagawa, Masamichi Wada, Hiroaki Mukawa, Masato Mizuguchi, Fumio Okuda, Teruaki Kimura, Kuniaki Taga, Masaaki Techigawara, Morio Igarashi, Hiroshi Watanabe, Toshihiko Seo, Shinya Hiramitsu, Hiroaki Hosokawa, Mitsumoto Hoshiai, Michitaka Hibino, Koichi Miyagawa, Hideki Horie, Nobuyoshi Sugishita, Yukio Shiga, Akira Soma, Kazuo Neya, Tetsuro Yoshida, Kunio Akahane, Sen Adachi, Chiei Takanaka, Saori Matsui, Hirofumi Kanda, Masanori Kaneko, Shiro Nagasaka, Atsushi Taguchi, Shuta Toru, Kazuyuki Saito, Akiko Miyashita, Hiroki Sasaguri, Jin Nariyama, Taketo Hatsuno, Takash Iwase, Kazuki Sato, Kazuya Kawai, Tomobumi Kotani, Tsuyoshi Tsuji, Hirosumi Sakai, Kiyoshi Nishino, Kenichi Ikeda, Kazuo Maeda, Tomohiro Shinozuka, Takeshi Inoue, Koichi Kawakami, Hiromichi Kitazumi, Tsutomu Takagi, Mamoru Hamaoka, Jisho Kojima, Akitoshi Sasaki, Yoshihiro Tsuchiya, Tetsuo Betsuyaku, Koji Higuchi, Masaaki Honda, Koichi Hasegawa, Takao Baba, Kazuaki Mineoi, Toshihiko Koeda, Kunihiko Hirasawa, Toshihide Kumazaki, Akira Nakagomi, Eiji Otaki, Takashi Shindo, Hiroyoshi Hirayama, Chikako Sugimoto, Takashi Yamagishi, Ichiro Mizuguchi, Kazunori Sezaki, Isamu Niwa, Ken Takenaka, Osamu Iiji, Koichi Taya, Hitoshi Kitazawa, samu Ueda, Hirokazu Kakuda, Takuya Ono, Seizo Oriso, Junya Kamata, Toshihiko Nanke, Itaru Maeda, Yoshifusa Matsuura, Hiroki Teragawa, Yasuyuki Maruyama, Kazuo Takei, Hajime Horie, Tetsutaro Kito, Hiroshi Asano, Koji Matsushita, Masaichi Nakamura, Takashi Washizuka, Tomoki Yoshida, Masato Sawano, Shinichi Arima, Hidekazu Arai, Hisanori Shinohara, Hiroyuki Takai, Nobufusa Furukawa, Akira Ota, Kentaro Yamamoto, Kenji Aoki, Taku Yamamoto, Takeaki Kasai, Shunji Suzuki, Shu Suzuki, Nitaro Shibata, Masayuki Watanabe, Yosuke Nishihata, Toru Arino, Masaki Okuyama, Tetsushi Wakiyama, Tomoko Kato, Yasuo Sasagawa, Takeshi Tana, Yoshihito Hayashi, Shinichi Hirota, Yukihiko Abe, Yoshihiro Saito, Hirohide Uchiyama, Hiroshi Takeda, Hiroshi Ono, Shuichi Tohyo, Naoto Hanazono, Seiichi Miyajima, Hisashi Shimono, Takuma Aoyama, Yasunobu Shozawa, Yawara Niijima, Osamu Murai, Hideko Inaba, Katsumasa Nomura, Masatsugu Nozoe, Kazuo Suzuki, Toshiyuki Furukawa, Toshihiko Shiraiwa, Nobuhisa Ito, Shunichi Nagai, Kiyoharu Sato, Shiro Nakahara, Yujin Shimoyama, Naoko Ohara, Teruhiko Kozuka, Hideaki Okita, Masato Endo, Tsutomu Goto, Makoto Hirose, Emiko Nagata, Noriyuki Nakanishi, Toshizumi Mori, Shuichi Seki, Katsuhiro Okamoto, Osamu Moriai, Yoko Emura, Tsuyoshi Fukuda, Haruhiko Date, Shuichi Kawakami, Sho Nagai, Yuya Ueyama, Tetsuro Fudo, Mitsuru Imaizumi, Takuo Ogawa, Shunsuke Take, Hideo Ikeda, Hiroaki Nishioka, Norihiko Sakamoto, Kiyomitsu Ikeoka, Nobuo Wakaki, Masatake Abe, Junji Doiuchi, Tetsuya Kira, Masato Tada, Ken Tsuzaki, Naoya Miura, Yasuaki Fujisawa, Wataru Furumoto, Susumu Suzuki, Akinori Fujisawa, Ryosai Nakamura, Hiroyasu Komatsu, Rei Fujiki, Shuichi Kawano, Keijiro Nishizawa, Yoji Kato, Junya Azuma, Kiyoshi Yasui, Toshio Amano, Yasuhiro Sekine, Tatsuo Honzawa, Yuichiro Koshibu, Yasuhide Sakamoto, Yukihiro Seta, Shingo Miyaguchi, Kojuro Morishita, Yasuko Samejima, Toyoshi Sasaki, Fumiko Iseki, Toshiyuki Kobayashi, Hiroshi Kano, Jaeyoung Kim, Hiroshi Yamaguchi, Yoichi Takagi, Yoko Onuki Pearce, Yasuyuki Suzuki, Takayuki Fukui, Toru Nakayama, Hideaki Kanai, Yoshiyuki Kawano, Tetsuji Ino, Hironori Miyoshi, Yasufumi Miyamoto, Masahito Shigekiyo, Shimato Ono, Yutaka Okamoto, Satoshi Ubukata, Kojiro Kodera, Tatsuo Oriuchi, Naoki Matsumoto, Koichi Inagaki, Atsushi Iseki, Tomohiro Yoshida, Toshihiro Goda, Tsukasa Katsuki, Atsushi Sato, Etsuo Mori, Toshio Tsubokura, Hiroshi Shudo, Shunichi Fujimoto, Tomohiro Katsuya, Yoshiyuki Furukawa, Hiroshi Hosokawa, Jun Narumi, Kiichiro Yamamoto, Masaki Owari, Takuya Inakura, Takafumi Anno, Kazuyuki Shirakawa, Chi Keong Ching Toon Wei Lim, David Foo, Kelvin Wong, Tan Yuyang, Seil Oh Hui Nam Park, Woo-Shik Kim, HyeYoung Lee, Sung-Won Jang, Dae Hyeok Kim, Jun Kim, DongRyeol Ryu, Jaemin Shim, Dae-Kyeong Kim, Dong Ju Choi, Yong Seog Oh, Myeong-Chan Cho, Hack-Lyoung Kim, Hui-Kyung Jeon, Dong-Gu Shin, Sang Weon Park, Hoon Ki Park, Sang-Jin Han, Jung Hoon Sung, Hyung-Wook Park, Gi-Byoung Nam, Young Keun On, Hong Euy Lim, JaeJin Kwak, Tae-Joon Cha, Taek Jong Hong, Seong Hoon Park, Jung Han Yoon, Nam-Ho Kim, Kee-Sik Kim, Byung Chun Jung, Gyo-Seung Hwang, Chong-Jin Kim, Sakda Rungaramsin Peerapat Katekangplu, Porames Khunrong, Thanita Bunyapipat, Wanwarang Wongcharoen, Pinij Kaewsuwanna, Khanchai Siriwattana, Waraporn Tiyanon, Supalerk Pattanaprichakul, Khanchit Likittanasombat, Doungrat Cholsaringkarl, Warangkana Boonyapisit, Sirichai Cheewatanakornkul, Songkwan Silaruks, Pisit Hutayanon, Seksan Chawanadelert, Pairoj Chattranukulchai, Boonsert Chatlaong, Yingsak Santanakorn, Khompiya Kanokphatcharakun, Piya Mongkolwongroj, Sasivimon Jai-Aue, Ongkarn Komson, Armagan Altun Ali Aydinlar, Ramazan Topsakal, Zeki Ongen, Sadik Acikel, Durmus Yildiray Sahin, Ozcan Yilmaz, Mehmet Birhan Yilmaz, Hasan Pekdemir, Mesut Demir, Murat Sucu, Levent Sahiner, Murat Ersanli, Ertugrul Okuyan, Dursun Aras, Florencia Rolandi Adrian Cesar Ingaramo, Gustavo Alberto Sambadaro, Vanina Fernandez Caputi, Hector Luciardi, Sofia Graciela Berman, Pablo Dragotto, Andres Javier Kleiban, Nestor Centurion, Rodolfo Andres Ahuad Guerrero, Leonel Adalberto Di Paola, Ricardo Dario Dran, Javier Egido, Matias Jose Fosco, Victor Alfredo Sinisi, Luis Rodolfo Cartasegna, Oscar Gomez Vilamajo, Jose Luis Ramos, Sonia Sassone, Gerardo Zapata, Diego Conde, Guillermo Giacomi, Alberto Alfredo Fernandez, Mario Alberto Berli, Fabian Ferroni, Dário Celestino Sobral Filho Jefferson Jaber, Luciana Vidal Armaganijan, Costantino Roberto Frack Costantini, André Steffens, Weimar Kunz Sebba Barroso de Souzaem, João David de Souza Neto, José Márcio Ribeiro, Marcelo Silveira Teixeira, Paulo Rossi, Leonardo Pires, Daniel Moreira, José Carlos Moura Jorge, Adalberto Menezes Lorga Filho, Luiz Bodanese, Marcelo Westerlund Montera, Carlos Henrique Del Carlo, Jamil Abdalla Saad, Fernando Augusto Alves da Costa, Renato Lopes, Gilson Roberto de Araújo, Euler Roberto Manenti, Jose Francisco Kerr Saraiva, João Carlos Ferreira Braga, Alexandre Negri, Carlos Moncada, Dalton Precoma, Fernando Roquette, Gilmar Reis, Roberto Álvaro Ramos Filho, Estêvão Lanna Figueiredo, Roberto Vieira Botelho, Cláudio Munhoz da Fontoura Tavares, Helius Carlos Finimundi, Adriano Kochi, César Cássio Broilo França, Fábio Alban, Guido Bernardo Aranha Rosito, João Batista de Moura Xavier Moraes Junior, Rogério Tadeu Tumelero, Lilia Maia, Roberto Simões de Almeida, Ney Carter do Carmo Borges, Luís Gustavo Gomes Ferreira, Ramón Corbalán Benjamin Aleck Joseh Stockins Fernandez, Humberto Montecinos, Fernando Lanas, Martín Larico Gómez, Carlos Astudillo, Carlos Conejeros, Patricio Marin Cuevas, Alejandro Forero, Claudio Bugueño Gutiérrez, Juan Aguilar, Sergio Potthoff Cardenas, German Eggers, Cesar Houzvic, Carlos Rey, Germán Arriagada, Gustavo Charme Vilches, Carlos Jerjes Sanchez Diaz Jesus Jaime Illescas Diaz, Raul Leal Cantu, Maria Guadalupe Ramos Zavala, Ricardo Cabrera Jardines, Nilda Espinola Zavaleta, Enrique Lopez Rosas, Guillermo Antonio Llamas Esperón, Gerardo Pozas, Ernesto Cardona Muñoz, Norberto Matadamas Hernandez, Adolfo Leyva Rendon, Norberto Garcia Hernandez, Manuel de los Rios Ibarra, Luis Ramon Virgen Carrillo, David Lopez Villezca, Carlos Hernandez Herrera, Juan Jose Lopez Prieto, Rodolfo Gaona Rodriguez, Efrain Villeda Espinosa, David Flores Martinez, Jose Velasco Barcena, Omar Fierro Fierro, Ignacio Rodriguez Briones, Jose Luis Leiva Pons, Humberto Alvarez Lopez, Rafael Olvera Ruiz, Carlos Gerardo Cantu Brito, Eduardo Julian Jose Roberto Chuquiure Valenzuela, Roxana Reyes Sanchez, Alberto Esteban Bazzoni Ruiz, Oscar Martin Lopez Ruiz, Roberto Arriaga Nava, Jesus David Morales Cerda, Pedro Fajardo Campos, Mario Benavides Gonzalez, Marianne Brodmann Kurt Lenz, Claus Hagn, Johannes Foechterle, Heinz Drexel, Kurt Huber, Andrea Podczeck-Schweighofer, Michael Winkler, Bruno Schneeweiss, Alfons Gegenhuber, Wilfried Lang, Sabine Eichinger-Hasenauer, Peter Kaserer, Josef Sykora, Heribert Rasch, Bernhard Strohmer, Luc Capiau Geert Vervoort, Bart Wollaert, Geert Hollanders, Jan Vercammen, Dirk Faes, Yohan Balthazar, Marc Delforge, Olivier Xhaet, Harry Striekwold, John Thoeng, Kurt Hermans, Georges Mairesse, Wim Anné, Ivan Blankoff, Michel Beutels, Stefan Verstraete, Peter Vandergoten, Philippe Purnode, Pascal Godart, Tim Boussy, Philippe Desfontaines, Alex Heyse, Joeri Voet, Axel De Wolf, Eva Zidkova Petr Jansky, Rudolf Spacek, Vilma Machova, Ondrej Ludka, Josef Olsr, Lubos Kotik, Blazej Racz, Richard Ferkl, Jan Hubac, Ilja Kotik, Zdenek Monhart, Hana Burianova, Ondrej Jerabek, Jana Pisova, Iveta Petrova, Vratislav Dedek, Michaela Honkova, Petr Podrazil, Petr Reichert, Jindrich Spinar, Miroslav Novak, Vaclav Durdil, Katarina Plocova, Jiri Lastuvka, Jørn Nielsen Steen Husted, Helena Dominguez, Ulrik Hintze, Søren Rasmussen, Næstved Sygehus, Arne Bremmelgaard, John Markenvard, Jan Børger, Jorgen Solgaard, Ebbe Eriksen, Thomas Løkkegaard, Michael Bruun, Jacob Mertz, Morten Schou, Michael Olsen, Pekka Raatikainen Carmela Viitanen, Franck Paganelli Joël Ohayon, Frédéric Casassus, Michel Galinier, Yannick Gottwalles, Philippe Loiselet, Jean-Joseph Muller, Mohamed Bassel Koujan, André Marquand, Sylvain Destrac, Olivier Piot, Nicolas Delarche, Jean-Pierre Cebron, Maxime Guenoun, Dominique Guedj-Meynier, A. 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Lokesh, Mathieu Zuber, Pierre Amarenco, Emmanuel Ellie, James Kadouch, Pierre-Yves Fournier, Jean-Pierre Huberman, Nestor Lemaire, Gilles Rodier, Xavier Vandamme, Igor Sibon, Jean-Philippe Neau, Marie Hélène Mahagne, Antoine Mielot, Marc Bonnefoy, Jean-Baptiste Churet, Vincent Navarre, Frederic Sellem, Gilles Monniot, Jean-Paul Boyes, Bernard Doucet, Michel Martelet, Désiré Obadia, Bernard Crousillat, Joseph Mouallem, Etienne Bearez, Jean Philippe Brugnaux, Alain Fedorowsky, Pierre Nazeyrollas, Jean-Baptiste Berneau, Frédéric Chemin, Sebastien Schellong Harald Darius, Georg Koeniger, Andreas Kopf, Uwe Gerbaulet, Bernd-Thomas Kellner, Thomas Schaefer, Jan Purr, Enno Eißfeller, Heinz-Dieter Zauzig, Peter Riegel, Christoph Axthelm, Gerd-Ulrich Heinz, Holger Menke, Andreas Pustelnik, Stefan Zutz, Wolfgang Eder, Guenter Rehling, Dirk Glatzel, Norbert Ludwig, Petra Sandow, Henning Wiswedel, Cosmas Wildenauer, Steffen Schoen, Toralf Schwarz, Adyeri Babyesiza, Maximilian Kropp, Hans-Hermann Zimny, Friedhelm Kahl, Andreas Caspar, Sabine Omankowsky, Torsten Laessig, Hermann-Josef Hartmann, Gunter Lehmann, Hans-Walter Bindig, Gunter Hergdt, Dietrich Reimer, Joachim Hauk, Holger Michel, Praxis Dres. 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Iwase, Kazuki Sato, Kazuya Kawai, Tomobumi Kotani, Tsuyoshi Tsuji, Hirosumi Sakai, Kiyoshi Nishino, Kenichi Ikeda, Kazuo Maeda, Tomohiro Shinozuka, Takeshi Inoue, Koichi Kawakami, Hiromichi Kitazumi, Tsutomu Takagi, Mamoru Hamaoka, Jisho Kojima, Akitoshi Sasaki, Yoshihiro Tsuchiya, Tetsuo Betsuyaku, Koji Higuchi, Masaaki Honda, Koichi Hasegawa, Takao Baba, Kazuaki Mineoi, Toshihiko Koeda, Kunihiko Hirasawa, Toshihide Kumazaki, Akira Nakagomi, Eiji Otaki, Takashi Shindo, Hiroyoshi Hirayama, Chikako Sugimoto, Takashi Yamagishi, Ichiro Mizuguchi, Kazunori Sezaki, Isamu Niwa, Ken Takenaka, Osamu Iiji, Koichi Taya, Hitoshi Kitazawa, samu Ueda, Hirokazu Kakuda, Takuya Ono, Seizo Oriso, Junya Kamata, Toshihiko Nanke, Itaru Maeda, Yoshifusa Matsuura, Hiroki Teragawa, Yasuyuki Maruyama, Kazuo Takei, Hajime Horie, Tetsutaro Kito, Hiroshi Asano, Koji Matsushita, Masaichi Nakamura, Takashi Washizuka, Tomoki Yoshida, Masato Sawano, Shinichi Arima, Hidekazu Arai, Hisanori Shinohara, Hiroyuki Takai, Nobufusa Furukawa, Akira Ota, Kentaro Yamamoto, Kenji Aoki, Taku Yamamoto, Takeaki Kasai, Shunji Suzuki, Shu Suzuki, Nitaro Shibata, Masayuki Watanabe, Yosuke Nishihata, Toru Arino, Masaki Okuyama, Tetsushi Wakiyama, Tomoko Kato, Yasuo Sasagawa, Takeshi Tana, Yoshihito Hayashi, Shinichi Hirota, Yukihiko Abe, Yoshihiro Saito, Hirohide Uchiyama, Hiroshi Takeda, Hiroshi Ono, Shuichi Tohyo, Naoto Hanazono, Seiichi Miyajima, Hisashi Shimono, Takuma Aoyama, Yasunobu Shozawa, Yawara Niijima, Osamu Murai, Hideko Inaba, Katsumasa Nomura, Masatsugu Nozoe, Kazuo Suzuki, Toshiyuki Furukawa, Toshihiko Shiraiwa, Nobuhisa Ito, Shunichi Nagai, Kiyoharu Sato, Shiro Nakahara, Yujin Shimoyama, Naoko Ohara, Teruhiko Kozuka, Hideaki Okita, Masato Endo, Tsutomu Goto, Makoto Hirose, Emiko Nagata, Noriyuki Nakanishi, Toshizumi Mori, Shuichi Seki, Katsuhiro Okamoto, Osamu Moriai, Yoko Emura, Tsuyoshi Fukuda, Haruhiko Date, Shuichi Kawakami, Sho Nagai, Yuya Ueyama, Tetsuro Fudo, Mitsuru Imaizumi, Takuo Ogawa, Shunsuke Take, Hideo Ikeda, Hiroaki Nishioka, Norihiko Sakamoto, Kiyomitsu Ikeoka, Nobuo Wakaki, Masatake Abe, Junji Doiuchi, Tetsuya Kira, Masato Tada, Ken Tsuzaki, Naoya Miura, Yasuaki Fujisawa, Wataru Furumoto, Susumu Suzuki, Akinori Fujisawa, Ryosai Nakamura, Hiroyasu Komatsu, Rei Fujiki, Shuichi Kawano, Keijiro Nishizawa, Yoji Kato, Junya Azuma, Kiyoshi Yasui, Toshio Amano, Yasuhiro Sekine, Tatsuo Honzawa, Yuichiro Koshibu, Yasuhide Sakamoto, Yukihiro Seta, Shingo Miyaguchi, Kojuro Morishita, Yasuko Samejima, Toyoshi Sasaki, Fumiko Iseki, Toshiyuki Kobayashi, Hiroshi Kano, Jaeyoung Kim, Hiroshi Yamaguchi, Yoichi Takagi, Yoko Onuki Pearce, Yasuyuki Suzuki, Takayuki Fukui, Toru Nakayama, Hideaki Kanai, Yoshiyuki Kawano, Tetsuji Ino, Hironori Miyoshi, Yasufumi Miyamoto, Masahito Shigekiyo, Shimato Ono, Yutaka Okamoto, Satoshi Ubukata, Kojiro Kodera, Tatsuo Oriuchi, Naoki Matsumoto, Koichi Inagaki, Atsushi Iseki, Tomohiro Yoshida, Toshihiro Goda, Tsukasa Katsuki, Atsushi Sato, Etsuo Mori, Toshio Tsubokura, Hiroshi Shudo, Shunichi Fujimoto, Tomohiro Katsuya, Yoshiyuki Furukawa, Hiroshi Hosokawa, Jun Narumi, Kiichiro Yamamoto, Masaki Owari, Takuya Inakura, Takafumi Anno, Kazuyuki Shirakawa, Chi Keong Ching Toon Wei Lim, David Foo, Kelvin Wong, Tan Yuyang, Seil Oh Hui Nam Park, Woo-Shik Kim, HyeYoung Lee, Sung-Won Jang, Dae Hyeok Kim, Jun Kim, DongRyeol Ryu, Jaemin Shim, Dae-Kyeong Kim, Dong Ju Choi, Yong Seog Oh, Myeong-Chan Cho, Hack-Lyoung Kim, Hui-Kyung Jeon, Dong-Gu Shin, Sang Weon Park, Hoon Ki Park, Sang-Jin Han, Jung Hoon Sung, Hyung-Wook Park, Gi-Byoung Nam, Young Keun On, Hong Euy Lim, JaeJin Kwak, Tae-Joon Cha, Taek Jong Hong, Seong Hoon Park, Jung Han Yoon, Nam-Ho Kim, Kee-Sik Kim, Byung Chun Jung, Gyo-Seung Hwang, Chong-Jin Kim, Sakda Rungaramsin Peerapat Katekangplu, Porames Khunrong, Thanita Bunyapipat, Wanwarang Wongcharoen, Pinij Kaewsuwanna, Khanchai Siriwattana, Waraporn Tiyanon, Supalerk Pattanaprichakul, Khanchit Likittanasombat, Doungrat Cholsaringkarl, Warangkana Boonyapisit, Sirichai Cheewatanakornkul, Songkwan Silaruks, Pisit Hutayanon, Seksan Chawanadelert, Pairoj Chattranukulchai, Boonsert Chatlaong, Yingsak Santanakorn, Khompiya Kanokphatcharakun, Piya Mongkolwongroj, Sasivimon Jai-Aue, Ongkarn Komson, Armagan Altun Ali Aydinlar, Ramazan Topsakal, Zeki Ongen, Sadik Acikel, Durmus Yildiray Sahin, Ozcan Yilmaz, Mehmet Birhan Yilmaz, Hasan Pekdemir, Mesut Demir, Murat Sucu, Levent Sahiner, Murat Ersanli, Ertugrul Okuyan, Dursun Aras, Florencia Rolandi Adrian Cesar Ingaramo, Gustavo Alberto Sambadaro, Vanina Fernandez Caputi, Hector Luciardi, Sofia Graciela Berman, Pablo Dragotto, Andres Javier Kleiban, Nestor Centurion, Rodolfo Andres Ahuad Guerrero, Leonel Adalberto Di Paola, Ricardo Dario Dran, Javier Egido, Matias Jose Fosco, Victor Alfredo Sinisi, Luis Rodolfo Cartasegna, Oscar Gomez Vilamajo, Jose Luis Ramos, Sonia Sassone, Gerardo Zapata, Diego Conde, Guillermo Giacomi, Alberto Alfredo Fernandez, Mario Alberto Berli, Fabian Ferroni, Dário Celestino Sobral Filho Jefferson Jaber, Luciana Vidal Armaganijan, Costantino Roberto Frack Costantini, André Steffens, Weimar Kunz Sebba Barroso de Souzaem, João David de Souza Neto, José Márcio Ribeiro, Marcelo Silveira Teixeira, Paulo Rossi, Leonardo Pires, Daniel Moreira, José Carlos Moura Jorge, Adalberto Menezes Lorga Filho, Luiz Bodanese, Marcelo Westerlund Montera, Carlos Henrique Del Carlo, Jamil Abdalla Saad, Fernando Augusto Alves da Costa, Renato Lopes, Gilson Roberto de Araújo, Euler Roberto Manenti, Jose Francisco Kerr Saraiva, João Carlos Ferreira Braga, Alexandre Negri, Carlos Moncada, Dalton Precoma, Fernando Roquette, Gilmar Reis, Roberto Álvaro Ramos Filho, Estêvão Lanna Figueiredo, Roberto Vieira Botelho, Cláudio Munhoz da Fontoura Tavares, Helius Carlos Finimundi, Adriano Kochi, César Cássio Broilo França, Fábio Alban, Guido Bernardo Aranha Rosito, João Batista de Moura Xavier Moraes Junior, Rogério Tadeu Tumelero, Lilia Maia, Roberto Simões de Almeida, Ney Carter do Carmo Borges, Luís Gustavo Gomes Ferreira, Ramón Corbalán Benjamin Aleck Joseh Stockins Fernandez, Humberto Montecinos, Fernando Lanas, Martín Larico Gómez, Carlos Astudillo, Carlos Conejeros, Patricio Marin Cuevas, Alejandro Forero, Claudio Bugueño Gutiérrez, Juan Aguilar, Sergio Potthoff Cardenas, German Eggers, Cesar Houzvic, Carlos Rey, Germán Arriagada, Gustavo Charme Vilches, Carlos Jerjes Sanchez Diaz Jesus Jaime Illescas Diaz, Raul Leal Cantu, Maria Guadalupe Ramos Zavala, Ricardo Cabrera Jardines, Nilda Espinola Zavaleta, Enrique Lopez Rosas, Guillermo Antonio Llamas Esperón, Gerardo Pozas, Ernesto Cardona Muñoz, Norberto Matadamas Hernandez, Adolfo Leyva Rendon, Norberto Garcia Hernandez, Manuel de los Rios Ibarra, Luis Ramon Virgen Carrillo, David Lopez Villezca, Carlos Hernandez Herrera, Juan Jose Lopez Prieto, Rodolfo Gaona Rodriguez, Efrain Villeda Espinosa, David Flores Martinez, Jose Velasco Barcena, Omar Fierro Fierro, Ignacio Rodriguez Briones, Jose Luis Leiva Pons, Humberto Alvarez Lopez, Rafael Olvera Ruiz, Carlos Gerardo Cantu Brito, Eduardo Julian Jose Roberto Chuquiure Valenzuela, Roxana Reyes Sanchez, Alberto Esteban Bazzoni Ruiz, Oscar Martin Lopez Ruiz, Roberto Arriaga Nava, Jesus David Morales Cerda, Pedro Fajardo Campos, Mario Benavides Gonzalez, Marianne Brodmann Kurt Lenz, Claus Hagn, Johannes Foechterle, Heinz Drexel, Kurt Huber, Andrea Podczeck-Schweighofer, Michael Winkler, Bruno Schneeweiss, Alfons Gegenhuber, Wilfried Lang, Sabine Eichinger-Hasenauer, Peter Kaserer, Josef Sykora, Heribert Rasch, Bernhard Strohmer, Luc Capiau Geert Vervoort, Bart Wollaert, Geert Hollanders, Jan Vercammen, Dirk Faes, Yohan Balthazar, Marc Delforge, Olivier Xhaet, Harry Striekwold, John Thoeng, Kurt Hermans, Georges Mairesse, Wim Anné, Ivan Blankoff, Michel Beutels, Stefan Verstraete, Peter Vandergoten, Philippe Purnode, Pascal Godart, Tim Boussy, Philippe Desfontaines, Alex Heyse, Joeri Voet, Axel De Wolf, Eva Zidkova Petr Jansky, Rudolf Spacek, Vilma Machova, Ondrej Ludka, Josef Olsr, Lubos Kotik, Blazej Racz, Richard Ferkl, Jan Hubac, Ilja Kotik, Zdenek Monhart, Hana Burianova, Ondrej Jerabek, Jana Pisova, Iveta Petrova, Vratislav Dedek, Michaela Honkova, Petr Podrazil, Petr Reichert, Jindrich Spinar, Miroslav Novak, Vaclav Durdil, Katarina Plocova, Jiri Lastuvka, Jørn Nielsen Steen Husted, Helena Dominguez, Ulrik Hintze, Søren Rasmussen, Næstved Sygehus, Arne Bremmelgaard, John Markenvard, Jan Børger, Jorgen Solgaard, Ebbe Eriksen, Thomas Løkkegaard, Michael Bruun, Jacob Mertz, Morten Schou, Michael Olsen, Pekka Raatikainen Carmela Viitanen, Franck Paganelli Joël Ohayon, Frédéric Casassus, Michel Galinier, Yannick Gottwalles, Philippe Loiselet, Jean-Joseph Muller, Mohamed Bassel Koujan, André Marquand, Sylvain Destrac, Olivier Piot, Nicolas Delarche, Jean-Pierre Cebron, Maxime Guenoun, Dominique Guedj-Meynier, A. G. Lokesh, Mathieu Zuber, Pierre Amarenco, Emmanuel Ellie, James Kadouch, Pierre-Yves Fournier, Jean-Pierre Huberman, Nestor Lemaire, Gilles Rodier, Xavier Vandamme, Igor Sibon, Jean-Philippe Neau, Marie Hélène Mahagne, Antoine Mielot, Marc Bonnefoy, Jean-Baptiste Churet, Vincent Navarre, Frederic Sellem, Gilles Monniot, Jean-Paul Boyes, Bernard Doucet, Michel Martelet, Désiré Obadia, Bernard Crousillat, Joseph Mouallem, Etienne Bearez, Jean Philippe Brugnaux, Alain Fedorowsky, Pierre Nazeyrollas, Jean-Baptiste Berneau, Frédéric Chemin, Sebastien Schellong Harald Darius, Georg Koeniger, Andreas Kopf, Uwe Gerbaulet, Bernd-Thomas Kellner, Thomas Schaefer, Jan Purr, Enno Eißfeller, Heinz-Dieter Zauzig, Peter Riegel, Christoph Axthelm, Gerd-Ulrich Heinz, Holger Menke, Andreas Pustelnik, Stefan Zutz, Wolfgang Eder, Guenter Rehling, Dirk Glatzel, Norbert Ludwig, Petra Sandow, Henning Wiswedel, Cosmas Wildenauer, Steffen Schoen, Toralf Schwarz, Adyeri Babyesiza, Maximilian Kropp, Hans-Hermann Zimny, Friedhelm Kahl, Andreas Caspar, Sabine Omankowsky, Torsten Laessig, Hermann-Josef Hartmann, Gunter Lehmann, Hans-Walter Bindig, Gunter Hergdt, Dietrich Reimer, Joachim Hauk, Holger Michel, Praxis Dres. Werner Erdle, Wilfried Dorsch, Janna Dshabrailov, Karl-Albrecht Rapp, Reinhold Vormann, Thomas Mueller, Peter Mayer, Uwe Horstmeier, Volker Eissing, Heinz Hey, Heinz Leuchtgens, Volker Lilienweiss, Heiner Mueller, Christian Schubert, Herrmann Lauer, Thomas Buchner, Gunter Brauer, Susanne Kamin, Karsten Mueller, Sylvia Baumbach, Muwafeg Abdel-Qader, Hans-Holger Ebert, Carsten Schwencke, Peter Bernhardt, Laszlo Karolyi, Britta Sievers, Wilhelm Haverkamp, Jens-Uwe Roehnisch, Andras Vertes Gabor Szantai, Andras Matoltsy, Nikosz Kanakaridisz, Zoltan Boda, Erno Kis, Balazs Gaszner, Ferenc Juhasz, Gizella Juhasz, Sandor Kancz, Zoltan Laszlo, Zsolt May, Bela Merkely, Ebrahim Noori, Tamas Habon, Peter Polgar, Gabriella Szalai, Sandor Vangel, Andras Nagy, Gabriella Engelthaler, Judit Ferenczi, Mihaly Egyutt, Giuliana Martini Leone Maria Cristina, Eros Tiraferri, Rita Santoro, Sophie Testa, Giovanni Di Minno, Marco Moia, Teresa Maria Caimi, Maria Tessitori, Roberto Cappelli, Daniela Poli, Roberto Quintavalla, Franco Cosmi, Raffaele Fanelli, Vincenzo Oriana, Raffaele Reggio, Roberto Santi, Leonardo Pancaldi, Raimondo De Cristofaro, Giuliana Guazzaloca, Angelo De Blasio, Jorge Salerno Uriate, Flavia Lillo, Enrico Maria Pogliani, Grzegorz Bilo, Michele Accogli, Antonio Mariani, Mauro Feola, Arturo Raisaro, Luciano Fattore, Andrea Mauric, Fabrizio Germini, Luca Tedeschi, Maria Settimi, Sergio Nicoli, Paolo Ricciarini, Antonio Argena, Paolo Ronchini, Claudio Bulla, Filippo Tradati, Massimo Volpe, Maria D’Avino, Maria Grazia Bongiorni, Silva Severi, Alessandro Capucci, Corrado Lodigiani, Enrico Salomone, Gaetano Serviddio, Claudio Tondo, Paolo Golino, Carmine Mazzone, Saverio Iacopino, Hugo ten Cate J. H. Ruiter, Andreas Lucassen, Henk Adriaansen, Maarten Bongaerts, Mathijs Pieterse, Coen van Guldener, Johannes Herrman, S. H. K. P. R. Nierop, Pieter Hoogslag, Walter Hermans, B. E. Groenemeijer, W. Terpstra, Cees Buiks, L. V. A. Boersma, Eivind Berge Per Anton Sirnes, Erik Gjertsen, Torstein Hole, Knut Erga, Arne Hallaråker, Gunnar Skjelvan, Anders Østrem, Beraki Ghezai, Arne Svilaas, Peter Christersson, Torbjørn Øien, Svein Høegh Henrichsen, Jan Erik Otterstad, Jan Berg-Johansen, Janina Stepinska Andrzej Gieroba, Malgorzata Biedrzycka, Michal Ogorek, Beata Wozakowska-Kaplon, Krystyna Loboz-Grudzien, Wieslaw Supinski, Jerzy Kuzniar, Roman Zaluska, Jaroslaw Hiczkiewicz, Lucyna Swiatkowska-Byczynska, Lech Kucharski, Marcin Gruchala, Piotr Minc, Maciej Olszewski, Grzegorz Kania, Malgorzata Krzciuk, Zbigniew Lajkowski, Bozenna Ostrowska-Pomian, Jerzy Lewczuk, Elzbieta Zinka, Agnieszka Karczmarczyk, Malgorzata Chmielnicka-Pruszczynska, Iwona Wozniak-Skowerska, Grzegorz Opolski, Marek Bronisz, Marcin Ogorek, Grazyna Glanowska, Piotr Ruszkowski, Grzegorz Skonieczny, Ryszard Sciborski, Boguslaw Okopien, Piotr Kukla, Krzysztof Galbas, Krzysztof Cymerman, Jaroslaw Jurowiecki, Pawel Miekus, Waldemar Myszka, Stanislaw Mazur, Roman Lysek, Jacek Baszak, Teresa Rusicka-Piekarz, Grzegorz Raczak, Ewa Domanska, Jadwiga Nessler, Jozef Lesnik, Vera Eltishcheva Roman Libis, Gadel Kamalov, Dmitry Belenky, Liudmila Egorova, Alexander Khokhlov, Eduard Yakupov, Dmitry Zateyshchikov, Olga Barbarash, Olga Miller, Evgeniy Mazur, Konstantin Zrazhevskiy, Tatyana Novikova, Yulia Moiseeva, Elena Polkanova, Konstantin Sobolev, Maria Rossovskaya, Yulia Shapovalova, Alla Kolesnikova, Konstantin Nikolaev, Oksana Zemlianskaia, Anna Zateyshchikova, Victor Kostenko, Sergey Popov, Maria Poltavskaya, Anton Edin, Elena Aleksandrova Oksana Drapkina, Alexander Vishnevsky, Oleg Nagibovich, Petr Chizhov, Svetlana Rachkova, Mikhail Sergeev, Borys Kurylo, Alexey Ushakov, Xavier Vinolas Pere Alvarez Garcia, Maria Fernanda Lopez Fernandez, Luis Tercedor Sanchez, Salvador Tranche Iparraguirre, Pere Toran Monserrat, Emilio Marquez Contreras, Jordi Isart Rafecas, Juan Motero Carrasco, Pablo Garcia Pavia, Casimiro Gomez Pajuelo, Luis Miguel Rincon Diaz, Luis Fernando Iglesias Alonso, Angel Grande Ruiz, Jordi Merce Klein, Jose Ramon Gonzalez Juanatey, Ines Monte Collado, Herminia Palacin Piquero, Carles Brotons Cuixart, Esther Fernandez Escobar, Joan Bayo i Llibre, Cecilia Corros Vicente, Manuel Vida Gutierrez, Francisco Epelde Gonzalo, Carlos Alexandre Almeida Fernandez, Encarnacion Martinez Navarro, Juan Jose Montero Alia, Maria Barreda Gonzalez, Maria Angels Moleiro Oliva, Jose Iglesias Sanmartin, Mercedes Jimenez Gonzalez, Maria del Mar Rodriguez Alvarez, Juan Herreros Melenchon, Tomas Ripoll Vera, Manuel Jimenez Navarro, Maria Vazquez Caamano, Maria Fe Arcocha Torres, Gonzalo Marcos Gomez, Andres Iniguez Romo, Miguel Angel Prieto Diaz, Mårten Rosenqvist Alexander Wirdby, Jan Lindén, Kerstin Henriksson, Micael Elmersson, Arnor Egilsson, Ulf Börjesson, Gunnar Svärd, Bo Liu, Anders Lindh, Lars-Bertil Olsson, Mikael Gustavsson, Lars Andersson, Lars Benson, Claes Bothin, Ali Hajimirsadeghi, Björn Martinsson, Marianne Ericsson, Åke Ohlsson, Håkan Lindvall, Peter Svensson, Katarina Thörne, Hans Händel, Pyotr Platonov, Fredrik Bernsten, Ingar Timberg, Milita Crisby, Jan-Erik Karlsson, Agneta Andersson, Lennart Malmqvist, Johan Engdahl, Jörgen Thulin, Aida Hot-Bjelak, Steen Jensen, Per Stalby, Jan Steffel Johann Debrunner, Juerg H. Beer, Dipen Shah, Iurii Rudyk Vira Tseluyko, Oleksandr Karpenko, Svitlana Zhurba, Igor Kraiz, Oleksandr Parkhomenko, Iryna Kupnovytska, Nestor Seredyuk, Yuriy Mostovoy, Oleksiy Ushakov, Olena Koval, Igor Kovalskiy, Yevgeniya Svyshchenko, Oleg Sychov, Mykola Stanislavchuk, Andriy Yagensky, Susanna Tykhonova, Ivan Fushtey, Will Murdoch Naresh Chauhan, Daryl Goodwin, Louise Lumley, Ramila Patel, Philip Saunders, Bennett Wong, Alex Cameron, Niranjan Patel, P. Jhittay, Andrew Ross, M. S. Kainth, Karim Ladha, Kevin Douglas, Gill Pickavance, Joanna McDonnell, Laura Handscombe, Trevor Gooding, Helga Wagner, Colin Bradshaw, Catherine Bromham, Kevin Jones, Shoeb Suryani, Richard Coates, Bhupinder Sarai, W. Willcock, S. Sircar, John Cairns, A. Gilliand, Roman Bilas, E. Strieder, Peter Hutchinson, Anne Wakeman, Michael Stokes, Graham Kirby, Bhaskhar Vishwanathan, Nigel Bird, Paul Evans, M. Clark, John Bisatt, Jennifer Litchfield, E. Fisher, Tim Fooks, Richard Kelsall, Neil Paul, Elizabeth Alborough, Michael Aziz, C. Ramesh, Pete Wilson, Simon Franklin, Sue Fairhead, Julian Thompson, Hasan Chowan, Gary Taylor, Dawn Tragen, Matt Parfitt, Claire Seamark, Carolyn Paul, Mark Richardson, Angus Jefferies, Helen Sharp, Hywel Jones, Claire Giles, Matthew Bramley, Philip Williams, Jehad Aldegather, Simon Wetherell, William Lumb, Phil Evans, Frances Scouller, Neil Macey, Stephen Rogers, Yvette Stipp, Richard West, Philip Pinney, Paul Wadeson, John Matthews, Preeti Pandya, Andrew Gallagher, T. Railton, Emyr Davies, Jonathan McClure, Marc Jacobs, Claire Hutton, R. Thompson, Bijoy Sinha, Keith Butter, Susan Barrow, Helen Little, David Russell, Ulka Choudhary, Ikram Haq, Paul Ainsworth, Claire Jones, Phil Weeks, Jane Eden, Lisa Gibbons, Janet Glencross, Alison MacLeod, K. Poland, Conor Mulolland, A. Warke, Paul Conn, D. Burns, R. Smith, R. Kamath, Jonathan Webster, Ian Hodgins, Stephen Vercoe, Paul Roome, Hilary Pinnock, Jayesh Patel, Amar Ali, Nigel Hart, Richard Davies, Nigel De-Sousa, Catherine Neden, Mark Danielsen, Purnima Sharma, Sophia Galloway, Charlotte Hawkins, Raife Oliver, Martin Aylward, Mira Pattni, Gordon Irvine, Shahid Ahmad, Catherine Rothwell, Fiaz Choudhary, Sabrina Khalaque, Stephanie Short, Sharon Peters, Warwick Coulson, Neil Roberts, Amy Butler Steven Coates, Ben Ward, Daniel Jackson, Steve Walton, Diane Shepherd, Toh Wong, Mark Boon, Melanie Deacon, David Cornelius, Sarah Davies, Ben Frankel, Nick Hargreaves, Henry Choi, Jon Sumner, Tim Myhill, Salah Estifanos, Diane Geatch, Justin Wilkinson, Richard Veale, Karen Forshaw, Rob Hirst, Kashif Zaman, Catherine Liley, Rebecca Wastling, Paul McEleny, Andre Beattie, Philip Cooke, Mike Wong, Mark Pugsley, Chaminda Dooldeniya, Greg Rogers, James Bennett, Polly Jacobs, Rajesh Muvva, Matthew Adam, Robin Fox, Nicolas Thomas, Simon Cartwright, Rory Reed, Simon Randfield, Christine A’Court, Ann Flynn, Andrew Halpin, Simon Dobson, Louise Lomax, Minnal Nadaph, Iain Munro, Jane Goram, Helen Stoddart, Phil Simmons, John Shewring, Emma Bowen-Simpkins, Mark Rickenbach, Adam Blenkhorn Bhuwanendu Singh, Penny Astridge, William van Gaal, Walter Abhayaratna, Philip Thomson, Ron Lehman, Jens Kilian, David Coulshed, Andrei Catanchin, David Colquhoun, Hosen Kiat, David Eccleston, John French, Bronte Ayres, Peter Blombery, Thanh Phan, James Rogers, David O’Donnell, Sang Cheol Bae, Harry Gibbs, Patrick Carroll, Greg Starmer, Margaret Arstall, Maurits Binnekamp, Astin Lee, John Eikelboom Robert Luton, Milan Gupta, Amritanshu Shekhar Pandey, Stephen Cheung, Rolland Leader, Philippe Beaudry, Félix Ayala-Paredes, Joseph Berlingieri, John Heath, Germain Poirier, Miranda du Preez, Bradley Schweitzer, Reginald Nadeau, Ripple Dhillon, Tomasz Hruczkowski, Andrea Lavoie, Ratika Parkash, James Cha, Benoit Coutu, Paul MacDonald, Brian Ramjattan, Jorge Bonet, Saul Vizel, Paul Angaran, Sameh Fikry, Ahmed Mowafy Azza Katta, Mazen Tawfik, Moustafa Nawar, Mohamed Sobhy, Seif Kamal Abou Seif, Tarek Khairy, Ahmed Abd El-Aziz, Nasser Taha, Ashraf Reda, Atef Elbahry, Mohamed Setiha, Mohamed Gamal El Din, Magdi Elkhadem, Adel El-Etreby, David Kettles Junaid Bayat, Heidi Siebert, Adrian Horak, Ynez Kelfkens, Riaz Garda, Thayabran Pillay, Michele Guerra, Louis van Zyl, Hendrik Theron, Andrew Murray, Rikus Louw, Deon Greyling, Pindile Mntla, Siddique Ismail, Fayzal Ahmed, Johannes Engelbrecht, Shambu Maharajh, Wessel Oosthuysen, Rehana Loghdey, Veronica Ueckermann, Wael AlAl Mahmeed AbdullahNaeemi, Ghazi Yousef, Nooshin Bazargani, Munther AlOmairi, Rajan Maruthanayagam, Rupesh Singh, Ahmed Naguib, Mohamed Ibrahim, Amrish Agrawal, Mukesh Nathani, Ehab M. Esheiba, Adel Wassef, Rajeev Gupta, Michael Cox Scott Beach, Peter Duffy, Stephen Falkowski, Kevin Ferrick, Miguel Franco, W. Michael Kutayli, Annette Quick, Niraj Sharma, Vance Wilson, Stephen Miller, Mark Alberts, Edwin Blumberg, Roddy Canosa, Ted Gutowski, Rodney Ison, Jorge Garcia, Paul Mullen, Howard Noveck, Pamela Rama, Rajneesh Reddy, Marcus Williams, Daniel Nishijima, Keith Ferdinand, Ihsan Haque, Robert Mendelson, Sridevi Pitta, Daniel Theodoro, Charles Treasure, Moustafa Moustafa, Cas Cader, Walter Pharr, Alisha Oropallo, George Platt, Jaspal Gujral, James Welker, and Firas Koura
Abstract: Background: The Global Anticoagulant Registry in the FIELD–Atrial Fibrillation (GARFIELD-AF) is a worldwide non-interventional study of stroke prevention in patients with non-valvular AF. Methods and results: 52,080 patients with newly diagnosed AF were prospectively enrolled from 2010 to 2016. 4121 (7.9%) of these patients were recruited in DACH [Germany (n = 3567), Austria (n = 465) and Switzerland (n = 89) combined], and 47,959 patients were from 32 countries in other regions worldwide (ORW). Hypertension was most prevalent in DACH and ORW (85.3% and 75.6%, respectively). Diabetes, hypercholesterolaemia, carotid occlusive disease and vascular disease were more prevalent in DACH patients vs ORW (27.6%, 49.4%, 5.8% and 29.0% vs 21.7%, 40.9%, 2.8% and 24.5%). The use of non-vitamin K antagonist oral anticoagulants (NOACs) increased more in DACH over time. Management of vitamin K antagonists was suboptimal in DACH and ORW (time in therapeutic range of INR ≥ 65% in 44.6% and 44.4% of patients or ≥ 70% in 36.9% and 36.0% of patients, respectively). Adjusted rates of cardiovascular mortality and MI/ACS were higher in DACH while non-haemorrhagic stroke/systemic embolism was lower after 2-year follow-up. Conclusions: Similarities and dissimilarities in AF management and clinical outcomes are seen in DACH and ORW. The increased use of NOAC was associated with a mismatch of risk-adapted anticoagulation (over-and-undertreatment) in DACH. Suboptimal control of INR requires educational activities in both regional groups. Higher rates of cardiovascular death in DACH may reflect the higher risk profile of these patients and lower rates of non-haemorrhagic stroke could be associated with increased NOAC use. Graphical abstract: [Figure not available: see fulltext.].
Published: 2023

34. Casemix, management, and mortality of patients receiving emergency neurosurgery for traumatic brain injury in the Global Neurotrauma Outcomes Study: a prospective observational cohort study

Author: David Clark, Alexis Joannides, Amos Olufemi Adeleye, Abdul Hafid Bajamal, Tom Bashford, Hagos Biluts, Karol Budohoski, Ari Ercole, Rocío Fernández-Méndez, Anthony Figaji, Deepak Kumar Gupta, Roger Härtl, Corrado Iaccarino, Tariq Khan, Tsegazeab Laeke, Andrés Rubiano, Hamisi K Shabani, Kachinga Sichizya, Manoj Tewari, Abenezer Tirsit, Myat Thu, Manjul Tripathi, Rikin Trivedi, Bhagavatula Indira Devi, Franco Servadei, David Menon, Angelos Kolias, Peter Hutchinson, Ghayur Abbas, Omar Ibrahim Abdallah, Ahmed Abdel-Lateef, Khalif Abdifatah, Awfa Abdullateef, Ruvini Abeygunaratne, Mostafa Aboellil, Abass Adam, Robert Adams, Amos Adeleye, Augustine Adeolu, Novan Krisno Adji, Nur Afianti, Sudarsan Agarwal, Ifeanyi Kene Aghadi, Paúl Martín Méndez Aguilar, Syeda Rida Ahmad, Daniyal Ahmed, Nafees Ahmed, Haider Aizaz, Yunus Kuntawi Aji, Alex Alamri, Augusto Jacinto Mussindo Alberto, Luis Alcocer Alcocer, Lesly Gonzales Alfaro, Amro Al-Habib, Ahmad Alhourani, Syed Muhammad Rafay Ali, Fahad Alkherayf, Ahmed AlMenabbawy, Aliyah Alshareef, Muhammad Adil s/o Aminullah, Madeha Amjad, Robson Luis Oliveira de Amorim, Sathiaprabhu Anbazhagan, Almir Andrade, Waleed Antar, Theophilus T.K. Anyomih, Salah Aoun, Tedy Apriawan, Daniele Armocida, Paul Arnold, Miguel Arraez, Temesgen Assefa, Andres Asser, S.P. Athiththan, Deepal Attanayake, Maung Maung Aung, Allan Avi, Victor Enrique Antolinez Ayala, Mohammed Azab, Gaousul Azam, Mohd Azharuddin, Olukemi Badejo, Mohamed Badran, Azam Ali Baig, Rehman Ali Baig, Ankur Bajaj, Paul Baker, Renu Bala, Artur Balasa, Ross Balchin, James Balogun, Vin Shen Ban, Bharath Kumar Reddy Bandi, Soham Bandyopadhyay, Matthew Bank, Ernest Barthelemy, Mohammed Talha Bashir, Luciano Silveira Basso, Surajit Basu, Auricelio Batista, Marlies Bauer, Devi Bavishi, Abi Beane, Shmuel Bejell, Anteneh Belachew, Antonio Belli, Amani Belouaer, Najia El Abbadi Bendahane, Okanga Benjamin, Youssef Benslimane, Chaymae Benyaiche, Claudio Bernucci, Luigi Valentino Berra, Arnold Bhebe, Alexios Bimpis, Diana Blanaru, Jean Claude Bonfim, Luis A B Borba, Alp Ozgun Borcek, Erika Borotto, Ahmad Elmabri Mohammad Bouhuwaish, Facundo Bourilhon, Gioia Brachini, Joshua Breedon, Maximilian Broger, Giacoma Maria Floriana Brunetto, Placido Bruzzaniti, Natalia Budohoska, Hira Burhan, Maximiliano Luis Calatroni, Catherine Camargo, Pier Francesco Cappai, Salvatore Massimiliano Cardali, Ana M Castaño-Leon, David Cederberg, Mikel Celaya, Marco Cenzato, Lakshmi Madhavi Challa, Dhanny Charest, Bipin Chaurasia, Rabah Chenna, Iype Cherian, Juliana Henry Ching'o, Tejas Chotai, Ajay Choudhary, Nabeel Choudhary, Florence Choumin, Tomislav Cigic, Juan Ciro, Carlo Conti, Antônio Carlos de Souza Corrêa, Giulia Cossu, Maíra Piani Couto, Aurora Cruz, Divya D'Silva, Giuseppe Antonio D'Aliberti, Lamin Dampha, Roy Thomas Daniel, Andrew Dapaah, Aneela Darbar, Gabriel Dascalu, Happy Amos Dauda, Owain Davies, Andrea Delgado-Babiano, Markus Dengl, Marko Despotovic, Indira Devi, Celeste Dias, Mohamed Dirar, Melina Dissanayake, Hananiah Djimbaye, Simon Dockrell, Ali Dolachee, Julija Dolgopolova, Muge Dolgun, Abdalrouf Dow, Davide Drusiani, Artjom Dugan, Dinh Tuan Duong, Trung Kien Duong, Tomasz Dziedzic, Ali Ebrahim, Nizar El Fatemi, Antonios El El Helou, Rachid El El Maaqili, Brahim El El Mostarchid, Abdessamad El El Ouahabi, Mohammad Elbaroody, Ahmed El-Fiki, Ahmed El-Garci, Nasser M.F. El-Ghandour, Muhammed Elhadi, Vanessa Elleder, Safa Elrais, Mohamed El-shazly, Mohamed Elshenawy, Hesham Elshitany, Omar El-Sobky, Marwa Emhamed, Basil Enicker, Onur Erdogan, Sebastian Ertl, Ignatius Esene, Omar Ocampo Espinosa, Tarig Fadalla, Mohammed Fadelalla, Rodrigo Moreira Faleiro, Nida Fatima, Charbel Fawaz, Assefa Fentaw, Carla Eiriz Fernandez, Ana Ferreira, Francesco Ferri, Tony Figaji, Emerson L B Filho, Loic Fin, Benjamin Fisher, Fitra Fitra, Alexis Palpan Flores, Ioan Stefan Florian, Vincenzo Fontana, Lauren Ford, Daniel Fountain, Jose Maria Roda Frade, Antonio Fratto, Christian Freyschlag, Aranzazu Sánchez Gabin, Clare Gallagher, Mario Ganau, Maria Luisa Gandia-Gonzalez, Andoni Garcia, Borja Hernandez Garcia, Sanjeewa Garusinghe, Biniam Gebreegziabher, Adrian Gelb, Jerome St George, Antonino Francesco Germanò, Ilaria Ghetti, Prajwal Ghimire, Alessandro Giammarusti, Jose Luis Gil, Panagiota Gkolia, Yoseph Godebo, Prakash Rao Gollapudi, Jagos Golubovic, Jeremias Fernando Gomes, Javier Gonzales, William Gormley, Alexander Gots, Giulia Letizia Gribaudi, Dylan Griswold, Paolo Gritti, Ruan Grobler, Rudy Gunawan, Birhanu Hailemichael, Elmehdi Hakkou, Mark Haley, Alhafidz Hamdan, Ali Hammed, Waeel Hamouda, Nurul Ashikin Hamzah, Nyein Latt Han, Sahin Hanalioglu, Rashan Haniffa, Martin Hanko, John Hanrahan, Timothy Hardcastle, Fahd Derkaoui Hassani, Volkmar Heidecke, Eirik Helseth, Miguel Ángel Hernández-Hernández, Zachary Hickman, Le Minh Chau Hoang, Alexa Hollinger, Lenka Horakova, Kismet Hossain-Ibrahim, Boru Hou, Samer Hoz, Janine Hsu, Martin Hunn, Madiha Hussain, Giorgia Iacopino, Mylena Miki Lopes Ideta, Irene Iglesias, Ali Ilunga, Nafiz Imtiaz, Rafiza Islam, Serge Ivashchenko, Karim Izirouel, Mohamed Sobhi Jabal, Soubhi Jabal, John Nute Jabang, Aimun Jamjoom, Irfan Jan, Landing BM Jarju, Saad Javed, Bojan Jelaca, Sukhdeep Singh Jhawar, Ting Ting Jiang, Fernando Jimenez, Jorge Jiris, Ron Jithoo, Walt Johnson, Mathew Joseph, Rameshman Joshi, Eija Junttila, Mubashir Jusabani, Stephen Akau Kache, Satyavara Prasad Kadali, Gabriela F Kalkmann, Usman Kamboh, Hitham Kandel, Ahmet Kamil Karakus, Mengistu Kassa, Ari Katila, Yoko Kato, Martin Keba, Kristy Kehoe, Huseyin Hayri Kertmen, Soha Khafaji, Monty Khajanchi, Mohammed Khan, Muhammad Mukhtar Khan, Sohail Daud Khan, Ahtesham Khizar, Amir Khriesh, Sara Kierońska, Paul Kisanga, Boniface Kivevele, Kacper Koczyk, Anna-Lucia Koerling, Danielle Koffenberger, Kennet Kõiv, Leho Kõiv, Branislav Kolarovszki, Marton König, Dilek Könü-Leblebicioglu, Santhoshi Devi Koppala, Tommi Korhonen, Boguslaw Kostkiewicz, Kacper Kostyra, Srinivas Kotakadira, Arjun Reddy Kotha, Madhu Narayana Rao Kottakki, Nenad Krajcinovic, Michal Krakowiak, Andreas Kramer, Selvamuthukumaran Krishnamoorthy, Ashok Kumar, Pankaj Kumar, Pradhumna Kumar, Nilaksha Kumarasinghe, Gowtham Kuncha, Raja K. Kutty, Ghazwan Lafta, Simon Lammy, Pierfrancesco Lapolla, Jacopo Lardani, Nebojsa Lasica, Giancarlo Lastrucci, Yoann Launey, Laura Lavalle, Tim Lawrence, Albert Lazaro, Vitalii Lebed, Ville Leinonen, Lawrence Lemeri, Leon Levi, Jia Yi Lim, Xiao Yi Lim, Jorge Linares-Torres, Laura Lippa, Lurdes Lisboa, Jinfang Liu, Ziyuan Liu, William B Lo, Jan Lodin, Federico Loi, Daniella Londono, Pedro Antonio Gomez Lopez, Cristina Barceló López, Madeleine De Lotbiniere-Bassett, Rihards Lulens, Facundo Hector Luna, Teemu Luoto, Vijaya Sekhar M.V., Ndyebo Mabovula, Matthew MacAllister, Alcina Americo Macie, Rodolfo Maduri, Moufid Mahfoud, Ashraf Mahmood, Fathia Mahmoud, Dominic Mahoney, Wissam Makhlouf, George Malcolm, Adefolarin Malomo, Toluyemi Malomo, Manoranjitha Kumari Mani, Tomás Gazzinelli Marçal, Jacopo Marchello, Nicolò Marchesini, Franz Marhold, Niklas Marklund, Rubén Martín-Láez, Vickneswaran Mathaneswaran, David José Mato-Mañas, Helen Maye, Aaron Lawson McLean, Catherine McMahon, Saniya Mediratta, Mehreen Mehboob, Alisson Meneses, Nesrine Mentri, Hagos Mersha, Ana Milena Mesa, Cristy Meyer, Christopher Millward, Salomao Amone Mimbir, Andrea Mingoli, Parashruram Mishra, Tejesh Mishra, Basant Misra, Siddharth Mittal, Imran Mohammed, Ioana Moldovan, Masechaba Molefe, Alexis Moles, Preston Moodley, Mario Augusto Narváez Morales, Lucy Morgan, German Del Castillo Morillo, Wahab Moustafa, Nikolaos Moustakis, Salma Mrichi, Satya Shiva Munjal, Abdul-Jalilu Mohammed Muntaka, Denver Naicker, Paulo E H Nakashima, Pratap Kumar Nandigama, Samantha Nash, Ionut Negoi, Valetina Negoita, Samundra Neupane, Manh Hung Nguyen, Fajar Herbowo Niantiarno, Abbi Noble, Mohd Arman Muhamad Nor, Blazej Nowak, Andrei Oancea, Frazer O'Brien, Oghenekevwe Okere, Sandra Olaya, Leandro Oliveira, Louise Makarem Oliveira, Fatma Omar, Okezi Ononeme, René Opšenák, Simone Orlandini, Alrobah Osama, Dorcas Osei-Poku, Haytham Osman, Alvaro Otero, Malte Ottenhausen, Shuli Otzri, Oumaima Outani, Emmanuel Abem Owusu, Kevin Owusu-Agyemang, Ahmad Ozair, Baris Ozoner, Elli Paal, Mauro Sérgio Paiva, Wellingson Paiva, Sharad Pandey, Gastone Pansini, Luigi Pansini, Tobias Pantel, Nikolaos Pantelas, Konstantinos Papadopoulos, Vladimir Papic, Kee Park, Nick Park, Eric Homero Albuquerque Paschoal, Mylla Christie de Oliveira Paschoalino, Rajesh Pathi, Anilkumar Peethambaran, Thiago Andrade Pereira, Irene Panero Perez, Claudio José Piqueras Pérez, Tamilanandh Periyasamy, Stefano Peron, Michael Phillips, Sofía Sotos Picazo, Ertugrul Pinar, Daniel Pinggera, Rory Piper, Pathmanesan Pirakash, Branko Popadic, Jussi P. Posti, Rajmohan Bhanu Prabhakar, Sivanesalingam Pradeepan, Manjunath Prasad, Paola Calvachi Prieto, Ron Prince, Andrea Prontera, Eva Provaznikova, Danilo Quadros, Nezly Jadid Romero Quintero, Mahmood Qureshi, Happiness Rabiel, Gabriel Rada, Sivagnanam Ragavan, Jueria Rahman, Omar Ramadhan, Padma Ramaswamy, Sakina Rashid, Jagath Rathugamage, Tõnu Rätsep, Minna Rauhala, Asif Raza, Naga Raju Reddycherla, Linus Reen, Mohamed Refaat, Luca Regli, Haijun Ren, Antonio Ria, Thales Francisco Ribeiro, Alessandro Ricci, Romana Richterová, Florian Ringel, Faith Robertson, Catarina Mayrink Siqueira Cabral Rocha, Juvenal de Souza Rogério, Adan Anibal Romano, Sally Rothemeyer, Gail Rousseau Gail Rousseau, Ranette Roza, Kevin David Farelo Rueda, Raiza Ruiz, Malin Rundgren, Radoslaw Rzeplinski, Raj S.Chandran, Ramesh Andi Sadayandi, William Sage, André Norbert Josef Sagerer, Mustafa Sakar, Mohcine Salami, Danjuma Sale, Youssuf Saleh, Cristina Sánchez-Viguera, Saning'o Sandila, Ahmet Metin Sanli, Laura Santi, Antonio Santoro, Aieska Kellen Dantas Dos Santos, Samir Cezimbra dos Santos, Borja Sanz, Shabal Sapkota, Gopalakrishnan Sasidharan, Ibrahim Sasillo, Rajeev Satoskar, Ali Caner Sayar, Vignesh Sayee, Florian Scheichel, Felipe Lourenzon Schiavo, Alexander Schupper, Andreas Schwarz, Teresa Scott, Esther Seeberger, Claudionor Nogueira Costa Segundo, Anwar Sadat Seidu, Antonio Selfa, Nazan Has Selmi, Claudiya Selvarajah, Necmiye Şengel, Martin Seule, Luiz Severo, Purva Shah, Muhammad Shahzad, Thobekile Shangase, Mayur Sharma, Ehab Shiban, Emnet Shimber, Temitayo Shokunbi, Kaynat Siddiqui, Emily Sieg, Martin Siegemund, Shahidur Rahman Sikder, Ana Cristina Veiga Silva, Ana Silva, Pedro Alberto Silva, Deepinder Singh, Carly Skadden, Josef Skola, Eirini Skouteli, Pawel Słoniewski, Brandon Smith, Guirish Solanki, Davi Fontoura Solla, Davi Solla, Ozcan Sonmez, Müge Sönmez, Wai Cheong Soon, Roberto Stefini, Martin Nikolaus Stienen, Bogdan Stoica, Matthew Stovell, Maria Natalia Suarez, Alaa Sulaiman, Mazin Suliman, Adi Sulistyanto, Şeniz Sulubulut, Sandra Sungailaite, Madlen Surbeck, Tomasz Szmuda, Graziano Taddei, Abraham Tadele, Ahmed Saleh Ahmed Taher, Riikka Takala, Krishna Murthy Talari, Bih Huei Tan, Leonardo Tariciotti, Murad Tarmohamed, Oumayma Taroua, Emiliano Tatti, Olli Tenovuo, Sami Tetri, Poojan Thakkar, Nqobile Thango, Satish Kumar Thatikonda, Tuomo Thesleff, Claudius Thomé, Owen Thornton, Shelly Timmons, Eva Ercilio Timoteo, Campbell Tingate, Souhil Tliba, Christos Tolias, Emma Toman, Ivan Torres, Luis Torres, Youness Touissi, Musa Touray, Maria Pia Tropeano, Georgios Tsermoulas, Christos Tsitsipanis, Mehmet Erhan Turkoglu, Özhan Merzuk Uçkun, Jamie Ullman, Gheorghe Ungureanu, Sarah Urasa, Obaid Ur-Rehman, Muhammed Uysal, Antonios Vakis, Egils Valeinis, Vaishali Valluru, Debby Vannoy, Pablo Vargas, Phillipos Varotsis, Rahul Varshney, Atul Vats, Damjan Veljanoski, Sara Venturini, Abhijit Verma, Clara Villa, Genaro Villa, Sofia Villar, Erin Villard, Antonio Viruez, Stefanos Voglis, Petar Vulekovic, Saman Wadanamby, Katherine Wagner, Rebecca Walshe, Jan Walter, Marriam Waseem, Tony Whitworth, Ruwani Wijeyekoon, Adam Williams, Mark Wilson, Sein Win, Achmad Wahib Wahju Winarso, Abraão Wagner Pessoa Ximenes, Anurag Yadav, Dipak Yadav, Kamal Makram Yakoub, Ali Yalcinkaya, Guizhong Yan, Eesha Yaqoob, Carlos Yepes, Ayfer Nazmiye Yılmaz, Betelehem Yishak, Farhat Basheer Yousuf, Muhammad Zamzuri Zahari, Hussein Zakaria, Diego Zambonin, Luca Zavatto, Bassel Zebian, Anna Maria Zeitlberger, Furong Zhang, Fengwei Zheng, and Michal Ziga
Subjects: casemix, management, mortality, emergency neurosurgery, traumatic brain injury, prospective observational cohort study, Neurology (clinical)
Abstract: © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Traumatic brain injury (TBI) is increasingly recognised as being responsible for a substantial proportion of the global burden of disease. Neurosurgical interventions are an important aspect of care for patients with TBI, but there is little epidemiological data available on this patient population. We aimed to characterise differences in casemix, management, and mortality of patients receiving emergency neurosurgery for TBI across different levels of human development. Methods: We did a prospective observational cohort study of consecutive patients with TBI undergoing emergency neurosurgery, in a convenience sample of hospitals identified by open invitation, through international and regional scientific societies and meetings, individual contacts, and social media. Patients receiving emergency neurosurgery for TBI in each hospital's 30-day study period were all eligible for inclusion, with the exception of patients undergoing insertion of an intracranial pressure monitor only, ventriculostomy placement only, or a procedure for drainage of a chronic subdural haematoma. The primary outcome was mortality at 14 days postoperatively (or last point of observation if the patient was discharged before this time point). Countries were stratified according to their Human Development Index (HDI)—a composite of life expectancy, education, and income measures—into very high HDI, high HDI, medium HDI, and low HDI tiers. Mixed effects logistic regression was used to examine the effect of HDI on mortality while accounting for and quantifying between-hospital and between-country variation. Findings: Our study included 1635 records from 159 hospitals in 57 countries, collected between Nov 1, 2018, and Jan 31, 2020. 328 (20%) records were from countries in the very high HDI tier, 539 (33%) from countries in the high HDI tier, 614 (38%) from countries in the medium HDI tier, and 154 (9%) from countries in the low HDI tier. The median age was 35 years (IQR 24–51), with the oldest patients in the very high HDI tier (median 54 years, IQR 34–69) and the youngest in the low HDI tier (median 28 years, IQR 20–38). The most common procedures were elevation of a depressed skull fracture in the low HDI tier (69 [45%]), evacuation of a supratentorial extradural haematoma in the medium HDI tier (189 [31%]) and high HDI tier (173 [32%]), and evacuation of a supratentorial acute subdural haematoma in the very high HDI tier (155 [47%]). Median time from injury to surgery was 13 h (IQR 6–32). Overall mortality was 18% (299 of 1635). After adjustment for casemix, the odds of mortality were greater in the medium HDI tier (odds ratio [OR] 2·84, 95% CI 1·55–5·2) and high HDI tier (2·26, 1·23–4·15), but not the low HDI tier (1·66, 0·61–4·46), relative to the very high HDI tier. There was significant between-hospital variation in mortality (median OR 2·04, 95% CI 1·17–2·49). Interpretation: Patients receiving emergency neurosurgery for TBI differed considerably in their admission characteristics and management across human development settings. Level of human development was associated with mortality. Substantial opportunities to improve care globally were identified, including reducing delays to surgery. Between-hospital variation in mortality suggests changes at an institutional level could influence outcome and comparative effectiveness research could identify best practices. Funding: National Institute for Health Research Global Health Research Group.
Published: 2022

35. Is perioperative COVID-19 really associated with worse surgical outcomes? A nationwide COVIDSurg propensity-matched analysis

Author: Argandykov, Dias, Dorken-Gallastegi, Ander, El Moheb, Mohamad, Gebran, Anthony, Proaño-Zamudio, Jefferson A, Bokenkamp, Mary, Renne, Angela M, Nepogodiev, Dmitri, Bhangu, Aneel, Kaafarani, Haytham M A, Kwabena, Siaw-Acheampong, Leah, Argus, Daoud, Chaudhry, Brett, E Dawson, James, C Glasbey, Rohan, R Gujjuri, Conor, S Jones, Sivesh, K Kamarajah, Chetan, Khatri, James, M Keatley, Samuel, Lawday, Elizabeth, Li, Harvinder, Mann, Ella, J Marson, Kenneth, A Mclean, Maria, Picciochi, Elliott, H Taylor, Abhinav, Tiwari, Joana F, F Simoes, Isobel, M Trout, Mary, L Venn, Richard J, W Wilkin, Aneel, Bhangu, Dmitri, Nepogodiev, Irida, Dajti, Arben, Gjata, Luis, Boccalatte, Mariamarta, Modolo, Daniel, Cox, Peter, Pockney, Philip, Townend, Felix, Aigner, Irmgard, Kronberger, Kamral, Hossain, Gabrielle, Vanramshorst, Ismail, Lawani, Gustavo, Ataide, Glauco, Baiocchi, Igor, Buarque, Muhammad, Gohar, Mihail, Slavchev, Arnav, Agarwal, Amanpreet, Brar, Janet, Martin, Maria Marta Modolo, Maricarmen, Olivos, Jose, Calvache, Carlos Jose Perez Rivera, Ana Danic Hadzibegovic, Tomislav, Kopjar, Jakov, Mihanovic, Jaroslav, Klat, René, Novysedlak, Peter, Christensen, Alaa, El-Hussuna, Sylvia, Batista, Eddy, Lincango, Sameh, H Emile, Mengistu Gebreyohanes Mengesha, Samuel, Hailu, Hailu, Tamiru, Joonas, Kauppila, Johanna, Laukkarinen, Alexis, Arnaud, Markus, Albertsmeiers, Hans, Lederhuber, Markus, Loffler, Stephen, Tabiri, Symeon, Metallidis, Georgios, Tsoulfas, Maria Aguilera Lorena, Gustavo, Grecinos, Tamas, Mersich, Daniel, Wettstein, Dhruv, Ghosh, Gabriele, Kembuan, Peiman, Brouk, Mohammad, Khosravi, Masoud, Mozafari, Ahmed, Adil, Helen, M Mohan, Oded, Zmora, Marco, Fiore, Gallo, Gaetano, Francesco, Pata, Gianluca, Pellino, Sohei, Satoi, Faris, Ayasra, Mohammad, Chaar, Ildar, R Fakhradiyev, Mohammad, Jamal, Muhammed, Elhadi, Aiste, Gulla, April, Roslani, Laura, Martinez, Antonio Ramos De La Medina, Oumaima, Outani, Pascal, Jonker, Schelto, Kruijff, Milou, Noltes, Pieter, Steinkamp, Willemijn van der Plas, Adesoji, Ademuyiwa, Babatunde, Osinaike, Justina, Seyi-Olajide, Emmanuel, Williams, Sofija, Pejkova, Knut Magne Augestad, Zainab Al Balushi, Ahmad, Qureshi, Raza, Sayyed, Mustafa Abu Mohsen Daraghmeh, Sadi, Abukhalaf, Moises, Cukier, Hugo, Gomez, Sebastian, Shu, Ximena, Vasquez, Marie Dione Parreno-Sacdalan, Piotr, Major, José, Azevedo, Miguel, Cunha, Irene, Santos, Ahmad, Zarour, Eduard-Alexandru, Bonci, Ionut, Negoi, Sergey, Efetov, Andrey, Litvin, Faustin, Ntirenganya, Ehab, Alameer, Dejan, Radenkovic, Frederick Koh Hong Xiang, Chew Min Hoe, James Ngu Chi Yong, Rachel, Moore, Ncamsile, Nhlabathi, Ruth Blanco Colino, Ana Minaya Bravo, Ana, Minaya-Bravo, Umesh, Jayarajah, Dakshitha, Wickramasinghe, Mohammed, Elmujtaba, William, Jebril, Martin, Rutegård, Malin, Sund, Arda, Isik, Sezai, Leventoğlu, Tom E, F Abbott, Ruth, Benson, Caruna, Ed, Sohini, Chakrabortee, Andreas, Demetriades, Anant, Desai, Thomas, D Drake, John, G Edwards, Jonathan, P Evans, Samuel, Ford, Christina, Fotopoulou, Ewen, Griffiths, Peter, Hutchinson, Michael, D Jenkinson, Tabassum, Khan, Stephen, Knight, Angelos, Kolias, Elaine, Leung, Siobhan, Mckay, Lisa, Norman, Riinu, Ots, Vidya, Raghavan, Keith, Roberts, Andrew, Schache, Richard, Shaw, Katie, Shaw, Neil, Smart, Grant, Stewart, Sudha, Sundar, Dale, Vimalchandran, Naomi, Wright, Sattar, Alshryda, Osaid, Alser, Kerry, Breen, Ian, Ganly, Haytham, Kaafarani, Brittany, Kendall, Hassan, Mashbari, Hamza Al Naggar, Dennis, Mazingi, J J, Wong, Napolitano, L, Hemmila, M, Amin, D, Abramowicz, S, S M, Roser, K A, Olson, Riley, C, Heron, C, Cardenas, T, Leede, E, Thornhill, M, A B, Haynes, Mcelhinney, K, Roward, S, M D, Trust, C E, Hill, P G, Teixeira, Etchill, E, Stevens, K, M R, Ladd, Long, C, Rose, J, Kent, A, Yesantharao, P, Vervoort, D, Jenny, H, Gabre-Kidan, A, Margalit, A, Tsai, L, Malapati, H, Yesantharao, L, Abdou, H, Diaz, J, Richmond, M, Clark, J, O'Meara, L, Hanna, N, Ying, Y, Fleming, J, Ovaitt, A, Gigliotti, J, Fuson, A, Cooper, Z, Salim, A, A Hirji, S, Brown, A, Chung, C, Hansen, L, U Okafor, B, Roxo, V, P Raut, C, S Jolissaint, J, A Mahvi, D, Kaafarani, H, Breen, K, Bankhead-Kendall, B, Alser, O, Mashbari, H, Velmahos, G, L R, Maurer, El Moheb, M, Gaitanidis, A, Naar, L, M A, Christensen, Kapoen, C, Langeveld, K, El Hechi, M, Mokhtari, A, H Haqqani, M, T Drake, F, Goldenberg-Sandau, A, Galbreath, B, Reinke, C, Ross, S, Thompson, K, Manning, D, Perkins, R, Eriksson, E, Evans, H, Masrur, M, Giulianotti, P, Benedetti, E, Chang, G, Ourieff, J, Dehart, D, Dorafshar, A, Price, T, R Bhama, A, Torquati, A, Cherullo, E, Kennedy, R, Myers, J, Rubin, K, S Ban, V, G Aoun, S, H Batjer, H, Caruso, J, Carmichael, H, G Velopulos, C, L Wright, F, Urban, S, C McIntyre Jr, R, J Schroeppel, T, A Hennessy, E, Dunn, J, Zier, L, Burlew, C, Coleman, J, P Colling, K, Hall, B, E Rice, H, S Hwang, E, A Olson, S, Moris, D, Verma, R, Hassan, R, Volpe, A, Merola, S, A O'Banion, L, Lilienstein, J, Dirks, R, Marwan, H, Almasri, M, Kulkarni, G, Mehdi, M, Abouassi, A, Abdallah, M, M San Andrés, Eid, J, Aigbivbalu, E, Sundaresan, J, George, B, Ssentongo, A, Ssentongo, P, S Oh, J, Hazelton, J, Maines, J, Gusani, N, Garner, M, Horvath, S, Zheng, F, Ujiki, M, Kinnaman, G, Meagher, A, Sharma, I, Holler, E, Mckenzie, K, Chan, J, Fretwell, K, W Nugent 3rd, Khalil, A, Chen, D, Post, N, Rostkowski, T, Brahmbhatt, D, Huynh, K, L Hibbard, M, Schellenberg, M, Martin, Rcg, Bhutiani, N, Giorgakis, E, Laryea, J, Bhavaraju, A, Sexton, K, Roberts, M, Kost, M, Kimbrough, M, Burdine, L, Kalkwarf, K, Robertson, R, Gosain, A, Camp, L, Lewit, R, P Kronenfeld, J, Urrechaga, E, Goel, N, Rattan, R, Hart, V, Allen, M, Gilna, G, Cioci, A, Ruiz, G, Rakoczy, K, Pavlis, W, Saberi, R, Morris, R, S Karam, B, Brathwaite, Cem, Liu, H, Petrone, P, Hakmi, H, H Sohail, A, Baltazar, G, Heckburn, R, M Nygaard, R, T Colonna, E, W Endorf, F, J Hill, M, Maiga, A, Dennis, B, H Levin, J, Lallemand, M, Choron, R, Peck, G, Soliman, F, Rehman, S, Glass, N, Juthani, B, Deisher, D, M Ruzgar, N, J Ullrich, S, Sion, M, Paranjape, C, M El Moheb, R Kar, A, Gillezeau, C, Rapp, J, Taioli, E, A Miles, B, Alpert, N, Podolsky, D, L Coleman, N, P Callahan, M, Ganly, I, Brown, L, Monson, Jrt, Dehal, A, Abbas, A, Soliman, A, Kim, B, Jones, C, Dauer, E, Renza-Stingone, E, Hernandez, E, Gokcen, E, Kropf, E, Sufrin, H, Hirsch, H, Ross, H, Engel, J, Sewards, J, Poggio, J, Sanserino, K, Rae, L, Philp, M, Metro, M, Mcnelis, P, Petrov, R, Pazionis, T, Till, B, Lamm, R, J Rios-Diaz, A, Palazzo, F, Rosengart, M, Nicholson, K, M Carrick, M, Rodkey, K, Suri, A, Callcut, R, Nicholson, S, Talathoti, N, Klaristenfeld, D, Biffl, W, Marsh, C, Schaffer, K, E Berndtson, A, Averbach, S, Curry, T, Kwan-Feinberg, R, Consorti, E, Gonzalez, R, Grolman, R, Liu, T, Merzlikin, O, K Abel, M, Ozgediz, D, Boeck, M, Z Kornblith, L, Nunez-Garcia, B, Robinson, B, Park, P, F Utria, A, E Rice-Townsend, S, Javid, P, Hauptman, J, Kieran, K, Nehra, D, Walters, A, Cuschieri, J, H Davidson, G, Nunez, J, Cosker, R, Eckhouse, S, Choudhry, A, Marx, W, Jamil, T, Seegert, S, Al-Embideen, S, Quintana, M, Jackson, H, D Wexner, S, Kent, I, and N Martins, P
Subjects: COVID-19, COVIDSurg, mortality, postoperative complications, Surgery, Critical Care and Intensive Care Medicine
Published: 2023

36. Correction to: Management of moderate to severe traumatic brain injury: an update for the intensivist

Author: Geert Meyfroidt, Pierre Bouzat, Michael P. Casaer, Randall Chesnut, Sophie Rym Hamada, Raimund Helbok, Peter Hutchinson, Andrew I. R. Maas, Geoffrey Manley, David K. Menon, Virginia F. J. Newcombe, Mauro Oddo, Chiara Robba, Lori Shutter, Martin Smith, Ewout W. Steyerberg, Nino Stocchetti, Fabio Silvio Taccone, Lindsay Wilson, Elisa R. Zanier, and Giuseppe Citerio
Subjects: Critical Care and Intensive Care Medicine
Published: 2022

37. Outcomes and Their State-level Variation in Patients Undergoing Surgery With Perioperative SARS-CoV-2 Infection in the USA

Author: Osaid, Alser, Ander Dorken Gallastegi, Anthony, Gebran, Kerry, Breen, Mohamad El Moheb, Apostolos, Gaitanidis, Leon, Naar, Brittany, Bankhead-Kendall, Hassan, Mashbari, Robert, D Sinyard, Lydia, R Maurer, Charu, Paranjape, George, C Velmahos, Dmitri, Nepogodiev, Aneel, Bhangu, Haytham M, A Kaafarani, Kwabena, Siaw-Acheampong, Leah, Argus, Daoud, Chaudhry, Brett, E Dawson, James, C Glasbey, Rohan, R Gujjuri, Conor, S Jones, Sivesh, K Kamarajah, Chetan, Khatri, James, M Keatley, Samuel, Lawday, Elizabeth, Li, Harvinder, Mann, Ella, J Marson, Kenneth, A Mclean, Maria, Picciochi, Elliott, H Taylor, Abhinav, Tiwari, Joana F, F Simoes, Isobel, M Trout, Mary, L Venn, Richard J, W Wilkin, Irida, Dajti, Arben, Gjata, Oussama, Kacimi, Luis, Boccalatte, Maria Marta Modolo, Daniel, Cox, Peter, Pockney, Philip, Townend, Felix, Aigner, Irmgard, Kronberger, Ahmed, Elgun, Amer, Alderazi, Kamral, Hossain, Greg, Padmore, Gabrielle, Vanramshorst, Ismail, Lawani, Duane, Wedderburn, Sonam, Dargay, Israël, Feraudy, Cerovac, Anis, Samir, Delibegovic, Alemayehu Ginbo Bedada, Gustavo, Ataide, Glauco, Baiocchi, Igor, Buarque, Muhammad, Gohar, Mihail, Slavchev, Jean Marie Vianney Butoyi, Chukwuemeka, Nwegbu, Arnav, Agarwal, Amanpreet, Brar, Janet, Martin, Maricarmen, Olivos, Dong-Lin, Ren, Wenhui, Lou, Jose, Calvache, Carlos Jose Perez Rivera, Ana Danic Hadzibegovic, Tomislav, Kopjar, Jakov, Mihanovic, Pablo, Avilés, Nikolaos, Gouvas, Jaroslav, Klat, René, Novysedlak, Nicolas, Amisi, Peter, Christensen, Alaa, El-Hussuna, Sylvia, Batista, Eddy, Lincango, Sameh, H Emile, Danilo Alfonso Arévalo Sandoval, Mengistu Gebreyohanes Mengesha, Samuel, Hailu, Hailu, Tamiru, Joonas, Kauppila, Johanna, Laukkarinen, Alexis, Arnaud, Roumanatou Bankole Sapin, Kebba, Marenah, Zaza, Demetrashvili, Andreas, A Schnitzbauer, Magdalena, Gruendl, Markus, Albertsmeiers, Hans, Lederhuber, Markus, Loffler, Bernard Ofori Appiah, Daniel, Acquah, Stephen, Tabiri, Symeon, Metallidis, Georgios, Tsoulfas, Maria Aguilera Lorena, Gustavo, Grecinos, Tamas, Mersich, Daniel, Wettstein, Atul, Suroy, Dhruv, Ghosh, Pranay, Pawar, Gabriele, Kembuan, Peiman, Brouk, Mohammad, Khosravi, Masoud, Mozafari, Ahmed, Adil, Helen, M Mohan, Oded, Zmora, Marco, Fiore, Gallo, G, Pata, Francesco, Gianluca, Pellino, Naoto, Kuroda, Sohei, Satoi, Yuki, Fujimoto, Faris, Ayasra, Mohammad, Chaar, Ildar, R Fakhradiyev, Intisar, Hisham, Jin-Young, Jang, Enver, Fekaj, Mohammad, Jamal, Anvar, Beisembaev, Muhammed, Elhadi, Aiste, Gulla, Luc, Samison, Jupsi, Neny, Palesa, Chisala, April, Roslani, Iran Irani Duran Sanchez, Laura Martinez Perez Maldonado, Antonio Ramos De La Medina, Jade, Nunez, Oumaima, Outani, Abd'Rashid, Nashidengo, Ashish Lal Shrestha, Rakesh, Shah, Pascal, Jonker, Schelto, Kruijff, Milou, Noltes, Pieter, Steinkamp, Willemijn van der Plas, Chris, Varghese, Deborah, Wright, Jorge, Neira, Adesoji, Ademuyiwa, Babatunde, Osinaike, Justina, Seyi-Olajide, Emmanuel, Williams, Sofija, Pejkova, Knut Magne Augestad, Kjetil, Soreide, Zainab Al Balushi, Ahmad, Qureshi, Raza, Sayyed, Mustafa Abu Mohsen Daraghmeh, Sadi, Abukhalaf, Moises, Cukier, Chris, Munguas, Hugo, Gomez, Sebastian, Shu, Ximena, Vasquez, Marie Dione Parreno-Sacdalan, Piotr, Major, José, Azevedo, Miguel, Cunha, Irene, Santos, Ahmad, Zarour, Eduard-Alexandru, Bonci, Ionut, Negoi, Sergey, Efetov, Andrey, Litvin, Faustin, Ntirenganya, Ehab, Alameer, Abdourahmane, Ndong, Dejan, Radenkovic, Ibrahim, Sesay, Frederick Koh Hong Xiang, Chew Min Hoe, James Ngu Chi Yong, Arpad, Panyko, Jurij, Kosir, Uros, Bele, Hassan, Ali, Rachel, Moore, Ncamsile, Nhlabathi, Ruth Blanco Colino, Ana Minaya Bravo, Umesh, Jayarajah, Dakshitha, Wickramasinghe, Mohammed, Elmujtaba, William, Jebril, Martin, Rutegård, Malin, Sund, Eleftherios, Gialamas, Karoline, Horisberger, Michel, Adamina, Muhammad, Alshaar, Abel, Huang, Ben, Mbwele, Varut, Lohsiriwat, Shane, Charles, Haithem, Jlassi, Arda, Isik, Sezai, Leventoğlu, Lekuya, Herve, Lekuya, Monka, Herman, Lule, Tom E, F Abbott, Ruth, Benson, Caruna, Ed, Sohini, Chakrabortee, Andreas, Demetriades, Anant, Desai, Thomas, D Drake, John, G Edwards, Jonathan, P Evans, Samuel, Ford, Christina, Fotopoulou, Ewen, Griffiths, Peter, Hutchinson, Michael, D Jenkinson, Tabassum, Khan, Stephen, Knight, Angelos, Kolias, Elaine, Leung, Siobhan, Mckay, Lisa, Norman, Riinu, Ots, Vidya, Raghavan, Keith, Roberts, Andrew, Schache, Richard, Shaw, Katie, Shaw, Neil, Smart, Grant, Stewart, Sudha, Sundar, Dale, Vimalchandran, Naomi, Wright, Slava, Kopetskiy, Sattar, Alshryda, Ian, Ganly, Haytham, Kaafarani, Brittany, Kendall, Fernando, Bonilla, Hamza Al Naggar, Mayaba, Maimbo, Dennis, Mazingi, J Wong, J, Napolitano, L, Hemmila, M, Amin, D, Abramowicz, S, M Roser, S, A Olson, K, Riley, C, Heron, C, Cardenas, T, Leede, E, Thornhill, M, B Haynes, A, Mcelhinney, K, Roward, S, D Trust, M, E Hill, C, G Teixeira, P, Etchill, E, Stevens, K, R Ladd, M, Long, C, Rose, J, Kent, A, Yesantharao, P, Vervoort, D, Jenny, H, Gabre-Kidan, A, Margalit, A, Tsai, L, Malapati, H, Yesantharao, L, Abdou, H, Diaz, J, Richmond, M, Clark, J, O'Meara, L, Hanna, N, Ying, Y, Fleming, J, Ovaitt, A, Gigliotti, J, Fuson, A, Cooper, Z, Salim, A, A Hirji, S, Brown, A, Chung, C, Hansen, L, U Okafor, B, Roxo, V, P Raut, C, S Jolissaint, J, A Mahvi, D, Kaafarani, H, Breen, K, Bankhead-Kendall, B, Alser, O, Mashbari, H, Velmahos, G, R Maurer, L, M El Moheb, Gaitanidis, A, Naar, L, A Christensen, M, Kapoen, C, Langeveld, K, M El Hechi, Mokhtari, A, H Haqqani, M, T Drake, F, Goldenberg-Sandau, A, Galbreath, B, Reinke, C, Ross, S, Thompson, K, Manning, D, Perkins, R, Eriksson, E, Evans, H, Masrur, M, Giulianotti, P, Benedetti, E, Chang, G, Ourieff, J, Dehart, D, Dorafshar, A, Price, T, R Bhama, A, Torquati, A, Cherullo, E, Kennedy, R, Myers, J, Rubin, K, S Ban, V, G Aoun, S, H Batjer, H, Caruso, J, Carmichael, H, G Velopulos, C, L Wright, F, Urban, S, C McIntyre Jr, R, J Schroeppel, T, A Hennessy, E, Dunn, J, Zier, L, Burlew, C, Coleman, J, P Colling, K, Hall, B, E Rice, H, S Hwang, E, A Olson, S, Moris, D, Verma, R, Hassan, R, Volpe, A, Merola, S, A O'Banion, L, Lilienstein, J, Dirks, R, Marwan, H, Almasri, M, Kulkarni, G, Mehdi, M, Abouassi, A, Abdallah, M, M San Andrés, Eid, J, Aigbivbalu, E, Sundaresan, J, George, B, Ssentongo, A, Ssentongo, P, S Oh, J, Hazelton, J, Maines, J, Gusani, N, Garner, M, Horvath, S, Zheng, F, Ujiki, M, Kinnaman, G, Meagher, A, Sharma, I, Holler, E, Mckenzie, K, Chan, J, Fretwell, K, W Nugent 3rd, Khalil, A, Chen, D, Post, N, Rostkowski, T, Brahmbhatt, D, Huynh, K, L Hibbard, M, Schellenberg, M, R C, G Martin, Bhutiani, N, Giorgakis, E, Laryea, J, Bhavaraju, A, Sexton, K, Roberts, M, Kost, M, Kimbrough, M, Burdine, L, Kalkwarf, K, Robertson, R, Gosain, A, Camp, L, Lewit, R, P Kronenfeld, J, Urrechaga, E, Goel, N, Rattan, R, Hart, V, Allen, M, Gilna, G, Cioci, A, Ruiz, G, Rakoczy, K, Pavlis, W, Saberi, R, Morris, R, S Karam, B, C E, M Brathwaite, Liu, H, Petrone, P, Hakmi, H, H Sohail, A, Baltazar, G, Heckburn, R, M Nygaard, R, T Colonna, E, W Endorf, F, J Hill, M, Maiga, A, Dennis, B, H Levin, J, Lallemand, M, Choron, R, Peck, G, Soliman, F, Rehman, S, Glass, N, Juthani, B, Deisher, D, M Ruzgar, N, J Ullrich, S, Sion, M, Paranjape, C, R Kar, A, Gillezeau, C, Rapp, J, Taioli, E, A Miles, B, Alpert, N, Podolsky, D, L Coleman, N, P Callahan, M, Ganly, I, Brown, L, J R, T Monson, Dehal, A, Abbas, A, Soliman, A, Kim, B, Jones, C, D Dauer, M, Renza-Stingone, E, Hernandez, E, Gokcen, E, Kropf, E, Sufrin, H, Hirsch, H, Ross, H, Engel, J, Sewards, J, Poggio, J, Sanserino, K, Rae, L, Philp, M, Metro, M, Mcnelis, P, Petrov, R, Pazionis, T, Till, B, Lamm, R, J Rios-Diaz, A, Palazzo, F, Rosengart, M, Nicholson, K, M Carrick, M, Rodkey, K, Suri, A, Callcut, R, Nicholson, S, Talathoti, N, Klaristenfeld, D, Biffl, W, Marsh, C, Schaffer, K, E Berndtson, A, Averbach, S, Curry, T, Kwan-Feinberg, R, Consorti, E, Gonzalez, R, Grolman, R, Liu, T, Merzlikin, O, K Abel, M, Ozgediz, D, Boeck, M, Z Kornblith, L, Nunez-Garcia, B, Robinson, B, Park, P, F Utria, A, E Rice-Townsend, S, Javid, P, Hauptman, J, Kieran, K, Nehra, D, Walters, A, Cuschieri, J, H Davidson, G, Nunez, J, Cosker, R, Eckhouse, S, Choudhry, A, Marx, W, Jamil, T, Seegert, S, Al-Embideen, S, Quintana, M, Jackson, H, D Wexner, S, Kent, I, N Martins, P, Xiao, Liu, and Alistair, Denniston
Subjects: Male, medicine.medical_specialty, Revised Cardiac Risk Index, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), pulmonary complications, Malignancy, Time-to-Treatment, Postoperative Complications, Sex Factors, Risk Factors, medicine, COVID-19, COVIDSurg, elective surgery, emergency surgery, mortality, pulmonary complications, Humans, In patient, Prospective Studies, emergency surgery, Elective surgery, Aged, Respiratory Distress Syndrome, SARS-CoV-2, business.industry, Pulmonary Complication, Age Factors, COVID-19, Pneumonia, Perioperative, Middle Aged, COVIDSurg, elective surgery, mortality, medicine.disease, United States, Surgery, Multicenter study, Elective Surgical Procedures, Female, business
Abstract: Objective To report the 30-day outcomes of patients with perioperative SARS-CoV-2 infection undergoing surgery in the USA. Summary background data Uncertainty regarding the postoperative risks of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exists. Methods As part of the COVIDSurg multicenter study, all patients aged ≥17 years undergoing surgery between January 1 and June 30, 2020 with perioperative SARS-CoV-2 infection in 70 hospitals across 27 states were included. The primary outcomes were 30-day mortality and pulmonary complications. Multivariable analyses (adjusting for demographics, comorbidities, and procedure characteristics) were performed to identify predictors of mortality. Results A total of 1,581 patients were included; more than half of them were males (n= 822, 52.0%) and older than 50 years (n=835, 52.8%). Most procedures (n=1,261, 79.8%) were emergent, and laparotomies (n= 538, 34.1%). The mortality and pulmonary complication rates were 11.0 and 39.5%, respectively. Independent predictors of mortality included age ≥70 years (OR 2.46, 95% CI [1.65-3.69]), male sex (2.26 [1.53-3.35]), ASA grades 3-5 (3.08 [1.60-5.95]), emergent surgery (2.44 [1.31-4.54]), malignancy (2.97 [1.58-5.57]), respiratory comorbidities (2.08 [1.30-3.32]), and higher Revised Cardiac Risk Index (1.20 [1.02-1.41]). While statewide elective cancelation orders were not associated with a lower mortality, a sub-analysis showed it to be associated with lower mortality in those who underwent elective surgery (0.14 [0.03-0.61]). Conclusions Patients with perioperative SARS-CoV-2 infection have a significantly high risk for postoperative complications, especially elderly males. Postponing elective surgery and adopting non-operative management, when reasonable, should be considered in the USA during the pandemic peaks.
Published: 2021

38. Assessing the accuracy of the International Classification of Disease (ICD) frameworkin the identification of patients with Chronic Subdural Haematoma from hospital records

Author: Stefan Yordanov, Shuaib Khan, Danial Stubbs, Benjamin Davies, Thomas Santarius, Peter Hutchinson, and Alexis Joannides
Subjects: History, Polymers and Plastics, Surgery, Business and International Management, Industrial and Manufacturing Engineering
Abstract: Background Chronic subdural hematoma (CSDH) is one of the commonest neurosurgical pathologies with an increasing incidence. Observational studies of routine care have demonstrated high perioperative morbidity and approximately 10% mortality at one year. 20 The development, implementation, and evaluation of a potential care framework relies on an accurate and reproducible method of case identification and case ascertainment. With this manuscript, we report on the accuracy of diagnostic ICD codes for identifying patients with CSDH from retrospective electronic data and explore whether basic demographic data could improve the identification of CSDH. Methods: Data were collected retrospectively from the hospital administrative system between 2014–2018 of all patients coded with either S065 or I620. Analysis of the ICD codes in identifying patients with CSDH diagnosis was calculated using the caretR package in RStudioR .and stepwise logistic regression analysis was performed to evaluate the best predictive model for CSDH. Results: A total of 1861 patients were identified. Of these, 189 (10.2%) had a diagnosis of non-traumatic SDH (I620) and 1672 (89.8%) traumatic subdural haematomas (S065). Variables that identified CSDH as a diagnosis on univariate logistic regression included male sex (Odds Ratios (OR) − 1.606(1.197–2.161), elderly age (OR) − 1.023(1.015–1.032) per year for age (p
Published: 2022

39. Surgery versus conservative treatment for traumatic acute subdural haematoma: a prospective, multicentre, observational, comparative effectiveness study

Author: Thomas A van Essen, Hester F Lingsma, Dana Pisică, Ranjit D Singh, Victor Volovici, Hugo F den Boogert, Alexander Younsi, Lianne D Peppel, Majanka H Heijenbrok-Kal, Gerard M Ribbers, Robert Walchenbach, David K Menon, Peter Hutchinson, Bart Depreitere, Ewout W Steyerberg, Andrew I R Maas, Godard C W de Ruiter, Wilco C Peul, Cecilia Åkerlund, Krisztina Amrein, Nada Andelic, Lasse Andreassen, Audny Anke, Anna Antoni, Gérard Audibert, Philippe Azouvi, Maria Luisa Azzolini, Ronald Bartels, Pál Barzó, Romuald Beauvais, Ronny Beer, Bo-Michael Bellander, Antonio Belli, Habib Benali, Maurizio Berardino, Luigi Beretta, Morten Blaabjerg, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Andras Buki, Monika Bullinger, Manuel Cabeleira, Alessio Caccioppola, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Guillermo Carbayo Lozano, Marco Carbonara, Ana M. Castaño-León, Simona Cavallo, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Hans Clusmann, Mark Steven Coburn, Jonathan Coles, Jamie D. Cooper, Marta Correia, Amra Čović, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot-Fizelier, Paul Dark, Helen Dawes, Véronique De Keyser, Vincent Degos, Francesco Della Corte, Đula Đilvesi, Abhishek Dixit, Emma Donoghue, Jens Dreier, Guy-Loup Dulière, Ari Ercole, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Valery L. Feigin, Kelly Foks, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Pradeep George, Alexandre Ghuysen, Lelde Giga, Ben Glocker, Jagoš Golubović, Pedro A. Gomez, Johannes Gratz, Benjamin Gravesteijn, Francesca Grossi, Russell L. Gruen, Deepak Gupta, Juanita A. Haagsma, Iain Haitsma, Raimund Helbok, Eirik Helseth, Lindsay Horton, Jilske Huijben, Bram Jacobs, Stefan Jankowski, Mike Jarrett, Ji-yao Jiang, Faye Johnson, Kelly Jones, Mladen Karan, Angelos G. Kolias, Erwin Kompanje, Daniel Kondziella, Evgenios Kornaropoulos, Lars-Owe Koskinen, Noémi Kovács, Alfonso Lagares, Linda Lanyon, Steven Laureys, Fiona Lecky, Didier Ledoux, Rolf Lefering, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Marc Maegele, Marek Majdan, Alex Manara, Geoffrey Manley, Hugues Maréchal, Costanza Martino, Julia Mattern, Catherine McMahon, Béla Melegh, Tomas Menovsky, Ana Mikolic, Benoit Misset, Visakh Muraleedharan, Lynnette Murray, Nandesh Nair, Ancuta Negru, David Nelson, Virginia Newcombe, Daan Nieboer, József Nyirádi, Matej Oresic, Fabrizio Ortolano, Olubukola Otesile, Aarno Palotie, Paul M. Parizel, Jean-François Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Anna Piippo-Karjalainen, Matti Pirinen, Horia Ples, Suzanne Polinder, Inigo Pomposo, Jussi P. Posti, Louis Puybasset, Andreea Rădoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Veronika Rehorčíková, Isabel Retel Helmrich, Jonathan Rhodes, Sylvia Richardson, Sophie Richter, Samuli Ripatti, Saulius Rocka, Cecilie Roe, Olav Roise, Jonathan Rosand, Jeffrey Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert, Martin Rusnák, Juan Sahuquillo, Oliver Sakowitz, Renan Sanchez-Porras, Janos Sandor, Nadine Schäfer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Charlie Sewalt, Toril Skandsen, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Ana Kowark, Robert Stevens, William Stewart, Nino Stocchetti, Nina Sundström, Riikka Takala, Viktória Tamás, Tomas Tamosuitis, Mark Steven Taylor, Braden Te Ao, Olli Tenovuo, Alice Theadom, Matt Thomas, Dick Tibboel, Marjolijn Timmers, Christos Tolias, Tony Trapani, Cristina Maria Tudora, Andreas Unterberg, Peter Vajkoczy, Egils Valeinis, Shirley Vallance, Zoltán Vámos, Mathieu Van der Jagt, Joukje van der Naalt, Gregory Van der Steen, Jeroen T.J.M. van Dijck, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Ernest Van Veen, Roel van Wijk, Thijs Vande Vyvere, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Jan Verheyden, Paul M. Vespa, Anne Vik, Rimantas Vilcinis, Nicole von Steinbüchel, Daphne Voormolen, Petar Vulekovic, Kevin K.W. Wang, Eveline Wiegers, Guy Williams, Lindsay Wilson, Stefan Winzeck, Stefan Wolf, Zhihui Yang, Peter Ylén, Frederick A. Zeiler, Agate Ziverte, Tommaso Zoerle, CENTER-TBI Collaboration Group, Molecular Neuroscience and Ageing Research (MOLAR), Public Health, Neurosurgery, Rehabilitation Medicine, van Essen, T, Lingsma, H, Pisică, D, Singh, R, Volovici, V, den Boogert, H, Younsi, A, Peppel, L, Heijenbrok-Kal, M, Ribbers, G, Walchenbach, R, and Citerio, G
Subjects: Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Brain Injuries, Traumatic, traumatic acute subdural haematoma, Glasgow Outcome Scale, Hematoma, Subdural, Acute, Humans, Surgery, Prospective Studies, Neurology (clinical), Human medicine, Conservative Treatment
Abstract: Contains fulltext : 251563.pdf (Publisher’s version ) (Closed access) BACKGROUND: Despite being well established, acute surgery in traumatic acute subdural haematoma is based on low-grade evidence. We aimed to compare the effectiveness of a strategy preferring acute surgical evacuation with one preferring initial conservative treatment in acute subdural haematoma. METHODS: We did a prospective, observational, comparative effectiveness study using data from participants enrolled in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) cohort. We included patients with no pre-existing severe neurological disorders who presented with acute subdural haematoma within 24 h of traumatic brain injury. Using an instrumental variable analysis, we compared outcomes between centres according to treatment preference for acute subdural haematoma (acute surgical evacuation or initial conservative treatment), measured by the case-mix-adjusted percentage of acute surgery per centre. The primary endpoint was functional outcome at 6 months as rated with the Glasgow Outcome Scale Extended, which was estimated with ordinal regression as a common odds ratio (OR) and adjusted for prespecified confounders. Variation in centre preference was quantified with the median OR (MOR). CENTER-TBI is registered with ClinicalTrials.gov, number NCT02210221, and the Resource Identification Portal (Research Resource Identifier SCR_015582). FINDINGS: Between Dec 19, 2014 and Dec 17, 2017, 4559 patients with traumatic brain injury were enrolled in CENTER-TBI, of whom 1407 (31%) presented with acute subdural haematoma and were included in our study. Acute surgical evacuation was done in 336 (24%) patients, by craniotomy in 245 (73%) of those patients and by decompressive craniectomy in 91 (27%). Delayed decompressive craniectomy or craniotomy after initial conservative treatment (n=982) occurred in 107 (11%) patients. The percentage of patients who underwent acute surgery ranged from 5·6% to 51·5% (IQR 12·3-35·9) between centres, with a two-times higher probability of receiving acute surgery for an identical patient in one centre versus another centre at random (adjusted MOR for acute surgery 1·8; p
Published: 2022

40. Dexamethasone should not be given to people with a chronic subdural haematoma

Author: Helen Saul, Deniz Gursul, Samantha Cassidy, Peter Hutchinson, and Angelos Kolias
Subjects: Hematoma, Subdural, Chronic, Humans, General Medicine, Dexamethasone
Abstract: The studyHutchinson P, Edlmann E, Bulters D, et al. Trial of dexamethasone for chronic subdural haematoma.N Engl J Med2020;383:2616-27.To read the full NIHR Alert, go to:https://evidence.nihr.ac.uk/alert/dexamethasone-should-not-be-used-chronic-subdural-haematoma/
Published: 2022

41. Strengthening neurosurgical care for patients with severe traumatic brain injury: Authors’ reply

Author: David, Clark, Alexis, Joannides, Angelos, Kolias, and Peter, Hutchinson
Subjects: Brain Injuries, Traumatic, Humans, Glasgow Coma Scale, Neurology (clinical)
Published: 2022

42. Management of moderate to severe traumatic brain injury: an update for the intensivist

Author: Geert Meyfroidt, Pierre Bouzat, Michael P. Casaer, Randall Chesnut, Sophie Rym Hamada, Raimund Helbok, Peter Hutchinson, Andrew I. R. Maas, Geoffrey Manley, David K. Menon, Virginia F. J. Newcombe, Mauro Oddo, Chiara Robba, Lori Shutter, Martin Smith, Ewout W. Steyerberg, Nino Stocchetti, Fabio Silvio Taccone, Lindsay Wilson, Elisa R. Zanier, Giuseppe Citerio, Meyfroidt, G, Bouzat, P, Casaer, M, Chesnut, R, Hamada, S, Helbok, R, Hutchinson, P, Maas, A, Manley, G, Menon, D, Newcombe, V, Oddo, M, Robba, C, Shutter, L, Smith, M, Steyerberg, E, Stocchetti, N, Taccone, F, Wilson, L, Zanier, E, and Citerio, G
Subjects: Traumatic brain injury, Cerebral perfusion pressure, Intracranial pressure, Intensive care unit, Human medicine, Critical Care and Intensive Care Medicine, Neuromonitoring, Pre-hospital management
Abstract: Traumatic brain injury (TBI) remains one of the most fatal and debilitating conditions in the world. Current clinical management in severe TBI patients is mainly concerned with reducing secondary insults and optimizing the balance between substrate delivery and consumption. Over the past decades, multimodality monitoring has become more widely available, and clinical management protocols have been published that recommend potential interventions to correct pathophysiological derangements. Even while evidence from randomized clinical trials is still lacking for many of the recommended interventions, these protocols and algorithms can be useful to define a clear standard of therapy where novel interventions can be added or be compared to. Over the past decade, more attention has been paid to holistic management, in which hemodynamic, respiratory, inflammatory or coagulation disturbances are detected and treated accordingly. Considerable variability with regards to the trajectories of recovery exists. Even while most of the recovery occurs in the first months after TBI, substantial changes may still occur in a later phase. Neuroprognostication is challenging in these patients, where a risk of self-fulfilling prophecies is a matter of concern. The present article provides a comprehensive and practical review of the current best practice in clinical management and long-term outcomes of moderate to severe TBI in adult patients admitted to the intensive care unit.
Published: 2022

43. Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: 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, Ehab Alameer, Abdourahmane Ndong, Dejan Radenkovic, Min Hoe Chew, Frederick Koh, James Ngu, Arpád Panyko, Uros Bele, Jurij Aleš Košir, Hassan Daoud, Ana Maria Minaya Bravo, Umesh Jayarajah, Dakshitha Wickramasinghe, Mohammed Elmujtba Adam Essa Adam, Martin Rutegård, Malin Sund, Michel Adamina, Eleftherios Gialamas, Karoline Horisberger, Muhammad Alshaar, Abel Huang, Varut Lohsiriwat, Shane Charles, Haithem Jlassi, Arda Isik, Hervé Monka Lekuya, Slava Kopetskyi, Hayder Alsaadi, Sattar Alshryda, Osaid Alser, Brittany Bankhead-Kendall, Kerry Breen, Hassan Mashbari, Fernando Bonilla Cal, Hamza Al-Naggar, Mayaba Maimbo, Dennis Mazingi, Tom Abbott, Melika Akhbari, Ruth Benson, Shivam Bhanderi, Bruce Biccard, Edward Caruana, Sohini Chakrabortee, Reema Chapatwala, Ainhoa Costas-Chavarri, Andreas K Demetriades, Anant Desai, Salomone Di Saverio, Thomas Drake, John Edwards, Jonathan Evans, Marco Fiore, Samuel Ford, Christina Fotopoulou, Alexander Fowler, Kaori Futaba, Ian Ganly, Harelimana Grace James, Ewen Griffiths, Alessandro Gronchi, Peter Hutchinson, Gabriella Yael Hyman, Joseph Incorvia, Ritu Jain, Michael Jenkinson, Tabassum Khan, Stephen Richard Knight, Angelos Kolias, Søren Kudsk-Iversen, Tsun Yu Kwan, Elaine Leung, Julio Mayol, Siobhan McKay, John G Meara, Emily Mills, Susan Moug, Akshay Patel, Roberto Perinotti, Henry E Rice, Keith Roberts, Andrew Schache, Richard Shaw, Neil Smart, Matthew Stephens, Grant D Stewart, Ella Teasdale, Peter Vaughan-Shaw, Raghavan Vidya, Naomi Wright, Natalie Zimmelman, Ervis Agastra, Dariel Thereska, Sergio Martin Lucchini, Veronica Laudani, Carina Chwat, Ivana Ines Pedraza Salazar, Diana Alejandra Pantoja Pachajoa, Agustin Duro, José Alfredo Calderón Arancibia, Giuliana D'Aulerio, Nagendra Dudi-Venkata, Natasha Egoroff, Shebani Farik, Natalie Lott, Jana-Lee Moss, Sarah Rennie, Lorwai Tan, Uyen Giao Vo, David Watson, David Watters, Tim Bright, Paul Hollington, Xuanyu Zhou, Hidde M Kroon, Anthony Farfus, John Barker, Eleanor Watson, Sean Stevens, Haider Latif, Amanda Caroline Dawson, Alwin Chuan, Vijayaragavan Muralidharan, Enoch Wong, Travis Ackermann, Maurizio Pacilli, Russell Hodgson, Alexander Heriot, Peter Choong, Wendy Brown, Surjit Lidder, Justin Yeung, Luke Traeger, Guillermo Regalo, Ralph Gourlay, Sarit Badiani, Cherry Koh, Soni Putnis, Fayza Haider, Ashrarur Rahman Mitul, Niels Komen, Bert Dhondt, Serge Cappeliez, Manon Pigeolet, Martijn Schoneveld, Jasper Stijns, Wouter Oosterlinck, Nicolas Flamey, Cyrille Kpangon, Mouhamed Agbadebo, S Mèvo Romaric Tobome, Aldo Vieira Barros, Samuel Aguiar Júnior, Heloisa Galvão do Amaral Campos, Jefferson Gross, Felipe José Fernandez Coimbra, Luiz Paulo Kowalski, Fabiana Makdissi, Suely Nakagawa, Joao Pedreira Duprat Neto, Jose Guilherme Vartanian, Guilherme Yazbek, Stenio C Zequi, Ronald Flumignan, Natalia Jaworska, Angela Dell, Harsha Shanthanna, Abdollah Behzadi, Carolyn Nessim, Michelle Mozel, Pascal St-Germain, Crispin Russell, Gary Groot, Najib Safieddine, Duminda Wijeysundera, Antoine Eskander, Sami Chadi, Shawn MacKenzie, Alana Flexman, Fernando Heredia, Julio Villanueva, Sofia Waissbluth, Roberto Macchiavello, Mario I Escudero, Tyare Fuentes, Ximena Mimica, Dinimo Bolivar Saenz, Lina Caicedo, Juan Pablo Alzate, Joaquin Luna, Nestor Fabian Pedraza Alonso, Camilo Ortiz Silva, Juliana Rodriguez, Liliana Silva-Igua, Martha Luz Torres, Lina María Trujillo, Albaro José Nieto Calvache, Julián Balanta-Melo, Rafael Figueroa-Casanova, Oscar-Julián García-Montoya, Carlos Andres Marulanda Toro, Marcela Velez Botero, Maria Clara Mendoza Arango, Eneida Diaz Martinez, Valentina Gutiérrez Perdomo, Emileth Montenegro, Julia Rodriguez-Abreu, Dolores Mejía, Galal Abouelnagah, Sameh Shehata, Ahmed Hossam Eldin Fouad Rida, Ramy A Hassan, Mahmoud M Saad, Mohamed Reda Loaloa, Badr Mostafa, Mohamed Qassem, Mohamed Fahmy, Hesham Abozied, Ahmed Y Azzam, Sherief Ghozy, Asser Sallam, Ahmed Shehta, Mohamed Abdelkhalek, Rehab Samaka, Amr Morsy, Ahmed Elshawadfy Sherif, Abraham Negussie, Tigist Fisseha, Kibruyisfaw Shumbash, Metasebia Abebe, Seid Mohammed Yasin, Yemisirach Bizuneh Akililu, Abebe Megersa, Teshome Tefera, Melatework Assefa, Bahru Atnafu, Bereket Tsegaye, Yoseph Solomon Bezabih, Silamlak Sisay, Kebebe Bekele, Moa Jira, Habtamu Derilo, Eyueal Degefa, Anteneh Tadesse, Melkamu Nidaw, Elise Sarjanoja, Sylvie Testelin, Sophie Boucher, Lionel Jouffret, Zaher Lakkis, Alban Zarzavadjian Le Bian, Luke Harper, Marc Danguy des Déserts, Benoît André, Karem Slim, Romain Verhaeghe, Andrea Police, Edouard Girard, Alexandre Chebaro, Armande Subayi Nkembi, Laurent Arnalsteen, Quentin Ballouhey, Diane Mege, Clement Jeandel, Emilie Duchalais, Pierre-Alban Bouche, Gilles Manceau, Célia Crétolle, Erik Hervieux, Noémie Girard, Agathe Seguin-Givelet, Sebastien Gaujoux, Belinda De Simone, Matthieu Boisson, Damien Bergeat, Fabien Fredon, Francesco Nappi, Radwan Kassir, Aurélien Scalabre, Federico Migliorelli, Anne-Cecile Ezanno, Barbara Seeliger, Charlotte Vaysse, Helene Charbonneau, Vincent Misrai, Olivier Abbo, Martina Aida Angeles, Laurent Brunaud, Ali Modabber, Sebastian Wolf, Carsten Kamphues, Philipp Höhn, Tim R Glowka, Alexander Christopher Rokohl, Ulrich Bork, Georg Fluegen, Raymund E Horch, Andrea Schmedding, Andreas Schnitzbauer, Helge Eberbach, Daniel Schlager, Fritz Spelsberg, Lena Keppler, Andreas Hecker, Susanne Wolfer, Ulrich Ronellenfitsch, Christine Nitschke, Christian Peiper, Ibrahim Hakami, Stefan Welter, Karine Nikolaieva, Andreas Roth, Judith Lindert, Konstantinos Gousias, Anke Rissmann, Valerie Catherine Linz, Nuh Rahbari, Marie-Claire Rassweiler-Seyfried, Anna Eleonora Gut, Jens Gempt, Daniel Reim, Arthur Wagner, Alexander M Keppler, Mircea Gabriel Stoleriu, Tim Saier, Josef Stadler, Julia Christina Kaiser, Stefan M Brunner, Karin Pfister, Jonas Herzberg, Kai Nowak, Tobias Reinhard, Gregor A Stavrou, Alfred Königsrainer, Christian Konrads, Markus Quante, Simon Laban, Silke von Pusch, Markus Hirschburger, Johannes Doerner, Armin Wiegering, Ekaterini Christina Tampaki, Alitza Gutiérrez Ruiz, Alejandra Rodas, Ana Lucía Portilla, Jacqueline Carrera, Amalia Barrios Duarte, Megan Lowey, Sabrina Barillas, Atul Suroy, Dhaivat Vaishnav, Raghunandan Gorantlu Chowdappa, Irappa Madabhavi, Dhananjaya Bhat, Sunil Kumar Venkatappa, Sumit Thakar, Kavitha Jain, Aruna Kumar, Manoj Nagar, Tushar Mishra, Arunkumar Sekar, Anand Gupta, Lileswar Kaman, Madhivanan Karthigeyan, Manjul Tripathi, Ashwin Rammohan, Sudheer Othiyil Vayoth, Anupama Rajanbabu, Anbukkani Subbian, Rahul Gupta, Monish Raut, Nissi Evelyn, R Lavanya Kannaiyan, Anil Matai, Sanjeev Misra, Vishal Bhende, Sathish Muthu, Indranil Ghosh, Abhishek Sharma, Ankur Bajaj, Shiv Rajan, Gaurav Agarwal, Pranay Pawar, Philip Alexander, M Vijayakumar Vijayakumar, Zeeshan Hameed, L Badareesh, Navneet Kumar Chaudhry, Lipika Baliarsing, Satish Dharap, Amruta Kulkarni, Yuvaraja Thyavihally, Rahul Deo Sharma, C S Pramesh, Rajesh Soni, Surya Kumar Dube, Shilpa Sharma, Harvinder Singh, Lovenish Bains, Rahul Ghodke, Ashwani Kumar, Vivek Sodhai, Suvendu Maji, Somprakas Basu, Chandrashekhar Mahakalkar, Ravi Kannan, Asif Mehraj, N Ranganath, Ashish Phadnis, I Yadev, Alfie Kavalakat, Rohin Mittal, Karthik Chandra Vallam, Hamed Akhavizadegan, Esmaeil Rezghi Maleki, Naser Yousefzadeh Kandevani, Hilary Ikele, Catherine McNestry, Christina Fleming, Stephen O'Brien, Sami Abd Elwahab, Niall Davis, Mohsen Javadpour, Brendan McDonnell, Clare O Connor, Jarlath Bolger, Cillian Clancy, Stefanie M Croghan, Noel Donlon, Carolyn Cullinane, Ben Creavin, Muheilan Muheilan, Helen Earley, Syed Mohammad Umar Kabir, Muhammad Fahadullah, Éanna Ryan, Tara Connelly, Daisuke Hashimoto, Majdi Ali Alqudah, Amer Alajalen, Rand Y Omari, Abdulrahman Qasem, Yazan Alawneh, Amer Ahmad, Omar Aladawi, Bourhan Alrayes, Hanan Haidar, Shatha Husain, Faisal Qassem, Adnan Sumadi, Ala'a Abu Salhiyeh, Balqees Mahmoud Al-Manaseer, Zaid Alsunna, Hazim Ra'ed, Faten Reyad Bani Hamad, Amro Abuleil, Elmi Ahmed Mohamed Jimaale, Marah Abu-Mehsen, Noor Olaywah, Omar Wafi, Hazim Ababneh, Luai Abu-Ismail, Almu'atasim Khamees, Ahmad Alkhatib, Raikhan Bolatbekova, Mukhtar Kulimbet, Talgat Nurgozhin, Timur Saliev, Baurzhan Zhussupov, Ydyrys Almabayev, Dilyara Kaidarova, Khalil Tamoos, Ahmed Aqeelah, Alsnosy Abdullah Khalefa Mohammed, Faraj Al Maadany, Ghadah Alkadeeki, Milad Gahwagi, Wafa Aldressi, Mohamed Amnaina, Arowa Hassan Abdulrahman Alansari, Akram Alkaseek, Ghozlan Yagoub, Anass Ben Amer, Marwa Salem, Ayman Almugaddami, Dania Burgan, Mohammed Abdelkabir, Khayriyah Alshareef, Rayet Al Islam Ben Jouira, Ayman Meelad, Ahmad Bouhuwaish, Sumayya Essayah Dwaga, Houda Khalifa, Bushray Almiqlash, Taha Suliaman, Mohammed Alawami, Fras Elhajdawe, Hajir Aboazamazem, Ibrahim Ellojli, Ahmed Msherghi, Ismail Ali Saleh, Mohammed Alayan, Marcel Didier Ndayishyigikiye, Akutu Munyika, Philipp Plarre, David W Borowski, Cameron Wells, Rebecca Teague, Brodie Elliott, David Kieser, Omar Mohyieldin, Nick McIntosh, Cheyaanthan Haran, Jasmin King, Jeong Ha, Matthew James McGuinness, Opeoluwa Adesanya, Julius Olaogun, Akinola Akinmade, Kefas Bwala, Peter Agbonrofo, Akinwale Afolabi, Usang Usang, Sebastian Ekenze, Samson Olori, Taiwo Akeem Lawal, Abiodun Okunlola, Stephen Kache, Danjuma Sale, Lofty-John Anyanwu, Chukwuma Okereke, Musliu Adetola Tolani, Venko Filipce, Lazar Todorovic, Sotir Stavridis, John George Massoud, Sareyah Alsibai, Rizwan Sultan, Humera Naz Altaf, Abu Bakar Hafeez Bhatti, Shahzad Hussain Waqar, Aliya Aziz, Asad Ali Kerawala, Lajpat Rai, Mariyah Anwer, Aiman Tariq, Bushra Ayub, Sami Ullah Niazi, Muhammad Yasir Naseem, Muhammad Zeeshan Sarwar, Muhammad Imran Khokhar, Imdad Ahmad Zahid, Haroon Javaid Majid, Nabila Talat, Muhammad Asif, Muhammad Hamid Chaudhary, Umer Farooq, Siddique Ahmad, Waleed Mabood, Syed Imran Bukhari, Muhammad Tariq, Eesha Yaqoob, Saad Javed, Muhammad Usman Malik, Hassan Nawaz Yaqoob, Glenda Marina Falcon Pacheco, Robinson Mas Melendez, Arazzelly Del Pilar Paucar Urbina, Jose Rios Chiuyari, Carlos Eduardo Otiniano Alvarado, Lorena Fuentes Rivera Lau, Giuliano Borda-Luque, Milagros Niquen-Jimenez, Claudia Arias, Sergio Zegarra, Jenner Betalleluz Pallardel, Regina Amparo Ugarte Oscco, Gian Mendiola, Yahaira Tatiana Carpio Colmenares, Carlos Shiraishi Zapata, Maria Rosa Ortiz, Filipe Castro Borges, Octavio Viveiros, Pedro Serralheiro, Paulo Santos-Costa, Filipa Mendes, Miguel Rocha Melo, Paulo Cardoso, Ana Soares, Rita Gonçalves Pereira, Nelson Silva, André Caiado, Maria Luís Sacras, Pedro Azevedo, Rui Almeida-Reis, João Oliveira, Jorge Nogueiro, Mafalda 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Wijeysundera, Antoine Eskander, Sami Chadi, Shawn MacKenzie, Alana Flexman, Fernando Heredia, Maria Marta Modolo, Julio Villanueva, Sofia Waissbluth, Roberto Macchiavello, Mario I Escudero, Tyare Fuentes, Ximena Mimica, Maricarmen Olivos, Dinimo Bolivar Saenz, Lina Caicedo, Juan Pablo Alzate, Joaquin Luna, Nestor Fabian Pedraza Alonso, Camilo Ortiz Silva, Carlos J Perez Rivera, Juliana Rodriguez, Liliana Silva-Igua, Martha Luz Torres, Lina María Trujillo, Albaro José Nieto Calvache, Julián Balanta-Melo, Rafael Figueroa-Casanova, Oscar-Julián García-Montoya, Carlos Andres Marulanda Toro, Marcela Velez Botero, Maria Clara Mendoza Arango, Eneida Diaz Martinez, Valentina Gutiérrez Perdomo, Jose Andres Calvache, Jose Andres Calvache, Emileth Montenegro, Jakov Mihanovic, Pablo Mijahil Avilés Jiménez, Nikolaos Gouvas, René Novysedlák, Julia Rodriguez-Abreu, Dolores Mejía, Eddy Lincango-Naranjo, Galal Abouelnagah, Sameh Shehata, Ahmed Hossam Eldin Fouad Rida, Ramy A Hassan, Mahmoud M Saad, Mohamed Reda Loaloa, Badr Mostafa, Mohamed Qassem, Mohamed Fahmy, Hesham Abozied, Ahmed Y Azzam, Sherief Ghozy, Asser Sallam, Ahmed Shehta, Sameh Emile, Mohamed Abdelkhalek, Rehab Samaka, Amr Morsy, Ahmed Elshawadfy Sherif, Danilo Alfonso Arévalo Sandoval, Abraham Negussie, Tigist Fisseha, Kibruyisfaw Shumbash, Metasebia Abebe, Samuel Hailu, Seid Mohammed Yasin, Yemisirach Bizuneh Akililu, Abebe Megersa, Teshome Tefera, Melatework Assefa, Bahru Atnafu, Bereket Tsegaye, Yoseph Solomon Bezabih, Silamlak Sisay, Kebebe Bekele, Moa Jira, Mengistu G Mengesha, Habtamu Derilo, Eyueal Degefa, Anteneh Tadesse, Melkamu Nidaw, Elise Sarjanoja, Joonas H Kauppila, Sylvie Testelin, Sophie Boucher, Lionel Jouffret, Zaher Lakkis, Alban Zarzavadjian Le Bian, Luke Harper, Marc Danguy des Déserts, Benoît André, Karem Slim, Romain Verhaeghe, Andrea Police, Edouard Girard, Alexandre Chebaro, Armande Subayi Nkembi, Laurent Arnalsteen, Quentin Ballouhey, Diane Mege, Clement Jeandel, Emilie Duchalais, Pierre-Alban Bouche, Gilles Manceau, Célia Crétolle, Erik Hervieux, Noémie Girard, Agathe Seguin-Givelet, Sebastien Gaujoux, Belinda De Simone, Matthieu Boisson, Damien Bergeat, Alexis P Arnaud, Fabien Fredon, Francesco Nappi, Radwan Kassir, Aurélien Scalabre, Federico Migliorelli, Romain Verhaeghe, Anne-Cecile Ezanno, Barbara Seeliger, Charlotte Vaysse, Helene Charbonneau, Vincent Misrai, Olivier Abbo, Martina Aida Angeles, Laurent Brunaud, Zaza Demetrashvili, Ali Modabber, Sebastian Wolf, Carsten Kamphues, Philipp Höhn, Tim R Glowka, Alexander Christopher Rokohl, Ulrich Bork, Georg Fluegen, Raymund E Horch, Andrea Schmedding, Andreas Schnitzbauer, Helge Eberbach, Daniel Schlager, Fritz Spelsberg, Lena Keppler, Andreas Hecker, Susanne Wolfer, Ulrich Ronellenfitsch, Christine Nitschke, Christian Peiper, Ibrahim Hakami, Stefan Welter, Karine Nikolaieva, Andreas Roth, Judith Lindert, Konstantinos Gousias, Anke Rissmann, Valerie Catherine Linz, Nuh Rahbari, Marie-Claire Rassweiler-Seyfried, Anna Eleonora Gut, Jens Gempt, Daniel Reim, Arthur Wagner, Markus Albertsmeier, Alexander M Keppler, Mircea Gabriel Stoleriu, Tim Saier, Josef Stadler, Julia Christina Kaiser, Stefan M Brunner, Karin Pfister, Jonas Herzberg, Kai Nowak, Tobias Reinhard, Gregor A Stavrou, Alfred Königsrainer, Christian Konrads, Markus Quante, Simon Laban, Silke von Pusch, Markus Hirschburger, Johannes Doerner, Armin Wiegering, Ekaterini Christina Tampaki, Alitza Gutiérrez Ruiz, Alejandra Rodas, Ana Lucía Portilla, Gustavo Recinos, Maria-Lorena Aguilera-Arevalo, Jacqueline Carrera, Amalia Barrios Duarte, Megan Lowey, Sabrina Barillas, Atul Suroy, Dhaivat Vaishnav, Raghunandan Gorantlu Chowdappa, Irappa Madabhavi, Dhananjaya Bhat, Sunil Kumar Venkatappa, Sumit Thakar, Kavitha Jain, Aruna Kumar, Manoj Nagar, Tushar Mishra, Arunkumar Sekar, Anand Gupta, Lileswar Kaman, Madhivanan Karthigeyan, Manjul Tripathi, Ashwin Rammohan, Sudheer Othiyil Vayoth, Anupama Rajanbabu, Anbukkani Subbian, Rahul Gupta, Monish Raut, Nissi Evelyn, R Lavanya Kannaiyan, Anil Matai, Sanjeev Misra, Vishal Bhende, Sathish Muthu, Indranil Ghosh, Abhishek Sharma, Ankur Bajaj, Shiv Rajan, Gaurav Agarwal, Pranay Pawar, Philip Alexander, M Vijayakumar Vijayakumar, Zeeshan Hameed, L Badareesh, Navneet Kumar Chaudhry, Lipika Baliarsing, Satish Dharap, Amruta Kulkarni, Yuvaraja Thyavihally, Rahul Deo Sharma, C S Pramesh, Rajesh Soni, Surya Kumar Dube, Shilpa Sharma, Harvinder Singh, Lovenish Bains, Rahul Ghodke, Ashwani Kumar, Vivek Sodhai, Suvendu Maji, Somprakas Basu, Chandrashekhar Mahakalkar, Ravi Kannan, Asif Mehraj, N Ranganath, Ashish Phadnis, I Yadev, Alfie Kavalakat, Rohin Mittal, Karthik Chandra Vallam, Hamed Akhavizadegan, Esmaeil Rezghi Maleki, Naser Yousefzadeh Kandevani, Hilary Ikele, Catherine McNestry, Christina Fleming, Stephen O'Brien, Sami Abd Elwahab, Niall Davis, Mohsen Javadpour, Brendan McDonnell, Clare O Connor, Jarlath Bolger, Cillian Clancy, Stefanie M Croghan, Noel Donlon, Carolyn Cullinane, Ben Creavin, Muheilan Muheilan, Helen Earley, Syed Mohammad Umar Kabir, Muhammad Fahadullah, Éanna Ryan, Tara Connelly, Oded Zmora, Daisuke Hashimoto, Majdi Ali Alqudah, Amer Alajalen, Rand Y Omari, Faris Ayasra, Abdulrahman Qasem, Yazan Alawneh, Amer Ahmad, Omar Aladawi, Bourhan Alrayes, Hanan Haidar, Shatha Husain, Faisal Qassem, Adnan Sumadi, Ala'a Abu Salhiyeh, Balqees Mahmoud Al-Manaseer, Zaid Alsunna, Hazim Ra'ed, Faten Reyad Bani Hamad, Amro Abuleil, Mohamad K Abou Chaar, Elmi Ahmed Mohamed Jimaale, Marah Abu-Mehsen, Noor Olaywah, Omar Wafi, Hazim Ababneh, Luai Abu-Ismail, Almu'atasim Khamees, Ahmad Alkhatib, Raikhan Bolatbekova, Mukhtar Kulimbet, Talgat Nurgozhin, Timur Saliev, Baurzhan Zhussupov, Ydyrys Almabayev, Ildar Fakhradiyev, Timur Saliev, Dilyara Kaidarova, Khalil Tamoos, Ahmed Aqeelah, Alsnosy Abdullah Khalefa Mohammed, Faraj Al Maadany, Ghadah Alkadeeki, Milad Gahwagi, Wafa Aldressi, Mohamed Amnaina, Arowa Hassan Abdulrahman Alansari, Akram Alkaseek, Ghozlan Yagoub, Anass Ben Amer, Marwa Salem, Ayman Almugaddami, Dania Burgan, Mohammed Abdelkabir, Khayriyah Alshareef, Rayet Al Islam Ben Jouira, Ayman Meelad, Ahmad Bouhuwaish, Sumayya Essayah Dwaga, Houda Khalifa, Bushray Almiqlash, Taha Suliaman, Mohammed Alawami, Fras Elhajdawe, Hajir Aboazamazem, Ibrahim Ellojli, Ahmed Msherghi, Ismail Ali Saleh, Mohammed Alayan, April Camilla Roslani, Marcel Didier Ndayishyigikiye, Akutu Munyika, Philipp Plarre, David W Borowski, Pueya Rashid Nashidengo, Milou Noltes, Pieter Steinkamp, Cameron Wells, Rebecca Teague, Brodie Elliott, David Kieser, Omar Mohyieldin, Chris Varghese, Nick McIntosh, Cheyaanthan Haran, Sarah Rennie, Jasmin King, Jeong Ha, Matthew James McGuinness, Opeoluwa Adesanya, Julius Olaogun, Akinola Akinmade, Kefas Bwala, Peter Agbonrofo, Akinwale Afolabi, Usang Usang, Sebastian Ekenze, Samson Olori, Taiwo Akeem Lawal, Justina Seyi-Olajide, Abiodun Okunlola, Omolara Williams, Adewale Adisa, Lukman Abdur-Rahman, Stephen Kache, Danjuma Sale, Lofty-John Anyanwu, Chukwuma Okereke, Musliu Adetola Tolani, Venko Filipce, Lazar Todorovic, Sofija Pejkova, Sotir Stavridis, John George Massoud, Sareyah Alsibai, Rizwan Sultan, Humera Naz Altaf, Abu Bakar Hafeez Bhatti, Shahzad Hussain Waqar, Aliya Aziz, Asad Ali Kerawala, Lajpat Rai, Mariyah Anwer, Aiman Tariq, Bushra Ayub, Sami Ullah Niazi, Muhammad Yasir Naseem, Muhammad Zeeshan Sarwar, Muhammad Imran Khokhar, Imdad Ahmad Zahid, Haroon Javaid Majid, Nabila Talat, Muhammad Asif, Muhammad Hamid Chaudhary, Umer Farooq, Siddique Ahmad, Waleed Mabood, Syed Imran Bukhari, Muhammad Tariq, Eesha Yaqoob, Saad Javed, Saad Javed, Muhammad Usman Malik, Hassan Nawaz Yaqoob, Moises Cukier, Glenda Marina Falcon Pacheco, Robinson Mas Melendez, Arazzelly Del Pilar Paucar Urbina, Jose Rios Chiuyari, Carlos Eduardo Otiniano Alvarado, Lorena Fuentes Rivera Lau, Giuliano Borda-Luque, Milagros Niquen-Jimenez, Claudia Arias, Sergio Zegarra, Jenner Betalleluz Pallardel, Regina Amparo Ugarte Oscco, Gian Mendiola, Yahaira Tatiana Carpio Colmenares, Carlos Shiraishi Zapata, Maria Rosa Ortiz, Marie Dione Sacdalan, Piotr Major, Filipe Castro Borges, Octavio Viveiros, Pedro Serralheiro, Paulo Santos-Costa, Filipa Mendes, Miguel Rocha Melo, Paulo Cardoso, Ana Soares, José Azevedo, Rita Gonçalves Pereira, Nelson Silva, André Caiado, Maria Luís Sacras, Pedro Azevedo, Rui Almeida-Reis, Miguel F Cunha, João Oliveira, Jorge Nogueiro, Mafalda Sampaio-Alves, Luciana Cidade Costa, Catarina Baía, Ana Cláudia Deus, Rita Branquinho, André Marçal, André Tojal, Ahmad Zarour, Ahmad Zarour, Silviu Tiberiu Makkai-Popa, Aurel Mironescu, Florin Grama, Elena Adelina Toma, Ionut Negoi, Daniela Filipescu, Nicolae Bacalbasa, Natalia Motas, Sebastian Ionescu, Octav Ginghina, Radu Costea, Narcis Octavian Zarnescu, Radu Drasovean, Eduard-Alexandru Bonci, Mihail-Gabriel Dimofte, Vlad Porumb, Mikhail Kirov, Yegor Molitvin, Andrey Litvin, Vadim Pykhteev, Marianna Raevskaya, Sergey Efetov, Aleksandr Butyrskii, Mushabab Alshahrani, Azah Althumairi, Nasser Alzerwi, Ahmed Al Ameer, Ahmed Al Ameer, Tariq Madkhali, Abddulrahman Saleh Almulhim, Salman Ghazwani, Abdu Ayoub, Othman Iskander, Mohammed Ghunaim, Mohammed Alharthi, Turki M Alzaidi, Azah Althumairi, Mohammad Alyami, Abdulrahman Al Amri, Azah Althumairi, Abdullah AlFakhri, Amal Alhefdhi, Sharfuddin Chowdhury, Thamer Nouh, Ameen Alshehri, Abdulrahman Alzahrani, Yousef Alalawi, Selmy Awad, Ibrahima Konate, Abdourahmane Ndong, Jacques Tendeng, Nan Zun Teo, Frederick Koh, Jurij Aleš Košir, Uros Bele, Sabra Aqil, Cristina Barrena López, Ana Sánchez Mozo, Antonio Rodriguez Infante, Patricia Caja Vivancos, Mikel Prieto, Igor Alberdi San Roman, Laura Gomez Fernandez, Josep Maria Muñoz Vives, Anna Carreras-Castañer, Berta Díaz-Feijoo, Ramon Sieira-Gil, Victor Turrado-Rodriguez, Anna Sánchez López, Santiago Sánchez-Cabús, Marta Jimenez Toscano, MªPilar Canals Sin, Saura García Laura, Oriol Martin Sole, Pedro Palazon Bellver, Sonia Pérez-Bertólez, Jordi Prat-Ortells, Mireia Riba Martínez, Josep Rubio-Palau, Xavier Tarrado, Jorge Nuñez, Veronica Alonso Mendoza, Coro Bescós, Eloy Espin-Basany, Martin Espinosa-Bravo, Daniel Gil-Sala, Susana González-Suárez, Nuria Montferrer Estruch, Jorge Nuñez, Lucia Porteiro Mariño, Ana Rodríguez-Tesouro, Fabian Rojas Portilla, M Pilar Tormos Pérez, Inmaculada Vives, Unai Garcia De Cortazar, Kiara Tudela, Aitor Landaluce-Olavarria, Mercedes Estaire Gómez, Jorge Almoguera, Bakarne Ugarte-Sierra, Virginia Jimenez, Marta Bertrand, Laura Cárdenas Puiggrós, Olga Delisau-Puig, Jorge Garcia-Adamez, David Julià Bergkvist, Eloy Maldonado-Marcos, Lucia Diego García, Marta Roldón Golet, Iván Soto-Darias, Aida Cristina Rahy-Martín, Diego Enjuto, Adolfo Ramos-Luengo, Juan Delgado Fernandez, Carolina Lugo Duarte, Cristina Ojeda Thies, Lucila Marquez, Diana Crego Vita, Jana Dziakova, Ana Maria Minaya Bravo, Jorge Caño Velasco, Olga Mateo-Sierra, Begoña Quintana-Villamandos, Cristina Rey Valcarcel, Javier Rio, Laura Román García de León, Marcello Di Martino, Jorge Prada, Javier Serrano González, Manuel Losada, Jose Tomas Castell Gomez, Ramon Corripio-Sanchez, Alexander Forero-Torres, José Manuel Morales-Puebla, Hanna Perez-Chrzanowska, Santiago Valderrabano Gonzalez, Alvaro Yebes, Ignacio Zapardiel, Manuel Diez Alonso, Nelson Morales Palacios, Alberto Cabañero Sánchez, Fátima Sánchez Fernández, Alfredo Abad Gurumeta, Ane Abad-Motos, Fernando Corella, Javier Ripollés-Melchor, Rosa Sanz-Gonzalez, Marta Alcaraz Fuentes, Maria Teresa Fernández Martín, Pablo Calvo Espino, Milagros Carrasco Prats, Antonio-José Fernández-López, Damián García Escudero, Vanesa Garcia Soria, Jesús Aarón Martínez Alonso, Miguel Ruiz-Marín, Beatriz Gómez Pérez, Joaquin Moya-Angeler, Daniel Fernández Martínez, Heura Llaquet Bayo, Enrique Colás-Ruiz, Susana Bella Romera, M Teresa Gavaldà Pellicé, Misericòrdia Jordà Solé, Enrique Jose Ruiz Velasquez, Bernardo Núñez, Raul Jimenez, Jon Zabaleta, Maria Jose González-Gimeno, Irene Ortega Vázquez, Antonio Perez Ferrer, Rubén Martín-Láez, Marcelo Moreno Suarez, Miguel Angel Freiria Eiras, Irene Ramallo-Solís, Juan-Carlos Gomez-Rosado, Jose Ramon Oliver Guillen, Mar Achalandabaso Boira, Juan Carlos Catalá Bauset, Julio Domenech, Rafael Badenes, Juan Carlos Bernal-Sprekelsen, Jorge Sancho-Muriel, Beatriz De Andrés-Asenjo, Francisco J Tejero-Pintor, Marc Vallve-Bernal, Alba Vazquez Melero, Laura Sánchez Blasco, Jorge Escartin, Victoria Duque Mallén, Selvaratnam Srishankar, Umesh Jayarajah, Charitha Sooriyabandara, Oshan Basnayake, Nalaka Gunawansa, Dakshitha Wickramasinghe, Prabuth Dulanjan Weeraddana, Thanusan Vimalakanthan, Shanthamoorthy Gishanthan, Pramodh Chandrasinghe, Eleftherios Gialamas, Marc-Olivier Sauvain, Ahmad Ghazal, Yusra Al-Sabbagh, Turki Alhassoun, Sara Maa Albared, Antoine Naem, Hareth Alnahr, Ghassan Jisry, Ali Hammed, Arda Isik, Okedi Francis Xaviour, Gaston Turinawe, Isaac Mubezi, Franck K Sikakulya, Andrew Kakeeto, Wilberforce M Kabweru, Hervé Monka Lekuya, Ronald Kiweewa, Herman Lule, Paul Matovu, Otolia Isaac, Mohamed Mashhour, Amin El Helw, Sattar Alshryda, Safeena Kherani, Awadelkarim Mohamed, Ferial Mohamed Ali Abbas, Diary Mohammed, Ehab Aldlyami, Rakesh Kundra, Mohamed Mashhour, Mohamed Mashhour, Antony Louis Rex Michael, Hayder Alsaadi, Kareem S Khalil, Rachel Dbeis, Shafaque Shaikh, Jenny Ferry, Aiman Jamal, Haleema Siddique, Rishi Das, Nikhil Ponugoti, Sivesh K Kamarajah, Pornjittra Rattanasirivilai, Asma Sultana, Frances Mosley, Matthew Chan, Antony Bateman, Gareth Davies-Jones, Fanourios Georgiades, Grant D Stewart, Navid Ahmadi, Aman Coonar, Mariam Baig, Chetan Khatri, Arthika Surendran, Julian Sonksen, Robert Sinnerton, Caitlin Brennan, Gemma Faulkner, Michael Greenhalgh, Hannah Emerson, Kiran Singisetti, Joshua Totty, Michael Wilson, Terence Lo, Harriet Corbett, Ijeoma Okonkwo, Gill Arbane, Kariem El-Boghdadly, Cyrus Kerawala, Chetan Parmar, Tom Abbott, Michael Bath, Funlayo Odejinmi, Jayesh Sagar, Rishi Talwar, Samuel Newman, John Hammond, John Moir, Natalie Duric, Tamas Szakmany, Ahmar Iftikhar Talib, Mina Youssef, Christopher Lewis-Lloyd, Christopher Lewis-Lloyd, Mariam Lami, Khurram Ayub, Benjamin Dean, Supriya Balasubramanya, Sathya Lakpriya, Luke Rogers, Paul Turner, Mark Maher, Kohila Sigamoney, John Edwards, Jihène El Kafsi, John Hardie, David Johnson, Christin Henein, Marianne Hollyman, Ketan Agarwal, Simon Powell, Govind Singh Chauhan, Rakesh Patel, Joel Gagnier, Heather Carmichael, Aurora, Kristofor A Olson, Eric Etchill, Joseph Incorvia, Sameer Hirji, Matthew Naunheim, Frederick Drake, Haytham Kaafarani, Caroline Reinke, Anna Alecci, Dennis Vaysburg, Jennifer Rodriquez, Emily Shih, Vin Shen Ban, Julia Coleman, Henry E Rice, Krista Kaups-Fresno, Emmanouil Giorgakis, Maggie DiNome, Neal Bhutiani, Omar Alnachoukati, Brittany Bankhead-Kendall, Taylor Aiken, Thomas Diehl, Ankush Gosain, Rishi Rattan, Muhammad Owais Abdul Ghani, Nensi Melissa Ruzgar, Anna Liveris, Nina Glass, Charu Paranjape, Theresa Chin, Antonio Meola, Kristina Nicholson, John Squiers, Stephanie Lueckel, Janani Reisenauer, Rachael Callcut, Ahmed Mansour, Allison Berndtson, Lucy Kornblith, Sara Seegert, Paulo Martins, Hamza Al-Naggar, Mohammed Al-Shehari, Ibrahim Al-Raimi, Allan Ngulube, Maphios Siamuchembu, Willard Mushiwokufa, Busisiwe Mlambo, Simbarashe Chinyowa, Ervis Agastra, Enton Bollano, Kostandin Gjyli, Dariel Thereska, Irida Dajti, Jola Kerpaci, Enxhi Vrapi, Lorena Zijaj, Bahraoui Djahida, Belabbes Fatima Zohra, Kouidri Khadidja, Oussama Bali, Nassim Benallel, Ismahene Lalmi, Meriem Abdoun, Nesrine Aouabed, Souad Bouaoud, Kamel Bouchenak, Assia Haif, Zineddine Soualili, Joaquin Bastet, Agustín Bianco, Daniel Capitaine, Jorge Centeno Lozada, Carlos Esquivel, Rodrigo Figueroa, Manuel Garcia, Pablo Martín García, José Ignacio Gerchunoff, Fernando Martinez Iascano, Jose Mondino, María Emilia Muriel, Carmignani Pablo, Martin Passadore, Alejandra Tornini, Rogelio Traverso, Lara Vargas, Gerardo Zanoni, Norberto Berber, Estefanía Cotta, Marcela Di Vincenzo, Esteban Sebastian Gallino, Cecilia Gigena, Bianca Grassano, Veronica Laudani, Ignacio Lugones, Constanza Madrid, Maximiliano Maricic, Antonio Alberto Martinez, Andres Rosso, Pablo Scher, Sofia Tachella, Damaris Idara Anabel Zezular, Carla Abuawad, Agustin Albani Forneris, Carola Allemand, Laura Gisela Alvarez Calzaretta, Luis Boccalatte, Jorge G Boretto, Rocio Boudou, Rodrigo Brandariz, Martin Buljubasich, Arturo Burchakchi, Martin Buttaro, Juan Pablo Campana, Virginia Cano Busnelli, Tomas Carminatti, Agustina Florencia Castro Lalín, Julian Cereghini, María Sol Crespi Amor, Roberto Sebastián Croattini, Maria Sol Fernandez, Marcelo Figari, Uriel Fraidenraij, Diego Gallegos, Agustín Maria García-Mansilla, Marcos Gonzalez, Matias Ignacio Gonzalez, Esteban Gonzalez Salazar, Jeremias Goransky, Guillermo Hernandez Gauna, Felipe Higuera, Fernando Holc, Esteban Gabriel Jauregui, Juan Larrañaga, Juan Liyo, Lionel Llano, Pablo Lobos, Emilia Luzzi, Gustavo Mastroianni, Santiago Miguel Mata-Suarez, Horacio F Mayer, Santiago Mc Loughlin, Efrain Mendoza, Ricardo Esteban Mentz, Pedro Mercado, Pablo Moyano, Florencia Noll, Diego Odetto, Agustina Rene Oliva, Rafael Perez Vidal, Catalina Poggi, Eduardo Jorge Premoli, María Lourdes Ramos, Patricio Rosas, Luciano Rossi, Gustavo Rossi, Jose Saadi, Jordán Scherñuk, Pablo Slullitel, María Verona Stang, María Victoria Taboada, Sebastian Tirapegui, Constanza Uffelmann, Carlos Vaccaro, Roberto Vagni, Ana Clara Valerio, Celeste Soledad Zarratea, Carina Chwat, Silvina Montal, Brian Morris, Pedro Valdez, Fernando Diaz-Couselo,Ricci C, Casadei R, Fruscio, R, Ornaghi, S, Felice Pecoraro, Emanuele Cammarata, Sofia Campanella, Daniela Canzonieri, Adriana Cordova, Federico De Michele, Ettore Dinoto, Mara Franza, Leo Licari, Daniele Matta, Domenico Mirabella, Roberto Pirrello, Pierfrancesco Pugliese, Fernando Rosatti, Giuseppe Salamone, Francesca Toia, Massimiliano Tripoli, Vito Chiantera, Mariano Catello Di Donna, Collaborative, Covidsurg, Collaborative, Globalsurg, Palmisano, Silvia, de Manzini, Nicolo', Simoes, J, Rosati, R, on behalf of COVIDSurg Collaborative, GlobalSurg Collaborative, Aldrighetti, L, Mortini, P, Olmi, S, Medical Oncology, Assoc Surg Training ASiT, European Soc Coloproctology ESCP, EuroSurg, G4 Alliance, GlobalPaedSurg, GICS, ItSURG, ISRC, Italian Soc Colorectal Surg SICCR, PTSurg, S-ECCO, South African Soc, and SpainSurg
Subjects: Lung Diseases, Male, Internationality, SARS-Cov-2, COVID-19, surgery, pathways, pre-operative isolation, Settore MED/18 - CHIRURGIA GENERALE, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], Lung Disease, ESTUDOS PROSPECTIVOS, Cohort Studies, Patient Isolation, Postoperative Complications, 80 and over, Prospective Studies, Prospective cohort study, 610 Medicine & health, Aged, 80 and over, Incidence (epidemiology), Treatment Outcome, Elective Surgical Procedures, Female, Elective Surgical Procedure, Cohort study, Human, medicine.medical_specialty, Isolation (health care), Preoperative care, NO, Anesthesiology, Preoperative Care, medicine, Humans, Elective surgery, LS7_4, Aged, business.industry, pathway, Surgery, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Prospective Studie, Anesthesiology and Pain Medicine, Human medicine, Postoperative Complication, Cohort Studie, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p=0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3days, with an OR (95%CI) at 4–7days or ≥8days of 1.25 (1.04–1.48), p=0.015 and 1.31 (1.11–1.55), p=0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p=0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3days, with an OR (95%CI) at 4–7days or ≥8days of 1.25 (1.04–1.48), p=0.015 and 1.31 (1.11–1.55), p=0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care.
Published: 2021

44. Standardizing Cranioplasty Outcomes Following Stroke or Traumatic Brain Injury: Protocol for the Development of a Core Outcome Set (Preprint)

Author: Harry Mee, Ana M Castaño-Leon, Ivan Timofeev, Amos Adeleye, Indira Devi Bhagavatula, Niklas Marklund, Susanne Muehlschlegel, Katie Bond, Clare Clement, Kirsty Grieve, Nicola Owen, Gemma Whiting, Carole Turner, Andres Mariano Rubiano Escobar, Dhaval Shukla, Maria Paul, Judith Allanson, Valerie Pomeroy, Edoardo Viaroli, Elizabeth Warburton, Adam Wells, Gregory Hawryluk, Adel Helmy, Fahim Anwar, Stephen Honeybul, Peter Hutchinson, and Angelos Kolias
Abstract: BACKGROUND Core outcome sets (COSs) are important and necessary as they help standardize reporting in research studies. Cranioplasty following traumatic brain injury (TBI) or stroke is becoming increasingly common, leading to an ever-growing clinical and research interest, especially regarding the optimal material, cost-effectiveness, and timing of cranioplasty concerning neurological recovery and complications. Consequently, heterogeneous reporting of outcomes from such diverse studies has led to limited meta-analysis ability and an ongoing risk of outcome reporting bias. This study aims to define a standardized COS for reporting in all future TBI and stroke cranioplasty studies. OBJECTIVE This study has four aims: (1) undertake a systematic review to collate the most current outcome measures used within the cranioplasty literature; (2) undertake a qualitative study to understand better the views of clinicians, patients' relatives, and allied health professionals regarding clinical outcomes following cranioplasty; (3) undertake a Delphi survey as part of the process of gaining consensus for the COS; and (4) finalize consensus through a consensus meeting resulting in the COS. METHODS An international steering committee has been formed to guide the development of the COS. In addition, recommendations from other clinical initiatives such as COMET (Core Outcomes and Effectiveness Trials) and OMERACT (Outcome Measures in Rheumatology) have been adhered to. Phase 1 is data collection through a systematic review and qualitative study. Phase 2 is the COS development through a Delphi survey and consensus meetings with consensus definitions decided and agreed upon before the Delphi survey begins to avoid bias. RESULTS Phase 1 started at the end of 2019, following ethical approval in December 2019, and the project completion date is planned for the end of 2022 or beginning of 2023. CONCLUSIONS This study should result in a consensus on a COS for cranioplasty, following TBI or stroke, to help standardize outcome reporting for future studies, which can be applied to future research and clinical services, help align future studies, build an increased understanding of cranioplasty and its impact on a patient’s function and recovery, and help standardize the evidence base. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/37442
Published: 2022

45. Current state of global neurosurgery activity amongst European neurosurgeons

Author: Saniya MEDIRATTA, Laura LIPPA, Sara VENTURINI, Andreas K. DEMETRIADES, Abdessamad EL-OUAHABI, Maria L. GANDÍA-GONZÁLEZ, William HARKNESS, Peter HUTCHINSON, Kee B. PARK, Katrin RABIEI, Gail ROSSEAU, Karl SCHALLER, Franco SERVADEI, Jesus LAFUENTE, and Angelos G. KOLIASÙ
Subjects: Surgery, Neurology (clinical)
Abstract: The expanding field of global neurosurgery calls for a committed neurosurgical community to advocate for universal access to timely, safe, and affordable neurosurgical care for everyone, everywhere. This study aims to (i) assess the current state of global neurosurgery activity amongst European neurosurgeons and (ii) identify barriers to involvement in global neurosurgery initiatives.Cross-sectional study through dissemination of a web-based survey, from September 2019 to January 2020, to collect data from European neurosurgeons at various career stages. Descriptive analysis was conducted on respondent data.Three hundred and ten neurosurgeons from 40 European countries responded. 53.5% regularly follow global neurosurgery developments. 29.4% had travelled abroad with a global neurosurgery collaborative, with 23.2% planning a future trip. Respondents from high income European countries predominantly travelled to Africa (41.6%) or Asia (34.4%), whereas, respondents from middle income European countries frequently traversed Europe (63.2%) and North America (47.4). Cost implications (66.5%) were the most common barrier to global neurosurgery activity, followed by interference with current practice (45.8%), family duties (35.2%), difficulties obtaining humanitarian leave (27.7%) and lack of international partners (27.4%). 86.8% would incorporate a global neurosurgery period within training programmes.European neurosurgeons are interested in engaging in global neurosurgery partnerships, and several sustainable programmes focused on local capacity building, education and research have been established over the last decade. However, individual and system barriers to engagement persist. We provide insight into these to allow development of tailored mechanisms to overcome such barriers, enabling European neurosurgeons to advocate for the Global Surgery 2030 goals.
Published: 2022

46. The Role of Neurosurgery in Global Health Head Trauma

Author: David Clark, Jebet Beverly Cheserem, Indira Devi Bhagavatula, Anthony Figaji, and Peter Hutchinson
Published: 2022

47. Traumatic brain injury : progress and challenges in prevention, clinical care, and research

Author: Andrew I R Maas, David K Menon, Geoffrey T Manley, Mathew Abrams, Cecilia Åkerlund, Nada Andelic, Marcel Aries, Tom Bashford, Michael J Bell, Yelena G Bodien, Benjamin L Brett, András Büki, Randall M Chesnut, Giuseppe Citerio, David Clark, Betony Clasby, D Jamie Cooper, Endre Czeiter, Marek Czosnyka, Kristen Dams-O'Connor, Véronique De Keyser, Ramon Diaz-Arrastia, Ari Ercole, Thomas A van Essen, Éanna Falvey, Adam R Ferguson, Anthony Figaji, Melinda Fitzgerald, Brandon Foreman, Dashiell Gantner, Guoyi Gao, Joseph Giacino, Benjamin Gravesteijn, Fabian Guiza, Deepak Gupta, Mark Gurnell, Juanita A Haagsma, Flora M Hammond, Gregory Hawryluk, Peter Hutchinson, Mathieu van der Jagt, Sonia Jain, Swati Jain, Ji-yao Jiang, Hope Kent, Angelos Kolias, Erwin J O Kompanje, Fiona Lecky, Hester F Lingsma, Marc Maegele, Marek Majdan, Amy Markowitz, Michael McCrea, Geert Meyfroidt, Ana Mikolić, Stefania Mondello, Pratik Mukherjee, David Nelson, Lindsay D Nelson, Virginia Newcombe, David Okonkwo, Matej Orešič, Wilco Peul, Dana Pisică, Suzanne Polinder, Jennie Ponsford, Louis Puybasset, Rahul Raj, Chiara Robba, Cecilie Røe, Jonathan Rosand, Peter Schueler, David J Sharp, Peter Smielewski, Murray B Stein, Nicole von Steinbüchel, William Stewart, Ewout W Steyerberg, Nino Stocchetti, Nancy Temkin, Olli Tenovuo, Alice Theadom, Ilias Thomas, Abel Torres Espin, Alexis F Turgeon, Andreas Unterberg, Dominique Van Praag, Ernest van Veen, Jan Verheyden, Thijs Vande Vyvere, Kevin K W Wang, Eveline J A Wiegers, W Huw Williams, Lindsay Wilson, Stephen R Wisniewski, Alexander Younsi, John K Yue, Esther L Yuh, Frederick A Zeiler, Marina Zeldovich, Roger Zemek, InTBIR Participants and Investigators, Maas, A, Menon, D, Manley, G, Abrams, M, Åkerlund, C, Andelic, N, Aries, M, Bashford, T, Bell, M, Bodien, Y, Brett, B, Büki, A, Chesnut, R, Citerio, G, Clark, D, Clasby, B, Cooper, D, Czeiter, E, Czosnyka, M, Dams-O'Connor, K, De Keyser, V, Diaz-Arrastia, R, Ercole, A, van Essen, T, Falvey, É, Ferguson, A, Figaji, A, Fitzgerald, M, Foreman, B, Gantner, D, Gao, G, Giacino, J, Gravesteijn, B, Guiza, F, Gupta, D, Gurnell, M, Haagsma, J, Hammond, F, Hawryluk, G, Hutchinson, P, van der Jagt, M, Jain, S, Jiang, J, Kent, H, Kolias, A, Kompanje, E, Lecky, F, Lingsma, H, Maegele, M, Majdan, M, Markowitz, A, Mccrea, M, Meyfroidt, G, Mikolić, A, Mondello, S, Mukherjee, P, Nelson, D, Nelson, L, Newcombe, V, Okonkwo, D, Orešič, M, Peul, W, Pisică, D, Polinder, S, Ponsford, J, Puybasset, L, Raj, R, Robba, C, Røe, C, Rosand, J, Schueler, P, Sharp, D, Smielewski, P, Stein, M, von Steinbüchel, N, Stewart, W, Steyerberg, E, Stocchetti, N, Temkin, N, Tenovuo, O, Theadom, A, Thomas, I, Espin, A, Turgeon, A, Unterberg, A, Van Praag, D, van Veen, E, Verheyden, J, Vyvere, T, Wang, K, Wiegers, E, Williams, W, Wilson, L, Wisniewski, S, Younsi, A, Yue, J, Yuh, E, Zeiler, F, Zeldovich, M, Zemek, R, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Intensive Care, and MUMC+: MA Medische Staf IC (9)
Subjects: NEUROTRAUMA EFFECTIVENESS RESEARCH, OUTCOME PREDICTION, PREHOSPITAL TRIAGE TOOLS, COMMON DATA ELEMENTS, Violence, INTENSIVE-CARE, CEREBRAL PERFUSION-PRESSURE, POSTTRAUMATIC-STRESS-DISORDER, Cost of Illness, LIFE-SUSTAINING THERAPY, CT HEAD RULE, Brain Injuries, Traumatic, Humans, Neurology (clinical), MAJOR TRAUMA, Human medicine, Sports
Abstract: Traumatic brain injury (TBI) has the highest incidence of all common neurological disorders, and poses a substantial public health burden. TBI is increasingly documented not only as an acute condition but also as a chronic disease with long-term consequences, including an increased risk of late-onset neurodegeneration. The first Lancet Neurology Commission on TBI, published in 2017, called for a concerted effort to tackle the global health problem posed by TBI. Since then, funding agencies have supported research both in high-income countries (HICs) and in low-income and middle-income countries (LMICs). In November 2020, the World Health Assembly, the decision-making body of WHO, passed resolution WHA73.10 for global actions on epilepsy and other neurological disorders, and WHO launched the Decade for Action on Road Safety plan in 2021. New knowledge has been generated by large observational studies, including those conducted under the umbrella of the International Traumatic Brain Injury Research (InTBIR) initiative, established as a collaboration of funding agencies in 2011. InTBIR has also provided a huge stimulus to collaborative research in TBI and has facilitated participation of global partners. The return on investment has been high, but many needs of patients with TBI remain unaddressed. This update to the 2017 Commission presents advances and discusses persisting and new challenges in prevention, clinical care, and research.
Published: 2022

48. The Myeloid Cell Secretome Regulates Zika Flavivirus Infection of Developing and Malignant Human Neural Progenitor Cells

Author: Harry Bulstrode, Gemma C. Girdler, Tannia Gracia, Alexander Aivazidis, Ilias Moutsopoulos, Adam MH Young, John Hancock, X. He, Katherine Ridley, Zhaoyang Xu, John H. Stockley, Clément Hallou, Teodoro Fajardo, Daniel M. Fountain, Stijn van Dongen, Alexis Joannides, Robert Morris, Richard Mair, Colin Watts, Thomas Santarius, Stephen J. Price, Peter Hutchinson, Emma J. Hodson, Steven M. Pollard, Irina Mohorianu, Roger A. Barker, Trevor R. Sweeney, Omer Bayraktar, Fanni Gergely, and David Rowitch
Subjects: History, Polymers and Plastics, Business and International Management, Industrial and Manufacturing Engineering
Published: 2022

49. Intracranial pressure: current perspectives on physiology and monitoring

Author: Gregory W. J. Hawryluk, Giuseppe Citerio, Peter Hutchinson, Angelos Kolias, Geert Meyfroidt, Chiara Robba, Nino Stocchetti, Randall Chesnut, Hawryluk, G, Citerio, G, Hutchinson, P, Kolias, A, Meyfroidt, G, Robba, C, Stocchetti, N, and Chesnut, R
Subjects: Critical care, Traumatic brain injury, Monitoring, Intracranial pressure, Physiology, Cerebrovascular Circulation, Brain Injuries, Traumatic, Humans, Non-invasive, Critical Care and Intensive Care Medicine, Monitoring, Physiologic, Intracranial hypertension
Abstract: Intracranial pressure (ICP) monitoring is now viewed as integral to the clinical care of many life-threatening brain insults, such as severe traumatic brain injury, subarachnoid hemorrhage, and malignant stroke. It serves to warn of expanding intracranial mass lesions, to prevent or treat herniation events as well as pressure elevation which impedes nutrient delivery to the brain. It facilitates the calculation of cerebral perfusion pressure (CPP) and the estimation of cerebrovascular autoregulatory status. Despite advancements in our knowledge emanating from a half century of experience with this technology, important controversies remain related even to fundamental aspects of ICP measurements, including indications for monitoring, ICP treatment thresholds, and management of intracranial hypertension. Here, we review the history of ICP monitoring, the underlying pathophysiology as well as current perspectives on why, when and how ICP monitoring is best used. ICP is typically assessed invasively but a number of emerging, non-invasive technologies with inherently lower risk are showing promise. In selected cases, additional neuromonitoring can be used to assist in the interpretation of ICP monitoring information and adapt directed treatment accordingly. Additional efforts to expand the evidence base relevant to ICP monitoring, related technologies and management remain a high priority in neurosurgery and neurocritical care.
Published: 2022

50. The Microglial Secretome Regulates Flavivirus Infection of Developing and Malignant Human Neural Stem Cells

Author: Harry Bulstrode, Gemma C. Girdler, Tannia Gracia, Alexander Aivazidis, Ilias Moutsopoulos, Adam MH Young, X. He, Katherine Ridley, Zhaoyang Xu, John H. Stockley, Clement Hallou, Teodoro Fajardo, Daniel M. Fountain, Stijn van Dongen, Alexis Joannides, Robert Morris, Richard Mair, Colin Watts, Thomas Santarius, Stephen J. Price, Peter Hutchinson, Emma J. Hodson, Steven M. Pollard, Irina Mohorianu, Roger A. Barker, Trevor R. Sweeney, Omer Bayraktar, Fanni Gergely, and David Rowitch
Published: 2022

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