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3. Experimental and mathematical insights on the interactions between poliovirus and a defective interfering genome.

Author

Shirogane, Yuta, Rousseau, Elsa, Voznica, Jakub, Xiao, Yinghong, Su, Weiheng, Catching, Adam, Whitfield, Zachary J, Rouzine, Igor M, Bianco, Simone, and Andino, Raul

Subjects
Genetics, Infectious Diseases, Human Genome, 2.2 Factors relating to the physical environment, 2.1 Biological and endogenous factors, Infection, Virology, Microbiology, Immunology, Medical Microbiology
Abstract

During replication, RNA viruses accumulate genome alterations, such as mutations and deletions. The interactions between individual variants can determine the fitness of the virus population and, thus, the outcome of infection. To investigate the effects of defective interfering genomes (DI) on wild-type (WT) poliovirus replication, we developed an ordinary differential equation model, which enables exploring the parameter space of the WT and DI competition. We also experimentally examined virus and DI replication kinetics during co-infection, and used these data to infer model parameters. Our model identifies, and our experimental measurements confirm, that the efficiencies of DI genome replication and encapsidation are two most critical parameters determining the outcome of WT replication. However, an equilibrium can be established which enables WT to replicate, albeit to reduced levels.

Published
2021

4. Species-Specific Evolution of Ebola Virus during Replication in Human and Bat Cells

Author

Whitfield, Zachary J, Prasad, Abhishek N, Ronk, Adam J, Kuzmin, Ivan V, Ilinykh, Philipp A, Andino, Raul, and Bukreyev, Alexander

Subjects
Vaccine Related, Genetics, Infectious Diseases, Biodefense, Prevention, Rare Diseases, Emerging Infectious Diseases, Aetiology, 2.1 Biological and endogenous factors, Infection, Good Health and Well Being, Animals, Chiroptera, Ebolavirus, Hemorrhagic Fever, Ebola, Humans, Virus Replication, ADAR, Ebola virus, bats, emerging viruses, evolution, filovirus, population genetics, reservoir biology, viral evolution, Biochemistry and Cell Biology, Medical Physiology
Abstract

Ebola virus (EBOV) causes a severe, often fatal disease in humans and nonhuman primates. Within the past decade, EBOV has caused two large and difficult-to-control outbreaks, one of which recently ended in the Democratic Republic of the Congo. Bats are the likely reservoir of EBOV, but little is known of their relationship with the virus. We perform serial passages of EBOV in human and bat cells and use circular sequencing to compare the short-term evolution of the virus. Virus populations passaged in bat cells have sequence markers indicative of host RNA editing enzyme activity, including evidence for ADAR editing of the EBOV glycoprotein. Multiple regions in the EBOV genome appear to have undergone adaptive evolution when passaged in bat and human cells. Individual mutated viruses are rescued and characterized. Our results provide insight into the host species-specific evolution of EBOV and highlight the adaptive flexibility of the virus.

Published
2020

5. Control of RNA viruses in mosquito cells through the acquisition of vDNA and endogenous viral elements.

Author

Tassetto, Michel, Kunitomi, Mark, Whitfield, Zachary J, Dolan, Patrick T, Sánchez-Vargas, Irma, Garcia-Knight, Miguel, Ribiero, Isabel, Chen, Taotao, Olson, Ken E, and Andino, Raul

Subjects
Animals, Aedes, RNA Viruses, Drosophila Proteins, RNA, Small Interfering, DNA, Complementary, DNA, Viral, Immunity, Innate, Argonaute Proteins, RNA viruses, adaptive immunity, endogenous retroviruses, immunology, infectious disease, inflammation, microbiology, mosquito vector, self-nonself discrimination, tolerance to infection, virus, Biochemistry and Cell Biology
Abstract

Aedes aegypti transmit pathogenic arboviruses while the mosquito itself tolerates the infection. We examine a piRNA-based immunity that relies on the acquisition of viral derived cDNA (vDNA) and how this pathway discriminates between self and non-self. The piRNAs derived from these vDNAs are essential for virus control and Piwi4 has a central role in the pathway. Piwi4 binds preferentially to virus-derived piRNAs but not to transposon-targeting piRNAs. Analysis of episomal vDNA from infected cells reveals that vDNA molecules are acquired through a discriminatory process of reverse-transcription and recombination directed by endogenous retrotransposons. Using a high-resolution Ae. aegypti genomic sequence, we found that vDNAs integrated in the host genome as endogenous viral elements (EVEs), produce antisense piRNAs that are preferentially loaded onto Piwi4. Importantly, EVE-derived piRNAs are specifically loaded onto Piwi4 to inhibit virus replication. Thus, Ae. aegypti employs a sophisticated antiviral mechanism that promotes viral persistence and generates long-lasting adaptive immunity.

Published
2019

8. Mapping the Evolutionary Potential of RNA Viruses

Author

Dolan, Patrick T, Whitfield, Zachary J, and Andino, Raul

Subjects
Genetics, Infectious Diseases, Biotechnology, Aetiology, 2.2 Factors relating to the physical environment, Infection, Adaptation, Biological, Evolution, Molecular, Genetics, Population, High-Throughput Nucleotide Sequencing, RNA Viruses, Selection, Genetic, Virology, deep mutational scanning, evolutionary dynamics, experimental evolution, gain-of-function experiments, microfluidics, phylogenetics, virus evolution, Microbiology, Medical Microbiology, Immunology
Abstract

The deterministic force of natural selection and stochastic influence of drift shape RNA virus evolution. New deep-sequencing and microfluidics technologies allow us to quantify the effect of mutations and trace the evolution of viral populations with single-genome and single-nucleotide resolution. Such experiments can reveal the topography of the genotype-fitness landscapes that shape the path of viral evolution. By combining historical analyses, like phylogenetic approaches, with high-throughput and high-resolution evolutionary experiments, we can observe parallel patterns of evolution that drive important phenotypic transitions. These developments provide a framework for quantifying and anticipating potential evolutionary events. Here, we examine emerging technologies that can map the selective landscapes of viruses, focusing on their application to pathogenic viruses. We identify areas where these technologies can bolster our ability to study the evolution of viruses and to anticipate and possibly intervene in evolutionary events and prevent viral disease.

Published
2018

9. The Diversity, Structure, and Function of Heritable Adaptive Immunity Sequences in the Aedes aegypti Genome

Author

Whitfield, Zachary J, Dolan, Patrick T, Kunitomi, Mark, Tassetto, Michel, Seetin, Matthew G, Oh, Steve, Heiner, Cheryl, Paxinos, Ellen, and Andino, Raul

Subjects
Genetics, Emerging Infectious Diseases, Vector-Borne Diseases, Vaccine Related, Biodefense, Infectious Diseases, Prevention, Biotechnology, Underpinning research, 1.1 Normal biological development and functioning, Infection, Good Health and Well Being, Adaptive Immunity, Aedes, Animals, DNA Transposable Elements, Genome, Mosquito Vectors, RNA Interference, RNA, Small Interfering, Aedes aegypti, EVE, endogenous viral element, piRNA clusters, retrotransposon, small RNAs, transposable element, transposon, Biological Sciences, Medical and Health Sciences, Psychology and Cognitive Sciences, Developmental Biology
Abstract

The Aedes aegypti mosquito transmits arboviruses, including dengue, chikungunya, and Zika virus. Understanding the mechanisms underlying mosquito immunity could provide new tools to control arbovirus spread. Insects exploit two different RNAi pathways to combat viral and transposon infection: short interfering RNAs (siRNAs) and PIWI-interacting RNAs (piRNAs) [1, 2]. Endogenous viral elements (EVEs) are sequences from non-retroviral viruses that are inserted into the mosquito genome and can act as templates for the production of piRNAs [3, 4]. EVEs therefore represent a record of past infections and a reservoir of potential immune memory [5]. The large-scale organization of EVEs has been difficult to resolve with short-read sequencing because they tend to integrate into repetitive regions of the genome. To define the diversity, organization, and function of EVEs, we took advantage of the contiguity associated with long-read sequencing to generate a high-quality assembly of the Ae. aegypti-derived Aag2 cell line genome, an important and widely used model system. We show EVEs are acquired through recombination with specific classes of long terminal repeat (LTR) retrotransposons and organize into large loci (>50 kbp) characterized by high LTR density. These EVE-containing loci have increased density of piRNAs compared to similar regions without EVEs. Furthermore, we detected EVE-derived piRNAs consistent with a targeted processing of persistently infecting virus genomes. We propose that comparisons of EVEs across mosquito populations may explain differences in vector competence, and further study of the structure and function of these elements in the genome of mosquitoes may lead to epidemiological interventions.

Published
2017

10. Characterization of Viral Populations by Using Circular Sequencing

Author

Whitfield, Zachary J and Andino, Raul

Subjects
Immunization, Biotechnology, Genetics, Vaccine Related, Human Genome, Infection, Responsible Consumption and Production, Good Health and Well Being, High-Throughput Nucleotide Sequencing, Metagenomics, Virology, Viruses, Biological Sciences, Agricultural and Veterinary Sciences, Medical and Health Sciences
Abstract

With the enormous sizes viral populations reach, many variants are at too low a frequency to be detected by conventional next-generation sequencing (NGS) methods. Circular sequencing (CirSeq) is a method by which the error rate of next-generation sequencing is decreased so that even low-frequency viral variants can be accurately detected. The ability to visualize almost the entire genetic makeup of a viral swarm has implications for epidemiology, viral evolution, and vaccine design. Here we discuss experimental planning, analysis, and recent insights using CirSeq.

Published
2016

13. Seasonal patterns and key chemical predictors of dissolved greenhouse gases in small prairie pothole ponds

Author

Miranda, Lauren T. and Whitfield, Colin J.

Abstract

Shallow ponds can provide ideal conditions for production of greenhouse gases (GHGs) carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O), and thus are important to include in global and regional GHG budgets. The Canadian Prairie Pothole Region contains millions of shallow natural ponds, and we investigated GHG dynamics in 145 ponds across the region. Ponds were consistently supersaturated with CH4, often supersaturated with CO2(57% occurrence), and often undersaturated with N2O (65% occurrence). Spring measurements showed higher N2O saturation (p= 0.0037) than summer, while summer had higher CH4(p < 0.001) and CO2(p= 0.023) saturation than spring. Ponds exhibited large physicochemical variation, yet sulfate concentration and pH were strong predictors of dissolved CH4and CO2, respectively. No predictor was identified for N2O. The link between sulfate and CH4has important implications as dissolved CH4in low sulfate (<178 mg L−1) systems was much more responsive to changes in temperature. This research fills an important knowledge gap about the GHG dynamics of prairie pothole ponds and the role of water chemistry for diffuse GHG release. Our work can also be used in ongoing efforts to describe ecosystem services (or disservices) assigned to ponds in this agriculture-dominated region.

Published
2024
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14. An integrated assessment of impacts to ecosystem services associated with prairie pothole wetland drainage quantifying wide-ranging losses

Author

Whitfield, Colin J., Cavaliere, Emily, Baulch, Helen M., Clark, Robert G., Spence, Christopher, Shook, Kevin R., He, Zhihua, Pomeroy, John W., and Wolfe, Jared D.

Abstract

In many regions, a tradeoff exists between draining wetlands to support the expansion of agricultural land, and conserving wetlands to maintain their valuable ecosystem services. Decisions about wetland drainage are often made without identifying the impacts on the services these systems provide. We address this gap through a novel assessment of impacts on ecosystem services via wetland drainage in the Canadian prairie landscape. Draining pothole wetlands has large impacts, but sensitivity varies among the indicators considered. Loss of water storage increased the magnitude of median annual flows, but absolute increases with drainage were higher for larger, less frequent events. Total phosphorus exports increased in concert with streamflow. Our analysis suggested disproportionate riparian habitat losses with the first 30% of wetland area drained. Dabbling ducks and wetland-associated bird abundances respond strongly to the loss of small wetland ponds; abundances were predicted to decrease by half with the loss of only 20%–40% of wetland area. This approach to evaluating changes to key wetland ecosystem services in a large region where wetland drainage is ongoing can be used with an economic valuation of the drainage impacts, which should be weighed against the benefits associated with agricultural expansion.

Published
2024
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15. Academic Effectiveness of Allegheny County Middle Schools' Instructional Support Teams.

Author

Whitfield, Tammy J.

Abstract

In July 1990, the Commonwealth of Pennsylvania adopted the Instructional Support Team initiative to identify those students who experience academic, behavioral, social-emotional, and/or communication difficulties, and to provide the needed support to help them succeed. A study evaluated the effectiveness of middle school Instructional Support Teams (IST) in Allegheny County, Pennsylvania with respect to "quality point average" (QPA) changes after a student had gone through the IST process. The IST initiative includes a mandated team of the building principal, classroom teacher, and support teacher. Various other adults such as counselors, psychologists, nurses, speech therapists, other teachers, and parents may be included on the team. The team works together to problem-solve and develop strategies that will help at-risk students to succeed in the regular classroom. Questionnaires were mailed to 13 school districts in the county who have IST in place in a middle school building. Completed questionnaires were received from 11 districts representing 47 students who were at-risk for school failure. Results indicated a significant improvement in QPA scores for the academically at-risk students who have gone through the IST process during the first semester of the 1995/1996 school year. Future research should focus on specific reasons why IST students are experiencing academic success. (Contains 22 references and 4 charts; appendixes contain a cover letter and the questionnaire.) (RS)

Published
1996

47. Elective surgery system strengthening: development, measurement, and validation of the surgical preparedness index across 1632 hospitals in 119 countries

Author

Glasbey, James C, Abbott, Tom EF, Ademuyiwa, Adesoji, Adisa, Adewale, AlAmeer, Ehab, Alshryda, Sattar, Arnaud, Alexis P, Bankhead-Kendall, Brittany, Abou Chaar, M K, Chaudhry, Daoud, Costas-Chavarri, Ainhoa, Cunha, Miguel F, Davies, Justine I, Desai, Anant, Elhadi, Muhammed, Fiore, Marco, Fitzgerald, James Edward, Fourtounas, Maria, Fowler, Alex James, Futaba, Kay, Gallo, Gaetano, Ghosh, Dhruva, Gujjuri, Rohan R, Hamilton, Rebecca, Haque, Parvez, Harrison, Ewen M, Hutchinson, Peter, Hyman, Gabriella, Isik, Arda, Jayarajah, Umesh, Kaafarani, Haytham MA, Kadir, Bryar, Lawani, Ismail, Lederhuber, Hans, Li, Elizabeth, Löffler, Markus W, Lorena, Maria Aguilera, Mann, Harvinder, Martin, Janet, Mazingi, Dennis, McClain, Craig D, McLean, Kenneth A, Meara, John G, Ramos-De La Medina, Antonio, Mengesha, Mengistu, Minaya, Ana, Modolo, Maria Marta, Moore, Rachel, Morton, Dion, Nepogodiev, Dmitri, Ntirenganya, Faustin, Pata, Francesco, Pearse, Rupert, Picciochi, Maria, Pinkney, Thomas, Pockney, Peter, van Ramshorst, Gabrielle H, Richards, Toby, Roslani, April Camilla, Satoi, Sohei, Sayyed, Raza, Shaw, Richard, Simões, Joana FF, Smart, Neil, Sullivan, Richard, Sund, Malin, Sundar, Sudha, Tabiri, Stephen, Taylor, Elliott H, Venn, Mary L, Wickramasinghe, Dakshitha, Wright, Naomi, Yip, Sebastian Bernardo Shu, Bhangu, Aneel, Omar, Omar, Harrison, Ewen, Bhangu, Aneel A, Siaw-Acheampong, Kwabena, Benson, Ruth A, Bywater, Edward, Dawson, Brett E, Evans, Jonathan P, Heritage, Emily, Jones, Conor S, Kamarajah, Sivesh K, Khatri, Chetan, Khaw, Rachel A, Keatley, James M, Knight, Andrew, Lawday, Samuel, Mann, Harvinder S, Marson, Ella J, Mckay, Siobhan C, Mills, Emily C, Pellino, Gianluca, Tiwari, Abhinav, Trout, Isobel M, Wilkin, Richard JW, Abukhalaf, Sadi, Adamina, Michel, Ademuyiwa, Adesoji O, Agarwal, Arnav, Akkulak, Murat, Alameer, Ehab, Alderson, Derek, Alakaloko, Felix, Albertsmeier, Markus, Alser, Osaid, Alshaar, Muhammad, Augestad, Knut Magne, Ayasra, Faris, Azevedo, José, Bankhead-Kendall, Brittany K, Barlow, Emma, Beard, David, Blanco-Colino, Ruth, Brar, Amanpreet, Minaya-Bravo, Ana, Breen, Kerry A, Bretherton, Chris, Buarque, Igor Lima, Burke, Joshua, Caruana, Edward J, Chaar, Mohammad, Chakrabortee, Sohini, Christensen, Peter, Cox, Daniel, Cukier, Moises, Davidson, Giana H, Di Saverio, Salomone, Drake, Thomas M, Edwards, John G, Emile, Sameh, Farik, Shebani, Ford, Samuel, Garmanova, Tatiana, Gomes, Gustavo Mendonça Ataíde, Grecinos, Gustavo, Griffiths, Ewen A, Gruendl, Magdalena, Halkias, Constantine, Hisham, Intisar, Hutchinson, Peter J, Hwang, Shelley, Jenkinson, Michael D, Jonker, Pascal, Keller, Debby, Kolias, Angelos, Kruijff, Schelto, Leventoglu, Sezai, Litvin, Andrey, Loehrer, Andrew, Modolo, Maria Marta, Major, Piotr, Mashbari, Hassan N, Metallidis, Symeon, Mohan, Helen M, Moszkowicz, David, Moug, Susan, Ng-Kamstra, Joshua S, Maimbo, Mayaba, Negoi, Ionut, Niquen, Milagros, Olivos, Maricarmen, Oussama, Kacimi, Outani, Oumaima, Parreno-Sacdalanm, Marie Dione, Rivera, Carlos Jose Perez, Pinkney, Thomas D, Plas, Willemijn van der, Qureshi, Ahmad, Radenkovic, Dejan, Ramos-De La Medina, Antonio, Revell, Elliot J, Roberts, Keith, Roslani, April C, Rutegård, Martin, Segura-Sampedro, Juan José, Santos, Irène, Schache, Andrew, Schnitzbauer, Andreas A, Seyi-Olajide, Justina O, Sharma, Neil, Shaw, Catherine A, Shu, Sebastian, Soreide, Kjetil, Spinelli, Antonino, Stewart, Grant D, Townend, Philip, Tsoulfas, Georgios, Vidya, Raghavan, Vimalachandran, Dale, Warren, Oliver J, Wedderburn, Duane, EuroSurg, NA, European Society of Coloproctology (ESCP), NA, Global Initiative for Children's Surgery, NA, GlobalSurg, NA, GlobalPaedSurg, NA, ItSURG, NA, PTSurg, NA, SpainSurg, NA, Italian Society of Colorectal Surgery, NA, Association of Surgeons in Training, NA, Irish Surgical Research Collaborative (ISRC), NA, Transatlantic Australasian Retroperitoneal Sarcoma Working, NA, Italian Society of Surgical Oncology, NA, Booth, Lesley, Barker, Margaret, Barker, Neil, Cooke, Shirley, Doré, Suzanne, Horwood, Nigel, Runigamugabo, Emmy, Weir, Carrie Tierney, Bahrami-Hessari, Mike, Riaz, Asad, Shah, Jaffer, Safi, Mohammed, Thereska, Dariel, Dajti, Irida, Cheddadi, Riadh, Tidjane, Anisse, Quinteros, Carlos A, khelfaoui, Ahmed, Salem, Khalifa M, Riffi, Omar, Kacimi, Salah Eddine O, Loudjedi, Salim, Damerdji, Tidjani, Pantoja Pachajoa, Diana A, Palacios Huatuco, René M, Alvarez, Fernando A, Doniquian, Alejandro M, Abeldaño Zuñiga, Roberto A, Schlottmann, Francisco, Cobos, Carlos M, Gigena, Cecilia, Forneris, Agustin Albani, Duro, Agustin, García-Mansilla, Agustín M, Busnelli, Virginia Cano, Poggi, Catalina, Mercado, Pedro L, González, Marcos, Castro Lalin, Agustina F, Mayer, Horacio F, Brandariz, Rodrigo, Slullitel, Pablo A, Boudou, Rocio, Lobos, Pablo A, Uffelmann, María C, Petersen, Maria L, Luzzi, Emilia, Padilla Lichtenberger, Fernando L, Crespi Amor, María S, Zarratea, Celeste S, Esteves, Tomas A, Gemelli, Nicolas A, Tirapegui, Sebastián, Liyo, Juan, Scherñuk, Jordán, Boccalatte, Luis A, Balmaceda, Ruben D, D'Addino, Jose L, Caubet, María M, Calderón Arancibia, José A, Chwat, Carina, Morris, Brian, Avellaneda, Nicolas, Pedraza Salazar, Ivana I, Eskinazi, Diego G, Vargas, Lara, Muriel, María E, Lucchini, Sergio M, Gosselink, Martijn P, Davis, Amelia L, Barker, John C, Qin, Kirby R, Proud, David M, Cox, Daniel RA, Goh, Su Kah, Liu, David S, Wu, Damien M, Merrett, Neil D, Badiani, Sarit S, Sengupta, Shomik, Jain, Anshini, Steen, Christopher J, Wong, Enoch, Ip, Christopher CK, Leaning, Matthew G, McCartney, Conor B, Gananadha, Sivakumar, Yeap, Evie FW, Stevens, Sean G, Vu, Anh N, Martin, Sarah A, Stanley, Guy H M, Watson, David I, Townend, Philip J, Young, Thomas K, Cox, Georgia T, Dawson, Amanda C, Laura, Sharon E, Lun, Elizabeth W Y, Liang, Ina X, O'Neill, Christine J, Lott, Natalie J, Chuan, Alwin, Saravanan, SK, Gundara, Justin, Ong, Bee Shan, Nataraja, Ramesh M, Pacilli, Maurizio, Foley, Daniel M, Ooi, Geraldine J, Traeger, Luke, MacDermid, Ewan, Daruwalla, Jurstine, Hodgson, Russell, Heriot, Alexander G, Mulligan, Christopher S, Blefari, Nicholas D A, Purcell, Shaun S, Frankel, Adam J, Guerra, Glen R, Tefay, Joan S, Liang, Rhea W Y, Kroon, Hidde M, Farfus, Anthony W, Warren, Leigh R, Roy, Jennifer M, Whitfield, Robert J, Moller, Cea-Cea B, Davis, Sean S, Sammour, Tarik, Lam, Yick Ho, Kour, Kevin, Gan, Siang Wei, Coventry, Brendon J, Dawson, Joseph A, Batstone, Martin D, King, Sebastian K, Scott, Nathan J, Foo, Jonathan W, Shepherd, Talia, Page, Richard S, Choong, Peter F, Badgery, Henry E, Chong, Lynn, Taylor, Lillian, Hii, Michael W, Wright, Gavin M, Kong, Joseph CH, Watson, Matthew M, Bock, Jacob, Lidder, Surjit S, Elias, Patrick, Kanavathy, Sathisvaran, Koh, Cherry E, Chennakesavan, Srinivas Kondalsamy, Panuganti, Vishwakar, Latif, Haider, Yeung, Justin MC, Besson, Alex J, Tse, Eunice Q Y, Pitcher, Meron E, Taylor, Danielle L, Nahm, Christopher B, Lim, Alicia, Tree, Kevin, Aigner, Felix, Dawoud, Christopher, Foessleitner, Philipp, Zimmermann, Matthias, Wiedemann, Dominik, Findl, Oliver, Messner, Franka, Bauer, Marlies, Nägele, Felix, Kronberger, Irmgard E, Öfner, Dietmar, Härter, Bettina, Bicz, Nina Ru B, Zwittag, Paul M, Poier, Nikolaus, Navarro, Francisco Ruiz, Zebuhr, Yorck A, Köglberger, Paul, Wiesinger, Clemens G, Mathew, Erwin, Trivik-Barrientos, Felipe, Königsrainer, Ingmar, Djedovic, Gabriel, Cohnert, Tina U, Lumenta, David B, Singer, Georg, Leithner, Andreas, Kamolz, Lars-Peter, Andrianakis, Alexandros, Puchwein, Paul, Mikalauskas, Saulius, Kirchweger, Patrick, Függer, Reinhold, Mittermair, Christof, Russe, Elisabeth, Paal, Peter, Grünbart, Martin, de Cillia, Michael, Weiss, Helmut G, Steiner, Florian, Binder, Alf Dorian, Samadov, Elgun, Ibrahimli, Arturan, Muslumov, Gurbankhan, Bayramov, Nuru Y, Saunders, Jada M, Almoosa, Noora, Haj-Ibrahim, Huzifa, Maresch, Martin, Ezzdean, Weaam K, Juma, Isam M, Hasan, Layla H, Haider, Fayza HA, Alfaqawi, Ghassan Salman, Alam, Mohammed S, Islam, Shahnoor, Basher, AKM K, Mitul, Ashrarur Rahman, Islam, Nazmul, Oosterkamp, Antje E, Ahmed, Tanveer, Hannan, M Jafrul, Padmore, Greg M, Doyle, Alex F, LaCorbiniere, Karisha L, Boyce, Rico D R, Ragoobar, Paul T, Walkes, Keisha M Y, Haynes, Amelia A, Corbin, Sasha M, Litvina, Yauheniya A, Makhmudov, Anvar, Strypstein, Sébastien, Dhondt, Bert, Rasschaert, Ricky, Farid, Yasser, Wahib, El Mahdi, Pigeolet, Manon, Belle, Koen Van, De Wachter, Stefan, Komen, Niels, Vandeputte, Mathieu PJ, van Ramshorst, Gabrielle H, Jansen, Yanina JL, Stijns, Jasper, Eynde, Jef Van den, Olowo, Benedicte I, Feraudy, Israel C, Dragisic, Vedran, Martinovic, Vlatka, Barišić, Tatjana, Penava, Nikolina, Hudic, Igor, Delibegovic, Samir, Bogdanović, Gordana, Grgić, Gordana, Cerovac, Anis, Cerovac, Elmedina, Bedada, Alemayehu G, Baiocchi, Glauco, Wainstein, Alberto, Moisés, Elaine Christine D, Zani, Ana Carolina Tagliatti, de Campos Prado, Caio Antonio, Panis, Carolina, Rech, Daniel, Soares da Silva, Ruan Gabriel, Joviliano, Edwaldo E, Rezende, Ricardo F, Reis, Igor G N, Pires, Robinson E S, Christiano, Adriana Borgonovi, Consani, Heitor F X, Pugliesi, Felipe G, Takeda, Flavio R, Mariani, Alessandro W, Valadares, Ricardo J B, Andreollo, Nelson A, Lopes, Luiz Roberto, Tonello, Cristiano, Alonso, Nivaldo, dos Santos, Carlos Ferreira, Lima, Leonardo S, Salgado, Wilson, Pereira, Thiago H S, Gatti, Arthur Paredes, Oliva, Ramon N L, Nardi, Caroline N, Sousa, Alvaro F L, Ribeiro, Ivonizete P, Carvalho, Herica E F, Oliveira, Layze B, Schneider, Guilherme, Casteleins, William Augusto, Silva, Larissa M, Gomes, Carlos Augusto, da Cunha Viana Júnior, Alonço, Cruz, Ricardo P, Gomes, Gustavo MA, Buarque, Igor L, Barros, Aldo V, Marangon, Gustavo B, Flumignan, Ronald LG, Nakano, Luís CU, Pascoal, Patrícia IF, Santos, Brena C, Kuramoto, Danielle AB, Correia, Rebeca M, Amaral, Fabio CF, Flumignan, Carolina DQ, Dussán-Sarria, Jairo A, Simões, Romeo L, Casteleins, William Augusto, Amorim, Robson L, Silva, Jeancarllo S, Lyra Junior, Humberto F, Julio, Nathalia S, Gerber, Marlus T, dos Santos, José Mauro, de Oliveira, Joao Carlos C, Palamim, Camila VC, Marson, Fernando AL, Gomes, Iolanda M, Oliveira, Priscila R, Lima, Ana Lucia L M, Carvalho, Vladimir C, Silva, Jorge S, NA, Ulysses Ribeiro, Laporte, Gustavo Andreazza, Gonçalves, Mateus Capuzzo, Botacin, Lais S, Avelino, Melissa AG, Brito, Luiz Gustavo O, Hristova, Evguenia T, Stoyanov, Vladislav Valentinov, Sakakushev, Boris E, Dardanov, Dragomir D, Sokolov, Manol B, Mehta, Ananya, Gyokova, Elitsa H, Abdullahi, Mohamed, Karamanliev, Martin P, Dimitrov, Dobromir D, Slavchev, Mihail T, Atanasov, Boyko Ch, Yotsov, Tsanko I, Hadzhiev, Dimitar Bozhidarov, Stock, Simon E, Nwegbu, Chukwuemeka Gerald, Tanyi, Tanyi John, Brown, James A, Arneja, Jugpal S, Lee, Susan M, Kancherla, Ramya, Kidane, Biniam, Champagne, Pierre-Olivier, Ma, Xiya, Munro, Allana, McKeen, Dolores M, Martin, Janet, Glinka, Juan, Vasarhelyi, Edward M, Subramani, Yamini, Alfaro, Hilda, Shah, Ushma J, Gonzalez, Nelson J, MacNeil, S Danielle, Nagappa, Mahesh, Malthaner, Richard A, Brackstone, Muriel, Alkhamesi, Nawar A, Qiabi, Mehdi, Arango-Ferreira, Camila, Prempeh, Agya B A, Dumitra, Sinziana, Spence, Richard T, Bedard, Eric LR, Lee, Susan M, Luc, Jessica GY, Johnston, Brian R, Attabib, Najmedden, Persad, Amit RL, Das, Sunit, Khoshbin, Amir, Ladha, Karim S, Sankar, Ashwin, Teja, Bijan, Daza, Julian F, Chan, Veronica F, Baertschiger, Reto M, Zani, Augusto, Nessim, Carolyn, McIsaac, Daniel I, Singh, Mandeep, Behzadi, Abdollah, Dell, Angela J, Al Riyami, Salim M, Dajani, Khaled Z, Bigam, David, Manikala, Vinod K, Street, John T, Mayson, Kelly V, Wallis, Christopher J D, Mimica, Ximena, Modolo, Maria Marta, Villanueva, Julio, Altamirano, Roberto, Waissbluth, Sofia, Marín, Diego I, Olivos, Maricarmen, Fonseca, Bruno Catoia, Hodali, Andrés J, Ramos, Andrea I, Valenzuela, Marco A, Torres, Janina J, Song, Yi, Yang, Wah, Safi, 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Siamuchembu, Maphios, Bondera, Tafadzwa, and Mushawarima, Trust

Abstract

The 2015 LancetCommission on global surgery identified surgery and anaesthesia as indispensable parts of holistic health-care systems. However, COVID-19 exposed the fragility of planned surgical services around the world, which have also been neglected in pandemic recovery planning. This study aimed to develop and validate a novel index to support local elective surgical system strengthening and address growing backlogs.

Published
2022
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