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4. Admission Serum Metabolites and Thyroxine Predict Advanced Hepatic Encephalopathy in a Multicenter Inpatient Cirrhosis Cohort.

Author

Bajaj, Jasmohan, Tandon, Puneeta, OLeary, Jacqueline, Reddy, K, Garcia-Tsao, Guadalupe, Thuluvath, Paul, Subramanian, Ram, Vargas, Hugo, Wong, Florence, Fagan, Andrew, McGeorge, Sara, Thacker, Leroy, Kamath, Patrick, and Lai, Jennifer

Subjects
Acute-on-Chronic Liver Failure, Brain Failure, Metabolomics, Outcomes, Thyroid, Humans, Hepatic Encephalopathy, Thyroxine, Prospective Studies, Inpatients, Liver Cirrhosis, Fibrosis
Abstract

BACKGROUND & AIMS: Grades 3 to 4 hepatic encephalopathy (advanced HE), also termed brain failure, is an organ failure that defines acute-on-chronic liver failure. It is associated with poor outcomes in cirrhosis but cannot be predicted accurately. We aimed to determine the admission metabolomic biomarkers able to predict the development of advanced HE with subsequent validation. METHODS: Prospective inpatient cirrhosis cohorts (multicenter and 2-center validation) without brain failure underwent admission serum collection and inpatient follow-up evaluation. Serum metabolomics were analyzed to predict brain failure on random forest analysis and logistic regression. A separate validation cohort also was recruited. RESULTS: The multicenter cohort included 602 patients, of whom 144 developed brain failure (105 only brain failure) 3 days after admission. Unadjusted random forest analysis showed that higher admission microbially derived metabolites and lower isoleucine, thyroxine, and lysophospholipids were associated with brain failure development (area under the curve, 0.87 all; 0.90 brain failure only). Logistic regression area under the curve with only clinical variables significantly improved with metabolites (95% CI 0.65-0.75; P = .005). Four metabolites that significantly added to brain failure prediction were low thyroxine and maltose and high methyl-4-hydroxybenzoate sulfate and 3-4 dihydroxy butyrate. Thyroxine alone also significantly added to the model (P = .05). The validation cohort including 81 prospectively enrolled patients, of whom 11 developed brain failure. Admission hospital laboratory thyroxine levels predicted brain failure development despite controlling for clinical variables with high specificity. CONCLUSIONS: In a multicenter inpatient cohort, admission serum metabolites, including thyroxine, predicted advanced HE development independent of clinical factors. Admission low local laboratory thyroxine levels were validated as a predictor of advanced HE development in a separate cohort.

Published
2023

5. Association of serum metabolites and gut microbiota at hospital admission with nosocomial infection development in patients with cirrhosis.

Author

Bajaj, Jasmohan, Reddy, K, Tandon, Puneeta, Garcia-Tsao, Guadalupe, Kamath, Patrick, OLeary, Jacqueline, Wong, Florence, Vargas, Hugo, Thuluvath, Paul, Subramanian, Ram, Pena-Rodriguez, Marcela, Sikaroodi, Masoumeh, Thacker, Leroy, Gillevet, Patrick, and Lai, Jennifer

Subjects
Humans, Cross Infection, Gastrointestinal Microbiome, End Stage Liver Disease, Severity of Illness Index, Liver Transplantation, Liver Cirrhosis, Fibrosis, Hospitals
Abstract

Cirrhosis is complicated by a high rate of nosocomial infections (NIs), which result in poor outcomes and are challenging to predict using clinical variables alone. Our aim was to determine predictors of NI using admission serum metabolomics and gut microbiota in inpatients with cirrhosis. In this multicenter inpatient cirrhosis study, serum was collected on admission for liquid chromatography-mass spectrometry metabolomics, and a subset provided stool for 16SrRNA analysis. Hospital course, including NI development and death, were analyzed. Metabolomic analysis using analysis of covariance (ANCOVA) (demographics, Model for End-Stage Liver Disease [MELD] admission score, white blood count [WBC], rifaximin, and infection status adjusted) and random forest analyses for NI development were performed. Additional values of serum metabolites over clinical variables toward NI were evaluated using logistic regression. Stool microbiota and metabolomic correlations were compared in patients with and without NI development. A total of 602 patients (231 infection admissions) were included; 101 (17%) developed NIs, which resulted in worse inpatient outcomes, including intensive care unit transfer, organ failure, and death. A total of 127 patients also gave stool samples, and 20 of these patients developed NIs. The most common NIs were spontaneous bacterial peritonitis followed by urinary tract infection, Clostridioides difficile, and pneumonia. A total of 247 metabolites were significantly altered on ANCOVA. Higher MELD scores (odds ratio, 1.05; p

Published
2022

6. Global prevalence and characteristics of infections and clinical outcomes in hospitalised patients with cirrhosis: a prospective cohort study for the CLEARED Consortium

Author

Kumar, Shiva, Gadano, Adrián, Marciano, Sebastián, Tudehope, Fiona, Prudence, Alexander, Gibson, Robert, Zekry, Amany, Doyle, Adam, Si, Hooi Ling, Kim, Yu Sung, Gofton, Cameron, Riordan, Stephen, MacQuillan, Gerry, Al-Tamimi, Hala, Michalczuk, Matheus, Farias, Alberto, Zitelli, Patricia, Pereira, Gustavo, Victor, Livia, Bera, Chinmay, Faisal, Nabiha, Dahiya, Monica, Tandon, Puneeta, Lohoues, Marie Jeanne, Lah, Ponan Claude Regis, Benítez, Carlos, Arrese, Marco, Guan, Jing, Xian, Yongchao, Zhu, Chuanwu, Wang, Yingling, Su, Man, Su, Minghua, Wang, Xinrui, Gao, Yanhang, Peng, Feng, Jiang, Yongfang, Zhao, Caiyan, Wang, Wei, Yin, Dedong, Wang, Lei, Lu, Mingqin, Cai, Yijing, Guo, Feng, Wang, Xiaozhong, Zhang, Ningping, Zhang, Wanqin, Dong, Fuchen, Li, Hai, Liu, Jing, Zheng, Xin, Tang, Hong, Yan, Libo, Xu, Bin, Wei, Linlin, Xu, Zhen, Gao, Zhiliang, Gao, Haibing, Lin, Minghua, Rao, Qunfang, Wu, Xiaoping, Li, Beiling, Chen, Jinjun, Liu, Chenghai, Zhang, Yanyun, Deng, Huan, Hu, Peng, Wang, Jian, Li, Jie, Bettinger, Dominik, Schultheiß, Michael, Belimi, Hibat Allah, Debzi, Nabil, Mostafa, Alaa, Fouad, Yasser, Fisseha, Henok, Venkatachalapathy, Suresh Vasan, Aravinthan, Aloysious D, Rajoriya, Neil, Faulkes, Rosemary, Leith, Damien, Forrest, Ewan, Danielle, Adebayo, Kennedy, James, Yung, Diana, Alexopoulou, Alexandra, Mani, Iliana, Fung, James, Katchman, Helena, Rabinowich, Liane, Jhaveri, Ajay, Nagral, Aabha, Kulkarni, Anand, Sharma, Mithun, Sarin, Shiv K, Goel, Ashish, Eapen, C E, Duseja, Ajay, Gandotra, Akash, Saraya, Anoop, yegurla, Jatin, Jothimani, Dinesh, Rela, Mohammad, Arora, Anil, Kumar, Ashish, Roy, Akash, Dhiman, R K, Anand, A C, Praharaj, Dibyalochan, Cabrera, Araceli Bravo, Hueso, Sarai Gonzalez, Hérnandez, José Luis Pérez, Gutierrez, Oscar Morales, Ramos-Pineda, Abraham, Zazueta, Godolfino Miranda, Barradas, Mauricio Castillo, Made, Lilian Torres, Velazquez, Rene Male, Félix-Tellez, Francisco, Velasco, José Antonio Velarde-Ruiz, Cordova-Gallardo, Jacqueline, Rajaram, Ruveena, Afendi, Nik Arsyad Nik Muhamad, Nyam, David P, Okeke, Edith N, Allam, Dalia, Patwa, Yashwi Haresh Kumar, Tan, Hiang Keat, Lun, Liou Wei, Ho, Wei Ling Danielle, Wong, Yu Jun, Thanapirom, Kessarin, Teerasarntipan, Tongluk, Haktaniyan, Busra, Gunduz, Feyza, Aslan, Rahmi, Yildirim, Abdullah Emre, Barutcu, Sezgin, Uysal, Alper, Karasu, Zeki, Ucbilek, Enver, Kosay, Tolga, Dinçer, Dinç, Adanır, Haydar, Albhaisi, Somaya, Fallahadeh, Mohammad Amin, Asrani, Sumeet, Reddy, K Rajender, Shaw, Jawaid, Vargas, Hugo, Filipek, Natalia, Biggins, Scott W, Thuluvath, Paul, Sheshadri, Somya, Wegermann, Kara, Kappus, Matthew, Keaveny, Andrew, Rojo, Andres, Negrillo, Ricardo Cabello, Verna, Elizabeth, Cao, Zhujun, Wong, Florence, Choudhury, Ashok K, Kamath, Patrick S, Topazian, Mark, Torre, Aldo, Hayes, Peter C, George, Jacob, Idilman, Ramazan, Seto, Wai-Kay, Desalegn, Hailemichael, Alvares-da-Silva, Mario Reis, Bush, Brian J, Thacker, Leroy R, Xie, Qing, and Bajaj, Jasmohan S

Published
2024
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11. The Classical and Nonclassical Renin-Angiotensin-Aldosterone System in Liver Cirrhosis

Author

Sansoè, Giovanni, Wong, Florence, Dhalla, Naranjan S., Series Editor, Bolli, Roberto, Editorial Board Member, Goyal, Ramesh, Editorial Board Member, Kartha, Chandrasekharan, Editorial Board Member, Kirshenbaum, Lorrie, Editorial Board Member, Makino, Naoki, Editorial Board Member, Mehta, Jawahar L. L., Editorial Board Member, Ostadal, Bohuslav, Editorial Board Member, Pierce, Grant N., Editorial Board Member, Slezak, Jan, Editorial Board Member, Varro, Andras, Editorial Board Member, Werdan, Karl, Editorial Board Member, Weglicki, William B., Editorial Board Member, Bhullar, Sukhwinder K., editor, and Tappia, Paramjit S., editor

Published
2023
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12. Admission Urinary and Serum Metabolites Predict Renal Outcomes in Hospitalized Patients With Cirrhosis

Author

Bajaj, Jasmohan S, Garcia‐Tsao, Guadalupe, Reddy, K Rajender, O’Leary, Jacqueline G, Vargas, Hugo E, Lai, Jennifer C, Kamath, Patrick S, Tandon, Puneeta, Subramanian, Ram M, Thuluvath, Paul, Fagan, Andrew, Sehrawat, Tejasav, de la Rosa Rodriguez, Randolph, Thacker, Leroy R, and Wong, Florence

Subjects
Digestive Diseases, Clinical Research, Chronic Liver Disease and Cirrhosis, Liver Disease, Kidney Disease, Renal and urogenital, Acute Kidney Injury, Aged, Biomarkers, End Stage Liver Disease, Female, Humans, Liver Cirrhosis, Male, Metabolomics, Middle Aged, Patient Admission, Prognosis, Prospective Studies, Renal Dialysis, Risk Assessment, Medical Biochemistry and Metabolomics, Clinical Sciences, Immunology, Gastroenterology & Hepatology
Abstract

Background and aimsAcute kidney injury (AKI) has a poor prognosis in cirrhosis. Given the variability of creatinine, the prediction of AKI and dialysis by other markers is needed. The aim of this study is to determine the role of serum and urine metabolomics in the prediction of AKI and dialysis in an inpatient cirrhosis cohort.Approach and resultsInpatients with cirrhosis from 11 North American Consortium of End-stage Liver Disease centers who provided admission serum/urine when they were AKI and dialysis-free were included. Analysis of covariance adjusted for demographics, infection, and cirrhosis severity was performed to identify metabolites that differed among patients (1) who developed AKI or not; (2) required dialysis or not; and/pr (3) within AKI subgroups who needed dialysis or not. We performed random forest and AUC analyses to identify specific metabolite(s) associated with outcomes. Logistic regression with clinical variables with/without metabolites was performed. A total of 602 patients gave serum (218 developed AKI, 80 needed dialysis) and 435 gave urine (164 developed AKI, 61 needed dialysis). For AKI prediction, clinical factor-adjusted AUC was 0.91 for serum and 0.88 for urine. Major metabolites such as uremic toxins (2,3-dihydroxy-5-methylthio-4-pentenoic acid [DMTPA], N2N2dimethylguanosine, uridine/pseudouridine) and tryptophan/tyrosine metabolites (kynunerate, 8-methoxykyunerate, quinolinate) were higher in patients who developed AKI. For dialysis prediction, clinical factor-adjusted AUC was 0.93 for serum and 0.91 for urine. Similar metabolites as AKI were altered here. For dialysis prediction in those with AKI, the AUC was 0.81 and 0.79 for serum/urine. Lower branched-chain amino-acid (BCAA) metabolites but higher cysteine, tryptophan, glutamate, and DMTPA were seen in patients with AKI needing dialysis. Serum/urine metabolites were additive to clinical variables for all outcomes.ConclusionsSpecific admission urinary and serum metabolites were significantly additive to clinical variables to predict AKI development and dialysis initiation in inpatients with cirrhosis. These observations can potentially facilitate earlier initiation of renoprotective measures.

Published
2021

15. Use of albumin infusion for cirrhosis-related complications: An international position statement

Author

Bai, Zhaohui, Méndez-Sánchez, Nahum, Romeiro, Fernando Gomes, Mancuso, Andrea, Philips, Cyriac Abby, Tacke, Frank, Basaranoglu, Metin, Primignani, Massimo, Ibrahim, Mostafa, Wong, Yu Jun, Nery, Filipe Gaio, Teschke, Rolf, Ferreira, Carlos Noronha, Muñoz, Alberto E., Pinyopornpanish, Kanokwan, Thevenot, Thierry, Singh, Shivaram Prasad, Mohanty, Arpan, Satapathy, Sanjaya K., Ridola, Lorenzo, Maruyama, Hitoshi, Cholongitas, Evangelos, Levi Sandri, Giovanni Battista, Yang, Li, Shalimar, Yang, Yongping, Villa, Erica, Krag, Aleksander, Wong, Florence, Jalan, Rajiv, O’Brien, Alastair, Bernardi, Mauro, and Qi, Xingshun

Published
2023
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17. Global disparities in mortality and liver transplantation in hospitalised patients with cirrhosis: a prospective cohort study for the CLEARED Consortium

Author

Sarin, Shiv K, Kumar, Shiva, Marciano, Sebastián, Gadano, Adrián, Tudehope, Fiona, Gibson, Robert, Prudence, Alexander, Doyle, Adam, Si, Hooi Ling, Riordan, Stephen, Farias, Alberto, Zitelli, Patricia, Bera, Chinmay, Faisal, Nabiha, Tandon, Puneeta, Dahiya, Monica, Lohoues, Marie Jeanne, Lah, Ponan Claude Regis, Benítez, Carlos, Arrese, Marco, Xian, Yongchao, Guan, Jin, Zhu, Chuanwu, Wang, Yingling, Su, Minghua, Su, Man, Gao, Yanhang, Wang, Xinrui, Jiang, Yongfang, Peng, Feng, Zhao, Caiyan, Wang, Wei, Wang, Lei, Yin, Dedong, Lu, Mingqin, Cai, Yijing, Zhang, Ningping, Zhang, Wanqin, Li, Hai, Dong, Fuchen, Zheng, Xin, Liu, Jing, Tang, Hong, Yan, Libo, Xu, Bin, Wei, Linlin, Gao, Zhiliang, Xu, Zhen, Lin, Minghua, Gao, Haibin, Chen, Jinjun, Li, Beiling, Liu, Chenghai, Zhang, Yanyun, Hu, Peng, Deng, Huan, Belimi, Hibat Allah, Debzi, Nabil, Fisseha, Henok, Aravinthan, Aloysious D, Venkatachalapathy, Suresh Vasan, Rajoriya, Neil, Faulkes, Rosemary, Leith, Damien, Forrest, Ewan, Adebayo, Danielle, Kennedy, James, Yung, Diana, Seto, Wai-Kay, Fung, James, Katchman, Helena, Rabinowich, Liane, Nagral, Aabha, Jhaveri, Ajay, Kulkarni, Anand, Sharma, Mithun, Eapen, C E, Goel, Ashish, Gandotra, Akash, Duseja, Ajay, Saraya, Anoop, Yegurla, Jatin, Rela, Mohamed, Jothimani, Dinesh, Arora, Anil, Kumar, Ashish, Dhiman, Radha Krishan, Roy, Akash, Anand, Anil C, Praharaj, Dibyalochan, Hueso, Sarai Gonzalez, Cabrera, Araceli Bravo, Pérez Hérnandez, José Luis, Gutierrez, Oscar Morales, Miranda Zazueta, Godolfino, Ramos-Pineda, Abraham, Castillo Barradas, Mauricio, Velazquez, Rene Male, Made, Lilian Torres, Velarde-Ruiz Velasco, José Antonio, Félix-Tellez, Francisco, Cordova-Gallardo, Jacqueline, Rajaram, Ruveena, Nik Muhamad Afendi, Nik Arsyad, Okeke, Edith N, Nyam, David P, Allam, Dalia, Kumar Patwa, Yashwi Haresh, Tan, Hiang Keat, Liou, Wei Lun, Treeprasertsuk, Sombat, Wejnaruemarn, Salisa, Haktaniyan, Busra, Gunduz, Feyza, Aslan, Rahmi, Yildirim, Abdullah Emre, Barutcu, Sezgin, Karasu, Zeki, Uysal, Alper, Ucbilek, Enver, Kosay, Tolga, Adanir, Haydar, Dinçer, Dinç, Albhaisi, Somaya, Asrani, Sumeet, Fallahadeh, Mohammad Amin, Reddy, K Rajender, Rahematpura, Suditi, Shaw, Jawaid, Vargas, Hugo E., Bayne, David, Biggins, Scott W, Filipek, Natalia, Thuluvath, Paul, Sheshadri, Somya, Keaveny, Andrew, Duarte Rojo, Andres, Cabello Negrillo, Ricardo, Bajaj, Jasmohan S, Choudhury, Ashok K, Xie, Qing, Kamath, Patrick S, Topazian, Mark, Hayes, Peter C, Torre, Aldo, Desalegn, Hailemichael, Idilman, Ramazan, Cao, Zhujun, Alvares-da-Silva, Mario R, George, Jacob, Bush, Brian J, Thacker, Leroy R, and Wong, Florence

Published
2023
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18. Role of Oral Health, Frailty, and Minimal Hepatic Encephalopathy in the Risk of Hospitalization: A Prospective Multi-Center Cohort of Outpatients With Cirrhosis

Author

Bajaj, Jasmohan S., Lai, Jennifer C., Tandon, Puneeta, O’Leary, Jacqueline G., Wong, Florence, Garcia-Tsao, Guadalupe, Vargas, Hugo E., Kamath, Patrick S., Biggins, Scott W., Limon-Miro, Ana, Shaw, Jawaid, Mbachi, Chimezie, Chew, Michael, Golob Deeb, Janina, Thacker, Leroy R., and Reddy, K. Rajender

Published
2023
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19. Serum Levels of Metabolites Produced by Intestinal Microbes and Lipid Moieties Independently Associated With Acute-on-Chronic Liver Failure and Death in Patients With Cirrhosis

Author

Bajaj, Jasmohan S, Reddy, K Rajender, O'Leary, Jacqueline G, Vargas, Hugo E, Lai, Jennifer C, Kamath, Patrick S, Tandon, Puneeta, Wong, Florence, Subramanian, Ram M, Thuluvath, Paul, Fagan, Andrew, White, Melanie B, Gavis, Edith A, Sehrawat, Tejasav, de la Rosa Rodriguez, Randolph, Thacker, Leroy R, Sikaroodi, Masoumeh, Garcia-Tsao, Guadalupe, and Gillevet, Patrick M

Subjects
Medical Biochemistry and Metabolomics, Biomedical and Clinical Sciences, Clinical Sciences, Liver Disease, Clinical Research, Digestive Diseases, Chronic Liver Disease and Cirrhosis, Oral and gastrointestinal, Good Health and Well Being, Acute-On-Chronic Liver Failure, Adult, Aged, Bacteria, Biomarkers, Databases, Factual, Feces, Female, Gastrointestinal Microbiome, Hospital Mortality, Humans, Lipidomics, Lipids, Liver Cirrhosis, Male, Metabolomics, Middle Aged, North America, Patient Admission, Predictive Value of Tests, Prognosis, Prospective Studies, Risk Assessment, Risk Factors, Time Factors, Tryptophan, Estrone, Sepsis, Neurosciences, Paediatrics and Reproductive Medicine, Gastroenterology & Hepatology, Clinical sciences, Nutrition and dietetics
Abstract

Background & aimsInpatients with cirrhosis have high rates of acute-on-chronic failure (ACLF) development and high mortality within 30 days of admission to the hospital. Better biomarkers are needed to predict these outcomes. We performed metabolomic analyses of serum samples from patients with cirrhosis at multiple centers to determine whether metabolite profiles might identify patients at high risk for ACLF and death.MethodsWe performed metabolomic analyses, using liquid chromatography, of serum samples collected at time of admission to 12 North American tertiary hepatology centers from 602 patients in the North American Consortium for the Study of End-Stage Liver Disease sites from 2015 through 2017 (mean age, 56 years; 61% men; mean model for end-stage liver disease score, 19.5). We performed analysis of covariance, adjusted for model for end-stage liver disease at time of hospital admission, serum levels of albumin and sodium, and white blood cell count, to identify metabolites that differed between patients who did vs did not develop ACLF and patients who did vs did not die during hospitalization and within 30 days. We performed random forest analysis to identify specific metabolite(s) that were associated with outcomes and area under the curve (AUC) analyses to analyze them in context of clinical parameters. We analyzed microbiomes of stool samples collected from 133 patients collected at the same time and examined associations with serum metabolites.ResultsOf the 602 patients analyzed, 88 developed ACLF (15%), 43 died in the hospital (7%), and 72 died within 30 days (12%). Increased levels of compounds of microbial origin (aromatic compounds, secondary or sulfated bile acids, and benzoate) and estrogen metabolites, as well as decreased levels of phospholipids, were associated with development of ACLF, inpatient, and 30-day mortality and were also associated with fecal microbiomes. Random forest analysis and logistic regression showed that levels of specific microbially produced metabolites identified patients who developed ACLF with an AUC of 0.84 (95% confidence interval [CI] 0.78-0.88; P = .001), patients who died while in the hospital with an AUC of 0.81 (95% CI 0.74-0.85; P = .002), and patients who died within 30 days with an AUC of 0.77 (95% CI 0.73-0.81; P = .02). The metabolites were significantly additive to clinical parameters for predicting these outcomes. Metabolites associated with outcomes were also correlated with microbiomes of stool samples.ConclusionsIn an analysis of serum metabolites and fecal microbiomes of patients hospitalized with cirrhosis at multiple centers, we associated metabolites of microbial origin and lipid moieties with development of ACLF and death as an inpatient or within 30 days, after controlling for clinical features.

Published
2020

21. List of contributors

Author

Abraldes, Juan Gonzalez, primary, Altieri, Mario, additional, Arroyo, Vicente, additional, Attia, Dina, additional, Baiges, Anna, additional, Baik, Soon Koo, additional, Betancourt, Fabian, additional, Chadha, Ryan, additional, Chahal, Daljeet, additional, Chen, Po-Hung, additional, Desai, Moreshwar S., additional, Doycheva, Iliana, additional, Fernandez, Javier, additional, Fouad, Yasser, additional, García-Pagán, Juan Carlos, additional, Gorgis, Noelle, additional, Gurram, Harini, additional, Hernández-Gea, Virginia, additional, Iqbal, Shaz, additional, Izzy, Manhal, additional, Jo, Jennifer, additional, Kang, Seong Hee, additional, Khalifa, Rofida, additional, Koseki, Masahiro, additional, Kuwabara, Masanari, additional, Lee, Samuel S., additional, Lisman, Ton, additional, Liu, Hongqun, additional, Luo, Xuefeng, additional, Magaz, Marta, additional, Marquez, Vladimir, additional, Moreau, Richard, additional, Nicoar-Farcu, Oana, additional, Niwa, Koichiro, additional, Okada, Atsushi, additional, Pollak, P. Timothy, additional, Saito, Yuki, additional, Singu, Bonifasius S., additional, Soy, Guillem, additional, Taniguchi, Tatsunori, additional, Turon, Fanny, additional, Valérie, Paradis, additional, VanWagner, Lisa B., additional, Verbeeck, Roger K., additional, Watt, Kymberly D., additional, Wong, Florence, additional, and Wray, Christopher L., additional

Published
2023
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25. THU-060 Lower inpatient mortality and second infections in inpatients with cirrhosis managed between 2021–22 than between 2011–13 in prospective North American cohorts

Author

Bajaj, Jasmohan, primary, Tandon, Puneeta, additional, Thuluvath, Paul J., additional, Wong, Florence, additional, Kamath, Patrick S., additional, Vargas, Hugo, additional, Asrani, Sumeet, additional, O'Leary, Jacqueline, additional, Thacker, Leroy, additional, and Reddy, K. Rajender, additional

Published
2024
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26. FRI-088 Patterns and predictors of postacute discharge location other than home in a global cohort of 3, 678 patients hospitalized with cirrhosis

Author

Seto, Wai-Kay, primary, Xie, Qing, additional, Kumar Choudhury, Ashok, additional, Kamath, Patrick S., additional, Topazian, Mark, additional, Hayes, Peter, additional, Torre, Aldo, additional, Desalegn, Hailemichael, additional, Idilman, Ramazan, additional, Cao, Zhujun, additional, Álvares-da-Silva, Mario, additional, George, Jacob, additional, Wong, Florence, additional, Bush, Brian, additional, Thacker, Leroy, additional, Kumar Sarin, Shiv, additional, Mani, Iliana, additional, Dincer, Dinc, additional, van Doorn, Diederick, additional, Sonavane, Amey, additional, Amin Fallahzadeh, Mohammad, additional, Wei, Linlin, additional, Bravo Cabrera, Araceli, additional, Goel, Ashish, additional, Ponan Claude Regis Lah, Ponan, additional, Kumar, Shiva, additional, Jun Wong, Yu, additional, Jothimani, Dinesh, additional, Robert Kappus, Matthew, additional, Emre Yıldırım, Abdullah, additional, H Forrest, Ewan, additional, Félix Tellez, Francisco, additional, Momoyo Zitelli, Patricia, additional, Barbero, Manuel, additional, Luis Pérez-Hernández, José, additional, Marciano, Sebastián, additional, Malé Velazquez, René, additional, Jhaveri, Ajay, additional, Gibson, Robert, additional, Chandra Anand, Anil, additional, Kayes, Tahrima, additional, Gunduz, Feyza, additional, Bayne, David, additional, Lin, Minghua, additional, Ucbilek, Enver, additional, Debzi, Nabil, additional, Wang, Jian, additional, Haresh Kumar Patwa, Yashwi, additional, Kumar Duseja, Ajay, additional, Arrese, Marco, additional, Faulkes, Rosemary, additional, Kennedy, James, additional, Sung Kim, Yu, additional, Krishan Dhiman, Radha, additional, Li, Hai, additional, Yin, Dedong, additional, Zhang, Yanyun, additional, MacQuillan, Gerry, additional, Kumar, Ashish, additional, Katchman, Helena, additional, Wang, Yingling, additional, Rao, Qunfang, additional, Cai, Yijing, additional, Wu, Liyang, additional, Jiang, Yongfang, additional, Xu, Zhen, additional, Xian, Yongchao, additional, Bettinger, Dominik, additional, Dahiya, Monica, additional, Faisal, Nabiha, additional, Rojo Andres, Duarte, additional, Filipek, Natalia, additional, Tudehope, Fiona, additional, Zhang, Wanqin, additional, and Bajaj, Jasmohan, additional

Published
2024
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27. SAT-082 A phase 2 study of OCE-205, a novel, selective vasopressin receptor mixed agonist-antagonist: positive proof-of-concept established in subjects with cirrhosis and hepatorenal syndromeacute kidney injury (HRS-AKI)

Author

Allegretti, Andrew S., primary, Bajaj, Jasmohan, additional, Bari, Khurram, additional, Brown, Robert S., additional, Cullaro, Giuseppe, additional, Ganger, Daniel, additional, Hassanein, Tarek, additional, Kemmer, Nyingi, additional, Khemichian, Saro, additional, Yien Kwo, Paul, additional, Lim, Nicholas, additional, Naqvi, Hasan, additional, Patidar, Kavish, additional, Pyrsopoulos, Nikolaos T., additional, Rahimi, Robert S., additional, Rockey, Don, additional, Sanyal, Arun J., additional, Shetty, Kirti, additional, Simonetto, Douglas, additional, Stein, Lance, additional, Vargas, Hugo, additional, Zamor, Philippe, additional, Bernstein, David, additional, Kjems, Lise, additional, Lam, Jason, additional, Reid, Susan, additional, and Wong, Florence, additional

Published
2024
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28. FRI-086 Untargeted serum metabolomic profiles remain stable over time in large multi-center cohort of >700 outpatients with cirrhosis

Author

Bajaj, Jasmohan, primary, Tandon, Puneeta, additional, Lai, Jennifer, additional, O'Leary, Jacqueline, additional, Garcia-Tsao, Guadalupe, additional, Vargas, Hugo, additional, Biggins, Scott, additional, Wong, Florence, additional, Kamath, Patrick S., additional, Lugon, Nicolas, additional, Limon-Miro, Ana, additional, Shaw, Jawaid, additional, Bush, Brian, additional, and Rajender Reddy, K., additional

Published
2024
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29. FRI-046 Alfapump implantation significantly improved quality of life and showed similar safety outcomes compared to a contemporaneously enrolled refractory ascites cohort

Author

Bajaj, Jasmohan, primary, Kamath, Patrick S., additional, Rajender Reddy, K., additional, Tandon, Puneeta, additional, Lai, Jennifer, additional, O'Leary, Jacqueline, additional, Klarenbeek, Gijs, additional, Capel, Jeroen, additional, Biggins, Scott, additional, Vargas, Hugo, additional, Garcia-Tsao, Guadalupe, additional, Thacker, Leroy, additional, and Wong, Florence, additional

Published
2024
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31. Nosocomial Infections Are Frequent and Negatively Impact Outcomes in Hospitalized Patients With Cirrhosis.

Author

Bajaj, Jasmohan S, OʼLeary, Jacqueline G, Tandon, Puneeta, Wong, Florence, Garcia-Tsao, Guadalupe, Kamath, Patrick S, Biggins, Scott W, Lai, Jennifer C, Vargas, Hugo E, Maliakkal, Benedict, Fallon, Michael B, Thuluvath, Paul J, Subramanian, Ram M, Thacker, Leroy R, and Reddy, K Rajender

Subjects
Medical Microbiology, Biomedical and Clinical Sciences, Clinical Sciences, Liver Disease, Chronic Liver Disease and Cirrhosis, Infectious Diseases, Digestive Diseases, Infection, Oral and gastrointestinal, Good Health and Well Being, Adult, Age Distribution, Aged, Cause of Death, Cohort Studies, Cross Infection, End Stage Liver Disease, Female, Hospital Mortality, Hospitalization, Humans, Incidence, Liver Function Tests, Male, Middle Aged, Prognosis, Prospective Studies, Reference Values, Risk Assessment, Sex Distribution, Treatment Outcome, Gastroenterology & Hepatology, Clinical sciences
Abstract

ObjectivesNosocomial infections (NIs) can be a major cause of morbidity and mortality in cirrhosis. This study aims to define the determinants of NI development and its impact on 30-day outcomes among hospitalized patients with cirrhosis.MethodsNorth American Consortium for the Study of End-Stage Liver Disease enrolled patients with cirrhosis who were admitted nonelectively. Admission variables and 30-day outcomes were compared between patients with and without NI. These were also compared based on whether there was an isolated admission infection, NI, or both. Models were created for NI development using admission variables and for 30-day mortality.ResultsThe study included 2,864 patients; of which, 15% (n = 436) developed NI. When comparing NI vs no NI, 1,866 patients were found to be infection free, whereas 562 had admission infections only, 228 had only NI, and 208 had both infections. At admission, patients with NI were more likely to be infected and have advanced cirrhosis. NIs were associated with higher rates of acute-on-chronic liver failure, death, and transplant regardless of admission infections. Patients with NI had higher respiratory infection, urinary tract infection, Clostridium difficile infection, fungal infections, and infection with vancomycin-resistant enterococci compared with patients without NI. Risk factors for NIs were admission infections, model for end-stage liver disease (MELD) > 20, systemic inflammatory response syndrome criteria, proton pump inhibitor, rifaximin, and lactulose use, but the regression model (sensitivity, 0.67; specificity, 0.63) was not robust. Age, alcohol etiology, admission MELD score, lactulose use, acute-on-chronic liver failure, acute kidney injury, intensive care unit, and NI increased the risk of death, whereas rifaximin decreased the risk of death.DiscussionNIs are prevalent in hospitalized patients with cirrhosis and are associated with poor outcomes. Although higher MELD scores and systemic inflammatory response syndrome are associated with NI, all hospitalized patients with cirrhosis require vigilance and preventive strategies.

Published
2019

32. Impact of Chronic Kidney Disease on Outcomes in Cirrhosis.

Author

Wong, Florence, Reddy, K, OLeary, Jacqueline, Tandon, Puneeta, Biggins, Scott, Garcia-Tsao, Guadalupe, Maliakkal, Benedict, Fallon, Michael, Vargas, Hugo, Subramanian, Ram, Thuluvath, Paul, Kamath, Patrick, Thacker, Leroy, Bajaj, Jasmohan, and Lai, Jennifer

Subjects
Acute Kidney Injury, Acute-On-Chronic Liver Failure, Adult, Aged, Comorbidity, End Stage Liver Disease, Female, Hospital Mortality, Humans, Liver Cirrhosis, Liver Transplantation, Male, Middle Aged, Patient Admission, Patient Selection, Prevalence, Prognosis, Prospective Studies, Renal Insufficiency, Chronic
Abstract

We hypothesize that the prevalence of chronic kidney disease (CKD) among patients with cirrhosis has increased due to the increased prevalence of CKD-associated comorbidities, such as diabetes. We aimed to assess the characteristics of hospitalized patients with cirrhosis with CKD and its impact on renal and patient outcomes. The North American Consortium for the Study of End-Stage Liver Disease (NACSELD) prospectively enrolled nonelectively admitted patients with cirrhosis and collected data on demographics, laboratory results, in-hospital clinical course, and postdischarge 3-month outcomes. CKD positive (CKD+) patients, defined as having an estimated glomerular filtration rate (eGFR; Modification of Diet in Renal Disease-4 variable formula) of ≤60 mL/minute for >3 months, were compared with chronic kidney disease negative (CKD-) patients for development of organ failures, hospital course, and survival. There were 1099 CKD+ patients (46.8% of 2346 enrolled patients) who had significantly higher serum creatinine (2.21 ± 1.33 versus 0.83 ± 0.21 mg/dL in the CKD- group) on admission, higher prevalence of nonalcoholic steatohepatitis cirrhosis etiology, diabetes, refractory ascites, and hospital admissions in the previous 6 months compared with the CKD- group (all P

Published
2019

33. Targets to improve quality of care for patients with hepatic encephalopathy: data from a multi‐centre cohort

Author

Bajaj, Jasmohan S, O’Leary, Jacqueline G, Tandon, Puneeta, Wong, Florence, Kamath, Patrick S, Biggins, Scott W, Garcia‐Tsao, Guadalupe, Lai, Jennifer, Fallon, Michael B, Thuluvath, Paul J, Vargas, Hugo E, Maliakkal, Benedict, Subramanian, Ram M, Thacker, Leroy R, and Reddy, K Rajender

Subjects
Digestive Diseases, Liver Disease, Clinical Research, Aged, Cohort Studies, Drug Therapy, Combination, End Stage Liver Disease, Female, Gastrointestinal Agents, Hepatic Encephalopathy, Humans, Lactulose, Liver Cirrhosis, Male, Middle Aged, Quality of Health Care, Recurrence, Rifaximin, Clinical Sciences, Pharmacology and Pharmaceutical Sciences, Gastroenterology & Hepatology
Abstract

BackgroundHepatic encephalopathy (HE) can adversely affect outcomes in both in-patients and out-patients with cirrhosis.AimTo define targets for improving quality of care in HE management in the multi-centre North American Consortium for End-Stage Liver Disease (NACSELD) cohort.MethodNACSELD in-patient cohort was analysed for (a) medication-associated precipitants, (b) aspiration pneumonia development, (c) HE medication changes, and (d) 90-day HE recurrence/readmissions. Comparisons were made between patients on no-therapy, lactulose only, rifaximin only or both. Ninety-day HE-readmission analysis was adjusted for MELD score.ResultsTwo thousand eight hundred and ten patients (1102 no-therapy, 659 lactulose, 154 rifaximin, 859 both) were included. HE on admission, and HE rates during hospitalisation were highest in those on lactulose only or dual therapy compared to no-therapy or rifaximin only (P

Published
2019

34. Outcomes After Listing for Liver Transplant in Patients With Acute-on-Chronic Liver Failure: The Multicenter North American Consortium for the Study of End-Stage Liver Disease Experience.

Author

OLeary, Jacqueline, Bajaj, Jasmohan, Tandon, Puneeta, Biggins, Scott, Wong, Florence, Kamath, Patrick, Garcia-Tsao, Guadalupe, Maliakkal, Benedict, Fallon, Michael, Vargas, Hugo, Thuluvath, Paul, Subramanian, Ram, Thacker, Leroy, Reddy, K, and Lai, Jennifer

Subjects
Acute Kidney Injury, Acute-On-Chronic Liver Failure, Adult, Disease Progression, End Stage Liver Disease, Female, Hospital Mortality, Hospitalization, Humans, Liver Cirrhosis, Liver Transplantation, Male, Middle Aged, North America, Prospective Studies, Renal Dialysis, Severity of Illness Index, Survival Rate, Time-to-Treatment, Waiting Lists
Abstract

Acute-on-chronic liver failure (ACLF) characterized with ≥2 extrahepatic organ failures in cirrhosis carries a high mortality. Outcomes of patients listed for liver transplantation (LT) after ACLF and after LT are largely unknown. The North American Consortium for the Study of End-Stage Liver Disease prospectively enrolled 2793 nonelectively hospitalized patients with cirrhosis; 768 were listed for LT. Within 3 months, 265 (35%) received a LT, 395 remained alive without LT, and 108 died/delisted. Compared with nonlisted patients, those listed were younger and more often had ACLF, acute kidney injury, and a higher admission Model for End-Stage Liver Disease (MELD) score. ACLF was most common in patients who died/delisted, followed by those alive with and without LT respectively, (30%, 22%, and 7%, respectively; P

Published
2019

35. Outcomes in Patients With Cirrhosis on Primary Compared to Secondary Prophylaxis for Spontaneous Bacterial Peritonitis.

Author

Bajaj, Jasmohan S, Tandon, Puneeta, OʼLeary, Jacqueline G, Wong, Florence, Biggins, Scott W, Garcia-Tsao, Guadalupe, Kamath, Patrick S, Maliakkal, Benedict, Fallon, Michael B, Lai, Jennifer C, Thuluvath, Paul J, Vargas, Hugo E, Subramanian, Ram M, Thacker, Leroy R, and Reddy, K Rajender

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Digestive Diseases, Clinical Research, Chronic Liver Disease and Cirrhosis, Liver Disease, Prevention, Patient Safety, Good Health and Well Being, Antibiotic Prophylaxis, Bacterial Infections, Biomarkers, Female, Humans, Liver Cirrhosis, Male, Middle Aged, North America, Peritonitis, Primary Prevention, Registries, Retrospective Studies, Secondary Prevention, Gastroenterology & Hepatology, Clinical sciences
Abstract

ObjectivesAntibiotic prophylaxis is recommended for prevention of the first episode of spontaneous bacterial peritonitis (SBP; primary prophylaxis 1°) and subsequent episodes (secondary prophylaxis 2°). We aimed to compare outcomes in cirrhotic inpatients on 1° vs 2° SBP prophylaxis.MethodsData from North American Consortium for the Study of End-Stage Liver Disease were evaluated for cirrhosis details, reasons for admission/medications, inpatient course recorded, and outcomes over 90 days. Outcomes (intensive care units, acute kidney injury, inpatient/90-day mortality) were compared between the 2 groups after propensity-matching on admission model for end-stage liver disease (MELD) score and serum albumin.ResultsAmong the 2,731 patients enrolled, 305 were on 1° and 187 on 2° SBP prophylaxis. After propensity-matching, 154 patients remained in each group. Patients on 1° prophylaxis were more likely to have admission systemic inflammatory response syndrome (P = 0.02), with higher intensive care unit admissions (31% vs 21%; P = 0.05) and inpatient mortality (19% vs 9%; P = 0.01) than the 2° prophylaxis group. Patients on 2° prophylaxis had higher total (22% vs 10%; P = 0004), readmission (16% vs 9%; P = 0.03), and nosocomial (6% vs 0.5%; P = 0.01) SBP rates with predominant Gram-negative organisms compared to 1° prophylaxis patients. At 90 days, 1° prophylaxis patients had a higher mortality (35% vs 22%; P = 0.02) and acute kidney injury incidence (48% vs 30%; P = 0.04) compared to 2° prophylaxis patients.DiscussionIn this inpatient cirrhosis study, despite prophylaxis, a high proportion of patients developed SBP, which was associated with mortality. Cirrhotic inpatients on 1° prophylaxis had worse outcomes than those on 2° prophylaxis when propensity-matched for the MELD score and serum albumin during the index admission and 90-day follow-up.

Published
2019

36. Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Author

Knight, Stephen R, Shaw, Catherine A, Pius, Riinu, Drake, Thomas M, Norman, Lisa, Ademuyiwa, Adesoji O, Adisa, Adewale O, Aguilera, Maria Lorena, Al-Saqqa, Sara W, Al-Slaibi, Ibrahim, Bhangu, Aneel, Biccard, Bruce M, Brocklehurst, Peter, Costas-Chavarri, Ainhoa, Chu, Kathryn, Dare, Anna, Elhadi, Muhammed, Fairfield, Cameron J, Fitzgerald, J Edward, Ghosh, Dhruv, Glasbey, James, van Berge Henegouwen, Mark I., Ingabire, J.C. Allen, Kingham, T Peter, Lapitan, Marie Carmela, Lawani, Ismaïl, Lieske, Bettina, Lilford, Richard, Martin, Janet, McLean, Kenneth A, Moore, Rachel, Morton, Dion, Nepogodiev, Dmitri, Ntirenganya, Faustin, Pata, Francesco, Pinkney, Thomas, Qureshi, Ahmad Uzair, Ramos-De la Medina, Antonio, Riad, Aya, Salem, Hosni Khairy, Simões, Joana, Spence, Richard, Smart, Neil, Tabiri, Stephen, Thomas, Hannah, Weiser, Thomas G, West, Malcolm, Whitaker, John, Harrison, Ewen M, Gjata, Arben, Modolo, Maria Marta, King, Sebastian, Chan, Erick, Nahar, Sayeda Nazmun, Waterman, Ade, Vervoort, Dominique, Bedada, Alemayehu Ginbo, De Azevedo, Bernardo, Figueiredo, Ana Gabriela, Sokolov, Manol, Barendegere, Venerand, Ekwen, Gerald, Agarwal, Arnav, Liu, Qinyang, Camilo Correa, Juan, Malemo, Kalisya Luc, Bake, Jacques, Mihanovic, Jakov, Kunčarová, Kamila, Orhalmi, Julius, Salem, Hosni, Teras, Jyri, Kechagias, Aristotelis, Arnaud, Alexis P, Lindert, Judith, Kalles, Vasileios, Aguilera-Arevalo, Maria-Lorena, Recinos, Gustavo, Baranyai, Zsolt, Kumar, Basant, Neelamraju Lakshmi, Harish, Zachariah, Sanoop Koshy, Alexander, Philip, Kumar Venkatappa, Sunil, Pramesh, C, Amandito, Radhian, Fleming, Christina, Ansaloni, Luca, Pellino, Gianluca, Altibi, Ahmed M., Nour, Ibrahim, Hamdun, Intisar, Ghellai, Ali M., Venskutonis, Donatas, Poskus, Tomas, Zilinskas, Justas, Malemia, Precious, Tew, Yong Yong, Borg, Elaine, Ellul, Sarah, Wafqui, fatima Zahraa, Borowski, David W, van Dalen, Anne Sophie, Wells, Cameron, Adamou, Harissou, Ademuyiwa, Adesoji, Adisa, Adewale, Søreide, Kjetil, Al Saqqa, Sara, Alser, Osaid, Tahboub, Haya, Segovia Lohse, Helmut Alfredo, Shu Yip, Sebastian, Major, Piotr, Sampaio Soares, António, Bratu, Matei Razvan, Litvin, Andrey, Vardanyan, Armen, Allen Ingabire, JC, Gudal, Ahmad, Albati, Naif, Juloski, Jovan, Rems, Miran, Rayne, Sarah, Van Straten, Stephanie, Moodley, Yoshan, Ortega Vázquez, Irene, Ruiz-Tovar, Jaime, Senanayake, Kithsiri Janakantha, Thalgaspitiya, Sujeewa Priyantha Bandara, Omer, Omer Abdelbagi, Homeida, Anmar, Cengiz, Yucel, Clerc, Daniel, Alshaar, Muhammad, Bouaziz, Hanen, Altinel, Yuksel, Doe, Matthew, Freigofer, Maryna, Teasdale, Ella, Kabariti, Rakan, Clements, Joshua Michael, Knight, Stephen Richard, Ashfaq, Ahsan, Azodo, Ijeoma, Wagner, Gabriela, Trostchansky, Ivan, Maimbo, Mayaba, Linyama, David, Nina, Helidon, Zeko, Amanda, Fermani, Claudio Gabriel, Villalobos, Santiago, Carballo, Federico, Farina, Pablo, Guckenheimer, Sebastian, Dickfos, Marilla, Ajmera, Ankit, Chong, Chester, Gourlay, Ralph, Hussaini, Sikandar, Lee, Yi Jia, Majid, Adeeb, Martin, Peter, Miles, Rebecca, Morris, Owen James, Phua, Jamie, Ridley, William, Saluja, Tarunpreet, Tan, Ryan Renxin, Teh, Jen, Wells, Anna, Arora, Bharti, Dollie, Qaasim, Ho, Debbie, Ma, Yanru, Perera, Omattage Mahasha, Truong, Anthony, Dawson, Amanda Caroline, Lim, Bryan, Pahalawatta, Upuli, Phan, Jacqueline, Woon-Shoo-Tong, Xiao-Ming Sarah, Yeoh, Andrea, Charman, Lillian, Drane, Andrew, Laura, Sharon, Lo, Charmaine Chu Wen, Mozes, Amy, Poon, Rita, Tan, Hao Han, Wall, Ellen, Chopra, Prakshi, De Giovanni, Jasmine, Dhital, Bal, Draganic, Brian, Duller, Alexander, Gani, Jonathan, Goh, Yao Kuan, Jeong, Jun Young, McManus, Brendan, Nagappan, Prakash, Pockney, Peter, Rugendyke, Anya, Sarrami, Mahsa, Smith, Stephen, Wills, Vanessa, Wong, Hsu Ven, Ye, Geoffrey, Zhang, Geoffrey, Brooker, Ethan, Feng, Daniel, Lau, Bonnie, Ngai, Carlin, Birks, Sarah, Gyorki, David, Otero de Pablos, Jaime, Abbosh, Ali, Gillespie, Chris, Mahmoud, Ahmed, Kwan, Bianca, Lawson, Joshua, Warwick, Andrea, Bingham, Janne, Cockbain, Andrew J, Dudi-Venkata, Nagendra Naidu, Ellaby-Hall, Jordan, Finlay, Ben, Humphries, Emily, Pisaniello, Jade, Pisaniello, Monique, Salih, Salma, Sammour, Tarik, Abd Wahab, Haidar Hadri, De Silva, April, Hayward, Nicola, Iyer, Kartik, Maddern, Guy, Prevost, Gian Andrea, Annapureddy, Naga, Settipalli, Krishna Pranathi, Yeo, Jeremy, Hempenstall, Lucy, Pham, Lily, Purcell, Shaun, Talavera, Cherry, Vaska, Ashish I, Chaggar, Gurpreet, Chrapko, Phillip, Cocco, Annelise, Coulter-Nile, Sarah Michelle Crystal Jade, Ctercteko, Grahame, French, James, Gong, Houchen, Gosselink, Martijn, Jegathees, Thuvarahan, Jin, Ivan, Kalachov, Michelle, Kiefhaber, Kathryn, Lee, Katherine, Luong, Jason, Phan, Steven, Pleass, Henry, Veale, Kelly, Zeng, Zhi, Au, Angela, DeBiasio, Ashe, Deng, Idy, Myooran, Jananee, Nair, Amrita, Stewart, Peter, Stift, Anton, Unger, Lukas Walter, Wimmer, Kerstin, Ahmed, Nabila, Hasan, Syed, Rahman, Saber, O'Shea, Margaret, Padmore, Greg, Peters, Adrian, Perduca, Pietro, Pulcina, Guenda, Tinton, Nicolas, Buxant, Frederic, Dabin, Elsa, Garofalo, Giulia, Dossou, Francis, Gnangnon, Freddy Houehanou Rodrigue, Imorou Souaibou, Yacoubou, Motlaleselelo, Pako, Tlhomelang, Omphile, Lima Buarque, Igor, Mendonça Ataíde Gomes, Gustavo, Vieira Barros, Aldo, Batashki, Ilia, Damianov, Nikolai, Stoyanov, Vladislav, Dardanov, Dragomir, Maslyankov, Svilen, Petkov, Plamen, Todorov, George, Zhivkov, Evgeni, Akisheva, Aygulya, Castilla Moreno, Miguel Angel, Genov, Geno, Ilieva, Ivelina, Ivanov, Tsvetomir, Karamanliev, Martin, Khan, Azhar, Mitkov, Emil, Yotsov, Tsanko, Atanasov, Boyko, Belev, Nikolay, Slavchev, Mihail, Nsengiyumva, Carlos, Jones, Elgan, Stock, Simon, Kyota, Steve, Brown, James, Mabanza K., Tresor, Nigo Samuel, Lemery, Otuneme, Chidi, Prosper, Ngwang, Umenze, Franklin, Boutros, Marylise, Caminsky, Natasha, Dumitra, Sinziana, Garfinkle, Richard, Morency, Dominique, Salama, Ebram, Banks, Alexander, Ferri, Lorenzo, He, Haitian, Katz, Amit, Liberman, Alexander Sender, Meterissian, Sarkis, Pang, Allison, Parvez, Elena, Hameed, Usmaan, Osman, Fahima, Sequeira, Sangita, Coburn, Natalie, Jaffer, Alisha, Karanicolas, Paul, Mosseler, Matthew, Musselman, Reilly, Liu, Xinyuan, Yip, Ching Wan, Garces-Otero, Juan Sebastian, Guzman, Carolina, Sierra, Sebastian, Uribe Valencia, Andres, Cabrera Rivera, Paulo Andrés, Camelo, Saul, Gonzalez, Andrea, González-Orozco, Alejandro, Mosquera Paz, Manuel Santiago, Perez Rivera, Carlos J, Gonzalez, Felipe, Isaza-Restrepo, Andres, Nino- Torres, Laura, Arias Madrid, Natalia, Mendoza Arango, Maria Clara, Tsandiraki, Justin, Jemendžić, Damir, Kocman, Branislav, Šuman, Oliver, Canic, Renata, Jurišić, Darko, Karakas, Ivana, Krizanovic Rupcic, Ana, Pitlovic, Vlatka, Samardžić, Josip, Kopljar, Mario, Bacic, Ivan, Domini, Edgar, Karlo, Robert, Miljanić, Danijela, Simic, Andrea, Ahmed, Mariam, Al Nassrallah, Majdi, Altaf, Rabiya, Amjad, Talal, Eltoum, Ruba, Haidar, Heba, Hassan, Alhassan, Khalil, Omar, Qasem, Marwan, Ramesh, Rommel, Sajith, Gautham, Wisal, Maham, Žatecký, Jan, Bujda, Michele, Jirankova, Katerina, Paclik, Ales, Abdallah, Aya, Abdulgawad Almogy, Mariam, Ayman El-sawy, Esraa, ElFayoumy, Ahmed Moustafa, Elghareeb, Nourhan, Esmat, Nourhan Ahmed, Fadel, Ahmed, Habater, Abdullah, Hamdy, Heba, Hefni, Amr, Kamal, Marwa, Mohamed Abobakr, Norhan, Sayed, Ahmed, Shaker, Nancy, Taha, Ehab, Tharwat, Hoda, Zakaria, Omar, Abdelmotaleb, Ibrahem, Al-Dhufri, Ali, Al-Himyari, Hamza S., El sheikh, Enas, Eldmaty, Asmaa, Elkhalawy, Aya, M.Elkhashen, Ahmed, Magdy, Kithara, Mostafa, Safa, Sadia, Habib Doutoum, Saleh, Mohamed mahmoud, Samir, Dina, Yahia Mohamed Ali, Mohamed, A. Nassar, Mahmoud, Abdelhady, Samar, Abdelrazek, Aly, Abdelsalam, Israa, El-Sawy, Aya, Essam, Eman, Gadelkarim, Mohamed, Ghaly, Khaled, Hassabalnaby, Mohamed, Masarani, Rana, Mohamed Shaaban, Nourhan, Sabry, Ahmed, Salem, Menatalla, Soliman, Nourhan Akram, Zahran, Diaaaldin, Abou El.soud, Moustafa Ramadan, Badr, Esraa Tarek, Borham, Hala, Elmeslemany, Nehal, Elsayed, Mohammad, Elsherif, Fawzia, Eslam, Sara, Gaber, Gehad, Ibrahim, Sondos, Kamh, Yara, Mahmoud, Abdelrahman, Mohamed, Shimaa gamal, Morshedy, Eman, Omar, Cinderella, Salem Soliman, Fatima, Abdelkawy, Shaza, Abdelmohsen, Naglaa, Abdelshakour, Mahmoud, Dahy, Ahmed, Gamal, Norhan, Gamal, Mohammed, Hasan, Ahmad, Hetta, Helal, Mousa, Nehad, Omar, Mohamed, Rabie, Somia, Saad, Mahmoud, Saleh, Bakeer, Sayed Mohamed, Marwa, Shawqi, Muhammad, Abdelhady Mousa, Heba, Alnoury, Mostafa, Elbealawy, Mohamed, Elshafey, Ahmed, Essam Ibrahim El Desouki Muhammad Ahmed, Muhammad, Ghonaim, Mennatullah, Hgag, Fawzy, Ibrahim, Mohamed, Morsy, Mahmoud, Reda Loaloa, Mohamed, Refaat, Ahmed, Samir, Hadeer, Shahien, Fatma, Sobhy, Mohamed, Sroor, Fathy, Abdellatif, Esraa, Adel, Marina, Afifi, Amr Abdelghani, Afifi, Eman, Antaky, Marco, Dawoud, Amr, El Zoghby, Naira, El-remaily, Amira, Elzanfaly, Ali Abdelazez, Gadallah, Ahmed, Gamal, Fatma Alzahraa, Hashem, Omar, Medhat Youssef, Shrouk, Muhammad Attyah, Aliaa, Munir, Malak, Shazly, Omar, Taha, Esraa, Wilson, Karim, Adel, Sawsan, Ali, Asmaa, Eid, Esraa, Elhelow, Esraa, Elmahdy, Marwa, Elshatby, Bassant, Hossam el-din Zakaria, Amany, Hossny, Ahmad, Ibrahim, Eman, M.Yonis, Ahmed, Metwalli, Maram, Yousry, Basant, Zid, Esraa, A Yacoub, Mina, Abdelhakim, Ahmed, Abouelsoad, Nervana, Alkhatib, Mo'min, Ashraf, Ahmed, Ashraf, Alaa, Elazab, Yasmin, Elfanty, Mahmoud, Elkabir, Osama, Elsayed, Mai, Elshimy, Ahmed, Elsobky, Hager, Eskander, John, Gad, Ahmed, Hamsho, Ward, Khaled Abdelwahed, Noura, Magdy, Menna, Moharam, Dalia, Osama, Abeer, Ramadan, Shereen, Roum, Radwa, Sayed, Taqwa, Shehada, Tarneem, Zidan, Ahmed Mohy, Abbas, Khalid, Ali, Amr, Attia, Mohamed, Balata, Mohamed, El Nakeeb, Ayman, Elewaily, Mohamed Ibrahim Elsayed, Elfallal, Ahmed, Elfeki, Hossam, Elkhadragy, Ahmed, Emile, Sameh, Ezzat, Helmy, Hosni, Hasnaa, Mansour, Islam, Omar, Waleed, Othman, Gehad, Sadek, Kareem, Shalaby, Mostafa, Shehab-Eldeen, Noura, Anas khalifa, Rawda, Badr, Helmy, Eldeep, Mostafa, Eldeep, Ahmed, Eldoseuky mohammed, Amany, Khallaf, Salwa, Magdy Hegazy, Eman, Mahmoud, Rokia, Mikhail, Pola, Morsi, Mahmoud, Mowafy, Sara, Raafat, Dina, Safy, Amina, Sera, Marwa, Sera, Ahmed shible, AbdAllah, Mostafa Salim Mohamed, Abdelkader, Muhammad, Abdou, Abdulrahman Osama, Ahmed, Ahmedgaber, Gaafar, Shireen, Ibrahim negm, Fatma, Lapic, Mina, Maher, Ahmed, Mahmoud, Hagar, Mostafa, Ahmed, Samir, Mohamed, Samy, Fatma, Semeda, Nourhan, Shalaby, Hind I., El-taweel, Alaa, Galal Elnagar, Ahmed, Hemidan, Ahmed Gamal, Hussein, Mohamed, Kandil, Ahmed.A., Moawad, Mf, Nasser Hamamah, Ayat Allah, Soliman, Mostafa, Abdelkhalek, Mohamed, Abdelmaksoud Tawakel, Noura, Abdelwahed, Ahmed Mohamed, Abdou, Alrawy, Atallah, Khalid, Elsherbeny, Mohammed Yasser, Emara, Eman, Hamdy, Mohamed, Hamdy, Omar, Haron, Amira, Ismail, Salma, Metwally, Islam Hany, Mohamed Hamed Elgaml, Nihal, Nassar, Ahmed, Refky, Basel, Sadek, Mirna, Saleh, Mahmoud, Yunes, Asmaa, Zakaria, Mai, Zuhdy, Mohammed, Fayed, Notila, Mohammed, Mohammed Mustafa Hassan, Kütner, Sander, Melnik, Priit, Seire, Indrek, Ümarik, Toomas, Ainoa, Eppu, Eerola, Verner, Koppatz, Hanna, Koskenvuo, Laura, Sallinen, Ville, Takala, Sini, Katunin, Jevgeni, Turunen, Arto, Christou, Niki, Mathonnet, Muriel, Lavoue, Vincent, Nyangoh Timoh, Krystel, Soulabaille, Lucie, Lesourd, Romain, Merdrignac, Aude, Sulpice, Laurent, André, Benoît, Chantalat, Elodie, Vaysse, Charlotte, Dousset, Bertrand, Gaujoux, Sebastien, Martin, Gregory, Clonda, Octavian, Juodis, Domantas, Kienle, Klaus, Mravik, Andras, Palmer, Samuel, Szabadhegyi, Gabor, Agbeko, Anita Eseenam, Gyabaah, Solomon, Gyamfi, Frank Enoch, Naabo, Nuhu, Owusu senior, Atta, Yorke, Joseph, Owusu, Frank, Abantanga, Francis, Anyomih, Theophilus Teddy Kojo, Muntaka, Abdul-Jalilu Mohammed, Owusu Abem, Emmanuel, Sheriff, Mohammed, Wondoh, Paul M., Balalis, Dimitrios, Korkolis, Dimitrios, Gkiokas, Georgios, Pantiora, Eirini, Theodosopoulos, Theodosios, Ioannidis, Argyrios, Konstantinidis, Konstantinos, Konstantinidou, Sofia, Machairas, Nikolaos, Paspala, Anna, Prodromidou, Anastasia, Chouliaras, Christos, Papadopoulos, Konstantinos, Baloyiannis, Ioannis, Mamaloudis, Ioannis, Tzovaras, George, Akrida, Ioanna, Argentou, Maria-Ioanna, Germanos, Stylianos, Iliopoulos, Evangelos, Maroulis, Ioannis, Skroubis, George, Theofanis, George, Chatzakis, Christos, Ioannidis, Orestis, Loutzidou, Lydia, Karathanasis, Panagiotis, Michalopoulos, Nikolaos, Theodoropoulos, Charalampos, Theodorou, Dimitrios, Triantafyllou, Tania, Garoufalia, Zoe, Hasemaki, Natasha, Kontos, Michalis, Kouraklis, Gregory, Kykalos, Stylianos, Liakakos, Theodore, Mpaili, Eustratia, Papalampros, Alexandros, Schizas, Dimitrios, Syllaios, Athanasios, Tampaki, Ekaterini Christina, Tsimpoukelis, Antonios, Antonopoulou, Maria Ioanna, Deskou, Eirini, Manatakis, Dimitrios K., Papageorgiou, Dimitrios, Zoulamoglou, Menelaos, Anthoulakis, Christos, Margaritis, Michalis, Nikoloudis, Nikolaos, Campo, Veronica, Ceballos, André, Flores, Mario-Andrés, Giron, Waleska, Ko, Donghyun, Martinez, Gabriel, Rivera Lara, Verónica, Rueda, Nataly, Sanchez, Andres, Tejeda Garrido, Jorge Carlos Guillermo, Alvarez Rivera, Alvaro Eduardo, Bamaca Ixcajoc, Elvis Benjamin, Barreda Zelaya, Lilian Elizabeth, Chacòn-Herrera, Patricia, Corea Ruiz, Ligia Margarita, Echeverria-Davila, Guillermo, Garcia, Mario, García, Danilo, Gutiérrez Mayen, Edgar Fernando, José, Noriega, Mazariegos, Nery, Méndez, Diego, Paniagua Espinoza, Michael, Bardos, David, Benke, Marton, Illes, Kristof, Kokas, Balint András, Szabó, Réka, Appukuttan, Akhila, Asok, Anjitha, D.k, Vijaykumar, Malik, Kapil, Ravishankaran, Praveen, Tapkire, Ritesh, Moorthy, Guru, Abraham, Joyner, Muthuvel, Ramesh, Alapatt, John, Kattepur, Abhay, Pareekutty, Nizamudheen, Garod, Mebanshanbor, Harris, Caleb, Wanniang, Cliff, Gupta, Ashish, Nehra, Deepak, Parshad, Sanjeev, Acharya, Rajgopal, Badwe, Rajendra, Bhandare, Manish, Jain, Urvashi, Kirti, Karishma, Nair, Nita, Shrikhande, Shailesh, Thakkar, Purvi, Anandan, Premkumar, C S, Archana, Holenarasipur Narasannaiah, Arun, Jagarlamudi, Tejaswi, M R, Rashmi, Manangi, Mallikarjuna, Raghavendra, Abhishek, Rao, K. Seshagiri, S, Vinay, Sajjan, Vinay, Shenoy, Aneesh, Shivashankar Chikkanayakanahalli, Santhosh, Tharanath, Kavya, V, Sushmita, Adidharma, Peter, Agarwal, Raksheeth, Anggita Gultom, Phebe, Arifin, Ghafur Rasyid, Billy, Matthew, Elfizri, Zatira, Fahira, Alessa, Felicia, Devi, Gunardi, Triana Hardianti, Johanna, Nadya, Nugrahadi, Nadia Rahmadiani, Panigoro, Sonar Soni, Rahmayanti, Siti, Sihotang, Retta Catherina, Brata, Santi Yuanita, Winoto, Hadi, Barati, Nastaran, Karami, Manoochehr, Khorshidi, Hamidreza, Naderifar, Homa, Abdulla, Mazin A., Coleman, Maggie, Doherty, Ronan J, Hannon, Rob, Murphy, Brenda, Stakelum, Aine, Winter, Des, Aljohmani, Lylas, Farnan, Richard, Seldon, Yeshey, Tan, Tanna, Varghese, Shriya, Alherz, Mohammad, Ather, Muaaz, Bajilan, Mohammad, Graziadei, Vivien, Pilkington, Isobel, Quidwai, Omar, Ridgway, Paul, Shiwani, Haaris, Tahir, Abd al-Rahman, Blunnie, Eimear, Burke, Daniel, Kennedy, Niall, Macdonagh, Kate, O'Neill, Maeve, Rooney, Siobhan, Falco, Giuseppe, Ferrari, Guglielmo, Mele, Simone, Nita, Gabriela Elisa, Ugoletti, Lara, Zizzo, Maurizio, Confalonieri, Gianmaria, Pesenti, Giovanni, Tagliabue, Fulvio, Baronio, Gianluca, Ongaro, Deborah, Pata, Giacomo, Compagnoni, Bruno, Salvadori, Renato, Taglietti, Lucio, D'Alessandro, Nicola, Di Lascio, Pierpaolo, Pascale, Giovanni, Bortolasi, Luca, Campagnaro, Tommaso, Carlini, Massimo, Lisi, Giorgio, Lombardi, Davide, Pedrazzani, Corrado, Spoletini, Domenico, Turri, Giulia, Violi, Paola, Altomare, Donato Francesco, Aquilino, Fabrizio, Musa, Nicola, Papagni, Vincenzo, Picciariello, Arcangelo, Vincenti, Leonardo, Andreotti, Dario, Occhionorelli, Savino, Tondo, Matteo, Basso, Stefano Maria Massimiliano., Ubiali, Paolo, Cirelli, Riccardo, Maino, Marco Enrico Mario, Piozzi, Guglielmo Niccolò, Picone, Emanuele, Scaramuzzo, Rosa, Sinibaldi, Giovanni, Amendola, Alfonso, Anastasio, Lorenzo, Bucci, Luigi, Caruso, Emanuele, Castaldi, Antonio, Di Maso, Sara, Dinuzzi, Vincenza Paola, Esposito, Giovanni, Gaudiello, Maria, Giglio, Mariano Cesare, Greco, Paola Antonella, Luglio, Gaetano, Manfreda, Andrea, Marra, Ester, Mastella, Federica, Pagano, Gianluca, Peltrini, Roberto, Pepe, Vincenzo, Sacco, Michele, Sollazzo, Viviana, Spiezio, Giovanni, Cianchetti, Ettore, Menduni, Nunzia, Carvello, Michele Maria, Di Candido, Francesca, Spinelli, Antonino, Corsi, Fabio, Sorrentino, Luca, Marino, Fabio, Asti, Emanuele Luigi Giuseppe, Bonavina, Luigi, Rausa, Emanuele, Asta, Martina, Belli, Andrea, Bianco, Francesco, Cervone, Carmela, Delrio, Paolo, Falato, Armando, Fares Bucci, Andrea, Guarino, Rita, Pace, Ugo, Rega, Daniela, De Luca, Emilia, Gallo, Gaetano, Sammarco, Giuseppe, Sena, Giuseppe, Vescio, Giuseppina, Santandrea, Letizia, Ugolini, Giampaolo, Zattoni, Davide, Chetta, Nicola, Logrieco, Gaetano, Vanella, Serafino, Garulli, Gianluca, Zanini, Nicola, Bondurri, Andrea, Cammarata, Francesco, Colombo, Francesco, Foschi, Diego, Lamperti, Giulia Maria Beatrice, Maffioli, Anna, Sampietro, Gianluca Matteo, Yakushkina, Al'ona, Zaffaroni, Gloria, Cicuttin, Enrico, Sibilla, Maria Grazia, Impellizzeri, Harmony, Inama, Marco, Moretto, Gianluigi, Mochet, Sylvie, Ponte, Elisa, Usai, Antonella, Mancini, Stefano, Sagnotta, Andrea, Solinas, Luigi, Bolzonaro, Elisa, Tamini, Nicolò, Curletti, Gianluca, Galleano, Raffaele, Malerba, Michele, Campanella, Sofia, Cocorullo, Gianfranco, Colli, Francesco, De Marco, Paolino, Falco, Nicolò, Fontana, Tommaso, Kamdem Mambou, Leonel jospin, La Brocca, Antonella, Licari, Leo, Randisi, Brenda, Rizzo, Giovanna, Rotolo, Giulia, Salamone, Giuseppe, Tutino, Roberta, Venturelli, Paolina, Malabarba, Stefano, Sgrò, Alessandro, Vella, Ivan, Cirillo, Bruno, Crocetti, Daniele, De Toma, Giorgio, Lapolla, Pierfrancesco, Mingoli, Andrea, Sapienza, Paolo, Belvedere, Angela, Bianchini, Stefania, Binetti, Margherita, Birindelli, Arianna, Tonini, Valeria, Podda, Mauro, Pulighe, Fabio, De Rosa, Michele, Bono, Lorenzo, Borghi, Felice, Geretto, Paolo, Giuffrida, Maria Carmela, Lauro, Corrado, Marano, Alessandra, Pellegrino, Luca, Salusso, Paola, Sasia, Diego, Campanelli, Michela, Realis Luc, Alberto, Trompetto, Mario, Cardia, Roberto, Cillara, Nicola, Giordano, Antonio Nicola, Costanzo, Antonio, Giovilli, Mario Alessandro, Turati, Luca, Canonico, Silvestro, Sciaudone, Guido, Selvaggi, Francesco, Selvaggi, Lucio, Albsoul, Nader, AlBsoul, Ahmad, Alkhatib, Ala'a Aldeen, Alsallaq, Osama, Amarin, Justin Z., Ayoub, Rami, Bsisu, Isam, El Muhtaseb, M S, Jabaiti, Mohammad, Melhem, Jamal, Qwaider, Yasmeen Z., Salameh, Mohammad Hasan, Suleihat, Ahmad, Suradi, Haya H., Alammarin, Mohammad, Aljaafreh, Almoutuz, Bani hani, Mohammad, Bani hani, Zeina, Bani Hani, Farah, Fahmawee, Toqa, Hamouri, Shadi, Katanani, Cyrine, Tawalbeh, Ra'fat, Tawalbeh, Tamara, Zawahrah, Hassan, Abou Chaar, Mohamad K., Abusalem, Lana, Al-Masri, Mahmoud, Al-Najjar, Hani, Barghuthi, Lutfi, Ahmed, Zahra, Maulana, Adnan, Ngotho, Omar, Kamau, Charbel, Stanley Mwenda, Aruyaru, Bosire, Fridah, Mwachiro, Elizabeth, Parker, Robert, Simel, Ian, Sylvester, Kimutai, Althini, Abdulmunem Ahmed Mustafa, Elbarouni, Sofian, Elbeshina, Aya Elseed, Gwea, Ahmed, Malek, Ans, Masoud Farag, Wedad Albashir, Abdalei, Abdulwahab, Abdel Malik, Abu Baker, Abo-khammash, Areej, Abuhlaiga, Ma'aly, Adnan, Nour, Albaggar, Marwa, Alfitory, Asma, Aljanfi, Asma, Almuzghi, Fakhruddin, Altumei, Zohoor, Alzabti, Fatima, Ashoushan, Hana, Assalhi, Mohamed, Azzubia, Joma, Bnhameida, Sondos, Delhen, Malik, Elshafei, Houssein, Elteir, Hana, Esbaga, Fatima, Gobbi, Abdel Aziz, Hamouda, Fatma, Hilan, Hamdan, Ismail, Rania, Jebran, Fieruz, Kasbour, Muataz, Maderi, Galia, Mohammad, Saja, Mohammed, Burooj, Murtadi, Habib, Mustafa, Hamassat, Rajab, Mohamed, Trenba, Sarah, Wafaa, Mariam, Al Sagheir, Eman, Almigheerbi, Alabas, Alzahaf, Ahmed, Bahroun, Sumayyah Ghayth, Ben Dallah, Najah, Elshaibani, Mahmoud, Eswaye, Haitem, Karar, Maha, Omar, Samah, Younes, Eman, Younes, Maha, Zreeg, Dafer, Abujamra, Saleh, Ashour, Firas, Elgammudi, Mala, Omar F. Aljadidi, Wesal, Saddouh, Enas, Sharif, Randa, Alabuzidi, Aya, Alwerfally, AbdulMawlay, Aribi, Sarra, Bibas, Fatma, Elfaituri, Taha, Elhajjaji, Yasmine, Khaled, Ala, Khalil, Wegdan, Layas, Tesneem, Soula, Enas, Tarek, Ahmed, Abu hallalah, Muad fathi khalleefah, Ahmed, Hazem Abdelkarem, Alsharef, Tagwa, Ben Saoud, Abdulsalam Ali, El Gharmoul, Tasnim, Elhadi, Ahmed, Elrais, Safa, Shebani, Abdulhalim, Zarti, Heba, Zeiton, Asaid, Ambrazevicius, Marijus, Kaselis, Nerijus, Stakyte, Migle, Aliosin, Oleg, Cizauskaite, Agne, Dailidenas, Sarunas, Eismontas, Vitalijus, Kybransiene, Migle, Nutautiene, Vitalija, Samalavicius, Narimantas, Simcikas, Dainius, Slepavicius, Algirdas, Tamosiunas, Albinas, Ubartas, Nerijus, Zeromskas, Paulius, Bradulskis, Saulius, Dainius, Edvinas, Juočas, Juozas, Kubiliute, Egle, Kutkevičius, Juozas, Opolskis, Aurimas, Parseliunas, Audrius, Subocius, Andrejus, Virbickaite, Egle, Zuikyte, Diana, Bogusevicius, Algirdas, Buzaite, Kristina, Čepuliené, Daiva, Cesleviciene, Ieva, Cesna, Vaidotas, Gribauskaite, Jolanta, Ignatavicius, Povilas, Jokubauskas, Mantas, Liugailaitè, Monika, Margelis, Ernest, Mazelyte, Ruta, Pankratjevaitè, Lina, Pažusis, Matas, Rackeviciute, Agne, Saladyte, Justina, Škimelytè, Monika, Šlenfuktas, Vygintas, Sudeikyte, Monika, Tamelis, Algimantas, Vanagas, Tomas, Žumbakys, Žygimantas, Atkociunas, Aivaras, Dulskas, Audrius, Kuliavas, Justas, Birutis, Justas, Paškevičius, Sigitas, Šatkauskas, Mindaugas, Danys, Donatas, Jakubauskas, Matas, Jakubauskiene, Lina, Kryzauskas, Marius, Lipnickas, Vytautas, Makūnaitè, Gabija, Rasoaherinomenjanahary, Fanjandrainy, Rasolofonarivo, Herizo, Samison, Luc Hervé, Banda, Bitiel, Msosa, Vanessa, Ahmad Izzuddin, Ahmad Imran, Das, Andre, Gan, Ying Yee, Shong Sheng, Tan, Siaw, Jia yng, Ab Rahim, Mohd Fadliyazid, Abang Jamari, Dyg Zahratul Hamrak, Che Husin, Nurfariza, Kamarulzaman, Muhd Yusairi, Lim, Yi Ping, Mohamed Kamil, Nil Amri, Mohd Hassan, Mohd Razeen, Mohd Sahid, Saidah, Mustafa, Johari, Ng, Elaine Hui Been, Wan Khazim, Wan Khamizar, Chang Ern, Ng, Lingeshan, P.g., Sulaiman, Syariz Ezuan, Ang, Sue Ean, Bin Mohamad Sithik, Muhammad Navid, Cheong, Yih Jeng, Deva Tata, Mahadevan, Jia Xian, Law, Kadravello, Aravinthan, Koh, I-Ern, Ng, Li-Yen, Ng We Yong, Yuki Julius, Palayan, Kandasami, Sam, Chi Xuan, Siow Jin, Phuah, Tan Ern Hwei, Jeremy, Tang, Yita, Ter, Alvin Zubin, Wong, Michael Pak-Kai, Zakaria, Andee Dzulkarnaen, Zakaria, Zaidi, Henry, Fitjerald, Kalaiselvan, Thyivya, Abd Karim, Muhammad Fairuz Shah, Abdul Aziz, Mohamed Rezal, Abdul Aziz, Nora, Khong, Tak Loon, Lau, Peng Choong, Lim, Hiong Chin, Roslani, April Camilla, Seak, Jonathan Chen Ken, Wong, Sui-Weng, Wong, Lai Fen, Yeen Chin, Leow, Anyanwu, Mercy Chinemerem, Busuttil, Zachary, Calleja, Thomas, Chircop, Kurt Lee, Cutajar, Ruth, Dimech, Andrew Michael, Galea, Joseph, Gascon Perai, Kiara, Gatt, Ruth, Kelman, Lisa, Micallef, Elizabeth, Nwolu, Favour, Sammut, Kim, Thompson, Joanna, Warwicker, Sean, Zammit, Matthew, Cordera, Fernando, Cruz González, Efraín, Sánchez-García, Jorge, Barbosa Camacho, Francisco José, Barrera López, Francisco Javier, Zuloaga Fernandez del Valle, Carlos Jose, Acosta, Eric, González Espinoza, Iván Romarico, Moreno, Perla, Cortes-Flores, Ana Olivia, Fuentes Orozco, Clotilde, Gonzalez Ojeda, Alejandro, Corro Díaz González, Samantha, Martinez, Laura, Mosqueda Amador, Bonifacio, Novoa, Armando, Olazo Espejo, Dennet Arturo, Jimenez, Alejandro, Lopez Rosales, Federico, Vanoye, Elva Gabriela, Garcia Gonzalez, Luis Alberto, Miranda-Ackerman, Roberto Carlos, Solano-Genesta, Manuel, Alvarez-Cano, Alethia, Romero-Garza, Hector Hugo, Medina-Franco, Heriberto, Mejía-Fernández, Lorelí, Salgado-Nesme, Noel, Vergara-Fernandez, Omar, Gutiérrez-Mota, Guadalupe Montserrat, Hernandez Vera, Francisco Xavier, Llantada Lopez, Anabella, Morgan Villela, Gilberto, Ramirez Padilla, Felipe de Jesus, Tapia Marin, Walezka, Martínez Maldonado, Mónica, Sánchez Suárez, Ramses, Troche, José Manuel, Benyaiche, Chaymae, Outani, Oumaima, Amine, Souadka, Benkabbou, Amine, Majbar, Anass Mohammed, Mohsine, Raouf, Rafik, Ali, Oung, Thida, Tin, Moe Moe, Plarre, Philipp, Alberga, Anna, Sluiter, Nina, Tuynman, Jurriaan, Blok, Robin, Cömert, Didem, Hompes, Roel, Kalff, Marianne, Stellingwerf, Merel Elisabeth, Tanis, Pieter, van Berge Henegouwen, Mark, van Praag, Elise Maria, Wisselink, Daan, Gerhards, Michael, Lopes Cardozo, Josephine, Westerduin, Emma, de Jonge, Joske, van Geloven, Aaw, van Schilt, Kaz, den Boer, Frank, Stoots, Simone, Vlek, Stijn, Adams, Jamie, Al-Busaidi, Ibrahim S., Budd, Gabrielle, Choi, Seung il, Chu, Michael Jen Jie, Ganugapati, Anurag, McKinstry, Lucy, Pascoe, Rebecca, Richards, Simon, Rosser, Kenrick, Stevenson, Annie, White, Rebecca, Farik, Shebani, Kwun, Jin, Murad, Ahmed, Cowan, Sarah, Hall, Timothy, Hayton, Michael, Malam Sani, Laminou, Oumarou Garba, Souleymane, Amadou Magagi, Ibrahim, Habou, Oumarou, Aliyu, Halima, Daniyan, Muhammad, Sholadoye, Tunde T., Abdullahi, Lawal, Anyanwu, Lofty-John, Mohammad Mohammad, Aminu, Muhammad, Abubakar Bala, Sheshe, Abdurrahman Abba, Suleiman, Ibrahim, Adesina, Alaba, Awolowo, Ajibola, Onuoha, Clement, Salami, Omotayo, Taiwo, Ogechukwu, Taiwo, Agboola, Kache, Stephen, Makama, Jerry Godfrey, Sale, Danjuma, Abiola, Olajide, Ajao, Akinlabi, Ajiboye, Anthony, Etonyeaku, Amarachukwu, Olaogun, Julius, Adebanjo, Ademola, Adesanya, Opeoluwa, Afolayan, Michael Olatunji, Balogun, Olanrewaju, Makanjuola, Ayomide, Nwokocha, Samuel, Ojewola, Rufus Wale, Olajide, Thomas Olagboyega, Aderounmu, Adewale, Adesunkanmi, Abdul-Rashid, Agbakwuru, Augustine, Akeem Aderogba, Adeleke, Alatise, Olusegun Isaac, Arowolo, Olukayode, Lawal, Oladejo, Mohammed, Tajudeen, Ndegbu, Chinedu, Olasehinde, Olalekan, Wuraola, Funmilola, Akinkuolie, Akinbolaji, Mosanya, Arinzechukwu, Ayandipo, Omobolaji, Elemile, Peter, Lawal, Taiwo Akeem, Ali SANI, Samuel, Garba, Stephen, Hauwa SANI, Rebecca, Olori, Samson, Onyebuashi, Henry, Umoke, Ifeanyi, Adenuga, Adedire, Adeyeye, Ademola, Habeeb, Olufemi, Lawal, Bashir, Nasir, Abdulrasheed, Aahlin, Eirik Kjus, Kjønås, Didrik, Myrseth, Elisabeth, Abbasy, Jibran, Alvi, Abdul, Saleem, Omair, Afzal, Asma, Nazir, Anam, Farooq, Muhammad, Liaqat, Ayesha, Naqi, Syed Asghar, Raza, Ali, Sarfraz, Muzna, Sarwar, Muhammad, Banglani, Muntaha, Munir, Ambreen, Sehrish, Rahmat, Ayub, Bushra, Sayyed, Raza, Altaf, Amna, Ayub, Saima, Saeed, Komal, Syed, Bilal, Akbar, Sana Amir, Anwer, Abdul Wahid, Khan, Ruqayya Naheed, Khan, Amina Iqbal, Khattak, Shahid, Mohtasham, Sameen, Parvaiz, Muhammad Asad, Syed, Aamir Ali, Ansari, Abdul Basit, Shahzad, Noman, Khaliq, Tanwir, Rashid, Isbah, Waqar, Shahzad Hussain, Abu Al-saleem, Hasan, Abu Alqumboz, Amjad, Alqadi, Mohammad, Amro, Adham, Assa, Rawan, Awesat, Eman, Ayyad, Rawan, Hammad, Mohammed, Haymony, Ayat, Hijazi, Bassel, Hmeidat, Bara, Lahaseh, Rowaa, Qawasmi, Aseel, Rajabi, Alaa, Shehada, Mohammed, Shkokani, Sundus, Yaghi, Yasmine, Yaghi, Nadine, AlZohour, Mohammad, Farid, Mohammad, Habes, Yousef Mahmoud, Juba, Wesam, Nubani, Yanal, Rabee, Abdelrahman, Sa'deh, Mohammad, Abed, Saeed, Al basos, Iyad, Alswerki, Mohammad, Ashour, Dina, Awad, Israa, Diab, Samar, El Jamassi, Alaa, El-Kahlout, Sahar, Elhout, Somaya, Hajjaj, Ahmed N K, Hasanain, Doaa, Nabil hajjaj, Baraa, Obaid, Mohammed, Saikaly, Eman, Salhi, Ahmed, Al-Tammam, Hiba, Almasri, Murad, Baniowda, Muath, Beshtawi, Doha, Horoub, Ali, Misk, Rami, Mohammad, Bayan, Qasrawi, Rami, Sholi, Tasnim, Abu-Nimeh, Samar, Abu-srour, Abrar, Abukhalaf, Sadi A., Adawi, Samer, Alsalameh, Barah, Ayesh, Kholoud, Elqadi, Muawiyah, Hammouri, Ahmad, Karim Mustafa, Fatima, Marzouqa, Natalie, Melhem, Shatha, Miqdad, Dima, Mohamad, Balqees, Rawhi, Mhammed, Abu Ahammala, Ayman B., Abu Ataya, Ahmed, Abu Jayyab, Israa, Al-Shwaikh, Samar, Alagha, Othman, Alasttal, Mohammed, Awadallah, Haneen, Elblbessy, Mahmood, Fares, Jehad, Jarbou, Akram, Mahfouz, Ibtisam, Albahnasawi, Moath A., Abo mahadi, Asmaa', Abuelhatal, Hasan, Abuelqomboz, Ayham, Almoqayyad, Abdelrahman, Alwali, Abdallah, Balaawi, Reem, Hamouda, Mahmoud, Humeid, Mohammed, Jedyan, Abdullah, Mahmoud Abu hamam, Tasneem, Matar, Ghadeer, Salem, Ali, Samra, Tahani, Shaheen, Nureddin, Shihada, Karam, A.Nemer, Ayoob, Abu Al Amrain, Mahmoud, Abu Alamrain, Abdulwhhab, Abu Jamie, Najlaa, Abu-Rous, Mohammed R., Alfarra, Nada, AlTaweel, Mohammed, Alwhaidi, Noor, Hamed, Ramadan, Saqqa, Bader, Shaheen, Ahmad, Aljaber, Dana, Aljaberi, Loay, Alwaheidi, Malak, Jawaada, Assef, Khaldi, Hani, Qahoush, Rami, Qari, Jalil, Saadeh, Rana, Salim, Ahlam, Yacoub, Aseel, Abbas, Abbas, Abu shua'ib, Rana, Abu Zainah, Baraa, AbuSirrees, Mahmoud, Babaa, Basheer, Barhoush, Ola, Belal qadomi, Asef, Daraghmeh, Laith, Haji, Reema, Khatatbeh, Alaa, Khatib, Lana, Qarariah, Salsabeel, Quzmar, Yara, Safadi, Khalil, Salameh, Roqaya, Hassan, Mohammad, Herzallah, Shifaa, Massad, Loai, Nazzal, Ahmed, Nazzal, Ranin, Escobar, Dennis, Machain V, Gustavo Miguel, Rodriguez Gonzalez, Agustin, Chachaima Mar, Jorge Emerson, Chinchihualpa Paredes, Nathaly Olga, Cuba, Vicente, Lopez, Walter, Niquen Jimenez, Maria Milagros, Sanchez Bartra, Nestor Alberto, Sapallanay Ojeda, Olenka, Sequeiros, Diego, Toscano Pacheco, Andrea, Vergara, María, Abarca, Sol, Alcorta, Rodrigo, Borda-Luque, Giuliano, Eusebio Zegarra, Ivan Edward, Luján López, Claudia, Marrufo, Mirella, Mogrovejo, Cinthya, Nomura, Andrea, Rodríguez Angeles, Yamile, Vidal Meza, Maitza Rosario, Zavala, Gabriela, Castillo Arrascue, José Neiser, Hidrogo Cabrera, Jomara Caroline, Larrea vera, José Julio Mariano, Osorio, Miguel, Ylatoma Díaz, Edgar Alcides, Fontanilla, Mark Anthony, Fuentes, Joseph Roy, Salazar, Anna Leah, Dominguez, Genieve, Lopez, Marc Paul, Macalindong, Shiela, Onglao, Mark Augustine, Ramirez, Arjel, Sacdalan, Marie Dione, Tampo, Mayou Martin, Uy, Gemma Leonora, Mangahas, Jeremiah, Yabut, Kenneth, Cañete, Joannes Paul, Cansana, Bernalynn Eris, Castro, Ernes John, Lipana, Maria Kaiserin, Roxas, Manuel Francisco, Zara, Vlu Jean, Chroł, Maciej, Franczak, Paula, Orłowski, Michał, Budzyński, Piotr, Budzyński, Andrzej, Bury, Pawel, Czerwińska, Agata, Dworak, Jadwiga, Dziedzic, Jacek, Kisielewski, Michał, Kulawik, Jan, Lasek, Anna, Małczak, Piotr, Migaczewski, Marcin, Pędziwiatr, Michał, Pisarska, Magdalena, Radkowiak, Dorota, Rubinkiewicz, Mateusz, Rzepa, Anna, Skoczylas, Tomasz, Stanek, Maciej, Truszkiewicz, Katarzyna, Wierdak, Mateusz, Winiarski, Marek, Zarzycki, Piotr, Zub-Pokrowiecka, Anna, Kowalewski, Piotr, Roszkowski, Rafał, Walędziak, Maciej, Tomé, Miguel, Patrocinio, Sara, Guerreiro, Ines, Almeida, Filipe, de Sousa, Xavier, Monteiro, Nuno, Costa Santos, Maria Teresa, de Oliveira, Daniela, Lopes Serra, Marta, Morgado, Daniela, Neves, Christian, Oliveira, Ana Carolina, Pimentel, Alice, Silva, Sofia, Carvalho, Márcia, Carvalho, Lúcia, Magalhães, Joana, Matos, Leonor, Monteiro, Tânia, Ramos, Carlota, Santos, Vanessa, Barbosa, José, Costa-Maia, Jose, Devezas, Vítor, Fareleira, Ana, Fernandes, Cristina, Gonçalves, Diana, Mora, Henrique, Morais, Marina, Silva de Sousa, Fabiana, Catarino Santos, Sara, Logrado, Ana, Tojal, André, Amorim, Edgar, Cunha, Miguel F., Fazenda, Ana, Melo Neves, João Pedro, Sampaio da Nóvoa Gomes Miguel, Inês Isabel, Veiga, Diogo, Azevedo, José, Cardoso Louro, Hugo, Leite, Mariana, Bairos Menezes, Maria, Gama, Bárbara, Brito, Diana, Cruz Martins, Marta Cristina, Graça e Magalhães, André, Longras, Ana Catarina, Lourenço, Rita, Matos, Diana, Castro, Luis, Policarpo, Filipa, Romano, Joana, Monteiro, Cristina, Pinto, Diogo, Duarte, Marina, Fortuna Martins, Sónia, Oliveira, Mariline, Galvão, Diogo, Martins, Lisandra, Silva, Anaisa, Taranu, Viorel, Vieira, Bárbara, Neves, Jessica, Oliveira, Simone, Ribeiro, Hugo, Cinza, Margarida, Felix, Rosa, Machado, Arnaldo, Oliveira, Joana, Patrício, Joana, Pedroso de Lima, Rita, Pereira, Mário, Rocha Melo, Miguel, Velez, Cristina, Abreu da Silva, Alberto, Claro, Mariana, Costa Santos, Daniel, Ferreira, Andreia, Capote, Hugo, Rosado, Daniela, Taré, Filipa, Nogueira, Oriana, Ângelo, Miguel, Baiao, José Miguel, Guimarães, Andreia, Marques, João, Nico Albano, Miguel, Silva, Marta, Valente da Costa, Ana, Vieira Caroço, Teresa, Almeida Braga, Sara, Capunge, Ines, Fragoso, Marta, Guimarães, João, Pinto, Bruno, Ribeiro, João, Angel, Miguel, Fialho, Guilherme, Guerrero, Monica, Campos Costa, Filipa, Cardoso, Diogo, Cardoso, Vasco, Alves, Magda, Estalagem, Inês, Louro, Tiago, Marques, Cláudia, Martelo, Rita, Morgado, Miguel, Canotilho, Rita, Correia, Ana Margarida, Martins, Pedro, Peyroteo, Mariana, Gomes, João, Monteiro, Rita, Romano, Manuela, Alves, Daniela Macedo, Peixoto, Rita, Quintela, Catarina, Jervis, Maria João, Melo, Débora, Pacheco, André, Paixão, Valter, Pedro, Vera, Pimenta, Joana, Pimenta de Castro, João, Rocha, Ana, Beuran, Mircea, Ciubotaru, Cezar, Diaconescu, Bogdan, Hostiuc, Sorin, Negoi, Ionut, Stoica, Bogdan, Anokhin, Evgeny, Kuznetsov, Georgy, Oganezov, Giorgi, 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Devorah, Koto, Modise Zacharia, Baiocchi, Daniella, Clarke, Damian, Steenkamp, Christina Johanna, Bannister, Sharon, Boutall, Adam, Chinnery, Galya, Coccia, Anna, Dell, Angela, Karjiker, Parveen, Kloppers, Christo, Loxton, Nicholas, Mabogoane, Tumi, Malherbe, Francois, Panieri, Eugenio, Rayamajhi, Shreya, van Wyngaard, Tirsa, Warden, Claire, Madiba, T E, Pillay, Nivashen, Brooks, Savannah, Kruger, Charlise, Van Der Merwe, Lisa Hannah, Gool, Ferhana, Kariem, Maahir, Bougard, Heather, Kariem, Nazmie, Noor, Fazlin, Pillay, Reantha, Steynfaardt, Leandi, González González, Lucía, Marín Santos, José Miguel, Martín-Borregón, Paula, Martínez Caballero, Javier, Nevado García, Cristina, Rodriguez Fraga, Pastora, De Castro Parga, Gonzalo, Fernández Veiga, Maria Pilar, Garrido López, Lucía, Infante Pino, Hugo, Lages Cal, Irene, López Otero, Marta, Nogueira Sixto, Manuel, Paniagua García Señorans, Marta, Rodríguez Fernández, Laura, Ruano Poblador, Alejandro, Rufo Crespo, Erika, Sanchez-Santos, 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Abdullah, Muhammad Tariq, Abuhilal, Baseel, Atawneh, Mohammad, Hamdan, Hamdan, Alhabil, Belal, Srour, Abedelrahman, Mousa, Ibrahim, Da Silva Medina, Luis, Bartosiak, Katarzyna, Ferreira, Pedro, Francisco, Vítor, Lemos, Ricardo, Frutuoso, Luísa, Fernandes, Sara, Fonseca, Telma, Pereira, Jorge, Rachadell, Juan, Torre, Ana, Madeira Martins, Filipe, Carvalho, Ana Cristina, Rodrigues Ferreira, Joana, Ribeiro da Silva, Bruno, Devesa, Helena, Vieira, Ana, Mónica, Inês, Amaro, Margarida, Sousa, Diogo, Reia, Marta, Louro, João, Martins, Ana, Dominguez, Joaquina, Santos, Inês, Freitas Oliveira, Nuno Miguel, Pereira, José Carlos, Silva-Vaz, Pedro, Freire, Ligia, Escrevente, Ricardo, Negoita, Valentina Madalina, Shakhmatov, Dmitry, Nezerwa, Yves, Radulovic, Radosav, Obery, Gareth, Viljoen, Francois, Mendes, Tome, Suarez, Antonio, Moncada, Enrique, Fernandez-Hevia, Maria, Curtis Martínez, Carolina, Gil Garcia, Julia Maria, González Zunzarren, Mariana, Idris, Tarig, Eklöv, Karolina, Grahn, Oskar, Amin, Leila, Blomqvist, Malin, Ajani, Costanza, Kraus, Rebecca, Seeger, Nico, Willemin, Melissa, Rayya, Fadi, Ayash, Mohammad, Msouti, Raneem, Kannas, Israa, Abazid, Eias, Esper, Asil, Slim, Skander, Kavcar, Akil Serdar, Aytac, Erman, Dural, Ahmet Cem, Ilker, Ayse, Eray, Ismail Cem, Kurnaz, Eray, Altiner, Saygin, Tepe, Mustafa Deniz, Şahin, Can, Savli, Evrim, Innocent, Aryon, Babirye, Lilian, Diachenko, Andrii, Hordoskiy, Vladislav, Curry, Heather, Chau, Charlene Yat Che, Robertson, Harry, Mahmoud, Arin, Lennon, Hannah, Loi, Lynette, Kirkham, Emily, McCann, Cameron, Watts, Daniel, Gurung, Binay, Wilson, Michael, Tribedi, Thomas, Garofalo, Eleonora, Zahra, Baryab, MacDonald, Scott, Daniels, Ian, Ng, Nathan, Khosla, Shivun, Olivier, James, Yue, Sum Yu Pansy, Suresh, Gayathri, Wellington, Jack, Lorejo, Emmanuel, Mossaad, Mafdi, Crutcher, Madison, Alimi, Marjan, Baiu, Ioana, Abdou, Hossam, Conway, Alison, Peck, Connor, Perdomo Perez, Mauro Andres, Zulu, Stanley, Nakazwe, Mildred, Burger, Sule, Davies, Justine, Donaldson, Rachel, Ede, Chikwendu, Garden, O James, Lesetedi, Chiapo, Mabedi, Charles, Magill, Laura, Makinde Alakaloko, Felix, Makupe, Alex, Monahan, Mark, Mulira, Soloman, Muller, Elmi, Musowoyo, Jospeh, Olory-Togbe, Jean Léon, Roberts, Tracey, Smith, Martin, Tayler, Viki, Windsor, John, Yepez, Raul, Sundar, Sudha, Runigamugabo, Emmy, Verjee, Azmina, Chen, José, Daya, Leonid, El Aroussi, Nouhaila, Farina, Valeria, Gnintedeme Olivier, Tchianze, Gonzales Nacarino, Mauricio, Hammani, Aamr, Honjo, Sarah, Jacobs, Rebecca, Kimura, Hitomi, Nkoronko, Mugisha, Oscullo Yepez, Jasson Javier, Pin Hung, Wei, Raj, Ankit, Romani Pozo, Alina, Rommaneh, Muna, Sassamela Fabiano, Samuel Chimbioputo, Shiroma Gago, Camila Milagros, Srinivas, Abhishekh, Sung, Chia-Yen, Tai, Aswan, Valle Aranda, Yener Cristyell, Venturini, Sara, and Wilguens Lartigue, Jean

Published
2022
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38. How Students Learn during the Pre-Briefing and Observation of Facilitation in a High-Fidelity Patient Simulation: A Narrative Analysis.

Author

Wong, Florence M. F.

Subjects
MEDICAL logic, INTELLECT, PROFESSIONALISM, NURSES, MEDICAL protocols, RESEARCH funding, NURSING education, TEACHING methods, DECISION making, ENTRY level employees, DESCRIPTIVE statistics, AUTODIDACTICISM, SIMULATED patients, COLLEGE students, LEARNING strategies, STUDENT attitudes, NURSING students, CRITICAL thinking
Abstract

The rapid development of technology has led to the emergence of innovative teaching approaches, such as high-fidelity patient simulation (HFPS). HFPSs have been shown to significantly enhance students' decision-making and intellectual skills. This study aimed to investigate how students learn from the pre-briefing to observation period of the facilitation of the HFPS based on the original quasi-experimental studies. This study analyzed the narratives from 92 students in the intervention group about their learning during the pre-briefing and observation of facilitation. The results indicated that the students learned more independently, received better support and resources for learning, were provided with more appropriate and safe care for the simulated case, and developed higher-level intellectual skills, such as self-directed learning, critical thinking, and clinical reasoning. Importantly, the structured guidelines provided roles and responsibilities and guiding questions or aspects for observation that directed the students to learn more actively and effectively while performing their roles in the HFPS. The structured guidelines serve as a roadmap to instruct students on learning during pre-briefing and applying what they have learned during the facilitation of the HFPS. This roadmap includes the learning journey from novice to competence in knowledge and skills and also from knowing to application. Therefore, this study's results have contributed important knowledge about well-structured HFPS guidelines for all stages of the HFPS, addressing the need for adequate guidance and learning support during the pre-briefing and observation of facilitation. The elements identified during the pre-briefing and observation of facilitation are crucial for directing students to learn and significantly enhance their understanding and application of knowledge and skills, ultimately promoting the development of higher-level intellectual skills, professionalism, and engagement. Nurse educators can incorporate these elements into HFPS training in curricula to enhance students' involvement and optimize the HFPS as an effective teaching tool with structured guidelines providing guidance and support throughout various stages of HFPS training. [ABSTRACT FROM AUTHOR]

Published
2024
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46. Global prevalence and characteristics of infections and clinical outcomes in hospitalised patients with cirrhosis: a prospective cohort study for the CLEARED Consortium

Author

Cao, Zhujun, Wong, Florence, Choudhury, Ashok K, Kamath, Patrick S, Topazian, Mark, Torre, Aldo, Hayes, Peter C, George, Jacob, Idilman, Ramazan, Seto, Wai-Kay, Desalegn, Hailemichael, Alvares-da-Silva, Mario Reis, Bush, Brian J, Thacker, Leroy R, Xie, Qing, Bajaj, Jasmohan S, Kumar, Shiva, Gadano, Adrián, Marciano, Sebastián, Tudehope, Fiona, Prudence, Alexander, Gibson, Robert, Zekry, Amany, Doyle, Adam, Si, Hooi Ling, Kim, Yu Sung, Gofton, Cameron, Riordan, Stephen, MacQuillan, Gerry, Al-Tamimi, Hala, Michalczuk, Matheus, Farias, Alberto, Zitelli, Patricia, Pereira, Gustavo, Victor, Livia, Bera, Chinmay, Faisal, Nabiha, Dahiya, Monica, Tandon, Puneeta, Lohoues, Marie Jeanne, Lah, Ponan Claude Regis, Benítez, Carlos, Arrese, Marco, Guan, Jing, Xian, Yongchao, Zhu, Chuanwu, Wang, Yingling, Su, Man, Su, Minghua, Wang, Xinrui, Gao, Yanhang, Peng, Feng, Jiang, Yongfang, Zhao, Caiyan, Wang, Wei, Yin, Dedong, Wang, Lei, Lu, Mingqin, Cai, Yijing, Guo, Feng, Wang, Xiaozhong, Zhang, Ningping, Zhang, Wanqin, Dong, Fuchen, Li, Hai, Liu, Jing, Zheng, Xin, Tang, Hong, Yan, Libo, Xu, Bin, Wei, Linlin, Xu, Zhen, Gao, Zhiliang, Gao, Haibing, Lin, Minghua, Rao, Qunfang, Wu, Xiaoping, Li, Beiling, Chen, Jinjun, Liu, Chenghai, Zhang, Yanyun, Deng, Huan, Hu, Peng, Wang, Jian, Li, Jie, Bettinger, Dominik, Schultheiß, Michael, Belimi, Hibat Allah, Debzi, Nabil, Mostafa, Alaa, Fouad, Yasser, Fisseha, Henok, Venkatachalapathy, Suresh Vasan, Aravinthan, Aloysious D, Rajoriya, Neil, Faulkes, Rosemary, Leith, Damien, Forrest, Ewan, Danielle, Adebayo, Kennedy, James, Yung, Diana, Alexopoulou, Alexandra, Mani, Iliana, Fung, James, Katchman, Helena, Rabinowich, Liane, Jhaveri, Ajay, Nagral, Aabha, Kulkarni, Anand, Sharma, Mithun, Sarin, Shiv K, Goel, Ashish, Eapen, C E, Duseja, Ajay, Gandotra, Akash, Saraya, Anoop, yegurla, Jatin, Jothimani, Dinesh, Rela, Mohammad, Arora, Anil, Kumar, Ashish, Roy, Akash, Dhiman, R K, Anand, A C, Praharaj, Dibyalochan, Cabrera, Araceli Bravo, Hueso, Sarai Gonzalez, Hérnandez, José Luis Pérez, Gutierrez, Oscar Morales, Ramos-Pineda, Abraham, Zazueta, Godolfino Miranda, Barradas, Mauricio Castillo, Made, Lilian Torres, Velazquez, Rene Male, Félix-Tellez, Francisco, Velasco, José Antonio Velarde-Ruiz, Cordova-Gallardo, Jacqueline, Rajaram, Ruveena, Afendi, Nik Arsyad Nik Muhamad, Nyam, David P, Okeke, Edith N, Allam, Dalia, Patwa, Yashwi Haresh Kumar, Tan, Hiang Keat, Lun, Liou Wei, Ho, Wei Ling Danielle, Wong, Yu Jun, Thanapirom, Kessarin, Teerasarntipan, Tongluk, Haktaniyan, Busra, Gunduz, Feyza, Aslan, Rahmi, Yildirim, Abdullah Emre, Barutcu, Sezgin, Uysal, Alper, Karasu, Zeki, Ucbilek, Enver, Kosay, Tolga, Dinçer, Dinç, Adanır, Haydar, Albhaisi, Somaya, Fallahadeh, Mohammad Amin, Asrani, Sumeet, Reddy, K Rajender, Shaw, Jawaid, Vargas, Hugo, Filipek, Natalia, Biggins, Scott W, Thuluvath, Paul, Sheshadri, Somya, Wegermann, Kara, Kappus, Matthew, Keaveny, Andrew, Rojo, Andres, Negrillo, Ricardo Cabello, and Verna, Elizabeth

Abstract

Infections have a poor prognosis in inpatients with cirrhosis. We aimed to determine regional variations in infections and their association with clinical outcomes in a global cohort of inpatients with cirrhosis.

Published
2024
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