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433 results on '"Conradie, A."'

1. Assessment of epidemiological and genetic characteristics and clinical outcomes of resistance to bedaquiline in patients treated for rifampicin-resistant tuberculosis: a cross-sectional and longitudinal study

Author

Harry Moultrie, Ebrahim Variava, Zaheda Bhyat., Martin Enwerem, Simon Schaaf, Xavier Padanilam, Norbert Ndjeka, Nana Okozi, Minty van der Meulen, Lavania Joseph, Yulene Kock, Shaheed V. Omar, Nazir Ahmed Ismail, Hannetjie Ferreira, Francesca Conradie, Vancy Letsaolo, Anja Reuter, Gary Maartens, Farzana Ismail, Jennifer Hughes, Julian Te Riele, Rodolf Romero, Graeme Meintjes, and Dumisani Ngcamu

Subjects
medicine.medical_specialty, Longitudinal study, Tuberculosis, Antitubercular Agents, Microbial Sensitivity Tests, Clofazimine, chemistry.chemical_compound, Internal medicine, Tuberculosis, Multidrug-Resistant, Epidemiology, medicine, Humans, Longitudinal Studies, Diarylquinolines, Transmission (medicine), business.industry, Incidence (epidemiology), Mycobacterium tuberculosis, Odds ratio, medicine.disease, Cross-Sectional Studies, Infectious Diseases, chemistry, Rifampin, Bedaquiline, business, medicine.drug
Abstract

Summary Background Bedaquiline improves outcomes of patients with rifampicin-resistant and multidrug-resistant (MDR) tuberculosis; however, emerging resistance threatens this success. We did a cross-sectional and longitudinal analysis evaluating the epidemiology, genetic basis, and treatment outcomes associated with bedaquiline resistance, using data from South Africa (2015–19). Methods Patients with drug-resistant tuberculosis starting bedaquiline-based treatment had surveillance samples submitted at baseline, month 2, and month 6, along with demographic information. Culture-positive baseline and post-baseline isolates had phenotypic resistance determined. Eligible patients were aged 12 years or older with a positive culture sample at baseline or, if the sample was invalid or negative, a sample within 30 days of the baseline sample submitted for bedaquiline drug susceptibility testing. For the longitudinal study, the first surveillance sample had to be phenotypically susceptible to bedaquiline for inclusion. Whole-genome sequencing was done on bedaquiline-resistant isolates and a subset of bedaquiline-susceptible isolates. The National Institute for Communicable Diseases tuberculosis reference laboratory, and national tuberculosis surveillance databases were matched to the Electronic Drug-Resistant Tuberculosis Register. We assessed baseline resistance prevalence, mutations, transmission, cumulative resistance incidence, and odds ratios (ORs) associating risk factors for resistance with patient outcomes. Findings Between Jan 1, 2015, and July 31, 2019, 8041 patients had surveillance samples submitted, of whom 2023 were included in the cross-sectional analysis and 695 in the longitudinal analysis. Baseline bedaquiline resistance prevalence was 3·8% (76 of 2023 patients; 95% CI 2·9–4·6), and it was associated with previous exposure to bedaquiline or clofazimine (OR 7·1, 95% CI 2·3–21·9) and with rifampicin-resistant or MDR tuberculosis with additional resistance to either fluoroquinolones or injectable drugs (pre-extensively-drug resistant [XDR] tuberculosis: 4·2, 1·7–10·5) or to both (XDR tuberculosis: 4·8, 2·0–11·7). Rv0678 mutations were the sole genetic basis of phenotypic resistance. Baseline resistance could be attributed to previous bedaquiline or clofazimine exposure in four (5·3%) of 76 patients and to primary transmission in six (7·9%). Odds of successful treatment outcomes were lower in patients with baseline bedaquiline resistance (0·5, 0·3–1). Resistance during treatment developed in 16 (2·3%) of 695 patients, at a median of 90 days (IQR 62–195), with 12 of these 16 having pre-XDR or XDR. Interpretation Bedaquiline resistance was associated with poorer treatment outcomes. Rapid assessment of bedaquiline resistance, especially when patients were previously exposed to bedaquiline or clofazimine, should be prioritised at baseline or if patients remain culture-positive after 2 months of treatment. Preventing resistance by use of novel combination therapies, current treatment optimisation, and patient support is essential. Funding National Institute for Communicable Diseases of South Africa.

Published
2022

2. Detection of isoniazid, fluoroquinolone, ethionamide, amikacin, kanamycin, and capreomycin resistance by the Xpert MTB/XDR assay: a cross-sectional multicentre diagnostic accuracy study

Author

Anura David, Francesca Conradie, Nelly Ciobanu, Claudia M. Denkinger, Lesley Scott, Adam Penn-Nicholson, Valeriu Crudu, Samuel G Schumacher, Vithal Prasad Myneedu, Sophia B. Georghiou, Camilla Rodrigues, Mubin Kazi, Manpreet Bhalla, and Morten Ruhwald

Subjects
Adult, medicine.medical_specialty, Tuberculosis, Capreomycin, Microbial Sensitivity Tests, Drug resistance, Sensitivity and Specificity, Kanamycin, Internal medicine, Drug Resistance, Bacterial, Tuberculosis, Multidrug-Resistant, Isoniazid, Humans, Medicine, Prospective Studies, Ethionamide, Amikacin, biology, business.industry, Australia, Sputum, Mycobacterium tuberculosis, biology.organism_classification, medicine.disease, Cross-Sectional Studies, Infectious Diseases, Mycobacterium tuberculosis complex, Rifampin, business, Fluoroquinolones, medicine.drug
Abstract

Summary Background The WHO End TB Strategy requires drug susceptibility testing and treatment of all people with tuberculosis, but second-line diagnostic testing with line-probe assays needs to be done in experienced laboratories with advanced infrastructure. Fewer than half of people with drug-resistant tuberculosis receive appropriate treatment. We assessed the diagnostic accuracy of the rapid Xpert MTB/XDR automated molecular assay (Cepheid, Sunnyvale, CA, USA) to overcome these limitations. Methods We did a prospective study involving individuals presenting with pulmonary tuberculosis symptoms and at least one risk factor for drug resistance in four sites in India (New Delhi and Mumbai), Moldova, and South Africa between July 31, 2019, and March 21, 2020. The Xpert MTB/XDR assay was used as a reflex test to detect resistance to isoniazid, fluoroquinolones, ethionamide, amikacin, kanamycin, and capreomycin in adults with positive results for Mycobacterium tuberculosis complex on Xpert MTB/RIF or Ultra (Cepheid). Diagnostic performance was assessed against a composite reference standard of phenotypic drug-susceptibility testing and whole-genome sequencing. This study is registered with ClinicalTrials.gov , number NCT03728725 . Findings Of 710 participants, 611 (86%) had results from both Xpert MTB/XDR and the reference standard for any drug and were included in analysis. Sensitivity for Xpert MTB/XDR detection of resistance was 94% (460 of 488, 95% CI 92–96) for isoniazid, 94% (222 of 235, 90–96%) for fluoroquinolones, 54% (178 of 328, 50–61) for ethionamide, 73% (60 of 82, 62–81) for amikacin, 86% (181 of 210, 81–91) for kanamycin, and 61% (53 of 87, 49–70) for capreomycin. Specificity was 98–100% for all drugs. Performance was equivalent to that of line-probe assays. The non-determinate rate of Xpert MTB/XDR (ie, invalid M tuberculosis complex detection) was 2·96%. Interpretation The Xpert MTB/XDR assay showed high diagnostic accuracy and met WHO's minimum target product profile criteria for a next-generation drug susceptibility test. The assay has the potential to diagnose drug-resistant tuberculosis rapidly and accurately and enable optimum treatment. Funding German Federal Ministry of Education and Research through KfW, Dutch Ministry of Foreign Affairs, and Australian Department of Foreign Affairs and Trade.

Published
2022

3. Icosapent Ethyl Reduces Ischemic Events in Patients With a History of Previous Coronary Artery Bypass Grafting: REDUCE-IT CABG

Author

Subodh Verma, Deepak L. Bhatt, Ph. Gabriel Steg, Michael Miller, Eliot A. Brinton, Terry A. Jacobson, Nitish K. Dhingra, Steven B. Ketchum, Rebecca A. Juliano, Lixia Jiao, Ralph T. Doyle, Craig Granowitz, C. Michael Gibson, Duane Pinto, Robert P. Giugliano, Matthew J. Budoff, R. Preston Mason, Jean-Claude Tardif, Christie M. Ballantyne, Fabrice M.A.C. Martens, Astrid Schut, Brian Olshansky, Mina Chung, Al Hallstrom, Lesly Pearce, Cyrus Mehta, Rajat Mukherjee, Anjan K. Chakrabarti, Eli V. Gelfand, Megan Carroll Leary, Duane S. Pinto, Yuri B. Pride, Steven Ketchum, Ramakrishna Bhavanthula, Gertrude Chester, Christina Copland, Katelyn Diffin, Ralph Doyle, Kurt Erz, Alex Giaquinto, Paula Glanton, Angela Granger, Richard H. Iroudayassamy, Rebecca Juliano, James Jin, Dimitry Klevak, Hardik Panchal, Robert Wang, Shin-Ru Wang, Gerard Abate, Peggy J. Berry, Rene Braeckman, Declan Doogan, Anne Elson, Amy HauptmannBaker, Isabel Lamela, Catherine Lubeck, Mehar Manku, Sabina Murphy, Monica Sanford, William Stirtan, Paresh Soni, Arnaud Bastien, Demetria Foster, Evangelito Gascon, Judith Johnson, Lasbert Latona, Gang Liu, Sandra Palleja, Nelly Sanjuan, Jimmy Shi, William Stager, Mukund Venkatakrishnan, Ahmed Youssef-Agha, Julie Zhu, Leela Aertker, Suresh Ankolekar, Lisa Goldberg, Natasa Rajicic, Jianfen Shu, Heng Zou, Magdy Mikhail, Gamil Dawood, N. Mathew Koshy, Sandip K. Mukherjee, Rafik Abadier, Andrea L. Lawless, William P. McGuinn, Howard Weintraub, Kathryn Rohr, Edmund Claxton, Robert J. Weiss, Terry D. Klein, Mani Nallasivan, Stephen Crowley, Marilyn King, Anthony D. Alfieri, David Fitz-Patrick, Irving Loh, Nolan J. Mayer, Rakesh Prashad, Samuel Lederman, Debra Weinstein, Harold E. Bays, Keith Chu, Alireza Maghsoudi, Paul D. Thompson, Jeff Carstens, Anna Chang, Kenneth R. Cohen, Julius Dean, Howard S. Ellison, Bernard Erickson, Enrique A. Flores, Daniel W. Gottlieb, Paul Grena, John R. Guyton, Peter H. Jones, John M. Joseph, Norman E. Lepor, Sam Lerman, Robert D. Matheney, Theodore R. Pacheco, Michael B. Russo, John Rubino, Edward S. Pereira, Albert A. Seals, Eduardo Viera, Alan D. Steljes, Jason Thompson, Shaival Kapadia, Michael McIvor, Jorge E. Salazar, Jose O. Santiago, Ralph Vicari, Martin R. Berk, William A. Kaye, Marcus McKenzie, David Podlecki, Brian D. Snyder, Stephen Nash, David M. Herrington, Wallace Johnson, Joseph R. Lee, Ronald Blonder, Alpa M. Patel, Ramon Castello, Susan Greco, Dean J. Kereiakes, Venkatesh K. Nadar, Mark Nathan, Ranganatha P. Potu, Robert Sangrigoli, Richard Smalling, Mitchell Davis, Robert Braastad, James McCriskin, Kunal Bodiwala, Joe L. Hargrove, Mark W. Graves, George Emlein, Raegan W. Durant, James W. Clower, Rohit Arora, Narendra Singh, Lisa Warsinger Martin, W Herbert Haught, Marc P. Litt, Michael D. Klein, Peter Hoagland, Michael Goldstein, Marco S. Mazzella, Daniel H. Dunker, Brian H. Kahn, Carlos S. Ince, Frank A. McGrew, Jay Lee, David Pan, Salman A. Khan, Uri Elkayam, Wasim Deeb, Anne C. Goldberg, Christopher S. Brown, Wayne N. Leimbach, Thomas S. Backer, David R. Sutton, Joel Gellman, Anu R. George, Alan S. Hoffman, Mark Kates, Kishlay Anand, Robert Bear, Brendan J. Cavanaugh, Ramon G. Reyes, Rodolfo Sotolongo, Kenneth Sabatino, Kevin Gallagher, Ehab Sorial, Chris Geohas, Kathleen E. Magness, Bernard P. Grunstra, Frederik A. Martin, William S. Knapp, Mel E. Lucas, John J. Champlin, Jason Demattia, Patrick H. Peters, Judith Kirstein, William J. Randall, Cezar S. Staniloae, Jennifer G. Robinson, Alexander Adler, Christopher Case, Andrew J. Kaplan, Gregory F. Lakin, Krishan K. Goyle, Michael J. DiGiovanna, Chester L. Fisher, Michael Lillestol, Michael Robinson, Robert G. Perry, Lawrence S. Levinson, Brian G. Everhart, Robert D. Madder, Earl F. Martin, Earl E. Martin, Imtiaz Alam, Jose Mari L. Elacion, Robina Poonawala, Taddese T. Desta, Jerome A. Robinson, Gilbert J. Martinez, Jakkidi S. Reddy, Jeffrey D. Wayne, Samuel Mujica Trenche, Westbrook I. Kaplan, Rubin H. Saavedra, Michael D. DiGregorio, Barry D. Bertolet, Neil J. Fraser, Terence T. Hart, Ronald J. Graf, David A. Jasper, Michael Dunn, Dan A. Streja, David J. Strobl, Nan Jiang, Vicki Kalen, Richard Mascolo, Mercedes B. Samson, Michael Stephens, Bret M. Bellard, Mario Juarez, Patrick J. McCarthy, John B. Checton, Michael Stillabower, Edward Goldenberg, Amin H. Karim, Naseem Jaffrani, Robert C. Touchon, Erich R. Fruehling, Clayton J. Friesen, Pradipta Chaudhuri, Frank H. Morris, Robert E. Broker, Rajesh J. Patel, Susan Hole, Randall P. Miller, Francisco G. Miranda, Sadia Dar, Shawn N. Gentry, Paul Hermany, Charles B. Treasure, Miguel E. Trevino, Raimundo Acosta, Anthony Japour, Samuel J. Durr, Thomas Wang, Om P. Ganda, Perry Krichmar, James L. Arter, Douglas Jacoby, Michael A. Schwartz, Amer Al-Karadsheh, Nelson E. Gencheff, John A. Pasquini, Richard Dunbar, Sarah Kohnstamm, Hector F. Lozano, Francine K. Welty, Thomas L. Pitts, Brian Zehnder, Salah El Hafi, Mark A. King, Arnold Ghitis, Marwan M. Bahu, Hooman Ranjbaran Jahromi, Ronald P. Caputo, Robert S. Busch, Michael D. Shapiro, Suhail Zavaro, Munib Daudjee, Shahram Jacobs, Vipul B. Shah, Frank Rubalcava, Mohsin T. Alhaddad, Henry Lui, Raj T. Rajan, Fadi E. Saba, Mahendra Pai N Gunapooti, Tshiswaka B. Kayembe, Timothy Jennings, Robert A. Strzinek, Michael H. Shanik, Pradeep K. Singh, Alastair C. Kennedy, Howard Rubenstein, Ramin Manshadi, Joanne Ladner, Lily Kakish, Ashley Kakish, Amy L. Little, Jaime Gerber, Nancy J. Hinchion, Janet Guarino, Denise Raychok, Susan Budzinski, Kathleen Kelley-Garvin, April Beckord, Jessica Schlinder, Arthur Schwartzbard, Stanley Cobos, Deborah Freeman, David Abisalih, Dervilla McCann, Kylie Guy, Jennifer Chase, Stacey Samuelson, Madeline Cassidy, Marissa Tardif, Jaime Smith, Brenna Sprout, Nanette Riedeman, Julie Goza, Lori Johnson, Chad Kraske, Sheila Hastings, Chris Dutka, Stephanie Smith, Toni McCabe, Kathleen Maloney, Paul Alfieri, Vinay Hosemane, Chanhsamone Syravanh, Cindy Pau, April Limcoiloc, Tabitha Carreira, Taryn S. Kurosawa, Razmig Krumian, Krista Preston, Ashraf Nashed, Daria Schneidman-Fernandez, Jack Patterson, John Tsakonas, Jennifer Esaki, Lynn Sprafka, Porous Patel, Brian Mitchell, Erin M. Ross, Donna Miller, Akash Prashad, Kristina M. Feyler, Natasha Juarbe, Sandra Herrera, Sarah M. Keiran, Becky Whitehead, Whitney Asher, Coury Hobbs, Abbey Elie, Jean Brooks, Amanda L. Zaleski, Brenda Foxen, Barb Lapke, Philippa Wright, Bristol Pavol, Gwen Carangi, Marla Turner, Katharine W. Sanders, Rikita S. Delamar, Virginia L. Wilson, Sarah M. Harvel, Alison M. Cartledge, Kaitlyn R. Bailey, Kathleen Mahon, Timothy Schuchard, Jen Humbert, Mark C. Hanson, Michael P. Cecil, James S. Abraham, Lorie Benedict, Claudia Slayton, Curtis S. Burnett, Rachel W. Ono-Lim, Sharon Budzinski, Shubi A. Khan, Sharon Goss, Terry Techmanski, Farida Valliani, Rimla Joseph, Edith Flores, Laurn Contreras, Ana Aguillon, Carrie-Ann Silvia, Maria Martin, Edmund K. Kerut, Leslie W. Levenson, Louis B. Glade, Brian J. Cospolich, Maureen W. Stein, Stephen P. LaGuardia, Thelma L. Sonza, Tracy M. Fife, Melissa Forschler, Jasmyne Watts, Judy Fritsch, Emese Futchko, Sarah Utech, Scott B. Baker, Miguel F. Roura, Scott A. Segel, James S. Magee, Cathy Jackson, Rebecca F. Goldfaden, Liudmila Quas, Elizabeth C. Ortiz, Michael Simpson, Robert Foster, Christopher Brian, James Trimm, Michael Bailey, Brian Snoddy, Van Reeder, Rachel Wilkinson, Harold Settle, Cynthia Massey, Angela Maiola, Michele Hall, Shelly Hall, Wanda Hall, Mark Xenakis, Janet Barrett, Giovanni Campanile, David Anthou, Susan F. Neill, Steven Karas, Enrique Polanco, Norberto Schechtman, Grace Tischner, Kay Warren, Cynthia St Cyr, Menna Kuczinski, Latrina Alexander, Maricruz Ibarra, Barry S. Horowitz, Jaime Steinsapir, Jeanette Mangual-Coughlin, Brittany Mooney, Precilia Vasquez, Kathleen Rodkey, Alexandria Biberstein, Christine Ignacio, Irina Robinson, Marcia Hibberd, Lisa B. Hoffman, Daniel J. Murak, Raghupathy Varavenkataraman, Theresa M. Ohlson Elliott, Linda A. Cunningham, Heather L. Palmerton, Sheri Poole, Jeannine Moore, Helene Wallace, Ted Chandler, Robert Riley, Farah Dawood, Amir Azeem, Michael Cammarata, Ashleigh Owen, Shivani Aggarwal, Waqas Qureshi, Mohamed Almahmoud, Abdullahi Oseni, Adam Leigh, Erin Barnes, Adam Pflum, Amer Aladin, Karen Blinson, Vickie Wayne, Lynda Doomy, Michele Wall, Valerie Bitterman, Cindi Young, Rachel Grice, Lioubov Poliakova, Jorge Davalos, David Rosenbaum, Mark Boulware, Heather Mazzola, J. Russell Strader, Russell Linsky, David Schwartz, Elizabeth Graf, Alicia Gneiting, Melissa Palmblad, Ashley Donlin, Emily Ensminger, Hillary Garcia, Dawn Robinson, Carolyn Tran, Jeffrey Jacqmein, Darlene Bartilucci, Michael Koren, Barbara Maluchnik, Melissa Parks, Jennifer Miller, Cynthia DeFosse, Albert B. Knouse, Amy Delancey, Stephanie Chin, Thomas Stephens, Mag Sohal, Juana Ingram, Swarooparani Kumar, Heather Foley, Nina Smith, Vera McKinney, Linda Schwarz, Judith Moore, Hildreth Vernon Anderson, Stefano Sdringola-Maranga, Ali Denktas, Elizabeth Turrentine, Rhonda Patterson, John Marshall, Terri Tolar, Donna Patrick, Pamela Schwartzkopf, Anthony M. Fletcher, Frances R. Harris, Sherry Clements, Tiffany Brown, William Smith, Stacey J. Baehl, Robin Fluty, Daniel VanHamersveld, Dennis Breen, Nancy Bender, Beverly Stafford, Tamika Washington, Margaret N. Pike, Mark A. Stich, Evyan Jawad, Amin Nadeem, Jill Nyland, Rhonda Hamer, Kendra Calhoun, Charlotte Mall, Samuel Cadogan, Kati Raynes, Richard Katz, Lorraine Marshall, Rashida Abbas, Jay L. Dinerman, John T. Hartley, Beth Lamb, Lisa Eskridge, Donna Raymond, Kristy Clemmer, Denise M. Fine, Paula Beardsley, Janet Werner, Bette Mahan, Courtney VanTol, Robert Herman, Christine Raiser-Vignola, Felicia McShan, Stefanie A. Neill, David R. Blick, Michael J. Liston, Denetta K. Nelson, Sandra K. Dorrell, Patricia Wyman, Ambereen Quraishi, Fernando Ferro, Frank Morris, Vicki J. Coombs, Autumn M. Mains, Austin A. Campbell, Jeanne Phelps, Cheryl A. Geary, Ellen G. Sheridan, Jean M. Downing, Arie Swatkowski, Tish Redden, Brian Dragutsky, Susan Thomas, Candace Mitchell, Diana Barker, Elanie Turcotte, Deborah Segerson, Jill Guy, Karena De La Mora, Jennifer Hong, Dennis Do, Rose Norris, Faisal Khan, Hector Montero, Stacy Kelly-White, Alan Cleland, Rosalyn Alcalde-Crawford, Melissa Morgan, Brijmohan Sarabu, Megan Minor, Shweta Kamat, Stephanie M. Estes, Nancee Harless, Alicia Disney, Jodi L. Pagano, Chad M. Alford, Noel W. Bedwell, Warren D. Hardy, Kevin DeAndrade, Jessica G. Elmore, Eric Auerbach, Anthony W. Haney, Miriam H. Brooks, Jose Torres, Lois Roper, Terry Backer, Katie Backer, John G. Evans, Ricardo A. Silva, Lorraine H. Dajani, Veronica Yousif, Tammy Ross, Sion K. Roy, Ronald Oudiz, Sajad Hamal, Ferdinand Flores, Amor Leahy, Debra Ayer, Swapna George, Chrisi Carine Stewart, Elvira Orellana, Cristina Boccalandro, Mary Rangel, Suzanne Hennings, Carl Vanselow, Teri Victor, Darlene Birdwell, Paul Haas, Anthony Sandoval, Gina Ciavarella, Caroline Saglam, Amy Bird, Keith Beck, Brian Poliquin, David Dominguez, Brittany Tenorio, Harvonya Perkins, Esther San Roman, Paris Bransford, Christy Lowrance, Marcy Broussard, Mary Ellis, Bobbi Skiles, Jessica Hamilton, Kathryn Hall, Diego Olvera, Julee A. Hartwell, Nevien Sorial, Mary Rickman, Kevin Berman, Nirav Mehta, Annie Laborin, Rodger Rothenberger, Sarah Beauvilliers, Kathy Morrell, Michael P. Schachter, Cindy L. Perkins, Elizabeth A. Gordon, Jennifer Lauer, Kim Bichsel, Kelly Oliver, Leslie J. Mellor, Candice Demattia, Jennifer Schomburg, Yenniffer Moreno, Eduardo Mansur-Garza, Lena Rippstein, Lorie Chacon, Andrea Pena, Michelle King, Susan Richardson, Annette Jessop, Nicole Tucker, Whitney Royer, Gilbert Templeton, Ann Moell, Christine Weller, Melissa J. Botts, Gretel Hollon, Elsa Homberg-Pinassi, Paula Forest, Aref Bin Abhulhak, Devona Chun-Furlong, Deborah Harrington, Emily Harlynn, Marjorie Schmitt, Constance Shelsky, Patricia Feldick, Mary Cherrico, Courtney Jagle, Nicholas Warnecke, Debra Myer, Deanna J. Ruder, Albina Underwood, Alan Rauba, George Carr, Barbara Oberhaus, Jessica Vanderfeltz, Mary Jo Stucky-Heil, Dale R. Gibson, Vonnie Fuentes, Kimberly L. Talbot, William C. Simon, Katlyn J. Grimes, Christina R. Wheeler, Cassaundra Shultz, Rhonda A. Metcalf, Jennifer L. Hill, Michelle R. Oliver, Basharat Ahmad, Fouzal Azeem, Abdul Rahim, George H. Freeman, Dawn Bloch, Heather Freeman, Jamie Brown, Sarah Rosbach, Pamela Melander, Nick Taralson, Alex Liu, Katlyn Harms, Mahfouz Michale, Jose Lopez, Maria Revoredo, Shari Edevane, Sarah Shawley, Timothy L. Jackson, Michael J. Oliver, Dina DeSalle, Patricia J. Matlock, Ionna M. Beraun, Heather Hendrix, Garrett Bromley, Ashley Niemerski, Gabby Teran, Sonia Guerrero, Murtaza Marvi, Zehra Palanpurwala, Andrea Torres, Patty Gloyd, Michelle Conger, Aziz Laurent, Olia Nayor, Catalina S. Villanueva, Munira Khambati, Tabetha J. Mumford, Melanie J. Castillo, Taddese Desta, Jerome Robinson, La Shawn Woods, Anita Bahri, Nancy Herrera, Cecilia Casaclang, Jeffrey R. Unger, Geraldine Martinez, Mia K. Moon, Stephen M. Mohaupt, Larry Sandoval, Louisito Valenzuela, Victora Ramirez, Nelly Mata, Veronica Avila, Marisol Patino, Cynthia Montano-Pereira, Omar Barnett, William M. Webster, Lorraine M. Christensen, Leighna Bofman, Melanie Livingston, Stacey Adams, Joseph Hobbs, Leesa Koskela, Mia Katz, Samuel Mujica-Trenche, Franklin Cala, Noreen T. Rana, Jennifer Scarlett, Milagros Cala Anaya, Marsha R. Jones, Kelly D. Hollis, Debbie Roth, Kristin Eads, Tina Watts, Judy Perkins, Alice Arnold, Daniel C. Ginsberg, Denise Quinn, Nicole Cureton, David B. Fittingoff, Mohammed I. Iqbal, Stephen R. White, Edith Sisneros, Michelle Ducca, David Streja, Danny Campos, Jennifer L. Boak, Farzeen Amir, Felice Anderson, James J. Kmetzo, Mary O. Bongarzone, Dawn Scott, Mary Grace De Leon, Cynthia Buda, William Graettinger, Michelle Alex, Erika Hess, James Govoni, Melissa Bartel, Travis L. Monchamp, Julie S. Roach, Sara Gibson, Amy M. Allfrey, Kristen Timpy, Kathy Bott, Karin A. Soucy, Jean Willis, Cecilia A. Valerio, Anusha Chunduri, Rebecca Coker, Nicole Vidrine, Ellen A. Thompson, Mark A. Studeny, Melissa K. Marcum, Tammy S. Monway, Douglas L. Kosmicki, Melissa J. Kelley, Corey M. Godfrey, Susan L. Krenk, Randy R. Holcomb, Deb K. Baehr, Mary K. Trauernicht, David Rowland Lowry, Betty Bondy Herts, Jeanne E Phelps, Jean-Marie Downing, Carol Gamer Dignon, Elisabeth S. Cockrill, Pravinchandra G. Chapla, Diane Fera, Margaret Chang, Patricia Fredette, Tamie Ashby, Renee Bergin, Zebediah A. Stearns, David B. Ware, Rachael M. Boudreaux, Joanna Rodriguez, Robert McKenzie, Amanda Huber, Rebecca Sommers, Heather Rowe, Stacy McLallen, Michale Haynes, Ashley Adamson, Janice Henderson, Lori McClure, Beverly A. Harris, Laura Ference, Sue Meissner-Dengler, Lisa Treasure, Doreen Nicely, Timothy L. Light, Tracey A. Osborn, Kimberly J. Mai, Pablo Vivas, Jose Rios, Dunia Rodriguez, Roger DeRaad, James Walder, Oscar Bailon, Denice Hockett, Debbie Anderson, Kelli McIntosh, Amber Odegard, Andrew Shepherd, Mary Seifert, Laurence Kelley, Rajendra Shetty, Michael Castine, David Brill, Gregory Fisher, Nicole Richmond, Kathleen Gray, Patricia Miller, Charlene Coneys, Yarixa Chanza, Monica Sumoza, Victoria M. Caudill, Kelly D. Harris, Courtney A. Manion, Melody J. Lineberger-Moore, Julie J. Wolfe, Barbara J. Rosen, Patricia DiVito, Janet L. Moffat, Christina Michaelis, Prashant Koshy, Diana Perea, Ghaith Al Yacoub, Stephanie Sadeghi, Thomas D. LeGalley, Rudolph F. Evonich, William J. Jean, Gary M. Friesen, John M. Pap, David A. Pesola, Mark D. Cowan, Kristofer M. Dosh, Dianna Larson, Adele M. Price, Jodi A. Nease, Jane E. Anderson, Lori A. Piggott, Robert Iwaoka, Kevin Sharkey, Edward McMillan, Laurie Lowder, Latisha Morgan, Kyle Davis, Tara Caldwell, Erica Breglio, Jasmine Summers, Rachel Poulimas, Muhammad Zahid, Hamid Syed, Maria Escobar, Jacob Levy, Rahma Warsi, Carol Ma, Puxiao Cen, Kimberly A. Cawthon, Delores B. Barnes, Deanna G. Allen, Margaret L. Warrington, Carol R. Stastny, Robin J. Michaels, Mohamad Saleh, John Sorin, Sunny Rathod, Urakay Juett, Steven Spencer, Aziza Keval, Jill McBride, Shane Young, Catherine Baxter, Carol Rasmussen, Shari L. Coxe, Luis Campos, Shahin Tavackoli, Diana Beckham, Darlynee Sanchez, Karanjit Basrai, Dorian Helms, Erica Clinton, Kasie Smith, Henry Cusnir, Mary Klaus Clark, Madhavagopal V. Cherukuri, Ameta Scarfaru, Stephen D. Nash, Loretta C. Grimm, Anna Grace, Kylie McElheran, Dino Subasic, Zedrick Buhay, Janet Litvinoff, Deepak Shah, Shannon Cervantes, Freda Usher, Farra Yasser, Theodore Trusevich, Ronnie L. Garcia, Jamison Wyatt, Rahul Bose, Holllilyn Miska, Traci Spivey, Amy B. Wren, Katie E. Vance, Lani L. Holman, Pam Gibbons, Elaine Eby, Sandra Shepard, Soratree Charoenthongtrakul, Brett Snodgrass, Mohammed Nazem, Shelly Keteenburg, Prathima Murthy, Frederic Prater, Ashley Rumfelt, Christina Eizensmits, Lisa Iannuzzi, Pourus R. Patel, Clellia Bergamino, Elizabeth McFeaters, Botros Rizk, Emiljia Pflaum, Danny Kalish, Rex Ambatali, Mona Ameli, Delaina Sanguinetti, Rakesh Vaidya, Martinus A.W. Broeders, Dorman Henrikus, Adrianus F.M. Kuijper, Nadea Al-Windy, Michael Magro, Karim Hamraoui, Ismail Aksoy, Guy L.J. Vermeiren, H.W.O. Roeters van Lennep, Gerard Hoedemaker, Johannes Jacobus Remmen, Kjell Bogaard, Dirk van der Heijden, Nicole MJ Knufman, Joost Frederiks, Johannes Willem Louwerenburg, Piet van Rossum, Johannes Milhous, Peter van der Meer, Arno van der Weerdt, Rob Breedveld, Mitran Keijzers, Walter Hermans, Ruud van de Wal, Peter A.G. Zwart, Marc M.J.M. van der Linden, Gerardus Zwiers, Dirk J. Boswijk, Jan Geert Tans, Jacob van Eck, Maarten V. Hessen, Barnabas J.B. Hamer, Stieneke Zoet-Nugteren, Lucien Theunissen, E.A. van Beek, Remco Nijmeijer, Pieter R. Nierop, Gerard Linssen, H.P. Swart, Timo Lenderink, Gerard L. Bartels, Frank den Hartog, Brian J. Berg van den, Wouter van Kempen, Susanne Kentgens, Gloria M. Rojas Lingan, Martinus M. Peeters, Hilligje Keterberg, Melchior Nierman, Annemieke K. den Hollander, Jacqueline Hoogendijk, Christine Voors-Pette, Vicdan Kose, Peter Viergever, Larysa Yena, Viktor Syvolap, Mykola P. Kopytsya, Olga Barna, Svitlana S. Panina, Mykhailo I. Lutai, Oxana V. Shershnyova, Iryna Luzkiv, Larysa S. Bula, Sergii Zotov, Ivan Vyjhovaniuk, Olena Lysunets, Volodymyr I. Koshlia, Nataliya Sydor, Myroslava F. Vayda, Olexiy Ushakov, Mykola Rishko, Viktor P. Shcherbak, Yevgeniya Svyshchenko, Vira Tseluyko, Andriy Yagensky, Viktoriia I. Zolotaikina, Olga Godlevska, Larysa Ivanova, Olena Koval, Olena I. Mitchenko, Galyna Y. Kardash, Yurii S. Rudyk, Mykola Stanislavchuk, Volodymyr Ivanovych Volkov, Olena G. Karlinskaya, Susanna A. Tykhonova, Nikolay Vatutin, Ganna Smirnova, Volodymyr M. Kovalenko, Viktor Lizogub, Denys Sebov, Oleksandr Dyadyk, Svetlana Andrievskaya, Mykola P. Krasko, Alexander N. Parkhomenko, Lidiya Horbach, Iryna G. Kupnovytska, Tetyana Pertseva, Oleksandr Karpenko, Dmytro Reshotko, Svitlana V. Zhurba, Leonid Rudenko, Viktoriia Yu Zharinova, Valerii B. Shatylo, Yuriy I. Karpenko, Mariya A. Orynchak, Tatiana R. Kameneva, Elena Zherlitsina, Diana N. Alpenidze, Grigoriy P. Arutyunov, Elena Baranova, Boris Bart, Dmitriy I. Belenkiy, Svetlana A. Boldueva, Elena A. Demchenko, Vera V. Eltishcheva, Alexander M. Gofman, Boris M. Goloshchekin, Ivan Gennadyevich Gordeev, Nikolay Gratsianskiy, Gadel Kamalov, Niyaz R. Khasanov, Irina M. Kholina, Zhanna D. Kobalava, Elena V. Kobeleva, Alexandra O. Konradi, Victor A. Kostenko, Andrey Dmitrievich Kuimov, Polina Y. Ermakova, Sofia K. Malyutina, Alexey V. Panov, Natalia V. Polezhaeva, Olga Reshetko, Nataliya P. Shilkina, Sergey B. Shustov, Elena A. Smolyarchuk, Raisa I. Stryuk, Elena Yurievnar Solovieva, Andrey V. Susekov, Natalia Vezikova, Svetlana N. Ivanova, Alexander A. Petrov, Vladimir O. Konstantinov, Alina S. Agafina, Victor Gurevich, Konstantin N. Zrazhevskiy, Tatiana V. Supryadkina, Nikita B. Perepech, Vadim L. Arkhipovskiy, Dmitry Yu Butko, Irina A. Zobenko, Olga V. Orlikova, Viktor Mordovin, Olga L. Barbarash, Anastasiya Lebedeva, Vladimir Nosov, Oleg V. Averkov, Elena P. Pavlikova, Yuri B. Karpov, Marina Lvovna Giorgadze, Oleg A. Khrustalev, Mikhail Arkhipov, Tatiana A. Raskina, Julia V. Shilko, Yulia Samoilova, Elena D. Kosmacheva, Sergey V. Nedogoda, Kathleen Coetzee, Lesley J. Burgess, F.C.R. Theron, Iftikhar O. Ebrahim, Gerbrand A. Haasbroek, Maria Pretorius, Julien S. Trokis, Dorothea V. Urbach, Mark J. Abelson, Adrian R. Horak, Aysha E. Badat, Ellen M. Makotoko, Hendrik Du Toit Theron, Padaruth Ramlachan, Clive H. Corbett, Ismail H. Mitha, Hendrik F.M. Nortje, Dirkie J. Jansen van Rensburg, Peter J. Sebastian, F.C.J. Bester, Louis J. van Zyl, Brian L. Rayner, Elżbieta Błach, Magda Dąbrowska, Grzegorz Kania, Agata E. Kelm-Warchol, Leszek P. Kinasz, Janusz Korecki, Mariusz Kruk, Ewa Laskowska-Derlaga, Andrzej Madej, Krzysztof Saminski, Katarzyna Wasilewska, Katarzyna Szymkowiak, Małgorzata Wojciechowska, Natalia Piorowska, Andrzej Dyczek, Rajpal K. Abhaichand, Ramesh B. Byrapaneni, Basavanagowdappa Hattur, Malipeddi Bhaskara Rao, Nitin Ghaisas, Sujit Shankar Kadam, Jugal B. Gupta, Santhosh M. Jayadev, V.A. Kothiwale, Atul Mathur, Vijay Bhaskar, Ravi K. Aluri, Udaya P. Ponangi, Mukesh K. Sarna, Sunil Sathe, Manish K. Sharma, Jilendra Pal Singh Sawhney, Chakrabhavi B. Keshavamurthy, Arun Srinivas, Hemant P. Thacker, A. Sharda, Johny Joseph, Sunil Dwivedi, Viswanathan Mohan, Rajendra K. Premchand, Jacques Bedard, Jean Bergeron, Ronald Collette, David Crowley, Richard Dumas, Sam Henein, Geoff Moran, William F. O’Mahony, Michael O’Mahony, Sammy Chan, Mark H. Sherman, Graham C. Wong, Brian D. Carlson, Milan K. Gupta, David Borts, Sean R. Peterson, Martyn Chilvers, Allan J. Kelly, Jean C. Gregoire, Simon Kouz, Josep Rodés Cabau, Minodora Andor, Mircea Cinteza, Radu Ciudin, Radu I. Cojan, Roxana O. Darabont, Dan-Lucian Dumitrascu, Carmen Fierbinteanu-Braticievici, Ana Gabriela Fruntelata, Constantin Militaru, Bogdon E. Minescu, Doina Luminita Serban, Florin Mitu, Dorel Nastase Melicovici, Ovidiu Petrascu, Octavian M. Pirvu, Cristian Podoleanu, Calin Pop, Rodica-Valentina V. Stanescu-Cioranu, Adrian Tase, Cristina Voiculet, Constantine N. Aroney, Anthony M. Dart, Timothy Davis, Karam Kostner, David N. O’Neal, Peter W. Purnell, Bhuwanendu B. Singh, David R. Sullivan, Peter Thompson, Gerald F. Watts, Adam F. Blenkhorn, John V. Amerena, Rafeeq Samie, Randall Hendriks, Joseph Proietto, Nikolai Petrovsky, Alan Whelan, David Colquhoun, Russell S. Scott, Simon C. Young, Tammy Pegg, Samuel JS Wilson, Andrew W. Hamer, Richard A. Luke, Hamish H. Hart, Gerard P. Devlin, Gerard T. Wilkins, Ian F. Ternouth, Samraj Nandra, Bruno S. Loeprich, Nicole McGrath, Stuart L. Tie, Rob J. Bos, Alexandra Wils, Tamara Jacobs, Erik A. Badings, Lillian A. Ebels-Tuinbeek, Mayke L. Scholten, Esther Bayraktar-Verver, Debby Zweers, Manoek Schiks, Carolien Kalkman, Tineke Tiemes, Jeanette Mulderij, Katarzyna Dabrowska, Wilma Wijnakker, Riny Van de Loo, Jeanne de Graauw, Giny Reijnierse, Mirjam van der Zeijst, Mariska Scholten, Henk R. Hofmeijer, Antoinette van Dijk-van der Zanden, Dineke J. van Belle, Jan Van Es, Gera Van Buchem, Wendy Zijda, Harald Verheij, Linnea Oldenhof-Janssen, Martina Bader, Marije Löwik, Sandra Stuij, Pascal Vantrimpont, Krista van Aken, Karen Hamilton, Han Blömer, Gabriela van Laerhoven, Raymond Tukkie, Maarten Janssen, Gerard Verdel, Jon Funke Küpper, Bob van Vlies, Caroline Kalkman, Joke Vooges, Marinella Vermaas, Rachel Langenberg, Niek Haenen, Frans Smeets, Arko Scheepmaker, Marcel Grosfeld, Ilvy Van Lieshout, Marleen van den Berg, Marian Wittekoek, Petra Mol, Antionette Stapel, Margaretha Sierevogel, Nancy van der Ven, Annemiek Berkelmans, Eric Viergever, Hanneke Kramer, Wilma Engelen, Karen V. Houwelingen, Thierry X. Wildbergh, Arend Mosterd, Coriet Hobé-Rap, Marjan van Doorn, Petra Bunschoten, Michel Freericks, Mireille Emans, Petra Den Boer-Penning, Els Verlek, Christine Freericks, Cornelis de Nooijer, Christina Welten, Ingrid Groenenberg, Claudia van der Horst, Esther Vonk, Geert Tjeerdsma, Gerard M. Jochemsen, Corinne van Daalen, Ingrid Y. Danse, Lucy Kuipers, Anke Pieterse, Antonius Oomen, Daan de Waard, Willem Jan Flu, Zusan Kromhout, Petra Van der Bij, Rob Feld, Brigitta Hessels-Linnemeijer, Rob Lardinois, Jan L. Posma, Zwanette R. Aukema-Wouda, Marjolijn Hendriks-van Woerden, Desiree van Wijk, Driek P. Beelen, Ingrid H. Hendriks, Jan J. Jonker, Stefanie Schipperen, Vicdan Köse, Gloria Rojas, Linda Goedhart, Hanneke van Meurs, Jacqueline Rijssemus, Lindy Swinkels-Diepenmaat, Marloes de Louw-Jansen, Dominique Bierens-Peters, Willem W. van Kempen, Marianne E. Wittekoek, Irmaina Agous, Geert Schenk, Janneke Wittekoek, Kevin Cox, Deborah F. Julia, Jan J.C. Jonker, Roel Janssen, Melchor Nierman, Hilligje Katerberg, Irene van der Haar, Willem W. Van Kempen, Taco van Mesdag, Leyda M. Alvarez Costa, Manon Schensema, Salomé Zweekhorst, Deborah Font Julia, Lauri Hanewinckel, Joyce Olsthoorn, Johan C. Berends, Arie C. van der Spek, Roy van der Berg, Rob J. Timmermann, Ingrid Boerema, Iryna Mudruk, Anna Khrystoforova, Serhii Kyselov, Yaroslava V. Hilova, Pavlo Logoida, Nataliia A. Sanina, Ilona P. Golikova, Olena O. Nemchyna, Ivan I. Isaichikov, Olga B. Potapova, Iurii V. Gura, Larysa Berestetska, Olena O. Kulianda, Oleksandr Tantsura, Oleksandr S. Kulbachuk, Volodymyr Petsentiy, Ihor Biskub, Tetyana Handych, Oleg Lagkuti, Alyna Gagarina, Taras Chendey, Oksana F. Bilonko, Olena Matova, Larysa Bezrodna, Olena Yarynkina, Tetiana Ovdiienko, Volodymyr Randchenko, Maryna Mospan, Olena Butko, Olga Romanenko, Mykhailo Pavelko, Iryna Sichkaruk, Svitlana O. Lazareva, Olena A. Kudryk, Inessa M. Koltsun, Tetiana Magdalits, Sergei Zadorozhniy, Kira Kompaniiets, Andrii Ivanov, Sergiy Romanenko, Pavlo Kaplan, Vadym Y. Romanov, Oksana P. Mykytyuk, Nataliia S. Zaitseva, Sergiy N. Pyvovar, Lyudmyla Burdeuna, Emerita Serdobinska, Tatiana I. Shevchenko, Igor I. Ivanytskyi, Olena V. Khyzhnyak, Nataliya Kalinkina, Olena Keting, Olena Sklyanna, Olga Kashanska, Anna Shevelok, Marina Khristichenko, Ievgenii Y. Titov, Danilenko O. Oleksander, Nataliia S. Polenova, Nataliia Altunina, Viktoriia Kororaieva, Stanislav Zborovskiy, Leonid Kholopov, Iurii Suliman, Lanna Lukashenko, Stanislav Shvaykin, Olexandr M. Glavatskiy, Roman O. Sychov, Roman L. Kulynych, Oleksandr A. Skarzhevskyi, Nataliia V. Dovgan, Marta Horbach, Olga Cherkasova, Iryna Tyshchenko, Liudmyla Todoriuk, Svitlana Kizim, Nataliia Brodi, Oleksandr Ivanko, Olga Garbarchuk, Liudmyla Alieksieieva, Tetiana L. Shandra, Olena Beregova, Larisa An Bodretska, Svitlana S. Naskalova, Ivanna A. Antoniuk-Shcheglova, Olena V. Bondarenko, Natalia G. Andreeva, Iryna I. Vakalyuk, Olha S. Chovganyuk, Nataliya R. Artemenko, Kiril A. Maltsev, Natalia Kalishevich, Natalia G. Kondratyeva, Svetlana A. Nikitina, Maria V. Martjanova, Anna V. Sokolova, Dmitrii O. Dragunov, Olga Kolesnik, Vera Larina, Oxana V. Tsygankova, Maria Ivanova, Illia A. Karpov, Elena M. Aronova, Ekaterina S. Vedernikova, Ekaterina I. Lubinskaya, Taras Y. Burak, Sergey I. Skichko, Farhad Rasulev, Ekaterina B. Soldatova, Alexander L. Fenin, Ilya I. Laptev, Elena E. Luchinkina, Alexandr Akatov, Natalia V. Polenova, Natalia N. Slavina, Irina N. Korovnika, Marina Yu Prochorova, Regina Shakirova, Elena N. Andreicheva, Olga A. Krasnova, Tinatin V. Lobzhanidze, Tatiana B. Dmitrova, Viktoriya V. Stakhiv, Maria I. Pechatnikova, Alexandra V. Panova, Maria Y. Tipikina, Oxana P. Rotar, Nikolay A. Bokovin, Saule K. Karabalieva, Farid Y. Tumarov, Elena V. Vasileva, Natalya Gennadevna Lozhkina, Ekaterina V. Filippova, Alisa I. Sharkaeva, Ekanerina V. Filippova Deilik, Natalia Yu Tolkacheva, Elena N. Domracheva, Andrey N. Ryabikov, Inga T. Abesadze, Marianna Z. Alugishvili, Elena P. Nikolaeva, Nadezda V. Smirnova, Valentina I. Rodionova, Polina V. Dolovstaya, Igor E. Yunonin, Sergey V. Kadin, Tatyana S. Sveklina, Anna V. Bushmanova, Elena L. Barkova, Irina S. Gomova, Yana V. Brytkova, Tatiana B. Ivanova, Marina Y. Zubareva, Inga Skopets, Lybov A. Galashevskaya, Emilia D. Butinskaya, Olga G. Gusarova, Natalia B. Kalishevich, Yana R. Pavlova, Marianna P Serebrenitskaya, Vitalina F. Grygorieva, Gulnara R. Kuchaeva, Inna A. Vasileva, Gulnara I. Ospanova, Yulia V. Vahrusheva, Irina A. Semenova, Irina E.E. Mikhailova, Olga O. Kvasova, Valeria D. Shurygina, Alexey E. Rivin, Alexey O. Savelyev, Alexey A. Savelyev, Olesya O. Milyaeva, Nadezhda N. Lapshina, Ninel A. Lantsova, Pavel V. Alexandrov, Evgeniy A. Orlikov, Alla Falkovskaya, Tatiana Ripp, Sergei Triss, Stanislav Pekarskiy, Sitkova Ekaterina, Evgeniya N. Zhuravleva, Olga Perova, Galina Kovaleva, Liubov Koroleva, Lydia Mishchenko, Boris P. Garshin, Svetlana A. Kutuzova, Lyudmila I. Provotorova, Igor P. Zadvorny, Olga V. Okhapkina, Anatoly O. Khrustalev, Tatiana Suvorova, Elena S. Shaf, Varvara A. Vershinina, Andrey A. Kozulin, Oxana A. Oleynik, Irina Y. Martynova, Natalia V. Kizhvatova, Alla S. Salasyuk, Vera V. Tsoma, Alla A. Ledyaeva, Elena V. Chumachek, S.C. Blignaut, Tersia Y. Alexander, Chano Du Plessis, Thirumani Govender, Samatha M. Du Toit, Leya Motala, Areesh Gassiep, Christina Naude (Smit), Marli Terblanche, Marlien Snoer (Kruger), Berenice Pillay, De Vries Basson, Marisa E. Theron, Bianca Fouche, Mareli E. Coetzee, Pieter Odendall, Frederik H. Van Wijk, Anna-Mari Conradie, Trudie Van der Westhuizen, Carine Tredoux, Mohamed S. Mookdam, Andie J. Van der Merwe, Karin Snyman, Gerda Smal, Yvonne De Jager, Thomas A. Mabin, Annusca King, Lindy L. Henley, Brenda M. Zwane, Jane Robinson, Marinda Karsten, Andonia M. Page, Valerie Nsabiyumva, Charmaine Krahenbuhl, Jaiprakash D. Patel, Yunus E. Motala, Ayesha Dawood, Nondumiso B. Koza, Lenore M.S. Peters, Shavashni Ramlachan, Wilhelm J. Bodenstein, Pierre Roux, Lizelle Fouche, Cecilia M. Boshoff, Haroon M. Mitha, Fathima Khan, Henry P. Cyster, Helen Cyster, E. C. Wessels, Florence J. Jacobs, Melanie A. Sebastian, Deborah A. Sebastian, Nadia Mahomed, Ignatius P. Immink, Celia Cotzee, Tanja Cronje, Madele Roscher, Maria Le Roux, Yvonne A. Trinder, Renata Wnętrzak-Michalska, Magdalena Piszczek, Andrzej Piela, Ewa Czernecka, Dorota Knychas, Alina Walczak, Izabella Gładysz, Katarzyna Filas, Ewelina Kiluk, Krzysztof Świgło, Iwona Jędrzejczyk, Kamila Łuczyńska, Katarzyna Tymendorf, Wojciech Piesiewicz, Wojciech L. Kinasz, Stefan Samborski, Ilona Bartuś, Gramzyna Latocha Korecka, Ewa Gulaj, Jolanta Sopa, Bogusław Derlaga, Marcin Baisiak, Allicia Kowalisko, Edyta Stainszewska-Marasazlek, Bartosz Szafran, Malgorzata Swiatkiewicz, Artur Racewicz, Sławomir Grycel, Jerzy Supronik, Sylwia Walendziuk, Magdalena Tarantowicz, Agata Stasiak, Anna Sidorowicz-Białynicka, Marek Dwojak, Ewa Jaźwińska-Tarnawska, Katarzyna Kupczyk, Kamila Martowska, Kamila Kulon, Katarzyna Gajda, Bivin Wilson, Krithika Velusamy, Swaidha S. Sadhiq, Bhavani Siddeshi, M. Bhanukumar, Abhishek Srivatsav, Madhan Ramesh, Sri Harsha Chalasani, Mini Johnson, Prashanth Gopu, Jeesa George, Sowmya Reddy, Swetha Tessy Thara Eleena, Damodara Rao Kodem, Haritha N. Nakkella, Padma Kumari Mandula, Anjan Kumar Vuriya, Syamala Rajana, Aruna Kale, Tiwari Rajeev, Raina Jain, Vipin Jain, Srilakshmi Mandayam Adhyapak, Lumin Sheeba, Uma C R, Ramya R, Aditya V. Kulkarni, M.S. Ganachari, Ruma Sambrekar, Mohammad Bilal, Kalyan Chakravarthy, Ravi Badhavath, Sravan Kumar, Meenakshi Simhadri, Farooque Salamuddin, Venkat Prasad, Vivek Dwivedi, Sudha Sarna, Tilak Arora, Deepak Chawla, Archana Sathe, Chaware Gayatree, Ajeet Nanda, Ram Avtar, Jyoti Sharma, Vaibhavi P S, Sasirekha D, Deepthi Kobbajji, Ramya Ningappa, Shwetha Shree, Chandrashekar K, Nandini M R, Sowjanya S, Devika I G, Yashaswini N, Sonika G, Rathna L, Priyanka R, Rupal J. Shrimanker, Lakshmi Vinutha Reddy, K. Sumathi, Babitha Devi, Bina N. Naik, Rohini Manjunath, Rajeshwari Ashok, Tony V. Kunjumon, Jesline Thomas, Shaik Samdhani, Kasthuri Selvam, Poongothai Subramani, Nandakumar Parthasarathy, Nirmal K. Bohra, Anvesh K. Gatla, Cheryl Horbatuk, Julie Sills, E B. Davey, Liz Paramonczyk, Olga Racanelli, Sandy Strybosch, Andre Belanger, Jean Palardy, Alicia Schiffrin, Sylvie Gauthier, Norman Kalyniuk, Shawn D. Whatley, Heather Lappala, Grishma Patel, Matthew Reeve, Catherine Moran, Jody Everitt, Teresa Ferrari, Christine Bouffard, Jirir Frohlich, Gordon Francis, John Mancini, Gregory Bondy, Debbie DeAngelis, Patricia Fulton, David W. Blank, Angela Lombardo, Mylène Roy, Jackie Chow, Hyman Fox, William J. Grootendorst, Angela Hutchinson, Sharon M. Chan, Christie Fitzgerald, Lynn Wilkins, Rebecca L. Raymond, Arlene Reyes, Lavoie Marc André, Denis Fortin, Hélène Ouimet, Thanh-Thao Tôn-Nu, Martine Dussureault, Marie-Hélène Blain, Madeleine Roy, Nathalie Kopajko, Chantal Fleury, Karine Maheux, Gabriela Valentina Ciobotaru, Maria C. Constantinescu, Carmen-Lucia Gherghinescu, Ana-Maria Avram, Ioan Manitiu, Aura Sinpetrean, Lucian Pop, Delia Lupu, Radu Usvat, Ana Petrisor, Nicoleta Dumitru, Camelia Moruju, Adelina Gheorghita, Magda V. Mitu, Cosmin Macarie, Ana Maria Pop, Maria-Catalina Diaconu, Iulia Grancea, Mihaela Cosma, Mihaela Crisan, Elizabeth Herron, Paul Nestel, Sally B. Kay, Kaye S. Carter, Imran Badshah, Ashley Makepeace, Jocelyn Drinkwater, Michelle England, Azette Rafei, Kylie Patterson, Alicia Jenkins, Sybil McAuley, Sue M. Kent, Joy E. Vibert, Leonie Perrett, Thomas David, Samantha L. Kaye, Monika O’Connor, Nimalie J. Perera, Nicole T. Lai, Kerry A. Kearins, Christinia Dicamillo, Heather Anderson, Louise Ferguson, Sharon D. Radtke, Charles T. Thamarappillil, Janice M. Boys, Anita K. Long, Toni Shanahan, Michael Nyguyen, Nicole Forrest, Gill Tulloch, Della Greenwell, Sarah L. Price, Aye N. Tint, Priya K. Sumithran, Tamara L. Debreceni, Lisa Walker, Mary Caruana, Kira Edwards, Maria Stathopoulos, Cilla Haywood, Dimitar Sajkov, Sharen Pringle, Anne Tabner, Kathrina Bartolay, Chamindi Abeyratne, Kylie Bragg, Patrick Mulhern, Peter Purnell, Lyn Williams, Jane Hamlyn, Aurelia Connelly, Jan Hoffman, Samantha Bailey, Jane Kerr, Zarnia Morrison, Sarah Maeder, Roberta McEwan, Prasanna Kunasekera, Patrice McGregor, Jo Young, Sharon Berry, Rick Cutfield, Michelle Choe, Catherine McNamara, Narrinder K. Shergill, Petra Crone, Miles G. Williams, Keith Dyson, Diana H. Schmid, Audrey C. Doak, Melissa Spooner, Colin Edwards, Anne Turner, Grainne M. McAnnalley, Raewyn A. Fisher, Fraser B. Hamilton, Denis H. Friedlander, Melissa R. Kirk, Jayne E. Scales, Marguerite A. McLelland, Neelam A. Dalman, Cathy E. Vickers, Carolyn Jackson, Wendy Coleman, Phillip I. Garden, and Wendy F. Arnold

Subjects
Male, medicine.medical_specialty, Rate ratio, Double-Blind Method, Ischemia, Risk Factors, Physiology (medical), Internal medicine, medicine, Clinical endpoint, Humans, Myocardial infarction, Coronary Artery Bypass, Stroke, Aged, business.industry, Unstable angina, Hazard ratio, Absolute risk reduction, Middle Aged, medicine.disease, Eicosapentaenoic Acid, Number needed to treat, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Background: Despite advances in surgery and pharmacotherapy, there remains significant residual ischemic risk after coronary artery bypass grafting surgery. Methods: In REDUCE-IT (Reduction of Cardiovascular Events With Icosapent Ethyl–Intervention Trial), a multicenter, placebo-controlled, double-blind trial, statin-treated patients with controlled low-density lipoprotein cholesterol and mild to moderate hypertriglyceridemia were randomized to 4 g daily of icosapent ethyl or placebo. They experienced a 25% reduction in risk of a primary efficacy end point (composite of cardiovascular death, myocardial infarction, stroke, coronary revascularization, or hospitalization for unstable angina) and a 26% reduction in risk of a key secondary efficacy end point (composite of cardiovascular death, myocardial infarction, or stroke) when compared with placebo. The current analysis reports on the subgroup of patients from the trial with a history of coronary artery bypass grafting. Results: Of the 8179 patients randomized in REDUCE-IT, a total of 1837 (22.5%) had a history of coronary artery bypass grafting, with 897 patients randomized to icosapent ethyl and 940 to placebo. Baseline characteristics were similar between treatment groups. Randomization to icosapent ethyl was associated with a significant reduction in the primary end point (hazard ratio [HR], 0.76 [95% CI, 0.63–0.92]; P =0.004), in the key secondary end point (HR, 0.69 [95% CI, 0.56–0.87]; P =0.001), and in total (first plus subsequent or recurrent) ischemic events (rate ratio, 0.64 [95% CI, 0.50–0.81]; P =0.0002) compared with placebo. This yielded an absolute risk reduction of 6.2% (95% CI, 2.3%–10.2%) in first events, with a number needed to treat of 16 (95% CI, 10–44) during a median follow-up time of 4.8 years. Safety findings were similar to the overall study: beyond an increased rate of atrial fibrillation/flutter requiring hospitalization for at least 24 hours (5.0% vs 3.1%; P =0.03) and a nonsignificant increase in bleeding, occurrences of adverse events were comparable between groups. Conclusions: In REDUCE-IT patients with a history of coronary artery bypass grafting, treatment with icosapent ethyl was associated with significant reductions in first and recurrent ischemic events. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01492361.

Published
2021

4. Abnormal Laboratory Results: Approach to the diagnosis of secondary hypertension in adults

Author

Ranita Siru, Melissa J Gillett, Michael M. Page, and Johan H Conradie

Subjects
medicine.medical_specialty, Creatinine, Aldosterone, Urinalysis, medicine.diagnostic_test, business.industry, Secondary hypertension, medicine.disease, chemistry.chemical_compound, Primary aldosteronism, Blood pressure, chemistry, medicine, Pharmacology (medical), Medical history, Family history, Intensive care medicine, business
Abstract

Presentations that should raise suspicion of secondary hypertension include early-onset, severe or resistant hypertension. A suggestive family history or clinical clues can point to a specific secondary cause. The most common causes and associations are renal disease, primary aldosteronism and obstructive sleep apnoea. Medicines, illicit substances and alcohol may also be responsible. The assessment of patients begins with history taking and examination, to look for clinical clues. Laboratory tests include electrolytes, urea, creatinine and the aldosterone:renin ratio, urinalysis and the urine albumin:creatinine ratio. Abnormal results should prompt further investigation. Initial testing for primary aldosteronism is best done before starting potentially interfering antihypertensive drugs. If the patient is already taking interfering antihypertensive drugs that cannot be stopped, the interpretation of the aldosterone:renin ratio must consider the presence of those drugs. Specialist advice can be sought if needed.

Published
2021

5. Bone health in patients undergoing surgery for primary hyperparathyroidism at Tygerberg Hospital, Cape Town, South Africa

Author

K Beviss-Challinor, Lindi Martin, M Budge, Ankia Coetzee, W Conradie, and Magda Conradie

Subjects
0301 basic medicine, medicine.medical_specialty, endocrine system diseases, business.industry, Endocrinology, Diabetes and Metabolism, Osteoporosis, Osteitis fibrosa cystica, Parathyroid hormone, 030209 endocrinology & metabolism, medicine.disease, Bone health, Surgery, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Endocrinology, Internal Medicine, medicine, Increased bone resorption, In patient, business, Primary hyperparathyroidism
Abstract

Increased bone resorption is a well-described consequence of primary hyperparathyroidism (PHPT). In South Africa, little is known about the impact of PHPT on skeletal health. To determine the preva...

Published
2020

6. Prevalence and aetiology of thyrotoxicosis in patients with hyperemesis gravidarum presenting to a tertiary hospital in Cape Town, South Africa

Author

T van der Made, M Conradie-Smit, Magda Conradie, and M. van de Vyver

Subjects
Pediatrics, medicine.medical_specialty, business.industry, Endocrinology, Diabetes and Metabolism, Graves' disease, Abnormal thyroid function, medicine.disease, Hyperemesis gravidarum, Endocrinology, Internal Medicine, medicine, Etiology, In patient, business
Abstract

The association between hyperemesis gravidarum (HG) and abnormal thyroid function is well known. The prevalence, aetiology and course of thyrotoxicosis in women with hyperemesis gravidarum (HG) wer...

Published
2020

7. COVID-19 and hyperglycaemic emergencies: perspectives from a developing country

Author

Jaco Cilliers, Elizabeth Du Plessis, Sa'ad Lahri, Gerhard Van Wyk, Marli Conradie-Smit, Raisa Bhikoo, Susan Hugo, and Ankia Coetzee

Subjects
COVID-19, dexamethasone, diabetes, diabetic ketoacidosis, hypokalaemia, Pediatrics, medicine.medical_specialty, endocrine system diseases, Coronavirus disease 2019 (COVID-19), Diabetic ketoacidosis, business.industry, Endocrinology, Diabetes and Metabolism, nutritional and metabolic diseases, Developing country, medicine.disease, Obesity, Endocrinology, Diabetes mellitus, Internal Medicine, Medicine, business
Abstract

Background: Pre-existing diabetes mellitus (DM), hyperglycaemia and obesity emerged as prognostic factors in severe Coronavirus disease 2019 (COVID-19). To date, no published South African studies report on the incidence, presentation and outcomes of DM and diabetic ketoacidosis (DKA) during the COVID-19 pandemic.Objective: To reflect on the diagnosis, management, obstacles to care and outcome of four patients who were admitted to Tygerberg Hospital, Cape Town, South Africa. The outcome of these cases that presented consecutively with DKA and COVID-19 between May and July 2020 are discussed, the presentation, management and long-term considerations with specific reference to DKA and COVID-19 are reviewed.Results: Three of the four patients had newly diagnosed DM. These patients presented with non-specific symptoms and signs leading to a diagnosis of both DKA and COVID-19. The single surviving patient in this series was known to have pre-existing DM but discontinued his insulin upon becoming unwell. One patient required insulin therapy at the time of initial presentation a week or two prior to the current admission but received metformin instead. She was diagnosed with COVID-19 after having poor glycaemic control for over one week, after which insulin was initiated. Ultimately she died as a result of severe hypokalaemia. One patient primarily had respiratory complaints, severe COVID-19 pneumonia and received concomitant dexamethasone. Glycaemic control in this patient was complicated by both hypo- and hyperglycaemia.Conclusion: These cases highlight the management challenges faced by many developing countries, and identify the missed opportunities in persons presenting with COVID-19 and hyperglycaemic emergencies.

Published
2021

8. Midgut neuroendocrine tumour presenting as orbital metastases

Author

W. Conradie, Magda Conradie, Helen Hoenck, and Ankia Coetzee

Subjects
Data limited, Pathology, medicine.medical_specialty, genetic structures, business.industry, Endocrinology, Diabetes and Metabolism, Midgut, medicine.disease, eye diseases, Metastasis, Neuroendocrine tumour, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, 030220 oncology & carcinogenesis, 030221 ophthalmology & optometry, Internal Medicine, medicine, Carcinoid tumour, sense organs, Orbit (control theory), business, Carcinoid syndrome
Abstract

Metastasis of a neuroendocrine tumour (NET) to the orbit is a rare occurrence, with published data limited to a few case reports. Orbital involvement usually presents with proptosis and decreased o...

Published
2020

9. Oral Presentations ‐ Thursday 24 June 2021

Author

Pan-Kar (Claudia) Wong, Susan Brandis, Cindy Jones, and Leandre Conradie

Subjects
medicine.medical_specialty, Occupational Therapy, business.industry, Physical therapy, Medicine, Retrospective cohort study, business, Functional Independence Measure
Published
2021

10. Pretomanid with bedaquiline and linezolid for drug-resistant TB: a comparison of prospective cohorts

Author

Francesca Conradie, G Wills, M. Olugbosi, A Calatroni, Mendel Carl M, Pauline Howell, Daniel Everitt, E Sun, N Ngubane, Aliasgar Esmail, A. del Parigi, Angela M. Crook, Melvin Spigelman, Andreas H. Diacon, Olatunde Olayanju, Keertan Dheda, and Suzette Oelofse

Subjects
0301 basic medicine, Pulmonary and Respiratory Medicine, Drug, medicine.medical_specialty, Extensively Drug-Resistant Tuberculosis, media_common.quotation_subject, 030106 microbiology, Antitubercular Agents, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, Tuberculosis, Multidrug-Resistant, Culture conversion, medicine, Humans, Prospective Studies, Diarylquinolines, media_common, business.industry, Linezolid, Regimen, Infectious Diseases, 030228 respiratory system, chemistry, Nitroimidazoles, Pretomanid, Relative risk, Cohort, Bedaquiline, business
Abstract

BACKGROUND: There are no data comparing the 6–9 month oral three-drug Nix regimen (bedaquiline, pretomanid and linezolid [BPaL]) to conventional regimens containing bedaquiline (B, BDQ) and linezolid (L, LZD).METHODS: Six-month post end-of-treatment outcomes were compared between Nix-TB (n = 109) and 102 prospectively recruited extensively drug-resistant TB patients who received an ˜18-month BDQ-based regimen (median of 8 drugs). A subset of patients received BDQ and LZD (n = 86), and a subgroup of these (n = 75) served as individually matched controls in a pairwise comparison to determine differences in regimen efficacy.RESULTS: Favourable outcomes (%) were significantly better with BPaL than with the B–L-based combination regimen (98/109, 89.9% vs. 56/86, 65.1%; adjusted relative risk ratio [aRRR] 1.35; P < 0.001) and in the matched pairwise analysis (67/75, 89.3% vs. 48/75, 64.0%; aRRR 1.39; P = 0.001), despite significantly higher baseline bacterial load and prior second-line drug exposure in the BPaL cohort. Time to culture conversion (P < 0.001), time to unfavourable outcome (P < 0.01) and time to death (P < 0.03) were significantly better or lower with BPaL than the B-L-based combinations.CONCLUSION: The BPaL regimen (and hence substitution of multiple other drugs by pretomanid and/or higher starting-dose LZD) may improve outcomes in drug-resistant TB patients with poor prognostic features. However, prospective controlled studies are required to definitively answer this question.

Published
2021

11. The effects of streptokinase in a Chacma baboon (Papio ursinus) model of acquired thrombotic thrombocytopenic purpura

Author

Seb Lamprecht, W J Janse van Rensburg, S M Meiring, Jaco Joubert, and C Conradie

Subjects
0301 basic medicine, medicine.medical_specialty, Plasmin, medicine.medical_treatment, Streptokinase, Thrombotic thrombocytopenic purpura, Pharmacology, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, 0302 clinical medicine, In vivo, hemic and lymphatic diseases, biology.animal, Internal medicine, Fibrinolysis, medicine, Acquired Thrombotic Thrombocytopenic Purpura, Hematology, biology, business.industry, General Medicine, medicine.disease, 030104 developmental biology, 030220 oncology & carcinogenesis, business, Baboon, medicine.drug
Abstract

TTP is a life-threatening disorder with limited pharmaceutical treatment options. Recently, the potential of streptokinase in the treatment of acquired TTP was demonstrated in humans in vitro, and in vivo in a mouse model. We aimed to determine the in vitro and in vivo effects of streptokinase in an established Papio ursinus model of acquired TTP. In vitro: VWF activities & multimer patterns and thromboelastograms were assessed with increasing concentrations of streptokinase. In vivo: After induction of TTP, escalating streptokinase doses (ranging from 50,000 to 900,000 IU) were administered, and the effects of streptokinase assessed on peripheral blood counts, fibrinolysis, VWF activities & multimer patterns and thromboelastograms. In an extension of the study, high-dose streptokinase (1,500,000–3,000,000 IU) was administered to another baboon. After spiking, fibrinolysis with loss of large VWF multimers was observed at [2200 IU/mL]—roughly equivalent to 1,500,000 IU. However, administration of escalating intravenous streptokinase doses had no in vivo effect on the TTP phenotype, and in vivo increases in plasmin activity were mild when compared with baseline, even at high doses. Minimal effect on VWF multimer patterns was observed but only at doses ≥ 1500,000 IU. Streptokinase is not effective in resolving TTP in a Papio ursinus model of TTP, possibly due to limited activation of the baboon fibrinolytic system. Modifications to this model, the use of alternative higher animal models, or alternative thrombolytics, should be considered to establish proof-of-concept.

Published
2021

12. District-level agricultural total factor productivity for the Karoo, South Africa: 1952–2002

Author

Jan C. Greyling, Beatrice Conradie, Jenifer Piesse, and Amelia Genis

Subjects
Economics and Econometrics, Geography, Agriculture, business.industry, Cape, Geography, Planning and Development, Western cape, business, Socioeconomics, Agronomy and Crop Science, Total factor productivity, District level
Abstract

An earlier study of district-level agricultural total factor productivity in the Western Cape province of South Africa Conradie et al. (2009a, b) is extended to include eleven Northern Cape distric...

Published
2021

13. Retrospective cohort study of paediatric splenic injuries at a major adult trauma centre in South Africa identifies areas of success and improvement

Author

Victor Kong, W Bekker, Grant L. Laing, Abdallah Elsabagh, Chris Varghese, Bernike Conradie, Cynthia Cheung, Damian L. Clarke, John L. Bruce, and Nigel Rajaretnam

Subjects
Adult, medicine.medical_specialty, Splenic trauma, medicine.medical_treatment, Splenectomy, Abdominal Injuries, Wounds, Nonpenetrating, South Africa, 03 medical and health sciences, Injury Severity Score, 0302 clinical medicine, Trauma Centers, Laparotomy, medicine, Humans, Trauma centre, Child, Retrospective Studies, Paediatric patients, business.industry, Major trauma, General surgery, Retrospective cohort study, General Medicine, medicine.disease, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Surgery, business
Abstract

This study reviews our experience with paediatric splenic trauma in a major trauma centre in South Africa. We reviewed the management and outcomes of 66 paediatric patients and concluded that selective non-operative management of paediatric splenic trauma can be undertaken successfully in a middle-income country such as South Africa. The grade of splenic injury itself is rarely the sole determinant of operative or non-operative treatment and clinical outcome.Over the last 50 years, the gold standard for paediatric trauma management has grown to be non-operative management. This study reviews a South African experience with paediatric splenic trauma in order to benchmark this against the international standard and to identify discrepancies in access to care and in surgical outcomes.This was a retrospective study conducted at a major trauma centre in South Africa. All children less than 18 years of age who were admitted to our trauma centre following trauma between December 2012 and October 2020 were identified and all those who sustained splenic trauma were reviewed.Of the 66 patients reviewed, 48 (72%) were male, and the median age was 12 years (0-18 years). Thirty-three (51%) were of rural origin and 61 (93%) sustained blunt trauma. Only eight (12%) had an isolated splenic injury, while the remaining 58 (88%) had other associated injuries. Forty-five patients (68%) were managed non-operatively whilst the remainder were subjected to laparotomy. Five (7%) required a splenectomy and one required angio-embolisation. Twenty-six patients (39%) required intensive care unit (ICU) admission: 15 (37%) in the non-operative cohort required ICU admission and eight (40%) in the laparotomy group required ICU admission. Twenty-eight (42%) patients required ventilatory support. Median length of stay was 5.5 days. Four (6%) patients died.Although non-operative management of paediatric splenic trauma can be undertaken successfully by adult trauma surgeons in a middle-income country such as South Africa, there remains room for improvement. To achieve splenic salvage rates comparable to those in dedicated paediatric trauma centres in high-income countries will require systematic quality improvement programmes.

Published
2021

14. A proposed definition of Critical Care Retrieval in the South African context

Author

Willem Stassen, Monique Venter, Cornelius Venter, Nathan Conradie, Maryna Venter, Louis Jordaan, and David Stanton

Subjects
Quality management, business.industry, Case selection, Political science, Specialty, Emergency medical services, Context (language use), Certification, Public relations, business, Core curriculum
Abstract

Background: Critical care retrieval is a nascent field in South Africa. An increasing number of private and provincial emergency medical services are starting to invest in developing and setting up dedicated critical care retrieval services (CCRS). To date, there are no minimum standards or definitions on what constitutes a CCRS in the South African context. The aim of this paper is to describe the development of and propose a consensus definition of CCRS within the South African context. Methods: A literature search was performed to determine the key aspects of CCRS definitions elsewhere. An initial draft definition was circulated to the CCRS working group of the Emergency Care Society of South Africa (ECSSA) for commentary. Comments were collated, and a second round of commentary was undertaken. Finally, a consensus meeting was held through video-conferencing to finalise the definition presented herein. Thereafter, the definition was circulated to key role-players in emergency and critical care, both locally and internationally, for endorsement. The definition, as it is presented, has been endorsed by the ECSSA, the Southern African Society of Critical Care (SASCC), and the International Board for Specialty Certification (IBSC). Results: The proposed definition outlines five equally important aspects that should be demonstrable and interlinked to be denoted a CCRS. These five aspects are: specific patient populations, case selection, dedicated crew with additional training, dedicated equipment, and continuous quality management and training. Conclusion: Numerous questions remain unanswered regarding the best approach for CCRS development in South Africa and internationally. Defining what CCRS is in a South African context is a necessary departure point for further research endeavours to develop a core curriculum and practice standards.

Published
2021

15. ADSC-conditioned media elicit an ex vivo anti-inflammatory macrophage response

Author

Maria Jacoba Kruger, Magda Conradie, Mari van de Vyver, and M M Conradie

Subjects
Adult, Blood Glucose, 0301 basic medicine, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Adipose tissue, Peripheral blood mononuclear cell, Young Adult, 03 medical and health sciences, Endocrinology, Internal medicine, medicine, Humans, Molecular Biology, Cells, Cultured, Inflammation, Tumor Necrosis Factor-alpha, business.industry, Macrophages, Mesenchymal Stem Cells, Middle Aged, Flow Cytometry, medicine.disease, M2 Macrophage, Interleukin 10, 030104 developmental biology, Cytokine, Culture Media, Conditioned, Leukocytes, Mononuclear, Female, Metabolic syndrome, business, CD163, Ex vivo
Abstract

Obesity-associated inflammatory mechanisms play a key role in the pathogenesis of metabolic-related diseases. Failure of anti-inflammatory control mechanisms within adipose tissue and peripheral blood mononuclear cells (PBMCs) have been implicated in disease progression. This study investigated the efficacy of allogeneic adipose tissue-derived mesenchymal stem cells conditioned media (ADSC-CM) to counteract persistent inflammation by inducing an anti-inflammatory phenotype and cytokine response within PBMCs derived from patients with and without metabolic syndrome. Forty-six (n = 46) mixed ancestry females (18–45 years) were subdivided into (a) healthy lean (HL) (n = 10) (BMI 2), (b) overweight/obese (OW/OB) (BMI ≥25 kg/m2, n = 22) and (c) metabolic syndrome (MetS) (visceral adiposity, ≥3 metabolic risk factors) (n = 14) groups. Body composition (DXA scan), metabolic (cholesterol, HDL, LDL, triglycerides, blood glucose) and inflammatory profiles (38-Plex cytokine panel) were determined. PBMCs were isolated from whole blood and treated ex vivo with either (i) autologous participant-derived serum, (ii) ADSCs-CM or (iii) a successive treatment regime. The activation status (CD11b+) and intracellular cytokine (IL6, IL10, TNFa) expression were determined in M1 (CD68+CD206−CD163−) and M2 (CD68+CD163+ CD206+) macrophage populations using flow cytometry. ADSC-CM treatment, promoted a M2 macrophage phenotype and induced IL10 expression, this was most pronounced in the OW/OB group. This response is likely mediated by multiple complementing factors within ADSC-CM, yet to be identified. This study is the first to demonstrate the therapeutic potential of ADSC-CM to restore the inflammatory balance in immune compromised obese individuals.

Published
2018

16. Miniaturized implantable cardiac monitor with a long sensing vector (BIOMONITOR III): Insertion procedure assessment, sensing performance, and home monitoring transmission success

Author

Dennis H. Lau, Tina Lin, Sam Lovibond, Andre Conradie, Uwais Mohamed, Jürgen Schrader, Stephen Pavia, Peter Illes, Ian Matthews, Justin A. Mariani, Rajeev Kumar Pathak, Paul A. Gould, David DiFiore, Rukshen Weerasooriya, Deepak Arumugam, Olivier W V van den Brink, and Kushwin Rajamani

Subjects
medicine.medical_specialty, Skin incision, business.industry, Australia, Arrhythmias, Cardiac, Single step, 030204 cardiovascular system & hematology, Electrocardiography, 03 medical and health sciences, 0302 clinical medicine, Transmission (telecommunications), Electrocardiography, Ambulatory, Implantable loop recorder, Humans, Medicine, Insertion procedure, Sinus rhythm, 030212 general & internal medicine, Implantable cardiac monitor, Radiology, Cardiology and Cardiovascular Medicine, business, Pocket formation
Abstract

Background Implantable Cardiac Monitors (ICMs) are used for long-term monitoring of arrhythmias. BIOMONITOR III is a novel ICM with a miniaturized profile, long sensing vector due to a flexible antenna, simplified implantation with a dedicated insertion tool for pocket formation and ICM placement in a single step, and daily automatic Home Monitoring (HM) function. Methods In 47 patients undergoing BIOMONITOR III insertion for any ICM indication, 16 investigators at 10 Australian sites assessed handling characteristics of the insertion tool, R-wave amplitudes, noise burden, P-wave visibility, and HM transmission success. Patients were followed for 1 month. Results All 47 attempted insertions were successful. Median time from skin incision to removal of the insertion tool after ICM insertion was 39 s (IQR 19–65) and to wound closure and cleaning was 4.7 min (IQR 3.5–7.8). All aspects of the insertion tool were rated as “good” or “excellent” in ≥97.9% and “fair” in ≤2.1% of patients, except for “force needed for tunnelling” (91.5% good/excellent, 8.5% fair). Based on HM data, R-waves in the first month were stable at 0.70 ± 0.37 mV. Median noise burden (disabling automatic rhythm evaluation) was 0.19% (IQR 0.00–0.93), equivalent to 2.7 min (IQR 0.0–13.4) per day. In HM-transmitted ECG strips with regular sinus rhythm, P-waves were visible in 89 ± 24% of heart cycles. Patient-individual automatic Home Monitoring transmission success was 98.0% ± 5.5%. Conclusions The novel ICM performed well in all aspects studied, including fast insertion, reliable R-wave sensing, good P-wave visibility, and highly successful HM transmissions.

Published
2020

17. AN EXPLORATIVE STUDY TOWARDS USING VR SKETCHING AS A TOOL FOR IDEATION AND PROTOTYPING IN PRODUCT DESIGN

Author

L. De Marez, Y. Christiaens, Jamil Joundi, Peter Conradie, and Jelle Saldien

Subjects
Technology and Engineering, Product design, Computer science, Process (engineering), business.industry, 0211 other engineering and technologies, 020207 software engineering, 02 engineering and technology, General Medicine, Virtual reality, Field (computer science), Sketch, Software, Human–computer interaction, 0202 electrical engineering, electronic engineering, information engineering, Design process, Product (category theory), business, ComputingMethodologies_COMPUTERGRAPHICS, 021106 design practice & management
Abstract

The advancements in the field of VR allow designers to use VR as a technology for sketching ideas in a virtual space. In this paper, Gravity Sketch (a VR sketching software) is used as an ideation sketching tool in the process of product styling. The goal of this research is to examine the advantages and points-of-pain when using virtual reality tools in the process of product styling. 29 Master students used the VR sketching tool in their design process and all of them had feedback and insights on the tool.

Published
2020

18. Treatment of Highly Drug-Resistant Pulmonary Tuberculosis

Author

Francesca, Conradie, Andreas H, Diacon, Nosipho, Ngubane, Pauline, Howell, Daniel, Everitt, Angela M, Crook, Carl M, Mendel, Erica, Egizi, Joanna, Moreira, Juliano, Timm, Timothy D, McHugh, Genevieve H, Wills, Anna, Bateson, Robert, Hunt, Christo, Van Niekerk, Mengchun, Li, Morounfolu, Olugbosi, Melvin, Spigelman, and Priya, Solanki

Subjects
Adult, Male, medicine.medical_specialty, Tuberculosis, Adolescent, Extensively Drug-Resistant Tuberculosis, Antitubercular Agents, Administration, Oral, Drug resistance, 030204 cardiovascular system & hematology, Article, Young Adult, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Pharmacotherapy, Tuberculosis, Multidrug-Resistant, medicine, Humans, 030212 general & internal medicine, Diarylquinolines, Intensive care medicine, Tuberculosis, Pulmonary, Intention-to-treat analysis, business.industry, Linezolid, Extensively drug-resistant tuberculosis, Mycobacterium tuberculosis, General Medicine, Middle Aged, medicine.disease, Bacterial Load, Intention to Treat Analysis, 3. Good health, Multiple drug resistance, Clinical trial, Treatment Outcome, chemistry, Nitroimidazoles, Pretomanid, Drug Therapy, Combination, Female, business
Abstract

Patients with highly drug-resistant forms of tuberculosis have limited treatment options and historically have had poor outcomes.In an open-label, single-group study in which follow-up is ongoing at three South African sites, we investigated treatment with three oral drugs - bedaquiline, pretomanid, and linezolid - that have bactericidal activity against tuberculosis and to which there is little preexisting resistance. We evaluated the safety and efficacy of the drug combination for 26 weeks in patients with extensively drug-resistant tuberculosis and patients with multidrug-resistant tuberculosis that was not responsive to treatment or for which a second-line regimen had been discontinued because of side effects. The primary end point was the incidence of an unfavorable outcome, defined as treatment failure (bacteriologic or clinical) or relapse during follow-up, which continued until 6 months after the end of treatment. Patients were classified as having a favorable outcome at 6 months if they had resolution of clinical disease, a negative culture status, and had not already been classified as having had an unfavorable outcome. Other efficacy end points and safety were also evaluated.A total of 109 patients were enrolled in the study and were included in the evaluation of efficacy and safety end points. At 6 months after the end of treatment in the intention-to-treat analysis, 11 patients (10%) had an unfavorable outcome and 98 patients (90%; 95% confidence interval, 83 to 95) had a favorable outcome. The 11 unfavorable outcomes were 7 deaths (6 during treatment and 1 from an unknown cause during follow-up), 1 withdrawal of consent during treatment, 2 relapses during follow-up, and 1 loss to follow-up. The expected linezolid toxic effects of peripheral neuropathy (occurring in 81% of patients) and myelosuppression (48%), although common, were manageable, often leading to dose reductions or interruptions in treatment with linezolid.The combination of bedaquiline, pretomanid, and linezolid led to a favorable outcome at 6 months after the end of therapy in a high percentage of patients with highly drug-resistant forms of tuberculosis; some associated toxic effects were observed. (Funded by the TB Alliance and others; ClinicalTrials.gov number, NCT02333799.).

Published
2020

19. Sosiale weerbaarheid, strukturele kwesbaarheid en instaatstellende geleenthede in Genadendal, Suid-Afrika

Author

Nicolette V. Roman, Anja Human-Hendricks, and Ina Conradie

Subjects
business.industry, General Arts and Humanities, Environmental resource management, General Social Sciences, Sociology, Structural vulnerability, business, Resilience (network)
Abstract

Die dorpie Genadendal in die Wes-Kaap is in 1837 deur die Morawiese Kerk gestig. Ons het 'n reeks in-diepte kwalitatiewe onderhoude met twaalf afgetrede inwoners van die dorp gevoer en hulle belewenisse en herinneringe geanaliseer om hulle geleenthede, sosiale weerbaarheid en strukturele kwesbaarheid te evalueer. Ons gebruik Amartya Sen se benadering van Instaatstellende Geleenthede ("capability approach"), sowel as Weerbaarheidsteorie (kyk voetnoot 2) as teoretiese raamwerke. Ons het gevind dat daar 'n baie sterk sosiale verbondenheid bestaan het terwyl die deelnemers grootgeword het, wat hulle meer weerbaarheid gegee het gedurende die apartheidsperiode. Na die oorgang na demokrasie het hulle werksgeleenthede en geleenthede vir beter integrasie in die breë samelewing uitgebrei, maar as gevolg van die feit dat Kaapse bendefamilies in Genadendal ingetrek het, het hulle op nuwe maniere struktureel kwesbaar geword. Die analise van geleenthede, sosiale weerbaarheid en strukturele kwes-baarheid in Genadendal tydens en na apartheid illustreer die belewenisse van 'n atipiese, afgesonderde landelike gemeenskap in die Wes-Kaap tydens hierdie twee historiese periodes.

Published
2020

20. Spinal tuberculosis: A systematic review of case studies and development of an evidence‐based clinical guidance tool for early detection

Author

Marisa Coetzee, Sjan-Mari van Niekerk, Nassib Tawa, Thandi Conradie, and Quinette Louw

Subjects
medicine.medical_specialty, Tuberculosis, Evidence-based practice, business.industry, Health Policy, Public Health, Environmental and Occupational Health, Early detection, Delayed diagnosis, medicine.disease, Risk Assessment, Spine, Critical appraisal, Early Diagnosis, Back Pain, Health care, Back pain, Humans, Medicine, Tuberculosis, Spinal, Stage (cooking), medicine.symptom, business, Intensive care medicine
Abstract

Rationale, aims, and objectives Despite research being done on spinal tuberculosis, diagnosing this condition at an early stage remains problematic due to its insidious onset and the varying symptoms being associated. Most individuals present to the health care facility with either simple back pain at an early stage or neurological complications at a later stage, when spinal compression and vertebral collapse have occurred as a result of delayed diagnosis. The prevention of secondary complications is therefore dependent on early recognition and diagnosis. The objective of this review was to identify common clinical patterns in case presentations and develop an evidence-based clinical guidance tool to assist clinicians in the early identification of spinal tuberculosis. Method A comprehensive literature search was conducted for published spinal tuberculosis case studies, which yielded 28 cases after critical appraisal. Data from the studies were categorized in order to assist with a factor analysis and the development of an evidence framework for screening and diagnosing spinal tuberculosis. An evidence-based clinical guidance tool was then designed from the data obtained. Results Factors associated with spinal tuberculosis and frequently reported symptoms and physical signs with which the patient could present upon assessment were identified. Options for investigations at primary, secondary, and tertiary levels were also identified. Conclusion Through the use of an evidence-based clinical guidance tool, the clinician could be guided in the early suspicion and management of individuals with spinal tuberculosis and prevention of secondary complications.

Published
2019

21. Virilising ovarian tumour in a postmenopausal woman after bilateral oophorectomy

Author

Viju Thomas, Ankia Coetzee, Annelize Barnard, Jocelynn Ann Hellig, Candice Sher-Lockitz, and Magda Conradie

Subjects
endocrine system, business.industry, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Cell, Physiology, 030209 endocrinology & metabolism, Bilateral oophorectomy, Steroid, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, medicine.anatomical_structure, Gonadal Steroid Hormones, 030220 oncology & carcinogenesis, Internal Medicine, medicine, business
Abstract

Ovarian neoplasms are rare tumours of steroid cell origin. These tumours present clinically due to the associated excess production of either androgenic or oestrogenic gonadal steroid hormones. The...

Published
2019

22. Cost-effectiveness of bedaquiline, pretomanid and linezolid for treatment of extensively drug-resistant tuberculosis in South Africa, Georgia and the Philippines

Author

Daniel Everitt, Sandeep Juneja, Anna Marie Celina Garfin, Nino Lomtadze, Norbert Ndjeka, Shelly Malhotra, Sarah Cook-Scalise, Anna Vassall, Gabriela B. Gomez, Zaza Avaliani, Francesca Conradie, Nana Kiria, Melvin Spigelman, and Mariana Siapka

Subjects
Marginal cost, Georgia, Tuberculosis, Cost effectiveness, Cost-Benefit Analysis, Extensively Drug-Resistant Tuberculosis, Philippines, Population, Antitubercular Agents, South Africa, chemistry.chemical_compound, Health Economics, Environmental health, Tuberculosis, Multidrug-Resistant, medicine, Humans, Diarylquinolines, education, health care economics and organizations, education.field_of_study, business.industry, public health, Linezolid, Extensively drug-resistant tuberculosis, economics, General Medicine, medicine.disease, Regimen, tuberculosis, chemistry, Nitroimidazoles, Economic evaluation, Medicine, Bedaquiline, business
Abstract

ObjectivesPatients with highly resistant tuberculosis have few treatment options. Bedaquiline, pretomanid and linezolid regimen (BPaL) is a new regimen shown to have favourable outcomes after six months. We present an economic evaluation of introducing BPaL against the extensively drug-resistant tuberculosis (XDR-TB) standard of care in three epidemiological settings.DesignCost-effectiveness analysis using Markov cohort model.SettingSouth Africa, Georgia and the Philippines.ParticipantsXDR-TB and multidrug-resistant tuberculosis (MDR-TB) failure and treatment intolerant patients.InterventionsBPaL regimen.Primary and secondary outcome measures(1) Incremental cost per disability-adjusted life years averted by using BPaL against standard of care at the Global Drug Facility list price. (2) The potential maximum price at which the BPaL regimen could become cost neutral.ResultsBPaL for XDR-TB is likely to be cost saving in all study settings when pretomanid is priced at the Global Drug Facility list price. The magnitude of these savings depends on the prevalence of XDR-TB in the country and can amount, over 5 years, to approximately US$ 3 million in South Africa, US$ 200 000 and US$ 60 000 in Georgia and the Philippines, respectively. In South Africa, related future costs of antiretroviral treatment (ART) due to survival of more patients following treatment with BPaL reduced the magnitude of expected savings to approximately US$ 1 million. Overall, when BPaL is introduced to a wider population, including MDR-TB treatment failure and treatment intolerant, we observe increased savings and clinical benefits. The potential threshold price at which the probability of the introduction of BPaL becoming cost neutral begins to increase is higher in Georgia and the Philippines (US$ 3650 and US$ 3800, respectively) compared with South Africa (US$ 500) including ART costs.ConclusionsOur results estimate that BPaL can be a cost-saving addition to the local TB programmes in varied programmatic settings.

Published
2021

23. Radiographic and CT features of zygomatic arch pneumatization in a Thoroughbred with a recurrent progressive ethmoid hematoma

Author

Marius Conradie, Ann Carstens, and Mickael Patrice Robert

Subjects
Male, Hematoma, Zygoma, Facial swelling, General Veterinary, medicine.diagnostic_test, business.industry, Radiography, Computed tomography, Anatomy, Maxillary Sinus, Ethmoid hematoma, medicine.anatomical_structure, Cortex (anatomy), Biopsy, Paranasal Sinus Diseases, otorhinolaryngologic diseases, medicine, Animals, Horse Diseases, Zygomatic arch, Horses, Tomography, X-Ray Computed, business, Sinus (anatomy)
Abstract

A 7-year-old Thoroughbred gelding presented with a history of mild unilateral right-sided epistaxis and facial swelling over the right caudal maxillary sinus and zygomatic arch. Eleven months previously a progressive ethmoid hematoma had been surgically removed from the right caudal maxillary and conchofrontal sinus. Computed tomography identified a large expansile soft-tissue attenuating mass in the right caudal maxillary sinus, with protrusion into the conchofrontal sinus, that extended into the zygomatic arch. Lytic expansion and thinning of the cortex with pneumatization of the zygomatic arch was present. The mass was surgically excised after a biopsy had confirmed the recurring progressive ethmoid hematoma.

Published
2021

24. Electrochemical oscillatory baffled reactors fabricated with additive manufacturing for efficient continuous-flow oxidations

Author

Pedro Lozano, Victor Sans, Sergio Chiva, Alex Conradie, Elena Alvarez, Maria Romero-Fernandez, Astrid E. Delorme, Raúl Martínez-Cuenca, Francesca Paradisi, Ruth D. Goodridge, Diego Iglesias, Peter Licence, Darren A. Walsh, and Obinna Okafor

Subjects
Materials science, Chemical engineering, Flow (mathematics), business.industry, Continuous flow, Mixing (process engineering), 3D printing, business, Electrochemistry
Abstract

Electrochemical oscillatory baffled reactors fabricated with additive manufacturing for efficient continuous-flow oxidations

Published
2021

25. Prevalence of Sarcopenia in Older South African Patients Following Surgery for Fragility Fractures of the Hip

Author

Cornelius V Laubscher, Jacobus D Jordaan, Magda Conradie, M M Conradie, and Marilize Burger

Subjects
medicine.medical_specialty, hip, medicine.medical_treatment, lcsh:Geriatrics, sarcopenia, 03 medical and health sciences, 0302 clinical medicine, Fragility, lcsh:Orthopedic surgery, medicine, Orthopedics and Sports Medicine, 030212 general & internal medicine, Dual-energy X-ray absorptiometry, handgrip strength, Rehabilitation, medicine.diagnostic_test, business.industry, fragility fractures, medicine.disease, musculoskeletal system, Surgery, body regions, lcsh:RD701-811, lcsh:RC952-954.6, 030220 oncology & carcinogenesis, Sarcopenia, Orthopedic surgery, Original Article, Geriatrics and Gerontology, business, human activities, dual-energy X-ray absorptiometry
Abstract

Introduction: Geriatric patients with a fragility fracture of the hip (FFH) are especially prone to sarcopenia with poor functional outcomes and quality of life. We assessed the prevalence of sarcopenia in older South African patients with FFH. Risk factors for sarcopenia were also investigated. Materials and Methods: From August 1 to November 30, 2018, all older patients with FFH were invited to participate. Sarcopenia was diagnosed based on the revised criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). Handgrip strength (HGS) and muscle strength were assessed. Muscle quantity was determined by dual-energy X-ray absorptiometry. Demographic information was collected, and 25-hydroxyvitamin D (25[OH]D) status was determined. Results: Of the 100 hip fracture cases, 65 were enrolled, and 52% (34/65) were sarcopenic (women: 62%; men: 38%). HGS accurately identified sarcopenia (sensitivity and specificity: 100%). Patients >80 years of age had a prevalence of sarcopenia twice (18/21 [83%]) that of younger patients (18/44 [36%]). Women with sarcopenia were smaller than those without (weight: p < 0.001; height: p < 0.001; body mass index: p = 0.018). Low 25(OH)D was almost universally present, with median 25(OH)D levels significantly lower in the patients with sarcopenia (27 nmol/L [interquartile range {IQR}: 20–39] vs. 40 nmol/L [IQR: 29–53]). Several risk factors, including advanced age; female sex; a smaller body size, especially among women; limited physical activity; and low 25(OH)D levels, were identified. Discussion: The accuracy of HGS testing in this cohort underscores EWGSOP2’s recommendation that muscle strength is key to sarcopenia. Further study and follow-up are required to determine the clinical relevance of sarcopenia among FFH patients. Conclusion: The prevalence of sarcopenia in our FFH population is high. Sarcopenia is associated with poor patient outcomes following surgical intervention. Orthopaedic surgeons should therefore be cognizant of the presentation and associated risk of sarcopenia as our patient populations age.

Published
2020

26. Digital Issue Movements: Political Repertoires and Drivers of Participation among Belgian Youth in the Context of ‘School Strike for Climate’

Author

Michel Walrave, Koen Ponnet, Cato Waeterloos, and Peter Conradie

Subjects
social media, Geography, Planning and Development, Social Sciences, climate movement, TJ807-830, Context (language use), Management, Monitoring, Policy and Law, TD194-195, Renewable energy sources, Politics, Political efficacy, latent class analysis, Social media, GE1-350, Sociology, Law and Political Science, Set (psychology), Biology, Multinomial logistic regression, youth, Environmental effects of industries and plants, Renewable Energy, Sustainability and the Environment, business.industry, school strike for climate, Public relations, Latent class model, political repertoires, protest, Environmental sciences, Chemistry, political efficacy, Expression (architecture), Mass communications, business, Engineering sciences. Technology, political participation, single-issue movement
Abstract

It often remains unclear how young citizens are combining various forms of political participation, as well as why they choose some over others, especially within a single-issue movement. Moreover, little is known about how social networking sites (SNS) fit into the political repertoires of citizens. Therefore, this study explores youths’ political participation patterns in the context of the 2019 youth-led climate strikes. We rely on data from a paper and pencil survey among 498 high school students in Belgium. To identify different types of activists, the study used latent class analysis (LCA). In addition, a multinomial logistic regression was conducted to assess how identified participation types differ from each other. Four different participation repertoires regarding the climate issue were identified, each distinctive in the way they rely on different forms of political participation. In addition, membership to each of the different classes is associated with a unique set of characteristics (in terms of political efficacies, climate issue involvement, and online expression motives). The article shows how SNS make up a crucial part of youths’ issue-specific participation patterns and sheds light on the mechanisms underlying their participation choices within the climate movement.

Published
2021

27. Intracranial malignant myopericytoma: case report and literature review

Author

Anthony Thomas, Embre G Bonnet, Jacques Marius Conradie, and Gerhard Van der Linde

Subjects
Larynx, Bronchus, Chemotherapy, medicine.medical_specialty, business.industry, medicine.medical_treatment, Myopericytoma, Soft tissue, General Medicine, medicine.disease, Antiretroviral therapy, Radiation therapy, medicine.anatomical_structure, medicine, Surgery, Neurology (clinical), Radiology, business, Superior sagittal sinus
Abstract

Malignant myopericytoma is an exceedingly rare soft tissue tumour with only 14 documented cases in the scientific literature. Myopericytomas can occur in association with HIV-AIDS and have a predilection for internal organs such as the bronchus, larynx, liver and brain. Ebstein-Barr virus encoded small RNA(EBER) was positive in three out of 14 cases. In this case report we present the second documented case of a malignant myopericytoma, with a positive EBER found intracranially - specifically in the supratentorial compartment - invading the superior sagittal sinus. Gross total excision of the tumour was achieved, and the patient responded well with no recurrence with only highly active antiretroviral therapy (HAART). No chemotherapy or radiotherapy has been necessary.

Published
2021

28. Descriptive Review of Online Information Resources for People With Stroke: Protocol for a Scoping Review

Author

Karen Grimmer, Gakeemah Inglis-Jassiem, Quinette Louw, and Thandi Conradie

Subjects
Protocol (science), Knowledge management, 020205 medical informatics, business.industry, Computer science, design, Information needs, 02 engineering and technology, General Medicine, stroke, Readability, 03 medical and health sciences, 0302 clinical medicine, Interactivity, Data extraction, 0202 electrical engineering, electronic engineering, information engineering, Protocol, online resources, readability, Data Protection Act 1998, The Internet, content, 030212 general & internal medicine, business, Research question
Abstract

Background People with stroke and their caregivers experience numerous information needs; internet-based resources may offer cost-effective ways to improve access to information about this condition and its management, including the availability of resources and support. The quality of online health information is, therefore, an important consideration for both developers and consumers of these online resources. Objective This study aims to map and evaluate the content, readability, understandability, design, and quality characteristics of freely available online information resources (ie, websites) that empower people with stroke and their caregivers with information and self-help strategies poststroke. Methods This descriptive review will follow the five systematic and rigorous methodological steps that are recommended for scoping reviews, which include the following: (1) identifying the research question, (2) identifying relevant studies, (3) selecting the studies, (4) charting the data, and (5) collating, summarizing, and reporting the results. Data will then be synthesized and analyzed thematically. Results As of February 2021, the scoping review is in the data extraction stage. Data will be synthesized, and the first results are expected to be submitted for publication in an open-access peer-reviewed journal in August 2021. In addition, we will develop an accessible summary of the results for stakeholder meetings. Ethical approval is not required for this review, as it will only include publicly available information. Conclusions This study is novel and will evaluate the typology, content, and design-related criteria, including accessibility, aesthetics, navigability, interactivity, privacy, and data protection, of online information resources for stroke. The review will be limited to online resources published in English. International Registered Report Identifier (IRRID) DERR1-10.2196/23174

Published
2021

29. Critical care admission following elective surgery was not associated with survival benefit

Author

Kahan, Brennan C., Desponia, Koulenti, Kostoula, Arvaniti, Vanessa, Beavis, Douglas, Campbell, Matthew, Chan, Rui, Moreno, Pearse, Rupert M., Scott, Beattie, Pierre-Alain, Clavien, Nicolas, Demartines, Lee, A Fleisher, Mike, Grocott, James, Haddow, Andreas, Hoeft, Peter, Holt, Naomi, Pritchard, Andrew, Rhodes, Duminda, Wijeysundera, Matt, Wilson, Tahania, Ahmed, Kirsty, Everingham, Russell, Hewson, Marta, Januszewska, Rupert, M Pearse, Mandeep-Kaur, Phull, Richard, Halliwell, Mark, Shulman, Paul, Myles, Werner, Schmid, Michael, Hiesmayr, Patrick, Wouters, Stefan de Hert, Suzana, Lobo, Xiangming, Fang, Lars, Rasmussen, Emmanuel, Futier, Matthieu, Biais, Aurélien, Venara, Karem, Slim, Michael, Sander, Despoina, Koulenti, Mathew, Chan, Atul, Kulkarni, Susilo, Chandra, Aida, Tantri, Emad, Geddoa, Muntadhar, Abbas, Giorgio Della Rocca, Datin, Sivasakthi, Marzida, Mansor, Pastor, Luna, Arthur, Bouwman, Wolfgang, Buhre, Tim, Short, Tunde, Osinaike, Ricardo, Matos, Ioana, Grigoras, Mikhail, Kirov, Denis, Protsenko, Bruce, Biccard, Cesar, Aldecoa, Michelle, Chew, Christoph, Hofer, Martin, Hubner, James, Ditai, Tamas, Szakmany, Lee, Fleisher, Marissa, Ferguson, Michael, Macmahon, Ritchie, Cherian, Helen, Currow, Kathirgamanathan, Kanathiban, David, Gillespie, Edward, Pathmanathan, Katherine, Phillips, Jenifer, Reynolds, Joanne, Rowley, Jeanene, Douglas, Ross, Kerridge, Sameer, Garg, Michael, Bennett, Megha, Jain, David, Alcock, Nico, Terblanche, Rochelle, Cotter, Kate, Leslie, Marcelle, Stewart, Nicolette, Zingerle, Antony, Clyde, Oliver, Hambidge, Adam, Rehak, Sharon, Cotterell, Wilson Binh Quan Huynh, Timothy, Mcculloch, Erez, Ben-Menachem, Thomas, Egan, Jennifer, Cope, Paul, Fellinger, Simone, Haselberger, Caroline, Holaubek, Paul, Lichtenegger, Florian, Scherz, Franz, Hoffer, Veronika, Cakova, Andreas, Eichwalder, Norbert, Fischbach, Reinhold, Klug, Elisabeth, Schneider, Martin, Vesely, Reinhart, Wickenhauser, Karl Gernot Grubmueller, Marion, Leitgeb, Friedrich, Lang, Nancy, Toro, Marlene, Bauer, Friedrich, Laengle, Thomas, Mayrhofer, Christian, Buerkle, Karin, Forstner, Reinhard, Germann, Harald, Rinoesl, Elke, Schindler, Ernst, Trampitsch, Gerhard, Fritsch, Christian, Szabo, Jawad, Bidgoli, Hans, Verdoodt, Patrice, Forget, David, Kahn, Fernande, Lois, Mona, Momeni, Caroline, Prégardien, Audrey, Pospiech, Arnaud, Steyaert, Laurent, Veevaete, Dirk De Kegel, Karen De Jongh, Luc, Foubert, Carine, Smitz, Marcel, Vercauteren, Jan, Poelaert, Veerle Van Mossevelde, Jacques, Abeloos, Stefaan, Bouchez, Marc, Coppens, Luc De Baerdemaeker, Isabel, Deblaere, Ann De Bruyne, Stefan De Hert, Kristine, Fonck, Bjorn, Heyse, Tom, Jacobs, Koen, Lapage, Anneliese, Moerman, Martine, Neckebroek, Aliaksandra, Parashchanka, Nathalie, Roels, Nancy Van Den Eynde, Michael, Vandenheuvel, Jurgen Van Limmen, Ann, Vanluchene, Caroline, Vanpeteghem, Piet, Wyffels, Christel, Huygens, Punitha, Vandenbempt, Marc Van de Velde, Dimitri, Dylst, Bruno, Janssen, Evelien, Schreurs, Fábia Berganton Aleixo, Keulle, Candido, Hugo Dias Batista, Mario, Guimarães, Jaqueline, Guizeline, João, Hoffmann, Suzana, M Lobo, Francisco Ricardo Lobo, Vinícius, Nascimento, Katia, Nishiyama, Lucas, Pazetto, Daniela, Souza, Rodrigo Souza Rodrigues, Ana Maria Vilela Dos Santos, Jaquelline, Jardim, Joao, Silva, Paulo do Nascimento Junior, Thalissa Hermínia Baio, Gabriel Isaac Pereira de Castro, Henri Roger Watanabe Oliveira, Cristina Prata Amendola, Gutemberg, Cardoso, Daniela, Ortega, Ana Flavia Brotto, Mirella Cristine De Oliveira, Álvaro, Réa-Neto, Fernando, Dias, Pedro, Azambuja, Marcos Freitas Knibel, Antonio, Martins, William, Almeida, Calim Neder Neto, Maria Angela Tardelli, Eliana, Caser, Marcio, Machado, Crisitiano, Aguzzoli, Sérgio, Baldisserotto, Fernanda Beck Tabajara, Fernanda, Bettega, La Hore Correa Rodrigues Júnior, Julia de Gasperi, Lais, Faina, Marcos Farias Nolasco, Bruna Ferreira da Costa Fischer, Mariana Fosch de Campos Ferreira, Cristina, Hartmann, Marta, Kliemann, Gustavo Luis Hubert Ribeiro, Julia Merladete Fraga, Thiago Motta Netto, Laura Valduga Pozza, Paulo Rafael Wendling, Caroline, Azevedo, Juliana, Garcia, Marcel, Lopes, Bernardo, Maia, Paula, Maselli, Ralph, Melo, Weslley, Mendes, Matheus, Neves, Jacqueline, Ney, Claudio, Piras, Christopher, Applewhaite, Adrienne, Carr, Lorraine, Chow, Kaylene, Duttchen, Julena, Foglia, Michael, Greene, Ashley, Hinther, Kendra, Houston, Thomas Jared McCormick, Jennifer, Mikhayel, Sam, Montasser, Alex, Ragan, Andrew, Suen, Adrianna, Woolsey, Hai Chuan Yu, Duane, Funk, Stephen, Kowalski, Regina, Legaspi, Heather, Mcdonald, Faisal, Siddiqui, Jeremy, Pridham, Bernadette, Rowe, Sonia, Sampson, Barton, Thiessen, Geoff, Zbitnew, Andre, Bernard, Ronald, George, Philip, Jones, Rita, Moor, Naveed, Siddiqui, Alexandra, Wolfer, Diem, Tran, Denyse, Winch, Gary, Dobson, Thomas, Mccormick, Osama, Montasser, Richard, Hall, Leyla, Baghirzada, Si Yuan Dai, Gregory, Hare, Esther, Lee, Uma, Shastri, Albert, Tsui, Anmol, Yagnik, Danielle, Alvares, Stephen, Choi, Heather, Dwyer, Kathrina, Flores, Colin, Mccartney, Priya, Somascanthan, Carroll, Jo, Janneth, Pazmino-Canizares, Noam, Ami, Vincent, Chan, Anahi, Perlas, Ruth, Argue, Katie, Lavis, Kelly, Mayson, Ying, Cao, Hong, Gao, Tingju, Hu, Jie, Lv, Jian, Yang, Yang, Yang, Zhong, Yi, Jing, Zhou, Xiaohua, Zou, Miao, He, Xiaoying, Li, Dihuan, Luo, Haiying, Wang, Tian, Yu, Liyong, Chen, Lijun, Wang, Yunfei, Cai, Zhongming, Cao, Yanling, Li, Jiaxin, Lian, Haiyun, Sun, Sheng, Wang, Zhipeng, Wang, Kenru, Wang, Zhu, Yi, Xindan, Du, Hao, Fan, Yunbin, Fu, Lixia, Huang, Yanming, Huang, Haifang, Hwan, Hong, Luo, Pi-Sheng, Qu, Fan, Tao, Zhen, Wang, Guoxiang, Wang, Shun, Wang, Yan, Zhang, Xiaolin, Zhang, Chao, Chen, Weixing, Wang, Zhengyuan, Liu, Lihua, Fan, Jing, Tang, Yijun, Chen, Yongjie, Chen, Yangyang, Han, Changshun, Huang, Guojin, Liang, Jing, Shen, Jun, Wang, Qiuhong, Yang, Jungang, Zhen, Haidong, Zhou, Junping, Chen, Zhang, Chen, Xiaoyu, Li, Meng, Bo, Haiwang, Ye, Xiaoyan, Zhang, Yanbing, Bi, Jianqiao, Cao, Fengying, Guo, Hong, Lin, Yang, Liu, Meng, Lv, Pengcai, Shi, Xiumei, Song, Chuanyu, Sun, Yongtao, Sun, Yuelan, Wang, Shenhui, Wang, Min, Zhang, Rong, Chen, Jiabao, Hou, Yan, Leng, Qing-Tao, Meng, Qian, Li, Zi-Ying, Shen, Zhong-Yuan, Xia, Rui, Xue, Yuan, Zhang, Zhao, Bo, Xian-Jin, Zhou, Qiang, Chen, Huinan, Guo, Yongqing, Guo, Yuehong, Qi, Zhi, Wang, Jianfeng, Wei, Weiwei, Zhang, Lina, Zheng, Bao, Qi, Yaqiu, Chen, Yijiao, Chen, Yue, Fei, Nianqiang, Hu, Xuming, Hu, Min, Lei, Xiaoqin, Li, Xiaocui, Lv, Fangfang, Miao, Lingling, Ouyang, Qian, Lu, Conyu, Shen, Sun, Yu, Yuting, Wang, Dong, Wang, Chao, Wu, Liyuan, Xu, Jiaqi, Yuan, Lina, Zhang, Huan, Zhang, Yapping, Zhang, Jinning, Zhao, Chong, Zhao, Lei, Zhao, Tianzhao, Zheng, Dachun, Zhou, Haiyan, Zhou, Zhou, Ce, Kaizhi, Lu, Ting, Zhao, Changlin, He, Hong, Chen, Shasha, Chen, Baoli, Cheng, Jie, He, Lin, Jin, Caixia, Li, Hui, Li, Yuanming, Pan, Yugang, Shi, Xiao Hong Wen, Shuijing, Wu, Guohao, Xie, Kai, Zhang, Bing, Zhao, Xianfu, Lu, Feifei, Chen, Qisheng, Liang, Xuewu, Lin, Yunzhi, Ling, Gang, Liu, Jing, Tao, Yang, Lu, Jialong, Zhou, Fumei, Chen, Yunlin, Feng, Benchao, Hou, Jiamei, Lin, Mei, Liu, Foquan, Luo, Xiaoyun, Shi, Yingfen, Xiong, Lin, Xu, Shuangjia, Yang, Qin, Zhang, Huaigen, Zhang, Weihong, Zhao, Weilu, Zhao, Yun, Bai, Linbi, Chen, Sijia, Chen, Qinxue, Dai, Wujun, Geng, Kunyuan, Han, Xin, He, Luping, Huang, Binbin, Ji, Danyun, Jia, Shenhui, Jin, Qianjun, Li, Dongdong, Liang, Shan, Luo, Lulu, Lwang, Yunchang, Mo, Yuanyuan, Pan, Xinyu, Qi, Meizi, Qian, Jinling, Qin, Yelong, Ren, Yiyi, Shi, Junlu, Wang, Junkai, Wang, Leilei, Wang, Junjie, Xie, Yixiu, Yan, Yurui, Yao, Mingxiao, Zhang, Jiashi, Zhao, Xiuxiu, Zhuang, Yanqiu, Ai, Fang, Du, Long, He, Ledan, Huang, Zhisong, Li, Huijuan, Li, Yetong, Li, Liwei, Li, Meng, Su, Yazhuo, Yuan, Enman, Zhang, Jie, Zhang, Shuna, Zhao, Zhenrong, Ji, Ling, Pei, Wang, Li, Chen, Chen, Beibei, Dong, Jing, Li, Ziqiang, Miao, Hongying, Mu, Chao, Qin, Lin, Su, Zhiting, Wen, Keliang, Xie, Yonghao, Yu, Fang, Yuan, Xianwen, Hu, Zhang, Ye, Wangpin, Xiao, Zhipeng, Zhu, Qingqing, Dai, Kaiwen, Fu, Rong, Hu, Xiaolan, Hu, Song, Huang, Yaqi, Li, Yingping, Liang, Shuchun, Yu, Zheng, Guo, Yan, Jing, Tang, Na, Jie, Wu, Dajiang, Yuan, Ruilin, Zhang, Xiaoying, Zhao, Yuhong, Li, Hui-Ping, Bai, Chun-Xiao, Liu, Fei-Fei, Liu, Wei, Ren, Xiu-Li, Wang, Guan-Jie, Xu, Na, Hu, Bo, Li, Yangwen, Ou, Yongzhong, Tang, Shanglong, Yao, Shihai, Zhang, Cui-Cui, Kong, Bei, Liu, Tianlong, Wang, Wei, Xiao, Bo, Lu, Yanfei, Xia, Jiali, Zhou, Fang, Cai, Pushan, Chen, Shuangfei, Hu, Hongfa, Wang, Qiong, Xu, Liu, Hu, Liang, Jing, Bin, Li, Qiang, Liu, Yuejiang, Liu, Xinjian, Lu, Zhen Dan Peng, Xiaodong, Qiu, Quan, Ren, Youliang, Tong, Jin, Wang, Yazhou, Wen, Qiong, Wu, Jiangyan, Xia, Jue, Xie, Xiapei, Xiong, Shixia, Xu, Tianqin, Yang, Hui, Ye, Ning, Yin, Jing, Yuan, Qiuting, Zeng, Baoling, Zhang, Kang, Zheng, Jing, Cang, Shiyu, Chen, Fan, Yu, Shuying, Fu, Xiaodong, Ge, Baolei, Guo, Wenhui, Huang, Linghui, Jiang, Xinmei, Jiang, Liu, Yi, Yan, Pan, Yun, Ren, Shan, Qi, Jiaxing, Wang, Fei, Wang, Chi, Wu, Xiaoguang, Zhang, Ida Cecilie Christiansen, Simon Nørgaard Granum, Bodil Steen Rasmussen, Morten, Daugaard, Rajiv, Gambhir, Guðný Erla Steingrímsdóttir, Peter, Jensen-Gadegaard, Karsten Skovgaard Olsen, Hanna, Siegel, Katrine Zwicky Eskildsen, Mona Ring Gätke, Ida, Wibrandt, Simon Bisgaard Heintzelmann, Kai Henrik Wiborg Lange, Rune Sarauw Lundsgaard, Louise, Amstrup-Hansen, Claus, Hovendal, Michael, Larsen, Mette, Lenstrup, Tina, Kobborg, Jens Rolighed Larsen, Anette Barbre Pedersen, Søren Hübertz Smith, Rebecca Monett Oestervig, Arash, Afshari, Cheme, Andersen, Kim, Ekelund, Erik Lilja Secher, Birgitte, Brandsborg, Helene, Beloeil, Sigismond, Lasocki, Alexandre, Ouattara, Marlene, Sineus, Serge, Molliex, Marie Lim Legouge, Florent, Wallet, Antoine, Tesniere, Christophe, Gaudin, Paul, Lehur, Emma, Forsans, Stéphane de Rudnicki, Valerie Serra Maudet, Didier, Mutter, Ghassan, Sojod, Mehdi, Ouaissi, Jean-Marc, Regimbeau, Jacques, Desbordes, Nicolas, Comptaer, Diae El Manser, Sabine, Ethgen, Gilles, Lebuffe, Patrick, Auer, Christine, Härtl, Maria, Deja, Kirill, Legashov, Susanne, Sonnemann, Carola, Wiegand-Loehnert, Elke, Falk, Marit, Habicher, Stefan, Angermair, Beatrix, Laetsch, Katrin, Schmidt, Christian Von Heymann, Axel, Ramminger, Florian, Jelschen, Svenja, Pabel, Andreas, Weyland, Elke, Czeslick, Jochen, Gille, Michael, Malcharek, Armin, Sablotzki, Katharina, Lueke, Peter, Wetzel, Joerg, Weimann, Franz-Peter, Lenhart, Florian, Reichle, Frederike, Schirmer, Michael, Hüppe, Karl, Klotz, Carla, Nau, Julika, Schön, Thomas, Mencke, Christina, Wasmund, Carla, Bankewitz, Georg, Baumgarten, Andreas, Fleischer, Vera, Guttenthaler, Yvonne, Hack, Katharina, Kirchgaessner, Olja, Männer, Marlen, Schurig-Urbaniak, Rafael, Struck, Rebekka van Zyl, Maria, Wittmann, Ulrich, Goebel, Sarah, Harris, Siegfried, Veit, Evangelia, Andreadaki, Flora, Souri, Ioannis, Katsiadramis, Anthi, Skoufi, Maria, Vasileiou, Eleni, Aimoniotou-Georgiou, Anastasios, Katsourakis, Fotini, Veroniki, Glyceria, Vlachogianni, Konstantina, Petra, Dimitra, Chlorou, Eirini, Oloktsidou, Vasileios, Ourailoglou, Konstantinos, Papapostolou, Georgia, Tsaousi, Panagoula, Daikou, Georgia, Dedemadi, Ioannis, Kalaitzopoulos, Christos, Loumpias, Sotirios, Bristogiannis, Nikolaos, Dafnios, Georgios, Gkiokas, Elissaios, Kontis, Dimitra, Kozompoli, Aspasia, Papailia, Theodosios, Theodosopoulos, Christol, Bizios, Anastasia, Koutsikou, Aleaxandra, Moustaka, Ioannis, Plaitakis, Apostolos, Armaganidis, Theodora, Christodoulopoulou, Mihail, Lignos, Maria, Theodorakopoulou, Andreas, Asimakos, Eleni, Ischaki, Angeliki, Tsagkaraki, Spyros, Zakynthinos, Eleni, Antoniadou, Ioannis, Koutelidakis, Dimitrios, Lathyris, Irene, Pozidou, Nikolaos, Voloudakis, Maria, Dalamagka, Elena, Gkonezou, Christos, Chronis, Dimitra, Manolakaki, Dimitris, Mosxogiannidis, Tatiana, Slepova, Isaia-Sissy, Tsakiridou, Claire Lampiri Lampiri, Anastasia Vachlioti Vachlioti, Christos Panagiotakis Panagiotakis, Dimitrios Sfyras Sfyras, Fotios Tsimpoukas Tsimpoukas, Athanasia, Tsirogianni, Elena, Axioti, Andreas, Filippopoulos, Elli, Kalliafa, George, Kassavetis, Petros, Katralis, Ioannis, Komnos, Georgios, Pilichos, Ifigenia, Ravani, Antonis, Totis, Eymorfia, Apagaki, Andromachi, Efthymiadi, Nikolaos, Kampagiannis, Theoniki, Paraforou, Agoritsa, Tsioka, Georgios, Georgiou, Aristeidis, Vakalos, Aggeliki, Bairaktari, Efthimios, Charitos, George, Markou, Panagiota, Niforopoulou, Nikolaos, Papakonstantinou, Evdoxia, Tsigou, Archontoula, Xifara, Menelaos, Zoulamoglou, Panagiota, Gkioni, Stylianos, Karatzas, Aikaterini, Kyparissi, Efstratios, Mainas, Ioannis, Papapanagiotou, Theonymfi, Papavasilopoulou, George, Fragandreas, Eleni, Georgopoulou, Eleni, Katsika, Kyriakos, Psarras, Eirini, Synekidou, Maria, Verroiotou, Evangelia, Vetsiou, Donika, Zaimi, Athina, Anagnou, Konstantinos, Apostolou, Theodora, Melissopoulou, Theophilos, Rozenberg, Christos, Tsigris, Georgios, Boutsikos, Vasileios, Kalles, Nikolaos, Kotsalas, Christina, Lavdaiou, Fotini, Paikou, Georgia-Laura, Panagou, Anna, Spring, Ioannis, Botis, Maria, Drimala, Georgios, Georgakakis, Ellada, Kiourtzieva, Panagiota, Ntouma, Apostolos, Prionas, Kyriakos, Xouplidis, Eleftheria, Dalampini, Chrysavgi, Giannaki, Christina, Iasonidou, Orestis, Ioannidis, Athina, Lavrentieva, Athena, Lavrentieva, George, Papageorgiou, Maria, Kokkinoy, Maria, Stafylaraki, Stylianos, Gaitanakis, Periclis, Karydakis, Josef, Paltoglou, Panagiotis, Ponireas, Panagiotis, Chaloulis, Athanasios, Provatidis, Anisoglou, Sousana, Varvara Vanessa Gardikou, Maria, Konstantivelli, Olga, Lataniotou, Elisavet, Lisari, Maria, Margaroni, Konstantinos, Stamatiou, Edouardos, Nikolaidis, Ioannis, Pnevmatikos, Eleni, Sertaridou, Alexandros, Andreou, Eleni, Arkalaki, Elias, Athanasakis, Fotini, Chaniotaki, Aikaterini, Chatzimichali, Maria, Christofaki, Despina, Dermitzaki, Klara, Fiorentza, Georgios, Frantzeskos, Elisavet, Geromarkaki, Kalliopi, Kafkalaki, Marina, Kalogridaki, Konstyllia, Karydi, Sofia, Kokkini, Georgios, Kougentakis, Tatiana, Lefaki, Emmanouhl, Lilitsis, Aikaterini, Makatounaki, Polychronis, Malliotakis, Dimosthenis, Michelakis, Maria, Neonaki, Vasileia, Nyktari, Iliana, Palikyra, Eleftherios, Papadakis, Alexandra, Papaioannou, Konstantinos, Sfakianakis, Maria, Sgouraki, Xenia, Souvatzis, Anastasia, Spartinou, Nefeli, Stefanidou, Paulina, Syrogianni, Georgia, Tsagkaraki, Elena, Arnaoutoglou, Christina, Arnaoutoglou, Christina, Bali, Vasilios, Bouris, Rodamanthos, Doumos, Konstantia-Paraskevi, Gkini, Clio, Kapaktsi, Vasilios, Koulouras, Arian, Lena, Dimitra, Lepida, Evangelos, Michos, Dimitrios, Papadopoulos, Minas, Paschopoulos, Vaia Aliki Rompou, Ioanna, Siouti, Stavros, Tsampalas, Ourania, Ververidou, Georgios, Zilis, Alexandra, Charlalampidoy, Gregory, Christodoulidis, Andreas, Flossos, Konstantinos, Stamoulis, Man Shing Caleb Tsang, Man Shing Tsang, Man Ling Lai, Chi Pang Yip, Hey Man Heymans Chan, Bassanio, Law, Wing Sze Li, Hiu Man Chu, Emily Gar Yee Koo, Chi Cheong Joe Lam, Ka Ho Cheng, Tracy, Lam, Susanna, Chu, Wing Yan Lam, Kin Wai Kevin Wong, Dilys, Kwok, Ching Yue Janice Hung, Wai Kit Jacky Chan, Wing, Lamwong, Chun Kwong Eric Chung, Shu Kai Ma, Shuchi, Kaushik, Bhagyesh, Shah, Dhiren, Shah, Sanjay, Shah, Praburaj, Ar, Radhakrishnan, Muthuchellappan, Vandana, Agarwal, Jigeeshu, Divatia, Sanghamitra, Mishra, Ganesh, Nimje, Swati, Pande, Sukhada, Savarkar, Aditi, Shrivastava, Martin, Thomas, Shashikant, Yegnaram, Rahmat, Hidayatullah, Nasman, Puar, Sumara, Niman, Imai, Indra, Zulkarnain, Hamzah, Annika, Yuliana, Ucu Nurhadiat Abidin, Ade Nurkacan Dursin, Andri, Kurnia, Ade, Susanti, Dini, Handayani, Mahaalit Alit Aribawa, Aryabiantara, Arya, Tjokorda Gde Agung Senapathi, Utara Hartawan Utara, Widnyana Made Wid, Semarawima, Wima, Wiryana Made Wir, 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Hongying, Qin, Chao, Su, Lin, Wen, Zhiting, Xie, Keliang, Yu, Yonghao, Yuan, Fang, Hu, Xianwen, Zhang, Ye, Xiao, Wangpin, Zhu, Zhipeng, Dai, Qingqing, Fu, Kaiwen, Hu, Rong, Hu, Xiaolan, Huang, Song, Li, Yaqi, Liang, Yingping, Yu, Shuchun, Guo, Zheng, Jing, Yan, Tang, Na, Wu, Jie, Yuan, Dajiang, Zhang, Ruilin, Zhao, Xiaoying, Li, Yuhong, Bai, Hui-Ping, Liu, Chun-Xiao, Liu, Fei-Fei, Ren, Wei, Wang, Xiu-Li, Xu, Guan-Jie, Hu, Na, Li, Bo, Ou, Yangwen, Tang, Yongzhong, Yao, Shanglong, Zhang, Shihai, Kong, Cui-Cui, Liu, Bei, Wang, Tianlong, Xiao, Wei, Lu, Bo, Xia, Yanfei, Zhou, Jiali, Cai, Fang, Chen, Pushan, Hu, Shuangfei, Wang, Hongfa, Xu, Qiong, Hu, Liu, Jing, Liang, Li, Bin, Liu, Qiang, Liu, Yuejiang, Lu, Xinjian, Peng, Zhen Dan, Qiu, Xiaodong, Ren, Quan, Tong, Youliang, Wang, Jin, Wen, Yazhou, Wu, Qiong, Xia, Jiangyan, Xie, Jue, Xiong, Xiapei, Xu, Shixia, Yang, Tianqin, Ye, Hui, Yin, Ning, Yuan, Jing, Zeng, Qiuting, Zhang, Baoling, Zheng, Kang, Cang, Jing, Chen, Shiyu, Fan, Yu, Fu, Shuying, Ge, Xiaodong, Guo, Baolei, Huang, Wenhui, Jiang, Linghui, Jiang, Xinmei, Liu, Yi, Pan, Yan, Ren, Yun, Shan, Qi, Wang, Jiaxing, Wang, Fei, Wu, Chi, Zhang, Xiaoguang, Christiansen, Ida Cecilie, Granum, Simon Nørgaard, Rasmussen, Bodil Steen, Daugaard, Morten, Gambhir, Rajiv, Steingrímsdóttir, Guðný Erla, Jensen-Gadegaard, Peter, Olsen, Karsten Skovgaard, Siegel, Hanna, Zwicky Eskildsen, Katrine, Gätke, Mona Ring, Wibrandt, Ida, Heintzelmann, Simon Bisgaard, Lange, Kai Henrik Wiborg, Lundsgaard, Rune Sarauw, Amstrup-Hansen, Louise, Hovendal, Clau, Larsen, Michael, Lenstrup, Mette, Kobborg, Tina, Larsen, Jens Rolighed, Pedersen, Anette Barbre, Smith, Søren Hübertz, Oestervig, Rebecca Monett, Afshari, Arash, Andersen, Cheme, Ekelund, Kim, Secher, Erik Lilja, Brandsborg, Birgitte, Beloeil, Helene, Lasocki, Sigismond, Ouattara, Alexandre, Sineus, Marlene, Molliex, Serge, Legouge, Marie Lim, Wallet, Florent, Tesniere, Antoine, Gaudin, Christophe, Lehur, Paul, Forsans, Emma, de 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Siegfried, Andreadaki, Evangelia, Souri, Flora, Katsiadramis, Ioanni, Skoufi, Anthi, Vasileiou, Maria, Aimoniotou-Georgiou, Eleni, Katsourakis, Anastasio, Veroniki, Fotini, Vlachogianni, Glyceria, Petra, Konstantina, Chlorou, Dimitra, Oloktsidou, Eirini, Ourailoglou, Vasileio, Papapostolou, Konstantino, Tsaousi, Georgia, Daikou, Panagoula, Dedemadi, Georgia, Kalaitzopoulos, Ioanni, Loumpias, Christo, Bristogiannis, Sotirio, Dafnios, Nikolao, Gkiokas, Georgio, Kontis, Elissaio, Kozompoli, Dimitra, Papailia, Aspasia, Theodosopoulos, Theodosio, Bizios, Christol, Koutsikou, Anastasia, Moustaka, Aleaxandra, Plaitakis, Ioanni, Armaganidis, Apostolo, Christodoulopoulou, Theodora, Lignos, Mihail, Theodorakopoulou, Maria, Asimakos, Andrea, Ischaki, Eleni, Tsagkaraki, Angeliki, Zakynthinos, Spyro, Antoniadou, Eleni, Koutelidakis, Ioanni, Lathyris, Dimitrio, Pozidou, Irene, Voloudakis, Nikolao, Dalamagka, Maria, Gkonezou, Elena, Chronis, Christo, Manolakaki, Dimitra, Mosxogiannidis, Dimitri, 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Despina, Fiorentza, Klara, Frantzeskos, Georgio, Geromarkaki, Elisavet, Kafkalaki, Kalliopi, Kalogridaki, Marina, Karydi, Konstyllia, Kokkini, Sofia, Kougentakis, Georgio, Lefaki, Tatiana, Lilitsis, Emmanouhl, Makatounaki, Aikaterini, Malliotakis, Polychroni, Michelakis, Dimostheni, Neonaki, Maria, Nyktari, Vasileia, Palikyra, Iliana, Papadakis, Eleftherio, Papaioannou, Alexandra, Sfakianakis, Konstantino, Sgouraki, Maria, Souvatzis, Xenia, Spartinou, Anastasia, Stefanidou, Nefeli, Syrogianni, Paulina, Tsagkaraki, Georgia, Arnaoutoglou, Elena, Arnaoutoglou, Christina, Bali, Christina, Bouris, Vasilio, Doumos, Rodamantho, Gkini, Konstantia-Paraskevi, Kapaktsi, Clio, Koulouras, Vasilio, Lena, Arian, Lepida, Dimitra, Michos, Evangelo, Papadopoulos, Dimitrio, Paschopoulos, Mina, Rompou, Vaia Aliki, Siouti, Ioanna, Tsampalas, Stavro, Ververidou, Ourania, Zilis, Georgio, Charlalampidoy, Alexandra, Christodoulidis, Gregory, Flossos, Andrea, Stamoulis, Konstantino, Tsang, Man Shing Caleb, Tsang, Man Shing, Lai, Man Ling, Yip, Chi Pang, Chan, Hey Man Heyman, Law, Bassanio, Li, Wing Sze, Chu, Hiu Man, Koo, Emily Gar Yee, Lam, Chi Cheong Joe, Cheng, Ka Ho, Lam, Tracy, Chu, Susanna, Lam, Wing Yan, Wong, Kin Wai Kevin, Kwok, Dily, Hung, Ching Yue Janice, Chan, Wai Kit Jacky, LamWong, Wing, Chung, Chun Kwong Eric, Ma, Shu Kai, Kaushik, Shuchi, Shah, Bhagyesh, Shah, Dhiren, Shah, Sanjay, Ar, Praburaj, Muthuchellappan, Radhakrishnan, Agarwal, Vandana, Divatia, Jigeeshu, Mishra, Sanghamitra, Nimje, Ganesh, Pande, Swati, Savarkar, Sukhada, Shrivastava, Aditi, Thomas, Martin, Yegnaram, Shashikant, Hidayatullah, Rahmat, Puar, Nasman, Niman, Sumara, Indra, Imai, Hamzah, Zulkarnain, Yuliana, Annika, Abidin, Ucu Nurhadiat, Dursin, Ade Nurkacan, Kurnia, Andri, Susanti, Ade, Handayani, Dini, Aribawa, Mahaalit Alit, Arya, Aryabiantara, Senapathi, Tjokorda Gde Agung, Utara, Utara Hartawan, Wid, Widnyana Made, Wima, Semarawima, Wir, Wiryana Made, Jehosua, Brillyan, Kaunang, Jonathan, 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Sarki, Adamu Muhammad, Adekola, Oyebola, Akanmu, Olanrewaju, Durodola, Akanmu, Olukoju, Olusegun, Raji, Victor, Olajumoke, Tokunbo, Oyebamiji, Emmanuel, Adenekan, Anthony, Adetoye, Adenekan, Faponle, Folayemi, Olateju, Simeon, Owojuyigbe, Afolabi, Talabi, Ademola, Adenike, Odewabi, Adewale, Badru, Collins, Nwokoro, Ezekiel, Emmanuel, Fatungase, Oluwabunmi Motunrayo, Grace, Anuforo, Sola, Sotannde, Stella, Ogunmuyiwa, Ademola, Adeyinka, Adeolu, Augustine A., Adigun, Tinuolac, Akinwale, Mukaila, Fasina, Oluyemi, Gbolahan, Olalere, Idowu, Olusola, Olonisakin, Rotimi Peter, Osinaike, Babatunde Babasola, Asudo, Felicia, Mshelia, Danladi, Abdur-Rahman, Lukman, Agodirin, Olayide, Bello, Jibril, Bolaji, Benjamin, Oyedepo, Olanrewaju Olubukola, Ezike, Humphrey, Iloabachie, Ikechukwu, Okonkwo, Ikemefuna, Onuora, Elia, Onyeka, Tonia, Ugwu, Innocent, Umeh, Friday, Alagbe-Briggs, Olubusola, Dodiyi-Manuel, Amabra, Echem, Richard, Obasuyi, Bright, Onajin-Obembe, Bisola, Bandeira, Maria Expedito, 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Diaconescu, Ciresica, Iosep, Gabriel Florin, Pulbere, Dorin, Ursu, Irina, Balanescu, Andreea, Grintescu, Ioana, Mirea, Liliana, Rentea, Irina, Vartic, Mihaela, Lupu, Mary-Nicoleta, Stanescu, Dorin, Streanga, Lavinea, Antal, Oana, Hagau, Natalia, Patras, Dumitru, Petrisor, Cristina, Tosa, Flaviu, Tranca, Sebastian, Copotoiu, Sanda Maria, Ungureanu, Liviu Lucian, Harsan, Cristian Remu, Papurica, Mariu, Cernea, Daniela Denisa, Dragoescu, Nicoleta Alice, Aflori, Laura, Vaida, Carmen, Ciobotaru, Oana Roxana, Aignatoaie, Mariana, Carp, Cristina Paula, Cobzaru, Isabelle, Mardare, Oana, Purcarin, Bianca, Tutunaru, Valentin, Ionita, Victor, Arustei, Mirela, Codita, Anisoara, Busuioc, Mihai, Chilinciuc, Ion, Ciobanu, Cristina, Belciu, Ioana, Tincu, Eugen, Blaj, Mihaela, Grosu, Ramona-Mihaela, Sandu, Gigel, Bruma, Dana, Corneci, Dan, Dutu, Madalina, Krepil, Adriana, Copaciu, Elena, Dumitrascu, Clementina Oana, Jemna, Ramona, Mihaescu, Florentina, Petre, Raluca, Tudor, Cristina, Ursache, Elena, Kulikov, Alexander, Lubnin, Andrey, Grigoryev, Evgeny, Pugachev, Stanislav, Tolmasov, Alexander, Hussain, Ayyaz, Ilyina, Yana, Roshchina, Anna, Iurin, Aleksandr, Chazova, Elena, Dunay, Artem, Karelov, Alexey, Khvedelidze, Irina, Voldaeva, Olga, Belskiy, Vladislav, Dzhamullaev, Parvin, Grishkowez, Elena, Kretov, Vladimir, Levin, Valeriy, Molkov, Aleksandr, Puzanov, Sergey, Samoilenko, Aleksandr, Tchekulaev, Aleksandr, Tulupova, Valentina, Utkin, Ivan, Allorto, Nikki Leigh, Bishop, David Gray, Builu, Pierre Monji, Cairns, Carel, Dasrath, Ashish, de Wet, Jacque, den Hoedt, Marielle, Grey, Ben, Hayes, Morgan Philip, Küsel, Belinda Senta, Shangase, Nomcebo, Wise, Robert, Cacala, Sharon, Farina, Zane, Govindasamy, Vishendran, Kruse, Carl-Heinz, Lee, Carolyn, Marais, Leonard, Naidoo, Thinagrin Dhasarthun, Rajah, Chantal, Rodseth, Reitze Nil, Ryan, Lisa, von Rhaden, Richard, Adam, Suwayba, Alphonsus, Christella, Ameer, Yusuf, Anderson, Frank, Basanth, Sujith, Bechan, Sudha, Bhula, Chettan, Biccard, Bruce M., Biyase, Thuli, Buccimazza, Ine, Cardosa, Jorge, Chen, Jame, Daya, Bhavika, Drummond, Leanne, Elabib, Ali, Goad, Ehab Helmy Abdel, Goga, Ismail E., Goga, Riaz, Harrichandparsad, R., Hodgson, Richard E., Jordaan, J., Kalafatis, Nicky, Kampik, Christian, Landers, At, Loots, Emil, Madansein, Rajhmum, Madaree, Anil, Madiba, Thandinkosi E., Manzini, Vukani T., Mbuyisa, Mbali, Moodley, Rajan, Msomi, Mduduzi, Mukama, Innocent, Naidoo, Desigan, Naidoo, Rubeshan, Naidu, Tesuven K., Ntloko, Sindiswa, Padayachee, Eneshia, Padayachee, Lucelle, Phaff, Martijn, Pillay, Bala, Pillay, Desigan, Pillay, Lutchmee, Ramnarain, Anupa, Ramphal, Suren R., Ryan, Paul, Saloojee, Ahmed, Sebitloane, Motshedisi, Sigcu, Noluyolo, Taylor, Jenna L., Torborg, Alexandra, Visser, Linda, Anderson, Philip, Conradie, Alae, de Swardt, Mathew, de Villiers, Martin, Eikman, Johan, Liebenberg, Riaan, Mouton, Johan, Paton, Abbey, van der Merwe, Louwrence, Wilscott-Davids, Candice, Barrett, Wendy Joan, Bester, 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Dempsey, Ged, Seasman, Colette, Basit Nawaz Khan, Raja, Kurasz, Claire, Macgregor, Mark, Shawki, Burhan, Hariharan, Vimal, Chau, Simon, Ellis, Kate, Butt, Georgina, Chicken, Dennis-Wayne, Christmas, Natasha, Allen, Samantha, Daniel, Gayatri Daniel, Dempster, Angie, Kemp, Juliette, Matthews, Lewi, Mcglone, Philip, Tambellini, Joanne, Trodd, Dawn, Freitas, Katie, Garg, Atul, Karpate, Shilpaja, Kulkarni, Aditi, O’Hara, Chloe, Troko, Jtroko, Angus, Kirsty, Bradley, Jacqueline, Brennan, Emma, Brooks, Carolyn, Brown, Janette, Brown, Gemma, Finch, Amanda, Gratrix, Karen, Hesketh, Sue, Hill, Gillian, Jeffs, Carol, Morgan, Maureen, Pemberton, Chri, Slawson, Nicola, Spickett, Helen, Swarbrick, Gemma, Thomas, Megan, Van Duyvenvoorde, Greta, Brennan, Andrew, Briscoe, Richard, Cooper, Sarah, Lawton, Tom, Northey, Martin, Senaratne, Rashmi, Stanworth, Helen, Burrows, Lorna, Cain, Helen, Craven, Rachael, Davies, Keith, Jonas, Attila, Pachucki, Marcin, Walkden, Graham, Davies, Helen, Gudaca, Mariethel, Hobrok, Maria, Arawwawala, Dilshan, Fergey, Lauren, Gardiner, Matthew, Gunn, Jacqueline, Johnson, Lyndsay, Lofting, Amanda, Lyle, Amanda, Mc Neela, Fiona, Smolen, Susan, Topliffe, Joanne, Williams, Sarah, Bland, Martin, Kaura, Vika, Lanka, Prasad, Naylor, Chardé, Smith, Neil, Ahmed, Ahmed, Myatt, John, Shenoy, Ravikiran, Soon, Wai Cheong, Tan, Jessica, Karadia, Sunny, Self, Jame, Durant, Emma, Tripathi, Shiva, Bullock, Clare, Campbell, Debbie, Ghosh, Alison, Hughes, Thoma, Zsisku, Lajo, Bengeri, Sheshagiri, Cowton, Amanda, Khalid, Mohammed Shazad, Limb, Jame, McAdam, Colin, Porritt, Mandy, Rafi, M. Amir, Shekar, Priya, Harden, Catherine, Hollands, Heidi, King, Angela, March, Linda, Minto, Gary, Patrick, Abigail, Waugh, Darren, Kumara, Paramesh, Simeson, Karen, Yarwood, Jamie, Browning, Julie, Hatton, Jonathan, Julian, Howe, Mitra, Atideb, Newton, Maria, Pernu, Pawan, Wilson, Alison, Commey, Thelma, Foot, Helen, Glover, Lyn, Gupta, Ajay, Lancaster, Nicola, Levin, Jill, Mackenzie, Felicity, Mestanza, Claire, Nofal, Emma, Pout, Lauren, Varden, Rosanna, Wild, Jonathan, Jones, Stephanie, Moreton, Sarah, Pulletz, Mark, Davies, Charlotte, Martin, Matthew, Thomas, Sian, Burns, Karen, McArthur, Carol, Patel, Panna, Lau, Gary, Rich, Natalie, Davis, Fiona, Lyons, Rachel, Port, Beth, Prout, Rachel, Smith, Christopher, Adelaja, Yemi, Bennett, Victoria, Bidd, Heena, Dumitrescu, Alexandra, Murphy, Jacqui Fox, Keen, Abigail, Mguni, Nhlanhla, Ong, Cheng, Adams, George, Boshier, Pier, Brown, Richard, Butryn, Izabella, Chatterjee, Jayanta, Freethy, Alexander, Lockwood, Geoffrey, Tsakok, Maria, Tsiligiannis, Sophia, Peat, William, Stephenson, Lorraine, Bradburn, Mike, Pick, Sara, Cunha, Pedro, Olagbaiye, Olufemi, Tayeh, Salim, Abernethy, Caroline, Balasubramaniam, Madhu, Bennett, Rachael, Bolton, David, Martinson, Victoria, Naylor, Charde, Bell, Stephanie, Heather, Blaylock, Kushakovsky, Vlad, Alcock, Liam, Alexander, Hazel, Anderson, Colette, Baker, Paul, Brookes, Morag, Cawthorn, Louise, Cirstea, Emanuel, Colling, Kerry, Coulter, Ian, Das, Suparna, Haigh, Kathryn, Hamdan, Alhafidz, Hugill, Keith, Kottam, Lucksy, Lisseter, Emily, Mawdsley, Matthew, McGivern, Julie, Padala, Krishnaveni, Phelps, Victoria, kumar, Vineshykaa Ramesh, Stewart, Kirsten, Towse, Kayley, Tregonning, Julie, Vahedi, Ali, Walker, Alycon, Baines, Duncan, Bilolikar, Anjali, Chande, Shiv, Copley, Edward, Dunk, Nigel, Kulkarni, Raghavendra, Kumar, Pawan, Metodiev, Yavor, Ncomanzi, Dumisani, Raithatha, Bhavesh, Raymode, Parizade, Szafranski, Jan, Twohey, Linda, Watt, Philip, Weatherall, Lucie, Weatherill, J., Whitman, Zoe, Wighton, Elinor, Abayasinghe, Chamika, Chan, Alexander, Darwish, Sharif, Gill, Jame, Glasgow, Emma, Hadfield, Daniel, Harris, Clair, Kochhar, Arun, Mellis, Clare, Pool, Andrew, Riozzi, Paul, Selman, Andrew, Smith, Emma-Jane, Vele, Liana, Gercek, Yuksel, Guy, Kramer, Holden, Dougla, Watson, Nichola, Whysall, Karen, Andreou, Prematie, Hales, Dawn, Thompson, Jonathan, Bowrey, Sarah, McDonald, Shara, Gilmore, Jemma, Hills, Vicky, Kelly, Chan, Kelly, Sinead, Lloyd, Geraint, Abbott, Tom, Gall, Lewi, Torrance, Hew, Vivian, Mark, Berntsen, Emer, Nolan, Tracey, Turner, Angu, Vohra, Akbar, Brown, Andrew, Clark, Richard, Coughlan, Elaine, Daniel, Conway, Patvardhan, Chinmay, Pearson, Rachel, Predeep, Sheba, Saad, Hesham, Shanmugam, Mohanakrishnan, Varley, Simon, Wylie, Katharine, Cooper, Lucy, Makowski, Arystarch, Misztal, Beata, Moldovan, Eliza, Pegg, Claire, Donovan, Andrew, Foot, Jayne, Large, Simon, Claxton, Andrew, Netke, Bhagyashree, Armstrong, Richard, Calderwood, Claire, Kwok, Andy, Mohr, Otto, Oyeniyi, Peter, Patnaik, Lisa, Post, Benjamin, Ali, Sarah, Arshad, Homa, Baker, Gerard, Brenner, Laura, Brincat, Maximilian, Brunswicker, Annemarie, Cox, Hannah, Cozar, Octavian Ionut, Durst, Alexander, Fengas, Lior, Flatt, Jim, Glister, Georgina, Narwani, Vishal, Photi, Evangelo, Rankin, Adeline, Rosbergen, Melissa, Tan, Mark, Beaton, Ceri, Horn, Rachel, Hunt, Jane, Rousseau, Guy, Stancombe, Lucia, Absar, Mohammed, Allsop, Joanne, Drinkwater, Zoe, Hodgkiss, Tracey, Smith, Kirsty, Brown, Jamie, Alexander-Sefre, Farhad, Campey, Lorraine, Dudgeon, Lucy, Hall, Kathryn, Hitchcock, Rachael, James, Lynne, Smith, Kate, Winstone, Ulrika, Ahmad, Norfaizan, Bauchmuller, Kri, Harrison, Jonathan, Jeffery, Holly, Miller, Duncan, Pinder, Angela, Pothuneedi, Sailaja, Rosser, Jonathan, Sanghera, Sumayer, Swift, Diane, Walker, Rachel, Bester, Delia, Cavanagh, Sarah, Cripps, Heather, Daniel, Harvey, Lynch, Julie, Paton, Alison, Pyke, Shirley, Scholefield, John, Whitworth, Helen, Bottrill, Fiona, Ramalingam, Ganesh, Webb, Stephen, Akerman, Nik, Antill, Philip, Bourner, Lynsey, Buckley, Sarah, Castle, Gail, Charles, Rob, Eggleston, Christopher, Foster, Rebecca, Gill, Satwant, Lindley, Kate, Lklouk, Mohamed, Lowery, Tracey, Martin, Oliver, Milne, David, O’Connor, Patrick, Ratcliffe, Andrew, Rose, Alastair, Smith, Annie, Varma, Sandeep, Ward, Jackie, Barcraft-Barnes, Helena, Camsooksai, Julie, Colvin, Carolyn, Reschreiter, Henrik, Tbaily, Lee, Venner, Nicola, Hamilton, Caroline, Kelly, Lewi, Toth-Tarsoly, Piroska, Dodsworth, Kerry, Foord, Denise, Gordon, Paul, Hawes, Elizabeth, Lamb, Nikki, Mouland, Johanna, Nightingale, Jeremy, Rose, Steve, Schrieber, Joe, Al ‘Amri, Khalid, Aladin, Hafiz, Arshad, Mohammed Asif, Barraclough, Jame, Bentley, Conor, Bergin, Colin, Carrera, Ronald, Clarkson, Aisling, Collins, Michelle, Cooper, Lauren, Denham, Samuel, Griffiths, Ewen, Ip, Peter, Jeyanthan, Somasundaram, Joory, Kavita, Kaur, Satwant, Marriott, Paul, Mitchell, Natalie, Nagaiah, Sukumar, Nilsson, Annette, Parekh, Nilesh, Pope, Martin, Seager, Joseph, Serag, Hosam, Tameem, Alifia, Thomas, Anna, Thunder, Joanne, Torrance, Andrew, Vohra, Ravinder, whitehouse, Arlo, Wong, Tony, Blunt, Mark, Wong, Kate, Giles, Julian, Reed, Isabelle, Weller, Debbie, Bell, Gillian, Birch, Julie, Damant, Rose, Maiden, Jane, Mewies, Clare, Prince, Claire, Radford, Jane, Balain, Birender, Banerjee, Robin, Barnett, Andrew, Burston, Ben, Davies, Kirsty, Edwards, Jayne, Evans, Chri, Ford, David, Gallacher, Pete, Hill, Simon, Jaffray, David, Karlakki, Sudheer, Kelly, Cormac, Kennedy, Julia, Kiely, Nigel, Lewthwaite, Simon, Marquis, Chri, Ockendon, Matthew, Phillips, Stephen, Pickard, Simon, Richardson, Jame, Roach, Richard, Smith, Tony, Spencer-Jones, Richard, Steele, Niall, Steen, Julie, Van Liefland, Marck, White, Steve, Faulds, Matthew, Harris, Meredyth, Kelly, Carrie, Nicol, Scott, Pearson, Sally Anne, Chukkambotla, Srikanth, Andrew, Alyson, Attrill, Elizabeth, Campbell, Graham, Datson, Amanda, Fouracres, Anna, Graterol, Juan, Graves, Lynne, Hong, Bosun, Ishimaru, Alexander, Karthikeyan, Arvind, King, Helen, Lawson, Tom, Lee, Gregory, Lyons, Saoirse, Macalister Hall, Andrew, Mathoulin, Sophie, Mcintyre, Eilidh, Mclaughlin, Danny, Mulcahy, Kathleen, Ratcliffe, Anna, Robbins, Jame, Sung, Weilin, Tayo, Adeoluwa, Trembath, Lisa, Venugopal, Suneetha, Walker, Robert, Wigmore, Geoffrey, Boereboom, Catherine, Downes, Charlotte, Humphries, Ryan, Melbourne, Susan, Smith, Coral, Tou, Samson, Ullah, Shafa, Batchelor, Nick, Boxall, Leigh, Broomby, Rupert, Deen, Tariq, Hellewell, Alistair, Helliwell, Laurence, Hutchings, Melanie, Hutchins, David, Keenan, Samantha, Mackie, Donna, Donna, Alison, Smith, France, Stone, Lucy, Thorpe, Kevin, Wassall, Richard, Woodgate, Andrew, Baillie, Shelley, Campbell, Tara, James, Sarah, King, Chri, Marques de Araujo, Daniela, Martin, Daniel, Morkane, Clare, Neely, Julia, Rajendram, Rajkumar, Burton, Megan, James, Kathryn, Keevil, Edward, Minik, Orsolya, Morgan, Jenna, Musgrave, Anna, Rajanna, Harish, Roberts, Tracey, Adamson, Michael, Jumbe, Sandra, Kendall, Jennie, Muthuswamy, Mohan Babu, Anderson, Charlotte, Cruikshanks, Andrew, Wrench, Ian, Zeidan, Lisa, Ardern, Diane, Harris, Benjamin, Hellstrom, Johanna, Martin, Jane, Thomas, Richard, Varsani, Nimu, Wrey Brown, Caroline, Docherty, Philip, Gillies, Michael, McGregor, Euan, Usher, Helen, Craig, Jayne, Smith, Andrew, Ahmad, Tahania, Bodger, Phoebe, Creary, Thai, Fowler, Alexander, Hewson, Ru, Ijuo, Eke, Jones, Timothy, Kantsedikas, Ilya, Lahiri, Sumitra, McLean, Aaron Lawson, Niebrzegowska, Edyta, Phull, Mandeep, Wang, Difei, Wickboldt, Nadine, Baldwin, Jacqueline, Doyle, Donna, Mcmullan, Sean, Oladapo, Michelle, Owen, Thoma, Williams, Alexandra, Daniel, Hull, Gregory, Peter, Husain, Tauqeer, Kirk-Bayley, Justin, Mathers, Edward, Montague, Laura, White, Stuart, Avis, Joanne, Cook, Tim, Dali-Kemmery, Lola, Kerslake, Ian, Lambourne, Victoria, Pearson, Annabel, Boyd, Christine, Callaghan, Mark, Lawson, Cathy, McCrossan, Roopa, Nesbitt, Vanessa, O’connor, Laura, Scott, Julia, Sinclair, Rhona, Farid, Nahla, Morgese, Ciro, Bhatia, Kailash, Karmarkar, Swati, Ahmed, Jamil, Branagan, Graham, Hutton, Monica, Swain, Andrew, Brookes, Jamie, Cornell, Jonathan, Dolan, Rachael, Hulme, Jonathan, Jansen van Vuuren, Amanda, Jowitt, Tom, Kalashetty, Gunasheela, Lloyd, Fran, Patel, Kiran, Sherwood, Nichola, Brown, Lynne, Chandler, Ben, Deighton, Kerry, Emma, Temlett, Haunch, Kirsty, Cheeseman, Michelle, Dent, Kathy, Garg, Sanjeev, Gray, Carol, Hood, Marion, Jones, Dawn, Juj, Joanne, Rao, Roshan, Walker, Tara, Al Anizi, Mashel, Cheah, Clarissa, Cheing, Yushio, Coutinho, Francisco, Gondo, Prisca, Hadebe, Bernard, Onie Hove, Mazvangu, khader, Ahamed, Krishnachetty, Bobby, Rhodes, Karen, Sokhi, Jagdish, Baker, Katie-Anne, Bertram, Wendy, Looseley, Alex, Mouton, Ronelle, Arnold, Glenn, Arya, Shobhit, Balfoussia, Danai, Baxter, Linden, Harris, Jame, Jones, Craig, Knaggs, Alison, Markar, Sheraz, Perera, Anisha, Scott, Alasdair, Shida, Asako, Sirha, Ravneet, Wright, Sally, Frost, Victoria, Gray, Catherine, MacGregor, Mark, Andrews, Emma, Arrandale, Lindsay, Barrett, Stephen, Cifra, Elna, Cooper, Mariese, Dragnea, Drago, Elna, Cifra, Maclean, Jennifer, Meier, Sonja, Milliken, Donald, Munns, Christopher, Ratanshi, Nadir, Salvana, Abegail, Watson, Anthony, Ali, Hani, Campbell, Gill, Critchley, Rebecca, Hicks, Catherine, Liddle, Alison, Pass, Marc, Ritchie, Charlotte, Thomas, Charlotte, Too, Lingxi, Welsh, Sarah, Gill, Talvinder, Johnson, Joanne, Reed, Joanne, Davis, Edward, Papadopoullos, Sam, Attwood, Clare, Biffen, Andrew, Boulton, Kerenza, Gray, Sophie, Hay, David, Mills, Sarah, Montgomery, Jane, Riddell, Rory, Simpson, Jame, Bhardwaj, Neeraj, Paul, Elaine, Uwubamwen, Nosakhare, Alexander, Maini, Arrich, Jame, Arumugam, Swarna, Blackwood, Dougla, Boggiano, Victoria, Brown, Robyn, Lam Chan, Yik, Chatterjee, Devnandan, Chhabra, Ashok, Christian, Rachel, Costelloe, Hannah, Coxwell Matthewman, Madeline, Dalton, Emma, Darko, Julia, Davari, Maria, Dave, Tejal, Deacon, Matthew, Deepak, Shantal, Edmond, Holly, Ellis, Jessica, El-Sayed, Ahmed, Eneje, Philip, English, Rose, Ewe, Renee, Foers, William, Franklin, John, Gallego, Laura, Garrett, Emily, Goldberg, Olivia, Goss, Harry, Greaves, Rosanna, Harris, Rudy, Hennings, Charle, Jones, Eleanor, Kamali, Nelson, Kokkinos, Naomi, Lewis, Cary, Lignos, Leda, Malgapo, Evaleen Victoria, Malik, Rizwana, Milne, Andrew, Mulligan, John-Patrick, Nicklin, Philippa, Palipane, Natasha, Parsons, Thoma, Piper, Rebecca, Prakash, Rohan, Ramesh, Byron, Rasip, Sarah, Reading, Jacob, Rela, Mariam, Reyes, Anna, Robert, Stephen, Rooms, Martin, Shah, Karishma, Simons, Henry, Solanki, Shalil, Spowart, Emma, Stevens, Amy, Thomas, Christopher, Waggett, Helena, Yassaee, Arrash, Kennedy, Anthony, Scott, Sara, Somanath, Sameer, Berg, Andrew, Hernandez, Miguel, Nanda, Rajesh, Tank, Ghanshyambhai, Wilson, Natalie, Wilson, Debbie, Al-Soudaine, Yassr, Baldwin, Matthew, Cornish, Julie, Davies, Zoe, Davies, Leigh, Edwards, Marc, Frewer, Natasha, Gallard, Sian, Glasbey, Jame, Harries, Rhiannon, Hopkins, Luke, Kim, Taeyang, Koompirochana, Vilavan, Lawson, Simon, Lewis, Megan, Makzal, Zaid, Scourfield, Sarah, Ahmad, Yousra, Bates, Sarah, Blackwell, Clare, Bryant, Helen, Coulter, Suzanne, Cruickshank, Ro, Daniel, Sonya, Daubeny, Thoma, Edwards, Mark, Golder, Kim, Hawkins, Lesley, Helen, Bryant, Hinxman, Honor, Levett, Denny, Skinner, Ben, Walsgrove, Joseph, Dickson, Jane, Constantin, Kathryn, Karen, Markwell, O’Brien, Peter, O’Donohoe, Lynn, Payne, Hannah, Sundayi, Saul, Walker, Elaine, Brooke, Jenny, Cardy, Jon, Humphreys, Sally, Kessack, Laura, Kubitzek, Christiane, Kumar, Suha, Cotterill, Donna, Hodzovic, Emil, Hosdurga, Gurunath, Miles, Edward, Saunders, Glenn, Campbell, Marta, Chan, Peter, Jemmett, Kim, Raj, Ashok, Naik, Aditi, Ramamoorthy, Rajarajan, Shah, Nimesh, Sylvan, Axel, Blyth, Katharine, 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D., Martin, D., Morkane, C., Neely, J., Rajendram, R., Burton, M., James, K., Keevil, E., Minik, O., Morgan, J., Musgrave, A., Rajanna, H., Roberts, T., Adamson, M., Jumbe, S., Kendall, J., Muthuswamy, M.B., Cruikshanks, A., Wrench, I., Zeidan, L., Ardern, D., Harris, B., Hellstrom, J., Martin, J., Thomas, R., Varsani, N., Wrey Brown, C., Docherty, P., Gillies, M., McGregor, E., Usher, H., Craig, J., Ahmad, T., Bodger, P., Creary, T., Fowler, A., Ijuo, E., Jones, T., Kantsedikas, I., Lahiri, S., McLean, A.L., Niebrzegowska, E., Phull, M., Wickboldt, N., Baldwin, J., Doyle, D., Mcmullan, S., Oladapo, M., Owen, T., Williams, A., Gregory, P., Husain, T., Kirk-Bayley, J., Mathers, E., Montague, L., Avis, J., Cook, T., Dali-Kemmery, L., Kerslake, I., Lambourne, V., Pearson, A., Boyd, C., Callaghan, M., Lawson, C., McCrossan, R., Nesbitt, V., O'connor, L., Sinclair, R., Farid, N., Morgese, C., Bhatia, K., Karmarkar, S., Ahmed, J., Branagan, G., Hutton, M., Swain, A., Brookes, J., Cornell, 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Subjects
Male, HSJ UCI, Critical Care and Intensive Care Medicine, law.invention, Perioperative Care/methods, 0302 clinical medicine, Surgical procedures, 030202 anesthesiology, law, Critical care/utilisation, Postoperative care/methods, Postoperative care/statistics and numerical data, Surgical procedures, operative/mortality, statistics and numerical data, Prospective Studies, Postoperative Period, Postoperative care/methods, education.field_of_study, Postoperative care/method, Elective Surgical Procedures/mortality, fluid output, Middle Aged, fluid administration, Intensive care unit, Hospitalization, Length of Stay/statistics & numerical data, operative/mortality, Intensive Care Units/statistics & numerical data, outcome, Female, Elective Surgical Procedure, Human, Adult, medicine.medical_specialty, Logistic Model, Postoperative care/statistics and numerical data, Critical care/utilisation, Population, Intensive Care Unit, Elective Surgical Procedures/statistics & numerical data, Hospitalization/statistics & numerical data, Humans, Logistic Models, Surgical procedures, operative/mortality, Postoperative care, methods, Perioperative Care, NO, 03 medical and health sciences, Anesthesiology, Intensive care, medicine, Elective surgery, Intensive care medicine, education, business.industry, 030208 emergency & critical care medicine, Perioperative, Length of Stay, Clinical trial, Prospective Studie, septic shock, business
Abstract

PURPOSE: As global initiatives increase patient access to surgical treatments, there is a need to define optimal levels of perioperative care. Our aim was to describe the relationship between the provision and use of critical care resources and postoperative mortality. METHODS: Planned analysis of data collected during an international 7-day cohort study of adults undergoing elective in-patient surgery. We used risk-adjusted mixed-effects logistic regression models to evaluate the association between admission to critical care immediately after surgery and in-hospital mortality. We evaluated hospital-level associations between mortality and critical care admission immediately after surgery, critical care admission to treat life-threatening complications, and hospital provision of critical care beds. We evaluated the effect of national income using interaction tests. RESULTS: 44,814 patients from 474 hospitals in 27 countries were available for analysis. Death was more frequent amongst patients admitted directly to critical care after surgery (critical care: 103/4317 patients [2%], standard ward: 99/39,566 patients [0.3%]; adjusted OR 3.01 [2.10-5.21]; p < 0.001). This association may differ with national income (high income countries OR 2.50 vs. low and middle income countries OR 4.68; p = 0.07). At hospital level, there was no association between mortality and critical care admission directly after surgery (p = 0.26), critical care admission to treat complications (p = 0.33), or provision of critical care beds (p = 0.70). Findings of the hospital-level analyses were not affected by national income status. A sensitivity analysis including only high-risk patients yielded similar findings. CONCLUSIONS: We did not identify any survival benefit from critical care admission following surgery. info:eu-repo/semantics/publishedVersion

Published
2017

30. Evaluation of the treatment guidelines, practices and outcomes of complicated severe acute malnutrition in children aged 0-59 months in sub-Saharan Africa: a study protocol for the SAMAC study

Author

Cornelia Conradie, Cristian Ricci, Janet Carboo, Robin C. Dolman, Martani J Lombard, 28272374 - Carboo, Janet Adede, 25719815 - Lombard, Martani Johanni, 10676287 - Dolman, Robin Claire, 29790514 - Ricci, Cristian, and 25872273 - Conradie, Cornelia

Subjects
medicine.medical_specialty, 030231 tropical medicine, Severe Acute Malnutrition, Developing country, Treatment practices, severe acute malnutrition, treatment guidelines, World Health Organization, Child Nutrition Disorders, Severity of Illness Index, 03 medical and health sciences, Patient Admission, 0302 clinical medicine, children, Case fatality rate, parasitic diseases, medicine, Global health, Treatment guidelines, Sub-Saharan Africa, medical complications, treatment practices, mortality, Humans, 030212 general & internal medicine, Mortality, Children, Africa South of the Sahara, business.industry, Research, Medical record, Public health, Infant, Newborn, Infant, General Medicine, Guideline, Medical complications, Infant Nutrition Disorders, Patient Discharge, Hospitalization, Severe acute malnutrition, Child, Preschool, Family medicine, Acute Disease, Practice Guidelines as Topic, Observational study, business
Abstract

Introduction in hospitals across Africa, the case fatality rates of severe acute malnutrition (SAM) have remained consistently high (over 20%), despite the existence of the WHO treatment guideline. This has been attributed to inconsistencies in the implementation of the WHO treatment guidelines in sub-Saharan African countries. In spite of this awareness, the SAM treatment guidelines adopted by various sub-Saharan African countries and hospitals are unknown. Knowledge of the exact treatment practices employed in the management of SAM in different hospitals in sub-Saharan Africa is not known. This study aims to investigate the admission criteria, in-patient treatment guidelines and practices and outcomes of complicated SAM in sub-Saharan African children aged 0-59 months. Methods this is an observational study which involves the extraction of admission, treatment and discharge data from the medical records of infants and children aged 0-59 months diagnosed and treated for complicated SAM in sub-Saharan Africa. This information is being used to develop a comprehensive database on the treatment of complicated SAM across sub-Saharan Africa. Information on the national and hospital guidelines for the treatment of complicated SAM is also collected. Results results of this study will serve as a useful resource on the true reflection of the treatment of complicated SAM across sub-Saharan Africa and will provide valuable information for optimising SAM treatment. Conclusion in order to advocate best practice and reduce SAM-related mortality in sub-Saharan Africa, the identification of the different diagnostic and treatment methods and respective outcomes across different hospitals and countries is imperative.

Published
2020

31. CYP19A1 rs10046 Pharmacogenetics in Postmenopausal Breast Cancer Patients Treated with Aromatase Inhibitors: One-year Follow-up

Author

Armand V. Peeters, Magda Conradie, Justus P. Apffelstaedt, Micheal McCaul, Maritha J. Kotze, M M Conradie, and Karin Baatjes

Subjects
Oncology, medicine.medical_specialty, Estrogen receptor, Breast Neoplasms, Polymorphism, Single Nucleotide, Breast cancer, Aromatase, Bone Density, Internal medicine, Drug Discovery, medicine, Humans, Clinical significance, Adverse effect, Pharmacology, Bone mineral, biology, business.industry, Aromatase Inhibitors, medicine.disease, Postmenopause, Pharmacogenetics, biology.protein, Population study, Female, business, Follow-Up Studies
Abstract

Background: Significant individual variation in bone loss associated with aromatase inhibitors (AIs) emphasizes the importance of identifying postmenopausal breast cancer patients at high risk for this adverse effect. The study explores the clinical relevance of genetic variation in the Cytochrome P450 19A1 (CYP19A1) gene in a subset of South African patients during the first year of taking AIs for estrogen receptor (ER)-positive breast cancer. Methods: The study population consisted of ER-positive breast cancer patients on AIs, followed in real-life clinical practice. Body mass index was measured and bone mineral density (BMD) was determined at baseline and at month 12. CYP19A1 genotyping was performed using real-time polymerase chain reaction analysis of rs10046, extended to Sanger sequencing and whole exome sequencing in 10 patients with more than 5% bone loss at month 12 at the lumbar spine. Results: After 12 months of AI treatment, 72 patients had completed BMD and were successfully genotyped. Ten patients (14%) experienced more than 5% bone loss at the lumbar spine over the study period. Genotyping for CYP19A1 rs10046 revealed that patients with two copies of the A-allele were 10.79 times more likely to have an ordinal category change of having an increased percentage of bone loss or no increase at the lumbar spine, compared to patients with the GA or GG genotypes (CI of 1.771- 65.830, p=0.01). None of the 34 patients without lumbar spine bone loss at month 12 were homozygous for the functional CYP19A1 polymorphism. At the total hip region, patients with the AA genotype were 7. 37 times more likely to have an ordinal category change of having an increased percentage of bone loss or no increase (CI of 1.101- 49.336, p=0.04). Conclusions: Homozygosity for the CYP19A1 rs10046 A-allele may provide information, in addition to clinical and biochemical factors that may be considered in risk stratification to optimize bone health in postmenopausal breast cancer women on AIs. Further investigation is required to place the clinical effect observed for a single CYP19A1 gene variant in a genomic context.

Published
2020

32. Towards a needs-based design of the physical rehabilitation workforce in South Africa: trend analysis [1990–2017] and a 5-year forecasting for the most impactful health conditions based on global burden of disease estimates

Author

Karen Grimmer, Quinette Louw, T. Conradie, D. T. Bedada, Tiago S. Jesus, and Karina Berner

Subjects
Adult, Burden of disease, medicine.medical_specialty, medicine.medical_treatment, Rehabilitation workforce, Disease, Global Health, South Africa, 03 medical and health sciences, 0302 clinical medicine, Epidemiology, Prevalence, medicine, Humans, 030212 general & internal medicine, Rehabilitation, business.industry, Research, 030503 health policy & services, Public health, Infant, Newborn, Public Health, Environmental and Occupational Health, Global burden of disease, YLDs, Trend analysis, Diabetes Mellitus, Type 2, Human resources, Workforce, Physical therapy, Quality-Adjusted Life Years, Public aspects of medicine, RA1-1270, Biostatistics, 0305 other medical science, business
Abstract

Background Rehabilitation can improve function in many people with chronic health conditions. It is important to consider priority conditions requiring rehabilitation, so it can be realistically positioned and costed in national health financing systems like South Africa (SA)‘s proposed National Health Insurance (NHI). This paper describes temporal trends of top-ranked conditions on years lived with disability (YLDs) rates in SA, for which physical rehabilitation can ameliorate associated disability. Methods This study is a systematic synthesis of publicly available Global Burden of Disease (GBD) 2017 estimates. The top 11 conditions contributing most to YLDs and for which evidence-based rehabilitation interventions exist were identified. Age-standardized rates per 100,000 and YLDs counts were extracted from 1990 to 2017. Significance of changes in temporal trends was determined using Mann-Kendall trend tests. Best-fit rates of yearly changes were calculated per condition, using GBD estimates (2012–2017), and extrapolated (by imposing the best-fit regression line onto results for each subsequent predicted year) as forecasts (2018–2022). Results Trends for YLDs counts per condition year (1990–2017) and forecasted values (2018–2022) showed an overall steady increase for all conditions, except HIV and respiratory conditions. YLDs counts almost doubled from 1990 to 2017, with a 17% predicted increase from 2017 to 2022. The proportionate contribution to YLDs counts reduced over time for all conditions, except HIV. Although age-standardized YLDs rates appear relatively stable over the analyzed periods for all conditions (except HIV, respiratory conditions and type 2 diabetes), trend changes in YLDs rates over 28 years were significant for all conditions, except neonatal (p = 0.855), hearing loss (p = 0.100) and musculoskeletal conditions (p = 0.300). Significant trend decreases were apparent for 4/9 conditions, implying that another 5/9 conditions showed trend increases over 28 years. Predicted all-age prevalence in 2022 suggests relatively large increases for cardiovascular disease and heart failure, and burns, while relative decreases are predicted for fractures and dislocations, stroke, and musculoskeletal conditions. Conclusion Rehabilitation needs in SA are potentially massive and unmet, highlighting the need for innovative and context-specific rehabilitation that considers current local needs and projected changes. These findings should be considered when designing the NHI and other schemes in SA to ensure human and financial resources are deployed efficiently.

Published
2021

33. Clinical evaluation of the Xpert MTB/XDR assay for rapid detection of isoniazid, fluoroquinolone, ethionamide and second-line drug resistance: A cross-sectional multicentre diagnostic accuracy study

Author

Morten Ruhwald, Bhalla M, Myneedu Vp, Adam Penn-Nicholson, Lesley Scott, Camilla Rodrigues, Sophia B. Georghiou, Nelly Ciobanu, Anura David, Crudu, Samuel G Schumacher, Mubin Kazi, Francesca Conradie, and Claudia M. Denkinger

Subjects
medicine.medical_specialty, education.field_of_study, GeneXpert MTB/RIF, Tuberculosis, business.industry, Population, Context (language use), Drug resistance, medicine.disease, Drug detection, Internal medicine, medicine, Sputum, Ethionamide, medicine.symptom, education, business, medicine.drug
Abstract

BackgroundThe WHO End TB Strategy requires universal drug susceptibility testing and treatment of all people with tuberculosis. However, available second-line diagnostic tools are cumbersome and require sophisticated laboratory infrastructure, and ultimately less than half of those with drug-resistant tuberculosis receive appropriate treatment. Xpert MTB/XDR was developed to help overcome these limitations.MethodsWe assessed the diagnostic accuracy of sputum-based Xpert MTB/XDR for isoniazid, fluoroquinolone, ethionamide and second-line injectable resistance detection in adults with an Xpert MTB/RIF or Ultra Mycobacterium tuberculosis-positive result against a composite reference standard of phenotypic drug-susceptibility testing and whole genome sequencing (NCT03728725). Participants with pulmonary tuberculosis symptoms and ≥1 risk factor for drug resistance were consecutively enrolled between four clinical sites in India, Moldova and South Africa.FindingsBetween 31 July 2019 and 21 March 2020, we enrolled 710 patients, of which 611 (86.1%) had results from index and composite reference standard tests and were included in analysis. The sensitivity of Xpert MTB/XDR was 94% for isoniazid, 95% for fluoroquinolones, 54% for ethionamide, 73% for amikacin, 86% for kanamycin, and 61% for capreomycin resistance detection. Specificity was 98-100% for all drugs. Performance was equivalent to line-probe assays. The non-determinate rate of Xpert MTB/XDR was 2·96%.InterpretationThis first prospective, multicentre clinical study of the Xpert MTB/XDR assay demonstrated high diagnostic test accuracy, meeting target product profile criteria for a next-generation drug susceptibility test.FundingGerman Federal Ministry of Education and Research through KfW, Dutch Ministry of Foreign Affairs, and Australian Department of Foreign Affairs and Trade.Research in contextEvidence before this studyThe World Health Organization (WHO) has highlighted the development of expanded, rapid molecular drug susceptibility tests as a key priority to tackle drug-resistant tuberculosis (TB). Prior to the Cepheid Xpert MTB/XDR assay, the only WHO-recommended rapid molecular assay for second-line resistance detection was the Bruker-Hain GenoType MTBDRsl line probe assay. However, the high complexity of DNA-based hybridization assays limits their use to central reference or regional-level laboratories where the appropriate infrastructure and user expertise can be ensured. In this context, the Xpert MTB/XDR assay is the only lower complexity, automated molecular assay for broader resistance detection suitable for use at lower levels of the laboratory network. We searched PubMed databases for articles evaluating the performance of the sputum-based assay using search terms (tuberculosis or TB) AND (Xpert OR GeneXpert OR cartridge) AND (second-line OR XDR OR “extensively drug-resistant”) AND (sputum OR sputa) AND (test OR assay OR diagnostic OR “point of care”) AND (performance OR accuracy OR sensitivity OR specificity OR diagnos*). The search was done on 8 Feb 2021 with no search date or language restrictions. Our search yielded 51 studies, of which only three reported on a sputum-based cartridge for expanded resistance detection. The first two studies described the assay design approach and reported initial performance metrics for a prototype version of the Xpert MTB/XDR assay. In the third study, the manufacturer demonstrated high performance for the final assay (sensitivity of 94–100% and a specificity of 100% for all drugs except for ethionamide) when compared with sequencing for 314 sputum specimens and sediments. This study was the first assessment of Xpert MTB/XDR assay diagnostic accuracy in a prospective patient cohort.Added value of this studyThis is the first clinical study of the diagnostic performance of the Xpert MTB/XDR assay for expanded drug resistance detection. This study was performed independent of the manufacturer in settings of intended use utilizing prospectively collected primary clinical samples. The study employed a comprehensive reference standard using both phenotypic drug susceptibility testing and whole genome sequencing separately, as well as in combination, which allowed a differentiated view of performance of the assay for resistance detection. Moreover, we compared the performance of the assay on direct sputum samples with the performance of the WHO-recommended Bruker-Hain MTBDRplus and MTBDRsl line probe assays on culture.Implications of all the available evidenceThe WHO End TB Strategy calls for early diagnosis and universal access to drug susceptibility testing. With a 10-color calibration to GeneXpert instruments, the Xpert MTB/XDR assay expands upon the drug detection landscape of the Xpert MTB/RIF and Ultra assays and overcomes the limitations of the Bruker-Hain line probe assays to offer an option for lower-level health care centres to conduct rapid, expanded drug susceptibility testing in follow-up to a TB-positive result using existing laboratory infrastructure. Data from this study demonstrates that the Xpert MTB/XDR assay has high performance for a diverse clinical population in the intended setting of use, providing national TB programmes with a valuable tool for expanded drug susceptibility testing for all persons with signs and symptoms of TB.

Published
2021

34. Valuation practices under business rescue circumstances in South Africa

Author

Shaneen Conradie and Christiaan Lamprecht

Subjects
Finance, business rescue value, HF5001-6182, business.industry, going concern, chapter 6, companies act, HD28-70, General Business, Management and Accounting, business rescue practitioner, financial distress, Valuation (logic), Economics as a science, Management. Industrial management, Business, Citation, valuation, HB71-74, General Economics, Econometrics and Finance, liquidation
Abstract

Background: A business rescue plan should indicate the benefits of adopting a business rescue plan as opposed to the benefits of immediate liquidation. Performing a valuation is thus a vital aspect of the business rescue process as the estimated values determine the amount to be divided between creditors and, if possible, shareholders. Conventional valuation methods have the underlying assumption that the business is a going concern (based on liquidy and solvency tests). However, a company in business rescue is not necessarily a going concern, nor in liquidation, leaving the company in a grey area in terms of valuation. Aim: This research explored how the business rescue value of a financially distressed company is determined. Setting: The setting for this study was South Africa. Method: Thematic analysis of qualitative data collected through 11 semi-structured interviews with senior business rescue practitioners (BRPs). Results: When the intention is to return the company to solvency, the BRPs prepared a short-term, undiscounted cash flow budget to determine the business rescue value, but without including a terminal value in the projected cash flows. In contrast, when the intention is to obtain a better return compared to immediate liquidation, BRPs follow an asset approach to determine the business rescue value. The results also showed that the business, digital and relational acumen of the BRP is a major influencer in the business rescue value. Conclusion: The financial elements identified and substantiated in this study may serve as best practice guidance in the business rescue industry and lead to an expansion of the existing valuation theory.

Published
2021

35. Proposed Linezolid Dosing Strategies to Minimize Adverse Events for Treatment of Extensively Drug-Resistant Tuberculosis

Author

Francesca Conradie, Rada M. Savic, Marjorie Z. Imperial, and Jerry R Nedelman

Subjects
Microbiology (medical), Adult, medicine.medical_specialty, Extensively Drug-Resistant Tuberculosis, Antitubercular Agents, linezolid, Neurodegenerative, Medical and Health Sciences, Microbiology, tuberculosis therapeutics, Vaccine Related, chemistry.chemical_compound, Rare Diseases, Pharmacokinetics, Clinical Research, Internal medicine, Tuberculosis, Multidrug-Resistant, PK–PD modeling, medicine, Tuberculosis, Humans, Dosing, Prospective Studies, PK-PD modeling, Adverse effect, Peripheral Neuropathy, business.industry, drug-resistant tuberculosis, Neurosciences, Linezolid, Extensively drug-resistant tuberculosis, Peripheral Nervous System Diseases, Anemia, Hematology, Multidrug-Resistant, Biological Sciences, medicine.disease, Thrombocytopenia, adverse events, Clinical trial, Infectious Diseases, Peripheral neuropathy, Treatment Outcome, chemistry, 6.1 Pharmaceuticals, Toxicity, Patient Safety, business
Abstract

Background We evaluated Nix-TB trial data (NCT02333799, N = 109) to provide dosing recommendations to potentially minimize linezolid toxicity in patients with extensively drug-resistant tuberculosis. . Methods A pharmacokinetic model and toxicodynamic models for peripheral neuropathy, hemoglobin, and platelets were developed. Simulations compared safety outcomes for daily linezolid of 1200 and 600 mg, with and without dose adjustments for toxicity. Severe neuropathy was based on symptom scores from the Brief Peripheral Neuropathy Screen. Severe anemia and thrombocytopenia were defined as ≥ grade 3 adverse events according to the NIAID Division of Microbiology and Infectious Disease Adult Toxicity table. Results Predicted concentration-time profiles were a major predictor in all toxicodynamic models. Simulations showed higher percentages of patients with severe neuropathy (median, 19%; 90% confidence interval [CI], 17%–22% vs 5%, 4%–7%) and severe anemia (15%, 12%–17% vs 1%, 0%–2%) between 1200 and 600 mg daily linezolid. No differences in severe thrombocytopenia were observed (median, 10% decrease in hemoglobin level after 4 weeks of treatment would have maximum sensitivity (82%) and specificity (84%) for predicting severe anemia. Reducing the dose from 1200 to 600 mg triggered by this marker may prevent 60% (90% CI, 45%–72%) of severe anemia. Conclusions Simple neuropathy symptom and hemoglobin monitoring may guide linezolid dosing to avoid toxicities, but prospective testing is needed to confirm the benefit-to-risk ratio.

Published
2021

36. A partially randomised trial of pretomanid, moxifloxacin and pyrazinamide for pulmonary TB

Author

G Wills, Andrew J. Nunn, J. Caoili, Mookho Malahleha, Francis Apolinary Mhimbira, Issa Sabi, Muge Cevik, Cheryl Louw, Anna Bateson, Ahmad Izuanuddin Ismail, M. C. Betteridge, Mendel Carl M, Ebrahim Variava, Daniel Everitt, Vincent Balanag, Suzanne Staples, Ronelle Moodliar, Umesh G. Lalloo, L. Lombard, Stephen H. Gillespie, Richard E. Chaisson, Robert D Hunt, Angela M. Crook, Videlis Nduba, Modulakgotla Sebe, Conor D. Tweed, Susan Swindells, Melvin Spigelman, A. Y.L. Ban, Evans Amukoye, C. H. van Niekerk, Andreas H. Diacon, Stella M. Fabiane, A. del Parigi, Rodney Dawson, R. A. P. Selepe, Francesca Conradie, Timothy D. McHugh, William Brumskine, European and Developing Countries, University of St Andrews. School of Medicine, University of St Andrews. Infection and Global Health Division, University of St Andrews. Sir James Mackenzie Institute for Early Diagnosis, University of St Andrews. Centre for Biophotonics, University of St Andrews. Biomedical Sciences Research Complex, University of St Andrews. Global Health Implementation Group, and University of St Andrews. Gillespie Group

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, RM, Tuberculosis, Moxifloxacin, Antitubercular Agents, NDAS, Drug resistance, chemistry.chemical_compound, SDG 3 - Good Health and Well-being, Internal medicine, medicine, Humans, In patient, Adverse effect, drug resistance, business.industry, Original Articles, QR Microbiology, Pyrazinamide, medicine.disease, RM Therapeutics. Pharmacology, QR, Treatment Outcome, Infectious Diseases, chemistry, tuberculosis, Nitroimidazoles, Pretomanid, TB treatment, Drug Therapy, Combination, TB-HIV, Pulmonary tb, business, medicine.drug
Abstract

STAND was sponsored by TB Alliance with support from the UK Department for International Development, UK Department of Health (London, UK), Bill and Melinda Gates Foundation (Seattle, WA, USA), US Agency for International Development (Washington DC, USA), Directorate General for International Cooperation of the Netherlands (Amsterdam, The Netherlands), Irish Aid (Dublin, Ireland), Australia Department of Foreign Affairs and Trade (Canberra ACT, Australia) and the Federal Ministry for Education and Research of Germany (Berlin, Germany) through KfW (Kreditanstalt fur Wiederaufbau) and the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (NIH; Bethesda, MD, USA) under Award Numbers UM1 AI068634 and UM1 AI068636. AMC and AJN are supported by Medical Research Council Grant: MC_UU_12023/27 Tuberculosis Treatment Trials. BACKGROUND: Treatment for TB is lengthy and toxic, and new regimens are needed. METHODS: Participants with pulmonary drug-susceptible TB (DS-TB) were randomised to receive: 200 mg pretomanid (Pa, PMD) daily, 400 mg moxifloxacin (M) and 1500 mg pyrazinamide (Z) for 6 months (6Pa200MZ) or 4 months (4Pa200MZ); 100 mg pretomanid daily for 4 months in the same combination (4Pa100MZ); or standard DS-TB treatment for 6 months. The primary outcome was treatment failure or relapse at 12 months post-randomisation. The non-inferiority margin for between-group differences was 12.0%. Recruitment was paused following three deaths and not resumed. RESULTS: Respectively 4/47 (8.5%), 11/57 (19.3%), 14/52 (26.9%) and 1/53 (1.9%) DS-TB outcomes were unfavourable in patients on 6Pa200MZ, 4Pa200MZ, 4Pa100MZ and controls. There was a 6.6% (95% CI –2.2% to 15.4%) difference per protocol and 9.9% (95%CI –4.1% to 23.9%) modified intention-to-treat difference in unfavourable responses between the control and 6Pa200MZ arms. Grade 3+ adverse events affected 68/203 (33.5%) receiving experimental regimens, and 19/68 (27.9%) on control. Ten of 203 (4.9%) participants on experimental arms and 2/68 (2.9%) controls died. CONCLUSION: PaMZ regimens did not achieve non-inferiority in this under-powered trial. An ongoing evaluation of PMD remains a priority. Publisher PDF

Published
2021

37. Critical changes to services for TB patients during the COVID-19 pandemic

Author

Jennifer Hughes, Anja Reuter, A Grimsrud, Cox, Jeremy Nel, Lynne Wilkinson, Tom H. Boyles, and Francesca Conradie

Subjects
Pulmonary and Respiratory Medicine, 2019-20 coronavirus outbreak, medicine.medical_specialty, Tuberculosis, Coronavirus disease 2019 (COVID-19), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), medicine.disease, Infectious Diseases, Tuberculosis diagnosis, Pandemic, Emergency medicine, medicine, Disease management (health), business, Coronavirus Infections
Published
2020

38. Land Use and Redistribution in the Arid West: The case of Laingsburg Magisterial District

Author

Beatrice Conradie

Subjects
Economics and Econometrics, Redistribution (election), Geography, Land use, Agriculture, business.industry, Geography, Planning and Development, business, Agronomy and Crop Science, Arid, Land reform, Agricultural economics
Abstract

Data collected during a multi-year study of farming in the district is updated to compile a land register. It identifies 30% of farmland by farm size and type and provides estimates of fina...

Published
2019

39. The prevalence and risk factors for diabetes mellitus in healthcare workers at Tygerberg hospital, Cape Town, South Africa: a retrospective study

Author

Magda Conradie, Ankia Coetzee, Mari van de Vyver, Amanda Beukes, Lourentia van Wyk, Roshni Mistry, Reinhardt Dreyer, and Salaamah Solomon

Subjects
medicine.medical_specialty, endocrine system diseases, business.industry, Endocrinology, Diabetes and Metabolism, Medical screening, nutritional and metabolic diseases, Type 2 Diabetes Mellitus, 030209 endocrinology & metabolism, Retrospective cohort study, medicine.disease, Obesity, 03 medical and health sciences, 0302 clinical medicine, Endocrinology, Cape, Family medicine, Diabetes mellitus, Health care, Internal Medicine, medicine, 030212 general & internal medicine, business
Abstract

Objectives: To assess the contribution of traditional and modifiable risk factors to the overall risk and prevalence of type 2 diabetes mellitus (T2DM) amongst health workers (HWs) in the public se...

Published
2019

40. A Trial of a Shorter Regimen for Rifampin-Resistant Tuberculosis

Author

Daniel Meressa, Gabriela Torrea, I. D. Rusen, Patrick P. J. Phillips, Ngoc Lan, Chen Yuan Chiang, Phan Thu Ong Dat, Stephen Bertel Squire, Sarah Meredith, Iqbal Master, Nosipho Ngubane, Andrew J. Nunn, Armand Van Deun, Francesca Conradie, Doljinsuren Dalai, Bazarragchaa Tsogt, Karen Sanders, Tesfamarium Mebrahtu, and Ronelle Moodliar

Subjects
medicine.medical_specialty, Intention-to-treat analysis, Tuberculosis, business.industry, General Medicine, 030204 cardiovascular system & hematology, medicine.disease, law.invention, Clinical trial, 03 medical and health sciences, Regimen, 0302 clinical medicine, Pharmacotherapy, Equivalence Trial, Randomized controlled trial, law, Internal medicine, Medicine, 030212 general & internal medicine, business, Cohort study
Abstract

Background Cohort studies in Bangladesh showed promising cure rates among patients with multidrug-resistant tuberculosis who received existing drugs in regimens shorter than that recommend...

Published
2019

41. Nurses’ Knowledge of Ionizing Radiation in Northern Gauteng State Hospitals in South Africa

Author

Sune’ Klopper, Conradie I. Vinette, and Muchui J. Thambura

Subjects
Advanced and Specialized Nursing, Radiological and Ultrasound Technology, business.industry, Nurses knowledge, 030204 cardiovascular system & hematology, medicine.disease, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Basic knowledge, Radiological weapon, medicine, Medical emergency, Descriptive research, business, Curriculum
Abstract

Nurses are part of the team that often visits the radiology department and often participates in bedside procedures during mobile radiological examinations. Researchers observed that nurses often withdrew assistance during radiological examinations, standing behind curtains in wards without adhering to radiation-protection measures. To assess nurses’ knowledge of ionizing radiation, the researchers conducted a quantitative, cross-sectional, descriptive research study. More than 50% (n = 123) of nurses lacked basic knowledge on principles of radiation safety, and 63% of nurses were never taught or attended a workshop on radiation safety. Radiation safety should be included as basic knowledge in nursing curricula, and radiation-safety guidelines are needed in radiography suites.

Published
2019

42. The influence of eleven Ps: An internal marketing and brand awareness perspective in a service environment

Author

Mornay Roberts-Lombard, HB Klopper, and Elizabeth Stephanie Conradie

Subjects
Service (business), business.industry, media_common.quotation_subject, Brand awareness, 05 social sciences, 050401 social sciences methods, Advertising, General Medicine, Product (business), Brand management, Renting, Promotion (rank), 0504 sociology, 0502 economics and business, Loyalty, 050211 marketing, Brand equity, Marketing, business, media_common
Abstract

9Service organisations, of which car rental companies are an example, play a vital role in South Africa’s economy, contributing 74% to the country’s gross domestic product (GDP) (Department of Trade and Industry 2009) . Car rental companies, like many other service organisations, operate in a complex and extremely competitive environment. The employees of car rental companies are their most important asset. They require special attention to ensure their loyalty and commitment to deliver service excellence to customers. The brand’s image depends on the role employees play in delivering the service (Wilson, Zeithaml, Bitner & Gremler 2012: 249). The aim of this research was to provide guidance to South African car rental companies to improve their respective brand awareness, enabling them to expand their customer bases whilst retaining existing customers. The influence of the 11 internal marketing mix elements (product, price, place, promotion, people, processes, physical evidence, personal relationships, packaging, positioning and performance) on South African car rental customers’ perception of brand awareness (brand recognition, trustworthiness, overall evaluation and loyalty) was investigated using structural equation modelling. Recommendations emanating from the findings include continual training of employees, communication with employees, rewarding employees and participation of employees in strategic discussions. Key words : service organisations, internal marketing mix elements, brand awareness, structural equation modelling, equivalence testing

Published
2019

43. Quality adjusting agricultural machinery in South Africa

Author

Frikkie Liebenberg, Ferdinand Meyer, Colleta Gandidzanwa, and Beatrice Conradie

Subjects
Economics and Econometrics, Agricultural machinery, business.industry, 050204 development studies, media_common.quotation_subject, 05 social sciences, Geography, Planning and Development, Paper quality, Agricultural economics, Agriculture, 0502 economics and business, Quality adjustment, Quality (business), 050202 agricultural economics & policy, business, Agronomy and Crop Science, Total factor productivity, media_common
Abstract

This paper quality adjusts machinery inputs for South African agriculture. It does this by treating different qualities of machinery as separate inputs. Thus, quality adjustment becomes quantity ad...

Published
2019

44. Strategic Constructions of Diversity in Blame Games Surrounding the Overvaal Furore

Author

Marthinus Conradie

Subjects
business.industry, Communication, media_common.quotation_subject, Discourse analysis, 05 social sciences, Media studies, 050801 communication & media studies, Racism, Topos theory, Argumentation theory, Digital media, Blame, Appropriation, 0508 media and communications, 0502 economics and business, 050211 marketing, Sociology, business, Diversity (politics), media_common
Abstract

This article critiques the appropriation of diversity in blame games surrounding the Hoerskool Overvaal (Overvaal High School) controversy that seized media attention in January 2018. Relying on di...

Published
2019

46. Reconciling the sustainable manufacturing of commodity chemicals with feasible technoeconomic outcomes assessing the investment case for heat integrated aerobic gas fermentation

Author

Sarah Rodgers, Rebekah King, Alex Conradie, Martin Hayes, Jon McKechnie, Fanran Meng, Stephen Poulston, Rajesh Reddy Bommareddy, Meng, Fanran [0000-0002-9014-1231], and Apollo - University of Cambridge Repository

Subjects
Commodity chemicals, 020209 energy, 38 Economics, 02 engineering and technology, 03 medical and health sciences, Manufacturing, 0202 electrical engineering, electronic engineering, information engineering, Electrochemistry, Production (economics), 3106 Industrial Biotechnology, Life-cycle assessment, 030304 developmental biology, 0303 health sciences, 13 Climate Action, Waste management, business.industry, Process Chemistry and Technology, Metals and Alloys, Renewable energy, Greenhouse gas, Environmental science, business, Black liquor, 12 Responsible Consumption and Production, Renewable resource, 31 Biological Sciences
Abstract

The manufacturing industry must diverge from a ‘take, make and waste’ linear production paradigm towards more circular economies. Truly sustainable, circular economies are intrinsically tied to renewable resource flows, where vast quantities need to be available at a central point of consumption. Abundant, renewable carbon feedstocks are often structurally complex and recalcitrant, requiring costly pretreatment to harness their potential fully. As such, the heat integration of supercritical water gasification (SCWG) and aerobic gas fermentation unlocks the promise of renewable feedstocks such as lignin. This study models the technoeconomics and life cycle assessment (LCA) for the sustainable production of the commodity chemicals, isopropanol and acetone, from gasified Kraft black liquor. The investment case is underpinned by rigorous process modelling informed by published continuous gas fermentation experimental data. Time series analyses support the price forecasts for the solvent products. Furthermore, a Monte Carlo simulation frames an uncertain boundary for the technoeconomic model. The technoeconomic assessment (TEA) demonstrates that production of commodity chemicals priced at ~US$1000 per tonne is within reach of aerobic gas fermentation. In addition, owing to the sequestration of biogenic carbon into the solvent products, negative greenhouse gas (GHG) emissions are achieved within a cradle-to-gate LCA framework. As such, the heat integrated aerobic gas fermentation platform has promise as a best-in-class technology for the production of a broad spectrum of renewable commodity chemicals.

Published
2021
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47. FRAX-based fracture probabilities in South Africa

Author

S.L. Brown, Ozayr Mohamed, Nicholas C. Harvey, Eugene V. McCloskey, Johannes D. Jordaan, John A. Kanis, Bilkish Cassim, Mkhululi Lukhele, Pariva Chutterpaul, Farhanah Paruk, Magda Conradie, Mattias Lorentzon, Helena Johansson, Sapna S. Dela, Enwu Liu, Asgar Ali Kalla, and Liesbeth Vandenput

Subjects
Male, FRAX, Epidemiology, Osteoporosis, Standard score, Risk Assessment, Hip fracture, South Africa, Bone Density, Risk Factors, Medicine, Humans, Orthopedics and Sports Medicine, Risk factor, Femoral neck, Aged, 80 and over, business.industry, Femur Neck, Hip Fractures, Mortality rate, Incidence (epidemiology), Middle Aged, medicine.disease, Fracture probability, medicine.anatomical_structure, Original Article, Female, business, Osteoporotic Fractures, Demography
Abstract

Summary The hip fracture rates in South Africa were used to create ethnic-specific FRAX® models to facilitate fracture risk assessment. Introduction The aim of this study was to develop FRAX models to compute the 10-year probability of hip fracture and major osteoporotic fracture and assess their potential clinical application. Methods Age- and sex-specific incidence of hip fracture and national mortality rates were incorporated into a FRAX model for the White, Black African, Coloured and Indian population of South Africa. Age-specific 10-year probabilities of a major osteoporotic fracture were calculated in women to determine fracture probabilities at a femoral neck T score of -2.5 SD, or those equivalent to a woman with a prior fragility fracture. Fracture probabilities were compared with those from selected countries. Results Probabilities were consistently higher in Indian than in Coloured men and women, in turn, higher than in Black South Africans. For White South Africans, probabilities were lower than in Indians at young ages up to the age of about 80 years. When a BMD T score of −2.5 SD was used as an intervention threshold, FRAX probabilities in women age 50 years were approximately 2-fold higher than in women of the same age but with an average BMD and no risk factors. The increment in risk associated with the BMD threshold decreased progressively with age such that, at the age of 80 years or more, a T score of −2.5 SD was no longer a risk factor. Probabilities equivalent to women with a previous fracture rose with age and identified women at increased risk at all ages. Conclusions These FRAX models should enhance accuracy of determining fracture probability amongst the South African population and help guide decisions about treatment.

Published
2021

48. Serum Amyloid A Promotes Inflammation-Associated Damage and Tumorigenesis in a Mouse Model of Colitis-Associated Cancer

Author

Preetha Shridas, Anna-Mart Engelbrecht, Frederick C. de Beer, Willem J.S. de Villiers, Daleen Conradie, and Tanja Davis

Subjects
Colorectal cancer, Macrophage, medicine.medical_treatment, RC799-869, Inflammatory bowel disease, Mice, AOM, azoxymethane, SAA, serum amyloid A, Protein Isoforms, apoSAA, acute-phase serum amyloid A, Intestinal Mucosa, qPCR, quantitative real-time polymerase chain reaction, Original Research, Mice, Knockout, TNF, tumor necrosis factor, Colon Cancer, IBD, inflammatory bowel disease, Gastroenterology, Diseases of the digestive system. Gastroenterology, Serum Amyloid A, Immunohistochemistry, Interleukin 10, Cytokine, Cell Transformation, Neoplastic, Tumor necrosis factor alpha, Disease Susceptibility, DAI, disease activity index, medicine.symptom, CAC, colitis-associated cancer, Inflammation, MCM2, Minichromosome maintenance 2 protein, DSS, dextran sulfate sodium, medicine, Animals, Serum amyloid A, SAADKO, serum amyloid A double-knockout, Serum Amyloid A Protein, Hepatology, business.industry, Macrophages, Cancer, medicine.disease, IL, interleukin, Disease Models, Animal, Cancer research, Colitis-Associated Cancer, Colitis-Associated Neoplasms, business, Biomarkers
Abstract

Background & Aims Identifying new approaches to lessen inflammation, as well as the associated malignant consequences, remains crucial to improving the lives and prognosis of patients diagnosed with inflammatory bowel diseases. Although it previously has been suggested as a suitable biomarker for monitoring disease activity in patients diagnosed with Crohn’s disease, the role of the acute-phase protein serum amyloid A (SAA) in inflammatory bowel disease remains unclear. In this study, we aimed to assess the role of SAA in colitis-associated cancer. Methods We established a model of colitis-associated cancer in wild-type and SAA double-knockout (Saa1/2-/-) mice by following the azoxymethane/dextran sulfate sodium protocol. Disease activity was monitored throughout the study while colon and tumor tissues were harvested for subsequent use in cytokine analyses, Western blot, and immunohistochemistry +experiments. Results We observed attenuated disease activity in mice deficient for Saa1/2 as evidenced by decreased weight loss, increased stool consistency, decreased rectal bleeding, and decreased colitis-associated tissue damage. Macrophage infiltration, including CD206+ M2-like macrophages, also was attenuated in SAA knockout mice, while levels of interleukin 4, interleukin 10, and tumor necrosis factor-ɑ were decreased in the distal colon. Mice deficient for SAA also showed a decreased tumor burden, and tumors were found to have increased apoptotic activity coupled with decreased expression for markers of proliferation. Conclusion Based on these findings, we conclude that SAA has an active role in inflammatory bowel disease and that it could serve as a therapeutic target aimed at decreasing chronic inflammation and the associated risk of developing colitis-associated cancer., Graphical abstract

Published
2021

49. Re-imagining health professions education in the coronavirus disease 2019 era: Perspectives from South Africa

Author

Louis S. Jenkins, Elizabeth M Joubert, Hofmeyr Conradie, Susan van Schalkwyk, Dianne Matthews, James Irlam, Francois Coetzee, and Anna M S Schmutz

Subjects
Value (ethics), responsiveness, education, Vulnerability, Context (language use), law.invention, South Africa, law, Pandemic, Health care, Opinion Paper, Medicine, Humans, remote teaching, Set (psychology), Pandemics, business.industry, SARS-CoV-2, Public Health, Environmental and Occupational Health, COVID-19, health professions education, General Medicine, Public relations, primary health, CLARITY, clinical training, Health education, Public aspects of medicine, RA1-1270, business, Family Practice
Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic hit South Africa in March 2020, severely disrupting health services and health education. This fundamentally impacted the training of future health professionals and catalysed a significant response from across the health education sector. In 2020, the South African Association of Health Educationalists requested members to submit reflections on different aspects of their COVID-19 related educational responses.Responding to the pandemic: Seven vignettes focused specifically on clinical training in the context of primary care and family medicine. This short report highlights the key insights that emerged from these vignettes, considering what has been learnt in terms of health professions education and what we need to take forward. These insights include building on what was already in place, the student role, technology in the clinical learning context, taking workshops online, vulnerability and presence and the way going forward.Discussion and conclusion: The contributions emphasised the value of existing relationships between the health services and training institutions, collaboration and transparent communication between stakeholders when navigating a crisis, responsiveness to the changed platform and dynamic environment and aligning teaching with healthcare needs. It is more important than ever to set explicit goals, have clarity of purpose when designing learning opportunities and to provide support to students. Some of these learning points may be appropriate for similar contexts in Africa. How we inculcate what we have learned into the post-pandemic period will bear testimony to the extent to which this crisis has enabled us to re-imagine health professions education.

Published
2021

50. Longitudinal and vertical focusing with a field gradient spiral inflector

Author

Johan Broodryk, J. L. Conradie, Rainer Thomae, Joele Mira, J. G. de Villiers, Adriaan Barnard, and F. Nemulodi

Subjects
Physics, Nuclear and High Energy Physics, Optics, Physics and Astronomy (miscellaneous), Field (physics), business.industry, lcsh:QC770-798, lcsh:Nuclear and particle physics. Atomic energy. Radioactivity, Surfaces and Interfaces, business, Spiral
Abstract

Traditional spiral inflectors of the Belmont-Pabot type are commonly used for axial injection of external ion beams into cyclotrons. These inflectors are designed to control the trajectory of the central path, and do not actively focus the beam in the vertical and longitudinal directions. This can introduce effects such as a large vertical divergence and a debunching longitudinal spread, making it difficult to match the injection line emittance to the cyclotron acceptance. In an attempt to overcome this, some recent inflectors have started incorporating electrodes specially shaped to produce field gradients along the central path, thereby influencing the inflector optics. This method has shown some success, and at iThemba LABS an inflector was built exhibiting good vertical focusing. However, it performed poorly longitudinally, worse than traditional spiral inflectors. In this article a generalized field gradient spiral inflector design is presented, based on a mathematical description of all possible first-order field gradients along the central path. Such a design is numerically optimized to simultaneously focus longitudinally and vertically. Experimental studies of this design show a 60% improvement in overall current extracted from the cyclotron.

Published
2021

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