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2,179 results on '"Chiesa, A."'

1. Age and sex impact plasma NFL and t-Tau trajectories in individuals with subjective memory complaints: a 3-year follow-up study.

Author: Baldacci, Filippo, Lista, Simone, Manca, Maria Laura, Chiesa, Patrizia A, Cavedo, Enrica, Lemercier, Pablo, Zetterberg, Henrik, Blennow, Kaj, Habert, Marie-Odile, Potier, Marie Claude, Dubois, Bruno, Vergallo, Andrea, Hampel, Harald, INSIGHT-preAD study group, and Alzheimer Precision Medicine Initiative (APMI)
Subjects: INSIGHT-preAD study group, Alzheimer Precision Medicine Initiative, Humans, Alzheimer Disease, Neurofilament Proteins, tau Proteins, Follow-Up Studies, Female, Male, Amyloid beta-Peptides, Biomarkers, Cognitive Dysfunction, Alzheimer’s disease, Mild cognitive impairment, Neurofilament light chain, Subjective memory complainers, Tau, Dementia, Neurodegenerative, Alzheimer's Disease, Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD), Clinical Research, Brain Disorders, Prevention, Aging, Acquired Cognitive Impairment, Neurosciences, Neurological, Medical and Health Sciences
Abstract: BackgroundPlasma neurofilament light (NFL) and total Tau (t-Tau) proteins are candidate biomarkers for early stages of Alzheimer's disease (AD). The impact of biological factors on their plasma concentrations in individuals with subjective memory complaints (SMC) has been poorly explored. We longitudinally investigate the effect of sex, age, APOE ε4 allele, comorbidities, brain amyloid-β (Aβ) burden, and cognitive scores on plasma NFL and t-Tau concentrations in cognitively healthy individuals with SMC, a condition associated with AD development.MethodsThree hundred sixteen and 79 individuals, respectively, have baseline and three-time point assessments (at baseline, 1-year, and 3-year follow-up) of the two biomarkers. Plasma biomarkers were measured with an ultrasensitive assay in a mono-center cohort (INSIGHT-preAD study).ResultsWe show an effect of age on plasma NFL, with women having a higher increase of plasma t-Tau concentrations compared to men, over time. The APOE ε4 allele does not affect the biomarker concentrations while plasma vitamin B12 deficiency is associated with higher plasma t-Tau concentrations. Both biomarkers are correlated and increase over time. Baseline NFL is related to the rate of Aβ deposition at 2-year follow-up in the left-posterior cingulate and the inferior parietal gyri. Baseline plasma NFL and the rate of change of plasma t-Tau are inversely associated with cognitive score.ConclusionWe find that plasma NFL and t-Tau longitudinal trajectories are affected by age and female sex, respectively, in SMC individuals. Exploring the influence of biological variables on AD biomarkers is crucial for their clinical validation in blood.
Published: 2020

2. Hsp70 and Hsp40 inhibit an inter-domain interaction necessary for transcriptional activity in the androgen receptor.

Author: Eftekharzadeh, Bahareh, Banduseela, Varuna C, Chiesa, Giulio, Martínez-Cristóbal, Paula, Rauch, Jennifer N, Nath, Samir R, Schwarz, Daniel MC, Shao, Hao, Marin-Argany, Marta, Di Sanza, Claudio, Giorgetti, Elisa, Yu, Zhigang, Pierattelli, Roberta, Felli, Isabella C, Brun-Heath, Isabelle, García, Jesús, Nebreda, Ángel R, Gestwicki, Jason E, Lieberman, Andrew P, and Salvatella, Xavier
Subjects: Animals, Mice, Transgenic, Humans, Mice, Receptors, Androgen, Androgens, Ligands, Nuclear Magnetic Resonance, Biomolecular, Solubility, Male, HSP70 Heat-Shock Proteins, HSP40 Heat-Shock Proteins, Protein Multimerization, Gene Knock-In Techniques, HEK293 Cells, Protein Aggregates, Protein Domains, Transgenic, Nuclear Magnetic Resonance, Biomolecular, Receptors, Androgen
Abstract: Molecular chaperones such as Hsp40 and Hsp70 hold the androgen receptor (AR) in an inactive conformation. They are released in the presence of androgens, enabling transactivation and causing the receptor to become aggregation-prone. Here we show that these molecular chaperones recognize a region of the AR N-terminal domain (NTD), including a FQNLF motif, that interacts with the AR ligand-binding domain (LBD) upon activation. This suggests that competition between molecular chaperones and the LBD for the FQNLF motif regulates AR activation. We also show that, while the free NTD oligomerizes, binding to Hsp70 increases its solubility. Stabilizing the NTD-Hsp70 interaction with small molecules reduces AR aggregation and promotes its degradation in cellular and mouse models of the neuromuscular disorder spinal bulbar muscular atrophy. These results help resolve the mechanisms by which molecular chaperones regulate the balance between AR aggregation, activation and quality control.
Published: 2019

3. Bactericidal activity of gallium‐doped chitosan coatings against staphylococcal infection

Author: Esfahani, A Ghalayani, Lazazzera, B, Draghi, L, Farè, S, Chiesa, R, De Nardo, L, and Billi, F
Subjects: Microbiology, Biological Sciences, Biomedical and Clinical Sciences, Clinical Sciences, Infectious Diseases, Emerging Infectious Diseases, Antimicrobial Resistance, Infection, Anti-Bacterial Agents, Biofilms, Chitosan, Gallium, Humans, Staphylococcal Infections, Staphylococcus epidermidis, Staphylococcus aureus, biofilm, chitosan, electrophoretic deposition, gallium, postarthroplasty infection, pulsed electromagnetic field, Agricultural, veterinary and food sciences, Biological sciences, Biomedical and clinical sciences
Abstract: AimsThe aim of this study was to develop a new class of gallium (Ga)-doped chitosan (CS) coatings fabricated by electrophoretic deposition (EPD) in staphylococcal infection therapy.Methods and resultsBiofilm formation on EPD CS/Ga coatings by Staphylococcus epidermidis and Staphylococcus aureus, which are the main strains involved in postarthroplasty infections, was assessed. The codeposition of an antibacterial agent was effective; Ga loaded into CS matrix reduces biofilm viability by up to 86% and 80% for S. epidermidis and S. aureus strains respectively. Lastly, the influence of pulsed electromagnetic field (PEMF) on the bactericidal activity of CS/Ga coatings was investigated in vitro. To this end, the coatings were incubated with S. epidermidis and S. aureus and exposed to the PEMF using two different frequencies and times. Biofilm viability for S. epidermidis was decreased by 35-40% in the presence of low-frequency (LF) and high-frequency (HF) PEMF respectively. Biofilm viability by S. aureus was not further reduced in the presence of LF PEMF, but decreased by 38% at HF PEMF.ConclusionsThis study has established that a combination of PEMFs with the antibacterial agent improves bactericidal activity of Ga against S. epidermidis strain 14990 and S. aureus strain 12600.Significance and impact of the studyThis new integrated approach could reduce the incidence of infection in orthopaedic implant applications. It also clearly demonstrates that the combination of Ga treatment with PEMF could aid biofilm-associated infection therapy due to improved Ga efficiency.
Published: 2019

4. Bactericidal activity of gallium-doped chitosan coatings against staphylococcal infection.

Author: Ghalayani Esfahani, A, Lazazzera, B, Draghi, L, Farè, S, Chiesa, R, De Nardo, L, and Billi, F
Subjects: Humans, Biofilms, Staphylococcus epidermidis, Staphylococcal Infections, Gallium, Chitosan, Anti-Bacterial Agents, Staphylococcus aureus, biofilm, chitosan, electrophoretic deposition, gallium, postarthroplasty infection, pulsed electromagnetic field, Microbiology
Abstract: AimsThe aim of this study was to develop a new class of gallium (Ga)-doped chitosan (CS) coatings fabricated by electrophoretic deposition (EPD) in staphylococcal infection therapy.Methods and resultsBiofilm formation on EPD CS/Ga coatings by Staphylococcus epidermidis and Staphylococcus aureus, which are the main strains involved in postarthroplasty infections, was assessed. The codeposition of an antibacterial agent was effective; Ga loaded into CS matrix reduces biofilm viability by up to 86% and 80% for S. epidermidis and S. aureus strains respectively. Lastly, the influence of pulsed electromagnetic field (PEMF) on the bactericidal activity of CS/Ga coatings was investigated in vitro. To this end, the coatings were incubated with S. epidermidis and S. aureus and exposed to the PEMF using two different frequencies and times. Biofilm viability for S. epidermidis was decreased by 35-40% in the presence of low-frequency (LF) and high-frequency (HF) PEMF respectively. Biofilm viability by S. aureus was not further reduced in the presence of LF PEMF, but decreased by 38% at HF PEMF.ConclusionsThis study has established that a combination of PEMFs with the antibacterial agent improves bactericidal activity of Ga against S. epidermidis strain 14990 and S. aureus strain 12600.Significance and impact of the studyThis new integrated approach could reduce the incidence of infection in orthopaedic implant applications. It also clearly demonstrates that the combination of Ga treatment with PEMF could aid biofilm-associated infection therapy due to improved Ga efficiency.
Published: 2019

5. Association of busulfan exposure with survival and toxicity after haemopoietic cell transplantation in children and young adults: a multicentre, retrospective cohort analysis

Author: Bartelink, Imke H, Lalmohamed, Arief, van Reij, Elisabeth ML, Dvorak, Christopher C, Savic, Rada M, Zwaveling, Juliette, Bredius, Robbert GM, Egberts, Antoine CG, Bierings, Marc, Kletzel, Morris, Shaw, Peter J, Nath, Christa E, Hempel, George, Ansari, Marc, Krajinovic, Maja, Théorêt, Yves, Duval, Michel, Keizer, Ron J, Bittencourt, Henrique, Hassan, Moustapha, Güngör, Tayfun, Wynn, Robert F, Veys, Paul, Cuvelier, Geoff DE, Marktel, Sarah, Chiesa, Robert, Cowan, Morton J, Slatter, Mary A, Stricherz, Melisa K, Jennissen, Cathryn, Long-Boyle, Janel R, and Boelens, Jaap Jan
Subjects: Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Cancer, Transplantation, 6.1 Pharmaceuticals, Good Health and Well Being, Adolescent, Adult, Area Under Curve, Busulfan, Child, Child, Preschool, Cohort Studies, Disease-Free Survival, Dose-Response Relationship, Drug, Female, Graft Rejection, Graft Survival, Graft vs Host Disease, Hematopoietic Stem Cell Transplantation, Humans, Infant, Male, Recurrence, Retrospective Studies, Transplantation Conditioning, Transplantation, Homologous, Treatment Outcome, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Cardiovascular medicine and haematology
Abstract: BackgroundIntravenous busulfan combined with therapeutic drug monitoring to guide dosing improves outcomes after allogeneic haemopoietic cell transplantation (HCT). The best method to estimate busulfan exposure and optimum exposure in children or young adults remains unclear. We therefore assessed three approaches to estimate intravenous busulfan exposure (expressed as cumulative area under the curve [AUC]) and associated busulfan AUC with clinical outcomes in children or young adults undergoing allogeneic HCT.MethodsIn this retrospective analysis, patients from 15 centres in the Netherlands, USA, Canada, Switzerland, UK, Italy, Germany, and Australia who received a busulfan-based conditioning regimen between March 18, 2001, and Feb 12, 2015, were included. Cumulative AUC was calculated by numerical integration using non-linear mixed effect modelling (AUCNONMEM), non-compartmental analysis (AUC from 0 to infinity [AUC0-∞] and to the next dose [AUC0-τ]), and by individual centres using various approaches (AUCcentre). The main outcome of interest was event-free survival. Other outcomes of interest were graft failure or relapse, or both; transplantation-related mortality; acute toxicity (veno-occlusive disease or acute graft versus-host disease [GvHD]); chronic GvHD; overall survival; and chronic-GvHD-free event-free survival. We used propensity-score-adjusted Cox proportional hazard models, Weibull models, and Fine-Gray competing risk regressions for statistical analyses.Findings790 patients were enrolled, 674 of whom were included: 274 (41%) with malignant and 400 (59%) with non-malignant disease. Median age was 4·5 years (IQR 1·4-10·7). The median busulfan AUCNONMEM was 74·4 mg × h/L (95% CI 31·1-104·6), which correlated with the standardised method AUC0-∞ (r2=0·74), but the latter correlated poorly with AUCcentre (r2=0·35). Estimated 2-year event-free survival was 69·7% (95% CI 66·2-73·0). Event-free survival at 2 years was 77·0% (95% CI 72·1-82·9) in the 257 patients with an optimum intravenous busulfan AUC of 78-101 mg × h/L compared with 66·1% (60·9-71·4) in the 235 patients at the low historical target of 58-86 mg × h/L and 49·5% (29·2-66·0) in the 44 patients with a high (>101 mg × h/L) busulfan AUC (p=0·011). Compared with the low AUC group, graft failure or relapse occurred less frequently in the optimum AUC group (hazard ratio [HR] 0·57, 95% CI 0·39-0·84; p=0·0041). Acute toxicity (HR 1·69, 1·12-2·57; p=0·013) and transplantation-related mortality (2·99, 1·82-4·92; p101 mg × h/L) than in the low AUC group (
Published: 2016

6. Metabolomic profiles predict individual multidisease outcomes

Author: Thore Buergel, Jakob Steinfeldt, Greg Ruyoga, Maik Pietzner, Daniele Bizzarri, Dina Vojinovic, Julius Upmeier zu Belzen, Lukas Loock, Paul Kittner, Lara Christmann, Noah Hollmann, Henrik Strangalies, Jana M. Braunger, Benjamin Wild, Scott T. Chiesa, Joachim Spranger, Fabian Klostermann, Erik B. van den Akker, Stella Trompet, Simon P. Mooijaart, Naveed Sattar, J. Wouter Jukema, Birgit Lavrijssen, Maryam Kavousi, Mohsen Ghanbari, Mohammad A. Ikram, Eline Slagboom, Mika Kivimaki, Claudia Langenberg, John Deanfield, Roland Eils, Ulf Landmesser, Department of Public Health, Clinicum, Buergel, Thore [0000-0003-1159-007X], Bizzarri, Daniele [0000-0002-6881-273X], Upmeier Zu Belzen, Julius [0000-0002-0966-4458], Hollmann, Noah [0000-0001-8556-518X], Wild, Benjamin [0000-0002-7492-8448], Chiesa, Scott T [0000-0003-4323-2189], Spranger, Joachim [0000-0002-8900-4467], van den Akker, Erik B [0000-0002-7693-0728], Trompet, Stella [0000-0001-5006-0528], Sattar, Naveed [0000-0002-1604-2593], Jukema, J Wouter [0000-0002-3246-8359], Ghanbari, Mohsen [0000-0002-9476-7143], Ikram, Mohammad A [0000-0003-0372-8585], Kivimaki, Mika [0000-0002-4699-5627], Eils, Roland [0000-0002-0034-4036], Landmesser, Ulf [0000-0002-0214-3203], Apollo - University of Cambridge Repository, Epidemiology, Surgery, and Radiology & Nuclear Medicine
Subjects: Heart Failure, Magnetic Resonance Spectroscopy, Diabetes Mellitus, Type 2, SDG 3 - Good Health and Well-being, 3121 General medicine, internal medicine and other clinical medicine, Humans, Metabolomics, Female, Breast Neoplasms, General Medicine, General Biochemistry, Genetics and Molecular Biology
Abstract: Publisher Copyright: © 2022, The Author(s). Risk stratification is critical for the early identification of high-risk individuals and disease prevention. Here we explored the potential of nuclear magnetic resonance (NMR) spectroscopy-derived metabolomic profiles to inform on multidisease risk beyond conventional clinical predictors for the onset of 24 common conditions, including metabolic, vascular, respiratory, musculoskeletal and neurological diseases and cancers. Specifically, we trained a neural network to learn disease-specific metabolomic states from 168 circulating metabolic markers measured in 117,981 participants with ~1.4 million person-years of follow-up from the UK Biobank and validated the model in four independent cohorts. We found metabolomic states to be associated with incident event rates in all the investigated conditions, except breast cancer. For 10-year outcome prediction for 15 endpoints, with and without established metabolic contribution, a combination of age and sex and the metabolomic state equaled or outperformed established predictors. Moreover, metabolomic state added predictive information over comprehensive clinical variables for eight common diseases, including type 2 diabetes, dementia and heart failure. Decision curve analyses showed that predictive improvements translated into clinical utility for a wide range of potential decision thresholds. Taken together, our study demonstrates both the potential and limitations of NMR-derived metabolomic profiles as a multidisease assay to inform on the risk of many common diseases simultaneously.
Published: 2022

7. Normative Gaps in the Criminal Law: A Reasons Theory of Wrongdoing

Author: Aponte, Luis Ernesto Chiesa
Published: 2007
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8. Vocal Outcomes in Vagus Nerve Stimulation: A Laryngeal Pattern-Based Objective Analysis

Author: Valentina Chiesa, Giovanni Felisati, Antonio Schindler, Martha De Gasperis, Alberto Maccari, Nicole Pizzorni, Maria Paola Canevini, Giorgia Carlotta Pipolo, Alberto Maria Saibene, and Emanuela Fuccillo
Subjects: Adult, medicine.medical_specialty, Vagus Nerve Stimulation, medicine.medical_treatment, Objective analysis, Vocal Cords, Audiology, Voice analysis, 030507 speech-language pathology & audiology, 03 medical and health sciences, Speech and Hearing, Epilepsy, 0302 clinical medicine, otorhinolaryngologic diseases, Recurrent laryngeal nerve, medicine, Humans, Voice Handicap Index, 030223 otorhinolaryngology, Breathy voice, Voice Disorders, business.industry, LPN and LVN, medicine.disease, Otorhinolaryngology, Implant, Larynx, 0305 other medical science, business, Vagus nerve stimulation
Abstract: The aim of our study is to evaluate objective and subjective vocal outcomes in patients undergoing vagus nerve stimulation (VNS) therapy for drug-resistant epilepsy and to assess the vocal outcome in the known laryngeal dysmotility patterns induced by VNS. We enrolled 16 adult patients without cognitive impairment who had undergone VNS implant for drug-resistant epilepsy at least 1 year prior. They were evaluated by flexible fibreoptic laryngeal examination and Voice Handicap Index questionnaire administration; acoustic and perceptual voice analysis was performed both at rest and during VNS activation. All recruited patients were admitted to the study. The VNS implant systematically determined laryngeal motility alterations, which were in turn mirrored by perceptual, subjective, and/or acoustic analysis voice alterations in all patients. Patients with intact vocal fold function at rest performed worse during acoustic voice analysis in terms of jitter during VNS activation and shimmer at rest when compared to other laryngeal patterns (P= 0.027 and P = 0.034, respectively, Kruskal-Wallis test). Furthermore, VNS activation determined an overall worsening of the perceptual and acoustically analysed voice quality: the grade of hoarseness, instability and breathiness parameters of the GRBASI (grade, roughness, breathiness, asthenia, strain, instability) scale and the jitter, shimmer and noise-to-harmonic ratio of the acoustic analysis worsened significantly during VNS activation (P = 0.001, P = 0.021, P = 0.012, P.001, P = 00.002, P = 0.039, respectively, Wilcoxon test). According to our results, the VNS implant determines a significantly impaired vocal outcome that has a surprisingly mild impact on Voice Handicap Index scores. Such impairment is significantly greater in patients with intact vocal fold function at rest.
Published: 2022
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9. Gracilis free flap in head and neck reconstruction beyond facial palsy reanimation

Author: Carlos Miguel Chiesa-Estomba, Jos?? ??ngel Gonz??lez-Garc??a, Piazza, Cesare, Miguel, Mayo-Yanez, Alberto, Grammatica, Lechien, Jerome R., Din, Taseer F., Petros, Karkos, Leire, Garc??a-Iza, and Tareck, Ayad
Subjects: Otorhinolaryngology, Head and Neck Neoplasms, Facial Paralysis, Humans, General Medicine, Plastic Surgery Procedures, Free Tissue Flaps, Neck
Abstract: The gracilis muscle free flap has gained popularity in head and neck reconstruction due to minimal donor-site morbidity, reliable vascular pedicle, strong muscular component, and possibility to perform nerve coaptation. However, almost all the existing evidence in the literature is related to its use for facial palsy reanimation. The aim of this study was therefore to review and provide a comprehensive summary of all the possible indications and outcomes of this versatile free flap in head neck reconstructive surgery.A systematic review of the literature was conducted including articles from 1970 to 2019. All articles were examined and described.Twenty-seven papers published between 1994 and 2019 were identified for analysis. The evidence highlights the use of the gracilis muscle free flap for parotid, forehead and midface defects, oral tongue, oral sphincter, lower and upper lip, cheek, and oral commissure defects, among others, as the most common defects reconstructed.This flap represents an easy to harvest and versatile free flap with low donor-site morbidity and multiple proven uses in headneck reconstruction. We therefore encourage reconstructive surgeons to include this flap in their armoury, either as a first or as a second-line option.
Published: 2022
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10. Diagnostic performance of deep learning algorithm for analysis of computed tomography myocardial perfusion

Author: Giuseppe Muscogiuri, Mattia Chiesa, Andrea Baggiano, Pierino Spadafora, Rossella De Santis, Marco Guglielmo, Stefano Scafuri, Laura Fusini, Saima Mushtaq, Edoardo Conte, Andrea Annoni, Alberto Formenti, Maria Elisabetta Mancini, Francesca Ricci, Francesco Paolo Ariano, Luigi Spiritigliozzi, Mario Babbaro, Rocco Mollace, Riccardo Maragna, Carlo Maria Giacari, Daniele Andreini, Andrea Igoren Guaricci, Gualtiero I. Colombo, Mark G. Rabbat, Mauro Pepi, Francesco Sardanelli, Gianluca Pontone, Muscogiuri, G, Chiesa, M, Baggiano, A, Spadafora, P, De Santis, R, Guglielmo, M, Scafuri, S, Fusini, L, Mushtaq, S, Conte, E, Annoni, A, Formenti, A, Mancini, M, Ricci, F, Ariano, F, Spiritigliozzi, L, Babbaro, M, Mollace, R, Maragna, R, Giacari, C, Andreini, D, Guaricci, A, Colombo, G, Rabbat, M, Pepi, M, Sardanelli, F, and Pontone, G
Subjects: Myocardial ischemia, Computed Tomography Angiography, Coronary Stenosis, Myocardial Perfusion Imaging, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, Convolutional neural network, Deep learning, General Medicine, Coronary Angiography, Coronary artery disease, Fractional Flow Reserve, Myocardial, Perfusion, Predictive Value of Tests, Humans, Coronary computed tomography angiography, Myocardial CT perfusion, Radiology, Nuclear Medicine and imaging
Abstract: Purpose: Artificial intelligence could play a key role in cardiac imaging analysis. To evaluate the diagnostic accuracy of a deep learning (DL) algorithm predicting hemodynamically significant coronary artery disease (CAD) by using a rest dataset of myocardial computed tomography perfusion (CTP) as compared to invasive evaluation. Methods: One hundred and twelve consecutive symptomatic patients scheduled for clinically indicated invasive coronary angiography (ICA) underwent CCTA plus static stress CTP and ICA with invasive fractional flow reserve (FFR) for stenoses ranging between 30% and 80%. Subsequently, a DL algorithm for the prediction of significant CAD by using the rest dataset (CTP-DLrest) and stress dataset (CTP-DLstress) was developed. The diagnostic accuracy for identification of significant CAD using CCTA, CCTA+CTPStress, CCTA+CTP-DLrest, and CCTA+CTP-DLstress were measured and compared. The time of analysis for CTPStress, CTP-DLrest and CTP-DLStress were recorded. Results: Patient-specific sensitivity, specificity, NPV, PPV, accuracy and area under the curve (AUC) of CCTA alone and CCTA+CTPStress were 100%, 33%, 100%, 54%, 63%, 67% and 86%, 89%, 89%, 86%, 88%, 87%, respectively. Patient-specific sensitivity, specificity, NPV, PPV, accuracy and AUC of CCTA+DLrest and CCTA+DLstress were 100%, 72%, 100%, 74%, 84%, 96% and 93%, 83%, 94%, 81%,88%,98%, respectively. All CCTA+CTPStress, CCTA+CTP-DLRest and CCTA+CTP-DLStress significantly improved detection of hemodynamically significant CAD (pConclusion: Evaluation of myocardial ischemia using a DL approach on rest CTP datasets is feasible and accurate. This approach may be a useful gatekeeper prior to CTPStress.
Published: 2022
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11. Association between polarity of first episode and solar insolation in bipolar I disorder

Author: Michael Bauer, Tasha Glenn, Eric D. Achtyes, Martin Alda, Esen Agaoglu, Kürşat Altınbaş, Ole A. Andreassen, Elias Angelopoulos, Raffaella Ardau, Memduha Aydin, Yavuz Ayhan, Christopher Baethge, Rita Bauer, Bernhard T. Baune, Ceylan Balaban, Claudia Becerra-Palars, Aniruddh P. Behere, Prakash B. Behere, Habte Belete, Tilahun Belete, Gabriel Okawa Belizario, Frank Bellivier, Robert H. Belmaker, Francesco Benedetti, Michael Berk, Yuly Bersudsky, Şule Bicakci, Harriet Birabwa-Oketcho, Thomas D. Bjella, Conan Brady, Jorge Cabrera, Marco Cappucciati, Angela Marianne Paredes Castro, Wei-Ling Chen, Eric Y.W. Cheung, Silvia Chiesa, Marie Crowe, Alessandro Cuomo, Sara Dallaspezia, Maria Del Zompo, Pratikkumar Desai, Seetal Dodd, Bruno Etain, Andrea Fagiolini, Frederike T. Fellendorf, Ewa Ferensztajn-Rochowiak, Jess G. Fiedorowicz, Kostas N. Fountoulakis, Mark A. Frye, Pierre A. Geoffroy, Ana Gonzalez-Pinto, John F. Gottlieb, Paul Grof, Bartholomeus C.M. Haarman, Hirohiko Harima, Mathias Hasse-Sousa, Chantal Henry, Lone Høffding, Josselin Houenou, Massimiliano Imbesi, Erkki T. Isometsä, Maja Ivkovic, Sven Janno, Simon Johnsen, Flávio Kapczinski, Gregory N. Karakatsoulis, Mathias Kardell, Lars Vedel Kessing, Seong Jae Kim, Barbara König, Timur L. Kot, Michael Koval, Mauricio Kunz, Beny Lafer, Mikael Landén, Erik R. Larsen, Melanie Lenger, Ute Lewitzka, Rasmus W. Licht, Carlos Lopez-Jaramillo, Alan MacKenzie, Helle Østergaard Madsen, Simone Alberte Kongstad A. Madsen, Jayant Mahadevan, Agustine Mahardika, Mirko Manchia, Wendy Marsh, Monica Martinez-Cengotitabengoa, Klaus Martiny, Yuki Mashima, Declan M. McLoughlin, Ybe Meesters, Ingrid Melle, Fátima Meza-Urzúa, Yee Ming Mok, Scott Monteith, Muthukumaran Moorthy, Gunnar Morken, Enrica Mosca, Anton A. Mozzhegorov, Rodrigo Munoz, Starlin V. Mythri, Fethi Nacef, Ravi K. Nadella, Takako Nakanotani, René Ernst Nielsen, Claire O'Donovan, Adel Omrani, Yamima Osher, Uta Ouali, Maja Pantovic-Stefanovic, Pornjira Pariwatcharakul, Joanne Petite, Andrea Pfennig, Yolanda Pica Ruiz, Marco Pinna, Maurizio Pompili, Richard Porter, Danilo Quiroz, Francisco Diego Rabelo-da-Ponte, Raj Ramesar, Natalie Rasgon, Woraphat Ratta-apha, Michaela Ratzenhofer, Maria Redahan, M.S. Reddy, Andreas Reif, Eva Z. Reininghaus, Jenny Gringer Richards, Philipp Ritter, Janusz K. Rybakowski, Leela Sathyaputri, Ângela M. Scippa, Christian Simhandl, Daniel Smith, José Smith, Paul W. Stackhouse, Dan J. Stein, Kellen Stilwell, Sergio Strejilevich, Kuan-Pin Su, Mythily Subramaniam, Ahmad Hatim Sulaiman, Kirsi Suominen, Andi J. Tanra, Yoshitaka Tatebayashi, Wen Lin Teh, Leonardo Tondo, Carla Torrent, Daniel Tuinstra, Takahito Uchida, Arne E. Vaaler, Eduard Vieta, Biju Viswanath, Maria Yoldi-Negrete, Oguz Kaan Yalcinkaya, Allan H. Young, Yosra Zgueb, Peter C. Whybrow, Clinical Cognitive Neuropsychiatry Research Program (CCNP), Bauer, Michael, Glenn, Tasha, Achtyes, Eric D, Alda, Martin, Agaoglu, Esen, Altınbaş, Kürşat, Andreassen, Ole A, Angelopoulos, Elia, Ardau, Raffaella, Aydin, Memduha, Ayhan, Yavuz, Baethge, Christopher, Bauer, Rita, Baune, Bernhard T, Balaban, Ceylan, Becerra-Palars, Claudia, Behere, Aniruddh P, Behere, Prakash B, Belete, Habte, Belete, Tilahun, Belizario, Gabriel Okawa, Bellivier, Frank, Belmaker, Robert H, Benedetti, Francesco, Berk, Michael, Bersudsky, Yuly, Bicakci, Şule, Birabwa-Oketcho, Harriet, Bjella, Thomas D, Brady, Conan, Cabrera, Jorge, Cappucciati, Marco, Castro, Angela Marianne Parede, Chen, Wei-Ling, Cheung, Eric Y W, Chiesa, Silvia, Crowe, Marie, Cuomo, Alessandro, Dallaspezia, Sara, Del Zompo, Maria, Desai, Pratikkumar, Dodd, Seetal, Etain, Bruno, Fagiolini, Andrea, Fellendorf, Frederike T, Ferensztajn-Rochowiak, Ewa, Fiedorowicz, Jess G, Fountoulakis, Kostas N, Frye, Mark A, Geoffroy, Pierre A, Gonzalez-Pinto, Ana, Gottlieb, John F, Grof, Paul, Haarman, Bartholomeus C M, Harima, Hirohiko, Hasse-Sousa, Mathia, Henry, Chantal, Høffding, Lone, Houenou, Josselin, Imbesi, Massimiliano, Isometsä, Erkki T, Ivkovic, Maja, Janno, Sven, Johnsen, Simon, Kapczinski, Flávio, Karakatsoulis, Gregory N, Kardell, Mathia, Kessing, Lars Vedel, Kim, Seong Jae, König, Barbara, Kot, Timur L, Koval, Michael, Kunz, Mauricio, Lafer, Beny, Landén, Mikael, Larsen, Erik R, Lenger, Melanie, Lewitzka, Ute, Licht, Rasmus W, Lopez-Jaramillo, Carlo, Mackenzie, Alan, Madsen, Helle Østergaard, Madsen, Simone Alberte Kongstad A, Mahadevan, Jayant, Mahardika, Agustine, Manchia, Mirko, Marsh, Wendy, Martinez-Cengotitabengoa, Monica, Martiny, Klau, Mashima, Yuki, Mcloughlin, Declan M, Meesters, Ybe, Melle, Ingrid, Meza-Urzúa, Fátima, Mok, Yee Ming, Monteith, Scott, Moorthy, Muthukumaran, Morken, Gunnar, Mosca, Enrica, Mozzhegorov, Anton A, Munoz, Rodrigo, Mythri, Starlin V, Nacef, Fethi, Nadella, Ravi K, Nakanotani, Takako, Nielsen, René Ernst, O'Donovan, Claire, Omrani, Adel, Osher, Yamima, Ouali, Uta, Pantovic-Stefanovic, Maja, Pariwatcharakul, Pornjira, Petite, Joanne, Pfennig, Andrea, Ruiz, Yolanda Pica, Pinna, Marco, Pompili, Maurizio, Porter, Richard, Quiroz, Danilo, Rabelo-da-Ponte, Francisco Diego, Ramesar, Raj, Rasgon, Natalie, Ratta-Apha, Woraphat, Ratzenhofer, Michaela, Redahan, Maria, Reddy, M S, Reif, Andrea, Reininghaus, Eva Z, Richards, Jenny Gringer, Ritter, Philipp, Rybakowski, Janusz K, Sathyaputri, Leela, Scippa, Ângela M, Simhandl, Christian, Smith, Daniel, Smith, José, Stackhouse, Paul W, Stein, Dan J, Stilwell, Kellen, Strejilevich, Sergio, Su, Kuan-Pin, Subramaniam, Mythily, Sulaiman, Ahmad Hatim, Suominen, Kirsi, Tanra, Andi J, Tatebayashi, Yoshitaka, Teh, Wen Lin, Tondo, Leonardo, Torrent, Carla, Tuinstra, Daniel, Uchida, Takahito, Vaaler, Arne E, Vieta, Eduard, Viswanath, Biju, Yoldi-Negrete, Maria, Yalcinkaya, Oguz Kaan, Young, Allan H, Zgueb, Yosra, and Whybrow, Peter C
Subjects: Bipolar Disorder/complications, Male, Polarity, Bipolar disorder, Circadian rhythm, Depression, Psychiatry and Mental health, Clinical Psychology, Solar insolation, Sunlight, Humans, Female, Seasons
Abstract: OBJECTIVE: Circadian rhythm disruption is commonly observed in bipolar disorder (BD). Daylight is the most powerful signal to entrain the human circadian clock system. This exploratory study investigated if solar insolation at the onset location was associated with the polarity of the first episode of BD I. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area of the Earth.METHODS: Data from 7488 patients with BD I were collected at 75 sites in 42 countries. The first episode occurred at 591 onset locations in 67 countries at a wide range of latitudes in both hemispheres. Solar insolation values were obtained for every onset location, and the ratio of the minimum mean monthly insolation to the maximum mean monthly insolation was calculated. This ratio is largest near the equator (with little change in solar insolation over the year), and smallest near the poles (where winter insolation is very small compared to summer insolation). This ratio also applies to tropical locations which may have a cloudy wet and clear dry season, rather than winter and summer.RESULTS: The larger the change in solar insolation throughout the year (smaller the ratio between the minimum monthly and maximum monthly values), the greater the likelihood the first episode polarity was depression. Other associated variables were being female and increasing percentage of gross domestic product spent on country health expenditures. (All coefficients: P ≤ 0.001).CONCLUSION: Increased awareness and research into circadian dysfunction throughout the course of BD is warranted.
Published: 2022
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12. Misconceptions of photoprotection in skin of color

Author: Susan C. Taylor, Andrew F. Alexis, April W. Armstrong, Zelma C. Chiesa Fuxench, and Henry W. Lim
Subjects: Hyperpigmentation, Infrared Rays, Ultraviolet Rays, Quality of Life, Humans, Skin Pigmentation, Dermatology, Sunscreening Agents, Skin
Abstract: Terrestrial sunlight is the portion of electromagnetic radiation that is emitted by the sun and reaches Earth's surface. It encompasses 3 major components: UV radiation (290-400 nm), visible light (400-700 nm), and infrared radiation. The deleterious effects of UV radiation have been appreciated for decades, particularly among those with light skin tones (Fitzpatrick skin types I-II) who primarily manifest with burns of varying degrees of severity with sun exposure. In recent years, studies have increasingly shown the negative impact of visible light on skin health, particularly in individuals with skin of color (Fitzpatrick skin types IV-VI), including the exacerbation of hyperpigmentation disorders such as melasma and post-inflammatory hyperpigmentation, as well as induction of the former. Recommendations from medical societies and the US Food and Drug Administration for photoprotection have been evolving along with the knowledge base. Yet, misconceptions about skin damage related to sunlight and the benefits of photoprotection (particularly among those with Fitzpatrick skin types V-VI) are still prevalent among both clinicians and patients. Among patients with skin of color, disorders of hyperpigmentation and other consequences from sun exposure have been associated with impaired skin health and negative burden on quality of life. This review summarizes currently available evidence of the impact of both UV and visible wavelengths and the low utilization of photoprotection measures among people with skin of color, with the goal of providing recommendations to help educate patients.
Published: 2022
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13. Photoprotection for skin of all color: Consensus and clinical guidance from an expert panel

Author: Darrell S. Rigel, Susan C. Taylor, Henry W. Lim, Andrew F. Alexis, April W. Armstrong, Zelma C. Chiesa Fuxench, Zoe D. Draelos, and Iltefat H. Hamzavi
Subjects: Consensus, Ultraviolet Rays, Sunlight, Humans, Dermatology, Sunscreening Agents, Skin
Abstract: The negative effects of sun exposure have become better accepted among health care professionals and the lay public over recent decades. Most attention has been focused on the effects of UV light, particularly UVB wavelengths (290-320 nm). Accordingly, products to protect skin from sunlight-associated harm (sunscreens) have been developed to minimize UVB exposure. The effects of longer wavelengths, including UVA (320-400 nm) and visible light (VL, 400-700 nm), are increasingly appreciated. VL accounts for approximately half of the solar radiation that reaches the earth's surface and understanding of its effects on the skin is improving. Studies have shown that VL can induce hyperpigmentation in individuals with dark skin types (Fitzpatrick skin types IV-VI). In addition, VL can contribute to the exacerbation of pigmentary disorders, including melasma. Because these findings are relatively new, there are gaps in understanding the needs for photoprotection and guidance for clinicians. A panel of dermatologists and photobiologists was convened to develop consensus recommendations and clinical guidance about sunscreen use relevant to the current understanding of risks associated with sun exposure using a modified Delphi method.
Published: 2022
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14. Global economic burden of unmet surgical need for appendicitis

Author: Reuter, Anna, Rogge, Lisa, Monahan, Mark, Kachapila, Mwayi, Morton, Dion G, Davies, Justine, Vollmer, Sebastian, A A Essam, Abd Elkhalek Sallam, Abd Elrahman Elshafay, Abd El-Rahman Hegazy Khedr, Abdalla Gamal Saad, Abdalla Gharib, Abdalla Kenibar, Abdallah Salah Elsherbiny, Abdalrahman Adel, Abdelaziz Abdelaal, Abdelaziz Osman Abdelaziz Elhendawy, Abdelfatah Hussein, Abdelkader Belkouchi, Abdelmalek Hrora, Abdelrahman Adelshone, Abdelrahman Alkammash, Abdelrahman Assal, Abdelrahman Geuoshy, Abdelrahman Haroun, Abdelrahman Mohammed, Abdelrahman Sayed, Abdelrahman Soliman, Abdelrhman Essam Elnemr, Abdelrhman Kz Darwish, Abdelrhman Osama Elsebaaye, Abdul Khalique, Abdul Rehman Alvi, Abdul Wahid Anwar, Abdulaziz Altwijri, Abdullah Al-Mallah, Abdullah Almoflihi, Abdullah Altamimi, Abdullah Daqeeq, Abdullah Dwydar, Abdullah Gouda, Abdullah Hashim, Abdulmalik Altaf, Abdulmalik Huwait, Abdulrahman Abdel-Aty, Abdulrahman M Altwigry, Abdulrahman Sheshe, Abdulrasheed A Nasir, AbdulRazzaq Oluwagbemiga Lawal, Abdulshafi Khaled Abdrabou, Abdurrahaman Sheshe, Abdussemiu Abdurrazzaaq, Abebe Bekele Zerihun, Abeer Al-Shammari, Abeer El Gendy, Abeer Esam, Abeer Marey, Abhishek Mittal, Abiboye Yifieyeh, Abid Bin Mahamood, Abidemi Adesuyi, Abouelatta Khairy Aly, Abrar Nawawi, Adam Gyedu, Ade Waterman, Adedapo Osinowo, Adedeji Fatuga, Adel Albiety, Adel B Hassanein, Adel Denewar, Adeleke Adekoya, Ademola Adebanjo, Ademola Adeyeye, Ademola Popoola, Adesina Adedeji, Adesoji O Ademuyiwa, Adesoji Tade, Adewale Adeniyi, Adewale O Adisa, Adham Tarek, Adomas Ladukas, Adrian F Palma, Afifatun Hasanah, Afizah Salleh, Afnan Abdelfatah, Afnan Altamimi, Afnan Altamini, Agazi Fitsum, Agboola Taiwo, Ahamed Hassan, Ahed Ghaben, Ahmad Abdel Fattah, Ahmad Abdel Razaq Al Rafati, Ahmad Aboelkassem Ibrahem, Ahmad Aldalaq, Ahmad Ali, Ahmad Almallah, Ahmad Alrifaie, Ahmad Ashour, Ahmad Bakr, Ahmad Bani-Sadar, Ahmad Bin Adnan, Ahmad Elbatahgy, Ahmad Faraz, Ahmad Gudal, Ahmad Hasan, Ahmad Khaled Sabe, Ahmad Khoja, Ahmad Nashaat, Ahmad Qaissieh, Ahmad Sabe, Ahmad Saber Sleem, Ahmad Sakr, Ahmad Shalabi, Ahmad Uzair Qureshi, Ahmed Aamer, Ahmed Abd El Galeel, Ahmed Abd Elmoen Elhusseiny, Ahmed Abd Elsameea, Ahmed Abdelkareem, Ahmed Abdelmotaleb Ghazy, Ahmed Abo El Magd, Ahmed Abo Elazayem, Ahmed Adamu, Ahmed Adel, Ahmed Afandy, Ahmed Ahmed, Ahmed Alghamdi, Ahmed Ali, Ahmed Al-Khatib, Ahmed Altibi, Ahmed Alzahrani, Ahmed Ata, Ahmed Badr, Ahmed Dahy, Ahmed Diab, Ahmed El Kashash, Ahmed El Kholy, Ahmed Elgaili Khalid Musa, Ahmed Elgebaly, Ahmed Elkelany, Ahmed Elkholy, Ahmed El-Sehily, Ahmed Essam, Ahmed Fahiem, Ahmed Farag, Ahmed Fawzy, Ahmed Fouad, Ahmed Gad, Ahmed Ghanem, Ahmed Gheith, Ahmed Gomaa, Ahmed Hafez El-Badri Kotb, Ahmed Hammad, Ahmed Hassan, Ahmed Hossam Eldin Fouad Rida, Ahmed Ismail, Ahmed Karim, Ahmed Khyrallh, Ahmed Lasheen, Ahmed M Rashed, Ahmed Magdy, Ahmed Mahmoud Abdelraouf, Ahmed Menshawy, Ahmed Meshref, Ahmed Mohamed Afifi, Ahmed Mohamed Ibrahim, Ahmed Mohameden, Ahmed Mohammed, Ahmed Mokhtar, Ahmed Mosad, Ahmed Moustafa, Ahmed Moustafa Saeed, Ahmed Negida, Ahmed Rabeih Mohammed, Ahmed Rabie Mohamed, Ahmed Ragab Nayel, Ahmed Ragab Soliman, Ahmed Raslan, Ahmed Raza, Ahmed Refaat, Ahmed Rslan, Ahmed Sabry, Ahmed Sabry El-Hamouly, Ahmed Safwan Marey, Ahmed Saidbadr, Ahmed Sakr, Ahmed Samir, Ahmed Shahine, Ahmed Sheta, Ahmed Soliman, Ahmed Tammam, Ahmed Tarek Abdelbaset Hassan, Ahmed W Shamsedine, Ahmed Zaki, Ahmed Zaki Eldeeb, Ahmed Zohair, Ahmedali M Kandil, Ahmedglal Elnagar, Ahsan Zil-E-Ali, Aijaz Jabbar, Ailsa Claire Snaith, Ainhoa Costas-Chavarri, Aiste Austraite, Ajayesh Mistry, Akin Olaolorun, Akinlabi E Ajao, Al Faifi Jubran, Ala Shamasneh, Alaa Abouelnasr, Alaa Al-Buhaisi, Alaa Bowabsak, Alaa El Jamassi, Alaa Elazab, Alaa Elhadad, Alaa Fergany, Alaa Habeebullah, Alaa Hassan, Alaa Shabkah, Alaa Shaheen, Alaba Adesina, Alan Baird, Alan Grant, Alasdair Ball, Alban Cacurri, Albert Mohale Mphatsoe, Alberto Realis Luc, Alejandro Matheu, Alejandro Munera, Alemayehu Ginbo Bedada, Alessandro Favero, Alessio Maniscalco, Alexander Canta Calua, Alexander J Fowler, Alexandra Gerosa, Alexandre Horobjowsky, Alexandre Venancio De Sousa, Alexia Farrugia, Alexis Pierre Arnaud, Alfio Alessandro Russo, Alfredo Gulielmi, Ali Ababneh, Ali Abo El Dahab, Ali Amin Ahmed Ata, Ali Khan Niazi, Ali Kiasat, Ali Mohamed Hammad, Ali Zardab, Ali Zeynel Abidin Balkan, Aliaa Gamal Toeema, Aliaa Sadek, Aliaksandr Filatau, Aliang Latif, Alibeth Andres Baquero Suarez, Alice Faure, Alice Niragire, Alina Robledo-Rabanal, Aline Broch, Alireza Hasheminia, Alisdair Macdonald, Aliyu Ndajiwo, Allan Novak, Alphonse Zeta Mutabazi, Alvaro Enrique Mendoza Beleño, Alvin Ee Zhiun Cheah, Aly Abd Elrazek, Aly Nasr, Aly Sanad, Alyaa Halim Elgendy, Alyne Daltri Lazzarini Cury, Amal Ibrahim, Amandine Martin, Amani Althwainy, Amany Abouzahra, Amany Eldosouky Mohammed, Amar Kourdouli, Amel Hashish, Amerdip Birring, Amgad Al Meligy, Amina Abdelhamid, Aminah Hanum Haji Abdul Majid, Aminu Mohammad, Amir Ait Kaci, Amira Atef Omar, Amira Elsawy, Amira Hassan Bekhet, Amira Reda, Amjad Abu Qumbos, Amjad Elmashala, Ammar Gado, Amna Mamdouh Mohamed, Amna Mohamed, Amoudtha Rasendran, Amr Ahmed Saleh, Amr Fadel, Amr Hasan, Amr Hassaan, Amr Hossameldin, Amr Muhammad Elkorashy, Amr Tarek Hafez, Amreen Faruq, Amro Aglan, Ana Cecilia Manchego Bautista, Ana Lucia Contreras-Vergara, Ana Maria Sandoval Barrantes, Ana Vega Carreiro De Freitas, Ana Vega Freitas, Anam Rashid, Anan Rady Abdelazeam, Anand Kirishnan, Anass Majbar, Anastasia Bamicha, Anastasios Stefanopoulos, Anders Thorell, Andre Das, Andre Dubois, Andre L Mihaljevic, Andre Navarro, Andrea Allegri, Andrea Armellini, Andrea Belli, Andrea Bondurri, Andrea Echevarria Rosas Moran, Andrea Natili, Andrea Ruzzenente, Andrea Simioni, Andreass Haloho, Andrei Tanase, Andrej Kolosov, Andrejus Subocius, Andrew G N Robertson, Andrew Kirby, Andrew Mcguigan, Andrew Spina, Andrey Litvin, Andrius Burmistrovas, Andrius 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Arlindawati Suyadi, Armando José Román Velásquez, Arnaud Bonnard, Arnav Agarwal, Aroub Alkaaki, Arturas Vaicius, Arvin Khamajeet, Arvo Reinsoo, Arwa Abouzaid, Arwa Elfarargy, Arwa Ibrahim, Arwa Mohamed, Asaf Kedar, Asdaq Ahmed, Ased Ali, Aseel Alnusairat, Aseel Hamarshi, Aseel Musleh, Ash Prabhudesai, Ashraf A Maghrabi, Ashraf Morsi, Ashrarur Rahman Mitul, Asmaa Abdelgelil, Asmaa Abdel-Rahman Al-Aarag, Asmaa Rezq, Asmaa Salah, Aspasia Papailia, Assmaa Badwy, Astrid Leusink, Ata Khan, Ataa Ahmed, Athanasia Bamicha, Athar Eysa, Athirah Zulkifli, Atif Mahdi, Attia Attia, Attia Mohamed Attia, Audrey Clarissa, Audrius Dulskas, Audrius Parseliunas, Augusto Zani, Aung Kyaw Tun, Aurel Mironescu, Aurel Sandu Mironescu, Aurelien Scalabre, Aurora Mariani, Aurore Haffreingue, Aurore Thollot, Ausrine Usaityte, Austė Skardžiukaitė, Awais Raza, Aya Abdel Fatah Ibraheem, Aya Aboarab, Aya Adel Elsharkawy, Aya El-Sawy, Aya Elwaey, Aya Firwana, Aya Hagar, Aya Hammad, Aya Mohamed Fathy, Aya Reda, Aya Yehia Ata, Ayah Hamdan, Ayat Hassaan, Ayman And Taher, Ayman Elwan, Ayman Nabawi, Ayman Salman, Ayman Shwky, Ayokunle Ogunyemi, Azher Herebat, Azmina Verjee, Babajide Adenekan, Babatunde Odeyemi, Badr Eldin Adel, Badreldin Adel Tawfik, Bahar Busra Ozkan, Bakeer Mohamed, Bakhtiar Nighat, Bandar Albeladi, Bárbara Málaga, Barbara Mijuskovic, Barbara Pereira Silvestre, Basant Kumar, Basem Sieda, Bashir Bello, Basim Alghamdi, Basma Magdy, Basma Mahmoud, Basmah Alhassan, Bassant Mowafy, Beatrice Brunoni, Beatrix Weber, Belen Sanchez, Ben Thompson, Benoît Parmentier, Bernard Limoges, Bernard Van Duren, Bernhard Wolf, Bertrand Dousset, Besmir Grizhja, Bettina Lieske, Betty Maillot, Billal Mansour, Bjorn Frisk, Bogdan Diaconescu, Bogdan-Valeriu Martian, Boris Marinkovic, Brendan Skelly, Brian Cameron, Britta Dedekind, Bruno Noukpozounkou, Bryon Frankie Hon Khi Chong, Bylapudi Seshu Kumar, Caio Vinícius Barroso de Lima, Calogero Iacono, Cameron Fairfield, Camila Sanchez Samaniego, Camilla Cona, Camilo Lopez-Arevalo, Caoimhe Normile, Caranj Venugopal, Carla Cecilia Ramã Rez Cabrera, Carla Pierina García Torres, Carlo Corbellini, Carlos Alejandro Arroyo Basto, Carlos Iván Pérez Velásquez, Carlos Morales, Carlos Nsengiyumva, Carlos Paz Galvez, Carmen Capito, Carmen Fernández, Carmina Diaz-Zorrilla, Carolina Guzmán Dueñas, Carolina Oliveira Felipe, Caroline Clifford, Caroluce K Musyoka, Catherine A Shaw, Cathy Magee, Cecile Muller, Cecilia Costa, Cecilia Tolg, Cecilia Wredberg, Celeste Del Basso, Céline Grosos, Cesar Augusto Azmitia Mendizabal, Cesar Miranda, Cesar Razuri, Cezar Ciubotaru, Chali Chibuye, Challine Alexandre, Charing Cheuk Ling Szeto, Charles Dally, Charlotte Jane Mcintyre, Chaymae Benyaiche, Chean Leung Chong, Chee Siong Wong, Cheewei Gan, Chelise Currow, Chelsea Deane, Cheng Chun Goh, Cherry Koh, Cheryl Ou Yong, Chetan Khatri, Chi Chung Foo, Chi Ying Jacquelyn Fok, Chia Kong, Chiara Ceriani, Chimwemwe Kwatiwani, Chingwan Yip, Chintya Tedjaatmadja, Choon Seng Chong, Chouikh Taieb, Choy Ling Tan, Chris Bode, Chris Lee, Christel Leanne Almanon, Christian Hinojosa, Christian Lari Coompson, Christin Schoewe, Christina Neophytou, Christina P Major, Christina Panteli, Christine Mizzi, Christoforos Ferousis, Christopher Bode, Christos Agalianos, Christos Anthoulakis, Christos Barkolias, Christos Dervenis, Chu-Ann Chai, Chui Yee Wong, Ciara Fahy, Cicilia Viany Evajelista, Cirugia De Emergencia, Ciskje Zarb, Citra Dewi Mohd Ali, Claire Sharpin, Clara Milagros Herrera Puma, Clare M Rees, Clare Morgan, Claudia Reali, Claudio Arcudi, Claudio Fermani, Claudio Gabriel Fermani, Clemens Nawara, Clement Onuoha, Clodagh Mangan, Colleen Sampson, Collins Nwokoro, Colombani Jean-Francois, Constantinos Marinos, Cornelius Mukuzunga, Corrado Bottini, Craig Gouldthorpe, Crislee Elizabeth Lopez, Cristina Fernandes, Crystal Yern Nee Chow, Cutting Edge Manipal, Dale Vimalachandran, Dalia Alkhabbaz, Dalia Hemeda, Damien Brown, Damir Ljuhar, Dan L Deckelbaum, Dana Jaradat, Danelo Du Plessis, Daniel Ardian Soeselo, Daniel Cox, Daniel Dabessa, Daniel Estuardo Marroquín Rodríguez, Daniel Hamill, Daniel Nel, Daniel Youssef, Daniela Magri, Daniele Angelieri, Daniele Gui, Danilo Herrera Cruz, Danjuma Sale, Dansou Gaspard Gbessi, Dario Andreotti, Darius Kazanavicius, Darragh McCullagh, David Mcnish, David Merlini, David Monterroso Cohen, Davide De Boni, Davide Rossi, Dayang Nita Abdul Aziz, D C Grobler, Debora Schivo, Deborah Chiesa, Deimante Mikuckyte, Deividas Dragatas, Demi Gray, Diaa Eldin Abdelazeem Amin Elsorogy, Diaa Moustafa Elbendary Elsawahly, Diaaaldin Zahran, Diana Duarte Cadogan, Diana Sanchez, Dickson Bandoh, Diego Alonso Romani Pozo, Diego Antezana, Diego Coletta, Diego Romani, Diego Sasia, Dietmar Öfner, Dieudonne Duhoranenayo, Dimitri Aristotle Raptis, Dimitrios Balalis, Dimitrios K Manatakis, Dimitrios Karousos, Dimitrios Korkolis, Dimitrios Kyziridis, Dimitrios Lytras, Dimitrios Papageorgiou, Dimitrios Sfougaris, Dimitris-Christos Zachariades, Dina Al-Marakby, Dina Faizatur Rahmah, Dina Gamal, Dina Tarek, Dineshwary Periasammy, Diogo Vinicius Dos Santos, Dion Morton, Diya Mirghani, Djifid Morel Seto, D M Cocker, Dmitri A Raptis, Dmitri Nepogodiev, Dmitri Raptis, Doaa Emadeldin, Doaa Gamil, Doaa Hasan, Doaa Hasanain, Doaa Maher Abdelrouf, Domenica Pata, Domingos Mapasse, Dominic Charles Marshall, Donal B O'Connor, Donatas Danys, Donatas Venskutonis, Dorota Radkowiak, Doug Bowley, Dovilè Majauskyté, Dulan Irusha Samaraweera, Durvesh Lacthman Jethwani, Dush Iyer, Dushyant Iyer, Dzianis Khokha, Dzmitry Paulouski, Ebenezer Takyi Atkins, Echaieb Anis, Edgar Domini, Edilberto Temoche, Eduardo Huaman, Edvard Grisin, Edvinas Dainius, Efeson Thomas, Egle Preckailaite, Ehab Alnawam, Ehab Mamdouh, Eirik Kjus Aahlin, Eirini Kefalidi, Ekow Mensah, Elaine Borg, Eldaa Prisca Refianti Sutanto, Eleanor Marks, Elena Goldin, Elena Muzio, Elena Vendramin, Elena Zdanyte Sruogiene, Eleonora Ciccioli, Elio Jovine, Elisa Francone, Elisabeth Jensen, Elissa Rifhan Mohd Basir, Elizabeth Snyder, Ella Teasdale, Elliot Akoto, Elodie Gaignard, Elodie Haraux, Elsa Robert, Elsayed Ali, Elsayed Gamaly, Emad Abdallah, Emad Al-Dakka, Emad Ali Ahmed, Emad Aljohani, Emad Mohamed Saeed Taha, Eman Abd Al Raouf, Eman Abdelmageed, Eman Abuqwaider, Eman Adel Sayma, Eman Elwy, Eman Emara, Eman Hashad, Eman Ibrahim, Eman Magdy, Eman Magdy Hegazy, Eman Mahmoud Abdulhakeem, Eman Mohamed Ibrahim, Eman Mohamed Morshedy, Eman Nofal, Eman Rashad, Eman Yahya Mansor, Emanuel Barrios, Emanuele Rausa, Emeka Nwabuoku, Emilia De Luca, Emilie Eyssartier, Emilio Dijan, Emma Blower, Emma Jurdell, Emma Upchurch, Emmanuel Acquah, Emmanuel Akatibo, Emmanuel Barrios, Emmy Runigamugabo, Enas Alaloul, Enas Alqahtani, Enoch Dagoe, Enoch Tackie, Eriberto Farinella, Eric Ackom, Eric Kofi Appiah, Erick Samuel Florez Farfan, Erik Hervieux, Erik Schadde, Erika Vicario, Erikas Laugzemys, Ernest Yemalin Stephane Ahounou, Eslam Elbanby, Eslam Ezzat, Esraa Abd Elkhalek, Esraa Abdalmageed Kasem, Esraa Alm Eldeen, Esraa El-Gizawy, Esraa Elhalawany, Esraa El-Taher, Esraa Gamal, Esraa Ghanem, Esraa Kasem, Esraa Samir Elbanby, Esraay Zakaria, Ethar Hany, Etienne Courboin, Eu Xian Lee, Euan Macdonald, Eugene Niyirera, Eugenio Grasset, Eugenio Morandi, Eugenio Panieri, Eva Borin, Evangelos Voulgaris, Evelina Slapelyte, Evelina Woin, Ewan Macdermid, Ewen M Harrison, Eyad Khalifah, Ezio Veronese, Fabian Deichsel, Fabrizio Aquilino, Fahd Abdel Sabour, Faisal Idris, Faith Qi Hui Leong, Fanjandrainy Rasoaherinomenjanahary, Farah Mahmoud Ali, Farhana Iftekhar, Farrag Sayed, Fatai Balogun, Fatema Al Bastawis, Fatema Asi, Fathee Nada, Fathi Elzowawi, Fathia Abd El-Salam, Fathy Sroor, Fatima Baluch, Fatimah I Elgendy, Fatma Elkady, Faustin Ntirenganya, Fawzia Abdellatif Elsherif, Fawzy Mohamed, Fayez Elian Al Barrawi, Fazlin Noor, Federica Bianco, Federica Falaschi, Federico Coccolini, Fei Zheng, Felipe Zapata, Felix Alakaloko, Felix Lee, Feng Yih Chai, Ferdy Iskandar, Fernanda Altoe, Fernanda Frade, Fernande Djivoh, Fernando Espinoza, Fernando Fernandez-Bueno, Fernando Tale, Ferry Fitriya Ayu Andika, Fidelis Jacklyn Adella, Filippo Di Franco, Finaritra Casimir Fleur Prudence Rahantasoa, Fitjerald Henry, Fitriana Nur Rahmawati, Florence Dedey, Florian Primavesi, Florin-Mihail Iordache, Fong Yee Lam, Foteini Koumpa, Francesca Steccanella, Francesco Pata, Francesco Riente, Francesco Ruben Giardino, Francesco Selvaggi, Francis Abantanga, Francis Dossou, Francisco Fujii, Francisco Regalado, Francois-Coridon Helene, Françoise Schmitt, Frank Enoch Gyamfi, Frank Owusu, Fred Alexander Naranjo Aristizã Bal, Fred Hodonou, Frederick Du Toit, Frederique Sauvat, Fredrik Wogensen, Frehun Ayele Asele, Fridiz Saravia, Gabriel Pardo, Gabriela Elisa Nita, Gaetano Gallo, Gaetano Luglio, Gaetano Tessera, Galaleldin Abdelazim, Gamal Shimy, Gandau Naa Barnabas, Garba Samson, Gareth Irwin, Gehad El Ashal, Gehad Samir El Sayed, Gehad Tawfik, Gemma Humm, Genoveffa Balducci, George Christian Manrique Sila, George Ihediwa, George Manrique Sila, Georges Azzie, Georgette Marie Camilleri, Georgios Gemenetzis, Georgios Gkiokas, Georgios Karabelias, Georgios Kyrou, Georgios Tzikos, Gerardo Perrotta, Gerfried Teufelberger, Germain Ahlonsou, German Minguez, Geta Maharaj, Gezim Galiqi, Ghada Elhoseny, Ghada Saied Nagy, Ghiath Al Saied, Ghina Shamim Shamsi, Giacomo Nastri, Giacomo Pata, Gianfranco Cocorullo, Gianluca Curletti, Gianluca Pagano, Gianluca Pellino, Gianmaria Confalonieri, Gianpiero Gravante, Giedrius Lauzikas, Giles Dawnay, Gintaras Simutis, Giorgio Vasquez, Giovanni Landolfo, Giovanni Lazzari, Giovanni Luca Lamanna, Giovanni Pascale, Giovanni Pesenti, Giovanni Sgroi, Giridhar H Devadasar, Gisele Moreira, Giuliano Borda-Luque, Giuseppe Clerico, Giuseppe Rotunno, Giuseppe Salamone, Giuseppe Sammarco, Gokhan Lap, Greg Padmore, Gregorio Tugnoli, Gregory Kouraklis, Greta Mclachlan, Greta Wood, Greta Žiubrytė, Guillaume Podevin, Guillermo Sanchez Rosenberg, Guo Liang Yong, Gurdeep Singh Mannu, Gurpreet Singh Banipal, Gustavo Miguel Machain Vega, Gustavo Peixoto Soares Miguel, Gustavo Pereira Fraga, Gustavo Recinos, Gustavo Rodolfo Pertersen Servin, Haaris A Shiwani, Hadeel Al-Farram, Hafiz Hakim, Hagar Zidan, Hager Abdul Aziz Amin, Hager Abdulaziz, Hager Ahmed El-Badawy, Hager Elwakil, Hager Tolba, Hagir Zain Elabdin, Haidar Hajeh, Hala Ahmed, Hala Saad, Halima Aliyu, Hamdi Ebdewi, Hamza Asumah, Hamza Waleed, Hanan Adel Saad, Haney Youssef, Hani Natalie, Hanna Royson, Hannah Anderson-Knight, Hannah Burns, Hannah S Thomas, Hans-Ivar Pahlsson, Harish Neelamraju Lakshmi, Harriet Jordan, Hasan Ismael Ibraheem, Hasan Ismael Ibraheem Al-Hameedi, Hasbi Maulana Arsyad, Hasnain Abbas Dharamshi, Hassan Ali Mostafa, Hatem El-Sheemy, Haya Tahboub, Hayam Ahmed, Hayden Kretzmann, Hayssam Rashwan, Haytham Abudeeb, Hazem Khaled, Hazmi Dwinanda Nurqistan, Heather Bougard, Heba Baraka, Heba Gamal, Heba Shaker, Hector Shibao Miyasato, Helen Mohan, Helen Woodward, Helena Franco, Helene Francois-Coridon, Helmut Alfredo Segovia Lohse, Hend Adel Gawad Shakshouk, Hend Kandil, Hend Mahmoud, Henri Kotobi, Henry Mendel, Henry Nnaj, Herlin Karismaningtyas, Herman Cruz, Hesham Magdy, Hesham Mohammed Bakry, Hian Ee Heng, Hildur Thorarinsdottir, Hisham Safa, Hisham Samih, Hogea Mircea, Hong Kong Sar, Hong Yee Wong, Hoong-Yin Chong, Hope Edem Kofi Kordorwu, Hope Glover-Addy, Horacio Paredes Decoud, Hosni Khairy Salem, Hossam Dawoud, Hossam Elfeki, Hossam Emadeldin, Houda Bachri, Hunain Shiwani, Hussein Ali, Hussein El-Kashef, Hussein Mohammed, Hussien Ahmed, Iason-Antonios Papaskarlatos, Ibrahem Abdelmotaleb, Ibrahim AbdelFattah, Ibrahim Alhabli, Ibrahim Al-Slaibi, Ibrahim AlYoussef, Ibrahim Elzayat, Ibrahim Elzayyat, Ibrahim N Alomar, Ibrahim Rakha, Ibrahim Raza, Ida Björklund, Idelso Vasquez, Ignas Rakita, Ihab Hassan, Ihdaa Adawi, Iloba Njokanma, Iman Elkadsh, Immacolata Iannone, Ingemar Havemann, Ioannis Kyriazanos, Ioannis Patoulias, Ioannis Valioulis, Ionasc Dan, Ionut Negoi, Ionut-Bogdan Diaconescu, Irene Montes, Irene Ortega-Vazquez, Isaac Amole, Isaac Bertuello, Isaac Hanley, Isam Bsisu, Islam Magdy El Sayed, Ismael Isaac Zelada Alvarez, Ismail Lawani, Israa Abdullah Aziz Al-Azraqi, Israa Adel, Israa Awad, Israa Qawasmi, Ivan Mendoza Restrepo, J Edward Fitzgerald, Jack Almy, Jacqueline Sheehan, Jaime Andres Montoya Botero, Jaime Herrera-Matta, Jakeline Restrepo, Jakov Mihanovic, James Adeniran, James Brown, James Davies, James Giles, James Glasbey, James Olivier, James Pape, James Richards, James Wheeler, James Yang, Jamie Shah, Janet Pagnozzi, Jannin Salcedo, Jasim Amin, Jason Brown, Javier Pastora, Javier Rosales, Jazmin Coronel, Jean Bréaud, Jean De La Croix Allen Ingabire, Jean-Baptiste Marret, Jean-Francois Colombani, Jean-François Lecompte, Jeffrey Dalli, Jehad Hassan Youssif, Jehad Meqbil, Jemina Onimowo, Jen Cornick, Jenifa Jeyakumar, Jennifer Nowers, Jennifer Rickard, Jennifer Skehan, Jerry Makama, Jesse Ron Swire Ting, Jessica Juliana Tan, Jessica Patricia Gonzales Stuva, Jessica Roth, Jessica Souza Luiz, Jia Hao Law, Jia Yng Siaw, Jian Er Saw, Jibran Abbasy, Jiheon Song, Jimy Harold Jara Quezada, Joachim Amoako, Joachim Wiborg, Joanna Swann, Jo-Anne Carreira, Joanne Edwards, Joe Vincent, Joel Kin Tan, Joe-Nat Clegg-Lamptey, Johanna Joosten, Johanna Nyberg, Johannes Kurt Schultz, Johannes Wiik Larsen, John Bondin, John F Camilleri-Brennan, John Jemuel V Mora, John Lee Y Allen, John Whitaker, Jolanta Gribauskaite, Jon Arne Søreide, Jon Kristian Narvestad, Jonathan Ajah, Jonathan Dakubo, Jonathan Heath, Jonathan R L Wild, Jonny Setiawan, Jorge Armando Chungui Bravo, Jorge Torres Cardozo, Jose Aguilar-Jimenez, Jose Andres Garcia-Marin, Jose Antonio Cabala Chiong, Jose Costa-Maia, José Hamasaki, José Luis Hamasaki Hamaguchi, Jose Luis Rodicio, Jose María Vergara Celis, José René Arévalo Azmitia, Joselyn Ye, Joseph Awuku-Asabre, Josephine Psaila, Joshua Luck, Joshua Michael Clements, Joyeta Razzaque, Juan Camilo Correa, Juan Carpio, Juan Gouws, Juan Jaime Herrera Matta, Juan Manuel Carmona, Juan Marcelo Delgado, Juana Kabba, Jubran J Al-Faifi, Julia Guasti Pinto Vianna, Julian Camilleri-Brennan, Juliana Menegussi, Julien Leroux, Julien Rod, Juliette Hascoet, Julio Jimenez, Junyeong Oh, Juozas Kutkevicius, Justas Kuliavas, Justas Žilinskas, Justin Chak Yiu Lam, Justus Lando, Ka Hin Gabriel Li, Ka Wai Leung, Kai Yin Lee, Kalangu Kabongo, Kalitha Pinnagoda, Kalon Hewage, Kamau Kinandu, Kamran Faisal Bhopal, Kandasami Palayan, Kareem Dabbour, Kareem Elshaer, Karen Bailey, Karim Hilal, Karl Bonavia, Karolis Lagunavicius, Karolis Varkalys, Kate Cross, Kate Yu-Ching Chang, Katharina Beate Reinisch, Katharine Whitehurst, Katherine Gash, Kathryn Chu, Kathryn Lee, Katie Connor, Katrin Gudlaugsdottir, Kaustuv Das, Kazeem Atobatele, K C Janardha, Kean Leong Koay, Keat-Seong Poh, Keiran David Clement, Keith Sammut, Keith Say Kwang Tan, Kenneth Aaniana, Kenneth Johnson, Kenneth Mealy, Kenneth Thorsen, Kenny Turpo Espinoza, Kent Pluke, Kestutis Strupas, Kevin C Conlon, Kevin Turpo Espinoza, Khaled Abozeid, Khaled Alhady, Khaled Aljboor, Khaled Dawood, Khaled Hesham Elbisomy, Khaled Ibrahim, Khaled Khattab, Khaled Naser El Deen, Khalid Mahmud, Khalid Qurie, Khalid Salah El-Dien, Khalil Abdul Bassit, Khaoula Boukhal, Khlood Ashour, Kholod Tarek Lasheen, Kholoud Abdelbadeai, Khurram Khan, Khuzaimah Zahid Syibrah, Kieran Atkinson, Kieran Ka Kei Li, Kirsten Lafferty, Kjetil Søreide, Knut Magne Augestad, Kolonia Konstantina, Konstantinos Farmakis, Konstantinos Gasteratos, Kornelija Maceviciute, Kpèmahouton René Keke, Kresimir Zamarin, Kristian Styles, Kristijonas Jasaitis, Kristijonas Jokubonis, Kristina Cassar, Kuet Jun Chung, Kuhaendran Gunaseelan, Kuok Chung Lee, Kurt Carabott, Kwabena Agbedinu, Kwaku Boakye-Yiadom, Kwame Maison, Kwasi Asare-Bediako, Kwasi Kusi, Kyaw Phyo Aung, Kylie Joan-Yi Szeto, Kyriakos Psarianos, Laimonas Uščinas, Lalith Asanka Jayasooriya Jayasooriya Arachchige, Lana Abusalem, Larissa Ines Páez Lopez, Lau Wen Liang Joel, Laura Gavagna, Laura Koskenvuo, Laura Lorenzon, Laura Luque, Laurent Fourcade, Lawal Abdullahi, Lawani Ismaïl, Lawrence Bongani Khulu, Layza-Alejandra Mercado Rodriguez, Lee Shi Yeo, Leif Israelsson, Lemuel Davies Bray, Lenin Peña, Leo Licari, Leonardo Solaini, Li Jing Yeang, Liam Henderson, Liam Richardson, Liana Roodt, Lillian Reza, Linas Urbanavicius, Linas Venclauskas, Linda Alvi Madrid Barrientos, Linda Andersson, Ling Wilson, Linn Nymo, Linnea Mauro, Liviu Iuliu Muntean, Liviu Muntean, Ljiljana Jeremic, Lofty-John Anyanwu, Lopna Ahmed Mohamed Ahmed, Lorena Fuentes-Rivera, Lorena Rodriguez, Lorena Solar García, Lorraine Sproule, Lotfy Eldamaty, Luai Jamal, Luana Ayres Da Silva, Lubna Sabeeh, Luc Hervé Samison, Luca Ansaloni, Luca Bortolasi, Luca Turati, Lucia Duinhouwer, Lucian Corneliu Vida, Lucile Fievet, Lucio Selvaggi, Ludwing Alexander Zeta Solis, Luen Shaun Chew, Luigi Bonavina, Luigi Bucci, Luigi Maria Cloro, Luis Alberto Valente Laufer, Luis Barneo, Luis Joaquín García Florez, Luis M Helguero-Santin, Luis Miguel Alvarez Barreda, Luis Tale, Luisa Giavarini, Luiz Carlos Barros De Castro Segundo, Luiza Sarmento Tatagiba, Lukas Eisner, Lusi Padma Sulistianingsih Mata, Maarten Vermaas, Mabel Amoako-Boateng, Maciej Walędziak, Madan Jha, Madelaine Gimzewska, Mads Gran, Maeve O'neill, Magdalini Mitroudi, Magnus Boijsen, Maha Al-Faqawi, Maha Elmasry, Maha Gamal Mohamad Hamad, Maha Nasr, Mahadevan Deva Tata, Mahitab Essam, Mahitab Morsy Farahat, Mahmoud A Elnajjar, Mahmoud Abdelshafy, Mahmoud Abdelshakour, Mahmoud Abdulgawad, Mahmoud Ahmed Fathi Abozyed, Mahmoud Alrahawy, Mahmoud Amreia, Mahmoud Badawy, Mahmoud Eldafrawy, Mahmoud Elfiky, Mahmoud Elkhadragy Maher, Mahmoud Elkhadrawi, Mahmoud Elsayed Moghazy, Mahmoud Gomah, Mahmoud M Saad, Mahmoud Mohamed Metwally, Mahmoud Morsi, Mahmoud Saad, Mahmoud Saami, Mahmoud Salama, Mahmoud Salma, Mahmoud Shalaby, Mahmoud Warda, Mahmoud Zakaria, Mahmut Arif Yuksek, Mahnoor Javaid, Mahnuma Mahfuz Estee, Mai Ebidy, Mai Mohamed Ebidy, Mai Salama, Maíra Cassa Careta, Maja Marcus, Majd Dabboor, Majed Aboelella, Makafui Dayie, Makki Elsayed, Malcolm Falzon, Maleeha Hassan, Malin Sund, Man Fung Leung, Man Hon Andrew Yeung, Manar Abd-Elmawla, Manar Saeed, Mantas Drungilas, Mantas Jokubauskas, Mantas Vilčinskas, Manuel Francisco Roxas, Manuel Hache-Marliere, Manuel Lopez, Manuel Rodriguez Castro, Manuela Mendez, Manzoor Dar, Maram Abu-Toyour, Maram Salah, Marcelo O Higgins Roche, Marco Catani, Marco Maria Pascale, Marco Migliore, Mardelangel Zapata Ponze De Leon, Margaret O'Shea, Margarita Montrimaite, Margherita Notarnicola, Margub Hussain, Maria Clara Mendoza Arango, Maria Giovanna Grella, Maria Hjertberg, Maria Isabel Villegas Lanau, Maria Jesusa B Maño, Maria Lorena Aguilera, Maria Marta Modolo, Maria Mayasari, Maria Novella Ringressi, Maria Soledad Gonzales Montejo, Maria Soledad Merlo, Maria Utter, María Valcarcel-Saldaña, Maria-Lorena Aguilera-Arevalo, Mariam Darweesh, Mariam O Gad, Mariam Saad Aboul-Naga, Mariano Cesare Giglio, Mariastella Malavenda, Marie Carmela Lapitan, Marie Dione Parreno-Sacdalan, Marie Paul, Mariette Renaux-Petel, Marija Agius, Marilia Del Carmen Escalante Salas, Marilla Dickfos, Marina Luiza Pimenta, Mario Contreras Urquizu, Mario Corbellino, Mário Jacobe, Mario Lopez, Mario Pasini, Mario Trompetto, Marisa Leal, Marisol Manriquez-Reyes, Mariuca Popa, Mark Ian Hampton, Mark Sykes, Mark Wagener, Markus Zuber, Marte Bliksøen, Martha Glynn, Martin Jarmin, Martin Kyereh, Martina Perino, Martina Yusuf Shawky, Martinique Vella-Baldacchino, Marvin Vargas, Marwa Altarayra, Marwa Elashmawy, Marwa Elshobary, Marwa Hamdan, Marwa Sayed, Marwan Abubakr, Marwan Fahim, Marwan Shawki, Maryam Ali Khan, Maryna Shubianok, Mashael Al-Mousa, Masood Alghamdi, Masood Jawaid, Massiell Machaca, Massimiliano Dal Canto, Massimo Coletti, Matas Pažuskis, Matei Bratu, Matei Razvan Bratu, Mateusz Rubinkiewicz, Matteo Papandrea, Matteo Ripa, Mattew Ekow, Matthew Baldacchino, Matthew Billy, Matthew Young-Han Kim, Matthieu Peycelon, Matti Tolonen, Maureen Bezzina, Maurizio Foco, Mawaddah Alrajraji, Max Dénakpo, Max Rath, Mayaba Maimbo, Mazed Mohamed, Mazen Hassanain, Megan Turner, Mehmet Ali Yavuz, Mehmet Gumar, Mehmet Uluşahin, Melanie Castro Mollo, Melanie Zapata Ponze De Leon, Menatalla Salem, Mengistu Worku, Menna Tallah Ramadan, Mennaallah Hafez, Mennat-Allah Mustafa, Menold Archee P Redota, Meran Allam, Meric Mericliler, Merna Mostafa, Meryem Abbouch, Metwally Aboraya, Michael Amoah, Michael Cox, Michael Edye, Michael Gillespie, Michael Hanrahan, Michael Livingston, Michael Puttick, Michael Stoddart, Michael Van Niekerk, Michael Walsh, Michael Wilson, Michail Kontos, Michail Margaritis, Michał Janik, Micheal Ohene-Yeboah, Michela Monteleone, Michele Carlucci, Michele Sacco, Michelle Mccarthy, Midhun Mohan, Miguel Angel Paludi, Miguel Siguantay, Mihael Radic, Mihaela Vartic, Miklosh Bala, Milaksh Kumar Nirumal, Milan Radojkovic, Milica Nestorovic, Millika Ghetia, Mindaugas Kiudelis, Mircea Beuran, Mircea Hogea, Mirko Mangiapane, Mitchelle Solange De Fã Tima Linares Delgado, Moayad Othman, Mobolaji Oludara, Modise Zacharia Koto, Mohamad Baheeg, Mohamad Bakhaidar, Mohamad Jeffrey Bin Ismail, Mohamed A Abdelaziz, Mohamed A Amer, Mohamed A Baky Fahmy, Mohamed Abbas, Mohamed Abd El Slam, Mohamed Abdelaty, Mohamed Abdelaty Mohamed, Mohamed Abdelkhalek, Mohamed Abdelraheim, Mohamed Abozaid, Mohamed Abozed Abdullah, Mohamed Abuseif, Mohamed Adel Badenjki, Mohamed Ali Ghonaim, Mohamed Ali Mahmoud, Mohamed Ameen, Mohamed Ammar, Mohamed Asal, Mohamed Awad Elkarim Hamad Mohamed, Mohamed Dablouk, Mohamed El Halawany, Mohamed Elazoul, Mohamed Elbermawy, Mohamed Elfil, Mohamed Elsehimy, Mohamed Elzayat, Mohamed Etman, Mohamed F Zalabia, Mohamed Fares, Mohamed Fawzy Mahrous Badr, Mohamed Fouad Hamed, Mohamed Gadelkarim, Mohamed Ghoneem, Mohamed Gulamhussein, Mohamed Hafez, Mohamed Hashish, Mohamed Hassab Alnaby, Mohamed Husseini, Mohamed Ibrahim, Mohamed Ismail, Mohamed Karkeet, Mohamed Kelany, Mohamed Mabrouk, Mohamed Magdy, Mohamed Mahmoud, Mohamed Moamen Mohamed, Mohamed Moaty, Mohamed Mostafa, Mohamed Mustafa, Mohamed Nashat, Mohamed Nazir, Mohamed Reda Loaloa, Mohamed Rezal Abdul Aziz, Mohamed Sabry Ammar, Mohamed Salah, Mohamed Salah Elhelbawy, Mohamed Seisa, Mohamed Shaalan, Mohamed Sleem, Mohamed Sobhi Jabal, Mohamed Youssef, Mohamed Zidan, Mohamedraed Elshami, Mohammad Abdulkhalek Habeeb, Mohammad Aboraya, Mohammad Adawi, Mohammad Alherz, Mohammad Aliyu, Mohammad Elsayed Omar, Mohammad Ghannam, Mohammad Ghassan Alwafai, Mohammad Mohsin Arshad, Mohammad Rashid, Mohammadasim Amjad, Mohammed Alamoudi, Mohammed Alhendy, Mohammed AlRowais, Mohammed Alsaggaf, Mohammed Alzahrani, Mohammed Bukari, Mohammed Deputy, Mohammed Elgheriany, Mohammed Elsayed, Mohammed Elshaar, Mohammed Elsiddig, Mohammed Firdouse, Mohammed G Azizeldine, Mohammed Hanafy, Mohammed Ismail, Mohammed Kamal Ismail, Mohammed Mousa, Mohammed Mousa Salem, Mohammed Mustafa Hassan Mohammed, Mohammed Mustafa Mohammed, Mohammed Najjar, Mohammed Nasr, Mohammed Osman, Mohammed Osman Dablouk, Mohammed Saeed, Mohammed Saleh A Alghamdi, Mohammed Ubaid Alsaggaf, Mohammed Yahia Mohamed Aly, Mohannad Aledrisy, Mojolaoluwa Olugbemi, Mona Hamdy Madkor, Mona Hosh, Mona Rashad, Monica Bassem, Monique Moron Munhoz, Monty Khajanchi, Morgan Haines, Morvarid Ashtari, Mostada Samy, Mostafa Abdelkader, Mostafa Ahmed Bahaa Eldin, Mostafa Allam, Mostafa Gemeah, Mostafa Mahmoud Eid, Mostafa Qenawy, Mostafa Samy, Mostafa Seif, Mostafa Shalaby, Mousa Mustafa, Moustafa Ibrahim Mahmoud, Moustafa R Aboelsoud, Msafiri Kimaro, Muayad Ahmed Alfarsi, Muhamed M H Farhan-Alanie, Muhammad Adil, Muhammad Alkelani, Muhammad Amsyar Auni Lokman, Muhammad Bin Hasnan, Muhammad Daniyan, Muhammad El-Saied Ahmad Muhammad Gohar, Muhammad Fathi Waleed Omar, Muhammad Habib Ibrahim, Muhammad Mohsin Furqan, Muhammad Rashid Minhas Qadir, Muhammad Saqlain, Muhammad Shawqi, Muhammad Talha Butt, Muhammad Taqiyuddin Yahaya, Muhammad Waqar, Muhammed Masood Riaz, Muhammed Talaat, Muhtarima Haque, Muna Rommaneh, Murad Aljiffry, Murat Karakahya, Musah Yakubu, Muslimat Alada, Mustafa Farhad, Mustafa Mohammed Taher, Muthukumaran Rangarajan, Muwaffaq Mezeil Telfah, Myint Tun, Myranda Attard, Nada Ahmed Reda Elsayed, Nada El-Sagheer, Nada Elzahed, Nada Mohamed Bekhet, Nader Abd El Hamid, Nadia Khalid Abd El-Latif, Nadia Ortiz, Nadin Elsayed, Nadya Johanna, Nahilia Carrasco, Najwa Nadeem, Naomi J Wright, Napoleon Mendez, Narimantas E Samalavicius, Nashat Ghandora, Nasir Bustangi, Natale Di Martino, Natalie Blencowe, Natalie Redgrave, Nathalie Botto, Nathania Sutandi, Nawal Sadig, Nazmie Kariem, Nebil Behar, Nebiyou Seyoum Abebe, Nebyou Seyoum, Nebyou Seyoum Abebe, Neel Gobin, Neel Limaye, Neerav Aruldas, Nehal Yosri Elsayed Abdel-Wahab, Neil Smart, Nelson Manuel Urbina 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Thabet, Waleed, Adham, Walid, Forno, Walter, Ruiz Panez, Walter, Nurul 'Ain Wan Mohd Nasir, Wan, Senanayake Mudiyanselage Kithsiri Janakantha Senanayake, Wanigasekara, Hamsho, Ward, Dar, Wasim, Alhazmi, Wedyan, Guo, Wei, Ho, Weiguang, Dao, Weihei, Leslie Messa Aguilar, Wendy, Goh, Wennweoi, Saditya Jeo, Wifanto, Pino, Wilfredo, Appeadu-Mensah, William, Beasley, William, Bonney, William, Hutch, William, J Lossius, William, Milligan, William, Alcca Ticona, Willy, Sum Li, Wing, Chachulski, Witold, Delforge, Xavier, Rodriguez, Xianelle, Low, Xinwei, Wei Chan, Xue, Theng Neo, Ya, Imorou Souaibou, Yacoubou, Ukwenya, Yahaya, Salama, Yahya, Rajjoub, Yaseen, Ibrahim, Yasmein, Abd-Elrasoul, Yasmin, Elfouly, Yasmin, Hegazy, Yasmin, Soliman, Yasmin, Abd El Salam, Yasser, Wen Tan, Yee, Zakaria, Yehia, Reddy, Yella, Koon Tan, Yi, Ting Mok, Yi, Jeng Cheong, Yih, Yee Gan, Yiing, Der, Yishan, Praveen Mogan, Yogendra, Allam, Yomna, Hosny Asar, Yomna, Yong Tew, Yong, Abuowda, Yousef, El Shoura, Yousra, Esthefany Alejos Bermúdez, Ysabel, Cengiz, Yücel, Hong Eric Cheung, Yuk, Altinel, Yuksel, Kok Ng, Yung, Macchitella, Yuri, Aigrain, Yve, Mikwar, Zaher, Jaffry, Zahra, Ali Khan, Zain, Iftikhar, Zainab, M Elsayed, Zaynab, Zhang, Zhongtao, Hao Sam, Zi, Urniežius, Zigmanta, Dambrauskas, Zilvina, Bentounsi, Zineb, Tverskis, Zygimantas, Reuter A., Rogge L., Monahan M., Kachapila M., Morton D.G., Davies J., Vollmer S., Essam A.A., Sallam A.E., Elshafay A.E., Khedr A.E.-R.H., Saad A.G., Gharib A., Kenibar A., Elsherbiny A.S., Adel A., Abdelaal A., Elhendawy A.O.A., Hussein A., Belkouchi A., Hrora A., Adelshone A., Alkammash A., Assal A., Geuoshy A., Haroun A., Mohammed A., Sayed A., Soliman A., Elnemr A.E., Darwish A.K.Z., Elsebaaye A.O., Khalique A., Alvi A.R., Anwar A.W., Altwijri A., Al-Mallah A., Almoflihi A., Altamimi A., Daqeeq A., Dwydar A., Gouda A., Hashim A., Altaf A., Huwait A., Abdel-Aty A., Altwigry A.M., Sheshe A., Nasir A.A., Lawal A.O., Abdrabou A.K., Abdurrazzaaq A., Zerihun A.B., Al-Shammari A., Gendy A.E., Esam A., Marey A., Mittal A., Yifieyeh A., Bin Mahamood A., Adesuyi A., Aly A.K., Nawawi A., Gyedu A., Waterman A., Osinowo A., Fatuga A., Albiety A., Hassanein A.B., Denewar A., Adekoya A., Adebanjo A., Adeyeye A., Popoola A., Adedeji A., Ademuyiwa A.O., Tade A., Adeniyi A., Adisa A.O., Tarek A., Ladukas A., Palma A.F., Hasanah A., Salleh A., Abdelfatah A., Altamini A., Fitsum A., Taiwo A., Hassan A., Ghaben A., Fattah A.A., Al Rafati A.A.R., Ibrahem A.A., Aldalaq A., Ali A., Almallah A., Alrifaie A., Ashour A., Bakr A., Bani-Sadar A., Bin Adnan A., Elbatahgy A., Faraz A., Gudal A., Hasan A., Sabe A.K., Khoja A., Nashaat A., Qaissieh A., Sabe A., Sleem A.S., Sakr A., Shalabi A., Qureshi A.U., Aamer A., El Galeel A.A., Elhusseiny A.A.E., Elsameea A.A., Abdelkareem A., Ghazy A.A., El Magd A.A., Elazayem A.A., Adamu A., Afandy A., Ahmed A., Alghamdi A., Al-Khatib A., Altibi A., Alzahrani A., Ata A., Badr A., Dahy A., Diab A., Kashash A.E., Kholy A.E., Musa A.E.K., Elgebaly A., Elkelany A., Elkholy A., El-Sehily A., Essam A., Fahiem A., Farag A., Fawzy A., Fouad A., Gad A., Ghanem A., Gheith A., Gomaa A., El-Badri Kotb A.H., Hammad A., Rida A.H.E.F., Ismail A., Karim A., Khyrallh A., Lasheen A., Rashed A.M., Magdy A., Abdelraouf A.M., Menshawy A., Meshref A., Afifi A.M., Ibrahim A.M., Mohameden A., Mokhtar A., Mosad A., Moustafa A., Saeed A.M., Negida A., Mohammed A.R., Mohamed A.R., Nayel A.R., Soliman A.R., Raslan A., Raza A., Refaat A., Rslan A., Sabry A., El-Hamouly A.S., Marey A.S., Saidbadr A., Samir A., Shahine A., Sheta A., Tammam A., Hassan A.T.A., Shamsedine A.W., Zaki A., Eldeeb A.Z., Zohair A., Kandil A.M., Elnagar A., Zil-E-Ali A., Jabbar A., Snaith A.C., Costas-Chavarri A., Austraite A., Mistry A., Olaolorun A., Ajao A.E., Jubran A.F., Shamasneh A., Abouelnasr A., Al-Buhaisi A., Bowabsak A., Jamassi A.E., Elazab A., Elhadad A., Fergany A., Habeebullah A., Shabkah A., Shaheen A., Adesina A., Baird A., Grant A., Ball A., Cacurri A., Mphatsoe A.M., Luc A.R., Matheu A., Munera A., Bedada A.G., Favero A., Maniscalco A., Calua A.C., Fowler A.J., Gerosa A., Horobjowsky A., De Sousa A.V., Farrugia A., Arnaud A.P., Russo A.A., Gulielmi A., Ababneh A., El Dahab A.A., Ata A.A.A., Niazi A.K., Kiasat A., Hammad A.M., Zardab A., Balkan A.Z.A., Toeema A.G., Sadek A., Filatau A., Latif A., Suarez A.A.B., Faure A., Niragire A., Robledo-Rabanal A., Broch A., Hasheminia A., Macdonald A., Ndajiwo A., Novak A., Mutabazi A.Z., Beleno A.E.M., Cheah A.E.Z., Elrazek A.A., Nasr A., Sanad A., Elgendy A.H., Cury A.D.L., Ibrahim A., Martin A., Althwainy A., Abouzahra A., Mohammed A.E., Kourdouli A., Hashish A., Birring A., Al Meligy A., Abdelhamid A., Majid A.H.H.A., Mohammad A., Kaci A.A., Omar A.A., Elsawy A., Bekhet A.H., Reda A., Qumbos A.A., Elmashala A., Gado A., Mohamed A.M., Mohamed A., Rasendran A., Saleh A.A., Fadel A., Hassaan A., Hossameldin A., Elkorashy A.M., Hafez A.T., Faruq A., Aglan A., Bautista A.C.M., Contreras-Vergara A.L., Barrantes A.M.S., De Freitas A.V.C., Freitas A.V., Rashid A., Abdelazeam A.R., Kirishnan A., Majbar A., Bamicha A., Stefanopoulos A., Thorell A., Das A., Dubois A., Mihaljevic A.L., Navarro A., Allegri A., Armellini A., Belli A., Bondurri A., Moran A.E.R., Natili A., Ruzzenente A., Simioni A., Haloho A., Tanase A., Kolosov A., Subocius A., Robertson A.G.N., Kirby A., McGuigan A., Spina A., Litvin A., Burmistrovas A., Strazdas A., Arenas A., Bhangu A., Rudzenskaite A., Rojas A.D.P., Dell A., Mejia A.G.V., Charles A., Antoniozzi A., Benevento A., Tselos A., El-Ma'doul A.S., Sreedharan A., Bhatnagar A., Kjellin A., Lasek A., Maffioli A., Powell A., Rinaldi A., Watts A., lo Conte A., Bigaran A., Ashton A., Mukin A.D.F., Gulbinas A., Zadoroznas A., Rulie A.S., Ajiboye A., Avoka A., Lai A.C.-H., Davor A., Sander A., Oosterkamp A., Bediako-Bowan A., Brocca A.L., Leal A., Nocito A., La Medina A.R.-D., Taddei A., Atiyeh A., Kojo A.T.T., Driscoll A., Shah A., Vlachogiorgos A., Roslani A.C., Abdelhaq A., del Pilar Paucar A., Picciariello A., Kanani A., Leppaniemi A., Birindelli A., Nesaratnam A., Suyadi A., Velasquez A.J.R., Bonnard A., Agarwal A., Alkaaki A., Vaicius A., Khamajeet A., Reinsoo A., Abouzaid A., Elfarargy A., Kedar A., Alnusairat A., Hamarshi A., Musleh A., Prabhudesai A., Maghrabi A.A., Morsi A., Mitul A.R., Abdelgelil A., Al-Aarag A.A.-R., Rezq A., Salah A., Papailia A., Badwy A., Leusink A., Khan A., Eysa A., Zulkifli A., Mahdi A., Attia A., Attia A.M., Clarissa A., Dulskas A., Parseliunas A., Zani A., Tun A.K., Mironescu A., Mironescu A.S., Scalabre A., Mariani A., Haffreingue A., Thollot A., Usaityte A., Skardziukaite A., Ibraheem A.A.F., Aboarab A., Elsharkawy A.A., El-Sawy A., Elwaey A., Firwana A., Hagar A., Fathy A.M., Ata A.Y., Hamdan A., Taher A.A., Elwan A., Nabawi A., Salman A., Shwky A., Ogunyemi A., Herebat A., Verjee A., Adenekan B., Odeyemi B., Adel B.E., Tawfik B.A., Ozkan B.B., Mohamed B., Nighat B., Albeladi B., Malaga B., Mijuskovic B., Silvestre B.P., Kumar B., Sieda B., Bello B., Alghamdi B., Magdy B., Mahmoud B., Alhassan B., Mowafy B., Brunoni B., Weber B., Sanchez B., Thompson B., Parmentier B., Limoges B., Van Duren B., Wolf B., Dousset B., Grizhja B., Lieske B., Maillot B., Mansour B., Frisk B., Diaconescu B., Martian B.-V., Marinkovic B., Skelly B., Cameron B., Dedekind B., Noukpozounkou B., Chong B.F.H.K., Kumar B.S., de Lima C.V.B., Iacono C., Fairfield C., Samaniego C.S., Cona C., Lopez-Arevalo C., Normile C., Venugopal C., Cabrera C.C.R., Torres C.P.G., Corbellini C., Basto C.A.A., Velasquez C.I.P., Morales C., Nsengiyumva C., Galvez C.P., Capito C., Fernandez C., Diaz-Zorrilla C., Duenas C.G., Felipe C.O., Clifford C., Musyoka C.K., Shaw C.A., Magee C., Muller C., Costa C., Tolg C., Wredberg C., Del Basso C., Grosos C., Mendizabal C.A.A., Miranda C., Razuri C., Ciubotaru C., Chibuye C., Alexandre C., Szeto C.C.L., Dally C., McIntyre C.J., Benyaiche C., Chong C.L., Wong C.S., Gan C., Currow C., Deane C., Goh C.C., Koh C., Yong C.O., Khatri C., Foo C.C., Fok C.Y.J., Kong C., Ceriani C., Kwatiwani C., Yip C., Tedjaatmadja C., Chong C.S., Taieb C., Tan C.L., Bode C., Lee C., Almanon C.L., Hinojosa C., Coompson C.L., Schoewe C., Neophytou C., Major C.P., Panteli C., Mizzi C., Ferousis C., Agalianos C., Anthoulakis C., Barkolias C., Dervenis C., Chai C.-A., Wong C.Y., Fahy C., Evajelista C.V., De Emergencia C., Zarb C., Ali C.D.M., Sharpin C., Puma C.M.H., Rees C.M., Morgan C., Reali C., Arcudi C., Fermani C., Fermani C.G., Nawara C., Onuoha C., Mangan C., Sampson C., Nwokoro C., Jean-Francois C., Marinos C., Mukuzunga C., Bottini C., Gouldthorpe C., Lopez C.E., Fernandes C., Chow C.Y.N., Manipal C.E., Vimalachandran D., Alkhabbaz D., Hemeda D., Brown D., Ljuhar D., Deckelbaum D.L., Jaradat D., Du Plessis D., Soeselo D.A., Cox D., Dabessa D., Rodriguez D.E.M., Hamill D., Nel D., Youssef D., Magri D., Angelieri D., Gui D., Cruz D.H., Sale D., Gbessi D.G., Andreotti D., Kazanavicius D., McCullagh D., McNish D., Merlini D., Cohen D.M., De Boni D., Rossi D., Aziz D.N.A., Grobler D.C., Schivo D., Chiesa D., Mikuckyte D., Dragatas D., Gray D., Elsorogy D.E.A.A., Elsawahly D.M.E., Zahran D., Cadogan D.D., Sanchez D., Bandoh D., Pozo D.A.R., Antezana D., Coletta D., Romani D., Sasia D., Ofner D., Duhoranenayo D., Raptis D.A., Balalis D., Manatakis D.K., Karousos D., Korkolis D., Kyziridis D., Lytras D., Papageorgiou D., Sfougaris D., Zachariades D.-C., Al-Marakby D., Rahmah D.F., Gamal D., Tarek D., Periasammy D., dos Santos D.V., Morton D., Mirghani D., Seto D.M., Cocker D.M., Nepogodiev D., Raptis D., Emadeldin D., Gamil D., Hasan D., Hasanain D., Abdelrouf D.M., Pata D., Mapasse D., Marshall D.C., O'Connor D.B., Danys D., Venskutonis D., Radkowiak D., Bowley D., Majauskyte D., Samaraweera D.I., Jethwani D.L., Iyer D., Khokha D., Paulouski D., Atkins E.T., Anis E., Domini E., Temoche E., Huaman E., Grisin E., Dainius E., Thomas E., Preckailaite E., Alnawam E., Mamdouh E., Aahlin E.K., Kefalidi E., Mensah E., Borg E., Sutanto E.P.R., Marks E., Goldin E., Muzio E., Vendramin E., Sruogiene E.Z., Ciccioli E., Jovine E., Francone E., Jensen E., Basir E.R.M., Snyder E., Teasdale E., Akoto E., Gaignard E., Haraux E., Robert E., Ali E., Gamaly E., Abdallah E., Al-Dakka E., Ahmed E.A., Aljohani E., Taha E.M.S., Al Raouf E.A., Abdelmageed E., Abuqwaider E., Sayma E.A., Elwy E., Emara E., Hashad E., Ibrahim E., Magdy E., Hegazy E.M., Abdulhakeem E.M., Ibrahim E.M., Morshedy E.M., Nofal E., Rashad E., Mansor E.Y., Barrios E., Rausa E., Nwabuoku E., De Luca E., Eyssartier E., Dijan E., Blower E., Jurdell E., Upchurch E., Acquah E., Akatibo E., Runigamugabo E., Alaloul E., Alqahtani E., Dagoe E., Tackie E., Farinella E., Ackom E., Appiah E.K., Farfan E.S.F., Hervieux E., Schadde E., Vicario E., Laugzemys E., Ahounou E.Y.S., Elbanby E., Ezzat E., Elkhalek E.A., Kasem E.A., Eldeen E.A., El-Gizawy E., Elhalawany E., El-Taher E., Gamal E., Ghanem E., Kasem E., Elbanby E.S., Zakaria E., Hany E., Courboin E., Lee E.X., Macdonald E., Niyirera E., Grasset E., Morandi E., Panieri E., Borin E., Voulgaris E., Slapelyte E., Woin E., Macdermid E., Harrison E.M., Khalifah E., Veronese E., Deichsel F., Aquilino F., Sabour F.A., Idris F., Leong F.Q.H., Rasoaherinomenjanahary F., Ali F.M., Iftekhar F., Sayed F., Balogun F., Al Bastawis F., Asi F., Nada F., Elzowawi F., El-Salam F.A., Sroor F., Baluch F., Elgendy F.I., Elkady F., Ntirenganya F., Elsherif F.A., Mohamed F., Al Barrawi F.E., Noor F., Bianco F., Falaschi F., Coccolini F., Zheng F., Zapata F., Alakaloko F., Lee F., Chai F.Y., Iskandar F., Altoe F., Frade F., Djivoh F., Espinoza F., Fernandez-Bueno F., Tale F., Andika F.F.A., Adella F.J., Di Franco F., Rahantasoa F.C.F.P., Henry F., Rahmawati F.N., Dedey F., Primavesi F., Iordache F.-M., Lam F.Y., Koumpa F., Steccanella F., Pata F., Riente F., Giardino F.R., Selvaggi F., Abantanga F., Dossou F., Fujii F., Regalado F., Helene F.-C., Schmitt F., Gyamfi F.E., Owusu F., Aristizabal F.A.N., Hodonou F., Du Toit F., Sauvat F., Wogensen F., Asele F.A., Saravia F., Pardo G., Nita G.E., Gallo G., Luglio G., Tessera G., Abdelazim G., Shimy G., Barnabas G.N., Samson G., Irwin G., El Ashal G., El Sayed G.S., Tawfik G., Humm G., Balducci G., Sila G.C.M., Ihediwa G., Sila G.M., Azzie G., Camilleri G.M., Gemenetzis G., Gkiokas G., Karabelias G., Kyrou G., Tzikos G., Perrotta G., Teufelberger G., Ahlonsou G., Minguez G., Maharaj G., Galiqi G., Elhoseny G., Nagy G.S., Al Saied G., Shamsi G.S., Nastri G., Pata G., Cocorullo G., Curletti G., Pagano G., Pellino G., Confalonieri G., Gravante G., Lauzikas G., Dawnay G., Simutis G., Vasquez G., Landolfo G., Lazzari G., Lamanna G.L., Pascale G., Pesenti G., Sgroi G., Devadasar G.H., Moreira G., Borda-Luque G., Clerico G., Rotunno G., Salamone G., Sammarco G., Lap G., Padmore G., Tugnoli G., Kouraklis G., McLachlan G., Wood G., Ziubryte G., Podevin G., Rosenberg G.S., Yong G.L., Mannu G.S., Banipal G.S., Vega G.M.M., Miguel G.P.S., Fraga G.P., Recinos G., Servin G.R.P., Shiwani H.A., Al-Farram H., Hakim H., Zidan H., Amin H.A.A., Abdulaziz H., El-Badawy H.A., Elwakil H., Tolba H., Elabdin H.Z., Hajeh H., Ahmed H., Saad H., Aliyu H., Ebdewi H., Asumah H., Waleed H., Saad H.A., Youssef H., Natalie H., Royson H., Anderson-Knight H., Burns H., Thomas H.S., Pahlsson H.-I., Lakshmi H.N., Jordan H., Ibraheem H.I., Al-Hameedi H.I.I., Arsyad H.M., Dharamshi H.A., Mostafa H.A., El-Sheemy H., Tahboub H., Kretzmann H., Rashwan H., Abudeeb H., Khaled H., Nurqistan H.D., Bougard H., Baraka H., Gamal H., Shaker H., Miyasato H.S., Mohan H., Woodward H., Franco H., Francois-Coridon H., Lohse H.A.S., Shakshouk H.A.G., Kandil H., Mahmoud H., Kotobi H., Mendel H., Nnaj H., Karismaningtyas H., Cruz H., Magdy H., Bakry H.M., Heng H.E., Thorarinsdottir H., Safa H., Samih H., Mircea H., Sar H.K., Wong H.Y., Chong H.-Y., Kordorwu H.E.K., Glover-Addy H., Decoud H.P., Salem H.K., Dawoud H., Elfeki H., Emadeldin H., Bachri H., Shiwani H., Ali H., El-Kashef H., Mohammed H., Papaskarlatos I.-A., Abdelmotaleb I., AbdelFattah I., Alhabli I., Al-Slaibi I., AlYoussef I., Elzayat I., Elzayyat I., Alomar I.N., Rakha I., Raza I., Bjorklund I., Vasquez I., Rakita I., Hassan I., Adawi I., Njokanma I., Elkadsh I., Iannone I., Havemann I., Kyriazanos I., Patoulias I., Valioulis I., Dan I., Negoi I., Diaconescu I.-B., Montes I., Ortega-Vazquez I., Amole I., Bertuello I., Hanley I., Bsisu I., El Sayed I.M., Alvarez I.I.Z., Lawani I., Al-Azraqi I.A.A., Adel I., Awad I., Qawasmi I., Restrepo I.M., Fitzgerald J.E., Almy J., Sheehan J., Botero J.A.M., Herrera-Matta J., Restrepo J., Mihanovic J., Adeniran J., Brown J., Giles J., Glasbey J., Olivier J., Pape J., Richards J., Wheeler J., Yang J., Shah J., Pagnozzi J., Salcedo J., Amin J., Pastora J., Rosales J., Coronel J., Breaud J., De La Croix Allen Ingabire J., Marret J.-B., Colombani J.-F., Lecompte J.-F., Dalli J., 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Subjects: surgical unmetneed, no keywords listed, appendicitis, global surgery, Financial Stress, Health Care Costs, Appendicitis, Financial Stre, Health Care Cost, Cost of Illness, Humans, appendicitis,economic burden, surgery, Surgery, Appendiciti, Human
Abstract: Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and $73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and $75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially.
Published: 2022

15. Commentary on Periprosthetic Leakage in Tracheoesophageal Prosthesis: Proposal of a Standardized Therapeutic Algorithm

Author: Miguel, Mayo-Yáñez, Luigi A, Vaira, Jérôme R, Lechien, Carlos Miguel, Chiesa-Estomba, Carlos Miguel, Calvo-Henríquez, Christian, Calvo-Henríquez, and Irma, Cabo-Varela
Subjects: Otorhinolaryngology, Humans, Surgery, Larynx, Artificial, Algorithms, Prosthesis Failure
Published: 2022
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16. Carbon Nanotubes/Regenerated Silk Composite as a Three-Dimensional Printable Bio-Adhesive Ink with Self-Powering Properties

Author: Luca Valentini, Antonino Morabito, Micaela Degli Esposti, Riccardo Coletta, Giacomo Giorgi, Carmelo De Maria, Amelia Morrone, Silvia Bittolo Bon, Martino Calamai, Rodolfo Tonin, Francesco S. Pavone, Davide Morselli, Irene Chiesa, Paola Fabbri, Bon, Silvia Bittolo, Chiesa, Irene, Degli Esposti, Micaela, Morselli, Davide, Fabbri, Paola, De Maria, Carmelo, Morabito, Antonino, Coletta, Riccardo, Calamai, Martino, Pavone, Francesco Saverio, Tonin, Rodolfo, Morrone, Amelia, Giorgi, Giacomo, and Valentini, Luca
Subjects: Fabrication, Materials science, self-powering bio-adhesives, Composite number, Silk, Biocompatible Materials, Nanotechnology, 02 engineering and technology, Substrate (printing), Carbon nanotube, mechanical properties, 010402 general chemistry, 01 natural sciences, law.invention, law, Adhesives, mechanical propertie, Animals, Humans, General Materials Science, carbon nanotube, Cell Proliferation, carbon nanotubes, Tissue Scaffolds, Nanotubes, Carbon, Bilayer, Biomaterial, 3D printing, 021001 nanoscience & nanotechnology, Rats, 3. Good health, 0104 chemical sciences, interface modeling, regenerated silk, Printing, Three-Dimensional, Surface modification, Ink, Adhesive, 0210 nano-technology, Research Article
Abstract: In this study, regenerated silk (RS) obtained from Bombyx Mori cocoons is compounded with carboxyl-functionalized carbon nanotubes (f-CNTs) in an aqueous environment for the fabrication of functional bio-adhesives. Molecular interactions between RS and carboxyl groups of CNTs result in structural increase of the β-sheet formation, obtaining a resistant adhesive suitable for a wet biological substrate. Moreover, the functionalization of CNTs promotes their dispersion in RS, thus enabling the production of films with controlled electrical conductivity. The practical utility of such a property is demonstrated through the fabrication of a piezoelectric device implanted in a rat to monitor the breathing in vivo and to be used as a self-powered system. Finally, RS/f-CNTs were used as a printable biomaterial ink to three dimensionally print bilayer hollow tubular structures composed of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) and RS. Initial tests carried out by seeding and growing human skin fibroblasts demonstrated that the 3D printed bilayer hollow cylindrical structures offer a suitable surface for the seeded cells to attach and proliferate. In general, the herein proposed RS/f-CNT composite serves as a versatile material for solvent-free dispersion processing and 3D printing, thus paving a new approach to prepare multifunctional materials with potential applications of great interest in sealing biological substrates and implantable devices for regenerative medicine.
Published: 2021
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17. Management of acute and chronic aortic disease during the COVID-19 pandemic-Results from a web-based ad hoc platform

Author: Roman Gottardi, Eduardo Quintana, Juerg Schmidli, Thomas R Wyss, Michael J. Jacobs, Hansjörg Jenni, Jos C. van den Berg, Roberto Chiesa, Davide Pacini, Roberto Lorusso, Martin Czerny, Bartosz Rylski, Klaus Staier, Nikolaos Tsilimparis, Stephan M. Jakob, Czerny M., van den Berg J., Chiesa R., Jacobs M., Jakob S., Jenni H.-J., Lorusso R., Pacini D., Quintana E., Rylski B., Staier K., Tsilimparis N., Wyss T., Gottardi R., and Schmidli J.
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, Aortic Diseases, Review Article, Disease, 030204 cardiovascular system & hematology, Aortic disease, 03 medical and health sciences, 0302 clinical medicine, COVID‐19, Pandemic, INFECTION, Extracorporeal membrane oxygenation, Humans, Medicine, Aortic rupture, Pandemics, Review Articles, Acute aortic syndrome, Internet, SARS-CoV-2, business.industry, medicine.disease, Pulmonary embolism, 030228 respiratory system, covid-19, Emergency medicine, acute and chronic aortic disease, Surgery, business, Cardiology and Cardiovascular Medicine
Abstract: Background: To share the results of a web-based expert panel discussion focusing on the management of acute and chronic aortic disease during the coronavirus (COVID-19) pandemic. Methods: A web-based expert panel discussion on April 18, 2020, where eight experts were invited to share their experience with COVID-19 disease touching several aspects of aortic medicine. After each talk, specific questions were asked by the online audience, and results were immediately evaluated and shared with faculty and participants. Results: As of April 18, 73.3% answered that more than 200 patients have been treated at their respective settings. Sixty-four percent were reported that their hospital was well prepared for the pandemic. In 57.7%, the percentage of infected healthcare professionals was below 5% whereas 19.2% reported the percentage to be between 10% and 20%. Sixty-seven percent reported the application of extracorporeal membrane oxygenationin less than 2% of COVID-19 patients whereas 11.8% reported application in 5%–10% of COVID-19 patients. Thirty percent of participants reported the occurrence of pulmonary embolism in COVID-19 patients. Three percent reported to have seen aortic ruptures in primarily elective patients having been postponed because of the anticipated need to provide sufficient ICU capacity because of the pandemic. Nearly70% reported a decrease in acute aortic syndrome referrals since the start of the pandemic. Conclusion: The current COVID-19 pandemic has—besides the stoppage of elective referrals—also led to a decrease of referrals of acute aortic syndromes in many settings. The reluctance of patients seeking medical help seems to be a major driver. The number of patients, who have been postponed due to the provisioning of ICU resources but having experienced aortic rupture in the waiting period, is still low. Further, studies are needed to learn more about the influence that the COVID-19 pandemic has on the treatment of patients with acute and chronic aortic disease.
Published: 2021
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18. Early results of mechanochemical ablation for small saphenous vein incompetency using 2% polidocanol

Author: Nicola Favia, Luca Apruzzi, Germano Melissano, Vincenzo Ardita, Domenico Baccellieri, Concetta Saracino, Niccolò Carta, Roberto Chiesa, Baccellieri, D., Apruzzi, L., Ardita, V., Favia, N., Saracino, C., Carta, N., Melissano, G., and Chiesa, R.
Subjects: Adult, Male, medicine.medical_specialty, Time Factors, Visual analogue scale, Deep vein, Polidocanol, Pain, 030204 cardiovascular system & hematology, Varicose Veins, 03 medical and health sciences, Small saphenous vein, 0302 clinical medicine, Endovenous ablation, Interquartile range, Catheterization, Peripheral, Sclerotherapy, Varicose veins, Humans, Medicine, Local anesthesia, 030212 general & internal medicine, Aged, Retrospective Studies, business.industry, Nonthermal ablation, Middle Aged, medicine.disease, Sclerosing Solutions, Thrombosis, Surgery, Treatment Outcome, medicine.anatomical_structure, Venous Insufficiency, Chronic Disease, Quality of Life, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract: The aim of the present study was to investigate the early results of mechanochemical ablation (MOCA) for the treatment of small saphenous vein (SSV) incompetence.We performed a single-center, retrospective analysis of a prospectively collected database of 60 patients treated with MOCA for single-axis SSV incompetence. All procedures were performed with the patient under local anesthesia using the ClariVein catheter (Merit Medical, South Jordan, Utah) combined with 2% polidocanol and, where appropriate, additional microphlebectomy. The primary study endpoint was to assess the SSV occlusion rate at the 1-, 6-, and 12-month follow-up examinations. The secondary endpoints included the Venous Clinical Severity Score, quality of life (QoL) assessment, periprocedural pain, and further complications after the intervention and during the follow-up period. Patient QoL was assessed using the Aberdeen Varicose Vein Questionnaire. Pain was measured using a 100-mm visual analog scale.Technical success was achieved in 100% of the cases. The mean visual analog scale score on the first postoperative day was 15 mm. No major events were recorded. No neurological complications or deep vein thrombosis were observed. Minor complications included ecchymosis in 3.3% of cases (2 of 60), transient phlebitis of the SSV in 5% of cases (3 of 60), and itching in 3.3% of cases (2 of 60). At the 1-, 6-, and 12-month follow-up examinations, the occlusion rate was 100% (60 of 60), 98.3% (57 of 58), and 92.6% (50 of 54). The median Venous Clinical Severity Score had significantly decreased from 5 (interquartile range [IQR], 3-6) at baseline to 2 (IQR, 1-4) at the 1-month follow-up (P .001), 1 (IQR, 1-2) at the 6-month follow-up (P .001) and 1 (IQR, 0-1) at the 12-month follow-up (P .001). The mean Aberdeen Varicose Vein Questionnaire score had improved from the baseline score of 25 ± 14.61 to 15.81 ± 13.76 at the 1-month follow-up (P .001), to 9.81 ± 7.42 at the 6-month follow-up (P .001) and 4.73 ± 3.32 at the 12-month follow-up (P .001).The results of our study have shown that MOCA is a feasible, safe, and painless procedure for the treatment of SSV incompetence with an occlusion rate of 92.6% at the 12-month examination. No sural nerve injuries or other major complications were observed. The procedure also provided good clinical results and positive effects on patient QoL.
Published: 2021
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19. Regional Survey in Lombardy, Northern Italy, on Vascular Surgery Intervention Outcomes During The COVID-19 Pandemic

Author: Raffaello Bellosta, Gabriele Piffaretti, Stefano Bonardelli, Patrizio Castelli, Roberto Chiesa, Dalmazio Frigerio, Gaetano Lanza, Stefano Pirrelli, Giovanni Rossi, Santi Trimarchi, Franco Briolini, Pietro Cefali, Roberto Caronno, Aldo Arzini, Domenico Diaco, Vittorio Baratta, Stefano Aiello, Alessandro C.L. Molinari, Francesca Giovannini, Anna Maria Socrate, Matteo Ferraris, Antonino Silvestro, Gianluca Canu, Emidio Costantini, Davide Logaldo, Federico Romani, Alfredo Lista, Cristina Busoni, Marco Setti, Roberto Mezzetti, Piergiorgio Sala, Luca Bassi, Luca Luzzani, Matteo A. Pegorer, Luca Attisani, Claudio Carugati, Monica Vescovi, Piero Trabattoni, Stefano Zoli, Andrea Rignano, Clara Magri, Pierluigi Vandone, Sergio Losa, Efrem Civilini, Giovanni Nano, Daniela Mazzaccaro, Valerio Tolva, Jessica Lanza, Ruggiero Curci, Giovanna Simonetti, Chiara Lomazzi, Viviana Grassi, Daniele Bissacco, Andrea Kahlberg, Daniele Mascia, Raffaello Dallatana, Michele Carmo, Franco Ragni, Enrico M. Marone, Antonio Bozzani, Matteo Tozzi, Marco Franchin, Gianluca Lussardi, Vittorio Segramora, Gaetano Deleo, Matteo Crippa, Tiziano Porretta, Marco Viani, Silvia Stegher, Davide Foresti, Giovanni Bonalumi, Bellosta, R., Piffaretti, G., Bonardelli, S., Castelli, P., Chiesa, R., Frigerio, D., Lanza, G., Pirrelli, S., Rossi, G., Trimarchi, S., Briolini, F., Cefali, P., Caronno, R., Arzini, A., Diaco, D., Baratta, V., Aiello, S., Molinari, A. C. L., Giovannini, F., Socrate, A. M., Ferraris, M., Silvestro, A., Canu, G., Costantini, E., Logaldo, D., Romani, F., Lista, A., Busoni, C., Setti, M., Mezzetti, R., Sala, P., Bassi, L., Luzzani, L., Pegorer, M. A., Attisani, L., Carugati, C., Vescovi, M., Trabattoni, P., Zoli, S., Rignano, A., Magri, C., Vandone, P., Losa, S., Civilini, E., Nano, G., Mazzaccaro, D., Tolva, V., Lanza, J., Curci, R., Simonetti, G., Lomazzi, C., Grassi, V., Bissacco, D., Kahlberg, A., Mascia, D., Dallatana, R., Carmo, M., Ragni, F., Marone, E. M., Bozzani, A., Tozzi, M., Franchin, M., Lussardi, G., Segramora, V., Deleo, G., Crippa, M., Porretta, T., Viani, M., Stegher, S., Foresti, D., and Bonalumi, G.
Subjects: Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), COVID-19, acute limb ischaemia, vascular surgery activities, Cohort Studies, Postoperative Complications, Intervention (counseling), Pandemic, Humans, Medicine, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Outbreak, Middle Aged, Vascular surgery, Northern italy, Treatment Outcome, Italy, Health Care Surveys, Emergency medicine, Female, Surgery, Cardiology and Cardiovascular Medicine, business, Complication, Vascular Surgical Procedures, Cohort study
Abstract: Objective: The characteristics and outcomes of patients undergoing vascular surgery hospitalised and managed in Lombardy are described with a comparison of patients tested positive for COVID-19 (CV19-pos) vs. those tested negative (CV19-neg). Methods: This was a multicentre, retrospective, observational cohort study which involved all vascular surgery services in Lombardy, Northern Italy. Data were retrospectively merged into a combined dataset covering the nine weeks of the Italian COVID-19 pandemic phase 1 (8 March 2020 to 3 May 2020). The primary outcome was freedom from in hospital death, secondary outcomes were re-thrombosis rate after peripheral revascularisation, and freedom from post-operative complication. Results: Among 674 patients managed during the outbreak, 659 (97.8%) were included in the final analysis: 121 (18.4%) were CV19-pos. CV19-pos status was associated with a higher rate of complications (OR 4.5; p < .001, 95% CI 2.64 – 7.84), and a higher rate of re-thrombosis after peripheral arterial revascularisation (OR 2.2; p = .004, 95% CI 1.29 – 3.88). In hospital mortality was higher in CV19-pos patients (24.8% vs. 5.6%; OR 5.4, p < .001;95% CI 2.86 – 8.92). Binary logistic regression analysis identified CV19-pos status (OR 7.6; p < .001, 95% CI 3.75 – 15.28) and age > 80 years (OR 3.2; p = .001, 95% CI 1.61 – 6.57) to be predictors of in hospital death. Conclusion: In this experience of the vascular surgery group of Lombardy, COVID-19 infection was a marker of poor outcomes in terms of mortality and post-operative complications for patients undergoing vascular surgery treatments.
Published: 2021
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20. Long-term outcomes and cost-effectiveness of a magnet-based valve voice prosthesis for endoprosthesis leakage treatment

Author: Miguel Mayo-Yáñez, Carlos Chiesa-Estomba, Jérôme R. Lechien, Christian Calvo-Henríquez, Luigi A. Vaira, and Irma Cabo-Varela
Subjects: Cross-Over Studies, Otorhinolaryngology, Cost-Benefit Analysis, Magnets, Humans, Laryngectomy, General Medicine, Larynx, Artificial, Prosthesis Design, Prosthesis Failure
Abstract: Tracheoesophageal speech is considered the gold standard for rehabilitation following total laryngectomy. The main reason of voice prosthesis failure is the endoprosthesis leakage. Provox ActiValveProspective case-crossover study in laryngectomized patients with Provox VegaA total of 159 prostheses were evaluated. The most frequent reason for replacement was the endoprosthesis leakage (N = 129; 83.77%) in both models. The mean duration-time of Provox Vega
Published: 2022
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21. Urinary albumin/creatinine ratio tertiles predict risk of diabetic retinopathy progression: a natural history study from the Adolescent Cardio-Renal Intervention Trial (AdDIT) observational cohort

Author: Paul Z, Benitez-Aguirre, M Loredana, Marcovecchio, Scott T, Chiesa, Maria E, Craig, Tien Y, Wong, Elizabeth A, Davis, Andrew, Cotterill, Jenny J, Couper, Fergus J, Cameron, Farid H, Mahmud, H Andrew W, Neil, Timothy W, Jones, Lauren A B, Hodgson, R Neil, Dalton, Sally M, Marshall, John, Deanfield, David B, Dunger, and Kim C, Donaghue
Subjects: Diabetes Mellitus, Type 1, Diabetic Retinopathy, Adolescent, Risk Factors, Albumins, Creatinine, Endocrinology, Diabetes and Metabolism, Internal Medicine, Albuminuria, Humans, Diabetic Nephropathies, Child
Abstract: Aims/hypothesis We hypothesised that adolescents with type 1 diabetes with a urinary albumin/creatinine ratio (ACR) in the upper tertile of the normal range (high ACR) are at greater risk of three-step diabetic retinopathy progression (3DR) independent of glycaemic control. Methods This was a prospective observational study in 710 normoalbuminuric adolescents with type 1 diabetes from the non-intervention cohorts of the Adolescent Cardio-Renal Intervention Trial (AdDIT). Participants were classified as ‘high ACR’ or ‘low ACR’ (lowest and middle ACR tertiles) using baseline standardised log10 ACR. The primary outcome, 3DR, was determined from centrally graded, standardised two-field retinal photographs. 3DR risk was determined using multivariable Cox regression for the effect of high ACR, with HbA1c, BP, LDL-cholesterol and BMI as covariates; diabetes duration was the time-dependent variable. Results At baseline mean ± SD age was 14.3 ± 1.6 years and mean ± SD diabetes duration was 7.2 ± 3.3 years. After a median of 3.2 years, 83/710 (12%) had developed 3DR. In multivariable analysis, high ACR (HR 2.1 [1.3, 3.3], p=0.001), higher mean IFCC HbA1c (HR 1.03 [1.01, 1.04], p=0.001) and higher baseline diastolic BP SD score (HR 1.43 [1.08, 1.89], p=0.01) were independently associated with 3DR risk. Conclusions/interpretation High ACR is associated with greater risk of 3DR in adolescents, providing a target for future intervention studies. Trial registration isrctn.org ISRCTN91419926. Graphical abstract
Published: 2022
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22. Pyogenic and Non-pyogenic Spinal Infections: Diagnosis and Treatment

Author: Abhinandan Reddy Mallepally, Marco Girolami, Riccardo Ghermandi, Anna Maria Chiesa, Valerio Pipola, Maddalena Di Carlo, Gisberto Evangelisti, Giuseppe Tedesco, Nandan Amrit Marathe, and Alessandro Gasbarrini
Subjects: Spondylodiscitis, medicine.medical_specialty, Pediatrics, Tuberculosis, Neurology, business.industry, medicine.drug_class, Antibiotics, Guideline, medicine.disease, Magnetic Resonance Imaging, Anti-Bacterial Agents, Radiological weapon, Concomitant, medicine, Humans, Radiology, Nuclear Medicine and imaging, business, Spondylitis
Abstract: Spinal Infection (SI) is an infection of vertebral bodies, intervening disc, and/or adjoining para-spinal tissue. It represents less than 10% of all skeletal infections. There are numerous factors that predispose to developing a SI. Due to the low specificity of signs, delayed diagnosis is common. Hence, SI may be associated with poor outcomes. Diagnosis of SI must be supported by clinicopathological and radiological findings. MRI is a reliable modality of choice. Treatment options vary according to the site of the infection, disease progression, neurology, presence of instability, and general condition of the subject. Conservative treatment (orthosis/ bed-rest + antibiotics) is recommended during the early course with no/ lesser degree of neurological involvement and to medically unfit patients. Nevertheless, when conservative measures alone fail, surgical interventions must be considered. The use of concomitant antimicrobial drugs intravenously during initial duration followed by oral administration is a necessity. Controversies exist regarding the optimal duration of antimicrobial therapy, yet never given less than six weeks. Heterogeneity in clinical picture and associated co-morbidities with a range of treatment modalities are available; however, a common applicable guideline for SI does not exist. Managing SI must be tailored on a case-to-case basis.
Published: 2022
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23. Target site mutations underlying insecticide resistance in Tunisian populations of Myzus persicae (Sulzer) on peach orchards and potato crops

Author: Amen Hlaoui, Olga Chiesa, Christian C Figueroa, Rebha Souissi, Emanuele Mazzoni, and Sonia Boukhris‐Bouhachem
Subjects: Insecticides, Qualitative Sybr green genotyping, Myzus persicae, MACE, R81T, General Medicine, kdr and super-kdr resistance, Insecticide Resistance, L1014F, Settore AGR/11 - ENTOMOLOGIA GENERALE E APPLICATA, M918L, Aphids, Insect Science, Mutation, Pyrethrins, Animals, Humans, M918T, Agronomy and Crop Science, Solanum tuberosum
Abstract: The massive use of synthetic insecticides strongly affects the level of insecticide resistance in populations of Myzus persicae worldwide. The selection of target site insensitivity-mutations is particularly worrying in areas where agro-industrial crops are vulnerable to the attacks of aphids that vector viruses, as in the case of Tunisia. Knowledge of the resistance mechanisms evolved locally in this aphid pest is a prerequisite to improving and retaining the sustainability of integrated pest management strategies.Target site mutations were surveyed in several populations of M. persicae collected from peach and potato crops between 2011 and 2017 in three Tunisian regions using real-time allele-specific PCR. The L1014F mutation (kdr locus) was found at a moderate frequency mostly in the heterozygous state and the homozygous resistant genotype was very uncommon. The M918T mutation (super-kdr locus) was present in a few heterozygous individuals, whereas the M918L mutation was detected for the first time in Tunisia and extreme North Africa. This latter mutation was shown to be widespread and well-established in Tunisia mainly as homozygous individuals, and was more abundant on peach than on potato crops. The S431F mutation (MACE) was found in a few heterozygous individuals. No individuals carrying the R81T mutation linked to neonicotinoid resistance were detected.This study points out a critical situation for the efficacy of pyrethroid insecticides to control M. persicae populations in Tunisia. It also confirms the rapid spread of the M918L mutation which has been detected in many different areas of the Mediterranean basin. © 2022 Society of Chemical Industry.
Published: 2022
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24. Novel germline MET pathogenic variants in French patients with papillary renal cell carcinomas type I

Author: Molka Sebai, David Tulasne, Sandrine M. Caputo, Virginie Verkarre, Marie Fernandes, Célia Guérin, Fanny Reinhart, Séverine Adams, Christine Maugard, Olivier Caron, Marine Guillaud‐Bataille, Pascaline Berthet, Yves‐Jean Bignon, Brigitte Bressac‐de Paillerets, Nelly Burnichon, Jean Chiesa, Sophie Giraud, Sophie Lejeune, Jean‐Marc Limacher, Antoine Pauw, Dominique Stoppa‐Lyonnet, Hélène Zattara‐Cannoni, Sophie Deveaux, Rosette Lidereau, Stéphane Richard, and Etienne Rouleau
Subjects: Male, Germ Cells, Phenotype, Neoplastic Syndromes, Hereditary, Genetics, Humans, Female, Proto-Oncogene Proteins c-met, Carcinoma, Renal Cell, Kidney Neoplasms, Genetics (clinical)
Abstract: Hereditary papillary renal cell carcinoma (HPRC) is a rare inherited renal cancer syndrome characterized by bilateral and multifocal papillary type 1 renal tumors (PRCC1). Activating germline pathogenic variants of the MET gene were identified in HPRC families. We reviewed the medical and molecular records of a large French series of 158 patients screened for MET oncogenic variants. MET pathogenic and likely pathogenic variants rate was 12.4% with 40.6% among patients with familial PRCC1 and 5% among patients with sporadic PRCC1. The phenotype in cases with MET pathogenic and likely pathogenic variants was characteristic: PRCC1 tumors were mainly bilateral (84.3%) and multifocal (87.5%). Histologically, six out of seven patients with MET pathogenic variant harbored biphasic squamoid alveolar PRCC. Genetic screening identified one novel pathogenic variant MET c.3389TC, p.(Leu1130Ser) and three novel likely pathogenic variants: MET c.3257AT, p.(His1086Leu); MET c.3305TC, p.(Ile1102Thr) and MET c.3373TG, p.(Cys1125Gly). Functional assay confirmed their oncogenic effect as they induced an abnormal focus formation. The genotype-phenotype correlation between MET pathogenic variants and PRCC1 presentation should encourage to widen the screening, especially toward nonfamilial PRCC1. This precise phenotype also constitutes a strong argument for the classification of novel missense variants within the tyrosine kinase domain when functional assays are not accessible.
Published: 2022
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25. Benign Peripheral Non-cranial Nerve Sheath Tumors of the Neck

Author: Carlos Suárez, Fernando López, Juan P. Rodrigo, William M. Mendenhall, Remco de Bree, Antti A. Mäkitie, Vincent Vander Poorten, Robert P. Takes, Stefano Bondi, Luiz P. Kowalski, Ashok R. Shaha, Veronica Fernández-Alvarez, Julio C. Gutiérrez, Nina Zidar, Carlos Chiesa-Estomba, Primoz Strojan, Alvaro Sanabria, Alessandra Rinaldo, and Alfio Ferlito
Subjects: Neurofibroma, Humans, Pharmacology (medical), General Medicine, Nerve Sheath Neoplasms, Neurilemmoma, Neurosurgical Procedures, Rare cancers Radboud Institute for Health Sciences [Radboudumc 9], Aged
Abstract: Contains fulltext : 273922.pdf (Publisher’s version ) (Closed access) Benign peripheral non-cranial nerve sheath tumors are rare lesions, including both schwannomas and neurofibromas. These tumors arise from Schwann cells, and may originate from any peripheral, cranial, or autonomic nerve. Most of them are localized and sporadic but multifocal systemic forms can occur. Cervical sympathetic chain, brachial plexus, cervical plexus and spinal roots and nerves are the major nerve systems commonly affected. Dumbbell-shaped intra- and extradural tumors occur most commonly in the cervical spine, as well as purely extradural and paravertebral tumors. The management of these tumors has improved greatly owing to the developments in imaging techniques and surgical innovations such as endoscopically assisted approaches and robotic surgery. Microsurgical intracapsular excision of the tumor helped by the use of intraoperative fluorescent dyes and intraoperative neurophysiological monitoring minimize postoperative neural deficit, since most schwannomas are encapsulated. Most tumors can be removed with a low rate of complications and recurrence. Radiotherapy should be considered for growing lesions that are not amenable to surgery. In asymptomatic patients, observation and serial scans is an option for elderly infirm patients.
Published: 2022

26. Preoperative and postoperative predictors of clinical outcome of fenestrated and branched endovascular repair for complex abdominal and thoracoabdominal aortic aneurysms in an Italian multicenter registry

Author: Speziali Sara, Mascoli Chiara, Massimo Lenti, Simonte Gioele, Gargiulo Mauro, Logiacco Antonino, Carlo Pratesi, Kahlberg Andrea, Pratesi Carlo, Faggioli Gianluca, Aaron Fargion, Mauro Gargiulo, Gianluca Faggioli, Enrico Gallitto, Pini Rodolfo, Fargion Aaron, Isernia Giacomo, Roberto Chiesa, Bertoglio Luca, Fenelli Cecilia, Gallitto Enrico, Germano Melissano, Chiesa Roberto, Lenti Massimo, Giacomo Isernia, Melissano Germano, Gallitto E., Faggioli G., Melissano G., Fargion A., Isernia G., Lenti M., Pratesi C., Chiesa R., Gargiulo M., Luca B., Roberto C., Gianluca F., Aaron F., Cecilia F., Enrico G., Mauro G., Giacomo I., Massimo L., Antonino L., Chiara M., Germano M., Rodolfo P., Carlo P., Andrea K., Gioele S., Sara S., Gallitto, E., Faggioli, G., Melissano, G., Fargion, A., Isernia, G., Lenti, M., Pratesi, C., Chiesa, R., Gargiulo, M., Bertoglio, Luca, Chiesa, Roberto, Gianluca, F., Aaron, F., Cecilia, F., Enrico, G., Mauro, G., Giacomo, I., Massimo, L., Antonino, L., Chiara, M., Germano, M., Rodolfo, P., Carlo, P., Kahlberg, Andrea, Gioele, S., and Sara, S.
Subjects: Male, Registrie, Time Factors, Multivariate analysis, Complex aortic repair, Fenestrated/branched endograft, Juxta/pararenal aneurysm, Thoracoabdominal aneurysm, Aged, 80 and over, Aortic Aneurysm, Abdominal, Thoracic, Female, Hospital Mortality, Humans, Italy, Postoperative Complications, Registries, Retreatment, Retrospective Studies, Risk Assessment, Risk Factors, Treatment Outcome, Blood Vessel Prosthesis Implantation, Endovascular Procedures, 030204 cardiovascular system & hematology, Thoracoabdominal Aortic Aneurysms, 0302 clinical medicine, Retrospective Studie, 030212 general & internal medicine, Aged, 80 and over, Cardiology and Cardiovascular Medicine, Paraplegia, Human, medicine.medical_specialty, Time Factor, 03 medical and health sciences, medicine, Aortic Aneurysm, Thoracic, Proportional hazards model, business.industry, Risk Factor, Odds ratio, Perioperative, Vascular surgery, medicine.disease, Confidence interval, Surgery, Postoperative Complication, business, Aortic Aneurysm, Abdominal
Abstract: Objective: Complex aortic aneurysms (juxtarenal aortic aneurysms [JAAA], pararenal aortic aneurysms [PAAAs], thoracoabdominal aortic aneurysms TAAAs) are treated with increasing frequency through fenestrated and branched endovascular repair (F/B-EVAR); however, the outcome of these procedures is usually reported separately by single experiences and wider overviews are not frequent. The aim of this study was therefore to report an Italian experience analyzing the results obtained in four academic centers to evaluate the predictors of outcomes. Methods: Between 2008 and 2019, all consecutive patients undergoing F/B-EVAR in four Italian university centers were recorded prospectively and analyzed retrospectively. Preoperative comorbidities and postoperative complications were classified according with the Society for Vascular Surgery reporting standard. Postoperative complications and 30-day/in-hospital mortality were assessed as early outcomes. Survival, freedom from reinterventions and target visceral vessels patency were assessed as follow-up outcomes by Kaplan-Meier analysis. Risk factors for 30-day/in-hospital mortality and spinal cord ischemia (SCI) were determined by multivariate analysis. Risk factors for follow-up mortality and reinterventions were evaluated by Cox regression model. Results: Five hundred ninety-six patients underwent F/B-EVAR for 124 JAAAs (21%), 121 PAAAs (20%), and 351 TAAAs (59%). Elective and urgent procedures were performed in 520 (87%) and 76 (13%) cases, respectively. Postoperative cardiac, pulmonary, and renal complications were reported in 41 (7%), 50 (8%), and 80 (13%) patients, respectively. Seven bowel ischemia (1%) and 23 cerebrovascular complications (4%) occurred. Forty-seven (8%) patients suffered SCI with 17 cases (3%) of permanent paraplegia. Crawford's extent I-II-III TAAAs (odds ratio [OR], 13.41; 95% confidence interval [CI], 1.77-101.65; P =.012) and postoperative renal complications (OR, 3.84; 95% CI, 1.70-8.69; P =.001) independently predicted SCI. Thirty-two patients (5%) died in the perioperative period. Preoperative chronic renal failure (OR, 7.81; 95% CI, 7.81-26.31; P =.001), postoperative bowel ischemia (OR, 26.97; 95% CI, 3.37-215.5; P =.002), cardiac complications (OR, 5.77; 95% CI, 1.41-23.64; P ≤.001), cerebrovascular complications (OR, 28.63; 95% CI, 5.20-157.5; P
Published: 2021

27. Gene’s expression underpinning the divergent predictive value of [18F]F-fluorodeoxyglucose and prostate-specific membrane antigen positron emission tomography in primary prostate cancer: a bioinformatic and experimental study

Author: Matteo Bauckneht, Cecilia Marini, Vanessa Cossu, Cristina Campi, Mattia Riondato, Silvia Bruno, Anna Maria Orengo, Francesca Vitale, Sonia Carta, Silvia Chiola, Sabrina Chiesa, Alberto Miceli, Francesca D’Amico, Giuseppe Fornarini, Carlo Terrone, Michele Piana, Silvia Morbelli, Alessio Signori, Paola Barboro, and Gianmario Sambuceti
Subjects: Male, Glucose, Fluorodeoxyglucose F18, Positron-Emission Tomography, Positron Emission Tomography Computed Tomography, Prostate, Humans, Prostatic Neoplasms, General Medicine, General Biochemistry, Genetics and Molecular Biology
Abstract: Background Positron Emission Tomography (PET) imaging with Prostate-Specific Membrane Antigen (PSMA) and Fluorodeoxyglucose (FDG) represent promising biomarkers for risk-stratification of Prostate Cancer (PCa). We verified whether the expression of genes encoding for PSMA and enzymes regulating FDG cellular uptake are independent and additive prognosticators in PCa. Methods mRNA expression of genes involved in glucose metabolism and PSMA regulation obtained from primary PCa specimens were retrieved from open-source databases and analyzed using an integrative bioinformatics approach. Machine Learning (ML) techniques were used to create predictive Progression-Free Survival (PFS) models. Cellular models of primary PCa with different aggressiveness were used to compare [18F]F-PSMA-1007 and [18F]F-FDG uptake kinetics in vitro. Confocal microscopy, immunofluorescence staining, and quantification analyses were performed to assess the intracellular and cellular membrane PSMA expression. Results ML analyses identified a predictive functional network involving four glucose metabolism-related genes: ALDOB, CTH, PARP2, and SLC2A4. By contrast, FOLH1 expression (encoding for PSMA) did not provide any additive predictive value to the model. At a cellular level, the increase in proliferation rate and migratory potential by primary PCa cells was associated with enhanced FDG uptake and decreased PSMA retention (paralleled by the preferential intracellular localization). Conclusions The overexpression of a functional network involving four glucose metabolism-related genes identifies a higher risk of disease progression since the earliest phases of PCa, in agreement with the acknowledged prognostic value of FDG PET imaging. By contrast, the prognostic value of PSMA PET imaging is independent of the expression of its encoding gene FOLH1. Instead, it is influenced by the protein docking to the cell membrane, regulating its accessibility to tracer binding.
Published: 2023
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28. Outcomes of routine use of percutaneous access with large-bore introducer sheaths (>21F outer diameter) during endovascular aneurysm repair

Author: Rosalba Lembo, Luca Bertoglio, Sara Spelta, Germano Melissano, Alessandro Grandi, Roberto Chiesa, Simone Salvati, Diletta Loschi, Andrea Melloni, Melloni, A., Grandi, A., Spelta, S., Salvati, S., Loschi, D., Lembo, R., Melissano, G., Chiesa, R., and Bertoglio, L.
Subjects: Male, medicine.medical_specialty, Multivariate analysis, Percutaneous, Thoracic, medicine.medical_treatment, Preclose, 030204 cardiovascular system & hematology, Endovascular aneurysm repair, Blood Vessel Prosthesis Implantation, 03 medical and health sciences, 0302 clinical medicine, Catheterization, Peripheral, Stent graft, Humans, Medicine, Vascular closure device, 030212 general & internal medicine, Aged, Retrospective Studies, Univariate analysis, Endovascular, Hemostatic Techniques, business.industry, Endovascular Procedures, Equipment Design, Odds ratio, Vessel closure device, Confidence interval, Surgery, Femoral Artery, Treatment Outcome, ProGlide, Thoracoabdominal, Propensity score matching, Female, Cardiology and Cardiovascular Medicine, business, Vascular Closure Devices, Aortic Aneurysm, Abdominal
Abstract: Objective: The objective of this study was to evaluate the performance of percutaneous femoral access with large-bore sheaths (>21F outer diameter) mainly employed for thoracic and thoracoabdominal aortic endovascular treatment and to stratify the outcomes on the basis of the introducer size. Methods: Between December 2015 and December 2018, all consecutive patients who received endovascular repair through a percutaneous approach with a suture-mediated vascular closure device (VCD) and the preclose technique were included in a retrospective single-center study called Totally Percutaneous Approach to Endovascular Treatment of Aortic Aneurysms (PEVAR-PRO). The morphologic characteristics of the access vessels and patients' demographics were recorded, and 30-day closure success was defined as the primary end point. Analysis of the closure success comparing large-bore sheaths vs small-bore sheaths (≤21F outer diameter) was performed after 1:1 propensity score matching of preoperative confounding variables. Results: The closure success rate of the entire study cohort was 94% (622 femoral accesses in 360 patients; median age, 74 years; 84% male). Univariate analysis identified eight different factors associated with failure, but only two remained significant on multivariate analysis: diabetes (odds ratio [OR], 2.8; 95% confidence interval [CI], 1.3-6.2; P =.011) and common femoral artery stenosis >50% (OR, 4.5; 95% CI, 1.3-13.7; P =.019). After propensity score matching (1:1, 172 femoral accesses per group), closure success rate was not significantly different between large-bore and small-bore sheaths (90.7% vs 93.0%; P =.43). Multivariate analysis of the large-sheath group identified two factors associated with failure: small (
Published: 2021
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29. Artificial Intelligence in Coronary Computed Tomography Angiography: From Anatomy to Prognosis

Author: Mattia Chiesa, Marco Guglielmo, Gianluca Pontone, Laura Fusini, Mark G. Rabbat, Andrea Igoren Guaricci, Carlo N. De Cecco, Andrea Baggiano, Marly van Assen, Stefano Scafuri, Giuseppe Muscogiuri, Christian Tesche, Muscogiuri, G, Van Assen, M, Tesche, C, De Cecco, C, Chiesa, M, Scafuri, S, Guglielmo, M, Baggiano, A, Fusini, L, Guaricci, A, Rabbat, M, and Pontone, G
Subjects: Risk, Myocardial ischemia, Computed Tomography Angiography, Coronary Stenosi, Prognosi, Myocardial Ischemia, CAD, Review Article, Coronary Artery Disease, Fractional flow reserve, 030204 cardiovascular system & hematology, General Biochemistry, Genetics and Molecular Biology, 030218 nuclear medicine & medical imaging, Machine Learning, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Artificial Intelligence, Image Processing, Computer-Assisted, medicine, Humans, Diagnosis, Computer-Assisted, Coronary Vessel, Cardiac imaging, Computed tomography angiography, General Immunology and Microbiology, medicine.diagnostic_test, business.industry, Coronary Stenosis, Coronary computed tomography angiography, General Medicine, Middle Aged, Prognosis, medicine.disease, Coronary Vessels, Plaque, Atherosclerotic, Algorithm, Fractional Flow Reserve, Myocardial, Stenosis, Phenotype, Medicine, Calcium, Artificial intelligence, business, Algorithms, Human
Abstract: Cardiac computed tomography angiography (CCTA) is widely used as a diagnostic tool for evaluation of coronary artery disease (CAD). Despite the excellent capability to rule-out CAD, CCTA may overestimate the degree of stenosis; furthermore, CCTA analysis can be time consuming, often requiring advanced postprocessing techniques. In consideration of the most recent ESC guidelines on CAD management, which will likely increase CCTA volume over the next years, new tools are necessary to shorten reporting time and improve the accuracy for the detection of ischemia-inducing coronary lesions. The application of artificial intelligence (AI) may provide a helpful tool in CCTA, improving the evaluation and quantification of coronary stenosis, plaque characterization, and assessment of myocardial ischemia. Furthermore, in comparison with existing risk scores, machine-learning algorithms can better predict the outcome utilizing both imaging findings and clinical parameters. Medical AI is moving from the research field to daily clinical practice, and with the increasing number of CCTA examinations, AI will be extensively utilized in cardiac imaging. This review is aimed at illustrating the state of the art in AI-based CCTA applications and future clinical scenarios.
Published: 2020
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30. Sleep medicine in otolaryngology units: an international survey

Author: Cammaroto, Giovanni, Bianchi, Giulia, Zhang, Henry, Veer, Vik, Kotecha, Bhik, Jacobowitz, Ofer, Llatas, Marina Carrasco, de Apodaca, Paula Martinez Ruiz, Lugo, Rodolfo, Meccariello, Giuseppe, Iannella, Giannicola, Gobbi, Riccardo, Toh, Song Tar, Hsu, Ying-Shuo, Baghat, Ahmed Yassin, Lechien, Jerome R., Calvo-Henriquez, Christian, Chiesa-Estomba, Carlos, Barillari, Maria Rosaria, Ibrahim, Badr, Ayad, Tareck, Fakhry, Nicolas, Hoff, Paul, Thuler, Eric Rodrigues, Chan, Lyndon, Kastoer, Chloé, Ravesloot, Madeline, dos Santos Sobreira Nunes, Heloisa, De Vito, Andrea, Montevecchi, Filippo, Vicini, Claudio, Cammaroto, G., Bianchi, G., Zhang, H., Veer, V., Kotecha, B., Jacobowitz, O., Llatas, M. C., de Apodaca, P. M. R., Lugo, R., Meccariello, G., Iannella, G., Gobbi, R., Toh, S. T., Hsu, Y. -S., Baghat, A. Y., Lechien, J. R., Calvo-Henriquez, C., Chiesa-Estomba, C., Barillari, M. R., Ibrahim, B., Ayad, T., Fakhry, N., Hoff, P., Thuler, E. R., Chan, L., Kastoer, C., Ravesloot, M., De Vito, A., Montevecchi, F., Vicini, C., Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Laboratoire Parole et Langage (LPL), and Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS)
Subjects: medicine.medical_specialty, Neurology, [SDV]Life Sciences [q-bio], Concordance, Psychological intervention, otolaryngologists, Sleep medicine, hospital departments, OSA, Otolaryngology, 03 medical and health sciences, DISE, 0302 clinical medicine, otorhinolaryngologic surgical procedures, medicine, Robotic surgery, health care surveys, humans, Survey, sleep wake disorders, Sleep surgery, Soft palate, business.industry, 3. Good health, Europe, medicine.anatomical_structure, otolaryngology, sleep surgery, survey, Americas, clinical competence, 030228 respiratory system, Otorhinolaryngology, Family medicine, Human medicine, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract: PURPOSE: No study to date has described the overall landscape of sleep disorders management and training in otolaryngology departments of different countries. The aim of our study was to investigate and compare settings, diagnostic and therapeutic approaches and training programmes. METHODS: An international online survey was developed with the collaboration of the YO-IFOS (Young Otolaryngologists-International Federation of Otorhinolaryngological Societies) to assess the current practice of otolaryngologists in the management of sleep disorders. The survey also included a session dedicated to training. RESULTS: A total of 126 otolaryngologists completed the survey. The larger part of responses was collected from Central/South America and Europe. The majority of responders from South/Central America (97%) declared to be certified as sleep specialist while 49% of Europeans stated the opposite. Of responders 83% perform a drug-induced sleep endoscopy (DISE) before planning a possible surgical intervention. Soft palate and base of tongue interventions were the most common procedure, respectively performed in 94% and 79% of the cases. Residents were allowed to perform soft palate surgery in 77% of the cases. Upper airway stimulation (26% vs 10%), trans-oral robotic surgery (36% vs 11%) and radiofrequency of the base of the tongue (58% vs 25%) were preferred more frequently by European responders. The highest caseloads of soft palate surgery and bi-maxillary advancement were registered in the academic institutions. CONCLUSION: Significant concordance and few interesting divergences in diagnosis and treatment of sleep disorders were observed between nationalities and types of institution. Economic resources might have played a significant role in the therapeutic choice. Trainees' lack of exposure to certain interventions and to a sufficient caseload appeared to be the main burden to overcome.
Published: 2020
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31. Sex-Related Anatomical Feasibility Differences in Endovascular Repair of Thoracoabdominal Aortic Aneurysms With a Multibranched Stent-Graft

Author: Luca Bertoglio, Roberto Chiesa, Victor Bilman, Tommaso Cambiaghi, Niccolò Carta, Germano Melissano, Alessandro Grandi, Grandi, A., Carta, N., Cambiaghi, T., Bilman, V., Melissano, G., Chiesa, R., and Bertoglio, L.
Subjects: Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, endovascular repair, multibranched design, access vessels, anatomical feasibility, aortic anatomy, branched stent-graft, female sex, off-the-shelf stent-graft, target vessels, thoracoabdominal aortic aneurysm, Prosthesis Design, Thoracoabdominal Aortic Aneurysms, Blood Vessel Prosthesis Implantation, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Aged, Retrospective Studies, Aortic Aneurysm, Thoracic, business.industry, Endovascular Procedures, Female sex, Stent, Sex related, Blood Vessel Prosthesis, Surgery, Treatment Outcome, Feasibility Studies, Female, Stents, Cardiology and Cardiovascular Medicine, business
Abstract: Purpose:To evaluate the potential anatomical feasibility of using the off-the-shelf multibranched Zenith t-Branch for the treatment of thoracoabdominal aortic aneurysms (TAAAs) in female patients.Materials and Methods:A total of 268 patients (median age 68 years; 69 women) with degenerative TAAA treated at a single institution by means of open or endovascular repair between 2007 and 2019 were retrospectively analyzed to determine the feasibility of using the Zenith t-Branch based on the manufacturer’s instructions for use. The factors determining overall anatomical feasibility were divided into vascular access, aortic anatomy, and visceral vessels. The results were stratified by sex and compared. A logistic regression model was constructed to determine any association between feasibility and clinical factors or potential confounding variables; results are expressed as the odds ratio (OR) with 95% confidence interval (CI).Results:The overall anatomical feasibility was 39% (22% women vs 45% men, p=0.001). The feasibility was negatively influenced by female sex (pConclusion:A little more than a third of an all-comers cohort of patients with degenerative TAAA could have been treated with on-label use of the Zenith t-Branch. However, only 22% of women could have been treated because of sex-related anatomical limitations. New generations of multibranched devices should address these differences.
Published: 2020
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32. Emergency management of the COVID‐19 pandemic in a vascular surgery department of a large metropolitan hospital in Italy. Preparation, escalation, de‐escalation, and normal activity

Author: Daniele Mascia, Roberto Chiesa, Enrico Rinaldi, Andrea Kahlberg, Chiesa, R., Kahlberg, A., Rinaldi, E., and Mascia, D.
Subjects: Pulmonary and Respiratory Medicine, vascular complications, Coronavirus disease 2019 (COVID-19), 030204 cardiovascular system & hematology, 03 medical and health sciences, Hospitals, Urban, 0302 clinical medicine, Pandemic, Humans, Medicine, Surgical treatment, Pandemics, Emergency management, SARS-CoV-2, business.industry, pandemic, COVID-19, medicine.disease, Metropolitan area, Vascular surgery department, Italy, 030228 respiratory system, emergencies, Surgery, Medical emergency, Cardiology and Cardiovascular Medicine, business, De-escalation, Healthcare system
Abstract: Background During the first phase of coronavirus disease-2019 (COVID-19) pandemic in Italy, several strategies have been taken to deal with the pandemic outbreak. Aim of the study To report the remodeling of the Vascular Surgery Department of San Raffaele Hospital as regards the strategies of preparation, escalation, and return to normal activities during the COVID-19 pandemic. Preparation, escalation, de-escalation The Regional Authority of Lombardy remodeled the hospitalization system to allocate appropriate resources to treat patients with COVID-19 and to identify "Hub/Spoke" hospitals for highly specialized medical activities. The Hubs hospitals were required to guarantee full-time evaluation of all patients presenting with cardiovascular diseases with an independent pathway for patients with suspect or confirmed COVID-19 infection. San Raffaele Hospital was identified as Hub for cardiovascular emergencies and the Vascular Surgery Department was remodeled to face this epidemic situation. Surgical treatment was reserved only to symptomatic, urgent, or emergent cases. Large areas of the hospital were simultaneously reorganized to assist patients with COVID-19. Results During this period, 135 patients were referred to San Raffaele Vascular Surgery Department. COVID-19 was diagnosed in 24 patients and, among them, acute limb ischemia was the most common cause of admission. At this time, the COVID-19 trend is in decline in Italy, and the local authorities reorganized the healthcare system to return to normal activities avoiding new escalations of COVID-19 cases. The COVID-19 pandemic will be remembered in Lombardy as a cataclysm. Nevertheless, the HUB/spoke system has proven to be a valid model in the management of ischemic emergencies. Continuous surveillance, cooperation, coordination, and communication to effectively respond to COVID-19 pandemic is crucial because COVID-19 reference centers could face similar issues in the near future.
Published: 2020
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33. Elevated blood pressure, cardiometabolic risk and target organ damage in youth with overweight and obesity

Author: Claudia Forziato, Lucia Pacifico, Anita Morandi, Melania Manco, Giuseppina Campana, Claudio Maffeis, Emanuele Miraglia del Giudice, Giuliana Valerio, Giovanni de Simone, Claudio Chiesa, Sandro Loche, Marco Giorgio Baroni, Maria Rosaria Licenziati, Luisa Gilardini, Nicola Moio, Gianluca Tornese, Procolo Di Bonito, Anna Di Sessa, Di Bonito, P., Pacifico, L., Licenziati, M. R., Maffeis, C., Morandi, A., Manco, M., del Giudice, E. M., Di Sessa, A., Campana, G., Moio, N., Baroni, M. G., Chiesa, C., De Simone, G., Valerio, G., Forziato, C., Gilardini, L., Loche, S., and Tornese, G.
Subjects: Carotid Artery Diseases, Male, Pediatric Obesity, Cross-sectional study, Endocrinology, Diabetes and Metabolism, Left ventricular ma, Liver steatosis, Medicine (miscellaneous), Blood Pressure, 030204 cardiovascular system & hematology, Overweight, Adolescents, Body Mass Index, Left ventricular mass, Prehypertension, 0302 clinical medicine, Non-alcoholic Fatty Liver Disease, Risk Factors, Carotid intima media thickness, Prevalence, Child, Children, Carotid intima media thickne, education.field_of_study, Nutrition and Dietetics, Age Factors, Left Ventricular, Italy, Cardiovascular Diseases, Child, Preschool, Liver steatosi, Elevated blood pressure, Obesity, Adolescent, Cross-Sectional Studies, Female, Humans, Hypertrophy, Left Ventricular, Insulin Resistance, Risk Assessment, medicine.symptom, Cardiology and Cardiovascular Medicine, medicine.medical_specialty, Population, 030209 endocrinology & metabolism, 03 medical and health sciences, Insulin resistance, Internal medicine, medicine, Preschool, education, business.industry, Hypertrophy, medicine.disease, Blood pressure, business, Body mass index
Abstract: Background and aim: To compare cardiometabolic risk profile and preclinical signs of target organ damage in youth with normal and elevated blood pressure (BP), according to the American Academy of Pediatrics (AAP) guidelines. Methods and results: This cross-sectional multicenter study included 2739 youth (5-17 year-old; 170 normal-weight, 610 overweight and 1959 with obesity) defined non hypertensive by the AAP guidelines. Anthropometric, biochemical and liver ultrasound data were available in the whole population; carotid artery ultrasound and echocardiographic assessments were available respectively in 427 and 264 youth. Elevated BP was defined as BP >= 90th to = 120/80 to
Published: 2020
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34. ACE2 & TMPRSS2 Expressions in Head & Neck Tissues: A Systematic Review

Author: Christian Calvo-Henriquez, Thomas Radulesco, Justin Michel, Carlos M. Chiesa-Estomba, Giacomo De Riu, Julien Hsieh, Géraldine Descamps, Leigh J. Sowerby, Luigi Angelo Vaira, Jerome R. Lechien, Giovanni Cammaroto, Sven Saussez, Stéphane Hans, Isabelle Gengler, Maria Rosaria Barillari, Institut universitaire des systèmes thermiques industriels (IUSTI), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Lechien, J. R., Radulesco, T., Calvo-Henriquez, C., Chiesa-Estomba, C. M., Hans, S., Barillari, M. R., Cammaroto, G., Descamps, G., Hsieh, J., Vaira, L., De Riu, G., Sowerby, L., Gengler, I., Michel, J., and Saussez, S.
Subjects: 0301 basic medicine, Cell type, medicine.medical_specialty, Pathology, Coronaviru, Population, ACE2, Review, Cochrane Library, urologic and male genital diseases, TMPRSS2, Pathology and Forensic Medicine, 03 medical and health sciences, Basal (phylogenetics), 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, medicine, Animals, Humans, 10. No inequality, education, COVID, education.field_of_study, Head Neck, SARS-CoV-2, business.industry, Serine Endopeptidases, COVID-19, 3. Good health, Coronavirus, 030104 developmental biology, Oncology, Otorhinolaryngology, 030220 oncology & carcinogenesis, Oral and maxillofacial surgery, Angiotensin-Converting Enzyme 2, Animal studies, business, Head, Neck, hormones, hormone substitutes, and hormone antagonists
Abstract: International audience; To review the data regarding the expression of angiotensin converting enzyme-2 (ACE2) and transmembrane protease serine-2 (TMPRSS2) in head and neck tissue. Scopus, Cochrane Library, Medrxiv, Google Scholar and PubMED/MEDLINE were searched by four independent investigators for studies investigating ACE2 or TMPRSS2 expressions in head and neck tissues. The following outcomes were considered: sample origin (animal versus human); detection method; anatomical location and cell types. PRISMA checklist and modified population, intervention, comparison, outcome, timing and setting (PICOTS) framework were used to perform the review. Of the 24 identified studies, 17 met our inclusion criteria. Thirteen studies were conducted during the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic. ACE2 and TMPRSS2 were expressed in oral, pharyngeal, sinusonasal human mucosa. The following cell types expressed ACE2: basal, apical, goblet, minor salivary, and endothelial cells. TMPRSS2 was found in goblet and apical respiratory cells. ACE2 and TMPRSS2 were found in the olfactory region, especially in sustentacular non-neural and neural stem cells. Animal studies suggested that ACE2 expression may vary regarding age. There was an important heterogeneity between studies in the methods used to detect ACE2 and TMPRSS2, leading to a potential identification bias. The SARS-CoV-2 receptors, ACE2 and TMPRSS2, are both expressed in many head and neck tissues, enabling the viral entry into the host organism.
Published: 2020
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35. Early Limb Reperfusion Using Routinely Preloaded Fenestrated Stent-graft Designs for Complex Endovascular Aortic Procedures

Author: Germano Melissano, Alessandro Grandi, Victor Bilman, Diletta Loschi, Andrea Melloni, Luca Bertoglio, Roberto Chiesa, Bertoglio, L., Loschi, D., Grandi, A., Melloni, A., Bilman, V., Melissano, G., and Chiesa, R.
Subjects: Male, Branched, Endovascular, Fenestrated, Ischemia, Limb, Paraplegia, Spinal cord, Thoraco-abdominal aneurysms, medicine.medical_specialty, Blood transfusion, medicine.medical_treatment, Prosthesis Design, Endovascular aneurysm repair, Blood Vessel Prosthesis Implantation, Postoperative Complications, Aneurysm, Risk Factors, Preoperative Care, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Adverse effect, Aorta, Aged, Leg, business.industry, Endovascular Procedures, Stent, Vascular surgery, medicine.disease, Aortic Aneurysm, Blood Vessel Prosthesis, Surgery, Reperfusion, Female, Stents, Cardiology and Cardiovascular Medicine, business
Abstract: Introduction: To evaluate the outcomes of the preloaded stent-graft design (PLD) in the routine treatment of pararenal and thoraco-abdominal aneurysms compared to the standard design (SND). Methods: Patients treated by fenestrated/branched endovascular aneurysm repair from 2013 were collected. Since 2017, PLD (23F delivery system) was implemented in our standard practice and the outcomes are reported. Primary outcome measurements were: technical success, 30-day adverse events, leg ischemia time, procedural time and radiation exposure. Secondary outcome measurements were: intraoperative urinary output, need of bicarbonate supplementation, postoperative biomarkers elevations and need for blood transfusions. A propensity 1:1 matching for graft design and aneurysm extent was performed with the SND (18F delivery system) cohort to highlight possible PLD advantages. Results: A PLD was employed in 32 non-consecutive patients with a technical and clinical success rate of 100% and 81% respectively: no mortality was recorded. The Society for Vascular Surgery grade ≥ 1 adverse event was observed in 10 cases (31%): five temporary paraparesis were observed. Seventeen PLD patients were matched. The procedural time was shorter in PLD group (266 vs. 390min; p = 0.001) as well as fluoroscopy time (68 vs. 96min; p = 0.019) and contrast media used (180 vs. 382ml; p = 0.045). Contralateral limb ischemic time was significantly higher in SND group (0 vs. 70min; p = 0.042). The need for blood transfusion and the postoperative peak of creatine phosphokinase was lower in PLD group (151 vs. 449 U/l; p < 0.001). Conclusions: Preloaded stent-graft design allows a uni-femoral approach in the majority of the interventions reducing procedural times and the ischemia on the contralateral leg, leading to possible benefits.
Published: 2020
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36. Elective Embolization of Splenic Artery Aneurysms with an Ethylene Vinyl Alcohol Copolymer Agent (Squid) and Detachable Coils

Author: Diego Palumbo, Francesco De Cobelli, Carolina Lanza, Massimo Venturini, Roberto Chiesa, Anna Colarieti, Germano Melissano, Giorgia Guazzarotti, Paolo Marra, Luigi Augello, Venturini, M., Marra, P., Augello, L., Colarieti, A., Guazzarotti, G., Palumbo, D., Lanza, C., Melissano, G., Chiesa, R., and De Cobelli, F.
Subjects: Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Ischemia, Splenic artery, Revascularization, Asymptomatic, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, Aneurysm, medicine.artery, Occlusion, medicine, Humans, Radiology, Nuclear Medicine and imaging, Embolization, Aged, Retrospective Studies, Aged, 80 and over, medicine.diagnostic_test, business.industry, Middle Aged, medicine.disease, Embolization, Therapeutic, Surgery, Treatment Outcome, 030220 oncology & carcinogenesis, Angiography, Female, Polyvinyls, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Splenic Artery
Abstract: Purpose To report the safety and efficacy of the embolization of splenic artery aneurysms (SAAs) with coils plus ethylene vinyl alcohol copolymer (EVOH) agent. Materials and Methods A single-center retrospective study was conducted from 2016 to 2019 to collect SAAs. Twelve asymptomatic patients (mean age, 59 years) with 15 SAAs (mean size, 23.6 mm; size range, 15–40 mm) were treated with embolization. Embolization was performed with EVOH (Squid 8/34) and fibered detachable coils. Transfemoral embolization was performed with a microcatheter to achieve a splenic artery occlusion embolizing the SAA and its efferent and afferent branches. Follow-up was based on color Doppler ultrasound at 24 hours and on computed tomography (CT) angiography at 1 (n = 12) and 6 months (n = 12) after embolization. Mean number of coils and Squid vials used for each patient, major/minor complications, technical success, 30-day clinical success, cases of revascularization/reintervention, and mortality were assessed. Technical success was defined as complete exclusion of the aneurysmal segment and cessation of blood flow into the sac. Clinical success at 1 month was based on the absence of clinical symptoms and the exclusion of aneurysm revascularization on CT angiography. Results The mean number of coils and Squid vials was 5.75 (standard deviation [SD], 1.58; range, 3–9) and 1.41 (SD, 0.49; range, 1–2), respectively. Both technical and 30-day clinical success were 100%, with no cases of aneurysm revascularization (CT angiography performed in all patients at 1 month and 6 months and in 3 patients at 24 months). No major complications or fatal events were recorded. In terms of minor complications, 2 cases of mild pancreatitis (transient amylases increase) and 1 case of focal splenic ischemia without clinical sequelae were recorded. Conclusions Embolization in SAAs using coils plus EVOH was safe and effective without SAA revascularization
Published: 2020
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37. Safety and Feasibility of Percutaneous Purse-String-Like Downsizing for Femoral Access During Complex Endovascular Aortic Repair

Author: Luca Bertoglio, Roberto Chiesa, Andrea Melloni, Germano Melissano, Alessandro Grandi, Melloni, A., Grandi, A., Melissano, G., Chiesa, R., and Bertoglio, L.
Subjects: Femoral, Male, medicine.medical_specialty, Percutaneous, Ischemia, Downsizing, Limb, 030218 nuclear medicine & medical imaging, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Aneurysm, Suture (anatomy), FEVAR, Humans, Medicine, EVAR, Radiology, Nuclear Medicine and imaging, Vascular closure device, Access, Spinal cord ischemia, Thoracoabdominal, Aged, Aorta, Aortic Aneurysm, Endovascular Procedures, Feasibility Studies, Female, Femoral Artery, Retrospective Studies, Treatment Outcome, Ultrasonography, Interventional, Vascular Closure Devices, Ultrasonography, Interventional, Pelvis, business.industry, Multimodal therapy, medicine.disease, Surgery, medicine.anatomical_structure, Hemostasis, Cardiology and Cardiovascular Medicine, business
Abstract: Purpose: To describe a percutaneous “purse-string-like” technique to downsize the femoral access sheath achieving early pelvis and limb reperfusion during complex endovascular aortic repair, while maintaining a sheath in place. Materials and Methods: After ultrasound-guided femoral catheterization, two Perclose ProGlide vascular closure devices (VCD) are employed with the pre-close technique. When the deployment of aortic components is complete, the large delivery sheath is exchanged for a smaller non-occlusive one (≤ 10 F) and the rail suture of both VCDs is pulled to achieve hemostasis. At the end of the procedure, the access is closed according to standard technique. Results: Fifty-eight femoral accesses were downsized achieving hemostasis with a completion percutaneous closure success of 95% (55/58). The median ischemic time to the limb was 66min (IQR 31–131) for the main access and 65min (IQR 30–100) for the contralateral one. When compared to a 1:2 propensity score-matched cohort who did not undergo access downsizing, no differences in closure success were recorded (95% vs. 89%, p = 0.19). However, hemostasis required more frequently an additional ProGlide in the downsizing group (26 cases, 45% vs. 17 cases, 15%; p
Published: 2020
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38. Elective Multistaged Endovascular Repair of Thoraco-abdominal Aneurysms with Fenestrated and Branched Endografts to Mitigate Spinal Cord Ischaemia

Author: Enrico Rinaldi, Germano Melissano, Andrea Kahlberg, Daniele Mascia, Maria Katsarou, Diletta Loschi, Roberto Chiesa, Luca Bertoglio, Rosalba Lembo, Bertoglio, L., Katsarou, M., Loschi, D., Rinaldi, E., Mascia, D., Kahlberg, A., Lembo, R., Melissano, G., and Chiesa, R.
Subjects: Male, medicine.medical_specialty, Endoleak, Staged, Single step, 030204 cardiovascular system & hematology, 030230 surgery, Branched, Endovascular, Fenestrated, Paraplegia, Prevention, Spinal cord, Thoraco-abdominal aneurysms, Blood Vessel Prosthesis Implantation, 03 medical and health sciences, 0302 clinical medicine, Aneurysm, medicine, Humans, Statistical analysis, Aged, Aged, 80 and over, Aortic Aneurysm, Thoracic, Spinal Cord Ischemia, business.industry, Endovascular Procedures, Middle Aged, medicine.disease, Blood Vessel Prosthesis, Surgery, medicine.anatomical_structure, Elective Surgical Procedures, Spinal cord ischaemia, Female, Stents, Abdominal aneurysm, Cardiology and Cardiovascular Medicine, business, Surgical patients
Abstract: Objectives To evaluate the safety and effectiveness of a multistaged approach for elective thoraco-abdominal aneurysm (TAAAs) repair by means of endovascular fenestrated and/or branched (F/B-EVAR) grafts. Methods Between 2013 and 2018, 80 high risk surgical patients received elective F/B-EVAR for TAAAs with a protocolled multistaged approach (thoracic, visceral, and limb steps) and were enrolled in an ambispective single centre study called STEAR (STaged Endovascular Aortic Repair - NCT03342755 ). Data regarding all study participants, single step mortality and morbidity (systemic complications) rates were recorded and the overall results were considered for statistical analysis. Results Previous aortic interventions (61/80 cases, 76.3%) combined with the TAAA extents resulted in different staging strategies: 58 patients (73%) had a thoracic step and 33 (41%) a limb step. The median TAAA treatment time was 77 days (50–107). The overall mortality was six cases (8%) and 30 day clinical success rate 64 cases (80%). The overall rate of grade 2 or 3 (including death) systemic complications was 19 cases (24%) and 20 patients (25%) experienced grade 1 complications. Three patients with type II or III TAAAs (4%) had permanent and fatal spinal cord (SC) impairment. On multivariable analysis, SC ischaemia was associated with an aortic coverage ≥350 mm (OR: 9.15, p = .03, 95% CI: 1.3–66.4) and bovine arch (OR: 10.6, p = .01, 95% CI: 1.6–68.6). The overall short term (six month) clinical success was 72 cases (90%) and none experienced SC ischaemia after late endoleak resolution or treatment. At mid term (mean follow up: 13.3 ± 15.4 months), the overall freedom from conversions, re-interventions, late rupture, or type I and III endoleaks was 57 of 72 survivors (79%). Conclusions A multistaged approach with a third limb step in case of TAAAs is safe and technically feasible, with an acceptable rate of permanent spinal cord ischaemia. Different staging methods and protocols have been proposed and standardisation is required, especially for type I-II-III aneurysms.
Published: 2020
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39. Isolated fallopian tube torsion in pediatric age: An Italian multicenter retrospective study

Author: Silvana Federici, Mirko Bertozzi, Francesco Molinaro, Giovanni Cobellis, Mario Messina, Carmine Noviello, Alberto Ratta, Gabriele Lisi, Pierluigi Lelli Chiesa, Ascanio Martino, Bertozzi, M., Noviello, C., Molinaro, F., Ratta, A., Lisi, G., Cobellis, G., Federici, S., Chiesa, P. L., Martino, A., and Messina, M.
Subjects: Torsion Abnormality, Abdominal pain, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Fallopian Tube Disease, Salpingectomy, 03 medical and health sciences, 0302 clinical medicine, Retrospective Studie, Isolated fallopian tube torsion, 030225 pediatrics, Laparotomy, Pediatric surgery, medicine, Humans, Children, Conservative management, Fertility, Hydrosalpinx, Child, Laparoscopy, Fallopian Tubes, Sport, Retrospective Studies, Ultrasonography, Abdomen, Acute, medicine.diagnostic_test, business.industry, General surgery, Retrospective cohort study, General Medicine, Fallopian Tube Diseases, Italy, Acute abdomen, 030220 oncology & carcinogenesis, Pediatrics, Perinatology and Child Health, Fallopian Tube, Female, Surgery, Fallopian tube torsion, medicine.symptom, business, Human, Sports
Abstract: Purpose The purpose of this study was to quantify the experience of five Italian centers on the diagnosis and management of isolated fallopian tube torsion (IFTT) in children. Methods We retrospectively reviewed the data of 20 patients aged 1–16 years of age with surgically diagnosed IFTT between 1991 and 2017 from five Italian centers of pediatric surgery. We analyzed common presenting signs, symptoms, and radiographic findings, as well as surgical interventions to describe management offering further insight into the diagnosis and treatment of this rare entity. Results Twenty cases of IFTT were collected. Median age was 13.1 years. Menarche was present in 14 cases. A clinical history of abdominal pain was present in 13 patients, whereas in 7 patients the clinical picture was an acute abdomen. Ultrasonography was the first diagnostic examination in 16 cases. Surgical approach was by laparoscopy in 16 cases and laparotomy in 4 cases. In 11 patients IFTT was associated with another pathologic condition. In 7 of the remaining 9 IFTT without pathologic association, the girls played sports. Salpingectomy was performed in 13 patients and de-torsion in 7. Conclusions IFTT is a rare condition that seems to occur in younger adolescents. Vague clinical presentation contributes to low preoperative suspicion. IFTT should be considered in girls with abdominal pain who practice sports with sudden body movements. Preoperative suspicion may be increased based on radiographic findings of an enlarged tubular/cystic structure with adjacent normal ovary. Conservative management is controversial but could be preferred in order to provide the best option for future fertility of these girls. Type of Study Treatment Study (Retrospective Study) – Level IV.
Published: 2020
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40. Intraoperative electroneurography-guided intercostal nerve cryoablation for pain control after thoracoabdominal aneurysm open surgical repair

Author: Daniele MASCIA, Andrea KAHLBERG, Sarah TINAGLIA, Americo PENA, Dhaniel MORGAD DE FREITAS, Ubaldo DEL CARRO, Luca BOSCO, Fabrizio MONACO, Monica DE LUCA, Roberto CHIESA, Germano MELISSANO, Mascia, Daniele, Kahlberg, Andrea, Tinaglia, Sarah, Pena, Americo, Morgad DE Freitas, Dhaniel, Del Carro, Ubaldo, Bosco, Luca, Monaco, Fabrizio, DE Luca, Monica, Chiesa, Roberto, and Melissano, Germano
Subjects: Male, Pain, Postoperative, Treatment Outcome, Aortic Aneurysm, Thoracic, Humans, Pain Management, Intercostal Nerves, Middle Aged, Cardiology and Cardiovascular Medicine, Cryosurgery, Retrospective Studies
Abstract: Background: Postoperative pain after thoracoabdominal (TAAA) or thoracic (TAA) aortic aneurysm open surgical repair may be debilitating and induce limitations in mobilization resulting in a longer length of stay, higher rate of pulmonary adverse events, readmissions, and a higher risk of mortality. Commonly employed analgesic strategies do not completely solve this issue and have their own drawbacks. Cryoablation of intercostal nerves has been proposed as an appealing alternative to address the postoperative pain. Methods: Between 2020 and 2021, data of all consecutive patients undergoing TAA or TAAA aortic aneurysms open repair with electroneurography-guided cryoablation of intercostal nerves were collected. Postoperative pain was recorded using patient-reported 0-10 numeric rating scale (NRS). Need for adjunctive opioid drugs and postoperative complications were also recorded. Narcotic usage was calculated as morphine milligram equivalents (MMEs) per day. Results: A total of 15 patients (8 males, mean age 61.1-year-old) underwent open surgical repair for TAAA (13 cases) or TAA (2 cases) and received intercostal nerve cryoablation. There were no intraoperative deaths and cases of spinal cord ischemia. Overall, 70 intercostal nerves underwent electroneurography-guided cryoablation, with a mean of 4.6 nerves per patient. On the first day after extubating, mean NRS was 4.6 and the MMEs calculated was 6.7, decreasing over the days. There was one case of pneumonia and atelectasis requiring bronchoscopy. There were no reported bowel complications. The mean postoperative length of stay was 16 days and in the intensive care unit stay was 6.5 days. Conclusions: Electroneurography-guided cryoablation of intercostal nerves is a safe and reproducible technique which can be used in addition to systemic pain management for TAA and TAAA open repair.
Published: 2022
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41. The STABILISE technique to address malperfusion on acute-subacute type B aortic dissections

Author: Daniele MASCIA, Enrico RINALDI, Andrea KAHLBERG, Fabrizio MONACO, Monica DE LUCA, Roberto CHIESA, Germano MELISSANO, Mascia, Daniele, Rinaldi, Enrico, Kahlberg, Andrea, Monaco, Fabrizio, DE Luca, Monica, Chiesa, Roberto, and Melissano, Germano
Subjects: Aortic Dissection, Blood Vessel Prosthesis Implantation, Treatment Outcome, Aortic Aneurysm, Thoracic, Endovascular Procedures, Humans, Surgery, Stents, General Medicine, Cardiology and Cardiovascular Medicine, Aortic Aneurysm, Abdominal, Blood Vessel Prosthesis, Retrospective Studies
Abstract: Endovascular treatment is the current standard of care for complicated acute and subacute type B aortic dissection. Closure of the primary entry tear with thoracic endovascular aneurysm repair (TEVAR) is often insufficient to induce complete false lumen thrombosis and a positive aortic remodeling. Moreover TEVAR doesn't solve all the cases of malperfusion. The Provisional ExTension to Induce COmplete ATtachment (PETTICOAT) technique (deploying self-expandable bare metal stents in the true lumen in addition to TEVAR) can re-expand the true lumen, stabilize the lamella and promote aortic remodeling, but it does not recreate a single-lumen aorta and long-term aneurysmal degeneration of the aorta is frequent. Endovascular treatment by means of TEVAR + PETTICOAT does not recreate a single-lumen aorta so long-term aneurysmal degeneration of the aorta is frequent. The stent-assisted, balloon-induced intimal disruption and relamination of aortic dissection (STABILISE) technique may help to this purpose disrupting the intimal lamella and creating a relaminated uni-luminal aorta.
Published: 2022

42. Abnormal Liver Tests during Hospitalization Predict Mortality in Patients with COVID-19: A Multicenter Study from South America

Author: Yanina Carlino, Isadora Z Bombassaro, Domingo Balderramo, Jhon Prieto, Javier Diaz-Ferrer, Denusa Wiltgen, Victoria Mulqui, Jose D. Debes, Laura Tenorio Castillo, Jaysoom Abarca, Zuly Plácido-Damián, Andrea Bolomo, Enrique Carrera, Talita Chiesa, Karina Díaz, Angelo Z. Mattos, Johana Acuña, and Estela Manero
Subjects: Adult, Male, medicine.medical_specialty, Article Subject, Coronavirus disease 2019 (COVID-19), RC799-869, Comorbidity, law.invention, Risk Factors, law, Internal medicine, medicine, Humans, Hospital Mortality, Risk factor, Retrospective Studies, Hepatology, medicine.diagnostic_test, SARS-CoV-2, business.industry, Gastroenterology, COVID-19, Retrospective cohort study, General Medicine, Odds ratio, Diseases of the digestive system. Gastroenterology, Middle Aged, medicine.disease, Intensive care unit, Confidence interval, Hospitalization, Intensive Care Units, Liver, business, Liver function tests, Research Article
Abstract: Background. The role of liver function tests (LFT) as prognostic factors in patients admitted with COVID-19 has not been fully investigated, particularly outside resource-rich countries. We aimed at evaluating the prognostic value of abnormal LFT on admission and during hospitalization of patients with COVID-19. Methods. We performed a retrospective study that included 298 adult patients hospitalized for COVID-19, between 05/2020 and 02/2021, in 6 hospitals from 5 countries in South America. We analyzed demographic and comorbid variables and laboratory tests on admission and during hospitalization. LFT over twice the upper limit of normal (ALEx2) were also evaluated in relation to a variety of factors on admission and during hospitalization. De novo-ALEx2 was defined as the presence of ALEx2 at one week of hospitalization in patients without ALEx2 on admission. Patients were followed until hospital discharge or death. Multivariable analysis was used to evaluate the association between ALEx2 on admission and during hospitalization and mortality. Results. Of the total of 298 patients, 60% were male, with a mean age of 60 years, and 74% of patients had at least one comorbidity. Of those, 137 (46%) patients were transferred to the intensive care unit and 66 (22.1%) patients died during hospitalization. ALEx2 on admission was present in 87 (29.2%) patients and was found to be independently associated with 1-week mortality (odds ratio (OR) = 3.55; 95% confidence interval (95%CI) 1.05–12.05). Moreover, 84 (39.8%) out of 211 patients without ALEx2 at admission developed de novo-ALEx2, which was independently associated with mortality during second week of hospitalization (OR = 6.09; 95%CI 1.28–29) and overall mortality (OR = 2.93, 95%CI 1.05–8.19). Conclusions. A moderate elevation of LFT during admission was associated with a poor short-term prognosis in patients hospitalized with COVID-19. In addition, moderate elevation of LFT at one week of hospitalization was an independent risk factor for overall mortality in these patients.
Published: 2021
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43. CAR T cells with dual targeting of CD19 and CD22 in pediatric and young adult patients with relapsed or refractory B cell acute lymphoblastic leukemia: a phase 1 trial

Author: Nushmia Z. Khokhar, Denise Bonney, Paul Virgo, Saket Srivastava, Simon Thomas, Ram Jha, Jan Chu, Shaun Cordoba, Robert Chiesa, Persis Amrolia, Yiyun Zhang, Jeremy Hancock, Rachael Hough, Carlotta Peticone, Shimobi Onuoha, Kanchan Rao, Vania Baldan, Kevin Duffy, Paul Veys, Lucy Wheeler, Robert Wynn, William Day, Daniela Soriano Pignataro, Sara Ghorashian, Giovanna Lucchini, Koval Smith, Martin Pule, Liz Clark, Vijay G R Peddareddigari, Mathieu Ferrari, Sabine Domning, Ajay Vora, Frederick Arce Vargas, Muhammad Al-Hajj, Mei Mei Fung, and Farzin Farzaneh
Subjects: Oncology, Adult, Male, medicine.medical_specialty, Antigen Targeting, Adolescent, Sialic Acid Binding Ig-like Lectin 2, Antigens, CD19, Cancer immunotherapy, Immunotherapy, Adoptive, Pediatrics, General Biochemistry, Genetics and Molecular Biology, Article, Paediatric cancer, Young Adult, Phase I trials, hemic and lymphatic diseases, Internal medicine, Precursor B-Cell Lymphoblastic Leukemia-Lymphoma, medicine, Clinical endpoint, Humans, Young adult, Adverse effect, Child, Acute lymphocytic leukaemia, Receptors, Chimeric Antigen, business.industry, Infant, General Medicine, medicine.disease, Chimeric antigen receptor, Progression-Free Survival, Cytokine release syndrome, medicine.anatomical_structure, Child, Preschool, Toxicity, Female, Bone marrow, Immunotherapy, business
Abstract: Chimeric antigen receptor (CAR) T cells targeting CD19 or CD22 have shown remarkable activity in B cell acute lymphoblastic leukemia (B-ALL). The major cause of treatment failure is antigen downregulation or loss. Dual antigen targeting could potentially prevent this, but the clinical safety and efficacy of CAR T cells targeting both CD19 and CD22 remain unclear. We conducted a phase 1 trial in pediatric and young adult patients with relapsed or refractory B-ALL (n = 15) to test AUTO3, autologous transduced T cells expressing both anti-CD19 and anti-CD22 CARs (AMELIA trial, EUDRA CT 2016-004680-39). The primary endpoints were the incidence of grade 3–5 toxicity in the dose-limiting toxicity period and the frequency of dose-limiting toxicities. Secondary endpoints included the rate of morphological remission (complete response or complete response with incomplete bone marrow recovery) with minimal residual disease-negative response, as well as the frequency and severity of adverse events, expansion and persistence of AUTO3, duration of B cell aplasia, and overall and event-free survival. The study endpoints were met. AUTO3 showed a favorable safety profile, with no dose-limiting toxicities or cases of AUTO3-related severe cytokine release syndrome or neurotoxicity reported. At 1 month after treatment the remission rate (that is, complete response or complete response with incomplete bone marrow recovery) was 86% (13 of 15 patients). The 1 year overall and event-free survival rates were 60% and 32%, respectively. Relapses were probably due to limited long-term AUTO3 persistence. Strategies to improve CAR T cell persistence are needed to fully realize the potential of dual targeting CAR T cell therapy in B-ALL., Bicistronic CAR T cells targeting CD19 and CD22 exhibit clinical activity and low toxicity in pediatric and young adult patients with B cell acute lymphoblastic leukemia, with relapses associated with limited CAR T cell persistence.
Published: 2021

44. Pitfalls and technical errors in the first approach to neonates with anorectal malformations in a non-specialist context: can we do any better? A review from three Eastern African Centres

Author: Alessandro Calisti, Pierluigi Lelli Chiesa, Faisal Abdel Galil Nugud, Kibreab Belay, and Agnes Mlawa
Subjects: medicine.medical_specialty, Referral, Demographics, business.industry, General surgery, medicine.medical_treatment, Infant, Newborn, Rectum, Colostomy, Surgical Stomas, Pediatric Surgeon, Context (language use), Mean age, General Medicine, Anorectal Malformations, Ano rectal malformations, neonate, low resources context, Postoperative Complications, medicine, Humans, Child, business, Retrospective Studies
Abstract: Introduction: In sub-Saharan Africa, Anorectal malformations (ARM) are the most frequent cause of neonatal obstruc- tion. Referral to a Pediatric Surgeon is frequently delayed. The first treatment is often delivered at not specialist level and mismanagement may result. Aim: To study ARM patients referred beyond neonatal period and managed at a non-specialist level. Materials and Methods: One hundred and thirty patients were included (M/F ratio 63/67) among 144 admitted to three Eastern African Hospitals with Pediatric Surgical facilities. Demographics, type of anomaly, delay on referral, previous man- agement, most commonly observed errors are reported. Results: The Mean age at referral was 23 months (range five weeks – 23 years). Colostomy was the most frequent surgery (92 cases). Stomas often did not follow the recommended criteria. Ten per cent were not on the sigmoid, and 35% were not divided. "Loop" or "double-barrel" colostomies did not exclude the distal loop. Inverted (10,5%), prolapsed stomas (7,5%), short distal loop (16%) were observed. Twenty-four cases (26%) needed redo. Primary perineal exploration in eight patients resulted in incontinence. Conclusions: Investments on training practitioners, acting at District/Rural level, and closer links with tertiary centres are recommended to avoid ARM mismanagement and delayed referral to a Specialist. Keywords: Ano rectal malformations; neonate; low resources context.
Published: 2021
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45. Timing of elective tracheotomy and duration of mechanical ventilation among patients admitted to intensive care with severe <scp>COVID</scp> ‐19: A multicenter prospective cohort study

Author: Gabriela Simonetti, Vanessa Villarraga, Albert Prats-Uribe, Estefania Hernandez-Garcia, Clara Garcia-Bastida, Nieves Mata-Castro, Carlos M. Chiesa-Estomba, Pablo Parente-Arias, Victoria Duque Holguera, Alvaro Sanchez Barrueco, Laura Rodriganez, Jordi Rello, Isabel Vilaseca, Daniel Poletti, Jose Miguel Villacampa, Adriana Agüero, Carla Meler-Claramonte, Marc Tobed, Jose Ignacio Tato, Pedro Castro, Maria Casasayas, Daniel Prieto-Alhambra, and Francesc Xavier Avilés-Jurado
Subjects: Critical Care, complications, medicine.medical_treatment, Rate ratio, SARS‐CoV‐2, Tracheotomy, Intensive care, medicine, Humans, Prospective Studies, Prospective cohort study, intensive care, Mechanical ventilation, SARS-CoV-2, business.industry, weaning, Mortality rate, Hazard ratio, respiratory failure, COVID-19, Original Articles, Respiration, Artificial, Intensive Care Units, Otorhinolaryngology, Respiratory failure, Anesthesia, Original Article, business
Abstract: Background Optimal timing for tracheotomy for critically ill COVID‐19 patients requiring invasive mechanical ventilation (IMV) is not established. Methods Multicenter prospective cohort including all COVID‐19 patients admitted to intensive care units (ICUs) in 36 hospitals who required tracheotomy during first pandemic wave. With a target emulation trial framework, we studied the causal effects of early (7–10 days) versus late (>10 days) tracheotomy (LT) on time from tracheotomy to weaning, postoperative mortality, and tracheotomy complications. Results Of 696 patients, 20.4% received early tracheotomy (ET). ET was associated with faster weaning (hazard ratio [HR] [95% confidence interval, CI]: 1.25 [1.00–1.56]) without differences in mortality (HR [95% CI]: 0.85 [0.60–1.21]) or complications (adjusted rate ratio [95% CI]: 0.56 [0.23–1.33]). Conclusions ET had a similar or lower post‐tracheotomy weaning time than LT, potentially shortening IMV and ICU stays, without changing complication or mortality rates in COVID‐19 patients.
Published: 2021
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46. Comparison of mechanochemical ablation versus ligation and stripping for the treatment of incompetent small saphenous vein

Author: Domenico Baccellieri, Roberto Chiesa, Concetta Saracino, Victor Bilman, Nicola Favia, Vincenzo Ardita, and Luca Apruzzi
Subjects: Adult, Male, medicine.medical_specialty, Stripping (fiber), Varicose Veins, Small saphenous vein, Varicose veins, medicine, Humans, Saphenous Vein, Ligation, Aged, Retrospective Studies, Pain, Postoperative, Mechanochemical ablation, business.industry, Saphenopopliteal junction, Endovenous ablation, General Medicine, Middle Aged, Surgery, Treatment Outcome, Venous Insufficiency, Catheter Ablation, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business
Abstract: Objective to compare the outcomes of mechanochemical ablation (MOCA) versus saphenopopliteal junction ligation and stripping (OS) for symptomatic small saphenous vein (SSV) insufficiency. Methods This is a retrospective study including symptomatic SSV patients treated with MOCA using the ClariVein catheter (Merit Medical, South Jordan, Utah, USA) or OS from 2015 to 2019. Results A total of 60 limbs (73.3% women, mean age 54.7 ± 14.4 years) were treated with MOCA and 58 limbs (63.8% women, mean age 54 ± 11.6 years) with OS. At 18 months follow-up, recurrence rates were 7.5% (4/53) for MOCA vs. 5.7% (3/52) for the OS group. MOCA group was associated with less pain at first postoperative day, and an early return to work (MOCA 3.5 ± 2.3 days vs. OS 14.2 ± 3.8 days, p Conclusion MOCA and OS are both safe and effective techniques for symptomatic SSV insufficiency. MOCA group demonstrated to be associated with less postoperative pain and early return to work compared to OS.
Published: 2021
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47. Creation and validation of a radiological checklist for functional endoscopic sinonasal surgery. A YO-IFOS initiative

Author: Byron Maldonado-Alvarado, Gabriel Martínez-Capoccioni, Miguel Mayo-Yáñez, Cristóbal López-Cortijo, Christian Calvo-Henriquez, Alberto Ruano-Ravina, Carlos Martin-Martin, Jerome R. Lechien, and Carlos M. Chiesa-Estomba
Subjects: Rhinology, medicine.medical_specialty, Cerebrospinal fluid leak, Referral, business.industry, Endoscopy, General Medicine, Functional endoscopic sinus surgery, medicine.disease, Turbinates, Checklist, Surgery, Ethmoid Bone, Cross-Sectional Studies, Onodi cell, Otorhinolaryngology, Radiological weapon, Vidian nerve, Medicine, Humans, business
Abstract: Background Functional endoscopic sinus surgery might lead to dangerous complications. Studying and analysing preoperative CT scans provides surgeons with a precise knowledge of their patient's anatomy, thus reducing the risk of potential complications. Checklists highlighting key anatomical areas have been published and proven useful. However, none of these are widely accepted or systematically used in daily practice. Objective In this paper, the rhinology group of the Young-Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO-IFOS) aim to create and validate a new checklist designed to be fast and user friendly for daily practice. Methods Two CT sinonasal scans were selected as test cases. Forty otolaryngologists were selected from five tertiary referral hospitals. It was a cross-sectional study; each participant was their own control. All participants completed a questionnaire after the analysis of both CT scans to prevent learning bias. The evaluation included ten items critical in endoscopic sinus surgery according to previous publications. Results There were 80 evaluations. There was a significant increase in the number of correctly identified critical structures with the use of the checklist (p = .009). There was a statistically significant difference in low- experience evaluators, while it was not statistically significant for experienced surgeons. The most unanswered structures were suprabullar recess, dangerous v2 nerve, anterior ethmoid artery, dangerous vidian nerve and Onodi cell. The most wrongly identified structures were Keros type, septal deviation and cribiform middle turbinate. Conclusion The YO-IFOS radiological checklist has proven a useful tool for correctly studying sinonasal anatomical variations. There is a clear learning component in the use of the checklist although it does not in any way exempt specialists from thorough study of sinonasal anatomy. Given the risk-benefit ratio, we strongly suggest the routine use of the checklist to systematically assess CT-scans prior to endoscopic sinonasal surgery.
Published: 2021
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48. Cardiovascular magnetic resonance images with susceptibility artifacts: artificial intelligence with spatial-attention for ventricular volumes and mass assessment

Author: Marco Penso, Mario Babbaro, Sara Moccia, Marco Guglielmo, Maria Ludovica Carerj, Carlo Maria Giacari, Mattia Chiesa, Riccardo Maragna, Mark G. Rabbat, Andrea Barison, Nicola Martini, Mauro Pepi, Enrico G. Caiani, and Gianluca Pontone
Subjects: Cardiac magnetic resonance, Radiological and Ultrasound Technology, Deep learning, Settore MED/11 - Malattie dell'Apparato Cardiovascolare, Cardiac segmentation, Cardioverter-defibrillators, Pacemaker, Susceptibility artifacts, Magnetic Resonance Imaging, Artificial Intelligence, Predictive Value of Tests, Humans, Attention, Radiology, Nuclear Medicine and imaging, Artifacts, Cardiology and Cardiovascular Medicine, Retrospective Studies
Abstract: Background Segmentation of cardiovascular magnetic resonance (CMR) images is an essential step for evaluating dimensional and functional ventricular parameters as ejection fraction (EF) but may be limited by artifacts, which represent the major challenge to automatically derive clinical information. The aim of this study is to investigate the accuracy of a deep learning (DL) approach for automatic segmentation of cardiac structures from CMR images characterized by magnetic susceptibility artifact in patient with cardiac implanted electronic devices (CIED). Methods In this retrospective study, 230 patients (100 with CIED) who underwent clinically indicated CMR were used to developed and test a DL model. A novel convolutional neural network was proposed to extract the left ventricle (LV) and right (RV) ventricle endocardium and LV epicardium. In order to perform a successful segmentation, it is important the network learns to identify salient image regions even during local magnetic field inhomogeneities. The proposed network takes advantage from a spatial attention module to selectively process the most relevant information and focus on the structures of interest. To improve segmentation, especially for images with artifacts, multiple loss functions were minimized in unison. Segmentation results were assessed against manual tracings and commercial CMR analysis software cvi42(Circle Cardiovascular Imaging, Calgary, Alberta, Canada). An external dataset of 56 patients with CIED was used to assess model generalizability. Results In the internal datasets, on image with artifacts, the median Dice coefficients for end-diastolic LV cavity, LV myocardium and RV cavity, were 0.93, 0.77 and 0.87 and 0.91, 0.82, and 0.83 in end-systole, respectively. The proposed method reached higher segmentation accuracy than commercial software, with performance comparable to expert inter-observer variability (bias ± 95%LoA): LVEF 1 ± 8% vs 3 ± 9%, RVEF − 2 ± 15% vs 3 ± 21%. In the external cohort, EF well correlated with manual tracing (intraclass correlation coefficient: LVEF 0.98, RVEF 0.93). The automatic approach was significant faster than manual segmentation in providing cardiac parameters (approximately 1.5 s vs 450 s). Conclusions Experimental results show that the proposed method reached promising performance in cardiac segmentation from CMR images with susceptibility artifacts and alleviates time consuming expert physician contour segmentation.
Published: 2022
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49. Maternal distress, DNA methylation, and fetal programming of stress physiology in Brazilian mother-infant pairs

Author: Kyle Wiley, Caroline Camilo, Gisele Gouveia, Veronica Luiza Vale Euclydes, Catherine Panter Brick, Alicia Matijasevich, Alexandre Archanjo Ferraro, Lislaine Ap. Fracolli, Anna Maria Chiesa, Eurípedes C. Miguel, Guilherme V. Polanczyk, and Helena Paula Brentani
Subjects: Hypothalamo-Hypophyseal System, Adolescent, Hydrocortisone, Depression, Infant, Mothers, Pituitary-Adrenal System, DNA Methylation, Article, Behavioral Neuroscience, Developmental Neuroscience, Pregnancy, Prenatal Exposure Delayed Effects, Developmental and Educational Psychology, Humans, Female, Brazil, Stress, Psychological, Developmental Biology
Abstract: Objectives:Maternal prenatal psychosocial stress is associated with adverse hypothalamic-pituitary-adrenal axis function among infants. While the biological mechanisms influencing this process remain unknown, altered DNA methylation is considered to be one potential mechanism. We investigated associations between maternal prenatal psychological distress, infant salivary DNA methylation and stress physiology at 12 months. Methods:Mother’s distress was measured via depression and anxiety in early and late pregnancy in a cohort of 80 pregnant adolescents. Maternal hair cortisol was collected during pregnancy. Saliva samples were collected from infants at 12 months to quantify DNA methylation of three stress-related genes (FKBP5, NR3C1, OXTR) (n=62) and diurnal cortisol (n=29). Multivariable linear regression was used to test for associations between prenatal psychological distress, and infant DNA methylation and cortisol. Results:Hair cortisol concentrations in late pregnancy were negatively associated with two sites of FKBP5 (Site 1: B=-22.33, p=0.003; Site 2: B=-15.60, p=0.012). Infants of mothers with elevated anxiety symptoms in late pregnancy had lower levels of OXTR2 CpG2 methylation (B=-2.17, p=0.03) and higher evening salivary cortisol (B=0.41, p=0.03). Furthermore, OXTR2 methylation was inversely associated with evening cortisol (B=-.14, p-value≤0.001). Discussion: Our results are, to our knowledge, the first evidence that methylation of the oxytocin receptor may contribute to the regulation of hypothalamic-pituitary-adrenal axis during infancy
Published: 2022
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50. A scoping review on the approaches for cannulation of reno-visceral target vessels during complex endovascular aortic repair

Author: Alessandro Grandi, Mario D’Oria, Andrea Melloni, Cristiano Calvagna, Jacopo Taglialavoro, Roberto Chiesa, Sandro Lepidi, and Luca Bertoglio
Subjects: Pulmonary and Respiratory Medicine, Endovascular Procedures, Outcomes, Review, General Medicine, Catheterization, Thoraco-abdominal aortic aneurysms, Stroke, Treatment Outcome, Complex endovascular aortic repair, Humans, Surgery, Cardiology and Cardiovascular Medicine, Retrospective Studies
Abstract: OBJECTIVES The aim of this study was to assess the approaches to reno-visceral target vessels (TVs) cannulation during branched-fenestrated endovascular aortic repair, determine the evidence base that links these approaches to clinical outcomes and identify literature gaps. METHODS A scoping review following the PRISMA Protocols Extension for Scoping Reviews was performed. Available full-text studies published in English (PubMed, Cochrane and EMBASE databases; last queried, 31 June 2022) were systematically reviewed and analysed. Data were reported as descriptive narrative or tables, without any statistical analysis nor quality assessment. RESULTS Fourteen retrospective articles were included. Seven articles studied the use of upper extremity access (UEA) during branched-fenestrated endovascular aortic repair, 3 studied the use of steerable sheaths and 4 included both approaches. A left UEA was used in 757 patients (technical success: 99%, stroke rate: 1–3%) and a right UEA in 215 patients (technical success: 92–98%, stroke rate: 0–13%). Seven studies (1066 patients) described a surgical access only (technical success: 80–99%, stroke rate: 0–13%), while 3 studies (146 patients) described a percutaneous access only (technical success: 83–90%, stroke rate: 3%) and lastly 4 studies compared UEA versus use of steerable sheaths from the transfemoral approach (TFA) (UEA: 563 patients, technical success: 95–98%, stroke rate: 1–8%; TFA: 209 patients, technical success: 98–100%, stroke rate: 0–1%). CONCLUSIONS Both UEA and TFA as cannulation approaches were associated with high technical success and low perioperative complications. Currently, there is a paucity of high-quality data to provide definitive indication. Optimal UEA in terms of side (left versus right) and approach (surgical versus percutaneous) needs further study.
Published: 2022
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