Patterns of pediatric trauma in Ramadan: an observational study

Introduction Motor vehicle crashes are a major cause of death among the Saudi population. In Ramadan, the working hours and the road traffic rush hours differ from other months of the year; the pattern of trauma may also differ. We compared trauma in the pediatric age group in Ramadan with non-Ramadan months in terms of frequency, patterns, and severity.Methods We conducted a retrospective study, which included all pediatric trauma cases, from 2001 to 2009, who were registered in King Abdulaziz Medical City Trauma Registry. Trauma patterns were divided into two groups according to the date of occurrence: victims in Ramadan versus victims in non-Ramadan.Results A total of 3766 patients were included. The average number of trauma per month was 39.2 versus 44 for non-Ramadan and Ramadan months, respectively (P = 0.79). The mean patient age in Ramadan was 8.04 years compared with 8.07 years in non-Ramadan months (P = 0.037). Blunt trauma was the most common type in both groups. The median of the Injury Severity Score was the same and equal to 4. In both groups, neurological and vascular injuries were more common in Ramadan: P = 0.02 and P = 0.03 respectively.Conclusion There were no significant differences between trauma in Ramadan and non-Ramadan months, except for the higher percentage of vascular and neurological injuries in Ramadan.Key words: children, head injury, motor vehicle accidents, Ramadan, Saudi, trauma, vascular injur

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Toward an objective assessment of technical skills: a national survey of surgical program directors in Saudi Arabia

Abdullah Alkhayal,1 Shahla Aldhukair,2 Nahar Alselaim,1 Salah Aldekhayel,1 Sultan Alhabdan,1 Waleed Altaweel,3 Mohi Elden Magzoub,4 Mohammed Zamakhshary1,21Department of Surgery, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 2Public Health Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 3Urology Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia; 4Department of Medical Education, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaBackground: After almost a decade of implementing competency-based programs in postgraduate training programs, the assessment of technical skills remains more subjective than objective. National data on the assessment of technical skills during surgical training are lacking. We conducted this study to document the assessment tools for technical skills currently used in different surgical specialties, their relationship with remediation, the recommended tools from the program directors’ perspective, and program directors’ attitudes toward the available objective tools to assess technical skills.Methods: This study was a cross-sectional survey of surgical program directors (PDs). The survey was initially developed using a focus group and was then sent to 116 PDs. The survey contains demographic information about the program, the objective assessment tools used, and the reason for not using assessment tools. The last section discusses the recommended tools to be used from the PDs’ perspective and the PDs’ attitude and motivation to apply these tools in each program. The associations between the responses to the assessment questions and remediation were statistically evaluated.Results: Seventy-one (61%) participants responded. Of the respondents, 59% mentioned using only nonstandardized, subjective, direct observation for technical skills assessment. Sixty percent use only summative evaluation, whereas 15% perform only formative evaluations of their residents, and the remaining 22% conduct both summative and formative evaluations of their residents’ technical skills. Operative portfolios are kept by 53% of programs. The percentage of programs with mechanisms for remediation is 29% (19 of 65).Conclusion: The survey showed that surgical training programs use different tools to assess surgical skills competency. Having a clear remediation mechanism was highly associated with reporting remediation, which reflects the capability to detect struggling residents. Surgical training leadership should invest more in standardizing the assessment of surgical skills.Keywords: objective assessment, program directors, surgical skills, surgical residenc

Evolving Trends in the Management of Acute Appendicitis During COVID-19 Waves: The ACIE Appy II Study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Global attitudes in the management of acute appendicitis during COVID-19 pandemic: ACIE Appy Study

676sinoneBackground: Surgical strategies are being adapted to face the COVID-19 pandemic. Recommendations on the management of acute appendicitis have been based on expert opinion, but very little evidence is available. This study addressed that dearth with a snapshot of worldwide approaches to appendicitis. Methods: The Association of Italian Surgeons in Europe designed an online survey to assess the current attitude of surgeons globally regarding the management of patients with acute appendicitis during the pandemic. Questions were divided into baseline information, hospital organization and screening, personal protective equipment, management and surgical approach, and patient presentation before versus during the pandemic. Results: Of 744 answers, 709 (from 66 countries) were complete and were included in the analysis. Most hospitals were treating both patients with and those without COVID. There was variation in screening indications and modality used, with chest X-ray plus molecular testing (PCR) being the commonest (19·8 per cent). Conservative management of complicated and uncomplicated appendicitis was used by 6·6 and 2·4 per cent respectively before, but 23·7 and 5·3 per cent, during the pandemic (both P < 0·001). One-third changed their approach from laparoscopic to open surgery owing to the popular (but evidence-lacking) advice from expert groups during the initial phase of the pandemic. No agreement on how to filter surgical smoke plume during laparoscopy was identified. There was an overall reduction in the number of patients admitted with appendicitis and one-third felt that patients who did present had more severe appendicitis than they usually observe. Conclusion: Conservative management of mild appendicitis has been possible during the pandemic. The fact that some surgeons switched to open appendicectomy may reflect the poor guidelines that emanated in the early phase of SARS-CoV-2.noneIelpo B.; Podda M.; Pellino G.; Pata F.; Caruso R.; Gravante G.; Di Saverio S.; Ielpo B.; Podda M.; Pellino G.; Pata F.; Caruso R.; Gravante G.; Di Saverio S.; Gallo G.; Lui R.; Orengia A.; Chowdary A.; Kulkarni A.; Kuvvetli A.; Navarro A.; Pisanu A.; Smith A.; Ibiricu A.C.; Nacion A.J.D.; Alsaleh A.; Alhazmi A.; Elmabri A.; Wani A.; Rencuzogullari A.; Lasarte A.S.; Rubio A.V.; Bavikatte A.; Kumar A.; Jamiri A.-R.; Padilla A.M.A.; Cacurri A.; de San Ildefonso A.; Porcu A.; Sartori A.; Rocca A.; Yanez A.P.; Becaria A.; Solis-Pena A.; Sretenovic A.; Urbistondo A.; Bandin A.; Najar A.; De Luca A.; Boddy A.; Charalabopoulos A.; Tzivanakis A.; Amendola A.; de Velasco A.R.-G.; Yildirim A.C.; Frontali A.; Toure A.O.; Garcia-Granero A.; Roldan A.M.; Larrainzar A.S.; Ratnayake A.S.; Gonzalez-Ganso A.M.; Minaya-Bravo A.M.; Das A.; Bondurri A.; Costanzi A.; Lucchi A.; Mazzari A.; Musig A.; Peloso A.; Piano A.; Police A.; Mihailescu A.; Pouy A.; Romano A.; Iossa A.; Leonetti A.C.; Guariniello A.; Isaac A.; Bovi A.P.D.; Chessa A.; Tromba A.; Martinez A.A.; Brillantino A.; Caira A.; Castaldi A.; Ferronetti A.; Giuliani A.; Prestera A.; la Medina A.R.-D.; Tarasconi A.; Tornambe A.; Picciariello A.; Ioannidis A.; Leppaniemi A.; Khan A.; Rashid A.; Perez-Sanchez A.L.E.; Mittal A.; Mitul A.R.; Mehraj A.; Laharwal A.; Dorisme A.; Marinis A.; Iqbal A.; Moncada A.; Braccio B.; Alkhafaji B.; de Andres Asenjo B.; Martin-Perez B.; Perez B.S.; Creavin B.; Cali B.; Cali B.; Pascotto B.; Stubbs B.; Retes B.Z.; Jovanovic B.; Goh B.K.P.; Sensi B.; Biddau C.; Gazia C.; Vallicelli C.; Fagundes C.A.; Santacruz C.C.; Chirico C.; Diaz C.J.G.; Petrola C.; Rodriguez C.S.; Benitez C.Y.; Dammaro C.; Faro C.L.; Reinke C.; Paez C.D.; Oliva C.; Paranjape C.; Thomas C.; Chia C.F.; Kong C.K.; De Lucia C.; Chao C.O.; Arcudi C.; Guerci C.; Chia C.; Parise C.; Folliero C.; Varela C.; Ferguson D.M.; Camacho D.; Popowich D.; Lima D.S.; Rega D.; Delogu D.; Zigiotto D.; Vinci D.; D'Antonio D.; Parini D.; Merlini D.A.; Zimmerman D.D.E.; Moro-Valdezate D.; Pertile D.; Giusti D.M.; Keller D.S.; Tarik D.; Kalivaci D.; Mazingi D.; Maldonado-Pintado D.G.; Sasia D.; Linardoutsos D.; Osilli D.; Murrone D.; Russello D.; Rodas E.; Roa E.A.A.; Ricciardi E.; Rosso E.; Saladino E.; Flores-Villalba E.; Ajs E.R.; Smith-Singares E.; Baili E.; Kouroumpas E.; Bourmpouteli E.; Douka E.; Martin-Perez E.; Guaitoli E.; Samadov E.; Francone E.; Vaterlini E.; Morales E.; Pena E.; Zhao E.; Andres E.D.P.; Benzoni E.; Erdas E.; Pinotti E.; Colas-Ruiz E.; Aytac E.; Laterza E.; Agastra E.; Foianini E.; Moscoso E.; Laviano E.; Marra E.; Cardamone E.; Licardie E.; Mpaili E.; Pinna E.; Varo E.; Navarro F.M.; Marino F.; Medas F.; Romano F.; Maraska F.; Saliu F.; Madrid F.; Rosa F.; Mastella F.; Gheza F.; Luvisetto F.; Alconchel F.; Vieira F.M.; Pareja F.; Agresta F.; Luna F.; Bonilla F.; Cordera F.; Burdio F.; Mendoza-Moreno F.; Flores F.M.; Aranda F.P.; Taylor F.; Ramos F.L.; Fernandes F.; Tropeano F.P.; Balestra F.; Bianco F.; Ceci F.; Colombo F.; Di Marzo F.; Ferrara F.; Lancellotti F.; Lazzarin F.; Litta F.; Martini F.; Pizza F.; Roscio F.; Virdis F.; Antona F.B.; Ramirez F.C.; Fernandez F.M.; Llinares F.O.; Quezada F.; Schlottmann F.; Quezada F.; Herrera-Almario G.; Massaferro G.; Bislenghi G.; van Ramshorst G.; Gallo G.; Luglio G.; Bointas G.; Kampouroglou G.; Papadopoulos G.; Manrique G.A.; Calini G.; Nastri G.; Formisano G.; Galiffa G.; Palini G.M.; Colucci G.; Pagano G.; Pellino G.; Vanni G.; Pattacini G.C.; Gravante G.; De Paola G.; Lisi G.; Partida G.; Bellanova G.; De Nobili G.; Necchi G.S.; Sinibaldi G.; Tebala G.; Bagaglini G.; Izzo G.; Argenio G.; Brisinda G.; Candilio G.; Di Grezia G.; Esposito G.; Faillace G.; Frazzetta G.; La Gumina G.; Nigri G.; Romeo G.; Amatriain G.C.; Ortega G.; Martin-Martin G.; Stavrou G.A.; Gunadi; Ugon G.A.; Machain G.; Marcucci G.; Martinez-Mier G.; Machain G.M.; Nari G.; Calvo H.; Fathy H.; Hamilto; Ahmed H.; Faraj H.; Nava H.; Macias H.O.; Nikaj H.; Solano H.; Khan H.A.; Alarcon H.S.; Ebied H.; Giani I.; Ateca I.V.; Neri I.; Roman I.A.S.; Fidoshev I.; Rodriguez I.M.; Negoi I.; Ortega I.; Bernescu I.; Russo I.S.; Rodriguez I.V.; Palomares I.; Baltazar I.; Torrejimeno I.J.; Jurado I.M.C.; Reccia I.; Hussain I.; Toledo I.B.; Mora-Guzman I.; Dogaru I.; Romic I.; Balciscueta I.; Kenington J.C.; Sagolsem J.; Jang J.Y.; Olivier J.; Lammel-Lindemann J.; Dziakova J.; Villavicencio J.I.R.; Salinas J.; Parreira J.P.J.G.; Jovanovic; Perez J.R.; Reyes J.A.S.; Luque J.A.M.; Mak J.; Rodriguez J.S.; Kok J.H.H.; Krook J.; Diaz-Elizondo J.A.; Castell J.; Garcia-Flores J.E.; Navalon J.M.J.; Rodrigues J.M.S.; Pereira J.; Gomez J.T.C.; Luque J.B.; del Olmo J.C.M.; Salamea J.C.; Olivier J.F.C.; Laina J.L.B.; Ordonez J.M.; Gutierrez J.; Abba J.; Sofi J.A.; Sherafgan K.; Sahnan K.; Yanaga K.; Beatson K.; Asim L.; Alvarez L.; Siragusa L.; Farber L.; Ong L.; Athanasios L.; Garcia-Bruna L.; De Martino L.; Ferrario L.; Giordano L.; Gordini L.; Pio L.; Ponchietti L.; Moletta L.; Curella L.; Poggi L.; Taglietti L.; Bonavina L.; Conti L.; Goffredi L.; Ruiz L.A.G.; Barrionuevo L.; Fregoso L.E.; Cabrera L.F.; Rodriguez L.G.; Grande L.; Osoria L.G.; Gonzalez L.J.K.; Sanchez-Guillen L.; Tallon-Aguilar L.; Tresierra L.; Giavarini L.; Hasabelnabi M.; Odovic M.; Uemura M.; Khan M.; Artiles-Armas M.; David M.; Di Martino M.; Spampinato M.G.; Ribeiro M.A.F.; Viola M.; Angrisani M.; Calussi M.; Cannistra M.; Catarci M.; Cereda M.; Conte M.; Giordano M.; Pellicciaro M.; Marino M.V.; Vaterlini M.E.; Jimenez M.F.; Lolli M.G.; Bellini M.I.; Lemma M.; Chiarello M.M.; Nicola M.; Arrigo M.; Mejia M.C.; Manrique M.M.; Rodriguez-Lopez M.; Serradilla-Martin M.; Lara M.Z.; Martinez M.; Bagnall M.; Peter M.; Lara M.C.; Gomez M.J.; Paniagua-Garcia-Senorans M.; Gonzalez M.P.; Rutegard M.; Salo M.; Franceschilli M.; Silveri M.; Veroux M.; Pezzulo M.; Nardi M.; Rottoli M.; Tolonen M.; Ciro M.P.; Zuluagua M.; Cannavo M.; Cervellera M.; Iacobone M.; Montuori M.; Podda M.; Dominguez M.G.; Bingol-Kologlu M.; Tahir M.; Lim M.; Wilson M.S.; Wilson M.; Campanelli M.; Bisaccia M.; De Rosa M.; Maruccia M.; Paterno M.; Pisano M.; Torre M.; Trevino M.; Zuolo M.; Hernandez Bartolome M.A.; Farina M.; Pera M.; Calvo M.P.; Sotelo M.; Thway M.M.; Hassan M.; Hassan M.S.E.; Azfar M.; Bouhuwaish M.; Taha M.; Zaieem M.; Korkoman M.; Guraieb M.; Shalaby M.; Raza M.A.; Younis M.U.; Elhadi M.; Ali M.Z.; Quazi N.; Dudi-Venkata N.N.; Alselaim N.; Loria N.; Ramirez N.V.; Than N.W.; Smart N.; Trelles N.; Pinto N.; Allievi N.; Petrucciani N.; Antonacci N.; Cillara N.; Gica N.; Cristiana N.D.; Krystek N.; Falco N.; Pecorelli N.; Tamini N.; Dallas N.A.; Machairas N.; Brito N.; Fieturi N.A.; Ortega N.; Mercado O.A.; Irkorucu O.; Alsherif O.; Valles O.; Ioannidis O.; Palmas O.H.; Palmas O.I.H.; Guadarrama O.S.; Bozbiyik O.; Omelanczuk P.; Ottolino P.; Rodrigues P.; Ruiz P.; Campenni P.; Chiarade P.; Olivares P.P.; Baroffio P.; Panaccio P.; Wintringer P.; Di Fronzo P.; Talento P.; Favoriti P.; Sendino P.; Marsanic P.; Mifsut P.; Andrade P.; Ajawin P.; Abadia-Barno P.; Castaneda P.A.N.; Arevalos P.O.S.; Bellver P.P.; Koh P.S.; Souza P.; Major P.; Bali R.S.; Khattar R.M.; Melo R.B.; Ebrahiminia R.; Azar R.; Murga R.L.; Caruso R.; Pirolo R.; Brady R.; Davies R.J.; Dholakia R.; Rattan R.; Singhal R.; Lim R.; Angelico R.; Isernia R.M.; Tutino R.; Faccincani R.; Peltrini R.; Carrera-Ceron R.; Tejos R.; Kashyap R.; Fajardo R.; Lozito R.; Pareja R.M.; Garbarino S.; Di Saverio S.; Morales-Conde S.; Benli S.; Mansour S.; Flores S.; Suarez S.L.; Ben S.L.; Fuentes S.; Napetti S.; de Guzman S.O.; Awad S.; Weckmann Lujan S.A.; Gentilli S.; Grimaldi S.; Pizarro S.O.; Tayar S.; Nabi S.; Chan S.M.; Junaid S.; Rojas S.; Monetti S.; Garcia S.; Salvans S.; Tenconi S.; Shaw S.; Santoni S.; Parra S.A.; Cardenas S.; Perez-Bertolez S.; Chiappetta S.; Dessureault S.; Delis S.; Bonapasta S.A.; Rausei S.; Scaringi S.; Keswani S.; Ali S.M.; Cetinkunar S.; Fung T.L.D.; Rawashdeh T.; Lopez T.N.; De Campos T.; Duque T.C.; Perra T.; Liakakos T.; Daskalakis T.; Liakakos T.; Barnes T.; Koeter T.; Zalla T.; Gonzalez T.E.; Elosua T.; Campagnaro T.; Brown T.; Luoto T.; Oumar T.A.; Giustizieri U.; Grossi U.; Bracale U.; Rivas U.; Sosa V.; Testa V.; Andriola V.; Tonini V.; Balassone V.; Celentano V.; Progno V.; Raju V.; Carroni V.; Cavallaro V.; Katta V.R.; De Simone V.; Romaguera V.P.; Orozco V.H.G.; Luraschi V.; Rachkov V.; Turrado-L V.; Visag-Castillo V.; Dowling V.; Graham V.; Papagni V.; Vigorita V.; Fonseca V.C.; Carneros V.J.; Bellato V.; Goncalves W.; Powers W.F.; Grigg W.; Bechstein W.O.; Lim Y.B.; Altinel Y.; Golubovic Z.; Balciscueta Z.Ielpo, B.; Podda, M.; Pellino, G.; Pata, F.; Caruso, R.; Gravante, G.; Di Saverio, S.; Ielpo, B.; Podda, M.; Pellino, G.; Pata, F.; Caruso, R.; Gravante, G.; Di Saverio, S.; Gallo, G.; Lui, R.; Orengia, A.; Chowdary, A.; Kulkarni, A.; Kuvvetli, A.; Navarro, A.; Pisanu, A.; Smith, A.; Ibiricu, A. C.; Nacion, A. J. D.; Alsaleh, A.; Alhazmi, A.; Elmabri, A.; Wani, A.; Rencuzogullari, A.; Lasarte, A. S.; Rubio, A. V.; Bavikatte, A.; Kumar, A.; Jamiri, A. -R.; Padilla, A. M. A.; Cacurri, A.; de San Ildefonso, A.; Porcu, A.; Sartori, A.; Rocca, A.; Yanez, A. P.; Becaria, A.; Solis-Pena, A.; Sretenovic, A.; Urbistondo, A.; Bandin, A.; Najar, A.; De Luca, A.; Boddy, A.; Charalabopoulos, A.; Tzivanakis, A.; Amendola, A.; de Velasco, A. R. -G.; Yildirim, A. C.; Frontali, A.; Toure, A. O.; Garcia-Granero, A.; Roldan, A. M.; Larrainzar, A. S.; Ratnayake, A. S.; Gonzalez-Ganso, A. M.; Minaya-Bravo, A. M.; Das, A.; Bondurri, A.; Costanzi, A.; Lucchi, A.; Mazzari, A.; Musig, A.; Peloso, A.; Piano, A.; Police, A.; Mihailescu, A.; Pouy, A.; Romano, A.; Iossa, A.; Leonetti, A. C.; Guariniello, A.; Isaac, A.; Bovi, A. P. D.; Chessa, A.; Tromba, A.; Martinez, A. A.; Brillantino, A.; Caira, A.; Castaldi, A.; Ferronetti, A.; Giuliani, A.; Prestera, A.; la Medina, A. R. -D.; Tarasconi, A.; Tornambe, A.; Picciariello, A.; Ioannidis, A.; Leppaniemi, A.; Khan, A.; Rashid, A.; Perez-Sanchez, A. L. E.; Mittal, A.; Mitul, A. R.; Mehraj, A.; Laharwal, A.; Dorisme, A.; Marinis, A.; Iqbal, A.; Moncada, A.; Braccio, B.; Alkhafaji, B.; de Andres Asenjo, B.; Martin-Perez, B.; Perez, B. S.; Creavin, B.; Cali, B.; Cali, B.; Pascotto, B.; Stubbs, B.; Retes, B. Z.; Jovanovic, B.; Goh, B. K. P.; Sensi, B.; Biddau, C.; Gazia, C.; Vallicelli, C.; Fagundes, C. A.; Santacruz, C. C.; Chirico, C.; Diaz, C. J. G.; Petrola, C.; Rodriguez, C. S.; Benitez, C. Y.; Dammaro, C.; Faro, C. L.; Reinke, C.; Paez, C. D.; Oliva, C.; Paranjape, C.; Thomas, C.; Chia, C. F.; Kong, C. K.; De Lucia, C.; Chao, C. O.; Arcudi, C.; Guerci, C.; Chia, C.; Parise, C.; Folliero, C.; Varela, C.; Ferguson, D. M.; Camacho, D.; Popowich, D.; Lima, D. S.; Rega, D.; Delogu, D.; Zigiotto, D.; Vinci, D.; D'Antonio, D.; Parini, D.; Merlini, D. A.; Zimmerman, D. D. E.; Moro-Valdezate, D.; Pertile, D.; Giusti, D. M.; Keller, D. S.; Tarik, D.; Kalivaci, D.; Mazingi, D.; Maldonado-Pintado, D. G.; Sasia, D.; Linardoutsos, D.; Osilli, D.; Murrone, D.; Russello, D.; Rodas, E.; Roa, E. A. A.; Ricciardi, E.; Rosso, E.; Saladino, E.; Flores-Villalba, E.; Ajs, E. R.; Smith-Singares, E.; Baili, E.; Kouroumpas, E.; Bourmpouteli, E.; Douka, E.; Martin-Perez, E.; Guaitoli, E.; Samadov, E.; Francone, E.; Vaterlini, E.; Morales, E.; Pena, E.; Zhao, E.; Andres, E. D. P.; Benzoni, E.; Erdas, E.; Pinotti, E.; Colas-Ruiz, E.; Aytac, E.; Laterza, E.; Agastra, E.; Foianini, E.; Moscoso, E.; Laviano, E.; Marra, E.; Cardamone, E.; Licardie, E.; Mpaili, E.; Pinna, E.; Varo, E.; Navarro, F. M.; Marino, F.; Medas, F.; Romano, F.; Maraska, F.; Saliu, F.; Madrid, F.; Rosa, F.; Mastella, F.; Gheza, F.; Luvisetto, F.; Alconchel, F.; Vieira, F. M.; Pareja, F.; Agresta, F.; Luna, F.; Bonilla, F.; Cordera, F.; Burdio, F.; Mendoza-Moreno, F.; Flores, F. M.; Aranda, F. P.; Taylor, F.; Ramos, F. L.; Fernandes, F.; Tropeano, F. P.; Balestra, F.; Bianco, F.; Ceci, F.; Colombo, F.; Di Marzo, F.; Ferrara, F.; Lancellotti, F.; Lazzarin, F.; Litta, F.; Martini, F.; Pizza, F.; Roscio, F.; Virdis, F.; Antona, F. B.; Ramirez, F. C.; Fernandez, F. M.; Llinares, F. O.; Quezada, F.; Schlottmann, F.; Quezada, F.; Herrera-Almario, G.; Massaferro, G.; Bislenghi, G.; van Ramshorst, G.; Gallo, G.; Luglio, G.; Bointas, G.; Kampouroglou, G.; Papadopoulos, G.; Manrique, G. A.; Calini, G.; Nastri, G.; Formisano, G.; Galiffa, G.; Palini, G. M.; Colucci, G.; Pagano, G.; Pellino, G.; Vanni, G.; Pattacini, G. C.; Gravante, G.; De Paola, G.; Lisi, G.; Partida, G.; Bellanova, G.; De Nobili, G.; Necchi, G. S.; Sinibaldi, G.; Tebala, G.; Bagaglini, G.; Izzo, G.; Argenio, G.; Brisinda, G.; Candilio, G.; Di Grezia, G.; Esposito, G.; Faillace, G.; Frazzetta, G.; La Gumina, G.; Nigri, G.; Romeo, G.; Amatriain, G. C.; Ortega, G.; Martin-Martin, G.; Stavrou, G. A.; Gunadi, ; Ugon, G. A.; Machain, G.; Marcucci, G.; Martinez-Mier, G.; Machain, G. M.; Nari, G.; Calvo, H.; Fathy, H.; Hamilto, ; Ahmed, H.; Faraj, H.; Nava, H.; Macias, H. O.; Nikaj, H.; Solano, H.; Khan, H. A.; Alarcon, H. S.; Ebied, H.; Giani, I.; Ateca, I. V.; Neri, I.; Roman, I. A. S.; Fidoshev, I.; Rodriguez, I. M.; Negoi, I.; Ortega, I.; Bernescu, I.; Russo, I. S.; Rodriguez, I. V.; Palomares, I.; Baltazar, I.; Torrejimeno, I. J.; Jurado, I. M. C.; Reccia, I.; Hussain, I.; Toledo, I. B.; Mora-Guzman, I.; Dogaru, I.; Romic, I.; Balciscueta, I.; Kenington, J. C.; Sagolsem, J.; Jang, J. Y.; Olivier, J.; Lammel-Lindemann, J.; Dziakova, J.; Villavicencio, J. I. R.; Salinas, J.; Parreira, J. P. J. G.; Jovanovic, ; Perez, J. R.; Reyes, J. A. S.; Luque, J. A. M.; Mak, J.; Rodriguez, J. S.; Kok, J. H. H.; Krook, J.; Diaz-Elizondo, J. A.; Castell, J.; Garcia-Flores, J. E.; Navalon, J. M. J.; Rodrigues, J. M. S.; Pereira, J.; Gomez, J. T. C.; Luque, J. B.; del Olmo, J. C. M.; Salamea, J. C.; Olivier, J. F. C.; Laina, J. L. B.; Ordonez, J. M.; Gutierrez, J.; Abba, J.; Sofi, J. A.; Sherafgan, K.; Sahnan, K.; Yanaga, K.; Beatson, K.; Asim, L.; Alvarez, L.; Siragusa, L.; Farber, L.; Ong, L.; Athanasios, L.; Garcia-Bruna, L.; De Martino, L.; Ferrario, L.; Giordano, L.; Gordini, L.; Pio, L.; Ponchietti, L.; Moletta, L.; Curella, L.; Poggi, L.; Taglietti, L.; Bonavina, L.; Conti, L.; Goffredi, L.; Ruiz, L. A. G.; Barrionuevo, L.; Fregoso, L. E.; Cabrera, L. F.; Rodriguez, L. G.; Grande, L.; Osoria, L. G.; Gonzalez, L. J. K.; Sanchez-Guillen, L.; Tallon-Aguilar, L.; Tresierra, L.; Giavarini, L.; Hasabelnabi, M.; Odovic, M.; Uemura, M.; Khan, M.; Artiles-Armas, M.; David, M.; Di Martino, M.; Spampinato, M. G.; Ribeiro, M. A. F.; Viola, M.; Angrisani, M.; Calussi, M.; Cannistra, M.; Catarci, M.; Cereda, M.; Conte, M.; Giordano, M.; Pellicciaro, M.; Marino, M. V.; Vaterlini, M. E.; Jimenez, M. F.; Lolli, M. G.; Bellini, M. I.; Lemma, M.; Chiarello, M. M.; Nicola, M.; Arrigo, M.; Mejia, M. C.; Manrique, M. M.; Rodriguez-Lopez, M.; Serradilla-Martin, M.; Lara, M. Z.; Martinez, M.; Bagnall, M.; Peter, M.; Lara, M. C.; Gomez, M. J.; Paniagua-Garcia-Senorans, M.; Gonzalez, M. P.; Rutegard, M.; Salo, M.; Franceschilli, M.; Silveri, M.; Veroux, M.; Pezzulo, M.; Nardi, M.; Rottoli, M.; Tolonen, M.; Ciro, M. P.; Zuluagua, M.; Cannavo, M.; Cervellera, M.; Iacobone, M.; Montuori, M.; Podda, M.; Dominguez, M. G.; Bingol-Kologlu, M.; Tahir, M.; Lim, M.; Wilson, M. S.; Wilson, M.; Campanelli, M.; Bisaccia, M.; De Rosa, M.; Maruccia, M.; Paterno, M.; Pisano, M.; Torre, M.; Trevino, M.; Zuolo, M.; Hernandez Bartolome, M. A.; Farina, M.; Pera, M.; Calvo, M. P.; Sotelo, M.; Thway, M. M.; Hassan, M.; Hassan, M. S. E.; Azfar, M.; Bouhuwaish, M.; Taha, M.; Zaieem, M.; Korkoman, M.; Guraieb, M.; Shalaby, M.; Raza, M. A.; Younis, M. U.; Elhadi, M.; Ali, M. Z.; Quazi, N.; Dudi-Venkata, N. N.; Alselaim, N.; Loria, N.; Ramirez, N. V.; Than, N. W.; Smart, N.; Trelles, N.; Pinto, N.; Allievi, N.; Petrucciani, N.; Antonacci, N.; Cillara, N.; Gica, N.; Cristiana, N. D.; Krystek, N.; Falco, N.; Pecorelli, N.; Tamini, N.; Dallas, N. A.; Machairas, N.; Brito, N.; Fieturi, N. A.; Ortega, N.; Mercado, O. A.; Irkorucu, O.; Alsherif, O.; Valles, O.; Ioannidis, O.; Palmas, O. H.; Palmas, O. I. H.; Guadarrama, O. S.; Bozbiyik, O.; Omelanczuk, P.; Ottolino, P.; Rodrigues, P.; Ruiz, P.; Campenni, P.; Chiarade, P.; Olivares, P. P.; Baroffio, P.; Panaccio, P.; Wintringer, P.; Di Fronzo, P.; Talento, P.; Favoriti, P.; Sendino, P.; Marsanic, P.; Mifsut, P.; Andrade, P.; Ajawin, P.; Abadia-Barno, P.; Castaneda, P. A. N.; Arevalos, P. O. S.; Bellver, P. P.; Koh, P. S.; Souza, P.; Major, P.; Bali, R. S.; Khattar, R. M.; Melo, R. B.; Ebrahiminia, R.; Azar, R.; Murga, R. L.; Caruso, R.; Pirolo, R.; Brady, R.; Davies, R. J.; Dholakia, R.; Rattan, R.; Singhal, R.; Lim, R.; Angelico, R.; Isernia, R. M.; Tutino, R.; Faccincani, R.; Peltrini, R.; Carrera-Ceron, R.; Tejos, R.; Kashyap, R.; Fajardo, R.; Lozito, R.; Pareja, R. M.; Garbarino, S.; Di Saverio, S.; Morales-Conde, S.; Benli, S.; Mansour, S.; Flores, S.; Suarez, S. L.; Ben, S. L.; Fuentes, S.; Napetti, S.; de Guzman, S. O.; Awad, S.; Weckmann Lujan, S. A.; Gentilli, S.; Grimaldi, S.; Pizarro, S. O.; Tayar, S.; Nabi, S.; Chan, S. M.; Junaid, S.; Rojas, S.; Monetti, S.; Garcia, S.; Salvans, S.; Tenconi, S.; Shaw, S.; Santoni, S.; Parra, S. A.; Cardenas, S.; Perez-Bertolez, S.; Chiappetta, S.; Dessureault, S.; Delis, S.; Bonapasta, S. A.; Rausei, S.; Scaringi, S.; Keswani, S.; Ali, S. M.; Cetinkunar, S.; Fung, T. L. D.; Rawashdeh, T.; Lopez, T. N.; De Campos, T.; Duque, T. C.; Perra, T.; Liakakos, T.; Daskalakis, T.; Liakakos, T.; Barnes, T.; Koeter, T.; Zalla, T.; Gonzalez, T. E.; Elosua, T.; Campagnaro, T.; Brown, T.; Luoto, T.; Oumar, T. A.; Giustizieri, U.; Grossi, U.; Bracale, U.; Rivas, U.; Sosa, V.; Testa, V.; Andriola, V.; Tonini, V.; Balassone, V.; Celentano, V.; Progno, V.; Raju, V.; Carroni, V.; Cavallaro, V.; Katta, V. R.; De Simone, V.; Romaguera, V. P.; Orozco, V. H. G.; Luraschi, V.; Rachkov, V.; Turrado-L, V.; Visag-Castillo, V.; Dowling, V.; Graham, V.; Papagni, V.; Vigorita, V.; Fonseca, V. C.; Carneros, V. J.; Bellato, V.; Goncalves, W.; Powers, W. F.; Grigg, W.; Bechstein, W. O.; Lim, Y. B.; Altinel, Y.; Golubovic, Z.; Balciscueta, Z