9 research outputs found
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
- Author
- Abad-Motos Ane
- Abbas Ahmed M.
- Abbas Mostafa
- Abbasi Mujeeb
- Abbott Tom
- Abd Karim Muhammad Fairuz Shah
- Abdalaal Ibrahim
- Abdel-Galil Khalid
- Abdelemam Rania
- Abdelgawad Abdalrahman
- Abdelkarim Maryam
- Abdelkhalek Mohamed
- Abdelmageed Abdelfatah
- Abdelmawgoud Sherif
- Abdelmohsen Sarah
- Abdelrahman Ahmed Saber
- Abdelrahman Mostafa
- Abdelwahab Khaled
- Abdou Hossam
- Abdulai Darling Ramatu
- Abdulkhaleq Marwa
- Abdullah Bahiyah
- Abdulsalam Khalifa
- Abdulsalam Shuaib
- Abdur-Rahman Lukman
- Abdus-Salam Rukiyat
- Abdussalam Hameedat Opeyemi
- Abebrese John Tabiri
- Abeldaño Ariel
- Abou-Khalil Jad
- Abou-Taleb Hisham
- Abozid Anwaar
- Abozied Hesham
- Abrate Alberto
- Abu-Zaid Ahmed
- Abubakar Mohammed Kabir
- Abud Burçin
- Abuzaid Mohammed
- Adam Albushra Altayeb
- Adamina Michel
- Adamou Harissou
- Adamu Auwal
- Adamu Kabir Musa
- Adanu Kekeli
- Adebara Idowu
- Adebola Oluwaseyi
- Ademuyiwa Adesoji
- Adeniran Abiodun
- Adepiti Akinfolarin
- Aderogba Adeleke Akeem
- Adesunkanmi Abdulhafiz
- Adeyeye Ademola
- Adisa Adewale
- Adjeso Theophilus Justus Kofi
- Ads Adel Mohamed
- Ads Alaa Mohamed
- Adu-Aryee Nii Armah
- Adumah Collins
- Afzal Irrum
- Agapov Mikhail
- Agarwal Gaurav
- Agarwal Ravi
- Agbeko Anita Eseenam
- Agbeno Evans Kofi
- Agbonrofo Peter
- Agboola Oluseyi
- Aggarwal Gaurav
- Aghadi Ifeanyi
- Aghtarafi Natasha
- Agrawal Amit
- Agresta Ferdinando
- Aguado Héctor J.
- Aguilera-Arevalo Maria-Lorena
- Aherne Thomas
- Ahmad Aline
- Ahmad Maleeha
- Ahmad Misbahu
- Ahmad Sarwat
- Ahmad Shahzaib
- Ahmad Shoaib
- Ahmed Hayat Tarig Abdelhafiz
- Ahmed Khalid
- Ahmed Sharwany
- Ahmed Shima
- Ahmed Usama
- Aisuodionoe-Shadrach Oseremen
- Aitken Sarah
- Ajenifuja Kayode
- Ajiya Abdulrazak
- Akeel Nouf
- Akin Emrah
- Akinajo Opeyemi
- Akinyemi Tosin
- Akrida Ioanna
- Aktokmakyan Talar Vartanoglu
- Akwaisah Ayoub
- Al Bettar Osama
- Al-Badawi Ismail A.
- Al-Juaifari Maytham
- Al-Khyatt Waleed
- Al-Mallah Abdullah
- Al-Nusairi Ahmed
- Al-Saadi Nina
- Al-Sayaghi Khaled
- Al-Shaiji Tariq
- Al-Shehari Mohammed
- Al-Touny Aiman
- Al-Touny Shimaa A.
- Aladawi Omar
- Aladna Abdallah
- Alali Mahmoud
- Alam Mahmood
- Alam Mohammed Shadrul
- Alarabi Rehab
- Alawneh Yazan
- Alayande Barnabas
- Albanese Erminia
- Albayadi Eslam
- Albdour Maram
- Alconchel Felipe
- Alderazi Amer
- Alegbeleye Bamidele
- Alekberli Tural
- Alemu Misganaw Alemu Adimass
- Alexander Philip
- Alfieri Alex
- Algahtany Khaled
- Algarni Kamal
- Alhamad Ameen
- Alhamid Mohammad
- Alharmi Rawan A. Rahman
- Alharthi Mohammed
- Alhazmi Barrag
- Ali Mohamed Shafi Mahboob
- Ali Stephen
- Alibrahim Hidar
- Aljaaly Hattan
- Aljaiuossi Anas
- Aljanadi Firas
- Aljiffry Murad
- Aljirdabi Noof
- Alkahlan Mohammed
- Alkhalifa Elmustafa
- Alkhatib Sondos
- Alkhatieb Maram
- Allan Anna
- Almarshad Felwa
- Almgla Naser
- Almhimid Ali
- Almiqlash Bushray
- Almoshantaf Mohammad Badr
- Almutairi Abdulmjeed
- Alnsour Abed Alfattah Mahmoud
- Alobied Majd
- Alomar Osama
- Alonso Jesús Aarón Martínez
- Alonso Manuel Diez
- Alonso Nestor Fabian Pedraza
- Alonso Veronica
- Alqallaf Abdullah
- Alqaseer Asma
- Alrayes Bourhan
- Alsefri Maryam
- Alser Osaid
- Alsharif Mohammed
- Alsori Mohamed
- Altaf Abdulmalik
- Altinel Yuksel
- Altiner Saygin
- Altouny Ahmad
- Altun Demet
- Alvarez Natalia
- Alvarez-Lozada Luis Adrian
- Alvi Abdul
- Alwael Athari
- Alwash Mohammed
- Alyami Ziyad
- Alyousef Mohammed
- Alzahrani Saud
- Alzerwi Nasser
- Amin Shivang
- Amir Mohammed
- Ammar Ahmed Siddique
- Ammendola Michele
- Amores Remedios Revilla
- Amrayev Sultan
- Anastasiadou Sofia
- Ancans Guntis
- Anderson Caroline
- Andreani Lorenzo
- Andreotti Dario
- Andreuccetti Jacopo
- Andrianakis Alexandros
- Andro Christophe
- Anesi Alexandre
- Angamuthu Stephen
- Angeles Martina Aida
- Angelico Roberta
- Angelis Fragkiskos
- Angelou Dimitrios
- Angelou Kyveli
- Angulo Victor Pinto
- Anjum Arfa
- Anjum Muhammad Ayyub
- Annicchiarico Alfredo
- Anoldo Pietro
- Ansaloni Luca
- Anthoulakis Christos
- Antonelli Amedeo
- Anwar Mohamed
- Anwar Sumadi Lukman
- Anwer Mariyah
- Anyanwu Lofty-John
- Apostolou Christos
- Apostolou Konstantinos
- Appiah-Kubi Adu
- Aprea Giovanni
- Arbab Hana
- Archer James
- Ardura Francisco
- Aremu Muyiwa
- Arif Tahera
- Arkani Samara
- Armatura Giulia
- Armijos Daniel
- Arnaout Ali
- Arnaoutoglou Eleni
- Arnaud Alexis P.
- Arneja Jugpal
- Arrangoiz Rodrigo
- Arshad Muhammad
- Arthur Joshua
- Ashcroft James
- Ashford Bruce
- Ashraf Fariha
- Asiimwe Daniel
- Asirifi Samuel Amoako
- Asla Amir
- Aslam Ramisha
- Aspide Raffaele
- Ataya Karim
- Ateca Ibabe Villalabeitia
- Atici Semra Demirli
- Atis Gokhan
- Atkins William
- Atkinson Kate
- Attwood Joseph
- Auerkari Aino
- Augestad Knut Magne
- Augustin Goran
- Aujayeb Avinash
- Avella Pasquale
- Awad Ahmed K.
- Awad Hadeel
- Awad Rabih
- Awad Selmy
- Ayad Kusay
- Ayana Birhanu
- Aydin Yener
- Ayeni Funbi
- Aytac Erman
- Azab Ahmed
- Azami Rizwan
- Azize Diallo Abdoul
- Azzam Ahmed Y.
- Azzis Olivier
- Baba Yabasin Iddrisu
- Babis George
- Bacalbasa Nicolae
- Badiani Sarit
- Badran Saif
- Baduell Albert
- Baeesa Saleh
- Baertschiger Reto
- Bafaquh Mohammed
- Bahassan Omar Mohammed
- Bahrami-Hessari Michael
- Baia Marco
- Baidoo Ebikela Ivie
- Bailey Karen
- Baili Efstratia
- Bains Lovenish
- Baiocchi Gian Luca
- Baiocchi Glauco
- Baiyewu Lateef Ayodele
- Bajaj Ankur
- Bajunaid Khalid
- Balagobi Balasingam
- Balasubramanian Ishwarya
- Balduzzi Alberto
- Baldwin Alexander
- Balla Andrea
- Balogh Zsolt J.
- Balogun James A.
- Balogun Simon
- Baloyiannis Ioannis
- Ban Vin Shen
- Bandyopadhyay Samik Kumar
- Bandyopadhyay Soham
- Banerjee Sumit
- Banipal Gurpreet Singh
- Banky Balazs
- Bannone Elisa
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- Barberis Andrea
- Barbosa-Breda Joao
- Bareka Metaxia
- Barišić Tatjana
- Barlas Aziz Mutlu
- Barlow Ciaran
- Barmayehvar Behrad
- Baroffio Paolo
- Barone Mirko
- Barra Fabio
- Barranquero Alberto G.
- Barugola Giuliano
- Basendowah Mohammed
- Bashir Mahmod
- Basnayake Oshan
- Bass Gary Alan
- Basu Somprakas
- Bateman Antony
- Bateman Kellie
- Batista Sylvia
- Batstone Martin
- Bauer Marlies
- Bauset Juan Carlos Catalá
- Bawa Ashvind
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- Bayhan Hüseyin
- Bayo Heura Llaquet
- Bazzi Nagham
- Beamish Andrew
- Beasley Nigel
- Beatty Jasmine Winter
- Becerra Angel
- Bedada Alemayehu Ginbo
- Bedzhanyan Arkady
- Begum Farzana
- Beisenov Bekzat
- Bellio Gabriele
- Bello Usman Mohammed
- Bellés Ana Ciscar
- Belzile Etienne
- Benamar Safia
- Bence Matthew
- Benshetrit Guy
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- Bergkvist David Julià
- Beristain-Hernandez Jose-Luis
- Bernante Paolo
- Bernardi Daniele
- Beron Reinaldo Isaacs
- Berselli Bruno
- Berselli Mattia
- Bertelli Giacomo
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- Beswick Daniel
- Bette Birgit
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- Bharathan Rasiah
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- Bilfaqirah Majed
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- Bissacco Daniele
- BİŞGİN TAYFUN
- Blair James
- Blanco Jose
- Blencowe Natalie
- Bloemers Frank
- Board Timothy
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- Boccalatte Luis
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- Bohmer Rob
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- Boisson Matthieu
- Boligo Sofia
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- Bondurri Andrea
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- Bonsaana Gilbert Batieka
- Booth L.
- Borg Elaine
- Borges Miguel Fróis
- Borges Nuno
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- Botelho Pedro
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- Bowen Joel
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- Bramis Konstantinos
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- Bravo Sybil Lizanne
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- Bruzzaniti Placido
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- Cunningham Brian
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- D'Acapito Fabrizio
- D'Addino José Luis
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- Dawson Jonathon
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- De Alarcón Jaime Rodríguez
- De Andrés-Asenjo Beatriz
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- De Jesus Labrador Hernandez Gregorio
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- Ekwen Gerald
- Ekwunife Okechukwu Hyginus
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- Elbadawy Merihan A.
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- Fayad Elsayed A.
- Federer Simon
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- Giacometti Marco
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- Gmati Aimen
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- Gomez-Fernandez Hugo
- Gomez-Rosado Juan-Carlos
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- Gonzalez Lourdes Elorduy
- Gonzalez Luis Angel Suarez
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- González-Suárez Susana
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- Gosselink Martijn
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- Yigit Banu
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- Yotsov Tsanko
- Younis Muhammad Umar
- Yunus Alif
- Yusefi Hossein
- Zabaleta Jon
- Zabkiewicz Catheriner
- Zaccaria Giulia
- Zacharia Bincy
- Zafar Syed Nabeel
- Zago Mauro
- Zaheen Zakia
- Zahid Zahra
- Zaimis Tilemachos
- Zakaria Andee Dzulkarnaen
- Zambon Martina
- Zamora Lindsey
- Zampogna Biagio
- Zancana Giuseppa
- Zani Augusto
- Zanin Luca
- Zanini Nicola
- Zapardiel Ignacio
- Zapata Carlos Shiraishi
- Zarif Pierre
- Zaránd Attila
- Zehnder Philipp
- Zenger Serkan
- Zenha Horácio
- Zhu Michael Z. L.
- Ziemann Sebastian
- Zimak Danijela Mrazovac
- Zimak Zoran
- Zivkovic Dragana
- Zizzo Maurizio
- Zucker Benjamin
- Zwain Yasir
- Zyskowski Michael
- Ávila Clara Castro
- Älgå Andreas
- Çakici Mehmet Çaǧlar
- Çelik Enes
- Çelik Meryem Nur
- Özçay Necdet
- Şevik Hüsnü
- Šantak Goran
- Šimko Kristián
- Žatecký Jan
- Publication venue
- 'Oxford University Press (OUP)'
- Publication date
- 01/01/2023
- Field of study
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
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- Ávila C.C.
- Älgå A.
- Çakıcı MÇ
- Çelik E.
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- Özçay N.
- Şevi̇k H.
- Šantak G.
- Šimko K.
- Žatecký J.
- Publication venue
- Oxford University Press (OUP)
- Publication date
- 01/07/2023
- Field of study
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Performance of Hong Kong liver cancer staging system in patients of hepatocellular carcinoma treated with surgical resection: an Indian validation study
- Publication venue
- 'Elsevier BV'
- Publication date
- 01/01/2019
- Field of study
Platelet–Neutrophil Association in NETs-Rich Areas in the Retrieved AIS Patient Thrombi
- Author
- Publication venue
- MDPI AG
- Publication date
- 01/11/2022
- Field of study
Histological structure of thrombi is a strong determinant of the outcome of vascular recanalization therapy, the only treatment option for acute ischemic stroke (AIS) patients. A total of 21 AIS patients from this study after undergoing non-enhanced CT scan and multimodal MRI were treated with mechanical stent-based and manual aspiration thrombectomy, and thromboembolic retrieved from a cerebral artery. Complementary histopathological and imaging analyses were performed to understand their composition with a specific focus on fibrin, von Willebrand factor, and neutrophil extracellular traps (NETs). Though distinct RBC-rich and platelet-rich areas were found, AIS patient thrombi were overwhelmingly platelet-rich, with 90% of thrombi containing + and neutrophil-elastase+) containing citrullinated histone-decorated DNA. Citrullinated histone-decorated DNA also accumulated extracellularly, pointing to NETosis by the activated neutrophils. Notably, NETs-containing areas showed strong reactivity to VWF, platelets, and high-mobility group box 1 (HMGB1), signifying a close interplay between these components
Primary Hepatic Gastrointestinal Stromal Tumour (GIST): Unusual Presentation and Diagnosis
- Author
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study
Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries
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- Publication venue
- Publication date
- 01/01/2024
- Field of study
Background: Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods: The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results: A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion: Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)
Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries
- Author
- Aad Sinha
- Aamal Ebrahem
- Abay Jumanov
- Abd El-Fattah Mouhandes
- Abdalla Emhareb
- Abdalrahmman G Abdalradiy
- Abdelmalek Ousadden
- Abdelrahman Mahmoud
- Abdenour Aissat
- Abdi Tessema
- Abdullah Kağan Zengin
- Abdulrahman Abba Sheshe
- Abdurrahman Aremu
- Abelevich Alexnder
- Abhishek Chaudhari
- Abhishek Chitnis
- Abid Jamal
- Abidemi Akere
- Abigail Hallett
- Abiodun Okunlola
- Abu Bakr H Widatalla
- Abubakar Ballah
- Abubakar Muhammad Bala
- Abylai Baimakhanov
- Adam Walsh
- Adamu Ningi
- Adegbolahan Fakoya
- Ademola Adeyeye
- Adnan Hacim
- Adolfo Pisanu
- Adriana Galaviz Muro
- Afia Arshed Dodhy
- Aghyad Kudra Danial
- Agnieszka Fiedziuk
- Agnieszka Kubisz-Pudelko
- Ahmad Al Jabar
- Ahmad Saad
- Ahmad Sakr
- Ahmad Shehu
- Ahmad Suhaimi Amir
- Ahmed Abaidalla
- Ahmed Abd El Aal
- Ahmed Abdellatif
- Ahmed Al-Alnsi
- Ahmed Ali
- Ahmed Elfallal
- Ahmed Nafea
- Ahmed Ragab
- Ahmed Shehta
- Ahmed Siddique Ammar
- Ahmet Akbas
- Ahmet Aşkar
- Ahmet Burak Ciftci
- Ahmet Ipek
- Ahmet Necati Şanlı
- Ahsan Hussain
- Aicha Bengueddach
- Ainhoa Valle Rubio
- Ajeet Pratap Maurya
- Ajesh Raj Saksena
- Ajit Kumar
- Akanksha Sharma
- Akihiko Horiguchi
- Akram Gharbi
- Alaa El-Hussuna
- Alaa Hamdan
- Alam Noor Khan
- Albano Silva
- Albash Sarwar
- Alberto Biondi
- Alberto Mondini
- Alberto Porcu
- Alberto Roxo
- Alberto Silva
- Alejandro Espí-Macías
- Alejandro Hoyos-Torres
- Alejandro Marcelo Doniquian
- Alejandro Mitidieri
- Alejandro Romero-De Diego
- Aleksander Dychko
- Aleksandra Baker
- Aleksei Karachun
- Aleksei Petrov
- Alelign Tasew
- Alena Naiqiso
- Alena Rybachuk
- Alessandra Grazia Giuseppina Garau
- Alessandra Marano
- Alessandra Novi
- Alessandro Arturi
- Alessandro Cois
- Alessandro Iacomino
- Alessandro Vasale
- Alessandro Zapparoli
- Alessio Palumbo
- Alexander Bogatikov
- Alexander Forero-Torres
- Alexander Hoetzel
- Alexander Shin
- Alexander V Lodygin
- Alexandra Charakopoulou
- Alexandra Triantafyllou
- Alexandre Carvalho
- Alexandre da Silveira Sete
- Alexey Yanishev
- Alfredo Alonso
- Alfredo Gallardo
- Ali Akbar
- Ali Mansour
- Aliaa Shamardal
- Alican Güreşin
- Alice Frontali
- Alice Ryl
- Alicia Ruiz-De-La-Hermosa
- Alina Capusan
- Alison Marshall
- Alma Blazquez-Martin
- Almir Miftari
- Almudena Castro Calvo
- Aloysius Okoye
- Alvarado José
- Alysson Bomfa-Barbosa
- Amal Singh
- Aman Bhargava
- Amane Hammed
- Amar Al-Jarrah
- Amari Thompson
- Ameer Afzal
- Amier Mohamed Rashed
- Amine Benkabbou
- Amine Khayreddine Ghouali
- Amine Souadka
- Amit Mahajan
- Amjed Yassir Ahmed
- Ammar Niazi
- Amparo Camacho
- Amr Hamza
- Amrit Pipara
- An Windels
- Ana Assis
- Ana Belen Pedregosa
- Ana Cláudia Deus
- Ana Faustino
- Ana Isabel Rodrigues
- Ana Llamazarez Llamazares
- Ana Loscos
- Ana Lozano Valbuena
- Ana Margarida Coelho
- Ana María Minaya-Bravo
- Ana Martins
- Ana Minaya Bravo
- Ana Minaya-Bravo
- Ana Otero
- Ana Ribeiro
- Ana Sanches
- Ana Torre
- Ana-Maria Musina
- Anabela Santos
- Anabella Houdin
- Analia Potolicchio
- Anam Butt
- Anamaria Luca
- Anastasia Novikova
- Anatoliy Shudrak
- Anca-Irina Ristescu
- Andee Dzulkarnaen Zakaria
- Anders Høgn
- Anderson Barbosa
- Andre Fernandes
- Andrea Bruni
- Andrea Felice Ferroni
- Andrea Fernandez Pujol
- Andrea Galimberti
- Andrea Mingoli
- Andrea Muratore
- Andrea Peri
- Andrea Pisani Ceretti
- Andrea Porta
- Andrea Vázquez-Fernández
- Andrea Vignali
- Andrea Zanoni
- Andreas Jud
- Andreas Polidorou
- Andrei Chitul
- Andrei Domanskiy
- Andrei Pasca
- Andreia Amado
- Andreia Ferreira
- Andrejs Pcolkins
- Andres Valenzuela
- Andrew Ekwesianya
- Andrew Kakeeto
- Andrew Woodward
- Andrey Koshel
- Andrey Litvin
- Andrey Zaycev
- André Marçal
- André Pacheco
- Andrius Macas
- Andriy Beznosenko
- Andrzej Kwiatkowski
- Ane Abad-Motos
- Aneel Bhangu
- Angel Arabadzhiev
- Angel Martin de Pablos
- Angela Belvedere
- Angela Correia
- Angela Genoefa Rudell
- Angela Marzella
- Angela Romano
- Angeliki Petra
- Angelo Antonio Ciccarese
- Anil Chacko
- Anil Ghosh
- Anil Tore
- Anisse Tidjane
- Anna Ekepil
- Anna Feiss
- Anna Kapustina
- Anna Lawrence
- Anna Los
- Anna Mori
- Anna Panagiotou
- Anna Paola Sanesi
- Anna Wątroba
- Anna Zappone
- Annamaria Minicozzi
- Anne Marie Camilleri Podesta
- Anthony Lin
- Anton Sumbaev
- Antonella Di Trani
- Antonia Pascual
- Antonino Spinelli
- Antonio Cappiello
- Antonio Castaldi
- Antonio Hilário Freitas
- Antonio Maria de Lacy
- Antonio Melero Abellán
- Antonio Pesce
- Antonios Gklavas
- António Freitas
- António Oliveira
- António Pires
- Antônio Lacerda Filho
- Antti Väyrynen
- Anu Carpelan
- April Roslani
- Arai Aitbaeva
- Aras Emre Canda
- Arcangelo Picciariello
- Archana Khanduri
- Arda Isik
- Arda Ulaş Mutlu
- Ardak Arynov
- Arend Merrie
- Ari Kechagias
- Aridai Resendiz
- Ariel Grinblat
- Arina Provozina
- Aristeidis Papadopoulos
- Aristidis Mpakas
- Arkadeep Dhali
- Arkady Bedzhanyan
- Armando Galván-Pérez
- Armands Sivins
- Armen Vardanyan
- Armin Belarmino
- Arnaldo Machado
- Arto Turunen
- Arturan Ibrahimli
- Arun Chaturvedi
- Arzu Koklucan
- Asad Kerawala
- Ashish Shrestha
- Ashish Shukla
- Ashwani Kumar
- Asif Mehraj
- Asuncion Perez-Sanchez
- Athanasia Kikira
- Athanasios Marinis
- Athanasios Xanthis
- Athina Samara
- Athula Tennakoon
- Atiqur Rahman
- Audrius Dulskas
- Augusto Carrie
- Augusto Lauro
- Aun Jamal Gill
- Aurora Pinto
- Auxiliadora Cano-Matias
- Awais Malik
- Aya Haji Mohamad
- Aya Zazo
- Aylin Incesu
- Aymen Kutkut
- Ayr Nasser Júnior
- Ayra Suleman
- Aysegul Ferlengez
- Aziza El Metwally
- Álvaro Soler Silva
- Åsa Lindén
- Badareesh Lakshminarayana
- Bala Mahesh Polamreddy
- Balaji Jayasankar
- Balázs Bánky
- Baljit Singh
- Banu Vural Gökay
- Baraa Shebli
- Barbara Proietto
- Barbara Sanna
- Baris Gulcu
- Barış Mantoğlu
- Basanth Kumar Rayani
- Basel Refky
- Bashiru Aminu
- Bassam Oqaili
- Baver Baris
- Bayan Saada
- Beatriz Amorós Alfonso
- Beatriz de Andrés-Asenjo
- Beatriz Diéguez
- Beatriz Díaz San Andrés
- Beatriz Mendes
- Begoña Fadrique Fernández
- Begoña González Sierra
- Begoña Toribio-Combarro
- Bei En Siew
- Ben Creavin
- Benali Tabeti
- Benicia Perez Leon
- Benita Adams
- Benson Oguttu
- Berik Dzhumabekov
- Bernard Costa Favacho
- Bernarda Bakmaz
- Bernardo Hanan
- Bernice Theodore
- Betina Møller
- Béatrice Pinard
- Bhagya Gunetilleke
- Bharath Veerabhadrappa S
- Bianca Santos
- Billy Jimenez Bobadilla
- Bodhisattva Bose
- Bogdan Stoica
- Bojan Kovacevic
- Boyko Atanasov
- Brahim El Ahmadi
- Brenda Chayanny Alves
- Breno Xaia Martins Costa
- Brett E Dawson
- Bruno Giusti Werneck Cortes
- Bruno Lucena de Souza Pires
- Bruno Scotto
- Bruno Sensi
- Calin Ionescu
- Camelia Calin
- Camilla Cremonini
- Camille Nobile
- Camino Morales Marcos
- Can Arican
- Can Saraçoğlu
- Candeniz Erturk
- Carina Chwat
- Carina Gomes
- Carina Yumi Takahashi
- Carla Galmes
- Carla Mariela Gonzalez
- Carla Pinto
- Carlo Bergamini
- Carlo Maria Neri
- Carlo V Feo
- Carlos Augusto Real Martinez
- Carlos Gracia Roche
- Carlos Ruiz-Lozano
- Carlos San Miguel-Méndez
- Carmel Dawson
- Carmela Cervone
- Carmelo Mazzeo
- Carmine Antropoli
- Carolina Martínez Pérez
- Caroline Witjes
- Carolyn Cullinane
- Carolynne Vaizey
- Carsten Fütterer
- Casiraghi Umberto
- Catalin Vlad
- Catalina Simeanu
- Catarina Lareiro
- Caterina Foppa
- Catherine Victor
- Cati Diaconescu
- Catia Sbarbaro
- Cátia Ferreira
- Cemil Caliskan
- Cezar Ciubotaru
- Chakib Behilil
- Chamaidi Sarakatsianou
- Chandrashekhar Mahakalkar
- Chang Woo Kim
- Chantal de Kort
- Charalampos Theodoropoulos
- Charles Berlo Van
- Charles Cini
- Charles H Knowles
- Charles Knowles
- Charlotte Dempsy
- Charlotte Hill
- Charmaine Shovelton
- Chaves Pablo
- Che Saniati Che Ali
- Chetan Parmar
- Chiara de Lucia
- Chiara Leoni
- Chiemelu Emegoakor
- Chimdiebele Nwosu
- Chin Wee Ang
- Chor Kuan Yew
- Chris Coldwell
- Chris Varghese
- Christina Delimpalta
- Christine Paterson
- Christoph Reißfelder
- Christopher Liao
- Chu Yik Tang
- Chukwuemeka Nwoye
- Chukwuma Okereke
- Chun Hin Angus Lee
- Cian Davis
- Ciciliot Massimo
- Cihad Tatar
- Claire Carden
- Claire Kilbride
- Claudia Armellin
- Claudia Cabrera
- Claudia Carrizo
- Claudia Flandoli
- Claudia Martinez Martinez
- Claudilaine Reis
- Claudio Baldi
- Claudio Fermani
- Claudio Mospane
- Clelia Cutellè
- Collette Flynn
- Constantin Krasnoselsky
- Constantinos Simillis
- Corina Alexandrescu
- Corissa Chee
- Cosimo Callari
- Cosmin Bezede
- Crescenza Fortunato
- Crisitna Tavares
- Cristian Ariel Rodriguez
- Cristian-Ene Roata
- Cristina Ciulli
- Cristina García Amador
- Cristina Lillo-García
- Cristina Martinez
- Cristina Palomar Puertas
- Cristina Petrisor
- Cristina Rey Valcárcel
- Cristina Ribeiro
- Cristina Sanchez Del Pueblo
- Cristina Soto-Montesinos
- Cristina Vacca
- Cristina Valentino
- Cristina Velez
- Cristina Vera-Mansilla
- Daisuke Koike
- Daiva Luckute
- Dakshitha Wickramasinghe
- Damiano Vespo
- Damila Klyshbayeva
- Dana Crisan
- Dani Rixson
- Daniel Agara
- Daniel Casanova
- Daniel Cristian
- Daniel Fernández-Martínez
- Daniel Jordão
- Daniel Osei Bordom
- Daniel Rezende
- Daniela Rega
- Daniela Roncoletta Espinha
- Danielle Seuren
- Danielle Taylor
- Daniil Markaryan
- Danish Ali
- Danut Constantin Ciotarla
- Dario Di Miceli
- Dario Francesco Venezia
- Dario Tartaglia
- Darshana Rathod
- David Beard
- David D E Zimmerman
- David Finch
- David Irabor
- David Moro-Valdezate
- Davide Cuneo
- Deborah Jones
- Deborah Wright
- Deepak Jain
- Deepu Daryanani
- Deniz Ozzeybek
- Despoina Danassi
- Devane Liam
- Devanshi Verma
- Débora Correia
- Dharma Ram Poonia
- Dhruv Ghosh
- Diana Alejandra Pantoja Pachajoa
- Didem Onk
- Diego Fiume
- Diego Sasia
- Diego Valli
- Dilek Kara
- Dimitrina Tonova
- Dimitrios Balalis
- Dimitrios Korkolis
- Dimitrios Manatakis
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- Dimitris Giakoustidis
- Dina Alawlaqi
- Dinamulla Wanshantha
- Dinesh Balasubramaniam
- Diogo Andrade
- Diogo Cardoso
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- Diogo Sousa
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- Dion Morton
- Dirar Zatari
- Direnç Yiğit
- Dmitri Nepogodiev
- Dmitrii Rogozhev
- Dmitrijs Lobovs
- Dmitry Kostromitsky
- Dobromir Dimitrov
- Dochka Tzoneva
- Domenico Caliendo
- Domenico Spoletini
- Dominik Jauch
- Domitilla Gaia Passantino
- Donatas Danys
- Donatas Venskutonis
- Donatella Pardo
- Donato F Altomare
- Dootika Liddle
- Dorthe Katrine Slot
- Draga Mandi
- Dragomir Dardanov
- Dulantha de Silva
- Dupe Oluyori
- Ebrahim Almahmeed
- Edgar Amorim
- Eduard Galliamov
- Eduard-Alexandru Bonci
- Eduardo de San Pío Carvajal
- Eduardo Delgado
- Eduardo Schiffer
- Edvardas Daugėla
- Edvinas Dainius
- Edward Bywater
- Effrosyni Bompou
- Egle Kontrimaviciute
- Eirini Apostolidi
- Eirini Kalamara
- Eirini Zarzava
- Ekaterina Semina
- Ekaterina Terentyeva
- El Bachir Benjelloun
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- U Aravindan
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- Ugur Sungurtekin
- Umar Masoro
- Umberto Bracale
- Ummuhan Vural
- Umut Kara
- Usama Waqar
- Utku Ozgen
- Vaishali Waindeskar
- Valdemaras Jotautas
- Valentina Madalina Negoita
- Valentina Testa
- Valeria Tonini
- Valerio Donatiello
- Vamsi Velchuru
- Vanesa Crespo Garcia Del Castillo
- Vania Fernandes
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- Victoria Fraj
- Victoriano Soria-Aledo
- Vida Hamilton
- Vihara Dassanayake
- Vijay Kumar
- Vijaykumar Ishwarappagol
- Viktor Kakotkin
- Villamarín Ricardo
- Ville Falenius
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- Vincenzo Sorce
- Vincenzo Vigorita
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- Virginia Laurenti
- Virginia Moreno
- Vitalii Zvirych
- Vitaliy Stamov
- Vittoria Bellato
- Vivian Nga Man Lau
- Vlad Alexandru Gata
- Vlad Dudric
- Vlad Fagarasan
- Vlada Bernotaite
- Vladimir Balaban
- Volkan Ozben
- Wafa Sabri
- Walid A S Mohmmad
- Walid Rezoug
- Wan Zainira Wan Zain
- Wasantha Wijenayake
- Wei Ming Ong
- Wilhelmina Somera
- Will Loh
- William Marshall
- William Prem
- Wilson Manuel Sánchez Bautista
- Wing Kin Tse
- Wisam Hasan
- Wladimiro Siciliano
- Won-Suk Lee
- Xavier Guedes
- Xrysoyla Livanou
- Yahya Abou El-Wafa
- Yasemin Kirmizi
- Yasin Kara
- Yaşar Subutay Peker
- Yathev Balathayalan
- Yenny Quiroga
- Yeoh Chih Nie
- Yi Chien Hsieh
- Yolanda Olivella
- Young Song
- Youngbae Jeon
- Yucel Karadere
- Yukio Asano
- Yuksel Altinel
- Yulia Frolova
- Yuriy Pelipas
- Yvonne Mouvet
- Zahed Abu Arida
- Zaidi Zakaria
- Zain Douba
- Zairul Azwan Mohd Azman
- Zakiah Mohd Yusoff
- Zaman Mamedli
- Zameer Shah
- Zaure Dushimova
- Zdeněk Kala
- Zewude Gudisa
- Zilvinas Saladzinskas
- Zinash Teferu
- Zoe Garoufalia
- Zoe Gates
- Zumrud Aliyeva
- Zülfü Bayhan
- Zvonimir Katušić
- Publication venue
- Publication date
- 01/01/2024
- Field of study
Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries
- Author
- Aarts Frits
- Ababneh Hazim
- Abad-Motos Ane
- Abaidalla Ahmed
- Abbakar Malaz
- Abd El Aal Ahmed
- Abd-Errazik Mohammad Ahmad
- Abdalradiy Abdalrahmman G
- Abdelkhalek Mohamed
- Abdelkhalek Mostafa
- Abdellatif Ahmed
- Abdellatif Mohamed
- Abdelsaid Kirolas
- Abdou Khaled
- Abdulfatah Mustapha
- Abdullah Mohammad Amer
- Abdullahi Mustapha Miko Mohammed
- Abellán Antonio Melero
- Abeysinghe Nayana
- Abiyere Henry
- Achimas-Cadariu Patriciu Andrei
- Adakaya Sıla
- Adam Nicolas
- Adams Benita
- Adams Ferdinand
- Adegboye Kazeem
- Adeyeye Ademola
- Adra Lama
- Adu-Poku Patricia
- Afuwape Oludolapo
- Afzal Ameer
- Afzal Muhammad Farooq
- Agapov Mihail
- Agara Daniel
- Aggarwal Manisha
- Agger Erika
- Aghadi Ifeanyi Kene
- Ahmed Amjed Yassir
- Ahmed Haleemasahdia
- Ahmed Khalil
- Ahmed Manar
- Ahmed Masood
- Ahmed Safia
- Ahn Hong Min
- Aibe Raquel
- Aigner Felix
- Aissat Abdenour
- Aitbaeva Arai
- Akay Omer
- Akbar Ali
- Akbas Ahmet
- Akçay Özlem
- Akere Abidemi
- Akesen Selcan
- Akgun Erhan
- Akhtar Naseem
- Akın Emrah
- Akova Elif
- Aktas Serhat
- Al Masri Mahmoud
- Al-Alnsi Ahmed
- Al-Hutheifi Roqia'A
- Al-Jarrah Amar
- Al-Naggar Hamza
- Al-Shehari Mohammed
- Alamin Nadeen
- Alawi Raneen
- Alawlaqi Dina
- Alawneh Fade
- Alberola Maria José
- Albers Michael
- Alcolea Natalia González
- Aleem Muhammad
- Alegre Inês
- Alegre Javier Martinez
- Alexandre Flavia
- Alexandrescu Corina
- Alexnder Abelevich
- Alexopoulou Kalliopi
- Alfonso Beatriz Amorós
- Ali Ahmed
- Ali Che Saniati Che
- Ali Danish
- Ali Madeeha
- Ali Mahmoud Abdelwahab
- Ali Manhal Hashim
- Ali Noura Al
- Alikhanli Jhale
- Aliyeva Zumrud
- Aliyu Mohammed
- Aljawder Hasan
- Allen Kate
- Almahmeed Ebrahim
- Alonso Alfredo
- Alonso Javier Etreros
- Alsamneh Muneer
- Alsayadi Ramzi
- Altinel Yuksel
- Altintoprak Fatih
- Altomare Donato F
- Alvarenga Isabella
- Alvarez Laura Jimenez
- Alvarez-Bautista Francisco Emmanuel
- Alvarez-Díez Marcos
- Alves Brenda Chayanny
- Amadigwe Rita
- Amado Andreia
- Amado Fabíola
- Amador Cristina García
- Amanullah Nazli
- Amaral Hélida Aline Tomacheski
- Amaral Luis
- Amin-Tai Hizami
- Aminu Bashiru
- Amir Ahmad Suhaimi
- Ammar Ahmed Siddique
- Ammar Mona Ahmed
- Ammendola Michele
- Ammerata Giorgio
- Amorim Edgar
- Ancans Guntis
- Anderson Tom
- Andrade Diogo
- Andrejevic Predrag
- Andrés Beatriz Díaz San
- Anestiadou Elissavet
- Ang Chin Wee
- Angelo Franceschi
- Anokhin Evgeny
- Anoldo Pietro
- Antakia Ramez
- Anton Majd
- Antonelli Serena
- Antropoli Carmine
- Anula Rocio
- Anwar Jamal
- Anyadike Florence
- Apostolakidou Magda
- Apostolidi Eirini
- Aprea Giovanni
- Arabadzhiev Angel
- Arakawa Satoshi
- Arauz Jazmin
- Aravindan U
- Aremu Abdurrahman
- Aremu Isiaka
- Argawy Osama
- Arican Can
- Arida Zahed Abu
- Armellin Claudia
- Arnaoutoglou Eleni
- Arreguy-Borges Kanthya
- Artigot Mariano
- Arturi Alessandro
- Arulappan Nirupama
- Arya Shobhit
- Arynov Ardak
- Asaad Peter
- Asano Yukio
- Ascari Francesca
- Asgarov Mohsum
- Ashmawy Soad
- Aslam Muhammad Imran
- Assimakopoulou Elena
- Assis Ana
- Astilleta Romina
- Aşkar Ahmet
- Atanasov Boyko
- Atendido Tiffany
- Athanasakis Elias
- Atici Semra Demirli
- Avellaneda Nicholas
- Avellaneda Nicolas
- Avseren Goksu
- Awead Marwa
- Ayandipo Omobolaji
- Aybar Engin
- Aydin Funda
- Aydin Gaye
- Ayoub Kusay
- Aytac Erman
- Aytaç Erman
- Azevedo Jose
- Azevedo Patricia
- Azhar Najia
- Aziz Gowhar
- Azman Zairul Azwan Mohd
- Álvarez-Llano Laura
- Ângelo Miguel Duarte
- Babatunde Olanrewaju
- Badawi Marwa
- Baek Jeong-Heum
- Baez Noelia Fernández
- Baeza-Murcia Melody
- Bagnardi Francesco
- Baharom Salahudin
- Baik Seung Hyuk
- Baimakhanov Abylai
- Bains Lovenish
- Baker Aleksandra
- Bakmaz Bernarda
- Bala Abubakar Muhammad
- Balaban Vladimir
- Balalis Dimitrios
- Balasubramaniam Dinesh
- Balathayalan Yathev
- Baldi Claudio
- Balestri Riccardo
- Balfour James
- Ballah Abubakar
- Ballian Nikiforos
- Balooshi Iman Al
- Baloyiannis Ioannis
- Bamford Richard
- Bandar Mahdi Al
- Banham Gail
- Bannoud Mohammad Hassan
- Baños Pedro Antonio Parra
- Baptista Victor
- Baral Jörg
- Barbalace Nicolas
- Barbato Giuseppe
- Barbosa Anderson
- Bareka Metaxia
- Baris Baver
- Barradas Renato
- Barreda Sara Castillo
- Barrena-Blazquez Silvestra
- Barton Jess
- Bartosiak Katarzyna
- Bashilkina Olga
- Bashir Mohammed
- Basile Raffaele
- Basnyat Pradeep
- Batool Sana
- Bautista Wilson Manuel Sánchez
- Bayhan Zülfü
- Bayo José Manuel Muros
- Bayón Raquel Álvaro
- Bánky Balázs
- Beard David
- Bedzhanyan Arkady
- Behilil Chakib
- Bekele Kebebe
- Belarmino Armin
- Belay Million
- Belev Nikolay
- Bellato Vittoria
- Beltrán de Heredia Juan
- Belvedere Angela
- Benetti Emilio
- Benetti Sara
- Bengueddach Aicha
- Benjelloun El Bachir
- Benkabbou Amine
- Bennett James
- Bensafir Salim
- Bergamini Carlo
- Bernotaite Vlada
- Beron Reinaldo Isaacs
- Bethune Robert
- Bezede Cosmin
- Beznosenko Andriy
- Bhangu Aneel
- Bhargava Aman
- Bhat Rama Rani Krishna
- Bianchi Romina
- Bianco Francesco
- Bigoni Irene
- Binetti Margherita
- Bintintan Vasile
- Biondi Alberto
- Biondo Santino Antonio
- Bisgin Tayfun
- Bisheet George
- Bissett Ian
- Biswas Jyotirmoy
- Blackwell Sue
- Blanco Pablo
- Blanco Raquel Ríos
- Blanco-Colino Ruth
- Blasco Laura Fraile
- Blazquez-Martin Alma
- Bobadilla Billy Jimenez
- Bocancia Raluca
- Boccia Giuseppe
- Bogatikov Alexander
- Bolanle Olajide Edward
- Bomfa-Barbosa Alysson
- Bompou Effrosyni
- Bonardello Michela
- Bonci Eduard-Alexandru
- Bordom Daniel Osei
- Borges Filipe
- Borghi Felice
- Boschiero Matheus Negri
- Bose Bodhisattva
- Bouchagier Konstantinos
- Boudjenan-Serradj Nabil
- Boudoux Sabrina
- Bourazani Maria
- Boyce Stephen
- Bozbiyik Osman
- Bracale Umberto
- Brachini Gioia
- Bradulskis Saulius
- Brainsa Eneida
- Brandström Gustav
- Braumille Markus
- Bravo Ana Minaya
- Bravo Raquel
- Bredikhin Mikhail
- Brito Noelia
- Bruni Andrea
- Buccianti Piero
- Buchs Nicolas
- Buchwald Pamela
- Budnikova Ina
- Budrikienė Rima
- Buey Lourdes
- Buijs Louis
- Buleje Jorge Alejandro Benavides
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- Yadev I P
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- Yakunina Natalia
- Yalkin Ömer
- Yanishev Alexey
- Yao Hongwei
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- Yemez Kursat
- Yew Chor Kuan
- Yiğit Direnç
- Yılmaz Gülseren
- Yilmazlar Tuncay
- Yoldas Tayfun
- Yonekura Hiroshi
- Yorkmui Liu
- Yoshino Kenji
- Younes Lina
- Young Trudi
- Yule Michael
- Yusoff Zakiah Mohd
- Zaari Fatimazahraa
- Zabiyaka Mikhail
- Zadrożna Monika
- Zafar Madiha
- Zagaynov Eugeny
- Zaidi Syed-Nadeem
- Zaimis Tilemachos
- Zain Wan Zainira Wan
- Zainy Rhendra Hardy Mohamad
- Zakaria Andee Dzulkarnaen
- Zakaria Maheen
- Zakaria Zaidi
- Zamudio-Bautista Jorge Luis
- Zanc Loredana
- Zanoni Andrea
- Zanus Giacomo
- Zapparoli Alessandro
- Zappone Anna
- Zarzava Eirini
- Zatari Dirar
- Zawadzki Marek
- Zayakov Georgi
- Zaycev Andrey
- Zazo Aya
- Zazo Rama
- Zdravkovic Maja
- Zengin Abdullah Kağan
- Zeringa Georgia
- Zimmerman David D E
- Zuhdy Mohammad
- Zvirych Vitalii
- Zywicka Ewa
- Publication venue
- Publication date
- 01/01/2023
- Field of study
Background
Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks.
Methods
The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned.
Results
A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31).
Conclusion
Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
- Author
- Abad-Motos A.
- Abbas A. M.
- Abbas M.
- Abbasi M.
- Abbott T.
- Abd Karim M. F. S.
- Abdalaal I.
- Abdel-Galil K.
- Abdelemam R.
- Abdelgawad A.
- Abdelkarim M.
- Abdelkhalek M.
- Abdelmageed A.
- Abdelmawgoud S.
- Abdelmohsen S.
- Abdelrahman A. S.
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- Publication venue
- country:GB
- Publication date
- 01/01/2023
- Field of study
Background: Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods: This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was coprioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low-middle-income countries. Results: In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of 'single-use' consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low-middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion: This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high- and low-middle-income countries