Different carbon sources result in differential activation of sigma B and stress resistance in Listeria monocytogenes

Listeria monocytogenes is an important food-borne pathogen that is ubiquitous in the environment. It is able to utilize a variety of carbon sources, to produce biofilms on food-processing surfaces and to survive food preservation–associated stresses. In this study, we investigated the effect of three common carbon sources, namely glucose, glycerol and lactose, on growth and activation of the general stress response Sigma factor, SigB, and corresponding phenotypes including stress resistance. A fluorescent reporter coupled to the promoter of lmo2230, a highly SigB-dependent gene, was used to determine SigB activation via quantitative fluorescence spectroscopy. This approach, combined with Western blotting and fluorescence microscopy, showed the highest SigB activation in lactose grown cells and lowest in glucose grown cells. In line with this observation, lactose grown cells showed the highest resistance to lethal heat and acid stress, the highest biofilm formation, and had the highest adhesion/invasion capacity in Caco-2-derived C2Bbe1 cell lines. Our data suggest that lactose utilisation triggers a strong SigB dependent stress response and this may have implications for the resistance of L. monocytogenes along the food chain

Glycerol metabolism induces Listeria monocytogenes biofilm formation at the air-liquid interface

Listeria monocytogenes is a food-borne pathogen that can grow as a biofilm on surfaces. Biofilm formation in food-processing environments is a big concern for food safety, as it can cause product contamination through the food-processing line. Although motile aerobic bacteria have been described to form biofilms at the air-liquid interface of cell cultures, to our knowledge, this type of biofilm has not been described in L. monocytogenes before. In this study we report L. monocytogenes biofilm formation at the air-liquid interface of aerobically grown cultures, and that this phenotype is specifically induced when the media is supplemented with glycerol as a carbon and energy source. Planktonic growth, metabolic activity assays and HPLC measurements of glycerol consumption over time showed that glycerol utilization in L. monocytogenes is restricted to growth under aerobic conditions. Gene expression analysis showed that genes encoding the glycerol transporter GlpF, the glycerol kinase GlpK and the glycerol 3-phosphate dehydrogenase GlpD were upregulated in the presence of oxygen, and downregulated in absence of oxygen. Additionally, motility assays revealed the induction of aerotaxis in the presence of glycerol. Our results demonstrate that the formation of biofilms at the air-liquid interface is dependent on glycerol-induced aerotaxis towards the surface of the culture, where L. monocytogenes has access to higher concentrations of oxygen, and is therefore able to utilize this compound as a carbon source

Global multi-stakeholder endorsement of the MAFLD definition

none1055noneMendez-Sanchez N.; Bugianesi E.; Gish R.G.; Lammert F.; Tilg H.; Nguyen M.H.; Sarin S.K.; Fabrellas N.; Zelber-Sagi S.; Fan J.-G.; Shiha G.; Targher G.; Zheng M.-H.; Chan W.-K.; Vinker S.; Kawaguchi T.; Castera L.; Yilmaz Y.; Korenjak M.; Spearman C.W.; Ungan M.; Palmer M.; El-Shabrawi M.; Gruss H.-J.; Dufour J.-F.; Dhawan A.; Wedemeyer H.; George J.; Valenti L.; Fouad Y.; Romero-Gomez M.; Eslam M.; Abate M.L.; Abbas B.; Abbassy A.A.; Abd El Ghany W.; Abd Elkhalek A.; Abd ElMajeed E.; Abdalgaber M.; AbdAllah M.; Abdallah M.; Abdallah N.; Abdelaleem S.; Abdelghani Y.; Abdelghany W.; Abdelhalim S.M.; Abdelhamid W.; Abdelhamid N.; Abdelkader N.A.; Abdelkreem E.; Abdelmohsen A.M.; Abdelrahman A.A.; Abd-elsalam S.M.; Abdeltawab D.; Abduh A.; Abdulhakam N.; Abdulla M.; Abedpoor N.; Abenavoli L.; Aberg F.; Ablack O.; Abo elftouh M.; Abo-Amer Y.E.-E.; Aboubkr A.; Aboud A.; Abouelnaga A.M.; Aboufarrag G.A.; Aboutaleb A.; Abundis L.; Adali G.; Adames E.; Adams L.; Adda D.; Adel N.; Adel N.; Adel Sayed M.; Afaa T.J.; Afredj N.; Aghayeva G.; Aghemo A.; Aguilar-Salinas C.A.; Ahlenstiel G.; Ahmady W.; Ahmed W.; Ahmed A.; Ahmed S.N.; Ahmed H.M.; Ahmed R.; Aigner E.; Akarsu M.; Akroush M.; Akyuz U.; Al Mahtab M.; Al Qadiri T.; Al Rawahi Y.; AL rubaee R.; Al Saffar M.; Alam S.; Al-Ani Z.; Albillos A.; Alboraie M.; Al-Busafi S.; Al-Emam M.; Alharthi J.; Ali K.; Ali B.A.; Ali M.; Ali R.A.R.; Alisi A.; AL-Khafaji A.R.; Alkhatry M.; Aller R.; Almansoury Y.; Al-Naamani K.; Alnakeeb A.; Alonso A.; Alqahtani S.A.; Alrabadi L.; Alswat K.; Altaher M.; Altamimi T.; Altamirano J.; Alvares-da-Silva M.R.; Aly E.A.M.; Alzahaby A.; Alzamzamy A.; Amano K.; Amer M.A.; Amin M.A.; Amin S.A.; Amir A.A.; Ampuero J.; Anas N.; Andreone P.; Andriamandimby S.F.; Anees M.; Angela P.; Antonios M.; Arafat W.; Araya J.M.; Armendariz-Borunda J.; Armstrong M.J.; Ashktorab H.; Aspichueta P.; Assal F.; Atef M.; Attia D.; Atwa H.; Awad R.; Awad M.A.E.; Awny S.; Awolowo O.; Awuku Y.A.; Ayada I.; Aye T.T.; Ayman S.; Ayman H.; Ayoub H.; Azmy H.M.; Babaran R.P.; Badreldin O.; Badry A.; Bahcecioglu I.H.; Bahour A.; Bai J.; Balaban Y.; Balasubramanyam M.; Bamakhrama K.; Banales J.M.; Bangaru B.; Bao J.; Barahona J.S.; Barakat S.; Barbalho S.M.; Barbra B.; Barranco B.; Barrera F.; Baumann U.; Bazeed S.; Bech E.; Benayad A.; Benesic A.; Bernstein D.; Bessone F.; Birney S.; Bisseye C.; Blake M.; Bobat B.; Bonfrate L.; Bordin D.S.; Bosques-Padilla F.; Boursier J.; Boushab B.M.; Bowen D.; Bravo P.M.; Brennan P.N.; Bright B.; Broekaert I.; Buque X.; Burgos-Santamaria D.; Burman J.; Busetto L.; Byrne C.D.; Cabral-Prodigalidad P.A.I.; Cabrera-Alvarez G.; Cai W.; Cainelli F.; Caliskan A.R.; Canbay A.; Cano-Contreras A.; Cao H.-X.; Cao Z.; Carrion A.; Carubbi F.; Casanovas T.; Castellanos Fernandez M.I.; Chai J.; Chan S.P.; Charatcharoenwitthaya P.; Chavez-Tapia N.; Chayama K.; Chen J.; Chen L.; Chen Z.-W.; Chen H.; Chen S.-D.; Chen Q.; Chen Y.; Chen G.; Chen E.-Q.; Chen F.; Chen P.-J.; Cheng R.; Cheng W.; Chieh J.T.W.; Chokr I.; Cholongitas E.; Choudhury A.; Chowdhury A.; Chukwudike E.S.; Ciardullo S.; Clayton M.; Clement K.; Cloa M.M.; Coccia C.; Collazos C.; Colombo M.; Cosar A.M.; Cotrim H.P.; Couillerot J.; Coulibaly A.; Crespo G.; Crespo J.; Cruells M.; Cua I.H.Y.; Dabbous H.K.; Dalekos G.N.; D'Alia P.; Dan L.; Dao V.H.; Darwish M.; Datz C.; Davalos-Moscol M.B.; Dawoud H.; de Careaga B.O.; de Knegt R.; de Ledinghen V.; de Silva J.; Debzi N.; Decraecker M.; Del Pozo E.; Delgado T.C.; Delgado-Blanco M.; Dembinski L.; Depina A.; Derbala M.; Desalegn H.; Desbois-Mouthon C.; Desoky M.; Dev A.; Di Ciaula A.; Diago M.; Diallo I.; Diaz L.A.; Dirchwolf M.; Dongiovanni P.; Dorofeyev A.; Dou X.; Douglas M.W.; Doulberis M.; Dovia C.K.; Doyle A.; Dragojevic I.; Drenth J.P.; Duan X.; Dulskas A.; Dumitrascu D.L.; Duncan O.; Dusabejambo V.; Dwawhi R.S.N.A.; Eiketsu S.; El Amrousy D.; El Deeb A.; El Deriny G.; El Din H.S.; El Kamshishy S.; El Kassas M.; El Raziky M.; Elagamy O.A.; Elakel W.; Elalfy D.; Elaraby H.; ElAwady H.; Elbadawy R.; Eldash H.H.; Eldefrawy M.S.; Elecharri C.L.; Elfaramawy A.; Elfatih M.; Elfiky M.; Elgamsy M.; Elgendy M.; El-Guindi M.A.; Elhussieny N.; Eliwa A.M.; Elkabbany Z.; El-Khayat H.; El-Koofy N.M.; Elmetwalli A.; Elrabat A.; El-Raey F.; Elrashdy F.; Elsahhar M.; Elsaid E.M.; Elsayed S.; Elsayed H.; Elsayed A.; Elsayed A.M.; Elsayed H.; El-Serafy M.; Elsharkawy A.M.; Elsheemy R.Y.; Elshemy E.E.; Elsherbini S.; Eltoukhy N.; Elwakil R.; Emad O.; Emad S.; Embabi M.; Ergenc I.; Ermolova T.; Esmat G.; Esmat D.M.; Estupinan E.C.; Ettair S.; Eugen T.; Ezz-Eldin M.; Falcon L.P.V.; Fan Y.-C.; Fandari S.; Farag M.; Farahat T.M.; Fares E.M.; Fares M.; Fassio E.; Fathy H.; Fathy D.; Fathy W.; Fayed S.; Feng D.; Feng G.; Fernandez-Bermejo M.; Ferreira C.T.; Ferrer J.D.; Forbes A.; Fouad R.; Fouad H.M.; Frisch T.; Fujii H.; Fukunaga S.; Fukunishi S.; Fulya H.; Furuhashi M.; Gaber Y.; Galang A.J.G.; Gallardo J.C.; Galloso R.; Gamal M.; Gamal R.; Gamal H.; Gan J.; Ganbold A.; Gao X.; Garas G.; Garba T.; Garcia-Cortes M.; Garcia-Monzon C.; Garcia-Samaniego J.; Gastaldelli A.; Gatica M.; Gatley E.; Gegeshidze T.; Geng B.; Ghazinyan H.; Ghoneem S.; Giacomelli L.; Giannelli G.; Giannini E.G.; Giefer M.; Gines P.; Girala M.; Giraudi P.J.; Goh G.B.-B.; Gomaa A.A.; Gong B.; Gonzales D.H.C.; Gonzalez H.C.; Gonzalez-Huezo M.S.; Graupera I.; Grgurevic I.; Gronbaek H.; Gu X.; Guan L.; Gueye I.; Guingane A.N.; Gul O.O.; Gul C.B.; Guo Q.; Gupta P.P.; Gurakar A.; Gutierrez J.C.R.; Habib G.; Hafez A.; Hagman E.; Halawa E.; Hamdy O.; Hamed A.E.; Hamed D.H.; Hamid S.; Hamoudi W.; Han Y.; Haridy J.; Haridy H.; Harris D.C.H.H.; Hart M.; Hasan F.; Hashim A.; Hassan I.; Hassan A.; Hassan E.A.; Hassan A.A.; Hassan M.S.; Hassanin F.; Hassnine A.; Haukeland J.W.; Hawal A.I.M.; He J.; He Q.; He Y.; He F.-P.; Hegazy M.; Hegazy A.; Henegil O.; Hernandez N.; Hernandez-Guerra M.; Higuera-de-la-Tijera F.; Hindy I.; Hirota K.; Ho L.C.; Hodge A.; Hosny M.; Hou X.; Huang J.-F.; Huang Y.; Huang Z.; Huang Y.; Huang A.; Huang X.-P.; Hui-ping S.; Hunyady B.; Hussein M.A.; Hussein O.; Hussien S.M.; Ibanez-Samaniego L.; Ibdah J.; Ibrahim L.; Ibrahim M.; Ibrahim I.; Icaza-Chavez M.E.; Idelbi S.; Idilman R.I.; Ikeda M.; Indolfi G.; Invernizzi F.; Irshad I.; Isa H.M.A.; Iskandar N.J.; Ismaiel A.; Ismail M.; Ismail Z.; Ismail F.; Iwamoto H.; Jack K.; Jacob R.; Jafarov F.; Jafri W.; Jahshan H.; Jalal P.K.; Jancoriene L.; Janicko M.; Jayasena H.; Jefferies M.; Jha V.; Ji F.; Ji Y.; Jia J.; Jiang C.; Jiang N.; Jiang Z.-Z.; Jin X.; Jin Y.; Jing X.; Jingyu Q.; Jinjolava M.; Jong F.H.H.; Jucov A.; Julius I.; Kaddah M.; Kamada Y.; kamal A.; Kamal E.M.; Kamel A.S.; Kao J.-H.; Karin M.; Karlas T.; Kashwaa M.; Katsidzira L.; Kaya E.; Kayasseh M.A.; Keenan B.; Keklikkiran C.; Keml W.; Khalaf D.K.; Khalefa R.; Khamis S.; Khater D.; khattab H.; Khavkin A.; Khlynova O.; Khmis N.; Kobyliak N.; Koffas A.; Koike K.; Kok K.Y.Y.; Koller T.; Komas N.P.; Korochanskaya N.V.; Koulla Y.; Koya S.; Kraft C.; Kraja B.; Krawczyk M.; Kuchay M.S.; Kulkarni A.V.; Kumar A.; Kumar M.; Lakoh S.; Lam P.; Lan L.; Lange N.F.; Lankarani K.B.; Lanthier N.; Lapshyna K.; Lashen S.A.; Laure K.N.J.; Lazebnik L.; Lebrec D.; Lee S.S.; Lee W.S.; Lee Y.Y.; Leeming D.J.; Leite N.C.; Leon R.; Lesmana C.R.A.; Li J.; Li Q.; Li J.; Li Y.-Y.; Li Y.; Li L.; Li M.; li Y.; Liang H.; Lijuan T.; Lim S.G.; Lim L.-L.; Lin S.; Lin H.-C.; Lin R.; Lithy R.; Liu Y.; Liu Y.; Liu X.; Liu W.-Y.; Liu S.; Liu K.; Liu T.; Lonardo A.; Lopez M.B.; Lopez-Benages E.; Lopez-Jaramillo P.; Lu H.; Lu L.G.; Lu Y.; Lubel J.; Lui R.; Lupasco I.; Luzina E.; Lv X.-H.; Lynch K.; Ma H.-L.; Machado M.V.; Maduka N.; Madzharova K.; Magdaong R.; Mahadeva S.; Mahfouz A.; Mahmood N.R.K.N.; Mahmoud E.; Mahrous M.; Maiwall R.; Majeed A.; Majumdar A.; Mak L.; Maklouf M.M.; Malekzadeh R.; Mandato C.; Mangia A.; Mann J.; Mansour H.H.; Mansouri A.; Mantovani A.; Mao J.Q.; Maramag F.; Marchesini G.; Marcus C.; Marinho R.A.R.T.; Martinez-Chantar M.L.; Martins A.A.S.; Marwan R.; Mason K.F.; Masoud G.; Massoud M.N.; Matamoros M.A.; Mateos R.M.; Mawed A.; Mbanya J.C.; Mbendi C.; McColaugh L.; McLeod D.; Medina J.F.R.; Megahed A.; Mehrez M.; Memon I.; Merat S.; Mercado R.; Mesbah A.; Meskini T.; Metwally M.; Metwaly R.; Miao L.; Micah E.; Miele L.; Milivojevic V.; Milovanovic T.; Mina Y.L.; Mishkovik M.; Mishriki A.; Mitchell T.; Mohamed A.; Mohamed M.; Mohamed S.; Mohammed S.; Mohammed A.; Mohan V.; Mohie S.; Mokhtar A.; Moniem R.; Montilla M.S.; Morales J.A.O.; Morata M.M.S.; Moreno-Planas J.M.; Morise S.; Mosaad S.; Moselhy M.; Mostafa A.M.; Mostafa E.; Mouane N.; Mousa N.; Moustafa H.M.; Msherif A.; Muller K.; Munoz C.; Munoz-Urribarri A.B.; Murillo O.A.; Mustapha F.I.; Muzurovic E.; Nabil Y.; Nafady S.; Nagamatsu A.; Nakajima A.; Nakano D.; Nan Y.; Nascimbeni F.; Naseef M.S.; Nashat N.; Natalia T.; Negro F.; Nersesov A.V.; Neuman M.; Ng'wanasayi M.; Ni Y.; Nicoll A.; Niizeki T.; Nikolova D.; Ningning W.; Niriella M.; Nogoibaeva K.A.; Nordien R.; O Sullivan C.; O'Beirne J.; Obekpa S.; Ocama P.; Ochwoto M.; Ogolodom M.P.; Ojo O.; Okrostsvaridze N.; Oliveira C.P.; Omana R.C.; Omar O.M.; Omar H.; Omar M.; Omran S.; Omran R.; Osman M.M.; Owise N.; Owusu-Ansah T.; Padilla- Machaca P.M.; Palle S.; Pan Z.; Pan X.-Y.; Pan Q.; Papaefthymiou A.; Paquissi F.C.; Par G.; Parkash A.; Payawal D.; Peltekian K.M.; Peng X.; Peng L.; Peng Y.; Pengoria R.; Perez M.; Perez J.L.; Perez N.M.; Persico M.; Pessoa M.G.; Petta S.; Philip M.; Plaz Torres M.C.; Polavarapu N.; Poniachik J.; Portincasa P.; Pu C.; Purnak T.; Purwanto E.; Qi X.; Qi X.; Qian Z.; Qiang Z.; Qiao Z.; Qiao L.; Queiroz A.; Rabiee A.; Radwan M.; Rahetilahy A.M.; Ramadan Y.; Ramadan D.; Ramli A.S.; Ramm G.A.; Ran A.; Rankovic I.; RAO H.; Raouf S.; Ray S.; Reau N.; Refaat A.; Reiberger T.; Remes-Troche J.M.; Reyes E.C.; Richardson B.; Ridruejo E.; Riestra Jimenez S.; Rizk I.; Roberts S.; Roblero J.P.; Robles J.A.P.; Rockey D.; Rodriguez M.; Rodriguez Hernandez H.; Roman E.; Romeiro F.G.; Romeo S.; Rosales-Zabal J.M.; Roshdi G.R.; Rosso N.; Ruf A.; Ruiz P.C.; Runes N.R.; Ruzzenente A.; Ryan M.; Saad A.; Sabbagh E.B.; Sabbah M.; Saber S.; Sabrey R.; Sabry R.; Saeed M.A.; Said D.; Said E.M.; Sakr M.A.; Salah Y.; Salama R.M.; Salama A.; Saleh H.; Saleh A.; Salem A.; Salem A.T.; Salifou A.; Salih A.F.; Salman A.; Samouda H.; Sanai F.; Sanchez-Avila J.F.; Sanker L.; Sano T.; Sanz M.; Saparbu T.; Sawhney R.; Sayed F.; Sayed S.A.; Sayed A.O.; Sayed M.; Sebastiani G.; Secadas L.; Sediqi K.Q.; Seif S.; Semida N.; Senates E.; Serban E.D.; Serfaty L.; Seto W.-K.; Sghaier I.; Sha M.; Shabaan H.M.; Shalaby L.; Shaltout I.; Sharara A.I.; Sharma V.; Shawa I.T.; Shawkat A.; Shawky N.; Shehata O.; Sheils S.; Shewaye A.B.; Shi G.; Shi J.; Shimose S.; Shirono T.; Shou L.; Shrestha A.; Shui G.; Sievert W.; Sigurdardottir S.; Sira M.M.; Siradj R.; Sison C.; Smyth L.; Soliman R.; Sollano J.D.; Sombie R.; Sonderup M.; Sood S.; Soriano G.; Stedman C.A.M.; Stefanyuk O.; Stimac D.; Strasser S.; Strnad P.; Stuart K.; Su W.; Su M.; Sumida Y.; Sumie S.; Sun D.-Q.; Sun J.; Suzuki H.; Svegliati-Baroni G.; Swar M.O.; TAHARBOUCHT S.; Taher Z.; Takamura S.; Tan L.; Tan S.-S.; Tanwandee T.; Tarek S.; Tatiana G.; Tavaglione F.; Tecson G.Y.; Tee H.-P.; Teschke R.; Tharwat M.; Thong V.D.; Thursz M.; Tine T.; Tiribelli C.; Tolmane I.; Tong J.; Tongo M.; Torkie M.; Torre A.; Torres E.A.; Trajkovska M.; Treeprasertsuk S.; Tsutsumi T.; Tu T.; Tur J.A.; Turan D.; Turcan S.; Turkina S.; Tutar E.; Tzeuton C.; Ugiagbe R.; Uygun A.; Vacca M.; Vajro P.; Van der Poorten D.; Van Kleef L.A.; Vashakidze E.; Velazquez C.M.; Velazquez M.I.; Vento S.; Verhoeven V.; Vespasiani-Gentilucci U.; Vethakkan S.R.; Vilaseca J.; Vitek L.; Volkanovska A.; Wallace M.; Wan W.; Wang Y.; Wang Y.; Wang X.; Wang X.; Wang C.; Wang C.; Wang M.; Wangchuk P.; Weltman M.; White M.; Wiegand J.; Wifi M.-N.; Wigg A.; Wilhelmi M.; William R.; Wittenburg H.; Wu S.; Wubeneh A.M.; Xia H.; Xiao J.; Xiao X.; Xiaofeng W.; Xiong W.; Xu L.; Xu J.; Xu W.; Xu J.-H.; Xu K.; Xu Y.; Xu S.-H.; Xu M.; Xu A.; Xu C.; Yan H.; Yang J.; Yang R.-X.; Yang Y.; Yang Q.; Yang N.; Yao J.; Yara J.; Yaras S.; Yilmaz N.; Younes R.; younes H.; Young S.; Youssef F.; Yu Y.; Yu M.-L.; Yuan J.; Yue Z.; Yuen M.-F.; Yun W.; Yurukova N.; Zakaria S.; Zaky S.; Zaldastanishvili M.; Zapata R.; Zare N.; Zerem E.; Zeriban N.; Zeshuai X.; Zhang H.; Zhang X.; Zhang Y.; Zhang W.-H.; Zhang X.; Zhang Y.-P.; Zhang Y.; Zhang Z.-Q.; Zhao J.; Zhao R.-R.; Zhao H.; Zheng C.; Zheng Y.; Zheng R.; Zheng T.-L.; Zheng K.; Zhou X.Q.; Zhou Y.; Zhou Y.-J.; Zhou H.; Zhou L.; Zhou Y.; Zhu L.D.; Zhu Y.F.; Zhu Y.; Zhu P.-W.; Ziada E.; Ziring D.; Ziyi L.; Zou S.; Zou Z.; Zou H.; Zuart Ruiz R.Mendez-Sanchez, N.; Bugianesi, E.; Gish, R. G.; Lammert, F.; Tilg, H.; Nguyen, M. H.; Sarin, S. K.; Fabrellas, N.; Zelber-Sagi, S.; Fan, J. -G.; Shiha, G.; Targher, G.; Zheng, M. -H.; Chan, W. -K.; Vinker, S.; Kawaguchi, T.; Castera, L.; Yilmaz, Y.; Korenjak, M.; Spearman, C. W.; Ungan, M.; Palmer, M.; El-Shabrawi, M.; Gruss, H. -J.; Dufour, J. -F.; Dhawan, A.; Wedemeyer, H.; George, J.; Valenti, L.; Fouad, Y.; Romero-Gomez, M.; Eslam, M.; Abate, M. L.; Abbas, B.; Abbassy, A. A.; Abd El Ghany, W.; Abd Elkhalek, A.; Abd ElMajeed, E.; Abdalgaber, M.; Abdallah, M.; Abdallah, M.; Abdallah, N.; Abdelaleem, S.; Abdelghani, Y.; Abdelghany, W.; Abdelhalim, S. M.; Abdelhamid, W.; Abdelhamid, N.; Abdelkader, N. A.; Abdelkreem, E.; Abdelmohsen, A. M.; Abdelrahman, A. A.; Abd-elsalam, S. M.; Abdeltawab, D.; Abduh, A.; Abdulhakam, N.; Abdulla, M.; Abedpoor, N.; Abenavoli, L.; Aberg, F.; Ablack, O.; Abo elftouh, M.; Abo-Amer, Y. E. -E.; Aboubkr, A.; Aboud, A.; Abouelnaga, A. M.; Aboufarrag, G. A.; Aboutaleb, A.; Abundis, L.; Adali, G.; Adames, E.; Adams, L.; Adda, D.; Adel, N.; Adel, N.; Adel Sayed, M.; Afaa, T. J.; Afredj, N.; Aghayeva, G.; Aghemo, A.; Aguilar-Salinas, C. A.; Ahlenstiel, G.; Ahmady, W.; Ahmed, W.; Ahmed, A.; Ahmed, S. N.; Ahmed, H. M.; Ahmed, R.; Aigner, E.; Akarsu, M.; Akroush, M.; Akyuz, U.; Al Mahtab, M.; Al Qadiri, T.; Al Rawahi, Y.; AL rubaee, R.; Al Saffar, M.; Alam, S.; Al-Ani, Z.; Albillos, A.; Alboraie, M.; Al-Busafi, S.; Al-Emam, M.; Alharthi, J.; Ali, K.; Ali, B. A.; Ali, M.; Ali, R. A. R.; Alisi, A.; AL-Khafaji, A. R.; Alkhatry, M.; Aller, R.; Almansoury, Y.; Al-Naamani, K.; Alnakeeb, A.; Alonso, A.; Alqahtani, S. A.; Alrabadi, L.; Alswat, K.; Altaher, M.; Altamimi, T.; Altamirano, J.; Alvares-da-Silva, M. R.; Aly, E. A. M.; Alzahaby, A.; Alzamzamy, A.; Amano, K.; Amer, M. A.; Amin, M. A.; Amin, S. A.; Amir, A. A.; Ampuero, J.; Anas, N.; Andreone, P.; Andriamandimby, S. F.; Anees, M.; Angela, P.; Antonios, M.; Arafat, W.; Araya, J. M.; Armendariz-Borunda, J.; Armstrong, M. J.; Ashktorab, H.; Aspichueta, P.; Assal, F.; Atef, M.; Attia, D.; Atwa, H.; Awad, R.; Awad, M. A. E.; Awny, S.; Awolowo, O.; Awuku, Y. A.; Ayada, I.; Aye, T. T.; Ayman, S.; Ayman, H.; Ayoub, H.; Azmy, H. M.; Babaran, R. P.; Badreldin, O.; Badry, A.; Bahcecioglu, I. H.; Bahour, A.; Bai, J.; Balaban, Y.; Balasubramanyam, M.; Bamakhrama, K.; Banales, J. M.; Bangaru, B.; Bao, J.; Barahona, J. S.; Barakat, S.; Barbalho, S. M.; Barbra, B.; Barranco, B.; Barrera, F.; Baumann, U.; Bazeed, S.; Bech, E.; Benayad, A.; Benesic, A.; Bernstein, D.; Bessone, F.; Birney, S.; Bisseye, C.; Blake, M.; Bobat, B.; Bonfrate, L.; Bordin, D. S.; Bosques-Padilla, F.; Boursier, J.; Boushab, B. M.; Bowen, D.; Bravo, P. M.; Brennan, P. N.; Bright, B.; Broekaert, I.; Buque, X.; Burgos-Santamaria, D.; Burman, J.; Busetto, L.; Byrne, C. D.; Cabral-Prodigalidad, P. A. I.; Cabrera-Alvarez, G.; Cai, W.; Cainelli, F.; Caliskan, A. R.; Canbay, A.; Cano-Contreras, A.; Cao, H. -X.; Cao, Z.; Carrion, A.; Carubbi, F.; Casanovas, T.; Castellanos Fernandez, M. I.; Chai, J.; Chan, S. P.; Charatcharoenwitthaya, P.; Chavez-Tapia, N.; Chayama, K.; Chen, J.; Chen, L.; Chen, Z. -W.; Chen, H.; Chen, S. -D.; Chen, Q.; Chen, Y.; Chen, G.; Chen, E. -Q.; Chen, F.; Chen, P. -J.; Cheng, R.; Cheng, W.; Chieh, J. T. W.; Chokr, I.; Cholongitas, E.; Choudhury, A.; Chowdhury, A.; Chukwudike, E. S.; Ciardullo, S.; Clayton, M.; Clement, K.; Cloa, M. M.; Coccia, C.; Collazos, C.; Colombo, M.; Cosar, A. M.; Cotrim, H. P.; Couillerot, J.; Coulibaly, A.; Crespo, G.; Crespo, J.; Cruells, M.; Cua, I. H. Y.; Dabbous, H. K.; Dalekos, G. N.; D'Alia, P.; Dan, L.; Dao, V. H.; Darwish, M.; Datz, C.; Davalos-Moscol, M. B.; Dawoud, H.; de Careaga, B. O.; de Knegt, R.; de Ledinghen, V.; de Silva, J.; Debzi, N.; Decraecker, M.; Del Pozo, E.; Delgado, T. C.; Delgado-Blanco, M.; Dembinski, L.; Depina, A.; Derbala, M.; Desalegn, H.; Desbois-Mouthon, C.; Desoky, M.; Dev, A.; Di Ciaula, A.; Diago, M.; Diallo, I.; Diaz, L. A.; Dirchwolf, M.; Dongiovanni, P.; Dorofeyev, A.; Dou, X.; Douglas, M. W.; Doulberis, M.; Dovia, C. K.; Doyle, A.; Dragojevic, I.; Drenth, J. P.; Duan, X.; Dulskas, A.; Dumitrascu, D. L.; Duncan, O.; Dusabejambo, V.; Dwawhi, R. S. N. A.; Eiketsu, S.; El Amrousy, D.; El Deeb, A.; El Deriny, G.; El Din, H. S.; El Kamshishy, S.; El Kassas, M.; El Raziky, M.; Elagamy, O. A.; Elakel, W.; Elalfy, D.; Elaraby, H.; Elawady, H.; Elbadawy, R.; Eldash, H. H.; Eldefrawy, M. S.; Elecharri, C. L.; Elfaramawy, A.; Elfatih, M.; Elfiky, M.; Elgamsy, M.; Elgendy, M.; El-Guindi, M. A.; Elhussieny, N.; Eliwa, A. M.; Elkabbany, Z.; El-Khayat, H.; El-Koofy, N. M.; Elmetwalli, A.; Elrabat, A.; El-Raey, F.; Elrashdy, F.; Elsahhar, M.; Elsaid, E. M.; Elsayed, S.; Elsayed, H.; Elsayed, A.; Elsayed, A. M.; Elsayed, H.; El-Serafy, M.; Elsharkawy, A. M.; Elsheemy, R. Y.; Elshemy, E. E.; Elsherbini, S.; Eltoukhy, N.; Elwakil, R.; Emad, O.; Emad, S.; Embabi, M.; Ergenc, I.; Ermolova, T.; Esmat, G.; Esmat, D. M.; Estupinan, E. C.; Ettair, S.; Eugen, T.; Ezz-Eldin, M.; Falcon, L. P. V.; Fan, Y. -C.; Fandari, S.; Farag, M.; Farahat, T. M.; Fares, E. M.; Fares, M.; Fassio, E.; Fathy, H.; Fathy, D.; Fathy, W.; Fayed, S.; Feng, D.; Feng, G.; Fernandez-Bermejo, M.; Ferreira, C. T.; Ferrer, J. D.; Forbes, A.; Fouad, R.; Fouad, H. M.; Frisch, T.; Fujii, H.; Fukunaga, S.; Fukunishi, S.; Fulya, H.; Furuhashi, M.; Gaber, Y.; Galang, A. J. G.; Gallardo, J. C.; Galloso, R.; Gamal, M.; Gamal, R.; Gamal, H.; Gan, J.; Ganbold, A.; Gao, X.; Garas, G.; Garba, T.; Garcia-Cortes, M.; Garcia-Monzon, C.; Garcia-Samaniego, J.; Gastaldelli, A.; Gatica, M.; Gatley, E.; Gegeshidze, T.; Geng, B.; Ghazinyan, H.; Ghoneem, S.; Giacomelli, L.; Giannelli, G.; Giannini, E. G.; Giefer, M.; Gines, P.; Girala, M.; Giraudi, P. J.; Goh, G. B. -B.; Gomaa, A. A.; Gong, B.; Gonzales, D. H. C.; Gonzalez, H. C.; Gonzalez-Huezo, M. S.; Graupera, I.; Grgurevic, I.; Gronbaek, H.; Gu, X.; Guan, L.; Gueye, I.; Guingane, A. N.; Gul, O. O.; Gul, C. B.; Guo, Q.; Gupta, P. P.; Gurakar, A.; Gutierrez, J. C. R.; Habib, G.; Hafez, A.; Hagman, E.; Halawa, E.; Hamdy, O.; Hamed, A. E.; Hamed, D. H.; Hamid, S.; Hamoudi, W.; Han, Y.; Haridy, J.; Haridy, H.; Harris, D. C. H. H.; Hart, M.; Hasan, F.; Hashim, A.; Hassan, I.; Hassan, A.; Hassan, E. A.; Hassan, A. A.; Hassan, M. S.; Hassanin, F.; Hassnine, A.; Haukeland, J. W.; Hawal, A. I. M.; He, J.; He, Q.; He, Y.; He, F. -P.; Hegazy, M.; Hegazy, A.; Henegil, O.; Hernandez, N.; Hernandez-Guerra, M.; Higuera-de-la-Tijera, F.; Hindy, I.; Hirota, K.; Ho, L. C.; Hodge, A.; Hosny, M.; Hou, X.; Huang, J. -F.; Huang, Y.; Huang, Z.; Huang, Y.; Huang, A.; Huang, X. -P.; Hui-ping, S.; Hunyady, B.; Hussein, M. A.; Hussein, O.; Hussien, S. M.; Ibanez-Samaniego, L.; Ibdah, J.; Ibrahim, L.; Ibrahim, M.; Ibrahim, I.; Icaza-Chavez, M. E.; Idelbi, S.; Idilman, R. I.; Ikeda, M.; Indolfi, G.; Invernizzi, F.; Irshad, I.; Isa, H. M. A.; Iskandar, N. J.; Ismaiel, A.; Ismail, M.; Ismail, Z.; Ismail, F.; Iwamoto, H.; Jack, K.; Jacob, R.; Jafarov, F.; Jafri, W.; Jahshan, H.; Jalal, P. K.; Jancoriene, L.; Janicko, M.; Jayasena, H.; Jefferies, M.; Jha, V.; Ji, F.; Ji, Y.; Jia, J.; Jiang, C.; Jiang, N.; Jiang, Z. -Z.; Jin, X.; Jin, Y.; Jing, X.; Jingyu, Q.; Jinjolava, M.; Jong, F. H. H.; Jucov, A.; Julius, I.; Kaddah, M.; Kamada, Y.; Kamal, A.; Kamal, E. M.; Kamel, A. S.; Kao, J. -H.; Karin, M.; Karlas, T.; Kashwaa, M.; Katsidzira, L.; Kaya, E.; Kayasseh, M. A.; Keenan, B.; Keklikkiran, C.; Keml, W.; Khalaf, D. K.; Khalefa, R.; Khamis, S.; Khater, D.; Khattab, H.; Khavkin, A.; Khlynova, O.; Khmis, N.; Kobyliak, N.; Koffas, A.; Koike, K.; Kok, K. Y. Y.; Koller, T.; Komas, N. P.; Korochanskaya, N. V.; Koulla, Y.; Koya, S.; Kraft, C.; Kraja, B.; Krawczyk, M.; Kuchay, M. S.; Kulkarni, A. V.; Kumar, A.; Kumar, M.; Lakoh, S.; Lam, P.; Lan, L.; Lange, N. F.; Lankarani, K. B.; Lanthier, N.; Lapshyna, K.; Lashen, S. A.; Laure, K. N. J.; Lazebnik, L.; Lebrec, D.; Lee, S. S.; Lee, W. S.; Lee, Y. Y.; Leeming, D. J.; Leite, N. C.; Leon, R.; Lesmana, C. R. A.; Li, J.; Li, Q.; Li, J.; Li, Y. -Y.; Li, Y.; Li, L.; Li, M.; Li, Y.; Liang, H.; Lijuan, T.; Lim, S. G.; Lim, L. -L.; Lin, S.; Lin, H. -C.; Lin, R.; Lithy, R.; Liu, Y.; Liu, Y.; Liu, X.; Liu, W. -Y.; Liu, S.; Liu, K.; Liu, T.; Lonardo, A.; Lopez, M. B.; Lopez-Benages, E.; Lopez-Jaramillo, P.; Lu, H.; Lu, L. G.; Lu, Y.; Lubel, J.; Lui, R.; Lupasco, I.; Luzina, E.; Lv, X. -H.; Lynch, K.; Ma, H. -L.; Machado, M. V.; Maduka, N.; Madzharova, K.; Magdaong, R.; Mahadeva, S.; Mahfouz, A.; Mahmood, N. R. K. N.; Mahmoud, E.; Mahrous, M.; Maiwall, R.; Majeed, A.; Majumdar, A.; Mak, L.; Maklouf, M. M.; Malekzadeh, R.; Mandato, C.; Mangia, A.; Mann, J.; Mansour, H. H.; Mansouri, A.; Mantovani, A.; Mao, J. Q.; Maramag, F.; Marchesini, G.; Marcus, C.; Marinho, R. A. R. T.; Martinez-Chantar, M. L.; Martins, A. A. S.; Marwan, R.; Mason, K. F.; Masoud, G.; Massoud, M. N.; Matamoros, M. A.; Mateos, R. M.; Mawed, A.; Mbanya, J. C.; Mbendi, C.; Mccolaugh, L.; Mcleod, D.; Medina, J. F. R.; Megahed, A.; Mehrez, M.; Memon, I.; Merat, S.; Mercado, R.; Mesbah,

Global multi-stakeholder endorsement of the MAFLD definition

none1055noneMendez-Sanchez N.; Bugianesi E.; Gish R.G.; Lammert F.; Tilg H.; Nguyen M.H.; Sarin S.K.; Fabrellas N.; Zelber-Sagi S.; Fan J.-G.; Shiha G.; Targher G.; Zheng M.-H.; Chan W.-K.; Vinker S.; Kawaguchi T.; Castera L.; Yilmaz Y.; Korenjak M.; Spearman C.W.; Ungan M.; Palmer M.; El-Shabrawi M.; Gruss H.-J.; Dufour J.-F.; Dhawan A.; Wedemeyer H.; George J.; Valenti L.; Fouad Y.; Romero-Gomez M.; Eslam M.; Abate M.L.; Abbas B.; Abbassy A.A.; Abd El Ghany W.; Abd Elkhalek A.; Abd ElMajeed E.; Abdalgaber M.; AbdAllah M.; Abdallah M.; Abdallah N.; Abdelaleem S.; Abdelghani Y.; Abdelghany W.; Abdelhalim S.M.; Abdelhamid W.; Abdelhamid N.; Abdelkader N.A.; Abdelkreem E.; Abdelmohsen A.M.; Abdelrahman A.A.; Abd-elsalam S.M.; Abdeltawab D.; Abduh A.; Abdulhakam N.; Abdulla M.; Abedpoor N.; Abenavoli L.; Aberg F.; Ablack O.; Abo elftouh M.; Abo-Amer Y.E.-E.; Aboubkr A.; Aboud A.; Abouelnaga A.M.; Aboufarrag G.A.; Aboutaleb A.; Abundis L.; Adali G.; Adames E.; Adams L.; Adda D.; Adel N.; Adel N.; Adel Sayed M.; Afaa T.J.; Afredj N.; Aghayeva G.; Aghemo A.; Aguilar-Salinas C.A.; Ahlenstiel G.; Ahmady W.; Ahmed W.; Ahmed A.; Ahmed S.N.; Ahmed H.M.; Ahmed R.; Aigner E.; Akarsu M.; Akroush M.; Akyuz U.; Al Mahtab M.; Al Qadiri T.; Al Rawahi Y.; AL rubaee R.; Al Saffar M.; Alam S.; Al-Ani Z.; Albillos A.; Alboraie M.; Al-Busafi S.; Al-Emam M.; Alharthi J.; Ali K.; Ali B.A.; Ali M.; Ali R.A.R.; Alisi A.; AL-Khafaji A.R.; Alkhatry M.; Aller R.; Almansoury Y.; Al-Naamani K.; Alnakeeb A.; Alonso A.; Alqahtani S.A.; Alrabadi L.; Alswat K.; Altaher M.; Altamimi T.; Altamirano J.; Alvares-da-Silva M.R.; Aly E.A.M.; Alzahaby A.; Alzamzamy A.; Amano K.; Amer M.A.; Amin M.A.; Amin S.A.; Amir A.A.; Ampuero J.; Anas N.; Andreone P.; Andriamandimby S.F.; Anees M.; Angela P.; Antonios M.; Arafat W.; Araya J.M.; Armendariz-Borunda J.; Armstrong M.J.; Ashktorab H.; Aspichueta P.; Assal F.; Atef M.; Attia D.; Atwa H.; Awad R.; Awad M.A.E.; Awny S.; Awolowo O.; Awuku Y.A.; Ayada I.; Aye T.T.; Ayman S.; Ayman H.; Ayoub H.; Azmy H.M.; Babaran R.P.; Badreldin O.; Badry A.; Bahcecioglu I.H.; Bahour A.; Bai J.; Balaban Y.; Balasubramanyam M.; Bamakhrama K.; Banales J.M.; Bangaru B.; Bao J.; Barahona J.S.; Barakat S.; Barbalho S.M.; Barbra B.; Barranco B.; Barrera F.; Baumann U.; Bazeed S.; Bech E.; Benayad A.; Benesic A.; Bernstein D.; Bessone F.; Birney S.; Bisseye C.; Blake M.; Bobat B.; Bonfrate L.; Bordin D.S.; Bosques-Padilla F.; Boursier J.; Boushab B.M.; Bowen D.; Bravo P.M.; Brennan P.N.; Bright B.; Broekaert I.; Buque X.; Burgos-Santamaria D.; Burman J.; Busetto L.; Byrne C.D.; Cabral-Prodigalidad P.A.I.; Cabrera-Alvarez G.; Cai W.; Cainelli F.; Caliskan A.R.; Canbay A.; Cano-Contreras A.; Cao H.-X.; Cao Z.; Carrion A.; Carubbi F.; Casanovas T.; Castellanos Fernandez M.I.; Chai J.; Chan S.P.; Charatcharoenwitthaya P.; Chavez-Tapia N.; Chayama K.; Chen J.; Chen L.; Chen Z.-W.; Chen H.; Chen S.-D.; Chen Q.; Chen Y.; Chen G.; Chen E.-Q.; Chen F.; Chen P.-J.; Cheng R.; Cheng W.; Chieh J.T.W.; Chokr I.; Cholongitas E.; Choudhury A.; Chowdhury A.; Chukwudike E.S.; Ciardullo S.; Clayton M.; Clement K.; Cloa M.M.; Coccia C.; Collazos C.; Colombo M.; Cosar A.M.; Cotrim H.P.; Couillerot J.; Coulibaly A.; Crespo G.; Crespo J.; Cruells M.; Cua I.H.Y.; Dabbous H.K.; Dalekos G.N.; D'Alia P.; Dan L.; Dao V.H.; Darwish M.; Datz C.; Davalos-Moscol M.B.; Dawoud H.; de Careaga B.O.; de Knegt R.; de Ledinghen V.; de Silva J.; Debzi N.; Decraecker M.; Del Pozo E.; Delgado T.C.; Delgado-Blanco M.; Dembinski L.; Depina A.; Derbala M.; Desalegn H.; Desbois-Mouthon C.; Desoky M.; Dev A.; Di Ciaula A.; Diago M.; Diallo I.; Diaz L.A.; Dirchwolf M.; Dongiovanni P.; Dorofeyev A.; Dou X.; Douglas M.W.; Doulberis M.; Dovia C.K.; Doyle A.; Dragojevic I.; Drenth J.P.; Duan X.; Dulskas A.; Dumitrascu D.L.; Duncan O.; Dusabejambo V.; Dwawhi R.S.N.A.; Eiketsu S.; El Amrousy D.; El Deeb A.; El Deriny G.; El Din H.S.; El Kamshishy S.; El Kassas M.; El Raziky M.; Elagamy O.A.; Elakel W.; Elalfy D.; Elaraby H.; ElAwady H.; Elbadawy R.; Eldash H.H.; Eldefrawy M.S.; Elecharri C.L.; Elfaramawy A.; Elfatih M.; Elfiky M.; Elgamsy M.; Elgendy M.; El-Guindi M.A.; Elhussieny N.; Eliwa A.M.; Elkabbany Z.; El-Khayat H.; El-Koofy N.M.; Elmetwalli A.; Elrabat A.; El-Raey F.; Elrashdy F.; Elsahhar M.; Elsaid E.M.; Elsayed S.; Elsayed H.; Elsayed A.; Elsayed A.M.; Elsayed H.; El-Serafy M.; Elsharkawy A.M.; Elsheemy R.Y.; Elshemy E.E.; Elsherbini S.; Eltoukhy N.; Elwakil R.; Emad O.; Emad S.; Embabi M.; Ergenc I.; Ermolova T.; Esmat G.; Esmat D.M.; Estupinan E.C.; Ettair S.; Eugen T.; Ezz-Eldin M.; Falcon L.P.V.; Fan Y.-C.; Fandari S.; Farag M.; Farahat T.M.; Fares E.M.; Fares M.; Fassio E.; Fathy H.; Fathy D.; Fathy W.; Fayed S.; Feng D.; Feng G.; Fernandez-Bermejo M.; Ferreira C.T.; Ferrer J.D.; Forbes A.; Fouad R.; Fouad H.M.; Frisch T.; Fujii H.; Fukunaga S.; Fukunishi S.; Fulya H.; Furuhashi M.; Gaber Y.; Galang A.J.G.; Gallardo J.C.; Galloso R.; Gamal M.; Gamal R.; Gamal H.; Gan J.; Ganbold A.; Gao X.; Garas G.; Garba T.; Garcia-Cortes M.; Garcia-Monzon C.; Garcia-Samaniego J.; Gastaldelli A.; Gatica M.; Gatley E.; Gegeshidze T.; Geng B.; Ghazinyan H.; Ghoneem S.; Giacomelli L.; Giannelli G.; Giannini E.G.; Giefer M.; Gines P.; Girala M.; Giraudi P.J.; Goh G.B.-B.; Gomaa A.A.; Gong B.; Gonzales D.H.C.; Gonzalez H.C.; Gonzalez-Huezo M.S.; Graupera I.; Grgurevic I.; Gronbaek H.; Gu X.; Guan L.; Gueye I.; Guingane A.N.; Gul O.O.; Gul C.B.; Guo Q.; Gupta P.P.; Gurakar A.; Gutierrez J.C.R.; Habib G.; Hafez A.; Hagman E.; Halawa E.; Hamdy O.; Hamed A.E.; Hamed D.H.; Hamid S.; Hamoudi W.; Han Y.; Haridy J.; Haridy H.; Harris D.C.H.H.; Hart M.; Hasan F.; Hashim A.; Hassan I.; Hassan A.; Hassan E.A.; Hassan A.A.; Hassan M.S.; Hassanin F.; Hassnine A.; Haukeland J.W.; Hawal A.I.M.; He J.; He Q.; He Y.; He F.-P.; Hegazy M.; Hegazy A.; Henegil O.; Hernandez N.; Hernandez-Guerra M.; Higuera-de-la-Tijera F.; Hindy I.; Hirota K.; Ho L.C.; Hodge A.; Hosny M.; Hou X.; Huang J.-F.; Huang Y.; Huang Z.; Huang Y.; Huang A.; Huang X.-P.; Hui-ping S.; Hunyady B.; Hussein M.A.; Hussein O.; Hussien S.M.; Ibanez-Samaniego L.; Ibdah J.; Ibrahim L.; Ibrahim M.; Ibrahim I.; Icaza-Chavez M.E.; Idelbi S.; Idilman R.I.; Ikeda M.; Indolfi G.; Invernizzi F.; Irshad I.; Isa H.M.A.; Iskandar N.J.; Ismaiel A.; Ismail M.; Ismail Z.; Ismail F.; Iwamoto H.; Jack K.; Jacob R.; Jafarov F.; Jafri W.; Jahshan H.; Jalal P.K.; Jancoriene L.; Janicko M.; Jayasena H.; Jefferies M.; Jha V.; Ji F.; Ji Y.; Jia J.; Jiang C.; Jiang N.; Jiang Z.-Z.; Jin X.; Jin Y.; Jing X.; Jingyu Q.; Jinjolava M.; Jong F.H.H.; Jucov A.; Julius I.; Kaddah M.; Kamada Y.; kamal A.; Kamal E.M.; Kamel A.S.; Kao J.-H.; Karin M.; Karlas T.; Kashwaa M.; Katsidzira L.; Kaya E.; Kayasseh M.A.; Keenan B.; Keklikkiran C.; Keml W.; Khalaf D.K.; Khalefa R.; Khamis S.; Khater D.; khattab H.; Khavkin A.; Khlynova O.; Khmis N.; Kobyliak N.; Koffas A.; Koike K.; Kok K.Y.Y.; Koller T.; Komas N.P.; Korochanskaya N.V.; Koulla Y.; Koya S.; Kraft C.; Kraja B.; Krawczyk M.; Kuchay M.S.; Kulkarni A.V.; Kumar A.; Kumar M.; Lakoh S.; Lam P.; Lan L.; Lange N.F.; Lankarani K.B.; Lanthier N.; Lapshyna K.; Lashen S.A.; Laure K.N.J.; Lazebnik L.; Lebrec D.; Lee S.S.; Lee W.S.; Lee Y.Y.; Leeming D.J.; Leite N.C.; Leon R.; Lesmana C.R.A.; Li J.; Li Q.; Li J.; Li Y.-Y.; Li Y.; Li L.; Li M.; li Y.; Liang H.; Lijuan T.; Lim S.G.; Lim L.-L.; Lin S.; Lin H.-C.; Lin R.; Lithy R.; Liu Y.; Liu Y.; Liu X.; Liu W.-Y.; Liu S.; Liu K.; Liu T.; Lonardo A.; Lopez M.B.; Lopez-Benages E.; Lopez-Jaramillo P.; Lu H.; Lu L.G.; Lu Y.; Lubel J.; Lui R.; Lupasco I.; Luzina E.; Lv X.-H.; Lynch K.; Ma H.-L.; Machado M.V.; Maduka N.; Madzharova K.; Magdaong R.; Mahadeva S.; Mahfouz A.; Mahmood N.R.K.N.; Mahmoud E.; Mahrous M.; Maiwall R.; Majeed A.; Majumdar A.; Mak L.; Maklouf M.M.; Malekzadeh R.; Mandato C.; Mangia A.; Mann J.; Mansour H.H.; Mansouri A.; Mantovani A.; Mao J.Q.; Maramag F.; Marchesini G.; Marcus C.; Marinho R.A.R.T.; Martinez-Chantar M.L.; Martins A.A.S.; Marwan R.; Mason K.F.; Masoud G.; Massoud M.N.; Matamoros M.A.; Mateos R.M.; Mawed A.; Mbanya J.C.; Mbendi C.; McColaugh L.; McLeod D.; Medina J.F.R.; Megahed A.; Mehrez M.; Memon I.; Merat S.; Mercado R.; Mesbah A.; Meskini T.; Metwally M.; Metwaly R.; Miao L.; Micah E.; Miele L.; Milivojevic V.; Milovanovic T.; Mina Y.L.; Mishkovik M.; Mishriki A.; Mitchell T.; Mohamed A.; Mohamed M.; Mohamed S.; Mohammed S.; Mohammed A.; Mohan V.; Mohie S.; Mokhtar A.; Moniem R.; Montilla M.S.; Morales J.A.O.; Morata M.M.S.; Moreno-Planas J.M.; Morise S.; Mosaad S.; Moselhy M.; Mostafa A.M.; Mostafa E.; Mouane N.; Mousa N.; Moustafa H.M.; Msherif A.; Muller K.; Munoz C.; Munoz-Urribarri A.B.; Murillo O.A.; Mustapha F.I.; Muzurovic E.; Nabil Y.; Nafady S.; Nagamatsu A.; Nakajima A.; Nakano D.; Nan Y.; Nascimbeni F.; Naseef M.S.; Nashat N.; Natalia T.; Negro F.; Nersesov A.V.; Neuman M.; Ng'wanasayi M.; Ni Y.; Nicoll A.; Niizeki T.; Nikolova D.; Ningning W.; Niriella M.; Nogoibaeva K.A.; Nordien R.; O Sullivan C.; O'Beirne J.; Obekpa S.; Ocama P.; Ochwoto M.; Ogolodom M.P.; Ojo O.; Okrostsvaridze N.; Oliveira C.P.; Omana R.C.; Omar O.M.; Omar H.; Omar M.; Omran S.; Omran R.; Osman M.M.; Owise N.; Owusu-Ansah T.; Padilla- Machaca P.M.; Palle S.; Pan Z.; Pan X.-Y.; Pan Q.; Papaefthymiou A.; Paquissi F.C.; Par G.; Parkash A.; Payawal D.; Peltekian K.M.; Peng X.; Peng L.; Peng Y.; Pengoria R.; Perez M.; Perez J.L.; Perez N.M.; Persico M.; Pessoa M.G.; Petta S.; Philip M.; Plaz Torres M.C.; Polavarapu N.; Poniachik J.; Portincasa P.; Pu C.; Purnak T.; Purwanto E.; Qi X.; Qi X.; Qian Z.; Qiang Z.; Qiao Z.; Qiao L.; Queiroz A.; Rabiee A.; Radwan M.; Rahetilahy A.M.; Ramadan Y.; Ramadan D.; Ramli A.S.; Ramm G.A.; Ran A.; Rankovic I.; RAO H.; Raouf S.; Ray S.; Reau N.; Refaat A.; Reiberger T.; Remes-Troche J.M.; Reyes E.C.; Richardson B.; Ridruejo E.; Riestra Jimenez S.; Rizk I.; Roberts S.; Roblero J.P.; Robles J.A.P.; Rockey D.; Rodriguez M.; Rodriguez Hernandez H.; Roman E.; Romeiro F.G.; Romeo S.; Rosales-Zabal J.M.; Roshdi G.R.; Rosso N.; Ruf A.; Ruiz P.C.; Runes N.R.; Ruzzenente A.; Ryan M.; Saad A.; Sabbagh E.B.; Sabbah M.; Saber S.; Sabrey R.; Sabry R.; Saeed M.A.; Said D.; Said E.M.; Sakr M.A.; Salah Y.; Salama R.M.; Salama A.; Saleh H.; Saleh A.; Salem A.; Salem A.T.; Salifou A.; Salih A.F.; Salman A.; Samouda H.; Sanai F.; Sanchez-Avila J.F.; Sanker L.; Sano T.; Sanz M.; Saparbu T.; Sawhney R.; Sayed F.; Sayed S.A.; Sayed A.O.; Sayed M.; Sebastiani G.; Secadas L.; Sediqi K.Q.; Seif S.; Semida N.; Senates E.; Serban E.D.; Serfaty L.; Seto W.-K.; Sghaier I.; Sha M.; Shabaan H.M.; Shalaby L.; Shaltout I.; Sharara A.I.; Sharma V.; Shawa I.T.; Shawkat A.; Shawky N.; Shehata O.; Sheils S.; Shewaye A.B.; Shi G.; Shi J.; Shimose S.; Shirono T.; Shou L.; Shrestha A.; Shui G.; Sievert W.; Sigurdardottir S.; Sira M.M.; Siradj R.; Sison C.; Smyth L.; Soliman R.; Sollano J.D.; Sombie R.; Sonderup M.; Sood S.; Soriano G.; Stedman C.A.M.; Stefanyuk O.; Stimac D.; Strasser S.; Strnad P.; Stuart K.; Su W.; Su M.; Sumida Y.; Sumie S.; Sun D.-Q.; Sun J.; Suzuki H.; Svegliati-Baroni G.; Swar M.O.; TAHARBOUCHT S.; Taher Z.; Takamura S.; Tan L.; Tan S.-S.; Tanwandee T.; Tarek S.; Tatiana G.; Tavaglione F.; Tecson G.Y.; Tee H.-P.; Teschke R.; Tharwat M.; Thong V.D.; Thursz M.; Tine T.; Tiribelli C.; Tolmane I.; Tong J.; Tongo M.; Torkie M.; Torre A.; Torres E.A.; Trajkovska M.; Treeprasertsuk S.; Tsutsumi T.; Tu T.; Tur J.A.; Turan D.; Turcan S.; Turkina S.; Tutar E.; Tzeuton C.; Ugiagbe R.; Uygun A.; Vacca M.; Vajro P.; Van der Poorten D.; Van Kleef L.A.; Vashakidze E.; Velazquez C.M.; Velazquez M.I.; Vento S.; Verhoeven V.; Vespasiani-Gentilucci U.; Vethakkan S.R.; Vilaseca J.; Vitek L.; Volkanovska A.; Wallace M.; Wan W.; Wang Y.; Wang Y.; Wang X.; Wang X.; Wang C.; Wang C.; Wang M.; Wangchuk P.; Weltman M.; White M.; Wiegand J.; Wifi M.-N.; Wigg A.; Wilhelmi M.; William R.; Wittenburg H.; Wu S.; Wubeneh A.M.; Xia H.; Xiao J.; Xiao X.; Xiaofeng W.; Xiong W.; Xu L.; Xu J.; Xu W.; Xu J.-H.; Xu K.; Xu Y.; Xu S.-H.; Xu M.; Xu A.; Xu C.; Yan H.; Yang J.; Yang R.-X.; Yang Y.; Yang Q.; Yang N.; Yao J.; Yara J.; Yaras S.; Yilmaz N.; Younes R.; younes H.; Young S.; Youssef F.; Yu Y.; Yu M.-L.; Yuan J.; Yue Z.; Yuen M.-F.; Yun W.; Yurukova N.; Zakaria S.; Zaky S.; Zaldastanishvili M.; Zapata R.; Zare N.; Zerem E.; Zeriban N.; Zeshuai X.; Zhang H.; Zhang X.; Zhang Y.; Zhang W.-H.; Zhang X.; Zhang Y.-P.; Zhang Y.; Zhang Z.-Q.; Zhao J.; Zhao R.-R.; Zhao H.; Zheng C.; Zheng Y.; Zheng R.; Zheng T.-L.; Zheng K.; Zhou X.Q.; Zhou Y.; Zhou Y.-J.; Zhou H.; Zhou L.; Zhou Y.; Zhu L.D.; Zhu Y.F.; Zhu Y.; Zhu P.-W.; Ziada E.; Ziring D.; Ziyi L.; Zou S.; Zou Z.; Zou H.; Zuart Ruiz R.Mendez-Sanchez, N.; Bugianesi, E.; Gish, R. G.; Lammert, F.; Tilg, H.; Nguyen, M. H.; Sarin, S. K.; Fabrellas, N.; Zelber-Sagi, S.; Fan, J. -G.; Shiha, G.; Targher, G.; Zheng, M. -H.; Chan, W. -K.; Vinker, S.; Kawaguchi, T.; Castera, L.; Yilmaz, Y.; Korenjak, M.; Spearman, C. W.; Ungan, M.; Palmer, M.; El-Shabrawi, M.; Gruss, H. -J.; Dufour, J. -F.; Dhawan, A.; Wedemeyer, H.; George, J.; Valenti, L.; Fouad, Y.; Romero-Gomez, M.; Eslam, M.; Abate, M. L.; Abbas, B.; Abbassy, A. A.; Abd El Ghany, W.; Abd Elkhalek, A.; Abd ElMajeed, E.; Abdalgaber, M.; Abdallah, M.; Abdallah, M.; Abdallah, N.; Abdelaleem, S.; Abdelghani, Y.; Abdelghany, W.; Abdelhalim, S. M.; Abdelhamid, W.; Abdelhamid, N.; Abdelkader, N. A.; Abdelkreem, E.; Abdelmohsen, A. M.; Abdelrahman, A. A.; Abd-elsalam, S. M.; Abdeltawab, D.; Abduh, A.; Abdulhakam, N.; Abdulla, M.; Abedpoor, N.; Abenavoli, L.; Aberg, F.; Ablack, O.; Abo elftouh, M.; Abo-Amer, Y. E. -E.; Aboubkr, A.; Aboud, A.; Abouelnaga, A. M.; Aboufarrag, G. A.; Aboutaleb, A.; Abundis, L.; Adali, G.; Adames, E.; Adams, L.; Adda, D.; Adel, N.; Adel, N.; Adel Sayed, M.; Afaa, T. J.; Afredj, N.; Aghayeva, G.; Aghemo, A.; Aguilar-Salinas, C. A.; Ahlenstiel, G.; Ahmady, W.; Ahmed, W.; Ahmed, A.; Ahmed, S. N.; Ahmed, H. M.; Ahmed, R.; Aigner, E.; Akarsu, M.; Akroush, M.; Akyuz, U.; Al Mahtab, M.; Al Qadiri, T.; Al Rawahi, Y.; AL rubaee, R.; Al Saffar, M.; Alam, S.; Al-Ani, Z.; Albillos, A.; Alboraie, M.; Al-Busafi, S.; Al-Emam, M.; Alharthi, J.; Ali, K.; Ali, B. A.; Ali, M.; Ali, R. A. R.; Alisi, A.; AL-Khafaji, A. R.; Alkhatry, M.; Aller, R.; Almansoury, Y.; Al-Naamani, K.; Alnakeeb, A.; Alonso, A.; Alqahtani, S. A.; Alrabadi, L.; Alswat, K.; Altaher, M.; Altamimi, T.; Altamirano, J.; Alvares-da-Silva, M. R.; Aly, E. A. M.; Alzahaby, A.; Alzamzamy, A.; Amano, K.; Amer, M. A.; Amin, M. A.; Amin, S. A.; Amir, A. A.; Ampuero, J.; Anas, N.; Andreone, P.; Andriamandimby, S. F.; Anees, M.; Angela, P.; Antonios, M.; Arafat, W.; Araya, J. M.; Armendariz-Borunda, J.; Armstrong, M. J.; Ashktorab, H.; Aspichueta, P.; Assal, F.; Atef, M.; Attia, D.; Atwa, H.; Awad, R.; Awad, M. A. E.; Awny, S.; Awolowo, O.; Awuku, Y. A.; Ayada, I.; Aye, T. T.; Ayman, S.; Ayman, H.; Ayoub, H.; Azmy, H. M.; Babaran, R. P.; Badreldin, O.; Badry, A.; Bahcecioglu, I. H.; Bahour, A.; Bai, J.; Balaban, Y.; Balasubramanyam, M.; Bamakhrama, K.; Banales, J. M.; Bangaru, B.; Bao, J.; Barahona, J. S.; Barakat, S.; Barbalho, S. M.; Barbra, B.; Barranco, B.; Barrera, F.; Baumann, U.; Bazeed, S.; Bech, E.; Benayad, A.; Benesic, A.; Bernstein, D.; Bessone, F.; Birney, S.; Bisseye, C.; Blake, M.; Bobat, B.; Bonfrate, L.; Bordin, D. S.; Bosques-Padilla, F.; Boursier, J.; Boushab, B. M.; Bowen, D.; Bravo, P. M.; Brennan, P. N.; Bright, B.; Broekaert, I.; Buque, X.; Burgos-Santamaria, D.; Burman, J.; Busetto, L.; Byrne, C. D.; Cabral-Prodigalidad, P. A. I.; Cabrera-Alvarez, G.; Cai, W.; Cainelli, F.; Caliskan, A. R.; Canbay, A.; Cano-Contreras, A.; Cao, H. -X.; Cao, Z.; Carrion, A.; Carubbi, F.; Casanovas, T.; Castellanos Fernandez, M. I.; Chai, J.; Chan, S. P.; Charatcharoenwitthaya, P.; Chavez-Tapia, N.; Chayama, K.; Chen, J.; Chen, L.; Chen, Z. -W.; Chen, H.; Chen, S. -D.; Chen, Q.; Chen, Y.; Chen, G.; Chen, E. -Q.; Chen, F.; Chen, P. -J.; Cheng, R.; Cheng, W.; Chieh, J. T. W.; Chokr, I.; Cholongitas, E.; Choudhury, A.; Chowdhury, A.; Chukwudike, E. S.; Ciardullo, S.; Clayton, M.; Clement, K.; Cloa, M. M.; Coccia, C.; Collazos, C.; Colombo, M.; Cosar, A. M.; Cotrim, H. P.; Couillerot, J.; Coulibaly, A.; Crespo, G.; Crespo, J.; Cruells, M.; Cua, I. H. Y.; Dabbous, H. K.; Dalekos, G. N.; D'Alia, P.; Dan, L.; Dao, V. H.; Darwish, M.; Datz, C.; Davalos-Moscol, M. B.; Dawoud, H.; de Careaga, B. O.; de Knegt, R.; de Ledinghen, V.; de Silva, J.; Debzi, N.; Decraecker, M.; Del Pozo, E.; Delgado, T. C.; Delgado-Blanco, M.; Dembinski, L.; Depina, A.; Derbala, M.; Desalegn, H.; Desbois-Mouthon, C.; Desoky, M.; Dev, A.; Di Ciaula, A.; Diago, M.; Diallo, I.; Diaz, L. A.; Dirchwolf, M.; Dongiovanni, P.; Dorofeyev, A.; Dou, X.; Douglas, M. W.; Doulberis, M.; Dovia, C. K.; Doyle, A.; Dragojevic, I.; Drenth, J. P.; Duan, X.; Dulskas, A.; Dumitrascu, D. L.; Duncan, O.; Dusabejambo, V.; Dwawhi, R. S. N. A.; Eiketsu, S.; El Amrousy, D.; El Deeb, A.; El Deriny, G.; El Din, H. S.; El Kamshishy, S.; El Kassas, M.; El Raziky, M.; Elagamy, O. A.; Elakel, W.; Elalfy, D.; Elaraby, H.; Elawady, H.; Elbadawy, R.; Eldash, H. H.; Eldefrawy, M. S.; Elecharri, C. L.; Elfaramawy, A.; Elfatih, M.; Elfiky, M.; Elgamsy, M.; Elgendy, M.; El-Guindi, M. A.; Elhussieny, N.; Eliwa, A. M.; Elkabbany, Z.; El-Khayat, H.; El-Koofy, N. M.; Elmetwalli, A.; Elrabat, A.; El-Raey, F.; Elrashdy, F.; Elsahhar, M.; Elsaid, E. M.; Elsayed, S.; Elsayed, H.; Elsayed, A.; Elsayed, A. M.; Elsayed, H.; El-Serafy, M.; Elsharkawy, A. M.; Elsheemy, R. Y.; Elshemy, E. E.; Elsherbini, S.; Eltoukhy, N.; Elwakil, R.; Emad, O.; Emad, S.; Embabi, M.; Ergenc, I.; Ermolova, T.; Esmat, G.; Esmat, D. M.; Estupinan, E. C.; Ettair, S.; Eugen, T.; Ezz-Eldin, M.; Falcon, L. P. V.; Fan, Y. -C.; Fandari, S.; Farag, M.; Farahat, T. M.; Fares, E. M.; Fares, M.; Fassio, E.; Fathy, H.; Fathy, D.; Fathy, W.; Fayed, S.; Feng, D.; Feng, G.; Fernandez-Bermejo, M.; Ferreira, C. T.; Ferrer, J. D.; Forbes, A.; Fouad, R.; Fouad, H. M.; Frisch, T.; Fujii, H.; Fukunaga, S.; Fukunishi, S.; Fulya, H.; Furuhashi, M.; Gaber, Y.; Galang, A. J. G.; Gallardo, J. C.; Galloso, R.; Gamal, M.; Gamal, R.; Gamal, H.; Gan, J.; Ganbold, A.; Gao, X.; Garas, G.; Garba, T.; Garcia-Cortes, M.; Garcia-Monzon, C.; Garcia-Samaniego, J.; Gastaldelli, A.; Gatica, M.; Gatley, E.; Gegeshidze, T.; Geng, B.; Ghazinyan, H.; Ghoneem, S.; Giacomelli, L.; Giannelli, G.; Giannini, E. G.; Giefer, M.; Gines, P.; Girala, M.; Giraudi, P. J.; Goh, G. B. -B.; Gomaa, A. A.; Gong, B.; Gonzales, D. H. C.; Gonzalez, H. C.; Gonzalez-Huezo, M. S.; Graupera, I.; Grgurevic, I.; Gronbaek, H.; Gu, X.; Guan, L.; Gueye, I.; Guingane, A. N.; Gul, O. O.; Gul, C. B.; Guo, Q.; Gupta, P. P.; Gurakar, A.; Gutierrez, J. C. R.; Habib, G.; Hafez, A.; Hagman, E.; Halawa, E.; Hamdy, O.; Hamed, A. E.; Hamed, D. H.; Hamid, S.; Hamoudi, W.; Han, Y.; Haridy, J.; Haridy, H.; Harris, D. C. H. H.; Hart, M.; Hasan, F.; Hashim, A.; Hassan, I.; Hassan, A.; Hassan, E. A.; Hassan, A. A.; Hassan, M. S.; Hassanin, F.; Hassnine, A.; Haukeland, J. W.; Hawal, A. I. M.; He, J.; He, Q.; He, Y.; He, F. -P.; Hegazy, M.; Hegazy, A.; Henegil, O.; Hernandez, N.; Hernandez-Guerra, M.; Higuera-de-la-Tijera, F.; Hindy, I.; Hirota, K.; Ho, L. C.; Hodge, A.; Hosny, M.; Hou, X.; Huang, J. -F.; Huang, Y.; Huang, Z.; Huang, Y.; Huang, A.; Huang, X. -P.; Hui-ping, S.; Hunyady, B.; Hussein, M. A.; Hussein, O.; Hussien, S. M.; Ibanez-Samaniego, L.; Ibdah, J.; Ibrahim, L.; Ibrahim, M.; Ibrahim, I.; Icaza-Chavez, M. E.; Idelbi, S.; Idilman, R. I.; Ikeda, M.; Indolfi, G.; Invernizzi, F.; Irshad, I.; Isa, H. M. A.; Iskandar, N. J.; Ismaiel, A.; Ismail, M.; Ismail, Z.; Ismail, F.; Iwamoto, H.; Jack, K.; Jacob, R.; Jafarov, F.; Jafri, W.; Jahshan, H.; Jalal, P. K.; Jancoriene, L.; Janicko, M.; Jayasena, H.; Jefferies, M.; Jha, V.; Ji, F.; Ji, Y.; Jia, J.; Jiang, C.; Jiang, N.; Jiang, Z. -Z.; Jin, X.; Jin, Y.; Jing, X.; Jingyu, Q.; Jinjolava, M.; Jong, F. H. H.; Jucov, A.; Julius, I.; Kaddah, M.; Kamada, Y.; Kamal, A.; Kamal, E. M.; Kamel, A. S.; Kao, J. -H.; Karin, M.; Karlas, T.; Kashwaa, M.; Katsidzira, L.; Kaya, E.; Kayasseh, M. A.; Keenan, B.; Keklikkiran, C.; Keml, W.; Khalaf, D. K.; Khalefa, R.; Khamis, S.; Khater, D.; Khattab, H.; Khavkin, A.; Khlynova, O.; Khmis, N.; Kobyliak, N.; Koffas, A.; Koike, K.; Kok, K. Y. Y.; Koller, T.; Komas, N. P.; Korochanskaya, N. V.; Koulla, Y.; Koya, S.; Kraft, C.; Kraja, B.; Krawczyk, M.; Kuchay, M. S.; Kulkarni, A. V.; Kumar, A.; Kumar, M.; Lakoh, S.; Lam, P.; Lan, L.; Lange, N. F.; Lankarani, K. B.; Lanthier, N.; Lapshyna, K.; Lashen, S. A.; Laure, K. N. J.; Lazebnik, L.; Lebrec, D.; Lee, S. S.; Lee, W. S.; Lee, Y. Y.; Leeming, D. J.; Leite, N. C.; Leon, R.; Lesmana, C. R. A.; Li, J.; Li, Q.; Li, J.; Li, Y. -Y.; Li, Y.; Li, L.; Li, M.; Li, Y.; Liang, H.; Lijuan, T.; Lim, S. G.; Lim, L. -L.; Lin, S.; Lin, H. -C.; Lin, R.; Lithy, R.; Liu, Y.; Liu, Y.; Liu, X.; Liu, W. -Y.; Liu, S.; Liu, K.; Liu, T.; Lonardo, A.; Lopez, M. B.; Lopez-Benages, E.; Lopez-Jaramillo, P.; Lu, H.; Lu, L. G.; Lu, Y.; Lubel, J.; Lui, R.; Lupasco, I.; Luzina, E.; Lv, X. -H.; Lynch, K.; Ma, H. -L.; Machado, M. V.; Maduka, N.; Madzharova, K.; Magdaong, R.; Mahadeva, S.; Mahfouz, A.; Mahmood, N. R. K. N.; Mahmoud, E.; Mahrous, M.; Maiwall, R.; Majeed, A.; Majumdar, A.; Mak, L.; Maklouf, M. M.; Malekzadeh, R.; Mandato, C.; Mangia, A.; Mann, J.; Mansour, H. H.; Mansouri, A.; Mantovani, A.; Mao, J. Q.; Maramag, F.; Marchesini, G.; Marcus, C.; Marinho, R. A. R. T.; Martinez-Chantar, M. L.; Martins, A. A. S.; Marwan, R.; Mason, K. F.; Masoud, G.; Massoud, M. N.; Matamoros, M. A.; Mateos, R. M.; Mawed, A.; Mbanya, J. C.; Mbendi, C.; Mccolaugh, L.; Mcleod, D.; Medina, J. F. R.; Megahed, A.; Mehrez, M.; Memon, I.; Merat, S.; Mercado, R.; Mesbah,

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society

Risk of COVID-19 after natural infection or vaccinationResearch in context

Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health

Risk of COVID-19 after natural infection or vaccinationResearch in context

Summary: Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health

Erratum to: Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition) (Autophagy, 12, 1, 1-222, 10.1080/15548627.2015.1100356

non present