Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Effects of soil pulverisation level and freeze and thaw cycles on fly-ash- and lime-stabilised high plasticity clay: implications on pavement design and performance

This study investigates the effects of soil pulverisation level and freeze and thaw cycles on mechanical properties of a stabilised high plasticity clay. Class F fly ash and hydrated lime were used as additives. Tested compositions were 3% lime, 20% Class F fly ash, 20% Class F fly and 3% lime and 40% Class F fly ash and 3% lime, respectively. Two different soil pulverisation levels which meet the criteria in relevant specifications were used. Unconfined compression strength tests were conducted on 61 samples. The results revealed that both fly ash and hydrated lime increased the mechanical properties. Lime addition increased the effectiveness of Class F fly ash stabilisation significantly. Soil pulverisation level was found to be as important as the amount of the additive used. The most important effect of soil pulverisation level and freeze and thaw cycles was on initial modulus value, which is a key parameter in pavement performance. Coarse soil pulverisation resulted in much lower modulus values than fine pulverisation. High compression strength was not always accompanied with high modulus for coarse soil pulverisation and therefore designing pavements based solely on strength without giving enough consideration to modulus has been shown to be a misleading approach. KENPAVE analysis revealed that shorter design lives were associated with coarse soil pulverisation. The results of this study show that the amount of achieved improvements and economic benefits due to stabilisation of clayey soils for pavements are strongly dependent on the degree of soil pulverisation achieved in the field. Therefore, better soil pulverisation in the field is crucial in increasing pavement performance and therefore decreasing total life cycle costs

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

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.; 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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,

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58\ub75%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31\ub72%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10\ub72%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12\ub73%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9\ub74%] of 7339 patients), middle (549 [14\ub70%] of 3918 patients), and low (298 [23\ub72%] of 1282) HDI (p&lt;0\ub7001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17\ub78%] of 574 patients in high-HDI countries; 74 [31\ub74%] of 236 patients in middle-HDI countries; 72 [39\ub78%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1\ub760, 95% credible interval 1\ub705\u20132\ub737; p=0\ub7030). 132 (21\ub76%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16\ub76%) of 295 patients in high-HDI countries, in 37 (19\ub78%) of 187 patients in middle-HDI countries, and in 46 (35\ub79%) of 128 patients in low-HDI countries (p&lt;0\ub7001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication. Funding: DFID-MRC-Wellcome Trust Joint Global Health Trial Development Grant, National Institute of Health Research Global Health Research Unit Grant

A multi-country analysis of COVID-19 hospitalizations by vaccination status

Background: Individuals vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), when infected, can still develop disease&nbsp;that requires hospitalization. It remains unclear whether these patients differ from hospitalized unvaccinated patients with regard to presentation, coexisting comorbidities, and outcomes. Methods: Here, we use data from an international consortium to study this&nbsp;question and assess whether differences between these groups are&nbsp;context specific. Data from 83,163 hospitalized COVID-19 patients (34,843 vaccinated, 48,320 unvaccinated) from 38 countries were analyzed. Findings: While typical symptoms were more often reported in unvaccinated patients, comorbidities, including some associated with worse prognosis in previous studies, were more common in vaccinated patients. Considerable between-country variation in both in-hospital fatality risk and vaccinated-versus-unvaccinated difference in this outcome was observed. Conclusions: These findings will inform allocation of healthcare resources in future surges as well as design of longer-term international studies to characterize changes in clinical profile of hospitalized COVID-19 patients related to vaccination history. Funding: This work was made possible by the UK Foreign, Commonwealth and Development Office and Wellcome (215091/Z/18/Z, 222410/Z/21/Z, 225288/Z/22/Z, and 220757/Z/20/Z); the Bill&nbsp;&amp; Melinda Gates&nbsp;Foundation (OPP1209135); and the philanthropic support of the donors&nbsp;to the University of Oxford's COVID-19 Research Response Fund (0009109). Additional funders are listed in the "acknowledgments" section