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

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

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

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

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

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

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Rock Typing and Characterization of the Late Cretaceous Abu Roash "G" Reservoirs at East Alam El-Shawish Field, Western Desert, Egypt

Rock typing and petrophysical characterization play a vital role in constructing reservoir models for petroleum exploration and development. This study focuses on evaluating the petrophysical characteristics of the Late Cretaceous Abu Roash "G" Reservoirs at the East Alam El Shawish field in Egypt's Western Desert. The study involved five vertical wells and employed various techniques and analyses to investigate the reservoir. Lithology determination utilizing well logs and core analysis helps identify the lithology types and corresponding porosity of the Abu Roash "G" reservoirs. Sandstone and limestone lithologies with varying porosity ranges were identified, along with the influence of shale on neutron porosity values. Facies analysis of the Abu Roash "G" Member identified seven lithofacies types, categorized into shallow marine and deeper marine depositional environments. The petrophysical analysis involves evaluating gamma-ray logs, porosity, permeability, flow zone indicator (FZI), and reservoir quality index (RQI) values for each lithofacies type. This analysis classifies the core samples into seven reservoir rock types (RRT1 to RRT7) based on petrophysical attributes, providing a clear classification of the Abu Roash "G" reservoir interval. RRT1, RRT2, and RRT3 exhibit the highest reservoir quality, while RRT4 and RRT5 indicate moderate reservoir quality. RRT6 and RRT7 exhibit low reservoir quality due to unfavorable petrophysical behavior. The findings of this study provide valuable insights into the Abu Roash "G" reservoir, including its lithofacies, reservoir properties, and depositional environments. This knowledge is crucial for reservoir characterization and optimizing oil production strategies in the region

Drought versus flood: What matters more to the performance of Sahel farming systems?

AbstractRecent climate change has brought new patterns of extreme events in terms of both drought and heavy rainfall to the drought‐prone African Sahel. The effects of these recent extreme events on the performance of the Sahel farming systems are still weakly investigated. This study aims at assessing effects of droughts versus floods on crop yield levels and losses, focusing on the so‐called recovery period, particularly 2001–2020. A newly developed productivity‐drought condition index (PDCI) is utilized to assess agricultural productivity as related to drought or flood in a highly vulnerable region, that is, the Sudanese Sahel. Four farming systems, namely traditional rainfed, mechanized rainfed, gravity irrigated and spate irrigated systems, with sorghum and millet as staple food crops, are considered. The PDCI is defined as a function of the integrated normalized difference vegetation index (iNDVI) over the growing season. To address temporal and spatial variabilities, scaling of the PDCI is done in two dimensions: space and time. Crop statistics are used to derive yield losses. Our results show that both drought and flood episodes (seven and six episodes, respectively) can be captured using the PDCI. Drought remains the most relevant risk to Sahel's crop productivity. Some recent large‐scale floods led to yield loss. However, floods cause smaller risks to agricultural productivity compared to droughts. Floods may even result in enhanced crop yields. Based upon scaling in the time or space domain, ranking the severity of drought impacts on crop yield for individual years from 2001 to 2020 reveals least to slightly different results. Vulnerability to drought depends on the crop type and farming system. Drought effect on crop yield from the irrigated sector is clear on individual years but not as a general statistical relationship. The parameter ‘percentage area under drought’ explains around one‐third of the variation in the rainfed crop yield. The spate irrigation scheme, the gravity irrigated system and the rainfed farmlands experienced respectively 87%, 57% and 46% of area under drought on average. Irrigated systems produce much higher crop yields than rainfed systems. The mechanized system is more drought‐vulnerable than the traditional system. These results call for identifying agricultural management pathways that recognize the combined implications of both hydrological extremes for the region's food security.A newly devised productivity‐drought condition index (PDCI) based on integrated normalized difference vegetation index (iNDVI) data is used to capture the performance of different Sahel farming systems. The performance is evaluated spatially and temporally in a comparative study of effects of droughts versus floods on crop yield levels and losses during 2001–2020. Our research shows that: Crop productivity of all farming systems is severely affected by drought; Flood events can also lead to a decline in productivity, but usually to a much lesser extent; The vulnerability to droughts and floods depends upon the farming system and crop type. Our analysis shows that the farming systems in the Sudanese Sahel have not reverted to conditions that could be described as a Sahel recovery. This study calls for agricultural management decisions, which are specific for the different farming systems, in response to climate variability. Deutsche Forschungsgemeinschaft http://dx.doi.org/10.13039/501100001659https://doi.org/10.1594/PANGAEA.921846https://edcintl.cr.usgs.gov/downloads/sciweb1/shared/fews/web/africa/east/dekadal/emodis/ndvi_c6/https://earlywarning.usgs.gov/fews/datadownloads/East 20Africa/eMODIS 20NDVI 20C

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.; 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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. 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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,