Critical Care - Research Publications

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    Distribution of Potential Eye and Tissue Donors Within a Public Teaching Hospital [Abstract]
    Dutch, M (Ovid Technologies (Wolters Kluwer Health), 2017-08)
    Introduction: Eye and Tissue donation has the capacity to transform lives, yet the vast majority of potential in-hospital donors are not recognised. Studies which describe the relative importance of specific units or wards in determining the size of the donor pool are extremely limited. Objectives: The aim of this study was to map the distribution of potential Eye and Tissue donors with the study hospital. Methods: A 12-month retrospective analysis of all patient deaths at the study hospital was undertaken. The ability to donate corneal, heart valve, bone and skin tissue was investigated. Patients were classified as potential donors if they met specific age criteria and had an absence of contraindications based on electronic database search. Results: There were 985 deaths during the study period. Deaths occurred under the care of 26 separate clinical units, and within 28 unique wards and treatment places. Four hundred and fortynine (45.6%) patients were identified as potential eye or tissue donors. The majority of potential donors occurred in ICU, Emergency and palliative care units. Of the subset of 328 deaths ≤70yrs, the frequency of potential tissue donors was 55% (n=181). ED and ICU had significantly higher frequencies of potential donor than other wards (86%, and 77%, p <0.01). Conclusion: The current study has identified the ED, ICU and PCUs as being important sites for potential Eye and Tissue Donors within our hospital. These will provide an important focus for future interventions to improve the rate of eye and tissue donation.
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    Factors Associated with Long-Term Functional and Psychological Outcomes in Persons with Moderate to Severe Traumatic Brain Injury
    Khan, F ; Amatya, B ; Judson, R ; Chung, P ; Truesdale, M ; Elmalik, A ; Galea, MP (Medical Journals Sweden, 2016-05-01)
    Objective: To examine factors impacting long-term functional and psychological outcomes in persons with moderate-severe traumatic brain injury. Methods: A prospective cross-sectional study (n = 103) assessed the long-term (up to 5 years) impact of traumatic brain injury on participants’ current activity and restriction in participation using validated questionnaires. Results: Participants’ median age was 49. 5 years (interquartile range (IQR) 20. 4–23. 8), the majority were male (77%), and 49% had some form of previous rehabilitation. The common causes of traumatic brain injury were falls (42%) and motor vehicle accidents (27%). Traumatic brain injury-related symptoms were: pain/headache (47%), dizziness (36%), bladder/bowel impairment (34%), and sensory-perceptual deficits (34%). Participants reported minimal change in their physical function and cognition (Functional Assessment Measure: motor (median 102, IQR 93–111) and cognition (median 89, IQR 78–95)). Participants were well-adjusted to community-living; however, they reported high levels of depression. Factors significantly associated with poorer current level of functioning/well-being included: older age (≥ 60 years), presence of traumatic brain injury-related symptoms, a lack of previous rehabilitation and those classified in “severe disability categories” at admission. Caregivers reported high levels of strain and burden (55%). Conclusion: Cognitive and psychosocial problems are more commonly reported than physical disability in the longer-term. A greater focus on participation and ageing with disability in these persons is needed.
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    Chronic pain in multiple sclerosis: A 10-year longitudinal study
    Young, J ; Amatya, B ; Galea, M ; Khan, F (sevier B.V. on behalf of Scandinavian Association for the Study of Pain, 2017-07-01)
    BACKGROUND AND PURPOSE: Pain is a common symptom associated with multiple sclerosis (MS), and has lasting effects on an individual's functional capacity and quality of life. A wide range of prevalence rates of pain (between 23% and 90% )have been reported in MS and this is mainly due to the methodological differences amongst the studies such as variability in patient sources, method of sampling and the definition of pain used. Chronic pain in MS, defined as pain lasting for greater than 3-6 months, can have a significant impact on their biopsychosocial health, including negative impact on activities of daily living, relationships and social participation. The long-term course of MS-related pain and its impact in an Australian cohort over a 7-year period has been investigated earlier. The aim of this longitudinal study was to describe the impact of chronic pain, pain-related disability and carer burden in persons with MS over a 10-year period. The aim of this longitudinal study was to describe the impact of chronic pain, pain-related disability and carer burden in persons with MS over a 10-year period. METHODS: This was a prospective longitudinal study conducted at the Rehabilitation Department of Royal Melbourne Hospital (RMH), a tertiary referral hospital in Victoria and Australia. The source of participants was from the RMH MS database and contains detailed MS patient information including demographic data, diagnosis details (using McDonald's criteria), pain characteristics. Structured face-face interviews and validated measures were used, which include the visual analogue scale (VAS); chronic pain grade (CPG); the assessment of quality of life (AQoL) and the carer strain index (CSI). The mean age of the participants (n=70) was 55.3 years and majority (70%) were female. RESULTS: The mean age of the participants (n=70) was 55.3 years and majority (70%) were female. The findings show that over time (10 years), participants report having greater bilateral bodily pain and greater description of pain as 'worse as it could be'. Pain types were similar to 7-years follow-up but remained higher than baseline. There was a significant deterioration in quality of life in those with more severe CPG over time. Almost half of the participants 31 (44%) required care either from a private carer, institution or from a family member. Although fear of taking medications and side effects were common barriers to treatment for pain, there was an increase in the use of pharmacological treatment over time and an increase in the use of healthcare services, mainly neurologists and general practitioners. CONCLUSIONS: The pain measures reported by the participants were similar to those at the 7-year follow-up except there was a greater representation of bilateral pain locations (limb, trunk and facial pain) compared to baseline and 7-year follow-up. At 10-year follow-up, more participants used medications compared to 7-year follow-up and there was an increase in the use of health professionals at the 10-year follow-up. At the 10-year follow up QoL of the participants deteriorated significantly and more participants had progressed to higher CPG III and CPG IV. This study demonstrates that chronic pain is a significant issue over time in MS, with clinical and health implications, impact on quality of life, disability and healthcare utilization. IMPLICATIONS: Greater awareness of chronic pain in pwMS, cognitive classifications and an interdisciplinary approach is required to improve long-term patient outcomes and well-being.
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    Chronic pain in persons with multiple sclerosis
    Amatya, B ; Young, J ; Galea, M ; Khan, F (Elsevier, 2018-07)
    Introduction/Background: Pain can be a significant long-term problem for a substantial proportion of persons with multiple sclerosis (pwMS). The aim of this study was to examine the course and impact of chronic pain over a span of 10-years. Material and method: A longitudinal, cross-sectional study assessed pwMS residing in the community at seven and ten years using validated measures: Visual Analogue Scale; Numerical Rating Scale; Chronic Pain Grade (CPG); Assessment of Quality of Life and the Carer Strain Index (CSI). Results: Mean age of the participants (n = 70) was 59.8 ± 9 years (range: 39–74 years) and majority (70%) were female. The findings show that over 10-year period, majority report bilateral lower limb dysesthesia (40%), mixed pain (35.2%) and widespread pain (17.1%). There was a significant deterioration in quality of life (QoL) in those with more severe CPG. Almost half of the participants (44%) required care either from a private carer/family or institution. The carers (n = 13) reported higher carer strain (mean CSI = 5.2), with over half reporting sleep disturbance, inconvenience, physical strains, family and personal constraints. Although fear of taking medications and side effects were common barriers to treatment for pain, there was an increase in the use of pharmacological treatment and healthcare services, mainly neurologists and general practitioners over time. Conclusion: This study demonstrates that persistent chronic pain is a significant issue over time in pwMS, with clinical and health implications, poorer QoL, and increased healthcare utilisation. Greater awareness of chronic pain in pwMS and interdisciplinary approach is required to improve long-term patient outcomes and well-being.
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    Designing an App for Pregnancy Care for a Culturally and Linguistically Diverse Community
    Smith, W ; Wadley, G ; Daly, JO ; Webb, M ; Hughson, J ; Hajek, J ; Parker, A ; Woodward-Kron, R ; Story, DA (The Association for Computing Machinery, 2017)
    We report a study to design and evaluate an app to support pregnancy information provided to women through an Australian health service. As part of a larger project to provide prenatal resources for culturally and linguistically diverse groups, this study focused on the design and reception of an app with the local Vietnamese community and health professionals of a particular hospital. Our study had three stages: an initial design workshop with the hospital; prototype design and development; prototype-based interviews with health professionals and focus groups with Vietnamese women. We explore how an app of this sort must be designed for a range of different use scenarios, considering its use by consumers with a multiplicity of differing viewpoints about its nature and purpose in relation to pregnancy care.
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    French Intensive Care Society, International congress - Réanimation 2016.
    (Springer Science and Business Media LLC, 2016-06)
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    Use of collaborative request model was highly correlated with organ donation consent.
    Rippon, VA ; Callaghan, G ; Henry, M ; Karcher, C ; Rechnitzer, T ; Dutch, M (LIPPINCOTT WILLIAMS & WILKINS, 2019-11)
    Background: There continues to be a disconnect between Australian’s self-reported support for organ donation and formal end-of-life family consent rates. In 2015, a multi-site Australian study by Lewis et al. demonstrated that consent rates were optimised by involving a clinician who had specific training in donation conversations, and in addition, was independent of the treating team. This approach is known as “Collaborative requesting” in Australia. The aim of the study was to report our single institution’s experience in introducing and augmenting the collaborative request model. Methods: The Royal Melbourne Hospital (RMH), is one of two adult tertiary trauma centres for the city of Melbourne, Australia. Additionally, the hospital has specialist neurosurgical and stroke services. Australia permits organ donation via both brain death and controlled circulatory death pathways. The hospital co-employs 4 embedded Donation Specialist Nursing Coordinators, and 3 fractionally appointed Medical Donation Specialists. Both craft groups have specialist communication training, and in addition, nursing coordinators have detailed end-to-end case donation management experience. Over a three-year period, the RMH progressively implemented the request model. Rather than using “any” independent clinician with donation communication training (the Lewis Model), the unit promoted the use of embedded Donation Specialist Nursing Coordinators as the collaborative requestors (the augmented collaborative model). Results: From January 2016 to June 2018 there were 135 donation requests raised by staff. Donation conversations raised by the family were excluded from analysis, as they have a consent rate at our hospital of over 90%. During the study period collaborative requesting increased from 50% (Jan 2016) to 96% (Jun 2018). Over the 3 study years (2016, 2017 and first half of 2018), the consent rate was highly positively correlated with the increased use of a collaborative model (r2=0.984). Conclusions: Since the introduction of embedded donation specialist nursing coordinators in RMH ICU, the hospital has seen both a clinically and statistically significant improvement in organ donation consent rates.
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    Protocol for a prospective, school-based standardisation study of a digital social skills assessment tool for children: The Paediatric Evaluation of Emotions, Relationships, and Socialisation (PEERS) study
    Thompson, EJ ; Beauchamp, MH ; Darling, SJ ; Hearps, SJC ; Brown, A ; Charalambous, G ; Crossley, L ; Darby, D ; Dooley, JJ ; Greenham, M ; Jaimangal, M ; McDonald, S ; Muscara, F ; Turkstra, L ; Anderson, VA (BMJ PUBLISHING GROUP, 2018-05)
    BACKGROUND: Humans are by nature a social species, with much of human experience spent in social interaction. Unsurprisingly, social functioning is crucial to well-being and quality of life across the lifespan. While early intervention for social problems appears promising, our ability to identify the specific impairments underlying their social problems (eg, social communication) is restricted by a dearth of accurate, ecologically valid and comprehensive child-direct assessment tools. Current tools are largely limited to parent and teacher ratings scales, which may identify social dysfunction, but not its underlying cause, or adult-based experimental tools, which lack age-appropriate norms. The present study describes the development and standardisation of Paediatric Evaluation of Emotions, Relationships, and Socialisation (PEERS®), an iPad-based social skills assessment tool. METHODS: The PEERS project is a cross-sectional study involving two groups: (1) a normative group, recruited from early childhood, primary and secondary schools across metropolitan and regional Victoria, Australia; and (2) a clinical group, ascertained from outpatient services at The Royal Children's Hospital Melbourne (RCH). The project aims to establish normative data for PEERS®, a novel and comprehensive app-delivered child-direct measure of social skills for children and youth. The project involves recruiting and assessing 1000 children aged 4.0-17.11 years. Assessments consist of an intellectual screen, PEERS® subtests, and PEERS-Q, a self-report questionnaire of social skills. Parents and teachers also complete questionnaires relating to participants' social skills. Main analyses will comprise regression-based continuous norming, factor analysis and psychometric analysis of PEERS® and PEERS-Q. ETHICS AND DISSEMINATION: Ethics approval has been obtained through the RCH Human Research Ethics Committee (34046), the Victorian Government Department of Education and Early Childhood Development (002318), and Catholic Education Melbourne (2166). Findings will be disseminated through international conferences and peer-reviewed journals. Following standardisation of PEERS®, the tool will be made commercially available.
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    Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries The International Surgical Outcomes Study group
    Ahmad, T ; Bouwman, RA ; Grigoras, I ; Aldecoa, C ; Hofer, C ; Hoeft, A ; Holt, P ; Fleisher, LA ; Buhre, W ; Pearse, RM ; Ferguson, M ; MacMahon, M ; Shulman, M ; Cherian, R ; Currow, H ; Kanathiban, K ; Gillespie, D ; Pathmanathan, E ; Phillips, K ; Reynolds, J ; Rowley, J ; Douglas, J ; Kerridge, R ; Garg, S ; Bennett, M ; Jain, M ; Alcock, D ; Terblanche, N ; Cotter, R ; Leslie, K ; Stewart, M ; Zingerle, N ; Clyde, A ; Hambidge, O ; Rehak, A ; Cotterell, S ; Huynh, WBQ ; McCulloch, T ; Ben-Menachem, E ; Egan, T ; Cope, J ; Halliwell, R ; Fellinger, P ; Haisjackl, M ; Haselberger, S ; Holaubek, C ; Lichtenegger, P ; Scherz, F ; Schmid, W ; Hoffer, F ; Cakova, V ; Eichwalder, A ; Fischbach, N ; Klug, R ; Schneider, E ; Vesely, M ; Wickenhauser, R ; Grubmueller, KG ; Leitgeb, M ; Lang, F ; Toro, N ; Bauer, M ; Laengle, F ; Haberl, C ; Mayrhofer, T ; Trybus, C ; Buerkle, C ; Forstner, K ; Germann, R ; Rinoesl, H ; Schindler, E ; Trampitsch, E ; Bogner, G ; Dankl, D ; Duenser, M ; Fritsch, G ; Gradwohl-Matis, I ; Hartmann, A ; Hoelzenbein, T ; Jaeger, T ; Landauer, F ; Lindl, G ; Lux, M ; Steindl, J ; Stundner, O ; Szabo, C ; Bidgoli, J ; Verdoodt, H ; Forget, P ; Kahn, D ; Lois, F ; Momeni, M ; Pregardien, C ; Pospiech, A ; Steyaert, A ; Veevaete, L ; De Kegel, D ; De Jongh, K ; Foubert, L ; Smitz, C ; Vercauteren, M ; Poelaert, J ; Van Mossevelde, V ; Abeloos, J ; Bouchez, S ; Coppens, M ; De Baerdemaeker, L ; Deblaere, I ; De Bruyne, A ; De Hert, S ; Fonck, K ; Heyse, B ; Jacobs, T ; Lapage, K ; Moerman, A ; Neckebroek, M ; Parashchanka, A ; Roels, N ; Van Den Eynde, N ; Vandenheuvel, M ; Van Limmen, J ; Vanluchene, A ; Vanpeteghem, C ; Wouters, P ; Wyffels, P ; Huygens, C ; Vandenbempt, P ; Van de Velde, M ; Dylst, D ; Janssen, B ; Schreurs, E ; Aleixo, FB ; Candido, K ; Batista, HD ; Guimaraes, M ; Guizeline, J ; Hoffmann, J ; Lobo, S ; Marques Lobo, FR ; Nascimento, V ; Nishiyama, K ; Pazetto, L ; Souza, D ; Rodrigues, RS ; Vilela dos Santos, AM ; Jardim, J ; Sa Malbouisson, LM ; Silva, J ; do Nascimento Junior, P ; Baio, TH ; Pereira de Castro, GI ; Watanabe Oliveira, HR ; Amendola, CP ; Cardoso, G ; Ortega, D ; Brotto, AF ; De Oliveira, MC ; Rea-Neto, A ; Dias, F ; Travi, ME ; Zerman, L ; Azambuja, P ; Knibel, MF ; Martins, A ; Almeida, W ; Neder Neto, C ; Tardelli, MA ; Caser, E ; Machado, M ; Aguzzoli, C ; Baldisserotto, S ; Tabajara, FB ; Bettega, F ; Rodrigues Junior, LHC ; de Gasperi, J ; Faina, L ; Nolasco, MF ; da Costa Fischer, BF ; de Campos Ferreira, MF ; Hartmann, C ; Kliemann, M ; Ribeiro, GLH ; Fraga, JM ; Netto, TM ; Pozza, LV ; Wendling, PR ; Azevedo, C ; Garcia, J ; Lopes, M ; Maia, B ; Maselli, P ; Melo, R ; Mendes, W ; Neves, M ; Ney, J ; Piras, C ; Applewhaite, C ; Carr, A ; Chow, L ; Duttchen, K ; Foglia, J ; Greene, M ; Hinther, A ; Houston, K ; McCormick, TJ ; Mikhayel, J ; Montasser, S ; Ragan, A ; Suen, A ; Woolsey, A ; Yu, HC ; Funk, D ; Kowalski, S ; Legaspi, R ; McDonald, H ; Siddiqui, F ; Pridham, J ; Rowe, B ; Sampson, S ; Thiessen, B ; Zbitnew, G ; Bernard, A ; George, R ; Jones, P ; Moor, R ; Siddiqui, N ; Wolfer, A ; Tran, D ; Winch, D ; Dobson, G ; McCormick, T ; Montasser, O ; Hall, R ; Baghirzada, L ; Curley, G ; Dai, SY ; Hare, G ; Lee, E ; Shastri, U ; Tsui, A ; Yagnik, A ; Alvares, D ; Choi, S ; Dwyer, H ; Flores, K ; McCartney, C ; Somascanthan, P ; Beattie, S ; Carroll, J ; Pazmino-Canizares, J ; Wijeysundera, D ; Ami, N ; Chan, V ; Perlas, A ; Argue, R ; Huang, Y ; Lavis, K ; Mayson, K ; Cao, Y ; Gao, H ; Hu, T ; Lv, J ; Yang, J ; Yang, Y ; Zhong, Y ; Zhou, J ; Zou, X ; He, M ; Li, X ; Luo, D ; Wang, H ; Yu, T ; Chen, L ; Wang, L ; Cai, Y ; Cao, Z ; Li, Y ; Lian, J ; Sun, H ; Wang, S ; Wang, Z ; Wang, K ; Zhu, Y ; Du, X ; Fan, H ; Fu, Y ; Huang, L ; Huang, Y ; Hwan, H ; Luo, H ; Qu, P-S ; Tao, F ; Wang, Z ; Wang, G ; Wang, S ; Zhang, Y ; Zhang, X ; Chen, C ; Wang, W ; Liu, Z ; Fan, L ; Tang, J ; Chen, Y ; Chen, Y ; Han, Y ; Huang, C ; Liang, G ; Shen, J ; Wang, J ; Yang, Q ; Zhen, J ; Zhou, H ; Chen, J ; Chen, Z ; Li, X ; Meng, B ; Ye, H ; Zhang, X ; Bi, Y ; Cao, J ; Guo, F ; Lin, H ; Liu, Y ; Lv, M ; Shi, P ; Song, X ; Sun, C ; Sun, Y ; Wang, Y ; Wang, S ; Zhang, M ; Chen, R ; Hou, J ; Leng, Y ; Meng, Q-T ; Qian, L ; Shen, Z-Y ; Xia, Z-Y ; Xue, R ; Zhang, Y ; Zhao, B ; Zhou, X-J ; Chen, Q ; Guo, H ; Guo, Y ; Qi, Y ; Wang, Z ; Wei, J ; Zhang, W ; Zheng, L ; Bao, Q ; Chen, Y ; Chen, Y ; Fei, Y ; Hu, N ; Hu, X ; Lei, M ; Li, X ; Lv, X ; Lv, J ; Miao, F ; Ouyang, L ; Qian, L ; Shen, C ; Sun, Y ; Wang, Y ; Wang, D ; Wu, C ; Xu, L ; Yuan, J ; Zhang, L ; Zhang, H ; Zhang, Y ; Zhao, J ; Zhao, C ; Zhao, L ; Zheng, T ; Zhou, D ; Zhou, H ; Zhou, C ; Lu, K ; Zhao, T ; He, C ; Chen, H ; Chen, S ; Cheng, B ; He, J ; Jin, L ; Li, C ; Li, H ; Pan, Y ; Shi, Y ; Wen, XH ; Wu, S ; Xie, G ; Zhang, K ; Zhao, B ; Lu, X ; Chen, F ; Liang, Q ; Lin, X ; Ling, Y ; Liu, G ; Tao, J ; Yang, L ; Zhou, J ; Chen, F ; Cheng, Z ; Dai, H ; Feng, Y ; Hou, B ; Gong, H ; Hu, CH ; Huang, H ; Huang, J ; Jiang, Z ; Li, M ; Lin, J ; Liu, M ; Liu, W ; Liu, Z ; Liu, Z ; Luo, F ; Ma, L ; Min, J ; Shi, X ; Song, Z ; Wan, X ; Xiong, Y ; Xu, L ; Yang, S ; Zhang, Q ; Zhang, H ; Zhang, H ; Zhang, X ; Zhao, L ; Zhao, W ; Zhao, W ; Zhu, X ; Bai, Y ; Chen, L ; Chen, S ; Dai, Q ; Geng, W ; Han, K ; He, X ; Huang, L ; Ji, B ; Jia, D ; Jin, S ; Li, Q ; Liang, D ; Luo, S ; Lwang, L ; Mo, Y ; Pan, Y ; Qi, X ; Qian, M ; Qin, J ; Ren, Y ; Shi, Y ; Wang, J ; Wang, J ; Wang, L ; Xie, J ; Yan, Y ; Yao, Y ; Zhang, M ; Zhao, J ; Zhuang, X ; Ai, Y ; Du, F ; He, L ; Huang, L ; Li, Z ; Li, H ; Li, Y ; Li, L ; Meng, S ; Yuan, Y ; Zhang, E ; Zhang, J ; Zhao, S ; Ji, Z ; Pei, L ; Wang, L ; Chen, C ; Dong, B ; Li, J ; Miao, Z ; Mu, H ; Qin, C ; Su, L ; Wen, Z ; Xie, K ; Yu, Y ; Yuan, F ; Hu, X ; Zhang, Y ; Xiao, W ; Zhu, Z ; Dai, Q ; Fu, K ; Hu, R ; Hu, X ; Huang, S ; Li, Y ; Liang, Y ; Yu, S ; Guo, Z ; Jing, Y ; Tang, N ; Wu, J ; Yuan, D ; Zhang, R ; Zhao, X ; Li, Y ; Bai, H-P ; Liu, C-X ; Liu, F-F ; Ren, W ; Wang, X-L ; Xu, G-J ; Hu, N ; Li, B ; Ou, Y ; Tang, Y ; Yao, S ; Zhang, S ; Kong, C-C ; Liu, B ; Wang, T ; Xiao, W ; Lu, B ; Xia, Y ; Zhou, J ; Cai, F ; Chen, P ; Hu, S ; Wang, H ; Wu, J ; Xu, Q ; Hu, L ; Jing, L ; Li, J ; Li, B ; Liu, Q ; Liu, Y ; Lu, X ; Peng, ZD ; Qiu, X ; Ren, Q ; Tong, Y ; Wang, Z ; Wang, J ; Wen, Y ; Wu, Q ; Xia, J ; Xie, J ; Xiong, X ; Xu, S ; Yang, T ; Ye, H ; Yin, N ; Yuan, J ; Zeng, Q ; Zhang, B ; Zheng, K ; Cang, J ; Chen, S ; Du, F ; Fan, Y ; Fu, S ; Ge, X ; Guo, B ; Huang, W ; Jiang, L ; Jiang, X ; Jin, L ; Liu, Y ; Pan, Y ; Ren, Y ; Shan, Q ; Wang, J ; Wang, F ; Wu, C ; Zhang, X ; Christiansen, IC ; Granum, SN ; Rasmussen, BS ; Daugaard, M ; Gambhir, R ; Brandsborg, B ; Steingrimsdottir, GE ; Jensen-Gadegaard, P ; Olsen, KS ; Siegel, H ; Eskildsen, KZ ; Gatke, MR ; Wibrandt, I ; Heintzelmann, SB ; Lange, KHW ; Lundsgaard, RS ; Amstrup-Hansen, L ; Hovendal, C ; Larsen, M ; Lenstrup, M ; Kobborg, T ; Larsen, JR ; Pedersen, AB ; Smith, SH ; Oestervig, RM ; Rasmussen, L ; Afshari, A ; Andersen, C ; Ekelund, K ; Secher, EL ; Beloeil, H ; Lasocki, S ; Venara, A ; Biais, M ; Ouattara, A ; Sineus, M ; Molliex, S ; Legouge, ML ; Wallet, F ; Tesniere, A ; Gaudin, C ; Lehur, P ; Forsans, E ; de Rudnicki, S ; Maudet, VS ; Mutter, D ; Sojod, G ; Ouaissi, M ; Regimbeau, J-M ; Futier, E ; Desbordes, J ; Comptaer, N ; el Manser, D ; Ethgen, S ; Lebuffe, G ; Auer, P ; Haertl, C ; Deja, M ; Legashov, K ; Sonnemann, S ; Wiegand-Loehnert, C ; Falk, E ; Habicher, M ; Angermair, S ; Laetsch, B ; Schmidt, K ; Von Heymann, C ; Ramminger, A ; Jelschen, F ; Pabel, S ; Weyland, A ; Czeslick, E ; Gille, J ; Malcharek, M ; Sablotzki, A ; Lueke, K ; Wetzel, P ; Weimann, J ; Lenhart, F-P ; Reichle, F ; Schirmer, F ; Hueppe, M ; Klotz, K ; Nau, C ; Schoen, J ; Mencke, T ; Wasmund, C ; Bankewitz, C ; Baumgarten, G ; Fleischer, A ; Guttenthaler, V ; Hack, Y ; Hoeft, A ; Kirchgaessner, K ; Maenner, O ; Schurig-Urbaniak, M ; Struck, R ; van Zyl, R ; Wittmann, M ; Goebel, U ; Harris, S ; Veit, S ; Andreadaki, E ; Souri, F ; Katsiadramis, I ; Skoufi, A ; Vasileiou, M ; Aimoniotou-Georgiou, E ; Katsourakis, A ; Veroniki, F ; Vlachogianni, G ; Petra, K ; Chlorou, D ; Oloktsidou, E ; Ourailoglou, V ; Papapostolou, K ; Tsaousi, G ; Daikou, P ; Dedemadi, G ; Kalaitzopoulos, I ; Loumpias, C ; Bristogiannis, S ; Dafnios, N ; Gkiokas, G ; Kontis, E ; Kozompoli, D ; Papailia, A ; Theodosopoulos, T ; Bizios, C ; Koutsikou, A ; Moustaka, A ; Plaitakis, I ; Armaganidis, A ; Christodoulopoulou, T ; Lignos, M ; Theodorakopoulou, M ; Asimakos, A ; Ischaki, E ; Tsagkaraki, A ; Zakynthinos, S ; Antoniadou, E ; Koutelidakis, I ; Lathyris, D ; Pozidou, I ; Voloudakis, N ; Dalamagka, M ; Elena, G ; Chronis, C ; Manolakaki, D ; Mosxogiannidis, D ; Slepova, T ; Tsakiridou, I-S ; Lampiri, C ; Vachlioti, A ; Panagiotakis, C ; Sfyras, D ; Tsimpoukas, F ; Tsirogianni, A ; Axioti, E ; Filippopoulos, A ; Kalliafa, E ; Kassavetis, G ; Katralis, P ; Komnos, I ; Pilichos, G ; Ravani, I ; Totis, A ; Apagaki, E ; Efthymiadi, A ; Kampagiannis, N ; Paraforou, T ; Tsioka, A ; Georgiou, G ; Vakalos, A ; Bairaktari, A ; Charitos, E ; Markou, G ; Niforopoulou, P ; Papakonstantinou, N ; Tsigou, E ; Xifara, A ; Zoulamoglou, M ; Gkioni, P ; Karatzas, S ; Kyparissi, A ; Mainas, E ; Papapanagiotou, I ; Papavasilopoulou, T ; Fragandreas, G ; Georgopoulou, E ; Katsika, E ; Psarras, K ; Synekidou, E ; Verroiotou, M ; Vetsiou, E ; Zaimi, D ; Anagnou, A ; Apostolou, K ; Melissopoulou, T ; Rozenberg, T ; Tsigris, C ; Boutsikos, G ; Kalles, V ; Kotsalas, N ; Lavdaiou, C ; Paikou, F ; Panagou, G-L ; Spring, A ; Arvaniti, K ; Botis, I ; Drimala, M ; Georgakakis, G ; Kiourtzieva, E ; Ntouma, P ; Prionas, A ; Xouplidis, K ; Dalampini, E ; Giannaki, C ; Iasonidou, C ; Ioannidis, O ; Lavrentieva, A ; Lavrentieva, A ; Papageorgiou, G ; Kokkinoy, M ; Stafylaraki, M ; Gaitanakis, S ; Karydakis, P ; Paltoglou, J ; Ponireas, P ; Chaloulis, P ; Provatidis, A ; Sousana, A ; Gardikou, VV ; Konstantivelli, M ; Lataniotou, O ; Lisari, E ; Margaroni, M ; Stamatiou, K ; Nikolaidis, E ; Pnevmatikos, I ; Sertaridou, E ; Andreou, A ; Arkalaki, E ; Athanasakis, E ; Chaniotaki, F ; Chatzimichali, CA ; Christofaki, M ; Dermitzaki, D ; Fiorentza, K ; Frantzeskos, G ; Geromarkaki, E ; Kafkalaki, K ; Kalogridaki, M ; Karydi, K ; Kokkini, S ; Kougentakis, G ; Lefaki, T ; Lilitsis, E ; Makatounaki, A ; Malliotakis, P ; Michelakis, D ; Neonaki, M ; Nyktari, V ; Palikyra, I ; Papadakis, E ; Papaioannou, A ; Sfakianakis, K ; Sgouraki, M ; Souvatzis, X ; Spartinou, A ; Stefanidou, N ; Syrogianni, P ; Tsagkaraki, G ; Arnaoutoglou, E ; Arnaoutoglou, C ; Bali, C ; Bouris, V ; Doumos, R ; Gkini, K-P ; Kapaktsi, C ; Koulouras, V ; Lena, A ; Lepida, D ; Michos, E ; Papadopoulos, D ; Paschopoulos, M ; Rompou, VA ; Siouti, I ; Tsampalas, S ; Ververidou, O ; Zilis, G ; Charlalampidoy, A ; Christodoulidis, G ; Flossos, A ; Stamoulis, K ; Chan, M ; Tsang, MSC ; Tsang, MS ; Lai, ML ; Yip, CP ; Chan, HMH ; Law, B ; Li, WS ; Chu, HM ; Koo, EGY ; Lam, CCJ ; Cheng, KH ; Lam, T ; Chu, S ; Lam, WY ; Wong, KWK ; Kwok, D ; Hung, CYJ ; Chan, WKJ ; Wong, WL ; Chung, CKE ; Ma, SK ; Kaushik, S ; Shah, B ; Shah, D ; Shah, S ; Ar, P ; Muthuchellappan, R ; Agarwal, V ; Divatia, J ; Kulkarni, A ; Mishra, S ; Nimje, G ; Pande, S ; Savarkar, S ; Shrivastava, A ; Thomas, M ; Yegnaram, S ; Hidayatullah, R ; Chandra, S ; Tantri, A ; Puar, N ; Niman, S ; Indra, I ; Hamzah, Z ; Yuliana, A ; Abidin, UN ; Dursin, AN ; Kurnia, A ; Susanti, A ; Handayani, D ; Alit, MA ; Arya, A ; Senapathi, TGA ; Utara, UH ; Wid, WM ; Wima, S ; Wir, WM ; Jehosua, B ; Kaunang, J ; Lantang, EY ; Najoan, R ; Waworuntu, N ; Awad, H ; Fuad, A ; Geddoa, E ; Geddoa, B ; Khalaf, AR ; Al hussaini, S ; Albaj, S ; Kenber, M ; Bettinelli, A ; Spadaro, S ; Volta, CA ; Giancarlo, L ; Sottosanti, V ; Copetti, E ; Della Rocca, G ; Spagnesi, L ; Toretti, I ; Alloj, C ; Cardellino, S ; Carmino, L ; Costanzo, E ; Fanfani, LC ; Novelli, MT ; Roasio, A ; Bellandi, M ; Beretta, L ; Bignami, E ; Bocchino, S ; Cabrini, L ; Corti, D ; Landoni, G ; Meroni, R ; Moizo, E ; Monti, G ; Pintaudi, M ; Plumari, VP ; Taddeo, D ; Testa, V ; Winterton, D ; Zangrillo, A ; Cloro, LM ; Colangelo, C ; Colangelo, A ; Rotunno, G ; Paludi, MA ; Maria, CP ; Pata, A ; Parrini, V ; Gatta, A ; Nastasi, M ; Tinti, C ; Baroselli, A ; Arrigo, M ; Benevento, A ; Bottini, C ; Cannavo, M ; Gastaldi, C ; Marchesi, A ; Pascazio, A ; Pata, F ; Pozzi, E ; Premoli, A ; Tessera, G ; Boschi, L ; D'Andrea, R ; Ghignone, F ; Poggioli, G ; Sibilio, A ; Taffurelli, M ; Ugolini, G ; Ab Majid, MA ; Ab Rahman, R ; Joseph, J ; Pathan, F ; Shah, MHS ; Yap, HL ; Cheah, S ; Chin, II ; Looi, JK ; Tan, SC ; Visvalingam, S ; Kwok, FY ; Lee, CK ; Tan, TS ; Wong, SM ; Abdullah, NH ; Liew, CF ; Luxuman, L ; Zin, NHM ; Norddin, MF ; Alias, RLR ; Wong, JY ; Yong, J ; Bin Mustapha, MT ; Chan, WK ; Dzulkipli, N ; Kuan, PX ; Lee, YC ; Alias, A ; Guok, EC ; Jee, CC ; Ramon, BR ; Wong, CW ; Ghafar, FNIA ; Aziz, FZ ; Hussain, N ; Lee, HS ; Sukawi, I ; Woon, YL ; Hadi, HZA ; Azam, UAA ; Alias, AH ; Kesut, SA ; Lee, JM ; Ooi, DV ; Sulaiman, HA ; Lih, TAT ; Mansor, M ; Veerakumaran, J ; Luna, P ; Rojas, E ; Resendiz, GEA ; Zapata, DDM ; Lopez, JCJA ; Flores, AAA ; Amador, JCB ; Avila, EJD ; Aquino, LPG ; Rodriguez, RL ; Landa, MT ; Urias, E ; Hollmann, M ; Hulst, A ; Preckel, OKB ; Koopman-van Gemert, A ; Bouwman, A ; Buise, M ; Tolenaar, N ; Weber, E ; de Fretes, J ; Houweling, P ; Ormskerk, P ; Van Bommel, J ; Buhre, W ; Lance, M ; Smit-Fun, V ; van Zundert, T ; Baas, P ; de Boer, HD ; Sprakel, J ; Elferink-Vonk, R ; Noordzij, P ; van Zeggeren, L ; Brand, B ; Spanjersberg, R ; ten Bokkel-Andela, J ; Numan, S ; van Klei, W ; van Zaane, B ; Boer, C ; van Duivenvoorde, Y ; Hering, JP ; van Rossum, S ; Zonneveldt, H ; Campbell, D ; Hoare, S ; Santa, S ; Ali, M ; Allen, SJ ; Beavis, V ; Bell, R ; Campbell, D ; Choi, H-MD ; Drake, M ; Farrell, H ; Hayes, K ; Higgie, K ; Holmes, K ; Jenkins, N ; Kim, CJ ; Kim, S ; Law, KC ; McAllister, D ; Park, K ; Pedersen, K ; Pfeifer, L ; Pozaroszczyk, A ; Salmond, T ; Steynor, M ; Tan, M ; Short, T ; Waymouth, E ; Ab Rahman, AS ; Armstrong, J ; Dudson, R ; Jenkins, N ; Nilakant, J ; Richard, S ; Virdi, P ; Dixon, L ; Donohue, R ; Farrow, M ; Kennedy, R ; Marissa, H ; McKellow, M ; Nicola, D ; Pascoe, R ; Roberts, SJ ; Rowell, G ; Sumner, M ; Templer, P ; Chandrasekharan, S ; Fulton, G ; Jammer, I ; More, R ; Wilson, L ; Chang, YH ; Foley, J ; Fowler, C ; Panckhurst, J ; Sara, R ; Stapelberg, F ; Cherrett, V ; Ganter, DL ; McCann, L ; Gilmour, F ; Lumsden, R ; Moores, M ; Olliff, S ; Sardareva, E ; Tai, J ; Wikner, M ; Wong, C ; Chaddock, M ; Czepanski, C ; McKendry, P ; Polakovic, D ; Polakovich, D ; Robert, A ; Belda, MT ; Norton, T ; Alherz, F ; Barneto, L ; Ramirez, A ; Sayeed, A ; Smith, N ; Bennett, C ; McQuoid, S ; Jansen, T-L ; Nico, Z ; Scott, J ; Freschini, D ; Freschini, A ; Hopkins, B ; Manson, L ; Stoltz, D ; Bates, A ; Davis, S ; Freeman, V ; McGaughran, L ; Williams, M ; Sharma, SB ; Burrows, T ; Byrne, K ; English, D ; Johnson, R ; Manikkam, B ; Naidoo, S ; Rumball, M ; Whittle, N ; Franks, R ; Gibson-Lapsley, H ; Salter, R ; Walsh, D ; Cooper, R ; Perry, K ; Obobolo, A ; Sule, UM ; Ahmad, A ; Atiku, M ; Mohammed, AD ; Sarki, AM ; Adekola, O ; Akanmu, O ; Durodola, A ; Olukoju, O ; Raji, V ; Olajumokex, T ; Oyebamiji, E ; Adenekan, A ; Adetoye, A ; Faponle, F ; Olateju, S ; Owojuyigbe, A ; Talabi, A ; Adenike, O ; Adewale, B ; Collins, N ; Ezekiel, E ; Fatungase, OM ; Grace, A ; Sola, S ; Stella, O ; Ademola, A ; Adeolu, AA ; Adigun, T ; Akinwale, M ; Fasina, O ; Gbolahan, O ; Idowu, O ; Olonisakin, RP ; Osinaike, BB ; Asudo, F ; Mshelia, D ; Abdur-Rahman, L ; Agodirin, O ; Bello, J ; Bolaji, B ; Oyedepo, OO ; Ezike, H ; Iloabachie, I ; Okonkwo, I ; Onuora, E ; Onyeka, T ; Ugwu, I ; Umeh, F ; Alagbe-Briggs, O ; Dodiyi-Manuel, A ; Echem, R ; Obasuyi, B ; Onajin-Obembe, B ; Bandeira, ME ; Martins, A ; Tome, M ; Martins Costa, ACM ; Krystopchuk, A ; Branco, T ; Esteves, S ; Melo, MA ; Monte, J ; Rua, F ; Martins, I ; Pinho-Oliveira, VM ; Rodrigues, CM ; Cabral, R ; Marques, S ; Rego, S ; Teixeira Jesus, JS ; Marques, MC ; Romao, C ; Dias, S ; Santos, AM ; Alves, MJ ; Salta, C ; Cruz, S ; Duarte, C ; Furtado Paiva, AA ; Cabral, TDN ; Faria e Maia, D ; Correia da Silva, RFM ; Langner, A ; Resendes, HO ; Soares, MDC ; Abrunhosa, A ; Faria, F ; Miranda, L ; Pereira, H ; Serra, S ; Ionescu, D ; Margarit, S ; Mitre, C ; Vasian, H ; Manga, G ; Stefan, A ; Tomescu, D ; Filipescu, D ; Paunescu, M-A ; Stefan, M ; Stoica, R ; Gavril, L ; Patrascanu, E ; Ristescu, I ; Rusu, D ; Diaconescu, C ; Iosep, GF ; Pulbere, D ; Ursu, I ; Balanescu, A ; Grintescu, I ; Mirea, L ; Rentea, I ; Vartic, M ; Lupu, M-N ; Stanescu, D ; Streanga, L ; Antal, O ; Hagau, N ; Patras, D ; Petrisor, C ; Tosa, F ; Tranca, S ; Copotoiu, SM ; Ungureanu, LL ; Harsan, CR ; Papurica, M ; Cernea, DD ; Dragoescu, NA ; Aflori, L ; Vaida, C ; Ciobotaru, OR ; Aignatoaie, M ; Carp, CP ; Cobzaru, I ; Mardare, O ; Purcarin, B ; Tutunaru, V ; Ionita, V ; Arustei, M ; Codita, A ; Busuioc, M ; Chilinciuc, I ; Ciobanu, C ; Belciu, I ; Tincu, E ; Blaj, M ; Grosu, R-M ; Sandu, G ; Bruma, D ; Corneci, D ; Dutu, M ; Krepil, A ; Copaciu, E ; Dumitrascu, CO ; Jemna, R ; Mihaescu, F ; Petre, R ; Tudor, C ; Ursache, E ; Kulikov, A ; Lubnin, A ; Grigoryev, E ; Pugachev, S ; Protsenko, D ; Tolmasov, A ; Hussain, A ; Ilyina, Y ; Kirov, M ; Roshchina, A ; Iurin, A ; Ayyaz, H ; Chazova, E ; Dunay, A ; Karelov, A ; Khvedelidze, I ; Voldaeva, O ; Belskiy, V ; Dzhamullaev, P ; Grishkowez, E ; Kretov, V ; Levin, V ; Molkov, A ; Puzanov, S ; Samoilenko, A ; Tchekulaev, A ; Tulupova, V ; Utkin, I ; Allorto, NL ; Bishop, DG ; Builu, PM ; Cairns, C ; Dasrath, A ; de Wet, J ; den Hoedt, M ; Grey, B ; Hayes, MP ; Kusel, BS ; Shangase, N ; Wise, R ; Cacala, S ; Farina, Z ; Govindasamy, V ; Kruse, C-H ; Lee, C ; Marais, L ; Naidoo, TD ; Rajah, C ; Rodseth, RN ; Ryan, L ; von Rhaden, R ; Adam, S ; Alphonsus, C ; Ameer, Y ; Anderson, F ; Basanth, S ; Bechan, S ; Bhula, C ; Biccard, BM ; Biyase, T ; Buccimazza, I ; Cardosa, J ; Chen, J ; Daya, B ; Drummond, L ; Elabib, A ; Goad, EHA ; Goga, IE ; Goga, R ; Harrichandparsad, R ; Hodgson, RE ; Jordaan, J ; Kalafatis, N ; Kampik, C ; Landers, AT ; Loots, E ; Madansein, R ; Madaree, A ; Madiba, TE ; Manzini, VT ; Mbuyisa, M ; Moodley, R ; Msomi, M ; Mukama, I ; Naidoo, D ; Naidoo, R ; Naidu, TK ; Ntloko, S ; Padayachee, E ; Padayachee, L ; Phaff, M ; Pillay, B ; Pillay, D ; Pillay, L ; Ramnarain, A ; Ramphal, SR ; Ryan, P ; Saloojee, A ; Sebitloane, M ; Sigcu, N ; Taylor, JL ; Torborg, A ; Visser, L ; Anderson, P ; Conradie, A ; de Swardt, M ; de Villiers, M ; Eikman, J ; Liebenberg, R ; Mouton, J ; Paton, A ; van der Merwe, L ; Wilscott-Davids, C ; Barrett, WJ ; Bester, M ; de Beer, J ; Geldenhuys, J ; Gouws, H ; Potgieter, J-H ; Strydom, M ; Turton, EW ; Chetty, RR ; Chirkut, S ; Cronje, L ; de Vasconcellos, K ; Dube, NZ ; Gama, NS ; Green, GM ; Green-Thompson, R ; Kinoo, SM ; Kistnasami, P ; Maharaj, K ; Moodley, MS ; Mothae, SJ ; Naidoo, R ; Noorbhai, MAF ; Rughubar, V ; Reddy, J ; Singh, A ; Skinner, DL ; Smith, MJ ; Singh, B ; Misra, R ; Naidoo, M ; Ramdharee, P ; Selibea, Y ; Sewpersad, S ; Sham, S ; Wessels, JD ; Africander, C ; Bejia, T ; Blakemore, SP ; Botes, M ; Bunwarie, B ; Hernandez, CB ; Jeeraz, MA ; Legutko, DA ; Lopez, AG ; De Meyer, JN ; Muzenda, T ; Naidoo, N ; Patel, M ; Pentela, R ; Junge, M ; Mansoor, N ; Rademan, L ; Scislowski, P ; Seedat, I ; van den Berg, B ; van der Merwe, D ; van Wyk, S ; Govender, K ; Naicker, D ; Ramjee, R ; Saley, M ; Kuhn, WP ; Matos-Puig, R ; Moolla, Z ; Lisi, A ; Perez, G ; Valle Beltran, A ; Lozano, A ; Delgado Navarro, C ; Duca, A ; Martinez Ernesto, EP ; Ferrando, C ; Fuentes, I ; Luisa Garcia-Perez, M ; Gracia, E ; Izquierdo Palomares, A ; Katime, A ; Minana, A ; Raul Incertis, R ; Romero, E ; Romero Garcia, CS ; Rubio, C ; Socorro Artiles, T ; Soro, M ; Valls, P ; Alaman Laguarda, G ; Benavent, P ; Chisbert Cuenca, V ; Cueva, A ; Lafuente, M ; Marques Parra, A ; Romero Rodrigo, A ; Sanchez-Morcillo, S ; Tormo, S ; Javier Redondo, F ; De Andres Ibanez, JA ; Gomez Diago, L ; Hernandez Cadiz, MJ ; Gil Manuel, G ; Peris, R ; Saiz, C ; Tatay Vivo, J ; Tebar Soto, MT ; Brunete, T ; Cancho, D ; Delgado Garcia, DR ; Zamudio, D ; Garcia Del Valle, S ; Luz Serrano, M ; Alonso, E ; Anillo, V ; Maseda, E ; Salgado, P ; Suarez, L ; Suarez-de-la-Rica, A ; Jose Villagran, M ; Aldecoa, C ; Ignacio Alonso, J ; Cabezuelo, E ; Garcia-Saiz, I ; Lopez del Moral, O ; Martin, S ; Perez Gonzalez, A ; Tovar Doncel, MS ; Aguero Vera, M ; Avila Sanchez, FJ ; Castano, B ; Castano Moreira, B ; Flores Risco, S ; Paz Martin, D ; Perez Martín, F ; Poza, P ; Ruiz, A ; Serna Martinez, WF ; Vazquez Vicente, B ; Velaz Dominguez, S ; Fernandez, S ; Munoz-Lopez, A ; Jose Bernat, M ; Mas, A ; Planas, K ; Jawad, M ; Saeed, Y ; Hedin, A ; Levander, H ; Chew, M ; Holmstrom, S ; Lonn, D ; Zoerner, F ; Akring, I ; Widmark, C ; Zettergren, J ; Liljequist, VA ; Nystrom, L ; Odeberg-Wernerman, S ; Oldner, A ; Fagerlund, MJ ; Reje, P ; Lyckner, S ; Sperber, J ; Adolfsson, A ; Klarin, B ; Ogren, K ; Barras, J-P ; Buhrer, T ; Despotidis, V ; Helmy, N ; Holliger, S ; Raptis, DA ; Schmid, R ; Meyer, A ; Jaquet, Y ; Kessler, U ; Muradbegovic, M ; Nahum, SR ; Rotunno, T ; Schiltz, B ; Voruz, F ; Worreth, M ; Christoforidis, D ; Popeskou, SG ; Furrer, M ; Prevost, GA ; Stocker, A ; Lang, K ; Breitenstein, S ; Ganter, MT ; Geisen, M ; Soll, C ; Korkmaz, M ; Lubach, I ; Schmitz, M ; Schwabedissen, MMZ ; Moritz, MZS ; Zingg, U ; Hillermann, T ; Wildi, S ; Hofer, C ; Pinto, BB ; Walder, B ; Hubner, M ; Mariotti, G ; Slankamenac, K ; Namuyuga, M ; Kyomugisha, E ; Kituuka, O ; Shikanda, AW ; Kakembo, N ; Tom, CO ; Antonina, W ; Bua, E ; Ditai, J ; Ssettabi, EM ; Epodoi, J ; Kabagenyi, F ; Kirya, F ; Dempsey, G ; Seasman, C ; Khan, RBN ; Kurasz, C ; Macgregor, M ; Shawki, B ; Francis, D ; Hariharan, V ; Chau, S ; Ellis, K ; Butt, G ; Chicken, D-W ; Christmas, N ; Allen, S ; Daniel, GD ; Dempster, A ; Kemp, J ; Matthews, L ; Mcglone, P ; Tambellini, J ; Trodd, D ; Freitas, K ; Garg, A ; Gupta, JK ; Karpate, S ; Kulkarni, A ; O'Hara, C ; Troko, J ; Angus, K ; Bradley, J ; Brennan, E ; Brooks, C ; Brown, J ; Brown, G ; Finch, A ; Gratrix, K ; Hesketh, S ; Hill, G ; Jeffs, C ; Morgan, M ; Pemberton, C ; Slawson, N ; Spickett, H ; Swarbrick, G ; Thomas, M ; Van Duyvenvoorde, G ; Brennan, A ; Briscoe, R ; Cooper, S ; Lawton, T ; Northey, M ; Senaratne, R ; Stanworth, H ; Burrows, L ; Cain, H ; Craven, R ; Davies, K ; Jonas, A ; Pachucki, M ; Walkden, G ; Davies, H ; Gudaca, M ; Hobrok, M ; Arawwawala, D ; Fergey, L ; Gardiner, M ; Gunn, J ; Johnson, L ; Lofting, A ; Lyle, A ; Mc Neela, F ; Smolen, S ; Topliffe, J ; Williams, S ; Bland, M ; Balaji, P ; Kaura, V ; Lanka, P ; Naylor, C ; Smith, N ; Ahmed, A ; Myatt, J ; Shenoy, R ; Soon, WC ; Tan, J ; Karadia, S ; Self, J ; Durant, E ; Tripathi, S ; Bullock, C ; Campbell, D ; Ghosh, A ; Hughes, T ; Zsisku, L ; Bengeri, S ; Cowton, A ; Khalid, MS ; Limb, J ; McAdam, C ; Porritt, M ; Rafi, MA ; Shekar, P ; Adams, D ; Harden, C ; Hollands, H ; King, A ; March, L ; Minto, G ; Patrick, A ; Squire, R ; Waugh, D ; Kumara, P ; Simeson, K ; Yarwood, J ; Browning, J ; Hatton, J ; Julian, H ; Mitra, A ; Newton, M ; Pernu, PK ; Wilson, A ; Commey, T ; Foot, H ; Glover, L ; Gupta, A ; Lancaster, N ; Levin, J ; Mackenzie, F ; Mestanza, C ; Nofal, E ; Pout, L ; Varden, R ; Wild, J ; Jones, S ; Moreton, S ; Pulletz, M ; Davies, C ; Martin, M ; Thomas, S ; Burns, K ; McArthur, C ; Patel, P ; Lau, G ; Rich, N ; Davis, F ; Lyons, R ; Port, B ; Prout, R ; Smith, C ; Adelaja, Y ; Bennett, V ; Bidd, H ; Dumitrescu, A ; Murphy, JF ; Keen, A ; Mguni, N ; Ong, C ; Adams, G ; Boshier, P ; Brown, R ; Butryn, I ; Chatterjee, J ; Freethy, A ; Lockwood, G ; Tsakok, M ; Tsiligiannis, S ; Peat, W ; Stephenson, L ; Bradburn, M ; Pick, S ; Cunha, P ; Olagbaiye, O ; Tayeh, S ; Packianathaswamy, B ; Abernethy, C ; Balasubramaniam, M ; Bennett, R ; Bolton, D ; Martinson, V ; Bell, S ; Heather, B ; Kushakovsky, V ; Alcock, L ; Alexander, H ; Anderson, C ; Baker, P ; Brookes, M ; Cawthorn, L ; Cirstea, E ; Clarkson, R ; Colling, K ; Coulter, I ; Das, S ; Haigh, K ; Hamdan, A ; Hugill, K ; Kottam, L ; Lisseter, E ; Mawdsley, M ; McGivern, J ; Padala, K ; Phelps, V ; kumar, VR ; Stewart, K ; Towse, K ; Tregonning, J ; Vahedi, A ; Walker, A ; Baines, D ; Bilolikar, A ; Chande, S ; Copley, E ; Dunk, N ; Kulkarni, R ; Kumar, P ; Metodiev, Y ; Ncomanzi, D ; Raithatha, B ; Raymode, P ; Szafranski, J ; Twohey, L ; Watt, P ; Weatherall, L ; Weatherill, J ; Whitman, Z ; Wighton, E ; Abayasinghe, C ; Chan, A ; Darwish, S ; Gill, J ; Glasgow, E ; Hadfield, D ; Harris, C ; Hopkins, P ; Kochhar, A ; Kunst, G ; Mellis, C ; Pool, A ; Riozzi, P ; Selman, A ; Smith, E-J ; Vele, L ; Gercek, Y ; Guy, K ; Holden, D ; Watson, N ; Whysall, K ; Andreou, P ; Hales, D ; Thompson, J ; Bowrey, S ; McDonald, S ; Gilmore, J ; Hills, V ; Kelly, C ; Kelly, S ; Lloyd, G ; Abbott, T ; Gall, L ; Torrance, H ; Vivian, M ; Berntsen, E ; Nolan, T ; Turner, A ; Vohra, A ; Brown, A ; Clark, R ; Coughlan, E ; Daniel, C ; Patvardhan, C ; Pearson, R ; Predeep, S ; Saad, H ; Shanmugam, M ; Varley, S ; Wylie, K ; Cooper, L ; Makowski, A ; Misztal, B ; Moldovan, E ; Pegg, C ; Donovan, A ; Foot, J ; Large, S ; Claxton, A ; Netke, B ; Armstrong, R ; Calderwood, C ; Kwok, A ; Mohr, O ; Oyeniyi, P ; Patnaik, L ; Post, B ; Ali, S ; Arshad, H ; Baker, G ; Brenner, L ; Brincat, M ; Brunswicker, A ; Cox, H ; Cozar, OI ; Cheong, E ; Durst, A ; Fengas, L ; Flatt, J ; Glister, G ; Narwani, V ; Photi, E ; Rankin, A ; Rosbergen, M ; Tan, M ; Beaton, C ; Horn, R ; Hunt, J ; Rousseau, G ; Stancombe, L ; Absar, M ; Allsop, J ; Drinkwater, Z ; Hodgkiss, T ; Smith, K ; Brown, J ; Alexander-Sefre, F ; Campey, L ; Dudgeon, L ; Hall, K ; Hitchcock, R ; James, L ; Smith, K ; Winstone, U ; Ahmad, N ; Bauchmuller, K ; Harrison, J ; Jeffery, H ; Miller, D ; Pinder, A ; Pothuneedi, S ; Rosser, J ; Sanghera, S ; Swift, D ; Walker, R ; Bester, D ; Cavanagh, S ; Cripps, H ; Daniel, H ; Lynch, J ; Paton, A ; Pyke, S ; Scholefield, J ; Whitworth, H ; Bottrill, F ; Ramalingam, G ; Webb, S ; Akerman, N ; Antill, P ; Bourner, L ; Buckley, S ; Castle, G ; Charles, R ; Eggleston, C ; Foster, R ; Gill, S ; Lindley, K ; Lklouk, M ; Lowery, T ; Martin, O ; Milne, D ; O'Connor, P ; Ratcliffe, A ; Rose, A ; Smith, A ; Varma, S ; Ward, J ; Barcraft-Barnes, H ; Camsooksai, J ; Colvin, C ; Reschreiter, H ; Tbaily, L ; Venner, N ; Hamilton, C ; Kelly, L ; Toth-Tarsoly, P ; Dodsworth, K ; Foord, D ; Gordon, P ; Hawes, E ; Lamb, N ; Mouland, J ; Nightingale, J ; Rose, S ; Schrieber, J ; Al 'Amri, K ; Aladin, H ; Arshad, MA ; Barraclough, J ; Bentley, C ; Bergin, C ; Carrera, R ; Clarkson, A ; Collins, M ; Cooper, L ; Denham, S ; Griffiths, E ; Ip, P ; Jeyanthan, S ; Joory, K ; Kaur, S ; Marriott, P ; Mitchell, N ; Nagaiah, S ; Nilsson, A ; Parekh, N ; 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Sanchez, A ; Tinuoye, E ; Bateman, B ; Eng, K ; Jiang, N ; Ladha, K ; Needleman, J ; Chen, L-L ; Lane, R ; Robinowitz, D ; Ghushe, N ; Irshad, M ; O'Connor, J ; Patel, S ; Takemoto, S ; Wallace, A ; Mazzeffi, M ; Rock, P ; Wallace, K ; Zhu, X ; Chua, P ; Fleisher, L ; Mattera, M ; Sharar, R ; Thilen, S ; Treggiari, M ; Morgan, A ; Sofjan, I ; Subramaniam, K ; Avidan, M ; Maybrier, H ; Muench, M ; Wildes, T (ELSEVIER SCI LTD, 2016-11)
    BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN51817007
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    Organising health care services for people with an acquired brain injury: an overview of systematic reviews and randomised controlled trials
    Laver, K ; Lannin, NA ; Bragge, P ; Hunter, P ; Holland, AE ; Tavender, E ; O'Connor, D ; Khan, F ; Teasell, R ; Gruen, R (BMC, 2014-09-17)
    BACKGROUND: Acquired brain injury (ABI) is the leading cause of disability worldwide yet there is little information regarding the most effective way to organise ABI health care services. The aim of this review was to identify the most up-to-date high quality evidence to answer specific questions regarding the organisation of health care services for people with an ABI. METHODS: We conducted a systematic review of English papers using MEDLINE, EMBASE, PsycINFO, CINAHL and the Cochrane Library. We included the most recently published high quality systematic reviews and any randomised controlled trials, non-randomised controlled trials, controlled before after studies or interrupted time series studies published subsequent to the systematic review. We searched for papers that evaluated pre-defined organisational interventions for adults with an ABI. Organisational interventions of interest included fee-for-service care, integrated care, integrated care pathways, continuity of care, consumer engagement in governance and quality monitoring interventions. Data extraction and appraisal of included reviews and studies was completed independently by two reviewers. RESULTS: A total of five systematic reviews and 21 studies were included in the review; eight of the papers (31%) included people with a traumatic brain injury (TBI) or ABI and the remaining papers (69%) included only participants with a diagnosis of stroke. We found evidence supporting the use of integrated care to improve functional outcome and reduce length of stay and evidence supporting early supported discharge teams for reducing morbidity and mortality and reducing length of stay for stroke survivors. There was little evidence to support case management or the use of integrated care pathways for people with ABI. We found evidence that a quality monitoring intervention can lead to improvements in process outcomes in acute and rehabilitation settings. We were unable to find any studies meeting our inclusion criteria regarding fee-for-service care or engaging consumers in the governance of the health care organisation. CONCLUSIONS: The review found evidence to support integrated care, early supported discharge and quality monitoring interventions however, this evidence was based on studies conducted with people following stroke and may not be appropriate for all people with an ABI.