27 research outputs found
Is there a role of percutaneous drainage in non-parasitic splenic cysts? Case report
No full textPathogenesis, classification and treatment of non-parasitic splenic cysts (NPSCs) are controversial.
The utility of percutaneous aspiration of the cyst is not well understood. We report a case of a 32 year-old woman with a symptomatic giant epidermoid cyst of the spleen treated with laparoscopic splenectomy. A percutaneous transcatheter drainage was performed under ultrasound guidance before surgical procedure in order to classify the type of cyst and to choose the best treatment
Mapping the human genetic architecture of COVID-19
No full textnone3597The genetic make-up of an individual contributes to the susceptibility and response to viral infection. Although environmental, clinical and social factors have a role in the chance of exposure to SARS-CoV-2 and the severity of COVID-19(1,2), host genetics may also be important. Identifying host-specific genetic factors may reveal biological mechanisms of therapeutic relevance and clarify causal relationships of modifiable environmental risk factors for SARS-CoV-2 infection and outcomes. We formed a global network of researchers to investigate the role of human genetics in SARS-CoV-2 infection and COVID-19 severity. Here we describe the results of three genome-wide association meta-analyses that consist of up to 49,562 patients with COVID-19 from 46 studies across 19 countries. We report 13 genome-wide significant loci that are associated with SARS-CoV-2 infection or severe manifestations of COVID-19. Several of these loci correspond to previously documented associations to lung or autoimmune and inflammatory diseases(3-7). They also represent potentially actionable mechanisms in response to infection. Mendelian randomization analyses support a causal role for smoking and body-mass index for severe COVID-19 although not for type II diabetes. The identification of novel host genetic factors associated with COVID-19 was made possible by the community of human genetics researchers coming together to prioritize the sharing of data, results, resources and analytical frameworks. This working model of international collaboration underscores what is possible for future genetic discoveries in emerging pandemics, or indeed for any complex human disease.noneNiemi, Mari E. K.; Karjalainen, Juha; Liao, Rachel G.; Neale, Benjamin M.; Daly, Mark; Ganna, Andrea; Pathak, Gita A.; Andrews, Shea J.; Kanai, Masahiro; Veerapen, Kumar; Fernandez-Cadenas, Israel; Schulte, Eva C.; Striano, Pasquale; Marttila, Minttu; Minica, Camelia; Marouli, Eirini; Karim, Mohd Anisul; Wendt, Frank R.; Savage, Jeanne; Sloofman, Laura; Butler-Laporte, Guillaume; Kim, Han-Na; Kanoni, Stavroula; Okada, Yukinori; Byun, Jinyoung; Han, Younghun; Uddin, Mohammed Jashim; Smith, George Davey; Willer, Cristen J.; Buxbaum, Joseph D.; Mehtonen, Juha; Finucane, Hilary; Cordioli, Mattia; Martin, Alicia R.; Zhou, Wei; Pasaniuc, Bogdan; Julienne, Hanna; Aschard, Hugues; Shi, Huwenbo; Yengo, Loic; Polimanti, Renato; Ghoussaini, Maya; Schwartzentruber, Jeremy; Dunham, Ian; Chwialkowska, Karolina; Francescatto, Margherita; Trankiem, Amy; Balaconis, Mary K.; Davis, Lea; Lee, Sulggi; Priest, James; Renieri, Alessandra; Sankaran, Vijay G.; van Heel, David; Deelen, Patrick; Richards, J. Brent; Nakanishi, Tomoko; Biesecker, Les; Kerchberger, V. Eric; Baillie, J. Kenneth; Mari, Francesca; Bernasconi, Anna; Baillie, Stefano Ceri; Canakoglu, Arif; Wolford, Brooke; Faucon, Annika; Dutta, Atanu Kumar; Schurmann, Claudia; Harry, Emi; Birney, Ewan; Nguyen, Huy; Nasir, Jamal; Kaunisto, Mari; Solomonson, Matthew; Dueker, Nicole; Vadgama, Nirmal; Limou, Sophie; Rahmouni, Souad; Mbarek, Hamdi; Darwish, Dima; Uddin, Md Mesbah; Albertos, Raquel; Pérez-Tur, Jordi; Li, Ruolin; Folkersen, Lasse; Moltke, Ida; Koelling, Nils; Teumer, Alexander; Kousathanas, Athanasios; Utrilla, Alicia; Verdugo, Ricardo A.; Zárate, Ruth; Medina-Gómez, Carolina; Gómez-Cabrero, David; Carnero-Montoro, Elena; Cadilla, Carmen L.; Moreno-Estrada, Andrés; Garmendia, Adriana; Moya, Leire; Sedaghati-Khayat, Bahar; Boua, Palwendé Romuald; Favé, Marie-Julie; Francioli, Laurent; Lemaçon, Audrey; Migeotte, Isabelle; Patel, Sanjay; Varnai, Reka; Szentpeteri, Jozsef L.; Sipeky, Csilla; Colombo, Francesca; von Hohenstaufen, Kathrin; Lio, Pietro; Vallerga, Costanza; Wang, Qingbo; Tanigawa, Yosuke; Im, Hogune; Han, Chulho; Song, Han; Lim, Jiwoo; Lee, Younhe; Kim, Sugyeong; Im, Sangyoon; Atanasovska, Biljana; Ahmad, Hajar Fauzan; Boer, Cindy; Jansen, Philip; Franke, Lude; Kaja, Elżbieta; Pasko, Dorota; Kennis-Szilagyi, Ingrid; Kornilov, Sergey A.; Prijatelj, Vid; Prokić, Ivana; Sivanadhan, Ilangkumaran; Perumal, Sarala; Esmaeeli, Sahar; Pearson, Nathaniel M.; Auton, Adam; Shelton, Janie F.; Shastri, Anjali J.; Filshtein-Sonmez, Teresa; Coker, Daniella; Symons, Antony; Esparza-Gordillo, Jorge; Aslibekyan, Stella; O’Connell, Jared; Ye, Chelsea; Weldon, Catherine H.; Perera, Minoli; O’Leary, Kevin; Tuck, Matthew; O’Brien, Travis; Meltzer, David; O’Donnell, Peter; Nutescu, Edith; Yang, Guang; Alarcon, Cristina; Herrmann, Stefanie; Mazurek, Sophia; Banagan, Jeff; Hamidi, Zacharia; Barbour, April; Raffat, Noora; Moreno, Diana; Friedman, Paula; Ferwerda, Bart; van de Beek, Diederik; Brouwer, Matthijs C.; Vlaar, Alexander P. J.; Wiersinga, W. Joost; Posthuma, Danielle; Tissink, Elleke; Koos Zwinderman, A. H.; Uffelmann, Emil; van Agtmael, Michiel; Algera, Anne Geke; van Baarle, Frank; Bax, Diane; Beudel, Martijn; Jan Bogaard, Harm; Bomers, Marije; Bonta, Peter I.; Bos, Lieuwe; Botta, Michela; de Brabander, Justin; de Bree, Godelieve; de Bruin, Sanne; Bugiani, Marianna; Bulle, Esther; Chouchane, Osoul; Cloherty, Alex; Dongelmans, Dave; Elbers, Paul; Fleuren, Lucas; Geerlings, Suzanne; Geerts, Bart; Geijtenbeek, Theo; Girbes, Armand; Goorhuis, Bram; Grobusch, Martin P.; Hafkamp, Florianne; Hagens, Laura; Hamann, Jorg; Harris, Vanessa; Hemke, Robert; Hermans, Sabine M.; Heunks, Leo; Hollmann, Markus; Horn, Janneke; Hovius, Joppe W.; de Jong, Menno D.; Koning, Rutger; van Mourik, Niels; Nellen, Jeannine; Nossent, Esther J.; Paulus, Frederique; Peters, Edgar; van der Poll, Tom; Preckel, Bennedikt; Prins, Jan M.; Raasveld, Jorinde; Reijnders, Tom; Schinkel, Michiel; Schultz, Marcus J.; Schuurman, Alex; Sigaloff, Kim; Smit, Marry; Stijnis, Cornelis S.; Stilma, Willemke; Teunissen, Charlotte; Thoral, Patrick; Tsonas, Anissa; van der Valk, Marc; Veelo, Denise; de Vries, Heder; van Vugt, Michèle; Wouters, Dorien; Minnaar, René P.; Kromhout, Adrie; van Uffelen, Kees W. J.; Wolterman, Ruud A.; Roberts, Genevieve; Park, Danny; Ball, Catherine A.; Coignet, Marie; McCurdy, Shannon; Knight, Spencer; Partha, Raghavendran; Rhead, Brooke; Zhang, Miao; Berkowitz, Nathan; Gaddis, Michael; Noto, Keith; Ruiz, Luong; Pavlovic, Milos; Hong, Eurie L.; Rand, Kristin; Girshick, Ahna; Guturu, Harendra; Baltzell, Asher Haug; Rahmouni, Souad; Guntz, Julien; Beguin, Yves; Pigazzini, Sara; Nkambule, Lindokuhle; Bouysran, Youssef; Busson, Adeline; Peyrassol, Xavier; Wilkin, Françoise; Pichon, Bruno; Smits, Guillaume; Vandernoot, Isabelle; Goffard, Jean-Christophe; Georges, Michel; Moutschen, Michel; Misset, Benoit; Darcis, Gilles; Guiot, Julien; Jadot, Laurent; Azarzar, Samira; Dellot, Patricia; Gofflot, Stéphanie; Claassen, Sabine; Bertrand, Axelle; Parzibut, Gilles; Clarinval, Mathilde; Moermans, Catherine; Malaise, Olivier; El Kandoussi, Kamilia; Thonon, Raphaël; Huynen, Pascale; Mesdagh, Alyssia; Melo, Sofia; Jacques, Nicolas; Di Valentin, Emmanuel; Giroule, François; Collignon, Alice; Radermecker, Coraline; Lebrun, Marielle; Perée, Hélène; Latour, Samuel; Barada, Olivia; Sanchez, Judit; Josse, Claire; Boujemla, Bouchra; Meunier, Margot; Mariavelle, Emeline; Anania, Sandy; Gazon, Hélène; Juszczak, Danusia; Fadeur, Marjorie; Camby, Séverine; Meuris, Christelle; Thys, Marie; Jacques, Jessica; Henket, Monique; Léonard, Philippe; Frippiat, Frederic; Giot, Jean-Baptiste; Sauvage, Anne-Sophie; Von Frenckell, Christian; Mni, Myriam; Wéry, Marie; Staderoli, Alicia; Belhaj, Yasmine; Lambermont, Bernard; Morrison, David R.; Mooser, Vincent; Forgetta, Vincenzo; Li, Rui; Ghosh, Biswarup; Laurent, Laetitia; Belisle, Alexandre; Henry, Danielle; Abdullah, Tala; Adeleye, Olumide; Mamlouk, Noor; Kimchi, Nofar; Afrasiabi, Zaman; Rezk, Nardin; Vulesevic, Branka; Bouab, Meriem; Guzman, Charlotte; Petitjean, Louis; Tselios, Chris; Xue, Xiaoqing; Afilalo, Jonathan; Afilalo, Marc; Oliveira, Maureen; Brenner, Bluma; Brassard, Nathalie; Durand, Madeleine; Schurr, Erwin; Lepage, Pierre; Ragoussis, Jiannis; Auld, Daniel; Chassé, Michaël; Kaufmann, Daniel E.; Lathrop, G. Mark; Adra, Darin; Davis, Lea K.; Cox, Nancy J.; Below, Jennifer E.; Sealock, Julia M.; Faucon, Annika B.; Shuey, Megan M.; Polikowsky, Hannah G.; Petty, Lauren E.; Shaw, Douglas M.; Chen, Hung-Hsin; Zhu, Wanying; Ludwig, Kerstin U.; Schröder, Julia; Maj, Carlo; Rolker, Selina; Nöthen, Markus M.; Fazaal, Julia; Keitel, Verena; Jensen, Björn-Erik Ole; Feldt, Torsten; Kurth, Ingo; Marx, Nikolaus; Dreher, Michael; Pink, Isabell; Cornberg, Markus; Illig, Thomas; Lehmann, Clara; Schommers, Philipp; Augustin, Max; Rybniker, Jan; Knopp, Lisa; Eggermann, Thomas; Volland, Sonja; Altmüller, Janine; Berger, Marc M.; Brenner, Thorsten; Hinney, Anke; Witzke, Oliver; Bals, Robert; Herr, Christian; Ludwig, Nicole; Walter, Jörn; Fuchsberger, Christian; Pattaro, Cristian; De Grandi, Alessandro; Pramstaller, Peter; Emmert, David; Melotti, Roberto; Foco, Luisa; Mascalzoni, Deborah; Gögele, Martin; Domingues, Francisco; Hicks, Andrew; Gignoux, Christopher R.; Wicks, Stephen J.; Crooks, Kristy; Barnes, Kathleen C.; Daya, Michelle; Shortt, Jonathan; Rafaels, Nicholas; Chavan, Sameer; Goldstein, David B.; Kiryluk, Krzysztof; Sengupta, Soumitra; Chung, Wendy; Reilly, Muredach P.; Khan, Atlas; Wang, Chen; Povysil, Gundula; Bhardwaj, Nitin; Gharavi, Ali G.; Ionita-Laza, Iuliana; Shang, Ning; O’Byrne, Sheila M.; Nandakumar, Renu; Menon, Amritha; So, Yat S.; Hod, Eldad; Pendrick, Danielle; Kim, Han-Na; Park, Soo-Kyung; Kim, Hyung-Lae; Kang, Chang Kyung; Lee, Hyo-Jung; Song, Kyoung-Ho; Jae Yoon, Kyung; Paik, Nam-Jong; Seok, Woojin; Yoon, Heejun; Joo, Eun-Jeong; Chang, Yoosoo; Ryu, Seungho; Park, Wan Beom; Su Park, Jeong; Un Park, Kyoung; Ham, Sin Young; Jung, Jongtak; Kim, Eu Suk; Kim, Hong Bin; Ellinghaus, David; Degenhardt, Frauke; Cáceres, Mario; Juzenas, Simonas; Lenz, Tobias L.; Albillos, Agustín; Julià, Antonio; Heidecker, Bettina; Garcia, Federico; Kurth, Florian; Tran, Florian; Hanses, Frank; Zoller, Heinz; Holter, Jan C.; Fernández, Javier; Sander, Leif Erik; Rosenstiel, Philip; Koehler, Philipp; de Cid, Rafael; Asselta, Rosanna; Schreiber, Stefan; Hehr, Ute; Prati, Daniele; Baselli, Guido; Valenti, Luca; Bujanda, Luis; Banales, Jesus M.; Duga, Stefano; D’Amato, Mauro; Romero-Gómez, Manuel; Buti, Maria; Invernizzi, Pietro; Franke, Andre; Hov, Johannes R.; Karlsen, Tom H.; Folseraas, Trine; Maya-Miles, Douglas; Teles, Ana; Azuure, Clinton; Wacker, Eike Matthias; Uellendahl-Werth, Florian; ElAbd, Hesham; Arora, Jatin; Lerga-Jaso, Jon; Wienbrandt, Lars; Rühlemann, Malte Christoph; Wendorff, Mareike; Vadla, May Sissel; Lenning, Ole Bernt; Özer, Onur; Myhre, Ronny; Raychaudhuri, Soumya; Tanck, Anja; Gassner, Christoph; Hemmrich-Stanisak, Georg; Kässens, Jan; Figuera Basso, Maria E.; Schulzky, Martin; Wittig, Michael; Braun, Nicole; Wesse, Tanja; Albrecht, Wolfgang; Yi, Xiaoli; Ortiz, Aaron Blandino; Chercoles, Adolfo Garrido; Ruiz, Agustín; Mantovani, Alberto; Holten, Aleksander Rygh; Mayer, Alena; Cherubini, Alessandro; Protti, Alessandro; Aghemo, Alessio; Gerussi, Alessio; Ramirez, Alfredo; Braun, Alice; Barreira, Ana; Lleo, Ana; Kildal, Anders Benjamin; Glück, Andreas; Nolla, Anna Carreras; Latiano, Anna; Dyrhol-Riise, Anne Ma; Muscatello, Antonio; Voza, Antonio; Rando-Segura, Ariadna; Solier, Aurora; Karina, Banasik; Cortes, Beatriz; Mateos, Beatriz; Nafria-Jimenez, Beatriz; Schaefer, Benedikt; Bellinghausen, Carla; Ferrando, Carlos; Quereda, Carmen; Skurk, Carsten; Thibeault, Charlotte; Spinner, Christoph D.; Lange, Christoph; Hu, Cinzia; Cappadona, Claudio; Bianco, Cristiana; Sancho, Cristina; Lihaug Hoff, Dag Arne; Galimberti, Daniela; Jiménez, David; Pestaña, David; Toapanta, David; Azzolini, Elena; Scarpini, Elio; Helbig, Elisa T.; Urrechaga, Eloisa; Paraboschi, Elvezia Maria; Pontali, Emanuele; Reverter, Enric; Navas, Enrique; Arana, Eunate; Sánchez, Félix García; Ceriotti, Ferruccio; Malvestiti, Francesco; Mesonero, Francisco; Pezzoli, Gianni; Lamorte, Giuseppe; Neb, Holger; My, Ilaria; Hernández, Isabel; de Rojas, Itziar; Galván-Femenia, Iván; Heyckendorf, Jan; Rybniker, Jan; Badia, Joan Ramon; Schneider, Jochen; Goikoetxea, Josune; Kraft, Julia; Müller, Karl Erik; Gaede, Karoline I.; Garcia-Etxebarria, Koldo; Tonby, Kristian; Heggelund, Lars; Izquierdo-Sanchez, Laura; Sumoy, Lauro; Lippert, Lena J.; Terranova, Leonardo; Garbarino, Lucia; Téllez, Luis; Roade, Luisa; Ostadreza, Mahnoosh; Intxausti, Maider; Kogevinas, Manolis; Gutiérrez-Stampa, María A.; Vehreschild, Maria J. G. T.; Marquié, Marta; Castoldi, Massimo; Cecconi, Maurizio; Boada, Mercè; Seilmaier, Michael J.; Mazzocco, Michela; Rodríguez-Gandía, Miguel; Ayo, Natale Imaz; Blay, Natalia; Martínez, Nilda; Cornely, Oliver A.; Palmieri, Orazio; Tentorio, Paolo; Rodrigues, Pedro M.; España, Pedro P.; Hoffmann, Per; Bacher, Petra; Suwalski, Phillip; de Pablo, Raúl; Nieto, Rosa; Badalamenti, Salvatore; Ciesek, Sandra; Bombace, Sara; Wilfling, Sibylle; Brunak, Søren; Heilmann-Heimbach, Stefanie; Ripke, Stephan; Bahmer, Thomas; Landmesser, Ulf; Protzer, Ulrike; Rimoldi, Valeria; Skogen, Vegard; Andrade, Victor; Moreno, Victor; Poller, Wolfgang; Farre, Xavier; Wang, Xiaomin; Khodamoradi, Yascha; Karadeniz, Zehra; de Salazar, Adolfo; Palom, Adriana; Garcia-Fernandez, Alba-Estela; Blanco-Grau, Albert; Zanella, Alberto; Bandera, Alessandra; Nebel, Almut; Biondi, Andrea; Caballero-Garralda, Andrea; Gori, Andrea; Lind, Andreas; Fracanzani, Anna Ludovica; Peschuck, Anna; Pesenti, Antonio; de la Horra, Carmen; Milani, Chiara; Paccapelo, Cinzia; Angelini, Claudio; Cea, Cristina; Muñiz-Diaz, Eduardo; Sandoval, Elena; Calderón, Enrique J.; Solligård, Erik; Aziz, Fátima; Martinelli-Boneschi, Filippo; Peyvandi, Flora; Blasi, Francesco; Medrano, Francisco J.; Rodriguez-Frias, Francisco; Müller, Fredrik; Grasselli, Giacomo; Costantino, Giorgio; Cardamone, Giulia; Foti, Giuseppe; Matullo, Giuseppe; Kurihara, Hayato; Afset, Jan Egil; Damås, Jan Kristian; Ampuero, Javier; Martín, Javier; Erdmann, Jeanette; Bergan, Jonas; Goerg, Siegfried; Ferrusquía-Acosta, Jose; Quero, Jose Hernández; Delgado, Juan; Guerrero, Juan M.; Risnes, Kari; Bettini, Laura Rachele; Moreira, Leticia; Gustad, Lise Tuset; Santoro, Luigi; Scudeller, Luigia; Riveiro-Barciela, Mar; Schaefer, Marco; Carrabba, Maria; Valsecchi, Maria G.; Hernandez-Tejero, María; Acosta-Herrera, Marialbert; D’Angiò, Mariella; Baldini, Marina; Cazzaniga, Marina; Ciccarelli, Michele; Bocciolone, Monica; Miozzo, Monica; Chueca, Natalia; Montano, Nicola; Faverio, Paola; Preatoni, Paoletta; Bonfanti, Paolo; Omodei, Paolo; Castro, Pedro; Ferrer, Ricard; Gualtierotti, Roberta; Gallego-Durán, Rocío; Morilla, Rubén; Haider, Sammra; Marsal, Sara; Aneli, Serena; Pelusi, Serena; Bosari, Silvano; Aliberti, Stefano; Dudman, Susanne; Zheng, Tenghao; Pumarola, Tomas; Cejudo, Trinidad Gonzalez; Monzani, Valter; Friaza, Vicente; Peter, Wolfgang; Dopazo, Ximo; Duga, Stefano; May, Sandra; Grimsrud, Marit M.; Gudbjartsson, Daniel F.; Stefansson, Kari; Sulem, Patrick; Sveinbjornsson, Gardar; Melsted, Pall; Norddahl, Gudmundur; Swerford Moore, Kristjan Helgi; Thorsteinsdottir, Unnur; Holm, Hilma; Alarcón-Riquelme, Marta E.; Bernardo, David; Martínez-Bueno, Manuel; Rello, Silvia Rojo; Magi, Reedik; Milani, Lili; Metspalu, Andres; Laisk, Triin; Läll, Kristi; Lepamets, Maarja; Esko, Tõnu; Reimann, Ene; Naaber, Paul; Laane, Edward; Pesukova, Jaana; Peterson, Pärt; Kisand, Kai; Tabri, Jekaterina; Allos, Raili; Hensen, Kati; Starkopf, Joel; Ringmets, Inge; Tamm, Anu; Kallaste, Anne; Alavere, Helene; Metsalu, Kristjan; Puusepp, Mairo; Kristiansson, Kati; Koskelainen, Sami; Perola, Markus; Donner, Kati; Kivinen, Katja; Palotie, Aarno; Palotie, Aarno; Rivolta, Carlo; Bochud, Pierre-Yves; Bibert, Stéphanie; Boillat, Noémie; Nussle, Semira Gonseth; Albrich, Werner; Quinodoz, Mathieu; Kamdar, Dhryata; Suh, Noémie; Neofytos, Dionysios; Erard, Véronique; Voide, Cathy; Bochud, P. Y.; Rivolta, C.; Bibert, S.; Quinodoz, M.; Kamdar, D.; Neofytos, D.; Erard, V.; Voide, C.; Friolet, R.; Vollenweider, P.; Pagani, J. L.; Oddo, M.; zu Bentrup, F. Meyer; Conen, A.; Clerc, O.; Marchetti, O.; Guillet, A.; Guyat-Jacques, C.; Foucras, S.; Rime, M.; Chassot, J.; Jaquet, M.; Viollet, R. Merlet; Lannepoudenx, Y.; Portopena, L.; Desgranges, F.; Filippidis, P.; Guéry, B.; Haefliger, D.; Kampouri, E. E.; Manuel, O.; Munting, A.; Papadimitriou-Olivgeris, M.; Regina, J.; Rochat-Stettler, L.; Suttels, V.; Tadini, E.; Tschopp, J.; Van Singer, M.; Viala, B.; Boillat-Blanco, N.; Brahier, T.; Hügli, O.; Meuwly, J. Y.; Pantet, O.; Nussle, S. Gonseth; Bochud, M.; D’Acremont, V.; Younes, S. Estoppey; Albrich, W. C.; Suh, N.; Cerny, A.; O’Mahony, L.; von Mering, C.; Bochud, P. Y.; Frischknecht, M.; Kleger, G.-R.; Filipovic, M.; Kahlert, C. R.; Wozniak, H.; Negro, T. Rochat; Pugin, J.; Bouras, K.; Knapp, C.; Egger, T.; Perret, A.; Montillier, P.; di Bartolomeo, C.; Barda, B.; de Cid, Rafael; Carreras, Anna; Moreno, Victor; Galván-Femenía, Iván; Blay, Natalia; Farré, Xavier; Sumoy, Lauro; Cortés, Beatriz; Mercader, Josep Maria; Guindo-Martinez, Marta; Torrents, David; Garcia-Aymerich, Judith; Castaño-Vinyals, Gemma; Dobaño, Carlota; Gori, Marco; Renieri, Alessandra; Mondelli, Mario Umberto; Castelli, Francesco; Vaghi, Massimo; Rusconi, Stefano; Montagnani, Francesca; Bargagli, Elena; Franchi, Federico; Mazzei, Maria Antonietta; Cantarini, Luca; Tacconi, Danilo; Feri, Marco; Scala, Raffaele; Spargi, Genni; Nencioni, Cesira; Bandini, Maria; Caldarelli, Gian Piero; Spagnesi, Maurizio; Canaccini, Anna; Ognibene, Agostino; D’Arminio Monforte, Antonella; Girardis, Massimo; Antinori, Andrea; Francisci, Daniela; Schiaroli, Elisabetta; Scotton, Pier Giorgio; Panese, Sandro; Scaggiante, Renzo; Monica, Matteo Della; Capasso, Mario; Fiorentino, Giuseppe; Castori, Marco; Aucella, Filippo; Di Biagio, Antonio; Masucci, Luca; Valente, Serafina; Mandalà, Marco; Zucchi, Patrizia; Giannattasio, Ferdinando; Coviello, Domenico A.; Mussini, Cristina; Bosio, Giancarlo; Tavecchia, Luisa; Crotti, Lia; Rizzi, Marco; La Rovere, Maria Teresa; Sarzi-Braga, Simona; Bussotti, Maurizio; Ravaglia, Sabrina; Artuso, Rosangela; Perrella, Antonio; Romani, Davide; Bergomi, Paola; Catena, Emanuele; Vincenti, Antonella; Ferri, Claudio; Grassi, Davide; Pessina, Gloria; Tumbarello, Mario; Di Pietro, Massimo; Sabrina, Ravaglia; Luchi, Sauro; Barbieri, Chiara; Acquilini, Donatella; Andreucci, Elena; Paciosi, Francesco; Segala, Francesco Vladimiro; Tiseo, Giusy; Falcone, Marco; Lista, Mirjam; Poscente, Monica; De Vivo, Oreste; Petrocelli, Paola; Guarnaccia, Alessandra; Baroni, Silvia; Perticaroli, Valentina; Furini, Simone; Dei, Simona; Benetti, Elisa; Picchiotti, Nicola; Sanarico, Maurizio; Ceri, Stefano; Pinoli, Pietro; Raimondi, Francesco; Biscarini, Filippo; Stella, Alessandra; Bergomi, Mattia; Zguro, Kristina; Capitani, Katia; Tanfoni, Marco; Fallerini, Chiara; Daga, Sergio; Baldassarri, Margherita; Fava, Francesca; Frullanti, Elisa; Valentino, Floriana; Doddato, Gabriella; Giliberti, Annarita; Tita, Rossella; Amitrano, Sara; Bruttini, Mirella; Croci, Susanna; Meloni, Ilaria; Mencarelli, Maria Antonietta; Lo Rizzo, Caterina; Pinto, Anna Maria; Beligni, Giada; Tommasi, Andrea; Di Sarno, Laura; Palmieri, Maria; Carriero, Miriam Lucia; Alaverdian, Diana; Iuso, Nicola; Inchingolo, Gabriele; Busani, Stefano; Bruno, Raffaele; Vecchia, Marco; Belli, Mary Ann; Mantovani, Stefania; Ludovisi, Serena; Quiros-Roldan, Eugenia; Antoni, Melania Degli; Zanella, Isabella; Siano, Matteo; Emiliozzi, Arianna; Fabbiani, Massimiliano; Rossetti, Barbara; Zanelli, Giacomo; Bergantini, Laura; D’Alessandro, Miriana; Cameli, Paolo; Bennet, David; Anedda, Federico; Marcantonio, Simona; Scolletta, Sabino; Guerrini, Susanna; Conticini, Edoardo; Frediani, Bruno; Spertilli, Chiara; Donati, Alice; Guidelli, Luca; Corridi, Marta; Croci, Leonardo; Piacentini, Paolo; Desanctis, Elena; Cappelli, Silvia; Verzuri, Agnese; Anemoli, Valentina; Pancrazi, Alessandro; Lorubbio, Maria; Merlini, Esther; Miraglia, Federica Gaia; Venturelli, Sophie; Cossarizza, Andrea; Vergori, Alessandra; Gabrieli, Arianna; Riva, Agostino; Paciosi, Francesco; Andretta, Francesca; Gatti, Francesca; Parisi, Saverio Giuseppe; Baratti, Stefano; Piscopo, Carmelo; Russo, Roberta; Andolfo, Immacolata; Iolascon, Achille; Carella, Massimo; Merla, Giuseppe; Squeo, Gabriella Maria; Raggi, Pamela; Marciano, Carmen; Perna, Rita; Bassetti, Matteo; Sanguinetti, Maurizio; Giorli, Alessia; Salerni, Lorenzo; Parravicini, Pierpaolo; Menatti, Elisabetta; Trotta, Tullio; Coiro, Gabriella; Lena, Fabio; Martinelli, Enrico; Mancarella, Sandro; Gabbi, Chiara; Maggiolo, Franco; Ripamonti, Diego; Bachetti, Tiziana; Suardi, Claudia; Parati, Gianfranco; Bottà, Giordano; Di Domenico, Paolo; Rancan, Ilaria; Bianchi, Francesco; Colombo, Riccardo; van Heel, David A.; Hunt, Karen A.; Trembath, Richard C.; Huang, Qin Qin; Martin, Hilary C.; Mason, Dan; Trivedi, Bhavi; Wright, John; Finer, Sarah; Griffiths, Christopher J.; Akhtar, Shaheen; Anwar, Mohammad; Arciero, Elena; Ashraf, Samina; Breen, Gerome; Chung, Raymond; Curtis, Charles J.; Chowdhury, Maharun; Colligan, Grainne; Deloukas, Panos; Durham, Ceri; Finer, Sarah; Griffiths, Chris; Huang, Qin Qin; Hurles, Matt; Hunt, Karen A.; Hussain, Shapna; Islam, Kamrul; Khan, Ahsan; Khan, Amara; Lavery, Cath; Lee, Sang Hyuck; Lerner, Robin; MacArthur, Daniel; MacLaughlin, Bev; Martin, Hilary; Mason, Dan; Miah, Shefa; Newman, Bill; Safa, Nishat; Tahmasebi, Farah; Trembath, Richard C.; Trivedi, Bhavi; van Heel, David A.; Wright, John; Smith, Albert V.; Boughton, Andrew P.; Li, Kevin W.; LeFaive, Jonathon; Annis, Aubrey; Jannes, Cinthia E.; Krieger, Jose E.; Pereira, Alexandre C.; Velho, Mariliza; Marques, Emanuelle; Lima, Isabella Ramos; Tada, Mauricio Teruo; Valino, Karina; McCarthy, Mark; Rosenberger, Carrie; Lee, Jon
Temporal trends and treatment patterns in anal fissure management: insights from a multicenter study in Italy
No full textIntroduction Anal fissure (AF) poses a common challenge in clinical practice, prompting various treatment approaches. This multicenter study, conducted by the Italian Society of Colorectal Surgery, aimed to assess treatment trends in AF over a 10 year period. Methods A survey of proctologists and retrospective analysis of patient records were conducted to evaluate treatment modalities and outcomes across six different clinical scenarios based on AF presentation (acute/chronic) stratified by sphincter function (normal/hypertonic/hypotonic). Results Analysis of data from 17 principal investigators and 22,016 patients revealed significant variability in treatment approaches, influenced by factors such as symptom duration, anal tone, and surgeon preference. Conservative treatments were commonly utilized, while surgical interventions were reserved for refractory cases. Specifically, pharmaceutical treatment was administered to 66-75% of patients in cases of acute AF and 63-67% for chronic AF, while 10-15% underwent anal dilation, and < 2% received botulinum toxin injection. Among medical treatments, nifedipine with lidocaine and glycerin film-forming ointments were the most utilized. The most performed surgical techniques were fissurectomy and anoplasty, except for patients with chronic AF and hypertonic sphincter where sphincterotomy prevailed. Trends in treatment utilization varied depending on the clinical scenario, with notable shifts observed over time. Conclusions This study provides insights into the evolving landscape of AF management, highlighting the need for further research to elucidate optimal treatment strategies and improve patient outcomes
Long term morphotectonic evolution of the Southern Apennines
No full textABSTRACT
The main goal of this work is the study of the morphological and morphometrical features of the Southern Apennines thrust belt – foredeep system, carrying out both a large scale and a small scale analyses of areas of high relevance, with the aim to determine new morphological and morphometrical constraints to the reconstruction of the main morphotectonic events that have interested the chain. This type of research has been based on the idea to compare such data with new thermochronological data that have been produced in many areas of the chain (Aldega et al., 2003; Mazzoli et al., 2006; Mazzoli et al., 2008), which highlighted the role of the exhumation processes in the evolution of the thrust belt. The thermochronological data indicate that the exhumation processes started about 10Ma and they have been active since recent time (in the last million years), resulting contemporary to the main morphogenetic events responsible of the actual morphostructural setting of the chain.
The Southern Apennines chain formed has a consequence of the Neogene collision of the African (and in particular, the Adria microplate) and Euroasiatic plates, with the subduction of the Adria microplate beneath the Euroasiatic plate. The morphostructural setting of the Southern Apennines has been determined by its complex tectonic history (with the occurrence of both thrust faults and normal faults) and by the erosional processes that have sculptured the topography, also considering that the landforms are strongly influenced by the rock type too.
In the last years the development of new techniques of analysis has provided new constraints useful to the reconstruction of the morphotectonic history of the Southern Apennines. This techniques are based on thermochronological analysis, and in particular on the Apatite Fission Tracks, the Ur-Th-He series, the Vitrinite Reflectance, the Clay Mineralogy and the Fluid Inclusions. These data, that have been extensively produced in the whole chain, have pointed out the attention on tectonic exhumation processes (we mean by rock exhumation a variation of the position of a rock in relation to the air-topograhy interface), which have determined rock uplift of thousands of meters in the last 2-3Ma (Aldega et al., 2003; Mazzoli et al., 2006; Mazzoli et al., 2008). The individuation of so enhanced vertical and horizontal tectonic motions in recent times has expected to have interacted with the processes responsible of the exogenic modelling of the topography, and they have probably played an important role in the morphotectonic evolution of the chain, leaving their signature in the topography.
The research has been based on large scale geomorphological and morphometrical techniques of analysis, that have been used with the aim to describe the main morphological and morphometrical features of the chain, to compare the features of the Tyrrhenian, Adriatic and Ionian slopes of the Southern Apennines, and to relate these features with the proposed morphotectonic events. The large scale analysis has been accompanied by the small scale analysis of a selected transect namely the Noce-Sirino-Alpi-Sant’Arcangelo transect. This transect has been chosen because of the particular features that make this area one of the most relevant portion of the chain in order to reconstruct the morphotectonic evolution of the Southern Apennines, and in particular, to investigate the role played by the rock exhumation processes in the evolution of the relief. This transect assumes a high relevance because:
- it includes tectonic units which have been exhumed in recent times;
- it preserves a stratigraphical and morpho-stratigraphical record which is almost continuous both temporally (from the Middle Pliocene to the whole Quaternary) and spatially (from the Tyrrhenian to the Adriatic coasts);
- the topography, in this portion of the Southern Apennines, has been only slightly dismembered by the post-orogenic extensional tectonic, and may be considered resulting by the major geodynamic processes (shortening, thrusting, extension and exhumation).
One of the main parameters that can influence the geomorphological and morphometrical features of a determined region is the lithology, or more correctly the bedrock resistance to erosion. In fact, parameters such as the elevation, local relief, steepness, presence of knickpoints are strongly controlled by bedrock erodibility. As a result, the first step in the analysis of the landscape is represented by a clear depiction of the space distribution of the rock types with different erodibility. For the above mentioned reason, a “Map of the Morphostructural Units of the Southern Apennines” has been created. This map is a simplification of the “Geological Map of the Southern Apennines” in scale 1:250000, in fact the 81 formations distinguished in the “Geological Map of the Southern Apennines” have been reduced into the 20 morphostructural units which have been grouped based on the estimation of erodibility of each rock type relative to other rock types. The erodibility degree was basically assigned by the observations of the features (e.g. steepness, degree of development of the upper convexity/basal concavity of hillslopes, average elevation, etc.) associated with the various bedrocks. As regards the Quaternary deposits, these were grouped based on different criteria. Taking into account the main goal of this study, which consists in the reconstruction of the Plio-Quaternary relative/absolute vertical motions of the Southern Apennines, the grouping of the different Quaternary stratigraphical units was based on the depositional environment (marine vs continental), degree of correlation of the different units with the original depositional environment (i.e. whether and to what degree they are displaced/dissected), and tectonic context (e.g. peri-tyrrhenian grabens, foredeep and intramontane basins deposits).
The large scale geomorphological analysis of the Southern Apennines has been based on the determination of the following parameters: elevation map and the derived maximum, medium and minimum elevation maps, swath profiles and the derived relief curves, analysis of the river long profiles and the derived parameters (drainage area vs distance, Stream Gradient Index, steepness (ks) and concavity (Q) indexes, slope of the first order channels). This type of analysis enhance a series of particular feature of the Southern Apennines that can be summarized as follows:
- the minimum elevation map can be separated in two different sector, respectively located north and south of the hereinafter named “Sele-Ofanto line”: the north sector is characterized by the coincidence of the highest values with the apenninic divide, while the southern sector is characterized by the presence of a wide area with high values in the minimum elevations, which moves from the apenninic divide to the east, involving the foredeep (and the Lavello high) and the Murge-Salento area ;
- this data regarding the minimum elevation map is very interesting in particular when compared with the “Map of the Morphostructural Units of the Southern Apennines”: this comparison show that the valleys on the Adriatic flank are higher than the valleys on the Tyrrhenian flank despite the Adriatic flank is characterized by the outcropping of very weak lithologies (external flyschs and Quaternary filling of the foredeep);
- the minimum elevation map could be so considered a good representation of the differential uplift at the orogen scale; this fact let the maximum elevation map to play a less relevant role when we want to interpret it in terms of uplift, and it can be more correctly considered as a good representation of the distribution of the tectonic Quaternary lows;
- the medium elevation map clearly enhance the presence of the hard carbonatic highs on the Tyrrhenian slope respect to more eroded surrounding areas where weaker lithologies crop out. This means that the Tyrrhenian slope has experienced a more intense erosion, or even that it is experiencing erosion since older times than the Adriatic flank (where the same weak lithologies crop out), and that the amount of eroded rock volumes is higher on the Tyrrhenian flank than on the Adriatic flank. If this two sectors were experiencing erosion since the same time, than we cannot explain why the external flank of the chain is higher than its inner flank despite this two sectors are characterized by the same rock-type;
- the analysis of the maximum, medium and minimum elevation maps suggests that the Adriatic flank of the Southern Apennines has experienced more enhanced uplift in recent times than the Tyrrhenian flank;
- the Tyrrhenian and the Adriatic flanks of the chain have also other different morphological and morphometrical features, in particular the Tyrrhenian flank becomes steeper than the Adriatic flank as we move to the south, giving the typical asymmetrical feature to the Southern Apennine;
- this asymmetrical feature of the chain is clearly showed by the envelop of the minimum elevation line of the five swath profiles, which enhance the presence of a Tyrrhenian steep slope and of an Adriatic gentle slope;
- there is an important difference regarding the elevation of the valleys on Tyrrhenian and the Adriatic flanks, with a mean gradient that bring the valleys to reach elevations a.s.l. higher on both the flanks as we move to the south, but in general the valleys on the Tyrrhenian flank are always lower than the valleys on the Adriatica flank: such a difference suggest a more recent uplift on the Adriatic flank than on the Tyrrhenian one;
The analysis of the river system shows how there is a spatial variations of the morphological and morphometrical features of the Southern Apennine rivers. If we consider the shape of the river long profiles we notice that the Tyrrhenian rivers have a clear concave-up shape with no important knickpoints, while the Adriatic rivers show a more rectilinear shape and the Ionian rivers show a less evident concave-up shape, in same cases close to the rectilinear, with evident knickpoints along the profiles. The Q (concavity index) values show a difference among the three sectors, with the Tyrrhenian rivers showing the highest value (Q=0.52), the Adriatic rivers showing a lower value (Q=0.45) and with the Ionian rivers showing the lowest value (Q=0.43). This data confirm what we noticed by the analysis of the river long profiles, in particular the Tyrrhenian rivers have a more evident concave-up shape and the Ionian rivers the less evident concave-up shape. The clear concave up shape of the Tyrrhenian rivers can be related to a more enhanced uplift on the Adriatic and Ionian slopes than on the Tyrrhenian slope. If we consider the Ks (steepness index) values, we suggest that in a geological setting such as the Southern Apennines, that is characterized by important lithological variations also in very close areas, the Ks index seems to reflect such variations more than recent rock uplift
The geomorphological, morphometrical and sedimentological analysis of the Noce-Sirino-Alpi-Sant’Arcangelo transect allowed the individuation of two low relief landforms which are located on the western sector of the Sant’Arcangelo basin (700-900m a.s.l.) and in the area between the north side of Mt. Sirino, Mt. Raparo and Mt. Alpi (1200-1400m a.s.l.). The lowest surface (700-900m a.s.l.) corresponds to the eroded depositional surface of the Serracorneta Conglomerate, so it is temporally constrained at about 0.6Ma. The morphological relationships among this lower paleosurface and the highest one are not clear, we can anyway affirm that it is recognized in the area north of the Mt. Sirino and it involves both carbonates units than Lagonegro Units, so its modelling took place after the exhumation of the Mt. Sirino ended and so, considering the data we are going to talk about soon, it could temporally constrained in the Middle-Late Lower Pleistocene, and in particular between 1.5-0.6Ma.
The field analysis let us to recognize the oldest units of the Qquaternary filling of the Sant’Arcangelo basin that contains clasts of the Lagonegro Units coming from the Mt. Sirino area: this unit is the subsynthem A2a (Benvenuti et al., 2006) which should be not older than 1.5Ma, so this means that at this time the Mt. Sirino was already a morphostructural highs that was experiencing erosion. This data agrees with the thermochronological analysis, which suggested that the rock exhumation of the Mt. Sirino started since 2.5Ma, and it has allowed us to give a lower temporal limit to the formation of the highest paleosurface.
The analysis of the “map of the slope of the 1st order channels”, carried out within the Sant’Arcangelo basin, suggests that the area comprised between the Serrapotamo and the Sarmento river shows the highest values: these high slope values could be related to a more enhanced uplift that this area has experienced respect to the rest of the Sant’Arcangelo basin. If we combine this data with the uplift data obtained by the analysis of the marine terraces on the Ionian coast (Amato, 2000), we have that the southwestern portion of the Sant’Arcangelo basin seems to be aligned with the southernmost Ionian coast, that is the portion of the Ionian coast which has experienced a more enhanced uplift: this data could suggest a connection between these two sectors, highlighting the presence of this NW-SE oriented portion of the Southern Apennines that has been strongly uplifted.
The analysis of the river terraces inside the Sinni valley has allowed the individuation of 7 orders of river terraces. The highest order, the 7th, doesn’t correspond to a real river terrace but it corresponds with the eroded depositional surface of the Serracorneta Conglomerates, whose age is of about 0.6Ma (Benvenuti et al., 2006). To date the lowest terraces we can try to correlate them with the dated marine terraces on the Ionian coast (Amato, 2000), this analysis let us to propose a late Upper Pleistocene for the 1st order terraces of the Sinni valley Considering the age of the highest river terraces and the actual elevation of the Sinni valley it is also possible to establish an incision rate of about 1mm/yr: the incision rate is always greater or equal to the uplift rate, so we can say that the uplift rate of the Sinni valley since 0.6Ma doesn’t exceed 1mm/yr. This uplift rate agrees with the uplift rate that have been proposed by Amato (2000) for the marine terraces on the Ionian coast, where the author proposed an uplift rate comprised between 0.3-1.6mm/yr.
The analysis of the Noce valley river terraces has allowed the grouping of the several mapped fluvial terraces into three main orders: pre-lake, syn-lake and post-lake terraces. There are no absolute date available to date the lake time, so the age of the syn-lake terraces has been obtained using methods of relative chronology, by trying to correlate such terraces with dated marine terraces on the Tyrrhenian coast at the mouth of the Noce river: an Emilian-Sicilian age is proposed for the highest marine terraces at 170m and 140m a.s.l., while a Middle Pleistocene age is proposed for the 80m a.s.l. marine terrace. The oldest marine terraces are extended inside the Noce valley, so it means that at that time the Noce valley was already individuated. In addiction to this we have to consider that, on the basis of morphometrical considerations, such marine terraces are correlable with the river terraces at about 200m a.s.l. individuated in locality Feliceta, inside the Noce valley, and that are referred to the post-lake river terraces. Another important issue is given by the presence of Lagonegro clasts into this marine deposits and, considering that the only area from which these clasts could come from is Mt. Sirino, this data suggests that at the time of the formation of the oldest marine terraces (about 1Ma), Mt. Sirino was already experiencing erosion, so it was very close to the actual morphostructural setting.
The combination of the sedimentological data of the SAnt’Arcagenlo basin and the analysis of the Noce river terraces allowed us to affirm that about 1.5-1Ma Mt. Sirino was already a morphological high which was experiencing erosion, so it means that the rock exhumation processes was finished: the comparison of these data with the thermochronological data suggest that in the period between 2.5Ma and 1.5-1Ma Mt. Sirino has experienced an enhanced rock exhumation that has brought it from an initial situation where it was covered by about 4km of rocks (2.5Ma) to a final situation where it outcrops on the Earth surface and it was subject to the exogenic processes (1.5-1Ma).
This study has highlighted the importance of the morphotectonic approach in the reconstruction of the tectonic events occurred either at a regional scale or at a local scale. In particular, the numerical analysis of digital topographic data has been very useful to the large scale characterization of the Southern Apennines chain landscape. Furthermore, the integration of data provided by the digital analysis technique (e.g. swath profiles, river long profiles and the derived metrics), with the data obtained through the “classical” geomorphological approach, based on morphostructural and morphostratigraphical analyses, has provided new constraints to the reconstruction of the vertical motions which affected the entire chain during the Quaternary.
The main results of this study can be summarized as follows:
- long profiles, elevation of the valley bottoms and the minimum elevation map show that the outer portion of the Southern Apennines (Adriatic and Ionian slopes) has been uplifted more recently and with higher rates than its inner side (Tyrrhenian slope). These data agree with data provided by the analysis of the shorelines, marine terraces and coastal deposits observed on the Ionian belt (Amato, 2000) and the Tyrrhenian margin (Romano, 1992; Caiazzo et al., 2006), which indicate that the Ionian flank has experienced larger uplift, since the Middle Pleistocene, than the Tyrrhenian flank;
- the Ionian rivers show a very steep long profile when they flow into the Sant’Arcangelo basin. This suggests that the post-orogenic uplift recognized by the marine terraces in the foredeep affected also the outer portion of the chain, involving at least the Sant’Arcangelo area;
- by the comparison of the Agri and the Sinni long profile, by the map of the gradient of the first order channel, and by the Ks values (which are higher on the southern portion of the Sant’Arcangelo basin and that decrease moving towards its northern portion) it appears that the uplift in the Sant’Arcangelo area follows a N-S trend. However, further studies are necessary to discern about the reason of such different uplift;
- as regards to the Middle Pleistocene to Present uplift trend, the above observations indicate that the uplift increases towards the west, probably reaching the chain axis. Coeval uplift in the Tyrrhenian margin (as estimated by elevation of Middle to Late Pleistocene marine terraces shorelines; Romano, 1992; Caiazzo et al., 2006; Filocamo, 2006) was much lower, not exceeding about 100 m. These evidences suggest that the uplift trend of the outer flank of the chain is not recognizable in the whole orogen. The western boundary of the more rapidly uplifting belt can be tentatively located in correspondence to the deep-seated normal faults that have formed the several Quaternary intramontane basins;
- the stronger post-orogenic uplift occurred on the outer side of the chain since the Middle Pleistocene has determined a minor ability of the Adriatic and Ionian rivers (which experienced a continuous downcutting) to compete with the Tyrrhenian rivers. This fact is enhanced by the comparison of the valley bottoms, which are higher for the rivers flowing on the outer flank than for the rivers flowing on the inner flank of the chain. This has probably contributed, together with regressive river erosion due to the extensional tectonics on the Tyrrhenian margin (see sec. 3.5), in the decoupling between the maximum elevation line and the main divide, which is one of the peculiar features of the Southern Apennines chain;
- the combination of the field analysis together with the morphological and morphometrical analysis of the Noce-Sirino-Alpi-Sant’Arcangelo transect allowed us to affirm that during the late Lower Pleistocene Mt. Sirino was already a morphological high which was experiencing erosion, so it means that the rock exhumation processes was finished;
- this data is confirmed by the analysis of the river terraces of the Noce valley: the lacustrine conditions have been dated (by methods of relative chronology on the basis of the morphological relationships among the fluvial terraces of the Noce valley and dated marine terraces on the Tyrrhenian coast close to the Noce mouth) to the middle Lower Pleistocene, and the recognition of Lagonegro clasts inside the oldest marine deposits (Lower Pleistocene) suggests that at that time there was an active drainage from Mt. Sirino to the south, and so Mt. Sirino was already a morphological high subject to the erosional processes and able to produce debris, and the lake didn’t exist anymore;
- in addiction to this, we have to consider that since its exhumation, Mt. Sirino corresponds to the location of the Apennine divide, representing one of the few portion of the Southern Apennines where there is a coincidence between the maximum elevation line and the divide location. This situation is partly recognized also in Monti Picentini area, where the two lines (divide and maximum elevation lines) are very close. The Sirino and the Picentini ridge are two areas t
Acute diverticulitis management: evolving trends among Italian surgeons. A survey of the Italian Society of Colorectal Surgery (SICCR)
No full textAcute diverticulitis (AD) is associated with relevant morbidity/mortality and is increasing worldwide, thus becoming a major issue for national health systems. AD may be challenging, as clinical relevance varies widely, ranging from asymptomatic picture to life-threatening conditions, with continuously evolving diagnostic tools, classifications, and management. A 33-item-questionnaire was administered to residents and surgeons to analyze the actual clinical practice and to verify the real spread of recent recommendations, also by stratifying surgeons by experience. CT-scan remains the mainstay of AD assessment, including cases presenting with recurrent mild episodes or women of child-bearing age. Outpatient management of mild AD is slowly gaining acceptance. A conservative management is preferred in non-severe cases with extradigestive air or small/non-radiologically drainable abscesses. In severe cases, a laparoscopic approach is preferred, with a non-negligible number of surgeons confident in performing emergency complex procedures. Surgeons are seemingly aware of several options during emergency surgery for AD, since the rate of Hartmann procedures does not exceed 50% in most environments and damage control surgery is spreading in life-threatening cases. Quality of life and history of complicated AD are the main indications for delayed colectomy, which is mostly performed avoiding the proximal vessel ligation, mobilizing the splenic flexure and performing a colorectal anastomosis. ICG is spreading to check anastomotic stumps' vascularization. Differences between the two experience groups were found about the type of investigation to exclude colon cancer (considering the experience only in terms of number of colectomies performed), the size of the peritoneal abscess to be drained, practice of damage control surgery and the attitude towards colovesical fistula
Current approach to loop ileostomy closure: a nationwide survey on behalf of the Italian Society of ColoRectal Surgery (SICCR)
No full text: Compared to standardized minimally invasive colorectal procedures, there is considerable perioperative heterogeneity in loop ileostomy reversal. This study aimed to investigate the current perioperative practice and technical variations of loop ileostomy reversal following rectal cancer surgery. A nationwide online survey was conducted among members of the Italian Society of ColoRectal Surgery (SICCR). A link to the questionnaire was sent via mail. The survey consisted of 31 questions concerning the main procedural steps and application of the ERAS protocol after loop ileostomy reversal. Overall, 219 participants completed the survey. One respondent in four used a combination of water-soluble contrast studies (WSCS) and digital rectal examination to assess the integrity of the anastomosis before ileostomy closure. Conversely, 17.8% of them used either only WSCS or only endoscopy. Surgeons routinely perform hand-sewn or stapled anastomoses in 45.2% and 54.8% of the cases, respectively. Side-to-side antiperistaltic stapled anastomosis was the most performed anastomosis (36%). Most surgeons declared that they have never used prostheses for abdominal wall closure (64%), whereas 35% preferred retromuscular mesh placement in selected cases only. Forty-six respondents (66.7%) reported using interrupted stitches for skin closure, while 65 (29.7%) a purse-string suture. Furthermore, skin approximation at the stoma site using open methods was significantly more common among surgeons with greater experience in ileostomy reversal (p = 0.031). Overall, a good compliance with the ERAS protocol was found. However, colorectal surgeons were significantly more likely to follow the ERAS pathway than general surgeons (p < 0.05). Surgeons use different anastomotic techniques for ileostomy reversal after rectal cancer surgery. Based on current evidence, purse-string skin closure and ERAS pathway should be implemented, while the role of mesh prophylactic strategy needs to be explored further
Current state-of-the-art of adrenal surgery in Italy: the cancer risk in surgical adrenal lesions (CRISAL) survey
No full textAdrenalectomies are growing worldwide because of the frequent diagnosis of incidentaloma and the use of minimally invasive surgery (MIS). The factors used to identify a malignant lesion and the best surgical technique are uncertain. In this context, the definition of high-volume center and expert surgeon is under debate. The Italian Society of Endoscopic Surgery and New Technologies (SICE) developed a nationwide survey to investigate the state-of-the-art of adrenal surgery in Italy. A web-based survey comprising 37 questions was developed and distributed to Italian surgeons involved in adrenal surgery. Two hundred forty-eight answers were analyzed. Consensus was reached among the survey participants regarding local infiltration (83%) and rapid growth of the lesion (81%) as markers of malignancy. Nearly 30% of the participants used MIS in case of malignant adrenal lesions. The lateral (50%) and anterior transperitoneal (44%) approaches were the most common among Italian surgeons. Approximately 40% of participants believe that 20–40 adrenalectomies/year are needed to define an expert surgeon and at least 20 procedures/year to define a high-volume center. Approximately half of participants performed < 10 adrenalectomies/year in centers with a median volume < 10 procedures/year. Based on participant feedback, this survey highlights local infiltration and rapid growth as the most significant markers of malignant adrenal lesions. While open adrenalectomy remains the gold standard for suspected malignant lesions, nearly 30% of the participants practice MIS even in these cases. The lateral and anterior transperitoneal approaches emerge as the most familiar for Italian surgeons. A substantial proportion of Italian patients with adrenal lesions undergo surgery performed by surgeons with an annual case volume < 10 procedures, at centers with a low annual volume of adrenalectomies. Moreover, there is a lack of standardized definitions for ‘expert surgeon’ and ‘high-volume center’ in this context
Current status of liver surgery for non-colorectal non-neuroendocrine liver metastases: the NON.LI.MET. Italian Society for Endoscopic Surgery and New Technologies (SICE) and Association of Italian Surgeons in Europe (ACIE) collaborative international survey
No full textDespite the increasing trend in liver resections for non-colorectal non-neuroendocrine liver metastases (NCNNLM), the role of surgery for these liver malignancies is still debated. Registries are an essential, reliable tool for assessing epidemiology, diagnosis, and therapeutic approach in a single hub, especially when data are dispersive and inconclusive, as in our case. The dissemination of this preliminary survey would allow us to understand if the creation of an International Registry is a viable option, while still offering a snapshot on this issue, investigating clinical practices worldwide. The steering committee designed an online questionnaire with Google Forms, which consisted of 37 questions, and was open from October 5th, 2022, to November 30th, 2022. It was disseminated using social media and mailing lists of the Italian Society of Endoscopic Surgery and New Technologies (SICE), the Association of Italian Surgeons in Europe (ACIE), and the Spanish Chapter of the American College of Surgeons (ACS). Overall, 141 surgeons (approximately 18% of the total invitations sent) from 27 countries on four continents participated in the survey. Most respondents worked in general surgery units (62%), performing less than 50 liver resections/year (57%). A multidisciplinary discussion was currently performed to validate surgical indications for NCNNLM in 96% of respondents. The most commonly adopted selection criteria were liver resectability, RECIST criteria, and absence of extrahepatic disease. Primary tumors were generally of gastrointestinal (42%), breast (31%), and pancreaticobiliary origin (13%). The most common interventions were parenchymal-sparing resections (51% of respondents) of metachronous metastases with an open approach. Major post-operative complications (Clavien-Dindo > 2) occurred in up to 20% of the procedures, according to 44% of respondents. A subset analysis of data from high-volume centers (> 100 cases/year) showed lower post-operative complications and better survival. The present survey shows that NCNNLM patients are frequently treated by surgeons in low-volume hospitals for liver surgery. Selection criteria are usually based on common sense. Liver resections are performed mainly with an open approach, possibly carrying a high burden of major post-operative complications. International guidelines and a specific consensus on this field are desirable, as well as strategies for collaboration between high-volume and low-volume centers. The present study can guide the elaboration of a multi-institutional document on the optimal pathway in the management of patients with NCNNLM
Novel textbook outcomes following emergency laparotomy: Delphi exercise
No full textBackground: Textbook outcomes are composite outcome measures that reflect the ideal overall experience for patients. There are many of these in the elective surgery literature but no textbook outcomes have been proposed for patients following emergency laparotomy. The aim was to achieve international consensus amongst experts and patients for the best Textbook Outcomes for non-trauma and trauma emergency laparotomy. Methods: A modified Delphi exercise was undertaken with three planned rounds to achieve consensus regarding the best Textbook Outcomes based on the category, number and importance (Likert scale of 1-5) of individual outcome measures. There were separate questions for non-trauma and trauma. A patient engagement exercise was undertaken after round 2 to inform the final round. Results: A total of 337 participants from 53 countries participated in all three rounds of the exercise. The final Textbook Outcomes were divided into 'early' and 'longer-term'. For non-trauma patients the proposed early Textbook Outcome was 'Discharged from hospital without serious postoperative complications (Clavien-Dindo ≥ grade III; including intra-abdominal sepsis, organ failure, unplanned re-operation or death). For trauma patients it was 'Discharged from hospital without unexpected transfusion after haemostasis, and no serious postoperative complications (adapted Clavien-Dindo for trauma ≥ grade III; including intra-abdominal sepsis, organ failure, unplanned re-operation on or death)'. The longer-term Textbook Outcome for both non-trauma and trauma was 'Achieved the early Textbook Outcome, and restoration of baseline quality of life at 1 year'. Conclusion: Early and longer-term Textbook Outcomes have been agreed by an international consensus of experts for non-trauma and trauma emergency laparotomy. These now require clinical validation with patient data
Global variation in anastomosis and end colostomy formation following left-sided colorectal resection
No full text3427sinoneBackground: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and-2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle-and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results: In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 percent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low-compared with middle-and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion: Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone.noneGlasbey, James C; Adisa, Adewale O; Costas‐Chavarri, Ainhoa; Qureshi, Ahmad U; Allen‐Ingabire, Jean C; Salem, Hosni Khairy; Kojo, Anyomih Theophilus Teddy; Tabiri, Stephen; Nepogodiev, Dmitri; Lilford, Richard J; Harrison, Ewen M; Pinkney, Thomas D; Smart, Neil; Bhangu, Aneel; Verjee, Azmina; Runigamugabo, Emmy; Glasbey, James; Bhangu, Aneel; Ademuyiwa, Adesoji O; Adisa, Adewale O; Aguilera, Maria Lorena; Altamini, Afnan; Alexander, Philip; Al‐Saqqa, Sara W; Borda‐Luque, Giuliano; Cornick, Jen; Costas‐Chavarri, Ainhoa; Drake, Thomas M; Fergusson, Stuart J; Fitzgerald, J Edward; Glasbey, James; Ingabire, J.C Allen; Ismaïl, Lawani; Jaffry, Zahra; Salem, Hosni Khairy; Khatri, Chetan; Kirby, Andrew; Kojo, Anyomih Theophilus Teddy; Lapitan, Marie Carmela; Lilford, Richard; Mihaljevic, Andre L; Mohan, Midhun; Morton, Dion; 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Munhoz, Monique Moron; Moreira, Gisele; De Castro Segundo, Luiz Carlos Barros; Ferreira, Salim Anderson Khouri; Careta, Maíra Cassa; Kim, Stella Binna; De Sousa, Alexandre Venancio; Cury, Alyne Daltri Lazzarini; Miguel, Gustavo Peixoto Soares; De Freitas, Ana Vega Carreiro; Guasti, Barbara Pereira Silvestre Julia; Vianna, Pinto; Felipe, Carolina Oliveira; Laufer, Luis Alberto Valente; Altoe, Fernanda; Da Silva, Luana Ayres; Pimenta, Marina Luiza; Giuriato, Thiago Fernandes; Morais, Paulo Alves Bezerra; Araujo, Jessica Souza Luiz Rafael; Menegussi, Juliana; Leal, Marisa; Lima, Caio Vinícius Barroso; Tatagiba, Luiza Sarmento; Leal, Antônio; Santos, Diogo Vinicius; Fraga, Gustavo Pereira; Simoes, Romeo Lages; Stock, Simon; Nigo, Samuel; Kabba, Juana; Ngwa, Tagang Ebogo; Brown, James; King, Sebastian; Zani, Augusto; Azzie, Georges; Firdouse, Mohammed; Kushwaha, Sameer; Agarwal, Arnav; Bailey, Karen; Cameron, Brian; Livingston, Michael; Horobjowsky, Alexandre; Deckelbaum, Dan L; Razek, Tarek; 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Elshafay, Abd Elrahman; Gharib, Abdalla; Menshawy, Ahmed; Hanafy, Mohammed; Al‐Mallah, Abdullah; Abdulgawad, Mahmoud; Baheeg, Mohamad; Alhendy, Mohammed; AbdelFattah, Ibrahim; Kenibar, Abdalla; Osman, Omar; Gemeah, Mostafa; Mohammed, Ahmed; Adel, Abdalrahman; Gharib, Abdalla; Mohammed, Abdelrahman; Sayed, Abdelrahman; Abozaid, Mohamed; Kotb, Ahmed Hafez El‐Badri; Ata, Ali Amin Ahmed; Nasr, Mohammed; Alkammash, Abdelrahman; Saeed, Mohammed; El Hamid, Nader Abd; Attia, Attia Mohamed; El Galeel, Ahmed Abd; Elbanby, Eslam; El‐Dien, Khalid Salah; Hantour, Usama; Alahmady, Omar; Mansour, Billal; Elkorashy, Amr Muhammad; Taha, Emad Mohamed Saeed; Lasheen, Kholod Tarek; Elkolaly, Salma Said; Abdel‐Wahab, Nehal Yosri Elsayed; Abozyed, Mahmoud Ahmed Fathi; Adel, Ahmed; Saeed, Ahmed Moustafa; El Sayed, Gehad Samir; Youssif, Jehad Hassan; Ahmed, Soliman Magdy; El‐Shahat, Nermeen Soubhy; Khedr, Abd El‐Rahman Hegazy; Elsebaaye, Abdelrhman Osama; Elzayat, Mohamed; Abdelraheim, Mohamed; Elzayat, Ibrahim; Warda, Mahmoud; El Deen, Khaled Naser; Elnemr, Abdelrhman Essam; Salah, Omar; Abbas, Mohamed; Rashad, Mona; Elzayyat, Ibrahim; Hemeda, Dalia; Tawfik, Gehad; Salama, Mai; Khaled, Hazem; Seisa, Mohamed; Elshaer, Kareem; Hussein, Abdelfatah; Elkhadrawi, Mahmoud; Afifi, Ahmed Mohamed; Ebrahim, Osama Saadeldeen; Metwally, Mahmoud Mohamed; Elmelegy, Rowida; Elsawahly, Diaa Moustafa Elbendary; Safa, Hisham; Nofal, Eman; Elbermawy, Mohamed; Ghazy, Ahmed Abdelmotaleb; Samih, Hisham; Abdelgelil, Asmaa; Abdelghany, Sarah; El Kholy, Ahmed; Aboraya, Metwally; Elkady, Fatma; Salma, Mahmoud; Samy, Sarah; Fakher, Reem; Aboarab, Aya; Samir, Ahmed; Sakr, Ahmed; Haroun, Abdelrahman; Al‐Aarag, Asmaa Abdel‐Rahman; Elkholy, Ahmed; Elshanwany, Sally; Ghanem, Esraa; Tammam, Ahmed; Hammad, Ali Mohamed; El Shoura, Yousra; El Ashal, Gehad; Khairy, Hosni; Antar, Sarah; Mehrez, Sara; Abdelshafy, Mahmoud; Hamad, Maha Gamal Mohamad; Hosh, Mona; Abdallah, Emad; Magdy, Basma; Alzayat, Thuraya; Gamaly, Elsayed; Elfeki, Hossam; Abouzahra, Amany; Elsheikh, Shereen; Elgendy, Fatimah I; El‐Salam, Fathia Abd; Seifelnasr, Osama; Ammar, Mohamed; Eysa, Athar; Sadek, Aliaa; Toeema, Aliaa Gamal; Nasr, Aly; Abuseif, Mohamed; Zidan, Hagar; Barakat, Sara Abd Elmageed; Elsayed, Nadin; Elrasoul, Yasmin Abd; Elkelany, Ahmed; Ammar, Mohamed Sabry; Mustafa, Mennat‐Allah; Hegazy, Yasmin; Etman, Mohamed; Saad, Samar; Alrahawy, Mahmoud; Raslan, Ahmed; Morsi, Mahmoud; Rslan, Ahmed; Sabry, Ahmed; Elwakil, Hager; Shaker, Heba; Zidan, Hagar; Abd‐Elrasoul, Yasmin; Elkelany, Ahmed; El‐Kashef, Hussein; Shaalan, Mohamed; Tarek, Areej; Elwan, Ayman; Nayel, Ahmed Ragab; Seif, Mostafa; Elwan, Ayman; Emadeldin, Doaa; Ghonaim, Mohamed Ali; Almallah, Ahmad; Fouad, Ahmed; Sayma, Eman Adel; Elbatahgy, Ahmad; El‐Ma'doul, Angham Solaiman; Mosad, Ahmed; Tolba, Hager; Elsorogy, Diaa Eldin Abdelazeem Amin; Mostafa, Hassan Ali; Omar, Amira Atef; El Hameed, Ola Sherief Abd; Lasheen, Ahmed; El Salam, Yasser Abd; Morsi, Ashraf; Ismail, Mohammed; El‐badawy, Hager Ahmed; Amer, Mohamed A; Elkelany, Ahmed; Elkelany, Ahmed; El‐Hamouly, Ahmed Sabry; Attallah, Noura A.; Mosalum, Omnia; Afandy, Ahmed; Mokhtar, Ahmed; Abouelnasr, Alaa; Ayad, Sara; Shaker, Ramdan; Sakr, Rokia; Shaker, Ramadan; Amreia, Mahmoud; Elsobky, Soaad; Mustafa, Mohamed; El Magd, Ahmed Abo; Marey, Abeer; Hafez, Amr Tarek; Zalabia, Mohamed F; Mohamed, Mohamed Moamen; Fadel, Amr; Ahmed, Emad Ali; Ali, Ahmad; Alwafai, Mohammad Ghassan; Dwydar, Abdullah; Kharsa, Sara; Mamdouh, Ehab; El‐Sheemy, Hatem; AlYoussef, Ibrahim; Aly, Abouelatta Khairy; Aldalaq, Ahmad; Alnawam, Ehab; Alkhabbaz, Dalia; Saad, Mahmoud; Hussein, Shady; Elazayem, Ahmed Abo; Meshref, Ahmed; Elashmawy, Marwa; Mousa, Mohammed; Nashaat, Ahmad; Ghanem, Sara; Elsayed, Zaynab M; Elwaey, Aya; Elkadsh, Iman; Darweesh, Mariam; Mohameden, Ahmed; Hafez, Mennaallah; Badr, Ahmed; Badwy, Assmaa; El Slam, Mohamed Abd; Elazoul, Mohamed; Al‐Nahrawi, Safwat; Eldamaty, Lotfy; Nada, Fathee; Ameen, Mohamed; Hagar, Aya; Elsehimy, Mohamed; Aboraya, Mohammad; Dawoud, Hossam; El Mesery, Shorouk; El Gendy, Abeer; Abdelkareem, Ahmed; Marey, Ahmed Safwan; Allam, Mostafa; Shehata, Sherif; Abozeid, Khaled; Elshobary, Marwa; Fahiem, Ahmed; Sarsik, Sameh; Hashish, Amel; Zidan, Mohamed; Hashish, Mohamed; Aql, Shaimaa; Elhendawy, Abdelaziz Osman Abdelaziz; Husseini, Mohamed; Kasem, Esraa; Gheith, Ahmed; Elfouly, Yasmin; Soliman, Ahmed Ragab; Ibrahim, Yasmein; Elfouly, Nesma; Fawzy, Ahmed; Hassan, Ahmed; Rashid, Mohammad; Elsherbiny, Abdallah Salah; Sieda, Basem; Badwi, Nermin M; Mohammed, Mohammed Mustafa Hassan; Mohamed, Osama; Habeeb, Mohammad Abdulkhalek; Worku, Mengistu; Starr, Nichole; Desta, Semay; Wondimu, Sahlu; Abebe, Nebyou Seyoum; Thomas, Efeson; Asele, Frehun Ayele; Dabessa, Daniel; Abebe, Nebiyou Seyoum; Zerihun, Abebe Bekele; Mentula, Panu; Leppäniemi, Ari; Sallinen, Ville; Scalabre, Aurelien; Frade, Fernanda; Irtan, Sabine; Graffeille, Vivien; Gaignard, Elodie; Alimi, Quentin; Alimi, Quentin; Graffieille, Vivien; Gaignard, Elodie; Abbo, Olivier; Mouttalib, Sofia; Bouali, Ourdia; Hervieux, Erik; Aigrain, Yves; Botto, Nathalie; Faure, Alice; Fievet, Lucile; Panait, Nicoleta; Eyssartier, Emilie; Schmitt, Francoise; Podevin, Guillaume; Parent, Valentine; Martin, Amandine; Arnaud, Alexis Pierre; Muller, Cecile; Bonnard, Arnaud; Peycelon, Matthieu; Abantanga, Francis; Boakye‐Yiadom, Kwaku; Bukari, Mohammed; Owusu, Frank; Awuku‐Asabre, Joseph; Tabiri, Stephen; Bray, Lemuel Davies; Lytras, Dimitrios; Psarianos, Kyriakos; Bamicha, Anastasia; Kefalidi, Eirini; Gemenetzis, Georgios; Dervenis, Christos; Gouvas, Nikolaos; Agalianos, Christos; Kontos, Michail; Kouraklis, Gregory; Karousos, Dimitrios; Germanos, Stylianos; Marinos, Constantinos; Anthoulakis, Christos; Nikoloudis, Nikolaos; Mitroudis, Nikolaos; Recinos, Gustavo; Estupinian, Sergio; Forno, Walter; Azmitia, José René Arévalo; Cabrera, Carla Cecilia Ramãrez; Guevara, Romeo; Aguilera, Maria; Mendez, Napoleon; Mendizabal, Cesar Augusto Azmitia; Ramazzini, Pablo; Urquizu, Mario Contreras; Tale, Fernando; Soley, Rafael; Barrios, Emanuel; Barrios, Emmanuel; Rodríguez, Daniel Estuardo Marroquín; Velásquez, Carlos Iván Pérez; Mérida, Sara María Contreras; Regalado, Francisco; Lopez, Mario; Siguantay, Miguel; Lam, Fong Yee; Szeto, Kylie Joan‐yi; Szeto, Charing Cheuk Ling; Li, Wing Sum; Li, Kieran Ka Kei; Leung, Man Fung; Mak, Tony; Ng, Simon; Prasad, SS; Kirishnan, Anand; Gyanchandani, Nidhi; Kumar, Bylapudi Seshu; Rangarajan, Muthukumaran; Bhat, Sriram; Sreedharan, Anjana; Kinnera, S.V.; Reddy, Yella; Venugopal, Caranj; Kumar, Sunil; Mittal, Abhishek; Nadkarni, Shravan; Lakshmi, Harish Neelamraju; Malik, Puneet; Limaye, Neel; Pai, Srinivas; Jain, Pratik; Khajanchi, Monty; Satoskar, Savni; Satoskar, Rajeev; Mahamood, Abid Bin; Sutanto, Eldaa Prisca Refianti; Soeselo, Daniel Ardian; Tedjaatmadja, Chintya; Rahmawati, Fitriana Nur; Amandito, Radhian; Mayasari, Maria; Al‐Hasani, Ruqaya Kadhim Mohammed Jawad; Al‐Hameedi, Hasan Ismael Ibraheem; Ibraheem, Hasan Ismael; Al‐Azraqi, Israa Abdullah Aziz; Sabeeh, Lubna; Kamil, Rahma; Shawki, Marwan; Telfah, Muwaffaq Mezeil; Rasendran, Amoudtha; Sheehan, Jacqueline; Kerley, Robert; Normile, Caoimhe; Gilbert, Richard William; Song, Jiheon; Dablouk, Mohamed; Mauro, Linnea; Dablouk, Mohammed Osman; Hanrahan, Michael; Kielty, Paul; Marks, Eleanor; Gosling, Simon; Mccarthy, Michelle; Rasendran, Amoudtha; Mirghani, Diya; Naqvi, Syed Altaf; Wong, Chee Siong; Chung, Siyi; D'cruz, Reuban; Cahill, Ronan; Gosling, Simon George; Mccarthy, Michelle; Rasendran, Amoudtha; Fahy, Ciara; Song, Jiheon; Hanrahan, Michael; Cadogan, Diana Duarte; Powell, Anna; Gilbert, Richard; Clifford, Caroline; Normile, Caoimhe; Driscoll, Aoife; Paul, Stassen; Lee, Chris; Bowe, Ross; Hutch, William; Hanrahan, Michael; Mohan, Helen; O'neill, Maeve; Mealy, Kenneth; Danelli, Piergiorgio; Bondurri, Andrea; Maffioli, Anna; Pasini, Mario; Pata, Giacomo; Roncali, Stefano; Silvani, Paolo; Carlucci, Michele; Faccincani, Roberto; Bonavina, Luigi; Macchitella, Yuri; Ceriani, Chiara; Tugnoli, Gregorio; Di Saverio, Salomone; Khattab, Khaled; Paludi, Miguel Angel; Pata, Domenica; Cloro, Luigi Maria; Allegri, Andrea; Ansaloni, Luca; Coccolini, Federico; Veronese, Ezio; Bortolasi, Luca; Hasheminia, Alireza; Nastri, Giacomo; Canto, Massimiliano Dal; Cucumazzo, Stefano; Pata, Francesco; Benevento, Angelo; Tessera, Gaetano; Grandinetti, Pier Paolo; Maniscalco, Alessio; Lamanna, Giovanni Luca; Turati, Luca; Sgroi, Giovanni; Rausa, Emanuele; Villa, Roberta; Monteleone, Michela; Merlini, David; Coccolini, Federico; Ansaloni, Luca; Allegri, Andrea; Grassi, Veronica; Cirocchi, Roberto; Cacurri, Alban; Waleed, Hamza; Diab, Ahmed; Elzowawi, Fathi; Jokubauskas, Mantas; Varkalys, Karolis; Venskutonis, Donatas; Pranevicius, Robertas; Ambrozeviciute, Viktorija; Juciute, Simona; Skardžiukaitė, Austė; Venskutonis, Donatas; Bradulskis, Saulius; Urbanavicius, Linas; Austraite, Aiste; Riauka, Romualdas; Zilinskas, Justas; Dambrauskas, Zilvinas; Karumnas, Paulius; Urniezius, Zigmantas; Zilinskiene, Reda; Rudzenskaite, Anele; Usaityte, Ausrine; Montrimaite, Margarita; Kaselis, Nerijus; Strazdas, Andrius; Jokubonis, Kristijonas; Maceviciute, Kornelija; Beisa, Virgilijus; Poskus, Tomas; Strupas, Kestutis; Laugzemys, Erikas; Kolosov, Andrej; Jotautas, Valdemaras; Rakita, Ignas; Mikalauskas, Saulius; Kazanavicius, Darius; Rackauskas, Rokas; Strupas, Kestutis; Poskus, Tomas; Beisa, Virgilijus; Rakauskas, Ritauras; Preckailaite, Egle; Coomber, Ross; Johnson, Kenneth; Nowers, Jennifer; Periasammy, Dineshwary; Salleh, Afizah; Das, Andre; Tze, Reuben Goh Ern; Kumar, Milaksh Nirumal; Abdullah, Nik Azim Nik; Kosai, Nik Ritza; Taher, Mustafa; Rajan, Reynu; Chong, Hoong Yin; Roslani, April Camilla; Goh, Cheng Chun; Agius, Marija; Borg, Elaine; Bezzina, Maureen; Bugeja, Roberta; Vella‐Baldacchino, Martinique; Spina, Andrew; Psaila, Josephine; Francois‐Coridon, Helene; Tolg, Cecilia; Colombani, Jean‐Francois; Diaz‐Zorrilla, Carmina; De La Medina, Antonio Ramos‐; Gonzalez, Samantha Corro‐Diaz; Jacobe, Mário; Mapasse, Domingos; Snyder, Elizabeth; Oumer, Ramadan; Osman, Mohammed; Mohammad, Aminu; Anyanwu, Lofty‐John; Sheshe, Abdulrahman; Adesina, Alaba; Faturoti, Olubukola; Taiwo, Ogechukwu; Ibrahim, Muhammad Habib; Nasir, Abdulrasheed A; Suleiman, Siyaka Itopa; Adeniyi, Adewale; Adesanya, Opeoluwa; Adebanjo, Ademola; Osuoji, Roland; Atobatele, Kazeem; Ogunyemi, Ayokunle; Williams, Omolara; Oludara, Mobolaji; Oshodi, Olabode; Ademuyiwa, Adesoji; Lawal, AbdulRazzaq Oluwagbemiga; Alakaloko, Felix; Elebute, Olumide; Osinowo, Adedapo; Bode, Christopher; Adesuyi, Abidemi; Tade, Adesoji; Adekoya, Adeleke; Nwokoro, Collins; Ayandipo, Omobolaji O; Lawal, Taiwo Akeem; Ajao, Akinlabi E; Ali, Samuel Sani; Odeyemi, Babatunde; Olori, Samson; Popoola, Ademola; Adeyeye, Ademola; Adeniran, James; Lossius, William J.; Havemann, Ingemar; Thorsen, Kenneth; Narvestad, Jon Kristian; Soreide, Kjetil; Wold, Trude Beate; Nymo, Linn; Elsiddig, Mohammed; Dar, Manzoor; Bhopal, Kamran Faisal; Iftikhar, Zainab; Furqan, Muhammad Mohsin; Nighat, Bakhtiar; Jawaid, Masood; Khalique, Abdul; Zil‐E‐Ali, Ahsan; Rashid, Anam; Dharamshi, Hasnain Abbas; Naqvi, Tahira; Faraz, Ahmad; Anwar, Abdul Wahid; Yaseen, Tahir Muhammad; Shamsi, Ghina Shamim; Shamsi, Ghina; Yaseen, Tahir; Anwer, Wahid; Decoud, Horacio Paredes; Aguilera, Omar; Alvarez, Ismael Isaac Zelada; Delgado, Juan Marcelo; Vega, Gustavo Miguel Machain; Lohse, Helmut Alfredo Segovia; Aguilar, Wendy Leslie Messa; Chiong, Jose Antonio Cabala; Bautista, Ana Cecilia Manchego; Huaman, Eduardo; Zegarra, Sergio; Camacho, Rony; Celis, Jose María Vergara; Pozo, Diego Alonso Romani; Hamasaki, José; Temoche, Edilberto; Herrera‐Matta, Jaime; Torres, Carla Pierina García; Barreda, Luis Miguel Alvarez; Ojeda, Ronald Renato Barrionuevo; Garaycochea, Octavio; Mollo, Melanie Castro; Delgado, Mitchelle Solange De Fã Tima Linare; Fujii, Francisco; Bautista, Ana Cecilia Manchego; Aguilar, Wendy Leslie Messa; Chiong, Jose Antonio Cabala; Durand, Susana Yrma Aranzabal; Basto, Carlos Alejandro Arroyo; Rojas, Nelson Manuel Urbina; Yip, Sebastian Bernardo Shu; Vergara, Ana Lucia Contreras; Moran, Andrea Echevarria Rosas; Luque, Giuliano Borda; Castro, Manuel Rodriguez; Jaramillo, Ramon Alvarado; Sila, George Manrique; Lopez, Crislee Elizabeth; De Leon, Mardelangel Zapata Ponze; Machaca, Massiell; Huaraya, Ronald Coasaca; Arenas, Andy; López, Crislee; Puma, Clara Milagros Herrera; Pino, Wilfredo; Hinojosa, Christian; De Leon, Melanie Zapata Ponze; Limache, Susan; Sila, George Manrrique; Rodriguez, Layza‐Alejandra Mercado; Melo, Renato; Costa‐Maia, Jose; Muralha, Nuno; Sauvat, Frederique; Dan, Ionasc; Hogea, Mircea; Eduard, Pandi; Bratu, Razvan‐Matei; Beuran, Mircea; Diaconescu, Ionut‐Bogdan; Martian, Bogdan‐Valeriu; Iordache, Florin‐Mihail; Vartic, Mihaela; Vida, Lucian Corneliu; Muntean, Liviu Iuliu; Mironescu, Aurel Sandu; Nsengimana, Vizir Jean Paul; Niragire, Alice; Ingabire, Jean De La Croix Allen; Niyirera, Eugene; Zanini, Nicola; Jovine, Elio; Landolfo, Giovanni; Alomar, Ibrahim N.; Alnuqaydan, Saleh A.; Altwigry, Abdulrahman M.; Othman, Moayad; Osman, Nohad; Alqahtani, Enas; Alzahrani, Mohammed; Alyami, Rifan; Aljohani, Emad; Alhabli, Ibrahim; Mikwar, Zaher; Almuallem, Sultan; Aljohani, Emad; Alyami, Rifan; Alzahrani, Mohammed; Nawawi, Abrar; Bakhaidar, Mohamad; Maghrabi, Ashraf A.; Alsaggaf, Mohammed; Aljiffry, Murad; Altaf, Abdulmalik; Khoja, Ahmad; Habeebullah, Alaa; Akeel, Nouf; Ghandora, Nashat; Almoflihi, Abdullah; Huwait, Abdulmalik; Al‐shammari, Abeer; Al‐Mousa, Mashael; Alghamdi, Masood; Adham, Walid; Albeladi, Bandar; Alfarsi, Muayad Ahmed; Mahdi, Atif; Al Awwad, Saad; Altamimi, Afnan; Nouh, Thamer; Hassanain, Mazen; Aldhafeeri, Salman; Sadig, Nawal; Algohary, Osama; Aledrisy, Mohannad; Gudal, Ahmad; Alrifaie, Ahmad; AlRowais, Mohammed; Althwainy, Amani; Shabkah, Alaa; Alamoudi, Uthman; Alrajraji, Mawaddah; Alghamdi, Basim; Aljohani, Saud; Daqeeq, Abdullah; Al‐Faifi, Jubran J; Jennings, Vicky;
