NISAN - the National Institute for Stroke and Applied Neurosciences

Permanent link for this collection

https://hdl.handle.net/10292/10244

Institute Director: Professor Valery Feigin

Deputy Director: Associate Professor Alice Theadom

The National Institute for Stroke and Applied Neurosciences (NISAN) conducts epidemiological studies and clinical trials to improve health and outcomes in people with major neurological disorders. Current research programmes focus on:

Stroke
Traumatic brain injury
Neuromuscular disorders

Research with this aim is unique in New Zealand and NISAN is a hub for information sharing and developing a cohesive network between existing research and clinical groups with interests in:

Neuroepidemiology
Public health
Neurorehabilitation
Neuropsychology
Biostatistics

Browse

Now showing 1 - 20 of 106

2022 World Hypertension League, Resolve To Save Lives and International Society of Hypertension Dietary Sodium (Salt) Global Call to Action
(Springer Science and Business Media LLC, 2022) Campbell, NRC; Whelton, PK; Orias, M; Wainford, RD; Cappuccio, FP; Ide, N; Neal, B; Cohn, J; Cobb, LK; Webster, J; Trieu, K; He, FJ; McLean, RM; Blanco-Metzler, A; Woodward, M; Khan, N; Kokubo, Y; Nederveen, L; Arcand, J; MacGregor, GA; Owolabi, MO; Lisheng, L; Parati, G; Lackland, DT; Charchar, FJ; Williams, B; Tomaszewski, M; Romero, CA; Champagne, B; L’Abbe, MR; Weber, MA; Schlaich, MP; Fogo, A; Feigin, VL; Akinyemi, R; Inserra, F; Menon, B; Simas, M; Neves, MF; Hristova, K; Pullen, C; Pandeya, S; Ge, J; Jalil, JE; Wang, J-G; Wideimsky, J; Kreutz, R; Wenzel, U; Stowasser, M; Arango, M; Protogerou, A; Gkaliagkousi, E; Fuchs, FD; Patil, M; Chan, AW-K; Nemcsik, J; Tsuyuki, RT; Narasingan, SN; Sarrafzadegan, N; Ramos, ME; Yeo, N; Rakugi, H; Ramirez, AJ; Álvarez, G; Berbari, A; Kim, C-I; Ihm, S-H; Chia, Y-C; Unurjargal, T; Park, HK; Wahab, K; McGuire, H; Dashdorj, NJ; Ishaq, M; Ona, DID; Mercado-Asis, LB; Prejbisz, A; Leenaerts, M; Simão, C; Pinto, F; Almustafa, BA; Spaak, J; Farsky, S; Lovic, D; Zhang, X-H
A Brain Computer Interface Neuromodulatory Device for Stroke Rehabilitation: An Iterative User-Centred Design Approach
(JMIR Publications, 2023-12-11) Alder, Gemma; Taylor, Denise; Rashid, Usman; Olsen, Sharon; Brooks, Thonia; Terry, Gareth; Niazi, Imran Khan; Signal, Nada
BACKGROUND: Rehabilitation technologies for people with stroke are rapidly evolving. These technologies have the potential to support higher volumes of rehabilitation to improve outcomes for people with stroke. Despite growing evidence of their efficacy, there is a lack of uptake and sustained use in stroke rehabilitation and a call for user-centered design approaches during technology design and development. This study focuses on a novel rehabilitation technology called exciteBCI, a complex neuromodulatory wearable technology in the prototype stage that augments locomotor rehabilitation for people with stroke. The exciteBCI consists of a brain computer interface, a muscle electrical stimulator, and a mobile app. OBJECTIVE: This study presents the evaluation phase of an iterative user-centered design approach supported by a qualitative descriptive methodology that sought to (1) explore users' perspectives and experiences of exciteBCI and how well it fits with rehabilitation, and (2) facilitate modifications to exciteBCI design features. METHODS: The iterative usability evaluation of exciteBCI was conducted in 2 phases. Phase 1 consisted of 3 sprint cycles consisting of single usability sessions with people with stroke (n=4) and physiotherapists (n=4). During their interactions with exciteBCI, participants used a "think-aloud" approach, followed by a semistructured interview. At the end of each sprint cycle, device requirements were gathered and the device was modified in preparation for the next cycle. Phase 2 focused on a "near-live" approach in which 2 people with stroke and 1 physiotherapist participated in a 3-week program of rehabilitation augmented by exciteBCI (n=3). Participants completed a semistructured interview at the end of the program. Data were analyzed from both phases using conventional content analysis. RESULTS: Overall, participants perceived and experienced exciteBCI positively, while providing guidance for iterative changes. Five interrelated themes were identified from the data: (1) "This is rehab" illustrated that participants viewed exciteBCI as having a good fit with rehabilitation practice; (2) "Getting the most out of rehab" highlighted that exciteBCI was perceived as a means to enhance rehabilitation through increased engagement and challenge; (3) "It is a tool not a therapist," revealed views that the technology could either enhance or disrupt the therapeutic relationship; and (4) "Weighing up the benefits versus the burden" and (5) "Don't make me look different" emphasized important design considerations related to device set-up, use, and social acceptability. CONCLUSIONS: This study offers several important findings that can inform the design and implementation of rehabilitation technologies. These include (1) the design of rehabilitation technology should support the therapeutic relationship between the patient and therapist, (2) social acceptability is a design priority in rehabilitation technology but its importance varies depending on the use context, and (3) there is value in using design research methods that support understanding usability in the context of sustained use.
A Pilot Study of Application of the Stroke Riskometer Mobile App for Assessment of the Course and Clinical Outcomes of Covid-19 Among Hospitalised Patients
(Karger Publishers, 2023) Merkin, Alexander; Akinfieva, Sofya; Medvedev, Oleg N; Krishnamurthi, Rita V; Gutsaluk, Alexey; Reips, Ulf-Dietrich; Kuliev, Rufat; Dinov, Evgeny; Nikiforov, Igor; Shamalov, Nikolay; Shafran, Polina; Popova, Lyudmila; Burenchev, Dmitry; Feigin, VL
BACKGROUND: Early determination of COVID-19 severity and health outcomes could facilitate better treatment of patients. Different methods and tools have been developed for predicting outcomes of COVID-19, but they are difficult to use in routine clinical practice. METHODS: We conducted a prospective cohort study of inpatients aged 20-92 years, diagnosed with COVID-19 to determine whether their individual 5-year absolute risk of stroke at the time of hospital admission predicts the course of COVID-19 severity and mortality. The risk of stroke was determined by the Stroke Riskometer mobile application. RESULTS: We examined 385 patients hospitalised with COVID-19 (median age 61 years). The participants were categorised based on COVID-19 severity: 271 (70.4%) to the "Not severe" and 114 (29.6%) to the "Severe" groups. The median risk of stroke the next day after hospitalisation was significantly higher among patients in the Severe group (2.83 [95% CI 2.35-4.68]) vs the Not severe group (1.11 [95% CI 1.00-1.29]). The median risk of stroke and median systolic blood pressure (SBP) were significantly higher among non-survivors (12.04 [95% CI 2.73-21.19]) and (150 [95% CI 140-170]) vs survivors (1.31 [95% CI 1.14-1.52]), 134 [95% CI 130-135]), respectively. Those who spent more than 2.5 hours a week on physical activity were 3.1 times more likely to survive from COVID-19. Those who consumed more than one standard alcohol drink a day, or suffered with atrial fibrillation, or had poor memory were 2.5, 2.3, and 2.6 times more likely not to survive from COVID-19, respectively. CONCLUSIONS: High risk of stroke, physical inactivity, alcohol intake, high SBP, and atrial fibrillation are associated with severity and mortality of COVID-19. Our findings suggest that the Stroke Riskometer app could be used as a simple predictive tool of COVID-19 severity and mortality.
Ambient Air Pollution Exposure Estimation for the Global Burden of Disease 2012
(American Chemical Society (ACS), 2015) Brauer, M; Feigin, V; et al
Exposure to ambient air pollution is a major risk factor for global disease. Assessment of the impacts of air pollution on population health and evaluation of trends relative to other major risk factors requires regularly updated, accurate, spatially resolved exposure estimates. We combined satellite-based estimates, chemical transport model simulations, and ground measurements from 79 different countries to produce global estimates of annual average fine particle (PM2.5) and ozone concentrations at 0.1° × 0.1° spatial resolution for five-year intervals from 1990 to 2010 and the year 2013. These estimates were applied to assess population-weighted mean concentrations for 1990–2013 for each of 188 countries. In 2013, 87% of the world’s population lived in areas exceeding the World Health Organization Air Quality Guideline of 10 μg/m3 PM2.5 (annual average). Between 1990 and 2013, global population-weighted PM2.5 increased by 20.4% driven by trends in South Asia, Southeast Asia, and China. Decreases in population-weighted mean concentrations of PM2.5 were evident in most high income countries. Population-weighted mean concentrations of ozone increased globally by 8.9% from 1990–2013 with increases in most countries—except for modest decreases in North America, parts of Europe, and several countries in Southeast Asia.
Assessing the Individual Risk of Stroke in Caregivers of Patients with Stroke
(Georg Thieme Verlag KG, 2024-03-11) Marquez-Romero, Juan Manuel; Romo-Martínez, Jessica; Hernández-Curiel, Bernardo; Ruiz-Franco, Angélica; Krishnamurthi, Rita; Feigin, Valery
BACKGROUND: Genetic factors influence the risk of developing stroke. Still, it is unclear whether this risk is intrinsically high in certain people or if nongenetic factors explain it entirely. OBJECTIVE: To compare the risk of stroke in kin and nonkin caregivers. METHODS: In a cross-sectional study using the Stroke Riskometer app (AUT Ventures Limited, Auckland, AUK, New Zealand), we determined the 5- and 10-year stroke risk (SR) among caregivers of stroke inpatients. The degree of kinship was rated with a score ranging from 0 to 50 points. RESULTS: We studied 278 caregivers (69.4% of them female) with a mean age of 47.5 ± 14.2 years. Kin caregivers represented 70.1% of the sample, and 49.6% of them were offspring. The median SR at 5 years was of 2.1 (range: 0.35-17.3) versus 1.73 (range: 0.04-29.9), and of 4.0 (range: 0.45-38.6) versus 2.94 (range: 0.05-59.35) at 10 years for the nonkin and kin caregivers respectively. In linear logistic regression controlled for the age of the caregivers, adding the kinship score did not increase the overall variability of the model for the risk at 5 years (R2 = 0.271; p = 0.858) nor the risk at 10 years (R2 = 0.376; p = 0.78). CONCLUSION: Caregivers of stroke patients carry a high SR regardless of their degree of kinship.
Association of Early Blood-Based Biomarkers and Six-Month Functional Outcomes in Conventional Severity Categories of Traumatic Brain Injury: Capturing the Continuous Spectrum of Injury
(Elsevier BV, 2024) Wilson, L; Newcombe, VFJ; Whitehouse, DP; Mondello, S; Maas, AIR; Menon, DK; Ackerlund, C; Amrein, K; Andelic, N; Andreassen, L; Anke, A; Antoni, A; Audibert, G; Azouvi, P; Azzolini, ML; Bartels, R; Barzó, P; Beauvais, R; Beer, R; Bellander, BM; Belli, A; Benali, H; Berardino, M; Beretta, L; Blaabjerg, M; Bragge, P; Brazinova, A; Brinck, V; Brooker, J; Brorsson, C; Buki, A; Bullinger, M; Cabeleira, M; Caccioppola, A; Calappi, E; Calvi, MR; Cameron, P; Lozano, GC; Carbonara, M; Castaño-León, AM; Cavallo, S; Chevallard, G; Chieregato, A; Citerio, G; Clusmann, H; Coburn, MS; Coles, J; Cooper, JD; Correia, M; Čović, A; Curry, N; Czeiter, E; Czosnyka, M; Dahyot-Fizelier, C; Dark, P; Dawes, H; De Keyser, V; Degos, V; Della Corte, F; Boogert, HD; Depreitere, B; Đilvesi, Đ; Dixit, A; Donoghue, E; Dreier, J; Dulière, GL; Ercole, A; Esser, P; Ezer, E; Fabricius, M; Feigin, VL; Foks, K; Frisvold, S; Furmanov, A; Gagliardo, P; Galanaud, D; Gantner, D; Gao, G; George, P; Ghuysen, A; Giga, L; Glocker, B; Golubović, J; Gomez, PA; Gratz, J; Gravesteijn, B; Grossi, F; Gruen, RL; Gupta, D; Haagsma, JA; Haitsma, I; Helbok, R; Helseth, E; Horton, L; Huijben, J; Hutchinson, PJ; Jacobs, B; Jankowski, S; Jarrett, M; Jiang, JY
Background: Traumatic brain injury is conventionally categorised as mild, moderate, or severe on the Glasgow Coma Scale (GCS). Recently developed biomarkers can provide more objective and nuanced measures of the extent of brain injury. Methods: Exposure–response relationships were investigated in 2479 patients aged ≥16 enrolled in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) prospective observational cohort study. Neurofilament protein-light (NFL), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), and glial fibrillary acidic protein (GFAP) were assayed from serum sampled in the first 24 h; concentrations were divided into quintiles within GCS severity groups. Relationships with the Glasgow Outcome Scale-Extended were examined using modified Poisson regression including age, sex, major extracranial injury, time to sample, and log biomarker concentration as covariates. Findings: Within severity groups there were associations between biomarkers and outcomes after adjustment for covariates: GCS 13–15 and negative CT imaging (relative risks [RRs] from 1.28 to 3.72), GCS 13–15 and positive CT (1.21–2.81), GCS 9–12 (1.16–2.02), GCS 3–8 (1.09–1.94). RRs were associated with clinically important differences in expectations of prognosis. In patients with GCS 3 (RRs 1.51–1.80) percentages of unfavourable outcome were 37–51% in the lowest quintiles of biomarker levels and reached 90–94% in the highest quintiles. Similarly, for GCS 15 (RRs 1.83–3.79), the percentages were 2–4% and 19–28% in the lowest and highest biomarker quintiles, respectively. Interpretation: Conventional TBI severity classification is inadequate and underestimates heterogeneity of brain injury and associated outcomes. The adoption of circulating biomarkers can add to clinical assessment of injury severity. Funding: European Union 7th Framework program (EC grant 602150), Hannelore Kohl Stiftung, One Mind, Integra LifeSciences, Neuro-Trauma Sciences, NIHR Rosetrees Trust.
The burden of cardiovascular diseases among US states, 1990-2016
(American Medical Association, 2018) Global Burden of Cardiovascular Diseases Collaboration; Roth, GA; Johnson, CO; Abate, KH; Abd-Allah, F; Ahmed, M; Alam, K; Alam, T; Alvis-Guzman, N; Ansari, H; Ärnlöv, J; Atey, TM; Awasthi, A; Awoke, T; Barac, A; Bärnighausen, T; Bedi, N; Bennett, D; Bensenor, I; Biadgilign, S; Castañeda-Orjuela, C; Catalá-López, F; Davletov, K; Dharmaratne, S; Ding, EL; Dubey, M; Faraon, EJA; Farid, T; Farvid, MS; Feigin, V; Fernandes, J; Frostad, J; Gebru, A; Geleijnse, JM; Gona, PN; Griswold, M; Hailu, GB; Hankey, GJ; Hassen, HY; Havmoeller, R; Hay, S; Heckbert, SR; Irvine, CMS; James, SL; Jara, D; Kasaeian, A; Khan, AR; Khera, S; Khoja, AT; Khubchandani, J; Kim, D; Kolte, D; Lal, D; Larsson, A; Linn, S; Lotufo, PA; Magdy Abd El Razek, H; Mazidi, M; Meier, T; Mendoza, W; Mensah, GA; Meretoja, A; Mezgebe, HB; Mirrakhimov, E; Mohammed, S; Moran, AE; Nguyen, G; Nguyen, M; Ong, KL; Owolabi, M; Pletcher, M; Pourmalek, F; Purcell, CA; Qorbani, M; Rahman, M; Rai, RK; Ram, U; Reitsma, MB; Renzaho, AMN; Rios-Blancas, MJ; Safiri, S; Salomon, JA; Sartorius, B; Sepanlou, SG; Shaikh, MA; Silva, D; Stranges, S; Tabarés-Seisdedos, R; Tadele Atnafu, N; Thakur, JS; Topor-Madry, R; Truelsen, T; Tuzcu, EM; Tyrovolas, S; Ukwaja, KN; Vasankari, T; Vlassov, V; Vollset, SE; Wakayo, T; Weintraub, R; Wolfe, C; Workicho, A; Xu, G; Yadgir, S; Yano, Y; Yip, P; Yonemoto, N; Younis, M; Yu, C; Zaidi, Z; Zaki, MES; Zipkin, B; Afshin, A; Gakidou, E; Lim, SS; Mokdad, AH; Naghavi, M; Vos, T; Murray, CJL
Importance: Cardiovascular disease (CVD) is the leading cause of death in the United States, but regional variation within the United States is large. Comparable and consistent state-level measures of total CVD burden and risk factors have not been produced previously. Objective: To quantify and describe levels and trends of lost health due to CVD within the United States from 1990 to 2016 as well as risk factors driving these changes. Design, Setting, and Participants: Using the Global Burden of Disease methodology, cardiovascular disease mortality, nonfatal health outcomes, and associated risk factors were analyzed by age group, sex, and year from 1990 to 2016 for all residents in the United States using standardized approaches for data processing and statistical modeling. Burden of disease was estimated for 10 groupings of CVD, and comparative risk analysis was performed. Data were analyzed from August 2016 to July 2017. Exposures: Residing in the United States. Main Outcomes and Measures: Cardiovascular disease disability-adjusted life-years (DALYs). Results: Between 1990 and 2016, age-standardized CVD DALYs for all states decreased. Several states had large rises in their relative rank ordering for total CVD DALYs among states, including Arkansas, Oklahoma, Alabama, Kentucky, Missouri, Indiana, Kansas, Alaska, and Iowa. The rate of decline varied widely across states, and CVD burden increased for a small number of states in the most recent years. Cardiovascular disease DALYs remained twice as large among men compared with women. Ischemic heart disease was the leading cause of CVD DALYs in all states, but the second most common varied by state. Trends were driven by 12 groups of risk factors, with the largest attributable CVD burden due to dietary risk exposures followed by high systolic blood pressure, high body mass index, high total cholesterol level, high fasting plasma glucose level, tobacco smoking, and low levels of physical activity. Increases in risk-deleted CVD DALY rates between 2006 and 2016 in 16 states suggest additional unmeasured risks beyond these traditional factors. Conclusions and Relevance: Large disparities in total burden of CVD persist between US states despite marked improvements in CVD burden. Differences in CVD burden are largely attributable to modifiable risk exposures.
Burden of Disease Scenarios for 204 Countries and Territories, 2022–2050: A Forecasting Analysis for the Global Burden of Disease Study 2021
(Elsevier BV, 2024) Vollset, Stein Emil; Ababneh, Hazim S; Abate, Yohannes Habtegiorgis; Abbafati, Cristiana; Abbasgholizadeh, Rouzbeh; Abbasian, Mohammadreza; Abbastabar, Hedayat; Abd Al Magied, Abdallah HA; Abd ElHafeez, Samar; Abdelkader, Atef; Abdelmasseh, Michael; Abd-Elsalam, Sherief; Abdi, Parsa; Abdollahi, Mohammad; Abdoun, Meriem; Abdullahi, Auwal; Abebe, Mesfin; Abiodun, Olumide; Aboagye, Richard Gyan; Abolhassani, Hassan; Abouzid, Mohamed; Aboye, Girma Beressa; Abreu, Lucas Guimarães; Absalan, Abdorrahim; Abualruz, Hasan; Abubakar, Bilyaminu; Abukhadijah, Hana Jihad Jihad; Addolorato, Giovanni; Adekanmbi, Victor; Adetunji, Charles Oluwaseun; Adetunji, Juliana Bunmi; Adeyeoluwa, Temitayo Esther; Adha, Rishan; Adhikary, Ripon Kumar; Adnani, Qorinah Estiningtyas Sakilah; Adzigbli, Leticia Akua; Afrashteh, Fatemeh; Afzal, Muhammad Sohail; Afzal, Saira; Agbozo, Faith; Agodi, Antonella; Agrawal, Anurag; Agyemang-Duah, Williams; Ahinkorah, Bright Opoku; Ahlstrom, Austin J; Ahmad, Aqeel; Ahmad, Firdos; Ahmad, Muayyad M; Ahmad, Sajjad; Ahmad, Shahzaib; Ahmed, Anisuddin; Ahmed, Ayman; Ahmed, Haroon; Ahmed, Safoora; Ahmed, Syed Anees; Akinosoglou, Karolina; Akkaif, Mohammed Ahmed; Akrami, Ashley E; Akter, Ema; Al Awaidy, Salah; Al Hasan, Syed Mahfuz; Al Mosa, Amjad S; Al Ta'ani, Omar; Al Zaabi, Omar Ali Mohammed; Alahdab, Fares; Alajlani, Muaaz M; Al-Ajlouni, Yazan; Alalalmeh, Samer O; Al-Aly, Ziyad; Alam, Khurshid; Alam, Noore; Alam, Tahiya; Alam, Zufishan; Al-amer, Rasmieh Mustafa; Alanezi, Fahad Mashhour; Alanzi, Turki M; Albakri, Almaza; Aldhaleei, Wafa A; Aldridge, Robert W; Alemohammad, Seyedeh Yasaman; Alemu, Yihun Mulugeta; Al-Gheethi, Adel Ali Saeed; Al-Hanawi, Mohammed Khaled; Ali, Abid; Ali, Amjad; Ali, Iman; Ali, Mohammed Usman; Ali, Rafat; Ali, Syed Shujait Shujait; Ali, Victor Ekoche; Ali, Waad; Al-Ibraheem, Akram; Alicandro, Gianfranco; Alif, Sheikh Mohammad; Aljunid, Syed Mohamed; Alla, François; Almazan, Joseph Uy; Al-Mekhlafi, Hesham M; Alqutaibi, Ahmed Yaseen; Alrawashdeh, Ahmad; Alrousan, Sahel Majed; Al-Sabah, Salman Khalifah; Alsabri, Mohammed A; Altaany, Zaid; Al-Tammemi, Ala'a B; Al-Tawfiq, Jaffar A; Altirkawi, Khalid A; Aluh, Deborah Oyine; Alvis-Guzman, Nelson; Al-Wardat, Mohammad Sami; Al-Worafi, Yaser Mohammed; Aly, Hany; Alyahya, Mohammad Sharif; Alzoubi, Karem H; Al-Zyoud, Walid; Amani, Reza; Ameyaw, Edward Kwabena; Amin, Tarek Tawfik; Amindarolzarbi, Alireza; Amiri, Sohrab; Amirzade-Iranaq, Mohammad Hosein; Amu, Hubert; Amugsi, Dickson A; Ancuceanu, Robert; Anderlini, Deanna; Anderson, David B; Andrade, Pedro Prata; Andrei, Catalina Liliana; Andrei, Tudorel; Andrews, Erick Adrian; Anil, Abhishek; Anil, Sneha; Anoushiravani, Amir; Antony, Catherine M; Antriyandarti, Ernoiz; Anuoluwa, Boluwatife Stephen; Anvari, Saeid; Anyasodor, Anayochukwu Edward; Appiah, Francis; Aquilano, Michele; Arab, Juan Pablo; Arabloo, Jalal; Arafa, Elshaimaa A; Arafat, Mosab; Aravkin, Aleksandr Y; Ardekani, Ali; Areda, Demelash; Aregawi, Brhane Berhe; Aremu, Abdulfatai; Ariffin, Hany; Arkew, Mesay; Armani, Keivan; Artamonov, Anton A; Arumugam, Ashokan; Asghari-Jafarabadi, Mohammad; Ashbaugh, Charlie; Astell-Burt, Thomas; Athari, Seyyed Shamsadin; Atorkey, Prince; Atout, Maha Moh'd Wahbi; Aujayeb, Avinash; Ausloos, Marcel; Awad, Hamzeh; Awotidebe, Adedapo Wasiu; Ayatollahi, Haleh; Ayuso-Mateos, Jose L; Azadnajafabad, Sina; Azeez, Fahad Khan; Azevedo, Rui MS; Badar, Muhammad; Baghdadi, Soroush; Bagheri, Mahboube; Bagheri, Nasser; Bai, Ruhai; Baker, Jennifer L; Bako, Abdulaziz T; Balakrishnan, Senthilkumar; Balcha, Wondu Feyisa; Baltatu, Ovidiu Constantin; Barchitta, Martina; Bardideh, Erfan; Barker-Collo, Suzanne Lyn; Bärnighausen, Till Winfried; Barqawi, Hiba Jawdat; Barteit, Sandra; Basiru, Afisu; Basso, João Diogo; Bastan, Mohammad-Mahdi; Basu, Sanjay; Bauckneht, Matteo; Baune, Bernhard T; Bayati, Mohsen; Bayileyegn, Nebiyou Simegnew; Behnoush, Amir Hossein; Behzadi, Payam; Beiranvand, Maryam; Bello, Olorunjuwon Omolaja; Belo, Luis; Beloukas, Apostolos; Bemanalizadeh, Maryam; Bensenor, Isabela M; Benzian, Habib; Beran, Azizullah; Berezvai, Zombor; Bernstein, Robert S; Bettencourt, Paulo JG; Beyene, Kebede A; Beyene, Melak Gedamu; Bhagat, Devidas S; Bhagavathula, Akshaya Srikanth; Bhala, Neeraj; Bhandari, Dinesh; Bharadwaj, Ravi; Bhardwaj, Nikha; Bhardwaj, Pankaj; Bhargava, Ashish; Bhaskar, Sonu; Bhat, Vivek; Bhattacharjee, Natalia V; Bhatti, Gurjit Kaur; Bhatti, Jasvinder Singh; Bhatti, Manpreet S; Bhuiyan, Mohiuddin Ahmed; Bisignano, Catherine; Biswas, Bijit; Bjørge, Tone; Bodolica, Virginia; Bodunrin, Aadam Olalekan; Bonakdar Hashemi, Milad; Bora Basara, Berrak; Borhany, Hamed; Bosoka, Samuel Adolf; Botero Carvajal, Alejandro; Bouaoud, Souad; Boufous, Soufiane; Boxe, Christopher; Boyko, Edward J; Brady, Oliver J; Braithwaite, Dejana; Brauer, Michael; Brazo-Sayavera, Javier; Brenner, Hermann; Brown, Colin Stewart; Browne, Annie J; Brugha, Traolach; Bryazka, Dana; Bulamu, Norma B; Buonsenso, Danilo; Burkart, Katrin; Burns, Richard A; Busse, Reinhard; Bustanji, Yasser; Butt, Zahid A; Caetano dos Santos, Florentino Luciano; Çakmak Barsbay, Mehtap; Calina, Daniela; Campos, Luciana Aparecida; Cao, Shujin; Capodici, Angelo; Cárdenas, Rosario; Carreras, Giulia; Carugno, Andrea; Carvalho, Márcia; Castaldelli-Maia, Joao Mauricio; Castelpietra, Giulio; Cattaruzza, Maria Sofia; Caye, Arthur; Cegolon, Luca; Cembranel, Francieli; Cenko, Edina; Cerin, Ester; Chadban, Steven J; Chadwick, Joshua; Chakraborty, Chiranjib; Chakraborty, Sandip; Chalek, Julian; Chan, Jeffrey Shi Kai; Chandika, Rama Mohan; Chandy, Sara; Charan, Jaykaran; Chaudhary, Anis Ahmad; Chaurasia, Akhilanand; Chen, An-Tian; Chen, Haowei; Chen, Meng Xuan; Chen, Simiao; Cherbuin, Nicolas; Chi, Gerald; Chichagi, Fatemeh; Chimed-Ochir, Odgerel; Chimoriya, Ritesh; Ching, Patrick R; Chirinos-Caceres, Jesus Lorenzo; Chitheer, Abdulaal; Cho, Daniel Youngwhan; Cho, William CS; Choi, Dong-Woo; Chong, Bryan; Chong, Chean Lin; Chopra, Hitesh; Chu, Dinh-Toi; Chung, Eric; Chutiyami, Muhammad; Clayton, Justin T; Cogen, Rebecca M; Cohen, Aaron J; Columbus, Alyssa; Comfort, Haley; Conde, Joao; Connolly, Jon T; Cooper, Ezra EK; Cortese, Samuele; Cruz-Martins, Natália; da Silva, Alanna Gomes; Dadras, Omid; Dai, Xiaochen; Dai, Zhaoli; Dalton, Bronte E; Damiani, Giovanni; Dandona, Lalit; Dandona, Rakhi; Das, Jai K; Das, Saswati; Das, Subasish; Dash, Nihar Ranjan; Davletov, Kairat; De la Hoz, Fernando Pio; De Leo, Diego; Debopadhaya, Shayom; Delgado-Enciso, Ivan; Denova-Gutiérrez, Edgar; Dervenis, Nikolaos; Desai, Hardik Dineshbhai; Devanbu, Vinoth Gnana Chellaiyan; Dewan, Syed Masudur Rahman; Dhama, Kuldeep; Dhane, Amol S; Dhingra, Sameer; Dias da Silva, Diana; Diaz, Daniel; Diaz, Luis Antonio; Diaz, Michael J; Dima, Adriana; Ding, Delaney D; Do, Thao Huynh Phuong; do Prado, Camila Bruneli; Dodangeh, Masoud; Dodangeh, Milad; Doegah, Phidelia Theresa; Dohare, Sushil; Dong, Wanyue; D'Oria, Mario; Doshi, Rajkumar; Dowou, Robert Kokou; Dsouza, Haneil Larson; Dsouza, Viola; Dube, John; Dumith, Samuel C; Duncan, Bruce B; Duraes, Andre Rodrigues; Duraisamy, Senbagam; Durojaiye, Oyewole Christopher; Dushpanova, Anar; Dutta, Sulagna; Dzianach, Paulina Agnieszka; Dziedzic, Arkadiusz Marian; Eboreime, Ejemai; Ebrahimi, Alireza; Ebrahimi Kalan, Mohammad; Edinur, Hisham Atan; Efendi, Ferry; Eikemo, Terje Andreas; Eini, Ebrahim; Ekundayo, Temitope Cyrus; El Arab, Rabie Adel; El Sayed, Iman; Elamin, Osman; Elemam, Noha Mousaad; ElGohary, Ghada Metwally Tawfik; Elhadi, Muhammed; Elmeligy, Omar Abdelsadek Abdou; Elmoselhi, Adel B; Elshaer, Mohammed; Elsohaby, Ibrahim; Eltahir, Mohd Elmagzoub; Emeto, Theophilus I; Eshrati, Babak; Eslami, Majid; Esmaeili, Zahra; Fabin, Natalia; Fagbamigbe, Adeniyi Francis; Fagbule, Omotayo Francis; Falzone, Luca; Fareed, Mohammad; Farinha, Carla Sofia E Sá; Faris, MoezAlIslam Ezzat Mahmoud; Faro, Andre; Fasihi, Kiana; Fatehizadeh, Ali; Fauk, Nelsensius Klau; Fazylov, Timur; Feigin, Valery L; Fekadu, Ginenus; Feng, Xiaoqi; Fereshtehnejad, Seyed-Mohammad; Ferrara, Pietro; Ferreira, Nuno; Firew, Belete Sewasew; Fischer, Florian; Fitriana, Ida; Flavel, Joanne; Flor, Luisa S; Folayan, Morenike Oluwatoyin; Foley, Kristen Marie; Fonzo, Marco; Force, Lisa M; Foschi, Matteo; Freitas, Alberto; Fridayani, Ni Kadek Yuni; Fukutaki, Kai Glenn; Furtado, João M; Fux, Blima; Gaal, Peter Andras; Gadanya, Muktar A; Gallus, Silvano; Ganesan, Balasankar; Ganiyani, Mohammad Arfat; Gautam, Rupesh K; Gebi, Tilaye Gebru; Gebregergis, Miglas W; Gebrehiwot, Mesfin; Getacher, Lemma; Getahun, Genanew KA; Gething, Peter W; Ghadimi, Delaram J; Ghadirian, Fataneh; Ghafarian, Sadegh; Ghailan, Khalid Yaser; Ghasemi, MohammadReza; Ghasempour Dabaghi, Ghazal; Ghazy, Ramy Mohamed; Ghoba, Sama; Gholami, Ehsan; Gholamrezanezhad, Ali; Gholizadeh, Nasim; Ghorbani, Mahsa; Ghorbani Vajargah, Pooyan; Ghotbi, Elena; Gil, Artyom Urievich; Gill, Tiffany K; Girmay, Alem; Glasbey, James C; Glushkova, Ekaterina Vladimirovna; Gnedovskaya, Elena V; Göbölös, Laszlo; Goldust, Mohamad; Goleij, Pouya; Golinelli, Davide; Gopalani, Sameer Vali; Goulart, Alessandra C; Gouravani, Mahdi; Goyal, Anmol; Grivna, Michal; Grosso, Giuseppe; Guarducci, Giovanni; Gubari, Mohammed Ibrahim Mohialdeen; Guicciardi, Stefano; Guimarães, Rafael Alves; Gulati, Snigdha; Gulisashvili, David; Gunawardane, Damitha Asanga; Guo, Cui; Gupta, Anish Kumar; Gupta, Rahul; Gupta, Rajeev; Gupta, Renu; Gupta, Sapna; Gupta, Vijai Kumar; Haakenstad, Annie; Hadi, Najah R; Haep, Nils; Hafiz, Abdul; Haghmorad, Dariush; Haile, Demewoz; Hajj Ali, Adel; Hajj Ali, Ali; Haj-Mirzaian, Arvin; Halboub, Esam S; Haller, Sebastian; Halwani, Rabih; Hamagharib Abdullah, Kanaan; Hamdy, Nadia M; Hamoudi, Rifat; Hanifi, Nasrin; Hankey, Graeme J; Haq, Zaim Anan; Haque, Md Rabiul; Harapan, Harapan; Hargono, Arief; Haro, Josep Maria; Hasaballah, Ahmed I; Hasan, SM Mahmudul; Hasanian, Mohammad; Hasnain, Md Saquib; Hassan, Amr; Haubold, Johannes; Hay, Simon I; Hebert, Jeffrey J; Hegazi, Omar E; Heidari, Mohammad; Hemmati, Mehdi; Henson, Claire A; Herrera-Serna, Brenda Yuliana; Herteliu, Claudiu; Heydari, Majid; Hezam, Kamal; Hidayana, Irma; Hiraike, Yuta; Hoan, Nguyen Quoc; Holla, Ramesh; Hoogar, Praveen; Horita, Nobuyuki; Hossain, Md Mahbub; Hosseinzadeh, Hassan; Hosseinzadeh, Mehdi; Hostiuc, Mihaela; Hostiuc, Sorin; Hu, Chengxi; Huang, Junjie; Hultström, Michael; Hundie, Tsegaye Gebreyes; Hunt, Aliza J; Hushmandi, Kiavash; Hussain, Javid; Hussain, M Azhar; Hussein, Nawfal R; Huynh, Hong-Han; Hwang, Bing-Fang; Ibitoye, Segun Emmanuel; Iftikhar, Pulwasha Maria; Ikiroma, Adalia I; Ikwegbue, Paul Chukwudi; Ilic, Irena M; Ilic, Milena D; Immurana, Mustapha; Isa, Mustafa Alhaji; Islam, Md Rabiul; Islam, Sheikh Mohammed Shariful; Ismail, Faisal; Ismail, Nahlah Elkudssiah; Isola, Gaetano; Iwagami, Masao; Iyamu, Ihoghosa Osamuyi; Jacob, Louis; Jacobsen, Kathryn H; Jafarinia, Morteza; Jahankhani, Kasra; Jahanmehr, Nader; Jain, Nityanand; Jairoun, Ammar Abdulrahman; Jakhmola Mani, Dr Ruchi; Jamil, Safayet; Jamora, Roland Dominic G; Jatau, Abubakar Ibrahim; Javadov, Sabzali; Javaheri, Tahereh; Jayaram, Shubha; Jee, Sun Ha; Jeganathan, Jayakumar; Jiang, Heng; Jokar, Mohammad; Jonas, Jost B; Joseph, Nitin; Joshua, Charity Ehimwenma; Jürisson, Mikk; K, Vaishali; Kabir, Ali; Kabir, Zubair; Kadashetti, Vidya; Kalankesh, Laleh R; Kalra, Sanjay; Kamath, Ashwin; Kamath, Rajesh; Kamireddy, Arun; Kanaan, Mona; Kanchan, Tanuj; Kanmiki, Edmund Wedam; Kanmodi, Kehinde Kazeem; Kansal, Sushil Kumar; Karim, Asima; Karkhah, Samad; Kashoo, Faizan Zaffar; Kasraei, Hengameh; Kassel, Molly B; Katikireddi, Srinivasa Vittal; Kauppila, Joonas H; Kaur, Harkiran; Kayode, Gbenga A; Kazemi, Foad; Kazemian, Sina; Kebede, Fassikaw; Kendal, Evie Shoshannah; Kesse-Guyot, Emmanuelle; Khademvatan, Shahram; Khajuria, Himanshu; Khalaji, Amirmohammad; Khalid, Asaad; Khalid, Nauman; Khalilian, Alireza; Khamesipour, Faham; Khan, Fayaz; Khan, Mohammad Jobair; Khan, Moien AB; Khanmohammadi, Shaghayegh; Khatab, Khaled; Khatatbeh, Haitham; Khatatbeh, Moawiah Mohammad; Khatib, Mahalaqua Nazli; Khayat Kashani, Hamid Reza; Kheirallah, Khalid A; Khokhar, Manoj; Khormali, Moein; Khorrami, Zahra; Khosla, Atulya Aman; Khosravi, Majid; Khosrowjerdi, Mahmood; Khubchandani, Jagdish; Kifle, Zemene Demelash; Kim, Grace; Kim, Julie Sojin; Kim, Min Seo; Kim, Yun Jin; Kimokoti, Ruth W; Kisa, Adnan; Kisa, Sezer; Knibbs, Luke D; Knudsen, Ann Kristin Skrindo; Kochhar, Sonali; Kolahi, Ali-Asghar; Kompani, Farzad; Koren, Gerbrand; Korzh, Oleksii; Krishan, Kewal; Krishna, Varun; Krishnamoorthy, Vijay; Kucuk Bicer, Burcu; Kuddus, Md Abdul; Kuddus, Mohammed; Kuitunen, Ilari; Kujan, Omar; Kulimbet, Mukhtar; Kulkarni, Vishnutheertha; Kumar, G Anil; Kumar, Harish; Kumar, Nithin; Kumar, Rakesh; Kumar, Vijay; Kundu, Amartya; Kusuma, Dian; Kyei-Arthur, Frank; Kytö, Ville; Kyu, Hmwe Hmwe; La Vecchia, Carlo; Lacey, Ben; Ladan, Muhammad Awwal; Laflamme, Lucie; Lahariya, Chandrakant; Lai, Daphne Teck Ching; Lalloo, Ratilal; Lallukka, Tea; Lám, Judit; Lan, Qing; Lan, Tuo; Landires, Iván; Lanfranchi, Francesco; Langguth, Berthold; Lansingh, Van Charles; Laplante-Lévesque, Ariane; Larijani, Bagher; Larsson, Anders O; Lasrado, Savita; Lauriola, Paolo; Lawlor, Hilary R; Le, Huu-Hoai; Le, Long Khanh Dao; Le, Nhi Huu Hanh; Le, Thao Thi Thu; Le, Trang Diep Thanh; Leasher, Janet L; Lee, Doo Woong; Lee, Munjae; Lee, Paul H; Lee, Sang-woong; Lee, Seung Won; Lee, Shaun Wen Huey; Lee, Yo Han; Leigh, James; Leong, Elvynna; Li, Ming-Chieh; Libra, Massimo; Ligade, Virendra S; Lim, Lee-Ling; Lim, Stephen S; Limenh, Liknaw Workie; Lindholm, Daniel; Lindstedt, Paulina A; Listl, Stefan; Liu, Gang; Liu, Shiwei; Liu, Shuke; Liu, Xiaofeng; Liu, Xuefeng; Llanaj, Erand; López-Bueno, Rubén; López-Gil, José Francisco; Loreche, Arianna Maever; Lotufo, Paulo A; Lozano, Rafael; Lubinda, Jailos; Lucchetti, Giancarlo; Luo, Lisha; Lusk, Jay B; Lv, Lei; M Amin, Hawraz Ibrahim; Ma, Zheng Feei; Maass, Kelsey Lynn; Machairas, Nikolaos; Machoy, Monika; Madureira-Carvalho, Áurea M; Magdy Abd El Razek, Hassan; Maghazachi, Azzam A; Mahadeshwara Prasad, DR; Mahalleh, Mehrdad; Mahasha, Phetole Walter; Mahmoud, Mansour Adam; Mahmoudi, Elham; Mahmoudvand, Golnaz; Makama, Maureen; Malakan Rad, Elaheh; Malhotra, Kashish; Malik, Ahmad Azam; Malta, Deborah Carvalho; Manla, Yosef; Mansour, Ali; Mansouri, Mohammad Hadi; Mansouri, Pejman; Mansouri, Vahid; Mansourian, Marjan; Mansournia, Mohammad Ali; Marasini, Bishnu P; Marateb, Hamid Reza; Maravilla, Joemer C; Mardi, Parham; Marjani, Abdoljalal; Markazi Moghadam, Hamed; Marrugo Arnedo, Carlos Alberto; Martinez, Gabriel; Martinez-Piedra, Ramon; Martins-Melo, Francisco Rogerlândio; Martorell, Miquel; Marx, Wolfgang; Marzo, Roy Rillera; Masoudi, Sahar; Mathangasinghe, Yasith; Mathioudakis, Alexander G; Mathur, Medha; Mathur, Navgeet; Mathur, Neeta; Matozinhos, Fernanda Penido; Mattumpuram, Jishanth; Maude, Richard James; Maugeri, Andrea; Mayeli, Mahsa; Mazidi, Mohsen; Mazzotti, Antonio; McGrath, John J; McKee, Martin; McKowen, Anna Laura W; McPhail, Michael A; McPhail, Steven M; Mehmood, Asim; Mehrabani-Zeinabad, Kamran; Mehravar, Sepideh; Mekene Meto, Tesfahun; Melese, Endalkachew Belayneh; Mendez-Lopez, Max Alberto Mendez; Mendoza, Walter; Menezes, Ritesh G; Mensah, George A; Mensah, Laverne G; Mentis, Alexios-Fotios A; Meo, Sultan Ayoub; Meretoja, Atte; Meretoja, Tuomo J; Mersha, Abera M; Mestrovic, Tomislav; Mettananda, Kukulege Chamila Dinushi; Mettananda, Sachith; Mhlanga, Adquate; Mhlanga, Laurette; Miazgowski, Tomasz; Michalek, Irmina Maria; Micheletti Gomide Nogueira de Sá, Ana Carolina; Miller, Ted R; Minh, Le Huu Nhat; Mirahmadi, Alireza; Mirijello, Antonio; Mirrakhimov, Erkin M; Mirzaei, Roya; Mitchell, Philip B; Mittal, Chaitanya; Moberg, Madeline E; Moghadam Fard, Atousa; Mohajelin, Seyedehfatemeh; Mohamadkhani, Ashraf; Mohamed, Ahmed Ismail; Mohamed, Jama; Mohamed, Mouhand FH; Mohamed, Nouh Saad; Mohammad, Ameen Mosa; Mohammadi, Soheil; Mohammed, Hussen; Mohammed, Mustapha; Mohammed, Shafiu; Mokdad, Ali H; Molokhia, Mariam; Momani, Shaher Mohammad; Momtazmanesh, Sara; Monasta, Lorenzo; Mondello, Stefania; Moni, Mohammad Ali; Montazeri, Fateme; Moodi Ghalibaf, AmirAli; Moradi, Maryam; Moradi, Yousef; Moraga, Paula; Morawska, Lidia; Moreira, Rafael Silveira; Morovatdar, Negar; Morrison, Shane Douglas; Mosapour, Abbas; Mosser, Jonathan F; Mossialos, Elias; Motappa, Rohith; Mougin, Vincent; Mousavi, Parsa; Mrejen, Matías; Mubarik, Sumaira; Mueller, Ulrich Otto; Mulita, Francesk; Munjal, Kavita; Murillo-Zamora, Efrén; Musallam, Khaled M; Musina, Ana-Maria; Mustafa, Ghulam; Myung, Woojae; Nafei, Ayoub; Nagarajan, Ahamarshan Jayaraman; Naghavi, Pirouz; Naik, Ganesh R; Naik, Gurudatta; Nainu, Firzan; Najdaghi, Soroush; Nakhostin Ansari, Noureddin; Nangia, Vinay; Narasimha Swamy, Sreenivas; Nargus, Shumaila; Narimani Davani, Delaram; Nascimento, Bruno Ramos; Nascimento, Gustavo G; Naser, Abdallah Y; Nashwan, Abdulqadir J; Natto, Zuhair S; Nauman, Javaid; Navaratna, Samidi NK; Naveed, Muhammad; Nawsherwan; Nayak, Biswa Prakash; Nayak, Vinod C; Negash, Hadush; Negoi, Ionut; Negoi, Ruxandra Irina; Nejadghaderi, Seyed Aria; Nejjari, Chakib; Nematollahi, Soroush; Netsere, Henok Biresaw; Ng, Marie; Nguefack-Tsague, Georges; Ngunjiri, Josephine W; Nguyen, Anh Hoang; Nguyen, Dang H; Nguyen, Duc Hoang; Nguyen, Hau Thi Hien; Nguyen, Nhan; Nguyen, Nhien Ngoc Y; Nguyen, Phat Tuan; Nguyen, QuynhAnh P; Nguyen, Van Thanh; Nguyen Tran Minh, Duc; Niazi, Robina Khan; Nigatu, Yeshambel T; Niknam, Mahdieh; Nikoobar, Ali; Nikpoor, Amin Reza; Nikravangolsefid, Nasrin; Noman, Efaq Ali; Nomura, Shuhei; Noor, Syed Toukir Ahmed; Noroozi, Nafise; Nouri, Mehran; Nozari, Majid; Nri-Ezedi, Chisom Adaobi; Ntaios, George; Nunemo, Mengistu H; Nurrika, Dieta; Nutor, Jerry John; Nzoputam, Chimezie Igwegbe; Nzoputam, Ogochukwu Janet; Oancea, Bogdan; Obamiro, Kehinde O; Odetokun, Ismail A; Oduro, Michael Safo; Ogundijo, Oluwaseun Adeolu; Ogunfowokan, Adesola Adenike; Ogunkoya, Abiola; Oguntade, Ayodipupo Sikiru; Oh, In-Hwan; Ojo-Akosile, Tolulope R; Okati-Aliabad, Hassan; Okekunle, Akinkunmi Paul; Okonji, Osaretin Christabel; Olagunju, Andrew T; Olatubi, Matthew Idowu; Oliveira, Gláucia Maria Moraes; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Oluwafemi, Yinka Doris; Omar, Hany A; Omer, Goran Latif; Ong, Sokking; Onie, Sandersan; Onwujekwe, Obinna E; Opejin, Abdulahi Opejin; Ordak, Michal; Orish, Verner N; Ortiz, Alberto; Ortiz-Prado, Esteban; Osman, Wael MS; Ostojic, Sergej M; Ostroff, Samuel M; Osuagwu, Uchechukwu Levi; Otoiu, Adrian; Otstavnov, Stanislav S; Ouyahia, Amel; Owolabi, Mayowa O; Oyeyemi, Oyetunde T; Ozair, Ahmad; P A, Mahesh Padukudru; Padron-Monedero, Alicia; Padubidri, Jagadish Rao; Pal, Pramod Kumar; Palicz, Tamás; Pan, Feng; Pan, Hai-Feng; Panda-Jonas, Songhomitra; Pandey, Anamika; Pando-Robles, Victoria; Pangaribuan, Helena Ullyartha; Panos, Georgios D; Panos, Leonidas D; Pantazopoulos, Ioannis; Pantea Stoian, Anca Mihaela; Parikh, Romil R; Park, Eun-Kee; Park, Seoyeon; Park, Sungchul; Parsons, Nicholas; Parthasarathi, Ashwaghosha; Pasovic, Maja; Passera, Roberto; Patel, Jay; Pathan, Aslam Ramjan; Patil, Shankargouda; Patoulias, Dimitrios; Pawar, Shrikant; Pazoki Toroudi, Hamidreza; Pease, Spencer A; Peden, Amy E; Pedersini, Paolo; Pensato, Umberto; Pepito, Veincent Christian Filipino; Peprah, Prince; Pereira, Marcos; Pereira, Maria Odete; Perianayagam, Arokiasamy; Perico, Norberto; Perna, Simone; Pesudovs, Konrad; Petermann-Rocha, Fanny Emily; Pham, Hoang Tran; Philip, Anil K; Phillips, Michael R; Pigeolet, Manon; Piradov, Michael A; Pisoni, Enrico; Plotnikov, Evgenii; Poddighe, Dimitri; Polibin, Roman V; Poluru, Ramesh; Ponkilainen, Ville T; Popovic, Djordje S; Postma, Maarten J; Pour-Rashidi, Ahmad; Prabhu, Disha; Prada, Sergio I; Pradhan, Jalandhar; Pradhan, Pranil Man Singh; Prashant, Akila; Prates, Elton Junio Sady; Priscilla, Tina; Purnobasuki, Hery; Purohit, Bharathi M; Puvvula, Jagadeesh; Qasim, Nameer Hashim; Qattea, Ibrahim; Qazi, Asma Saleem; Qian, Gangzhen; Rabiee Rad, Mehrdad; Radhakrishnan, Venkatraman; Raeisi Shahraki, Hadi; Rafferty, Quinn; Raggi, Alberto; Raggi, Cat; Raheem, Nasiru; Rahim, Fakher; Rahim, Md Jillur; Rahimibarghani, Sarvenaz; Rahman, Md Mijanur Mijanur Rahman; Rahman, Mosiur; Rahman, Muhammad Aziz; Rahman, Tafhimur; Rahmani, Amir Masoud; Rahmanian, Mohammad; Rahmanian, Nazanin; Rahmati, Rahem; Rahmawaty, Setyaningrum; Raimondo, Diego; Raja, Adarsh; Rajput, Prashant; Ramadan, Majed; Ramasamy, Shakthi Kumaran; Ramazanu, Sheena; Ramteke, Pramod W; Rana, Kritika; Rana, Rishabh Kumar; Ranabhat, Chhabi Lal; Rane, Amey; Rao, Chythra R; Rao, Mithun; Rasella, Davide; Rashedi, Vahid; Rashid, Ahmed Mustafa; Rasouli-Saravani, Ashkan; Rastogi, Prateek; Rasul, Azad; Rathish, Devarajan; Rathnaiah Babu, Giridhara; Rauniyar, Santosh Kumar; Ravangard, Ramin; Rawaf, David Laith; Rawaf, Salman; Raza, Rabail Zehra; Redwan, Elrashdy Moustafa Mohamed; Reifels, Lennart; Reitsma, Marissa B; Remuzzi, Giuseppe; Rengasamy, Kannan RR; Reshmi, Bhageerathy; Resnikoff, Serge; Restaino, Stefano; Reyes, Luis Felipe; Rezaei, Nazila; Rezaei, Negar; Rezaei, Zahra Sadat; Rezaeian, Mohsen; Rhee, Taeho Gregory; Rickard, Jennifer; Robalik, Toshana; Robinson-Oden, Hannah Elizabeth; Rocha, Hermano Alexandre Lima; Rodrigues, Mónica; Rodriguez, Jefferson Antonio Buendia; Roever, Leonardo; Romadlon, Debby Syahru; Ronfani, Luca; Rony, Moustaq karim khan; Roshandel, Gholamreza; Rotimi, Kunle; Rout, Himanshu Sekhar; Roy, Bedanta; Rubagotti, Enrico; Ruela, Guilherme de Andrade; Rumisha, Susan Fred; Runghien, Tilleye; Russo, Michele; Saad, Aly MA; Saber, Korosh; Saber-Ayad, Maha Mohamed; Sabet, Cameron John; Sabour, Siamak; Sachdev, Perminder S; Saddler, Adam; Sadee, Bashdar Abuzed; Sadeghi, Masoumeh; Saeb, Mohammad Reza; Saeed, Umar; Safi, Sher Zaman; Sagar, Rajesh; Saghafi, Alireza; Sagoe, Dominic; Sahebkar, Amirhossein; Sahoo, Pragyan Monalisa; Sajid, Mirza Rizwan; Salam, Nasir; Salamati, Payman; Salami, Afeez Abolarinwa; Saleh, Mohamed A; Salehi, Leili; Salem, Marwa Rashad; Salemcity, Aanuoluwa James; Salimi, Sohrab; Samadi Kafil, Hossein; Samargandy, Saad; Samodra, Yoseph Leonardo; Samy, Abdallah M; Sanabria, Juan; Sanna, Francesca; Santric-Milicevic, Milena M; Sao Jose, Bruno Piassi; Saraswathy, Sivan Yegnanarayana Iyer; Saravanan, Aswini; Sarmiento-Suárez, Rodrigo; Sarode, Gargi Sachin; Sarode, Sachin C; Sartorius, Benn; Satpathy, Maheswar; Sayeed, Abu; Scarmeas, Nikolaos; Schaarschmidt, Benedikt Michael; Schinckus, Christophe; Schuermans, Art; Schumacher, Austin E; Schutte, Aletta Elisabeth; Schwebel, David C; Schwendicke, Falk; Selvaraj, Siddharthan; Semreen, Mohammad H; Senapati, Sabyasachi; Sengupta, Pallav; Senthilkumaran, Subramanian; Serban, Dragos; Sethi, Yashendra; Seylani, Allen; Shafie, Mahan; Shah, Pritik A; Shahbandi, Ataollah; Shahid, Samiah; Shahid, Wajeehah; Shahsavari, Hamid R; Shahwan, Moyad Jamal; Shaikh, Masood Ali; Shalash, Ali S; Shamekh, Ali; Shamim, Muhammad Aaqib; Shanawaz, Mohd; Shankar, Abhishek; Shannawaz, Mohammed; Sharath, Medha; Sharfaei, Sadaf; Sharifan, Amin; Sharifi-Rad, Javad; Sharma, Anupam; Sharma, Manoj; Sharma, Saurab; Sharma, Vishal; Shastry, Rajesh P; Shayan, Maryam; Shekhar, Shashank; Shenoy, Rekha R; Shetty, Mahabalesh; Shetty, Pavanchand H; Shetty, Premalatha K; Shi, Peilin; Shiani, Amir; Shigematsu, Mika; Shimels, Tariku; Shiri, Rahman; Shittu, Aminu; Shiue, Ivy; Shivakumar, KM; Shool, Sina; Shorofi, Seyed Afshin; Shrestha, Sunil; Shuval, Kerem; Si, Yafei; Siddig, Emmanuel Edwar; Sidhu, Jaspreet Kaur; Silva, João Pedro; Silva, Luís Manuel Lopes Rodrigues; Silva, Soraia; Silva, Thales Philipe R; Simpson, Colin R; Simpson, Kyle E; Singh, Abhinav; Singh, Balbir Bagicha; Singh, Baljinder; Singh, Harmanjit; Singh, Jasbir; Singh, Paramdeep; Singh, Puneetpal; Skou, Søren T; Smith, Georgia; Sobia, Farrukh; Socea, Bogdan; Solanki, Shipra; Soleimani, Hamidreza; Soliman, Sameh SM; Song, Yi; Soyiri, Ireneous N; Spartalis, Michael; Spearman, Sandra; Sreeramareddy, Chandrashekhar T; Stanaway, Jeffrey D; Stanikzai, Muhammad Haroon; Starodubova, Antonina V; Stein, Dan J; Steiner, Caitlyn; Steiropoulos, Paschalis; Stockfelt, Leo; Stokes, Mark A; Straif, Kurt; Subedi, Narayan; Suliankatchi Abdulkader, Rizwan; Sultana, Abida; Sun, Jing; Sundström, Johan; Swain, Chandan Kumar; Szarpak, Lukasz; Szeto, Mindy D; Tabaee Damavandi, Payam; Tabarés-Seisdedos, Rafael; Tabatabaei Malazy, Ozra; Tabatabaeizadeh, Seyed-Amir; Tabatabai, Shima; Tabb, Karen M; Tabche, Celine; Tabish, Mohammad; Taheri Abkenar, Yasaman; Taheri Soodejani, Moslem; Taiba, Jabeen; Talaat, Iman M; Tamuzi, Jacques Lukenze; Tan, Ker-Kan; Tang, Haosu; Tat, Nathan Y; Tavakoli Oliaee, Razieh; Tavangar, Seyed Mohammad; Taveira, Nuno; Tbakhi, Abdelghani; Tehrani, Hadi; Temsah, Mohamad-Hani; Teramoto, Masayuki; Tesfaye, Behailu Terefe; Teye-Kwadjo, Enoch; Thangaraju, Pugazhenthan; Thankappan, Kavumpurathu Raman; Thapar, Rekha; Thayakaran, Rasiah; Thirunavukkarasu, Sathish; Thomas, Nihal; Thygesen, Lau Caspar; Ticoalu, Jansje Henny Vera; Timalsena, Dinesh; Tiruye, Tenaw Yimer; Tiwari, Krishna; Tomo, Sojit; Tonelli, Marcello; Topor-Madry, Roman; Touvier, Mathilde; Tovani-Palone, Marcos Roberto; Tran, An Thien; Tran, Jasmine T; Tran, Nghia Minh; Tran, Thang Huu; Trico, Domenico; Tromans, Samuel Joseph; Truyen, Thien Tan Tri Tai; Tsatsakis, Aristidis; Tsermpini, Evangelia Eirini; Tumurkhuu, Munkhtuya; Turnock, Steven T; Udoh, Arit; Ullah, Atta; Ullah, Saeed; Ullah, Sana; Umakanthan, Srikanth; Umar, Muhammad; Umar, Shehu Salihu; Unim, Brigid; Unnikrishnan, Bhaskaran; Upadhyay, Era; Usman, Jibrin Sammani; Vahdati, Sanaz; Vaithinathan, Asokan Govindaraj; Vakili, Omid; Valizadeh, Rohollah; Van den Eynde, Jef; Vart, Priya; Varthya, Shoban Babu; Vasankari, Tommi Juhani; Vasic, Milena; Venketasubramanian, Narayanaswamy; Veroux, Massimiliano; Verras, Georgios-Ioannis; Vervoort, Dominique; Vijayageetha, Mathavaswami; Villafañe, Jorge Hugo; Vinayak, Manish; Violante, Francesco S; Vladimirov, Sergey Konstantinovitch; Vlassov, Vasily; Vo, Bay; Vohra, Karn; Vos, Theo; Wadood, Abdul Wadood; Waheed, Yasir; Wang, Fang; Wang, Shaopan; Wang, Shu; Wang, Yanqing; Wang, Yanzhong; Wang, Yuan-Pang; Wanjau, Mary Njeri; Waqas, Muhammad; Ward, Paul; Waris, Abdul; Wassie, Emebet Gashaw; Watson, Stefanie; Weaver, Marcia R; Weerakoon, Kosala Gayan; Weintraub, Robert G; Weldetinsaa, Haftom Legese Legese; Wells, Katherine M; Wen, Yi Feng; Westerman, Ronny; Wiangkham, Taweewat; Wickramasinghe, Dakshitha Praneeth; Widowati, Evi; Wojewodzic, Marcin W; Woldeyes, Dawit Habte; Wolf, Axel Walter; Wolfe, Charles DA; Wu, Chenkai; Wu, Dongze; Wu, Felicia; Wu, Jiayuan; Wu, Zenghong; Wulf Hanson, Sarah; Xiao, Hong; Xu, Suowen; Yadav, Rakesh; Yamagishi, Kazumasa; Yang, Danting; Yano, Yuichiro; Yarahmadi, Amir; Yazdani Nia, Iman; Ye, Pengpeng; Yesodharan, Renjulal; Yesuf, Subah Abderehim; Yezli, Saber; Yiğit, Arzu; Yiğit, Vahit; Yigzaw, Zeamanuel Anteneh; Yin, Dehui; Yip, Paul; Yonemoto, Naohiro; You, Yuyi; Younis, Mustafa Z; Yu, Chuanhua; Yu, Elaine A; Yu, Yong; Yuan, Chun-Wei; Yusuf, Hadiza; Zafar, Uzma; Zafari, Nima; Zahid, Mondal Hasan; Zakham, Fathiah; Zaki, Nazar; Zerfu, Taddese Alemu; Zhang, Haijun; Zhang, Jingya; Zhang, Liqun; Zhang, Yunquan; Zhang, Zhiqiang; Zhao, Xiu-Ju George; Zhao, Yang; Zhao, Zhongyi; Zhong, Chenwen; Zhou, Bolun; Zhou, Juexiao; Zhou, Shangcheng; Zhu, Bin; Zhumagaliuly, Abzal; Zielińska, Magdalena; Zoghi, Ghazal; Zumla, Alimuddin; Zyoud, Sa'ed H; Zyoud, Samer H; Smith, Amanda E; Murray, Christopher JL
The burden of headache disorders in the Eastern Mediterranean Region, 1990-2016: Findings from the Global Burden of Disease study 2016
(Springer, 2019) Vosoughi, K; Stovner, LJ; Steiner, TJ; Moradi-Lakeh, M; Fereshtehnejad, S-M; Farzadfar, F; Heydarpour, P; Malekzadeh, R; Naghavi, M; Sahraian, MA; Sepanlou, SG; Tehrani-Banihashemi, A; Majdzadeh, R; Feigin, VL; Vos, T; Mokdad, AH; Murray, CJL
OBJECTIVES: Using the findings of the Global Burden of Disease Study (GBD), we report the burden of primary headache disorders in the Eastern Mediterranean Region (EMR) from 1990 to 2016. METHODS: We modelled headache disorders using DisMod-MR 2.1 Bayesian meta-regression tool to ensure consistency between prevalence, incidence, and remission. Years lived with disability (YLDs) were calculated by multiplying prevalence and disability weight (DW) of migraine and tension-type headache (TTH). We assumed primary headache disorders as non-fatal, so their YLD is equal to disability-adjusted life years (DALYs). RESULTS: Migraine and TTH were the second and twentieth leading causes of YLDs in EMR. Between 1990 and 2016, the absolute YLD numbers of migraine and TTH increased from 2.3 million (95% uncertainty interval (UI): 1.5-3.2) to 4.7 million (95%UI: 3-6.5) and from 383 thousand (95%UI: 240-562) to 816 thousand (95%UI: 516-1221), respectively. During the same period, age-standardised YLD rates of migraine and TTH in EMR increased by 0.7% and 2.5%, respectively, in comparison to a small decrease in the global rates (0.2% decrease in migraine and TTH). The bulk of burden due to headache occurred in the 30-49 year age group, with a peak at ages 35-44 years. The age-standardised YLD rates of both headache disorders were higher in women with female to male ratio of 1.69 for migraine and 1.38 for TTH. All countries of the EMR except for Somalia and Djibouti had higher age-standardised YLD rates for migraine and TTH in compare to the global rates. Libya and Saudi Arabia had the highest increase in age-standardised YLD rates of migraine and TTH, respectively. CONCLUSION: The findings of this study show that primary headache disorders are a major and a growing cause of disability in EMR. Since 1990, burden of primary headache disorders has constantly been higher in EMR compared to rest of the world, which indicates that health systems in EMR must focus further on developing and implementing preventive and management strategies to control headache.
The Burden of Headache Disorders in the Eastern Mediterranean Region, 1990-2016: Findings From the Global Burden of Disease Study 2016
(Springer, 2019) Vosoughi, K; Stovner, LJ; Steiner, TJ; Moradi-Lakeh, M; Fereshtehnejad, S-M; Farzadfar, F; Heydarpour, P; Malekzadeh, R; Naghavi, M; Sahraian, MA; Sepanlou, SG; Tehrani-Banihashemi, A; Majdzadeh, R; Feigin, VL; Vos, T; Mokdad, AH; Murray, CJL
OBJECTIVES: Using the findings of the Global Burden of Disease Study (GBD), we report the burden of primary headache disorders in the Eastern Mediterranean Region (EMR) from 1990 to 2016. METHODS: We modelled headache disorders using DisMod-MR 2.1 Bayesian meta-regression tool to ensure consistency between prevalence, incidence, and remission. Years lived with disability (YLDs) were calculated by multiplying prevalence and disability weight (DW) of migraine and tension-type headache (TTH). We assumed primary headache disorders as non-fatal, so their YLD is equal to disability-adjusted life years (DALYs). RESULTS: Migraine and TTH were the second and twentieth leading causes of YLDs in EMR. Between 1990 and 2016, the absolute YLD numbers of migraine and TTH increased from 2.3 million (95% uncertainty interval (UI): 1.5-3.2) to 4.7 million (95%UI: 3-6.5) and from 383 thousand (95%UI: 240-562) to 816 thousand (95%UI: 516-1221), respectively. During the same period, age-standardised YLD rates of migraine and TTH in EMR increased by 0.7% and 2.5%, respectively, in comparison to a small decrease in the global rates (0.2% decrease in migraine and TTH). The bulk of burden due to headache occurred in the 30-49 year age group, with a peak at ages 35-44 years. The age-standardised YLD rates of both headache disorders were higher in women with female to male ratio of 1.69 for migraine and 1.38 for TTH. All countries of the EMR except for Somalia and Djibouti had higher age-standardised YLD rates for migraine and TTH in compare to the global rates. Libya and Saudi Arabia had the highest increase in age-standardised YLD rates of migraine and TTH, respectively. CONCLUSION: The findings of this study show that primary headache disorders are a major and a growing cause of disability in EMR. Since 1990, burden of primary headache disorders has constantly been higher in EMR compared to rest of the world, which indicates that health systems in EMR must focus further on developing and implementing preventive and management strategies to control headache.
Burden of Neurodegenerative Diseases in the Eastern Mediterranean Region, 1990-2016: Findings From the Global Burden of Disease 2016 Study
(Wiley, 2019) Fereshtehnejad, S-M; Vosoughi, K; Heydarpour, P; Sepanlou, SG; Farzadfar, F; Tehrani-Banihashemi, A; Malekzadeh, R; Sahraian, MA; Vollset, SE; Naghavi, M; Vos, T; Feigin, V; Murray, C; Mokdad, AH; Moradi-Lakeh, M
BACKGROUND AND PURPOSE: The Eastern Mediterranean Region (EMR) is experiencing a demographic shift towards rapid ageing at a time of political unrest. We aimed to estimate the burden of neurodegenerative disorders, and its relationship with sociodemographic indicators (SDI) in the EMR countries from 1990 to 2016. METHODS: Using data from the Global Burden of Disease (GBD) 2016 study, we calculated country-specific trends for prevalence, mortality, disability-adjusted life-years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for Alzheimer's disease/other dementias and Parkinson's disease in the EMR during 1990-2016. RESULTS: In EMR, age-standardized prevalence rate of Alzheimer's disease/other dementias and Parkinson's disease was estimated at 759.8 (642.9-899.9) and 87.1 (69.8-108.2) /100,000 in 2016, demonstrating 0.01% and 42.3% change from 1990, respectively. Neurodegenerative disorders contributed to 5.4% of total DALYs and 4.6% of total YLDs among the older EMR population aged 70 years or older in 2016. Age-standardized DALYs due to Parkinson's disease was strongly correlated with the SDI level (r=0.823, p-value<0.001). The YLD/DALY ratio of neurodegenerative diseases declined during this period in the low income EMR countries but not in high income ones. CONCLUSIONS: Our findings demonstrated an increasing trend in the burden of dementias and Parkinson's disease in most EMR countries between 1990 and 2016. With aging of the EMR populations, countries should target the modifiable risk factors of neurodegenerative diseases to control their increasing burden. This article is protected by copyright. All rights reserved.
The Burden of Stroke in China: Results From a Nationwide Population-based Epidemiological Survey
(PLoS, 2018) Gao, Y; Jiang, B; Sun, H; Ru, X; Sun, D; Wang, L; Wang, L; Jiang, Y; Feigin, VL; Wang, Y; Wang, W
Stroke is a serious threat to human health that often leads to severe complications, and currently ranks first as leading cause of death in China. However, reliable data on stroke burden in China in the 21st century are lacking. We used the data from NESS-China (National Epidemiological Survey of Stroke in China) for assessing the adverse health effects of stroke in Chinese population. We carried out inter-regional comparative study in order to obtain regular burden related characteristics of stroke in China, as measured by YLLs (years of life lost due to premature mortality), YLDs (years lived with disability) and DALYs (disability adjusted life years). Amongst the nationwide population of 596,536 individuals of all ages in 2013, the YLLs for stroke was 1748, the YLDs was 262, and the DALYs was 2010(per 100,000). The gender subtype analysis of DALYs was 2171(male) and 1848(female). The YLLs, YLDs and DALYs in rural areas were higher compared to urban areas. Among the 18 age groups, the highest YLLs was observed in ≥ 80 years old group. The impact of stroke on Chinese population is more severe compared to the global average levels. Stroke results as the main cause of YLLs in China, while there is no significant difference for the YLDs. Nevertheless, DALYs caused by stroke rank 3th in global epidemiologic study territories, 1st in China.
Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (Center-tbi): A Prospective Longitudinal Observational Study
(Congress of Neurological Surgeons, 2015) Theadom, A; Maas, AIR; Menon, D; Steyerberg, EW; Citerio, G; Lecky, F; Manley, GT; Hill, S; Legrand, V; Sorgner, A; On behalf of the CENTER-TBI participants and, I
BACKGROUND: Current classification of traumatic brain injury (TBI) is suboptimal, and management is based on weak evidence, with little attempt to personalize treatment. A need exists for new precision medicine and stratified management approaches that incorporate emerging technologies. OBJECTIVE: To improve characterization and classification of TBI and to identify best clinical care, using comparative effectiveness research approaches. METHODS: This multicenter, longitudinal, prospective, observational study in 22 countries across Europe and Israel will collect detailed data from 5400 consenting patients, presenting within 24 hours of injury, with a clinical diagnosis of TBI and an indication for computed tomography. Broader registry-level data collection in approximately 20 000 patients will assess generalizability. Cross sectional comprehensive outcome assessments, including quality of life and neuropsychological testing, will be performed at 6 months. Longitudinal assessments will continue up to 24 months post TBI in patient subsets. Advanced neuroimaging and genomic and biomarker data will be used to improve characterization, and analyses will include neuroinformatics approaches to address variations in process and clinical care. Results will be integrated with living systematic reviews in a process of knowledge transfer. The study initiation was from October to December 2014, and the recruitment period was for 18 to 24 months. EXPECTED OUTCOMES: Collaborative European NeuroTrauma Effectiveness Research in TBI should provide novel multidimensional approaches to TBI characterization and classification, evidence to support treatment recommendations, and benchmarks for quality of care. Data and sample repositories will ensure opportunities for legacy research. DISCUSSION: Comparative effectiveness research provides an alternative to reductionistic clinical trials in restricted patient populations by exploiting differences in biology, care, and outcome to support optimal personalized patient management.
Comparative Effectiveness of Decompressive Craniectomy Versus Craniotomy for Traumatic Acute Subdural Hematoma (CENTER-TBI): An Observational Cohort Study
(Elsevier BV, 2023) van Essen, TA; van Erp, IAM; Lingsma, HF; Pisică, D; Yue, JK; Singh, RD; van Dijck, JTJM; Volovici, V; Younsi, A; Kolias, A; Peppel, LD; Heijenbrok-Kal, M; Ribbers, GM; Menon, DK; Hutchinson, PJA; Manley, GT; Depreitere, B; Steyerberg, EW; Maas, AIR; de Ruiter, GCW; Peul, WC; Åkerlund, C; Amrein, K; Andelic, N; Andreassen, L; Anke, A; Antoni, A; Audibert, G; Azouvi, P; Azzolini, ML; Bartels, R; Barzó, P; Beauvais, R; Beer, R; Bellander, BM; Belli, A; Benali, H; Berardino, M; Beretta, L; Blaabjerg, M; Bragge, P; Brazinova, A; Brinck, V; Brooker, J; Brorsson, C; Buki, A; Bullinger, M; Cabeleira, M; Caccioppola, A; Calappi, E; Calvi, MR; Cameron, P; Lozano, GC; Carbonara, M; Castaño-León, AM; Cavallo, S; Chevallard, G; Chieregato, A; Citerio, G; Clusmann, H; Coburn, MS; Coles, J; Cooper, JD; Correia, M; Čović, A; Curry, N; Czeiter, E; Czosnyka, M; Dahyot-Fizelier, C; Dark, P; Dawes, H; De Keyser, V; Degos, V; Della Corte, F; Boogert, HD; Đilvesi, Đ; Dixit, A; Donoghue, E; Dreier, J; Dulière, GL; Ercole, A; Esser, P; Ezer, E; Fabricius, M; Feigin, VL; Foks, K; Frisvold, S; Furmanov, A; Gagliardo, P; Galanaud, D; Gantner, D; Gao, G; George, P; Ghuysen, A; Giga, L; Glocker, B; Golubović, J; Gomez, PA; Gratz, J; Gravesteijn, B
Background: Limited evidence existed on the comparative effectiveness of decompressive craniectomy (DC) versus craniotomy for evacuation of traumatic acute subdural hematoma (ASDH) until the recently published randomised clinical trial RESCUE-ASDH. In this study, that ran concurrently, we aimed to determine current practice patterns and compare outcomes of primary DC versus craniotomy. Methods: We conducted an analysis of centre treatment preference within the prospective, multicentre, observational Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (known as CENTER-TBI) and NeuroTraumatology Quality Registry (known as Net-QuRe) studies, which enrolled patients throughout Europe and Israel (2014–2020). We included patients with an ASDH who underwent acute neurosurgical evacuation. Patients with severe pre-existing neurological disorders were excluded. In an instrumental variable analysis, we compared outcomes between centres according to treatment preference, measured by the case-mix adjusted proportion DC per centre. The primary outcome was functional outcome rated by the 6-months Glasgow Outcome Scale Extended, estimated with ordinal regression as a common odds ratio (OR), adjusted for prespecified confounders. Variation in centre preference was quantified with the median odds ratio (MOR). CENTER-TBI is registered with ClinicalTrials.gov, number NCT02210221, and the Resource Identification Portal (Research Resource Identifier SCR_015582). Findings: Between December 19, 2014 and December 17, 2017, 4559 patients with traumatic brain injury were enrolled in CENTER-TBI of whom 336 (7%) underwent acute surgery for ASDH evacuation; 91 (27%) underwent DC and 245 (63%) craniotomy. The proportion primary DC within total acute surgery cases ranged from 6 to 67% with an interquartile range (IQR) of 12–26% among 46 centres; the odds of receiving a DC for prognostically similar patients in one centre versus another randomly selected centre were trebled (adjusted median odds ratio 2.7, p < 0.0001). Higher centre preference for DC over craniotomy was not associated with better functional outcome (adjusted common odds ratio (OR) per 14% [IQR increase] more DC in a centre = 0.9 [95% CI 0.7–1.1], n = 200). Primary DC was associated with more follow-on surgeries and complications [secondary cranial surgery 27% vs. 18%; shunts 11 vs. 5%]; and similar odds of in-hospital mortality (adjusted OR per 14% IQR more primary DC 1.3 [95% CI (1.0–3.4), n = 200]). Interpretation: We found substantial practice variation in the employment of DC over craniotomy for ASDH. This variation in treatment strategy did not result in different functional outcome. These findings suggest that primary DC should be restricted to salvageable patients in whom immediate replacement of the bone flap is not possible due to intraoperative brain swelling. Funding: Hersenstichting Nederland for the Dutch NeuroTraumatology Quality Registry and the European Union Seventh Framework Program.
Daytime Napping Associated With Increased Symptom Severity in Fibromyalgia Syndrome
(BioMed Central Ltd., 2015) Theadom, A; Cropley, M; Kantermann, T
Background: Previous qualitative research has revealed that people with fibromyalgia use daytime napping as a coping strategy for managing symptoms against clinical advice. Yet there is no evidence to suggest whether daytime napping is beneficial or detrimental for people with fibromyalgia. The purpose of this study was to explore how people use daytime naps and to determine the links between daytime napping and symptom severity in fibromyalgia syndrome. Methods: A community based sample of 1044 adults who had been diagnosed with fibromyalgia syndrome by a clinician completed an online questionnaire. Associations between napping behavior, sleep quality and fibromyalgia symptoms were explored using Spearman correlations, with possible predictors of napping behaviour entered into a logistic regression model. Differences between participants who napped on a daily basis and those who napped less regularly, as well as nap duration were explored. Results: Daytime napping was significantly associated with increased pain, depression, anxiety, fatigue, memory difficulties and sleep problems. Sleep problems and fatigue explained the greatest amount of variance in napping behaviour, p < 0.010. Those who engaged in daytime naps for >30 minutes had higher memory difficulties (t = -3.45) and levels of depression (t = -2.50) than those who napped for shorter periods (<30mins) (p < 0.010). Conclusions: Frequent use and longer duration of daytime napping was linked with greater symptom severity in people with fibromyalgia. Given the common use of daytime napping in people with fibromyalgia evidence based guidelines on the use of daytime napping in people with chronic pain are urgently needed.
Demographic Disparities in the Incidence and Case Fatality of Subarachnoid Haemorrhage: An 18-Year Nationwide Study from New Zealand
(Elsevier, 2024) Rautalin, I; Krishnamurthi, Rita; Anderson, CS; Barber, PA; Barker-Collo, S; Bennett, D; Boet, R; Correia, JA; Douwes, J; Law, A; Nair, B; Thrift, AG; Te Ao, B; Tunnage, B; Ranta, A; Feigin, VL
Background Although the incidence and case-fatality of subarachnoid haemorrhage (SAH) vary within countries, few countries have reported nationwide rates, especially for multi-ethnic populations. We assessed the nationwide incidence and case-fatality of SAH in New Zealand (NZ) and explored variations by sex, district, ethnicity and time. Methods We used administrative health data from the national hospital discharge and cause-of-death collections to identify hospitalised and fatal non-hospitalised aneurysmal SAHs in NZ between 2001 and 2018. For validation, we compared these administrative data to those of two prospective Auckland Regional Community Stroke Studies. We subsequently estimated the incidence and case-fatality of SAH and calculated adjusted rate ratios (RR) with 95% confidence intervals to assess differences between sub-populations. Findings Over 78,187,500 cumulative person-years, we identified 5371 SAHs (95% sensitivity and 85% positive predictive values) resulting in an annual age-standardised nationwide incidence of 8.2/100,000. In total, 2452 (46%) patients died within 30 days after SAH. Compared to European/others, Māori had greater incidence (RR = 2.23 (2.08–2.39)) and case-fatality (RR = 1.14 (1.06–1.22)), whereas SAH incidence was also greater in Pacific peoples (RR = 1.40 (1.24–1.59)) but lesser in Asians (RR = 0.79 (0.71–0.89)). By domicile, age-standardised SAH incidence varied between 6.3–11.5/100,000 person-years and case fatality between 40 and 57%. Between 2001 and 2018, the SAH incidence of NZ decreased by 34% and the case fatality by 12%. Interpretation Since the incidence and case-fatality of SAH varies considerably between regions and ethnic groups, caution is advised when generalising findings from focused geographical locations for public health planning, especially in multi-ethnic populations.
Development of the Standards of Reporting of Neurological Disorders (Strond) Checklist: A Guideline for the Reporting of Incidence and Prevalence Studies in Neuroepidemiology
(Wolters Kluwer, 2016) Bennett, DA; Brayne, C; Feigin, V; Barker-Collo, S; Brainin, M; Davis, D; Gallo, V; Jetté, N; Karch, A; Kurtzke, JF; Lavados, PM; Logroscino, G; Nagel, G; Preux, PM; Rothwell, PM; Svenson, LW
Background: Incidence and prevalence studies of neurologic disorders play an important role in assessing the burden of disease and planning services. However, the assessment of disease estimates is hindered by problems in reporting for such studies. Despite a growth in published reports, existing guidelines relate to analytical rather than descriptive epidemiologic studies. There are also no user-friendly tools (e.g., checklists) available for authors, editors, and peer reviewers to facilitate best practice in reporting of descriptive epidemiologic studies for most neurologic disorders. Objective: The Standards of Reporting of Neurological Disorders (STROND) is a guideline that consists of recommendations and a checklist to facilitate better reporting of published incidence and prevalence studies of neurologic disorders. Methods: A review of previously developed guidance was used to produce a list of items required for incidence and prevalence studies in neurology. A 3-round Delphi technique was used to identify the “basic minimum items” important for reporting, as well as some additional “ideal reporting items.” An e-consultation process was then used in order to gauge opinion by external neuroepidemiologic experts on the appropriateness of the items included in the checklist. Findings: Of 38 candidate items, 15 items and accompanying recommendations were developed along with a user-friendly checklist. Conclusions: The introduction and use of the STROND checklist should lead to more consistent, transparent, and contextualized reporting of descriptive neuroepidemiologic studies resulting in more applicable and comparable findings and ultimately support better health care decisions.
Differing Definitions of First-Ever Stroke Influence Incidence Estimates More Than Trends: A Study Using Linked Administrative Data
(S. Karger AG, 2023-09-26) Youens, David; Katzenellenbogen, Judith; Srinivasa Ragavan, Rathina; Sodhi-Berry, Nita; Carson, Jennie; Zemedikun, Dawit; Thrift, Amanda G; Feigin, Valery; Nedkoff, Lee
Introduction Researchers apply varying definitions when measuring stroke incidence using administrative data. We aimed to investigate the sensitivity of incidence estimates to varying definitions of stroke and lookback periods, and to provide updated incidence rates and trends for Western Australia (WA). Methods We used linked state-wide hospital and death data from 1985-2017 to identify incident strokes from 2005-2017. A standard definition was applied which included strokes coded as the principal hospital diagnosis or the underlying cause of death, with a 10-year lookback used to clear prevalent cases. Alternative definitions were compared against the standard definition by percentage difference in case numbers. Age-standardised incidence rates were calculated, and age- and sex-adjusted Poisson regression models used to estimate incidence trends. Results The standard definition with a 10-year lookback period captured 31,274 incident strokes. Capture increased by 19.3% when including secondary diagnoses, 4.1% when including nontraumatic subdural and extradural haemorrhage, and 8.1% when including associated causes of death. Excluding death records reduced capture by 11.1%. A 20-year lookback reduced over-ascertainment by 2.0% and a 1-year lookback increased capture by 13.3%. Incidence declined 0.6% annually (95% confidence interval -0.9, -0.3). Annual reductions were similar for most definitions except when death records were excluded (-0.1%, CI -0.4, 0.2) and with the shortest lookback periods (greatest annual reduction). Conclusion Stroke incidence has declined in WA. Differing methods of identifying stroke influence estimates of incidence to a greater extent than estimates of trends. Reductions in stroke incidence over time are primarily driven by declines in hospitalised stroke.
Digital Solutions for Primary Stroke and Cardiovascular Disease Prevention: A Mass Individual and Public Health Approach
(Elsevier BV, 2022-06) Feigin, VL; Krishnamurthi, R; Merkin, A; Nair, B; Kravchenko, M; Jalili-Moghaddam, S
The Effect of Spinal Position on Sciatic Nerve Excursion During Seated Neural Mobilisation Exercises: An in Vivo Study Using Ultrasound Imaging
(Taylor & Francis, 2016) Ellis, R; Osborne, S; Whitefield, J; Parmar, P; Hing, W
Objectives: Research has established that the amount of inherent tension a peripheral nerve tract is exposed to influences nerve excursion and joint range of movement (ROM). The effect that spinal posture has on sciatic nerve excursion during neural mobilisation exercises has yet to be determined. The purpose of this research was to examine the influence of different sitting positions (slump-sitting versus upright-sitting) on the amount of longitudinal sciatic nerve movement during different neural mobilisation exercises commonly used in clinical practice. Methods:High-resolution ultrasound imaging followed by frame-by-frame cross-correlation analysis was used to assess sciatic nerve excursion. Thirty-four healthy participants each performed three different neural mobilisation exercises in slump-sitting and upright-sitting. Means comparisons were used to examine the influence of sitting position on sciatic nerve excursion for the three mobilisation exercises. Linear regression analysis was used to determine whether any of the demographic data represented predictive variables for longitudinal sciatic nerve excursion. Results: There was no significant difference in sciatic nerve excursion (across all neural mobilisation exercises) observed between upright-sitting and slump-sitting positions (P50.26). Although greater body mass index, greater knee ROM and younger age were associated with higher levels of sciatic nerve excursion, this model of variables offered weak predictability (R 2 50.22). Discussion: Following this study, there is no evidence that, in healthy people, longitudinal sciatic nerve excursion differs significantly with regards to the spinal posture (slump-sitting and upright-sitting). Furthermore, although some demographic variables are weak predictors, the high variance suggests that there are other unknown variables that may predict sciatic nerve excursion. It can be inferred from this research that clinicians can individualise the design of seated neural mobilisation exercises, using different seated positions, based upon patient comfort and minimisation of neural mechanosensitivity with the knowledge that sciatic nerve excursion will not be significantly influenced.

Browse

Browsing NISAN - the National Institute for Stroke and Applied Neurosciences by Title

Results Per Page

Sort Options