AimPatient- and disease-related factors, as well as operation technique, all have the potential to impact on postoperative outcome in Crohn's disease. The available evidence is based on small series and often displays conflicting results. The aim was to investigate the effect of preoperative and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease.MethodThis was an international prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection. The study analysed a subset of patients who underwent surgery for Crohn's disease. The primary outcome measure was the overall Clavien-Dindo postoperative complication rate. The key secondary outcomes were anastomotic leak, reoperation, surgical site infection and length of stay in hospital. Multivariable binary logistic regression analyses were used to produce odds ratios and 95% confidence intervals.ResultsIn all, 375 resections in 375 patients were included. The median age was 37 and 57.1% were women. In multivariate analyses, postoperative complications were associated with preoperative parenteral nutrition (OR 2.36, 95% CI 1.10-4.97), urgent/expedited surgical intervention (OR 2.00, 95% CI 1.13-3.55) and unplanned intra-operative adverse events (OR 2.30, 95% CI 1.20-4.45). The postoperative length of stay in hospital was prolonged in patients who received preoperative parenteral nutrition (OR 31, 95% CI 1.08-1.61) and those who had urgent/expedited operations (OR 1.21, 95% CI 1.07-1.37).ConclusionPreoperative parenteral nutritional support, urgent/expedited operation and unplanned intra-operative adverse events were associated with unfavourable postoperative outcome. Enhanced preoperative optimization and improved planning of operation pathways and timings may improve outcomes for patients.

Risk factors for unfavourable postoperative outcome in patients with Crohn's disease undergoing right hemicolectomy or ileocaecal resection. An international audit by ESCP and S-ECCO

M Rubbini;
2018

Abstract

AimPatient- and disease-related factors, as well as operation technique, all have the potential to impact on postoperative outcome in Crohn's disease. The available evidence is based on small series and often displays conflicting results. The aim was to investigate the effect of preoperative and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease.MethodThis was an international prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection. The study analysed a subset of patients who underwent surgery for Crohn's disease. The primary outcome measure was the overall Clavien-Dindo postoperative complication rate. The key secondary outcomes were anastomotic leak, reoperation, surgical site infection and length of stay in hospital. Multivariable binary logistic regression analyses were used to produce odds ratios and 95% confidence intervals.ResultsIn all, 375 resections in 375 patients were included. The median age was 37 and 57.1% were women. In multivariate analyses, postoperative complications were associated with preoperative parenteral nutrition (OR 2.36, 95% CI 1.10-4.97), urgent/expedited surgical intervention (OR 2.00, 95% CI 1.13-3.55) and unplanned intra-operative adverse events (OR 2.30, 95% CI 1.20-4.45). The postoperative length of stay in hospital was prolonged in patients who received preoperative parenteral nutrition (OR 31, 95% CI 1.08-1.61) and those who had urgent/expedited operations (OR 1.21, 95% CI 1.07-1.37).ConclusionPreoperative parenteral nutritional support, urgent/expedited operation and unplanned intra-operative adverse events were associated with unfavourable postoperative outcome. Enhanced preoperative optimization and improved planning of operation pathways and timings may improve outcomes for patients.
El-Hussuna, A; Pinkney, T; Zmora, O; Frasson, M; Bhangu, A; Battersby, N; Chaudhri, S; Nepogodiev, D; Singh, B; Vennix, S; Altomare, D; Bemelman, W; Christensen, P; D'Hoore, A; Laurberg, S; Morton, D; Pinkney, T; Rubbini, M; Vaizey, C; Magill, L; Perry, R; Sheward, N; Nørmark Mortensen, Rikke; El-Hussuna, Alaa; Cillo, M; Estefania, D; Patron Uriburu, J; Ruiz, H; Salomon, M; Makhmudov, A; Selnyahina, L; Varabei, A; Vizhynis, Y; Claeys, D; Defoort, B; Muysoms, F; Pletinckx, P; Vergucht, V; Debergh, I; Feryn, T; Reusens, H; Nachtergaele, M; Francart, D; Jehaes, C; Markiewicz, S; Monami, B; Weerts, J; Bouckaert, W; Houben, B; Knol, J; Sergeant, G; Vangertruyden, G; Haeck, L; Lange, C; Sommeling, C; Vindevoghel, K; Castro, S; De Bruyn, H; Huyghe, M; De Wolf, E; Reynders, D; D'Hoore, A; de Buck van Overstraeten, A; Wolthuis, A; Delibegovic, S; Christiani, A; Marchiori Jr, M; Rocha de Moraes, C; Tercioti Jr, V; Arabadjieva, E; Bulanov, D; Dardanov, D; Stoyanov, V; Yonkov, A; Angelov, K; Maslyankov, S; Sokolov, M; Todorov, G; Toshev, S; Georgiev, Y; Karashmalakov, A; Zafirov, G; Wang, X; Condic, D; Kraljik, D; Mrkovic, H; Pavkovic, V; Raguž, K; Bencurik, V; Holášková, E; Skrovina, M; Farkašová, M; Grolich, T; Kala, Z; Antos, F; Pruchova, V; Sotona, O; Chobola, M; Dusek, T; Ferko, A; Örhalmi, J; Hoch, J; Kocian, P; Martinek, L; Bernstein, I; Gotschalck Sunesen, K; Leunbach, J; Thorlacius-Ussing, O; Uth Oveson, A; Christensen, P; Dahl Chirstensen, S; Gamez, V; Oeting, M; Schou Loeve, U; Ugianskis, A; Jessen, M; M Krarup, P; Linde, K; Mirza, Q; Overgaard Stovring, J; Erritzøe, L; Loft Jakobsen, H; Lykke, J; Palmgren Colov, E; Husted Madsen, A; Linde Friis, T; Amstrup Funder, J; Dich, R; Kjaer, S; Rasmussen, S; Schlesinger, N; Dilling Kjaer, M; Qvist, N; Khalid, A; Ali, G; El-Hussuna, A; Hadi, S; Rosell Walker, L; Kivelä, A; Lehtonen, T; Lepistö, A; Scheinin, T; Siironen, P; Kössi, J; Kuusanmäki, P; Tomminen, T; Turunen, A; Rautio, T; Vierimaa, M; Huhtinen, H; Karvonen, J; Lavonius, M; Rantala, A; Varpe, P; Cotte, E; Francois, Y; Glehen, O; Kepenekian, V; Passot, G; Maggiori, L; Manceau, G; Panis, Y; Gout, M; Rullier, E; van Geluwe, B; Chafai, N; H Lefevre, J; Parc, Y; Tiret, E; Couette, C; Duchalais, E; Agha, A; Hornberger, M; Hungbauer, A; Iesalnieks, I; Weindl, I; Crescenti, F; Keller, M; Kolodziejski, N; Scherer, R; Sterzing, D; Bock, B; Boehm, G; El-Magd, M; Krones, C; Niewiera, M; Buhr, J; Cordesmeyer, S; Hoffmann, M; Krückemeier, K; Vogel, T; Schön, M; Baral, J; Lukoschek, T; Münch, S; Pullig, F; Horisberger, K; Kienle, P; Magdeburg, J; Post, S; Batzalexis, K; Germanos, S; Agalianos, C; Dervenis, C; Gouvas, N; Kanavidis, P; Kottikias, A; E Katsoulis, I; Korkolis, D; Plataniotis, G; Sakorafas, G; Akrida, I; Argentou, M; Kollatos, C; Lampropoulos, C; Tsochatzis, S; Besznyák, I; Bursics, A; Egyed, T; Papp, G; Svastics, I; Atladottir, J; Möller, P; Sigurdsson, H; Stefánsson, T; Valsdottir, E; Andrews, E; Foley, N; Hechtl, D; Majeed, M; Mccourt, M; Hanly, A; Hyland, J; Martin, S; R O'Connell, P; Winter, D; Connelly, T; Joyce, W; Wrafter, P; Berkovitz, R; Avital, S; Haj Yahia, I; Hermann, N; Shpitz, B; White, I; Lishtzinsky, Y; Tsherniak, A; Wasserberg, N; Horesh, N; Keler, U; Pery, R; Shapiro, R; Zmora, O; Tulchinsky, H; Badran, B; Dayan, K; Iskhakov, A; Lecaros, J; Nabih, N; Angrima, I; Bardini, R; Pizzolato, E; Tonello, M; Arces, F; Balestri, R; Ceccarelli, C; Prosperi, V; Rossi, E; Giannini, I; Vincenti, L; F Altomare, D; Di Candido, F; Di Iena, M; Guglielmi, A; Caputi-Iambrenghi, O; Marsanic, P; Mellano, A; Muratore, A; Annecchiarico, M; Bencini, L; Amore Bonapasta, S; Coratti, A; Guerra, F; R Asteria, C; Boccia, L; Gerard, L; Pascariello, A; Manca, G; Marino, F; Casaril, A; Inama, M; Moretto, G; Bacchelli, C; Carvello, M; Mariani, N; Montorsi, M; Spinelli, A; Romairone, E; Scabini, S; Belli, A; Bianco, F; De Franciscis, S; Maria Romano, G; Delrio, P; Pace, U; Rega, D; Sassaroli, C; Scala, D; De Luca, R; Ruggieri, E; Elbetti, C; Garzi, A; Romoli, L; Scatizzi, M; Vannucchi, A; Curletti, G; Durante, V; Galleano, R; Mariani, F; Reggiani, L; Bellomo, R; Infantino, A; Franceschilli, L; Sileri, P; Clementi, I; Coletta, D; La Torre, F; Mingoli, A; Velluti, F; Di Giacomo, A; Fiorot, A; Massani, M; Padoan, L; Ruffolo, C; Caruso, S; Franceschini, F; Laessig, R; Monaci, I; Rontini, M; De Nardi, P; Elmore, U; Lemma, M; Rosati, R; Tamburini, A; De Luca, M; Sartori, A; Benevento, A; Bottini, C; C Ferrari, C; Pata, F; Tessera, G; Pellino, G; Selvaggi, F; Lanzani, A; Romano, F; Sgroi, G; Steccanella, F; Turati, L; Yamamoto, T; Ancans, G; Gerkis, S; Leja, M; Pcolkins, A; Sivins, A; Latkauskas, T; Lizdenis, P; Saladžinskas, Ž; Švagždys, S; Tamelis, A; Razbadauskas, A; Sokolovas, M; Dulskas, A; Samalavicius, N; Jotautas, V; Mikalauskas, S; Poskus, E; Poskus, T; Strupas, K; Camenzuli, C; Cini, C; Predrag, A; Psaila, J; Spiteri, N; Bemelman, W; Buskens, C; J de Groof, E; Gooszen, J; Tanis, P; Belgers, E; Davids, P; Furnee, E; Postma, E; Pronk, A; Smakman, N; Clermonts, S; Zimmerman, D; Omloo, J; van der Zaag, E; van Duijvendijk, P; Wassenaar, E; Bruijninckx, M; de Graff, E; Doornebosch, P; Tetteroo, G; Vermaas, M; Iordens, G; Knops, S; Toorenvliet, B; L van Westereenen, H; Boerma, E; Coene, P; van der Harst, E; Van Der Pool, A; Raber, M; Melenhorst, J; de Castro, S; Gerhards, M; Arron, M; Bremers, A; de Wilt, H; Ferenschild, F; Yauw, S; Cense, H; Demirkiran, A; Hunfeld, M; Mulder, I; Nonner, J; Swank, H; van Wagensveld, B; Bolmers, M; Briel, J; van Geloven, A; van Rossem, C; Klemann, V; Konsten, J; Leenders, B; Schok, T; Bleeker, W; Gidwani, A; Lawther, R; Loughlin, P; Skelly, B; Spence, R; Brun, M; Helgeland, M; Ignjatovic, D; Øresland, T; Yousefi, P; Flåten Backe, I; Helmer Sjo, O; Nesbakken, A; Tandberg-Eriksen, M; Cais, A; Hallvard Traeland, J; Herikstad, R; Kørner, H; Lauvland, N; Jajtner, D; Kabiesz, W; Rak, M; Gmerek, L; Horbacka, K; Horst, N; Krokowicz, P; Kwiatkowski, A; Pasnik, K; Karcz, P; Romaniszyn, M; Rusek, T; Walega, P; Czarencki, R; Obuszko, Z; Sitarska, M; Wojciech, W; Zawadzki, M; Amado, S; Clara, P; Couceiro, A; Malaquias, R; Rama, N; Almeida, A; Barbosa, E; Cernadas, E; Duarte, A; Silva, P; Costa, S; Martinez Insua, C; Pereira, J; Pereira, C; Sacchetti, M; Carvalho Pinto, B; Jorge Vieira Sousa, P; Marques, R; Oliveira, A; Cardoso, R; Carlos, S; Corte-Real, J; Moniz Pereira, P; Souto, R; Carneiro, C; Marinho, R; Nunes, V; Rocha, R; Sousa, M; Leite, J; Melo, F; Pimentel, J; Ventura, L; Vila Nova, C; Copăescu, C; Bintintan, V; Ciuce, C; Dindelegan, G; Scurtu, R; Seicean, R; Domansky, N; Karachun, A; Moiseenko, A; Pelipas, Y; Petrov, A; Pravosudov, I; Aiupov, R; Akmalov, Y; Parfenov, A; Suleymanov, N; Tarasov, N; Jumabaev, H; Mamedli, Z; Rasulov, A; Aliev, I; Chernikovskiy, I; Kochnev, V; Komyak, K; Pravosudov, I; Smirnov, A; Achkasov, S; Bolikhov, K; Shelygin, Y; Sushkov, O; Zapolskiy, A; Gvozdenovic, M; Jovanovic, D; Lausevic, Z; Cvetković, D; Maravić, M; Milovanovic, B; Stojakovic, N; Tripković, I; Mihajlovic, D; Nestorovic, M; Pecic, V; Petrovic, D; Stanojevic, G; Barisic, G; Dimitrijevic, I; Krivokapic, Z; Markovic, V; Popovic, M; Aleksic, A; Dabic, D; Kostic, I; Milojkovic, A; Perunicic, V; Lukic, D; Petrovic, T; Radovanovic, D; Radovanovic, Z; M Cuk, V; V Cuk, V; Kenic, M; Kovacevic, B; Krdzic, I; Korcek, J; Rems, M; Toplak, J; Escarrâ, J; Gil Barrionuevo, M; Golda, T; Kreisler Moreno, E; Zerpa Martin, C; Álvarez Laso, C; Cumplido, P; Padin, H; Baixauli Fons, J; Hernández-Lizoain, J; Martinez-Ortega, P; Molina-Fernández, M; Sánchez-Justicia, C; Antonio Gracia Solanas, J; Córdoba Díaz de Laspra, E; Echazarreta-Gallego, E; Elia-Guedea, M; Ramirez, J; Arredondo Chaves, J; Diez González, P; Elosua, T; Sahagún, J; Turienzo Frade, A; Álvarez Conde, J; Castrillo, E; Diaz Maag, R; Maderuelo, V; Saldarriaga, L; Aldrey Cao, I; Fernández Varela, X; Núñez Fernández, S; Parajó Calvo, A; Villar Álvarez, S; Blesa Sierra, I; Duarte, A; Lozano, R; Márquez, M; Porcel, O; Menendez, P; Fernández Hevia, M; Flores Sigüenza, L; Jimenez Toscano, M; Lacy Fortuny, A; Ordoñez Trujillo, J; Espi, A; Garcia-Botello, S; Martín-Arévalo, J; Moro-Valdezate, D; Pla-Martí, V; Blanco-Antona, F; Abrisqueta, J; Ibañez Canovas, N; Lujan Mompean, J; Escolá Ripoll, D; Martinez Gonzalez, S; Parodi, J; Fernández López, A; Ramos Fernández, M; Castellvi Valls, J; Ortiz de Zarate, L; Ribas, R; Sabia, D; Viso, L; Alonso Gonçalves, S; José Gil Egea, M; Pascual Damieta, M; Pera, M; Salvans Ruiz, S; Bernal, J; Landete, F; Ais, G; Etreros, J; Aguiló Lucia, J; Boscá, A; Deusa, S; García Del Caño, J; Viciano, V; García-Armengol, J; Roig, J; Blas, J; Escartin, J; Fatás, J; Fernando, J; Ferrer, R; Arias Pacheco, R; García Flórez, L; Moreno Gijón, M; Otero Díez, J; Solar Garcia, L; Aguilar Teixido, F; Balaguer Ojo, C; Bargallo Berzosa, J; Lamas Moure, S; Enrique Sierra, J; Fermiñán, A; Herrerias, F; Rufas, M; Viñas, J; Codina-Cazador, A; Farrés, R; Gómez, N; Julià, D; Planellas, P; López, J; Luna, A; Maristany, C; Muñoz Duyos, A; Puértolas, N; Alcantara Moral, M; Serra-Aracil, X; Concheiro Coello, P; Gómez, D; Carton, C; Miguel, A; Reoyo Pascual, F; Valero Cerrato, X; Zambrano Muñoz, R; Cervera-Aldama, J; García González, J; Ramos-Prada, J; Santamaría-Olabarrieta, M; Urigüen-Echeverría, A; Coves Alcover, R; Espinosa Soria, J; Fernandez Rodriguez, E; Hernandis Villalba, J; Maturana Ibañez, V; De la Torre Gonzalez, F; Huerga, D; Pérez Viejo, E; Rivera, A; Ruiz Ucar, E; Garcia-Septiem, J; Jiménez, V; Jiménez Miramón, J; Ramons Rodriquez, J; Rodriguez Alvarez, V; Garcea, A; Ponchietti, L; Borda, N; Enriquez-Navascues, J; Saralegui, Y; Febles Molina, G; Nogues, E; Rodríguez Méndez, Á; Roque Castellano, C; Sosa Quesada, Y; Alvarez-Gallego, M; Pascual, I; Rubio-Perez, I; Diaz-San Andrés, B; Tone-Villanueva, F; Alonso, J; Cagigas, C; Castillo, J; Gómez, M; Martín-Parra, J; Mengual Ballester, M; Pellicer Franco, E; Soria Aledo, V; Valero Navarro, G; Caballero Rodríguez, E; Gonzalez De Chaves, P; Hernandez, G; Perez Alvarez, A; Soto Sanchez, A; Cesar Becerra Garcia, F; Guillermo Alonso Roque, J; López Rodríguez Arias, F; R Del Valle Ruiz, S; Sánchez De La Villa, G; Compañ, A; García Marín, A; Nofuentes, C; Orts Micó, F; Pérez Auladell, V; Carrasco, M; Duque Perez, C; Gálvez-Pastor, S; Navarro Garcia, I; Sanchez Perez, A; Enjuto, D; Manuel Bujalance, F; Marcelin, N; Pérez, M; Serrano García, R; Cabrera, A; de la Portilla, F; Diaz-Pavon, J; Jimenez-Rodriguez, R; Vazquez-Monchul, J; Daza González, J; Gómez Pérez, R; Rivera Castellano, J; Roldán de la Rua, J; Errasti Alustiza, J; Fernandez, L; Romeo Ramirez, J; Sardon Ramos, J; Cermeño Toral, B; Alias, D; Garcia-Olmo, D; Guadalajara, H; Herreros, M; Pacheco, P; Del Castillo Díez, F; Lima Pinto, F; Martínez Alegre, J; Ortega, I; Picardo Nieto Antonio, A; Caro, A; Escuder, J; Feliu, F; Millan, M; Alos Company, R; Frangi Caregnato, A; Lozoya Trujillo, R; Rodríguez Carrillo, R; Ruiz Carmona, M; Alonso, N; Ambrona Zafra, D; Amilka Ayala Candia, B; Bonnin Pascual, J; Pineño Flores, C; Alcazar Montero, J; Angoso Clavijo, M; Garcia, J; Sanchez Tocino, J; Gómez-Alcazar, C; Costa-Navarro, D; Ferri-Romero, J; Rey-Riveiro, M; Romero-Simó, M; Arencibia, B; Esclapez, P; Frasson, M; García-Granero, E; Granero, P; J Medina Fernández, F; B Gallardo Herrera, A; Diaz López, C; Navarro Rodriguez, E; Torres Tordera, E; Arenal, J; Citores, M; Marcos, J; Sánchez, J; Tinoco, C; Espin, E; Garcia Granero, A; Jimenez Gomez, L; Sanchez Garcia, J; Vallribera, F; Folkesson, J; Sköldberg, F; Bergman, K; Borgström, E; Frey, J; Silfverberg, A; Söderholm, M; Nygren, J; Segelman, J; Gustafsson, D; Lagerqvist, A; Papp, A; Pelczar, M; Abraham-Nordling, M; Ahlberg, M; Sjovall, A; Tengstrom, J; Hagman, K; Chabok, A; Ezra, E; Nikberg, M; Smedh, K; Tiselius, C; Al-Naimi, N; Dao Duc, M; Meyer, J; Mormont, M; Ris, F; Prevost, G; Villiger, P; Hoffmann, H; Kettelhack, C; Kirchhoff, P; Oertli, D; Weixler, B; Aytac, B; Leventoglu, S; Mentes, B; Yuksel, O; Demirbas, S; Busra Ozkan, B; Selçuk Özbalci, G; Sungurtekin, U; Gülcü, B; Ozturk, E; Yilmazlar, T; Challand, C; Fearnhead, N; Hubbard, R; Kumar, S; Arthur, J; Barben, C; Skaife, P; Slawik, S; Williams, M; Zammit, M; Barker, J; French, J; Sarantitis, I; Slawinski, C; Clifford, R; Eardley, N; Johnson, M; Mcfaul, C; Vimalachandran, D; Allan, S; Bell, A; Oates, E; Shanmugam, V; Brigic, A; Halls, M; Pucher, P; Stubbs, B; Agarwal, T; Chopada, A; Mallappa, S; Pathmarajah, M; Sugden, C; Brown, C; Macdonald, E; Mckay, A; Richards, J; Robertson, A; Kaushal, M; Patel, P; Tezas, S; Touqan, N; Ayaani, S; Marimuthu, K; Piramanayagam, B; Vourvachis, M; Iqbal, N; Korsgen, S; Seretis, C; Shariff, U; Arnold, S; Battersby, N; Chan, H; Clark, E; Fernandes, R; Moran, B; Bajwa, A; Mcarthur, D; Cao, K; Cunha, P; Pardoe, H; Quddus, A; Theodoropoulou, K; Bolln, C; Denys, G; Gillespie, M; Manimaran, N; Reidy, J; I Malik, A; Malik, A; Pitt, J; Aryal, K; El-Hadi, A; Lal, R; Pal, A; Velchuru, V; Chaudhri, S; Oliveira Cunha, M; Singh, B; Thomas, M; Bains, S; Boyle, K; Miller, A; Norwood, M; Yeung, J; Goian, L; Gurjar, S; Saghir, W; Sengupta, N; Stewart-Parker, E; Bailey, S; Khalil, T; Lawes, D; Nikolaou, S; Omar, G; Church, R; Muthiah, B; Garrett, W; Marsh, P; Obeid, N; Chandler, S; Coyne, P; Evans, M; Hunt, L; Lim, J; Oliphant, Z; Papworth, E; Weaver, H; Cuiñas Leon, K; Williams, G; Hernon, J; Kapur, S; Moosvi, R; Shaikh, I; Swafe, L; Aslam, M; Evans, J; Ihedioha, U; Kang, P; Merchant, J; Hompes, R; Middleton, R; Broomfield, A; Crutten-Wood, D; Foster, J; Nash, G; Akhtar, M; Boshnaq, M; Eldesouky, S; Mangam, S; Rabie, M; Ahmed, J; Khan, J; Ming Goh, N; Shamali, A; Stefan, S; Nepogodiev, D; Pinkney, T; Thompson, C; Amin, A; Docherty, J; Lim, M; Walker, K; Watson, A; Hossack, M; Mackenzie, N; Paraoan, M; Alam, N; Daniels, I; Narang, S; Pathak, S; Smart, N; Al-Qaddo, A; Codd, R; Rutka, O; Williams, G; Bronder, C; Crighton, I; Davies, E; Raymond, T; Bookless, L; Griffiths, B; Plusa, S; Carlson, G; Harrison, R; Lees, N; Mason, C; Quayle, J; Branagan, G; Broadhurst, J; Chave, H; Sleight, S; Awad, F; Bhangu, A; Cruickshank, N; Joy, H; Boereboom, C; Daliya, P; Dhillon, A; Watson, N; Watson, R; Artioukh, D; Gokul, K; Javed, M; Kong, R; Sutton, J; Faiz, O; Jenkins, I; A Leo, C; F Samaranayake, S; Warusavitarne, J; Arya, S; Bhan, C; Mukhtar, H; Oshowo, A; Wilson, J; Duff, S; Fatayer, T; Mbuvi, J; Sharma, A; Cornish, J; Davies, L; Harries, R; Morris, C; Torkington, J; Knight, J; Lai, C; Shihab, O; Tzivanakis, A; Hussain, A; Luke, D; Padwick, R; Torrance, A; Tsiamis, A; Dawson, P; Balfour, A; Brady, R; Mander, J; Paterson, H; Chandratreya, N; Chu, H; Cutting, J; Vernon, S; Wai Ho, C; Andreani, S; Patel, H; Warner, M; Yan Qi Tan, J; Iqbal, A; Khan, A; Perrin, K; Raza, A; Tan, S
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