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Thiyagarajan D, Ibine R, Nuamah M, Lawrence E. Building bilateral global research capacity among students and faculty through initiation of a medical student research grant in Ghana. Int J Gynaecol Obstet 2024. [PMID: 39118498 DOI: 10.1002/ijgo.15847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 07/11/2024] [Accepted: 07/30/2024] [Indexed: 08/10/2024]
Abstract
SynopsisThis global grant program provides the opportunity for students to develop meaningful projects and translate them into academic success, while building bilateral faculty research capacity.
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Affiliation(s)
| | - Rebecca Ibine
- Department of Obstetrics and Gynecology, Family Health Medical School, Accra, Ghana
| | - Mercy Nuamah
- Department of Community Health, Family Health Medical School, Accra, Ghana
| | - Emma Lawrence
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, USA
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Asowata OJ, Okekunle AP, Olaiya MT, Akinyemi J, Owolabi M, Akpa OM. Stroke risk prediction models: A systematic review and meta-analysis. J Neurol Sci 2024; 460:122997. [PMID: 38669758 DOI: 10.1016/j.jns.2024.122997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Prediction algorithms/models are viable methods for identifying individuals at high risk of stroke across diverse populations for timely intervention. However, evidence summarizing the performance of these models is limited. This study examined the performance and weaknesses of existing stroke risk-score-prediction models (SRSMs) and whether performance varied by population and region. METHODS PubMed, EMBASE, and Web of Science were searched for articles on SRSMs from the earliest records until February 2022. The Prediction Model Risk of Bias Assessment Tool was used to assess the quality of eligible articles. The performance of the SRSMs was assessed by meta-analyzing C-statistics (0 and 1) estimates from identified studies to determine the overall pooled C-statistics by fitting a linear restricted maximum likelihood in a random effect model. RESULTS Overall, 17 articles (cohort study = 15, nested case-control study = 2) comprising 739,134 stroke cases from 6,396,594 participants from diverse populations/regions (Asia; n = 8, United States; n = 3, and Europe and the United Kingdom; n = 6) were eligible for inclusion. The overall pooled c-statistics of SRSMs was 0.78 (95%CI: 0.75, 0.80; I2 = 99.9%), with most SRSMs developed using cohort studies; 0.78 (95%CI: 0.75, 0.80; I2 = 99.9%). The subgroup analyses by geographical region: Asia [0.81 (95%CI: 0.79, 0.83; I2 = 99.8%)], Europe and the United Kingdom [0.76 (95%CI: 0.69, 0.83; I2 = 99.9%)] and the United States only [0.75 (95%CI: 0.72, 0.78; I2 = 73.5%)] revealed relatively indifferent performances of SRSMs. CONCLUSION SRSM performance varied widely, and the pooled c-statistics of SRSMs suggested a fair predictive performance, with very few SRSMs validated in independent population group(s) from diverse world regions.
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Affiliation(s)
- Osahon Jeffery Asowata
- Department of Epidemiology and Medical Statistics, University of Ibadan, 200284, Nigeria
| | - Akinkunmi Paul Okekunle
- Department of Epidemiology and Medical Statistics, University of Ibadan, 200284, Nigeria; Department of Medicine, College of Medicine, University of Ibadan, 200284, Nigeria; Research Institute of Human Ecology, Seoul National University, 08826, Republic of Korea.
| | - Muideen Tunbosun Olaiya
- Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC 3168, Australia
| | - Joshua Akinyemi
- Department of Epidemiology and Medical Statistics, University of Ibadan, 200284, Nigeria
| | - Mayowa Owolabi
- Department of Medicine, College of Medicine, University of Ibadan, 200284, Nigeria; Lebanese American University, 1102 2801 Beirut, Lebanon; Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, 200284, Nigeria
| | - Onoja M Akpa
- Department of Epidemiology and Medical Statistics, University of Ibadan, 200284, Nigeria; Preventive Cardiology Research Unit, Institute of Cardiovascular Diseases, College of Medicine, University of Ibadan, 200284, Nigeria; Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, USA.
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Anane-Binfoh NA, Flaherty KE, Zakariah AN, Nelson EJ, Becker TK, Afaa TJ. Barriers to Decolonizing Global Health: Identification of Research Challenges Facing Investigators Residing in Low- and Middle-Income Countries. GLOBAL HEALTH, SCIENCE AND PRACTICE 2024; 12:e2300269. [PMID: 38242635 PMCID: PMC10906550 DOI: 10.9745/ghsp-d-23-00269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/06/2023] [Indexed: 01/21/2024]
Abstract
The practice of global health is plagued by power structures favoring high-income countries. Efforts to decolonize global health must consider the systemic limitations that LMIC investigators face at local, national, and international levels.
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Affiliation(s)
| | - Katelyn E Flaherty
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
- Section of Global Health, Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | | | - Eric J Nelson
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Torben K Becker
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
- Section of Global Health, Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
- Center for African Studies, University of Florida, Gainesville, FL, USA
| | - Taiba Jibril Afaa
- Department of Child Health, Korle Bu Teaching Hospital, Accra, Ghana.
- Department of Child Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
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Salluh JIF, Quintairos A, Dongelmans DA, Aryal D, Bagshaw S, Beane A, Burghi G, López MDPA, Finazzi S, Guidet B, Hashimoto S, Ichihara N, Litton E, Lone NI, Pari V, Sendagire C, Vijayaraghavan BKT, Haniffa R, Pisani L, Pilcher D. National ICU Registries as Enablers of Clinical Research and Quality Improvement. Crit Care Med 2024; 52:125-135. [PMID: 37698452 DOI: 10.1097/ccm.0000000000006050] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
OBJECTIVES Clinical quality registries (CQRs) have been implemented worldwide by several medical specialties aiming to generate a better characterization of epidemiology, treatments, and outcomes of patients. National ICU registries were created almost 3 decades ago to improve the understanding of case-mix, resource use, and outcomes of critically ill patients. This narrative review describes the challenges, proposed solutions, and evidence generated by National ICU registries as facilitators for research and quality improvement. DATA SOURCES English language articles were identified in PubMed using phrases related to ICU registries, CQRs, outcomes, and case-mix. STUDY SELECTION Original research, review articles, letters, and commentaries, were considered. DATA EXTRACTION Data from relevant literature were identified, reviewed, and integrated into a concise narrative review. DATA SYNTHESIS CQRs have been implemented worldwide by several medical specialties aiming to generate a better characterization of epidemiology, treatments, and outcomes of patients. National ICU registries were created almost 3 decades ago to improve the understanding of case-mix, resource use, and outcomes of critically ill patients. The initial experience in European countries and in Oceania ensured that through locally generated data, ICUs could assess their performances by using risk-adjusted measures and compare their results through fair and validated benchmarking metrics with other ICUs contributing to the CQR. The accomplishment of these initiatives, coupled with the increasing adoption of information technology, resulted in a broad geographic expansion of CQRs as well as their use in quality improvement studies, clinical trials as well as international comparisons, and benchmarking for ICUs. CONCLUSIONS ICU registries have provided increased knowledge of case-mix and outcomes of ICU patients based on real-world data and contributed to improve care delivery through quality improvement initiatives and trials. Recent increases in adoption of new technologies (i.e., cloud-based structures, artificial intelligence, machine learning) will ensure a broader and better use of data for epidemiology, healthcare policies, quality improvement, and clinical trials.
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Affiliation(s)
- Jorge I F Salluh
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Post-Graduation Program, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Amanda Quintairos
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Department of Critical and Intensive Care Medicine, Academic Hospital Fundación Santa Fe de Bogota, Bogota, Colombia
| | - Dave A Dongelmans
- Amsterdam UMC location University of Amsterdam, Department of Intensive Care Medicine, Amsterdam, The Netherlands
- National Intensive Care Evaluation (NICE) Foundation, Amsterdam, The Netherlands
| | - Diptesh Aryal
- National Coordinator, Nepal Intensive Care Research Foundation, Kathmandu, Nepal
| | - Sean Bagshaw
- Department of Medicine, Faculty of Medicine and Dentistry (Ling, Bagshaw), University of Alberta and Alberta Health Services, Edmonton, AB, Canada
- Division of Internal Medicine (Villeneuve), Department of Critical Care Medicine, Faculty of Medicine and Dentistry and School of Public Health, University of Alberta and Grey Nuns Hospitals, Edmonton, AB, Canada
| | - Abigail Beane
- Critical Care, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | | | - Maria Del Pilar Arias López
- Argentine Society of Intensive Care (SATI). SATI-Q Program, Buenos Aires, Argentina
- Intermediate Care Unit, Hospital de Niños Ricardo Gutierrez, Buenos Aires, Argentina
| | - Stefano Finazzi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, Italy
- Associazione GiViTI, c/o Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Bertrand Guidet
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP, Hôpital Saint-Antoine, service de réanimation, Paris, France
| | - Satoru Hashimoto
- Division of Intensive Care, Department of Anesthesiology and Intensive Care Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Nao Ichihara
- Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Edward Litton
- Fiona Stanley Hospital, Perth, WA
- The University of Western Australia, Perth, WA
| | - Nazir I Lone
- Usher Institute, University of Edinburgh, Edinburgh, United Kingdom
- Scottish Intensive Care Society Audit Group, United Kingdom
| | - Vrindha Pari
- Chennai Critical Care Consultants, Pvt Ltd, Chennai, India
| | - Cornelius Sendagire
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil
- Anesthesia and Critical Care, Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Rashan Haniffa
- Critical Care, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
- Crit Care Asia, Network for Improving Critical Care Systems and Training, Colombo, Sri Lanka
- Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Luigi Pisani
- Critical Care, Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - David Pilcher
- University College Hospital, London, United Kingdom
- Department of Intensive Care, Alfred Health, Prahran, VIC, Australia
- The Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resource Evaluation, Camberwell, Australia
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Ferreira JC, Pizzichini MMM. The MECOR program: almost three decades inspiring and improving respiratory clinical research in Brazil and across the globe. J Bras Pneumol 2023; 49:e20230213. [PMID: 37493794 PMCID: PMC10578909 DOI: 10.36416/1806-3756/e20230213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Affiliation(s)
- Juliana Carvalho Ferreira
- . Methods in Epidemiologic, Clinical, and Operations Research-MECOR-program, American Thoracic Society/Asociación Latinoamericana del Tórax, Montevideo, Uruguay
- . Divisão de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Marcia M M Pizzichini
- . Methods in Epidemiologic, Clinical, and Operations Research-MECOR-program, American Thoracic Society/Asociación Latinoamericana del Tórax, Montevideo, Uruguay
- . Programa de Pós-Graduação em Ciências Médicas, Universidade Federal de Santa Catarina, Florianópolis (SC) Brasil
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Seguya A, Salano V, Okerosi S, Kim EK, Shrime MG, Viljoen G, Fagan JJ. Are open access article processing charges affordable for otolaryngologists in low-income and middle-income countries? Curr Opin Otolaryngol Head Neck Surg 2023; 31:202-207. [PMID: 37144583 DOI: 10.1097/moo.0000000000000892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
PURPOSE OF REVIEW Open access articles are more frequently read and cited, and hence promote access to knowledge and new advances in healthcare. Unaffordability of open access article processing charges (APCs) may create a barrier to sharing research. We set out to assess the affordability of APCs and impact on publishing for otolaryngology trainees and otolaryngologists in low-income and middle-income countries (LMICs). RECENT FINDINGS A cross-sectional online survey was conducted among otolaryngology trainees and otolaryngologists in LMICs globally. Seventy-nine participants from 21 LMICs participated in the study, with the majority from lower middle-income status (66%). Fifty-four percent were otolaryngology lecturers while 30% were trainees. Eighty-seven percent of participants received a gross monthly salary of less than USD 1500. Fifty-two percent of trainees did not receive a salary. Ninety-one percent and 96% of all study participants believed APCs limit publication in open access journals and influence choice of journal for publication, respectively. Eighty percent and 95% believed APCs hinder career progression and impede sharing of research that influences patient care, respectively. SUMMARY APCs are unaffordable for LMIC otolaryngology researchers, hinder career progression and inhibit the dissemination of LMIC-specific research that can improve patient care. Novel models should be developed to support open access publishing in LMICs.
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Somnuke P, Punpocha P, Punikhom P, Panitrat R, Nivatpumin P, Thanakiattiwibun C, Ramlee R, Thongkaew N, Siriussawakul A. Model for enhancing the research conducted by the university medical staff: Participatory action research. Heliyon 2023; 9:e13208. [PMID: 36793952 PMCID: PMC9922824 DOI: 10.1016/j.heliyon.2023.e13208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 01/19/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
This study employed mixed methods with a participatory action research approach to explore factors currently undermining the conduction of research and to develop strategies to boost research productivity. A questionnaire was distributed to 64 staff members of the Department of Anesthesiology at a university-based hospital. Thirty-nine staff members (60.9%) gave informed consent and responses. Staff views were also collected through focus group discussions. The staff reported that limited research methodology skills, time management, and complex managerial processes were the limitations. Age, attitudes, and performance expectancy were significantly correlated with research productivity. A regression analysis demonstrated that age and performance expectancy significantly influenced research productivity. A Business Model Canvas (BMC) was implemented to gain insight into the goal of enhancing the conduct of research. Business Model Innovation (BMI) established a strategy to improve research productivity. The concept, comprising personal reinforcement (P), aiding systems (A), and a lifting-up of the value of research (L), the PAL concept, was considered key to enhancing the conduct of research, with the BMC providing details and integrating with the BMI. To upgrade the research performance, the involvement of management is imperative, and future action will involve the implementation of a BMI model to increase research productivity.
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Affiliation(s)
- Pawit Somnuke
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | | | - Ploythai Punikhom
- Division of Anesthesiology, Kalasin Hospital, Kalasin 46000, Thailand
| | - Rungnapa Panitrat
- Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Hospital, Bangkok 10210, Thailand
| | - Patchareya Nivatpumin
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Chayanan Thanakiattiwibun
- Integrated Perioperative Geriatric Excellent Research Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Rachaneekorn Ramlee
- Integrated Perioperative Geriatric Excellent Research Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Nichapat Thongkaew
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
| | - Arunotai Siriussawakul
- Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
- Integrated Perioperative Geriatric Excellent Research Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
- Corresponding author. Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
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Barriers and Facilitators to Conducting Oncology Clinical Trials in the UAE. Clin Pract 2022; 12:885-896. [PMID: 36412672 PMCID: PMC9680222 DOI: 10.3390/clinpract12060093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/24/2022] [Accepted: 11/02/2022] [Indexed: 11/10/2022] Open
Abstract
Cancer research and clinical trials are essential to improve cancer patients' outcomes and advance the oncology field. The United Arab Emirates (UAE) has been lagging in cancer research with many barriers, including healthcare, institutional, regulatory, patient and community, the global oncology community, and the pharmaceutical industry. In this report, we try to address these challenges from our perspective. Making clinical trials accessible for cancer patients in the UAE requires a collaborative approach from all stakeholders and serious consideration for the greater cause to improve the patient's outcome and contribute to the advancement of the cancer field worldwide. There has been significant support from the UAE government and the regulators in the UAE to facilitate and encourage research in general and cancer research in particular with recent initiatives and international collaborations. Private and public institutions must overcome their competitive moods and work together to strengthen the research network across the UAE and improve accrual for potential clinical trials. Public awareness and education must overcome long-standing perceptions about research and clinical trials in the UAE. The pharmaceutical industry must work closely with institutions across the UAE and support them in establishing accredited research programs and clinical trial units. The Emirates Oncology Society is establishing the Oncology Research Working Group to advocate and advance cancer research in the UAE. All stakeholders must be engaged to successfully implement impactful clinical trials in the UAE and the region.
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Kotani Y, Na S, Phua J, Shime N, Kawasaki T, Yasuda H, Jun JH, Kawaguchi A. The research environment of critical care in three Asian countries: A cross-sectional questionnaire survey. Front Med (Lausanne) 2022; 9:975750. [PMID: 36203749 PMCID: PMC9530362 DOI: 10.3389/fmed.2022.975750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/24/2022] [Indexed: 11/13/2022] Open
Abstract
Although inadequate research support for intensivists can be one major reason of the poor research productivity, no study has investigated the current research environment in critical care medicine in Asia. The objective of this study was to describe Asian academia in critical care from the research environment perspective. We conducted a cross-sectional questionnaire survey targeting all physician members of the Societies of Intensive/Critical Care Medicine in Japan, South Korea, and Singapore. We collected the characteristics of the participants and their affiliated institutions and the research environment. The outcome was the number of peer-reviewed publications. Multivariable logistic regression analyses examined the association between the outcome and the following five research environmental factors (i.e., country of the respondents, availability of secured time for research activities or research supporting staff for the hospital, practice at a university-affiliated hospital, and years of clinical practice of 10 years or longer). Four hundred ninety responded (overall response rate: 5.6%) to the survey between June 2019 and January 2020. Fifty-five percent worked for a university-affiliated hospital, while 35% worked for a community hospital. Twenty-four percent had secured time for research within their full-time work hours. The multivariable logistic model found that a secured time for the research activities [odds ratio (OR): 2.77; 95% confidence interval (CI), 1.46-5.24], practicing at a university-affiliated hospital (OR: 2.61; 95% CI, 1.19-5.74), having clinical experience of 10 years or longer (OR:11.2; 95%CI, 1.41-88.5), and working in South Korea (OR: 2.18; 95% CI, 1.09-4.34, Reference: Japan) were significantly associated with higher research productivity. Intensivists in the three countries had limited support for their research work. Dedicated time for research was positively associated with the number of research publications.
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Affiliation(s)
- Yuki Kotani
- Department of Intensive Care Medicine, Kameda Medical Center, Kamogawa, Japan
| | - Sungwon Na
- Department of Anesthesiology and Pain Medicine, Anaesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Jason Phua
- FAST and Chronic Programmes, Alexandra Hospital, National University Health System, Singapore, Singapore
- Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Hospital, National University Health System, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Nobuaki Shime
- Department of Emergency and Critical Care Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University Hospital, Hiroshima, Japan
| | - Tatsuya Kawasaki
- Department of Pediatric Critical Care, Shizuoka Children's Hospital, Shizuoka, Japan
| | - Hideto Yasuda
- Department of Emergency and Critical Care Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Jong Hun Jun
- Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Atsushi Kawaguchi
- School of Medicine, Department of Pediatrics, St. Marianna University, Kawasaki, Japan
- CHU Sainte Justine Research Centre, University of Montreal, CHU Sainte Justine Research Centre, Montreal, QC, Canada
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