Time for a paradigm shift in shared decision-making in trauma and emergency surgery? Results from an international survey

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  • the Team Dynamics Study Group

Background: Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons. Methods: Grounding on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society’s website, and shared on the society’s Twitter profile. Results: A total of 650 trauma and emergency surgeons from 71 countries in five continents participated in the initiative. Less than half of the surgeons understood SDM, and 30% still saw the value in exclusively engaging multidisciplinary provider teams without involving the patient. Several barriers to effectively partnering with the patient in the decision-making process were identified, such as the lack of time and the need to concentrate on making medical teams work smoothly. Discussion: Our investigation underlines how only a minority of trauma and emergency surgeons understand SDM, and perhaps, the value of SDM is not fully accepted in trauma and emergency situations. The inclusion of SDM practices in clinical guidelines may represent the most feasible and advocated solutions.

OriginalsprogEngelsk
Artikelnummer14
TidsskriftWorld Journal of Emergency Surgery
Vol/bind18
Udgave nummer1
ISSN1749-7922
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
Please see the list of the Team Dynamics Study Group members. Recayi Aapoaylu, Sakarya University Training and Research Hospital General surgery Sakarya, Turkey. Kenneth Lyle Abbott, Department of Surgery, University of Florida Gainesville, United States. Abubaker Abdelmalik, General Surgery Dept., Misrata Medical Center, Misrata, Libya. Nebyou Seyoum Abebe, Department of surgery college of health sciences, Addis Ababa University, Addis Ababa, Ethiopia. Fikri Abu-Zidan, Research Office, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates. Yousif Abdallah Yousif Adam, Tullamore, Ireland. Harissou, Adamou, Department of Surgery, Université de Zinder Faculté des sciences de la Santé, Hãpital National de Zinder, Zinder, Niger. Dmitry Mikhailovich Adamovich, Department of Surgical Diseases II, Senior Lecturer at Gomel State Medical University, Gomel, Belarus. Ferdinando Agresta, Dept. of General Surgery, AULSS2 Trevigiana del Veneto, Vittorio Veneto (TV), Italy. Antonino Agrusa, Department of Surgical, Oncological and Oral Sciences—University of Palermo, Palermo, Italy. Emrah Akin, Sakarya University Faculty of Medicine, Sakarya, Turkey. Mario Alessiani, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia—Department of Surgery, ASST Pavia, Pavia, Italy. Henrique Alexandrino, Faculty of Medicine, University of Coimbra, Coimbra, Portugal. Syed Muhammad Ali, Acute Care Surgery, Hamad Medical Corporation, Doha, Qatar. Department of Acute Care Surgery, Hamad Medical Corporation, Doha, Qatar. Vasilescu, Alin Mihai, Grigore T Popa University of Medicine and Pharmacy, Iasi Romania, First Surgical Clinic, St Spiridon University Hospital, Iasi, Romania. Pedro Miguel Almeida, Centro Hospitalar e Universitario do Algarve—Hospital de Portimao, Portimão, Portugal. Mohammed Mohammed Al-Shehari, Sana’a University—College of Medicine, Sana’a, Yemen. Michele Altomare, Sapienza University of Rome, Rome, Italy. Francesco Amico, Dept. of Trauma at John Hunter Hospital, School of Medicine and Public Health at University of Newcastle, Newcastle NSW, Australia. Michele Ammendola, Health of Science Department, “Magna Graecia” University Medical School, Digestive Surgery Unit, “Mater Domini” Hospital, Catanzaro, Italy. Jacopo Andreuccetti, General Surgery 2, ASST Spedali Civili of Brescia, Brescia, Italy. Elissavet Anestiadou, 4th Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece. Alfredo Annicchiarico, Universitã di Parma, Italy. Amedeo Antonelli, Universitã degli studi di Roma Tor Vergata, Rome, Italy. Daniel Aparicio-Sanchez, Emergency Surgery Unit (Virgen del Rocío Hospital), Sevilla, Spain. Antonella Ardito, Departmento of General Surgery Asst-fbf-sacco, Milan, Italy. Giulio Argenio, UOC Chirurgia Generale ed Oncologica, AO San Pio, Benevento, Italy. Catherine Claude Arvieux, Grenoble-Alpes University Hospital, Grenoble, France. Catherine Arvieux, CHU et Université Grenobles Alpes, Grenoble, France. Ingolf Harald Askevold, Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Giessen, Germany. Boyko Tchavdarov Atanasov, Umhat Eurohospital, Medical University Plovdiv, Plovdiv, Bulgaria. Goran Augustin, University Hospital Centre Zagreb, Zagreb, Croatia. Selmy Sabry Awad, Department of General surgery-Mansoura Faculty of Medicine, Mansoura, Egypt. Giulia Bacchiocchi, Department of Surgical Science, University of Rome Tor Vergata, Rome, Italy. Carlo Bagnoli, Department of Management, Ca’ Foscari University of Venice, Venice, Italy. Hany Bahouth, Trauma center, Rambam medical center, Haifa, Israel, Israel. Efstratia Baili, UGI Surgery- Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom. Lovenish Bains, Department of Surgery, Maulana Azad Medical College, New Delhi, India, India. Gian Luca Baiocchi, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy. Miklosh Bala, Department of General Surgery, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel, Jerusalem, Israel. Carmen Balagué, Digestive Surgery. Hospital Universitari Mutua Terrassa, Terrassa, Spain. Dimitrios, Balalis, Surgery, Saint Savvas Cancer Hospital, Halandri—Athens, Greece. Edoardo, Baldini, Unitã Operativa Complessa di Chirurgia—Ospedale Santa Maria delle Stelle, Melzo (Milano), Italy. oussama, Baraket, Département of general surgery. Bizerte hospital.faculty of Médecine of Tunis University Tunis El Manar, Bizerte, Tunisia. Suman, Baral, Department of Surgery, Dirghayu Pokhara Hospital, Pokhara, Nepal. Mirko, Barone, Department of General and Thoracic Surgery, "SS. Annunziata" University Hospital of Chieti, Chieti, Italy. Alberto Gonzãlez Barranquero, General and Digestive Surgery Department, Ramãn y Cajal University Hospital, Madrid, Spain. Jorge Arturo Barreras, Secretaria de Salud, Hermosillo, Mexico. Gary Alan Bass, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, United States. Zulfu Bayhan, Sakarya University, Faculty of Medicine, Department of General Surgery, Sakarya, Turkey. Giovanni Bellanova, UOC Chirurgia Generale PO D. Camberlingo Francavilla Fontana, Francavilla Fontana (BR), Italy. Offir Ben-Ishay, Department of General Surgery, Rambam health Care Campus, Haifa Israel. Fabrizio Bert, University of Turin, Turin, Italy. Valentina Bianchi, Chirurgia d’Urgenza e del Trauma, Fondazione Policlinico Gemelli IRCCS, Roma, Italy. Helena Biancuzzi, Ipazia Observatory on Gender Research, Rome, Italy. Raluca Bievel Radulescu, Banca degli occhi, Mestre, Italy. Mark Brian Bignell, Surgical Emergency Unit, Oxford University NHS Trust, Oxford, United Kingdom. Alan Biloslavo, General Surgery Department, Cattinara University Hospital. ASUGI, Trieste, Trieste, Italy. Roberto Bini, Emergency Department Niguarda Hospital, Milano, Italy. Daniele Bissacco, Vascular Surgery Department IRCCS Ca Granda Ospedale Maggiore Policlinico, Milan, Italy. Paoll Boati, Asst Santi Paolo Carlo Milano, Milano, Italy. Guillaume Boddaert, Thoracic and Vascular surgery Department—Percy Military Hospital, Clamart, France. Branko Bogdanic, School of Medicine University of Zagreb, Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia. Cristina Bombardini, University Hospital of Ferrara, Surgical Department, Colorectal Unit, Ferrara, Italy. Luigi Bonavina, University of Milan, Department of Biomedical Sciences for Health, IRCCS Policlinico San Donato, Division of General Surgery, Milano (Italy), Italy. Luca Bonomo, Department of General Surgery University Hospitals Dorset, Poole, United Kingdom. Andrea Bottari, Digestive Surgery Unit, AOU Careggi, Firenze, Italy. Konstantinos Bouliaris, General Surgery Department, Koutlimbaneio & Triantafylleio General Hospital of Larissa, Larissa, Greece. Gioia Brachini, Dept of Surgery P. Valdoni—sapienza University, Rome, Italy. Antonio Brillantino, Department of Surgery, “A. Cardarelli” Hospital, Naples, Italy, Napoli, Italy. Giuseppe Brisinda, Department of Surgery, Fondazione Policlinico Universitario A Gemelli, IRCCS, Roma, Italy. Maloni Mamada Bulanauca, Labasa Hospital Fiji, Labasa, Fiji. Luis Antonio Buonomo, Hopital “Dr. Alberto Balestrini.” University of Buenos Aires, Buenos Aires, Argentina. Jakob Burcharth, Department of Gastrointestinal and Hepatic Diseases, Copenhagen University Hospitals Herlev and Gentofte; Emergency Surgery Research Group Copenhagen (EMERGE), Herlev, Denmark. Salvatore Buscemi, Department of Surgical, Oncological and Oral Science, Policlinico “P.Giaccone” Palermo, Italy. Francesca, Calabretto, University of Pavia, Corso Str. Nuova, 65, 27100, Pavia, Italy; Unit of General Surgery I, Fondazione I.R.C.C.S. Policlinico San Matteo, Viale Camillo Golgi, 19, 27100, Pavia, Italy. Giacomo Calini, University of Udine, Udine, Italy. Valentin Calu, Elias Emergency University Hospital, Department of Surgery, Bucharest, Romania. Fabio Cesare Campanile, Ospedale San Giovanni Decollato—Andosilla, Civita Castellana, Italy. Riccardo Campo Dall’Orto, Vascular Surgery, University of Padua, Padua, Italy. Andrea Campos-Serra, Department of Surgery, Parc Tauli University Hospital, Sabadell, Spain. Joao Miguel Carvas, Servicao de Cirurgia Geral, Hospital de Bragansa, Bragança, Portugal. Marco, Cascella, IRCCS Pascale, Naples, Italy. Gianmaria Casoni Pattacini, Chirurgia Generale, d’urgenza e Nuove Tecnologie, Ospedale Civile di Baggiovara, Modena, Italy. Valerio, Celentano, Chelsea and Westminster Hospital, London, United Kingdom. Danilo, Corrado, Centonze, Unitã operativa complessa chirurgia generale ospedale Umberto I di Enna, Enna, Italy. Marco Ceresoli, General and Emergency Surgery, Milano-Bicocca University, School of Medicine and Surgery, Monza, Italy. Dimitrios Chatzipetris, Department of Surgery, Metaxa Cancer Hospital, Piraeus, Greece. Antonella, Chessa, Chirurgia Generale uslsudesttoscana, Orbetello Grosseto, Italy. Maria Michela, Chiarello, Asp Cosenza, Cosenza, Italy. Mircea, Chirica, service de chirurgie digestive, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France. Serge, Chooklin, Department of Surgery, Lviv Regional Clinical Hospital, Lviv, Ukraine. Christos, Chouliaras, Athens Medical Center, Athens, Greece. Sharfuddin, Chowdhury, Trauma Center, King Saud Medical City, Riyadh, Saudi Arabia. Pasquale, Cianci, University of Foggia-ASL BAT, Andria, Italy. Nicola, Cillara, UOC Chirurgia Generale ASL8 Cagliari, Cagliari, Italy. Stefania Cimbanassi, Acute Care Surgery and Trauma-ASST GOM Niguarda, Milano, Italy. Stefano, Piero Bernardo, Cioffi, General Surgery Trauma Team ASST GOM NIGUARDA MILAN, ITALY, Milano, Italy. Enrique, Colãis-Ruiz, General Surgery. Hospital Universitario Son Llatzer, Palma de Mallorca, Spain. Elif, Colak, University of Samsun, Samsun Training and Research Hospital, Department of General Surgery, Samsun, Turkey. Luigi Conti, Department of Surgery, Acute care surgery Unit, G. Da Saliceto hospital, Piacenza, Italy. Alessandro, Coppola, General Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, General Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Italy. Tiago, Correia de Sa, General Surgery Department, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal. Silvia, Dantas, Costa, General Surgery, CHVNG/E,EPE, V.N. Gaia, Portugal. Valerio, Cozza, Chirurgia d’urgenza e del trauma, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy. Giuseppe, Curro’, Health Science Department, Magna Graecia University of Catanzaro, Catanzaro, Italy. Kirsten, Felicia Ann-Sophie Aimee, Dabekaussen, Department of Surgery, Spaarne Gasthuis, Haarlem, Netherlands. Fabrizio, D’ACAPITO, General and Oncologic Surgery, Morgagni—Pierantoni Hospital, AUSL Romagna, Forlì, Italy. Dimitrios, Damaskos, Department of General Surgery, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom. Giancarlo, D’Ambrosio, Department of General Surgery. University Sapienza, Rome, Italy. Koray, Das, University of Health Science Adana City Training and Research Hospital. General Surgery, Adana, Turkey. Richard, Justin, Davies, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom. Andrew, Charles, de Beaux, Royal Infirmary of Edinburgh, Department of General Surgery and Motol University Hospital, 3rd department of Surgery, Edinburgh, United Kingdom. Sara Patricia, De Lebrusant Fernandez, General and Digestive Surgery. Hospital Universitario de Jerez de la Frontera, Sevilla, Spain. Alessandro, De Luca, General Surgery Unit, Molfetta Hospital, Molfetta, Italy. Belinda, De Simone, Department of emergency, digestive And metabolic minimally invasive surgery, Poissy And Saint Germain en Laye Hospitals, Poissy, France, Poissy, France. Francesca, De Stefano, General surgery I, San Matteo Hospital, University of Pavia, Pavia, Italy. Luca, Degrate, San Gerardo Hospital, Monza, Italy. Zaza, Demetrashvili, Surgery Department, Tbilisi State Medical University, Georgia. Andreas, Kyriacou, Demetriades, Department of Neurosurgery, Royal Infirmary Edinburgh, Edinburgh, United Kingdom. Dzemail, Smail, Detanac, Department of general surgery, General hospital Novi Pazar, Novi Pazar, Serbia and Montenegro. Agnese, Dezi, Department of Emergency and Organ Transplantation (DETO), University of Bari, Italy, Bari, Italy. Giuseppe, Di Buono, Department of surgical, oncological and orale sciences—university of Palermo, Palermo, Italy. Isidoro Di Carlo, University of Catania, Catania, Italy. Pierpaolo Di Lascio, AOR San Carlo—Potenza—UOC Chirurgia Generale e Urgenza, Potenza, Italy. Marcello Di Martino, AORN Cardarelli, Italia (IT), Italy. Salomone, Di Saverio, Dept of General Surgery, San benedetto del tronto Hospital, AV5, ASUR marche, San benedetto del tronto, Italy. Bogdan Diaconescu, Carol Davila University of Medicine and Pharmacy Bucharest, Emergency Hospital of Bucharest Romania, Bucharest, Romania. Jose J. Diaz, R Adams Cowley Shock Trauma, University of Maryland Medical Center, Baltimore, United States. Rigers Dibra, Department of Emergency and Organ Transplant (DETO), University “Aldo Moro” Medical School of Bari, Bari, Italy. Evgeni Nikolaev Dimitrov, Department of Surgical Diseases, University Hospital “Prof. Dr. Stoyan Kirkovich,” Stara Zagora, Bulgaria. Vincenza, Paola, Dinuzzi, Operative Unit of General Surgery Magenta Hospital, Milan, Italy, Magenta, Italy. Sandra, Dios-Barbeito, University Hospital Virgen del Rocio, Seville, Spain. Jehangir Farman Ali, Diyani, Sindh Institute of Urology and Transplant, Karachi, Pakistan. Agron Dogjani, Department of Surgery, University of Medicine, Tirana, Albania. Maurizio, Domanin, Department of logo Clinical Sciences and Community Health, University of Milan, Italy. Mario, D’Oria, Division of Vascular and Endovascular Surgery, Cardiovascular Department, University Hospital of Trieste ASUGI, Italy, Trieste, Italy. Virginia, Duran Munoz-Cruzado, Department of General Surgery, Virgen del Rocao University Hospital, Seville, Spain. Barbora, East, 3rd Department of Surgery, 1st Medical Faculty of Charles University, Motol University Hospital, Prague, Czech Republic. Mikael, Ekelund, Department of Surgery, Skane University Hospital, Lund & Malmö, Sweden. Gerald Takem Ekwen, Surgery Lead. PIH Liberia, Harper, Liberia. Adel Hamed Elbaih, Associate Professor of Emergency Medicine, Faculty of Medicine, Suez Canal University, Ismailia, Egypt. Muhammed Elhadi, Tripoli University Hospital, Tripoli, Libya. Natalie Enninghorst, University of Newcastle, Department of Traumatology John Hunter Hospital, Newcastle, Australia. Mairam Ernisova, Department of Hospital Surgery with the Course of Operative Surgery of KSMA named after I.K. Akhunbaeva, Bishkek, Kyrgyzstan. Juan Pablo, Escalera-Antezana, Emergency/Surgery department—Hospital Viedma, Cochabamba, Bolivia. Sofia Esposito, General, Emergency Surgery and New Technologies, Baggiovara General Hospital, Modena, Italy. Giuseppe Esposito, ARNAS Brotzu, Cagliari, Italy. Mercedes Estaire-Gãmez, Hospital Universitario Severo Ochoa Leganés, Madrid, Spain. Camilla Nikita Farã, Universitã degli studi di Pavia, Pavia, Italy. Roser Farre, General Surgeon. Fundacia Althaia, Manresa, Spain. Francesco Favi, UOC Chirurgia Generale e d’Urgenza Ospedale M. Bufalini Cesena AUSL della Romagna, Cesena, Italy. Luca Ferrario, General Surgery and Trauma Team, ASST Niguarda, Milan, Italy. Antonjacopo Ferrario di Tor Vajana, Swiss Surgical Practice, Lugano, Switzerland. Claudia Filisetti, Pediatric Surgery Department, Vittore Buzzi Children’s Hospital of Milan, Milan, Italy. Francesco Fleres, Department of Human Pathology of the Adult and Evolutive Age “Gaetano Barresi,” General and Emergency Surgery Unit, University of Messina, Messina 98125, Italy, Messina, Italy. Vinicius Cordeiro Fonseca, Acute Care Surgery Service of Hospital Vivalle, São José dos Campos, Brazil. Alexander Forero-Torres, General Surgery. La Paz University Hospital, Madrid, Spain. Francesco Forfori, Università di Pisa, Pisa, Italy. Laura Fortuna, AOU Careggi, Firenze, Italy. Evangelos Fradelos, General Surgery Department, Saint Savvas Anticancer Hospital of Athens, Athens, Greece. Gustavo, P., Fraga, Division of Trauma Surgery, University of Campinas, Campinas, Brazil. Pietro, Fransvea, Chirurgia d’urgenza e del trauma. Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy. Simone, Frassini, General Surgery I Unit, Fondazione IRCCS Policlinico San Matteo, Universita di Pavia, Pavia, Italy. Giuseppe, Frazzetta, Chirurgia oncologica ARNAS civico Palermo, Palermo, Italy. Isabella, Frigerio, HPB Unit, Pederzoli Hospital, 37019 Peschiera del Garda, Italy. Maximos, Frountzas, First Propaedeutic Department of Surgery, Medical School of Athens, National and Kapodistrian University of Athens, Hippocration General Hospital of Athens, Athens, Greece. Mahir, Gachabayov, Department of Abdominal Surgery, Vladimir City Emergency Hospital, Vladimir, Russia. Rita, Galeiras, Critical Care Unit, A Coruña, Spain. Belen, MatÃas, GarcÃa, General Surgery of Princpe de Asturias Teaching, Alcalá de Henares, Spain. Alain, A., Garcia Vazquez, IHU Strasbourg, Strasbourg, France. Simone, Gargarella, Department of Medical Science, Oral and Biotechnology of University of Chieti-Pescara “G.D’Annunzio,” Chieti, Italy. Ibrahim Umar, Garzali, Department of Surgery, Aminu Kano Teaching Hospital, Nigeria., Kano, Nigeria. Wagih, Mommtaz, Ghannam, Mansoura faculty of medicine, Mansoura, Egypt. Faiz Najmuddin, Ghazi, Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia, Kota Bharu, Malaysia. Lawrence, Marshall, Gillman, Department of surgery university of Manitoba, Winnipeg, Canada. Rossella, Gioco, Department of General Surgery Policlinico G.Rodolico, Catania, Italy. Alessio, Giordano, Department of Surgery, General Surgery Unit, S.Stefano Hospital, Prato, Italy. Luca, Giordano, Department Valdoni; “La Sapienza” University of Rome, Roma, Italy. Carlo, Giove, Università degli studi di Bari, Bari, Italy. Giorgio, Giraudo, Department of Surgery, AO Santa Croce e Carle, Cuneo, Italy. Mario, Giuffrida, General Surgery Unit-Parma University Hospital, Parma, Italy. Michela, Giulii Capponi, UOC Chirurgia Generale e d’Urgenza, Ospedale Santo Spirito in Sassia, Roma, Italy. Emanuel, Gois Jr., Department of Surgery, State University of Londrina, Londrina, Brazil. Carlos, Augusto, Gomes, Universidade Federal de Juiz de Fora, Minas Gerais, Juiz de Fora, Brazil. Felipe, Couto, Gomes, Surgery Unit, Faculdade Ciências Médicas e da Saúde de Juiz de Fora (SUPREMA), MG, Brazil. Ricardo Alessandro, Teixeira, Gonsaga, Centro Universitario Padre Albino, Catanduva—SP, Brazil. Emre, Gonullu, Sakarya university training and research hospital, Sakarya, Turkey. Jacques, Goosen, Department of Surgery, University of Witwatersrand, Johannesburg, South Africa. Tatjana, Goranovic, University Department of Anaesthesiology, Resuscitation and Intensive Care Medicine, Sveti Duh University Hospital, Zagreb, Croatia. Raquel, Gracia-Roman, General surgery, Hospital Universitari Parc Tauli, Sabadell, Spain. Giorgio, Maria Paolo, Graziano, Dipartimento di Scienze Clinico-Chirurgiche, Diagnostiche e Pediatriche, Università degli studi di Pavia, Pavia, Italy. Ewen, Alexander, Griffiths, Department of Upper GI Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom. Tommaso, Guagni, Emergency surgery department, Careggi University Hospital, Florence, Italy. Dimitar, Bozhidarov, Hadzhiev, UMHAT “St. George”- First Clinic of Surgery, MU-Plovdiv- Prop. of Surgical Diseases, Plovdiv, Bulgaria. Muad, Gamil, Haidar, AlGamhoria teaching hospital and AlNaqib hospital, Aden, Yemen. Hytham, K. S., Hamid, Department of Surgery, Kuwaiti Specialized Hospital, Khartoum, Sudan. Timothy, Craig, Hardcastle, Dept of Surgery, Nelson R Mandela School of Clinical Medicine, UKZN and Inkosi Albert Luthuli Central Hospital, Trauma and Burns Service, Durban, South Africa. Firdaus, Hayati, Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia, Kota Kinabalu, Malaysia. Andrew, James, Healey, General Surgery, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom. Andreas, Hecker, Dept. of General & Thoracic Surgery, University Hospital of Giessen, Giessen, Germany. Matthias, Hecker, University Hospital Giessen, Germany. Edgar, Fernando, Hernandez Garcia, Cirugia de trauma, Hospital Central militar, Ciudad de México, Mexico. adrien, Montcho, hodonou, général surgery, CHUD, Université of Parakou, Parakou, Benin. eduardo, cancio, huaman, Hospital Almenara—Lima, Lima, Peru. Martin, Huerta, General and Digestive Surgery Unit, Hospital Universitari Vall d’Hebron, Barcelona, Spain, Barcelona, Spain. AINI, FAHRIZA, IBRAHIM, DEPARTMENT OF SURGERY, UNIVERSITI MALAYSIA SARAWAK, KUCHING, Malaysia. Basil, Mohamed Salabeldin, Ibrahim, Manchester Foundation Trust, Manchester, United Kingdom. Giuseppe, Ietto, University of Insubria, Varese, Italy. Marco, Inama, General Surgery Department—Pederzoli Hospital, Peschiera del Garda, Italy. Orestis, Ioannidis, 4th Department of Surgery, Medical School, Aristotle University of Thessaloniki, General Hospital “George Papanikolaou,” Thessaloniki, Greece, Thessaloniki, Greece. Arda, Isik, General Surgery, Istanbul Medeniyet University, Istanbul, Turkey. Nizar, Ismail, Trauma and Orthopaedics Department, Royal Cornwall Hospital, Truro, United Kingdom. Azzain, Mahadi Hamid, Ismail, Queen Elizabeth Hospital-Birmingham, Department of Trauma&Orthopaedics, Birmingham, United Kingdom. RUHI, FADZLYANA, JAILANI, Surgical Unit, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Negeri Sembilan, Malaysia. Ji Young, Jang, Department of Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea, South. Christos, Kalfountzos, General Hospital of Larissa “Koutlimpaneio and Triantafylleio,” Larissa, Greece. Sujala, Niatarika Rajsain, Kalipershad, Department of Surgery, Tameside General Hospital, Manchester, United Kingdom. Emmanouil, Kaouras, Department of Surgery, Metaxa Cancer Hospital, Piraeus, Greece. Lewis, Jay, Kaplan, University of Pennsylvania; Department of Surgery; Division of Trauma, Surgical Critical Care and Emergency Surgery, Philadelphia, United States. Yasin, Kara, Health Sciences University, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey. Evika, Karamagioli, School of Medicine, National and Kapodistrian University of Athens, Greece, NKUA, Filothei, Greece. Aleksandar, Karamarkovia, Surgical Clinic “Nikola Spasia,” Faculty of Medicine University of Belgrade, Belgrade, Serbia and Montenegro. Ioannis, Katsaros, Department of Surgery, Metaxa Cancer Hospital, Piraeus, Greece. Alfie, J, Kavalakat, Department of General Surgery,. Jubilee Mission Medical College & RI, Thrissur, India. Aristotelis, Kechagias, Department of General and Digestive Surgery, Kanta-Häme Central Hospital, Hämeenlinna, Finland. Jakub, Kenig, Department of General, Gastrointestinal, Oncologic Surgery and Transplantology, Krakow, Poland. Boris, Juli, Kessel, Hillel Yaffe Medical Center, Hadera, Israel. Jim, S, Khan, Portsmouth Hospitals University NHS trust, Portsmouth, United Kingdom. Vladimir, Khokha, Head surgeon, City Hospital, Mozyr, Belarus. Jae Il, Kim, Department of Surgery, Inje University Ilsan Paik Hospital, Goyang, Korea, South. Andrew, Wallace, Kirkpatrick, Departments of Surgery and Critical Care and the TeleMentored Ultrasound Supported Medical Interventions (TMUSMI) Research Group, Calgary, Canada. Roberto, Klappenbach, Fundación Trauma, Ciudad AutÃ3noma de Buenos Aires, Argentina. Yoshiro, Kobe, Fujita Health University Hospital, Toyoake, Japan. Efstratios, Kofopoulos Lymperis, Attikon hospital department of general surgery, Athens, Greece. Kenneth, Yuh Yen, Kok, Pengiran Anak Puteri Rashidah Saadatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei. VICTOR, KONG, Department of Surgery, University of KwaZulu Natal, Durban, South Africa. Dimitris, P, Korkolis, Department of Surgical Oncology Hellenic Anticancer Hospital “Saint Savvas,” Athens, Greece. Georgios, Koukoulis, General Surgery, General Hospital of Larissa, Larissa, Greece. Bojan, Kovacevic, UMC Zvezdara, Clinic for Surgery, Belgrade, Serbia and Montenegro. Vitor, Favali, Kruger, Department of trauma surgery—University of Campinas, Campinas, Brazil. Igor, A., Kryvoruchko, Kharkiv National Medical University, Department of Surgery No. 2, Kharkiv, Ukraine. Hayato, Kurihara, Emergency Surgery and Trauma Unit, IRCCS Humanitas Research Hospital, Rozzano, Italy. Akira, Kuriyama, Emergency and Critical Care Center, Kurashiki Central Hospital, Kurashiki, Japan. Aitor, Landaluce-Olavarria, Surgery department. Urduliz Hospital, Urduliz, Spain. Pierfrancesco, Lapolla, Department of Surgery “Pietro Valdoni,” Sapienza University of Rome, Rome, Italy. Leo, Licari, Department of Surgery. Buccheri La Ferla Hospital—Palermo, Palermo, Italy. Giorgio, Lisi, Department of Surgery, Sant’Eugenio Hospital, Rome, Italy. Andrey, Litvin, Department of Surgical Disciplines, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kaliningrad, Russia. Aintzane, Lizarazu, General Surgery, Hospital Universitario Donostia, Donostia, Spain. Heura, Llaquet Bayo, General Surgery. Corporación Sanitaria Parc Taulí, Sabadell, Spain. Varut, Lohsiriwat, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. Claudia, Cristina, Lopes Moreira, Donostia University Hospital, San Sebastian, Spain. Eftychios, Lostoridis, Department of Surgery, Kavala General Hospital, Kavala, Greece. Agustãn Tovar Luna, Surgery Department, Mexico City, Mexico. Davide, Luppi, General And Emergency Surgery—ASMN IRCCS Reggio Emilia, Reggio Emilia, Italy. Gustavo, Miguel, Machain V., Universidad Nacional de Asuncion, ASUNCIÓN, Paraguay. Marc, Maegele, Department of Trauma and Orthopedic Surgery, Insitute for Research in Operative Medicine (IFOM), Cologne-Merheim Medical Center (CMMC), University Witten/Herdecke, Cologne, Germany. Daniele, Maggiore, Nouvelle Clinique Vert Pré, Geneve, Switzerland. Stefano, Magnone, General Surgery ASST Papa Giovanni XXIII, Bergamo, Italy. Ronald, V, Maier, Surgery, Harborview Medical Center, University of Washington, Seatlle, WA, United States. Ronald, v, Maier, Department of Surgery, Harborview Medical Center, University of Washington, Seattle, United States. Piotr, Major, Jagiellonian University Medical College, KrakÃ3w, Poland. 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Mukhammad David, Naimzada, Laboratory of Public Health Indicators Analysis and Health Digitalization, Moscow Institute of Physics and Technology, Dolgoprudniy, Russia. Pradeep, H, Navsaria, Trauma Center, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa. Ionut, Negoi, Carol Davila University of Medicine and Pharmacy Bucharest, Emergency Hospital of Bucharest Romania, Bucharest, Romania. Luca, Nespoli, Dipartimento di Medicina e Chirurgia Università di Milano Bicocca, Italy. Christine, Nguyen, Rocky Vista University, Parker, USA. Melkamu, Kibret, Nidaw, General surgery and Pawi General Hospital, Pawi, Ethiopia. Giuseppe, Nigri, Department of Medical and Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy. Ioannis, Nikolopoulos, Lewisham & Greenwich NHS Trust, London, United Kingdom. Donal, Brendan, O’Connor, Department of Surgery Trinity College Dublin, Dublin, Ireland. 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Leonardo, Pagani, Antimicrobial Stewardship Program; Bolzano Central Hospital, Bolzano, Italy. Giuseppe, Palomba, Department of clinical medicine and surgery, university of Naples, Federico II, Naples, Italy. Desire’, Pantalone, Dept of Experimental and Clinical Medicine -University of Florence, Careggi University Hospital Florence, Italy, Florence, Italy. Arpad, Panyko, 4th Department of Surgery, University Hospital Bratislava, Bratislava, Slovakia. Ciro, Paolillo, Emergency Department ATTS Spedali Civili di Brescia, Brescia, Italy. Mario Virgilio, Papa, Department of Medical and Surgical Sciences, University of Padova, Padova, Italy. Dimitrios, Papaconstantinou, Third Department of Surgery, Athens, Greece. Maria, Papadoliopoulou, Fourth Department of surgery,Attikon University Hospital, Athens, Greece. Aristeidis, Papadopoulos, 1st Surgical Department, General Hospital of Nikaia, Nikaia, Greece. Davide, Papis, General Surgery, Sant’Anna Hospital, Como, Italy. 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Maria, Pelloni, General and Digestive Surgery- University Hospital of Gran Canaria Dr Negrín, Las Palmas de Gran Canaria, Spain. Andrea, Peloso, Divisions of Transplantation and Visceral Surgery, Department of Surgery, University of Geneva, Geneva, Switzerland. Eduardo, Perea del Pozo, General Surgery Emergency and Trauma Surgery, Seville, Spain. Rita, Goncalves, Pereira, Centro Hospitalar Barreiro Montijo, EPE, Barreiro, Portugal. Bruno, Monteiro, Pereira, Grupo Surgical, Campinas, Brazil. Aintzane, Lizarazu, perez, General surgery, Hospital Universitario Donostia, Donostia, Spain. Teresa, Perra, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy. Gennaro, Perrone, Depeartment of emergency surgery, Parma University Hospital, Parma, Italy. Antonio, Pesce, Delta Hospital, Azienda USL of Ferrara, Department of Surgery, University of Ferrara, Ferrara, Italy. Lorenzo, Petagna, General Surgery Residency Program, Tor Vergata University Rome, Rome, Italy. Giovanni, PETRACCA, Azienda Sanitaria Provinciale di Vibo Valentia, Vibo Valentia, Italy. Vorapong, Phupong, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. Biagio, Picardi, San Filippo Neri Hospital, ASL Roma 1, Roma, Italy. Arcangelo, Picciariello, Department of Emergency and Organ Transplantation, University Aldo Moro of Bari, Bari, Italy. Micaela, Piccoli, General surgery and emergency unit. Department of Surgery. AOU (azienda ospedaliero universitaria) of Modena, Modena, Italy. Daniele, Piccolo, Neurosurgery Department, University of Padua, Padua, Italy. Edoardo, Picetti, Department of Anesthesia and Intensive Care, Parma University Hospital, Parma, Italy. Emmanouil Pikoulis, Pikoulis, School of Medicine, National and Kapodistrian University of Athens (NKUA), Athens, Greece. Tadeja, Pintar, Abdominal Surgery Dep., UMC Ljubljana and Medical Faculty Ljubljana, Ljubljana, Slovenia. Giovanni, Pirozzolo, Emergency and General Surgery—Ospedale dell’Angelo—ULSS3 Serenissima, Venezia, Italy. Francesco, Piscioneri, Calvary Public Hospital, Canberra, Australia. Mauro, Podda, Department of Emergency Surgery, Cagliari University Hospital, Cagliari, Italy. Alberto, Porcu, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy. Francesca, Privitera, General Surgery, Ospedale Policlinico-Vittorio Emanuele, Catania, Italy. Clelia, Punzo, Department of Emergency and Organ Transplant (DETO), University “Aldo Moro” Medical School of Bari, Bari, Italy. Silvia, Quaresima, Sapienza University of Rome, department of General Surgery and surgical specialties Paride Stefanini, Rome, Italy. Martha, Alexa, Quiodettis, Trauma Surgery, Hospital Santo Tomas, Panama, Panama. Niels, Qvist, Research Unit fo Surgery, Odense University Hospital; Southern University of Denmark, Odense, Denmark. Razrim, Rahim, Universiti Sains Islam Malaysia, Nilai, Malaysia. Filipe, Ramalho de Almeida, Serviço de Cirurgia, Hospital Prof Doutor Fernando Fonseca, Amadora, Portugal. Rosnelifaizur, Bin, Ramely, Surgical Department, Universiti Sains Malaysia and Hospital USM, Kubang Kerian, Malaysia. Huseyin, Kemal, Rasa, Anadolu Medical Center, Kocaeli, Turkey. Martin, Reichert, Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Giessen, Germany. Alexander, Reinisch-Liese, Dep. of General, Visceral and Oncologic Surgery, Hospital and Clinics Wetzlar, Germany, Wetzlar, Germany. Angela, Renne, Division of Trauma, Emergency Surgery, and Surgical Critical Care, Boston, United States. Camilla, Riccetti, University of Rome Tor Vergata, Roma, Italy. Maria, Rita, Rodriguez-Luna, Surgical Research Fellow. Research Institute Against Digestive Cancer, IRCAD, Strasbourg, France, Strasbourg, France. Daniel, Roizblatt, Hospital del Trabajador, Surgery Department, Santiago, Chile. Andrea, Romanzi, Department of General Surgery, Valduce Hospital, Como, Italy. Luigi, Romeo, UO Chirurgia Generale, Ospedale Ceccarini, Riccione, Italy. Francesco, Pietro Maria, Roscio, General Surgery, ASST Valle Olona, Busto Arsizio, Italy. Ramely, Bin, Rosnelifaizur, Department of Surgery Universiti Sains Malaysia, Kota Bharu, Malaysia. Stefano, Rossi, Department of General and Emergency Surgery, San Filippo Neri Hospital, Rome, Italy, Roma, Italy. Andres M, Rubiano, Neuroscience Institute, Universidad El Bosque, Cali, Colombia. Elena, Ruiz-Úcar, Endocrine and Bariatric-Metabolic Surgery Department, Fuenlabrada Universitary Hospital, Madrid, Spain. Boris, Evgeniev, Sakakushev, Research Institute at Medical Institute Plovdiv, General Surgery Department, Plovdiv, 4000, Bulgaria. Juan, Carlos, Salamea, Hospital Vicente Corral Moscoso, Universidad del Azuay, Cuenca, Ecuador. Ibrahima, Sall, Department of visceral surgery. Military teaching hospital., Dakar, Senegal. Lasitha, Bhagya, Samarakoon, Consultant General surgeon ,University hospitals, Leicester, United Kingdom. Fabrizio, Sammartano, Trauma Team, San Carlo Borromeo Trauma Center, ASST Santi Paolo e Carlo, Milan, Italy. Alejandro, Sanchez Arteaga, Hospital Universitario Virgen del Rocío, Sevilla, Spain. Sergi, Sanchez-Cordero, Consorci Sanitari Integral—Hospital Moises Broggi Sant Joan DespÃ, Sant Joan DespÃ, Spain. Domenico, Pietro Maria, Santoanastaso, Cesena Hospital, Cesena, Italy. Diego, Sasia, General and Oncological Surgery Unit, Santa Croce and Carle Hospital, Cuneo, Cuneo, Italy. NORIO, SATO, Ehime University Department of Emergency and Critical Care, TOON, Japan. Artem, Savchuk, Surgery Department, Putyla District Hospital, Putyla, Ukraine. Robert, Grant, Sawyer, Western michigan University Homer Stryker MD School of Medicine, Kalamazoo, United States. Giacomo, Scaioli, University of Turin, Turin, Italy. DIMITRIOS, SCHIZAS, FIRST DEPARTMENT OF SURGERY, NATIONAL AND KAPODISTRIAN UNIVERSITY OF ATHENS, ATHENS, Greece. Simone, Sebastiani, AOUI Verona Chirurgia Generale E dell’Esofago e dello Stomaco, Verona, Italy. Barbara, Seeliger, IHU-Strasbourg, Institute of Image-Guided Surgery / Strasbourg University Hospitals, Department of General, Digestive and Endocrine Surgery, Strasbourg, France. Helmut, Alfredo, Segovia Lohse, II Cátedra de ClÃnica Quirúrgica, Hospital de Clinicas. Universidad Nacional de AsunciÃ3n, San Lorenzo, Paraguay. Charalampos, Seretis, Agios Andreas General Hospital of Patras, Patras, Greece. Giacomo, Sermonesi, DIMEC, University of Bologna, Bologna, Italy. Mario, Serradilla-Martin, Department of Surgery. Miguel Servet University Hospital, Zaragoza, Spain. Vishal, G, Shelat, General Surgery, Tan Tock Seng Hospital, Singapore, Singapore. Sergei, Shlyapnikov, Surgical Infections Department Emergency Care Research Institute n.a. I.I.Djanelidze, Saint-Petersburg, Russia. Theodoros, Sidiropoulos, 4th Surgical Department, University Hospital Attikon, Athens, Greece. Romeo, Lages, Simoes, Universidade Federal de Juiz de Fora Campus Governador Valadares—UFJF/GV (Federal University of Juiz de Fora) and Universidade Vale do Rio Doce—Univale (Vale do Rio Doce University)., Governador Valadares—MG, Brazil. Leandro, Siragusa, Department of Surgical Sciences, University of Roma “Tor Vergata,” Rome, Italy. Boonying, Siribumrungwong, Thammasat University Hospital, Pathum Thani, Thailand. Mihail, Slavchev, University Hospital Eurohospital, Plovdiv, Bulgaria. Leonardo, Solaini, Department of Medical and Surgical Sciences, University of Bologna, Forli, Italy. gabriele, soldini, Ospedale Sacra Famiglia Fatebenefratelli, Erba, Italy. Andrey, Sopuev, Department of Hospital Surgery with the Course of Operative Surgery of KSMA named after I.K. Akhunbaeva, Bishkek, Kyrgyzstan. Kjetil, Soreide, Department of Gastrointestinal Surgery, Stavanger University Hospital, Norway. APOSTOLOS, SOVATZIDIS, SURGICAL DEPARTMENT, GIANNITSA GENERAL HOSPITAL, GIANNITSA, PELLA, Greece. Philip, Frank, Stahel, East Carolina University, Brody School of Medicine, Greenville, NC, United States. Matt, Strickland, University of Alberta, Edmonton, Canada. Mohamed Arif, Hameed, Sultan, Department of General Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia, Kota Kinabalu, Sabah, Malaysia, Malaysia. Ruslan, Sydorchuk, Chernivtsi Regional Emergency Hospital, Chernivtsi, Ukraine. Larysa, Sydorchuk, Bukovinian State Medical University, Chernivtsi, Ukraine. Chiara Bidoli, Muhammad, Syed, Acute Care Surgery, Hamad Medical Corporation, Doha, Qatar. Ali, Muhammad, Syed, Department of Acute Care Surgery, Hamad Medical Corporation, Doha, Qatar. Luis, Tallon-Aguilar, Surgery Department. Virgen del Rocio University Hospital, Sevilla, Spain. Andrea, Marco, Tamburini, Gastrointestinal Surgery IRCCS San Raffaele Scientific Institute, Milan, Italy. Nicolò, Tamini, Asst Monza—Ospedale San Gerardo, Colorectal surgery unit, Monza, Italy. Edward, C.T.H., Tan, Department of Surgery, Radboudumc, Nijmegen, Netherlands. Jih Huei, Tan, HSAJB, Johor Bahru, Malaysia. Antonio, Tarasconi, Emergency Surgery Department, Parma University Hospital, Parma, Italy. Nicola, Tartaglia, Department of Medical and Surgical Sciences—University of Foggia, Foggia, Italy. Giuseppe, Tartaglia, Università degli studi di Pavia, Italy. Dario, Tartaglia, Emergency Surgery Unit & Trauma Center, Pisa University Hospital, University of Pisa, Pisa, Italy. John, Vincent, Taylor, Department of Surgery. University Hospital Aintree, Liverpool, United Kingdom. Giovanni, Domenico, Tebala, Digestive and Emergency Surgery Unit, Azienda Ospedaliera S.Maria, Terni, Italy. Ricardo, Alessandro, Teixeira Gonsaga, Departamento de cirurgia—UNIFIPA, Catanduva—SP, Brazil. Michel, Teuben, Dept. Of Trauma, University Hospital Zurich, Zurich, Switzerland. Alexis, Theodorou, Department of Surgery, Aretaieio University Hospital Athens, Athens, Greece. Matti, Tolonen, Abdominal Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. Giovanni, Tomasicchio, Department of Emergency and Organ Transplant (DETO), University “Aldo Moro” Medical School of Bari, Bari, Italy. Adriana, Toro, General Surgery, Augusta Hospital, Syracusa, Italy, Italy. Beatrice, Torre, Chirurgia Tratto Alimentare, IRCCS Policlinico Sant’Orsola, Bologna, Italy. Tania, Triantafyllou, UGI Senior Clinical Fellow,Department of Surgery,Royal Infirmary of Edinburgh, Edinburgh, United Kingdom. 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Michael Samuel James Wilson, Department of General Surgery, Forth Valley Royal Hospital, Larbert, United Kingdom. Ting Hway Wong, Duke-National University of Singapore, Singapore, Singapore. Sofia Xenaki, Department of Surgery. University Hospital of Heraklion Crete, Heraklion Crete, Greece. Byungchul Yu, Trauma surgery, Gachon University Gil Medical center, Incheon, Korea, South. Steven Yule, Royal Infirmary University of Edinburgh, Edinburgh, United Kingdom. Sanoop Koshy Zachariah, Department of General & Minimal Access Surgery, Kims-Kerala Institute of Medical Sciences, Trivandrum, India. Georgios Zacharis, General Surgery, St.Andrew Hospital, Patra, Greece. claudia, zaghi, Chirurgia Generale, ospedale San Bortolo, Vicenza, Italy. Andee Dzulkarnaen, Zakaria, Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia. Diego A. Zambrano, Departamento de Cirugia, Sociedad de Lucha Contra el Cancer—SOLCA, Guayaquil, Ecuador. Nikolaos, Zampitis, Third surgical department -Tzaneio hospital, Piraeus, Greece. Biagio, Zampogna, Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University Hospital, Rome, Italy. Simone, Zanghì, Università di Pavia, Unit of general surgery, Pavia, Italy. Konstantinos, Zapsalis, 4th Surgical Clinic Aristotle University of Thessaloniki, Thessaloniki, Greece. Fabio, Zattoni, Department of Surgical, Oncological and Gastroenterological Sciences-Urological Clinic, University of Padua, Padua, Italy. Monica, Zese, ULSS5 Polesana Department of General Surgery, Santa Maria della Misericordia Hospital, Rovigo, Italy. Silvia Pérez Farre, Hospital Arnau de Vilanova. Colorrectal surgery, Lleida, Spain. Boyko Tchavdarov, Atanasov, Medical university of Plovdiv, Propedeutics of Surgical disease, UMHAT Eurohospital, Plovdiv, Bulgaria. Veronica, Pegoraro, Ca' Foscari University of Venice, Venice, Italy. Maristella Zantedeschi, Ca' Foscari University of Venice, Venice, Italy. Elisa, Reitano, University of Eastern Piedmont, Novara, Italy. Erica Pizzocaro, University of Verona, Verona, Italy.

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