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Publication Open Access Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants(Elsevier, 2021) Zhou, Bin; Carrillo-Larco, Rodrigo M.; Danaei, Goodarz; Riley, Leanne M.; Paciorek, Christopher J.; Stevens, Gretchen A.; Gregg, Edward W.; Bennett, James E.; Solomon, Bethlehem; Singleton, Rosie K.; Sophiea, Marisa K.; Iurilli, Maria L. C.; Lhoste, Victor P. F.; Cowan, Melanie J.; Savin, Stefan; Woodward, Mark; Balanova, Yulia; Cifkova, Renata; Damasceno, Albertino; Elliott, Paul; Farzadfar, Farshad; He, Jiang; Ikeda, Nayu; Kengne, Andre P.; Khang, Young-Ho; Kim, Hyeon Chang; Laxmaiah, Avula; Lin, Hsien-Ho; Margozzini Maira, Paula; Miranda, J. Jaime; Neuhauser, Hannelore; Sundstrom, Johan; Varghese, Cherian; Widyahening, Indah S.; Zdrojewski, Tomasz; Ezzati, Majid; Abarca-Gomez, Leandra; Abdeen, Ziad A.; Rahim, Hanan F. Abdul; Abu-Rmeileh, Niveen M.; Acosta-Cazares, Benjamin; Adams, Robert J.; Aekplakorn, Wichai; Afsana, Kaosar; Afzal, Shoaib; Agdeppa, Imelda A.; Aghazadeh-Attari, Javad; Aguilar-Salinas, Carlos A.; Agyemang, Charles; Ahmad, Noor Ani; Ahmadi, Ali; Ahmadi, Naser; Ahmadi, Nastaran; Ahmadizar, Fariba; Ahmed, Soheir H.; Ahrens, Wolfgang; Ajlouni, Kamel; Al-Raddadi, Rajaa; Alarouj, Monira; AlBuhairan, Fadia; AlDhukair, Shahla; Ali, Mohamed M.; Alkandari, Abdullah; Alkerwi, Ala'a; Allin, Kristine; Aly, Eman; Amarapurkar, Deepak N.; Amougou, Norbert; Amouyel, Philippe; Andersen, Lars Bo; Anderssen, Sigmund A.; Anjana, Ranjit Mohan; Ansari-Moghaddam, Alireza; Ansong, Daniel; Aounallah-Skhiri, Hajer; Araujo, Joana; Ariansen, Inger; Aris, Tahir; Arku, Raphael E.; Arlappa, Nimmathota; Aryal, Krishna K.; Aspelund, Thor; Assah, Felix K.; Assuncao, Maria Cecilia F.; Auvinen, Juha; Avdicova, Maria; Azevedo, Ana; Azimi-Nezhad, Mohsen; Azizi, Fereidoun; Azmin, Mehrdad; Babu, Bontha V.; Bahijri, Suhad; Balakrishna, Nagalla; Balanova, Yulia; Bamoshmoosh, Mohamed; Banach, Maciej; Banadinovic, Maja; Bandosz, Piotr; Banegas, Jose R.; Baran, Joanna; Barbagallo, Carlo M.; Barcelo, Alberto; Barkat, Amina; Barreto, Marta; Barros, Aluisio J. D.; Gomes Barros, Mauro Virgilio; Bartosiewicz, Anna; Basit, Abdul; Bastos, Joao Luiz D.; Bata, Iqbal; Batieha, Anwar M.; Batyrbek, Assembekov; Baur, Louise A.; Beaglehole, Robert; Belavendra, Antonisamy; Ben Romdhane, Habiba; Benet, Mikhail; Bennett, James E.; Benson, Lowell S.; Berkinbayev, Salim; Bernabe-Ortiz, Antonio; Bettiol, Heloisa; Bezerra, Jorge; Bhagyalaxmi, Aroor; Bhargava, Santosh K.; Bia, Daniel; Biasch, Katia; Lele, Elysee Claude Bika; Bikbov, Mukharram M.; Bista, Bihungum; Bjerregaard, Peter; Bjertness, Espen; Bjertness, Marius B.; Bjorkelund, Cecilia; Bloch, Katia V.; Blokstra, Anneke; Bo, Simona; Bobak, Martin; Boeing, Heiner; Boggia, Jose G.; Boissonnet, Carlos P.; Bojesen, Stig E.; Bongard, Vanina; Bonilla-Vargas, Alice; Bopp, Matthias; Borghs, Herman; Bovet, Pascal; Boyer, Christopher B.; Braeckman, Lutgart; Brajkovich, Imperia; Branca, Francesco; Breckenkamp, Juergen; Brenner, Hermann; Brewster, Lizzy M.; Briceno, Yajaira; Brito, Miguel; Bruno, Graziella; Bueno-de-Mesquita, H. Bas; Bueno, Gloria; Bugge, Anna; Burns, Con; Bursztyn, Michael; Cabrera de Leon, Antonio; Cacciottolo, Joseph; Cameron, Christine; Can, Gunay; Candido, Ana Paula C.; Capanzana, Mario V.; Capkova, Nadezda; Capuano, Eduardo; Capuano, Vincenzo; Cardoso, Viviane C.; Carlsson, Axel C.; Carvalho, Joana; Casanueva, Felipe F.; Censi, Laura; Cervantes-Loaiza, Marvin; Chadjigeorgiou, Charalambos A.; Chamukuttan, Snehalatha; Chan, Angelique W.; Chan, Queenie; Chaturvedi, Himanshu K.; Chaturvedi, Nish; Chee, Miao Li; Chen, Chien-Jen; Chen, Fangfang; Chen, Huashuai; Chen, Shuohua; Chen, Zhengming; Cheng, Ching-Yu; Cheraghian, Bahman; Dekkaki, Imane Cherkaoui; Chetrit, Angela; Chien, Kuo-Liong; Chiolero, Arnaud; Chiou, Shu-Ti; Chirita-Emandi, Adela; Chirlaque, Maria-Dolores; Cho, Belong; Christensen, Kaare; Christofaro, Diego G.; Chudek, Jerzy; Cifkova, Renata; Cinteza, Eliza; Claessens, Frank; Clarke, Janine; Clays, Els; Cohen, Emmanuel; Concin, Hans; Cooper, Cyrus; Coppinger, Tara C.; Costanzo, Simona; Cottel, Dominique; Cowell, Chris; Craig, Cora L.; Crampin, Amelia C.; Crujeiras, Ana B.; Cruz, Juan J.; Csilla, Semanova; Cui, Liufu; Cureau, Felipe V.; Cuschieri, Sarah; D'Arrigo, Graziella; d'Orsi, Eleonora; Dallongeville, Jean; Damasceno, Albertino; Danaei, Goodarz; Dankner, Rachel; Dantoft, Thomas M.; Dauchet, Luc; Davletov, Kairat; De Backer, Guy; De Bacquer, Dirk; De Curtis, Amalia; de Gaetano, Giovanni; De Henauw, Stefaan; de Oliveira, Paula Duarte; De Ridder, David; De Smedt, Delphine; Deepa, Mohan; Deev, Alexander D.; DeGennaro, Vincent Jr; Delisle, Helene; Demarest, Stefaan; Dennison, Elaine; Deschamps, Valerie; Dhimal, Meghnath; Di Castelnuovo, Augusto F.; Dias-da-Costa, Juvenal Soares; Diaz, Alejandro; Dickerson, Ty T.; Dika, Zivka; Djalalinia, Shirin; Do, Ha T. P.; Dobson, Annette J.; Donfrancesco, Chiara; Donoso, Silvana P.; Doering, Angela; Dorobantu, Maria; Doerr, Marcus; Doua, Kouamelan; Dragano, Nico; Drygas, Wojciech; Duante, Charmaine A.; Duboz, Priscilla; Duda, Rosemary B.; Dulskiene, Virginija; Dushpanova, Anar; Dzakula, Aleksandar; Dzerve, Vilnis; Dziankowska-Zaborszczyk, Elzbieta; Eddie, Ricky; Eftekhar, Ebrahim; Eggertsen, Robert; Eghtesad, Sareh; Eiben, Gabriele; Ekelund, Ulf; El-Khateeb, Mohammad; El Ati, Jalila; Eldemire-Shearer, Denise; Eliasen, Marie; Elliott, Paul; Elosua, Roberto; Erasmus, Rajiv T.; Erbel, Raimund; Erem, Cihangir; Eriksen, Louise; Eriksson, Johan G.; Escobedo-de la Pena, Jorge; Eslami, Saeid; Esmaeili, Ali; Evans, Alun; Faeh, David; Fakhretdinova, Albina A.; Fall, Caroline H.; Faramarzi, Elnaz; Farjam, Mojtaba; Farzadfar, Farshad; Fattahi, Mohammad Reza; Fawwad, Asher; Felix-Redondo, Francisco J.; Felix, Stephan B.; Ferguson, Trevor S.; Fernandes, Romulo A.; Fernandez-Berges, Daniel; Ferrante, Daniel; Ferrao, Thomas; Ferrari, Marika; Ferrario, Marco M.; Ferreccio, Catterina; Ferreira, Haroldo S.; Ferrer, Eldridge; Ferrieres, Jean; Figueiro, Thamara Hubler; Fink, Gunther; Fischer, Krista; Foo, Leng Huat; Forsner, Maria; Fouad, Heba M.; Francis, Damian K.; Franco, Maria do Carmo; Frikke-Schmidt, Ruth; Frontera, Guillermo; Fuchs, Flavio D.; Fuchs, Sandra C.; Fujita, Yuki; Fumihiko, Matsuda; Furdela, Viktoriya; Furer, Ariel; Furusawa, Takuro; Gaciong, Zbigniew; Galbarczyk, Andrzej; Galenkamp, Henrike; Galvano, Fabio; Gao, Jingli; Gao, Pei; Garcia-de-la-Hera, Manoli; Garcia, Pablo; Gareta, Dickman; Garnett, Sarah P.; Gaspoz, Jean-Michel; Gasull, Magda; Gazzinelli, Andrea; Gehring, Ulrike; Geleijnse, Johanna M.; George, Ronnie; Ghanbari, Ali; Ghasemi, Erfan; Gheorghe-Fronea, Oana-Florentina; Ghimire, Anup; Gialluisi, Alessandro; Giampaoli, Simona; Gieger, Christian; Gill, Tiffany K.; Giovannelli, Jonathan; Gironella, Glen; Giwercman, Aleksander; Gkiouras, Konstantinos; Goldberg, Marcel; Goldsmith, Rebecca A.; Gomez, Luis F.; Gomula, Aleksandra; Cordeiro da Silva, Bruna Goncalves; Goncalves, Helen; Goncalves, Mauer; Gonzalez-Chica, David A.; Gonzalez-Gross, Marcela; Gonzalez-Rivas, Juan P.; Gonzalez-Villalpando, Clicerio; Gonzalez-Villalpando, Maria-Elena; Gonzalez, Angel R.; Bonet Gorbea, Mariano; Gottrand, Frederic; Graff-Iversen, Sidsel; Grafnetter, Dusan; Grajda, Aneta; Grammatikopoulou, Maria G.; Gregor, Ronald D.; Grodzicki, Tomasz; Grosso, Giuseppe; Gruden, Gabriella; Gu, Dongfeng; Guan, Ong Peng; Gudmundsson, Elias F.; Gudnason, Vilmundur; Guerrero, Ramiro; Guessous, Idris; Guimaraes, Andre L.; Gulliford, Martin C.; Gunnlaugsdottir, Johanna; Gunter, Marc J.; Gupta, Prakash C.; Gupta, Rajeev; Gureje, Oye; Gurzkowska, Beata; Gutierrez, Laura; Gutzwiller, Felix; Ha, Seongjun; Hadaegh, Farzad; Haghshenas, Rosa; Hakimi, Hamid; Halkjaer, Jytte; Hambleton, Ian R.; Hamzeh, Behrooz; Hange, Dominique; Hanif, Abu A. M.; Hantunen, Sari; Hao, Jie; Hardman, Carla Meneses; Kumar, Rachakulla Hari; Hashemi-Shahri, Seyed Mohammad; Hata, Jun; Haugsgjerd, Teresa; Hayes, Alison J.; He, Jiang; He, Yuna; Heier, Margit; Hendriks, Marleen Elisabeth; Henrique, Rafael dos Santos; Henriques, Ana; Cadena, Leticia Hernandez; Herrala, Sauli; Heshmat, Ramin; Hill, Allan G.; Ho, Sai Yin; Ho, Suzanne C.; Hobbs, Michael; Holdsworth, Michelle; Homayounfar, Reza; Dinc, Gonul Horasan; Horimoto, Andrea R. V. R.; Hormiga, Claudia M.; Horta, Bernardo L.; Houti, Leila; Howitt, Christina; Htay, Thein Thein; Htet, Aung Soe; Htike, Maung Maung Than; Hu, Yonghua; Huerta, Jose Maria; Huhtaniemi, Ilpo Tapani; Huiart, Laetitia; Huisman, Martijn; Husseini, Abdullatif S.; Huybrechts, Inge; Hwalla, Nahla; Iacoviello, Licia; Iannone, Anna G.; Ibrahim, Mohsen M.; Wong, Norazizah Ibrahim; Ikeda, Nayu; Ikram, M. Arfan; Iotova, Violeta; Irazola, Vilma E.; Ishida, Takafumi; Isiguzo, Godsent C.; Islam, Muhammad; Islam, Sheikh Mohammed Shariful; Iwasaki, Masanori; Jackson, Rod T.; Jacobs, Jeremy M.; Jaddou, Hashem Y.; Jafar, Tazeen; James, Kenneth; Jamrozik, Konrad; Janszky, Imre; Janus, Edward; Jarvelin, Marjo-Riitta; Jasienska, Grazyna; Jelakovic, Ana; Jelakovic, Bojan; Jennings, Garry; Jha, Anjani Kumar; Jiang, Chao Qiang; Jimenez, Ramon O.; Joeckel, Karl-Heinz; Joffres, Michel; Johansson, Mattias; Jokelainen, Jari J.; Jonas, Jost B.; Jorgensen, Torben; Joshi, Pradeep; Joukar, Farahnaz; Jozwiak, Jacek; Juolevi, Anne; Jurak, Gregor; Juresa, Vesna; Kaaks, Rudolf; Kafatos, Anthony; Kajantie, Eero O.; Kalmatayeva, Zhanna; Kalpourtzi, Natasa; Kalter-Leibovici, Ofra; Kampmann, Freja B.; Kannan, Srinivasan; Karaglani, Eva; Karhus, Line L.; Karki, Khem B.; Katibeh, Marzieh; Katz, Joanne; Kauhanen, Jussi; Kaur, Prabhdeep; Kavousi, Maryam; Kazakbaeva, Gyulli M.; Keil, Ulrich; Boker, Lital Keinan; Keinanen-Kiukaanniemi, Sirkka; Kelishadi, Roya; Kemper, Han C. G.; Kengne, Andre P.; Keramati, Maryam; Kerimkulova, Alina; Kersting, Mathilde; Key, Timothy; Khader, Yousef Saleh; Khalili, Davood; Khang, Young-Ho; Khaw, Kay-Tee; Kheiri, Bahareh; Kheradmand, Motahareh; Khosravi, Alireza; Kiechl-Kohlendorfer, Ursula; Kiechl, Stefan; Killewo, Japhet; Kim, Dong Wook; Kim, Hyeon Chang; Kim, Jeongseon; Klakk, Heidi; Klimek, Magdalena; Klumbiene, Jurate; Knoflach, Michael; Kolle, Elin; Kolsteren, Patrick; Kontto, Jukka P.; Korpelainen, Raija; Korrovits, Paul; Kos, Jelena; Koskinen, Seppo; Kouda, Katsuyasu; Kowlessur, Sudhir; Koziel, Slawomir; Kratenova, Jana; Kriaucioniene, Vilma; Kristensen, Peter Lund; Krokstad, Steiner; Kromhout, Daan; Kruger, Herculina S.; Kubinova, Ruzena; Kuciene, Renata; Kujala, Urho M.; Kulaga, Zbigniew; Kumar, R. Krishna; Kurjata, Pawel; Kusuma, Yadlapalli S.; Kutsenko, Vladimir; Kuulasmaa, Kari; Kyobutungi, Catherine; Laatikainen, Tiina; Lachat, Carl; Laid, Youcef; Lam, Tai Hing; Landrove, Orlando; Lanska, Vera; Lappas, Georg; Larijani, Bagher; Latt, Tint Swe; Laxmaiah, Avula; Le Coroller, Gwenaelle; Khanh Le Nguyen Bao; Le, Tuyen D.; Lee, Jeannette; Lee, Jeonghee; Lehmann, Nils; Lehtimaki, Terho; Lemogoum, Daniel; Levitt, Naomi S.; Li, Yanping; Lilly, Christa L.; Lim, Wei-Yen; Lima-Costa, M. Fernanda; Lin, Hsien-Ho; Lin, Xu; Lin, Yi-Ting; Lind, Lars; Lingam, Vijaya; Linneberg, Allan; Lissner, Lauren; Litwin, Mieczyslaw; Lo, Wei-Cheng; Loit, Helle-Mai; Lopez-Garcia, Esther; Lopez, Tania; Lotufo, Paulo A.; Lozano, Jose Eugenio; Lovrencic, Iva Lukacevic; Lukrafka, Janice L.; Luksiene, Dalia; Lundqvist, Annamari; Lundqvist, Robert; Lunet, Nuno; Lustigova, Michala; Luszczki, Edyta; Ma, Guansheng; Ma, Jun; Machado-Coelho, George L. L.; Machado-Rodrigues, Aristides M.; Macia, Enguerran; Macieira, Luisa M.; Madar, Ahmed A.; Maggi, Stefania; Magliano, Dianna J.; Magriplis, Emmanuella; Mahasampath, Gowri; Maire, Bernard; Majer, Marjeta; Makdisse, Marcia; Malekzadeh, Fatemeh; Malekzadeh, Reza; Malhotra, Rahul; Mallikharjuna, Kodavanti; Malyutina, Sofia K.; Maniego, Lynell V.; Manios, Yannis; Mann, Jim I.; Mansour-Ghanaei, Fariborz; Manzato, Enzo; Marcil, Anie; Margozzini, Paula; Marild, Staffan B.; Glavic, Mihalea Marinovic; Marques-Vidal, Pedro; Marques, Larissa Pruner; Marrugat, Jaume; Martorell, Reynaldo; Mascarenhas, Luis P.; Matasin, Marija; Mathiesen, Ellisiv B.; Mathur, Prashant; Matijasevich, Alicia; Matlosz, Piotr; Matsha, Tandi E.; Mavrogianni, Christina; Mbanya, Jean Claude N.; Mc Donald Posso, Anselmo J.; McFarlane, Shelly R.; McGarvey, Stephen T.; McLachlan, Stela; McLean, Rachael M.; McLean, Scott B.; McNulty, Breige A.; Benchekor, Sounnia Mediene; Medzioniene, Jurate; Mehdipour, Parinaz; Mehlig, Kirsten; Mehrparvar, Amir Houshang; Meirhaeghe, Aline; Meisinger, Christa; Mendoza Montano, Carlos; Menezes, Ana Maria B.; Menon, Geetha R.; Mereke, Alibek; Meshram, Indrapal I.; Metspalu, Andres; Meyer, Haakon E.; Mi, Jie; Michels, Nathalie; Mikkel, Kairit; Milkowska, Karolina; Miller, Jody C.; Minderico, Claudia S.; Mini, G. K.; Miranda, J. Jaime; Mirjalili, Mohammad Reza; Mirrakhimov, Erkin; Misigoj-Durakovic, Marjeta; Modesti, Pietro A.; Moghaddam, Sahar Saeedi; Mohajer, Bahram; Mohamed, Mostafa K.; Mohamed, Shukri F.; Mohammad, Kazem; Mohammadi, Mohammad Reza; Mohammadi, Zahra; Mohammadifard, Noushin; Mohammadpourhodki, Reza; Mohan, Viswanathan; Mohanna, Salim; Yusoff, Muhammad Fadhli Mohd; Mohebbi, Iraj; Mohebi, Farnam; Moitry, Marie; Mollehave, Line T.; Molnar, Denes; Momenan, Amirabbas; Mondo, Charles K.; Monterrubio-Flores, Eric; Monyeki, Kotsedi Daniel K.; Moon, Jin Soo; Moosazadeh, Mahmood; Moreira, Leila B.; Morejon, Alain; Moreno, Luis A.; Morgan, Karen; Moschonis, George; Mossakowska, Malgorzata; Mostafa, Aya; Mostafavi, Seyed-Ali; Mota, Jorge; Motlagh, Mohammad Esmaeel; Motta, Jorge; Andre Moura-dos-Santos, Marcos; Mridha, Malay K.; Msyamboza, Kelias P.; Mu, Thet Thet; Muhihi, Alfa J.; Muiesan, Maria L.; Muller-Nurasyid, Martina; Murphy, Neil; Mursu, Jaakko; Musa, Kamarul Imran; Milanovic, Sanja Music; Musil, Vera; Mustafa, Norlaila; Nabipour, Iraj; Naderimagham, Shohreh; Nagel, Gabriele; Naidu, Balkish M.; Najafi, Farid; Nakamura, Harunobu; Namesna, Jana; Nang, Ei Ei K.; Nangia, Vinay B.; Narake, Sameer; Ndiaye, Ndeye Coumba; Neal, William A.; Nejatizadeh, Azim; Nenko, Ilona; Neovius, Martin; Neuhauser, Hannelore K.; Nguyen, Chung T.; Nguyen, Nguyen D.; Nguyen, Quang V.; Quang Ngoc Nguyen; Nieto-Martinez, Ramfis E.; Niiranen, Teemu J.; Nikitin, Yury P.; Ninomiya, Toshiharu; Nishtar, Sania; Njelekela, Marina A.; Noale, Marianna; Noboa, Oscar A.; Noorbala, Ahmad Ali; Norat, Teresa; Nordendahl, Maria; Nordestgaard, Borge G.; Noto, Davide; Nowak-Szczepanska, Natalia; Al Nsour, Mohannad; Nunes, Baltazar; O'Neill, Terence W.; O'Reilly, Dermot; Ochimana, Caleb; Oda, Eiji; Odili, Augustine N.; Oh, Kyungwon; Ohara, Kumiko; Ohtsuka, Ryutaro; Olie, Valerie; Olinto, Maria Teresa A.; Oliveira, Isabel O.; Omar, Mohd Azahadi; Onat, Altan; Ong, Sok King; Ono, Lariane M.; Ordunez, Pedro; Ornelas, Rui; Ortiz, Pedro J.; Osmond, Clive; Ostojic, Sergej M.; Ostovar, Afshin; Otero, Johanna A.; Overvad, Kim; Owusu-Dabo, Ellis; Paccaud, Fred Michel; Padez, Cristina; Pahomova, Elena; de Paiva, Karina Mary; Pajak, Andrzej; Palli, Domenico; Palmieri, Luigi; Pan, Wen-Harn; Panda-Jonas, Songhomitra; Panza, Francesco; Paoli, Mariela; Papandreou, Dimitrios; Park, Soon-Woo; Park, Suyeon; Parnell, Winsome R.; Parsaeian, Mahboubeh; Pasquet, Patrick; Patel, Nikhil D.; Pavlyshyn, Halyna; Pecin, Ivan; Pednekar, Mangesh S.; Pedro, Joao M.; Peer, Nasheeta; Peixoto, Sergio Viana; Peltonen, Markku; Pereira, Alexandre C.; Peres, Karen G. D. A.; Peres, Marco A.; Peters, Annette; Petkeviciene, Janina; Peykari, Niloofar; Son Thai Pham; Pichardo, Rafael N.; Pigeot, Iris; Pikhart, Hynek; Pilav, Aida; Pilotto, Lorenza; Pitakaka, Freda; Piwonska, Aleksandra; Pizarro, Andreia N.; Plans-Rubio, Pedro; Polasek, Ozren; Porta, Miquel; Poudyal, Anil; Pourfarzi, Farhad; Pourshams, Akram; Poustchi, Hossein; Pradeepa, Rajendra; Price, Alison J.; Price, Jacqueline F.; Providencia, Rui; Puhakka, Soile E.; Puiu, Maria; Punab, Margus; Qasrawi, Radwan F.; Qorbani, Mostafa; Queiroz, Daniel; Tran Quoc Bao; Radic, Ivana; Radisauskas, Ricardas; Rahimikazerooni, Salar; Rahman, Mahfuzar; Raitakari, Olli; Raj, Manu; Rakhimova, Ellina M.; Rao, Sudha Ramachandra; Ramachandran, Ambady; Ramos, Elisabete; Rampal, Lekhraj; Rampal, Sanjay; Rangel Reina, Daniel A.; Rarra, Vayia; Rech, Cassiano Ricardo; Redon, Josep; Reganit, Paul Ferdinand M.; Regecova, Valeria; Revilla, Luis; Rezaianzadeh, Abbas; Ribeiro, Robespierre; Riboli, Elio; Richter, Adrian; Rigo, Fernando; de Wit, Tobias F. Rinke; Ritti-Dias, Raphael M.; Robitaille, Cynthia; Rodriguez-Artalejo, Fernando; del Cristo Rodriguez-Perez, Maria; Rodriguez-Villamizar, Laura A.; Roggenbuck, Ulla; Rojas-Martinez, Rosalba; Romaguera, Dora; Romeo, Elisabetta L.; Rosengren, Annika; Roy, Joel G. R.; Rubinstein, Adolfo; Ruidavets, Jean-Bernard; Sandra Ruiz-Betancourt, Blanca; Ruiz-Castell, Maria; Rusakova, Iuliia A.; Russo, Paola; Rutkowski, Marcin; Sabanayagam, Charumathi; Sabbaghi, Hamideh; Sachdev, Harshpal S.; Sadjadi, Alireza; Safarpour, Ali Reza; Safi, Sare; Safiri, Saeid; Saidi, Olfa; Saki, Nader; Salanave, Benoit; Salazar Martinez, Eduardo; Salmeron, Diego; Salomaa, Veikko; Salonen, Jukka T.; Salvetti, Massimo; Sanchez-Abanto, Jose; Sans, Susana; Santos, Diana A.; Santos, Ina S.; Santos, Lelita C.; Santos, Maria Paula; Santos, Rute; Saramies, Jouko L.; Sardinha, Luis B.; Sarganas, Giselle; Sarrafzadegan, Nizal; Sathish, Thirunavukkarasu; Saum, Kai-Uwe; Savva, Savvas; Sawada, Norie; Sbaraini, Mariana; Scazufca, Marcia; Schaan, Beatriz D.; Schargrodsky, Herman; Schipf, Sabine; Schmidt, Carsten O.; Schnohr, Peter; Schoettker, Ben; Schramm, Sara; Schultsz, Constance; Schutte, Aletta E.; Sebert, Sylvain; Sein, Aye Aye; Sen, Abhijit; Senbanjo, Idowu O.; Sepanlou, Sadaf G.; Servais, Jennifer; Shalnova, Svetlana A.; Shamah-Levy, Teresa; Shamshirgaran, Morteza; Shanthirani, Coimbatore Subramaniam; Sharafkhah, Maryam; Sharma, Sanjib K.; Shaw, Jonathan E.; Shayanrad, Amaneh; Shayesteh, Ali Akbar; Shi, Zumin; Shibuya, Kenji; Shimizu-Furusawa, Hana; Shin, Dong Wook; Shirani, Majid; Shiri, Rahman; Shrestha, Namuna; Si-Ramlee, Khairil; Siani, Alfonso; Siantar, Rosalynn; Sibai, Abla M.; de Moura Silva, Caroline Ramos; Santos Silva, Diego Augusto; Simon, Mary; Simons, Judith; Simons, Leon A.; Sjostrom, Michael; Slowikowska-Hilczer, Jolanta; Slusarczyk, Przemyslaw; Smeeth, Liam; So, Hung-Kwan; Soares, Fernanda Cunha; Sobngwi, Eugene; Soderberg, Stefan; Soemantri, Agustinus; Sofat, Reecha; Solfrizzi, Vincenzo; Somi, Mohammad Hossein; Sonestedt, Emily; Song, Yi; Sorensen, Thorkild I. A.; Sorgjerd, Elin P.; Soric, Maroje; Jerome, Charles Sossa; Soumare, Aicha; Sparboe-Nilsen, Bente; Sparrenberger, Karen; Staessen, Jan A.; Starc, Gregor; Stavreski, Bill; Steene-Johannessen, Jostein; Stehle, Peter; Stein, Aryeh D.; Stergiou, George S.; Stessman, Jochanan; Stieber, Jutta; Stoeckl, Doris; Stocks, Tanja; Stokwiszewski, Jakub; Stronks, Karien; Strufaldi, Maria Wany; Suka, Machi; Sun, Chien-An; Sundstrom, Johan; Sung, Yn-Tz; Suriyawongpaisal, Paibul; Sy, Rody G.; Syddall, Holly E.; Sylva, Rene Charles; Szklo, Moyses; Tai, E. Shyong; Tammesoo, Mari-Liis; Tamosiunas, Abdonas; Tan, Eng Joo; Tang, Xun; Tanser, Frank; Tao, Yong; Tarawneh, Mohammed Rasoul; Tarqui-Mamani, Carolina B.; Taylor, Anne; Taylor, Julie; Tebar, William R.; Tell, Grethe S.; Tello, Tania; Tham, Yih Chung; Thankappan, K. R.; Theobald, Holger; Theodoridis, Xenophon; Thijs, Lutgarde; Thinggaard, Mikael; Thomas, Nihal; Thorand, Barbara; Thuesen, Betina H.; Timmermans, Erik J.; Tjandrarini, Dwi H.; Tjonneland, Anne; Toft, Ulla; Tolonen, Hanna K.; Tolstrup, Janne S.; Topbas, Murat; Topor-Madry, Roman; Jose Tormo, Maria; Tornaritis, Michael J.; Torrent, Maties; Torres-Collado, Laura; Touloumi, Giota; Traissac, Pierre; Triantafyllou, Areti; Trichopoulos, Dimitrios; Trichopoulou, Antonia; Trinh, Oanh T. H.; Trivedi, Atul; Tshepo, Lechaba; Tsugane, Shoichiro; Tuliakova, Azaliia M.; Tulloch-Reid, Marshall K.; Tullu, Fikru; Tuomainen, Tomi-Pekka; Tuomilehto, Jaakko; Turley, Maria L.; Twig, Gilad; Tynelius, Per; Tzourio, Christophe; Ueda, Peter; Ugel, Eunice; Ulmer, Hanno; Uusitalo, Hannu M. T.; Valdivia, Gonzalo; Valvi, Damaskini; van Dam, Rob M.; van den Born, Bert-Jan; Van der Heyden, Johan; van der Schouw, Yvonne T.; Van Herck, Koen; Hoang Van Minh; Van Schoor, Natasja M.; van Valkengoed, Irene G. M.; van Zutphen, Elisabeth M.; Vanderschueren, Dirk; Vanuzzo, Diego; Varbo, Anette; Vasan, Senthil K.; Vega, Tomas; Veidebaum, Toomas; Velasquez-Melendez, Gustavo; Veronesi, Giovanni; Verschuren, W. M. Monique; Verstraeten, Roosmarijn; Victora, Cesar G.; Viet, Lucie; Villalpando, Salvador; Vineis, Paolo; Vioque, Jesus; Virtanen, Jyrki K.; Visvikis-Siest, Sophie; Viswanathan, Bharathi; Vlasoff, Tiina; Vollenweider, Peter; Voutilainen, Ari; Wade, Alisha N.; Walton, Janette; Wambiya, Elvis O. A.; Bebakar, Wan Mohamad Wan; Mohamud, Wan Nazaimoon Wan; Wanderley Junior, Rildo de Souza; Wang, Ming-Dong; Wang, Ningli; Wang, Qian; Wang, Xiangjun; Wang, Ya Xing; Wang, Ying-Wei; Wannamethee, S. Goya; Wareham, Nicholas; Wei, Wenbin; Weres, Aneta; Werner, Bo; Whincup, Peter H.; Widhalm, Kurt; Widyahening, Indah S.; Wiecek, Andrzej; Wilks, Rainford J.; Willeit, Johann; Willeit, Peter; Williams, Emmanuel A.; Wilsgaard, Tom; Wojtyniak, Bogdan; Wong-McClure, Roy A.; Wong, Andrew; Wong, Tien Yin; Woo, Jean; Woodward, Mark; Wu, Frederick C.; Wu, Shouling; Wyszynska, Justyna; Xu, Haiquan; Xu, Liang; Yaacob, Nor Azwany; Yan, Weili; Yang, Ling; Yang, Xiaoguang; Yang, Yang; Yasuharu, Tabara; Ye, Xingwang; Yiallouros, Panayiotis K.; Yoosefi, Moein; Yoshihara, Akihiro; You, San-Lin; Younger-Coleman, Novie O.; Yusoff, Ahmad Faudzi; Zainuddin, Ahmad A.; Zakavi, Seyed Rasoul; Zamani, Farhad; Zambon, Sabina; Zampelas, Antonis; Elisa Zapata, Maria; Zaw, Ko Ko; Zdrojewski, Tomasz; Zejglicova, Kristyna; Vrkic, Tajana Zeljkovic; Zeng, Yi; Zhang, Luxia; Zhang, Zhen-Yu; Zhao, Dong; Zhao, Ming-Hui; Zhen, Shiqi; Zheng, Yingfeng; Zholdin, Bekbolat; Zhu, Dan; Zins, Marie; Zitt, Emanuel; Zocalo, Yanina; Zoghlami, Nada; Zuniga Cisneros, Julio.; Sakarya, Sibel; Faculty Member; School of Medicine; 172028Background: hypertension can be detected at the primary health-care level and low-cost treatments can effectively control hypertension. We aimed to measure the prevalence of hypertension and progress in its detection, treatment, and control from 1990 to 2019 for 200 countries and territories. Methods: we used data from 1990 to 2019 on people aged 30-79 years from population-representative studies with measurement of blood pressure and data on blood pressure treatment. We defined hypertension as having systolic blood pressure 140 mm Hg or greater, diastolic blood pressure 90 mm Hg or greater, or taking medication for hypertension. We applied a Bayesian hierarchical model to estimate the prevalence of hypertension and the proportion of people with hypertension who had a previous diagnosis (detection), who were taking medication for hypertension (treatment), and whose hypertension was controlled to below 140/90 mm Hg (control). The model allowed for trends over time to be non-linear and to vary by age. Findings: the number of people aged 30-79 years with hypertension doubled from 1990 to 2019, from 331 (95% credible interval 306-359) million women and 317 (292-344) million men in 1990 to 626 (584-668) million women and 652 (604-698) million men in 2019, despite stable global age-standardised prevalence. In 2019, age-standardised hypertension prevalence was lowest in Canada and Peru for both men and women; in Taiwan, South Korea, Japan, and some countries in western Europe including Switzerland, Spain, and the UK for women; and in several low-income and middle-income countries such as Eritrea, Bangladesh, Ethiopia, and Solomon Islands for men. Hypertension prevalence surpassed 50% for women in two countries and men in nine countries, in central and eastern Europe, central Asia, Oceania, and Latin America. Globally, 59% (55-62) of women and 49% (46-52) of men with hypertension reported a previous diagnosis of hypertension in 2019, and 47% (43-51) of women and 38% (35-41) of men were treated. Control rates among people with hypertension in 2019 were 23% (20-27) for women and 18% (16-21) for men. In 2019, treatment and control rates were highest in South Korea, Canada, and Iceland (treatment >70%; control >50%), followed by the USA, Costa Rica, Germany, Portugal, and Taiwan. Treatment rates were less than 25% for women and less than 20% for men in Nepal, Indonesia, and some countries in sub-Saharan Africa and Oceania. Control rates were below 10% for women and men in these countries and for men in some countries in north Africa, central and south Asia, and eastern Europe. Treatment and control rates have improved in most countries since 1990, but we found little change in most countries in sub-Saharan Africa and Oceania. Improvements were largest in high-income countries, central Europe, and some upper-middle-income and recently high-income countries including Costa Rica, Taiwan, Kazakhstan, South Africa, Brazil, Chile, Turkey, and Iran. Interpretation Improvements in the detection, treatment, and control of hypertension have varied substantially across countries, with some middle-income countries now outperforming most high-income nations. The dual approach of reducing hypertension prevalence through primary prevention and enhancing its treatment and control is achievable not only in high-income countries but also in low-income and middle-income settings.Publication Open Access Assessment of the optic nerve, optic disc, and perineural area using shear-wave elastography in patients with multiple sclerosis(Wiley, 2021) Şahin Ediz, Suna; Atalay, Başak; Aydın Cantürk, İlknur; Kabaalioğlu, Adnan; Faculty Member; Koç University HospitalPurpose: to observe and describe the stiffness changes of the optic nerve in the patients with multiple sclerosis (MS) with or without optic neuritis and healthy adults via shear wave elastography (SWE). Methods: 70 optic nerves from 35 patients with MS and 60 optic nerves from 30 healthy subjects were included prospectively in the study. The optic nerve (ON), optic disc (OD), and perineural area were evaluated with SWE and optic nerve sheat diameter (ONSD) was measured by ultrasound. Results: The mean age of patients was 39.68 +/- 9.99 years. There was no statistically significant difference between the groups in terms of ONSD, SWE ON, SWE OD, and SWE perineural area levels (P > .05). In the MS group; No statistically significant difference was found between patients with and without optic neuritis for the mean age, gender distribution, duration of MS, types of MS, ONSD, SWE ON, SWE OD, SWE perineural area, and Expanded Disability Status Scale (EDSS) scores (P > .05). No statistically significant difference in terms of ONSD, SWE ON, SWE OD, and SWE perineural area between the MS patients with or without optic neuritis and the control group (P > .05). Conclusion: shear wave elastography measurements of the optic nerve, optic disc, and perineural area do not contribute to the evaluation of optic neuritis in a patient with MS.Publication Open Access COVID-19 booster doses in pregnancy and global vaccine equity(Elsevier, 2022) Magee, L.A.; Von Dadelszen, P.; Heath, P.; Khalil A; Kalafat, Erkan; Faculty Member; School of Medicine; 197389Publication Open Access Pathology associated with adherent perirenal fat and its clinical effect(Wiley, 2021) Ceyhan, Erman; İleri, Fatih; Akı, Fazıl Tuncay; Yazıcı, Mustafa Sertaç; Karçaaltıncaba, Muşturay; Bilen, Cenk Yücel; Baydar, Dilek Ertoy; Faculty Member; School of Medicine; 8025Introduction: the dissection of perirenal fat is of critical importance to kidney surgery and ease of dissection is more important when using minimally invasive approaches. This study aimed to determine the clinical, radiological, and pathological significance of adherent perirenal fat (APF). Materials and methods: this prospective study included 22 patients scheduled for partial nephrectomy and 40 patients for donor nephrectomy. Intraoperative fat dissection time was recorded, and the complexity of perirenal fat dissection was surgeon-classified as easy, moderate, and difficult. Perirenal fat and subcutaneous fat thickness were measured. Measurement of perirenal fat depth and the Hounsfield unit (HU) for both perirenal and subcutaneous fields were performed using computed tomography (CT) images. All specimens were submitted for histopatological analysis. Researchers in each arm were blinded to other researchers' data. Results: mean age of the patients was 51.3 +/- 12.7 years. Mean perirenal fat dissection time was 15.0 +/- 13.5 minutes. Patient demographics, BMI, nor occupational status differed between the 3 complexity of perirenal fat dissection groups. Radiological findings showed that there was a significant correlation between perirenal fat depth and complexity of perirenal fat dissection (P < .05), but not with HU measurements or subcutaneous fat thickness. Surgeon classification of the complexity of perirenal fat dissection was in accordance with the duration of dissection (P < .05). Perinephric fat contained more fibrous tissue in the patients with histologically proven APF than in those without (P < .05). Conclusions: APF is a challenge during kidney surgery. Difficult dissection prolongs the duration of perirenal fat dissection and surgery. Perirenal fat thickness measured via preoperative CT might be used to predict APF.Publication Open Access Intravenous iron and maintenance hemodialysis(Massachusetts Medical Society (MMS), 2019) Afşar, Barış; Afşar, Rengin Elsürer; N/A; Kanbay, Mehmet; Faculty Member; School of Medicine; 110580Publication Open Access Evaluation of hydrogen peroxide-assisted endoscopic ultrasonography-guided necrosectomy in walled-off pancreatic necrosis: a single-center experience(Lippincott Williams and Wilkins (LWW), 2021) Günay, Süleyman; Paköz, Betül; Çekiç, Cem; Çamyar, Hakan; Yüksel, Elif Sarıtaş; Topal, Firdevs; Binicier, Ömer Burçak; Alper, Emrah; Faculty Member; School of MedicineHydrogen peroxide is a liquid that functions in mechanical removal of the necrotic tissue via the elimination of tissue debris. In this study, we aimed to evaluate the effectiveness of the use of hydrogen peroxide in necrosectomy treatment of walled-off pancreatic necrosis. Records of 24 patients who were diagnosed with pancreatic necrosis or walled-off pancreatic necrosis and underwent endoscopic necrosectomy (EN) were retrospectively assessed. Patients were divided into 2 groups; hydrogen peroxide used for treatment or not used, and these 2 groups were compared. A total of 24 patients underwent endoscopic intervention for walled-off pancreatic necrosis. Procedural success was comparable between the 2 groups. During the post-procedural follow-up, the duration of the hospital stay, recurrence, and complication rates were found to be similar in both groups. The mean number of the endoscopic interventions was significantly lower in the hydrogen peroxide group (4.2 +/- 1.4 vs 6.1 +/- 4.2; P = .01). The use of hydrogen peroxide for EN in walled-off pancreatic necrosis patients seems to have similar efficiency and safety. However, it can be said that the use of hydrogen peroxide could reduce the number of endoscopic procedures.Publication Open Access Rituximab treatment for difficult-to-treat nephrotic syndrome in children: a multicenter, retrospective study(TÜBİTAK, 2021) Canpolat, N.; Yıldız, N.; Özçelik, G.; Benzer, M.; Saygılı, S.K; Özkayin, E.N.; Türkkan, Ö.N.; Balat, A.; Candan, C.; Çelakıl, M.; Yavuz, S.; Akıncı, N.; Göknar, N.; Akgün, C.; Tülpar, S.; Alpay, H.; Sever, F.L.; Taşdemir, Mehmet; Bilge, İlmay; Doctor; Faculty Member; School of Medicine; Koç University Hospital; N/A; 198907Background/aim: this study aimed to evaluate the efficacy of rituximab in children with difficult-to-treat nephrotic syndrome, considering the type of disease (steroid-sensitive or -resistant) and the dosing regimen. Materials and methods: this multicenter retrospective study enrolled children with difficult-to-treat nephrotic syndrome on rituximab treatment from 13 centers. The patients were classified based on low (single dose of 375 mg/m(2)) or high (2-4 doses of 375 mg/m(2)) initial dose of rituximab and the steroid response. Clinical outcomes were compared. Results: data from 42 children [20 steroid-sensitive (frequent relapsing / steroid-dependent) and 22 steroid-resistant nephrotic syndrome, aged 1.9-17.3 years] were analyzed. Eleven patients with steroid-sensitive nephrotic syndrome (55%) had a relapse following initial rituximab therapy, with the mean time to first relapse of 8.4 +/- 5.2 months. Complete remission was achieved in 41% and 36% of steroid-resistant patients, with the median remission time of 3.65 months. At Year 2, eight patients in steroid-sensitive group (40%) and four in steroid-resistant group (18%) were drug-free. Total cumulative doses of rituximab were higher in steroid-resistant group (p = 001). Relapse rates and time to first relapse in steroid-sensitive group or remission rates in steroid-resistant group did not differ between the low and high initial dose groups. Conclusion: the current study reveals that rituximab therapy may provide a lower relapse rate and prolonged relapse-free survival in the steroid-sensitive group, increased remission rates in the steroid-resistant group, and a significant number of drug-free patients in both groups. The optimal regimen for initial treatment and maintenance needs to be determined.Publication Open Access Individualised immunosuppression with intravenously administered donor-derived modified immune cells compared with standard of care in living donor kidney transplantation (TOL-2 Study): protocol for a multicentre, open-label, phase II, randomised controlled trial(BMJ Publishing Group, 2022) Morath, C.; Schmitt, A.; Schmitt, M.; Wang, L.; Kleist, C.; Opelz, G.; Tran, T.H.; Scherer, S.; Schwenger, V.; Kemmner, S.; Fischereder, M.; Stangl, M.; Hauser, I.A.; Sommerer, C.; Nusshag, C.; Kalble, F.; Speer, C.; Benning, L.; Bischofs, C.; Sauer, S.; Schubert, M.L.; Kunz, A.; Hückelhoven-Krauss, A.; Neuber, B.; Mehrabi, A.; Schwab, C.; Waldherr, R.; Sander, A.; Büsch, C.; Czock, D.; Böhmig, G.A.; Reiser, J.; Roers, A.; Müller-Tidow, C.; Terness, P.; Zeier, M.; Daniel, V.; Schaier, M.; Süsal, Caner; Other; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; 351800Introduction: donor-derived modified immune cells (MIC) induced long-term specific immunosuppression against the allogeneic donor in preclinical models of transplantation. In a phase I clinical trial (TOL-1 Study), MIC treatment resulted in a cellular phenotype that was directly and indirectly suppressive to the recipient's immune system allowing for reduction of conventional immunosuppressive therapy. Here, we describe a protocol for a randomised controlled, multicentre phase-IIb clinical trial of individualised immunosuppression with intravenously administered donor MIC compared with standard-of-care (SoC) in living donor kidney transplantation (TOL-2 Study). Methods and analysis: sixty-three living donor kidney transplant recipients from six German transplant centres are randomised 2:1 to treatment with MIC (MIC group, N=42) or no treatment with MIC (control arm, N=21). MIC are manufactured from donor peripheral blood mononuclear cells under Good Manufacturing Practice conditions. The primary objective of this trial is to determine the efficacy of MIC treatment together with reduced conventional immunosuppressive therapy in terms of achieving an operational tolerance-like phenotype compared with SoC 12 months after MIC administration. Key secondary endpoints are the number of patient-relevant infections as well as a composite of biopsy-proven acute rejection, graft loss, graft dysfunction or death. Immunosuppressive therapy of MIC-treated patients is reduced during follow-up under an extended immunological monitoring including human leucocyte antigen-antibody testing, and determination of lymphocyte subsets, for example, regulatory B lymphocytes (Breg) and antidonor T cell response. A Data Safety Monitoring Board has been established to allow an independent assessment of safety and efficacy. Ethics and dissemination: ethical approval has been provided by the Ethics Committee of the Medical Faculty of the University of Heidelberg, Heidelberg, Germany (AFmu-580/2021, 17 March 2022) and from the Federal Institute for Vaccines and Biomedicines, Paul-Ehrlich-Institute, Langen, Germany (Vorlage-Nr. 4586/02, 21 March 2022). Written informed consent will be obtained from all patients and respective donors prior to enrolment in the study. The results from the TOL-2 Study will be published in peer-reviewed medical journals and will be presented at symposia and scientific meetings. Trial registration number NCT05365672.Publication Open Access Global changes in maternity care provision during the COVID-19 pandemic: a systematic review and meta-analysis(Elsevier, 2021) Townsend, R.; Chmielewska, B.; Barratt, I.; Van der Meulen, J.; Gürol Urgancı, I.; O'Brien, P.; Morris, E.; Draycott, T.; Thangaratinam, S.; Doare, K. L.; Ladhani, S.; Dadelszen, P. V.; Magee, L. A.; Khalil, A.; Kalafat, Erkan; Faculty Member; School of Medicine; 197389Background: the COVID-19 pandemic has had a profound impact on healthcare systems globally, with a worrying increase in adverse maternal and foetal outcomes. We aimed to assess the changes in maternity healthcare provision and healthcare-seeking by pregnant women during the COVID-19 pandemic. Methods: we performed a systematic review and meta-analysis of studies of the effects of the pandemic on provision of, access to and attendance at maternity services (CRD42020211753). We searched MEDLINE and Embase in accordance with PRISMA guidelines from January 1st, 2020 to April 17th 2021 for controlled observational studies and research letters reporting primary data comparing maternity healthcare-seeking and healthcare delivery during compared to before the COVID-19 pandemic. Case reports and series, systematic literature reviews, and pre-print studies were excluded. Meta-analysis was performed on comparable outcomes that were reported in two or more studies. Data were combined using random-effects meta-analysis, using risk ratios (RR) or incidence rate ratios (IRR) with 95% confidence intervals (CI). Findings: of 4743 citations identified, 56 were included in the systematic review, and 21 in the meta-analysis. We identified a significant decrease in the number of antenatal clinic visits (IRR 0614, 95% CI 0486–0776, P<00001, I2=54.6%) and unscheduled care visits (IRR 0741, 95% CI 0602–0911, P = 00046, I2=00%) per week, and an increase in virtual or remote antenatal care (IRR 4656 95% CI 7762–2794, P<00001, I2=90.6%) and hospitalisation of unscheduled attendees (RR 1214, 95% CI 1118–1319, P<00001, I2=00%). There was a decrease in the use of GA for category 1 Caesarean sections (CS) (RR 0529, 95% CI 0407–0690, P<00001, I2=00%). There was no significant change in intrapartum epidural use (P = 00896) or the use of GA for elective CS (P = 079) Interpretation: reduced maternity healthcare-seeking and healthcare provision during the COVID-19 pandemic has been global, and must be considered as potentially contributing to worsening of pregnancy outcomes observed during the pandemic.Publication Open Access Postoperative atrial fibrillation in adults with obstructive sleep apnea undergoing coronary artery bypass grafting in the RICCADSA cohort(Multidisciplinary Digital Publishing Institute (MDPI), 2022) Holtstrand-Hjalm, H.; Glantz, H.; Thunström, E.; Peker, Yüksel; Çelik, Yeliz; Faculty Member; Researcher; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; Graduate School of Health Sciences; 234103; N/APostoperative atrial fibrillation (POAF) occurs in 20-50% of patients with coronary artery disease (CAD) after coronary artery bypass grafting (CABG). Obstructive sleep apnea (OSA) is also common in adults with CAD, and may contribute to POAF as well to the reoccurrence of AF in patients at long-term. In the current secondary analysis of the Randomized Intervention with Continuous Positive Airway Pressure (CPAP) in Coronary Artery Disease and Obstructive Sleep Apnea (RICCADSA) trial (Trial Registry: ClinicalTrials.gov; No: NCT 00519597), we included 147 patients with CABG, who underwent a home sleep apnea testing, in average 73 +/- 30 days after the surgical intervention. POAF was defined as a new-onset AF occurring within the 30 days following the CABG. POAF was observed among 48 (32.7%) patients, occurring within the first week among 45 of those cases. The distribution of the apnea-hypopnea-index (AHI) categories < 5.0 events/h (no-OSA); 5.0-14.9 events/h (mild OSA); 15.0-29.9 events/h (moderate OSA); and >= 30 events/h (severe OSA), was 4.2%, 14.6%, 35.4%, and 45.8%, in the POAF group, and 16.2%, 17.2%, 39.4%, and 27.3%, respectively, in the no-POAF group. In a multivariate logistic regression model, there was a significant risk increase for POAF across the AHI categories, with the highest odds ratio (OR) for severe OSA (OR 6.82, 95% confidence interval 1.31-35.50; p = 0.023) vs. no-OSA, independent of age, sex, and body-mass-index. In the entire cohort, 90% were on beta-blockers according to the clinical routines, they all had sinus rhythm on the electrocardiogram at baseline before the study start, and 28 out of 40 patients with moderate to severe OSA (70%) were allocated to CPAP. During a median follow-up period of 67 months, two patients (none with POAF) were hospitalized due to AF. To conclude, severe OSA was significantly associated with POAF in patients with CAD undergoing CABG. However, none of those individuals had an AF-reoccurrence at long term, and whether CPAP should be considered as an add-on treatment to beta-blockers in secondary prevention models for OSA patients presenting POAF after CABG requires further studies in larger cohorts.