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Perioperative patient outcomes in the African Surgical Outcomes Study: a 7-day prospective observational cohort study
Bruce Biccard, T E Madiba, Hyla‐Louise Kluyts, Dolly M. Munlemvo, Farai Madzimbamuto, Apollo Basenero, Christina Salmina Gordon, Coulibaly Youssouf, Sylvia R Rakotoarison, Veekash Gobin, Ahmadou Lamin Samateh, Chaibou Maman Sani, Akinyinka Omigbodun, S D Amanor-Boadu, Janat Tumukunde, Tonya M. Esterhuizen, Yannick Le Manach, Patrice Forget, Abdulaziz M Elkhogia, Ryad Mehyaoui, Eugene Zoumeno, Gabriel Ndayisaba, Henry Ndasi, Andrew Ndonga, Zipporah Ngumi, Ushmah P Patel, Daniel Zemenfes Ashebir, Akwasi Antwi‐Kusi, Bernard Mbwele, Hamza Dôlès Sama, Mahmoud Elfiky, Maher Fawzy, Rupert M. Pearse, Hippolyte Abadagan, Nadine Abbas, A Ibrahim Abdelatif, Traoré Abdoulaye, A Abd-rouf, Abdulkamal H. Abduljalil, A. Abdulrahman, S Abdurazig, A Abokris, Wisam Abozaid, SOA Abugassa, F Abuhdema, SA Abujanah, Rania Abusamra, Abubaker Abushnaf, SA Abusnina, TS Abuzalout, HM Ackermann, YB Adamu, A Addanfour, DM Adeleke, Adigun Ta, Adewale Adisa, Sèhivè Valéry Adjignon, Nii Armah Adu-Aryee, Bosede Bukola Afolabi, AFX Agaba, PKA Agaba, Kene Ifeanyi Aghadi, Hamza Mahmoud Agilla, Boushra Ahmed, El-Z Ahmed, Al-J Ahmed, Muhammed Ahmed, Rene Ahossi, SA Aji, S Akanyun, Irene Akhideno, Murtaza Akhter, OA Akinyemi, Manel Akkari, Joseph Akodjènou, AL AL Samateh, ES al Shams, Olubusola Alagbe-Briggs, EA Alakkari, RB Alalem, Mohamed Ebrahim Ali Al-Ashhab, OI Alatise, A Alatresh, MSI Alayeb Alayeb, BA Albakosh, F Albert, ANJD Alberts, AD Aldarrat, A Alfari, A Alfetore, M Algbali, A Algddar, HA Algedar, IA Alghafoud, A Alghazali, Mohammed Nasser Alhajj, A Alhendery Alhendery, FFH Alhoty, A Ali, Yusra S. Al Ali, Beye Seïdina Alioune, Mulham Alkassem, MA Alkchr, TS Alkesa, A Alkilani, F Alkobty Alkobty, Thomas Allaye, SBM Alleesaib, Ahmad Alli, K Allopi, Nikki Allorto, A Almajbery, R Almesmary, SHA Almisslati, F Almoraid, H Alobeidi, MA Alomami, Christella S. Alphonsus, OA Alqawi, Anwar Abd Alraheem, SA Alsabri, A Alsayed, B Alsellabi, M Al-Serksi, MSA Alshareef, AA Altagazi, JS Aluvale, HW Alwahedi, EA Alzahra, MA Alzarouk, Kais Alzubaidy, Maiga Amadou, Al-A Amer, BT Amisi, MA Amuthenu, TWA Anabah, Felix Anani, PGR Anderson, AGB Andriamampionona, L Andrianina, Angelica A. Anele, R Angelin, N Anjar, O Antùnez, LJC Anyanwu, AA Aribi, OA Arowolo, O Arrey, SB Assefa, Guy Assoum, V Athanse, JS Athombo, Mudassir Atiku, Evans Atito‐Narh, Anatole Atomabe, Attia Attia, M Aungraheeta, DMA Aurélia, O O Ayandipo, AET Ayebale, HMZ Azzaidey, NB Babajee, EK Badianga, RB Baghni, MT Bahta, Michelle Bai, Y Baitchu, AM Baloyi, KA Bamuza, MI Bamuza, L Bangure, Olufemi Bankole, ML Barongo, MM Barow, L Bashiya, CH Basson, S. Belhaj, MM Ben Mansour, D Benali, ASB Benamour, A Berhe, JD Bertie, JJA Bester, Marlet Bester, JD Bezuidenhout, Kamal Bhagwan, DR Bhagwandass, KAP Bhat, MMZU Bhuiyan, F. Bigirimana, CJ Bikuelo, BE Bilby, SS Bingidimi, KE Bischof, David G. Bishop, Caesar Bitta, Mustapha Bittaye, Thuli Biyase, CA Blake, E Blignaut, F Blignaut, BN BN Tanjong, A Bogoslovskiy, PM Boloko, SKB Boodhun, I Bori, F Boufas, Margaret Brand, Nicholas T Brouckaert, JD Bruwer, Ines Buccimazza, IM Bula Bula, Fred Bulamba, BC Businge, YB Bwambale, SRC Cacala, MA Cadersa, Chris Cairns, Francisco Luan Sales Carlos, ME Casey, AC Castro, ND Chabayanzara, MS Chaïbou, TNO Chaibva, NK Chakafa, C Chalo, C Changfoot, MC Chari, L Chelbi, JT Chibanda, HN Chifamba, N Chikh, Edson Chikumba, Pugie Tawanda Chimberengwa, J Chirengwa, FM Chitungo, MC Chiwanga, MM Chokoe, T Chokwe, B Chrirangi, M. Shaffer Christian, Bruce W. Church, JC Cisekedi, J. N. A. Clegg-Lamptey, Estie Cloete, Megan Coltman, W Conradie, Nwadike Constance, L Cronjé, MA Da Silva, H Daddy, L Dahim, D Daliri, MS Dambaki, Ashish Dasrath, J Davids, Gareth Davies, JT De Lange, JB de Wet, Britta Dedekind, MA Degaulle, V Dehal, PD Deka, S Delinikaytis, Ibironke Desalu, Hubert Dewanou, MB Moussa Deye, Celestino Dhege, BSG Diale, DF Dibwe, BJS Diedericks, JM Dippenaar, L Dippenaar, MP Diyoyo, Edith Djessouho, SN Dlamini, A Dodiyi-Manuel, BA Dokolwana, DP Domoyyeri, Leanne Drummond, DE du Plessis, WM du Plessis, LJ du Preez, Kudakwashe Dube, NZ Dube, KD Dullab, R Duvenhage, RC Echem, SA Edaigbini, AK Egote, A Ehouni, Gerald Ekwen, NC Ekwunife, M El Hensheri, IE Elfaghi, MA Elfagieh, Sara Elfallah, Saad El Gelany, AM Elghallal, MG Elghandouri, Zahia Elghazal, AM Elghobashy, FT Elharati, RM Elkhwildi, Susan Ellis, L Elmadani, HB Elmadany, Haitham Elmehdawi, A Elmgadmi, H Eloi, D Elrafifi, G Elsaadi, RB Elsaity, A Elshikhy, M Eltaguri, A Elwerfelli, IE Elyasir, AZ Elzoway, AM Elzufri, EO Enendu, BC Enicker, EO Enwerem, Reiye Esayas, M Eshtiwi, AA Eshwehdi, JL Esterhuizen, EB Etuk, O Eurayet, OR Eyelade, RF Fanjandrainy, Lionelle Fanou, Zane Farina, A Feituri, NL Fernandes, LM Ford, T François, Thomas H. Freeman, YBM Freeman, VM Gacii, B Gadi, M Gagara, A Gakenia, PD Gallou, GGN Gama, MG Gamal, YG Gandy, Aravind Ganesh, Diallo Gangaly, M Garcia, AP Gatheru, SSD Gaya, Oswald Gbéhadé, G Gerbel, A Ghnain, R Gigabhoy, DG Giles, GT Girmaye, S Gitau, B Githae, Said Gitta, Riaz Goga, AAG Gomati, ME González, Jayprakash Gopall, O Gorelyk, Murtaza Ali Gova, Komalan Govender, P Govender, S. Govender, V Govindasamy, JTK Green-Harris, MB Greenwood, SV Grey-Johnson, Mariette Grobbelaar, MA Groenewald, KK Grünewald, Ambroise Guegni, M Guenane, Sérigne Maguèye Gueye, Marius Guezo, T Gunguwo, MG Gweder, Mohamed Gwila, Laurence Habimana, Rodrigue Hadecon, E Hadia, L Hamadi, M. Hammouda, MI Hampton, R Hanta, Timothy Craig Hardcastle, JA Hariniaina, S Hariparsad, AH Harissou, Rohen Harrichandparsad, SHA Hasan, HB Hashmi, MP Hayes, A Hdud, SH Hebli, HMSN Heerah, Salad Abdirahman Hersi, AH Hery, Adam Hewitt‐Smith, TC Hlako, S Hodges, Richard Hodgson, M Hokoma, Hillary B. Holder, EB Holford, E Horugavye, Collette Houston, Mazvangu Onie Hove, D Hugo, CM Human, Heikki Hurri, O Huwidi, AI Ibrahim, Traoré Ibrahim, OK Idowu, IE Igaga, John Igenge, O Ihezie, K Ikandi, IAR Ike, JJN Ikuku, MN Ilbarasi, IBB Ilunga, NAV Imbangu, Z Imessaoudene, DH Imposo, AM Iraya, Moenieba Isaacs, MC Isiguzo, A Issoufou, P Izquirdo, Ahmad Jaber, UV Jaganath, CS Jallow, S Jamabo, ZS Jamal, Lamin Janneh, MJ Jannetjies, I Jasim, Megan Jaworska, Sonali Narain, K Jermi, Rasheed Gbenga Jimoh, Sandhya Jithoo, Mary Ann Johnson, Shehzaad Joomye, RM Judicael, M Judicaël, A Juwid, LP Jwambi, R Kabango, JK Kabangu, DK Kabatoro, AN Kabongo, Kizito Mulamba Changachanga Kabongo, LT Kabongo, MD Kabongo, N Kady, S Kafu, M Kaggya, BNK Kaholongo, PCK Kairuki, SI Kakololo, K Kakudji, A Kalisa, Richard Kalisa, MR Kalufwelu, S Kalume, RJ Kamanda, MK Kangili, Houda Kanoun, Kapesa, Paul Kapp, JK Karanja, Maha Karar, Kevin Kariuki, K Kaseke, PNK Kashuupulwa, KJP Kasongo, SK Kassa, GK Kateregga, MIS Kathrada, PM Katompwa, Locadia Katsukunya, KAM Kavuma, Khalfallah, Arvin Khamajeet, SB Khetrish, Kibandwa, W Kibochi, AM Kilembe, AK Kintu, B Kipng'etich, B Kiprop, VMK Kissoon, Theroshnie Kisten, J. K. Kiwanuka, MEK Knox, AK Koledale, VL Koller, MA Kolotsi, Moïse Kongolo, ND Konwuoh, WJ Koperski, MYK Koraz, AA Kornilov, Modise Zach KOTO, Samantha Kransingh, D Krick, Salomé H. Kruger, Carl‐Heinz Kruse, W Kuhn, AM Kukembila, KL Kule, Manoj Kumar, Belinda Kusel, VK Kusweje, KJ Kuteesa, YY Kutor, MA Labib, M Laksari, F Lanos, Taiwo Lawal, C Lee, RM Lekoloane, SN Lelo, B Lerutla, MT Lerutla, Andrew Levin, TB Likongo, ML Limbajee, DM Linyama, C. Lionnet, MM Liwani, Emil Loots, A Garrido Lopez, CLC Lubamba, KF Lumbala, AJM Lumbamba, John Lumona, RF Lushima, L Luthuli, HL Luweesi, TSK Lyimo, HM Maakamedi, BM Mabaso, M Mabina, ME Maboya, Isaac Macharia, AM Macheka, AZ Machowski, ASM Madsen, LJ Madzivhe, SC Mafafo, M Maghrabi, Diango Djibo Mahamane, A Maharaj, AD Maharaj, MR Mahmud, M Mahoko, NA Mahomedy, O Mahomva, TM Mahureva, RK Maila, DM Maimane, Mayaba Maimbo, SN Maina, Dela A Maiwald, MD Maiyalagan, Nelisile Majola, N Makgofa, V Makhanya, WP Makhaye, NM Makhlouf, S Makhoba, EK Makopa, O Makori, Alex Makupe, MA Makwela, ME Malefo, SM Malongwe, DM Maluleke, MR Maluleke, Kaloga Mamadou, MP Mamaleka, Y Mampangula, RM Mamy, MNR Mananjara, MTM Mandarry, DM Mangoo, C Manirimbere, Alagie Manneh, A. Mansour, Islam Mansour, M Manvinder, DV Manyere, VT Manzini, JK Manzombi, PM Mapanda, LC Marais, O. Maranga, JPB Maritz, FK Mariwa, RS Masela, MM Mashamba, Doreen Mashava, MV Mashile, E Mashoko, OR Masia, JN Masipa, ATM Masiyambiri, MW Matenchi, W Mathangani, RC Mathe, Christopher Y Matola, PM Matondo, Roel Matos‐Puig, JT Matubatuba, HP Mavesere, R Mavhungu, S Maweni, CJM Mawire, Timothe Nkemfuni Mawisa, S. Mayeza, R Mbadi, Michel Mandungu Mbayabu, Njelembo J. Mbewe, WD Mbombo, Timothée Kamanga Mbuyi, WMS Mbuyi, MW Mbuyisa, RM Mehyaoui, ID Menkiti, LVM Mesarieki, A Metali, Serge Mewanou, L Mgonja, N. Mgoqo, S Mhatu, TM Mhlari, S. Miima, IM Milod, P Minani, F Mitema, A Mlotshwa, JE Mmasi, T Mniki, BO Mofikoya, JO Mogale, A Mohamed, S Mohamed, TS Mohamed, AM Mohamed, P Mohamed, Imran Pasha Mohammed, Mohammed Mustafa Hassan Mohammed, NM Mohammed, MP Mohlala, R Mokretar, FM Molokoane, KN Mongwe, Lisa M. Montenegro, OD Montwedi, QK Moodie, M Moopanar, M Morapedi, TG Morulana, VL Moses, P Mossy, Heba H. Mostafa, SR Motilall, SP Motloutsi, Moussa Kanté, M Moutari, OM Moyo, PE Mphephu, Busi Mrara, C Msadabwe, VM Mtongwe, FK Mubeya, K Muchiri, Jim Kelly Mugambi, GIM Muguti, AB Muhammad, IF Mukama, MM Mukenga, Fidele Kanyimbu Mukinda, PM Mukuna, ARW Mungherera, TW Munyaradzi, AA Munyika, JM Muriithi, MP Muroonga, R Murray, V. Mushangwe, M Mushaninga, VEM Musiba, JM Musowoya, S Mutahi, MGH Mutasiigwa, G Mutizira, Alex Muturi, Tanaka Muzenda, KR Mvwala, NM Mvwama, A. Mwale, CN Mwaluka, JD Mwamba, HAM Mwanga, CM Mwangi, S Mwansa, Valerian Mwenda, IM Mwepu, TM Mwiti, SZ Mzezewa, L Nabela, SM Nabulindo, K Naicker, Devarani Naidoo, L Naidoo, N Naidoo, R Naidoo, Shaun Naidoo, TD Naidoo, TK Naidu, NZ Najat, Y Najm, F Nakandungile, P Nakangombe, CN Namata, ES Namegabe, A Nansook, NP Nansubuga, Christian Nantulu, Rodrigue Nascimento, GT Naude, Henry Nchimunya, MA Ndaie, PN Ndarukwa, D. Ndegwa, R. Ndikumana, C Ndung'u, MC Neil, MS Nel, EV Neluheni, DS Nesengani, NT Nesengani, LE Netshimboni, AM Ngalala, BM Ngari, NBM Ngari, E Ngatia, GK Ngcobo, TS Ngcobo, D Ngorora, D Ngouane, K Ngugi, Z Nibe, E Ninise, JC Niyondiko, PW Njenga, MN Njenga, Martin Njoroge, Scolastica Njoroge, W Njuguna, PN Njuki, T Nkesha, TN Nkuebe, NP Nkuliyingoma, M Nkunjana, Ernest Nkwabi, RN Nkwine, Chimaobi Tim Nnaji, I Notoane, Shaaban Nsalamba, LM Ntlhe, Crispin Ntoto, B Ntueba, MT Nyassi, Z Nyatela-Akinrinmade, HO Nyawanda, NN Nyokabi, VN Nziene, S Obadiah, OJP Ochieng, PK Odia, OEO Oduor, EO Ogboli-Nwasor, Swo Ogendo, Olayinka Ogunbode, TO Ogundiran, Omondi Ogutu, Rufus Wale Ojewola, M Ojujo, DO Ojuka, OS Okelo, S Okiya, N Okonu, P Olang, S Omoding, J. Omoshoro–Jones, Rosebella Onyango, A Onyegbule, O Orjiako, MO Osazuwa, Kpatinvo Oscar, Babatunde Osinaike, AO Osinowo, OM Othin, FFH Otman, Job Otokwala, F Ouanes, Oumar Ongoïba, AO Ousseini, Soundrie Padayachee, SM Pahlana, J Pansegrouw, Fathima Paruk, MB Patel, Ushmaben Patel, AP Patience, JD Pembe, GN Pengemale, Noelia Pérez, MF Perez, Aunel Mallier Peter, M Phaff, RM Pheeha, BH Pienaar, V Pillay, KA Pilusa, MP Pochana, О. В. Поліщук, Owen S Porrill, EF Post, A Prosper, M Pupyshev, A Rabemazava, MS Rabiou, Lana Rademan, M Rademeyer, RAR Raherison, FR Rajah, MSR Rajcoomar, Z. Rakhda, AHR Rakotoarijaona, AHN Rakotoarisoa, RR Rakotoarison, Lamiaa Zakria Taha Ramadan, MLR Ramananasoa, M Rambau, TPR Ramchurn, HE Ramilson, Rajesh Ramjee, H Ramnarain, Rodrigo Rizzo Nogueira Ramos, TJ Rampai, S.R. Ramphal, T Ramsamy, R Ramuntshi, Randy Randolph, D.M.A. Randriambololona, WAP Ras, RAF Rasolondraibe, JDLC Rasolonjatovo, RM Rautenbach, Sunanda Ray, Sarah Rayne, FAR Razanakoto, K. Srinath Reddy, Anthony Reed, JR Rian, FR Rija, B Rink, AT Robelie, C Roberts, AGL Rocher, Sylvain Rocher, Reitze Rodseth, I Rois, W Rois, S Rokhsi, John Roos, Nicolette F. Rorke, Héctor León Roura, FJ Rousseau, Nikki Rousseau, L Royas, David Roytowski, Devan Rungan, SSR Rwehumbiza, BB Ryabchiy, V Ryndine, CR Saaiman, HK Sabwa, Said Hamid Sadat, SS Saed, E Salaheddin, H Salaou, Mahmoud Saleh, HM Salisu-Kabara, W. Sam-Awortwi, N Samuel, DK Sanduku, LN Sanyang, HN Sarah, A. Sarkin-Pawa, Ronisha Sathiram, T Saurombe, H. Schütte, MP Sebei, MD Sedekounou, MP Segooa, EM Semenya, BO Semo, CS Sendagire, SA Senoga, FS Senusi, T. Serdyn, MD Seshibe, GB Shah, R Shamamba, CS Shambare, TN Shangase, SH Shanin, IE Shefren, AA Sheshe, OB Shittu, AS Shkirban, Tunde Sholadoye, A Shubba, Nompumelelo Sigcu, SE Sihope, DS Sikazwe, BS Sikombe, Koffi Abdoul, WAG Simo, K Singata, AS Singh, Sweta Singh, Usha Singh, V Sinoamadi, N. Sipuka, NLM Sithole, S Sitima, David Lee Skinner, GC Skinner, OI Smith, CAG Smits, MSI Sofia, Sogoba Gaoussou, A Sohoub, SS Sookun, O Sosinska, Rosalie Souhe, G Souley, Souleymane Thiam, JM Spicer, Sandra Spijkerman, Harald Steinhaus, Annemarie Steyn, Gert Steyn, HC Steyn, Heidi L Stoltenkamp, S Stroyer, Abu Swaleh, E Swayeb, AJ Szpytko, NA Taiwo, A Tarhuni, D Tarloff, Blaise Adelin Tchaou, Charles Tchegnonsi, M Tchoupa, MO Teeka, B Thakoor, MM Theunissen, BP Thomas, MB Thomas, A. Thotharam, O Tobiko, Alexandra Torborg, SM Tshisekedi, SK Tshisola, R Tshitangano, F Tshivhula, HT Tshuma, Myint Tun, IA Udo, DI Uhuebor, KU Umeh, AO Usenbo, JdD Uwiteyimbabazi, DJ Van der Merwe, Haynes Van Der Merwe, JE van der Walt, Dominique van Dyk, JJS van Niekerk, S van Wyk, HA van Zyl, B Veerasamy, PJ Venter, AJ Vermeulen, Roberto Villarreal, Jantien Visser, Linda Visser, Michael Voigt, Richard P von Rahden, A Wafa, A Wafula, PK Wambugu, P Waryoba, EN Waweru, Mark W. Weideman, Robert Wise, EE Wynne, AI Yahya, A. K. Yahya, Rani Haj Yahya, Yusuf Yakubu, JJ Yanga, YM Yangazov, Osama Yousef, George M. Yousef, A Yunus, AS Yusuf, AZ Zeiton, HZ Zentuti, Henry Zepharine, AB Zerihun, Sheng Zhou, Ahmed Mohy Zidan, Sanogo Zimogo Zié, CZ Zinyemba, A Zo, Lidwine Zomahoun, NZ Zoobei, Eugène Zoumènou, NZ Zubia
Bibliographic record
VenueThe Lancet · 2018
Typearticle
Languageen
FieldMedicine
TopicGlobal Health and Surgery
Canadian institutionsMcMaster UniversityPopulation Health Research Institute
FundersNational Institute for Health and Care Research
KeywordsMedicinePerioperativeObservational studyCohortPopulationCohort studyProspective cohort studyEmergency medicinePediatricsSurgeryInternal medicineEnvironmental health
Abstract
No abstract in any covered source. Its absence is recorded, not treated as a negative.
No abstract. This is not a gap in this database; OpenAlex has none either. 23.3% of the frame is in this state, and the screen finds HALF as much metaresearch here, so the absence is a measured bias rather than a missing field.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
metaresearch head score (Codex)0.002
metaresearch head score (Gemma)0.004
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.009
Threshold uncertainty score0.018
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
Opus teacher head0.063
GPT teacher head0.365
Teacher spread0.301 · how far apart the two teachers sit on this one work
Validation status
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".
Quick stats
Citations586
Published2018
Admission routes1
Has abstractno