Wednesday, Feb 27, 2019
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1 Hall: Hall A - 08:00-10:00 Ahmed Bahaa Ahmed El Shahat Aly Moftah Amr Magdy Ashraf Abdel Kader Ashraf Zekry Hossam Elkafrawi Session 1 Rising stars Ismail Ibrahim Mohamed El Shazly Safwat Abdel Kader Soha Mekawy Soraya Terzaki Wael Sakr 08:00-08:06 Super drainage reverse flow sural flap for foot and ankle reconstruction Ibrahim Sameh Rihan South Valley University 08:06-08:12 Role of MRI in Detection of Repaired Cleft Palate Muscles and Correlation to Speech Amr Mahmoud Abdel Rahman El Sahel Teaching Hospital 08:12-08:18 Multi-Disciplinary Team (MDT) Experience at Kasr Al Ainy Burns Unit Yusuf Ashraf Elkholy 08:18-08:24 Comparison Between Traditional Mustardé Sutures And Incisionless Otoplasty for Prominent Ear Correction Mohamed Elsayed Mohamed Abdelwahed Al-Ahrar Teaching Hospital 08:24-08:30 The Role of Newer Modalities of Conservative Treatment on the Functional and Aesthetic outcome of Fingertip Injuries Kareem Ahmed El-Shishtawy Tanta University Hospitals 08:30-08:36 The impact of remodeling psychological status on morbidity and prognosis of major burn patients Medhat Samy Aly Hassan Menoufia University 08:36-08:42 Dorsal ulnar artery based flap with adipofascial pedicle for coverage of dorsal hand defects Mohamed Radi Hassan Abdalla Mansoura International Hospital 1
2 08:42-08:48 MRL and Clinical Evaluation of Free Lymph Node Transfer in Management of Lymphedema of Extremities Mohamed Said Mohamed Ali Elkholy El Shikh Zaied Al Nahian Hospital 08:48-08:54 Reliability of the suprafascial groin flap Nadeen Mohamed El-Essawy 08:54-09:00 Management of facial burns: our experience with hydrogel Noura Khaled Ahmed Mamdouh Abdelwahed 09:00-09:06 Silver containing Hydro fiber dressing in management of pediatric patients with partial thickness burns Youssef Rizkalla Hospital 09:06-09:12 Innovative Management Strategy for Combined Proximal Median and Ulnar Nerve Extensive Injury: A Case Report Samir Mohamed Ghoraba Tanta University 09:12-09:18 Prospective study to evaluate effect of autologous plasma injection in the wound site immediately after wound closure Mohamed Mustafa Saeed Um Elmasryeen Hospital 09:18-09:24 A comparative study between vac and prp in management of complex wounds Fatema Youssef El Helmeya Military Hospital 09:24-09:30 Functional and aesthetic evaluation of conservative management of fingertip amputations Abdulrahman Mahmoud Alnakeeb Um Elmasryeen Hospital 09:30-09:36 Plastic surgery resident Mohamed Abd Allah Abd Elmohsen Atta Kafer El-Shikh Hospital 09:36-10:00 Discussion 2
3 Hall: Hall B - 08:00-10:00 Ashraf Barakat Fawzy Hamza Gamal Abdelazim Rabie Hany Saad Helmy Shalaby Mahmoud Abdel Rahman Session 2 Rising stars #2 Mamdouh Badwi Mohamed Osamah Kotb Moustafa Abuel Soued Raafat Anani Tarek Keshk Yehia Zakaria 08:00-08:06 Total autologous breast reconstruction in post mastectomy patients by Extended Latissimus Dorsi muscle flap Riham Eldesouki Ibrahim Ain Shams University 08:06-08:12 Efficacy of interpostional vascular grafts as a tool for revascularization in crushing injuries of the upper extremity; case series Mahmoud Elsayed Gouda Zagazig University 08:12-08:18 Dorsalis pedis artery free flap as spare part surgery. Case report Ahmed Mohamed Soliman Al-Ahrar Teaching Hospital 08:18-08:24 Comparison of the effect of topical lidocaine and verapamil on vessel diameter in microsurgery: an experimental study in rats Mostafa Edris 08:24-08:30 Effect of Incisional Negative Pressure wound Therapy versus Standard Care Dressing in Prevention of Wound Complications in Breast Reduction Mina Samir Nan Abd El Maseih Um Elmasryeen Hospital 08:30-08:36 Role of Integra in post-traumatic foot defects (preliminary report) Mahmoud Farouk Elsagheer Ahmed Maher Teaching Hospital 08:36-08:42 Gynecomastia, no more debate, updated solutions for all degrees (Cases presentation) -converted Ibrahim Yehia Um Elmasryeen Hospital 08:42-08:48 A Review in Management of Animal Assault Sarah Omar Minia University 3
4 08:48-08:54 Lateral Nasal Artery Perforator flap: Clinical applications Ahmed Mohamed Khazbak Mataria Teaching Hospital 08:54-09:00 Optimizing Surgical Outcomes in Acute Facial Nerve Injuries Ahmed Taher Ismail 09:00-09:06 Different Modalities of Soleus Muscle Flap in Reconstruction of Middle Third Pretibial Defects Ola Ahmed Safe Banha University Hospital 09:06-09:12 Combined scar subcision and autologous fat grafting for depressed facial scar correction Ahmed Abdel Rahman Samak El Salam Specialized Hospital 09:12-09:18 Posterior approach to neurotize suprascapular nerve by spinal accessory nerve Ahmed Mohamed Eldesoky Al-Ahrar Teaching Hospital 09:18-09:24 Efficacy of adipose derived stem cells in management of chronic ulcers: clinical and laboratory study Emil Sabry Assiut University 09:24-09:30 The workflow of CADCAM process & its application in crainofacial surgery Hossam Hassan Menoufia University 09:30-09:36 Use of the masseteric nerve to treat segmental midface paresis Mahmoud Soliman Assiut University 09:36-09:42 Female Genitoplasty Plastic surgeons VS Gynecologists..Why? Eman Ahmed Ahmed Mohamed Health Insurance Organization Hospital in Assuit 09:42-10:00 Discussion 4
5 Hall: Hall A - 10:00-11:45 Session 3 Breast I " Aesthetic " The Head of ESPRS Aesthetic Chapter: Prof. Hassan Badran Abdul Shaheed Fadhul Iman Labib Ahmed El Badawy Mohamed El Hadidy Alaa Gheita Mohamed Sobhi Zaki 10:00-10:10 The Universal Mammoplasty Alaa Gheita 10:10-10:20 Inverted T versus Vertical technique in Reduction Mammoplasty: Towards a safe Aesthetic Breast Saad Elfayomy Ain Shams University 10:20-10:30 Dermal vault technique in breast aesthetic surgery Abdul Shaheed Fadhul Manama-Bahrain 10:30-10:40 Reduction Mammoplasty: " Lalardrie Technique " Dermal Vault Ashraf Zekri Mataria Teaching Hospital 10:40-10:50 Breast asymmetry is it a difficult task? Youssef Saleh Hassan Assiut University 10:50-11:00 T- Junction Suffer in Skin Reduction Mammoplasty Wael Sakr Beni Suef University 11:00-11:10 Auto-augmentation mastopexy, a natural alternative to breast implants Ihab Zayed Tanta University 11:10-11:20 Breast surgery in Elzahraa university Asmaa Ali Dahy Al Azhar University 11:20-11:45 Discussion 5
6 Hall: Hall B - 10:00-11:45 Session 4 Hand & Upper Extremity The Head of the ESPRS Chapter: Prof. Hussein Saber Ahmed Abo-Hashem Ahmed Maged Elmofty Fayez El Deeb Mohamed Hassan Mohammad Reda Omar Shouman 10:00-10:10 Multidisciplinary approach to mangled upper extremity: Identification of management pitfalls Raafat Anani Zagazig University 10:10-10:20 Distraction Histogenesis of contracted fingers Ismail Ibrahim Mataria Teaching Hospital 10:20-10:30 Mutilating Hand Injuries; Always a Challenge to Plastic Surgeons Medhat Emil Habib Abu Dhabi 10:30-10:40 The versatility of propeller perforator flaps in upper extremity reconstruction Mohamed Ellabban Suez Canal University 10:40-10:50 Homodigital flap reconstruction for digital injuries Khaled Hassan Minia University 10:50-11:00 Updated concepts in optimizing the management of ulnar nerve injuries using neurotization and tendon transfers Mohamed El Wahsh Zagazig University 11:00-11:10 Various Finger Swellings in Plastic Surgery Practice Hany Saad Algalaa Military Medical 11:10-11:20 Clinical applications of ulnar artery perforator flaps Omar Ahmed El Sharkawy 11:20-11:30 Outcome of Thumb Reconstruction Using the First Dorsal Metacarpal Artery Island Flap. Wael Hussein Mahmoud Tanta University 11:30-11:45 Discussion 6
7 Hall: Hall A - 11:45-12:45 Opening Ceremony 12:45 12:15 Ahmed Maged Elmofty Ayman Abo El Makarem Atef Emam Hashem Ayad Osama Elshahat 12:15-12:45 Behrei Lecture Our ESPRS its vision & future Hussein Saber Alexandria University 12:45-13:15 Coffee Break Hall: Hall A - 13:15-15:15 Session 5 A.O Founder of AOCMF Middle East & Northern Africa Board: Prof. Mostafa Hemeda Ahmed Medra Mohamed Amin Amir El Barbary Mohamed Hazem Ikram Safe Mostafa Hemeda Karam Allam Susan Hassan 13:15-13:23 Welcome address, introduction of faculty, session objectives Mostafa Hemeda Ain Shams University 13:23-13:31 Managing midfacial trauma using hidden surgical approaches Amir El Barbary Ain Shams University 7
8 13:31-13:39 Improving aesthetic outcome in managing recent & old upper & midface deformities using computer-assisted planning Mohamed Amin Ain Shams University 13:39-13:47 Rhinoplasty for post traumatic nasal deformities Mostafa Hemeda Ain Shams University 13:47-13:55 Aesthetic periorbital reconstruction Ikram Safe Ain Shams University 13:55-14:03 Optimizing cosmetic outcome in managing CMF fractures using endoscopic assisted techniques Mohamed Abdel Azeem 14:03-14:11 Managing post traumatic mandibular deformities with navigations and 3D printing Ahmed Medra Alexandria University 14:11-14:19 Enhancing aesthetic results in management of TMJ ankylosis Susan Hassan Al Azhar University 14:19-14:27 Aesthetic considerations in managing pan facial fractures Mostafa Hemeda Ain Shams University 14:27-14:35 Reflection and Q&A All Faculty 14:35-14:43 Aesthetic reconstruction of orbital deformities in craniofacial anomalies Amir El Barbary Ain Shams University 14:43-14:51 Craniofacial clefts: the aesthetic challenge of reconstruction Karam Allam Sohag University 14:51-14:59 Reflection and Q&A All Faculty 14:59-15:07 AOCMF educational offerings Amir El Barbary Ain Shams University 15:07-15:15 Summary & Conclusions Mostafa Hemeda Ain Shams University 8
9 Hall: Hall B - 13:15-15:15 Session 6 Burn The Head of ESPRS Burn Chapter: Prof. Mohamed Kadry Amr Mabrok Mohamed Kadry Ezzeldin Eldolify Naeem Moamen Marwan Al-Zarwani WU Jun 13:15-13:25 Management of burns of hands Mohamed Kadry 13:25-13:35 Surgical Management of major Burns Naeem Moamen UK 13:35-13:45 The talks are: Burn injury in China WU Jun China 13:45-13:55 burn scar contrcure of hands upper and lower exrimity. Diaa Mohamed Diab USA 13:55-14:05 Topical antimicrobial treatment of the burn wound Naeem Moamen UK 14:05-14:15 Design of a Modern Burns Unit: Guidelines and Challenges Ahmed Nawar 14:15-14:25 ABSI scoring system for burns: concerns and modifications in a developing country Rama Ahmed Ali 14:25-14:35 Pattern of burns in a population presented to hospitals over one year; an epidemiological study Ahmed Ali Taha 14:35-14:45 Our Protocol in Burn centers by early excision & cellulous dressing Atef Emam Military Medical Academy 14:45-15:15 Discussion 9
10 Hall: Hall A - 15:15-17:15 Session 7 Micro Surgery & Reconstruction The Head of ESPRS Micro Surgery Chapter: Prof. Ayman Abo Elmakarem Abdou Darwish Elsayed Mandour Ismail Ahmed Tarek Atta Magdy Abdel Moktader Ayman Abo El Makarem Wael Ayad 15:15-15:25 Lower lip reconstruction after excision of carcinoma Abdou Darwish Minia University 15:25-15:35 Perioral defects - Reconstructive techniques Ahmed Mahrous Minia University 15:35-15:45 Deep External Peudendal Artery (DEPA) Flap for Phalloplasty a Single Stage Sensate Phallus Magdy Abdel Moktader Al Azhar University 15:45-15:55 V-Y modified TFL flap for deep aggravated trochanteric pressure ulcer Fayez El Deeb Ahmed Maher Teaching Hospital 15:55-16:05 Head and Neck Microsurgery Outcomes and Complication Abdulaziz Jarman KSA 16:05-16:15 Replantation surgery challenges and prospect Mohammad Reda Zagazig University 16:15-16:25 Reconstruction of the knee defects by saphenous artery based posteromedial leg fascia-cutaneous flap Ayman Altramsy Al Azhar University 16:25-16:35 Perforator to Perforator Vascularized Sural Nerve Flap using Supermicrosurgery technique in Extremity Reconstruction Mohammed El Fahar Mansoura University 16:35-16:45 The Keystone Island Perforator Flap in Reconstruction of Large Myelomeningocele Defect Mahmoud Abdalla Hifny South Valley University 10
11 16:45-16:55 Reconstruction of Complex Soft-tissue Defects in Leg and Foot with Free Anterolateral Thigh Perforator Flap. Mohamed Abdalla Elnahas Menoufia University 16:55-17:05 Evolutions in peripheral nerve surgeries Salah Abdel Ghani Al Azhar University 17:05-17:15 Discussion Hall: Hall B - 15:15-17:15 Ahmed Mohamed Aly Saad Elfayomy Tarek Abulezz Session 8 Miscellaneous Tarek Atta Tarek Said 15:15-15:25 Pressure injuries patients: do they developed deep venous thrombosis, Yes or No? Fawzy Hamza Al Azhar Univerisity 15:25-15:35 SPOTLIGHT ON chronic sinus of the foot Mahmoud Abdel Rahman El Sahel Teaching Hospital 15:35-15:45 Treatment of Vaginal Relaxation Syndrome Gamal Gomaa KSA 15:45-15:55 Proposed Genetic Classification for the Skin Types (Helmy s Skin Types Classification) Yasser Helmy Al Azhar University 15:55-16:05 Artificial Dermis; Will it Replace Flaps Surgery? Medhat Emil Habib Abu Dhabi 16:05-16:15 Surgical management of penile and scrotal lymphedema Walid Moustafa Tanta University 11
12 16:15-16:25 Plastic Surgery in Diabetic Foot care Mohammed AlNasir KSA 16:25-16:35 New strategies for scar management Mohamed Shoeib Sohag University 16:35-16:45 Evaluation of the use of single stage dermal substitutes in acute and chronic wounds of the hand Ahmed Awad Mitwalli Mohamed KSA 16:45-16:55 Congenital Muscular torticollis, what is the appropriate time for intervention? Mohammed Ahmed Hussein 16:55-17:05 Platelet Rich Plasma (PRP) Enriched Fat Graft and Co2 Fraction Laser for Improvement of Depressed Facial Scars. Maurice Fekry Khalil Mataria Teaching Hospital 17:05-17:15 Discussion 17:15 Lunch Break 12
13 Thursday, Feb 28, 2019 Hall: Hall A - 08:30-11:00 Session 9 Aesthetic The Head of ESPRS Aesthetic Chapter: Prof. Hassan Badran Ahmed Adel Nor Eldin Hassan Badran Ahmed El Sharkawy Heba Hussein Amir Abdel Kareem Karim Massoud 08:30-08:40 Role of chin in facial aesthetics Hassan Badran Ain Shams University 08:40-08:50 History and Evolution of Fat Grafting Mohamed Sobhi Zaki 08:50-09:00 Fat transfer for management of facial atrophy Ahmed El Sharkawy 09:00-09:10 Lip beautification by fillers and fat, which of which Ahmed Adel Nor Eldin 09:10-09:20 Traction alopecia prophylaxis for children & treatment in adults. Mostafa Abdelhafiz Elsonbaty Assiut University 09:20-09:30 Special indications of Autologus fat graft & Adipose stem cells Yasser Jamal KSA Sabah Meshref KSA 09:30-09:40 Complications after Face Lift Ahmed El Danaf Mataria Teaching Hospital 09:40-09:50 Follicular Unit Extraction Hair Transplantation in Cicatricle Alopecia Ahmed Bahaa Mansoura University 09:50-10:00 Scar Management with fat grafting Sabreen El Zamil Al Babtain center- Kuwait 10:00-10:10 Rule of SMAS in midface-lift Alaa Nabil Elsadek Zagazig University 13
14 Thursday, Feb 28, :10-10:20 Neck Rejuvenation Mohamed Abozeid 10:20-10:30 Minimal invasive lower face lift by absorbable threads Nahed Samir Ain Shams University 10:30-11:00 Discussion Hall: Hall A - 11:00-12:30 Ahmed El Tawdi Amir Abdel Kareem Mohamed Awad Elmarakby Session 10 Breast II " Reconstruction " Mostafa Abdelhafiz Elsonbaty Nasser Ghozlan Sabreen El Zamil 11:00-11:10 A logic approach for decision making in immediate breast reconstruction Ayman Abo El Makarem Ain Shams University 11:10-11:20 Post Mastectomy Delayed Breast Reconstruction with DIEP flap: Experience with 33 Unilateral Cases Yehia Zakaria Zagazig University 11:20-11:30 The Fascia-Sparing Muscle-Sparing free TRAM flap for breast reconstruction Ashraf Abolfotooh M Khalil 11:30-11:40 Outcomes of Breast Free Flap Reconstruction in the Middle East Loai Abdullah Alsalmi King Fahad Medical City Riyadh KSA 11:40-11:50 A novel technique for enhancement of the survival and aesthetic outcome in pedicled TRAM flap Dalia Mohamed Galal Saleh Ain Shams University 11:50-12:00 Composite breast augmentation; a new trend for optimal breast augmentations Aly Hussein Saber Alexandria University 12:00-12:30 Discussion 14
15 Thursday, Feb 28, 2019 Hall: Hall B - 11:00-12:30 Fouad Ghareeb Hussein Saber Khaled Maken Session 11 Facial Oncoplastic Surgery a new subspecialty Maamoun Ismail Nader Elmelegy Youssef Saleh Hassan 11:00-11:10 Aesthetic consideration in nasal reconstruction Hussein Saber Alexandria University 11:10-11:20 Plan of management of facial tumors Maamoun Ismail 11:20-11:30 Oncoplastic orbital surgery Fouad Ghareeb Menoufia University 11:30-11:40 Oncoplastic facial bony restoration Ahmed Serag Alexandria University 11:40-11:50 Aesthetic restoration of the face Tarek A. Amer 11:50-12:00 Introduction of facial oncoplastic surgery: a new subspecialty Hesham Aly Helal Ain Shams University 12:00-12:10 Moh's surgery in facial trauma Dina El Sharkawy 12:10-12:20 Oncoplastic nasal reconstruction Mohamed Elyounsi Assiut University 12:20-12:30 Discussion 12:30-13:00 Coffee Break 15
16 Thursday, Feb 28, 2019 Hall: Hall A - 13:00-14:45 Ahmed Khashaba Amr Salah Ihab Zayed Khaled Hassan Session 12 Body Contouring Khaled Nowair Sabah Meshref Sherif Zamer 13:00-13:10 Body Contouring after Massive Weight Loss: the Roxo experience Ahmed Khashaba Zagazig University 13:10-13:20 Brachioplasty, scar is moving Amr Magdy Ain Shams University 13:20-13:30 Complex Abdominal Wall Defects reconstruction with Two Steps Technique (TST) Marwan Al-Zoroani UAE 13:30-13:40 Abdominal skin stria Ahmed El Tawdi Military Medical Academy 13:40-13:50 Trunks contouring in one go Abdul Shaheed Fadhul Manama-Bahrain 13:50-14:00 Considering scar tension values while designing for abdominoplasty incision Sameh El Noamany 14:00-14:10 The impact of Hernioplasty umblicoplasty and previous abdominal scars on abdomioplasry Gamal Abdelazim Rabie Um Elmasryeen Hospital 14:10-14:20 Abdominoplasty with huge irreducible ventral hernia. Case report. Step by step approach with video presentation Khaled Nowair El Mahalla Elkobra Hospital 14:20-14:30 Buttocks Lipo augmentation in middle eastern population: ethnic influences, technique and outcome.. Hossam Tahseen 14:30-14:45 Discussion 16
17 Thursday, Feb 28, 2019 Hall: Hall B - 13:00-14:45 Workshop I Hall: Hall A - 14:45-17:15 Session 13 Maxillofacial The Head of ESPSR Maxillofacial Chapter: Prof. Ikram Safe Ahmed Mahrous Mohamed Warda Alaa Nabil Samia Saied Ibrahim Zaitoun Tarek Elbanoby 14:45-14:55 Treatment protocol of cleft palate and outcome Baek-Kyu Kim Seoul National University 14:55-15:05 A new algorithm for management of post irradiation per-orbital deformities. Ayman Abo El Makarem Ain Shams University 15:05-15:15 Vomer bone graft for unilateral correction of secondary cleft lip nasal deformity Baek-Kyu Kim Seoul National University 15:15-15:25 Cranio-Maxillofacial Aspects of OSAS, Anesthetic and Surgical Considerations. Ahmed Medra Alexandria University 15:25-15:35 Reconstruction of Oromandibular Defects by Free Tissue Transfer Wael Ayad Al Azhar University 15:35-15:45 Facial balance and orthographic surgery Samia Saied Military Medical Academy 15:45-15:55 Cleft Lip and Palate, 30-year Experience in Malaysia and Saudi Arabia Ahmed Hussein Rahoma National Defence University of Malaysia 15:55-16:05 Segmental cranial Bone transport in pediatric cranial Bon Tarek Elbanoby Al Azhar University 17
18 Thursday, Feb 28, :05-16:15 Fascial Graft Repair of Wide Bilateral Cleft Lip Deformity Husam Hosny 16:15-16:25 Evaluation of alloplastic temporomandibular joint reconstruction using artificial condyles. Yasser Mohamed Elsheikh Menoufia University 16:25-16:35 One-Stage Simultaneous Repair of Complete Cleft Lip and Palate: What to expect? Wael Ahmed Ghanem Ain Shams University 16:35-16:45 Facial Skeletal Augmentation with Porous Poly Ethylene Implants Amir Mrad KSA 16:45-16:55 Assessment of surgical management of the temporomandibular joint ankylosis by a piezoelectric device in comparison with conventional drills. Ibrahim Kamel Ain Shams University 16:55-17:05 Motor Bike accident is a main cause of maxillofacial fractures in Cairo Youssif Khachaba 17:05-17:15 Discussion Hall: Hall B - 14:45-17:15 Workshop II 17:15 Lunch Break 18
19 Friday, Mar 01, 2019 Hall: Hall A - 09:00-10:00 Essam Taman Fathy Khodair Fawzy Hamza Session 14 Learning session Hashem Ayad Osama Elshahat Wael Elshaer 09:00-09:30 Medical humanities Fathy Khodair 09:30-10:00 Egyptian Medical Education from 1994 till 2030 Ahmed El Tawdi Military Medical Academy Hall: Hall A - 10:00-11:30 Session 15 Rhinoplasty Amgad Hendy Ashraf El Sebaie Mohamed Megahed Soha Mekawy Taher Ismail Tarek Elmenoufy 10:00-10:10 Nasal Sculpture: A New Approach to Rhinoplasty Taher Ismail 10:10-10:20 The role of lateral crural turnover flaps in enhancing the supraalar crease in middle eastern noses Ahmed El Shahat Ain Shams University 10:20-10:30 The Importance of Asymmetric Developmentally Deviated Nose in Rhinoplasty Patients Karima Taher Ismail 19
20 Friday, Mar 01, :30-10:40 A Novel Technique for Tip Contouring Mariam Taher Ismail 10:40-10:50 Secrets of Success of Septorhinoplasty Ahmed Hussein Rahoma National Defence University of Malaysia 10:50-11:00 Colum Ellar strut versus septal extension graft in thick skin nose Yasser Elbadawy Zayed Specialized Hospital 11:00-11:10 Aesthetic nasal reconstruction Ibrahim Ali Elabd Kafer El-Shikh Hospital 11:10-11:30 Discussion 11:30-13:00 Gomaa Prayer & Coffee Break Hall: Hall A - 13:00-15:00 ESPRS General Assembly Meeting 20
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