bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of COVID-19 pandemic on Spine Surgeons
Authors: Chan Chris Yin Wei , Chiu Chee Kidd , Cheung Jason Pui Yin , Cheung Prudence Wing Hang , Gani Siti Mariam Abd , Kwan Mun Keong 
Published: August 2020

Study Design.
Cross-sectional survey.

Objective.
The aim of this study was to investigate the impact of COVID-19 pandemic on the clinical practices of spine surgeons within the Asia Pacific region.

Summary of Background Data.
COVID-19 pandemic had changed spine surgeons’ clinical practices and their concerns toward personal and family risk of infection.

Methods.
This cross-sectional survey was carried out from May 4, 2020 to June 4, 2020. The questionnaire was administered using REDCAP. The online questionnaire includes four sections. First section includes surgeon's demographics, background, type of clinical practice, and status of pandemic in their country. Second section includes volume and the type of spine surgery practice before the COVID pandemic. Third section includes changes of clinical practice during the pandemic and the last section was regarding their concern on COVID transmission.

Results.
Total of 222 respondents from 19 countries completed the questionnaire. During the pandemic, 92.3% of the respondents felt their clinical practice was affected. 58.5% respondents reported reduced outpatient clinic hours and 74.6% respondents reported reduced operation theatre hours due to the enforcement by the hospital administration. The mean reduction of clinic volume for all countries was 48.1%. There was a significant reduction in the number of surgeries performed in Japan, Malaysia, India, Philippines, and South Korea. This was due to reduced patient load. More than 60% of respondents were worried being infected by COVID-19 virus and >68% were worried of transmission to their family members.

Conclusion.
COVID-19 pandemic has significantly affected the clinical and surgical practice of spine surgeons in the Asia Pacific region. Clinics were closed or the practice hours reduced. Similarly, surgical theaters were closed, reduced, or limited to semi-emergency and emergency surgeries. Spine surgeons were moderately concerned of contracting COVID-19 during their clinical practice but were extremely concerned to transmit this disease to their family members.

Level of Evidence: 4.
Complications, Costs, and Quality Outcomes of Patients Undergoing Cervical Deformity Surgery With Intraoperative BMP Use
Authors: Varshneya Kunal , Wadhwa Harsh , Pendharkar Arjun V. , Medress Zachary A. , Stienen Martin N. , Ratliff John K. , Veeravagu Anand 
Published: August 2020

Study Design.
An epidemiological study using national administrative data from the MarketScan database.

Objective.
The aim of this study was to identify the impact of bone morphogenetic protein (BMP) on postoperative outcomes in patients undergoing adult cervical deformity (ACD) surgery.

Summary of Background Data.
BMP has been shown to stimulate bone growth and improve fusion rates in spine surgery. However, the impact of BMP on reoperation rates and postoperative complication rate is controversial.

Methods.
We queried the MarketScan database to identify patients who underwent ACD surgery from 2007 to 2015. Patients were stratified by BMP use in the index operation. Patients <18 years and those with any history of tumor or trauma were excluded. Baseline demographics and comorbidities, postoperative complication rates, and reoperation rates were analyzed.

Results.
A total of 13,549 patients underwent primary ACD surgery, of which 1155 (8.5%) had intraoperative BMP use. The overall 90-day complication rate was 27.6% in the non-BMP cohort and 31.1% in the BMP cohort (P < 0.05). Patients in the BMP cohort had longer average length of stay (4.0 days vs. 3.7 days, P < 0.05) but lower revision surgery rates at 90 days (14.5% vs. 28.3%, P < 0.05), 6 months (14.9% vs. 28.6%, P < 0.05), 1 year (15.7% vs. 29.2%, P < 0.05), and 2 years (16.5% vs. 29.9%, P < 0.05) postoperatively. BMP use was associated with higher payments throughout the 2-year follow-up period ($107,975 vs. $97,620, P < 0.05). When controlling for baseline group differences, BMP use independently increased the odds of postoperative complication (odds ratio [OR] 1.22, 95% confidence interval [CI] 1.1–1.4) and reduced the odds of reoperation throughout 2 years of follow-up (OR 0.49, 95% CI 0.4–0.6).

Conclusion.
Intraoperative BMP use has benefits for fusion integrity in ACD surgery but is associated with increased postoperative complication rate. Spine surgeons should weigh these benefits and drawbacks to identify optimal candidates for BMP use in ACD surgery.

Level of Evidence: 3
Performance of Everyday Occupations and Perceived Health of Spouses of Men With Spinal Cord Injury at Discharge and 6 Months Later
Authors: Treisman Hadas , Ratzon Navah Z. , Itzkovich Malka , Avrech Bar Michal 
Published: August 2020

Study Design.
An exploratory longitudinal study.

Objectives.
(a) Compare the occupational performance, and life satisfaction of spouses of men with SCI with those of spouses of healthy men, (b) compare the occupational performance, perceived health, and life satisfaction of spouses of men with SCI at discharge from inpatient rehabilitation and 6 months postdischarge; and (c) assess whether the functioning levels of men with SCI and the perceived mental health of the spouse, correlate with her occupational performance.

Summary of Background Data.
Spouses of men with spinal cord injury (SCI) report having symptoms of depression and anxiety. However, their ability to choose everyday occupations and perform them satisfactorily (occupational performance) was less studied.

Methods.
Fifteen women spouses of men with SCI and 15 women spouses of healthy men participated. Study measures included four self-report questionnaires and the Occupational Performance History Interview that was analyzed quantitatively and measured occupational performance by three components: occupational identity, competence, and settings.

Results.
Occupational performance and life satisfaction of caregivers were lower than those of spouses of healthy men and did not significantly change over 6 months. However, they had higher scores on physical, mental, and general health 6 months postdischarge than at discharge. Mental health of the spouse correlated with her occupational identity.

Conclusion.
It is recommended that rehabilitation intervention focus not only on patients with SCI, but also on their healthy spouses to promote their occupational performance, health, and well-being.

Level of Evidence: 3
Parents’/Patients’ Perception of the Informed Consent Process and Surgeons Accountability in Corrective Surgery for Adolescent Idiopathic Scoliosis
Authors: Chan Chris Yin Wei , Chong Jessamine Sze Lynn , Lee Sin Ying , Ch’ng Pei Ying , Chung Weng Hong , Chiu Chee Kidd , Hasan Mohd Shahnaz , Kwan Mun Keong 
Published: August 2020

Study Design.
Prospective study.

Objective.
To determine the parents’/patients’ perception on the informed consent process prior to posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) patients.

Summary of Background Data.
Understanding parents/patients perspective on the process is important in order to achieve the goal of consent and prevent medico-legal implications.

Methods.
Fifty AIS patients operated between August 2019 and November 2019 were prospectively recruited. Parents’/patients’ perceptions on three sections were evaluated: the process of the informed consent, specific operative risk which they were most concerned with and the accountability of surgeons for the surgical risks. These data were ranked and scored using a 5-point Likert Scale. Preferences were reported in mean and standard deviation. Differences in terms of preferences were studied using One-way analysis of variance (ANOVA) analysis and deemed significant when P < 0.05.

Results.
There were 30 females (60.0%) and 20 males (40.0%) with a mean age of 41.8 ± 10.6 years. Majority of parents/patients preferred the inform consent to be explained more than once (P = 0.021), once during clinic consultation and once during admission (4.2 ± 1.0). Consent taking by both attending surgeons was preferred (4.5 ± 0.6) compared with other healthcare providers, P < 0.001. Death (60.0%) and neurological deficit (30.0%) were the two most concerned surgical risks. Parents/patients would still hold the surgeon accountable for any complications despite signing the informed consent and they felt that surgeons were directly responsible for screw-related injuries (3.9 ± 0.9), neurological injury (3.8 ± 0.9), and intraoperative bleeding (3.7 ± 0.9).

Conclusion.
Parents/patients preferred the attending surgeons to personally explain the informed consent, more than once with the use of visual aid. They would still hold the surgeons accountable when complications occur despite acceptance of the informed consent.

Level of Evidence: 2.
Expression Analysis of Susceptibility Genes for Ossification of the Posterior Longitudinal Ligament of the Cervical Spine in Human OPLL-related Tissues and a Spinal Hyperostotic Mouse (ttw/ttw)
Authors: Nakajima Hideaki , Watanabe Shuji , Honjoh Kazuya , Okawa Atsushi , Matsumoto Morio , Matsumine Akihiko 
Published: August 2020

Study Design.
Immunohistochemical and real-time reverse transcription-polymerase chain reaction (RT-PCR) analysis.

Objective.
The aim of this study was to analyze the expression of five susceptibility genes (RSPO2, HAO1, CCDC91, RHPH9, and STK38L) for human ossification of the posterior longitudinal ligaments (OPLL) identified in a genome-wide association study.

Summary of Background Data.
Detailed expression and functional studies for the five susceptibility genes are needed to aid in clarification of the etiology and pathogenesis of OPLL.

Methods.
Immunostaining, cell culture, and real-time RT-PCR were performed on ossified ligament samples collected during anterior cervical decompression for symptomatic OPLL (n = 39 patients) and on control non-OPLL samples (n = 8 patients). Immunohistochemical analysis in spinal hyperostotic mice (ttw/ttw) (n = 25) was also performed. The sample sections were stained for RSPO2, HAO1, CCDC91, RHPH9, STK38L, Runx2, Sox9, and CD90. The mRNA expression levels of the five susceptibility genes were also analyzed in cultured human OPLL and non-OPLL cells subjected to cyclic tensile strain.

Results.
Immunoreactivity for RSPO2 and Sox9 was evident in proliferating chondrocytes in human OPLL tissues and ttw/ttw mice. Application of cyclic tensile strain to cultured human OPLL cells resulted in increases in mRNA levels for RSPO2, HAO1, and CCDC91. However, individual differences in expression in human OPLL-related samples were seen. HAO1-positive cells were detected only in 3- to 6-week-old ttw/ttw mice that did not simultaneously express RSPO2-positive samples.

Conclusion.
Among the five susceptibility genes, RSPO2, HAO1, and CCDC91 might be contributory factors in progression of OPLL. RSPO2 may be involved in endochondral ossification, especially in mixed or continuous type OPLL, HAO1 may be an initiation factor for OPLL that is rarely seen in mature human OPLL samples, and CCDC91 may be associated with progression of ossification caused by mechanical stress. These findings provide important insights into the pathogenesis and therapeutic targets for OPLL.

Level of Evidence: N/A.
Spirometric Outcomes and Oxidative Stress Among Cement Factory Workers
Authors: Shanshal Sadeel A. , Al-Qazaz Harith Kh. 
Published: August 2020

Background:Cement industry workers are at high risk due to the dust emitted at various steps of its production. Pulmonary damage is the most important hazard. This work aimed to evaluate lung function and oxidative stress parameters of the workers.Methods:A cross-sectional study involving 97 workers in four cement factories was conducted from December/2019 to March/2020. Data collection was performed by spirometry test and measuring oxidative stress parameters.Results:There were significant differences in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) between workers in milling and packaging departments. Negative correlations were found between oxidative stress and spirometric parameters.Conclusions:Prolonged occupational exposure to cement dust could worsen the pulmonary function. Working in milling department is associated with a pronounced effect on oxidative stress. Higher oxidative stress parameters were associated with lower pulmonary function.
Optic Nerve Hypoplasia: “Neural Guidance” and the Role of Mentorship
Authors: Brodsky Michael C. 
Published: August 2020

Abstract:
Over the past 50 years, our understanding of optic nerve hypoplasia has advanced in a series of waves, with each wave producing a paradigm shift in clinical diagnosis and management. First was the recognition that optic nerve hypoplasia is a condition distinct from optic atrophy and is a frequent cause of blindness in children. Second was the identification of associated brain malformations. Third was the realization that many children with optic nerve hypoplasia have hypopituitarism. Fourth was the identification of segmental forms of optic nerve hypoplasia. Fifth was the recognition that some children are at risk for sudden death, which can often be prevented with preemptive measures. Last was the identification of additional systemic accompaniments. Genetic studies have been largely unfruitful and, for most cases, the cause remains unknown.
The Role of Neuro-Ophthalmologists in the Care of Patients With Neurofibromatosis Type 2
Authors: Landau Klara 
Published: August 2020

Abstract:
Neurofibromatosis type 2 (NF2) is a rare genetic disorder, affecting the central nervous system and leading to various degrees of disability. Its hallmark is bilateral vestibular schwannomas that invariably lead to progressive hearing loss. Specific ophthalmic abnormalities in patients with NF2 may help to establish an early diagnosis. These include juvenile cataract, epiretinal membrane, combined hamartoma of the retina and the retinal pigment epithelium, optic disc glioma, and optic nerve sheath meningioma. In addition, intracranial tumors may produce a variety of neuro-ophthalmic abnormalities that have the potential to impair visual function, such as postpapilledema optic atrophy, compression of the visual pathways, keratopathy, ocular motor cranial nerve palsies, and amblyopia. Care of NF2 patients is best provided by interdisciplinary medical teams including a neuro-ophthalmologist.
Improved COVID-19 testing by extraction free SARS-Cov-2 RT-PCR
Authors: Mokhtar Khelil Mohamed 
Published: August 2020

ABSTRACTThe RNA extraction is an important checkpoint for the detection of SARS-CoV-2 in swab samples, but it is a major barrier to available and rapid COVID-19 testing. In this study, we validated the extraction-free RT-qPCR method by heat-treatment as an accurate option to nucleic acid purification in Algerian population.
SARS-CoV-2 seroprevalence survey among 18,000 healthcare and administrative personnel at hospitals, pre-hospital services, and specialist practitioners in the Central Denmark Region
Authors: Jespersen Sanne , Mikkelsen Susan , Greve Thomas , Kaspersen Kathrine Agergård , Tolstrup Martin , Boldsen Jens Kjærgaard , Redder Jacob Dvinge , Nielsen Kent , Abildgaard Anders Mønsted , Kolstad Henrik Albert , Østergaard Lars , Thomsen Marianne Kragh , Møller Holger Jon , Erikstrup Christian 
Published: August 2020

AbstractObjectivesThe objective of this study was to perform a large seroprevalence survey on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among Danish healthcare workers to identify high risk groups.DesignCross-sectional survey.SettingAll healthcare workers and administrative personnel at the seven hospitals, pre-hospital services and specialist practitioner clinics in the Central Denmark Region were invited by e-mail to be tested for antibodies against SARS-CoV-2 by a commercial SARS-CoV-2 total antibody enzyme-linked immunosorbent assay (ELISA, Wantai Biological Pharmacy Enterprise Co., Ltd., Beijing, China).ParticipantsA total of 25,950 participants were invited. Of these, 17,987 (69%) showed up for blood sampling, and 17,971 had samples available for SARS-CoV-2 antibody testing.Main outcome measures1) Prevalence of SARS-CoV-2 antibodies; 2) Risk factors for seropositivity; 3) Association of SARS-CoV-2 RNA and antibodies.ResultsAfter adjustment for assay sensitivity and specificity, the overall seroprevalence was 3.4% (CI: 2.5%-3.8%). The seroprevalence was higher in the western part of the region than in the eastern part (11.9% vs 1.2%, difference: 10.7 percentage points, CI: 9.5-12.2). In the high prevalence area, the emergency departments had the highest seroprevalence (29.7%) while departments without patients or with limited patient contact had the lowest seroprevalence (2.2%). Multivariable logistic regression analysis with age, sex, and profession as the predictors showed that nursing staff, medical doctors, and biomedical laboratory scientists had a higher risk than medical secretaries, who served as reference (OR = 7.3, CI: 3.5–14.9; OR = 4., CI: 1.8–8.9; and OR = 5.0, CI: 2.1–11.6, respectively).Among the total 668 seropositive participants, 433 (64.8%) had previously been tested for SARS-CoV-2 RNA, and 50.0% had a positive RT-PCR result. A total of 98% of individuals who had a previous positive viral RNA test were also found to be seropositive.ConclusionsWe found large differences in the prevalence of SARS-CoV-2 antibodies in staff working in the healthcare sector within a small geographical area of Denmark and signs of in-hospital transmission. Half of all seropositive staff had been tested positive by PCR prior to this survey. This study raises awareness of precautions which should be taken to avoid in-hospital transmission. Additionally, regular testing of healthcare workers for SARS-CoV-2 should be considered to identify areas with increased transmission.Trial registrationThe study is approved by the Danish Data Protection Agency (1-16-02-207-20).
Percolation of Microparticle Matrix Promotes Cell Migration and Integration while Supporting Native Tissue Architecture
Authors: Barthold Jeanne E. , St. Martin Brittany M. , Sridhar Shankar Lalitha , Vernerey Franck , Schneider Stephanie Ellyse , Wacquez Alexis , Ferguson Virginia , Calve Sarah , Neu Corey P. 
Published: August 2020

ABSTRACTCells embedded in the extracellular matrix of tissues play a critical role in maintaining homeostasis while promoting integration and regeneration following damage or disease. Emerging engineered biomaterials utilize decellularized extracellular matrix as a tissue-specific support structure; however, many dense, structured biomaterials unfortunately demonstrate limited formability, fail to promote cell migration, and result in limited tissue repair. Here, we developed a reinforced composite material of densely packed acellular extracellular matrix microparticles in a hydrogel, termedtissue clay, that can be molded and crosslinked to mimic native tissue architecture. We utilized hyaluronic acid-based hydrogels, amorphously packed with acellular articular cartilage tissue particulated to ~125-250 microns in diameter and defined a percolation threshold of 0.57 (v/v) beyond which the compressive modulus exceeded 300kPa. Remarkably, primary chondrocytes recellularized particles within 48 hours, a process driven by chemotaxis, exhibited distributed cellularity in large engineered composites, and expressed genes consistent with native cartilage repair. We additionally demonstrated broad utility of tissue clays through recellularization and persistence of muscle, skin, and cartilage composites in a subcutaneousin vivomouse model. Our findings suggest optimal strategies and material architectures to balance concurrent demands for large-scale mechanical properties while also supporting integration of dense musculoskeletal and connective tissues.
The Build-Up of Droplet/Aerosols Carrying the SARS-CoV-2 Coronavirus, in Confined Spaces
Authors: Birnir Björn , Angheluta Luiza 
Published: August 2020

AbstractA model of the distribution of respiratory droplets and aerosols by Lagrangian turbulent air-flow is developed and used to show how the SARS-CoV-2 Coronavirus can be dispersed by the breathing of an infected person. It is shown that the concentration of viruses in the exhaled cloud can increase to infectious levels with time, in a confined space where the air recirculates. The model is used to analyze the air-flow and SARS-CoV-2 Coronavirus build-up in a restaurant in Guangzhou, China [17, 16]. It is concluded that the outbreak of Covid-19 in the restaurant in January 2020, is due to the build-up of the airborne droplets and aerosols carrying the SARS-CoV-2 Coronavirus and could not have been prevented by standard air-conditioning.
Common low complexity regions for SARS-CoV-2 and human proteomes as potential multidirectional risk factor in vaccine development
Authors: Gruca Aleksandra , Ziemska-Legiecka Joanna , Jarnot Patryk , Sarnowska Elzbieta , Sarnowski Tomasz J. , Grynberg Marcin 
Published: August 2020

AbstractThe rapid spread of the COVID-19 demands immediate response from the scientific communities. Appropriate countermeasures mean thoughtful and educated choice of viral targets (epitopes). There are several articles that discuss such choices in the SARS-CoV-2 proteome, other focus on phylogenetic traits and history of the Coronaviridae genome/proteome. However none consider viral protein low complexity regions (LCRs). Recently we created the first methods that are able to compare such fragments. We show that five low complexity regions (LCRs) in three proteins (nsp3, S and N) encoded by the SARS-CoV-2 genome are highly similar to regions from human proteome. As many as 21 predicted T-cell epitopes and 27 predicted B-cell epitopes overlap with the five SARS-CoV-2 LCRs similar to human proteins. Interestingly, replication proteins encoded in the central part of viral RNA are devoid of LCRs. Similarity of SARS-CoV-2 LCRs to human proteins may have implications on the ability of the virus to counteract immune defenses. The vaccine targeted LCRs may potentially be ineffective or alternatively lead to autoimmune diseases development. These findings are crucial to the process of selection of new epitopes for drugs or vaccines which should omit such regions.Author summaryThe outbreak of the COVID-19 disease affects humans all over the globe. More and more people get sick and many die because of the deadly SARS-CoV-2 virus. The whole machinery of this pathogen is enclosed in a short sequence of nucleotides, building blocks for both RNA and DNA strands. This RNA virus encodes less than 30 protein sequences that change the fate of our societies. Its proteins are composed of 20 amino acids (building bricks) that are usually used quite freely by proteins. However, there are fragments where only one or a few amino acids are used. We name those low complexity regions (LCRs). We invented the first programmes able to compare such LCRs. Using this new methodology we were able to show similarity of some viral proteins to human ones. This discovery has a serious implication when designing vaccines or drugs. It means that companies should not use these very LCRs as targets because it may trigger an autoimmune disease. On the other hand this specific similarity may suggest some kind of disguise of viral proteins into the machinery of human cells.