bluuebunny/crossref_metadata_2025_split huggingface dataset:
A cost–benefit analysis of the COVID-19 disease
Authors: Rowthorn Robert , Maciejowski Jan 
Published: July 2020

AbstractThe British government has been debating how to escape from the lockdown without provoking a resurgence of the COVID-19 disease. There is a growing recognition of the damage the lockdown has caused to economic and social life. This paper presents a simple cost–benefit analysis inspired by optimal control theory and incorporating the SIR model of disease propagation. It also reports simulations informed by the theoretical discussion. The optimal path for government intervention is computed under a variety of conditions. These include a cap on the permitted level of infection to avoid overload of the health system, and the introduction of a test and trace system. We quantify the benefits of early intervention to control the disease. We also examine how the government’s valuation of life influences the optimal path. A 10-week lockdown is only optimal if the value of life for COVID-19 victims exceeds £10m. The study is based on a standard but simple epidemiological model, and should therefore be regarded as presenting a methodological framework rather than giving policy prescriptions.
Paediatric hypertension for the primary care provider: What you need to know
Authors: Saini Priya , Betcherman Laura , Radhakrishnan Seetha , Etoom Yousef 
Published: July 2020

Abstract
The prevalence of hypertension has increased in the paediatric and adolescent populations, and is estimated between 1% and 2% in Canada. Paediatric and adolescent hypertension differs from adult hypertension in many ways, and primary care providers may not be up to date with current guidelines and recommendations. Recently, the American Academy of Pediatrics updated and published guidelines on the diagnosis, evaluation, and management of hypertension in children and adolescents. This paper summarizes these new guidelines in addition to the existing Canadian guidelines in a simple four-step approach, catered to a primary care setting, detailing the diagnosis, evaluation, workup, and management of hypertension in children and adolescents.
A Comparison of Attribute-Focused and Harm-Focused Methods for Assessing the Risk of Organized Crime Groups: Are They in Agreement?
Authors: Mulholland Paul , Cole Terri 
Published: July 2020

Abstract
Risk assessment methods are used to map the threat posed by organized crime and assist in the prioritization of policing resources. Within policing, risk assessment methods are currently in use that either focus on the attributes of organized crime groups or the types of harm posed. Statistical analysis was undertaken of risk assessment data produced using one attribute-focused and one harm-focused method. The study was based on a non-random sample of 113 attribute-focused and 77 harm-focused risk assessments of the same 17 OCGs, and a sub-sample of 36 pairs of risk assessments of 16 of the OCGs. A moderate correlation was found between the two methods, despite differences in their risk assessment processes. Lower levels of agreement tended to be associated with OCGs posing high levels of harm, particularly financial and psychological. Using the two risk assessment methods in combination is proposed as a way of building consensus that draws on their alternative perspectives. The techniques applied in this analysis could be used to inform revisions to the methods and their supporting materials, identify outlying risk assessments, and potentially incorporate other information sources such as harm indices.
Thai Police Officers: A Survey of Police Attitudes Regarding Traffic Police Training
Authors: Khruakham Seksan , Cheurprakobkit Sutham 
Published: July 2020

Abstract
Traffic accidents have become a major issue in Thailand since the World Health Organization reported in 2018 that Thailand had the second highest death rate of road accidents in the world (over 24,000 deaths each year). Because the effectiveness of traffic enforcement was found to be a key factor that helps reduce the number of traffic accidents, this study examined how well the policy on traffic training programmes has been implemented and how traffic training programmes prepare traffic officials to perform their traffic duties. A random sample of 247 traffic officials was chosen from the four police regions and the Bangkok Metropolitan area to complete a survey. The results of the study show that the implementation of traffic training programmes is inconsistent with the given policy, resulting in traffic officials gaining insufficient knowledge and skills from training to do their work.
Blockchain without Waste: Proof-of-Stake
Authors: Saleh Fahad 
Published: July 2020

AbstractPermissionless blockchains require a protocol to generate consensus. Many prominent permissionless blockchains employ Proof-of-Work (PoW) for that purpose, but PoW possesses significant shortcomings. Various alternatives have been proposed. This paper provides the first formal economic model of the most famous alternative, Proof-of-Stake (PoS), and establishes conditions under which PoS generates consensus. A sufficiently modest reward schedule not only implies the existence of an equilibrium in which consensus obtains as soon as possible but also precludes a persistent forking equilibrium. The latter result arises because PoS, unlike PoW, requires that validators are also stakeholders.
Renal involvement in eosinophilic granulomatosis with polyangiitis (EGPA): a multicentric retrospective study of 63 biopsy-proven cases
Authors: Durel Cécile-Audrey , Sinico Renato A , Teixeira Vitor , Jayne David , Belenfant Xavier , Marchand-Adam Sylvain , Pugnet Gregory , Gaultier Jacques , Le Gallou Thomas , Titeca-Beauport Dimitri , Agard Christian , Barbet Christelle , Bardy Antoine , Blockmans Daniel , Boffa Jean-Jacques , Bouet Julien , Cottin Vincent , Crabol Yoann , Deligny Christophe , Essig Marie , Godmer Pascal , Guilpain Philippe , Hirschi-Santelmo Sandrine , Rafat Cédric , Puéchal Xavier , Taillé Camille , Karras Alexandre ,   for the French Vasculitis Study Group (FVSG)
Published: July 2020

Abstract

Objective
Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic small-vessel vasculitis characterized by asthma, hypereosinophilia and ANCA positivity in 40% of patients. Renal involvement is rare and poorly described, leading to this renal biopsy-proven based study in a large EGPA cohort.

Methods
We conducted a retrospective multicentre study including patients fulfilling the 1990 ACR criteria and/or the 2012 revised Chapel Hill Consensus Conference criteria for EGPA and/or the modified criteria of the MIRRA trial, with biopsy-proven nephropathy.

Results
Sixty-three patients [27 women, median age 60 years (18–83)] were included. Renal disease was present at vasculitis diagnosis in 54 patients (86%). ANCA were positive in 53 cases (84%) with anti-MPO specificity in 44 (83%). All patients had late-onset asthma. Peripheral neuropathy was present in 29 cases (46%), alveolar haemorrhage in 10 (16%). The most common renal presentation was acute renal failure (75%). Renal biopsy revealed pauci-immune necrotizing GN in 49 cases (78%). Membranous nephropathy (10%) and membranoproliferative GN (3%) were mostly observed in ANCA-negative patients. Pure acute interstitial nephritis was found in six cases (10%); important interstitial inflammation was observed in 28 (44%). All patients received steroids with adjunctive immunosuppression in 54 cases (86%). After a median follow-up of 51 months (1–296), 58 patients (92%) were alive, nine (14%) were on chronic dialysis and two (3%) had undergone kidney transplantation.

Conclusion
Necrotizing pauci-immune GN is the most common renal presentation in ANCA-positive EGPA. ANCA-negative patients had frequent atypical renal presentation with other glomerulopathies such as membranous nephropathy. An important eosinophilic interstitial infiltration was observed in almost 50% of cases.
A Comparison of Complications and Clinical and Radiologic Outcome Between the Mini-open Prepsoas and Mini-open Transpsoas Approaches for Lumbar Interbody Fusion
Authors: Spiessberger Alexander , Arvind Varun , Dietz Nicholas , Grueter Basil , Huber Florian , Guggenberger Roman , Moriggl Bernhard , Varma Vikas , Cho Samuel K. 
Published: July 2020

Study Design:
Systematic review and meta-analysis.

Objective:
To compare complication rates and clinical and radiologic outcome between the mini-open prepsoas and mini-open transpsoas approaches for lateral lumbar interbody fusion.

Summary of Background Data:
Both approaches are believed to be safe with similar complication rates. Previous studies suggest that the rate of neurological injury might be higher in the transpsoas group, whereas visceral or vascular injury might be more frequent in the prepsoas group.

Methods:
A systematic review of the literature was performed. Data were extracted from original publications up until December 26, 2018. Evidence was extracted from well-designed case-control or cohort studies and sorted in 2 groups, the prepsoas and transpsoas approaches. A meta-analysis was performed using a random-effects model (I
2 statistic >50% for all analyses).

Results:
A total of 115 studies included data of 13,260 patients, 2450 in the prepsoas group and 10,810 in the transpsoas group. Demographics for prepsoas versus transpsoas group were (N-weighted means): age 61.9 versus 60.9 years; %female sex 53% versus 63%, levels fused 1.4 versus 2.6, blood loss 52.4 versus 122.3 mL, and operating time 125.1 versus 200.7 min. The following statistically significant differences in complication rates between prepsoas and transpsoas approaches were found: transient psoas weakness or thigh/groin numbness 4% versus 26% [95% confidence interval (CI): 11%–17%], motor neural injury 0.4% versus 1.3% (95% CI: 16%–62.3%); no statistically significant differences were found for: major vascular injury 2% versus 1% (95% CI: 1.04%–2.31%), kidney or ureter injury 0.04% versus 0.08% (95% CI: 0.057%–5.2%), injury pleural/peritoneal structures 0.6% versus 0.2% (95% CI: 0.89%–6.58%), cage subsidence 5% versus 4% (95% CI: 0.9%–1.97%), surgical site infection 1% versus 1% (95% CI: 0.57%–1.66%), abdominal wall pseudohernia 1% versus 1% (95% CI: 0.07%–21.22%), sympathetic chain injury 5% versus 0% (95% CI: 0.34%–97.86%), and directly procedure-related death 0.04% versus 0% (95% CI: 0.127%–76.8%). Pooled mean perioperative changes between prepsoas and transpsoas approaches were: segmental sagittal Cobb angle 3.07 versus 1.99 degrees; foraminal height 2 versus 6.96 mm.

Conclusions:
The prepsoas had fewer complications than the transpsoas approach. Furthermore, the prepsoas approach showed superior restoration of segmental lordosis, whereas foraminal height restoration was superior with the transpsoas approach. This could be explained by the differences in location of the interbody device placement in relation to the center of rotation of the spine between the 2 surgical techniques.
Associations Between Preoperative Hyponatremia and 30-Day Perioperative Complications in Lumbar Interbody Spinal Fusion
Authors: Pennington Zach , Bomberger Thomas T. , Lubelski Daniel , Benzel Edward C. , Steinmetz Michael P. , Mroz Thomas E. 
Published: July 2020

Study Design:
Retrospective population database study.

Objective:
To investigate the relationship of preoperative hyponatremia to postoperative morbidity and mortality in lumbar interbody fusion patients.

Summary of Background Data:
Optimization of preoperative patient selection and perioperative management can improve patient outcomes in spinal surgery. Hyponatremia, incidentally identified in 1.7% of the US population, has previously been tied to poorer postoperative outcomes in both the general surgery and orthopedic surgery populations.

Materials and Methods:
Using the National Surgical Quality Improvement Program database, the authors identified all lumbar interbody fusion patients treated between 2012 and 2014. Patients were classified as hyponatremic (Na<135 mEq/L) or as having normal sodium levels (135–145 mEq/L) preoperatively. The primary outcome was major morbidity and secondary endpoints were prolonged hospitalization, 30-day readmission, and reoperation. Multivariable linear regression was used to find independent predictors of these outcomes.

Results:
Of 10,654 patients, 45.6% were male individuals, 5.5% were hyponatremic, and 4.2% experienced a major postoperative complication. On multivariable analysis, preoperative hyponatremia was independently associated with major morbidity (odds ratio, 1.22; 95% confidence interval, 1.03–1.44; P<0.05) and prolonged hospitalization (odds ratio, 1.14; 95% confidence interval, 1.02–1.27).

Conclusions:
Here the authors provide the first evidence suggesting preoperative hyponatremia is an independent predictor of major morbidity after lumbar interbody fusion. Hyponatremia may represent a modifiable risk factor for improved patient care and preoperative risk counseling.
Are the Outcomes of Minimally Invasive Transforaminal/Posterior Lumbar Fusion Influenced by the Patient’s Age or BMI?
Authors: Manson Neil , Hubbe Ulrich , Pereira Paulo , Lam Khai , Fuster Salvador , Senker Wolfgang 
Published: July 2020

Study Design:
A retrospective subgroup analysis of a prospective observational study was carried out.

Summary of Background Data:
Patients’ baseline characteristics may influence the clinical outcomes after minimally invasive lumbar interbody fusion (MILIF).

Objective:
This study aimed to investigate the influence of patient’s age and body mass index (BMI) on the clinical outcomes of MILIF for degenerative lumbar disorder.

Materials and Methods:
A total of 252 patients underwent MILIF. The clinical outcomes, including time to first ambulation, time to postsurgical recovery, back/leg pain in visual analog scale, Oswestry Disability Index, and EuroQol-5 Dimension, were collected at baseline, 4 weeks, 6, and 12 months. Patients were subgrouped by age (50 y and below: N=102; 51–64 y: N=102; 65 y and above: N=48) and BMI (≤25.0: N=79; 25.1–29.9: N=104; ≥30.0: N=69). Data from baseline to 12 months were compared for all clinical outcomes within age/BMI subgroups. Adverse events (AEs) and serious adverse events (SAEs) were summarized by age and BMI subgroups.

Results:
All age and BMI subgroups showed significant improvements in clinical outcomes at 12 months compared with the baseline. The median time to first ambulation was similar for all subgroups (age groups: P=0.8707; BMI: P=0.1013); older people show a trend of having longer time to postsurgical recovery (age groups: P=0.0662; BMI: P=0.1591). Oswestry Disability Index, back, and leg pain visual analog scale, and EuroQol-5 Dimension were similar in all subgroups at every timepoint. A total of 50 AEs (N=39) were reported, 9 of which were SAEs; 3 AEs and 1 SAE were considered to be related to surgical procedure. No differences were observed in safety by age groups and BMI groups.

Conclusion:
MILIF appears to be safe and effective, independent of age or weight in the treatment of degenerative lumbar disorder.

Level of Evidence:
Level II.
Processing and Handling Cost of Single-use Versus Traditional Instrumentation for 1 Level Lumbar Fusions
Authors: Galetta Matthew S. , Divi Srikanth N. , Shapses Mark A. , Hartman Joseph B. , Nicholson Kristen J. , Goyal Dhruv K.C. , Fang Taolin , Mangan John J. , Kaye Ian David , Kurd Mark F. , Woods Barrett I. , Radcliff Kris E. , Rihn Jeffrey A. , Anderson David Greg , Hilibrand Alan S. , Kepler Christopher K. , Vaccaro Alexander R. , Schroeder Gregory D. 
Published: July 2020

Study Design:
A single center, observational prospective clinical study.

Objective:
The aim of this study was to compare the instrumentation-related cost and efficiency of single-use instrumentation versus traditional reusable instrument trays.

Summary of Background Data:
Single-use instrumentation provides the opportunity to reduce costs associated with cleaning and sterilizing instrumentation after surgery. Although previous studies have shown single-use instrumentation is effective in other orthopedic specialties, it is unclear if single-use instrumentation could provide economic advantages in spine surgery.

Materials and Methods:
A total of 40 (20 reusable instrumentation and 20 single-use instrumentation) lumbar decompression (1–3 level) and fusion (1 level) spine surgeries were collected. Instrument handling, opening, setup, re-stocking, cleaning, sterilization, inspection, packaging, and storage were recorded by direct observation for both reusable and single-use instrumentation. The rate of infection was noted for each group.

Results:
Mean time of handling instruments by the scrub nurse was 11.6 (±3.9) minutes for reusable instrumentation and 2.1 (±0.5) minutes for single-use instrumentation. Mean cost of handling reusable instruments was estimated to be $8.52 (±$2.96) per case, and the average cost to reprocess a single tray by Sterilization Processing Department (SPD) was $58. Thus, the median cost for sterilizing 2 reusable trays per case was $116, resulting in an average total Costresuable of $124.52 (±$2.96). Mean cost of handling single-use instrumentation was estimated to be $1.57 ($0.38) per case.

Conclusion:
Single-use instrumentation provided greater cost savings and reduced time from the opening of instrumentation to use in surgery when compared with reusable instrumentation.
Spontaneous Intracranial Hypotension Followed by Intracranial Hypertension
Authors: Videira Gonçalo , Carneiro Ângelo , Mota Dória Hugo , Mendes Alexandre , Andrade Carlos 
Published: July 2020

Introduction:
Spontaneous intracranial hypotension is a secondary cause of headache caused by suspected cerebrospinal fluid leaks. It is associated with vascular changes that may predispose to superficial siderosis. When treated with an epidural blood patch, rebound intracranial hypertension may ensue.

Case Report:
A 55-year-old man presented with orthostatic headaches responsive to rest and hydration. Brain magnetic resonance revealed subdural collections, consistent with intracranial hypotension. Three weeks later, the patient experienced sudden severe holocranial headache and spontaneous subarachnoid hemorrhage was found. This resulted in rebound intracranial hypertension with bilateral papilledema and sixth-nerve palsy, which completely resolved with acetazolamide.

Discussion:
Spontaneous intracranial hypotension may predispose to subarachnoid hemorrhage through vascular compensatory changes. Blood in subarachnoid space may seal the hidden cerebrospinal fluid leak or trigger an inflammatory reaction, leading to rebound intracranial hypertension, a well-known epidural blood patch complication.
Different Components of Subjective Well-being Are Associated With Chronic Nondisabling and Disabling Knee Pain
Authors: Castelo Azevedo Daniela , Carneiro Machado Luciana Andrade , Giatti Luana , Harter Griep Rosane , Telles Rosa Weiss , Barreto Sandhi Maria 
Published: July 2020

Background/Objective
Chronic knee pain (CKP) is a common pain complaint in older adults that is often associated with disability. This study investigated the relationship between 2 components of subjective well-being (depressive symptoms and life satisfaction) and CKP phenotypes based on the presence of knee disability.

Methods
A cross-sectional study was performed at baseline of ELSA-Brasil Musculoskeletal cohort (2012–2014). Chronic knee pain phenotypes were identified according to the presence of CKP that was accompanied or not by disability, which was assessed by a question on pain-related limitations to perform everyday activities (overall), Western Ontario and McMaster Universities Osteoarthritis Index's physical function subscale (daily tasks) and 5-times sit-to-stand test (objective). Depressive symptoms were assessed by the Clinical Interview Schedule–Revised and life satisfaction by the Satisfaction With Life Scale. Multinomial logistic regressions used CKP phenotypes as response variables (no CKP as reference).

Results
The sample comprised 2898 participants (mean age, 55.9 ± 8.9 years; 52.9% were female). After adjustments for sociodemographic and clinical factors, depressive symptoms were associated with daily tasks disabling CKP (odds ratio [OR], 2.30; 95% confidence interval [CI], 1.45–3.66) and objective disabling CKP (OR, 1.95; 95% CI, 1.29–2.93) and with nondisabling CKP for the overall disability measure (OR, 1.54; 95% CI, 1.17–2.04). Life satisfaction was inversely associated with all phenotypes in fully adjusted models, with strongest magnitude of associations observed for disabling CKP.

Conclusions
The association of depressive symptoms and life satisfaction with CKP phenotypes suggest the need to address both negative and positive components of subjective well-being in the assessment of individuals with knee complaints.
Development and External Validation of a Diagnostic Model for Coronary Microvascular Obstruction
Authors: Li Yong , Lyu Shuzheng 
Published: July 2020

AbstractBackgroundPrevention of coronary microvascular obstruction /no-reflow phenomenon(CMVO/NR) is a crucial step in improving prognosis of patients with acute ST segment elevation myocardial infarction (STEMI)during primary percutaneous coronary intervention (PPCI). We wanted to develop and externally validate a diagnostic model of CMVO/NR in patients with acute STEMI underwent PPCI.MethodsDesign: Multivariable logistic regression of a cohort of acute STEMI patients. Setting: Emergency department ward of a university hospital. Participants: Diagnostic model development: Totally 1232 acute STEMI patients who were consecutively treated with PPCI from November 2007 to December 2013. External validation: Totally 1301 acute STEMI patients who were treated with PPCI from January 2014 to June 2018. Outcomes: CMVO/NR during PPCI.Results147(11.9%)patients presented CMVO/NR in the development dataset and 120(9.2%) patients presented CMVO/NR in the validation dataset. The strongest predictors of CMVO/NR were age, periprocedural bradycardia, using thrombus aspiration devices during procedure and total occlusion of culprit vessel. We developed a diagnostic model of CMVO/NR.The area under the receiver operating characteristic curve (AUC) was 0.6833 in the development set.We constructed a nomogram using the development database.The AUC was 0.6547 in the validation set. Discrimination, calibration, and decision curve analysis were satisfactory.ConclusionsWe developed and externally validated a diagnostic model of CMVO/NR during PPCI.We registered this study with WHO International Clinical Trials Registry Platform on 16 May 2019. Registration number: ChiCTR1900023213.http://www.chictr.org.cn/edit.aspx?pid=39057&htm=4.
Homozygote loss-of-function variants in the humanCOCHgene underlie hearing loss
Authors: Danial-Farran Nada , Chervinsky Elena , Nadar-Ponniah Prathamesh Thangaraj , Barak Eran Cohen , Taiber Shahar , Khayat Morad , Avraham Karen B. , Shalev Stavit A. 
Published: July 2020

AbstractSince 1999, theCOCHgene encoding cochlin, has been linked to the autosomal dominant non-syndromic hearing loss, DFNA9, with or without vestibular abnormalities. The hearing impairment associated with the variants affecting gene function has been attributed to a dominant-negative effect. Mutant cochlin was seen to accumulate intracellularly, with the formation of aggregates both inside and outside the cells, in contrast to the wild-type cochlin that is normally secreted. While an additional recessive variant in theCOCHgene (DFNB110) has recently been reported, the mechanism of the loss-of-function (LOF) effect of theCOCHgene product remains unknown. In this study, we used COS7 cell lines to investigate the consequences of a novel homozygous frameshift variant on RNA transcription, and on cochlin translation. Our results indicate a LOF effect of the variant and a major decrease in cochlin translation. This data has a dramatic impact on the accuracy of genetic counseling for both heterozygote and homozygote carriers of LOF variants inCOCH.