Patient outcomes after laminotomy, hemilaminectomy, laminectomy and laminectomy with instrumented fusion for spinal canal stenosis: a propensity score-based study from the Spine Tango registry.

PURPOSE To compare patient outcomes and complication rates after different decompression techniques or instrumented fusion (IF) in lumbar spinal stenosis (LSS). METHODS The multicentre study was based on Spine Tango data. Inclusion criteria were LSS with a posterior decompression and pre- and postoperative COMI assessment between 3 and 24 months. 1,176 cases were assigned to four groups: (1) laminotomy (n = 642), (2) hemilaminectomy (n = 196), (3) laminectomy (n = 230) and (4) laminectomy combined with an IF (n = 108). Clinical outcomes were achievement of minimum relevant change in COMI back and leg pain and COMI score (2.2 points), surgical and general complications, measures taken due to complications, and reintervention on the index level based on patient information. The inverse propensity score weighting method was used for adjustment. RESULTS Laminotomy, hemilaminectomy and laminectomy were significantly less beneficial than laminectomy in combination with IF regarding leg pain (ORs with 95% CI 0.52, 0.34-0.81; 0.25, 0.15-0.41; 0.44, 0.27-0.72, respectively) and COMI score improvement (ORs with 95% CI 0.51, 0.33-0.81; 0.30, 0.18-0.51; 0.48, 0.29-0.79, respectively). However, the sole decompressions caused significantly fewer surgical (ORs with 95% CI 0.42, 0.26-0.69; 0.33, 0.17-0.63; 0.39, 0.21-0.71, respectively) and general complications (ORs with 95% CI 0.11, 0.04-0.29; 0.03, 0.003-0.41; 0.25, 0.09-0.71, respectively) than laminectomy in combination with IF. Accordingly, the likelihood of required measures was also significantly lower after laminotomy (OR 0.28, 95% CI 0.17-0.46), hemilaminectomy (OR 0.28, 95% CI 0.15-0.53) and after laminectomy (OR 0.39, 95% CI 0.22-0.68) in comparison with laminectomy with IF. The likelihood of a reintervention was not significantly different between the treatment groups. DISCUSSION As already demonstrated in the literature, decompression in patients with LSS is a very effective treatment. Despite better patient outcomes after laminectomy in combination with IF, caution is advised due to higher rates of surgical and general complications and consequent required measures. Based on the current study, laminotomy or laminectomy, rather than hemilaminectomy, is recommendable for minimum relevant pain relief.

Special Tax Treatment as Trade Policy: A Database on Export Processing and Special Economic Zones

Many countries treat income generated via exports favourably, especially when production takes places in special zones known as export processing zones (EPZs). EPZs can be defined as specific, geographically defined zones or areas that are subject to special administration and that generally offer tax incentives, such as duty‐free imports when producing for export, exemption from other regulatory constraints linked to import for the domestic market, sometimes favourable treatment in terms of industrial regulation, and the streamlining of border clearing procedures. We describe a database of WTO Members that employ special economic zones as part of their industrial policy mix. This is based on WTO notification and monitoring through the WTO’s trade policy review mechanism (TPRM), supplemented with information from the ILO, World Bank, and primary sources. We also provide some rough analysis of the relationship between use of EPZs and the carbon intensity of exports, and relative levels of investment across countries with and without special zones.

Export Restrictions on Critical Minerals and Metals: Testing the Adequacy of WTO Disciplines

Conventional wisdom on the insufficiency of existing WTO disciplines on export restrictions has triggered momentum on the issue. In this book, Ilaria Espa offers a comprehensive analysis of the scope and coverage of WTO disciplines on export restrictions in light of emerging case law. She investigates whether such rules still provide a credible and effective framework capable of preventing abuses in the use of export restrictive measures on critical minerals and metals during a period of economic crisis and change in international trade patterns. Giving a broad overview of the export restrictions applied to these materials, Espa identifies distinctive features in the proliferation of export barriers and analyses the existing WTO rules to reveal their gaps and inconsistencies. She goes on to present solutions based upon her findings with the aim of bringing more coherence and equity to WTO rules on the export side.

Energy Export Restrictions in the WTO Between Resources Nationalism and Sustainable Development

This chapter aims at contributing to the trade and energy debate by focusing on the specific issue of export restrictions. It starts from the premise that a balanced and efficient regulation of export barriers in the energy sector would contribute to tackle emerging energy concerns such as energy security and the elimination of fossil fuel subsidies in light of the challenge of climate change mitigation. It assesses the adequacy of existing WTO rules on export restric­tions and accordingly identifies the main gaps and inconsistencies inherent in the current disciplines from an energy-specific perspective. Finally, it discusses the merits of an energy-specific approach to advance existing disciplines in the most deficient area of export duties based on the systematisation of the Russian ‘model’. Such approach could raise the overall level of commitments in the energy sector while still allowing for the systemic applicability of GATT environmental exceptions in a manner consistent with the principle of sus­tainable development recognised in the Preamble of the WTO Agreement.

Export Restrictions in relation to Extractive Industries

A new E15 Think Piece by Ilaria Espa produced under the E15Initiative (E15). Implemented jointly by the International Centre for Trade and Sustainable Development (ICTSD) and the World Economic Forum, the E15 convenes world-class experts and institutions to generate strategic analysis and recommendations for government, business and civil society geared towards strengthening the global trade system. This paper considers concrete policy options to better regulate the use of export restrictions in relation to extractive industries. It briefly describes recent trends in the use of export restrictions on mineral and energy resources. It gives an account of the main shortcomings in the WTO legal treatment of export restrictions. It accordingly discusses possible avenues for reforming existing WTO disciplines in the interest of secure access to supplies, while still taking into account the need to preserve some policy space for host countries to use such measures as legitimate development tools.

ESTOUT: Stata module to export estimation results from estimates table

estout produces a table of regression results from one or several models for use with spreadsheets, LaTeX, HTML, or a word-processor table. eststo stores a quick copy of the active estimation results for later tabulation. esttab is a wrapper for estout. It displays a pretty looking publication-style regression table without much typing. estadd adds additional results to the e()-returns for one or several models previously fitted and stored. This package subsumes the previously circulated esto, esta, estadd, and estadd_plus. An earlier version of estout is available as estout1.

Personality traits and the propensity to trust friends and strangers

Research on the foundations of social trust mainly concentrates on the evaluation of one's social environment. Empirical evidence focusing on the psychological origins of social trust is quite rare and the findings of these few studies remain inconclusive. Two innovations are proposed in order to systemize the knowledge about the foundations of social trust. First, we propose using a trust measure that is sensitive to different categories of trustees and refers to a realistic situation. Second, we argue for a broad conception of personality, rather than focusing only on selected attributes. Using data from a unique Swiss population survey, we show that the impact of personality traits on trust in strangers is stronger than on trust in friends. While conscientiousness and openness, in particular, are important traits for the development of both trust in friends and strangers, agreeableness is related to trust in strangers.

A probabilistic assessment of calcium carbonate export and dissolution in the modern ocean

The marine cycle of calcium carbonate (CaCO3) is an important element of the carbon cycle and co-governs the distribution of carbon and alkalinity within the ocean. However, CaCO3 export fluxes and mechanisms governing CaCO3 dissolution are highly uncertain. We present an observationally constrained, probabilistic assessment of the global and regional CaCO3 budgets. Parameters governing pelagic CaCO3 export fluxes and dissolution rates are sampled using a Monte Carlo scheme to construct a 1000-member ensemble with the Bern3D ocean model. Ensemble results are constrained by comparing simulated and observation-based fields of excess dissolved calcium carbonate (TA*). The minerals calcite and aragonite are modelled explicitly and ocean–sediment fluxes are considered. For local dissolution rates, either a strong or a weak dependency on CaCO3 saturation is assumed. In addition, there is the option to have saturation-independent dissolution above the saturation horizon. The median (and 68 % confidence interval) of the constrained model ensemble for global biogenic CaCO3 export is 0.90 (0.72–1.05) Gt C yr−1, that is within the lower half of previously published estimates (0.4–1.8 Gt C yr−1). The spatial pattern of CaCO3 export is broadly consistent with earlier assessments. Export is large in the Southern Ocean, the tropical Indo–Pacific, the northern Pacific and relatively small in the Atlantic. The constrained results are robust across a range of diapycnal mixing coefficients and, thus, ocean circulation strengths. Modelled ocean circulation and transport timescales for the different set-ups were further evaluated with CFC11 and radiocarbon observations. Parameters and mechanisms governing dissolution are hardly constrained by either the TA* data or the current compilation of CaCO3 flux measurements such that model realisations with and without saturation-dependent dissolution achieve skill. We suggest applying saturation-independent dissolution rates in Earth system models to minimise computational costs.