bluuebunny/crossref_metadata_2025 huggingface dataset:
Музей як феномен соціальної пам’яті
Authors: Kalibovets S. M.
Published: November 2020

У статті аналізується процес становлення музею як інституту соціальної пам’яті, що має динамічну структуру, здатного виконувати соціальніфункції, які обумовлені суспільними потребами на сучасному етапі розвитку. Зазначено, що музей є соціальним інститутом, який виконує певні соціокультурні функції, а вивчення взаємозв’язку музею і соціальної пам’яті – актуальна наукова проблема, яка недостатньо досліджена на даний час. Музей як соціальний інститут організовує і координує діяльність людей по відношенню до минулого, передачі знань про нього, без чого ця діяльність набула би розрізненого, непослідовного характеру. Музей інституціоналізує нормативні моделі, зразки поведінки, які визначають, що в даному суспільстві вважається законним чи очікуваним у відношенні історичного минулого і попередників, формує ставлення до світу символічних об’єктів, які відносяться до минулого. Музей забезпечує символічну присутність минулого в теперішньому, демонструючи реальні цінності різних епох і народів. До того ж музей як соціальний інститут може внести суттєвий вклад у проблему екології, культури через трансляцію цінностей. Музейявляє собою цілісну, штучну, цілеспрямовану систему, зародження якої зумовлено суспільними потребами і відповідними соціальними діями, що має на меті збереження соціальної пам’яті. В ході історичного розвитку музей як система набув сталий склад компонентів, виробив структуру їхвзаємодій і функції, конструювався в соціальний інститут, одержав статус науково-дослідного і культурно-освітнього закладу, адаптувався до впливів економічних, політичних, соціальних, духовно-ідеологічних факторів, став об’єктом держаної політики.
Матеріальне забезпечення повсякденного життя ніжинців у 1944–1964 рр.: міфи та реальність
Authors: Strashko E.
Published: November 2020

Стаття присвячена історії повсякденних практик міського населення Ніжина у повоєнне двадцятиріччя 1944–1964 рр. Сучасна історіографічнапарадигма дозволила авторці проаналізувати новітні праці зарубіжних і українських вчених, застосувати методи історичної реконструкції повсякденного життя ніжинців крізь призму архівних документів, друкованих джерел і матеріалів регіональної преси. Беручи до уваги розмаїтістьвизначень і поглядів на природу повсякденності, дослідниця прагнула дотримуватися інтегрованого характеру категорії повсякдення та максимально зберегти історичний контекст щоденного життя. Порівняльний аналіз життєзабезпечувальної сфери повсякденного буття містян Ніжина у період пізнього сталінізму (1944–1953 рр.) і добу хрущовської лібералізації (1954–1964 рр.) дозволив виявити як спільні, тотожні тенденції, так і певні соціальні особливості у вимірі повсякденності. Охарактеризовано динаміку відбудови матеріально-забезпечувальної сфери побуту, суспільні деформації та незавершені реформи, проблеми та труднощі повсякденного життя ніжинців. Авторка стверджує, що суспільний індикатор матеріального забезпечення українців – продовольчі картки (до 1947 р.), заробітна плата, харчовий раціон, промислові товари, а також громадянські емоції людей про "омріяну казку" на тлі ейфорії від перемоги – варто розглядати у контексті повсякденної історії діяльності органів радянської влади. На конкретних фактах і подіях регіональної історії повсякденного життя ніжинців маємо можливість моделювати типові картини, як влада УРСР втручалася у побут громадян, виховуючи та підтримуючи в суспільстві ті якості "тоталітаризму повсякденності", що були їй потрібні.
The psychology of regions
Authors: Van Langenhove Luk
Published: November 2020

Abstract: There exists today a large consensus among scholars of different disciplines that regions are more than a geographical concept and that they are socially constructed. This implies that somehow people must play a role in the emergence of a region as an entity of governance and as a source of identity. But the relation between regions and the socio-psychological processes that constitute them remains unclear. This article aims to clarify what the social construction process of a region means and what kind of psychological processes play a role in it as well how such social construction relates with how regions contribute to people’s identity formation. For this theoretical exercise, use will be made of the so-called Vygotsky scheme that distinguishes between four different conversational spaces.

Resumen: Hoy en día existe un gran consenso entre los estudiosos de las diferentes disciplinas de que las regiones son más que un concepto geográfico y que están construidas socialmente. Esto implica que las personas deben desempeñar un papel en el surgimiento de una región como entidad de gobierno y como fuente de identidad. Pero la relación entre las regiones y sus procesos socio-psicológicos constituyentes sigue siendo vaga. Este artículo pretende aclarar qué significa el proceso de construcción social de una región y qué tipo de procesos psicológicos ocurren en él, y también cómo dicha construcción social se relaciona con cómo las regiones contribuyen a la formación de la identidad de las personas. Se utilizará el esquema de Vygotsky que distingue entre cuatro espacios de conversación.

Résumé: Il est aujourd’hui largement reconnu au sein de différentes disciplines que les régions sont plus qu’un simple concept géographique et qu’elles sont socialement construites. Cela implique que les individus doivent jouer un rôle dans l’émergence d’une région en tant qu’entité de gouvernance et source d’identité. Mais la relation entre les régions et les processus socio-psychologiques qui les constituent reste floue. Cet article vise à clarifier le sens exact du processus de construction sociale d’une région et quels types de processus psychologiques y jouent un rôle, ainsi que la relation entre cette construction sociale et la façon dont les régions contribuent à la formation de l’identité des personnes. Pour cet exercice théorique, nous utiliserons le schéma dit de Vygotsky qui distingue quatre espaces conversationnels différents.
A supposed fifth wave of Latin American regionalism and human needs
Authors: Dubé Sébastien
Published: November 2020

Abstract: This article analyzes the evolution, between 2010 and 2020, of the organizations created during the Latin American post–liberal regionalism wave. It describes their rise and decline and includes recent public opinion data to claim that there is no demand or supply for an eventual fifth wave of regionalism that would replicate the previous models. Considering the failure of national governments in fulfilling basic human needs, it nonetheless claims that the deepening of the critical social and economic conditions, especially in the COVID-19 pandemic context, could lead to a fifth wave of regionalism in Latin America. Nevertheless, to succeed, such a wave could be inspired by international and regional technical organizations in a way that would recall the principles of David Mitrany’s functionalist theory.

Resumen: Este artículo analiza la evolución de las organizaciones creadas durante la ola de regionalismo post-liberal en América Latina entre 2010 y 2020. Describe su auge y caída e incluye datos recientes de opinión pública para plantear que no existe una demanda ni una oferta para una quinta ola de regionalismo similar a las olas anteriores. Sin embargo, el fracaso de los Estados en asegurar las necesidades sociales básicas y la degradación de las condiciones socioeconómicas, particularmente en el contexto de la pandemia COVID-19, podrían llevar a una quinta ola de regionalismo latinoamericano. Para que dicha ola pudiese tener éxito, podría inspirarse en las acciones de organizaciones técnicas internacionales y regionales, de una manera que recuerda los principios de la teoría funcionalista de David Mitrany.

Résumé: Cet article analyse l’évolution, entre 2010 et 2020, des organisations créées durant la vague de régionalisme postlibéral en Amérique latine. Il décrit leur montée et leur déclin et inclut des données récentes d’opinion publique afin de soutenir l’argument selon lequel il n’y a actuellement ni demande, ni offre d’une cinquième vague de régionalisme latino-américain semblable aux vagues précédentes. Cependant, l’échec des États à assurer les besoins humains fondamentaux et la dégradation des conditions sociales et économiques, notamment dans le contexte de la pandémie de Covid-19, pourraient mener à une cinquième vague de régionalisme dans la région. Pour donner des résultats concrets, celle-ci pourrait être inspirée par l’action des organisations techniques internationales et régionales d’une façon rappelant les principes de la théorie fonctionnaliste de David Mitrany.
Rethinking “new regionalisms” out of Africa 2020
Authors: Shaw Timothy M. , Kabandula Abigail
Published: November 2020

Abstract:This article suggests that the quarter of the world’s states that are African can yet contribute to new “developmental” regionalisms in theory and practice, as the North enters a period of ambivalence about, if not retreat from, positive global engagement. This article builds on the pioneering analysis of Björn Hettne with Inotai on new regionalism and the related contributions out of contemporary “development” studies by Jan Nederveen Pieterse on East-South relations and Oliver Stuenkel on a non-Western world.

Resumen:Este artículo sugiere que la cuarta parte de los Estados del mundo que son africanos pueden todavía contribuir a nuevos regionalismos “desarrollistas” (DR) en la teoría y en la práctica, a medida que el Norte entra en un período de ambivalencia sobre, si no de retractación de, su compromiso global positivo. Este artículo se basa en el análisis pionero de Björn Hettne con Inotai sobre el nuevo regionalismo y las contribuciones conexas de los estudios contemporáneos sobre “desarrollo” de Jan Nederveen Pieterse sobre las relaciones Este–Sur y Oliver Stuenkel sobre un mundo no occidental.

Résumé:Cet article suggère que le quart des États du monde qui sont africains peuvent encore contribuer à de nouveaux régionalismes “développementaux” (DR) en théorie et en pratique, alors que le Nord entre dans une période d’ambivalence, voire de retrait, quant à son engagement mondial. Cet essai s’appuie sur l’analyse pionnière de Hettne et Inotai (1994) concernant le nouveau régionalisme et sur les contributions connexes des études contemporaines relatives au “développement” de Pieterse (2011) et les relations Est-Sud et de Stuenkel (2015 & 2016) pour le monde non occidental.
The West Africa Institute’s (WAI) contribution to the ECOWAS Post 2020 Vision
Authors: Traoré Djénéba
Published: November 2020

Abstract: This article addresses the commitments of ECOWAS to citizen
perspectives, and it underlines the added value of scientifi c research in the
successful achievement of regional integration for West Africans. Specifi -
cally, it asks, how can the eff ectiveness and relevance of academic studies
be used to enhance economic growth and social development? The creation
of the West Africa Institute (WAI), a research center and think tank
dedicated to regional integration and social transformations, was a major
step in the search for adequate local and regional development solutions
fi 􀄴 ing with the West African context. WAI works with a participatory
approach, promoting free debates among policy makers, open spaces for
dialogue, and exchange among all social actors concerned with issues of
regional integration and social transformation.

Resumen: Este artículo analiza los compromisos de la CEDEAO en términos
de perspectivas ciudadanas y enfatiza el valor agregado de la investigación
científi ca en el éxito de la integración regional para África
Occidental. Específi camente, pregunta cómo la efi ciencia y relevancia de
los estudios universitarios pueden usarse para mejorar el crecimiento
económico y el desarrollo social. La creación del Instituto de África Occidental
(IAO) fue un paso importante en la búsqueda de soluciones para
un desarrollo apropiado, adaptado a los contextos local y regional de
África Occidental. La IAO trabaja con un enfoque participativo promoviendo
el fl ujo libre de debates entre los tomadores de decisiones y espacios
abiertos para el diálogo e intercambio entre todos los actores sociales
interesados en temas de integración regional y transformación social.

Résumé: Cet article traite des engagements de la CEDEAO en matière
de perspectives citoyennes et met l’accent sur la valeur ajoutée de la
recherche scientifi que dans la réussite de l’intégration régionale pour l’Afrique de l’Ouest. Plus précisément, il étudie comment l’effi cacité et la
pertinence de la recherche scientifi que peuvent être utilisées pour améliorer
la croissance économique et le développement social. La création
de l’Institut de l’Afrique de l’Ouest (IAO), un centre de recherche et un
groupe de réfl exion dédié à l’intégration régionale et aux transformations
sociales, a été une étape majeure dans la recherche de solutions de développement
local et régional adéquates adaptées au contexte ouest-africain.
L’IAO travaille avec une approche participative, favorisant la libre
circulation des débats entre les décideurs et des espaces ouverts pour
le dialogue et l’échange entre tous les acteurs sociaux concernés par les
questions d’intégration régionale et de transformation sociale.
THE INFLUENCE OF GLASS CONTAINING COMPONENT ON GYPSUM BINDER AND DRY MIX MORTAR PROPERTIES
Authors: Sopegin G. V. , Semeynykh N. S. , Rustamova D. Ch.
Published: November 2020

The paper studies the properties of the gypsum binder after the addition of glass containing component (crushed granulated foam glass) and the suitability of the latter for the development of a new composition of the heat-insulated gypsum mixture.

It is shown that the addition of the glass containing component (GCC) fraction of 0.14–1.25 mm in the amount of 5–15 % provides the highest strength increase of the gypsum binder. The presence of GCC fractions of 0.063–0.14 mm in the composition of the gypsum binder increases its softening coefficient from 0.42 to 0.48.

The main properties of the gypsum mixture are studied after the addition of the GCC fraction of 0.063–4.0 mm in the amount of 30, 40 and 50 % of the binder mass. The initial setting of the GСС-containing mortar mixture occurs no later than in 6 minutes. The introduction of 50 % GCC significantly reduces the water retaining power to 85 %. An increase in the GСС content from 30 to 50 % in the composition of the gypsum mixture leads to a decrease in the thermal conductivity of the samples from 0.279 to 0.209 W/(m×°С). The compressive strength reduces from 15.85 to 9.273 MPa as the GСС content increases to 50 %. The adhesive strength to ceramic brick for compositions containing 30 and 40 % GСС ranges from 0.44 to 0.69 MPa.

In relation to physical, mechanical and heat insulating properties, compositions containing 30 and 40 % of GСС are the most effective. These compositions can be modified by the addition of various setting retardants, water-retaining and plasticizing additives.
STRUCTURAL DEFORMATION OF FUEL AND CHEMICAL REFINER OBJECTS IN SEASONAL SOIL FREEZING
Authors: Fursov V. V. , Tayukin G. I. , Balyura M. V.
Published: November 2020

The paper presents the analysis of deformation caused by seasonal freezing and thawing of clay foundation soils during the construction of construction industry bases, waste treatment facilities and others, etc. The deformation generation and development during a single freezingthawing cycle and long-term cycles are discussed depending on the foundation depth of seasonally freezing soil, foundation pressure and other factors. It is shown that soil setting during thawing of the frozen soil significantly exceeds its bulging during freezing. Recommendations are given on the reduction and prevention of inadmissible deformations, and structural restoration and reinforcement. The advantages of pile foundations are shown against the natural foundations in seasonal soil freezing conditions.
IMPROVEMENT OF ENVIRONMENTAL SAFETY IN CONSTRUCTION AND ROAD SERVICE
Authors: Lukashevich O. D. , Lukashevich V. N.
Published: November 2020

The paper considers the road transportation sector in the context of the negative impacts of the global economic and financial crises on the environment. The ecology-oriented development of the road construction, road repair and maintenance are described herein. The promising research and innovation development in Siberia includes the ways to increase the stability of asphalt concrete pavements, studying the possibilities of waste utilization produced by the local industrial enterprises (for example, stillage residues of the chemical industry) for the road asphalt modification; replacement of rock materials used in the upper and lower layers of the pavement coatings by by-passed stone, utilization of plastics scrap and rubber in polymer modification.
MODEL CONSTRUCTION IN RUSSIAN CITIES AND TOMSK
Authors: Babinovich N. U. , Sitnikova E. V.
Published: November 2020

The article examines the general trends in design and construction in accordance with the model projects on classicism in Russia and the city of Tomsk. The development stages of design and construction in Russia late in the 18th and early 19th centuries are presented. Stand ard design ensures fast and high-quality construction throughout the country. This phenomenon covers almost and all design areas has a strong impact on the architecture of the Russian cities. The research concerns the preservation of historical buildings built in accordance with the model projects widespread in the Russian cities in the 18–19th centuries. Despite many works on classical architecture in the Russian cities, it has not been studied enough for Siberian cities and, in particular the city of Tomsk.

The purpose of this work is to study the development stages of the model design, identify bjects built according to the model projects in Tomsk and other cities of Russia, and carry out the comparative analysis. The following methods are explored: the literature review, comparative architectural analysis and cross-sectional analysis of the data obtained.

The novelty is the comparative analysis of classical buildings in Russia. This research involves previously unpublished archival materials and field studies.

It is found that in the 18–19th centuries, the spontaneous construction was ceased in Russia.

The streets took on clear geometric outlines and the houses met the given requirements accompanied by the model projects. In Tomsk and other Siberian cities, the model projects were based on wooden architecture that continued until the end of the 19th century. Buildings built during this period already had deviations from the classical style, namely the odd number of windows, symmetry breaking, and fillet decoration.
FUNCTIONAL AND PLANNING ORGANIZATION OF RURAL ARCHITECTURE NEAR THE RIVER TOM IN 1900–1960
Authors: Rublev M. A. , Bulgach R. V.
Published: November 2020

The paper analyzes the changes in the functional and planning solutions of the rural architecture near the river Tom during the period of 1900–1960. The study identifies the main periods of transformation, factors affecting changes in the planning structure of the region, the degree and nature of their influence. The purpose of the paper is to identify the regularities of transformation and analyze the experience of adapting the functional and planning organization in West Siberia to changing economic relations in agriculture: from private ownership to strict state control (a new type of economic conditions) for the period of 1900–1960. The following problems are considered:

1. Identification of factors that determine changes in the functional and planning organization of the rural architecture for the specified period.

2. Determination of the development stages of the functional and planning organization of the rural architecture.

3. Evolution of the nature and structure of the functional and planning organization of the rural architecture.

Methodology and approaches involve the literature review, comparative and historical method of determining the architectural styles of the river Tom region for the period of the late 20th century, ethnographic methods of field research to collect the required materials (interviews, surveys, photographs).

The research implications determine the nature and results of transformation of functional and planning decisions in the context of Siberian material culture of the 20th century. The theoretical basis of this research is the work of Siberian historians, architects and ethnographers.
ARCHITECTURAL AND URBAN TYPOLOGY OF CULTURAL AND HISTORICAL PLACES
Authors: Leizerova A. V.
Published: November 2020

The article proposes a typology of the historical places in a city for their identification and typification. Classification is based on the analysis of the structural techniques that determine the morphological features of historical places in the urban structure. The use of fuzzy logics seems to be an actual tool to achieve objectivity in the analysis of territories of different development. The hierarchy of the regulated order is determined by the following system of factors: sustainable urban framework - ordinary buildings – visual accents; building-blockbuster, visual gap. Taking into account the sustainability, the following cultural and historical places are identified: the museum cluster, cultural and historical island, cultural and historical island of a mixed type, island-type town-planning with historical buildings, modern cluster.
ARCHITECTURE OF KOLPASHEVO INFLUENCED BY LOCAL ENTREPRENEURS
Authors: Sitnikova E. V.
Published: November 2020

The paper examines the historical and cultural heritage of the Kolpashevo town founded in the 17th century in the Tomsk region. The architecture of the individual objects built by the local entrepreneurs late in the 19th and early 20th centuries is studied. The paper replenishes knowledge on the valuable historical and cultural heritage of the Russian towns and discussesи the problem of preserving historical settlements at the regional level.

The purpose of this work is to study the history of the architecture development in Kolpashevo with the assistance of local entrepreneurs.

The research methods include the literature review and the comparative and systems analysis of the data obtained. The practical implications of the research lie in using the obtained results in the lecture preparation and reports on the history of the Siberian architecture.

The novelty is the study of the historical and cultural heritage of Kolpashevo, one of the small towns of Russia, which has not been previously studied. The methodological and theoretical bases include the theoretical works of scientists, historians and architects, and the field study conducted by the author in 2019.

It is found that the Kolpashevo town has a great potential, including the valuable historical and cultural heritage, the rich history and unique nature. It is advisable to pay attention to the potential preservation and development of this historical town.
The attitude of Parents towards Their Daughters Higher Education in Khyber Pakhtunkhwa Pakistan
Authors: Amin Roohul , Rashid Abdur , Ahmad Shabir
Published: November 2020

The present paper focused on finding out attitudes of parents towards their daughters' higher education in Khyber Pakhtunkhwa, Pakistan. The objective was to find out the attitude of parents towards their daughters' higher education. The study was delimited to male parents of three districts, namely Dir Lower, Dir Upper and Swat. The target population was 4872 male parents. A sample of 360 male parents was selected according to L.R Gay sample selection table, and self-developed five Likert scale questionnaires were distributed among them. The data was fed into SPSS version 16 and analyzed through percentage and chi-square. The study found that positive attitude of parents had good effects on their daughters' higher education and recommended that government should increase the number of institutes, provide facilities at female higher education institutes and encourage the community to make parents' attitudes positive.
Malpractice and socioeconomic aspects in neurosurgery: a developing-country reality
Authors: de Macêdo Filho Leonardo J. M. , Aragão Ana Carolina A. , Moura Ian A. , Olivier Lucas B. , Albuquerque Lucas Alverne F.
Published: November 2020

OBJECTIVE

Neurosurgery occupies a prominent place in medical malpractice, but cases are still underreported in Brazil. This study describes the socioeconomic issues of medical malpractice in neurosurgery procedures and how they culminate in unfavorable outcomes in a developing country.

METHODS

The authors analyzed 112 neurosurgical procedures listed in the Brazilian Hospital Information System (Sistema de Informações Hospitalares do Sistema Único de Saúde [SIHSUS]) records in the DATASUS (Departamento de Informática do SUS) database between January 2008 and February 2020. Malpractice data were collected using the JusBrasil platform, with the authors searching the name of each of the 112 neurosurgical procedures plus “medical malpractice” among the jurisprudence records for January 2008 to February 2020. A simple linear regression analysis was performed using appropriate software. Analyses were considered statistically significant at p < 0.05.

RESULTS

According to DATASUS, 842,041 neurosurgical procedures were performed by the Brazilian Unified Health System between January 2008 and February 2020. The mean hospitalization cost for neurosurgical procedures was $714.06, and the average amount paid to professionals per procedure was $145.28 with variations according to the type of practice (public or private) in which they were performed, the complexity of the procedure, and the Brazilian region. The mortality rate and mean length of stay for neurosurgical procedures were 11.37% and 10.15 days, respectively. There were 79 medical malpractice lawsuits in the studied period. In these lawsuits, 26.58% of the court decisions were unfavorable to the neurosurgeons, with a mean compensation per procedure 15 times higher than the median value paid for all professionals in a neurosurgical procedure. The spine subspecialty had more lawsuits, and the brain tumor subspecialty had the most expensive compensation.

A lack of resources in public healthcare negatively impacts inpatient care. The mortality rate was 1.5 times higher in public practice than in private practice and was inversely proportional to the MTCs paid for the neurosurgical procedure. Patients with the lower educational levels associated with limited access to good medical care could reflect the lower plaintiff motivation in regions with a low gross domestic product and Human Development Index. In most cases, there is no understanding from either the patient or his family about the health-disease process, nor that there was medical malpractice committed by the physician to be sued.

CONCLUSIONS

The socioeconomic inequalities and the population’s low awareness of their rights could explain the few malpractice cases reported in Brazil. The authors recommend better decisions regarding the investments to be made in neurosurgical procedures to reduce malpractice lawsuits.
Medicolegal issues in abusive head trauma for the pediatric neurosurgeon
Authors: Bass David I. , Lee Amy , Browd Samuel R. , Ellenbogen Richard G. , Hauptman Jason S.
Published: November 2020

The purpose of this article is to serve as a rational guide for the pediatric neurosurgeon in navigating common medicolegal issues that arise in the management of abusive head trauma (AHT). Many of these issues may be unfamiliar or unpleasant to surgeons focused on addressing disease. The authors begin with a brief history on the origins of the diagnosis of AHT and the controversy surrounding it, highlighting some of the facets of the diagnosis that make it particularly unique in pediatric neurosurgery. They then review some special medical considerations in these patients through the perspective of the neurosurgeon and provide several examples as illustration. The authors discuss how to appropriately document these cases in the medical record for expected legal review, and last, they provide an overview of the legal process through which the neurosurgeon may be called to provide testimony.
The medicolegal impact of misplaced pedicle and lateral mass screws on spine surgery in the United States
Authors: Sankey Eric W. , Mehta Vikram A. , Wang Timothy Y. , Than Tracey T. , Goodwin C. Rory , Karikari Isaac O. , Shaffrey Christopher I. , Abd-El-Barr Muhammad M. , Than Khoi D.
Published: November 2020

Spine surgery has been disproportionately impacted by medical liability and malpractice litigation, with the majority of claims and payouts related to procedural error. One common area for the potential avoidance of malpractice claims and subsequent payouts involves misplaced pedicle and/or lateral mass instrumentation. However, the medicolegal impact of misplaced screws on spine surgery has not been directly reported in the literature. The authors of the current study aimed to describe this impact in the United States, as well as to suggest a potential method for mitigating the problem.

This retrospective analysis of 68 closed medicolegal cases related to misplaced screws in spine surgery showed that neurosurgeons and orthopedic spine surgeons were equally named as the defendant (n = 32 and 31, respectively), and cases were most commonly due to misplaced lumbar pedicle screws (n = 41, 60.3%). Litigation resulted in average payouts of $1,204,422 ± $753,832 between 1995 and 2019, when adjusted for inflation. The median time to case closure was 56.3 (35.2–67.2) months when ruled in favor of the plaintiff (i.e., patient) compared to 61.5 (51.4–77.2) months for defendant (surgeon) verdicts (p = 0.117).
Sovereign immunity and its implications for neurosurgery
Authors: Dossani Rimal H. , Waqas Muhammad , Meyer Michael J. , Chin Felix , Rai Hamid H. , Dossani Rameez , Dossani Anshara Munir , Riaz Muhammad
Published: November 2020

The proportion of neurosurgeons facing a malpractice suit each year is highest among all medical and surgical specialties. It is critical for neurosurgeons to understand local malpractice laws because they vary among states. Sovereign immunity, as described in the 11th constitutional amendment, provides absolute immunity to states from being sued by their residents and by other states. A state may waive its sovereign immunity, however, and substitute itself as the defendant in place of a state-employed physician in the court of law. This means that a physician working for a state-funded hospital may not be liable to a malpractice suit. Further provisions of the law allow the state not to pay indemnity beyond a certain limit, which discourages plaintiff attorneys from pursuing indemnity charges against physicians working for state-funded institutions. In this review, the authors describe the concept of sovereign immunity and its implications for the practice of neurosurgery.
Status of current medicolegal reform in the United States: a neurosurgical perspective
Authors: LeFever Devon , Demand Audrey , Kandregula Sandeep , Vega Alexis , Hobley Breydon , Paterson Soleil , Trosclair Krystle , Menger Richard , Kosty Jennifer , Guthikonda Bharat
Published: November 2020

OBJECTIVE

There are approximately 85,000 lawsuits filed against medical practitioners every year in the US. Among these lawsuits, neurosurgery has been identified as a “high-risk specialty” with exceptional chance of having medical malpractice suits filed. Major issues affecting the overall medicolegal environment include tort reform, the formation of medical review panels, the increasing practice of defensive medicine, and the rising costs of medical insurance. In this study, the authors provide a concise update of the current medicolegal environments of the 50 states and provide a general guide to favorable and unfavorable states in which to practice neurosurgery.

METHODS

Data were acquired related to state-by-state medical review panel status, noneconomic damage caps, economic damage caps, and civil suit filing fees. States were placed into 5 categories based on the status of their current medicolegal environment.

RESULTS

Of the 50 states in the US, 18 have established a medical review panel process. Fifteen states have a mandatory medical review process, whereas 3 states rely on a voluntary process. Thirty-five states have tort reform and have placed a cap on noneconomic damages. These caps range from $250,000 to $2,350,000, with the median cap of $465,900. Only 8 states have placed a cap on total economic damages. These caps range from $500,000 to $2,350,000, with the median cap of $1,050,000. All states have a filing fee for a medical malpractice lawsuit. These costs range from $37 to $884, with the median cost for filing of $335.

CONCLUSIONS

Medicolegal healthcare reform will continue to play a vital role in physicians’ lives. It will dictate if physicians may practice proactively or be forced to act defensively. With medicolegal reform varying greatly among states, it will ultimately dictate if physicians move into or away from certain states and thus guide the availability of healthcare services. A desirable legal system for neurosurgeons, including caps on economic and noneconomic damages and availability of medical review panels, can lead to safer practice.
Study of the Head of Human Dry Radii in a Medical College of Nepal: A Descriptive Cross-sectional Study
Authors: Kadel Muna , Thapa Trilok Pati
Published: November 2020

Introduction: Radius is a lateral bone of forearm. Its proximal end forms a part of elbow joint and superior radioulnar joint. Knowledge of the shape and size of radial head is essential for construction of radial head prosthesis. The objective of this study is to study the morphology of head of human dry radii.

Methods: A descriptive cross-sectional study was conducted in human dry radii in the Dissection hall of Nepalese Army Institute of Health Sciences, Sanobharyang, Kathmandu, Nepal from September to October 2019. Ethical approval was taken. Altogether, 68 dry bones were enrolled in the study by convenience sampling method. Radial head was studied in respect to anteroposterior and transverse diameter, height at medial and distal end and shape. Mean and standard deviations of the parameters were obtained by using Statistical Package for Social Sciences version 20.

Results: Mean height of radial head at medial and lateral end was 0.91cm and 0.76cm respectively.  Mean anteroposterior and transverse diameter of radial head were 2.09 cm and 2.02 cm respectively. Most common shape of radial head in this study was circular in 40 radii (59%) followed by elliptical in 23 (34%). Mean depth of the superior articular facet of the radial head was 0.19 mm.

Conclusions: The most common shape of radial head is elliptical but it was found to be circular  in this study. This study will be useful for orthopedic surgeons in making prosthesis of radial head.
Prevalence of Self-medication among MBBS students of a Medical College in Kathmandu
Authors: Khadka Anjan , Kafle Kumud Kumar
Published: November 2020

Introduction: Self-medication refers to self-prescription which includes diagnosing and treating one’s own illness and prescribing for one’s self. Though appropriate self-medication relieves acute symptoms, is time saving and economical, it should not be advocated because of more risks than benefits. Self-medication practices were found to vary in medical students of Nepal and India. This study was aimed to determine the prevalence of self-medication among medical students.

Methods: This descriptive cross-sectional study was conducted among 76 MBBS students. The study involved the administration of the research questionnaire including demographic information, practice of self-medication, type of illness, factors influencing self-medication, commonly self- prescribed drugs, sources and strategies to reduce such practices. The data were analyzed using Graph pad prism version 6.

Results: The prevalence of self-medication was 58 (76.6%), more common among first year students. The common illness found was headache and common drug self-prescribed was analgesic-antipyretic. The most common source of obtaining medicines for all three year medical students was pharmacy. Students were also prescribing medicines to family members, friends and juniors. More than half of the students 52 (68.4%) reported that self-medication practices should be encouraged.

Conclusions: Self-medication had been widely practiced among medical students. Self-medication can relieve medical problems but also involve the risks of adverse drug reactions, resistance and masking of underlying diseases. Medical students should be given enough exposure for better understanding of rational prescribing to minimize self-medication. The further study on practice of self-medication is needed on various health professionals and even in general community.
Utilization of Pre-Anesthetic Medications for Major Surgical Procedures at a Tertiary Care Center: A Descriptive Cross-sectional Study
Authors: Shah Rekha , Pradhan Roshan , Shah Arbindra
Published: November 2020

Introduction: Drug utilization research is an important tool to analyze the use of drugs with specialemphasis on medical, social, and economic consequences in society. This study aims to find out theutilization of pre-anesthetic medications in a major surgical procedure.

Methods: A descriptive cross-sectional study was conducted from 15th April - 15th August 2019 inthe postoperative ward at Birat Medical College and Teaching Hospital. The convenience samplingmethod was used after ethical clearance from the Institutional Review Committee (IRC) of BiratMedical College and Teaching Hospital, Biratnagar, Nepal. About 400 patients were studied.The collected data were entered into a statistical package for social science version 20 for furthercalculations at 95% Confidence Interval.

Results: Out of 400 patients, 215 (53.8%) of patients were underwent into different major surgeries.All patients received midazolam 2 mg except children (1 mg) and Pethidine 25 mg along with 0.2 mgglycopyrrolate 352 (88%), ondansetron 276 (69%) and others 58 (14.5%) as a preanesthetic agent. Forgeneral anesthesia propofol, 30 mg have been utilized followed by fentanyl 306 (76.5%) and others(halothane, isoflurane, etc) 115 (28.8%). In case of prophylactic drug were ceftriaxone 500 mg, 100 mgmetoclopramide 387 (96.8%), dexamethasone 251 (62.8%), tramadol 237 (59.3%), 15 mg ketorolac 368(92%), ranitidine 163 (40.8%), and pantoprazole 237 (59.3%).

Conclusions: The most commonly administered pre-anesthetic drugs were midazolam, pethidine,glycopyrrolate, and ondansetron. The incidence of postoperative nausea and vomiting the patientwithin 24 hours after surgery was significantly very low.
Adult-onset Still's Disease: A Case Report
Authors: Sapkota Ashok , Pokhrel Nirdesh , Adhikari Jayaram , Shrestha Bishal , Yadav Yoveen Kumar
Published: November 2020

Adult-onset Still’s Disease is a rare auto inflammatory disorder of unknown etiology characterized mainly by high spiking fever, arthritis, evanescent rash and lymphadenopathy. It is a form of systemic onset juvenile rheumatoid arthritis that is encountered in adults, typically between 15-25 years and 36-45years. We here describe a 28 years lady with fever, arthritis of multiple large joints, lymphadenopathy and rash, with negative Rheumatoid factor and evidence of past infection with Ebstein-Barr virus and Parvovirus B19. History, examination findings and investigations showed several features consistent with adult-onset Still’s disease along with high ferritin level. After exclusion of probable other diagnosis and use of Yamaguchi criteria, she was diagnosed with adult-onset Still’s disease. All the major and minor criteria of Yamaguchi for diagnosis were met. Her disease responded well with steroid, she achieved remission and is currently under maintenance therapy.
Pattern of Pediatric Supracondylar Fracture Operated at A Rural Teaching Hospital of Nepal: A Descriptive Cross-sectional Study
Authors: Rokaya Poojan , Karki Dhan Bahadur , Rawal Mangal , Limbu Deoman , Menyangbo Suryaman , Devkota Harihar
Published: November 2020

Introduction: Supracondylar fracture of humerus is one of the common pediatric fractures encountered in our daily clinical practice. The purpose of this study is to determine the pattern of supracondylar fracture operated at rural teaching hospital of Jumla, Karnali Nepal.

Methods: A descriptive cross sectional study was conducted at Jumla, Karnali after Institutional Review Committee approval. Operating room notes from 15 May 2017 to 16 November 2019 were retrieved to gather the following information: patients address, age, sex, side, injury mechanism, displacement, neurovascular injury, concurrent injuries, initial management by traditional bone setters, time between injury and surgery, operative technique. Data analysis was done using Statistical Package for Social Sciences version 20.

Results: A total of 138 children underwent operative fixation with mean age of 7.47 years and gender ratio of 2:1 boy to girl. Fall from cliff, ladders and rooftops were the prevailing cause of injury 72 (52.8%). Left side predominated with 88 (63.7%) and extension type was common in 135 (97.8%). Thirteen (9.4%) patients were initially managed by traditional bonesetters. Average time between injury and surgery was 5.2 days. Closed reduction was done in 100 (72.4%) patients whereas open reduction was necessary in 38 (27.5%) patients.

Conclusions: Closed extension type pediatric supracondylar fracture was common in this study. Fall from cliff, rooftop and ladder are the major cause of fracture. Delayed presentation and initial management of the fracture by the traditional bonesetters makes supracondylar fracture more challenging in resource limited setting like ours.
Prevalence of Polycystic Ovarian Syndrome among Medical Students of a Tertiary Care Hospital
Authors: KC Shreeyanta , Shah Rakesh Kumar , Singh Avilasha , Prasai Astha , Bhandari Birat , Aryal Saman , Khatri Asmita , Thapa Meena
Published: November 2020

Introduction: Polycystic ovarian syndrome is considered to be one of the most common endocrinedisorders among women of reproductive age. Characterized by a triad of androgen excess,anovulation, infertility, and obesity the disease can lead to several complications like infertility,endometrial carcinoma. This study aims to find out its prevalence among female medicalundergraduates.

Methods: A descriptive cross-sectional study was conducted among female undergraduate medicalstudents in a tertiary care hospital from 1st to 7th February 2018. Ethical approval was taken fromthe Institutional Review Committee (reference number 10012018). The sample size was calculated.Systematic random sampling was done. Statistical Package for the Social Sciences version 20.0 wasused. Point estimate at 95% Confidence Interval was calculated along with frequency and proportionfor binary data.

Results: Out of 381 participants, the prevalence of polycystic ovarian syndrome was found to be 35(9.18%) at 95% Confidence Interval (6.28-12.08). Eighty (20.99%) participants were reported to haveprolonged menses, 28 (7.34%) tended to grow dark, coarse hair, 79 (20.73%) reported being obese oroverweight, and milky discharge from nipple was present in 4 (1.049%).

Conclusions: The prevalence of polycystic ovarian syndrome was found to be similar to other studiesconducted in similar settings. But still, it is a growing endocrinological problem in the females of thereproductive age group. Early screening is necessary to prevent lifelong complications.
Self-medication Practice of Antibiotics among Medical and Dental Undergraduate Students in a Medical College in Eastern Nepal: A Descriptive Cross-sectional Study
Authors: Mandal Namita Kumari , Rauniyar Gajendra Prasad , Rai Dilli Sher , Panday Dipesh Raj , Kushwaha Ramayan , Agrawal Santosh Kumari , Regmee Pragya
Published: November 2020

Introduction: Self-medication plays significant role in the development of adverse drug reactions,antibiotic resistance, and masking of underlying diseases. Medical students have some knowledgeabout the use of antibiotics and have a higher chance of irrational and injudicious use. This studyaims to find the prevalence of self-medication practice of antibiotics among medical and dentalundergraduate students.

Methods: A descriptive cross-sectional study was done among medical and dental undergraduatestudents from the first year to the fifth year at BP Koirala Institute of Health Sciences from 1st June2018 to 30th August 2018. Ethical approval was obtained from the Institutional Review Committee(IRC/1210/018). Whole sampling was done. Data was collected using a self-responding, semistructured questionnaire and analyzed using Statistical Package for the Social Sciences version 11.5.

Results: In total 558 students, the prevalence of self-medication practice of different antibioticswas 285 (51.1%) within the past year. Among self-medicated students, 152 (53.3%) were males. Thecommon drug self-medicated was Azithromycin 80 (28.1%) and the common medical condition touse non-prescription antibiotics was for treatment of sore throat with runny nose 129 (45.3%). Themain source for obtaining non-prescription antibiotics were retail pharmacies 157 (55.1%).

Conclusions: Self-medication with antibiotics was at increasing rate with each succeeding yearsof the medical courses. Medical students should be made aware of the rational use of antibioticsby incorporating appropriate courses in their academic curriculum for more refined practice onantibiotics rather than advancement of theoretical knowledge alone.
Combined Penetrating Keratoplasty Followed by Pars Plana Vitrectomy for Firecracker Induced Bilateral Corneal and Intraocular Foreign Body: A Case Report
Authors: Rajbanshi Lily , Kumari Archana , Singh Sanjay
Published: November 2020

Firecracker induced open globe injury is a big challenge for ophthalmic surgeons. Its associationwith the intraocular foreign body makes the diagnosis and treatment even more difficult resultingin poor anatomical and visual outcomes. We report a case of a 35-year-old male who presented withbilateral, multiple corneal and intraocular foreign body due to firecracker explosion. His vision waslimited to hand movement in both eyes. Combined penetrating keratoplasty and cataract surgerywere done in both eyes followed by pars plana vitrectomy for intraocular foreign body removal.The final best-corrected visual acuity of the patient stood to be 6/6 and 6/9 in the right and left eyerespectively. The encouraging result in our case prompts ophthalmologists for a timely stepwisemultidisciplinary approach in all open globe injuries with intraocular foreign body cases havingpoor initial acuity.
Anaphylaxis: Act Now or Never
Authors: Yadav Bishal
Published: November 2020

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Anatomy of Internal Iliac Artery and Its Ligation to Control Pelvic Hemorrhage
Authors: Shrestha Ramesh , Shrestha Sapana , Sitaula Sarita , Basnet Pritha
Published: November 2020

Pelvic hemorrhage is a major cause of maternal morbidity and mortality in developing countries. A sound clinical judgment, adequate assessment, and preparation of the patient are the best preoperative means to avoid its occurrence. Bilateral internal iliac artery ligation is a life-saving procedure to control massive obstetric and gynecological hemorrhage when other measures fail. This procedure significantly reduces the pulse pressure and rate of blood flow abolishing the‘triphammer effect’ of arterial pulsation and subsequently resulting in sluggish blood flow allowing effective thrombosis within the small bleeding vessels. This has helped to save many lives and uteruses for more than a century. No tissue necrosis occurs due to ample collateral circulation in the pelvis from the major pelvic anastomoses. An increased understanding of retroperitoneal anatomy and regional variations of the internal iliac artery is needed to reduce the risk of intraoperative andpostoperative complications.