bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.
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

OBJECTIVENeurosurgery 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.METHODSThe 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.RESULTSAccording 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.CONCLUSIONSThe 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.
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).
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

OBJECTIVEThere 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.METHODSData 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.RESULTSOf 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.CONCLUSIONSMedicolegal 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.
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.
Psychiatric Morbidities of Elderly Out-patients Attending Various Outreach Clinics in Gandaki Province of Nepal: A Descriptive Cross-sectional Study
Authors: Khattri Jai Bahadur , Godar Srijana Thapa , Subedi Anil , Tirkey Shweta 
Published: November 2020

Introduction: Dramatic growth of the aging population resulted in an increased number of mentaldisorders and such data are limited in Nepal. The objective is to find out the psychiatric morbiditiesof elderly out-patients attending Baglung, Kusma, Walling, and Dumre out-reach clinics in GandakiProvince of Nepal.
Methods: This was a descriptive cross-sectional study conducted in 392 patients attending out-reachclinics of Baglung, Kusma, Walling, and Dumre of Gandaki Province for one year with the convenientsampling method. Ethical approval was taken from the Institutional Review Committee of ManipalCollege of Medical Sciences, Pokhara. The diagnosis was done according to the InternationalClassification of Disease-10 guidelines. Epi-info 7 was used and point estimate at 95% ConfidenceInterval was calculated along with frequency and proportion for binary data and the analysis wasdone.
Results: The prevalence of neurotic, stress-related, and somatoform disorders 145 (37.0%) wasmaximum followed by mood disorders 111 (28.3%). Maximum cases were in between 66 and 75years, Brahmin and Chhetri caste, females, married, and from an extended nuclear family. Thereis more prevalence of female gender in all psychiatric diagnoses except in mental and behavioraldisorders due to psychoactive substance use. There is more prevalence of age groups of patients lessthan or equal to 75 years in all the psychiatric diagnosis.
Conclusions: Neurotic, stress-related, and somatoform disorders were the most common diagnosis.The risk of development of certain disorders based on gender and age group of the patients wouldbe helpful for case identification.