bluuebunny/crossref_metadata_2025_split huggingface dataset:
AMPLITUDE OF ACCOMMODATION IN DIFFERENT AGE GROUPS, AND ONSET OF PRESBYOPIA IN GENERAL POPULATION OF CENTRAL NEPAL
Authors: Pradeep Bastola  , Polina Dahal  
Published: February 2023

Background: Accommodation is the ability of the eye to change the refractive power of the lens to automatically focus on objects at various distances, amplitude of accommodation varies with age, and different types of refractive errors. The study aimed to find out amplitude of accommodation in different age groups in people with different refractive status of the eye, and onset of presbyopia in central Nepal.
Methods: A descriptive cross-sectional study was conducted in the Department of Ophthalmology of a tertiary care hospital from 15 October 2021 to 15 May 2022. Convenience sampling was done. Basic demographic data, clinical characteristics, data regarding amplitude of accommodation, refractive status, and age of onset of presbyopia was noted. Data entry, and analysis was done using Statistical Package for the Social Sciences version 26.
Results: A total of 519 study participants, (1038 eyes) were enrolled in the study aging 30-60 years. Mean amplitude of accommodation in the study participants was3.4±1.5 (2-9.0) Dioptre. Amplitude of accommodation was high in younger age group participants, and myopes, 4.4±1.7 (2-9.09) Dioptre followed by the emmetropes. Age of onset of presbyopia in myopes, 43.9±0.7 years was late than the hypermetropes, and the emmetropes.
Conclusions: Amplitude of accommodation was highest in younger age group subjects, and subjects with myopia. In hypermetropes the amplitude of accommodation was low and they presented with presbyopic features early, when compared with emmetropes, and myopes.
STUDY OF A VARIATION OF LUMBOSACRAL PLEXUS: SCIATIC NERVE AND ITS CLINICAL SIGNIFICANCE
Authors: Khan Gulam Anwer , Gautam Ajeevan , Shakya Shuvechha , Shrestha Amit 
Published: February 2023

Background: The pelvis is a home to pelvic parts of the sympathetic and parasympathetic nervous systems, the sacral and coccygeal plexuses, and the lumbosacral trunk. The lower spine’s sciatic nerve is made up of a combination of motor and sensory fibers from spinal nerves fourth lumbar to third sacral segment (ventral rami). The objective of study was to determine morphological variations in origin and formation of branching pattern of sciatic nerve.
Methods: A descriptive cross-sectional study was conducted on twenty-four (forty-eight lower limbs) cadavers available in the Department of Anatomy at School of Basic Sciences, Chitwan Medical College. All damaged cadavers were excluded. The cadavers for undergraduate first year medical students dissected as per Cunningham’s Manual. The branching pattern of the sciatic nerve was noted. All Variation of each sacral plexus was photographed. Statistical analysis was done using Microsoft Excel and SPSS version 20. Both gluteal regions were studied for the locations and variation of the sciatic nerve.
Results: Forty-eight lower limbs were examined. Among them forty-two lower limbs (87.5 percent) showed a normal anatomy of the sciatic nerve. Six lower limbs (12.5 percent) showed variations in the sciatic nerve.
Conclusions: The study concluded that there are variations in origin and formation of branches of sciatic nerve. Variations of sciatic nerve observed could be beneficial for various surgical interventions like nerve release and pain management in compressed nerve.
POST-STROKE DEPRESSION AMONG STROKE SURVIVORS ATTENDING THERAPY CENTERS IN CHITWAN
Authors: Koirala Arun , Koirala Subash , Shrestha Niki , Adhikari Shailendra Raj 
Published: February 2023

Background: The neuropsychiatric side effect of post-stroke depression is one of the most prevalent in stroke survivors. The purpose of this study was to determine the extent of post-stroke depression and the factors that influence post-stroke depression among stroke survivors attending therapy centers at various hospitals in Chitwan.
Methods: A hospital-based cross-sectional study using the face-to-face interview method was carried out in different therapy centers in Chitwan, Nepal. A total of 137 stroke survivors were considered as a sample. The data was collected from November 25, 2021 to January 29, 2021. We used Pearson’s Chi-square test and binary logistic regression analysis to assess the factors influencing post-stroke depression among stroke survivors in Chitwan.
Results: Among 137 stroke survivors, just more than half i.e., 54.70% (75) suffered from any kind of depression, and the remaining participants i.e. 45.30% (62) did not have depression. Result showed that current depression status among stroke survivors were significantly associated with age group [above 60 years (COR =2.88; CI=1.17-7.10)], educational status [primary and below (COR =4.02; CI=1.47-10.95)], past employment status [unemployment (COR=2.79; CI=1.37-5.69)], past alcohol intake [alcohol intake (COR=1.04; CI=0.52-2.10)] and current BMI status [underweight (COR =1.23; CI=0.24-6.07)].
Conclusions: More than half, or 54.70% (75), suffered from depression, which is an unacceptable rate. Increased literacy, improved socioeconomic status, and lifestyle changes among stroke survivors would reduce the severity of depression. It is necessary to provide comprehensive, up-to-date information as well as supportive interventions with the goal of reducing depression among stroke survivors.
ROLE OF THREE DIFFERENT DISINFECTANTS FOR PREVENTING BACTERIAL GROWTH IN DENTAL IMPRESSION MATERIAL
Authors: Joshi Kalit Raj , Guragain Manjeev , Khanal Lok Raj , Shrestha Anupama , Khanal Bibek , Khathiwada Sulochana , Palikhey Anjan , Khanal Shishtata 
Published: February 2023

Background:
Dental impressions become contaminated with micro-organism from patient’s saliva and blood which can cross-infect stone cast poured against them. The aim of the present study was to compare the efficacy of commercially available disinfection products, one containing glutaraldehyde, sodium hypo chloride and ethanol for disinfection of impressions material.
Methods: For this investigations, dental impression of 60 patients were taken. Impression was made in 5 mm slices for each disinfectants. Sectioned impression were immersed in gluteral aldehyde, sodium hypo chloride, and ethanol solutions. Antibacterial property of these disinfectants were evaluated by inoculating the sample saline solution into nutrient agar medium.
Results: There is no significant different between these three disinfecting solution (P<0.05).all these disinfecting solution seems effective against the bacterial growth.
Conclusions: Addition silicone impressions should always be disinfected after water wash in order to reduce effectively the cross-infection risk. All disinfectants tested showed high antimicrobial efficiency. Ethanol can be good economical alternative for disinfecting addition silicone.
SPECTRUM OF OTORHINOLARYNGOLOGICAL PROBLEMS AMONG PAEDIATRIC AGE GROUP AT A TERTIARY HOSPITAL OF NEPAL
Authors: Thapa Jeegyasha , Regmi Chalise Sangita , Khadka Subash , Shakya Abishesh , Ranjan Rashmi , Chettri Prabha 
Published: February 2023

Background: Otorhinolaryngological problems are very common among children. The pattern of ENT disorders varies from community to hospital depending upon the demographic, socioeconomic and health facilities available in that particular region. The objective of the study was to evaluate and determine the hospital based prevalence of disorders of Ear, Nose and Throat among children.
Methods: A prospective cross-sectional study was conducted in department of KIST Medical College and Teaching Hospital during the period of 1 year from 15th June 2021 to 15th June 2022. 320 patients attending the ENT outpatients during the study period were enrolled in the study. Informed consent was taken from patient and attendant. Diagnosis was made on the basis of history and clinical examination. Results were expressed in numbers and percentage.
Results: Among the 320 (3.66%) respondents (58.7%) were Males and (42.2%) were Females. Most of the children belonged to age group 0-5 years (56.25%), were living in Nuclear family (73.4%), belong to Middle upper middle class of family (43.1%). The most common ENT disorders were ear wax (32.5%) among otological disorders, pharyngitis (6.9%) among throat disorders and rhinitis (6.6%) among nasal disorders.
Conclusions: The study revealed ear wax, pharyngitis and rhinitis were the most common ENT related disorders in our area. We can improve the rate of prevalence of ENT disorders by firstly raising awareness among people and then taking further steps to improve education and health system.
PRESENCE OF EXTRA CANAL IN PERMANENT MANDIBULAR FIRST MOLAR
Authors: Joshi Neera , Shrestha Suraj , Prajapati Kranti , Wagle Sharada Devi , Nyachhyon Rinky , Sundas Sunanda 
Published: February 2023

Background: The success of root canal therapy depends on proper knowledge of root canal system, presence of extra canals, complete debridement and three-dimensional obturation of the entire root canal system. Previous studies have reported three to five canals in mandibular first molars. There might be chance of missing the canal that may lead to root canal failure, because of the variability in the number of root canals. The objective of this study was to determine the percentage of extra canal in the permanent mandibular first molar in patients undergoing root canal treatment.
Methods: This cross-sectional study was conducted in the Department of Conservative Dentistry and Endodontics of Peoples Dental College and Hospital over a period of ten months from 6th September 2021 to 31st July 2022 after receiving ethical clearance from Institutional review Committee (IRC) Peoples dental college on 5th September 2021 (ref no1/ch no 5,2078/2079). About 350 mandibular first molar was selected by convenient sampling. After access preparation, all canal orifices were located and data were recorded. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 22.0 with frequency table.
Results: Out of 350 patients, the percentage of three canals, four canals and five canals were respectively 273(78%), 76(21.7%) and 1(0.3%).
Conclusions: The finding of this study supports the presence of extra canals in mandibular first molar. Thus, the clinicians require more diagnostic approaches, access modifications, and skills to locate, clean and shape the entire root canal system.
DIURNAL VARIATION OF PEAK EXPIRATORY FLOW RATE IN HEALTHY YOUNG ADULTS
Authors: Bhattarai Anshu , Karmacharya Poonam , Tiwari Indu , Singh Surjit 
Published: February 2023

Background: Peak expiratory flow rate is an indicator of respiratory capacity and bronchial responsiveness which can be useful in diagnosing respiratory diseases. However, a circadian rhythm has been observed in its values. The aim of this study was to determine the diurnal variation of peak expiratory flow rate in healthy young adults.
Methods: A total of 160 subjects of age 18-24 years were studied in this cross-sectional study done on students of Manipal College of Medical Sciences between March to September 2021. Subjects were asked to record their peak expiratory flow rates five times a day using Mini-Wright peak flow meter after adequate training. Diurnal variability was expressed as amplitude percent mean and standard deviation percent mean. Data analysis was done in SPSS version 25 by Kruskal Wallis test and Mann Whitney U test.
Results: Lowest mean peak expiratory flow rate (L/min) was observed in morning in both males (564.21 ± 57.10) and females (320.68 ± 17.05) with progressive rise throughout the day thus reaching highest value in evening (males: 583.16 ± 64.45; females: 349.13 ± 36.32). Statistically significant (<0.005) difference in mean peak expiratory flow rate at different time intervals was found in the overall population. Diurnal variation calculated as amplitude percent mean and standard deviation percent mean was found to be significantly higher in females than males (<0.005).
Conclusions: Significant diurnal variation of peak expiratory flow rate was seen in healthy young adults.
European Union and United Kingdom Competition Law Developments in the Aviation Sector: January to June 2022
Authors: Deasy Geoffrey 
Published: February 2023

It goes without saying that the effects of the COVID-19 pandemic continue to be acutely felt by the aviation industry. This can be readily seen from the competition law developments in the first half of 2022 which continues to be dominated by State aid cases – not only Commission decisions approving State aid to carriers and arports, but also appeals against previous Commission decisions. This article summarizes the main developments over the past six months and provides the reader with an overview of the details of each of these developments.
The first six months of 2022 continue to be dominated by State aid cases, be it decisions by the European Commission (‘Commission’) to approve State aid applications, appeals of those or previously decided State aid cases, or the handing down of judgments from the General Court (GC). As mentioned previously, this is to be expected for years to come.
Taking a quick look at the State aid applications submitted to the Commission, most of the applications were submitted under Article 107(2)(b) of the Treaty on the Functioning of the European Union (‘TFEU’), which enables the Commission to approve State aid granted to compensate specific companies or specific sectors for the damages directly caused by ‘exceptional occurrences’. While COVID-19 restrictions continued to be eased in early 2022, operators continued to count the cost of the pandemic, and Member States continued to support operators for the damages directly linked to the COVID-19 pandemic. The Commission is also empowered to assess State aid measures under Article 107(3)(b) TFEU, which enables it to approve State aid granted to promote important projects of common European interest or to remedy a serious disturbance in the economy of a Member State and few would dispute that the COVID-19 pandemic caused serious disturbances in the economies of EU Member States. The final main mechanism to consider State aid is the Temporary Framework specifically set up by the Commission to enable the quick approval of State aid providing that the measures fell within defined parameters.
The author is not aware of any merger notifications to EU/UK authorities – indeed, following the abandonment of some previous mergers, and challenges faced by the industry as it attempts to ramp up operations following the pandemic, it is perhaps unsurprising that mergers have not been a priority matter in the aviation sector.
No Compensation for Pain and Suffering Due to an Air Conditioning System Failure in the Event of a Delay
Authors: J. Haas Sarah 
Published: February 2023

German court rules about a claim for pain and suffering due to an air conditioning failure under national law and ignoring international law. However, claimants would, under national law, have to prove, that an injury occurred; a simple inconvenience does not entitle passengers to a compensation.
Montreal Convention, Bodily Injury, Health Injury, Inconvenience, Compensation, German Law
Forum: A New Scope for the ‘Debt Collection’ Carveout as a Post-Brexit VAT Quick Fix?
Authors: Barth Fabian 
Published: February 2023

Following Brexit, the United Kingdom (UK) legislature is in principle free to amend UK Value Added Tax (VAT) law as it deems appropriate, without having to have regard to European Union (EU) Directives. Using the ‘debt collection’ carveout of the VAT exemption for financial services as an example, the author explores whether there is a case for Post-Brexit ‘VAT Quick Fixes’ in the UK.
VAT, Exemptions, Brexit, Debt Collection, Financial Services
Article: The Contribution of Geopolitics to the Study of EU Foreign Policy Illustrated Through the Example of Empires and Colonialism
Authors: Lonardo Luigi 
Published: February 2023

This article presents some theoretical reflections, and one empirical case study, on the contribution of geopolitics to the study of EU foreign policy. The article asks in particular how geopolitics can contribute to causal explanation in foreign policy. First, the article identifies and discusses two problems with a crude, early version of geopolitics: arbitrariness in the measurement of dependent and independent variables, and spurious causation. Second, drawing from concepts developed by rational choice theorists, the article argues that geopolitics can prove insightful in at least two ways. The first way in which geopolitics can establish causal explanations is when it studies how geography provides opportunity to act, that is, options for a political actor. The second way in which geopolitics is useful is that it can establish causality through negation (an event was prevented, or made more difficult, by geographical features). Both ways are illustrated through the example of empires and colonialism and their influence over EU foreign policy.
EU foreign policy, Geopolitics, Methodology, Political geography, Empire
The ‘Then’ and the ‘Now’ of Forced Relocation of Indigenous Peoples: Repercussions in International Law, Torts and Beyond
Authors: Holle Marie-Louise 
Published: February 2023

Forced relocations of tribal and indigenous peoples may seem a thing of the past, as few still defend colonialism. It is therefore seen as a historical trait that has reached its conclusion. Nevertheless, forced relocations of peoples still happens to this day, and may happen again; in the Arctic, for instance, several superpowers of this world express much interest in a strategic presence in this specific area. Today, a number of European countries have indigenous peoples on their territories. This article discusses this topic, taking its starting point in a case on forced relocation, which lasted for six decades. This article also discusses how forced relocation is regulated and possibly could be better handled today.
Indigenous People, Tort law, Human rights, Forced relocation, Expropriation, The Thule Tribe, Greenland, Public Liability, Leniency, Compensation Schemes
Settling Trade Related Labour Disputes: FTAs’ Pathways for Greater Social Justice in Globalization
Authors: Choukroune Leïla 
Published: February 2023

Since the conclusion of North African Free Trade Agreement (NAFTA) in 1994, an increasing number of Foreign Trade Agreements (FTAs) have included labour provisions along with specific dispute settlement mechanisms for these provisions. This article analyses how labour provisions have been included in FTAs’ since the early 1990s and critically accesses their suitability and effectiveness in terms of domestic labour reform and trade-related labour dispute settlement. It concludes by evaluating the case for the inclusion of labour provisions in FTAs’ and argues in favour of tailor-made rules suited to the precise reality of countries’ labour markets and regulatory environment.
FTAs, labour provisions, sustainable development, ILO, globalization, CPTPP, NAFTA, rule of law, European Union FTAs, dispute settlement
Writing a Script for India’s FTA Dispute Settlement Chapters
Authors: Bhala Raj 
Published: February 2023

India should negotiate robust dispute settlement chapters in its free trade agreements (FTAs). Through appropriate specific provisions in those chapters, India should pursue three goals, namely, the swift, just resolution of disputes, development of a common law on international trade, and enhancement of the rule of law in the Indo-Pacific region. India’s pursuit of these goals will help it expand its influence across the region, and counter the prospect of an authoritarian Chinese Communist Party (CCP) essentially dictating how trade and investment disputes are to be resolved. However, for India to pursue such negotiations, it must first resolve its bipolar approach to trade policy, between Nehruvian Socialism and Market-Oriented Reformism, which has paralysed it from pursuing an aggressive FTA agenda amidst understandable concerns about the nexus among trade, growth, and poverty alleviation. That means it will have to de-emphasize its current – and quixotic – policy of Atmanirbhar Bharat (Self-Reliant India).
dispute settlement, adjudication, arbitration, WTO, USMCA, FTA, CPTPP, judicial interpretation, textualism, negotiations, binding, blockage, panel, appellate, procedures, deadlines, subject matter jurisdiction, transparency, precedent, stare decisis, common law, rule of law
EU-China Agreement on Investment: Lessons for India from the Sino-European Model
Authors: Singh Vishnoi Apoorva , Kaur Bajwa Amandeep 
Published: February 2023

The European Union (EU) is the biggest source of outbound investment in the world and China is one of the top recipients of Foreign Direct Investment (FDI). The EU-China Comprehensive Agreement on Investment (CAI) is a unique international investment agreement that reflects the evolving economic relations of the EU and China and their strategic partnership. It also serves as one of the latest examples of the ever-evolving legal approach of the EU concerning international investment, particularly the dispute settlement mechanism in the CAI. This is why CAI might hold lessons for India, which also has a complex experience with its international investment agreements (IIAs), particularly the dispute settlement. Against this background, this article critically examines the dispute settlement provision of the CAI, its implications and lessons for India in the wake of renegotiation of the India-EU Broad-based Trade and Investment Agreement (BTIA).
dispute settlement, international economic law, international investment agreements, European Union-China relations, Indian Model BIT, trade and investment law
A Practical Narrative of Tariff Protection in Pakistan
Authors: Zeshan Muhammad 
Published: February 2023

This research work quantifies the changes in effective rates of protection in Pakistan during the last decade of 2011–20. Based on its results, it supports a more flexible trade policy in Pakistan. Further, it identifies the sectors with strong and weak long-run productive capacities and highlights the role of trade barriers in these industries. A key concern is the decreasing productive capacity of textile and leather sectors where the textile industry has the largest share in the total exports from Pakistan. Hence, there is a dire need to invest more in research and development activities in such industries. Finally, the country needs to increase its range of export items and export destinations with more favourable terms of trade, which can be achieved by reducing its historically high import tariff rates.
Effective Rate of Protection, Input-Output Table, Industry, Trade, Pakistan JEL Classification: C67, D57, F6, L5, R15
Turkey–Pharmaceuticals: The First WTO Arbitration for Appellate Review
Authors: Ya Qin Julia 
Published: February 2023

On 25 July 2022, the World Trade Organization (WTO) issued an arbitration award under Article 25 of the Dispute Settlement Understanding (DSU) on the appeal from the Panel Report in Turkey–Pharmaceuticals. This is the first use of the DSU Article 25 arbitration proceedings for the review of a WTO panel decision. As such, the case is highly significant in that it demonstrates how this alternative dispute settlement method can be successfully utilized to fulfil the function of appellate review after the Appellate Body (AB) became paralysed. Moreover, this innovative use of Article 25 arbitration may suggest a long-term solution in the reform of WTO dispute settlement. With respect to substantive legal issues, this case is also noteworthy, for it dealt with the question of public health and WTO law, a particularly sensitive topic in the post-pandemic era. This essay provides a critical review of the findings of the Panel and the Arbitrators on the substantive issues, while appraising the systemic significance of this first appeal arbitration.
WTO Dispute Settlement, DSU Article 25 Arbitration, WTO Reform, Appellate Review, GATT Article XX(b), public health, localization measure