Neurosurgical departments functioning during the COVID-19 pandemic - report

We present a short article on the actual state of functioning of neurosurgical departments, performing neurosurgical procedures during the COVID-19 pandemic on the example of our department - Department of Neurosurgery, Neurotraumatology and Pediatric Neurosurgery of Ludwik Rydygier Collegium Medicum of Nicolaus Copernicus University. The pandemic disrupted so far, proper work of neurosurgical departments and put neurosurgeons in a new reality. Despite the widespread exacerbation of spine diseases, they were pushed to the background. Many neurosurgical departments have been converted into COVID-19 isolation departments. We present a brief report on the actual state of the work of neurosurgeons and that a year after the pandemic began, the work of neurosurgical departments is still disrupted and the prospect of performing non-urgent neurosurgical procedures is uncertain

Neurosurgery education of medical students in Nicolaus Copernicus University during the COVID-19 pandemic

We present a short article on the actual state of education and didactics in the Department of Neurosurgery during the COVID-19 pandemic. The pandemic disrupted the education of students in the 2019/2020 and 2020/2020 academic years. From March 2020, there are no traditional classes with students and they have been deprived the possibility of patients examining and participating in surgical procedures. Only on-line classes are conducted by the use of Microsoft Teams and by e-mail contact. We emphasize that this is unprecedented situation in history of clinical medicine education. We also affirm difficulty of surgical medical specializations training by e-learning. Due to the practical nature of neurosurgery, we provide numerous neuroimaging and videos of surgical procedures using Microsoft Teams. The effects of on-line education of surgical sciences, including neurosurgery, can be assessed after a longer period of time. Currently, in the new reality that surprised unexpectedly medical academics in 2020, we are unable to interpret it

Guz rzekomy jako powikłanie po protezoplastyce stawu biodrowego

Pseudotumor trochanteric region after hip replacement is rarely described in the literature. The cause of the tumor is not clear. Metalosis that occurred in this case was established as a result of increased abrasion artificial elements on the border of metal-polyethylene articulation. Authors depict stages of proceedings and they give possible reasons for the treatment of patients after total different joints.Guz rzekomy okolicy krętarzowej po protezoplastyce bezcementowej stawu biodrowego rzadko jest opisywany w literaturze fachowej. Przyczyny powstania przedstawionego guza nie są jednoznaczne. Metaloza, która wystąpiła w tym przypadku, powstała w wyniku zwiększonej ścieralności elementów protezy na granicy artykulacji metal-polietylen. Autorzy pracy przedstawiają kolejne etapy postępowania, możliwe przyczyny i poddają pod rozwagę sposób postępowania z pacjentami po protezoplastykach dużych stawów

Nonlinear friction in underdamped anharmonic stochastic oscillators

Stationary states of overdamped anharmonic stochastic oscillators driven by L\'evy noise are typically multimodal. The very same situation is recorded for an underdamped L\'evy noise driven motion in single-well potentials with linear friction. Within current manuscript we relax the assumption that the friction experienced by a particle is linear. Using computer simulations, we study underdamped motion in single-well potentials in the regime of nonlinear friction. We demonstrate that it is relatively easy to observe multimodality in the velocity distribution as it is determined by the friction itself and it is the same as the multimodality in the overdamped case with the analogous deterministic force. Contrary to the velocity marginal density, it is more difficult to produce multimodality in the position. Nevertheless, for fine-tuned nonlinear friction, the spatial multimodality can be recorded.Comment: 10 page

Cranioplasty as neurosurgical procedure with potential risk of legal claims

We present the current state of affairs regarding the legal claims of patients after cranioplasty operations who are dissatisfied with the treatment effect and have claims that the perioperative course is unfavorable. In the period of 11 years (2010-2020), 2 legal claims were submitted in our neurosurgical center after cranioplasty. Both are civil claims. One of them about purulent infection of the bone prosthesis was found by the judgment to be unfounded. The second one concerning the alleged general condition deterioration as a consequence of cranioplasty has been declared obsolete. A cranioplasty is a surgical procedure used to correct a defect in a bone of the skull. It is not urgent sugery and is performed in patients who had been previously in serious condition. The same medical staff who previously saved the live of patients by performing brain decompression may be subject of legal claims in the case of cranioplasty. Thus, according to authors, claims of patients regarding the alleged negative effects of cranioplasty is an interesting psychological phenomenon.  Authors epmhasized that cranioplasty should be considered as a procedure of increased risk of potential legal claims for medical staff

H-index in medicine is driven by original research

Aim To investigate the contribution of selected types of articles to h-indices of medical researchers. Methods We used the Web of Science to export the publication records of various members from 26 scientific medical societies (13 European, 13 North American) associated with 13 medical specialties. Those included were presidents (n = 26), heads of randomly chosen committees (n = 52), and randomly selected members of those committees (n = 52). Publications contributing to h-index were categorized as research articles, reviews, guidelines, metaanalyses, or other published work. Results Overall, 3259 items authored by 129 scholars were analyzed. The median h-index was 19.5. The median contribution of research articles to h-index was 84.4%. Researchers in the upper h-index tercile (≥28.5) had a larger share of research articles that contributed to h-index in comparison with those in the lower h-index tercile (≤12.5) (median 87.3% [1st-3rd quartile: 80.0%-93.1%] vs 80.0% [50.0%- 88.9%], P = 0.015). We observed an analogous difference with regard to guidelines (1.1% [0%-3.7%] vs 0% [0%-0%], P = 0.007). Conclusions Original research drives h-indices in medicine. Although guidelines contribute to h-indices in medicine, their influence is low. The specific role of randomized controlled trials in building h-index in medicine remains to be assessed

ANALIZA MODELU UŁAMKOWEGO RZĘDU PROCESÓW SZYBKICH REAKTORA JĄDROWEGO

The paper presents the results concerning numerical solutions of the fractional point kinetics and heat exchange model for nuclear reactor. The fractional neutron point kinetics model with six groups of delayed neutron precursors was developed and numerical solutions were proposed. Mathematical model has been implemented in the Matlab environment and tested using typical step input change. The analysis of the impact of chosen parameters was conducted.W artykule przedstawiono wyniki badań dotyczące rozwiązań numerycznych punktowego modelu ułamkowego rzędu kinetyki neutronów oraz wymiany ciepła w reaktorze jądrowym. Zbudowano model ułamkowego rzędu z sześcioma grupami neutronów opóźnionych wraz równaniami wymiany ciepła. Model matematyczny został zaimplementowany w środowisku Matlab i zbadany symulacyjnie dla skoków reaktywności. Przeprowadzono analizę wpływu wybranych parametrów modelu na uzyskiwane rozwiązania

Delayed thrombin generation is associated with minor bleedings in venous thromboembolism patients on rivaroxaban : usefulness of calibrated automated thrombography

leeding is the most feared and difficult to predict adverse event of anticoagulation. We sought to investigate whether calibrated automated thrombography (CAT) parameters are associated with minor bleeding (MB) in anticoagulated patients following venous thromboembolism (VTE). Enrolled were 132 patients on rivaroxaban, 145 on vitamin K antagonists (VKA) and 31 controls who stopped anticoagulation. Prior to the next dose of the anticoagulant, we measured CAT parameters, along with rivaroxaban concentration and INR. During a median follow-up of 10 months, we recorded minor and major bleedings. On rivaroxaban, 27 (20.5%) patients with MB had longer time to start thrombin generation, lower peak thrombin generation and lower endogenous thrombin potential compared with subjects without MB (all p < 0.001). All CAT parameters, except for peak thrombin generation (p = 0.049), were similar in VKA patients with (n = 25, 17.2%) vs. without MBs. By logistic regression, time to start thrombin generation (p = 0.007) and unprovoked VTE (p = 0.041) independently predicted MBs on rivaroxaban. Major bleedings were more frequent in patients with MBs (17.3% vs. 1.8%, p < 0.001). Abnormal CAT parameters characterize VTE patients prone to MBs on rivaroxaban, but not on VKA. Time to start thrombin generation measured about 24 h since the last rivaroxaban dose might help predict MBs