Local Head Research Articles

ANALYSIS OF FACTORS AFFECTING QUALITY OF LIFE OF HEAD AND NECK CANCER PATIENTS IN SANGLAH HOSPITAL

Head and neck cancer ranked as the fifth most common cancer in the world. A series of treatment is likely to cause changes in the quality of life in cancer patients. This study aims to determine the factors that affect the patient's quality of life and the relationship between EORTC QLQ-H&N35 and Karnofsky Performance Scale (KPS). This study is analytic with a cross sectional approach. The technique is total sampling adjusted to the inclusion and exclusion criteria. Data obtained were gender, age, anatomical location of head and neck cancer, stage of cancer, therapy, KPS, and EORTC QLQ-H&N35. Data was collected for 3 months and 45 samples were obtained. There were 24 patients ((53.3%) above 45 years old. 33 men (73.3%) and 12 women (26.7%). The most cases were nasopharyngeal cancer is 25 people (55.6%). A total of 19 patients (42.2%) were in stage IV. The most used therapies were surgery, chemotherapy, and radiotherapy is 19 people (41.3%). The mean KPS is 72.23 ± 16.992. The factor affect the quality of life of head and neck cancer patients the most is weight loss with a mean of 59.49 ± 49.989 and a significant correlation (p=0.000, p<0.05) between EORTC QLQ-H&N35 and KPS.

Filling the Position of the Local Administration Head by Competition: Russias Experience

The position of the head of the local administration, in whose hands is the management of the activities of the executive and administrative body for resolving issues of local importance and the implementation of certain state powers and other powers of local self-government, occupies a special place in the organizational system of local self-government. The article considers the necessity and validity of the introduction of an organizational model into Russian local self-government, which provides for the filling of the position of the head of the local administration on the basis of a competition. The history of the competition and the position experience of introducing professional managers into the local government system is given, the genesis of the development of the issue in Russian legislation is investigated. Various circumstances are pointed out that prevent a positive assessment of the competition for the filling of a key position of local self-government by the scientific community and municipal practitioners (municipalities lack the right to independently make a decision on the application of the competitive election of the head of the municipality or the appointment of the head of the local administration, the actual non-participation of the population in the procedure of filling the position, which contradicts the nature of local self-government, and others). Taking into account the types of municipalities, the statistical data of the Ministry of Justice of the Russian Federation are analyzed for the actual implementation of organizational models provided by the municipality using a competition to fill the position of the head of the local administration. The features and disadvantages of the competition as a way of electing the head of a municipality are considered. The article formulates proposals for improving legislation in the direction of unification of competitive procedures and requirements of professionalism and competence for candidates for the position of head of a municipality and head of a local administration.

Local elections 2021: an overview of survey research

The President of Kazakhstan, on September 1, 2020, addressing the citizens of the country, took the initiative to hold direct local elections. Such elections should become a new stage of political modernization. A course was set for the liberalization of the political system in the country. This article presents partial results of the experience of conducting a study into the recent elections of local heads. The methodology of the study is described, and there are answers to some hypotheses presented. The assessment of the socio-economic situation of the objects of research- settlements is presented. The article considers electoral behavior, communication of the authorities with the population and the effectiveness of the reform. The theoretical significance of this study consists in the study and identification of factors related to electoral issues. The practical significance lies in the development and application of the questionnaire, in the pre-electoral and post-electoral period in the subsequent direct elections of heads of local executive authorities. The information obtained can be used for further study of the problematic issue, both for the areas under consideration and in similar types. The article examines the theoretical aspects of elections in general, and in particular, of local executive bodies. The research of electoral behavior in the perspective of transition into democracy, the interaction of "power and society" are considered. Some problems of personnel management, economic management and budgeting are raised.

Automated detection and analysis of piglet suckling behaviour using high-accuracy amodal instance segmentation

Piglet suckling behaviour is a critical indicator of piglet liveability and health status; however, automated detection of this important behaviour is rarely reported in literatures. In this study, we proposed a two-step computer vision-based detection method for piglet suckling behaviour. In the first step, an anchor-free deep learning network was employed in instance segmentation of individual sows and piglets. Firstly the localization head detected piglets to obtain the features of the region of interest (ROI). The features extracted from ROI were passed to a novel attention graph convolution-based structure to distil element-wise features. The distilled features were further encoded by a graph convolutional network and were fed into the boundary head and the mask head for piglet contour and mask prediction, respectively. In the second step, the piglets, in adhesion with the sow, were tracked by intersection over union (IOU) which was calculated between adjacent frames. Piglet motion features were derived from the maximum, minimum, variance, and average values in IOU sequence within the 21-frame (3-s) independent processing units. The extracted motion features were input into an SVM, classifying a piglet into suckling or nonsuckling. The dataset, for training and verifying the proposed network respectively, was composed of 100 1-min and 7-fps short video clips as well as one 8-h long video episode, from seven pens of Large White sows and piglets. Our method achieved favourable detection performance with F1 score of 93.6%, Recalls of 92.1%, and Precisions of 95.2% in short video clips, which showed that detecting suckling behaviours for piglets using amodal instance segmentation was feasible. The time budgets of at least one piglet, more than half of the piglets, or all piglets exhibiting suckling behaviour were 74.0 min, 65.6 min, and 1.1 min in an 8-h long video.

Elaboration and pilot study of 3D vaccines for oncotherapy

The purpose of the study was to study the possibility of using intracorporeal constructs in vivo with healthy or autologous dead tumor cells on porous extracellular matrix of titanium nickelide (PEMTN).We aimed to determine the advantage of the effect of this method on the change in the immunological status of cancer patients in comparison with patients receiving traditional treatment.The study used CBA and AKR JY mice and studied 10 patients with solid stage IV tumors of various localization (pancreas, intestines, lungs, ovary, head and neck) and 3 oncohematological patients (lymphoblastic lymphosarcoma, chronic myeloid leukemia (CML)).PEMTN was seeded with a suspension with bone marrow cells from CBA mice and cultured for 8 weeks in a long-term Dexter culture. It was shown that after 6 weeks of incubation of bone marrow cells on PEMNT in vitro, the proportion of bone marrow cells produced from the pores of the matrix into the liquid medium varied within 58–82%, which corresponded to the figures of the 1st week of incubation.After implantation of PEMTN with fetal liver cells in AKR/JY mice with spontaneous lympholeukemia, the implant successfully engrafted and after 30 days, no noticeable fluctuations in the leukocyte count were observed. After 3–4 weeks implantation, a 3-fold increase in the level of erythrocytes with fetal hemoglobin, which is not normally found in adult AKR/JY mice, was observed. There was also an increase (by 274%, p < 0.05) in the number of blood reticulocytes and a 26% decrease in the activity of the tumor process.In cancer patients with solid tumors, the level of SH-groups erythrocytes of blood increased 1.5–2.3 times 2 months after the implantation of hybrid oncotherapy implants carrying autologous apoptized tumor cells, treated in vitro. This implants, already 3–4 weeks after implantation in oncopatients, restored the blood system parameters.The most active (2–3 times) increased individual indicators of cellular immunity, in particular the number of NK cells, active (CD25+) and apoptotic lymphocytes (CD95+ marker). From the 3rd month of the study, the level of humoral immunity increased (immunoglobulins, circulating immune complexes). Clinically, the activation of immunity was accompanied by the stabilization of the process or a decrease in the volume and fragmentation of the primary nodes of solid tumors.In oncohematological patients, an increase in the CD95 marker in the peripheral cells of blood was observed.Therefore, in a patient with CML, the implantation, which followed therapy with low doses of cytostatics (myelosan, hydroxyurea) and the immune effect of the implantation, led to a 6-month hematological remission with normal values of the total number of leukocytes and leukocyte blood count. It has been shown that healthy cells in this matrix retain their viability and it allows them to multiply both in the in vitro system and in the in vivo system. The possibility of clinical use of PEMNT carrying autologous dead tumor cells treated in vitro with the aim of improving antitumor immunity, accelerating the recovery of blood counts in cancer patients and achieving partial remission has been shown.

Livelihood Pattern of Riverine Areas of Dibrugarh District and its Prospects of Livelihood Diversification

Background: Diversification is a continuous adaptive process whereby household add new ctivities maintain existing one or drop others, thereby maintaining diverse and changing make greater contribution to general livelihood portfolios. Livelihood in rural areas is very erratic and risk hidden. The land-based livelihood of small and marginal farmers is becoming unsustainable in recent times due to continuous flood and decrease in availability of arable land. Diversification activities make greater contribution ta key strategy by which people try to improve the generate cash incomes for poor households and it is a key strategy by which people try to improve their wellbeing. Methods: Based on the primary and secondary data, Barbarua Development Block is finally selected for the study. In the block itself three nos Missing community dominated villages and three nos Scheduled Caste dominated villages are selected for the study. Through random sampling, 10 households of each diverse socio economic background are selected from each village. Semi structured schedules are prepared for interviewing the villagers, local village head (Gaon Burah), school teacher, unemployed youth, agricultural labour, landless people and women. Result: As the entire survey area is inundated by flood water in every year, a part from farm activities various income generating activities carried out under livelihood diversification. Some households end upon multiple activities. A common pattern is for every poor and the comprehensive well-off households to have most diverse livelihood. Farm income accounts for 54.0 per cent of the total household income coming from off farm activities. It is also revealed that 44 per cent households prefer livelihood diversification due to limited agricultural income. About 22 per cent reported that the availability of non-farm activities encouraged them to adopt non farm activities. Managing livelihood has always been a critical factor or challenge among the poor in everywhere.

Abstract 3450: Impact of model inaccuracy on dose estimation in TTFields therapy

Abstract Introduction: Tumor Treating Fields (TTFields) is a modality for treating Glioblastoma (GBM). A recent study combining clinical data and simulations demonstrated that the simulation-based dose estimation at the tumor level is directly correlated with patient survival (Ballo M, et al. Int J Radiat Oncol Biol Phys. 2019;104(5):1106-1113). This study highlights the importance of computer-modelling based TTFields treatment planning in the clinic. Performing such planning in a meaningful manner requires an understanding about how inaccuracies in the patient model influence calculated TTFields distributions. In this study we show the effect of local perturbations in the model, errors in tumor segmentation, and inaccuracy in the patient head model on TTFields dose estimation. Methods: Computational studies were performed with Sim4Life software. 1) Local model uncertainty outside of tumor region: To create defects in the models, conductive spheres with varying conductivities and radii were placed into the model’s brains at different distances from the tumor. Virtual transducer arrays were placed on the models, and delivery of TTFields numerically simulated. The error in the electric field induced by the defects as a function of defect conductivity, radius, and distance to tumor was investigated. 2) Tumor segmentation uncertainty: For illustrating segmentation errors in tumors and necrotic cores, layered spheres with various conductivities and radii were placed in different head locations. Tumor conductivity uncertainty was defined as (σ-σref)/σref where σref = 0.24 S/m is the standard tumor conductivity and σ is the varied conductivity over the tumor. The normalized tumor radius was calculated when each of the varied radii was normalized to the results obtained by all the other combinations. Results: The results show that that when a defect of radius R is placed at a distance, d, from the tumor that is larger than seven times R, the error is below 1% regardless of the defect conductivity. Conclusions: Our models and results show the impact of uncertainty in segmentation of the tumor or other tissue distant from it on the TTFields dose estimation. These results could serve as a guideline for model creation and tissue segmentation that would lead to optimal dose estimation in TTFields treatment planning. Citation Format: Tal Marciano, Oshrit Zeevi, Zeev Bomzon. Impact of model inaccuracy on dose estimation in TTFields therapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3450.

CONFLICTS OF THE ADMINISTRATORS OF THE FORTRESS CITIES OF THE SOUTH OF RUSSIA IN THE 17th CENTURY: REASONS, MECHANISMS OF PERMISSION

The article is devoted to the study of conflicts among representatives of the administration of the fortress cities of the South of Russia in the 17th century. The causes and methods of conflict resolution are of great interest. These reasons demonstrate the specifics of the organization of management of the border region. In the border fortresses of Russia, conflicts arose very often. Governors, musketeer and Cossack heads, siege heads, elders constantly wrote complaints about their colleagues. Most often, the cause for disagreement was disobedience to the governor, insufficient division of functions, attempts by the governor to limit the powers of other officials. The contradictions of the local chiefs were sorted out in the Moscow orders. The central government carried out a search, identified and punished the perpetrators. The decisions taken on behalf of the king strengthened the authority of the supreme power, contributed to the stabilization of the internal situation in the southern outskirts of the state. The supreme arbiter of the local level was the governor, who often clashed with the local head. If the governor himself was a participant in the dispute, then he wrote a complaint to the Discharge with accusations against the other side. If there were no complaints from the other side, then a letter was sent to the city instructing the head to listen to the governor. If the accused party sent a reply explaining their actions, then a special detective was appointed to the city. In conflicts, insufficient delimitation of the powers of officials, subordination to various Moscow orders, and personal ambitions were manifested.

Spectrometry of leakage photoneutrons of 18 MV medical accelerator head by Sohrabi passive multi-directional spherical neutron spectrometry system

PurposeSpectrometry of leakage photoneutrons (PN) of a Siemens ONCOR medical linear accelerator head by applying recently invented Sohrabi passive multi-directional multi-detector neutron spherical spectrometry system; measurements of scientific interest and of importance for meeting the regulatory and safety standards. MethodsThe neutron spectrometry system applied consists of 6 polycarbonate/10B detectors mounted on 6 sides of a polyethylene cube used as bare and also embedded at center of 8 PE spheres of different diameters. Multi-directional and mean PN spectra at isocenter as well as at the left and right sides of head at 100 cm distance from the X-ray target on its plane of 10x10 cm2 18-MV X-ray beams were determined applying Multisphere Neutron Spectrometry Unfolding Code (MNSU + ). ResultsThe well-resolved unfolded directional leakage PN spectra obtained at the 3 positions showed a thermal PN peak of lower intensityfollowed by a tail of epithermal PNs before reaching a fast PN higher peak.“ The mean PN energy are 0.47 ± 0.03 MeV and 0.48 ± 0.02 MeV respectively for the left and right sides of the head and 0.48 ± 0.02 MeV at the isocenter. ConclusionsDue to importance of leakage PN spectra of an accelerator head being of scientific interest and for meeting regulatory and safety standards, well-resolved leakage PN spectra of 3 locations of the medical accelerator head were determined using Sohrabi passive multi-directional neutron spectrometry system. It is a novel learning that the mean PN spectra and mean PN energy of the 3 locations are quite similar within statistical variations.

Kepastian Hukum Pembukaan Rekam Medis Pasien COVID-19 Dalam Situasi Pandemi

medical record is a document made by a hospital containing the identity, examination, treatment, and medical actions taken against confidential patients. Medical records are medical secrets that can be shown or disclosed in certain situations, one of which is a pandemic situation. In the event of an outbreak of infectious disease, namely the COVID-19 pandemic situation, medical records belonging to COVID-19 patients can be used by doctors, hospitals, and researchers to identify and analyze the causes as well as be useful for the government to determine policy and regulatory directions to suppress virus transmission. Based on the Minister of Health Regulation on Medical Secrets which regulates the opening of medical records in a pandemic situation, there is a blurring of norms regarding legal certainty and procedures for opening medical records in a pandemic situation. To identify and analyze these problems, the researcher uses a normative legal research method with a conceptual approach and legislation. The results obtained that the opening of medical records of COVID-19 patients in a pandemic situation may only be opened to certain parties such as local government officials, hospital heads, and related parties who play a role in reducing the number of virus transmissions. In addition, the information in the medical record shown is only information related to epidemic control, so the patient's personal confidential information is maintained.

Assessing the Impact of Artificial Recharge Ponds on Hydrological Fluxes in an Irrigated Stream–Aquifer System

Artificial recharge ponds have been used increasingly in recent years to store water in underlying aquifers and modify baseline groundwater gradients or alter natural hydrologic fluxes and state variables in an aquifer system. The number of constructed ponds, their geographic spacing, and the volume of water diverted to each pond can have a significant impact on baseline system hydrologic fluxes and state variables such as groundwater head, with the latter sometimes rising to cause waterlogging in cultivated areas. This study seeks to quantify the impact of recharge ponds on groundwater state variables (head, saturated thickness) and associated fluxes within an irrigated stream-aquifer system. We use a numerical modeling approach to assess the impact of a set of 40 recharge ponds in a 246 km2 region of the South Platte River Basin, Colorado on localized groundwater head, regional groundwater flow patterns, and groundwater interactions with the South Platte River. We then use this information to determine the overall influence of recharge ponds on the hydrologic system. A linked agroecosystem–groundwater (DayCent-MODFLOW) modeling system is used to simulate irrigation, crop evapotranspiration, deep percolation to the water table, groundwater pumping, seepage from irrigation canals, seepage from recharge ponds, groundwater flow, and groundwater–surface water interactions. The DayCent model simulates the plant–soil-water dynamics in the root zone and soil profile, while MODFLOW simulates the water balance in the aquifer system. After calibration and testing, the model is used in scenario analysis to quantify the hydrologic impact of recharge ponds. Results indicate that recharge ponds can raise groundwater levels by approximately 2.5 m in localized areas, but only 15 cm when averaged over the entire study region. Ponds also increase the rate of total groundwater discharge to the South Platte River by approximately 3%, due to an increase in groundwater hydraulic gradient, which generally offsets stream depletion caused by groundwater pumping. These results can assist with groundwater resource management in the study region, and generally provide valuable information for the interplay between pumping wells and recharge ponds, and their composite effect on groundwater–surface water interactions. In addition, the developed linked DayCent-MODFLOW modeling system presented herein can be used in any region for which recharge rates should be calculated on a per-field basis.

A Case of 27-Year-Old Localized Solitary Neurofibroma of the Base Tongue; A Case Report

Introduction: Neurofibromas, benign peripheral nerve sheath tumors, are the most common among neural lesion. Neurofibromas are rare in head and neck location, although it may involve any part of oral cavity. However, tongue is the most common region. Case Presentation: A 27 year-old man was admitted to Otorhinolaryngology Department due to a swelling in the base of his tongue, since two weeks before. This mass was painless, and without any associated symptoms. He was suffered from a mild eating disorder, too. He had no any positive past medical history, and only a large soft 6×5 cm mass was found at the base of his tongue without bleeding in the oral cavity. Excisional biopsy was performed for him under general anesthesia and the tumor was easily enucleated. The final diagnosis was neurofibroma. After the diagnosis of neurofibroma, the physical reexamination revealed a series of café au lait spots on his skin. Conclusion: the neurofibroma should be considered by otorhinolaryngologist, as a differential diagnosis of tongue mass, and more accurate physical examination are recommended for better management.

Long-term outcomes of high-risk basal cell carcinoma treated with Mohs micrographic surgery

To the Editor: Mohs micrographic surgery (MMS) is indicated for the treatment of high-risk basal cell carcinoma (BCC) based on superior long-term outcomes compared to wide local excision (WLE).1,2 Factors that may predict poor outcomes include tumor diameter of ≥2 cm, head and neck location, deep invasion, recurrence, aggressive histologic subtype, and perineural invasion.3,4 The American Joint Committee on Cancer (AJCC, 8th edition) and the Brigham and Women Hospital (BWH) staging systems have incorporated some of these parameters to risk-stratify BCC.

Multi-head collaborative learning for graph neural networks

Recently, graph neural networks (GNNs) have been widely used for graph-structured data representation. However, existing GNNs generally either employ one classifier head which usually makes the model fall into local minima or multiple classifier heads independently which lack of exploiting the correlation of them. To overcome this issue, in this paper, we propose to employ Multi-head Collaborative Learning for Graph Neural Networks (MCL-GNNs). The MCL-GNNs provide a collaborative learning process via multiple classifiers to complement each other’s information. Experimental results on several benchmark data sets show that our method has better generality and stability than other comparison methods.

Sound Localization of World and Head-Centered Space in Ferrets.

The location of sounds can be described in multiple coordinate systems that are defined relative to ourselves, or the world around us. Evidence from neural recordings in animals point towards the existence of both head-centered and world-centered representations of sound location in the brain; however, it is unclear whether such neural representations have perceptual correlates in the sound localization abilities of non-human listeners. Here, we establish novel behavioral tests to determine the coordinate systems in which ferrets can localize sounds. We found that ferrets could learn to discriminate between sound locations that were fixed in either world-centered or head-centered space, across wide variations in sound location in the alternative coordinate system. Using probe sounds to assess broader generalization of spatial hearing, we demonstrated that in both head and world-centered tasks, animals used continuous maps of auditory space to guide behavior. Single trial responses of individual animals were sufficiently informative that we could then model sound localization using speaker position in specific coordinate systems and accurately predict ferrets’ actions in held-out data. Our results indicate that an animal model in which neurons are known to be tuned to sound location in egocentric and allocentric reference frames can also localize sounds in multiple head and world-centered spaces.

Enhancing Nutrition Care Through Real-Time, Sensor-Based Capture of Eating Occasions: A Scoping Review.

As food intake patterns become less structured, different methods of dietary assessment may be required to capture frequently omitted snacks, smaller meals, and the time of day when they are consumed. Incorporating sensors that passively and objectively detect eating behavior may assist in capturing these eating occasions into dietary assessment methods. The aim of this study was to identify and collate sensor-based technologies that are feasible for dietitians to use to assist with performing dietary assessments in real-world practice settings. A scoping review was conducted using the PRISMA extension for scoping reviews (PRISMA-ScR) framework. Studies were included if they were published between January 2016 and December 2021 and evaluated the performance of sensor-based devices for identifying and recording the time of food intake. Devices from included studies were further evaluated against a set of feasibility criteria to determine whether they could potentially be used to assist dietitians in conducting dietary assessments. The feasibility criteria were, in brief, consisting of an accuracy ≥80%; tested in settings where subjects were free to choose their own foods and activities; social acceptability and comfort; a long battery life; and a relatively rapid detection of an eating episode. Fifty-four studies describing 53 unique devices and 4 device combinations worn on the wrist (n = 18), head (n = 16), neck (n = 9), and other locations (n = 14) were included. Whilst none of the devices strictly met all feasibility criteria currently, continuous refinement and testing of device software and hardware are likely given the rapidly changing nature of this emerging field. The main reasons devices failed to meet the feasibility criteria were: an insufficient or lack of reporting on battery life (91%), the use of a limited number of foods and behaviors to evaluate device performance (63%), and the device being socially unacceptable or uncomfortable to wear for long durations (46%). Until sensor-based dietary assessment tools have been designed into more inconspicuous prototypes and are able to detect most food and beverage consumption throughout the day, their use will not be feasible for dietitians in practice settings.

Alternatif Penyelesaian Sengketa Lelang Lebak, Lebung dan Sungai di Kabupaten Ogan Ilir

For a long time, people in several sub-districts of Ogan Ilir Regency who live on the banks of the river have used flooded areas or puddles of water around the river due to river overflow to become one of the sources of PAD in the field of fisheries. Utilization is carried out by conducting auctions in lebak, lebung and rivers which are regulated in the Regent's Regulation on the management of fishery resources. In addition to being the legal basis, this regional regulation also aims to protect the environment in the Lebak, Lebung and river areas from damage caused by fishing by the Manager (the winner of the auction). Managers who do not carry out the management of lebak, lebung and rivers according to the rules may be subject to criminal sanctions or fines. This study aims to find out how the dispute resolution of the lebak lebung auction between the parties in practice is carried out. The problem in this study is how the forms of dispute resolution in the Lebak Lebung auction are carried out by the parties in practice. This type of research is normative legal research using a statutory approach. From the results of the study, it can be concluded that the settlement of disputes between the management committee and the management of lebak lebung and rivers is in practice mostly resolved by deliberation mediated by the village head or local village head, but if no agreement is found then the settlement is through the courts.

Experience of Using a New Brain Surgery Head Frame and Location Sticker for Treating Spontaneous Intracranial Hematoma.

ObjectivesVarious stereotactic aspirations have been accepted; however, no standard stereotactic aspiration has been established for the treatment of spontaneous intracerebral hemorrhage (ICH). The authors explored an easy, fast, and effective procedure by using a new brain surgery head frame and location sticker for the removal of spontaneous hematoma.Patients and MethodsA retrospective database review was performed from January 2018 to March 2020 to identify patients with ICH who were treated with puncture and drainage for hematoma by using a new brain surgery head frame and location sticker for positioning and guidance.ResultsA total of 45 patients with spontaneous ICH were enrolled in our study. The mean (± SD) surgical time was 29.3 ± 4.1 min. The average hematoma evacuation rate was 72.2%. The mean (± SD) preoperative Glasgow Coma Scale (GCS) score was 9.58 ± 2.92; the mean GCS score increased to 11.55 ± 2.59 (p = 0.006) and 12.86 ± 2.04 (p < 0.001) at 1 week after surgery and at the time of discharge, respectively. The mean (± SD) preoperative muscle force score was 1.25 ± 1.51; the mean muscle force score had improved to 2.20 ± 1.64 (p = 0.009) and 2.88 ± 1.64 (p < 0.001) at 1 week after the operation and the time of discharge, respectively. Out of these, one patient experienced postoperative rebleeding, however, no further hematoma expansion was found after the second aspiration and thrombolysis.ConclusionUsing this brain surgery, head frame and location sticker combined with urokinase infusion appears simple, safe, and effective for the removal of hematoma for patients with spontaneous ICH. However, randomized controlled trials are necessary to provide more concrete evidence-based results.

Framework for the Priority Actions of Filipino Physical Therapists in Disaster Risk Reduction and Management

Introduction: The study was conducted to develop a framework where physical therapists could be integrated into the disaster risk reduction and management (DRRM) initiatives of a province in the northern Philippines. Methods: This was a mixed-methods study that utilized a research and development design. A validated questionnaire on the experience and perceptions of DRRM was administered to 20 selected physical therapists. A validated interview guide was administered to 10 local disaster control office head and members. Descriptive statistics were used to analyze the quantitative data. Thematic analysis was used to synthesize and examine the qualitative data. Results: Physical therapists were found to have minimal exposure to disaster scenarios due to lack of training and experiences in disaster response. However, the physical therapists perceive that they are prepared to participate in DRRM and should be included. The study also revealed that physical therapists are not part of the local disaster management team because of limited awareness of leaders and members of the disaster control office on the roles of physical therapists in disaster management. Discussion: This study developed an action-oriented framework to guide physical therapists' active involvement in all phases of disaster management. Specific strategies for the priorities for action of physical therapists in DRRM were identified based on the results of the study and its theoretical underpinnings

Ketoacidosis and otitis media as a potencial cause of cerebral venous thrombosis in a 7-year-old boy

Cerebral venous sinus thrombosis (CVST) in childhood is a rare disorder, occurring most often in the neonatal period, with mortality approaching 10%. This condition has multifactorial etiology including common childhood illnesses such as fever, infection, dehydration, and anemia, as well as acute and chronic medical conditions such as congenital heart disease, nephrotic syndrome, and malignancy. Thrombosis can also develop and propagate in response to local venous stasis. A large number of children have coincident local head or neck pathology, including head trauma, brain tumors, or recent intracranial surgery. Clinical symptoms are frequently nonspecific and include seizures, depressed level of consciousness, coma, lethargy, nausea, vomiting, headache, visual impairment, papilledema, and hemiparesis, which may often obscure the diagnosis and delay treatment. In the case of patients with neurological symptoms, imaging studies such as computed tomography (CT) and magnetic resonance imaging (MRI) are invaluable in diagnostics of various pathologies of the nervous system, because of their non-invasiveness, high sensitivity, and specificity. Early diagnosis with management along with a plan for secondary prevention can save from catastrophic consequences.