bluuebunny/crossref_metadata_2025 huggingface dataset:
The economic impact of endemic respiratory disease in pigs and related interventions - a systematic review
Authors: Boeters Marloes , Garcia-Morante Beatriz , van Schaik Gerdien , Segalés Joaquim , Rushton Jonathan , Steeneveld Wilma
Published: October 2023

Background

Understanding the financial consequences of endemically prevalent pathogens within the porcine respiratory disease complex (PRDC) and the effects of interventions assists decision-making regarding disease prevention and control. The aim of this systematic review was to identify what economic studies have been carried out on infectious endemic respiratory disease in pigs, what methods are being used, and, when feasible, to identify the economic impacts of PRDC pathogens and the costs and benefits of interventions.

Results

By following the PRISMA method, a total of 58 studies were deemed eligible for the purpose of this systematic review. Twenty-six studies used data derived from European countries, 18 from the US, 6 from Asia, 4 from Oceania, and 4 from other countries, i.e., Canada, Mexico, and Brazil. Main findings from selected publications were: (1) The studies mainly considered endemic scenarios on commercial fattening farms; (2) The porcine reproductive and respiratory syndrome virus was by far the most studied pathogen, followed byMycoplasma hyopneumoniae, but the absence or presence of other endemic respiratory pathogens was often not verified or accounted for; (3) Most studies calculated the economic impact using primary production data, whereas twelve studies modelled the impact using secondary data only; (4) Seven different economic methods were applied across studies; (5) A large variation exists in the cost and revenue components considered in calculations, with feed costs and reduced carcass value included the most often; (6) The reported median economic impact of one or several co-existing respiratory pathogen(s) ranged from €1.70 to €8.90 per nursery pig, €2.30 to €15.35 per fattening pig, and €100 to €323 per sow per year; and (7) Vaccination was the most studied intervention, and the outcomes of all but three intervention-focused studies were neutral or positive.

Conclusion

The outcomes and discussion from this systematic review provide insight into the studies, their methods, the advantages and limitations of the existing research, and the reported impacts from the endemic respiratory disease complex for pig production systems worldwide. Future research should improve the consistency and comparability of economic assessments by ensuring the inclusion of high impact cost and revenue components and expressing results similarly.
Global Barriers to Accessing Off-Patent Endocrine Therapies: A Renaissance of the Orphan Disease?
Authors: de Silva Nipun Lakshitha , Dissanayake Harsha , Kalra Sanjay , Meeran Karim , Somasundaram Noel P , Jayasena Channa N
Published: October 2023

Context

Clinical endocrinology encompasses many diseases requiring long-term drug therapy. Prohibitive pricing of some endocrine drugs classified as essential by the World Health Organization has created suboptimal care of patients with endocrine disorders.

Evidence acquisition

This review is based on evidence obtained from several databases and search engines including PubMed, Google, and Google Scholar; reference searches; manual searching for web pages of international regulatory bodies; and the authors’ experience from different healthcare settings.

Evidence synthesis

After the expiry of a patent, generic versions with the opportunity for increased availability and a price reduction are expected. There are access barriers worldwide for many off-patent endocrine drugs. The high price is the main issue for several medicines including insulin, hydrocortisone, testosterone, and gonadotropins. This is caused by several factors including the market monopoly due to the lack of registered generics or suppliers limiting the benefit of competition and a complex supply chain. Additionally, the lack of some medicines has been concerning due to market factors such as the relatively small number of patients, making it less attractive for the manufacturers. Commissioning of nonprofit manufacturers and state manufacturing as well as strict price control measures could alleviate this situation.

Conclusion

Lack of availability and disproportionate price inflation affecting essential off-patent endocrine therapies is common due to several interrelated factors. Global collaboration among healthcare organizations with the support of policymaking bodies might be needed to mitigate this.
Surgical Outcome of Patients With Supratentorial Meningiomas Aged 80 Years or Older—Retrospective International Multicenter Study
Authors: Schwartz Christoph , Rautalin Ilari , Grauvogel Jürgen , Bissolo Marco , Masalha Waseem , Steiert Christine , Schnell Oliver , Beck Jürgen , Ebel Florian , Bervini David , Raabe Andreas , Eibl Thomas , Steiner Hans-Herbert , Shlobin Nathan A. , Nandoliya Khizar R. , Youngblood Mark W. , Chandler James P. , Magill Stephen T. , Romagna Alexander , Lehmberg Jens , Fuetsch Manuel , Spears Julian , Rezai Arwin , Ladisich Barbara , Demetz Matthias , Griessenauer Christoph J. , Niemelä Mika , Korja Miikka
Published: October 2023

BACKGROUND AND OBJECTIVES:

Demographic changes will lead to an increase in old patients, a population with significant risk of postoperative morbidity and mortality, requiring neurosurgery for meningiomas. This multicenter study aims to report neurofunctional status after resection of patients with supratentorial meningioma aged 80 years or older, to identify factors associated with outcome, and to validate a previously proposed decision support tool.

METHODS:

Neurofunctional status was assessed by the Karnofsky Performance Scale (KPS). Patients were categorized in poor (KPS ≤40), intermediate (KPS 50-70), and good (KPS ≥80) preoperative subgroups. Volumetric analyses of tumor and peritumoral brain edema (PTBE) were performed; volumes were scored as small (<10 cm3), medium (10-50 cm3), and large (>50 cm3).

RESULTS:

The study population consisted of 262 patients, and the median age at surgery was 83.0 years. The median preoperative KPS was 70; 117 (44.7%) patients were allotted to the good, 113 (43.1%) to the intermediate, and 32 (12.2%) to the poor subgroup. The median tumor and PTBE volumes were 30.2 cm3 and 27.3 cm3; large PTBE volume correlated with poor preoperative KPS status (P = .008). The 90-day and 1-year mortality rates were 9.0% and 13.2%, respectively. Within the first postoperative year, 101 (38.5%) patients improved, 87 (33.2%) were unchanged, and 74 (28.2%) were functionally worse (including deaths). Each year increase of age associated with 44% (23%-70%) increased risk of 90-day and 1-year mortality. In total, 111 (42.4%) patients suffered from surgery-associated complications. Maximum tumor diameter ≥5 cm (odds ratio 1.87 [1.12-3.13]) and large tumor volume (odds ratio 2.35 [1.01-5.50]) associated with increased risk of complications. Among patients with poor preoperative status and large PTBE, most (58.3%) benefited from surgery.

CONCLUSION:

Patients with poor preoperative neurofunctional status and large PTBE most often showed postoperative improvements. The decision support tool may be of help in identifying cases that most likely benefit from surgery.
Trailblazers in cancer research: the next generation – the British Association of Cancer Research early-career conference
Authors: Greenland Kyle K. , Pennel Kathryn A. F. , Cioccoloni Giorgia , Rogerson Connor , Barnieh Francis M. , Speirs Valerie
Published: October 2023

The inaugural ‘British Association of Cancer Research (BACR) Early Career Conference, Trailblazers in Cancer Research 2023’, was a 2-day meeting held in Manchester, UK. Recognising the disruption caused by the COVID-19 pandemic to early-career researchers (ECRs), the BACR executive committee organised an in-person conference to address the lack of network and training opportunities during this time. The conference brought together PhD students and post-doctoral researchers from across the UK and beyond, who shared their outstanding contributions to cancer research. The meeting incorporated several cutting-edge cancer themes, including ‘Cancer Cell Signalling and The Tumour Microenvironment’; ‘Emerging Approaches in Cancer Treatment’; ‘Cancer Omics and Lifestyle’, and ‘Nutrition and Cancer’. Alongside showcasing world-class cancer research, the meeting included a career-focused session which allowed industrial and non-academic speakers to provide vital insight into alternative career paths aside from the familiar ‘academic’ route. Importantly, the conference also introduced delegates to Patient Public Involvement in cancer research, an area of limited experience for many. Overall, the BACR Trailblazers Conference was hugely successful and presented an excellent platform for collaboration and networking among ECRs in cancer research.
Insulin signaling in development
Authors: Suzawa Miyuki , Bland Michelle L.
Published: October 2023

Nutrient intake is obligatory for animal growth and development, but nutrients alone are not sufficient. Indeed, insulin and homologous hormones are required for normal growth even in the presence of nutrients. These hormones communicate nutrient status between organs, allowing animals to coordinate growth and metabolism with nutrient supply. Insulin and related hormones, such as insulin-like growth factors and insulin-like peptides, play important roles in development and metabolism, with defects in insulin production and signaling leading to hyperglycemia and diabetes. Here, we describe the insulin hormone family and the signal transduction pathways activated by these hormones. We highlight the roles of insulin signaling in coordinating maternal and fetal metabolism and growth during pregnancy, and we describe how secretion of insulin is regulated at different life stages. Additionally, we discuss the roles of insulin signaling in cell growth, stem cell proliferation and cell differentiation. We provide examples of the role of insulin in development across multiple model organisms: Caenorhabditis elegans, Drosophila, zebrafish, mouse and human.
Mortality caused by extracellular freezing is associated with fragmentation of nuclear DNA in larval haemocytes of two drosophilid flies
Authors: Štětina Tomáš , Koštál Vladimír
Published: October 2023

The great complexity of extracellular freezing stress, involving mechanical, osmotic, dehydration and chemical perturbations of the cellular milieu, hampers progress in understanding the nature of freezing injury and the mechanisms to cope with it in naturally freeze-tolerant insects. Here, we show that nuclear DNA fragmentation begins to occur in larval haemocytes of two fly species, Chymomyza costata and Drosophila melanogaster, before or at the same time as the sub-zero temperature is reached that causes irreparable freezing injury and mortality in freeze-sensitive larval phenotypes. However, when larvae of the freeze-tolerant phenotype (diapausing–cold acclimated–hyperprolinemic) of C. costata were subjected to severe freezing stress in liquid nitrogen, no DNA damage was observed. Artificially increasing the proline concentration in freeze-sensitive larvae of both species by feeding them a proline-enriched diet resulted in a decrease in the proportion of nuclei with fragmented DNA during freezing stress. Our results suggest that proline accumulated in diapausing C. costata larvae during cold acclimation may contribute to the protection of nuclear DNA against fragmentation associated with freezing stress.
N-Borane-Substituted Cyclic Phosphine Imides (BCPIs)
Authors: Nagai Shun , Hinogami Takaya , Ogoshi Sensuke , Hoshimoto Yoichi
Published: October 2023

Phosphine imides are ubiquitous nucleophiles/Lewis bases in modern organic chemistry. The introduction of unexplored substituents on the phosphine imidoyl nitrogen and/or phosphorus atoms should facilitate the discovery of unprecedented utility for phosphine imides. Herein, we have designed and prepared a novel class of phosphine imides known as N-borane-substituted cyclic phosphine imides (BCPIs). Experimental and theoretical analyses of the electronic structure of BCPIs demonstrate the existence of substantial negative hyperconjugation between the nitrogen and the phosphorus atoms. Given a characteristic nucleophilic/Lewis basic reactivity of BCPIs, we demonstrate the spontaneous heterolysis of a B–Cl bond in a BCPI-coordinated chloroborane, suggesting that such process is a plausible key step in the Lewis acid-promoted generation of borenium species from chloroboranes, although it has been previously considered unlikely.
Perceived Fatigability, Fatigue, and Mortality in Mid-to-Late Life in the Baltimore Longitudinal Study of Aging
Authors: MARINO FRANCESCA R. , CHEN XIAOMENG , DEAL JENNIFER A. , SIMONSICK ELEANOR M. , FERRUCCI LUIGI , SCHRACK JENNIFER A. , WANIGATUNGA AMAL A.
Published: October 2023

Introduction/Purpose

Fatigue is an established prognostic indicator of mortality risk. It remains unknown whether fatigability anchored to a physical task is a more sensitive prognostic indicator and whether sensitivity differs by prevalent chronic conditions.

Methods

A total of 1076 physically well-functioning participants 50 yr or older in the Baltimore Longitudinal Study of Aging self-reported fatigue (unusual tiredness or low energy) and had perceived fatigability assessed after a standardized treadmill walk. All-cause mortality was ascertained by proxy contact and National Death Index linkage. Cox proportional hazards models estimated associations of perceived fatigability and fatigue with all-cause mortality, adjusting for demographic and clinical covariates. Interactions by chronic conditions were also examined.

Results

Each 1 SD higher in perceived fatigability, unusual tiredness, or low energy was associated with a higher relative hazard of all-cause mortality after covariate adjustment (fatigability: hazard ratio (HR), 1.18 (95% confidence interval (CI), 1.03–1.36); unusual tiredness: HR, 1.25 (95% CI, 1.08–1.44); low energy: HR, 1.27 (95% CI, 1.10–1.46)). Models had similar discrimination (P > 0.14 for all). Perceived fatigability was associated with mortality risk among participants free of arthritis or osteoarthritis who otherwise appeared healthy (no arthritis: HR, 1.45 (95% CI, 1.15–1.84); arthritis: HR, 1.09 (95% CI, 0.92–1.30); P-interaction = 0.031). Unusual tiredness was associated with mortality among those with a history of diabetes (no diabetes: HR, 1.16 (95% CI, 0.97–1.38); diabetes: HR, 1.65 (95% CI, 1.22–2.23); P-interaction = 0.045) or pulmonary disease (no pulmonary disease: HR, 1.22 (95% CI, 1.05–1.43); pulmonary disease: HR, 2.15 (95% CI, 1.15–4.03); P-interaction = 0.034).

Conclusions

Higher perceived fatigability and fatigue symptoms were similarly associated with higher all-cause mortality, but utility differed by chronic condition. Perceived fatigability might be useful for health screening and long-term mortality risk assessment for well-functioning adults. Alternatively, self-reported fatigue seems more disease-specific with regard to mortality risk.
Delivery of an Exercise Program for Breast Cancer Survivors on Treatment in a Community Setting
Authors: Leach Heather J. , Gainforth Heather L. , Culos-Reed S. Nicole
Published: October 2023

Purpose

Exercise can help reduce the negative physical and psychological side effects of breast cancer treatments. Breast Cancer Patients Engaging in Activity while Undergoing Treatment (BEAUTY) is an exercise program that has been operating in a university-based setting for 4 years. This study describes the feasibility of implementing BEAUTY at the YMCA following the RE-AIM framework.

Methods

This is a single-center, single-cohort interventional feasibility study. Breast cancer patients undergoing or within 3 months of completing chemotherapy and/or radiation treatment (N = 12) received individualized exercise programs and group-based exercise classes twice per week for 19 wk. Outcome variables were measured pre- and post program.

Results

YMCA BEAUTY had similar reach to the university BEAUTY program in terms of recruitment rate and representativeness. Participants attended M = 10.7 ± 10.0 classes and 75% completed post program assessments. Participants showed improvement in the 6-min walk test (M∆ = 45.7 m). All other physical outcomes and quality of life were maintained. Overall, the program was delivered as intended, evidenced by outcomes assessed, exercise class, and education session delivery. A key component for setting level maintenance is the expertise of YMCA fitness professionals needed to deliver an exercise program for a clinical population.

Conclusions

On the basis of RE-AIM metrics, BEAUTY was feasible and appears to be promising for improving health and well-being of breast cancer survivors. These findings will inform researchers, clinicians, health professionals, and fitness facilities of the implementation considerations for future community-based programs for cancer survivors undergoing treatment.
Deep learning techniques in biomedical imaging
Authors: Κατάκης Σοφοκλής
Published: October 2023

O μυοσκελετικός Υπέρηχος (MSK-US) είναι ένα πολύτιμο διαγνωστικό εργαλείο για την εξέταση του μυοσκελετικού συστήματος αφού επιτρέπει τη λεπτομερή απεικόνιση των μυών. Μέσα στην τελευταία δεκαετία, διάφορα Υπολογιστικά Υποβοηθούμενα Συστήματα Διάγνωσης (CAD) εμφανίστηκαν ως αναλυτικά εργαλεία που ενσωμάτωσαν ένα επιλεγμένο σύνολο ποσοτικών χαρακτηριστικών (π.χ. στατιστικά χαρακτηριστικά πρώτης, δεύτερης και ανώτερης τάξης) για να βοηθήσουν το κλινικό προσωπικό στην κλινική πρακτική. Τα συστήματα αυτά εφαρμόζονταν συνήθως για την ανίχνευση κλινικά σημαντικών παραμέτρων όπως η ηχογένεια των μυών ή για την ταξινόμηση διαφορετικών παθολογιών με βάση τα εξαγόμενα ακτινολογικά χαρακτηριστικά. Ωστόσο, με τις πρόσφατες εξελίξεις στην Τεχνητή Νοημοσύνη έχουν εμφανιστεί νέες ισχυρές τεχνικές επεξεργασίας εικόνας με την ενσωμάτωσή τους σε συστήματα CAD να είναι σε πρώιμο επίπεδο. Αντικείμενο της παρούσας διπλωματικής εργασίας είναι η εισαγωγή των σύγχρονων τεχνικών βαθιάς μάθησης με σκοπό τη βελτίωση της απόδοσης των ήδη υπαρχόντων συστημάτων. Για να επιτευχθεί αυτό, έχει μελετηθεί ένα ευρύ φάσμα διαφορετικών προβλημάτων σε μία νέα, μεγάλη και ποικίλα βάση δεδομένων. Συγκεκριμένα, τα προβλήματα που εξετάζονται στην παρούσα διπλωματική εργασία μπορούν να κατηγοριοποιηθούν στις ακόλουθες θεματικές ενότητες: 1. Αυτοματοποιημένη ανάλυση της αρχιτεκτονικής των μυών στο μυοσκελετικό υπέρηχο. 2. Αυτοματοποιημένη ανάλυση της υφής των μυών στο μυοσκελετικό υπέρηχο. 3. Παραγωγή μυοσκελετικών υπερηχογραφικών εικόνων.Κάθε ένα από αυτά τα θέματα έχει τη δική του αξία, καθώς διερευνά ξεχωριστές πτυχές της συνολικής κατάστασης υγείας των ασθενών. Ωστόσο, είναι επίσης διασυνδεδεμένα, καθώς η συλλογική μελέτη τους μπορεί να αποφέρει ακριβέστερα διαγνωστικά συστήματα υπολογιστών. Η αυτοματοποιημένη αρχιτεκτονική ανάλυση διαδραματίζει κρίσιμο ρόλο στην επιθεώρηση των μυών σε πραγματικό χρόνο, παρέχοντας καλύτερες εκτιμήσεις της ποιότητας των μυών όσον αφορά το μέγεθος, καθώς και το μήκος και τη γωνία των περιτοναίων τους. Ταυτόχρονα, η αυτοματοποιημένη ανάλυση υφής ανοίγει το δρόμο για συστήματα που βασίζονται αποκλειστικά στην υφή των μυών για την παρακολούθηση της υγείας τους - μια σημαντική πτυχή της μυϊκής ευεξίας. Τα πρότυπα υφής έχουν τη δυνατότητα να σηματοδοτούν ανωμαλίες ή συγκεκριμένες μυϊκές παθήσεις, επιτρέποντας ενδεχομένως έγκαιρες παρεμβάσεις και προληπτικά μέτρα στους ασθενείς. Είναι σημαντικό να σημειωθεί ότι η ανάπτυξη τέτοιων συστημάτων απαιτεί σημαντικό όγκο δεδομένων, μια πρόκληση που επιδεινώνεται από αυστηρούς κανονιστικούς περιορισμούς και απορρήτου στον ιατρικό τομέα. Για την αντιμετώπιση αυτών των περιορισμών, η αυτοματοποιημένη παραγωγή συνθετικών ρεαλιστικών μυοσκελετικών εικόνων υπερήχων αναδεικνύεται ως πρακτική λύση. Η προσέγγιση αυτή παρακάμπτει αυτούς τους φραγμούς, διευκολύνοντας την απόκτηση σημαντικών όγκων δεδομένων που είναι απαραίτητοι για την προώθηση της έρευνας και της ανάπτυξης αποδοτικών συστημάτων.
Isolation, identification, and structure elucidation of Beta-sitosterol from Iraqi Plantago major using GC-MS, HPTLC, NMR, and FTIR
Authors: Badea Albadri Haider M. , Saleh Ibrahim , Mohammed Hasan Zainab Yaseen
Published: October 2023

Background: Plantago major, a plant well recognized for its therapeutic features, has been widely adopted in several cultural instances and conventionally used due to its anti-inflammatory, antibacterial, and wound-healing characteristics. Recent research efforts have been focused on the identification and validation of the phytochemical elements of P. major in order to establish their association with their corresponding pharmacological effects. The main aim of this study is to precisely define, isolate, purify, and completely analyse the chemical composition of beta-sitosterol, a phytosterol obtained from the Plantago major plant native to Iraq. Methods: In November 2021, P. major samples were procured from the Al-Salihiya Neighbourhood in Baghdad. These samples were afterward verified for authenticity by the Iraqi local Herbarium, located at the Al-Razi institute for alternative medicine. The desiccated botanical matter was subjected to a hexane-based defatting process inside a Soxhlet device, followed by gas chromatography/mass spectrometry (GC/MS) analysis in order to ascertain the presence of bioactive compounds. The evaluation of beta-sitosterol’s presence was afterwards conducted via the use of conventional and preparative thin layer chromatography (TLC) methodologies and high-performance thin layer chromatography (HPTLC). The identification of the molecule was further validated by the use of Fourier transform infrared (FTIR) and nuclear magnetic resonance (NMR) spectroscopy techniques. Results: The findings revealed that Compound No. 5 had notable attributes that were consistent with those of Beta-Sitosterol. The provided data pertains to mass spectrometry (MS), especially the observation of a molecular ion peak at 414. This finding is consistent with the previously documented characteristics of beta-sitosterol. This finding provides further evidence supporting its classification as a prominent organic component originating from P. major. Conclusions: We effectively determined beta-sitosterol as the primary bioactive component in the P. major samples collected. The compound’s existence highlights the plant’s longstanding therapeutic standing, ascribing it several advantageous pharmacological benefits.
Intention for internal whistleblowing to report sexual violence in higher education institutions: a Nigerian national study
Authors: Ogunfowokan Adesola A. , Garba Saleh N. , Orisadare Monica A. , Adeleke Ayobami G. , Samson-Akpan Patience E. , Olatubi Mathew O. , Salau Omowumi R. , Titilayo Ayotunde
Published: October 2023

Background Sexual violence is prevalent in higher education institutions in Nigeria and stakeholders have encouraged staff and students to blow the whistle whenever they fall victim to or are aware of any sexual violence case. However, there is lack of data about whether the staff and students of these institutions have the intention to blow the whistle internally (within the institution) or not. There is also a lack of data on the existing reporting mechanisms or preferred whistleblowing mechanisms in these institutions. These have hindered the analysis of stakeholders’ opinions on this topic. Methods This data note presents a comprehensive quantitative and qualitative data set collected from staff and students of three categories of government owned higher education institutions (Universities, Polytechnics, Colleges of Education) in Nigeria. Data collection was between February and December, 2021, during which quantitative data were collected from 21,937 students and 3,108 staff. Qualitatively, 138 students and 111 staff participated in a total of 35 focus group discussion sessions. The study provides unique information on respondents’ attitude, self-efficacy, and subjective norm to sexual violence whistleblowing. It also provides information on self-reported sexual violence experiences, whistleblowing intention, reporting systems in higher institutions and the preferred sexual violence whistleblowing mechanisms. Conclusions In this data note, we provide a detailed account of the variables in the dataset and then highlight the potential of this study to contribute to improved sexual violence reporting in higher education institutions, thereby reducing the occurrence of the social menace.
First-principles calculation of electron-phonon coupling in doped KTaO3
Authors: Esswein Tobias , Spaldin Nicola A.
Published: October 2023

Background: Motivated by the recent experimental discovery of strongly surface-plane-dependent superconductivity at surfaces of KTaO3 single crystals, we calculate the electron-phonon coupling strength, λ, of doped KTaO3 along the reciprocal space high-symmetry directions.

Methods: Using the Wannier-function approach implemented in the EPW package, we calculate λ across the experimentally covered doping range and compare its mode-resolved distribution along the [001], [110] and [111] reciprocal-space directions.

Results: We find that the electron-phonon coupling is strongest in the optical modes around the Γ point, with some distribution to higher k values in the [001] direction. The electron-phonon coupling strength as a function of doping has a dome-like shape in all three directions and its integrated total is largest in the [001] direction and smallest in the [111] direction, in contrast to the experimentally measured trends in critical temperatures.

Conclusions: This disagreement points to a non-BCS character of the superconductivity. Instead, the strong localization of λ in the soft optical modes around Γ suggests an importance of ferroelectric soft-mode fluctuations, which is supported by our findings that the mode-resolved λ values are strongly enhanced in polar structures. The inclusion of spin-orbit coupling has negligible influence on our calculated mode-resolved λ values.
The Democratic People’s Republic of Korea
Authors: Kwiatkowska Monika
Published: October 2023

Located in a mountainous region on the Korean Peninsula in the Northeast Asia and inhabited by little more than 26 million people, the Democratic People’s Republic of Korea remains a tragic symbol of the Cold War rivalry. North Korean domestic and foreign policy has been significantly influenced by extreme nationalist and anti-imperial ideology, a product of traumatic colonial experience of all Koreans. The DPRK is believed to be the most isolationist state in the modern, highly integrated and globalized world, yet it poses a serious security threat in its geopolitical region and impacts the balance of power over the Pacific Ocean. The aim of this article is to briefly analyze the historical, political, as well as socio-cultural roots of the North Korean autocracy in its complexity and paradoxicality while also regarding contemporary condition of the DPRK’s government characteristics, state’s narrative (juche ideology), economy, and society.
Concordancia entre el Índice de Capacidad Laboral y los Años de Discapacidad Sobrevenida Estimados mediante metodología PoRT-9LSQ
Authors: Soriano Tarin Guillermo , Francisco-García Juan C. , Alonso-Bosque José M. , Valle-Robles Marisa , Bernabeu-Atanasio Alba
Published: October 2023

Objetivo: Analizar la asociación entre los estilos de vida y factores de riesgo para la salud que pueden suponer un abandono prematuro del trabajo, con los años de discapacidad sobrevenida estimados (ADSE) en población laboral, y calcular la correlación entre el Índice de Capacidad Laboral (ICL) y el Work Ability Score (WAS), y ambos con los ADSE y su coste económico.
Métodos: Estudio transversal en una muestra de trabajadores a los que se realizó un examen de salud. La información se recogió mediante los cuestionarios ICL y WAS, y la metodología PoRT-9LSQ. Se realizó un análisis de la asociación entre los factores de riesgo analizados y los ADSE mediante regresión lineal y análisis de la varianza (ANOVA). Se analizó la correlación entre ICL y WAS usando el coeficiente de correlación intraclase (CCI), y con los ADSE y su coste económico mediante regresión lineal ajustada. 
Resultados: Se incluyeron 590 trabajadores. Los factores que más influyeron en la media de ADSE fueron el sedentarismo, la mala alimentación y el sobrepeso/obesidad, con diferencias estadísticamente significativas según sexo, turno y ocupación (p<0,05). El CCI entre ICL y WAS fue del 93,0% para una valoración excelente/buena. La regresión lineal ajustada entre ICL y los ADSE fue de 7,982-0,136xICL (p<0,05), siendo similar para el WAS. 
Conclusiones: El ICL se ha mostrado útil para la predictibilidad de los ADSE en población laboral, lo que facilitará la toma de decisiones del personal sanitario para identificar personas vulnerables favoreciendo cambios en los estilos de vida y el autocuidado.
A Meta-analysis Study on the Communication Attitudes of People Who Do and Do Not Stutter by Age
Authors: Kim Eunna , Sim Hyun Sub , Kim Young Tae
Published: October 2023

Objectives: The present study aimed to compare the communicative attitudes of stuttering groups with the general population using a meta-analysis and to examine the patterns of change in communicative attitudes across different age groups: pre-school, school-age, and adults. Methods: The author conducted a meta-analysis to compare communication attitude scores between people who stutter (PWS) and people who do not stutter (PWNS) from 2000 to June 2022 using domestic and foreign databases. 15 articles meeting the selection criteria were included, with 16 data points extracted. The study aimed to determine the overall effect size of communication attitude scores between groups and to analyze age as a moderator. Results: The overall effect size of the communication attitude scores between the two groups showed a large effect size (g = 2.507) and was statistically significant. Meta ANOVA analysis of group communication attitude scores by age category showed that there was a significant difference in effect size between the three age categories (χ2 = 13.53, p < .01). Post-hoc analysis was performed, and there was no significant difference in effect size between the pre-school and school-age groups (χ2 = 0.72, p = .40). A large effect size and a statistically significant difference were observed between the school-age and adult groups (χ2 = 5.95, p < .05), and a very large effect size and a statistically significant difference were observed between the pre-school and adult groups (χ2=13.52, p < .01). Conclusion: The research findings indicate that individuals who stutter exhibited more negative communicative attitudes compared to the non-stuttering group across all age groups. Particularly during adulthood, the negative communicative attitudes were more pronounced when compared to the other two age groups (pre-school and school-age). Therefore, when providing treatment for stuttering, it is important to not only focus on external behaviors but also incorporate activities that address age-appropriate communicative attitudes.
Comparative Analysis of Inferencing in Low-Reading and Average-Reading Comprehenders: Utilizing the Think-Aloud Protocol
Authors: Kim Woori , Shin Mikyung , Yoo Yongseok
Published: October 2023

Objectives: This is a conceptual replication aiming to investigate the cognitive processes of students with reading comprehension difficulties using the think-aloud protocol. Methods: Among 72 third- and fourth-grade participants, 28 poor comprehenders and 44 average students were identified based on screening criteria and standardized tests. The think-aloud protocol was used to monitor comprehension processes during reading. The participants verbalized their thoughts as they read expository and narrative texts. Those responses were transcribed and coded according to inference rates, correctness, and inferential types (explanation, prediction, or association). Results: First, poor comprehenders showed significantly lower rates and accuracies of inferences for both expository and narrative texts than average students did. Second, there were significant differences between poor comprehenders and average students in the proportions of the three types of inferences. Poor comprehenders generated significantly lower rates of explanatory, predictive, and associative inferences. Third, the inference types differed for different type of texts. Both groups made more predictive inferences when reading the narrative text than when reading the expository text. Conclusion: Differences in inference patterns between poor comprehenders and average students were identified using the think-aloud protocol. Different types of inferences were involved in processing different types of texts. Future research directions for developing learning strategies for encouraging solid inference are discussed.
The Relationship among Cognition, Receptive Vocabulary and Speech Production Skills in Children with Cerebral Palsy
Authors: Jeong Pil Yeon , Sim Hyun Sub
Published: October 2023

Objectives: The purpose of this study was to identify the differences of cognition in children with cerebral palsy (CP) based on a Speech, Language Profile Group (SLPG), and explore the relationship among cognition, receptive vocabulary, and speech production skills. Methods: Forty children aged 4-16 years with CP, 10 with no speech motor involvement and age-appropriate language ability (NSMI-LCT), 7 with no speech motor involvement and impaired language ability (NSMI-LCI), 11 with speech motor involvement and age-appropriate language ability (SMI-LCT), and 12 with speech motor involvement and impaired language ability (SMI-LCI) participated in the study (spastic 31, dyskinetic 3, ataxic 2, mixed 4). To evaluate cognitive ability, language ability, and speech production skill, data were collected from the K-WISC-III or K-WIPPSI, receptive vocabulary test, prolonged vowel /a/, Assessment of Articulation and Phonology for Children, and carrier phrases repetition task. Results: The results showed significant differences between the NSMI-LCT and SMI-LCI groups in cognitive abilities. Moreover, cognitive abilities in children with CP were significantly related to receptive vocabulary and speech rate. Conclusion: This study revealed that cognition has an internal relationship with receptive vocabulary and speech production skills. Therefore cognition, language, and speech ability are important factors in the assessment and intervention for children with CP. This study suggest that multidimensional considerations are crucial in evaluating and intervening in children with CP.
Comprehension of Indirect Speech Act according to Emoticon Expression Types in Instant Messenger Conversation of School-Aged Children
Authors: Jun Soo Jung , Ha EunBin , Lee Eun-Ju
Published: October 2023

Objectives: This study aims to examine if there is a difference in indirect speech comprehension ability based on grade level and to identify which type of emoticon is most helpful in the students’ understanding of indirect speech. Methods: A total of 60 students were gathered, consisting of 20 children each from the second, fourth, and sixth grades of elementary school, who lived in Seoul and Gyeongi-do. The indirect speech comprehension task divided the emoticons into four types: facial expression clue, motion clue, object clue, and no clue. The experiment was conducted using a slideshow, where students read sentences and answered clues. They were then required to select the meaning of the underlined part in the last sentence of the article among three answer choices: the correct answer, example of surface meaning answer, and example with weak connection answer. The task consisted of a total of 32 questions, with 8 questions for each emoticon type and an additional 16 questions involving direct conversations as filler questions. Results: A statistically significant difference was observed in indirect speech comprehension scores between second and fourth graders, as well as between second and sixth graders. Statistical significance was found in the indirect speech comprehension task with regard to grade level and emoticon types. In addition, the effect of interaction between grade level and emoticon type was statistically significant. There was a decreasing trend in the overall frequency of error types as grade level increased. Conclusion: This study revealed that, as the grade level increases, individuals develop the ability to comprehend indirect speech accurately, even when the meaning is not explicit on the surface, by understanding the social context and utilizing their knowledge of the world. For future research, it is essential to examine the tendencies of children with disabilities or conversational language difficulties compared to non-disabled children.
Performances of Pointing Phonological Memory Tasks between Children with and without Speech Sound Disorders
Authors: Jeong Se-In , Ha Ji-Wan
Published: October 2023

Objectives: A new phonological memory task using pointing responses was developed and the performance of each sub-task was compared between children with and without speech sound disorders (SSD). Methods: 16 children with SSD and 14 typically developing children (TD) performed pointing memory tasks, which consists of four sub-tasks—auditory short-term, auditory working, visual short-term, and visual working memory; and performances between groups and between each sub-task were compared. In addition, the correlation between the new task and the existing task (digit span task), vocabulary sizes and the accuracy of consonants was analyzed. Results: First, the SSD group showed significantly lower performance in the pointing memory tasks than the TD group. Second, both the SSD and TD groups showed significantly higher performance in auditory stimulation compared with visual stimulation, and in short-term memory than working memory. Third, in the case of the TD group, the performance of the auditory short-term memory task was much better, and there were no significant differences among the other three sub-tasks, while the SSD group showed a sequential decline in performances among the four sub-tasks. Finally, there was a high correlation between the new task and the existing task, vocabulary sizes, and the accuracy of consonants. Conclusion: The low performance in the phonological memory task of the SSD group is not due to weakness in articulation or in auditory processing, but to defects in phonological short-term/working memory itself. The results of this study provide meaningful information on the different performance patterns of phonological memory tasks according to stimulus modalities between the SSD and TD groups.
Speech Intelligibility Improvement with Concrete and Abstract Auditory Cues
Authors: Kim Hyun Seung
Published: October 2023

Objectives: The present study investigated several acoustic parameters to determine intelligibility strategies implemented by eight normal healthy individuals (NHI) and eight individuals with dysarthria (IWD) following concrete and abstract auditory speech cues. Methods: Ten acoustic parameters reportedly sensitive to intelligibility changes were selected and analyzed. Those included fundamental frequency (f0), vowel duration, vowel-consonant-vowel syllable duration, closure duration, aspiration duration, the ratio of closure duration to closure and aspiration combined duration, the 1st & 2nd formant (F1, F2) consonant-to-vowel (C/V) ratio, and the F2 slope. They were compared in three different auditory speech cue conditions: No cue (NC), Concrete cue (CC), and Abstract cue (AC) conditions. Results: IWD showed higher values in most of the measurements compared to the NHI group. Group differences appeared in seven out of ten measurements in the NC condition. Such group differences only appeared in the closure duration and the closure duration ratio in the CC condition. Group difference disappeared in the AC condition. The results suggested that while NHI manipulated pitch and durational aspects of speech to increase intelligibility, IWD manipulated only the durational aspect in the cue conditions. Conclusion: The pitch might already be heightened while IWD implement clear speech strategy regardless of the cue condition. The aspiration duration was unaffected by cue or group condition. Participants reduced group differences on the relational measurements (F2 C/V ratio or F2 slope) after cues suggesting that IWD maintained the ability to control relational aspects of speech because they are critical for distinctive stop production. Abstract cues appeared to make IWD’s speech closer to NHI.
Proximal Femur Endoprosthesis Augmentation with Polymethylmethacrylate and Condylar Plate: A Case Series
Authors:   Orthopedic Surgery Department, San Ignacio University Hospital, Pontificia Universidad Javeriana, Bogotá, Colombia., Gaitán-Lee Hernando , Chavarro Ingrid P ,   Orthopedic Surgery Department, San Ignacio University Hospital, Pontificia Universidad Javeriana, Bogotá, Colombia., Rincón Mariana Piñeros ,   Orthopedic Surgery Department, San Ignacio University Hospital, Pontificia Universidad Javeriana, Bogotá, Colombia., Visbal Nicolle L ,   Orthopedic Surgery Department, San Ignacio University Hospital, Pontificia Universidad Javeriana, Bogotá, Colombia., Leal Efraím ,   Orthopedic Surgery Department, San Ignacio University Hospital, Pontificia Universidad Javeriana, Bogotá, Colombia.
Published: October 2023

Introduction: Aseptic and septic loosening by mechanical failure is one of the main causes of proximal femur endoprosthesis failure with different clinical consequences such as pain, inflammation, progressive loosening of muscular volume, and strength with functional limitation. We present a case series of four patients with aseptic and septic loosening of femur endoprosthesis that was treated with a novel technique that combines different methods to achieve primary stability. Case Report: Four patients with an average age of 49.5 years (35–70 years), two women and two men, were referred to the Orthopedic Surgery Department of the San Ignacio University Hospital of Bogota. Two of them with a history of oncological disease, ruling out a tumor relapse through local images and extension examinations; another patient with a history of firearm injury to the left thigh with multiple secondary complications, which required various reconstructive procedures; and the oldest patient with a history of total hip replacement. The main complaint of the four patients was thigh pain not caused by trauma and initial assessment radiographs of all of them showed signs of loosening of the prosthetic material, with septic etiology in two of the patients and aseptic etiology in the other two. Therefore, they were scheduled for revision surgery of prosthetic components. These patients recover functional status and resolved pain in the early post-operative period and during long-term follow-up. Only one of the patients, time after the surgical procedure, required removal of the osteosynthesis material due to persistent bone infectious process. Conclusion: Septic and aseptic loosening is one of the most common complications of proximal femur endoprosthesis, resulting in significant pain and functional decline in patients. We present a novel surgical technique that allows primary stabilization of the construct that allows early rehabilitation, improvement of functionality, and no signs of new loosening. Keywords: Proximal femur endoprosthesis, aseptic loosening, septic loosening, mechanical failure, augmentation, condylar plate, polymethylmethacrylate.
Pubic Symphysis Tuberculosis Recurrence – A Rare Case Report and Literature Review
Authors:   Department of Orthopedics, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India., Kumar Rajnand , Kumar [ Nitish ,   Department of Orthopedics, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India., Bharti Ajay ,   Department of Orthopedics, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India., Kushwaha Sudhir Shyam ,   Department of Orthopedics, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India., Kumar Vivek ,   Department of Orthopedics, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India., Choudhary Milind Chandra ,   Department of Orthopedics, All India Institute of Medical Sciences, Gorakhpur, Uttar Pradesh, India.
Published: October 2023

Introduction: Tuberculosis (TB) of pubic symphysis is an extremely uncommon condition accounting <1% of all musculoskeletal TB. Further recurrence of TB of symphysis pubis is a rare clinical scenario requiring a high level of suspicion for diagnosing the condition. Recurrence of tuberculosis can occur either be due to relapse of the original infection or reinfection due to exogenous Mycobacterium tuberculosis strain. There have only been nine case reports on TB of the pubic symphysis in the last three decades and only 40 patients were identified in English language medical literature so to the best of our knowledge this is the first case report on the recurrence of TB of pubic symphysis. Case Report: A 26-year-old female patient presented with pain over symphyseal area for 2 months. Laboratory and radiological investigations were suggestive of TB of symphysis pubis. She was started on oral, category I anti-tubercular therapy (ATT) from DOTS center. Patient on improvement in symptoms discontinued taking ATT after 6 months. About 7 months after stopping ATT, she again presented with pain over symphyseal area and difficulty in walking. Laboratory, radiological investigation, and biopsy were obtained to rule out multidrug-resistant (MDR) TB. The patient improved on 12 months’ oral daily ATT regime (HRZES2+HRZE4+HRE6). She was followed up for another 1 year with clinical examination and laboratory investigation after stopping ATT. At present, she is asymptomatic with no signs of recurrence after 1 year of completion of treatment. Conclusion: ATT intake should be continued for 12 months for musculoskeletal TB for preventing recurrence. The biopsy needs to be taken from the affected region in recurrence TB to rule out MDR. Keywords: Recurrence, tuberculosis, pubic symphysis.
Calcaneal Osteosarcoma: A Rare Instance in Adolescent Patient
Authors:   Department of Orthopedics, KIMS, Sunshine Hospital, Hyderabad, Telangana, India., Lingala Himakanth , Vecham Ratnakar ,   Department of Orthopedics, KIMS, Sunshine Hospital, Hyderabad, Telangana, India., Shah Ruchit ,   Department of Orthopedics, KIMS, Sunshine Hospital, Hyderabad, Telangana, India., Reddy A V Gurava ,   Department of Orthopedics, KIMS, Sunshine Hospital, Hyderabad, Telangana, India.
Published: October 2023

Introduction: Calcaneal osteosarcoma is extremely uncommon, accounting for <1% of all osteosarcomas. They typically exhibit swelling and chronic heel pain and are frequently clinically misdiagnosed as traumatic or inflammatory process. Case Report: We report a case of a 19-year-old girl with calcaneal osteosarcoma who initially complained of heel pain that was refractory to analgesic medications over a period of 4 months. Conclusion: The case highlights the importance of early diagnosis and management of osteosarcoma in patients with chronic heel pain and also highlights the importance of considering osteosarcoma as a differential diagnosis in adolescents who present with chronic heel pain, despite the rarity of the condition. Keywords: Calcaneus, diagnosis, osteosarcoma, pain.