Abstract: Diarrhea is the most common cause of death in calves, and remains a major health challenge. Although there are many studies on the related pathogens, the understanding of the clinicopathological changes is limited. This study aimed to identify the pathogens and observe the clinicopathological changes in electrolytes and acute phase proteins (APPs) associated with diarrhea.Blood samples and fecal samples were collected from 141 calves for the determination of APPs, electrolyte and acid-base status and identification of enteropathogens, respectively. Single or co-infections with enteropathogens, including virus (bovine viral diarrhea virus, coronavirus, and rotavirus), Eimeria, Cryptosporidium, and Escherichia coliK99 were detected in both non-diarrheic and diarrheic calves. Levels of APPs such as serum amyloid A, haptoglobin and fibrinogen were comparable between diarrheic and nondiarrheic calves. Hypoglycemia, high blood urea, electrolytes and acid-base imbalance (hyponatremia, hypochloremia, and decreased bicarbonate), and strong ion difference (SID) acidosis showed a significant association in diarrheic calves (p < 0.01). Particularly, significant hyponatremia, bicarbonate loss, SID acidosis, hypoglycemia, and elevated blood urea nitrogen were found in rotavirusinfected calves. Monitoring the clinicopathological parameters of APPs and electrolyte levels could be vital in the clinical management of diarrheic calves.

Purpose: Adherence and persistence to adjuvant hormone therapy (AHT) are seldom maintained among early-stage hormone receptor-positive breast cancer (BC) survivors, despite the significant clinical benefits of long-term AHT. As the factors influencing adherence to AHT remain unclear, this study aimed to comprehensively identify such factors and classify them into specific dimensions. Methods: PubMed, Cochrane Library, Embase, PsycINFO, and CINAHL were searched for qualified articles. The search mainly focused on three components: early-stage (0–III) BC, oral AHT administration, and adherence to AHT, with keywords derived from MeSH and entry terms. The factors identified were then classified into six categories based on a modified WHO multidimensional model. Results: Overall, 146 studies were included; the median sample size was 651 (range, 31– 40,009), and the mean age of the population was 61.5 years (standard deviation, 8.3 years).Patient- and therapy-related factors were the most frequently investigated factors. Necessity/ concern beliefs and self-efficacy among patient-related factors were consistently related to better adherence than depression. Although drug side effects and medication use cannot be modified easily, a refined prescription strategy for the initiation and switching of AHT is likely to increase adherence levels. Conclusion An effective psychological program that encourages positive views and beliefs about medication and management strategies for each therapy may be necessary to improve adherence to AHT. Social support and a sense of belonging can be enhanced through community participation and social media for better adherence to AHT. Patient-centered communication and appropriate recommendations by physicians may be attributable to better adherence outcomes. Findings from systematically organized factors that influence adherence to AHT may contribute to the establishment of intervention strategies to benefit patients with early-stage BC to achieve optimal health.

Purpose: The use of an ostomy for urination and defecation leads to reduced quality of life. Although many ostomy management strategies are needed, such strategies are often implemented by patients. Thus, there is a need for a home health care service platform that can be used in ostomy patient management. Methods: We developed an ostomy patient management platform by identifying the needs of patients and medical staff through the Chronic Care Ostomy Self-Management Training Program in the United States and from studies conducted in Korea. Results: The platform encompassed physical management, psychological management, maintenance of social function, spiritual stability, and home medical care. These components were implemented through monitoring, self-care guidance, and a community platform. For the monitoring function, patients entered their health status in a mobile application (app); the medical staff at the affiliated hospital then monitored the stoma status through a web interface. Conclusion Our platform allows medical staff to monitor ostomy patients through a web interface and help such patients to fully manage their ostomy at home using an app. We expect that the continued development of patient-oriented functions in our app will allow ostomy patients to experience quality-of-life improvements.

Anaplastic carcinomas of the pancreas, also known as pleomorphic, sarcomatoid, or undifferentiated carcinomas, are in most cases variants of duct-derived carcinomas. However, their appearance is so distinctive and their behavior so aggressive that a distinction from the ordinary ductal adenocarcinoma is warranted. They comprise about 7% of all non-endocrine pancreatic malignancies. Most tumors are large and apparently more likely to involve the body or tail of the pancreas rather than the head. Most patients are above the age of 50 at the time of diagnosis, and there is a distinct male predilection. Here we report on a 50-year woman who diagnosed pathologically as a anaplastic carcinoma of the pancreas. The patient underwent Whipple's operation because of a distal common bile duct cancer 6 years ago. Distal pancreatectomy and splenectomy were performed. The patient was discharged with a good general condition.
Adenocarcinoma ; Carcinoma* ; Common Bile Duct* ; Diagnosis ; Female ; Head ; Humans ; Male ; Pancreas* ; Pancreatectomy ; Splenectomy

OBJECTIVE: To evaluate the influence of weight-bearing on foot shape measured by 3-D foot scanner. METHOD: Forty-two feet of twenty-one normal subjects were studied. The foot length, width, girth and arch parameters under non weight-bearing and weight-bearing conditions were measured by 3-D foot scanner (Nexcan(R), K & I, Korea), analysis software (EnFOOT(r), K & I, Korea) and 3-D foot arch measurement program. RESULTS: The foot length, ball width, ball girth, waist girth, instep girth, short heel girth, long heel girth and length from heel point to proximal arch point significantly increased under weight-bearing condition (p<0.01). However, vamp height, waist height, instep height, length of arch, height of arch, width of arch, length from heel point to distal arch point, maximal arch height and volume of arch were significantly decreased under 50% weight-bearing condition (p<0.01). CONCLUSION: Foot parameters associated with length, width and girth increased but volume, width, length, and height of medial longitudinal arch decreased under weight bearing condition. We suggest that these findings under weight- bearing condition result from the pronation of subtalar joint and the decrement of heights of transverse and longitudinal arch heights.
Foot* ; Heel ; Pronation ; Subtalar Joint ; Weight-Bearing*

OBJECTIVES: This study was conducted to investigate the prevalence of playing-related musculoskeletal disorders (PRMDs) of some music college freshmen majoring in string instruments. METHODS: The study subjects were 199 freshmen majoring in strings at three colleges in Seoul and surrounds. The symptom prevalence and related factors of PRMDs were surveyed with a self-administered questionnaire. The Southampton Protocol was used to diagnose PRMDs. RESULTS: The freshmen had played for 9 years and 7 months on average. The symptom prevalence of PRMDs according to the modified-NIOSH surveillance criteria was 73.4%. The shoulder was the most prevalent symptom complaint site. The prevalence of PRMDs by the Southampton Protocol was 54.3% and myofascial pain syndrome was the most common. The instrument (violin or viola vs. cello or bass), regular breaks, self perceived evaluation of playing posture and regular computer use had a significant association with the symptom prevalence of PRMDs in univariate logistic regression analysis (p<0.05). The instrument, regular breaks and regular computer use were significant variables affecting the symptom prevalence of PRMDs in multivariate logistic regression analysis (p<0.05). CONCLUSIONS: This study suggests that music college freshmen playing strings are a high risk group for musculoskeletal disorders. Therefore, the prevention of PRMDs requires the establishment of an ergonomic playing-environment, and the education of comfortable posture and stretching program such as musical warming up and physical stretching. It is especially important to form an effective treatment and rehabilitation system based on earlier diagnosis for musicians who are suffering from the PRMDs.
Diagnosis ; Education ; Logistic Models ; Music* ; Myofascial Pain Syndromes ; Posture ; Prevalence* ; Questionnaires ; Rehabilitation ; Seoul ; Shoulder ; Viola

Purpose: Fetal well-being is usually assessed via fetal heart rate (FHR) monitoring during the antepartum period. However, the interpretation of FHR is a complex and subjective process with low reliability. This study developed a machine learning model that can classify fetal cardiotocography results as normal or abnormal. Materials and Methods: In total, 17492 fetal cardiotocography results were obtained from Ajou University Hospital and 100 fetal cardiotocography results from Czech Technical University and University Hospital in Brno. Board-certified physicians then reviewed the fetal cardiotocography results and labeled 1456 of them as gold-standard; these results were used to train and validate the model. The remaining results were used to validate the clinical effectiveness of the model with the actual outcome. Results: In a test dataset, our model achieved an area under the receiver operating characteristic curve (AUROC) of 0.89 and area under the precision-recall curve (AUPRC) of 0.73 in an internal validation dataset. An average AUROC of 0.73 and average AUPRC of 0.40 were achieved in the external validation dataset. Fetus abnormality score, as calculated from the continuous fetal cardiotocography results, was significantly associated with actual clinical outcomes [intrauterine growth restriction: odds ratio, 3.626 (p=0.031); Apgar score 1 min: odds ratio, 9.523 (p<0.001), Apgar score 5 min: odds ratio, 11.49 (p=0.001), and fetal distress: odds ratio, 23.09 (p<0.001)]. Conclusion The machine learning model developed in this study showed precision in classifying FHR signals. This suggests that the model can be applied to medical devices as a screening tool for monitoring fetal status.

OBJECTIVE: To evaluate and quantify the medial longitudinal arch of foot using a 3-D foot scanner and 3-D arch measurement program. METHOD: 997 subjects (363 men and 634 women) were selected. The foot length, width, girth and medial longitudinal arch parameters were measured with a 3-D foot scanner (Nexcan(r), K&I, Korea), analysis software (EnFOOT(R), K&I, Korea) and 3-D measurement program of the medial longitudinal arch. RESULTS: The mean arch lengths were 100.3 mm for men, 90.4 mm for women. The mean arch height and arch volume in both genders were 14.7 mm, 12.1 mm and 10.3 cm3, 6.0 cm3, respectively. We compared the arch parameters of both genders by univariate analysis of variance and in most cases the parameters of men were larger than those of women. Moderate positive relationships were found between foot length and arch width of talonavicular joint in cases of men, foot length and length from heel point to distal arch point in both genders (Pearson correlation coefficient > 0.3, p<0.01). CONCLUSION: We evaluated the medial longitudinal arch of Korean feet three dimensionally. These data sould be a useful reference for making shoes, insoles, and orthoses.
Female ; Foot* ; Heel ; Humans ; Joints ; Male ; Orthotic Devices ; Shoes

Objectives: Early detection of developmental issues in infants and necessary intervention are important. To identify the comorbid conditions, a comprehensive evaluation is required. The study’s objectives were to 1) generate scale items by identifying and eliciting concepts relevant to young children (12–71 months) with developmental delays, 2) develop a comprehensive screening tool for developmental delay and comorbid conditions, and 3) assess the tool’s validity and cut-off. Methods: Multidisciplinary experts devised the “Infant Comprehensive Evaluation for Neurodevelopmental Delay (ICEND),” an assessment method that comes in two versions depending on the age of the child: 12–36 months and 37–71 months, through monthly seminars and focused group interviews. The ICEND is composed of three parts: risk factors, resilience factors, and clinical scales. In parts 1 and 2, there were 41 caretakers responded to the questionnaires. Part 3 involved clinicians evaluating ten subscales using 98 and 114 questionnaires for younger and older versions, respectively. The Child Behavior Checklist, Strengths and Difficulties Questionnaire, Infant-Toddler Social Emotional Assessment, and Korean Developmental Screening Test for Infants and Children were employed to analyze concurrent validity with the ICEND. The analyses were performed on both typical and high-risk infants to identify concurrent validity, reliability, and cut-off scores. Results: A total of 296 people participated in the study, with 57 of them being high-risk (19.2%). The Cronbach’s alpha was positive (0.533–0.928). In the majority of domains, the ICEND demonstrated a fair discriminatory ability, with a sensitivity of 0.5–0.7 and specificity 0.7–0.9. Conclusion The ICEND is reliable and valid, indicating its potential as an auxiliary tool for assessing neurodevelopmental delay and comorbid conditions in children aged 12–36 months and 37–71 months.

Objectives: This study aimed to analyze trends in the timely diagnosis of malaria cases over the past 10 years in relation to the utilization of different types of healthcare facilities. Methods: The study included 3,697 confirmed and suspected cases of malaria reported between January 1, 2013, and December 31, 2022, in the national integrative disease and healthcare management system. Some cases lacking a case report or with information missing from the case report were excluded from the analysis. A generalized linear model with a Poisson distribution was constructed to estimate rate ratios and 95% confidence intervals adjusted for other variables, such as distance. Results: When cases involving diagnosis >5 days after symptom onset in confirmed patients (5DD) were examined according to the type of healthcare facility, the rate ratio of 5DD cases was found to be higher for public health facilities than for tertiary hospitals. Specifically, the rate ratio was higher when the diagnosis was established at a tertiary hospital, even after a participant had visited primary or secondary hospitals. In an analysis adjusted for the distance to each participant’s healthcare facility, the results did not differ substantially from the results of the crude analysis. Conclusion It is imperative to improve the diagnostic capabilities of public facilities and raise awareness of malaria at primary healthcare facilities for effective prevention and control.