• Journal of Genetic Medicine
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• v.16 no.1
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• pp.31-38
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• 2019

Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is a maternally inherited mitochondrial disorder of which m.3243A>G is the most commonly associated mutation, resulting in an inability to meet the energy requirements of various organs. MELAS poses a diagnostic challenge owing to its multiple organ involvement and great clinical variability due to its heteroplasmic nature. We report three cases from a family who were initially misdiagnosed with myasthenia gravis or undiagnosed. Although there is no optimal consensus treatment approach for patients with MELAS because of the disease's heterogeneity, our 21-year-long therapy regimen of ${\text\tiny{L}}-arginine$, ${\text\tiny{L}}-carnitine$, and coenzyme Q10 supplementation combined with dietary management appeared to provide noticeable protection from the symptoms and complications. Prompt early diagnosis is important, as optimal multidisciplinary management and early intervention may improve outcomes.

• The Journal of Asian Finance, Economics and Business
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• v.9 no.4
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• pp.109-120
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• 2022

This study has incorporated the mechanics-dynamics-emotions (MDE) and two behavioral learning paths to investigate the customers' co-creation behavior in Taiwan. The intuitive path begins with a gamification design that reflects the customers' proactive and innovative behavior; the cognitive path begins with persuasion knowledge remarks based on rational and reactive reasoning. These two paths conclude what forms user co-creation. The study collects data of 505 active social media users in Taiwan and employs structural equation modeling. The empirical findings demonstrate persuasive knowledge and gamification design are significantly associated with self-reference, and in turn, positively associated with co-creation. It indicates that cognitive behavior plays the main role in forming co-creation. Participants are more drawn to co-creation behaviors by the marketing contents that prompt reactive behaviors than proactive ones. Therefore, marketing managers can use appropriate stimuli to enhance co-creation behavior. Companies can design activities related to users, and more accessible for reactive, instead of proactive behavior, i.e., asking for their initiatives. It also suggests that companies' marketing campaigns should involve key opinion leaders matching the product image and the target audience's preferences. The novelty of this study is to introduce a novel augmented MDE framework to extend the "dynamics" into the incubation and implementation stage.

• Nuclear Engineering and Technology
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• v.54 no.9
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• pp.3324-3335
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• 2022

Several countries show interest in the Generation-IV power reactor innovative small module (PRISM), including: Canada, Japan, Korea, Saudi Arabia and the United Kingdom. Generation IV International Forum (GIF) has recommended the utilizing of probabilistic safety assessment (PSA) in evaluating the safety of Generation-IV reactors. This paper reviews the PSA performed for PRISM using SAPHIRE 7.27 code. This work shows that the core damage frequency (CDF) of PRISM for a single module is estimated by 8.5E-8/year which is lower than the Generation-IV target that is 1E-6 core damage per year. The social risk of PRISM (likelihood of latent cancer fatality) with evacuation is estimated by 9.0E-12/year which is much lower than the basic safety objective (BSO) that is 1E-7/year. The social risk without evacuation is estimated by 1.2E- 11/year which is also much lower than the BSO. For the individual risk (likelihood of prompt fatality), it is concluded that it can be considered negligible with evacuation (1.0E-13/year). Assuming no evacuation, the individual risk is 2.7E-10/year which is again much lower than the BSO. In comparison with other PSAs performed for similar sodium fast reactors (SFRs), it shows that PRISM concept has the lowest CDF.

• Journal of Distribution Science
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• v.20 no.1
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• pp.13-26
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• 2022

Purpose: The Covid-19 pandemic has accelerated and triggered changes in online shopping especially in an emerging market. This paper develops a modification of SERVQUAL model to examine the relationship between individual dimensions of e-service quality, online trust and purchase intentions in singular online shopping platform. Research design, data and methodology: Data from an online survey of 385 Lazada's shoppers were used to test the research model. The structural equation modeling technique was performed to test the research model. Results: The analytical results revealed that five dimensions of e-service quality were positively correlated with one another whereas some dimensions were negatively correlated with purchase intentions. The results of this study provide new insight into the literature as well as practical implications for marketers especially in Thai online market. Conclusion: This study develops the instrument dimensions of e-service quality through modifying the SERVQUAL model to examine the e-commerce context and to testify how these individual dimensions are interlinked with one another. It also suggests that responsiveness has two-sided affects that in responses which are too prompt and insistent could make the customer feel uncomfortable and perhaps ending up with no interaction and transaction.

• The Journal of Industrial Distribution & Business
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• v.14 no.8
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• pp.19-25
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• 2023

Using a procurement and construction stage emphasis on the capabilities of the Sub-Contractor (SC), the present research aims to discover the types of unfair activities between the Main Contractor (MC) and SC and their influence on project completion. This research also tries to figure out solutions which can reduce unfair activities between MC and SC. Research design, data and methodology: The qualitative textual analysis was selected for the current research and has been used by numerous previous researchers commonly to review relevant themes in the prior resources and suggested for researchers who conduct a reviewing procedure to analyze meta-analysis approach for figuring out better research findings from prior resources. Results: The result indicates the prevalence and consequences of bid shopping, emphasizing the need for transparency and fair bidding practices. Late payment issues were also found to be crucial for subcontractors' financial stability, urging the implementation of prompt payment legislation and agreements. Conclusions: In conclusion, the research revealed that subcontracting is common in construction projects, with general contractors relying on multiple subcontractors to carry out specific work items. The accomplishment of building projects hinges on the collaborative efforts between the main contractor (MC) and subcontractors (SCs), each focusing on different aspects of the project.

• Archives of Plastic Surgery
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• v.50 no.5
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• pp.496-500
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• 2023

Fournier's gangrene is a life-threatening infection which requires prompt recognition, early surgical debridement of unhealthy tissue, and initiation of broad-spectrum antibiotics. Relook debridement are usually performed until all the devitalized tissue has been removed. Involvement of the anal sphincter may result in significant morbidity such as permanent incontinence. Dynamic reconstruction of the anal sphincter has always been one of the holy grails in the field of pelvic reconstruction. We demonstrate a new method of camera shutter style double-opposing gracilis muscle flaps that allows dynamic sphincteric function without the need for electrostimulation. The bilateral gracilis muscles are inset in a fashion that allows orthograde contraction of the muscle to narrow and collapse the neoanal opening. With biofeedback training, the patient is able to regain dynamic continence and return to function without a stoma. There was also no need for neurotization or microsurgery techniques to restore sphincteric function to the anus. The patient was able to reverse his stoma 14 months after the initial insult and reconstruction with biofeedback training without the use of electrostimulation.

• Journal of Wellbeing Management and Applied Psychology
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• v.7 no.1
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• pp.51-65
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• 2024

Purpose: This study is to propose the establishment and direction of a public health-medical cooperation system for rehabilitation medical services for people with physical and brain disabilities in Gangneung, Korea. Research design, data and methodology: The study focused on 30 individuals with these disabilities registered. Data was collected from December 20, 2021, to December 31, 2021, through structured surveys administered by researchers visiting disability-related facilities, utilizing convenience and random sampling methods. Descriptive statistics and cross-analysis were applied for analysis. Results: Specifically, among respondents with physical disabilities, a total of 20 needs were identified, with 'Visiting health services' (25.0%) and 'Oral health services' (20.0%) ranking highest. The survey results regarding visit-based rehabilitation services for disability support showed a high demand, emphasizing the necessity of service provision tailored to the needs of recipients, focusing on disability prevention, health management, and motor function recovery, rather than solely medical or therapeutic concepts. Conclusions: Gangwon National University Hospital, as the regional referral hospital in Gangwon, should collaborate with Gangwon Province Rehabilitation Hospital to provide prompt acute rehabilitation services. Moreover, cooperation and collaboration with Gangneung Asan Hospital, the tertiary hospital in the region, are essential to ensure continued acute and recovery phase rehabilitation therapy for a certain period in the Gangneung area.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.1
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• pp.33-41
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• 2011

The objective of this study was to compare the shear bond strengths of five dentin adhesive systems cured with three different light curing sources. Seventy five noncarious permanent teeth were collected and stored in an 0.1% thymol solution at room temperature after extraction. The tested adhesives were: Adper Scotchbond Multi-purpose Plus Adhesive (SM) Adper Single bond 2 (SB), Clearfil SE Bond (SE), Adper Prompt L-Pop (PL), G-Bond (GB). And three light curing unit systems were used: Elipar Free light 2(LED), OptiLux 501 (Halogen), Flipo (PAC). For the shear bonding test, the labial and lingual surfaces of permanent teeth were used. To obtain a flat dentin surface, the labial and lingual surfaces of the teeth were sanded on SiO2 with number 600 grit and then divided into 15 groups of 10 surfaces each. All samples were theromocycled in water $5^{\circ}C$ and $55^{\circ}C$ for 1000 cycles. The results were as follows: 1. When cured with Freelight 2, the shear bond strength of SM was significantly higher than that of PL, GB (p<0.05), whereas no significant difference was found among those of any other bonding agents. 2. When cured with Optilux 501, the shear bond strength of SM was significantly higher than those of any other bonding agents (p<0.05), whereas no singnificant difference was found among those of andy other bonding agents. 3. When cured with Flipo, the shear bond strength of SM was significantly higher than those of SB, SE, GB (p<0.05), whereas no significant differences was found among those of any other bonding agents. 4. For comparison according to three different light cure unit system, except SB and GB, each three dentin bonding agents showed no significant difference. For SB, only Freelight 2 was significantly higher than the others, with no significant difference between Optilux 501 and Flip. For GB, Statistically significant difference was found only between Freelight and Flipo.

• Asian-Australasian Journal of Animal Sciences
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• v.29 no.2
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• pp.280-287
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• 2016

Foot and mouth disease (FMD) has a long history in Sri Lanka and was found to be endemic in various parts of the country and constitutes a constant threat to farmers. In Sri Lanka, currently there is no regular, nationwide vaccination programme devised to control FMD. Therefore, improving farmers' knowledge regarding distinguishing FMD from other diseases and ensuring prompt reporting of any suspicion of FMD as well as restricting movement of animals are critical activities for an effective FMD response effort. Therefore, the main purpose of this study was to clarify the relationship between farmers' knowledge levels and their behaviors to establish a strategy to control FMD. In our study, item count technique was applied to estimate the number of farmers that under-report and sell FMD-infected animals, although to do so is prohibited by law. The following findings were observed: about 63% of farmers have very poor knowledge of routes of FMD transmission; 'under-reporting' was found to be a sensitive behavior and nearly 23% of the farmers were reluctant to report FMD-infected animals; and 'selling FMD-infected animals' is a sensitive behavior among high-level knowledge group while it is a non-sensitive behavior among the low-level knowledge group. If farmers would understand the importance of prompt reporting, they may report any suspected cases of FMD to veterinary officials. However, even if farmers report honestly, they do not want to cull FMD-infected animals. Thus, education programs should be conducted not only on FMD introduction and transmission, but also its impact. Furthermore, consumers may criticize the farmers for culling their infected animals. Hence, not only farmers, but also consumers need to be educated on the economic impact of FMD and the importance of controlling an outbreak. If farmers have a high knowledge of FMD transmission, they consider selling FMD-infected animals as a sensitive behavior. Therefore, severe punishment should be levied for selling FMD-infected animals.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.4
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• pp.514-521
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• 2009

The aim of this study was to evaluate the bonding ability of two self etch systems to human primary and permanent enamel and the effect of additional acid etching time. Exfoliated, caries free human primary molar(n=65) and permanent molar extracted (n=65) were used. prepared enamel specimens were randomly divided into 2 test groups and a control group. The control group(n=10) were treated with 35% phosphoric acid gel and Scotchbond Multi-purpose adhesive. Experimental groups(self-etching systems) were subdivided into 6 groups(each n=10) according to additional etching time(0s, 5s, 10s, 15s, 20s, 30s). The result were as follows : 1) The shear bond strengths of the self-etching adhesives(Clearfil SE Bond, Adper Prompt L-pop) without additional etching were lower than control group(Scotch Bond Multipurpose). 2) Between the same self-etch adhesive groups, additional etched groups showed higher shear bond strength 3) There was no significant difference between primary and permanent enamel. In conclusion, bond strength of self-etch adhesives to enamel could be increased with additional etching.