The validity of ICD-11 PTSD and complex PTSD in North Korean defectors using the International Trauma Questionnaire.

Background: The International Trauma Questionnaire (ITQ) is a self-report assessment focused on the core features of Post-Traumatic Stress Disorder (PTSD) and complex Post-Traumatic Stress Disorder (CPTSD). It is consistent with the organizing principles of the 11th revision to the WHO's International Classification of Diseases (ICD-11). Since the 1990s, the number of North Korean defectors (NKD) entering South Korea to escape human rights violations has been increasing rapidly, with 33,815 NKD settled by 2021. The South Korean government faces an important challenge in supporting NKD to successfully adapt and settle in South Korean society. NKD experience various traumatic events during the process of defecting and repatriation. Therefore, it is essential to understand the psychological disorders of NKD, especially PTSD and CPTSD. Objective: This study aimed to test the validity of the ITQ assessment and explore the differences in symptoms and quality of life between PTSD and CPTSD. Method: The study sample comprised 503 trauma-exposed NKD. Confirmatory factor analysis (CFA) and latent class analysis (LCA) were used to evaluate the validity of ITQ. One-way analysis of variances and post-hoc analyses revealed the difference in the Depression and Somatic Symptoms Scale (DSSS) and WHOQOL-BREF results among PTSD and CPTSD symptom LCA classes. Results: The CFA and LCA results supported the ICD-11 conceptualization of PTSD and CPTSD in NKD. The CFA results confirmed that both the first- and second-order models were statistically fit, but for community-dwelling NKD the first-order model had better model fit than the second-order model. The LCA findings revealed a four-class model with 'PTSD', 'CPTSD', 'DSO', and 'low symptom' classes. Compared to the PTSD class, CPTSD class had higher levels of depression and somatic symptoms and a lower quality of life. Conclusion: This study provided evidence that ITQ is a valid tool to assess PTSD or CPTSD in community-dwelling NKD.

Antecedentes: El Cuestionario Internacional de Trauma (ITQ en su sigla en inglés) es una evaluación de autoreporte focalizado en las características principales del Trastorno de Estrés Postraumático (TEPT) y del Trastorno de Estrés Postraumático complejo (TEPT-C). Es consistente con los principios organizadores de la onceava revisión de la Clasificación International de las Enfermedades (CIE-11) de la OMS. Desde 1990, ha aumentado rápidamente el número de desertores de Corea del Norte (NKD en su sigla en inglés) que han entrado a Corea del Sur para escapar de las violaciones a los derechos humanos, con 33,815 NKD instalados hasta 2021. El gobierno de Corea del Sur enfrenta un desafío importante en apoyar a los NKD para adaptarse e instalarse en la sociedad de Corea del Sur. Los NKD experimentan varios eventos traumáticos durante el proceso de deserción y repatriación. Por lo tanto, es esencial entender los trastornos psicológicos de NKD, especialmente TEPT y TEPT-C.Objetivo: Este estudio busca evaluar la validez de la evaluación ITQ y explorar las diferencias en los síntomas y la calidad de vida entre TEPT y TEPT-C.Método: La muestra del estudio estuvo compuesta de 503 NKD expuesto a trauma. Se usaron el análisis factorial confirmatorio (CFA en su sigla en inglés) y análisis de clases latentes (LCA en su sigla en inglés) para evaluar la validez de ITQ. Los análisis de una vía de las varianzas y los análisis post-hoc revelaron la diferencia en los resultados de la Escala de los Síntomas somáticos y Depresión (DSSS en su sigla en inglés) y WHOQOL-BREF entre los síntomas TEPT y TEPT-C de las clases de los LCA.Resultados: Los resultados de CFA y LCA apoyan la conceptualización del TEPT y TEPT-C de la CIE-11 en NKD. Los resultados del CFA confirmaron que tanto los modelos de primer y de segundo orden fueron estadísticamente adecuados, pero para los NKD viviendo en residencias comunitarias, el modelo de primer orden tuvo un mejor ajuste que el modelo de segundo orden. Los hallazgos del LCA revelaron un modelo de cuatro clases con las clases 'TEPT', 'TEPT-C', 'DSO', y 'baja sintomatología'. En comparación con la clase TEPT, la clase TEPT-C tuvo niveles más altos de síntomas somáticos y depresión y una calidad de vida más baja.Conclusión: Este estudio proporciona evidencia que el ITQ es una herramienta válida para evaluar TEPT o TEPT-C en NKD viviendo en residencias comunitarias.

Bioactive Compounds and Quality Evaluation of Red-Pigmented Rice Processed by Germination and Roasting.

Red-pigmented rice was germinated and processed to develop germinated red rice tea, and the changes in physicochemical, bioactive, and microbial properties due to germination and roasting were investigated. The moisture and crude ash contents of red rice decreased after germination and roasting. Crude protein and crude fat contents increased after germination but slightly decreased after roasting. Total phenolics, flavonoids, and antioxidant activities (DPPH and ABTS radical scavenging activities) increased following germination and heat treatment. However, the increased levels of γ-amino butyric acid after germination significantly decreased during the subsequent roasting step. In addition, total bacteria, yeast, and mold counts increased during the germination process but decreased after heat treatment as compared to those in the original grain; Escherichia coli was not detected. Therefore, germination and subsequent roasting could effectively enhance the contents of the most bioactive compounds and maintain microbial stability in red-pigmented rice.

Clinical Course of Dysphagia in Patients with Nemaline Myopathy.

Nemaline myopathy (NM) is a rare congenital myopathy, a group of disorders that are clinically and genetically heterogeneous. Infants and children with NM often suffer from recurrent pulmonary infections and swallowing difficulty, leading to malnutrition. However, knowledge about the clinical course and prognosis of dysphagia is limited. In this study, we reported the clinical course of two NM patients suffering from dysphagia. Although tube feeding was required for several months after birth, it was eventually possible to obtain sufficient nutrition with an oral diet. Therefore, dysphagia rehabilitation therapy through a series of evaluations should be considered even in children with severe oral motor dysfunction. Through these cases, physicians should be convinced that the symptoms of dysphagia in children with NM can be improved and be able to encourage their parents by explaining this progress. They have the potential to show improvements in swallowing function and will finally be able to take food slowly but fully orally.

Preservation of Cerebellar Afferent Pathway May Be Related to Good Hand Function in Patients with Stroke.

Many chronic stroke patients suffer from worsened hand function, and functional recovery of the hand does not occur well after six months of stroke. Therefore, predicting final hand function after stroke through acute phase imaging would be an important issue in counseling with the patients or their family. Thus, we investigated the remaining white matter integrity in the corticospinal tract (CST) and cortico-ponto-cerebellar tract (CPCT) at the acute stage of stroke and chronic hand function after stroke, and present the cut-off value of fiber number (FN) and fractional anisotropy (FA) of CST and CPCT at the acute stage for predicting final hand function after the recovery period. This retrospective case-control study included 18 stroke patients who were classified into two groups: poor hand function with stroke (n = 11) and good hand function with stroke (n = 7). DTI was done within two months ± 15 days after onset, and the Jebson's Hand Function test was conducted 6-12 months after onset. The investigation of white matter was focused on the values of FN and FA for CST and CPCT, which were measured separately. The normalized (affected/non-affected) FA and FN values in the CPCT in the good hand function group were higher than those in the poor hand function group. The normalized FN and FA values in the CST were not significantly different between the poor hand function group and the good hand function group. The normalized cut-off value that distinguished the good hand function group from the poor hand function group was 0.8889 for FA in the CPCT. The integrity of the CPCT in the acute stage was associated with hand function in the chronic stage after a stroke. Ultimately, the integrity of the CPCT in the early stage after onset can be used to predict chronic hand function. Based on these results, cerebellar afferent fiber measurements may be a useful addition to predict hand function and plan specific rehabilitation strategies in stroke patients.

Assessment of biochemical compounds and antioxidant enzyme activity in barley and wheatgrass under water-deficit condition.

Wheatgrass and barley grass are freshly sprouted leaves of wheat and barley seeds and are rich sources of phytochemicals. This study was conducted to investigate the effects of drought stress on the biochemical compounds and antioxidant activities of barley grass and wheatgrass extracts. The grass was cultivated in an organic soil growing medium with different levels of drought stress (a control with 100% water holding capacity (WHC), mild drought stress with 75% WHC, moderate drought stress with 50% WHC, and severe drought stress with 25% WHC) in a growth chamber by controlling temperature (20/15 °C, day/night), light (12/12 h, light/dark; intensity 150 µmol m-2  s-1 with quantum dot light-emitting diodes), and relative humidity (60%) for 7 days. The drought stress showed increased levels of biochemical compounds, especially phenolics, flavonoids, and vitamin C, in both barley grass and wheatgrass extracts. The wheatgrass extracts showed 1.38-1.67 times higher phenolics, flavonoids, and vitamin C contents than the barley grass extracts did. The antioxidant (2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid), 2,2-diphenyl-1-picrylhydrazyl radical-scavenging activity, and nitrite-scavenging activity) and antioxidant enzymes (guaiacol peroxidase, catalase, and glutathione reductase) were the highest under severe drought stress in both barley grass and wheatgrass extracts; and the wheatgrass extracts showed 1.20-5.70 times higher antioxidant enzyme activities than the barley grass extracts did. Proper drought-stress treatment of barley grass and wheatgrass may be a convenient and efficient method to increase biochemical compounds and antioxidants in our diet to exploit the related health benefits. © 2021 Society of Chemical Industry.

Effects of Age on Long-Term Functional Recovery in Patients with Stroke.

Background and objectives: Age might be a determinant that limits functional recovery in patients with stroke. Here, we investigated the effect of age on functional recovery within 30 months after stroke onset. Materials and Methods: This retrospective longitudinal study enrolled 111 patients with first-ever stroke. Functional recovery was assessed at 2 weeks and at 1, 6, and 30 months after stroke onset using the modified Barthel Index (MBI), modified Rankin Score (mRS), functional ambulation category (FAC), muscle strength, and Mini-Mental State Examination (MMSE). A generalized estimating equation analysis was performed. Results: With the MBI, function improved until 6 months after stroke onset in patients aged <70 years and until 1 month after stroke onset in patients ≥70 years. At 30 months after stroke, there was no significant change of MBI in patients aged <70 years, whereas there was a significant decline in older patients. With the mRS and FAC, function improved until 30 months after stroke onset in patients aged <70 years and until 1 month after stroke onset in older patients. Motor deficit, assessed using the Medical Research Council (MRC), improved significantly until 6 months after stroke onset in patients aged <70 years. There was a significant improvement in cognition (assessed using the MMSE) until 6 months after stroke onset in patients aged <70 years and until 1 month after stroke onset in older patients. Conclusions: Long-term functional recovery occurred for up to 30 months after stroke. Patients aged ≥70 years showed functional decline between 6 and 30 months after onset. These findings could be useful when measuring functional recovery after stroke.

National Health Priorities under the Kim Jong Un regime in Democratic People's Republic of Korea (DPRK), 2012-2018.

The National Health Priorities (NHP) 2016-2020 is the healthcare policy which was most recently announced to the international community by the Democratic People's Republic of Korea (DPRK). However, understanding DPRK's internal and practical perspectives and priorities in the healthcare sector is difficult. Hence, there is a need to analyse domestic documents. One such document is the Sa-seol-a kind of editorial in the first issue of the each quarterly medical journal published in DPRK. We analyse the content of 56 Sa-seol published in eight medical journals during the Kim Jong Un regime (2012-2018), and then classified them in terms of their relevance to each of 12 items presented in NHP 2016-2020. Sa-seol mentioned a total of 612 medical and health issues which could be classified into 12 items based on NHP 2016-2020. We divided the items into three categories of concern in the NHP by summarising the total number of mentions: the areas of the most, medium and least concern. The areas of most concern (development of medical science and technology) are not directly related to the present improvement of health and rather, seem to focus on more future development. The areas of medium concern focused on disease control, health systems and social determinants of health. The areas of the least concern were emergency or disaster response and reproductive health services. This study suggests a two-track approach for healthcare cooperation with DPRK:, a well-balanced approach between 'present' and 'future' needs.

Different isoforms of apolipoprotein AI present heterologous post-translational expression in HIV infected patients.

Human immunodeficiency virus (HIV) is rapidly becoming a global health concern. Proteomics technology was employed to examine HIV infected plasma samples in an attempt to identify disease-associated proteins. By comparison with normal and HIV positive plasma samples, at least eight proteins were significantly changed in HIV infected plasma. In particular, apolipoprotein AI presents a heterogeneous change in expression level with different isoforms. Apolipoprotein AI could be a useful biomarker for HIV diagnosis.