Earticle

본 연구에서는 표현활동을 교육무용(education through dance)관점에서 바라보고, 비교적 최신의 무용교육모형인 NDEO(National Dance Education Organization) Standards에 비추어 표현활동의 목표를 탐색하였다. NDEO Standards에서는 무용교육의 가치를 실현하기 위한 핵심(inner core) 과정으로 수행하기(performing), 창작하기(creating), 반응하기(responding), 연계하기(inter-connecting)를 제시하였으며 각 과정에서 성취해야 할 목표는 다음과 같다. 수행하기(performing)는 움직임 실행을 의미하는 것이며 학생들은 댄스요소와 움직임 기능을 적절히 활용하여 공연할 수 있어야 한다. 창작하기(creating)는 움직임을 탐구하고 창조하는 것을 의미하는 것이며 학생들은 움직임 구성에 있어서 발생되는 문제를 협력하여 해결하고 생각, 느낌, 이야기를 창작할 수 있어야 한다. 반응하기(responding)는 움직임에 대한 성찰을 표현하는 것을 의미하며 학생들은 언어 및 신체를 포함한 다양한 매체를 활용하여 적절히 표현할 수 있어야 한다. 연계하기(inter-connecting)는 교육, 문화, 삶의 제 영역을 춤과 관련지어 이해하고 학습하는 것을 의미하며 학생들은 의미, 아이디어, 경험을 다른 분야의 지식과 관련짓고 다양한 지식을 적용할 수 있어야 한다. NDEO Standards가 우리나라 체육과 교육과정 중 표현활동 영역에 시사하는 바는 3가지로 요약될 수 있으며, 표현활동 목표의 체계화, 성취기준의 세분화 및 목표차원의 통합교육 활성화가 그것이다. NDEO Standards에 근거하여 제시한 대안적인 표현활동의 목표와 성취기준은 향후 표현활동 교육과정 개정 및 수업 개선에 기여할 수 있을 것이다.

This study was to explore Physical Expression Activities' Objective in terms of the NDEO(National Dance Education Organization) Standards in Dance Education. In order to realize the unique value of dance, the NDEO Standards consist of 4 inner core experiences; "Performing", "Creating", "Responding", and Inter-connecting". Performing is the execution of dance movement. Students can execute original or existing artistic dance movement or a work of art, using elements and skills of dance. Creating means the exploration or invention of dance movement. Students can communicate solution to movement problems and choreograph dance movement based on ideas, feelings and stories. Responding is to express one’s reflection on the movements in the observation and performance. Response may be communicated ideas to others via other ways of expression verbally and kinesthetically. Inter-connecting is to understand in education, culture, and life in relevant to dance. Through this phrase, students can connect their meanings, ideas, experiences via dance with other areas of learning and apply to it. Performing, creating, and responding phrases are connected to inter-connecting. Students can relate and transfer meanings, ideas, and experiences from other disciplines and areas of knowledge to dance experiences. Inter-connecting is a phrase of the ultimates goals to understand dance in terms of cultural and historical contexts, and to expand knowledge, and to project onto the life. Therefore, to accomplish Inter-connecting, we should teach dance through the integrative model and understand dance education through holistic perspectives. The implications of NDEO Standards are the systemization of expressive activities’ objectives, the subdivision of achievement goals, and the vitalization of integrated education. This study will be contributed to make an alternative objective and achievement goals of physical expressive activities.

이 연구는 다문화 교육의 체계적인 실행을 위해 개발된 교수·학습 프로그램의 프로 토타입(prototype)을 목표(objective)와 다문화 교육의 내용, 교육방법을 중심으로 분 석하고 향후 프로그램 개발의 시사점을 모색하고자 하였다. 연구 결과 2014년~2016년 까지 3년 동안에 프로그램 개발이 가장 활발히 진행되었고 현재는 이보다 줄어 새로운 연구 동력이 필요한 시점이라고 판단하였다. 이를 위하여 주로 초등 고학년 대상, 사회 교육의 관점에서 진행해온 프로그램 개발에서 중등 학습자로 대상을 확대하고 국어교 육 관점의 프로그램 개발이 필요하다고 분석하였다. 또한, 국내 다문화 교육의 목표 (objective)와 내용이 ‘다양성 존중과 이해’에 초점이 맞추어 있음을 지적하였다. 이를 개선하기 위하여 다문화 교육이론을 국내 현실에 맞게 재개념화하고 이를 기반으로 학 습자가 다문화 교육의 궁극적 목적인 ‘사회정의’, ‘사회 실천’을 달성할 수 있는 프로그 램 개발 방향을 제시하였다.

This study analyzes the teaching/learning program prototype developed for the systematic implementation of multicultural education, focusing on multicultural education's objective, content, and teaching methods, and seeks implications for future program development. First, the research result shows that the multicultural teaching/learning program was the most actively developed during the three years from 2014 to 2016. It also indicates that a new motivation for research should emerge, for the development of those programs has currently decreased. Second, the program so far was developed primarily for upper elementary students based on social education. However, from now on, it is necessary to expand the program's target to secondary education learners and develop it from the perspective of Korean language education. Third, the objective and content of the current multicultural education in Korea tend to focus on 'respect and understanding of diversity.' This study suggests that the multicultural education theory should be reconceptualized to fit the situation in Korea. In addition, the program should be developed to enable learners to achieve 'social justice' and 'social practice,' which are the ultimate goals of multicultural education.

이 연구는 다문화 교육의 체계적인 실행을 위해 개발된 교수·학습 프로그램의 프로 토타입(prototype)을 목표(objective)와 다문화 교육의 내용, 교육방법을 중심으로 분 석하고 향후 프로그램 개발의 시사점을 모색하고자 하였다. 연구 결과 2014년~2016년 까지 3년 동안에 프로그램 개발이 가장 활발히 진행되었고 현재는 이보다 줄어 새로운 연구 동력이 필요한 시점이라고 판단하였다. 이를 위하여 주로 초등 고학년 대상, 사회 교육의 관점에서 진행해온 프로그램 개발에서 중등 학습자로 대상을 확대하고 국어교 육 관점의 프로그램 개발이 필요하다고 분석하였다. 또한, 국내 다문화 교육의 목표 (objective)와 내용이 ‘다양성 존중과 이해’에 초점이 맞추어 있음을 지적하였다. 이를 개선하기 위하여 다문화 교육이론을 국내 현실에 맞게 재개념화하고 이를 기반으로 학 습자가 다문화 교육의 궁극적 목적인 ‘사회정의’, ‘사회 실천’을 달성할 수 있는 프로그 램 개발 방향을 제시하였다.

This study analyzes the teaching/learning program prototype developed for the systematic implementation of multicultural education, focusing on multicultural education's objective, content, and teaching methods, and seeks implications for future program development. First, the research result shows that the multicultural teaching/learning program was the most actively developed during the three years from 2014 to 2016. It also indicates that a new motivation for research should emerge, for the development of those programs has currently decreased. Second, the program so far was developed primarily for upper elementary students based on social education. However, from now on, it is necessary to expand the program's target to secondary education learners and develop it from the perspective of Korean language education. Third, the objective and content of the current multicultural education in Korea tend to focus on 'respect and understanding of diversity.' This study suggests that the multicultural education theory should be reconceptualized to fit the situation in Korea. In addition, the program should be developed to enable learners to achieve 'social justice' and 'social practice,' which are the ultimate goals of multicultural education.

Task offloading in multi-access edge computing (MEC) systems is critical for managing computational tasks in dynamic urban environments. Existing strategies face challenges such as high communication overheads and regional performance deviations including centralized and distributed methods. Clustering approaches have been explored to address these issues, yet they often rely on physical proximity to form clusters, overlooking the variability in task rate distributions across edges. To overcome these limitations, this paper proposes a graph-driven inter-cluster resource distribution (GIRD) clustering scheme that clusters edge nodes based on task request distribution and computing resource status, ensuring similar resource utilization across clusters. Building on this, a proximal policy optimization (PPO)-enabled intra-cluster task offloading algorithm (PITO) is introduced to determine one execution server for task offloading?either an edge server within a cluster or a cloud server?using various network state information. This dynamic decision-making process optimizes a multi-objective function that includes task processing delay, consumed energy, success rate, and cloud cost. Simulation results demonstrate the proposed GIRD-PITO framework achieves superior task success rates, reduced delays, and improved regional performance fairness, making it a promising solution for large-scale MEC systems. 2018 The Korean Institute of Communications and Information Sciences. Publishing Services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Objective To determine whether patients with lumbosacral (LS) radiculopathy and peripheral polyneuropathy (PPNP) exhibit sudomotor abnormalities and whether SUDOSCAN (Impeto Medical, Paris, France) can complement nerve conduction study (NCS) and electromyography (EMG).Methods Outpatients with lower extremity dysesthesia underwent electrophysiologic studies and SUDOSCAN. They were classified as normal (group A), LS radiculopathy (group B), or PPNP (group C). Pain severity was measured by the Michigan Neuropathy Screening Instrument (MNSI) and visual analogue scale (VAS). Demographic features, electrochemical skin conductance (ESC) values on hands and feet, and SUDOSCAN-risk scores were analyzed.Results There were no statistical differences in MNSI and VAS among the three groups. Feet-ESC and hands-ESC values in group C were lower than group A and B. SUDOSCAN-risk score in group B and C was higher than group A. With a cut-off at 48 microSiemens of feet-ESC, PPNP was detected with 57.1% sensitivity and 94.2% specificity (area under the curve [AUC]=0.780; 95% confidence interval [CI], 0646?0.915). With a SUDOSCAN-risk score cut-off at 29%, NCS and EMG abnormalities related to LS radiculopathy and PPNP were detected with 64.1% sensitivity and 84.2% specificity (AUC=0.750; 95% CI, 0.674?0.886). Conclusion SUDOSCAN can discriminate outpatients with abnormal electrophysiological findings and sudomotor dysfunction. This technology may be a complementary tool to NCS and EMG in outpatients with lower extremity dysesthesia.

Objective To compare an objective assessment scale for “come-to-sit” in stroke patients with the previously established subjective assessment scales of “performance-based assessment” and the “ability for basic movement scale”. Method A specifically designed jacket was used to determine the objective degree of assistance needed for patients to perform the task. While patients were sitting up, the investigator evaluated the amount of assistance needed in a fully dependent state (A) and with maximal eff ort (B). Using this measure, we obtained an objective scale, {(A-B)/A} ×100. In addition, patients were tested in two starting positions: hemiplegic-side lying and soundside lying. We then compared the objective scale with subjective scales and other parameters related to functional outcomes. Results For both starting positions, the objective assessment scale showed high correlation with the previously established subjective scales (p<0.01). Only the hemiplegic-side lying-to-sit objective scale showed a signifi cant correlation with the parameters used to assess functional outcomes (p<0.05). In terms of Brunnstrom stages, only the leg stage showed a signifi cant correlation with the objective “come-to-sit” scale (p<0.01). Conclusion The objective scale was comparable to established subjective assessment scales when used by an expert. The hemiplegic-side lying-to-sit maneuver had a high correlation with patient’s functional recovery. Specifi cally, balance and lower extremity function appear to be important factors in the “come-to-sit” activity.

Establishing impact of a research paper is essential for academia, industry and research community alike. The attempts made in this direction are hitherto limited to some objective metrics, largely based on the citation count. The number of citations has always been used as a measure for ascertaining quality and popularity of research papers. Though, citations play an essential role in academic research, sometimes researchers may cite a paper to just point out its weaknesses and infirmities. A subjective look into the sentiments behind citations of a research paper aids in understanding the opinion of the peer research community for a paper. Objective measures such as citing author’s impact factor and the publication’s impact factor, may help to quantify the weightage of citations themselves and should also be included in the assessment of impact of a research paper. In this paper, we formulate a model that combines both the objective and subjective metrics and forms basis for an index to objectively convey the impact of a research paper.

Purpose: Patients with diabetes frequently need to perform certain numeric tasks such as interpreting blood glucose levels. However, there is no psychometrically sound instrument for objectively measuring diabetes-specific health numeracy. This study aimed to develop a new objective diabetes health numeracy test (DHNT) and evaluate its psychometric properties in adult patients with type 2 diabetes. Methods: An instrument development study was conducted. Initial items were evaluated by six experts for content validity. After a pilot test, a convenience sample of 257 participants with type 2 diabetes was recruited at 2 university hospitals from May to September 2018. The structural, convergent, and criteria validity, and internal consistency of the DHNT with binary item responses were evaluated. Data were analyzed using exploratory factor analysis, Rasch analysis, tetrachoric correlation, Spearman's correlation, and the KudereRichardson-20 formula. Results: Exploratory factor analysis yielded a single-factor solution comprising seven items. Rasch analysis confirmed that no item did not fit with the single factor and identified that the item difficulty parameters had moderate values. The convergent and criterion validity of the instrument were demonstrated, with diabetes knowledge and subjective diabetes numeracy, respectively, as was its acceptable internal consistency, by a KudereRichardson-20 coefficient of .81. Conclusion: The DHNT demonstrated satisfactory psychometric properties. The instrument with moderate levels of item difficulty may have a lower cognitive burden. The developed instrument can be applied in practice to tailor the education of diabetes self-management as per the levels of health numeracy of specific patients.

Two patients with stage three secondary lymphedema of the upper extremities underwent treatment for breast cancer, including surgery, chemotherapy, and radiotherapy. They were examined with computed tomography (CT) before and after extracorporeal shock wave therapy (ESWT). We used a manual tracing method using PiViewSTAR software to calculate the volume of the upper extremities. There was a decrease in the volume of the subcutaneous compartment measured by CT before and after ESWT. CT may be helpful in determining the treatment target area of ESWT and to monitor the effect of treatment by measuring the changes in volume before and after ESWT in patients with lymphedema. Therefore, CT may have good clinical potential for treatment and follow-up in the management of lymphedema.

In cloud computing systems the continuous increasing need for a variety of applications has made workload distribution and resource allocation more difficult. These difficulties lead to a high degree of imbalance and poor system performance. To address these issues, this study presented a high scalable Improved Multi-Objective Hybrid Load Balancing (IMH_LB) Algorithm. It combines the Grey Wolf Optimization (GWO) algorithm with the velocity driven approach of Particle Swarm Optimization (PSO) technique. The suggested method has been developed to optimize cloud computing environments by improving resource utilization with high scalability. The quality-of-service (QoS) parameters are comparatively analyzed in CloudSim by benchmarking the proposed algorithm against standard (GWO and PSO) algorithms and state of the art (Hybrid GWO-PSO and Improved Hybrid Genetic Algorithm-GWO) algorithms. The experimental findings show the superiority of the proposed approach with average improvements of 72.16% in average response time, 67.27% in makespan, 5.18 times in throughput, in 7.51 times in average resource utilization and 78.51% in degree of imbalance over the standard (GWO and PSO) and state of the art (HGWO-PSO and IHGA-GWO) methods. The proposed algorithm achieves high scalability while stabilizing at an average utilization of 89 % at significantly high workloads.

Objective To investigate whether motor evoked potential (MEP) amplitude ratio measurements are sufficiently objective to assess functional activities of the extremities. We also delineated the distribution between the presence or absence of MEPs and the Medical Research Council (MRC) scale for muscle strength of the extremities.Methods We enrolled 183 patients with first-ever unilateral hemiplegia after stroke. The MEP parameters were amplitude ratio (amplitude of affected side/amplitude of unaffected side) recorded at the first dorsal interosseous (FDI) and tibialis anterior (TA) muscles. We performed frequency analyses using the MRC scale for muscle strength and the presence or absence of evoked MEPs. Change on the MRC scale, hand function tests (HFTs), and the Modified Barthel Index (MBI) subscore were compared between the evoked MEP and absent MEP groups using the independent t-test. Receiver operating characteristic curves were used to determine the optimal cutoff scores for the MEP amplitude ratio using the HFT results and MBI subscores. Correlations between the MEP amplitude ratio and the MRC scale, HFTs, and MBI subscore were analyzed. Results About 10% of patients with MRC scale grades 0?2 showed evoked MEPs at the FDI muscle, and 4% of patients with MRC scale grades 3?5 did not show MEPs. About 18% of patients with MRC scale grades 0?2 showed evoked MEPs at the TA muscle, and 4% of patients with MRC scale grades 3?5 did not show MEPs. MEP amplitude increased with increasing MRC scale grade. The evoked MEP group had more significant changes on the MRC scale, HFT, and the climbing stair score on the MBI than those in the group without MEPs. Larger MEP amplitude ratios were observed in patients who had more difficulty with the HFTs and ambulation. The MEP amplitude ratio was significantly correlated with the MRC scale, HFT, and MBI subscore.Conclusion We conclude that the MEP amplitude ratio may be useful to predict functional status of the extremities in patients who suffered stroke.

Purpose: The purpose of this study was to assess the psychometric properties of the Dutch Objective Burden Inventory (DOBI) for the Turkish society. Methods: This is a descriptive, methodological study. The sample was composed of 230 heart failure patients' caregivers. Results: The DOBI was translated using translation and back-translation. The translated Turkish version was submitted to eight experts who analyzed it for its content validity. Scores from the experts were evaluated using the Kendall W analysis, and no statistically significant difference was found among the scores (Kendall W = .13, p = .338). In the confirmatory factor analysis, factor loading was found to be between 0.75 and 1.00 for all subscales. Thus, the DOBI demonstrated acceptable internal consistency (the components displayed a scores from .96 to .99), good test-retest reliability (no statistically significant differences were found, p > .050). Conclusions: The Turkish version of the DOBI scale is a valid and reliable tool for the Turkish population. It can be used in nursing practices and research.

Purpose: The purpose of this study was to assess insomnia and the quality of sleep, investigate the concordance between objective and self-report sleep patterns, and identify physiological, psychological, and situational factors influencing insomnia and sleep quality among firefighters. Methods: A descriptive, cross-sectional study was conducted with 103 firefighters in Korea. The collected data were analyzed using SPSS 23.0. Descriptive statistics, the independent t-test, and hierarchical logistic regression analysis were performed. Results: Insomnia was found in 66 (64.1 %) of the total subjects, and the average quality of sleep (PSQI) was 5.65 (SD=2.57). Total sleep time (401.00 minutes) and sleep latency (21.60 minutes) measured using self-reported scales were longer than the ones measured using objective measurements by approximately 48.70 and 17.10 minutes, respectively. Factors related to insomnia included the role as a paramedic (OR=4.28, 95% CI: 1.02~17.92), anxiety (OR=1.12, 95% CI: 1.01~1.24), and sedentary lifestyle (OR=0.85, 95% CI: 0.78~0.94), and factors related to sleep quality were physical illness status (OR=5.17, 95% CI: 1.53~17.51) and social support (OR=0.86, 95% CI: 0.78~0.95). Conclusion: The results show a high prevalence of insomnia, poor quality of sleep and the discrepancy between objective and subjective sleep patterns among firefighters. To promote sleep quality and health, early screening and treatment of anxiety and physical illness are required. It is necessary to conduct further studies examining the relationship between physical activity level and sleep.

도시 내에서 발생한 화재와 같은 재난은 도시 내 광범위한 지역에서 다수의 인명, 경제적 피해를 야기한다. 이러한 피해를 최소화하기 위하여 강화학습을 활용한 효과적인 재난 대응 팀의 배치 방안이 주로 연구되었으나, 기존 방안은 재난 대응팀의 관할 지역의 크기가 증가될 때 효과적인 재난 대응을 기대하기 어렵다. 따라서, 본 연구팀은 대규모의 재난 상황에서 기존 강화학습 기반 대응팀 배치 방식의 문제를 해결하기 위해 상충되는 목표들 간의 가중치를 조절하는 새로운 강화학습 기법과 각 대응 목표들의 정의를 화재 재난 상황을 기반으로 설계하고 제안한다.

본 논문에서는 수치심에 대한 하인즈 코헛의 이론을 한국인의 수치심 이해에 적용해 본다. 이를 위하여 하인즈 코헛의 자기 의식적(self-conscious) 감정으로서의 수치심 이론에 대한 기존의 연구들을 확장하여 한국인의 수치심 이해를 위한 코헛의 이론적 틀을 재검토 한다. 코헛은 자기 전체에 영향을 미치는 자기 의식적 감정으로서의 수치심에 주목하였으나 그러한 자기의식을 형성하게 하는 사회문화적 가치체계의 상이성에는 관심하지 않았다. 따라서 코헛은 자기의 발달구조 안에서 이상화 자기를 수치심과 관련시키지 않음으로서 자기 인식적 감정으로서의 수치심에 대하여 객체(object)로서의 자기의 역할은 상정하지 않았다. 본고에서는 한국인의 수치심 이해를 위하여 코헛의 수치심 이론 안에서 자기의식에 대한 확장이 필요함을 강조한다. 이를 위해서 코헛의 수치심 이론에 대한 브루첵(Francis J. Broucek)의 자기의식 개념의 확장이 제시되며, 이러한 확장을 통해 객체적 자기 인식(objective self-awareness) 안에서 한국인의 수치심 이해를 제안한다. 브루첵의 객체적 자기인식의 개념은 코헛의 수치심 이론에 보다 포괄적인 자기의 이해를 제안함으로서 주체와 객체로서의 자기의 역할을 통해서 수치심을 경험하는 자기의식의 구조를 새롭게 해준다. 객체적 자기인식 안에서의 수치심 이해는 특별히 한국문화의 “체면” 속에서 자기 의식적 감정으로서 한국인이 경험하는 수치심을 잘 설명할 수 있는 이론적 틀이 된다. 한국인의 수치심 경험 안에서의 한국인의 객체적 자기인식에 대한 공감적 이해와 한국인의 체면유지를 위한 방어적 노력에 대한 공감적으로 이해는 수치심의 돌봄과 치유를 위하여 한국인의 자기가 필요로 하는 자기대상 기능의 문화적 요청이라 할 수 있다.

The purpose of this study is to reconsider Heinz Kohut's frameworks on shame as a self-conscious emotion for an understanding of the Korean experience of shame. Kohut's psychoanalytic theory of the self provides excellent formulations for an understanding of the phenomena of self-consciousness in shame, which emphasizes the whole self in relation to shame in the narcissistic development of the self. However, he does not focus on the self as the object in shame as he emphasizes the concept of the self as a supraordinate agency, i.e., an independent center of initiative, which is subjectively experienced, on the basis of western cultural assumptions. For an exploration of the Korean experience of shame as a self-conscious emotion on the basis of Kohut's frameworks, the conceptualization of self-consciousness needs to be elaborated and expanded. Francis J. Broucek's extension of Kohut's formulations with regard to objective self-awareness yields a basic tool to analyze the Korean experience of shame. It is a notion that allows for the Korean experience of shame after objective self-awareness, an experience that depends on objectifying the Korean self largely according to social standards, ideals, or goals in the Korean culture. The Korean experience of shame involves an extended sense of self-consciousness, i.e., objective self-awareness, in interpersonal relationships, in which the self becomes both subject and object, particularly in terms of the Korean structure of chemyeon; loss of chemyeon is inherent in shame.

마사지 치료는 1회 치료만으로 통증을 경감시키고 스트레스를 이완시킵니다. 그러나 아직까지 1회 마사지 치료의 효과에 대한 객관적인 데이터를 확인한 연구가 없었습니다. 그래서 본 연구에서는 마사지 치료와 동일한 효과가 있는 것으로 보고된 척추 마사지 기구로 1회 치료를 실시하여 통증 경감과 스트레스 이완의 효과의 증거를 확인하고자 하였습니다. 10년 전부터 시각적상사척도 4점의 요통이 있었던 45세 남자 환자 1인을 대상으로 척추 마사지 기구를 실시한 1차 실험과 침상안 정을 실시한 2차 실험을 실시하였습니다. 시각적상사척도 측정과 실시간으로 심박 변이도를 측정하여 자율신경계를 확인하 였고 총 5회 혈액검사를 실시하여 스트레스 관련 혈액검사(코르티솔, 에피네프린, 노르에피네프린)를 실시하였습니다. 침상 안정을 취한 2차 실험에 비해 척추 마사지 기구로 1회 치료를 받은 1차 실험에서 유의미한 통증 감소효과를 보였습니다. 또 한 1차 실험에서 자율신경계 활성도 및 부교감 신경계의 활성도가 증가되어 있었으며 혈중 에피네프린과 노르에피네프린이 감소되어 있었습니다. 이것은 기존의 마사지 치료 효과와 동일한 결과이며 1회 척추 마사지 기구를 통해 얻어지는 효과의 증 거라 사료됩니다.

Individuals often report significant relief from pain and stress even after a single session of massage therapy; however, no previous studies have provided objective evidence supporting the effectiveness of a solitary massage therapy session. In the present study, we aimed to investigate the effectiveness of one-time treatment with a spinal thermal massage device reported to exert the same therapeutic effects as massage therapy in terms of pain reduction and stress relief. A man with chronic low back pain (LBP) underwent two rounds of experiments involving spinal massage treatment and bed rest, respectively. Pain was assessed using a visual analog scale, and heart rate variability (HRV) was measured in real-time to examine autonomic nervous system (ANS) activity. Blood samples were obtained at five points during each round of the experiment to examine changes in cortisol, epinephrine, and norepinephrine. Spinal massage significantly reduced pain and enhanced parasympathetic activity when compared with the bed rest condition. In addition, both epinephrine and norepinephrine levels were lower following spinal massage than following bed rest. These results are consistent with the reported effects of conventional massage therapy and support the effectiveness of one-time treatment using a spinal thermal massage device.

The purpose of this study was to examine the level of objective control skill and performance criteria of students with intellectual disability at special school. Three hundred thirty one students with intellectual dis-ability were participated this study (M: 230, F: 101). Their aged was from 10-18 aged old. We had the test the objective control skill by video, ob-jective control skill consisted of overhand throwing, catching, kicking, hitting, dribbling. Data were analyzed using liner regression and calcu-lated mean, standard error, standard deviation and 95% confidence in-terval. Total objective control skill mastery was 47%, and hitting skill score was the highest than another subtest, the lowest performance skill was overhand throwing. There were showed that not significant difference object control skill in according to gender. Also not effect ob-ject control skill and subtest in according to age except dribbling. It was showed that significant effect objective control skill in according to dis-ability level.

Background: Rare digestive system cancers, including cholangiocarcinoma and other low-incidence malignancies, have limited treatment options and often harbor alterations in the RAS–RAF–MEK–ERK pathway. MEK inhibitors have shown preclinical activity, but clinical efficacy remains unclear. This systematic review and meta-analysis evaluated the therapeutic impact of MEK inhibitors in rare digestive cancers. Methods: Following PRISMA guidelines, MEDLINE, Cochrane Library, and ClinicalTrials. gov were searched for randomized phase II or III trials investigating MEK inhibitors in rare cancers. Data extraction and riskof- bias assessment were performed independently by two reviewers. Pooled odds ratios (OR) were calculated using randomor fixed-effects models depending on heterogeneity. Results: Total of 522 records screened, four phase II trials (n=210) met inclusion criteria, evaluating selumetinib, trametinib, and cobimetinib. MEK inhibitor therapy did not improve ORR compared with control (OR 0.93; 95% CI 0.35-2.48; I2=0%). No complete responses were reported. Most studies demonstrated high performance and detection bias due to open-label design, and overall certainty of evidence was rated low. Conclusions: MEK inhibitors showed limited clinical activity in rare digestive system cancers and the current evidence remains insufficient to confirm their efficacy as either monotherapy or in combination therapy. Future trials should incorporate biomarker-selected populations and rational combination strategies to overcome pathway resistance.

This study investigates the contribution of customer knowledge to customer intention to adopt mobile banking by evaluating the interaction among knowledge, perceived risk and trust, and behavioral intentions. Analysis is conducted through structural equation modelling using SPSS and AMOS and data from 783 customers representing the seven largest banks in Vietnam. Our study is the first one to find the existence of the bidirectional perspective between objective and subjective knowledge. The study further shows that the attenuation effect in the heuristic-systematic model could be used to explain the stronger influence of objective knowledge on intention compered to subjective knowledge. Our findings suggest that customer knowledge, perceived risk and trust impact the intention of mobile banking users in different manners and to different degrees. Particularly, objective customer knowledge is the most influential predictor of mobile banking adoption. Having a greater understanding of these relationships can help firms in deciding the kind of intervention that is most likely to convince customers to adopt a service.