South Korea in 2014

The Sewol ferry tragedy revealed weaknesses in South Korea’s politics, economy, and society that had been sidestepped during economic development and political transition. The split in local elections, the Saenuri Party’s sweep in by-elections, and the installation of critics of President Park as leaders of the ruling party all underscore the public’s rejection of political stonewalling or politicking-as-usual

Local politics for democratic quality and depth: Lessons from South Korea

National Research Foundation of Korea,Grant/Award Number:NRF‐2018S1A3A207553

Local government performance and democratic consolidation: Explaining ordinance proposal in Busan Metropolitan Council

This article assesses the role of local councils as a conduit for democratic consolidation through the examination of the legislative performance of the members of a South Korean metropolitan city council. We collected data on ordinance proposals in Busan Metropolitan Council from 2006 to 2018 (the 5th to 7th Councils) and analysed, first, the effects of individual attributes of local council members on legislative performance through negative binomial model analysis and, second, the effects of legislative networks on council members' performance. Three findings contribute to the literature: first, the number of proposed ordinances by council members increased over time, while those by the mayor decreased in the same period, suggesting an erosion of executive dominance of policymaking in local councils. Second, female and newly elected council members are most active in legislative proposals, which underlines that these members are more connected to the electorate than long-serving incumbents. Third, network analyses show increasingly diverse and multi-centred communities behind ordinance proposals; this suggests a move from personalistic politics to institutionalised politics.National Research Foundation of Korea, Grant/Award Number: NRF2018S1A5A2A03033767; Ministry of Education of the Republic of Kore

Reovirus exerts potent oncolytic effects in head and neck cancer cell lines that are independent of signalling in the EGFR pathway

Background: reovirus exploits aberrant signalling downstream of Ras to mediate tumor-specific oncolysis. Since ~90% squamous cell carcinomas of the head and neck (SCCHN) over-express EGFR and SCCHN cell lines are sensitive to oncolytic reovirus, we conducted a detailed analysis of the effects of reovirus in 15 head and neck cancer cell lines. Both pre- and post-entry events were studied in an attempt to define biomarkers predictive of sensitivity/resistance to reovirus. In particular, we analysed the role of EGFR/Ras signalling in determining virus-mediated cytotoxicity in SCCHN. Methods: to test whether EGFR pathway activity was predictive of increased sensitivity to reovirus, correlative analyses between reoviral IC50 by MTT assay and EGFR levels by western blot and FACS were conducted. Inhibition or stimulation of EGFR signalling were analysed for their effect on reoviral oncolysis by MTT assay, and viral growth by TCID50 assay. We next analysed the effects of inhibiting signalling downstream of Ras, by specific inhibitors of p38MAPK, PI3-K or MEK, on reoviral killing examined by MTT assay. The role of PKR in reoviral killing was also determined by blockade of PKR using 2-aminopurine and assaying for cell survival by MTT assay. The apoptotic response of SCCHN to reovirus was examined by western blot analysis of caspase 3 cleavage. Results: correlative analyses between reoviral sensitivity and EGFR levels revealed no association. Intermediate sub-viral and core particles showed the same infectivity/cytotoxicity as intact reovirus. Therefore, sensitivity was not determined by cell entry. In 4 cell lines, oncolysis and viral growth were both unaffected by inhibition or stimulation of EGFR signalling. Inhibition of signalling downstream of Ras did not abrogate reoviral oncolysis and, in addition, modulation of PKR using 2-aminopurine did not alter reovirus sensitivity in resistant cell lines. Caspase 3 cleavage was not detected in infected cells and oncolysis was observed in pan-caspase inhibited cells. Conclusions: in summary, reovirus is potently oncolytic in a broad panel of SCCHN cell lines. Attempts to define sensitivity/resistance by analysis of the EGFR/Ras/MAPK pathway have failed to provide a clear predictive biomarker of response. Further analysis of material from in vitro and clinical studies is ongoing in an attempt to shed further light on this issue

Imaging biomarker roadmap for cancer studies.

Imaging biomarkers (IBs) are integral to the routine management of patients with cancer. IBs used daily in oncology include clinical TNM stage, objective response and left ventricular ejection fraction. Other CT, MRI, PET and ultrasonography biomarkers are used extensively in cancer research and drug development. New IBs need to be established either as useful tools for testing research hypotheses in clinical trials and research studies, or as clinical decision-making tools for use in healthcare, by crossing 'translational gaps' through validation and qualification. Important differences exist between IBs and biospecimen-derived biomarkers and, therefore, the development of IBs requires a tailored 'roadmap'. Recognizing this need, Cancer Research UK (CRUK) and the European Organisation for Research and Treatment of Cancer (EORTC) assembled experts to review, debate and summarize the challenges of IB validation and qualification. This consensus group has produced 14 key recommendations for accelerating the clinical translation of IBs, which highlight the role of parallel (rather than sequential) tracks of technical (assay) validation, biological/clinical validation and assessment of cost-effectiveness; the need for IB standardization and accreditation systems; the need to continually revisit IB precision; an alternative framework for biological/clinical validation of IBs; and the essential requirements for multicentre studies to qualify IBs for clinical use.Development of this roadmap received support from Cancer Research UK and the Engineering and Physical Sciences Research Council (grant references A/15267, A/16463, A/16464, A/16465, A/16466 and A/18097), the EORTC Cancer Research Fund, and the Innovative Medicines Initiative Joint Undertaking (grant agreement number 115151), resources of which are composed of financial contribution from the European Union's Seventh Framework Programme (FP7/2007-2013) and European Federation of Pharmaceutical Industries and Associations (EFPIA) companies' in kind contribution

Significant benefits of AIP testing and clinical screening in familial isolated and young-onset pituitary tumors

Context Germline mutations in the aryl hydrocarbon receptor-interacting protein (AIP) gene are responsible for a subset of familial isolated pituitary adenoma (FIPA) cases and sporadic pituitary neuroendocrine tumors (PitNETs). Objective To compare prospectively diagnosed AIP mutation-positive (AIPmut) PitNET patients with clinically presenting patients and to compare the clinical characteristics of AIPmut and AIPneg PitNET patients. Design 12-year prospective, observational study. Participants & Setting We studied probands and family members of FIPA kindreds and sporadic patients with disease onset ≤18 years or macroadenomas with onset ≤30 years (n = 1477). This was a collaborative study conducted at referral centers for pituitary diseases. Interventions & Outcome AIP testing and clinical screening for pituitary disease. Comparison of characteristics of prospectively diagnosed (n = 22) vs clinically presenting AIPmut PitNET patients (n = 145), and AIPmut (n = 167) vs AIPneg PitNET patients (n = 1310). Results Prospectively diagnosed AIPmut PitNET patients had smaller lesions with less suprasellar extension or cavernous sinus invasion and required fewer treatments with fewer operations and no radiotherapy compared with clinically presenting cases; there were fewer cases with active disease and hypopituitarism at last follow-up. When comparing AIPmut and AIPneg cases, AIPmut patients were more often males, younger, more often had GH excess, pituitary apoplexy, suprasellar extension, and more patients required multimodal therapy, including radiotherapy. AIPmut patients (n = 136) with GH excess were taller than AIPneg counterparts (n = 650). Conclusions Prospectively diagnosed AIPmut patients show better outcomes than clinically presenting cases, demonstrating the benefits of genetic and clinical screening. AIP-related pituitary disease has a wide spectrum ranging from aggressively growing lesions to stable or indolent disease course

Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose: Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods: Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results: The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion: We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Government's Credible Accountability and Strategic Policy Capacity: Evidence from Asian NICs of Taiwan, South Korea, Malaysia, and Singapore

How does increasing government accountability to its citizens increase policy capacity? In this chapter, we build on the strategic interaction approach to provide a theoretical framework of government’s credible accountability that increases policy capacity. Importantly, the government’s credible accountability rests on its commitment to specific processes that embody transparency, accountability, and responsiveness that are independent of democratic progress. Drawing on evidence from East and Southeast Asia—specifically, South Korea, Taiwan, Singapore, and Malaysia—during the 1997–1998 Asian Financial Crisis, we show how each government’s demonstration or failure to demonstrate credible accountability affected its policy capacity. This chapter makes three contributions to the literature. First, it provides a theoretical framework for building policy capacity through the government’s credible accountability. This departs from prevailing economic-growth explanations of policy capacity in East and Southeast Asia. Second, this evidence maps citizens’ quiescence to government accountability rather than citizens’ passiveness or ignorance; thus, the model treats citizens as active and strategic. Third, the increased policy capacity reveals an overlooked process that increases government accountability without compromising the government’s policy reach or absorbing its resources

Non-electoral responsiveness mechanisms: Evidence from the Asian less democratic newly industrializing countries

Does the lack of competitive elections in the less democratic newly industrialized or industrializing countries (NICs) mean that their governments are unconstrained by their citizens' preferences for economic performance? In this article, I show how non-electoral mechanisms in the less democratic NICs of South Korea, Singapore and Malaysia constrain their governments. Governments pay attention to the effects of policies on economic performance because labour disquiet and disinvestment are likely to arise otherwise. To pre-empt labour disquiet and disinvestment, the governments offer 'credible apologies' that include punishment and monitoring of government when economic performance is less than optimal in these countries. When they fail to offer credible apologies, labour and producers respond with strikes and disinvestment. Governments' credible apologies play an important role in explaining labour quiescence and production investment. The argument and evidence contrasts with the general impression that governments in the less democratic NICs are constrained only by elites or are responsible only to themselves. The analysis shows that governments use bargaining mechanisms even where the citizens are perceived as meek and without bargaining strength