İnme Sonrası Üst Motor Nöron Dizartrisi Alt Tiplerinde Diadokokinetik Hız Ölçümleri

Süleyman Kocaoğlu; Elçin Tadıhan Özkan

doi:10.58563/dkyad.1906583.2026.2.3

EN TR

Diadochokinetic Rates in Post-Stroke Upper Motor Neuron Dysarthria Subtypes

Abstract

Purpose: The aim of this study was to objectively evaluate speech motor performance using diadochokinetic (DDK) rate measurements across different post-stroke upper motor neuron dysarthria subtypes (Spastic Dysarthria [SD], Unilateral Upper Motor Neuron Dysarthria [UUMND]: right and left) and in healthy older adults. The effects of lesion lateralization on speech motor control were investigated using Alternating Motion Rate (AMR) and Sequential Motion Rate (SMR) tasks. Method: This cross-sectional comparative study included 32 healthy adults aged 65–85 years and 32 individuals with dysarthria at 1 to 12 months post-stroke. The dysarthric group was categorized into SD (n=10), right UUMND (n=10), and left UUMND (n=12). AMR (/pʌ/, /tʌ/, /kʌ/) and SMR (/pʌtʌkʌ/) recordings were analyzed using Praat software. Syllable rates per second were calculated and compared across groups. Results: The dysarthria group exhibited significantly slower DDK rates across all tasks compared with the healthy group. Among the dysarthria subtypes, the right UUMND group exhibited significantly faster DDK rates than the SD and left UUMND groups in the bilabial /pʌ/ task and the sequential /pʌtʌkʌ/ task. No significant differences were observed between the SD and left UUMND groups in these tasks. Additionally, no significant differences were detected among the dysarthria subtypes in the /tʌ/ and /kʌ/ tasks, which primarily require lingual articulation. Conclusion: DDK rate measurements objectively indicate motor speech slowing in post-stroke dysarthria. These asymmetric patterns are consistent with the proposed dominant role of the left hemisphere in speech motor planning. Furthermore, the absence of subtype differentiation in lingual tasks (/tʌ/, /kʌ/) suggests that tongue muscles may be similarly affected by upper motor neuron lesions regardless of lesion laterality.

Keywords

stroke, dysarthria, diadochokinetic rate, alternating motion rate, sequential motion rate, unilateral upper motor neuron dysarthria, spastic dysarthria

Supporting Institution

This study did not receive any specific funding from public, commercial, or not-for-profit organizations.

Ethical Statement

The study was approved by the Anadolu University Health Sciences Scientific Research and Publication Ethics Committee (June 25, 2020; protocol no: 35744). Permission for data collection was obtained from DİLKOM, and written informed consent was obtained from all participants.

Thanks

This article is derived from the master's thesis titled "Türkçe Konuşan Sağlıklı Yetişkin Bireylerde Diadokokinetik Hız Normatif Değerlerinin Belirlenmesi ve Dizartrik Bireylerle Karşılaştırılması," completed by the first author under the supervision of the second author at Anadolu University, Graduate School of Health Sciences, Department of Speech and Language Therapy (2021). The authors thank all participants who took part in the study.

İnme Sonrası Üst Motor Nöron Dizartrisi Alt Tiplerinde Diadokokinetik Hız Ölçümleri

Abstract

Amaç: İnme sonrası dönemde en sık karşılaşılan konuşma bozukluğu dizartridir (Flowers vd., 2013). Klinik tabloda en yaygın görülen alt tipler ise Unilateral Üst Motor Nöron Dizartrisi (UUMND) ve Spastik Dizartridir (SD) (Duffy, 2007). Artikülasyon bozukluklarının objektif biçimde tespit edilebilmesi için Diadokokinetik (DDK) hız ölçümleri gibi konuşma mekanizmasını zorlayan maksimum performans görevlerine klinik bir ihtiyaç duyulmaktadır (Ziegler, 2002). Bu çalışmanın amacı; sağlıklı yaşlı bireyler ile inme sonrası gelişen farklı dizartri alt tiplerine (SD, Sağ UUMND ve Sol UUMND) sahip hastaların DDK hızlarını nesnel olarak karşılaştırmak ve lezyon lateralizasyonunun konuşma motor kontrolü üzerindeki etkilerini incelemektir. Yöntem: Kesitsel ve karşılaştırmalı desende tasarlanan bu çalışmaya, yaşları 65-85 arasında değişen 32 sağlıklı yetişkin ile inmelerinin üzerinden 3-12 ay geçmiş 32 dizartrik birey dâhil edilmiştir. Olası kognitif yıkım ve demans şüphesini dışlamak amacıyla, katılımcıların SMMSE puanlarının 18 ve üzeri olmasına dikkat edilmiştir. Dizartri varlığı Algısal Değerlendirme Protokolü ile doğrulanmış; ardından dizartrik katılımcılar beyin görüntüleme raporları doğrultusunda SD (n=10), sağ UUMND (n=10) ve sol UUMND (n=12) alt gruplarına ayrılmıştır. Katılımcılardan 30 dB(A) altındaki sessiz bir ortamda Alternatif Hareket Hızı (AMR: /pʌ/, /tʌ/, /kʌ/) ve Ardışık Hareket Hızı (SMR: /pʌtʌkʌ/) görevlerine ait ses kayıtları alınmıştır. Elde edilen veriler Praat yazılımı kullanılarak akustik olarak analiz edilmiş, ölçümler "time-by-count" yöntemiyle hesaplanarak saniye başına düşen hece hızına (hece/sn) dönüştürülmüştür. İstatistiksel analizlerde t-testi, Kruskal-Wallis H ve Dunn-Bonferroni testlerinden yararlanılmıştır. Bulgular: Dizartrik bireylerin hem AMR hem de SMR görevlerinde sağlıklı kontrol grubuna kıyasla istatistiksel olarak anlamlı düzeyde daha yavaş üretim hızlarına (hece/sn) sahip olduğu görülmüştür (p < .001). Sağlıklı ve dizartrik gruplar arasındaki ortalama hız farkları sırasıyla; /pʌ/ için 3.78, /tʌ/ için 4.00, /kʌ/ için 3.67 ve /pʌtʌkʌ/ için 4.61 hece/sn olarak bulunmuştur. Dizartri alt tipleri arası karşılaştırmalarda ise yalnızca bilabial AMR (/pʌ/) (p = .008) ve ardışık SMR (/pʌtʌkʌ/) (p = .005) görevlerinde gruplar arası anlamlı farklılıklar saptanmıştır. Post-hoc analiz sonuçlarına göre sağ UUMND grubu; bilabial /pʌ/ görevinde SD (p = .032) ve sol UUMND (p = .014) gruplarından, ardışık SMR (/pʌtʌkʌ/) görevinde ise yine SD (p = .012) ve sol UUMND (p = .007) gruplarından anlamlı derecede daha hızlı performans sergilemiştir. Belirtilen bu iki görevde SD ile sol UUMND arasında ise anlamlı bir fark bulunamamıştır (p = 1.00). Alveolar (/tʌ/) ve velar (/kʌ/) üretim ölçümlerinde ise alt tipler arasında istatistiksel olarak anlamlı bir ayrışma gözlenmemiştir. Tartışma: Bulgularımız, inme sonrası dizartrik vakalarda belirgin bir DDK yavaşlaması olduğunu bildiren mevcut literatürle paralellik göstermektedir. Sağ UUMND hastalarının /pʌ/ ve /pʌtʌkʌ/ sekanslarında daha hızlı üretim yapabilmesi; buna karşın sol UUMND hastalarının bilateral hasarlı SD hastaları kadar yavaş kalması, lezyon lateralizasyonunun konuşma motor kontrolü üzerindeki asimetrik etkilerine işaret etmektedir (Urban vd., 2006). Bu bulgu, sol hemisferin konuşmanın ardışık motor planlamasındaki dominant rolünü güçlü bir biçimde desteklemektedir. Alveolar ve velar üretimlerde alt tipler arası fark görülmemesi ise, dil hareketlerini kapsayan geniş kas gruplarının lezyon lateralitesinden bağımsız olarak ortak bir nöromotor bozulmayla etkilendiğini düşündürmektedir. Sonuç: DDK hız ölçümleri, inme sonrası gelişen dizartri alt tiplerindeki konuşma yavaşlamasını nicel olarak ayırt edebilen son derece duyarlı bir klinik araçtır. Özellikle /pʌ/ ve /pʌtʌkʌ/ görevlerinde saptanan sağ-sol hemisfer asimetrisi, sol hemisferin ardışık motor planlama üzerindeki baskın rolünü açıkça pekiştirmektedir. Gelecekte, elde edilen bu akustik verilerin nörogörüntüleme teknikleriyle desteklendiği ve daha geniş örneklem gruplarıyla yürütülen kapsamlı klinik çalışmalara ihtiyaç vardır.

Keywords

inme, dizartri, diadokokinetik hız, alternatif hareket hızı, ardışık hareket hızı, unilateral üst motor nöron dizartrisi, spastik dizartri

Supporting Institution

Bu araştırma, kamu, ticari veya kâr amacı gütmeyen kuruluşlardan herhangi bir özel fon desteği almamıştır.

Ethical Statement

Çalışma, Anadolu Üniversitesi Sağlık Bilimleri Bilimsel Araştırma ve Yayın Etiği Kurulu tarafından onaylanmıştır (25.06.2020; protokol no: 35744). Veri toplama izni DİLKOM’dan alınmış olup, tüm katılımcılardan yazılı bilgilendirilmiş onam alınmıştır

Thanks

Bu makale, birinci yazarın ikinci yazar danışmanlığında Anadolu Üniversitesi Sağlık Bilimleri Enstitüsü Dil ve Konuşma Terapisi Anabilim Dalı'nda tamamladığı "Türkçe Konuşan Sağlıklı Yetişkin Bireylerde Diadokokinetik Hız Normatif Değerlerinin Belirlenmesi ve Dizartrik Bireylerle Karşılaştırılması" başlıklı yüksek lisans tezinden (2021) üretilmiştir. Yazarlar, çalışmaya katılan tüm katılımcılara teşekkür eder.

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Details

Primary Language

Turkish

Subjects

Speech Pathology

Journal Section

Research Article

Authors

Süleyman Kocaoğlu ^*
0000-0002-2176-0354
Türkiye

Elçin Tadıhan Özkan
0000-0003-3154-5305
Türkiye

Publication Date

August 5, 2026

Submission Date

March 10, 2026

Acceptance Date

May 20, 2026

Published in Issue

Year 2026 Number: 2

DOI

https://doi.org/10.58563/dkyad.1906583.2026.2.3

IZ

https://izlik.org/JA48FM36TG

APA

Kocaoğlu, S., & Tadıhan Özkan, E. (2026). İnme Sonrası Üst Motor Nöron Dizartrisi Alt Tiplerinde Diadokokinetik Hız Ölçümleri. Dil Konuşma Ve Yutma Araştırmaları Dergisi, 2, 239-261. https://doi.org/10.58563/dkyad.1906583.2026.2.3

AMA

1.Kocaoğlu S, Tadıhan Özkan E. İnme Sonrası Üst Motor Nöron Dizartrisi Alt Tiplerinde Diadokokinetik Hız Ölçümleri. DKYAD. 2026;(2):239-261. doi:10.58563/dkyad.1906583.2026.2.3

Chicago

Kocaoğlu, Süleyman, and Elçin Tadıhan Özkan. 2026. “İnme Sonrası Üst Motor Nöron Dizartrisi Alt Tiplerinde Diadokokinetik Hız Ölçümleri”. Dil Konuşma Ve Yutma Araştırmaları Dergisi, nos. 2: 239-61. https://doi.org/10.58563/dkyad.1906583.2026.2.3.

EndNote

Kocaoğlu S, Tadıhan Özkan E (August 1, 2026) İnme Sonrası Üst Motor Nöron Dizartrisi Alt Tiplerinde Diadokokinetik Hız Ölçümleri. Dil Konuşma ve Yutma Araştırmaları Dergisi 2 239–261.

IEEE

[1]S. Kocaoğlu and E. Tadıhan Özkan, “İnme Sonrası Üst Motor Nöron Dizartrisi Alt Tiplerinde Diadokokinetik Hız Ölçümleri”, DKYAD, no. 2, pp. 239–261, Aug. 2026, doi: 10.58563/dkyad.1906583.2026.2.3.

ISNAD

Kocaoğlu, Süleyman - Tadıhan Özkan, Elçin. “İnme Sonrası Üst Motor Nöron Dizartrisi Alt Tiplerinde Diadokokinetik Hız Ölçümleri”. Dil Konuşma ve Yutma Araştırmaları Dergisi. 2 (August 1, 2026): 239-261. https://doi.org/10.58563/dkyad.1906583.2026.2.3.

JAMA

1.Kocaoğlu S, Tadıhan Özkan E. İnme Sonrası Üst Motor Nöron Dizartrisi Alt Tiplerinde Diadokokinetik Hız Ölçümleri. DKYAD. 2026;:239–261.

MLA

Kocaoğlu, Süleyman, and Elçin Tadıhan Özkan. “İnme Sonrası Üst Motor Nöron Dizartrisi Alt Tiplerinde Diadokokinetik Hız Ölçümleri”. Dil Konuşma Ve Yutma Araştırmaları Dergisi, no. 2, Aug. 2026, pp. 239-61, doi:10.58563/dkyad.1906583.2026.2.3.

Vancouver

1.Süleyman Kocaoğlu, Elçin Tadıhan Özkan. İnme Sonrası Üst Motor Nöron Dizartrisi Alt Tiplerinde Diadokokinetik Hız Ölçümleri. DKYAD. 2026 Aug. 1;(2):239-61. doi:10.58563/dkyad.1906583.2026.2.3

Aim & Scope

Author Guidelines

Journal of Language, Speech and Swallowing Research (DKYAD) Instructions for Manuscript Writing

The Forms section includes an "Article Template" which should aid in writing the manuscript.

Important: Please upload your manuscript in word (.doc or .docx) format to the DergiPark system so that the referees can take notes on the manuscript and your manuscript can enter the double-blind refereeing process.

Title Page
Authors should write their names, credentials and contact addresses on a separate page. The manuscript should not include any information about the identities of author(s). Any acknowledgements should also be mentioned on the title page.

The title page should be submitted separately. The title page should be written using Times New Roman font, 12 font size, bold and middle-aligned. In case where there is more than one author, the names of authors should be separated with a comma and the corresponding author should be indicated. The names, affiliations, contact information such as addresses, e-mails and ORCID IDs of author(s) should be submitted as a separate title page.

General Considerations

1. The manuscript should be prepared double-spaced and justified in a single column, leaving 2.5 cm. from the bottom, top, left and right side of the page.

2. The manuscript should be written in Times New Roman font and 12 font size. Please see the relevant sections for the information about the title, Turkish-English abstract, tables and figures.

3. The title should be written in Times New Roman font, 12 font size, bold, middle-aligned with the initial letters of the words in capital letters.

4. In case that the study is based on a project or thesis, or presented previously, this information should be provided as a footnote at the end of the title.

5. The length of the entire manuscript should not exceed 10000 words including the references. The abstract should not exceed 300 words for the manuscripts written in Turkish. In these manuscripts, the extended English abstract should contain at least 40% of the Turkish text in terms of word count. The abstract should not exceed 300 words for the manuscripts written in English. In these manuscripts, the extended Turkish abstract should contain at least 40% of the English text in terms of word count (for detailed information, see the announcement dated 26.03.2025). When transferring article abstracts into the DergiPark system, the character limit for the box under the heading Abstract is set to 5000 by the system. Due to this technical issue, you need to adjust your in-text abstract to comply with the 5000-character limit before uploading it to the system. There is no need to make any changes to the article manuscript itself. In short, your extended abstract should have two versions: one written according to the 40% rule in the article text, and another shortened version (up to 5000 characters) for uploading to the system. For English manuscripts, the Editorial Office will provide help in translating the extended summary into Turkish if requested. Please state your request on the title page.

6. The abstracts should be arranged under the following headings: Purpose, Method, Results, and Conclusion.

7. The abstracts should be written in Times New Roman font, 12 font size and justified. The keywords should be (at least) five to (at most) seven words; the keywords must be separated with a comma and written in lower case letters.

8. The main body of the manuscript should appear in the next page after the Turkish and English versions of the abstracts.

9. The first line of each new paragraph in the manuscript should be indented by one tab space, which should be set to 1.25 cm.

10. In empirical research articles, the main body of the manuscript should include introduction, method, results and discussion sections, in that order. The tables and figures, etc. should be attached to the end of the manuscript. However, their place should be indicated by their numbers within the text.

11. The headings should be arranged as follows:
-All the main headings (introduction, method, results, discussion) should be written with the first letter in capital, bold, plain text font and justified,
-The first level heading (i.e. participants, data analysis) should be written with the first letter in capital, bold and left-aligned,
-The second level heading should be written with the first letter in capital, bold, italic and left-aligned,
-The third level heading should be written with the first letter in capital, bold, with 1.25 cm (one tab) space indented,
-The fourth level heading should be written with the first letter in capital, bold, italic, with 1.25 cm (one tab) space indented.

12. The references section should appear at a separate page following the end of manuscript. The writing rules stated in the “Publication Manual of American Psychological Association” (APA) (7th ed.) should be considered both in the manuscript and references.

13. All the citations in the manuscript should be properly stated in the references section, and vice versa.

14. The appendices, if present, should be given under an “Appendix” heading following the references. The numbering should start with Appendix-1, Appendix-2; a heading related to the appendix should be provided. Please see the Appendix-1: The text given to the participants.

The in-text citations should be provided as follows:
1. Crow (2010) defines the articulation competence as a skill where the inpidual correctly produces the speech sounds belonging to a specific language in a sequential and coherent manner.
2. Speech sound disorders include problems related to the erroneous production of speech sounds in terms of place, manner, speed, timing and pressure (Crow, 2010).
3. According to a study by Crow in 2010, the phonological competence refers to a skill in which the speech sounds are utilized appropriately in the language context.

Type of Citation	In case of the initial citation	Other citations to the same publication	The initial citation in the parenthesis format to the publication	Other citations to the same publication in the parenthesis format
Work by one author	Crow (2009)	Crow (2009)	(Crow, 2009)	(Crow, 2009)
Work by two authors	Crow and Stacey (2009)	Crow and Stacey (2009)	(Crow & Stacey, 2009)	(Crow & Stacey, 2009)
Work by three authors	Crow et al., (2009)	Crow et al., (2009)	(Crow et al., 2009)	(Crow et al., 2009)
Work by four authors	Crow et al., (2006)	Crow et al., (2006)	(Crow et al., 2006)	(Crow et al., 2006)
Work by five authors	Crow et al., (2006)	Crow et al., (2006)	(Crow et al., 2006)	(Crow et al., 2006)
Work by six authors (or more)	Crow et al., (2006)	Crow et al., (2006)	(Crow et al., 2006)	(Crow et al., 2006)
Name of the institution (abbreviated)	Association of Speech and Language Therapists (DKTD, 2006)	DKTD (2006)	(Association of Speech and Language Therapists [DKTD], 2006)	(DKTD, 2006)
Name of the institution (without abbreviation)	Anadolu University (2007)	Anadolu University (2007)	(Anadolu University, 2007)	(Anadolu University, 2007)

Tables and Figures

1. The title and number of the table should be above the table.
2. The title and number of the table and the text inside should be written in Times New Roman font, 10 font size, single-spaced, and left-aligned.
3. The initial letters in the table numbers should be capital, the table titles should be in italic and the initial letters should be capital.
4. Space should be provided both before the table title and after the table.
5. In the manuscript, a statement referring to the table such as “as shown in Table 1” should be made. The table should then follow.

6. The title and number of figures should be above the figure.
7. Each word in the title and number of figures should be capitalized and written in Times New Roman font, 10 font size, and left-aligned. The title should be in italic.
8. Space (enter) should be provided both before the figure title and following the figure.
9. In the manuscript, a statement referring to the figure such as “as shown in Figure 1” should be made. And the figure should follow.
10. If the figure is taken from a separate resource, a reference to the source should be given with the page number.

References
1. The references should be given in their alphabetical order. In case where the surnames are the same, the initial letters of the first names should be considered.
2. In the paragraph tab and indentation section, the right and left space should be zero, the custom tabs should be hanging and set to 1.25 cm (1 tab).
3. The references should be written with Times New Roman font, 10 font size, double-spaced and justified.
4. Some examples related to reporting the references are provided below. For further information, please see the “Publication Manual of American Psychological Association” (APA) (7th ed.).

Article	Vuolo, J., & Goffman, L. (2020). Vowel accuracy and segmental variability differentiate children with developmental language disorder in nonword repetition. Journal of Speech, Language, and Hearing Research, 63(12), 3897-4332. https://doi.org/10.104/2020_JSLHR-20-00166
Book	Bloodstein, O. & Bernstein Ratner, N. (2008). A Handbook on Stuttering. Delmar Learning.
Chapter in edited book	Rvachew, S. (2007). Perceptual foundations of speech acquisition. In S. McLeod (Ed.), The International Guide to Speech Acquisition (pp: 26-30). Delmar Learning.
Thesis	Ünal, Ö. (2011). Nasometric evaluation in resonans disorders: Turkish norms for 4-8 year-olds. Unpublished Doctoral dissertation. Anadolu University, Institute of Health Sciences, Eskişehir, Turkey
Internet Sources	Britton, L. (2021, Jan. 9). Why does the impact of COVID-19 feel so hard for many SLTs? RCSLT Home. https://www.rcslt.org/covid-case-studies/impact-of-covid-19-hard-for-many-slts/

Ethical Principles and Publication Policy

DKYAD Ethical Principles and Publication Policy

Journal of Language, Speech and Swallowing Research (DKYAD) is an open-access, double-blind, peer-reviewed academic journal that publishes articles about normal processes, disorders, assessment and remediation and other issues regarding the field of speech and language and swallowing. It is a publication of the Turkish Association of Speech and Language Therapists (DKTD). No fee is required by DKYAD for the processes of submission, reviewing, acceptance or publication of articles.

DKYAD is an open access journal and provides instant open access to its content. The Journal applies the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 (CC BY-NC-ND 4.0) license to its published articles. When authors submit their articles for publication, they agree to have the CC BY-NC-ND license applied to their work. Under this Open Access License, the authors agree that anyone may read, download, copy, print, distribute, or reuse the content of their articles free of charge for non-commercial purposes as long as the author and the original source are properly cited.

DKYAD aims to achieve high ethical standards in the publication of the articles. For this purpose, the journal adheres to the Code of Conduct and Best Practice Guidelines of COPE (Committee on Publication Ethics). The writers, chief editor, associate editors, reviewers and the journal management all share responsibility in achieving the declared goals. Editors are expected to follow the Cope Guidance for Editors and reviewers are expected to review the COPE Ethical Guidelines for Peer Reviewers and pay attention to the issues specified in the guidelines.

Within the scope of these guidelines:

Responsibilities of the Publisher and the Editors

• Editors have complete responsibility and authority to reject/accept an article.

• Only papers in line with the Journal’s scope of interest should be accepted.

• Editors should have no conflict of interest with respect to articles they reject/accept.

• Objectivity and anonymity should be maintained; information about the rejected articles, names of the reviewers and before publication any information regarding the accepted articles should not be revealed.

• Plagiarism and presentation of false data should be prevented.

Responsibilities of Authors

• Authors are expected to submit original articles.

• When authors submit their articles for publication, they agree to have the Creative Commons BY-NC-ND 4.0 license applied to their work. Under this Open Access License, the authors agree that anyone may read, download, copy, print, distribute, or reuse the content of their articles free of charge for non-commercial purposes as long as the author and the original source are properly cited.

• Authors should also confirm by signing a form entitled "Copyright and Publication Policy Consent Form" that (a) the article they submitted is their original work and has not been published or is under review in any other journal; (b) authors do not violate the copyright of the text, tables, and other documents pertaining to other individuals within the article; (c) authors accept and authorize DKYAD to permit the commercial use of the content as well as publication, republication in electronic and print format in the journal and distribution of the content, in addition to the non-exclusive rights DKYAD holds under the CC BY-NC-ND licence. In addition to these terms, the Authors should confirm that they retain all patent and other proprietary rights to the article, including copyright. Moreover, the Authors should assure in this form that they are responsible for any possible ethical violations, the results achieved and suggestions presented (See: DKYAD-Copyright and Publication Policy Consent Form).

• All individuals that have made a scientific and professional contribution to the study should be included as authors. The nature, content and percentage of the contribution should be revealed in detail (See: DKYAD Author Contribution Form).

• Direct or indirect institutional supports should be declared. Authors should be clear about any situations that might potentially create conflict of interest (See: DKYAD Conflict of Interest Disclosure Form).

• For all studies involving the ‘human factor’, confirmation is required by an ethics committee in accordance with the Helsinki Declaration (https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/).The authors have all the rights about the use of their data pertinent to their study. However, they should obtain ‘informed consent’ from their participants that contributed to the collection of data. Information regarding this procedure should be explained in detail under the Method section.

• The authors should provide complete and correct references to their sources. The manuscript is screened for plagiarism through softwares such as iThenticate or Turnitin and the maximum similarity rate is 20%. For more information, please see the Plagiarism Control Policy page.

• When necessary, authors should be ready to provide the raw data or output regarding the statistical analyses for purposes of transparency or clarity.

Responsibilities of Reviewers

• Reviewers act according to the requirements of the double-blind reviewing process.

• When sent an invitation for a review, they are expected to provide a prompt negative or positive response.

• If the topic is outside their area of expertise, they are expected to declare that and withdraw.

• The reviewers are expected to disclose any possible conflict of interest with the study. For example, if they are in the process of conducting a similar study, they should refrain from reviewing the article.

• When the reviewers detect any plagiarism, they are expected to inform the editor.

• The reviewers should be confidential about the information in the study they review before the study is published.

• The reviewers should inform the editors if they feel they are unable perform an objective and unbiased review.