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Incorporating ethics into infectious disease clinical practice guidelines
No full textBackground: Incorporating ethics into clinical practice guidelines (CPGs) can be challenging. This is particularly evident for infectious diseases (ID) CPGs because of the complexity of ID ethics (IDE) and the multiplicity of populations at risk for infections. Objectives: The OPENING project (IncOrPorating Ethics iN ClINical Guidelines: Practical Indications) was initiated by the European Society of Clinical Microbiology and Infectious Diseases Ethics Advisory Committee in collaboration with the European Society of Clinical Microbiology and Infectious Diseases Guidelines Subcommittee to generate guidelines for the systematic inclusion of ethics principles into ID CPGs. Sources: The first part of the project, presented here, aimed at: (a) performing a scoping review of articles published in PubMed and Google Scholar between 1990 and 2024 discussing ethics inclusion in CPGs; (b) reviewing guidance documents for ethics incorporation in documents from international societies; (c) outlining how the main ethics principles could be included in ID CPGs according to the results retrieved. Content: We retrieved 21 articles written between 1994 and 2024. None of these specifically focused on IDE. The main topic discussed in articles and societies' guidance was the inclusion of equity principles at different stages of CPGs development. Multiple authors also addressed how specific subgroups and disadvantaged populations should be considered in the preparation of CPGs. Involvement of patients and their representatives in CPGs was also advocated. A structured framework for the systematic inclusion of IDE principles in CPGs was suggested to summarize these points
Investigation the effect of rigid taping on knee and hip joint kinematics in chronic stroke patients with knee hyperextension gait
No full textBackground: Although stroke patients gain an advantage in gait due to the knee hyperextension that occurs during the stance phase, this situation disrupts the biomechanical structure of the knee and increases the risk of injury to the capsular and ligamentous structures. The aim of this study was to examine the effects of rigid taping on hyperextension control and pelvic kinematics in stroke patients with knee hyperextension during the stance phase of gait. Research question: Does rigid taping have an effect on hyperextension control and pelvic kinematics in stroke patients with knee hyperextension? Methods: Thirty stroke patients aged between 40 and 70 were included in this pre-postintervention study. Kinematic assessment of gait was performed using a motion analysis system (Vicon Ltd, Bilston). Then, the rigid taping was applied to the patients using the hyperextension taping technique, and the kinematic analysis of the gait was repeated with the motion analysis system. Results: It was found that the rigid taping for the knee hyperextension significantly reduced the knee hyperextension (p < 0.05). Additionally, it was observed that the rigid taping significantly reduced the pelvic retraction (p < 0.05). However, no change was observed in the pelvic drop with the rigid taping application. Significance: Our results showed that the rigid taping effectively controlled the knee hyperextension. It was thought that the rigid taping application contributed to reducing knee hyperextension and pelvic retraction because it mechanically gave the knee a flexion moment and provided proprioceptive input
Long wavelength analysis amendment on the cilia beating assisted peristalsis in a tube
No full textThis work delves into the peristaltic rheology of two-wave sinusoidal cilia beating within a tubular pipe. Cilia movement drives the dynamic phenomenon of peristaltic fluid flow. Employing the traditional long-wavelength lubrication assumption, the flow equations are transformed into similarity form. The main objective is to take into account the true peristaltic-ciliary motion effects. We then derive analytical solutions for the radial and axial velocities of fluid particles within the tube. Notably, at this leading approximation level, the impacts of cilia beating are negligible, suggesting the motion is solely driven by peristaltic surface waves. However, analyzing the correction to the long-wavelength limit reveals the emergence of ciliated boundary effects through their largely eccentric elliptic paths. This correction enables us to extract expressions for the pressure gradient, stream function, axial and radial velocities, resultant pressure rise, and drag force, all based on the time-averaged mean flow rate across the pipe. Finally, we present a general discussion of fluid rheology due to cilia-assisted peristaltic motion, illustrated with informative graphical displays. It is shown that the drag force on the tube walls owing to the cilia beating waves in biology or biomedical applications necessitates addition of correction terms to the traditional long-wavelength adoption
High prevalence of low bone mineral density in young adults with phenylketonuria
No full textBackground: It has been reported that phenylalanine (Phe)-restricted diets may have negative effects on bone health in patients with classical phenylketonuria (cPKU). We aimed to evaluate bone mineral density (BMD) in adults with cPKU and determine the risk factors associated with low BMD. Methods: Eighty adult patients with cPKU were examined, including 41 women and 39 men. The age range was 18.3-39.4 years (median 22.8). The femoral and lumbar BMD were measured by dual energy X-ray absorptiometry. The patients were evaluated in two groups with low (Z-score -2). Results: Low BMD was detected in 20 patients (25%). The low BMD group had significantly more males (75% vs 40%, p g/L respectively, p < 0.05). The groups did not differ significantly with regards to age, mean Phe levels at diagnosis, median Phe levels above the age of 12 years, other nutritional parameters or vitamin-mineral supplementation. There was no history of clinical fractures. Discussion: Although osteopenia, osteoporosis and low BMD have been reported in PKU, conflicting data also exist. Our study of a large adult cPKU cohort strongly supports previously published limited data that suggest male sex and low BMI confer a higher risk for low BMD in cPKU; and age, Phe levels and dietary adherence do not. In our study, although the patients were young, low BMD was quite common (25%). Bone health should be evaluated even in young adults with cPKU, especially in males and those with low BMI, regardless of treatment compliance and vitamin-mineral status. Prospective studies reporting on clinical outcomes such as bone pain or fractures will be valuable in the coming years
Developing a high-fidelity reduced chemical kinetic mechanism for liquefied petroleum gas (LPG)
No full textThe current study aimed at developing an optimal and highly accurate reduced chemical kinetic mechanism for the Liquid Petroleum Gas (LPG). A three-stage reduction process including pre-processing, the main body reduction, and post-processing was utilized. In the main body reduction, a five-step reduction schematic was applied to the detailed mechanism including 980 species and 4972 reactions released by LLNL utilizing the Direct Relation Graph Error Propagation (DRGEP) method coupled with the isomer lumping and sensitivity analysis. Four different reduced mechanisms including 88, 73, 67, and 44 species were developed and compared with the experimental data. The laminar flame speed/equivalence ratio, ignition delay/temperature curves of the LPG combustion as well as 3D combustion parameters including in-cylinder pressure, mean temperature, heat release rate, and fuel consumption rate for an LPG-fueled opposed-piston engine were considered. It was seen that the 73 species mechanism results for the ignition delay/temperature and laminar flame speed/equivalence ratio matched with the experimental data with discrepancies of 3% and 5%, respectively. The 88 species and 73 species mechanisms showed good agreement in 3D modeling for all the considered parameters in comparison with the detailed mechanism with error values less than 2%. However, the 67 and 44 mechanisms results were not in accordance with the experimental data. Consequently, the developed 73-species mechanism was considered the optimal mechanism for LPG fuel
Two sides of the same coin-sexuality from the perspective of women diagnosed with breast cancer and their partners: A qualitative study
No full textPurpose: After the diagnosis of breast cancer, women's sexuality becomes complex, and the sexual lives of couples are strongly affected by the treatment process of the disease. The aim of this study is to determine the perceptions, experiences, expectations, and needs related to sexuality from the perspective of women diagnosed with breast cancer and their partners. Method: In this study, a descriptive qualitative design based on a thematic analysis approach was used. The data were collected through individual semi-structured interviews with women diagnosed with breast cancer (n = 22) and their partners (n = 14). The thematic analysis approach was used to analyse the data. Results: The main themes of this study that came out from both the patients' and partners' perspectives were 'suspension (postponement) of sexual life' and 'unmet need for care related to sexuality'. The main themes consist of four sub-themes: 'changes in sexual dynamics', 'unsatisfied sexuality', 'barriers to accessing information and support', and 'demand for individualised and tailored comprehensive counselling'. Conclusion: Women with breast cancer and their partners were found to have difficulty in asking for help about sexuality and to postpone their sexual lives. Findings of the present study suggest that sexual counselling is of critical importance at every stage of the breast cancer treatment process, and the patients and their partners need a culturally sensitive, individualised care thereof and expect a continuous support
Tele-MiYo: A tele-yoga program for mother-preterm infant dyads
No full textObjective: To assess the effects of mother-infant yoga groups on the motor development of preterm infants, anxiety, postpartum bonding, and quality of life (QoL) of the mothers. Study design: In a prospective experimental study, the intervention group received 6-session teleyoga for mother-preterm infant dyads (Tele-MiYo) and standard care, while the comparison group received outpatient standard care. Motor performance of the infants and anxiety, postpartum bonding, and QoL of the mothers were assessed before and after the study period. Results: Tele-MiYo group (n = 15) significantly improved in motor performance (p = 0.040). Mothers in the intervention group improved in terms of bonding (0.004), trait anxiety (p = 0.002), and QoL (p 0.05). Discussion: Tele-MiYo might improve the dyadic outcomes of mothers and preterm infants. This complementary and distant method might be considered especially when access to on-site healthcare is limited, such as the COVID-19 pandemic
