RESUMO
A significant portion of human cancers are caused by oncoviruses (12%-25%). Oncoviruses employ various strategies to promote their replication and induce tumourigenesis in host cells, one of which involves modifying the gene expression patterns of the host cells, leading to the rewiring of genes and resulting in significant changes in cellular processes and signalling pathways. In recent studies, a specific mode of gene regulation known as circular RNA (circRNA)-mediated competing endogenous RNA (ceRNA) networks has emerged as a key player in this context. CircRNAs, a class of non-coding RNA molecules, can interact with other RNA molecules, such as mRNAs and microRNAs (miRNAs), through a process known as ceRNA crosstalk. This interaction occurs when circRNAs, acting as sponges, sequester miRNAs, thereby preventing them from binding to their target mRNAs and modulating their expression. By rewiring the host cell genome, oncoviruses have the ability to manipulate the expression and activity of circRNAs, thereby influencing the ceRNA networks that can profoundly impact cellular processes such as cell proliferation, differentiation, apoptosis, and immune responses. This review focuses on a comprehensive evaluation of the latest findings on the involvement of virus-induced reprogramming of host circRNA-mediated ceRNA networks in the development and pathophysiology of human viral cancers, including cervical cancer, gastric cancer, nasopharyngeal carcinoma, Kaposi's sarcoma, hepatocellular carcinoma, and diffuse large B cell lymphoma. Understanding these mechanisms can improve our knowledge of how oncoviruses contribute to human tumourigenesis and identify potential targets for developing optimised therapies and diagnostic tools for viral cancers.
Assuntos
Neoplasias Hepáticas , MicroRNAs , Humanos , MicroRNAs/genética , RNA Circular/genética , RNA Mensageiro/metabolismo , RNA Endógeno Competitivo , Retroviridae/genética , Retroviridae/metabolismo , Perfilação da Expressão Gênica/métodos , Carcinogênese/genéticaRESUMO
The use of plant genetic resources (PGR)-wild relatives, landraces, and isolated breeding gene pools-has had substantial impacts on wheat breeding for resistance to biotic and abiotic stresses, while increasing nutritional value, end-use quality, and grain yield. In the Global South, post-Green Revolution genetic yield gains are generally achieved with minimal additional inputs. As a result, production has increased, and millions of hectares of natural ecosystems have been spared. Without PGR-derived disease resistance, fungicide use would have easily doubled, massively increasing selection pressure for fungicide resistance. It is estimated that in wheat, a billion liters of fungicide application have been avoided just since 2000. This review presents examples of successful use of PGR including the relentless battle against wheat rust epidemics/pandemics, defending against diseases that jump species barriers like blast, biofortification giving nutrient-dense varieties and the use of novel genetic variation for improving polygenic traits like climate resilience. Crop breeding genepools urgently need to be diversified to increase yields across a range of environments (>200 Mha globally), under less predictable weather and biotic stress pressure, while increasing input use efficiency. Given that the ~0.8 m PGR in wheat collections worldwide are relatively untapped and massive impacts of the tiny fraction studied, larger scale screenings and introgression promise solutions to emerging challenges, facilitated by advanced phenomic and genomic tools. The first translocations in wheat to modify rhizosphere microbiome interaction (reducing biological nitrification, reducing greenhouse gases, and increasing nitrogen use efficiency) is a landmark proof of concept. Phenomics and next-generation sequencing have already elucidated exotic haplotypes associated with biotic and complex abiotic traits now mainstreamed in breeding. Big data from decades of global yield trials can elucidate the benefits of PGR across environments. This kind of impact cannot be achieved without widescale sharing of germplasm and other breeding technologies through networks and public-private partnerships in a pre-competitive space.
Assuntos
Segurança Alimentar , Melhoramento Vegetal , Doenças das Plantas , Triticum , Triticum/genética , Triticum/microbiologia , Doenças das Plantas/microbiologia , Doenças das Plantas/prevenção & controle , Resistência à Doença/genética , Pandemias , Fungicidas Industriais , Meio AmbienteRESUMO
Metastasis is a significant clinical challenge responsible for cancer mortality and non-response to treatment. However, the molecular mechanisms driving metastasis remain unclear, limiting the development of efficient diagnostic and therapeutic approaches. Recent breakthroughs in cancer biology have discovered a group of small non-coding RNAs called tRNA-derived fragments (tRFs), which play a critical role in the metastatic behavior of various tumors. tRFs are produced from cleavage modifications of tRNAs and have different functional classes based on the pattern of these modifications. They perform post-transcriptional regulation through microRNA-like functions, displacing RNA-binding proteins, and play a role in translational regulation by inducing ribosome synthesis, translation initiation, and epigenetic regulation. Tumor cells manipulate tRFs to develop and survive the tumor mass, primarily by inducing metastasis. Multiple studies have demonstrated the potential of tRFs as therapeutic, diagnostic, and prognostic targets for tumor metastasis. This review discusses the production and function of tRFs in cells, their aberrant molecular contributions to the metastatic environment, and their potential as promising targets for anti-metastasis treatment strategies.
Assuntos
MicroRNAs , Neoplasias , Humanos , Epigênese Genética , RNA de Transferência/genética , RNA de Transferência/metabolismo , Neoplasias/diagnóstico , Neoplasias/terapia , Neoplasias/genética , Regulação da Expressão GênicaRESUMO
Cancer is responsible for about one in six deaths in the world. Conventional cancer treatments like chemotherapy, radiotherapy, and surgery are associated with drug poisoning and poor prognosis. Thanks to advances in RNA delivery and target selection, new cancer medicines are now conceivable to improve the quality of life and extend the lives of cancer patients. Antisense oligonucleotides (ASOs) and siRNAs are the most important tools in RNA therapies. Locked Nucleic Acids (LNAs) are one of the newest RNA analogs, exhibiting more affinity to binding, sequence specificity, thermal stability, and nuclease resistance due to their unique properties. Assays using LNA are also used in molecular diagnostic methods and provide accurate and rapid mutation detection that improves specificity and sensitivity. This study aims to review the special properties of LNA oligonucleotides that make them safe and effective antisense drugs for cancer treatment by controlling gene expression. Following that, we go over all of the molecular detection methods and cancer treatment antisense tactics that are possible with LNA technology.
Assuntos
Neoplasias , Qualidade de Vida , Humanos , Oligonucleotídeos/genética , Oligonucleotídeos/uso terapêutico , Oligonucleotídeos/química , Oligonucleotídeos Antissenso/genética , Oligonucleotídeos Antissenso/uso terapêutico , Oligonucleotídeos Antissenso/química , RNA , Conformação de Ácido Nucleico , Neoplasias/diagnóstico , Neoplasias/genética , Neoplasias/terapiaRESUMO
Background: This qualitative study was designed to investigate parental adherence to cranial remolding orthotic (CRO) treatment of infants with positional cranial deformities. Methods: A qualitative content analysis was employed in this study. Researchers sought to find parental behavior while using a CRO for their infant with cranial deformity. Through in-depth and in-person interviews, researchers collected data from 22 participants using semi-structured questions regarding adherence to CRO treatment. Data were examined for patterns until saturation occurred, yielding categories that focused on the parents' main barriers and facilitators. Results: Two general themes of "potential barriers to CRO treatment adherence" and "potential facilitators to CRO treatment adherence" were extracted from 12 subthemes of parental burden, transportation, availability of CRO services in hometown, financial responsibility, maternal/paternal attachment attitudes, CRO-related problems, others feedback, adjustment to the treatment, motivation and self-confidence, aesthetic satisfaction, communication with orthotist, and wife's empathy/spousal support. Conclusion: Getting time off work, transportation to the orthotics' clinic, the lack of medical insurance coverage for CRO, reduced physical contact between parents and their child, and getting negative feedback from others were the most reported challenges. However, overcoming the initial difficulties and adjustment to the treatment with CRO, the high motivation of parents during therapy, an orthosis with good fitting and minor complications, a strong relationship between the parents and orthotist, and the father's companionship were revealed to facilitate the treatment process and increase adherence of treatment with CRO.
RESUMO
PURPOSE: The efficacy of intraperitoneal (IP) and incisional use of local anesthesia in laparoscopic cholecystectomy is a promising subject regarding post-operative pain control. In this study, we aim to compare these methods using lidocaine as the local anesthetic. METHODS: This study was a double-blinded randomized controlled trial. Eighty-two patients, candidates for laparoscopic cholecystectomy, were included. Participants were randomly divided into two equal groups; the instillation group and the infiltration group. In the instillation group, a 2% lidocaine ampule was instilled in the gallbladder bed after removal of the gallbladder. In the infiltration group, a 2% lidocaine ampule was injected subcutaneously into the port sites before making the incisions for the insertion of laparoscopic ports. RESULTS: The mean age of patients were 41.66 ± 14.44 and 48.05 ± 17.03 years in the instillation and infiltration groups, respectively. The etiologies recorded in this study were: acute calculous cholecystitis (29.3%), symptomatic gallstone (68.3%), and polyp (2.4). The pain severity, evaluated at six different times, from immediately after awakening from anesthesia to 24 h after the operation, was not significantly different between the two groups (p-value = 0.329). Consumption of nonsteroidal anti-inflammatory drugs and narcotics, were statistically lower in the instillation group (p-value = 0.013 and 0.003, respectively). However, hospitalization period, time spent to return to normal bowel movements and oral diet, and postoperative nausea/vomiting were not significantly significant between the groups. CONCLUSION: IP instillation of lidocaine following laparoscopic cholecystectomy offers post-operative pain relief and is associated with lower analgesic consumption in comparison to subcutaneous injection of this agent at the port site.
Assuntos
Colecistectomia Laparoscópica , Cálculos Biliares , Humanos , Adulto , Pessoa de Meia-Idade , Lidocaína/uso terapêutico , Colecistectomia Laparoscópica/efeitos adversos , Colecistectomia Laparoscópica/métodos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Dor Pós-Operatória/prevenção & controle , Anestésicos Locais/uso terapêutico , Injeções Subcutâneas , Método Duplo-CegoRESUMO
BACKGROUND: Muscle tension dysphonia (MTD) is common in traditional singers and can lead to serious complications, but there is inconclusive evidence about how MTD should be treated in singers as professional voice users. This study was conducted to investigate the effects of breathing exercises combined with manual therapy versus breathing exercises and manual therapy on voice quality in traditional singers suffering from MTD. METHODS: In this blinded randomized clinical trial, 60 patients with MTD were randomly allocated to four groups: (1) breathing exercises, (2) manual therapy, (3) combined intervention (CI) and (4) control. Patients received treatments for 13 sessions, once per week. Treatment effects were assessed in terms of primary outcome measures: (1) breathing performance, measured by maximum phonation time (MPT) and (2) laryngeal function, measured by Stroboscopy Evaluation Rating Form (SERF). Secondary outcome measure was patient's self-perceived voice handicap, measured by Persian version of Singing Voice Handicap Index (SVHIp). All outcome variables were measured before and after treatment. The between group comparisons on MPT and SVHIp score were investigated using analysis of covariance (ANCOVA). The Kruskal-Wallis non-parametric test was used for between group comparisons of SERF items. RESULTS: Three treatment groups had improved regarding breathing performance, laryngeal function and voice handicap over the time (P < 0.01). The improvements achieved in all outcomes were significantly greater in the CI group than those of the breathing exercises, manual therapy and control groups. CONCLUSIONS: This randomized controlled trial showed that the combination of breathing exercises and manual therapy significantly improved the laryngeal function, breathing performance and voice handicap in traditional singers suffering from MTD. TRIAL REGISTRATION: IRCT2015102524686N1.
Assuntos
Disfonia , Manipulações Musculoesqueléticas , Canto , Exercícios Respiratórios , Disfonia/terapia , Rouquidão , Humanos , Tono Muscular , Treinamento da VozRESUMO
Stringent lockdowns have been one of the defining features of the COVID-19 pandemic. Lockdowns have brought about drastic changes in living styles, including increased residential occupancy and telework practices predicted to last long. The variation in occupancy pattern and energy use needs to be assessed at the household level. Consequently, the new occupancy times will impact the performance of energy efficiency measures. To address these gaps, this work uses a real case study, a two-story residential building in the Okanagan Valley (British Columbia, Canada). Further, steady-state building energy simulations are performed on the HOT2000 tool to evaluate the resiliency of energy efficiency measures under a full lockdown. Three-year monitored energy data is analyzed to study the implications of COVID-19 lockdowns on HVAC and non-HVAC loads at a monthly temporal scale. The results show a marked change in energy use patterns and a higher increase in May 2020 compared to the previous two years. Calibrated energy models built on HOT2000 are then used to study the impacts of pre-COVID-19 (old normal occupancy) and post-COVID-19 (new normal occupancy) on energy upgrades performance. The simulations show that under higher occupancy times, the annual electricity use increased by 16.4%, while natural gas use decreased by 7.6%. The results indicate that overall residential buildings following pre-COVID-19 occupancy schedules had higher energy-saving potential than those with new normal occupancy. In addition, the variation in occupancy and stakeholder preferences directly impact the ranking of energy efficiency measures. Furthermore, this study identifies energy efficiency measures that provide flexibility for the decision-makers by identifying low-cost options feasible under a range of occupancy schedules.
RESUMO
Background: Adolescent idiopathic scoliosis (AIS) and Scheuermann kyphosis (SK) are the most common spinal deformities in adolescents aged 10 to 16. During the past 50 years, brace treatment has been suggested as the most common nonsurgical treatment for AIS and SK. The brace efficacy strongly depends on wearing time. Also, previous studies indicated that patients with spinal deformities undergoing brace treatment experience deformity-related emotional distress. This study aimed to comprehend the experiences of braces-treated adolescents during school time using a qualitative approach. Methods: This descriptive qualitative research was used with an interpretative framework and enlisted the help of children with spinal deformities who have been prescribed "brace wearing." This study was conducted using semi-structured, face-to-face, in-depth interviews and phone conversations from September 2020 to May 2021. Additionally, content analysis was employed. Results: A total of 64 participants were interviewed, including 32 adolescents with spinal deformities under brace treatment and their parents (27 mothers, and 5 fathers). Three main categories-concerns, actual problems, received support-6 subcategories, and 278 codes were discovered following data analysis about participants' experiences. Conclusion: Special school-based programs are required for such tortious conditions. This qualitative study motivates a better understanding of these special children and their hidden problems and suggests developing a supportive protocol.
RESUMO
BACKGROUND: The current study aimed to develop a comprehensive phonological awareness intervention to train all levels of phonological awareness skills and to investigate its effect on the reading abilities of cochlear implanted children. MATERIALS AND METHODS: This study was the single-subject intervention. Phonological awareness intervention programme was developed and validated by experts' opinions. Six elementary first graders with cochlear implants and weak or delayed reading development, in 5-7-year-old range, were trained in phonological awareness skills. 'Auditory test of phonological awareness skills' was used to evaluate the subjects' phonological awareness skills. Nama reading test was also used to determine the level of reading performance. RESULTS: The results showed that all six subjects with cochlear implants had improvements of both phonological awareness skills and reading skills after participating in the phonological awareness intervention programme. This improvement was not only observed immediately after intervention but was also preserved in follow-up. CONCLUSION: The findings of this study demonstrated the importance of planning an intervention programme about phonological awareness skills for elementary first graders with cochlear implant, and the important role of such an intervention programme in improving their performance in phonological awareness tasks, and then in reading tasks consequently. The importance of improvement in these skills could considerably affect these children's linguistic and psychological abilities, which may facilitate their education at higher grades.
Assuntos
Implante Coclear , Implantes Cocleares , Criança , Pré-Escolar , Escolaridade , Humanos , Nigéria , LeituraRESUMO
Background: Previous studies have shown that children with cochlear implants have difficulty in grammar acquisition. Vocabulary acquisition and grammar abilities are important during language development. The purpose of this study was to investigate the effect of grammar therapy on the lexical ability of cochlear implanted children. Methods: Five children with cochlear implants and grammatical problems were treated using a grammar task designed for the current study. Before and after the treatment, repeated evaluations were performed using the Mean Length of Utterance (MLU) and Persian Developmental Sentence Scoring (PDSS) indices for grammar and NDW and NTW indices for vocabulary abilities; these show the number of different words and the number of total words respectively. Results: Grammar intervention was successful in cochlear implanted children of the present study. In addition, treatment of grammatical problems increased the lexical ability of all children; NDW and NTW scores increased, which was confirmed by the effect size indices. In the follow-up phase, the cochlear implanted children were able to maintain the increase in NTW and NDW values. Conclusion: Improving grammar skills in cochlear implanted children also increased their lexical ability. Therefore, grammar therapy helps to increase the vocabulary of children too.
RESUMO
BACKGROUND: Although the main aims of sanctions are the political and economic pressures on governments, literature has demonstrated the harsh effects of sanctions on the general public, especially on the patients, poor and disabled people. Since the international sanctions regime negatively affected almost all dimensions of Iran's health sector, this qualitative study was conducted to investigate the situation of the physical rehabilitation sector after these sanctions. METHODS: This qualitative study was conducted from January 2019 to June 2019 in Iran using Skype, telephone, and face-to-face in-depth semi-structured interviews. Purposive and snowball sampling approaches were used to identify the participants. Also, framework analysis approach was applied to analyze the collected data. RESULTS: In total, 38 individuals including health policy-maker, faculty member, rehabilitation expert, Physiotherapist, Occupational therapist, and Orthotist/Prosthetist, were involved in the study. Based on our findings, a number of challenges facing the Iranian physical rehabilitation sector during the international sanctions period included: 1) socioeconomic challenges (inadequate funding, rising inflation rate, high unemployment rate, catastrophic expenditures, and inappropriate employment status of practitioners); 2) education challenges (decreased international collaboration and shortage of training devices and materials); 3) international challenges (rising issues in accessing services for patients from neighborhood countries); and 4) service delivery challenges (shortage of raw materials for producing the orthoses and prostheses, hardening of the importing the needed equipment, inappropriate infrastructures, and impossibility to use external assistance). CONCLUSION: After international sanctions, the Iranian physical rehabilitation sector has faced considerable multifaceted challenges. Therefore, the international community must be aware of the situation and be concerned about the irreparable consequences.
Assuntos
Política de Saúde , Acessibilidade aos Serviços de Saúde , Reabilitação , Gastos em Saúde , Humanos , Cooperação Internacional , Irã (Geográfico) , Pesquisa Qualitativa , Controle Social FormalRESUMO
OBJECTIVE: The aim of this study was to evaluate the effects of ankle-foot orthoses on speed walking in patients with stroke. DATA SOURCES: PubMed, Embase, Web of Science, Scopus, CENTRAL, PEDro, RehabData, RECAL, and ProQuest were searched from inception until 30 September 2019. REVIEW METHODS: This study was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline statement. Risk of bias assessment was performed using the Cochrane Risk of Bias Tool. Begg's test and Egger's regression method were used to assess the publication bias. Trim and fill analysis was also used to adjust any potential publication bias. Sensitivity analysis was performed to evaluate the effect of individual studies. The quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. RESULTS: Overall, 14 studies were included with a total of 1186 participants. A small-to-moderate and non-significant improvement in favor of the ankle-foot orthosis versus without ankle-foot orthosis (standardized mean difference (SMD) = 0.41, 95% confidence interval = -0.15 to 0.96), similar effects of ankle-foot orthosis and functional electrical stimulation (SMD = 0.00, 95% confidence interval = -0.16 to 0.16), and a small and non-significant improvement in favor of ankle-foot orthosis versus another type of ankle-foot orthosis (SMD = 0.22, 95% confidence interval = -0.05 to 0.49) in walking speed were found. However, the quality of evidence for all comparisons was low or very low. CONCLUSION: Despite reported positive effects in some studies, there is no firm evidence of any benefit of ankle-foot orthoses on walking speed.
Assuntos
Órtoses do Pé , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/fisiopatologia , Velocidade de Caminhada , Tornozelo , Feminino , Pé , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
PURPOSE: The aim of the present study was to evaluate the effect of base-in prism on symptoms and clinical characteristics of young adults with convergence insufficiency. METHODS: In this randomised clinical trial, 64 CI patients aged 18-38 years who presented to Bina Eye Hospital, Tehran, Iran between November 2018 and April 2019 were selected and randomly assigned to either prism or placebo groups. All participants underwent complete optometric examinations, including the measurement of visual acuity, objective and subjective refraction, and complete accommodative and binocular vision examinations. Clinical examinations were repeated after three months. The overall score of the Convergence Insufficiency Symptom Survey (CISS) was considered as the primary outcome measure. Secondary outcome measures included near exophoria, positive fusional vergence at near, near point of convergence, vergence facility, monocular accommodative facility, accommodative response, negative relative accommodation and accommodative convergence/accommodation (AC/A) ratio. RESULTS: The mean (S.D.) age of the participants was 25.5 (5.5) years and 44% of them were male. The mean CISS score was significantly lower in the prism group compared to the placebo group in the outcome examination (p < 0.001). Moreover, the values of monocular accommodative facility, accommodative response, and negative relative accommodation were significantly higher in the prism group versus the placebo group (p < 0.001). There was no significant difference in other parameters, including near positive fusional vergence, near point of convergence, vergence facility, and AC/A ratio between the two groups in the outcome examination (p > 0.10). CONCLUSION: The base-in prism reduced symptoms in young adults with convergence insufficiency, while it had no significant effect on the near point of convergence, near positive fusional vergence, vergence facility and AC/A ratio. However, the results of this study only supports the symptomatic effectiveness of prism in the short term and further studies are needed to assess the long-term effect of prism.
Assuntos
Acomodação Ocular/fisiologia , Convergência Ocular/fisiologia , Óculos , Transtornos da Motilidade Ocular/diagnóstico , Optometria/métodos , Visão Binocular/fisiologia , Acuidade Visual , Adolescente , Adulto , Feminino , Seguimentos , Humanos , Masculino , Transtornos da Motilidade Ocular/fisiopatologia , Transtornos da Motilidade Ocular/terapia , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND: Inadequate financing is one of the major barriers in securing equitable access to high-quality physical rehabilitation services, without imposing financial hardship. Despite this, no sufficient attention has been paid to physical rehabilitation services and no specific financial resources have been allocated to such services in many countries including Iran. Owing to the fact that effective decision- and policy-making requires identifying possible stakeholders and actors and their characteristics, in the current study a stakeholder analysis and also a social network analysis (SNA) was conducted to identify the potential stakeholders and also their characteristics involved in physical rehabilitation financing (PRF)-related policies in Iran. METHODS: The present study was performed in two phases. Firstly, semi-structured interviews and relevant document review were conducted to identify the stakeholders. Then, the position, power, interest, and influence of each stakeholder were determined using a web-based questionnaire. Secondly, SNA approach was utilized to map and visualize the interactions among stakeholders. RESULTS: The findings showed that there are different stakeholders in PRF-related decision- and policy-making processes in Iran. In addition, the position, power, interest, and influence level of the identified stakeholders were varied. Moreover, although some stakeholders, like the Ministry of Health and the parliament have the highest level of power and position, they lack sufficient interest to participate in PRF-policies. Furthermore, SNA demonstrated that social network density was low, which indicates the lack of proper collaboration and interaction among the stakeholders. CONCLUSION: As many powerful and influential stakeholders had low interest levels to warrant participate in the FPR-related decision- and policy-making processes in Iran, employing careful and effective strategies, that is ongoing negotiations, receiving advocacy, and making senior managers and policy-makers aware can be helpful.
Assuntos
Financiamento da Assistência à Saúde , Reabilitação/economia , Política de Saúde , Humanos , Irã (Geográfico) , Formulação de Políticas , Análise de Rede Social , Participação dos InteressadosRESUMO
Background: Ankle Foot Orthosis (AFOs) are frequently prescribed in the management of drop-foot patients. However, few studies have examined the benefits of different design of Ankle Foot Orthosis with extra elements like dampers or springs. Therefore, the objective of this study was to investigate the efficacy of articulated Ankle Foot Orthosis with Hydra pneumatic damper, in kinetic, kinematic and spatiotemporal parameters of drop foot patients. Methods: Ten drop foot patients were recruited for this study, walked at self-selected comfortable speed. A three-dimensional motion analysis, were used for obtaining kinetic, spatio-temporal and kinematic gait parameters. Results: The articulated Ankle Foot Orthosis with Hydra pneumatic damper was significantly improved speed, cadence, step length of walking (p<0.005). Furthermore, the peak and mean of moment, push off velocity and energy storing/returning were significantly improved by articulated Ankle Foot Orthosis with Hydra pneumatic damper (p<0.005). Conclusion: The newly designed articulated Ankle Foot Orthosis with Hydra pneumatic damper improved the ankle moment in at the loading response, power generation and the ankle range in drop foot patient.
RESUMO
Background: Drop foot syndrome is a disorder characterized by foot slapping after the initial contact and foot-dragging during the swing phase. Passive and hybrid passive ankle foot orthoses (AFOs) are often prescribed in these patients; however, the effects of these AFO designs on kinematic parameters during gait are unclear. The aim of this study was to compare the effect of innovative designed storing-restoring hybrid passive AFOs versus posterior leaf spring AFO on ankle joint kinematics in drop foot patients. Methods: The present study was a case series where a single case and 3 cases with drop foot syndrome were recruited. This study was designed in 2 phases: the baseline phase with their PLS AFOs and an intervention phase in which innovative designed AFO were assessed. Each phase included 5 measurement sessions which were performed in 5 consecutive weeks. The celeration line method was used to detect the significant differences between the phases. Results: The results of this study showed a significant increase in the kinematic angles parameters at the initial contact, the loading response, the mid stance, terminal stance, pre swing, initial swing, mid swing, and terminal swing with the innovative designed AFO than with PLS AFO (p<0.05). Conclusion: The results of the present study suggested that use of the innovative designed AFO may have a positive effect on ankle joint kinematics parameters in people with drop foot.
RESUMO
BACKGROUND: Speech and language pathologists should include connected speech assessment as part of their evaluation for children with speech sound disorders. The purpose of the present study was to design and validate an instrument for assessment of articulation by story-retelling for Persian children. METHODS: 261 typically developing children, aged 4-5 years old in Iran, Tehran, in 2016-2017, were recruited in the current study. First, two stories were designed. Next, the expert panel reviewed those two stories and selected one story for assessment. The strengths of the test for discriminating between the two age groups (48-54 months and 55-60 months) and between boys and girls were investigated for construct validity. Test-retest was performed for 15 children. Also, inter-rater reliability was evaluated via calculating the correlation between the two examiners' scores. Statistical Package for Social Sciences (SPSS), version 24, was used for statistical analysis. The significance level was set at (P<0.05). RESULTS: There was 80% or more agreement in experts' response to questions regarding content validity. All of the reliability values were higher than 0.85. No significant difference was observed between boys and girls (P=0.77), but there was a significant difference between the two age groups (P<0.001). There was a significant correlation between this test and phonetic test of the Persian version of diagnostic articulation and phonology (r=0.62, P=0.002). CONCLUSION: The Persian story for the assessment of speech sound production is a reliable and valid instrument that can be used to evaluate the articulation of Persian children.
RESUMO
Background: Ankle foot orthoses (AFOs) are frequently prescribed to improve gait deviation and normalize walking pattern in patients with drop foot hemiplegia disorder. This study was to review the efficacy of different techniques of AFO construction and biomechanics parameters of AFOs. Furthermore, this study aimed to provide a guideline for researchers in detail and help them choose a sufficient measurement instrument. Methods: Information sources included MEDLINE, CINAHL, Scopus, PubMed, and the Full Cochrane Library up to December 25, 2015. The inclusion criteria include: (1) type and method of controlled clinical trial studies; (2) age of hemiplegia groups (3); AFOs as an intervention; and (4) kinetic and kinematic parameters, and energy expenditure as an intervention of gait performance. Results: Considering eligibility criteria such as study design, setting, time frame and Language 9 papers with Pedro scores of 5 to 8 for methodological quality were included in the review. Conclusion: The findings of this review can help to develop guidelines for the best AFO reporting as an intervention and to prevent vagueness of results in the different types of AFOs.
RESUMO
Background: In developing countries, people with disabilities (PWD) are more likely to have unequitable access to health care services than their counterparts without disabilities. Access to health care is a multidimensional concept and PWD experience various barriers to use health care. This quantitative study explored the predictors and determents of access to health care for PWD in an Iranian context. Methods: Data were collected from a cross sectional study conducted in Tehran in 2017. A total of 403 adults with physical and/or intellectual disabilities were selected using census method. The data on PWD were collected from 14 rehabilitation centers affiliated to Welfare Organization and Red Crescent Organization. The self-report World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) was used to collect data on disability status. T test, ANOVA, and multiple linear regressions were used to determine factors influencing access to health care for PWD. Significance level was set at 5%. Also, SPSS software version 20.0 was used for data analysis. Results: The mean of access to health care among people with intellectual disabilities (mean: 61.77, 95% confidence interval (CI):59.20, 64.35) was significantly lower than their counterparts with physical disabilities (Mean: 67.97, 95% CI: 65.26, 70.69). The results of multiple linear regression analysis showed that in the affordability dimension, type of disability, marital status, and supplemental health insurance could predict access to health services for PWD. In availability dimension, only location predicted the outcome variable significantly. Also, location and type of disability were considered to be potential predictors of access to health services in acceptability dimension. Conclusion: The results indicate that various factors can limit access to health services for PWD. To achieve universal health coverage, vulnerable groups and their needs should be identified to increase equitable access to health care services. Also, the health care system should pay more attention to demographic differences when planning and providing affordable and acceptable health care for PWD. Finally, the role of the government as the heath stewardship is vital to promote health care access for PWD in Iran.