Translingual neurostimulation combined with physical therapy to improve walking and balance in multiple sclerosis (NeuroMSTraLS): Study protocol for a randomized controlled trial

INTRODUCTION: Physical rehabilitation restores lost function and promotes brain plasticity in people with Multiple Sclerosis (MS). Research groups worldwide are testing the therapeutic effects of combining non-invasive neuromodulation with physical therapy (PT) to further improve functional outcomes in neurological disorders but with mixed results. Whether such devices enhance function is not clear. We present the rationale and study design for a randomized controlled trial evaluating if there is additional benefit to the synergistic pairing of translingual neurostimulation (TLNS) with PT to improve walking and balance in MS. METHODS AND ANALYSIS: A parallel group [PT + TLNS or PT + Sham], quadruple-blinded, randomized controlled trial. Participants (N = 52) with gait and balance deficits due to relapsing-remitting or progressive MS, who are between 18 and 70 years of age, will be recruited through patient registries in Newfoundland & Labrador and Saskatchewan, Canada. All participants will receive 14 weeks of PT while wearing either a TLNS or sham device. Dynamic Gait Index is the primary outcome. Secondary outcomes include fast walking speed, subjective ratings of fatigue, MS impact, and quality of life. Outcomes are assessed at baseline (Pre), after 14 weeks of therapy (Post), and 26 weeks (Follow Up). We employ multiple methods to ensure treatment fidelity including activity and device use monitoring. Primary and secondary outcomes will be analyzed using linear mixed-effect models. We will control for baseline score and site to test the effects of Time (Post vs. Follow-Up), Group and the Group x Time interaction as fixed effects. A random intercept of participant will account for the repeated measures in the Time variable. Participants must complete the Post testing to be included in the analysis. ETHICS AND DISSEMINATION: The Human Research Ethics Boards in Newfoundland & Labrador (HREB#2021.085) & Saskatchewan (HREB Bio 2578) approved the protocol. Dissemination avenues include peer-reviewed journals, conferences and patient-oriented communications

Modelling the variation of soil stiffness during sequential construction

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A Study on Iterative Solution of Population Dynamics Models

Abstract In this paper, simple approximate solutions of differential equations pertaining to population dynamics are obtained using iterative method. When the order of approximation tends to infinity, the solutions obtained converge towards an exact solution in some finite time interval. Mathematics Subject Classifications: 34A34, 34B15, 34D10, 37M9

Identification of a Novel Axon Regeneration Role for Noncanonical Wnt Signaling in the Adult Retina after Injury

Canonical and noncanonical Wnt signaling pathways are essential for development and maintenance of the CNS. Whereas the roles of canonical Wnt pathways in neuronal survival and axonal regeneration in adult CNS have been described, the functions of noncanonical Wnt pathways are not well understood. Furthermore, the role of noncanonical Wnt ligands in the adult retina has not been investigated. Noncanonical Wnt signaling shares receptors with canonical Wnt ligands but functions through calcium and c-Jun N-terminal kinase (JNK) signaling pathways. Noncanonical ligands, such as the prototypic ligand Wnt5a, have varying effects in the developing CNS, including inhibiting or promoting axonal growth. To identify a role for noncanonical Wnt signaling in the developed retina after injury, we characterized the effect of Wnt5a on neurite outgrowth in cultured retinal ganglion cell (RGC) neurons and on axonal regeneration in the injured optic nerve in the mouse. Endogenous Wnt5a was upregulated after injury and exogenous Wnt5a significantly enhanced neurite growth of primary RGCs and led to extensive axonal regeneration after optic nerve crush (ONC) injury. Wnt5a also significantly increased RGC survival. Furthermore, Wnt5a induced phosphorylation of CamKII and JNK and induced expression of their downstream pathway components. Therefore, these results demonstrate for the first time that Wnt5a promotes axonal growth and protects RGCs in the adult retina

Cross-Cultural Variation in BMI, Sedentary Behavior, and Physical Activity in International School Girls Residing in Saudi Arabia

Background: The current study was done to assess the cross-cultural difference in physical activity and sedentary behavior among girls from culturally, environmentally, and geographically diverse countries residing in Saudi Arabia. Methods: This was a comparative cross-sectional study conducted among expatriate girls (N = 275), aged 9–16 years. Participants were from India (n = 65), Pakistan (n = 88), Egypt (n = 50), Sudan (n = 49), and other nationals (n = 23). They were randomly selected from different schools in Riyadh and their Body Mass Index (BMI) and screen time was assessed. Physical activity (PA) and leisure-time activity was assessed using Physical Activity Questionnaire for Older Children (PAQ-C) and the Godin-Shephard Leisure-Time Exercise Questionnaire (GSLTPAQ) respectively. Results: Out of 275, 65.8% were active and 34.2% were insufficiently active as per the GSLTPAQ, and half of them were moderately active and only 22.2% were extremely active as per PAQ-C. No statistical significant differences in their BMI status, screen time, or the levels of PA among expatriate girls. Conclusions: This study shows that the expatriate female school children in Saudi Arabia demonstrated a similar pattern in their BMI, sedentary time spent, and PA levels

Accurate superimposed component estimation for improved relay performance during power swing

There is continuous variation in amplitude, phase, and frequency of voltage and current signals during power swing in a power system. Such variation makes the memorized prefault data less accurate to be used as nonfault component while computing superimposed quantity for protection decisions during power swing. In this article, the voltage and current signal characteristics during power swing are analyzed and a technique is proposed to obtain correct nonfault components for superimposed quantity computation. The accuracy of the method in estimating the nonfault components is observed for different power swing conditions simulated in a 39-bus New England system and field data. The relay performance improvement as observed is also provided while applying the method to directional relaying, fault type classification, and fault location applications for faults during power swing. Comparative assessment reveals the superiority of the proposed method in improving the accuracy of the superimposed components computed during power swing

Effect of Therapy Ball Seating on Learning and Sitting Discomforts among Saudi Female Students

The aim of the study was to evaluate the effect of therapy ball seating as an alternative for typical chair seating in a classroom. We evaluated the effect of ball seating on the student's sitting discomfort and academic performance using Cornell Musculoskeletal Discomfort Questionnaire and problem-based learning scales, respectively. A sample of convenience was taken. Data was collected and analyzed using t-test. Subjects experienced a major discomfort at neck and a minor discomfort at knee joint. Results showed that there was a significant improvement (P≤0.05) in sitting discomfort and student's performance when seated on therapy balls compared to typical classroom chairs. This study provides evidence for the effectiveness of therapy balls as a classroom seating for students who exhibit sitting discomfort and problem-based learning

Cosmological Evolution of Bianchi type-VIₒ Kaniadakis Holographic Dark Energy Model

The purpose of this paper is to construct anisotropic and spatially homogeneous Bianchi type-VI0 Kaniadakis holographic dark energy (KHDE) model in general relativity. For this purpose, we consider Hubble horizons as the IR cutoff. To obtain a deterministic solution of the field equations of the model we assume a relationship between the metric potentials which leads to an exponential solution and accelerated expansion. In order to investigate the physical behavior of our dark energy model, we obtain some important cosmological parameters like Hubble, deceleration, equation of state and statefinder as well as ωkhde-ω'khde, r-s and r-q planes. We also included the stability analysis for the dark energy model through the squared speed of sound. It is observed that the equation of state parameter shows ΛCDM model at late times. Also, the squared speed of sound gives the stability of KHDE model at initial epoch and model is unstable at late times. Statefinder diagnostic and deceleration parameters exhibit a smooth transition of the universe from decelerating phase to current accelerated expansion of the universe and also correspond to the ΛCDM model at late times. All these cosmological parameters support recent observational data