Effect of transcutaneous spinal direct current stimulation on spasticity in upper motor neuron conditions: a systematic review and meta-analysis

STUDY DESIGN: A systematic review and meta-analysis of clinical trials. OBJECTIVES: To determine the effect of non-invasive transcutaneous spinal direct current stimulation (tsDCS) on spasticity, activity limitations and participation restrictions in various upper motor neuron diseases. METHODS: Six databases including CINAHL plus, Cochrane CENTRAL, Embase, MEDLINE, SCOPUS and Web of Science were searched for the relevant records from January 2008 to December 2022. Two reviewers independently selected and extracted data on spasticity, activity limitations and participation restrictions. The risk of bias was evaluated using the PEDro scale while the GRADE approach established the certainty of the evidence. RESULTS: Eleven studies were identified of which 5 (45.5%) were rated as having a low risk of bias and 8 (72.7%) were meta-analyzed. The meta-analyses did not show any significant differences between cathodal (SMD = -0.67, 95% CI = -1.50 to 0.15, P = 0.11, I2 = 75%, 6 RCTs) or anodal (SMD = 0.11, 95% CI = -0.43 to -0.64, p = 0.69, I2 = 0%, 2 RCTs) and sham tsDCS for spasticity. There was also no significant difference between active and sham tsDCS for activity limitations (SMD = -0.42, 95% CI = -0.04 to 0.21, p = 0.2, I2 = 0%, 2 RCTs) and participation restrictions (MD = -8.10, 95% CI = -18.02 to 1.82, p = 0.11, 1 RCT). CONCLUSIONS: The meta-analysis of the available evidence provides an uncertain estimate of the effect of cathodal tsDCS on spasticity, activity limitation and participation restriction. It might be very helpful, or it may make no difference at all. However, considering the level of the evidence and the limitation in the quality of the majority of the included studies, further well-designed research may likely change the estimate of effect. TRIAL REGISTRATION: PROSPERO CRD42021245601

Two decades of neuroscience publication trends in Africa.

Neuroscience research in Africa remains sparse. Devising new policies to boost Africa's neuroscience landscape is imperative, but these must be based on accurate data on research outputs which is largely lacking. Such data must reflect the heterogeneity of research environments across the continent's 54 countries. Here, we analyse neuroscience publications affiliated with African institutions between 1996 and 2017. Of 12,326 PubMed indexed publications, 5,219 show clear evidence that the work was performed in Africa and led by African-based researchers - on average ~5 per country and year. From here, we extract information on journals and citations, funding, international coauthorships and techniques used. For reference, we also extract the same metrics from 220 randomly selected publications each from the UK, USA, Australia, Japan and Brazil. Our dataset provides insights into the current state of African neuroscience research in a global context

Predicting Preterm Birth Among Women Screened by North Carolina’s Pregnancy Medical Home Program

To determine which combination of risk factors from Community Care of North Carolina’s (CCNC) Pregnancy Medical Home (PMH) risk screening form was most predictive of preterm birth (PTB) by parity and race/ethnicity

The Politics of Intergovernmental Relations: Assessing the Many Phases and Challenges of Nigeria’s Judicial System

The judiciary is an important organ of government as it functions as a counterbalancing institution in states. Notwithstanding the nature of the political system in place, either democratic or nondemocratic, the judiciary plays the essential role of interpreting the extant laws and adjudicating between competing interests whether domiciled in individuals, groups, institutions of government or the various arms of government. The stabilising role of the judiciary in modern governance is exemplified by its ingrained function of checking the excesses of individuals, groups and government institutions through the application of state laws. Since Nigeria’s independence, its judiciary has been discharging its constitutional responsibilities. The journey of the Nigerian judiciary has been quite explosive, considering that it traversed both the jackboot of military authoritarianism and democratic governance in diverse forms, with each presenting its own peculiar bouquet of challenges. This chapter examines the various phases and attendant challenges that the Nigerian judiciary has passed through. It chronicles its many challenges and triumphs as well as low points. In sum, the Nigerian judiciary has acquitted itself admirably in dealing with such challenges as judicial independence, judicial accountability and crisis of condence occasioned by judicial recklessness and corruption. However, Nigeria’s judicial system still has room for further improvement in order to continue to command the respect of the citizens and thus, deserve such epithets as “the last hope of the common man”, “the bulwark of the people’s liberty”, “the defender of the rights of the people” and “the bastion of constitutional democracy,” among others, which demonstrate public acceptance and confidence