Effects of designed feeding patterns on fatigue in multiple sclerosis patients

زمینه و هدف: بیماری مولتیپل اسکلروزیس (MS) شایع ترین بیماری نورولوژیک در بالغین جوان است که آنها را ناتوان می سازد. خستگی یکی از شایع ترین علائم این بیماری است که نه تنها فعالیت و توانایی بیماران بلکه کیفیت زندگی آنها را نیز کاهش می‌دهد. تغذیه صحیح یکی از روش هایی است که می‌تواند برای کاهش خستگی مورد استفاده قرار گیرد. این مطالعه با هدف بررسی تأثیر الگوی تغذیه‌ای طراحی شده بر خستگی بیماران مولتیپل اسکلروزیس مراجعه کننده به انجمن MS ایران انجام شد. روش بررسی: در این مطالعه نیمه تجربی، 40 بیمار مبتلا به مولتیپل اسکلروزیس به روش نمونه گیری هدفمند و در دسترس انتخاب شدند. ابزار گردآوری داده ها، پرسشنامه محقق ساخته بود. آموزش رعایت الگوی غذایی به مدت 12 هفته بر روی بیماران انجام شد. پرسشنامه ها توسط بیماران قبل و بعد از مداخله تکمیل گردیدند. آنالیز داده ها با استفاده از شاخص های توصیفی (میانگین، انحراف معیار) و آمار استنباطی نظیرt زوجی، انجام شد. یافته ها: میانگین سنی نمونه های مورد مطالعه 5/1 ± 8/35 سال بود. میانگین شدت خستگی نمونه های مورد پژوهش قبل از مطالعه 77/0 ± 9/14 و بعد از رعایت الگوی غذایی 44/0 ± 6/25 بود که نشان می دهد شدت خستگی کاهش معنی داری داشته است (001/0>P). نتیجه گیری: الگوی غذایی ارائه شده در این مطالعه به عنوان یک روش ساده، ارزان، بدون عارضه و غیر تهاجمی برای کاهش خستگی بیماران مبتلا به مولتیپل اسکلروزیس موثر و قابل استفاده است

Modulation of the Expression of the GABAA Receptor β1 and β3 Subunits by Pretreatment with Quercetin in the KA Model of Epilepsy in Mice -The Effect of Quercetin on GABAA Receptor Beta Subunits-

Objectives: Quercetin is a flavonoid and an important dietary constituent of fruits and vegetables. In recent years, several pharmacological activities of quercetin, such as its neuroprotective activity and, more specifically, its anti-convulsant effects in animal models of epilepsy, have been reported. This study evaluated the role of quercetin pretreatment on gene expression of γ-amino butyric acid type A (GABAA) receptor beta subunits in kainic acid (KA)-induced seizures in mice. Methods: The animals were divided into four groups: one saline group, one group in which seizures were induced by using KA (10 mg/kg) without quercetin pretreatment and two groups pretreated with quercetin (50 and 100 mg/kg) prior to seizures being induced by using KA. Next, the messenger ribonucleic acid (mRNA) levels of the GABAA receptor β subunits in the hippocampus of each animal were assessed at 2 hours and 7 days after KA administration. Quantitative real-time polymerase chain reaction (RT-PCR) assay was used to detect mRNA content in hippocampal tissues. Results: Pretreatments with quercetin at doses of 50 and 100 mg/kg prevented significant increases in the mRNA levels of the β1 and the β3 subunits of the GABAA receptor at 2 hours after KA injection. Pretreatment with quercetin (100 mg/kg) significantly inhibited β1 and β3 gene expression in the hippocampus at 7 days after KA injection. But, this inhibitory effect of quercetin at 50 mg/kg on the mRNA levels of the β3 subunit of the GABAA receptor was not observed at 7 days after KA administration. Conclusion: These results suggest that quercetin (100 mg/kg) modulates the expression of the GABAA receptor β1 and β3 subunits in the KA model of epilepsy, most likely to prevent compensatory responses. This may be related to the narrow therapeutic dose range for the anticonvulsant activities of quercetin

Improvement in Activity of Daily Living and Fatigue in Multiple Sclerosis Patients: the Impact of Nutrition Education

Background: Fatigue is one of the most common complications of Multiple Sclerosis (MS). However, a few studies are available on the effect of nutrition education on fatigue and Activities of Daily Living (ADL) in patients with MS. Objectives: This study aimed to assess the effect of nutrition education on fatigue and ability to perform ADL in patients with MS. Methods: This quasi-experimental one group, pretest and posttest study was performed on 40 patients with MS, who were conveniently recruited among patients, registered at the Iranian MS Society. Data were collected through a demographic questionnaire, the Fatigue Severity Scale (FSS), a standard ADL scale, and a 24-hour food recall for two days. The instruments were completed at the start and two months after the intervention. Descriptive statistics and paired t test were used to analyze the data. Results: Sixty percent of the patients had severe fatigue before the intervention while, 90% of them reported mild fatigue after the intervention. The mean posttest ADL was increased by 12.45 units after the intervention when compared with the pretest value (P<0.001). Moreover, the daily intake of vitamin D and E, calcium and omega3 were lower than 75% of the Dietary Reference Intake (DRI) in most of the patients. Conclusions: The present study showed the beneficial effects of nutritional training on fatigue and ADL in patients with MS. Therefore, nurses and dietitians should regularly assess the patients’ dietary pattern and train them and their families about appropriate diet

SOY PROTEIN ISOLATE (SPI) “GREEN” SCAFFOLDS WITH ORIENTED MICROCHANNELS FOR APPLICATIONS IN SPINAL CORD INJURY

Every year, accidents, falls, sport injuries and other incidents cause thousands of people to suffer spinal cord injury (SCI). In the United States alone, it is estimated that the number of Americans that live with SCI is around 259,000, with 12,000 new cases that happen annually (1). These injuries lead to spinal cord damages expressed by massive nerve tract degeneration followed by neurological loss, paralysis and disabilities. Therapy of SCI patients with non-steroidal anti-inflammatory drugs (NSAIDs) help in diminishing secondary injury and lessen pain and swelling. However these drugs do not promote tissue repair. Therefore there is an unmet clinical need to develop technologies and therapeutic strategies that compensate loss of neuronal tissue, support and facilitate reestablishment of nerve tracks connectivity in the injured spinal cord. Recent progress in nerve regeneration indicates that a tissue engineering approach using soft tissue scaffolds, stem cells and neurotrophins, can lead to a partial therapy in animal models of SCI. Bioengineered scaffolds prepared by freeze casting technology provide an experimental tool for guidance of regenerating neuronal tracts and/or axons and therefore are useful for regeneration of injured spinal cord. In this engineering approach for scaffold preparation, temperature controlled directional solidification of an aqueous polymer(s) solution creates channels of different diameters that can direct axonal outgrowth of neurons populating the scaffold. In a previous study from our laboratory, such scaffolds promoted differentiation of neurons, a process facilitated by co-population of the scaffold’s channels with endothelial cells. “Green” plant proteins, such as soybean proteins, are becoming an attractive alternative source of natural polymers for a variety of biomedical applications including scaffold fabrication for neuronal tissue regeneration. In the present study, we developed a second generation of improved, microchanneled composite scaffolds from gelatin and soy protein isolate cross-linked with genipin (2 w/v %, 0.5 w/v %, 1 w/v %, respectively). The fabrication of these scaffolds by a controlled freeze drying technique, their mechanical properties (stiffness, ~3-4 kPa) as well as their uniform longitudinal channels of a diameter of ~30-55 µm is described. Preliminary biocompatibility experiments in 2D and 3D using the above mentioned scaffolds populated with either undifferentiated PC12 cells or nerve growth factor differentiated PC12 cells indicated partial biocompatibility of the scaffolds for neuronal growth. Improving the biocompatibility of these composite scaffolds is under investigation in our laboratory.Bioengineerin

Modelling and cruise control of a mobile machine with hydrostatic power transmission

A parallel hydrostatic power transmission is studied and the possible constraint which can effect on the fluid division in the system is analyzed. The dynamic model of the machine is studied in two sections: a simplified model and a complicated model. In both of the models all the acting forces and their effect on the vehicle’s motion are studied and the dynamic behavior of the machine is calculated using mathematical equations. The speed of the machine cannot be controlled by a simple feedback control. It is concluded that a simple feedback controller does not provide the best performance for this application. The gain-scheduled PID controller is used for this application. This Type of controller can adapt itself with the variable dynamic characteristics of the hydraulic system. Gain scheduling is the major key in gain-scheduled PID controller. The results of tuning with different gains are shown and the Bode & step diagrams are presented. Several static tests on the machine have been done to monitor the behavior of the HST. For the first test the diesel engine rotational speed is kept constant at 1200 RPM and the displacement of hydraulic pump is modified. For the second test the displacement of hydraulic pump is kept constant at 60% and the diesel engine rotational speed RPM is modified. In both of the tests the vehicle is moved in a straight direction and on a smooth terrain. The result of comparison between the open loop & closed loop control response is presented. The behavior of the open loop & closed loop controllers is studied in the presence and absence of an external disturbance. The external disturbance is considered to be a gradient terrain. In the last section, the conclusion of the thesis is presented. Some useful hints are recommended to overcome the difficulties that the cruise control of the machine is faced

Could Fampridine Attenuate the Severity of COVID-19 in Patients with Multiple Sclerosis?

Since the onset of COVID-19 in December 2019, millions of people have been infected with SARS-CoV-2 across the world and many have died of the disease. Therefore, the search for any drug with a positive effect on the course of this disease is of great value. Fampridine is a drug widely used to improve gait disorders in patients with multiple sclerosis. The mentioned drug is a potassium channel blocker that increases the conduction of action potentials in damaged axons. However, it is not evident whether this drug can affect potassium channels on the surface of other cells. Some studies have revealed that potassium-blocking drugs can play a role in reducing the incidence or severity of infectious diseases. Hence, the question of whether fampridine could also have a protective effect on patients with MS in the face of COVID-19 should be attended to. The incidence and severity of COVID-19 in patients with MS receiving fampridine (Dalfyra®, Arvand Pharmed) were evaluated to address the mentioned question.&nbsp;In the present study conducted in November 2020, 117 MS patients receiving fampridine were tested for COVID-19. The majority of these patients (55.6%) were receiving rituximab. Of these 117 patients, nine were infected by the COVID-19 virus. Of these nine patients, five and four were female and male, respectively. Eight of the infected patients took rituximab, and one did not take any disease modulatory drug (DMD). One of these nine patients required to be hospitalized. She was a 40-year-old woman with MS disease duration of 3.5 years and was treated with rituximab. Her symptoms were manifested by fever, shortness of breath, and dry cough. The mentioned patient was hospitalized for three days due to the conditions associated with COVID-19. She did not need to be admitted to the intensive care unit (ICU) and was discharged with a good medical condition after three days.&nbsp;The incidence of COVID-19 in these patients was 7%, and the hospitalization rate was 11% in patients receiving fampridine. None of the patients with COVID-19 required hospitalization in the ICU, and no fatalities were reported.&nbsp;In a previous study conducted on 4,647 patients with MS in Iran, the incidence rate was reported to be 1.46% during the first wave of COVID-19 (May 2020). The incidence rate in our study was 7%, which was significantly higher than the&nbsp;percentage of the previous report. It should be noted that our study was conducted at the height of the second wave of COVID-19 in Iran, during which a much larger number of people were infected with COVID-19, according to official statistics.&nbsp;In the previous study, the hospitalization rate was 25%. However, fampridine users, despite being more infected, had a lower hospitalization rate (11%), which indicated a lower severity of the disease in these patients. The mentioned finding could be due to the possible protective effect of fampridine on the exacerbation of COVID-19 in these patients.&nbsp;This hypothesis requires further examination in more detail

A Novel Neural Network Approach for Predicting the Arrival Time of Buses for Smart On-Demand Public Transit

Among the major public transportation systems in cities, bus transit has its problems, including more accuracy and reliability when estimating the bus arrival time for riders. This can lead to delays and decreased ridership, especially in cities where public transportation is heavily relied upon. A common issue is that the arrival times of buses do not match the schedules, resulting in latency for fixed schedules. According to the study in this paper on New York City bus data, there is an average delay of around eight minutes or 491 seconds mismatch between the bus arrivals and the actual scheduled time. This research paper presents a novel AI-based data-driven approach for estimating the arrival times of buses at each transit point (station). Our approach is based on a fully connected neural network and can predict the arrival time collectively across all bus lines in large metropolitan areas. Our neural-net data-driven approach provides a new way to estimate the arrival time of the buses, which can lead to a more efficient and smarter way to bring the bus transit to the general public. Our evaluation of the network bus system with more than 200 bus lines, and 2 million data points, demonstrates less than 40 seconds of estimated error for arrival times. The inference time per each validation set data point is less than 0.006 ms

The Assessment of Safe Nursing Care: development and psychometric evaluation

This paper discusses the development of an instrument to assess safe nursing care snd the process of evaluating its reliability and valdit