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.

Impact of Age Difference, Sex Matching, and Body Mass Index Matching Between Donor and Recipient in Renal Transplant.

BACKGROUND: Various factors influence kidney transplant (KT) outcome. The impact of age difference between donor and recipient on long- and short-term graft and patient survival in living donor KT remains unclear. OBJECTIVE: We aim to determine whether age difference, sex matching, and body mass index (BMI) matching between donor and recipient affect the 12-month patient and graft survival in KT. METHOD: We studied a retrospective cohort of 804 patients 18 years or older with primary KT from January 2010 to December 2014. Patient renal function and patient survival were followed up for 12 months post KT. Repeated analysis of variance measurement determined if there was a significant difference in the mean creatinine levels when the sample was grouped according to the matching groups for sex, age difference, and BMI classification. Odds ratios were computed to ascertain graft loss and graft rejection. Results were considered statistically significant if P < .05. RESULTS: Male donor-female recipient had the lowest creatinine levels over time compared with male donor-male recipient (P < .001) and female donor-male recipient (P < .001). Older donor-younger recipient with age difference of ≥ 15 years had the highest overall creatinine (P < .001). For BMI matching, a normal donor and an underweight recipient combination resulted in the lowest mean creatinine levels over the course of 12 months (P < .001). In terms of graft rejection, odds ratio was highest for a female donor and a male recipient (P < .00a) compared with a male donor and a female recipient. For graft loss, older donors (≥ 15 years) had the highest risk (P < .001) vs those older by 11 to 15 years. CONCLUSION: There was significant difference in the 12-month graft function of patients when grouped according to their matching for age difference, sex, and BMI. The risk for graft rejection increases when the combination for donor-recipient is female donor-male recipient. For graft loss, this is most significant for donors who are older by ≥ 15 years than their recipients.

Effect of Ta Additions on the Microstructure, Damping, and Shape Memory Behaviour of Prealloyed Cu-Al-Ni Shape Memory Alloys.

The influence of Ta additions on the microstructure and properties of Cu-Al-Ni shape memory alloys was investigated in this paper. The addition of Ta significantly affects the green and porosity densities; the minimum percentage of porosity was observed with the modified prealloyed Cu-Al-Ni-2.0 wt.% Ta. The phase transformation temperatures were shifted towards the highest values after Ta was added. Based on the damping capacity results, the alloy of Cu-Al-Ni-3.0 wt.% Ta has very high internal friction with the maximum equivalent internal friction value twice as high as that of the prealloyed Cu-Al-Ni SMA. Moreover, the prealloyed Cu-Al-Ni SMAs with the addition of 2.0 wt.% Ta exhibited the highest shape recovery ratio in the first cycle (i.e., 100% recovery), and when the number of cycles is increased, this ratio tends to decrease. On the other hand, the modified alloys with 1.0 and 3.0 wt.% Ta implied a linear increment in the shape recovery ratio with increasing number of cycles. Polarization tests in NaCl solution showed that the corrosion resistance of Cu-Al-Ni-Ta SMA improved with escalating Ta concentration as shown by lower corrosion current densities, higher corrosion potential, and formation of stable passive film.

Ophthalmologic abnormalities among deaf students in Kaduna, Northern Nigeria.

BACKGROUND: The association between deafness and ocular problems is well established; however the nature and prevalence of these problems are diverse across the globe. OBJECTIVE: The aim of this study is to determine the nature and prevalence of ophthalmologic abnormalities in deaf students and offer treatment to those with remediable conditions. METHOD: Six hundred and twenty deaf students aged between 5 and 38 years were examined in a school for the deaf. RESULTS: One hundred and thirty (20.9%) had some form of ophthalmologic abnormality. Some had anterior segment abnormalities such as corneal opacities (0.5%) and allergic conjunctivitis (3.4%) while others had posterior segment abnormalities like optic atrophy (0.3%), Waardenburg syndrome (0.6%) and Ushers syndrome (0.6%). Refractive error was the most common (7.9%). CONCLUSION: Since these deaf students use their sight to compensate for the deafness, routine ophthalmologic examination should be carried out on them so that ophthalmologic abnormalities are detected early and treatment offered for remediable diseases.