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Relapsing-remitting Multiple Sclerosis is the most common demyelinating neurodegenerative disease and is characterized by periods of relapses and generation of various motor symptoms. These symptoms are associated with the corticospinal tract integrity, which is quantified by means of corticospinal plasticity which can be probed via transcranial magnetic stimulation and assessed with corticospinal excitability measures. Several factors, such as exercise and interlimb coordination, can influence corticospinal plasticity. Previous work in healthy and in chronic stroke survivors showed that the greatest improvement in corticospinal plasticity occurred during in-phase bilateral exercises of the upper limbs. During in-phase bilateral movement, both upper limbs are moving simultaneously, activating the same muscle groups and triggering the same brain region respectively. Altered corticospinal plasticity due to bilateral cortical lesions is common in MS, yet, the impact of these type of exercises in this cohort is unclear. The aim of this concurrent multiple baseline design study is to investigate the effects of in-phase bilateral exercises on corticospinal plasticity and on clinical measures using transcranial magnetic stimulation and standardized clinical assessment in five people with relapsing-remitting MS. The intervention protocol will last for 12 consecutive weeks (30–60 minutes /session x 3 sessions/week) and include in-phase bilateral movements of the upper limbs, adapted to different sports activities and to functional training. To define functional relation between the intervention and the results on corticospinal plasticity (central motor conduction time, resting motor threshold, motor evoked potential amplitude and latency) and on clinical measures (balance, gait, bilateral hand dexterity and strength, cognitive function), we will perform a visual analysis and if there is a potential sizeable effect, we will perform statistical analysis. A possible effect from our study, will introduce a proof-of-concept for this type of exercise that will be effective during disease progression. Trial registration: ClinicalTrials.gov NCT05367947 .

Orbital and surface observations can shed light on the internal structure of Mars. NASA’s InSight mission allows mapping the shallow subsurface of Elysium Planitia using seismic data. In this work, we apply a classical seismological technique of inverting Rayleigh wave ellipticity curves extracted from ambient seismic vibrations to resolve, for the first time on Mars, the shallow subsurface to around 200 m depth. While our seismic velocity model is largely consistent with the expected layered subsurface consisting of a thin regolith layer above stacks of lava flows, we find a seismic low-velocity zone at about 30 to 75 m depth that we interpret as a sedimentary layer sandwiched somewhere within the underlying Hesperian and Amazonian aged basalt layers. A prominent amplitude peak observed in the seismic data at 2.4 Hz is interpreted as an Airy phase related to surface wave energy trapped in this local low-velocity channel. We invert Rayleigh wave ellipticity curves extracted from ambient seismic vibrations at the InSight landing site to resolve, for the first time on Mars, the shallow subsurface to around 200 m depth. While our seismic velocity model is largely consistent with the expected stacks of lava flows, we find a seismic low velocity zone at about 30 to 75 m depth that we interpret as a sedimentary layer sandwiched between layers of basalt flows.

PurposeChronic post-operative groin pain is a substantial complication following open mesh inguinal hernia repair. The exact cause of this pain is still unclear, but entrapment or trauma of the ilioinguinal nerve may have a role to play. Elective division of this nerve during hernia repair has been proposed in an attempt to reduce the incidence of chronic groin pain.MethodsWe performed a meta-analysis of nine randomized controlled trials comparing preservation versus elective division of the ilioinguinal nerve during this operation.ResultsA substantial proportion of patients having open mesh inguinal hernia repair experience chronic groin pain when the ilioinguinal nerve is preserved (estimated rate of 9.4% at 6 months and 4.8% at 1 year). Elective division of the nerve resulted in a significant reduction of groin pain at 6-months post-surgery (RR 0.47, p = 0.02), including moderate/severe pain (RR 0.57, p = 0.01). However, division of the nerve also resulted in an increase of subjective groin numbness at this time point (RR 1.55, p = 0.06). At 12-month post-surgery, the beneficial effect of nerve division on chronic pain was reduced, with no significant difference in the rates of overall groin pain (RR 0.69, p = 0.38), or of moderate-to-severe groin pain (RR 0.99, p = 0.98) between the two groups. The prevalence of groin numbness was also similar between the two groups at 12-month post-surgery (RR 0.79, p = 0.48).ConclusionsRoutine elective division of the ilioinguinal nerve during open mesh inguinal hernia repair does not significantly reduce chronic groin pain beyond 6 months, and may result in increased rates of groin numbness, especially in the first 6-months post-surgery.

Mars’s seismic activity and noise have been monitored since January 2019 by the seismometer of the InSight (Interior Exploration using Seismic Investigations, Geodesy and Heat Transport) lander. At night, Mars is extremely quiet; seismic noise is about 500 times lower than Earth’s microseismic noise at periods between 4 s and 30 s. The recorded seismic noise increases during the day due to ground deformations induced by convective atmospheric vortices and ground-transferred wind-generated lander noise. Here we constrain properties of the crust beneath InSight, using signals from atmospheric vortices and from the hammering of InSight’s Heat Flow and Physical Properties (HP3) instrument, as well as the three largest Marsquakes detected as of September 2019. From receiver function analysis, we infer that the uppermost 8–11 km of the crust is highly altered and/or fractured. We measure the crustal diffusivity and intrinsic attenuation using multiscattering analysis and find that seismic attenuation is about three times larger than on the Moon, which suggests that the crust contains small amounts of volatiles.The crust beneath the InSight lander on Mars is altered or fractured to 8–11 km depth and may bear volatiles, according to an analysis of seismic noise and wave scattering recorded by InSight’s seismometer.

Steroid injections in joints are commonly administered for the management of inflammatory or degenerative conditions. There is substantial controversy as to whether to continue warfarin when undertaking joint injection or aspiration. To assess the rate of bleeding complications in patients on warfarin undergoing joint injection/aspiration. Systematic review and meta-analysis. A literature search of 3 online databases was conducted by 2 reviewers using the Cochrane methodology for systematic reviews. Eligibility criteria were any study that reported bleeding complication rates in adult patients on warfarin undergoing a joint injection/aspiration whilst taking warfarin anticoagulation. Studies reporting on less than 5 patients were excluded. Meta-analysis was conducted using a random effects model. The search of databases resulted in a total of 1547 articles. After screening, 8 articles were deemed suitable for inclusion in the analysis, involving 871 injection/aspiration procedures. There were only 5 reported cases of bleeding. On meta-analysis the estimated bleeding complication rate was 1.5% (95% CI 0.5–4.5%). This meta-analysis shows that it is safe to perform joint injection and aspiration in patients on warfarin without routine prior testing of INR. Level of evidence: Level 4.

Perception of sensory stimulation is influenced by numerous psychological variables. One example is placebo analgesia, where expecting low pain causes a painful stimulus to feel less painful. Yet, because pain evolved to signal threats to survival, it should be maladaptive for highly-erroneous expectations to yield unrealistic pain experiences. Therefore, we hypothesised that a cue followed by a highly discrepant stimulus intensity, which generates a large prediction error, will have a weaker influence on the perception of that stimulus. To test this hypothesis we collected two independent pain-cueing datasets. The second dataset and the analysis plan were preregistered ( https://osf.io/5r6z7/ ). Regression modelling revealed that reported pain intensities were best explained by a quartic polynomial model of the prediction error. The results indicated that the influence of cues on perceived pain decreased when stimulus intensity was very different from expectations, suggesting that prediction error size has an immediate functional role in pain perception.

The Interior Exploration using Seismic Investigations, Geodesy and Heat Transport (InSight) spacecraft landed successfully on Mars and imaged the surface to characterize the surficial geology. Here we report on the geology and subsurface structure of the landing site to aid in situ geophysical investigations. InSight landed in a degraded impact crater in Elysium Planitia on a smooth sandy, granule- and pebble-rich surface with few rocks. Superposed impact craters are common and eolian bedforms are sparse. During landing, pulsed retrorockets modified the surface to reveal a near surface stratigraphy of surficial dust, over thin unconsolidated sand, underlain by a variable thickness duricrust, with poorly sorted, unconsolidated sand with rocks beneath. Impact, eolian, and mass wasting processes have dominantly modified the surface. Surface observations are consistent with expectations made from remote sensing data prior to landing indicating a surface composed of an impact-fragmented regolith overlying basaltic lava flows.

The seismic activity of a planet can be described by the corner magnitude, events larger than which are extremely unlikely, and the seismic moment rate, the long‐term average of annual seismic moment release. Marsquake S1222a proves large enough to be representative of the global activity of Mars and places observational constraints on the moment rate. The magnitude‐frequency distribution of relevant Marsquakes indicates a b $b$‐value of 1.06. The moment rate is likely between 1.55×1015Nm/a $1.55\\times {10}^{15}\\mathrm{N}\\mathrm{m}/\\mathrm{a}$ and 1.97×1018Nm/a $1.97\\times {10}^{18}\\mathrm{N}\\mathrm{m}/\\mathrm{a}$, with a marginal distribution peaking at 4.9×1016Nm/a $4.9\\times {10}^{16}\\mathrm{N}\\mathrm{m}/\\mathrm{a}$. Comparing this with pre‐InSight estimations shows that these tended to overestimate the moment rate, and that 30% or more of the tectonic deformation may occur silently, whereas the seismicity is probably restricted to localized centers rather than spread over the entire planet. Plain Language Summary The seismic moment rate is a measure for how fast quakes accumulate deformation of the planet's rigid outer layer, the lithosphere. In the past decades, several models for the deformation rate of Mars were developed either from the traces quakes leave on the surface, or from mathematical models of how quickly the planet's interior cools down and shrinks. The large marsquake that occurred on the 4th of May 2022 now allows a statistical estimation of the deformation accumulated on Mars per year, and thus to confront these models with reality. It turns out that, although there is a considerable overlap, the models published prior to InSight tend to overestimate the seismic moment rate, and hence the ongoing deformation on Mars. Possible explanations are that 30% or more of the deformation occurs silently, that is, without causing quakes, or that not the entire planet is seismically active but only specific regions. Key Points A single large marsquake suffices to constrain the global seismic moment rate Pre‐InSight estimations tended to overestimate the moment rate Either a significant part of the ongoing deformation occurs silent, or seismic activity is restricted to some activity centers, or both

Photosynthesis is common in nature, converting sunlight energy into proton motive force and reducing power. The increased spectral range absorption of light exerted by pigments (i.e. chlorophylls, Chls) within Light Harvesting Complexes (LHCs) proves an important advantage under low light conditions. However, in the exposure to excess light, oxidative damages and ultimately cell death can occur. A down-regulatory mechanism, thus, has been evolved (non-photochemical quenching, NPQ). The mechanistic details of its major component (qE) are missing at the atomic scale. The research herein, initiates on solid evidence from the current NPQ state of the art , and reveals a detailed atomistic view by large scale Molecular Dynamics, Metadynamics and ab initio Simulations. The results demonstrate a complete picture of an elaborate common molecular design. All probed antenna proteins (major LHCII from spinach-pea, CP29 from spinach) show striking plasticity in helix-D, under NPQ conditions. This induces changes in Qy bands in excitation and absorption spectra of the near-by pigment pair (Chl613-614) that could emerge as a new quenching site. Zeaxanthin enhances this plasticity (and possibly the quenching) even at milder NPQ conditions.

We investigate the heat transport and the control of heat current among two spatially separated trapped Bose-Einstein Condensates (BECs), each of them at a different temperature. To allow for heat transport among the two independent BECs we consider a link made of two harmonically trapped impurities, each of them interacting with one of the BECs. Since the impurities are spatially separated, we consider long-range interactions between them, namely a dipole-dipole coupling. We study this system under theoretically suitable and experimentally feasible assumptions/parameters. The dynamics of these impurities is treated within the framework of the quantum Brownian motion model, where the excitation modes of the BECs play the role of the heat bath. We address the dependence of heat current and current-current correlations on the physical parameters of the system. Interestingly, we show that heat rectification, i.e. the unidirectional flow of heat, can occur in our system, when a periodic driving on the trapping frequencies of the impurities is considered. Therefore, our system is a possible setup for the implementation of a phononic circuit. Motivated by recent developments on the usage of BECs as platforms for quantum information processing, our work offers an alternative possibility to use this versatile setting for information transfer and processing, within the context of phononics, and more generally in quantum thermodynamics.