Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system (CNS) and leads to demyelination and loss of CNS neurons. MS usually occurs in young people, and it is mostly women between the ages of 20 and 40 who are affected by the disease. The disease can lead to impairments in motor functions such as walking ability, coordination, reduced balance, and strength. Until now, there is no treatment that can cure the disease, but there is complementary medicine that can suppress the symptoms of the disease or prevent the development of the disease. Nowadays there are studies that show that there may be alternative treatments that can be an ultimate treatment for MS disease that can be effective and beneficial. A novel treatment that researchers have developed is transplantation of autologous mesenchymal multipotent stem cells (MSC), which appear to be the most promising of the emerging treatments of MS. There is research in the field that shows that the treatment is progressive and beneficial. However, there are some study results that show that the treatment can cause side effects. The four chosen articles are reviewed on how effective and safe the treatment with MSC transplantation is in patients with MS. The studies show promising results bur have some shortcomings such as low study population, uneven gender distribution and ethnic considerations. To confirm these results, larger studies with high quality and quantity are needed. The results showed that the treatment gave indications of beneficial effects, including improvements in neurological functions. The Expanded Disability Status Scale (EDSS) value improved during the MSC transplantation in the patients with severe disease which indicate a beneficial effect of this novel treatment.

Environmental management has increasingly become a participatory process. In recent times, emphasis has been placed on watershed-based solutions to remediate the problems of diffuse source pollution and to engage stakeholders in designing solutions. Water quality models are an integral part of this process; such models are often inaccessible to lay stakeholders. A review of the literature suggests that properly applied partnerships have several benefits that go beyond decision-making. Stakeholder education and enhancements to the eventual outcome from stakeholder insight and support are two such benefits. To aid engineers and scientists, who often do not interact directly with other stakeholders, several best practices were identified that may be applied to develop, manage, and evaluate stakeholder partnerships. Environmental Decision Support Systems (EDSSs) have been shown to be an effective way to promote stakeholder partnerships in environmental decision-making. Many current EDSSs were designed to be used by experts, thus limiting their effectiveness for stakeholder engagement. Often, these EDSSs, if designed for lay stakeholders, were not coupled with water quality models. To demonstrate that complex water quality models may be made accessible to stakeholders, without any significant changes to the modeling scheme, a web-based EDSS was developed for the Occoquan Reservoir, located in northern Virginia, U.S.A., and its tributary watershed. The developed EDSS may also be readily extended to other watersheds and their modeling programs. The current implementation of the EDSS enables users to modify land use and analyze simulated changes to water quality due to these modifications. A local-network server cluster, based on the Locally Distributed Simultaneous Model Execution (LDSME) framework, was also developed and served as a backend to the EDSS. The server cluster can support simultaneous execution of multiple water quality models or any other software on disparate computers. This system was employed to study pre-development and other land use modification scenarios in the Occoquan Watershed. The pre-development scenario offers an easy-to-understand and universally-applicable baseline for measuring waterbody and watershed restoration progress. It enabled computation of a measure called the "developed-excess," which is independent of local conditions and may be used for comparisons among various watershed sub-divisions or between watersheds. / Ph. D.

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A esclerose múltipla (EM), doença neurodegenerativa do sistema nervoso central (SNC) com característica auto-imune e inflamatória, com eventos iniciais, bem como a evolução da EM. É uma doença heterogênea (três principais formas clínicas) e multifatoriais. A imunidade inata demonstrou recentemente ser um fator importante na EM e as variantes genéticas dos componentes do inflamassoma têm sido associadas a doenças autoimunes e neurodegenerativas, com isso hipotetizamos que o inflamassoma e suas citocinas IL-1Beta e IL-18, podem representar importantes contribuintes na patogênese da EM e eventualmente explicar, pelo menos em parte, a heterogeneidade observada em pacientes com EM. Fizemos uma análise multivariada que foi realizada com base na forma clínica (recorrente remitente/RR, primária progressivo /PP ou secundário progressiva /SP, índice de gravidade (EDSS) e índice de progressão (IP). Os monócitos do sangue periférico (PBMC) dos pacientes foram examinados para ativação do inflamassoma (Produção de IL-1Beta e IL-18, clivagem de caspase-1). Com os objetivos de avaliar a contribuição do inflamassoma na EM, em termos de (a) efeito genético sobre o desenvolvimento, gravidade e / ou prognóstico, e (b) ativação complexa de células de sangue periférico como uma forma de avaliar a inflamação sistêmica. Para isso, utilizamos variantes genéticas funcionais em componentes do inflamassoma, que foram analisadas em uma coorte de pacientes com EM, pelo uso de ensaios específicos de alelos e qPCR. A analise multivariada resultou em associação com a variante -511C / T IL1B ganho de função, sendo essa mais frequente em formas progressivas (especialmente SP) do que em RR. A variante de ganho de função NLRP3 Q705K resultou mais frequente em pacientes com EDSS > 3 do que em pacientes com EDSS < 3 e, consequentemente, esse SNP está associado a um IP mais elevado. A análise de PBMC mostrou que as células de indivíduos EM, são mais propensas a responder a um estímulo NLRP3 clássico (isto é, LPS) do que as dos doadores saudáveis. Em conjunto, esses achados indicaram que os pacientes com EM apresentam uma desregulação no inflamassoma NLRP3, podendo ser avaliada no sangue periférico facilitando um prognóstico, e que esse perfil pode ser secundário a um mecanismo genético pró-inflamassoma / The multiple sclerosis (MS), neurodegenerative disease of the central nervous system (CNS) with autoimmune and inflammatory characteristics, with initial events, as well as the evolution of MS, are heterogeneous (three main clinical forms) and multifactorial. Innate immunity has recently been shown to be an important factor in MS and the genetic variants of the components of inflammassoma have been associated with autoimmune and neurodegenerative diseases, thereby hypothesizing that the inflammassoma and its IL-1Beta and IL-18 cytokines may represent important contributors in the pathogenesis of MS and possibly explain, at least in part, the heterogeneity observed in MS patients. We performed a multivariate analysis that was performed based on clinical form (recurrent recurrent / RR, progressive primary / PP or progressive secondary / SP, EDSS and progression index.) Peripheral blood mononuclear cells (PBMC) of patients were examined for inflammatory activation (IL-1Beta and IL-18 production, caspase-1 cleavage). With the objectives of evaluating the contribution of inflammassoma in MS in terms of (a) genetic effect on development, severity and / or prognosis, and (b) complex activation of peripheral blood cells as a way of assessing systemic inflammation. For this, we used functional genetic variants in components of the inflammassoma, which were analyzed in a cohort of MS patients, through the use of specific allele and qPCR assays. For this, we used functional genetic variants in components of the inflammassoma, which were analyzed in a cohort of MS patients, through the use of specific allele and qPCR assays. Multivariate analysis resulted in association with the -511C / T IL1B function gain, which is more frequent in progressive forms (especially SP) than in RR. The gain variant of NLRP3 Q705K function was more frequent in patients with EDSS > 3 than in patients with EDSS < 3 and, consequently, this SNP is associated with a higher PI. PBMC analysis showed that cells from MS individuals are more likely to respond to a classical NLRP3 (ie LPS) stimulus than healthy donors. Taken together, these findings indicated that patients with MS have a dysregulation in the NLRP3 inflammassoma and can be evaluated in the peripheral blood facilitating a prognosis and that this profile may be secondary to a pro-inflammatory genetic mechanism

A esclerose múltipla (EM), doença neurodegenerativa do sistema nervoso central (SNC) com característica auto-imune e inflamatória, com eventos iniciais, bem como a evolução da EM. É uma doença heterogênea (três principais formas clínicas) e multifatoriais. A imunidade inata demonstrou recentemente ser um fator importante na EM e as variantes genéticas dos componentes do inflamassoma têm sido associadas a doenças autoimunes e neurodegenerativas, com isso hipotetizamos que o inflamassoma e suas citocinas IL-1Beta e IL-18, podem representar importantes contribuintes na patogênese da EM e eventualmente explicar, pelo menos em parte, a heterogeneidade observada em pacientes com EM. Fizemos uma análise multivariada que foi realizada com base na forma clínica (recorrente remitente/RR, primária progressivo /PP ou secundário progressiva /SP, índice de gravidade (EDSS) e índice de progressão (IP). Os monócitos do sangue periférico (PBMC) dos pacientes foram examinados para ativação do inflamassoma (Produção de IL-1Beta e IL-18, clivagem de caspase-1). Com os objetivos de avaliar a contribuição do inflamassoma na EM, em termos de (a) efeito genético sobre o desenvolvimento, gravidade e / ou prognóstico, e (b) ativação complexa de células de sangue periférico como uma forma de avaliar a inflamação sistêmica. Para isso, utilizamos variantes genéticas funcionais em componentes do inflamassoma, que foram analisadas em uma coorte de pacientes com EM, pelo uso de ensaios específicos de alelos e qPCR. A analise multivariada resultou em associação com a variante -511C / T IL1B ganho de função, sendo essa mais frequente em formas progressivas (especialmente SP) do que em RR. A variante de ganho de função NLRP3 Q705K resultou mais frequente em pacientes com EDSS > 3 do que em pacientes com EDSS < 3 e, consequentemente, esse SNP está associado a um IP mais elevado. A análise de PBMC mostrou que as células de indivíduos EM, são mais propensas a responder a um estímulo NLRP3 clássico (isto é, LPS) do que as dos doadores saudáveis. Em conjunto, esses achados indicaram que os pacientes com EM apresentam uma desregulação no inflamassoma NLRP3, podendo ser avaliada no sangue periférico facilitando um prognóstico, e que esse perfil pode ser secundário a um mecanismo genético pró-inflamassoma / The multiple sclerosis (MS), neurodegenerative disease of the central nervous system (CNS) with autoimmune and inflammatory characteristics, with initial events, as well as the evolution of MS, are heterogeneous (three main clinical forms) and multifactorial. Innate immunity has recently been shown to be an important factor in MS and the genetic variants of the components of inflammassoma have been associated with autoimmune and neurodegenerative diseases, thereby hypothesizing that the inflammassoma and its IL-1Beta and IL-18 cytokines may represent important contributors in the pathogenesis of MS and possibly explain, at least in part, the heterogeneity observed in MS patients. We performed a multivariate analysis that was performed based on clinical form (recurrent recurrent / RR, progressive primary / PP or progressive secondary / SP, EDSS and progression index.) Peripheral blood mononuclear cells (PBMC) of patients were examined for inflammatory activation (IL-1Beta and IL-18 production, caspase-1 cleavage). With the objectives of evaluating the contribution of inflammassoma in MS in terms of (a) genetic effect on development, severity and / or prognosis, and (b) complex activation of peripheral blood cells as a way of assessing systemic inflammation. For this, we used functional genetic variants in components of the inflammassoma, which were analyzed in a cohort of MS patients, through the use of specific allele and qPCR assays. For this, we used functional genetic variants in components of the inflammassoma, which were analyzed in a cohort of MS patients, through the use of specific allele and qPCR assays. Multivariate analysis resulted in association with the -511C / T IL1B function gain, which is more frequent in progressive forms (especially SP) than in RR. The gain variant of NLRP3 Q705K function was more frequent in patients with EDSS > 3 than in patients with EDSS < 3 and, consequently, this SNP is associated with a higher PI. PBMC analysis showed that cells from MS individuals are more likely to respond to a classical NLRP3 (ie LPS) stimulus than healthy donors. Taken together, these findings indicated that patients with MS have a dysregulation in the NLRP3 inflammassoma and can be evaluated in the peripheral blood facilitating a prognosis and that this profile may be secondary to a pro-inflammatory genetic mechanism

Title: Internal consistency of assessment set of clinical features of patients with multiple sclerosis and its correlation with the degree of neurological impairment. Objectives: The aim of this work is to verify the internal consistency of Assessment set of clinical features in patients with multiple sclerosis and its correlation with the degree of neurological disability that would comprehensively and objectively judged effect of physiotherapy in patients with MS. Method: Clinical Examination set of functions includes well-known, standard and validated assessments that evaluate the function associated with the central movement disorders focusing on the clinical manifestations of RS (Low-Contrast Letter Acuity Test contrasting vision, Motricity Index assesses muscle strength, spasticity Modified Ashworth Scale, Berg balance Scale equilibrium, Nine Hole Peg Test investigate fine motor skills, Timed 25 - Foot Walk assess walking speed over a distance of 7.5 m, Paced Auditory Serial Addition Test investigates cognitive function, and auditory information processing speed, simple computational skills and ability to concentrate after the duration of the test. Belong to this set as evaluation of righting, equilibrium and protective reactions, examination dysdiadochokinesia, ataxia, and test evaluation...

In group decision support systems, understanding the roles, dynamics and relationships between participants is imperative to streamlining the decision-making process. This is especially true when decision makers have varying interests. Research has shown that decision-making processes amongst groups with varying interests will often reach bottlenecks with issues, such as unwillingness to share information, or a limited ability of the participants to share ideas at the same time. We explored this research territory of group decision-making by implementing collaboration software to support Ocean Summits, a new approach that uses real-time simulations as part of the decision-making process for stakeholders to explore fisheries management policies. The research reported in this thesis has three goals: (1) to better understand the decision-making process in fisheries management, (2) to build a prototype system to tackle the major issues in the decision-making process and (3) to determine the best way to share and display information critical to the stakeholders' decision-making process by exploring the use of shared screens and information in comparison to private displays. We discovered that the use of shared screens with shared information yielded the best results, as opposed to private screens with shared information or private screens with private information. It was observed that sharing information allowed participants to explore more alternative solutions.

In group decision support systems, understanding the roles, dynamics and relationships between participants is imperative to streamlining the decision-making process. This is especially true when decision makers have varying interests. Research has shown that decision-making processes amongst groups with varying interests will often reach bottlenecks with issues, such as unwillingness to share information, or a limited ability of the participants to share ideas at the same time. We explored this research territory of group decision-making by implementing collaboration software to support Ocean Summits, a new approach that uses real-time simulations as part of the decision-making process for stakeholders to explore fisheries management policies. The research reported in this thesis has three goals: (1) to better understand the decision-making process in fisheries management, (2) to build a prototype system to tackle the major issues in the decision-making process and (3) to determine the best way to share and display information critical to the stakeholders' decision-making process by exploring the use of shared screens and information in comparison to private displays. We discovered that the use of shared screens with shared information yielded the best results, as opposed to private screens with shared information or private screens with private information. It was observed that sharing information allowed participants to explore more alternative solutions.

In group decision support systems, understanding the roles, dynamics and relationships between participants is imperative to streamlining the decision-making process. This is especially true when decision makers have varying interests. Research has shown that decision-making processes amongst groups with varying interests will often reach bottlenecks with issues, such as unwillingness to share information, or a limited ability of the participants to share ideas at the same time. We explored this research territory of group decision-making by implementing collaboration software to support Ocean Summits, a new approach that uses real-time simulations as part of the decision-making process for stakeholders to explore fisheries management policies. The research reported in this thesis has three goals: (1) to better understand the decision-making process in fisheries management, (2) to build a prototype system to tackle the major issues in the decision-making process and (3) to determine the best way to share and display information critical to the stakeholders' decision-making process by exploring the use of shared screens and information in comparison to private displays. We discovered that the use of shared screens with shared information yielded the best results, as opposed to private screens with shared information or private screens with private information. It was observed that sharing information allowed participants to explore more alternative solutions. / Science, Faculty of / Computer Science, Department of / Graduate

Introduction: Multiple sclerosis (MS) is associated with impaired bone health in comparison to an equally healthy population, even already in patients at the onset of this disease. The main risk factors for development of osteoporosis in MS patients are known. The aim of the study was to find the relationship of the decrease in bone mineral density (BMD) to the administered cumulative dose of steroids and to other risk factors in MS, mainly to the degree of motor deficit. Further goal was to evaluate the occurence of the risk of low-trauma fractures in multiple sclerosis patients.. The BMD and muscle mass was compared in MS patients (women and men) and control subjects, to examine the effect of main ones - physical disability and long-term glucocorticoid (GC) therapy on BMD. Clinical values of bone remodeling markers were evaluated in assessment of rate of bone loss in patients with multiple sclerosis long term treated with low dose of GC. Patients and methods: We used dual -energy X-ray absorptiometry for a measurement of BMD in 591 MS patients (455 females and 136 males) in 2004 and in cross-sectional longitudinal study published in 2014 with 474 patients (353 women and 121 men). Out of the whole study group body composition was evaluated in 250 MS females, 104 males and 247 healthy controls (193...