Participants will receive usual care from their treating neurologist

Participants will be trained via videos from a three day in-person seminar that teaches the public about the use of a therapeutic diet and lifestyle to reduce multiple sclerosis related fatigue and improve quality of life.

Clinically Isolated Syndrome

Relapsing Remitting Multiple Sclerosis

Educational videos, 4 individual support calls and monthly support group meetings conducted via an internet based audio/ video conference platform. Patients will be trained on a low lectin modified paleolithic diet; breathing meditation practice, and body weight strengthening

Therapeutic diet and lifestyle

University of Iowa

Clinically Isolated Syndrome and Relapsing-Remitting Multiple Sclerosis

Composite scores for physical health subscales

Composite scores for mental health subscales

The number of seconds it takes to walk 25 feet

Survey asking about mood and daily activities. Change in anxiety score for the hospital anxiety and depression scale score based on the responses.

Survey asking about mood and daily activities. Change in depress score for the hospital anxiety and depression scale score based on the responses.

Terry L. Wahls

Professor

Comparison of the intervention arm to standard of care.

Corinthian currant supplementation: 1.5 g CHO/kg BW prior to exercise

Glucose drink (Top Star 100, Esteriplas, Portugal) supplementation: 1.5 g CHO/kg BW prior to exercise

Water ingestion: 7 ml/kg BW prior to exercise

Athletic Performance

Oxidative Stress

Inflammation

Supplementation of 1.5 g CHO/kg BW in the form of Corinthian currant prior to exercise

Corinthian currant

Supplementation of 1.5 g CHO/kg BW in the form of glucose drink prior to exercise

Glucose drink

Supplementation of 7ml/kg BW prior to exercise

Water ingestion

School of Physical Education and Sport Science, University of Thessaly

Ergogenic and Antioxidant Effects of Corinthian Currant

Effects of Corinthian Currant Supplementation on Redox Status, Inflammatory Markers, and Performance During Prolonged Exercise

Participants performed an exercise protocol on a cycloergometer (Cycloergometer, Monark 834, ERGOMED C, Sweeden) consisted of 90 min of cycling at 70% - 75% VO2max, followed by a time trial (TT) at 95% VO2max to exhaustion or until the participants could not maintain a pace above 60 rpm. Gas exchange was monitored for the first 15 min until the desired steady state is established (70% - 75% VO2max), and every 25 min for 5 min thereafter.

Blood GLU concentration was assessed as a marker of human metabolism. Blood GLU concentration was estimated in a Clinical Chemistry Analyzer Z 1145 (Zafiropoulos Diagnostica, Athens, Greece) with commercially available kits (Zafiropoulos, Athens, Greece). Each sample is analyzed in duplicates.

Blood LA concentration was assessed as a marker of human metabolism. Blood LA concentration was estimated in a Clinical Chemistry Analyzer Z 1145 (Zafiropoulos Diagnostica, Athens, Greece) with commercially available kits (Zafiropoulos, Athens, Greece). Each sample is analyzed in duplicates.

Cardiorespiratory changes were recorded throughout the entire exercise. Gas exchange was monitored using a gas analyzer (CareFusion, Viasis, Yorba Linda, USA).

Assessment of CBC was performed in an automated hematological analyzer (Mythic 18, Orphee SA, Geneva, Switzerland).

GSH will be measured as a general index of oxidative stress. For GSH, 20 μL of erythrocyte lysate will be treated with 5% TCA mixed with 660 μL of 67 mM sodium potassium phosphate (pH 8.0) and 330 ΜL of 1 mM 5,5-dithiobis-2 nitrobenzoate. The samples will be incubated in the dark at room temperature for 45 min, and the absorbance will be read at 412 nm.

GSSG will be measured as a general index of oxidative stress. Blood collected will be treated with NEM. For the analysis, 50 μL of erythrocyte lysate will be treating with 5% TCA and neutralized up to pH 7.0-7.5. One microliter of 2-vinylpyridine will be added, and the samples will be incubated for 2 h. Sample will be treated with TCA and will be mixed with 600 μL of 143 mM sodium phosphate 100 ΜL of 3 mM NADPH, 100 ΜL of 10 mM 5,5-dithiobis-2-nitrobenzoate, and 194 μL of distilled water. After the addition of 1 μL of glutathione reductase, the change in absorbance at 412 nm will be read for 3 min.

TBARS will be measured as an index of lipid peroxidation. For TBARS determination, 100 μL of plasma will be mixed with 500 ΜL of 35% TCA and 500 μL of Tris-HCl (200 mM, pH 7.4) and will be incubated for 10 min at room temperature. One milliliter of 2 M Na2SO4 and 55 mM thiobarbituric acid solution will be added, and the samples will be incubated at 95O C for 45 min. The samples will be cooled on ice for 5 min and then will be vortexed after adding 1 mL of 70% TCA. The samples will be centrifuged at 15,000g for 3 min, and the absorbance of the supernatant will be read at 530 nm.

Changes in Protein carbonyls, PC (nmol/mg pr) Carbonyls will be measured as an index of protein oxidation. Protein carbonyls will be determined adding 50 μL of 20% TCA to 50 μL of plasma. Samples will be incubated in the dark at room temperature for 1 hour. The supernatant will be discarded, and 1 mL of 10% TCA will be added. The supernatant will be discarded, and 1 mL of ethanol-ethyl acetate will be added and centrifuged. The supernatant will be discarded, and 1 mL of 5 M urea will be added, vortexed, and incubated at 37C for 15 min. The samples will be centrifuged at 15,000g for 3 min at 4C, and the absorbance will be read at 375 nm.

Athanasios Z. Jamurtas

University of Thessaly

Behavioral: Psychosocial stimulation, Cognitive behavioral therapy and positive parenting practice The mothers of intervention (ECD+HN) group will receive fortnightly group sessions for 12 months that will include combined messages on a) psychosocial stimulation, b) positive parenting to prevent child maltreatment and c) cognitive behavioural therapy (CBT) for positive thinking, d) health and nutrition messages and e) 15 micronutrient sprinkle supplement.(90 sachets of over 6 month-period)

Only regular health message from government health services

Maltreatment

The mothers of intervention (ECD+HN) group will receive fortnightly group sessions for 12 months that will include combined messages on a) psychosocial stimulation, b) positive parenting to prevent child maltreatment and c) cognitive behavioural therapy (CBT) for positive thinking, d) health and nutrition messages and e) 15 micronutrient sprinkle supplement.(90 sachets of over 6 month-period)

Psychosocial stimulation, Cognitive behavioral therapy and positive parenting practice

Runyan, Child-Maltreatment-Research-L (CMRL) list serve, 2014

Uddin MK, Islam MT, Asaduzzaman M. Perceived Stress and Self-Esteem as Significant Predictors of Cigarette Smoking Behavior of Bangladeshi Male Adults.

World Health Organization 2008, The Global Burden of Disease 2004 update

Fahmida Tofail, PhD

Reduce Childhood Maltreatment and Promote Development

Effect of Integrated Management of Childhood Maltreatment, Maternal Depression, Psychosocial Stimulation and Nutritional Intervention on Child Development - A Randomized Controlled Trial

cognitive development will be measured by Bayley tools. All individuals score will be aggregated in to composite score of cognitive,motor, language and social-emotional development of children

The International Society for the Prevention of Child Abuse and Neglect (ISPCAN) has developed ISPCAN Child Abuse Screening Tool- Parent Version (ICAST-P) will be used for measuring the severity of maltreatment calculating score.

Height will be measure in centimeter through World Health Organization (WHO) guideline.

Weight will be measure in gram through World Health Organization (WHO) guideline.

Head circumference will be measure in centimeter through World Health Organization (WHO) guideline.

The Hematological measurement will be measured as Hb per g/dl ,

folic acid status will be measured as ng/ml

The Hematological measurement will be measured as Retinol per Mg /ml

The Hematological measurement will be measured as STfR per Mg/ml

the Rosenberg Self Esteem Scale (Rosenberg, 1965), the most widely used measure of self esteem for research purposes and Measurement of maternal depressive symptoms will be done using Center for Epidemiologic Studies Depression Scale (CESD)

pyridoxine/fatigue

Clinically Isolated Syndrome and Relapsing-Remitting Multiple Sclerosis

Ergogenic and Antioxidant Effects of Corinthian Currant

Reduce Childhood Maltreatment and Promote Development

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