Psychological factors and brain magnetic resonance imaging metrics associated with fatigue in persons with multiple sclerosis.

BACKGROUND Besides demographics and clinical factors, psychological variables and brain-tissue changes have been associated with fatigue in persons with multiple sclerosis (pwMS). Identifying predictors of fatigue could help to improve therapeutic approaches for pwMS. Therefore, we investigated predictors of fatigue using a multifactorial approach. METHODS 136 pwMS and 49 normal controls (NC) underwent clinical, neuropsychological, and magnetic resonance imaging examinations. We assessed fatigue using the "Fatigue Scale for Motor and Cognitive Functions", yielding a total, motor, and cognitive fatigue score. We further analyzed global and subcortical brain volumes, white matter lesions and microstructural changes (examining fractional anisotropy; FA) along the cortico striatal thalamo cortical (CSTC) loop. Potential demographic, clinical, psychological, and magnetic resonance imaging predictors of total, motor, and cognitive fatigue were explored using multifactorial linear regression models. RESULTS 53% of pwMS and 20% of NC demonstrated fatigue. Besides demographics and clinical data, total fatigue in pwMS was predicted by higher levels of depression and reduced microstructural tissue integrity in the CSTC loop (adjusted R2 = 0.52, p < 0.001). More specifically, motor fatigue was predicted by lower education, female sex, higher physical disability, higher levels of depression, and self-efficacy (adjusted R2 = 0.54, p < 0.001). Cognitive fatigue was also predicted by higher levels of depression and lower self-efficacy, but in addition by FA reductions in the CSTC loop (adjusted R2 = 0.45, p < 0.001). CONCLUSIONS Our results indicate that depression and self-efficacy strongly predict fatigue in MS. Incremental variance in total and cognitive fatigue was explained by microstructural changes along the CSTC loop, beyond demographics, clinical, and psychological variables

Peri-operative red blood cell transfusion in neonates and infants: NEonate and Children audiT of Anaesthesia pRactice IN Europe: A prospective European multicentre observational study

BACKGROUND: Little is known about current clinical practice concerning peri-operative red blood cell transfusion in neonates and small infants. Guidelines suggest transfusions based on haemoglobin thresholds ranging from 8.5 to 12 g dl-1, distinguishing between children from birth to day 7 (week 1), from day 8 to day 14 (week 2) or from day 15 (≥week 3) onwards. OBJECTIVE: To observe peri-operative red blood cell transfusion practice according to guidelines in relation to patient outcome. DESIGN: A multicentre observational study. SETTING: The NEonate-Children sTudy of Anaesthesia pRactice IN Europe (NECTARINE) trial recruited patients up to 60 weeks' postmenstrual age undergoing anaesthesia for surgical or diagnostic procedures from 165 centres in 31 European countries between March 2016 and January 2017. PATIENTS: The data included 5609 patients undergoing 6542 procedures. Inclusion criteria was a peri-operative red blood cell transfusion. MAIN OUTCOME MEASURES: The primary endpoint was the haemoglobin level triggering a transfusion for neonates in week 1, week 2 and week 3. Secondary endpoints were transfusion volumes, 'delta haemoglobin' (preprocedure - transfusion-triggering) and 30-day and 90-day morbidity and mortality. RESULTS: Peri-operative red blood cell transfusions were recorded during 447 procedures (6.9%). The median haemoglobin levels triggering a transfusion were 9.6 [IQR 8.7 to 10.9] g dl-1 for neonates in week 1, 9.6 [7.7 to 10.4] g dl-1 in week 2 and 8.0 [7.3 to 9.0] g dl-1 in week 3. The median transfusion volume was 17.1 [11.1 to 26.4] ml kg-1 with a median delta haemoglobin of 1.8 [0.0 to 3.6] g dl-1. Thirty-day morbidity was 47.8% with an overall mortality of 11.3%. CONCLUSIONS: Results indicate lower transfusion-triggering haemoglobin thresholds in clinical practice than suggested by current guidelines. The high morbidity and mortality of this NECTARINE sub-cohort calls for investigative action and evidence-based guidelines addressing peri-operative red blood cell transfusions strategies. TRIAL REGISTRATION: ClinicalTrials.gov, identifier: NCT02350348

A New Algebraic Reynolds Stress Turbulence Model for Prediction of Wall-Affected Three Dimensional Room Airflows

In the past various experimental investigations about room airflows were published. But most investiagtions are limited regarding measurements positions (restricted gflow patttern) and the availability of turbulent quantities (Reynolds-Stresses, entrainment, macroscopic instabilities etc.) based on the avaiable experimental data a targeted improvement of turbulence models is difficult. Therefore a complex three dimensional room airflow situation was investigatedwith three-dimensional Particle Image Velocmetry. Detailed informatiom of the floww, the Reynolds-stress distribution and the entertainment are presented. Based on the experimental results the behaviour of RANS-based turbulence models in predicting roomairflow is discussed. In this context, it is shown that intensive anisotropic Reynolds stresses near the wall arise and influences the airflow pattern. For this reason a new algebraic Reynolds stress turbulence model - which can in princible reproduce the turbulence anisotropic behaviour- is proposed. Compared with the linear eddy viscoity turbulence models the new nonlinear model agrees clearly better with the presented experimental findings.Energie-Umweltmanagemen

CFD-Gestützte Methoden zur Optimierung von innovativen Deckenkühl- und -heizsystemen

Kongressbeitrag zum 8. Forschungsforum der österreichischen Fachhochschulen (FFH 2014), Kufstein, Austria, 23.-24. April 201

Numerische Untersuchungen des Wärme- und Stofftransportes zur Optimierung der Raumzustände

Energie-Umweltmanagemen

Demand Side Flexibility Potentials of Redox Flow Batteries

Science.Research.Pannonia. 17Forschung BurgenlandEnergie-Umweltmanagemen

Beschreibung des instationären Wärmeentzugs aus dem Erdreich und der Regeneration des Erdreichs mittels eines eindimensionalen Erdreichkollektormodells

Science.Research.Pannonia. 10Energie-Umweltmanagemen

On the Influence of the Reynolds-Stress Anisotropy Tensor on the Prediction of Wall-Affected Three-Dimensional Room Airflows

It is well known that the turbulence anisotropy has a remarkable influence on the flow of three dimensional wall jets. So the accurate simulation of room airflows with air supplies mounted just below the ceiling requires a highlevel turbulence closure. Therefore in this paper the potential for the improvement of room airflow prediction by using different Reynolds stress models and a new nonlinear eddy viscosity turbulence model are discussed. For this purpose detailed three dimensional PIV measurement results of the velocity distribution and the Reynolds stress in a symmetrical model room are compared with the calculations using different turbulence models.Energie-Umweltmanagemen

Rahmenbedingungen für die effiziente Integration von hybriden Speicherlösungen

Konferenzbeitrag zum Internationalen Kongress „e-nova 2017 - Zukunft der Gebäude“; Pinkafeld 201

Development of an innovative blind control strategy to increase the thermal comfort of an office building

Konferenzbeitrag zur internationalen Konferenz „Indoor Climate of Buildings 2019“; Nový Smokovec 2019Energie-Umweltmanagemen