Ms Duration Research Articles

Choosing Optimal Cutoff Frequencies for Filtering Linear Acceleration and Angular Velocity Signals Associated with Head Impacts Measured by Instrumented Mouthguards

Head impact sensors worn in the mouth are popular because they couple directly to the teeth and provide six-degree-of-freedom head measurements. Mouthpiece signal filters have conventionally used cutoff frequencies lower than recommended practices (Society of Automotive Engineers, SAE J211-1) to eliminate extraneous noise when measuring with live subjects. However, there is little information about the effects of filter choice on the accuracy of signals measured by instrumented mouthpieces. Lack of standardization in head impact measurement device post-processing techniques can result in data that are not comparable across studies or device brands. This study sought optimal filter cutoff frequencies for six-degree-of-freedom measurements made at the teeth using instrumented mouthguards. We collected linear acceleration and angular velocity signals at the head center of gravity (CG) using laboratory-grade instrumentation. We also collected and filtered similar six-degree-of-freedom measurements from an instrumented mouthguard using 24 cutoff frequencies, from 25 to 600 Hz. We transformed the measurements to linear acceleration at the center of gravity of the head (CG) using all kinematic variables at the teeth, optimizing linear and angular mouthguard cutoff frequencies with one equation. We calculated the percent error in transformed peak resultant linear acceleration and minimized the mean and standard deviation in error. The optimal cutoff frequencies were 175 Hz for linear acceleration and 250 Hz for angular velocity. Rigid impacts (3–5 ms duration) had higher optimal cutoff frequencies (175 Hz linear acceleration, 275 Hz angular velocity) than padded impacts (10–12 ms duration; 100 Hz linear acceleration, 175 Hz angular velocity), and all impacts together (3–12 ms duration; 175 Hz linear acceleration, 250 Hz angular velocity). Instrumented mouthpiece manufacturers and researchers using these devices should consider these optimal filter cutoff frequencies to minimize measurement error. Sport-specific filter criteria for teeth-based sensors may be warranted to account for the difference in optimal cutoff frequency combination by impact duration.

The equivalence of different types of electric pulses for electrochemotherapy with cisplatin - an in vitro study.

Electrochemotherapy (ECT) is a treatment involving the administration of chemotherapeutics drugs followed by the application of 8 square monopolar pulses of 100 μs duration at a repetition frequency of 1 Hz or 5000 Hz. However, there is increasing interest in using alternative types of pulses for ECT. The use of high-frequency short bipolar pulses has been shown to mitigate pain and muscle contractions. Conversely, the use of millisecond pulses is interesting when combining ECT with gene electrotransfer for the uptake of DNA-encoding proteins that stimulate the immune response with the aim of converting ECT from a local to systemic treatment. Therefore, the aim of this study was to investigate how alternative types of pulses affect the efficiency of the ECT. We performed in vitro experiments, exposing Chinese hamster ovary (CHO) cells to conventional ECT pulses, high-frequency bipolar pulses, and millisecond pulses in the presence of different concentrations of cisplatin. We determined cisplatin uptake by inductively coupled plasma mass spectrometry and cisplatin cytotoxicity by the clonogenic assay. We observed that the three tested types of pulses potentiate the uptake and cytotoxicity of cisplatin in an equivalent manner, provided that the electric field is properly adjusted for each pulse type. Furthermore, we quantified that the number of cisplatin molecules, resulting in the eradication of most cells, was 2-7 × 107 per cell. High-frequency bipolar pulses and millisecond pulses can potentially be used in ECT to reduce pain and muscle contraction and increase the effect of the immune response in combination with gene electrotransfer, respectively.

Myoclonus: Differential diagnosis and current management.

Myoclonus classically presents as a brief (10-50 ms duration), non-rhythmic jerk movement. The etiology could vary considerably ranging from self-limited to chronic or even progressive disorders, the latter falling into encephalopathic pictures that need a prompt diagnosis. Beyond the etiological classification, others evaluate myoclonus' body distribution (i.e., clinical classification) or the location of the generator (i.e., neurophysiological classification); particularly, knowing the anatomical source of myoclonus gives inputs on the observable clinical patterns, such as EMG bursts duration or EEG correlate, and guides the therapeutic choices. Among all the chronic disorders, myoclonus often presents itself as a manifestation of epilepsy. In this context, myoclonus has many facets. Myoclonus occurs as one, or the only, seizure manifestation while it can also present as a peculiar type of movement disorder; moreover, its electroclinical features within specific genetically determined epileptic syndromes have seldom been investigated. In this review, following a meeting of recognized experts, we provide an up-to-date overview of the neurophysiology and nosology surrounding myoclonus. Through the dedicated exploration of epileptic syndromes, coupled with pragmatic guidance, we aim to furnish clinicians and researchers alike with practical advice for heightened diagnostic management and refined treatment strategies. PLAIN LANGUAGE SUMMARY: In this work, we described myoclonus, a movement characterized by brief, shock-like jerks. Myoclonus could be present in different diseases and its correct diagnosis helps treatment.

Modulation of Extracellular Matrix Composition and Chronic Inflammation with Pirfenidone Promotes Scar Reduction in Retinal Wound Repair.

Wound repair in the retina is a complex mechanism, and a deeper understanding of it is necessary for the development of effective treatments to slow down or even prevent degenerative processes leading to photoreceptor loss. In this study, we harnessed a laser-induced retinal degeneration model (532-nm laser photocoagulation with 300 μm spot size, 60 ms duration and 60 mV pulse), enabling a profound molecular elucidation and a comprehensive, prolonged observation of the wound healing sequence in a murine laser-induced degeneration model (C57BL/6J mice, 6-12 weeks) until day 49 post-laser. Our observations included the expression of specific extracellular matrix proteins and myofibroblast activity, along with an analysis of gene expression related to extracellular matrix and adhesion molecules through RNA measurements. Furthermore, the administration of pirfenidone (10 mg/kg via drinking water), an anti-inflammatory and anti-fibrotic compound, was used to modulate scar formation after laser treatment. Our data revealed upregulated collagen expression in late regenerative phases and sustained inflammation in the damaged tissue. Notably, treatment with pirfenidone was found to mitigate scar tissue formation, effectively downregulating collagen production and diminishing the presence of inflammatory markers. However, it did not lead to the regeneration of the photoreceptor layer.

Effects of Voltage and Treatment Time of Pulsed Electric Field on Electroporation in Rhizoctonia solani.

The pulsed electric field (PEF) of μs duration can induce electroporation by causing permanent damage to the membrane, leading to cell death. The microbe was treated by a homemade PEF generator instrument. The sterilization effect of PEF on the Rhizoctonia solani was observed by scanning electron microscope (SEM) and transmission electron microscope (TEM), and the leakage of the intracellular contents was measured with a conductometer and an ultraviolet spectrophotometer. The increases in the electrical conductivity and the optical density (OD) value indicated that the cell membrane was damaged, and the intracellular contents overflowed. As a result, according to our experimental conditions, the optimum condition was the high-pulsed electric voltage of 26kV, and the treatment time was 4min. It could be concluded that the PEF could damage the cell membrane, and the ratio of electroporation reached 100%, which provides a new method of killing R. solani efficiently.

Optical coherence tomography in the diagnosis of multiple sclerosis

This study explores the main structural changes in patients with MS and their relationships with the activity and type of disease course. This prospective study included 159 patients (318 eyes) with an established diagnosis of MS: group (44 eyes; 13.84%) - relapsing-remitting type MS (RRMS) lasting up to 1 year without a history of optic neuritis (ON); group 2 (30 eyes; 9.43%) - RRMS up to 1 year with ON; group 3 (56 eyes; 17.61%) - RRMS lasting from 1 to 10 years without ON; group 4 (38 eyes; 11.95%) - RRMS from 1 to 10 years with ON; group 5 (49 eyes; 15.41%) - RRMS >10 years without ON; group 6 (37 eyes; 11.63%) - RRMS >10 years with ON; group 7 (34 eyes; 10.69%) - secondary progressive multiple sclerosis (SPMS) without ON; group 8 (30 eyes; 9.43%) - SPMS with ON. Patients underwent standard ophthalmological examinations, including optical coherence tomography. A decrease in structural parameters was diagnosed, progressing with the duration of the disease and the presence of ON: the minimum values of mGCL+IPL (65.83±9.14 μm) and mSNFL (76.37±14.77 μm) were detected in the group with SPMS with ON. High inverse correlations of EDSS with mGCL+IPL and mRNFL were demonstrated, with maximum in the group with the longest duration of MS without ON (-0.48 and -0.52 (p=0.01), respectively). Changes in the thickness of the structural parameters of the retina, measured by OCT, can be considered as a predictor of the course of MS.

EPN2EOS Data Transfer System

EPN2EOS Data Transfer System

Temporary and highly variable recovery of neuromuscular dysfunction by electrical stimulation in the follow-up of acute critical illness neuromyopathy: a pilot study

BackgroundIn sepsis-associated critical illness neuromyopathy (CIPNM) serial electrical stimulation of motor nerves induces a short-lived temporary recovery of compound muscle action potentials (CMAPs) termed facilitation phenomenon (FP). This technique is different from other stimulation techniques published. The identification of FP suggests a major functional component in acute CIPNM.MethodsFrom our previous study cohort of 18 intensive care unit patients with sepsis associated CIPNM showing profound muscle weakness and low or missing CMAPs on nerve conduction studies, six patients with different severity could be followed. In a pilot sub-study we analyzed the variability of FP during follow up. Over up to 6 weeks we performed 2–6 nerve conduction studies with our novel stimulation paradigm. Motor nerves were stimulated at 0.2–0.5 Hz with 60–100 mA at 0.2–0.5 ms duration, and CMAP responses were recorded. Standard motor nerve conduction velocities (NCV) could be done when utilizing facilitated CMAPs. Needle electromyography was checked once for spontaneous activity to discover potential denervation and muscle fiber degeneration. Serum electrolytes were checked before any examination and corrected if abnormal.ResultsIn all six patients a striking variability in the magnitude and pattern of FP could be observed at each examination in the same and in different motor nerves over time. With the first stimulus most CMAPs were below 0.1 mV or absent. With slow serial pulses CMAPs could gradually recover with normal shape and near normal amplitudes. With facilitated CMAPs NCV measurements revealed low normal values. With improvement of muscle weakness subsequent tests revealed larger first CMAP amplitudes and smaller magnitudes of FP. Needle EMG showed occasional spontaneous activity in the tibialis anterior muscle.ConclusionIn this pilot study striking variability and magnitude of FP during follow-up was a reproducible feature indicating major fluctuations of neuromuscular excitability that may improve during follow-up. FP can be assessed by generally available electrophysiological techniques, even before patients could be tested for muscle strength. Large scale prospective studies of the facilitation phenomenon in CIPNM with or without sepsis are needed to define diagnostic specificity and to better understand the still enigmatic pathophysiology.Trial registration: This trial was registered at the Leipzig University Medical Center in 2021 after approval by the Ethics Committee.

Penning ion source based surface modification of titanium by nitrogen ion implantation

The nitrogen ions of the Penning ion source are bombarded on commercially available pure titanium substrates in pulses of about 5.6 μs duration. A thin film (∼500 nm) of multiphase titanium nitride is produced without additional heating of the substrate. The surface modification is studied for various energies of implanted ions at a low flux density. The 2.4 × 109 ions of specific energy are bombarded on the sample in each single pulse of the ion. Each sample is exposed to one thousand such pulses at a repetition rate of 0.1 Hz. The corresponding energy flux was transferred to the sample, promoting the growth of a thin nitride layer. X-ray diffraction (XRD) analysis demonstrates the formation of a monocrystalline multiphase titanium nitride thin film. The XRD spectra show the multiphase reflections of Ti4N2 (111), Ti9N3.87 (009), and Ti12N7 (0012) that depend on the energy of the ion beam. Ti4N2 is observed to be the dominant phase in this ion implantation process. The morphological and compositional changes of ion implanted samples are investigated using field emission scanning electron microscopy (SEM) along with energy dispersive x-ray spectroscopy (EDX). Raman scattering analysis of treated samples verified the XRD results. The penetration depth of nitrogen ions inside the titanium is calculated using the SRIM code. Vickers hardness has improved three times compared to the original sample.

Cancerous cell viability affected by synergism between electric pulses and a low dose of silver nanoparticle: An adaptive neuro-fuzzy inference system

In the current study, applying simultaneously electroporation and silver nanoparticles (SNPs) are considered. Moreover, one restriction normally assigned to such nanoparticles is their side effects on the vital organs of the body. To mitigate such deleterious effects, it is better to use lower dosages of them. However, this can result in a decline in the technique's effectiveness. To compensate for the lower dose of SNPs, one can use secondary method like electroporation to deliver SNPs directly into the cells and reinforces the effect of electric pulses due to the high electrical conductivity of SNPs while having a minimal cytotoxicity effect on normal cells that are not treated with electroporation. In the present study, synergism effects of both procedures (SNPs and electroporation) experimentally and theoretically are considered to investigate the property of each technique in increasing the performance with respect to both procedures' limitations. To investigate more, adaptive neuro-fuzzy inference system (ANFIS) is used to predict the percent cell viability of cancerous cells affected by both procedures by considering amplitude and duration as inputs affecting on change of cell viability as an output. The results obtained from both experimental and simulation procedures showed that the maximum synergism between nanoparticles and electric pulses was recorded at 700 ​V/cm strength and 100 μs duration. Also, Results indicated high correlation between observed and predicted data (r2 ​= ​0.88). Moreover, the calculated root mean square error for the results of the ANFIS model was equal to 1.1. This implies that the model has practical value and can estimate the percent cell viability of cancerous cells influenced by both procedures with varying electric field amplitude and duration. This method can be proposed for other biophysical or drug delivery applications to save time and resources by utilizing the previous experimental data rather than performing more experiments.

Relation between cortical thickness and frontal lobe P50 response in neurotypical aging: MEG study

AbstractBackgroundThe auditory Event Related Potential (ERP) with latency at peak at 50 ms is a potential biomarker of prodromal Alzheimer’s disease (AD). However, the relation between P50 ERP and the thickness of the gray matter over frontal brain regions in healthy individuals over 55 y.o is not well studied. We examined the relation between frontal lobe generator of auditory P50 and degree of the gray matter volume lost in healthy individuals. We hypothesized that reduced thickness in the cingulate cortex is associated with aberrant function of the frontal lobe generator of the P50 response.MethodSeven healthy subjects (ages 58‐72 years, 4 women) participated in the ongoing study. P50 response was calculated from magnetoencephalographic and electroencephalographic data during presentation of 7 tones (30 ms duration) ranging from 500 to 986 Hz. Each tone was preceded by 850 ms period of silence. Free‐surfer computed the cortical thickness for each subject as the distance between the gray/white matter boundary and the pial surface for each pair of vertices. 110 T1‐MPRAGE scans of elderly healthy controls (over 65 yo) from a Neurocognitive aging dataset were used as an average‐control group. To calculate the difference in thickness between averaged control and individual subject, the z‐value was applied. The template of 110‐averaged data was transformed into the subject’s space, and for each vertices we subtracted the mean and divide by the standard deviationResultIn this study we show, that in subjects with less thickness in the cingulate cortex the amplitude of P50 response was enhanced with respect to those subjects who had more cortical thickness (Z value >5 vs. Z value <2). The aberrant function of the frontal lobe generator of P50 response was associated with enchanted amplitude of the P50 in MEG and EEG data.ConclusionOur results suggest that age‐related deficiency in frontal lobe generators of auditory P50 in healthy aging participants is associated with a reduction of gray matter volume in cingulate cortex. Present results support the notion about age‐related changes in modulatory role of frontal lobe generator of auditory P50 that are located at the cingulate cortex.

Can the length of a catheter change the time to bubble at the tip performing the "Bubble Test"? A bench study.

Intraprocedural tip control techniques are critical during central venous catheter placement. According to international guidelines (INS 2021), intracavitary electrocardiography is the first method of choice to verify it; when this technique is not feasible, it is considered acceptable to use a contrast-enhanced ultrasound-based tip location method, commonly known as "bubble-test" as an effective alternative. To assess whether the length of the vascular catheter can alter the time between the injection of the contrast media and its appearance at the catheter tip and the injection duration. Differences between operators stratified according to experience were evaluated as secondary endpoints. A bench study was conducted using an extracorporeal circuit. For each catheter length (60, 40, and 20 cm), three injections were obtained by each of the five operators with different levels of experience for a total of 45 measurements. Differences among operators were evaluated using ANOVA, and the impact of catheter length and operator expertise on times was assessed using repeated measurement models. Hub-to-tip times of 247.33 ms (SD 168.82), 166 ms (SD 95.46), 138 ms (SD 54.48), and injection duration of 1620 ms (SD 748.58), 1614 ms (SD 570.95), 1566 ms (SD 302.83) were observed for 60, 40, 20 cm catheter length, respectively. A significant time variability between operators was observed. Moreover, moving from 60 to 20 cm, hub-to-tip time was significantly longer for 60 cm devices (p = 0.0124), while little differences were observed for injection duration. Catheter length can change both the time between the injection of the contrast media and its appearance at the catheter tip and the injection duration. Hub-to-tip times obtained with 20 and 40 cm and overall injection duration did not differ significantly; skilled personnel could substantially reduce both values analyzed in this study.

Occupational outcomes of people with multiple sclerosis during the COVID-19 pandemic: a systematic review with meta-analysis.

People with Multiple Sclerosis (PwMS) are vulnerable to unfavorable occupational outcomes and the COVID-19 pandemic brought major consequences on people's professional lives. In this view, we decided to investigate the occupational outcomes of PwMS during the COVID-19 pandemic. We performed a systematic review with meta-analysis searching key terms in four databases. We initially included any peer-reviewed original article that enrolled adult patients with the diagnosis of MS and assessed any occupational variable during the COVID-19 pandemic. There were no time limits and no language restrictions. The primary outcomes were the prevalence of unemployment, retirement and employment status change among people with MS during the COVID-19 pandemic. Other outcomes included the modality and characteristics of work: type of work, full-time work, part-time work and remote work. We also searched for data from studies that addressed any change in the work status due to the COVID-19 outbreak. We identified 49 eligible articles comprising a total sample size of 17,364 individuals with MS. The pooled prevalence of unemployment and retirement was 0.47 (95% CI = 0.42-0.53). The pooled prevalence of PwMS who were unemployed or retired was positively associated with the progressive phenotype of the disease (p = 0.017) and the use of glatiramer acetate (p = 0.004), but negatively associated with hospitalization due to COVID-19 (p = 0.008) and the use of immunosuppressants (p = 0.032), siponimod (p < 0.001), and cladribine (p = 0.021). The pooled proportion of PwMS that reported any change of the employment status during the COVID-19 pandemic was 0.43 (95% CI = 0.36-0.50) while the pooled prevalence of PwMS who worked remotely during this period was 0.37 (95% CI = 0.15-0.58). The change in employment status was negatively associated with the duration of MS (p = 0.03) but positively associated with the progressive phenotype of the disease (p < 0.001). Our seminal review may serve as an example of how patients with neurological diseases or disabilities in general may have their jobs impacted in a pandemic and foster the context of global socio-economic crisis.

Real-time OCT feedback-controlled RPE photodisruption in ex vivo porcine eyes using 8 microsecond laser pulses.

Selective retinal pigment epithelium (RPE) photodisruption requires reliable real-time feedback dosimetry (RFD) to prevent unwanted overexposure. In this study, optical coherence tomography (OCT) based RFD was investigated in ex vivo porcine eyes exposed to laser pulses of 8 µs duration (wavelength: 532 nm, exposure area: 90 × 90 µm2, radiant exposure: 247 to 1975 mJ/µm2). For RFD, fringe washouts in time-resolved OCT M-scans (central wavelength: 870 nm, scan rate: 85 kHz) were compared to an RPE cell viability assay. Statistical analysis revealed a moderate correlation between RPE lesion size and applied treatment energy, suggesting RFD adaptation to inter- and intraindividual RPE pigmentation and ocular transmission.

Potential beneficial effect of IFN-β1a and ocrelizumab in people with MS during the COVID-19 pandemic.

Disease-modifying therapy (DMT) has led to added challenges in the management of people with multiple sclerosis (pwMS) during the COVID-19 era. It can reduce relapse in MS or slow down disease progression, but some DMTs can increased risk of infection. The aim of study was to evaluate risk and severity of COVID-19 in pwMS. The examined group of pwMS were divided in group treated with IFN-β1a, group treated with ocrelizumab and untreated group. The examination included impact of age, gender, duration of MS, type of MS, vaccination status and Expanded Disability Status Scale (EDSS) on the risk and severity of COVID-19 infection. A diagnosis of COVID-19 in pwMS was confirmed by positive polymerase-chain-reaction (PCR) or antigen test. Out of 207 pwMS, 82 patients were treated with ocrelizumab, 63 with IFN-β1a, while 62 patients were untreated pwMS. The average duration of the MS was longer in the group of patients treated with ocrelizumab than in the group treated with IFN-β1a (p < 0.05). EDSS was higher in the ocrelizumab group compared to the other two groups (p < 0.001). Untreated (more often unvaccinated) had the same COVID frequency as ocrelizumab-treated (more vaccinated, but higher EDSS). The multivariate logistic regression model indicated that administration of IFN-β1a reduces the risk of COVID-19 infection (p = 0.001, OR = 0.381, 95% CI 0.602-0.160). The use of both DMTs, driven mainly by the IFN-β1a effect, reduces the risk of moderate and severe COVID-19 (p < 0.05, OR = 0.105, 95% CI 0.011-0.968). This study provides evidence that IFN-β1a can reduce the frequency of COVID-19 infection and that two DMTs, driven mainly by the IFN-β1a effect, do not increase the risk of moderate/severe COVID-19.

Flash-Thermal Shock Synthesis of Single Atoms in Ambient Air.

Single-atom catalysts feature interesting catalytic activity toward applications that rely on surface reactions such as electrochemical energy storage, catalysis, and gas sensors. However, conventional synthetic approaches for such catalysts require extended periods of high-temperature annealing in vacuum systems, limiting their throughput and increasing their production cost. Herein, we report an ultrafast flash-thermal shock (FTS)-induced annealing technique (temperature > 2850 °C, <10 ms duration, and ramping/cooling rates of ∼105 K/s) that operates in an ambient-air environment to prepare single-atom-stabilized N-doped graphene. Melamine is utilized as an N-doping source to provide thermodynamically favorable metal-nitrogen bonding sites, resulting in a uniform and high-density atomic distribution of single metal atoms. To demonstrate the practical utility of the single-atom-stabilized N-doped graphene produced by the FTS method, we showcased their chemiresistive gas sensing capabilities and electrocatalytic activities. Overall, the air-ambient, ultrafast, and versatile (e.g., Co, Ni, Pt, and Co-Ni dual metal) FTS method provides a general route for high-throughput, large area, and vacuum-free manufacturing of single-atom catalysts.

Shielded ionisation discharge (SID) probe for spatiotemporal profiling of pulsed molecular beam.

Intense pulsed supersonic molecular beams are used in many applications such as tokamak fueling, edge plasma diagnostics, ion beam profile monitors, laser cluster experiments, chemical kinetics, etc. Measurement of absolute density is required to optimize beam sources used in these experiments. Absolute density measurement of a continuous molecular beam is challenging due to its small size and rarefied flow, which makes it even more difficult for a pulsed molecular beam due to its transient nature. In this work, we demonstrate a novel probe to measure the spatiotemporal evolution of the absolute number density of a pulsed supersonic molecular beam. The probe is named the Shielded Ionization Discharge probe. It measures density using localized discharge within the molecular beam created by the thermionic emission of electrons from a hot filament. We describe the design, calibration, and characterization of the developed probe. The performance of the probe is demonstrated by measuring the spatial and temporal profiles of a pulsed supersonic molecular beam of 1.5ms duration.

Studies of multisensory integration in sound localization and updating of auditory spatial attention during head motion

In daily life, our heads are in continual motion, but much of our knowledge of spatial hearing is based on experimental paradigms in which this behavior is discouraged or prevented. Head motion can benefit spatial hearing though the creation of dynamic acoustical cues, but also creates challenges such as the need to update head-centered spatial representations or the locus of spatial auditory attention. To utilize acoustic information generated by, or to compensate for, head movements, the auditory system must integrate self-motion information provided by other sensory systems. This presentation will review and contextualize a series of studies from the author's laboratory focused on the psychophysics of dynamic sound localization and the weighting of sensory information from vestibular, proprioceptive, and visual modalities in dynamic localization and maintenance of spatially selective auditory attention during head rotation. Notable findings include a velocity-independent ∼100-ms minimum stimulus duration for disambiguation of front/rear location in dynamic localization and the apparent dominance of vestibular information in the interpretation of dynamic localization cues and in attentional updating. The approach taken provides a step towards understanding the effects of naturalistic behavior on spatial hearing while maintaining significant experimental control and repeatability of stimuli and head movements.

Health behaviors of people with multiple sclerosis and its associations with MS related outcomes: a German clinical cohort.

Health behaviors in persons with multiple sclerosis (pwMS) have been associated with MS-related disease outcomes. The aim of the study was to gain knowledge about current patient health behaviors in a convenience sample representative for pwMS presenting to a large university-based outpatient clinic and to investigate associations between modifiable risk factors with physical impairment, quality of life (QoL) and cardiovascular comorbidities. A questionnaire was administered at the MS Outpatient Clinic of the University Medical Center Hamburg Eppendorf asking for health behaviors regarding dietary habits assessed with the German adaptation of the validated Spanish short Diet Quality Screener (sDQS), level of physical activity assessed with the Godin Leisure Time Questionnaire (GLTEQ) and tobacco smoking. Participants were asked to report cardiovascular comorbidities using items from the Self-Report Comorbidity Questionnaire for Multiple Sclerosis. Additionally, cardiovascular risk factors like blood pressure, height and weight (to calculate BMI) and waist circumference were measured. MS specific clinical data, e.g., disease course, duration, disability and MS-specific QoL were collected from the clinical database. Descriptive analyses were performed and multivariate regression analyses for complete cases were carried out for each of the three outcome variables including all mentioned modifiable risk factors (dietary behavior, smoking, physical activity and BMI) as independent variables. In this sample of 399 pwMS the mean age was 42 years (SD 12.8) with a mean disease duration since diagnosis of 7.4 years (SD 8.4) and a mean EDSS of 2.8 (SD 1.9). 24% were current smokers, 44% were insufficiently physically active and 54% did not follow a healthy dietary pattern. 49% of this relatively young clinical population was overweight and 27% reported one or more cardiovascular comorbidities. Most modifiable risk factors showed no convincing associations with MS-related disease outcomes in the multiple regression analyses. This clinical cohort of pwMS shows a high prevalence of critical health behaviors and comorbidities and emphasizes the need for monitoring, education and assistance for behavior change in this population.

Wavelength Conversion of Multi-Joule Energy 532 nm Pulse Bursts via a Potassium Gadolinium Tungstate Raman Laser

In this study, pulse bursts at 559, 589, and 621 nm, with a record energy of ~10 J, are generated using a KGW Raman laser with an external resonator, while pumping at 532 nm. The pulse bursts have a 10 ms duration, and consist of 78 subpulses with a duration of &lt;10 ns, at 8 kHz. The maximum energy of the bursts is restricted only by the characteristics of the Nd: YAG laser used as the 532 nm pump source, and can be increased.