Fatigue Rate Research Articles

Characteristics of post COVID-19 condition in children after mild COVID-19

Introduction. Post COVID-19 condition in children causes variety of persistent symptoms such as fatigue, post-exertional malaise, cognitive problems, muscle pain and can affect different aspects of patient’s life.Aim. The aim of this study was to describe the prevalence and characteristics of persistent symptoms of COVID-19 in non-hospitalized pediatric patients one year after infection.Material and methods. This is a single center case-control study including children and young people (COVID-19 as cases and other acute respiratory infections as controls). A survey using ISARIC Global COVID-19 paediatric follow-up questionnaire was conducted by a pediatrician in person or via telephone interview one year after infection. Post COVID-19 condition was defined using WHO case definition.Results and discussion. 206 cases and 176 controls were analyzed. The mean ages of cases and controls were 8.8 years and 8.4 years accordingly, with 55% and 50% being females. The most frequent persistent symptoms in cases at 1 year were loss of taste – 8.7% [5.3%; 13.1%], fatigue – 8.7% [4.9%; 13.1%], chest pain – 4.9% [1.9%; 7.8%], headache – 2.4% [1.0%; 4.9%], tingling – 2.4% [0.5%; 4.9%]. Controls had similar persistent symptoms, but cases had significantly higher rates of sensory disturbances (taste/smell alterations) and fatigue. There were no statistically significant differences between other groups of symptoms found. Prevalence of post COVID-19 condition in cases group was 1.5% [0.0%; 3.4%].Conclusion. Prevalence of post COVID-19 condition in children one year after mild infection is low. However, compared to other respiratory infections, COVID-19 may cause persistent taste/smell disturbances and fatigue.

Numerical evaluation of the tension mooring effects on the hydrodynamic response of moored ships under harbor oscillations

Tension mooring is the main way of restraining moored ships in a port to ensure operating conditions. Harbor oscillations have been observed in many ports and adversely affected the safe operation of moored vessels. This paper analyses the influence of different line pretensions and mooring arrangements on the efficacy of tension mooring in mitigating ship motions and line forces. A hybrid Boussinesq-panel model is adopted to simulate the hydrodynamic response of a moored container ship under harbor oscillations induced by irregular waves.Results show that the moored ships near nodes and antinodes are more likely to experience larger amplitudes of horizontal motions and lead to higher loads on the shorter lines of the mooring system, which subsequently affects the lines' performance. Inceasing the pretension of mooring lines can minimize ship's horizontal motions, thus improving operational efficiency. A reasonable increase in pretension would effectively relieve line forces, while an excessive increase in pretension may accelerate the rate of fatigue and failure on the lines. The main advantage of utilizing mooring arrangements with multiple lines attached to the same bollard is reducing the uneven distribution of line forces. But this approach carries the potential risk of exerting overload pressure on the bollards.

Low-load blood flow restriction reduces time-to-minimum single motor unit discharge rate.

Resistance training with low loads in combination with blood flow restriction (BFR) facilitates increases in muscle size and strength comparable with high-intensity exercise. We investigated the effects of BFR on single motor unit discharge behavior throughout a sustained low-intensity isometric contraction. Ten healthy individuals attended two experimental sessions: one with, the other without, BFR. Motor unit discharge rates from the tibialis anterior (TA) were recorded with intramuscular fine-wire electrodes throughout the duration of a sustained fatigue task. Three 5-s dorsiflexion maximal voluntary contractions (MVC) were performed before and after the fatigue task. Each participant held a target force of 20% MVC until endurance limit. A significant decrease in motor unit discharge rate was observed in both the non-BFR condition (from 13.13 ± 0.87Hz to 11.95 ± 0.43Hz, P = 0.03) and the BFR condition (from 12.95 ± 0.71Hz to 10.9 ± 0.75Hz, P = 0.03). BFR resulted in significantly shorter endurance time and time-to-minimum discharge rates and greater end-stage motor unit variability. Thus, low-load BFR causes an immediate steep decline in motor unit discharge rate that is greater than during contractions performed without BFR. This shortened neuromuscular response of time-to-minimum discharge rate likely contributes to the rapid rate of neuromuscular fatigue observed during BFR.

Dynamic Prevalence of and Factors Associated With Fatigue Following Traumatic Brain Injury: A Systematic Review and Meta-analysis of Observational Studies.

To implement a systematic review and meta-analysis to comprehensively synthesize the prevalence of and factors associated with fatigue following traumatic brain injury (TBI). We systematically searched the PubMed, EMBASE, Cochrane Library, Cumulated Index to Nursing and Allied Health Literature, PsycINFO, and ProQuest Dissertations and Theses A&I databases in all fields from their inception to March 31, 2021. We included observational studies investigating fatigue at specific time points following TBI or factors associated with post-TBI fatigue. All data were analyzed using a random-effects model. This meta-analysis included 29 studies that involved 12 662 patients with TBI and estimated the prevalence of post-TBI fatigue (mean age = 41.09 years); the meta-analysis also included 23 studies that involved 6681 patients (mean age = 39.95 years) and investigated factors associated with post-TBI fatigue. In patients with mild-to-severe TBI, the fatigue prevalence rates at 2 weeks or less, 1 to 3 months, 6 months, 1 year, and 2 years or more after TBI were 52.2%, 34.6%, 36.0%, 36.1%, and 48.8%, respectively. Depression ( r = 0.48), anxiety ( r = 0.49), sleep disturbance ( r = 0.57), and pain ( r = 0.46) were significantly associated with post-TBI fatigue. No publication bias was identified among the studies, except for those assessing fatigue prevalence at 6 months after TBI. The pooled prevalence rates of post-TBI fatigue exhibited a U-shaped pattern, with the lowest prevalence rates occurring at 1 to 3 months after TBI. Depression, anxiety, sleep disturbance, and pain were associated with post-TBI fatigue. Younger patients and male patients were more likely to experience post-TBI fatigue. Our findings can assist healthcare providers with identifying appropriate and effective interventions targeting post-TBI fatigue at specific periods.

Effectiveness of different recovery postures during high-intensity interval training.

High-intensity interval training (HIIT) has become a very popular mode of exercise practiced by the elite as well as recreationally active adults. The aim of this study was to evaluate the effects of four recovery postures that are typically used by exercisers on recovery rate and performance in subsequent bouts of HIIT. Sixteen young, healthy adults performed four HIIT trials with randomized recovery postures. Each trial consisted of four sets of modified Wingate anaerobic power tests (20-sec duration) on a cycle ergometer (Monark 894E, Vansbro, Sweden) separated by four-minute recovery between each exercise set. Participants adopted one of four recovery postures immediately following each set: standing still with hands on the back of the head (head), standing still with hands resting on knees (knees), slow walking with hands on hips (walking), or supine rest (supine). Differences were assessed by a two-way (posture × set) repeated measures analysis of variance. Peak and mean anaerobic power progressively declined within each set (P<0.05), with no differences between postures. Fatigue rate was significantly slower during supine (59±12%) than knees (63±13%). Heart rate recovery was faster (P<0.001) during supine than the other three standing postures. Pulmonary ventilation was not significantly different between postures. Blood lactate concentrations measured after HIIT were not significantly different between postures. Supine posture appears to be more advantageous in facilitating recovery when compared to the three standing postures. None of the recovery postures examined was responsible for better performance in subsequent bouts of HIIT.

Laboratory, clinical, neurological and neuropsychological features of the course of post-COVID syndrome in patients with cerebrovascular disease

A review of the literature reveals a wide range of terms for conditions after coronavirus disease (COVID-19): post-­COVID syndrome, post-acute COVID syndrome, chronic COVID-19, long-term complications of COVID-19, long COVID-19, and post-acute sequelae of severe acute respiratory syndrome coronavirus 2 infection. All these terms and others indicate that after ­COVID-19, a person does not return to his/her usual state of health. Many scientists are researching and looking for the causes of these symptoms, why and when they occur, and how to diagnose and treat them. Therefore, the aim of the study was to improve the diagnosis of post-COVID syndrome in patients with cerebrovascular disease (CVD) by studying clinical, neurological, laboratory and neuropsychological markers. Materials and methods. The study uses psychometric methods — Beck Anxiety Inventory, Hamilton Depression Rating Scale, Fatigue Assessment Scale; neuropsychological — Montreal Cognitive Assessment; clinical — neurological status; laboratory — hemoglobin, C-reactive protein, fibrinogen, albumin, ferritin, lactate dehydrogenase. All patients were divided into four groups: the first group included 20 people with post-­COVID syndrome and CVD, the second — 15 individuals with post-COVID syndrome without CVD, the third — 15 patients without post-COVID syndrome with CVD, and the fourth — 15 people without post-COVID syndrome and without CVD. Results. In the group of patients with post-COVID syndrome with cerebrovascular disease (n1 = 20), the average level of hemoglobin (M = 115.15 ± 4.93) and albumin (M = 32.15 ± 1.53) was below the normal range; the content of fibrinogen (M = 6.04 ± 0.82), C-reactive protein (M = 5.50 ± 0.68) was above normal. Data of the Hamilton Depression Rating Scale indicate that patients with post-COVID syndrome and cerebrovascular disease Data of the Hamilton Depression Rating Scale indicate that patients with post-COVID syndrome and cerebrovascular disease (n1 = 20) had a mild depression (M = 6.75 ± 3.90; M = 8.60 ± ± 3.06). Correlation analysis revealed a direct relationship between cognitive functions and hemoglobin (r = 0.455, p ≤ 0.01), albumin (r = 0.571, p ≤ 0.01) and an inverse relationship between cognitive functions and fibrinogen (r = –0.605, p ≤ 0.01), C-reactive protein (r = –0.547, p ≤ 0.01), ferritin (r = 0.408, p ≤ 0.01). There was an inverse correlation between anxiety and hemoglobin (r = –0.619, p ≤ 0.01) and albumin (r = –0.567, p ≤ 0.01) and a direct relationship between anxiety and fibrinogen (r = 0.550, p ≤ 0.01) and C-reactive protein (r = 0.537, p ≤ 0.01). The depression scale negatively correlates with the level of hemoglobin (r = –0.597, p ≤ 0.01), albumin (r = –0.543, p ≤ 0.01) and directly with the content of fibrinogen (r = 0.433, p ≤ 0.01), C-reactive protein (r = 0.383, p ≤ 0.01) and lactate dehydrogenase (r = 0.276, p ≤ 0.05). The indicators of fibrinogen, C-reactive protein, and ferritin were the highest in the group of patients with post-COVID syndrome and cerebrovascular disease. According to the obtained data, there are statistically significant differences between four groups in cognitive functions (χ2 = 36.419, p ≤ 0.01), fatigue (χ2 = 37.251, p ≤ 0.01), anxiety (χ2 = 37.981, p ≤ 0.01) and depression (χ2 = 37.171, p ≤ 0.01). The highest rate of fatigue, anxiety, and depression was found in patients with post-COVID syndrome and cerebrovascular disease.

Predictors of Poor Treatment Experience in Cervical Cancer Patients Receiving Definitive Chemoradiation and Brachytherapy Boost: A Prospective Study

Cervical cancer patients experience high overall symptom burden. Here, we analyzed patient reported outcomes (PROs) to identify disease, treatment, or patient-related characteristics that can predict poor treatment experience. Cervical cancer patients treated with definitive chemoradiation (CRT) at a single institution enrolled on a prospective trial evaluating PROs between 2021-2023 were included. Patients received PRO questionnaires at baseline (BL) and 2-7 days after final brachytherapy implant (post-BT). Data was collected using the EORTC-QLQ-C30, which is a validated metric scored on a 4-point Likert scale (1 = not at all, 2 = a little, 3 = quite a bit, 4 = very much). Poor treatment experience was defined as low physical function [score >2], significant overall symptom burden [> population mean], or substantial nausea/vomiting (N/V), diarrhea, pain, or fatigue [score >2] after BT. Potential predictors included age, menopause status, stage, radiation field size, BT modality (PDR vs HDR), marital status, high baseline financial toxicity [score >2], depression [score >2], worse social function [score >2] and poor emotional function [score >2]. Logistic regression modeling was performed and p<0.05 were considered significant. A total of 36 patients completed BL and post-BT PRO metrics. Median age was 42 (range, 18-85), 22% (n = 8) of patients had localized disease, 75% (n = 27) had regional disease, and 3% (n = 1) had distant disease. Low BL social function was associated with high symptom burden after BT (HR 12.5, 95% CI 2.3-68.2, p = 0.004), significant N/V (HR 19.0, 95% CI 1.9-191.0, p = 0.012), high rates of fatigue (HR 9.29, 95% CI 1.6-54.8, p = 0.014), and overall poor physical function after treatment (HR 5.67, 95% CI 1.1-30.1, p = 0.042). High BL financial toxicity was predictive of elevated symptom burden after BT (HR 12.0, 95% CI 2.2-66.0, p = 0.004) and substantial fatigue (HR 7.33, 95% CI 1.5-36.7, p = 0.015). Significant depression at BL was also associated with high rates of N/V (HR 9.78, 95% CI 1.4-66.9, p = 0.02). Patient age, menopausal status, disease stage, radiation field size, BT modality, and marital status were not significantly predictive for symptom burden or physical function after treatment. Patients with poor baseline social function, high financial toxicity, and depression are at risk for increased symptom burden. Screening for these factors may provide an opportunity to intervene early and improve patient treatment experience.

Effect of Repeated, On-Field Sprints on Kinematic Variables in Wheelchair Rugby Players.

The aim of the study was to evaluate the influence of repeated sprints on kinematic performance and propulsion variables during the acceleration and constant peak velocity phases in wheelchair rugby players classified as defensive (low point in defensive [LP-D]) or offensive players (high point in offensive [HP-O]). Twenty-two players (13 LP-D and 9 HP-O) performed 6 × 20-m repeated sprint field tests. We calculated peak wheelchair velocities, propulsion phase times, deceleration phase times, cycle times, and left-right velocity asymmetry of the best and last sprints during the acceleration and constant peak velocity phases, the rate of decline in performance variables between the best and the last sprint and a fatigue index. Peak velocities during the acceleration and constant peak velocity phases and mean velocity over the whole sprint were significantly higher during the best than last sprint. Peak velocities were higher during the acceleration and constant peak velocity phases for the best and last sprint for HP-O. The rate of decline in peak velocity during the constant peak velocity phase was higher for LP-D. Fatigue index and rate of decline in velocities and sprint time were higher for LP-D. Performance variables and the rate of decline in performance variables depended on functional capacity and wheelchair type.

Burnout and fatigue amongst internal medicine residents: A cross-sectional study on the impact of alternative scheduling models on resident wellness.

Fatigue and burnout are prevalent among resident physicians across Canada. Shifts exceeding 24 hours are commonly purported as detrimental to resident health and performance. Residency training programs have employed strategies towards understanding and intervening upon the complex issue of resident fatigue, where alternative resident scheduling models have been an area of active investigation. This study sought to characterize drivers and outcomes of fatigue and burnout amongst internal medicine residents across different scheduling models. We conducted cross-sectional surveys were among internal medicine resident physicians at the University of Alberta. We collected anonymized socioeconomic demographics and medical education background, and estimated associations between demographic or work characteristics and fatigue and burnout outcomes. Sixty-nine participants competed burnout questionnaires, and 165 fatigue questionnaires were completed (response rate of 48%). The overall prevalence of burnout was 58%. Lower burnout prevalence was noted among respondents with dependent(s) (p = 0.048), who identified as a racial minority (p = 0.018), or completed their medical degree internationally (p = 0.006). The 1-in-4 model was associated with the highest levels of fatigue, reported increased risk towards personal health (OR 4.98, 95%CI 1.77-13.99) and occupational or household harm (OR 5.69, 95%CI 1.87-17.3). Alternative scheduling models were not associated with these hazards. The 1-in-4 scheduling model was associated with high rates of resident physician fatigue, and alternative scheduling models were associated with less fatigue. Protective factors against fatigue are best characterized as strong social supports outside the workplace. Further studies are needed to characterize the impacts of alternative scheduling models on resident education and patient safety.

P01.08.B MENTAL FATIGUE IN PATIENTS WITH LOW-GRADE GLIOMA: ASSOCIATIONS WITH NEUROCOGNITIVE FUNCTIONING AND TUMOR CHARACTERISTICS

Abstract BACKGROUND Fatigue is a frequent consequence of low-grade glioma (LGG), but the causes are still barely understood. Specifically mental fatigue might be related to cognitive impairment such as mental slowness and decreased attention. Also, patients with greater tumor volumes or tumors in certain locations (such as the frontal cortex) might have more cognitive impairments and experience more fatigue. The aim of the present study was twofold: (1) to examine the relationship between mental fatigue and information processing speed and complex attention and (2) to investigate the associations between mental fatigue and tumor volume and location in patients with LGG. MATERIAL AND METHODS 124 patients with LGG (IDH mutated astrocytoma and oligodendroglioma grade 2 and 3) were included before the start of proton therapy. Different facets of fatigue, including mental fatigue, were measured after surgery, with a multidimensional fatigue scale, the Dutch Multifactor Fatigue Scale (DMFS). The Vienna Test System was used to examine simple information processing speed, response inhibition, and divided attention. Tumor location and tumor volume (radiation target volume) were scored on the pre-radiotherapy MRI scan. Descriptive statistics, Spearman’s correlations, and between group comparisons were performed. RESULTS 41% of patients with LGG reported severe mental fatigue. No significant differences were found in mean performance on simple information processing speed, response inhibition and divided attention between severely mental fatigued patients and non-severely mental fatigued patients. However, the percentage of patients with impaired divided attention was significantly higher in the severely mental fatigued group (39%) compared to the non-severely mental fatigued group (16.2%), χ2 = 7.6, p &amp;lt; 0.05. No significant relationships were found between mental fatigue and tumor volume and location. Also, tumor location was not related to neurocognitive functioning, but larger tumor volume was significantly associated with poorer performance on divided attention (r = -0.19, p &amp;lt; 0.05). CONCLUSION A high rate of mental fatigue was found in patients with LGG. Furthermore, a relationship between impaired divided attention and severe mental fatigue was found. This implies that patients may develop mental fatigue due to increased cognitive efforts to compensate for attentional deficits. This might be especially important in patients with larger tumors, considering the relationship between tumor volume and divided attention. The results stress the importance of neuropsychological assessment in this patient group before the start of adjuvant treatment, to timely offer individual rehabilitation.

“No association between disease modifying treatment and fatigue in multiple sclerosis”

BackgroundFatigue affects 60–90% of people with multiple sclerosis (MS). It reduces quality of life and the ability to work. The cause of fatigue in MS remains unknown. Several disease-modifying treatments (DMTs) slow the disease process in relapsing MS by suppressing neuroinflammation. We aimed to investigate if treatment with a DMT is associated with lower rates of fatigue. MethodsIn this cross-sectional study of the MS population in three counties in Norway, we used the Fatigue Scale for Motor and Cognitive Functions (FSMC) and the Hospital Anxiety and Depression Scale (HADS) to assess patient-reported fatigue, anxiety and depression. Clinical data were retrieved from the electronic patient record system. We categorized DMTs as high-efficacy therapy or moderate-efficacy therapy. High-efficacy drugs included fingolimod, natalizumab, ocrelizumab, rituximab, alemtuzumab, daclizumab, and autologous hematopoietic stem cell transplantation. Moderate-efficacy drugs included interferons, glatiramer acetate, dimethyl fumarate, and teriflunomide. We included persons with relapsing MS only. ResultsOf 1142 patients, 80% had fatigue. Fifty-six percent of the patients were on DMTs (25% on moderate-efficacy treatment and 30% on high-efficacy treatment), 18% had discontinued treatment and 26% had never received any DMT. Sex, level of disability as measured by the Multiple Sclerosis Severity Score, anxiety and depression were independently associated with fatigue. Moderate-efficacy treatment was associated with less fatigue, but not after adjustment for other variables. There was no association between high-efficacy treatment and fatigue. ConclusionWe found no independent relationship between the use of disease-modifying treatment and fatigue in MS.

A Standard Practice Protocol for Addressing Depression in a Hospice Setting.

Depression can worsen physical suffering and psychiatric distresses in individuals with life-limiting illnesses and is associated with increased rates of pain, fatigue, dyspnea, and worse survival outcomes. Evidence supports protocol development to address depression in the hospice setting using validated screening tools and a process for referral and treatment. After protocol development and integration of validated screening tools into the electronic medical record, newly admitted patients meeting inclusion criteria were screened during the social workers' initial psychosocial assessment. Patients were referred for pharmacological and nonpharmacological treatment strategies based on the severity of depression detailed in the protocol. Of all patients who met inclusion criteria, 100% were screened using the Patient Health Questionnaire-2 with 52% being identified as having some severity of depression, 26% being appropriately referred for treatment, and 50% receiving a pharmacological strategy, whereas 26% received nonpharmacological strategies. There was a statistically significant difference in severity of depression found between those identified as having a depressed mood preintervention and those with some severity of depression using a validated screening tool postintervention. Implementing a standardized practice protocol to address depression in a hospice setting allowed for consistent evaluation through the use of validated screening tool(s) and increased recognition of those with symptoms of depression.

Application of machine learning approaches for modelling crack growth rates

AbstractThe scientific community has widely accepted the use of machine learning techniques to tackle complex engineering problems. Among the most intriguing problems is finding the correlation between alloy steel properties and cyclic fatigue and crack growth rate. Employing machine‐learning models can provide more robust and accurate predictive models to address such challenges. This paper presents the application of four machine learning models, namely decision trees (DT), random forest (RF), adoptive boosting (AdaBoost), and gradient boosting regression tree (GBRT) to predict the crack growth rate of steel/alloys. The study utilizes a large database gathered from literature to construct the predictive models and compares the results using various statistical metrics and graphical representation. The study's findings demonstrate the effectiveness and suitability of machine learning techniques to handle complex databases related to fatigue problems.

Physical, psychological, and cognitive outcomes after coronavirus disease 2019 hospitalization: a prospective study with 3-month follow-up of a Brazilian cohort

Context: Post–coronavirus disease (COVID) is associated with multiple impairments. Aims: To identify consequences of COVID 2019 (COVID-19) hospitalization, and risk factors for functional dependence 3 months after discharge. Settings and design: Prospective cohort in a verticalized health care network. Material and methods: Individuals hospitalized from June to November 2020 due to COVID-19 were investigated assessing outcomes pertaining to physical and respiratory symptoms, mental health, and physical, swallow and vocal, and cognitive function at baseline, and after 1 and 3 months. Those admitted to the intensive care unit were compared with those in the ward. Statistical analysis used: Within and between-group comparison and across time points using T test paired samples, Wilcoxon test, 1-way analysis of variance and Kruskal-Wallis, Pearson χ2 and Fisher exact test, with a statistical power of 80% and α = 5%, and a post hoc univariable and multivariable logistic regression. Results: Participants (n = 326) had a mean of 70.3 (9.2) years and were hospitalized for a median (interquartile range) of 5 (3–8) days. In the 3-month follow-up, participants persisted with fatigue (64.7%), breathlessness (44.5%), aches, and pains (18.5%). Dyspnea and fatigue rates worsened during the same time period. Multivariable regression showed Timed Up and Go (test) ≥20 seconds at discharge as a predictor of functional dependence for IADL at the 3-month follow-up [odds ratio =3.12 (95% CI: 1.25–7.84)]. Conclusions: The impact of COVID-19 persisted for at least 3 months, with improvement of only some outcomes in the period. A poor performance at the Timed Up and Go test at baseline was a predictor of functional dependence at 3 months.

Long-term healthcare professionals' experiences of burnout and correlation between burnout and fatigue: a cross-sectional study.

The aim of the study was to analyze the long-term burnout levels of healthcare professionals (HCPs) working in Slovenian nursing homes during the fifth wave of the pandemic; to compare the results of similar facilities in 2020 and 2013; and to examine the correlation between demographics and burnout and fatigue among HCPs. The study used a descriptive, correlational cross-sectional method. In the fifth wave, HCPs suffered more from emotional exhaustion, depersonalization and lack of personal accomplishment than in the first wave of the pandemic and in the spring of 2013. The HCPs caring for COVID-19 patients and younger women had higher rates of burnout and fatigue than other occupational groups. There is a strong positive correlation between burnout and fatigue. There is an urgent need to address the problem of fatigue and burnout with administrative measures. Int J Occup Med Environ Health. 2023;36(3):396-405.

Restless Legs Syndrome and fatigue in multiple sclerosis: A cross-sectional clinical study

BackgroundRestless Legs Syndrome is a sleep-related sensorimotor disorder with a higher prevalence in Multiple Sclerosis (MS) patients than in the general population. Our aim was to determine the prevalence of RLS in a group of relapsing-remittent multiple sclerosis (RRMS) patients, and to investigate whether RLS is associated with MS-related disability, sleep quality, mood disorders and fatigue. MethodsIn this retrospective, mono-centric, observational study, 92 RRMS patients were recruited (median age 46.5 years, 68.5% female patients). Data on MS clinical and radiological variables were collected. Patients underwent a subjective evaluation with standardized questionnaires on sleep fatigue and mood, which were evaluated by an expert neurologists specialized in sleep disorders about the occurrence of RLS. ResultsPrevalence of RLS in our sample was of 47.8%. Patients with RLS had a significantly higher rate of worse sleep quality and fatigue, compared to non RLS subjects (respectively 56.8% vs. 35.4%, p=0.04 and 54.4% vs 22.7%, p=0.002). Univariate analysis showed that RLS was significantly more frequent in fatigued patients (66.7% vs 38.5% RLS- patients, p=0.009). Multivariate analysis showed that fatigue correlated with MS-related disability (OR 1.556, p=0.011), poor sleep quality (OR 1.192, p 0.036), and mood disorders (OR 1.096, p 0.046). RLS appears to independently increase the risk of fatigue of 50%, without reaching clear statistical significance (OR 1.572, p 0,0079). ConclusionOur study confirms the high prevalence of RLS in patients with multiple sclerosis and highlights the potential impact of RLS on fatigue and its strict interaction with sleep quality.

Physical activity is related to disease severity and fatigue, but not to relapse rate in persons with relapsing remitting multiple sclerosis - a self-reported questionnaire based study.

Based on theoretical models, physical activity has been introduced as a promoting method to mitigate the disease severity, fatigue and relapse rate in multiple sclerosis. The primary objective of the study was to investigate the relation between self-reported physical activity level and disease severity, fatigue and relapse rate in persons with relapsing remitting multiple sclerosis (RRMS). A survey was offered to persons with RRMS from March 2019 to August 2021 (n = 253). Physical activity level, fatigue and disease severity were determined using the Godin Leisure-Time Questionnaire (GLTEQ), the Patient Determined Disease Steps (PDDS) scale and the Fatigue Scale for Motor and Cognitive Functions (FSMC). Additionally, participants' relapse rate was recorded. Bivariate correlations revealed an inverse relation between physical activity level and PDDS (ρ = -0.279; p < 0.001) as well as between physical activity and FSMC (r = -0.213, p < 0.001), but not between physical activity and relapse rate (r = 0.033, p > 0.05). Multiple linear regression analyses explained 12.6% and 5.2% of the variance of PDDS and FSMC. Our findings confirm a relation between self-reported physical activity, disease severity and fatigue in persons with RRMS. However, self-reported physical activity level does not seem to affect the annualised relapse rate.

Correlates of Rates and Treatment Readiness for Depressive Symptoms, Pain, and Fatigue in Hemodialysis Patients: Results from the TĀCcare Study.

Patients on hemodialysis (HD) often experience clinically significant levels of pain, fatigue, and depressive symptoms. We explored potential sociodemographic differences in symptom burden, current treatment, and readiness to seek treatment for these symptoms in patients screened for the TĀCcare trial. In-center HD patients from Pennsylvania and New Mexico were screened for fatigue (≥5 on 0 to10-point Likert scale), pain (Likert scale ≥4), depressive symptoms (≥10 Patient Health Questionnaire-9) and readiness to seek treatment (5-item Stages of Behavior Change questionnaire). Symptom burden and treatment status by sociodemographic factors were evaluated using chi-square, Fisher's exact tests, and logistic regression models. From March 2018-Dec 2021, 506 of 896 (57%) patients screened met eligibility criteria and completed the symptom screening (mean age 60±13.9 years, 44% females, 17% Black, 25% American Indian, 25% Hispanics). Of these, 77% screened positive for ≥1 symptom and 35% of those were receiving treatment for ≥1 of these symptoms. Pain, fatigue, and depressive symptom rates were 52%, 64%, and 24%, respectively. Age <65 was associated with a higher burden of depressive symptoms, pain, and reporting ≥1 symptom (p<0.05). The percentage of patients ready to seek treatment increased with symptom burden. More males reported readiness to seek treatment (85% vs. 68% of females, p<0.001). Among those with symptoms and treatment readiness, income was inversely associated with pain (>$60k/yr: OR=0.16, CI=0.03-0.76), and living in less walkable neighborhoods with more depressive symptoms (OR= 5.34, CI=1.19-24.05) and fatigue (OR= 5.29, CI=1.38-20.33). Pain, fatigue, and depressive symptoms often occurred together, and younger age, less neighborhood walkability, and lower income were associated with a higher burden of symptoms in HD patients. Male patients were less likely to be receiving treatment for symptoms. These findings could inform priority HD patient symptom identification and treatment targets.

Cross-flow vortex-induced vibrations of a top tensioned riser subjected to boundary disturbances with frequencies close to vortex shedding

In the present paper, the effects of external disturbances on cross-flow vortex-induced vibrations (VIVs) of a top tensioned riser are investigated based on a wake oscillator model. Two different flow conditions, namely uniform and linearly sheared profiles, and different combinations of disturbance frequency and amplitude were considered. Simulation results showed that synchronization between VIV and disturbance can occur when the disturbance frequency approaches the Strouhal frequency or when the disturbance amplitude is significant. This synchronization leads to a significant increase in riser response and the commonly used industry practice of simulating VIV and disturbance independently and summing both could underestimate the actual fatigue rate in such condition. However, in certain cases where VIV did not lock onto the disturbance, it was found that the disturbance could suppress the VIV and the industry practice tends to overestimate the fatigue rate.

Effect of a 3.5% NaCl-10% HCl Corrosive Environment on the Fatigue Behavior of Hot Rolled Aluminum 5083-H111.

This study deals with the microstructure of rolled Al5083-H111 materials, their hardness, corrosion in different solutions, and rotary bending fatigue properties of non-corroded and corroded samples in different solutions. This study is the first to report the fatigue behavior of corroded samples in different aggressive corrosion environments of Al5083. The microstructure of the Al5083-H111 material is in the form of grains oriented towards the rolling direction and it consists of binary Al-Mg, Al-Mn, and Mg-Si; ternary Al-Mg-Si; and quaternary Al-Mn-Fe-Si and Al-Cr-Mn precipitated randomly at the grain boundary. The Brinell hardness of the Al5083-H111 material is 68.67 HB. According to the results of the immersion corrosion, while the sample was more resistant to corrosion in a 3.5% NaCl environment, it showed a less resistant behavior in a 3.5% NaCl + 10% HCl environment. As a result of the fatigue test, it was observed that the sample that did not undergo corrosion showed a higher fatigue life than the samples that were exposed to corrosion. The fatigue rate of the 3.5% NaCl corrosion sample was 3.5 times lower than the fatigue rate of the 3.5% NaCl + 10% HCl corrosion sample.