4 results
Early detection of cognitive dysfunction in patients with multiple sclerosis: Implications on outcome
- Maged Abdel Naseer, Shereen Fathi, Dalia M. Labib, Dalia H. Khalil, Alshaimaa M. Aboulfotooh, Rehab Magdy
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- Journal:
- Brain Impairment / Volume 21 / Issue 2 / September 2020
- Published online by Cambridge University Press:
- 19 September 2019, pp. 208-216
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- Article
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Objective:
Cognitive impairment in multiple sclerosis (MS) has a complex relationship with disease progression and neurodegeneration. The aim of this study was to shed light on the importance of early detection of cognitive impairment in MS patients.
Methods:The study comprised two groups of definite MS patients, relapsing remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS), each with 25 patients. Physical disability was assessed using the Expanded Disability Status Scale (EDSS), while the risk of secondary progression was assessed using the Bayesian Risk Estimate for Multiple Sclerosis (BREMS). Cognitive functions were assessed using the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) and Controlled Oral Word Association Test (COWAT). Assessment of neurodegeneration was done using optical coherence tomography (OCT) via quantification of retinal nerve fiber layer (RNFL).
Results:MS patients with higher RNFL thickness demonstrated a larger learning effect size than patients who had lower values in RNFL thickness regardless of MS type. RRMS patients showed significant improvement in delayed recall after giving cues than SPMS. The symbol digit modalities test was the only neuropsychological test that showed a significant negative correlation with EDSS (P = 0.009). There was a statistically significant negative correlation between BREMS scores and performance in all neuropsychological tests.
Conclusion:Inclusion of neurocognitive evaluation in the periodic assessment of MS patients is mandatory to detect patients at increased risk of secondary progression. The thickness of RNFL is suggested as a method to estimate the expected benefit of cognitive rehabilitation, regardless of MS type.
1 - Jets and mixing layers
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- By M. M. Koochesfahani, P. E. Dimotakis, M. Gharib, P. Derango, E. Villermaux, H. Rehab, E. J. Hopfinger, D. E. Parekh, W. C. Reynolds, M. G. Mungal, T. Loiseleux, J.-M. Chomaz, T. F. Fric, A. Roshko, S. P. Gogineni, M. M. Whitaker, L. P. Goss, W. M. Roquemore, S. Wernz, H. F. Fasel, S. Gogineni, C. Shih, A. Krothapalli
- M. Samimy, Ohio State University, K. S. Breuer, Brown University, Rhode Island, L. G. Leal, University of California, Santa Barbara, P. H. Steen, Cornell University, New York
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- Book:
- A Gallery of Fluid Motion
- Published online:
- 25 January 2010
- Print publication:
- 12 January 2004, pp 1-10
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Summary
Laser-induced fluorescence (LIF) diagnostics and highspeed, real-time digital image acquisition techniques are combined to map the composition field in a water mixing layer. A fluorescent dye, which is premixed with the lowspeed freestream fluid and dilutes by mixing with the highspeed fluid, is used to monitor the relative concentration of high-speed to low-speed fluid in the layer.
The three digital LIF pictures shown here were obtained by imaging the laser-induced fluorescence originating from a collimated argon ion laser beam, extending across the transverse dimension of the shear layer, onto a 512–element linear photodiode array. Each picture represents 384 contiguous scans, each at 400 points across the layer, for a total of 153 600 point measurements of concentration. The vertical axis maps onto 40 mm of the transverse coordinate of the shear layer, and the horizontal axis is time increasing from right to left for a total flow real time of 307 msec. The pseudocolor assignment is linear in the mixture fraction (ξ) and is arranged as follows: red-unmixed fluid from the low-speed stream (ξ=0); blue-unmixed fluid from the high-speed stream (ξ=1); and the rest of the spectrum corresponds to intermediate compositions.
Figures 1 and 2, a single vortex and pairing vortices, respectively, show the composition field before the mixing transition. The Reynolds number based on the local visual thickness of the layer and the velocity difference across the layer is Re=1750 with U2/U1=0.46 and U1=13 cm/sec. Note the large excess of high-speed stream fluid in the cores of the structures.
Mixing in coaxial jets
- E. VILLERMAUX, H. REHAB
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- Journal:
- Journal of Fluid Mechanics / Volume 425 / 25 December 2000
- Published online by Cambridge University Press:
- 01 December 2000, pp. 161-185
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The stirring and mixing properties of one-phase coaxial jets, with large outer (annular) to inner velocity ratio ru = u2/u1 are investigated. Mixing is contemplated according to its geometrical, statistical and spectral facets with particular attention paid to determining the relevant timescales of the evolution of, for example, the interface area generation between the streams, the emergence of its scale-dependent (fractal) properties and of the mixture composition after the mixing transition. The two key quantities are the vorticity thickness of the outer, fast stream velocity profile which determines the primary shear instability wavelength and the initial size of the lamellar structures peeled-off from the slow jet, and the elongation rate γ = (u2 − u1)/e constructed with the velocity difference between the streams and the gap thickness e of the annular jet. The kinetics of evolution of the interface corrugations, and the rate at which the mixture evolves from the initial segregation towards uniformity is prescribed by γ−1. The mixing time ts, that is the time needed to bring the initial scalar lamellae down to a transverse size where molecular diffusion becomes effective, and the corresponding dissipation scale s(ts) are
formula here
where Re and Sc denote the gap Reynolds number and the Schmidt number, respectively. The persistence of the large-scale straining motion is also apparent from the spectra of the scalar fluctuations which exhibit a k−1 shape on the inertial range of scales.
Flow regimes of large-velocity-ratio coaxial jets
- H. REHAB, E. VILLERMAUX, E. J. HOPFINGER
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- Journal:
- Journal of Fluid Mechanics / Volume 345 / 25 August 1997
- Published online by Cambridge University Press:
- 25 August 1997, pp. 357-381
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An investigation of the near-field flow structure of coaxial jets with large outer to inner velocity ratio ru has been conducted. Since in all cases ru>1, the outer jet dominates the near-field flow structure. Two flow regimes are identified depending on whether ru is larger or smaller than a critical value ruc. When ru<ruc, the fast annular jet periodically pinches the central, slow jet near the end of the inner potential cone. The pinching frequency corresponds to the outer-jet mode. The length of the inner potential cone is strongly dependent on ru and behaves like A/ru, where A depends weakly on the initial conditions. When ru>ruc, the inner potential cone is truncated and is followed by an unsteady recirculation bubble with low-frequency oscillation.
The transition from one regime to another is explained by a simple model whose ingredients are the turbulent entrainment rate, governed by the outer-jet mixing layers and mass conservation. This model satisfactorily predicts the dependence of the inner potential cone length on ru and the critical velocity ratio ruc. The recirculation bubble has a wake-type instability. It oscillates at a low frequency and a large amplitude compared to the Kelvin–Helmholtz mode. Angular cross-correlations in the plane parallel to the jet outlet show moreover that this oscillation displays an azimuthal precession such that the rotation time of the phase of the oscillation equals the oscillation period. These salient features are discussed in the framework of the nonlinear delayed saturation (NLDS) model.