A randomised controlled trial of calcium channel blockade (CCB) with Amlodipine For the treatment oF subcortical ischaEmic vasCular demenTia (AFFECT): study protocol

BACKGROUND: Vascular dementia is the second most common cause of dementia affecting over seven million people worldwide, yet there are no licensed treatments. There is an urgent need for a clinical trial in this patient group. Subcortical ischaemic vascular dementia is the most common variant of vascular dementia. This randomised trial will investigate whether use of calcium channel blockade with amlodipine, a commonly used agent, can provide the first evidence-based pharmacological treatment for subcortical ischaemic vascular dementia.

METHODS/DESIGN: This is a randomised controlled trial of calcium channel blockade with Amlodipine For the treatment oF subcortical ischaEmic vasCular demenTia (AFFECT) to test the hypothesis that treatment with amlodipine can improve outcomes for these patients in a phase IIb, multi-centre, double-blind, placebo-controlled randomised trial. The primary outcome is the change from baseline to 12 months in the Vascular Dementia Assessment Scale cognitive subscale (VADAS-cog). Secondary outcomes include cognitive function, executive function, clinical global impression of change, change in blood pressure, quantitative evaluation of lesion accrual based on magnetic resonance imaging (MRI), health-related quality of life, activities of daily living, non-cognitive dementia symptoms, care-giver burden and care-giver health-related quality of life, cost-effectiveness and institutionalisation. A total of 588 patients will be randomised in a 1:1 ratio to either amlodipine or placebo, recruited from sites across the UK and enrolled in the trial for 104 weeks.

DISCUSSION: There are no treatments licensed for vascular dementia. The most common subtype is subcortical ischaemic vascular dementia (SIVD). This study is designed to investigate whether amlodipine can produce benefits compared to placebo in established SIVD. It is estimated that the numbers of people with VaD and SIVD will increase globally in the future and the results of this study should inform important treatment decisions.

Experimental evaluation of the response of micro-channel plate detector to ions with 10s of MeV energies

The absolute calibration of a microchannel plate (MCP) assembly using a Thomson spectrometer for laser-driven ion beams is described. In order to obtain the response of the whole detection system to the particles’ impact, a slotted solid state nuclear track detector (CR-39) was installed in front of the MCP to record the ions simultaneously on both detectors. The response of the MCP (counts/particles) was measured for 5–58 MeV carbon ions and for protons in the energy range2–17.3 MeV. The response of the MCP detector is non-trivial when the stopping range of particles becomes larger than the thickness of the detector. Protons with energiesE>~ 10 MeV are energetic enough that they can pass through the MCP detector. Quantitative analysis of the pits formed in CR-39 and the signal generated in the MCP allowed to determine the MCP response to particles in this energy range. Moreover, a theoretical model allows to predict the response of MCP at even higher proton energies. This suggests that in this regime the MCP response is a slowly decreasing function of energy, consistently with the decrease of the deposited energy. These calibration data will enable particle spectra to be obtained in absolute terms over a broad energy range.

Combined Conduction-Convection-Radiation Heat Transfer of Slip Flow inside a Micro-channel Filled with a Cellular Porous Material

Combined conduction–convection–radiation heat transfer is investigated numerically in a micro-channel filled with a saturated cellular porous medium, with the channel walls held at a constant heat flux. Invoking the velocity slip and temperature jump, the thermal behaviour of the porous–fluid system are studied by considering hydrodynamically fully developed flow and applying the Darcy–Brinkman flow model. One energy equation model based on the local thermal equilibrium condition is adopted to evaluate the temperature field within the porous medium. Combined conduction and radiation heat transfer is treated as an effective conduction process with a temperature-dependent effective thermal conductivity. Results are reported in terms of the average Nusselt number and dimensionless temperature distribution, as a function of velocity slip coefficient, temperature jump coefficient, porous medium shape parameter and radiation parameters. Results show that increasing the radiation parameter (Tr)(Tr) and the temperature jump coefficient flattens the dimensionless temperature profile. The Nusselt numbers are more sensitive to the variation in the temperature jump coefficient rather than to the velocity slip coefficient. Such that for high porous medium shape parameter, the Nusselt number is found to be independent of velocity slip. Furthermore, it is found that as the temperature jump coefficient increases, the Nusselt number decrease. In addition, for high temperature jump coefficients, the Nusselt number is found to be insensitive to the radiation parameters and porous medium shape parameter. It is also concluded that compared with the conventional macro-channels, wherein using a porous material enhances the rate of heat transfer (up to about 40 % compared to the clear channel), insertion of a porous material inside a micro-channel in slip regime does not effectively enhance the rate of heat transfer that is about 2 %.