DemTect:a new, sensitive cognitive screening test to support the diagnosis of mild cognitive impairment and early dementia

To design a new, highly sensitive psychometric screening to identify patients with mild cognitive impairment (MCI) and patients with dementia in the early stages of the disease.

A multinational, randomised, 12-week, comparative study of donepezil and rivastigmine in patients with mild to moderate Alzheimer's disease

This 12-week, multinational study compared the tolerability and cognitive effects of donepezil (up to 10 mg once daily) and rivastigmine (up to 6 mg twice daily) in 111 patients with mild to moderate Alzheimer's disease. Both medications were administered open label according to recommended dosing regimens from the respective product labelling available during the conduct of the study. More patients in the donepezil group (89.3%) completed the study compared with the rivastigmine group (69.1%; p=0.009), and 10.7% of the donepezil group and 21.8% of the rivastigmine group discontinued due to adverse events (AEs); 87.5% of donepezil-treated patients and 47.3% of rivastigmine-treated patients remained on the maximum approved dose of each drug at the last study visit. Both groups showed comparable improvements on the ADAS-cog administered by raters blind to study medication at weeks 4 and 12. Thus, using the recommended dosing schedules, donepezil was better tolerated with fewer discontinuations due to AEs, and both agents improved cognition to a similar extent.

Crack detection of steel girders using Brillouin optical time domain analysis

This article presents the results from an experimental program designed to evaluate the performance of a system consisting of a readout unit and a ribbon type Fiber Optic Sensor (FOS) based on Brillouin Optical Time Domain Analysis (BOTDA). The system is intended for the detection of cracks as well as the monitoring of long-term performance for steel bridge girders. The program consisted of introducing a crack at the center of a 3-m-long steel beam and monitoring its progression using static loading tests performed at ambient and sub-zero temperatures. For sensor lengths similar to those used in the field, the resonant frequency shifts per unit increase in crack width were found to decrease from 114 MHz/mm at ambient temperature (~25C) to 65 MHz/mm at -10C. Results also revealed nonlinearity and variability, which can be attributed to an incompatibility between the settings of the laser pump in the readout unit and the sensor length. Significant losses were detected along the bonded segments of the sensor and were attributed to the presence of ripples along the sensor. These undulations worsen with a reduction in temperature and are induced by the bonding procedure as well as the slack provided in the plastic sleeves containing the splices.

Effect of offset web holes on web crippling strength of cold-formed steel channel sections under end-two-flange loading condition

A combination of experiments and non-linear finite element analyses are used to investigate the effect of offset web holes on the web crippling strength of cold-formed steel channel sections under the end-two-flange (ETF) loading condition; the cases of both flanges fastened and unfastened to the support are considered. The web holes are located at the mid-depth of the sections, with a horizontal clear distance of the web holes to the near edge of the bearing plate. Finite element analysis results are compared against the laboratory test results; good agreement was obtained in terms of both strength and failure modes. A parametric study was then undertaken to investigate both the effect of the position of holes in the web and the cross-section sizes on the web crippling strength of the channel sections. It was demonstrated that the main factors influencing the web crippling strength are the ratio of the hole depth to the depth of the web, and the ratio of the distance from the edge of the bearing to the flat depth of the web. Design recommendations in the form of web crippling strength reduction factors are proposed in this study.

Encouraging lifestyle behaviour change in mild cognitive impairment patients:development of appropriate educational material

Objectives: A healthy lifestyle may help maintain cognitive function and reduce the risk of developing dementia. This study employed a focus group approach in order to gain insight into opinions of mild cognitive impairment (MCI) patients, caregivers (CG) and health professionals (HP) regarding lifestyle and its relationship with cognition. The qualitative data were used to design, develop and pilot test educational material (EM) to help encourage lifestyle behaviour change. Method: Data gathering phase: structured interviews were conducted with HP (n = 10), and focus groups with MCI patients (n = 24) and CG (n = 12). EM was developed and pilot tested with a new group of MCI patients (n = 21) and CG (n = 6). Results: HP alluded to the lack of clinical trial evidence for a lifestyle and MCI risk link. Although they felt that lifestyle modifications should be recommended to MCI patients, they appeared hesitant in communicating this information and discussions were often patient-driven. MCI patients lacked awareness of the lifestyle cognition link. Participants preferred EM to be concise, eye-catching and in written format, with personal delivery of information favoured. Most pilot testers approved of the EM but were heterogeneous in terms of lifestyle, willingness to change and support needed to change. Conclusion: MCI patients need to be made more aware of the importance of lifestyle for cognition. EM such as those developed here, which are specifically tailored for this population would be valuable for HP who, currently, appear reticent in initiating lifestyle-related discussions. Following further evaluation, the EM could be used in health promotion activities targeting MCI patients.

ALCOHOL-RELATED KNOWLEDGE AND ATTITUDES IN PEOPLE WITH A MILD LEARNING-DISABILITY - THE EFFECTS OF A SENSIBLE DRINKING GROUP

Alcohol-related knowledge and attitudes in people with a mild learning disability, who were either living, or being prepared to live, in relatively independent conditions in the community, were assessed through a structured interview format. Compared with non-learning-disabled teenagers, adults and a hospitalized patient sample, alcohol-related knowledge in the people with a learning disability was found to be significantly poorer, alcohol was reported as having particularly negative effects and susceptibility to social pressure to drink alcohol was greater. A 'sensible drinking' group, taking a social skills and influences approach to alcohol education, was conducted with a subgroup of the individuals with a learning disability. The group format and methods, including in vivo sessions in a public house, are described. Follow-up evaluations suggested some significant positive changes in knowledge, attitudes and sensible drinking skills. It is concluded that this population, which is increasingly living, or being moved into, independent conditions in the community, is at least as vulnerable to social influences on alcohol use and abuse as are young people. As with young people, the usefulness of making available such alcohol-education programmes as described in this study, is discussed.

Shear Strength Model for FRP-Strengthened RC Beams with Adverse FRP-Steel Interaction

RC beams shear strengthened with externally bonded fiber-reinforced polymer (FRP) U strips or side strips usually fail owing to debonding of the bonded FRP shear reinforcement. Because such debonding usually occurs in a brittle manner at relatively small shear crack widths, some of the internal steel stirrups intersected by the critical shear crack may not have reached yielding at beam shear failure. Consequently, the yield stress of internal steel stirrups in such a strengthened RC beam cannot be fully utilized. This adverse shear interaction between the internal steel shear reinforcement and the external FRP shear reinforcement may significantly reduce the benefit of the shear strengthening FRP but has not been considered explicitly by any of the shear strength models in the existing design guidelines. This paper presents a new shear strength model considering this adverse shear interaction through the introduction of a shear interaction factor. A comprehensive evaluation of the proposed model, as well as three other shear strength models, is conducted using a large test database. It is shown that the proposed shear strength model performs the best among the models compared, and the performance of the other shear strength models can be significantly improved by including the proposed shear interaction factor. Finally, a design recommendation is presented.