The use of recycled demolition aggregate in precast concrete products – Phase III: Concrete pavement flags

A study undertaken at the University of Liverpool has investigated the potential for using construction and demolition waste (C&DW) derived aggregate in the manufacture of a range of precast concrete products, i.e. building and paving blocks and pavement flags. Phase III, which is reported here, investigated
concrete pavement flags. This was subsequent to studies on building and paving blocks. Recycled demolition aggregate can be used to replace newly quarried limestone aggregate, usually used in coarse (6 mm) and fine (4 mm-to-dust) gradings. The first objective was, as was the case with concrete building
and paving blocks, to replicate the process used by industry in fabricating concrete pavement flags in the laboratory. The ‘‘wet’’ casting technique used by industry for making concrete flags requires a very workable mix so that the concrete flows into the mould before it is compressed. Compression squeezes out water from the top as well as the bottom of the mould. This industrial casting procedure was successfully replicated in the laboratory by using an appropriately modified cube crushing machine and a special mould typical of what is used by industry. The mould could be filled outside of the cube crushing machine and then rolled onto a steel frame and into the machine for it to be compressed. The texture and mechanical properties of the laboratory concrete flags were found to be similar to the factory ones. The experimental work involved two main series of tests, i.e. concrete flags made with concrete- and
masonry-derived aggregate. Investigation of flexural strength was required for concrete paving flags. This is different from building blocks and paving blocks which required compressive and tensile splitting strength respectively. Upper levels of replacement with recycled demolition aggregate were determined
that produced similar flexural strength to paving flags made with newly quarried aggregates, without requiring an increase in the cement content. With up to 60% of the coarse or 40% of the fine fractions replaced with concrete-derived aggregates, the target mean flexural strength of 5.0 N/mm2 was still
achieved at the age of 28 days. There was similar detrimental effect by incorporating the fine masonry-derived aggregate. A replacement level of 70% for coarse was found to be satisfactory and also conservative. However, the fine fraction replacement could only be up to 30% and even reduced to 15% when used for mixes where 60% of the coarse fraction was also masonry-derived aggregate.

Cognitive, global, and functional benefits of donepezil in Alzheimer's disease and vascular dementia:results from large-scale clinical trials

Alzheimer's disease (AD) and vascular dementia (VaD) are both associated with deficits in cholinergic neurotransmission that are amenable to therapeutic intervention. The cholinesterase inhibitor, donepezil, is clinically effective in both AD and VaD. Results from a 10-study metaanalysis of donepezil (5 or 10 mg/day) in AD and a two-study combined analysis of donepezil (5 or 10 mg/day) in VaD are presented to compare patient characteristics and donepezil treatment outcomes. The analyzed studies were randomized, placebo-controlled, and of up to 24 weeks duration. In both AD and VaD, donepezil provided significant benefits compared with placebo on measures of cognition and global function. Placebo-treated AD patients showed a decline in cognition and global function, whereas placebo-treated VaD patients remained stable, suggesting treatment effects of donepezil in VaD were driven by improvement rather than stabilization or reduced decline. More VaD patients than AD patients received concomitant medications. Cardiovascular adverse events were more common in VaD than AD patients but were not increased by donepezil. In conclusion, although there are differences between AD and VaD patients in comorbid conditions and concomitant medications, donepezil is effective and well tolerated in both types of dementia.

The geriatric minimum data set for clinical trials (GMDS)

To overcome the weak evidence base coming from often poor and insufficient clinical research in older people, a minimum data set to achieve harmonisation is highly advisable. This will lead to uniform nomenclature and to the standardisation of the assessment tools. Our primary objective was to develop a Geriatric Minimum Data Set (GMDS) for clinical research.