Subjective cognitive decline (SCD) might represent the first symptomatic representation of Alzheimer's disease (AD), which is associated with increased mortality. Only few studies, however, have ...analyzed the association of SCD and mortality, and if so, based on prevalent cases. Thus, we investigated incident SCD in memory and mortality.
Data were derived from the German AgeCoDe study, a prospective longitudinal study on the epidemiology of mild cognitive impairment (MCI) and dementia in primary care patients over 75 years covering an observation period of 7.5 years. We used univariate and multivariate Cox regression analyses to examine the relationship of SCD and mortality. Further, we estimated survival times by the Kaplan Meier method and case-fatality rates with regard to SCD.
Among 971 individuals without objective cognitive impairment, 233 (24.0%) incidentally expressed SCD at follow-up I. Incident SCD was not significantly associated with increased mortality in the univariate (HR = 1.0, 95% confidence interval = 0.8-1.3, p = .90) as well as in the multivariate analysis (HR = 0.9, 95% confidence interval = 0.7-1.2, p = .40). The same applied for SCD in relation to concerns. Mean survival time with SCD was 8.0 years (SD = 0.1) after onset.
Incident SCD in memory in individuals with unimpaired cognitive performance does not predict mortality. The main reason might be that SCD does not ultimately lead into future cognitive decline in any case. However, as prevalence studies suggest, subjectively perceived decline in non-memory cognitive domains might be associated with increased mortality. Future studies may address mortality in such other cognitive domains of SCD in incident cases.
Objective: Chronic conditions often require multiple medication intake. However, past research has focused on assessing overall adherence or adherence to a single index medication only. This study ...explored adherence measures for multiple medication intake, and in daily life, among patients with multiple chronic conditions (i.e. multimorbidity).
Design: Eighty-four patients with multimorbidity and multiple-medication regimens completed three monthly panel questionnaires. A randomly assigned subsample additionally completed a 30-day daily diary.
Main outcome measure: The Non-Adherence Report; a brief self-report measure of adherence to each prescribed medication (NAR-M), and in daily life. We further assessed the Medication Adherence Report Scale (MARS), and a subsample of participants were randomised to electronic adherence monitoring.
Results: The NAR-M indicated M = 94.7% adherence at Time 1 (SD = 9.3%). The NAR-M was significantly correlated with the MARS (r
t1
= .52, r
t2
= .57, and r
t3
= .65; p < .001), and in tendency with electronically assessed adherence (r
t2
= .45, r
t3
= .46, p < .10). Variance components analysis indicated that between-person differences accounted for 10.2% of the variance in NAR-M adherence rates, whereas 22.9% were attributable to medication by person interactions.
Conclusion: This study highlights the importance and feasibility of studying adherence to multiple medications differentially, and in daily life. Future studies may use these measures to investigate within-person and between-medication differences in adherence.
There is a strong demand for screening instruments for mild cognitive impairment (MCI), as a pre-stage of dementia. The clock drawing test (CDT) is widely used to screen for dementia, but the utility ...in screening for MCI remains uncertain. In particular, it is still questionable which scoring system is the best in order to screen for MCI. We therefore aimed to compare the utility of different CDT scoring systems for screening for MCI.
In a sample of 428 subjects of the Leipzig Longitudinal Study of the Aged (LEILA 75+) study, CDT scores of different scoring systems were compared between subjects with and without MCI. Comparison of receiver operating characteristic (ROC; area under the curve, sensitivity, specificity) was performed and inter-rater reliability was calculated.
The CDT scores differed significantly between MCI and non-MCI subjects according to all scoring systems applied. However, ROC of the CDT scores was not adequate.
None of the present CDT scoring systems has sufficient utility to screen reliably for MCI. The clinical value of the CDT could be improved by using semi-quantitative scoring, having a wider score range and focusing on specific details of the clock (e.g. the hands and numbers).
It is a fascinating phenomenon in nuclear physics that states with a pronounced few-body structure can emerge from the complex dynamics of many nucleons. Such halo or cluster states often appear near ...the boundaries of nuclear stability. As such, they are an important part of the experimental program beginning at the Facility for Rare Isotope Beams (FRIB). A concerted effort of theory and experiment is necessary both to analyze experiments involving effective few-body states, as well as to constrain and refine theories of the nuclear force in light of new data from these experiments. As a contribution to exactly this effort, this paper compiles a collection of “perspectives” that emerged out of the Topical Program “Few-body cluster structures in exotic nuclei and their role in FRIB experiments” that was held at FRIB in August 2022 and brought together theorists and experimentalists working on this topic.
We investigated the relations of self-rated omission errors (i.e., forgetting to take one's medication) and commission errors (i.e., unnecessary repetitions of medication intake because of forgetting ...that it has already been taken) in medication adherence in multimorbidity to prospective and retrospective memory performance. Moreover, we examined whether these relations were moderated by the number of medications that had to be taken. Eighty-four patients with multimorbidity (aged 28-84 years, M = 62.4) reported medication adherence regarding the last seven days and the number of medications they had to take. In addition, we administered psychometric tests on prospective memory (PM) and retrospective memory performance. We found that reported omission errors in medication adherence were related significantly to lower PM performance. This relationship was increased in individuals with a lower number of medications. In comparison, reported commission errors in medication adherence were related significantly to lower retrospective memory performance. This relationship was increased in individuals with a larger number of medications. Present data suggest that omission errors in medication adherence in multimorbidity may reflect primarily PM errors, particularly if few medications have to be taken, while commission errors may reflect mainly retrospective memory failures, especially with a large number of medications that need to be taken as prescribed. From an applied neuropsychological perspective, these results underline the importance of trying to enhance PM and retrospective memory performance in patients with multimorbidity.
BIM‐Anwendungen im Tunnelbau König, Markus; Rahm, Tobias; Nagel, Felix ...
Die Bautechnik,
April 2017, Letnik:
94, Številka:
4
Journal Article
Die Anwendung von Building Information Modeling (BIM) im Infrastrukturbau soll bis zum Jahr 2020 in Deutschland eingeführt und anschließend etabliert werden. Dies schließt auch die Planung, die ...Herstellung und den Betrieb von Tunnelbauwerken ein. Im Rahmen von Forschungs‐ und Praxisprojekten wurden in den letzten Jahren bereits Erfahrungen zur Verwendung der BIM‐Methodik gesammelt. Es hat sich gezeigt, dass die ganzheitliche Einführung von BIM eine genaue Analyse der einzelnen Prozesse und eine projektspezifische Definition von sinnvollen Anwendungsfällen erfordert. Im Rahmen des Beitrags werden aktuelle Erfahrungen und einzelne BIM‐Anwendungsfälle im Tunnelbau erläutert. Es wird exemplarisch gezeigt, wie die geometrische und semantische Informationstiefe anwendungsfallorientiert festgelegt werden kann. Anschließend wird auf die Umsetzung einer gemeinsamen Datenumgebung sowie die Verknüpfung und den Austausch von Fachmodellen eingegangen. Hierbei haben sich insbesondere Ansätze auf Basis von Linked Data bzw. Multimodell‐Containern als besonders geeignet herausgestellt. Anhand von praxisnahen Beispielen werden verschiedene Anwendungsfälle und damit verbundene Ziele für den Einsatz von BIM präsentiert.
Building Information Modeling in tunneling – digital design and construction of tunneling projects
The application of Building Information Modeling (BIM) in the field of infrastructure engineering is to be introduced and subsequently established in Germany by 2020. This includes the planning, production and operation of tunnel structures. In research and real projects, experiences concerning the application of the BIM methodology were collected over the last couple of years. As it turned out, the holistic introduction of BIM requires a detailed analysis of processes and project specific definition of reasonable use cases.
Within the scope of this paper, current experiences and BIM use cases in the field of tunneling are discussed. The definition of a reasonable geometric and semantical level of detail for the specific use cases is exemplified. Following that, the implementation of a shared data interface, as well as the correlation and exchange of subject‐specific models are described. Hereby, approaches based on linked data or multi model containers have proven to be especially suitable. Based on practical examples, several use cases and the associated project goals for the application of BIM are discussed.
Although crystals of strongly correlated metals exhibit a diverse set of electronic ground states, few approaches exist for spatially modulating their properties. In this study, we demonstrate ...disorder-free control, on the micrometer scale, over the superconducting state in samples of the heavy-fermion superconductor CeIrIn
We pattern crystals by focused ion beam milling to tailor the boundary conditions for the elastic deformation upon thermal contraction during cooling. The resulting nonuniform strain fields induce complex patterns of superconductivity, owing to the strong dependence of the transition temperature on the strength and direction of strain. These results showcase a generic approach to manipulating electronic order on micrometer length scales in strongly correlated matter without compromising the cleanliness, stoichiometry, or mean free path.
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