Performance-based Testing Research Articles

Assessment of the quality of full depth reclamation (FDR) using a dynamic cone penetrometer (DCP): a case study

The full-depth reclamation with no stabilization (FDR-NS) is widely used as a pavement rehabilitation technique. It is important to evaluate the on-site characteristics of FDR-NS materials to avoid short-term underperformance. The need for performance-based testing could then be supported by in-situ and non-destructive testing, such as dynamic cone penetrometer (DCP). DCP allows to estimate the bearing capacity of the pavement structure and to verify its homogeneity according to the depth. The objective of this research is to evaluate the applicability of using DCP to assess the quality of FDR-NS. Overall, DCP results showed a good reliability, allows to measure the effective depth of reclamation and to observe a significant reduction (average of 75 %), in terms of DCP values, between before and after the reclamation process. Thus, the potential of using DCP for FDR-NS rehabilitation was confirmed. The results from this research provide a rational basis for establishing specifications.

Online unsupervised performance-based cognitive testing: A feasible and reliable approach to scalable cognitive phenotyping of Parkinson's patients

IntroductionA better understanding of the heterogeneity in the cognitive and mood symptoms of Parkinson's disease will require research conducted in large samples of patients. Fully online and remote research assessments present interesting opportunities for scaling up research but the feasibility and reliability of remote and fully unsupervised performance-based cognitive testing in individuals with Parkinson's disease is unknown. This study aims to establish the feasibility and reliability of this testing modality in Parkinson's patients. MethodsSixty-seven Parkinson's patients and 36 older adults completed two sessions of an at-home, online battery of five cognitive tasks and three self-report questionnaires. Feasibility was established by examining completion rates and data quality. Test-retest reliability was evaluated using the Intraclass Correlation Coefficient (ICC (2,1)). ResultsOverall completion rates and data quality were high with few participant exclusions across tasks. With regards to test-retest reliability, intraclass correlation coefficients were quite variable across measures extracted from a task as well as across tasks, but at least one standard measure from each task achieved moderate to good reliability levels. Self-report questionnaires achieved a higher test-retest reliability than cognitive tasks. Feasibility and reliability were similar between Parkinson's patients and older adults. ConclusionThese results demonstrate that remote and unsupervised testing is a feasible and reliable method of measuring cognition and mood in Parkinson's patients that achieves levels of test-retest reliability that are comparable to those reported for standard in-person testing.

A Performance-Based Test for Mitigating the Risk of Geopolymer Concrete Surface Efflorescence Due to Alkali Leaching.

Geopolymer concretes are considered to be a potential sustainable, low-embodied carbon alternative for Ordinary Portland Cement (OPC) concrete. Alkali leaching is considered to be a major esthetic concern for Na-silicate-based geopolymers as it can lead to the formation of efflorescence products on the surfaces of concrete members exposed to humidity. In this context, this research aims to investigate the effect of the alkali content and the FA/GGBS mass ratio on the alkali leaching and formation of the efflorescence products. Paste cylinders were fabricated and cured in ambient conditions. Samples were submerged in deionized water and the concentration of the leached-out ions was measured. Efflorescence potential was also investigated by partial immersion of the samples in deionized water. The results highlight the complexity of the interacting parameters governing the formation of efflorescence products in geopolymer materials. Establishing relationships between the concrete mix variables and the risk of efflorescence seems unfeasible particularly because of the wide range of possible precursors and activators available to design geopolymer concrete mixes. To overcome this barrier, a practical performance-based testing method is developed. For the first time, by testing a wide range of geopolymer materials, performance-based requirements associated with the risk of efflorescence for geopolymer concrete surfaces exposed to humidity are calibrated. Four categories of risk are proposed and typical suitable exposure conditions for geopolymer concrete surfaces are suggested for each risk category.

Significant functional impairment and disability in individuals with psoriatic arthritis and Achilles tendon pain: a cross-sectional observational study

The Achilles tendon (AT) insertion is the most common site of enthesitis in psoriatic arthritis (PsA). The structure and function of the AT in PsA, and the prevalence of mid-portion pathology, is unknown. To compare the structure and function of the AT in people with PsA with self-reported AT pain (PsA + AT), PsA without self-reported AT pain (PsA-AT) and healthy controls. A cross-sectional, observational study was conducted. The ATs were assessed by clinical and US examination (B-mode and Power Doppler), performance-based testing (bilateral heel raise test (HRT) and 10 m walk test), and patient-reported outcome measures (PROMs) (including the Victorian Institute of Sport Assessment-Achilles [VISA-A]). Between-group differences were described using descriptive statistics, Chi-squared testing, parametric (1-way ANOVA) and non-parametric (Mann-Whitney or Kruskal-Wallis) testing. 22 PsA (11 per group) and 11 healthy control participants who were comparable in terms of sex, age, and BMI (PsA-AT = longer PsA disease duration) were recruited. VISA-A scores were significantly worse in the PsA + AT group compared to the PsA-AT group and healthy controls (p < 0.001). Inflammatory US features were significantly more prevalent in the PsA + AT group (p < 0.001). Mid-portion AT pathology was observed in the PsA + AT group, irrespective of entheseal disease. Clinical examination alone missed 5/7 cases of ‘active’ US-confirmed AT enthesitis. AT functional deficits were significant in the PsA + AT group and both PsA groups had lower HRT repetition rates and walked slower compared to healthy controls. Less than 1/3 of the PsA + AT group had received podiatry or physiotherapy care. Significant differences in the structure and function of the AT in PsA were noted. Despite management in line with current guidance, AT pain appears to persist and can result in severe functional impairment.

Performance Characterisation of High RA Asphalt Mixes – A Laboratory and Field Study

The research project highlights the significance of incorporating reclaimed asphalt (RA) into hot mix asphalt (HMA) production for sustainable road construction. Despite limited RA utilization in Hungary in the past decades, the project demonstrates the feasibility of manufacturing HMA with significant RA content using advanced technology. The establishment of a capable asphalt plant and the development of laboratory assessments and mix design methodologies laid a solid foundation for future high RA integration in Hungarian road projects. Large-scale production trials confirmed the practicality of integrating high RA content into heavy-duty asphalt mixes with various binder types, including normal bitumen (B), polymer modified binder (PmB), and rubber modified bitumen (GmB). The large-scale validation project described in this paper was based on crucial binder blend designs carried out prior to the trials. Production control and performance-based laboratory testing proved that asphalt mixes can be designed and manufactured with high RA content while maintaining performance standards. Balancing resistance to distress modes like rutting and low-temperature cracking through careful binder blend design and mix design is achievable, even with high RA proportions. Visual assessments and production control indicated the uniformity of high RA content asphalt mixes. The details provided in this paper emphasise the potential for economic and environmental benefits through increased RA utilization in Hungarian road construction.

Effects of the simultaneous use of post-industrial polypropylene waste plastic and soybean oil recycling additive on the performance of high-RAP recycled mixtures

Using reclaimed asphalt pavement (RAP) in asphalt concrete (AC) reduces the need for nonrenewable resources. However, excessive RAP can cause premature cracking in pavements due to its stiff and aged nature. To address this issue, studies propose the incorporation of recycling agents (RA) in RAP recycled mixtures. Nevertheless, incorporating RA may reduce mixture's rutting and moisture resistance. Alternatively, incorporating waste plastic in AC can positively balance the RA negative effects. Therefore, this study explores the simultaneous use of polypropylene (PP) waste plastics and soybean oil RA to improve the overall performance of high-RAP mixtures. Due to its high melting point, PP can have different roles in the asphalt mixture depending on the mixing temperature used. To explore that, three different methods of incorporating PP into a high-RAP mixture were attempted. Five different mixtures were developed varying the binder (virgin and modified with RA), and the PP mixing procedure. Then, the mixtures were subjected to performance-based testing procedures (SCB IFIT and HWTT) as well as to boiling test to verify binder-aggregate adhesion. It was confirmed that the use of soybean oil enhances the cracking performance of the high-RAP mixtures, but the rutting and moisture performances were compromised. However, incorporating PP made the mixture more resistant to moisture and rutting in different instances. It was found that pre-heating the aggregates at higher than PP melting point allows a better coating of aggregates by PP, and results in improved binder-aggregate adhesion, leading to better cracking, rutting, and moisture performance of high-RAP mixtures.

Large-Scale Performance Evaluation of Various Woven Silt Fence Installations under Nebraska Highway Conditions

Sediment barriers are used on construction sites to protect downstream waterbodies from the impacts of sediment-laden stormwater runoff. Although ubiquitous on construction sites, many sediment barrier practices lack performance-based testing to determine effectiveness and treatment mechanisms, with previous evaluations being limited to conditions local to the Southeastern U.S., with conditions in other regions remaining untested. Testing was conducted to determine the effectiveness of woven silt fence barriers and provide structural improvements to common installation methods. Testing was conducted using a large-scale sediment barrier testing apparatus at the Auburn University—Stormwater Research Facility. The results from testing indicate that Nebraska DOT standard silt fence installations can be improved to reduce the risk of structural failures such as undermining, complete installation failure, slow dewatering, and overtopping. To improve structural performance, four modifications (a 15.2 cm [6 in.] offset trench, wooden posts, a dewatering board with an overflow weir, and a dewatering board with an overflow weir with adjusted post spacing) were tested. On average, 83% of introduced sediment was retained behind the tested barriers. The water quality results across the testing of standard and modified installations indicated that stormwater treatment was due to sedimentation within the impoundment formed by silt fence installations and not filtration through geotextile fabric.

Cognitive and affective perspective taking amongst adolescent offenders with variants of callous–unemotional traits

Evidence suggests that associations between antisocial behaviour, callous–unemotional (CU) traits and cognitive empathy (e.g. perspective taking) vary depending on more fine-grained dimensions of these constructs. This study examined associations between adolescent antisocial behaviour and individual differences in cognitive and affective perspective taking ability. Based on current theory regarding distinct variants of CU traits, we further tested whether the correlates of CU traits differed amongst youth with high versus low levels of anxiety. Participants were 130 male adolescents (81 youth offenders; 49 non-offenders) aged 13–20 years, of predominantly Caucasian and Aboriginal Australian ethnicity. Perspective taking skills were indexed using performance-based testing, and self-report data was collected on CU traits and anxiety in a cross-sectional design. Offender status was associated with poorer cognitive and affective perspective taking. In addition, associations between CU traits and perspective taking skills were moderated by anxiety. Specifically, CU traits were associated with poorer skills for second-order cognitive perspective taking amongst high-anxiety youth, whereas CU traits were associated with better cognitive and affective perspective taking skills amongst low-anxiety youth. More fine-grained assessment of such factors stands to enhance understanding of, and effective intervention for, antisocial youth.

50 Examining the Utility of a Performance-Based Test of Everyday Function for Assessing Cognition in Older Adults Who Speak English as a Second Language

Objective:Accurate early detection of subtle cognitive difficulties is critical for optimizing treatment of neurodegenerative disease. Those who speak English as a second language (ESL) in the US may be at a disadvantage on Englishwritten neuropsychological tests, increasing the potential for error, particularly when cognitive difficulties are mild and/or when informants are not available/unreliable. This study examined the utility of a standardized, performance-based test of everyday function for the assessment of cognition in ESL older adults.Participants and Methods:Five ESL participants (Mage=83 years; range 65-84 years old) were recruited along with 43 cognitively healthy, native English speakers (controls) as part of a larger study of functional assessment in community-dwelling older adults. Participants were required to identify a study partner to answer questions about their cognitive abilities and everyday functioning. ESL participants reported diverse native languages: Cantonese, Mandarin, Gujarati/Hindi, Farsi, and Azeri. One of the 5 ESL participants reported a diagnosis of MCI. Participants completed the Mini-Mental Status Exam, Trail Making Tests, Digit Span, Boston Naming Test, Hopkins Verbal Learning Test, and Brief Visual Memory Test, resulting in 15 test scores. Participants also completed the Naturalistic Action Test (NAT), a performance-based tests that requires preparation of a breakfast and lunch using standardized objects presented on a table. Recordings of NAT performance were scored by two coders for time to completion, accomplishment of task steps, and errors (overt, micro-error, motor), resulting in 10 scores for the Breakfast and the Lunch tasks. Any discrepancies amongst the two coders were resolved by our lab. Informant-report questionnaires included the Functional Assessment Questionnaire (FAQ), Everyday Cognition Questionnaire (ECog) and IADL-C. Total scores from the cognitive tests, NAT, and informant reports for each ESL participant were compared against the scores of Controls by computing T-scores using the Control M and SD. Low/impaired test scores were defined as &lt;1.5 SD.Results:Informants reported intact everyday function (FAQ, IADL-C) for all ESL participants. Informant-reported ECog scores varied as expected; with mild decline reported for the participant with MCI. On traditional cognitive tests, ESL participants showed variable performance, such that low scores were obtained on up to 9 of the 15 scores. The ESL participant with MCI obtained low scores on 11/15 scores. On the NAT, all of the ESL participants without MCI showed scores on the Breakfast (accomplishment, errors) that were comparable to Controls. Completion time for both Breakfast and Lunch and Lunch scores (accomplishment, errors) were variable, with low across observed in ESL participants with healthy cognition.Conclusions:Older participants with ESL and healthy cognition showed highly variable scores on traditional, neuropsychological tests. However, on one item from a performance-based assessment of everyday function (NAT Breakfast), ESL participants with healthy cognition consistently performed well compared to healthy Controls. Performance was less consistent for completion time across both NAT tasks and on all measures from the Lunch task, for which the steps and objects may have been less familiar to ESL participants. Thus, performance-based testing holds promise for informing neuropsychological assessment of ESL older adults, but care should be taken in selecting test items that are highly familiar and outcome measures that are most meaningful across a range of cultures.

P072 Significant functional impairment and disability in individuals with psoriatic arthritis and Achilles tendon pain

Abstract Background/Aims Enthesitis is a hallmark clinical feature of psoriatic arthritis (PsA) with the most commonly affected site being the Achilles tendon (AT) insertion into the posterior calcaneum. There is overlap in the clinical and ultrasound (US) pathological presentation of Achilles enthesitis and Achilles tendinopathy, however their treatment guidelines differ significantly. AT pain in PsA is complex, with the potential interplay of mechanobiology and inflammation. The aim of this study was to assess the structure and function of the AT in individuals with PsA to inform the future development of a non-pharmacological intervention. Methods A single-centre, cross-sectional observational study was conducted. People with PsA with (PsA+AT) and without (PsA-AT) AT pain were age and sex-matched with healthy controls (n = 11 per group). AT structure and function were assessed by clinical examination (Leeds Enthesitis Index and AT tendinopathy tests), B-mode and Power Doppler (PD) US, the Victorian Institute of Sports Assessment - Achilles (VISA-A) questionnaire, the bilateral heel raise test and 10-metre walk test (10MWT). Patient-reported outcome measures were used to evaluate local and global disease activity, impact, and quality of life. Group membership associations and between-group differences for domains of interest were evaluated using Pearson’s Chi-squared, one-way ANOVA, Mann-Whitney or Kruskal-Wallis tests. Results All groups were comparable in terms of sex, age and BMI. PsA disease duration was longer in the PsA-AT group (mean [SD], 20.1 years [13.1]) compared to the PsA+AT group (7.4 [6.3]). Structural changes at the enthesis on US were detected in all groups; however inflammatory features were significantly more prevalent in the PsA+AT group (p&amp;lt;0.001). PD signal was only detected in the PsA+AT group. Mid-portion and myotendinous AT pathology, including diffuse thickening, altered echogenicity and partial tears were also present, irrespective of the presence of enthesitis. PsAID-12 and HAQ-DI scores were significantly worse in the PsA+AT compared to the PsA-AT group (p=0.018 and p=0.001, respectively). The PsA+AT group walked slower (mean=17.89 seconds for 10MWT) compared to the PsA-AT group (12.23) and controls (11.55), could perform significantly less heel raises until the point of fatigue (PsA+AT mean=19.45, PsA-AT=39.18, controls=51.55, p=0.007) and had significantly worse VISA-A scores (PsA+AT mean=33, PsA-AT=71, controls=92, p&amp;lt;0.001), indicative of impaired AT function. In the PsA+AT group, AT pain was persistent and disabling despite pharmacological management in line with current guidelines and &amp;lt;30% had received treatment from podiatry or physiotherapy services. Conclusion People with PsA and AT pain exhibit severe functional limitations as demonstrated by the bilateral heel raise test, 10MWT and VISA-A scores. The diversity of US imaging features detected, and the inconsistencies in treatment provided, highlights an opportunity to develop individualised non-pharmacological management strategies stratified by US features and performance-based testing. Disclosure A. Patience: None. M.P. Steultjens: None. S. Siebert: None. G.J. Hendry: None.

Predictive Validity of Performance-Based Metacognitive Testing is Superior to Self-report: Evidence from Undergraduate Freshman Students

Predictive Validity of Performance-Based Metacognitive Testing is Superior to Self-report: Evidence from Undergraduate Freshman Students

Activated sugarcane bagasse ash as efficient admixture in cement-based mortars: Mechanical and durability improvements

Biomass ashes can be used in cementitious materials as cement or sand substitution. Nevertheless, ashes resulted from the combustion of biomass in generation plants present drawbacks that can reduce their potential use if they are not previously treated. In this research, industrial sugarcane bagasse ash (SCBA) was mechanically activated by grinding and its effects evaluated when used as mineral admixture in cementitious materials. Four different substitution rates (0%, 10%, 20% and 30%) where used to investigate the influence of the amount of ashes replaced on the durability and mechanical performance of mortars and identify the optimal substitution rate. To get a thorough comprehension, results were also compared to mortars containing untreated ashes. The combination of a performance-based testing campaign (compressive and flexural strength, open porosity, apparent density, water capillary absorption, surface electrical resistivity, rapid chloride migration coefficient) and a set of analytical techniques (XRD, FT-IR, SEM and TGA-DTA) enabled to characterise the mechanical and durability properties of mortars and identify the mechanisms behind the results. The research concluded that, at 28 days, the incorporation of ground SCBA enhances the compressive strength of mortars up to 62%, decreases the porosity of samples by 35%, highly improves the resistance to the diffusion of chlorides by 10 times and improve the interfacial transition zone by narrowing and closing the gap between aggregates and pastes.

Functional Cognition in Individuals Experiencing Homelessness: A Relationship With Well-Being

Abstract Date Presented 03/31/2022 Individuals experiencing homelessness (IEH) (N = 19) were assessed to examine the prevalence of cognitive impairment and its impact on participation and well-being through performance-based testing. Participants demonstrated decreased cognition on standardized assessments and self-reported poor well-being. Results demonstrate that cognitive supports are needed for some IEH to complete essential daily activities, participate in their communities, navigate services, and manage health. Primary Author and Speaker: Emily Jean Prins Additional Authors and Speakers: Samantha Strich, Madeline Contreras Contributing Authors: Quinn P. Tyminski, Carolyn Baum

A prospective cohort study of head circumference and its association with neurodevelopmental outcomes in infants and young children in rural Guatemala.

Microcephaly, an anthropometric marker of reduced brain volume and predictor of developmental disability, is rare in high-income countries. Recent reports show the prevalence of microcephaly to be much higher in lower resource settings. We calculated the prevalence of microcephaly in infants and young children (n = 642; age range = 0.1-35.9 months), examined trends in occipitofrontal circumference (OFC) growth in the year after birth and evaluated the relationship between OFC and performance on the Mullen Scales of Early Learning (MSEL) in rural Guatemala. Multivariable regression analyses adjusted for age were performed: (1) a model comparing concurrent MSEL performance and OFC at all visits per child, (2) concurrent OFC and MSEL performance by age group, and (3) OFC at enrollment and MSEL at final visit by age group. Prevalence of microcephaly ranged from 10.1% to 25.0%. OFC z-score decreased for most infants throughout the first year after birth. A significant positive association between continuous OFC measurement and MSEL score suggested that children with smaller OFC may do worse on ND tests conducted both concurrently and ∼1 year later. Results were variable when analyzed by OFC cutoff scores and stratified by 6-month age groups. OFC should be considered for inclusion in developmental screening assessments at the individual and population level, especially when performance-based testing is not feasible.

Standardized assessment of cognitive function, mood, and pain among patients who are unable to communicate.

Assessments of patients have sought to increase the patient voice through direct patient interviews and performance-based testing. However, some patients in post-acute care (PAC) are unable to communicate and cannot participate in interviews or structured cognitive tests. Therefore, we tested the feasibility and reliability of observational assessments of cognitive function, mood, and pain for patients who are unable to communicate in PAC settings. We conducted a national test of observational assessments of cognitive function, mood, and pain in 143 PAC facilities (57 home health agencies, 28 Inpatient Rehabilitation Facilities, 28 Long-Term Care Hospitals, and 73 Skilled Nursing Facilities) across 14 U.S. markets from November 2017 to August 2018. For the 548 patients identified as unable to make themselves understood, we assessed descriptive statistics, percent of missing data, time to complete, and inter-rater reliability (IRR) between paired research nurse and facility staff assessors. Most sampled non-communicative patients were administered all three observational assessments. Among assessed patients, overall missing data was high for some items within the Staff Assessment for Mental Status (2.9% to 33.5%) and Staff Assessment of Patient Mood (12.4% to 44.3%), but not the Observational Assessment of Pain or Distress (0.0% to 4.4%). Average time to complete the data elements ranged from 2.4 to 3.5min and IRR was good to excellent for all items (kappa range: 0.74-0.98). The three observational data elements had acceptable reliability. Although results revealed varying feasibility, there was support for feasibility overall in terms of implementing a standardized observational assessment of pain for patients in PAC settings. Additional work is needed for the Staff Assessment for Mental Status and the Staff Assessment of Patient Mood to improve the observable nature of these data elements and enhance instructions and training for standardizing the assessments.

Predicting Clinical Outcomes 7-10 Years after Severe Traumatic Brain Injury: Exploring the Prognostic Utility of the IMPACT Lab Model and Cerebrospinal Fluid UCH-L1 and MAP-2.

Severe traumatic brain injury (TBI) is a major contributor to disability and mortality in the industrialized world. Outcomes of severe TBI are profoundly heterogeneous, complicating outcome prognostication. Several prognostic models have been validated for acute prediction of 6-month global outcomes following TBI (e.g., morbidity/mortality). In this preliminary observational prognostic study, we assess the utility of the International Mission on Prognosis and Analysis of Clinical Trials in TBI (IMPACT) Lab model in predicting longer term global and cognitive outcomes (7-10years post injury) and the extent to which cerebrospinal fluid (CSF) biomarkers enhance outcome prediction. Very long-term global outcome was assessed in a total of 59 participants (41 of whom did not survive their injuries) using the Glasgow Outcome Scale-Extended and Disability Rating Scale. More detailed outcome information regarding cognitive functioning in daily life was collected from 18 participants surviving to 7-10years post injury using the Cognitive Subscale of the Functional Independence Measure. A subset (n = 10) of these participants also completed performance-based cognitive testing (Digit Span Test) by telephone. The IMPACT lab model was applied to determine its prognostic value in relation to very long-term outcomes as well as the additive effects of acute CSF ubiquitin C-terminal hydrolase-L1 (UCH-L1) and microtubule associated protein 2 (MAP-2) concentrations. The IMPACT lab model discriminated favorable versus unfavorable 7- to 10-year outcome with an area under the receiver operating characteristic curve of 0.80. Higher IMPACT lab model risk scores predicted greater extent of very long-term morbidity (β = 0.488 p = 0.000) as well as reduced cognitive independence (β = - 0.515, p = 0.034). Acute elevations in UCH-L1 levels were also predictive of lesser independence in cognitive activities in daily life at very long-term follow-up (β = 0.286, p = 0.048). Addition of two CSF biomarkers significantly improved prediction of very long-term neuropsychological performance among survivors, with the overall model (including IMPACT lab score, UCH-L1, and MAP-2) explaining 89.6% of variance in cognitive performance 7-10years post injury (p = 0.008). Higher acute UCH-L1 concentrations were predictive of poorer cognitive performance (β = - 0.496, p = 0.029), whereas higher acute MAP-2 concentrations demonstrated a strong cognitive protective effect (β = 0.679, p = 0.010). Although preliminary, results suggest that existing prognostic models, including models with incorporation of CSF markers, may be applied to predict outcome of severe TBI years after injury. Continued research is needed examining early predictors of longer-term outcomes following TBI to identify potential targets for clinical trials that could impact long-ranging functional and cognitive outcomes.

Assessment of frailty in cirrhosis using bedside measures and its correlation with Child-Turcotte-Pugh, MELD & MELD-Na Scores.

Objectives:To assess frailty in cirrhotic by calculating Liver Frailty Index (LFI) using bedside clinical tests and correlate it with Child-Turcotte-Pugh (CTP), MELD, MELD Na, Fib- 4 and Transient Elastography (TE) scoresMethods:This cross-sectional observational comparative study was carried out in Dr Ruth KM Pfau Civil Hospital, Karachi from August 2020 to September 2021. Patients were subjected to three performance-based testing including dominant hand grip strength (HGS), Chair to Stand (CTS) Time & Three Position Balance (TPB). LFI was calculated using the online LFI calculator, available at http://liverfrailtyindex.ucsf.edu and classified as ‘Robust’ if LFI <3.2, ‘Prefrail’ LFI between 3.2 and 4.4, and ‘Frail’ as LFI ≥4.5. Correlation of frailty with MELD, MELD-Na and CTP Scores was done. Means of MELD & MELD-Na Scores and CTP scores were calculated in all 3 classes of frailty using one way ANOVA. A p-value of ≤.05 was taken as significant.Results:Out of 118 patients, 62 (52.5%) were males. Mean MELD score was 11.4 ±3.3, MELD-Na was 15.97 ±8.54, CTP 8.25 ±2.21, Fib-4 was 2.79 ±1.034 and TE score was 18.20 ±9.17. Mean LFI was 3.87 ±1.07; mean HGS was 18.12 ±4.68; mean of CTS was 9.62 ±3.55. LFI Class distribution in our cohort showed Robust were 36 (30.5%), Prefrail 34 (28.8%) and Frail were 48 (40.8%). Correlation of all these variables with LFI showed significant correlation with LFI, but highest correlation coefficient was seen with MELD-Na.Conclusion:Significant correlation between frailty score in cirrhotic with cirrhosis severity scores highlights the need for frequently assessing LFI in all cirrhotic at regular follow up visits.

Metamemory and financial decision making in older adults without dementia.

Metamemory refers to self-awareness of one's memory function, and the extent to which metamemory deficit impacts financial decision making is unknown. This study tested the hypothesis that metamemory deficit is associated with poor financial decision making among older adults without dementia. Data came from 502 community-dwelling older adults participating in the Rush Memory and Aging Project. Metamemory deficit was determined empirically by contrasting subjective memory ratings with performance on objective memory tests. Larger discrepancy of self-rated memory scores from performance-based testing scores indicates greater deficit. Financial decision making was assessed using a performance-based measure. Multivariable regression analyses examined the association of metamemory deficit with financial decision making. Participants had a mean age of 83 years and a mean education of 15 years. Approximately 75% were female. On average, participants answered two thirds of the financial decision making questions correctly. Female sex, older age, lower education, and lower financial literacy were correlated with poorer financial decision making. In an ordinal logistic regression model controlled for demographics and financial literacy, an 1SD increase in metamemory deficit reduced the odds of having better financial decision making by approximately 15%, OR: 0.844, 95% CI [0.719-0.991]. This association persisted after further controlling for family income, early life socioeconomic status, depressive symptoms and executive function. Metamemory deficit in older adults is a potential indicator of impaired financial decision making. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Preface: RILEM technical committee 258-AAA–Development of a performance-based testing concept

Preface: RILEM technical committee 258-AAA–Development of a performance-based testing concept

An Investigation into the Effects of a Curcumin Extract (Curcugen®) on Osteoarthritis Pain of the Knee: A Randomised, Double-Blind, Placebo-Controlled Study.

Curcumin, a phytochemical from the spice turmeric, has anti-inflammatory properties and has been shown to have pain-relieving effects. In this 8-week, randomised, double-blind, placebo-controlled study, 101 adults with knee osteoarthritis received either 500 mg twice daily of a standardised curcumin extract (Curcugen®) or placebo. Outcome measures included the Knee Injury and Osteoarthritis Outcome Score (KOOS), knee pain ratings, Japanese Orthopaedic Association Score for Osteoarthritic Knees (JOA), PROMIS–29, and performance-based testing comprising the 40-m fast-paced walk test, 6-min walk test, timed up-and-go test, and 30-s chair stand test. Compared to the placebo, curcumin significantly reduced the KOOS knee pain score (p = 0.009) and numeric knee pain ratings (p = 0.001). Curcumin was also associated with greater improvements (p ≤ 0.05) than the placebo on the timed up-and-go test, 6-min walk test, and the JOA total score; but not the 30-s chair stand test or 40-m fast-paced walk test. Pain-relieving medication was reduced in 37% of participants on curcumin compared to 13% on placebo. The findings support the potential efficacy of curcumin for the treatment of osteoarthritis of the knee but studies of longer duration, varying treatment doses, differing curcumin extracts, and the use of other objective outcome measures will be helpful to expand on these findings.