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Health‐related quality of life (HRQOL) is a patient‐reported outcome that assesses the impact of a disease or illness on different domains of a patient's life. Different general and disease‐specific measures can be used to evaluate HRQOL. This article aimed to summarize the evidence for HRQOL among patients with transfusion‐dependent (TDT) and non‐transfusion‐dependent thalassemia (NTDT). We included HRQOL data related to standard therapy with blood transfusions, iron chelation, and/or luspatercept in TDT and NTDT, as well as curative therapies for TDT, including hematopoietic stem cell transplant (HSCT) and gene therapy. Patients with thalassemia had worse HRQOL scores compared to the general population, and chronic pain was seen to increase in frequency and severity over time with age. NTDT patients reported worse physical health and functioning, mental health, general health, and vitality than TDT patients. However, TDT patients reported worse pain, change in health, and social support than NTDT. Most therapies improved overall HRQOL among thalassemia patients. Deferasirox, an oral iron chelator, was associated with more HRQOL benefits compared to deferoxamine, an intravenous iron chelator. Luspatercept showed clinically meaningful improvement in physical functioning among TDT and NTDT. Furthermore, HSCT and gene therapy were associated with better physical, emotional, and mental domains scores. [ABSTRACT FROM AUTHOR]

Sickle cell disease (SCD) is one of the most common inherited blood disorders. Deoxygenated hemoglobin S (HbS) polymerizes and causes anemia and various end organ effects. Voxelotor acts by increasing HbS oxygen affinity, decreasing anemia and hemolysis. Voxelotor is approved for use in individuals with SCD age 4 years and older. Phase 3 trials demonstrated an increase in hemoglobin levels and a decrease in markers of hemolysis; however, data or benefits related to clinical and quality of life outcomes are relatively limited and varied across different studies. This review summarizes the published clinical trials and research studies focused on the use of voxelotor in SCD to provide an evidence-based practical guide for hematology providers on its utilization in clinical settings, including physicians and independent licensed practitioners. [ABSTRACT FROM AUTHOR]

Given that appropriate long-term iron chelation is essential in the treatment of transfusion-dependent anaemias,14,15 deferiprone b.i.d. has the potential to improve treatment adherence and health outcomes in patients with transfusional iron overload. Twenty-seven patients had a primary diagnosis of thalassaemia major, one patient had -thalassaemia/haemoglobin H disease and one patient had sickle -thalassaemia. Fourteen patients reported mild AEs, 13 patients reported moderate AEs and one patient reported a severe AE. Lifelong iron chelation therapy is critical for patients with transfusion-dependent anaemias, and full adherence to therapy is essential to optimise long-term patient outcomes.1,2 Deferiprone is an oral iron chelator with high efficiency in binding and removing excess intracellular and extracellular iron.3,4 Owing to its elimination half-life of approximately 2 h, deferiprone is administered three times daily (t.i.d.) to promote longer extent of exposure and better control of labile iron.5-7 Clinical trial data show adherence rates with deferiprone t.i.d. from 79% to 98%8,9; however, real-world adherence is generally lower than in clinical trials, as the t.i.d. regimen may be inconvenient and the midday dose may often be missed.10-12 The United States Food and Drug Administration recently approved a twice-a-day modified-release formulation of deferiprone (Ferriprox TAD 1000 mg tablet; manufactured by Apotex Inc., Toronto, Ontario, Canada) for the treatment of patients with transfusional iron overload due to thalassaemia syndromes, sickle cell disease or other anaemias.13 In single-dose and multiple-dose pharmacokinetic studies of deferiprone in healthy volunteers (Tables S1 and S2), we found that the twice-daily (b.i.d.) formulation had equivalent 24-h drug exposure to the original immediate-release tablet administered t.i.d. (Figure S1), and exposure was not affected by administration with food (Table S3). [Extracted from the article]

International Roughness Index (IRI) is a key parameter in pavement performance evaluation. This study investigates developing a reliable prediction model that can be used to estimate IRI of rigid pavements using innovative machine learning techniques. Optimally Pruned Extreme Learning Machine (OP-ELM) and Wavelet analysis are integrated to improve the OP-ELM results and design a novel hybrid Wavelet-OPELM (WOPELM) model for the IRI prediction. The proposed model is compared statistically to the OP-ELM and conventional feed-forward Artificial Neural Network (ANN) as well as regression model with respect to their efficiency to predict IRI of jointed plain concrete pavement (JPCP) sections in USA. The relevant data was collected from the Long-Term Pavement Performance (LTPP) database. Eight input variables, initial IRI, pavement age, transverse cracks, percent joints spalled, flexible and rigid patching areas, total joint faulting, freeze index, and percent subgrade passing No. 200 U.S. sieve, are assessed and used to predict the IRI. The results show that the initial IRI, total joint faulting, and freezing index are the most significant parameters for IRI prediction. The WOPELM is found to be a robust and more accurate modelling technique compared to OP-ELM, ANN, and regression for IRI prediction with only a 7% prediction error. [ABSTRACT FROM AUTHOR]

Control haemoglobinopathy blood safety project Keywords: sickle cell disease; thalassaemia; vaccines; iron overload; hepatitis EN sickle cell disease thalassaemia vaccines iron overload hepatitis e160 e164 5 11/30/21 20211201 NES 211201 Non-concordance with preventive recommendations is common among patients with chronic conditions, including sickle cell disease (SCD) and transfusion-dependent thalassaemia (TDT).1,2 Iron overload is common among chronically transfused patients with SCD and TDT leading to increased morbidity, mortality and cost of care, especially as they live longer.3-5 The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) recommendations support completion of hepatitis A (HepA) and hepatitis B (HepB) vaccinations, including SCD and TDT.6,7 Cardiac iron overload is the leading cause of mortality in TDT,8 while it is rare in SCD.9 Guidelines recommend liver iron overload assessment every 1-2 years for patients with SCD receiving chronic transfusions.10,11 The recommendation for TDT is annual assessment of liver and cardiac iron concentration.3,8 However, there are limited data on concordance with these recommendations. Child/adolescent patients with TDT who were concordant with HepA vaccination recommendations were concordant with the other two preventive service recommendations (Fig 1B). [Extracted from the article]

International Roughness Index (IRI) is an important pavement performance indicator that is widely used to reflect existing pavement condition and ride quality. Due to the importance of this significant index, the current research aims to develop a precise IRI prediction model using the Gaussian Process Regression (GPR) and Locally Weighted Polynomials (LWP). The long-term pavement performance (LTPP) datasets of pavement age, initial IRI, alligator, longitudinal and transverse cracks, standard deviation of rutting, and subgrade plasticity index variables are employed in predicting IRI. These datasets are collected from 126 different flexible pavement sections of the LTPP specific pavement studies (SPS-1) located in different climatic zones in the US. The total number of IRI measurements in the collected database is 925 which covers a wide range of IRI values. Multiple linear regression (MLR) is firstly applied to classify the input variables. Then the MLR model is compared with four machine learning techniques which are GPR, LWP, Particle Swarm Optimization-Adaptive Network based Fuzzy Inference System (PSO-ANFIS) and PSO-Artificial Neural Networks (PSO-ANN). The developed models' performance is validated using different statistical indices, including the coefficient of determination (R 2). The results demonstrate that the GPR ( R 2 = 0. 93) and LWP ( R 2 = 0. 90) outperformed the PSO-ANFIS ( R 2 = 0. 65) and PSO-ANN ( R 2 = 0. 52) in predicting IRI. Thus, the GPR model is found to be more accurate for IRI modeling compared to the hybrid investigated models. [ABSTRACT FROM AUTHOR]

The medical needs of individuals with sickle cell disease (SCD) are complex. Patients with SCD experience complications such as recurrent pain episodes and increased hospitalizations. Over 70% of AYA and their parents seek medical information from the Internet; 83% inquire on sites that have interactive/social features, such as Facebook or Twitter, yet accuracy remains unclear. Our objective was to assess the accuracy of the SCD-information posted on social media. We hypothesized that most of the posted information is inaccurate. We coded one month of threads from two common SCD Facebook groups (Sickle Cell Warriors Unity and Sickle Cell Anemia) to identify the purpose of each post and the accuracy of medical information posted. Amongst both social media sites, there were 487 posts. Most of the posts were directed toward socializations (n = 311, 63.8%), while other posts mainly focused mainly on SCD and its management (n = 173, 35.5%). When looking at the medical posts, 44.9% were accurate, whereas 55.1% of the posts included inaccurate information. We found that less than half of the medical information posted on interactive social media is inaccurate. Our findings raise potentially serious implications for individuals with SCD and/or their caregivers who may rely on social media to gather more information about their or their child's disease. Our data highlight the importance of health care providers encouraging patients and parents to ask any questions they may have about SCD, given they may consult social media and Internet site that provide inaccurate information. [ABSTRACT FROM AUTHOR]

Acute lymphoblastic leukemia (ALL) is the most common malignancy in children and young adults. Treatment is long and involves 2–3 years of a prolonged maintenance phase composed of oral chemotherapies. Adherence to these medications is critical to achieving good outcomes. However, adherence is difficult to determine, as there is currently no consensus on measures of adherence or criteria to determine nonadherence. Furthermore, there have been few studies in pediatric B-ALL describing factors associated with nonadherence. Thus, we performed a systematic review of literature on oral chemotherapy adherence during maintenance therapy in ALL following PRISMA guidelines. Published studies demonstrated various objective and subjective methods of assessing adherence without generalizable definitions of nonadherence. However, the results of these studies suggested that nonadherence to oral maintenance chemotherapy was associated with increased risk of relapse. Future studies of B-ALL therapy should utilize a uniform assessment of adherence and definitions of nonadherence to better determine the impact of nonadherence on B-ALL outcomes and identify predictors of nonadherence that could yield targets for adherence improving interventions. [ABSTRACT FROM AUTHOR]

• SEA modified with rPE is sustainable, economic, and ecofriendly alternative. • rPE made SEA stiffer/elastic thus better resistance to rutting/fatigue cracking. • Addition of rPE to SEA improved elastic and viscous properties. This research evaluates the rheological properties of virgin asphalt and sulfur extended asphalt (SEA) modified with two types of recycled plastic waste (rPW). The investigated plastic wastes are the recycled low-density polyethylene (rLDPE) and recycled high-density polyethylene (rHDPE). It also assesses the environmental and economic benefits of recycling such materials. A total of 16 modified binder samples are produced by adding rLDPE and rHDPE modifiers to virgin asphalt and SEA in four different concentrations of 2%, 4%, 6%, and 8% by weight of asphalt. The basic and rheological properties of the virgin and modified asphalts are explored by conventional tests, and advanced rheological tests at different aging conditions. Finally, cost-effectiveness and environmental analyses are conducted. The environmental benefit analysis is performed by comparing carbon and non-methyl volatile organic compound (NMVOC) emission from the various recycled polyethylene (rPE) with the manufacturing process of the same quantities of virgin LDPE and HDPE when used to modify asphalt. The effect of incorporating sulfur into virgin asphalt on the environment is also determined. Results show that modification yields a higher binder complex shear modulus (G*) and a lower loss tangent (tan δ) at all traffic speeds meaning improved rut resistance behavior under heavy traffic loading and high temperature conditions. About 29% reduction in material cost occurs when rPE-modified SEA is used instead of virgin asphalt. The environmental and economic analyses show that using SEA modified with rPE for road construction is an economic, sustainable, and ecological alternative with better performance compared to virgin asphalt. [ABSTRACT FROM AUTHOR]

This paper represents the results of a comprehensive experimental work on developing high performance concrete mixes containing different percentages of electric arc furnace steel slag (EAFSS) coarse aggregate (0, 25, 50, 75, and 100% by weight) for sustainable pavements. The use of steel slag powder (SSP) and silica fume (SF) as a mineral filler was also investigated. Mechanical properties of concrete such as compressive, splitting tensile and flexural strengths, modulus of elasticity, permeability, and thermal conductivity, were measured in the laboratory. The morphological and microstructural properties of the investigated steel slag were also determined. Finally, the field performance of the investigated concrete mixes was predicted using the AASHTOWare Pavement ME for a typical Jointed Plain Concrete Pavement (JPCP) system in terms of transverse cracking, faulting, and roughness. The results of this research indicate that, all investigated mechanical properties for steel slag mixes are better than the natural aggregate mix with optimum mechanical properties and performance for the concrete mix with 50% EAFSS. Using the SSP powder with or instead of SF did not show significant improvement in mechanical properties/performance. The results emphasise that EAFSS is a viable sustainable construction material for rigid pavements. [ABSTRACT FROM AUTHOR]

Purpose: To examine the relations between patient-reported outcomes (PROs) within a conceptual model for adults with sickle cell disease (SCD) ages 18 – 45 years enrolled in the multi-site Sickle Cell Disease Implementation Consortium (SCDIC) registry. We hypothesized that patient and SCD-related factors, particularly pain, and barriers to care would independently contribute to functioning as measured using PRO domains. Methods: Participants (N = 2054) completed a 48-item survey including socio-demographics and PRO measures, e.g., social functioning, pain impact, emotional distress, and cognitive functioning. Participants reported on lifetime SCD complications, pain episode frequency and severity, and barriers to healthcare. Results: Higher pain frequency was associated with higher odds of worse outcomes in all PRO domains, controlling for age, gender and site (OR range 1.02–1.10, 95% CI range [1.004–1.12]). Reported history of treatment for depression was associated with 5 of 7 PRO measures (OR range 1.58–3.28 95% CI range [1.18–4.32]). Fewer individual barriers to care and fewer SCD complications were associated with better outcomes in the emotion domain (OR range 0.46–0.64, 95% CI range [0.34–0.86]). Conclusions: Study results highlight the importance of the biopsychosocial model to enhance understanding of the needs of this complex population, and to design multi-dimensional approaches for providing more effective interventions to improve outcomes. [ABSTRACT FROM AUTHOR]

Background. Sickle cell disease (SCD) is a hemoglobinopathy with increasing global prevalence resulting in pain episodes and multiorgan complications. Complications of SCD have been shown to adversely impact health-related quality of life (HRQOL) comprised of physical, social, and emotional domains; hence, HRQOL measures can serve as an effective evaluator of disease burden. Hydroxyurea (HU) and other disease-modifying therapies have demonstrated to significantly improve clinical outcomes in patients with SCD. Medication adherence is an essential mediator of the clinical benefits of these therapies; low adherence has been shown to increase disease burden and healthcare utilization. This systematic literature review intends to determine the association between adherence to disease-modifying therapies and HRQOL in patients with SCD. Methods. We found a total of 12 articles involving 788 participants, which included both patients with SCD and caregivers/parents. Adherence was measured using self-report instruments, laboratory markers, such as fetal hemoglobin and mean corpuscular volume, and mHealth medication trackers. HRQOL was measured using self-report instruments. Results. All studies demonstrated a correlation between higher HU adherence and better HRQOL scores. Higher HU adherence was associated with lower pain impact, less frequent pain episodes, less fatigue, and improved physical function and mobility, reflecting better physical HRQOL outcomes. Higher adherence was also associated with improved emotional response, decreased anxiety and depressive symptoms, and better social functioning and peer relationships. In addition, our findings indicated that having less frequent barriers to HU adherence was associated with better HRQOL scores. No studies evaluated HRQOL outcomes in relation to adherence to l-glutamine, voxelotor, or crizanlizumab. Conclusions. Optimizing HU adherence has the potential to improve HRQOL in patients with SCD in addition to reducing healthcare utilization and improving treatment satisfaction. Addressing barriers to HU adherence can positively strengthen the relationship between adherence and HRQOL to potentially improve patient outcomes. [ABSTRACT FROM AUTHOR]

One of the main difficulties with employing recycled asphalt pavement (RAP) in hot mix asphalt (HMA) is bitumen aging; hence, the percentage of RAP in the HMA is limited. This research evaluates the rheological properties of the RAP binder and the performance of HMA containing high RAP content using waste engine oil (WEO) from an Electrical Power Plant as a rejuvenator. The rheological and microstructural properties of the RAP binder and rejuvenated RAP binder were determined in the laboratory. Both the recycled and rejuvenated recycled mixes were tested for Marshall stability, indirect tensile strength, dynamic modulus (E*), and flow number tests. The RAP binder was recovered using two different processes: rotavapor distillation followed by centrifugation (RCRD) and column distillation without centrifugation (RNCCD). The optimal WEO percentages for the RCRD and RNCCD recovery procedures were 0.5% and 3%, respectively. The Marshall test results revealed that adding WEO to the recycled mix enhanced its stability and flow compared to the control mix. The rejuvenated mix containing recovered binder from the RCRD recovery process was found to be better than the rejuvenated mix containing recovered binder from the RNCCD recovery process. The rejuvenated recycled mixes outperformed the recycled mix in terms of moisture resistance, which was evidenced by tensile strength ratio values of 0.88, 0.90, and 0.91 for the control and 0.5% and 3% WEO modified mixes, respectively. Finally, the results of dynamic modulus and flow number testing revealed that the rejuvenated mixes had a modest drop in both the dynamic modulus and flow number compared to the non-rejuvenated mix. [ABSTRACT FROM AUTHOR]

Iron chelation therapy (ICT) is essential to prevent complications of iron overload in patients with transfusion-dependent thalassemia. However, the role that adherence to ICT plays in health-related outcomes is less well known. Our objectives were to identify adherence rates of ICT, and to assess methods of measurement, predictors of adherence, and adherence-related health outcomes in the literature published between 1980 and 2020. Of 543 articles, 43 met the inclusion criteria. Studies measured ICT adherence, predictors, and/or outcomes associated with adherence. Most studies were across multiple countries in Europe and North America (n = 8/43, 18.6%), recruited in clinics (n = 39/43, 90.7%), and focused on β-thalassemia (β-thal) (n = 25/43, 58.1%). Common methods of assessing ICT adherence included patient self-report (n = 24/43, 55.8%), pill count (n = 9/43, 20.9%), prescription refill history (n = 3/43, 7.0%), provider scoring (n = 3/43, 7.0%), and combinations of methods (n = 4/43, 9.3%). Studies reported adherence either in 'categories' with different levels of adherence (n = 24) or 'quantitatively' as a percentage of doses of medication taken out of those prescribed (n = 17). Adherence levels varied (median 91.7%, range 42.0–99.97%). Studies varied in sample size and methods of adherence assessment and reporting, which prohibited meta-analysis. Due to a lack of consensus on how adherence is defined, it is difficult to compare ICT adherence reporting. Further research is needed to establish guidelines for assessing adherence and identifying suboptimal adherence. Behavioral digital interventions have the potential to optimize ICT adherence and health outcomes. [ABSTRACT FROM AUTHOR]

Currently, Egypt is using the [AASHTO, 1993. Guide for design of pavement structures. Washington, DC: American Association of State Highway and Transportation Officials] guide for the flexible pavement structural design. In this method the resilient modulus (MR) of the unbound granular base/subbase materials and subgrade soils is a measure of material stiffness used for characterisation. It is considered one of the major factors affecting the pavement layerthicknesses. However, in Egypt, California Bearing Ratio (CBR) is the main strength parameter used for characterisation of the unbound materials and subgrade soils due to its availability and simplicity. In this research, a comprehensive experimental testing programme was conducted on different unbound granular base/subbase materials typically used in pavement construction projects in Egypt. The testing programme includes MR, CBR, and basic material properties. The effect of aggregate gradation on MR is investigated. A model predicting MR as a function of the basic material properties is proposed. The MR–CBR relationship adopted in the current Egyptian Code of Practice is verified based on the testing results. The experimental data warranted the calibration of the current model. The calibrated model has reasonable goodness of fit statistics and yields rational MR estimates for the local materials. [ABSTRACT FROM AUTHOR]

Summary: Depressive symptoms are prevalent in individuals living with sickle cell disease (SCD) and may exacerbate pain. This study examines whether higher depressive symptoms are associated with pain outcomes, pain catastrophizing, interference and potential opioid misuse in a large cohort of adults with SCD. The study utilized baseline data from the 'CaRISMA' trial, which involved 357 SCD adults with chronic pain. Baseline assessments included pain intensity, daily mood, the Patient Health Questionnaire (PHQ), the Generalized Anxiety Disorders scale, PROMIS Pain Interference, Pain Catastrophizing Scale, the Adult Sickle Cell Quality of Life Measurement Information System and the Current Opioid Misuse Measure. Participants were categorized into 'high' or 'low' depression groups based on PHQ scores. Higher depressive symptoms were significantly associated with increased daily pain intensity, negative daily mood, higher pain interference and catastrophizing, poorer quality of life and a higher likelihood of opioid misuse (all p < 0.01). SCD patients with more severe depressive symptoms experienced poorer pain outcomes, lower quality of life and increased risk of opioid misuse. Longitudinal data from this trial will determine whether addressing depressive symptoms may potentially reduce pain frequency and severity in SCD. [ABSTRACT FROM AUTHOR]

Severe acute and chronic pain are the most common complications of sickle cell disease (SCD). Pain results in disability, psychosocial distress, repeated clinic visits/hospitalizations, and significant healthcare costs. Psychosocial pain interventions that teach cognitive and behavioral strategies for managing pain have been effective in other adolescent populations when delivered in person or through digital technologies. Our aim was to conduct a multisite, randomized, controlled trial to improve pain and coping in youth aged 12 to 18 years with SCD using a digital cognitive–behavioral therapy program (iCanCope with Sickle Cell Disease; iCC-SCD) vs Education control. We enrolled 137 participants (ages 12-18 years, 59% female) and analyzed 111 adolescents (107 caregivers), 54 randomized to Education control and 57 randomized to iCC-SCD. Ninety-two percent of youth completed posttreatment assessments and 88% completed 6-month follow-up. There was a significant effect of treatment group (iCC-SCD vs Education) on reduction in average pain intensity from baseline to 6-month follow-up (b = −1.32, P = 0.009, 95% CI [−2.29, −0.34], d = 0.50), and for the number of days with pain, adolescents in the iCC-SCD group demonstrated fewer pain days compared with the Education group at 6-month follow-up (incident rate ratio = 0.63, P = 0.006, 95% CI [0.30, 0.95], d = 0.53). Treatment effects were also found for coping attempts, momentary mood, and fatigue. Several secondary outcomes did not change with intervention, including anxiety, depression, pain interference, and global impression of change. Future studies are needed to identify effective implementation strategies to bring evidence-based cognitive–behavioral therapy for sickle cell pain to SCD clinics and communities. [ABSTRACT FROM AUTHOR]

Summary: Sickle cell disease (SCD) is an inherited red blood cell disorder associated with frequent painful events and organ damage. Hydroxyurea (HU) is the recommended evidence‐based treatment of SCD. However, among patients eligible for HU, prescription rates are low. Utilizing a scoping review approach, we summarized and synthesized relevant findings regarding provider barriers and facilitators to the prescription of HU in youth and adults with SCD and provided suggestions for future implementation strategies to improve prescription rates. Relevant databases were searched using specified search terms. Articles reporting provider barriers and/or facilitators to prescribing HU were included. A total of 10 studies met the inclusion criteria. Common barriers to the prescription of HU identified by providers included: doubts around patients' adherence to HU and their engaging in required testing, concerns about side effects, lack of knowledge, cost and patient concerns about side effects. Facilitators to the prescription of HU included beliefs in the effectiveness of HU, provider demographics and knowledge. Findings suggest significant provider biases exist, particularly in the form of negative perceptions towards patients' ability to adhere to taking HU and engaging in the required follow‐up. Improving provider knowledge and attitudes towards HU and SCD may help improve low prescription rates. [ABSTRACT FROM AUTHOR]

Sickle cell disease (SCD) state level surveillance data are limited. We performed a retrospective review of emergency department (ED) visits and hospitalizations from individuals with SCD in Illinois (2016–2020) using the Illinois Health and Hospital Association's Comparative Health Care and Hospital Data Reporting Services. There were 48,094 outpatient ED visits and 31,686 hospitalizations. Most visits (67%) occurred in Cook County, were covered by public insurance (77%) and were from individuals with medium high (40.3%) or high (36.1%) poverty levels. SCD healthcare utilization remains high and surveillance data may inform SCD program development and resource allocation at the state level. Abbreviations CDC Centers for Disease Control and Prevention ED Emergency Department FDA Food & Drug Administration ICD International Classification of Diseases IL Illinois SCD Sickle cell disease [ABSTRACT FROM AUTHOR]

This study presents a novel hybrid intelligent approach using Extreme Learning Machine (ELM) and Equilibrium Optimiser (EO) (ELM-EO) for predicting resilient modulus, Mr of Unbound Granular Materials (UGMs). Fourteen various blends of Recycled Concrete Aggregate (RCA) with Recycled Clay Masonry (RCM), and Electric Arc Furnace Steel (EAFS) slag with limestone aggregates were tested in the laboratory using routine and advanced tests. The laboratory Mr testing produced 224 measurements based on the average of triplicate samples for each blend. The performance of the ELM-EO approach was evaluated and compared with conventional regression, ELM-biogeography-based optimisation (BBO) (ELM-BBO) and ELM-genetic algorithm (ELM-GA) approaches using the same input properties. The inputs used for the Mr prediction are the bulk stress, percent of RCM, and/or percent of EAFS. The results demonstrate that the performance of ELM-EO and ELM-BBO approaches is better than ELM-GA and regression approaches for predicting Mr. The overall statistical measures of the proposed approaches show that the ELM-EO approach ranks first as it outperforms the other approaches with coefficient of determination (R2) of 0.924 and Root Mean Square Error (RMSE) of 37.08 MPa. [ABSTRACT FROM AUTHOR]

Currently, sustainable pavement research focuses on modified asphalt binders with self-healing features for achieving durability and safety goals. This study assesses the self-healing behavior of asphalt binders incorporating innovative lab-manufactured hybrid-structured phase change material capsules (HPCMC). The HPCMC, using by-product paraffin oil as a core encapsulated by waste nano-silica fume as a shell, varied in core-to-shell ratios (0.5:1, 1:1, 2:1) and dosages (1 %, 3 %, 5 %, 7 %) by asphalt weight. Morphological, thermal, and chemical characterizations were conducted using scanning electron microscopy (SEM), transmission electron microscopy (TEM), thermal gravimetric analysis (TGA), and Fourier transform infrared spectroscopy (FTIR). Healing efficiency of unaged and short-term aged HPCMC-modified binders was evaluated using SEM and energy dispersive X-ray (EDX) for morphological and chemical analysis. Rheomechanics were examined through rotational viscosity (RV), performance grading (PG), multiple stress creep recovery (MSCR), strain sweep (SS), frequency sweep (FS), linear amplitude sweep (LAS), and linear amplitude sweep-based healing (LASH). Study findings exhibit superior healing in HPCMC-modified binders compared to unmodified ones, particularly at a 3 % dosage and 1:1 core-to-shell ratio in unaged conditions. This study also evaluates healing assessment criteria and validates the self-healing mechanism, indicating significant potential for the proposed approach to revolutionize pavement construction and maintenance. [Display omitted] • Innovative and sustainable self-healing approach through the incorporation of HPCMC to enhance asphalt binder durability. • Synthesis and characterization of HPCMC through morphological analysis, thermal stability, and chemical investigations. • Evaluation of rheomechanical performance and healing efficiency of HPCMC-modified asphalt binders under varied aging states. • Optimization of core-to-shell ratios and HPCMC dosages to maximize healing efficiency and rheomechanical performance. • Validation of self-healing mechanism, proving HPCMC's ability to repair microcracks and boost pavement quality. [ABSTRACT FROM AUTHOR]

Objectives: Discrete choice experiments (DCEs) are increasingly used to elicit preferences for health and healthcare. Although many applications assume preferences are homogenous, there is a growing portfolio of methods to understand both explained (because of observed factors) and unexplained (latent) heterogeneity. Nevertheless, the selection of analytical methods can be challenging and little guidance is available. This study aimed to determine the state of practice in accounting for preference heterogeneity in the analysis of health-related DCEs, including the views and experiences of health preference researchers and an overview of the tools that are commonly used to elicit preferences.Methods: An online survey was developed and distributed among health preference researchers and nonhealth method experts, and a systematic review of the DCE literature in health was undertaken to explore the analytical methods used and summarize trends.Results: Most respondents (n = 59 of 70, 84%) agreed that accounting for preference heterogeneity provides a richer understanding of the data. Nevertheless, there was disagreement on how to account for heterogeneity; most (n = 60, 85%) stated that more guidance was needed. Notably, the majority (n = 41, 58%) raised concern about the increasing complexity of analytical methods. Of the 342 studies included in the review, half (n = 175, 51%) used a mixed logit with continuous distributions for the parameters, and a third (n = 110, 32%) used a latent class model.Conclusions: Although there is agreement about the importance of accounting for preference heterogeneity, there are noticeable disagreements and concerns about best practices, resulting in a clear need for further analytical guidance. [ABSTRACT FROM AUTHOR]

Summary: It is not known whether obesity has a differential effect on allogeneic haematopoietic cell transplantation outcomes with alternative donor types. We report the results of a retrospective registry study examining the effect of obesity [body mass index (BMI) > 30] on outcomes with alternative donors (haploidentical related donor with two or more mismatches and receiving post‐transplant cyclophosphamide [haplo] and cord blood (CBU)] versus matched unrelated donor (MUD). Adult patients receiving haematopoietic cell transplantation for haematologic malignancy (2013–2017) (N = 16 182) using MUD (n = 11 801), haplo (n = 2894) and CBU (n = 1487) were included. The primary outcome was non‐relapse mortality (NRM). The analysis demonstrated a significant, non‐linear interaction between pretransplant BMI and the three donor groups for NRM: NRM risk was significantly higher with CBU compared to haplo at BMI 25–30 [hazard ratio (HR) 1.66–1.71, p < 0.05] and MUD transplants at a BMI of 25–45 (HR, 1.61–3.47, p < 0.05). The results demonstrated that NRM and survival outcomes are worse in overweight and obese transplant recipients (BMI ≥ 25) with one alternative donor type over MUD, although obesity does not appear to confer a uniform differential mortality risk with one donor type over the other. BMI may serve as a criterion for selecting a donor among the three (MUD, haplo and CBU) options, if matched sibling donor is not available. [ABSTRACT FROM AUTHOR]

Infertility secondary to chemotherapy, myeloablative conditioning regimens prior to stem cell transplantation, radiation therapy, and/or surgery is an important cause of morbidity and psychosocial distress among pediatric cancer patients. Known options exist for fertility preservation; however, knowledge among providers varies. We conducted a pilot study with an educational intervention over one-hour for hematology-oncology faculty, fellows, and advanced practice providers. Participants completed pre-/post-test assessment on fertility preservation knowledge. Participants' pretest mean (SD) score was 53% (17%), which significantly increased to 72% (11%) in the post-test (p = 0.0004). We demonstrated that a fertility education intervention could improve knowledge regarding infertility risk assessment and fertility preservation options. [ABSTRACT FROM AUTHOR]

• Granular base material was stabilized by geopolymer, calcium carbide residue (CCR) • CCR was activated by a diluted linear alkyl benzene sulfonic acid (LABSA) • Seven solid/liquid (CCR: diluted LABSA) mixes were prepared and investigated. • Geopolymer of (300/1000) ml LABSA with a (80%:20%) achieved best strength (UCS) • Stabilized aggregate by CCR/LABSA gels produced denser and uniform microstructures. Alkali activated industrial waste/by-product geopolymers have recently gained extensive attention from researchers as a replacement for cement in concrete manufacturing. However, little attention has been given to their employment as a stabilizer of unbound granular base/subbase (UGB) materials in road construction. Stabilizing granular base materials with geopolymers is explored in this study. The investigated geopolymer is composed of calcium carbide residue (CCR), a waste product resulting from the manufacturing of acetylene gas, which activated by a linear alkyl benzene sulfonic acid (LABSA). Four proportions of sulfonic acid dilution ratios and seven solid/liquid (CCR/diluted LABSA) mixes were prepared. The unconfined compressive strength (UCS) of the mixtures was determined in the laboratory. The maximum UCS was achieved by blending a diluted LABSA of (300/1000) ml with a geopolymer (solid: liquid) blend proportion of (80%:20%) by the total weight of aggregate. Based on the results, aggregate mixtures of 2.5%, 5%, 7.5%, and 10% of geopolymer blend content were prepared to determine the maximum UCS value corresponded to the optimum geopolymer mixing ratio. This optimum geopolymer ratio was recommended at 7.5%, which was then exposed to different curing times and environmental conditions to explore the variation in UCS as well as the elastic modulus (E). In addition, Scanning Electron Microscopy (SEM) and Energy Dispersive X-ray Spectroscopy (EDX) measurements revealed that the stabilized aggregate contained geopolymer gels generally produced microstructures that are more uniform and denser than the untreated aggregate structure. A blend of CCR and LABSA can be used as a feasible and sustainable eco-friendly alternative as a stabilizing agent for UGB in pavement engineering applications. [ABSTRACT FROM AUTHOR]