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Full depth recycling (FDR) has emerged as a feasible rehabilitation alternative in California. This study focuses on addressing the economic feasibility of example FDR structures using life cycle cost analysis (LCCA) that included probabilistic and deterministic life cycle agency costs and deterministic life cycle road user costs. Two LCCA case studies were performed to provide an initial understanding of the agency cost variation. Estimating roadway construction costs plays a key role in pavement LCCA and long-term planning. Materials costs per functional unit are the major input values affecting pavement cost and total construction cost, and they are dependent on project scale, market, region, risk, climate, and economic circumstances. Publicly available contract cost data from past roadway construction activities on the California state highway network were used in this study. Economies of scale suggest that high quantities of materials would have lower unit costs. Unsupervised machine learning techniques were employed to divide the available data into four volume categories (low, medium, high, very high) based on material quantities in a project to accomplish the probabilistic LCCA. Work zone delay road user costs were estimated in RealCost-CA and incorporated into the life cycle cost of each alternative. Case studies were conducted for rehabilitation of two California highways, State Route 113 (SOL 113) and State Route 84 (YOL 84), for a 60-year design life. Two different pavement rehabilitation alternatives were considered for the project, an FDR structure and a hot mix asphalt HMA reconstruction, along with their respective maintenance and rehabilitation sequences. Two different pavement structural design methods were also included in the study to enable comparison: R-value and CalME.

Procurement of more environmentally sustainable materials for civil infrastructure can be supported using environmental product declarations (EPDs). An EPD is a standardized label that is a scientifically sound way to communicate the potential environmental impacts and selected resource use and waste production flows from all or part of the life cycle of a product. To be called a Type III EPD, the life cycle assessment (LCA) for products used in civil infrastructure must be performed in accordance with ISO standards and the relevant product category rule (PCR) for the product type. Most EPDs for civil infrastructure materials in North America are “cradle-to-gate”, i.e., they include the impacts from the extraction of raw materials from the earth and end at the point at which the product is ready to leave the gate of the last manufacturing location. The steps leading to publication of an EPD include: 1) Developing the PCR, 2) Developing the LCA for the EPD, 3) Creating the EPD, and 4) Verification and publishing of the EPD. Industry-average, regional-average, product-specific, and facility-specific EPDs—with differing specificity to a particular product—are used for different purposes. EPDs are a source of data for materials impacts for use in assessment of the complete life cycle. They provide information to identify changes in impacts that can be made early in the materials production. They also can be used to help procure lower impact materials. This white paper discusses benefits of using EPDs and makes recommendations for improving their validity. Several areas needing improvement in current use in procurement are identified and recommendations are presented for improving the use of cradle-to-gate EPDs in transport infrastructure construction materials procurement and to provide input to complete life cycle pavement LCA to support decision-making.View the NCST Project Webpage

Abstract High speed side-view videos of sliding drops enable researchers to investigate drop dynamics and surface properties. However, understanding the physics of sliding requires knowledge of the drop width. A front-view perspective of the drop is necessary. In particular, the drop’s width is a crucial parameter owing to its association with the friction force. Incorporating extra cameras or mirrors to monitor changes in the width of drops from a front-view perspective is cumbersome and limits the viewing area. This limitation impedes a comprehensive analysis of sliding drops, especially when they interact with surface defects. Our study explores the use of various regression and multivariate sequence analysis (MSA) models to estimate the drop width at a solid surface solely from side-view videos. This approach eliminates the need to incorporate additional equipment into the experimental setup. In addition, it ensures an unlimited viewing area of sliding drops. The Long Short Term Memory (LSTM) model with a 20 sliding window size has the best performance with the lowest root mean square error (RMSE) of 67 µm. Within the spectrum of drop widths in our dataset, ranging from 1.6 to 4.4 mm, this RMSE indicates that we can predict the width of sliding drops with an error of 2.4%. Furthermore, the applied LSTM model provides a drop width across the whole sliding length of 5 cm, previously unattainable.

Ti–6Al–4V, an alloy of titanium has recently gained focus of research to overcome its machinability challenges. Miniaturization in devices has forced a shift towards micro and meso-scale machining. Sustainability and green manufacturing concepts have shifted focus in machining from cutting fluids towards modern cooling approaches to minimize or eliminate them. In present research, cutting forces & tool wear in Ultrasonic Vibrations Assisted End Milling of Ti–6Al–4V at meso-scale under Dry, Flooded, Minimum Quantity Lubrication & Cryogenic cooling have been analyzed to develop optimum machining parameters. Taguchi L16 orthogonal array was designed to perform experiments keeping Cutting Speed, Feed per tooth, Depth of cut, Ultrasonic vibrations amplitude & Cooling environment as inputs. ANOVA was used to analyze contribution ratios by these parameters towards cutting forces & tool wear. Results indicated that machining conditions, cooling environment and Ultrasonic Vibrations influence cutting forces & tool wear. Depth of cut had the highest influence with 63.41% contribution towards cutting forces while cutting speed remained the highest influencing factor with 39.86% contribution towards tool wear. Cutting forces were reduced by 33.49%, 16.93% and 4.91% while tool wear was reduced by 26.43%, 9.48% and 5.17% under Minimum Quantity Lubrication environment compared to dry, flooded and cryogenic cooling respectively. Cutting forces and tool wear under ultrasonic vibrations were reduced by 24.52% and 13.16% respectively as compared to Conventional Machining (CM). For optimum results, Minimum Quantity Lubrication with low Cutting Speed, Depth of cut, Feed per tooth and high amplitude of ultrasonic vibrations is recommended to machine Ti–6Al–4V.

Dental restoration has been a major concern of healthcare since centuries. Several alloys are in use for dental prostheses including Ni–Cr–Mo alloy. The Ni–Cr–Mo alloy has advantage of economy and density over other alloys, while possessing equivalent corrosion and biocompatibility characteristics. However, beryllium in Ni–Cr–Mo dental casting alloys has associated health hazards, being carcinogenic. In this research Ni–Cr–Mo alloys with minor additions of boron (0.2 wt %), cerium (0.4 wt %) and titanium (2 wt %), to replace beryllium were developed through vacuum induction melting and investment casting technique. Manufacturing steps are detailed for the alloy development to have medically clean alloy, suitable for biomedical applications. The cast alloy samples were tested for microstructure, phases, melting temperatures, wear and corrosion characteristics. Corrosion and wear test results demonstrate that the composition with minor addition of cerium had a significant effect to have low corrosion rate (25.92 × 10−3 mills per year), low wear rate (0.04 × 10−4 mm3/N.m) and lowest coefficient of friction.

Abstract Background Dengue Viral Infection (DVI) has become endemic in Pakistan since the first major outbreak in Karachi in 1996. Despite aggressive measures taken by relevant authorities, Pakistan has been dealing with a worsening dengue crisis for the past two decades. DHF is severe form of dengue infection which is linked with significant morbidity and mortality. Early identification of severe dengue infections can reduce the morbidity and mortality. In this context we planned current study in which we find out the different factors related with DHF as well as clinical laboratory features of DHF and compare them to DF so that patients can be best evaluated for DHF and managed accordingly at admission. Methods Retrospective study conducted over a period of 6 years (2013–2018) in two tertiary care hospitals in Pakistan. Data were collected by using a pre-structured data collection form. Data were statistically analyzed to determine the clinical and laboratory characteristics of DVI and risk factors of dengue hemorrhagic fever (DHF). Results A total 512 dengue cases (34.05 ± 15.08 years; Male 69.53%) were reviewed. Most common clinical manifestations of DVI were fever (99.60%), headache (89.1%), chills (86.5%), rigors (86.5%), myalgia (72.3%). Less common clinical manifestations were vomiting (52.5%), arthralgia (50.2%) and skin rashes (47.5%). Furthermore, nasal bleeding (44.1%), gum bleeding (32.6%), pleural effusion (13.9%) and hematuria (13.1%) were more profound clinical presentations among DHF patients. Mortality rate was 1.5% in this study. Logistic regression analysis indicated that delayed hospitalization (OR: 2.30) and diabetes mellitus (OR:2.71), shortness of breath (OR:2.21), association with risk groups i.e., living near stagnant water, travelling to endemic areas, living in endemic regions (OR:1.95), and presence of warning signs (OR:2.18) were identified as risk factors of DHF. Statistically we found that there is strong association of diabetes mellitus (DM) with DHF while the patient suffering from DM individually had higher odds (2.71) of developing DHF than patients without disease. Conclusions The current study demonstrated that the clinical and laboratory profiles of DF and DHF are significantly distinct. Significant predictors of DHF were advanced age, diabetes mellitus, ascites, pleural effusion, thick gallbladder and delayed hospitalization. The identification of these factors at early stage provides opportunities for the clinicians to identify high risk patients and to reduce dengue-related morbidity and mortality.

Abstract Slide electrification is the spontaneous separation of electric charges at the rear of water drops sliding over solid surfaces. This study delves into how surfaces treated with a low-pressure plasma impact water slide electrification. Ar, O2, and N2 plasma treatment reduced the drop charge and contact angles on glass, quartz, and SU-8 coated with 1H,1H,2H,2H-perfluoroctyltrichlorosilane (PFOTS), and polystyrene. Conversely, 64% higher drop charge was achieved using electrode-facing treatment in plasma chamber. Based on the zeta potential, Kelvin potential, and XPS measurements, the plasma effects were attributed to alterations of the topmost layer's chemistry, such as oxidation and etching, and superficially charge deposition. The surface top layer charges were less negative after electrode-facing and more negative after bulk plasma treatment. As a result, the zeta potential was less negative after electrode-facing and more negative after bulk plasma treatment. Although the fluorinated layer was applied after plasma activation, we observed a discernible impact of plasma-glass treatment on drop charging. Plasma surface modification offers a means to adjust drop charges: electrode-facing treatment of the fluorinated layer leads to an enhanced drop charge, while plasma treatment on the substrate prior to fluorination diminishes drop charges, all without affecting contact angles or surface roughness.

This paper aims to show how concepts and analytical methods of systemic functional linguistics can work congruently with other human practices to improve outcomes for those undergoing the suffering around loss of meaning and the absence of purposeful, self-directed experience. Based on a two-decade collaboration between linguists and psychotherapists in Sydney, Australia, and using the tools of text linguistics as developed by Michael A. K. Halliday and Ruqaiya Hasan in systemic functional theory, the paper presents an indicative selection of intense exchanges between traumatized persons and therapists (centrally the experience of ‘Ruth’). The level by level linguistic descriptions of these exchanges offer opportunities for understanding how progress in the clinical interaction might be achieved. The descriptions can also be evaluated against the theoretical claims of psychotherapy in psychiatry – in particular, the emphasis of the Conversational Model of Psychotherapy developed in England and Australia by Robert Hobson and Russell Meares, whose characterization of disorders involves an emphasis on ‘co-ordination’ and ‘cohesion’ within frontal lobe activity of traumatized patients. In this way the paper also explores conceptual parallels and intellectual antecedents shared between the Conversational Model and Systemic Functional Linguistics, contributing to the broader intellectual history of the human sciences.

(1) Current literature on ethnic minorities, comorbidities, and COVID-19 tends to investigate these factors separately, leaving gaps in our understanding about their interactions. Our review seeks to identify a relationship between ethnicity, comorbidities, and severe COVID-19 outcomes (ICU admission and mortality). We hope to enhance our understanding of the various factors that exacerbate COVID-19 severity and mortality in ethnic minorities in Canada and the USA. (2) All articles were received from PubMed, Scopus, CINAHL, and Ovid EMBASE from November 2020 to June 2022. Included articles contain information regarding comorbidities among ethnic minorities in relation to COVID-19 severity and mortality. (3) A total of 59 articles were included that examined various ethnic groups, including Black/African American, Asian, Hispanic, White/Caucasian, and Indigenous people. We found that the most examined comorbidities were diabetes, hypertension, obesity, and chronic kidney disease. A total of 76.9% of the articles (40 out of 52) found a significant association between different races and COVID-19 mortality, whereas 21.2% of the articles (11 out of 52) did not. (4) COVID-19 ICU admissions and mortality affect various ethnic groups differently, with Black patients generally having the most adverse outcomes. These outcomes may also interact with sex and age, though more research is needed assessing these variables together with ethnicity.

Systemic Lupus Erythematosus (SLE) is an autoimmune multisystem disease usually affecting mucocutaneous, hematologic, and renal organs. Whereas, Celiac Disease is a chronic digestive and immune disorder of the small intestine leading to diarrhea and malnutrition. We report the case of an 18-year-old girl with chronic diarrhea for 1 year with bilateral feet swelling, photosensitive skin rash over sun-exposed areas, recurrent oral ulcers, marked hair fall, generalized lethargy, and fatigue. On examination, she was underweight having malar butterfly rash, oral ulcers, alopecia, conjunctival pallor, and bilateral pitting pedal edema. Investigations revealed raised ESR, microcytic anemia due to iron deficiency, and low serum albumin. Duodenal biopsy showed villous atrophy, lamina propria inflammation, and intraepithelial lymphocytosis. The autoimmune profile revealed positive anti-tissue transglutaminase (tTG-IgA and tTG-IgG), ANA, anti-DsDNA, and Anti-Sm antibodies with low serum C3 and serum C4 levels. A diagnosis of co-existing Celiac Disease and SLE was made and was managed with a gluten-free diet, steroids, and hydroxychloroquine.

Abstract Background Higher numbers of family physicians (FPs) stopped practicing or retired during the COVID-19 pandemic, worsening the family doctor shortage in Canada. Our study objective was to determine which factors were associated with FPs’ plans to retire earlier during the COVID-19 pandemic. Methods We administered two cross-sectional online surveys to Ontario FPs asking whether they were “planning to retire earlier” as a result of the pandemic during the first and third COVID-19 pandemic waves (Apr-Jun 2020 and Mar-Jul 2021). We used logistic regression to determine which factors were associated with early retirement planning, adjusting for age. Results The age-adjusted proportion of FP respondents planning to retire earlier was 8.2% (of 393) in the first-wave and 20.5% (of 454) in the third-wave. Planning for earlier retirement during the third-wave was associated with age over 50 years (50–59 years odds ratio (OR) 5.37 (95% confidence interval (CI):2.33–12.31), 60 years and above OR 4.18 (95% CI: 1.90-10.23)), having difficulty handling increased non-clinical responsibilities (OR 2.95 (95% CI: 1.79–4.94)), feeling unsupported to work virtually (OR 1.96 (95% CI: 1.19–3.23)) or in-person (OR 2.70 (95% CI: 1.67–4.55)), feeling unable to provide good care (OR 1.82 (95% CI: 1.10–3.03)), feeling work was not valued (OR 1.92 (95% CI: 1.15–3.23)), feeling frightened of dealing with COVID-19 (OR 2.01 (95% CI: 1.19–3.38)), caring for an elderly relative (OR 2.36 (95% CI: 1.69–3.97)), having difficulty obtaining personal protective equipment (OR 2.00 (95% CI: 1.16–3.43)) or difficulty implementing infection control practices in clinic (OR 2.10 (95% CI: 1.12–3.89)). Conclusions Over 20% of Ontario FP respondents were considering retiring earlier by the third-wave of the COVID-19 pandemic. Supporting FPs in their clinical and non-clinical roles, such that they feel able to provide good care and that their work is valued, reducing non-clinical (e.g., administrative) responsibilities, dealing with pandemic-related fears, and supporting infection control practices and personal protective equipment acquisition in clinic, particularly in those aged 50 years or older may help increase family physician retention during future pandemics.

The fabric quality in textile industry is characterized by the texture (weave pattern) as it plays a vital role for the production and design of best quality fabric. The earlier proposed automated weave identification methods based on image processing techniques are highly dependent on the lighting conditions. The machine learning methods have been reported to show better accuracy. However, they require very large training datasets, very high processing power and computation time. This study proposes improved accuracy with smaller dataset and reduced computation time by proposing a modification of VGG16 model by adding two additional pooling layers. Using evaluation metrics of both models, the modified model results were analysed according to accuracy, balanced accuracy, and F1-score. On the basis of investigational outcomes, a comparison has been performed with earlier work. The results show that the proposed VGG-16 model is capable to achieve state-of-the-art accuracy and avoid unnecessary activation features by freezing the main convolutional base layers. Ultimately, as evidenced by the performance of the modified VGG-16 deep learning model, the proposed method demonstrated improved accuracy. The study results show that the proposed modified VGG16 algorithm is able to recognize the features of provided database with 90% accuracy and F1-Score ranging from 0.8 to1.

Purpose – This literature review aims to assess the current research on healthcare job availability and skilled professionals. The objective of this research is to identify challenges caused by the imbalance between healthcare service demand and qualified professionals and propose potential solutions and future research directions. Design/methodology/approach – The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was employed as the guiding framework for conducting this review. A qualitative research design analyzed 38 peer-reviewed, evidence-based research works from 50 journal publications. Inclusion criteria focused on empirical studies, observational research and comprehensive reviews published within the last ten years. Thematic and discourse analysis categorized themes and factors explored in selected publications. Findings – The findings highlight significant challenges in the healthcare sector regarding job availability and skilled professionals. Developed countries face understaffed healthcare facilities, resulting in increased workloads and compromised care. Developing countries experience high rates of unemployment among healthcare graduates due to limited resources and mentorship. Practical implications – Improving educational infrastructure, expanding training opportunities and increasing healthcare investments are crucial for nurturing a skilled workforce. Implementing effective retention policies, fostering international collaborations and addressing socioeconomic determinants can create a sustainable job market. Originality/value – The healthcare sector faces critical challenges in balancing job availability and skilled professionals. Strategic solutions are proposed to create a sustainable and equitable healthcare workforce. By implementing recommendations and conducting further research, access to quality healthcare and global public health outcomes can be improved.

Cemetery waste accounts for only a small amount of municipal waste, but its collection and inadequate management are problematic. The purpose of this study was to identify problems in the operation and logistics of the waste management system through the eyes of the cemetery user and the body responsible for collecting this type of waste. The tradition of caring for and decorating gravestones is significant in the production of cemetery waste. Most waste is generated during the holiday of the dead. The problem is the lack of adequate regulations and a permanent system of cemetery waste management throughout Europe and, for example, Poland. These issues affect both visitors and cemetery managers. Success in logistics of sustainable cemetery waste management can come from canvassing the opinions of cemetery visitors and managers and dissemination of the principles of minimalism.

Background: Non-Alcoholic Fatty Liver Disease (NAFLD) prevalence has doubled in the last 20 years and is becoming a vital health concern due to its increasing prevalence. Lean patients having normal-weight central obesity with NAFLD may have increased morbidity and all-cause mortality and thus form an important target for lifestyle modifications and preventive strategies. Objective: To determine frequencies of NAFLD and Metabolic Syndrome in lean individuals. Methods: The present cross-sectional study was undertaken at the Medicine Department, Pakistan Ordinance Factories Hospital, Wah Cantonment Pakistan from July 2018 to June 2020 enrolling 230 patients aged 20 to 70 years, of both sex. Demographic information, co-morbid conditions, BMI, and waist circumference were recorded. An abdominal ultrasound was performed to determine hepatic fatty infiltration. Blood samples were collected for serum HDL-cholesterol (HDL-C) and serum triglyceride estimation. SPSS 22.0 was used for data entry and analysis. Results: Mean age was 45.7+12.5 years with male predominance at 130 (56.5%). Diabetes mellitus was present in 104 (45.2%) and 102 (44.3%) were hypertensive. The mean BMI was 23.4+3.6 kg/m2. The mean serum triglyceride level was 209+10.1 mg/dl and elevated at 141 (61.3%). The mean serum HDL-C level was 23.1+4.2 mg/dl and was reduced by 142 (61.8%). NAFLD was seen in 38 (16.5%) patients and 24 (10.4%) had Metabolic Syndrome. Among the 38 lean NAFLD patients, 21 (55.3%) had Metabolic Syndrome. Conclusion: NAFLD was seen in almost one-fifth of lean patients enrolled. Metabolic syndrome was reported in more than one-half of these lean NAFLD patients