Moisture susceptibility and fatigue performance of hydrated lime-modified asphalt concrete : experiment and design application case study

Hydrated lime has been recognized as an effective additive used to improve asphalt concrete properties in pavement applications. However, further work is still needed to quantify the effect of hydrated lime on asphaltic concrete performance under varied weather, temperature and environmental conditions and in the application of different pavement courses. A research project has been conducted using hydrated lime to modify the asphalt concretes used for the applications of wearing (surface), levelling (binder) and base courses. A previous publication has reported the experimental study on the resistance to Marshall stability and the volumetric properties, the resilient modulus and permanent deformation at three different weather temperatures. This paper reports the second phase experimental study for material durability, which investigated the effect of hydrated lime content on moisture susceptibility when exposed to a freeze-thaw cycle, and the fatigue life. The experimental results show an improvement in the durability of the modified asphalt concrete mixtures. Optimum hydrated lime contents for different course applications are suggested based on the series experimental studies. Finally, the advantage of using the optimum mixtures for a pavement application is demonstrated

Observations from Space: A Unique Vantage Point for the Study of the Environment and Possible Associations with Disease Occurrence

Health providers/researchers need environmental data to study and understand the geographic, environmental, and meteorological differences in disease. Satellite remote sensing of the environment offers a unique vantage point that can fill in the gaps of environmental, spatial, and temporal data for tracking disease. The field of geospatial health remains in its infancy, and this program will demonstrate the need for collaborations between multi-disciplinary research groups to develop the full potential. NASA will discuss the Public Health Projects developed to work with Grantees and the CDC while providing them with information on opportunities for future collaborations with NASA for future research

Are GPs under-investigating older patients presenting with symptoms of ovarian cancer? Observational study using General Practice Research Database

Background: Recent studies suggest that older patients in the United Kingdom are not benefiting as much from improvements in cancer treatments as their younger counterparts. We investigate whether this might be partly due to differential referral rates using ovarian cancer as an example. Methods: From the General Practice Research Database (GPRD), we identified all women aged 40–80 years on 1 June 2002 with a Read code for ovarian cancer between 1 June 2002 and 31 May 2007. Using these records, we compared the GPRD incidence of ovarian cancer with rates compiled from the UK cancer registries and investigated the relationship between age and coded investigations for suspected ovarian cancer. Results: The GPRD rates peaked earlier, at 70–74, and were lower than registry rates for nearly all ages particularly for patients over 59. The proportion investigated or referred by the GP decreased significantly with age and delays between first coded symptom and investigation showed a U-shaped distribution by age. Conclusions: GPs appear to be less likely to recognise and to refer patients presenting with ovarian cancer as they get older. If our findings extend to other cancers, lack of or delays in referral to secondary care may partly explain poor UK cancer mortality rates of older people

Experimental study of temperature effect on the mechanical tensile fatigue of hydrated lime modified asphalt concrete and case application for the analysis of climatic effect on constructed pavement

Previous experimental studies have suggested that hot mixed asphalt (HMA) concrete using hydrated lime (HL) to partially replace the conventional limestone dust filler at 2.5% by the total weight of all aggregates showed an optimum improvement on several key mechanical properties, fatigue life span and moisture susceptibility. However, so far, the knowledge of the thermal response of the modified asphalt concrete and thermal influence on the durability of the pavement constructed are still relatively limited but important to inform pavement design. This paper, at first, reports an experimental study of the tensile fatigue life of HMA concrete mixes designed for wearing layer application. Tests were conducted under three different temperatures for five mixes of different HL contents and one with no use of HL. On the experimental data, temperature effect on material fatigue was characterized in terms of the S-N curve modelling parameters. At last, numerical modelling, set at a climatic scenario in the UK, was performed to analyse and compare the seasonal climatic thermal influence on the fatigue life of two pavement structures using and not using the HL modified HMA concrete. Both the experiment and modelling have demonstrated that the 2.5% HL HMA concrete largely enhances the fatigue life of the material and the constructed pavement

Uni- and tri-axial tests and property characterization for thermomechanical effect on hydrated lime modified asphalt concrete

Permanent deformation, fatigue and thermal cracking are the three typical distresses of flexible pavement. Using hydrated lime (HL) into the conventional limestone mineral additive has been widely practiced, including in Europe, to improve the mechanical properties of hot mix asphalt (HMA) concrete and as the result the durability of the constructed pavement. Large number of experimental studies have been reported to find the optimum addition of HL for the improvement on HMA concrete mechanical properties, moisture susceptibility and fatigue resistance. Pavement in service is under complex thermomechanical stress-strain conditions due to coupled atmospheric and surrounding environment temperature variation and the traffic loading. To predict and analyse the performance of pavement structures the data only from uniaxial compressive test for the resilient modulus and permanent deformation would be not enough. However, so far, the data of HL modified HMA concrete under complex loading conditions are still not well informatively complete. To contribute new knowledge, this paper reports an experimental study of both uni- and tri-axial tests for the asphalt concrete using HL into mineral additive for the mixes designed for the applications of wearing, levelling, and base layers, respectively. All the tests were conducted under three controlled temperatures and four stress deviations. The test results have showed that, for all three types of mixes, the permanent deformation of the HL mixes is less than the ones of no HL addition. The degree of the improvement on permanent deformation resistance using HL is much pronounced at high stress deviation states. The results have also showed that the resilient modulus strongly depends on the temperature and stress deviation while the mixes of HL addition demonstrate higher rigidity. At last, mathematical characterization models have been proposed for the measured material properties. A numerical simulation case study has been performed to test and demonstrate the application of the proposed unified property model

Technology mediator: a new role for the reference librarian?

The Arizona Health Sciences Library has collaborated with clinical faculty to develop a federated search engine that is useful for meeting real-time clinical information needs. This article proposes a technology mediation role for the reference librarian that was inspired by the project, and describes the collaborative model used for developing technology-mediated services for targeted users

Assessment of medication adherence in Saudi patients with type II diabetes mellitus in Khobar city, Saudi Arabia

Objective: Medication adherence is defined as taking medications as advised and prescribed by health care professionals for stated duration. Diabetes mellitus (DM) is one of the most common chronic illnesses in Saudi Arabia. This study aimed to document medication adherence in Saudi patients with type 2 diabetes. Methods: A quantitative cross-sectional study was conducted in Saudi out-patients with type 2 DM in the city of Khobar, Saudi Arabia. The study used the General Medication Adherence Scale (GMAS) to document medication adherence in this population. Data was analyzed through SPSS version 23. Study was ethically approved. Results: Data was collected from 212 patients. Few patients (35.8%) had high adherence to anti diabetic medications. The correlation between HbA1c level and adherence score was negative and significantly strong (ρ = -0.413, p < 0.0001). Most patients (N = 126, 59.4%) modified their medication therapy during month of Ramadan and on Eid occassion. Education level was not a determinant of adherence in this population. Conclusion: This study highlighted that medication adherence is influenced by religious and social factors. Patient counseling is required to improve patient beliefs and increase awareness of adhering to prescribed anti diabetic pharmacotherapy. A pharmacist can play constructive role of a disease educator and patient counselor

Does self-monitoring reduce blood pressure? Meta-analysis with meta-regression of randomized controlled trials

Introduction. Self-monitoring of blood pressure (BP) is an increasingly common part of hypertension management. The objectives of this systematic review were to evaluate the systolic and diastolic BP reduction, and achievement of target BP, associated with self-monitoring. Methods. MEDLINE, Embase, Cochrane database of systematic reviews, database of abstracts of clinical effectiveness, the health technology assessment database, the NHS economic evaluation database, and the TRIP database were searched for studies where the intervention included self-monitoring of BP and the outcome was change in office/ambulatory BP or proportion with controlled BP. Two reviewers independently extracted data. Meta-analysis using a random effects model was combined with meta-regression to investigate heterogeneity in effect sizes. Results. A total of 25 eligible randomized controlled trials (RCTs) (27 comparisons) were identified. Office systolic BP (20 RCTs, 21 comparisons, 5,898 patients) and diastolic BP (23 RCTs, 25 comparisons, 6,038 patients) were significantly reduced in those who self-monitored compared to usual care (weighted mean difference (WMD) systolic −3.82 mmHg (95% confidence interval −5.61 to −2.03), diastolic −1.45 mmHg (−1.95 to −0.94)). Self-monitoring increased the chance of meeting office BP targets (12 RCTs, 13 comparisons, 2,260 patients, relative risk = 1.09 (1.02 to 1.16)). There was significant heterogeneity between studies for all three comparisons, which could be partially accounted for by the use of additional co-interventions. Conclusion. Self-monitoring reduces blood pressure by a small but significant amount. Meta-regression could only account for part of the observed heterogeneity

Dialogues:Anthropology and theology

The past five years have witnessed an increased interest in a dialogue between anthropology and theology, evidenced in part by a suite of edited volumes (e.g. Lauterbach & Vähäkangas 2020; Lemons 2018; Tomlinson & Mathews 2018). Analyses informed by this interdisciplinary nexus have demonstrated the utility of theological concepts for anthropological inquiry (e.g. Robbins 2020; Tomlinson 2020; Williams Green 2021). The following series of dialogues between anthropologists and theologians builds on this growing body of work, expanding it at two main points. First, while the above conversations are all focused on Christian theology, mainly as a means of engaging Christian practice, our dialogues move beyond this religion. The following conversations engage the intersection of anthropology and Islamic, Buddhist, Hindu, as well as Christian, theology.1 Second, many of these dialogues foreground particular experiences of scholars in both anthropology and theology who identify in some way with the religious traditions they study. Some of these dialogues took place between scholars who had an established relationship; others involved partners who had not previously met, but who agreed to correspond in view of a shared interest in this interdisciplinary dialogue. As a starting point, participants were given a series of questions to orient their exchanges, such as, ‘How does faith relate to knowledge in both disciplines?’ Conversations mostly took place over email and were later edited with the help of one of the journal editors, Adam Reed, and one of the members of our Editorial Board, Naomi Haynes.Publisher PDFPeer reviewe