Salt Gradation Analysis for Winter Road Maintenance

This research investigates the salt gradation specifications adopted by different provincial or state highway departments in Canada and the US for winter road maintenance operations. To understand the type of used salt, its quantity, grain size distribution, application method and the level of satisfaction of the user, a questionnaire was prepared and sent to selected provincial/state highway departments in Canada and the US. The survey-based comparative analysis performed on the salt gradation in different jurisdictions showed that the salt gradation does not always fit in ASTM (American Society of the International Association for Testing and Materials) and BS (British Standard) standard curves. However, it was found that the gradation of coarse and fine salt used by most Canadian provinces follows ASTM I and the Finnish standards, respectively. Although the majority of jurisdictions surveyed in this study have specific requirements for gradation of the salt used in their winter maintenance operations, no laboratory tests or field trials have been conducted to investigate the effectiveness of a particular salt gradation for road winter maintenance operations. It was also found that salt gradation standards are compromised due to factors such as local availability of the material, purity of the available material, ease of material handling, ease of application, and the preference of private contractors for certain materials

A Review of Two Ambiguities in the Novel "The Adventures of Hajji Baba Isfahani"

The translation of the novel "The Adventures of Hajji Baba Isfahani" is a turning point in the history of Persian prose literature and the history of translation into Persian; much research has been done on this novel. Ambiguities about this novel and its Persian translation have been raised and investigated, including whether the original text was written by James Murrier or did he expand the novel on the basis of a Persian text and is "Mirza Habib Isfahani" the main translator, or is it Sheikh Ahmad Rouhi as written in the First publish of this novel? This paper has attempted to make new points by relying on intra-textual cues, comparing the translation with the original text, stylistic features, and so on. This study considers the existence of a Persian text as the main text more probable. And about the second ambiguity, this article emphasizes that Mirza Habib is the main translator of the novel, also determining the contribution of Sheikh Ahmad Rouhi and Mirza Agha Khan Kermani in the translation of the novel

Program to reduce empowerment barriers hindering mothers to contribute to speech skills of hearing-impaired children with cochlear implant

Background and aims: Given the importance of reducing barriers hindering the empowerment of mothers from contributing to the rehabilitation of hearing-impaired children with cochlear implants, the present study points to the direction of designing, adopting, and assessing a program that would lessen such barriers. Methods: In this randomized controlled trial (RCT), participants were consecutively selected from individuals referring to speech-therapy centers serving hearing-impaired children in the Town of Shiraz (Iran). Intervention and control groups were established using randomized block selection (35 individuals per group). The parent-based intervention was adopted in 6 training sessions, each session lasting 80 minutes. A researcher-made questionnaire was employed to investigate empowerment barriers, while children’s speech skill was assessed using the Newsha scale. Results: Data collected from 35 intervention and 33 control group members were examined. Evaluation of primary and interactional effects of "time" and "group" shows time to have a meaningful effect on "parental discord" and "empowerment barrier" variables (P<0.001). Time-group interaction also proved significant regarding effects on "difficulty working with hearing-impaired child" and "parents’ false beliefs". Compared to the control group, the intervention group shows significant improvement across all variables at studied different time periods. Not to forget the immediate effects of time and group on the "speech skill" variable, which also proved significant (P=0.001). Conclusion: The results denote the effectiveness of the parent-based intervention on mothers’ empowerment and speech improvement in children with impaired hearing

Budesonide facilitates weaning from mechanical ventilation in difficult-to-wean very severe COPD patients: Association with inflammatory mediators and cells

INTRODUCTION: Mechanical ventilatory support is life-saving therapy for patients with respiratory failure in intensive care units (ICU) but is linked to ventilator-associated pneumonia and other nosocomial infections. Interventions that improve the efficiency of weaning from mechanical ventilation may improve patient outcomes. OBJECTIVE: To determine whether inhaled budesonide decreases time-to-weaning in COPD stage 4 difficult-to-wean patients and reduces the release of pro-inflammatory cytokines in ICU patients. MATERIALS AND METHODS: We recruited 55 difficult-to-wean COPD patients (Stage 4) within the ICU of the Masih Daneshvari Hospital. Subjects were randomly assigned to receive inhaled budesonide (0.5mg/day) or placebo (normal saline). Dynamic compliance and BAL cytokines were measured. RESULTS: Budesonide significantly reduced the number of days on MV (days-to-weaning=4.6±1.6days) compared to that seen in the control group (7.2±2.7days, p=0.014). Dynamic compliance was significantly improved in the budesonide group on days 3 (p=0.018) and 5 (p=0.011) The levels of CXCL-8 and IL-6 diminished on days 3-5 after start of budesonide (p<0.05). CONCLUSION: In COPD patients on MV, nebulized budesonide was associated with reduced BAL CXCL8 and IL-6 levels and neutrophil numbers as well as an improvement in ventilatory mechanics and facilitated weaning

The unfinished agenda of communicable diseases among children and adolescents before the COVID-19 pandemic, 1990-2019: a systematic analysis of the Global Burden of Disease Study 2019

BACKGROUND: Communicable disease control has long been a focus of global health policy. There have been substantial reductions in the burden and mortality of communicable diseases among children younger than 5 years, but we know less about this burden in older children and adolescents, and it is unclear whether current programmes and policies remain aligned with targets for intervention. This knowledge is especially important for policy and programmes in the context of the COVID-19 pandemic. We aimed to use the Global Burden of Disease (GBD) Study 2019 to systematically characterise the burden of communicable diseases across childhood and adolescence. METHODS: In this systematic analysis of the GBD study from 1990 to 2019, all communicable diseases and their manifestations as modelled within GBD 2019 were included, categorised as 16 subgroups of common diseases or presentations. Data were reported for absolute count, prevalence, and incidence across measures of cause-specific mortality (deaths and years of life lost), disability (years lived with disability [YLDs]), and disease burden (disability-adjusted life-years [DALYs]) for children and adolescents aged 0-24 years. Data were reported across the Socio-demographic Index (SDI) and across time (1990-2019), and for 204 countries and territories. For HIV, we reported the mortality-to-incidence ratio (MIR) as a measure of health system performance. FINDINGS: In 2019, there were 3·0 million deaths and 30·0 million years of healthy life lost to disability (as measured by YLDs), corresponding to 288·4 million DALYs from communicable diseases among children and adolescents globally (57·3% of total communicable disease burden across all ages). Over time, there has been a shift in communicable disease burden from young children to older children and adolescents (largely driven by the considerable reductions in children younger than 5 years and slower progress elsewhere), although children younger than 5 years still accounted for most of the communicable disease burden in 2019. Disease burden and mortality were predominantly in low-SDI settings, with high and high-middle SDI settings also having an appreciable burden of communicable disease morbidity (4·0 million YLDs in 2019 alone). Three cause groups (enteric infections, lower-respiratory-tract infections, and malaria) accounted for 59·8% of the global communicable disease burden in children and adolescents, with tuberculosis and HIV both emerging as important causes during adolescence. HIV was the only cause for which disease burden increased over time, particularly in children and adolescents older than 5 years, and especially in females. Excess MIRs for HIV were observed for males aged 15-19 years in low-SDI settings. INTERPRETATION: Our analysis supports continued policy focus on enteric infections and lower-respiratory-tract infections, with orientation to children younger than 5 years in settings of low socioeconomic development. However, efforts should also be targeted to other conditions, particularly HIV, given its increased burden in older children and adolescents. Older children and adolescents also experience a large burden of communicable disease, further highlighting the need for efforts to extend beyond the first 5 years of life. Our analysis also identified substantial morbidity caused by communicable diseases affecting child and adolescent health across the world. FUNDING: The Australian National Health and Medical Research Council Centre for Research Excellence for Driving Investment in Global Adolescent Health and the Bill & Melinda Gates Foundation

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Global age-sex-specific fertility, mortality, healthy life expectancy (HALE), and population estimates in 204 countries and territories, 1950-2019 : a comprehensive demographic analysis for the Global Burden of Disease Study 2019

Background: Accurate and up-to-date assessment of demographic metrics is crucial for understanding a wide range of social, economic, and public health issues that affect populations worldwide. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 produced updated and comprehensive demographic assessments of the key indicators of fertility, mortality, migration, and population for 204 countries and territories and selected subnational locations from 1950 to 2019. Methods: 8078 country-years of vital registration and sample registration data, 938 surveys, 349 censuses, and 238 other sources were identified and used to estimate age-specific fertility. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate age-specific fertility rates for 5-year age groups between ages 15 and 49 years. With extensions to age groups 10–14 and 50–54 years, the total fertility rate (TFR) was then aggregated using the estimated age-specific fertility between ages 10 and 54 years. 7417 sources were used for under-5 mortality estimation and 7355 for adult mortality. ST-GPR was used to synthesise data sources after correction for known biases. Adult mortality was measured as the probability of death between ages 15 and 60 years based on vital registration, sample registration, and sibling histories, and was also estimated using ST-GPR. HIV-free life tables were then estimated using estimates of under-5 and adult mortality rates using a relational model life table system created for GBD, which closely tracks observed age-specific mortality rates from complete vital registration when available. Independent estimates of HIV-specific mortality generated by an epidemiological analysis of HIV prevalence surveys and antenatal clinic serosurveillance and other sources were incorporated into the estimates in countries with large epidemics. Annual and single-year age estimates of net migration and population for each country and territory were generated using a Bayesian hierarchical cohort component model that analysed estimated age-specific fertility and mortality rates along with 1250 censuses and 747 population registry years. We classified location-years into seven categories on the basis of the natural rate of increase in population (calculated by subtracting the crude death rate from the crude birth rate) and the net migration rate. We computed healthy life expectancy (HALE) using years lived with disability (YLDs) per capita, life tables, and standard demographic methods. Uncertainty was propagated throughout the demographic estimation process, including fertility, mortality, and population, with 1000 draw-level estimates produced for each metric. Findings: The global TFR decreased from 2·72 (95% uncertainty interval [UI] 2·66–2·79) in 2000 to 2·31 (2·17–2·46) in 2019. Global annual livebirths increased from 134·5 million (131·5–137·8) in 2000 to a peak of 139·6 million (133·0–146·9) in 2016. Global livebirths then declined to 135·3 million (127·2–144·1) in 2019. Of the 204 countries and territories included in this study, in 2019, 102 had a TFR lower than 2·1, which is considered a good approximation of replacement-level fertility. All countries in sub-Saharan Africa had TFRs above replacement level in 2019 and accounted for 27·1% (95% UI 26·4–27·8) of global livebirths. Global life expectancy at birth increased from 67·2 years (95% UI 66·8–67·6) in 2000 to 73·5 years (72·8–74·3) in 2019. The total number of deaths increased from 50·7 million (49·5–51·9) in 2000 to 56·5 million (53·7–59·2) in 2019. Under-5 deaths declined from 9·6 million (9·1–10·3) in 2000 to 5·0 million (4·3–6·0) in 2019. Global population increased by 25·7%, from 6·2 billion (6·0–6·3) in 2000 to 7·7 billion (7·5–8·0) in 2019. In 2019, 34 countries had negative natural rates of increase; in 17 of these, the population declined because immigration was not sufficient to counteract the negative rate of decline. Globally, HALE increased from 58·6 years (56·1–60·8) in 2000 to 63·5 years (60·8–66·1) in 2019. HALE increased in 202 of 204 countries and territories between 2000 and 2019

Addressing Climate Change Resilience in Pavements: Major Vulnerability Issues and Adaptation Measures

Climate change is the one of the greatest challenges of our time, and it poses a threat to the surrounding built and natural environments. This review paper addresses climate change resilience in pavements by considering major vulnerability issues and adaptation measures. First, a review on foundational information of climate change related to transportation infrastructure is provided to bring all transportation professionals and practitioners to the same knowledge base on climate change terminology. Such information includes sources of climate information, climate scenarios, downscaling climate data, and uncertainty in climate projection information. Relevant climate stressors to pavements are discussed in some depth, including the most significant ones, which are increases in temperature and precipitation intensity. Thus, the proposed different engineering-informed adaptation measures relevant to the climate stressors of interest were evidence-based with reference to published peer-reviewed articles and case studies. Such adaptation solutions are related to monitoring pavement key performance parameters and pavement adaptations in structural design, robust materials and mix design, along with adaptation in maintenance, regulation, and construction. Efforts to adapt pavement systems to climate change are ongoing. In addition to such research works, this study concludes that impacts of adaptation measures on pavement and environment should be incorporated in the decision-making process in planning and design. This makes it important to integrate practical adaptation strategies in design and construction standards and guides, and implement awareness and education of climate change adaptation among engineers and practitioners

Properties of WMA–foam mixes based on major mechanical tests / Šiltai maišyto asfalto mišinių, gaminamų pagal putoto bitumo technologiją (WMA-Foam), savybės remiantis pagrindiniais mechaniniais bandymais

One of the main advantages of warm mix asphalt (WMA) used as an alternative to conventional hot mix asphalt (HMA), is to reduce mixing and compaction temperatures. This laboratory study was conducted with the aim of determining physical properties of WMA mixes produced using foam bitumen technology (WMA–Foam), while applying different mixing and compaction temperatures. The effect of laboratory compaction method on mix properties was also investigated. WMA–Foam mixes were produced, adding a soft bitumen to coarse aggregate particles at the first stage, then a hard bitumen, transformed into foam bitumen using a laboratory foam making device, was directly added to aggregates at the next stage. Compaction was performed separately applying both Marshall and gyratory compactors (GC) at different temperatures. Marshall Stability and void contents of the samples were determined as two major parameters for characterizing WMA–Foam mixes. Moisture susceptibility and rutting potential of WMA–Foam samples were evaluated using indirect tensile strength (ITS) and wheel tracking tests. In addition, separate samples were prepared, in which hydrated lime powder was added as an anti-stripping agent to improve adhesion properties of the mixes. Comparing the results of WMA–Foam mixes with control HMA of the same content, resulted in mixes with similar properties of the control HMA, with appreciably lower production and compaction temperatures of the former. It was also resulted that mixes compacted with gyratory compactor were less sensitive to temperature variations than those compacted with Marshall Hammer. Santrauka Pagrindinis šiltai maišyto asfalto mišinių privalumas, lyginant su įprastiniais karštai maišyto asfalto mišiniais, yra galimybė sumažinti asfalto mišinio maišymo ir tankinimo temperatūras. Šio laboratorinio tyrimo tikslas – nustatyti šiltai maišyto asfalto mišinių, gaminamų pagal putoto bitumo technologiją (WMA-Foam), fizines savybes taikant skirtingas maišymo ir tankinimo temperatūras. Taip pat buvo tirtas skirtingų laboratorinių tankinimo metodų poreikis asfalto mišinio savybėms. WMA-Foam technologijos mišiniai gaminti pirmame etape į stambiąsias mineralines medžiagas dedant minkštąjį bitumą, o kitame etape – kietajį bitumą specialiu laboratoriniu putojimo įrenginiu pavertus putotu bitumu dedant į pirmame etape paruoštas mineralines medžiagas. Tankinta atskirai Maršalo plūktuvu ir giratoriaus presu skirtingose mišinio temperatūrose. Maršalo bandinių pastovumas ir oro tuštumų skaičius buvo nustatyti kaip du pagrindiniai WMA-Foamtechnologijos mišinius charakterizuojantys parametrai. WMA-Foam technologijos bandinių jautrumas vandeniui ir atsparumas provėžų susidarymui buvo vertinti pagal netiesioginio tempimo jėgos ir rato riedėjimo vėžės nustatymo bandymus. Keletas bandinių papildomai buvo pagaminti su gesintosiomis kalkėmis, t. y. asfalto mišinio sukibimą gerinančiu priedu. Lyginant WMA-Foam technologijos ir karštai maišyto asfalto mišinių bandymų rezultatus nustatyta, kad identiškos sudėties WMA-Foam technologijos mišinių savybės yra panašios į karštai maišyto asfalto mišinių savybes, tačiau jos pasiekiamos pastebimai žemesnėse maišymo ir tankinimo temperatūrose. Taip pat nustatyta, kad asfalto mišinio bandiniai, pagaminti giratoriaus presu, buvo ne tokie jautrūs gamybos temperatūros kitimui, lyginant su bandiniais, pagamintais Maršalo plūktuvu. Reikšminiai žodžiai: WMA-Foam technologija, karštai maišyto asfalto mišinys, mišinio sudėtis, putotas bitumas, tankinimas, jautrumas vandeniui, provėžų susidarymas, netiesioginė tempimo jėga (angl. Indirect Tensile Strength–IT