Study of the asphalt pavement damage through nondestructive testing on overweight truck routes

Many highway facilities experience deterioration due to high traffic volumes and a service life that has been extended beyond facility design life. The 75th and 76th Texas Legislatures passed bills allowing trucks of gross vehicle weights (GVW) up to 125,000 lbs to routinely use a route in south Texas. Since the Texas Department of Transportation (Tx DOT) is concerned about the impact of overweight truck traffic (OTT) on its highways, there is a need to establish how the impact of this OTT on Texas roads will be incorporated into a long-term strategy for identifying and developing solutions to this problem. In this study was investigated the effects of overweight truck traffic on a permitted truck route in the city of Brownsville. This route proceeds from the Veterans International Bridge to the Port of Brownsville via US77, SH4 and SH48 (SH 4/48). The objective of this study is to establish the impact of this heavy loads on the pavement structure through nondestructive testing. The problem increased in severity due to the increased flow of trade from the Port of Brownsville to Mexico, thus the expecting deterioration on the routes is mainly along the southbound lanes K6 and K7. To accomplish this objective was conducted two nondestuctive testing as GPR and FWD test. The K6 and K7 lanes were divided on 56 and 50 FWD stations, respectively. In addition, it was taken AC core samples to be tested with frequency sweep test. All these information assisted to analyze: the route profile, layers thickness, static and dynamic backcalculated AC moduli, dynamic (complex) modulus from laboratory testing, creep compliance parameters from the laboratory testing and dynamic analysis, and corrected AC moduli by temperature using three differents equations. In addition, it was analyzed the effect of the cumulative 18-kip Equivalent Single Axle (ESAL) in both K6 and K7 lanes. The results from the first analysis provide evidence of damage in the K6 lane; however, more significant results were found in the traffic analysis. This study confirms that because of greater amount of truck traffic (OTT) travels on K6 it has lesser AC moduli than the K7 lane

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030