Search results for: participatory methods

Authors: Nurul Mazni Abdullah, Saw Kian Cheah, Raha Abdul Rahman, Qurratu 'Aini Musthafa

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Purpose: Candidemia was associated with high mortality in the critically ill patients. Early candidemia prediction is imperative for preemptive antifungal treatment. This study aimed to externally validate the candidemia risk prediction scores by Jameran et al. (2021) by identifying risk factors of acute kidney injury, renal replacement therapy, parenteral nutrition, and multifocal candida colonization. Methods: This single-center, retrospective observational study included all critically ill patients admitted to the intensive care unit (ICU) in a tertiary referral center from January 2018 to December 2023. The study evaluated the candidemia risk prediction score performance by analysing the occurrence of candidemia within the study period. Patients’ demographic characteristics, comorbidities, SOFA scores, and ICU outcomes were analyzed. Patients who were diagnosed with candidemia prior to ICU admission were excluded. Results: A total of 500 patients were analyzed with 2 dropouts due to incomplete data. Validation analysis showed that the candidemia risk prediction score has a sensitivity of 75.00% (95% CI: 59.66-86.81), specificity of 65.35% (95% CI: 60.78-69.72), positive predictive value of 17.28, and negative predictive value of 96.44. The incidence of candidemia was 8.86%, with no significant differences in demographics or comorbidities except for higher SOFA scoring in the candidemia group. The candidemia group showed significantly longer ICU, hospital LOS, and higher ICU in-hospital mortality. Conclusion: This study concluded the candidemia risk prediction score by Jameran et al. (2021) had good sensitivity and a high negative prediction value. Thus, the risk prediction score was validated for candidemia prediction in critically ill patients.

Keywords: Candidemia, intensive care, acute kidney injury, clinical prediction rule, incidence

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Authors: Choukri Lekbir, Mira Mokhtari

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Hydrogen-Materials interaction and mechanisms can be modeled at nano scale by quantum methods. In this work, the effect of hydrogen on the electronic properties of a cluster material model «nickel» has been studied by using of density functional theoretical (DFT) method. Two types of clusters are optimized: Nickel and hydrogen-nickel system. In the case of nickel clusters (n = 1-6) without presence of hydrogen, three types of electronic structures (neutral, cationic and anionic), have been optimized according to three basis sets calculations (B3LYP/LANL2DZ, PW91PW91/DGDZVP2, PBE/DGDZVP2). The comparison of binding energies and bond lengths of the three structures of nickel clusters (neutral, cationic and anionic) obtained by those basis sets, shows that the results of neutral and anionic nickel clusters are in good agreement with the experimental results. In the case of neutral and anionic nickel clusters, comparing energies and bond lengths obtained by the three bases, shows that the basis set PBE/DGDZVP2 is most suitable to experimental results. In the case of anionic nickel clusters (n = 1-6) with presence of hydrogen, the optimization of the hydrogen-nickel (anionic) structures by using of the basis set PBE/DGDZVP2, shows that the binding energies and bond lengths increase compared to those obtained in the case of anionic nickel clusters without the presence of hydrogen, that reveals the armor effect exerted by hydrogen on the electronic structure of nickel, which due to the storing of hydrogen energy within nickel clusters structures. The comparison between the bond lengths for both clusters shows the expansion effect of clusters geometry which due to hydrogen presence.

Keywords: binding energies, bond lengths, density functional theoretical, geometry optimization, hydrogen energy, nickel cluster

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Authors: C. E. Chinma, S. O. Azeez, J. C. Anuonye, O. B. Ocheme, C. M. Yakubu, S. James, E. U. Ohuoba, I. A. Baba

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There is growing interest in the use of rice bran protein in food formulation due to its hypoallergenic protein, high nutritional value and health promoting potentials. For the first time, the amino acid profile, protein digestibility, antioxidant, and functional properties of protein concentrate from some local varieties of rice bran from Nigeria were studied for possible food applications. Protein concentrates were prepared from rice bran and analysed using standard methods. Results showed that protein content of Kwandala, Yardass, Jeep, and Jamila were 69.24%, 69.97%, 68.73%, and 71.62%, respectively while total essential amino acid were 52.71, 53.03, 51.86, and 55.75g/100g protein, respectively. In vitro protein digestibility of protein concentrate from Kwandala, Yardass, Jeep and Jamila were 90.70%, 91.39%, 90.57% and 91.63% respectively. DPPH radical inhibition of protein from Kwandala, Yardass, Jeep, and Jamila were 48.15%, 48.90%, 47.56%, and 53.29%, respectively while ferric reducing ability power were 0.52, 0.55, 0.47 and 0.67mmol TE per gram, respectively. Protein concentrate from Jamila had higher onset (92.57oC) and denaturation temperature (102.13oC), and enthalpy (0.72J/g) than Jeep (91.46oC, 101.76oC, and 0.68J/g, respectively), Kwandala (90.32oC, 100.54oC and 0.57J/g, respectively), and Yardass (88.94oC, 99.45oC, and 0.51J/g, respectively). In vitro digestibility of protein from Kwandala, Yardas, Jeep, and Jamila were 90.70%, 91.39%, 90.57% and 91.63% respectively. Oil absorption capacity of Kwandala, Yardass, Jeep, and Jamila were 3.61, 3.73, 3.40, and 4.23g oil/g sample respectively, while water absorption capacity were 4.19, 4.32, 3.55 and 4.48g water/g sample, respectively. Protein concentrates had low bulk density (0.37-0.43g/ml). Protein concentrate from Jamila rice bran had the highest foam capacity (37.25%), followed by Yardass (34.20%), Kwandala (30.14%) and Jeep (28.90%). Protein concentrates showed low emulsifying and gelling capacities. In conclusion, protein concentrate prepared from these local rice bran varieties could serve as functional ingredients in food formulations and for enriching low protein foods.

Keywords: rice bran protein, amino acid profile, protein digestibility, antioxidant and functional properties

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Authors: Diab Z., Hamad A., Dixit A., Al-Rikabi M., Keshaverzi F.

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Introduction: According to the NICE guidelines, 2020Prasugrel is the recommended first line treatment in adults with acute coronary syndromes (ACS) in patients with ST-segment-elevation myocardial infarction (STEMI), defined as ST elevation or new left bundle branch block on ECG , that cardiologists intend to treat with primary percutaneous coronary intervention (PCI). The current literature suggests that this is largely due to safety and efficacy, and cost effectiveness. We wanted to do an audit to examine the adherence of the MRI hospital with guidelines in using prasugrel as first-line therapy in patients with STEMI and undergoing PPCI. AIM: To examine the adherence of the MRI hospital with guidelines in using prasugrel as first-line therapy in patients with STEMI and undergoing PPCI Methods: We looked at the patients presented to MRI during1^st of January 2022 to 28th February 2022. We included all the people who were above 18 and were brought to the hospital through the PPCI pathway and diagnosed as ACS and underwent PPCI. We excluded Patients who were brought to the hospital through the PPCI pathway and underwent coronary angiography and their diagnosis was found other than STEMI or if the outcome was death before discharge or they were above age >75 (as per guideline increase bleeding risk of prasugrel in a person aged 75 or older). Results: The total number of patients was 100. There were a total of seventy patients who had STEMI and fit the criteria for inclusion. Out of these, only 72.9% (51) were given Prasugrel as a first line. Seventeen (17) 24.3% STEMI patients were candidates for prasugrel as first-line therapy but were instead offered (clopidogrel/ticagrelor). Two 2 (2.9%) STEMI patients were not given prasugrel as first-line therapy because of C/I (CVA) or the use of anticoagulant Nine 9 (9%) of them died before discharge. Eleven 11 (11%) were above the age of 75. Ten 10 (10%) of patients had a diagnosis other than STEMI. Conclusions and recommendations: Our audit has shown the need to increase awareness amongst staff re: the first line use of Prasugrel as per NICE guidelines. We aim to arrange awareness sessions for staff and increase visibility of the guidelines for the staff to encourage them to adhere to the guideline. Further research is needed to find the optimum treatment in patients above 75.

Keywords: pasurgrel, PCI, NICE, STEMI

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Authors: Saeid Haghjoo, Ebrahim Reyhani, Fahimeh Kolahdouz

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The present study aimed to evaluate the understanding of the students in Tehran universities (Iran) about the numerical representation of the average rate of change based on the Structure of Observed Learning Outcomes (SOLO). In the present descriptive-survey research, the statistical population included undergraduate students (basic sciences and engineering) in the universities of Tehran. The samples were 604 students selected by random multi-stage clustering. The measurement tool was a task whose face and content validity was confirmed by math and mathematics education professors. Using Cronbach's Alpha criterion, the reliability coefficient of the task was obtained 0.95, which verified its reliability. The collected data were analyzed by descriptive statistics and inferential statistics (chi-squared and independent t-tests) under SPSS-24 software. According to the SOLO model in the prestructural, unistructural, and multistructural levels, basic science students had a higher percentage of understanding than that of engineering students, although the outcome was inverse at the relational level. However, there was no significant difference in the average understanding of both groups. The results indicated that students failed to have a proper understanding of the numerical representation of the average rate of change, in addition to missconceptions when using physics formulas in solving the problem. In addition, multiple solutions were derived along with their dominant methods during the qualitative analysis. The current research proposed to focus on the context problems with approximate calculations and numerical representation, using software and connection common relations between math and physics in the teaching process of teachers and professors.

Keywords: average rate of change, context problems, derivative, numerical representation, SOLO taxonomy

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Authors: Ghulamhossein Nezami

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Civilizations based in Iran, especially in the south, have always realized the all-around importance of the Persian Sea and for various reasons, have paid full attention to it. The first of these was the pre-Aryan government, Ilam in the coastal province of Sharihum and the city of Lian (now the port of Bushehr) in terms of trade, defense and religion. With the establishment of the Achaemenids on the entire plateau of Iran to the center of Persia, they created several communication routes from Parseh to the shores of the Persian Gulf, which ended in the present Bushehr province. This coastal area was extended by a road in the coastal plain to the more southern parts of the ports of Ausinze - according to Ptolemy the port of Siraf before the Sassanids - and Epstane and Hormozia in the present-day Strait of Hormuz. Meanwhile, the ancient city of Temukknana, whose new historical documents testify to its extraordinary importance in the Achaemenid period, especially Darius I of the Achaemenids, from a strategic position with the coastal areas, the coasts and on the other hand with the gamers, the political center. - Achaemenid administration, had. New archeological evidence, research, and excavations show that both the famous Achaemenid kings and courtiers paid special attention to Tamukknana. The discovery of a tomb and three Achaemenid palaces from before the reign of Cyrus to Xerxes in this region showed the importance of the strategic, security-defense and commercial position of this region, extraordinary for the Achaemenids. Therefore, the city of Temukkana in the Dashtestan region of present-day Bushehr province became an important Achaemenid center on the Persian Gulf coast and became the political-economic center of gravity of the Achaemenids and the regulator of communication networks on the Persian Gulf coast. This event showed that the Achaemenids attached importance to their economic goals and oversight of their vast territory by the Persian Gulf. Methods: Book resources and field study.

Keywords: Achaemenids, Bushehr, Persian Gulf, Tamukkana

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Authors: Bhenjamin Jordan L. Ona

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Weather modification is an act of altering weather systems that catches interest on scientific studies. Cloud seeding is a common form of weather alteration. On the same principle, tropical cyclone mitigation experiment follows the methods of cloud seeding with intensity to account for. This study will present the effects of aerosol to tropical cyclone cloud microphysics and intensity. The framework of Weather Research and Forecasting (WRF) model incorporated with Thompson aerosol-aware scheme is the prime host to support the aerosol-cloud microphysics calculations of cloud condensation nuclei (CCN) ingested into the tropical cyclones before making landfall over the Philippine coast. The coupled microphysical and radiative effects of aerosols will be analyzed using numerical data conditions of Tropical Storm Ketsana (2009), Tropical Storm Washi (2011), and Typhoon Haiyan (2013) associated with varying CCN number concentrations per simulation per typhoon: clean maritime, polluted, and very polluted having 300 cm-3, 1000 cm-3, and 2000 cm-3 aerosol number initial concentrations, respectively. Aerosol species like sulphates, sea salts, black carbon, and organic carbon will be used as cloud nuclei and mineral dust as ice nuclei (IN). To make the study as realistic as possible, investigation during the biomass burning due to forest fire in Indonesia starting October 2015 as Typhoons Mujigae/Kabayan and Koppu/Lando had been seeded with aerosol emissions mainly comprises with black carbon and organic carbon, will be considered. Emission data that will be used is from NASA's Moderate Resolution Imaging Spectroradiometer (MODIS). The physical mechanism/s of intensification or deintensification of tropical cyclones will be determined after the seeding experiment analyses.

Keywords: aerosol, CCN, IN, tropical cylone

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Authors: Darshana Rathod, Kirtikumar Rathod, Kamlesh Kumari, Abhilasha Motghare

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Background and Aims: Hypospadias is one of the common congenital anomalies in males. Various modalities are used for pain management, including caudal, penile, pudendal, ring blocks, and systemic analgesics. There has yet to be a consensus regarding the most effective and safe analgesic method for controlling pain in these children. We planned this study to determine our institute's pain management practices for hypospadias surgeries. Material and Methods: This retrospective cohort study reviewed 150 children with hypospadias undergoing surgery from January 2020 to December 2023. Data regarding the mode of pain management, postoperative opioid requirement, PACU discharge, and complications was collected from the records. Results: For postoperative pain, 33 (22%) children received caudal block, 60 (40%) penile block, and 57 (38%) were managed by intravenous analgesics. A significant difference was found in the three groups, with the IV analgesic group requiring significantly higher opioid boluses in PACU [43 (75.4%) required two boluses (p < 0.05)]. The difference in PACU discharge time among the three groups was statistically significant (p< 0.05), with IV analgesics groups having the highest (55 mins [47, 60]), the Caudal group at 35mins (30, 40), and the dorsal penile block group at 35mins (25, 40). There was no significant difference in complications like edema, meatal stenosis, urethra-cutaneous fistula, or wound dehiscence among all three groups. Conclusion: Intravenous analgesics and regional blocks like caudal and penile blocks are the common pain management modalities in our institute. The regional blocks are effective in managing pain in the postoperative period and are not significantly associated with complications.

Keywords: caudal block, hypospadias, pain management, penile block

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Authors: Ravid Yinon

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Introduction: Pelvic trauma causes high mortality, particularly among the elderly population. Pelvic injury ranges from low-energy incidents such as falls to high-energy trauma like motor vehicle accidents. The mortality rate among high-energy trauma patients is higher, as can be expected. The elderly population is more vulnerable to pelvic trauma even at low energy mechanisms due to the fragility and diminished physiological reserve of these patients. The aim of this study is to examine whether there is a higher long-term mortality in pelvic injuries in the elderly from the low-energy mechanism than those injured in high energy. Methods: A retrospective cohort study was conducted in a level 1 trauma center with injured patients aged 65 years and over with pelvic trauma. The patients were divided into two groups of low and high-energy mechanisms of injury. Multivariate analysis was conducted to characterize the differences between the groups. Results: There were 585 consecutive injured patients over the age of 65 with a documented pelvic injury who were treated at the primary trauma center between 2008-2020. The injured in the high energy group were younger (mean HE- 75.18, LE-80.73), with fewer comorbidities (mean 0.78 comorbidities at HE and 1.28 at LE), more men (52.6% at HE and 27.4% at LE), were consumed more treatments facilities such as angioembolization, ICU admission, emergency surgeries and blood products transfusion and higher mortality rate at admission (HE- 19/133, 14.28%, LE- 10/452, 2.21%) compared to the low energy group. However, in a long-term follow-up of one year after the injury, mortality in the low-energy group was significantly higher (HE- 14/114, 12.28%, LE- 155/442, 35.06%). Discussion: Although it can be expected that in the mechanism of high energy, the mortality rate in the long term would be higher, it was found that mortality at the low energy patient was higher. Apparently, low-energy pelvic injury in geriatric patients is a measure of frailty in these patients, causes injury to more frail and morbid patients, and is a predictor of mortality in this population in the long term. Conclusion: The long-term follow-up of injured elderly with pelvic trauma should be more intense, and the healthcare provider should put more emphasis on the rehabilitation of these special patient populations in an attempt to prevent long-term mortality.

Keywords: pelvic trauma, elderly trauma, high energy trauma, low energy trauma

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Authors: P. Panwalkar, K. Veravalli, R. Gwynn, M. Tofighi, R. Clement, A. Mofidi

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When operating on tibial plateau fracture especially medial tibial plateau, it has regularly been said “where do I put my thumb to reduce the fracture”. This refers to the ideal placement of the buttress device to hold the fracture till union. The aim of this study was to see if one can identify this sweet spot using a CT scan. Methods: Forty-five tibial plateau fractures with medial plateau involvement were identified and included in the study. The preoperative CT scans were analysed and the medial plateau involvement pattern was classified based on modified radiological classification by Yukata et-al of stress fracture of medial tibial plateau. The involvement of part of plateau was compared with position of buttress plate position which was classified as medial posteromedial or both. Presence and position of the buttress was compared with ability to achieve and hold the reduction of the fracture till union. Results: Thirteen fractures were type-1 fracture, 19 fractures were type-2 fracture and 13 fractures were type-3 fracture. Sixteen fractures were buttressed correctly according to the potential deformity and twenty-six fractures were not buttressed and three fractures were partly buttressed correctly. No fracture was over butressed! When the fracture was buttressed correctly the rate of the malunion was 0%. When fracture was partly buttressed 33% were anatomically united and 66% were united in the plane of buttress. When buttress was not used, 14 were malunited, one malunited in one of the two planes of deformity and eleven anatomically healed (of which 9 were non displaced!). Buttressing resulted in statistically significant lower mal-union rate (x2=7.8, p=0.0052). Conclusion: The classification based on involvement of medial condyle can identify the placement of buttress plate in the tibial plateau. The correct placement of the buttress plate results in predictably satisfactory union. There may be a correlation between injury shape of the tibial plateau and the fracture type.

Keywords: knee, tibial plateau, trauma, CT scan, surgery

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Authors: Tess Hartland, Moitree Banerjee, Sue Churchill, Antonina Pereira, Ian Tyndall, Ruth Lowry

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Background: Sexual health services and policies for middle-aged and older adults are underdeveloped, while global sexually transmitted infections in this age group are on the rise. The Interreg cross-Europe Sexual Health In Over 45s (SHIFT) project aims to increase participation in sexual health services and improve sexual health and wellbeing in people aged over 45, with an additional focus on disadvantaged groups. Methods: A two-pronged mixed-methodology is being used to develop a model for good service provision in sexual health for over 45s. (1) Following PRISMA-ScR guidelines, a scoping review is being conducted, using the databases PsychINFO, Web of Science, ERIC and PubMed. A key search strategy using terms around sexual health, good practice, over 45s and disadvantaged groups. The initial search for literature yielded 7914 results. (2) Surveys (n=1000) based on the Theory of Planned Behaviour are being administered across the UK, Belgium and Netherlands to explore current sexual health knowledge, awareness and attitudes. Expected results: It is expected that sexual health needs and potential gaps in service provision will be identified in order to inform good practice for sexual health services for the target population. Results of the scoping review are being analysed, while focus group and survey data is being gathered. Preliminary analysis of the survey data highlights barriers to access such as limited risk awareness and stigma. All data analysis will be completed by the time of the conference. Discussion: Findings will inform the development of a model to improve sexual health and wellbeing for among over 45s, a population which is often missed in sexual health policy improvement.

Keywords: adult health, disease prevention, health promotion, over 45s, sexual health

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Authors: Driouiche Ali, Karmal Ilham

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The Agadir region is characterized by a dry climate, ranging from arid attenuated by oceanic influences to hyper-arid. The water mobilized in the agricultural sector of greater Agadir is 95% of underground origin and comes from the water table of Chtouka. The rest represents the surface waters of the Youssef Ben Tachfine dam. These waters are intended for the irrigation of 26880 hectares of modern agriculture. More than 120 boreholes and wells are currently exploited. Their depth varies between 10 m and 200 m and the unit flow rates of the boreholes are 5 to 50 l/s. A drop in the level of the water table of about 1.5 m/year, on average, has been observed during the last five years. Farmers are thus called upon to improve irrigation methods. Thus, localized or drip irrigation is adopted to allow rational use of water. The importance of this irrigation system is due to the fact that water is applied directly to the root zone and its compatibility with fertilization. However, this irrigation system faces a thorny problem which is the clogging of pipes and drippers. This leads to a lack of uniformity of irrigation over time. This so-called scaling phenomenon, the consequences of which are harmful (cleaning or replacement of pipes), leads to considerable unproductive expenditure. The objective set by this work is the search for green inhibitors likely to prevent this phenomenon of scaling. This study requires a better knowledge of these waters, their physico-chemical characteristics and their scaling power. Thus, using the "LCGE" controlled degassing technique, we initially evaluated, on pure calco-carbonic water at 30°F, the scaling-inhibiting power of some available plant extracts in our region of Souss-Massa. We then carried out a comparative study of the efficacy of these green inhibitors. The action of the most effective green inhibitor on real agricultural waters was then studied.

Keywords: green inhibitors, localized irrigation, plant extracts, scaling inhibition

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Authors: Wei Zhang, Chye Kiang Heng, John Chye Fung

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Background: The world’s demographics is currently undergoing the largest wave of both rapid ageing and dramatic urbanisation in human history. As one of the most rapidly ageing countries, Singapore will see about one in four residents aged 65 years and above by 2030 in its high-rise and high-density urban environment. Research questions: To support urban seniors ageing in place and interdependence among senior residents and their informal caregivers, this study argues a community-based care model with bottom-up mutual help networks and asks how neighbourhood built-environment influences the formulation and facilitation of bottom-up mutual help networks in Singapore. Methods: Two public housing communities with different physical environment and rich age-friendly neighbourhood initiatives were chosen as the case studies. The categories, participants and places of bottom-up mutual help activities will be obtained via field observation, non-structural interviews of participants, service providers and managers of care facilities, and documents. Mapping and content analysis will be used to explore the influences of neighbourhood built-environment on the formulation and facilitation of bottom-up mutual help networks. Results and conclusions: The results showed that neighbourhood design, place programming, and place governance have a confluence on the bottom-up mutual help networks for senior residents. Significance: The outcomes of this study will provide fresh evidence for paradigm shifts of community-based care for the elderly and neighbourhood planning. In addition, the research findings will shed light on meaningful implications of urban planners and policy makers as they tackle with the issues arising from the ageing society.

Keywords: Built environment, Mutual help, Neighbourhood, Senior residents, Singapore

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Authors: Yan Wang; Mathis Stock

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The World Heritage Site of Honghe Hani rice terrace, also a marginal rural region in Southern China, is undergoing rapid change because of urbanization and heritage tourism. Influenced by out-migration and changing ways of living in the urbanization process, the place sees a tendency of losing its rice terrace landscape, traditional housings and other forms of cultural traditions. However, heritage tourism tends to keep the past, valorize them for tourism purposes and diversifies rural livelihood strategies. The place stands at this development trajectories, where the same resources are subjected to different uses by different actors. The research seeks to answer the questions of how the site is transformed and co-constructed by different institutions, practices and actors, and the how heritage tourism affects local livelihood. The research aims to describe the transformation of villages, rice terraces, and cultural traditions, analyze the place-making process, and assess the role of heritage tourism in local livelihood transition. The research uses a mixed of methods including direct observation, participant observation, interviews; collects various data of images, words, narratives, and statistics, and analyze them qualitatively and qualitatively. Theoretically, it is hoped that the research would reexamine the concept of heritage, the world heritage practice from UNESCO, reveal the conflicts it entails in development and brings more thoughts from a functional perspective on heritage in relation to rural development. Practically, it is also anticipated that the research could access the linkage between heritage tourism and local livelihood, and generate concrete suggestions on how tourism could engage locals and improve their livelihood.

Keywords: cultural landscape, Hani rice terraces, heritage tourism, livelihood strategy, place making, rural development, transformation

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Authors: David Tanujaya Kurniawan

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Background: Liver injury caused by paracetamol is marked by increased serum transaminase levels. Turmeric is a local herb that is available in large quantities and inexpensive in contradiction to its substantial benefits, including its potency to increase glutathione production and regenerate hepatocyte into normal condition. Aim: The aim of this study was to analyze the potencial treatment effect of turmeric rhizome extract to reduce serum transaminase level on paracetamol induced liver toxicity in rats. Methods: This study was a laboratory experimental research with post-test only controlled group design. A group of 24 Wistar white male rats was induced with paracetamol 360 mg/kg body weight for 10 days. The group was then separated into four groups: the first and the second was treated with 100 mg/kg body weight and 150 mg/kg body weight of turmeric rhizome extract, subsequently, the third as positive control was given 27 mg/kg body weight of lesichol, while the fourth as negative control was given CMC-Na 1%. Each of this treatment was given for seven days. At the end of the study, the blood samples were taken to measure SGOT and SGPT levels. The one-way Anova test revealed significant difference in mean of SGPT level (p=0,001). The LSD test showed significant differences of SGPT levels in both treatment groups and negative control group. However, there was no sgnificant difference between positive control and both treatment groups. Conclusion: Curcuma domestica Val. rhizome extract could not reduce SGOT level, but it reduced SGPT level significantly.

Keywords: Curcuma domestica val., SGOT, SGPT, paracetamol, liver toxicity

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Authors: M. Alsharqawi, T. Zayed, S. Abu Dabous

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To ensure safety and serviceability of bridge infrastructure, accurate condition assessment and rating methods are needed to provide basis for bridge Maintenance, Repair and Replacement (MRR) decisions. In North America, the common practices to assess condition of bridges are through visual inspection. These practices are limited to detect surface defects and external flaws. Further, the thresholds that define the severity of bridge deterioration are selected arbitrarily. The current research discusses the main deteriorations and defects identified during visual inspection and Non-Destructive Evaluation (NDE). NDE techniques are becoming popular in augmenting the visual examination during inspection to detect subsurface defects. Quality inspection data and accurate condition assessment and rating are the basis for determining appropriate MRR decisions. Thus, in this paper, a novel method for bridge condition assessment using the Quality Function Deployment (QFD) theory is utilized. The QFD model is designed to provide an integrated condition by evaluating both the surface and subsurface defects for concrete bridges. Moreover, an integrated condition rating index with four thresholds is developed based on the QFD condition assessment model and using K-means clustering technique. Twenty case studies are analyzed by applying the QFD model and implementing the developed rating index. The results from the analyzed case studies show that the proposed threshold model produces robust MRR recommendations consistent with decisions and recommendations made by bridge managers on these projects. The proposed method is expected to advance the state of the art of bridges condition assessment and rating.

Keywords: concrete bridge decks, condition assessment and rating, quality function deployment, k-means clustering technique

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Authors: Marji Umil, Miane Karyle Urolaza, Ian Winston Dale Uy, John Charle Magne Valdez, Karen Elizabeth Valdez, Ervin Charles Valencia, Cheryleen Tan-Chua

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Objective: Distraction techniques can be successful in reducing the anxiety of children during medical procedures. Dental procedures, in particular, are associated with dental anxiety which has been identified as a significant and common problem in children, however, only limited studies were conducted to address such problem. Thus, this study determined the effectiveness of computer video games on the levels of anxiety of children between 5-12 years old scheduled for tooth extraction. Methods: A pre-test post-test quasi-experimental study was conducted involving 30 randomly-assigned subjects, 15 in the experimental and 15 in the control. Subjects in the experimental group played computer video games for a maximum of 15 minutes, however, no intervention was done on the control. The modified Yale Pre-operative Anxiety Scale (m-YPAS) with a Cronbach’s alpha of 0.9 was used to assess anxiety at two different points: upon arrival in the clinic (pre-test anxiety) and 15 minutes after the first measurement (post-test anxiety). Paired t-test and ANCOVA were used to analyze the gathered data. Results: Results showed that there is a significant difference between the pre-test and post-test anxiety scores of the control group (p=0.0002) which indicates an increased anxiety. A significant difference was also noted between the pre-test and post-test anxiety scores of the experimental group (p=0.0002) which indicates decreased anxiety. Comparatively, the experimental group showed lower anxiety score (p=<0.0001) than the control. Conclusion: The use of computer video games is effective in reducing the pre-operative anxiety among children and can be an alternative non-pharmacological management in giving pre-operative care.

Keywords: play therapy, preoperative anxiety, tooth extraction, video games

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Authors: Ozan Yavuz Baytemir, Ender Cigeroglu, Gokhan Osman Ozgen

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Vibration is an important issue in the design of various components of aerospace, marine and vehicular applications. In order not to lose the components’ function and operational performance, vibration isolation design involving the optimum isolator properties selection and isolator positioning processes appear to be a critical study. Knowing the growing need for the vibration isolation system design, this paper aims to present two types of software capable of implementing modal analysis, response analysis for both random and harmonic types of excitations, static deflection analysis, Monte Carlo simulations in addition to study of parameter and location optimization for different types of isolation problem scenarios. Investigating the literature, there is no such study developing a software-based tool that is capable of implementing all those analysis, simulation and optimization studies in one platform simultaneously. In this paper, the theoretical system model is generated for a 6-DOF rigid body. The vibration isolation system of any mechanical structure is able to be optimized using hybrid method involving both global search and gradient-based methods. Defining the optimization design variables, different types of optimization scenarios are listed in detail. Being aware of the need for a user friendly vibration isolation problem solver, two types of graphical user interfaces (GUIs) are prepared and verified using a commercial finite element analysis program, Ansys Workbench 14.0. Using the analysis and optimization capabilities of those GUIs, a real application used in an air-platform is also presented as a case study at the end of the paper.

Keywords: hybrid optimization, Monte Carlo simulation, multi-degree-of-freedom system, parameter optimization, location optimization, passive vibration isolation analysis

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Authors: Maryam Kakavand, Samira Entezari, Sara Khoshjamalfekri, Raghad Mimar

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The objective of this study is 1) to compare elite female and beginner taekwondo players in terms of plantar pressure distribution, vertical ground reaction force, contact area, mean pressure, and right and left longitudinal arches, and 2) to compare preferred and non-preferred limbs among elite players. To the best of authors’ knowledge, as of yet, there is no information available about the plantar pressure distribution and arch index among taekwondo players. Material and Methods: An analytical-comparative research method is applied. Therefore seven elite athletes and eight novice athletes were selected. The emed-C50 platform was used to assess plantar pressure distribution, vertical ground reaction force, contact area, mean pressure of different areas, and planter longitudinal arch in a second step protocol. Independent t-test and dependent t-test were used at a level of 0.05 to compare the elites and beginners' right and left feet, and preferred and non-preferred limbs among elite athletes, respectively. Results: In comparing the right and left limbs of elite and beginner groups, findings indicate that there is only a significant difference in the mean pressure of the first metatarsal of the right foot. Findings also showed a significant difference in the contact area of the toes 3, 4, 5 regions between elites’ preferred and non-preferred limbs. However, no significant difference was found between the two groups’ right and left limbs and elites’ preferred and non-preferred limbs in terms of pressure distribution, vertical ground reaction force, and arch index. Conclusion: It seems that taekwondo exercises have affected pressure distribution patterns among advanced players causing some differences in their planter pressure distribution pattern when compared to that of beginners. Therefore, taekwondo exercises may be a factor contributing to asymmetry performance in preferred and non-preferred limbs.

Keywords: planter pressure, arch index, taekwondo, elite

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Authors: Adeyinka Adeniran, Omowunmi Bakare, Esther Oluwole, Florence Chieme, Temitope Durojaiye, Modupe Akinyinka, Omobola Ojo, Babatunde Olujobi, Marcus Ilesanmi, Akintunde Ogunsakin

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Introduction: Globally, COVID-19 has greatly impacted the human race physically, socially, mentally, and economically. However, healthcare workers seemed to bear the greatest impact. The study, therefore, sought to assess the impact of COVID-19 on the primary healthcare workers in Ekiti, South-west Nigeria. Methods: The study was a cross-sectional descriptive study using a quantitative data collection method of 716 primary healthcare workers in Ekiti state. Respondents were selected using an online convenience sampling method via their social media platforms. Data was collected, collated, and analyzed using SPSS version 25 software and presented as frequency tables, mean and standard deviation. Bivariate and multivariate analyses were conducted using a t-test, and the level of statistical significance was set at p<0.05. Results: Less than half (47.1%) of respondents were between 41-50 age group and a mean age of 44.4+6.4SD. A majority (89.4%) were female, and almost all (96.2%) were married. More than (90%) had ever heard of Coronavirus, and (85.8%) had to spend more money on activities of daily living such as transportation (90.1%), groceries (80.6%), assisting relations (95.8%) and sanitary measures (disinfection) at home (95.0%). COVID-19 had a huge negative impact on about (89.7%) of healthcare workers, with a mean score of 22+4.8. Conclusion: COVID-19 negatively impacted the daily living and professional duties of primary healthcare workers, which reflected their psychological, physical, social, and economic well-being. Disease outbreaks are unlikely to disappear in the near future. Hence, global proactive interventions and homegrown measures should be adopted to protect healthcare workers and save lives.

Keywords: Covid-19, health workforce, primary health care, health systems, depression

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Authors: Selvam M., Vadthya Poornachandar, Surender Singh

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These Reclaimed Asphalt Pavement (RAP) aggregates are generally dumped in the open area after the demolition of Asphalt Pavements. The utilization of RAP aggregates in cement concrete pavements may provide several socio-economic-environmental benefits and could embrace the circular economy. The cross recycling of RAP aggregates in the concrete pavement could reduce the consumption of virgin aggregates and saves the fertile land. However, the structural, as well as functional properties of RAP-concrete could be significantly lower than the conventional Pavement Quality Control (PQC) pavements. This warrants judicious selection of RAP fraction (coarse and fine aggregates) along with the accurate proportion of the same for PQC highways. Also, the selection of the RAP fraction and its proportion shall not be solely based on the mechanical properties of RAP-concrete specimens but also governed by the structural and functional behavior of the pavement system. In this study, an effort has been made to predict the optimum RAP fraction and its corresponding proportion for cement concrete pavements by considering the low-volume and high-volume roads. Initially, the effect of inclusions of RAP on the fresh and mechanical properties of concrete pavement mixes is mapped through an extensive literature survey. Almost all the studies available to date are considered for this study. Generally, Indian Roads Congress (IRC) methods are the most widely used design method in India for the analysis of concrete pavements, and the same has been considered for this study. Subsequently, fatigue damage analysis is performed to evaluate the required safe thickness of pavement slab for different fractions of RAP (coarse RAP). Consequently, the performance of RAP-concrete is predicted by employing the AASHTO-1993 model for the following distresses conditions: faulting, cracking, and smoothness. The performance prediction and total cost analysis of RAP aggregates depict that the optimum proportions of coarse RAP aggregates in the PQC mix are 35% and 50% for high volume and low volume roads, respectively.

Keywords: concrete pavement, RAP aggregate, performance prediction, pavement design

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Authors: Magdalena B. Kaziuk, Waldemar Kosiba

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Background: In the XXI century we have to deal with the epidemic of obesity which is important risk factor for the cardiovascular and kidney diseases. Lipo proteins are directly involved in the atherosclerotic process. Non-high-density lipo protein (non-HDL) began following widespread recognition of its superiority over LDL as a measurement of vascular event risk. Non-HDL includes residual risk which persists in patients after achieved recommended level of LDL. Materials and Methods: The study covered 111 patients (52 females, 59 males, age 51,91±14 years), hospitalized on the intern department. Body composition was assessed using the bioimpendance method and anthropometric measurements. Physical activity data were collected during the interview. The nutritional status and the obesity type were determined with the Waist to Height Ratio and the Waist to Hip Ratio. A function of the kidney was evaluated by calculating the estimated glomerular filtration rate (eGFR) using MDRD formula. Non-HDL was calculated as a difference between concentration of the Total and HDL cholesterol. Results: 10% of patients were found to be underweight; 23.9 % had correct body weight; 15,08 % had overweight, while the remaining group had obesity: 51,02 %. People with the android shape have higher non-HDL cholesterol versus with the gynoid shape (p=0.003). The higher was non-HDL, the lower eGFR had studied subjects (p < 0.001). Significant correlation was found between high non-HDL and incorrect dietary habits in patients avoiding eating vegetables, fruits and having low physical activity (p < 0.005). Conclusions: Android type of figure raises the residual risk of the heart disease associated with higher levels of non-HDL. Increasing physical activity in these patients reduces the level of non-HDL. Non-HDL seems to be the best predictor among all cholesterol measures for the cardiovascular events and worsening eGFR.

Keywords: obesity, non-HDL cholesterol, glomerular filtration rate, lifestyle

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Authors: Saif Obaid Alkaabi, Nabil Ayad

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Governments constantly seek to offer faster, more secure, efficient and effective services for their citizens. Recent changes and developments to communication services and technologies, mainly due the Internet, have led to immense improvements in the way governments of advanced countries carry out their interior operations Therefore, advances in e-government services have been broadly adopted and used in various developed countries, as well as being adapted to developing countries. The implementation of advances depends on the utilization of the most innovative structures of data techniques, mainly in web dependent applications, to enhance the main functions of governments. These functions, in turn, have spread to mobile and wireless techniques, generating a new advanced direction called m-government. This paper discusses a selection of available m-government applications and several business modules and frameworks in various fields. Practically, the m-government models, techniques and methods have become the improved version of e-government. M-government offers the potential for applications which will work better, providing citizens with services utilizing mobile communication and data models incorporating several government entities. Developing countries can benefit greatly from this innovation due to the fact that a large percentage of their population is young and can adapt to new technology and to the fact that mobile computing devices are more affordable. The use of models of mobile transactions encourages effective participation through the use of mobile portals by businesses, various organizations, and individual citizens. Although the application of m-government has great potential, it does have major limitations. The limitations include: the implementation of wireless networks and relative communications, the encouragement of mobile diffusion, the administration of complicated tasks concerning the protection of security (including the ability to offer privacy for information), and the management of the legal issues concerning mobile applications and the utilization of services.

Keywords: e-government, m-government, system dependability, system security, trust

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Authors: Shakhawath Hossain, Tazkia Tahsin

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Introduction/Background: Intellectual disability is a disability characterized by significant limitations both in intellectual functioning and in adaptive behavior, which covers many everyday social and practical skills. Vocational education is a multi-professional approach that is provided to individuals of working age with health-related impairments, limitations, or restrictions with work functioning and whose primary aim is to optimize work participation. Instrumental Activities of Daily Living activities to support daily life within the home and community. Like as community mobility, financial management, meal preparation, and clean-up, shopping. Material and Method: Electronic searches of Medline, PubMed, Google scholar, OT Seeker literature using the key terms of intellectual disability, vocational rehabilitation, instrumental activities of daily living and Occupational Therapy, as well as a thorough manual search for relevant literature. Results: There were 13 articles, all qualitative and quantitative, which are included in this review. All studies were mixed methods in design. To take the Occupational Therapy services, there is a significant improvement in their children's various areas like as sensory issues, cognitive abilities, perceptual skills, visual, motor planning, and group therapy. After taking the vocational and instrumental activities of daily living training children with intellectual disabilities to participate in their daily activities and work as an employee different company or organizations. Conclusion: The persons with intellectual disability are an integral part of our society who deserves social support and opportunities like other human beings. From the result section of the project papers, it is found that the significant benefits of Occupational Therapy services in the aspects of vocational and instrumental activities of daily living.

Keywords: occupational therapy, daily living activities, intellectual disabilities, instrumental ADL

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Authors: Bushra Alghamdi, Alla Alsharif, Hamzah Aljohani, Saba Kassim

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Introduction: Collaborative work has always been acknowledged as a fundamental concept in delivering oral health care. Aim: This study aimed to assess the perception and attitude of pharmacists in oral health promotion and to determine the confident levels of pharmacists in delivering advice on oral health problems. Methods: An observational cross-sectional survey, using self-administered anonymous questionnaires, was conducted between March and April 2017. The study recruited a convenience sample of registered community pharmacists who were working in local private pharmaceutical stores in the urban area of Madinah, Kingdom of Saudi Arabia (KSA). A preliminary descriptive analysis was performed. Results: Thirty-five pharmacists have completed the surveys. All participants were males, with a mean age of 35.5 ( ± 6.92) years. Eighty-six percent of the participants reported that pharmacists should have a role in oral health promotion. Eighty percent have reported adequate level of confident when giving advice on most of the common oral health problems that include; oral health related risk behaviors such as tobacco cessation (46%), bleeding gums (63%) and sensitive teeth (60%). However, higher percentages of pharmacists have reported low confident levels when giving advice in relation to specific domain of dentistry, such as lost dental fillings (57%), loose crowns (60%), trauma to teeth (40%), denture-related problems (51%) and oral cancer (6.9%). Conclusion: Community pharmacists recognized their potential role in promoting oral health in KSA. Community pharmacists had varying levels of ability and confidence to offer support for oral health. The study highlighted that inner professional collaboration between pharmacists and dental care healthcare should be enhanced.

Keywords: community, oral health, promotion, pharmacist

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Authors: Maryam Ghavam Sadri, Kimia Moiniafshari

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Objectives: Autism is a neuro-developmental disorder that has negative effects on verbal, mental and behavioral development. Studies have shown the role of a maternal dietary pattern before and during pregnancy. The relation of exerting of nutritional management programs in prevention of Autism has been approved. This review article has been made to investigate the role of nutritional management strategies before and during pregnancy in the prevention of Autism. Methods: This review study was accomplished by using the keywords related to the topic, 67 articles were found (2000-2015) and finally 20 article with criteria such as including maternal lifestyle, nutritional deficiencies and Autism prevention were selected. Results: Maternal dietary pattern and health before and during pregnancy have important roles in the incidence of Autism. Studies have suggested that high dietary fat intake and obesity can increase the risk of Autism in offspring. Maternal metabolic condition specially gestational diabetes (GDM) (p-value < 0.04) and folate deficiency (p-value = 0.04) is associated with risk of Autism. Studies have shown that folate intake in mothers with autistic children is less than mothers who have typically developing children (TYP) (p-value<0.01). As folate is an essential micronutrient for fetus mental development, consumption of average 600 mcg/day especially in P1 phase of pregnancy results in significant reduction in incidence of Autism (OR:1.53, 95%CI=0.42-0.92, p-value = 0.02). furthermore, essential fatty acid deficiency especially omega-3 fatty acid increases the rate of Autism and consumption of supplements and food sources of omega-3 can decrease the risk of Autism up to 34% (RR=1.53, 95%CI=1-2.32). Conclusion: regards to nutritional deficiency and maternal metabolic condition before and during pregnancy in prevalence of Autism, carrying out the appropriate nutritional strategies such as well-timed folate supplementation before pregnancy and healthy lifestyle adherence for prevention of metabolic syndrome (GDM) seems to help Autism prevention.

Keywords: autism, autism prevention, dietary inadequacy, maternal lifestyle

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Authors: Eman Elsebaie, A. Sedrak, R. Ziada

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Introduction: In the recent decades, heart failure (HF) has become one of the most prevalent cardio-vascular disease (CVDs), especially in the elderly and the main cause of hospitalization in Egypt cardiology departments. By 2030, the prevalence of HF is expected to increase by 25%. Total direct costs will increase to $818 billion, and the total indirect cost in terms of lost productivity is close to $275 billion. The current study was conducted to estimate the economic costs of services delivered for heart failure patients at the cardiology department in Cairo University Hospitals (CUHs). Aim: To gain an understanding of the cost of heart failure disease and its main drivers aiming to minimize associated health care costs. Subjects and Methods: Economic cost analysis study was conducted for a prospective group of all cases of HF admitted to the cardiology department in CUHs from end of March till end of April 2016 and another retrospective randomized sample from patients with HF, during the first 3 months of 2016 to measure estimated average cost per patient per day. Results: The mean age of the prospective group was 48.6 ± 17.16 years versus 52.3 ± 11.5 years for the retrospective group. The median (IQR) of Length of stay was 15 (15) days in the prospective group versus 9 (16) days in the retrospective group. The average HF inpatient cost/day in the cardiology department during April 2016 was 362.32 (255.5) L.E. versus 391.2(255.9) L.E. during January and February 2016. Conclusion: Up to 70% of expenditure in the management of HF is related to hospital admission. The average cost of such an admission was 5540.03 (IQR=7507.8) L.E. and 4687.4 (IQR=7818.8) L.E. with the average cost per day estimated at 362.32 (IQR=255.5) L.E. and 386.2(IQR=255.9) L.E. in prospective and retrospective groups respectively.

Keywords: health care cost, heart failure, hospitalization, inpatient

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Authors: Sunday Oladele, Joseph Oluwagbeja Simeon

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Subsurface exploration, integrating methods of geotechnics and geophysics, of a planned construction site in the coastal city of Lagos, Nigeria has been carried out with the aim of characterizing the soil properties and their implication for the proposed infrastructural development. Six Standard Penetration Tests (SPT), fourteen Dutch Cone Penetrometer Tests (DCPT) and 2D Electrical Resistivity Imaging employing Dipole-dipole and Pole-dipole arrays were implemented on the site. The topsoil (0 - 4m) consists of highly compacted sandy lateritic clay(10 to 5595Ωm) to 1.25m in some parts and dense sand in other parts to 5.50m depth. This topsoil was characterized as a material of very high shear strength (≤ 150kg/m2) and allowable bearing pressure value of 54kN/m2 to 85kN/m2 and a safety factor of 2.5. Soft amorphous peat/peaty clay (0.1 to 11.4Ωm), 3-6m thick, underlays the lateritic clay to about 18m depth. Grey, medium dense to very dense sand (0.37 to 2387Ωm) with occasional gravels underlies the peaty clay down to 30m depth. Within this layer, the freshwater bearing zones are characterized by high resistivity response (83 to 2387Ωm), while the clayey sand/saline water intruded sand produced subdued resistivity output (0.37 to 40Ωm). The overall ground-bearing pressure for the proposed structure would be 225kN/m2. Bored/cast-in-place pile at 18.00m depth with any of these diameters and respective safe working loads 600mm/1,140KN, 800mm/2,010KN and 1000mm/3,150KN is recommended for the proposed multi-story structure.

Keywords: subsurface exploration, Geotechnical properties, resistivity imaging, pile

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Authors: Mehak Nagpal, T. S. Sathyanarayan Rao

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Background: Sexual functioning is a neglected aspect of health in women with diabetes, though it contributes greatly towards quality of life and feeling of wellbeing. Also women with DM are at higher risk than men of developing sexual dysfunction and depression. Materials and Methods: Cross-sectional comparison study. Sample size: 100 previously diagnosed type 2DM patients attending Outpatient Diabetic Clinic at Medicine department JSS Hospital Mysore; aged 20-65 years and 60 normal healthy female subjects for Control group. Data was collected with ethical approval over a period of 2 years. Tools Used: 1) Hamilton Depression Rating Scale (HAMD – 17 item) 2) Female Sexual Functioning Index (FSFI) 3) Arizona Sexual Experience Scale (ASEX-F) for female-for screening. 4) The Appraisal of Diabetes Scale (ADS). Results: Statistically significant differences were observed in prevalence rate and severity of depression between diabetic group (45% vs 11% syndromal depression) and controls. Depression scores correlated significantly with glycaemic control, adherence to treatment, BMI and the cognitive appraisal of diabetes. There was significantly greater impairment in the sexual functioning of women with type 2 diabetes mellitus as compared to controls; both prevalence (62% vs 38.3%) and severity (p value < 0.01). Arousal (74.2% vs 53.3%), Desire (76.3% vs 50%) and Satisfaction (76.7% vs 63.7%) were most affected and 64.5% were affected in 2 or more domains. A negative illness appraisal on ADS correlated significantly with poor glycaemic control, higher rates of depression and also more severe female sexual dysfunction (p value < 0.05). Conclusion: Diabetes specific factors that correlated significantly with FSD in this study included the psychological appraisal of diabetes, duration of diabetes, presence of complications and BMI.

Keywords: depression, female sexual dysfunction, India, type 2 diabetes mellitus

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Authors: Tao Yang, Yongli Zhao

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Low-temperature cracking is one of the major challenges for asphalt pavement in the cold region. Fracture energy could determine from various test methods, which is a commonly used parameter to evaluate the low-temperature cracking resistance of asphalt mixture. However, the feasibility of evaluating the low-temperature cracking performance of asphalt mixture using fracture energy is not investigated comprehensively. This paper aims to verify whether fracture energy is an appropriate parameter to evaluate the low-temperature cracking performance. To achieve this goal, this paper compared the test results of thermal stress restrained specimen test (TSRST) and semi-circular bending test (SCB) of asphalt mixture with different types of aggregate, TSRST and indirect tensile test (IDT) of asphalt mixture with different additives, and single-edge notched beam test (SENB) and TSRST of asphalt mixture with different asphalt. Finally, the correlation between in-suit cracking performance and fracture energy was surveyed. The experimental results showed the evaluation result of critical cracking temperature and fracture energy are not always consistent; the in-suit cracking performance is also not correlated well with fracture energy. These results indicated that it is not feasible to evaluate low-temperature performance by fracture energy. Then, the composition of fracture energy of TSRST, SCB, disk-shaped compact tension test (DCT), three-point bending test (3PB) and IDT was analyzed. The result showed: the area of thermal stress versus temperature curve is the multiple of fracture energy and could be used to represent fracture energy of TSRST, as the multiple is nearly equal among different asphalt mixtures for a specific specimen; the fracture energy, determined from TSRST, SCB, DCT, 3PB, SENB and IDT, is mainly the surface energy that forms the fracture face; fracture energy is inappropriate to evaluate the low-temperature cracking performance of asphalt mixture, as the relaxation/viscous performance is not considered; if the fracture energy was used, it is recommended to combine this parameter with an index characterizing the relaxation or creep performance of asphalt mixture.

Keywords: asphalt pavement, cold region, critical cracking temperature, fracture energy, low-temperature cracking

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