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VA-Alternative Times Vol 59-2005-KSi

UHPC has attracted the growing interest of researchers in academia, engineers in the public and private sectors, and contractors across the world due to its highly enhanced mechanical and durability properties in comparison to conventional concrete. It is generally understood that UHPC is a concrete that uses a relatively high binderratio, has a water-to-cement (w/c) ratio of 0.24 and lower, and has a compressive strength in excess of 22 ksi (150 MPa). Low matrix porosity and high particle packing density leads to significantly higher durability at a similar unit weight compared to conventional concrete. The addition of discontinuous fibers leads to significantly higher ductility and durability of the cracked matrix. Although there are many advantagesof UHPC over conventional concrete, there is currently only one commercial supplier tothe transportation infrastructure market in the United States. The commercially available product is a proprietary blend and is sold for about $2,000/yd3 ($2,600/m3). This price includes the material costs of the proprietary blend and the fiber reinforcement, as well as costs associatedwith the development and delivery of said material. Commercially available UHPC is about20 times more expensive than conventional concrete, which is about $100/yd3 ($130/m3).The proprietary nature, increased qualitycontrol, and high material costs are somefactors that have limited the wide spread useof UHPC in the U.S. infrastructure.

VA-Alternative Times Vol 59-2005-KSi


Dark Light received mostly mixed to positive reviews from critics, with an average score of 52 out of 100 on Metacritic, based on 10 reviews.[1] The New York Times described the material as "sturdier than ever", while Q called the album a "collection of irresistible pop-rock anthems".[1] Chris Ingold of musicOMH touted Dark Light as HIM's "most accessible album to date", containing "the powerful sense of identity and cohesion that has allowed the band to shamelessly rip-off all manner of classic rock moments yet always sound like themselves."[47] Rumba's Tapio Ahola gave the album five out of five stars, praising it as fulfilling the potential of the band, as well as featuring material "with more depth" than some of the group's other work.[44] Conny Schiffbauer of Rock Hard, who gave the album eight-point-five out of ten, called Dark Light a "successful album", giving praise to both the vocals and instrumentation, and likening the album to The Cult, Black Sabbath and U2.[45] Turkka Holmqvist of gave the album eight-plus out of ten, and called it "fresh" and a "positive surprise".[46] He did, however, comment on only half the album being up to par, but concluded that the album "takes the band back to the times when they were good on their own terms".[46] Vesa Sirén of Soundi described Valo's melodies as sounding even more like traditional Finnish schlager than before, and commended the arrangements as "precise" and "nuanced".[48] Sirén also felt that the second half of the album did not live up to the first, but still awarded Dark Light four stars out of five.[48]

Therapeutic inertia, sometimes referred to as clinical inertia, refers to failure to intensify therapy when treatment targets are not met. The causes of therapeutic inertia are multifactorial, occurring at the level of the practitioner, patient, and/or health care system (40). Interventions targeting therapeutic inertia have facilitated improved glycemic control and timely insulin intensification (41,42). For example, multidisciplinary teams that include nurse practitioners or pharmacists may help reduce therapeutic inertia (43,44). A fragmented health care system may contribute to therapeutic inertia and impair delivery of patient-centered care. A coordinated chronic care model, including self-management support, decision support, delivery system design, clinical information systems, and community resources and policies, promotes interaction between more empowered patients and better prepared and proactive health care teams (45). 350c69d7ab


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