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The purpose of this article is to provide a viewpoint on a controversial aspect of evidence‐based medicine (EBM) and its application to clinical decision making and healthcare policy. To draw attention to the potential for using EBM as a rationalising tool, as opposed to rationalising treatment options, and to discuss how legitimacy in the decision‐making process may be secured.

A range of academic commentary and case law is reviewed. A model for the legitimacy of due process is suggested through the application of the framework for the “accountability for reasonableness”.

Provides information about sources indicating their relevance and where they can be found. Emphasises that NHS organisations and trusts need to enhance the legitimacy of due process through clinical governance.

Presents a viewpoint designed to stimulate debate, which is based on a critical evaluation of the literature as well as contemporary quality initiative issues in the context of clinical governance.

A useful source of guidance for NHS Trust decision makers, healthcare practitioners and those involved with patient support initiatives.

This paper provides an original viewpoint on a topical and important issue and develops the concept of legitimacy and decision making that is delivered by the application of legal principles through clinical governance.

Clinical guidelines from National Institute of Clinical Excellence (NICE) have been developed by a rigorous process using the highest‐level evidence base. Their objectives are to reduce the variations in clinical care and end the postcode lottery of healthcare delivery. They are backed strongly by the government's agenda, are expected to be implemented and to be monitored, and this is to be monitored by CHAI. Up until now, clinical guidelines have had a secondary status to expert witness testimony in determining the standard of care in law in medical litigation. However, guidelines from NICE may have a more influential role in determining the standard of care in law by setting the standard of expected clinical practice. Trusts need to be sensitive to this as part of their risk management strategy. Trusts should facilitate the implementation of guidelines from NICE and audit their use through the framework of clinical governance. In the rare event that a trust should decide to positively diverge from such guidelines, it should do so only through a mechanism of due process that is required in public law for the accountability of the reasonableness of such a decision.

The purpose of this paper is to provide a viewpoint on decision making in do not attempt resuscitation (DNAR) orders from the perspective of a competent patient who requests cardiopulmonary resuscitation (CPR) when their clinical prognosis is poor. This issue will be examined from the position of patient autonomy and self determination.

The literature is reviewed including academic commentary, case law and statute.

The paper finds that factors such as futility and quality of life that engage in DNAR considerations should be gauged from the patient's perspective. There is a definite argument for supporting a competent patient's positive autonomous choice for CPR. This should feature clearly within the framework of clinical governance.

Presents a viewpoint designed to stimulate debate based on a contemporary perspective of patient autonomy.

End‐of‐life care is assuming a greater importance as evidenced by an increase in reported complaints. Decisions regarding CPR need to form part of the clinical governance agenda.

This paper provides an original viewpoint on the tension between a competent positive choice for CPR against opposing medical opinion, and argues for a resolution on a principled basis to protect patients from arbitrary decision making with regard to resuscitation.

Present study focuses on scope of developing sustainable heat resistant concrete by adding steel fibre (Sf) and polypropylene fibre (PPf) along with partially replacement of ordinary portland cement (OPC) and natural fine aggregate with fly ash (FA) and granular blast furnace slag (GBFS). Replacement percentages of FA and GBFS were 40% and 50%, whereas Sf and PPf for fibre-added mixes were 1% by volume of concrete and 0.25% by weight of cement, respectively.

An experimental work had been carried out to make comparison between control mix (CM), fibre-added sustainable mix (SCMF) and fibre-added control mix (CMF) with reference to weight loss, mechanical strength (compressive, split and flexure) after exposed to room temperature (27°C) to 1000°C at the interval of 200°C for 4 h of heat curing followed by furnace cooling and then natural cooling. Furthermore, microstructural analysis was executed at 27°C, 400°C and 800°C, respectively.

Colour change and hair line cracks were started to appear at 600°C. Fibre-added control mix and sustainable mix did not exhibit any significant cracks as compared to control mix even at 1000°C. Major losses were occurred at temperature higher than 600°C, loss in compressive strength was about 70% in control mix, while 60% in fibre-added mixes. SCMF exhibited the highest retention of strength with respect to all cases of mechanical strength.

Present study is based on the slow heating condition followed by longer duration of heat curing at target temperature.

Present work can be helpful for the design engineer for assessing the fire deterioration of concrete structure existing near the fire establishment such as furnace and ovens. Building fire (high temperature for short duration) might be the further scope of work.

Concept of incorporating pozzolanic binder and calcareous fine aggregate was adopted to take the advantage pozzolanacity and fire resistivity. To the best of author’s knowledge, there is a scope for fill the research gap in this area.

One of the often-employed building constituents in the construction sector is concrete, which involves hydration of cement, leading to the generation of carbon footprints during its production. Also, massive amount of natural aggregate is illegally mined, which poses serious environmental issues along with ecological misbalance. Researchers are in continuous search of appropriate substitutes to mitigate those challenges and develop innovative concrete mix. Consequently, depletion of natural resources, the disturbances to the environmental and ecological imbalance will reduce. The purpose of this study is to develop a Portland Slag Cement based novel sustainable concrete incorporating Alccofine and Recycled Refractory Brick as fractional replacement of cement and fine aggregate, respectively and evaluate its destructive, non-destructive and microstructural properties.

M25 grade of concrete adopting 0.45 water-binder proportion, with diverse percentage of Alccofine as fractional substitution of cement and 20% of recycled refractory brick (RRB) as fine aggregate, has been cast and evaluated for diverse mechanical strength following a curing of 7, 14 and 28 days. Scanning electron microscopic analysis has been carried out to study the microstructural changes in the specimens.

Supplementary use of Alccofine enhanced normal compressive strength of sustainable concrete mix blended with Portland Slag Cement by a large amount at all levels of 7, 14 and 28 days of curing. Test results indicated development of a favourable high-strength sustainable concrete mix by substituting cement with Alccofine.

This manuscript has demonstrated the possibility of developing sustainable concrete blends by incorporating Alccofine 1203 and RRB as partial replacement of Portland Slag Cement and natural fine aggregate, respectively. The strength and potential of concrete incorporating RRB for wider and special application in adverse environmental conditions having higher thermal gradient, as RRB is a valuable waste from high temperature kiln and furnaces. Alccofine 1203 has been included in the concrete mix as an alternative to Portland Slag Cement to improve the mechanical strength properties and durability of concrete intended for adverse environmental application.

Accurate predictions of the steady-state corrosion phase and service life to achieve specific safety limits are crucial for assessing the service of reinforced concrete (RC) structures. Forecasting the service life (SL) of structures is imperative for devising maintenance and repair strategy plans. The optimization of maintenance strategies serves to prolong asset life, mitigate asset failures, minimize repair costs and enhance health and safety standards for society.

The well-known empirical conventional (traditional) approaches and machine learning (ML)-based SL prediction models were presented and compared. A comprehensive parametric study was conducted on existing models, considering real-world conditions as reported in the literature. The analysis of traditional and ML models underscored their respective limitations.

Empirical models have been developed by considering simplified assumptions and relying on factors such as corrosion rate, steel reinforcement diameter and concrete cover depth, utilizing fundamental mathematical formulas. The growth of ML in the structural domain has been identified and highlighted. The ML can capture complex relationships between input and output variables. The performance of ML in corrosion and service life evaluation has been satisfactory. The limitations of ML techniques are discussed, and its open challenges are identified, along with insights into the future direction to develop more accurate and reliable models.

To enhance the traditional modeling of service life, key areas for future research have been highlighted. These include addressing the heterogeneous properties of concrete, the permeability of concrete and incorporating the interaction between temperature and bond-slip effect, which has been overlooked in existing models. Though the performance of the ML model in service life assessment is satisfactory, models overlooked some parameters, such as the material characterization and chemical composition of individual parameters, which play a significant role. As a recommendation, further research should take these factors into account as input parameters and strive to develop models with superior predictive capabilities.

Recent deployment has revealed that ML algorithms can grasp complex relationships among key factors impacting deterioration and offer precise evaluations of remaining SL without relying on traditional models. Incorporation of more comprehensive and diverse data sources toward potential future directions in the RC structural domain can provide valuable insights to decision-makers, guiding their efforts toward the creation of even more resilient, reliable, cost-efficient and eco-friendly RC structures.

The purpose of this paper is to use the natural wastage plant product, bannana pseudostem sap (BPS) for using as fire retardant of cellulosic textile substrate. The study aims to use first time any wastage plant product for making fire retardant cellulosic textile. In this regard flame retardant functionality was imparted in cellulosic textile using BPS, an eco-friendly natural wastage product.

The extracted sap was made alkaline and applied in pre-mordanted bleached and mercerized cotton fabrics. Flame retardant properties of the control and treated fabrics were analyzed in terms of limiting oxygen index (LOI), horizontal and vertical flammability and total heat of combustion using bomb calorimeter. The thermal degradation and pyrolysis was studied using thermogravimetric analysis (TGA). The chemical composition of the control and BPS treated cellulosic fabric were analyzed by FTIR, SEM and EDX. Durability of the flame retardant functionality to soap washing had also been studied.

The study showed that the treated fabrics had good flame retardant property compared to control fabrics. The LOI value was found to increase by 1.6 times after application of BPS. As a result of this, the fabric does not catch flame. In horizontal flammability, the treated fabric showed burning with afterglow (without presence of flame) with a propagation rate of 7.5 mm/min, which is almost ten times lower than the control fabric. After application of BPS cellulosic fabric sample produced natural khaki colour. There was no significant change in other physical properties.

The application process is simple and cost-effective as no costly chemicals were used. Further advantage is that the treated fabric could also be considered as natural dyed cotton fabric. The developed khaki colour is quite attractive and stable to sun light exposure. This developed process could used in colouration and flame retardant finishing of home furnishing products such as home-window curtain, railway curtain, hospital curtain, table lamp and as a covering material of non-permanent structure like in book fair, festival, religious purpose, etc., where large quantity of textile is used and has chance of fire hazards.

BPS abundantly available in Indian as well as other countries and it is normally considered as waste material. It is eco-friendly and produced from renewable source. Therefore, the application of BPS in cotton textile for colouration and functionalization will give the advantages of value addition using natural product. Rural people will be benifited lot by applying this technology whenever it required.

This paper helps to clarify first time why and how a wastage plant product like BPS can be used for preparing fire retardant cotton cellulosic fabric.

The increasing accumulation of synthetic plastic waste in oceans and landfills, along with the depletion of non-renewable fossil-based resources, has sparked environmental concerns and prompted the search for environmentally friendly alternatives. Biodegradable plastics derived from lignocellulosic materials are emerging as substitutes for synthetic plastics, offering significant potential to reduce landfill stress and minimise environmental impacts. This study highlights a sustainable and cost-effective solution by utilising agricultural residues and invasive plant materials as carbon substrates for the production of biopolymers, particularly polyhydroxybutyrate (PHB), through microbiological processes. Locally sourced residual materials were preferred to reduce transportation costs and ensure accessibility. The selection of suitable residue streams was based on various criteria, including strength properties, cellulose content, low ash and lignin content, affordability, non-toxicity, biocompatibility, shelf-life, mechanical and physical properties, short maturation period, antibacterial properties and compatibility with global food security. Life cycle assessments confirm that PHB dramatically lowers CO₂ emissions compared to traditional plastics, while the growing use of lignocellulosic biomass in biopolymeric applications offers renewable and readily available resources. Governments worldwide are increasingly inclined to develop comprehensive bioeconomy policies and specialised bioplastics initiatives, driven by customer acceptability and the rising demand for environmentally friendly solutions. The implications of climate change, price volatility in fossil materials, and the imperative to reduce dependence on fossil resources further contribute to the desirability of biopolymers. The study involves fermentation, turbidity measurements, extraction and purification of PHB, and the manufacturing and testing of composite biopolymers using various physical, mechanical and chemical tests.

The purpose of this paper is to show the dyeing effect of banana peel on polyamide fabric by using various mordants and to reveal alternatives to metallic mordants.

The simultaneous mordanting method was used in the dyeing process.

From environmental and economical points of view, this paper studies the use of a natural waste product in textile dyeing. Assessment of domestic organic wastes will provide new possibilities for valorization of biomaterials. It is concluded that colorimetric data are affected by the amount of plant used in extraction, amount and type of mordant and pH of dye bath. Tin II chloride ensured the lightest color shades. No alternative mordants could be presented to iron II sulfate and tin II chloride, as they generated completely different color shades. Acids can be an alternative to 0.8 g/L alum mordant. Ammonium sulfate and sodium acetate also generated similar colors to alum. Ammonium sulfate can be substituted for citric acid and alum. Banana peel can be considered as a natural dye source for polyamide elastane blend fabric.

Banana peel can be suggested as a natural colorant with good wash fastness for dyeing of polyamide elastane blend fabric.

This paper aims to optimize the weighing control system and compensate weighing error for weighing control system of coal mine paste-filling weighing control system.

The process of the paste-filling weighing control system is analyzed and the mathematical model of the paste-filling material weight is established. Then, the back-propagation (BP) neural network is used to optimize the control system and compensate the weighing error.

Without the BP neural network, the weighing error of the paste-filling control system is more than 3 per cent, whereas after optimization with the BP neural network, the weighing error is less than 1 per cent. With the simulation results, it is seen that the weighing error of the paste-filling control system decreases and the accuracy of the weighing control system improves and optimizes.

The method can be further used to improve the control precision of the coal mine paste-filling system.