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The present study deals with two types of warm-mix asphalt additives [i.e., wax-based and chemical-based warm-mix asphalt (WMA)]. It involves the application of low calcium fly ash (FA) as a replacement for natural stone dust (NSD) in WMA. The FA content varied from 2% to 8% by the weight of the mix and was subjected to moisture susceptibility tests. The Marshall properties and indirect tensile strength (ITS) tests were conducted for strength evaluation, and the tensile strength ratio was evaluated per AASTHO T283. Also, cohesion resistance and rutting were evaluated for the mixes. A significant increment in strength and reduction in moisture susceptibility was observed in both methods with FA addition. The Cantabro loss and rut depth with wax-based prepared samples was less compared to chemical-based samples. The statistical analysis reported that there was a significant difference between the two techniques. [ABSTRACT FROM AUTHOR]

The purpose of this study is to examine the possibility of using Coal Mine Overburden (CMOB) material as a secondary aggregate in low volume roadways' sub-base and/or base layer. Such roads usually experience less traffic, which means that weaker materials like CMOB could be used in various layers of the road after stabilization, either alone or in combination with cement or fly ash. After 7 and 28 days of curing, samples taken from Jharkhand mines were used to assess the strength characteristics of the stabilized samples, namely Unconfined Compressive Strength (UCS) and California Bearing Ratio (CBR). The findings demonstrate that the material, which has CBR of 80% or above and UCS of 3 MPa at 6% for Cement-Treated (CT-CMOB) and Cement-Fly Ash-Treated (CFA-CMOB) samples, may be utilized successfully as a secondary aggregate in low-volume road building. The results were then validated through standard acceptance as per IRC provisions and microstructural analysis. Additionally, correlations were established between the 7 and 28-day UCS properties of CT-CMOB and CFA-CMOB samples. This information can be beneficial for pavement engineers to estimate the strength properties associated with the base and subbase layer of pavement using CMOB as a suitable alternative to conventional aggregates. [ABSTRACT FROM AUTHOR]

Due to the depletion of supplies for high-quality aggregates, it has become necessary to incorporate marginally soft materials like moorum in pavement structural layers. This study aimed to investigate the mechanical characteristics of cementitiously stabilised moorum materials (CSMM), which would be relevant during the mechanistic design of pavements. The tests includes the unconfined compressive strength, california bearing ratio in a soaked state, flexural strength, indirect tensile strength, durability and shrinkage behaviour through a comprehensive laboratory investigation procedure. In this investigation, the collected moorum sample was from Bihar, the eastern state of India. Relationships between various mechanical characteristics have been developed for pavement analyses. The properties are achieved as per standards to study the behaviour of the pavement structures. Based on the research findings, the effectiveness of the strength and shrinkage characteristics in determining the acceptability of CSMM as a road base and subbase applications have been discussed. [ABSTRACT FROM AUTHOR]

Background: Chronic pulmonary aspergillosis (CPA) is known to complicate patients with post‐tubercular lung disease. However, some evidence suggests that CPA might co‐exist in patients with newly‐diagnosed pulmonary tuberculosis (P.TB) at diagnosis and also develop during therapy. The objective of this study was to confirm the presence of CPA in newly diagnosed P.TB at baseline and at the end‐of‐TB‐therapy. Materials and Methods: This prospective longitudinal study included newly diagnosed P.TB patients, followed up at third month and end‐of‐TB‐therapy with symptom assessment, anti‐Aspergillus IgG antibody and imaging of chest for diagnosing CPA. Results: We recruited 255 patients at baseline out of which 158 (62%) completed their follow‐up. Anti‐Aspergillus IgG was positive in 11.1% at baseline and 27.8% at end‐of‐TB‐therapy. Overall, proven CPA was diagnosed in 7% at baseline and 14.5% at the end‐of‐TB‐therapy. Around 6% patients had evidence of aspergilloma in CT chest at the end‐of‐TB‐therapy. Conclusions: CPA can be present in newly diagnosed P.TB patients at diagnosis and also develop during anti‐tubercular treatment. Patients with persistent symptoms or developing new symptoms during treatment for P.TB should be evaluated for CPA. Whether patients with concomitant P.TB and CPA, while receiving antitubercular therapy, need additional antifungal therapy, needs to be evaluated in future studies. [ABSTRACT FROM AUTHOR]

A study was undertaken to analyse farmers' access to various agricultural extension service sources, their preferences and to delineate underlying determinants for their access. The study used NSSO 77th survey dataset of 14,782 households of IGP states (Bihar, Haryana, Punjab, Uttar Pradesh, West Bengal). Farmers' preferences varied, with private agencies--particularly input dealers-- emerging as the top choice, followed by traditional mass media channels and the public extension system. Utility of Cooperative model, and farmer-based organizations have not yet been fully explored for information needs. The inputs (seeds, fertilizers, plant protection) were the most sought-after information. However, in an era of changing needs, farmers should strive to acquire additional information on aspects such as marketing, climate change, and post-harvest functions. The type of information sought by the farmers, influences their preferred sources of extension services. Irrespective of the source, the degree of access diminishes with the decreasing landholding. Among the five IGP states, Haryana emerged as the champion of information access for farmers, while Bihar lagged. Multivariate probit analysis reported that the likelihood of access to agricultural information sources was positively influenced by age, gender, education, size of operational landholding, irrigated area, and sale of produce at MSP. The study suggests making the extension services for small and socio-economically marginalized farmers more inclusive. Inclusiveness of extension services is essential for sustainability because it ensures that all farmers, regardless of their landholding, gender, age, caste, etc., have access to knowledge and resources they need to adopt improved agricultural practices and thus, secure prosperous livelihoods. [ABSTRACT FROM AUTHOR]

This investigation is primarily focused on addressing the prevailing uncertainty surrounding the compressive strength of three distinct types of bricks: nanomodified; simple; and commercial. Nanomodified bricks are specifically fabricated using a minute concentration of 0.01% w/w multiwalled carbon nanotubes combined with 1% sodium hexametaphosphate. However, the utilization of both materials in a single brick is currently limited. In view of this constraint, a diligent effort was made in this study to comprehend the effects of multiwalled carbon nanotubes and sodium hexametaphosphate as additive materials for brick construction. It is important to note that the compressive strength of the bricks remains the pivotal and critical characteristic under investigation, and an exhaustive analysis was undertaken employing a probabilistic approach. The findings of the study suggest that the variability observed in the compressive strength parameters of nanomodified, simple, and commercial bricks can be explained by a normal distribution at a significance level of 5%. The calculated values for the characteristic compressive strength were determined to be 24.47, 16.47, and 14.24 N/mm2 , respectively, for the three types of bricks. Further, the regression analysis conducted to assess the relationship between brick compressive strength and the independent variables yielded a cubic fit with R2 (coefficient of determination) values of 0.984, 0.995, and 0.995 for nanomodified, simple, and commercial bricks, respectively. Consequently, the application of multiwalled carbon nanotubes in conjunction with sodium hexametaphosphate in fired clay bricks can be recommended to achieve enhanced compressive strength. [ABSTRACT FROM AUTHOR]

Background: Bronchoalveolar lavage (BAL) galactomannan (GM) is commonly used to diagnose Aspergillus‐related lung diseases. However, unlike serum GM, which is measured in undiluted blood, BAL‐GM is estimated using variable aliquots and cumulative volume of instillates during bronchoscopy. Objective: Since different studies have reported varying diagnostic accuracy and cut‐offs for BAL‐GM in CPA, we hypothesized that the total volume of instillate and ‘order/label’ of aliquots significantly affects the BAL‐GM values, which was evaluated as part of this study. Patients & Methods: We obtained 250 BAL samples from 50 patients (five from each) with suspected chronic pulmonary aspergillosis. BAL fluid was collected after instilling sequential volumes of 40 mL of normal saline each for the first four labels and a fifth label was prepared by mixing 1 mL from each of the previous labels. The GM level of each label was measured by PLATELIA™ ASPERGILLUS Ag enzyme immunoassay. This study measured the discordance, level of agreement, diagnostic characteristics (sensitivity, specificity and AUROC) and best cut‐offs for BAL‐GM in the different aliquots of lavage fluid. Results: The study population, classified into CPA (28%) and non‐CPA (72%) groups, based on ERS/ESCMID criteria (excluding BAL‐GM) were not different with respect to clinico‐radiological characteristics. The discordance of BAL‐GM positivity (using a cut‐off of >1) between the serial labels for the same patient ranged between 10% and 22%, while the discordance between classification using BAL‐GM positivity (using a cut‐off of ≥1) and clinic‐radio‐microbiological classification ranged between 18% and 30%. The level of agreement for serial labels was at best fair (<0.6 for all except one ‘label’). The AUROC for the serial samples ranged between 0.595 and 0.702, with the ‘40 mL and the ‘mix’ samples performing the best. The best BAL‐GM cut‐off also showed significant variation between serial labels of varying dilutions (Range:1.01 ‐ 4.26). Interpretation: This study highlights the variation in BAL‐GM measured and the ‘positivity’ between different ‘labels’ of aliquots of BAL, with the first aliquot and the mixed sample showing the best performances for diagnosis of CPA. Future studies should attempt to ‘standardise’ the instilled volume for BAL‐GM estimation to standardise the diagnostic yield. [ABSTRACT FROM AUTHOR]

AbstractBackgroundFor antiretroviral therapy (ART) naive human immunodeficiency virus (HIV) infected adults suffering from tuberculosis (TB), there is uncertainty about the optimal time to initiate highly active antiretroviral therapy (HAART) after starting antituberculosis treatment (ATT), in order to minimize mortality, HIV disease progression, and adverse events.MethodsIn a randomized, open label trial at All India Institute of Medical Sciences, New Delhi, India, eligible HIV positive individuals with a diagnosis of TB were randomly assigned to receive HAART after 2-4 or 8-12 weeks of starting ATT, and were followed for 12 months after HAART initiation. Participants received directly observed therapy short course (DOTS) for TB, and an antiretroviral regimen comprising stavudine or zidovudine, lamivudine, and efavirenz. Primary end points were death from any cause, and progression of HIV disease marked by failure of ART.FindingsA total of 150 patients with HIV and TB were initiated on HAART: 88 received it after 2-4 weeks (early ART) and 62 after 8-12 weeks (delayed ART) of starting ATT. There was no significant difference in mortality between the groups after the introduction of HAART. However, incidence of ART failure was 31% in delayed versus 16% in early ART arm (p = 0.045). Kaplan Meier disease progression free survival at 12 months was 79% for early versus 64% for the delayed ART arm (p = 0.05). Rates of adverse events were similar.InterpretationEarly initiation of HAART for patients with HIV and TB significantly decreases incidence of HIV disease progression and has good tolerability.Trial registrationCTRI/2011/12/002260

Abstract Background Rifampicin reduces the plasma concentrations of nevirapine in human immunodeficiency virus (HIV) and tuberculosis (TB) co-infected patients, who are administered these drugs concomitantly. We conducted a prospective interventional study to assess the efficacy of nevirapine-containing highly active antiretroviral treatment (HAART) when co-administered with rifampicin-containing antituberculosis treatment (ATT) and also measured plasma nevirapine concentrations in patients receiving such a nevirapine-containing HAART regimen. Methods 63 cases included antiretroviral treatment naïve HIV-TB co-infected patients with CD4 counts less than 200 cells/mm3 started on rifampicin-containing ATT followed by nevirapine-containing HAART. In control group we included 51 HIV patients without tuberculosis and on nevirapine-containing HAART. They were assessed for clinical and immunological response at the end of 24 and 48 weeks. Plasma nevirapine concentrations were measured at days 14, 28, 42 and 180 of starting HAART. Results 97 out of 114 (85.1%) patients were alive at the end of 48 weeks. The CD4 cell count showed a mean increase of 108 vs.113 cells/mm3 (p=0.83) at 24 weeks of HAART in cases and controls respectively. Overall, 58.73% patients in cases had viral loads of less than 400 copies/ml at the end of 48 weeks. The mean (± SD) Nevirapine concentrations of cases and control at 14, 28, 42 and 180 days were 2.19 ± 1.49 vs. 3.27 ± 4.95 (p = 0.10), 2.78 ± 1.60 vs. 3.67 ± 3.59 (p = 0.08), 3.06 ± 3.32 vs. 4.04 ± 2.55 (p = 0.10) respectively and 3.04 μg/ml (in cases). Conclusions Good immunological and clinical response can be obtained in HIV-TB co-infected patients receiving rifampicin and nevirapine concomitantly despite somewhat lower nevirapine trough concentrations. This suggests that rifampicin-containing ATT may be co administered in resource limited setting with nevirapine-containing HAART regimen without substantial reduction in antiretroviral effectiveness. Larger sample sized studies and longer follow-up are required to identify populations of individuals where the reduction in nevirapine concentration may result in lower ART response or shorter response duration.

Warm-mix asphalt (WMA) is produced at lower temperatures—about 30°C–40°C lower—than hot-mix asphalt (HMA). Huge amounts of brick dust (BD) and fly ash (FA) are generated every year throughout the world, causing an environmental hazard, and their disposal is a serious problem. In addition, the high mixing temperature of HMA production increases environmental load. This study evaluated warm mixes made using organic wax and chemical-based technologies. Two types of filler material, i.e., FA and BD, were used as binary blended fillers (BBF). Cylindrical Marshall specimens were prepared and subjected to moisture susceptibility tests for both aged and unaged conditions. The durability of these samples was tested by evaluating the tensile strength ratio using the modified Lottman test method. The cohesion resistance of the mixtures was evaluated by Cantabro loss. Furthermore, a wheel tracker test (WTT) setup was used for rutting evaluation. Results revealed that the use of BBF in mixes led to a marked increase in mechanical properties. Microstructural behavior was studied using scanning electron microscopy (SEM) images for particle-size distribution. The statistical test indicated a significant difference in stability values and rut depths. [ABSTRACT FROM AUTHOR]