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Geotextiles and geogrids have been in use for several decades in variety of geo-structure applications including foundation of embankments, retaining walls, pavements. Geocells is one such variant in geosynthetic reinforcement of recent years, which provides a three dimensional confinement to the infihl material. Although extensive research has been carried on geocell reinforced sand, clay and layered soil subgrades, limited research has been reported on the aggregates/ballast reinforced with geocells. This paper presents the behavior of a railway sleeper subjected to monotonic loading on geocell reinforced aggregates, of size ranging from 20 to 75 mm, overlying soft clay subgrades. Series of tests were conducted in a steel test tank of dimensions 700 mm × 300 mm × 700 mm. In addition to the laboratory model tests, numerical simulations were performed using a finite difference code to predict the behavior of geocell reinforced ballast. The results from numerical simulations were compared with the experimental data. The numerical and experimental results manifested the importance that the geocell reinforcement has a significant effect on the ballast behaviour. The results depicted that the stiffness of underlying soft clay subgrade has a significant influence on the behavior of the geocell-aggregate composite material in redistributing the loading system. [ABSTRACT FROM AUTHOR]

Background Enteric fever is endemic in Nepal and its economic burden is unknown. The objective of this study was to estimate the cost of illness due to enteric fever (typhoid and paratyphoid) at selected sites in Nepal. Methods We implemented a study at 2 hospitals in Nepal to estimate the cost per case of enteric fever from the perspectives of patients, caregivers, and healthcare providers. We collected direct medical, nonmedical, and indirect costs per blood culture–confirmed case incurred by patients and their caregivers from illness onset until after enrollment and 6 weeks later. We estimated healthcare provider direct medical economic costs based on quantities and prices of resources used to diagnose and treat enteric fever, and procedure frequencies received at these facilities by enrolled patients. We collected costs in Nepalese rupees and converted them into 2018 US dollars. Results We collected patient and caregiver cost of illness information for 395 patients, with a median cost of illness per case of $59.99 (IQR, $24.04–$151.23). Median direct medical and nonmedical costs per case represented ~3.5% of annual individual labor income. From the healthcare provider perspective, the average direct medical economic cost per case was $79.80 (range, $71.54 [hospital B], $93.43 [hospital A]). Conclusions Enteric fever can impose a considerable economic burden on patients, caregivers, and health facilities in Nepal. These new estimates of enteric fever cost of illness can improve evaluation and modeling of the costs and benefits of enteric fever–prevention measures. [ABSTRACT FROM AUTHOR]

Background Typhoid fever is endemic in the urban Kathmandu Valley of Nepal; however, there have been no population-based studies of typhoid outside of this community in the past 3 decades. Whether typhoid immunization should be prioritized in periurban and rural communities has been unclear. Methods We performed population-based surveillance for enteric fever in 1 urban catchment (Kathmandu) and 1 periurban and rural catchment (Kavrepalanchok) as part of the Surveillance for Enteric Fever in Asia Project (SEAP). We recruited individuals presenting to outpatient and emergency departments at 2 study hospitals with suspected enteric fever and performed blood cultures. Additionally, we conducted a household survey in each catchment area to characterize care seeking for febrile illness. We evaluated spatial heterogeneity in febrile illness, care seeking, and enteric fever incidence. Results Between September 2016 and September 2019, we enrolled 5736 participants with suspected enteric fever at 2 study hospitals. Among these, 304 (5.3%) were culture positive for Salmonella Typhi (249 [81.9%]) or Paratyphi A (55 [18.1%]). Adjusted typhoid incidence in Kathmandu was 484 per 100 000 person-years and in Kavrepalanchok was 615 per 100 000 person-years. While all geographic areas for which estimates could be made had incidence >200 per 100 000 person-years, we observed spatial heterogeneity with up to 10-fold variation in incidence between communities. Conclusions In urban, periurban, and rural communities in and around Kathmandu, we measured a high but heterogenous incidence of typhoid. These findings provide some support for the introduction of conjugate vaccines in Nepal, including outside urban areas, alongside other measures to prevent enteric fever. [ABSTRACT FROM AUTHOR]