P < 0.001). In the annual data GMM model, a 1% increase in private vaccine consumption per 1000 under‐5 children was associated with a 0.2% increase in private antibiotic consumption (P < 0.001). In the monthly data GMM model, private vaccine consumption was negatively associated with antibiotic consumption when 32, 34, 35, and 44–47 months had elapsed after vaccine consumption, with a positive association with lags of fewer than 18 months. These results indicate vaccine‐induced longer‐term reductions in antibiotic use in India, similar to findings of studies from other low‐ and middle‐income countries.Vaccines can reduce antibiotic use and, consequently, antimicrobial resistance by averting vaccine‐preventable and secondary infections. We estimated the associations between private vaccine and antibiotic consumption across Indian states during 2009–2017 using monthly and annual consumption data from IQVIA and employed fixed‐effects regression and the Arellano–Bond Generalized Method of Moments (GMM) model for panel data regression, which controlled for income and public sector vaccine use indicators obtained from other sources. In the annual data fixed‐effects model, a 1% increase in private vaccine consumption per 1000 under‐5 children was associated with a 0.22% increase in antibiotic consumption per 1000 people ( The link between vaccines and reductions in antibiotic use is an emerging research area. In the United States and France, studies have found a reduction in antibiotic use associated with introduction of the seven‐valent pneumococcal conjugate vaccine. To improve understanding of the relationship between vaccines and antibiotic use, we examined the associations between consumption of vaccines and antibiotics from 2009 to 2017 in the private health sector in India, which has a lower. Although most high‐income countries (HICs) have greater access to antibiotics and greater consumption of antibiotics per capita than low‐ and middle‐income countries (LMICs),Rising consumption reflects improved access to antibiotics among patients in underserved communities within India, but overuse and misuse of antibiotics in communities with greater access remains a major challenge. A recent study of urban India estimated that more than 70% of children undergoing treatment for acute diarrhea may be inappropriately prescribed antibiotics.Routine childhood vaccination could substantially reduce the burden of vaccine‐preventable diseases and secondary infections, thereby reducing both appropriate and inappropriate use of antimicrobials and, in turn, lowering AMR.The link between vaccines and reductions in antibiotic use is an emerging research area. In the United States and France, studies have found a reduction in antibiotic use associated with introduction of the seven‐valent pneumococcal conjugate vaccine (PCV).Studies of the effect of vaccination on antibiotic use in LMICs are few, and results from HICs may not be generalizable to India, where the underlying burden of infectious diseases is higher, vaccination rates are lower, out‐of‐pocket expenditure on health is high, and access to antibiotics is often unregulated.We used data on antibiotic and vaccine consumption from January 2009 to December 2017 obtained from IQVIA India.Data on antibiotics delivered by public sector healthcare providers were not included in this analysis, as nationwide records were only available for gentamicin and co‐trimoxazole,To ensure comparability across formulations and products, antibiotic consumption data  were converted to DDDs using the Anatomical Therapeutic Chemical Classification System  developed by the Collaborating Centre for Drug Statistics Methodology of the World Health Organization (WHOCC).Haemophilus influenzae type b (Hib), rotavirus, diphtheria‐tetanus‐pertussis, Streptococcus pneumoniae, typhoid, and meningococcal meningitis. We considered the total number of doses of these vaccines, which were available annually and monthly in both the HMIS and IQVIA data.Private vaccine consumption data were obtained from IQVIA based on surveys of vaccine sales in private pharmacies and facilities, and public vaccine consumption data were obtained from the Government of India Ministry of Health and Family Welfare's Health Management Information System (HMIS).Private sector vaccines account for an estimated 20% of all vaccines in India, and the remaining vaccines are delivered through the national routine childhood vaccination program known as the Universal Immunization Programme (UIP).The primary source of state‐wise population data was the Indian census population projections.Antibiotic consumption per 1000 people of all ages was calculated for each state or territory. Vaccine consumption rates were constructed per 1000 children under the age of 5 years in each state or territory.We used fixed effects panel regression analysis to quantify the association between annual vaccination and antibiotic consumption rates. To capture the effect of socioeconomic status on capacity to access medication through the private sector, we included logged state‐wise income per capita. Standard errors were clustered at the state level. Fixed effects analysis was used only for annual data, as covariate data were not available in monthly increments.P < 0.05. Additional details of the model are presented in the Supplemental Text (online only).To account for autocorrelation in antibiotic consumption, we also employed the Arellano–Bond Generalized Method of Moments (GMM) estimator, controlling for income. We evaluated the relationship between antibiotic consumption per capita and vaccination consumption per 1000 children under 5, allowing the time elapsed between vaccine and antibiotic consumption to vary, as vaccination provides long‐lasting protection against disease and existing evidence has suggested a reduction in antibiotic use in children aged 24–59 months due to vaccination.Complete data were available for 15 states and Delhi for years 2009–2012 and for 21 states and Delhi for 2013–2017 , such as pneumonia, meningitis, and measles,Most childhood vaccines provide long‐term or lifelong protection against infections. In an aggregate setting such as this study, the relationship between population‐level immunity from vaccines and the volume of antibiotic use may evolve over time. We modeled the prolonged effect by varying the number of months elapsed between vaccination and antibiotic consumption and found a negative association at higher lags. While most literature on the impact of vaccination on antibiotic use addresses this relationship over the course of a year or two, other studies have shown reductions in antibiotic use years later.Increased levels of private sector antibiotic and vaccine consumption at low numbers of lags are likely driven by increased use of health care in the short term. This is supported by our finding that income exhibits a positive association with antibiotic consumption. Cyclical associations between public sector vaccination and antibiotic consumption may reflect the impact of regularly scheduled supplementary immunization activities at various points of the year or intermittent distribution of vaccines from the national to state governments. Additionally, efforts such as Mission Indradhanush—a large‐scale supplementary immunization program for underserved areas—shifted resources across states, likely resulting in temporal clustering of public sector vaccine delivery and changes in private antibiotic consumption. The relatively poor quality of public sector vaccination data and delays in reporting vaccine distribution figures to HMIS may also influence this relationship.This analysis is novel in its use of Indian vaccine and antibiotic consumption data, and data availability posed limitations. Vaccine data were only available for 9 years, limiting the number of lagged values, which could be used in the annual Arellano–Bond GMM analysis. Data for antibiotic use in the public sector, which is estimated to represent 10% of overall antibiotic consumption,Age‐disaggregated antibiotic sales were not available in our data. As a result, we could not discern how much of the long‐term reduction in antibiotic consumption can be attributed to the prevention of VPDs among children and how much may be due to secondary protection afforded to other adults in the household. Previous research has found a direct effect of vaccination on antibiotic use in children, but the indirect effects on antibiotic consumption in adults are not well established.The potential of vaccination to reduce unnecessary antibiotic consumption relies on large‐scale investments in childhood vaccination. A large majority of children from all communities must be vaccinated to achieve the necessary threshold for herd immunity and protect susceptible individuals against these diseases.Although the benefits of vaccination have been widely studied in terms of reductions in morbidity and mortality for patients, there is little research on its effect on antibiotic use in India. Our results indicate a negative relationship between monthly lagged vaccine consumption and monthly antibiotic consumption after a period of 32 months. However, this analysis was exploratory and limited by data availability. Further research, such as cohort‐based studies of vaccination and antibiotic use in children and comparisons of antibiotic use after the rollout of new vaccines, should examine long‐term secular trends and will further refine our understanding of vaccination as a potential mitigator of antibiotic consumption in India. Furthermore, changing patterns of health care‐seeking and the role of vaccines in specific antigens, coverage levels, and population groups must be considered as inappropriate antibiotic use continues. Vaccination must be used in tandem with other approaches, such as stewardship programs, to control infections and lower antibiotic use.This work was supported by the Value of Vaccination Research Network (VoVRN) through a grant from the Bill & Melinda Gates Foundation (OPP1158136). The content is solely the responsibility of the authors and does not necessarily reflect the views of the VoVRN or the foundation.A.N., J.J., R.L., and E.K. designed the study. E.S. and E.K. conducted the analysis and wrote the first version of the manuscript. All authors interpreted the findings and critically evaluated and edited the manuscript. All authors approved the final draft for publication.The authors declare no competing interests.Table S1. Data availability by Indian State or Union Territory.Click here for additional data file.


Drift-diffusion models or DDMs are becoming a standard in the field of computational neuroscience. They extend models from signal detection theory by proposing a simple mechanistic explanation for the observed relationship between decision outcomes and reaction times (RT). In brief, they assume that decisions are triggered once the accumulated evidence in favor of a particular alternative option has reached a predefined threshold. Fitting a DDM to empirical data then allows one to interpret observed group or condition differences in terms of a change in the underlying model parameters. However, current approaches only yield reliable parameter estimates in specific situations . In addition, they become computationally unfeasible when more general DDM variants are considered . In this note, we propose a fast and efficient approach to parameter estimation that relies on fitting a “self-consistency” equation that RT fulfill under the DDM. This effectively bypasses the computational bottleneck of standard DDM parameter estimation approaches, at the cost of estimating the trial-specific neural noise variables that perturb the underlying evidence accumulation process. For the purpose of behavioral data analysis, these act as nuisance variables and render the model “overcomplete,” which is finessed using a variational Bayesian system identification scheme. However, for the purpose of neural data analysis, estimates of neural noise perturbation terms are a desirable (and unique) feature of the approach. Using numerical simulations, we show that this “overcomplete” approach matches the performance of current parameter estimation approaches for simple DDM variants, and outperforms them for more complex DDM variants. Finally, we demonstrate the added-value of the approach, when applied to a recent value-based decision making experiment. These models tie together decision outcomes and response times (RT) by assuming that decisions are triggered once the accumulated evidence in favor of a particular alternative option has reached a predefined threshold  may be systematically varied from one trial to the next. Under current applications of the DDM, this implies that some internal model variables  effectively vary over trials. Classical DDM parameter estimation approaches do not optimally handle this kind of experimental designs, because these lack the trial repetitions that would be necessary to provide empirical estimates of RT moments in each condition. In turn, alternative statistical approaches to parameter estimation have been proposed, which can exploit predictable inter-trial variations of DDM variables to fit the model to RT data . In brieself-consistency equation, which RTs necessarily fulfill under the DDM. This provides a simple and elegant way to bypassing the common computational bottleneck of existing approaches, at the cost of considering additional trial-specific nuisance model variables. These are the cumulated “neural” noise that perturbs the evidence accumulation process at the corresponding trial. Including these variables in the model makes it “overcomplete,” the identification of which is finessed with a dedicated variational Bayesian scheme. In turn, the ensuing overcomplete approach generalizes to a large class of DDM model variants, without any additional computational and/or implementational burden.This note is concerned with the issue of obtaining reliable DDM parameter estimates from concurrent trial-by-trial choice and response time data, for a broad class of DDM variants. We propose a fast and efficient approach that relies on fitting a Model Formulation and Impact of DDM Parameters section of this document, we briefly recall the derivation of the DDM, and summarize the impact of DDM parameters onto the conditional RT distributions. In A Self-Consistency Equation for DDMs and An Overcomplete Likelihood Approach to DDM Inversion sections, we derive the DDM's self-consistency equation and describe the ensuing overcomplete approach to DDM-based data analysis. In Parameter Recovery Analysis section, we perform parameter recovery analyses for standard DDM fitting procedures and the overcomplete approach. In Application to a Value-Based Decision Making Experiment section, we demonstrate the added-value of the overcomplete approach, when applied to a value-based decision making experiment. Finally, in Discussion section, we discuss our results in the context of the existing literature. In particular, we comment on the potential utility of neural noise perturbation estimates for concurrent neuroimaging data analysis.In First, let us recall the simplest form of a drift-diffusion decision model or DDM . Let The joint distribution of response times and decision outcomes depends upon the DDM parameters, which include: the drift rate n system .Under such simple DDM variant, analytical expressions exist for the first two moments of RT distributions . Higher-But let first us summarize the impact of DDM parameters. To do this, we first set model parameters to the following “default” values: One can see that increasing the initial bias accelerates decision times for “up” decisions, and decelerates decision times for “down” decisions. This is because increasing One can see that the mean and variance of decision times are maximal when the drift rate is null. This is because the probability of an early (upper or lower) bound hit decreases as One can see that increasing the standard deviation decreases the mean HT, and increases its skewness. This is, again, because increasing One can see that increasing the bound's height increases both the mean and the variance of HT, and decreases its skewness, identically for “up” and “down” decisions. Finally, increasing the threshold’s height decreases the entropy of the decision outcomes, i.e., Note that the impact of the “non-decision” time In brief, DDM parameters have distinct impacts on the sufficient statistics of response times. This means that they could, in principle, be discriminated from each other. Standard DDM fitting procedures rely on adjusting the DDM parameters so that the RT moments  match model predictions. In what follows, we refer to this as the “method of moments” see . HoweverBelow, we suggest a simple and efficient way of performing DDM parameter estimation, which applies to a broad class of DDM variants without significant additional computational burden. This follows from fitting a self-consistency equation that, under a broad class of DDM variants, response times have to obey.ith trial. Note that decision times are trivially related to cumulative perturbations because, by definition, ith trial.First, note that Information regarding the binary decision outcome From self-consistency equation of DDMs. This, however, prevents us from using Note that decision times effectively appear on both the left-hand and the right-hand side of One can see that the DDM’s self-consistency equation is valid, i.e., simulated response times almost always equate their theoretical prediction. The few  deviations that can be eyeballed on the lower-right panel of Δt cf.  is too lNow recall that recent extensions of vanilla DDMs include e.g., collapsing bounds  and/or nIf the transformation lla” DDM  when setImportantly, inverting Fitting a. Prior moments of the cumulative perturbations: the “no barrier” approximationDealing with such overcomplete likelihood function requires additional constraints on model parameters: this is easily done within a Bayesian framework. Therefore, we rely on the variational Laplace approach , which wRecall that, under the DDM framework, errors can only be due to the stochastic perturbation noise. More precisely, errors are due to those perturbations that are strong enough to deviate the system’s trajectory and make it hit the “wrong” bound . Let )=Q= see  below. TA simple moment-matching approach thus suggests to approximate the conditional distribution Note that we derived this approximation without accounting for the (only) mathematical subtlety of the DDM: namely, the fact that decision bounds formally act as “absorbing barriers” for the system . CriticaOne can see on the upper-right panel of b. Prior constraints on native DDM parameters.When fitting the DDM to empirical RT data, one thus wants to enforce the distributional constraint in • The bound’s height • The standard deviation • The non-decision time • The initial bias • In principle, the drift rate In addition, one may want to introduce the following prior constraints on the native DDM parameters:Here again, we use the set of dummy variables c. Accounting for predictable trial-by-trial RT variability.The statistical efficiency of the ensuing overcomplete approach can be evaluated by simulating RT and choice data under different settings of the DDM parameters, and then comparing estimated and simulated parameters. Below, we use such recovery analysis to compare the overcomplete approach with standard DDM fitting procedures.a prioriCritically, the above overcomplete approach can be extended to ask whether trial-by-trial variations in DDM parameters explain trial-by-trial variations in observed RT, above and beyond the impact of the random perturbation term in In what follows, we use numerical simulations to evaluate the approach’s ability to recover DDM parameters. Our parameter recovery analyses proceed as follows. First, we sample 1,000 sets of model parameters An Overcomplete Likelihood Approach to DDM Inversion (section b) above, along with standard normal priors on unmapped parameters To begin with, we will focus on “vanilla” DDMs, because they provide a fair benchmark for parameter estimation methods. In this context, we will compare the overcomplete approach with two established methods , namely:a. Vanilla DDM: recovery analysis for the full parameter set.Finally, we perform a parameter recovery analysis in the context of a generalized DDM, which includes collapsing bounds. This will serve to demonstrate the flexibility and robustness of the overcomplete approach.First, we compare the three approaches when all DDM parameters have to be estimated. This essentially serves as a reference point for the other recovery analyses. The ensuing recovery analysis is summarized in –4, two-sided F-test) and the method of moments . However, the overcomplete approach and the method of trial means yield comparable estimation errors . In addition, the overcomplete approach yields lower estimation error than the method of trial means . The reason why the methods of trial means performs worst here is that it is blind to trial-by-trial variability in the data (beyond mean RT differences between the two decision outcomes). This is not the case however, for the two other methods.Comparing We then evaluated non-identifiability issues using recovery matrices, which are summarized in c. Vanilla DDM: recovery analysis with varying drift rates.We note that fixing another DDM parameter, e.g., the noise’s standard deviation Now, accounting for predictable trial-by-trial variations in model parameters may, in principle, improve model identifiability. This is due to the fact that the net effect of each DDM parameter depends upon the setting of other parameters. Let us assume, for example, that the drift rate varies across trials according to some predictor variable . The impact of other DDM parameters will not be the same, depending on whether the drift rate is high or low. In turn, there are fewer settings of these parameters that can predict trial-by-trial variations in RT data from variations in drift rate. To test this, we re-performed the recovery analysis, this time setting the drift rate according to a varying predictor variable, which is supposed to be known. The ensuing comparison between simulated and estimated parameters is summarized in –4, two-sided F-test) or the method of trial means . Note that the latter eventually performs slightly better than the overcomplete approach . This is because the ensuing offset and slope parameters would then need to be estimated along with other native DDM parameters. In turn, this would reintroduce identifiability issues similar or worse than when the full set of parameters have to be estimated (cf. An Overcomplete Likelihood Approach to DDM Inversion section.a). This is why people then typically fix another DDM parameter, e.g., the standard deviation d. Generalized DDM: recovery analysis with collapsing bounds.We note that the gain in parameter recovery that obtains from exploiting predictable trial-by-trial variations in drift rates  does not generalize to situations where drift rates are defined in term of an affine transformation of some predictor variable . We note that, under such generalized DDM variant, no analytical solution is available to derive RT moments. Applying the method of moments or the method of trial means to such generalized DDM variant thus involves either sampling schemes or numerical solvers for the underlying Fokker-Planck equation . However–4, two-sided F-test) or the method of trial means .In brief, the overcomplete approach seems to perform as well as for non-collapsing bounds see . Expectee. Summary of recovery analyses.For the overcomplete approach, x ΔV cf. .To demonstrate the above overcomplete likelihood approach, we apply it to data acquired in the context of a value-based decision making experiment . This exPrior to the choice session, participants (n = 24) rated the likeability of 432 items belonging to three different domains . Each domain included four categories of 36 items. At that time, participants were unaware of these categories. During the choice session, subjects performed series of choices between two items, knowing that one choice in each domain would be randomly selected at the end of the experiment and that they would stay in the lab for another 15 min to enjoy their reward . Trials were blocked in a series of nine choices between items belonging to the same two categories within a same domain. The two categories were announced at the beginning of the block, such that subjects could form a prior or "default" preference . We quantified this prior preference as the difference between mean likeability ratings . In what follows, we refer to the "default" option as the choice options that belonged to the favored category. Each choice can then be described in terms of choosing between the default and the alternative option.def-Valt between the default and alternative option values . In addition, choice bias is significant at the group-level . Similarly, RT significantly decreases with absolute decision value |Vdef-Valt| , and RT bias is significant at the group-level .A simple random effect analysis based upon logistic regression shows that the probability of choosing the default option significantly increases with decision value, i.e. the difference Vdef-Valt or Vright-Vleft). It turns out that within-subject estimates of –4; –4; –4). This implies that inter-individual differences in –4) but not for the native frame . In brief, the two choice frames only differ in terms of the underlying initial bias, which is only revealed in the default/alternative frame.To interpret these results, we fitted the DDM using the above overcomplete approach, when encoding the choice either (i) in terms of default versus alternative option . This is important, because this provides further evidence in favor of the hypothesis that people's covert decision frame facilitates the default option. Note that this could not be shown using the method of moments or the method of trial means, which were not able to capture these inter-individual differences  are varied on a trial-by-trial basis. More precisely, one would need a few trial repetitions of empirical conditions  to estimate the underlying DDM parameters from the observed moments of associated RT distributions . AlternaWe note that this feature of the overcomplete approach makes it particularly suited for learning experiments, where sequential decisions are based upon beliefs that are updated on a trial-by-trial basis from systematically varying pieces of evidence. In such contexts, existing modeling studies restrict the number of DDM parameters to deal with parameter recovery issues . This isNow what are the limitations of the overcomplete approach?In brief, the overcomplete approach effectively reduces to adjusting DDM parameters such that RT become self-consistent. Interestingly, we derived the self-consistency equation without regard to the subtle dynamical degeneracies that (absorbing) bounds induce on stochastic processes . It simpFirst and foremost, the self-consistency equation cannot be used to simulate data . This restricts the utility of the approach to data analysis. Note however, that data simulations can still be performed using Let us now discuss the results of our model-based data analysis from the value-based decision making experiment . Recall At this point, we would like to discuss potential neuroscientific applications of trial-by-trial estimates of “neural” perturbation terms. Recall that the self-consistency equation makes it possible to infer these neural noise variables from response times cf.  or 9. Foconfidence reaches a bound (Finally, one may ask how generalizable the overcomplete approach is? Strictly speaking, one can evaluate the self-consistency equation under any DDM variant, as long as the mapping ible cf. 9. No suible cf. . For exa a bound . To the  a bound  and/or m a bound , for whihttps://mbb-team.github.io/VBA-toolbox/(To conclude, we note that the code that is required to perform a DDM-based data analysis under the overcomplete approach will be made available soon from the VBA academic freeware -toolbox/.


This paper presents the testing of the durability of concrete where a part of cement was replaced with ground panel cathode ray tube glass (CRT) finer than 63 µm. The percentage of cement replaced with glass is 5%, 10%, 15%, 20%, and 35%, by mass. The highest percent share of mineral admixtures in CEM II (Portland-composiste cement) cement was chosen as the top limit of replacement of cement with glass. In terms of the concrete durability, the following tests are performed: freeze-thaw resistance, freeze-thaw resistance with de-icing salts-scaling, resistance to wear according to the Böhme test, sulfate attack resistance, and resistance to penetration of water under pressure. A compressive strength test is performed, and shrinkage of concrete is monitored. In order to determine the microstructure of concrete, SEM (Scanning Electron Microscopy) and EDS (Energy Dispersive X-ray Spectroscopy) analyses were performed. The obtained research results indicate that the replacement of a part of cement with finely ground CRT glass up to 15% by mass has a positive effect on the compressive strength of concrete in terms of its increase without compromising the durability of concrete. The results obtained by experimental testing unequivocally show that concrete mixtures made with partial replacement (up to 15%) of cement with finely ground CRT glass have the same freeze-thaw resistance, resistance to freeze/thaw with de-icing salt, resistance to wear by abrasion, and resistance to sulfate attack as the reference concrete. In terms of environmental protection, the use of CRT glass as a component for making concrete is also very significant. It is well known that different waste materials are very successfully implemented in the contemporary construction industry. To date, extensive research on fly ash, blast furnace slag, and silica dust use, as well as on mineral admixtures when making concrete and concrete prefabricates, has been conducted. The potential to use waste glass, including cathode ray tube (CRT) glass, for making of new products or as an admixture to the existing ones is being intensively investigated. This kind of research intensified particularly in the period after CRT TV sets and computer monitors were replaced in the market by the advanced technology of thin film transistor (TFT) and liquid crystal display (LCD) screens. Cathode ray tube glass represents a considerable part of electronic waste (e-waste). E-waste globally increases at a far higher rate than other solid waste materials. According to the data of the United Nations University, in 2018 solely, a total of 49.8 million tons of e-waste was generated in the world, CRT comprising a considerable part of it . In thatOne possibility to use waste glass is to replace a part of the natural aggregate for concrete making ,7,8,9,102 emissions. Previous research determined that grinding the glass with a high content of amorphous silicon into a fine dust (particles finer than 100 µm) activates its pozzolanic reactivity, which is the basic precondition for its use as a supplementary cementitious material [The other option is the use of finely ground waste glass as a substitution for part of the cement, supplementary cementitious material (SCM), when making concrete. Such use of waste glass would have both economic and environmental benefits considering that cement-producing industries emit almost 7% of the total amount of global COmaterial ,20,21,22material  determinmaterial , it was material  determinmaterial  producedIn the research of the use of CRT glass as SCM, special attention is paid to the durability of such cement composites. Papers ,30,31,32Based on the review of a large number of papers, only some of which have been mentioned in the introduction, it can be concluded that only a small number of researches on the durability of concrete were performed with finely ground CRT glass. One of the goals set for this research is proving the potential use of CRT recycled glass as a partial replacement for cement in concretes, which are expected to have the same durability properties as the reference concrete. Moreover, the goal of this experimental research is to determine the ultimate percentage of replacement of cement with finely ground CRT glass, where the durability properties of concrete are at such a level to allow their practical use. In order to achieve the set goals, we conducted very extensive and comprehensive research that lasted several years. In this paper, we presented the research results referring only to the durability of concrete, and for that purpose solely, 350 concrete test specimens were made. The basic motivation for conducting this study is solving the problem of CRT glass disposal, which is a severe environmental problem that can, to a great extent, be solved by proving it can be used as a component of concrete. The importance of the study is reflected in the successfully proven potential for the use of CRT as a replacement for cement while even making certain economic gains. Namely, the practice up to date in Serbia is that the collected CRT glass is exported to other countries and the countries taking in the recycled CRT glass are paid for that.The experimental research presented in this paper is directed towards testing the durability of concrete where a part of cement is replaced by finely ground panel CRT glass. In terms of concrete durability, the following tests are conducted: freeze-thaw resistance, freeze-thaw resistance with de-icing salts-scaling, resistance to wear according to the Böhme test, sulfate attack resistance, and resistance to penetration of water under pressure. Additionally, the compressive strength is measured and the shrinkage of concrete is monitored. For the purpose of observing the concrete microstructure, SEM and EDS analyses are performed.3 and the Blaine specific area of 245 m2/kg, which is around 40% less than the cement. The particle size distribution of cement and ground CRT glass is presented in Portland cement CEM I 52.5R  is used for making the concrete mixtures, according to standard EN 197-1. Panel CRT glass is taken from the recycling center of Niš, Serbia. Large shards of CRT glass are ground using the laboratory ball mill so that the glass particles are finer than 0.063 mm. The physico-chemical composition of finely ground CRT glass and cement is presented in In the experiment three fractions of river aggregate are used . The particle size distribution of aggregate fractions is determined using the dry sieving method according to EN 933-1 and shown in slump 100–130 mm) of fresh concrete, tested according to the standard EN 12350-2. The shares of individual fractions of aggregate in the mixture are 43% (fraction 0/4 mm), 23% (fraction 4/8 mm), and 34% (fraction 8/16 mm). Reference concrete is made with 400 kg of cement and 1800 kg of three-fraction aggregate. The water/binder ratio (w/b) is constant and amounts to 0.438. Superplasticizer on the basis of polycarboxylate is used for making the concrete mixes, which reduces the amount of water. The percentage of cement replaced with CRT glass amounts to 5%, 10%, 15%, 20%, and 35%, compared to the mass of cement. The highest percent of the share of mineral admixtures in CEM II cement was chosen as the top limit of replacement of cement with glass. The markings of concrete mixtures are made corresponding to the percentage of cement replacement  is made with fine river aggregate and cement, with no addition of glass. In mortar WG1, 35% of cement is replaced by CRT glass having fineness 0.063/0.090 mm, while in mortar series WG2, 35% of cement is replaced by the ground CRT glass finer than 0.063 mm. The goal of the research is to check the alkali-silicate reactivity of CRT glass in a mortar and to investigate the effect of the fineness of glass on the intensity of ASR. Such a percentage of cement replaced with finely ground CRT glass is chosen because it is later found to be the highest percentage of cement replaced in concrete. The other reason is the assumption that the potential ASR will be more manifest if the replacement of cement is 35% in comparison to the lower percentages of replacement.Prior to the test, nine specimens of concrete in the shape of a cube having a side of 150 mm, 28 days old, are immersed in water having a temperature of +20 ± 3 °C until saturated. After that, they are exposed to 200 cycles of subsequent freezing and thawing. One cycle consists of freezing the specimens at the temperature of −20 ± 2 °C for 4 h and thawing in the water having temperature +20 ± 3 °C for 4 h. According to the standard SRPS U.M1.206 , concretThe compressive strength of the frozen specimens is tested after the completed 200th cycle, and the reduction in the compressive strength of concrete is calculated in comparison to the reference specimens cured in water to the equivalent age according to the formula:—the reduction in compressive strength of concrete after 200 cycles of freezing in %.Freeze-thaw resistance with de-icing salts-scaling is estimated by measuring the mass of the material scaled from the surface of the samples after 28 cycles of freezing and thawing. After 7, 14, and 28 cycles, visual inspection of samples is performed, scaled material is collected, its quantity measured, and replacement of the 3% solution of NaCl is performed.sc (t), caused by the shrinkage of concrete in the air, is calculated in relation to the first-initial measurement after 72 ± 0.5 h.Concrete shrinkage testing is performed according to the standard UNI 6555  on concr2SO4 until the moment of testing. The entire 5% solution of Na2SO4 in the curing vessels is replaced in a way to retain the pH value of the solution. The pH value of the Na2SO4 solution is je ~7.5, i.e., ~12.5 in the case of saturated lime water. Sulfate attack resistance of concrete series with added CRT glass is determined by comparing the compressive strength of reference samples of each series with the samples exposed to the sulfate attack after the exposure of concrete to the sulfate solution in the duration of 3, 6, and 12 months. Testing of the compressive strength was conducted according to the standard ASTM C1231-14 [Each concrete series comprises 18 samples of cylinder-shaped specimens having a diameter of 100 mm and a height of 100 mm. Half of all specimens are reference specimens that are cured in saturated lime water until the moment of testing. The other half of the specimens are, at the age of 28 days, immersed and maintained in a 5% solution of NaC1231-14 . Apart fSEM and EDS analyses are performed in order to acquire knowledge of the concrete microstructure. All concretes are observed and analyzed, but this paper displays only the samples representing the following concrete series: reference, WG15 and WG35. The age of the samples during the analysis of the microstructure is 90 days.3) and finely ground CRT glass (2.84 g/cm3) has not had a considerable impact on the change of density of fresh concrete. This can be explained by the fact that when replacing cement with 35% of glass, it constitutes only around 5% of the concrete volume and therefore cannot have a considerable impact on the variation of density. The content of entrained air in concrete mixtures ranges between 3.0% and 3.6%  in the standard SRPS U.M1.206 [U.M1.206 .Kim et al.  tested tThe highest value of penetration of water under pressure is measured in WG20 concrete, but it was only 20 mm . The serThe effect of the presence of ground CRT glass on the resistance to wear by abrasion is shown in A graphical presentation of the impact of the replacement of cement with finely ground CRT glass in concrete on the water absorption is presented in 2 (pH = 12.5) and of the samples cured in sodium-sulfate solution (pH = 7.5) at the ages of 3, 6 and 12 months. Not even after curing samples in a 5% solution of Na2SO4 for a year, has there been any variation of compressive strength higher than 10%, compared to the samples cured in calcium-hydroxide (reference samples). The highest reduction in compressive strength is determined by the reference concretes, which have no CRT glass added, and it is 10.01%. As can be seen in After the very impact of the presence of CRT glass on the compressive strength of concrete has been defined (3.2), one can observe the resistance to sulfate attack of the experimental concrete. SEM and EDS analyses were conducted on the specimens of all experimental concrete series, while in the following text, only analyses referring to pure ground CRT glass, WG15, and WG35 are presented. Microscopic observation of finely ground CRT glass a revealsOn the observed concrete samples, SEM and EDS analyses do not indicate the presence of an undesirable alkali-silicate reaction, more precisely the A-S-R gel, which is in agreement with the results of the experimental tests of this phenomenon.Replacement of a part of cement with finely ground CRT glass in the amount of 5% has a negligible impact on the compressive strength of concrete, while replacing cement with 10% and 15% of ground glass has a positive effect on the mechanical strength of concrete, as it increases it. The replacement of cement in the quantity of 20% has practically no impact on the variation of compressive strength in comparison to the reference concrete, while the replacement in the amount of 35% has a considerable effect on compressive strength by reducing it in comparison to the reference concrete (around −25%).The durability of concrete, in terms of the properties which were tested and whose results were presented in the paper, corresponds to the durability of the reference concrete up to the quantity of 15% of CRT glass replacing the cement. The concretes in which cement was replaced with glass in the amount of 20% reached the ultimate values in terms of resistance to freeze-thaw action and simultaneous action of freezing and defrosting salt. This makes their use problematic and questionable in the conditions where they undergo such influences, and their use cannot be recommended. Finally, concrete mixtures with the highest replacement of cement with CRT glass in the amount of 35% did not exhibit satisfactory durability.In general, based on the presented results of experimental research, it can be concluded that concrete composition with replacement of a part of cement with finely ground CRT glass up to the amount of 15% meets the requirements for practical use of concrete which is exposed to the aggressive impacts of the environment.A very important reason for using ground CRT glass as a cementitious material in practice is environment protection and solving the hazardous waste disposal matter. The amount of CRT glass that is still present and which is being collected by the recycling centers worldwide is remarkable and cannot be neglected. On the other hand, the production of cement concrete as the most used material in civil engineering is more than adequate to use up the entire available CRT glass as a replacement of a part of cement. Of course, it requires a certain investment, for instance, in the CRT glass mills, transport, storage, but its contribution to the protection of the environment is far more important.


The lubrication layer plays a governing role in predicting the pumpability of fresh concrete. To determine the effect of measurement methods on the characterization of the rheological properties of the lubrication layer, different measurement systems, including Sliper, tribometer, and the utilization of a mortar rheometer, were employed. The rheological properties and workability of bulk concrete were measured in parallel to investigate the correlation between them and the rheological properties of the lubrication layer. The results show that the measured values of the rheological parameters of the lubrication layer differ due to the systematic deviation between different measurement methods. The results obtained by both tribometer and mortar rheometer were well-correlated, having a linear relationship with the rheological parameters of bulk concrete. The correlation coefficient between results gained with Sliper and rheological parameters of concrete or lubrication layer determined with other methods was not high enough. Addition friction led to the large accidental error and overestimated yield stress obtained with Sliper. The workability of concrete is only suitable for characterizing the rheological properties of bulk concrete. Concrete pumping has become a common technology at present for pouring concrete during the construction of super high-rise buildings, mass concrete structures, and long-distance tunnels ,2,3. ConGenerally, when the fresh concrete is in a steady flow state through the pump pipe, a lubrication layer is formed near the pipe wall . DependiThere are some measurement methods available to measure the rheological parameters of the lubrication layer. First, a tribometer is often used to determine the rheological properties of the lubrication layer ,39,40. IIn general, the three methods for measuring the rheological properties of the lubrication layer are feasible in principle. However, the pumpability prediction models require absolute values of the rheological parameters of the lubrication layer. Due to the low value of the viscosity and yield stress for the highly flowable concrete, it is sensitive to the type of measurement system. Slight errors in the measurement can result in an inaccurate pumpability prediction of the concrete. Few studies have evaluated the three measurement methods simultaneously. The difference and stability of the results obtained by different measurement systems have not been fully understood, which is important to guide the determination of the rheological properties of the lubrication layer in actual engineering.The present study was designed to investigate the effects of different measurement systems on the rheological properties of the lubrication layer. The tribometer and Sliper test were employed to determine the yield stress and viscosity of the lubrication layer. The mortar wet-screened from the fresh concrete was also measured with a rheometer to acquire the yield stress and viscosity of the lubrication layer. Simultaneously, the workability and rheological properties of fresh concrete were investigated and compared with the lubrication layer measured using the three methods.3 and 2675 kg/m3, respectively. A commercially available polycarboxylate-based superplasticizer (PCE) with a solid content of 50% was used to adjust the workability of concrete.P∙I 42.5 Portland cement, which conforms to Chinese National Standard GB 175-2007 , was usAs shown in The fine aggregate and the cementitious materials were firstly added into a mixer and mixed for two minutes to ensure the homogeneity of the raw materials. Then half of the water was added to the mixer. After stirring for two minutes, the incorporation of the superplasticizer and the remaining water was accomplished, and the mixture was mixed for another two minutes. In the meantime, the wall of the mixer was manually scraped. Finally, the coarse aggregate was poured into the mixer and stirred for three minutes. Due to the high viscosity of the concrete, it took a long time to stir to make the concrete uniform. The workability of fresh concrete remained basically unchanged within one hour because of the retarding effect of the superplasticizer.According to the mix proportions in h1) of 70 mm and radius (iR) of 35 mm, was utilized to carry out the rheological measurement of samples. The radius (oR) of the outer cylinder was 82 mm, and the outer cylinder was ribbed to prevent the mortar from slipping. The scheme for measuring the rheological parameters of the mortar is shown in T is the torque (N·m), Ω is the angular velocity (rad/s), The constitutive mortar was obtained by screening the fresh concrete. The measurement applied was improved following the method proposed in ,27. A ViP is the pressure (Pa), Q is the flow rate (m3/s), e is the thickness of the lubrication layer (m). l = 0.5 m and d = 0.126 m were the length and diameter of the Sliper pipe, respectively. Therefore, the rheological parameters of the lubrication layer measured with Sliper could be gained according to the intercept and slope of the linear relation by fitting the pressure-flow rate data.The rheological measurement of the lubrication layer was employed with Sliper following the method proposed in ,43 at thSince the value of concrete rheological properties is required when measuring and calculating the rheological parameters of the lubrication layer with a tribometer, the rheological measurement of fresh concrete was carried out. This also helps to understand the relationship between the rheological properties of the lubrication layer and bulk concrete. The test was started ten minutes after the concrete mixing was completed, which considered the time required to screen the concrete during the mortar test. A Viskomat XL coaxial rheometer was also utilized for this rheological measurement. The distance between the inner vane and the outer cylinder was larger than four times the size of the coarse aggregate particles. The scheme for measuring the rheological parameters of the concrete was described in Simultaneously, the slump flow and V-Funnel flow time of different concrete were determined according to the Chinese national standard GB/T 50080-2016 to investigate the variation of its workability.The tribometer was used to carry out the rheological measurement of the lubrication layer ten minutes after the concrete mixing was finished. The test method applied was improved according to the scheme proposed in ,40,41. Th2) of the inner cylinder was 71 mm. The torque difference between the two experiments was the applied torque value. Since the thickness of the lubrication layer cannot be accurately measured during the test, rheological parameters of the lubrication layer were described by Equation (5):In order to eliminate the bottom effect of the cone part, rheological measurements were performed at two different filling heights. The final effective height :Therefore, the Some investigations concluded that the pressure loss during the pumping process was well correlated to the viscosity of the lubrication layer and bulk concrete, which was especially obvious for SCC and HWC . TherefoA rough linear relationship between the viscosity of bulk concrete and the viscous constant of lubrication layer measured with tribometer was determined by Kaplan et al., but the correlation coefficient was only 0.44 . In ordeThe yield stress also plays an important role in estimating the pumpability of concrete, especially at the condition of low viscosities. The yield stress of the lubrication layer investigated with different methods is displayed in Some studies have shown that the yield stress of the lubrication layer was very small and even zero, which was far lower than the yield stress of bulk concrete . HoweverThe workability of fresh concrete is often utilized as an index to evaluate its pumpability in engineering. The parameters commonly used to represent the workability of concrete are mainly the slump flow and V-Funnel flow time ,48. It iIn general, according to the formation principle of the lubrication layer, the utilization of Sliper, tribometer, and mortar rheometer are all effective methods to determine the rheological properties of the lubrication layer. Theoretically, the calculation results should be consistent when measuring the same lubrication layer. However, as mentioned above, the experimental data gained by different methods vary significantly. The absolute values of rheological parameters, including yield stress and plastic viscosity, are different, but an obvious linear correlation between different measurement results could be observed, which indicates that there is a certain systematic deviation between different measurement systems. In fact, although the principle of the various methods was correct, the distinguishing formation processes of the lubrication layer mean that the test objects were not identical. In addition, each method had unavoidable inherent defects during the experiment, which also led to the discretization of the data points, especially when measuring with Sliper.For Sliper, the effective length of the pipe was very short, and the sliding speed of the pipe was slow, especially when the viscosity of concrete was high. Thus, the bulk concrete is always in the state of plug flow during the measurement. The influence of the concrete shear on the formation of the lubrication layer is ignored. Moreover, it is found that the rubber ring in the middle of Sliper had a great effect on the experimental results. Friction occurs when the rubber ring is in close contact with the pipe, which prevents the pipe from sliding. Conversely, when the contact between the two is relatively loose, the mortar can leak from the gap because of its small particle size, resulting in additional friction during the slide of the pipe. It is conceivable that the friction caused by the existence of the rubber ring makes the predicted pressure-flow rate curve shift. As a result, the small viscosity and significantly large yield stress of the lubrication layer are obtained. The mix proportions of the concrete samples are diverse, and for the concrete with a large sand ratio, paste-aggregate ratio, or superplasticizer content, the phenomenon of paste leakage is more likely to occur. Therefore, the random error of each sample was different, which made the data points measured by Sliper more scattered. It was found that the lubricating oil on the rubber ring could reduce friction resistance. For the tribometer, one of the main causes of error was segregation. When the paste-aggregate ratio or the superplasticizers content was too high, the static segregation of concrete and the settlement of coarse aggregate happens. In the process of high-speed rotation of the tribometer, the concrete may also undergo dynamic segregation in the vertical direction. The segregation of concrete results in the heterogeneity of concrete. The torque at the bottom of the inner cylinder under different filling heights may thus be various, resulting in the deviation of the corrected torque. Moreover, when the mix proportion of concrete changes, the thickness of the lubrication layer may change accordingly. Therefore, the error in the assumed thickness of the lubrication layer could also cause deviation of the calculative results. Regardless, a full-scale pumping test is needed to verify the results of which test method is closer to the reality, but the results of different measures may all be useful through modification.(1)The viscosity of the lubrication layer obtained through the mortar rheology was the highest, while that gained by Sliper was the smallest of all the measurement systems. However, it could be found that the yield stress determined with Sliper was significantly higher than other experimental results. The linear correlation between the rheological parameters gained by different methods was more obvious between the measurement with tribometer and mortar rheometer.(2)There was a good linear relationship between the rheological parameters of the lubrication layer determined through tribometer or mortar rheometer and the rheological parameters of concrete. However, the correlation coefficient between the experimental results obtained with Sliper and rheological properties of concrete was not high enough.(3)There was a good linear relationship between the workability indicators and the rheological parameters of bulk concrete. The workability of fresh concrete might only be suitable to predict the rheological properties of bulk concrete.(4)The friction caused by the rubber ring and the leaking mortar during the Sliper measuring results in a significantly overestimated yield stress of the lubrication layer. The segregation of concrete leads to the error of experimental results obtained by the tribometer. The difference in the formation of the lubrication layer results in the systematic deviation between different methods.


Background: Differences in management and outcomes of extremely preterm infants have been reported across European countries. Implementation of standardized guidelines and interventions within existing neonatal care facilities can improve outcomes of extremely preterm infants. This study evaluated whether a multifactorial educational training (MET) course in Vienna focusing on the management of extremely preterm infants had an impact on the management of extremely preterm infants in Central-Eastern European (CEE) countries.Methods: Physicians and nurses from different hospitals in CEE countries participated in a two-day MET in Vienna, Austria with theoretical lectures, bedside teaching, and simulation trainings. In order to evaluate the benefit of the workshops, participants had to complete pre- and post-workshop questionnaires, as well as follow-up questionnaires three and twelve months after the MET.Results: 162 participants from 15 CEE countries completed the two-day MET at our department. Less invasive surfactant administration (LISA) was only used by 39% (63/162) of the participants. After the MET, 80% (122/152) were planning to introduce LISA, and 66% (101/152) were planning to introduce regular simulation training, which was statistically significantly increased three and twelve months after the MET. Thirty-six percent and 57% of the participants self-reported improved outcomes three and twelve months after the MET, respectively.Conclusion: Our standardized training in Vienna promoted the implementation of different perinatal concepts including postnatal respiratory management using LISA as well as regular simulation trainings at the participants' home departments. Moreover, our MET contributed to dissemination of guidelines, promoted best-practice, and improved self-reported outcomes. The burden of preterm birth extends globally and contributes significantly to neonatal morbidity and mortality . AdvanceVariations in outcomes between European countries may be associated with differences in maternal demographic and socioeconomic characteristics , as wellWe invited physicians and nurses from CEE countries to participate in a two-day multifactorial educational training (MET) course to discuss standardized interventions , strategies to avoid mechanical ventilation, principles of developmental care, and simulation training of neonatal emergency situations) to improve neonatal outcomes.We aimed to evaluate whether MET facilitates the implementation of LISA, a change of perinatal management, and regular simulation trainings at the participants' home departments. Furthermore, we evaluated if the MET course would result in management changes at the participants' home institution as well as improved self-reported outcomes.Between 2014 and 2018, physicians and nurses from several CEE hospitals were invited to participate in a two-day MET at the Department of Pediatrics at the Medical University of Vienna, Austria. Our MET was structured like a collaborative quality improvement workshop with the ultimate goal to share theoretical and practical knowledge on different surfactant application approaches (with a focus on LISA), delivery room management, neonatal emergencies, and postnatal management of extremely premature infants. Throughout the MET, participants attended theoretical lectures, LISA and simulation trainings, as well as bedside teaching in our neonatal intensive care unit . ParticiThe course started with state-of-the-art lectures and case presentations about delivery room and developmental care principles, including approaches to minimally invasive respiratory management, infections, and patient safety. Furthermore, “The Viennese Concept”, which represents the local approach to postnatal management of extremely premature infants, was presented. The “Viennese Concept”  includesAfter a demonstration, participants practiced the LISA technique with continuous feedback from the instructors using the PremieHal  or Paul  manikin.Participants received a lecture about the general principles of simulation trainings, human factors, crisis resource management, teamwork, and communication. Afterwards, attendees used the Paul and SimNewB  manikins to practice delivery room management including szenarios on a i) term infant with meconium aspiration syndrome and ii) mechanically ventilated preterm infant with a sudden decrease in oxygen saturation due to an occluded endotracheal tube. The scenarios were video recorded using SIMStation . After each simulation, a structured debriefing video analysis with focus on human factors including teamwork and communication was performed.Participants were guided through the department's four neonatal intensive and intermediate care units  and thus gained insight into daily clinical work and got to know the structural, logistical, and IT-solutions in our wards. Daily clinical work in Vienna and similarities as well as differences to the participant's home institutions were discussed. Furthermore, there were discussion rounds on how to implement these new ideas and concepts in NICU teams at their respective home institutions.Questionnaires were used to evaluate the benefit of our MET course. The pre-MET questionnaire included demographic data of participants, home institutional guidelines, current clinical standards as well as teamwork and communication during LISA/emergency situations in the home institution. Post-MET questionnaires assessed the participants' experience with the MET course and the individual learning effect. The follow-up questionnaires aimed to determine whether the MET course impacted the participants' approach to LISA, neonatal emergencies, teamwork, and communication, whether Viennese concepts and standards were introduced in the participants' home institution and whether the outcome and/or patient safety in the participant's home institution improved following the MET course in Vienna.P < 0.05 (two-tailed).Collected data were analyzed retrospectively and descriptively. Categorical variables are presented in absolute frequencies and percentages. McNemar's test was used to compare pre and post MET questionnaires. Data analysis was performed using SPSS statistics for Mac, version 24 . The level of significance was set at Between October 2014 and November 2018, 162 health care providers from 15 CEE countries  finishedSatisfaction with the MET was high among participants. Particularly, 95% of the participants (144/152) who completed the post-MET questionnaire reported a “very good experience”. Simulation training  and lectures/cases  were the most popular parts of the educational session, followed by demonstration of LISA .Of the 162 participants who completed the pre-MET questionnaire, 65% (105/162) reported a standardized protocol for surfactant administration in their home department. LISA was only used by 39% (63/162) of the participants, INSURE was used by 57% (93/162) and tube surfactant with mechanical ventilation and extubation when ready was reported by 50% (81/162) . While LAfter the MET, all participants who completed the post-training questionnaire (152/152) stated that they planned to implement some of the standards and concepts learned during the MET at their home institution. More specifically, 80% (122/152) were planning to introduce LISA, 66% (101/152) were planning to introduce regular simulation trainings, 70% (106/152) wanted to pay more attention on reducing stress of the preterm baby, and 49% (74/152) were prepared to focus more on better teamwork and communication . An overForty-seven of 162 (29%) participants completed the follow-up questionnaire three months after the MET. Thirty participants (19%) completed the follow-up questionnaire after twelve months. One hundred percent (47/47) and 97% (29/30) of the respondents had changed anything in their clinical management three months and twelve months after the MET, respectively. Of those participants who conducted changes, 70% after three (80% after twelve) months had paid more attention on reducing stress of the newborn, 38% (47%) had introduced regular simulation trainings, 60% (60%) had introduced new principals of developmental care, 60% (70%) had introduced LISA in their department, and 55% (53%) had focused more on teamwork and communication, 32% (47%) had introduced better heat management, 23% (27%) had implemented high-flow CPAP, and 17% (27%) had introduced standardized protocols three and twelve months after the MET, respectively .An overview of responses according to each center after the MET is provided in p = 0.013 and p = 0.021, respectively)   . In addictively) .Many participants reported difficulties with implementation of change processes in the home institution, such as shortage of physicians and nurses as main obstacle for successful change processes and reported structural difficulties as main obstacle for a change. Furthermore, some participants assumed that other physicians or nurses in their home department were reluctant to change.Thirty-six percent (17/47) and 57% (17/30) of the participants reported improved patient outcomes three and twelve months after the MET, respectively. Of all participants who reported improved outcomes, 71% (88%) observed a decrease in intubation rates and fewer days on mechanical ventilation, 52% (59%) observed fewer days on CPAP, 47% (47%) observed reduced lengths of hospital stay, 47% (41%) reported reduced days on additional oxygen, and 29% (41%) reported reduced rates of IVH and bronchopulmonary dysplasia 29 (35%) three and twelve months after the MET, respectively . In partTo our knowledge, this is the first study to examine the impact of an international MET covering postnatal respiratory management, surfactant administration, principles of developmental care, and simulation training on the change of local management at the participants home departments. Our standardized MET significantly contributed to a re-evaluation of local management including a potential implementation of LISA and regular simulation trainings at the participants home departments as stated by participants in the questionnaires three and twelve months after the MET. Moreover, participants reported that they subjectively observed improved clinical outcomes after the implementation of LISA and other concepts of the MET at their home department.In 2008, we modified a method previously described by Kribs et al.  and estaHence, we invited neonatologists from CEE countries to a standardized two-day MET in Vienna in order to share theoretical and practical experience with LISA and other delivery room concepts, with the ultimate goal to facilitate the implementation of those concepts at the participants' home departments. Neonatal networks encompassing regions and countries offer the perfect platform for implementing quality improvement projects in order to exchange local guidelines and knowledge . An actiRecent surveys revealed an increased use of LISA within European countries with a rapid growth from less than 10% in 2010 up to 52% in 2015 of all units assessed . The iniOur study has several limitations. First, the design of the study was only observational. Second, as with other surveys, responder bias could not be ruled out since answers may not be representative for the unit practices. Third, the outcomes of this study were only based on subjective questionnaires responses and the response rate of follow-up questionnaires was low and the number of responses varied between countries. We speculate that the reason for the low response rate was that we sent the follow-up questionnaires as PDF files via e-mail and asked for scanning them to send it back rather than using an online survey tool. Further, some participants were from the same center, which potentially distorted parts of our results. Consequently, we also provided data of participants according to their affiliation. Nevertheless, we presented a broad overview on the change of management after our MET course across CEE countries. Fourth, because of the study design we were not able to exclude the possibility that the improvement in outcomes was caused by other influencing factors. In addition, self-reported improvement of outcomes was only assessed by a follow-up questionnaire three and twelve months after the MET and the study was not designed to assess clinical outcomes. We are aware that self-reported observed outcomes which are not supported by actual objective data are prone to bias.Our intervention in the format of a two-day MET course, including our standardized postnatal respiratory management protocol with LISA and simulation-based trainings, promoted the implementation of different perinatal concepts including postnatal respiratory management with LISA as well as regular simulation trainings at the participants home departments. Moreover, our MET contributed to dissemination of guidelines, promoted best-practice, and improved self-reported clinical outcomes.The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.Ethical review and approval was not required for the study on human participants in accordance with the local legislation and institutional requirements. The patients/participants provided their written informed consent to participate in this study.PS, MO, GS, and MW conceptualized and designed the study, drafted the initial manuscript, and reviewed and revised the manuscript. KK-S, FC, KB, TW, and AB helped with data collection, the analysis process, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


BLM. We report the clinical and genetic details of a boy who first presented with infantile fibrosarcoma (IFS) at the age of 6 months and subsequently was diagnosed with BS at the age of 9 years. Molecular analysis identified the pathogenic germline BLM sequence variants (c.1642C>T and c.2207_2212delinsTAGATTC). This is the first report of IFS related to BS, for which we show that both BLM alleles are maintained in the tumor and demonstrate a TPM3-NTKR1 fusion transcript in the IFS. Our communication emphasizes the importance of long-term follow up after treatment for pediatric neoplastic conditions, as clues to important genetic entities might manifest later, and the identification of a heritable tumor predisposition often leads to changes in patient surveillance and management.Bloom syndrome (BS) is a genomic and chromosomal instability disorder with prodigious cancer predisposition caused by pathogenic variants in The online version of this article (10.1007/s10689-020-00221-1) contains supplementary material, which is available to authorized users. BLM gene, encoding a RecQ helicase , designated as BLM_000052. They represent patients from the Netherlands, while others locate the origin of this mutation with the effect Gln548* to Eastern Europe, being more frequent in the Slavic populations with a carrier frequency of 0.1% [BLM variant identified in Ashkenazi Jews, a 6-bp deletion/7-bp insertion in exon 10 of BLM, often (for brevity) designated blmAsh, which has recently been described in a BS patient with nasopharyngeal carcinoma later in life [ a TPM3-NTRK1 fusion, highlighting that RNA sequencing is capable of identifying all NTRK fusions without prior knowledge of the breakpoint or partner [In the individual reported here the presentation of IFS, poor growth during childhood, microcephaly and progressive skin abnormalities, but not the characteristic facial rash, led to the diagnosis of BS. The absence of the typical facial rash—as holds for the presented case—was noted in several BS patients, among them an individual with BS presenting later in life with nasopharyngeal carcinoma . Multipldred 12) . It has dred 12) . More rel cancer . There a in life . Given t partner . NTRK fu partner , may be Supplementary file1 (DOCX 22 KB)Below is the link to the electronic supplementary material.


Immunoglobulin G4-related disease (IgG4-RD) is a heterogeneous autoimmune fibrosing disorder that presents common pathologic features but with unclear etiology. We report a rare case of IgG4-RD accompanied by primary myelofibrosis that eventually transformed into acute myeloid leukemia. A 50-year-old woman suffered from progressive lacrimal and parotid gland enlargement, diaphoresis, and rapid weight loss. Important clinical findings included remarkable leukocytosis, hyperglobulinemia, and splenomegaly. IgG4-RD was confirmed by salivary gland biopsy. Meanwhile, myelofibrosis was diagnosed according to histopathological findings of bone marrow and genetic mutation test of peripheral blood. The patient was on corticosteroid treatment. However, she developed into acute myeloid leukemia (AML) in the 8th month of follow-up. Our case suggested that myeloproliferative neoplasm (MPN) may co-occur with IgG4-RD. Bone morrow aspiration and genetic tests are helpful for throughout evaluation. An active search for hematological malignancies is warranted at diagnosis and during follow-up for patients who present with unexplained leukocytosis, pancytopenia, splenomegaly, or weight loss. Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory disease that can involve multiple organ systems. Due to a heterogeneity in clinical features, intensive investigation is often required for differential diagnosis. Recently, an increased incidence of solid malignancies was found in patients with IgG4-RD , 2. HemaA 50-year-old woman was referred to the rheumatology department in October 2018. She reported a 4-year history of lacrimal and parotid gland enlargement that progressed gradually without treatment . ApproxiOn physical examination, the patient appeared to be anemic. Bilateral lacrimal and parotid glands expanded substantially . SplenomLab tests reported a remarkably elevated white blood cell count of 450,000 per cubic millimeter. Hemoglobin was 81 g/l. Bilirubin and pancreatic enzymes were normal. Serum immunoglobulin G (IgG) was 83 g/l, and IgG4 was 2,410 mg/dl on protein electrophoresis. Hypocomplementemia was presented with C3 0.249 g/l and C4 0.009 g/l. For rheumatic evaluation, antinuclear antibodies and anti-neutrophil cytoplasmic antibodies (ANCA) were negative. The serum creatinine was normal. The 24-h urine protein was 1.82 g. Renal perfusion imaging reported right hydronephrosis and decreased function on both kidneys.IgG4-RD was suspected. Parotid gland biopsy showed dense lymphocyte infiltration with >40% IgG4-positive plasma cells. No sign of Castleman disease or lymphoma was identified . An 18F-The unexplained leukocytosis added complexity to the clinical scenario. Blood smear revealed nucleated erythrocytes and 1% immature granulocytes. Bone marrow aspiration showed a myelodysplastic pattern with 2.5% myeloblasts. Bone marrow biopsy showed histopathological signs of fibroplastic proliferation. BCL-ABR translocation was negative. Noticeably, genetic mutation screening by polymerase chain reaction test of peripheral blood reported mutations of MPL (81.17%), IDH (45.38%), and FLT (44.9%). Primary myelofibrosis was diagnosed.Under the diagnosis of IgG4-RD, the patient started intravenous methylprednisolone 40 mg once daily for 2 weeks. She also started oral mycophenolate mofetil 0.5 g twice daily. The enlargement of salivary glands and adenopathy alleviated substantially . The levin situ hybridization identified the cytogenetic feature of monosomy 7 or deletion 7q (-7/7-q). Karyotype analysis showed 46, XX, t (3:21)    /46, XX IgG4-RD is a heterogeneous multisystem disease that presents common pathologic features but with unclear etiology. Clinical phenotypes mainly include autoimmune pancreatitis, sclerosing cholangitis, salivary and lacrimal gland enlargement, lymphadenopathy, orbital disease, periaortitis, lung involvement, tubulointerstitial nephritis, and retroperitoneal fibrosis . Our patNumerous inflammatory and neoplastic processes may mimic IgG4-RD. Correlating with clinical features, differential diagnosis for this case mainly included lymphoproliferative diseases and Sjogren's syndrome. According to the biopsy of the parotid gland as well as bone morrow aspiration, there was no histological evidence of Castleman disease or lymphoma. Sjogren's syndrome is a systemic autoimmune disease causing secretory gland dysfunction that often leads to Sicca symptoms. However, it could not explain the elevated serum IgG4 concentrations. Besides, this patient was negative for anti-SSA/SSB autoantibodies, and parotid biopsy did not show focal lymphocyte infiltration either.The co-occurrence of myelofibrosis with IgG4-RD was unique. An increased bone marrow fibrosis can occur in various benign or malignant conditions, including myeloproliferative neoplasms (MPNs), autoimmune myelofibrosis (AIMF), lymphoid neoplasms, metastatic solid tumors, chronic infections, and metabolic disorders . While oFor clinical physicians, it is important to realize timely when malignancy is likely to occur in IgG4-RD. Although an increased risk of solid tumors was noticed in IgG4-RD , 2, hemaIgG4-RD is a heterogeneous entity with diverse clinical clusters where malignancies should be carefully excluded. To our best knowledge, this is the first case with IgG4-RD accompanied by myelofibrosis that ultimately transformed into AML. Hematological malignancies, including MPNs and leukemia, should be suspected for patients who present with unexplained leukocytosis, pancytopenia, splenomegaly, or weight loss. Genetic mutation test can be helpful for diagnosis, especially when results of bone marrow aspiration and biopsy were atypical.The original contributions presented in the study are included in the article/Written informed consent was obtained from the individual for the publication of any potentially identifiable images or data included in this article.ZL participated in the management of the patient and wrote the manuscript. SZ treated the patient and revised the manuscript. WZ, JF, ML, and XZ participated the management and follow-up of the patient. All authors contributed to the article and approved the submitted version.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


Every year, the world is producing around 100 million tons of waste glass (WG), the majority of them are going to landfills that create massive environmental problems. One approach to solve this problem is to transform waste glass into construction materials. Glass is recyclable; however, the melting temperature of the glass is highly dependent on its colour that requires sorting before recycling. To overcome this challenge, many researchers and end-users are using broken glass in concrete either as a binder or aggregates. While significant investigations have done in this area, however, the outcomes of these studies are scattered, and difficult to reach a firm conclusion about the effectiveness of WG in concrete. In this study, the roles of WG and its impact on microstructural and durability properties for both cement and geopolymer concrete are critically reviewed. This review reveals that the amorphous silica in WG effectively participate to the hydration and geopolymerization process and improve concrete microstructural properties. This behaviour of WG help to produce durable concrete against shrinkage, chemical attack, freeze-thaw action, electrical and thermal insulation properties. The optimum replacement volume of binders or natural aggregates and particle size of WG need to be selected carefully to minimise the possible alkali-silica reaction. This review discusses a wide range of parameters for durability properties and challenges associated with WG concrete, which provides necessary guidelines for best practice with future research directions. The production of concrete requires a significant volume of natural aggregates and non-eco-friendly cement. The extraction of natural river sand and stone chips for concrete construction is increasing day by day, paving us to a shortage of natural resources. The extraction of river sand causes a change in river bed level and hydrological strata, affecting the regular stream directions ,2,3. FurGlobally, around 130 million tons of glass are being produced each year among which approximately 100 million tons are being discarded as waste , and theAs the glass powder containing amorphous silica, thus it can be a perfect substitute for natural sand. Moreover, the high toughness and abrasion resistance nature of glass particles are helpful when used as an effective substitution of natural aggregate in cement and geopolymer concrete. Additionally, the fine glass powder is highly pozzolanic and amorphous, thus can be perfectly introduced into concrete as a partial substitution of binders ,15. MostThe most common concerning factors are the high alkalinity of WG powder solution and the negative effect of expansion due to the alkali-silica reaction (ASR) gels, which is negatively affecting the strength and durability properties of concretes ,23. AlthThe durability of concrete is an important parameter that needs to be analyzed before applying it to any environmental exposures. The required durability properties for a typical concrete structure are resistance against shrinkage, chemical penetration/attack, high-temperature variation, freeze-thawing cycle. The dense and compact microstructure is noticed in cement and geopolymer concrete with WG powder ,26,27. TThere are some review studies on WG incorporated concrete ,29,30, bWaste glass can be used in concrete as a replacement for binder or substitution of inert materials. However, depending upon the role of WG in concrete and expected outcomes, the typical size of WG particles can be selected. As reported in the literature, the particle size and chemical compositions of WG are the main points that need to be carefully selected during mix design. A typical flow diagram, as shown in 2 (71–75%), CaO (8–11%), Al2O3 (0.95–2.5%), Na2O (0–14.5%), MgO (1.6–3.6%), Fe2O3 (0.3–1%) [2 and mostly amorphous nature, WG plays a vital role in concrete, starting from the hydration of binders and up to the final state of strength development. A short induction period is observed for hydration of WG-bases binder, and consequently, the peak heat flows shortly [2, heat flow during hydration, and final products of hydration, it can be ensured that the WG powder can undoubtedly improve the structure and strength of the concrete matrix [The main chemical constituents of waste glass are SiO(0.3–1%) ,33. Give shortly ,35. This shortly , materia shortly . Observie matrix .However, to ensure high pozzolanicity, the particle size of WG powder should well below the optimum limit around 38–75 µm ,40. BeyoA high Si/Al ratio has a significant influence on geopolymerization. With a highly alkaline activator solution, a high amount of silica is dissolved from WG powder in geopolymer concrete ,46. Cons2SO4, and Ca(OH)2 for WG-based geopolymer concrete [WG powder is highly pozzolanic, and its pozzolanicity increases with its specific surface area; thus calcium oxide and hydroxide can be alternative alkaline activators for WG powder-based composites . As it wconcrete ,53,54,55On the contrary, Torres-Carrasco and Puertas  reportedTherefore, WG is a suitable source of silica for developing geopolymer concrete by replacing conventional precursors or aggregate. The role of WG and the main parameters shown in The fine WG powder helps to refine the pore size and divide the ITZ into a very thin layer; thus the density of the concrete increases . HoweverThe WG participates in geopolymerization reactions and thus has an impact on the microstructure of geopolymer concrete. From the research conducted by Burciaga-Díaz et al. , the SEMHowever, after the replacement of metakaolin by 15% WG powder, the matrix density is improved certainly, and there were very low unreacted components left. Thus dark gray spots are less in numbers . MoreoveHowever, for the increasing amount of WG replacement, the unreacted WG are started to appear in final products, and the width of the internal crack widens significantly c. As it Shrinkage of concrete depends on the type of aggregates, voids, and availability of internal water in concrete. The drying shrinkage of WG concrete is lower than that of plain concrete (PC). As reported in the study of Lu et al. , a concrThe drying shrinkage is much pronounced by the evaporation of internal water within the concrete pore rather than the surface by thermal drying . Though While talking about geopolymer concretes, major shrinkage occurs at an early age (<90 days) due to the internal water loss from pores and further compaction in unreacted and unpacked base materials. As a result, shrinkage stresses and high strain can arise for highly fine base materials. On the other hand, in WG geopolymer concretes, WG powder acts like a micro filler and refines the pore size; and consequently, the amount of internal trapped water also decreases, which integrally reduces the shrinkage in volume and minimizes the drying shrinkage stress . BesidesFor glass-based geopolymer concretes, the rising curing temperature has a positive effect on drying shrinkage reduction because it helps to reduce the portion of evaporable water and resulting in a dense matrix of geopolymer . The dryAdditionally, shrinkage can occur abnormally when exposed to environmental temperature instead of a uniform laboratory-based shrinkage experiment. Therefore, the long-term serviceability of the WG-based cement and geopolymer concrete under practical conditions needs to be revealed by future deep investigations.The most important durability parameter of concrete is the penetration and absorption of water and chemical into its pores. Given the filler effect and pozzolanic reactivity of fine WG powder, the density of WG-based concrete increases, and the porosity and pore connectivity decreases. Thus, the water and chemical absorption and penetration into WG-based concrete are generally less than those of PC up to an optimum replacement level of cement and aggregates  elements . Carbonaresearch .Beyond a certain optimum level of WG powder substitution, the chemical penetration in WG concrete is generally increased. This increase is due to the agglomeration of WG powder and the low production of C–S–H, resulting in porous and low bonding in WG concrete. Increasing pore and loose bonds can easily act as media for chemical penetration. When WG powder is used as a replacement for cement in excess (>50%), the secondary C–S–H products transform into M–S–H gels in magnesium sulphate media . When WGGeopolymer concretes generally show high durability against chemical attacks. As observed from the study of Torres-Carrasco et al. , WG powdAdditionally, the increasing porosity can lower the resistance to the chemical attack in WG powder-based geopolymer concretes, which may be attributed to unreacted silica. Unreacted WG powder can be the reason for the deterioration in sodium aluminosilicate bonding and leaching in mild- to high-concentration acidic media . The detMoreover, the leaching of unreacted alkali is a common problem in geopolymer concrete, resulting from activation with a highly alkaline solution. The molarity of the alkaline actor should be compatible with the amount of WG in geopolymers; as the content of WG increase, high alkaline media is required to activate entirely. However, for low replacement levels, excessive alkaline solution is more vulnerable regarding high alkali leaching. There is a lack of details investigations on the optimum level of WG and proper alkalinity for the WG-geopolymer system; thus, future investigations on this issue are required.High curing temperature (40–60 °C) and long curing periods are recommended for stable WG-based geopolymer concrete with high mass stability and minimal leaching ,71. HoweBesides, silica depolymerization may occur due to the removal of physically bound water . The addHowever, there is minimal data, and very few investigations were done on WG-based geopolymer concretes to evaluate the durability against chemical exposure conditions. Therefore, this review finds a lack of details investigation on the durability of glass-based geopolymer concrete at the current state of the art. Thus, detailed investigations are needed to find the appropriateness of WG-based geopolymer application in a harsh environment, especially in chloride and acidic medium.n (N/M), where Pn is the relative dynamic modulus of elasticity at n cycles (%), N is the smallest number of cycles at which Pn reaches the minimum threshold value for stopping the test or at which exposure is to be terminated, and M is the designed number of cycles at which the exposure is to be terminated. With the increasing number of cycles, the durability factor decreases, but in every cycle, the durability factor for WG added sample is higher than the others, as shown in Porous concrete is more susceptible when exposed to freeze-thawing cycles. The stress is generated due to the freezing cycles that cause internal micro-cracks in the concrete and create an additional path to penetrate chemicals and water into concrete. Thus, dense matrix and less susceptible aggregates are preferable. High resistance to freeze-thaw cycles of WG-based cement concrete has been reported in previous researches ,74. The Dense WG-based geopolymer concretes offer high resistance to freeze-thaw cycles. WG powder influences the formation of strong Si–O–Si link, and deterioration due to chemical decomposition is minimal ,48. AddiHigh bond strength and less porous microstructure of the WG-concrete matrix effectively resist electrical charges passing through it. Porosity, pore connectivity, pore solution, and ion mobility in concrete are the main factors that control electrical resistivity. The addition of WG with cement-based composite improves electrical resistivity, which may be attributed to the change in chemical composition within the pore solution because of the high alkali content . SchwarzIt is already proven that geopolymers possess high electrical resistivity. The alkalinity of the activator solution and the base materials are the main controlling parameters for the resistance to electrical conductivity. As reported in researches , fly ashThe typical durability properties of WG concrete observed from previous research are listed in The thermal conductivity of concrete depends on the type and size of aggregates, density of matrix, and the size and content of air voids . The inc3 density when 30% WG is used, and the thermal conductivity was around 0.15 W/mK. The lowest pore connectivity was observed in the WG-based geopolymers compared to the sand-based or control geopolymer. However, the porous structure within cement concrete or geopolymer concrete is undesirable because it is related to mechanical strength reduction.In geopolymer concretes, the addition of WG powder causes a reduction in thermal conductivity for the minimal interconnections in the internal pores, thereby preventing the temperature flow inside the composite . The coeThe glass transformation temperature is 600–800 °C. At a high temperature beyond this indicated value, significant changes occur in the glass and WG concrete’s behavior. The contribution of melted WG powder to the residual strength of concrete after exposure to glass melting temperature is sufficiently high . The melThe mass loss in glass-based geopolymer concretes at high temperatures (approximately 200–600 °C) is more than that in sand-based geopolymer concretes . The conThe high shrinkage due to the softening of glass and more ASR expansion could resulted in with the increasing temperature in WG-based cement and geopolymer concrete ,88. ThesRecycling of WG as a construction material simultaneously reduces solid waste management problems, demand for landfills, and carbon footprints and problems on resource preservation . The env2/gWG powder, resulting in up to an 83% reduction in CO2 production compared with OPC [Glass-based cement produces approximately 0.17–0.42 gCOwith OPC . Similarwith OPC , who repOne of the major challenges of WG concrete is the presence of high silica, and alkali content in glass and cement causes the ASR, which could cause expansive gel formation ,23,92. THowever, the risk associated with ASR gel formation can be minimized using finer WG powder instead of coarse glass aggregates. The critical particle size of WG powder is margined by researchers as 1–1.18 mm ,93. HoweThe risk of ASR expansion in geopolymer concrete is observed less than the ordinary cement concrete. As reported in the literature, the high silica dissolution and alkali activation are effective for geopolymerization and development of dense microstructure of geopolymer concrete. Thus the major part of alkali ions is being balanced through ASR ,51. A coThe challenge of minimizing ASR expansion should be carefully considered during the mix design and application of WG concrete. Expansive alkali-silica-based products can be transferred to rigid and stiff products in concrete, which will also be effective in enhancing the strength of the concrete. However, investigations on this topic are still ongoing in several fields. For example, Lee et al.  explaineMoreover, the Ca/Si ratio must be within the threshold value because a low value of Ca/Si in the concrete mix causes considerable ASR expansion . Thus, uLow adhesion between cement paste and WG is another major issue, which is a reason for strength reduction in concrete . Porous Another challenge of WG-based geopolymer concrete is incorporating a suitable activator and precursor for high volume WG geopolymer. There is no data available in the current state of practice to activate the WG-powder binders with a suitable binder. However, the alkali activation of WG powder is good and compatible but needs an additional additive to gain certain strength, as metakaolin, fly-ash, or slag. Thus, for high volume WG binder activation and full-strength development, a suitable activator is needed. Similarly, using the WG-derived activator is still under investigation, which needs to be established.However, in the current state of the art, there is a need for investigations on the durability properties of waste glass-based geopolymer concrete, as in current research gaps are being revealed through this review. As reported in previous researches that the geopolymer concretes can stabilize heavy metal ions with their complex geopolymeric networks , but no The waste glass acts as a rich source of silica in concrete. Thus the pozzolanic activity increases, hydration product formation increases, and microstructures get improved after the addition of fine WG in concrete. Additionally, the silica dissolution in the geopolymer system also increases due to the presence of fine WG powder and consequently improved geopolymeric reaction. To optimize the silica dissolution and pozzolanicity, the optimum particle size of WG must be maintained as recommended around 38–75 µm.WG powder does not hold free water in the internal pores of the concrete and minimizes the pore connectivity. Thus a lower drying shrinkage occurred. Additionally, curing with raised temperature is effective to reduce the shrinkage and improve the micro-structure compactness.The high pozzolanic reactivity and filler effect of fine WG powder result in a high-performance composite with high durability against water, chloride, and sulphate penetration and adverse effect of any chemical attack. Concrete’s resistance to acid attack and carbonation is also improved. Besides, electrical charge flow, the thermal conductivity of glass-based concrete and geopolymers are reduced due to the addition of WG.Very limited research has been conducted on the durability of WG-based concrete; thus the recommendation for optimum level of WG inclusion replacing binders or aggregates in concrete remains an open research question. However, based on current knowledge, it is estimated that the optimum level of binder replacement could be around 20–30%, and this range is approximately 30–50% for fine aggregate. Beyond the optimum level of replacement, a porous concrete matrix will result in lower durability.The most critical issue of glass incorporation is the ASR and expansive gel formation within concrete. This issue is less critical for geopolymers compared with cement concrete. The ASR expansion can be minimized by using fine WG powder (<75 µm), replacing cement instead of aggregates, and adding recommended by-products, such as silica fume, fly ash, and slag optimum level of around 10–30%.This review includes a critical discussion on the current research progress of cement and geopolymer concretes containing waste glass. The durability of concrete is a major concerning point, where different degrees of durability may require each type of concrete depending on their exposure conditions. However, WG addition significantly altering the microstructure and product characteristics of concrete; thus its durability needs to be investigated broadly. Current research progress is not sufficient to address significant guidelines and examples of durable WG-based concrete. The following conclusions are drawn from the state-of-the-art review:This review reveals that no significant investigations have been done on the durability of geopolymer concrete with WG. Additionally, there is a lack of details of investigations on the chemical attack of concrete with WG. Therefore, it is highly recommended to investigate the durability of the cement and geopolymer concrete with WG by considering all possible exposure conditions. Furthermore, while ASR is critical for cement concrete containing WG, the behaviour could be different for geopolymer concrete. Therefore, a comparative evaluation between cement and geopolymer concrete having similar physical and mechanical properties would be interesting for future investigation on ASR.