Search results for: mineral water development policy in Georgia
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 26257

Search results for: mineral water development policy in Georgia

877 Development and Validation of a Turbidimetric Bioassay to Determine the Potency of Ertapenem Sodium

Authors: Tahisa M. Pedroso, Hérida R. N. Salgado

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The microbiological turbidimetric assay allows the determination of potency of the drug, by measuring the turbidity (absorbance), caused by inhibition of microorganisms by ertapenem sodium. Ertapenem sodium (ERTM), a synthetic antimicrobial agent of the class of carbapenems, shows action against Gram-negative, Gram-positive, aerobic and anaerobic microorganisms. Turbidimetric assays are described in the literature for some antibiotics, but this method is not described for ertapenem. The objective of the present study was to develop and validate a simple, sensitive, precise and accurate microbiological assay by turbidimetry to quantify ertapenem sodium injectable as an alternative to the physicochemical methods described in the literature. Several preliminary tests were performed to choose the following parameters: Staphylococcus aureus ATCC 25923, IAL 1851, 8 % of inoculum, BHI culture medium, and aqueous solution of ertapenem sodium. 10.0 mL of sterile BHI culture medium were distributed in 20 tubes. 0.2 mL of solutions (standard and test), were added in tube, respectively S1, S2 and S3, and T1, T2 and T3, 0.8 mL of culture medium inoculated were transferred to each tube, according parallel lines 3 x 3 test. The tubes were incubated in shaker Marconi MA 420 at a temperature of 35.0 °C ± 2.0 °C for 4 hours. After this period, the growth of microorganisms was inhibited by addition of 0.5 mL of 12% formaldehyde solution in each tube. The absorbance was determined in Quimis Q-798DRM spectrophotometer at a wavelength of 530 nm. An analytical curve was constructed to obtain the equation of the line by the least-squares method and the linearity and parallelism was detected by ANOVA. The specificity of the method was proven by comparing the response obtained for the standard and the finished product. The precision was checked by testing the determination of ertapenem sodium in three days. The accuracy was determined by recovery test. The robustness was determined by comparing the results obtained by varying wavelength, brand of culture medium and volume of culture medium in the tubes. Statistical analysis showed that there is no deviation from linearity in the analytical curves of standard and test samples. The correlation coefficients were 0.9996 and 0.9998 for the standard and test samples, respectively. The specificity was confirmed by comparing the absorbance of the reference substance and test samples. The values obtained for intraday, interday and between analyst precision were 1.25%; 0.26%, 0.15% respectively. The amount of ertapenem sodium present in the samples analyzed, 99.87%, is consistent. The accuracy was proven by the recovery test, with value of 98.20%. The parameters varied did not affect the analysis of ertapenem sodium, confirming the robustness of this method. The turbidimetric assay is more versatile, faster and easier to apply than agar diffusion assay. The method is simple, rapid and accurate and can be used in routine analysis of quality control of formulations containing ertapenem sodium.

Keywords: ertapenem sodium, turbidimetric assay, quality control, validation

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876 Tourism Management of the Heritage and Archaeological Sites in Egypt

Authors: Sabry A. El Azazy

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The archaeological heritage sites are one of the most important touristic attractions worldwide. Egypt has various archaeological sites and historical locations that are classified within the list of the archaeological heritage destinations in the world, such as Cairo, Luxor, Aswan, Alexandria, and Sinai. This study focuses on how to manage the archaeological sites and provide them with all services according to the traveler's needs. Tourism management depends on strategic planning for supporting the national economy and sustainable development. Additionally, tourism management has to utilize highly effective standards of security, promotion, advertisement, sales, and marketing while taking into consideration the preservation of monuments. In Egypt, the archaeological heritage sites must be well-managed and protected, which would assist tourism management, especially in times of crisis. Recently, the monumental places and archeological heritage sites were affected by unstable conditions and were threatened. It is essential to focus on preserving our heritage. Moreover, more efforts and cooperation between the tourism organizations and ministry of archaeology have to be done in order to protect the archaeology and promote the tourism industry. Methodology: Qualitative methods have been used as the overall approach to this study. Interviews and observations have provided the researcher with the required in-depth insight to the research subject. The researcher was a lecturer of tourist guidance that allows visiting all historical sites in Egypt. Additionally, the researcher had the privilege to communicate with tourism specialists and attend meetings, conferences, and events that were focused on the research subject. Objectives: The main purpose of the research was gaining information in order to develop theoretical research on how to effectively benefit out of those historical sights both economically and culturally, and pursue further researches and scientific studies to be well-suited for tourism and hospitality sector. The researcher works hard to present further studies in a field related to tourism and archaeological heritage using previous experience. Pursing this course of study enables the researcher to acquire the necessary abilities and competencies to achieve the set goal successfully. Results: The professional tourism management focus on making Egypt one of the most important destinations in the world, and provide the heritage and archaeological sites with all services that will place those locations into the international map of tourism. Tourists interested in visiting Egypt and making tourism flourish supports and strengths Egypt's national economy and the local community, taking into consideration preserving our heritage and archaeology. Conclusions: Egypt has many tourism attractions represented in the heritage, archaeological sites, and touristic places. These places need more attention and efforts to be included in tourism programs and be opened for visitors from all over the world. These efforts will encourage both local and international tourism to see our great civilization and provide different touristic activities.

Keywords: archaeology, archaeological sites, heritage, ministry of archaeology, national economy, touristic attractions, tourism management, tourism organizations

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875 Epidemiological Data of Schistosoma haematobium Bilharzia in Rural and Urban Localities in the Republic of Congo

Authors: Jean Akiana, Digne Merveille Nganga Bouanga, Nardiouf Sjelin Nsana, Wilfrid Sapromet Ngoubili, Chyvanelle Ndous Akiridzo, Vishnou Reize Ampiri, Henri-Joseph Parra, Florence Fenollar, Didier Raoult, Oleg Mediannikov, Cheikh Sadhibou Sokhna

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Schistosoma haematobium schistosomiasis is an endemic disease in which the level of human exposure, incidence, and fatality attributed to it remains, unfortunately, high worldwide. The erection of hydroelectric infrastructures constitute a major factor in the emergence of this disease. In the context of the Republic of the Congo, which considers industrialization and modernization as two essential pillars of development, building the hydroelectric dams of Liouesso (19 Mw) and the feasibility studies of the dams of Chollet (600MW) in the Sangha, of Sounda (1000MW) in Kouilou and Kouembali (150MW) on Lefini is necessary to increase the country's energy capacities. Likewise, the urbanization of former endemic localities should take into account the maintenance of contamination points. However, health impact studies on schistosomiasis epidemiology in general and urinary bilharzia, in particular, have never been carried out in these areas, neither before nor after the erection of those dams. Participants benefited from an investigative questionnaire, urinalysis both by dipstick and urine filtrate examined under a microscope. Assessment of the genetic diversity of schistosoma species populations was considered as well as PCR analysis to confirm the test strip and microscopy tests. 405 participants were registered in five localities. The sampling was made up of a balanced population in terms of male/female ratio, which is around 1. The prevalence rate was 45% (55/123) in Nkayi, 10.40% (11/106) in Loudima, 1 case in Mbomo (West Cuvette), which would probably be imported, zero in Liouesso and Kabo. The highest oviuria (number of eggs per volume of urine) is 150 S. haematobium eggs/10ml in Nkayi, apart from the case of imported Mbomo, imported from Gabon, which has 160 S. haematobium eggs/10ml. The lowest oviuria was 2 S. haematobium eggs/10ml. Prevalence rates are still high in semi-urban areas (Nkayi). As praziquantel treatments are available and effective, it is important to step up mass treatment campaigns in high risk areas already largely initiated by the National Schistosomiasis Control Program. Prevalence rates are still high in semi-urban areas (Nkayi). As praziquantel treatments are available and effective, it is important to step up mass treatment campaigns in high risk areas already largely initiated by the National Schistosomiasis Control Program.

Keywords: Bilharzia, Schistosoma haematobium, oviuria, urbanization, Congo

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874 An Integrated HCV Testing Model as a Method to Improve Identification and Linkage to Care in a Network of Community Health Centers in Philadelphia, PA

Authors: Catelyn Coyle, Helena Kwakwa

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Objective: As novel and better tolerated therapies become available, effective HCV testing and care models become increasingly necessary to not only identify individuals with active infection but also link them to HCV providers for medical evaluation and treatment. Our aim is to describe an effective HCV testing and linkage to care model piloted in a network of five community health centers located in Philadelphia, PA. Methods: In October 2012, National Nursing Centers Consortium piloted a routine opt-out HCV testing model in a network of community health centers, one of which treats HCV, HIV, and co-infected patients. Key aspects of the model were medical assistant initiated testing, the use of laboratory-based reflex test technology, and electronic medical record modifications to prompt, track, report and facilitate payment of test costs. Universal testing on all adult patients was implemented at health centers serving patients at high-risk for HCV. The other sites integrated high-risk based testing, where patients meeting one or more of the CDC testing recommendation risk factors or had a history of homelessness were eligible for HCV testing. Mid-course adjustments included the integration of dual HIV testing, development of a linkage to care coordinator position to facilitate the transition of HIV and/or HCV-positive patients from primary to specialist care, and the transition to universal HCV testing across all testing sites. Results: From October 2012 to June 2015, the health centers performed 7,730 HCV tests and identified 886 (11.5%) patients with a positive HCV-antibody test. Of those with positive HCV-antibody tests, 838 (94.6%) had an HCV-RNA confirmatory test and 590 (70.4%) progressed to current HCV infection (overall prevalence=7.6%); 524 (88.8%) received their RNA-positive test result; 429 (72.7%) were referred to an HCV care specialist and 271 (45.9%) were seen by the HCV care specialist. The best linkage to care results were seen at the test and treat the site, where of the 333 patients were current HCV infection, 175 (52.6%) were seen by an HCV care specialist. Of the patients with active HCV infection, 349 (59.2%) were unaware of their HCV-positive status at the time of diagnosis. Since the integration of dual HCV/HIV testing in September 2013, 9,506 HIV tests were performed, 85 (0.9%) patients had positive HIV tests, 81 (95.3%) received their confirmed HIV test result and 77 (90.6%) were linked to HIV care. Dual HCV/HIV testing increased the number of HCV tests performed by 362 between the 9 months preceding dual testing and first 9 months after dual testing integration, representing a 23.7% increment. Conclusion: Our HCV testing model shows that integrated routine testing and linkage to care is feasible and improved detection and linkage to care in a primary care setting. We found that prevalence of current HCV infection was higher than that seen in locally in Philadelphia and nationwide. Intensive linkage services can increase the number of patients who successfully navigate the HCV treatment cascade. The linkage to care coordinator position is an important position that acts as a trusted intermediary for patients being linked to care.

Keywords: HCV, routine testing, linkage to care, community health centers

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873 Articulating the Colonial Relation, a Conversation between Afropessimism and Anti-Colonialism

Authors: Thomas Compton

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As Decolonialism becomes an important topic in Political Theory, the rupture between the colonized and the colonist relation has lost attention. Focusing on the anti-colonial activist Madhi Amel, we shall consider his attention to the permanence of the colonial relation and how it preempts Frank Wilderson’s formulation of (white) culturally necessary Anti-Black violence. Both projects draw attention away from empirical accounts of oppression, instead focusing on the structural relation which precipitates them. As Amel says that we should stop thinking of the ‘underdeveloped’ as beyond the colonial relation, Wilderson says we should stop think of the Black rights that have surpassed the role of the slave. However, Amel moves beyond his idol Althusser’s Structuralism toward a formulation of the colonial relation as source of domination. Our analysis will take a Lacanian turn in considering how this non-relation was formulated as a relation how this space of negativity became a ideological opportunity for Colonial domination. Wilderson’s work shall problematise this as we conclude with his criticisms of Structural accounts for the failure to consider how Black social death exists as more than necessity but a cite of white desire. Amel, a Lebanese activist and scholar (re)discovered by Hicham Safieddine, argues colonialism is more than the theft of land, but instead a privatization of collective property and form of investment which (re)produces the status of the capitalist in spaces ‘outside’ the market. Although Amel was a true Marxist-Leninsist, who exposited the economic determinacy of the Colonial Mode of Production, we are reading this account through Alenka Zupančič’s reformulation of the ‘invisible hand job of the market’. Amel points to the signifier ‘underdeveloped’ as buttressed on a pre-colonial epistemic break, as the Western investor (debt collector) sees the (post?) colony narcissistic image. However, the colony can never become site of class conflict, as the workers are not unified but existing between two countries. In industry, they are paid in Colonial subjectivisation, the promise of market (self)pleasure, at home, they are refugees. They are not, as Wilderson states, in the permanent social death of the slave, but they are less than the white worker. This is formulated as citizen (white), non-citizen (colonized), anti-citizen (Black/slave). Here we may also think of how indentured Indians were used as instruments of colonial violence. Wilderson’s aphorism “there is no analogy to anti-Black violence” lays bare his fundamental opposition between colonial and specifically anti-Black violence. It is not only that the debt collector, landowner, or other owners of production pleasures themselves as if their hand is invisible. The absolute negativity between colony and colonized provides a new frontier for desire, the development of a colonial mode of production. An invention inside the colonial structure that is generative of class substitution. We shall explore how Amel ignores the role of the slave but how Wilderson forecloses the history African anti-colonial.

Keywords: afropessimism, fanon, marxism, postcolonialism

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872 Intracommunity Attitudes Toward the Gatekeeping of Asexuality in the LGBTQ+ Community on Tumblr

Authors: A.D. Fredline, Beverly Stiles

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This is a qualitative investigation that examines the social media site, Tumblr, for the goal of analyzing the controversy regarding the inclusion of asexuality in the LGBTQ+ community. As platforms such as Tumblr permit the development of communities for marginalized groups, social media serves as a core component to exclusionary practices and boundary negotiations for community membership. This research is important because there is a paucity of research on the topic and a significant gap in the literature with regards to intracommunity gatekeeping. However, discourse on the topic is blatantly apparent on social media platforms. The objectives are to begin to bridge the gap in the literature by examining attitudes towards the inclusion of asexuality within the LGBTQ+ community. In order to analyze the attitudes developed towards the inclusion of asexuality in the LGBTQ+ community, eight publicly available blogs on Tumblr.com were selected from both the “inclusionist” and “exclusionist” perspectives. Blogs selected were found through a basic search for “inclusionist” and “exclusionist” on the Tumblr website. Out of the first twenty blogs listed for each set of results, those centrally focused on asexuality discourse were selected. For each blog, the fifty most recent postings were collected. Analysis of the collected postings exposed three central themes from the exclusionist perspective as well as for the inclusionist perspective. Findings indicate that from the inclusionist perspective, asexuality belongs to the LGBTQ+ community. One primary argument from this perspective is that asexual individuals face opposition for their identity just as do other identities included in the community. This opposition is said to take a variety of forms, such as verbal shaming, assumption of illness and corrective rape. Another argument is that the LGBTQ+ community and asexuals face a common opponent in cisheterosexism as asexuals struggle with the assumed and expected sexualization. A final central theme is that denying asexual inclusion leads to the assumption of heteronormativity. Findings also indicate that from the exclusionist perspective, asexuality does not belong to the LGBTQ+ community. One central theme from this perspective is the equivalization of cisgender heteroromantic asexuals with cisgender heterosexuals. As straight individuals are not allowed in the community, exclusionists argue that asexuals engaged in opposite gender partnerships should not be included. Another debate is that including asexuality in the community sexualizes all other identities by assuming sexual orientation is inherently sexual rather than romantic. Finally, exclusionists also argue that asexuality encourages childhood labeling and forces sexual identities on children, something not promoted by the LGBTQ+ community. Conclusions drawn from analyzing both perspectives is that integration may be a possibility, but complexities add another layer of discourse. For example, both inclusionists and exclusionists agree that privileged identities do not belong to the LGBTQ+ community. The focus of discourse is whether or not asexuals are privileged. Clearly, both sides of the debate have the same vision of what binds the community together. The question that remains is who belongs to that community.

Keywords: asexuality, exclusionists, inclusionists, Tumblr

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871 Analysis of Digital Transformation in Banking: The Hungarian Case

Authors: Éva Pintér, Péter Bagó, Nikolett Deutsch, Miklós Hetényi

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The process of digital transformation has a profound influence on all sectors of the worldwide economy and the business environment. The influence of blockchain technology can be observed in the digital economy and e-government, rendering it an essential element of a nation's growth strategy. The banking industry is experiencing significant expansion and development of financial technology firms. Utilizing developing technologies such as artificial intelligence (AI), machine learning (ML), and big data (BD), these entrants are offering more streamlined financial solutions, promptly addressing client demands, and presenting a challenge to incumbent institutions. The advantages of digital transformation are evident in the corporate realm, and firms that resist its adoption put their survival at risk. The advent of digital technologies has revolutionized the business environment, streamlining processes and creating opportunities for enhanced communication and collaboration. Thanks to the aid of digital technologies, businesses can now swiftly and effortlessly retrieve vast quantities of information, all the while accelerating the process of creating new and improved products and services. Big data analytics is generally recognized as a transformative force in business, considered the fourth paradigm of science, and seen as the next frontier for innovation, competition, and productivity. Big data, an emerging technology that is shaping the future of the banking sector, offers numerous advantages to banks. It enables them to effectively track consumer behavior and make informed decisions, thereby enhancing their operational efficiency. Banks may embrace big data technologies to promptly and efficiently identify fraud, as well as gain insights into client preferences, which can then be leveraged to create better-tailored products and services. Moreover, the utilization of big data technology empowers banks to develop more intelligent and streamlined models for accurately recognizing and focusing on the suitable clientele with pertinent offers. There is a scarcity of research on big data analytics in the banking industry, with the majority of existing studies only examining the advantages and prospects associated with big data. Although big data technologies are crucial, there is a dearth of empirical evidence about the role of big data analytics (BDA) capabilities in bank performance. This research addresses a gap in the existing literature by introducing a model that combines the resource-based view (RBV), the technical organization environment framework (TOE), and dynamic capability theory (DC). This study investigates the influence of Big Data Analytics (BDA) utilization on the performance of market and risk management. This is supported by a comparative examination of Hungarian mobile banking services.

Keywords: big data, digital transformation, dynamic capabilities, mobile banking

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870 Tracing a Timber Breakthrough: A Qualitative Study of the Introduction of Cross-Laminated-Timber to the Student Housing Market in Norway

Authors: Marius Nygaard, Ona Flindall

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The Palisaden student housing project was completed in August 2013 and was, with its eight floors, Norway’s tallest timber building at the time of completion. It was the first time cross-laminated-timber (CLT) was utilized at this scale in Norway. The project was the result of a concerted effort by a newly formed management company to establish CLT as a sustainable and financially competitive alternative to conventional steel and concrete systems. The introduction of CLT onto the student housing market proved so successful that by 2017 more than 4000 individual student residences will have been built using the same model of development and construction. The aim of this paper is to identify the key factors that enabled this breakthrough for CLT. It is based on an in-depth study of a series of housing projects and the role of the management company who both instigated and enabled this shift of CLT from the margin to the mainstream. Specifically, it will look at how a new building system was integrated into a marketing strategy that identified a market potential within the existing structure of the construction industry and within the economic restrictions inherent to student housing in Norway. It will show how a key player established a project model that changed both the patterns of cooperation and the information basis for decisions. Based on qualitative semi-structured interviews with managers, contractors and the interdisciplinary teams of consultants (architects, structural engineers, acoustical experts etc.) this paper will trace the introduction, expansion and evolution of CLT-based building systems in the student housing market. It will show how the project management firm’s position in the value chain enabled them to function both as a liaison between contractor and client, and between contractor and producer. A position that allowed them to improve the flow of information. This ensured that CLT was handled on equal terms to other structural solutions in the project specifications, enabling realistic pricing and risk evaluation. Secondly, this paper will describe and discuss how the project management firm established and interacted with a growing network of contractors, architects and engineers to pool expertise and broaden the knowledge base across Norway’s regional markets. Finally, it will examine the role of the client, the building typology, and the industrial and technological factors in achieving this breakthrough for CLT in the construction industry. This paper gives an in-depth view of the progression of a single case rather than a broad description of the state of the art of large-scale timber building in Norway. However, this type of study may offer insights that are important to the understanding not only of specific markets but also of how new technologies should be introduced in big and well-established industries.

Keywords: cross-laminated-timber (CLT), industry breakthrough, student housing, timber market

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869 Prevalence of Positive Serology for Celiac Disease in Children With Autism Spectrum Disorder

Authors: A. Venkatakrishnan, M. Juneja, S. Kapoor

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Background: Gastrointestinal dysfunction is an emerging co morbidity seen in autism and may further strengthen the association between autism and celiac disease. This is supported by increased rates (22-70%) of gastrointestinal symptoms like diarrhea, constipation, abdominal discomfort/pain, and gastrointestinal inflammation in children with the etiology of autism is still elusive. In addition to genetic factors, environmental factors such as toxin exposure, intrauterine exposure to certain teratogenic drugs, are being proposed as possible contributing factors in the etiology of Autism Spectrum Disorders (ASD) in cognizance with reports of increased gut permeability and high rates of gastrointestinal symptoms noted in children with ASD, celiac disease has also been proposed as a possible etiological factor. Despite insufficient evidence regarding the benefit of restricted diets in Autism, GFD has been promoted as an alternative treatment for ASD. This study attempts to discern any correlation between ASD and celiac disease. Objective: This cross sectional study aims to determine the proportion of celiac disease in children with ASD. Methods: Study included 155 participants aged 2-12 yrs, diagnosed as ASD as per DSM-5 attending the child development center at a tertiary care hospital in Northern India. Those on gluten free diet or having other autoimmune conditions were excluded. A detailed Performa was filled which included sociodemographic details, history of gastrointestinal symptoms, anthropometry, systemic examination, and pertinent psychological testing was done using was assessed using Developmental Profile-3(DP-3) for Developmental Quotient, Childhood Autism Rating Scale-2 (CARS-2) for severity of ASD, Vineland Adaptive Behavior Scales (VABS) for adaptive behavior, Child Behavior Checklist (CBCL) for behavioral problems and BAMBI (Brief Autism Mealtime Behavior Scales) for feeding problems. Screening for celiac was done by TTG-IgA levels, and total serum IgA levels were measured to exclude IgA deficiency. Those with positive screen were further planned for HLA typing and endoscopic biopsy. Results: A total of 155 cases were included, out of which 5 had low IgA levels and were hence excluded from the study. The rest 150 children had TTG levels below the ULN and normal total serum IgA level. History of Gastrointestinal symptoms was present in 51 (34%) cases abdominal pain was the most frequent complaint (16.6%), followed by constipation (12.6%). Diarrhea was seen in 8 %. Gastrointestinal symptoms were significantly more common in children with ASD above 5 yrs (p-value 0.006) and those who were verbal (p = 0.000). There was no significant association between socio-demographic factors, anthropometric data, or severity of autism with gastrointestinal symptoms. Conclusion: None of the150 patients with ASD had raised TTG levels; hence no association was found between ASD and celiac disease. There is no justification for routine screening for celiac disease in children with ASD. Further studies are warranted to evaluate association of Non Celiac Gluten Sensitivity with ASD and any role of gluten-free diet in such patients.

Keywords: autism, celiac, gastrointestinal, gluten

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868 Coupling Strategy for Multi-Scale Simulations in Micro-Channels

Authors: Dahia Chibouti, Benoit Trouette, Eric Chenier

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With the development of micro-electro-mechanical systems (MEMS), understanding fluid flow and heat transfer at the micrometer scale is crucial. In the case where the flow characteristic length scale is narrowed to around ten times the mean free path of gas molecules, the classical fluid mechanics and energy equations are still valid in the bulk flow, but particular attention must be paid to the gas/solid interface boundary conditions. Indeed, in the vicinity of the wall, on a thickness of about the mean free path of the molecules, called the Knudsen layer, the gas molecules are no longer in local thermodynamic equilibrium. Therefore, macroscopic models based on the continuity of velocity, temperature and heat flux jump conditions must be applied at the fluid/solid interface to take this non-equilibrium into account. Although these macroscopic models are widely used, the assumptions on which they depend are not necessarily verified in realistic cases. In order to get rid of these assumptions, simulations at the molecular scale are carried out to study how molecule interaction with walls can change the fluid flow and heat transfers at the vicinity of the walls. The developed approach is based on a kind of heterogeneous multi-scale method: micro-domains overlap the continuous domain, and coupling is carried out through exchanges of information between both the molecular and the continuum approaches. In practice, molecular dynamics describes the fluid flow and heat transfers in micro-domains while the Navier-Stokes and energy equations are used at larger scales. In this framework, two kinds of micro-simulation are performed: i) in bulk, to obtain the thermo-physical properties (viscosity, conductivity, ...) as well as the equation of state of the fluid, ii) close to the walls to identify the relationships between the slip velocity and the shear stress or between the temperature jump and the normal temperature gradient. The coupling strategy relies on an implicit formulation of the quantities extracted from micro-domains. Indeed, using the results of the molecular simulations, a Bayesian regression is performed in order to build continuous laws giving both the behavior of the physical properties, the equation of state and the slip relationships, as well as their uncertainties. These latter allow to set up a learning strategy to optimize the number of micro simulations. In the present contribution, the first results regarding this coupling associated with the learning strategy are illustrated through parametric studies of convergence criteria, choice of basis functions and noise of input data. Anisothermic flows of a Lennard Jones fluid in micro-channels are finally presented.

Keywords: multi-scale, microfluidics, micro-channel, hybrid approach, coupling

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867 The Effect of Regulation and Investment in Sustainable Practices on Environmental Performance and Consumer Trust: a Time Series Analysis of the Dominant Companies within the Energy Sector

Authors: Sempiga Olivier, Dominika Latusek-Jurczak

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Climate change has allegedly been attributed to a high consumption of fossil fuels, leading to severe environmental problems. The energy sector has been among the most polluting sectors for many decades. Consequently, there is a lack of trust in several energy firms, especially those in fossil fuels and nuclear energy. A robust regulatory framework is needed, and more investment in renewable energy sources is paramount for a better environmental outcome. Given the significant environmental impact of energy production and consumption in the energy sector, sustainable marketing practices have become increasingly important. Although the latter has had the lion’s share in polluting the environment, much effort has been made recently to move away from fossil fuels and privilege renewable energy sources. How this shift would help rebuild trust in the energy industry is unclear. For the shift to have lasting effects, it may be essential that regulatory agencies examine how energy firms engage in sustainable investment. There is little empirical evidence on whether adopting regulating marketing practices and investment initiatives can help different organizations reduce their environmental impact and promote sustainable development. Little is known about how and whether the environmental value in firms goes beyond rhetoric, greenwashing and publicity to translate into economic gains and environmental performance. The study investigates how regulatory agencies can help energy firms invest sustainably and take sustainable initiatives even amid the energy crisis caused by the Russia-Ukraine conflict and how these sustainable practices relate to renewed consumer trust. Using data from Corporate Knights, the study, through time series, analyses the relationship between sustainable regulation, sustainable practices of energy firms from around the world and their relation to consumer trust and environmental performance over the past 20 years. It examines how their sustainable investment, energy, and carbon productivity relate to environmental sustainability and consumer trust. This longitudinal study provides empirical evidence of the interplay between regulation, trust and environmental performance. The research is grounded in institutional trust theory, which emphasizes the role of regulatory frameworks and organizational practices in shaping public perceptions of fairness, transparency, and legitimacy. Results show that organizations in the energy sector, supported by robust regulatory tools, can overcome the negative image of polluters and compete with other companies in the fight against climate change and global warming. However, to do so, energy firms should consider investing more in renewable energy sources and implementing sustainable strategies and practices that go beyond greenwashing to improve their environmental performance, thereby rebuilding consumer trust in the energy sector. Results allow regulatory regimes and organizations to learn why it is crucial for energy firms to invest in renewable energy sources and engage in various sustainable initiatives and practices to contribute to better environmental outcomes and higher levels of trust.

Keywords: consumer trust, energy, environmental performance, regulation, renewable energy sources, sustainable practices

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866 The Influence of Argumentation Strategy on Student’s Web-Based Argumentation in Different Scientific Concepts

Authors: Xinyue Jiao, Yu-Ren Lin

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Argumentation is an essential aspect of scientific thinking which has been widely concerned in recent reform of science education. The purpose of the present studies was to explore the influences of two variables termed ‘the argumentation strategy’ and ‘the kind of science concept’ on student’s web-based argumentation. The first variable was divided into either monological (which refers to individual’s internal discourse and inner chain reasoning) or dialectical (which refers to dialogue interaction between/among people). The other one was also divided into either descriptive (i.e., macro-level concept, such as phenomenon can be observed and tested directly) or theoretical (i.e., micro-level concept which is abstract, and cannot be tested directly in nature). The present study applied the quasi-experimental design in which 138 7th grade students were invited and then assigned to either monological group (N=70) or dialectical group (N=68) randomly. An argumentation learning program called ‘the PWAL’ was developed to improve their scientific argumentation abilities, such as arguing from multiple perspectives and based on scientific evidence. There were two versions of PWAL created. For the individual version, students can propose argument only through knowledge recall and self-reflecting process. On the other hand, the students were allowed to construct arguments through peers’ communication in the collaborative version. The PWAL involved three descriptive science concept-based topics (unit 1, 3 and 5) and three theoretical concept-based topics (unit 2, 4 and 6). Three kinds of scaffoldings were embedded into the PWAL: a) argument template, which was used for constructing evidence-based argument; b) the model of the Toulmin’s TAP, which shows the structure and elements of a sound argument; c) the discussion block, which enabled the students to review what had been proposed during the argumentation. Both quantitative and qualitative data were collected and analyzed. An analytical framework for coding students’ arguments proposed in the PWAL was constructed. The results showed that the argumentation approach has a significant effect on argumentation only in theoretical topics (f(1, 136)=48.2, p < .001, η2=2.62). The post-hoc analysis showed the students in the collaborative group perform significantly better than the students in the individual group (mean difference=2.27). However, there is no significant difference between the two groups regarding their argumentation in descriptive topics. Secondly, the students made significant progress in the PWAL from the earlier descriptive or theoretical topic to the later one. The results enabled us to conclude that the PWAL was effective for students’ argumentation. And the students’ peers’ interaction was essential for students to argue scientifically especially for the theoretical topic. The follow-up qualitative analysis showed student tended to generate arguments through critical dialogue interactions in the theoretical topic which promoted them to use more critiques and to evaluate and co-construct each other’s arguments. More explanations regarding the students’ web-based argumentation and the suggestions for the development of web-based science learning were proposed in our discussions.

Keywords: argumentation, collaborative learning, scientific concepts, web-based learning

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865 X-Ray Detector Technology Optimization in Computed Tomography

Authors: Aziz Ikhlef

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Most of multi-slices Computed Tomography (CT) scanners are built with detectors composed of scintillator - photodiodes arrays. The photodiodes arrays are mainly based on front-illuminated technology for detectors under 64 slices and on back-illuminated photodiode for systems of 64 slices or more. The designs based on back-illuminated photodiodes were being investigated for CT machines to overcome the challenge of the higher number of runs and connection required in front-illuminated diodes. In backlit diodes, the electronic noise has already been improved because of the reduction of the load capacitance due to the routing reduction. This is translated by a better image quality in low signal application, improving low dose imaging in large patient population. With the fast development of multi-detector-rows CT (MDCT) scanners and the increasing number of examinations, the clinical community has raised significant concerns on radiation dose received by the patient in both medical and regulatory community. In order to reduce individual exposure and in response to the recommendations of the International Commission on Radiological Protection (ICRP) which suggests that all exposures should be kept as low as reasonably achievable (ALARA), every manufacturer is trying to implement strategies and solutions to optimize dose efficiency and image quality based on x-ray emission and scanning parameters. The added demands on the CT detector performance also comes from the increased utilization of spectral CT or dual-energy CT in which projection data of two different tube potentials are collected. One of the approaches utilizes a technology called fast-kVp switching in which the tube voltage is switched between 80 kVp and 140 kVp in fraction of a millisecond. To reduce the cross-contamination of signals, the scintillator based detector temporal response has to be extremely fast to minimize the residual signal from previous samples. In addition, this paper will present an overview of detector technologies and image chain improvement which have been investigated in the last few years to improve the signal-noise ratio and the dose efficiency CT scanners in regular examinations and in energy discrimination techniques. Several parameters of the image chain in general and in the detector technology contribute in the optimization of the final image quality. We will go through the properties of the post-patient collimation to improve the scatter-to-primary ratio, the scintillator material properties such as light output, afterglow, primary speed, crosstalk to improve the spectral imaging, the photodiode design characteristics and the data acquisition system (DAS) to optimize for crosstalk, noise and temporal/spatial resolution.

Keywords: computed tomography, X-ray detector, medical imaging, image quality, artifacts

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864 Qualitative Characterization of Proteins in Common and Quality Protein Maize Corn by Mass Spectrometry

Authors: Benito Minjarez, Jesse Haramati, Yury Rodriguez-Yanez, Florencio Recendiz-Hurtado, Juan-Pedro Luna-Arias, Salvador Mena-Munguia

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During the last decades, the world has experienced a rapid industrialization and an expanding economy favoring a demographic boom. As a consequence, countries around the world have focused on developing new strategies related to the production of different farm products in order to meet future demands. Consequently, different strategies have been developed seeking to improve the major food products for both humans and livestock. Corn, after wheat and rice, is the third most important crop globally and is the primary food source for both humans and livestock in many regions around the globe. In addition, maize (Zea mays) is an important source of protein accounting for up to 60% of the daily human protein supply. Generally, many of the cereal grains have proteins with relatively low nutritional value, when they are compared with proteins from meat. In the case of corn, much of the protein is found in the endosperm (75 to 85%) and is deficient in two essential amino acids, lysine, and tryptophan. This deficiency results in an imbalance of amino acids and low protein content; normal maize varieties have less than half of the recommended amino acids for human nutrition. In addition, studies have shown that this deficiency has been associated with symptoms of growth impairment, anemia, hypoproteinemia, and fatty liver. Due to the fact that most of the presently available maize varieties do not contain the quality and quantity of proteins necessary for a balanced diet, different countries have focused on the research of quality protein maize (QPM). Researchers have characterized QPM noting that these varieties may contain between 70 to 100% more residues of the amino acids essential for animal and human nutrition, lysine, and tryptophan, than common corn. Several countries in Africa, Latin America, as well as China, have incorporated QPM in their agricultural development plan. Large parts of these countries have chosen a specific QPM variety based on their local needs and climate. Reviews have described the breeding methods of maize and have revealed the lack of studies on genetic and proteomic diversity of proteins in QPM varieties, and their genetic relationships with normal maize varieties. Therefore, molecular marker identification using tools such as mass spectrometry may accelerate the selection of plants that carry the desired proteins with high lysine and tryptophan concentration. To date, QPM maize lines have played a very important role in alleviating the malnutrition, and better characterization of these lines would provide a valuable nutritional enhancement for use in the resource-poor regions of the world. Thus, the objectives of this study were to identify proteins in QPM maize in comparison with a common maize line as a control.

Keywords: corn, mass spectrometry, QPM, tryptophan

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863 Large-Scale Production of High-Performance Fiber-Metal-Laminates by Prepreg-Press-Technology

Authors: Christian Lauter, Corin Reuter, Shuang Wu, Thomas Troester

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Lightweight construction became more and more important over the last decades in several applications, e.g. in the automotive or aircraft sector. This is the result of economic and ecological constraints on the one hand and increasing safety and comfort requirements on the other hand. In the field of lightweight design, different approaches are used due to specific requirements towards the technical systems. The use of endless carbon fiber reinforced plastics (CFRP) offers the largest weight saving potential of sometimes more than 50% compared to conventional metal-constructions. However, there are very limited industrial applications because of the cost-intensive manufacturing of the fibers and production technologies. Other disadvantages of pure CFRP-structures affect the quality control or the damage resistance. One approach to meet these challenges is hybrid materials. This means CFRP and sheet metal are combined on a material level. Therefore, new opportunities for innovative process routes are realizable. Hybrid lightweight design results in lower costs due to an optimized material utilization and the possibility to integrate the structures in already existing production processes of automobile manufacturers. In recent and current research, the advantages of two-layered hybrid materials have been pointed out, i.e. the possibility to realize structures with tailored mechanical properties or to divide the curing cycle of the epoxy resin into two steps. Current research work at the Chair for Automotive Lightweight Design (LiA) at the Paderborn University focusses on production processes for fiber-metal-laminates. The aim of this work is the development and qualification of a large-scale production process for high-performance fiber-metal-laminates (FML) for industrial applications in the automotive or aircraft sector. Therefore, the prepreg-press-technology is used, in which pre-impregnated carbon fibers and sheet metals are formed and cured in a closed, heated mold. The investigations focus e.g. on the realization of short process chains and cycle times, on the reduction of time-consuming manual process steps, and the reduction of material costs. This paper gives an overview over the considerable steps of the production process in the beginning. Afterwards experimental results are discussed. This part concentrates on the influence of different process parameters on the mechanical properties, the laminate quality and the identification of process limits. Concluding the advantages of this technology compared to conventional FML-production-processes and other lightweight design approaches are carried out.

Keywords: composite material, fiber-metal-laminate, lightweight construction, prepreg-press-technology, large-series production

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862 Phenomena-Based Approach for Automated Generation of Process Options and Process Models

Authors: Parminder Kaur Heer, Alexei Lapkin

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Due to global challenges of increased competition and demand for more sustainable products/processes, there is a rising pressure on the industry to develop innovative processes. Through Process Intensification (PI) the existing and new processes may be able to attain higher efficiency. However, very few PI options are generally considered. This is because processes are typically analysed at a unit operation level, thus limiting the search space for potential process options. PI performed at more detailed levels of a process can increase the size of the search space. The different levels at which PI can be achieved is unit operations, functional and phenomena level. Physical/chemical phenomena form the lowest level of aggregation and thus, are expected to give the highest impact because all the intensification options can be described by their enhancement. The objective of the current work is thus, generation of numerous process alternatives based on phenomena, and development of their corresponding computer aided models. The methodology comprises: a) automated generation of process options, and b) automated generation of process models. The process under investigation is disintegrated into functions viz. reaction, separation etc., and these functions are further broken down into the phenomena required to perform them. E.g., separation may be performed via vapour-liquid or liquid-liquid equilibrium. A list of phenomena for the process is formed and new phenomena, which can overcome the difficulties/drawbacks of the current process or can enhance the effectiveness of the process, are added to the list. For instance, catalyst separation issue can be handled by using solid catalysts; the corresponding phenomena are identified and added. The phenomena are then combined to generate all possible combinations. However, not all combinations make sense and, hence, screening is carried out to discard the combinations that are meaningless. For example, phase change phenomena need the co-presence of the energy transfer phenomena. Feasible combinations of phenomena are then assigned to the functions they execute. A combination may accomplish a single or multiple functions, i.e. it might perform reaction or reaction with separation. The combinations are then allotted to the functions needed for the process. This creates a series of options for carrying out each function. Combination of these options for different functions in the process leads to the generation of superstructure of process options. These process options, which are formed by a list of phenomena for each function, are passed to the model generation algorithm in the form of binaries (1, 0). The algorithm gathers the active phenomena and couples them to generate the model. A series of models is generated for the functions, which are combined to get the process model. The most promising process options are then chosen subjected to a performance criterion, for example purity of product, or via a multi-objective Pareto optimisation. The methodology was applied to a two-step process and the best route was determined based on the higher product yield. The current methodology can identify, produce and evaluate process intensification options from which the optimal process can be determined. It can be applied to any chemical/biochemical process because of its generic nature.

Keywords: Phenomena, Process intensification, Process models , Process options

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861 Combating Corruption to Enhance Learner Academic Achievement: A Qualitative Study of Zimbabwean Public Secondary Schools

Authors: Onesmus Nyaude

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The aim of the study was to investigate participants’ views on how corruption can be combated to enhance learner academic achievement. The study was undertaken on three select public secondary institutions in Zimbabwe. This study also focuses on exploring the various views of educators; parents and the learners on the role played by corruption in perpetuating the seemingly existing learner academic achievement disparities in various educational institutions. The study further interrogates and examines the nexus between the prevalence of corruption in schools and the subsequent influence on the academic achievement of learners. Corruption is considered a form of social injustice; hence in Zimbabwe, the general consensus is that it is perceived rife to the extent that it is overtaking the traditional factors that contributed to the poor academic achievement of learners. Coupled to this, have been the issue of gross abuse of power and some malpractices emanating from concealment of essential and official transactions in the conduct of business. Through proposing robust anti-corruption mechanisms, teaching and learning resources poured in schools would be put into good use. This would prevent the unlawful diversion and misappropriation of the resources in question which has always been the culture. This study is of paramount significance to curriculum planners, teachers, parents, and learners. The study was informed by the interpretive paradigm; thus qualitative research approaches were used. Both probability and non-probability sampling techniques were adopted in ‘site and participants’ selection. A representative sample of (150) participants was used. The study found that the majority of the participants perceived corruption as a social problem and a human right threat affecting the quality of teaching and learning processes in the education sector. It was established that corruption prevalence within institutions is as a result of the perpetual weakening of ethical values and other variables linked to upholding of ‘Ubuntu’ among general citizenry. It was further established that greediness and weak systems are major causes of rampant corruption within institutions of higher learning and are manifesting through abuse of power, bribery, misappropriation and embezzlement of material and financial resources. Therefore, there is great need to collectively address the problem of corruption in educational institutions and society at large. The study additionally concludes that successful combating of corruption will promote successful moral development of students as well as safeguarding their human rights entitlements. The study recommends the adoption of principles of good corporate governance within educational institutions in order to successfully curb corruption. The study further recommends the intensification of interventionist strategies and strengthening of systems in educational institutions as well as regular audits to overcome the problem associated with rampant corruption cases.

Keywords: academic achievement, combating, corruption, good corporate governance, qualitative study

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860 Proposed Design Principles for Low-Income Housing in South Africa

Authors: Gerald Steyn

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Despite the huge number of identical, tiny, boxy, freestanding houses built by the South African government after the advent of democracy in 1994, squatter camps continue to mushroom, and there is no evidence that the backlog is being reduced. Not only is the wasteful low-density detached-unit approach of the past being perpetuated, but the social, spatial, and economic marginalization is worse than before 1994. The situation is precarious since squatters are vulnerable to fires and flooding. At the same time, the occupants of the housing schemes are trapped far from employment opportunities or any public amenities. Despite these insecurities, the architectural, urban design, and city planning professions are puzzlingly quiet. Design projects address these issues only at the universities, albeit inevitably with somewhat Utopian notions. Geoffrey Payne, the renowned urban housing and urban development consultant and researcher focusing on issues in the Global South, once proclaimed that “we do not have a housing problem – we have a settlement problem.” This dictum was used as the guiding philosophy to conceptualize urban design and architectural principles that foreground the needs of low-income households and allow them to be fully integrated into the larger conurbation. Information was derived from intensive research over two decades, involving frequent visits to informal settlements, historic Black townships, and rural villages. Observations, measured site surveys, and interviews resulted in several scholarly articles from which a set of desirable urban and architectural criteria could be extracted. To formulate culturally appropriate design principles, existing vernacular and informal patterns were analyzed, reconciled with contemporary designs that align with the requirements for the envisaged settlement attributes, and reimagined as residential design principles. Five interrelated design principles are proposed, ranging in scale from (1) Integrating informal settlements into the city, (2) linear neighborhoods, (3) market streets as wards, (4) linear neighborhoods, and (5) typologies and densities for clustered and aggregated patios and courtyards. Each design principle is described, first in terms of its context and associated issues of concern, followed by a discussion of the patterns available to inform a possible solution, and finally, an explanation and graphic illustration of the proposed design. The approach is predominantly bottom-up since each of the five principles is unfolded from existing informal and vernacular practices studied in situ. They are, however, articulated and represented in terms of contemporary design language. Contrary to an idealized vision of housing for South Africa’s low-income urban households, this study proposes actual principles for critical assessment by peers in the tradition of architectural research in design.

Keywords: culturally appropriate design principles, informal settlements, South Africa’s housing backlog, squatter camps

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859 A Computational Approach to Screen Antagonist’s Molecule against Mycobacterium tuberculosis Lipoprotein LprG (Rv1411c)

Authors: Syed Asif Hassan, Tabrej Khan

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Tuberculosis (TB) caused by bacillus Mycobacterium tuberculosis (Mtb) continues to take a disturbing toll on human life and healthcare facility worldwide. The global burden of TB remains enormous. The alarming rise of multi-drug resistant strains of Mycobacterium tuberculosis calls for an increase in research efforts towards the development of new target specific therapeutics against diverse strains of M. tuberculosis. Therefore, the discovery of new molecular scaffolds targeting new drug sites should be a priority for a workable plan for fighting resistance in Mycobacterium tuberculosis (Mtb). Mtb non-acylated lipoprotein LprG (Rv1411c) has a Toll-like receptor 2 (TLR2) agonist actions that depend on its association with triacylated glycolipids binding specifically with the hydrophobic pocket of Mtb LprG lipoprotein. The detection of a glycolipid carrier function has important implications for the role of LprG in Mycobacterial physiology and virulence. Therefore, considering the pivotal role of glycolipids in mycobacterial physiology and host-pathogen interactions, designing competitive antagonist (chemotherapeutics) ligands that competitively bind to glycolipid binding domain in LprG lipoprotein, will lead to inhibition of tuberculosis infection in humans. In this study, a unified approach involving ligand-based virtual screening protocol USRCAT (Ultra Shape Recognition) software and molecular docking studies using Auto Dock Vina 1.1.2 using the X-ray crystal structure of Mtb LprG protein was implemented. The docking results were further confirmed by DSX (DrugScore eXtented), a robust program to evaluate the binding energy of ligands bound to the Ligand binding domain of the Mtb LprG lipoprotein. The ligand, which has the higher hypothetical affinity, also has greater negative value. Based on the USRCAT, Lipinski’s values and molecular docking results, [(2R)-2,3-di(hexadecanoyl oxy)propyl][(2S,3S,5S,6R)-3,4,5-trihydroxy-2,6-bis[[(2R,3S,4S,5R,6S)-3,4,5-trihydroxy-6 (hydroxymethyl)tetrahydropyran-2-yl]oxy]cyclohexyl] phosphate (XPX) was confirmed as a promising drug-like lead compound (antagonist) binding specifically to the hydrophobic domain of LprG protein with affinity greater than that of PIM2 (agonist of LprG protein) with a free binding energy of -9.98e+006 Kcal/mol and binding affinity of -132 Kcal/mol, respectively. A further, in vitro assay of this compound is required to establish its potency in inhibiting molecular evasion mechanism of MTB within the infected host macrophages. These results will certainly be helpful in future anti-TB drug discovery efforts against Multidrug-Resistance Tuberculosis (MDR-TB).

Keywords: antagonist, agonist, binding affinity, chemotherapeutics, drug-like, multi drug resistance tuberculosis (MDR-TB), RV1411c protein, toll-like receptor (TLR2)

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858 ‘Green Gait’ – The Growing Relevance of Podiatric Medicine amid Climate Change

Authors: Angela Evans, Gabriel Gijon-Nogueron, Alfonso Martinez-Nova

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Background The health sector, whose mission is protecting health, also contributes to the climate crisis, the greatest health threat of the 21st century. The carbon footprint from healthcare exceeds 5% of emissions globally, surpassing 7% in the USA and Australia. Global recognition has led to the Paris Agreement, the United Nations Sustainable Development Goals, and the World Health Organization's Climate Change Action Plan. It is agreed that the majority of health impacts stem from energy and resource consumption, as well as the production of greenhouse gases in the environment and deforestation. Many professional medical associations and healthcare providers advocate for their members to take the lead in environmental sustainability. Objectives To avail and expand ‘Green Podiatry’ via the three pillars of: Exercise ; Evidence ; Everyday changes; to highlight the benefits of physical activity and exercise for both human health and planet health. Walking and running are beneficial for health, provide low carbon transport, and have evidence-based health benefits. Podiatrists are key healthcare professionals in the physical activity space and can influence and guide their patients to increase physical activity and avert the many non-communicable diseases that are decimating public health, eg diabetes, arthritis, depression, cancer, obesity. Methods Publications, conference presentations, and pilot projects pertinent to ‘Green Podiatry’ have been activated since 2021, and a survey of podiatrist’s knowledge and awareness has been undertaken.The survey assessed attitudes towards environmental sustainability in work environment. The questions addressed commuting habits, hours of physical exercise per week, and attitudes in the clinic, such as prescribing unnecessary treatments or emphasizing sports as primary treatment. Results Teaching and Learning modules have been developed for podiatric medicine students and graduates globally. These will be availed. A pilot foot orthoses recycling project has been undertaken and will be reported, in addition to established footwear recycling. The preliminary survey found almost 90% of respondents had no knowledge of green podiatry or footwear recycling. Only 30% prescribe sports/exercise as the primary treatment for patients, and 45% do not to prescribe unnecessary treatments. Conclusions Podiatrists are in a good position to lead in the crucial area of healthcare and climate change implications. Sufficient education of podiatrists is essential for the profession to beneficially promote health and physical activity, which is beneficial for the health of all peoples and all communities.

Keywords: climate change, gait, green, healthcare, sustainability

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857 Trauma Scores and Outcome Prediction After Chest Trauma

Authors: Mohamed Abo El Nasr, Mohamed Shoeib, Abdelhamid Abdelkhalik, Amro Serag

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Background: Early assessment of severity of chest trauma, either blunt or penetrating is of critical importance in prediction of patient outcome. Different trauma scoring systems are widely available and are based on anatomical or physiological parameters to expect patient morbidity or mortality. Up till now, there is no ideal, universally accepted trauma score that could be applied in all trauma centers and is suitable for assessment of severity of chest trauma patients. Aim: Our aim was to compare various trauma scoring systems regarding their predictability of morbidity and mortality in chest trauma patients. Patients and Methods: This study was a prospective study including 400 patients with chest trauma who were managed at Tanta University Emergency Hospital, Egypt during a period of 2 years (March 2014 until March 2016). The patients were divided into 2 groups according to the mode of trauma: blunt or penetrating. The collected data included age, sex, hemodynamic status on admission, intrathoracic injuries, and associated extra-thoracic injuries. The patients outcome including mortality, need of thoracotomy, need for ICU admission, need for mechanical ventilation, length of hospital stay and the development of acute respiratory distress syndrome were also recorded. The relevant data were used to calculate the following trauma scores: 1. Anatomical scores including abbreviated injury scale (AIS), Injury severity score (ISS), New injury severity score (NISS) and Chest wall injury scale (CWIS). 2. Physiological scores including revised trauma score (RTS), Acute physiology and chronic health evaluation II (APACHE II) score. 3. Combined score including Trauma and injury severity score (TRISS ) and 4. Chest-Specific score Thoracic trauma severity score (TTSS). All these scores were analyzed statistically to detect their sensitivity, specificity and compared regarding their predictive power of mortality and morbidity in blunt and penetrating chest trauma patients. Results: The incidence of mortality was 3.75% (15/400). Eleven patients (11/230) died in blunt chest trauma group, while (4/170) patients died in penetrating trauma group. The mortality rate increased more than three folds to reach 13% (13/100) in patients with severe chest trauma (ISS of >16). The physiological scores APACHE II and RTS had the highest predictive value for mortality in both blunt and penetrating chest injuries. The physiological score APACHE II followed by the combined score TRISS were more predictive for intensive care admission in penetrating injuries while RTS was more predictive in blunt trauma. Also, RTS had a higher predictive value for expectation of need for mechanical ventilation followed by the combined score TRISS. APACHE II score was more predictive for the need of thoracotomy in penetrating injuries and the Chest-Specific score TTSS was higher in blunt injuries. The anatomical score ISS and TTSS score were more predictive for prolonged hospital stay in penetrating and blunt injuries respectively. Conclusion: Trauma scores including physiological parameters have a higher predictive power for mortality in both blunt and penetrating chest trauma. They are more suitable for assessment of injury severity and prediction of patients outcome.

Keywords: chest trauma, trauma scores, blunt injuries, penetrating injuries

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856 Destination Nollywood: A Newspaper Analysis of the Connections between Film and Tourism in Nigeria, 2012-2022

Authors: E. S. Martens, E. E. Onwuliri

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Over the past three decades, Nigeria’s film industry has become a global powerhouse, releasing hundreds of films annually and even monthly. Nollywood, a portmanteau of Nigeria and Hollywood as well as Bollywood that was coined by New York Times journalist Norimitsu Onishi in 2002, came to mark the plenitude of filmmaking happening in Lagos from the early 1990s onwards. Following the success of the 1992 straight-to-VHS film Living in Bondage, the Nigerian film industry experienced a popular home video boom that gained a huge following in Nigeria, across Africa, and among the global African diaspora. In fact, with an estimated worth of $6.4 billion as of 2021, Nollywood is nowadays considered the world’s second-largest film industry and even the largest in terms of output and popularity. Producing about 2,500 films annually and reaching an estimated audience of over 200 million people worldwide, Nollywood has not only seemingly surpassed Hollywood but also Bollywood with regard to production and consumption size. Due to its commercial success and cultural impact from the early 2010s, Nollywood has often been heralded as a potential driver of Africa’s tourism industry. In its 2012 Global Trends Report, the World Travel Market forecasted an increase in GDP in Africa due to tourism in Nollywood filming locations. Additionally, it was expected that the rising popularity of Nollywood would significantly contribute to growth in the leisure sector, drawing both film enthusiasts and business travelers intrigued by the expanding significance of the Nigerian film industry. Still, despite much talk about the potential impact of Nollywood on Nigerian tourism in the past 10 years or so, relatively little is known about Nollywood’s association with film tourism and the existing connections between Nigeria’s film and tourism industries more generally. Already well over a decade ago, it was observed that there is still a lack of research examining the extent to which film tourism related to Nollywood in Africa has been generated – and to date, this is still largely the case. This paper, then, seeks to discuss the reported connections between Nollywood and tourism and to review the efforts and opportunities related to Nollywood film tourism as suggested in Nigeria’s public domain. Based on a content analysis of over 50 newspaper articles and other online available materials, such as websites, blogs and forums, this paper explores the practices and discourses surrounding Nollywood connections with tourism in Nigeria and across Africa over the past ten years. The analysis shows that, despite these high expectations, film tourism related to Nollywood has remained limited. Despite growing government attention and support to Nollywood and its potential for tourism, most state initiatives in this direction have not (yet) materialize – and it very much remains to be seen to what extent ‘Destination Nollywood’ is really able to come to fruition as long as the structural issues underlying the development of Nigerian film (and) tourism are not sufficiently addressed.

Keywords: film tourism, Nigerian cinema, Nollywood, tourist destination

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855 Interfacial Instability and Mixing Behavior between Two Liquid Layers Bounded in Finite Volumes

Authors: Lei Li, Ming M. Chai, Xiao X. Lu, Jia W. Wang

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The mixing process of two liquid layers in a cylindrical container includes the upper liquid with higher density rushing into the lower liquid with lighter density, the lower liquid rising into the upper liquid, meanwhile the two liquid layers having interactions with each other, forming vortices, spreading or dispersing in others, entraining or mixing with others. It is a complex process constituted of flow instability, turbulent mixing and other multiscale physical phenomena and having a fast evolution velocity. In order to explore the mechanism of the process and make further investigations, some experiments about the interfacial instability and mixing behavior between two liquid layers bounded in different volumes are carried out, applying the planar laser induced fluorescence (PLIF) and the high speed camera (HSC) techniques. According to the results, the evolution of interfacial instability between immiscible liquid develops faster than theoretical rate given by the Rayleigh-Taylor Instability (RTI) theory. It is reasonable to conjecture that some mechanisms except the RTI play key roles in the mixture process of two liquid layers. From the results, it is shown that the invading velocity of the upper liquid into the lower liquid does not depend on the upper liquid's volume (height). Comparing to the cases that the upper and lower containers are of identical diameter, in the case that the lower liquid volume increases to larger geometric space, the upper liquid spreads and expands into the lower liquid more quickly during the evolution of interfacial instability, indicating that the container wall has important influence on the mixing process. In the experiments of miscible liquid layers’ mixing, the diffusion time and pattern of the liquid interfacial mixing also does not depend on the upper liquid's volumes, and when the lower liquid volume increases to larger geometric space, the action of the bounded wall on the liquid falling and rising flow will decrease, and the liquid interfacial mixing effects will also attenuate. Therefore, it is also concluded that the volume weight of upper heavier liquid is not the reason of the fast interfacial instability evolution between the two liquid layers and the bounded wall action is limited to the unstable and mixing flow. The numerical simulations of the immiscible liquid layers’ interfacial instability flow using the VOF method show the typical flow pattern agree with the experiments. However the calculated instability development is much slower than the experimental measurement. The numerical simulation of the miscible liquids’ mixing, which applying Fick’s diffusion law to the components’ transport equation, shows a much faster mixing rate than the experiments on the liquids’ interface at the initial stage. It can be presumed that the interfacial tension plays an important role in the interfacial instability between the two liquid layers bounded in finite volume.

Keywords: interfacial instability and mixing, two liquid layers, Planar Laser Induced Fluorescence (PLIF), High Speed Camera (HSC), interfacial energy and tension, Cahn-Hilliard Navier-Stokes (CHNS) equations

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854 Wave Agitated Signatures in the Oolitic Limestones of Kunihar Formation, Proterozoic Simla Group, Lesser Himalaya, India

Authors: Alono Thorie, Ananya Mukhopadhyay

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Ooid bearing horizons of the Proterozoic Kunihar Formation, Simla Group, Lesser Himalaya have been addressed in the present work. The study is concentrated around the outskirts of Arki town, Solan district, Himachal Pradesh, India. Based on the sedimentary facies associations, the processes that promote the formation of ooids have been documented. The facies associations that have been recorded are: (i) Oolitic-Intraclastic grainstone (FA1), (ii) Oolitic grainstone (FA2), (iii) Boundstone (FA3), (iv) Dolomudstone (FA4) and (v) Rudstone (FA5). Oolitic-Intraclastic grainstone (FA1) mainly consists of well sorted ooids with concentric laminae and intraclasts. Large ooids with grain sizes more than 4 mm are characteristic of oolites throughout the area. Normally graded beds consisting of ooids and intraclasts are frequently documented in storm sediments in shelf environments and carbonate platforms. The well-sorted grainstone fabric indicates deposition in a high-energy shoal with tidal currents and storm reworking. FA2 comprises spherical to elliptical grains up to 8.5cm in size with concentric cortex and micritic nuclei. Peloids in FA2 are elliptical, rounded objects <0.3 mm in size. FA1 and FA2 have been recorded alongside boundstones (FA3) comprising stromatolites having columnar, wavy and domal morphology. Boundstones (FA3) reflect microbial growth in carbonate platforms and reefs. Dolomudstones (FA4) interbedded with cross laminated sandstones and erosional surfaces reflect sedimentation in storm dominated zones below fair-weather wave base. Rudstone (FA5) is composed of oolitic grainstone (FA2), boundstone (FA3) and dolomudstone (FA4). These clasts are few mm to more than 10 cm in length. Rudstones indicate deposition along a slope with intermittent influence of wave currents and storm activities. Most ooids from the Kunihar Formation are regular ooids with abundance of broken ooids. Compound and concentric ooids indicating medium to low energy environments are present but scarce. Ooids from high energy domains are more dominant than ooids developed from low energy environments. The unusually large size of the Kunihar ooids (more than 8.5 cm) is rare in the geological record. Development of carbonate deposits such as oolitic- intraclastic Grainstones (FA1), oolitic grainstones (FA2) and rudstones (FA5), and reflect deposition in an agitated beach environment with abundant microbial activity and high energy shallow marine waters influenced by tide, wave and storm currents. Occurrences of boundstone (FA4) or stromatolitic carbonate amongst oolitic facies (FA1 and FA2) and appearance of compound and concentric ooids indicate intervals of calm in between agitated phases of storm, wave and tidal activities.

Keywords: proterozoic, Simla Group, ooids, stromatolites

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853 Stimulation of Nerve Tissue Differentiation and Development Using Scaffold-Based Cell Culture in Bioreactors

Authors: Simon Grossemy, Peggy P. Y. Chan, Pauline M. Doran

Abstract:

Nerve tissue engineering is the main field of research aimed at finding an alternative to autografts as a treatment for nerve injuries. Scaffolds are used as a support to enhance nerve regeneration. In order to successfully design novel scaffolds and in vitro cell culture systems, a deep understanding of the factors affecting nerve regeneration processes is needed. Physical and biological parameters associated with the culture environment have been identified as potentially influential in nerve cell differentiation, including electrical stimulation, exposure to extracellular-matrix (ECM) proteins, dynamic medium conditions and co-culture with glial cells. The mechanisms involved in driving the cell to differentiation in the presence of these factors are poorly understood; the complexity of each of them raises the possibility that they may strongly influence each other. Some questions that arise in investigating nerve regeneration include: What are the best protein coatings to promote neural cell attachment? Is the scaffold design suitable for providing all the required factors combined? What is the influence of dynamic stimulation on cell viability and differentiation? In order to study these effects, scaffolds adaptable to bioreactor culture conditions were designed to allow electrical stimulation of cells exposed to ECM proteins, all within a dynamic medium environment. Gold coatings were used to make the surface of viscose rayon microfiber scaffolds (VRMS) conductive, and poly-L-lysine (PLL) and laminin (LN) surface coatings were used to mimic the ECM environment and allow the attachment of rat PC12 neural cells. The robustness of the coatings was analyzed by surface resistivity measurements, scanning electron microscope (SEM) observation and immunocytochemistry. Cell attachment to protein coatings of PLL, LN and PLL+LN was studied using DNA quantification with Hoechst. The double coating of PLL+LN was selected based on high levels of PC12 cell attachment and the reported advantages of laminin for neural differentiation. The underlying gold coatings were shown to be biocompatible using cell proliferation and live/dead staining assays. Coatings exhibiting stable properties over time under dynamic fluid conditions were developed; indeed, cell attachment and the conductive power of the scaffolds were maintained over 2 weeks of bioreactor operation. These scaffolds are promising research tools for understanding complex neural cell behavior. They have been used to investigate major factors in the physical culture environment that affect nerve cell viability and differentiation, including electrical stimulation, bioreactor hydrodynamic conditions, and combinations of these parameters. The cell and tissue differentiation response was evaluated using DNA quantification, immunocytochemistry, RT-qPCR and functional analyses.

Keywords: bioreactor, electrical stimulation, nerve differentiation, PC12 cells, scaffold

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852 An Absolute Femtosecond Rangefinder for Metrological Support in Coordinate Measurements

Authors: Denis A. Sokolov, Andrey V. Mazurkevich

Abstract:

In the modern world, there is an increasing demand for highly precise measurements in various fields, such as aircraft, shipbuilding, and rocket engineering. This has resulted in the development of appropriate measuring instruments that are capable of measuring the coordinates of objects within a range of up to 100 meters, with an accuracy of up to one micron. The calibration process for such optoelectronic measuring devices (trackers and total stations) involves comparing the measurement results from these devices to a reference measurement based on a linear or spatial basis. The reference used in such measurements could be a reference base or a reference range finder with the capability to measure angle increments (EDM). The base would serve as a set of reference points for this purpose. The concept of the EDM for replicating the unit of measurement has been implemented on a mobile platform, which allows for angular changes in the direction of laser radiation in two planes. To determine the distance to an object, a high-precision interferometer with its own design is employed. The laser radiation travels to the corner reflectors, which form a spatial reference with precisely known positions. When the femtosecond pulses from the reference arm and the measuring arm coincide, an interference signal is created, repeating at the frequency of the laser pulses. The distance between reference points determined by interference signals is calculated in accordance with recommendations from the International Bureau of Weights and Measures for the indirect measurement of time of light passage according to the definition of a meter. This distance is D/2 = c/2nF, approximately 2.5 meters, where c is the speed of light in a vacuum, n is the refractive index of a medium, and F is the frequency of femtosecond pulse repetition. The achieved uncertainty of type A measurement of the distance to reflectors 64 m (N•D/2, where N is an integer) away and spaced apart relative to each other at a distance of 1 m does not exceed 5 microns. The angular uncertainty is calculated theoretically since standard high-precision ring encoders will be used and are not a focus of research in this study. The Type B uncertainty components are not taken into account either, as the components that contribute most do not depend on the selected coordinate measuring method. This technology is being explored in the context of laboratory applications under controlled environmental conditions, where it is possible to achieve an advantage in terms of accuracy. In general, the EDM tests showed high accuracy, and theoretical calculations and experimental studies on an EDM prototype have shown that the uncertainty type A of distance measurements to reflectors can be less than 1 micrometer. The results of this research will be utilized to develop a highly accurate mobile absolute range finder designed for the calibration of high-precision laser trackers and laser rangefinders, as well as other equipment, using a 64 meter laboratory comparator as a reference.

Keywords: femtosecond laser, pulse correlation, interferometer, laser absolute range finder, coordinate measurement

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851 Contentious Politics during a Period of Transition to Democracy from an Authoritarian Regime: The Spanish Cycle of Protest of November 1975-December 1978

Authors: Juan Sanmartín Bastida

Abstract:

When a country experiences a period of transition from authoritarianism to democracy, involving an earlier process of political liberalization and a later process of democratization, a cycle of protest usually outbreaks, as there is a reciprocal influence between that kind of political change and the frequency and scale of social protest events. That is what happened in Spain during the first years of its transition to democracy from the Francoist authoritarian regime, roughly between November 1975 and December 1978. Thus, the object of this study is to show and explain how that cycle of protest started, developed, and finished in relation to such a political change, and offer specific information about the main features of all protest cycles: the social movements that arose during that period, the number of protest events by month, the forms of collective action that were utilized, the groups of challengers that engaged in contentious politics, the reaction of the authorities to the action and claims of those groups, etc. The study of this cycle of protest, using the primary sources and analytical tools that characterize the model of research of protest cycles, will make a contribution to the field of contentious politics and its phenomenon of cycles of contention, and more broadly to the political and social history of contemporary Spain. The cycle of protest and the process of political liberalization of the authoritarian regime began around the same time, but the first concluded long before the process of democratization was completed in 1982. The ascending phase of the cycle and therefore the process of liberalization started with the death of Francisco Franco and the proclamation of Juan Carlos I as King of Spain in November 1975; the peak of the cycle was around the first months of 1977; the descending phase started after the first general election of June 1977; and the level of protest stabilized in the last months of 1978, a year that finished with a referendum in which the Spanish people approved the current democratic constitution. It was then when we can consider that the cycle of protest came to an end. The primary sources are the news of protest events and social movements in the three main Spanish newspapers at the time, other written or audiovisual documents, and in-depth interviews; and the analytical tools are the political opportunities that encourage social protest, the available repertoire of contention, the organizations and networks that brought together people with the same claims and allowed them to engage in contentious politics, and the interpretative frames that justify, dignify and motivates their collective action. These are the main four factors that explain the beginning, development and ending of the cycle of protest, and therefore the accompanying social movements and events of collective action. Among those four factors, the political opportunities -their opening, exploitation, and closure-proved to be most decisive.

Keywords: contentious politics, cycles of protest, political opportunities, social movements, Spanish transition to democracy

Procedia PDF Downloads 138
850 Development of a Finite Element Model of the Upper Cervical Spine to Evaluate the Atlantoaxial Fixation Techniques

Authors: Iman Zafarparandeh, Muzammil Mumtaz, Paniz Taherzadeh, Deniz Erbulut

Abstract:

The instability in the atlantoaxial joint may occur due to cervical surgery, congenital anomalies, and trauma. There are different types of fixation techniques proposed for restoring the stability and preventing harmful neurological deterioration. Application of the screw constructs has become a popular alternative to the older techniques for stabilizing the joint. The main difference between the various screw constructs is the type of the screw which can be lateral mass screw, pedicle screw, transarticular screw, and translaminar screw. The aim of this paper is to study the effect of three popular screw constructs fixation techniques on the biomechanics of the atlantoaxial joint using the finite element (FE) method. A three-dimensional FE model of the upper cervical spine including the skull, C1 and C2 vertebrae, and groups of the existing ligaments were developed. The accurate geometry of the model was obtained from the CT data of a 35-year old male. Three screw constructs were designed to compare; Magerl transarticular screw (TA-Screw), Goel-Harms lateral mass screw and pedicle screw (LM-Screw and Pedicle-Screw), and Wright lateral mass screw and translaminar screw (LM-Screw and TL-Screw). Pure moments were applied to the model in the three main planes; flexion (Flex), extension (Ext), axial rotation (AR) and lateral bending (LB). The range of motion (ROM) of C0-C1 and C1-C2 segments for the implanted FE models are compared to the intact FE model and the in vitro study of Panjabi (1988). The Magerl technique showed less effect on the ROM of C0-C1 than the other two techniques in sagittal plane. In lateral bending and axial rotation, the Goel-Harms and Wright techniques showed less effect on the ROM of C0-C1 than the Magerl technique. The Magerl technique has the highest fusion rate as 99% in all loading directions for the C1-C2 segment. The Wright technique has the lowest fusion rate in LB as 79%. The three techniques resulted in the same fusion rate in extension loading as 99%. The maximum stress for the Magerl technique is the lowest in all load direction compared to other two techniques. The maximum stress in all direction was 234 Mpa and occurred in flexion with the Wright technique. The maximum stress for the Goel-Harms and Wright techniques occurred in lateral mass screw. The ROM obtained from the FE results support this idea that the fusion rate of the Magerl is more than 99%. Moreover, the maximum stress occurred in each screw constructs proves the less failure possibility for the Magerl technique. Another advantage of the Magerl technique is the less number of components compared to other techniques using screw constructs. Despite the benefits of the Magerl technique, there are drawbacks to using this method such as reduction of the C1 and C2 before screw placement. Therefore, other fixation methods such as Goel-Harms and Wright techniques find the solution for the drawbacks of the Magerl technique by adding screws separately to C1 and C2. The FE model implanted with the Wright technique showed the highest maximum stress almost in all load direction.

Keywords: cervical spine, finite element model, atlantoaxial, fixation technique

Procedia PDF Downloads 384
849 Blockchain for the Monitoring and Reporting of Carbon Emission Trading: A Case Study on Its Possible Implementation in the Danish Energy Industry

Authors: Nkechi V. Osuji

Abstract:

The use of blockchain to address the issue of climate change is increasingly a discourse among countries, industries, and stakeholders. For a long time, the European Union (EU) has been combating the issue of climate action in industries through sustainability programs. One of such programs is the EU monitoring reporting and verification (MRV) program of the EU ETS. However, the system has some key challenges and areas for improvement, which makes it inefficient. The main objective of the research is to look at how blockchain can be used to improve the inefficiency of the EU ETS program for the Danish energy industry with a focus on its monitoring and reporting framework. Applying empirical data from 13 semi-structured expert interviews, three case studies, and literature reviews, three outcomes are presented in the study. The first is on the current conditions and challenges of monitoring and reporting CO₂ emission trading. The second is putting into consideration if blockchain is the right fit to solve these challenges and how. The third stage looks at the factors that might affect the implementation of such a system and provides recommendations to mitigate these challenges. The first stage of the findings reveals that the monitoring and reporting of CO₂ emissions is a mandatory requirement by law for all energy operators under the EU ETS program. However, most energy operators are non-compliant with the program in reality, which creates a gap and causes challenges in the monitoring and reporting of CO₂ emission trading. Other challenges the study found out are the lack of transparency, lack of standardization in CO₂ accounting, and the issue of double-counting in the current system. The second stage of the research was guided by three case studies and requirement engineering (RE) to explore these identified challenges and if blockchain is the right fit to address them. This stage of the research addressed the main research question: how can blockchain be used for monitoring and reporting CO₂ emission trading in the energy industry. Through analysis of the study data, the researcher developed a conceptual private permissioned Hyperledger blockchain and elucidated on how it can address the identified challenges. Particularly, the smart contract of blockchain was highlighted as a key feature. This is because of its ability to automate, be immutable, and digitally enforce negotiations without a middleman. These characteristics are unique in solving the issue of compliance, transparency, standardization, and double counting identified. The third stage of the research presents technological constraints and a high level of stakeholder collaboration as major factors that might affect the implementation of the proposed system. The proposed conceptual model requires high-level integration with other technologies such as the Internet of Things (IoT) and machine learning. Therefore, the study encourages future research in these areas. This is because blockchain is continually evolving its technology capabilities. As such, it remains a topic of interest in research and development for addressing climate change. Such a study is a good contribution to creating sustainable practices to solve the global climate issue.

Keywords: blockchain, carbon emission trading, European Union emission trading system, monitoring and reporting

Procedia PDF Downloads 129
848 Effectiveness, Safety, and Tolerability Profile of Stribild® in HIV-1-infected Patients in the Clinical Setting

Authors: Heiko Jessen, Laura Tanus, Slobodan Ruzicic

Abstract:

Objectives: The efficacy of Stribild®, an integrase strand transfer inhibitor (INSTI) -based STR, has been evaluated in randomized clinical trials and it has demonstrated durable capability in terms of achieving sustained suppression of HIV-1 RNA-levels. However, differences in monitoring frequency, existing selection bias and profile of patients enrolled in the trials, may all result in divergent efficacy of this regimen in routine clinical settings. The aim of this study was to assess the virologic outcomes, safety and tolerability profile of Stribild® in a routine clinical setting. Methods: This was a retrospective monocentric analysis on HIV-1-infected patients, who started with or were switched to Stribild®. Virological failure (VF) was defined as confirmed HIV-RNA>50 copies/ml. The minimum time of follow-up was 24 weeks. The percentage of patients remaining free of therapeutic failure was estimated using the time-to-loss-of-virologic-response (TLOVR) algorithm, by intent-to-treat analysis. Results: We analyzed the data of 197 patients (56 ART-naïve and 141 treatment-experienced patients), who fulfilled the inclusion criteria. Majority (95.9%) of patients were male. The median time of HIV-infection at baseline was 2 months in treatment-naïve and 70 months in treatment-experienced patients. Median time [IQR] under ART in treatment-experienced patients was 37 months. Among the treatment-experienced patients 27.0% had already been treated with a regimen consisting of two NRTIs and one INSTI, whereas 18.4% of them experienced a VF. The median time [IQR] of virological suppression prior to therapy with Stribild® in the treatment-experienced patients was 10 months [0-27]. At the end of follow-up (median 33 months), 87.3% (95% CI, 83.5-91.2) of treatment-naïve and 80.3% (95% CI, 75.8-84.8) of treatment-experienced patients remained free of therapeutic failure. Considering only treatment-experienced patients with baseline VL<50 copies/ml, 83.0% (95% CI, 78.5-87.5) remained free of therapeutic failure. A total of 17 patients stopped treatment with Stribild®, 5.4% (3/56) of them were treatment-naïve and 9.9% (14/141) were treatment-experienced patients. The Stribild® therapy was discontinued in 2 (1.0%) because of VF, loss to follow-up in 4 (2.0%), and drug-drug interactions in 2 (1.0%) patients. Adverse events were in 7 (3.6%) patients the reason to switch from therapy with Stribild® and further 2 (1.0%) patients decided personally to switch. The most frequently observed adverse events were gastrointestinal side effects (20.0%), headache (8%), rash events (7%) and dizziness (6%). In two patients we observed an emergence of novel resistances in integrase-gene. The N155H evolved in one patient and resulted in VF. In another patient S119R evolved either during or shortly upon switch from therapy with Stribild®. In one further patient with VF two novel mutations in the RT-gene were observed when compared to historical genotypic test result (V106I/M and M184V), whereby it is not clear whether they evolved during or already before the switch to Stribild®. Conclusions: Effectiveness of Stribild® for treatment-naïve patients was consistent with data obtained in clinical trials. The safety and tolerability profile as well as resistance development confirmed clinical efficacy of Stribild® in a daily practice setting.

Keywords: ART, HIV, integrase inhibitor, stribild

Procedia PDF Downloads 285