Search results for: geological setting

Authors: Ifeanyichukwu Valerie Oguafor

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Women generally have been categorized and placed under the chain of business industry, sometimes highly regarded and other times merely. The social construction of womanhood does not in all sense support a woman going into business, let alone succeed in it because it is believed that it a man’s world. In a typical patriarchal setting, a woman is expected to know nothing more domestic roles. For some women, this is not the case as they have been able to break these barriers to excel in business amidst these social setting and stereotypes. This study examines media representation of Nigerians business women, using content analysis of TV interviews as media text, framing analysis as an approach in qualitative methodology, The study further aims to analyse media frames of two Nigerian business women: FolorunshoAlakija, a business woman in the petroleum industry with current net worth 1.1 billion U.S dollars, emerging as the richest black women in the world 2014. MosunmolaAbudu, a media magnate in Nigeria who launched the first Africa’s global black entertainment and lifestyle network in 2013. This study used six predefined frames: the business woman, the myth of business women, the non-traditional woman, women in leading roles, the family woman, the religious woman, and the philanthropist woman to analyse the representation of Nigerian business women in the media. The analysis of the aforementioned frames on TV interviews with these women reveals that the media perpetually reproduces existing gender stereotype and do not challenge patriarchy. Women face challenges in trying to succeed in business while trying to keep their homes stable. This study concludes that the media represent and reproduce gender stereotypes in spite of the expectation of empowering women. The media reduces these women’s success insignificant rather than a role model for women in society.

Keywords: representation of business women in the media, business women in Nigeria, framing in the media, patriarchy, women's subordination

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Authors: Minna K. Miller, Chantel. E. Canessa, Suzanna V. McRae, Susan Shumay, Alissa Collingridge

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Primary care provides the first point of contact and access to health care services. For the pediatric population, the goal is to help healthy children stay healthy and to help those that are sick get better. Primary care facilitates regular well baby/child visits; health promotion and disease prevention; investigation, diagnosis and management of acute and chronic illnesses; health education; both consultation and collaboration with, and referral to other health care professionals. There is a protective association between regular well-child visit care and preventable hospitalization. Further, low adherence to well-child care and poor continuity of care are independently associated with increased risk of hospitalization. With a declining number of family physicians caring for children, and only a portion of pediatricians providing primary care services, it is becoming increasingly difficult for children and their families to access primary care. Nurse practitioners are in a unique position to improve access to primary care and improve health outcomes for children. Limited literature is available on the nurse practitioner role in primary care pediatrics. The purpose of this paper is to describe the development, implementation and evaluation of a Nurse Practitioner-led pediatric primary care clinic in a tertiary care setting. Utilizing the participatory, evidence-based, patient-focused process for advanced practice nursing (PEPPA framework), this paper highlights the results of the initial needs assessment/gap analysis, the new service delivery model, populations served, and outcome measures.

Keywords: access, health outcomes, nurse practitioner, pediatric primary care, PEPPA framework

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Authors: Ibrahim Abdel Gadir Malik, Dafalla Siddig Dafalla, Abdelazim Ibrahim

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Jabal Omar is located in the western side of Makkah city in Saudi Arabia. The proposed Jabal Omar Development project includes several multi-storey buildings, roads, bridges and below ground structures founded at various depths. In this study, geological mapping and site inspection which covered pre-selected areas were carried out within the easily accessed parts. Geological features; including rock types, structures, degree of weathering, and geotechnical hazards were observed and analyzed with specified software and also were documented in form of photographs. The presence of joints and fractures in the area made the rock blocks small and weak. The site is full of jointing; it was observed that, the northern side consists of 3 to 4 jointing systems with 2 random fractures associated with dykes. The southern part is affected by 2 to 3 jointing systems with minor fault and shear zones. From the field measurements and observations, it was concluded that, the Jabal Omar intruded by andesitic and basaltic dykes of different thickness and orientation. These dykes made the outcrop weak, highly deformed and made the rock masses sensitive to weathering.

Keywords: rock, slope, stabilization, protection, Makkah

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Authors: Mrinmoy Dhara, Vivek K. Sengar, Shovan L. Chattoraj, Soumiya Bhattacharjee

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Remote sensing techniques have emerged as an asset for various geological studies. Satellite images obtained by different sensors contain plenty of information related to the terrain. Digital image processing further helps in customized ways for the prospecting of minerals. In this study, an attempt has been made to map the hydrothermally altered zones using multispectral and hyperspectral datasets of South East Rajasthan. Advanced Space-borne Thermal Emission and Reflection Radiometer (ASTER) and Hyperion (Level1R) dataset have been processed to generate different Band Ratio Composites (BRCs). For this study, ASTER derived BRCs were generated to delineate the alteration zones, gossans, abundant clays and host rocks. ASTER and Hyperion images were further processed to extract mineral end members and classified mineral maps have been produced using Spectral Angle Mapper (SAM) method. Results were validated with the geological map of the area which shows positive agreement with the image processing outputs. Thus, this study concludes that the band ratios and image processing in combination play significant role in demarcation of alteration zones which may provide pathfinders for mineral prospecting studies.

Keywords: ASTER, hyperion, band ratios, alteration zones, SAM

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Authors: Tadele Tesfaw, Ajit Pal Singh, Abebaw Mekonnen Gezahegn

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Welding is a basic manufacturing process for making components or assemblies. Recent welding economics research has focused on developing the reliable machinery database to ensure optimum production. Research on welding of materials like steel is still critical and ongoing. Welding input parameters play a very significant role in determining the quality of a weld joint. The metal active gas (MAG) welding parameters are the most important factors affecting the quality, productivity and cost of welding in many industrial operations. The aim of this study is to investigate the optimization process parameters for metal active gas welding for 60x60x5mm dead mild steel plate work-piece using Taguchi method to formulate the statistical experimental design using semi-automatic welding machine. An experimental study was conducted at Bishoftu Automotive Industry, Bishoftu, Ethiopia. This study presents the influence of four welding parameters (control factors) like welding voltage (volt), welding current (ampere), wire speed (m/min.), and gas (CO2) flow rate (lit./min.) with three different levels for variability in the welding hardness. The objective functions have been chosen in relation to parameters of MAG welding i.e., welding hardness in final products. Nine experimental runs based on an L9 orthogonal array Taguchi method were performed. An orthogonal array, signal-to-noise (S/N) ratio and analysis of variance (ANOVA) are employed to investigate the welding characteristics of dead mild steel plate and used in order to obtain optimum levels for every input parameter at 95% confidence level. The optimal parameters setting was found is welding voltage at 22 volts, welding current at 125 ampere, wire speed at 2.15 m/min and gas flow rate at 19 l/min by using the Taguchi experimental design method within the constraints of the production process. Finally, six conformations welding have been carried out to compare the existing values; the predicated values with the experimental values confirm its effectiveness in the analysis of welding hardness (quality) in final products. It is found that welding current has a major influence on the quality of welded joints. Experimental result for optimum setting gave a better hardness of welding condition than initial setting. This study is valuable for different material and thickness variation of welding plate for Ethiopian industries.

Keywords: Weld quality, metal active gas welding, dead mild steel plate, orthogonal array, analysis of variance, Taguchi method

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Authors: Marlin Mubarak

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Background: Endometriosis is a complex disabling disease affecting young females in the reproductive period mainly. The aim of this project is to generate a diagnostic model to predict severity and stage of endometriosis prior to Laparoscopic surgery. This will help to improve the pre-operative diagnostic accuracy of stage 3 & 4 endometriosis and as a result, refer relevant women to a specialist centre for complex Laparoscopic surgery. The model is based on the British Society of Gynaecological Endoscopy (BSGE) pain questionnaire, clinical examination and ultrasound scan. Design: This is a prospective, observational, study, in which women completed the BSGE pain questionnaire, a BSGE requirement. Also, as part of the routine preoperative assessment patient had a routine ultrasound scan and when recto-vaginal and deep infiltrating endometriosis was suspected an MRI was performed. Setting: Luton & Dunstable University Hospital. Patients: Symptomatic women (n = 56) scheduled for laparoscopy due to pelvic pain. The age ranged between 17 – 52 years of age (mean 33.8 years, SD 8.7 years). Interventions: None outside the recognised and established endometriosis centre protocol set up by BSGE. Main Outcome Measure(s): Sensitivity and specificity of endometriosis diagnosis predicted by symptoms based on BSGE pain questionnaire, clinical examinations and imaging. Findings: The prevalence of diagnosed endometriosis was calculated to be 76.8% and the prevalence of advanced stage was 55.4%. Deep infiltrating endometriosis in various locations was diagnosed in 32/56 women (57.1%) and some had DIE involving several locations. Logistic regression analysis was performed on 36 clinical variables to create a simple clinical prediction model. After creating the scoring system using variables with P < 0.05, the model was applied to the whole dataset. The sensitivity was 83.87% and specificity 96%. The positive likelihood ratio was 20.97 and the negative likelihood ratio was 0.17, indicating that the model has a good predictive value and could be useful in predicting advanced stage endometriosis. Conclusions: This is a hypothesis-generating project with one operator, but future proposed research would provide validation of the model and establish its usefulness in the general setting. Predictive tools based on such model could help organise the appropriate investigation in clinical practice, reduce risks associated with surgery and improve outcome. It could be of value for future research to standardise the assessment of women presenting with pelvic pain. The model needs further testing in a general setting to assess if the initial results are reproducible.

Keywords: deep endometriosis, endometriosis, minimally invasive, MRI, ultrasound.

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Authors: John Rothrock

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Background: The role of transthoracic echocardiography (TTE) in the diagnosis and management of patients with acute ischemic stroke remains controversial. While many stroke subspecialist reserve TTE for selected patients, others consider the procedure obligatory for most or all acute stroke patients. This study was undertaken to assess the cost vs. benefit of 'routine' TTE. Methods: We examined a consecutive series of patients who were admitted to a single institution in 2019 for acute ischemic stroke and underwent TTE. We sought to determine the frequency with which the results of TTE led to a new diagnosis of cardioembolism, redirected therapeutic cerebrovascular management, and at least potentially influenced the short or long-term clinical outcome. We recorded the direct cost associated with TTE. Results: There were 1076 patients in the study group, all of whom underwent TTE. TTE identified an unsuspected source of possible/probable cardioembolism in 62 patients (6%), confirmed an initially suspected source (primarily endocarditis) in an additional 13 (1%) and produced findings that stimulated subsequent testing diagnostic of possible/probable cardioembolism in 7 patients ( < 1%). TTE results potentially influenced the clinical outcome in a total of 48 patients (4%). With a total direct cost of $1.51 million, the mean cost per case wherein TTE results potentially influenced the clinical outcome in a positive manner was $31,375. Diagnostically and therapeutically, TTE was most beneficial in 67 patients under the age of 55 who presented with 'cryptogenic' stroke, identifying patent foramen ovale in 21 (31%); closure was performed in 19. Conclusions: The utility of TTE in the setting of acute ischemic stroke is modest, with its yield greatest in younger patients with cryptogenic stroke. Given the greater sensitivity of transesophageal echocardiography in detecting PFO and evaluating the aortic arch, TTE’s role in stroke diagnosis would appear to be limited.

Keywords: cardioembolic, cost-benefit, stroke, TTE

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Authors: Schadrack Mwizerwa

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The characterization and prediction of landslides are crucial for assessing geological hazards and mitigating risks to infrastructure and communities. This research aims to develop a probabilistic framework for analyzing excavation-induced landslides, which is fundamental for assessing geological hazards and mitigating risks to infrastructure and communities. The study uses Hermite polynomial chaos, a non-stationary random process, to analyze the stability of a slope and characterize the failure probability of a real landslide induced by highway construction excavation. The correlation within the data is captured using the Karhunen-Loève (KL) expansion theory, and the finite element method is used to analyze the slope's stability. The research contributes to the field of landslide characterization by employing advanced random field approaches, providing valuable insights into the complex nature of landslide behavior and the effectiveness of advanced probabilistic models for risk assessment and management. The data collected from the Baiyuzui landslide, induced by highway construction, is used as an illustrative example. The findings highlight the importance of considering the probabilistic nature of landslides and provide valuable insights into the complex behavior of such hazards.

Keywords: Hermite polynomial chaos, Karhunen-Loeve, slope stability, probabilistic analysis

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Authors: Neşe Işık, Şenol Altıok, Galip Devrim Eryılmaz, Aydın durukan, Hasan Özgür Daş

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In this study, an active landslide zone affecting the road alignment on the Tortum-Uzundere (Erzurum/Turkey) highway was investigated. Due to the landslide movement, problems have occurred in the existing road pavement, which has caused both safety problems and reduced driving comfort in the operation of the road. In order to model the landslide, drilling, geophysical and inclinometer studies were carried out in the field within the scope of ground investigation. Laboratory tests were carried out on soil and rock samples obtained from the borings. When the drilling and geophysical studies were evaluated together, it was determined that the study area has a complex geological structure. In addition, according to the inclinometer results, the direction and speed of movement of the landslide mass were observed. In order to create an idealized geological profile, all field and laboratory studies were evaluated together and then the sliding surface of the landslide was determined by back analysis method. According to the findings obtained, it was determined that the landslide was massively large, and the movement occurred had a deep sliding surface. As a result of the numerical analyses, it was concluded that the Slope angle reduction is the most economical and environmentally friendly method for the control of the landslide mass.

Keywords: landslide, geotechnical methods, geophysics, monitoring, highway

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Authors: Jill Garner, Belinda Lange, Sheila Lennon, Maayken van den Berg

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Currently, there are approximately one billion people worldwide affected by a neurological condition. Many of whom are assessed and treated by a physiotherapist in a variety of settings. There is a lack of consensus in the literature related to what is clinically assessed by physiotherapists in people with neurological conditions. This study aimed to explore assessment in people with neurological conditions, including how health care setting, experience, and therapeutic approach, may influence neurological assessment. A national survey targeted Australian physiotherapists who assess adults with neurological conditions as part of their clinical practice. The survey consisted of 39 questions and was distributed to physiotherapists through the Australian Physiotherapy Association, and Chief Allied Health Officers across Australia and advertised on the National Neurological Physiotherapy Facebook page. In total, 395 respondents consented to the survey from all states within Australia. Most respondents were female (85.4%) with a mean (SD) age of 35.7 years. Respondents reported working clinically in acute, community, outpatients, and community settings. Stroke was the most assessed condition (58.0%). There is variability in domains assessed by Australian physiotherapists, with common inclusions of balance, muscle strength, gait, falls and safety, function, goal setting, range of movement, pain, coordination, activity tolerance, postural alignment and symmetry and upper limb. There is little evidence to support what physiotherapists assess in practice, in different settings, and in different states within Australia and not enough information to develop a decision tree regarding what is important for assessment in different settings. Further research is needed to explore this area and develop a consensus around best practices.

Keywords: physiotherapy, neurological, assessment, domains

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Authors: Cory B. Lord

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Falls among the elderly population has become an area of concern in healthcare today. The negative impacts of falls lead to increased morbidity, mortality, and financial burdens for both patients and healthcare systems. Falls in the United States is reported at an annual rate of 36 million in those aged 65 and older. Each year, one out of four people in this age group will suffer a fall, with 20% of these falls causing injury. The setting for this Doctor of Nursing Practice (DNP) project was a memory care unit in an assisted living community, as these facilities house cognitively impaired older adults. These communities lack fall prevention programs; therefore, the need exists to add to the body of knowledge to positively impact this population. The objective of this project was to reduce fall rates through the implementation of the Center for Disease Control and Prevention (CDC) STEADI (stopping elderly accidents, deaths, and injuries) program. The DNP project performed was a quality improvement pilot study with a pre and post-test design. This program was implemented in the memory care setting over 12 weeks. The project included an educational session for staff and a fall risk assessment with appropriate resident referrals. The three aims of the DNP project were to reduce fall rates among the elderly aged 65 and older who reside in the memory care unit, increase staff knowledge of STEADI fall prevention measures after an educational session, and assess the willingness of memory care unit staff to adopt an evidence-based a fall prevention program. The Donabedian model was used as a guiding conceptual framework for this quality improvement pilot study. The fall rate data for 12 months before the intervention was evaluated and compared to post-intervention fall rates. The educational session comprised of a pre and post-test to assess staff knowledge of the fall prevention program and the willingness of staff to adopt the fall prevention program. The overarching goal was to reduce falls in the elderly population who live in memory care units. The results of the study showed, on average that the fall rate during the implementation period of STEADI (μ=6.79) was significantly lower when compared to the prior 12 months (μ= 9.50) (p=0.02, α = 0.05). The mean staff knowledge scores improved from pretest (μ=77.74%) to post-test (μ=87.42%) (p=0.00, α= 0.05) after the education session. The results of the willingness to adopt a fall prevention program were scored at 100%. In summation, implementing the STEADI fall prevention program can assist in reducing fall rates for residents aged 65 and older who reside in a memory care setting.

Keywords: dementia, elderly, falls, STEADI

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Authors: Olia Kanevskaia

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Standardization has been in the limelight of numerous academic studies. Typically described as ‘any set of technical specifications that either provides or is intended to provide a common design for a product or process’, standards do not only set quality benchmarks for products and services, but also spur competition and innovation, resulting in advantages for manufacturers and consumers. Their contribution to globalization and technology advancement is especially crucial in the Information and Communication Technology (ICT) and telecommunications sector, which is also characterized by a weaker state-regulation and expert-based rule-making. Most of the standards developed in that area are interoperability standards, which allow technological devices to establish ‘invisible communications’ and to ensure their compatibility and proper functioning. This type of standard supports a large share of our daily activities, ranging from traffic coordination by traffic lights to the connection to Wi-Fi networks, transmission of data via Bluetooth or USB and building the network architecture for the Internet of Things (IoT). A large share of ICT standards is developed in the specialized voluntary platforms, commonly referred to as Standards Development Organizations (SDOs), which gather experts from various industry sectors, private enterprises, governmental agencies and academia. The institutional architecture of these bodies can vary from semi-public bodies, such as European Telecommunications Standards Institute (ETSI), to industry-driven consortia, such as the Internet Engineering Task Force (IETF). The past decades witnessed a significant shift of standard setting to those institutions: while operating independently from the states regulation, they offer a rather informal setting, which enables fast-paced standardization and places technical supremacy and flexibility of standards above other considerations. Although technical norms and specifications developed by such nongovernmental platforms are not binding, they appear to create significant regulatory impact. In the United States (US), private voluntary standards can be used by regulators to achieve their policy objectives; in the European Union (EU), compliance with harmonized standards developed by voluntary European Standards Organizations (ESOs) can grant a product a free-movement pass. Moreover, standards can de facto manage the functioning of the market when other regulative alternatives are not available. Hence, by establishing (potentially) mandatory norms, SDOs assume regulatory functions commonly exercised by States and shape their own legal order. The purpose of this paper is threefold: First, it attempts to shed some light on SDOs’ institutional architecture, focusing on private, industry-driven platforms and comparing their regulatory frameworks with those of formal organizations. Drawing upon the relevant scholarship, the paper then discusses the extent to which the formulation of technological standards within SDOs constitutes a private legal order, operating in the shadow of governmental regulation. Ultimately, this contribution seeks to advise whether a state-intervention in industry-driven standard setting is desirable, and whether the increasing regulatory importance of SDOs should be addressed in legislation on standardization.

Keywords: private order, standardization, standard-setting organizations, transnational law

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Authors: Ernest Nweke

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The work of Professional Accountants and Corporate governance are synonymous and cannot be divorced from each other. Organizations, profit and non-profit alike cannot implement sound corporate practices without inputs from Professional Accountants. In today’s dynamic corporate world, good corporate governance practice is a sine qua non. More so, following the corporate failures of the past decades like Enron and WorldCom, governments around the world, including Mongolia are becoming more proactive in ensuring sound corporate governance mechanisms. In the past fifteen years, the Mongolian government has taken several measures to establish and strengthen internal corporate governance structures in firms. This paper highlights the role of professional accountants and auditors play in ensuring that good corporate governance mechanisms are entrenched in listed companies in Mongolia. Both primary and secondary data are utilized in this research. In collection of primary data, Delphi method was used, securing responses from only knowledgeable senior employees, top managers, and some CEOs. Using this method, a total of 107 top-level company employees and executives randomly selected from 22 companies were surveyed; maximum of 5 and minimum of 4 from each company. These companies cut across several sectors. It was concluded that Professional Accountants play key roles in setting and maintaining firm governance. They do this by ensuring full compliance with all the requirements of good and sound corporate governance, establishing reporting, monitoring and evaluating standards, assisting in the setting up of proper controls, efficient and effective audit systems, sound fraud risk management and putting in place an overall vision for the enterprise. Companies with effective corporate governance mechanisms are usually strong and fraud-resilient. It was also discovered that companies with big 4 audit firms tend to have better governance structures in Mongolia.

Keywords: accountants, corporate disclosure, corporate failure, corporate governance

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Authors: Hayder H. Kareem, Shunqi Pan

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The geological environment where the groundwater is collected represents the most important element that affects the behaviour of groundwater aquifer. As groundwater is a worldwide vital resource, it requires knowing the parameters that affect this source accurately so that the conceptualized mathematical models would be acceptable to the broadest ranges. Therefore, groundwater models have recently become an effective and efficient tool to investigate groundwater aquifer behaviours. Groundwater aquifer may contain aquitards, aquicludes, or interfaces within its geological formations. Aquitards and aquicludes have geological formations that forced the modellers to include those formations within the conceptualized groundwater models, while interfaces are commonly neglected from the conceptualization process because the modellers believe that the interface has no effect on aquifer behaviour. The current research highlights the impact of an interface existing in a real unconfined groundwater aquifer called Dibdibba, located in Al-Najaf City, Iraq where it has a river called the Euphrates River that passes through the eastern part of this city. Dibdibba groundwater aquifer consists of two types of soil layers separated by an interface soil layer. A groundwater model is built for Al-Najaf City to explore the impact of this interface. Calibration process is done using PEST 'Parameter ESTimation' approach and the best Dibdibba groundwater model is obtained. When the soil interface is conceptualized, results show that the groundwater tables are significantly affected by that interface through appearing dry areas of 56.24 km² and 6.16 km² in the upper and lower layers of the aquifer, respectively. The Euphrates River will also leak water into the groundwater aquifer of 7359 m³/day. While these results are changed when the soil interface is neglected where the dry area became 0.16 km², the Euphrates River leakage became 6334 m³/day. In addition, the conceptualized models (with and without interface) reveal different responses for the change in the recharge rates applied on the aquifer through the uncertainty analysis test. The aquifer of Dibdibba in Al-Najaf City shows a slight deficit in the amount of water supplied by the current pumping scheme and also notices that the Euphrates River suffers from stresses applied to the aquifer. Ultimately, this study shows a crucial need to represent the interface soil layer in model conceptualization to be the intended and future predicted behaviours more reliable for consideration purposes.

Keywords: Al-Najaf City, groundwater aquifer behaviour, groundwater modelling, interface soil layer, Visual MODFLOW

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Authors: Stjepka Popović, Lucija Vejmelka

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Background: Cyberbullying has become a prevalent issue worldwide, including in Croatia. However, a comprehensive understanding of the extent and nature of cyberbullying in the Croatian context is lacking. Objective: The objective of this systematic review is to evaluate the quality of current research conducted in Croatia on the subject of cyberbullying, identify any gaps in the research, and provide suggestions for future investigations. It examines the prevalence gender and age differences of cyberbullying in Croatia. Participants and Setting: Research is done on secondary data resources (published studies) of cyberbullying in Croatia. The participants in these studies that were included in systematic review are children and youth of all ages residing in Croatia who have been involved in cyberbullying incidents. The setting includes various environments where cyberbullying may occur, such as social media platforms and educational institutions. Methods: To identify pertinent studies on cyberbullying in Croatia, a comprehensive exploration of both international and domestic electronic databases was systematically undertaken. Relevant studies were chosen according to predefined criteria that determined inclusion and exclusion. Key findings from the selected studies were extracted and synthesized, enabling the identification of patterns in the data. Results: A total of 43 studies that fulfilled the inclusion criteria were identified in the review. The prevalence of cyberbullying victimization in Croatia ranged from 7% - 55.3%, with adolescents being the most affected group. The prevalence of cyberbullying perpetration was ranging from 3.2% - 30.3%. The most prevalent form of cyberbullying included gossiping and mocking others. Gender and age differences are highlighted. Conclusions: The outcomes of this systematic review highlight the pressing need for targeted interventions and preventative measures to address cyberbullying in Croatia. Additionally, it is crucial to conduct further research to investigate the long-term impacts and potential factors that can help mitigate cyberbullying in the context of Croatia.

Keywords: cyberbullying, online risky behavior, Croatia, systematic review

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Authors: Yi Ding

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With the upsurge of Chinese international students in American higher education, serious academic problems Chinese international students are suffering from are also striking. While most practices and research in higher education focus on the role of professors, writing centers, and tutoring centers to help international students succeed in college, this research study focuses on a more fundamental skill that is neglected in most conversations: information literacy, which is usually addressed by academic librarians. Transitioning from an East-Asian, developing educational system that values authority, set knowledge more than independent thinking, scholarly conversation, Chinese international students need support from academic librarians to acquire information literacy, which is crucial to understand expectations of a Western academic setting and thus to succeed in college. This research study illustrates how academic librarians can play an integral role in helping Chinese international students acclimate to the expectations of American higher education by teaching information literacy as academic literacy unique to the Western academic setting. Six keys of information literacy put forward by Association of College and Research Libraries, which are 'Authority Is Constructed and Contextual', 'Information Creation as a Process', 'Information Has Value', 'Research as Inquiry', 'Scholarship as Conversation', and 'Searching as Strategic Exploration', are analyzed through the lens of Chinese educational system and students’ backgrounds. Based on the analysis as well as results from surveys and interviews among academic librarians, professors, and international students, this research further examines current practices from a wide range of academic libraries and finally, provides evidence-based recommendations for academic librarians to use information literacy instruction to help Chinese international students succeed in American higher education.

Keywords: academic librarians, Chinese international students, information literacy, student success

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Authors: Harmeet Pal Singh Dhooria, Deepinder Chinna, UPS Sidhu, Alok Jain

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Serious infections caused by gram-negative bacteria are a significant cause of mortality and morbidity in the hospital setting. In acute care facilities like in intensive care units (ICUs), the intensity of antimicrobial use together with a population highly susceptible to infection, creates an environment, which facilitates both emergence and transmission of Extended Spectrum -lactamase (ESBL) producing Enterobacteriaceae species. The study was conducted in the Medical Intensive Care Unit (MICU) and the Pulmonary Critical Care Unit (PCCU) of the Department of Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India. Out of a total of 1108 samples of urine, blood and respiratory tract secretions received for culture and sensitivity analysis from Medical Intensive Care Unit and Pulmonary Critical Care Unit, a total of 170 isolates of Enterobacteriaceae species were obtained which were then included in our study. Out of these 170 isolates, confirmed ESBL production was seen in 116 (68.24%) cases. E.coli was the most common species isolated (56.47%) followed by Klebsiella (32.94%), Enterobacter (5.88%), Citrobacter (3.53%), Enterobacter (0.59%) and Morganella (0.59%) among the total isolates. The rate of ESBL production was more in Klebsiella (78.57%) as compared to E.coli (60.42%). ESBL producers were found to be significantly more common in patients with prior history of hospitalization, antibiotic use, and prolonged ICU stay. Also significantly increased the prevalence of ESBL related infections was observed in patients with a history of catheterization or central line insertion but not in patients with the history of intubation. Patients who had an underlying malignancy had significantly higher prevalence of ESBL related infections as compared to other co-morbid illnesses. A slightly significant difference in the rate of mortality/LAMA was observed in the ESBL producer versus the non-ESBL producer group. The rate of mortality/LAMA was significantly higher in the ESBL related UTI but not in the ESBL related respiratory tract and bloodstream infections. ESBL producing isolates had significantly higher rates of resistance to Cefepime and Piperacillin/Tazobactum, and to non β-lactum antibiotics like Amikacin and Ciprofloxacin. The level of resistance to Imipenem was lower as compared to other antibiotics. However, it was noted that ESBL producing isolates had higher levels of resistance to Imipenem as compared to non-ESBL producing isolates. Conclusion- The prevalence of ESBL producing organisms was found to be very high (68.24%) among Enterobacteriaceae isolates in our ICU setting as among other ICU care settings around the world.

Keywords: enterobacteriaceae, extended spectrum B-lactamase (ESBL), ICU, antibiotic resistance

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Authors: Hiromi Kawai

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This study investigates the nature of EFL older children’s L2 perceptive and productive abilities using classroom data, in order to find a pedagogical solution to the teaching of L2 sounds at an early stage of learning in a formal school setting. It is still inconclusive whether older children with only EFL formal school instruction at the initial stage of L2 learning are able to attain native-like perception and production in English within the very limited amount of exposure to the target language available. Based on the notion of the lack of study of EFL Japanese children’s acquisition of English segments, the researcher uses a model of L1 speech processing which was developed for investigating L1 English children’s speech and literacy difficulties using a psycholinguistic framework. The model is composed of input channel, output channel, and lexical representation, and examines how a child receives information from spoken or written language, remembers and stores it within the lexical representations and how the child selects and produces spoken or written words. Concerning language universality and language specificity in the language acquisitional process, the aim of finding any sound errors in L1 English children seemed to conform to the author’s intention to find abilities of English sounds in older Japanese children at the novice level of English in an EFL setting. 104 students in Grade 5 (between the ages of 10 and 11 years old) of an elementary school in Tokyo participated in this study. Four tests to measure their perceptive ability and three oral repetition tests to measure their productive ability were conducted with/without reference to lexical representation. All the test items were analyzed to calculate item facility (IF) indices, and correlational analyses and Structural Equation Modeling (SEM) were conducted to examine the relationship between the receptive ability and the productive ability. IF analysis showed that (1) the participants were better at perceiving a segment than producing a segment, (2) they had difficulty in auditory discrimination of paired consonants when one of them does not exist in the Japanese inventory, (3) they had difficulty in both perceiving and producing English vowels, and (4) their L1 loan word knowledge had an influence on their ability to perceive and produce L2 sounds. The result of the Multiple Regression Modeling showed that the two production tests could predict the participants’ auditory ability of real words in English. The result of SEM showed that the hypothesis that perceptive ability affects productive ability was supported. Based on these findings, the author discusses the possible explicit method of teaching English segments to EFL older children in a formal school setting.

Keywords: EFL older children, english segments, perception, production, speech processing system

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Authors: Ana Violante, Jodie Maccarrone, Maria Fimiani

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In the United States, over 30 million people are hospitalized annually for conditions that require acute, 24-hour, supervised care. The experience of hospitalization can be traumatic, exposing the patient to loss of control, autonomy, and productivity. Furthermore, 40% of patients admitted to hospitals for general medical illness have a comorbid psychiatric diagnosis. Research suggests individuals admitted with psychiatric comorbidities experience poorer health outcomes, higher utilization rates and increased overall cost of care. Empirical work suggests hospital settings that include a consultation liaison (CL) service report reduced length of stay, lower costs per patient, improved medical staff and patient satisfaction and reduced readmission after 180 days. Despite the overall positive impact CL services can have on patient care, it is estimated that only 1% - 2.8% of hospital admits receive these services, and most research has been conducted by the field of psychiatry. Health psychologists could play an important role in increasing access to this valuable service, though the extent to which health psychologists participate in CL settings is not well known. Objective: Outline the preliminary findings from an empirical study to understand how many APPIC internship training programs offer adult consultation liaison rotations within inpatient hospital settings nationally, as well as describe the specific nature of these training experiences. Research Method/Design: Data was exported into Excel from the 2022-2023 APPIC Directory categorized as “health psychology” sites. It initially returned a total of 537 health training programs out 1518 total programs (35% of all APPIC programs). A full review included a quantitative and qualitative comprehensive review of the APPIC program summary, the site website, and program brochures. The quantitative review extracted the number of training positions; amount of stipend; location or state of program, patient, population, and rotation. The qualitative review examined the nature of the training experience. Results: 29 (5%) of all APPIC health psychology internship training programs (2%) respectively of all APPIC training internship programs offering internship CL training were identified. Of the 29 internship training programs, 16 were exclusively within a pediatric setting (55%), 11 were exclusively within an adult setting (38%), and two were a mix of pediatric and adult settings (7%). CL training sites were located to 19 states, offering a total of 153 positions nationally, with Florida containing the largest number of programs (4). Only six programs offered 12-month training opportunities while the rest offered CL as a major (6 month) to minor (3-4 month) rotation. The program’s stipend for CL training positions ranged from $25,000 to $62,400, with an average of $32,056. Conclusions: These preliminary findings suggest CL training and services are currently limited. Training opportunities that do exist are mostly limited to minor, short rotations and governed by psychiatry. Health psychologists are well-positioned to better define the role of psychology in consultation liaison services and enhance and formalize existing training protocols. Future research should explore in more detail empirical outcomes of CL services that employ psychology and delineate the contributions of psychology from psychiatry and other disciplines within an inpatient hospital setting.

Keywords: consultation liaison, health psychology, hospital setting, training

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Authors: Ugahara Bin Mahyuddin Yunus

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In English Language Teaching, it cannot be denied that the backgrounds of English teachers do affect the way they teach English to their students, which in turn will affect their students’ English learning itself. Thus, it is very important to understand who the English teachers are so that how they teach English to their students can be understood. One of their backgrounds that is essential to be highlighted is their culture. Certainly, they wittingly or not will bring the perspectives and values of their culture into their daily teaching practices. In other words, their cultural identities do shape how they teach their students. Cultural identities themselves actually consist of some elements, one of which is regional identity. Indeed, the culture of the region in which English teachers identify with has impact on their beliefs and actions during teaching. For this reason, this study aims to understand how the regional identity of English teachers influence the way they teach English to their students. This study is a qualitative study conducted in a multilingual and multicultural setting, namely Aceh, Indonesia. Here, four Acehnese English teachers were involved as the research participants. In addition, this study adopted poststructuralist perspective to identity as the theoretical framework. Three research instruments were used in this study, namely semi-structured interviews, classroom observation, and teacher journal. The data gained from these instruments were then analyzed by using thematic analysis. Obviously, the research about the regional identity of English teachers in English Language Teaching has been studied worldwide. However, little is still known about it in Indonesian context, let alone Indonesia itself is a super diverse country with 34 regions. As a result, this study presents a good opportunity to advance the knowledge of how the regional identity construction of English teachers in this setting is. The findings of the study revealed that their regional identity construction in teaching was highly influenced by their indigenous language and religious faith. Even, how they teach English in classroom, in fact, is related to these two things. The conclusion that can be drawn from this study is for these English teachers, in fact, their regional identity itself constitutes their use of local language and religious identity, which are considered by them as their core identity.

Keywords: English language teaching, English teachers, identity construction, regional identity

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Authors: Atif Zafar, Fan Haijun

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A sequence of different Reservoir Engineering methods and tools in reservoir characterization and field development are presented in this paper. The real data of Jin Gas Field of L-Basin of Pakistan is used. The basic concept behind this work is to enlighten the importance of well test analysis in a broader way (i.e. reservoir characterization and field development) unlike to just determine the permeability and skin parameters. Normally in the case of reservoir characterization we rely on well test analysis to some extent but for field development plan, the well test analysis has become a forgotten tool specifically for locations of new development wells. This paper describes the successful implementation of well test analysis in Jin Gas Field where the main uncertainties are identified during initial stage of field development when location of new development well was marked only on the basis of G&G (Geologic and Geophysical) data. The seismic interpretation could not encounter one of the boundary (fault, sub-seismic fault, heterogeneity) near the main and only producing well of Jin Gas Field whereas the results of the model from the well test analysis played a very crucial rule in order to propose the location of second well of the newly discovered field. The results from different methods of well test analysis of Jin Gas Field are also integrated with and supported by other tools of Reservoir Engineering i.e. Material Balance Method and Volumetric Method. In this way, a comprehensive way out and algorithm is obtained in order to integrate the well test analyses with Geological and Geophysical analyses for reservoir characterization and field development. On the strong basis of this working and algorithm, it was successfully evaluated that the proposed location of new development well was not justified and it must be somewhere else except South direction.

Keywords: field development plan, reservoir characterization, reservoir engineering, well test analysis

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Authors: Sevilay Çankaya

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The detection of deception in children’s interviews is essential for statement veracity. The widely used method for deception detection is building cognitive load, which is the logic of the cognitive interview (CI), and its effectiveness for adults is approved. This meta-analysis delves into the effectiveness of inducing cognitive load as a means of enhancing veracity detection during interviews with children. Additionally, the effectiveness of cognitive load on children's total number of events recalled is assessed as a second part of the analysis. The current meta-analysis includes ten effect sizes from search using databases. For the effect size calculation, Hedge’s g was used with a random effect model by using CMA version 2. Heterogeneity analysis was conducted to detect potential moderators. The overall result indicated that cognitive load had no significant effect on veracity outcomes (g =0.052, 95% CI [-.006,1.25]). However, a high level of heterogeneity was found (I² = 92%). Age, participants’ characteristics, interview setting, and characteristics of the interviewer were coded as possible moderators to explain variance. Age was significant moderator (β = .021; p = .03, R2 = 75%) but the analysis did not reveal statistically significant effects for other potential moderators: participants’ characteristics (Q = 0.106, df = 1, p = .744), interview setting (Q = 2.04, df = 1, p = .154), and characteristics of interviewer (Q = 2.96, df = 1, p = .086). For the second outcome, the total number of events recalled, the overall effect was significant (g =4.121, 95% CI [2.256,5.985]). The cognitive load was effective in total recalled events when interviewing with children. All in all, while age plays a crucial role in determining the impact of cognitive load on veracity, the surrounding context, interviewer attributes, and inherent participant traits may not significantly alter the relationship. These findings throw light on the need for more focused, age-specific methods when using cognitive load measures. It may be possible to improve the precision and dependability of deceit detection in children's interviews with the help of more studies in this field.

Keywords: deceit detection, cognitive load, memory recall, children interviews, meta-analysis

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Authors: Ibrahim M. Metwally

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Have you ever thought that earth was not the same earth we live on? Was it bigger or smaller? Was it a great continent surrounded by huge ocean as Alfred Wegener (1912) claimed? Earth is the most amazing planet in our Milky Way galaxy and may be in the universe. It is the only deformed planet that has a variable orbit around the sun and the only planet that has water on its surface. How did earth deformation take place? What does cause earth to deform? What are the results of earth deformation? How does its orbit around the sun change? First earth size computation can be achieved only considering the quantum of iron and nickel rested into earth core. This paper introduces a new theory “Earth expansion Theory”. The principles of “Earth Expansion Theory” are leading to new approaches and concepts to interpret whole earth dynamics and its geological and environmental changes. This theory is not an attempt to unify the two divergent dominant theories of continental drift, plate tectonic theory and earth expansion theory. The new theory is unique since it has a mathematical derivation, explains all the change to and around earth in terms of geological and environmental changes, and answers all unanswered questions in other theories. This paper presents the basic of the introduced theory and discusses the mechanism of earth expansion and how it took place, the forces that made the expansion. The mechanisms of earth size change from its spherical shape with radius about 3447.6 km to an elliptic shape of major radius about 6378.1 km and minor radius of about 6356.8 km and how it took place, are introduced and discussed. This article also introduces, in a more realistic explanation the formation of oceans and seas, the preparation of river formation. It also addresses the role of iron in earth size enlargement process within the continuum mechanics framework.

Keywords: earth size, earth expansion, continuum mechanics, continental and ocean formation

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Authors: K. Raja Rajan, D. Nagarajan

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Bored cast in-situ pile is a popular choice amongst consultant and contractor due to the ability to adjust the pile length suitably in case if any variation found in the actual geological strata. Bangladesh geological strata are dominated by silt content. Design is normally based on field test such as Standard Penetration test N-values. Initially, pile capacity estimated through static formula with co-relation of N-value and angle of internal friction. Initial pile load test was conducted in order to validate the geotechnical parameters assumed in design. Initial pile load test was conducted on 1.5m diameter bored cast in-situ pile. Kentledge method is used to load the pile for 2.5 times of its working load. Initially, safe working load of pile has been estimated as 570T, so test load is fixed to 1425T. Max load applied is 777T for which the settlement reached around 155mm which is more than 10% of diameter of piles. Pile load test results was not satisfactory and compelled to increase the pile length approximately 20% of its total length. Due to unpredictable geotechnical parameters, length of each pile has been increased which is having a major impact on the project cost and as well as in project schedule. Extra bore holes have been planned along with lab test results in order to redefine the assumed geotechnical parameters. This article presents detailed design assumptions of geotechnical parameters in the design stage and the results of pile load test which made to redefine the assumed geotechnical properties.

Keywords: end bearing, pile load test, settlement, shaft friction

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Authors: K. Ravi, Sabu Subhash

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Densely compacted bentonite or bentonite–sand mixture has been identified as a suitable buffer in the deep geological repository (DGR) for the safe disposal of high-level nuclear waste (HLW) due to its favourable physicochemical and hydro-mechanical properties. The addition of sand to the bentonite enhances the thermal conductivity and compaction properties and reduces the drying shrinkage of the buffer material. The buffer material may undergo cyclic wetting and drying upon ingress of groundwater from the surrounding rock mass and from evaporation due to high temperature (50–210 °C) derived from the waste canister. The cycles of changes in temperature may result in thermal history, and the hydro-mechanical properties of the buffer material may be affected. This paper examines the influence of thermal history on the undrained shear strength of bentonite and bentonite-sand mixture. Bentonite from Rajasthan state and sand from the Assam state of India are used in this study. The undrained shear strength values are obtained by conducting unconfined compressive strength (UCS) tests on cylindrical specimens (dry densities 1.30 and 1.5 Mg/m3) of bentonite and bentonite-sand mixture consisting of 30 % bentonite+ 70 % sand. The specimens are preheated at temperatures varying from 50-150 °C for one, two and four hours in hot air oven. The results indicate that the undrained shear strength is increased by the thermal history of the buffer material. The specimens of bentonite-sand mixture exhibited more increase in strength compared to the pure bentonite specimens. This indicates that the sand content of the mixture plays a vital role in taking the thermal stresses of the bentonite buffer in DGR conditions.

Keywords: bentonite, deep geological repository, thermal history, undrained shear strength

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Authors: Shaista Meghani, Rozina Karmaliani, Khairulnissa Ajani, Shireen Shahzad, Nadeem Ullah Khan

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Background: The concept of Family Presence During Resuscitation (FPDR) is gradually gaining recognition in western countries, however, it is rarely considered in South Asian countries including Pakistan. Over time, patients’ and families’ rights have gained recognition and healthcare has progressed to become more patient-family centered. Objectives: The objective of this study was to evaluate the impact of an educational program on the Knowledge, Attitude, and Practices (KAP) of healthcare professionals (HCPs) towards FPDR in Emergency Department (ED), at a tertiary care setting, in Karachi, Pakistan. Methods: This was a Pre-test and Post-test study design. A convenient universal sampling was done, and all ED nurses and physicians with more than one year of experience were eligible. The intervention included one-hour training sessions for physicians (three sessions) and nurses (eight sessions), The KAP of nurses and physicians were assessed immediately after (post-test I), and two weeks(post-test II) after the intervention using a pretested questionnaire. Results: The findings of the study revealed that the mean scores of knowledge and attitude of HCPs at both time points were statistically significant (p-value=<0.001), however, an insignificant difference was found on practice of FPDR (p-value=>0.05). Conclusion: The study findings recommend that the educational program on FPDR for HCPs needs to be offered on an ongoing basis. Moreover, training modules need to be developed for the staff, and formal guidelines need to be proposed for FPDR, through a multidisciplinary team approach.

Keywords: family presence, cardiopulmonary resuscitation, attitude, education, practices, health care professionals

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Authors: Muqadis Shazia Rajpar, Lawrence Mitelberg, Rubaiat S. Ahmed, Jemer Garrido, Rukhsana Hossain, Sergey M. Motov

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Distraction techniques have been used as a means to reduce pain, anxiety, and stress in various healthcare settings to facilitate care and make visits less unpleasant. Using virtual reality (VR) in the pediatric emergency setting can be a valuable, effective, and safe non-pharmacological alternative to the current standard of care for pain and anxiety management in pediatric patients. Our pilot study aimed to evaluate the effectiveness of a VR-based intervention as an alternative distraction modality to alleviate pain and anxiety associated with pediatric emergency department (ED) visits and acute pain conditions. The pilot study period was from November 16 to December 9, 2022, for pediatric ED visits for pain, anxiety, or both. Patients were selected based on a novel VR protocol to receive the VR intervention with the administration of pre and post-intervention surveys concerning pain/anxiety ratings and pain scores (Wong-Baker FACES/NRS). Descriptive statistics, paired t-test, and a Fisher Exact Test were used for data analysis, assuming a p-value of 0.05 for significance. A total of 33 patients (21 females, 12 males), ages 5-20 (M = 10.5, SD = 3.43) participated in this study – 12 patients had pain, 2 patients had anxiety, and 19 patients had both pain and anxiety. There was a statistically significant decrease in post-intervention pain scores of less than one point on the rating scale (6.48 vs. 5.62, p < .001). There was a statistically significant reduction in the percentage of patients suffering from “considerable” or “great” pain after the VR intervention (51.6% to 42.3%, p < .001). Similarly, we noticed an increase in the number of patients with “slight” or “moderate” pain post–VR intervention (48.4% to 57.7%, p < .001). Lastly, we demonstrated a decrease in anxiety among patients after utilizing VR (63.6% vs. 36.4%, p < .001). To conclude, VR can alleviate pain and anxiety in pediatric patients and be a useful non-pharmacological tool in the emergency setting.

Keywords: anxiety, emergency room, pain management, pediatric emergency medicine, virtual reality

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Authors: A. G. Barua, Uttam Rajkhowa, Pranjal Moni Nath, Nur Abdul Kadir

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Mycobacterium tuberculosis (MTB) is one of the most closely-related intracellular bacterial pathogens, grouped as the M. tuberculosis complex (MTC). MTB, the primary agent of human tuberculosis (TB), can develop clinical TB in animals as 75 percent of canine mycobacterial infection is caused by close contact with an infected human being. In the present study, molecular detection of TB in dogs in three North-eastern states of India, Assam Mizoram, and Nagaland was carried out. So far, there has been a lack of systematic study in these regions, hampered by slow diagnostic methods and poor infrastructure. In an attempt to rectify this situation, molecular epidemiology was carried out for nine months to detect canine TB in a sample of 340 dogs. Isolation of DNA was done with swabs (throat/nasal), nodules of lungs and fluids from 100 suspected dogs and the molecular study were carried out with the help of conventional and real-time PCR. Post-mortem study was also carried out. Our results showed that the prevalence of clinical TB in dogs from a high-risk setting was 1 percent. However, the prevalence of immunological sensitization to M. tuberculosis antigen in dogs living in contact with sputum smeared positive TB cases was almost 50 percent. The latter setting had the maximum impact in terms of TB transmission. During the study period, a survey with a standard questionnaire was carried out in the TB hospitals to study reverse zoonosis. It was observed that an infected human being was one of the major risk factors for dogs to contract the infection. This observation was drawn by examining the probable airborne transmission from humans to their pets or strays. The present study helped to discover the nuances of TB transmission more clearly and systematically as compared to other sporadic tests to detect MTB in canine.

Keywords: Assam and Nagaland, canine TB, India, molecular detection, tuberculosis

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Authors: Tom Hickey

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It is difficult to conceive of a case that might more starkly bring the arguments concerning judicial review to the fore than State (Ryan) v Lennon. Small wonder that it has attracted so much scholarly attention, although the fact that almost all of it has been in an Irish setting is perhaps surprising, given the illustrative value of the case in respect of a philosophical quandary that continues to command attention in all developed constitutional democracies. Should judges have power to invalidate legislation? This article revisits Ryan v Lennon with an eye on the importance of the idea of “democracy” in the case. It assesses the meaning of democracy: what its purpose might be and what practical implications might follow, specifically in respect of judicial review. Based on this assessment, it argues for a particular institutional model for the vindication of constitutional rights. In the context of calls for the drafting of a new constitution for Ireland, however forlorn these calls might be for the moment, it makes a broad and general case for the abandonment of judicial supremacy and for the taking up of a model in which judges have a constrained rights reviewing role that informs a more robust role that legislators would play, thereby enhancing the quality of the control that citizens have over their own laws. The article is in three parts. Part I assesses the exercise of judicial power over legislation in Ireland, with the primary emphasis on Ryan v Lennon. It considers the role played by the idea of democracy in that case and relates it to certain apparently intractable dilemmas that emerged in later Irish constitutional jurisprudence. Part II considers the concept of democracy more generally, with an eye on overall implications for judicial power. It argues for an account of democracy based on the idea of equally shared popular control over government. Part III assesses how this understanding might inform a new constitutional arrangement in the Irish setting for the vindication of fundamental rights.

Keywords: constitutional rights, democracy as popular control, Ireland, judicial power, republican theory, Ryan v Lennon

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Authors: Heiko Jessen, Laura Tanus, Slobodan Ruzicic

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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

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