Search results for: non-invasive ventilation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 425

Search results for: non-invasive ventilation

155 Wakala Buildings of Mamluk Era in Cairo, Egypt and Its Rating According to Rating Criteria of Leadership in Energy and Environmental Design V4

Authors: M. Fathy, I. Maarouf, S. El-Sayary

Abstract:

Our buildings are responsible for around 50% of energy consumption and most of this consumption because of spaces design, low heat isolation building material and occupant presence and behavior in buildings beside non-efficient architectural treatments. It has been shown to have large impact on heating, cooling and ventilation demand, energy consumption of lighting and appliances, and building controls. This paper aims to focus on passive treatments in Wakala Buildings in Cairo and how far it meets the LEED Criteria as the LEED – Leadership in Energy and Environmental Design – considered the widest spread rating system in the world. By studying Wakala buildings in Cairo, there are a lot of environmental potentials in it in the field of passive treatments and energy efficiency that could be found in examples by surveying and analyzing Wakala buildings. Besides the environmental treatments through the natural materials and façade architectural treatments, there is a measuring phase to declare the efficiency of the Wakala building through temperature decline between outdoor and indoor the Wakala building. Also, measuring how far the indoor conditions matched the thermal comfort for occupants. After measuring the Wakala buildings, it is the role of applying the criteria of LEED rating system to find out how fare Wakala buildings meet the LEED rating system criteria. After all, the building technologies used in Wakala buildings in the field of passive design and caused that energy efficiency would be clear and what is needed for Wakala buildings to have a LEED Certification.

Keywords: energy awareness, historical commercial buildings, LEED, Wakala buildings

Procedia PDF Downloads 202
154 An Investigation of the Quantitative Correlation between Urban Spatial Morphology Indicators and Block Wind Environment

Authors: Di Wei, Xing Hu, Yangjun Chen, Baofeng Li, Hong Chen

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To achieve the research purpose of guiding the spatial morphology design of blocks through the indicators to obtain a good wind environment, it is necessary to find the most suitable type and value range of each urban spatial morphology indicator. At present, most of the relevant researches is based on the numerical simulation of the ideal block shape and rarely proposes the results based on the complex actual block types. Therefore, this paper firstly attempted to make theoretical speculation on the main factors influencing indicators' effectiveness by analyzing the physical significance and formulating the principle of each indicator. Then it was verified by the field wind environment measurement and statistical analysis, indicating that Porosity(P₀) can be used as an important indicator to guide the design of block wind environment in the case of deep street canyons, while Frontal Area Density (λF) can be used as a supplement in the case of shallow street canyons with no height difference. Finally, computational fluid dynamics (CFD) was used to quantify the impact of block height difference and street canyons depth on λF and P₀, finding the suitable type and value range of λF and P₀. This paper would provide a feasible wind environment index system for urban designers.

Keywords: urban spatial morphology indicator, urban microclimate, computational fluid dynamics, block ventilation, correlation analysis

Procedia PDF Downloads 137
153 Improved Thermal Comfort in Cabin Aircraft with in-Seat Microclimate Conditioning Module

Authors: Mathieu Le Cam, Tejaswinee Darure, Mateusz Pawlucki

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Climate control of cabin aircraft is traditionally conditioned as a single unit by the environmental control system. Cabin temperature is controlled by the crew while passengers of the aircraft have control on the gaspers providing fresh air from the above head area. The small nozzles are difficult to reach and adjust to meet the passenger’s needs in terms of flow and direction. More dedicated control over the near environment of each passenger can be beneficial in many situations. The European project COCOON, funded under Clean Sky 2, aims at developing and demonstrating a microclimate conditioning module (MCM) integrated into a standard economy 3-seat row. The system developed will lead to improved passenger comfort with more control on their personal thermal area. This study focuses on the assessment of thermal comfort of passengers in the cabin aircraft through simulation on the TAITherm modelling platform. A first analysis investigates thermal comfort and sensation of passengers in varying cabin environmental conditions: from cold to very hot scenarios, with and without MCM installed in the seats. The modelling platform is also used to evaluate the impact of different physiologies of passengers on their thermal comfort as well as different seat locations. Under the current cabin conditions, a passenger of a 50th percentile body size is feeling uncomfortably cool due to the high velocity cabin air ventilation. The simulation shows that the in-seat MCM developed in COCOON project improves the thermal comfort of the passenger.

Keywords: cabin aircraft, in-seat HVAC, microclimate conditioning module, thermal comfort

Procedia PDF Downloads 200
152 Wind Energy Loss Phenomenon Over Volumized Building Envelope with Porous Air Portals

Authors: Ying-chang Yu, Yuan-lung Lo

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More and more building envelopes consist of the construction of balconies, canopies, handrails, sun-shading, vertical planters or gardens, maintenance platforms, display devices, lightings, ornaments, and also the most commonly seen double skin system. These components form a uniform but three-dimensional disturbance structure and create a complex surface wind field in front of the actual watertight building interface. The distorted wind behavior would affect the façade performance and building ventilation. Comparing with sole windscreen walls, these three-dimensional structures perform like distributed air portal assembly, and each portal generates air turbulence and consume wind pressure and energy simultaneously. In this study, we attempted to compare the behavior of 2D porous windscreens without internal construction, porous tubular portal windscreens, porous tapered portal windscreens, and porous coned portal windscreens. The wind energy reduction phenomenon is then compared to the different distributed air portals. The experiments are conducted in a physical wind tunnel with 1:25 in scale to simulate the three-dimensional structure of a real building envelope. The experimental airflow was set up to smooth flow. The specimen is designed as a plane with a distributed tubular structure behind, and the control group uses different tubular shapes but the same fluid volume to observe the wind damping phenomenon of various geometries.

Keywords: volumized building envelope, porous air portal, wind damping, wind tunnel test, wind energy loss

Procedia PDF Downloads 133
151 Performance Gap and near Zero Energy Buildings Compliance of Monitored Passivhaus in Northern Ireland, the Republic of Ireland and Italy

Authors: S. Colclough, V. Costanzo, K. Fabbri, S. Piraccini, P. Griffiths

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The near Zero Energy Building (nZEB) standard is required for all buildings from 2020. The Passive House (PH) standard is a well-established low-energy building standard, having been designed over 25 years ago, and could potentially be used to achieve the nZEB standard in combination with renewables. By comparing measured performance with design predictions, this paper considers if there is a performance gap for a number of monitored properties and assesses if the nZEB standard can be achieved by following the well-established PH scheme. Analysis is carried out based on monitoring results from real buildings located in Northern Ireland, the Republic of Ireland and Italy respectively, with particular focus on the indoor air quality including the assumed and measured indoor temperature and heating periods for both standards as recorded during a full annual cycle. An analysis is carried out also on the energy performance certificates of each of the dwellings to determine if they meet the near Zero Energy Buildings primary energy consumption targets set in the respective jurisdictions. Each of the dwellings is certified as complying with the passive house standard, and accordingly have very good insulation levels, heat recovery and ventilation systems of greater than 75% efficiency and an airtightness of less than 0.6 air changes per hour at 50 Pa. It is found that indoor temperature and relative humidity were within the comfort boundaries set in the design stage, while carbon dioxide concentrations are sometimes higher than the values suggested by EN 15251 Standard for comfort class I especially in bedrooms.

Keywords: monitoring campaign, nZEB (near zero energy buildings), Passivhaus, performance gap

Procedia PDF Downloads 152
150 Capnography in Hypoxic Pseudo-Pea May Correlate to the Amount of Required Intervention for Resuscitation

Authors: Yiyuan David Hu, Alex Lindqwister, Samuel B. Klein, Karen Moodie, Norman A. Paradis

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Introduction: Pseudo-Pulseless Electrical Activity (p-PEA) is a lifeless form of profound cardiac shock characterized by measurable cardiac mechanical activity without clinically detectable pulses. Patients in pseudo-PEA carry different prognoses than those in true PEA and may require different therapies. End-tidal carbon dioxide (ET-CO2) has been studied in ventricular fibrillation and true PEA but in p-PEA. We utilized an hypoxic porcine model to characterize the performance of ET-CO2 in resuscitation from p-PEA. Hypothesis: Capnography correlates to the number of required interventions for resuscitation from p-PEA. Methods: Female swine (N = 14) under intravenous anesthesia were instrumented with aortic and right atrial micromanometer pressure. ECG and ET-CO2 were measured continuously. p-PEA was induced by ventilation with 6% oxygen in 94% nitrogen and was defined as a systolic aortic (Ao) pressure less than 40 mmHg. Pigs were grouped based on the interventions required to achieve ROSC: 100%O2, 100%O2 + CPR, 100%O2 + CPR + epinephrine. Results: End tidal CO2 reliably predicted O2 therapy vs CPR-based interventions needed for resuscitation (Figure 1). Pigs who would recover with 100%O2 only had a mean ET-CO2 slope of 0.039 ± 0.013 [ R2 = 0.68], those requiring oxygen + CPR had a slope of -0.15 ± 0.016 [R2 = 0.95], and those requiring oxygen + CPR + epinephrine had a slope of -0.12 ± 0.031 [R2 = 0.79]. Conclusions: In a porcine model of hypoxic p-PEA, measured ET-CO2 appears to be strongly correlated with the required interventions needed for ROSC. If confirmed clinically, these results indicate that ET-CO2 may be useful in guiding therapy in patients suffering p-PEA cardiac arrest.

Keywords: pseudo-PEA, resuscitation, capnography, hypoxic pseudo-PEA

Procedia PDF Downloads 194
149 Investigation on the Physical Conditions of Façade Systems of Campus Buildings by Infrared Thermography Tests

Authors: N. Türkmenoğlu Bayraktar, E. Kishalı

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Campus buildings are educational facilities where various amount of energy consumption for lighting, heating, cooling and ventilation occurs. Some of the new universities in Turkey, where this investigation takes place, still continue their educational activities in existing buildings primarily designed for different architectural programs and converted to campus buildings via changes of function, space organizations and structural interventions but most of the time without consideration of appropriate micro climatic conditions. Reducing energy consumption in these structures not only contributes to the national economy but also mitigates the negative effects on environment. Furthermore, optimum thermal comfort conditions should be provided during the refurbishment of existing campus structures and their building envelope. Considering this issue, the first step is to investigate the climatic performance of building elements regarding refurbishment process. In the context of the study Kocaeli University, Faculty of Design and Architecture building constructed in 1980s in Anıtpark campus located in the central part of Kocaeli, Turkey was investigated. Climatic factors influencing thermal conditions; the deteriorations on building envelope; temperature distribution; heat losses from façade elements observed by thermography were presented in order to improve strategies for retrofit process for the building envelope. Within the scope of the survey, refurbishment strategies towards providing optimum climatic comfort conditions, increasing energy efficiency of building envelope were proposed.

Keywords: building envelope, IRT, refurbishment, non-destructive test

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148 Noninvasive Technique for Measurement of Heartbeat in Zebrafish Embryos Exposed to Electromagnetic Fields at 27 GHz

Authors: Sara Ignoto, Elena M. Scalisi, Carmen Sica, Martina Contino, Greta Ferruggia, Antonio Salvaggio, Santi C. Pavone, Gino Sorbello, Loreto Di Donato, Roberta Pecoraro, Maria V. Brundo

Abstract:

The new fifth generation technology (5G), which should favor high data-rate connections (1Gbps) and latency times lower than the current ones (<1ms), has the characteristic of working on different frequency bands of the radio wave spectrum (700 MHz, 3.6-3.8 GHz and 26.5-27.5 GHz), thus also exploiting higher frequencies than previous mobile radio generations (1G-4G). The higher frequency waves, however, have a lower capacity to propagate in free space and therefore, in order to guarantee the capillary coverage of the territory for high reliability applications, it will be necessary to install a large number of repeaters. Following the introduction of this new technology, there has been growing concern in recent years about the possible harmful effects on human health and several studies were published using several animal models. This study aimed to observe the possible short-term effects induced by 5G-millimeter waves on heartbeat of early life stages of Danio rerio using DanioScope software (Noldus). DanioScope is the complete toolbox for measurements on zebrafish embryos and larvae. The effect of substances can be measured on the developing zebrafish embryo by a range of parameters: earliest activity of the embryo’s tail, activity of the developing heart, speed of blood flowing through the vein, length and diameters of body parts. Activity measurements, cardiovascular data, blood flow data and morphometric parameters can be combined in one single tool. Obtained data are elaborate and provided by the software both numerical as well as graphical. The experiments were performed at 27 GHz by a no commercial high gain pyramidal horn antenna. According to OECD guidelines, exposure to 5G-millimeter waves was tested by fish embryo toxicity test within 96 hours post fertilization, Observations were recorded every 24h, until the end of the short-term test (96h). The results have showed an increase of heartbeat rate on exposed embryos at 48h hpf than control group, but this increase has not been shown at 72-96 h hpf. Nowadays, there is a scant of literature data about this topic, so these results could be useful to approach new studies and also to evaluate potential cardiotoxic effects of mobile radiofrequency.

Keywords: Danio rerio, DanioScope, cardiotoxicity, millimeter waves.

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147 Comparative Analysis of Hybrid and Non-hybrid Cooled 185 KW High-Speed Permanent Magnet Synchronous Machine for Air Suspension Blower

Authors: Usman Abubakar, Xiaoyuan Wang, Sayyed Haleem Shah, Sadiq Ur Rahman, Rabiu Saleh Zakariyya

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High-speed Permanent magnet synchronous machine (HSPMSM) uses in different industrial applications like blowers, compressors as a result of its superb performance. Nevertheless, the over-temperature rise of both winding and PM is one of their substantial problem for a high-power HSPMSM, which affects its lifespan and performance. According to the literature, HSPMSM with a Hybrid cooling configuration has a much lower temperature rise than non-hybrid cooling. This paper presents the design 185kW, 26K rpm with two different cooling configurations, i.e., hybrid cooling configuration (forced air and housing spiral water jacket) and non-hybrid (forced air cooling assisted with winding’s potting material and sleeve’s material) to enhance the heat dissipation of winding and PM respectively. Firstly, the machine’s electromagnetic design is conducted by the finite element method to accurately account for machine losses. Then machine’s cooling configurations are introduced, and their effectiveness is validated by lumped parameter thermal network (LPTN). Investigation shows that using potting, sleeve materials to assist non-hybrid cooling configuration makes the machine’s winding and PM temperature closer to hybrid cooling configuration. Therefore, the machine with non-hybrid cooling is prototyped and tested due to its simplicity, lower energy consumption and can still maintain the lifespan and performance of the HSPMSM.

Keywords: airflow network, axial ventilation, high-speed PMSM, thermal network

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146 Power Supply by Soil Battery and Production of Hydrogen Fuel for Greenhouse and Space Heating

Authors: Mohsen Azarmjoo, Yasaman Azarmjoo, Zahra Alikhani Koopaei

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The increasing global population and continued growth in energy consumption underscore the need for renewable and sustainable energy sources more than ever. Soil batteries are a method for generating electrical energy by using recycled materials. Recycled materials include galvanized and copper sheets and recycled tires. Additionally, hydrogen, being a clean and efficient fuel, has the potential to replace fossil fuels. Consequently, hydrogen production from water presents a sustainable solution for energy supply. By utilizing aged materials, hydrogen production becomes more cost-effective and environmentally friendly. This article focuses on energy-deprived agricultural lands, explaining how soil batteries and hydrogen can provide the necessary energy for agricultural equipment, such as irrigation, lighting, greenhouse ventilation, and heating. The article explores the benefits of utilizing this method, emphasizing its potential to reduce environmental pollution through the use of recyclable materials. It is worth mentioning that these technologies face challenges, but their progress toward achieving zero-energy consumer standards positions them as promising future technologies for electricity generation. This article provides detailed insights into emerging technologies using a constructed case study involving soil batteries and a hydrogen fuel production device.

Keywords: electricity generation, soil batteries, tires, hydrogen, heat supply, water, aged materials, recycling, agricultural lands

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145 A Comparative Analysis of the Indoor Thermal Environment of a Room with and without Transitional Space or Threshold in Traditional Row Houses Adjacent to a Narrow Alley 'Rupchan Lane' in Old Dhaka, Bangladesh

Authors: Fatema Tasmia, Brishti Majumder, Atiqur Rahman

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Attaining appropriate thermal comfort conditions in a place where the climate is hot and humid can be perplexing. Especially, when it resides at a congested place like old Dhaka Bangladesh, the provision of giving cross ventilation and building with proper orientation is quite difficult. This paper aims to investigate the indoor thermal environment of a room with and without transitional space or threshold in traditional row houses adjacent to a narrow alley of old Dhaka through field measurements. Transitional spaces are the part of buildings which are used for semi-outdoor household activities, social gathering and it is also proved to provide an indoor thermal effect. The field study was conducted by collecting thermal data (temperature, humidity and airflow) respectively, among the outdoor narrow alley, transitional space and adjacent indoor. This east-west elongated alley has an average width of 2.13 meter (varies from 1.5 to 2.6 meter) holding row houses on both sides. Among different aspects of thermal environment, the study of this paper is based on the analysis of temperature of corresponding cases. Other aspects and their variables were considered as constant (especially material) for accuracy and avoidance of confusion. This study focuses on the outcome that can ultimately contribute to the configuration of row houses with transitional spaces and in its relation to the adjacent outdoor space while achieving thermal comfort.

Keywords: alley, Old-Dhaka, row houses, temperature, thermal comfort, threshold, transitional space

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144 An Operators’ Real-sense-based Fire Simulation for Human Factors Validation in Nuclear Power Plants

Authors: Sa-Kil Kim, Jang-Soo Lee

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On March 31, 1993, a severe fire accident took place in a nuclear power plant located in Narora in North India. The event involved a major fire in the turbine building of NAPS unit-1 and resulted in a total loss of power to the unit for 17 hours. In addition, there was a heavy ingress of smoke in the control room, mainly through the intake of the ventilation system, forcing the operators to vacate the control room. The Narora fire accident provides us lessons indicating that operators could lose their mind and predictable behaviors during a fire. After the Fukushima accident, which resulted from a natural disaster, unanticipated external events are also required to be prepared and controlled for the ultimate safety of nuclear power plants. From last year, our research team has developed a test and evaluation facility that can simulate external events such as an earthquake and fire based on the operators’ real-sense. As one of the results of the project, we proposed a unit real-sense-based facility that can simulate fire events in a control room for utilizing a test-bed of human factor validation. The test-bed has the operator’s workstation shape and functions to simulate fire conditions such as smoke, heat, and auditory alarms in accordance with the prepared fire scenarios. Furthermore, the test-bed can be used for the operators’ training and experience.

Keywords: human behavior in fire, human factors validation, nuclear power plants, real-sense-based fire simulation

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143 Circle of Learning Using High-Fidelity Simulators Promoting a Better Understanding of Resident Physicians on Point-of-Care Ultrasound in Emergency Medicine

Authors: Takamitsu Kodama, Eiji Kawamoto

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Introduction: Ultrasound in emergency room has advantages of safer, faster, repeatable and noninvasive. Especially focused Point-Of-Care Ultrasound (POCUS) is used daily for prompt and accurate diagnoses, for quickly identifying critical and life-threatening conditions. That is why ultrasound has demonstrated its usefulness in emergency medicine. The true value of ultrasound has been once again recognized in recent years. It is thought that all resident physicians working at emergency room should perform an ultrasound scan to interpret signs and symptoms of deteriorating patients in the emergency room. However, a practical education on ultrasound is still in development. To resolve this issue, we established a new educational program using high-fidelity simulators and evaluated the efficacy of this course. Methods: Educational program includes didactic lectures and skill stations in half-day course. Instructor gives a lecture on POCUS such as Rapid Ultrasound in Shock (RUSH) and/or Focused Assessment Transthoracic Echo (FATE) protocol at the beginning of the course. Then, attendees are provided for training of scanning with cooperation of normal simulated patients. In the end, attendees learn how to apply focused POCUS skills at clinical situation using high-fidelity simulators such as SonoSim® (SonoSim, Inc) and SimMan® 3G (Laerdal Medical). Evaluation was conducted through surveillance questionnaires to 19 attendees after two pilot courses. The questionnaires were focused on understanding course concept and satisfaction. Results: All attendees answered the questionnaires. With respect to the degree of understanding, 12 attendees (number of valid responses: 13) scored four or more points out of five points. High-fidelity simulators, especially SonoSim® was highly appreciated to enhance learning how to handle ultrasound at an actual practice site by 11 attendees (number of valid responses: 12). All attendees encouraged colleagues to take this course because the high level of satisfaction was achieved. Discussion: Newly introduced educational course using high-fidelity simulators realizes the circle of learning to deepen the understanding on focused POCUS by gradual stages. SonoSim® can faithfully reproduce scan images with pathologic findings of ultrasound and provide experimental learning for a growth number of beginners such as resident physicians. In addition, valuable education can be provided if it is used combined with SimMan® 3G. Conclusions: Newly introduced educational course using high-fidelity simulators is supposed to be effective and helps in providing better education compared with conventional courses for emergency physicians.

Keywords: point-of-care ultrasound, high-fidelity simulators, education, circle of learning

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142 Two-Phase Flow Study of Airborne Transmission Control in Dental Practices

Authors: Mojtaba Zabihi, Stephen Munro, Jonathan Little, Ri Li, Joshua Brinkerhoff, Sina Kheirkhah

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Occupational Safety and Health Administration (OSHA) identified dental workers at the highest risk of contracting COVID-19. This is because aerosol-generating procedures (AGP) during dental practices generate aerosols ( < 5µm) and droplets. These particles travel at varying speeds, in varying directions, and for varying durations. If these particles bear infectious viruses, their spreading causes airborne transmission of the virus in the dental room, exposing dentists, hygienists, dental assistants, and even other dental clinic clients to the infection risk. Computational fluid dynamics (CFD) simulation of two-phase flows based on a discrete phase model (DPM) is carried out to study the spreading of aerosol and droplets in a dental room. The simulation includes momentum, heat, and mass transfers between the particles and the airflow. Two simulations are conducted and compared. One simulation focuses on the effects of room ventilation in winter and summer on the particles' travel. The other simulation focuses on the control of aerosol and droplets' spreading. A suction collector is added near the source of aerosol and droplets, creating a flow sink in order to remove the particles. The effects of the suction flow on the aerosol and droplet travel are studied. The suction flow can remove aerosols and also reduce the spreading of droplets.

Keywords: aerosols, computational fluid dynamics, COVID-19, dental, discrete phase model, droplets, two-phase flow

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141 A Case Study on Post-Occupancy Evaluation of User Satisfaction in Higher Educational Buildings

Authors: Yuanhong Zhao, Qingping Yang, Andrew Fox, Tao Zhang

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Post-occupancy evaluation (POE) is a systematic approach to assess the actual building performance after the building has been occupied for some time. In this paper, a structured POE assessment was conducted using the building use survey (BUS) methodology in two higher educational buildings in the United Kingdom. This study aims to help close the building performance gap, provide optimized building operation suggestions, and to improve occupants’ satisfaction level. In this research, the questionnaire survey investigated the influences of environmental factors on user satisfaction from the main aspects of building overall design, thermal comfort, perceived control, indoor environment quality for noise, lighting, ventilation, and other non-environmental factors, such as the background information about age, sex, time in buildings, workgroup size, and so on. The results indicate that the occupant satisfaction level with the main aspects of building overall design, indoor environment quality, and thermal comfort in summer and winter on both two buildings, which is lower than the benchmark data. The feedback of this POE assessment has been reported to the building management team to allow managers to develop high-performance building operation plans. Finally, this research provided improvement suggestions to the building operation system to narrow down the performance gap and improve the user work experience satisfaction and productivity level.

Keywords: building performance assessment systems, higher educational buildings, post-occupancy evaluation, user satisfaction

Procedia PDF Downloads 152
140 Guillain Barre Syndrome in Children

Authors: A. Erragh, K. Amanzoui, M. Elharit, H. Salem, M. Ababneh, K. Elfakhr, S. Kalouch, A. Chlilek

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Guillain-Barre syndrome (GBS) is the most common form of acute polyradiculoneuritis (PRNA). It is a medical emergency in pediatrics that requires rapid diagnosis and immediate assessment of the severity criteria for the implementation of appropriate treatment. Retrospective, descriptive study in 24 patients under the age of 18 who presented with GBS between September 2017 and July 2021 and were hospitalized in the multipurpose pediatric intensive care unit of the Abderrahim EL Harouchi children's hospital in Casablanca. The average age was 7.91 years, with extremes ranging from 18 months and 14 years and a male predominance of 75%. After a prodromal event, most often infectious (80%) and a free interval of 12 days on average, 2 types of motor disorders begin either hypo or arereflectic flaccid paralysis of the lower limbs (45.8%) or flaccid quadriplegia hypo or arereflectic (54.2%). During GBS, the most formidable complication is respiratory distress, which can occur at any time. In our study, respiratory impairment was observed in 70.8% of cases. In addition, other signs of severity, such as swallowing disorders (75%) and dysautonomic disorders (8.33%), were also observed, which justified care in the intensive care unit for all of our patients. The use of invasive ventilation was necessary in 76.5% of cases, and specific treatments based on immunoglobulins were administered in all our patients. Despite everything, the death rate remains high (25%) and is mainly due to complications related to hospitalization. Guillain Barré syndrome is, therefore, a pediatric emergency that requires rapid diagnosis and immediate assessment of severity criteria for the implementation of appropriate treatment.

Keywords: guillain barre syndrome, emergency, children, medical

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139 Verification of the Necessity of Maintenance Anesthesia with Isoflurane after Induction with Tiletamine-Zolazepam in Dogs Using the Dixon's up-and-down Method

Authors: Sonia Lachowska, Agnieszka Antonczyk, Joanna Tunikowska, Pawel Kucharski, Bartlomiej Liszka

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Isoflurane is one of the most commonly used anaesthetic gases in veterinary medicine. Due to its numerous side effects, intravenous anaesthesia is more often used. The combination of tiletamine with zolazepam has proved to be a safe and pharmacologically beneficial combination. Analgesic effect, fast induction time, effective myorelaxation, and smooth recovery are the main advantages of this combination of drugs. In the following study, the authors verified the necessity of isoflurane to maintain anaesthesia in dogs after the use of tiletamine-zolazepam for induction. 12 dogs were selected to the group with the inclusion criteria: ASA (American Society of Anaesthesiology) I or II. Each dog received premedication intramuscularly with medetomidine-butorfanol (10 μg/kg, 0,1 mg/kg respectively). 15 minutes from premedication, preoxygenation lasting 5 minutes was started. Anaesthesia was induced with tiletamine-zolazepam at the dose of 5 mg/kg. Then the dogs were intubated and anaesthesia was maintained with isoflurane. Initially, MAC (Minimum Alveolar Concentration) was set to 0.7 vol.%. After 15 minutes equilibration, MAC was determined using Dixon’s up-and-down method. Painful stimulation including compressions of paw pad, phalange, groin area, and clamping Backhaus on skin. Hemodynamic and ventilation parameters were measured and noted in 2 minutes intervals. In this method, the positive or negative response to the noxious stimulus is estimated and then used to determine the concentration of isoflurane for next patient. The response is only assessed once in each patient. The results show that isoflurane is not necessary to maintain anaesthesia after tiletamine-zolazepam induction. This is clinically important because the side effects resulting from using isoflurane are eliminated.

Keywords: anaesthesia, dog, Isoflurane, The Dixon's up-and-down method, Tiletamine, Zolazepam

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138 Ipsilateral Heterotopic Ossification in the Knee and Shoulder Post Long COVID-19

Authors: Raheel Shakoor Siddiqui, Calvin Mathias, Manikandar Srinivas Cheruvu, Bobin Varghese

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A 58 year old gentleman presented to accident and emergency at the district general hospital with worsening shortness of breath and a non-productive cough over a period of five days. He was initially admitted under the medical team for suspicion of SARS-CoV-2 (COVID-19) pneumonitis. Subsequently, upon deterioration of observations and a positive COVID-19 PCR, he was taken to intensive care for invasive mechanical ventilation. He required frequent proning, inotropic support and was intubated for thirty-three days. After successful extubation, he developed myopathy with a limited range of motion to his right knee and right shoulder. Plain film imaging of these limbs demonstrated an unusual formation of heterotopic ossification without any precipitating trauma or surgery. Current literature demonstrates limited case series portraying heterotopic ossification post-COVID-19. There has been negligible evidence of heterotopic ossification in the ipsilateral knee and shoulder post-prolonged immobility secondary to a critical illness. Physiotherapy and rehabilitation are post-intensive care can be prolonged due to the formation of heterotopic ossification around joints. Prolonged hospital stays may lead to a higher risk of developing infections of the chest, urine and pressure sores. This raises the question of whether a severe systemic inflammatory immune response from the SARS-CoV-2 virus results in histopathological processes leading to the formation of heterotopic ossification not previously seen, requiring prolonged physiotherapy.

Keywords: orthopaedics, rehabilitation, physiotherapy, heterotopic ossification, COVID-19

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137 Muscle and Cerebral Regional Oxygenation in Preterm Infants with Shock Using Near-Infrared Spectroscopy

Authors: Virany Diana, Martono Tri Utomo, Risa Etika

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Background: Shock is one severe condition that can be a major cause of morbidity and mortality in the Neonatal Intensive Care Unit. Preterm infants are very susceptible to shock caused by many complications such as asphyxia, patent ductus arteriosus, intra ventricle haemorrhage, necrotizing enterocolitis, persistent pulmonal hypertension of the newborn, and septicaemia. Limited hemodynamic monitoring for early detection of shock causes delayed intervention and comprises the outcomes. Clinical parameters still used in neonatal shock detection, such as Capillary Refill Time, heart rate, cold extremity, and urine production. Blood pressure is most frequently used to evaluate preterm's circulation, but hypotension indicates uncompensated shock. Near-infrared spectroscopy (NIRS) is known as a noninvasive tool for monitoring and detecting the state of inadequate tissue perfusion. Muscle oxygen saturation shows decreased cardiac output earlier than systemic parameters of tissue oxygenation when cerebral regional oxygen saturation is still stabilized by autoregulation. However, to our best knowledge, until now, no study has analyzed the decrease of muscle oxygen regional saturation (mRSO₂) and the ratio of muscle and cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Purpose: The purpose of this study is to analyze the decrease of mRSO₂ and ratio of muscle to cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Patients and Methods: This cross-sectional study was conducted on preterm infants with 28-34 weeks gestational age, admitted to the NICU of Dr. Soetomo Hospital from November to January 2022. Patients were classified into two groups: shock and non-shock. The diagnosis of shock is based on clinical criteria (tachycardia, prolonged CRT, cold extremity, decreased urine production, and MAP Blood Pressure less than GA in weeks). Measurement of mRSO₂ and cRSO₂ by NIRS was performed by the doctor in charge when the patient came to NICU. Results: We enrolled 40 preterm infants. The initial conventional hemodynamic parameter as the basic diagnosis of shock showed significant differences in all variables. Preterm with shock had higher mean HR (186.45±1.5), lower MAP (29.8±2.1), and lower SBP (45.1±4.28) than non-shock children, and most had a prolonged CRT. The patients’ outcome was not a significant difference between shock and non-shock patients. The mean mRSO₂ in the shock and non-shock groups were 33,65 ± 11,32 vs. 69,15 ± 3,96 (p=0.001), and the mean ratio mRSO₂/cRSO₂ 0,45 ± 0,12 vs. 0,84 ± 0,43 (p=0,001), were significantly different. The mean cRSO₂ in the shock and non-shock groups were 71,60 ± 4,90 vs. 81,85 ± 7,85 (p 0.082), not significantly different. Conclusion: The decrease of mRSO₂ and ratio of mRSO₂/cRSO₂ can differentiate between shock and non-shock in the preterm infant when cRSO₂ is still normal.

Keywords: preterm infant, regional muscle oxygen saturation, regional cerebral oxygen saturation, NIRS, shock

Procedia PDF Downloads 91
136 A Three-Dimensional (3D) Numerical Study of Roofs Shape Impact on Air Quality in Urban Street Canyons with Tree Planting

Authors: Bouabdellah Abed, Mohamed Bouzit, Lakhdar Bouarbi

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The objective of this study is to investigate numerically the effect of roof shaped on wind flow and pollutant dispersion in a street canyon with one row of trees of pore volume, Pvol = 96%. A three-dimensional computational fluid dynamics (CFD) model for evaluating air flow and pollutant dispersion within an urban street canyon using Reynolds-averaged Navier–Stokes (RANS) equations and the k-Epsilon EARSM turbulence model as close of the equation system. The numerical model is performed with ANSYS-CFX code. Vehicle emissions were simulated as double line sources along the street. The numerical model was validated against the wind tunnel experiment. Having established this, the wind flow and pollutant dispersion in urban street canyons of six roof shapes are simulated. The numerical simulation agrees reasonably with the wind tunnel data. The results obtained in this work, indicate that the flow in 3D domain is more complicated, this complexity is increased with presence of tree and variability of the roof shapes. The results also indicated that the largest pollutant concentration level for two walls (leeward and windward wall) is observed with the upwind wedge-shaped roof. But the smallest pollutant concentration level is observed with the dome roof-shaped. The results also indicated that the corners eddies provide additional ventilation and lead to lower traffic pollutant concentrations at the street canyon ends.

Keywords: street canyon, pollutant dispersion, trees, building configuration, numerical simulation, k-Epsilon EARSM

Procedia PDF Downloads 365
135 A Low Order Thermal Envelope Model for Heat Transfer Characteristics of Low-Rise Residential Buildings

Authors: Nadish Anand, Richard D. Gould

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A simplistic model is introduced for determining the thermal characteristics of a Low-rise Residential (LRR) building and then predicts the energy usage by its Heating Ventilation & Air Conditioning (HVAC) system according to changes in weather conditions which are reflected in the Ambient Temperature (Outside Air Temperature). The LRR buildings are treated as a simple lump for solving the heat transfer problem and the model is derived using the lumped capacitance model of transient conduction heat transfer from bodies. Since most contemporary HVAC systems have a thermostat control which will have an offset temperature and user defined set point temperatures which define when the HVAC system will switch on and off. The aim is to predict without any error the Body Temperature (i.e. the Inside Air Temperature) which will estimate the switching on and off of the HVAC system. To validate the mathematical model derived from lumped capacitance we have used EnergyPlus simulation engine, which simulates Buildings with considerable accuracy. We have predicted through the low order model the Inside Air Temperature of a single house kept in three different climate zones (Detroit, Raleigh & Austin) and different orientations for summer and winter seasons. The prediction error from the model for the same day as that of model parameter calculation has showed an error of < 10% in winter for almost all the orientations and climate zones. Whereas the prediction error is only <10% for all the orientations in the summer season for climate zone at higher latitudes (Raleigh & Detroit). Possible factors responsible for the large variations are also noted in the work, paving way for future research.

Keywords: building energy, energy consumption, energy+, HVAC, low order model, lumped capacitance

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134 Behavioral Response of Dogs to Interior Environment: An Exploratory Study on Design Parameters for Designing Dog Boarding Centers in Indian Context

Authors: M. R. Akshaya, Veena Rao

Abstract:

Pet population in India is increasing phenomenally owing to the changes in urban lifestyle with increasing number of single professionals, single parents, delayed parenthood etc. The animal companionship as a means of reducing stress levels, deriving emotional support, and unconditional love provided by dogs are a few reasons attributed for increasing pet ownership. The consequence is the booming of the pet care products and dog care centers catering to the different requirements of rearing the pets. Dog care centers quite popular in tier 1 metros of India cater to the requirement of the dog owners providing space for the dogs in absence of the owner. However, it is often reported that the absence of the owner leads to destructive and exploratory behavior issues; the main being the anxiety disorders. In the above context, it becomes imperative for a designer to design dog boarding centers that help in reducing the separation anxiety in dogs keeping in mind the different interior design parameters. An exploratory research with focus group discussion is employed involving a group of dog owners, behaviorists, proprietors of day care as well as boarding centers, and veterinarians to understand their perception on the significance of different interior parameters of color, texture, ventilation, aroma therapy and acoustics as a means of reducing the stress levels in dogs sent to the boarding centers. The data collected is organized as thematic networks thus enabling the listing of the interior design parameters that needs to be considered in designing dog boarding centers. 

Keywords: behavioral response, design parameters, dog boarding centers, interior environment

Procedia PDF Downloads 204
133 Microbial Reduction of Terpenes from Pine Wood Material

Authors: Bernhard Widhalm, Cornelia Rieder-Gradinger, Thomas Ters, Ewald Srebotnik, Thomas Kuncinger

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Terpenes are natural components in softwoods and rank among the most frequently emitted volatile organic compounds (VOC) in the wood-processing industry. In this study, the main focus was on α- and β-pinene as well as Δ3-carene, which are the major terpenes in softwoods. To lower the total emission level of wood composites, defined terpene degrading microorganisms were applied to basic raw materials (e.g. pine wood particles and strands) in an optimised and industry-compatible testing procedure. In preliminary laboratory tests, bacterial species suitable for the utilisation of α-pinene as single carbon source in liquid culture were selected and then subjected to wood material inoculation. The two species Pseudomonas putida and Pseudomonas fluorescens were inoculated onto wood particles and strands and incubated at room temperature. Applying specific pre-cultivation and daily ventilation of the samples enabled a reduction of incubation time from six days to one day. SPME measurements and subsequent GC-MS analysis indicated a complete absence of α- and β-pinene emissions after 24 hours from pine wood particles. When using pine wood strands rather than particles, bacterial treatment resulted in a reduction of α- and β-pinene by 50%, while Δ3-carene emissions were reduced by 30% in comparison to untreated strands. Other terpenes were also reduced in the course of the microbial treatment. The method developed here appears to be feasible for industrial application. However, growth parameters such as time and temperature as well as the technical implementation of the inoculation step will have to be adapted for the production process.

Keywords: GC-MS, pseudomonas, SPME, terpenes

Procedia PDF Downloads 347
132 Triple Intercell Bar for Electrometallurgical Processes: A Design to Increase PV Energy Utilization

Authors: Eduardo P. Wiechmann, Jorge A. Henríquez, Pablo E. Aqueveque, Luis G. Muñoz

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PV energy prices are declining rapidly. To take advantage of the benefits of those prices and lower the carbon footprint, operational practices must be modified. Undoubtedly, it challenges the electrowinning practice to operate at constant current throughout the day. This work presents a technology that contributes in providing modulation capacity to the electrode current distribution system. This is to raise the day time dc current and lower it at night. The system is a triple intercell bar that operates in current-source mode. The design is a capping board free dogbone type of bar that ensures an operation free of short circuits, hot swapability repairs and improved current balance. This current-source system eliminates the resetting currents circulating in equipotential bars. Twin auxiliary connectors are added to the main connectors providing secure current paths to bypass faulty or impaired contacts. All system conductive elements are positioned over a baseboard offering a large heat sink area to the ventilation of a facility. The system works with lower temperature than a conventional busbar. Of these attributes, the cathode current balance property stands out and is paramount for day/night modulation and the use of photovoltaic energy. A design based on a 3D finite element method model predicting electric and thermal performance under various industrial scenarios is presented. Preliminary results obtained in an electrowinning facility with industrial prototypes are included.

Keywords: electrowinning, intercell bars, PV energy, current modulation

Procedia PDF Downloads 154
131 Assessing the NYC's Single-Family Housing Typology for Urban Heat Vulnerability and Occupants’ Health Risk under the Climate Change Emergency

Authors: Eleni Stefania Kalapoda

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Recurring heat waves due to the global climate change emergency pose continuous risks to human health and urban resources. Local and state decision-makers incorporate Heat Vulnerability Indices (HVIs) to quantify and map the relative impact on human health in emergencies. These maps enable government officials to identify the highest-risk districts and to concentrate emergency planning efforts and available resources accordingly (e.g., to reevaluate the location and the number of heat-relief centers). Even though the framework of conducting an HVI is unique per municipality, its accuracy in assessing the heat risk is limited. To resolve this issue, varied housing-related metrics should be included. This paper quantifies and classifies NYC’s single detached housing typology within high-vulnerable NYC districts using detailed energy simulations and post-processing calculations. The results show that the variation in indoor heat risk depends significantly on the dwelling’s design/operation characteristics, concluding that low-ventilated dwellings are the most vulnerable ones. Also, it confirmed that when building-level determinants of exposure are excluded from the assessment, HVI fails to capture important components of heat vulnerability. Lastly, the overall vulnerability ratio of the housing units was calculated between 0.11 to 1.6 indoor heat degrees in terms of ventilation and shading capacity, insulation degree, and other building attributes.

Keywords: heat vulnerability index, energy efficiency, urban heat, resiliency to heat, climate adaptation, climate mitigation, building energy

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130 A Constructivist Grounded Theory Study on the Impact of Automation on People and Gardening

Authors: Hamilton V. Niculescu

Abstract:

Following a three year study conducted on eighteen Irish people that are involved in growing vegetables in various community gardens around Dublin, Republic of Ireland, it was revealed that addition of some automated features aimed at improving agricultural practices represented a process which was regarded as potentially beneficial, and as a great tool to closely monitor climate conditions inside the greenhouses. The participants were provided with a free custom-built mobile app through which they could remotely monitor and control features such as irrigation, air ventilation, and windows to ensure optimal growing conditions for vegetables growing inside purpose-built greenhouses. While the initial interest was generally high, within weeks, the participants' level of interaction with the enclosures slowly declined. By employing a constructivist grounded theory methodology, following focus group discussions, in-depth semi-structured interviews, and observations, it was revealed that participants' trust in newer technologies, and renewables, in particular, was low. There are various reasons for this, but because the participants in this study consist of mainly working-class people, it can be argued that lack of education and knowledge are the main barriers acting against the adoption of innovations. Consequently, it was revealed that most participants eventually decided to "set and forget" the systems in automatic working mode, indicating that the immediate effect of introducing people to assisting technologies also introduced some unintended consequences into their lifestyle. It is argued that this occurrence also indicates the fact that people initially "read" newer technologies and only adopt those features that they find useful and less intrusive in regards to their current lifestyle.

Keywords: automation, communication, greenhouse, sustainable

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129 An Audit on Tracheal Tube Cuff Pressure Check and Monitoring during Current Practice

Authors: Mahmoud Hassanin, Roshan Thawale, Kiran Yelamati

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Background: During current practice, intraoperative regular endotracheal cuff pressure monitoring is not routine, despite the significant number of clinicians interested in checking it after intubation to ensure a good seal and adequate ventilation. Aims and objectives: to highlight that the current practice has no guidance related to regular intra-operative monitoring of the endotracheal tube cuff pressure, which can improve patient safety and post-operative experience. Methods: local department survey was done targeting anaesthetists' current practice, measuring their knowledge and problem awareness to improve patient satisfaction and change the current approach. Results: The participants were not using the manometer, despite their interest in ensuring that the cuff pressure was high enough and there was a proper seal. More than 50% of the participant don't know the ideal range of the endotracheal tube cuff pressure range, and 32% don't know whether it is available or not in the theatre. Despite the previous finding, 100% of the participants used different methods to ensure adequate cuff pressure. The collected data revealed that at least 26% of the participant confirmed that they had seen patients having post-intubation complications. Conclusion: There is an increasing importance placed on quality assurance. Clinical practice varies widely among practitioners, with the only consistency being the omission of cuff manometers during routine intra-operative management, despite their proven benefit and efficacy. Encourage the anaesthetists and ODPs to use cuff pressure manometers. The availability of portable pressure manometers can help to maintain safe cuff pressures in patients requiring endotracheal intubation.

Keywords: endotracheal cuff pressure, intra-operative monitoring, current practice, patient satisfaction

Procedia PDF Downloads 106
128 Performance Investigation of Silica Gel Fluidized Bed

Authors: Sih-Li Chen, Chih-Hao Chen, Chi-Tong Chan

Abstract:

Poor ventilation and high carbon dioxide (CO2) concentrations lead to the formation of sick buildings. This problem cannot simply be resolved by introducing fresh air from outdoor environments because this creates extra loads on indoor air-conditioning systems. Desiccants are widely used in air conditioning systems in tropical and subtropical regions with high humidity to reduce the latent heat load from fresh air. Desiccants are usually used as a packed-bed type, which is low cost, to combine with air-conditioning systems. Nevertheless, the pressure drop of a packed bed is too high, and the heat of adsorption caused by the adsorption process lets the temperature of the outlet air increase, bringing about an extra heat load, so the high pressure drop and the increased temperature of the outlet air are energy consumption sources needing to be resolved. For this reason, the gas-solid fluidised beds that have high heat and mass transfer rates, uniform properties and low pressure drops are very suitable for use in air-conditioning systems.This study experimentally investigates the performance of silica gel fluidized bed device which applying to an air conditioning system. In the experiments, commercial silica gel particles were filled in the two beds and to form a fixed packed bed and a fluidized bed. The results indicated that compared to the fixed packed bed device, the total adsorption and desorption by amounts of fluidized bed for 40 minutes increased 20.6% and 19.9% respectively when the bed height was 10 cm and superficial velocity was set to 2 m/s. In addition, under this condition, the pressure drop and outlet air temperature raise were reduced by 36.0% and 30.0%. Given the above results, application of the silica gel fluidized bed to air conditioning systems has great energy-saving potential.

Keywords: fluidized bed, packed bed, silica gel, adsorption, desorption, pressure drop

Procedia PDF Downloads 535
127 An Automated Magnetic Dispersive Solid-Phase Extraction Method for Detection of Cocaine in Human Urine

Authors: Feiyu Yang, Chunfang Ni, Rong Wang, Yun Zou, Wenbin Liu, Chenggong Zhang, Fenjin Sun, Chun Wang

Abstract:

Cocaine is the most frequently used illegal drug globally, with the global annual prevalence of cocaine used ranging from 0.3% to 0.4 % of the adult population aged 15–64 years. Growing consumption trend of abused cocaine and drug crimes are a great concern, therefore urine sample testing has become an important noninvasive sampling whereas cocaine and its metabolites (COCs) are usually present in high concentrations and relatively long detection windows. However, direct analysis of urine samples is not feasible because urine complex medium often causes low sensitivity and selectivity of the determination. On the other hand, presence of low doses of analytes in urine makes an extraction and pretreatment step important before determination. Especially, in gathered taking drug cases, the pretreatment step becomes more tedious and time-consuming. So developing a sensitive, rapid and high-throughput method for detection of COCs in human body is indispensable for law enforcement officers, treatment specialists and health officials. In this work, a new automated magnetic dispersive solid-phase extraction (MDSPE) sampling method followed by high performance liquid chromatography-mass spectrometry (HPLC-MS) was developed for quantitative enrichment of COCs from human urine, using prepared magnetic nanoparticles as absorbants. The nanoparticles were prepared by silanizing magnetic Fe3O4 nanoparticles and modifying them with divinyl benzene and vinyl pyrrolidone, which possesses the ability for specific adsorption of COCs. And this kind of magnetic particle facilitated the pretreatment steps by electromagnetically controlled extraction to achieve full automation. The proposed device significantly improved the sampling preparation efficiency with 32 samples in one batch within 40mins. Optimization of the preparation procedure for the magnetic nanoparticles was explored and the performances of magnetic nanoparticles were characterized by scanning electron microscopy, vibrating sample magnetometer and infrared spectra measurements. Several analytical experimental parameters were studied, including amount of particles, adsorption time, elution solvent, extraction and desorption kinetics, and the verification of the proposed method was accomplished. The limits of detection for the cocaine and cocaine metabolites were 0.09-1.1 ng·mL-1 with recoveries ranging from 75.1 to 105.7%. Compared to traditional sampling method, this method is time-saving and environmentally friendly. It was confirmed that the proposed automated method was a kind of highly effective way for the trace cocaine and cocaine metabolites analyses in human urine.

Keywords: automatic magnetic dispersive solid-phase extraction, cocaine detection, magnetic nanoparticles, urine sample testing

Procedia PDF Downloads 204
126 Fuzzy Control of Thermally Isolated Greenhouse Building by Utilizing Underground Heat Exchanger and Outside Weather Conditions

Authors: Raghad Alhusari, Farag Omar, Moustafa Fadel

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A traditional greenhouse is a metal frame agricultural building used for cultivation plants in a controlled environment isolated from external climatic changes. Using greenhouses in agriculture is an efficient way to reduce the water consumption, where agriculture field is considered the biggest water consumer world widely. Controlling greenhouse environment yields better productivity of plants but demands an increase of electric power. Although various control approaches have been used towards greenhouse automation, most of them are applied to traditional greenhouses with ventilation fans and/or evaporation cooling system. Such approaches are still demanding high energy and water consumption. The aim of this research is to develop a fuzzy control system that minimizes water and energy consumption by utilizing outside weather conditions and underground heat exchanger to maintain the optimum climate of the greenhouse. The proposed control system is implemented on an experimental model of thermally isolated greenhouse structure with dimensions of 6x5x2.8 meters. It uses fans for extracting heat from the ground heat exchanger system, motors for automatic open/close of the greenhouse windows and LED as lighting system. The controller is integrated also with environmental condition sensors. It was found that using the air-to-air horizontal ground heat exchanger with 90 mm diameter and 2 mm thickness placed 2.5 m below the ground surface results in decreasing the greenhouse temperature of 3.28 ˚C which saves around 3 kW of consumed energy. It also eliminated the water consumption needed in evaporation cooling systems which are traditionally used for cooling the greenhouse environment.

Keywords: automation, earth-to-air heat exchangers, fuzzy control, greenhouse, sustainable buildings

Procedia PDF Downloads 129