Search results for: common drug combinations
2785 Correlation of Nutritional Status and Anemia Among School-Aged Children in Indonesian Urban Area
Authors: William Cheng, Yuni Astria, Rini Sekartini
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Background: Prevalence of anemia among school-aged children is relatively high (25.4%). This condition can affect children’s life, including cognitive function. One of the most common factors that is associated with anemia in children is nutritional status. This simple indicator will be very helpful in identifying more population at risk. The aim of this study is to correlate the clinical implication of nutritional status to the prevalence of anemia in children, with intention to determine a more effective nutritional status indicator in detecting anemia. Method: Anthropometric and haemoglobin status were gathered from children between 5 to 7-years-old in one of the urban areas in Jakarta in 2012. We identified children with haemoglobin level under 11.5 as anemia and correlated them to their WHO z-score from each of these indicators: Body Weight for Age (normal weight and underweight), Height for Age (not stunted and stunted), and Body Mass Index for Age (not wasted and wasted). Results: A total of 195 children were included in this research and 57 of them (29,2%) were diagnosed as anemia. The majority of the children had good nutritional status, however, 30 (15,4%) of them were found to be underweight, 33 (16,9%) were stunted, and 1 children (0,5%) was wasted. There were no overweight result found in this population. From the three nutritional status indicators, none proved to be statistically significant in relation to the incidence of anemia (p>0.05). Out of 33 children who were diagnosed as stunted, 36.36 % were found to have anemia, in comparison to 27,7% of children who were not stunted. Meanwhile, among 30 children who were diagnosed as underweight, 33,3 % of them were anemic whereas only 28,4% of the normal weight group were anemic. Conclusion: In this study, there is no significant correlation between anemia with any nutritional status indicator. However, more than a third of the stunted children are proven to have low haemoglobin status. The finding of stunting in children should be given more attention to further investigate for anemia.Keywords: school-aged children, nutritional status, anemia, pediatrics
Procedia PDF Downloads 5562784 Mastering Test Automation: Bridging Gaps for Seamless QA
Authors: Rohit Khankhoje
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The rapid evolution of software development practices has given rise to an increasing demand for efficient and effective test automation. The paper titled "Mastering Test Automation: Bridging Gaps for Seamless QA" delves into the crucial aspects of test automation, addressing the obstacles faced by organizations in achieving flawless quality assurance. The paper highlights the importance of bridging knowledge gaps within organizations, emphasizing the necessity for management to acquire a deeper comprehension of test automation scenarios, coverage, report trends, and the importance of communication. To tackle these challenges, this paper introduces innovative solutions, including the development of an automation framework that seamlessly integrates with test cases and reporting tools like TestRail and Jira. This integration facilitates the automatic recording of bugs in Jira, enhancing bug reporting and communication between manual QA and automation teams as well as TestRail have all newly added automated testcases as soon as it is part of the automation suite. The paper demonstrates how this framework empowers management by providing clear insights into ongoing automation activities, bug origins, trend analysis, and test case specifics. "Mastering Test Automation" serves as a comprehensive guide for organizations aiming to enhance their quality assurance processes through effective test automation. It not only identifies the common pitfalls and challenges but also offers practical solutions to bridge the gaps, resulting in a more streamlined and efficient QA process.Keywords: automation framework, API integration, test automation, test management tools
Procedia PDF Downloads 642783 The Formulation of R&D Strategy for Biofuel Technology: A Case Study of the Aviation Industry in Iran
Authors: Maryam Amiri, Ali Rajabzade, Gholam Reza Goudarzi, Reza Heidari
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Growth of technology and environmental changes are so fast and therefore, companies and industries have much tendency to do activities of R&D for active participation in the market and achievement to a competitive advantages. Aviation industry and its subdivisions have high level technology and play a special role in economic and social development of countries. So, in the aviation industry for getting new technologies and competing with other countries aviation industry, there is a requirement for capability in R&D. Considering of appropriate R&D strategy is supportive that day technologies of the world can be achieved. Biofuel technology is one of the newest technologies that has allocated discussion of the world in aviation industry to itself. The purpose of this research has been formulation of R&D strategy of biofuel technology in aviation industry of Iran. After reviewing of the theoretical foundations of the methods and R&D strategies, finally we classified R&D strategies in four main categories as follows: internal R&D, collaboration R&D, out sourcing R&D and in-house R&D. After a review of R&D strategies, a model for formulation of R&D strategy with the aim of developing biofuel technology in aviation industry in Iran was offered. With regard to the requirements and aracteristics of industry and technology in the model, we presented an integrated approach to R&D. Based on the techniques of decision making and analyzing of structured expert opinion, 4 R&D strategies for different scenarios and with the aim of developing biofuel technology in aviation industry in Iran were recommended. In this research, based on the common features of the implementation process of R&D, a logical classification of these methods are presented as R&D strategies. Then, R&D strategies and their characteristics was developed according to the experts. In the end, we introduced a model to consider the role of aviation industry and biofuel technology in R&D strategies. And lastly, for conditions and various scenarios of the aviation industry, we have formulated a specific R&D strategy.Keywords: aviation industry, biofuel technology, R&D, R&D strategy
Procedia PDF Downloads 5692782 Disease Level Assessment in Wheat Plots Using a Residual Deep Learning Algorithm
Authors: Felipe A. Guth, Shane Ward, Kevin McDonnell
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The assessment of disease levels in crop fields is an important and time-consuming task that generally relies on expert knowledge of trained individuals. Image classification in agriculture problems historically has been based on classical machine learning strategies that make use of hand-engineered features in the top of a classification algorithm. This approach tends to not produce results with high accuracy and generalization to the classes classified by the system when the nature of the elements has a significant variability. The advent of deep convolutional neural networks has revolutionized the field of machine learning, especially in computer vision tasks. These networks have great resourcefulness of learning and have been applied successfully to image classification and object detection tasks in the last years. The objective of this work was to propose a new method based on deep learning convolutional neural networks towards the task of disease level monitoring. Common RGB images of winter wheat were obtained during a growing season. Five categories of disease levels presence were produced, in collaboration with agronomists, for the algorithm classification. Disease level tasks performed by experts provided ground truth data for the disease score of the same winter wheat plots were RGB images were acquired. The system had an overall accuracy of 84% on the discrimination of the disease level classes.Keywords: crop disease assessment, deep learning, precision agriculture, residual neural networks
Procedia PDF Downloads 3212781 Erectile Dysfunction among Bangladeshi Men with Diabetes
Authors: Shahjada Selim
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Background: Erectile dysfunction (ED) is an important impediment to quality of life of men. ED is approximate, three times more common in diabetic than non-diabetic men, and diabetic men develop ED earlier than age-matched non-diabetic subjects. Glycemic control and other factors may contribute in developing and or deteriorating ED. Aim: The aim of the study was to determine the prevalence of ED and its risk factors in type 2 diabetic (T2DM) men in Bangladesh. Methods: During 2013-2014, 3980 diabetic men aged 30-69 years were interviewed at the out-patient departments of seven diabetic centers in Dhaka by using the validated Bengali version of the questionnaire of the International index of erectile function (IIEF) for evaluation of baseline erectile function (EF). The indexes indicate a very high correlation between the items and the questionnaire is consistently reliable. Data were analyzed with Chi-squared (χ²) test using SPSS software. P ≤ 0.05 was considered significant. Results: Out of 3790, ED was found in 2046 (53.98%) of T2DM men. The prevalence of ED was increased with age from 10.5% in men aged 30-39 years to 33.6% in those aged over 60 years (P < 0.001). In comparison with patients with reported diabetes lasting ≤ 5 years (26.4%), the prevalence of ED was less than in those with diabetes of 6-11 years (35.3%) and of 12-30 years (42.5%, P <0.001). ED increased significantly in those who had poor glycemic control. The prevalence of ED in patients with good, fair and poor glycemic control was 22.8%, 42.5% and 47.9% respectively (P = 0.004). Treatment modalities (medical nutrition therapy, oral agents, insulin, and insulin plus oral agents) had significant association with ED and its severity (P < 0.001). Conclusion: Prevalence of ED is very high among T2DM men in Bangladesh and can be reduced the burden by improving glycemic status. Glycemic control, duration of diabetes, treatment modalities, increasing age are associated with ED.Keywords: erectile dysfunction, diabetes, men, Bangladesh
Procedia PDF Downloads 2582780 Artificial Intelligence in the Design of a Retaining Structure
Authors: Kelvin Lo
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Nowadays, numerical modelling in geotechnical engineering is very common but sophisticated. Many advanced input settings and considerable computational efforts are required to optimize the design to reduce the construction cost. To optimize a design, it usually requires huge numerical models. If the optimization is conducted manually, there is a potentially dangerous consequence from human errors, and the time spent on the input and data extraction from output is significant. This paper presents an automation process introduced to numerical modelling (Plaxis 2D) of a trench excavation supported by a secant-pile retaining structure for a top-down tunnel project. Python code is adopted to control the process, and numerical modelling is conducted automatically in every 20m chainage along the 200m tunnel, with maximum retained height occurring in the middle chainage. Python code continuously changes the geological stratum and excavation depth under groundwater flow conditions in each 20m section. It automatically conducts trial and error to determine the required pile length and the use of props to achieve the required factor of safety and target displacement. Once the bending moment of the pile exceeds its capacity, it will increase in size. When the pile embedment reaches the default maximum length, it will turn on the prop system. Results showed that it saves time, increases efficiency, lowers design costs, and replaces human labor to minimize error.Keywords: automation, numerical modelling, Python, retaining structures
Procedia PDF Downloads 452779 Incentive Policies to Promote Green Infrastructure in Urban Jordan
Authors: Zayed Freah Zeadat
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The wellbeing of urban dwellers is strongly associated with the quality and quantity of green infrastructure. Nevertheless, urban green infrastructure is still lagging in many Arab cities, and Jordan is no exception. The capital city of Jordan, Amman, is becoming more urban dense with limited green spaces. The unplanned urban growth in Amman has caused several environmental problems such as urban heat islands, air pollution, and lack of green spaces. This study aims to investigate the most suitable drivers to leverage the implementation of urban green infrastructure in Jordan through qualitative and quantitative analysis. The qualitative research includes an extensive literature review to discuss the most common drivers used internationally to promote urban green infrastructure implementation in the literature. The quantitative study employs a questionnaire survey to rank the suitability of each driver. Consultants, contractors, and policymakers were invited to fill the research questionnaire according to their judgments and opinions. Relative Importance Index has been used to calculate the weighted average of all drivers and the Kruskal-Wallis test to check the degree of agreement among groups. This study finds that research participants agreed that indirect financial incentives (i.e., tax reductions, reduction in stormwater utility fee, reduction of interest rate, density bonus, etc.) are the most effective incentive policy whilst granting sustainability certificate policy is the least effective driver to ensure widespread of UGI is elements in Jordan.Keywords: urban green infrastructure, relative importance index, sustainable urban development, urban Jordan
Procedia PDF Downloads 1502778 Self-Efficacy in Online Vocal Learning: Current Situation, Influencing Factors and Optimization Strategies
Authors: Tianyou Wang
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Students' own intrinsic motivation is the main source of energy for learning activities, and their self-efficacy becomes a key factor affecting the learning effect. In today's increasingly common situation of online vocal music teaching, virtualized teaching scenarios have brought a considerable impact on students' personal efficacy. Since personal efficacy is the result of the interaction between environmental factors and subject characteristics, an empirical study was conducted to investigate the changes in students' self-efficacy, influencing factors, and characteristics in online vocal teaching scenarios based on the three dimensions of teachers, students, and technology. One hundred valid questionnaires were studied through a quantitative survey. The results showed that students' personal efficacy was significantly lower in online learning environments compared to offline vocal teaching and showed significant differences due to factors such as gender and class type; students' self-efficacy in online vocal teaching was significantly affected by factors such as technological environment, teaching style, and information technology ability. Based on the results of the study, it is recommended to pay attention to inquiry and practice in the teaching design, use singing projects as the teaching organization, grasp the learning process with the orientation of problem-solving, push the applicable vocal music teaching resources in time, lead students to explore and refine the problems and push students to learn independently according to the goals and plans.Keywords: vocal pedagogy, self-efficacy, online learning, intrinsic motivation, information technology
Procedia PDF Downloads 492777 Properties Optimization of Keratin Films Produced by Film Casting and Compression Moulding
Authors: Mahamad Yousif, Eoin Cunningham, Beatrice Smyth
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Every year ~6 million tonnes of feathers are produced globally. Due to feathers’ low density and possible contamination with pathogens, their disposal causes health and environmental problems. The extraction of keratin, which represents >90% of feathers’ dry weight, could offer a solution due to its wide range of applications in the food, medical, cosmetics, and biopolymer industries. One of these applications is the production of biofilms which can be used for packaging, edible films, drug delivery, wound healing etc. Several studies in the last two decades investigated keratin film production and its properties. However, the effects of many parameters on the properties of the films remain to be investigated including the extraction method, crosslinker type and concentration, and the film production method. These parameters were investigated in this study. Keratin was extracted from chicken feathers using two methods, alkaline extraction with 0.5 M NaOH at 80 °C or sulphitolysis extraction with 0.5 M sodium sulphite, 8 M urea, and 0.25-1 g sodium dodecyl sulphate (SDS) at 100 °C. The extracted keratin was mixed with different types and concentrations of plasticizers (glycerol and polyethylene glycol) and crosslinkers (formaldehyde (FA), glutaraldehyde, cinnamaldehyde, glyoxal, and 1,4-Butanediol diglycidyl ether (BDE)). The mixtures were either cast in a mould or compression moulded to produce films. For casting, keratin powder was initially dissolved in water to form a 5% keratin solution and the mixture was dried in an oven at 60 °C. For compression moulding, 10% water was added and the compression moulding temperature and pressure were in the range of 60-120 °C and 10-30 bar. Finally, the tensile properties, solubility, and transparency of the films were analysed. The films prepared using the sulphitolysis keratin had superior tensile properties to the alkaline keratin and formed successfully with lower plasticizer concentrations. Lowering the SDS concentration from 1 to 0.25 g/g feathers improved all the tensile properties. All the films prepared without crosslinkers were 100% water soluble but adding crosslinkers reduced solubility to as low as 21%. FA and BDE were found to be the best crosslinkers increasing the tensile strength and elongation at break of the films. Higher compression moulding temperature and pressure lowered the tensile properties of the films; therefore, 80 °C and 10 bar were considered to be the optimal compression moulding temperature and pressure. Nevertheless, the films prepared by casting had higher tensile properties than compression moulding but were less transparent. Two optimal films, prepared by film casting, were identified and their compositions were: (a) Sulphitolysis keratin, 20% glycerol, 10% FA, and 10% BDE. (b) Sulphitolysis keratin, 20% glycerol, and 10% BDE. Their tensile strength, elongation at break, Young’s modulus, solubility, and transparency were: (a) 4.275±0.467 MPa, 86.12±4.24%, 22.227±2.711 MPa, 21.34±1.11%, and 8.57±0.94* respectively. (b) 3.024±0.231 MPa, 113.65±14.61%, 10±1.948 MPa, 25.03±5.3%, and 4.8±0.15 respectively. A higher value indicates that the film is less transparent. The extraction method, film composition, and production method had significant influence on the properties of keratin films and should therefore be tailored to meet the desired properties and applications.Keywords: compression moulding, crosslinker, film casting, keratin, plasticizer, solubility, tensile properties, transparency
Procedia PDF Downloads 192776 A Phenomenological Method Based on Professional Descriptions of Community-of-Practice Members to Scientifically Determine the Level of Child Psycho-Social-Emotional Development
Authors: Gianni Jacucci
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Alfred Schutz (1932), at the very turning towards phenomenology, of the attention for the social sciences, stated that successful communication of meanings requires the sharing of “sedimenta-tions “ of previous meanings. Börje Langefors (1966), at the very beginning of the social studies of information systems, stated that a common professional basis is required for a correct sharing of meanings, e. g., “standardised accounting data among accountants”. Harold Garfinkel (1967), at the very beginning of ethnomethodology, stated that the accounting of social events must be carried out in the same language used by the actors of those events in managing their practice. Community of practice: we advocate professional descriptions of the community of practice members to scientifically determine the level of child psycho social emotional development. Our approach consists of an application to Human Sciences of Husserl’s Phenomenological Philosophy using a method reminder of Giorgi’s DPM in Psychology. Husserl’s requirement of "Epoché," which involves eliminating prejudices from the minds of observers, is met through "concept cleaning," achieved by consistently sharing disciplinary concepts within their community of practice. Mean-while, the absence of subjective bias is ensured by the meticulous attention to detail in their professional expertise. Our approach shows promise in accurately assessing many other properties through detailed professional descriptions of the community of practice members.Keywords: scientific rigour, descriptive phenomenological method, sedimentation of meanings, community of practice
Procedia PDF Downloads 352775 Vagal Nerve Stimulator as a Treatment Approach in CHARGE Syndrome: A Case Report
Authors: Roya Vakili, Lekaa Elhajjmoussa, Barzin Omidi-Shal, Kim Blake
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Objective: The purpose of this case report is to highlight the successful treatment of a patient with Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness, (CHARGE syndrome) using a vagal nerve stimulator (VNS). Background: This is the first documented case report, to the authors' best knowledge, for a patient with CHARGE syndrome, epilepsy, autism, and postural orthostatic tachycardia syndrome (POTS) that was successfully treated with an implanted VNS therapeutic device. Methodology: The study is a case report. Results: This is the case of a 24-year-old female patient with CHARGE syndrome (non-random association of anomalies Coloboma, Heart defect, Atresia choanae, Retarded growth and development, Genital hypoplasia, Ear anomalies/deafness) and several other comorbidities including refractory epilepsy, Patent Ductus Arteriosus (PDA) and POTS who had significant improvement of her symptoms after VNS implantation. She was a VNS candidate given her longstanding history of drug-resistant epilepsy and current disposition secondary to CHARGE syndrome. Prior to VNS implantation, she experienced three generalized seizures a year and daily POTS-related symptoms. She was having frequent lightheadedness and syncope spells due to a rapid heart rate and low blood pressure. The VNS device was set to detect a rapid heart rate and send appropriate stimulation anytime the heart rate exceeded 20% of the patient’s normal baseline. The VNS device demonstrated frequent elevated heart rates and concurrent VNS release every 8 minutes in addition to the programmed events. Following VNS installation, the patient became more active, alert, and communicative and was able to verbally communicate with words she was unable to say prior. Her GI symptoms also improved, as she was able to tolerate food better orally in addition to her G and J tube, likely another result of the vagal nerve stimulation. Additionally, the patient’s seizures and POTS-related cardiac events appeared to be well controlled. She had prolonged electroencephalogram (EEG) testing, showing no significant change in epileptiform activity. Improvements in the patient’s disposition are believed to be secondary to parasympathetic stimulation, adequate heart rate control, and GI stimulation, in addition to behavioral changes and other benefits via her implanted VNS. Conclusion: VNS showed promising results in improving the patient's quality of life and managing her diverse symptoms, including dysautonomia, POTs, gastrointestinal mobility, cognitive functioning as well seizure control.Keywords: autism, POTs, CHARGE, VNS
Procedia PDF Downloads 812774 Iterative Segmentation and Application of Hausdorff Dilation Distance in Defect Detection
Authors: S. Shankar Bharathi
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Inspection of surface defects on metallic components has always been challenging due to its specular property. Occurrences of defects such as scratches, rust, pitting are very common in metallic surfaces during the manufacturing process. These defects if unchecked can hamper the performance and reduce the life time of such component. Many of the conventional image processing algorithms in detecting the surface defects generally involve segmentation techniques, based on thresholding, edge detection, watershed segmentation and textural segmentation. They later employ other suitable algorithms based on morphology, region growing, shape analysis, neural networks for classification purpose. In this paper the work has been focused only towards detecting scratches. Global and other thresholding techniques were used to extract the defects, but it proved to be inaccurate in extracting the defects alone. However, this paper does not focus on comparison of different segmentation techniques, but rather describes a novel approach towards segmentation combined with hausdorff dilation distance. The proposed algorithm is based on the distribution of the intensity levels, that is, whether a certain gray level is concentrated or evenly distributed. The algorithm is based on extraction of such concentrated pixels. Defective images showed higher level of concentration of some gray level, whereas in non-defective image, there seemed to be no concentration, but were evenly distributed. This formed the basis in detecting the defects in the proposed algorithm. Hausdorff dilation distance based on mathematical morphology was used to strengthen the segmentation of the defects.Keywords: metallic surface, scratches, segmentation, hausdorff dilation distance, machine vision
Procedia PDF Downloads 4202773 Black-Brown and Yellow-Brown-Red Skin Pigmentation Elements are Shared in Common: Using Art and Science for Multicultural Education
Authors: Mary Kay Bacallao
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New research on the human genome has revealed secrets to the variation in skin pigmentation found in all human populations. Application of this research to multicultural education has a profound effect on students from all backgrounds. This paper identifies the four locations in the human genome that code for variation in skin pigmentation worldwide. The research makes this new knowledge accessible to students of all ages as they participate in an art project that brings these scientific multicultural concepts to life. Students participate in the application of breakthrough scientific principles through hands-on art activities where they simulate the work of the DNA coding to create their own skin tone using the colors expressed to varying degrees in every people group. As students create their own artwork handprint from the pallet of colors, they realize that each color on the pallet is essential to creating every tone of skin. This research project serves to bring people together and appreciate the variety and diversity in skin tones. As students explore the variations, they create pigmentation with the use of the eumelanins, which are the black-brown sources of pigmentation, and the pheomelanins, which are the yellow-reddish-brown sources of pigmentation. The research project dispels myths about skin tones that have divided people in the past. As a group project, this research leads to greater appreciation and understanding of the diverse family groups.Keywords: diversity, multicultural, skin pigmentation, eumelanins, pheomelanins, handprint, artwork, science, genome, human
Procedia PDF Downloads 602772 Gender Differences in Negotiation: Considering the Usual Driving Forces
Authors: Claude Alavoine, Ferkan Kaplanseren
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Negotiation is a specific form of interaction based on communication in which the parties enter into deliberately, each with clear but different interests or goals and a mutual dependency towards a decision due to be taken at the end of the confrontation. Consequently, negotiation is a complex activity involving many different disciplines from the strategic aspects and the decision making process to the evaluation of alternatives or outcomes and the exchange of information. While gender differences can be considered as one of the most researched topic within negotiation studies, empirical works and theory present many conflicting evidences and results about the role of gender in the process or the outcome. Furthermore, little interest has been shown over gender differences in the definition of what is negotiation, its essence or fundamental elements. Or, as differences exist in practices, it might be essential to study if the starting point of these discrepancies does not come from different considerations about what is negotiation and what will encourage the participants in their strategic decisions. Some recent and promising experiments made with diverse groups show that male and female participants in a common and shared situation barely consider the same way the concepts of power, trust or stakes which are largely considered as the usual driving forces of any negotiation. Furthermore, results from Human Resource self-assessment tests display and confirm considerable differences between individuals regarding essential behavioral dimensions like capacity to improvise and to achieve, aptitude to conciliate or to compete and orientation towards power and group domination which are also part of negotiation skills. Our intention in this paper is to confront these dimensions with negotiation’s usual driving forces in order to build up new paths for further research.Keywords: negotiation, gender, trust, power, stakes, strategies
Procedia PDF Downloads 5052771 Physiotherapy Program for Frozen Shoulder Related to Onset of Symptom, Range of Motions and Obtaining Modalities
Authors: Narupon Kunbootsri, P. Sirasaporn
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Frozen shoulder is a common problem present by pain and limit range of motion. The prevalence of frozen shoulder showed 18-31% of population. The effect of frozen shoulder lead to limit activities daily living life, high medical care cost and so on. Physiotherapy is one of the treatments for frozen shoulder but there was no data about the treatment of physiotherapy. Moreover, it is question about onset of symptom relate to physiotherapy program and obtaining physical modalities and delayed start physiotherapy program lead to delayed improvement. Thus the aim of this study was to investigate physiotherapy program for frozen shoulder relate to onset of symptom, range of motion and obtaining physical modalities. A retrospective study design was conducted. 182 medical records of patients with frozen shoulder were reviewed. These frozen shoulders were treated at physiotherapy unit, department of Rehabilitation last 3 years (January, 2014- December, 2016). The data consist of onset of symptom, range of motion and obtaining physical modalities were recorded. There was a statistically significant increase in shoulder flexion [mean difference 38.88 with 95%CI were [16.00-61.77], shoulder abduction [mean difference 48.47 with 95%CI were 16.07-90.59], shoulder internal rotation [mean difference 22.36 with 95%CI were 2.81-37.18] and shoulder external rotation [mean difference 32.12 with 95%CI were [(-2.47)-(46.91)]. In addition, the onset of symptom was 76.42±46.90 days. And the physical modalities used frequently were hot pack 14.8% and ultrasound diathermy 13.7%. In conclusion, the physiotherapy program including, hot pack and ultrasound diathermy seem to be useful for frozen shoulder. But onset of symptom is too long to start physiotherapy programs.Keywords: frozen shoulder, range of motions, onset of symptom, physiotherapy, physical modality
Procedia PDF Downloads 2772770 A Concept Analysis of Self-Efficacy for Cancer Pain Management
Authors: Yi-Fung Lin, Yuan-Mei Liao
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Background: Pain is common among patients with cancer and is also one of the most disturbing symptoms. As this suffering is subjective, if patients proactively participate in their pain self-management, pain could be alleviated effectively. However, not everyone can carry out self-management very well because human behavior is a product of the cognition process. In this process, we can see that "self-efficacy" plays an essential role in affecting human behaviors. Methods: We used the eight steps of concept analysis proposed by Walker and Avant to clarify the concept of “self-efficacy for cancer pain management.” A comprehensive literature review was conducted for relevant publications that were published during the period of 1977 to 2021. We used several keywords, including self-efficacy, self-management, concept analysis, conceptual framework, and cancer pain, to search the following databases: PubMed, CINAHL, Web of Science, and Embase. Results: We identified three defining attributes for the concept of self-efficacy for cancer pain management, including pain management abilities, confidence, and continuous pain monitoring, and recognized six skills related to pain management abilities: problem-solving, decision-making, resource utilization, forming partnerships between medical professionals and patients, planning actions, and self-regulation. Five antecedents for the concept of self-efficacy for cancer pain management were identified: pain experience, existing cancer pain, pain-related knowledge, a belief in pain management, and physical/mental state. Consequences related to self-efficacy for cancer pain management were achievement of pain self-management, well pain control, satisfying quality of life, and containing motivation. Conclusions: This analysis provides researchers with a clearer understanding of the concept of “self-efficacy for cancer pain management.” The findings presented here provide a foundation for future research and nursing interventions to enhance self-efficacy for cancer pain management.Keywords: cancer pain, concept analysis, self-efficacy, self-management
Procedia PDF Downloads 642769 ALDH1A1 as a Cancer Stem Cell Marker: Value of Immunohistochemical Expression in Benign Prostatic Hyperplasia, Prostatic Intraepithelial Neoplasia, and Prostatic Adenocarcinoma
Authors: H. M. Abdelmoneim, N. A. Babtain, A. S. Barhamain, A. Z. Kufiah, A. S. Malibari, S. F. Munassar, R. S. Rawa
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Introduction: Prostate cancer is one of the most common causes of morbidity and mortality in men in developed countries. Cancer Stem Cells (CSCs) could be responsible for the progression and relapse of cancer. Therefore, CSCs markers could provide a prognostic strategy for human malignancies. Aldehyde dehydrogenase 1A1 (ALDH1A1) activity has been shown to be associated with tumorigenesis and proposed to represent a functional marker for tumor initiating cells in various tumor types including prostate cancer. Material & Methods: We analyzed the immunohistochemical expression of ALDH1A1 in benign prostatic hyperplasia (BPH), prostatic intraepithelial neoplasia (PIN) and prostatic adenocarcinoma and assessed their significant correlations in 50 TURP sections. They were microscopically interpreted and the results were correlated with histopathological types and tumor grade. Results: In different prostatic histopathological lesions we found that ALDH1A1 expression was low in BPH (13.3%) and PIN (6.7%) and then its expression increased with prostatic adenocarcinoma (40%), and this was statistically highly significant (P value = 0.02). However, in different grades of prostatic adenocarcinoma we found that the higher the Gleason grade the higher the expression for ALDH1A1 and this was statistically significant (P value = 0.02). We compared the expression of ALDH1A1 in PIN and prostatic adenocarcinoma. ALDH1A1 expression was decreased in PIN and highly expressed in prostatic adenocarcinoma and this was statistically significant (P value = 0.04). Conclusion: Increasing ALDH1A1 expression is correlated with aggressive behavior of the tumor. Immunohistochemical expression of ALDH1A1 might provide a potential approach to study tumorigenesis and progression of primary prostate carcinoma.Keywords: ALDH1A1, BPH, PIN, prostatic adenocarcinoma
Procedia PDF Downloads 2562768 Prevalence of Anaemia Amongst Antenatal Clinic Attendees at Booking: A Nigerian Study
Authors: S Eli, DGB Kalio, BOA Altraide, P Kua, DA MacPepple, FE Okonofua
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Background: Anaemia in pregnancy is worrisome morbidity encountered by obstetricians and gynaecologist in the developing countries of the world. It is an indirect cause of maternal mortality and also a cause of perinatal mortality. Aim: The study aimed to ascertain the prevalence of anaemia amongst antenatal clinic (ANC) attendees at booking at The Rivers State University Teaching Hospital (RSUTH), Port Harcourt, Rivers State, Nigeria. Method: The method was a cross-sectional study of ANC attendees at booking at RSUTH. The cut-off for anaemia by the WHO used for this study was packed cell volume (PCV) less than 33%. Simple randomized sampling method was used. Information was analyzed using SPSS version 25. Result: A total of 500 questionnaires were distributed, and 488 questionnaires retrieved. The mean age was of the ANC attendees was 31.44 years, and the modal parity was 0. Three hundred and fifty-seven (73.2%) of the respondents had a tertiary level of education, 126(25.8%) had a secondary level of education while 5 (1%) of the respondents had a primary level of education. Five (1%) of the respondents did not volunteer their educational status. The modal packed cell volume was 32%. Three hundred and eighty-two (78.3%) of the ANC attendees had PCV level less than 33% compared to 106 (21.7%) who had PCV equal or greater than 33%. Conclusion: The study revealed that the prevalence of anaemia in pregnancy amongst ANC attendees at the RSUTH was high, representing 73.3% of the subjects. Anaemia was common amongst multiparas (38.5%). Malaria prophylaxis, as well as encouraging pregnant women to be compliant with their routine antenatal drugs as well as counseling on the right diet, cannot be overemphasized during pregnancy. In addition, women should use family planning for child spacing for them to recover from previous pregnancies.Keywords: anaemia, ANC attendees, Nigeria, prevalence
Procedia PDF Downloads 1142767 Prenatal Development of Heart and Great Vessels in Buffalo (Bubalus bubalis)
Authors: Anuradha Gupta, Neelam Bansal, Varinder Uppal
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The present investigation was made on 35 Indian buffalo fetuses ranging from 0.9 cm to 104 cm curved crown rump length (CVRL). The gross anatomical study revealed that all structures were developed at 13 cm CVRL (87 days) in group I. At 0.9 cm CVRL (32 days) the heart was unseptated and tubular and was clearly divided into common atrial chamber dorsally and primitive ventricle in 1.2 cm CVRL fetus (34 days). Septum primum appeared at 1.9 cm CVRL (37 days), truncal ridges at 2.5 cm CVRL (39 days) and foramen ovale in 3.0 cm CVRL (42 days) buffalo foetuses. At 7.6 cm CVRL (62 days) endocardial cushions fused to form left and right atrioventricular openings and four chambered heart was formed in 8.7 cm CVRL (66 days). Endocardium and epicardium was thicker in atria as compared to ventricles in all the age groups. Myocardium of atria was thin as compared to ventricles in all the age groups and was loosely arranged. Immature hyaline cartilage was first appeared at base of aorta in 62 cm CVRL (213 days) fetuses. Intercalated discs were seen in group III and aorta, pulmonary artery, coronary artery were well appreciated in 3.2 cm CVRL (43 days). Neutral and acid mucopolysaccharides were comparatively more in atria than ventricles. Basic proteins showed strong reaction in atrium and ventricle, and intense in conduction system. Lipids and phospholipids were more in myocardium and conduction system than endocardium and epicardium. All the histochemical moieties were comparatively more in tunica intima than media and adventitia of all the great vessels of heart.Keywords: buffalo, fetal development, histochemistry, heart
Procedia PDF Downloads 2712766 Comparison of Microwave-Assisted and Conventional Leaching for Extraction of Copper from Chalcopyrite Concentrate
Authors: Ayfer Kilicarslan, Kubra Onol, Sercan Basit, Muhlis Nezihi Saridede
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Chalcopyrite (CuFeS2) is the most common primary mineral used for the commercial production of copper. The low dissolution efficiency of chalcopyrite in sulfate media has prevented an efficient industrial leaching of this mineral in sulfate media. Ferric ions, bacteria, oxygen and other oxidants have been used as oxidizing agents in the leaching of chalcopyrite in sulfate and chloride media under atmospheric or pressure leaching conditions. Two leaching methods were studied to evaluate chalcopyrite (CuFeS2) dissolution in acid media. First, the conventional oxidative acid leaching method was carried out using sulfuric acid (H2SO4) and potassium dichromate (K2Cr2O7) as oxidant at atmospheric pressure. Second, microwave-assisted acid leaching was performed using the microwave accelerated reaction system (MARS) for same reaction media. Parameters affecting the copper extraction such as leaching time, leaching temperature, concentration of H2SO4 and concentration of K2Cr2O7 were investigated. The results of conventional acid leaching experiments were compared to the microwave leaching method. It was found that the copper extraction obtained under high temperature and high concentrations of oxidant with microwave leaching is higher than those obtained conventionally. 81% copper extraction was obtained by the conventional oxidative acid leaching method in 180 min, with the concentration of 0.3 mol/L K2Cr2O7 in 0.5M H2SO4 at 50 ºC, while 93.5% copper extraction was obtained in 60 min with microwave leaching method under same conditions.Keywords: extraction, copper, microwave-assisted leaching, chalcopyrite, potassium dichromate
Procedia PDF Downloads 3572765 Conditionality in the European Union as a New Instrument to Guarantee the Principle of Separation of Powers
Authors: Ana Neves
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The European Union’s multi-level constitutionalism is grounded in an intricate network of vertical and horizontal legal relationships among different levels and types of public authorities. In a very significant way since the 2008 crisis, evolving institutional arrangements and institutional dynamics in the European Union have been progressively impacting Member States and the terms under which national public authorities are organised, interact and exercise their powers. This impact occurs in both macro and micro dimensions. Several examples are relevant here, such as the involvement of national Parliaments in the activities of the European Union, the enhanced integration of public administrations, the side effects of the Council framework decision on the European Arrest Warrant, the European Union Justice Scoreboard, the protection of whistle-blowers regulation, the enhanced cooperation on the establishment of the European Public Prosecutor’s Office, the regime for the protection of the Union budget and the European Rule of Law Mechanism. A common trend or denominator underlies the deepening of institutional interdependence and the increased interactions between the European Union, Member States, and public authorities at different levels. This seems to be conditionality as a general principle. The European multi-level constitutionalism must be considered in the light of this conditionality principle, which does not “imply a relationship of command and obedience”. Nevertheless, it might be more effective or be a very compelling principle. It is as if the extension of the shared rule is being accompanied by a contrapuntal dialogue. The different public authorities at various levels are being called to rethink and readjust themselves within a broader and more plural framework concerning understanding the limitation of power.Keywords: european union -, multi-level hierarchy, conditionality, separation of powers
Procedia PDF Downloads 1032764 Generation of Medical Waste in Hospitals in Interior of São Paulo, Brazil
Authors: Silvia Carla Da Silva André, Angela Maria Magosso Takayanagui
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Introduction: The Medical Waste (MW) are responsible per 2% of total waste generated for a city and has merited attention due the risks that offers to the public health and environment, representing an important aspect in waste management. In Brazil, the Resolution 306/04 of the National Health Surveillance Agency classifies the MW into 5 groups as follows: Group A (GA) biological, Group B (GB) chemical, Group C (GC) radioactive waste, Group D (GD) common, and Group E (GE) sharps. Objective: This study aimed to determine the amount of waste generated in hospitals of Ribeirão Preto, São Paulo, Brazil. Material and Methods: This is a field research, exploratory, using quantitative variables. The survey was conducted in 11 hospitals in Ribeirão Preto, located in the State of São Paulo, Brazil. It is noted that the study sample included general hospitals, skilled, university, maternity, and psychiatric; public, private, and philanthropic; and large, medium, and small. To quantify the MW, the weighing of the waste was held for six days, following methodology adapted from PAHO. Data were analyzed using descriptive statistics, determining the average global generation of MW and for each group. This research was carried out after approval by the Ethics in Research of the University of São Paulo. Thus, in order to comply with the ethical principles of research, to present the results hospitals were numbered from 1 to 11. Results: The data revealed a greater generation of biological waste among teaching hospitals, which can be justified by the use of materials for the realization of techniques.Keywords: environmental health, management of medical waste, medical waste, public health
Procedia PDF Downloads 3622763 Convolutional Neural Networks versus Radiomic Analysis for Classification of Breast Mammogram
Authors: Mehwish Asghar
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Breast Cancer (BC) is a common type of cancer among women. Its screening is usually performed using different imaging modalities such as magnetic resonance imaging, mammogram, X-ray, CT, etc. Among these modalities’ mammogram is considered a powerful tool for diagnosis and screening of breast cancer. Sophisticated machine learning approaches have shown promising results in complementing human diagnosis. Generally, machine learning methods can be divided into two major classes: one is Radiomics analysis (RA), where image features are extracted manually; and the other one is the concept of convolutional neural networks (CNN), in which the computer learns to recognize image features on its own. This research aims to improve the incidence of early detection, thus reducing the mortality rate caused by breast cancer through the latest advancements in computer science, in general, and machine learning, in particular. It has also been aimed to ease the burden of doctors by improving and automating the process of breast cancer detection. This research is related to a relative analysis of different techniques for the implementation of different models for detecting and classifying breast cancer. The main goal of this research is to provide a detailed view of results and performances between different techniques. The purpose of this paper is to explore the potential of a convolutional neural network (CNN) w.r.t feature extractor and as a classifier. Also, in this research, it has been aimed to add the module of Radiomics for comparison of its results with deep learning techniques.Keywords: breast cancer (BC), machine learning (ML), convolutional neural network (CNN), radionics, magnetic resonance imaging, artificial intelligence
Procedia PDF Downloads 2192762 The Amalgamation of Fashion and Art: A Camaraderie of the Creative Abilities
Authors: Brar Prabhdip
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Art and fashion are coupled by a common bridge which is ‘Creativity’. For centuries art has influenced fashion and has been inspirational for modern-day national as well as international designers. Italian artists during the Renaissance period were highly influenced by art. 20th and 21st-century artists have often found themselves the muses of major fashion houses. Many times artists and designers like Andy Warhol, Damien Hirst, and Dior, Prada, respectively, have collaborated and successfully created prints, textiles, and silhouettes that have dazzled the art and fashion world. This paper nudges deeper and discourses the statement pieces of remarkable designers that have been influenced by art and adorned by international celebrities. Indian designer Manish Arora has been able to design a remarkable position for himself in the international fashion world. His clothes are avant-garde and favoured choice of celebrities like Lady Gaga and Katy Perry. The Manish Arora collaboration with Berlin-based artist Amrie Hoffstater has carved its space for a new segment. The latest collaboration, despite being in the pandemic, is between Sabyasachi (India) and Bergdorfs Goodman (New York). It boasts of the traditional Colonial Indian sensibility juxtaposed with the eclectic Western American mix for the new-age wearer. A qualitative and exploratory research design is steered towards both art and fashion as they reflect social, economic, and political changes. Social issues are highlighted through these platforms. Secondary data has been used for this paper to explain how designers have bridged the way for how one could wear fashion as a piece of art in and of itself. Conclusively we reach the perfect camaraderie between art and fashion.Keywords: art, artist, collaboration, designer, fashion, relationship commas
Procedia PDF Downloads 812761 Differentiating Morphological Patterns of the Common Benthic Anglerfishes from the Indian Waters
Authors: M. P. Rajeeshkumar, K. V. Aneesh Kumar, J. L. Otero-Ferrer, A. Lombarte, M. Hashim, N. Saravanane, V. N.Sanjeevan, V. M. Tuset
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The anglerfishes are widely distributed from shallow to deep-water habitats and are highly diverse in morphology, behaviour, and niche occupancy patterns. To understand this interspecific variability and degree of niche overlap, we performed a functional analysis of five species inhabiting Indian waters where diversity of deep-sea anglerfishes is very high. The sensory capacities (otolith shape and eye size) were also studied to improve the understanding of coexistence of species. The analyses of fish body and otolith shape clustered species in two morphotypes related to phylogenetic lineages: i) Malthopsis lutea, Lophiodes lugubri and Halieutea coccinea were characterized by a dorso-ventrally flattened body with high swimming ability and relative small otoliths, and ii) Chaunax spp. were distinguished by their higher body depth, lower swimming efficiency, and relative big otoliths. The sensory organs did not show a pattern linked to depth distribution of species. However, the larger eye size in M. lutea suggested a nocturnal feeding activity, whereas Chaunax spp. had a large mouth and deeper body in response to different ecological niches. Therefore, the present study supports the hypothesis of spatial and temporal segregation of anglerfishes in the Indian waters, which can be explained from a functional approach and understanding from sensory capabilities.Keywords: functional traits, otoliths, niche overlap, fishes, Indian waters
Procedia PDF Downloads 1272760 Ankle Arthroscopy: Indications, Patterns of Admissions, Surgical Outcomes, and Associated Complications Among Saudi Patients at King Abdul-Aziz Medical City in Riyadh
Authors: Mohammad Abdullah Almalki
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Background: Despite the frequent usage of ankle arthroscopy, there is limited medical literature regarding its indications, patterns of admissions, surgical outcomes, and associated complicated at Saudi Arabia. Hence, this study would highlight the surgical outcomes of such surgical approach that will assist orthopedic surgeons to detect which surgical procedure needs to be done as well as to help them regarding their diagnostic workups. Methods: At the Orthopedic Division of King Abdul‑Aziz Medical City in Riyadh and through a cross‑sectional design and convenient sampling techniques, the present study had recruited 20 subjects who fulfill the inclusion and exclusion criteria between 2016 and 2018. Data collection was carried out by a questionnaire designed and revised by an expert panel of health professionals. Results: Twenty patients were reviewed (11M and 9F) with an average age of 40.1 ± 12.2. Only 30% of the patients (5M, 1F) have no comorbidity, but 70% of patients (7M, 8F) were having at least one comorbidity. The most common indications were osteochondritis dissecans (n = 7, 35%), ankle fracture without dislocation (n = 4, 20%), and tibiotalar impingement (n = 3, 15%). Patients recorded pain in all cases (100%). The top four symptoms after pain were instability (30%, n = 6), muscle weakness (15%, n = 3) swelling (15%, n = 3), and stiffness (5%, n = 1). Two‑third of cases reached to their full healthy status and toe‑touch weight‑bearing was seen in two patients (10%). Conclusion: Ankle arthroscopy improved the rehabilitation rates in our tertiary care center. In addition, the surgical outcomes are favorable in our hospital since it has a very short length of stay, unexpended surgery, and fewest physiotherapy sessions.Keywords: ankle, arthroscopy, indications, patterns
Procedia PDF Downloads 822759 Physical, Morphological, and Rheological Properties of Polypropylene Modified Bitumen
Authors: Nioushasadat Haji Seyed Javadi, Ailar Hajimohammadi, Nasser Khalili
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The common method to improve the performance of asphalt binders is through modification. The utilization of recycled plastics for asphalt modification has been the subject of research studies due to their environmental and economic benefits over using commercial polymers. Polypropylene (PP) is one of the most available recycled plastics in Australia. Unlike other plastics, its contamination with other plastics during the recycling process is negligible. Therefore, the quality of recycled plastic is high, which makes it a good candidate for road construction applications. To assess its effectiveness for bitumen modification, three different grades of PP were selected. The PP grades were compared for blendability with bitumen, and the best suitable grade was chosen for further studies. The PP-modified bitumen and the base bitumen were then compared through physical and rheological properties. The stability of the PP-modified bitumen at elevated temperatures was measured, and the morphology of the samples before and after the storage stability was characterized by fluorescent microscopy. The results showed that PP had a significant influence on reducing the penetration and increasing the viscosity and the rutting resistance of the virgin bitumen. Storage stability test results indicated that the difference between the softening point of the top and bottom section of the tube sample is below the defined limit, which means the PP-modified bitumen is storage stable. However, the fluorescence microscopy results showed that the distribution of the PP particles in the bitumen matrix in the top and bottom sections of the tube are significantly different, which is an indicator of poor storage stability.Keywords: polypropylene, waste plastic, bitumen, road pavements, storage stability, fluorescent microscopy, morphology
Procedia PDF Downloads 712758 Review of Comparison of Subgrade Soil Stabilised with Natural, Synthetic, and Waste Fibers
Authors: Jacqueline Michella Anak Nathen
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Subgrade soil is an essential component in the design of road structures as it provides lateral support to the pavement. One of the main reasons for the failure of the pavement is the settlement of the subgrade and the high susceptibility to moisture, which leads to a loss of strength of the subgrade. Construction over weak or soft subgrade affects the performance of the pavement and causes instability of the pavement. If the mechanical properties of the subgrade soils are lower than those required, the soil stabilisation method can be an option to improve the soil properties of the weak subgrade. Soil stabilisation is one of the most popular techniques for improving poor subgrade soils, resulting in a significant improvement in the subgrade soil’s tensile strength, shear strength, and bearing capacity. Soil stabilisation encompasses the various methods used to alter the properties of soil to improve its engineering properties. Soil stabilisation can be broadly divided into four types: thermal, electrical, mechanical, and chemical. The most common method of improving the physical and mechanical properties of soils is stabilisation using binders such as cement and lime. However, soil stabilisation with conventional methods using cement and lime has become uneconomical in recent years, so there is a need to look for an alternative, such as fiber. Although not a new technique, adding fiber is a very practical alternative to soil stabilisation. Various types of fibers, such as natural, synthetic, and waste fibers, have been used as stabilising agents to improve the strength and durability of subgrade soils. This review provides a comprehensive comparison of the effectiveness of natural, synthetic, and waste fibers in stabilising subgrade soils.Keywords: subgrade, soil stabilisation, pavement, fiber, stabiliser
Procedia PDF Downloads 882757 Conflicts and Similarities among Energy Law, Environmental Law and Economic Aspects
Authors: Bahareh Arghand, Seyed Abbas Poorhashemi, Ramin Roshandel
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Nowadays, Economic growth and the increasing use of fossil fuel have caused major damages to environment. Therefore, international law has tried to codify the rules and regulations and identify legal principles to decrease conflict of interests between energy law and environmental law. The open relationship between energy consumption and the law of nature has been ignored for years, because the focus of energy law has been on an affordable price of a reliable supply of energy; while the focus of environmental law was on protection of the nature. In fact, the legal and overall policies of energy are based on Sic Omnes and inter part for governments whereas environmental law is based on common interests and Erga Omnes. The relationship between energy law, environmental law and economic aspects is multilateral, complex and important. Moreover, they influence each other. There are similarities in the triangle of energy, environment and economic aspects and in some cases there are conflict of interest but their conflicts are in goals not in practice and their legal jurisdiction is in international law. The development of national and international rules and regulations relevant to energy-environment has been done by separate sectors, whereas sustainable development principle, especially in the economic sector, requires environmental considerations. It is an important turning point to integrate and decrease conflict of interest among energy law, environmental law and economic aspects. The present study examines existing legal principles on energy and the environment and identifies the similarities and conflicts based on the descriptive-analytic study. The purpose of investigating these legal principles is to integrate and decrease conflict of interest between energy law and environmental law.Keywords: energy law, environmental law, erga omnes, sustainable development
Procedia PDF Downloads 3732756 Mass Media and Electoral Conflict Management in Kogi State, Nigeria
Authors: Okpanachi Linus Odiji, Chris Ogwu Attah
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Election is no doubt widely assumed as one of the most suitable means of resolving political quagmires even though it has never been bereft of conflict which can manifest before, during, or after polls. What, however, advances democracy and promotes electoral integrity is the existence and effectiveness of institutional frameworks for electoral conflict management. Electoral conflicts are no doubt unique in the sense that they represent the struggles of people over the control of public resources. In most cases, the stakes involved are high and emotional that they do not only undermine inter-group relationship but also threaten national security. The need, therefore, for an effectively functional conflict management apparatus becomes imperative. While at the State level, there exist numerous governmental initiatives at various electoral stages aimed at managing conflicts, this paper examines the activities of the mass media, which is another prominent stakeholder in the electoral process. Even though media influence has increased tremendously in the last decade, researchers are yet to agree on its utility in the management of conflicts. Guided by the social responsibility theory of media reporting and drawing data from observed trends in Kogi state, the paper, which context analyses the 2019 gubernatorial election coverage in the state, observes both conflict escalation and de-escalation roles in the media. To mitigate conflict reporting misrepresentation, therefore, a common approach to conflict reporting should be designed and ordered by the National Broadcasting Commission as well as the Nigerian Press Council. This should be garnished with the training of journalists on conflict reporting and development of a standard conflict reporting procedure.Keywords: conflict management, electoral conflict, mass media, media reporting
Procedia PDF Downloads 140