Search results for: service period

Authors: Indu Bhushan Sharma, Rashmi Saraswat

Abstract:

The thermotolerant, solvent stable and alkalophilic lipase producing bacterial strain was isolated from the water sample of the foothills of Trikuta Mountain in Kakryal (Reasi district) in Jammu and Kashmir, India. The lipase-producing microorganisms were screened using tributyrin agar plates. The selected microbe was optimized for maximum lipase production by subjecting to various carbon and nitrogen sources, incubation period and inoculum size. The selected strain was identified as Bacillus subtilis strain kakrayal_1 (BSK_1) using 16S rRNA sequence analysis. Effect of pH, temperature, metal ions, detergents and organic solvents were studied on lipase activity. Lipase was found to be stable over a pH range of 6.0 to 9.0 and exhibited maximum activity at pH 8. Lipolytic activity was highest at 37°C and the enzyme activity remained at 60°C for 24hrs, hence, established as thermo-tolerant. Production of lipase was significantly induced by vegetable oil and the best nitrogen source was found to be peptone. The isolated Bacillus lipase was stimulated by pre-treatment with Mn2+, Ca2+, K+, Zn2+, and Fe2+. Lipase was stable in detergents such as triton X 100, tween 20 and Tween 80. The 100% ethyl acetate enhanced lipase activity whereas, lipase activity were found to be stable in Hexane. The optimization resulted in 4 fold increase in lipase production. Bacillus lipases are ‘generally recognized as safe’ (GRAS) and are industrially interesting. The inducible alkaline, thermo-tolerant lipase exhibited the ability to be stable in detergents and organic solvents. This could be further researched as a potential biocatalyst for industrial applications such as biotransformation, detergent formulation, bioremediation and organic synthesis.

Keywords: bacillus, lipase, thermotolerant, alkalophilic

Procedia PDF Downloads 242

Authors: Shveta Puri, Shiv Jyoti Pandey, G. M. Bhat, Neha Raina

Abstract:

TheJammu and Kashmir region of the Northwest Himalaya had witnessed many devastating earthquakes in the recent past and has remained unexplored for any kind of seismic investigations except scanty records of the earthquakes that occurred in this region in the past. In this study, we have used local seismic data of year 2013 that was recorded by the network of Broadband Seismographs in J&K. During this period, our seismic stations recorded about 207 earthquakes including two moderate events of Mw 5.7 on 1st May, 2013 and Mw 5.1 of 2nd August, 2013.We analyzed the events of Mw 3-4.6 and the main events only (for minimizing the error) for source parameters, b value and sense of movement through waveform modeling for understanding seismotectonic and seismic hazard of the region. It has been observed that most of the events are bounded between 32.9° N – 33.3° N latitude and 75.4° E – 76.1° E longitudes, Moment Magnitude (Mw) ranges from Mw 3 to 5.7, Source radius (r), from 0.21 to 3.5 km, stress drop, from 1.90 bars to 71.1 bars and Corner frequency, from 0.39 – 6.06 Hz. The b-value for this region was found to be 0.83±0 from these events which are lower than the normal value (b=1), indicating the area is under high stress. The travel time inversion and waveform inversion method suggest focal depth up to 10 km probably above the detachment depth of the Himalayan region. Moment tensor solution of the (Mw 5.1, 02:32:47 UTC) main event of 2ndAugust suggested that the source fault is striking at 295° with dip of 33° and rake value of 85°. It was found that these events form intense clustering of small to moderate events within a narrow zone between Panjal Thrust and Kishtwar Window. Moment tensor solution of the main events and their aftershocks indicating thrust type of movement is occurring in this region.

Keywords: b-value, moment tensor, seismotectonics, source parameters

Procedia PDF Downloads 305

Authors: Ndukwe, Chinedu O.

Abstract:

Background: There are only a few epidemiological studies published on skin disorders in the elderly within the Nigerian context and none from the Southeast Region of the country. In addition, none of these studies has considered the pattern and frequency of histopathologically diagnosed geriatric skin lesions. Hence, we attempted to determine the frequency as well as the age and gender distributions of histologically diagnosed dermatological diseases in the geriatric population from skin biopsies submitted to the histopathology department of a tertiary care hospital in Southeast Nigeria. Material and methods: This is a cross-sectional retrospective hospital-based study involving all skin biopsies of patients 60 years and above, received at the Department of Histopathology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria from January 2004 to December 2019. Results: During the study period, 751 skin biopsies were received in the histopathology department. Of these, 142 were from patients who were older than 60 years. Thus, the overall share of geriatric patients was 18.9%. The mean age at presentation was 71.1 ± 8.6 years. The M: F was 1:1 and most of the patients belonged to the age group of 60–69 years (69 cases, 48.6%). The mean age of the male patients was 72.1±9.5 years. In the female patients, it was 70.1±7.5 years. The commonest disease category was neoplasms (91, 64.1%). Most neoplasms were malignant. There were 67/142 (47.2%) malignant lesions. Commonest was Squamous cell carcinoma (SCC) (30 cases) which is 21.1% of all geriatric skin biopsies and 44.8% of malignant skin biopsies. This is closely followed by melanoma (29 cases). Conclusion: Malignant neoplasms, benign neoplasms and papulosquamous disorders are the three commonest histologically diagnosed skin lesions in our geriatric population. The commonest skin malignancies in this group of patients are squamous cell carcinoma and malignant melanoma.

Keywords: geriatric, skin, Nigeria, histopathology

Procedia PDF Downloads 156

Authors: Ibrahim Mamat, Wan Mohd Zaifurin Wan Nawang

Abstract:

Malaysia's poverty eradication program is a long-term plan that was initially implemented by the government after the riots of the races on May 13, 1969. The incident broke out due to the huge economic gap between the majority of Malaysians,Malays and non-Malays minorities. As a result of the event, the government drafted the New Economic Policy(NEP) in 1970 to reduce the differences in economic status among races in Malaysia. At the end of this policy period (NEP) in 1990, the incidence of poverty in Malaysia was around 6.5 per cent. The incidence of poverty in Malaysia continued to decline to 0.6 per cent (2014) through some other policy after the NEP. The decline in poverty has been the result of the government's efforts to implement the New Economic Policy (1970-1990), National Development Policy (1991-2000), NationalVision Policy (2001-2010), and National Transformation Policy (2011-2020).This article also explains the meaning, concepts and measurements of poverty in order to identify the Poverty Level and measure the Poverty Index using various dimensions. This explanation is very important for a country like Malaysia who has some people living below the poverty line. In such a context, an effective poverty eradication policy can benefit the poor.Consequently, this article examines the continuing involvement of the government and non-governmental organizations through the empowerment program of the hardcore poor to change their lifestyle and culture as well as the vicious circle of poverty is indispensable to ensure that poverty eradication programs are in line with current economic and social changes. In addition, the involvement of non-governmental organizations and the State Islamic Religious Council to provide assistance to the poor is appropriate as the institution has its own distinctive interpretation of poverty to determine the type of assistance, criteria and so on to enable the rights of the poor to be ensured and protected.

Keywords: economic policy, poor, poverty eradication, poverty program

Procedia PDF Downloads 216

Authors: Himanshi Rathore, Shalinee Prasad, Satyawati Sharma, Ajay Singh Yadav

Abstract:

Medicinal mushrooms are acceptable all over the world not only because they have a unique flavour and texture but also due to the presence of great nutritional, nutraceutical and functional properties. High content of physiologically active substances like ergosterol, vitamin D, phenolic compounds, triterpenoids and steroids make these medicinal mushrooms a key source of nutraceuticals. Calocybe indica is a popular medicinal mushroom of India which is known to possess high amount of secondary metabolites including ergosterol (vitamin D2). The ergosterol gets converted to vitamin D in the presence of UV rays by a photochemical reaction. In lieu of the above facts the present study was undertaken to investigate the effect of UV-B light treatment on the vitamin D2 concentration, phenolic content and non volatile compounds in Calocybe indica. For this study, UV-B light source of intensity 5.3w/m2 was used to expose mushrooms for the time period of 0min, 30min, 60min and 90 min. It was found that the vitamin D2 concentration increased with the time duration i.e. 85±0.15 (0 min), 182±1.6 (30 min), 187±0.4 (60 min) and 182 ±0.8 (90 min) μg/g (dry weight). Highest concentration of vitamin D2 was found at 60 min duration. No discoloration in sliced mushrooms was observed during the exposure time. The results revealed that the exposure of mushrooms for a minimum of 30 min duration under UVB source can be a novel, convenient and cheapest way to increase the vitamin D content in mushrooms. This can be one of richest source to fulfil the recommended dietary allowances of vitamin D in our daily diets. The paper provides information on the enhancement of vitamin D content by UV lights and its effects on the non volatile (soluble sugars, free amino acids, 5′-nucleotides and phenolics) compounds will also be presented.

Keywords: Calocybe indica, ergosterol, nutraceutical, phenolics

Procedia PDF Downloads 460

Authors: Romeo Botes, Imelda Smit

Abstract:

In today’s modern age of technology vast amounts of data needs to be processed in real-time to keep users satisfied. This data comes from various sources and in many formats, including electronic and mobile devices such as GPRS modems and GPS devices. They make use of different protocols including TCP, UDP, and HTTP/s for data communication to web servers and eventually to users. The data obtained from these devices may provide valuable information to users, but are mostly in an unreadable format which needs to be processed to provide information and business intelligence. This data is not always current, it is mostly historical data. The data is not subject to implementation of consistency and redundancy measures as most other data usually is. Most important to the users is that the data are to be pre-processed in a readable format when it is entered into the database. To accomplish this, programmers build processing programs and scripts to decode and process the information stored in databases. Programmers make use of various techniques in such programs to accomplish this, but sometimes neglect the effect some of these techniques may have on database performance. One of the techniques generally used,is to pull data from the database server, process it and push it back to the database server in one single step. Since the processing of the data usually takes some time, it keeps the database busy and locked for the period of time that the processing takes place. Because of this, it decreases the overall performance of the database server and therefore the system’s performance. This paper follows on a paper discussing the performance increase that may be achieved by utilizing array lists along with a pull-process-push data processing technique split in three steps. The purpose of this paper is to expand the number of clients when comparing the two techniques to establish the impact it may have on performance of the CPU storage and processing time.

Keywords: performance measures, algorithm techniques, data processing, push data, process data, array list

Procedia PDF Downloads 232

Authors: L. Petrosyan

Abstract:

The problem of psychologist training remains a key priority in Armenia. During the Soviet period, the notion of a psychologist was obscure not only in Armenia but also in other Soviet republics. The breakup of the Soviet Union triggered a gradual change in this area activating the cooperation with specialists from other countries. The need for recovery from the psychological trauma caused by the 1988 earthquake pushed forward the development of practical psychology in Armenia. This phenomenon led to positive changes in perception of and interest to a psychologist profession.Armenian universities started designing special programs for psychologists’ preparation. Armenian psychologists combined their efforts in the field of training relevant specialists. During the recent years, the Bologna educational system was introduced in Armenia which led to implementation of education quality improvement programs. Nevertheless, even today the issue of psychologists’ training is not yet settled in Armenian universities. So far graduate psychologists haven’t got a clear idea of personal and professional qualities of a psychologist. Recently, as a result of educational reforms, the psychology curricula underwent changes, but so far they have not led to a desired outcome. Almost all curricula in certain specialties are aimed to form professional competencies and strengthen practical skills. A survey conducted in Armenia aimed to identify what are the ideas of young psychology specialists on the image of a psychologist. The survey respondents were 45 specialists holding bachelor’s degree as well as 30 master degree graduates, who have not been working yet. The research reveals that we need to change the approach of preparing psychology practitioners in the universities of Armenia. Such an approach to psychologist training will make it possible to train qualified specialists for enhancement of modern psychology theory and practice.

Keywords: practitioners, psychology degree, study, professional competencies

Procedia PDF Downloads 441

Authors: Ghadeer A.Al-Jabaree, Husam Aldeen Al-Khadash, M. Nassar

Abstract:

This study aimed at investigating the effect of well-designed corporate governance system on the financial stability of insurance companies listed in ASE. Further, this study provides a comprehensive model for evaluating and analyzing insurance companies' financial position and prospective for comparing the degree of corporate governance application provisions among Jordanian insurance companies. In order to achieve the goals of the study, a whole population that consist of (27) listed insurance companies was introduced through the variables of (board of director, audit committee, internal and external auditor, board and management ownership and block holder's identities). Statistical methods were used with alternative techniques by (SPSS); where descriptive statistical techniques such as means, standard deviations were used to describe the variables, while (F) test and ANOVA analysis of variance were used to test the hypotheses of the study. The study revealed the existence of significant effect of corporate governance variables except local companies that are not listed in ASE on financial stability within control variables especially debt ratio (leverage),where it's also showed that concentration in motor third party doesn't have significant effect on insurance companies' financial stability during study period. Moreover, the study concludes that Global financial crisis affect the investment side of insurance companies with insignificant effect on the technical side. Finally, some recommendations were presented such as enhancing the laws and regulation that help the appropriate application of corporate governance, and work on activating the transparency in the disclosures of the financial statements and focusing on supporting the technical provisions for the companies, rather than focusing only on profit side.

Keywords: corporate governance, financial stability and solvency margin, insurance companies, Jordan

Procedia PDF Downloads 482

Authors: Azusa Katsumata

Abstract:

Several universities in Japan have introduced activities aimed at the mutual enlightenment of a diversity of people in career education. However, several programs emphasize on delivering results, and on practicing the prepared materials as planned. Few programs focus on unexpected failures and setbacks. This way of learning is important in career education so that classmates can help each other, overcome difficulties, draw out each other’s strengths, and learn from them. Seijo University in Tokyo offered excursion focusing Various Problems of Society, as second year career education course, Students will learn about contraception, infertility, homeless people, LGBT, and they will discuss based on the excursion. This paper aims to study the ‘learning platform’ created by a series of processes such as the excursion, the discussion, and the presentation. In this course, students looked back on their lives and imagined the future in concrete terms, performing tasks in groups. The students came across a range of values through lectures and conversations, thereby developing feelings of self-efficacy. We conducted a questionnaire to measure the development of career in class. From the results of the questionnaire, we can see, in the example of this class, that students respected diversity and understood the importance of uncertainty and discontinuity. Whereas the students developed career awareness, they actually did not come across that scene and would do so only in the future when it became necessary. In this class, students consciously considered social problems, but did not develop the practical skills necessary to deal with these. This is appropriate for one of project, but we need to consider how this can be incorporated into future courses. University constitutes only a single period in life-long career formation. Thus, further research may be indicated to determine whether the positive effects of career education at university continue to contribute to individual careers going forward.

Keywords: career education of university, excursion, learning platform, problems of society

Procedia PDF Downloads 253

Authors: Kelly F. Delgado-De Agrela, Sonia E. Ruiz, Marco A. Santos-Santiago

Abstract:

An approach is proposed for the design of regular buildings equipped with non-linear viscous dissipating devices. The approach is based on a direct-displacement seismic design method which satisfies seismic performance objectives. The global system involved is formed by structural regular moment frames capable of supporting gravity and lateral loads with elastic response behavior plus a set of non-linear viscous dissipating devices which reduce the structural seismic response. The dampers are characterized by two design parameters: (1) a positive real exponent α which represents the non-linearity of the damper, and (2) the damping coefficient C of the device, whose constitutive force-velocity law is given by F=Cvᵃ, where v is the velocity between the ends of the damper. The procedure is carried out using a substitute structure. Two limits states are verified: serviceability and near collapse. The reduction of the spectral ordinates by the additional damping assumed in the design process and introduced to the structure by the viscous non-linear dampers is performed according to a damping reduction factor. For the design of the non-linear damper system, the real velocity is considered instead of the pseudo-velocity. The proposed design methodology is applied to an 8-story steel moment frame building equipped with non-linear viscous dampers, located in intermediate soil zone of Mexico City, with a dominant period Tₛ = 1s. In order to validate the approach, nonlinear static analyses and nonlinear time history analyses are performed.

Keywords: based design, direct-displacement based design, non-linear viscous dampers, performance design

Procedia PDF Downloads 185

Authors: Laurence G. Almoguera, Vitaliana U. Malamug, Armando N. Espino, Marvin M. Cinense

Abstract:

The mangrove pens were modified to produce mud crab (Scylla serrata) and milkfish (Chanos chanos) in a polyculture system. The modification of mangrove pens was done by adding excavations inside the pen. The water quality parameters (dissolved oxygen, pH, salinity, and temperature) were monitored, the recovery and the production rate in each pen were evaluated. The experiment was conducted for a rearing period of 143 days in nine mangrove pens, each having an area of 32 m² with an average net enclosure height of 3 m from the soil surface. The three different pens constructed (existing design - with canal only, with 43% excavation by area, and 54% excavation by area) were designated as T₁, T₂, and T₃, respectively. All experimental units were stocked with 31 pieces of crablets (with 33.3 g average weight) and additional 130 pieces of milkfish fingerlings (with 0.11 g average weight) to the modified mangrove pens. The water quality parameters recorded in the pens were favorable for the growth and recovery of the mud crab and milkfish, except for dissolved oxygen (DO). It was found to be the reason for the total mortality of the stocked milkfish. For mud crab, the highest mean recovery was recorded in T₂ (34.41%), followed by T₃ (26.91%) and the lowest in T1 (21.50%). The production rate followed the same trend as the recovery, where T₂ (74.49 g/m²) obtained the highest, followed by T₃ (55 g/m2) and the lowest was in T₁ (34.87 g/m²). The statistical analysis revealed that the variations of the mud crab recovery were not significant, while in terms of production rate, modified mangrove pens were found to be more effective than the existing design. Due to the total mortality of the cultured milkfish, the current set-up of modified mangrove pens was found to be not suitable for the polyculture system of milkfish and mud crab production.

Keywords: aquasilviculture, milkfish, modified mangrove pen, mud crab, polyculture, production rate

Procedia PDF Downloads 182

Authors: Alpana Meena

Abstract:

Background: Tuberculosis is one of the major causes of death in south-east nations. Anti-TB–induced hepatotoxicity (AIH) is associated with a mortality of 6%–12%. The risk is increased when the drugs are combined. Reintroduction of anti-tuberculosis drugs in patients with AIH has never been studied systematically. The present study was planned to see the clinical profile of patients of AIH and the response to reintroduction of therapy. Methods: The trial was conducted in the Department of Medicine, Maulana Azad Medical College and associated Lok Nayak Hospital, on 32 patients with extra-pulmonary tuberculosis who developed AIH. Patients were randomly allocated into 3 groups. In group 1- Isoniazid (INH) and Rifampicin (RIF) were given at full dosages (weight calculated) from day 1. In group 2- RIF was given at maximum dosage from day 1 and INH at maximum dosage from day 8. In group 3- INH was given at maximum dosage from day 1 and RIF at maximum dosage from day 8. Pyrazinamide was added when above regimens were tolerated. Results: The mean age of presentation was 29.37±13.497 years. The incidence was found to be highest in patients with tubercular meningitis (41%) followed by abdominal, pericardial, disseminated, spinal, and lymph nodes. The mean latent period for development of AIH was 7.84 days ± 6.149 days and the median normalization days for LFT’s was 8.81 ± 4.22 days (3-21). In the study, 21% patients had recurrence of AIH with majority of patients having tolerated the reintroduction of drugs. Pyrazinamide was introduced after establishing isoniazid and rifampicin safety, thus emphasizing the role of gradual reintroduction of ATT to avoid the combined effects of hepatotoxicity. Conclusion: To conclude, the recurrence rate of hepatotoxicity was not statistically significant between the three groups studied (p > 0.05), and thus all 3 hepatotoxic drugs can be reintroduced safely in patients developing AIH.

Keywords: anti-tubercular therapy induced hepatotoxicity, extra-pulmonary tuberculosis, reintroduction regimens, risk factors

Procedia PDF Downloads 287

Authors: Umberto Di Staso, Marco Soave, Alessio Giori, Federico Prandi, Raffaele De Amicis

Abstract:

The increasing availability of information about earth surface elevation (Digital Elevation Models DEM) generated from different sources (remote sensing, Aerial Images, Lidar) poses the question about how to integrate and make available to the most than possible audience this huge amount of data. In order to exploit the potential of 3D elevation representation the quality of data management plays a fundamental role. Due to the high acquisition costs and the huge amount of generated data, highresolution terrain surveys tend to be small or medium sized and available on limited portion of earth. Here comes the need to merge large-scale height maps that typically are made available for free at worldwide level, with very specific high resolute datasets. One the other hand, the third dimension increases the user experience and the data representation quality, unlocking new possibilities in data analysis for civil protection, real estate, urban planning, environment monitoring, etc. The open-source 3D virtual globes, which are trending topics in Geovisual Analytics, aim at improving the visualization of geographical data provided by standard web services or with proprietary formats. Typically, 3D Virtual globes like do not offer an open-source tool that allows the generation of a terrain elevation data structure starting from heterogeneous-resolution terrain datasets. This paper describes a technological solution aimed to set up a so-called “Terrain Builder”. This tool is able to merge heterogeneous-resolution datasets, and to provide a multi-resolution worldwide terrain services fully compatible with CesiumJS and therefore accessible via web using traditional browser without any additional plug-in.

Keywords: Terrain Builder, WebGL, Virtual Globe, CesiumJS, Tiled Map Service, TMS, Height-Map, Regular Grid, Geovisual Analytics, DTM

Procedia PDF Downloads 413

Authors: Aferdita Stroka Koka, Laver Stroka, Juna Musa, Samanda Celaj

Abstract:

Non-melanoma skin cancers (NMSCs) are the most common human malignancies. About 5.4 million basal and squamous cell skin cancers are diagnosed each year in the US and new cases continue to grow. About eight out of ten of these are basal cell cancers. Squamous cell cancers occur less often. NMSC usually are treatable, but treatment is expensive and can leave scars. In 2019, 167 patients of both sexes suffering from NMSC were treated by traditional medicine. Patients who have been diagnosed with Basal Cell Carcinoma were 122 cases, Squamous Cell Carcinoma 32 cases and both of them 13 cases. Of these,122 cases were ulcerated lesions and 45 unulcerated lesions. All patients were treated with the herbal solution called NILS, which contains extracts of some Albanian plants such as Allium sativum, Jugulans regia and Laurus nobilis. The treatment is done locally, on the surface of the tumor, applying the solution until the tumor mass is destroyed and, after that, giving the necessary time to the wound to make the regeneration that coincides with the complete healing of the wound. We have prepared a collection of photos for each case. Since the first sessions, a shrinkage and reduction of the tumor mass were evident, up to the total disappearance of the lesion at the end of treatment. The normal period of treatment lasted 1 to 2 weeks, depending on the size of the tumor, then take care of it until the closure of the wound, taking the whole process from 1 to 3 months. In 7 patients, the lesion failed to be dominated by treatment and they underwent standard treatment with radiotherapy or surgery, while in 10 patients, the lesion recurred and was treated again. The aim of this survey was to put in evidence the good results obtained by treatment of NMSC with Albanian traditional medicine methods.

Keywords: local treatment, nils, NMSC, traditional medicine

Procedia PDF Downloads 200

Authors: Kimiyo Shimomai, Mihoko Harada

Abstract:

This study is a literature review of the psychological reactions that occur in end-of-life cancer patients who are nearing death. It searched electronic databases and selected literature related to psychological studies of end-of-life patients. There was no limit on the search period, and the search was conducted until the second week of December 2021. The keywords were specified as “death and dying”, “terminal illness”, “end-of-life”, “palliative care”, “psycho-oncology” and “research”. These literatures referred to Holly (2017): Comprehensive Systematic Review for Advanced Practice Nursing, P268 Figure 10.3 to ensure quality. These literatures were selected with a dissertation score of 4 or 5. The review was conducted in two stages with reference to the procedure of George (2002). First, these references were searched for keywords in the database, and then relevant references were selected from the psychology and nursing studies of end-of-life patients. The number of literatures analyzed was 76 for overseas and 17 for domestic. As for the independent variables, "physical variable" was the most common in 36 literatures (66.7%), followed by "psychological variable" in 35 literatures (64.8%), "spiritual variable" in 21 literatures (38%), and "social variable" in 17 literatures. (31.5%), "Variables related to medical care / treatment" were 16 literatures (29.6%). To summarize the relationship between these independent variables and the dependent variable, when the dependent variable is "psychological variable", the independent variables are "psychological variable", "social variable", and "physical variable". Among the independent variables, the physical variables were the most common. The psychological responses that occur in end-stage cancer patients who are nearing death are mutually influenced by psychological, social, and physical variables. Therefore, it supported the "total pain" advocated by Cicely Saunders.

Keywords: cancer patient, end-of-life, literature review, psychological process

Procedia PDF Downloads 118

Authors: Paula García-Llamas, Polonia Díez González, Angela Taboada

Abstract:

In an era marked by unprecedented anthropogenic alterations to landscapes and biodiversity, the consequential loss of fauna, flora, and habitats poses a grave concern. It is imperative to evaluate our capacity to manage and mitigate such changes effectively. This study aims to scrutinize the efficacy of the Natura 2000 Network (NN2000) in landscape conservation within the autonomous community of Castile and Leon (Spain), spanning from 1990 to 2018. Leveraging land use change maps from the European Corine Land Cover database across four subperiods (1990-2000, 2000-2006, 2006-2012, and 2012-2018), we quantified alterations occurring both within NN2000 protected sites and within a 5km buffer zone. Additionally, we spatially assess land use/land cover patterns of change considering fluxes of various habitat types defined within NN2000. Our findings reveal that the protected areas under NN2000 were particularly susceptible to change, with the most significant transformations observed during the 1990-2000 period. Predominant change processes include secondary succession and scrubland formation due to land use cessation, deforestation, and agricultural intensification. While NN2000 demonstrates efficacy in curtailing urbanization and industrialization within buffer zones, its management measures have proven insufficient in safeguarding landscapes against the dynamic changes witnessed between 1990 and 2018, especially in relation to rural abandonment.

Keywords: Corine land cover, land cover changes, site of community importance, special protection area

Procedia PDF Downloads 38

Authors: Peiyin Hung, Katy Kozhimannil, Michelle Casey, Ira Moscovice

Abstract:

Background/Objective: The loss of obstetric services has been a pressing concern in urban and rural areas nationwide. This study aims to determine factors that contribute to the loss of obstetric care through closures of a hospital or obstetric unit. Methods: Data from 2002-2013 American Hospital Association annual surveys were used to identify hospitals providing obstetric services. We linked these data to Medicare Healthcare Cost Report Information for hospital financial indicators, the US Census Bureau’s American Community Survey for zip-code level characteristics, and Area Health Resource files for county- level clinician supply measures. A discrete-time multinomial logit model was used to determine contributing factors to obstetric unit or hospital closures. Results: Of 3,551 hospitals providing obstetrics services during 2002-2013, 82% kept units open, 12% stopped providing obstetrics services, and 6% closed down completely. State-level variations existed. Factors that significantly increased hospitals’ probability of obstetric unit closures included lower than 250 annual birth volume (adjusted marginal effects [95% confidence interval]=34.1% [28%, 40%]), closer proximity to another hospital with obstetric services (per 10 miles: -1.5% [-2.4, -0.5%]), being in a county with lower family physician supply (-7.8% [-15.0%, -0.6%), being in a zip code with higher percentage of non-white females (per 10%: 10.2% [2.1%, 18.3%]), and with lower income (per $1,000 income: -0.14% [-0.28%, -0.01%]). Conclusions: Over the past 12 years, loss of obstetric services has disproportionately affected areas served by low-volume urban and rural hospitals, non-white and low-income communities, and counties with fewer family physicians, signaling a need to address maternity care access in these communities.

Keywords: access to care, obstetric care, service line discontinuation, hospital, obstetric unit closures

Procedia PDF Downloads 211

Authors: G. Venkatesha, Urs Samarth, H. K. Ramaraju, Arun Kumar Sharma

Abstract:

The projection for Groundwater states that the total domestic water demand for greater Bangalore would increase from 1,170 MLD in 2010 to 1,336 MLD in 2016. Dependence on groundwater is ever increasing due to rapid Industrialization & Urbanization. It is estimated that almost 40% of the population of Bangalore is dependent on groundwater. Due to the unscientific disposal of domestic and industrial waste generated, groundwater is getting highly polluted in the city. The scale of this impact will depend mainly upon the water-service infrastructure, the superficial geology and the regional setting. The quality of ground water is equally important as that of quantity. Jointed and fractured granites and gneisses constitute the major aquifer system of BBMP area. Two new observatory Borewells were drilled and lithology report has been prepared. Petrographic Analysis (XRD/XRF) and Water quality Analysis were carried out as per the standard methods. Petrographic samples were analysed by collecting chip of rock from the borewell for every 20ft depth, most of the samples were similar and samples were identified as Biotite-Gneiss, Schistose Amphibolite. Water quality analysis was carried out for individual chemical parameters for two borewells drilled. 1st Borewell struck water at 150ft (Total depth-200ft) & 2nd struck at 740ft (Total depth-960ft). 5 water samples were collected till end of depth in each borewell. Chemical parameter values such as, Total Hardness (360-348, 280-320) mg/ltr, Nitrate (12.24-13.5, 45-48) mg/ltr, Chloride (104-90, 70-70)mg/ltr, Fe (0.75-0.09, 1.288-0.312)mg/ltr etc. are calculated respectively. Water samples were analysed from various parts of BBMP covering 750 sq kms, also thematic maps (IDW method) of water quality is generated for these samples for Post-Monsoon season. The study aims to explore the sub-surface Lithological layers and the thickness of weathered zone, which indirectly helps to know the Groundwater pollution source near surface water bodies, dug wells, etc. The above data are interpreted for future ground water resources planning and management.

Keywords: lithology, petrographic, pollution, urbanization

Procedia PDF Downloads 282

Authors: Jessica Achebe, Susan Tighe

Abstract:

The recent Canadian infrastructure report card reveals the unhealthy state of municipal infrastructure intensified challenged faced by municipalities to maintain adequate infrastructure performance thresholds and meet user’s required service levels. For a road agency, huge funding gap issue is inflated by growing concerns of the environmental repercussion of road construction, operation and maintenance activities. As the reduction of material consumption and greenhouse gas emission when maintain and rehabilitating road networks can achieve added benefits including improved life cycle performance of pavements, reduced climate change impacts and human health effect due to less air pollution, improved productivity due to optimal allocation of resources and reduced road user cost. Incorporating environmental sustainability measure into pavement management is solution widely cited and studied. However measuring the environmental performance of road network is still a far-fetched practice in road network management, more so an ostensive agency-wide environmental sustainability or sustainable maintenance specifications is missing. To address this challenge, this present research focuses on the environmental sustainability performance of network-level pavement management. The ultimate goal is to develop a framework to incorporate environmental sustainability in pavement management systems for network-level maintenance programming. In order to achieve this goal, this study reviewed previous studies that employed environmental performance measures, as well as the suitability of environmental performance indicators for the evaluation of the sustainability of network-level pavement maintenance strategies. Through an industry practice survey, this paper provides a brief forward regarding the pavement manager motivations and barriers to making more sustainable decisions, and data needed to support the network-level environmental sustainability. The trends in network-level sustainable pavement management are also presented, existing gaps are highlighted, and ideas are proposed for sustainable network-level pavement management.

Keywords: pavement management, sustainability, network-level evaluation, environment measures

Procedia PDF Downloads 200

Authors: Ruttayaporn Ngasaman, Saowakon Indouang, Usa Chethanond

Abstract:

Leptospirosis is a public health concern zoonosis in Thailand. Human and animals are often infected by contact with contaminated water. The infected animals play an important role in leptospira infection for both human and other hosts via urine. In humans, it can cause a wide range of symptoms, some of which may present mild flu-like symptoms including fever, vomiting, and jaundice. Without treatment, Leptospirosis can lead to kidney damage, meningitis, liver failure, respiratory distress, and even death. The prevalence of leptospirosis in stray animals in Thailand is unknown. The aim of this study was to investigate leptospira infection in stray animals including dogs and cats in Songkhla province, Thailand. Total of 434 blood samples were collected from 370 stray dogs and 64 stray cats during the population control program from 2014 to 2018. Screening test using latex agglutination for the detection of antibodies against Leptospira interrogans in serum samples shows 29.26% (127/434) positive. There were 120 positive samples of stray dogs and 7 positive samples of stray cats. Detection by polymerase chain reaction specific to LipL32 gene of Leptospira interrogans showed 1.61% (7/434) positive. Stray cats (5/64) show higher prevalence than stray dogs (2/370). Although active infection was low detected, but seroprevalence was high. This result indicated that stray animals were not active infection during sample collection but they use to get infected or in a latent period of infection. They may act as a reservoir for domestic animals and human in which stay in the same environment. In order to prevent and reduce the risk of leptospira infection in a human, stray animals should be done health checking, vaccination, and disease treatment.

Keywords: leptospirosis, stray animals, risk reduction, Thailand

Procedia PDF Downloads 117

Authors: Abdalla Mansour, Dan Brown, Adel Helmy, Rikin Trivedi, Mathew Guilfoyle

Abstract:

Introduction: Diagnosing delayed cerebral ischaemia (DCI) following aneurysmal subarachnoid haemorrhage (SAH) can be challenging, particularly in poor-grade patients. Objectives: This study sought to assess the value of routine CTP in identifying (or excluding) DCI and in guiding management. Methods: Eight-year retrospective neuroimaging study at a large UK neurosurgical centre. Subjects included a random sample of adult patients with confirmed aneurysmal SAH that had a CTP scan during their inpatient stay, over a 8-year period (May 2014 - May 2022). Data collected through electronic patient record and PACS. Variables included age, WFNS scale, aneurysm site, treatment, the timing of CTP, radiologist report, and DCI management. Results: Over eight years, 916 patients were treated for aneurysmal SAH; this study focused on 466 patients that were randomly selected. Of this sample, 181 (38.84%) had one or more CTP scans following brain aneurysm treatment (Total 318). The first CTP scan in each patient was performed at 1-20 days following ictus (median 4 days). There was radiological evidence of DCI in 83, and no reversible ischaemia was found in 80. Findings were equivocal in the remaining 18. Of the 103 patients treated with clipping, 49 had DCI radiological evidence, in comparison to 31 of 69 patients treated with endovascular embolization. The remaining 9 patients are either unsecured aneurysms or non-aneurysmal SAH. Of the patients with radiological evidence of DCI, 65 had a treatment change following the CTP directed at improving cerebral perfusion. In contrast, treatment was not changed for (61) patients without radiological evidence of DCI. Conclusion: CTP is a useful adjunct to clinical assessment in the diagnosis of DCI and is helpful in identifying patients that may benefit from intensive therapy and those in whom it is unlikely to be effective.

Keywords: SAH, vasospasm, aneurysm, delayed cerebral ischemia

Procedia PDF Downloads 59

Authors: Ellen Lagast, Melissa Ceuterick, Mark Leys

Abstract:

Although adolescence is a stressful period with an increased risk for mental illnesses such as anxiety and depression, little in-depth knowledge is available on the determinants of the use of psychotropic drugs (BZD/SSRIs) and the effects. A qualitative research with adolescents in Flanders was performed. Based on indepth interviews, the interviewees indicate feelings of ambiguity towards their medication use because on the one hand the medication helps to manage their mental vulnerability and disrupted lives, but on the other hand they experience a loss of control of their self and their environment. Undesired side-effects and stigma led to a negative pharmaceutical self. The interviewed youngsters also express dissatisfaction about the prescription behavior with regard to psychotropic drugs of their general practitioner (GP). They wished to have received more information about alternative non-pharmaceutical treatment options. Notwithstanding these comments, the majority of the interviewees maintained trust in their GP to act in their best interest. This paper will relate the prescription behavior in primary care to the organization of mental health care to better understand the “phamaceuticalization” and medicalization of mental health problems in Belgium. Belgium implemented fundamental mental health care reforms to collaborate, to integrate care and to optimize continuity of care. Children and adolescents still are confronted with long waiting lists to access (non-medicalized) mental health services. This access to mental health care partly explains general practitioners’ prescription behavior of psychotropics. Moreover, multidisciplinary practices have not pervaded primary health care yet. Medicalization and pharmaceuticalization of mental health vulnerabilities of youth are both a structural and cultural problem.

Keywords: adolescents, antidepressants, benzodiazepines, mental health system, psychotropic drugs

Procedia PDF Downloads 94

Authors: Hassam Hassan Elborombaly

Abstract:

The pollution generated from transportation modes, congestion and traffic heritage has led to the deterioration of historic buildings and the urban heritage in historic cities. Accordingly, this paper attempts to diagnose the transport and traffic problems in historic cities. In general and in Heritage Cities, and to investigate methods for conserving the urban heritage from negative effects of traffic congestion and of the traditional red modes of transportation. It also attempts to explore possible areas for intervention to mitigate transportation and traffic problems in the light of the principles of the sustainable transportation framework. It aims to draw conclusion and propose recommendation that would increase the efficiency and effectiveness of transportation plans in historic Cairo and consequently achieve sustainable transportation. Problems In historic cities public paths compose an irregular network enclosing large residential plots (defined as super blocks quarters or hettas). The blocks represent the basic morphology units in historic Cities. Each super block incorporates several uses (i.e. residential, non-residential, service uses and others). Local paths reach the interior of the super blocks in an organized inter core, which deals mainly with residential functions mixed with handicraft activities and is composed of several local path units; (b) the other core, which is bound by the public paths and contains a combination of residential, commercial and social activities. Objectives: 1- To provide amenity convenience and comfort for visitors and people who live and work in the area. Pedestrianizing, accessibility and safety are to be reinforced while respecting the organic urban pattern. 2- To enhance street life, vitality and activity, in order to attract people and increase economic prosperity. Research Contents • Relation between residential areas and transportation in the inner core • Analytical studies for historic areas in heritage cities • Sustainable transportation planning in heritage cities • Dynamic and flexible methodology for achieving sustainable transportation network for the Heritage Cities • Result and Recommendation

Keywords: irregular network, public paths, sustainable transportation, urban heritage

Procedia PDF Downloads 516

Authors: Laila Seada, Ashraf Ibrahim, Amjad Al Shammari

Abstract:

Background and Objectives: Breast carcinoma is the most common cancer of females in Hail region, accounting for 31% of all diagnosed cancer cases followed by thyroid carcinoma (25%) and colorectal carcinoma (13%). Methods: In the present retrospective study, all cases of breast lesions received at the histopathology department in King Khalid Hospital, Hail, during the period from May 2011 to April 2016 have been retrieved from department files. For all cases, a trucut biopsy, lumpectomy, or modified radical mastectomy was available for histopathologic diagnosis, while 105/140 (75%) had, as well, preoperative fine needle aspirates (FNA). Results: 49 cases out of 140 (35%) breast lesions were carcinomas: 44/49 (89.75%) was invasive ductal, 2/49(4.1%) invasive lobular carcinomas, 1/49(2.05%) intracystic low grade papillary carcinoma and 2/49 (4.1%) ductal carcinoma in situ (DCIS). Mean age for malignant cases was 45.06 (+/-10.58): 32.6% were below the age of 40 and 30.6 below 50 years, 18.3% below 60 and 16.3% below 70 years. For the benign group, mean age was 32.52 (+/10.5) years. Benign lesions were in order of frequency: 34 fibroadenomas, 14 fibrocystic disease, 12 chronic mastitis, five granulomatous mastitis, three intraductal papillomas, and three benign phyllodes tumor. Tubular adenoma, lipoma, skin nevus, pilomatrixoma, and breast reduction specimens constituted the remaining specimens. Conclusion: Breast lesions are common in our series and invasive carcinoma accounts for more than 1/3^rd of the lumps, with 63.2% incidence in pre-menopausal ladies, below the age of 50 years. FNA as a non-invasive procedure, proved to be an effective tool in diagnosing both benign and malignant/suspicious breast lumps and should continue to be used as a first assessment line of palpable breast masses.

Keywords: age incidence, breast carcinoma, fine needle aspiration, hail region

Procedia PDF Downloads 260

Authors: Thidathit Prachanukool, Chaiyaporn Yuksen, Welawat Tienpratarn, Sorravit Savatmongkorngul, Panvilai Tangkulpanich, Chetsadakon Jenpanitpong, Yuranan Phootothum, Malivan Phontabtim, Promphet Nuanprom

Abstract:

Background: Ruptured appendicitis has a high morbidity and mortality and requires immediate surgery. The Alvarado Score is used as a tool to predict the risk of acute appendicitis, but there is no such score for predicting rupture. This study aimed to developed the prediction score to determine the likelihood of ruptured appendicitis in an Asian population. Methods: This study was diagnostic, retrospectively cross-sectional and exploratory model at the Emergency Medicine Department in Ramathibodi Hospital between March 2016 and March 2018. The inclusion criteria were age >15 years and an available pathology report after appendectomy. Clinical factors included gender, age>60 years, right lower quadrant pain, migratory pain, nausea and/or vomiting, diarrhea, anorexia, fever>37.3°C, rebound tenderness, guarding, white blood cell count, polymorphonuclear white blood cells (PMN)>75%, and the pain duration before presentation. The predictive model and prediction score for ruptured appendicitis was developed by multivariable logistic regression analysis. Result: During the study period, 480 patients met the inclusion criteria; of these, 77 (16%) had ruptured appendicitis. Five independent factors were predictive of rupture, age>60 years, fever>37.3°C, guarding, PMN>75%, and duration of pain>24 hours to presentation. A score > 6 increased the likelihood ratio of ruptured appendicitis by 3.88 times. Conclusion: Using the Ramathibodi Welawat Ruptured Appendicitis Score. (RAMA WeRA Score) developed in this study, a score of > 6 was associated with ruptured appendicitis.

Keywords: predictive model, risk score, ruptured appendicitis, emergency room

Procedia PDF Downloads 156

Authors: Jiranun Sreecharit, Anongnat Boonrut, Kunvadee Munvaradee, Phechnoy Singchungchai

Abstract:

Hatyai Hospital as center of hospital with a capacity of 670 beds. Medicine intensive care units (MICU240) provide care for critically ill patients who are at high risk need to be monitored closely. Intravenous catheter is vital to help assess the level of water in the body fluids and medications. Potential complications such as infection. We need to have guidelines for the care of patients who received intravenous catheter used to achieve good results. The operations research in this study was intended 1) To study the effects of practice for nurses in caring for patients with central venous catheter to infection rate and 2) To assess the satisfaction of nurses and patient care practices in central venous catheterization patients in the MICU 240. The sample of the patient's central venous catheter crisis that everyone who admitted in MICU 240 during the period from October 2013 to May 2014. Samples prior to practice and 148 samples with 249 case of practice. A systematic review of the research NSWHealth Statewide Guideline for Intensive Care. Data were analyzed by statistics, percentages and frequency NON-PARAMETRICS with Mann-Whitney U. The finding revealed that: 1. Results of the practice patient care central venous catheter infection rates were found to be reduced from 35.14 percent to 25.3 percent. 2. The results of the evaluation of nurses and patients in the patient care practices central venous catheter found to be satisfied and happy to work 85 percent.

Keywords: clinical practice guidelines, central venous catheter, infection satisfaction

Procedia PDF Downloads 468

Authors: S. O. Okoro

Abstract:

Some words become the catch phrase of a particular decade. Globalization, Openness, and Privatization are certainly among the most frequently encapsulation of 1990’s; the market is ‘in’, ‘the state is out’. In the 1970’s, there were many political economists who spoke of autarky as one possible response to global economic forces. Be self-contained, go it alone, put up barriers to trans-nationalities, put in place import-substitution industrialization policy and grow domestic industries. In 1990’s, the emasculation of the state is by no means complete, but there is an acceptance that the state’s power is circumscribed by forces beyond its control and potential leverage. Autarky is no longer as a policy option. Nigeria, since its emergence as an independent nation, has evolved two macroeconomic management regimes of the interventionist and market friendly styles. This paper investigates Nigeria’s growth performance over the periods incorporating these two regimes and finds that there is no structural break in Total Factor Productivity, (TFP) growth and besides, the TFP growth over the entire period of study 1970-2012 is very negligible and hence growth can only be achieved by the unsustainable factor accumulation. Another important finding of this work is that the openness-human capital interaction term has a significant impact on the TFP growth, but the sign of the estimated coefficient does not meet it a theoretical expectation. This is because the negative coefficient on the human capital outweighs the positive openness effect. The poor quality of human capital is considered to have given rise to this. Given these results a massive investment in the education sector is required. The investment should be targeted at reforms that go beyond mere structural reforms to a reform agenda that will improve the quality of human capital in Nigeria.

Keywords: globalization, emasculation, openness and privatization, total factor productivity

Procedia PDF Downloads 235

Authors: Wahid Terro, Miray Terro, Omar Zain

Abstract:

Context: The immediate placement of dental implants into fresh, non-infected sockets is an accepted successful technique, while the placement of these implants into pathological Dento-alveolar sockets is still a controversial issue. Aims: This clinical case-serious study aimed to report, retrospectively, the survival rate of immediate dental implants placed immediately after extraction of teeth with infected Dento-alveolar sockets in the maxilla and mandible during the osseointegration period (3 months). Material and Methods: A retrospective analysis was made of the clinical and radiographic findings corresponding to 15 consecutive patients (7 women and 8 men, between the ages of 21 and 59 years) with a mean age of 44.14 years (SD= 9.28). A total of 36 locking-taper Bicon dental implants (hydroxyapatite, HA-coated) were immediately placed into infected fresh extraction sockets, including radicular cysts, chronic periapical lesions, and sub-acute periodontal and endodontic infections using a flap or flapless surgery. Retrospective data on implant position, implant size, pathological condition, and baseline radiographs were obtained from patient records. Clinical and radiographic analyses were performed to evaluate the treatment outcome. Data were considered using descriptive statistics. Results: All the implants (N=36) except two achieved osseointegration in 3 months follow-up. This reflects a 94.44% success rate within this small study group and a 5.55% failure rate. Complications were related to the reasons for tooth loss. Conclusions: This retrospective clinical case-series study showed the possibility that immediate dental implant placement is successful in infected extraction sockets.

Keywords: implant, socket, infected, osteointegration

Procedia PDF Downloads 16

Authors: Murad Gasanov, Shagen Danielyan, Ali Gasanov, Yuri Teterin, Peter Yartsev

Abstract:

Background: Despite the advances made in modern surgery, the treatment of patients with esophageal injuries remains one of the most topical and complex issues. In recent years, high-technology minimally invasive methods, such as endoscopic vacuum therapy (EVT) in the treatment of esophageal injuries. The effectiveness of EVT has been sufficiently studied in case of failure of esophageal anastomoses, however the application of this method in case of mechanical esophageal injuries is limited by a small series of observations, indicating the necessity of additional study. Aim: The aim was to аnalyzed of own experience in the use of endoscopic vacuum therapy (EVT) in a comprehensive examination of patients with esophageal injuries. Methods: We analyzed the results of treatment of 24 patients with mechanical injuries of the esophagus for the period 2019-2021. Complex treatment of patients included the use of minimally invasive technologies, including percutaneous endoscopic gastrostomy (PEG), EVT and video-assisted thoracoscopic debridement. Evaluation of the effectiveness of treatment was carried out using multislice computed tomography (MSCT), endoscopy and laboratory tests. The duration of inpatient treatment and the duration of EVT, the number of system replacements, complications and mortality were taken into account. Result: EVT in patients with mechanical injuries of the esophagus allowed to achieve epithelialization of the esophageal defect in 21 patients (87.5%) in the form of linear scar on the site of perforation or pseudodiverticulum. Complications were noted in 4 patients (16.6%), including bleeding (2) and and esophageal stenosis in the perforation area (2). Lethal outcome was in one observation (4.2%). Conclusion. EVT may be the method of choice in complex treatment in patients with esophageal lesions.

Keywords: esophagus injuries, damage to the esophagus, perforation of the esophagus, spontaneous perforation of the esophagus, mediastinitis, endoscopic vacuum therapy

Procedia PDF Downloads 99

Authors: Suraj Muke, Vikas Mankumare, Sadhana Sathaye

Abstract:

Osteoporosis is the most common metabolic bone disease which affects an estimated 25 million people worldwide, leading to 1 million fractures, 40,000 annual deaths and health costs of billions of dollars. It is estimated that about 80% of total osteoporosis patients are women, amongst which majority are above the age of 45 years. Postmenopausal osteoporosis is associated with lack of intestinal calcium absorption, increasing pro-oxidant and inflammatory mediators. Lawsonia inermis is a biennial dicotyledonous herbaceous shrub is reported to possess a high flavonoid, high phenolic and Inhibitors of osteoclastogenesis like Daphneside and Daphnorin. The present study aimed to screen osteoprotective effect of methanolic extract of Lawsonia inermis (LIM) in rat model along with its antioxidant activity. LIM shows phenolic content 146.3Milligrams of Gallic acid equivalent present per gram of extract and 19.8 Milligrams of rutin per gram of extract of Total flavonoid content with IC50 value 42.99μg/ml. bilateral ovariectomized rat model in which Healthy female wistar rats were used for screening. Treatment with LIM was carried out using graded doses of 25mg/kg, 50mg/kg and 100mg/kg for period of 28 days. The negative control group comprised of ovariectomized rats along with saline treatment for four weeks whereas sham operated rats were used as positive control.LIM showed a decrease in bone turnover by preventing loss of urinary calcium and phosphorous moreover it decreased the alkaline phosphatase levels and loss of bone density is prevented by LIM suggesting decrease in osteoclast activity.

Keywords: antioxidant, osteoclast, osteoporosis, ovariectomized

Procedia PDF Downloads 396