Search results for: tehran times
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3773

Search results for: tehran times

3173 The Impact of Blended Learning on Developing the students' Writing Skills and the Perception of Instructors and Students: Hawassa University in Focus

Authors: Mulu G. Gencha, Gebremedhin Simon, Menna Olango

Abstract:

This study was conducted at Hawassa University (HwU) in the Southern Nation Nationalities Peoples Regional State (SNNPRS) of Ethiopia. The prime concern of this study was to examine the writing performances of experimental and control group students, perception of experimental group students, and subject instructors. The course was blended learning (BL). Blended learning is a hybrid of classroom and on-line learning. Participants were eighty students from the School of Computer Science. Forty students attended the BL delivery involved using Face-to-Face (FTF) and campus-based online instruction. All instructors, fifty, of School of Language and Communication Studies along with 10 FGD members participated in the study. The experimental group went to the computer lab two times a week for four months, March-June, 2012, using the local area network (LAN), and software (MOODLE) writing program. On the other hand, the control group, forty students, took the FTF writing course five times a week for four months in similar academic calendar. The three instruments, the attitude questionnaire, tests and FGD were designed to identify views of students, instructors, and FGD participants on BL. At the end of the study, students’ final course scores were evaluated. Data were analyzed using independent samples t-tests. A statistically, significant difference was found between the FTF and BL (p<0.05). The analysis showed that the BL group was more successful than the conventional group. Besides, both instructors and students had positive attitude towards BL. The final section of the thesis showed the potential benefits and challenges, considering the pedagogical implications for the BL, and recommended possible avenues for further works.

Keywords: blended learning, computer attitudes, computer usefulness, computer liking, computer confidence, computer phobia

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3172 Phonology and Syntax of Article Incorporation in Mauritian Creole: Evidence from Bantou Languages

Authors: Emmanuel Nikiema

Abstract:

This paper examines article incorporation in Mauritian Creole, a French Lexifier Creole which exhibits three forms of article incorporation as illustrated in (1-3). While various analyses of article incorporation have been proposed in the literature, fewer studies have explored the motivation of this widespread phenomenon in Mauritian Creole (MC) as opposed to other French Lexifier Creoles spoken in the Caribbean. For example, Mauritian Creole exhibits 4 times more CV incorporation than Haitian Creole, and 40 times more than Reunion Creole. (1) Consonantal type (C): loraz ‘thunder storm’, lete ‘summer’, zwazo ‘bird’, nide ‘idea’. (2) Syllabic type (CV): lapo ‘skin’, liku ‘neck’, ledo ‘back’, leker ‘heart’, diber ‘butter’. (3) Bi-consonantal (CVC): delo ‘water’, dizef ‘egg’, lizye ‘eye’, dilwil ‘oil’. The goal of this study is twofold: 1) uncover the rules governing the three types of article incorporation in MC, and 2) account for its remarkable occurrence in MC as opposed to its quasi-absence in Reunion Creole. We have collected a corpus of over 700 cases and organized it into three categories (C; CV and CVC). For example, there are 471 examples of CV incorporation in MC against 112 in Haitian Creole and only 12 in Reunion Creole. Two questions can be raised: 1) what is the motivation and distribution of the three types of incorporation in MC, and 2) how can one account for the high volume of incorporation in MC as opposed to its quasi-absence in Reunion Creole? We suggest that article incorporation in MC is related to the structure of nouns in Bantou languages. While previous authors have largely used population settlement data in the colonies during the Creole formation period to justify their analyses, we propose an account based on the syntactic structure of Bantou nouns. This analysis will shed light on the contribution of African languages to the formation of MC, and on to why MC has exhibited more article incorporation cases than any other French Lexifier Creole.

Keywords: article incorporation, creole languages, description, phonology

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3171 Study on the Effect of Different Media on Green Roof Water Retention

Authors: Chen Zhi-Wei, Hsieh Wei-Fang

Abstract:

Taiwan annual rainfall is global average of 2.5 times, plus city excessive development, green constantly to reduced, instead of is big area of artificial base disc, makes Taiwan rainy season during occurred of storm cannot timely of emissions, led to flood constantly, and rain also cannot was retained again using, led to city hydrological balance suffered damage, and to Regulation city of by brings of negative effect, increased green covered rate became most effective of method, and city land limited, so roof green gradually became a alternative program. Green roofs have become one of the Central and local government policy initiatives for urban development, in foreign countries, such as the United States, and Japan, and Singapore etc. Development of roof greening as an important policy, has become a trend of the times. In recent years, many experts and scholars are also on the roof greening all aspects of research, mostly for green roof for the environmental impact of benefits, such as: carbon reduction, cooling, thermostat, but research on the benefits of green roofs under water cut but it is rare. Therefore, this research literature from green roof in to view and analyze what kind of medium suitable for roof greening and use of green base plate combination simulated green roof structure, via different proportions of the medium with water retention plate and drainage board, experiment with different planting base plate combination of water conservation performance. Research will want to test the effect of roof planting base mix, promotion of relevant departments and agencies in future implementation of green roofs, prompted the development of green roofs, which in the end Taiwan achieve sustainable development of the urban environment help.

Keywords: thin-layer roof greening and planting medium, water efficiency

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3170 Improving Technical Translation Ability of the Iranian Students of Translation Through Multimedia: An Empirical Study

Authors: Dina Zakeri, Ali Aminzad

Abstract:

Multimedia-assisted teaching results in eliminating traditional training barriers, facilitating the cognition process and upgrading learning outcomes. This study attempted to examine the effects of implementing multimedia on teaching technical translation model and on the technical text translation ability of Iranian students of translation. To fulfill the purpose of the study, a total of forty-six learners were selected out of fifty-seven participants in a higher education center in Tehran based on their scores in Preliminary English Test (PET) and were divided randomly into the experimental and control groups. Prior to the treatment, a technical text translation questionnaire was devised and then approved and validated by three assistant professors of technical fields and three assistant professors of Teaching English as a Foreign Language (TEFL) at the university. This questionnaire was administered as a pretest to both groups. Control and experimental groups were trained for five successive weeks using identical course books but with a different lesson plan that allowed employing multimedia for the experimental group only. The devised and approved questionnaire was administered as a posttest to both groups at the end of the instruction. A multivariate ANOVA was run to compare the two groups’ means on the PET, pretest and posttest. The results showed the rejection of all null hypotheses of the study and revealed that multimedia significantly improved technical text translation ability of the learners.

Keywords: multimedia, multimedia-mediated teaching, technical translation model, technical text, translation ability

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3169 Bilateral Simultaneous Acute Primary Angle Closure Glaucoma: A Remarkable Case

Authors: Nita Nurlaila Kadarwaty

Abstract:

Purpose: This study presents a rare case of bilateral Acute Primary Angle Closure Glaucoma (PACG). Method: A case report of a 64-year-old woman with a good outcome Acute PACG in both eyes who underwent phacotrabeculectomy surgery. Result: A 64-year-old woman complained of acute pain in both eyes, accompanied by decreased vision, photophobia, and seeing halos for three weeks. There was no history of trauma, steroid or other systemic drugs used, or intraocular surgery before. Ophthalmologic examination revealed a right eye (RE) visual acuity of 0.1, left eye (LE) 0.2. RE intraocular pressure (IOP) was 12 mmhg and LE: 36.4 mmHg in medication of timolol maleat ED and acetazolamide oral. Both eyes' anterior segments revealed mixed injection, corneal edema, shallow anterior chamber, posterior synechiae, mid-dilatation pupil with negative pupillary reflection, and cloudy lens without intumescent. There was a glaucomatous optic and closed iridocorneal angle on the gonioscopy. Initial treatments included oral acetazolamide and potassium aspartate 250 mg three times a day, timolol maleate ED 0.5% twice a day, and prednisolone acetate ED 1% four times a day. This patient underwent trabeculectomy, phacoemulsification, and implantation of IOL in both eyes. One week after the surgeries, both eyes showed decreased IOP and good visual improvement. Conclusion: Bilateral simultaneous Acute PACG is generally severe and results in a poor outcome. It causes rapidly progressive visual loss and is often irreversible. Phacotrabeculectomy has more benefits compared to only phacoemulsification for the intervention regarding the reduced IOP post-surgical.

Keywords: acute primary angle closure glaucoma, intraocular pressure, phacotrabeculectomy, glaucoma

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3168 A Markov Model for the Elderly Disability Transition and Related Factors in China

Authors: Huimin Liu, Li Xiang, Yue Liu, Jing Wang

Abstract:

Background: As one of typical case for the developing countries who are stepping into the aging times globally, more and more older people in China might face the problem of which they could not maintain normal life due to the functional disability. While the government take efforts to build long-term care system and further carry out related policies for the core concept, there is still lack of strong evidence to evaluating the profile of disability states in the elderly population and its transition rate. It has been proved that disability is a dynamic condition of the person rather than irreversible so it means possible to intervene timely on them who might be in a risk of severe disability. Objective: The aim of this study was to depict the picture of the disability transferring status of the older people in China, and then find out individual characteristics that change the state of disability to provide theory basis for disability prevention and early intervention among elderly people. Methods: Data for this study came from the 2011 baseline survey and the 2013 follow-up survey of the China Health and Retirement Longitudinal Study (CHARLS). Normal ADL function, 1~2 ADLs disability,3 or above ADLs disability and death were defined from state 1 to state 4. Multi-state Markov model was applied and the four-state homogeneous model with discrete states and discrete times from two visits follow-up data was constructed to explore factors for various progressive stages. We modeled the effect of explanatory variables on the rates of transition by using a proportional intensities model with covariate, such as gender. Result: In the total sample, state 2 constituent ratio is nearly about 17.0%, while state 3 proportion is blow the former, accounting for 8.5%. Moreover, ADL disability statistics difference is not obvious between two years. About half of the state 2 in 2011 improved to become normal in 2013 even though they get elder. However, state 3 transferred into the proportion of death increased obviously, closed to the proportion back to state 2 or normal functions. From the estimated intensities, we see the older people are eleven times as likely to develop at 1~2 ADLs disability than dying. After disability onset (state 2), progression to state 3 is 30% more likely than recovery. Once in state 3, a mean of 0.76 years is spent before death or recovery. In this model, a typical person in state 2 has a probability of 0.5 of disability-free one year from now while the moderate disabled or above has a probability of 0.14 being dead. Conclusion: On the long-term care cost considerations, preventive programs for delay the disability progression of the elderly could be adopted based on the current disabled state and main factors of each stage. And in general terms, those focusing elderly individuals who are moderate or above disabled should go first.

Keywords: Markov model, elderly people, disability, transition intensity

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3167 A View of Flexible Housing in China

Authors: L. I. Shanshan

Abstract:

Beginning with the debate of concept, this essay explains the historical source and development of flexible housing in China. In the former part, the flexibility contained in traditional house is explored. While in the latter, the relevant practices in modern times are systematically analyzed as three phases–the Embryonic Period (1949 - 1980), the Systematic Practice (1981 - 2000), as well as the Integrated Trend and Prosperity (2001 - present). As a conclusion, the generalized flexibility is tentatively discussed.

Keywords: flexibility, long-term effectiveness, variety, social background

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3166 Applications of High Intensity Ultrasound to Modify Millet Protein Concentrate Functionality

Authors: B. Nazari, M. A. Mohammadifar, S. Shojaee-Aliabadi, L. Mirmoghtadaie

Abstract:

Millets as a new source of plant protein were not used in food applications due to its poor functional properties. In this study, the effect of high intensity ultrasound (frequency: 20 kHz, with contentious flow) (US) in 100% amplitude for varying times (5, 12.5, and 20 min) on solubility, emulsifying activity index (EAI), emulsion stability (ES), foaming capacity (FC), and foaming stability (FS) of millet protein concentrate (MPC) were evaluated. In addition, the structural properties of best treatments such as molecular weight and surface charge were compared with the control sample to prove the US effect. The US treatments significantly (P<0.05) increased the solubility of the native MPC (65.8±0.6%) at all sonicated times with the maximum solubility that is recorded at 12.5 min treatment (96.9±0.82 %). The FC of MPC was also significantly affected by the US treatment. Increase in sonicated time up to 12.5 min significantly increased the FC of native MPC (271.03±4.51 ml), but higher increase reduced it significantly. Minimal improvements were observed in the FS of all sonicated MPC compared to the native MPC. Sonicated time for 12.5 min affected the EAI and ES of the native MPC more markedly than 5 and 20 min that may be attributed to higher increase in proteins tendency to adsorption at the oil and water interfaces after the US treatment at this time. SDS-PAGE analysis showed changes in the molecular weight of MPC that attributed to shearing forces created by cavitation phenomenon. Also, this phenomenon caused an increase in the exposure of more amino acids with negative charge in the surface of US treated MPC, that was demonstrated by Zetasizer data. High intensity ultrasound, as a green technology, can significantly increase the functional properties of MPC and can make this usable for food applications.

Keywords: functional properties, high intensity ultrasound, millet protein concentrate, structural properties

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3165 Evaluation of Effectiveness of Three Common Equine Thrush Treatments

Authors: A. S. Strait, J. A. Bryk-Lucy, L. M. Ritchie

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Thrush is a common disease of ungulates primarily affecting the frog and sulci, caused by the anaerobic bacteria Fusobacterium necrophorum. Thrush accounts for approximately 45.0% of hoof disorders in horses. Prevention and treatment of thrush are essential to prevent horses from developing severe infections and becoming lame. Proper knowledge of hoof care and thrush treatments is crucial to avoid financial costs, unsoundness and lost training time. Research on the effectiveness of numerous commercial and homemade thrush treatments is limited in the equine industry. The objective of this study was to compare the effectiveness of three common thrush treatments for horses: weekly application of Thrush Buster, daily dilute bleach solution spray, or Metronidazole pastes every other day. Cases of thrush diagnosed by a veterinarian or veterinarian-trained researcher were given a score, from 0 to 4, based on the severity of the thrush in each hoof (n=59) and randomly assigned a treatment. Cases were rescored each week of the three-week treatment, and the final and initial scores were compared to determine effectiveness. The thrush treatments were compared with Thrush Buster as the reference at a significance level of α=.05. Binomial Logistic Regression Modeling was performed, finding that the odds of a hoof treated with Metronidazole to be thrush-free was 6.1 times greater than a hoof treated with Thrush Buster (p=0.001), while the odds of a hoof that was treated with bleach to be thrush-free was only 0.97 times greater than a hoof treated with Thrush Buster (p=0.970), after adjustment for treatment week. Of the three treatments utilized in this study, Metronidazole paste applied to the affected areas every other day was the most effective treatment for thrush in horses. There are many other thrush remedies available, and further research is warranted to determine the efficacy of additional treatment options.

Keywords: fusobacterium necrophorum, thrush, equine, horse, lameness

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3164 Green Fruit and Vegetables Have Favorable Effects on 3-Year Changes of Cardiometabolic Risk Factors: A Cohort Study

Authors: Parvin Mirmiran, Zahra Bahadoran, Nazanin Moslehi, Fereidoun Azizi

Abstract:

Background and aim: We aimed to investigate the effects of green fruits and vegetables (green FV) consumption on the 3-year changes of cardiometabolic risk factors. Methods: This longitudinal study was conducted in the framework of Tehran Lipid and Glucose Study, between 2006-2008 and 2009-2011, on 1272 adults. Dietary intake of green FV, including green cabbage, broccoli, lettuce, celery, green beans, green peas, cucumber, leafy vegetables, zucchini, green chili and bell pepper, and kiwi fruit, has been assessed by a validated semi-quantitative food frequency questionnaire at baseline and second examination. Demographics, anthropometrics and biochemical measures were evaluated at baseline and 3 years later. The associations of cardiometabolic risk changes with mean intake of green FV were estimated. Results: The mean age of men and women at baseline was 39.8±12.7 and 37.3±12.1 years, respectively. Mean intake of green FV was 152±77 g/d. More intake from green FV was accompanied to more intake of vitamin A, α and β-carotene, lutein, β-criptoxanthine, potassium, magnesium and fiber. Consumption of green FV was inversely associated with 3-year change of waist circumference (β= -0.07, P=0.01), total cholesterol (β= -0.11, P=0.01) and triglycerides (β= -0.13, P=0.01). Each 25 g/d increase in consumption of green FV decreased the incidence of hyper-triglyceridemia by 12% (OR:0.88, 95%CI:0.71-0.99) in men. In women, no significant association was observed between consumption of green FV with cardiometabolic risk factors. Conclusion: Higher consumption of green FV could have preventive effects against abdominal fat gain and lipid disorders.

Keywords: cardiometabolic risk factors, abdominal obesity, lipid disorders, fruits, vegetables

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3163 A Structure-Switching Electrochemical Aptasensor for Rapid, Reagentless and Single-Step, Nanomolar Detection of C-Reactive Protein

Authors: William L. Whitehouse, Louisa H. Y. Lo, Andrew B. Kinghorn, Simon C. C. Shiu, Julian. A. Tanner

Abstract:

C-reactive protein (CRP) is an acute-phase reactant and sensitive indicator for sepsis and other life-threatening pathologies, including systemic inflammatory response syndrome (SIRS). Currently, clinical turn-around times for established CRP detection methods take between 30 minutes to hours or even days from centralized laboratories. Here, we report the development of an electrochemical biosensor using redox probe-tagged DNA aptamers functionalized onto cheap, commercially available screen-printed electrodes. Binding-induced conformational switching of the CRP-targeting aptamer induces a specific and selective signal-ON event, which enables single-step and reagentless detection of CRP in as little as 1 minute. The aptasensor dynamic range spans 5-1000nM (R=0.97) or 5-500nM (R=0.99) in 50% diluted human serum, with a LOD of 3nM, corresponding to 2-orders of magnitude sensitivity under the clinically relevant cut-off for CRP. The sensor is stable for up to one week and can be reused numerous times, as judged from repeated real-time dosing and dose-response assays. By decoupling binding events from the signal induction mechanism, structure-switching electrochemical aptamer-based sensors (SS-EABs) provide considerable advantages over their adsorption-based counterparts. Our work expands on the retinue of such sensors reported in the literature and is the first instance of an SS-EAB for reagentless CRP detection. We hope this study can inspire further investigations into the suitability of SS-EABs for diagnostics, which will aid translational R&D toward fully realized devices aimed at point-of-care applications or for use more broadly by the public.

Keywords: structure-switching, C-reactive protein, electrochemical, biosensor, aptasensor.

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3162 Quoting Jobshops Due Dates Subject to Exogenous Factors in Developing Nations

Authors: Idris M. Olatunde, Kareem B.

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In manufacturing systems, especially job shops, service performance is a key factor that determines customer satisfaction. Service performance depends not only on the quality of the output but on the delivery lead times as well. Besides product quality enhancement, delivery lead time must be minimized for optimal patronage. Quoting accurate due dates is sine quo non for job shop operational survival in a global competitive environment. Quoting accurate due dates in job shops has been a herculean task that nearly defiled solutions from many methods employed due to complex jobs routing nature of the system. This class of NP-hard problems possessed no rigid algorithms that can give an optimal solution. Jobshop operational problem is more complex in developing nations due to some peculiar factors. Operational complexity in job shops emanated from political instability, poor economy, technological know-how, and the non-promising socio-political environment. The mentioned exogenous factors were hardly considered in the previous studies on scheduling problem related to due date determination in job shops. This study has filled the gap created in the past studies by developing a dynamic model that incorporated the exogenous factors for accurate determination of due dates for varying jobs complexity. Real data from six job shops selected from the different part of Nigeria, were used to test the efficacy of the model, and the outcomes were analyzed statistically. The results of the analyzes showed that the model is more promising in determining accurate due dates than the traditional models deployed by many job shops in terms of patronage and lead times minimization.

Keywords: due dates prediction, improved performance, customer satisfaction, dynamic model, exogenous factors, job shops

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3161 Fabrication and Characterization of Folic Acid-Grafted-Thiomer Enveloped Liposomes for Enhanced Oral Bioavailability of Docetaxel

Authors: Farhan Sohail, Gul Shahnaz Irshad Hussain, Shoaib Sarwar, Ibrahim Javed, Zajif Hussain, Akhtar Nadhman

Abstract:

The present study was aimed to develop a hybrid nanocarrier (NC) system with enhanced membrane permeability, bioavailability and targeted delivery of Docetaxel (DTX) in breast cancer. Hybrid NC’s based on folic acid (FA) grafted thiolated chitosan (TCS) enveloped liposomes were prepared with DTX and evaluated in-vitro and in-vivo for their enhanced permeability and bioavailability. Physicochemical characterization of NC’s including particle size, morphology, zeta potential, FTIR, DSC, PXRD, encapsulation efficiency and drug release from NC’s was determined in vitro. Permeation enhancement and p-gp inhibition were performed through everted sac method on freshly excised rat intestine which indicated that permeation was enhanced 5 times as compared to pure DTX and the hybrid NC’s were strongly able to inhibit the p-gp activity as well. In-vitro cytotoxicity and tumor targeting was done using MDA-MB-231 cell line. The stability study of the formulations performed for 3 months showed the improved stability of FA-TCS enveloped liposomes in terms of its particles size, zeta potential and encapsulation efficiency as compared to TCS NP’s and liposomes. The pharmacokinetic study was performed in vivo using rabbits. The oral bioavailability and AUC0-96 was increased 10.07 folds with hybrid NC’s as compared to positive control. Half-life (t1/2) was increased 4 times (58.76 hrs) as compared to positive control (17.72 hrs). Conclusively, it is suggested that FA-TCS enveloped liposomes have strong potential to enhance permeability and bioavailability of hydrophobic drugs after oral administration and tumor targeting.

Keywords: docetaxel, coated liposome, permeation enhancement, oral bioavailability

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3160 Exploring Leadership Adaptability in the Private Healthcare Organizations in the UK in Times of Crises

Authors: Sade Ogundipe

Abstract:

The private healthcare sector in the United Kingdom has experienced unprecedented challenges during times of crisis, necessitating effective leadership adaptability. This qualitative study delves into the dynamic landscape of leadership within the sector, particularly during crises, employing the lenses of complexity theory and institutional theory to unravel the intricate mechanisms at play. Through in-depth interviews with 25 various levels of leaders in the UK private healthcare sector, this research explores how leaders in UK private healthcare organizations navigate complex and often chaotic environments, shedding light on their adaptive strategies and decision-making processes during crises. Complexity theory is used to analyze the complicated, volatile nature of healthcare crises, emphasizing the need for adaptive leadership in such contexts. Institutional theory, on the other hand, provides insights into how external and internal institutional pressures influence leadership behavior. Findings from this study highlight the multifaceted nature of leadership adaptability, emphasizing the significance of leaders' abilities to embrace uncertainty, engage in sensemaking, and leverage the institutional environment to enact meaningful changes. Furthermore, this research sheds light on the challenges and opportunities that leaders face when adapting to crises within the UK private healthcare sector. The study's insights contribute to the growing body of literature on leadership in healthcare, offering practical implications for leaders, policymakers, and stakeholders within the UK private healthcare sector. By employing the dual perspectives of complexity theory and institutional theory, this research provides a holistic understanding of leadership adaptability in the face of crises, offering valuable guidance for enhancing the resilience and effectiveness of healthcare leadership within this vital sector.

Keywords: leadership, adaptability, decision-making, complexity, complexity theory, institutional theory, organizational complexity, complex adaptive system (CAS), crises, healthcare

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3159 Assessing the Effects of Sub-Concussive Head Impacts on Clinical Measures of Neurologic Function

Authors: Gianluca Del Rossi

Abstract:

Sub-concussive impacts occur frequently in collision sports such as American tackle football. Sub-concussive level impacts are defined as hits to the head that do not result in the clinical manifestation of concussion injury. Presently, there is limited information known about the short-term effects of repeated sub-concussive blows to the head. Therefore, the purpose of this investigation was to determine if standard clinical measures could detect acute impairments in neurologic function resulting from the accumulation of sub-concussive impacts throughout a season of high school American tackle football. Simple reaction time using the ruler-drop test, and oculomotor performance using the King-Devick (KD) test, were assessed in 15 athletes prior to the start of the athletic season, then repeated each week of the season, and once following its completion. The mean reaction times and fastest KD scores that were recorded or calculated from each study participant and from each test session were analyzed to assess for change in reaction time and oculomotor performance over the course of the American tackle football season. Analyses of KD data revealed improvements in oculomotor performance from baseline measurements (i.e., decreased time), with most weekly comparisons to baseline being significantly different. Statistical tests performed on the mean reaction times obtained via the ruler-drop test throughout the season revealed statistically significant declines (i.e., increased time) between baseline and weeks 3, 4, 10, and 12 of the athletic season. The inconsistent and contrasting findings between KD data and reaction time demonstrate the need to identify more robust clinical measures to definitively assess if repeated sub-concussive impacts to the head are acutely detrimental to patients.

Keywords: head injury, mTBI and sport, subclinical head trauma, sub-concussive impacts

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3158 Decision Support System for Hospital Selection in Emergency Medical Services: A Discrete Event Simulation Approach

Authors: D. Tedesco, G. Feletti, P. Trucco

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The present study aims to develop a Decision Support System (DSS) to support the operational decision of the Emergency Medical Service (EMS) regarding the assignment of medical emergency requests to Emergency Departments (ED). In the literature, this problem is also known as “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies are mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a request. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the transport time and release the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs, considering information relating to the subsequent phases of the process, such as the case-mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to evaluate different hospital selection policies. Therefore, the next steps of the research consisted of the development of a general simulation architecture, its implementation in the AnyLogic software and its validation on a realistic dataset. The hospital selection policy that produced the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, which is based on a retrospective estimate of the TTP, and a dynamic approach, which is based on a predictive estimate of the TTP determined with a constantly updated Winters model. Findings reveal that considering the minimization of TTP as a hospital selection policy raises several benefits. It allows to significantly reduce service throughput times in the ED with a minimum increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case-mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms of TTP estimation than a retrospective approach but entails a more difficult application. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: discrete event simulation, emergency medical services, forecast model, hospital selection

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3157 Numerical Simulation of Axially Loaded to Failure Large Diameter Bored Pile

Authors: M. Ezzat, Y. Zaghloul, T. Sorour, A. Hefny, M. Eid

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Ultimate capacity of large diameter bored piles is usually determined from pile loading tests as recommended by several international codes and foundation design standards. However, loading of this type of piles till achieving apparent failure is practically seldom. In this paper, numerical analyses are carried out to simulate load test of a large diameter bored pile performed at the location of Alzey highway bridge project (Germany). Test results of pile load settlement relationship till failure as well as results of the base and shaft resistances are available. Apparent failure was indicated in this test by the significant increase of the induced settlement during the last load increment applied on the pile head. Measurements of this pile load test are used to assess the quality of the numerical models investigated. Three different material soil models are implemented in the analyses: Mohr coulomb (MC), Soft soil (SS), and Modified Mohr coulomb (MMC). Very good agreement is obtained between the field measured settlement and the calculated settlement using the MMC model. Results of analysis showed also that the MMC constitutive model is superior to MC, and SS models in predicting the ultimate base and shaft resistances of the large diameter bored pile. After calibrating the numerical model, behavior of large diameter bored piles under axial loads is discussed and the formation of the plastic zone around the pile is explored. Results obtained showed that the plastic zone below the base of the pile at failure extended laterally to about four times the pile diameter and vertically to about three times the pile diameter.

Keywords: ultimate capacity, large diameter bored piles, plastic zone, failure, pile load test

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3156 Exploring Reading into Writing: A Corpus-Based Analysis of Postgraduate Students’ Literature Review Essays

Authors: Tanzeela Anbreen, Ammara Maqsood

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Reading into writing is one of university students' most required academic skills. The current study explored postgraduate university students’ writing quality using a corpus-based approach. Twelve postgraduate students’ literature review essays were chosen for the corpus-based analysis. These essays were chosen because students had to incorporate multiple reading sources in these essays, which was a new writing exercise for them. The students were provided feedback at least two times which comprised of the written comments by the tutor highlighting the areas of improvement and also by using the ‘track changes’ function. This exercise was repeated two times, and students submitted two drafts. This investigation included only the finally submitted work of the students. A corpus-based approach was adopted to analyse the essays because it promotes autonomous discovery and personalised learning. The aim of this analysis was to understand the existing level of students’ writing before the start of their postgraduate thesis. Text Inspector was used to analyse the quality of essays. With the help of the Text Inspector tool, the vocabulary used in the essays was compared to the English Vocabulary Profile (EVP), which describes what learners know and can do at each Common European Framework of Reference (CEFR) level. Writing quality was also measured for the Flesch reading ease score, which is a standard to describe the ease of understanding the writing content. The results reflected that students found writing essays using multiple sources challenging. In most essays, the vocabulary level achieved was between B1-B2 of the CEFL level. The study recommends that students need extensive training in developing academic writing skills, particularly in writing the literature review type assignment, which requires multiple sources citations.

Keywords: literature review essays, postgraduate students, corpus-based analysis, vocabulary proficiency

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3155 Needs and Expectations of Digital Support among Parents of Children in Child Healthcare

Authors: Lotha Valan, Åsa Hörnsten, Ulf Isaksson

Abstract:

Introduction: Sweden has a national child health care program (CHCP) where all parents are offered support to raise their children and support them for lifelong health. A systematic review concludes that there is a request for guidance in using the internet effectively for the health purposes of their children. However, a study about internet use among young mothers means that the internet is not always easy to navigate for parents, and they may need support. To fill this gap and develop a digital channel to complement the child health care (CHC) for the support of parents of children within CHC, there is a demand to investigate parents' needs in relation to this purpose. Methods: The study had a qualitative approach using focus group interviews with parents. The interview data were analyzed using qualitative content analysis. Results: The main theme highlights that parents expected that a digital support channel would be something that might strengthen them toward independence concerning the care of their children in a positive way. However, they also felt that they needed personal support and that relationships with other parents and the child health care nurse were significant and meaningful. Another parental desire that emerged was that a future digital channel would facilitate and simplify access to care, and they suggested having both planned and urgent times available for parents to book. The digital channel was expected to make this possible and be a good complement to the physical contacts the traditional child healthcare currently offers. Discussion/conclusions: The parents in this study believed that digital solutions could increase their parental power in relation to the care of their children. Examples were given as nurse-led parent groups where parents with similar problems and experiences around their children could support each other and were expected to strengthen them over time. The parents stressed that a planned digital support channel also needs satisfactory solutions for both contact and response. It was suggested that there should be bookable times for both planned and urgent needs and also the possibility of rescheduling visits.

Keywords: child healthcare, parents, digital support, nursing

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3154 Development of a Methodology for Surgery Planning and Control: A Management Approach to Handle the Conflict of High Utilization and Low Overtime

Authors: Timo Miebach, Kirsten Hoeper, Carolin Felix

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In times of competitive pressures and demographic change, hospitals have to reconsider their strategies as a company. Due to the fact, that operations are one of the main income and one of the primary cost drivers otherwise, a process-oriented approach and an efficient use of resources seems to be the right way for getting a consistent market position. Thus, the efficient operation room occupancy planning is an important cause variable for the success and continued the existence of these institutions. A high utilization of resources is essential. This means a very high, but nevertheless sensible capacity-oriented utilization of working systems that can be realized by avoiding downtimes and a thoughtful occupancy planning. This engineering approach should help hospitals to reach her break-even point. Firstly, the aim is to establish a strategy point, which can be used for the generation of a planned throughput time. Secondly, the operation planning and control should be facilitated and implemented accurately by the generation of time modules. More than 100,000 data records of the Hannover Medical School were analyzed. The data records contain information about the type of conducted operation, the duration of the individual process steps, and all other organizational-specific data such as an operating room. Based on the aforementioned data base, a generally valid model was developed by an analysis to define a strategy point which takes the conflict of capacity utilization and low overtime into account. Furthermore, time modules were generated in this work, which allows a simplified and flexible operation planning and control for the operation manager. By the time modules, it is possible to reduce a high average value of the idle times of the operation rooms. Furthermore, the potential is used to minimize the idle time spread.

Keywords: capacity, operating room, surgery planning and control, utilization

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3153 Comparisonal Study of Succinylation and Glutarylation of Jute Fiber: Study of Mechanical Properties of Modified Fiber Reinforced Epoxy Composites

Authors: R. Vimal, K. Hari Hara Subramaniyan, C. Aswin, B. Logeshwaran, M. Ramesh

Abstract:

Due to several environmental concerns, natural fibers have greatly replaced the synthetic fibers as a reinforcing material in polymer matrix composites. Among the natural fibers, jute fibers are the most abundant plant fibers which are manufactured mainly in countries like India. In recent years, modification of plant fibers with range of chemicals to increase various mechanical and thermal properties has been focused greatly. Among that, some of the plant fibers were modified using succinic anhydride. In the present study, Jute fibers have been modified chemically by treatment with succinic anhydride and glutaric anhydride at different concentrations of 5%, 10%, 20%, 30% and 40%. The fiber modification was done under retting condition at various retention times of 3, 6, 12, 24, 36, and 48 hours. The modification of fiber structure in both the cases is confirmed with Infrared Spectroscopy. The degree of modification increases with increase in retention time, but higher retention time has damaged the fiber structure which is common in both the cases. Comparatively, treatment of fibers with glutaric anhydride has shown efficient output than that of succinic anhydride. The unmodified fibers, succinylated fibers and glutarylated fibers at different retention times are reinforced with epoxy matrix at various volume fractions of fiber under room temperature. The composite made using unmodified fiber is used as a standard material. The tensile strength and flexural strength of the composites are analyzed in detail. Among these, the composite made with glutarylated fiber has shown good mechanical properties when compared to those made of succinylated and unmodified fiber.

Keywords: flexural strength, glutarylation, jute fibers, succinylation, tensile strength

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3152 Quantitative Analysis of Nutrient Inflow from River and Groundwater to Imazu Bay in Fukuoka, Japan

Authors: Keisuke Konishi, Yoshinari Hiroshiro, Kento Terashima, Atsushi Tsutsumi

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Imazu Bay plays an important role for endangered species such as horseshoe crabs and black-faced spoonbills that stay in the bay for spawning or the passing of winter. However, this bay is semi-enclosed with slow water exchange, which could lead to eutrophication under the condition of excess nutrient inflow to the bay. Therefore, quantification of nutrient inflow is of great importance. Generally, analysis of nutrient inflow to the bays takes into consideration nutrient inflow from only the river, but that from groundwater should not be ignored for more accurate results. The main objective of this study is to estimate the amounts of nutrient inflow from river and groundwater to Imazu Bay by analyzing water budget in Zuibaiji River Basin and loads of T-N, T-P, NO3-N and NH4-N. The water budget computation in the basin is performed using groundwater recharge model and quasi three-dimensional two-phase groundwater flow model, and the multiplication of the measured amount of nutrient inflow with the computed discharge gives the total amount of nutrient inflow to the bay. In addition, in order to evaluate nutrient inflow to the bay, the result is compared with nutrient inflow from geologically similar river basins. The result shows that the discharge is 3.50×107 m3/year from the river and 1.04×107 m3/year from groundwater. The submarine groundwater discharge accounts for approximately 23 % of the total discharge, which is large compared to the other river basins. It is also revealed that the total nutrient inflow is not particularly large. The sum of NO3-N and NH4-N loadings from groundwater is less than 10 % of that from the river because of denitrification in groundwater. The Shin Seibu Sewage Treatment Plant located below the observation points discharges treated water of 15,400 m3/day and plans to increase it. However, the loads of T-N and T-P from the treatment plant are 3.9 mg/L and 0.19 mg/L, so that it does not contribute a lot to eutrophication.

Keywords: Eutrophication, groundwater recharge model, nutrient inflow, quasi three-dimensional two-phase groundwater flow model, submarine groundwater discharge

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3151 Re-Visiting Rumi and Iqbal on Self-Enhancement for Social Responsibility

Authors: Javed Y. Uppal

Abstract:

The background of this study is the great degree of stress that the world is experiencing today, internationally among the countries, within a community among people, and even individually within one’s own self. The significance of the study is the attempt to find a solution of this stress in the philosophy of the olden times of Jalaluddin Rumi and comparatively recently of that of Allama Iqbal. The methodology adopted in this paper is firstly exploration of the perspectives of these philosophers that are being consolidated by a number of psychic and spiritual experts of today, who are being widely read but less followed. This paper further goes on presenting brief life sketches of Rumi and Iqbal. It expounds the key concepts proposed by them and the social change that was resulted in the times of the two above mentioned metaphysical philosophers. It is further amplified that with the recent advancements, in both metaphysics and the physical sciences, the gap between the two is closing down. Both Rumi and Iqbal emphasized their common essence. The old time's concepts, postulates, and philosophies are hence once again becoming valid. The findings of this paper are that the existence of human empathy, affection and mutual social attraction among humans is still valid. The positive inner belief system that dictates our thoughts and actions is vital. As a conclusion, empathy should enable us solving our problems collectively. We need to strengthen our inner communication system, to listen to the messages that come to our inner-selves. We need to get guidance and strength from them. We need to value common needs and purposes collectively to achieve results. Spiritual energy among us is to be harnessed and utilized. Connectivity is to be recognized to unify and strengthen ties among people. Mutual bonding at small and large group levels is to be employed for the survival of the disadvantaged, and sustainability of the empowering trends. With the above guidelines, hopefully, we can define a framework towards a brave and happy new humane world.

Keywords: belief system, connectivity, human empathy, inner-self, mutual bonding, spiritual energy

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3150 Determining the Relationship Between Maternal Stress and Depression and Child Obesity: The Mediating Role of Maternal Self-efficacy

Authors: Alireza Monzavi Chaleshtori, Mahnaz Aliakbari Dehkordi, Maryam Aliakbari, Solmaz Seyed Mostafaii

Abstract:

Objective: Considering the growing obesity among children and the role of mother's psychological factors as well as the need to prevent childhood obesity, this study aimed to investigate the mediating role of mother's self-efficacy in the relationship between mother's stress and depression and child obesity. Method: For this purpose, in a descriptive-correlation study, 222 mothers and children aged 1 to 5 years in Tehran, who had the opportunity to answer an online questionnaire, were selected by random sampling and to the depression scales of the Kroenke and Spitzer Patient Health Questionnaire, Cohen's stress and Self-efficacy of Berkeley mothers answered. Pearson correlation test and path analysis were used for data analysis. Findings: The findings showed that maternal depression had an indirect and significant effect on child obesity, and the effect of stress and depression on child obesity was indirect and non-significant. Therefore, the model has a good fit with the research data, and stress and depression indirectly predicted child obesity with the mediating role of self-efficacy. Conclusion: The hypothesized model tested based on mother's stress and depression with the mediating role of mother's self-efficacy was a good model in explaining the prediction of child obesity. Based on the findings of this research, a practical framework can be provided to explain the psychological factors of the mother in relation to child obesity and its treatment.

Keywords: stress, self-efficacy, child obesity, depression

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3149 Investigating the relationship between Emotional Intelligence of principals in high schools(secondary school principals) and Teachers Conflict Management: A Case Study on secondary schools, Tehran, Iran

Authors: Amir Ahmadi, Hossein Ahmadi, Alireza Ahmadi

Abstract:

Emotional Intelligence (EI) has been defined as the ability to empathize, persevere, control impulses, communicate clearly, make thoughtful decisions, solve problems, and work with others in a way that earns friends and success. These abilities allow an individual to recognize and regulate emotion, develop self-control, set goals, develop empathy, resolve conflicts, and develop skills needed for leadership and effective group participation. Due to the increasing complexity of organizations and different ways of thinking, attitudes and beliefs of individuals, conflict as an important part of organizational life has been examined frequently. The main point is that the conflict is not necessarily in organization, unnecessary; but it can be more creative (increase creativity), to promote innovation. The purpose of this study was to investigate the relation between principals emotional intelligence as one of the factors affecting conflict management among teachers. This relation was analyzed through cluster sampling with a sample size consisting of 120 individuals. The results of the study showed that at the 95% level of confidence, the two secondary hypotheses (i.e. relation between emotional intelligence of principals and use of competition and cooperation strategies of conflict management among teachers) were confirmed, but the other three secondary hypotheses (i.e. the relation between emotional intelligence of managers and use of avoidance, adaptation and adaptability strategies of conflict management among teachers) were rejected. The primary hypothesis (i.e. relation between emotional intelligence of principals with conflict management among teachers) is supported.

Keywords: emotional intelligence, conflict, conflict management, strategies of conflict management

Procedia PDF Downloads 336
3148 Therapeutic Effect of 12 Weeks of Sensorimotor Exercise on Pain, Functionality and Quality of Life in Non-athlete Women With Patellofemoral Pain Syndrome

Authors: Kasbparast Mehdi, Hassani Zainab

Abstract:

Aim: The purpose of this research was to investigate the effectiveness of therapeutical sensorimotor exercise. The statistical population of women who were diagnosed with patellofemoral pain syndrome by a doctor and were between the ages of 35 and 45 and registered for the first time in a sports club in the 4th district of Tehran, 30 people by random sampling and according to The include and exclude criteria were selected and divided into 2 equal control and experimental and homogeneous groups (in terms of height, weight and BMI).In both control and experimental groups, the pain was measured using a Visual Analog Scale(VAS) functionality was measured using the step-down test and quality of life was measured using a World Health Organization Quality of Life Scale (WHOQOL-BREF) (pre-test). Then, only the experimental group performed sensorimotor exercises for 12 weeks and 3 sessions each week, a total of 24 sessions and each session for 1 hour, and during this period, the control group only continued their daily activities. After the end of the training period, the desired factors were evaluated again (post-test) in the same way as the pre-test was done for them (experimental group and control group), with the same quality. Findings: The statistical results showed that in the experimental group, the amount of pain, function and quality of life had a statistical improvement (P≤0.05). Conclusion: In general conclusion, it can be stated that using sensorimotor exercises not only improved functionality and quality of life but also reduced the amount of pain in people with patellofemoral pain syndrome.

Keywords: pain, PFPS, sensori motor training, functionality

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3147 Low-Voltage and Low-Power Bulk-Driven Continuous-Time Current-Mode Differentiator Filters

Authors: Ravi Kiran Jaladi, Ezz I. El-Masry

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Emerging technologies such as ultra-wide band wireless access technology that operate at ultra-low power present several challenges due to their inherent design that limits the use of voltage-mode filters. Therefore, Continuous-time current-mode (CTCM) filters have become very popular in recent times due to the fact they have a wider dynamic range, improved linearity, and extended bandwidth compared to their voltage-mode counterparts. The goal of this research is to develop analog filters which are suitable for the current scaling CMOS technologies. Bulk-driven MOSFET is one of the most popular low power design technique for the existing challenges, while other techniques have obvious shortcomings. In this work, a CTCM Gate-driven (GD) differentiator has been presented with a frequency range from dc to 100MHz which operates at very low supply voltage of 0.7 volts. A novel CTCM Bulk-driven (BD) differentiator has been designed for the first time which reduces the power consumption multiple times that of GD differentiator. These GD and BD differentiator has been simulated using CADENCE TSMC 65nm technology for all the bilinear and biquadratic band-pass frequency responses. These basic building blocks can be used to implement the higher order filters. A 6th order cascade CTCM Chebyshev band-pass filter has been designed using the GD and BD techniques. As a conclusion, a low power GD and BD 6th order chebyshev stagger-tuned band-pass filter was simulated and all the parameters obtained from all the resulting realizations are analyzed and compared. Monte Carlo analysis is performed for both the 6th order filters and the results of sensitivity analysis are presented.

Keywords: bulk-driven (BD), continuous-time current-mode filters (CTCM), gate-driven (GD)

Procedia PDF Downloads 245
3146 In Search for the 'Bilingual Advantage' in Immersion Education

Authors: M. E. Joret, F. Germeys, P. Van de Craen

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Background: Previous studies have shown that ‘full’ bilingualism seems to enhance the executive functions in children, young adults and elderly people. Executive functions refer to a complex cognitive system responsible for self-controlled and planned behavior and seem to predict academic achievement. The present study aimed at investigating whether similar effects could be found in children learning their second language at school in immersion education programs. Methods: In this study, 44 children involved in immersion education for 4 to 5 years were compared to 48 children in traditional schools. All children were between 9 and 11 years old. To assess executive functions, the Simon task was used, a neuropsychological measure assessing executive functions with reaction times and accuracy on congruent and incongruent trials. To control for background measures, all children underwent the Raven’s coloured progressive matrices, to measure non-verbal intelligence and the Echelle de Vocabulaire en Images Peabody (EVIP), assessing verbal intelligence. In addition, a questionnaire was given to the parents to control for other confounding variables, such as socio-economic status (SES), home language, developmental disorders, etc. Results: There were no differences between groups concerning non-verbal intelligence and verbal intelligence. Furthermore, the immersion learners showed overall faster reaction times on both congruent and incongruent trials compared to the traditional learners, but only after 5 years of training, not before. Conclusion: These results show that the cognitive benefits found in ‘full’ bilinguals also appear in children involved in immersion education, but only after a sufficient exposure to the second language. Our results suggest that the amount of second language training needs to be sufficient before these cognitive effects may emerge.

Keywords: bilingualism, executive functions, immersion education, Simon task

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3145 Increased Reaction and Movement Times When Text Messaging during Simulated Driving

Authors: Adriana M. Duquette, Derek P. Bornath

Abstract:

Reaction Time (RT) and Movement Time (MT) are important components of everyday life that have an effect on the way in which we move about our environment. These measures become even more crucial when an event can be caused (or avoided) in a fraction of a second, such as the RT and MT required while driving. The purpose of this study was to develop a more simple method of testing RT and MT during simulated driving with or without text messaging, in a university-aged population (n = 170). In the control condition, a randomly-delayed red light stimulus flashed on a computer interface after the participant began pressing the ‘gas’ pedal on a foot switch mat. Simple RT was defined as the time between the presentation of the light stimulus and the initiation of lifting the foot from the switch mat ‘gas’ pedal; while MT was defined as the time after the initiation of lifting the foot, to the initiation of depressing the switch mat ‘brake’ pedal. In the texting condition, upon pressing the ‘gas’ pedal, a ‘text message’ appeared on the computer interface in a dialog box that the participant typed on their cell phone while waiting for the light stimulus to turn red. In both conditions, the sequence was repeated 10 times, and an average RT (seconds) and average MT (seconds) were recorded. Condition significantly (p = .000) impacted overall RTs, as the texting condition (0.47 s) took longer than the no-texting (control) condition (0.34 s). Longer MTs were also recorded during the texting condition (0.28 s) than in the control condition (0.23 s), p = .001. Overall increases in Response Time (RT + MT) of 189 ms during the texting condition would equate to an additional 4.2 meters (to react to the stimulus and begin braking) if the participant had been driving an automobile at 80 km per hour. In conclusion, increasing task complexity due to the dual-task demand of text messaging during simulated driving caused significant increases in RT (41%), MT (23%) and Response Time (34%), thus further strengthening the mounting evidence against text messaging while driving.

Keywords: simulated driving, text messaging, reaction time, movement time

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3144 Injury Prevention among Construction Workers: A Case Study on Iranian Steel Bar Bending Workers

Authors: S. Behnam Asl, H. Sadeghi Naeini, L. Sadat Ensaniat, R. Khorshidian, S. Alipour, S. Behnam Asl

Abstract:

Nowadays, the construction industry is growing, especially among developing countries. Iran also has a critical role in these industries in terms of workers disorders. Work-related musculoskeletal disorders (WMSDs) account for 7% of the whole diseases in the society, which makes some limitations. One of the main factors which causes WMSDs is awkward posture. Steel bar bending is considered as one of the prominent performance among construction workers. In this case study, we aimed to find the major tasks of bar benders and the most important risk factors related to it. This study was carried out among twenty workers (18-45 years) as our volunteer samples in some construction sites with less than 6 floors in two regions of Tehran municipality. The data was gathered through in depth observation, interview and questionnaire. Also postural analysis was done by OWAS method. In another part of study we used NMQ for gathering some data about psychosocial effects of work related disorders. Our findings show that 64% of workers were not aware of work risks, about 59% of workers had troubles in their wrists, hands, especially workers who worked in steel bar bending. In 46% cases lower back pain was in prevalence. Considering gathered data and results, awkward postures and long term tasks and their duration are known as the main risk factors of WMSDs among construction workers, meaning that work-rest schedule and tools design should be reconsidered to make an ergonomic condition for the mentioned workers.

Keywords: bar benders, construction workers, musculoskeletal disorders (WMSDs), OWAS method

Procedia PDF Downloads 289