Search results for: levels of care
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10409

Search results for: levels of care

3329 Origanum vulgare as a Possible Modulator of Testicular Endocrine Function in Mice

Authors: Eva Tvrdá, Barbora Babečková, Michal Ďuračka, Róbert Kirchner, Július Árvay

Abstract:

This study was designed to assess the in vitro effects of Origanum vulgare L. (oregano) extract on the testicular steroidogenesis. We focused on identifying major biomolecules present in the oregano extract, as well as to investigate its in vitro impact on the secretion of cholesterol, testosterone, dehydroepiandrosterone and androstenedione by murine testicular fragments. The extract was subjected to high performance liquid chromatography (HPLC) which identified cyranosid, daidzein, thymol, rosmarinic and trans-caffeic acid among the predominant biochemical components of oregano. For the in vitro experiments, testicular fragments from 20 sexually mature Institute of Cancer Research (ICR) mice were incubated in the absence (control group) or presence of the oregano extract at selected concentrations (10, 100 and 1000 μg/mL) for 24 h. Cholesterol levels were quantified using photometry and the hormones were assessed by ELISA (Enzyme-Linked Immunosorbent Assay). Our data revealed that the release of cholesterol and androstenedione (but not dehydroepiandrosterone and testosterone) by the testicular fragments was significantly impacted by the oregano extract in a dose-dependent fashion. Supplementation of the extract resulted in a significant decline of cholesterol (P < 0.05 in case of 100 μg/mL; P < 0.01 with respect 100 μg/mL extract), as well as androstenedione (P < 0.01 with respect to 100 and 1000 μg/mL extract). Our results suggest that the biomolecules present in Origanum vulgare L. could exhibit a dose-dependent impact on the secretion of male steroids, playing a role in the regulation of testicular steroidogenesis.

Keywords: mice, Origanum vulgare L., steroidogenesis, testes

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3328 The Effect of Career Decision Self Efficacy on Coping with Career Indecision among Young Adults

Authors: Yuliya Lipshits-Braziler

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For many young adults, career decision making is a difficult and complex process that may lead to indecision. Indecision is frequently associated with great psychological distress and low levels of well-being. One important resource for dealing with indecision is career decision self-efficacy (CDSE), which refers to people’s beliefs about their ability to successfully accomplish certain tasks involved in career choice. Drawing from Social Cognitive Theory, it has been hypothesized that CDSE correlates with (a) people’s likelihood to engage in or avoid career decision making tasks, (b) the amount of effort put into the decision making process, (c) the people’s persistence in decision making efforts when faced with difficulties, and (d) the eventual success in arriving at career decisions. Based on these assumptions, the present study examines the associations between the CDSE and 14 strategies for coping with career indecision among young adults. Using the structural equation modeling (SEM), the results showed that CDSE is positively associated with the use of productive coping strategies, such as information-seeking, problem-solving, positive thinking, and self-regulation. In addition, CDSE was negatively associated with nonproductive coping strategies, such as avoidance, isolation, ruminative thinking, and blaming others. Contrary to our expectations, CDSE was not significantly correlated with instrumental help-seeking, while it was negatively correlated with emotional help-seeking. The results of this study can be used to facilitate the development of interventions aiming to reinforce young adults’ career decision making self-efficacy, which may provide them with a basis for overcoming career indecision more effectively.

Keywords: career decision self-efficacy, career indecision, coping strategies, career counseling

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3327 Extracellular Enzymes as Promising Soil Health Indicators: Assessing Response to Different Land Uses Using Long-Term Experiments

Authors: Munisath Khandoker, Stephan Haefele, Andy Gregory

Abstract:

Extracellular enzymes play a key role in soil organic carbon (SOC) decomposition and nutrient cycling and are known indicators for soil health; however, it is not understood how these enzymes respond to different land uses and their relationships to other soil properties have not been extensively reviewed. The relationships among the activities of three soil enzymes: β-glucosaminidase (NAG), phosphomonoesterase (PHO) and β-glucosidase (GLU), were examined. The impact of soil organic amendments, soil types and land management on soil enzyme activities were reviewed, and it was hypothesized that soils with increased SOC have increased enzyme activity. Long-term experiments at Rothamsted Research Woburn and Harpenden sites in the UK were used to evaluate how different management practices affect enzyme activity involved in carbon (C) and nitrogen (N) cycling in the soil. Samples were collected from soils with different organic treatments such as straw, farmyard manure (FYM), compost additions, cover crops and permanent grass cover to assess whether SOC can be linked with increased levels of enzymatic activity and what influence, if any, enzymatic activity has on total C and N in the soil. Investigating the interactions of important enzymes with soil characteristics and SOC can help to better understand the health of soils. Studies on long-term experiments with known histories and large datasets can better help with this. SOC tends to decrease during land use changes from natural ecosystems to agricultural systems; therefore, it is imperative that agricultural lands find ways to increase and/or maintain SOC in the soil.

Keywords: biological soil health indicators, extracellular enzymes, soil health, soil, microbiology

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3326 Understanding the Linkages of Human Development and Fertility Change in Districts of Uttar Pradesh

Authors: Mamta Rajbhar, Sanjay K. Mohanty

Abstract:

India's progress in achieving replacement level of fertility is largely contingent on fertility reduction in the state of Uttar Pradesh as it accounts 17% of India's population with a low level of development. Though the TFR in the state has declined from 5.1 in 1991 to 3.4 by 2011, it conceals large differences in fertility level across districts. Using data from multiple sources this paper tests the hypothesis that the improvement in human development significantly reduces the fertility levels in districts of Uttar Pradesh. The unit of analyses is district, and fertility estimates are derived using the reverse survival method(RSM) while human development indices(HDI) are are estimated using uniform methodology adopted by UNDP for three period. The correlation and linear regression models are used to examine the relationship of fertility change and human development indices across districts. Result show the large variation and significant change in fertility level among the districts of Uttar Pradesh. During 1991-2011, eight districts had experienced a decline of TFR by 10-20%, 30 districts by 20-30% and 32 districts had experienced decline of more than 30%. On human development aspect, 17 districts recorded increase of more than 0.170 in HDI, 18 districts in the range of 0.150-0.170, 29 districts between 0.125-0.150 and six districts in the range of 0.1-0.125 during 1991-2011. Study shows significant negative relationship between HDI and TFR. HDI alone explains 70% variation in TFR. Also, the regression coefficient of TFR and HDI has become stronger over time; from -0.524 in 1991, -0.7477 by 2001 and -0.7181 by 2010. The regression analyses indicate that 0.1 point increase in HDI value will lead to 0.78 point decline in TFR. The HDI alone explains 70% variation in TFR. Improving the HDI will certainly reduce the fertility level in the districts.

Keywords: Fertility, HDI, Uttar Pradesh

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3325 Role of Activated Partial Thromboplastin Time (APTT) to Assess the Need of Platelet Transfusion in Dengue

Authors: Kalyan Koganti

Abstract:

Background: In India, platelet transfusions are given to large no. of patients suffering from dengue due to the fear of bleeding especially when the platelet counts are low. Though many patients do not bleed when the platelet count falls to less than 20,000, certain patients bleed even if the platelet counts are more than 20,000 without any comorbid condition (like gastrointestinal ulcer) in the past. This fear has led to huge amounts of unnecessary platelet transfusions which cause significant economic burden to low and middle-income countries like India and also sometimes these transfusions end with transfusion-related adverse reactions. Objective: To identify the role of Activated Partial Thromboplastin Time (APTT) in comparison with thrombocytoenia as an indicator to assess the real need of platelet transfusions. Method: A prospective study was conducted at a hospital in South India which included 176 admitted cases of dengue confirmed by immunochromatography. APTT was performed in all these patients along with platelet count. Cut off values of > 60 seconds for APTT and < 20,000 for platelet count were considered to assess the bleeding manifestations. Results: Among the total 176 patients, 56 patients had bleeding manifestations like malena, hematuria, bleeding gums etc. APTT > 60 seconds had a sensitivity and specificity of 93% and 90% respectively in identifying bleeding manifestations where as platelet count of < 20,000 had a sensitivity and specificity of 64% and 73% respectively. Conclusion: Elevated APTT levels can be considered as an indicator to assess the need of platelet transfusion in dengue. As there is a significant variation among patients who bleed with respect to platelet count, APTT can be considered to avoid unnecessary transfusions.

Keywords: activated partial thromboplastin time, dengue, platelet transfusion, thrombocytopenia

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3324 Removal of Heavy Metals by KOH Activated Diplotaxis harra Biomass: Experimental Design Optimization

Authors: H. Tounsadi, A. Khalidi, M. Abdennouri, N. Barka

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The objective of this study was to produce high quality activated carbons from Diplotaxis harra biomass by potassium hydroxide activation and their application for heavy metals removal. To reduce the number of experiments, full factorial experimental design at two levels were carried out to occur optimal preparation conditions and better conditions for the removal of cadmium and cobalt ions from aqueous solutions. The influence of different variables during the activation process, such as carbonization temperature, activation temperature, activation time and impregnation ratio (g KOH/g carbon) have been investigated, and the best production conditions were determined. The experimental results showed that removal of cadmium and cobalt ions onto activated carbons was more sensitive to methylene blue index instead of iodine number. Although, the removal of cadmium and cobalt ions is more influenced by activation temperature with a negative effect followed by the impregnation ratio with a positive impact. Based on the statistical data, the best conditions for the removal of cadmium and cobalt by prepared activated carbons have been established. The maximum iodine number and methylene blue index obtained under these conditions and the greater sorption capacities for cadmium and cobalt were investigated. These sorption capacities were greater than those of a commercial activated carbon used in water treatment.

Keywords: activated carbon, cadmium, cobalt, Diplotaxis harra, experimental design, potassium hydroxide

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3323 Effect of Peganum harmala Seeds on Blood Factors, Immune Response and Intestinal Selected Bacterial Population in Broiler Chickens

Authors: Majid Goudarzi

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This experiment was designed to study the effects of feeding different levels of Peganum harmala seeds (PHS) and antibiotic on serum biochemical parameters, immune response and intestinal microflora composition in Ross broiler chickens. A total of 240 one-d-old unsexed broiler chickens were randomly allocated to each of the four treatment groups, each with four replicate pens of 15 chicks. The dietary treatments included of control (C) - without PHS and antibiotic - the diet contains 300 mg/kg Lincomycin 0.88% (A) and the diets contain 2 g/kg (H1) and 4 g/kg (H2) PHS. The chicks were raised on floor pens and received diets and water ad libitum for six weeks. Blood samplings were performed for the determination of antibody titer against Newcastle disease on 14 and 21 days and for biochemical parameters on 42 days of age. The populations of Lactobacilli spp. and Escherichia coli were enumerated in ileum by conventional microbiological techniques using selective agar media. Inclusion of PHS in diet resulted in a significant decrease in total cholesterol and significant increase in HDL relative to the control and antibiotic groups. Antibody titer against NDV was not affected by experimental treatments. E. coli population in birds supplemented with antibiotic and PHS was significantly lower than control, but Lactobacilli spp. population increased only by antibiotic and not by PHS. In conclusion, the results of this study showed that addition of PHS powder seem to have a positive influence on some biochemical parameters and gastrointestinal microflora.

Keywords: antibiotic, biochemical parameters, immune system, Peganum harmala

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3322 Measurement of Solids Concentration in Hydrocyclone Using ERT: Validation Against CFD

Authors: Vakamalla Teja Reddy, Narasimha Mangadoddy

Abstract:

Hydrocyclones are used to separate particles into different size fractions in the mineral processing, chemical and metallurgical industries. High speed video imaging, Laser Doppler Anemometry (LDA), X-ray and Gamma ray tomography are previously used to measure the two-phase flow characteristics in the cyclone. However, investigation of solids flow characteristics inside the cyclone is often impeded by the nature of the process due to slurry opaqueness and solid metal wall vessels. In this work, a dual-plane high speed Electrical resistance tomography (ERT) is used to measure hydrocyclone internal flow dynamics in situ. Experiments are carried out in 3 inch hydrocyclone for feed solid concentrations varying in the range of 0-50%. ERT data analysis through the optimized FEM mesh size and reconstruction algorithms on air-core and solid concentration tomograms is assessed. Results are presented in terms of the air-core diameter and solids volume fraction contours using Maxwell’s equation for various hydrocyclone operational parameters. It is confirmed by ERT that the air core occupied area and wall solids conductivity levels decreases with increasing the feed solids concentration. Algebraic slip mixture based multi-phase computational fluid dynamics (CFD) model is used to predict the air-core size and the solid concentrations in the hydrocyclone. Validation of air-core size and mean solid volume fractions by ERT measurements with the CFD simulations is attempted.

Keywords: air-core, electrical resistance tomography, hydrocyclone, multi-phase CFD

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3321 A Moroccan Natural Solution for Treating Industrial Effluents: Evaluating the Effectiveness of Using Date Kernel Residues for Purification

Authors: Ahmed Salim, A. El Bouari, M. Tahiri, O. Tanane

Abstract:

This research aims to develop and comprehensively characterize a cost-effective activated carbon derived from date residues, with a focus on optimizing its physicochemical properties to achieve superior performance in a variety of applications. The samples were synthesized via a chemical activation process utilizing phosphoric acid (H₃PO₄) as the activating agent. Activated carbon, produced through this method, functions as a vital adsorbent for the removal of contaminants, with a specific focus on methylene blue, from industrial wastewater. This study meticulously examined the influence of various parameters, including carbonization temperature and duration, on both the combustion properties and adsorption efficiency of the resultant material. Through extensive analysis, the optimal conditions for synthesizing the activated carbon were identified as a carbonization temperature of 600°C and a duration of 2 hours. The activated carbon synthesized under optimized conditions demonstrated an exceptional carbonization yield and methylene blue adsorption efficiency of 99.71%. The produced carbon was subsequently characterized using X-ray diffraction (XRD) analysis. Its effectiveness in the adsorption of methylene blue from contaminated water was then evaluated. A comprehensive assessment of the adsorption capacity was conducted by varying parameters such as carbon dosage, contact time, initial methylene blue concentration, and pH levels.

Keywords: environmental pollution, adsorbent, activated carbon, phosphoric acid, date Kernels, pollutants, adsorption

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3320 Utilizing Computational Fluid Dynamics in the Analysis of Natural Ventilation in Buildings

Authors: A. W. J. Wong, I. H. Ibrahim

Abstract:

Increasing urbanisation has driven building designers to incorporate natural ventilation in the designs of sustainable buildings. This project utilises Computational Fluid Dynamics (CFD) to investigate the natural ventilation of an academic building, SIT@SP, using an assessment criterion based on daily mean temperature and mean velocity. The areas of interest are the pedestrian level of first and fourth levels of the building. A reference case recommended by the Architectural Institute of Japan was used to validate the simulation model. The validated simulation model was then used for coupled simulations on SIT@SP and neighbouring geometries, under two wind speeds. Both steady and transient simulations were used to identify differences in results. Steady and transient results are agreeable with the transient simulation identifying peak velocities during flow development. Under a lower wind speed, the first level was sufficiently ventilated while the fourth level was not. The first level has excessive wind velocities in the higher wind speed and the fourth level was adequately ventilated. Fourth level flow velocity was consistently lower than those of the first level. This is attributed to either simulation model error or poor building design. SIT@SP is concluded to have a sufficiently ventilated first level and insufficiently ventilated fourth level. Future works for this project extend to modifying the urban geometry, simulation model improvements, evaluation using other assessment metrics and extending the area of interest to the entire building.

Keywords: buildings, CFD Simulations, natural ventilation, urban airflow

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3319 Integration and Translation: The Comparison of Religious Rituals of Caodaism in Vietnam and Yi-Kuan-Tao

Authors: Lim Pey Huan

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In the second half of the 19th century, Vietnam has long been influenced by Han culture, so there are many similarities in religion and folk beliefs. Even after the acceptance process of the Catholic Church introduced from Europe is quite similar. Therefore, in the spiritual life of Vietnamese civil society, Confucianism, Buddhism, Taoism, Christianity, Islam, and folk beliefs can be said to be the main trend, but in the twentieth century, two indigenous new religions were born: Caodai and He Hao Jiao, both of which are produced and developed in the south, each of which has millions of believers and become important Vietnamese religions. Their political participation has a major impact on the development of the Republic of Vietnam, and their fate is also in the north and south. Significant changes have taken place after reunification. Caodai was later approved by the colonial authorities and became the third largest religion in Vietnam. The teachings of Caodai teach the ideas of the major religions of the world. The classics used in the teachings also contain important theories of various religions, with particular emphasis on the comprehensiveness of the three sects of Confucianism, Buddhism, and Taoism. The obvious manifestation lies in the interpretation of the important proposition of 'opening the three religions and returning to the five branches.' The full name of Caodaism is 'Da Dao San Qi Pu Du Gao Tai Jiao'. This name coincides with the 'Longhua Club' and the 'San Qi Mo Jie' idea and the consistent central idea. The emerging road of Caodai advocates to lead the sentient beings back to their original missions; the sentient beings will be centered on people, and the nature of the talks is nothing more than the original mission and standard. There are many opinions about the introduction of Caodaism into southern Vietnam. Caodai believers believe that Caodaism is an emerging new religion in Vietnam. If we further explore the teachings and religious rituals of Caodai, it is not difficult to find that many Chinese sects have been introduced to Vietnam. Some of the colors can be discussed from the spread and influence of Congenital Road in Vietnam. This article will present the author's analysis of the actual process of tutoring in Vietnam's Caodai, and then compare it with the consistent religious experience, trying to explore the Yi-Kuan-Tao and consistent Yi-Kuan-Tao rituals, religious organization, religious teachings, religious life care, and Funeral rituals and other comparative studies.

Keywords: Vietnam, Caodaism, Yi-Kuan-Tao, religious rituals

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3318 Effects of Word Formation Dissimilarities on Youruba Learners of English

Authors: Pelumi Olowofoyeku

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English as a language has great reach and influence; it is taught all over the world. For instance, in Nigeria, English language is been taught and learned as a second language; therefore second learners of English in Nigeria have certain problems they contend with. Because of the dissimilarities in word formation patterns of English and Yoruba languages, Yoruba learners of English mostly found in the south west of Nigeria, and some parts of Kwara, Kogi, and Edo states of Nigeria have problems with word formation patterns in English. The objectives of this paper therefore, are: to identify the levels of word formation dissimilarities in English and Yoruba languages and to examine the effects of these dissimilarities on the Yoruba learners of English. The data for this paper were graded words purposely selected and presented to selected students of Adeniran Ogunsanya College of Education, Oto-Ijanikin, Lagos, who are Yoruba learners of English. These respondents were randomly selected to form words which are purposively selected to test the effects of word formation dissimilarities between Yoruba (the respondent’s first language) and English language on the respondents. The dissimilarities are examined using contrastive analysis tools. This paper reveals that there are differences in the word formation patterns of Yoruba and English languages. The writer believes that there is need for language teachers to undertake comparative studies of the two languages involved for methodological reasons. The author then suggests that teachers should identify the problem areas and systematically teach their students. The paper concludes that although English and Yoruba word formation patterns differ very significantly in many respects, there exist language universals in all languages which language educators should take advantage of in teaching.

Keywords: word formation patterns, graded words, ESL, Yoruba learners

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3317 Fight the Burnout: Phase Two of a NICU Nurse Wellness Bundle

Authors: Megan Weisbart

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Background/Significance: The Intensive Care Unit (ICU) environment contributes to nurse burnout. Burnout costs include decreased employee compassion, missed workdays, worse patient outcomes, diminished job performance, high turnover, and higher organizational cost. Meaningful recognition, nurturing of interpersonal connections, and mindfulness-based interventions are associated with decreased burnout. The purpose of this quality improvement project was to decrease Neonatal ICU (NICU) nurse burnout using a Wellness Bundle that fosters meaningful recognition, interpersonal connections and includes mindfulness-based interventions. Methods: The Professional Quality of Life Scale Version 5 (ProQOL5) was used to measure burnout before Wellness Bundle implementation, after six months, and will be given yearly for three years. Meaningful recognition bundle items include Online submission and posting of staff shoutouts, recognition events, Nurses Week and Unit Practice Council member gifts, and an employee recognition program. Fostering of interpersonal connections bundle items include: Monthly staff games with prizes, social events, raffle fundraisers, unit blog, unit wellness basket, and a wellness resource sheet. Quick coherence techniques were implemented at staff meetings and huddles as a mindfulness-based intervention. Findings: The mean baseline burnout score of 14 NICU nurses was 20.71 (low burnout). The baseline range was 13-28, with 11 nurses experiencing low burnout, three nurses experiencing moderate burnout, and zero nurses experiencing high burnout. After six months of the Wellness Bundle Implementation, the mean burnout score of 39 NICU nurses was 22.28 (low burnout). The range was 14-31, with 22 nurses experiencing low burnout, 17 nurses experiencing moderate burnout, and zero nurses experiencing high burnout. Conclusion: A NICU Wellness Bundle that incorporated meaningful recognition, fostering of interpersonal connections, and mindfulness-based activities was implemented to improve work environments and decrease nurse burnout. Participation bias and low baseline response rate may have affected the reliability of the data and necessitate another comparative measure of burnout in one year.

Keywords: burnout, NICU, nurse, wellness

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3316 Traditional Women's Clothes at Tekirdağ Region

Authors: E. Elhan Özus, Melek Tufan, Filiz Erden

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Cloth is a special wearing style of a society for a period or of a profession. Clothes reflect the social status difference than the fashion. Within this context, society forms a wearing style in the direction of its customs, usage, traditions and social structure. One of the properties of a society indicating the social levels and cultural differences differing the societies from each other is clothing style. Clothing is one of the most important needs in life depending on the individual and social attributes. The clothing which first emerged as protection means is a social fact complementing the physical and psychological existence of human being, changing forms depending on technological developments and phases, and continuously changing under the affect of fashion today. Clothing is an aesthetic value fed by the feelings of individuals. So, clothing has an indispensable place in the structure and communication of cultural and social identity within this direction. The traditional Turkish clothing has a rich ethnography. It is also possible to see the winds coming from our predecessors in these cultural assets reflecting the feelings and thoughts of Anatolian women. When the long history of our nation and the cultures interacted by our nation are taken into account, it is seen that the magnificence of our nation has also reflected into the clothing culture.For this reason, we tried to keep the traditional women’s clothing of Tekirdağ region alive by investigating and documenting them. In this study, it is purposed to contribute a little bit to protect our culture and form a source for the future generations, to carry our national cultural values from the past up to now and to the future and deliver to the young people.

Keywords: Turkish, traditional, culture, clothing

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3315 The Impact of One Session of Kumite Training, Speed Kata and Strength Kata on the Rate of Viscosity, Fibrinogen and Plasma Lipid Profile in Young Karate Player Women

Authors: Miesam Golzadeh Gangraj, Abbas Ganbari Niaki, Lila Bahrami

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The main aim of this study is to investigate the effect of one session of Karate training (Kumite, speed Kata and strength Kata) on viscosity, fibrinogen and plasma lipid profile in young Karate player women. To this end, 40 individuals with required condition were selected and randomly placed in four groups. 10 mL forearm venous blood was taken before and immediately after a session of training for measuring variables. Data were analyzed using statistical methods (covariance, by consideration of group factor) and Bonfferoni post hoc test and the significant difference was determined in P ≤ 0.05. The variation of plasma fibrinogen concentration was not meaningful. The variation of plasma viscosity concentration was not meaningful in groups and between groups. The variation of cortisol concentration was meaningful before and after and between control and experimental groups; however, no difference was observed between three experimental groups. The variation of complete cholesterol, neither tri-glyceride nor intense lipoprotein, was meaningful and significant difference was just seen between control and Kumite groups. The results show that despite meaningful changes in fibrinogen levels, plasma viscosity has not been much affected that might be due to lack of variation in other effective variables such as TG, HDL and hematocrit. Based on the results of present study, it seems that the use of speed Kata seems to be more appropriate to increase the performance of Karate player than strength Karate.

Keywords: female karate player, viscosity, fibrinogen, cortisol, lactate di-dehydrogenase

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3314 Reflections of Nocturnal Librarian: Attaining a Work-Life Balance in a Mega-City of Lagos State Nigeria

Authors: Oluwole Durodolu

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The rationale for this study is to explore the adaptive strategy that librarians adopt in performing night shifts in a mega-city like Lagos state. Maslach Burnout Theory would be used to measure the three proportions of burnout in understanding emotional exhaustion, depersonalisation, and individual accomplishment to scrutinise job-related burnout syndrome allied with longstanding, unsolved stress. The qualitative methodology guided by a phenomenological research paradigm, which is an approach that focuses on the commonality of real-life experience in a particular group, would be used, focus group discussion adopted as a method of data collection from library staff who are involved in night-shift. The participant for the focus group discussion would be selected using a convenience sampling technique in which staff at the cataloguing unit would be included in the sample because of the representative characteristics of the unit. This would be done to enable readers to understand phenomena as it is reasonable than from a remote perspective. The exploratory interviews which will be in focus group method to shed light on issues relating to security, housing, transportation, budgeting, energy supply, employee duties, time management, information access, and sustaining professional levels of service and how all these variables affect the productivity of all the 149 library staff and their work-life balance.

Keywords: nightshift, work-life balance, mega-city, academic library, Maslach Burnout Theory, Lagos State, University of Lagos

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3313 The Inhibitory Effect of Riceberry Rice Extract on Acetylcholinesterase Activity

Authors: Yaiprae Chatree, Tawan Chaiwon, Rodjana Chunhabundit, Kritsana Piriyawatcharakon, Waralai Ratwiset, Sasiwimol Chaiya

Abstract:

The world is facing a serious situation of aging society. Elderly may have many physical health problems due to degenerative diseases including Alzheimer’s disease. Riceberry rice relatively contain high levels of carbohydrate, vitamin E, -oryzanol, and also abundant of bioactive compound of anthocyanin. This study aimed to determine the inhibitory effect of Riceberry rice crude extract on acetylcholinesterase activity. The active compound was extracted by using 70% ethanol (v/v). The inhibitory effect of Riceberry rice on acetylcholinesterase was evaluated by using slightly modified method of Ellman’s method. The 120 seconds time interval of kinetics measurement showed that Riceberry rice extract at concentrations of 2.5-12.5 mg/ml presented the acetylcholinesterase inhibitory activity at the statistically significant difference at p  0.05 compared to control group over 60 -120 seconds. At the concentrations of 10 and 12.5 mg/ml of Riceberry rice extract expressed the high percentage of inhibitory activity of 50.86 and 71.22%, respectively. The half maximal inhibitory concentration (IC50) of acetylcholinesterase inhibitory activity of Riceberry rice extract; considered to the end point, was found at concentration of 9.34 mg/ml. The physostigmine (positive control); however, showed a higher inhibitory capacity than that of Riceberry rice extract. The inhibitory activity of the positive control group was around at 80.40 – 90.41%. In conclusion, the results of this study indicated that Riceberry rice extract possessed the inhibitory capacity of acetylcholinesterase activity. Moreover, at the concentrations of 12.5 mg/ml it showed the identical inhibitory effect with physostigmine group. The Riceberry rice extract might be able to alleviate the clinical manifestations of Alzheimer’s disease.

Keywords: acetylcholine, acetylcholinesterase, Alzheimer's disease, riceberry rice

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3312 Neonatal Subcutaneous Fat Necrosis with Severe Hypercalcemia: Case Report

Authors: Atitallah Sofien, Bouyahia Olfa, Krifi farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Subcutaneous fat necrosis of the newborn (SCFN) is a rare acute hypodermatitis characterized by skin lesions in the form of infiltrated, hard plaques and subcutaneous nodules, with a purplish-red color, occurring between the first and sixth week of life. SCFN is generally a benign condition that spontaneously regresses without sequelae, but it can be complicated by severe hypercalcemia. Methodology: This is a retrospective case report of neonatal subcutaneous fat necrosis complicated with severe hypercalcemia and nephrocalcinosis. Results: This is a case of a female newborn with a family history of a hypothyroid mother on Levothyrox, born to non-consanguineous parents and from a well-monitored pregnancy. The newborn was delivered by cesarean section at 39 weeks gestation due to severe preeclampsia. She was admitted to the Neonatal Intensive Care Unit at 1 hour of life for the management of grade 1 perinatal asphyxia and immediate neonatal respiratory distress related to transient respiratory distress. Hospitalization was complicated by a healthcare-associated infection, requiring intravenous antibiotics for ten days, with a good clinical and biological response. On the 20th day of life, she developed skin lesions in the form of indurated purplish-red nodules on the back and on both arms. A SCFN was suspected. A calcium level test was conducted, which returned a result of 3 mmol/L. The rest of the phosphocalcic assessment was normal, with early signs of nephrocalcinosis observed on renal ultrasound. The diagnosis of SCFN complicated by nephrocalcinosis associated with severe hypercalcemia was made, and the condition improved with intravenous hydration and corticosteroid therapy. Conclusion: SCFN is a rare and generally benign hypodermatitis in newborns with an etiology that is still poorly understood. Despite its benign nature, SCFN can be complicated by hypercalcemia, which can sometimes be life-threatening. Therefore, it is important to conduct a thorough skin examination of newborns, especially those with risk factors, to detect and correct any potential hypercalcemia.

Keywords: subcutaneous fat necrosis, newborn, hypercalcemia, nephrocalcinosis

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3311 Significance of Water Saving through Subsurface Drip Irrigation for Date Palm Trees

Authors: Ahmed I. Al-Amoud

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A laboratory and field study were conducted on subsurface drip irrigation systems. In the first laboratory study, eight subsurface drip irrigation lines available locally, were selected and a number of experiments were made to evaluate line hydraulic characteristics to insure it's suitability for drip irrigation design requirements and high performance to select the best for field experiments. The second study involves field trials on mature date palm trees to study the effect of subsurface drip irrigation system on the yield and water consumption of date palms, and to compare that with the traditional surface drip irrigation system. Experiments were conducted in Alwatania Agricultural Project, on 50 mature palm trees (17 years old) of Helwa type with 10 meters spacing between rows and between trees. A high efficiency subsurface line (Techline) was used based on the results of the first study. Irrigation scheduling was made through a soil moisture sensing device to ensure enough soil water levels in the soil. Experiment layouts were installed during 2001 season, measurements continued till end of 2008 season. Results have indicated that there is an increase in the yield and a considerable saving in water compared to the conventional drip irrigation method. In addition there were high increases in water use efficiency using the subsurface system. The subsurface system proves to be durable and highly efficient for irrigating date palm trees.

Keywords: drip irrigation, subsurface drip irrigation, date palm trees, date palm water use, date palm yield

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3310 Efficacy Of Tranexamic Acid On Blood Loss After Primary Total Hip Replacement : A Case-control Study In 154 Patients

Authors: Fedili Benamar, Belloulou Mohamed Lamine, Ouahes Hassane, Ghattas Samir

Abstract:

Introduction: Perioperative blood loss is a frequent cause of complications in total hip replacement (THR). The present prospective study assessed the efficacy of tranexamic acid (Exacyl(®)) in reducing blood loss in primary THR. Hypothesis: Tranexamic acid reduces blood loss in THR. Material and method: -This is a prospective randomized study on the effectiveness of Exacyl (tranexamic acid) in total hip replacement surgery performed on a standardized technique between 2019 and September 2022. -It involved 154 patients, of which 84 received a single injection of Exacyl (group 1) at a dosage of 10 mg/kg over 20 minutes during the perioperative period. -All patients received postoperative thromboprophylaxis with enoxaparin 0.4 ml subcutaneously. -All patients were admitted to the post-interventional intensive care unit for a duration of 24 hours for monitoring and pain management as per the service protocol. Results: 154 patients, of which 84 received a single injection of Exacyl (group 1) and 70 patients patients who did not receive Exacyl perioperatively : (Group 2 ) The average age is 57 +/- 15 years The distribution by gender was nearly equal with 56% male and 44% female; "The distribution according to the ASA score was as follows: 20.2% ASA1, 82.3% ASA2, and 17.5% ASA3. "There was a significant difference in the average volume of intraoperative and postoperative bleeding during the 48 hours." The average bleeding volume for group 1 (received Exacyl) was 614 ml +/- 228, while the average bleeding volume for group 2 was 729 +/- 300, with a chi-square test of 6.35 and a p-value < 0.01, which is highly significant. The ANOVA test showed an F-statistic of 7.11 and a p-value of 0.008. A Bartlett test revealed a chi-square of 6.35 and a p-value < 0.01." "In Group 1 (patients who received Exacyl), 73% had bleeding less than 750 ml (Group A), and 26% had bleeding exceeding 750 ml (Group B). In Group 2 (patients who did not receive Exacyl perioperatively), 52% had bleeding less than 750 ml (Group A), and 47% had bleeding exceeding 750 ml (Group B). "Thus, the use of Exacyl reduced perioperative bleeding and specifically decreased the risk of severe bleeding exceeding 750 ml by 43% with a relative risk (RR) of 1.37 and a p-value < 0.01. The transfusion rate was 1.19% in the population of Group 1 (Exacyl), whereas it was 10% in the population of Group 2 (no Exacyl). It can be stated that the use of Exacyl resulted in a reduction in perioperative blood transfusion with an RR of 0.1 and a p-value of 0.02. Conclusions: The use of Exacyl significantly reduced perioperative bleeding in this type of surgery.

Keywords: acid tranexamic, blood loss, anesthesia, total hip replacement, surgery

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3309 Pregnant Women with Dental Amalgam Fillings Limiting Their Exposure to Electromagnetic Fields to Prevent the Toxic Effects of Mercury in Their Fetuses

Authors: Ghazal Mortazavi, S. M. J. Mortazavi

Abstract:

Although seems to be ultra-conservative, it has recently been suggested that whenever it is possible, pregnant women should postpone dental amalgam restorations to avoid the toxic effect of mercury on the foetus. Dental amalgam fillings cause significant exposure to elemental mercury vapour in the general population. Over the past several years, our lab has focused on the health effects of exposure of laboratory animals and humans to different sources of electromagnetic fields such as mobile phones and their base stations, mobile phone jammers, laptop computers, radars, dentistry cavitrons and MRI. Today, substantial evidence indicates that mercury even at low doses may lead to toxicity. Increased release of mercury from dental amalgam fillings after exposure to MRI or microwave radiation emitted by mobile phones has been previously shown by our team. Moreover, our recent studies on the effects of stronger magnetic fields entirely confirmed our previous findings. From the other point of view, we have also shown that papers which reported no increased release of mercury after MRI, may have some methodological flaws. As a strong positive correlation between maternal and cord blood mercury levels has been found in some studies, our findings regarding the effect of exposure to electromagnetic fields on the release of mercury from dental amalgam fillings lead us to this conclusion that pregnant women with dental amalgam fillings should limit their exposure to electromagnetic fields to prevent toxic effects of mercury in their foetuses.

Keywords: pregnancy, foetus, mercury release, dental amalgam, electromagnetic fields, MRI, mobile phones

Procedia PDF Downloads 264
3308 Factors Affecting Residential Satisfaction in Low-Income Housing: Case Study of War College Housing in Gwarinpa Estate-Abuja, Nigeria

Authors: Abdulmajeed Mustapha, Murat Sahin, Ebru Karahan

Abstract:

Low-income housing for poor people in urban areas is a global challenge, especially in developing countries. The quality of construction of mass housing is oftentimes compromised, thus resulting in a housing deficit, thereby affecting the residential satisfaction of users. This research analyses the various factors affecting residential satisfaction in War College Housing Estate, Abuja, Nigeria. These were investigated using parameters such as environmental characteristics and public amenities such as public benefits, safety/security, and sociodemographic characteristics. The study adopted a quantitative approach for the data gathering through literature reviews within the topic’s scope. The survey was conducted between April to May 2021 using a questionnaire form that was distributed to household members, onsite analysis within the selected housing project, and interviews with a few professionals within the field of this research. Data gathered from the survey and analysis on housing and sociodemographic characteristics, amongst others, were acquired through the means of interviews and site surveys of the selected Housing Estate. Findings from the various characteristics determining satisfaction revealed that residents had varying levels of satisfaction, ranging from a scale of satisfied to dissatisfied. It is recommended that the government come up with policies that will not only make the environment clean and safe but also make sure that the needs of the people who live there are taken into account. This will help the people who live there be more satisfied with their homes.

Keywords: residential satisfaction, neighborhood satisfaction, low-income housing, socio-demographic characteristics, Nigeria

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3307 Management of Acute Biliary Pathology at Gozo General Hospital

Authors: Kristian Bugeja, Upeshala A. Jayawardena, Clarissa Fenech, Mark Zammit Vincenti

Abstract:

Introduction: Biliary colic, acute cholecystitis, and gallstone pancreatitis are some of the most common surgical presentations at Gozo General Hospital (GGH). National Institute for Health and Care Excellence (NICE) guidelines advise that suitable patients with acute biliary problems should be offered a laparoscopic cholecystectomy within one week of diagnosis. There has traditionally been difficulty in achieving this mainly due to the reluctance of some surgeons to operate in the acute setting, limited, timely access to MRCP and ERCP, and organizational issues. Methodology: A retrospective study was performed involving all biliary pathology-related admissions to GGH during the two-year period of 2019 and 2020. Patients’ files and electronic case summary (ECS) were used for data collection, which included demographic data, primary diagnosis, co-morbidities, management, waiting time to surgery, length of stay, readmissions, and reason for readmissions. NICE clinical guidance 188 – Gallstone disease were used as the standard. Results: 51 patients were included in the study. The mean age was 58 years, and 35 (68.6%) were female. The main diagnoses on admission were biliary colic in 31 (60.8%), acute cholecystitis in 10 (19.6%). Others included gallstone pancreatitis in 3 (5.89%), chronic cholecystitis in 2 (3.92%), gall bladder malignancy in 4 (7.84%), and ascending cholangitis in 1 (1.97%). Management included laparoscopic cholecystectomy in 34 (66.7%); conservative in 8 (15.7%) and ERCP in 6 (11.7%). The mean waiting time for laparoscopic cholecystectomy for patients with acute cholecystitis was 74 days – range being between 3 and 146 days since the date of diagnosis. Only one patient who was diagnosed with acute cholecystitis and managed with laparoscopic cholecystectomy was done so within the 7-day time frame. Hospital re-admissions were reported in 5 patients (9.8%) due to vomiting (1), ascending cholangitis (1), and gallstone pancreatitis (3). Discussion: Guidelines were not met for patients presenting to Gozo General Hospital with acute biliary pathology. This resulted in 5 patients being re-admitted to hospital while waiting for definitive surgery. The local issues resulting in the delay to surgery need to be identified and steps are taken to facilitate the provision of urgent cholecystectomy for suitable patients.

Keywords: biliary colic, acute cholecystits, laparoscopic cholecystectomy, conservative management

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3306 Dynamic Ambulance Deployment to Reduce Ambulance Response Times Using Geographic Information Systems

Authors: Masoud Swalehe, Semra Günay

Abstract:

Developed countries are losing many lives to non-communicable diseases as compared to their developing counterparts. The effects of these diseases are mostly sudden and manifest at a very short time prior to death or a dangerous attack and this has consolidated the significance of emergency medical system (EMS) as one of the vital areas of healthcare service delivery. The primary objective of this research is to reduce ambulance response times (RT) of Eskişehir province EMS since a number of studies have established a relationship between ambulance response times and survival chances of patients especially out of hospital cardiac arrest (OHCA) victims. It has been found out that patients who receive out of hospital medical attention in few (4) minutes after cardiac arrest because of low ambulance response times stand higher chances of survival than their counterparts who take longer times (more than 12 minutes) to receive out of hospital medical care because of higher ambulance response times. The study will make use of geographic information systems (GIS) technology to dynamically reallocate ambulance resources according to demand and time so as to reduce ambulance response times. Geospatial-time distribution of ambulance calls (demand) will be used as a basis for optimal ambulance deployment using system status management (SSM) strategy to achieve much demand coverage with the same number of ambulance resources to cause response time reduction. Drive-time polygons will be used to come up with time specific facility coverage areas and suggesting additional facility candidate sites where ambulance resources can be moved to serve higher demands making use of network analysis techniques. Emergency Ambulance calls’ data from 1st January 2014 to 31st December 2014 obtained from Eskişehir province health directorate will be used in this study. This study will focus on the reduction of ambulance response times which is a key Emergency Medical Services performance indicator.

Keywords: emergency medical services, system status management, ambulance response times, geographic information system, geospatial-time distribution, out of hospital cardiac arrest

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3305 A Questionnaire-Based Survey: Therapists Response towards Upper Limb Disorder Learning Tool

Authors: Noor Ayuni Che Zakaria, Takashi Komeda, Cheng Yee Low, Kaoru Inoue, Fazah Akhtar Hanapiah

Abstract:

Previous studies have shown that there are arguments regarding the reliability and validity of the Ashworth and Modified Ashworth Scale towards evaluating patients diagnosed with upper limb disorders. These evaluations depended on the raters’ experiences. This initiated us to develop an upper limb disorder part-task trainer that is able to simulate consistent upper limb disorders, such as spasticity and rigidity signs, based on the Modified Ashworth Scale to improve the variability occurring between raters and intra-raters themselves. By providing consistent signs, novice therapists would be able to increase training frequency and exposure towards various levels of signs. A total of 22 physiotherapists and occupational therapists participated in the study. The majority of the therapists agreed that with current therapy education, they still face problems with inter-raters and intra-raters variability (strongly agree 54%; n = 12/22, agree 27%; n = 6/22) in evaluating patients’ conditions. The therapists strongly agreed (72%; n = 16/22) that therapy trainees needed to increase their frequency of training; therefore believe that our initiative to develop an upper limb disorder training tool will help in improving the clinical education field (strongly agree and agree 63%; n = 14/22).

Keywords: upper limb disorder, clinical education tool, inter/intra-raters variability, spasticity, modified Ashworth scale

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3304 PM10 Chemical Characteristics in a Background Site at the Universidad Libre Bogotá

Authors: Laura X. Martinez, Andrés F. Rodríguez, Ruth A. Catacoli

Abstract:

One of the most important factors for air pollution is that the concentrations of PM10 maintain a constant trend, with the exception of some places where that frequently surpasses the allowed ranges established by Colombian legislation. The community that surrounds the Universidad Libre Bogotá is inhabited by a considerable number of students and workers, all of whom are possibly being exposed to PM10 for long periods of time while on campus. Thus, the chemical characterization of PM10 found in the ambient air at the Universidad Libre Bogotá was identified as a problem. A Hi-Vol sampler and EPA Test Method 5 were used to determine if the quality of air is adequate for the human respiratory system. Additionally, quartz fiber filters were utilized during sampling. Samples were taken three days a week during a dry period throughout the months of November and December 2015. The gravimetric analysis method was used to determine PM10 concentrations. The chemical characterization includes non-conventional carcinogenic pollutants. Atomic absorption spectrophotometry (AAS) was used for the determination of metals and VOCs were analyzed using the FTIR (Fourier transform infrared spectroscopy) method. In this way, concentrations of PM10, ranging from values of 13 µg/m3 to 66 µg/m3, were obtained; these values were below standard conditions. This evidence concludes that the PM10 concentrations during an exposure period of 24 hours are lower than the values established by Colombian law, Resolution 610 of 2010; however, when comparing these with the limits set by the World Health Organization (WHO), these concentrations could possibly exceed permissible levels.

Keywords: air quality, atomic absorption spectrophotometry, gas chromatography, particulate matter

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3303 Informal Land Subdivision and Its Implications for Infrastructural Development in Kano Metropolis, Nigeria

Authors: A. A. Yakub, Omavudu Ikogho

Abstract:

Land subdivision in most peri-urban areas of Kano metropolis is the entrenched prerogative of ‘KAFADA’ a group of informal plot partitioners who oversee the demarcation of mainly previous farmland into residential plots popularly called 'awon igiya' for those in need. With time these areas are engulfed in the milieu of the rapidly expanding urban landscape and form clusters of poorly planned settlements with tendencies to become future slums. This paper studies the practice of informal land subdivision in Kano metropolis with emphasis on the practitioners, the institutional framework, and the demand and supply scenario that sustains this trend as well as the extent of infrastructural development in these areas. Using three selected informally planned settlements as case-studies, a series of interviews and questionnaires are administered to 'KAFADA,' residents and the state land officers to generate data in these areas. Another set of data was similarly generated in three government subdivided residential layouts, and both sets analysed comparatively. The findings identify varying levels of infrastructural deficits in the informal communities compared to the planned neighbourhoods which are seen to be as a result of the absence of government participation and an informal subdivision process which did not provide for proper planning standards. This study recommends that the regulatory agencies concerned register and partner with KAFADA to ensure that minimal planning standards are maintained in future settlements.

Keywords: peri-urban, informal land markets, land subdivision, infrastructure

Procedia PDF Downloads 263
3302 A Deep Learning Approach to Online Social Network Account Compromisation

Authors: Edward K. Boahen, Brunel E. Bouya-Moko, Changda Wang

Abstract:

The major threat to online social network (OSN) users is account compromisation. Spammers now spread malicious messages by exploiting the trust relationship established between account owners and their friends. The challenge in detecting a compromised account by service providers is validating the trusted relationship established between the account owners, their friends, and the spammers. Another challenge is the increase in required human interaction with the feature selection. Research available on supervised learning (machine learning) has limitations with the feature selection and accounts that cannot be profiled, like application programming interface (API). Therefore, this paper discusses the various behaviours of the OSN users and the current approaches in detecting a compromised OSN account, emphasizing its limitations and challenges. We propose a deep learning approach that addresses and resolve the constraints faced by the previous schemes. We detailed our proposed optimized nonsymmetric deep auto-encoder (OPT_NDAE) for unsupervised feature learning, which reduces the required human interaction levels in the selection and extraction of features. We evaluated our proposed classifier using the NSL-KDD and KDDCUP'99 datasets in a graphical user interface enabled Weka application. The results obtained indicate that our proposed approach outperformed most of the traditional schemes in OSN compromised account detection with an accuracy rate of 99.86%.

Keywords: computer security, network security, online social network, account compromisation

Procedia PDF Downloads 101
3301 Double Functionalization of Magnetic Colloids with Electroactive Molecules and Antibody for Platelet Detection and Separation

Authors: Feixiong Chen, Naoufel Haddour, Marie Frenea-Robin, Yves MéRieux, Yann Chevolot, Virginie Monnier

Abstract:

Neonatal thrombopenia occurs when the mother generates antibodies against her baby’s platelet antigens. It is particularly critical for newborns because it can cause coagulation troubles leading to intracranial hemorrhage. In this case, diagnosis must be done quickly to make platelets transfusion immediately after birth. Before transfusion, platelet antigens must be tested carefully to avoid rejection. The majority of thrombopenia (95 %) are caused by antibodies directed against Human Platelet Antigen 1a (HPA-1a) or 5b (HPA-5b). The common method for antigen platelets detection is polymerase chain reaction allowing for identification of gene sequence. However, it is expensive, time-consuming and requires significant blood volume which is not suitable for newborns. We propose to develop a point-of-care device based on double functionalized magnetic colloids with 1) antibodies specific to antigen platelets and 2) highly sensitive electroactive molecules in order to be detected by an electrochemical microsensor. These magnetic colloids will be used first to isolate platelets from other blood components, then to capture specifically platelets bearing HPA-1a and HPA-5b antigens and finally to attract them close to sensor working electrode for improved electrochemical signal. The expected advantages are an assay time lower than 20 min starting from blood volume smaller than 100 µL. Our functionalization procedure based on amine dendrimers and NHS-ester modification of initial carboxyl colloids will be presented. Functionalization efficiency was evaluated by colorimetric titration of surface chemical groups, zeta potential measurements, infrared spectroscopy, fluorescence scanning and cyclic voltammetry. Our results showed that electroactive molecules and antibodies can be immobilized successfully onto magnetic colloids. Application of a magnetic field onto working electrode increased the detected electrochemical signal. Magnetic colloids were able to capture specific purified antigens extracted from platelets.

Keywords: Magnetic Nanoparticles , Electroactive Molecules, Antibody, Platelet

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3300 Maternal Nutrition Supplementation for Improving Progress and Outcome of Pregnancy in a Tribal Block of Maharashtra

Authors: Rajnish Gourh, Nitesh Sharma, Nikhil Patil

Abstract:

Introduction: Adequate nutrition is essential for improving pregnancy and its outcomes. Failure to comply with the required daily intake of nutrition can lead to complications threatening both mother and child survival. Objectives: To provide access to nutritious diet to mothers in antenatal and post-natal stage for supporting a healthy progressive pregnancy, positive delivery outcome, and lactation and to promote regular consumption of the foods by the mothers and help overcome the dietary gap by nutrition education during pregnancy time. Methodology: Total of 95 ANC mothers were identified from Malvada PHC area, in Palghar district of Maharashtra. This short-term cohort intended for the proposed supplementation and education was targeted for follow-up until birth and six-months of post-natal period. In month of May 2016 to June 2017. Results: Average weight of women was observed 40.01kg, (SD- 5.024) at registered for ANC at Centre in the first month. In same month, average Haemoglobin level of women was observed 9.13gm/dl. Average increase in weight of women during pregnancy in month October 2016 was 48.83kg. Birth weight of 14 babies was less than 2 kgs. 13 babies with birth weight in range of 2.1kgs to 2.4kgs. 68 babies with birth weight in range of 2.5kg to 3kg and above. Conclusion: Importance of consumption of food, improving levels of nutrient intake and outcome of delivery was excellent.

Keywords: delivery status, nutrition, pregnancy, education

Procedia PDF Downloads 153