Search results for: disability-adaptive assist
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1079

Search results for: disability-adaptive assist

149 Comparison of the Yumul Faces Anxiety Scale to the Categorization Scale, the Numerical Verbal Rating Scale, and the State-Trait Anxiety Inventory for Preoperative Anxiety Evaluation

Authors: Ofelia Loani Elvir Lazo, Roya Yumul, David Chernobylsky, Omar Durra

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Background: It is crucial to detect the patient’s existing anxiety to assist patients in a perioperative setting which is to be caused by the fear associated with surgical and anesthetic complications. However, the current gold standard for assessing patient anxiety, the STAI, is problematic to use in the preoperative setting, given the duration and concentration required to complete the 40-item questionnaire. Our primary aim in the study is to investigate the correlation of the Yumul Visual Facial Anxiety Scale (VFAS) and Numerical Verbal Rating Scale (NVRS) to State-Trait Anxiety Inventory (STAI) to determine the optimal anxiety scale to use in the perioperative setting. Methods: A clinical study of patients undergoing various surgeries was conducted utilizing each of the preoperative anxiety scales. Inclusion criteria included patients undergoing elective surgeries, while exclusion criteria included patients with anesthesia contraindications, inability to comprehend instructions, impaired judgement, substance abuse history, and those pregnant or lactating. 293 patients were analyzed in terms of demographics, anxiety scale survey results, and anesthesia data via Spearman Coefficients, Chi-Squared Analysis, and Fischer’s exact test utilized for comparative analysis. Results: Statistical analysis showed that VFAS had a higher correlation to STAI than NVRS (rs=0.66, p<0.0001 vs. rs=0.64, p<0.0001). The combined VFAS-Categorization Scores showed the highest correlation with the gold standard (rs=0.72, p<0.0001). Subgroup analysis showed similar results. STAI evaluation time (247.7 ± 54.81 sec) far exceeds VFAS (7.29 ± 1.61 sec), NVRS (7.23 ± 1.60 sec), and Categorization scales (7.29 ± 1.99 sec). Patients preferred VFAS (54.4%), Categorization (11.6%), and NVRS (8.8%). Anesthesiologists preferred VFAS (63.9%), NVRS (22.1%), and Categorization Scales (14.0%). Of note, the top five causes of preoperative anxiety were determined to be waiting (56.5%), pain (42.5%), family concerns (40.5%), no information about surgery (40.1%), or anesthesia (31.6%). Conclusıons: Both VFAS and Categorization tests also take significantly less time than STAI, which is critical in the preoperative setting. Combined VFAS-Categorization Score (VCS) demonstrates the highest correlation to the gold standard, STAI. Among both patients and anesthesiologists, VFAS was the most preferred scale. This forms the basis of the Yumul Faces Anxiety Scale, designed for quick quantization and assessment in the preoperative setting while maintaining a high correlation to the golden standard. Additional studies using the formulated Yumul Faces Anxiety Scale are merited.

Keywords: numerical verbal anxiety scale, preoperative anxiety, state-trait anxiety inventory, visual facial anxiety scale

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148 An Empirical Analysis of Farmers Field Schools and Effect on Tomato Productivity in District Malakand Khyber Pakhtunkhwa-Pakistan

Authors: Mahmood Iqbal, Khalid Nawab, Tachibana Satoshi

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Farmer Field School (FFS) is constantly aims to assist farmers to determine and learn about field ecology and integrated crop management. The study was conducted to examine the change in productivity of tomato crop in the study area; to determine increase in per acre yield of the crop, and find out reduction in per acre input cost. A study of tomato crop was conducted in ten villages namely Jabban, Bijligar Colony, Palonow, Heroshah, Zara Maira, Deghar Ghar, Sidra Jour, Anar Thangi, Miangano Korona and Wartair of district Malakand. From each village 15 respondents were selected randomly on the basis of identical allocation making sample size of 150 respondents. The research was based on primary as well as secondary data. Primary data was collected from farmers while secondary data were taken from Agriculture Extension Department Dargai, District Malakand. Interview schedule was planned and each farmer was interviewed personally. The study was based on comparison of cost, yield and income of tomato before and after FFS. Paired t-test and Statistical Package for Social Sciences (SPSS) was used for analysis; outcome of the study show that integrated pest management project has brought a positive change in the attitude of farmers of the project area through FFS approach. In district Malakand 66.0% of the respondents were between the age group of 31-50 years, 11.3% of respondents had primary level of education, 12.7% of middle level, 28.7% metric level, 3.3% of intermediate level and 2.0% of graduate level of education while 42.0% of respondents were illiterate and have no education. Average land holding size of farmers was 6.47 acres, cost of seed, crop protection from insect pest and crop protection from diseases was reduced by Rs. 210.67, Rs. 2584.43 and Rs. 3044.16 respectively, the cost of fertilizers and cost of farm yard manure was increased by Rs.1548.87 and Rs. 1151.40 respectively while tomato yield was increased by 1585.03 kg/acre from 7663.87 to 9248.90 kg/acre. The role of FFS initiate by integrated pest management project through department of agriculture extension for the development of agriculture was worth mentioning. It has brought enhancement in crop yield of tomato and their income through FFS approach. On the basis of results of the research studies, integrated pest management project should spread their developmental activities for maximum participation of the complete rural masses through participatory FFS approach.

Keywords: agriculture, Farmers field schools, extension education, tomato

Procedia PDF Downloads 613
147 Recognising and Managing Haematoma Following Thyroid Surgery: Simulation Teaching is Effective

Authors: Emily Moore, Dora Amos, Tracy Ellimah, Natasha Parrott

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Postoperative haematoma is a well-recognised complication of thyroid surgery with an incidence of 1-5%. Haematoma formation causes progressive airway obstruction, necessitating emergency bedside haematoma evacuation in up to ¼ of patients. ENT UK, BAETS and DAS have developed consensus guidelines to improve perioperative care, recommending that all healthcare staff interacting with patients undergoing thyroid surgery should be trained in managing post-thyroidectomy haematoma. The aim was to assess the effectiveness of a hybrid simulation model in improving clinician’s confidence in dealing with this surgical emergency. A hybrid simulation was designed, consisting of a standardised patient wearing a part-task trainer to mimic a post-thyroidectomy haematoma in a real patient. The part-task trainer was an adapted C-spine collar with layers of silicone representing the skin and strap muscles and thickened jelly representing the haematoma. Both the skin and strap muscle layers had to be opened in order to evacuate the haematoma. Boxes have been implemented into the appropriate post operative areas (recovery and surgical wards), which contain a printed algorithm designed to assist in remembering a sequence of steps for haematoma evacuation using the ‘SCOOP’ method (skin exposure, cut sutures, open skin, open muscles, pack wound) along with all the necessary equipment to open the front of the neck. Small-group teaching sessions were delivered by ENT and anaesthetic trainees to members of the multidisciplinary team normally involved in perioperative patient care, which included ENT surgeons, anaesthetists, recovery nurses, HCAs and ODPs. The DESATS acronym of signs and symptoms to recognise (difficulty swallowing, EWS score, swelling, anxiety, tachycardia, stridor) was highlighted. Then participants took part in the hybrid simulation in order to practice this ‘SCOOP’ method of haematoma evacuation. Participants were surveyed using a Likert scale to assess their level of confidence pre- and post teaching session. 30 clinicians took part. Confidence (agreed/strongly agreed) in recognition of post thyroidectomy haematoma improved from 58.6% to 96.5%. Confidence in management improved from 27.5% to 89.7%. All participants successfully decompressed the haematoma. All participants agreed/strongly agreed, that the sessions were useful for their learning. Multidisciplinary team simulation teaching is effective at significantly improving confidence in both the recognition and management of postoperative haematoma. Hybrid simulation sessions are useful and should be incorporated into training for clinicians.

Keywords: thyroid surgery, haematoma, teaching, hybrid simulation

Procedia PDF Downloads 96
146 Development of Intellectual Property Information Services in Zimbabwe’s University Libraries: Assessing the Current Status and Mapping the Future Direction

Authors: Jonathan Munyoro, Takawira Machimbidza, Stephen Mutula

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The study investigates the current status of Intellectual Property (IP) information services in Zimbabwe's university libraries. Specifically, the study assesses the current IP information services offered in Zimbabwe’s university libraries, identifies challenges to the development of comprehensive IP information services in Zimbabwe’s university libraries, and suggests solutions for the development of IP information services in Zimbabwe’s university libraries. The study is born out of a realisation that research on IP information services in university libraries has received little attention, especially in developing country contexts, despite the fact that there are calls for heightened participation of university libraries in IP information services. In Zimbabwe, the launch of the National Intellectual Property Policy and Implementation Strategy 2018-2022 and the introduction of the Education 5.0 concept are set to significantly change the IP landscape in the country. Education 5.0 places more emphasis on innovation and industrialisation (in addition to teaching, community service, and research), and has the potential to shift the focus and level of IP output produced in higher and tertiary education institutions beyond copyrights and more towards commercially exploited patents, utility models, and industrial designs. The growing importance of IP commercialisation in universities creates a need for appropriate IP information services to assist students, academics, researchers, administrators, start-ups, entrepreneurs, and inventors. The critical challenge for university libraries is to reposition themselves and remain relevant in the new trajectory. Designing specialised information services to support increased IP generation and commercialisation appears to be an opportunity for university libraries to stay relevant in the knowledge economy. However, IP information services in Zimbabwe’s universities appear to be incomplete and focused mostly on assisting with research publications and copyright-related activities. Research on the existing status of IP services in university libraries in Zimbabwe is therefore necessary to help identify gaps and provide solutions in order to stimulate the growth of new forms of such services. The study employed a quantitative approach. An online questionnaire was administered to 57 academic librarians from 15 university libraries. Findings show that the current focus of the surveyed institutions is on providing scientific research support services (15); disseminating/sharing university research output (14); and copyright activities (12). More specialised IP information services such as IP education and training, patent information services, IP consulting services, IP online service platforms, and web-based IP information services are largely unavailable in Zimbabwean university libraries. Results reveal that the underlying challenge in the development of IP information services in Zimbabwe's university libraries is insufficient IP knowledge among academic librarians, which is exacerbated by inadequate IP management frameworks in university institutions. The study proposes a framework for the entrenchment of IP information services in Zimbabwe's university libraries.

Keywords: academic libraries, information services, intellectual property, IP knowledge, university libraries, Zimbabwe

Procedia PDF Downloads 156
145 Diminishing Constitutional Hyper-Rigidity by Means of Digital Technologies: A Case Study on E-Consultations in Canada

Authors: Amy Buckley

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The purpose of this article is to assess the problem of constitutional hyper-rigidity to consider how it and the associated tensions with democratic constitutionalism can be diminished by means of using digital democratic technologies. In other words, this article examines how digital technologies can assist us in ensuring fidelity to the will of the constituent power without paying the price of hyper-rigidity. In doing so, it is impossible to ignore that digital strategies can also harm democracy through, for example, manipulation, hacking, ‘fake news,’ and the like. This article considers the tension between constitutional hyper-rigidity and democratic constitutionalism and the relevant strengths and weaknesses of digital democratic strategies before undertaking a case study on Canadian e-consultations and drawing its conclusions. This article observes democratic constitutionalism through the lens of the theory of deliberative democracy to suggest that the application of digital strategies can, notwithstanding their pitfalls, improve a constituency’s amendment culture and, thus, diminish constitutional hyper-rigidity. Constitutional hyper-rigidity is not a new or underexplored concept. At a high level, a constitution can be said to be ‘hyper-rigid’ when its formal amendment procedure is so difficult to enact that it does not take place or is limited in its application. This article claims that hyper-rigidity is one problem with ordinary constitutionalism that fails to satisfy the principled requirements of democratic constitutionalism. Given the rise and development of technology that has taken place since the Digital Revolution, there has been a significant expansion in the possibility for digital democratic strategies to overcome the democratic constitutionalism failures resulting from constitutional hyper-rigidity. Typically, these strategies have included, inter alia, e- consultations, e-voting systems, and online polling forums, all of which significantly improve the ability of politicians and judges to directly obtain the opinion of constituents on any number of matters. This article expands on the application of these strategies through its Canadian e-consultation case study and presents them as a solution to poor amendment culture and, consequently, constitutional hyper-rigidity. Hyper-rigidity is a common descriptor of many written and unwritten constitutions, including the United States, Australian, and Canadian constitutions as just some examples. This article undertakes a case study on Canada, in particular, as it is a jurisdiction less commonly cited in academic literature generally concerned with hyper-rigidity and because Canada has to some extent, championed the use of e-consultations. In Part I of this article, I identify the problem, being that the consequence of constitutional hyper-rigidity is in tension with the principles of democratic constitutionalism. In Part II, I identify and explore a potential solution, the implementation of digital democratic strategies as a means of reducing constitutional hyper-rigidity. In Part III, I explore Canada’s e-consultations as a case study for assessing whether digital democratic strategies do, in fact, improve a constituency’s amendment culture thus reducing constitutional hyper-rigidity and the associated tension that arises with the principles of democratic constitutionalism. The idea is to run a case study and then assess whether I can generalise the conclusions.

Keywords: constitutional hyper-rigidity, digital democracy, deliberative democracy, democratic constitutionalism

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144 Link People from Different Age Together: Attitude and Behavior Changes in Inter-Generational Interaction Program

Authors: Qian Sun, Dannie Dai, Vivian Lou

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Background: Changes in population structure and modernization have left traditional channels of achieving intergenerational solidarity in crisis. Policies and projects purposefully structuring intergenerational interaction are regarded as effective ways to enhance positive attitude changes between generations. However, few inter-generational interaction program has put equal emphasis on promoting positive changes on both attitude and behavior across generational groups. Objective: This study evaluated the effectiveness of an intergenerational interaction program which aims to facilitate positive attitude and behavioral interaction between both young and old individuals in Hong Kong. Method: A quasi-experimental design was adopted with the sample of 150 older participants and 161 young participants. Among 73 older and 78 young participants belong to experiment groups while 77 older participants and 84 young participants belong to control groups. The Age Group Evaluation and Description scale (AGED) was adopted to measure attitude toward young people by older participants and the Chinese version of Kogan’s Attitude towards Older People (KAOP) as well as Polizzi’s refined version of the Ageing Semantic Differential Scale (ASD) were used to measure attitude toward older people by the younger generation. The interpersonal behaviour of participants was assessed using Beglgrave’s behavioural observation tool. Six primary verbal or non-verbal interpersonal behaviours including smiles, looks, touches, encourages, initiated conversations and assists were identified and observed. Findings Effectiveness of attitude and behavior changes on both younger and older participants was confirmed in results. Compared with participants from the control group, experimental participants of elderly showed significant positive changes of attitudes toward the younger generation as assessed by AGED (F=138.34, p < .001). Moreover, older participants showed significant positive changes on three out of six behaviours (visual attention: t=2.26, p<0.05; initiate conversation: t=3.42, p<0.01; and touch: t=2.28, p<0.05). For younger participants, participants from experimental group showed significant positive changes in attitude toward older people (with F-score of 47.22 for KAOP and 72.75 for ASD, p<.001). Young participants also showed significant positive changes in two out of six behaviours (visual attention: t=3.70, p<0.01; initiate conversation: t=2.04, p<0.001). There is no significant relationship between attitude change and behaviour change in both older (p=0.86) and younger (p=0.22) groups. Conclusion: This study has brought practical implications for social work. The effective model of this program could assist social workers and allied professionals to design relevant projects for nurture intergenerational solidarity. Furthermore, insignificant results between attitude and behavior changes revealed that attitude change was not a strong predictor for behavior change, hence, intergenerational programs against age-stereotype should put equal emphasis on both attitudinal and behavioral aspects.

Keywords: attitude and behaviour changes, intergenerational interaction, intergenerational solidarity, program design

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143 Modulation of Receptor-Activation Due to Hydrogen Bond Formation

Authors: Sourav Ray, Christoph Stein, Marcus Weber

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A new class of drug candidates, initially derived from mathematical modeling of ligand-receptor interactions, activate the μ-opioid receptor (MOR) preferentially at acidic extracellular pH-levels, as present in injured tissues. This is of commercial interest because it may preclude the adverse effects of conventional MOR agonists like fentanyl, which include but are not limited to addiction, constipation, sedation, and apnea. Animal studies indicate the importance of taking the pH value of the chemical environment of MOR into account when designing new drugs. Hydrogen bonds (HBs) play a crucial role in stabilizing protein secondary structure and molecular interaction, such as ligand-protein interaction. These bonds may depend on the pH value of the chemical environment. For the MOR, antagonist naloxone and agonist [D-Ala2,N-Me-Phe4,Gly5-ol]-enkephalin (DAMGO) form HBs with ionizable residue HIS 297 at physiological pH to modulate signaling. However, such interactions were markedly reduced at acidic pH. Although fentanyl-induced signaling is also diminished at acidic pH, HBs with HIS 297 residue are not observed at either acidic or physiological pH for this strong agonist of the MOR. Molecular dynamics (MD) simulations can provide greater insight into the interaction between the ligand of interest and the HIS 297 residue. Amino acid protonation states are adjusted to the model difference in system acidity. Unbiased and unrestrained MD simulations were performed, with the ligand in the proximity of the HIS 297 residue. Ligand-receptor complexes were embedded in 1-palmitoyl-2-oleoyl-sn glycero-3-phosphatidylcholine (POPC) bilayer to mimic the membrane environment. The occurrence of HBs between the different ligands and the HIS 297 residue of MOR at acidic and physiological pH values were tracked across the various simulation trajectories. No HB formation was observed between fentanyl and HIS 297 residue at either acidic or physiological pH. Naloxone formed some HBs with HIS 297 at pH 5, but no such HBs were noted at pH 7. Interestingly, DAMGO displayed an opposite yet more pronounced HB formation trend compared to naloxone. Whereas a marginal number of HBs could be observed at even pH 5, HBs with HIS 297 were more stable and widely present at pH 7. The HB formation plays no and marginal role in the interaction of fentanyl and naloxone, respectively, with the HIS 297 residue of MOR. However, HBs play a significant role in the DAMGO and HIS 297 interaction. Post DAMGO administration, these HBs might be crucial for the remediation of opioid tolerance and restoration of opioid sensitivity. Although experimental studies concur with our observations regarding the influence of HB formation on the fentanyl and DAMGO interaction with HIS 297, the same could not be conclusively stated for naloxone. Therefore, some other supplementary interactions might be responsible for the modulation of the MOR activity by naloxone binding at pH 7 but not at pH 5. Further elucidation of the mechanism of naloxone action on the MOR could assist in the formulation of cost-effective naloxone-based treatment of opioid overdose or opioid-induced side effects.

Keywords: effect of system acidity, hydrogen bond formation, opioid action, receptor activation

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142 Comparative Analysis of Simulation-Based and Mixed-Integer Linear Programming Approaches for Optimizing Building Modernization Pathways Towards Decarbonization

Authors: Nico Fuchs, Fabian Wüllhorst, Laura Maier, Dirk Müller

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The decarbonization of building stocks necessitates the modernization of existing buildings. Key measures for this include reducing energy demands through insulation of the building envelope, replacing heat generators, and installing solar systems. Given limited financial resources, it is impractical to modernize all buildings in a portfolio simultaneously; instead, prioritization of buildings and modernization measures for a given planning horizon is essential. Optimization models for modernization pathways can assist portfolio managers in this prioritization. However, modeling and solving these large-scale optimization problems, often represented as mixed-integer problems (MIP), necessitates simplifying the operation of building energy systems particularly with respect to system dynamics and transient behavior. This raises the question of which level of simplification remains sufficient to accurately account for realistic costs and emissions of building energy systems, ensuring a fair comparison of different modernization measures. This study addresses this issue by comparing a two-stage simulation-based optimization approach with a single-stage mathematical optimization in a mixed-integer linear programming (MILP) formulation. The simulation-based approach serves as a benchmark for realistic energy system operation but requires a restriction of the solution space to discrete choices of modernization measures, such as the sizing of heating systems. After calculating the operation of different energy systems in terms of the resulting final energy demands in simulation models on a first stage, the results serve as input for a second stage MILP optimization, where the design of each building in the portfolio is optimized. In contrast to the simulation-based approach, the MILP-based approach can capture a broader variety of modernization measures due to the efficiency of MILP solvers but necessitates simplifying the building energy system operation. Both approaches are employed to determine the cost-optimal design and dimensioning of several buildings in a portfolio to meet climate targets within limited yearly budgets, resulting in a modernization pathway for the entire portfolio. The comparison reveals that the MILP formulation successfully captures design decisions of building energy systems, such as the selection of heating systems and the modernization of building envelopes. However, the results regarding the optimal dimensioning of heating technologies differ from the results of the two-stage simulation-based approach, as the MILP model tends to overestimate operational efficiency, highlighting the limitations of the MILP approach.

Keywords: building energy system optimization, model accuracy in optimization, modernization pathways, building stock decarbonization

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141 Applicability of Polyisobutylene-Based Polyurethane Structures in Biomedical Disciplines: Some Calcification and Protein Adsorption Studies

Authors: Nihan Nugay, Nur Cicek Kekec, Kalman Toth, Turgut Nugay, Joseph P. Kennedy

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In recent years, polyurethane structures are paving the way for elastomer usage in biology, human medicine, and biomedical application areas. Polyurethanes having a combination of high oxidative and hydrolytic stability and excellent mechanical properties are focused due to enhancing the usage of PUs especially for implantable medical device application such as cardiac-assist. Currently, unique polyurethanes consisting of polyisobutylenes as soft segments and conventional hard segments, named as PIB-based PUs, are developed with precise NCO/OH stoichiometry (∽1.05) for obtaining PIB-based PUs with enhanced properties (i.e., tensile stress increased from ∽11 to ∽26 MPa and elongation from ∽350 to ∽500%). Static and dynamic mechanical properties were optimized by examining stress-strain graphs, self-organization and crystallinity (XRD) traces, rheological (DMA, creep) profiles and thermal (TGA, DSC) responses. Annealing procedure was applied for PIB-based PUs. Annealed PIB-based PU shows ∽26 MPa tensile strength, ∽500% elongation, and ∽77 Microshore hardness with excellent hydrolytic and oxidative stability. The surface characters of them were examined with AFM and contact angle measurements. Annealed PIB-based PU exhibits the higher segregation of individual segments and surface hydrophobicity thus annealing significantly enhances hydrolytic and oxidative stability by shielding carbamate bonds by inert PIB chains. According to improved surface and microstructure characters, greater efforts are focused on analyzing protein adsorption and calcification profiles. In biomedical applications especially for cardiological implantations, protein adsorption inclination on polymeric heart valves is undesirable hence protein adsorption from blood serum is followed by platelet adhesion and subsequent thrombus formation. The protein adsorption character of PIB-based PU examines by applying Bradford assay in fibrinogen and bovine serum albumin solutions. Like protein adsorption, calcium deposition on heart valves is very harmful because vascular calcification has been proposed activation of osteogenic mechanism in the vascular wall, loss of inhibitory factors, enhance bone turnover and irregularities in mineral metabolism. The calcium deposition on films are characterized by incubating samples in simulated body fluid solution and examining SEM images and XPS profiles. PIB-based PUs are significantly more resistant to hydrolytic-oxidative degradation, protein adsorption and calcium deposition than ElastEonTM E2A, a commercially available PDMS-based PU, widely used for biomedical applications.

Keywords: biomedical application, calcification, polyisobutylene, polyurethane, protein adsorption

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140 Attachment Theory and Quality of Life: Grief Education and Training

Authors: Jane E. Hill

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Quality of life is an important component for many. With that in mind, everyone will experience some type of loss within his or her lifetime. A person can experience loss due to break up, separation, divorce, estrangement, or death. An individual may experience loss of a job, loss of capacity, or loss caused by human or natural-caused disasters. An individual’s response to such a loss is unique to them, and not everyone will seek services to assist them with their grief due to loss. Counseling can promote positive outcomes for clients that are grieving by addressing the client’s personal loss and helping the client process their grief. However, a lack of understanding on the part of counselors of how people grieve may result in negative client outcomes such as poor health, psychological distress, or an increased risk of depression. Education and training in grief counseling can improve counselors’ problem recognition and skills in treatment planning. The purpose of this study was to examine whether the Council for Accreditation of Counseling and Related Educational Programs (CACREP) master’s degree counseling students view themselves as having been adequately trained in grief theories and skills. Many people deal with grief issues that prevent them from having joy or purpose in their lives and that leaves them unable to engage in positive opportunities or relationships. This study examined CACREP-accredited master’s counseling students’ self-reported competency, training, and education in providing grief counseling. The implications for positive social change arising from the research may be to incorporate and promote education and training in grief theories and skills in a majority of counseling programs and to provide motivation to incorporate professional standards for grief training and practice in the mental health counseling field. The theoretical foundation used was modern grief theory based on John Bowlby’s work on Attachment Theory. The overall research question was how competent do master’s-level counselors view themselves regarding the education or training they received in grief theories or counseling skills in their CACREP-accredited studies. The author used a non-experimental, one shot survey comparative quantitative research design. Cicchetti’s Grief Counseling Competency Scale (GCCS) was administered to CACREP master’s-level counseling students enrolled in their practicum or internship experience, which resulted in 153 participants. Using a MANCOVA, there was significance found for relationships between coursework taken and (a) perceived assessment skills (p = .029), (b) perceived treatment skills (p = .025), and (c) perceived conceptual skills and knowledge (p = .003). Results of this study provided insight for CACREP master’s-level counseling programs to explore and discuss curriculum coursework inclusion of education and training in grief theories and skills.

Keywords: counselor education and training, grief education and training, grief and loss, quality of life

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139 Mining Scientific Literature to Discover Potential Research Data Sources: An Exploratory Study in the Field of Haemato-Oncology

Authors: A. Anastasiou, K. S. Tingay

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Background: Discovering suitable datasets is an important part of health research, particularly for projects working with clinical data from patients organized in cohorts (cohort data), but with the proliferation of so many national and international initiatives, it is becoming increasingly difficult for research teams to locate real world datasets that are most relevant to their project objectives. We present a method for identifying healthcare institutes in the European Union (EU) which may hold haemato-oncology (HO) data. A key enabler of this research was the bibInsight platform, a scientometric data management and analysis system developed by the authors at Swansea University. Method: A PubMed search was conducted using HO clinical terms taken from previous work. The resulting XML file was processed using the bibInsight platform, linking affiliations to the Global Research Identifier Database (GRID). GRID is an international, standardized list of institutions, including the city and country in which the institution exists, as well as a category of the main business type, e.g., Academic, Healthcare, Government, Company. Countries were limited to the 28 current EU members, and institute type to 'Healthcare'. An article was considered valid if at least one author was affiliated with an EU-based healthcare institute. Results: The PubMed search produced 21,310 articles, consisting of 9,885 distinct affiliations with correspondence in GRID. Of these articles, 760 were from EU countries, and 390 of these were healthcare institutes. One affiliation was excluded as being a veterinary hospital. Two EU countries did not have any publications in our analysis dataset. The results were analysed by country and by individual healthcare institute. Networks both within the EU and internationally show institutional collaborations, which may suggest a willingness to share data for research purposes. Geographical mapping can ensure that data has broad population coverage. Collaborations with industry or government may exclude healthcare institutes that may have embargos or additional costs associated with data access. Conclusions: Data reuse is becoming increasingly important both for ensuring the validity of results, and economy of available resources. The ability to identify potential, specific data sources from over twenty thousand articles in less than an hour could assist in improving knowledge of, and access to, data sources. As our method has not yet specified if these healthcare institutes are holding data, or merely publishing on that topic, future work will involve text mining of data-specific concordant terms to identify numbers of participants, demographics, study methodologies, and sub-topics of interest.

Keywords: data reuse, data discovery, data linkage, journal articles, text mining

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138 The Role of Interest Groups in Foreign Policy: Assessing the Influence of the 'Pro-Jakarta Lobby' in Australia and Indonesia's Bilateral Relations

Authors: Bec Strating

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This paper examines the ways that domestic politics and pressure–generated through lobbying, public diplomacy campaigns and other tools of soft power-contributes to the formation of short-term and long-term national interests, priorities and strategies of states in their international relations. It primarily addresses the conceptual problems regarding the kinds of influence that lobby groups wield in foreign policy and how this influence might be assessed. Scholarly attention has been paid to influential foreign policy lobbies and interest groups, particularly in the areas of US foreign policy. Less attention has been paid to how lobby groups might influence the foreign policy of a middle power such as Australia. This paper examines some of the methodological complexities in developing and conducting a research project that can measure the nature and influence of lobbies on foreign affairs priorities and activities. This paper will use Australian foreign policy in the context of its historical bilateral relationship with Indonesia as a case study for considering the broader issues of domestic influences on foreign policy. Specifically, this paper will use the so-called ‘pro-Jakarta lobby’ as an example of an interest group. The term ‘pro-Jakarta lobby’ is used in media commentary and scholarship to describe an amorphous collection of individuals who have sought to influence Australian foreign policy in favour of Indonesia. The term was originally applied to a group of Indonesian experts at the Australian National University in the 1980s but expanded to include journalists, think tanks and key diplomats. The concept of the ‘pro-Jakarta lobby’ was developed largely through criticisms of Australia’s support for Indonesia’s sovereignty of East Timor and West Papua. Pro-Independence supporters were integral for creating the ‘lobby’ in their rhetoric and criticisms about the influence on Australian foreign policy. In these critical narratives, the ‘pro-Jakarta lobby’ supported a realist approach to relations with Indonesia during the years of President Suharto’s regime, which saw appeasement of Indonesia as paramount to values of democracy and human rights. The lobby was viewed as integral in embedding a form of ‘foreign policy exceptionalism’ towards Indonesia in Australian policy-making circles. However, little critical and scholarly attention has been paid to nature, aims, strategies and activities of the ‘pro-Jakarta lobby.' This paper engages with methodological issues of foreign policy analysis: what was the ‘pro-Jakarta lobby’? Why was it considered more successful than other activist groups in shaping policy? And how can its influence on Australia’s approach to Indonesia be tested in relation to other contingent factors shaping policy? In addressing these questions, this case study will assist in addressing a broader scholarly concern about the capacities of collectives or individuals in shaping and directing the foreign policies of states.

Keywords: foreign policy, interests groups, Australia, Indonesia

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137 Adapting Cyber Physical Production Systems to Small and Mid-Size Manufacturing Companies

Authors: Yohannes Haile, Dipo Onipede, Jr., Omar Ashour

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The main thrust of our research is to determine Industry 4.0 readiness of small and mid-size manufacturing companies in our region and assist them to implement Cyber Physical Production System (CPPS) capabilities. Adopting CPPS capabilities will help organizations realize improved quality, order delivery, throughput, new value creation, and reduced idle time of machines and work centers of their manufacturing operations. The key metrics for the assessment include the level of intelligence, internal and external connections, responsiveness to internal and external environmental changes, capabilities for customization of products with reference to cost, level of additive manufacturing, automation, and robotics integration, and capabilities to manufacture hybrid products in the near term, where near term is defined as 0 to 18 months. In our initial evaluation of several manufacturing firms which are profitable and successful in what they do, we found low level of Physical-Digital-Physical (PDP) loop in their manufacturing operations, whereas 100% of the firms included in this research have specialized manufacturing core competencies that have differentiated them from their competitors. The level of automation and robotics integration is low to medium range, where low is defined as less than 30%, and medium is defined as 30 to 70% of manufacturing operation to include automation and robotics. However, there is a significant drive to include these capabilities at the present time. As it pertains to intelligence and connection of manufacturing systems, it is observed to be low with significant variance in tying manufacturing operations management to Enterprise Resource Planning (ERP). Furthermore, it is observed that the integration of additive manufacturing in general, 3D printing, in particular, to be low, but with significant upside of integrating it in their manufacturing operations in the near future. To hasten the readiness of the local and regional manufacturing companies to Industry 4.0 and transitions towards CPPS capabilities, our working group (ADMAR Working Group) in partnership with our university have been engaged with the local and regional manufacturing companies. The goal is to increase awareness, share know-how and capabilities, initiate joint projects, and investigate the possibility of establishing the Center for Cyber Physical Production Systems Innovation (C2P2SI). The center is intended to support the local and regional university-industry research of implementing intelligent factories, enhance new value creation through disruptive innovations, the development of hybrid and data enhanced products, and the creation of digital manufacturing enterprises. All these efforts will enhance local and regional economic development and educate students that have well developed knowledge and applications of cyber physical manufacturing systems and Industry 4.0.

Keywords: automation, cyber-physical production system, digital manufacturing enterprises, disruptive innovation, new value creation, physical-digital-physical loop

Procedia PDF Downloads 140
136 Assessment of the Growth Enhancement Support Scheme in Adamawa State, Nigeria

Authors: Oto J. Okwu, Ornan Henry, Victor A. Otene

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The agricultural sector contributes a great deal to the sustenance of Nigeria’s food security and economy, with an attendant impact on rural development. In spite of the relatively high number of farmers in the country, self-sufficiency in food production is still a challenge. Farmers are faced with myriad problems which hinder their production efficiency, one of which is their access to agricultural inputs required for optimum production. To meet the challenges faced by farmers, the government at the federal level has come up with many agricultural policies, one of which is the Agricultural Transformation Agenda (ATA). The Growth Enhancement Support Scheme (GESS) is one of the critical components of ATA, which is aimed at ensuring the effective distribution of agricultural inputs delivered directly to farmers, and at a regulated cost. After about 8 years of launching this policy, it will be necessary to carry out an assessment of GESS and determine the impact it has made on rural farmers with respect to their access to farm inputs. This study was carried out to assess the Growth Enhancement Support Scheme (GESS) in Adamawa State, Nigeria. Crop farmers who registered under the GESS in Adamawa State, Nigeria, formed the population for the study. Primary data for the study were obtained through a survey, and the use of a structured questionnaire. A sample size of 167 respondents was selected using multi-stage, purposive, and random sampling techniques. The validity and reliability of the research instrument (questionnaire) were obtained through pilot testing and test-retest method, respectively. The objectives of the study were to determine the difference in the level of access to agricultural inputs before and after GESS, determine the difference in cost of agricultural inputs before and after GESS, and to determine the challenges faced by rural farmers in accessing agricultural inputs through GESS. Both descriptive and inferential statistics were used in analyzing the collected data. Specifically, Mann-Whitney, student t-test, and factor analysis were used to test the stated hypotheses. Research findings revealed there was a significant difference in the level of access to farm inputs after the introduction of GESS (Z=14.216). Also, there was a significant difference in the cost of agro-inputs after the introduction of GESS (Pr |T| > |t|= 0.0000). The challenges faced by respondents in accessing agro-inputs through GESS were administrative and technical in nature. Based on the findings of the research, it was recommended that efforts be made by the government to sustain the GESS, as it has significantly improved the level of farmers’ access to agricultural inputs and has reduced the cost of agro-inputs, while administrative challenges faced by the respondents in accessing inputs be addressed by the government, and extension agents assist the farmers to overcome the technical challenges they face in accessing inputs.

Keywords: agricultural policy, agro-inputs, assessment, growth enhancement support scheme, rural farmers

Procedia PDF Downloads 110
135 Airport Pavement Crack Measurement Systems and Crack Density for Pavement Evaluation

Authors: Ali Ashtiani, Hamid Shirazi

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This paper reviews the status of existing practice and research related to measuring pavement cracking and using crack density as a pavement surface evaluation protocol. Crack density for pavement evaluation is currently not widely used within the airport community and its use by the highway community is limited. However, surface cracking is a distress that is closely monitored by airport staff and significantly influences the development of maintenance, rehabilitation and reconstruction plans for airport pavements. Therefore crack density has the potential to become an important indicator of pavement condition if the type, severity and extent of surface cracking can be accurately measured. A pavement distress survey is an essential component of any pavement assessment. Manual crack surveying has been widely used for decades to measure pavement performance. However, the accuracy and precision of manual surveys can vary depending upon the surveyor and performing surveys may disrupt normal operations. Given the variability of manual surveys, this method has shown inconsistencies in distress classification and measurement. This can potentially impact the planning for pavement maintenance, rehabilitation and reconstruction and the associated funding strategies. A substantial effort has been devoted for the past 20 years to reduce the human intervention and the error associated with it by moving toward automated distress collection methods. The automated methods refer to the systems that identify, classify and quantify pavement distresses through processes that require no or very minimal human intervention. This principally involves the use of a digital recognition software to analyze and characterize pavement distresses. The lack of established protocols for measurement and classification of pavement cracks captured using digital images is a challenge to developing a reliable automated system for distress assessment. Variations in types and severity of distresses, different pavement surface textures and colors and presence of pavement joints and edges all complicate automated image processing and crack measurement and classification. This paper summarizes the commercially available systems and technologies for automated pavement distress evaluation. A comprehensive automated pavement distress survey involves collection, interpretation, and processing of the surface images to identify the type, quantity and severity of the surface distresses. The outputs can be used to quantitatively calculate the crack density. The systems for automated distress survey using digital images reviewed in this paper can assist the airport industry in the development of a pavement evaluation protocol based on crack density. Analysis of automated distress survey data can lead to a crack density index. This index can be used as a means of assessing pavement condition and to predict pavement performance. This can be used by airport owners to determine the type of pavement maintenance and rehabilitation in a more consistent way.

Keywords: airport pavement management, crack density, pavement evaluation, pavement management

Procedia PDF Downloads 185
134 Spectrum of Bacteria Causing Oral and Maxillofacial Infections and Their Antibiotic Susceptibility among Patients Attending Muhimbili National Hospital

Authors: Sima E. Rugarabamu, Mecky I. Matee, Elison N. M. Simon

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Background: In Tanzania bacteriological studies of etiological agents of oro-facial infections are very limited, and very few have investigated anaerobes. The aim of this study was to determine the spectrum of bacterial agents involved in oral and maxillofacial infections in patients attending Muhimbili National Hospital, Dar-es-salaam, Tanzania. Method: This was a hospital based descriptive cross-sectional study that was conducted in the Department of Oral and Maxillofacial Surgery of the Muhimbili National Hospital in Dar es Salaam, Tanzania from 1st January 2014 to 31st August 2014. Seventy (70) patients with various forms of oral and maxillofacial infections who were recruited for the study. The study participants were interviewed using a prepared questionnaire after getting their consent. Pus aspirate was cultured on Blood agar, Chocolate Agar, MacConkey agar and incubated aerobically at 37°C. Imported blood agar was used for anaerobic culture whereby they were incubated at 37°Cin anaerobic jars in an atmosphere of generated using commercial gas-generating kits in accordance with manufacturer’s instructions. Plates were incubated at 37°C for 24 hours (For aerobic culture and 48 hours for anaerobic cultures). Gram negative rods were identified using API 20E while all other isolates were identified by conventional biochemical tests. Antibiotic sensitivity testing for isolated aerobic and anaerobic bacteria was detected by the disk diffusion, agar dilution and E-test using routine and commercially available antibiotics used to treat oral facial infections. Results: This study comprised of 41 (58.5%) males and 29 (41.5%) females with a mean age of 32 years SD +/-15.1 and a range of 19 to 70 years. A total of 161 bacteria strains were isolated from specimens obtained from 70 patients which were an average of 2.3 isolates per patient. Of these 103 were aerobic organism and 58 were strict anaerobes. A complex mix of strict anaerobes and facultative anaerobes accounted for 87% of all infections.The most frequent aerobes isolated was streptococcus spp 70 (70%) followed by Staphylococcus spp 18 (18%). Other organisms such as Klebsiella spp 4 (4%), Proteus spp 5 (5%) and Pseudomonas spp 2 (2%) were also seen. The anaerobic group was dominated by Prevotella spp 25 (43%) followed by Peptostreptococcus spp 18 (31%); other isolates were Pseudomonas spp 2 (1%), black pigmented Pophyromonas spp 4 (5%), Fusobacterium spp 3 (3%) and Bacteroides spp 5 (8%). Majority of these organisms were sensitive to Amoxicillin (98%), Gentamycin (89%), and Ciprofloxacin (100%). A 40% resistance to metronidazole was observed in Bacteroides spp otherwise this drug and others displayed good activity against anaerobes. Conclusions: Oral and maxillofacial facial infections at Muhimbili National Hospital are mostly caused by streptococcus spp and Prevotella spp. Strict anaerobes accounted for 36% of all isolates. The profile of isolates should assist in selecting empiric therapy for infections of the oral and maxillofacial region. Inclusion of antimicrobial agents against anaerobic bacteria is highly recommended.

Keywords: bacteria, oral and maxillofacial infections, antibiotic susceptibility, Tanzania

Procedia PDF Downloads 331
133 Approaching a Tat-Rev Independent HIV-1 Clone towards a Model for Research

Authors: Walter Vera-Ortega, Idoia Busnadiego, Sam J. Wilson

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Introduction: Human Immunodeficiency Virus type 1 (HIV-1) is responsible for the acquired immunodeficiency syndrome (AIDS), a leading cause of death worldwide infecting millions of people each year. Despite intensive research in vaccine development, therapies against HIV-1 infection are not curative, and the huge genetic variability of HIV-1 challenges to drug development. Current animal models for HIV-1 research present important limitations, impairing the progress of in vivo approaches. Macaques require a CD8+ depletion to progress to AIDS, and the maintenance cost is high. Mice are a cheaper alternative but need to be 'humanized,' and breeding is not possible. The development of an HIV-1 clone able to replicate in mice is a challenging proposal. The lack of human co-factors in mice impedes the function of the HIV-1 accessory proteins, Tat and Rev, hampering HIV-1 replication. However, Tat and Rev function can be replaced by constitutive/chimeric promoters, codon-optimized proteins and the constitutive transport element (CTE), generating a novel HIV-1 clone able to replicate in mice without disrupting the amino acid sequence of the virus. By minimally manipulating the genomic 'identity' of the virus, we propose the generation of an HIV-1 clone able to replicate in mice to assist in antiviral drug development. Methods: i) Plasmid construction: The chimeric promoters and CTE copies were cloned by PCR using lentiviral vectors as templates (pCGSW and pSIV-MPCG). Tat mutants were generated from replication competent HIV-1 plasmids (NHG and NL4-3). ii) Infectivity assays: Retroviral vectors were generated by transfection of human 293T cells and murine NIH 3T3 cells. Virus titre was determined by flow cytometry measuring GFP expression. Human B-cells (AA-2) and Hela cells (TZMbl) were used for infectivity assays. iii) Protein analysis: Tat protein expression was determined by TZMbl assay and HIV-1 capsid by western blot. Results: We have determined that NIH 3T3 cells are able to generate HIV-1 particles. However, they are not infectious, and further analysis needs to be performed. Codon-optimized HIV-1 constructs are efficiently made in 293T cells in a Tat and Rev independent manner and capable of packaging a competent genome in trans. CSGW is capable of generating infectious particles in the absence of Tat and Rev in human cells when 4 copies of the CTE are placed preceding the 3’LTR. HIV-1 Tat mutant clones encoding different promoters are functional during the first cycle of replication when Tat is added in trans. Conclusion: Our findings suggest that the development of an HIV-1 Tat-Rev independent clone is challenging but achievable aim. However, further investigations need to be developed prior presenting our HIV-1 clone as a candidate model for research.

Keywords: codon-optimized, constitutive transport element, HIV-1, long terminal repeats, research model

Procedia PDF Downloads 308
132 Mealtime Talk as a Context of Learning: A Multiple Case Study of Australian Chinese Parents' Interaction with Their Preschool Aged Children at Dinner Table

Authors: Jiangbo Hu, Frances Hoyte, Haiquan Huang

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Research identifies that mealtime talk can be a significant learning context that provides children with rich experiences to foster their language and cognitive development. Middle-classed parents create an extended learning discourse for their children through sophisticated vocabulary, narrative and explanation genres at dinner table. However, mealtime opportunities vary with some parents having little interaction with their children and some parents focusing on directive of children’s behaviors. This study investigated five Chinese families’ parent-child interaction during mealtime that was rarely reported in the literature. The five families differ in terms of their living styles. Three families are from professional background where both mothers the fathers work in Australian companies and both of them present at dinner time. The other two families own business. The mothers are housemakers and the fathers are always absent at dinner time due to their busy business life. Employing case study method, the five Chinese families’ parent-child interactions at dinner table were recorded using a video camera. More than 3000 clauses were analyzed with the framework of 'systems of clause complexing' from systemic functional linguistic theory. The finding shows that mothers played a critical role in the interaction with their children by initiating most conversations. The three mothers from professional background tended to use more language in extending and expanding pattern that is beneficial for children’s language development and high level of thinking (e.g., logical thinking). The two house making mothers’ language focused more on the directive of their children’s social manners and dietary behaviors. The fathers though seemed to be less active, contributing to the richness of the conversation through their occasional props such as asking open questions or initiating a new topic. In general, the families from professional background were more advantaged in providing learning opportunities for their children at dinner table than the families running business were. The home experiences of Chinese children is an important topic in research due to the rapidly increasing number of Chinese children in Australia and other English speaking countries. Such research assist educators in the education of Chinese children with more awareness of Chinese children experiences at home that could be very unlike the settings in English schools. This study contributes to the research in this area through the analysis of language in parent-child interaction during mealtime, which is very different from previous research that mainly investigated Chinese families through survey and interview. The finding of different manners in language use between the professional families and business families has implication for the understanding of the variation of Chinese children’s home experiences that is influenced not only by parents’ socioeconomic status but their lifestyles.

Keywords: Chinese children, Chinese parents, mealtime talk, parent-child interaction

Procedia PDF Downloads 233
131 A Multifactorial Algorithm to Automate Screening of Drug-Induced Liver Injury Cases in Clinical and Post-Marketing Settings

Authors: Osman Turkoglu, Alvin Estilo, Ritu Gupta, Liliam Pineda-Salgado, Rajesh Pandey

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Background: Hepatotoxicity can be linked to a variety of clinical symptoms and histopathological signs, posing a great challenge in the surveillance of suspected drug-induced liver injury (DILI) cases in the safety database. Additionally, the majority of such cases are rare, idiosyncratic, highly unpredictable, and tend to demonstrate unique individual susceptibility; these qualities, in turn, lend to a pharmacovigilance monitoring process that is often tedious and time-consuming. Objective: Develop a multifactorial algorithm to assist pharmacovigilance physicians in identifying high-risk hepatotoxicity cases associated with DILI from the sponsor’s safety database (Argus). Methods: Multifactorial selection criteria were established using Structured Query Language (SQL) and the TIBCO Spotfire® visualization tool, via a combination of word fragments, wildcard strings, and mathematical constructs, based on Hy’s law criteria and pattern of injury (R-value). These criteria excluded non-eligible cases from monthly line listings mined from the Argus safety database. The capabilities and limitations of these criteria were verified by comparing a manual review of all monthly cases with system-generated monthly listings over six months. Results: On an average, over a period of six months, the algorithm accurately identified 92% of DILI cases meeting established criteria. The automated process easily compared liver enzyme elevations with baseline values, reducing the screening time to under 15 minutes as opposed to multiple hours exhausted using a cognitively laborious, manual process. Limitations of the algorithm include its inability to identify cases associated with non-standard laboratory tests, naming conventions, and/or incomplete/incorrectly entered laboratory values. Conclusions: The newly developed multifactorial algorithm proved to be extremely useful in detecting potential DILI cases, while heightening the vigilance of the drug safety department. Additionally, the application of this algorithm may be useful in identifying a potential signal for DILI in drugs not yet known to cause liver injury (e.g., drugs in the initial phases of development). This algorithm also carries the potential for universal application, due to its product-agnostic data and keyword mining features. Plans for the tool include improving it into a fully automated application, thereby completely eliminating a manual screening process.

Keywords: automation, drug-induced liver injury, pharmacovigilance, post-marketing

Procedia PDF Downloads 152
130 Fe3O4 Decorated ZnO Nanocomposite Particle System for Waste Water Remediation: An Absorptive-Photocatalytic Based Approach

Authors: Prateek Goyal, Archini Paruthi, Superb K. Misra

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Contamination of water resources has been a major concern, which has drawn attention to the need to develop new material models for treatment of effluents. Existing conventional waste water treatment methods remain ineffective sometimes and uneconomical in terms of remediating contaminants like heavy metal ions (mercury, arsenic, lead, cadmium and chromium); organic matter (dyes, chlorinated solvents) and high salt concentration, which makes water unfit for consumption. We believe that nanotechnology based strategy, where we use nanoparticles as a tool to remediate a class of pollutants would prove to be effective due to its property of high surface area to volume ratio, higher selectivity, sensitivity and affinity. In recent years, scientific advancement has been made to study the application of photocatalytic (ZnO, TiO2 etc.) nanomaterials and magnetic nanomaterials in remediating contaminants (like heavy metals and organic dyes) from water/wastewater. Our study focuses on the synthesis and monitoring remediation efficiency of ZnO, Fe3O4 and Fe3O4 coated ZnO nanoparticulate system for the removal of heavy metals and dyes simultaneously. Multitude of ZnO nanostructures (spheres, rods and flowers) using multiple routes (microwave & hydrothermal approach) offers a wide range of light active photo catalytic property. The phase purity, morphology, size distribution, zeta potential, surface area and porosity in addition to the magnetic susceptibility of the particles were characterized by XRD, TEM, CPS, DLS, BET and VSM measurements respectively. Further on, the introduction of crystalline defects into ZnO nanostructures can also assist in light activation for improved dye degradation. Band gap of a material and its absorbance is a concrete indicator for photocatalytic activity of the material. Due to high surface area, high porosity and affinity towards metal ions and availability of active surface sites, iron oxide nanoparticles show promising application in adsorption of heavy metal ions. An additional advantage of having magnetic based nanocomposite is, it offers magnetic field responsive separation and recovery of the catalyst. Therefore, we believe that ZnO linked Fe3O4 nanosystem would be efficient and reusable. Improved photocatalytic efficiency in addition to adsorption for environmental remediation has been a long standing challenge, and the nano-composite system offers the best of features which the two individual metal oxides provide for nanoremediation.

Keywords: adsorption, nanocomposite, nanoremediation, photocatalysis

Procedia PDF Downloads 237
129 Additive Manufacturing – Application to Next Generation Structured Packing (SpiroPak)

Authors: Biao Sun, Tejas Bhatelia, Vishnu Pareek, Ranjeet Utikar, Moses Tadé

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Additive manufacturing (AM), commonly known as 3D printing, with the continuing advances in parallel processing and computational modeling, has created a paradigm shift (with significant radical thinking) in the design and operation of chemical processing plants, especially LNG plants. With the rising energy demands, environmental pressures, and economic challenges, there is a continuing industrial need for disruptive technologies such as AM, which possess capabilities that can drastically reduce the cost of manufacturing and operations of chemical processing plants in the future. However, the continuing challenge for 3D printing is its lack of adaptability in re-designing the process plant equipment coupled with the non-existent theory or models that could assist in selecting the optimal candidates out of the countless potential fabrications that are possible using AM. One of the most common packings used in the LNG process is structured packing in the packed column (which is a unit operation) in the process. In this work, we present an example of an optimum strategy for the application of AM to this important unit operation. Packed columns use a packing material through which the gas phase passes and comes into contact with the liquid phase flowing over the packing, typically performing the necessary mass transfer to enrich the products, etc. Structured packing consists of stacks of corrugated sheets, typically inclined between 40-70° from the plane. Computational Fluid Dynamics (CFD) was used to test and model various geometries to study the governing hydrodynamic characteristics. The results demonstrate that the costly iterative experimental process can be minimized. Furthermore, they also improve the understanding of the fundamental physics of the system at the multiscale level. SpiroPak, patented by Curtin University, represents an innovative structured packing solution currently at a technology readiness level (TRL) of 5~6. This packing exhibits remarkable characteristics, offering a substantial increase in surface area while significantly enhancing hydrodynamic and mass transfer performance. Recent studies have revealed that SpiroPak can reduce pressure drop by 50~70% compared to commonly used commercial packings, and it can achieve 20~50% greater mass transfer efficiency (particularly in CO2 absorption applications). The implementation of SpiroPak has the potential to reduce the overall size of columns and decrease power consumption, resulting in cost savings for both capital expenditure (CAPEX) and operational expenditure (OPEX) when applied to retrofitting existing systems or incorporated into new processes. Furthermore, pilot to large-scale tests is currently underway to further advance and refine this technology.

Keywords: Additive Manufacturing (AM), 3D printing, Computational Fluid Dynamics (CFD, structured packing (SpiroPak)

Procedia PDF Downloads 87
128 Analysis of Interparticle interactions in High Waxy-Heavy Clay Fine Sands for Sand Control Optimization

Authors: Gerald Gwamba

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Formation and oil well sand production is one of the greatest and oldest concerns for the Oil and gas industry. The production of sand particles may vary from very small and limited amounts to far elevated levels which has the potential to block or plug the pore spaces near the perforated points to blocking production from surface facilities. Therefore, the timely and reliable investigation of conditions leading to the onset or quantifying sanding while producing is imperative. The challenges of sand production are even more elevated while producing in Waxy and Heavy wells with Clay Fine sands (WHFC). Existing research argues that both waxy and heavy hydrocarbons exhibit far differing characteristics with waxy more paraffinic while heavy crude oils exhibit more asphaltenic properties. Moreover, the combined effect of WHFC conditions presents more complexity in production as opposed to individual effects that could be attributed to a consolidation of a surmountable opposing force. However, research on a combined high WHFC system could depict a better representation of the surmountable effect which in essence is more comparable to field conditions where a one-sided view of either individual effects on sanding has been argued to some extent misrepresentative of actual field conditions since all factors act surmountably. In recognition of the limited customized research on sand production studies with the combined effect of WHFC however, our research seeks to apply the Design of Experiments (DOE) methodology based on latest literature to analyze the relationship between various interparticle factors in relation to selected sand control methods. Our research aims to unearth a better understanding of how the combined effect of interparticle factors including: strength, cementation, particle size and production rate among others could better assist in the design of an optimal sand control system for the WHFC well conditions. In this regard, we seek to answer the following research question: How does the combined effect of interparticle factors affect the optimization of sand control systems for WHFC wells? Results from experimental data collection will inform a better justification for a sand control design for WHFC. In doing so, we hope to contribute to earlier contrasts arguing that sand production could potentially enable well self-permeability enhancement caused by the establishment of new flow channels created by loosening and detachment of sand grains. We hope that our research will contribute to future sand control designs capable of adapting to flexible production adjustments in controlled sand management. This paper presents results which are part of an ongoing research towards the authors' PhD project in the optimization of sand control systems for WHFC wells.

Keywords: waxy-heavy oils, clay-fine sands, sand control optimization, interparticle factors, design of experiments

Procedia PDF Downloads 131
127 Life at the Fence: Lived Experiences of Navigating Cultural and Social Complexities among South Sudanese Refugees in Australia

Authors: Sabitra Kaphle, Rebecca Fanany, Jenny Kelly

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Australia welcomes significant numbers of humanitarian arrivals every year with the commitment to provide equal opportunities and the resources required for integration into the new society. Over the last two decades, more than 24,000 South Sudanese people have come to call Australia home. Most of these refugees experienced several challenges whilesettlinginto the new social structures and service systems in Australia. The aim of the research is to explore the factors influencing social and cultural integration of South Sudanese refugees who have settled in Australia. Methodology: This studyused a phenomenological approach based on in-depth interviews designed to elicit the lived experiences of South Sudanese refugees settled in Australia. It applied the principles of narrative ethnography, allowing participants an opportunity to speak about themselves and their experiences of social and cultural integration-using their own words. Twenty-six participants were recruited to the study. Participants were long-term residents (over 10 years of settlement experience)who self-identified as refugees from South Sudan. Participants were given an opportunity to speak in the language of their choice, and interviews were conducted by a bilingual interviewer in their preferred language, time, and location. Interviews were recorded and transcribed verbatim and translated to Englishfor thematic analysis. Findings: Participants’ experiences portray the complexities of integrating into a new society due tothe daily challenges that South Sudaneserefugees face. Themes emerged from narrativesindicated that South Sudanese refugees express a high level of association with a Sudanese identity while demonstrating a significant level of integration into the Australian society. Despite this identity dilemma, these refugees show a high level of consensus about the experiencesof living in Australia that is closely associated with a group identity. In the process of maintaining identity andsocial affiliation, there are significant inter-generational cultural conflicts that participants experience in adapting to Australian society. It has been elucidated that identityconflict often emerges centeringon what constitutes authentic cultural practice as well as who is entitled to claim to be a member of the South Sudanese culture. Conclusions: Results of this study suggest that the cultural identity and social affiliations of South Sudanese refugees settling into Australian society are complex and multifaceted. While there are positive elements of theirintegration into the new society, inter-generational conflictsand identity confusion require further investigation to understand the context that will assist refugees to integrate more successfully into their new society. Given the length of stay of these refugees in Australia, government and settlement agencies may benefit from developing appropriate resources and process that are adaptive to the social and cultural context in which newly arrived refugees will live.

Keywords: cultural integration, inter-generational conflict, lived experiences, refugees, South sudanese

Procedia PDF Downloads 115
126 Female Autism Spectrum Disorder and Understanding Rigid Repetitive Behaviors

Authors: Erin Micali, Katerina Tolstikova, Cheryl Maykel, Elizabeth Harwood

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Female ASD is seldomly studied separately from males. Further, females with ASD are disproportionately underrepresented in the research at a rate of 3:1 (male to female). As such, much of the current understanding about female rigid repetitive behaviors (RRBs) stems from research’s understanding of male RRBs. This can be detrimental to understanding female ASD because this understanding of female RRBs largely discounts female camouflaging and the possibility that females present their autistic symptoms differently. Current literature suggests that females with ASD engage in fewer RRBs than males with ASD and when females do engage in RRBs, they are likely to engage in more subtle, less overt obsessions and repetitive behaviors than males. Method: The current study utilized a mixed methods research design to identify the type and frequency of RRBs that females with ASD engaged in by using a cross-sectional design. The researcher recruited only females to be part of the present study with the criteria they be at least age six and not have co-occurring cognitive impairment. Results: The researcher collected previous testing data (Autism Diagnostic Interview-Revised (ADI-R), Child or Adolescent/Adult Sensory Profile-2, Autism/ Empathy Quotient, Yale Brown Obsessive Compulsive Checklist, Rigid Repetitive Behavior Checklist (evaluator created list), and demographic questionnaire) from 25 total participants. The participants ages ranged from six to 52. The participants were 96% Caucasion and 4% Latin American. Qualitative analysis found the current participant pool engaged in six RRB themes including repetitive behaviors, socially restrictive behaviors, repetitive speech, difficulty with transition, obsessive behaviors, and restricted interests. The current dataset engaged in socially restrictive behaviors and restrictive interests most frequently. Within the main themes 40 subthemes were isolated, defined, and analyzed. Further, preliminary quantitative analysis was run to determine if age impacted camouflaging behaviors and overall presentation of RRBs. Within this dataset this was not founded. Further qualitative data will be run to determine if this dataset engaged in more overt or subtle RRBs to confirm or rebuff previous research. The researcher intends to run SPSS analysis to determine if there was statistical difference between each RRB theme and overall presentation. Secondly, each participant will be analyzed for presentation of RRB, age, and previous diagnoses. Conclusion: The present study aimed to assist in diagnostic clarity. This was achieved by collecting data from a female only participant pool across the lifespan. Current data aided in clarity of the type of RRBs engage in. A limited sample size was a barrier in this study.

Keywords: autism spectrum disorder, camouflaging, rigid repetitive behaviors, gender disparity

Procedia PDF Downloads 143
125 The Administration of Infection Diseases During the Pandemic COVID-19 and the Role of the Differential Diagnosis with Biomarkers VB10

Authors: Sofia Papadimitriou

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INTRODUCTION: The differential diagnosis between acute viral and bacterial infections is an important cost-effectiveness parameter at the stage of the treatment process in order to achieve the maximum benefits in therapeutic intervention by combining the minimum cost to ensure the proper use of antibiotics.The discovery of sensitive and robust molecular diagnostic tests in response to the role of the host in infections has enhanced the accurate diagnosis and differentiation of infections. METHOD: The study used a sample of six independent blood samples (total=756) which are associated with human proteins-proteins, each of which at the transcription stage expresses a different response in the host network between viral and bacterial infections.Τhe individual blood samples are subjected to a sequence of computer filters that identify a gene panel corresponding to an autonomous diagnostic score. The data set and the correspondence of the gene panel to the diagnostic patents a new Bangalore -Viral Bacterial (BL-VB). FINDING: We use a biomarker based on the blood of 10 genes(Panel-VB) that are an important prognostic value for the detection of viruses from bacterial infections with a weighted average AUROC of 0.97(95% CL:0.96-0.99) in eleven independent samples (sets n=898). We discovered a base with a patient score (VB 10 ) according to the table, which is a significant diagnostic value with a weighted average of AUROC 0.94(95% CL: 0.91-0.98) in 2996 patient samples from 56 public sets of data from 19 different countries. We also studied VB 10 in a new cohort of South India (BL-VB,n=56) and found 97% accuracy in confirmed cases of viral and bacterial infections. We found that VB 10 (a)accurately identifies the type of infection even in unspecified cases negative to the culture (b) shows its clinical condition recovery and (c) applies to all age groups, covering a wide range of acute bacterial and viral infectious, including non-specific pathogens. We applied our VB 10 rating to publicly available COVID 19 data and found that our rating diagnosed viral infection in patient samples. RESULTS: Τhe results of the study showed the diagnostic power of the biomarker VB 10 as a diagnostic test for the accurate diagnosis of acute infections in recovery conditions. We look forward to helping you make clinical decisions about prescribing antibiotics and integrating them into your policies management of antibiotic stewardship efforts. CONCLUSIONS: Overall, we are developing a new property of the RNA-based biomarker and a new blood test to differentiate between viral and bacterial infections to assist a physician in designing the optimal treatment regimen to contribute to the proper use of antibiotics and reduce the burden on antimicrobial resistance, AMR.

Keywords: acute infections, antimicrobial resistance, biomarker, blood transcriptome, systems biology, classifier diagnostic score

Procedia PDF Downloads 155
124 Needs-Gap Analysis on Culturally and Linguistically Diverse Grandparent Carers ‘Hidden Issues’: An Insight for Community Nurses

Authors: Mercedes Sepulveda, Saras Henderson, Dana Farrell, Gaby Heuft

Abstract:

In Australia, there is a significant number of Culturally and Linguistically Diverse (CALD) Grandparent Carers who are sole carers for their grandchildren. Services in the community such as accessible healthcare, financial support, legal aid, and transport to services can assist Grandparent Carers to continue to live in their own home whilst caring for their grandchildren. Community nurses can play a major role by being aware of the needs of these grandparents and link them to services via information and referrals. The CALD Grandparent Carer experiences have only been explored marginally and may be similar to the general Grandparent Carer population, although cultural aspects may add to their difficulties. This Needs-Gap Analysis aimed to uncover ‘hidden issues’ for CALD Grandparent Carers such as service gaps and actions needed to address these issues. The stakeholders selected for this Needs-Gap Analysis were drawn from relevant service providers such as community and aged care services, child and/or grandparents support services and CALD specific services. One hundred relevant service providers were surveyed using six structured questions via face to face, phone interviews, or email correspondence. CALD Grandparents who had a significant or sole role of being a carer for grandchildren were invited to participate through their CALD community leaders. Consultative Forums asking five questions that focused on the caring role, issues encountered, and what needed to be done, were conducted with the African, Asian, Spanish-Speaking, Middle Eastern, European, Pacific Islander and Maori Grandparent Carers living in South-east Queensland, Australia. Data from the service provider survey and the CALD Grandparent Carer forums were content analysed using thematic principles. Our findings highlighted social determinants of health grouped into six themes. These were; 1) service providers and Grandparent Carer perception that there was limited research data on CALD grandparents as carers; 2) inadequate legal and financial support; 3) barriers to accessing information and advice; 4) lack of childcare options in the light of aging and health issues; 5) difficulties around transport; and 6) inadequate technological skills often leading to social isolation for both carer and grandchildren. Our Needs-Gap Analysis provides insight to service providers especially health practitioners such as doctors and community nurses, particularly on the impact of caring for grandchildren on CALD Grandparent Carers. Furthermore, factors such as cultural differences, English language difficulties, and migration experiences also impacted on the way CALD Grandparent Carers are able to cope. The findings of this Need-Gap Analysis signposts some of the ‘ hidden issues’ that CALD Grandparents Carers face and draws together recommendations for the future as put forward by the stakeholders themselves.

Keywords: CALD grandparents, carer needs, community nurses, grandparent carers

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123 Tourism Management of the Heritage and Archaeological Sites in Egypt

Authors: Sabry A. El Azazy

Abstract:

The archaeological heritage sites are one of the most important touristic attractions worldwide. Egypt has various archaeological sites and historical locations that are classified within the list of the archaeological heritage destinations in the world, such as Cairo, Luxor, Aswan, Alexandria, and Sinai. This study focuses on how to manage the archaeological sites and provide them with all services according to the traveler's needs. Tourism management depends on strategic planning for supporting the national economy and sustainable development. Additionally, tourism management has to utilize highly effective standards of security, promotion, advertisement, sales, and marketing while taking into consideration the preservation of monuments. In Egypt, the archaeological heritage sites must be well-managed and protected, which would assist tourism management, especially in times of crisis. Recently, the monumental places and archeological heritage sites were affected by unstable conditions and were threatened. It is essential to focus on preserving our heritage. Moreover, more efforts and cooperation between the tourism organizations and ministry of archaeology have to be done in order to protect the archaeology and promote the tourism industry. Methodology: Qualitative methods have been used as the overall approach to this study. Interviews and observations have provided the researcher with the required in-depth insight to the research subject. The researcher was a lecturer of tourist guidance that allows visiting all historical sites in Egypt. Additionally, the researcher had the privilege to communicate with tourism specialists and attend meetings, conferences, and events that were focused on the research subject. Objectives: The main purpose of the research was gaining information in order to develop theoretical research on how to effectively benefit out of those historical sights both economically and culturally, and pursue further researches and scientific studies to be well-suited for tourism and hospitality sector. The researcher works hard to present further studies in a field related to tourism and archaeological heritage using previous experience. Pursing this course of study enables the researcher to acquire the necessary abilities and competencies to achieve the set goal successfully. Results: The professional tourism management focus on making Egypt one of the most important destinations in the world, and provide the heritage and archaeological sites with all services that will place those locations into the international map of tourism. Tourists interested in visiting Egypt and making tourism flourish supports and strengths Egypt's national economy and the local community, taking into consideration preserving our heritage and archaeology. Conclusions: Egypt has many tourism attractions represented in the heritage, archaeological sites, and touristic places. These places need more attention and efforts to be included in tourism programs and be opened for visitors from all over the world. These efforts will encourage both local and international tourism to see our great civilization and provide different touristic activities.

Keywords: archaeology, archaeological sites, heritage, ministry of archaeology, national economy, touristic attractions, tourism management, tourism organizations

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122 Exploring the Motivations That Drive Paper Use in Clinical Practice Post-Electronic Health Record Adoption: A Nursing Perspective

Authors: Sinead Impey, Gaye Stephens, Lucy Hederman, Declan O'Sullivan

Abstract:

Continued paper use in the clinical area post-Electronic Health Record (EHR) adoption is regularly linked to hardware and software usability challenges. Although paper is used as a workaround to circumvent challenges, including limited availability of a computer, this perspective does not consider the important role paper, such as the nurses’ handover sheet, play in practice. The purpose of this study is to confirm the hypothesis that paper use post-EHR adoption continues as paper provides both a cognitive tool (that assists with workflow) and a compensation tool (to circumvent usability challenges). Distinguishing the different motivations for continued paper-use could assist future evaluations of electronic record systems. Methods: Qualitative data were collected from three clinical care environments (ICU, general ward and specialist day-care) who used an electronic record for at least 12 months. Data were collected through semi-structured interviews with 22 nurses. Data were transcribed, themes extracted using an inductive bottom-up coding approach and a thematic index constructed. Findings: All nurses interviewed continued to use paper post-EHR adoption. While two distinct motivations for paper use post-EHR adoption were confirmed by the data - paper as a cognitive tool and paper as a compensation tool - further finding was that there was an overlap between the two uses. That is, paper used as a compensation tool could also be adapted to function as a cognitive aid due to its nature (easy to access and annotate) or vice versa. Rather than present paper persistence as having two distinctive motivations, it is more useful to describe it as presenting on a continuum with compensation tool and cognitive tool at either pole. Paper as a cognitive tool referred to pages such as nurses’ handover sheet. These did not form part of the patient’s record, although information could be transcribed from one to the other. Findings suggest that although the patient record was digitised, handover sheets did not fall within this remit. These personal pages continued to be useful post-EHR adoption for capturing personal notes or patient information and so continued to be incorporated into the nurses’ work. Comparatively, the paper used as a compensation tool, such as pre-printed care plans which were stored in the patient's record, appears to have been instigated in reaction to usability challenges. In these instances, it is expected that paper use could reduce or cease when the underlying problem is addressed. There is a danger that as paper affords nurses a temporary information platform that is mobile, easy to access and annotate, its use could become embedded in clinical practice. Conclusion: Paper presents a utility to nursing, either as a cognitive or compensation tool or combination of both. By fully understanding its utility and nuances, organisations can avoid evaluating all incidences of paper use (post-EHR adoption) as arising from usability challenges. Instead, suitable remedies for paper-persistence can be targeted at the root cause.

Keywords: cognitive tool, compensation tool, electronic record, handover sheet, nurse, paper persistence

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121 Unification of Lactic Acid Bacteria and Aloe Vera for Healthy Gut

Authors: Pavitra Sharma, Anuradha Singh, Nupur Mathur

Abstract:

There exist more than 100 trillion bacteria in the digestive system of human-beings. Such bacteria are referred to as gut microbiota. Gut microbiota comprises around 75% of our immune system. The bacteria that comprise the gut microbiota are unique to every individual and their composition keeps changing with time owing to factors such as the host’s age, diet, genes, environment, and external medication. Of these factors, the variable easiest to control is one’s diet. By modulating one’s diet, one can ensure an optimal composition of the gut microbiota yielding several health benefits. Prebiotics and probiotics are two compounds that have been considered as viable options to modulate the host’s diet. Prebiotics are basically plant products that support the growth of good bacteria in the host’s gut. Examples include garden asparagus, aloe vera etc. Probiotics are living microorganisms that exist in our intestines and play an integral role in promoting digestive health and supporting our immune system in general. Examples include yogurt, kimchi, kombucha etc. In the context of modulating the host’s diet, the key attribute of prebiotics is that they support the growth of probiotics. By developing the right combination of prebiotics and probiotics, food products or supplements can be created to enhance the host’s health. An effective combination of prebiotics and probiotics that yields health benefits to the host is referred to as synbiotics. Synbiotics comprise of an optimal proportion of prebiotics and probiotics, their application benefits the host’s health more than the application of prebiotics and probiotics used in isolation. When applied to food supplements, synbiotics preserve the beneficial probiotic bacteria during storage period and during the bacteria’s passage through the intestinal tract. When applied to the gastrointestinal tract, the composition of the synbiotics assumes paramount importance. Reason being that for synbiotics to be effective in the gastrointestinal tract, the chosen probiotic must be able to survive in the stomach’s acidic environment and manifest tolerance towards bile and pancreatic secretions. Further, not every prebiotic stimulates the growth of a particular probiotic. The prebiotic chosen should be one that not only maintains 2 balance in the host’s digestive system, but also provides the required nutrition to probiotics. Hence in each application of synbiotics, the prebiotic-probiotic combination needs to be carefully selected. Once the combination is finalized, the exact proportion of prebiotics and probiotics to be used needs to be considered. When determining this proportion, only that amount of a prebiotic should be used that activates metabolism of the required number of probiotics. It was observed that while probiotics are active is both the small and large intestine, the effect of prebiotics is observed primarily in the large intestine. Hence in the host’s small intestine, synbiotics are likely to have the maximum efficacy. In small intestine, prebiotics not only assist in the growth of probiotics, but they also enable probiotics to exhibit a higher tolerance to pH levels, oxygenation, and intestinal temperature

Keywords: microbiota, probiotics, prebiotics, synbiotics

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120 Hygro-Thermal Modelling of Timber Decks

Authors: Stefania Fortino, Petr Hradil, Timo Avikainen

Abstract:

Timber bridges have an excellent environmental performance, are economical, relatively easy to build and can have a long service life. However, the durability of these bridges is the main problem because of their exposure to outdoor climate conditions. The moisture content accumulated in wood for long periods, in combination with certain temperatures, may cause conditions suitable for timber decay. In addition, moisture content variations affect the structural integrity, serviceability and loading capacity of timber bridges. Therefore, the monitoring of the moisture content in wood is important for the durability of the material but also for the whole superstructure. The measurements obtained by the usual sensor-based techniques provide hygro-thermal data only in specific locations of the wood components. In this context, the monitoring can be assisted by numerical modelling to get more information on the hygro-thermal response of the bridges. This work presents a hygro-thermal model based on a multi-phase moisture transport theory to predict the distribution of moisture content, relative humidity and temperature in wood. Below the fibre saturation point, the multi-phase theory simulates three phenomena in cellular wood during moisture transfer, i.e., the diffusion of water vapour in the pores, the sorption of bound water and the diffusion of bound water in the cell walls. In the multi-phase model, the two water phases are separated, and the coupling between them is defined through a sorption rate. Furthermore, an average between the temperature-dependent adsorption and desorption isotherms is used. In previous works by some of the authors, this approach was found very suitable to study the moisture transport in uncoated and coated stress-laminated timber decks. Compared to previous works, the hygro-thermal fluxes on the external surfaces include the influence of the absorbed solar radiation during the time and consequently, the temperatures on the surfaces exposed to the sun are higher. This affects the whole hygro-thermal response of the timber component. The multi-phase model, implemented in a user subroutine of Abaqus FEM code, provides the distribution of the moisture content, the temperature and the relative humidity in a volume of the timber deck. As a case study, the hygro-thermal data in wood are collected from the ongoing monitoring of the stress-laminated timber deck of Tapiola Bridge in Finland, based on integrated humidity-temperature sensors and the numerical results are found in good agreement with the measurements. The proposed model, used to assist the monitoring, can contribute to reducing the maintenance costs of bridges, as well as the cost of instrumentation, and increase safety.

Keywords: moisture content, multi-phase models, solar radiation, timber decks, FEM

Procedia PDF Downloads 175