Search results for: providing health in remote areas
2450 Plackett-Burman Design for Microencapsulation of Blueberry Bioactive Compounds
Authors: Feyza Tatar, Alime Cengiz, Dilara Sandikçi, Muhammed Dervisoglu, Talip Kahyaoglu
Abstract:
Blueberries are known for their bioactive properties such as high anthocyanin contents, antioxidant activities and potential health benefits. However, anthocyanins are sensitive to environmental conditions during processes. The objective of this study was to evaluate the effects of spray drying conditions on the blueberry microcapsules by Plackett-Burman experimental design. Inlet air temperature (120 and 180°C), feed pump rate (20% and 40%), DE of maltodextrin (6 and 15 DE), coating concentration (10% and 30%) and source of blueberry (Duke and Darrow) were independent variables, tested at high (+1) and low (-1) levels. Encapsulation efficiency (based on total phenol) of blueberry microcapsules was the dependent variable. In addition, anthocyanin content, antioxidant activity, water solubility, water activity and bulk density were measured for blueberry powders. The antioxidant activity of blueberry powders ranged from 72 to 265 mmol Trolox/g and anthocyanin content was changed from 528 to 5500 mg GAE/100g. Encapsulation efficiency was significantly affected (p<0.05) by inlet air temperature and coating concentration. Encapsulation efficiency increased with increasing inlet air temperature and decreasing coating concentration. The highest encapsulation efficiency could be produced by spray drying at 180°C inlet air temperature, 40% pump rate, 6 DE of maltodextrin, 13% maltodextrin concentration and source of duke blueberry.Keywords: blueberry, microencapsulation, Plackett-Burman design, spray drying
Procedia PDF Downloads 2872449 Deciphering the Gut Microbiome's Role in Early-Life Immune Development
Authors: Xia Huo
Abstract:
Children are more vulnerable to environmental toxicants compared to adults, and their developing immune system is among the most sensitive targets regarding toxicity of environmental toxicants. Studies have found that exposure to environmental toxicants is associated with impaired immune function in children, but only a few studies have focused on the relationship between environmental toxicant exposure and vaccine antibody potency and immunoglobulin (Ig) levels in children. These studies investigated the associations of exposure to polychlorinated biphenyls (PCBs), perfluorinated compounds (PFCs), heavy metals (Pb, Cd, As, Hg) and PM2.5 with the serum-specific antibody concentrations and Ig levels against different vaccines, such as anti-Hib, tetanus, diphtheria toxoid, and analyze the possible mechanisms underlying exposure-related alterations of antibody titers and Ig levels against different vaccines. Results suggest that exposure to these toxicants is generally associated with decreased potency of antibodies produced from childhood immunizations and an overall deficiency in the protection the vaccines provide. Toxicant exposure is associated with vaccination failure and decreased antibody titers, and increased risk of immune-related diseases in children by altering specific immunoglobulin levels. Age, sex, nutritional status, and co-exposure may influence the effects of toxicants on the immune function in children. Epidemiological evidence suggests that exposure-induced changes to humoral immunerelated tissue/cells/molecules response to vaccines may have predominant roles in the inverse associations between antibody responsiveness to vaccines and environmental toxicants. These results help us to conduct better immunization policies for children under environmental toxicant burden.Keywords: environmental toxicants, immunotoxicity, vaccination, antibodies, children's health
Procedia PDF Downloads 592448 Physical Fitness Evaluation of MARA Junior Science Collage Rugby Player
Authors: Mohamad Nizam Asmuni, Ahmad Naszeri Salleh, Yunus Adam, Azhar Yaacob, Mohd Hafiz Rosli, Muhamad Nazrul Hakim Abdullah
Abstract:
Athletes at the school should have good physical fitness to participate in tournament. Currently, there are no standards for the level of physical fitness for MARA Junior Science Collage (MJSC). Therefore, this research is to determine the level of physical fitness of rugby player at MJSC. A total of 62 samples (age 16.4 ± 0.75) among rugby players at MJSC were randomly selected to participate in this study. Height, weight, body fat percentage, body mass index (BMI) and other physical testing are measured and recorded. The results showed that the average of body mass index (BMI) for rugby players is 23.4 ± 4:51. Body mass index (BMI) of rugby players can be categorized as pre-obese based on World Health Organization (WHO) guidelines. BMI for rugby players was categorized as healthy based on body fat ranges for standard adults at NY Obesity Research Center. Bleep test results show that the average Bleep test is level 7 and shuttle 5; average VO2max was 37.94 L/min. Physical fitness and performance of rugby players at MJSC is lower compared to the rugby junior athletes in University Putra Malaysia (UPM). Therefore, physical fitness of rugby players must be improved to ensure the rugby players at MJSC could be performs better in the tournament.Keywords: physical fitness, MARA junior science collage (MJSC), body mass index (BMI), bleep test
Procedia PDF Downloads 4822447 Examination of Predictive Factors of Depression among Asian American Adolescents: A Narrative Review
Authors: Annisa Siu, Ping Zou
Abstract:
Background: Existent literature addressing Asian American children and adolescents reveals that this population is experiencing rates of depression comparable to those of European American and other ethnic minority youths. Within the last decade, increased attention has been given to Asian American adolescent mental health. Methods: 44 articles were extracted from Pubmed, PsycINFO, EMBASE, and Proquest CINAHL. Data were subject to thematic analyses and categorized into factors under individual, familial, and community levels. Results: Of all the individual factors, age and gender were the most supported in their relationship with depressive symptoms. Likewise, living situations, parent-child relations, peer relations, and broader environmental factors were strongly evidenced. The remaining psychosocial factors faced contrary evidence or were insubstantially addressed in the empirical literature. Discussion: The identified psychosocial factors within this study offer a starting point for future research to examine what factors should be included in formal or informal methods of screening/consultations. Clinicians should aim to understand the cultural influences specific to Asian American adolescents, particularly the central role that family relations may have on their depressive symptoms. Conclusion: Low awareness of culturally linked expressions of psychological distress can lead to misdiagnosis or under-diagnosis of depression in Asian American youth. Further evidence is needed to clarify the relationship of psychosocial factors linked to Asian American adolescent depressive symptoms.Keywords: adolescent, Asian American, depression, psychosocial factors
Procedia PDF Downloads 1212446 Family Living with Adolescent Mother: The Consequential Effects of Adolescent Pregnancy
Authors: Somsakhool Neelasmith, Darunee Jongudomkarn, Rutja Phuphaibul
Abstract:
Adolescent pregnancy is a major global concern including Thailand, which has long adopted policies and solutions to prevent such problem. Family is one of the key strategies to drive policy achievement whereas the various families and regional differences will be challenges. This article reports a preliminary study finding using qualitative case study methods, aiming to explore the situation of families living with adolescent mother in the North Eastern of Thailand or ISAN. Data were collected by in-depth interview with six key informants; five adolescent mothers age 14- 19 years and one mother in law of adolescent mother during November to December of 2017. The preliminary suggests that firstly, the adolescent pregnancy was found to be one of the significant issues among most of the families and that adolescent mothers and their family perceived other families were also faced with this problem with despite different conditions. Secondly, the parents assumed simultaneous roles as both parents and grandparents when one of their adolescent girls became an adolescent mother. Lastly, when perceiving that their adolescent daughter became pregnant, families addressed this issue by compromise with the related parties to maintain family and social relationship. This situation can be a potential intractable problem to adolescents and their families. Families may suffer from adolescent pregnancy with respect to health, economy and other family burdens. Moreover, the national development may be affected or delayed since this group of people is considered promising human resource. It is therefore required to further conduct in-depth research to cope with this issue particularly about the policies related to adolescent pregnancy.Keywords: adolescent mother, adolescent pregnancy, consequential effect, family living with adolescent mother
Procedia PDF Downloads 2782445 Synthesis and Modification of Azardirachta indica (Neem Leaf) with Nimibidin: Bioadsorptive Remediation
Authors: Nene Pearl Eluchie
Abstract:
Globally, metal ion, particularly those generated from oil and gas effluents, form environmental pollution, particularly in developing regions like Nigeria, where water borne disease is fatal. This is clear evidence for metal ion contamination within the environment. Ecofriendly and cost effective biomaterials are the best ways of reducing metal ion contamination, thus reducing the need for chemical treatment of oil and gas effluent. Despite this, research efforts to understand the mechanism of adsorption and possible bio-adsorptive remediation interventions are limited. The study combined biomaterial and adsorption techniques: A. Indica, UV-Visible spectroscopy, SEM, FTIR in a progressive manner to provide insight. The biosorption efficiency of Azadirachta Indica silver nanoparticle AI-AgNPs was within the range of 63-95%. The study demonstrates that AI-AgNPs can be a promising agent, cheap, efficient, and biodegradable bio-sorbent for lowering oil and gas effluents. This is one of the studies to show that Azadirachta Indica is just one of the many biomaterials to synthesize silver nanoparticles through the reduction of active constituents (Nimbidin) present in them to ensure stability and surface properties, which are critical for their performance in effluent treatment. Therefore, leveraging the knowledge from this study to raise awareness through public health initiatives and community engagement will help. The prevalence of metal ions observed in the visible region in the study indicates the need for bio-adsorptive remediation interventions, not only in social settings but also in the immediate environment. There is, thus, an urgent need for targeted interventions in vulnerable communities.Keywords: Azadirachta indica, bioadsorption, biosynthesis, effluent, nimbidin, silver nanoparticle
Procedia PDF Downloads 272444 Robust Decision Support Framework for Addressing Uncertainties in Water Resources Management in the Mekong
Authors: Chusit Apirumanekul, Chayanis Krittasudthacheewa, Ratchapat Ratanavaraha, Yanyong Inmuong
Abstract:
Rapid economic development in the Lower Mekong region is leading to changes in water quantity and quality. Changes in land- and forest-use, infrastructure development, increasing urbanization, migration patterns and climate risks are increasing demands for water, within various sectors, placing pressure on scarce water resources. Appropriate policies, strategies, and planning are urgently needed for improved water resource management. Over the last decade, Thailand has experienced more frequent and intense drought situations, affecting the level of water storage in reservoirs along with insufficient water allocation for agriculture during the dry season. The Huay Saibat River Basin, one of the well-known water-scarce areas in the northeastern region of Thailand, is experiencing ongoing water scarcity that affects both farming livelihoods and household consumption. Drought management in Thailand mainly focuses on emergency responses, rather than advance preparation and mitigation for long-term solutions. Despite many efforts from local authorities to mitigate the drought situation, there is yet no long-term comprehensive water management strategy, that integrates climate risks alongside other uncertainties. This paper assesses the application in the Huay Saibat River Basin, of the Robust Decision Support framework, to explore the feasibility of multiple drought management policies; including a shift in cropping season, in crop changes, in infrastructural operations and in the use of groundwater, under a wide range of uncertainties, including climate and land-use change. A series of consultative meetings were organized with relevant agencies and experts at the local level, to understand and explore plausible water resources strategies and identify thresholds to evaluate the performance of those strategies. Three different climate conditions were identified (dry, normal and wet). Other non-climatic factors influencing water allocation were further identified, including changes from sugarcane to rubber, delaying rice planting, increasing natural retention storage and using groundwater to supply demands for household consumption and small-scale gardening. Water allocation and water use in various sectors, such as in agriculture, domestic, industry and the environment, were estimated by utilising the Water Evaluation And Planning (WEAP) system, under various scenarios developed from the combination of climatic and non-climatic factors mentioned earlier. Water coverage (i.e. percentage of water demand being successfully supplied) was defined as a threshold for water resource strategy assessment. Thresholds for different sectors (agriculture, domestic, industry, and environment) were specified during multi-stakeholder engagements. Plausible water strategies (e.g. increasing natural retention storage, change of crop type and use of groundwater as an alternative source) were evaluated based on specified thresholds in 4 sectors (agriculture, domestic, industry, and environment) under 3 climate conditions. 'Business as usual' was evaluated for comparison. The strategies considered robust, emerge when performance is assessed as successful, under a wide range of uncertainties across the river basin. Without adopting any strategy, the water scarcity situation is likely to escalate in the future. Among the strategies identified, the use of groundwater as an alternative source was considered a potential option in combating water scarcity for the basin. Further studies are needed to explore the feasibility for groundwater use as a potential sustainable source.Keywords: climate change, robust decision support, scenarios, water resources management
Procedia PDF Downloads 1702443 The Role of Psychological Resilience in Predicting Psychological Distress in Kuwaiti Adults during Corona Varies Pandemic
Authors: Al-Tammar M. Shahah
Abstract:
Background and Objective: A novel pneumonia caused by coronavirus disease 2019 (COVID-19), which is spreading domestically and internationally, has been identified by the Chinese city of Wuhan since the end of December 2019. Limited studies examined the psychological experience such as anxiety, depression, and stress during Corona pandemic. Moreover, to the best of author's knowledge, there is no study to date has examined the psychological resilience and mental health during Corona pandemic in Kuwait. Therefore, the present research investigates the role of psychological resilience in predicting psychological distress among Kuwaiti adults during Corona pandemic. Method: Kuwaiti citizens (N = 735) completed an online survey, which includes four scales the Hospital Anxiety and Depression Scale HADS (anxiety and depression), the Connor-Davidson Resilience Scale (CD-RISC-25), and the Perceived Stress Scale (PSS). A cross-sectional correlational design was used. Results: A high level of stress was observed, with 59% reported moderate to severe stress. In contrast, low levels of anxiety and depression were observed; with 70% reporting no anxiety symptoms and 74% report no depression symptoms. Psychological resilience was negatively correlated with anxiety, depression, and stress, consistent with previous studies. As expected, resilience was found to account for significant variance in anxiety and stress after controlling for quarantine variables and demographic variables. Conclusion: The findings suggest that increasing psychological resilience might help reduce psychological distress after confronting with stressful live events in Kuwaiti citizen.Keywords: anxiety, corona, depression, psychological resilience, stress
Procedia PDF Downloads 1232442 Pattern of Substance Use: Study in a De-Addiction Clinic
Authors: Mohammad Muntasir Maruf, Muhammad Zillur Rahman Khan, Nasim Jahan, Md. Waziul Alam Chowdhury, Satparkash, Md. Nozrul Islam
Abstract:
Background: Substance use disorders have become a major public health problem in Bangladesh. Objectives: The present study was designed to assess the pattern of substance use and factors related to it among the hospitalized patients. Methods: This was a cross-sectional study. All the patients who were admitted in a private drug de-addiction clinic in the capital city (Dhaka) of Bangladesh during 1 July-31 December, 2013 and diagnosed as a case of substance use disorder by applying Structured Clinical Interview for DSM- Clinician Version were enrolled in the study. Data were collected through face to face interview by a semi-structured questionnaire and the information was complemented by the case-notes. Study subjects were 105 in number. Data analysis was performed using Statistical Package for Social Sciences (SPSS). Results: Most (90.5%) of the respondents were male. The mean age of the respondents was 28.8 (± 8.0) years. Majority (91.4%) were poly-substance users. Most (27.6%) respondents used 3 types of substances. Smoking or inhalation was the route used by most (90.5%) respondents. More than three-fourth (81%) of the respondents used nicotine. Among the other substances, majority (79%) used opiates group, followed by cannabinoids group (55.2%) and alcohol (41%). Curiosity, peer pressure and to have enjoyment or fun were identified as the common reasons for initiating substance use. Conclusions: A high proportion of poly-substance use was found. The study findings would help in management and prevention strategy of substance use in Bangladesh.Keywords: Bangladesh, de-addiction clinic, poly-substance users, substance use disorder
Procedia PDF Downloads 4582441 Analysis of the Presence of Alkylglycerols by Gas Chromatography in Ostrich Oil
Authors: Luana N. Cardozo, Debora A. S. Coutinho, Fabiola Lagher, Bruno J. G. Silva, Ivonilce Venture, Mainara Tesser, Graciela Venera
Abstract:
Ostrich oil is used as food in Brazil, and it has been the subject of scientific research because it contains essential fatty acids (Omega 3, 6, 7, and 9), which provide benefits to human health. Alkylglycerols are lipid ethers consisted of a saturated or unsaturated hydrocarbon chain joined by ether-type bonding to one of the glycerol hydroxyls. It is known that supplementation with alkylglycerols can act significantly on the functioning of immune system cells, both in pathological situations and in homeostasis. Objective: Analyze the presence of alkylglycerols in ostrich oil. Methods: The ostrich oil was bought from an industry that manufactures the product for sale as food, located in Mirante da Serra, northern Brazil. The samples were sent for analysis to the chemistry department of the Federal University of Paraná, where they were analyzed by the gas chromatography method. Results: The analysis of the ostrich oil presented alkylglycerols in area 514505154. Comparison, it is possible to observe that shark liver oil contains the area 26190196, and the difference between both is highly significant. Conclusion: The importance of alkylglycerol supplementation for the immune system is known. The analysis of the results made it possible to verify the presence of alkylglycerols in the ostrich oil, which is five times higher than in the shark liver oil, that would be the largest source food, but was surpassed by the ostrich oil until the present time. The present study emphasizes that ostrich oil can be considered a food source of alkylglycerols and may play a promising role in the immune system because it contains such substance, but further studies are needed to prove its performance in the body.Keywords: ostrich oil, nutritional composition, alkylglycerols, food
Procedia PDF Downloads 1412440 Analyzing Perceptions of Leadership Capacities After a Year-Long Leadership Development Training: An Exploratory Study of School Leaders in South Africa
Authors: Norma Kok, Diemo Masuko, Thandokazi Dlongwana, Komala Pillay
Abstract:
CONTEXT: While many school principals have been outstanding teachers and have inherent leadership potential, many have not had access to the quality of leadership development or support that empowers them to produce high-quality education outcomes in extremely challenging circumstances. Further, school leaders in under-served communities face formidable challenges arising from insufficient infrastructure, overcrowded classrooms, socio-economic challenges within the community, and insufficient parental involvement, all of which put a strain on principals’ ability to lead their schools effectively. In addition few school leaders have access to other supportive networks, and many do not know how to build and leverage social capital to create opportunities for their schools and learners. Moreover, we know that fostering parental involvement in their children’s learning improves a child’s morale, attitude, and academic achievement across all subject areas, and promotes better behaviour and social adjustment. Citizen Leader Lab facilitates the Partners for Possibility (PfP) programme to provide leadership development and support to school leaders serving under-resourced communities in South Africa to create effective environments of learning. This is done by creating partnerships between school leaders and private-sector business leaders over a 12-month period. (185) OBJECTIVES: To explore school leaders’ perceptions of their leadership capacities and changes at their schools after being exposed to a year-long leadership development training programme. METHODS: School leaders gained new leadership capacities e.g. resilience, improved confidence, communication and conflict resolution skills - catalysing into improved cultures of collaborative decision-making and environments for enhanced teaching and learningprogramme based on the 70:20:10 model whereby: 10% of learning comes from workshops, 20% of learning takes place through peer learning and 70% of learning occurs through experiential learning as partnerships work together to identify and tackle challenges in targeted schools. Participants completed a post-programme questionnaire consisting of structured and unstructured questions and semi-structured interviews were conducted with them and their business leader. The interviews were audio-recorded, transcribed and thematic content analysis was undertaken. The analysis was inductive and emerging themes were identified. A code list was generated after coding was undertaken using computer software (Dedoose). Quantitative data gathered from surveys was aggregated and analysed. RESULTS: School leadership found the programme interesting and rewarding. They gained new leadership capacities such as resilience, improved confidence, communication and conflict resolution skills - catalyzing into improved cultures of collaborative decision-making and environments for enhanced teaching and learning. New networks resulted in tangible outcomes such as upgrades to school infrastructure, water and sanitation, vegetable gardens at schools resulting in nutrition for learners and/or intangible outcomes such as skills for members of school management teams (SMTs). Collaborative leadership led to SMTs being more aligned, efficient, and cohesive; and teachers being more engaged and motivated. Notable positive changes at the school inspired parents and community members to become more actively involved in the school and in their children’s education. CONCLUSION: The PfP programme leads to improved leadership capacities and improved school culture which leads to improved teaching and learning and new resources for schools.Keywords: collaborative decision-making, collaborative leadership, community involvement, confidence
Procedia PDF Downloads 912439 The Effect of Addition of White Mulberry Fruit on the Polyphenol Content in the New Developed Bioactive Bread
Authors: Kobus-Cisowska Joanna, Flaczyk Ewa, Gramza-Michalowska Anna, Kmiecik Dominik, Przeor Monika, Marcinkowska Agata
Abstract:
In recent years, proceed to the attractiveness of typical bakery products. Expanding the education and nutrition knowledge society will develop the production of functional foods, which has a positive impact on human health. Therefore, the aim of the present study was to evaluate the effect of the addition of white mulberry fruit on the content of biologically active compounds in the new designed functional bread premixes designed for selected disease: anemia, diabetes, obesity and cardiovascular disease. For flavonols and phenolic acids content UPLC was conducted, using an NovaPack C18 column and a gradient elution system. It was found that all attempts bread characterized by a high content of biologically active compounds: polyphenols, phenolic acids, and flavonoids. The highest total content of polyphenolic compounds found in the samples of bread for anemia, diabetes and cardiovascular disease both before and after storage. The analyzed sample differed in content of phenolic acids. The highest content of these compounds were found in samples of bread for anemia and diabetes. It was found that the analyzed sample contained phenolic acids that are derivatives of hydroxybenzoic and hydroxycinnamic acid. The new designed bread contained significant amounts of flavonols, of which the dominant was routine.Keywords: mulberry, antioxidant, polyphenols, phenolic acids, flavonols
Procedia PDF Downloads 4162438 Testing Ammonia Borane for Multilayer Aprons in Nuclear Medicine as a Promising Non-toxic, Lightweight, Hydrogen Rich Material and to Enhance the Efficiency of Aprons for Workers Who Deal with Neutrons Radiation in Nuclear Medicine
Authors: Wed Othman Alghamdi
Abstract:
The current study aims to find a non-toxic, low density, hydrogen-rich material that can be used in aprons without causing health issues for nuclear medical workers that could hinder their work and negatively affect patients. Five samples were tested in terms of fast neutron removal cross-section(C21H25ClO5, C2H4, LiH,H3NBH3,MgH2) mathematically using computer program called Phy-x/PSD it is a computer program designed to calculate the fast neutron removal cross section, and it was obtained that ammonia borane (𝐻3𝑁𝐵𝐻3) with a density of 0.78 (g/ cm3) ,And it containment of the three most important elements that play a major role in protection shields, which are (hydrogen, boron, nitrogen), Hydrogen works as a moderator that slows neutrons and turn them into thermal neutrons, boron and nitrogen both have the largest neutron absorption cross section. Ammonia borane has the highest fast neutron removal cross-section with the value of (0.122959317985393cm-1) and the least for polyethylene (𝐶2𝐻4) with the value of (0.0838038707225853 cm-1) which made the ammonia borane a better candidate than polyethylene and other compounds that have been tasted in previous research for multi-layer aprons in nuclear medicine, and may approve a proper protection against the hazard radiations that its produced in nuclear medicine filed by several ways, due to it is low density and non-toxicity.Keywords: aprons, radiation, non-toxic, nuclear medicine, neutrons
Procedia PDF Downloads 662437 Promoting Couple HIV Testing among Migrants for HIV Prevention: Learnings from Integrated Counselling and Testing Centre (ICTC) in Odisha, India
Authors: Sunil Mekale, Debasish Chowdhury, Sanchita Patnaik, Amitav Das, Ashok Agarwal
Abstract:
Background: Odisha is a low HIV prevalence state in India (ANC-HIV positivity of 0.42% as per HIV sentinel surveillance 2010-2011); however, it is an important source migration state with 3.2% of male migrants reporting to be PLHIV. USAID Public Health Foundation of India -PIPPSE project is piloting a source-destination corridor programme between Odisha and Gujarat. In Odisha, the focus has been on developing a comprehensive strategy to reach out to the out migrants and their spouses in the place of their origin based on their availability. The project has made concerted attempts to identify vulnerable districts with high out migration and high positivity rate. Description: 48 out of 97 ICTCs were selected from nine top high out migration districts through multistage sampling. A retrospective descriptive analysis of HIV positive male migrants and their spouses for two years (April 2013-March 2015) was conducted. A total of 3,645 HIV positive records were analysed. Findings: Among 34.2% detected HIV positive in the ICTCs, 23.3% were male migrants and 11% were spouses of male migrants; almost 50% of total ICTC attendees. More than 70% of the PLHIV male migrants and their spouses were less than 45 years old. Conclusions: Couple HIV testing approach may be considered for male migrants and their spouses. ICTC data analysis could guide in identifying the locations with high HIV positivity among male migrants and their spouses.Keywords: HIV testing, migrants, spouse of migrants, Integrated Counselling and Testing Centre (ICTC)
Procedia PDF Downloads 3792436 Food Insecurity and Quality of Life among the Poor Elderly in South Korea
Authors: Jayoung Cho
Abstract:
Poverty has become a social problem in South Korea, given that seven out of ten elderly experience multidimensional poverty. As quality of life is a major social welfare measure of a society, verifying the major factors affecting the quality of life among the elderly in poverty can be used as baseline data for the promotion of welfare. This study aims to investigate the longitudinal relationships between food insecurity and quality of life among the elderly in poverty. In this study, panel regression analysis using 5-year longitudinal panel data were derived from Korea Welfare Panel Study (KWPS, 2011-2015) were used to identify the research question. A total of 1,327 elderly people aged 65 or older with less than 60% of median income was analyzed. The main results of the study are as follows; first, the level of quality of life of the poor elderly was on average of 5, and repeated the increase and decrease over time. Second, food insecurity and quality of life of the elderly in poverty had a longitudinal causal relationship. Furthermore, the statistical significance of food insecurity was the highest despite controlling for major variables affecting the quality of life among the poor elderly. Therefore, political and practical approaches are strongly suggested and considered regarding the food insecurity for the quality of life among the elderly in poverty. In practical intervention, it is necessary to pay attention to food insecurity when assessing the poor elderly. Also, there is a need to build a new delivery system that incorporates segmented health and nutrition-related services. This study has an academic significance in that it brought out the issue of food insecurity of the poor elderly and confirmed the longitudinal relationship between food insecurity and quality of life.Keywords: food insecurity, longitudinal panel analysis, poor elderly, quality of life
Procedia PDF Downloads 2402435 Bias Prevention in Automated Diagnosis of Melanoma: Augmentation of a Convolutional Neural Network Classifier
Authors: Kemka Ihemelandu, Chukwuemeka Ihemelandu
Abstract:
Melanoma remains a public health crisis, with incidence rates increasing rapidly in the past decades. Improving diagnostic accuracy to decrease misdiagnosis using Artificial intelligence (AI) continues to be documented. Unfortunately, unintended racially biased outcomes, a product of lack of diversity in the dataset used, with a noted class imbalance favoring lighter vs. darker skin tone, have increasingly been recognized as a problem.Resulting in noted limitations of the accuracy of the Convolutional neural network (CNN)models. CNN models are prone to biased output due to biases in the dataset used to train them. Our aim in this study was the optimization of convolutional neural network algorithms to mitigate bias in the automated diagnosis of melanoma. We hypothesized that our proposed training algorithms based on a data augmentation method to optimize the diagnostic accuracy of a CNN classifier by generating new training samples from the original ones will reduce bias in the automated diagnosis of melanoma. We applied geometric transformation, including; rotations, translations, scale change, flipping, and shearing. Resulting in a CNN model that provided a modifiedinput data making for a model that could learn subtle racial features. Optimal selection of the momentum and batch hyperparameter increased our model accuracy. We show that our augmented model reduces bias while maintaining accuracy in the automated diagnosis of melanoma.Keywords: bias, augmentation, melanoma, convolutional neural network
Procedia PDF Downloads 2112434 Natural Ventilation for the Sustainable Tall Office Buildings of the Future
Authors: Ayşin Sev, Görkem Aslan
Abstract:
Sustainable tall buildings that provide comfortable, healthy and efficient indoor environments are clearly desirable as the densification of living and working space for the world’s increasing population proceeds. For environmental concerns, these buildings must also be energy efficient. One component of these tasks is the provision of indoor air quality and thermal comfort, which can be enhanced with natural ventilation by the supply of fresh air. Working spaces can only be naturally ventilated with connections to the outdoors utilizing operable windows, double facades, ventilation stacks, balconies, patios, terraces and skygardens. Large amounts of fresh air can be provided to the indoor spaces without mechanical air-conditioning systems, which are widely employed in contemporary tall buildings. This paper tends to present the concept of natural ventilation for sustainable tall office buildings in order to achieve healthy and comfortable working spaces, as well as energy efficient environments. Initially the historical evolution of ventilation strategies for tall buildings is presented, beginning with natural ventilation and continuing with the introduction of mechanical air-conditioning systems. Then the emergence of natural ventilation due to the health and environmental concerns in tall buildings is handled, and the strategies for implementing this strategy are revealed. In the next section, a number of case studies that utilize this strategy are investigated. Finally, how tall office buildings can benefit from this strategy is discussed.Keywords: tall office building, energy efficiency, double-skin façade, stack ventilation, air conditioning
Procedia PDF Downloads 5132433 Design and in Slico Study of the Truncated Spike-M-N SARS-CoV-2 as a Novel Effective Vaccine Candidate
Authors: Aghasadeghi MR., Bahramali G., Sadat SM., Sadeghi SA., Yousefi M., Khodaei K., Ghorbani M., Sadat Larijani M.
Abstract:
Background:The emerging COVID-19 pandemic is a serious concernfor the public health worldwide. Despite the many mutations in the virus genome, it is important to find an effective vaccine against viral mutations. Therefore, in current study, we aimed at immunoinformatic evaluation of the virus proteins immunogenicity to design a preventive vaccine candidate, which could elicit humoral and cellular immune responses as well. Methods:Three antigenic regions are included;Spike, Membrane, and Nucleocapsid amino acid sequences were obtained, and possible fusion proteins were assessed andcompared by immunogenicity, structural features, and population coverage. The best fusion protein was also evaluated for MHC-I and MHC-II T-cell epitopes and the linear and conformational B-cell epitopes. Results: Among the four predicted models, the truncated Spike protein in fusion with M and N proteins is composed of 24 highly immunogenic human MHC class I and 29 MHC class II, along with 14 B-cell linear and 61 discontinues epitopes. Also, the selected protein has high antigenicity and acceptable population coverage of 82.95% in Iran and 92.51% in Europe. Conclusion: The data indicate that the truncated Spike-M-N SARS-CoV-2form which could be potential targets of neutralizing antibodies. The protein also has the ability to stimulate humoral and cellular immunity. The in silico study provided the fusion protein as a potential preventive vaccine candidate for further in vivo evaluation.Keywords: SARS-CoV-2, immunoinformatic, protein, vaccine
Procedia PDF Downloads 2232432 The Effects of Smoking Prevention Intervention on Smoking Knowledge, Attitudes and Anti-Smoking Self-Efficiency among Adolescent Students
Authors: Yi-Ying Lin, Su-Guo, Chia-Hao, Ming-Szu Hong
Abstract:
Objectives: Smoking is a common addictive behavior in teenagers. Long-term smoking is hazardous to health, causes family and social expenditure, and is an important topic that should not be overlooked by academia or the government. The aims of this study are to examine the effectiveness of these courses in terms of teenagers’ knowledge and attitudes towards the hazards of smoking and the effectiveness of their self-efficacy in rejecting smoking. Methods: This study adopted a pre-test post-test design and selected 7th, 8th, 10th, and 11th graders from two junior high schools. Total of 1073 valid questionnaires were collected. The self-completed questionnaire included background information, smoking status of relatives staying with the subject, attitudes of parents towards child smoking, knowledge and attitudes towards smoking, and anti-smoking self-efficacy. Results and clinical applications: Subjects in the experimental group underwent course interventions, which are 'smoking prevention courses,' in the semester. After course intervention, it was found that the intervention showed significant efficacy in terms of knowledge and self-efficacy in rejecting smoking in senior high school students but no efficacy in junior high school. We recommend that this course can be used in normal senior high schools. With regards to junior high schools, smoking prevention courses should be designed to be gamified, or combined with activities with both anti-smoking messages and entertainment at the same time, so that knowledge, attitudes, and self-efficacy can be subconsciously cultivated.Keywords: adolescent students, smoking knowledge, attitudes, anti-smoking self-efficiency, smoking prevention intervention
Procedia PDF Downloads 1242431 Comparative Scanning Electron Microscopic Observations of Anthelminthic Effect of Trigonella foenum-graecum on Paramphistomum cervi in Buffalo
Authors: Kiran Roat, Bhanupriya Sanger, Gayatri Swarnakar
Abstract:
Amphistomiasis disease is the main health problem throughout of the world and responsible for great economic losses to cattle industries, mostly to poor cattle farmers in developing countries. Among the rumen parasites, the Paramphistomum cervi were collected from the rumen of freshly slaughtered buffalo for the further treatment process. Trigonella foenum-graecum is commonly known as methi and fenugreek and their seeds are known for their therapeutic value. The present study was considered to evaluate in vitro efficacy of aqueous extract of Trigonella foenum-graecum on P. cervi. 130 mg/ml concentration of aqueous extract shows total mortality of P. cervi at 5 hours. The ultrastructural surface topography of untreated animal was compared with a treated animal by scanning electron microscope (SEM). The body of untreated P. cervi in conical shape, tegumental surface is highly ridged with transverse folds and present abundance number of papillaes. Observations demonstrated that the body of treated P. cervi become shrunken & elongated. Treated parasite shows the deep breakage in tegument and the disappearance of tegumental folds & papillae. Severe blebs formations have been found. Above findings, it can be concluded that the seeds of Trigonella foenum-graecum can be used as an anthelminthic agent to eliminate P. cervi from the body of buffalo.Keywords: Paramphistomum cervi, Trigonella foenum-graecum, scanning electron microscope, buffalo
Procedia PDF Downloads 2412430 The Effect of Theory of Mind Training on Adolescents with Low Social Cognition and Eudaimonic Well-Being
Authors: Leema Jacob
Abstract:
The concept of psychological well-being is complex and has familiar use not only in psychology but also in the area of lifespan development. Eudaimonic well-being is finding a purpose and meaning in life, and this depends on both the individual and society, especially during adolescence; the social-cognitive environment can be decisive. The social environment of adolescents, including family, school, and friends, is recognized as an essential context for successful human life. The development of mature social relationships is also undoubtedly important. Theory of Mind is an emerging domain in cognitive neuroscience that involves the ability to attribute mental states to oneself and others. ToM skills training constitutes a new aspect of the adolescent’s social development, including four domains: cognitive ToM, affective ToM, and an inter-intra-personal understanding of social norms. Still, little effort has been made to promote this training as a modality to foster their psychological well-being. This study aims to use the eudaimonic approach to evaluate psychological well-being with a quasi-experimental research design (pre-post-test). The major objective of the study was to identify the effect of ToM skills training on the eudaimonic well-being of adolescents with low social cognition. The data was analyzed to find their effect size from a sample of 74 adolescents from India between 17 and 19 years old. The result revealed that ToM skills training has a positive outcome on the well-being of adolescents post-training. The results are discussed based on the effect of ToM skills training on psychological well-being during adolescence, as well as on the importance of focusing on mental health as a developmental asset that can potentially influence mental well-being in the future.Keywords: ToM training, adolescents, eudaimonic well-being, social cognition
Procedia PDF Downloads 722429 Prevalence of Selected Cardiovascular Risk Factors Obesity among University of Venda Staff
Authors: Avhasei Dorothy Rasifudi, Josephine Mandizha
Abstract:
Cardiovascular risk factors continue to be the leading cause of death in the majority of developed and developing countries. In 2011, the World Health Organization reported that every year an estimated 17 million people globally die of CVD, representing 30% of all global deaths, particularly caused by heart attacks and strokes. The purpose of the study was to determine and describe the prevalence of selected cardiovascular risk factors among university of Venda staff. A cross-sectional study was conducted among 100 staff aged 20-65 years. The anthropometric measurements were conducted in accordance to and with standardized procedures advocated by the International Society for the Advanced Kinanthropometry. Weight, Height, waist circumference and hip circumference were measured for calculation of body mass index and waist-hip ratio. Blood pressure was measured using a Heine cuff and sphygmomanometer. Questionnaire was administered to gather demographic details and cardiovascular risk factors of hypertension and obesity. Data were analyzed using mean and standard deviation. The parameter t-test was applied to test significance level at p ≤ 0.05 between sexes. The statistical significance was set at p ≤ 0.05. The prevalence of hypertension was 23% with the highest prevalence amongst those aged 40 years and above. Factors found to be to be significantly associated with hypertension were gender, age, physical inactivity and family history. Prevalence of obesity was 43%, with the highest prevalence among those aged 40 years. The factors associated with obesity were diet, age and physical activity. The prevalence of hypertension and obesity in the study were high.Keywords: cardiovascular, prevalence, risk factors, staff
Procedia PDF Downloads 2952428 Evaluation of Clinical Decision Support System in Electronic Medical Record System: A Case of Malawi National Art Electronic Medical Record System
Authors: Pachawo Bisani, Goodall Nyirenda
Abstract:
The Malawi National Antiretroviral Therapy (NART) Electronic Medical Record (EMR) system was designed and developed with guidance from the Ministry of Health through the Department of HIV and AIDS (DHA) with the aim of supporting the management of HIV patient data and reporting in high prevalence ART clinics. As of 2021, the system has been scaled up to over 206 facilities across the country. The system is integrated with the clinical decision support system (CDSS) to assist healthcare providers in making a decision about an individual patient at a particular point in time. Despite NART EMR undergoing several evaluations and assessments, little has been done to evaluate the clinical decision support system in the NART EMR system. Hence, the study aimed to evaluate the use of CDSS in the NART EMR system in Malawi. The study adopted a mixed-method approach, and data was collected through interviews, observations, and questionnaires. The study has revealed that the CDSS tools were integrated into the ART clinic workflow, making it easy for the user to use it. The study has also revealed challenges in system reliability and information accuracy. Despite the challenges, the study further revealed that the system is effective and efficient, and overall, users are satisfied with the system. The study recommends that the implementers focus more on the logic behind the clinical decision-support intervention in order to address some of the concerns and enhance the accuracy of the information supplied. The study further suggests consulting the system's actual users throughout implementation.Keywords: clinical decision support system, electronic medical record system, usability, antiretroviral therapy
Procedia PDF Downloads 992427 New Forms of Living and Compatibility with the Three Ages of Life - Definition of Fundamental Design Characteristics for Intergenerational Mansions
Authors: Alessandra Marino
Abstract:
This paper thoroughly investigates the design characteristics necessary for intergenerational living and evaluates their applicability within the Italian social panorama in order to identify a model that can serve as a reference for subsequent regulatory adjustments of a new building typology. The applied methodology involves the collaboration of people with various background and architects, all representing the three main ages of life - childhood or youth, adulthood, seniority - through questionnaires aimed at researching the peculiar characteristics that contemporary intergenerational housing should include; the questionnaires are then compared with each other in order to identify any recurring patterns by age group and/or influenced by the specialist knowledge on the subject of the architects compared to the rest of the user sample. The results indicate that among specialist users in the field of architecture, young students identify home automation as the key to the inclusion of the weakest groups within the building, adult architects believe that the identification of intergenerational/community services within the building is the cornerstone, and senior architects focus on widespread spatial accessibility. At the same time, the results among non-specialist users do not identify a significantly diversified model by age group but are generally in agreement in the importance of separation between private environments and collective spaces. The interpretation of the results obtained leads to a compositional study of a new building typology with the future objective of channeling the subsequent outcomes within the regulatory adjustments of the sector.Keywords: intergenerational living, social sustainability, health, lifestyle, well-being
Procedia PDF Downloads 692426 Comparative Analysis of the Psychosocial Impact of Skin Diseases in India
Authors: Priyanka Jain, Sushila Pareek
Abstract:
Skin disease is often considered to be ‘only cosmetic’ by many medical professionals and lay-people alike but unlike most internal illnesses, skin disease is often immediately visible to others and therefore people suffering from dermatological conditions may suffer serious social and emotional consequences. The purpose of this research was to compare patients suffering from acne, alopecia areata (AA) and melanosis on perceived stress, social appearance anxiety and coping. The study included 120 patients (acne = 40 AA = 40 melanosis = 40) ages ranged from 15 to 25 years. Perceived Stress Scale (PSS), Social Appearance Anxiety Scale (SAAS), and The Brief COPE were administered to the patients. Analytical evaluation was done by Kruskal Wallis and ANOVA-tests. The results of the present study clearly revealed that perceived stress and social appearance anxiety were highest in patients with AA followed by acne patients and found least in patients with melanosis. With regard to coping, self-distraction as a coping technique was found highest in patients suffering from AA followed by acne and then melanosis. Denial was highest in acne patients followed by AA and experienced least by patients with melanosis. Behavioural disengagement was almost equal in patients with melanosis and acne and a little less in patients suffering from AA Acceptance was highest in patients with melanosis, followed by AA and least in acne patients. Self-blame was found highest in patients with acne, followed by AA patients further followed by patients suffering from melanosis. This study is an attempt to stimulate professionals working in the field of dermatology and mental health to explore their supportive communication and increase awareness regarding the difficulties that patients with skin disease can face.Keywords: coping, dermatology, perceived stress, psychosocial impact, social appearance anxiety
Procedia PDF Downloads 4722425 Prediction of PM₂.₅ Concentration in Ulaanbaatar with Deep Learning Models
Authors: Suriya
Abstract:
Rapid socio-economic development and urbanization have led to an increasingly serious air pollution problem in Ulaanbaatar (UB), the capital of Mongolia. PM₂.₅ pollution has become the most pressing aspect of UB air pollution. Therefore, monitoring and predicting PM₂.₅ concentration in UB is of great significance for the health of the local people and environmental management. As of yet, very few studies have used models to predict PM₂.₅ concentrations in UB. Using data from 0:00 on June 1, 2018, to 23:00 on April 30, 2020, we proposed two deep learning models based on Bayesian-optimized LSTM (Bayes-LSTM) and CNN-LSTM. We utilized hourly observed data, including Himawari8 (H8) aerosol optical depth (AOD), meteorology, and PM₂.₅ concentration, as input for the prediction of PM₂.₅ concentrations. The correlation strengths between meteorology, AOD, and PM₂.₅ were analyzed using the gray correlation analysis method; the comparison of the performance improvement of the model by using the AOD input value was tested, and the performance of these models was evaluated using mean absolute error (MAE) and root mean square error (RMSE). The prediction accuracies of Bayes-LSTM and CNN-LSTM deep learning models were both improved when AOD was included as an input parameter. Improvement of the prediction accuracy of the CNN-LSTM model was particularly enhanced in the non-heating season; in the heating season, the prediction accuracy of the Bayes-LSTM model slightly improved, while the prediction accuracy of the CNN-LSTM model slightly decreased. We propose two novel deep learning models for PM₂.₅ concentration prediction in UB, Bayes-LSTM, and CNN-LSTM deep learning models. Pioneering the use of AOD data from H8 and demonstrating the inclusion of AOD input data improves the performance of our two proposed deep learning models.Keywords: deep learning, AOD, PM2.5, prediction, Ulaanbaatar
Procedia PDF Downloads 482424 Medication Errors in a Juvenile Justice Youth Development Center
Authors: Tanja Salary
Abstract:
This paper discusses a study conducted in a juvenile justice facility regarding medication errors. It includes an introduction to data collected about medication errors in a juvenile justice facility from 2011 - 2019 and explores contributing factors that relate to those errors. The data was obtained from electronic incident records of medication errors that were documented from the years 2011 through 2019. In addition, the presentation reviews both current and historical research of empirical data about patient safety standards and quality care comparing traditional health care facilities to juvenile justice residential facilities and acknowledges a gap in research. The theoretical/conceptual framework for the research study was Bandura and Adams’s self-efficacy theory of behavioral change and Mark Friedman’s results-based accountability theory. Despite the lack of evidence in previous studies addressing medication errors in juvenile justice facilities, this presenter will share information that adds to the body of knowledge, including the potential relationship of medication errors and contributing factors of race and age. Implications for future research include the effect that education and training will have on the communication among juvenile justice staff, including nurses, who administer medications to juveniles to ensure adherence to patient safety standards. There are several opportunities for future research concerning other characteristics about factors that may affect medication administration errors within the residential juvenile justice facility.Keywords: Juvenile justice, medication errors, juveniles, error reduction strategies
Procedia PDF Downloads 662423 Prevalence and Determinants of Depression among Orphans and Vulnerable Children in Child Care Homes in Nepal
Authors: Kumari Bandana Bhatt, Navin Bhatt
Abstract:
Background: Orphans and vulnerable children (OVC) are high risk of physical, mental, sexual and emotional abuse and face social stigma and discrimination which significantly increase the risk of mental and behavioral disorders such as anxiety, depression or emotional problems even they stay in well run child care homes. The objective of this study was to estimate the prevalence of depression and determine the determinants among OVC in child care homes in Nepal. Methods: An institutional-based analytical cross-sectional study was conducted in twenty orphanages of five districts of Nepal. Six hundred two children were recruited into the study. After the informed consent form obtaining, the guardian and assent were interviewed by a semi-structured questionnaire and Beck Depression Inventory-II (BDI-II). Logistic regression was used for detecting the association between variables at the significant level of =0.05. Results: The study revealed that 33.20% of OVC had depression. Among them 66.80% of children experienced minimal depression, 17.40% had mild depression, 11.30% had moderate depression 4.50% had severe depression. Sex, alcohol drinking, congenital problem, social support and bully were the main variables associated with depression among OVC of the child care homes in Nepal. Conclusion: Prevalence of depression was high among the orphans and vulnerable children living in child care homes especially among the female children in Nepal. Therefore, early identification and instituting of preventive measures of depression are essential to reduce this problem in this special group of children living in child care homes.Keywords: Mental health, Depression, Orphans and vulnerable children, child care homes
Procedia PDF Downloads 1492422 Nutritive Value of Three-Stage Olive Cake (Olea europaea L.) for Growing Rabbit
Authors: Zahia Dorbane, Si Ammar Kadi, Dalila Boudouma, Thierry Gidenne
Abstract:
In rabbits feeding, minimum fibre intake is essential to avoid digestive disorders. However, this concentration of fibre is not easy to obtain when formulating feeds, without reduction of nutritional value. Three stage olive cake, the residual material after oil extraction by centrifugation, including pulp and stones, can be used as a fibre source in rabbit diet. The incorporation of olive cake can allow a better balance between different fibre fractions and reduce health disorder. However, for practical use of any raw material, it is necessary to know its chemical and nutritive value. The aim of this study was to assess the nutritive value of three-stage olive cake (TSOC) for growing rabbits. Thus, 36 rabbits weaned at 35 days (702.8 ± 28.5) were divided into three groups of 12 receiving one of the following diets: control with 0% of TSOC, TSOC10 (10% of TSOC) and TSOC20 (20% TSOC). The rabbits were individually housed in digestibility cages and received ad libitum one of the three diets, fresh and clean water was provided ad libitum. After an adaptation period of 7d, feces were collected for 4d. Collected feces were frozen and stored for further analysis. The chemical composition of TSOC shows that it is a rich fiber raw material since it contains (%DM): 6% of CP; 7.4% of EE; 78.7% of NDF; 55.4% of ADF and 24.3% of ADL. The inclusion of TSOC at 20% of basal diet reduced the digestibility coefficient of organic matter, crude protein and NDF from 67.8 to 55.3%, 80.4 to 75.3% and from 31.5 to 18.4% (p < 0.001) respectively. The digestible energy and digestible protein content of the three-stage olive cake estimated by regression was 2.94 ± 0.52MJ DE/kg DM and 22.4 ± 6 g DP/kg DM respectively. In conclusion, based on the results of the present experiment, the three-stage olive cake can be used as a fibre source for rabbit.Keywords: digestibility, nutritive value, olive cake, rabbit
Procedia PDF Downloads 1562421 Assessment of Hemostatic Activity of the Aqueous Extract of Leaves of Marrubium vulgare L.: A Mediterranean Lamiaceae Algeria
Authors: Nabil Ghedadba, Abdessemed Samira, Leila Hambaba, Sidi Mohamed Ould Mokhtar, Nassima Fercha, Houas Bousselsela
Abstract:
The overall objective of this study was to evaluate in vitro the hemostatic activity of secondary metabolites (polyphenols, flavonoids, and tannins) of Marrubium vulgare leaves, aromatic plant widely used in traditional medicine for the treatment of asthma, cough, diabetes (by its effect on the pancreas to secrete insulin), heart disease, fever has a high efficiency as against inflammation. Qualitative analysis of the aqueous extract (AQE) by thin layer chromatography revealed the presence of quercetin, kaempferol and rutin. Quantification of total phenols by Folin Ciocalteu method and flavonoids by AlCl3 method gave high values with AQE: 175±0.80 mg GAE per 100g of the dry matter, 23.86±0.36 mg QE per 100g of dry matter. Moreover, the assay of condensed tannins by the vanillin method showed that AQE contains the highest value: 16.55±0.03 mg e-catechin per 100 g of dry matter. Assessment of hemostatic activity by the plasma recalcification method (time of Howell) has allowed us to discover the surprising dose dependent anticoagulant effect of AQE lyophilized from leaves of M. vulgare. A positive linear correlation between the two parameters studied: the content of condensed tannins and hemostatic activity (r=0.96) were used to highlight a possible role of these compounds that are potent vasoconstrictor activity in hemostatic. From these results we can see that Marrubium vulgre could be used for the treatment of health.Keywords: Marrubium vulgare L., aqueous extract, phenolic compounds dosing, hemostatic activity, condensed tannins
Procedia PDF Downloads 242