Search results for: internal organisational factors
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12530

Search results for: internal organisational factors

10940 Assessment of Hepatosteatosis Among Diabetic and Nondiabetic Patients Using Biochemical Parameters and Noninvasive Imaging Techniques

Authors: Tugba Sevinc Gamsiz, Emine Koroglu, Ozcan Keskin

Abstract:

Aim: Nonalcoholic fatty liver disease (NAFLD) is considered the most common chronic liver disease in the general population. The higher mortality and morbidity among NAFLD patients and lack of symptoms makes early detection and management important. In our study, we aimed to evaluate the relationship between noninvasive imaging and biochemical markers in diabetic and nondiabetic patients diagnosed with NAFLD. Materials and Methods: The study was conducted from (September 2017) to (December 2017) on adults admitted to Internal Medicine and Gastroenterology outpatient clinics with hepatic steatosis reported on ultrasound or transient elastography within the last six months that exclude patients with other liver diseases or alcohol abuse. The data were collected and analyzed retrospectively. Number cruncher statistical system (NCSS) 2007 program was used for statistical analysis. Results: 116 patients were included in this study. Diabetic patients compared to nondiabetics had significantly higher Controlled Attenuation Parameter (CAP), Liver Stiffness Measurement (LSM) and fibrosis values. Also, hypertension, hepatomegaly, high BMI, hypertriglyceridemia, hyperglycemia, high A1c, and hyperuricemia were found to be risk factors for NAFLD progression to fibrosis. Advanced fibrosis (F3, F4) was present in 18,6 % of all our patients; 35,8 % of diabetic and 5,7 % of nondiabetic patients diagnosed with hepatic steatosis. Conclusion: Transient elastography is now used in daily clinical practice as an accurate noninvasive tool during follow-up of patients with fatty liver. Early diagnosis of the stage of liver fibrosis improves the monitoring and management of patients, especially in those with metabolic syndrome criteria.

Keywords: diabetes, elastography, fatty liver, fibrosis, metabolic syndrome

Procedia PDF Downloads 133
10939 Statistical Optimization of Adsorption of a Harmful Dye from Aqueous Solution

Authors: M. Arun, A. Kannan

Abstract:

Textile industries cater to varied customer preferences and contribute substantially to the economy. However, these textile industries also produce a considerable amount of effluents. Prominent among these are the azo dyes which impart considerable color and toxicity even at low concentrations. Azo dyes are also used as coloring agents in food and pharmaceutical industry. Despite their applications, azo dyes are also notorious pollutants and carcinogens. Popular techniques like photo-degradation, biodegradation and the use of oxidizing agents are not applicable for all kinds of dyes, as most of them are stable to these techniques. Chemical coagulation produces a large amount of toxic sludge which is undesirable and is also ineffective towards a number of dyes. Most of the azo dyes are stable to UV-visible light irradiation and may even resist aerobic degradation. Adsorption has been the most preferred technique owing to its less cost, high capacity and process efficiency and the possibility of regenerating and recycling the adsorbent. Adsorption is also most preferred because it may produce high quality of the treated effluent and it is able to remove different kinds of dyes. However, the adsorption process is influenced by many variables whose inter-dependence makes it difficult to identify optimum conditions. The variables include stirring speed, temperature, initial concentration and adsorbent dosage. Further, the internal diffusional resistance inside the adsorbent particle leads to slow uptake of the solute within the adsorbent. Hence, it is necessary to identify optimum conditions that lead to high capacity and uptake rate of these pollutants. In this work, commercially available activated carbon was chosen as the adsorbent owing to its high surface area. A typical azo dye found in textile effluent waters, viz. the monoazo Acid Orange 10 dye (CAS: 1936-15-8) has been chosen as the representative pollutant. Adsorption studies were mainly focused at obtaining equilibrium and kinetic data for the batch adsorption process at different process conditions. Studies were conducted at different stirring speed, temperature, adsorbent dosage and initial dye concentration settings. The Full Factorial Design was the chosen statistical design framework for carrying out the experiments and identifying the important factors and their interactions. The optimum conditions identified from the experimental model were validated with actual experiments at the recommended settings. The equilibrium and kinetic data obtained were fitted to different models and the model parameters were estimated. This gives more details about the nature of adsorption taking place. Critical data required to design batch adsorption systems for removal of Acid Orange 10 dye and identification of factors that critically influence the separation efficiency are the key outcomes from this research.

Keywords: acid orange 10, activated carbon, optimum adsorption conditions, statistical design

Procedia PDF Downloads 160
10938 The Impact of Board Characteristics on Firm Performance: Evidence from Banking Industry in India

Authors: Manmeet Kaur, Madhu Vij

Abstract:

The Board of Directors in a firm performs the primary role of an internal control mechanism. This Study seeks to understand the relationship between internal governance and performance of banks in India. The research paper investigates the effect of board structure (proportion of nonexecutive directors, gender diversity, board size and meetings per year) on the firm performance. This paper evaluates the impact of corporate governance mechanisms on bank’s financial performance using panel data for 28 listed banks in National Stock Exchange of India for the period of 2008-2014. Returns on Asset, Return on Equity, Tobin’s Q and Net Interest Margin were used as the financial performance indicators. To estimate the relationship among governance and bank performance initially the Study uses Pooled Ordinary Least Square (OLS) Estimation and Generalized Least Square (GLS) Estimation. Then a well-developed panel Generalized Method of Moments (GMM) Estimator is developed to investigate the dynamic nature of performance and governance relationship. The Study empirically confirms that two-step system GMM approach controls the problem of unobserved heterogeneity and endogeneity as compared to the OLS and GLS approach. The result suggests that banks with small board, boards with female members, and boards that meet more frequently tend to be more efficient and subsequently have a positive impact on performance of banks. The study offers insights to policy makers interested in enhancing the quality of governance of banks in India. Also, the findings suggest that board structure plays a vital role in the improvement of corporate governance mechanism for financial institutions. There is a need to have efficient boards in banks to improve the overall health of the financial institutions and the economic development of the country.

Keywords: board of directors, corporate governance, GMM estimation, Indian banking

Procedia PDF Downloads 245
10937 Optimization of Personnel Selection Problems via Unconstrained Geometric Programming

Authors: Vildan Kistik, Tuncay Can

Abstract:

From a business perspective, cost and profit are two key factors for businesses. The intent of most businesses is to minimize the cost to maximize or equalize the profit, so as to provide the greatest benefit to itself. However, the physical system is very complicated because of technological constructions, rapid increase of competitive environments and similar factors. In such a system it is not easy to maximize profits or to minimize costs. Businesses must decide on the competence and competence of the personnel to be recruited, taking into consideration many criteria in selecting personnel. There are many criteria to determine the competence and competence of a staff member. Factors such as the level of education, experience, psychological and sociological position, and human relationships that exist in the field are just some of the important factors in selecting a staff for a firm. Personnel selection is a very important and costly process in terms of businesses in today's competitive market. Although there are many mathematical methods developed for the selection of personnel, unfortunately the use of these mathematical methods is rarely encountered in real life. In this study, unlike other methods, an exponential programming model was established based on the possibilities of failing in case the selected personnel was started to work. With the necessary transformations, the problem has been transformed into unconstrained Geometrical Programming problem and personnel selection problem is approached with geometric programming technique. Personnel selection scenarios for a classroom were established with the help of normal distribution and optimum solutions were obtained. In the most appropriate solutions, the personnel selection process for the classroom has been achieved with minimum cost.

Keywords: geometric programming, personnel selection, non-linear programming, operations research

Procedia PDF Downloads 256
10936 Energy Related Carbon Dioxide Emissions in Pakistan: A Decomposition Analysis Using LMDI

Authors: Arsalan Khan, Faisal Jamil

Abstract:

The unprecedented increase in anthropogenic gases in recent decades has led to climatic changes worldwide. CO2 emissions are the most important factors responsible for greenhouse gases concentrations. This study decomposes the changes in overall CO2 emissions in Pakistan for the period 1990-2012 using Log Mean Divisia Index (LMDI). LMDI enables to decompose the changes in CO2 emissions into five factors namely; activity effect, structural effect, intensity effect, fuel-mix effect, and emissions factor effect. This paper confirms an upward trend of overall emissions level of the country during the period. The study finds that activity effect, structural effect and intensity effect are the three major factors responsible for the changes in overall CO2 emissions in Pakistan with activity effect as the largest contributor to overall changes in the emissions level. The structural effect is also adding to CO2 emissions, which indicates that the economic activity is shifting towards more energy-intensive sectors. However, intensity effect has negative sign representing energy efficiency gains, which indicate a good relationship between the economy and environment. The findings suggest that policy makers should encourage the diversification of the output level towards more energy efficient sub-sectors of the economy.

Keywords: energy consumption, CO2 emissions, decomposition analysis, LMDI, intensity effect

Procedia PDF Downloads 384
10935 The Influence of Human Factors Education on the Irish Registered Pre-Hospital Practitioner within the National Ambulance Service

Authors: Desmond Wade, Alfredo Ormazabal

Abstract:

Background: Ever since it commenced its registration process of pre-hospital practitioners in the year 2000 through the Irish Government Statute Instrument (SI 109 of 2000) process, the approach to education of its professionals has changed drastically. The progression from the traditional behaviouristic to the current constructivist approach has been based on experiences from other sectors and industries, nationally and internationally. Today, the delivery of a safe and efficient ambulance service heavily depends on its practitioners’ range of technical skills, academic knowledge, and overall competences. As these increase, so does the level of complexity of paramedics’ everyday practice. This has made it inevitable to consider the 'Human Factor' as a source of potential risk and made formative institutions like the National Ambulance Service College to include it in their curriculum. Methods: This paper used a mixed-method approach, where both, an online questionnaire and a set of semi-structured interviews were the source of primary data. An analysis of this data was carried out using qualitative and quantitative data analysis. Conclusions: The evidence presented leads to the conclusion that in the National Ambulance Service there is a considerable lack of education of Human Factors and the levels in understanding of how to manage Human Factors in practice vary across its spectrum. Paramedic Practitioners in Ireland seem to understand that the responsibility of patient care lies on the team, rather than on the most hierarchically senior practitioner present in the scene.

Keywords: human factors, ergonomics, stress, decision making, pre-hospital care, paramedic, education

Procedia PDF Downloads 141
10934 The Pursuit of Marital Sustainability Inspiring by Successful Matrimony of Two Distinguishable Indonesian Ethnics as a Learning Process

Authors: Mutiara Amalina Khairisa, Purnama Arafah, Rahayu Listiana Ramli

Abstract:

In recent years, so many cases of divorce increasingly occur. Betrayal in form of infidelity, less communication one another, economically problems, selfishness of two sides, intervening parents from both sides which frequently occurs in Asia, especially in Indonesia, the differences of both principles and beliefs, “Sense of Romantism” depletion, role confict, a large difference in the purpose of marriage,and sex satisfaction are expected as the primary factors of the causes of divorce. Every couple of marriage wants to reach happy life in their family but severe problems brought about by either of those main factors come as a reasonable cause of failure marriage. The purpose of this study is to find out how marital adjustment and supporting factors in ensuring the success of that previous marital adjusment are inseparable two things assumed as a framework can affect the success in marriage becoming a resolution to reduce the desires to divorce. Those two inseparable things are able to become an aspect of learning from the success of the different ethnics marriage to keep holding on wholeness.

Keywords: marital adjustment, marital sustainability, learning process, successful ethnicity differences marriage, basical cultural values

Procedia PDF Downloads 416
10933 Optimization-Based Design Improvement of Synchronizer in Transmission System for Efficient Vehicle Performance

Authors: Sanyka Banerjee, Saikat Nandi, P. K. Dan

Abstract:

Synchronizers as an integral part of gearbox is a key element in the transmission system in automotive. The performance of synchronizer affects transmission efficiency and driving comfort. Synchronizing mechanism as a major component of transmission system must be capable of preventing vibration and noise in the gears. Gear shifting efficiency improvement with an aim to achieve smooth, quick and energy efficient power transmission remains a challenge for the automotive industry. Performance of the synchronizer is dependent on the features and characteristics of its sub-components and therefore analysis of the contribution of such characteristics is necessary. An important exercise involved is to identify all such characteristics or factors which are associated with the modeling and analysis and for this purpose the literature was reviewed, rather extensively, to study the mathematical models, formulated considering such. It has been observed that certain factors are rather common across models; however, there are few factors which have specifically been selected for individual models, as reported. In order to obtain a more realistic model, an attempt here has been made to identify and assimilate practically all possible factors which may be considered in formulating the model more comprehensively. A simulation study, formulated as a block model, for such analysis has been carried out in a reliable environment like MATLAB. Lower synchronization time is desirable and hence, it has been considered here as the output factors in the simulation modeling for evaluating transmission efficiency. An improved synchronizer model requires optimized values of sub-component design parameters. A parametric optimization utilizing Taguchi’s design of experiment based response data and their analysis has been carried out for this purpose. The effectiveness of the optimized parameters for the improved synchronizer performance has been validated by the simulation study of the synchronizer block model with improved parameter values as input parameters for better transmission efficiency and driver comfort.

Keywords: design of experiments, modeling, parametric optimization, simulation, synchronizer

Procedia PDF Downloads 292
10932 Investigating the Molecular Behavior of H₂O in Caso 4 -2h₂o Two-Dimensional Nanoscale System

Authors: Manal Alhazmi, Artem Mishchenko

Abstract:

A molecular fluids' behavior and interaction with other materials at the nanoscale is a complex process. Nanoscale fluids behave so differently than macroscale fluids and interact with other materials in unique ways. It is, therefore, feasible to understand the molecular behavior of H₂O in such two-dimensional nanoscale systems by studying (CaSO4-2H2O), commonly known as gypsum. In the present study, spectroscopic measurements on a 2D structure of exfoliated gypsum crystals are carried out by Raman and IR spectroscopy. An array of gypsum flakes with thicknesses ranging from 8nm to 100nm were observed and analyzed for their Raman and IR spectrum. Water molecules stretching modes spectra lines were also measured and observed in nanoscale gypsum flakes and compared with those of bulk crystals. CaSO4-2H2O crystals have Raman and infrared bands at 3341 cm-1 resulting from the weak hydrogen bonds between the water molecules. This internal vibration of water molecules, together with external vibrations with other atoms, are responsible for these bands. There is a shift of about 70 cm-1 In the peak position of thin flakes with respect to the bulk crystal, which is a result of the different atomic arrangement from bulk to thin flake on the nano scale. An additional peak was observed in Raman spectra around 2910-3137 cm⁻¹ in thin flakes but is missing in bulk crystal. This additional peak is attributed to a combined mode of water internal (stretching mode at 3394cm⁻¹) and external vibrations. In addition to Raman and infra- red analysis of gypsum 2D structure, electrical measurements were conducted to reveal the water molecules transport behavior in such systems. Electrical capacitance of the fabricated device is measured and found to be (0.0686 *10-12) F, and the calculated dielectric constant (ε) is (12.26).

Keywords: gypsum, infra-red spectroscopy, raman spectroscopy, H₂O behavior

Procedia PDF Downloads 92
10931 Assessment of Artists’ Socioeconomic and Working Conditions: The Empirical Case of Lithuania

Authors: Rusne Kregzdaite, Erika Godlevska, Morta Vidunaite

Abstract:

The main aim of this research is to explore existing methodologies for artists’ labour force and create artists’ socio-economic and creative conditions in an assessment model. Artists have dual aims in their creative working process: 1) income and 2) artistic self-expression. The valuation of their conditions takes into consideration both sides: the factors related to income and the satisfaction of the creative process and its result. The problem addressed in the study: tangible and intangible artists' criteria used for assessments creativity conditions. The proposed model includes objective factors (working time, income, etc.) and subjective factors (salary covering essential needs, self-satisfaction). Other intangible indicators are taken into account: the impact on the common culture, social values, and the possibility to receive awards, to represent the country in the international market. The empirical model consists of 59 separate indicators, grouped into eight categories. The deviation of each indicator from the general evaluation allows for identifying the strongest and the weakest components of artists’ conditions.

Keywords: artist conditions, artistic labour force, cultural policy, indicator, assessment model

Procedia PDF Downloads 133
10930 Factors Influencing Student's Decision to Pursue a Hospitality and Tourism Program

Authors: Zeenath Solih

Abstract:

The aim of the study is to analyze the factors that influence the decision to pursue a hospitality and tourism program for students of Maldives when pursuing higher education options. This research would further explore the implications and relationship between the universities and students. Quantitative research method will be used to demonstrate the hypothesis and achieve the objectives of this research, a questionnaire consisting of 30 closed questions will be used which will be analyzed based on SPSS18 software to handle and extract the data.10 public school and 3 private schools with secondary education and 3 universities with higher education facilities and a total of 500 students participated in the survey. The findings include selection criteria for decision making for higher studies being the university’s reputation, excellence and quality of educational program, the preference of pursuing further studies from a public over private universities and the academic, cultural and socio demographic factors that influence the students choice of program and university. Finally the study will provide valuable insight to how universities need to market their programs to attract the right students.

Keywords: choice criteria, higher education, hospitality and tourism studies, information sources

Procedia PDF Downloads 255
10929 Mental Health in Young People Living Poverty in Southeastern Mexico

Authors: Teresita Castillo, Concepción Campo, Carlos Carrillo

Abstract:

Attention, comprehension and solution of poverty can be worked considering a socioeconomic approach; but it also can be attended from a multidimensional perspective that allows considering other dimensions including psychological variables manifested in behaviors, thoughts and feelings concerning this phenomenon. Considering the importance of research regarding psychology and poverty, this paper presents results about psychosocial impacts of poverty on young people related to mental health issues and its relation to fatalism. These results are part of a bigger transcultural study done in collaboration with the Federal University of Ceará, in Brazil. Participants were 101 young men and women, between 12 and 29 years old, living in two emarginated suburbs in Mérida, Mexico, located in the southeastern zone of the country. Participants responded the Self Report Questionnaire (SRQ- 20), with 20 items dichotomous presence/absence that assess anxious and depressive issues and the Fatalism Scale, with 30 items Likert five-point spread over five factors. Results show that one third of participants mentioned to get easily frightened, feeling nervous, tense or worried as well as unhappy, difficulty on making decisions, and troubles in thinking clearly. About 20% mentioned to have headaches, to sleep badly, to cry more than usual and to feel tired all the time. Regarding Fatalism, results show there is a greater internal allocation and lower external attribution in young participants, but they have some symptoms regarding poor mental health. Discussion is in terms of possible explanations about the results and emphasizes the importance of holistic approaches for a better understanding of the psychosocial impacts of poverty on young people and strengthening the resilience to increase positive mental health in emarginated contexts, where Community Psychology could have an important duty in community health promotion.

Keywords: fatalism, mental health, poverty, youth

Procedia PDF Downloads 329
10928 The Interplay between Autophagy and Macrophages' Polarization in Wound Healing: A Genetic Regulatory Network Analysis

Authors: Mayada Mazher, Ahmed Moustafa, Ahmed Abdellatif

Abstract:

Background: Autophagy is a eukaryotic, highly conserved catabolic process implicated in many pathophysiologies such as wound healing. Autophagy-associated genes serve as a scaffolding platform for signal transduction of macrophage polarization during the inflammatory phase of wound healing and tissue repair process. In the current study, we report a model for the interplay between autophagy-associated genes and macrophages polarization associated genes. Methods: In silico analysis was performed on 249 autophagy-related genes retrieved from the public autophagy database and gene expression data retrieved from Gene Expression Omnibus (GEO); GSE81922 and GSE69607 microarray data macrophages polarization 199 DEGS. An integrated protein-protein interaction network was constructed for autophagy and macrophage gene sets. The gene sets were then used for GO terms pathway enrichment analysis. Common transcription factors for autophagy and macrophages' polarization were identified. Finally, microRNAs enriched in both autophagy and macrophages were predicated. Results: In silico prediction of common transcription factors in DEGs macrophages and autophagy gene sets revealed a new role for the transcription factors, HOMEZ, GABPA, ELK1 and REL, that commonly regulate macrophages associated genes: IL6,IL1M, IL1B, NOS1, SOC3 and autophagy-related genes: Atg12, Rictor, Rb1cc1, Gaparab1, Atg16l1. Conclusions: Autophagy and macrophages' polarization are interdependent cellular processes, and both autophagy-related proteins and macrophages' polarization related proteins coordinate in tissue remodelling via transcription factors and microRNAs regulatory network. The current work highlights a potential new role for transcription factors HOMEZ, GABPA, ELK1 and REL in wound healing.

Keywords: autophagy related proteins, integrated network analysis, macrophages polarization M1 and M2, tissue remodelling

Procedia PDF Downloads 131
10927 Association of Sociodemographic Factors and Loneliness of Adolescents in China

Authors: Zihan Geng, Yifan Hou

Abstract:

Background: Loneliness is the feeling of being isolated, which is becoming increasingly common among adolescents. A cross-sectional study was performed to determine the association between loneliness and different demographics. Methods: To identify the presence of loneliness, the UCLA Loneliness Scale (Version 3) was employed. The "Questionnaire Star" in Chinese version, as the online survey on the official website, was used to distribute the self-rating questionnaires to the students in Beijing from Grade 7 to Grade 12. The questionnaire includes sociodemographic items and the UCLA Loneliness Scale. Results: Almost all of the participants exhibited “caseness” for loneliness, as defined by UCLA. Out of 266 questionnaires, 2.6% (7 in 266) students fulfilled the presence criteria for a low degree of loneliness. 29.7% (79 in 266) of adolescents met the criteria for a moderate degree of loneliness. Moreover, 62.8% (167 in 266) and 4.9% (13 in 266) of students fulfilled the presence criteria for a moderately high and high degree of loneliness, respectively. In the Pearson χ2 test, there were significant associations between loneliness and some demographic factors, including grade (P<0.001), the number of adults in the family (P=0.001), the evaluation of appearance (P=0.034), the evaluation of self-satisfaction (P<0.001), the love in family (P<0.001), academic performance (P=0.001) and emotional support from friends (P<0.001). In the multivariate logistic analysis, the number of adults (2 vs.≤1, OR=0.319, P=0.015), time spent on social media (≥4h vs. ≤1h, OR=4.862, P=0.029), emotional support of friends (more satisfied vs. dissatisfied, OR=0.363, P=0.027) were associated with loneliness. Conclusions: Our results suggest the relationship between loneliness and some sociodemographic factors, which raise the possibility to reduce the loneliness among adolescents. Therefore, the companionship of family, the encouragement from friends and regulating the time spent on social media may decrease the loneliness in adolescents.

Keywords: loneliness, adolescents, demographic factors, UCLA loneliness scale

Procedia PDF Downloads 60
10926 Political Economy of Electronic News Media in Pakistan

Authors: Asad Ullah Khalid

Abstract:

This paper encompasses the application of the concept of political economy of mass media in Pakistan. The media has developed at a massive pace and now is considered as one of the vital parts in having better administration furthermore helps in conveying the issues identified with the government to the public. Albeit Pakistani media has gained much independence after 2003 but there are many social, political and economy factors which influence the content of the media. The study employs triangulation of quantitative and qualitative methods. In terms of methods, content analysis and interview method both are used. The content of Pakistani media is analyzed quantitatively and qualitatively. Moreover, interviews with various journalists are conducted, and their findings are disclosed in this paper. Pakistan's communication landscape is neither well documented nor well understood, leaving its public off guard with regards to reviewing the role and impact of news inflow, correspondence and media in political, economic and social life. It has been found out that on particular issues some media channels have strong affiliations with certain political parties, moreover reporting and coverage have also been affected by the factors like terrorism, state policies(written and verbal), advertising/economic and demographic factors like the composition of the population.

Keywords: political economy, news media, Pakistan, electronic news media, journalism, mass media

Procedia PDF Downloads 316
10925 Application of Random Forest Model in The Prediction of River Water Quality

Authors: Turuganti Venkateswarlu, Jagadeesh Anmala

Abstract:

Excessive runoffs from various non-point source land uses, and other point sources are rapidly contaminating the water quality of streams in the Upper Green River watershed, Kentucky, USA. It is essential to maintain the stream water quality as the river basin is one of the major freshwater sources in this province. It is also important to understand the water quality parameters (WQPs) quantitatively and qualitatively along with their important features as stream water is sensitive to climatic events and land-use practices. In this paper, a model was developed for predicting one of the significant WQPs, Fecal Coliform (FC) from precipitation, temperature, urban land use factor (ULUF), agricultural land use factor (ALUF), and forest land-use factor (FLUF) using Random Forest (RF) algorithm. The RF model, a novel ensemble learning algorithm, can even find out advanced feature importance characteristics from the given model inputs for different combinations. This model’s outcomes showed a good correlation between FC and climate events and land use factors (R2 = 0.94) and precipitation and temperature are the primary influencing factors for FC.

Keywords: water quality, land use factors, random forest, fecal coliform

Procedia PDF Downloads 186
10924 Vitamin D Status in Tunisian Obese Patients

Authors: O. Berriche, R. Ben Othmen, H. Sfar, H. Abdesslam, S. Bou Meftah, S. Bhouri, F. Mahjoub, C. Amrouche, H. Jamoussi

Abstract:

Introduction: Although current evidence emphasizes a high prevalence of vitamin D deficiency and an inverse association between serum 25-hydroxyvitamin D (25-OHD) concentration and obesity, no studies have been conducted in Tunisian obese. The objectives of our study were to estimate the vitamin D deficiency in obese, identify risk factors for vitamin D deficiency, demonstrating a possible association between vitamin D levels and metabolic parameters. Methods: This was a descriptive study of 100 obese 18-65 year-old. Anthropometric measurements were determined. Fasting blood samples were assessed for the following essays : serum calcium, 25 OH vitamin D, inorganic phosphorus, fasting glucose, HDL, LDL cholesterol and triglyceride. Insulin resistance was evaluated by fasting insulin, HOMA-IR and HOMA-ß. Consumption of foods riche in vitamin D, sunscreen use, wearing protective clothes and exposed surface were assessed through applied questionnaires. Results: The deficit of vitamin D (< 30 ng/ml) among obese was 98,8%. Half of them had a rate < 10ng/ml. Environmental factors involved in vitamin D deficiency are : the veil (p = 0,001), wearing protective clothes (p = 0,04) and the exposed surface (p = 0,011) and dietary factors are represented by the daily caloric intake (p = 0,0001). The percent of fat mass was negatively related to vitamin D levels (p = 0,01) but not with BMI (p = 0,11) or waist circumference (p = 0,88). Similarly, lipid and glucose profile had no link with vitamin D. We found no relationship between Insulin resistance and vitamin D levels. Conclusion: At the end of our study, we have identified a very important vitamin D deficiency among obese. Dosage and systematic supplementation should be applied and for that physician awareness is needed.

Keywords: insulinresistance, risk factors, obesity, vitamin D

Procedia PDF Downloads 640
10923 Examining the Factors That Mediate the Effects of Mindfulness on Conflict Resolution Strategies

Authors: Franco Ceasar Agbalog, Shintaro Yukawa

Abstract:

Mindfulness is increasingly being used as a method for resolving conflict. However, less is known about how its positive outcome develops. To better understand the underlying effects of mindfulness on conflict resolution strategies, this study examines the potential mediating factors between them. The researchers hypothesized that Emotional Intelligence (EI) mediates the effects of mindfulness on conflict resolution strategies due to its similar components to the benefits of mindfulness, such as awareness and control of one’s emotions, awareness and understanding of other’s emotions, and cultivation of compassion and empathy. Using a random sampling, 157 participants completed three questionnaires: Five Facet Mindfulness Questionnaire (FFMQ), Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), and Rahim Organizational Conflict Inventory-II (ROCI-II). Utilizing the SPSS Process, results showed a significant relationship between mindfulness and EI. However, among the five approaches to conflict resolution, only the integrating style was significantly related to EI. Following the principle of Mediation Analysis, mindfulness has an indirect effect on integrating style. Moreover, mindfulness and conflict resolution strategies were not significantly related. This is a rather surprising result because research literature has always indicated a positive relationship between the two variables. These findings imply that although integrating style is generally considered the best approach in handling conflict, each style may be appropriate depending on the situation. Mindfulness allows practitioners to have a holistic view of the conflict situation and choose the approach they think best for that specific situation. This could explain why statistically, there is no direct effect of mindfulness on conflict resolution strategies. This work provides basis for the necessity to investigate the factors of conflict instead of the conflict resolution strategies; factors that can be manipulated and may be directly influenced by mindfulness.

Keywords: conflict resolution strategies, emotional intelligence, mindfulness and conflict, ROCI-II integrating style

Procedia PDF Downloads 350
10922 Assessment of Predictive Confounders for the Prevalence of Breast Cancer among Iraqi Population: A Retrospective Study from Baghdad, Iraq

Authors: Nadia H. Mohammed, Anmar Al-Taie, Fadia H. Al-Sultany

Abstract:

Although breast cancer prevalence continues to increase, mortality has been decreasing as a result of early detection and improvement in adjuvant systemic therapy. Nevertheless, this disease required further efforts to understand and identify the associated potential risk factors that could play a role in the prevalence of this malignancy among Iraqi women. The objective of this study was to assess the perception of certain predictive risk factors on the prevalence of breast cancer types among a sample of Iraqi women diagnosed with breast cancer. This was a retrospective observational study carried out at National Cancer Research Center in College of Medicine, Baghdad University from November 2017 to January 2018. Data of 100 patients with breast cancer whose biopsies examined in the National Cancer Research Center were included in this study. Data were collected to structure a detailed assessment regarding the patients’ demographic, medical and cancer records. The majority of study participants (94%) suffered from ductal breast cancer with mean age 49.57 years. Among those women, 48.9% were obese with body mass index (BMI) 35 kg/m2. 68.1% of them had positive family history of breast cancer and 66% had low parity. 40.4% had stage II ductal breast cancer followed by 25.5% with stage III. It was found that 59.6% and 68.1% had positive oestrogen receptor sensitivity and positive human epidermal growth factor (HER2/neu) receptor sensitivity respectively. In regard to the impact of prediction of certain variables on the incidence of ductal breast cancer, positive family history of breast cancer (P < 0.0001), low parity (P< 0.0001), stage I and II breast cancer (P = 0.02) and positive HER2/neu status (P < 0.0001) were significant predictive factors among the study participants. The results from this study provide relevant evidence for a significant positive and potential association between certain risk factors and the prevalence of breast cancer among Iraqi women.

Keywords: Ductal Breast Cancer, Hormone Sensitivity, Iraq, Risk Factors

Procedia PDF Downloads 120
10921 Corporate Cautionary Statement: A Genre of Professional Communication

Authors: Chie Urawa

Abstract:

Cautionary statements or disclaimers in corporate annual reports need to be carefully designed because clear cautionary statements may protect a company in the case of legal disputes and may undermine positive impressions. This study compares the language of cautionary statements using two corpora, Sony’s cautionary statement corpus (S-corpus) and Panasonic’s cautionary statement corpus (P-corpus), illustrating the differences and similarities in relation to the use of meaningful cautionary statements and critically analyzing why practitioners use the way. The findings describe the distinct differences between the two companies in the presentation of the risk factors and the way how they make the statements. The word ability is used more for legal protection in S-corpus whereas the word possibility is used more to convey a better impression in P-corpus. The main similarities are identified in the use of lexical words and pronouns, and almost the same wordings for eight years. The findings show how they make the statements unique to the company in the presentation of risk factors, and the characteristics of specific genre of professional communication. Important implications of this study are that more comprehensive approach can be applied in other contexts, and be used by companies to reflect upon their cautionary statements.

Keywords: cautionary statements, corporate annual reports, corpus, risk factors

Procedia PDF Downloads 154
10920 Effect of Modulation Factors on Tomotherapy Plans and Their Quality Analysis

Authors: Asawari Alok Pawaskar

Abstract:

This study was aimed at investigating quality assurance (QA) done with IBA matrix, the discrepan­cies observed for helical tomotherapy plans. A selection of tomotherapy plans that initially failed the with Matrix process was chosen for this investigation. These plans failed the fluence analysis as assessed using gamma criteria (3%, 3 mm). Each of these plans was modified (keeping the planning constraints the same), beamlets rebatched and reoptimized. By increasing and decreasing the modula­tion factor, the fluence in a circumferential plane as measured with a diode array was assessed. A subset of these plans was investigated using varied pitch values. Factors for each plan that were examined were point doses, fluences, leaf opening times, planned leaf sinograms, and uniformity indices. In order to ensure that the treatment constraints remained the same, the dose-volume histograms (DVHs) of all the modulated plans were compared to the original plan. It was observed that a large increase in the modulation factor did not significantly improve DVH unifor­mity, but reduced the gamma analysis pass rate. This also increased the treatment delivery time by slowing down the gantry rotation speed which then increases the maximum to mean non-zero leaf open time ratio. Increasing and decreasing the pitch value did not substantially change treatment time, but the delivery accuracy was adversely affected. This may be due to many other factors, such as the complexity of the treatment plan and site. Patient sites included in this study were head and neck, breast, abdomen. The impact of leaf tim­ing inaccuracies on plans was greater with higher modulation factors. Point-dose measurements were seen to be less susceptible to changes in pitch and modulation factors. The initial modulation factor used by the optimizer, such that the TPS generated ‘actual’ modulation factor within the range of 1.4 to 2.5, resulted in an improved deliverable plan.

Keywords: dose volume histogram, modulation factor, IBA matrix, tomotherapy

Procedia PDF Downloads 163
10919 An Investigation of Wind Loading Effects on the Design of Elevated Steel Tanks with Lattice Tower Supporting Structures

Authors: J. van Vuuren, D. J. van Vuuren, R. Muigai

Abstract:

In recent times, South Africa has experienced extensive droughts that created the need for reliable small water reservoirs. These reservoirs have comparatively quick fabrication and installation times compared to market alternatives. An elevated water tank has inherent potential energy, resulting in that no additional water pumps are required to sustain water pressure at the outlet point – thus ensuring that, without electricity, a water source is available. The initial construction formwork and the complex geometric shape of concrete towers that requires casting can become time-consuming, rendering steel towers preferable. Reinforced concrete foundations, cast in advance, are required to be of sufficient strength. Thereafter, the prefabricated steel supporting structure and tank, which consist of steel panels, can be assembled and erected on site within a couple of days. Due to the time effectiveness of this system, it has become a popular solution to aid drought-stricken areas. These sites are normally in rural, schools or farmland areas. As these tanks can contain up to 2000kL (approximately 19.62MN) of water, combined with supporting lattice steel structures ranging between 5m and 30m in height, failure of one of the supporting members will result in system failure. Thus, there is a need to gain a comprehensive understanding of the operation conditions because of wind loadings on both the tank and the supporting structure. The aim of the research is to investigate the relationship between the theoretical wind loading on a lattice steel tower in combination with an elevated sectional steel tank, and the current wind loading codes, as applicable to South Africa. The research compares the respective design parameters (both theoretical and wind loading codes) whereby FEA analyses are conducted on the various design solutions. The currently available wind loading codes are not sufficient to design slender cantilever latticed steel towers that support elevated water storage tanks. Numerous factors in the design codes are not comprehensively considered when designing the system as these codes are dependent on various assumptions. Factors that require investigation for the study are; the wind loading angle to the face of the structure that will result in maximum load; the internal structural effects on models with different bracing patterns; the loading influence of the aspect ratio of the tank; and the clearance height of the tank on the structural members. Wind loads, as the variable that results in the highest failure rate of cantilevered lattice steel tower structures, require greater understanding. This study aims to contribute towards the design process of elevated steel tanks with lattice tower supporting structures.

Keywords: aspect ratio, bracing patterns, clearance height, elevated steel tanks, lattice steel tower, wind loads

Procedia PDF Downloads 137
10918 The Analysis of the Stress Phenomenon among the Academic Teachers

Authors: Monika Szpringer, Mariola Wojciechowska, Robert Dutkiewicz, Grażyna Nowak-Starz, Marzena Olędzka

Abstract:

The main aim of this article is to determine the phenomenon of stress among academic teachers as well as to identify the extent to which the teachers experience work-related psychological risks. It is also important to support academic teachers trade unions in scope of stress-oriented activities, including psychological dangers in the assessment of risk in the workplace (college). The authors used a method of a diagnostic survey with a polling as a technique and authors’ questionnaire as a tool. The survey was conducted between September and December of 2013 and it comprised 1890 academic teachers from five voivodeships. The study reveals that 84.0% of the respondents found the work of an academic teacher to be borne with a considerable stress. The percentage values of the most frequent causes of stress are as follows: frequent changes of both organisational and didactic matters as well as overwhelming bureaucracy (77.8 %), time pressure regarding professional development and related risk of losing job (68.2 %), difficult working conditions (45.4%), conflicts and rivalry between teachers (44.1%), excessive amount of duties as well as increasing requirements and demanding attitude of students (33.7%). Work-related stress affects or significantly affects the private life of 69 % and 66.4 % of the respondents respectively. The majority of the people surveyed deals with stress by undertaking various activities, with 40% pointing at using various substances, mostly cigarettes and alcohol (p > 0,05) Physical ailments were experienced by 81% of the respondents, in 9% they were rare and 8 % of the respondents had never experienced such disorders. The entire group of the surveyed people (100 %) claimed that they have no possibility of contacting a psychologist at their workplace (p > 0.05), and they stated that the need of contacting specialists does exist.

Keywords: stress, academic teachers, psychological risks, work-related

Procedia PDF Downloads 382
10917 Study of Some Epidemiological Factors Influencing the Disease Incidence in Chickpea (Cicer Arietinum L.)

Authors: Muhammad Asim Nazir

Abstract:

The investigations reported in this manuscript were carried on the screening of one hundred and seventy-eight chickpea germplasm lines/cultivars against wilt disease, caused by Fusarium oxysporum f. sp. ciceris. The screening was conducted in vivo (field) conditions. The field screening was accompanied with the study of some epidemiological factors affecting the occurrence and severity of the disease. Among the epidemiological factors maximum temperature range (28-40°C), minimum temperature range (12-24°C), relative humidity (19-44%), soil temperature (26-41°C) and soil moisture range (19-34°C) was studied for affecting the disease incidence/severity. The results revealed that air temperature was positively correlated with diseases. Soil temperature data revealed that in all cultivars disease incidence was maximum as 39°C. Most of the plants show 40-50% disease incidence. Disease incidence decreased at 33.5°C. The result of correlation of relative humidity of air and wilt incidence revealed that all cultivars/lines were negatively correlated with relative humidity. With increasing relative humidity wilt incidence decreased and vice versa.

Keywords: chickpea, epidemiological, screening, disease

Procedia PDF Downloads 627
10916 Validating Chronic Kidney Disease-Specific Risk Factors for Cardiovascular Events Using National Data: A Retrospective Cohort Study of the Nationwide Inpatient Sample

Authors: Fidelis E. Uwumiro, Chimaobi O. Nwevo, Favour O. Osemwota, Victory O. Okpujie, Emeka S. Obi, Omamuyovbi F. Nwoagbe, Ejiroghene Tejere, Joycelyn Adjei-Mensah, Christopher N. Ekeh, Charles T. Ogbodo

Abstract:

Several risk factors associated with cardiovascular events have been identified as specific to Chronic Kidney Disease (CKD). This study endeavors to validate these CKD-specific risk factors using up-to-date national-level data, thereby highlighting the crucial significance of confirming the validity and generalizability of findings obtained from previous studies conducted on smaller patient populations. The study utilized the nationwide inpatient sample database to identify adult hospitalizations for CKD from 2016 to 2020, employing validated ICD-10-CM/PCS codes. A comprehensive literature review was conducted to identify both traditional and CKD-specific risk factors associated with cardiovascular events. Risk factors and cardiovascular events were defined using a combination of ICD-10-CM/PCS codes and statistical commands. Only risk factors with specific ICD-10 codes and hospitalizations with complete data were included in the study. Cardiovascular events of interest included cardiac arrhythmias, sudden cardiac death, acute heart failure, and acute coronary syndromes. Univariate and multivariate regression models were employed to evaluate the association between chronic kidney disease-specific risk factors and cardiovascular events while adjusting for the impact of traditional CV risk factors such as old age, hypertension, diabetes, hypercholesterolemia, inactivity, and smoking. A total of 690,375 hospitalizations for CKD were included in the analysis. The study population was predominantly male (375,564, 54.4%) and primarily received care at urban teaching hospitals (512,258, 74.2%). The mean age of the study population was 61 years (SD 0.1), and 86.7% (598,555) had a CCI of 3 or more. At least one traditional risk factor for CV events was present in 84.1% of all hospitalizations (580,605), while 65.4% (451,505) included at least one CKD-specific risk factor for CV events. The incidence of CV events in the study was as follows: acute coronary syndromes (41,422; 6%), sudden cardiac death (13,807; 2%), heart failure (404,560; 58.6%), and cardiac arrhythmias (124,267; 18%). 91.7% (113,912) of all cardiac arrhythmias were atrial fibrillations. Significant odds of cardiovascular events on multivariate analyses included: malnutrition (aOR: 1.09; 95% CI: 1.06–1.13; p<0.001), post-dialytic hypotension (aOR: 1.34; 95% CI: 1.26–1.42; p<0.001), thrombophilia (aOR: 1.46; 95% CI: 1.29–1.65; p<0.001), sleep disorder (aOR: 1.17; 95% CI: 1.09–1.25; p<0.001), and post-renal transplant immunosuppressive therapy (aOR: 1.39; 95% CI: 1.26–1.53; p<0.001). The study validated malnutrition, post-dialytic hypotension, thrombophilia, sleep disorders, and post-renal transplant immunosuppressive therapy, highlighting their association with increased risk for cardiovascular events in CKD patients. No significant association was observed between uremic syndrome, hyperhomocysteinemia, hyperuricemia, hypertriglyceridemia, leptin levels, carnitine deficiency, anemia, and the odds of experiencing cardiovascular events.

Keywords: cardiovascular events, cardiovascular risk factors in CKD, chronic kidney disease, nationwide inpatient sample

Procedia PDF Downloads 54
10915 Understanding Tourism Innovation through Fuzzy Measures

Authors: Marcella De Filippo, Delio Colangelo, Luca Farnia

Abstract:

In recent decades, the hyper-competition of tourism scenario has implicated the maturity of many businesses, attributing a central role to innovative processes and their dissemination in the economy of company management. At the same time, it has defined the need for monitoring the application of innovations, in order to govern and improve the performance of companies and destinations. The study aims to analyze and define the innovation in the tourism sector. The research actions have concerned, on the one hand, some in-depth interviews with experts, identifying innovation in terms of process and product, digitalization, sustainability policies and, on the other hand, to evaluate the interaction between these factors, in terms of substitutability and complementarity in management scenarios, in order to identify which one is essential to be competitive in the global scenario. Fuzzy measures and Choquet integral were used to elicit Experts’ preferences. This method allows not only to evaluate the relative importance of each pillar, but also and more interestingly, the level of interaction, ranging from complementarity to substitutability, between pairs of factors. The results of the survey are the following: in terms of Shapley values, Experts assert that Innovation is the most important factor (32.32), followed by digitalization (31.86), Network (20.57) and Sustainability (15.25). In terms of Interaction indices, given the low degree of consensus among experts, the interaction between couples of criteria on average could be ignored; however, it is worth to note that the factors innovations and digitalization are those in which experts express the highest degree of interaction. However for some of them, these factors have a moderate level of complementarity (with a pick of 57.14), and others consider them moderately substitutes (with a pick of -39.58). Another example, although outlier is the interaction between network and digitalization, in which an expert consider them markedly substitutes (-77.08).

Keywords: innovation, business model, tourism, fuzzy

Procedia PDF Downloads 250
10914 Developing Emission Factors of Fugitive Particulate Matter Emissions for Construction Sites in the Middle East Area

Authors: Hala A. Hassan, Vasiliki K. Tsiouri, Konstantinos E. Konstantinos

Abstract:

Fugitive particulate matter (PM) is a major source of airborne pollution in the Middle East countries. The meteorological conditions and topography of the area make it highly susceptible to wind-blown particles which raise many air quality concerns. Air quality tools such as field monitoring, emission factors, and dispersion modeling have been used in previous research studies to analyze the release and impacts of fugitive PM in the region. However, these tools have been originally developed based on experiments made for European and North American regions. In this work, an experimental campaign was conducted on April-May 2014 in a construction site in Doha city, Qatar. The ultimate goal is to evaluate the applicability of the existing emission factors for construction sites in dry and arid areas like the Middle East. This publication was made possible by a NPRP award [NPRP 7-649-2-241] from the Qatar National Research Fund (a member of The Qatar Foundation). The statements made herein are solely the responsibility of the authors.

Keywords: particulate matter, emissions, fugitive, construction, air pollution

Procedia PDF Downloads 338
10913 Ideation, Plans, and Attempts for Suicide among Adolescents with Disability

Authors: Nyla Anjum, Humaira Bano

Abstract:

Disability, regardless of its type and nature limits one or two significant life activities. These limitations constitute risk factors for suicide. Rate and intensity of problem upsurges in critical age of adolescence. Researches in the field of mental health over look problem of suicide among persons with disability. Aim of the study was to investigate prevalence and risk factors for suicide among adolescents with disability. The study constitutes purposive sample of 106 elements of both gender with four major categories of disability: hearing impairment, physical impairment, visual impairment and intellectual disabilities. Face to face interview technique was opted for data collection. Other variable are: socio-economic status, social and family support, provision of services for persons with disability, education and employment opportunities. For data analysis independent sample t-test was applied to find out significant differences in gender and One Way Analysis of variance was run to find out differences among four types of disability. Major predictors of suicide were identified with multiple regression analysis. It is concluded that ideation, plans and attempts of suicide among adolescents with disability is a multifaceted and imperative concern in the area of mental health. Urgent research recommendations contains valid measurement of suicide rate and identification of more risk factors for suicide among persons with disability. Study will also guide towards prevention of this pressing problem and will bring message of happy and healthy life not only for persons with disability but also for their families. It will also help to reduce suicide rate in society.

Keywords: suicide, risk factors, adolescent, disability, mental health

Procedia PDF Downloads 369
10912 Strategic Development of Urban Environmental Management Base on Good Governance - Case study of (Waste Management of Tehran)

Authors: A. Farhad Sadri, B. Ali Farhadi, C. Nasim Shalamzari

Abstract:

Waste management is a principle of urban and environmental governance. Waste management in Tehran metropolitan requires good strategies for better governance. Using of good urban governance principles together with eight main indexes can be an appropriate base for this aim. One of the reasonable tools in this field is usage of SWOT methods which provides possibility of comparing the opportunities, threats, weaknesses, and strengths by using IFE and EFE matrixes. The results of the above matrixes, respectively 2.533 and 2.403, show that management system of Tehran metropolitan wastes has performed weak regarding to internal factors and has not have good performance regarding using the opportunities and dealing with threats. In this research, prioritizing and describing the real value of each 24 strategies in waste management in Tehran metropolitan have been surveyed considering good governance derived from Quantitative Strategic Planning Management (QSPM) by using Kolomogrof-Smirnoff by 1.549 and significance level of 0.073 in order to define normalization of final values and all of the strategies utilities and Variance Analysis of ANOVA has been calculated for all SWOT strategies. Duncan’s test results regarding four WT, ST, WO, and SO strategies show no significant difference. In addition to mean comparison by Duncan method in this research, LSD (Lowest Significant Difference test) has been used by probability of 5% and finally, 7 strategies and final model of Tehran metropolitan waste management strategy have been defined. Increasing the confidence of people with transparency of budget, developing and improving the legal structure (rule-oriented and law governance, more responsibility about requirements of private sectors, increasing recycling rates and real effective participation of people and NGOs to improve waste management (contribution) and etc, are main available strategies which have been achieved based on good urban governance management principles.

Keywords: waste, strategy, environmental management, urban good governance, SWOT

Procedia PDF Downloads 304
10911 Risk Factors for Post-Induction Hypotension Among Elderly Patients Undergoing Elective Non-Cardiac Surgery Under General Anesthesia

Authors: Karuna Sutthibenjakul, Sunisa Chatmongkolchart

Abstract:

Background: Postinduction hypotension is common and occurs more often in elderly patients. We aimed to determine risk factors for hypotension after induction among elderly patients (aged 65 years and older) who underwent elective non-cardiac surgery under general anesthesia. Methods: This cohort study analyzed from 580 data between December 2017 and July 2018 at a tertiary university hospital in south of Thailand. Hypotension is defined as more than 30% decrease mean arterial pressure from baseline after induction within 20 minutes or the use of vasopressive agent to treat low blood pressure. Intraoperative parameters were blood pressure and heart rate at T0, TEI, T5, T10, T15 and T20 (immediately after arrival at operating room, time after intubation, 5, 10, 15 and 20 minutes after intubation) respectively. Results: The median age was 72.5 (68, 78) years. A prevalence of post-induction hypotension was 64.8%. The highest prevalence (39.7%) was at 15 minutes after intubation. The association of post-induction hypotension is rising with diuretic drug as preoperative medication (P-value=0.016), hematocrit level (P-value=0.031) and the degree of hypertension immediately after arrival at operating room (P-value<0.001). Increasing fentanyl dosage during induction was associated with hypotension at intubation time (P-value<0.01) and 5 minutes after intubation (P-value<0.001). There was no statistically significant difference in the increasing propofol dosage. Conclusion: The degree of hypertension immediately after arrival at operating room and increasing fentanyl dosage were a significant risk factors for postinduction hypotension in elderly patients.

Keywords: risk factors, post-induction, hypotension, elderly

Procedia PDF Downloads 120