Search results for: early interventions

Authors: Abbas R. Ali, Diana A. Bayiz

Abstract:

14 mudstone samples were collected within the sedimentary succession of Mukdadiya Formation (Late Miocene – Early Pliocene) from Shewasoor area at Northeastern Iraq. The samples were subjected to laboratory studies including mineralogical analysis (using X-ray Diffraction technique) in order to identify the clay mineralogy of Mukdadiya Formation of both clay and non-clay minerals. The results of non-clay minerals are: quartz, feldspar and carbonate (calcite and dolomite) minerals. The clay minerals are: montmorillonite, kaolinite, palygorskite, chlorite, and illite by the major basal reflections of each mineral. The origins of these minerals are deduced also.

Keywords: Mukdadiya Formation, mudstone, clay minerals, XRD, Shewasoor

Procedia PDF Downloads 345

Authors: Ahmed Saeed Mohamed, Sadok Sassi, Mohammad Roshun Paurobally

Abstract:

Gears are important machine components that are widely used to transmit power and change speed in many rotating machines. Any breakdown of these vital components may cause severe disturbance to production and incur heavy financial losses. One of the most common causes of gear failure is the tooth fatigue crack. Early detection of teeth cracks is still a challenging task for engineers and maintenance personnel. So far, to analyze the vibration behavior of gears, different approaches have been tried based on theoretical developments, numerical simulations, or experimental investigations. The objective of this study was to develop a numerical model that could be used to simulate the effect of teeth cracks on the resulting vibrations and hence to permit early fault detection for gear transmission systems. Unlike the majority of published papers, where only one single crack has been considered, this work is more realistic, since it incorporates the possibility of multiple simultaneous cracks with different lengths. As cracks significantly alter the gear mesh stiffness, we performed a finite element analysis using SolidWorks software to determine the stiffness variation with respect to the angular position for different combinations of crack lengths. A simplified six degrees of freedom non-linear lumped parameter model of a one-stage gear system is proposed to study the vibration of a pair of spur gears, with and without tooth cracks. The model takes several physical properties into account, including variable gear mesh stiffness and the effect of friction, but ignores the lubrication effect. The vibration simulation results of the gearbox were obtained via Matlab and Simulink. The results were found to be consistent with the results from previously published works. The effect of one crack with different levels was studied and very similar changes in the total mesh stiffness and the vibration response, both were observed and compared to what has been found in previous studies. The effect of the crack length on various statistical time domain parameters was considered and the results show that these parameters were not equally sensitive to the crack percentage. Multiple cracks are introduced at different locations and the vibration response and the statistical parameters were obtained.

Keywords: dynamic simulation, gear mesh stiffness, simultaneous tooth cracks, spur gear, vibration-based fault detection

Procedia PDF Downloads 210

Authors: Xiao-Hua Zhu, Xin Yuan, Yi-Ran Zhao

Abstract:

High-cadmium pollution in rice is a serious problem in many parts of China. Many kinds of remediation technologies have been tested and applied in many farmlands. Because of the productive function of the farmland, most technologies are inappropriate due to their destruction to the tillage soil layer. And the large labours and expensive fees of many technologies are also the restrictive factors for their applications. The conception of 'Root Micro-Geochemical Barrier' was proposed to reduce cadmium (Cd) bioavailability and the concentration of the cadmium in rice. Remediation and mitigation techniques were demonstrated on contaminated farmland in the downstream of some mine. According to the rule of rice growth, Cd would be absorbed by the crops in every growth stage, and the plant-absorb efficiency in the first stage of the tillering stage is almost the highest. We should create a method to protect the crops from heavy metal pollution, which could begin to work from the early growth stage. Many materials with repair property get our attention. The materials will create a barrier preventing Cd from being absorbed by the crops during all the growing process because the material has the ability to adsorb soil-Cd and making it losing its migration activity. And we should choose a good chance to put the materials into the crop-growing system cheaply as soon as early. Per plant, rice has a little root system scope, which makes the roots reach about 15cm deep and 15cm wide. So small root radiation area makes it possible for all the Cd approaching the roots to be adsorbed with a small amount of adsorbent. Mixing the remediation materials with the seed-raising soli and adding them to the tillage soil in the process of transplanting seedlings, we can control the soil-Cd activity in the range of roots to reduce the Cd-amount absorbed by the crops. Of course, the mineral materials must have enough adsorptive capacity and no additional pollution. More than 3000 square meters farmlands have been remediated. And on the application of root micro-geochemical barrier, the Cd-concentration in rice and the remediation-cost have been decreased by 90% and 80%, respectively, with little extra labour brought to the farmers. The Cd-concentrations in rice from remediated farmland have been controlled below 0.1 ppm. The remediation of one acre of contaminated cropland costs less than $100. The concept has its advantage in the remediation of paddy field contaminated by Cd, especially for the field with outside pollution sources.

Keywords: cadmium pollution, growth stage, cost, root micro-geochemistry barrier

Procedia PDF Downloads 83

Authors: Alfalah Tasneem, Abdallah Bataineh, Falah Jannat, Alfalah Salsabeel

Abstract:

The term emotional intelligence has been unnoticed by a number of scholars in the early 1990s, which was then a major factor that many business managers became interested in understanding its meaning, functions and how it could be integrated in their business life, emotional intelligence is very important for the top managers, to operate in emotionally intelligence way to meet the needs of their employees. Speaking of emotional intelligence success is influenced by personal qualities such as self-awareness, motivation, empathy and relationship skills. The aim of this research is to critically evaluate the potential contribution of emotional intelligence for the Jordanian universities on the level of job satisfaction and the performance of faculty as well as its positive impact on the educational standards.

Keywords: emotional intelligence, higher education, job performance, job satisfaction

Procedia PDF Downloads 353

Authors: Erick C. Valverde, Wansu Lim

Abstract:

Facial emotion recognition (FER) system has been recently developed for more advanced computer vision applications. The ability to identify human emotions would enable smart healthcare facility to diagnose mental health illnesses (e.g., depression and stress) as well as better human social interactions with smart technologies. The FER system involves two steps: 1) face detection task and 2) facial emotion recognition task. It classifies the human expression in various categories such as angry, disgust, fear, happy, sad, surprise, and neutral. This system requires intensive research to address issues with human diversity, various unique human expressions, and variety of human facial features due to age differences. These issues generally affect the ability of the FER system to detect human emotions with high accuracy. Early stage of FER systems used simple supervised classification task algorithms like K-nearest neighbors (KNN) and artificial neural networks (ANN). These conventional FER systems have issues with low accuracy due to its inefficiency to extract significant features of several human emotions. To increase the accuracy of FER systems, deep learning (DL)-based methods, like convolutional neural networks (CNN), are proposed. These methods can find more complex features in the human face by means of the deeper connections within its architectures. However, the inference speed and computational costs of a DL-based FER system is often disregarded in exchange for higher accuracy results. To cope with this drawback, an optimized DL-based FER system is proposed in this study.An extreme version of Inception V3, known as Xception model, is leveraged by applying different network optimization methods. Specifically, network pruning and quantization are used to enable lower computational costs and reduce memory usage, respectively. To support low resource requirements, a 68-landmark face detector from Dlib is used in the early step of the FER system.Furthermore, a DL compiler is utilized to incorporate advanced optimization techniques to the Xception model to improve the inference speed of the FER system. In comparison to VGG-Net and ResNet50, the proposed optimized DL-based FER system experimentally demonstrates the objectives of the network optimization methods used. As a result, the proposed approach can be used to create an efficient and real-time FER system.

Keywords: deep learning, face detection, facial emotion recognition, network optimization methods

Procedia PDF Downloads 118

Authors: Joann Douziech

Abstract:

Individuals with intellectual and developmental disabilities (IDD) possess characteristics that present both challenges and gifts. Individuals with IDD require and are worthy of intentional, strategic, and specialized support throughout their lifespan to ensure optimum quality-of-life outcomes. The current global advocacy movement advancing the rights of individuals with IDD emphasizes a high degree of choice over life decisions. For some individuals, this degree of choice results in a variety of negative health and well-being outcomes. Improving the quality of life outcomes requires the combination of a commitment to the rights of the individual with a responsibility to provide support and choice commensurate with individual capacity. A belief that individuals with IDD are capable of learning and they are worthy of being taught provides the foundation for a holistic model of support throughout their lifespan. This model is based on three pillars of engineering the environment, promoting skill development and maintenance, and staff support. In an ever-changing world, supporting quality of life requires attention to moments, phases, and changes in stages throughout the lifespan. Balancing these complexities with strategic, responsive, and dynamic interventions enhances the quality of life of individuals with ID throughout their lifespan.

Keywords: achieving optimum quality of life, comprehensive support, lifespan approach, philosophy and pedagogy

Procedia PDF Downloads 66

Authors: Dongdong Bai

Abstract:

The curriculum is essential in determining the quality of early childhood education (ECE). Education policy is intricately linked to the effective execution of the preschool education curriculum. The learner-centred education (LCE) approach is a globally common educational concept. However, it is an approach that is applied variably in ECE policy-making and implementation across diverse cultural contexts. Notwithstanding its significance, limited study has investigated the ECE curriculum policies on the articulation and implementation of the LCE concept in England and Hong Kong’s non-profit-making kindergartens — two regions with intricate historical and cultural connections. Moreover, both regions have experienced significant transformations in ECE policy since 1997. This research employs a qualitative comparative approach, with discourse analysis of key policy documents and relevant literature as the primary methodology. The study develops a comparison framework grounded in Adamson and Morris' curriculum comparison theory, which evaluates curricula from the perspectives of purpose, focus, and manifestation. The paper is structured around three key elements: (1) educational objectives; (2) implementation guidance, including pedagogical strategies, learning content and assessment mechanism; and (3) influential cultural ideologies. Through this framework, the study explores the similarities and differences in the design and implementation of LCE within ECE policies in England and Hong Kong’s non-profit-making kindergartens, while examining the cultural factors that shape these policy variations. The findings indicate that both England and Hong Kong possess child-centered educational objectives focused on enhancing cognitive, skill-based, and physical development; however, Hong Kong's policies notably emphasize alleviating academic pressure in achieving these curriculum aims. England's recommendations advocate for play-based, and exploratory learning to augment children's cognitive development. Conversely, Hong Kong utilizes narrative techniques and indoor instruction to facilitate progressive education. Additionally, both areas encompass cognitive disciplines such as literacy and numeracy; however, England distinctly prioritizes citizenship education with an emphasis on cultural traits. In contrast, Hong Kong amalgamates Western educational ideas with an emphasis on traditional Chinese culture and values, encompassing the study of Chinese characters, etiquette, and moral education rooted in Confucian cultural ideologies. Ultimately, regarding assessment mechanisms, England has transitioned from government-led professional evaluation programs to a hybrid of market and governmental oversight. Conversely, Hong Kong's curriculum evaluation mechanism primarily consists of self-evaluation and public supervision, yet it is evident that the policy could benefit from greater receptiveness to public and expert input. The underlying cultural ideologies significantly influence these policy discrepancies. In England, ECE policies are guided by core concepts that viewing children as individuals, agents, and future citizens. In Hong Kong, the policies reflect Confucian traditions and cultural values, which shape their unique approach to ECE in Hong Kong societies. In conclusion, whereas both locations strive to advocate LCE for the comprehensive development of children, significant differences arise in curriculum focus and implementation policies, shaped by their respective cultural philosophies.

Keywords: curriculum policy, cultural contexts, early childhood education, learner-centred education

Procedia PDF Downloads 15

Authors: Natalia Kartushina

Abstract:

Foreign (second) language (L2) learning is highly promoted in modern society. Students are encouraged to study abroad (SA) to achieve the most effective learning outcomes. However, L2 learning has side effects for native language (L1) production, as L1 sounds might show a drift from the L1 norms towards those of the L2, and this, even after a short period of L2 learning. L1 assimilatory drift has been attributed to a strong perceptual association between similar L1 and L2 sounds in the mind of L2 leaners; thus, a change in the production of an L2 target leads to the change in the production of the related L1 sound. However, nowadays, it is quite common that speakers acquire two languages from birth, as, for example, it is the case for many bilingual communities (e.g., Basque and Spanish in the Basque Country). Yet, it remains to be established how FL learning affects native production in individuals who have two native languages, i.e., in simultaneous or very early bilinguals. Does FL learning (here a third language, L3) affect bilinguals’ both languages or only one? What factors determine which of the bilinguals’ languages is more susceptible to change? The current study examines the effects of L3 (English) learning on the production of vowels in the two native languages of simultaneous Spanish-Basque bilingual adolescents enrolled into the Erasmus SA English program. Ten bilingual speakers read five Spanish and Basque consonant-vowel-consonant-vowel words two months before their SA and the next day after their arrival back to Spain. Each word contained the target vowel in the stressed syllable and was repeated five times. Acoustic analyses measuring vowel openness (F1) and backness (F2) were performed. Two possible outcomes were considered. First, we predicted that L3 learning would affect the production of only one language and this would be the language that would be used the most in contact with English during the SA period. This prediction stems from the results of recent studies showing that early bilinguals have separate phonological systems for each of their languages; and that late FL learner (as it is the case of our participants), who tend to use their L1 in language-mixing contexts, have more L2-accented L1 speech. The second possibility stated that L3 learning would affect both of the bilinguals’ languages in line with the studies showing that bilinguals’ L1 and L2 phonologies interact and constantly co-influence each other. The results revealed that speakers who used both languages equally often (balanced users) showed an F1 drift in both languages toward the F1 of the English vowel space. Unbalanced speakers, however, showed a drift only in the less used language. The results are discussed in light of recent studies suggesting that the amount of language use is a strong predictor of the authenticity in speech production with less language use leading to more foreign-accented speech and, eventually, to language attrition.

Keywords: language-contact, multilingualism, phonetic drift, bilinguals' production

Procedia PDF Downloads 107

Authors: Diana Islam, Juan Fang, Vito Fanelli, Bing Han, Julie Khang, Jianfeng Wu, Arthur S. Slutsky, Haibo Zhang

Abstract:

Introduction: MSC delivery in preclinical models of ARDS has demonstrated significant improvements in lung function and recovery from acute injury. However, the role of MSC delivery in ARDS associated pulmonary fibrosis is not well understood. Some animal studies using bleomycin, asbestos, and silica-induced pulmonary fibrosis show that MSC delivery can suppress fibrosis. While other animal studies using radiation induced pulmonary fibrosis, liver, and kidney fibrosis models show that MSC delivery can contribute to fibrosis. Hypothesis: The beneficial and deleterious effects of MSC in ARDS are modulated by the lung microenvironment at the time of MSC delivery. Methods: To induce ARDS a two-hit mouse model of Hydrochloric acid (HCl) aspiration (day 0) and mechanical ventilation (MV) (day 2) was used. HCl and injurious MV generated fibrosis within 14-28 days. 0.5x106 mouse MSCs were delivered (via both intratracheal and intravenous routes) either in the active inflammatory phase (day 2) or during the remodeling phase (day 14) of ARDS (mouse fibroblasts or PBS used as a control). Lung injury accessed using inflammation score and elastance measurement. Pulmonary fibrosis was accessed using histological score, tissue collagen level, and collagen expression. In addition alveolar epithelial (E) and mesenchymal (M) marker expression profile was also measured. All measurements were taken at day 2, 14, and 28. Results: MSC delivery 2 days after HCl exacerbated lung injury and fibrosis compared to HCl alone, while the day 14 delivery showed protective effects. However in the absence of HCl, MSC significantly reduced the injurious MV-induced fibrosis. HCl injury suppressed E markers and up-regulated M markers. MSC delivery 2 days after HCl further amplified M marker expression, indicating their role in myofibroblast proliferation/activation. While with 14-day delivery E marker up-regulation was observed indicating their role in epithelial restoration. Conclusions: Early MSC delivery can be protective of injurious MV. Late MSC delivery during repair phase may also aid in recovery. However, early MSC delivery during the exudative inflammatory phase of HCl-induced ARDS can result in pro-fibrotic profiles. It is critical to understand the interaction between MSC and the lung microenvironment before MSC-based therapies are utilized for ARDS.

Keywords: acute respiratory distress syndrome (ARDS), mesenchymal stem cells (MSC), hydrochloric acid (HCl), mechanical ventilation (MV)

Procedia PDF Downloads 667

Authors: Giovanni Gonzalez Araujo, Michael Kyrilov, Angelo Kyrilov

Abstract:

STEAMplug is a web-based innovative educational platform which makes teaching easier and learning more effective. It requires no setup, eliminating the barriers to entry, allowing students to focus on their learning throughreal-world development environments. The student-centric tools enable easy collaboration between peers and teachers. Analyzing user interactions with the system enables us to predict student performance and identify at-risk students, allowing early instructor intervention.

Keywords: plagiarism detection, identifying at-Risk Students, education technology, e-learning system, collaborative development, learning and teaching with technology

Procedia PDF Downloads 151

Authors: Marcio Freire Cruz, Naoaki Ono, Shigehiko Kanaya, Carlos Arthur Mattos Teixeira Cavalcante

Abstract:

The systems that record patient care information, known as Electronic Medical Record (EMR) and those that monitor vital signs of patients, such as heart rate, body temperature, and blood pressure have been extremely valuable for the effectiveness of the patient’s treatment. Several kinds of research have been using data from EMRs and vital signs of patients to predict illnesses. Among them, we highlight those that intend to predict, classify, or, at least identify patterns, of sepsis illness in patients under vital signs monitoring. Sepsis is an organic dysfunction caused by a dysregulated patient's response to an infection that affects millions of people worldwide. Early detection of sepsis is expected to provide a significant improvement in its treatment. Preceding works usually combined medical, statistical, mathematical and computational models to develop detection methods for early prediction, getting higher accuracies, and using the smallest number of variables. Among other techniques, we could find researches using survival analysis, specialist systems, machine learning and deep learning that reached great results. In our research, patients are modeled as points moving each hour in an n-dimensional space where n is the number of vital signs (variables). These points can reach a sepsis target point after some time. For now, the sepsis target point was calculated using the median of all patients’ variables on the sepsis onset. From these points, we calculate for each hour the position vector, the first derivative (velocity vector) and the second derivative (acceleration vector) of the variables to evaluate their behavior. And we construct a prediction model based on a Long Short-Term Memory (LSTM) Network, including these derivatives as explanatory variables. The accuracy of the prediction 6 hours before the time of sepsis, considering only the vital signs reached 83.24% and by including the vectors position, speed, and acceleration, we obtained 94.96%. The data are being collected from Medical Information Mart for Intensive Care (MIMIC) Database, a public database that contains vital signs, laboratory test results, observations, notes, and so on, from more than 60.000 patients.

Keywords: dynamic analysis, long short-term memory, prediction, sepsis

Procedia PDF Downloads 124

Authors: Selen Muftuoglu, Dilara Kefeli

Abstract:

The present study was conducted by using the cross-sectional study design and to determine the relationship between body image, eating behavior and nutritional status in 80 female athletes who were basketball, volleyball, flag football, indoor soccer, and ice hockey players. This study demonstrated that 70.0% of the female athletes had skipped meal. Also, female athletes had a normal body mass index (BMI), but 65.0% of them indicated that want to be thinner. On the other hand, we analyzed that their daily nutrients intake, so we observed that 43.4% of the energy was from the fatty acids, especially saturated fatty acids, and they had lower fiber, calcium and iron intake. Also, we found that BMI, waist circumference, waist to hip ratio were negatively correlated with Multidimensional Body-Self Relations Questionnaire and The Dutch Eating Behavior Questionnaire score and they were lower in who had meal skipped or not received diet therapy. As a conclusion, nutrition education is frequently neglected in sports programs. There is a paucity of nutrition education interventions among different sports.

Keywords: body image, eating behavior, eating disorders, female athletes, nutritional status

Procedia PDF Downloads 161

Authors: Amin Masoumiganjgah, Luke Salmon, Julianne Burnton, Fahimeh Bagheri, Gavin Lenton, S. L. Ezekial Tan

Abstract:

Introduction: The incidence of proximal biceps tenodesis and acute distal biceps repair is increasing, and rehabilitation protocols following both are variable. Golf is a popular sport within Australia, and the Gold Coast has become a Mecca for golfers, with more courses per capita than anywhere else in the world. Currently, there are no clear guidelines regarding return to golf play following biceps procedures. The aim of this study was to determine biceps brachii activation during the golf swing through electromyographic analysis, and subsequently, aid in rehabilitation guidelines and return to golf following tenodesis and repair. Methods: Subjects were amateur golfers with no previous upper limb surgery. Surface electromyography (EMG) and high-speed video recording were used to analyse activation of the left and right biceps brachii and the anterior deltoid during the golf swing. Each participant’s maximum voluntary contraction (MVC) was recorded, and they were then required to hit a golf ball aiming for specific distances of 2, 50, 100 and 150 metres at a driving range. Noraxon myoResearch and Matlab were used for data analysis. Mean % MVC was calculated for leading and trailing arms during the full swing and its’ 4 phases: back-swing, acceleration, early follow-through and late follow-through. Results: 12 golfers (2 female and 10 male), participated in the study. Median age was 27 (25 – 38), with all being right handed. Over all distances, the mean activation of the short and long head of biceps brachii was < 10% through the full swing. When breaking down the 50, 100 and 150m swing into phases, mean MVC activation was lowest in backswing (5.1%), followed by acceleration (9.7%), early follow-through (9.2%), and late follow-through (21.4%). There was more variation and slightly higher activation in the right biceps (trailing arm) in backswing, acceleration, and early follow-through; with higher activation in the leading arm in late follow-through (25.4% leading, 17.3% trailing). 2m putts resulted in low MVC values (3.1% ) with little variation across swing phases. There was considerable individual variation in results – one tense subject averaged 11.0% biceps MVC through the 2m putting stroke and others recorded peak mean MVC biceps activations of 68.9% at 50m, 101.3% at 100m, and 111.3% at 150m. Discussion: Previous studies have investigated the role of rotator cuff, spine, and hip muscles during the golf swing however, to our knowledge, this is the first study that investigates the activation of biceps brachii. Many rehabilitation programs following a biceps tenodesis or repair allow active range against gravity and restrict strengthening exercises until 6 weeks, and this does not appear to be associated with any adverse outcome. Previous studies demonstrate a range of < 10% MVC is similar to the unloaded biceps brachii during walking(1), active elbow flexion with the hand positioned either in pronation or supination will produce MVC < 20% throughout range(2) and elbow flexion with a 4kg dumbbell can produce mean MVC’s of around 40%(3). Our study demonstrates that increasing activation is associated with the leading arm, increasing shot distance and the late follow-through phase. Although the cohort mean MVC of the biceps brachii is <10% through the full swing, variability is high and biceps activation reach peak mean MVC’s of over 100% in different swing phases for some individuals. Given these EMG values, caution is advised when advising patients post biceps procedures to return to long distance golf shots, particularly when the leading arm is involved. Even though it would appear that putting would be as safe as having an unloaded hand out of a sling following biceps procedures, the variability of activation patterns across different golfers would lead us to caution against accelerated golf rehabilitation in those who may be particularly tense golfers. The 50m short iron shot was too long to consider as a chip shot and more work can be done in this area to determine the safety of chipping.

Keywords: electromyographic analysis, biceps brachii rupture, golf swing, tendon surgery

Procedia PDF Downloads 79

Authors: Olajumoke Tolulope Esan, Odunayo Stephen Faluse

Abstract:

Nigeria’s electoral politics from independence has been tumultuous. Violence has continued to damage the conduct of almost all general elections in Nigeria, Thereby making free and fair elections an event that seems to be unachievable in the history of the nation’s politics. Apparently, electoral violence has subjected the Nation into stereotyped electoral procedures that are always dictated through powerful political Godfathers. However, the shameful act of riotous and tumultuous election processes has led to a political, national instability festering irregularities that manifest at different stages of the election, thus subjecting almost all elections carried out in Nigeria below the minimum democracy standard. Hence the fact that an average Nigerian is being deprived of his or her individual electoral rights should be enough to attract Global political interventions from the western world as Nigeria is part of the commonwealth countries and every Nigerians have the right to demand for posterity to be ensured by protecting individual rightful votes. Basically for elections to be termed democratic, it must be free and fair. In view of this, A deep understanding of this paper is a reflection on the tides of electoral violence and the alarming precipitating factors that make free and fair election almost unreachable in Nigeria.

Keywords: democracy, election, electoral violence, political violence

Procedia PDF Downloads 423

Authors: T. Pradhan, P. Rijal, M. C. Regmi

Abstract:

Background: Eclampsia is a multisystem disorder that involves vital organs and failure of these may lead to deterioration of maternal condition and hypoxia and acidosis of fetus resulting in high maternal and perinatal mortality and morbidity. Thus, evaluation of the contributing factors for this condition and its complications leading to maternal deaths should be the priority. Formulating the plan and protocol to decrease these losses should be our goal. Aims and Objectives: To evaluate the risk factors associated with adverse maternal and fetal outcome in patients with eclampsia and to correlate the risk factors associated with maternal and fetal morbidity and mortality. Methods: All patients with eclampsia admitted in Department of Obstetrics and Gynecology, B. P. Koirala Institute of Health Sciences were enrolled after informed consent from February 2013 to February 2014. Questions as per per-forma were asked to patients, and attendants like Antenatal clinic visits, parity, number of episodes of seizures, duration from onset of seizure to magnesium sulfate and the patients were followed as per the hospital protocol, the mode of delivery, outcome of baby, post partum maternal condition like maternal Intensive Care Unit admission, neurological impairment and mortality were noted before discharge. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS 11). Mean and percentage were calculated for demographic variables. Pearson’s correlation test and chi-square test were applied to find the relation between the risk factors and the outcomes. P value less than 0.05 was considered significant. Results: There were 10,000 antenatal deliveries during the study period. Fifty-two patients with eclampsia were admitted. All of the patients were unbooked for our institute. Thirty-nine patients were antepartum eclampsia. Thirty-one patients required mechanical ventilator support. Twenty-four patients were delivered by emergency c-section and 21 babies were Low Birth Weight and there were 9 stillbirths. There was one maternal mortality and 45 patients were discharged with improvement but 3 patients had neurological impairment. Mortality was significantly related with number of seizure episodes and time interval between seizure onset and administration of magnesium sulphate. Conclusion: Early detection and management of hypertensive complicating pregnancy during antenatal clinic check up. Early hospitalization and management with magnesium sulphate for eclampsia can help to minimize the maternal and fetal adverse outcomes.

Keywords: eclampsia, maternal mortality, perinatal mortality, risk factors

Procedia PDF Downloads 167

Authors: Ritu Nambiar, Shazia Tariq, Sumaira Jamil, Farida Munawar, Imelda Israell

Abstract:

GBS has emerged as a leading cause of neonatal infections worldwide and clinical trials have demonstrated that giving IAP was effective in reducing early onset GBS (EOGBS) disease of the newborn. There is no available data on the prevalence of GBS in the UAE, therefore, a retrospective chart analysis of our parturients were done to look at our prevalence. The aim of this study is: 1. To study the prevalence of GBS colonization of parturients at al Rahba Hospital following universal screening between 35-37 week. 2. To look at efficacy of GBS intrapartum antibiotic prophylaxis by NICU admission for EO GBS disease of the newborn. 1) The prevalence of GBS in our patient population is 24.15%. 2) Incidence of EO GBS disease of the newborn was 0.6%.

Keywords: GBS Screening, universal intrapartum antibiotic prophylaxis, parturients, newborn

Procedia PDF Downloads 394

Authors: Deepa Idnani

Abstract:

Attendance is an important factor in school success among children. Studies show that better attendance is related to higher academic achievement for students of all backgrounds, but particularly for children with lower socio-economic status. Beginning from the early years, students who attend school regularly score higher on tests than their peers who are frequently absent. The present study in different types of School In Delhi tries to highlight the impact of student absenteeism and the challenges it poses for the students. The study relies on Lewin ‘Model of Exclusion’ and tries to focus on the analysis of children with special needs and the inclusion and exclusion of students in the school.

Keywords: student absenteeism, pedagogy, learning, right to education act, exclusion

Procedia PDF Downloads 295

Authors: M. Nili, S. Tavasoli, A. R. Yazdandoost

Abstract:

In this paper, an experimental investigation on the effect of Isfahan Ground Granulate Blast Furnace Slag (GGBS) on the compressive strength development of self-consolidating concrete (SCC) and normal concrete (NC) was performed. For this purpose, Portland cement type I was replaced with GGBS in various Portions. For NC and SCC Mixes, 10*10*10 cubic cm specimens were tested in 7, 28 and 91 days. It must be stated that in this research water to cement ratio was 0.44, cement used in cubic meter was 418 Kg/m³ and Superplasticizer (SP) Type III used in SCC based on Poly-Carboxylic acid. The results of experiments have shown that increasing GGBS Percentages in both types of concrete reduce Compressive strength in early ages.

Keywords: compressive strength, GGBS, normal concrete, self-consolidating concrete

Procedia PDF Downloads 428

Authors: Murat Yildiz, Burcu Yildiz

Abstract:

Price Cap Regulation is a form of economic regulation designed in the 1980s in the United Kingdom. Price cap regulation sets a cap on the price that the utility provider can charge. The cap is set according to several economic factors, such as the price cap index, expected efficiency savings and inflation. It has been used by several countries as a regulatory regime in several sectors. Container port privatization is still in early stages in some countries. Lack of a general framework can be an impediment to privatization. This paper aims a general framework to comprising decisions to be made for variables which are able to accommodate the variety of container terminals. Several approaches that may be needed as well as a passage between approaches.

Keywords: Price Cap Regulation, ports privatization, container terminal price regime, earning sharing

Procedia PDF Downloads 356

Authors: Vicki Cameron

Abstract:

Background: Rheumatoid Arthritis (RA) typically effects the feet and about 20% of patients present initially with foot and ankle symptoms. Custom moulded foot orthoses (FO) in the management of foot and ankle problems in RA is well documented in the literature. Off-the-shelf FO are thought to provide an effective alternative to custom moulded FO in patients with RA, however they are not evidence based. Objectives: To determine the effects of off-the-shelf FO on; 1. quality of life (QOL) 2. walking speed 4. peak plantar pressure in the forefoot (PPPft) Methods: Thirty-five patients (six male and 29 female) participated in the study from 11/2006 to 07/2008. The age of the patients ranged from 26 to 80 years (mean 52.4 years; standard deviation [SD] 13.3 years). A repeated measures design was used, with patients presenting at baseline, three months and six months. Patients were tested walking barefoot, shod and shod with FO. The type of orthoses used was the Slimflex Plastic ® (Algeos). The Leeds Foot Impact Scale (LFIS) was used to investigate QOL. The Vicon 612 motion analysis system was used to determine the effect of FO on walking speed. The F-scan walkway and in-shoe systems provided information of the effect on PPPft. Ethical approval was obtained on 07/2006. Data was analysed using SPSS version 15.0. Results/Discussion: The LFIS data was analysed with a repeated measures ANOVA. There was a significant improvement in the LFIS score with the use of the FO over the six months (p<0.01). A significant increase in walking speed with the orthoses was observed (p<0.01). Peak plantar pressure in the forefoot was reduced with the FO, as shown by a non-parametric Friedman’s test (chi-square = 55.314, df=2, p<0.05). Conclusion: The results show that off-the-shelf FO are effective in managing foot problems in patients with RA. Patients reported an improved QOL with the orthoses, and further objective measurements were quantified to provide a rationale for this change. Patients demonstrated an increased walking speed, which has been shown to be associated with reduced pain. The FO decreased PPPft which have been reported as a site of pain and ulceration in patients with RA. Salient Clinical Points: Off-the-shelf FO offer an effective alternative to custom moulded FO, and can be dispensed at the chair side. This is crucial in the management of foot problems associated with RA as early intervention is advocated due to the chronic and progressive nature of the disease.

Keywords: podiatry, rheumatoid arthritis, foot orthoses, gait analysis

Procedia PDF Downloads 256

Authors: Kalangi Rodrigo

Abstract:

Sri Lanka has been known as an island which has a diverse variety of prehistoric occupation among ecological zones. Defining the paleoecology of the past societies has been an archaeological thought developed in the 1960s. It is mainly concerned with the reconstruction from available geological and biological evidence of past biota, populations, communities, landscapes, environments, and ecosystems. Sri Lanka has dealt with this subject, and considerable research has been already undertaken. The fossil and material record of Sri Lanka’s Wet Zone tropical forests continues from c. 38,000–34,000 ybp. This early and persistent human fossil, technical, and cultural florescence, as well as a collection of well-preserved tropical-forest rock shelters with associated 'on-site' palaeoenvironmental records, makes Sri Lanka a central and unusual case study to determine the extent and strength of early human tropical forest encounters. Excavations carried out in prehistoric caves in the low country wet zone has shown that in the last 50,000 years, the temperature in the lowland rainforests has not exceeded 5°C. When taking Batadombalena alone, the entire seven layers have yielded an uninterrupted occupation of Acavus sp and Canerium zeylanicum, a plant that grows in the middle of the rainforest. Acavus, which is highly sensitive to rainforest ecosystems, has been well documented in many of the lowland caves, confirming that the wetland rainforest environment has remained intact at least for the last 50,000 years. If the dry and arid conditions in the upper hills regions affected the wet zone, the Tufted Gray Lunger (semnopithecus priam), must also meet with the prehistoric caves in the wet zone thrown over dry climate. However, the bones in the low country wet zone do not find any of the fragments belonging to Turfed Gray Lunger, and prehistoric human consumption is bestowed with purple-faced leaf monkey (Trachypithecus vetulus) and Toque Macaque (Macaca Sinica). The skeletal remains of Lyriocephalus scutatus, a full-time resident in rain forests, have also been recorded among lowland caves. But, in zoological terms, these remains may be the remains of the Barking deer (Muntiacus muntjak), which is currently found in the wet zone. For further investigations, the mtDNA test of genetic diversity (Bottleneck effect) and pollen study from lowland caves should determine whether the wet zone climate has persisted over the last 50,000 years, or whether the dry weather affected in the mountainous region has invaded the wet zone.

Keywords: paleoecology, prehistory, zooarchaeology, reconstruction, palaeo-climate

Procedia PDF Downloads 139

Authors: Sehreen Moorat, Hiba, Maham Mahnoor, Faryal Soomro

Abstract:

Leakage of gases in a system makes infrastructures and users vulnerable; it can occur due to its environmental conditions or old groundwork. In hospitals and industries, it is very important to detect any small level of gas leakage because of their sensitivity. In this research, a portable detection system for the small leakage of gases has been developed, gas sensor (MQ-2) is used to find leakage when it’s at its initial phase. The sensor and transmitting module senses the change in level of gas by using a sensing circuit. When a concentration of gas reach at a specified threshold level, it will activate an alarm and send the alarming situation notification to receiver through GSM module. The proposed system works well in hospitals, home, and industries.

Keywords: gases, detection, Arduino, MQ-2, alarm

Procedia PDF Downloads 204

Authors: Edwin Dankano

Abstract:

Evident by incessant and sporadic attacks on Nigerians poise a serious threat to the unity of Nigeria, and secondly, the single biggest security nightmare to confront Nigeria since after amalgamation of the Southern and Northern protectorates by the British colonialist in 1914 is “Boko Haram” a terrorist organization also known as “Jama’atul Ahli Sunnah Lidda’wati wal Jihad”, or “people committed to the propagation of the Prophet’s teachings and jihad”. The sect also upholds an ideology translated as “Western Education is forbidden”, or rejection of Western civilization and institutions. By some estimates, more than 5,500 people were killed in Boko Haram attacks in 2014, and Boko Haram attacks have already claimed hundreds of lives and territories {caliphates}in early 2015. In total, the group may have killed more than 10,000 people since its emergence in the early 2000s. More than 1 million Nigerians have been displaced internally by the violence, and Nigerian refugee figures in neighboring countries continue to rise. This paper is predicated on secondary sources of data and anchored on the Huntington’s theory of clash of civilization. As such, the paper argued that the rise of Boko Haram with its violent disposition against Western values is a counter response to Western civilization that is fast eclipsing other civilizations. The paper posits that the Boko Haram insurrection going by its teachings, and destruction of churches is a validation of the propagation of the sect as a religious revolt which has resulted in dire humanitarian situation in Adamawa, Borno, Yobe, Bauchi, and Gombe states all in north eastern Nigeria as evident in human casualties, human right abuses, population displacement, refugee debacle, livelihood crisis, and public insecurity. The paper submits that the Nigerian state should muster the needed political will in terms of a viable anti-terrorism measures and build strong legitimate institutions that can adequately curb the menace of corruption that has engulfed the military hierarchy, respond proactively to the challenge of terrorism in Nigeria and should embrace a strategic paradigm shift from anti-terrorism to counter-terrorism as a strategy for containing the crisis that today threatens the secular status of Nigeria.

Keywords: Boko Haram, civilization, fundamentalism, Islam, religion revolt, terror

Procedia PDF Downloads 398

Authors: Michele Paleologo, Marta Acampora, Serena Barello, Guendalina Graffigna

Abstract:

Introduction: In the face of increasing demands for higher agricultural productivity with minimal environmental impact, participatory research approaches emerge as promising means to promote innovation. However, the complexities and ambiguities surrounding these approaches in both theory and practice present challenges. This Scoping Review seeks to bridge these gaps by mapping participatory approaches in agricultural contexts, analyzing their characteristics, and identifying indicators of success. Methods: Following PRISMA guidelines, we conducted a systematic Scoping Review, searching Scopus and Web of Science databases. Our review encompassed 34 projects from diverse geographical regions and farming contexts. Thematic analysis was employed to explore the types of innovation promoted and the categories of participants involved. Results: The identified innovation types encompass technological advancements, sustainable farming practices, and market integration, forming 5 main themes: climate change, cultivar, irrigation, pest and herbicide, and technical improvement. These themes represent critical areas where participatory research drives innovation to address pressing agricultural challenges. Participants were categorized as citizens, experts, NGOs, private companies, and public bodies. Understanding their roles is vital for designing effective participatory initiatives that embrace diverse stakeholders. The review also highlighted 27 theoretical frameworks underpinning participatory projects. Clearer guidelines and reporting standards are crucial for facilitating the comparison and synthesis of findings across studies, thereby enhancing the robustness of future participatory endeavors. Furthermore, we identified three main categories of barriers and facilitators: pragmatic/behavioral, emotional/relational, and cognitive. These insights underscore the significance of participant engagement and collaborative decision-making for project success beyond theoretical considerations. Regarding participation, projects were classified as contributory (5 cases), where stakeholders contributed insights; collaborative (10 cases), with active co-designing of solutions; and co-created (19 cases), featuring deep stakeholder involvement from ideation to implementation, resulting in joint ownership of outcomes. Such diverse participation modes highlight the adaptability of participatory approaches to varying agricultural contexts. Discussion: In conclusion, this Scoping Review demonstrates the potential of participatory research in driving transformative changes in farmers' practices, fostering sustainability and innovation in agriculture. Understanding the diverse landscape of participatory approaches, theoretical frameworks, and participant engagement strategies is essential for designing effective and context-specific interventions. Collaborative efforts among researchers, practitioners, and stakeholders are pivotal in harnessing the full potential of participatory approaches and driving positive change in agricultural settings worldwide. The identified themes of innovation and participation modes provide valuable insights for future research and targeted interventions in agricultural innovation.

Keywords: participatory research, co-creation, agricultural innovation, stakeholders' engagement

Procedia PDF Downloads 64

Authors: Ulrich Wake, Eniman Syamsuddin

Abstract:

The model for camera model identificaiton is trained using pretrained model ResNet43 and ResNet50. The dataset consists of 500 photos of each phone. Dataset is divided into 1280 photos for training, 320 photos for validation and 400 photos for testing. The model is trained using One Cycle Policy Method and tested using Test-Time Augmentation. Furthermore, the model is trained for 50 epoch using regularization such as drop out and early stopping. The result is 90% accuracy for validation set and above 85% for Test-Time Augmentation using ResNet50. Every model is also trained by slightly updating the pretrained model’s weights

Keywords: ​ One Cycle Policy, ResNet34, ResNet50, Test-Time Agumentation

Procedia PDF Downloads 207

Authors: Sylvie Sossou, Grégoire Gansou, Ildevert Egue

Abstract:

Introduction: The mission of the family and the school is to educate and train citizens of the city. But the family’s values , parental roles, respect for life collapse in their traditional African form. Indeed laxity with regard to divorce, liberal ideas about child rearing influence the emotional life of the latter. Several causes may contribute to the decline in academic performance. In order to seek a psychological solution to the issue, a study was conducted in 6 schools at the 9th district in Cotonou, cosmopolitan city of Benin. Objective: To evaluate the impact of single parenthood on the psycho child development. Materials and Methods: Questionnaires and interviews were used to gather verbal information. The questionnaires were administered to parents and children (schoolchildren 4, 5 and six form) from 7 to 12 years in lone parenthood. The interview was done with teachers and school leaders. We identified 209 cases of children living with a "single-parent" and 68 single parents. Results: Of the 209 children surveyed the results showed that 116 children are cut relational triangle in early childhood (before 3 years). The psychological effects showed that the separation has caused sadness for 52 children, anger 22, shame 17, crying at 31 children, fear for 14, the silence at 58 children. In front of complete family’s children, these children experience feelings of aggression in 11.48%; sadness in 30.64%; 5.26% the shame, the 6.69% tears; jealousy in 2.39% and 2.87% of indifference. The option to get married in 44.15% of children is a challenge to want to give a happy childhood for their offspring; 22.01% feel rejected, there is uncertainty for 11.48% of cases and 25.36% didn’t give answer. 49, 76% of children want to see their family together; 7.65% are against to avoid disputes and in many cases to save the mother of the father's physical abuse. 27.75% of the ex-partners decline responsibility in the care of the child. Furthermore family difficulties affecting the intellectual capacities of children: 37.32% of children see school difficulties related to family problems despite all the pressure single-parent to see his child succeed. Single parenthood affects inter-family relations: pressure 33.97%; nervousness 24.88%; overprotection 29.18%; backbiting 11.96%, are the lives of these families. Conclusion: At the end of the investigation, results showed that there is a causal relationship between psychological disorders, academic difficulties of children and quality of parental relationships. Other cases may exist, but the lack of resources meant that we have only limited at 6 schools. Early psychological treatment for these children is needed.

Keywords: single-parent, psycho child, school, Cotonou

Procedia PDF Downloads 387

Authors: Silvia D. Vaca, Benjamin J. Kuo, Joao Ricardo Nickenig Vissoci, Catherine A. Staton, Linda W. Xu, Michael Muhumuza, Hussein Ssenyonjo, John Mukasa, Joel Kiryabwire, Henry E. Rice, Gerald A. Grant, Michael M. Haglund

Abstract:

Background: Patients with traumatic brain injury (TBI) can develop rapid neurological deterioration from swelling and intracranial hematomas, which can result in focal tissue ischemia, brain compression, and herniation. Moreover, delays in management increase the risk of secondary brain injury from hypoxemia and hypotension. Therefore, in TBI patients with subdural hematomas (SDHs) and epidural hematomas (EDHs), surgical intervention is both necessary and time sensitive. Significant delays are seen along the care continuum in low- and middle-income countries (LMICs) largely due to limited healthcare capacity to address the disproportional rates of TBI in Sub Saharan Africa (SSA). While many LMICs have subsidized systems to offset surgical costs, the burden of securing funds by the patients for medications, supplies, and CT diagnostics poses a significant challenge to timely surgical interventions. In Kampala Uganda, the challenge of obtaining timely CT scans is twofold: logistical and financial barriers. These bottlenecks contribute significantly to the care continuum delays and are associated with poor TBI outcomes. Objective: The objectives of this study are to 1) describe the temporal delays through a modified three delays model that fits the context of neurosurgical interventions for TBI patients in Kampala and 2) investigate the association between delays and mortality. Methods: Prospective data were collected for 563 TBI patients presenting to a tertiary hospital in Kampala from 1 June – 30 November 2016. Four time intervals were constructed along five time points: injury, hospital arrival, neurosurgical evaluation, CT results, and definitive surgery. Time interval differences among mild, moderate and severe TBI and their association with mortality were analyzed. Results: The mortality rate of all TBI patients presenting to MNRH was 9.6%, which ranged from 4.7% for mild and moderate TBI patients receiving surgery to 81.8% for severe TBI patients who failed to receive surgery. The duration from injury to surgery varied considerably across TBI severity with the largest gap seen between mild TBI (174 hours) and severe TBI (69 hours) patients. Further analysis revealed care continuum differences for interval 3 (neurosurgical evaluation to CT result) and 4 (CT result to surgery) between severe TBI patients (7 hours for interval 3 and 24 hours for interval 4) and mild TBI patients (19 hours for interval 3, and 96 hours for interval 4). These post-arrival delays were associated with mortality for mild (p=0.05) and moderate TBI (p=0.03) patients. Conclusions: To our knowledge, this is the first analysis using a modified 'three delays' framework to analyze the care continuum of TBI patients in Uganda from injury to surgery. We found significant associations between delays and mortality for mild and moderate TBI patients. As it currently stands, poorer outcomes were observed for these mild and moderate TBI patients who were managed non-operatively or failed to receive surgery while surgical services were shunted to more severely ill patients. While well intentioned, high mortality rates were still observed for the severe TBI patients managed surgically. These results suggest the need for future research to optimize triage practices, understand delay contributors, and improve pre-hospital logistical referral systems.

Keywords: care continuum, global neurosurgery, Kampala Uganda, LMIC, Mulago, traumatic brain injury

Procedia PDF Downloads 219

Authors: Andrew Read, Alice Parry, Kate Woods

Abstract:

Since the advent of the SARS-CoV-2 pandemic, the search for medications that can reduce mortality and morbidity has been a global research priority. Several multi-center trials have recently demonstrated improved mortality associated with the use of Tocilizumab, an interleukin-6 receptor antagonist, in patients with severe SARS-CoV-2 pneumonia. Initial data supported the administration in patients requiring respiratory support (non-invasive or invasive ventilation), but more recent data has shown benefit in all hypoxic patients. At the height of the second wave of COVID-19 infections in London, our hospital introduced the use of Tocilizumab for patients with severe COVID-19. Tocilizumab is licensed for use in chronic inflammatory conditions and has been associated with an increased risk of severe bacterial and fungal infections, as well as reactivation of chronic viral infections (e.g., hepatitis B). It is a specialist drug that suppresses the formation of C-reactive protein (CRP) for 6 – 12 weeks. It is not widely used by the general medical community. We aimed to assess Tocilizumab use in our hospital and to implement changes to the protocol as required to ensure administration was safe and appropriate. A retrospective study design was used to assess prescriptions over an initial 3-week period in both intensive care and on the medical wards. This amounted to a total of 13 patients. The initial data collection identified four key areas of concern: adherence to national and local inclusion & exclusion criteria; a collection of appropriate screening blood prior to administration; documentation of informed consent or best interest decision and documentation of Tocilizumab administration on patient discharge information, to alert future healthcare providers that typical measures of inflammation and infection, such as CRP, are unreliable for up to 3-months. Data were collected from electronic notes, blood results and observation charts, and cross referenced with pharmacy data. Initial results showed that all four key areas were completed in approximately 50% of cases. Of particular concern was adherence to exclusion criteria, such as current evidence of bacterial infection, and ensuring the correct screening blood was sent to exclude infections such as hepatitis. To remedy this and improve patient safety, the initial data was presented to relevant healthcare professionals. Subsequently, three interventions were introduced and education on each provided to hospital staff. An electronic ‘order set’ collating the appropriate screening blood was created simplifying the screening process. Pre-formed electronic documentation which can be inserted into the notes was created to provide a framework for consent discussions and reduce the time needed for junior doctors to complete this task. Additionally, a ‘Tocilizumab’ administration card was created and administered via pharmacy. This was distributed to each patient on discharge to ensure future healthcare professionals were aware of the potential effects of Tocilizumab administration, including suppression of CRP. Following these changes, repeat data collection over two months illustrated that each of the 4 safety aspects was met with a 100% success rate in every patient. Although this demonstrates good progress and effective interventions the challenge will be to maintain this progress. The audit data collection is ongoing

Keywords: education, patient safety , SARS-CoV-2, Tocilizumab

Procedia PDF Downloads 174

Authors: Reyhane Hamed Kamran

Abstract:

Early stage morphogenesis requires the execution of complex systems that direct the nearby conduct of gatherings of cells. The organization of such instruments has been, for the most part, deciphered through the recognizable proof of moderated groups of flagging pathways that spatially and transiently control cell conduct. In any case, how this data is handled to control cell shape and cell elements is an open territory of examination. The structure that rises up out of differing controls, for example, cell science, material science, and formative science, focuses to bond and cortical actin arranges as controllers of cell surface mechanics. In this specific circumstance, a scope of formative marvels can be clarified by the guideline of cell surface pressure.

Keywords: cell, tissue damage, morphogenesis, cell conduct

Procedia PDF Downloads 103

Authors: Narin Salehiyan

Abstract:

Early stage morphogenesis requires the execution of complex systems that direct the nearby conduct of gatherings of cells. The organization of such instruments has been, for the most part, deciphered through the recognizable proof of moderated groups of flagging pathways that spatially and transiently control cell conduct. In any case, how this data is handled to control cell shape and cell elements is an open territory of examination. The structure that rises up out of differing controls, for example, cell science, material science and formative science, focuses to bond and cortical actin arranges as controllers of cell surface mechanics. In this specific circumstance, a scope of formative marvels can be clarified by the guideline of cell surface pressure.

Keywords: cell, tissue damage, morphogenesis, cell conduct

Procedia PDF Downloads 81