Search results for: and water resources management

Authors: Awatef Ahmed Ben Ramadan, Aqsa Arshad

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Background: There is a huge Muslim migration movement to North America and Europe for several reasons, primarily refuge from war areas and partly to search for better work and educational chances. There are always concerns regarding first-Generation Immigrant women's health and computer literacy, an adequate understanding of the health systems, and the use of the existing healthcare technology and services effectively and efficiently. Language proficiency level, preference for cultural and traditional remedies, socioeconomic factors, fear of stereotyping, limited accessibility to health services, and general unfamiliarity with the existing health services and resources are familiar variables among these women. Aims: The current study aims to assess the health and digital literacy of first-generation Muslim women in Atlanta city. Also, the study aims to examine how the COVID-19 pandemic has encouraged the use of health information technology and increased technology awareness among the targeted women. Methods: The study design is cross-sectional correlational research. The study will be conducted to produce preliminary results that the investigators want to have to supplement an NIH grant application about leveraging information technology to reduce the health inequalities amongst the first-generation immigrant Muslim women in Atlanta City. The investigators will collect the study data in two phases using different tools. Phase one was conducted in June 2022; the investigators used tools to measure health and digital literacy amongst 42 first-generation immigrant Muslim women. Phase two was conducted in November 2022; the investigators measured the Knowledge, Attitude, and Practice (KAP) of using health information technology such as telehealth from a sample of 45 first-generation Muslim immigrant women in Atlanta; in addition, the investigators measured how the current pandemic has affected their KAP to use telemedicine and telehealth services. Both phases' study participants were recruited using convenience sampling methodology. The investigators collected around 40 of 18 years old or older first-generation Muslim immigrant women for both study phases. The study excluded Immigrants who hold work visas and second-generation immigrants. Results: At the point of submitting this abstract, the investigators are still analyzing the study data to produce preliminary results to apply for an NIH grant entitled "Leveraging Health Information Technology (Health IT) to Address and Reduce Health Care Disparities (R01 Clinical Trial Optional)". This research will be the first step of a comprehensive research project to assess and measure health and digital literacy amongst a vulnerable community group. The targeted group might have different points of view from the U.S.-born inhabitants on how to: promote their health, gain healthy lifestyles and habits, screen for diseases, adhere to health treatment and follow-up plans, perceive the importance of using available and affordable technology to communicate with their providers and improve their health, and help in making serious decisions for their health. The investigators aim to develop an educational and instructional health mobile application considering the language and cultural factors that affect immigrants' ability to access different health and social support sources, know their health rights and obligations in their communities, and improve their health behavior and behavior lifestyles.

Keywords: first-generation immigrant Muslim women, telehealth, COVID-19 pandemic, health information technology, health and digital literacy

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Authors: M. Kosacka, I. Kudelska

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Vehicle is one of the most influential and complex product worldwide, which affects people’s life, state of the environment and condition of the economy (all aspects of sustainable development concept) during each stage of lifecycle. With the increase of vehicles’ number, there is growing potential for management of End of Life Vehicle (ELV), which is hazardous waste. From one point of view, the ELV should be managed to ensure risk elimination, but from another point, it should be treated as a source of valuable materials and spare parts. In order to obtain materials and spare parts, there are established recycling networks, which are an example of sustainable policy realization at the national level. The basic object in the polish recycling network is dismantling facility. The output material streams in dismantling stations include waste, which very often generate costs and spare parts, that have the biggest potential for revenues creation. Both outputs are stored into warehouses, according to the law. In accordance to the revenue creation and sustainability potential, it has been placed a strong emphasis on storage process. We present the concept of storage method, which takes into account the specific of the dismantling facility in order to support decision-making process with regard to the principles of sustainable development. The method was developed on the basis of case study of one of the greatest dismantling facility in Poland.

Keywords: dismantling, end of life vehicles, sustainability, storage

Procedia PDF Downloads 270

Authors: Jignasha Derasari, Patel Krishna M, Modi Jignasa G.

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Chemical stability of pharmaceutical molecules is a matter of great concern as it affects the safety and efficacy of the drug product.Stability testing data provides the basis to understand how the quality of a drug substance and drug product changes with time under the influence of various environmental factors. Besides this, it also helps in selecting proper formulation and package as well as providing proper storage conditions and shelf life, which is essential for regulatory documentation. The ICH guideline states that stress testing is intended to identify the likely degradation products which further help in determination of the intrinsic stability of the molecule and establishing degradation pathways, and to validate the stability indicating procedures. A simple, accurate and precise stability indicating RP- HPLC method was developed and validated for simultaneous estimation of Amiloride Hydrochloride and Furosemide in tablet dosage form. Separation was achieved on an Phenomenexluna ODS C18 (250 mm × 4.6 mm i.d., 5 µm particle size) by using a mobile phase consisting of Ortho phosphoric acid: Acetonitrile (50:50 %v/v) at a flow rate of 1.0 ml/min (pH 3.5 adjusted with 0.1 % TEA in Water) isocratic pump mode, Injection volume 20 µl and wavelength of detection was kept at 283 nm. Retention time for Amiloride Hydrochloride and Furosemide was 1.810 min and 4.269 min respectively. Linearity of the proposed method was obtained in the range of 40-60 µg/ml and 320-480 µg/ml and Correlation coefficient was 0.999 and 0.998 for Amiloride hydrochloride and Furosemide, respectively. Forced degradation study was carried out on combined dosage form with various stress conditions like hydrolysis (acid and base hydrolysis), oxidative and thermal conditions as per ICH guideline Q2 (R1). The RP- HPLC method has shown an adequate separation for Amiloride hydrochloride and Furosemide from its degradation products. Proposed method was validated as per ICH guidelines for specificity, linearity, accuracy; precision and robustness for estimation of Amiloride hydrochloride and Furosemide in commercially available tablet dosage form and results were found to be satisfactory and significant. The developed and validated stability indicating RP-HPLC method can be used successfully for marketed formulations. Forced degradation studies help in generating degradants in much shorter span of time, mostly a few weeks can be used to develop the stability indicating method which can be applied later for the analysis of samples generated from accelerated and long term stability studies. Further, kinetic study was also performed for different forced degradation parameters of the same combination, which help in determining order of reaction.

Keywords: amiloride hydrochloride, furosemide, kinetic study, stability indicating RP-HPLC method validation

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Authors: Athar Mahmood, Asad Ali

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Management considerations including harvesting time and nitrogen application considerably influence the biomass yield, quality and biogas production. Therefore, a field study was conducted to determine the effect of various harvesting times and nitrogen rates on the biomass yield, quality and biogas yield of maize crop. This experiment was consisted of various harvesting times i.e., harvesting after 45, 55 and 65 days of sowing (DAS) and nitrogen rates i.e., 0, 100, 150 and 200 kg ha-1 respectively. The data indicated that maximum plant height, leaf area, dry matter (DM) yield, protein, acid detergent fiber, neutral detergent fiber, crude fiber contents and biogas yield were recorded 65 days after sowing while lowest was recorded 45 days after sowing. In contrary to that significantly higher chlorophyll contents were observed at 45 DAS. In case of nitrogen rates maximum plant height, leaf area, and DM yield, protein contents, ash contents, acid detergent fiber, neutral detergent fiber, crude fiber contents and chlorophyll contents were determined with nitrogen at the rate of 200 kg ha-1, while minimum was observed when no N was applied. Therefore, harvesting 65 DAS and N application @ 200 kg ha-1 can be suitable for getting the higher biomass and biogas production.

Keywords: chemical composition, fiber contents, biogas, nitrogen, harvesting time

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Authors: Ekaterina Zvorykina

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Nowadays, Arctic and Antarctic regions are distinguished to be one of the most important strategic resources for global development. Nonetheless, living conditions in Arctic regions still demand certain improvements. As soon as the region is rarely populated, one of the main points of interest is health accommodation of the people, who migrate to Arctic region for permanent and shift work. At Arctic and Antarctic latitudes, personnel face polar day and polar night conditions during the time of the year. It means that they are deprived of natural sunlight in winter season and have continuous daylight in summer. Firstly, the change in light intensity during 24-hours period due to migration affects circadian rhythms. Moreover, the controlled artificial light in winter is also an issue. The results of the recent studies on night shift medical professionals, who were exposed to permanent artificial light, have already demonstrated higher risks in cancer, depression, Alzheimer disease. Moreover, people exposed to frequent time zones change are also subjected to higher risks of heart attack and cancer. Thus, our main goals are to understand how high latitude work and living conditions can affect human health and how it can be prevented. In our study, we analyze molecular and cellular factors, which play important role in circadian rhythm change and distinguish main risk groups in people, migrating to high latitudes. The main well-studied index of circadian timing is melatonin or its metabolite 6-sulfatoxymelatonin. In low light intensity melatonin synthesis is disturbed and as a result human organism requires more time for sleep, which is still disregarded when it comes to working time organization. Lack of melatonin also causes shortage in serotonin production, which leads to higher depression risk. Melatonin is also known to inhibit oncogenes and increase apoptosis level in cells, the main factors for tumor growth, as well as circadian clock genes (for example Per2). Thus, people who work in high latitudes can be distinguished as a risk group for cancer diseases and demand more attention. Clock/Clock genes, known to be one of the main circadian clock regulators, decrease sensitivity of hypothalamus to estrogen and decrease glucose sensibility, which leads to premature aging and oestrous cycle disruption. Permanent light exposure also leads to accumulation superoxide dismutase and oxidative stress, which is one of the main factors for early dementia and Alzheimer disease. We propose a new screening system adjusted for people, migrating from middle to high latitudes and accommodation therapy. Screening is focused on melatonin and estrogen levels, sleep deprivation and neural disorders, depression level, cancer risks and heart and vascular disorders. Accommodation therapy includes different types artificial light exposure, additional melatonin and neuroprotectors. Preventive procedures can lead to increase of migration intensity to high latitudes and, as a result, the prosperity of Arctic region.

Keywords: circadian rhythm, high latitudes, melatonin, neuroprotectors

Procedia PDF Downloads 155

Authors: Ayat-Allah Bouramdane

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Solar Photovoltaic (PV) and Concentrated Solar Power (CSP) do not burn fossil fuels and, therefore, could meet the world's needs for low-carbon power generation as they do not release greenhouse gases into the atmosphere as they generate electricity. The power output of the solar PV module and CSP collector is proportional to the temperature and the amount of solar radiation received by their surface. Hence, the determination of the most convenient locations of PV and CSP systems is crucial to maximizing their output power. This study aims to provide a hands-on and plausible approach to the multi-criteria evaluation of site suitability of PV and CSP plants using a combination of Geographic Referenced Information (GRI) and Analytic Hierarchy Process (AHP). Applying the GRI-based AHP approach is meant to specify the criteria and sub-criteria, to identify the unsuitable areas, the low-, moderate-, high- and very high suitable areas for each layer of GRI, to perform the pairwise comparison matrix at each level of the hierarchy structure based on experts' knowledge, and calculate the weights using AHP to create the final map of solar PV and CSP plants suitability in Morocco with a particular focus on the Dakhla city. The results recognize that solar irradiation is the main decision factor for the integration of these technologies on energy policy goals of Morocco but explicitly account for other factors that cannot only limit the potential of certain locations but can even exclude the Dakhla city classified as unsuitable area. We discuss the sensitivity of the PV and CSP site suitability to different aspects, such as the methodology, the climate conditions, and the technology used in each source, and provide the final recommendations to the Moroccan energy strategy by analyzing if actual Morocco's PV and CSP installations are located within areas deemed suitable and by discussing several cases to provide mutual benefits across the Food-Energy-Water nexus. The adapted methodology and conducted suitability map could be used by researchers or engineers to provide helpful information for decision-makers in terms of sites selection, design, and planning of future solar plants, especially in areas suffering from energy shortages, such as the Dakhla city, which is now one of Africa's most promising investment hubs and it is especially attractive to investors looking to root their operations in Africa and import to European markets.

Keywords: analytic hierarchy process, concentrated solar power, dakhla, geographic referenced information, Morocco, multi-criteria decision-making, photovoltaic, site suitability

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Authors: E. K. Soyele

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This study is on capacity building and motivation as determinants of productivity among library personnel in colleges of education in South West, Nigeria. This study made use of a descriptive research design of survey type. A total enumeration sampling technique was used for the selected sample. The research sample consisted of 40 library personnel. The instrument used for the study was a structured questionnaire divided into four parts. Statistics data analysis used were descriptive statistics with frequencies, percentages, and regression statistics analysis. Findings from this study revealed that capacity building and motivation have positive impact on library personnel productivity with their percentages greater than 50% acceptance level. A test of null hypotheses at P < 0.05 significant level was tested to see the significance between capacity building and productivity, which was positive at P < 0.05 significant level. This implies that capacity building and motivation significantly determine productivity among library personnel in selected college libraries in Nigeria. The study concluded that there is need for institutions to equip their library personnel via training programmes, in-service, digital training, ICT training, seminars, and conferences, etc. Incentives should be provided to motivate personnel for high productivity. The study, therefore, recommends that government, institutions and library management should fund college libraries adequately so as to enhance capacity building, staff commitment and training for further education

Keywords: capacity building, library personnel, motivation, productivity

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Authors: Muhammad Awais Kiani, Abdul Basit Kiani, Maryam Kiani

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Synergizing Sales and Marketing for Electronics Engineering with Web Development, explores the dynamic relationship between sales, marketing, and web development within the electronics engineering industry. This study is important for the power of digital platforms to connect with customers. Which increases brand visibility and drives sales. It highlights the need for collaboration between sales and marketing teams, as well as the integration of web development strategies to create seamless user experiences and effective lead generation. Furthermore, It also emphasizes the role of data analytics and customer insights in optimizing sales and marketing efforts in the ever-evolving landscape of electronics engineering. Sales and marketing play a crucial role in driving business growth, and in today's digital landscape, web development has become an integral part of these strategies. Web development enables businesses to create visually appealing and user-friendly websites that effectively showcase their products or services. It allows for the integration of e-commerce functionalities, enabling seamless online transactions. Furthermore, web development helps businesses optimize their online presence through search engine optimization (SEO) techniques, social media integration, and content management systems. This abstract highlights the symbiotic relationship between sales marketing in the electronics industry and web development, emphasizing the importance of a strong online presence in achieving business success.

Keywords: electronics industry, web development, sales, marketing

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Authors: Nedjar Abdelhadi

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The pharmaceutical industry is one of the most important structures and foundations for the management and development of the modern world, especially the advanced part of it, meaning that there are some exceptions for third-world countries. The world today has witnessed radical transformations and changes, some of which made it better and some of which affected the path of its growth. At the beginning of my research, there was a detailed presentation overview of the current situation of the world in terms of growth and development, and it proceeded through that overview as the introduction to my research. The first chapter had divided into three sections; each topic was unique to one of the new methods of manufacturing, deducing and developing medicines Several examples of various recently developed medicines were used The second chapter dealt with the defects and shortcomings that pioneers and drug makers at various levels, as well as various regions and major companies, suffer from on the basis that they are international, especially those specialized in the manufacture of medicines related to viruses and chronic diseases, as well as incurable. As for the third chapter, it was devoted to marketing methods, methods of achieving sales, as well as the basics of spreading medicines and preparing the minds of consumers. Through my research, the one concluded that the current world has become completely different from the world we used to know, and it means by saying the field of manufacturing, selling and marketing medicines. It was noted that one of the biggest factors that affected the change in the field of medicine was the corona disaster. At the end of my research, I was left with nothing but to show the importance and necessity of the pharmaceutical industry and its effective role, not only in the development of mankind, but its main role is in the survival of mankind.

Keywords: health, diseases, medicine, epidemics

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Authors: Ansong Richard Omari, Yosei Oikawa, Yoshiharu Fujii, Dorothea Sonoko Bellingrath-Kimura

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Renewed interest in soil management aimed at improving the productive capacity of Sub Saharan Africa (SSA) soils has called for the need to analyse the long term effect of different fertilization systems on soil. This study was conducted in two agroecological zones (i.e., Guinea Savannah (GS) and Deciduous forest (DF)) of Ghana to evaluate the impacts of long term (> 5 years) fertilization schemes on soil chemical and microbial properties. Soil samples under four different fertilization schemes (inorganic, inorganic and organic, organic, and no fertilization) were collected from 20 farmers` field in both agroecological zones. Soil analyses were conducted using standard procedures. All average soil quality parameters except extractable C, potential mineralizable nitrogen and CEC were significantly higher in DF sites compared to GS. Inorganic fertilization proved superior in soil chemical and microbial biomass especially in GS zone. In GS, soil deterioration index (DI) revealed that soil quality deteriorated significantly (−26%) under only organic fertilization system whereas soil improvement was observed under inorganic and no fertilization sites. In DF, either inorganic or organic and inorganic fertilization showed significant positive effects on soil quality. The high soil chemical composition and enhanced microbial biomass in DF were associated with the high rate of inorganic fertilization.

Keywords: deterioration index, fertilization scheme, microbial biomass, tropical agroecological zone

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Authors: Nana Benma Osei

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Patient discharge can be a hectic process. Patients are sometimes sent to the wrong location or forgotten in lounges in the waiting room. This ends up compromising patient care because the delay in picking the patients can affect how they adhere to medication. Patients may fail to take their medication, and this will lead to negative outcomes. The situation highlights the demands of modern-day healthcare, and the use of technology can help in reducing such challenges and in enhancing the patient’s experience, leading to greater satisfaction with the care provided. The paper contains the proposed changes to a healthcare facility by introducing the clinical decision support system, which will be needed to improve coordination and communication during patient discharge. This will be done under Kurt Lewin’s Change Management Model, which recognizes the different phases in the change process. A pilot program is proposed initially before the program can be implemented in the entire organization. This allows for the identification of challenges and ways of managing them. The paper anticipates some of the possible challenges that may arise during implementation, and a multi-disciplinary approach is considered the most effective. Opposition to the change is likely to arise because staff members may lack information on how the changes will affect them and the skills they will need to learn to use the new system. Training will occur before the technology can be implemented. Every member will go for training, and adequate time is allocated for training purposes. A comparison of data will determine whether the project has succeeded.

Keywords: patient discharge, clinical decision support system, communication, collaboration

Procedia PDF Downloads 103

Authors: Elżbieta Antczak

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Cities offer important opportunities for economic development and for expanding access to basic services, including health care and education, for large numbers of people. Moreover, green areas (as an integral part of sustainable urban development) present a major opportunity for improving urban environments, quality of lives and livelihoods. This paper examines, using spatial concentration and spatial taxonomic measures, regional diversification of greenery in the cities of Poland. The analysis includes location quotients, Lorenz curve, Locational Gini Index, and the synthetic index of greenery and spatial statistics tools: (1) To verify the occurrence of strong concentration or dispersion of the phenomenon in time and space depending on the variable category, and, (2) To study if the level of greenery depends on the spatial autocorrelation. The data includes the greatest Polish cities, categories of the urban greenery (parks, lawns, street greenery, and green areas on housing estates, cemeteries, and forests) and the time span 2004-2015. According to the obtained estimations, most of cites in Poland are already taking measures to become greener. However, in the country there are still many barriers to well-balanced urban greenery development (e.g. uncontrolled urban sprawl, poor management as well as lack of spatial urban planning systems).

Keywords: greenery, urban areas, regional spatial diversification and concentration, spatial taxonomic measure

Procedia PDF Downloads 286

Authors: Badawi Mahmoud, Eid Mohamed, Salih Hytham, Tahoun Mamdouh

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Cultural properties made of types of materials; we can classify them broadly into three categories. There are organic cultural properties which have their origin in the animal and plant kingdoms. There are the inorganic cultural properties made of metal or stone. Then there are those made of both organic and inorganic materials such as metal with wood. Most cultural properties are made from several materials rather than from one single material. Cultural properties reveal a lot of information about the past and often have great artistic value. It is important to extend the life of cultural properties and preserve themif possible, that is intended to preserve them for future generations. The study of metallic relics usually includes examining the techniques used to make them and the extent to which they have corroded. The conservation science of archaeological artifacts demands an accurate grasp of the interior of the article, which cannot be seen. This is essential to elucidate the method of manufacture and provides information that is important for cleaning, restoration, and other processes of conservation. Conservation treatment does not ensure the prevention of further degradation of the archaeological artifact. Instead, it is an attempt to inhibit further degradation as much as possible. Ancient metallic artifacts are made of many materials. Some are made of a single metal, such as iron, copper, or bronze. There are also composite relics made of several metals. Almost all metals (except gold) corrode while they rest underground. Corrosion is caused by the interaction of oxygen, water, and various ions. Chloride ions play a major role in the advance of corrosion. Excavated metallic relics are usually scientifically examined as to their structure and materials and treated for preservation before being displayed for exhibition or stored in a storehouse. Bird statue hermit body is made of wood and legs and beak bronze, the object broken separated to three parts. This statue came to Grand Egyptian Museum – Conservation Centre (GEM-CC) Inorganic Lab. Statuette representing the god djehoty shaped of the bird (ibis) sculpture made of bronze and wood the body of statues made from wood and bronze from head and leg and founded remains of black resin maybe it found with mummy, the base installed by wooden statue of the ancient writings there dating, the archaeological unit decided the dating is 3rd intermediate period - late period. This study aims to do conservation process for this statue, attempt to inhibit further degradation as much as possible and fill fractures and cracks in the wooden part.

Keywords: inorganic materials, metal, wood, corrosion, ibis

Procedia PDF Downloads 254

Authors: Manana Lobzhanidze

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The COVID-19 pandemic has made significant changes in migration processes, notably changes in the study migration process. The constraints caused by the COVID-19 pandemic led to changes in the studying process, which negatively affected its efficiency. The educational process has partially or completely shifted to distance learning; Both labor and study migration have increased significantly in the world. The employment and education market has become global and consequently, a number of challenges have arisen for employers, researchers, and businesses. The role of preparing qualified personnel in achieving high productivity is justified, the benefits for employers and employees are assessed on the one hand, and the role of study migration for the country’s development is examined on the other hand. Research methods. The research is based on methods of analysis and synthesis, quantitative and qualitative, groupings, relative and mean quantities, graphical representation, comparison, analysis and etc. In-depth interviews were conducted with experts to determine quantitative and qualitative indicators. Research findings. Factors affecting study migration are analysed in the paper and the environment that stimulates migration is explored. One of the driving forces of migration is considered to be the desire for receiving higher pay. Levels and indicators of study migration are studied by country. Comparative analysis has found that study migration rates are high in countries where the price of skilled labor is high. The productivity of individuals with low skills is low, which negatively affects the economic development of countries. It has been revealed that students leave the country to improve their skills during study migration. The process mentioned in the article is evaluated as a positive event for a developing country, as individuals are given the opportunity to share the technology of developed countries, gain knowledge, and then introduce it in their own country. The downside of study migration is the return of a small proportion of graduates from developed economies to their home countries. The article concludes that countries with emerging economies devote less resources to research and development, while this is a priority in developed countries, allowing highly skilled individuals to use their skills efficiently. The paper studies the national education system examines the level of competition in the education market and the indicators of educational migration. The level of competition in the education market and the indicators of educational migration are studied. The role of qualified personnel in achieving high productivity is substantiated, the benefits of employers and employees are assessed on the one hand, and the role of study migration in the development of the country is revealed on the other hand. The paper also analyzes the level of competition in the education and labor markets and identifies indicators of study migration. During the pandemic period, there was a great demand for the digital technologies. Open access to a variety of comprehensive platforms will significantly reduce study migration to other countries. As a forecast, it can be said that the intensity of the use of e-learning platforms will be increased significantly in the post-pandemic period. The paper analyzes the positive and negative effects of study migration on economic development, examines the challenges of study migration in light of the COVID-19 pandemic, suggests ways to avoid negative consequences, and develops recommendations for improving the study migration process in the post-pandemic period.

Keywords: study migration, COVID-19 pandemic, factors affecting migration, economic development, post-pandemic migration

Procedia PDF Downloads 127

Authors: D. Garg, S. Luthra, A. Haleem

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Due to growing concern about environmental and social consequences throughout the world, a need has been felt to incorporate sustainability concepts in conventional manufacturing. This paper is an attempt to identify and evaluate drivers in implementing sustainable manufacturing in Indian context. Nine possible drivers for successful implementation of sustainable manufacturing have been identified from extensive review. Further, Decision Making Trial and Evaluation Laboratory (DEMATEL) approach has been utilized to evaluate and categorize these identified drivers for implementing sustainable manufacturing in to the cause and effect groups. Five drivers (Societal Pressure and Public Concerns; Regulations and Government Policies; Top Management Involvement, Commitment and Support; Effective Strategies and Activities towards Socially Responsible Manufacturing and Market Trends) have been categorized into the cause group and four drivers (Holistic View in Manufacturing Systems; Supplier Participation; Building Sustainable culture in Organization; and Corporate Image and Benefits) have been categorized into the effect group. “Societal Pressure and Public Concerns” has been found the most critical driver and “Corporate Image and Benefits” as least critical or the most easily influenced driver to implementing sustainable manufacturing in Indian context. This paper may surely help practitioners in better understanding of these drivers and their priorities towards effective implementation of sustainable manufacturing.

Keywords: drivers, decision making trial and evaluation laboratory (DEMATEL), India, sustainable manufacturing

Procedia PDF Downloads 388

Authors: Palak V. Patel, Jessica Pixley, Steven R. Feldman

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Introduction: Basal cell carcinoma (BCC) is the most common skin cancer worldwide and requires substantial resources to treat. When choosing between indicated therapies, providers consider their associated adverse effects, efficacy, cosmesis, and function preservation. The patient’s tumor burden, infiltrative risk, and risk of tumor recurrence are also considered. Treatment cost is often left out of these discussions. This can lead to financial toxicity, which describes the harm and quality of life reductions inflicted by high care costs. Methods: We studied the guidelines set forth by the American Academy of Dermatology for the treatment of BCC. A PubMed literature search was conducted to identify the costs of each recommended therapy. We discuss costs alongside treatment efficacy and side-effect profile. Results: Surgical treatment for BCC can be cost-effective if the appropriate treatment is selected for the presenting tumor. Curettage and electrodesiccation can be used in low-grade, low-recurrence tumors in aesthetically unimportant areas. The benefits of cost-conscious care are not likely to be outweighed by the risks of poor cosmesis or tumor return ($471 BCC of the cheek). When tumor burden is limited, MMS offers better cure rates and lower recurrence rates than surgical excision, and with comparable costs (MMS $1263; SE $949). Surgical excision with permanent sections may be indicated when tumor burden is more extensive or if molecular testing is necessary. The utility of surgical excision with frozen sections, which costs substantially more than MMS without comparable outcomes, is less clear (SE with frozen sections $2334-$3085). Less data exists on non-surgical treatments for BCC. These techniques cost less, but recurrence-risk is high. Side-effects of nonsurgical treatment are limited to local skin reactions, and cosmesis is good. Cryotherapy, 5-FU, and MAL-PDT are all more affordable than surgery, but high recurrence rates increase risk of secondary financial and psychosocial burden (recurrence rates 21-39%; cost $100-270). Radiation therapy offers better clearance rates than other nonsurgical treatments but is associated with similar recurrence rates and a significantly larger financial burden ($2591-$3460 BCC of the cheek). Treatments for advanced or metastatic BCC are extremely costly, but few patients require their use, and the societal cost burden remains low. Vismodegib and sonidegib have good response rates but substantial side effects, and therapy should be combined with multidisciplinary care and palliative measures. Expert-review has found sonidegib to be the less expensive and more efficacious option (vismodegib $128,358; sonidegib $122,579). Platinum therapy, while not FDA-approved, is also effective but expensive (~91,435). Immunotherapy offers a new line of treatment in patients intolerant of hedgehog inhibitors ($683,061). Conclusion: Dermatologists working within resource-compressed practices and with resource-limited patients must prudently manage the healthcare dollar. Surgical therapies for BCC offer the lowest risk of recurrence at the most reasonable cost. Non-surgical therapies are more affordable, but high recurrence rates increase the risk of secondary financial and psychosocial burdens. Treatments for advanced BCC are incredibly costly, but the low incidence means the overall cost to the system is low.

Keywords: nonmelanoma skin cancer, basal cell skin cancer, squamous cell skin cancer, cost of care

Procedia PDF Downloads 124

Authors: Patience Manjengwa-Hungwe, Carmen White

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Background: Odyssean malaria refers to malaria acquired by infected mosquito bites from malaria endemic to non-endemic regions by mechanical modes of transport, such as airplanes, water vessels, trains and vehicles. Odyssean Malaria is rare and is characterised by absence of travel history to malaria endemic areas. As not anticipated in non-endemic areas, late diagnosis and treatment lead to a high case fatality rate. On 26 September 2014, the Outbreak Response Unit at the National Institute of Communicable Diseases was notified of a suspected death from Odyssean Malaria in Johannesburg, Gauteng Province, a non-endemic area. The main objective of this investigation was to identify the etiological agent's mode and source of transmission. Methods: Epidemiological surveys were conducted with the deceased’s family and clinical details were obtained from doctors who treated the victim in Southrand, Johannesburg. Blood samples were collected prior to death and sent to the National Health Laboratory Services, Johannesburg laboratory for a full blood count, urea electrolytes, creatinine, and C-reactive protein. Environmental assessments and entomological investigations, including collection of mosquito and larvae, were conducted at the deceased’s home and surrounding areas and sent to the laboratory for analysis. Results: Epidemiological surveys revealed no travel history, no mechanical transmission through blood transfusion and no previous possible exposure of the victim to malaria mosquitoes. Laboratory findings indicated that the platelet count was low. A further smear revealed that the malaria parasite was present and malaria antigen for P. falciparum was positive. Entomological findings revealed that none of the six adult or larval mosquitoes collected on site were malaria vectors. Dumping sites found at the back of the house were identified as possible sites where mosquitoes from endemic places could possibly breed. Conclusion: Given that there was no travel history or the possibility of mechanical transmission (blood transfusion or needle), the research team concluded that it is highly probable that the infection was acquired through an infective Anopheles mosquito inadvertently translocated from a Malaria endemic area by mechanical modes of transport. We recommend that clinicians in non-endemic malaria areas be aware of this type of malaria and test for malaria in patients showing malaria-like symptoms.

Keywords: Odyssean Malaria, vector Bourne, malaria, epidemiological surveys

Procedia PDF Downloads 338

Authors: Lamia Bouzgarrou, Amira Omrane, Haithem Kalel, Salma Kammoun

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Background: During recent decades, mechanical and electrical industrial sector has greatly expanded with a significant employability potential. However, this sector faces the increasing prevalence of musculoskeletal disorders with heavy consequences associated with direct and indirect costs. Objective: The current intervention was motivated by large musculoskeletal upper limbs and back disorders frequency among the operators of an assembly workshop in a leader company specialized in sanitary equipment and water and gas connections. We aimed to identify biomechanical constraints among these operators through activity and biomechanical exposures semi-quantitative analysis based on video recordings and MUSKA-TMS software. Methods: We conducted, open observations and exploratory interviews at first, in order to overall understand work situation. Then, we analyzed operator’s activity through systematic observations and interviews. Finally, we conducted a semi-quantitative biomechanical constraints analysis with MUSKA-TMS software after representative activity period video recording. The assessment of biomechanical constrains was based on different criteria; biomechanical characteristics (work positions), aggravating factor (cold, vibration, stress, etc.) and exposure time (duration and frequency of solicitations, recovery phase); with a synthetic score of risk level variable from 1 to 4 (1: low risk of developing MSD and 4: high risk). Results: Semi-quantitative analysis objective many elementary operations with higher biomechanical constrains like high repetitiveness, insufficient recovery time and constraining angulation of shoulders, wrists and cervical spine. Among these risky elementary operations we sited the assembly of sleeve with the body, the assembly of axis, and the control on testing table of gas valves. Transformation of work situations were recommended, covering both the redevelopment of industrial areas and the integration of new tools and equipment of mechanical handling that reduces operator exposure to vibration. Conclusion: Musculoskeletal disorders are complex and costly disorders. Moreover, an approach centered on the observation of the work can promote the interdisciplinary dialogue and exchange between actors with the objective to maximize the performance of a company and improve the quality of life of operators.

Keywords: musculoskeletal disorders, biomechanical constrains, semi-quantitative analysis, ergonomics

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Authors: Elona Saliaj

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The registration of real estate in Albania after the 90's has been a long process in time and with high cost for the country. Passing the registration system from a centralized system to a free market private system, it’s accompanied by legal uncertainties that have led to economic instability. The reforms that have been undertaken in terms of property rights have been numerous and continuous throughout the years. But despite the reforms, the system of registration of real estate, has failed to be standards requirements established by the European Union. The completion of initial registration of real estate, legal treatment of previous owners or legalization of illegal constructions remain among the main problems that prevent the development of the country in its economic sector. The performance of the registration of real estate system and dealing with issues that have appeared in the Court of First Instance, the civil section of the Albanian constitute the core of handling this analysis. This paper presents a detailed analysis on the registration system that is chosen to be applied in our country for real estate. In its content it is also determined the institution that administrates these properties, the management technique and the law that determinate its functionality. The strategy is determined for creating a modern and functional registration system and for the country remains a challenge to achieve. Identifying practical problems and providing their solutions are also the focus of reference in order to improve and modernize this important system to a state law that aims to become a member of the European Union.

Keywords: real estates registration system, comparative aspects, cadastral area, property certificate, legal reform

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Authors: Siva K. Bathina, Sudheer Siddapureddy

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Pool fires are formed when the flammable liquid accidentally spills on the ground or water and ignites. Pool fire is a kind of buoyancy-driven and diffusion flame. There have been many pool fire accidents caused during processing, handling and storing of liquid fuels in chemical and oil industries. Such kind of accidents causes enormous damage to property as well as the loss of lives. Pool fires are complex in nature due to the strong interaction among the combustion, heat and mass transfers and pyrolysis at the fuel surface. Moreover, the experimental study of such large complex fires involves fire safety issues and difficulties in performing experiments. In the present work, large eddy simulations are performed to study such complex fire scenarios using fire dynamic simulator. A 1 m diesel pool fire is considered for the studied cases, and diesel is chosen as it is most commonly involved fuel in fire accidents. Fire simulations are performed by specifying two different boundary conditions: one the fuel is in liquid state and pyrolysis model is invoked, and the other by assuming the fuel is initially in a vapor state and thereby prescribing the mass loss rate. A domain of size 11.2 m × 11.2 m × 7.28 m with uniform structured grid is chosen for the numerical simulations. Grid sensitivity analysis is performed, and a non-dimensional grid size of 12 corresponding to 8 cm grid size is considered. Flame properties like mass burning rate, irradiance, and time-averaged axial flame temperature profile are predicted. The predicted steady-state mass burning rate is 40 g/s and is within the uncertainty limits of the previously reported experimental data (39.4 g/s). Though the profile of the irradiance at a distance from the fire along the height is somewhat in line with the experimental data and the location of the maximum value of irradiance is shifted to a higher location. This may be due to the lack of sophisticated models for the species transportation along with combustion and radiation in the continuous zone. Furthermore, the axial temperatures are not predicted well (for any of the boundary conditions) in any of the zones. The present study shows that the existing models are not sufficient enough for modeling blended fuels like diesel. The predictions are strongly dependent on the experimental values of the soot yield. Future experiments are necessary for generalizing the soot yield for different fires.

Keywords: burning rate, fire accidents, fire dynamic simulator, pyrolysis

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Authors: Esha Thakkar, Ina Liu, Kalynn Hosea, Shana Katz, Katie Marks, Sarah Hall, Cat Liu, Suzanne Harris

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Purpose: Inequities in mental healthcare accessibility are cited as an international public health concern by the World Health Organization (WHO) and National Alliance on Mental Illness (NAMI). These disparities are further exacerbated in racial and ethnic minority groups and are especially concerning in health professional training settings such as Doctor of Pharmacy (PharmD) programs and postgraduate residency training where mental illness rates are high. The purpose of the study was to determine baseline access to culturally sensitive mental healthcare and how to improve such access and communication for racially and ethnically minoritized pharmacy students and residents at one school of pharmacy and a partnering academic medical center in the United States. Methods: This IRB-exempt study included 60-minute focus groups conducted in person or online from November 2021 to February 2022. Eligible participants included PharmD students in their first (P1), second (P2), third (P3), or fourth year (P4) or pharmacy residents completing a postgraduate year 1 (PGY1) or PGY2 who identify as Black, Indigenous, or Person of Color (BIPOC). There were four core theme questions asked during the focus groups to lead the discussion, specifically on the core themes of personal barriers, identities, areas that are working well, and areas for improvement. Participant responses were transcribed and analyzed using an open coding system with two individual reviews, followed by collaborative and intentional discussion and, as needed, an external audit of the coding by a third research team member to reach a consensus on themes. Results: This study enrolled 26 participants, with eight P1, five P2, seven P3, two P4, and four resident participants. Within the four core themes of barriers, identities, areas working well, and areas for improvement, emerging subthemes included: lack of time, access to resources, and stigma under barriers; lack of representation, cultural and family stigma, and gender identities for identity barriers; supportive faculty, sense of community and culture supporting paid time off for areas going well; and wellness days, reduced workload and diversity of the workforce in areas of improvement. Subthemes sometimes varied within a core theme depending on the participant year. Conclusions: There is a gap in the literature in addressing barriers and disparities in mental health access for pharmacy trainees who identify as BIPOC. We identified key findings in regards to barriers, identities, areas going well and areas for improvement that can inform the School and the Residency Program in two priority initiatives of well-being and diversity equity and inclusion in creating actionable recommendations for trainees, program directors, and employers of our institutions, and also has the potential to provide insight for other organizations about the structures influencing access to culturally sensitive care in BIPOC trainees. These findings can inform organizations on how to continue building on communication with those who identify as BIPOC and improve access to care.

Keywords: mental health, disparities, minorities, wellbeing, identity, communication, barriers

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Authors: Chao Li, Lei Zhou, Ruiqi Ren, Dan Li, Yali Wang, Daxin Ni, Zijian Feng, Qun Li

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Background: In 2016, yellow fever had been first ever discovered in China, soon after the yellow fever epidemic occurred in Angola. After the discovery, China had promptly made the national protocol of control and prevention and strengthened the surveillance on passenger and vector. In this study, a descriptive analysis was conducted to summarize China’s experiences of response towards this import epidemic, in the hope of providing experiences on prevention and control of yellow fever and other similar imported infectious diseases in the future. Methods: The imported cases were discovered and reported by General Administration of Quality Supervision, Inspection and Quarantine (AQSIQ) and several hospitals. Each clinically diagnosed yellow fever case was confirmed by real-time reverse transcriptase polymerase chain reaction (RT–PCR). The data of the imported yellow fever cases were collected by local Centers for Disease Control and Prevention (CDC) through field investigations soon after they received the reports. Results: A total of 11 imported cases from Angola were reported in China, during Angola’s yellow fever outbreak. Six cases were discovered by the AQSIQ, among which two with mild symptom were initiative declarations at the time of entry. Except for one death, the remaining 10 cases all had recovered after timely and proper treatment. All cases are Chinese, and lived in Luanda, the capital of Angola. 73% were retailers (8/11) from Fuqing city in Fujian province, and the other three were labors send by companies. 10 cases had experiences of medical treatment in Luanda after onset, among which 8 cases visited the same local Chinese medicine hospital (China Railway four Bureau Hospital). Among the 11 cases, only one case had an effective vaccination. The result of emergency surveillance for mosquito density showed that only 14 containers of water were found positive around places of three cases, and the Breteau Index is 15. Conclusions: Effective response was taken to control and prevent the outbreak of yellow fever in China after discovering the imported cases. However, though the similar origin of Chinese in Angola has provided an easy access for disease detection, information sharing, health education and vaccination on yellow fever; these conveniences were overlooked during previous disease prevention methods. Besides, only one case having effective vaccination revealed the inadequate capacity of immunization service in China. These findings will provide suggestions to improve China’s capacity to deal with not only yellow fever but also other similar imported diseases in China.

Keywords: yellow fever, first import, China, suggestion

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Authors: Sai Rajeev Reddy, Ishita Roy, M. Anji Reddy

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The paper describes the importance of preventive measures and immediate Emergency logistics during accidents and unfortunate Disasters for the Hyderabad Metro Rails in their various stages of construction. This is the need of the modern generation where accidents, explosions, attacks and sudden crisis are frequent casualties which take huge tolls of life in the present world. The paper utilizes the workflow and application of Geographical information System (GIS) to provide information about problems and crisis structures for efficient Metro Transportation in the city. The study analyzes the difficulties and problems which cause accidents during operation and maintenance stages of the Metro Rail. The paper focuses upon the intermediate and firsthand information of Crisis with the help of GIS technology to share Disaster data for effective measures by the Cyber Police stations, Emergency Responders, Hospitals and First Aid Centre to act immediately and save lives. The results and conclusions have nevertheless proved very informative and useful for the safety board authorities of the Hyderabad Metro Rail. The operation and Maintenance are integral stages in the development of any Multipurpose transportation Projects and are usually prone to various Disasters and tragedies. Hence, the GIS technologies help in distribution of information among the masses with the web Technologies and advanced software developed to prevent and manage crisis widely and in a cost-benefits manner.

Keywords: Geographical Information System, emergency assessment, accident zones, surveillance

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Authors: Mahmoud Ahmed Farrag, Ali Zain Elabdeen Heikal, Mohamed Shawky Ahmed, Ahmed Osama Amer

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Crowd-sourced data refers to data that is collected and shared by a large number of individuals or organizations, often through the use of digital technologies such as mobile devices and social media. The shortage in crash data collection in developing countries makes it difficult to fully understand and address road safety issues in these regions. In developing countries, crowd-sourced data can be a valuable tool for improving road safety, particularly in urban areas where the majority of road crashes occur. This study is -to our best knowledge- the first to develop safety performance functions using crowd-sourced data by adopting a negative binomial structure model and the Full Bayes model to investigate traffic safety for urban road networks and provide insights into the impact of roadway characteristics. Furthermore, as a part of the safety management process, network screening has been undergone through applying two different methods to rank the most hazardous road segments: PCR method (adopted in the Highway Capacity Manual HCM) as well as a graphical method using GIS tools to compare and validate. Lastly, recommendations were suggested for policymakers to ensure safer roads.

Keywords: crowdsourced data, road crashes, safety performance functions, Full Bayes models, network screening

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Authors: Rita U. Onolemhemhen, Saheed L. Bello, Akin P. Iwayemi

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The effectiveness of energy demand policy depends on identifying the key drivers of energy demand both in the short-run and the long-run. This paper examines the influence of regional differences on the link between energy demand and other explanatory variables for Nigeria, China and USA using the Vector Error Correction Model (VECM) approach. This study employed annual time series data on energy consumption (ED), real gross domestic product (GDP) per capita (RGDP), real energy prices (P) and urbanization (N) for a thirty-six-year sample period. The utilized time-series data are sourced from World Bank’s World Development Indicators (WDI, 2016) and US Energy Information Administration (EIA). Results from the study, shows that all the independent variables (income, urbanization, and price) substantially affect the long-run energy consumption in Nigeria, USA and China, whereas, income has no significant effect on short-run energy demand in USA and Nigeria. In addition, the long-run effect of urbanization is relatively stronger in China. Urbanization is a key factor in energy demand, it therefore recommended that more attention should be given to the development of rural communities to reduce the inflow of migrants into urban communities which causes the increase in energy demand and energy excesses should be penalized while energy management should be incentivized.

Keywords: economic growth, energy demand, income, real GDP, urbanization, VECM

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Authors: Sasan Aryaee, Mahdi Ravanshadnia

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Naturally, any activity is associated with risk, and humans have understood this concept from very long times ago and seek to identify its factors and sources. On the one hand, proper risk management can cause problems such as delays and unforeseen costs in the development projects, temporary or permanent loss of services, getting lost or information theft, complexity and limitations in processes, unreliable information caused by rework, holes in the systems and many such problems. In the present study, a model has been presented to rank the environmental risks of oil and gas projects. The statistical population of the study consists of all executives active in the oil and gas fields, that the statistical sample is selected randomly. In the framework of the proposed method, environmental risks of oil and gas projects were first extracted, then a questionnaire based on these indicators was designed based on Likert scale and distributed among the statistical sample. After assessing the validity and reliability of the questionnaire, environmental risks of oil and gas projects were ranked using the VIKOR method of multiple-criteria decision-making. The results showed that the best options for HSE planning of oil and gas projects that caused the reduction of risks and personal injury and casualties and less than other options is costly for the project and it will add less time to the duration of implementing the project is the entering of dye to the environment when painting the generator pond and the presence of the rigger near the crane.

Keywords: ranking, multi-criteria decision making, oil and gas projects, HSEmanagement, environmental risks

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Authors: Mirjana Dragas, Marli Gonan Bozac, Morena Paulisic

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Corporate social responsibility (CSR) is a balance between strategic and financial goals of companies, as well as social needs. The integration of competitive strategy and CSR in food and beverage industry has allowed companies to find new sources of competitive advantage. The paper discusses the fact that socially responsible companies encourage co-operation with socially responsible suppliers in order to strengthen market competitiveness. In addition to the descriptive interpretation of the results obtained by a questionnaire, factor analysis was used, while principal components analysis was applied as a factor extraction method. The research results based on two multiple regression analyses show that: (1) selecting the CSR supplier explains a statistically significant part of the variance of the results on the scale of financial aspects of competitiveness (as much as 44.7% of the explained variance); and (2) selecting the CSR supplier is a significant predictor of non-financial aspects of competitiveness (explains 43.9% of the variance of the results on the scale of non-financial aspects of competitiveness). A successful competitive strategy must ultimately support the growth strategy. This implies an analytical approach to finding factors that influence competitiveness through socially sustainable solutions and satisfactory top management decisions.

Keywords: competitiveness, corporate social responsibility, food and beverage industry, supply chain decision making

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Authors: Jitendra Aswani

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In the first section of this study, impact of Global Financial Crisis (GFC) on the synchronization of fourteen Asian Stock Markets (ASM’s) of countries like Hong Kong, India, Thailand, Singapore, Taiwan, Pakistan, Bangladesh, South Korea, Malaysia, Indonesia, Japan, China, Philippines and Sri Lanka, has been analysed using the network science and its metrics like degree of node, clustering coefficient and network density. Then in the second section of this study by introducing the US stock market in existing network and developing a Minimum Spanning Tree (MST) spread of crisis from the US stock market to Asian Stock Markets (ASM) has been explained. Data used for this study is adjusted the closing price of these indices from 6th January, 2000 to 15th September, 2013 which further divided into three sub-periods: Pre, during and post-crisis. Using network analysis, it is found that Asian stock markets become more interdependent during the crisis than pre and post crisis, and also Hong Kong, India, South Korea and Japan are systemic important stock markets in the Asian region. Therefore, failure or shock to any of these systemic important stock markets can cause contagion to another stock market of this region. This study is useful for global investors’ in portfolio management especially during the crisis period and also for policy makers in formulating the financial regulation norms by knowing the connections between the stock markets and how the system of these stock markets changes in crisis period and after that.

Keywords: global financial crisis, Asian stock markets, network science, Kruskal algorithm

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Authors: Jongsung Kim, Daegun Han, Myungjin Lee, Soojun Kim, Hung Soo Kim

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Recently, the frequency and magnitude of natural disasters are gradually increasing due to climate change. Especially in Korea, large-scale damage caused by heavy rainfall frequently occurs due to rapid urbanization. Therefore, this study proposed a Heavy rain Damage Risk Index (HDRI) using PSR (Pressure – State - Response) structure for heavy rain risk assessment. We constructed pressure index, state index, and response index for the risk assessment of each local government in Gyeonggi-do province, and the evaluation indices were determined by principal component analysis. The indices were standardized using the Z-score method then HDRIs were obtained for 31 local governments in the province. The HDRI is categorized into three classes, say, the safest class is 1st class. As the results, the local governments of the 1st class were 15, 2nd class 7, and 3rd class 9. From the study, we were able to identify the risk class due to the heavy rainfall for each local government. It will be useful to develop the heavy rainfall prediction function by risk class, and this was performed in this issue. Also, this risk class could be used for the decision making for efficient disaster management. Acknowledgements: This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2017R1A2B3005695).

Keywords: natural disaster, heavy rain risk assessment, HDRI, PSR

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Authors: Vathsala Kaluarachchi, Oshani Wimalarathna, Charith Vandebona, Gayani Chandrarathna, Lakmal Rupasinghe, Windhya Rankothge

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It is the fundamental function of a monitoring system to allow users to collect and process data. A worldwide threat, the corona outbreak has wreaked havoc in Sri Lanka, and the situation has gotten out of hand. Since the epidemic, the Sri Lankan government has been unable to establish a systematic system for monitoring corona patients and providing emergency care in the event of an outbreak. Most patients have been held at home because of the high number of patients reported in the nation, but they do not yet have access to a functioning medical system. It has resulted in an increase in the number of patients who have been left untreated because of a lack of medical care. The absence of competent medical monitoring is the biggest cause of mortality for many people nowadays, according to our survey. As a result, a smartphone app for analyzing the patient's state and determining whether they should be hospitalized will be developed. Using the data supplied, we are aiming to send an alarm letter or SMS to the hospital once the system recognizes them. Since we know what those patients need and when they need it, we will put up a desktop program at the hospital to monitor their progress. Deep learning, image processing and application development, natural language processing, and blockchain management are some of the components of the research solution. The purpose of this research paper is to introduce a mechanism to connect hospitals and patients even when they are physically apart. Further data security and user-friendliness are enhanced through blockchain and NLP.

Keywords: blockchain, deep learning, NLP, monitoring system

Procedia PDF Downloads 133