Search results for: squared prediction risk
5647 Influence of Causal beliefs on self-management in Korean patients with hypertension
Authors: Hyun-E Yeom
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Patients’ views about the cause of hypertension may influence their present and proactive behaviors to regulate high blood pressure. This study aimed to examine the internal structure underlying the causal beliefs about hypertension and the influence of causal beliefs on self-care intention and medical compliance in Korean patients with hypertension. The causal beliefs of 145 patients (M age = 57.7) were assessed using the Illness Perception Questionnaire-Revised. An exploratory factor analysis was used to identify the factor structure of the causal beliefs, and the factors’ influence on self-care intention and medication compliance was analyzed using multiple and logistic regression analyses. The four-factor structure including psychological, fate-related, risk and habitual factors was identified and the psychological factor was the most representative component of causal beliefs. The risk and fate-related factors were significant factors affecting lower intention to engage in self-care and poor compliance with medication regimens, respectively. The findings support the critical role of causal beliefs about hypertension in driving patients’ current and future self-care behaviors. This study highlights the importance of educational interventions corresponding to patients’ awareness of hypertension for improving their adherence to a healthy lifestyle and medication regimens.Keywords: hypertension, self-care, beliefs, medication compliance
Procedia PDF Downloads 3515646 The Association Between COL4A3 Variant RS55703767 With the Susceptibility to Diabetic Kidney Disease in Patients with Type 2 Diabetes Mellitus: Results from the Cohort Study
Authors: Zi-Han Li, Zi-Jun Sun, Dong-Yuan Chang, Li Zhu, Min Chen, Ming-Hui Zhao
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Aims: A genome-wide association study (GWAS) reported that patients with the rs55703767 minor allele in collagen type IV α3 chain encoding gene COL4A3 showed protection against diabetic kidney disease (DKD) in type 1 diabetes mellitus (T1DM). However, the role of rs55703767 in type 2 DKD has not been elucidated. The aim of the current study was to investigate the association between COL4A3 variant rs55703767 and DKD risk in Chinese patients with type 2 diabetes mellitus (T2DM). Methods: This nested case-control study was performed on 1311 patients who had T2DM for at least 10 years, including 580 with DKD and 731 without DKD. We detected the genotypes of all patients by TaqMan SNP Genotyping Assay and analyzed the association between COL4A3 variant rs55703767 and DKD risk. Results: Genetic analysis revealed that there was no significant difference between T2DM patients with DKD and those without DKD regarding allele or genotype frequencies of rs55703767, and the effect of this variant was not hyperglycemia specific. Conclusion: Our findings suggested that there was no detectable association between the COL4A3 variant rs55703767 and the susceptibility to DKD in the Chinese T2DM population.Keywords: collagen type IV α3 chain, gene polymorphism, type 2 diabetes, diabetic kidney disease
Procedia PDF Downloads 1105645 Estimation of Forces Applied to Forearm Using EMG Signal Features to Control of Powered Human Arm Prostheses
Authors: Faruk Ortes, Derya Karabulut, Yunus Ziya Arslan
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Myoelectric features gathering from musculature environment are considered on a preferential basis to perceive muscle activation and control human arm prostheses according to recent experimental researches. EMG (electromyography) signal based human arm prostheses have shown a promising performance in terms of providing basic functional requirements of motions for the amputated people in recent years. However, these assistive devices for neurorehabilitation still have important limitations in enabling amputated people to perform rather sophisticated or functional movements. Surface electromyogram (EMG) is used as the control signal to command such devices. This kind of control consists of activating a motion in prosthetic arm using muscle activation for the same particular motion. Extraction of clear and certain neural information from EMG signals plays a major role especially in fine control of hand prosthesis movements. Many signal processing methods have been utilized for feature extraction from EMG signals. The specific objective of this study was to compare widely used time domain features of EMG signal including integrated EMG(IEMG), root mean square (RMS) and waveform length(WL) for prediction of externally applied forces to human hands. Obtained features were classified using artificial neural networks (ANN) to predict the forces. EMG signals supplied to process were recorded during only type of muscle contraction which is isometric and isotonic one. Experiments were performed by three healthy subjects who are right-handed and in a range of 25-35 year-old aging. EMG signals were collected from muscles of the proximal part of the upper body consisting of: biceps brachii, triceps brachii, pectorialis major and trapezius. The force prediction results obtained from the ANN were statistically analyzed and merits and pitfalls of the extracted features were discussed with detail. The obtained results are anticipated to contribute classification process of EMG signal and motion control of powered human arm prosthetics control.Keywords: assistive devices for neurorehabilitation, electromyography, feature extraction, force estimation, human arm prosthesis
Procedia PDF Downloads 3675644 Identifying the Structural Components of Old Buildings from Floor Plans
Authors: Shi-Yu Xu
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The top three risk factors that have contributed to building collapses during past earthquake events in Taiwan are: "irregular floor plans or elevations," "insufficient columns in single-bay buildings," and the "weak-story problem." Fortunately, these unsound structural characteristics can be directly identified from the floor plans. However, due to the vast number of old buildings, conducting manual inspections to identify these compromised structural features in all existing structures would be time-consuming and prone to human errors. This study aims to develop an algorithm that utilizes artificial intelligence techniques to automatically pinpoint the structural components within a building's floor plans. The obtained spatial information will be utilized to construct a digital structural model of the building. This information, particularly regarding the distribution of columns in the floor plan, can then be used to conduct preliminary seismic assessments of the building. The study employs various image processing and pattern recognition techniques to enhance detection efficiency and accuracy. The study enables a large-scale evaluation of structural vulnerability for numerous old buildings, providing ample time to arrange for structural retrofitting in those buildings that are at risk of significant damage or collapse during earthquakes.Keywords: structural vulnerability detection, object recognition, seismic capacity assessment, old buildings, artificial intelligence
Procedia PDF Downloads 895643 Cerebral Pulsatility Mediates the Link Between Physical Activity and Executive Functions in Older Adults with Cardiovascular Risk Factors: A Longitudinal NIRS Study
Authors: Hanieh Mohammadi, Sarah Fraser, Anil Nigam, Frederic Lesage, Louis Bherer
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A chronically higher cerebral pulsatility is thought to damage cerebral microcirculation, leading to cognitive decline in older adults. Although it is widely known that regular physical activity is linked to improvement in some cognitive domains, including executive functions, the mediating role of cerebral pulsatility on this link remains to be elucidated. This study assessed the impact of 6 months of regular physical activity upon changes in an optical index of cerebral pulsatility and the role of physical activity for the improvement of executive functions. 27 older adults (aged 57-79, 66.7% women) with cardiovascular risk factors (CVRF) were enrolled in the study. The participants completed the behavioral Stroop test, which was extracted from the Delis-Kaplan executive functions system battery at baseline (T0) and after 6 months (T6) of physical activity. Near-infrared spectroscopy (NIRS) was applied for an innovative approach to indexing cerebral pulsatility in the brain microcirculation at T0 and T6. The participants were at standing rest while a NIRS device recorded hemodynamics data from frontal and motor cortex subregions at T0 and T6. The cerebral pulsatility index of interest was cerebral pulse amplitude, which was extracted from the pulsatile component of NIRS data. Our data indicated that 6 months of physical activity was associated with a reduction in the response time for the executive functions, including inhibition (T0: 56.33± 18.2 to T6: 53.33± 15.7,p= 0.038)and Switching(T0: 63.05± 5.68 to T6: 57.96 ±7.19,p< 0.001) conditions of the Stroop test. Also, physical activity was associated with a reduction in cerebral pulse amplitude (T0: 0.62± 0.05 to T6: 0.55± 0.08, p < 0.001). Notably, cerebral pulse amplitude was a significant mediator of the link between physical activity and response to the Stroop test for both inhibition (β=0.33 (0.61,0.23),p< 0.05)and switching (β=0.42 (0.69,0.11),p <0.01) conditions. This study suggests that regular physical activity may support cognitive functions through the improvement of cerebral pulsatility in older adults with CVRF.Keywords: near-infrared spectroscopy, cerebral pulsatility, physical activity, cardiovascular risk factors, executive functions
Procedia PDF Downloads 1955642 Hematological Malignancies in Children and Parental Occupational Exposure
Authors: H. Kalboussi, A. Aloui, W. Boughattas, M. Maoua, A. Brahem, S. Chatti, O. El Maalel, F. Debbabi, N. Mrizak, Y. Ben Youssef, A. Khlif, I. Bougmiza
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Background: In recent decades, the incidence of children's hematological malignancies has been increasing worldwide including Tunisia. Their severity is reflected in the importance of the medical, social and economic impact. This increase remains fully unexplained, and the involvement of genetic, environmental and occupational factors is strongly suspected. Materials and Methods: Our study is a cross-sectional survey of the type case-control conducted in the University Hospital of Farhat Hached of Sousse during the period ranging between 1 July 2011 and 30 June 2012,and which included children with acute leukemia compared to children unharmed by neoplastic disease . Cases and controls were matched by age and gender. Our objective was to: - Describe the socio-occupational characteristics of the parents of children with acute leukemia. - Identify potential occupational factors implicated in the genesis of acute leukemia. Result: The number of acute leukemia cases in the Hematology Service and day hospital of the University Hospital of Farhat Hached during the study period was 66 cases divided into in 40 boys and 26 girls with a sex ratio of 1.53. Our cases and controls were matched by age and gender. The risk of incidence of leukemia in children from smoking fathers was higher (p = 0.02, OR = 2.24, IC = [1.11 - 4.52]). The risk of incidence of leukemia in children from alcoholic fathers was higher with p = 0,009, OR = 3.9; CI = [1.33 - 11.39]. After adjusting different variables, the difference persisted significantly with pa = 0.03 and ORa = 3.5; ICa = [1.09 -11.6]. 25.7 % of cases had a family history of blood disease and neoplasia, whereas no control presented that. The difference was statistically significant (p = 0.006), OR = 1.46, IC = [1.38 - 1.56]. The parental occupational exposures associated to the occurrence of acute leukemia in children were: - Pesticides with a statistically significant difference (p = 0.03), OR = 2.94, IC = [1.06 - 8.13]. This difference persisted after adjustment with different variables pa = 0.01, ORa 3.75; ICa = [1.27 - 11.03]. - Cement without a statistically non-significant difference (p = 0.2). This difference has become significant after adjustment with the different variables pa = 0.03; ORa = 2.67; ICa = [1.06 - 6.7]. Conclusion: Parental exposure to occupational risk factors may play a role in the pathogenesis of acute leukemia in children.Keywords: hematological malignancies, children, parents, occupational exposure
Procedia PDF Downloads 3185641 Seroprevalence of Hepatitis B and C among Healthcare Workers in Dutse Metropolis, Jigawa State, Nigeria
Authors: N. M. Sani, I. Bitrus, A. M. Sarki, N. S. Mujahid
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Hepatitis is one of the neglected infectious diseases in sub Saharan Africa, and most of the available data is based on blood donors. Health care workers (HCWs) often get infected as a result of their close contact with patients. A cross-sectional study was conducted to determine the prevalence of hepatitis B and C among this group of professionals with a view to improving the quality of care to their patients. Hepatitis B and C infections pose a major public health problem worldwide. While infection is highest in the developing world particularly Asia and sub-Saharan Africa, healthcare workers are at higher risk of acquiring blood-borne viral infections, particularly Hepatitis B and C which are mostly asymptomatic. This study was aimed at determining the prevalence of Hepatitis B and C infections and associated risk factors among health care workers in Dutse Metropolis, Jigawa State - Nigeria. A standard rapid immuno-chromatographic technique i.e. rapid ELISA was used to screen all sera for Hepatitis B surface antigen (HBsAg) and Hepatitis C viral antibody (HCVAb) respectively. Strips containing coated antibodies and antigens to HBV and HCV respectively were removed from the foil. Strips were labeled according to samples. Using a separate disposable pipette, 2 drops of the sample (plasma) were added into each test strip and allowed to run across the absorbent pad. Results were read after 15 minutes. The prevalence of HBV and HCV infection in 100 healthcare workers was determined by testing the plasma collected from the clients during their normal checkup using HBsAg and HCVAb test strips. Results were subjected to statistical analysis using chi-square test. The prevalence of HBV among HCWs was 19 out of 100 (19.0%) and that of HCV was 5 out of 100 (5.0%) where in both cases, higher prevalence was observed among female nurses. It was also observed that all HCV positive cases were recorded among nurses only. The study revealed that nurses are at greater risk of contracting HBV and HCV due to their frequent contact with patients. It is therefore recommended that effective vaccination and other infection control measures be encouraged among healthcare workers.Keywords: prevalence, hepatitis, viruses, healthcare workers, infection
Procedia PDF Downloads 3615640 Six Failure Points Innovators and Entrepreneurs Risk Falling into: An Exploratory Study of Underlying Emotions and Behaviors of Self- Perceived Failure
Authors: Katarzyna Niewiadomska
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Many technology startups fail to achieve a worthwhile return on investment for their funders, founders, and employees. Failures in product development, to-market strategy, sales, and delivery are commonly recognized. Founder failures are not as obvious and harder to identify. This paper explores six critical failure points that entrepreneurs and innovators are susceptible to and aims to link their emotional intelligence and behavioral profile to the points at which they experienced self-perceived failure. A model of six failure points from the perspective of the technology entrepreneur ranging from pre-startup to maturity is provided. By analyzing emotional and behavioral profile data from entrepreneurs and recording in-person accounts, certain key emotional and behavioral clusters contributing to each failure point are determined, and several underlying factors are defined and discussed. Recommendations that support entrepreneurs and innovators stalling at each failure point are given. This work can enable stakeholders to evaluate founder emotional and behavioral profiles and to take risk-mitigating action, either through coaching or through more robust team creation, to avoid founder-related company failure. The paper will be of interest to investors funding startups, executives leading them and mentors supporting them.Keywords: behavior, emotional intelligence, entrepreneur, failure
Procedia PDF Downloads 2295639 Social Protection Reforms in Indonesia: Towards a Life Cycle Based Social Protection System
Authors: Dyah Larasati, Karishma Alize Huda, Sri Kusumastuti Rahayu, Martin Daniel Siyaranamual
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Indonesia continues to reform its social protection system to provide the needed protection for its citizen. Indonesia Social Protection consisted of social assistance programs (non-contributory/tax-financed) specifically targeted for the poor and at-risk and social security/insurance program (contributory system). The social assistance programs have mostly been implemented since 1998. The national health insurance has been implemented since 2014 and the employment social insurance since 2015. One major reform implemented has been improving the targeting performance of its major social assistance portfolios including (1) Food Assistance for the poor families (Rastra and BPNT/noncash foods assistance); (2) Education Assistance for poor children; (3) Conditional Cash Transfer for poor families (PKH); and (4) Subsidized beneficiaries of National Health Insurance (JKN-PBI) for the poor and at-risk individuals. For the Social Insurance (through BPJS Employment program), several initiatives have been implemented to expand the program contributing members, although it mostly benefits the formal sector workers. However, major gaps still exist especially for the emerging middle-income groups who typically work at the informal sectors. They have yet to get the protection needed to sustain their social and economic growth. Since 2017, TNP2K (the National Team for Poverty Reduction) under the Vice President office has led the social protection discourse as the government understands the need to address vulnerabilities across the lifecycle and prioritize support to the most at-risk population particularly the elderly, young children and people with disabilities. Discussion and advocacy to recommend for more investment is continuing in order for the government to establish a comprehensive social protection system in the near future (2020-2024) that protects children through an inclusive child benefit program; build a system to benefit more working-age adults (including individuals with disabilities) and a three-tier elderly protection as they reach 65 years.Keywords: poverty reduction, social assistance, social insurance, social protection
Procedia PDF Downloads 1795638 Current and Future Global Distribution of Drosophila suzukii
Authors: Yousef Naserzadeh, Niloufar Mahmoudi
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The spotted-wing drosophila, Drosophila suzukii (Matsumura) (Diptera: Drosophilidae), a vinegar fly native to South East Asia, has recently invaded Europe, North- and South America and is spreading rapidly. Species distribution modeling has been widely employed to indicate probable areas of invasion and to guide management strategies. Drosophila sp. is native to Asia, but since 2015, it has invaded almost every country in the world, including Africa, Australia, India, and most recently, the Americas. The growth of this species of Drosophila suzukii has been rapidly multiplying and spreading in the last decade. In fact, we examine and model the potential geographical distribution of D. suzukii for both present and future scenarios. Finally, we determine the environmental variables that affect its distribution, as well as assess the risk of encroachment on protected areas. D.suzukii has the potential to expand its occurrence, especially on continents that have already been invaded. The predictive models obtained in this study indicate potential regions that could be at risk of invasion by D. suzukii, including protected areas. These results are important and can assist in the establishment of management plans to avoid the possible harm caused by biological invasions.Keywords: climate change, Drosophila suzukii, environmental variables, host preference, host plant, nutrition
Procedia PDF Downloads 855637 A Methodology for Developing New Technology Ideas to Avoid Patent Infringement: F-Term Based Patent Analysis
Authors: Kisik Song, Sungjoo Lee
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With the growing importance of intangible assets recently, the impact of patent infringement on the business of a company has become more evident. Accordingly, it is essential for firms to estimate the risk of patent infringement risk before developing a technology and create new technology ideas to avoid the risk. Recognizing the needs, several attempts have been made to help develop new technology opportunities and most of them have focused on identifying emerging vacant technologies from patent analysis. In these studies, the IPC (International Patent Classification) system or keywords from text-mining application to patent documents was generally used to define vacant technologies. Unlike those studies, this study adopted F-term, which classifies patent documents according to the technical features of the inventions described in them. Since the technical features are analyzed by various perspectives by F-term, F-term provides more detailed information about technologies compared to IPC while more systematic information compared to keywords. Therefore, if well utilized, it can be a useful guideline to create a new technology idea. Recognizing the potential of F-term, this paper aims to suggest a novel approach to developing new technology ideas to avoid patent infringement based on F-term. For this purpose, we firstly collected data about F-term and then applied text-mining to the descriptions about classification criteria and attributes. From the text-mining results, we could identify other technologies with similar technical features of the existing one, the patented technology. Finally, we compare the technologies and extract the technical features that are commonly used in other technologies but have not been used in the existing one. These features are presented in terms of “purpose”, “function”, “structure”, “material”, “method”, “processing and operation procedure” and “control means” and so are useful for creating new technology ideas that help avoid infringing patent rights of other companies. Theoretically, this is one of the earliest attempts to adopt F-term to patent analysis; the proposed methodology can show how to best take advantage of F-term with the wealth of technical information. In practice, the proposed methodology can be valuable in the ideation process for successful product and service innovation without infringing the patents of other companies.Keywords: patent infringement, new technology ideas, patent analysis, F-term
Procedia PDF Downloads 2695636 Reliability Prediction of Tires Using Linear Mixed-Effects Model
Authors: Myung Hwan Na, Ho- Chun Song, EunHee Hong
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We widely use normal linear mixed-effects model to analysis data in repeated measurement. In case of detecting heteroscedasticity and the non-normality of the population distribution at the same time, normal linear mixed-effects model can give improper result of analysis. To achieve more robust estimation, we use heavy tailed linear mixed-effects model which gives more exact and reliable analysis conclusion than standard normal linear mixed-effects model.Keywords: reliability, tires, field data, linear mixed-effects model
Procedia PDF Downloads 5645635 Value of FOXP3 Expression in Prediction of Neoadjuvant Chemotherapy Effect in Triple Negative Breast Cancer
Authors: Badawia Ibrahim, Iman Hussein, Samar El Sheikh, Fatma Abou Elkasem, Hazem Abo Ismael
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Background: Response of breast carcinoma to neoadjuvant chemotherapy (NAC) varies regarding many factors including hormonal receptor status. Breast cancer is a heterogenous disease with different outcomes, hence a need arises for new markers predicting the outcome of NAC especially for the triple negative group when estrogen, progesterone receptors and Her2/neu are negative. FOXP3 is a promising target with unclear role. Aim: To examine the value of FOXP3 expression in locally advanced triple negative breast cancer tumoral cells as well as tumor infiltrating lymphocytes (TILs) and to elucidate its relation to the extent of NAC response. Material and Methods: Forty five cases of immunohistochemically confirmed to be triple negative breast carcinoma were evaluated for NAC (Doxorubicin, Cyclophosphamide AC x 4 cycles + Paclitaxel x 12 weeks, patients with ejection fraction less than 60% received Taxotere or Cyclophosphamide, Methotrexate, Fluorouracil CMF) response in both tumour and lymph nodes status according to Miller & Payne's and Sataloff's systems. FOXP3 expression in tumor as well as TILs evaluated in the pretherapy biopsies was correlated with NAC response in breast tumor and lymph nodes as well as other clinicopathological factors. Results: Breast tumour cells showed FOXP3 positive cytoplasmic expression in (42%) of cases. High FOXP3 expression percentage was detected in (47%) of cases. High infiltration by FOXP3+TILs was detected in (49%) of cases. Positive FOXP3 expression was associated with negative lymph node metastasis. High FOXP3 expression percentage and high infiltration by FOXP3+TILs were significantly associated with complete therapy response in axillary lymph nodes. High FOXP3 expression in tumour cells was associated with high infiltration by FOXP3+TILs. Conclusion: This result may provide evidence that FOXP3 marker is a good prognostic and predictive marker for triple negative breast cancer (TNBC) indicated for neoadjuvant chemotherapy and can be used for stratifications of TNBC cases indicated for NAC. As well, this study confirmed the fact that the tumour cells and the surrounding microenvironment interact with each other and the tumour microenvironment can influence the treatment outcomes of TNBC.Keywords: breast cancer, FOXP3 expression, prediction of neoadjuvant chemotherapy effect, triple negative
Procedia PDF Downloads 2755634 Using Hyperspectral Sensor and Machine Learning to Predict Water Potentials of Wild Blueberries during Drought Treatment
Authors: Yongjiang Zhang, Kallol Barai, Umesh R. Hodeghatta, Trang Tran, Vikas Dhiman
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Detecting water stress on crops early and accurately is crucial to minimize its impact. This study aims to measure water stress in wild blueberry crops non-destructively by analyzing proximal hyperspectral data. The data collection took place in the summer growing season of 2022. A drought experiment was conducted on wild blueberries in the randomized block design in the greenhouse, incorporating various genotypes and irrigation treatments. Hyperspectral data ( spectral range: 400-1000 nm) using a handheld spectroradiometer and leaf water potential data using a pressure chamber were collected from wild blueberry plants. Machine learning techniques, including multiple regression analysis and random forest models, were employed to predict leaf water potential (MPa). We explored the optimal wavelength bands for simple differences (RY1-R Y2), simple ratios (RY1/RY2), and normalized differences (|RY1-R Y2|/ (RY1-R Y2)). NDWI ((R857 - R1241)/(R857 + R1241)), SD (R2188 – R2245), and SR (R1752 / R1756) emerged as top predictors for predicting leaf water potential, significantly contributing to the highest model performance. The base learner models achieved an R-squared value of approximately 0.81, indicating their capacity to explain 81% of the variance. Research is underway to develop a neural vegetation index (NVI) that automates the process of index development by searching for specific wavelengths in the space ratio of linear functions of reflectance. The NVI framework could work across species and predict different physiological parameters.Keywords: hyperspectral reflectance, water potential, spectral indices, machine learning, wild blueberries, optimal bands
Procedia PDF Downloads 675633 Comparing Trastuzumab-Related Cardiotoxicity between Elderly and Younger Patients with Breast Cancer: A Prospective Cohort Study
Authors: Afrah Aladwani, Alexander Mullen, Mohammad AlRashidi, Omamah Alfarisi, Faisal Alterkit, Abdulwahab Aladwani, Asit Kumar, Emad Eldosouky
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Introduction: Trastuzumab is a HER-2 targeted humanized monoclonal antibody that significantly improves the therapeutic outcomes of metastatic and non-metastatic breast cancer. However, it is associated with increased risk of cardiotoxicity that ranges from mild decline in the cardiac ejection fraction to permanent cardiomyopathy. Concerns have been raised in treating eligible older patients. This study compares trastuzumab outcomes between two age cohorts in the Kuwait Cancer Control Centre (KCCC). Methods: In a prospective comparative observational study, 93 HER-2 positive breast cancer patients undergoing different chemotherapy protocols + trastuzumab were included and divided into two cohorts based on their age (˂60 and ≥60 years old). The baseline left ventricular ejection fraction (LVEF) was assessed and monitored every three months during trastuzumab treatment. Event of cardiotoxicity was defined as ≥10% decline in the LVEF from the baseline. The lower accepted normal limit of the LVEF was 50%. Results: The median baseline LVEF was 65% in both age cohorts (IQR 8% and 9% for older and younger patients respectively). Whereas, the median LVEF post-trastuzumab treatment was 51% and 55% in older and younger patients respectively (IQR 8%; p-value = 0.22), despite the fact that older patients had significantly lower exposure to anthracyclines compared to younger patients (60% and 84.1% respectively; p-value ˂0.001). 86.7% and 55.6% of older and younger patients, respectively, developed ≥10% decline in their LVEF from the baseline. Among those, only 29% of older and 27% of younger patients reached a LVEF value below 50% (p-value = 0.88). Statistically, age was the only factor that significantly correlated with trastuzumab induced cardiotoxicity (OR 4; p-value ˂0.012), but it did not increase the requirement for permanent discontinuation of treatment. A baseline LVEF value below 60% contributed to developing a post-treatment value below normal ranges (50%). Conclusion: Breast cancer patients aged 60 years and above in Kuwait were at 4-fold higher risk of developing ≥10% decline in their LVEF from the baseline than younger patients during trastuzumab treatment. Surprisingly, previous exposure to anthracyclines and multiple comorbidities were not associated with significant increased risk of cardiotoxicity.Keywords: breast cancer, elderly, Trastuzumab, cardiotoxicity
Procedia PDF Downloads 2055632 Modelling of Phase Transformation Kinetics in Post Heat-Treated Resistance Spot Weld of AISI 1010 Mild Steel
Authors: B. V. Feujofack Kemda, N. Barka, M. Jahazi, D. Osmani
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Automobile manufacturers are constantly seeking means to reduce the weight of car bodies. The usage of several steel grades in auto body assembling has been found to be a good technique to enlighten vehicles weight. This few years, the usage of dual phase (DP) steels, transformation induced plasticity (TRIP) steels and boron steels in some parts of the auto body have become a necessity because of their lightweight. However, these steels are martensitic, when they undergo a fast heat treatment, the resultant microstructure is essential, made of martensite. Resistance spot welding (RSW), one of the most used techniques in assembling auto bodies, becomes problematic in the case of these steels. RSW being indeed a process were steel is heated and cooled in a very short period of time, the resulting weld nugget is mostly fully martensitic, especially in the case of DP, TRIP and boron steels but that also holds for plain carbon steels as AISI 1010 grade which is extensively used in auto body inner parts. Martensite in its turn must be avoided as most as possible when welding steel because it is the principal source of brittleness and it weakens weld nugget. Thus, this work aims to find a mean to reduce martensite fraction in weld nugget when using RSW for assembling. The prediction of phase transformation kinetics during RSW has been done. That phase transformation kinetics prediction has been made possible through the modelling of the whole welding process, and a technique called post weld heat treatment (PWHT) have been applied in order to reduce martensite fraction in the weld nugget. Simulation has been performed for AISI 1010 grade, and results show that the application of PWHT leads to the formation of not only martensite but also ferrite, bainite and pearlite during the cooling of weld nugget. Welding experiments have been done in parallel and micrographic analyses show the presence of several phases in the weld nugget. Experimental weld geometry and phase proportions are in good agreement with simulation results, showing here the validity of the model.Keywords: resistance spot welding, AISI 1010, modeling, post weld heat treatment, phase transformation, kinetics
Procedia PDF Downloads 1185631 Mobile Smart Application Proposal for Predicting Calories in Food
Authors: Marcos Valdez Alexander Junior, Igor Aguilar-Alonso
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Malnutrition is the root of different diseases that universally affect everyone, diseases such as obesity and malnutrition. The objective of this research is to predict the calories of the food to be eaten, developing a smart mobile application to show the user if a meal is balanced. Due to the large percentage of obesity and malnutrition in Peru, the present work is carried out. The development of the intelligent application is proposed with a three-layer architecture, and for the prediction of the nutritional value of the food, the use of pre-trained models based on convolutional neural networks is proposed.Keywords: volume estimation, calorie estimation, artificial vision, food nutrition
Procedia PDF Downloads 995630 Synthesis and Prediction of Activity Spectra of Substances-Assisted Evaluation of Heterocyclic Compounds Containing Hydroquinoline Scaffolds
Authors: Gizachew Mulugeta Manahelohe, Khidmet Safarovich Shikhaliev
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There has been a significant surge in interest in the synthesis of heterocyclic compounds that contain hydroquinoline fragments. This surge can be attributed to the broad range of pharmaceutical and industrial applications that these compounds possess. The present study provides a comprehensive account of the synthesis of both linear and fused heterocyclic systems that incorporate hydroquinoline fragments. Furthermore, the pharmacological activity spectra of the synthesized compounds were assessed using the in silico method, employing the prediction of activity spectra of substances (PASS) program. Hydroquinoline nitriles 7 and 8 were prepared through the reaction of the corresponding hydroquinolinecarbaldehyde using a hydroxylammonium chloride/pyridine/toluene system and iodine in aqueous ammonia under ambient conditions, respectively. 2-Phenyl-1,3-oxazol-5(4H)-ones 9a,b and 10a,b were synthesized via the condensation of compounds 5a,b and 6a,b with hippuric acid in acetic acid in 30–60% yield. When activated, 7-methylazolopyrimidines 11a and b were reacted with N-alkyl-2,2,4-trimethyl-1,2,3,4-tetrahydroquinoline-6-carbaldehydes 6a and b, and triazolo/pyrazolo[1,5-a]pyrimidin-6-yl carboxylic acids 12a and b were obtained in 60–70% yield. The condensation of 7-hydroxy-1,2,3,4-tetramethyl-1,2-dihydroquinoline 3 h with dimethylacetylenedicarboxylate (DMAD) and ethyl acetoacetate afforded cyclic products 16 and 17, respectively. The condensation reaction of 6-formyl-7-hydroxy-1,2,2,4-tetramethyl-1,2-dihydroquinoline 5e with methylene-active compounds such as ethyl cyanoacetate/dimethyl-3-oxopentanedioate/ethyl acetoacetate/diethylmalonate/Meldrum’s acid afforded 3-substituted coumarins containing dihydroquinolines 19 and 21. Pentacyclic coumarin 22 was obtained via the random condensation of malononitrile with 5e in the presence of a catalytic amount of piperidine in ethanol. The biological activities of the synthesized compounds were assessed using the PASS program. Based on the prognosis, compounds 13a, b, and 14 exhibited a high likelihood of being active as inhibitors of gluconate 2-dehydrogenase, as well as possessing antiallergic, antiasthmatic, and antiarthritic properties, with a probability value (Pa) ranging from 0.849 to 0.870. Furthermore, it was discovered that hydroquinoline carbonitriles 7 and 8 tended to act as effective progesterone antagonists and displayed antiallergic, antiasthmatic, and antiarthritic effects (Pa = 0.276–0.827). Among the hydroquinolines containing coumarin moieties, compounds 17, 19a, and 19c were predicted to be potent progesterone antagonists, with Pa values of 0.710, 0.630, and 0.615, respectively.Keywords: heterocyclic compound, hydroquinoline, Vilsmeier–Haack formulation, quinolone
Procedia PDF Downloads 425629 Effect of Operating Conditions on the Process Hydrogen Storage in Metal Hydride
Authors: A. Babou, Y. Kerboua Ziari, Y. Kerkoub
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The risks of depletion of fossil fuel reserves and environmental problems caused by their consumption cause to consider alternative energy solutions. Hydrogen appears as a serious solution because its combustion produces only water. The objective of this study is to digitally analyze the effect of operating conditions on the process of absorption of hydrogen in a tank of metal hydride alloy Lanthanum - Nickel (LaNi 5). For this modeling of heat transfer and mass in the tank was carried .The results of numerical weather prediction are in good agreement with the experimental results.Keywords: hydrogen, storage, energy, fuel, simulation
Procedia PDF Downloads 3055628 Landslide Susceptibility Mapping Using Soft Computing in Amhara Saint
Authors: Semachew M. Kassa, Africa M Geremew, Tezera F. Azmatch, Nandyala Darga Kumar
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Frequency ratio (FR) and analytical hierarchy process (AHP) methods are developed based on past landslide failure points to identify the landslide susceptibility mapping because landslides can seriously harm both the environment and society. However, it is still difficult to select the most efficient method and correctly identify the main driving factors for particular regions. In this study, we used fourteen landslide conditioning factors (LCFs) and five soft computing algorithms, including Random Forest (RF), Support Vector Machine (SVM), Logistic Regression (LR), Artificial Neural Network (ANN), and Naïve Bayes (NB), to predict the landslide susceptibility at 12.5 m spatial scale. The performance of the RF (F1-score: 0.88, AUC: 0.94), ANN (F1-score: 0.85, AUC: 0.92), and SVM (F1-score: 0.82, AUC: 0.86) methods was significantly better than the LR (F1-score: 0.75, AUC: 0.76) and NB (F1-score: 0.73, AUC: 0.75) method, according to the classification results based on inventory landslide points. The findings also showed that around 35% of the study region was made up of places with high and very high landslide risk (susceptibility greater than 0.5). The very high-risk locations were primarily found in the western and southeastern regions, and all five models showed good agreement and similar geographic distribution patterns in landslide susceptibility. The towns with the highest landslide risk include Amhara Saint Town's western part, the Northern part, and St. Gebreal Church villages, with mean susceptibility values greater than 0.5. However, rainfall, distance to road, and slope were typically among the top leading factors for most villages. The primary contributing factors to landslide vulnerability were slightly varied for the five models. Decision-makers and policy planners can use the information from our study to make informed decisions and establish policies. It also suggests that various places should take different safeguards to reduce or prevent serious damage from landslide events.Keywords: artificial neural network, logistic regression, landslide susceptibility, naïve Bayes, random forest, support vector machine
Procedia PDF Downloads 825627 Risk Assessment of Natural Gas Pipelines in Coal Mined Gobs Based on Bow-Tie Model and Cloud Inference
Authors: Xiaobin Liang, Wei Liang, Laibin Zhang, Xiaoyan Guo
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Pipelines pass through coal mined gobs inevitably in the mining area, the stability of which has great influence on the safety of pipelines. After extensive literature study and field research, it was found that there are a few risk assessment methods for coal mined gob pipelines, and there is a lack of data on the gob sites. Therefore, the fuzzy comprehensive evaluation method is widely used based on expert opinions. However, the subjective opinions or lack of experience of individual experts may lead to inaccurate evaluation results. Hence the accuracy of the results needs to be further improved. This paper presents a comprehensive approach to achieve this purpose by combining bow-tie model and cloud inference. The specific evaluation process is as follows: First, a bow-tie model composed of a fault tree and an event tree is established to graphically illustrate the probability and consequence indicators of pipeline failure. Second, the interval estimation method can be scored in the form of intervals to improve the accuracy of the results, and the censored mean algorithm is used to remove the maximum and minimum values of the score to improve the stability of the results. The golden section method is used to determine the weight of the indicators and reduce the subjectivity of index weights. Third, the failure probability and failure consequence scores of the pipeline are converted into three numerical features by using cloud inference. The cloud inference can better describe the ambiguity and volatility of the results which can better describe the volatility of the risk level. Finally, the cloud drop graphs of failure probability and failure consequences can be expressed, which intuitively and accurately illustrate the ambiguity and randomness of the results. A case study of a coal mine gob pipeline carrying natural gas has been investigated to validate the utility of the proposed method. The evaluation results of this case show that the probability of failure of the pipeline is very low, the consequences of failure are more serious, which is consistent with the reality.Keywords: bow-tie model, natural gas pipeline, coal mine gob, cloud inference
Procedia PDF Downloads 2505626 Vine Growers' Climate Change Adaptation Strategies in Hungary
Authors: Gabor Kiraly
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Wine regions are based on equilibria between climate, soil, grape varieties, and farming expertise that define the special character and quality of local vine farming and wine production. Changes in climate conditions may increase risk of destabilizing this equilibrium. Adaptation decisions, including adjusting practices, processes and capitals in response to climate change stresses – may reduce this risk. However, farmers’ adaptive behavior are subject to a wide range of factors and forces such as links between climate change implications and production, farm - scale adaptive capacity and other external forces that might hinder them to make efficient response to climate change challenges. This paper will aim to study climate change adaptation practices and strategies of grape growers in a way of applying a complex and holistic approach involving theories, methods and tools both from environmental and social sciences. It will introduce the field of adaptation studies as an evidence - based discourse by presenting an overview of examples from wine regions where adaptation studies have already reached an advanced stage. This will serve as a theoretical background for a preliminary research with the aim to examine the feasibility and applicability of such a research approach in the Hungarian context.Keywords: climate change, adaptation, viticulture, Hungary
Procedia PDF Downloads 2375625 Stage-Gate Based Integrated Project Management Methodology for New Product Development
Authors: Mert Kıranç, Ekrem Duman, Murat Özbilen
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In order to achieve new product development (NPD) activities on time and within budgetary constraints, the NPD managers need a well-designed methodology. This study intends to create an integrated project management methodology for the ones who focus on new product development projects. In the scope of the study, four different management systems are combined. These systems are called as 'Schedule-oriented Stage-Gate Method, Risk Management, Change Management and Earned Value Management'. New product development term is quite common in many different industries such as defense industry, construction, health care/dental, higher education, fast moving consumer goods, white goods, electronic devices, marketing and advertising and software development. All product manufacturers run against each other’s for introducing a new product to the market. In order to achieve to produce a more competitive product in the market, an optimum project management methodology is chosen, and this methodology is adapted to company culture. The right methodology helps the company to present perfect product to the customers at the right time. The benefits of proposed methodology are discussed as an application by a company. As a result, how the integrated methodology improves the efficiency and how it achieves the success of the project are unfolded.Keywords: project, project management, management methodology, new product development, risk management, change management, earned value, stage-gate
Procedia PDF Downloads 3125624 The Role Previous Cytomegalovirus Infection in Subsequent Lymphoma Develompment
Authors: Amalia Ardeljan, Lexi Frankel, Divesh Manjani, Gabriela Santizo, Maximillian Guerra, Omar Rashid
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Introduction: Cytomegalovirus (CMV) infection is a widespread infection affecting between 60-70% of people in industrialized countries. CMV has been previously correlated with a higher incidence of Hodgkin Lymphoma compared to noninfected persons. Research regarding prior CMV infection and subsequent lymphoma development is still controversial. With limited evidence, further research is needed in order to understand the relationship between previous CMV infection and subsequent lymphoma development. This study assessed the effect of CMV infection and the incidence of lymphoma afterward. Methods: A retrospective cohort study (2010-2019) was conducted through a Health Insurance Portability and Accountability Act (HIPAA) compliant national database and conducted using International Classification of Disease (ICD) 9th,10th codes, and Current Procedural Terminology (CPT) codes. These were used to identify lymphoma diagnosis in a previously CMV infected population. Patients were matched for age range and Charlson Comorbidity Index (CCI). A chi-squared test was used to assess statistical significance. Results: A total number of 14,303 patients was obtained in the CMV infected group as well as in the control population (matched by age range and CCI score). Subsequent lymphoma development was seen at a rate of 11.44% (1,637) in the CMV group and 5.74% (822) in the control group, respectively. The difference was statistically significant by p= 2.2x10-16, odds ratio = 2.696 (95% CI 2.483- 2.927). In an attempt to stratify the population by antiviral medication exposure, the outcomes were limited by the decreased number of members exposed to antiviral medication in the control population. Conclusion: This study shows a statistically significant correlation between prior CMV infection and an increased incidence of lymphoma afterward. Further exploration is needed to identify the potential carcinogenic mechanism of CMV and whether the results are attributed to a confounding bias.Keywords: cytomegalovirus, lymphoma, cancer, microbiology
Procedia PDF Downloads 2205623 Assesment of Quality of Life among Iranian Male Amateur Athletes via WHOQOL-Brief
Authors: Shirko Ahmadi, Ahmad Fallahi, Marco C. Uchida, Gustavo L. Gutierrez
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The aims of the present study are to assess and compare the health habits and quality of life (QoL) of Iranian amateur athletes in different sports. A total of 120 male amateur athletes between 17 and 31 years, engaged in 16 kinds of sports which include team (n=44), individual (n=40) and combat sports (n=36) from sports clubs in the west cities of Iran; and also those not involved in any competition in the past. Additionally, this is a cross-sectional, descriptive observational study, which the subjects completed the WHOQOL-brief questionnaire to evaluate QoL. The questionnaire is composed of 26 questions in four domains (physical health, psychological, social and environmental domains), that was applied in the Persian language. Information on the frequency and duration of training sessions were also collected. The Shapiro-Wilk test was used to verify normal distribution, followed by the chi-squared test for proportions and simple analysis of variance for comparisons between groups of sports. Pearson’s correlation was used to assess the relationships between the variables analyzed. According to the findings, those from individual sports obtained highest points in the all domains of QoL; physical domains (87.1 ± 8.1 point), psychological domains (87.6 ± 9.6 point), social domains (89.7 ± 9.2 point), environmental domains (75.5± 10.7 point) and overall QoL score (84.9 ± 9.4 point). Generally, social domains were the highest QoL index (84.3 ± 7.2 points), and environmental domains were the lowest QoL index (68.1 ± 10.8 points), in all of the sports. No correlations were found between QoL domains and time engaged in the sport (r = 0.01; p = 0.93), number of weekly training sessions (r = 0.09; p = 0.37) and session duration (r = -0.06; p= 0.58). Comparison of QoL results with those of the general population revealed higher levels in the physical and psychological components of amateur athletes. In the present study, engaging in sports was associated with higher QoL levels in amateur athletes, particularly in the physical and psychological domains. Moreover, correlations were found between the overall score and domains of QoL.Keywords: amateur, domains, Iranian, quality of life
Procedia PDF Downloads 1535622 Petroleum Play Fairway Analysis of the Middle Paleocene Lower Beda Formation, Concession 71, South-Central Sirt Basin, Libya
Authors: Hatem K. Hamed, Mohamed S. Hrouda
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The Middle Paleocene Lower Beda Formation was deposited in a ramp system with local shoaling. The main constituent is limestone, with subordinate dolomites and Shales. Reservoir quality is largely influenced by depositional environments and diagenesis processes. Generally the reservoir quality of Lower Beda Formation is low risk on the Inferred Horst and in the Southern Shelf where the Lower Beda formation comprises mainly of calcarenties. In the vicinity of the well GG1 the Lower Beda comprise mainly of argillaceous calcilutites and shale. The reservoir quality gradually improves from high risk to moderate risk towards KK1, LL1 and NN1 wells. The average gross thickness of Lower Beda Formation is about 300 ft. The net thickness varies from about 270 ft. in the E1-71 well to about 30 ft. in the vicinity of GG1-71 well. The net thickest of Lower Beda form a NNW-SSW trend with an average of 250 ft. the change in facies is due to change in the depositional environment, from lagoonal to shoal barrier to open marine affected the reservoir quality. The Upper Cretaceous Sirte Shale is the main source rock. It is developed within the three troughs surrounding the study area. S-Marada Trough to the N- E, Gerad Trough to the N N-W, and Abu Tummym Sub-basin to the S-W of the Inferred Horst. Sirte shale reaches 1000ft, of organically rich section. It has good organic contents over large area 2% to 3%. Hydrocarbon shows were encountered in several wells in Beda Formation this is an indication of vertical and lateral migration of hydrocarbon. The overlying Upper Paleocene Khalifa Formation is a transgressive shale, it is an effective regional top seal. Lithofacies variations in Khalifa Shale, from shales to limestones in the southern shelf in R1-71 well approximately 50-75% of the secession is limestone. About 47 million barrel of hydrocarbon recoverable reserves is expected to be trapped in structural and stratigraphic traps in Beda Formation in the study area.Keywords: Sirte basin, Beda formation, concession 71, petroleum play fairway analysis
Procedia PDF Downloads 885621 Vehicle Risk Evaluation in Low Speed Accidents: Consequences for Relevant Test Scenarios
Authors: Philip Feig, Klaus Gschwendtner, Julian Schatz, Frank Diermeyer
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Projects of accident research analysis are mostly focused on accidents involving personal damage. Property damage only has a high frequency of occurrence combined with high economic impact. This paper describes main influencing parameters for the extent of damage and presents a repair cost model. For a prospective evaluation method of the monetary effect of advanced driver assistance systems (ADAS), it is necessary to be aware of and quantify all influencing parameters. Furthermore, this method allows the evaluation of vehicle concepts in combination with an ADAS at an early point in time of the product development process. In combination with a property damage database and the introduced repair cost model relevant test scenarios for specific vehicle configurations and their individual property damage risk may be determined. Currently, equipment rates of ADAS are low and a purchase incentive for customers would be beneficial. The next ADAS generation will prevent property damage to a large extent or at least reduce damage severity. Both effects may be a purchasing incentive for the customer and furthermore contribute to increased traffic safety.Keywords: accident research, accident scenarios, ADAS, effectiveness, property damage analysis
Procedia PDF Downloads 3405620 Variation in Maternal Mortality in Sidama National Regional State, Southern Ethiopia: A Population Based Cross Sectional Household Survey
Authors: Aschenaki Zerihun Kea, Bernt Lindtjorn, Achamyelesh Gebretsadik, Sven Gudmund Hinderaker
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Introduction: Maternal mortality studies conducted at the national level do not provide the information needed for planning and monitoring health programs at lower administrative levels. The aim of this study was to measure maternal mortality, identify risk factors and district-level variations in Sidama National Regional State, southern Ethiopia. Methods: A cross sectional population-based survey was carried out in households where women reported pregnancy and birth outcomes in the past five years. The study was conducted in the Sidama National Regional State, southern Ethiopia, from July 2019 to May 2020. Multi-stage cluster sampling technique was employed. The outcome variable of the study was maternal mortality. Complex sample logistic regression analysis was applied to assess variables independently associated with maternal mortality. Results: We registered 10602 live births (LB) and 48 maternal deaths, yielding an overall maternal mortality ratio (MMR) of 419; 95% CI: 260-577 per 100,000 LB. Aroresa district had the highest MMR with 1142 (95% CI: 693-1591) per 100,000 LB. Leading causes of death were haemorrhage 21 (41%) and eclampsia 10 (27%). Thirty (59%) mothers died during labour, or within 24 hours after delivery, 25 (47%) died at home and 17 (38%) at a health facility. Mothers who did not have formal education had a higher risk of maternal death (AOR: 4.4; 95% CI: 1.7 – 11.0). The risk of maternal death was higher in districts with a low midwife-to-population ratio (AOR: 2.9; 95% CI: 1.0-8.9). Conclusion: The high maternal mortality with district-level variations in Sidama Region highlights the importance of improving obstetric care and employing targeted interventions in areas with high mortality rates. Due attention should be given to improving access to female education. Additional midwives have to be trained and deployed to improve maternal health services and consequently save the lives of mothers.Keywords: maternal mortality variation, maternal death, Sidama, Ethiopia
Procedia PDF Downloads 725619 Disaster Risk Reduction (DRR) through Harvesting Encosternum delegorguei Insect (Harurwa) in Nerumedzo, Bikita District, Zimbabwe
Authors: Mkhokheli Sithole, Brenda N. Muchapondwa
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Food security is becoming a critical issue for people residing mainly in the rural areas where frequent droughts interrupt food production, reduce income, compromise the ability to save and erode livelihoods. This tends to increase the vulnerability of poor households to food and income insecurity, hence, malnutrition. There is an emerging need for DRR strategies to complement the existing rain fed crop production based livelihoods. One of such strategies employed by the community of Nerumedzo in Bikita district is the harvesting of Encosternum delegorguei insect. This article analyses the livelihood impacts of Encosternum delegorguei insect as a DRR strategy. The research used a combination of qualitative and quantitative approaches. The insect samples were tested in the laboratory for their nutritional composition while surveys were done on a sample of 40 community members. Participatory observations and 5 focus group discussions were also done. The results revealed that harvesting the Encosternum delegorguei insects provides a livelihood for the locals by complementing crop production thereby mitigating potential negative effects of frequent droughts. The insects are now a significant source of income to poor households in the community.Keywords: disaster risk reduction, livelihoods, human, social sciences
Procedia PDF Downloads 1955618 Tsunami Vulnerability of Critical Infrastructure: Development and Application of Functions for Infrastructure Impact Assessment
Authors: James Hilton Williams
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Recent tsunami events, including the 2011 Tohoku Tsunami, Japan, and the 2015 Illapel Tsunami, Chile, have highlighted the potential for tsunami impacts on the built environment. International research in the tsunami impacts domain has been largely focused toward impacts on buildings and casualty estimations, while only limited attention has been placed on the impacts on infrastructure which is critical for the recovery of impacted communities. New Zealand, with 75% of the population within 10 km of the coast, has a large amount of coastal infrastructure exposed to local, regional and distant tsunami sources. To effectively manage tsunami risk for New Zealand critical infrastructure, including energy, transportation, and communications, the vulnerability of infrastructure networks and components must first be determined. This research develops infrastructure asset vulnerability, functionality and repair- cost functions based on international post-event tsunami impact assessment data from technologically similar countries, including Japan and Chile, and adapts these to New Zealand. These functions are then utilized within a New Zealand based impact framework, allowing for cost benefit analyses, effective tsunami risk management strategies and mitigation options for exposed critical infrastructure to be determined, which can also be applied internationally.Keywords: impact assessment, infrastructure, tsunami impacts, vulnerability functions
Procedia PDF Downloads 161