Abstract: Anthropometry helps in associating the physical properties of an individual with their racial, cultural, and psychological attributes. Numerous research studies have included different skeletal diameters as a variable. However, most of the studies suggest their inclusion describing specific characteristics/traits of the body. However, there seems to be a scarcity of literature related to the effect of any kind of longitudinal physical training on human skeletal diameters. Hence, the present investigation was conducted to study the variability of covariance of selected skeletal diameters of females in a longitudinal physical training programme. The sample for the study was 78 college going students of the University of Delhi, classified equally in three groups, i.e. viz. (a) Progressive load of training or conditioning group coded as PLT; (b) Constant load of training or non-conditioning group coded as CLT; and (c) No-load or control or sedentary group coded as NL. Collectively, mean age of the sample was 19.54±1.79 years. The randomly selected samples were given maximum consideration to maintain their homogeneity. The variables included biacromial diameter, biiliocristal diameter, bitrochantaerion diameter, humeral bicondylar, femoral bicondylar, wrist diameter, ankle diameter, and foot breadth. Multi-group repeated measure design was adopted for the experimentation. Each group was measured four times after completion of each of the three meso-cycles of six-weeks duration. The measurements were taken following the standard landmarks and procedures. Mean, standard deviation, analysis of co-variance and its post-hoc analysis were computed to analyze the data statistically. The study concluded that both the progressive and constant load of physical training bring changes in the selected skeletal diameters of females. It also reflected the increase due to growth also along with training.
Abstract: Moraceae family has immense phytochemical constituents and significant pharmacological properties, hence have great medicinal values. The aim of this study was to screen and quantify phytochemicals as well as the antioxidant activities of the leaf and stem bark extracts and fractions (crude ethanol extracts, n-hexane, ethyl acetate and aqueous ethanol fractions) of Ficus sagittifolia. Leaf and stem bark of F. sagittifolia were extracted by maceration method using ethanol to give ethanol crude extract. The ethanol crude extract was partitioned by n-hexane and ethyl-acetate to give their respective fractions. All the extracts were screened for their phytochemicals using standard methods. The total phenolic, flavonoid, tannin, saponin contents and antioxidant activity were determined by spectrophotometric method while the alkaloid content was evaluated by titrimetric method. The amount of total phenolic in extracts and fractions were estimated in comparison to gallic acid, whereas total flavonoids, tannins and saponins were estimated corresponding to quercetin, tannic acid and saponin respectively. 2, 2-diphenylpicryl hydrazyl radical (DPPH)* and phosphomolybdate methods were used to evaluate the antioxidant activities of leaf and stem bark of F. sagittifolia. Phytochemical screening revealed the presence of flavonoids, saponins, terpenoids/steroids, alkaloids for both extracts of leaf and stem bark of F. sagittifolia. The phenolic content of F. sagittifolia was most abundant in leaf ethanol crude extract as 3.53 ± 0.03 mg/g equivalent of gallic acid. Total flavonoids and tannins content were highest in stem bark aqueous ethanol fraction of F. sagittifolia estimated as 3.41 ± 0.08 mg/g equivalent of quercetin and 1.52 ± 0.05 mg/g equivalent of tannic acid respectively. The hexane leaf fraction of F. sagittifolia had the utmost saponin and alkaloid content as 5.10 ± 0.48 mg/g equivalent of saponins and 0.171 ± 0.39 g of alkaloids. Leaf aqueous ethanol fraction of F. sagittifolia showed high antioxidant activity (IC50 value of 63.092 µg/mL) and stem ethanol crude extract (227.43 ± 0.78 mg/g equivalent of ascorbic acid) for DPPH and phosphomolybdate method respectively and the least active was found to be the stem hexane fraction using both methods (313.32 µg/mL; 16.21 ± 1.30 mg/g equivalent of ascorbic acid). The presence of these phytochemicals in the leaf and stem bark of F. sagittifolia are responsible for their therapeutic importance as well as the ability to scavenge free radicals in living systems.
Abstract: This review describes some of the effects of repetitive strain/stress injury (RSI) on the human body especially among computer professionals today that spend extended hours of prolonged sitting in front of a computer day in and day out. The review briefly introduces the main factors that contribute to an increase of RSI among such computer professionals. The review briefly discusses how the human spinal column and knees are mainly affected by the onset of RSI resulting in poor posture. The root and secondary causes and effects of RSI are reviewed. The importance and value of the various breathing techniques are reviewed in an attempt to alleviate some of the effects of RSI. The review concludes with a small sample of suggested office stretches and poses geared towards at reducing RSI follows in this review. Readers will learn about the effects of RSI, as well as ways to cope with it. A better understanding of coping strategies may lead to well-being and a healthier overall lifestyle. Ultimately, the investment of time to connect with oneself with the poses and the power of the breath would promote a well-being that is overall healthier thus resulting in a better ability to cope/manage life stresses.
Abstract: The aim of this study is to assesses the lifting capabilities of persons experiencing hypoxia. It also examines the behavior of the physiological response induced through the lifting process related to changing in the hypoxia and lifting frequency variables. For this purpose, the study performed two consecutive tests by using; (1) training and acclimatization; and (2) an actual collection of data. A total of 10 male students from King Saud University, Kingdom of Saudi Arabia, were recruited in the study. A two-way repeated measures design, with two independent variables (ambient oxygen (15%, 18% and 21%)) and lifting frequency (1 lift/min and 4 lifts/min) and four dependent variables i.e., maximum acceptable weight of lift (MAWL), Electromyography (EMG) of four muscle groups (anterior deltoid, trapezius, biceps brachii, and erector spinae), rating of perceived exertion (RPE), and rating of oxygen feeling (ROF) were used in this study. The results show that lifting frequency has significantly impacted the MAWL and muscles’ activities. The oxygen content had a significant effect on the RPE and ROE. The study has revealed that acclimatization and training sessions significantly reduce the effect of the hypoxia on the human physiological parameters during the manual materials handling tasks.
Abstract: Autism is a lifelong developmental disability that affects how people perceive the world and interact with others. Most of these children have difficulty with fine motor skills which typically struggle with handwriting and fine activities in their routine life such as getting dressed and controlled use of the everyday tool. Because fine motor activities encompass so many routine functions, a fine motor delay can have a measurable negative impact on a person's ability to handle daily practical tasks. This project proposed a simple fine motor exercise aid plus the game (exergame) for autistic children who discover from fine motor difficulties. The proposed exergame will be blinking randomly and user needs to bend their finger accordingly. It will notify the user, whether they bend the right finger or not. The system is realized using Arduino, which is programmed to control all the operated circuit. The feasibility studies with six autistic children were conducted and found the child interested in using exergame and could quickly get used to it. This study provides important guidance for future investigations of the exergame potential for accessing and improving fine motor skill among autistic children.
Abstract: Introduction: Some parameters should be considered to investigate the chronic effects of radiation absorption in radiation workers. Trace elements are parameters which small changes in them can cause significant effects on live systems. The role of trace element concentration in human health is significant. These elements play an important role in the developing and functioning of the immune system, cellular respiration, and oxidation processes. Considering the importance and necessity of this issue and few studies, measurements of concentration changes of these elements due to the absorbed dose are important. Purpose: This study aimed to determine the biological effects of occupational dose absorption on plasma and erythrocyte concentration of Zn and Cu in the radiology staff of Tehran Oil Hospital. Material and methods: In this analytical-comparative study, 72 people have entered. 36 people (18 males and 18 females) were selected as radiology staff in the diagnostic and therapeutic departments of Tehran Oil Hospital. And 36 people (18 males and 18 females) were selected as general section staff in the same hospital as a control group. Radiology and control groups’ age and sex were matched. 10 ml of venous blood was taken from all people. An atomic absorption spectrometer was used to obtain zinc and copper plasma concentrations. Levine test was used to compare these results validity. Results: The mean concentrations of copper and zinc were measured as 0.951 and 0.754 mg/L in the plasma phase and 3.2 and 0.401 mg/L in the RBC phase for the radiology group. Copper and zinc average concentrations, respectively 0.976 and 0.813 mg/L in the plasma phase and 2.906 and 0.476 mg/L in the RBC phase, were measured for the control group. These elements Concentrations in the plasma phase were significantly different from that of the control group, but the concentrations in the red blood cell phase did not show a significant difference compared to the control group. In comparison, a separate comparison between men and women in the experimental and control groups showed a significant difference in the values of the elements mentioned. With a significant increase in samples, a better justification than the available statistical results can be extracted. Conclusions: Within this study results, chronic occupational probabilistic absorption destructive effects (even within the permitted range) on blood trace element concentration have been confirmed.
Abstract: Bone metastases are observed in a wide range of cancers leading to intolerable pain. While early detection can help the physicians in the decision of the type of treatment, various radiopharmaceuticals using phosphonates like 68Ga-EDTMP have been developed. In this work, due to the importance of absorbed dose, human absorbed dose of this new agent was calculated for the first time based on biodistribution data in Wild-type rats. 68Ga was obtained from 68Ge/68Ga generator with radionuclidic purity and radiochemical purity of higher than 99%. The radiolabeled complex was prepared in the optimized conditions. Radiochemical purity of the radiolabeled complex was checked by instant thin layer chromatography (ITLC) method using Whatman No. 2 paper and saline. The results indicated the radiochemical purity of higher than 99%. The radiolabelled complex was injected into the Wild-type rats and its biodistribution was studied up to 120 min. As expected, major accumulation was observed in the bone. Absorbed dose of each human organ was calculated based on biodistribution in the rats using RADAR method. Bone surface and bone marrow with 0.112 and 0.053 mSv/MBq, respectively, received the highest absorbed dose. According to these results, the radiolabeled complex is a suitable and safe option for PET bone imaging.
Abstract: Asthma, obesity and overweight are the main factors causing change within the heart and respiratory airways. Asthma symptoms are normally observed during exercising. Epidemiological studies have indicated asthma symptoms occurring due to certain lifestyle habits; for example, a sedentary lifestyle. In this study, eight weeks of aerobic exercises resulted in a positive effect overall in overweight women experiencing mild chronic asthma. The quasi-experimental applied research has been done based on experimental and control groups. The experimental group (seven patients) and control group (n = 7) were graded before and after the test. According to the Borg dyspnea and fatigue Perception Index, the training intensity has determined. Participants in the study performed a sub-maximal aerobic activity schedule (45% to 80% of maximum heart rate) for two months, while the control group (n = 7) stayed away from aerobic exercise. Data evaluation and analysis of covariance compared both the pre-test and post-test with paired t-test at significance level of P≤ 0.05. After eight weeks of exercise, the results of the experimental group show a significant decrease in resting heart rate, systolic blood pressure, minute ventilation, while a significant increase in maximal oxygen uptake and tolerance activity (P ≤ 0.05). In the control group, there was no significant difference in these parameters ((P ≤ 0.05). The results indicate the aerobic activity can strengthen the respiratory muscles, while other physiological factors could result in breathing and heart recovery. Aerobic activity also resulted in favorable changes in cardiovascular parameters, and exercise tolerance of overweight women with chronic asthma.
Abstract: A decline in visual sensitivity at arbitrary points on the retina can be measured using a precise perimetry apparatus along with a fundus camera. However, the retinal layer associated with this decline cannot be identified accurately with current medical technology. To investigate cryptogenic diseases, such as macular dystrophy, acute zonal occult outer retinopathy (AZOOR), and multiple evanescent white dot syndrome (MEWDS), we evaluated an electroretinogram (ERG) function that allows moving the center of the multifocal hexagonal stimulus array to a chosen position. Macular dystrophy is a generalized term used for a variety of functional disorders of the macula lutea, and the ERG shows a diminution of the b-wave in these disorders. AZOOR causes an acute functional disorder to an outer layer of the retina, and the ERG shows a-wave and b-wave amplitude reduction as well as delayed 30 Hz flicker responses. MEWDS causes acute visual loss and the ERG shows a decrease in a-wave amplitude. We combined an electroretinographic optical system and a perimetric optical system into an experimental apparatus that has the same optical system as that of a fundus camera. We also deployed an EO-50231 Edmund infrared camera, a 45-degree cold mirror, a lens with a 25-mm focal length, a halogen lamp, and an 8-inch monitor. Then, we also employed a differential amplifier with gain 10, a 50 Hz notch filter, a high-pass filter with a 21.2 Hz cut-off frequency, and two non-inverting amplifiers with gains 1001 and 11. In addition, we used a USB-6216 National Instruments I/O device, a NE-113A Nihon Kohden plate electrode, a SCB-68A shielded connector block, and LabVIEW 2017 software for data retrieval. The software was used to generate the multifocal hexagonal stimulus array on the computer monitor with C++Builder 10.2 and to move the center of the array toward the left and right and up and down. Cone and bright flash ERG results were observed using the moving ERG function. The a-wave, b-wave, c-wave, and the photopic negative response were identified with cone ERG. The moving ERG function allowed the identification of the retinal layer causing visual alterations.
Abstract: Various length dimensions of the body have been a variable of interest in the research areas of kinanthropometry. However the inclusion of length measurements in various studies remains restricted to reflect characteristics of a particular game/sport at a particular time. Hence, the present investigation was conducted to study various length dimensions correlates of a longitudinal physical conditioning program on Indian male youth. The study was conducted on 90 Indian male youth. The sample was equally divided into three groups namely, progressive load training (PLT), constant load training (CLT) and no load training (NL). The variables included sitting height, leg length, arm length and foot length. The study was conducted by adopting the multi group repeated measure design. Three different groups were measured four times after completion of each of the three meso-cycles of six-weeks duration each. The measurements were taken using the standard landmarks and procedures. Mean, standard deviation and analysis of co-variance were computed to analyze the data statistically. The post-hoc analysis was conducted for the significant F-ratios at 0.05 level. The study concluded that the followed longitudinal physical conditioning program had significant effect on various length dimensions of Indian male youth.
Abstract: The average American worker sits for thirteen hours a day, often with poor posture and infrequent breaks, which can lead to health issues and back problems. The Smart Cushion was created to alert individuals of their poor postures, and may potentially alleviate back problems and correct poor posture. The Smart Cushion is a portable, rectangular, foam cushion, with five strategically placed pressure sensors, that utilizes an Arduino Uno circuit board and specifically designed software, allowing it to collect data from the five pressure sensors and store the data on an SD card. The data is then compiled into graphs and compared to controlled postures. Before volunteers sat on the cushion, their levels of back pain were recorded on a scale from 1-10. Data was recorded for an hour during sitting, and then a new, corrected posture was suggested. After using the suggested posture for an hour, the volunteers described their level of discomfort on a scale from 1-10. Different patterns of sitting postures were generated that were able to serve as early warnings of potential back problems. By using the Smart Cushion, the areas where different volunteers were applying the most pressure while sitting could be identified, and the sitting postures could be corrected. Further studies regarding the relationships between posture and specific regions of the body are necessary to better understand the origins of back pain; however, the Smart Cushion is sufficient for correcting sitting posture and preventing the development of additional back pain.
Abstract: The present study was conducted to explore the basic pulmonary functions which may generally vary according to the bio-physical characteristics including age, height, body weight, and environment etc. of the sports performers. Regular and specific training exercises also change the characteristics of an athlete’s prowess and produce a positive effect on the physiological functioning, mostly upon cardio-pulmonary efficiency and thereby improving the body mechanism. The objective of the present study was to compare the differences in cardio-respiratory functions between aquatics and track and field performers. As cardio-respiratory functions are influenced by pulse rate and blood pressure (systolic and diastolic), so both of the factors were also taken into consideration. The component selected under cardio-respiratory functions for the present study were i) FEVI/FVC ratio (forced expiratory volume divided by forced vital capacity ratio, i.e. the number represents the percentage of lung capacity to exhale in one second) ii) FVC1 (this is the amount of air which can force out of lungs in one second) and iii) FVC (forced vital capacity is the greatest total amount of air forcefully breathe out after breathing in as deeply as possible). All the three selected components of the cardio-respiratory efficiency were measured by spirometry method. Pulse rate was determined manually. The radial artery which is located on the thumb side of our wrist was used to assess the pulse rate. Blood pressure was assessed by sphygmomanometer. All the data were taken in the resting condition. 36subjects were selected for the present study out of which 18were water polo players and rest were sprinters. The age group of the subjects was considered between 18 to 23 years. In this study the obtained data inform of digital score were treated statistically to get result and draw conclusions. The Mean and Standard Deviation (SD) were used as descriptive statistics and the significant difference between the two subject groups was assessed with the help of statistical ‘t’-test. It was found from the study that all the three components i.e. FEVI/FVC ratio (p-value 0.0148 < 0.01), FVC1 (p-value 0.0010 < 0.01) and FVC (p-value 0.0067 < 0.01) differ significantly as water polo players proved to be better in terms of cardio-respiratory functions than sprinters. Thus study clearly suggests that the exercise training as well as the medium of practice arena associated with water polo players has played an important role to determine better cardio respiratory efficiency than track and field athletes. The outcome of the present study revealed that the lung function in land-based activities may not provide much impact than that of in water activities.
Abstract: Warm-up is an essential component for optimizing performance in various sports before a physical fitness training session. This study investigated the immediate comparative effect of Self-Myofascial Release through vibration rolling (VR), non-vibration rolling (NVR), and static stretching as a part of a warm-up treatment on the functional fitness of young adults. Functional fitness is a classification of training that prepares the body for real-life movements and activities. For the present study 20male physical education students were selected as subjects. The age of the subjects was ranged from 20-25 years. The functional fitness variables undertaken in the present study were flexibility, muscle strength, agility, static and dynamic balance of the lower extremity. Each of the three warm-up protocol was administered on consecutive days, i.e. 24 hr time gap and all tests were administered in the morning. The mean and SD were used as descriptive statistics. The significance of statistical differences among the groups was measured by applying ‘F’-test, and to find out the exact location of difference, Post Hoc Test (Least Significant Difference) was applied. It was found from the study that only flexibility showed significant difference among three types of warm-up exercise. The observed result depicted that VR has more impact on myofascial release in flexibility in comparison with NVR and stretching as a part of warm-up exercise as ‘p’ value was less than 0.05. In the present study, within the three means of warm-up exercises, vibration roller showed better mean difference in terms of NVR, and static stretching exercise on functional fitness of young physical education practitioners, although the results were found insignificant in case of muscle strength, agility, static and dynamic balance of the lower extremity. These findings suggest that sports professionals and coaches may take VR into account for designing more efficient and effective pre-performance routine for long term to improve exercise performances. VR has high potential to interpret into an on-field practical application means.
Abstract: This study examines the levels of dopamine and serotonin in blood samples of children who stutter compared with normal fluent speakers. Blood specimens from 50 children who stutter (6 females, 44 males) and 50 normal children matched age and gender were collected for the purpose of the current study. The concentrations of dopamine and serotonin were measured using the 1100 series high-performance liquid chromatography coupled with ultraviolet detector instrument (HPLC-UV). It was revealed that dopamine level in the blood samples of stuttering group and fluent group was not significant (P = 0.769), whereas the level of serotonin was significantly higher in the blood samples of stuttering group than the blood samples of fluent normal group (P = 0.015). It is concluded that serotonin blockers could be used in future studies to evaluate its role as a medication for the treatment of stuttering.
Abstract: The paper declares effects of exercise intervention of the research project “Basic research of balance changes in seniors”, granted by the Czech Science Foundation. The objective of the presented study is to define predictors, which influence bio-psycho-social consequences and effects of balance ability in senior 65 years old and above. We focused on the Fall-Efficacy Scale changes evaluation in seniors. Comprehensive hypothesis of the project declares, that motion uncertainty (dyskinesia) can negatively affect the well-being of a senior in bio-psycho-social context. In total, random selection and testing of 100 seniors (30 males, 70 females) from Prague and Central Bohemian region was provided. The sample was divided by stratified random selection into experimental and control groups, who underwent input and output testing. For diagnostics the methods of Medical Anamnesis, Functional anthropological examinations, Tinetti Balance Assessment Tool, SF-36 Health Survey, Anamnestic comparative self-assessment scale were used. Intervention method called "Life in Balance" based on yoga techniques was applied in four-week cycle. Results of multivariate regression were verified by repeated measures ANOVA: subject factor, phase of intervention (between-subject factor), body fluid (within-subject factor) and phase of intervention × body fluid interaction). ANOVA was performed with a repetition involving the factors of subjects, experimental/control group, phase of intervention (independent variable), and x phase interaction followed by Bonferroni multiple comparison assays with a test strength of at least 0.8 on the probability level p < 0.05. In the paper results of the first-year investigation of the three years running project are analysed. Results of balance tests confirmed no significant difference between females and males in pre-test. Significant improvements in balance and walking ability were observed in experimental group in females comparing to males (F = 128.4, p < 0.001). In the females control group, there was no significant change in post- test, while in the female experimental group positive changes in posture and spine flexibility in post-tests were found. It seems that females even in senior age react better to incentives of intervention in balance and spine flexibility. On the base of results analyses, we can declare the significant improvement in social balance markers after intervention in the experimental group (F = 10.5, p < 0.001). In average, seniors are used to take four drugs daily. Number of drugs can contribute to allergy symptoms and balance problems. It can be concluded that static balance and walking ability of seniors according Tinetti Balance scale correlate significantly with psychic and social monitored markers.
Abstract: This study evaluates obstructive sleep apnea treatment through a case study involving a 67-year-old male driver who had a successful continuous positive airway pressure (CPAP) treatment at home but experienced difficulties with traveling and dental care. There are many cheap sleep apnea and snoring devices available, but there is little professional advice on what kind of devices can help. Professional drivers receive yearly specialized medical care follow-up.
Abstract: This paper aims at bringing a scientific contribution to the cardiac arrhythmia biomedical diagnosis systems; more precisely to the study of the amelioration of cardiac arrhythmia classification performance using artificial neural network, adaptive neuro-fuzzy and fuzzy inference systems classifiers. The purpose of this amelioration is to enable cardiologists to make reliable diagnosis through automatic cardiac arrhythmia analyzes and classifications based on high confidence classifiers. In this study, six classes of the most commonly encountered arrhythmias are considered: the Right Bundle Branch Block, the Left Bundle Branch Block, the Ventricular Extrasystole, the Auricular Extrasystole, the Atrial Fibrillation and the Normal Cardiac rate beat. From the electrocardiogram (ECG) extracted parameters, we constructed a matrix (360x360) serving as an input data sample for the classifiers based on neural networks and a matrix (1x6) for the classifier based on fuzzy logic. By varying three parameters (the quality of the neural network learning, the data size and the quality of the input parameters) the automatic classification permitted us to obtain the following performances: in terms of correct classification rate, 83.6% was obtained using the fuzzy logic based classifier, 99.7% using the neural network based classifier and 99.8% for the adaptive neuro-fuzzy based classifier. These results are based on signals containing at least 360 cardiac cycles. Based on the comparative analysis of the aforementioned three arrhythmia classifiers, the classifiers based on neural networks exhibit a better performance.
Abstract: This paper presents a Machine Learning (ML) approach to support Meningitis diagnosis in patients at a children’s hospital in Sao Paulo, Brazil. The aim is to use ML techniques to reduce the use of invasive procedures, such as cerebrospinal fluid (CSF) collection, as much as possible. In this study, we focus on predicting the probability of Meningitis given the results of a blood and urine laboratory tests, together with the analysis of pain or other complaints from the patient. We tested a number of different ML algorithms, including: Adaptative Boosting (AdaBoost), Decision Tree, Gradient Boosting, K-Nearest Neighbors (KNN), Logistic Regression, Random Forest and Support Vector Machines (SVM). Decision Tree algorithm performed best, with 94.56% and 96.18% accuracy for training and testing data, respectively. These results represent a significant aid to doctors in diagnosing Meningitis as early as possible and in preventing expensive and painful procedures on some children.
Abstract: The quality control procedures of a radiopharmaceutical include the assessment of its chemical purity. The method suggested by international pharmacopeias consists of a thin layer chromatographic run. In this paper, the method proposed by the United States Pharmacopeia (USP) is compared to a direct method to determine the final concentration of aminopolyether in Fludeoxyglucose (18F-FDG) preparations. The approach (no chromatographic run) was achieved by placing the thin-layer chromatography (TLC) plate directly on an iodine vapor chamber. Both methods were validated and they showed adequate results to determine the concentration of aminopolyether in 18F-FDG preparations. However, the direct method is more sensitive, faster and simpler when compared to the reference method (with chromatographic run), and it may be chosen for use in routine quality control of 18F-FDG.
Abstract: This study aimed to describe the operating model of obstructive sleep apnea. Due to the large number of patients, the role of nurses in the diagnosis and treatment of sleep apnea was important. Pulmonary physicians met only a minority of the patients. The sleep apnea study in 2018 included about 800 patients, of which about 28% were normal and 180 patients were classified as severe (apnea-hypopnea index [AHI] over 30). The operating model has proven to be workable and appropriate. The patients understand well that they may not be referred to a pulmonary doctor. However, specialized medical follow-up on professional drivers continues every year.