Search results for: location identification
Commenced in January 2007
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Edition: International
Paper Count: 4953

Search results for: location identification

483 Facial Recognition of University Entrance Exam Candidates using FaceMatch Software in Iran

Authors: Mahshid Arabi

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In recent years, remarkable advancements in the fields of artificial intelligence and machine learning have led to the development of facial recognition technologies. These technologies are now employed in a wide range of applications, including security, surveillance, healthcare, and education. In the field of education, the identification of university entrance exam candidates has been one of the fundamental challenges. Traditional methods such as using ID cards and handwritten signatures are not only inefficient and prone to fraud but also susceptible to errors. In this context, utilizing advanced technologies like facial recognition can be an effective and efficient solution to increase the accuracy and reliability of identity verification in entrance exams. This article examines the use of FaceMatch software for recognizing the faces of university entrance exam candidates in Iran. The main objective of this research is to evaluate the efficiency and accuracy of FaceMatch software in identifying university entrance exam candidates to prevent fraud and ensure the authenticity of individuals' identities. Additionally, this research investigates the advantages and challenges of using this technology in Iran's educational systems. This research was conducted using an experimental method and random sampling. In this study, 1000 university entrance exam candidates in Iran were selected as samples. The facial images of these candidates were processed and analyzed using FaceMatch software. The software's accuracy and efficiency were evaluated using various metrics, including accuracy rate, error rate, and processing time. The research results indicated that FaceMatch software could accurately identify candidates with a precision of 98.5%. The software's error rate was less than 1.5%, demonstrating its high efficiency in facial recognition. Additionally, the average processing time for each candidate's image was less than 2 seconds, indicating the software's high efficiency. Statistical evaluation of the results using precise statistical tests, including analysis of variance (ANOVA) and t-test, showed that the observed differences were significant, and the software's accuracy in identity verification is high. The findings of this research suggest that FaceMatch software can be effectively used as a tool for identifying university entrance exam candidates in Iran. This technology not only enhances security and prevents fraud but also simplifies and streamlines the exam administration process. However, challenges such as preserving candidates' privacy and the costs of implementation must also be considered. The use of facial recognition technology with FaceMatch software in Iran's educational systems can be an effective solution for preventing fraud and ensuring the authenticity of university entrance exam candidates' identities. Given the promising results of this research, it is recommended that this technology be more widely implemented and utilized in the country's educational systems.

Keywords: facial recognition, FaceMatch software, Iran, university entrance exam

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482 First-Trimester Screening of Preeclampsia in a Routine Care

Authors: Tamar Grdzelishvili, Zaza Sinauridze

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Introduction: Preeclampsia is a complication of the second trimester of pregnancy, which is characterized by high morbidity and multiorgan damage. Many complex pathogenic mechanisms are now implicated to be responsible for this disease (1). Preeclampsia is one of the leading causes of maternal mortality worldwide. Statistics are enough to convince you of the seriousness of this pathology: about 100,000 women die of preeclampsia every year. It occurs in 3-14% (varies significantly depending on racial origin or ethnicity and geographical region) of pregnant women, in 75% of cases - in a mild form, and in 25% - in a severe form. During severe pre-eclampsia-eclampsia, perinatal mortality increases by 5 times and stillbirth by 9.6 times. Considering that the only way to treat the disease is to end the pregnancy, the main thing is timely diagnosis and prevention of the disease. Identification of high-risk pregnant women for PE and giving prophylaxis would reduce the incidence of preterm PE. First-trimester screening model developed by the Fetal Medicine Foundation (FMF), which uses the Bayes-theorem to combine maternal characteristics and medical history together with measurements of mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor, has been proven to be effective and have superior screening performance to that of traditional risk factor-based approach for the prediction of PE (2) Methods: Retrospective single center screening study. The study population consisted of women from the Tbilisi maternity hospital “Pineo medical ecosystem” who met the following criteria: they spoke Georgian, English, or Russian and agreed to participate in the study after discussing informed consent and answering questions. Prior to the study, the informed consent forms approved by the Institutional Review Board were obtained from the study subjects. Early assessment of preeclampsia was performed between 11-13 weeks of pregnancy. The following were evaluated: anamnesis, dopplerography of the uterine artery, mean arterial blood pressure, and biochemical parameter: Pregnancy-associated plasma protein A (PAPP-A). Individual risk assessment was performed with performed by Fast Screen 3.0 software ThermoFisher scientific. Results: A total of 513 women were recruited and through the study, 51 women were diagnosed with preeclampsia (34.5% in the pregnant women with high risk, 6.5% in the pregnant women with low risk; P<0.000 1). Conclusions: First-trimester screening combining maternal factors with uterine artery Doppler, blood pressure, and pregnancy-associated plasma protein-A is useful to predict PE in a routine care setting. More patient studies are needed for final conclusions. The research is still ongoing.

Keywords: first-trimester, preeclampsia, screening, pregnancy-associated plasma protein

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481 Enumerating Insect Biodiversity in the Himalayan Mountains of India in Context to Species Richness, Biogeographic Distribution, and Possible Gap Areas in Taxonomic Research

Authors: Kailash Chandra, Devanshu Gupta

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The Himalayan Mountains of India fall under two biogeographic zones Trans Himalaya (TH) and Himalaya and seven biotic provinces (TH-Ladakh Mountains, TH-Tibetan Plateau, TH-Sikkim, North-West Himalaya, West Himalaya, Central Himalaya, and East Himalaya). Because of the extreme environment and altitudinal variations, unique physiography, varied ecological conditions, and different vegetations, the Himalaya exhibit a rich assemblage of life, both flora, and fauna, further subjected to the impacts of climate change. To the authors’ best knowledge, there is no comprehensive account except for sporadic faunal investigations, to assess or interpret the insect diversity and their biogeographic distribution in Indian Himalaya (IH), one of the biodiversity hotspots. Therefore, in this paper, a compelling review of the extensive knowledge of insect diversity of IH is presented for the first time to the best of our knowledge. The inventory of the known insect species of IH was compiled from the exploration cum faunal-study data ready with the zoological survey of India, Kolkata as well as from the information published in the scientific literature till date. The species were listed with their valid names with their distribution in seven biotic provinces of IH. The insect fauna of IH represents about 38% of the identified insect diversity of India. The interpretation of data provided significant information in detecting possible gap areas in the taxonomic representation of different insect orders. Archaeognatha, Zygentoma, Ephemeroptera, Phasmida, Embioptera, Psocoptera, Phthiraptera, Strepsiptera, Megaloptera, Raphidioptera, Siphonaptera, and Mecoptera need revisions, and it is required to collect more samples from remote areas of the region. Scope for finding new taxa even in the most diverse orders, Coleoptera, Lepidoptera, Hymenoptera, Diptera, and Hemiptera cannot be overlooked. Exploration of cold deserts of Trans Himalaya and East Himalaya (Arunachal Pradesh) may result in a good number of new species from these regions. The most notable data was that many of the species recorded from Himalaya are still known from their type localities only, so there is an urgency to revisit and resurvey those collection localities for the evaluation of the status of those species. It is also required to assess and monitor the impact of climate change on the diversity of insects inhabiting in the fragile Himalayan ecosystem. DNA barcoding especially pests and biological control agents to solve the problems of identification in species complexes is also the need of the hour. In a nutshell, it can be concluded that the inventory of insects of this region is extensive but is far from final as every year hundreds of new species are described.

Keywords: catalog, climate change, diversity, DNA barcoding

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480 Developing Digital Competencies in Aboriginal Students through University-College Partnerships

Authors: W. S. Barber, S. L. King

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This paper reports on a pilot project to develop a collaborative partnership between a community college in rural northern Ontario, Canada, and an urban university in the greater Toronto area in Oshawa, Canada. Partner institutions will collaborate to address learning needs of university applicants whose goals are to attain an undergraduate university BA in Educational Studies and Digital Technology degree, but who may not live in a geographical location that would facilitate this pathways process. The UOIT BA degree is attained through a 2+2 program, where students with a 2 year college diploma or equivalent can attain a four year undergraduate degree. The goals reported on the project are as: 1. Our aim is to expand the BA program to include an additional stream which includes serious educational games, simulations and virtual environments, 2. Develop fully (using both synchronous and asynchronous technologies) online learning modules for use by university applicants who otherwise are not geographically located close to a physical university site, 3. Assess the digital competencies of all students, including members of local, distance and Indigenous communities using a validated tool developed and tested by UOIT across numerous populations. This tool, the General Technical Competency Use and Scale (GTCU) will provide the collaborating institutions with data that will allow for analyzing how well students are prepared to succeed in fully online learning communities. Philosophically, the UOIT BA program is based on a fully online learning communities model (FOLC) that can be accessed from anywhere in the world through digital learning environments via audio video conferencing tools such as Adobe Connect. It also follows models of adult learning and mobile learning, and makes a university degree accessible to the increasing demographic of adult learners who may use mobile devices to learn anywhere anytime. The program is based on key principles of Problem Based Learning, allowing students to build their own understandings through the co-design of the learning environment in collaboration with the instructors and their peers. In this way, this degree allows students to personalize and individualize the learning based on their own culture, background and professional/personal experiences. Using modified flipped classroom strategies, students are able to interrogate video modules on their own time in preparation for one hour discussions occurring in video conferencing sessions. As a consequence of the program flexibility, students may continue to work full or part time. All of the partner institutions will co-develop four new modules, administer the GTCU and share data, while creating a new stream of the UOIT BA degree. This will increase accessibility for students to bridge from community colleges to university through a fully digital environment. We aim to work collaboratively with Indigenous elders, community members and distance education instructors to increase opportunities for more students to attain a university education.

Keywords: aboriginal, college, competencies, digital, universities

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479 Interdisciplinary Evaluations of Children with Autism Spectrum Disorder in a Telehealth Arena

Authors: Janice Keener, Christine Houlihan

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Over the last several years, there has been an increase in children identified as having Autism Spectrum Disorder (ASD). Specialists across several disciplines: mental health and medical professionals have been tasked with ensuring accurate and timely evaluations for children with suspected ASD. Due to the nature of the ASD symptom presentation, an interdisciplinary assessment and treatment approach best addresses the needs of the whole child. During the unprecedented COVID-19 Pandemic, clinicians were faced with how to continue with interdisciplinary assessments in a telehealth arena. Instruments that were previously used to assess ASD in-person were no longer appropriate measures to use due to the safety restrictions. For example, The Autism Diagnostic Observation Schedule requires examiners and children to be in very close proximity of each other and if masks or face shields are worn, they render the evaluation invalid. Similar issues arose with the various cognitive measures that are used to assess children such as the Weschler Tests of Intelligence and the Differential Ability Scale. Thus the need arose to identify measures that are able to be safely and accurately administered using safety guidelines. The incidence of ASD continues to rise over time. Currently, the Center for Disease Control estimates that 1 in 59 children meet the criteria for a diagnosis of ASD. The reasons for this increase are likely multifold, including changes in diagnostic criteria, public awareness of the condition, and other environmental and genetic factors. The rise in the incidence of ASD has led to a greater need for diagnostic and treatment services across the United States. The uncertainty of the diagnostic process can lead to an increased level of stress for families of children with suspected ASD. Along with this increase, there is a need for diagnostic clarity to avoid both under and over-identification of this condition. Interdisciplinary assessment is ideal for children with suspected ASD, as it allows for an assessment of the whole child over the course of time and across multiple settings. Clinicians such as Psychologists and Developmental Pediatricians play important roles in the initial evaluation of autism spectrum disorder. An ASD assessment may consist of several types of measures such as standardized checklists, structured interviews, and direct assessments such as the ADOS-2 are just a few examples. With the advent of telehealth clinicians were asked to continue to provide meaningful interdisciplinary assessments via an electronic platform and, in a sense, going to the family home and evaluating the clinical symptom presentation remotely and confidently making an accurate diagnosis. This poster presentation will review the benefits, limitations, and interpretation of these various instruments. The role of other medical professionals will also be addressed, including medical providers, speech pathology, and occupational therapy.

Keywords: Autism Spectrum Disorder Assessments, Interdisciplinary Evaluations , Tele-Assessment with Autism Spectrum Disorder, Diagnosis of Autism Spectrum Disorder

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478 Benefits of Tourist Experiences for Families: A Systematic Literature Review Using Nvivo

Authors: Diana Cunha, Catarina Coelho, Ana Paula Relvas, Elisabeth Kastenholz

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Context: Tourist experiences have a recognized impact on the well-being of individuals. However, studies on the specific benefits of tourist experiences for families are scattered across different disciplines. This study aims to systematically review the literature to synthesize the evidence on the benefits of tourist experiences for families. Research Aim: The main objective is to systematize the evidence in the literature regarding the benefits of tourist experiences for families. Methodology: A systematic literature review was conducted using Nvivo, analyzing 33 scientific studies obtained from various databases. The search terms used were "family"/ "couple" and "tourist experience". The studies included quantitative, qualitative, mixed methods, and literature reviews. All works prior to the year 2000 were excluded, and the search was restricted to full text. A language filter was also used, considering articles in Portuguese, English, and Spanish. For NVivo analysis, information was coded based on both deductive and inductive perspectives. To minimize the subjectivity of the selection and coding process, two of the authors discussed the process and agreed on criteria that would make the coding more objective. Once the coding process in NVivo was completed, the data relating to the identification/characterization of the works were exported to the Statistical Package for the Social Sciences (SPPS), to characterize the sample. Findings: The results highlight that tourist experiences have several benefits for family systems, including the strengthening of family and marital bonds, the creation of family memories, and overall well-being and life satisfaction. These benefits contribute to both immediate relationship quality improvement and long-term family identity construction and transgenerational transmission. Theoretical Importance: This study emphasizes the systemic nature of the effects and relationships within family systems. It also shows that no harm was reported within these experiences, with only some challenges related to positive outcomes. Data Collection and Analysis Procedures: The study collected data from 33 scientific studies published predominantly after 2013. The data were analyzed using Nvivo, employing a systematic review approach. Question Addressed: The study addresses the question of the benefits of tourist experiences for families and how these experiences contribute to family functioning and individual well-being. Conclusion: Tourist experiences provide opportunities for families to enhance their interpersonal relationships and create lasting memories. The findings suggest that formal interventions based on evidence could further enhance the potential benefits of these experiences and be a valuable preventive tool in therapeutic interventions.

Keywords: family systems, individual and family well-being, marital satisfaction, tourist experiences

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477 Investigating Selected Traditional African Medicinal Plants for Anti-fibrotic Potential: Identification and Characterization of Bioactive Compounds Through Fourier-Transform Infrared Spectroscopy and Gas Chromatography-Mass Spectrometry Analysis

Authors: G. V. Manzane, S. J. Modise

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Uterine fibroids, also known as leiomyomas or myomas, are non-cancerous growths that develop in the muscular wall of the uterus during the reproductive years. The cause of uterine fibroids includes hormonal, genetic, growth factors, and extracellular matrix factors. Common symptoms of uterine fibroids include heavy and prolonged menstrual bleeding which can lead to a high risk of anemia, lower abdominal pains, pelvic pressure, infertility, and pregnancy loss. The growth of this tumor is a concern because of its negative impact on women’s health and the increase in their economic burden. Traditional medicinal plants have long been used in Africa for their potential therapeutic effects against various ailments. In this study, we aimed to identify and characterize bioactive compounds from selected African medicinal plants with potential anti-fibrotic properties using Fourier-transform infrared spectroscopy (FTIR) and gas chromatography-mass spectrometry (GCMS) analysis. Two medicinal plant species known for their traditional use in fibrosis-related conditions were selected for investigation. Aqueous extracts were prepared from the plant materials, and FTIR analysis was conducted to determine the functional groups present in the extracts. GCMS analysis was performed to identify the chemical constituents of the extracts. The FTIR analysis revealed the presence of various functional groups, such as phenols, flavonoids, terpenoids, and alkaloids, known for their potential therapeutic activities. These functional groups are associated with antioxidant, anti-inflammatory, and anti-fibrotic properties. The GCMS analysis identified several bioactive compounds, including flavonoids, alkaloids, terpenoids, and phenolic compounds, which are known for their pharmacological activities. The discovery of bioactive compounds in African medicinal plants that exhibit anti-fibrotic effects, opens up promising avenues for further research and development of potential treatments for fibrosis. This suggests the potential of these plants as a valuable source of novel therapeutic agents for treating fibrosis-related conditions. In conclusion, our study identified and characterized bioactive compounds from selected African medicinal plants using FTIR and GCMS analysis. The presence of compounds with known antifibrotic properties suggests that these plants hold promise as a potential source of natural products for the development of novel anti-fibrotic therapies.

Keywords: uterine fibroids, african medicinal plants, bioactive compounds, identify and characterized

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476 Treatment Outcome Of Corneal Ulcers Using Levofloxacin Hydrate 1.5% Ophthalmic Solution And Adjuvant Oral Ciprofloxacin, A Treatment Strategy Applicable To Primary Healthcare

Authors: Celine Shi Ying Lee, Jong Jian Lee

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Background: Infectious keratitis is one of the leading causes of blindness worldwide. Prompt treatment with effective medication will control the infection early, preventing corneal scarring and visual loss. fluoroquinolones ophthalmic medication is used because of its broad-spectrum properties, potency, good intraocular penetration, and low toxicity. The study aims to evaluate the treatment outcome of corneal ulcers using Levofloxacin 1.5% ophthalmic solution (LVFX) with adjuvant oral ciprofloxacin when indicated and apply this treatment strategy in primary health care as first-line treatment. Methods: Patients with infective corneal ulcer treated in an eye center were recruited. Inclusion criteria includes Corneal infection consistent with bacterial keratitis, single or multiple small corneal ulcers. Treatment regime: LVFX hourly for the first 2 days, 2 hourly from the 3rd day, and 3 hourly on the 5th day of review. Adjuvant oral ciprofloxacin 500mg BD was administered for 5 days if there were multiple corneal ulcers or when the location of the cornea ulcer was central or paracentral. Results: 47 subjects were recruited. There were 16 (34%) males and 31 (66%) females. 40 subjects (85%) were contact lens (CL) related to corneal ulcer, and 7 subjects (15%) were non-contact lens related. 42 subjects (89%) presented with one ulcer, of which 20 of them (48%) needed adjuvant therapy. 5 subjects presented with 2 or 3 ulcers, of which 3 needed adjuvant therapy. A total of 23 subjects (49%) was given adjuvant therapy (oral ciprofloxacin 500mg BD for 5 days).21 of them (91%) were CL related. All subjects recovered fully, and the average duration of treatment was 3.7 days, with 49% of the subjects resolved on the 3rd day, 38% on the 5thday of and 13% on the 7thday. All subjects showed symptoms of relief of pain, light-sensitivity, and redness on the 3rd day with full visual recovery post-treatment. No adverse drug reactions were recorded. Conclusion: Our treatment regime demonstrated good clinical outcome as first-line treatment for corneal ulcers. A corneal ulcer is a common eye condition in Singapore, mainly due to CL wear. Pseudomonas aeruginosa is the most frequent and potentially sight-threatening pathogen involved in CL related corneal ulcer. Coagulase-negative Staphylococci, Staphylococcus aureus, and Streptococcus Pneumoniae were seen in non-CL users. All these bacteria exhibit good sensitivity rates to ciprofloxacin and levofloxacin. It is therefore logical in our study to use LVFX Eyedrops and adjuvant ciprofloxacin oral antibiotics when indicated as first line treatment for most corneal ulcers. Our study of patients, both CL related and non-CL related, have shown good clinical response and full recovery using the above treatment strategy. There was also a full restoration of visual acuity in all the patients. Eye-trained primary Healthcare practitioners can consider adopting this treatment strategy as first line treatment in patients with corneal ulcers. This is relevant during the COVID pandemic, where hospitals are overwhelmed with patients and in regions with limited access to specialist eye care. This strategy would enable early treatment with better clinical outcome.

Keywords: corneal ulcer, levofloxacin hydrate, treatment strategy, ciprofloxacin

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475 Analytical Tools for Multi-Residue Analysis of Some Oxygenated Metabolites of PAHs (Hydroxylated, Quinones) in Sediments

Authors: I. Berger, N. Machour, F. Portet-Koltalo

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Polycyclic aromatic hydrocarbons (PAHs) are toxic and carcinogenic pollutants produced in majority by incomplete combustion processes in industrialized and urbanized areas. After being emitted in atmosphere, these persistent contaminants are deposited to soils or sediments. Even if persistent, some can be partially degraded (photodegradation, biodegradation, chemical oxidation) and they lead to oxygenated metabolites (oxy-PAHs) which can be more toxic than their parent PAH. Oxy-PAHs are less measured than PAHs in sediments and this study aims to compare different analytical tools in order to extract and quantify a mixture of four hydroxylated PAHs (OH-PAHs) and four carbonyl PAHs (quinones) in sediments. Methodologies: Two analytical systems – HPLC with on-line UV and fluorescence detectors (HPLC-UV-FLD) and GC coupled to a mass spectrometer (GC-MS) – were compared to separate and quantify oxy-PAHs. Microwave assisted extraction (MAE) was optimized to extract oxy-PAHs from sediments. Results: First OH-PAHs and quinones were analyzed in HPLC with on-line UV and fluorimetric detectors. OH-PAHs were detected with the sensitive FLD, but the non-fluorescent quinones were detected with UV. The limits of detection (LOD)s obtained were in the range (2-3)×10-4 mg/L for OH-PAHs and (2-3)×10-3 mg/L for quinones. Second, even if GC-MS is not well adapted to the analysis of the thermodegradable OH-PAHs and quinones without any derivatization step, it was used because of the advantages of the detector in terms of identification and of GC in terms of efficiency. Without derivatization, only two of the four quinones were detected in the range 1-10 mg/L (LODs=0.3-1.2 mg/L) and LODs were neither very satisfying for the four OH-PAHs (0.18-0.6 mg/L). So two derivatization processes were optimized, comparing to literature: one for silylation of OH-PAHs, one for acetylation of quinones. Silylation using BSTFA/TCMS 99/1 was enhanced using a mixture of catalyst solvents (pyridine/ethyle acetate) and finding the appropriate reaction duration (5-60 minutes). Acetylation was optimized at different steps of the process, including the initial volume of compounds to derivatize, the added amounts of Zn (0.1-0.25 g), the nature of the derivatization product (acetic anhydride, heptafluorobutyric acid…) and the liquid/liquid extraction at the end of the process. After derivatization, LODs were decreased by a factor 3 for OH-PAHs and by a factor 4 for quinones, all the quinones being now detected. Thereafter, quinones and OH-PAHs were extracted from spiked sediments using microwave assisted extraction (MAE) followed by GC-MS analysis. Several mixtures of solvents of different volumes (10-25 mL) and using different extraction temperatures (80-120°C) were tested to obtain the best recovery yields. Satisfactory recoveries could be obtained for quinones (70-96%) and for OH-PAHs (70-104%). Temperature was a critical factor which had to be controlled to avoid oxy-PAHs degradation during the MAE extraction process. Conclusion: Even if MAE-GC-MS was satisfactory to analyze these oxy-PAHs, MAE optimization has to be carried on to obtain a most appropriate extraction solvent mixture, allowing a direct injection in the HPLC-UV-FLD system, which is more sensitive than GC-MS and does not necessitate a previous long derivatization step.

Keywords: derivatizations for GC-MS, microwave assisted extraction, on-line HPLC-UV-FLD, oxygenated PAHs, polluted sediments

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474 Atypical Intoxication Due to Fluoxetine Abuse with Symptoms of Amnesia

Authors: Ayse Gul Bilen

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Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed antidepressants that are used clinically for the treatment of anxiety disorders, obsessive-compulsive disorder (OCD), panic disorders and eating disorders. The first SSRI, fluoxetine (sold under the brand names Prozac and Sarafem among others), had an adverse effect profile better than any other available antidepressant when it was introduced because of its selectivity for serotonin receptors. They have been considered almost free of side effects and have become widely prescribed, however questions about the safety and tolerability of SSRIs have emerged with their continued use. Most SSRI side effects are dose-related and can be attributed to serotonergic effects such as nausea. Continuous use might trigger adverse effects such as hyponatremia, tremor, nausea, weight gain, sleep disturbance and sexual dysfunction. Moderate toxicity can be safely observed in the hospital for 24 hours, and mild cases can be safely discharged (if asymptomatic) from the emergency department once cleared by Psychiatry in cases of intentional overdose and after 6 to 8 hours of observation. Although fluoxetine is relatively safe in terms of overdose, it might still be cardiotoxic and inhibit platelet secretion, aggregation, and plug formation. There have been reported clinical cases of seizures, cardiac conduction abnormalities, and even fatalities associated with fluoxetine ingestions. While the medical literature strongly suggests that most fluoxetine overdoses are benign, emergency physicians need to remain cognizant that intentional, high-dose fluoxetine ingestions may induce seizures and can even be fatal due to cardiac arrhythmia. Our case is a 35-year old female patient who was sent to ER with symptoms of confusion, amnesia and loss of orientation for time and location after being found wandering in the streets unconsciously by police forces that informed 112. Upon laboratory examination, no pathological symptom was found except sinus tachycardia in the EKG and high levels of aspartate transaminase (AST) and alanine transaminase (ALT). Diffusion MRI and computed tomography (CT) of the brain all looked normal. Upon physical and sexual examination, no signs of abuse or trauma were found. Test results for narcotics, stimulants and alcohol were negative as well. There was a presence of dysrhythmia which required admission to the intensive care unit (ICU). The patient gained back her conscience after 24 hours. It was discovered from her story afterward that she had been using fluoxetine due to post-traumatic stress disorder (PTSD) for 6 months and that she had attempted suicide after taking 3 boxes of fluoxetine due to the loss of a parent. She was then transferred to the psychiatric clinic. Our study aims to highlight the need to consider toxicologic drug use, in particular, the abuse of selective serotonin reuptake inhibitors (SSRIs), which have been widely prescribed due to presumed safety and tolerability, for diagnosis of patients applying to the emergency room (ER).

Keywords: abuse, amnesia, fluoxetine, intoxication, SSRI

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473 Distributed Energy Resources in Low-Income Communities: a Public Policy Proposal

Authors: Rodrigo Calili, Anna Carolina Sermarini, João Henrique Azevedo, Vanessa Cardoso de Albuquerque, Felipe Gonçalves, Gilberto Jannuzzi

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The diffusion of Distributed Energy Resources (DER) has caused structural changes in the relationship between consumers and electrical systems. The Photovoltaic Distributed Generation (PVDG), in particular, is an essential strategy for achieving the 2030 Agenda goals, especially SDG 7 and SDG 13. However, it is observed that most projects involving this technology in Brazil are restricted to the wealthiest classes of society, not yet reaching the low-income population, aligned with theories of energy justice. Considering the research for energy equality, one of the policies adopted by governments is the social electricity tariff (SET), which provides discounts on energy tariffs/bills. However, just granting this benefit may not be effective, and it is possible to merge it with DER technologies, such as the PVDG. Thus, this work aims to evaluate the economic viability of the policy to replace the social electricity tariff (the current policy aimed at the low-income population in Brazil) by PVDG projects. To this end, a proprietary methodology was developed that included: mapping the stakeholders, identifying critical variables, simulating policy options, and carrying out an analysis in the Brazilian context. The simulation answered two key questions: in which municipalities low-income consumers would have lower bills with PVDG compared to SET; which consumers in a given city would have increased subsidies, which are now provided for solar energy in Brazil and for the social tariff. An economic model was created for verifying the feasibility of the proposed policy in each municipality in the country, considering geographic issues (tariff of a particular distribution utility, radiation from a specific location, etc.). To validate these results, four sensitivity analyzes were performed: variation of the simultaneity factor between generation and consumption, variation of the tariff readjustment rate, zeroing CAPEX, and exemption from state tax. The behind-the-meter modality of generation proved to be more promising than the construction of a shared plant. However, although the behind-the-meter modality presents better results than the shared plant, there is a greater complexity in adopting this modality due to issues related to the infrastructure of the most vulnerable communities (e.g., precarious electrical networks, need to reinforce roofs). Considering the shared power plant modality, many opportunities are still envisaged since the risk of investing in such a policy can be mitigated. Furthermore, this modality can be an alternative due to the mitigation of the risk of default, as it allows greater control of users and facilitates the process of operation and maintenance. Finally, it was also found, that in some regions of Brazil, the continuity of the SET presents more economic benefits than its replacement by PVDG. However, the proposed policy offers many opportunities. For future works, the model may include other parameters, such as cost with low-income populations’ engagement, and business risk. In addition, other renewable sources of distributed generation can be studied for this purpose.

Keywords: low income, subsidy policy, distributed energy resources, energy justice

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472 Psychopathic Manager Behavior and the Employee Workplace Deviance: The Mediating Role of Revenge Motive, the Moderating Roles of Core Self-Evaluations and Attitude Importance

Authors: Sinem Bulkan

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This study introduces the construct of psychopathic manager behaviour and aims for the development of psychopathic manager behaviour (Psycho-Man B) measure. The study also aims for the understanding of the relationship between psychopathic manager behaviour and workplace deviance while investigating the mediating role of a revenge motive and the moderating roles of the core self-evaluations and the attitude importance. Data were collected from 519 employees from a wide variety of jobs and industries who currently work for or previously worked for a manager in a collectivist culture, Turkey. Psycho-Man B Measure was developed resulting in five dimensions as opposed to the proposed ten dimensions. Simple linear and hierarchical regression analyses were conducted to test the hypotheses. The results of simple linear regression analyses showed that psychopathic manager behaviour was positively significantly related to supervisor-directed and organisation-directed deviance. Revenge motive towards the manager partially mediated the relationship between psychopathic manager behaviour and supervisor-directed deviance. Similarly, revenge motive towards the organisation partially mediated the relationship between psychopathic manager behaviour and organisation-directed deviance. Furthermore, no support was found for the expected moderating role of core self-evaluations in the revenge motive towards the manager-supervisor-directed deviance and revenge motive towards the organisation-organisation-directed deviance relationships. Attitude importance moderated the relationship between revenge motive towards the manager and supervisor-directed deviance; revenge motive towards the organisation and organisation-directed deviance. Moderated-mediation hypotheses were not supported for core self-evaluations but were supported for the attitude importance. Additional analyses for sub-dimensions were conducted to further examine the hypotheses. Demographic variables were examined through independent samples t-tests, and one way ANOVA. Finally, findings are discussed; limitations, suggestions and implications are presented. The major contribution of this study is that ‘psychopathic manager behaviour’ construct was introduced to the literature and a scale for the reliable identification of psychopathic manager behaviour was developed in to evaluate managers’ level of sub-clinical psychopathy in the workforce. The study introduced that employees engage in different forms of supervisor-directed deviance and organisation-directed deviance depending on the level of the emotions and personal goals. Supervisor-directed deviant behaviours and organisation-directed deviant behaviours became distinct in a way as impulsive and premeditated, active or passive, direct and indirect actions. Accordingly, it is important for organisations to notice that employees’ level of affective state and attitude importance for psychopathic manager behaviours predetermine the certain type of employee deviant behaviours.

Keywords: attitude importance, core self evaluations, psychopathic manager behaviour, revenge motive, workplace deviance

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471 Disaster Management Approach for Planning an Early Response to Earthquakes in Urban Areas

Authors: Luis Reynaldo Mota-Santiago, Angélica Lozano

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Determining appropriate measures to face earthquakesarea challenge for practitioners. In the literature, some analyses consider disaster scenarios, disregarding some important field characteristics. Sometimes, software that allows estimating the number of victims and infrastructure damages is used. Other times historical information of previous events is used, or the scenarios’informationis assumed to be available even if it isnot usual in practice. Humanitarian operations start immediately after an earthquake strikes, and the first hours in relief efforts are important; local efforts are critical to assess the situation and deliver relief supplies to the victims. A preparation action is prepositioning stockpiles, most of them at central warehouses placed away from damage-prone areas, which requires large size facilities and budget. Usually, decisions in the first 12 hours (standard relief time (SRT)) after the disaster are the location of temporary depots and the design of distribution paths. The motivation for this research was the delay in the reaction time of the early relief efforts generating the late arrival of aid to some areas after the Mexico City 7.1 magnitude earthquake in 2017. Hence, a preparation approach for planning the immediate response to earthquake disasters is proposed, intended for local governments, considering their capabilities for planning and for responding during the SRT, in order to reduce the start-up time of immediate response operations in urban areas. The first steps are the generation and analysis of disaster scenarios, which allow estimatethe relief demand before and in the early hours after an earthquake. The scenarios can be based on historical data and/or the seismic hazard analysis of an Atlas of Natural Hazards and Risk as a way to address the limited or null available information.The following steps include the decision processes for: a) locating local depots (places to prepositioning stockpiles)and aid-giving facilities at closer places as possible to risk areas; and b) designing the vehicle paths for aid distribution (from local depots to the aid-giving facilities), which can be used at the beginning of the response actions. This approach allows speeding up the delivery of aid in the early moments of the emergency, which could reduce the suffering of the victims allowing additional time to integrate a broader and more streamlined response (according to new information)from national and international organizations into these efforts. The proposed approachis applied to two case studies in Mexico City. These areas were affectedby the 2017’s earthquake, having limited aid response. The approach generates disaster scenarios in an easy way and plans a faster early response with a short quantity of stockpiles which can be managed in the early hours of the emergency by local governments. Considering long-term storage, the estimated quantities of stockpiles require a limited budget to maintain and a small storage space. These stockpiles are useful also to address a different kind of emergencies in the area.

Keywords: disaster logistics, early response, generation of disaster scenarios, preparation phase

Procedia PDF Downloads 105
470 Microplastic Concentrations in Cultured Oyster in Two Bays of Baja California, Mexico

Authors: Eduardo Antonio Lozano Hernandez, Nancy Ramirez Alvarez, Lorena Margarita Rios Mendoza, Jose Vinicio Macias Zamora, Felix Augusto Hernandez Guzman, Jose Luis Sanchez Osorio

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Microplastics (MPs) are one of the most numerous reported wastes found in the marine ecosystem, representing one of the greatest risks for organisms that inhabit that environment due to their bioavailability. Such is the case of bivalve mollusks, since they are capable of filtering large volumes of water, which increases the risk of contamination by microplastics through the continuous exposure to these materials. This study aims to determine, quantify and characterize microplastics found in the cultured oyster Crassostrea gigas. We also analyzed if there are spatio-temporal differences in the microplastic concentration of organisms grown in two bays having quite different human population. In addition, we wanted to have an idea of the possible impact on humans via consumption of these organisms. Commercial size organisms (>6cm length; n = 15) were collected by triplicate from eight oyster farming sites in Baja California, Mexico during winter and summer. Two sites are located in Todos Santos Bay (TSB), while the other six are located in San Quintin Bay (SQB). Site selection was based on commercial concessions for oyster farming in each bay. The organisms were chemically digested with 30% KOH (w/v) and 30% H₂O₂ (v/v) to remove the organic matter and subsequently filtered using a GF/D filter. All particles considered as possible MPs were quantified according to their physical characteristics using a stereoscopic microscope. The type of synthetic polymer was determined using a FTIR-ATR microscope and using a user as well as a commercial reference library (Nicolet iN10 Thermo Scientific, Inc.) of IR spectra of plastic polymers (with a certainty ≥70% for polymers pure; ≥50% for composite polymers). Plastic microfibers were found in all the samples analyzed. However, a low incidence of MP fragments was observed in our study (approximately 9%). The synthetic polymers identified were mainly polyester and polyacrylonitrile. In addition, polyethylene, polypropylene, polystyrene, nylon, and T. elastomer. On average, the content of microplastics in organisms were higher in TSB (0.05 ± 0.01 plastic particles (pp)/g of wet weight) than found in SQB (0.02 ± 0.004 pp/g of wet weight) in the winter period. The highest concentration of MPs found in TSB coincides with the rainy season in the region, which increases the runoff from streams and wastewater discharges to the bay, as well as the larger population pressure (> 500,000 inhabitants). Otherwise, SQB is a mainly rural location, where surface runoff from streams is minimal and in addition, does not have a wastewater discharge into the bay. During the summer, no significant differences (Manne-Whitney U test; P=0.484) were observed in the concentration of MPs found in the cultured oysters of TSB and SQB, (average: 0.01 ± 0.003 pp/g and 0.01 ± 0.002 pp/g, respectively). Finally, we concluded that the consumption of oyster does not represent a risk for humans due to the low concentrations of MPs found. The concentration of MPs is influenced by the variables such as temporality, circulations dynamics of the bay and existing demographic pressure.

Keywords: FTIR-ATR, Human risk, Microplastic, Oyster

Procedia PDF Downloads 164
469 A Visualization Classification Method for Identifying the Decayed Citrus Fruit Infected by Fungi Based on Hyperspectral Imaging

Authors: Jiangbo Li, Wenqian Huang

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Early detection of fungal infection in citrus fruit is one of the major problems in the postharvest commercialization process. The automatic and nondestructive detection of infected fruits is still a challenge for the citrus industry. At present, the visual inspection of rotten citrus fruits is commonly performed by workers through the ultraviolet induction fluorescence technology or manual sorting in citrus packinghouses to remove fruit subject with fungal infection. However, the former entails a number of problems because exposing people to this kind of lighting is potentially hazardous to human health, and the latter is very inefficient. Orange is used as a research object. This study would focus on this problem and proposed an effective method based on Vis-NIR hyperspectral imaging in the wavelength range of 400-1000 nm with a spectroscopic resolution of 2.8 nm. In this work, three normalization approaches are applied prior to analysis to reduce the effect of sample curvature on spectral profiles, and it is found that mean normalization was the most effective pretreatment for decreasing spectral variability due to curvature. Then, principal component analysis (PCA) was applied to a dataset composing of average spectra from decayed and normal tissue to reduce the dimensionality of data and observe the ability of Vis-NIR hyper-spectra to discriminate data from two classes. In this case, it was observed that normal and decayed spectra were separable along the resultant first principal component (PC1) axis. Subsequently, five wavelengths (band) centered at 577, 702, 751, 808, and 923 nm were selected as the characteristic wavelengths by analyzing the loadings of PC1. A multispectral combination image was generated based on five selected characteristic wavelength images. Based on the obtained multispectral combination image, the intensity slicing pseudocolor image processing method is used to generate a 2-D visual classification image that would enhance the contrast between normal and decayed tissue. Finally, an image segmentation algorithm for detection of decayed fruit was developed based on the pseudocolor image coupled with a simple thresholding method. For the investigated 238 independent set samples including infected fruits infected by Penicillium digitatum and normal fruits, the total success rate is 100% and 97.5%, respectively, and, the proposed algorithm also used to identify the orange infected by penicillium italicum with a 100% identification accuracy, indicating that the proposed multispectral algorithm here is an effective method and it is potential to be applied in citrus industry.

Keywords: citrus fruit, early rotten, fungal infection, hyperspectral imaging

Procedia PDF Downloads 287
468 Seafloor and Sea Surface Modelling in the East Coast Region of North America

Authors: Magdalena Idzikowska, Katarzyna Pająk, Kamil Kowalczyk

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Seafloor topography is a fundamental issue in geological, geophysical, and oceanographic studies. Single-beam or multibeam sonars attached to the hulls of ships are used to emit a hydroacoustic signal from transducers and reproduce the topography of the seabed. This solution provides relevant accuracy and spatial resolution. Bathymetric data from ships surveys provides National Centers for Environmental Information – National Oceanic and Atmospheric Administration. Unfortunately, most of the seabed is still unidentified, as there are still many gaps to be explored between ship survey tracks. Moreover, such measurements are very expensive and time-consuming. The solution is raster bathymetric models shared by The General Bathymetric Chart of the Oceans. The offered products are a compilation of different sets of data - raw or processed. Indirect data for the development of bathymetric models are also measurements of gravity anomalies. Some forms of seafloor relief (e.g. seamounts) increase the force of the Earth's pull, leading to changes in the sea surface. Based on satellite altimetry data, Sea Surface Height and marine gravity anomalies can be estimated, and based on the anomalies, it’s possible to infer the structure of the seabed. The main goal of the work is to create regional bathymetric models and models of the sea surface in the area of the east coast of North America – a region of seamounts and undulating seafloor. The research includes an analysis of the methods and techniques used, an evaluation of the interpolation algorithms used, model thickening, and the creation of grid models. Obtained data are raster bathymetric models in NetCDF format, survey data from multibeam soundings in MB-System format, and satellite altimetry data from Copernicus Marine Environment Monitoring Service. The methodology includes data extraction, processing, mapping, and spatial analysis. Visualization of the obtained results was carried out with Geographic Information System tools. The result is an extension of the state of the knowledge of the quality and usefulness of the data used for seabed and sea surface modeling and knowledge of the accuracy of the generated models. Sea level is averaged over time and space (excluding waves, tides, etc.). Its changes, along with knowledge of the topography of the ocean floor - inform us indirectly about the volume of the entire water ocean. The true shape of the ocean surface is further varied by such phenomena as tides, differences in atmospheric pressure, wind systems, thermal expansion of water, or phases of ocean circulation. Depending on the location of the point, the higher the depth, the lower the trend of sea level change. Studies show that combining data sets, from different sources, with different accuracies can affect the quality of sea surface and seafloor topography models.

Keywords: seafloor, sea surface height, bathymetry, satellite altimetry

Procedia PDF Downloads 68
467 Giving Children with Osteogenesis Imperfecta a Voice: Overview of a Participatory Approach for the Development of an Interactive Communication Tool

Authors: M. Siedlikowski, F. Rauch, A. Tsimicalis

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Osteogenesis Imperfecta (OI) is a genetic disorder of childhood onset that causes frequent fractures after minimal physical stress. To date, OI research has focused on medically- and surgically-oriented outcomes with little attention on the perspective of the affected child. It is a challenge to elicit the child’s voice in health care, in other words, their own perspective on their symptoms, but software development offers a way forward. Sisom (Norwegian acronym derived from ‘Si det som det er’ meaning ‘Tell it as it is’) is an award-winning, rigorously tested, interactive, computerized tool that helps children with chronic illnesses express their symptoms to their clinicians. The successful Sisom software tool, that addresses the child directly, has not yet been adapted to attend to symptoms unique to children with OI. The purpose of this study was to develop a Sisom paper prototype for children with OI by seeking the perspectives of end users, particularly, children with OI and clinicians. Our descriptive qualitative study was conducted at Shriners Hospitals for Children® – Canada, which follows the largest cohort of children with OI in North America. Purposive sampling was used to recruit 12 children with OI over three cycles. Nine clinicians oversaw the development process, which involved determining the relevance of current Sisom symptoms, vignettes, and avatars, as well as generating new Sisom OI components. Data, including field notes, transcribed audio-recordings, and drawings, were deductively analyzed using content analysis techniques. Guided by the following framework, data pertaining to symptoms, vignettes, and avatars were coded into five categories: a) Relevant; b) Irrelevant; c) To modify; d) To add; e) Unsure. Overall, 70.8% of Sisom symptoms were deemed relevant for inclusion, with 49.4% directly incorporated, and 21.3% incorporated with changes to syntax, and/or vignette, and/or location. Three additions were made to the ‘Avatar’ island. This allowed children to celebrate their uniqueness: ‘Makes you feel like you’re not like everybody else.’ One new island, ‘About Me’, was added to capture children’s worldviews. One new sub-island, ‘Getting Around’, was added to reflect accessibility issues. These issues were related to the children’s independence, their social lives, as well as the perceptions of others. In being consulted as experts throughout the co-creation of the Sisom OI paper prototype, children coded the Sisom symptoms and provided sound rationales for their chosen codes. In rationalizing their codes, all children shared personal stories about themselves and their relationships, insights about their OI, and an understanding of the strengths and challenges they experience on a day-to-day basis. The child’s perspective on their health is a basic right, and allowing it to be heard is the next frontier in the care of children with genetic diseases. Sisom OI, a methodological breakthrough within OI research, will offer clinicians an innovative and child-centered approach to capture this neglected perspective. It will provide a tool for the delivery of health care in the center that established the worldwide standard of care for children with OI.

Keywords: child health, interactive computerized communication tool, participatory approach, symptom management

Procedia PDF Downloads 143
466 Traditional Rainwater Harvesting Systems: A Sustainable Solution for Non-Urban Populations in the Mediterranean

Authors: S. Fares, K. Mellakh, A. Hmouri

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The StorMer project aims to set up a network of researchers to study traditional hydraulic rainwater harvesting systems in the Mediterranean basin, a region suffering from the major impacts of climate change and limited natural water resources. The arid and semi-arid Mediterranean basin has a long history of pioneering water management practices. The region has developed various ancient traditional water management systems, such as cisterns and qanats, to sustainably manage water resources under historical conditions of scarcity. Therefore, the StorMer project brings together Spain, France, Italy, Greece, Jordan and Morocco to explore traditional rainwater harvesting practices and systems in the Mediterranean region and to develop accurate modeling to simulate the performance and sustainability of these technologies under present-day climatic conditions. The ultimate goal of this project was to resuscitate and valorize these practices in the context of contemporary challenges. This project was intended to establish a Mediterranean network to serve as a basis for a more ambitious project. The ultimate objective was to analyze traditional hydraulic systems and create a prototype hydraulic ecosystem using a coupled environmental approach and traditional and ancient know-how, with the aim of reinterpreting them in the light of current techniques. The combination of ‘traditional’ and ‘modern knowledge/techniques’ is expected to lead to proposals for innovative hydraulic systems. The pandemic initially slowed our progress, but in the end it forced us to carry out the fieldwork in Morocco and Saudi Arabia, and so restart the project. With the participation of colleagues from chronologically distant fields (archaeology, sociology), we are now prepared to share our observations and propose the next steps. This interdisciplinary approach should give us a global vision of the project's objectives and challenges. A diachronic approach is needed to tackle the question of the long-term adaptation of societies in a Mediterranean context that has experienced several periods of water stress. The next stage of the StorMer project is the implementation of pilots in non-urbanized regions. These pilots will test the implementation of traditional systems and will be maintained and evaluated in terms of effectiveness, cost and acceptance. Based on these experiences, larger projects will be proposed and could provide information for regional water management policies. One of the most important lessons learned from this project is the highly social nature of managing traditional rainwater harvesting systems. Unlike modern, centralized water infrastructures, these systems often require the involvement of communities, which assume ownership and responsibility for them. This kind of community engagement leads to greater maintenance and, therefore, sustainability of the systems. Knowledge of the socio-cultural characteristics of these communities means that the systems can be adapted to the needs of each location, ensuring greater acceptance and efficiency.

Keywords: oasis, rainfall harvesting, arid regions, Mediterranean

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465 Determinants of Life Satisfaction in Canada: A Causal Modelling Approach

Authors: Rose Branch-Allen, John Jayachandran

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Background and purpose: Canada is a pluralistic, multicultural society with an ethno-cultural composition that has been shaped over time by immigrants and their descendants. Although Canada welcomes these immigrants, many will endure hardship and assimilation difficulties. Despite these life hurdles, surveys consistently disclose high life satisfaction for all Canadians. Most research studies on Life Satisfaction/ Subjective Wellbeing (SWB) have focused on one main determinant and a variety of social demographic variables to delineate the determinants of life satisfaction. However, very few research studies examine life satisfaction from a holistic approach. In addition, we need to understand the causal pathways leading to life satisfaction, and develop theories that explain why certain variables differentially influence the different components of SWB. The aim this study was to utilize a holistic approach to construct a causal model and identify major determinants of life satisfaction. Data and measures: This study utilized data from the General Social Survey, with a sample size of 19, 597. The exogenous concepts included age, gender, marital status, household size, socioeconomic status, ethnicity, location, immigration status, religiosity, and neighborhood. The intervening concepts included health, social contact, leisure, enjoyment, work-family balance, quality time, domestic labor, and sense of belonging. The endogenous concept life satisfaction was measured by multiple indicators (Cronbach’s alpha = .83). Analysis: Several multiple regression models were run sequentially to estimate path coefficients for the causal model. Results: Overall, above average satisfaction with life was reported for respondents with specific socio-economic, demographic and lifestyle characteristics. With regard to exogenous factors, respondents who were female, younger, married, from high socioeconomic status background, born in Canada, very religious, and demonstrated high level of neighborhood interaction had greater satisfaction with life. Similarly, intervening concepts suggested respondents had greater life satisfaction if they had better health, more social contact, less time on passive leisure activities and more time on active leisure activities, more time with family and friends, more enjoyment with volunteer activities, less time on domestic labor and a greater sense of belonging to the community. Conclusions and Implications: Our results suggest that a holistic approach is necessary for establishing determinants of life satisfaction, and that life satisfaction is not merely comprised of positive or negative affect rather understanding the causal process of life satisfaction. Even though, most of our findings are consistent with previous studies, a significant number of causal connections contradict some of the findings in literature today. We have provided possible explanation for these anomalies researchers encounter in studying life satisfaction and policy implications.

Keywords: causal model, holistic approach, life satisfaction, socio-demographic variables, subjective well-being

Procedia PDF Downloads 347
464 Genetic Variations of Two Casein Genes among Maghrabi Camels Reared in Egypt

Authors: Othman E. Othman, Amira M. Nowier, Medhat El-Denary

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Camels play an important socio-economic role within the pastoral and agricultural system in the dry and semidry zones of Asia and Africa. Camels are economically important animals in Egypt where they are dual purpose animals (meat and milk). The analysis of chemical composition of camel milk showed that the total protein contents ranged from 2.4% to 5.3% and it is divided into casein and whey proteins. The casein fraction constitutes 52% to 89% of total camel milk protein and it divided into 4 fractions namely αs1, αs2, β and κ-caseins which are encoded by four tightly genes. In spite of the important role of casein genes and the effects of their genetic polymorphisms on quantitative traits and technological properties of milk, the studies for the detection of genetic polymorphism of camel milk genes are still limited. Due to this fact, this work focused - using PCR-RFP and sequencing analysis - on the identification of genetic polymorphisms and SNPs of two casein genes in Maghrabi camel breed which is a dual purpose camel breed in Egypt. The amplified fragments at 488-bp of the camel κ-CN gene were digested with AluI endonuclease. The results showed the appearance of three different genotypes in the tested animals; CC with three digested fragments at 203-, 127- and 120-bp, TT with three digested fragments at 203-, 158- and 127-bp and CT with four digested fragments at 203-, 158-, 127- and 120-bp. The frequencies of three detected genotypes were 11.0% for CC, 48.0% for TT and 41.0% for CT genotypes. The sequencing analysis of the two different alleles declared the presence of a single nucleotide polymorphism (C→T) at position 121 in the amplified fragments which is responsible for the destruction of a restriction site (AG/CT) in allele T and resulted in the presence of two different alleles C and T in tested animals. The nucleotide sequences of κ-CN alleles C and T were submitted to GenBank with the accession numbers; KU055605 and KU055606, respectively. The primers used in this study amplified 942-bp fragments spanning from exon 4 to exon 6 of camel αS1-Casein gene. The amplified fragments were digested with two different restriction enzymes; SmlI and AluI. The results of SmlI digestion did not show any restriction site whereas the digestion with AluI endonuclease revealed the presence of two restriction sites AG^CT at positions 68^69 and 631^632 yielding the presence of three digested fragments with sizes 68-, 563- and 293-bp.The nucleotide sequences of this fragment from camel αS1-Casein gene were submitted to GenBank with the accession number KU145820. In conclusion, the genetic characterization of quantitative traits genes which are associated with the production traits like milk yield and composition is considered an important step towards the genetic improvement of livestock species through the selection of superior animals depending on the favorable alleles and genotypes; marker assisted selection (MAS).

Keywords: genetic polymorphism, SNP polymorphism, Maghrabi camels, κ-Casein gene, αS1-Casein gene

Procedia PDF Downloads 597
463 An Approach on Intelligent Tolerancing of Car Body Parts Based on Historical Measurement Data

Authors: Kai Warsoenke, Maik Mackiewicz

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To achieve a high quality of assembled car body structures, tolerancing is used to ensure a geometric accuracy of the single car body parts. There are two main techniques to determine the required tolerances. The first is tolerance analysis which describes the influence of individually tolerated input values on a required target value. Second is tolerance synthesis to determine the location of individual tolerances to achieve a target value. Both techniques are based on classical statistical methods, which assume certain probability distributions. To ensure competitiveness in both saturated and dynamic markets, production processes in vehicle manufacturing must be flexible and efficient. The dimensional specifications selected for the individual body components and the resulting assemblies have a major influence of the quality of the process. For example, in the manufacturing of forming tools as operating equipment or in the higher level of car body assembly. As part of the metrological process monitoring, manufactured individual parts and assemblies are recorded and the measurement results are stored in databases. They serve as information for the temporary adjustment of the production processes and are interpreted by experts in order to derive suitable adjustments measures. In the production of forming tools, this means that time-consuming and costly changes of the tool surface have to be made, while in the body shop, uncertainties that are difficult to control result in cost-intensive rework. The stored measurement results are not used to intelligently design tolerances in future processes or to support temporary decisions based on real-world geometric data. They offer potential to extend the tolerancing methods through data analysis and machine learning models. The purpose of this paper is to examine real-world measurement data from individual car body components, as well as assemblies, in order to develop an approach for using the data in short-term actions and future projects. For this reason, the measurement data will be analyzed descriptively in the first step in order to characterize their behavior and to determine possible correlations. In the following, a database is created that is suitable for developing machine learning models. The objective is to create an intelligent way to determine the position and number of measurement points as well as the local tolerance range. For this a number of different model types are compared and evaluated. The models with the best result are used to optimize equally distributed measuring points on unknown car body part geometries and to assign tolerance ranges to them. The current results of this investigation are still in progress. However, there are areas of the car body parts which behave more sensitively compared to the overall part and indicate that intelligent tolerancing is useful here in order to design and control preceding and succeeding processes more efficiently.

Keywords: automotive production, machine learning, process optimization, smart tolerancing

Procedia PDF Downloads 100
462 Ternary Organic Blend for Semitransparent Solar Cells with Enhanced Short Circuit Current Density

Authors: Mohammed Makha, Jakob Heier, Frank Nüesch, Roland Hany

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Organic solar cells (OSCs) have made rapid progress and currently achieve power conversion efficiencies (PCE) of over 10%. OSCs have several merits over other direct light-to-electricity generating cells and can be processed at low cost from solution on flexible substrates over large areas. Moreover, combining organic semiconductors with transparent and conductive electrodes allows for the fabrication of semitransparent OSCs (SM-OSCs). For SM-OSCs the challenge is to achieve a high average visible transmission (AVT) while maintaining a high short circuit current (Jsc). Typically, Jsc of SM-OSCs is smaller than when using an opaque metal top electrode. This is because the non-absorbed light during the first transit through the active layer and the transparent electrode is forward-transmitted out of the device. Recently, OSCs using a ternary blend of organic materials have received attention. This strategy was pursued to extend the light harvesting over the visible range. However, it is a general challenge to manipulate the performance of ternary OSCs in a predictable way, because many key factors affect the charge generation and extraction in ternary solar cells. Consequently, the device performance is affected by the compatibility between the blend components and the resulting film morphology, the energy levels and bandgaps, the concentration of the guest material and its location in the active layer. In this work, we report on a solvent-free lamination process for the fabrication of efficient and semitransparent ternary blend OSCs. The ternary blend was composed of PC70BM and the electron donors PBDTTT-C and an NIR cyanine absorbing dye (Cy7T). Using an opaque metal top electrode, a PCE of 6% was achieved for the optimized binary polymer: fullerene blend (AVT = 56%). However, the PCE dropped to ~2% when decreasing (to 30 nm) the active film thickness to increase the AVT value (75%). Therefore we resorted to the ternary blend and measured for non-transparent cells a PCE of 5.5% when using an active polymer: dye: fullerene (0.7: 0.3: 1.5 wt:wt:wt) film of 95 nm thickness (AVT = 65% when omitting the top electrode). In a second step, the optimized ternary blend was used of the fabrication of SM-OSCs. We used a plastic/metal substrate with a light transmission of over 90% as a transparent electrode that was applied via a lamination process. The interfacial layer between the active layer and the top electrode was optimized in order to improve the charge collection and the contact with the laminated top electrode. We demonstrated a PCE of 3% with AVT of 51%. The parameter space for ternary OSCs is large and it is difficult to find the best concentration ratios by trial and error. A rational approach for device optimization is the construction of a ternary blend phase diagram. We discuss our attempts to construct such a phase diagram for the PBDTTT-C: Cy7T: PC70BM system via a combination of using selective Cy7T selective solvents and atomic force microscopy. From the ternary diagram suitable morphologies for efficient light-to-current conversion can be identified. We compare experimental OSC data with these predictions.

Keywords: organic photovoltaics, ternary phase diagram, ternary organic solar cells, transparent solar cell, lamination

Procedia PDF Downloads 252
461 School Accidents in Educational Establishment in Tunisia: A Five Years Retrospective Survey in the Governorate of Mahdia

Authors: Lamia Bouzgarrou, Amira Omrane, Leila Mrabet, Taoufik Khalfallah

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Background and aims: School accidents are one of the leading causes of morbidity and mortality among pupils and students. Indeed, they may induce an elevated number of lost school days, heavy emotional and physical disabilities, and financial costs on the victims and their families. This study aims to evaluate the annual incidence of school accidents in the central Tunisian governorate of Mahdia and to identify the epidemiological profile of victims and risk factors of these accidents. Methods: A retrospective study was conducted over the period of 5 school years, focusing on school accidents that occurred in public educational institutions (primary, basic, secondary and university) in the governorate of Mahdia (area = 2 966 km² and number of inhabitants in 2014 = 410 812). All accidents declared near the only official insurance of this type of injuries (MASU: Mutual School and University Accidents), and initially taken in charge at the University Hospital of Mahdia were included. Data was collected from the MASU reporting forms and the medical records of emergency and other specialized hospital departments. Results: With 3248 identified victims, the annual incidence of school accidents was equal to 0.69 per 100 pupils and students per year. The average age of victims was 14.51 ± 0.059 years and the sex ratio was 1.58. Pupils aged between 12 and 15 years, were concerned by 46.7% of the identified accidents. The practice of sports was the most relevant circumstances of these accidents (76.2 %). In 56.58 % of cases, falls were the leading mechanism. Bruises and fractures were the most frequent lesions (32.43 % and 30.51 %). Serious school accidents were noted in 28% of cases with hospitalization in 2.27 % of them. The average lost school days, was 12.23±1.73 days. Accidents occurring during sports or leisure activities were significantly more serious (p= 0.021). Furthermore, the frequency of hospitalization was significantly higher among boys (2.81% vs. 1.43%; p= 0.035), students ≤11 years (p= 0.008), and following crush trauma (p= 0.000). In addition, the surgical interventions were statistically more frequent among male victims (p=0.00), accidents occurring during physical education sessions (p=0.000); those associated to falls (p=0.000) and to crushes mechanisms (p=0.002), and injuries affecting lower limbs (p=0.000). Following this Multi-varied analysis concluded that the severity of school accident is correlated to the activity practiced during the trauma and the geographical location of the school. Conclusion: Children and adolescents are one of the most vulnerable groups against incidents with the risk of permanent disability, mainly related to the perturbation of the growth process and physiological limitations. Our five-year study, objectified a real elevate incidence of school accident among children and adolescents, with a considerable rate of severe injuries. In any community, the promotion of adolescents and children’s health is an important indicator of the public health level. Thus, it’s important to develop a multidisciplinary prevention strategy of school accident, based on safety and security rules and adapted to the specificity of our context.

Keywords: children and adolescents, children health, injuries and disability, school accident

Procedia PDF Downloads 106
460 The Future Control Rooms for Sustainable Power Systems: Current Landscape and Operational Challenges

Authors: Signe Svensson, Remy Rey, Anna-Lisa Osvalder, Henrik Artman, Lars Nordström

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The electric power system is undergoing significant changes. Thereby, the operation and control are becoming partly modified, more multifaceted and automated, and thereby supplementary operator skills might be required. This paper discusses developing operational challenges in future power system control rooms, posed by the evolving landscape of sustainable power systems, driven in turn by the shift towards electrification and renewable energy sources. A literature review followed by interviews and a comparison to other related domains with similar characteristics, a descriptive analysis was performed from a human factors perspective. Analysis is meant to identify trends, relationships, and challenges. A power control domain taxonomy includes a temporal domain (planning and real-time operation) and three operational domains within the power system (generation, switching and balancing). Within each operational domain, there are different control actions, either in the planning stage or in the real-time operation, that affect the overall operation of the power system. In addition to the temporal dimension, the control domains are divided in space between a multitude of different actors distributed across many different locations. A control room is a central location where different types of information are monitored and controlled, alarms are responded to, and deviations are handled by the control room operators. The operators’ competencies, teamwork skills, team shift patterns as well as control system designs are all important factors in ensuring efficient and safe electricity grid management. As the power system evolves with sustainable energy technologies, challenges are found. Questions are raised regarding whether the operators’ tacit knowledge, experience and operation skills of today are sufficient to make constructive decisions to solve modified and new control tasks, especially during disturbed operations or abnormalities. Which new skills need to be developed in planning and real-time operation to provide efficient generation and delivery of energy through the system? How should the user interfaces be developed to assist operators in processing the increasing amount of information? Are some skills at risk of being lost when the systems change? How should the physical environment and collaborations between different stakeholders within and outside the control room develop to support operator control? To conclude, the system change will provide many benefits related to electrification and renewable energy sources, but it is important to address the operators’ challenges with increasing complexity. The control tasks will be modified, and additional operator skills are needed to perform efficient and safe operations. Also, the whole human-technology-organization system needs to be considered, including the physical environment, the technical aids and the information systems, the operators’ physical and mental well-being, as well as the social and organizational systems.

Keywords: operator, process control, energy system, sustainability, future control room, skill

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459 Development a Home-Hotel-Hospital-School Community-Based Palliative Care Model for Patients with Cancer in Suratthani, Thailand

Authors: Patcharaporn Sakulpong, Wiriya Phokhwang

Abstract:

Background: Banpunrug (Love Sharing House) established in 2013 provides a community-based palliative care for patients with cancer from 7 provinces in southern Thailand. These patients come to receive outpatient chemotherapy and radiotherapy at Suratthani Cancer Hospital. They are poor and uneducated; they need an accommodation during their 30-45 day course of therapy. Methods: A community-participatory action research (PAR) was employed to establish a model of palliative care for patients with cancer. The participants included health care providers, community, and patients and families. The PAR process includes problem identification and need assessment, community and team establishment, field survey, organization founding, model of care planning, action and inquiry (PDCA), outcome evaluation, and model distribution. Results: The model of care at Banpunrug involves the concepts of HHHS model, in that Banpunrug is a Home for patients; patients live in a house comfortable like in a Hotel resource; the patients are given care and living facilities similarly to those in a Hospital; the house is a School for patients to learn how to take care themselves, how to live well with cancer, and most importantly how to prepare themselves for a good death. The house is also a humanized care school for health care providers. Banpunrug’s philosophy of care is based on friendship therapy, social and spiritual support, community partnership, patient-family centeredness, Live & Love sharing house, and holistic and humanized care. With this philosophy, the house is managed as a home of the patients and everyone involved; everything is costless for all eligible patients and their family members; all facilities and living expense are donated from benevolent people, friends, and community. Everyone, including patients and family, has a sense of belonging to the house and there is no authority between health care providers and the patients in the house. The house is situated in a temple and a community and supported by many local nonprofit organizations and healthcare facilities such as a health promotion hospital at sub-disctrict level and Suratthani Cancer Hospital. Village health volunteers and multi-professional health care volunteers have contributed not only appropriate care, but also knowledge and experience to develop a distinguishing HHHS community-based palliative care model for patients with cancer. Since its opening the house has been a home for more than 400 patients and 300 family members. It is also a model for many national and international healthcare organizations and providers, who come to visit and learn about palliative care in and by community. Conclusions: The success of this palliative care model comes from community involvement, multi-professional volunteers and distributions, and concepts of HHHS model. Banpunrug promotes a consistent care across the cancer trajectory independent of prognosis in order to strengthen a full integration of palliative

Keywords: community-based palliative care, model, participatory action research, patients with cancer

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458 Household Climate-Resilience Index Development for the Health Sector in Tanzania: Use of Demographic and Health Surveys Data Linked with Remote Sensing

Authors: Heribert R. Kaijage, Samuel N. A. Codjoe, Simon H. D. Mamuya, Mangi J. Ezekiel

Abstract:

There is strong evidence that climate has changed significantly affecting various sectors including public health. The recommended feasible solution is adopting development trajectories which combine both mitigation and adaptation measures for improving resilience pathways. This approach demands a consideration for complex interactions between climate and social-ecological systems. While other sectors such as agriculture and water have developed climate resilience indices, the public health sector in Tanzania is still lagging behind. The aim of this study was to find out how can we use Demographic and Health Surveys (DHS) linked with Remote Sensing (RS) technology and metrological information as tools to inform climate change resilient development and evaluation for the health sector. Methodological review was conducted whereby a number of studies were content analyzed to find appropriate indicators and indices for climate resilience household and their integration approach. These indicators were critically reviewed, listed, filtered and their sources determined. Preliminary identification and ranking of indicators were conducted using participatory approach of pairwise weighting by selected national stakeholders from meeting/conferences on human health and climate change sciences in Tanzania. DHS datasets were retrieved from Measure Evaluation project, processed and critically analyzed for possible climate change indicators. Other sources for indicators of climate change exposure were also identified. For the purpose of preliminary reporting, operationalization of selected indicators was discussed to produce methodological approach to be used in resilience comparative analysis study. It was found that household climate resilient index depends on the combination of three indices namely Household Adaptive and Mitigation Capacity (HC), Household Health Sensitivity (HHS) and Household Exposure Status (HES). It was also found that, DHS alone cannot complement resilient evaluation unless integrated with other data sources notably flooding data as a measure of vulnerability, remote sensing image of Normalized Vegetation Index (NDVI) and Metrological data (deviation from rainfall pattern). It can be concluded that if these indices retrieved from DHS data sets are computed and scientifically integrated can produce single climate resilience index and resilience maps could be generated at different spatial and time scales to enhance targeted interventions for climate resilient development and evaluations. However, further studies are need to test for the sensitivity of index in resilience comparative analysis among selected regions.

Keywords: climate change, resilience, remote sensing, demographic and health surveys

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457 Diagnosis, Treatment, and Prognosis in Cutaneous Anaplastic Lymphoma Kinase-Positive Anaplastic Large Cell Lymphoma: A Narrative Review Apropos of a Case

Authors: Laura Gleason, Sahithi Talasila, Lauren Banner, Ladan Afifi, Neda Nikbakht

Abstract:

Primary cutaneous anaplastic large cell lymphoma (pcALCL) accounts for 9% of all cutaneous T-cell lymphomas. pcALCL is classically characterized as a solitary papulonodule that often enlarges, ulcerates, and can be locally destructive, but overall exhibits an indolent course with overall 5-year survival estimated to be 90%. Distinguishing pcALCL from systemic ALCL (sALCL) is essential as sALCL confers a poorer prognosis with average 5-year survival being 40-50%. Although extremely rare, there have been several cases of ALK-positive ALCL diagnosed on skin biopsy without evidence of systemic involvement, which poses several challenges in the classification, prognostication, treatment, and follow-up of these patients. Objectives: We present a case of cutaneous ALK-positive ALCL without evidence of systemic involvement, and a narrative review of the literature to further characterize that ALK-positive ALCL limited to the skin is a distinct variant with a unique presentation, history, and prognosis. A 30-year-old woman presented for evaluation of an erythematous-violaceous papule present on her right chest for two months. With the development of multifocal disease and persistent lymphadenopathy, a bone marrow biopsy and lymph node excisional biopsy were performed to assess for systemic disease. Both biopsies were unrevealing. The patient was counseled on pursuing systemic therapy consisting of Brentuximab, Cyclophosphamide, Doxorubicin, and Prednisone given the concern for sALCL. Apropos of the patient we searched for clinically evident, cutaneous ALK-positive ALCL cases, with and without systemic involvement, in the English literature. Risk factors, such as tumor location, number, size, ALK localization, ALK translocations, and recurrence, were evaluated in cases of cutaneous ALK-positive ALCL. The majority of patients with cutaneous ALK-positive ALCL did not progress to systemic disease. The majority of cases that progressed to systemic disease in adults had recurring skin lesions and cytoplasmic localization of ALK. ALK translocations did not influence disease progression. Mean time to disease progression was 16.7 months, and significant mortality (50%) was observed in those cases that progressed to systemic disease. Pediatric cases did not exhibit a trend similar to adult cases. In both the adult and pediatric cases, a subset of cutaneous-limited ALK-positive ALCL were treated with chemotherapy. All cases treated with chemotherapy did not progress to systemic disease. Apropos of an ALK-positive ALCL patient with clinical cutaneous limited disease in the histologic presence of systemic markers, we discussed the literature data, highlighting the crucial issues related to developing a clinical strategy to approach this rare subtype of ALCL. Physicians need to be aware of the overall spectrum of ALCL, including cutaneous limited disease, systemic disease, disease with NPM-ALK translocation, disease with ALK and EMA positivity, and disease with skin recurrence.

Keywords: anaplastic large cell lymphoma, systemic, cutaneous, anaplastic lymphoma kinase, ALK, ALCL, sALCL, pcALCL, cALCL

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456 Supplementing Aerial-Roving Surveys with Autonomous Optical Cameras: A High Temporal Resolution Approach to Monitoring and Estimating Effort within a Recreational Salmon Fishery in British Columbia, Canada

Authors: Ben Morrow, Patrick O'Hara, Natalie Ban, Tunai Marques, Molly Fraser, Christopher Bone

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Relative to commercial fisheries, recreational fisheries are often poorly understood and pose various challenges for monitoring frameworks. In British Columbia (BC), Canada, Pacific salmon are heavily targeted by recreational fishers while also being a key source of nutrient flow and crucial prey for a variety of marine and terrestrial fauna, including endangered Southern Resident killer whales (Orcinus orca). Although commercial fisheries were historically responsible for the majority of salmon retention, recreational fishing now comprises both greater effort and retention. The current monitoring scheme for recreational salmon fisheries involves aerial-roving creel surveys. However, this method has been identified as costly and having low predictive power as it is often limited to sampling fragments of fluid and temporally dynamic fisheries. This study used imagery from two shore-based autonomous cameras in a highly active recreational fishery around Sooke, BC, and evaluated their efficacy in supplementing existing aerial-roving surveys for monitoring a recreational salmon fishery. This study involved continuous monitoring and high temporal resolution (over one million images analyzed in a single fishing season), using a deep learning-based vessel detection algorithm and a custom image annotation tool to efficiently thin datasets. This allowed for the quantification of peak-season effort from a busy harbour, species-specific retention estimates, high levels of detected fishing events at a nearby popular fishing location, as well as the proportion of the fishery management area represented by cameras. Then, this study demonstrated how it could substantially enhance the temporal resolution of a fishery through diel activity pattern analyses, scaled monthly to visualize clusters of activity. This work also highlighted considerable off-season fishing detection, currently unaccounted for in the existing monitoring framework. These results demonstrate several distinct applications of autonomous cameras for providing enhanced detail currently unavailable in the current monitoring framework, each of which has important considerations for the managerial allocation of resources. Further, the approach and methodology can benefit other studies that apply shore-based camera monitoring, supplement aerial-roving creel surveys to improve fine-scale temporal understanding, inform the optimal timing of creel surveys, and improve the predictive power of recreational stock assessments to preserve important and endangered fish species.

Keywords: cameras, monitoring, recreational fishing, stock assessment

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455 Linear Evolution of Compressible Görtler Vortices Subject to Free-Stream Vortical Disturbances

Authors: Samuele Viaro, Pierre Ricco

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Görtler instabilities generate in boundary layers from an unbalance between pressure and centrifugal forces caused by concave surfaces. Their spatial streamwise evolution influences transition to turbulence. It is therefore important to understand even the early stages where perturbations, still small, grow linearly and could be controlled more easily. This work presents a rigorous theoretical framework for compressible flows using the linearized unsteady boundary region equations, where only the streamwise pressure gradient and streamwise diffusion terms are neglected from the full governing equations of fluid motion. Boundary and initial conditions are imposed through an asymptotic analysis in order to account for the interaction of the boundary layer with free-stream turbulence. The resulting parabolic system is discretize with a second-order finite difference scheme. Realistic flow parameters are chosen from wind tunnel studies performed at supersonic and subsonic conditions. The Mach number ranges from 0.5 to 8, with two different radii of curvature, 5 m and 10 m, frequencies up to 2000 Hz, and vortex spanwise wavelengths from 5 mm to 20 mm. The evolution of the perturbation flow is shown through velocity, temperature, pressure profiles relatively close to the leading edge, where non-linear effects can still be neglected, and growth rate. Results show that a global stabilizing effect exists with the increase of Mach number, frequency, spanwise wavenumber and radius of curvature. In particular, at high Mach numbers curvature effects are less pronounced and thermal streaks become stronger than velocity streaks. This increase of temperature perturbations saturates at approximately Mach 4 flows, and is limited in the early stage of growth, near the leading edge. In general, Görtler vortices evolve closer to the surface with respect to a flat plate scenario but their location shifts toward the edge of the boundary layer as the Mach number increases. In fact, a jet-like behavior appears for steady vortices having small spanwise wavelengths (less than 10 mm) at Mach 8, creating a region of unperturbed flow close to the wall. A similar response is also found at the highest frequency considered for a Mach 3 flow. Larger vortices are found to have a higher growth rate but are less influenced by the Mach number. An eigenvalue approach is also employed to study the amplification of the perturbations sufficiently downstream from the leading edge. These eigenvalue results are compared with the ones obtained through the initial value approach with inhomogeneous free-stream boundary conditions. All of the parameters here studied have a significant influence on the evolution of the instabilities for the Görtler problem which is indeed highly dependent on initial conditions.

Keywords: compressible boundary layers, Görtler instabilities, receptivity, turbulence transition

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454 Outcomes of Pregnancy in Women with TPO Positive Status after Appropriate Dose Adjustments of Thyroxin: A Prospective Cohort Study

Authors: Revathi S. Rajan, Pratibha Malik, Nupur Garg, Smitha Avula, Kamini A. Rao

Abstract:

This study aimed to analyse the pregnancy outcomes in patients with TPO positivity after appropriate L-Thyroxin supplementation with close surveillance. All pregnant women attending the antenatal clinic at Milann-The Fertility Center, Bangalore, India- from Aug 2013 to Oct 2014 whose booking TSH was more than 2.5 mIU/L were included along with those pregnant women with prior hypothyroidism who were TPO positive. Those with TPO positive status were vigorously managed with appropriate thyroxin supplementation and the doses were readjusted every 3 to 4 weeks until delivery. Women with recurrent pregnancy loss were also tested for TPO positivity and if tested positive, were monitored serially with TSH and fT4 levels every 3 to 4 weeks and appropriately supplemented with thyroxin when the levels fluctuated. The testing was done after an informed consent in all these women. The statistical software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Systat 12.0 and R environment ver.2.11.1 were used for the analysis of the data. 460 pregnant women were screened for thyroid dysfunction at booking of which 52% were hypothyroid. Majority of them (31.08%) were subclinically hypothyroid and the remaining were overt. 25% of the total no. of patients screened were TPO positive. The various pregnancy complications that were observed in the TPO positive women were gestational glucose intolerance [60%], threatened abortion [21%], midtrimester abortion [4.3%], premature rupture of membranes [4.3%], cervical funneling [4.3%] and fetal growth restriction [3.5%]. 95.6% of the patients who followed up till the end delivered beyond 30 weeks. 42.6% of these patients had previous history of recurrent abortions or adverse obstetric outcome and 21.7% of the delivered babies required NICU admission. Obstetric outcomes in our study in terms of midtrimester abortions, placental abruption, and preterm delivery improved for the better after close monitoring of the thyroid hormone [TSH and fT4] levels every 3 to 4 weeks with appropriate dose adjustment throughout pregnancy. Euthyroid women with TPO positive status enrolled in the study incidentally were those with recurrent abortions/infertility and required thyroxin supplements due to elevated Thyroid hormone (TSH, fT4) levels during the course of their pregnancy. Significant associations were found with age>30 years and Hyperhomocysteinemia [p=0.017], recurrent pregnancy loss or previous adverse obstetric outcomes [p=0.067] and APLA [p=0.029]. TPO antibody levels >600 I U/ml were significantly associated with development of gestational hypertension [p=0.041] and fetal growth restriction [p=0.082]. Euthyroid women with TPO positivity were also screened periodically to counter fluctuations of the thyroid hormone levels with appropriate thyroxin supplementation. Thus, early identification along with aggressive management of thyroid dysfunction and stratification of these patients based on their TPO status with appropriate thyroxin supplementation beginning in the first trimester will aid risk modulation and also help avert complications.

Keywords: TPO antibody, subclinical hypothyroidism, anti nuclear antibody, thyroxin

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