Search results for: security risk
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8490

Search results for: security risk

6420 Profiling Risky Code Using Machine Learning

Authors: Zunaira Zaman, David Bohannon

Abstract:

This study explores the application of machine learning (ML) for detecting security vulnerabilities in source code. The research aims to assist organizations with large application portfolios and limited security testing capabilities in prioritizing security activities. ML-based approaches offer benefits such as increased confidence scores, false positives and negatives tuning, and automated feedback. The initial approach using natural language processing techniques to extract features achieved 86% accuracy during the training phase but suffered from overfitting and performed poorly on unseen datasets during testing. To address these issues, the study proposes using the abstract syntax tree (AST) for Java and C++ codebases to capture code semantics and structure and generate path-context representations for each function. The Code2Vec model architecture is used to learn distributed representations of source code snippets for training a machine-learning classifier for vulnerability prediction. The study evaluates the performance of the proposed methodology using two datasets and compares the results with existing approaches. The Devign dataset yielded 60% accuracy in predicting vulnerable code snippets and helped resist overfitting, while the Juliet Test Suite predicted specific vulnerabilities such as OS-Command Injection, Cryptographic, and Cross-Site Scripting vulnerabilities. The Code2Vec model achieved 75% accuracy and a 98% recall rate in predicting OS-Command Injection vulnerabilities. The study concludes that even partial AST representations of source code can be useful for vulnerability prediction. The approach has the potential for automated intelligent analysis of source code, including vulnerability prediction on unseen source code. State-of-the-art models using natural language processing techniques and CNN models with ensemble modelling techniques did not generalize well on unseen data and faced overfitting issues. However, predicting vulnerabilities in source code using machine learning poses challenges such as high dimensionality and complexity of source code, imbalanced datasets, and identifying specific types of vulnerabilities. Future work will address these challenges and expand the scope of the research.

Keywords: code embeddings, neural networks, natural language processing, OS command injection, software security, code properties

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6419 The Role of the Renal Specialist Podiatrist

Authors: Clara Luwe, Oliver Harness, Helena Meally, Kim Martin, Alexandra Harrington

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Background: The role of ‘Renal Specialist Podiatrist’ originated in 2022 due to prevailing evidence of patients with diabetes and end-stage renal disease (ESRD) on haemodialysis (HD) and active ulcerations that were at higher risk of rapid deterioration, foot-related hospital admissions, and lower limb amputations. This role started in April 2022 with the aim of screening all patients on haemodialysis and instigating preventative measures to reduce serious foot related complications. Methods: A comprehensive neurovascular foot assessment was completed to establish baseline vascular status and identify those with peripheral arterial disease (PAD) for all patients on HD. Individual’s foot risk was stratified, advice and education tailored and issued. Identifying all diabetes patients on HD as high-risk for diabetic foot complications. Major Findings: All patients screened revealed over half of the caseload had diabetes, and more than half had a clinical presentation of PAD. All those presenting with ulcerations had a diagnosis of diabetes. Of the presenting ulcerations, the majority of these ulcers predated the renal specialist post and were classified as severe >3 SINBAD Score. Since April’22, complications have been identified quicker, reducing the severity (SINBAD<3 or below), and have improved healing times, in line with the national average. During the eight months of the role being in place, we have seen a reduction in minor amputations and no major amputations. Conclusion: By screening all patients on haemodialysis and focusing on education, early recognition of complications, appropriate treatment, and timely onward referral, we can reduce the risk of foot Diabetic foot ulcerations and lower limb amputations. Having regular podiatry input to stratify and facilitate high-risk, active wound patients across different services has helped to keep these patients stable, prevent amputations, and reduce foot-related hospital admissions and mortality from foot-related disease. By improving the accessibility to a specialist podiatrist, patients felt able to raise concerns sooner. This has helped to implement treatment at the earliest possible opportunity, enabling the identification and healing of ulcers at an earlier and less complex stage (SINBAD <3), thus, preventing potential limb-threatening complications.

Keywords: renal, podiatry, haemodialysis, prevention, early detection

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6418 Association between Hypertensive Disorders of Pregnancy and the Development of Offspring Mental and Behavioural Problems: Systematic Review and Meta-Analysis

Authors: Berihun Dachew, Abdullah Mamun, Joemer Maravilla, Rosa Alati

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Background: Hypertensive disorders of pregnancy are a major cause of maternal and childhood morbidity and mortality worldwide. However, its effect on offspring mental and behavioural disorders is unclear. Aims:The aim of this study was to provide the best scientific evidence regarding the association between hypertensive disorders of pregnancy and offspring mental and behavioural problems. Methods: We systematically searched Scopus, PubMed, Cochrane, EMBASE, CINAH and PsycINFO databases. A total of 23 studies (11 included in meta-analysis) were identified. A qualitative analysis was conducted by summarizing, comparing, and contrasting the abstracted data for all included studies. For quantitative analysis, relative risk (RR) with 95% confidence interval (95% CI) was used as pooled effect size. Heterogeneity was assessed by measuring Cochran’s Q and I2 test statistics. Results: Of the 23 studies included in this review, 15 studies found that hypertensive disorders of pregnancy had a negative impact for at least one mental or behavioural problem. The pooled effect of 11 studies included in the meta-analysis showed that preeclampsia was associated with increased risk of offspring schizophrenia (RR=1.37; 95% CI, 1.08-1.72). Conclusions: Intrauterine exposure to pre-eclampsia increased the risk of schizophrenia among offspring. However, we found inconclusive finding on the effect of hypertensive disorders of pregnancy and other mental and behavioural problems. Further high quality, large sample, mother child cohort studies are needed to further progress this area of research.

Keywords: behavioural disorders, hypertensive disorders of pregnancy, mental disorders, offspring

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6417 The Development of the Psychosomatic Nursing Model from an Evidence-Based Action Research on Proactive Mental Health Care for Medical Inpatients

Authors: Chia-Yi Wu, Jung-Chen Chang, Wen-Yu Hu, Ming-Been Lee

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In nearly all physical health conditions, suicide risk is increased compared to healthy people even after adjustment for age, gender, mental health, and substance use diagnoses. In order to highlight the importance of suicide risk assessment for the inpatients and early identification and engagement for inpatients’ mental health problems, a study was designed aiming at developing a comprehensive psychosomatic nursing engagement (PSNE) model with standardized operation procedures informing how nurses communicate, assess, and engage with the inpatients with emotional distress. The purpose of the study was to promote the gatekeeping role of clinical nurses in performing brief assessment and interventions to detect depression and anxiety symptoms among the inpatients, particularly in non-psychiatric wards. The study will be carried out in a 2000-bed university hospital in Northern Taiwan in 2019. We will select a ward for trial and develop feasible procedures and in-job training course for the nurses to offer mental health care, which will also be validated through professional consensus meeting. The significance of the study includes the following three points: (1) The study targets at an important but less-researched area of PSNE model in the cultural background of Taiwan, where hospital service is highly accessible, but mental health and suicide risk assessment are hardly provided by non-psychiatric healthcare personnel. (2) The issue of PSNE could be efficient and cost-effective in the identification of suicide risks at an early stage to prevent inpatient suicide or to reduce future suicide risk by early treatment of mental illnesses among the high-risk group of hospitalized patients who are more than three-times lethal to suicide. (3) Utilizing a brief tool with its established APP ('The Five-item Brief Symptom Rating Scale, BSRS-5'), we will invent the standardized procedure of PSNE and referral steps in collaboration with the medical teams across the study hospital. New technological tools nested within nursing assessment/intervention will concurrently be invented to facilitate better care quality. The major outcome measurements will include tools for early identification of common mental distress and suicide risks, i.e., the BSRS-5, revised BSRS-5, and the 9-item Concise Mental Health Checklist (CMHC-9). The main purpose of using the CMHC-9 in clinical suicide risk assessment is mainly to provide care and build-up therapeutic relationship with the client, so it will also be used to nursing training highlighting the skills of supportive care. Through early identification of the inpatients’ depressive symptoms or other mental health care needs such as insomnia, anxiety, or suicide risk, the majority of the nursing clinicians would be able to engage in critical interventions that alleviate the inpatients’ suffering from mental health problems, given a feasible nursing input.

Keywords: mental health care, clinical outcome improvement, clinical nurses, suicide prevention, psychosomatic nursing

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6416 Forecast Dispersion, Investor Sentiment and the Cross Section of Stock Returns

Authors: Guoyu Lin

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This paper explores the role investor sentiment plays in the relationship between analyst forecast dispersion and stock returns. With short sale constraints, stock prices are determined by the optimistic investors. During the high sentiment periods when investors suffer more from psychological bias, there are more optimistic investors. This is the first paper to document that following the high sentiment periods, stocks with the most analyst forecast dispersion are overpriced, earning significantly negative returns, while those with the least analyst forecast dispersion are not overpriced as the degree of belief dispersion is low. However, following the low sentiment periods, both are not overpriced. A portfolio which longs the least dispersed stocks and shorts the most dispersed stocks yields significantly positive returns only following the high sentiment periods. My findings can potentially reconcile the puzzling risk effect and mispricing effect in the literature. The risk (mispricing) effect suggests a positive (negative) relation between analyst forecast dispersion and future stock returns. Presumably, the magnitude of the mispricing effect depends on the proportion of irrational investors and their bias, which is positively related to investor sentiment. During the high sentiment period, the mispricing effect takes over and the overall effect is negative. During the low sentiment period, the percentage of irrational investors is mediate, and the mispricing effect and the risk effect counter each other, leading to insignificant relation.

Keywords: analyst forecast dispersion, short-sale constraints, investor sentiment, stock returns

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6415 Foodborne Pathogens in Different Types of Milk: From the Microbiome to Risk Assessment

Authors: Pasquali Frederique, Manfreda Chiara, Crippa Cecilia, Indio Valentina, Ianieri Adriana, De Cesare Alessandra

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Microbiological hazards can be transmitted to humans through milk. In this study, we compared the microbiome composition and presence of foodborne pathogens in organic milk (n=6), organic hay milk (n=6), standard milk (n=6) and high-quality milk (n=6). The milk samples were collected during six samplings between December 2022 to January 2023 and between April and May 2024 to take into account seasonal variations. The 24 milk samples were submitted to DNA extraction and library preparation before shotgun sequencing on the Illumina HiScan™ SQ System platform. The total sequencing output was 600 GB. In all the milk samples, the phyla with the highest relative abundances were Pseudomonadota, Bacillota, Ascomycota, Actinomycetota and Apicomplexa, while the most represented genera were Pseudomonas, Streptococcus, Geotrichum, Acinetobacter and Babesia. The alpha and beta diversity indexes showed a clear separation between the microbiome of high-quality milk and those of the other milk types. Moreover, in the high-quality milk, the relative abundance of Staphylococcus (4.4%), Campylobacter (4.5%), Bacillus (2.5%), Enterococcus (2.4%), Klebsiella (1.3%) and Escherichia (0 .7%) was significantly higher in comparison to other types of milk. On the contrary, the relative abundance of Geotrichum (0.5%) was significantly lower. The microbiome results collected in this study showed significant differences in terms of the relative abundance of bacteria genera, including foodborne pathogen species. These results should be incorporated into risk assessment models tailored to different types of milk.

Keywords: raw milk, foodborne pathogens, microbiome, risk assessment

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6414 Risk of Heatstroke Occurring in Indoor Built Environment Determined with Nationwide Sports and Health Database and Meteorological Outdoor Data

Authors: Go Iwashita

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The paper describes how the frequencies of heatstroke occurring in indoor built environment are related to the outdoor thermal environment with big statistical data. As the statistical accident data of heatstroke, the nationwide accident data were obtained from the National Agency for the Advancement of Sports and Health (NAASH) . The meteorological database of the Japanese Meteorological Agency supplied data about 1-hour average temperature, humidity, wind speed, solar radiation, and so forth. Each heatstroke data point from the NAASH database was linked to the meteorological data point acquired from the nearest meteorological station where the accident of heatstroke occurred. This analysis was performed for a 10-year period (2005–2014). During the 10-year period, 3,819 cases of heatstroke were reported in the NAASH database for the investigated secondary/high schools of the nine Japanese representative cities. Heatstroke most commonly occurred in the outdoor schoolyard at a wet-bulb globe temperature (WBGT) of 31°C and in the indoor gymnasium during athletic club activities at a WBGT > 31°C. The determined accident ratio (number of accidents during each club activity divided by the club’s population) in the gymnasium during the female badminton club activities was the highest. Although badminton is played in a gymnasium, these WBGT results show that the risk level during badminton under hot and humid conditions is equal to that of baseball or rugby played in the schoolyard. Except sports, the high risk of heatstroke was observed in schools houses during cultural activities. The risk level for indoor environment under hot and humid condition would be equal to that for outdoor environment based on the above results of WBGT. Therefore control measures against hot and humid indoor condition were needed as installing air conditions not only schools but also residences.

Keywords: accidents in schools, club activity, gymnasium, heatstroke

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6413 Perception of Nurses and Caregivers on Fall Preventive Management for Hospitalized Children Based on Ecological Model

Authors: Mirim Kim, Won-Oak Oh

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Purpose: The purpose of this study was to identify hospitalized children's fall risk factors, fall prevention status and fall prevention strategies recognized by nurses and caregivers of hospitalized children and present an ecological model for fall preventive management in hospitalized children. Method: The participants of this study were 14 nurses working in medical institutions and having more than one year of child care experience and 14 adult caregivers of children under 6 years of age receiving inpatient treatment at a medical institution. One to one interview was attempted to identify their perception of fall preventive management. Transcribed data were analyzed through latent content analysis method. Results: Fall risk factors in hospitalized children were 'unpredictable behavior', 'instability', 'lack of awareness about danger', 'lack of awareness about falls', 'lack of child control ability', 'lack of awareness about the importance of fall prevention', 'lack of sensitivity to children', 'untidy environment around children', 'lack of personalized facilities for children', 'unsafe facility', 'lack of partnership between healthcare provider and caregiver', 'lack of human resources', 'inadequate fall prevention policy', 'lack of promotion about fall prevention', 'a performanceism oriented culture'. Fall preventive management status of hospitalized children were 'absence of fall prevention capability', 'efforts not to fall', 'blocking fall risk situation', 'limit the scope of children's activity when there is no caregiver', 'encourage caregivers' fall prevention activities', 'creating a safe environment surrounding hospitalized children', 'special management for fall high risk children', 'mutual cooperation between healthcare providers and caregivers', 'implementation of fall prevention policy', 'providing guide signs about fall risk'. Fall preventive management strategies of hospitalized children were 'restrain dangerous behavior', 'inspiring awareness about fall', 'providing fall preventive education considering the child's eye level', 'efforts to become an active subject of fall prevention activities', 'providing customed fall prevention education', 'open communication between healthcare providers and caregivers', 'infrastructure and personnel management to create safe hospital environment', 'expansion fall prevention campaign', 'development and application of a valid fall assessment instrument', 'conversion of awareness about safety'. Conclusion: In this study, the ecological model of fall preventive management for hospitalized children reflects various factors that directly or indirectly affect the fall prevention of hospitalized children. Therefore, these results can be considered as useful baseline data for developing systematic fall prevention programs and hospital policies to prevent fall accident in hospitalized children. Funding: This study was funded by the National Research Foundation of South Korea (grant number NRF-2016R1A2B1015455).

Keywords: fall down, safety culture, hospitalized children, risk factors

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6412 Cloud Monitoring and Performance Optimization Ensuring High Availability

Authors: Inayat Ur Rehman, Georgia Sakellari

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Cloud computing has evolved into a vital technology for businesses, offering scalability, flexibility, and cost-effectiveness. However, maintaining high availability and optimal performance in the cloud is crucial for reliable services. This paper explores the significance of cloud monitoring and performance optimization in sustaining the high availability of cloud-based systems. It discusses diverse monitoring tools, techniques, and best practices for continually assessing the health and performance of cloud resources. The paper also delves into performance optimization strategies, including resource allocation, load balancing, and auto-scaling, to ensure efficient resource utilization and responsiveness. Addressing potential challenges in cloud monitoring and optimization, the paper offers insights into data security and privacy considerations. Through this thorough analysis, the paper aims to underscore the importance of cloud monitoring and performance optimization for ensuring a seamless and highly available cloud computing environment.

Keywords: cloud computing, cloud monitoring, performance optimization, high availability, scalability, resource allocation, load balancing, auto-scaling, data security, data privacy

Procedia PDF Downloads 58
6411 Study on Impact of Road Loads on Full Vehicle Squeak and Rattle Performance

Authors: R. Praveen, B. R. Chandan Ravi, M. Harikrishna

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Squeak and rattle noises are the most annoying transient vehicle noises produced due to different terrain conditions. Interpretation and prohibition of squeak and rattle noises are the dominant aspects of a vehicle refinement. This paper describes the computer-aided engineering (CAE) approach to evaluating the full vehicle squeak and rattle performance with the measured road surface profile as enforced excitation at the tire patch points. The E-Line methodology has been used to predict the relative displacement at the interface points and the risk areas were identified. Squeak and rattle performance has been evaluated at different speeds and at different road conditions to understand the vehicle characteristics. The competence of the process in predicting the risk and root cause of the problems showcased us a pleasing conformity between the physical testing and CAE simulation results.

Keywords: e-line, enforced excitation, full vehicle, squeak and rattle, road excitation

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6410 Prevalence of Complement Factor H (Y402H) Gene Polymorphism and Its Impact on the Predisposition of Syrians to Age-Related Macular Degeneration (AMD) and Response to Bevacizumab Intravitreal Injection

Authors: Loubna Safar, Lama Youssef, Majd Aljamali

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Age-related macular degeneration (AMD) is one of the leading causes of blindness worldwide. Complement factor H polymorphism (Y402H) is thought to play a potential role in the predisposition to AMD and response of patients with exudative AMD to treatment with anti-Vascular Endothelial Growth Factor (anti-VEGF). This study aimed to investigate the frequency of Y402H among Syrians, its impact on their susceptibility to AMD, and the hypothesized role of Y402H in patients' response to intravitreal anti-VEGF (i.e.,, bevacizumab). Our case-control study encompassed unrelated 54 AMD cases and 44 controls. Genotyping was determined by standard sequencing of PCR products. Frequency was compared between patients and controls, and correlation between genotype and response to treatment was assessed in 20 patients with wet AMD who received a therapeutic course of three intravitreal bevacizumab injections (once monthly). Our results revealed a significantly higher prevalence of the risk allele C among AMD cases (51.9%) in comparison with controls (37.5%) (P= 0.04, OR= 1.386, CI= 0.999- 1.923). Patients with the TT genotype (no risk allele) exhibited a significantly better primary response rate, reached 87.5% compared to only 41.7% in patients carrying the risk allele C (TC + CC), (P= 0.04, OR= 9.8, CI=0.899- 106.84). The findings of this study prove the importance of investigating Y402H polymorphism as a prognostic marker for predicting response to bevacizumab in AMD patients.

Keywords: age-related macular degeneration, bevacizumab, complement factor H gene, polymorphism, Y402H

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6409 Safety Management on Construction Sites

Authors: Jonathan Doku

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The study's goal was to evaluate construction site safety management in Ghana. The construction sector has long been seen as a high-risk business. It entails a variety of hazardous and challenging labor duties, such as lifting and working at a height, among others. The accident rate is a standard indicator for comparing the safety performance of construction projects. Because of its high-risk and fast-changing work environment, the construction business is regarded as one of the industries with the highest accident rates in the world. Many mishaps and work-related diseases have occurred there, and construction workers are particularly vulnerable to catastrophic calamities such as falls, collapses, and burial. The study's main goals were to discover characteristics that have a substantial impact on construction site safety, to evaluate the safety management methods utilized on construction sites, and to assess the obstacles associated with construction site safety management. The study was conducted using a quantitative research method and a purposive sampling strategy. Google forms were used to distribute self-administered surveys to 85 responders. 72 of the 85 questionnaires were completed and submitted for analysis, accounting for 84.7 percent of the total. The variables were analyzed using descriptive statistics, mean score ranking, and Cronbach's Alpha Coefficient to ensure the scale's reliability. The formal safety organization structure and the Safety checklist were identified as the key practices of safety management on site as part of the study goals. In addition, it was discovered that the most serious problem with safety management is ineffective supervision. To guarantee efficient monitoring and proper implementation of health and safety rules on building sites, management must be on the ball.

Keywords: construction, safety, risk, management

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6408 Hypertension and Obesity: A Cross-National Comparison of BMI and Waist-Height Ratio

Authors: Adam M. Yates, Julie E. Byles

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Hypertension has been identified as a prominent co-morbidity of obesity. To improve clinical intervention of hypertension, it is critical to identify metrics that most accurately reflect risk for increased morbidity. Two of the most relevant and accurate measures for increased risk of hypertension due to excess adipose tissue are Body Mass Index (BMI) and Waist-Height Ratio (WHtR). Previous research has examined these measures in cross-national and cross-ethnic studies, but has most often relied on secondary means such as meta-analysis to identify and evaluate the efficacy of individual body mass measures. In this study, we instead use cross-sectional analysis to assess the cross-ethnic discriminative power of BMI and WHtR to predict risk of hypertension. Using the WHO SAGE survey, which collected anthropometric and biometric data from respondents in six middle-income countries (China, Ghana, India, Mexico, Russia, South Africa), we implement logistic regression to examine the discriminative power of measured BMI and WHtR with a known population of hypertensive and non-hypertensive respondents. We control for gender and age to identify whether optimum cut-off points that are adequately sensitive as tests for risk of hypertension may be different between groups. We report results for OR, RR, and ROC curves for each of the six SAGE countries. As seen in existing literature, results demonstrate that both WHtR and BMI are significant predictors of hypertension (p < .01). For these six countries, we find that cut-off points for WHtR may be dependent upon gender, age and ethnicity. While an optimum omnibus cut-point for WHtR may be 0.55, results also suggest that the gender and age relationship with WHtR may warrant the development of individual cut-offs to optimize health outcomes. Trends through multiple countries show that the optimum cut-point for WHtR increases with age while the area under the curve (AUROC) decreases for both men and women. Comparison between BMI and WHtR indicate that BMI may remain more robust than WHtR. Implications for public health policy are discussed.

Keywords: hypertension, obesity, Waist-Height ratio, SAGE

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6407 A Comparison of Methods for Neural Network Aggregation

Authors: John Pomerat, Aviv Segev

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Recently, deep learning has had many theoretical breakthroughs. For deep learning to be successful in the industry, however, there need to be practical algorithms capable of handling many real-world hiccups preventing the immediate application of a learning algorithm. Although AI promises to revolutionize the healthcare industry, getting access to patient data in order to train learning algorithms has not been easy. One proposed solution to this is data- sharing. In this paper, we propose an alternative protocol, based on multi-party computation, to train deep learning models while maintaining both the privacy and security of training data. We examine three methods of training neural networks in this way: Transfer learning, average ensemble learning, and series network learning. We compare these methods to the equivalent model obtained through data-sharing across two different experiments. Additionally, we address the security concerns of this protocol. While the motivating example is healthcare, our findings regarding multi-party computation of neural network training are purely theoretical and have use-cases outside the domain of healthcare.

Keywords: neural network aggregation, multi-party computation, transfer learning, average ensemble learning

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6406 Measurements for Risk Analysis and Detecting Hazards by Active Wearables

Authors: Werner Grommes

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Intelligent wearables (illuminated vests or hand and foot-bands, smart watches with a laser diode, Bluetooth smart glasses) overflow the market today. They are integrated with complex electronics and are worn very close to the body. Optical measurements and limitation of the maximum light density are needed. Smart watches are equipped with a laser diode or control different body currents. Special glasses generate readable text information that is received via radio transmission. Small high-performance batteries (lithium-ion/polymer) supply the electronics. All these products have been tested and evaluated for risk. These products must, for example, meet the requirements for electromagnetic compatibility as well as the requirements for electromagnetic fields affecting humans or implant wearers. Extensive analyses and measurements were carried out for this purpose. Many users are not aware of these risks. The result of this study should serve as a suggestion to do it better in the future or simply to point out these risks. Commercial LED warning vests, LED hand and foot-bands, illuminated surfaces with inverter (high voltage), flashlights, smart watches, and Bluetooth smart glasses were checked for risks. The luminance, the electromagnetic emissions in the low-frequency as well as in the high-frequency range, audible noises, and nervous flashing frequencies were checked by measurements and analyzed. Rechargeable lithium-ion or lithium-polymer batteries can burn or explode under special conditions like overheating, overcharging, deep discharge or using out of the temperature specification. Some risk analysis becomes necessary. The result of this study is that many smart wearables are worn very close to the body, and an extensive risk analysis becomes necessary. Wearers of active implants like a pacemaker or implantable cardiac defibrillator must be considered. If the wearable electronics include switching regulators or inverter circuits, active medical implants in the near field can be disturbed. A risk analysis is necessary.

Keywords: safety and hazards, electrical safety, EMC, EMF, active medical implants, optical radiation, illuminated warning vest, electric luminescent, hand and head lamps, LED, e-light, safety batteries, light density, optical glare effects

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6405 Managing Uncertainty in Unmanned Aircraft System Safety Performance Requirements Compliance Process

Authors: Achim Washington, Reece Clothier, Jose Silva

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System Safety Regulations (SSR) are a central component to the airworthiness certification of Unmanned Aircraft Systems (UAS). There is significant debate on the setting of appropriate SSR for UAS. Putting this debate aside, the challenge lies in how to apply the system safety process to UAS, which lacks the data and operational heritage of conventionally piloted aircraft. The limited knowledge and lack of operational data result in uncertainty in the system safety assessment of UAS. This uncertainty can lead to incorrect compliance findings and the potential certification and operation of UAS that do not meet minimum safety performance requirements. The existing system safety assessment and compliance processes, as used for conventional piloted aviation, do not adequately account for the uncertainty, limiting the suitability of its application to UAS. This paper discusses the challenges of undertaking system safety assessments for UAS and presents current and envisaged research towards addressing these challenges. It aims to highlight the main advantages associated with adopting a risk based framework to the System Safety Performance Requirement (SSPR) compliance process that is capable of taking the uncertainty associated with each of the outputs of the system safety assessment process into consideration. Based on this study, it is made clear that developing a framework tailored to UAS, would allow for a more rational, transparent and systematic approach to decision making. This would reduce the need for conservative assumptions and take the risk posed by each UAS into consideration while determining its state of compliance to the SSR.

Keywords: Part 1309 regulations, risk models, uncertainty, unmanned aircraft systems

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6404 Scalable Performance Testing: Facilitating The Assessment Of Application Performance Under Substantial Loads And Mitigating The Risk Of System Failures

Authors: Solanki Ravirajsinh

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In the software testing life cycle, failing to conduct thorough performance testing can result in significant losses for an organization due to application crashes and improper behavior under high user loads in production. Simulating large volumes of requests, such as 5 million within 5-10 minutes, is challenging without a scalable performance testing framework. Leveraging cloud services to implement a performance testing framework makes it feasible to handle 5-10 million requests in just 5-10 minutes, helping organizations ensure their applications perform reliably under peak conditions. Implementing a scalable performance testing framework using cloud services and tools like JMeter, EC2 instances (Virtual machine), cloud logs (Monitor errors and logs), EFS (File storage system), and security groups offers several key benefits for organizations. Creating performance test framework using this approach helps optimize resource utilization, effective benchmarking, increased reliability, cost savings by resolving performance issues before the application is released. In performance testing, a master-slave framework facilitates distributed testing across multiple EC2 instances to emulate many concurrent users and efficiently handle high loads. The master node orchestrates the test execution by coordinating with multiple slave nodes to distribute the workload. Slave nodes execute the test scripts provided by the master node, with each node handling a portion of the overall user load and generating requests to the target application or service. By leveraging JMeter's master-slave framework in conjunction with cloud services like EC2 instances, EFS, CloudWatch logs, security groups, and command-line tools, organizations can achieve superior scalability and flexibility in their performance testing efforts. In this master-slave framework, JMeter must be installed on both the master and each slave EC2 instance. The master EC2 instance functions as the "brain," while the slave instances operate as the "body parts." The master directs each slave to execute a specified number of requests. Upon completion of the execution, the slave instances transmit their results back to the master. The master then consolidates these results into a comprehensive report detailing metrics such as the number of requests sent, encountered errors, network latency, response times, server capacity, throughput, and bandwidth. Leveraging cloud services, the framework benefits from automatic scaling based on the volume of requests. Notably, integrating cloud services allows organizations to handle more than 5-10 million requests within 5 minutes, depending on the server capacity of the hosted website or application.

Keywords: identify crashes of application under heavy load, JMeter with cloud Services, Scalable performance testing, JMeter master and slave using cloud Services

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6403 Market Solvency Capital Requirement Minimization: How Non-linear Solvers Provide Portfolios Complying with Solvency II Regulation

Authors: Abraham Castellanos, Christophe Durville, Sophie Echenim

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In this article, a portfolio optimization problem is performed in a Solvency II context: it illustrates how advanced optimization techniques can help to tackle complex operational pain points around the monitoring, control, and stability of Solvency Capital Requirement (SCR). The market SCR of a portfolio is calculated as a combination of SCR sub-modules. These sub-modules are the results of stress-tests on interest rate, equity, property, credit and FX factors, as well as concentration on counter-parties. The market SCR is non convex and non differentiable, which does not make it a natural optimization criteria candidate. In the SCR formulation, correlations between sub-modules are fixed, whereas risk-driven portfolio allocation is usually driven by the dynamics of the actual correlations. Implementing a portfolio construction approach that is efficient on both a regulatory and economic standpoint is not straightforward. Moreover, the challenge for insurance portfolio managers is not only to achieve a minimal SCR to reduce non-invested capital but also to ensure stability of the SCR. Some optimizations have already been performed in the literature, simplifying the standard formula into a quadratic function. But to our knowledge, it is the first time that the standard formula of the market SCR is used in an optimization problem. Two solvers are combined: a bundle algorithm for convex non- differentiable problems, and a BFGS (Broyden-Fletcher-Goldfarb- Shanno)-SQP (Sequential Quadratic Programming) algorithm, to cope with non-convex cases. A market SCR minimization is then performed with historical data. This approach results in significant reduction of the capital requirement, compared to a classical Markowitz approach based on the historical volatility. A comparative analysis of different optimization models (equi-risk-contribution portfolio, minimizing volatility portfolio and minimizing value-at-risk portfolio) is performed and the impact of these strategies on risk measures including market SCR and its sub-modules is evaluated. A lack of diversification of market SCR is observed, specially for equities. This was expected since the market SCR strongly penalizes this type of financial instrument. It was shown that this direct effect of the regulation can be attenuated by implementing constraints in the optimization process or minimizing the market SCR together with the historical volatility, proving the interest of having a portfolio construction approach that can incorporate such features. The present results are further explained by the Market SCR modelling.

Keywords: financial risk, numerical optimization, portfolio management, solvency capital requirement

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6402 Total Plaque Area in Chronic Renal Failure

Authors: Hernán A. Perez, Luis J. Armando, Néstor H. García

Abstract:

Background and aims Cardiovascular disease rates are very high in patients with renal failure (CRF), but the underlying mechanisms are incompletely understood. Traditional cardiovascular risk factors do not explain the increased risk, and observational studies have observed paradoxical or absent associations between classical risk factors and mortality in dialysis patients. A large randomized controlled trial, the 4D Study, the AURORA and the ALERT study found that statin therapy in CRF do not reduce cardiovascular events. These results may be the results of ‘accelerated atherosclerosis’ observed on these patients. The objective of this study was to investigate if carotid total plaque area (TPA), a measure of carotid plaque burden growth is increased at progressively lower creatinine clearance in patients with CRF. We studied a cohort of patients with CRF not on dialysis, reasoning that risk factor associations might be more easily discerned before end stage renal disease. Methods: The Blossom DMO Argentina ethics committee approved the study and informed consent from each participant was obtained. We performed a cohort study in 412 patients with Stage 1, 2 and 3 CRF. Clinical and laboratory data were obtained. TPA was determined using bilateral carotid ultrasonography. Modification of Diet in Renal Disease estimation formula was used to determine renal function. ANOVA was used when appropriate. Results: Stage 1 CRF group (n= 16, 43±2yo) had a blood pressure of 123±2/78±2 mmHg, BMI 30±1, LDL col 145±10 mg/dl, HbA1c 5.8±0.4% and had the lowest TPA 25.8±6.9 mm2. Stage 2 CRF (n=231, 50±1 yo) had a blood pressure of 132±1/81±1 mmHg, LDL col 125±2 mg/dl, HbA1c 6±0.1% and TPA 48±10mm2 ( p< 0.05 vs CRF stage 1) while Stage 3 CRF (n=165, 59±1 yo) had a blood pressure of 134±1/81±1, LDL col 125±3 mg/dl, HbA1c 6±0.1% and TPA 71±6mm2 (p < 0.05 vs CRF stage 1 and 2). Conclusion: Our data indicate that TPA increases along the renal function deterioration, and it is not related with the LDL cholesterol and triglycerides levels. We suggest that mechanisms other than the classics are responsible for the observed excess of cardiovascular disease in CKD patients and finally, determination of total plaque area should be used to measure effects of antiatherosclerotic therapy.

Keywords: hypertension, chronic renal failure, atherosclerosis, cholesterol

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6401 Epidemiological, Clinical, Diagnostic Indicators and Treatment Efficiency of Patients with Immune Thrombocytopenic Purpura Diagnosed in Albania

Authors: Sara Grazhdani, Alma Cili, Arben Ivanaj

Abstract:

Immune Thrombocytopenic Purpura is an autoimmune disease characterized by the destruction of platelets by immune mediators, their deficient production in the red bone marrow and increased splenic sequestration, leading to the appearance of thrombocytopenia and increased risk of hemorrhage. Treatment is indicated in patients with low platelet counts (<30 x 10 9 /L) who present clinically with hemorrhagic events or are at increased risk for hemorrhage. The goal of the treatment remains (I) prevention of hemorrhagic events and deaths resulting from them, (II) reaching an adequate level of the number of platelets, (III) treatment of patients with as few toxic effects as possible. Corticosteroid therapy remains the first choice in the treatment of patients with Primary Immune Thrombocytopenic Purpura. Rituximab (Mabthera) remains the first choice in the second line in the treatment of patients with Immune Thrombocytopenic Purpura, refractory to the use of cortisones.

Keywords: ITP, rituximab, prednisolone, relapse

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6400 Violent Conflict and the Protection of Women from Sex and Gender-Based Violence: A Third World Feminist Critique of the United Nations Women, Peace, and Security Agenda

Authors: Seember Susan Aondoakura

Abstract:

This paper examines the international legal framework established to address the challenges women and girls experience in situations of violent conflict. The United Nations (UN) women, peace, and security agenda (hereafter WPS agenda, the Agenda) aspire to make wars safer for women. It recognizes women's agency in armed conflict and their victimization and formulates measures for their protection. The Agenda also acknowledges women's participation in conflict transformation and post-conflict reconstruction. It also calls for the involvement of women in conflict transformation, encourages the protection of women from sex and gender-based violence (SGBV), and provides relief and recovery from conflict-related SGBV. Using Third World Critical Feminist Theory, this paper argues that the WPS agenda overly focus on the protection of women from SGBV occurring in the less developed and conflict-ridden states in the global south, obscures the complicity of western states and economies to the problem, and silences the privileges that such states derive from war economies that continue to fuel conflict. This protectionist approach of the UN also obliterates other equally pressing problems in need of attention, like the high rates of economic degradation in conflict-ravaged societies of the global south. Prioritising protection also 'others' the problem, obliterating any sense of interconnections across geographical locations and situating women in the less developed economies of the global south as the victims and their men as the perpetrators. Prioritising protection ultimately situates western societies as saviours of Third World women with no recourse to their role in engendering and sustaining war. The paper demonstrates that this saviour mentality obliterates chances of any meaningful coalition between the local and the international in framing and addressing the issue, as solutions are formulated from a specific lens—the white hegemonic lens.

Keywords: conflict, protection, security, SGBV

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6399 Scenario Analysis to Assess the Competitiveness of Hydrogen in Securing the Italian Energy System

Authors: Gianvito Colucci, Valeria Di Cosmo, Matteo Nicoli, Orsola Maria Robasto, Laura Savoldi

Abstract:

The hydrogen value chain deployment is likely to be boosted in the near term by the energy security measures planned by European countries to face the recent energy crisis. In this context, some countries are recognized to have a crucial role in the geopolitics of hydrogen as importers, consumers and exporters. According to the European Hydrogen Backbone Initiative, Italy would be part of one of the 5 corridors that will shape the European hydrogen market. However, the set targets are very ambitious and require large investments to rapidly develop effective hydrogen policies: in this regard, scenario analysis is becoming increasingly important to support energy planning, and energy system optimization models appear to be suitable tools to quantitively carry on that kind of analysis. The work aims to assess the competitiveness of hydrogen in contributing to the Italian energy security in the coming years, under different price and import conditions, using the energy system model TEMOA-Italy. A wide spectrum of hydrogen technologies is included in the analysis, covering the production, storage, delivery, and end-uses stages. National production from fossil fuels with and without CCS, as well as electrolysis and import of low-carbon hydrogen from North Africa, are the supply solutions that would compete with other ones, such as natural gas, biomethane and electricity value chains, to satisfy sectoral energy needs (transport, industry, buildings, agriculture). Scenario analysis is then used to study the competition under different price and import conditions. The use of TEMOA-Italy allows the work to catch the interaction between the economy and technological detail, which is much needed in the energy policies assessment, while the transparency of the analysis and of the results is ensured by the full accessibility of the TEMOA open-source modeling framework.

Keywords: energy security, energy system optimization models, hydrogen, natural gas, open-source modeling, scenario analysis, TEMOA

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6398 A Proposed Optimized and Efficient Intrusion Detection System for Wireless Sensor Network

Authors: Abdulaziz Alsadhan, Naveed Khan

Abstract:

In recent years intrusions on computer network are the major security threat. Hence, it is important to impede such intrusions. The hindrance of such intrusions entirely relies on its detection, which is primary concern of any security tool like Intrusion Detection System (IDS). Therefore, it is imperative to accurately detect network attack. Numerous intrusion detection techniques are available but the main issue is their performance. The performance of IDS can be improved by increasing the accurate detection rate and reducing false positive. The existing intrusion detection techniques have the limitation of usage of raw data set for classification. The classifier may get jumble due to redundancy, which results incorrect classification. To minimize this problem, Principle Component Analysis (PCA), Linear Discriminant Analysis (LDA), and Local Binary Pattern (LBP) can be applied to transform raw features into principle features space and select the features based on their sensitivity. Eigen values can be used to determine the sensitivity. To further classify, the selected features greedy search, back elimination, and Particle Swarm Optimization (PSO) can be used to obtain a subset of features with optimal sensitivity and highest discriminatory power. These optimal feature subset used to perform classification. For classification purpose, Support Vector Machine (SVM) and Multilayer Perceptron (MLP) used due to its proven ability in classification. The Knowledge Discovery and Data mining (KDD’99) cup dataset was considered as a benchmark for evaluating security detection mechanisms. The proposed approach can provide an optimal intrusion detection mechanism that outperforms the existing approaches and has the capability to minimize the number of features and maximize the detection rates.

Keywords: Particle Swarm Optimization (PSO), Principle Component Analysis (PCA), Linear Discriminant Analysis (LDA), Local Binary Pattern (LBP), Support Vector Machine (SVM), Multilayer Perceptron (MLP)

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6397 Investigating the Performance of Power Industry in a Developing Nation for Industrialization and Environmental Security

Authors: Abel Edeowede Abhulimen

Abstract:

Due to supply irregularity and frequent outages, the need for reliability in power supply has grown unsatisfactorily over time in developing nations, impeding industrialization and fueling insecurity. This article attempts to break down the Nigerian power issue into its numerous sub-sectors in order to pinpoint the industry's ailment and suggest a viable fix. Monthly average performance data were obtained for the various sub-sectors across the industry for eight consecutive quarters. Whereas the amount of energy generated was found to be insufficient to engender industrialization in a nation like Nigeria, the transmission infrastructure was inadequate for the amount of power needed to be wheeled. Additionally, the distribution sub-sector was plagued with problems such as revenue collection inefficiency, severe enough to impede the growth of the entire industry. The country's goal of attaining energy sufficiency and industrialization would significantly be closer to reality with a conscious effort to increase the base of power generation through aggressive investment in Combined Cycle Gas Turbines (CCGT), decentralization of the transmission infrastructure, and strict monitoring of the distribution sub-sector for improved accountability and system reliability.

Keywords: performance, power industry, industrialization, security, energy

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6396 An Empirical Study of Factors that Impact Government E-Services Acceptance by Citizens: Case Study from UAE

Authors: Emad Bataineh, Sara Al-Mutawa

Abstract:

The primary focus of this study is to investigate and identify the perceptions of potential end users relating to factors which impact on e-services acceptance. Technology Acceptance Model (TAM) has been adopted in this study as it can be extended when technologies are introduced. This research validates the developed TAM model and evaluates the variance of the outcome variable (acceptance of e-services). Five factors were adopted as determinants of acceptance of e-services: ease of use, security, trust, web skills, and language. The study was undertaken in the General Directorate of Residency and Foreigners Affairs (GDRFA) in the UAE. A quantitative survey methodology was adopted in this study, which surveyed 466 customers who use the GDRFA e-services. The overall findings revealed that security language, web skills and support significantly affected ease of use and perceived usefulness. However, the trust doesn’t affect the ease of use. Further, ease of use significantly affects intention to use and perceived usefulness while in turn intention to use was influenced by perceived usefulness. This study offers an understanding of people’s adoption of e-government services with the help of established theories such as TAM and various factors that influence the e-government adoption with reference to UAE.

Keywords: e-government portal, e-service, usability, TAM model

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6395 The Neutrophil-to-Lymphocyte Ratio after Surgery for Hip Fracture in a New, Simple, and Objective Score to Predict Postoperative Mortality

Authors: Philippe Dillien, Patrice Forget, Harald Engel, Olivier Cornu, Marc De Kock, Jean Cyr Yombi

Abstract:

Introduction: Hip fracture precedes commonly death in elderly people. Identification of high-risk patients may contribute to target patients in whom optimal management, resource allocation and trials efficiency is needed. The aim of this study is to construct a predictive score of mortality after hip fracture on the basis of the objective prognostic factors available: Neutrophil-to-lymphocyte ratio (NLR), age, and sex. C-Reactive Protein (CRP), is also considered as an alternative to the NLR. Patients and methods: After the IRB approval, we analyzed our prospective database including 286 consecutive patients with hip fracture. A score was constructed combining age (1 point per decade above 74 years), sex (1 point for males), and NLR at postoperative day+5 (1 point if >5). A receiver-operating curve (ROC) curve analysis was performed. Results: From the 286 patients included, 235 were analyzed (72 males and 163 females, 30.6%/69.4%), with a median age of 84 (range: 65 to 102) years, mean NLR values of 6.47+/-6.07. At one year, 82/280 patients died (29.3%). Graphical analysis and log-rank test confirm a highly statistically significant difference (P<0.001). Performance analysis shows an AUC of 0.72 [95%CI 0.65-0.79]. CRP shows no advantage on NLR. Conclusion: We have developed a score based on age, sex and the NLR to predict the risk of mortality at one year in elderly patients after surgery for a hip fracture. After external validation, it may be included in clinical practice as in clinical research to stratify the risk of postoperative mortality.

Keywords: neutrophil-to-lymphocyte ratio, hip fracture, postoperative mortality, medical and health sciences

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6394 Application of Watershed Modeling System for Urbanization Management in Tabuk Area, Saudi Arabia

Authors: Abd-Alrahman Embaby, Ayman Abu Halawa, Medhat Ramadan

Abstract:

The infiltrated water into the subsurface activates expansive soil in localized manner, leading to the differential heaving and destructive of the construction. The Watershed Modeling System (WMS) and Hydrologic Engineering Center (HEC-1) are used to delineate and identify the drainage system and basin morphometry in Tabuk area, where flash floods and accumulation of water may take place. Eight drainage basins effect on Tabuk city. Three of them are expected to be high. The flash floods and surface runoff behavior in these basins are important for any protection projects. It was found that the risky areas that contain Tabuk shale could be expanded when exposed to flash floods and/or surface runoff. The resident neighborhoods in the middle of Tabuk city and affected by surface runoff of the tributaries of the basin of Wadi Abu Nishayfah, Na'am and Atanah outlet, represent high-risk zones. These high-risk neighborhoods are Al Qadsiyah, Al Maseif, Arrwdah, Al Nakhil and Al Rajhi. It can be avoided new constructions on these districts. The low or very low-risk zones include the western and the eastern districts. The western side of the city is lying in the upstream of the small basin. It is suitable for a future urban extension. The direction of surface runoff flow or storm water drain discharge should be away from Tabuk city. The quicker the water can flow out, the better it is.

Keywords: digital elevation model (DEM), flash floods, Saudi Arabia, Tabuk City, watershed modeling system (WMS)

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6393 An Analysis of Non-Elliptic Curve Based Primality Tests

Authors: William Wong, Zakaria Alomari, Hon Ching Lai, Zhida Li

Abstract:

Modern-day information security depends on implementing Diffie-Hellman, which requires the generation of prime numbers. Because the number of primes is infinite, it is impractical to store prime numbers for use, and therefore, primality tests are indispensable in modern-day information security. A primality test is a test to determine whether a number is prime or composite. There are two types of primality tests, which are deterministic tests and probabilistic tests. Deterministic tests are adopting algorithms that provide a definite answer whether a given number is prime or composite. While in probabilistic tests, a probabilistic result would be provided, there is a degree of uncertainty. In this paper, we review three probabilistic tests: the Fermat Primality Test, the Miller-Rabin Test, and the Baillie-PSW Test, as well as one deterministic test, the Agrawal-Kayal-Saxena (AKS) Test. Furthermore, we do an analysis of these tests. All of the reviews discussed are not based on the Elliptic Curve. The analysis demonstrates that, in the majority of real-world scenarios, the Baillie- PSW test’s favorability stems from its typical operational complexity of O(log 3n) and its capacity to deliver accurate results for numbers below 2^64.

Keywords: primality tests, Fermat’s primality test, Miller-Rabin primality test, Baillie-PSW primality test, AKS primality test

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6392 Prevalence and Associated Factors of Overweight and Obesity in Children with Intellectual Disability: A Cross-Sectional Study among Chinese Children

Authors: Jing-Jing Wang, Yang Gao, Heather H. M. Kwok, Wendy Y. J. Huang

Abstract:

Objectives: Intellectual disability (ID) ranks among the top 20 most costly disorders. A child with ID creates a wide set of challenges to the individual, family, and society, and overweight and obesity aggravate those challenges. People with ID have the right to attain optimal health like the rest of the population. They should be given priority to eliminate existing health inequities. Childhood obesity epidemic and associated factors among children, in general, has been well documented, while knowledge about overweight and obesity in children with ID is scarce. Methods: A cross-sectional study was conducted among 524 Chinese children with ID (males: 68.9%, mean age: 12.2 years) in Hong Kong in 2015. Children’s height and weight were measured at school. Parents, in the presence of their children, completed a self-administered questionnaire at home about the children’s physical activity (PA), eating habits, and sleep duration in a typical week as well as parenting practices regarding children’s eating and PA, and their socio-demographic characteristics. Multivariate logistic regression estimated the potential risk factors for children being overweight. Results: The prevalence of overweight and obesity in children with ID was 31.3%, which was higher than their general counterparts (18.7%-19.9%). Multivariate analyses revealed that the risk factors of overweight and obese in children with ID included: comorbidity with autism, the maternal side being overweight or obese, parenting practices with less pressure to eat more, children having shorter sleep duration, longer periods of sedentary behavior, and higher intake frequencies of sweetened food, fried food, and meats, fish, and eggs. Children born in other places, having snacks more frequently, and having irregular meals were also more likely to be overweight or obese, with marginal significance. Conclusions: Children with ID are more vulnerable to being overweight or obese than their typically developing counterparts. Identified risk factors in this study highlight a multifaceted approach to the involvement of parents as well as the modification of some children’s questionable behaviors to help them achieve a healthy weight.

Keywords: prevalence, risk factors, obesity, children with disability

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6391 Pregnancy Outcome in Women with HIV Infection from a Tertiary Care Centre of India

Authors: Kavita Khoiwal, Vatsla Dadhwal, K. Aparna Sharma, Dipika Deka, Plabani Sarkar

Abstract:

Introduction: About 2.4 million (1.93 - 3.04 million) people are living with HIV/AIDS in India. Of all HIV infections, 39% (9,30,000) are among women. 5.4% of infections are from mother to child transmission (MTCT), 25,000 infected children are born every year. Besides the risk of mother to child transmission of HIV, these women are at risk of the higher adverse pregnancy outcome. The objectives of the study were to compare the obstetric and neonatal outcome in women who are HIV positive with low-risk HIV negative women and effect of antiretroviral drugs on preterm birth and IUGR. Materials and Methods: This is a retrospective case record analysis of 212 HIV-positive women delivering between 2002 to 2015, in a tertiary health care centre which was compared with 238 HIV-negative controls. Women who underwent medical termination of pregnancy and abortion were excluded from the study. Obstetric outcome analyzed were pregnancy induced hypertension, HIV positive intrauterine growth restriction, preterm birth, anemia, gestational diabetes and intrahepatic cholestasis of pregnancy. Neonatal outcome analysed were birth weight, apgar score, NICU admission and perinatal transmission.HIV-positiveOut of 212 women, 204 received antiretroviral therapy (ART) to prevent MTCT, 27 women received single dose nevirapine (sdNVP) or sdNVP tailed with 7 days of zidovudine and lamivudine (ZDV + 3TC), 15 received ZDV, 82 women received duovir and 80 women received triple drug therapy depending upon the time period of presentation. Results: Mean age of 212 HIV positive women was 25.72+3.6 years, 101 women (47.6 %) were primigravida. HIV positive status was diagnosed during pregnancy in 200 women while 12 women were diagnosed prior to conception. Among 212 HIV positive women, 20 (9.4 %) women had preterm delivery (< 37 weeks), 194 women (91.5 %) delivered by cesarean section and 18 women (8.5 %) delivered vaginally. 178 neonates (83.9 %) received exclusive top feeding and 34 neonates (16.03 %) received exclusive breast feeding. When compared to low risk HIV negative women (n=238), HIV positive women were more likely to deliver preterm (OR 1.27), have anemia (OR 1.39) and intrauterine growth restriction (OR 2.07). Incidence of pregnancy induced hypertension, diabetes mellitus and ICP was not increased. Mean birth weight was significantly lower in HIV positive women (2593.60+499 gm) when compared to HIV negative women (2919+459 gm). Complete follow up is available for 148 neonates till date, rest are under evaluation. Out of these 7 neonates found to have HIV positive status. Risk of preterm birth (P value = 0.039) and IUGR (P value = 0.739) was higher in HIV positive women who did not receive any ART during pregnancy than women who received ART. Conclusion: HIV positive pregnant women are at increased risk of adverse pregnancy outcome. Multidisciplinary team approach and use of highly active antiretroviral therapy can optimize the maternal and perinatal outcome.

Keywords: antiretroviral therapy, HIV infection, IUGR, preterm birth

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