Fog computing-assisted path planning for smart shopping.

A Smart City (SC) is a viable solution for green and sustainable living, especially with the current explosion in global population and rural-urban immigration. One of the fields that is not getting much attention in the Smart Economy (SE) is customer satisfaction. The SE is a component of SC that is concerned with using Information and Communication Technology (ICT) to improve stages of the traditional economy. In this paper, we propose a fog computing-based shopping recommendation system. Our simulations used Al-Madinah city as a case study. It aims to improve the customer shopping experience. Customers in shopping malls can connect to the system via Wi-Fi. Then the system recommends products to the shoppers according to their preferences. It optimizes shoppers' schedules using price, the distance between the shops, and the congestion. It also improves customers' savings by up to 30%. It also increases the shopping speed by up to 6.12% compared to the system proposed in the literature.

Insidious Mass Within a Sinus.

A 75-year-old patient was incidentally found to have an intracardiac mass by echocardiography. Subsequent cardiac magnetic resonance imaging and cardiac positron emission tomography confirmed a large and possibly malignant mass extending from the right atrium into the coronary sinus. The patient underwent an intracardiac echocardiography guided biopsy, which revealed diffuse B-cell lymphoma, and is currently undergoing rituximab, etoposide, vincristine, cyclophosphamide, and doxorubicin (R-EPOCH)-based chemotherapy.

A Balanced Algorithm for In-City Parking Allocation: A Case Study of Al Madinah City.

Parking in heavily populated areas has been considered one of the main challenges in the transportation systems for the past two decades given the limited parking resources, especially in city centres. Drivers often waste long periods of time hunting for an empty parking spot, which causes congestion and consumes energy during the process. Thus, finding an optimal parking spot depends on several factors such as street traffic congestion, trip distance/time, the availability of a parking spot, the waiting time on the lot gate, and the parking fees. Designing a parking spot allocation algorithm that takes those factors into account is crucial for an efficient and high-availability parking service. We propose a smart routing and parking algorithm to allocate an optimal parking space given the aforementioned limiting factors. This algorithm supports choosing the appropriate travel route and parking lot while considering the real-time street traffic and candidate parking lots. A multi-objective function is introduced, with varying weights of the five factors to produce the optimal parking spot with the least congested route while achieving a balanced utilization for candidate parking lots and a balanced traffic distribution. A queueing model is also developed to investigate the availability rate in candidate parking lots while considering the arrival rate, departure rate, and the lot capacity. To evaluate the performance of the proposed algorithm, simulation scenarios have been performed for different cases of high and low traffic intensity rates. We have tested the algorithm on in-city parking facility in the city of Al Madinah as a case study. The results show that the proposed algorithm is effective in achieving a balanced utilization of the parking lots, reducing traffic congestion rates on all routes to candidate parking lots, and minimizing the driving time to the assigned parking spot. Additionally, the proposed algorithm outperforms the MADM algorithm in terms of the selected three metrics for the five periods.

An approximate analytical formula for estimating the weight of factors affecting the spread of COVID-19: a case study of the first wave.

COVID-19 pandemic has changed the way we live our lives for the foreseen future. To date, there have been over 113 million reported cases and 2.5 million deaths worldwide. Many studies investigated the factors affecting the number of daily cases such as weather conditions, lockdown duration and other factors. In this study, we propose a COVID-19 analytical formula for factors contributing to the number of the new coronavirus daily cases. We have also calculated values of relative weights of those factors. We focus on the first wave data that are publically available. Seven countries were considered including the UK, Italy, Spain, Canada, South Korea, Germany and France. We considered the following factors: temperature, humidity, government expenditure, lockdown hours and the number of daily tests for COVID-19 performed. The weights were calculated based on the hypothesis that a high correlation between recorded data of a given pair of countries implies a high correlation of the pair's COVID-19 proposed analytical formula. The factors are calculated using the brute-force technique. Our results showed that in five out of the seven countries; temperature, humidity, and lockdown duration were the most dominant with values of 26%, 32% and 38%, respectively. In other countries, however, humidity, government expenditure and the daily performed tests for COVID-19 were the most effective factors, with relative values of 35%, 26%, and 28%.

RF-Based UAV Detection and Identification Using Hierarchical Learning Approach.

Unmanned Aerial Vehicles (UAVs) are widely available in the current market to be used either for recreation as a hobby or to serve specific industrial requirements, such as agriculture and construction. However, illegitimate and criminal usage of UAVs is also on the rise which introduces their effective identification and detection as a research challenge. This paper proposes a novel machine learning-based for efficient identification and detection of UAVs. Specifically, an improved UAV identification and detection approach is presented using an ensemble learning based on the hierarchical concept, along with pre-processing and feature extraction stages for the Radio Frequency (RF) data. Filtering is applied on the RF signals in the detection approach to improve the output. This approach consists of four classifiers and they are working in a hierarchical way. The sample will pass the first classifier to check the availability of the UAV, and then it will specify the type of the detected UAV using the second classifier. The last two classifiers will handle the sample that is related to Bebop and AR to specify their mode. Evaluation of the proposed approach with publicly available dataset demonstrates better efficiency compared to existing detection systems in the literature. It has the ability to investigate whether a UAV is flying within the area or not, and it can directly identify the type of UAV and then the flight mode of the detected UAV with accuracy around 99%.

Spectral Diversification and Trans-Species Allelic Polymorphism during the Land-to-Sea Transition in Snakes.

Snakes are descended from highly visual lizards [1] but have limited (probably dichromatic) color vision attributed to a dim-light lifestyle of early snakes [2-4]. The living species of front-fanged elapids, however, are ecologically very diverse, with ∼300 terrestrial species (cobras, taipans, etc.) and ∼60 fully marine sea snakes, plus eight independently marine, amphibious sea kraits [1]. Here, we investigate the evolution of spectral sensitivity in elapids by analyzing their opsin genes (which are responsible for sensitivity to UV and visible light), retinal photoreceptors, and ocular lenses. We found that sea snakes underwent rapid adaptive diversification of their visual pigments when compared with their terrestrial and amphibious relatives. The three opsins present in snakes (SWS1, LWS, and RH1) have evolved under positive selection in elapids, and in sea snakes they have undergone multiple shifts in spectral sensitivity toward the longer wavelengths that dominate below the sea surface. Several relatively distantly related Hydrophis sea snakes are polymorphic for shortwave sensitive visual pigment encoded by alleles of SWS1. This spectral site polymorphism is expected to confer expanded "UV-blue" spectral sensitivity and is estimated to have persisted twice as long as the predicted survival time for selectively neutral nuclear alleles. We suggest that this polymorphism is adaptively maintained across Hydrophis species via balancing selection, similarly to the LWS polymorphism that confers allelic trichromacy in some primates. Diving sea snakes thus appear to share parallel mechanisms of color vision diversification with fruit-eating primates.

Localized Hypermutation is the Major Driver of Meningococcal Genetic Variability during Persistent Asymptomatic Carriage.

Host persistence of bacteria is facilitated by mutational and recombinatorial processes that counteract loss of genetic variation during transmission and selection from evolving host responses. Genetic variation was investigated during persistent asymptomatic carriage of Neisseria meningitidis Interrogation of whole-genome sequences for paired isolates from 25 carriers showed that de novo mutations were infrequent, while horizontal gene transfer occurred in 16% of carriers. Examination of multiple isolates per time point enabled separation of sporadic and transient allelic variation from directional variation. A comprehensive comparative analysis of directional allelic variation with hypermutation of simple sequence repeats and hyperrecombination of class 1 type IV pilus genes detected an average of seven events per carrier and 2:1 bias for changes due to localized hypermutation. Directional genetic variation was focused on the outer membrane with 69% of events occurring in genes encoding enzymatic modifiers of surface structures or outer membrane proteins. Multiple carriers exhibited directional and opposed switching of allelic variants of the surface-located Opa proteins that enables continuous expression of these adhesins alongside antigenic variation. A trend for switching from PilC1 to PilC2 expression was detected, indicating selection for specific alterations in the activities of the type IV pilus, whereas phase variation of restriction modification (RM) systems, as well as associated phasevarions, was infrequent. We conclude that asymptomatic meningococcal carriage on mucosal surfaces is facilitated by frequent localized hypermutation and horizontal gene transfer affecting genes encoding surface modifiers such that optimization of adhesive functions occurs alongside escape of immune responses by antigenic variation.IMPORTANCE Many bacterial pathogens coexist with host organisms, rarely causing disease while adapting to host responses. Neisseria meningitidis, a major cause of meningitis and septicemia, is a frequent persistent colonizer of asymptomatic teenagers/young adults. To assess how genetic variation contributes to host persistence, whole-genome sequencing and hypermutable sequence analyses were performed on multiple isolates obtained from students naturally colonized with meningococci. High frequencies of gene transfer were observed, occurring in 16% of carriers and affecting 51% of all nonhypermutable variable genes. Comparative analyses showed that hypermutable sequences were the major mechanism of variation, causing 2-fold more changes in gene function than other mechanisms. Genetic variation was focused on genes affecting the outer membrane, with directional changes in proteins responsible for bacterial adhesion to host surfaces. This comprehensive examination of genetic plasticity in individual hosts provides a significant new platform for rationale design of approaches to prevent the spread of this pathogen.

Bacterial pathogens and antibiotic resistance patterns in children with urinary tract infection in a Malaysian tertiary hospital.

INTRODUCTION: Urinary tract infection (UTI) is a common bacterial infection affecting children and therefore, prompt recognition and accurate antimicrobial management are vital to prevent kidney damage. This study aims to determine the bacterial pathogens and their patterns of antimicrobial resistance in children presenting with UTI. METHODS: A retrospective study of 721 cases, involving children between the ages of 1-day old to 13 years old with culture-proven UTI in Selayang Hospital, Malaysia between January 2007 and December 2011. The bacterial pathogens and antibiotic resistance patterns in the total population, prophylaxis and no prophylaxis groups were studied. RESULTS: The 3 most common organisms isolated in the total population were E.Coli (41.6%), Klebsiella spp. (21.2%) and Enterococcus spp. (11.0%). With regards to the antibiotic resistance, E.Coli resistance rates to ampicillin, cefuroxime and gentamicin were 67.7%, 15.3% and 7.3% respectively. Ampicillin-resistance was also highest in Klebsiella spp. (84.3%), Enterococcus spp. (15.5%) and Proteus spp. (55.5%). CONCLUSION: E.coli remains to be the leading bacterial pathogen causing UTI in children, with ampicillin-resistance occurring in more than half of these cases. Therefore, accurate choice of antibiotics is important to ensure optimal outcome. In our study, cefuroxime and gentamicin have lower antibiotic resistance rates and can be used in the treatment of UTI in children.

Colonoscopic findings and management of patients with outbreak typhoid fever presenting with lower gastrointestinal bleeding.

Lower gastrointestinal bleeding (LGIB) along with intestinal perforation is a well-known complication of typhoid fever. Reports of colonoscopic appearance and intervention of typhoid perforation involve only few cases. This series reports the colonoscopic findings and the role of colonoscopic hemostatic interventions in controlling the bleeding ileocolonic lesions. During the typhoid fever outbreak in Sulaymaniyah City in Iraqi Kurdistan Region, we received 52 patients with LGIB manifesting as fresh bleeding per rectum or melena. We performed total colonoscopy with ileal intubation for all cases. The findings were recorded and endoscopic hemostatic intervention with adrenaline-saline injection and argon plasma coagulation was applied to actively bleeding lesion. These patients were young, 11-30 years of age, with female preponderance. Blood culture was positive in 50 %. Colonoscopic findings were mostly located in the ileocecal region, although other areas of the colon were involved in many cases. Twenty-four percent of the cases required endoscopic hemostatic intervention by adrenaline injection with argon plasma coagulation which was effective in all patients except one who died in spite of surgical intervention in addition of endoscopic hemostasis. Dual endoscopic hemostatic intervention can be a safe and effective management option for patients with LGIB due to typhoid fever.

Spinal injuries in a level-one trauma centre: a demographic study.

The incidence of spinal injuries in Malaysia is on the rise following similar trend of rapid development and increasing number of building constructions sites, and motor vehicles. This epidemiological study was aimed at compiling local data with a view to identifying target areas for preventive measures as well as improvement strategies in the management of these potentially devastating injuries. Seventy eight patients admitted with spine trauma in 1998 in a level-one trauma centre were retrospectively reviewed. All records were traced from the admission and discharge books of the orthopaedic wards, accident and emergency wards, operative registration book, spinal rehabilitation ward and orthopaedic registration data of the Department of Orthopaedics, Hospital Kuala Lumpur. Details on pre-treatment neurological and radiological level of injury and post-treatment outcomes were recorded according to the American Spinal Injury Association (ASIA) impairment scale. Most patients (61.5%) were in the productive ages of less than 34 years with a 4:1 male to female ratio. Majority were due to motor vehicle accidents (57.7%) and fall from a height (28.3%). The thoraco-lumbar junction was the most common site of injury followed by the lower cervical region with 62.5% of which associated with neurological deficit. Neurological deficits: 11 ASIA-A, 1 ASIA-B, 6 ASIA-C, and 3 ASIA-D were detected in 21 (27%) patients with fall from height (50%) particularly landing on the feet (50%) and recreational sports (100%) were the risk factors. Less than 10% of patients were treated surgically and this explains an average 39.4 days of hospitalization (5 times longer in patients treated non-operatively). On discharge, four patients with incomplete neurology recovered to ASIA-E status and the remaining improved to ASIA-C and -D in one and five patients respectively. Only one patient with complete neurology improved to ASIA-B status following surgical treatment. The demographic profiles of our patients were comparable to other series in the literature but still inadequate to provide enough epidemiological data. A multicenter study to provide a larger pool of patients is needed.

The HUKM Spinal Instrumentation System for adolescent idiopathic scoliosis. A biomechanical comparison study using finite element analysis.

This finite element analysis is aimed at comparing relative stiffness of three different posterior instrumentation constructs: the Hospital Universiti Kebangsaan Malaysia Spinal Instrumentation System (HUKM-SIS), the Cotrell-Dubousset Instrumentation (CDI) and Harrington Instrumentation System (HIS), used in the treatment of adolescent idiopathic scoliosis (AIS). The constructs were tested under various loads using MSC Patran 2001 r2a. Under increasing flexion loads, there was a linearly corresponding increase in deflection magnitudes for all constructs on the load-deflection curve. The CDI was the stiffest construct under axial, forward flexion and extension loads, followed by the HUKM-SIS and HIS. Under lateral bending loads, the HUKM-SIS construct was the stiffest followed by CDI and HIS. The HUKM-SIS construct was stiffer than HIS under torsional loads. We conclude that multiple pedicle screws increase the stiffness of posterior instrumentation constructs under all loads and inter-segmental spinous processes wiring increase the stiffness against lateral bending.

Geriatric dentistry education in European dental schools.

As the numbers of elderly adults continue to grow within European populations, the need for dental students to be trained in the management of geriatric patients becomes increasingly important. Many dental schools have developed training programmes in geriatric dentistry in response to the changing oral health needs of older adults. The purpose of this on-line survey was to identify the current status of geriatric dentistry education in European dental schools. A questionnaire relating to the teaching of geriatric dentistry was posted on the Internet, and 194 dental schools in 34 European countries were invited to participate. Data from completed questionnaires were submitted to the investigators via email from 82 schools in 27 countries (42% response rate). Thirty-six percent of schools offered a specific geriatric dentistry course that included didactic teaching or seminar groups, 21% taught geriatric dentistry by means of organised presentations in the curriculum, and 36% taught the subject by occasional lectures. 7% of schools did not teach geriatric dentistry at all. A clinical component to the geriatric dentistry curriculum was reported by 61% of schools and 18% reported operating a specific geriatric dentistry clinic within the school. Of those providing clinical geriatric dentistry training, it was provided within the school in 45% of cases, with a further 29% of schools providing training both within the school and at a remote location. Seven percent of schools operated a mobile dental clinic for treating geriatric patients. Twenty-eight percent of schools had a geriatric programme director or a chairman of a geriatric section and 39% indicated that they plan to extend the teaching of geriatric dentistry in the future. Geriatric dental education has clearly established itself in the curricula of European dental schools although the format of teaching the subject varies widely. It is of concern that geriatric dentistry was not taught at all in 7% of schools. No data are available concerning whether or not geriatric dentistry is taught in the 58% non-responding schools.

Spinal bone density and tooth loss in a cohort of postmenopausal women.

Osteoporosis has been suggested to contribute to the edentulous condition. However, studies specifically designed to examine the relationship between tooth loss and osteoporosis are scarce, and reported results have been mixed. This study investigated the correlation between tooth loss and spinal bone density in a nonHispanic white female population. Forty-four subjects were recruited and divided into high and low spinal bone density groups based on whether the bone density was higher or lower than the age-adjusted population mean bone density. Missing teeth and periodontal status in these groups were assessed and analyzed. Tooth loss was not significantly different between subjects with low spinal bone density (4.90 +/- 0.89 teeth) and high spinal bone density (3.81 +/- 0.90 teeth). Tooth loss did not differ after age and periodontal adjustment. However, the loss of attachment levels (relative to the cementoenamel junction) was greater in the low spinal bone density subjects (3.42 +/- 0.30 mm) than in the high spinal bone density subjects (2.37 +/- 0.26 mm) (P < .05). The difference may have resulted from gingival recession (P < .05), because the gingival pocket depths were not significantly different between the two groups. In this study, total tooth loss was not directly associated with systemic bone density. However, periodontal disease was negatively associated with spinal bone density. Whether periodontal disease will ultimately lead to greater tooth loss in low spinal bone density group merits further investigation.

The strength of association between systemic postmenopausal osteoporosis and periodontal disease.

This cross-sectional study examined the strength of association between systemic osteoporosis and periodontal status in postmenopausal non-Hispanic white women. Twenty subjects with low bone density and a spine bone density of 0.753 +/- 0.039 dual-energy x-ray absorptiometry units (g/cm2) and 22 subjects with high bone density and a spine bone density of 1.032 +/- 0.028 dual-energy x-ray absorptiometry units (g/cm2) were randomly selected from a cohort of 565 women. Periodontal assessment included Plaque Index, Gingival Index, pocket depth, gingival recession, and periodontal attachment level. There were no significant differences in Plaque Index, Gingival Index, and probing depth in both groups; however, there were significant differences in gingival recession components of periodontal attachment level in both groups. This study suggests that systemic osteoporosis may contribute to periodontal attachment loss in the form of gingival recession.

A pilot study of panoramic film density at selected sites in the mandible to predict osteoporosis.

Osteoporosis is the most common metabolic disease and presents a major public health problem among the elderly. This retrospective pilot study was designed to determine the strength of association of spinal bone density and the density of selected mandibular sites as determined from panoramic radiographs. Panoramic films of known low bone density and high bone density women between the ages of 50 and 75 were evaluated. These films were randomized and then converted to digital images for density analysis. Significant differences were noted between the groups at the 95th percentile. Further study is needed to ascertain the value of panoramic radiology as an adjunct diagnostic tool in the screening of patients thought to be at high risk of developing osteoporosis.

Osteoporosis and periodontal disease: a review.

A review of the literature on the relationship between osteoporosis and periodontal disease is presented. Osteoporosis, a metabolic disease, and periodontal disease, which is infectious, are both major health problems with multifactorial etiologies. There is histologic and radiographic evidence from animals and humans that osteoporosis does affect alveolar bone by decreasing bone mass and trabeculation. The literature reviewed in this paper suggests, but does not yet provide conclusive evidence for, a direct relationship between osteoporosis and periodontal disease.

Effects of dimethylbenz[a]anthracene-induced malignancy on the subcellular distribution of peripheral benzodiazepine receptors in submandibular glands of rats.

The binding of [3H]Ro 5-4864 to peripheral benzodiazepine receptors (PBRs) was studied in normal and malignant submandibular glands of rats. The carcinoma was induced by implantation of 7,12-dimethylbenz[a]anthracene (DMBA) into the glands. [3H]Ro 5-4864 binding to normal and malignant submandibular glands indicated one population of binding sites with high affinity (KD of 3.4 and 4.4 nM for normal and malignant respectively) and saturability (Bmax) of 487 and 321 pmol/g tissue for normal and malignant respectively). Subcellular localization of PBRs indicates that mitochondria was the primary locale of the receptor in both cases and the decrease in Bmax was due primarily to a decrease in the binding capacity of PBRs in mitochondria.

Oral ulcerations.

Ulcerations are common occurrences in the mouth. Causes include physical trauma, radiation, chemical injury, and microbial infection (bacterial, viral, and fungal). Some ulcerations, such as recurrent aphthous stomatitis, Behçet's syndrome, and erythema multiforme, are of uncertain etiology, whereas others (eg, pemphigus, pemphigoid) are apparently of immunologic origin. Malignant neoplasms also may present as ulcerations. Because the natural history and treatment varies with the diagnosis, the practitioner should become familiar with the clinical appearance of the various types of ulcerations so that appropriate treatment can be instituted.