An Optimized IoT-enabled Big Data Analytics Architecture for Edge-Cloud Computing.

The awareness of edge computing is attaining eminence and is largely acknowledged with the rise of Internet of Things (IoT). Edge-enabled solutions offer efficient computing and control at the network edge to resolve the scalability and latency-related concerns. Though, it comes to be challenging for edge computing to tackle diverse applications of IoT as they produce massive heterogeneous data. The IoT-enabled frameworks for Big Data analytics face numerous challenges in their existing structural design, for instance, the high volume of data storage and processing, data heterogeneity, and processing time among others. Moreover, the existing proposals lack effective parallel data loading and robust mechanisms for handling communication overhead. To address these challenges, we propose an optimized IoT-enabled big data analytics architecture for edge-cloud computing using machine learning. In the proposed scheme, an edge intelligence module is introduced to process and store the big data efficiently at the edges of the network with the integration of cloud technology. The proposed scheme is composed of two layers: IoT-edge and Cloud-processing. The data injection and storage is carried out with an optimized MapReduce parallel algorithm. Optimized Yet Another Resource Negotiator (YARN) is used for efficiently managing the cluster. The proposed data design is experimentally simulated with an authentic dataset using Apache Spark. The comparative analysis is decorated with existing proposals and traditional mechanisms. The results justify the efficiency of our proposed work.

Evaluation of chemical characterization and antihyperlipidemic potential of orange peel powder (Citrus sinensis) in male human subjects.

Citrus sinensis is an important member of the genus Citrus which contains phenolic compounds and bioflavonoids which have antihyperlipidemic and antiatherogenic effects. It also has the potential to reduce oxidative stress. To investigate the antihyperlipidemic effect of orange peel powder was encapsulated and analyzed in hyperlipidemic patients. Results showed that it contains moisture (12.2%), ash content (7.9%), crude fat (0.78%), crude protein (12.37%) and crude fiber (13.2%). Total phenolic content and total flavonoid content were observed as 163.17 mg and 17.23mg in quercetin equivalent per gram a dry weight basis. Furthermore, the Orange peel powder was given in the form of medicinal capsules to hyperlipidemia male subjects. The experimental groups (G1 and G2) were given orange peel powder in capsules 400mg/d to the G1 group and 800mg/d to the G2 group for the time of 45 days. The serum lipid profile of patients was measured before and after the experimental trial. The result showed that G1 and G2 showed a decrease in plasma lipid parameters and increased high-density lipoprotein content in blood substantially as compared to G0. Thus, it was concluded from the results that orange peel powder depicts a significant impact on treating hyperlipidemia.

Efficiency, market concentration and bank performance during the COVID-19 outbreak: Evidence from the MENA region.

This study aims to contribute to the existing literature that explores the impact of market concentration on bank efficiency in emerging economies. Using a sample of 225 banks in 18 countries in the Middle East and North Africa (MENA) region over the period 2006-2020, we empirically investigate the significance of this relationship. Since the evidence of concentration effect on efficiency during the COVID-19 outbreak is ambiguous, we test the hypothesis that the efficiency is positively affected by the level of banking market concentration in the MENA region. We adopt fixed effect model specifications and test the robustness of our results with the two-step Generalized Method of Moments (GMM) estimation technique. Our analysis finds a strong positive association between market concentration and bank efficiency. The analysis of different types of banking systems that co-existing in the MENA region (Islamic and conventional) indicates the market concentration effect is more pronounced when the banking institution is Islamic and during the COVID-19 outbreak. Moreover, the better economic performance of Islamic banks during the initial stage of pandemic further increases their efficiency. Our analysis indicated that the impact of market competitive conditions on bank efficiency varies significantly across banks with different ownership structures and is more pronounced for government-owned banks. The results are robust using different model specifications and alternative estimation techniques.

Description of Dissolved Organic Matter Transformational Networks at the Molecular Level.

Dissolved Organic Matter (DOM) is an important component of the global carbon cycle. Unscrambling the structural footprint of DOM is key to understand its biogeochemical transformations at the mechanistic level. Although numerous studies have improved our knowledge of DOM chemical makeup, its three-dimensional picture remains largely unrevealed. In this work, we compare four solid phase extracted (SPE) DOM samples from three different freshwater ecosystems using high resolution mobility and ultrahigh-resolution Fourier transform ion cyclotron resonance tandem mass spectrometry (FT-ICR MS/MS). Structural families were identified based on neutral losses at the level of nominal mass using continuous accumulation of selected ions-collision induced dissociation (CASI-CID)FT-ICR MS/MS. Comparison of the structural families indicated dissimilarities in the structural footprint of this sample set. The structural family representation using Cytoscape software revealed characteristic clustering patterns among the DOM samples, thus confirming clear differences at the structural level (Only 10% is common across the four samples.). The analysis at the level of neutral loss-based functionalities suggests that hydration and carboxylation are ubiquitous transformational processes across the three ecosystems. In contrast, transformation mechanisms involving methoxy moieties may be constrained in estuarine systems due to extensive upstream lignin biodegradation. The inclusion of the isomeric content (mobility measurements at the level of chemical formula) in the structural family description suggests that additional transformation pathways and/or source variations are possible and account for the dissimilarities observed. While the structural character of more and diverse types of DOM samples needs to be assessed and added to this database, the results presented here demonstrate that Graph-DOM is a powerful tool capable of providing novel information on the DOM chemical footprint, based on structural interconnections of precursor molecules generated by fragmentation pathways and collisional cross sections.

Ring-shaped cataract and urinary metabolites among 2,4,6-trinitrotoluene exposed population of Pakistan.

BACKGROUND: Safety protocols are usually neglected among most of the trinitrotoluene (TNT)-exposed population, therefore, rendering the community prone to various occupational hazards. The current study highlights ring-shaped cataract and urinary metabolites of TNT among TNT-exposed population (n = 26) against a control group (n = 20). METHOD: An observational case-control study was carried out in two groups: subjects exposed to TNT in Dir and Bajour Agency, Pakistan, and a control group from the base hospital. We determined the presence of ring-shaped cataract and urine metabolites of TNT using slit-lamp biomicroscope and gas chromatography-mass spectrometric analysis, respectively. RESULTS: Results substantiate a high level of urine metabolites for exposed subjects compared to the control group (p < 0.001). Age had no significant effect (p > 0.05) on the presence of ring-shaped cataract and the level of urinary metabolites of TNT, while duration of exposure showed significant effect (p < 0.001). Females showed high incidence of ring-shaped cataract and urinary metabolites of TNT than men ( p < 0.001). The mean age of the exposed subjects was 51 ± 14.38 (Mean ± SD) years. The mean year of exposure was 49 ± 5 (Mean ± SD) years. CONCLUSION: This study showed TNT as a risk factor for the presence of ring-shaped cataract among TNT-exposed group in Pakistan. It is important to screen exposed community for the presence of ring-shaped cataract, and pre-clinical identification of TNT adducts to prevent systemic complications.

Dedifferentiated Liposarcoma With Meningothelial-Like Whorls: Five Additional Cases and Review of the Literature.

Background. Diagnosis of dedifferentiated liposarcoma (DDL) can sometimes be challenging due to a wide variety of histological features. "Meningothelial-like" whorl is an uncommon histological feature of DDL, which is also observed in neural tumors and follicular dendritic cell sarcoma. This feature is frequently associated with metaplastic bone formation. We conducted this study to describe the clinicopathological features of DDL with meningothelial-like whorls that would aid in establishing accurate diagnosis. Material and Methods. Microscopic glass slides of 5 cases of DDL with meningothelial-like whorls, diagnosed between January 2010 and December 2019, were reviewed. Results. Paratesticular region was the most common site. Whorls occupied 10% to 75% of tumor area and ranged in size from <0.1 cm to >2 cm. In 1 case, these whorls coalesced to form large areas of dedifferentiation. The cells forming whorls were spindle to epithelioid shaped and lacked significant nuclear pleomorphism and increased mitoses. Metaplastic bone formation was observed in 4 cases and cartilage formation in 3 cases. p16 and α-smooth muscle actin (α-SMA) immunohistochemical stains were positive in 2 cases, when performed. MDM2 gene amplification was observed in all cases by fluorescence in situ hybridization technique. These tumors showed aggressive behavior, similar to that of DDL without meningothelial-like whorls. Two patients died, 1 developed recurrence, 1 presented as recurrent tumor, and 1 developed metastasis. Conclusion. Meningothelial-like whorls in DDL most likely represent an early stage of dedifferentiation. Presence of well-differentiated liposarcoma areas, metaplastic bone formation, positive expressions for p16 and α-SMA immunohistochemical stains, and MDM2 gene amplification are useful diagnostic clues. These tumors have the potential to behave aggressively.

Follow-Up Bibliometric Analysis of Neurosurgical Publications from Pakistan and Institutional Comparison with other Countries Using h-Index and i-10 Index.

AIM: The aim of the study was to analyze the neurosurgical research output of Pakistan and compare it with that of developed countries. METHODOLOGY: We conducted a bibliometric analysis of publically available databases for all neurosurgical publications from Pakistan. All indexed peer-reviewed publications from January 2009 to December 2014 where at least one author was affiliated with any neurosurgical departments in Pakistan and research was conducted in Pakistan were selected. Manual and electronic search was done using MeSH terms to search for articles from Pakistan. Articles were then categorized according to design, subspecialty, region, and year. RESULTS: Our search identified 121 articles during the defined study period (mean = 20.16 ± 5.2 papers/year). A relatively constant increase was noticed for the last 6 years, i.e., 2009-2014. From the total 121 references, 100 (82.4%) publications were from one city, and on subanalysis, 80 (66.1%) were from a single institution. Three primary authors cumulatively contributed to 76 (62.8%) of these publications. Almost two-thirds (n = 76, 62.8%) of these publications were published in either regional or international journals while only 37.2% (n = 45) were published in local nonneurosurgery-specific journals. Only one study in the 6-year study period was with Level I evidence (meta-analysis). CONCLUSION: Neurosurgery research in Pakistan has shown modest improvement in terms of quality and quantity. Collaboration between various centers and channelizing different resources to create national data registries along with basic science laboratories is much needed.

Complications of in-patient Cerebral Angiography: Comparison between patients with and without sub arachnoid haemorrhage.

OBJECTIVE: To compare complications of cerebral angiography among patients with and without subarachnoid haemorrhage. METHODS: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised records of patients undergoing inpatient therapeutic and diagnostic cerebral angiographies from 2001 to 2010. The patients were divided into subarachnoid and non-subarachnoid haemorrhage groups. During the study period no modifications were made to the operational protocol and all patients were subjected to the same procedure and prophylactic care. RESULTS: Of the 93 patients, 42(45.2%) were women and 51(54.8%) were men. The overall mean age was 45.27±16.15 years (range: 4-80 years). The comparison between the two groups regarding new onset of neurological deficit was statistically significant (p=0.001). However, the same comparison regarding drop in Glasgow Coma Scale was statistically not significant (p=0.073). CONCLUSIONS: The rate of neurological complications was higher in patients with subarachnoid haemorrhage.

Comparison of Irrigation versus No Irrigation during Burr Hole Evacuation of Chronic Subdural Hematoma.

Objective To compare the results of the use of irrigation versus no irrigation during burr hole evacuation of chronic subdural hematoma (CSDH). Methodology The study was a retrospective chart review of those patients who underwent burr hole evacuation of CSDH during a period of 5 years. Cases were divided into two groups based on the use of irrigation during surgery. A subdural drain was placed in all patients (i.e., in both the irrigation and no-irrigation groups) and removed 24 to 48 hours postoperatively. Results The total sample size was 56, of which 34 patients were in the irrigation group and 22 in the no-irrigation group. Recurrence rate was 17.6% in the irrigation group and 9.1% in the no-irrigation group (p = 0.46). Systemic complications were predominantly cardiac related in the no-irrigation group compared with respiratory complications in the irrigation group. The irrigation group had a mortality rate of 5.9% compared with 4.5% in the no-irrigation group (p = 0.66). Conclusion No statistically significant difference was found between the two groups in terms of recurrence or mortality.

Clinical outcome and cost effectiveness of early tracheostomy in isolated severe head injury patients.

BACKGROUND: Early tracheostomy (ET) has been shown to be effective in reducing complications associated with prolong mechanical ventilation. The study was carried out to evaluate the role of ET in reducing the duration of mechanical ventilation, duration of intensive care unit (ICU) stay, ICU-related morbidities, and its overall effect on outcome, in patients with isolated severe traumatic brain injury (TBI). METHODS: This 7-year review included 100 ICU patients with isolated severe TBI requiring mechanical ventilation. ET was defined as tracheostomy within 7 days of TBI, and prolonged endotracheal intubation (EI) as EI exceeding 7 days of TBI. Of 100 patients, 49 underwent ET and 51 remained on prolong EI for ventilation. All patients were comparable in term of age and initial Glasgow Coma Scale (GCS). We evaluated groups regarding clinical outcome in terms of ventilator-associated pneumonia (VAP), ICU stay, and Glasgow Outcome Score (GOS). RESULTS: The frequency of VAP was higher in EI group relative to ET group (63% vs. 45%, P value 0.09). ET group showed significantly less ventilator days (10 days vs. 13 days, P value 0.031), ICU stay (11 days vs. 13 days, P value 0.030), complication rate (14% vs. 18%), and mortality (8.2% vs. 17.6%). Clinical outcome assessed on the basis of GOS was also better in the ET group. Total inpatient cost was also considerably less (USD $8027) in the ET group compared with the EI group (USD $9961). CONCLUSIONS: In patients with severe TBI, ET decreases total days of ventilation and ICU stay, and is associated with a decrease in the frequency of VAP. ET should be considered in severe head injury patients requiring prolong ventilatory support.

Attitudes of medical students towards incentives offered by pharmaceutical companies -- perspective from a developing nation -- a cross-sectional study.

BACKGROUND: A training physician has his first interaction with a pharmaceutical representative during medical school. Medical students are often provided with small gifts such as pens, calendars and books, as well as free lunches as part of drug promotion offers. Ethical impact of these transactions as perceived by young medical students has not been investigated in Pakistan before. This study aimed to assess the association of socio-demographic variables with the attitudes of medical students towards pharmaceutical companies and their incentives. METHODS: As part of a cross-sectional survey, a validated questionnaire previously used for assessing attitude of medical students towards pharmaceutical industry, was modified, pre-tested and distributed among consenting clinical year students at DUHS and AKU. Questions included acceptability of pharmaceutically sponsored gifts, events and tuition fee, and their impact on future prescription. Responses were graded as agree, disagree or neutral which were then scored according to the AMSA guidelines of ethical conduct. RESULTS: Out of a total of 353 targeted students 303 responded, corresponding to a response rate of 85.8%. Responses indicated that 42.7% students believed in no interaction with drug companies during medical school. However, 81% of students favored pharmaceutical sponsorship of student-body events/seminars at medical colleges. More than one-third of the students were comfortable receiving gifts from drug companies. Overall, the results of this study offer an interesting comparison between the students of a private medical school (AKU) and a public medical school (DUHS); AKU students exhibited a greater degree of mistrust towards drug information provided by pharmaceutical companies compared to DUHS students (p = 0.040). Furthermore, when asked if there was a need to incorporate guidelines in the undergraduate curriculum with regard to interaction with drug companies, 84.2% students at AKU agreed, compared to 54.9% at DUHS. Medical student Attitude Scores are more or less similar to each other independent of their various demographical differences. CONCLUSION: This study highlights that medical students in our population have a high level of acceptability towards incentives offered by pharmaceutical industry and that formal guidance regarding the subject should be incorporated into medical curriculum.

Transcatheter versus surgical closure of atrial septum defect: a debate from a developing country.

INTRODUCTION: This study compares the effectiveness and cost of trans-catheter verses surgical closure of secundum atrial septum defect (ASD). ASD accounts for 10% of congenital cardiac defects. Trans-catheter closure of secundum ASD is increasingly used as the primary intervention. Surgical repair is advised in a proportion of secundum type defects which are unsuitable for device closure. METHODS: We reviewed the clinical course of 176 patients who underwent closure of isolated secundum ASD. The patients were assigned to either the device or surgical group depending upon the treatment they received. Successful closure was assessed immediately after the procedure. The following outcomes were studied: mortality, morbidity, hospital stay, and costs. RESULTS: Ninety five patients were in the surgical group and 81 patients were in the group undergoing device closure. The median age was 14.0 years (range 1.1-61.0) for surgical group and 24.0 years (range 0.5-68.0) for the device group. The mortality in both groups was 0. The procedure success rate was 100% for the surgical group and 96.3% for the device group. The complication rate was 13.7% for surgical group and 7.4% for the device group. The mean length of hospital stay was 5.0 ± 2.7 days for surgical group and 3.0 ± 0.4 days for device group. The procedure cost for surgery was found to be 12.3% lower than that of trans-catheter closure. CONCLUSION: Successful closure is achieved by both methods. Trans-catheter closure results in lower rate of complication and hospital stay but the cost of the procedure tends to be higher than surgery.