An Agent-Based Variogram Modeller: Investigating Intelligent, Distributed-Component Geographical Information Systems

Geo-Information Science (GIScience) is the field of study that addresses substantive questions concerning the handling, analysis and visualisation of spatial data. Geo- Information Systems (GIS), including software, data acquisition and organisational arrangements, are the key technologies underpinning GIScience. A GIS is normally tailored to the service it is supposed to perform. However, there is often the need to do a function that might not be supported by the GIS tool being used. The normal solution in these circumstances is to go out and look for another tool that can do the service, and often an expert to use that tool. This is expensive, time consuming and certainly stressful to the geographical data analyses. On the other hand, GIS is often used in conjunction with other technologies to form a geocomputational environment. One of the complex tools in geocomputation is geostatistics. One of its functions is to provide the means to determine the extent of spatial dependencies within geographical data and processes. Spatial datasets are often large and complex. Currently Agent system are being integrated into GIS to offer flexibility and allow better data analysis. The theis will look into the current application of Agents in within the GIS community, determine if they are used to representing data, process or act a service. The thesis looks into proving the applicability of an agent-oriented paradigm as a service based GIS, having the possibility of providing greater interoperability and reducing resource requirements (human and tools). In particular, analysis was undertaken to determine the need to introduce enhanced features to agents, in order to maximise their effectiveness in GIS. This was achieved by addressing the software agent complexity in design and implementation for the GIS environment and by suggesting possible solutions to encountered problems. The software agent characteristics and features (which include the dynamic binding of plans to software agents in order to tackle the levels of complexity and range of contexts) were examined, as well as discussing current GIScience and the applications of agent technology to GIS, agents as entities, objects and processes. These concepts and their functionalities to GIS are then analysed and discussed. The extent of agent functionality, analysis of the gaps and the use these technologies to express a distributed service providing an agent-based GIS framework is then presented. Thus, a general agent-based framework for GIS and a novel agent-based architecture for a specific part of GIS, the variogram, to examine the applicability of the agent- oriented paradigm to GIS, was devised. An examination of the current mechanisms for constructing variograms, underlying processes and functions was undertaken, then these processes were embedded into a novel agent architecture for GIS. Once the successful software agent implementation had been achieved, the corresponding tool was tested and validated - internally for code errors and externally to determine its functional requirements and whether it enhances the GIS process of dealing with data. Thereafter, its compared with other known service based GIS agents and its advantages and disadvantages analysed

Establishing a platform for networked games on mobile devices using SMS/GPRS

The gaming industry has being exponentially expanding during the recent years. This expansion has seen game playing spreading from dedicated consoles to mobile communication devices. However, currently the main challenge is to establish two or more player games from handheld mobile devices over a network. This paper will define a possible way of achieving network games using Short Messaging Services (SMS) and/or GPRS. In this paper the outline of what Network Gaming is, how it is traditionally implemented (using desktop computers) and how it can be initiated into the mobile environment will be explored. The efficient data transfer over SMS or GPRS will require formatting and so it is compressed and made easily identifiable by the receiving device. The platform identified implemented and tested over a Tic Tac Toe game scenario

An Agent-Based System to support Geo-Information Analysis

Geo-Information Systems (GIS) are software for the handling and analysis of spatial data and are at the heart of Geo-Information Science (GISc). Most GIS functions require interaction with human experts. This is considered problematic since it causes extra complexity and increases the amount of resources required. Agent Technology has the potential to assist in reducing this problem. However the current application of software agents to the GIS domain is very limited and fails to take into account the full functionality and advantages of Agent Technology. In this paper we discuss the application of agents in GIS and argue for the need to produce an agentbased framework for GIS. By way of context we define a novel agent-based system for one important aspect of GIS, the construction of a variogram. We quantitatively compare our architecture with two the existing agent-based tools: RePast for ArcGIS and Oracle Agents

DRUG UTILIZATION PATTERN IN AN INTENSIVE CARE UNIT AT A TERTIARY CARE TEACHING HOSPITAL IN OMAN

Objectives: To evaluate the drug prescribing trends in the ICU department and correlate them with the disease patterns and patients' outcomes.Methods: The case records of patients admitted to the ICU at Sultan Qaboos University Hospital (SQUH), a teaching hospital in Oman, during a 5-month period between June 1st to October 31st 2013 were analyzed. The variables collected included demographic and clinical characteristics as well as duration of hospitalization, indications and utilization of different drugs.Results: A total of 138 patients were evaluated with an average of age ‎46±19‎ years. The average length of stay at ICU‎ was ‎4.5±3.5 days. The‎ average number of drugs per prescription was ‎8.0±4.6‎. The most common route used was the parenteral route (66%) followed by the enteral route (25%). Anti-infective drugs were the most commonly prescribed class of drugs (25%) followed by gastrointestinal drugs (20%). Antibiotics accounted for 12% of the total drugs prescribed. Trauma was the most common indication for the admission to the ICU (22%).Conclusion: Drugs prescription patterns in the ICU appeared to be similar to those reported in previous studies. However, prescription protocols need to be addressed to guide appropriate use of drugs in the ICU setting.Â

Sensory texture of date fruits as a function of physicochemical properties and its use in date classification

Eight descriptive sensory textural attributes of whole date fruit were evaluated by twenty trained panel members and correlated with sixteen physicochemical properties. All sensory parameters, except gumminess, significantly correlated (Ps<0.05) with pectin, crude fibre, and moisture content. In addition, sensory hardness, cohesiveness, elasticity, and resilience correlated significantly with length of whole fruit (P<0.05), sensory adhesiveness with glucose content (P<0.05), sensory chewiness with mass of whole fruit (P<0.05), and sensory gumminess with fructose, glucose, and total sugar content (P<0.10). Sweetness, however, correlated only with moisture content (P<0.05). CA and the biplot (i.e. including all products, their sensory texture and physicochemical attributes) generated through PCA recognized three groups of dates as hard-chewy, soft-(medium-chewy), and soft-(non-adhesive)

Hepatocellular Carcinoma in Oman: An analysis of 284 cases

Objectives: Hepatocellular carcinoma (HCC) is the most common type of primary liver tumour worldwide and is increasing in incidence. This study aimed to describe the clinical characteristics of HCC among Omani patients, along with its major risk factors, outcomes and the role of surveillance. Methods: This retrospective case-series study was conducted between January 2008 and December 2015 at the three main tertiary care hospitals in Oman. All adult Omani patients diagnosed with HCC and visited these hospitals during the study period were included. Relevant data were collected from the patients’ electronic medical records. Results: A total of 284 HCC patients were included in the analysis. The mean age was 61.02 ± 11.41 years and 67.6% were male. The majority had liver cirrhosis (79.9%), with the most common aetiologies being chronic hepatitis C (46.5%) and B (43.2%). Only 13.7% of cases were detected by the HCC surveillance programme. Approximately half of the patients (48.5%) had a single liver lesion and 31.9% had a liver tumour of &gt;5 cm in size. Approximately half (49.2%) had alpha-fetoprotein levels of ≥200 ng/mL. The majority (72.5%) were diagnosed using multiphase computed tomography alone. Less than half of the patients (48.9%) were offered one or more HCC treatment modalities. Conclusion: The majority of Omani HCC patients were male and had cirrhosis due to viral hepatitis. In addition, few patients were identified by the national surveillance programme and presented with advanced disease precluding therapeutic or even palliative treatment.Keywords: Hepatocellular Carcinoma; Liver Cirrhosis; Human Viral Hepatitis; Public Health Surveillance; Early Detection of Cancer; Alpha-Fetoprotein; Oman

Development and Validation of R-hf Risk Score in Acute Heart Failure Patients in the Middle East

Objectives: The Rajan’s heart failure (R-hf) score was proposed to aid risk stratification in heart failure patients. The aim of this study was to validate R-hf risk score in patients with acute decompensated heart failure. Methods: R-hf risk score is derived from the product estimated glomerular filtration rate (mL/min), left ventricular ejection fraction (%), and hemoglobin levels (g/dL) divided by N-terminal pro-brain natriuretic peptide (pg/mL). This was a multinational, multicenter, prospective registry of heart failure from seven countries in the Middle East. Univariable and multivariable logistic regression was applied. Results: A total of 776 patients (mean age = 62.0±14.0 years, 62.4% males; mean left ventricular ejection fraction = 33.0±14.0%) were included. Of these, 459 (59.1%) presented with acute decompensated chronic heart failure. The R-hf risk score group (≤ 5) was marginally associated with a higher risk of all-cause cumulative mortality at three months (adjusted odds ratio (aOR) = 4.28; 95% CI: 0.90–20.30; p =0.067) and significantly at 12 months (aOR = 3.84; 95% CI: 1.23–12.00; p =0.021) when compared to those with the highest R score group (≥ 50). Conclusions: Lower R-hf risk scores are associated with increased risk of all-cause cumulative mortality at three and 12 months

Demystifying Smoker's Paradox: A Propensity Score-Weighted Analysis in Patients Hospitalized With Acute Heart Failure.

Background Smoker's paradox has been observed with several vascular disorders, yet there are limited data in patients with acute heart failure (HF). We examined the effects of smoking in patients with acute HF using data from a large multicenter registry. The objective was to determine if the design and analytic approach could explain the smoker's paradox in acute HF mortality. Methods and Results The data were sourced from the acute HF registry (Gulf CARE [Gulf Acute Heart Failure Registry]), a multicenter registry that recruited patients over 10 months admitted with a diagnosis of acute HF from 47 hospitals in 7 Middle Eastern countries. The association between smoking and mortality (in hospital) was examined using covariate adjustment, making use of mortality risk factors. A parallel analysis was performed using covariate balancing through propensity scores. Of 5005 patients hospitalized with acute HF, 1103 (22%) were current smokers. The in-hospital mortality rates were significantly lower in current smoker's before (odds ratio, 0.71; 95% CI, 0.52-0.96) and more so after (odds ratio, 0.47; 95% CI, 0.31-0.70) covariate adjustment. With the propensity score-derived covariate balance, the smoking effect became much less certain (odds ratio, 0.63; 95% CI, 0.36-1.11). Conclusions The current study illustrates the fact that the smoker's paradox is likely to be a result of residual confounding as covariate adjustment may not resolve this if there are many competing prognostic confounders. In this situation, propensity score methods for covariate balancing seem preferable. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT01467973.Gulf CARE (Gulf Acute Heart Failure Registry) is an investigator- initiated study conducted under the auspices of the Gulf Heart Association and funded by Servier, Paris, France; and (for centers in Saudi Arabia), by the Saudi Heart Association (The Deanship of Scientific Research at King Saud University, Riyadh, Saudi Arabia [research group number: RG -1436- 013]). This does not alter our adherence to policies on sharing data and materials; and the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The publication of this article was funded by the Qatar National Library

Combination therapy: the next opportunity and challenge of medicine

From an historical point of view, combination therapy was the basis for the care of important diseases like infection diseases or cancer. Today the "cocktail drug" of the Highly Active Anti Retroviral Therapy (HAART) has reduced the death for HIV infection changing the outcome of such disease. Moreover, the combination of different strategies changed the course of transplants (both in haematology and surgical transplant). Different diseases with high social impact including cardiovascular, metabolic (obesity, hypercholesterolaemia and diabetes) and autoimmune diseases, have better results with combinations of different drug classes of drugs. After recent successes in the immunotherapy field (Sepuleucel-T, ipilimumab) and the new promising small molecule therapies, cancer should be the next challenge for combination strategies

Clinical presentation and outcomes of peripartum cardiomyopathy in the Middle East: a cohort from seven Arab countries

Aims: Published data on the clinical presentation of peripartum cardiomyopathy (PPCM) are very limited particularly from the Middle East. The aim of this study was to examine the clinical presentation, management, and outcomes of patients with PPCM using data from a large multicentre heart failure (HF) registry from the Middle East. Methods and results: From February to November 2012, a total of 5005 consecutive patients with HF were enrolled from 47 hospitals in 7 Middle East countries. From this cohort, patients with PPCM were identified and included in this study. Clinical features, in-hospital, and 12 months outcomes were examined. During the study period, 64 patients with PPCM were enrolled with a mean age of 32.5 ± 5.8 years. Family history was identified in 11 patients (17.2%) and hypertension in 7 patients (10.9%). The predominant presenting symptom was dyspnoea New York Heart Association class IV in 51.6%, class III in 31.3%, and class II in 17.2%. Basal lung crepitations and peripheral oedema were the predominant signs on clinical examination (98.2% and 84.4%, respectively). Most patients received evidence-based HF therapies. Inotropic support and mechanical ventilation were required in 16% and 5% of patients, respectively. There was one in-hospital death (1.6%), and after 1 year of follow-up, nine patients were rehospitalized with HF (15%), and one patient died (1.6%). Conclusions: A high index of suspicion of PPCM is required to make the diagnosis especially in the presence of family history of HF or cardiomyopathy. Further studies are warranted on the genetic basis of PPCM.Gulf CARE is an investigator-initiated study conducted under the auspices of the Gulf Heart Association and funded by Servier, Paris, France, and (for centres in Saudi Arabia) by the Saudi Heart Association [The Deanship of Scientific Research at King Saud University, Riyadh, Saudi Arabia (Research Group Number RG-1436-013)]. This does not alter our adherence to policies on sharing data and materials, and the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript