Implementing a dynamic scaling of web applications in a virtualized cloud computing environment

Cloud computing is becoming more essential day by day. The allure of the cloud is the significant value and benefits that people gain from it, such as reduced costs, increased storage, flexibility, and more mobility. Flexibility is one of the major benefits that cloud computing can provide in terms of scaling up and down the infrastructure of a network. Once traffic has increased on one server within the network, a load balancer instance will route incoming requests to a healthy instance, which is less busy and less burdened. When the full complement of instances cannot handle any more requests, past research has been done by Chieu et. al. that presented a scaling algorithm to address a dynamic scalability of web applications on a virtualized cloud computing environment based on relevant indicators that can increase or decrease servers, as needed. In this project, I implemented the proposed algorithm, but based on CPU Utilization threshold. In addition, two tests were run exploring the capabilities of different metrics when faced with ideal or challenging conditions. The results did find a superior metric that was able to perform successfully under both tests

Role of female teachers in formation of wrong perceptions within female students of intermediate schools in Riyadh

Abstract: The research purpose is to acknowledge the role of female teachers in forming wrong perception about conceptions of heredity in minds of female students of intermediate schools, in Riyadh. The Research sample formed of (69) female teachers within the Riyadh North Education Office in 1436-1437H 2015/2016 . A questionnaire form was prepared to determine the wrong perceptions about conception of heredity in minds of science female teachers. It included (10) multiple choice questions, each with (4) choices, followed by (4) different explanations to chose from, after being reviewed by a group of arbitrators. The stability account was equal to (0.73) using Cronbach\u27s Alpha equation. The researchers also prepared an interview tool for a random sample of female teachers (8 science teachers), to recognize relation of teaching practices, teaching language of conceptions, with forming wrong perceptions in the minds of female students. It was composed of (8) questions that were reviewed and confirmed. The results pointed to the existence of a lot of wrong perceptions about conception of heredity (chromosome, gene, RNA, DNA, recessive and dominant character, genetic polymorphism, formalist models) at science teachers. Results also indicated a relation between educational practices and teaching language of conceptions, and formation of wrong perceptions in minds of female students. Results also pointed to nonexistence of relation between science specialization and formation of wrong perceptions about conception of heredity Chi-Square Tests value is (2.493) which is a non-statistical function value, where the [sig] associated value is (0.477), is larger than the level indication (0.05), which means that there are no substantial differences in the occurrences of right and wrong answers to the study sample depending on major specialization. The research concluded with a number of recommendations in the light of its results. Keywords: Science teacher, wrong perceptions, conception of heredity, intermediate school

Research Paper: Process Mining and Synthetic Health Data: Reflections and Lessons Learnt

Analysing the treatment pathways in real-world health data can provide valuable insight for clinicians and decision-makers. However, the procedures for acquiring real-world data for research can be restrictive, time-consuming and risks disclosing identifiable information. Synthetic data might enable representative analysis without direct access to sensitive data. In the first part of our paper, we propose an approach for grading synthetic data for process analysis based on its fidelity to relationships found in real-world data. In the second part, we apply our grading approach by assessing cancer patient pathways in a synthetic healthcare dataset (The Simulacrum provided by the English National Cancer Registration and Analysis Service) using process mining. Visualisations of the patient pathways within the synthetic data appear plausible, showing relationships between events confirmed in the underlying non-synthetic data. Data quality issues are also present within the synthetic data which reflect real-world problems and artefacts from the synthetic dataset’s creation. Process mining of synthetic data in healthcare is an emerging field with novel challenges. We conclude that researchers should be aware of the risks when extrapolating results produced from research on synthetic data to real-world scenarios and assess findings with analysts who are able to view the underlying data

Measuring the impact of COVID-19 on hospital care pathways

Care pathways in hospitals around the world reported significant disruption during the recent COVID-19 pandemic but measuring the actual impact is more problematic. Process mining can be useful for hospital management to measure the conformance of real-life care to what might be considered normal operations. In this study, we aim to demonstrate that process mining can be used to investigate process changes associated with complex disruptive events. We studied perturbations to accident and emergency (A &E) and maternity pathways in a UK public hospital during the COVID-19 pandemic. Co-incidentally the hospital had implemented a Command Centre approach for patient-flow management affording an opportunity to study both the planned improvement and the disruption due to the pandemic. Our study proposes and demonstrates a method for measuring and investigating the impact of such planned and unplanned disruptions affecting hospital care pathways. We found that during the pandemic, both A &E and maternity pathways had measurable reductions in the mean length of stay and a measurable drop in the percentage of pathways conforming to normative models. There were no distinctive patterns of monthly mean values of length of stay nor conformance throughout the phases of the installation of the hospital’s new Command Centre approach. Due to a deficit in the available A &E data, the findings for A &E pathways could not be interpreted

CARD15/NOD2, CD14 and Toll-like 4 Receptor Gene Polymorphisms in Saudi Patients with Crohn’s Disease

Crohn’s disease (CD) is a multifactorial disease with a genetic component and an observed association with genes related to the innate immune response. Polymorphisms in the CARD15/NOD2 gene, in addition to functional variants of the toll-like receptor-4 (TLR4) and CD14 genes, have been associated with the development of Crohn’s disease. There is no information about the frequency of these polymorphisms in the Saudi population. We examined the frequency of the three major CARD15/NOD2 risk alleles (Leu1007fsinsC, Arg702Trp, and Gly908Arg) and the TLR4 (Thr399Il) polymorphism as well as a functional polymorphism in the promoter of the CD14–159C/T in 46 Saudi CD patients and 50 matched controls. Genotyping was performed by allele-specific PCR or by restriction fragment length polymorphism (PCR-RFLP) analysis. The mutant genotype frequencies of the Leu1007fsinsC, Arg702Trp and Gly908Arg in the patient group were 6.5, 21.7 and 6.5%, respectively, compared with frequencies of 0, 4 and 2%, respectively, in the control group. There were 15 patients who carried the mutant alleles for all three CARD15/NOD2 variants, Leu1007fsinsC, Arg702Trp and Gly908Arg, while none of the control candidates carried the three alleles. This genetic study provides evidence that the three major CARD15/NOD2 variant alleles and the CD14 –159C/T polymorphism are associated with Crohn’s disease (CD) susceptibility in the Saudi population; however, there is no evidence that the TLR4 (Thr399Il) or CARD15/NOD2 polymorphisms can be considered risk factors for Crohn’s disease

Direct access cancer testing in primary care: a systematic review of use and clinical outcomes.

BACKGROUND: Direct access (DA) testing allows GPs to refer patients for investigation without consulting a specialist. The aim is to reduce waiting time for investigations and unnecessary appointments, enabling treatment to begin without delay. AIM: To establish the proportion of patients diagnosed with cancer and other diseases through DA testing, time to diagnosis, and suitability of DA investigations. DESIGN AND SETTING: Systematic review assessing the effectiveness of GP DA testing in adults. METHOD: MEDLINE, Embase, and the Cochrane Library were searched. Where possible, study data were pooled and analysed quantitatively. Where this was not possible, the data are presented narratively. RESULTS: The authors identified 60 papers that met pre-specified inclusion criteria. Most studies were carried out in the UK and were judged to be of poor quality. The authors found no significant difference in the pooled cancer conversion rate between GP DA referrals and patients who first consulted a specialist for any test, except gastroscopy. There were also no significant differences in the proportions of patients receiving any non-cancer diagnosis. Referrals for testing were deemed appropriate in 66.4% of those coming from GPs, and in 80.9% of those from consultants; this difference was not significant. The time from referral to testing was significantly shorter for patients referred for DA tests. Patient and GP satisfaction with DA testing was consistently high. CONCLUSION: GP DA testing performs as well as, and on some measures better than, consultant triaged testing on measures of disease detection, appropriateness of referrals, interval from referral to testing, and patient and GP satisfaction

Clinico-pathological patterns of colorectal cancer in Saudi Arabia: Younger with an advanced stage presentation

Aim: Colorectal cancer (CRC) is the third most common cancer in the world. The aim of this study was to identify the clinical and pathological features of CRC in a tertiary care hospital in Saudi Arabia. Materials and Methods: This is a retrospective study of all patients diagnosed to have CRC at King Khalid University Hospital in Riyadh, Saudi Arabia over a 10 year period (1995-2005). The data collected from medical files, endoscopy and imaging reports included age, gender, clinical presentation, smoking, relevant past or family history, site and size of the tumor, stage, carcinoembryonic antigen level and tumor grade. Results: A total of 113 patients were included over the 10 year period. The average age at diagnosis was 55 years (S.D.=15), 58% of the patients were males and 42% were females. Thirty-seven percent of the patients were 50 years of age or younger. The most common clinical presentation was abdominal pain (68%) followed by rectal bleeding (62%) and weight loss (55%). Left-sided lesions and rectal cancer constituted 76% and 48% of all CRC tumors respectively. Sixty-eight percent of lesions were stage C and above. Forty-five percent of patients presented with complete large bowel obstruction. Conclusion: In this analysis, we found that Saudi patients were more likely to present with colorectal cancer at a more advanced stage of the disease and at younger ages compared to Western populations. This data suggests the need for a mass screening program to be implemented for this common and preventable cancer in Saudi Arabia

A Narrative Study about the Transformative Visual Cultural Dialogue beyond Women's Veils

In this narrative study, I explore the transformative visual cultural dialogue behind the sight of the veil or veiled women in Denton, Texas as a Western culture. The narrative is constructed from the experiences of three Western non-Muslim women participants who wore the veil publicly in the Dallas-Fort Worth area, especially Denton, Texas, for about two weeks, in the spring of 2014. The main question for this study is: How do veiled Western women incite transformative visual cultural dialogue and ideas concerning veiled women? To gather rich data to answer the study's question, I utilized qualitative narrative inquiry to explore the transformative dialogue that the veil, as a visual culture object, can incite in non-Muslim Western women's narratives. The study involves three participants who are non-Muslim American women who voluntarily wore the veil in public and recorded their own and other's reactions. The participants' interviews and diaries demonstrated that the veil incited a particular perceptive dialogue and often transferred negative meanings. For example, the sight of the veil suggested the notion of being Muslim, and consequently, the ideas of not belonging. The reactions the participants received were either negative verbal interactions or physical ones, both of which are limited in this study to face gestures or some form of negative body language that is meant to be a message of disliking. In summation, this study shows that the women's veil is a visual culture symbol that transfers negative meaning in the DFW area in Texas