Architecture of a GPS-based road management system

Malfunctioning traffic lights, potholes and roads in bad condition are only a few of the innumerable common thoroughfare problems that occasionally contribute to accidents. People tend to ignore reporting those issues as the channels for making a complaint is inconvenient. Accuracy of complaints is also at doubt as it tends to be general eg. Pothole at Ampang Road, in front of a police station. This paper presents the architecture of a Global Positioning System (GPS) based approach for reporting thoroughfare problems via Global System for Mobile Communications (GSM) for road maintenance management environment. To increase accuracy and efficiency, GPS can be used as it enables the tracking and tracing of the three figures of a GPS receiver’s coordinates namely longitude, latitude and altitude. Data like location, date and time will be optimized by mapping the site of where the thoroughfare problem exists in a map, with the intention that the relevant authorities could identify the spot and have the problems resolved responsively. The proposed system will serve as a handier and convenient alternative means for road users to send complaints to the relevant authorities, in addition to the existing channels, so that these issues could be addressed in a timely manner

Individualised, short-course antibiotic treatment versus usual long-course treatment for ventilator-associated pneumonia (REGARD-VAP): a multicentre, individually randomised, open-label, non-inferiority trial

Background: Ventilator-associated pneumonia (VAP) is associated with increased mortality, prolonged hospitalisation, excessive antibiotic use and, consequently, increased antimicrobial resistance. In this phase 4, randomised trial, we aimed to establish whether a pragmatic, individualised, short-course antibiotic treatment strategy for VAP was non-inferior to usual care. Methods: We did an individually randomised, open-label, hierarchical non-inferiority–superiority trial in 39 intensive care units in six hospitals in Nepal, Singapore, and Thailand. We enrolled adults (age ≥18 years) who met the US Centers for Disease Control and Prevention National Healthcare Safety Network criteria for VAP, had been mechanically ventilated for 48 h or longer, and were administered culture-directed antibiotics. In culture-negative cases, empirical antibiotic choices were made depending on local hospital antibiograms reported by the respective microbiology laboratories or prevailing local guidelines. Participants were assessed until fever resolution for 48 h and haemodynamic stability, then randomly assigned (1:1) to individualised short-course treatment (≤7 days and as short as 3–5 days) or usual care (≥8 days, with precise durations determined by the primary clinicians) via permuted blocks of variable sizes (8, 10, and 12), stratified by study site. Independent assessors for recurrent pneumonia and participants were masked to treatment allocation, but clinicians were not. The primary outcome was a 60-day composite endpoint of death or pneumonia recurrence. The non-inferiority margin was prespecified at 12% and had to be met by analyses based on both intention-to-treat (all study participants who were randomised) and per-protocol populations (all randomised study participants who fulfilled the eligibility criteria, met fitness criteria for antibiotic discontinuation, and who received antibiotics for the duration specified by their allocation group). This study is registered with ClinicalTrials.gov, number NCT03382548. Findings: Between May 25, 2018, and Dec 16, 2022, 461 patients were enrolled and randomly assigned to the short-course treatment group (n=232) or the usual care group (n=229). Median age was 64 years (IQR 51–74) and 181 (39%) participants were female. 460 were included in the intention-to-treat analysis after excluding one withdrawal (231 in the short-course group and 229 in the usual care group); 435 participants received the allocated treatment and fulfilled eligibility criteria, and were included in the per-protocol population. Median antibiotic treatment duration for the index episodes of VAP was 6 days (IQR 5–7) in the short-course group and 14 days (10–21) in the usual care group. 95 (41%) of 231 participants in the short-course group met the primary outcome, compared with 100 (44%) of 229 in the usual care group (risk difference –3% [one-sided 95% CI −∞ to 5%]). Results were similar in the per-protocol population. Non-inferiority of short-course antibiotic treatment was met in the analyses, although superiority compared with usual care was not established. In the per-protocol population, antibiotic side-effects occurred in 86 (38%) of 224 in the usual care group and 17 (8%) of 211 in the short-course group (risk difference –31% [95% CI –37 to –25%; p<0·0001]). Interpretation: In this study of adults with VAP, individualised shortened antibiotic duration guided by clinical response was non-inferior to longer treatment durations in terms of 60-day mortality and pneumonia recurrence, and associated with substantially reduced antibiotic use and side-effects. Individualised, short-course antibiotic treatment for VAP could help to reduce the burden of side-effects and the risk of antibiotic resistance in high-resource and resource-limited settings

SLX4 Assembles a Telomere Maintenance Toolkit by Bridging Multiple Endonucleases with Telomeres

SummarySLX4 interacts with several endonucleases to resolve structural barriers in DNA metabolism. SLX4 also interacts with telomeric protein TRF2 in human cells. The molecular mechanism of these interactions at telomeres remains unknown. Here, we report the crystal structure of the TRF2-binding motif of SLX4 (SLX4TBM) in complex with the TRFH domain of TRF2 (TRF2TRFH) and map the interactions of SLX4 with endonucleases SLX1, XPF, and MUS81. TRF2 recognizes a unique HxLxP motif on SLX4 via the peptide-binding site in its TRFH domain. Telomeric localization of SLX4 and associated nucleases depend on the SLX4-endonuclease and SLX4-TRF2 interactions and the protein levels of SLX4 and TRF2. SLX4 assembles an endonuclease toolkit that negatively regulates telomere length via SLX1-catalyzed nucleolytic resolution of telomere DNA structures. We propose that the SLX4-TRF2 complex serves as a double-layer scaffold bridging multiple endonucleases with telomeres for recombination-based telomere maintenance

Polygenic Risk Modelling for Prediction of Epithelial Ovarian Cancer Risk

Funder: Funding details are provided in the Supplementary MaterialAbstractPolygenic risk scores (PRS) for epithelial ovarian cancer (EOC) have the potential to improve risk stratification. Joint estimation of Single Nucleotide Polymorphism (SNP) effects in models could improve predictive performance over standard approaches of PRS construction. Here, we implemented computationally-efficient, penalized, logistic regression models (lasso, elastic net, stepwise) to individual level genotype data and a Bayesian framework with continuous shrinkage, “select and shrink for summary statistics” (S4), to summary level data for epithelial non-mucinous ovarian cancer risk prediction. We developed the models in a dataset consisting of 23,564 non-mucinous EOC cases and 40,138 controls participating in the Ovarian Cancer Association Consortium (OCAC) and validated the best models in three populations of different ancestries: prospective data from 198,101 women of European ancestry; 7,669 women of East Asian ancestry; 1,072 women of African ancestry, and in 18,915 BRCA1 and 12,337 BRCA2 pathogenic variant carriers of European ancestry. In the external validation data, the model with the strongest association for non-mucinous EOC risk derived from the OCAC model development data was the S4 model (27,240 SNPs) with odds ratios (OR) of 1.38(95%CI:1.28–1.48,AUC:0.588) per unit standard deviation, in women of European ancestry; 1.14(95%CI:1.08–1.19,AUC:0.538) in women of East Asian ancestry; 1.38(95%CI:1.21-1.58,AUC:0.593) in women of African ancestry; hazard ratios of 1.37(95%CI:1.30–1.44,AUC:0.592) in BRCA1 pathogenic variant carriers and 1.51(95%CI:1.36-1.67,AUC:0.624) in BRCA2 pathogenic variant carriers. Incorporation of the S4 PRS in risk prediction models for ovarian cancer may have clinical utility in ovarian cancer prevention programs.</jats:p

Effects of prime decision-maker's wage on corruption level.

Many studies have confirmed the negative correlation between public sector wages and corruption level. However, corruption should not be curbed from below, but right at the top. Hence, this study attmepts to investgate the relationship between the wage of prime decision-maker and corruption level in each country

Hotel promotions in Singapore, Malaysia, & Indonesia

This project purports to study the finer details of the promotions strategies of hotels in Singapore, Malaysia, and Indonesia. In each country, we will attempt to draw the differences between the 3-star and the 5-star hotels. Promotions, being traditionally one of the four pillars of marketing, seems to be an area not really covered in its full glory in the marketing mix of most hotels. There is extreme emphasis on product, both in the tangible and intangible areas; pricing, where it is seen as a major competitive force, and distribution, the old cliche about the importance of location, location, location requires no repetition. In the three countries studied, promotions seem to be secondary and most of the promotions undertaken were on a reactive basis, though there are more promotional programmes that are now more proactive in nature. Promotions should be an integral part of the marketing mix of any hotel as communications from the service provider to the customer ~ past, present or potential is crucial to ensure success. We have approached this study from the point of view of the customer as we feel that the customer is of the utmost importance to a business. Indeed, without customers, no business can survive. Hence, the customers are the ultimate determinants of the success of hotels promotional efforts. In addition to the analysis of the current promotional practices, this research also seeks to forecast possible future trends in promotional methods and media in the hospitality industry. Hence, this research could be used as a reference for determing the possibie means with which hotels could reach their target customers more effectively and efficiently in future.BUSINES