HTML5 based Smart eService using Server Side JavaScript and JADE environment

This paper introduces the concept of Smart-eService to be the kernel building block of the Smart-eGovernment. The presented Smart-eService has many privileges over the traditional eService such as fully cross-platform, social, liable, negotiable, autonomous and mobile. Smart-eService is implemented in this paper as a deliverable mobile agent that complies with HTML5 as a frontend and Node.js modules to interface JADE platform at the backend.  The presented Smart-eService is preemptive behavior rather than reactive or even proactive; preemptive interpreted as actions based upon hard domain intelligence. HTML5 terminologies such as Real Multi-Threading and WebSockets have been exploited and deployed to efficiently increase the performance of Smart-eService and sustain its attributes. Keywords: Smartphone, smart-eGovernment, eService, Mobile Agent, Smart-eService, Node.js, HTML5, JAD

Multimedia Synchronization Protocol Dedicated for Virtual Classrooms over Narrowband networks

This paper is presenting design and implementation of web based e-learning synchronization protocol. The protocol is HTTP/TCP based and specifically designed to increase the cognitive productivity of learning session conducted over the internet in analogous scheme to real classroom interaction. The presenting protocol is holding an innovative technique to enhance the performance of broadcasting whiteboards and classrooms to distributed students over narrowband networks. In narrowband networks race condition is raised between multimedia streams  in gaining network bandwidth. Throughout presented protocol; multimedia streams are packetized and synchronized in a compatible model for the cognitive natural learning mechanisms for the human being where actions drag attention and continuous interaction maintain the focus. Keywords: virtual class, WebSocket, HTML5, Servlet, HTTP, JSpeex, Whiteboard CODEC, e-learning, synchronous and Asynchronous learning

Multi-Agent Based Security Framework for E-Government in Recently technology Developed Countries

E-Government is an environment where government produces services to citizens electronically, this is beside services to other e-Governments, and one crucial factor regarding the reliability of accepting services provided by e-Government is the security factor. This work is targeting Countries in their developing process that need to develop configurable management model, that capable of adapting security technologies to other factors revealed from the society.  The configuration of this management model will be autonomously built up through the association of three domains presented by this proposal: policies, measures and infrastructure. Along this work; ontology will be built up to accommodate these domains and eventually to grant Agent software the ability to perceive the environment and configure the management model for deploying security technologies. Keywords: Socio-Techno, Java Agent, Security policy, eGovernment, JADE, Ontology, knowledge development

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research