Smart Infrastructure and Applications
Foundations for Smarter Cities and Societies
Serieseditor
ImrichChlamtac,EuropeanAllianceforInnovation,Gent,Belgium
Editor’sNote
Theimpactofinformationtechnologiesiscreatinganewworldyetnotfully understood.Theextentandspeedofeconomic,lifestyleandsocialchanges alreadyperceivedineverydaylifeishardtoestimatewithoutunderstandingthe technologicaldrivingforcesbehindit.Thisseriespresentscontributedvolumes featuringthelatestresearchanddevelopmentinthevariousinformationengineering technologiesthatplayakeyroleinthisprocess.
Therangeoftopics,focusingprimarilyoncommunicationsandcomputingengineeringinclude,butarenotlimitedto,wirelessnetworks;mobilecommunication; designandlearning;gaming;interaction;e-healthandpervasivehealthcare;energy management;smartgrids;internetofthings;cognitiveradionetworks;computation; cloudcomputing;ubiquitousconnectivity,andinmodegeneralsmartliving,smart cities,InternetofThingsandmore.Theseriespublishesacombinationofexpanded papersselectedfromhostedandsponsoredEuropeanAllianceforInnovation(EAI) conferencesthatpresentcuttingedge,globalresearchaswellasprovidenew perspectivesontraditionalrelatedengineeringfields.Thiscontent,complemented withopencallsforcontributionofbooktitlesandindividualchapters,together maintainSpringer’sandEAI’shighstandardsofacademicexcellence.Theaudienceforthebooksconsistsofresearchers,industryprofessionals,advancedlevel studentsaswellaspractitionersinrelatedfieldsofactivityincludeinformationand communicationspecialists,securityexperts,economists,urbanplanners,doctors, andingeneralrepresentativesinallthosewalksoflifeaffectedadcontributingto theinformationrevolution.
AboutEAI
EAIisagrassrootsmemberorganizationinitiatedthroughcooperationbetween businesses,public,privateandgovernmentorganizationstoaddresstheglobal challengesofEurope’sfuturecompetitivenessandlinktheEuropeanResearch communitywithitscounterpartsaroundtheglobe.EAIreachesouttohundredsof thousandsofindividualsubscribersonallcontinentsandcollaborateswithaninstitutionalmemberbaseincludingFortune500companies,governmentorganizations, andeducationalinstitutions,provideafreeresearchandinnovationplatform.
ThroughitsopenfreemembershipmodelEAIpromotesanewresearchandinnovationculturebasedoncollaboration,connectivityandrecognitionofexcellenceby community.
Moreinformationaboutthisseriesat http://www.springer.com/series/15427
RashidMehmood•SimonSee•IyadKatib ImrichChlamtac
Editors
SmartInfrastructureand Applications
FoundationsforSmarterCitiesandSocieties
Editors
RashidMehmood
HighPerformanceComputingCenter
KingAbdulazizUniversity Jeddah,SaudiArabia
IyadKatib FacultyofComputingandInformation Technology(FCIT) KingAbdulazizUniversity Jeddah,SaudiArabia
SimonSee NvidiaAITechnologyCenter Singapore,Singapore
ImrichChlamtac EuropeanAllianceforInnovation Gent,Belgium
ISSN2522-8595ISSN2522-8609(electronic)
EAI/SpringerInnovationsinCommunicationandComputing ISBN978-3-030-13704-5ISBN978-3-030-13705-2(eBook) https://doi.org/10.1007/978-3-030-13705-2
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Preface
Infrastructurecanmeanseveralthingsandhasbeendefinedinseveralways.It couldrefertothefundamentalsystemsandfacilitiesthatanorganization,city, orcountryneedstofunction.Infrastructurecouldbeprovidedbyprivate,public, orpublic-privatepartnerships(PPPs)andcouldincluderoads,railways,bridges, airports,water,sewage,telephone,mobileandbroadbandequipment,manufacturingfacilities,clinicsandhospitals,schoolsanduniversities,andmanymore. Infrastructurecouldbehardorsoft.Hardinfrastructureisreferredtoasphysical thingssuchasports,buildings,andelectricityinstallations.Softinfrastructure referstotheinstitutionsthatfacilitateorganizationandnationstofunction,and theseinclude,forexample,bodies,procedures,andprogramsformanagement, education,health,transport,lawenforcement,andmilitary.ICTinfrastructures wereconsideredseparatefromhardinfrastructureinthepast;however,withthe increasingneedforICTpenetrationinsocieties,i.e.,digitalsocietiesoreconomies, itisincreasinglybeingconsideredpartofthebasicinfrastructure.
Infrastructureneedstobeunderstoodinthecontextoftheevolutionofour societies,recenttrendsinurbanization,andthebroaderlife.Smartcitiesprovidethe state-of-the-artapproachesforurbanization,havingevolvedfromthedevelopments carriedoutundertheumbrellaoftheknowledge-basedeconomyandsubsequently underthenotionofdigitaleconomyandintelligenteconomy.Smartcitiesencompassallaspectsofmoderndaylife,transportation,healthcare,entertainment,work, businesses,socialinteractions,andgovernance.Smartcitiesexploitphysicaland digitalinfrastructure,aswellastheintellectualandsocialcapital,forurbanand socialdevelopment.Technically,smartcitiesarecomplexsystemsofsystemsthat relyonconvergedandubiquitousinfrastructures.Thesmartcityphenomenonis drivenbyseveralinterdependenttrendsincludingapressingneedforenvironmental sustainabilityandpeoples’increasingdemandsforpersonalization,mobility,and higherqualityoflife.Thenotionofsmartcitiescanbeextendedtosmartsocieties, i.e.,digitallyenabled,knowledge-basedsocieties,awareofandworkingtoward social,environmental,andeconomicsustainability.
Sinceknowledgeandhumanandsocialcapitalareattheheartofthesmart cityandsmartsocietydevelopments,theroleofeducationshouldextendbeyond
themainstream“educationforemployment”scope.Itshouldextendtothenotion ofsocialandcollaborativegovernancewherethesocietycollaboratestotrain eachotherinmaintainingitsknowledge,moralfiber,operations,goodpractice,resilience,andcompetitivenessandforbringinginnovationandbecoming aknowledge-basedeconomy.Thekeytosucheffortswouldbethecreationof anecosystemofdigitalinfrastructuresthatareabletoworktogetherandenable dynamicreal-timeinteractionsbetweenvarioussmartcitysubsystems.
ThewordinfrastructurewasimportedfromFrenchinEnglishin1887.The prefix“infra”initmeans“below”whichimplied“structures”whichmostlywere undergroundsuchaswaterandsewagesystemsandtunnels.However,themeaning ofinfrastructureiscontinuingtobebroadened,andtheprefix“infra”couldbe takenas“foundational,”i.e.,“foundationalstructure,”hard,soft,virtual,anddigital, everythingthatweusetodayandwewilluseinthefuture,tosupportsmart life.Wedefinesmartinfrastructureas“knowledge-based,collaborative,converged, ubiquitous,self-aware,adaptive,resilient,digitally-enabled,andself-governing foundationalstructure;comprisinghard,soft,virtual,anddigitalfacilitiesand systems,andintellectualandsocialcapital;enablingsocial,environmentaland economicsustainability;enablinginnovationandcompetitiveness;facilitating personalizationinallaspectsofmodern-dayandfutureliving,theaspectsincluding transportation,healthcare,entertainment,work,businesses,socialinteractions, andgovernance;tomeetsocietal,economicandotherdemandsoforganizations, citiesorcountries.”SmartinfrastructurewouldincludetheInternetofThings (IoT)tomonitorandactuate.High-performancecomputing(HPC),bigdata, artificialintelligence,cloud,fog,andedgecomputingwillbeneededtoprovide thenecessaryintelligence,storage,compute,andcommunicationresourcesforthe smartinfrastructure.
Wearedelightedtointroducethisbook,whichbrings26chapterstogetheron cutting-edgetopicsrelatedtosmartinfrastructureandapplications.Thirteenofthese chaptersareinvitedextendedversionsofpapersfromtheproceedingsofthefirst EAI(EuropeanAllianceforInnovation)ConferenceonSmartSocieties,Infrastructure,TechnologiesandApplications(SCITA2017)heldatKingAbdulaziz University(KAU),Jeddah,SaudiArabia,on27–29November2017(see https:// www.springer.com/la/book/9783319941790).Thebookisdividedintotwomajor themesandfiveparts.Thefirstthemecontainschapterswherethefocusisonthe applications,incontrasttothesecondthemewherethecontributedchaptersare mainlyfocusedoninfrastructure.Lookingatthetitlesofthecontributedchapters inthisbook,thedistinctionbetweentheapplicationsandinfrastructurecouldbe subtleinmanycasesbecausemanyapplicationseventuallybecomepartofthe infrastructureandviceversa.Theplacementofthechaptersinthetwothemesis basedontheprimaryobjectivesandfocusofthechapters,exceptinacoupleof caseswherethechapterplacementisprioritizedtokeepthebookstructure.
Chapter 1 looksatenterprisesystemsandtherolethattheywillplayinthe conceptualizationandimplementationofnetworkedsmartcities,particularlythe informationsystemsaspectsofsmartinfrastructure.The“networked”aspectof smartcitiesisemphasizedbecausesmartcitieswillintegrateitsmultiplesubsystems
tocreateoperationaldynamicityandefficiencyamongothergoals.Theauthors reviewagoodnumberofconceptualdefinitionsofsmartcitiestoderiveits systemrequirements.Thetechnologicalfoundationsofsmartcitiesandsocieties arereviewedalongwithmanysmartcityapplicationsfromtheliterature.Partial leastsquareregressionisdescribedasamethodtomodelvariousinterdisciplinary smartcityconstructsalongwithexampleapplicationsfromtheliterature.Wehave placedthischapteratthebeginningofthebookoutsidethefivebookpartsbecause itprovidesfoundationalmaterialonsmartcitiesandinfrastructures.
Theapplicationsthemeofthebookcomprises13chaptersdividedinto3parts. PartIincludessevenchaptersrelatedtosmarttransportation.Thefirstthreechapters ofthispartarefocusedondetectionofeventsorincidentsusingTwitterorinductive loopsdata.Chapter 2 proposesamethodologyforanalyzingtraffic-relatedtweets intheArabiclanguageusingSAPHANA.Atechniqueisproposedforsentiment classificationusinglexicon-basedapproachtounderstanddriver’sfeelings.The tweetsarecollectedfromJeddahandMakkahcities(SaudiArabia)inorderto identifythemostcongestedroadsinthecitiesandtodetecteventssuchasaccidents, roadworks,fire,andweatherconditions.Chapter 3 isaimedatdevelopingdata managementandanalysistechniquesforsmartsocieties.Itspecificallyusesbig data,machinelearning,andotherplatformsincludingSpark,MLlib,Tableau,and GoogleMapsGeocodingAPI,tostudyTwitterdataforthedetectionandvalidation ofspatiotemporaleventsinLondon.Itempiricallydemonstratesthatphysical, virtual,andconceptualeventscanbedetectedautomaticallybyanalyzingdata. ItfindsandlocatescongestionaroundLondonandtheoccurrenceofmultiple eventsincluding“LondonNottingHillCarnival2017”andtheirlocationsandtimes, withoutanypriorknowledgeoftheevents.Chapter 4 bringstogethertransportbig data,deeplearning,in-memorycomputing,andGPUcomputingtopredicttraffic incidentsontheroad.Threedifferentkindsofdatasetsarecombinedtogetherto predictroadtrafficincidents.Thethreedatasetsincluderoadtrafficcharacteristics dataset,vehicledetectorstation(VDS),andincidentdata,acquiredfromtheCaliforniaDepartmentofTransportation(Caltrans)PerformanceMeasurementSystem (PeMS).
Chapter 5 providesareviewandtutorialonahybridstatisticalmachinelearning methodforbigdataroadtrafficmodelling.ThemethodisbasedonARIMA(autoregressiveintegratedmovingaverage)andSVM(supportvectormachine).The authorsuseGPSroadtrafficdataforprediction.Chapter 6 extendstheauthors’ earlierworkwheretheyhaddevelopedamethodologytointegratesupervised learninganddecisionfusiontoenhanceobjectclassificationaccuracyinadriving environment.Thischapterextendstheirearlierworkandprovidesanin-depth performancecomparisonofdeeplearningandC5.0decisiontreeclassifierfor objectclassificationindrivingenvironmentsusingabiggerdataset.Chapter 7 uses roadtrafficdatamadepubliclyavailablebytheUKDepartmentforTransport andprovidesanextendedanalysisofadisastermanagementsystemthatthey haveproposedintheirearlierwork.Chapter 8 proposesasystemcalledBigData ShortestPathGraphComputing(BDSPG)systemforsingle-sourceshortestpath computationsofbigdataroadnetworkgraphsusingApacheSpark.TheyusetheUS
roadnetworkdata,modelledasgraphs,andcalculateshortestpathsbetweenaset oflargenumbersofverticesinparallelonasupercomputer.Spark’sparallelization behaviorisanalyzedbysolvingproblemsofvaryinggraphsizes,variousstatesof theUSA(withover58millionedges),andavaryingnumberofshortestpathqueries reachinguptoonemillion.
PartIIincludesthreechaptersrelatedtosmarthealthcare.TheuseofDNAtyping orprofilingisrapidlygrowinginsmartapplicationssuchasforthediagnosisof geneticdiseases,paternitytests,andcriminalidentification.Chapter 9 providesan extendedreviewofDNAprofilingmethodsandtoolswithaparticularfocuson theircomputationalperformanceandaccuracy.Thecomputationalcomplexityof DNAtypingincreasessignificantlywiththenumberofunknownsinthemixture. FasterinterpretationsofDNAmixtureswithalargenumberofunknownsand higheraccuraciesareexpectedtoopenupnewfrontiersforthisarea.Chapter 10 proposesmethodsandarchitecturetoimprovecloudsecurityforhealthcare.Chapter 11 presentsareviewontheuseofbigdatainhealthcaresupplychainswithtopics includingbigdata,bigdataanalytics,theroleofbigdatainhealthcare,supplychain management(SCM),healthcaresupplychainmanagement,andtheroleofTwitter datainSCM.
PartIIIincludesthreechaptersonamixofsmartapplications.Chapter 12 proposesaframeworkthatusesmobileandcloudcomputingtechnologiestoprovide context-awareandportablerecommendationsforsmartmarkets.Theunderlying algorithmsandaprototypearedevelopedtosupportautomation,userintervention, andcustomizationofusers’preferencesduringtherecommendationprocess.Chapter 13 usesassociationruleminingtogaininsightintogradesofasetofcomputer sciencestudents.Chapter 14 proposesSelecWeb,anautomatictoolforselectinga Webframeworkbasedonasetofcriteriaanddeveloperpreferences.Theauthors developthesetofselectioncriteriausingtheanalytichierarchyprocess(AHP)and provideadetaileddescriptionandanalysisofthetoolincludingacasestudyforthe Webframeworkselection.
Thesecondthemeofthebookfocusesonsmartinfrastructurewithits12 chapters,dividedinto2parts.PartIVpresentsaselectionofninechapterson bigdata,high-performancecomputing(HPC),andtheirconvergence.Thefirst fourchaptersaremorefocusedonHPC.Chapter 15 investigatesandpresents thedesignandimplementationofHadoopclustersusingARM-basedsingleboardcomputers(SBCs).Thecost,energyconsumption,andperformanceofthe SBCclustersarediscussed.Chapter 16 investigatestheperformanceofparallel implementationsoftheJacobiiterativemethodonIntelMICKnightsCorner(KNC) architecturelookingatexecutiontime,offloadingtime,andspeedup.Chapter 17 reviewsimportantperformancecharacteristicsofsparsematrix-vector(SpMV) computationsongraphicsprocessingunit(GPU)architecturesalongwithvarious strategiestoimproveSpMVperformance.Severalwell-knownSpMVstorageand solutionschemesarediscussed.SpMVmultiplicationisanessentialbuildingblock fornumerousscientificandengineeringsmartapplications.Chapter 18 provides areviewofperformanceanalysistoolsandtechniquesforHPCapplicationsand
systemsalongwithcommonHPCapplicationsandacomparativeanalysisofHPC benchmarkingsuites.
ThenextfourchaptersofPartIVarefocusedonbigdata.Chapter 19 presentsa reviewofthestate-of-the-arttoolsandtechniquesfortheprocessingofbigdata applications.Indoingso,itcriticallyanalyzestheirobjectives,methodologies, andkeyapproachestoaddressthechallengesassociatedwithbigdata.Adetailed reviewandtaxonomyoftheresearcheffortsoffewcoreapplicationsareprovided. Althoughthischapterdiscussesapplications,itisincludedintheinfrastructurepart duetoitsmajorfocusontoolsandtechnologies.Chapter 20 discussesopportunities, issues,andchallengesofbigdatawiththefocusontheHadoopplatformstaking perspectivesondatalocality,loadbalancing,heterogeneityissues,scheduling issues,in-memorycomputation,multiplequeryoptimizations,andI/Oissuesofbig data.Ataxonomyofbigdataopportunitiesandchallengesisalsoproposed.Chapter 21 providesareviewofthetechnologiesrelatedtosoftwarequalityinemergingbig data,IoT,andsmartcityenvironments.Therolesofmodelcheckingandbigdata insoftwarequalityarediscussed.Chapter 22 discussesthegrowingsignificance ofopensoftwareandopendatalicensesinbigdataandsmartinfrastructures andproposesframeworksfortheselectionofopen-sourcesoftwareandopendata licenses.Areviewofnotableopen-sourceandopendatalicensesandthesuitability oftheselicensesforvariouskindsofdataandsoftwareisprovided.
Chapter 23 concludesPartIVwithareviewofandaproposedarchitecturefor bigdataandHPCconvergence.Thedrivingforces,challenges,andcurrentand futuretrendsassociatedwiththeintegrationofHPCandbigdataareidentified. TheprogrammingmodelsandframeworksofbigdataandHPCarereviewed,and theirchallengesintheexascalecomputingeraarediscussed.
BookPartVprovidesaselectionofthreechaptersonIoT.Chapter 24 proposes atestexecutionplatformbasedontheTTCN3standardfordynamicallyadaptable IoTnetworksinsmartcities.Theplatformconsidersbothstructuralandbehavioral adaptationsandaffordsaplatform-independenttestsystemforisolatingandexecutingruntimetests.Chapter 25 proposesahierarchicalclustereddynamicsource routing(HCDSR)techniquetoimprovefaulttoleranceandenergy-efficientrouting forwirelesssensornetworks(WSNs)inIoTenvironments.HCDSRisevaluated usingsimulationsandcomparedwithLEACH(low-energyadaptiveclusteringhierarchy)andDFTR(dynamicfault-tolerantrouting)protocols.Chapter 26 proposes amodel-basedapproachfortestingsecurityaspectsoftheInternetofThingsfor smartcitieswhichconsistsof(a)modellingthesystemunderinvestigationwithan appropriateformalism,(b)derivingtestsuitesfromtheobtainedmodel,(c)applying somecoveragecriteriatoselectsuitabletests,(d)executingtheobtainedtests,and (e)finallycollectingverdictsandanalyzingtheminordertodetecterrorsandrepair them.
Thebookcomprisesresearcharticles,andhence,itisaimedatearlytoadvanced researchers.Someofthechaptersarewritteninatutorialmannerandthereforecan alsobeusedforteachingpurposesinuniversities.
Wewouldliketoacknowledgethesupportofmanypeoplewhohelpedrealize thepublicationofthisbook.ThevariouscommitteesofSCITA2017includingthe
TPCareacknowledgedfortheircontributionsinreviewingthepapers,whichare includedinthisbook.SpecialthanksgotoEliškaVl ˇ cková,themanagingeditorat theEuropeanAllianceforInnovation(EAI),whosehelpandpatiencehavebeen fundamentalinbringingthisbooktopublication.
Thisbookisbeingintroducedinanimportanttimewhensomuchishappening inICTandsmartinfrastructurespace.Manynewsmartdistrictsandcitiesarebeing builtaroundtheworld,whilemanyexitingcitiesareevolvingortransforming intosmartcities.InSaudiArabia,itisalsoaveryhightimewiththerecent announcementofitsplanstobuildasmartcitycalledNEOMsupportedby$500 billionfromtheSaudigovernment.Thisbookwillcontributetoandshapethese smartdevelopmentsinSaudiArabiaandglobally.
Jeddah,SaudiArabiaRashidMehmood SingaporeSimonSee
Jeddah,SaudiArabiaIyadKatib Gent,BelgiumImrichChlamtac
Contents
1EnterpriseSystemsforNetworkedSmartCities ........................1 NaimAhmadandRashidMehmood
PartISmartTransportation
2SentimentAnalysisofArabicTweetsforRoadTraffic CongestionandEventDetection ..........................................37 EbtesamAlomari,RashidMehmood,andIyadKatib
3AutomaticDetectionandValidationofSmartCityEvents UsingHPCandApacheSparkPlatforms ................................55 SugimiyantoSuma,RashidMehmood,andAiiadAlbeshri
4In-MemoryDeepLearningComputationsonGPUsfor PredictionofRoadTrafficIncidentsUsingBigDataFusion ..........79 MuhammadAqib,RashidMehmood,AhmedAlzahrani, andIyadKatib
5HybridStatisticalandMachineLearningMethodsforRoad TrafficPrediction:AReviewandTutorial ...............................115 BdoorAlsolami,RashidMehmood,andAiiadAlbeshri
6ComparisonofDecisionTreesandDeepLearningforObject ClassificationinAutonomousDriving ....................................135 FurqanAlam,RashidMehmood,andIyadKatib
7ASmartDisasterManagementSystemforFutureCitiesUsing DeepLearning,GPUs,andIn-MemoryComputing ....................159 MuhammadAqib,RashidMehmood,AhmedAlzahrani, andIyadKatib
8ParallelShortestPathBigDataGraphComputationsofUS RoadNetworkUsingApacheSpark:Survey,Architecture, andEvaluation ..............................................................185 YasirArfat,SugimiyantoSuma,RashidMehmood, andAiiadAlbeshri
PartIISmartHealthcare
9ASurveyofMethodsandToolsforLarge-ScaleDNAMixture Profiling ......................................................................217 EmadAlamoudi,RashidMehmood,AiiadAlbeshri, andTakashiGojobori
10AnArchitecturetoImprovetheSecurityofCloudComputing intheHealthcareSector ...................................................249 SalehM.Altowaijri
11TheRoleofBigDataandTwitterDataAnalyticsinHealthcare SupplyChainManagement ...............................................267 ShoayeeAlotaibi,RashidMehmood,andIyadKatib
PartIIIMiscellaneousApplications
12AMobileCloudFrameworkforContext-AwareandPortable RecommenderSystemforSmartMarkets ...............................283 AftabKhan,AakashAhmad,AnisUrRahman,andAdelAlkhalil
13AssociationRuleMininginHigherEducation:ACaseStudy ofComputerScienceStudents ............................................311 NjoudAlangariandRaadAlturki
14SelecWeb:ASoftwareToolforAutomaticSelectionofWeb Frameworks .................................................................329 ThahaMuhammed,RashidMehmood,EhabAbozinadah, andSanaaSharaf
PartIVBigDataandHighPerformanceComputing
15OnPerformanceofCommoditySingleBoardComputer-Based Clusters:ABigDataPerspective .........................................349 BasitQureshiandAnisKoubaa
16ParallelIterativeSolutionofLargeSparseLinearEquation SystemsontheIntelMICArchitecture ..................................377 HanaAlyahya,RashidMehmood,andIyadKatib
17PerformanceCharacteristicsforSparseMatrix-Vector MultiplicationonGPUs ....................................................409 SarahAlAhmadi,ThahaMuhammed,RashidMehmood, andAiiadAlbeshri
18HPC-SmartInfrastructures:AReviewandOutlook onPerformanceAnalysisMethodsandTools ...........................427 ThahaMuhammed,RashidMehmood,AiiadAlbeshri, andFawazAlsolami
19BigDataTools,Technologies,andApplications:ASurvey ............453 YasirArfat,SardarUsman,RashidMehmood,andIyadKatib
20BigDataforSmartInfrastructureDesign:Opportunities andChallenges ..............................................................491 YasirArfat,SardarUsman,RashidMehmood,andIyadKatib
21SoftwareQualityintheEraofBigData,IoTandSmartCities .......519 FatmahYousefAssiriandRashidMehmood
22OpenSourceandOpenDataLicensesintheSmart InfrastructureEra:ReviewandLicenseSelectionFrameworks ......537 EmadAlamoudi,RashidMehmood,WajdiAljudaibi,AiiadAlbeshri, andSyedHamidHasan
23BigDataandHPCConvergenceforSmartInfrastructures:A ReviewandProposedArchitecture .......................................561 SardarUsman,RashidMehmood,andIyadKatib
PartVInternetofThings(IoT)
24TowardsaRuntimeTestingFrameworkforDynamically AdaptableInternetofThingsNetworksinSmartCities ...............589 MoezKrichenandMariamLahami
25HCDSR:AHierarchicalClusteredFaultTolerantRouting TechniqueforIoT-BasedSmartSocieties ................................609 ThahaMuhammed,RashidMehmood,AiiadAlbeshri, andAhmedAlzahrani
26SecurityTestingofInternetofThingsforSmartCity Applications:AFormalApproach ........................................629 MoezKrichen,MariamLahami,OmarCheikhrouhou, RoobaeaAlroobaea,andAfefJmalMaâlej
1.2TheConceptofSmartCity
Theconceptofsmartcitiesoriginatesfromtheexcellenceofmultitudesof disciplinessuchasinformationtechnology,sustainability,architectureandurban planning,socialandeconomicdevelopmenttomentionsome.Therearenumerous definitionsavailableintheliteratureonthesmartcityfocusingondifferentaspects. Someofthemaregivenbelowinthechronologicalorder.
Halletal.[2]presentedvisionofsmartcityasintegrationofscienceand technologythroughinformationsystem,andnewrelationshipsbetweengovernment,citymanagers,businessacademiaandtheresearchcommunity.Andgave workingdefinitionas“Acitythatmonitorsandintegratesconditionsofallofits criticalinfrastructures,includingroads,bridges,tunnels,rails,subways,airports, seaports,communications,water,power,evenmajorbuildings,canbetteroptimize itsresources,planitspreventivemaintenanceactivities,andmonitorsecurityaspects whilemaximizingservicestoitscitizens.”Hemoreoverpredictedthat“smartcities vision,systemsandstructureswillmonitortheirownconditionsandcarryoutselfrepairasneeded.”
Giffinger[3]definedsmartcityas“Acitywellperforminginaforward-looking wayinthesesixcharacteristics(smarteconomy,smartpeople,smartgovernance, smartmobility,smartenvironment,andsmartliving),builtonthesmartcombination ofendowmentsandactivitiesofself-decisive,independentandawarecitizens.”He identifiedthirty-threefactorsand1–4indicatorstomeasurethesixcharacteristicsof thestateofthesmartcityandranked70mid-sizedEuropeancities.Hestressedon reportingofmetricsalongwithrankingtomakethewholeexercisemoreactionable.
Hollands[4]didn’tgivetheformaldefinitionbutpointedthatliteratureonsmart citytalksabout“utilizationofnetworkedinfrastructuretoimproveeconomicand politicalefficiencyandenablesocial,cultural,andurbandevelopment,”where theterminfrastructureindicatesbusinessservices,housing,leisureandlifestyle services,andICTs(mobileandfixedphones,satelliteTVs,computernetworks, e-commerce,andinternetservices).Hegivesadiscourseonhowtheoveremphasis
ontechnologycandevelopfalsesmartcitieswhichcanfurtheraggravatethe problemssuchasgentrificationandpowerimbalance.Therefore,inhisviewsmart cityinitiativeshouldstartfromthepeopleandensurethebalanceofpowerbetween privilegedclassandordinarypeople.
Washburnetal.[5]mentionthesmartcitydefinitionofForresteras“Theuse ofSmartComputingtechnologiestomakethecriticalinfrastructurecomponents andservicesofacity––whichincludecityadministration,education,healthcare, publicsafety,realestate,transportation,andutilities––moreintelligent,interconnected,andefficient”andsmartcomputingas“Anewgenerationofintegrated hardware,software,andnetworktechnologiesthatprovideITsystemswithrealtimeawarenessoftherealworldandadvancedanalyticstohelppeoplemake moreintelligentdecisionsaboutalternativesandactionsthatwilloptimizebusiness processesandbusinessbalancesheetresults.”TheyassertthattheCIOsarethe primaryenablersofsmartcities.TheyhavedefinedtherolesofCIOssuchascity levelCIO,criticalpublicinfrastructureandservicesrelatedCIOs,andCIOsrelated withentitiesthatactasconsumerofcriticalpublicinfrastructureandservicesin planning,implementinganddeliveringthesmartcityvision.
Harrisonetal.[6]havedefinedthesmartcityfromtheperspectiveofinformation technologyas“connectingthephysicalinfrastructure,theITinfrastructure,the socialinfrastructure,andthebusinessinfrastructuretoleveragethecollective intelligenceofthecity.”TheyhavepresentedtheITinfrastructurethatwillimprove theoperationalefficiencyofthecityandqualityoflife.Theyproposedtheserviceorientedarchitecture(SOA)modelandmentioneditsshortcomingsaswellsuchas itcanhandleonlyupto1000eventspersecond.
Chen[7]definedtheconceptas“Smartcitieswilltakeadvantageofcommunicationsandsensorcapabilitiessewnintothecities’infrastructurestooptimize electrical,transportation,andotherlogisticaloperationssupportingdailylife, therebyimprovingthequalityoflifeforeveryone.”Thefocusofhisnotechallenged thecapabilityofexistingnetworkinfrastructurethatisbasedonTCP/IP,theprotocol thatutilizesthestatelessroutersandtruststhehosts.Heemphasizesonthenew inherentcapabilitiesinthenetworksuchasfastself-healing,senderauthentication, andper-hoppacketaccountingforpackettracebacktosupportsmartcitycritical infrastructure.
Caragliuetal.[8]identifiedthecharacteristicsofsmartcitiesthroughliterature reviewas:utilizationofnetworkedinfrastructure,business-ledurbandevelopment, socialinclusion,high-techandcreativeindustries,socialandrelationalcapital,and socialandenvironmentalsustainability.Furthertheygavetheoperationaldefinition as“cityissmartwheninvestmentsinhumanandsocialcapitalandtraditional(transport)andmodern(ICT)communicationinfrastructurefuelsustainableeconomic growthandahighqualityoflife,withawisemanagementofnaturalresources, throughparticipatorygovernance.”BasedontheanalysisofUrbanAuditdatafor theyears2003–2006(morethan250indicatorsforaround260citiesofEU27 nations)theyfoundthepositivecorrelationbetweenurbanwealth(measuredusing PPP),andthepresenceofvastnumberofcreativeprofessionals,ahighscorein multimodalaccessibilityindicators,thequalityofurbantransportationnetworks, thediffusionofICTs,andthequalityofhumancapital.
Velosaetal.[9]definesthesmartcityas“Asmartcityisbasedonintelligent exchangesofinformationthatflowbetweenitsmanydifferentsubsystems.This flowofinformationisanalyzedandtranslatedintocitizenandcommercialservices. Thecitywillactonthisinformationflowtomakeitswiderecosystemmoreresource efficientandsustainable.Theinformationexchangeisbasedonasmartgovernance operatingframeworkdesignedtomakecitiessustainable.”
Komninos[1]bringstheconceptofspatialintelligencetodescribethephenomenonofsmartcities.Thespatialintelligencematerializesfromtheagglomerationandintegrationofintelligenceofintellectualcapital,socialcapitaland infrastructuralcapital.Andemergenceandutilizationsofthisspatialintelligenceto solvediverseproblemsmakesacitysmart.Healsopoisedthatsustainableknowledgeeconomyandinternetaretheprimarydriversforthesmartcities.Thereafter fromcasesofBletchleyPark,CyberportHongKong,andAmsterdamSmartCity,he bringsoutthreetypesofspatialintelligencesuchasorchestrationintelligence(integrationalongcommunity-basedworkflows),amplificationintelligence(integration ofskills,digitaltools,andcityinfrastructures),andinstrumentationintelligence (integrationofcityinfrastructure,activitydataflows,measurementdevices,and predictivemodeling).Thesespatialintelligencescanbeadoptedinisolationor incombinationtodevelopsmartcites.Healsomentionsthatthesmartcities shouldaddressthechallengesofcompetitivenessthroughknowledgeeconomy, efficientemploymentmarkettoreducepovertyandenvironmentalsustainabilityas pointedoutinthereportofEuropeanCommission,2008.Finally,hepointsoutthat researchshouldfocusontodeveloparchitecturesofintegrationbetweenphysical, institutionalanddigitalaspectsofcitiestohavehigherspecialintelligencethatwill leadtorealsmartcity.
NamandPardo[10]haveproposedthestrategiestomakeasmartcity.They gavetheworkingdefinitionofitas“Asmartcityinfusesinformationintoits physicalinfrastructuretoimproveconveniences,facilitatemobility,addefficiencies, conserveenergy,improvethequalityofairandwater,identifyproblemsandfix themquickly,recoverrapidlyfromdisasters,collectdatatomakebetterdecisions, deployresourceseffectively,andsharedatatoenablecollaborationacrossentities anddomains.”Thentheyidentifiedthreecorefactorssuchastechnology,human andinstitutioncriticaltoachievethevisionofsmartcity.Technologyfactorhelps inintegratingthetechnologies,systems,infrastructures,services,andcapabilities intoanorganicnetwork.Humanfactorshouldfacilitatelearningmoresothesocial learningthatcanbridgethegapofdigitaldivide.Institutionfactorwillprovide dynamicgovernancetoconnectcitizens,communities,andbusinessinrealtimeto sparkgrowth,innovation,andprogressinassistancewiththepivotalandvisionary roleofleadership.
Thite[11]putsforththepointthatsmartcityneedssmartpeopleandusing theeconomicgeographytheoryillustratesonthefactorsthatinfluenceknowledge workerinchoosingaplacetoliveandwork.Fromthisperspectiveheposited that“Smartcityaimsatnurturingacreativeeconomythroughinvestmentin qualityoflifewhichinturnattractsknowledgeworkerstoliveandworkinsmart cities.”TheNewEconomicGeographyrelatingto“economiesofscaleandspatial
development”describestheagglomerationoffirmsandworkers.Ontheotherhand, NewNeoclassicalUrbanEconomicsrelatingto“optimalpreference-satisfying behaviors”describesthejoiningofmorefirmsandindividuals.
Rios[12]definedasmartcityas“Acitythatgivesinspiration,sharesculture, knowledge,andlife,acitythatmotivatesitsinhabitantstocreateandflourishintheir ownlives.”Hisemphasisisontocreateempoweredspacesthathelpdiversepeople andculturetoachieveidentityandgenerateideas.Andthearchitecturaldesignof cityshouldcausemotivationtocreategreatplaces,inspiration(connectivity)to becomeentrepreneur,innovationtoreinventthemselves,andidentitytobecome leader.
Thuzar[13]definedtheconceptas“Smartcitiesarecitiesthathaveahighquality oflife;thosethatpursuesustainableeconomicdevelopmentthroughinvestmentsin humanandsocialcapital,andtraditionalandmoderncommunicationsinfrastructure(transportandinformationcommunicationtechnology);andmanagenatural resourcesthroughparticipatorypolicies.Smartcitiesshouldalsobesustainable, convergingeconomic,social,andenvironmentalgoals.”Heemphasizedthecorrelationofsmartcitywiththelivabilityandentitiestopromoteprosperity,equity,and sustainability.
Barrionuevoetal.[14]proposed“Beingasmartcitymeansusingallavailable technologyandresourcesinanintelligentandcoordinatedmannertodevelopurban centersthatareatonceintegrated,habitable,andsustainable.”Theyidentifiedfive typesofcapitalsuchaseconomic,human,social,environmental,andinstitutional thatcanbenurturedthroughinnovation,socialcohesion,sustainability,andconnectivity.Theyalsopresentedthestepbystepprocessalongwithtimelinetobuild asmartcitysuchasdiagnosethesituation(2–5months),developastrategicplan (5–12months)andtakeaction(2–10years).Furthercitymustassessthelevers ofchangesuchasstrategicandscenarioplanning;collaborationandcommunication;public–privatepartnerships;fundingstrategies;capacitymanagement;and technologicalinfrastructureinthecontextofitscompetitivesituationandstrategic position.
Cretu[15]identifiedtwomainstreamsofresearchideaswithrespecttosmart cities:“(1)smartcitiesshoulddoeverythingrelatedtogovernanceandeconomy usingnewthinkingparadigmsand(2)smartcitiesareallaboutnetworksof sensors,smartdevices,real-timedata,andICTintegrationineveryaspectof humanlife.”Exploringfurthertheseconddimensionheproposesthreeaxioms regardingasmartcitythatithaswell-designedICTinfrastructure,transforms real-timedataintomeaningfulinformation,andallowsinhabitantstopredefined automatedactioninresponsetoevents.Heproposedthesystemperspectivefor smartcityas“Event-drivenSmartCity(EdSC)asasystem(softwareplatform) representinganinternet-awaredigitalliving,environmentwherepeople,software services,sensorsandsmartdevicesinteractbymeansofeventsandlisteners.”The basicingredientsofthisplatformareabilitytoconvertsignaltoevent;knowledge sharing;actiondefinition,storageandevent-condition-action(ECA)relationship; andabilitytoconvertactionintosignals.TheSmartCommunitySpace(SCS) isthecentralarchitecturalcomponentofEdSCthatimplementsthepartialview
overtheworld.TheSCSisbuiltonsubsetofcommoninterestsuchasfamily, school,andphysicalareainordertosustaincomplexitywhenitcomestorealtimedataprocessingandcomplexeventprocessing(CEP).EdSCrequiresevent drivenarchitecture(EDA)andsemanticeventprocessingbasedonECA.That willusedifferentontologiesanddomainknowledgetoremoveambiguitywith events.Andthemodulareventontologiescanalsoencompassdifferentlanguagesin additiontodifferentontologies.SemanticwebtechnologiessuchasRDF(Resource DescriptionFramework),LOD(LinkedOpenData)Cloud,OWL(WebOntology Language),SWRL(SemanticWebRuleLanguage),RIF(RuleInterchangeFormat), SBVR(SemanticsofBusinessVocabularyandBusinessRules),andSPARQL (RDFQueryLanguage)areusefulinimplementingtheEdSC.RDFcanbeused torepresenteventandontologiesinLODCloudtoattachsemantictoidentify themeaningofsignalsinEdSCplatform.OWLcanbeusedinsignal-to-event transformer,CEPalgorithms,andidentificationoflistenersforparticularevents. SWRLandRIFareaptfordefininglistenersandSBVRcanprovidethenatural languageextension.AndSPARQLcanprovidetheadvancedsupportforquerying therightlistenersfortheparticularevent.
KourtitandNijkamp[16]definetheconceptas“Smartcitiesaretheresult ofknowledge-intensiveandcreativestrategiesaimingatenhancingthesocioeconomic,ecological,logisticandcompetitiveperformanceofcities.Suchsmart citiesarebasedonapromisingmixofhumancapital(e.g.skilledlaborforce), infrastructuralcapital(e.g.high-techcommunicationfacilities),socialcapital(e.g. intenseandopennetworklinkages)andentrepreneurialcapital(e.g.creativeand risk-takingbusinessactivities).”Theyalsoassertthattheproductivitygaininsmart cityshouldoffsettheriseinthelocalproblems.Theseplacesattractandretain varietyofcreativepeopleandofferinnovativeandsustainablesolution.Andthese placesexploittheagglomerationadvantagestoitsmaximum.
Kourtitetal.[17]posittheconceptas“Smartcitieshavehighproductivityasthey havearelativelyhighshareofhighlyeducatedpeople,knowledge-intensivejobs, output-orientedplanningsystems,creativeactivitiesandsustainability-oriented initiatives.”Theyidentifiedthattheknowledgeorientationandculturaldiversityare thekeyfactorsinpresenteraofsmartcities.Thephysical,geographical,andsocial proximitiesamplifytheagglomerationeffectstofacilitateknowledgeprocesses. ICTcanhelpincodifiedknowledgebutfailsintacitandcontextualknowledge. Therefore,theproximitiesandagglomerationphenomenonremainimportant.
LazaroiuandRoscia[18]definetheconceptofsmartcityas“Acommunity ofaveragetechnologysize,interconnectedandsustainable,comfortable,attractive andsecure.”Theyproposedthesmartcityassessmentmodelhaving18indicators devisedwiththehelpoffuzzylogic.
Lombardietal.[19]definetheconceptsas“Theapplicationofinformationand communicationstechnology(ICT)withtheireffectsonhumancapital/education, socialandrelationalcapital,andenvironmentalissuesisoftenindicatedbythe notionofsmartcity.”Theyhaveproposedasmartcityassessmentmodelwith thehelpofANP(AnalyticalNetworkProcess)technique.Theydevelopedtheir modelonthefourhelicesprincipalsuchasCivilSociety,University,Industry,and
Government.Further,theyidentifiedthecivicinvolvementalongwithsocialand culturalcapitalendowments,shapestherelationshipbetweenthetriplehelicessuch asuniversity,industryandgovernment.Andtheinterplaybetweenallfourhelices includingthecivicsocietydeterminestheprogressofsmartcity.Theymodeled thefiveclusters(SmartGovernment,SmartEconomy,SmartHumanCapital,Smart Living,andSmartEnvironment),fourhelices(Government,University,Industry, andCivilSociety),andfourpolicyvisions(ConnectedCity,EntrepreneurialCity, LivableCity,andPioneerCity)alongwiththeindicators.Theresultwasthatallthe clustersaretryingtopursuethepolicystrategyofentrepreneurialcity.
Bakicietal.[20]inthecontextofBarcelonacityposited“Smartcityasahightechintensiveandadvancedcitythatconnectspeople,informationandcityelements usingnewtechnologiesinordertocreateasustainable,greenercity,competitive andinnovativecommerce,andanincreasedlifequalitywithastraightforward administrationandgoodmaintenancesystem.”Achievingcompetitivenessofthe Barcelonahasbeentheforemostfactortotransformitintoaleadingsmartcityin Europe.ThecityhassagaciouslyusedtheadvancedICTtechnologytodevelop infrastructuressuchasOpenData,LivingLabs,andSmartDistrict.tofoster thedynamismoftriplehelix(faculty,companyandcitizeninteraction)toboost creativity,knowledge,andinnovationandhencesupportstheconceptualmodelof Barcelonaforsmartcity,knowledgeeconomyandknowledgesociety.
Zygiaris[21]illustratestheconceptas“Asmartcityisunderstoodasacertain intellectualabilitythataddressesseveralinnovativesocio-technicalandsocioeconomicaspectsofgrowth.Theseaspectsleadtosmartcityconceptionsas “green”referringtourbaninfrastructureforenvironmentprotectionandreduction ofCO2 emission,“interconnected”relatedtorevolutionofbroadbandeconomy, “intelligent”declaringthecapacitytoproduceaddedvalueinformationfromthe processingofcity’sreal-timedatafromsensorsandactivators,whereastheterms “innovating”,“knowledge”citiesinterchangeablyrefertothecity’sabilitytoraise innovationbasedonknowledgeableandcreativehumancapital.”Heproposed sixlayersforsmartcityplanninginadditiontoTheCityLayerasLayer0. Thesesixlayersare:TheGreenCityLayer,TheInterconnectionLayer,The InstrumentationLayer,TheOpenIntegrationLayer,TheApplicationLayer,and TheInnovationLayer.TheCityLayer(Layer0)referstotherecognitionofcity’s identityandplanningofurbaninfrastructureincompliancewiththesmartcity prioritiesandsociallyinclusivevision.TheGreenCityLayer(Layer1)refersto theenvironmentfriendlydevelopmentsuchasCO2 footprintreduction,alternative energyoptions,greentransportmanagement,andgreenbuildingspecification.The InterconnectionLayer(Layer2)referstotheholisticbroadbandconnectivityto bringallcommunitiesonline.TheInstrumentationLayer(Layer3)referstorealtimeeventaggregationfromtherangeofsensorsandactuatorsthroughInternetof Thingsframework.TheOpenIntegrationLayer(Layer4)referstothedevelopment ofUrbanOperatingSystemtosharethedata,contentandservices.Thisplatform isdesignedandimplementedontechnologiessuchasSemanticWeb,Linked OpenData,VisualizationofAPIs,InternetofTrustandCloudComputing.The ApplicationLayer(Layer5)referstothedevelopmentofintelligentapplicationin
differentdomainssuchase-traffic,e-government,e-democracy,andsmartenergy gridsetc.TheInnovationLayer(Layer6)referstothecommunitywideutilization ofurbaninnovationecosystemofasmartcitytodevelopnewbusinessmodels tonavigatethecityonthesustainablegrowth.Authoralsoemphasizesuponthe developmentofprocesses-orientedassessmentmodelforsmartcitysuccessrather thansimplebenchmarkingindexes.
Marsal-Llacunaetal.[22]definetheconceptas“SmartCitiesinitiativestryto improveurbanperformancebyusingdata,informationandinformationtechnologies(IT)toprovidemoreefficientservicestocitizens,tomonitorandoptimize existinginfrastructure,toincreasecollaborationamongdifferenteconomicactors, andtoencourageinnovativebusinessmodelsinboththeprivateandpublicsectors.” Andtheyalsogavemoretechnicaldefinitionofitas“citieswishingtobecome smartmustbeequippedwitha“brain”(software)suppliedwithlotsofreal-time information(datacollectedfromsensors)enablingthemtotakemoresustainable, efficientandcitizen-centricdecisions,smoothlytransformingdecisionsintoactions bymeansoftechnologicalsolutions.”Heemphasizedonthenormalizationprocess ofindicatorsanddevelopmentofsummarizationindex,essentialtocomparethe smartnessofthecitiesinadditiontotheirrankings.Andreal-timedataismore importantthanthestatisticaldataforwhichubiquitouscomputing,remotesensing imaginary,smartmeters,etc.shouldbeutilized.
Albinoetal.[23]identifiedfourcommoncharacteristicsforthesmartcity “acity’snetworkedinfrastructurethatenablespoliticalefficiencyandsocialand culturaldevelopment;anemphasisonbusiness-ledurbandevelopmentandcreative activitiesforthepromotionofurbangrowth;socialinclusionofvariousurban residentsandsocialcapitalinurbandevelopment;thenaturalenvironmentasa strategiccomponentforthefuture.”Authoralsoproposesthattheassessmentof smartcityinitiativesshouldbetailoredtoitsuniquecharacteristicsandvision.
Mehmoodetal.[24]define,“smartcitiesprovidethestateoftheartapproaches forurbanisation,havingevolvedfromthedevelopmentscarriedoutunderthe umbrellaofknowledge-basedeconomy,andsubsequentlyunderthenotionofdigital economyandintelligenteconomy.”Smartsocietyisanextensionofthesmart citiesconcept,“adigitally-enabled,knowledge-basedsociety,awareofandworking towardssocial,environmentalandeconomicsustainability”[24].Muhammedetal. [25]notethatsmartcitiesareconsideredamajordriverforthetransformationof manyindustriesduetothefactthatsmartcitiesaredrivenby,orinvolve,integration ofmultiplecitysystems,suchastransport,healthcare,andoperationsresearch,with theaimtoprovideitscitizensahighqualityoflife.
Toidentifythefrequentdominatingthemesofsmartcity,thewordcloudhasbeen generatedfromthesedefinitions(seeFig. 1.1).Lookingatthewordcloudcreated fromthedefinitionsofsmartcitiesthreemajorareascanbeidentified,firstisthe enablementthroughadvancedinformationandcommunicationtechnology(ICT) infrastructure.Secondistheachievementofhigheststandardsofneedsofasociety orcommunitysuchasknowledge,economyandlife.Andthethirddealswiththe operationalization,meaningdoingsoinresourceefficientwayorsustainableway. Thesechallengesorrequirementscandefinethevisionforthesmartcitysystemas follows.
Fig.1.1 Wordcloudgeneratedfromthesmartcitydefinitions
“SmartCitySystemisaconvergenceofintegratedsystemssupportingcity processesreengineeredonsustainabilityprinciplesandutilizingstateoftheart technologytoadvancefrontiersofknowledge,economyandlifeinasociety.”In theorganizationalcontext,thesetypesofintegratedsystemshavebeenexisting since1990s.TheywerelabeledbydifferentnamessuchasEnterpriseSystems (ES)orEnterpriseResourcePlanning(ERP).Alsoknownwiththeapplicationspecificmodulessuchascustomerrelationshipmanagement(CRM)orsupplychain management(SCM).Followingsectionillustratesuponthisinnovativetechnology.
1.3EnterpriseSystems:TechnologyandEvolution
Enterprisesfacestiffcompetitionandoperateattimesonraiserthinmargins. Sustainingthebusinessrequiresinnovationandproactiveapproachinanticipation offutureissuesandproblems.Itismandatorytomaintainoptimalproductivity, excellentcustomerserviceandreducedcycletimes.Enterpriseshavebeenapplying ICTtogaincompetitiveadvantagessince1950s.Thissectiongivestheintroduction ofinformationtechnologyinenterprises,technologyofenterprisesystemsandits architecture.
1.3.1InformationTechnologyinOrganizations
InvestmentsinITareeverincreasingandnoneoftheorganizationwantstomiss thisbandwagonofIT.Asizableportionof4.2%ofannualrevenueisspentonIT [26].Onanaverageorganizations’50percentcapitalexpenditurebudgetisutilized byITthathassteadilyincreasedeverydecadefromlessthan5%intheyear1965 [27].
Thecorefunctionsoftheinformationtechnologyaredatastorage,datatransport, anddataprocessing.ThecosttocarryoutthesefunctionsisdecreasingashypothesizedbyMoore’sLaw“Everytwoyearsthenumberoftransistorsonintegrated circuitdoubles.”Theinformationtechnologycanbethoughtofabundleofshared servicestocatertotheneedofcommunicationandfoundationforimplementing businessapplications[28].ITinfrastructureisdefinedasasetofsharedITresources whichisafoundationforbothcommunicationacrosstheorganizationandthe implementationofpresent/futurebusinessapplications[29].ITinfrastructureis composedoftwocomponents,Technicalconsistingofhardware,software,network, telecommunications,applications,andtangibleITresources,andHumanreferring toknowledgeandskillrequiredtoorchestratethetechnicalcomponents[29].
Weilletal.[30]collecteddatabelongingtotheperiodof1990–2001.They gatheredthedatafor180businessinitiativesfrom118businessesin89enterprises. Theenterprisesselectedweretopthreeintheirindustry.Afteranalysisofthe datacollected,theyproposedthattheITinfrastructurehastobethoughtofin termsofservicessincetheagreementlevelcanbemadestablewhereasunderlying technologyismoredynamic.Theseinfrastructuralservicesaredeployedatmultiple levelenterprisewideorbusinessunitlevel.Wheretoplaceacapabilityisastrategic decisionpursuedbytheconcernedorganization.Forinstance,keepingasinglepoint ofcustomercontactrequirescapabilitytobedevelopedattheenterprisewidescale sothatthedatacanbesharedandfacilitatecrossselling.
Theyfurtheridentified70ITinfrastructuralservicesandgroupedtheminto10 capabilityclusters.SixlayersweredefinedasthephysicallayerofITinfrastructure capability,namelyChannelManagement,SecurityandRisk,Communications, DataManagement,ApplicationInfrastructure,andITFacilitiesManagement.And reamingfourclustersITManagement,ITArchitectureandStandards,ITEducation, andITResearchandDevelopmentwereconsideredasmanagement-orientedIT infrastructurecapability.ApplicationslikeenterprisesystemssuchasEnterprise ResourcePlanning(ERP),SupplyChainManagement(SCM),andCustomer RelationshipManagement(CRM)fallundertheclusterofapplicationinfrastructure. TechnicalcomponentsofITarereadilyavailableandmoreorlesshavebecome commodityinputtothewholeinfrastructure.Thedistinctionliesinskillsand abilitiestoutilizethemtogainstrategicadvantage.Whereassomeauthorslike[27] havegonetotheextentthatITdoesn’taddanystrategicvalueandwholeofIThas becomeaninfrastructuraltechnologysimilartorailroads,telegraph,electricity,etc.
1.3.2AboutEnterpriseSystems
Mostorganizationshave,broadlyspeaking,followingdivisionsprocurement,productionandoperationsinventorymanagement,finance,marketing,andsalesand distribution.Eachdepartmenthasgotitsownprocessesandprocedures.Information andcontrolfromonedepartmenttoanotherdepartmentneedtobecoordinatedin ordertoexecuteabusiness.Traditionallythesedepartmentsusedtoworkinavery fragmentedfashion.Thatoftenresultedinthecreationofinformationsilos.
EverydepartmentusedtotackleitsownITinitiativesofteninisolationwith theoverallstrategicdirectionoftheorganization.Attimessamesoftwarewas implementedinmultiplebusinessunitsincurringunnecessarycost.Asweknow softwareisnothing,butasetofcomplexcodewritteninaprogramminglanguage. Duetoinfinitescenariospossiblewithanysimplesoftware,testingthesoftwareisa Herculeantask.Astimepassedbytheseisolatedsoftwarecouldnotcopeupwiththe importantparametersofITlikescalability,portability,robustness,andintegration.
Theinnovationsintheinformationtechnologyhaveledtothecreationofa perfectnetworkofinformationinterchangethatallowstheremovalofallthehassles ininformationsharing.Moreover,softwarepackageshavebeendevelopedthatcan ideallysuittoanyorganization’sprocesses.Thesepackagesareknownasenterprise systemsthataresetofapplicationsthatinterconnectthedifferentprocessesand proceduresoftheorganization.Theyutilizeacentraldatabaseforallthedataneeds [31].
1.3.3EvolutionofEnterpriseSystems
Enterprisesystemsarealsoknownasenterpriseapplicationsorbusinessapplications.Thesesystemsallowtheseamlessintegrationofinformationflowinthe organizationsinternallyandexternally.ThecurrentEShavealongevolutionary historywiththem.ThepromotersofEShavebeenbroadeningthecanvassof integrationfromfinancialandaccounting,productionandmanufacturing,marketing andsales,logisticsanddistribution,humanresourcetostrategicfunctions[31]. Theofferingsareincreasingdaybydayalongwiththecomplexityandfailuresof implementations[32].Accordingly,researchersandpractitionerhavebeenlabeling thesesystemsastheyaregrowing.
Inventorymanagementandcontrolprocessingsoftwarewerefamousinthefifties andsixties.ThesesystemsweredevelopedonmainframeplatformusingthirdgenerationprogramminglanguagessuchasFortranandCobol.Thefocusofthese systemswasonmanagingandtrackinginventoryeffectivelyandefficientlyby automatinginventorymanagementandproductionschedules.
ThenextinlinewereManufacturingResourcePlanning(MRP)softwareinthe seventies.Thissoftwarewasdevelopedonthesametechnologicalparadigmasthe previousone.Thefocusofthesesystemsgotenlargedtoincludesalesandmarketing
bylinkingtheplanningofproductorpartsrequirementstothemasterproduction schedule.ThenextversionofmanufacturingresourceplanningwastermedasMRP II.Theyweredevelopedonthemainframelegacyplatformusingfourth-generation databasesoftwareandmanufacturingapplications.Thefocusofthesesystemswas furtherrefinedtomanufacturingstrategyandqualitycontrol,andincludedthe supportfordesigningproductionsupplychainprocesses.
Inthenineties,themostcomprehensivesoftwarepackages,EnterpriseResource Planning(ERP)cameintoexistence.ThesesystemshadoriginatedfromMRPand MRPII[33].Theyweredevelopedonmultipleplatformmainframeandclientserverusingfourth-generationdatabasesoftwareandpackagessoftwareapplication. Thefocusofthesesystemswasapplicationintegrationandcustomerserviceby automatingandoptimizingalltheprocessessalesanddistribution,financeand accounts,humanresource,procurement,etc.
Atoneendpromotersweretryingtointegrateinformationflowinternallyand endedupindevelopingERPpackages.Ontheotherhand,somesoftwarevendors wereworkingontointegratetheexternalinformationflowfromthecustomer andsuppliersideanddevelopedCRMandSCMsoftwarepackages.TheERP vendorsintegratedthefunctionalitiesofSCMandCRMintheirpackages[34]. HenceresearchersandpractitionershavestartedusingthetermERPII[35].These systemsaredevelopedonweb-basedclient-serverplatformandintegratedwithfifthgenerationapplicationslikeSCM,CRM,andSFAetc.Thefocusofthesesystems isagilityandcustomer-centricglobalenvironmentbye-enablement.Table 1.1 describesthetimeline,system,andplatformtheyutilized.
1.3.4DefinitionsofEnterpriseSystems
ThetermERPinthepresswasfirstusedin1992byLopesandintheyear1996 DavenportintroducedittoIScommunityatAMCIS‘96andcalledthesepackages metapackages[36].ERPsystemsaresaidtohavepackagedprocessesforbest businesspracticesasbusinessblueprintthatcanguidetheorganizationforproduct engineering,evaluationandanalysis,andimplementation[33].
Thetermenterprisesystemswasinusesince1980storefertoanyenterprise wideintegratedsystems[37].Davenport[38]usedthesametermenterprisesystems insteadofERPinhisfamousarticle“Puttingtheenterpriseintotheenterprise system.”Thereafteracademicfraternitypreferstousethetermenterprisesystems andincludesmanyotherenterprisewideintegratedsystemssuchasSCM,CRM, andPLM.Fewofthedefinitionsofenterprisesystemsaregiveninthefollowing paragraphs.
“An,integrated,multi-dimensionalsystemforallfunctions,basedonabusiness modelforplanning,control,andglobal(resource)optimizationfortheentiresupply chain,byusingthestateoftheartIS/ITtechnologythatsuppliesvalueadded servicestoallinternalandexternalparties”[39].
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Franklinic or Static Electricity.—This form of electricity is now being much used, especially abroad, in the treatment of nervous affections, but does not appear to have been employed in the different copodyscinesiæ, as but few reports of such treatment have found their way into current literature. Romain Vigouroux111 states that he has cured one case by statical electricity. Another case is reported by Arthuis112 as rapidly cured by this treatment after many other means, carried on during a period of five years, had failed; but his brochure contains too many reports of cures of hitherto incurable diseases to be relied upon.
111 Le Progrès médical, Jan. 21, 1882.
112 A. Arthuis, Traitement des Maladies nerveuses, etc., Paris, 1880, 3me ed.
Gymnastics and Massage.—As those suffering from copodyscinesia are generally compelled by their vocation to be more or less sedentary, exercise in the open air is indicated, inasmuch as it tends to counteract the evil effects of their mode of life; but the use of dumb-bells or Indian clubs, riding, rowing, and similar exercises do not ward off the neuroses in question or diminish them when they are present.
Such is not the case when rhythmical exercises and systematic massage of all the affected muscles are employed, as marked benefit has followed this method of treatment. The method employed by J. Wolff, a teacher of penmanship at Frankfort-on-the-Main, which consists of a peculiar combination of exercise and massage, appears to have been wonderfully successful, judging from his own statements and editorial testimonials of such eminent men as Bamberger, Bardenleben, Benedikt, Billroth, Charcot, Erb, Esmarch, Hertz, Stein, Stellwag, Vigouroux, Von Nussbaum, Wagner, and De Watteville. The method is described by Romain Vigouroux113 and Th. Schott,114 the latter claiming priority for himself and his brother, who employed this method as early as 1878 or 1879. Wolff,115 however, states that he had successfully treated this disease by his method as early as 1875. Theodor Stein,116 having had personal experience in Wolff's treatment, also describes and extols it: 277 cases of
muscular spasms of the upper extremities were treated; of these, 157 were cured, 22 improved, while 98 remained unimproved; these comprised cases of writers', pianists', telegraphers', and knitters' cramp.
113 Le Progrès médical, 1882, No. 13.
114 “Zur Behandlung des Schreibe- und Klavierkrampfes,” Deutsche Medizinal Zeitung, 2 März, 1882, No. 9, Berlin; also “Du Traitement de la Crampe des Écrivains, reclamation de Priorité, Details de Procedes, par le Dr. Th. Schott,” Le Progrès médical, 1re Avril, 1882.
115 “Treatment of Writers' Cramp and Allied Muscular Affections by Massage and Gymnastics,” N. Y. Med. Record, Feb. 23, 1884, pp. 204, 205.
116 “Die Behandlung des Schreibekrampfes,” Berliner klinische Wochenschrift, No. 34, 1882, pp. 527-529.
It must be borne in mind that Wolff, not being a physician, can refuse to treat a case if he thinks it incurable; and in fact he does so, as he has personally stated to the writer, so that his statistics probably show a larger percentage of cures than otherwise would be the case.
His method may be described as follows: It consists of a combined employment of gymnastics and massage; the gymnastics are of two kinds: 1st, active, in which the patient moves the fingers, hands, forearms, and arms in all the directions possible, each muscle being made to contract from six to twelve times with considerable force, and with a pause after each movement, the whole exercise not exceeding thirty minutes and repeated two or three times daily; 2d, passive, in which the same movements are made as in the former, except that each one is arrested by another person in a steady and regular manner; this may be repeated as often as the active exercise. Massage is practised daily for about twenty minutes, beginning at the periphery; percussion of the muscles is considered an essential part of the massage. Combined with this are peculiar lessons in pen-prehension and writing.
The rationale of this treatment is not easy, but any method which even relieves these neuroses should be hailed with pleasure, as they heretofore have been considered almost incurable.
The method employed by Poore, as mentioned under Electricity, of rhythmical exercise of the muscles during the application of the galvanic current, is worthy of further trial, as it combines the two forms of treatment hitherto found most successful.
Internal and External Medication.—Generally speaking, drugs are of comparatively little value in the treatment of these affections. This statement does not apply to those cases where the symptoms are produced by some constitutional disorder, or where there is some other well-recognized affection present which does not stand in relation to these neuroses as cause and effect.
In any case where an accompanying disorder can be discovered which is sufficient in itself to depress the health, the treatment applicable to that affection should be instituted, in the hope, however unlikely it is to be fulfilled, that with returning health there will be a decrease of the copodyscinesia. In the majority of cases no constitutional disease can be detected, and it is in these that internal medication has particularly failed.
The following are some of the remedies that have been employed: Cod-liver oil, iron, quinine, strychnia, arsenic, ergot, iodoform, iodide and bromide of potassium, nitrate of silver, phosphorus, physostigma, gelsemium, conium, and some others.
Hypodermic Medication.—Atropia hypodermically, as first suggested by Mitchell, Morehouse, and Keen117 in the treatment of spasmodic affections following nerve-injury, has been used with good effect in those cases where there is a tendency to tonic contraction; it should be thrown into the body of the muscle. Vance118 speaks very favorably of one-sixtieth of a grain of atropia used in this manner three times a week. Morphia, duboisia, and arsenic in the form of Fowler's solution have been used hypodermically with but little effect. Rossander119 reports a cure in one month of a case of two years'
duration by the hypodermic use of strychnia. Onimus and Legros120 used curare in one case without effect.
117 Gunshot Wounds and Other Injuries to Nerves, Philada., 1864.
118 Reuben A. Vance, M.D., “Writers' Cramp or Scriveners' Palsy,” Brit. Med. and Surg. Journal, vol. lxxxvii. pp. 261-285.
119 J. C. Rossander, Irish Hosp. Gazette, Oct. 1, 1873.
120 Loc. cit.
Local Applications.—The apparent benefit following the local application of lotions, etc. to the arms in some cases appears to be as much due to the generous kneading and frictions that accompany them as to the lotions themselves. Onimus and Legros, believing the lesion to be an excitability of the sensitive nerves at the periphery, employed opiated embrocations, but report amelioration in one case only.
When there are symptoms of congestion of the nerves or of neuritis, then the proper treatment will be the application of flying blisters, or the actual cautery very superficially applied to the points of tenderness from time to time, so as to keep up a continual counterirritation. This treatment may be alternated with the application of the galvanic current (descending, stabile, as previously mentioned) or combined with it. As these conditions are often found in nervous women, care should be taken lest this treatment be too vigorously carried out.
Considerable relief has been reported from the use of alternate hot and cold douches to the affected part—a procedure which is well known to do good in some cases of undoubted spinal disease; the application peripherally applied altering in some way, by the impression conveyed to the centres, the nutrition of the spinal cord.
Tenotomy.—Tenotomy has been but little practised for the cure of these affections. Stromeyer121 cut the short flexors of the thumb in a
case of writers' cramp without any benefit, but in a second case, where he cut the long flexor of the thumb, the result was a cure. Langenbeck122 quotes Dieffenbach as having performed the operation twice without success, and states that there has been but one observation of complete success, and that was the one of Stromeyer. Aug. Tuppert123 has also performed this operation, and Haupt124 advises it as a last resource.
121 “Crampe des Écrivains,” Arch. gén. de Méd., t. xiii., 1842, 3d Series, p. 97.
122 Ibid., t. xiv., 1842, 3d Series.
123 Quoted by Poore, loc. cit.
124 “Der Schreibekrampf,” rev. in Schmidt's Jahrbuch, Bd. cxv., p. 136, 1862.
Very few would be willing to repeat the experiment in a true case of copodyscinesia after the failures above enumerated, for the temporary rest given the muscle does not prove of any more service than rest without tenotomy, which has failed in all the more advanced cases, which are the only ones where tenotomy would be thought of.
Nerve-Stretching.—It is curious that no cases have been reported (at least I have not been able to discover them) of nerve-stretching for aggravated cases of copodyscinesia, as the operation has been performed in several cases of local spasm of the upper extremity following injuries to the nerves.
Von Nussbaum125 alone mentions the operation, and states that it has been of no avail, but gives no references; he previously126 stretched the ulnar nerve at the elbow and the whole of the brachial plexus for spasm of the left pectoral region and of the whole arm, following a blow upon the nape of the neck; the patient made a good recovery.
125 Aerztliches Intelligenzblatt, Munich, Sept. 26, 1882, No. 39, p. 35.
126 London Lancet, vol. ii., 1872, p. 783.
This operation, according to an editorial in the American Journal of Neurology, 127 has been performed seven times for spastic affections of the arm with the following results: 2 cures (1 doubtful), 3 great improvement, and 2 slight relief.
127 Am. Journ. of Neurology and Psychiatry, 1882.
This procedure would seem to be indicated in those cases of copodyscinesia where spasms are present which have a tendency to become tonic in their character, where other means of treatment have failed. One such case has fallen under the writer's notice, which, on account of its singularity and the rarity of the operation, seems worthy of record. The patient is a physician in large practice, and his account, fortunately, is more exact than it otherwise would be:
——
——, æt. 36. Paternal uncle had a somewhat similar trouble in right arm, father died of paralysis agitans, and one brother has writers' cramp. From nine to twelve years of age he was considered an expert penman, and was employed almost constantly, during school-hours, writing copies for the scholars. At the age of eleven he began to feel a sense of tire in right forearm and hand when writing; soon after this the flexors of right wrist and hand began to contract involuntarily and become rigid only when writing. He remembers being able to play marbles well for two years after the onset of the first symptoms. The trouble gradually increased until every motion of the forearm became involved. At the age of nineteen he became a bookkeeper, using his left hand, but at the end of one year this became affected also. Since then both arms have been growing gradually worse, and at one time exhaustion would bring on pain at the third dorsal vertebra. At the age of thirty a period of sleeplessness and involuntary contractions of all the muscles of the body came on, accompanied by difficulty in articulation from muscular inco-ordination. After persistent use of the cold douche to spine these symptoms ameliorated, but the general muscular twitching sometimes occurs yet, and overwork brings on spasm of the extensors of the feet. The condition of his arms in December,
1882, was as follows: At rest the right forearm is pronated, the wrist completely flexed and bent toward the ulnar side, the thumb is slightly adducted, and the fingers, although slightly flexed, are comparatively free, enabling him to use the scalpel with dexterity. This contraction can be overcome by forcibly extending the fingers and wrist and supinating forearm, but if the arm be now placed in supination the following curious series of contractions occur, occupying from one to two minutes from their commencement to their completion: gradually the little finger partially flexes, then the ring, middle, and fore finger follow in succession; the wrist then slowly begins to flex and to turn toward the ulnar side, and finally the arm pronates, in which position it will remain unless disturbed. The contraction is accompanied by a tense feeling in the muscles, but is painless. The left arm behaves in a somewhat similar manner, and if this is placed in supination a gradual pronation of the arm begins; then follows the flexion of the fingers, commencing with the little finger and ending with the thumb; the wrist also flexes, but not as much as the right, although the flexion of the fingers is more marked. There is no pain on pressure over muscles or nerves. The extensor muscles of both arms, although weaker than normal, are not paralyzed, those of the right responding more readily to both faradic and galvanic currents than do the left. There is no reaction of degeneration. The flexors respond too readily, the right showing the greatest quantitative increase.
In 1879, while abroad, his condition being essentially as above described, he consulted Spence of Edinburgh, who as an experiment stretched the left ulnar nerve at the elbow; immediately after the operation the muscles were paralyzed and the arm remained quiet; in twenty-four hours the nerve became intensely painful, and remained so, day and night, for three weeks; this gradually subsided, and ceased with the healing of the wound two weeks later. Fortyeight hours after the operation the spasm of the muscles returned, and in a short time became as bad as ever, proving the operation to have been a failure.
An interesting point to decide in this case is whether the symptoms point to an abnormal condition of the nerve-centres, first manifesting itself in difficulty of writing, or whether the constant writing induced a superexcitability (for want of a better term) of the spinal cord in a patient markedly predisposed to nervous troubles. This last hypothesis I believe to be the correct one.
It might be considered at first sight that the symptoms presented by this patient were due to a paralytic condition of the extensors, and not a spasm of the flexors, or at least that the latter was secondary to the former While the extensors are somewhat weaker than normal from want of use, a careful study of the mode of onset of this affection and the symptoms presented later prove this idea to be erroneous.
In regard to the operation and its results, it seems that a fairer test of the efficacy of nerve-stretching in this case would have been made if the median and not the ulnar nerve had been stretched, as the latter only supplies in the forearm the flexor carpi ulnaris and the inner part of the flexor profundus digitorum, while the former supplies the two pronators and the remainder of the flexor muscles.
Of the mode of action of this operation we are still much in the dark, but it would seem to be indicated in any case where the contractions are very marked and tonic in their nature—not, however, until other means have failed to relieve.
In the ordinary forms of copodyscinesia, it is needless to say, the operation would be unjustifiable.
Mechanical
Appliances.—Most of the prothetic appliances have been devised for the relief of writers' cramp, the other forms of copodyscinesia having received little if any attention in this direction. The relief obtained by their use is usually but temporary, especially if the patient attempts to perform his usual amount of work, which is generally the case.
These instruments are of undoubted benefit when used judiciously in conjunction with other treatment, as by them temporary rest may be obtained, or in some cases the weakened antagonists of cramped muscles may be exercised and strengthened. They all, without exception, operate by throwing the work upon another set of muscles, and failure is almost sure to follow their use if they alone are trusted in, as the new set of muscles sooner or later becomes implicated in the same way that the left hand is apt to do if the whole amount of work is thrown upon it.
To accurately describe these instruments is out of place in this article: those wishing to study this branch of the subject more fully are referred to the article by Debout,128 where drawings and descriptions of the most important appliances are given.
128 “Sur les Appareils prothetiques, etc.,” Bull. de Thérap., 1860, pp. 327-377.
Their mode of action may be considered under the following heads:
I. Advantage is taken of muscles as yet unaffected, which are made to act as splints (so to speak) to those affected, greater stability being thus given and cramp controlled when present.
Under this head may be mentioned the simple plan of placing a rubber band around the wrist, wearing a tight-fitting glove, or applying Esmarch's rubber bandage with moderate firmness to the forearm. Large cork pen-holders, by distributing the points of resistance over a larger surface, are thus much easier to hold than small, hard pen-holders.
Two of the instruments devised by Cazenave—one, consisting of two rings joined together in the same plane (to which the pen-holder is attached), and through which the index and middle fingers are thrust as far as the distal joints; and another consisting of two rings of hard rubber, one above the other, sufficiently large to receive the thumb, fore and middle fingers, which are thus held rigidly in the writing position—act in this manner, and are used when the cramp affects the thumb or fore finger.
II. The cramp of one set of muscles is made use of to hold the instrument, the patient writing entirely with the arm movement.
The simple plan of grasping the pen-holder in the closed hand, as previously described, or of thrusting a short pen-holder into a small apple or potato, which is grasped in the closed hand, occasionally affords relief and acts in this way. The instruments of Mathieu, Velpeau, Charrière, and one by Cazenave are based upon this principle. The first consists of two rings rigidly joined together about one inch apart, one above the other, through which the fore finger is thrust, and of a semicircle against which the tip of the thumb is pressed; the pen-holder is attached to a bar adjoining the semicircle and rings. Velpeau's apparatus consists of an oval ball of hard rubber carrying at one extremity the pen-holder at an angle of 45°; the ball is grasped in the closed hand, and the pen-holder allowed to pass between the fore and middle fingers. Charrière's instrument is a modification of the last, having in addition to the ball a number of rings and rests for the fixation of the fingers. The latter has also devised an instrument consisting of a large oval ball of hard rubber; this is grasped in the outstretched palm, which it fills, and is allowed to glide over the paper; the pen-holder is attached to one side. Cazenave's instrument is simply a large pen-holder with rest and rings to fix the fingers.
III. The instrument prevents the spasm of the muscles used in poising the hand from interfering with those used in forming the letters.
One of the instruments devised by Cazenave acts in this way: it consists of a small board, moving upon rollers, upon which the hand is placed; lateral pads prevent the oscillations of the arm due to spasmodic action of the supinators. The pen-holder is held in the ordinary manner.
IV. The antagonistic muscles to those affected by cramp are made to hold the instrument, while the cramped muscles are left entirely free.
But one instrument acts in this manner—viz. the bracelet invented by Von Nussbaum,129 which consists of an oval band of hard rubber to which the pen-holder is attached. The bracelet is held by placing the thumb and the first three fingers within it and strongly extending them.
129 Aerztliches Intelligenzblatt, Munich, 1883, No. 39.
The inventor claims great success by its use alone, as the weakened muscles are exercised and strengthened and the cramped muscles given absolute rest.
Résumé of Treatment.—In the complicated cases of copodyscinesia rest of the affected parts, as far as the disabling occupation is concerned, must be insisted upon: this should be conjoined with the use of the galvanic descending stabile current, combined with rhythmical exercise of the affected muscles and of their antagonists, and massage. Where there is evidence of a peripheral local congestion or inflammation, this must be attended to; for instance, if there is congestion of the nerves, or neuritis, flying blisters or the actual cautery should be applied over the painful spots, followed by the galvanic current. Where there is paralysis of one or more muscles, with evidence of interference of nerve-supply, the faradic current may be used with advantage.
Evidences of constitutional disease should lead to the employment of the treatment suitable for those affections.
Arm movement 13
Finger movement 6
Combination of the two 24—43
TETANUS.
BY P. S. CONNER, M.D.
Tetanus (τεινω, to stretch) is a morbid condition characterized by tonic contraction of the voluntary muscles, local or general, with clonic exacerbations, occurring usually in connection with a wound. Cases of it may be classified according to cause (traumatic or idiopathic); to age (of the new-born and of those older); to severity (grave and mild); or to course (acute and chronic), this latter classification being the one of greatest value.
Though known from the earliest times, it is in the civil practice of temperate regions of comparatively rare occurrence, and even in military surgery has in recent periods only exceptionally attacked any considerable proportion of the wounded.
Occurring in individuals of all ages, the great majority of the subjects of it are children and young adults. Women seem to be decidedly less liable to it than men. That this is due to sexual peculiarity may well be doubted, since the traumatic cases are by far the most numerous, and females are much less often wounded than males. The traumatisms of childbed are occasionally followed by it (puerperal tetanus).
That race has a predisposing influence would appear to be well established; the darker the color, the greater the proportion of tetanics. Negroes are especially likely to be attacked with either the traumatic or idiopathic form.
Atmospheric and climatic conditions, beyond question, act powerfully in, if not producing at least favoring, the development of tetanus. Places and seasons in which there is great difference between the midday and the midnight temperature, the winds are strong, and the air is moist, are those in which the disease is most prevalent; and it is because of these conditions that the late spring and early autumn are the periods of the year when cases are most often seen.1
1 In his account of the Austrian campaign of 1809, Larrey wrote: “The wounded who were most exposed to the cold, damp air of the chilly spring nights, after having been subjected to the quite considerable heat of the day, were almost all attacked with tetanus, which prevailed only at the time when the Reaumur thermometer varied almost constantly between the day and the night by the half of its rise and fall; so that we would have it in the day at 19°, 20°, 21°, and 23° above zero (75°–84° F.), while the mercury would fall to 13°, 12°, 10°, 9°, and 8° during the night (50°–61° F.). I had noticed the same thing in Egypt.”
Cold has, from the time of Hippocrates, been regarded as a great predisposing if not exciting cause, and the non-traumatic cases have been classed together as those a frigore. It is not, however, the exposure to simply a low temperature that is followed by the disease, but to cold combined with dampness, and quickly succeeding to a temperature decidedly higher, as in the cool nights coming on after hot days in tropical regions, or in the spring and fall seasons of temperate latitudes, or in the cold air blowing over or cold water
dashed upon a wound or the heated skin. That such cold, thus operating, does most usually precede the attack of tetanus is unquestionable; and it has by many been held that without it no traumatism will be followed by the disease. Observers generally are agreed, with Sir Thomas Watson, that “there is good reason for thinking that in many instances one of these causes (wound and cold) alone would fail to produce it, while both together call it forth.”
In the low lands of hot countries (as the East and West Indies) the disease is very frequently met with, at times prevailing almost epidemically; and, on the other hand, it is rare in dry elevated regions and in high northern latitudes, as in Russia, where during a long military and civil experience Pirogoff met with but eight cases. Trismus nascentium would seem to be an exception to the general rule of the non-prevalence of tetanus in places far north, since, e.g., it has been at different periods very common in the Hebrides and the small islands off the southern coast of Iceland. But these localities, from their peculiar position, are not extremely cold, and their climate is damp and variable; so that, even if the lockjaw of infants be accepted as a variety of true tetanus, the geographical exception indicated is but an apparent one.
Traumatic cases are greatly more numerous than idiopathic, and no class of wounds is free from the possibility of the supervention of tetanus. Incised wounds are much less likely to be thus complicated than either of the other varieties, though operation-wounds of all sorts, minor and major, have been followed by this affection. So frequently has it been associated with comparatively trivial injuries that it has become a common belief that the slighter the traumatism the greater the danger of tetanus. That this is not true the records of military surgery abundantly show. Wounds of the lower extremity are much graver in this respect than those of the upper. Injuries of the hand and feet, especially roughly punctured wounds of the palmar and plantar fasciæ (as, e.g., those made by rusty nails), have long been regarded as peculiarly liable to develop the disease, and accidents of this nature always give rise to the fear of lockjaw. Though there can be no question but that more than one-half of the
cases of tetanus in civil life are associated with wounds of these localities, yet the number of such injuries is so much greater than of those of other parts of the body that the special liability of the subjects of them to become tetanic may well be questioned. In this connection it is a significant fact that during our late war of perhaps 12,000 or 13,000 wounds of the hand, only 37 were followed by tetanus, and of 16,000 of the foot, but 57. A few years ago numerous cases of tetanus were observed in our larger cities complicating hand-wounds produced by the toy pistol—injuries that were often associated with considerable laceration of the soft parts, and generally with lodgment of the wad.
Not even the complete cicatrization of a wound altogether protects against the occurrence of the disease, the exciting cause of which, under such circumstances, is probably to be found in retained foreign bodies or pent-up fluids.
ETIOLOGY.—Almost universally regarded as an affection of the central nervous system, inducing a heightened state of the reflex irritability, though some have maintained that the reflex excitability of the medulla and the cord is actually lessened, how such affection is produced is unknown; and it is an unsettled question whether it is through the medium of the nerves or the vessels, whether by ascending inflammation, by reflected irritation, or by the presence of a septic element or a special micro-organism in the blood.
That the disease is due to ascending neuritis finds support in the congested and inflamed state of the nerves leading up from the place of injury (affecting them in whole or in part, it may be in but a few of their fibres), and in the inflammatory changes discoverable in the cord and its vessels. But time and again thorough and careful investigation by experienced observers has altogether failed to detect any alterations in the nerves or pathological changes in the cord, other than those that might properly be attributed to the spasms, the temperature, or the drugs administered. The symptoms of acute neuritis and myelitis (pain, paralyses, and later trophic changes) are not those which are present in cases of tetanus. The
evidences of inflammation of the cord are most apparent, not in that portion of it into which the nerves from the wounded part enter, but, as shown by Michaud, so far as the cellular changes in the gray matter are concerned, always in the lumbar region, no matter where the wound may be located.
The much more generally accepted theory of reflex neurosis is based upon the association of the disease with “all forms of nerveirritation, mechanical, thermal, chemical, and pathological;” upon the direct relation existing between the likelihood of its occurrence and the degree of sensibility of the wounded nerve;2 in the, at times, very short interval between the receipt of the injury and the commencement of the tetanic symptoms; in the local spasms unquestionably developed by nerve-pressure and injury; in the primary affection of muscles at a distance from the damaged part; in the already-referred-to absence of the structural lesions of inflammation; and in the relief at times afforded by the removal of irritating foreign bodies, the temporary cutting off of the nerveconnection with the central organs, or the amputation of the injured limb. But that something more than irritation of peripheral nerves is necessary to the production of tetanus would seem to be proved by the frequency of such irritation and the rarity of the disease; by the not infrequent prolonged yet harmless lodgment of foreign bodies, even sharp and angular ones, against or in nerves of high sensibility;3 by the primary affection of the muscles about the jaws, and not those in the neighborhood of the wound; by the almost universal failure to produce the affection experimentally, either by mechanical injuries or by electrical excitations; by certain wellattested instances of its repeated outbreak in connection with a definite locality, a single ship of a squadron, a particular ward in a hospital, or even bed in a ward; by the usual absence of that pain which is the ordinary effect of nerve-irritation; and by the small measure of success which has attended operations, even when early performed, permitting the taking away of foreign bodies pressing upon or resting in a nerve, interrupting the connection with the cord, or altogether removing the wound and its surroundings. Even in the idiopathic cases—many of which, it would at first sight
appear, can be due only to reflected irritation—another explanation of the mode of their production may, as we will see, be offered.
2 According to Gubler, the danger is greatest in wounds of parts containing numerous Pacinian corpuscles.
3 Heller has reported a case in which a piece of lead was lodged in the sheath of the sciatic nerve. Though chronic neuritis resulted, the wound healed perfectly Two years later, after exposure while drilling, the man was seized with tetanus and died of it.
The so-called humoral theory would find the exciting cause of the disease in a special morbific agent developed in the secretions of the unbroken skin or the damaged tissues of the wound, or introduced from without and carried by the blood-stream to the medulla and the cord, there to produce such cell-changes as give rise to the tetanic movements. It finds support in the unsatisfactory character of the neural theories; in the strong analogy in many respects of the symptoms of the disease to the increased irritability and muscular contractions of hydrophobia and strychnia-poisoning, or those produced by experimental injections of certain vegetable alkaloids; in the recent discoveries in physiological fluids, as urine and saliva, of chemical compounds,4 and in decomposing organic matter of ptomaïnes capable of tetanizing animals when injected into them; in the rapidly-enlarging number of diseases known to be, or with good reason believed to be, consequent upon the presence of peculiar microbes; in the more easy explanation by it than upon other theories of the ordinary irregularity and infrequency of its occurrence, its occasional restriction within narrow limits, and its almost endemic prevalence in certain buildings and even beds; in the extreme gravity of acute cases and the protracted convalescence of those who recover from the subacute and chronic forms; in the very frequent failure of all varieties of operative treatment; and in the success of therapeutic measures just in proportion to their power to quiet and sustain the patient during the period of apparent elimination of a poison or development and death of an organism.
4 Paschkie in some recent experiments found that the sulphocyanide of sodium applied in small quantities caused a tetanic state more lasting than that caused by
strychnia.
This theory is as yet unsupported by any positive facts. Neither septic element nor peculiar microbe has been discovered.5 Failure has attended all efforts to produce the disease in animals by injecting into them the blood of tetanics. There is no testimony worthy of acceptance of the direct transmission of the disease to those, either healthy or wounded, coming in contact with the tetanic patient; nor can much weight be attached to such reports as that of Betoli of individuals being attacked with it who had eaten the flesh of an animal dead of it.
5 Curtiss of Chicago thought that he had found a special organism, but further investigation showed that it was present in the blood of healthy members of the family and in the water of a neighboring pond.
The ordinary absence of fever has been thought to prove the incorrectness of this theory, but increased body-heat is not a symptom of rabies or strychnia-poisoning, of the tetanic state following the injection of ptomaïnes, or of cholera—a disease very probably dependent upon the presence and action of a bacillus. Martin de Pedro, regarding the affection as rheumatic in character, located it in the muscles themselves, there being produced, through poisoning of the venous blood, a muscular asphyxia.
MORBID ANATOMY.—The pathological conditions observed upon autopsy in the wound, the nerves, the central organs, and the muscles, have been so various and inconstant that post-mortem examinations have afforded little or no definite information respecting the morbid anatomy of the disease. Many of the reported lesions have unquestionably been dependent upon cadaveric changes or defective preparation for microscopic study. The wound itself has been found on the one hand healthy and in due course of cicatrization,6 on the other showing complete arrest of the reparative process (“the sores are dry in tetanus,” wrote Aretæus),7 or even gangrenous, with pus-collections, larger or smaller, in its immediate vicinity, usually in connection with retained foreign bodies.
