Design of a secure architecture for the exchange of biomedical information in m-Health scenarios

El paradigma de m-Salud (salud móvil) aboga por la integración masiva de las más avanzadas tecnologías de comunicación, red móvil y sensores en aplicaciones y sistemas de salud, para fomentar el despliegue de un nuevo modelo de atención clínica centrada en el usuario/paciente. Este modelo tiene por objetivos el empoderamiento de los usuarios en la gestión de su propia salud (p.ej. aumentando sus conocimientos, promocionando estilos de vida saludable y previniendo enfermedades), la prestación de una mejor tele-asistencia sanitaria en el hogar para ancianos y pacientes crónicos y una notable disminución del gasto de los Sistemas de Salud gracias a la reducción del número y la duración de las hospitalizaciones. No obstante, estas ventajas, atribuidas a las aplicaciones de m-Salud, suelen venir acompañadas del requisito de un alto grado de disponibilidad de la información biomédica de sus usuarios para garantizar una alta calidad de servicio, p.ej. fusionar varias señales de un usuario para obtener un diagnóstico más preciso. La consecuencia negativa de cumplir esta demanda es el aumento directo de las superficies potencialmente vulnerables a ataques, lo que sitúa a la seguridad (y a la privacidad) del modelo de m-Salud como factor crítico para su éxito. Como requisito no funcional de las aplicaciones de m-Salud, la seguridad ha recibido menos atención que otros requisitos técnicos que eran más urgentes en etapas de desarrollo previas, tales como la robustez, la eficiencia, la interoperabilidad o la usabilidad. Otro factor importante que ha contribuido a retrasar la implementación de políticas de seguridad sólidas es que garantizar un determinado nivel de seguridad implica unos costes que pueden ser muy relevantes en varias dimensiones, en especial en la económica (p.ej. sobrecostes por la inclusión de hardware extra para la autenticación de usuarios), en el rendimiento (p.ej. reducción de la eficiencia y de la interoperabilidad debido a la integración de elementos de seguridad) y en la usabilidad (p.ej. configuración más complicada de dispositivos y aplicaciones de salud debido a las nuevas opciones de seguridad). Por tanto, las soluciones de seguridad que persigan satisfacer a todos los actores del contexto de m-Salud (usuarios, pacientes, personal médico, personal técnico, legisladores, fabricantes de dispositivos y equipos, etc.) deben ser robustas y al mismo tiempo minimizar sus costes asociados. Esta Tesis detalla una propuesta de seguridad, compuesta por cuatro grandes bloques interconectados, para dotar de seguridad a las arquitecturas de m-Salud con unos costes reducidos. El primer bloque define un esquema global que proporciona unos niveles de seguridad e interoperabilidad acordes con las características de las distintas aplicaciones de m-Salud. Este esquema está compuesto por tres capas diferenciadas, diseñadas a la medidas de los dominios de m-Salud y de sus restricciones, incluyendo medidas de seguridad adecuadas para la defensa contra las amenazas asociadas a sus aplicaciones de m-Salud. El segundo bloque establece la extensión de seguridad de aquellos protocolos estándar que permiten la adquisición, el intercambio y/o la administración de información biomédica -- por tanto, usados por muchas aplicaciones de m-Salud -- pero no reúnen los niveles de seguridad detallados en el esquema previo. Estas extensiones se concretan para los estándares biomédicos ISO/IEEE 11073 PHD y SCP-ECG. El tercer bloque propone nuevas formas de fortalecer la seguridad de los tests biomédicos, que constituyen el elemento esencial de muchas aplicaciones de m-Salud de carácter clínico, mediante codificaciones novedosas. Finalmente el cuarto bloque, que se sitúa en paralelo a los anteriores, selecciona herramientas genéricas de seguridad (elementos de autenticación y criptográficos) cuya integración en los otros bloques resulta idónea, y desarrolla nuevas herramientas de seguridad, basadas en señal -- embedding y keytagging --, para reforzar la protección de los test biomédicos.The paradigm of m-Health (mobile health) advocates for the massive integration of advanced mobile communications, network and sensor technologies in healthcare applications and systems to foster the deployment of a new, user/patient-centered healthcare model enabling the empowerment of users in the management of their health (e.g. by increasing their health literacy, promoting healthy lifestyles and the prevention of diseases), a better home-based healthcare delivery for elderly and chronic patients and important savings for healthcare systems due to the reduction of hospitalizations in number and duration. It is a fact that many m-Health applications demand high availability of biomedical information from their users (for further accurate analysis, e.g. by fusion of various signals) to guarantee high quality of service, which on the other hand entails increasing the potential surfaces for attacks. Therefore, it is not surprising that security (and privacy) is commonly included among the most important barriers for the success of m-Health. As a non-functional requirement for m-Health applications, security has received less attention than other technical issues that were more pressing at earlier development stages, such as reliability, eficiency, interoperability or usability. Another fact that has contributed to delaying the enforcement of robust security policies is that guaranteeing a certain security level implies costs that can be very relevant and that span along diferent dimensions. These include budgeting (e.g. the demand of extra hardware for user authentication), performance (e.g. lower eficiency and interoperability due to the addition of security elements) and usability (e.g. cumbersome configuration of devices and applications due to security options). Therefore, security solutions that aim to satisfy all the stakeholders in the m-Health context (users/patients, medical staff, technical staff, systems and devices manufacturers, regulators, etc.) shall be robust and, at the same time, minimize their associated costs. This Thesis details a proposal, composed of four interrelated blocks, to integrate appropriate levels of security in m-Health architectures in a cost-efcient manner. The first block designes a global scheme that provides different security and interoperability levels accordingto how critical are the m-Health applications to be implemented. This consists ofthree layers tailored to the m-Health domains and their constraints, whose security countermeasures defend against the threats of their associated m-Health applications. Next, the second block addresses the security extension of those standard protocols that enable the acquisition, exchange and/or management of biomedical information | thus, used by many m-Health applications | but do not meet the security levels described in the former scheme. These extensions are materialized for the biomedical standards ISO/IEEE 11073 PHD and SCP-ECG. Then, the third block proposes new ways of enhancing the security of biomedical standards, which are the centerpiece of many clinical m-Health applications, by means of novel codings. Finally the fourth block, with is parallel to the others, selects generic security methods (for user authentication and cryptographic protection) whose integration in the other blocks results optimal, and also develops novel signal-based methods (embedding and keytagging) for strengthening the security of biomedical tests. The layer-based extensions of the standards ISO/IEEE 11073 PHD and SCP-ECG can be considered as robust, cost-eficient and respectful with their original features and contents. The former adds no attributes to its data information model, four new frames to the service model |and extends four with new sub-frames|, and only one new sub-state to the communication model. Furthermore, a lightweight architecture consisting of a personal health device mounting a 9 MHz processor and an aggregator mounting a 1 GHz processor is enough to transmit a 3-lead electrocardiogram in real-time implementing the top security layer. The extra requirements associated to this extension are an initial configuration of the health device and the aggregator, tokens for identification/authentication of users if these devices are to be shared and the implementation of certain IHE profiles in the aggregator to enable the integration of measurements in healthcare systems. As regards to the extension of SCP-ECG, it only adds a new section with selected security elements and syntax in order to protect the rest of file contents and provide proper role-based access control. The overhead introduced in the protected SCP-ECG is typically 2{13 % of the regular file size, and the extra delays to protect a newly generated SCP-ECG file and to access it for interpretation are respectively a 2{10 % and a 5 % of the regular delays. As regards to the signal-based security techniques developed, the embedding method is the basis for the proposal of a generic coding for tests composed of biomedical signals, periodic measurements and contextual information. This has been adjusted and evaluated with electrocardiogram and electroencephalogram-based tests, proving the objective clinical quality of the coded tests, the capacity of the coding-access system to operate in real-time (overall delays of 2 s for electrocardiograms and 3.3 s for electroencephalograms) and its high usability. Despite of the embedding of security and metadata to enable m-Health services, the compression ratios obtained by this coding range from ' 3 in real-time transmission to ' 5 in offline operation. Complementarily, keytagging permits associating information to images (and other signals) by means of keys in a secure and non-distorting fashion, which has been availed to implement security measures such as image authentication, integrity control and location of tampered areas, private captioning with role-based access control, traceability and copyright protection. The tests conducted indicate a remarkable robustness-capacity tradeoff that permits implementing all this measures simultaneously, and the compatibility of keytagging with JPEG2000 compression, maintaining this tradeoff while setting the overall keytagging delay in only ' 120 ms for any image size | evidencing the scalability of this technique. As a general conclusion, it has been demonstrated and illustrated with examples that there are various, complementary and structured manners to contribute in the implementation of suitable security levels for m-Health architectures with a moderate cost in budget, performance, interoperability and usability. The m-Health landscape is evolving permanently along all their dimensions, and this Thesis aims to do so with its security. Furthermore, the lessons learned herein may offer further guidance for the elaboration of more comprehensive and updated security schemes, for the extension of other biomedical standards featuring low emphasis on security or privacy, and for the improvement of the state of the art regarding signal-based protection methods and applications

WiFi-Based Human Activity Recognition Using Attention-Based BiLSTM

Recently, significant efforts have been made to explore human activity recognition (HAR) techniques that use information gathered by existing indoor wireless infrastructures through WiFi signals without demanding the monitored subject to carry a dedicated device. The key intuition is that different activities introduce different multi-paths in WiFi signals and generate different patterns in the time series of channel state information (CSI). In this paper, we propose and evaluate a full pipeline for a CSI-based human activity recognition framework for 12 activities in three different spatial environments using two deep learning models: ABiLSTM and CNN-ABiLSTM. Evaluation experiments have demonstrated that the proposed models outperform state-of-the-art models. Also, the experiments show that the proposed models can be applied to other environments with different configurations, albeit with some caveats. The proposed ABiLSTM model achieves an overall accuracy of 94.03%, 91.96%, and 92.59% across the 3 target environments. While the proposed CNN-ABiLSTM model reaches an accuracy of 98.54%, 94.25% and 95.09% across those same environments

Machine Learning Modelling of Critical Care Patients in the Intensive Care Units

The ICU is a fast-paced data-rich environment which treats the most critically ill patients. On average, over 15 % of patients admitted to the ICU amount in mortality. Therefore, machine learning (ML) is paramount to aiding the optimisation and inference of insight in critical care. In addition, the early and accurate evaluation of the severity at the time of admission is significant for physicians. Such evaluations make patient management more effective as they are more likely to predict whose physical conditions may worsen. Moreover, ML techniques could potentially enhance patients' experience in the clinical setting by providing medical alerts and insight into future events occurring during hospitalisation. The need for interpretable models is crucial in the ICU and clinical setting, as it is vital to explain a decision that leads to any course of action related to an individual patient. This thesis primarily focuses on mortality, length of stay forecasting, and AF classification in critical care. We cover multiple outcomes and modelling methods whilst using multiple cohorts throughout the research. However, the analysis conducted throughout the thesis aims to create interpretable models for each modelling objective. In Chapter 3, we investigate three publicly available critical care databases containing multiple modalities of data and a wide range of parameters. We describe the processes and contemplations which must be considered to create actionable data for analysis in the ICU. Furthermore, we compared the three data sources using traditional statistical and ML methods and compared predictive performance. Based on 24 hours of sequential data, we achieved AUC performances of 79.5% for ICU mortality prediction and a prediction error of approximately 1.3 hours for ICU LOS. In Chapter 4, we investigate a sepsis cohort and conduct three sub-studies. Firstly, we investigated sepsis subtypes and compared biomarkers using traditional modelling methods. Next, we compare our approach to commonly and routinely used scoring systems in the ICU, such as APACHE IV and SOFA. Our tailored approach achieved superior performance with pulmonary and abdominal sepsis (AUC 0.74 and 0.71respectivly), displaying distinct individualities amongst the different sepsis groups. Next, we further expand our analysis by comparing ML methods and inference approaches to our baseline model and ICU acuity scores. We further investigate extending analysis to other outcomes of interest (In-hospital/ICU mortality, In-hospital/ICU LOS) to gain a more holistic view of the sepsis derivatives. This research shows that nonlinear models such as RF and GBM commonly outperformICU scoring, methods such as APACHE IV and SOFA and linear methods such as logistic/linear regression. Lastly, we extend our analysis in a multi-task learning framework for model optimisation and improved predictive performance. Our results showed superior performance with pulmonary, abdominal and renal/UTI sepsis (AUC 0.76, 0.77 and 0.73, respectively). Lastly, Chapter 5 investigates the classification of atrial fibrillation (AF) in long-lead ECG waveforms in sepsis patients. We developed a deep neural network to classify AF ECGs from Non-AF ECG cases in conjunction with refining a method to gain insight from the neural network model. We achieved a predictive performance of 0.99 and 0.89 regarding the test and external validation data. The inference from the model was achieved through the use of saliency maps, dimensionality reduction methods and clustering, utilising the automatic features learned by the developed model. We developed visualisations to help support the inference behind the classification of each ECG prediction. Overall, the research displays a wide range of novelties and unique approaches to solving various outcomes of interest in the ICU. In addition, this research demonstrates the implication of ML applicability in the ICU environment by providing insight and inference to diverse tasks regardless of the level of complexity. With further development, the frameworks and approaches outlined in this thesis have the potential to be used in clinical practice as decision-support tools in the ICU, allowing the automated alert and detection of patient classification, amongst others. The results generated in this thesis resulted in journal publications and medical understanding gained from insight available in the developed ML frameworks

Runtime Adaptation of Scientific Service Workflows

Software landscapes are rather subject to change than being complete after having been built. Changes may be caused by a modified customer behavior, the shift to new hardware resources, or otherwise changed requirements. In such situations, several challenges arise. New architectural models have to be designed and implemented, existing software has to be integrated, and, finally, the new software has to be deployed, monitored, and, where appropriate, optimized during runtime under realistic usage scenarios. All of these situations often demand manual intervention, which causes them to be error-prone. This thesis addresses these types of runtime adaptation. Based on service-oriented architectures, an environment is developed that enables the integration of existing software (i.e., the wrapping of legacy software as web services). A workflow modeling tool that aims at an easy-to-use approach by separating the role of the workflow expert and the role of the domain expert. After the development of workflows, tools that observe the executing infrastructure and perform automatic scale-in and scale-out operations are presented. Infrastructure-as-a-Service providers are used to scale the infrastructure in a transparent and cost-efficient way. The deployment of necessary middleware tools is automatically done. The use of a distributed infrastructure can lead to communication problems. In order to keep workflows robust, these exceptional cases need to treated. But, in this way, the process logic of a workflow gets mixed up and bloated with infrastructural details, which yields an increase in its complexity. In this work, a module is presented that can deal automatically with infrastructural faults and that thereby allows to keep the separation of these two layers. When services or their components are hosted in a distributed environment, some requirements need to be addressed at each service separately. Although techniques as object-oriented programming or the usage of design patterns like the interceptor pattern ease the adaptation of service behavior or structures. Still, these methods require to modify the configuration or the implementation of each individual service. On the other side, aspect-oriented programming allows to weave functionality into existing code even without having its source. Since the functionality needs to be woven into the code, it depends on the specific implementation. In a service-oriented architecture, where the implementation of a service is unknown, this approach clearly has its limitations. The request/response aspects presented in this thesis overcome this obstacle and provide a SOA-compliant and new methods to weave functionality into the communication layer of web services. The main contributions of this thesis are the following: Shifting towards a service-oriented architecture: The generic and extensible Legacy Code Description Language and the corresponding framework allow to wrap existing software, e.g., as web services, which afterwards can be composed into a workflow by SimpleBPEL without overburdening the domain expert with technical details that are indeed handled by a workflow expert. Runtime adaption: Based on the standardized Business Process Execution Language an automatic scheduling approach is presented that monitors all used resources and is able to automatically provision new machines in case a scale-out becomes necessary. If the resource's load drops, e.g., because of less workflow executions, a scale-in is also automatically performed. The scheduling algorithm takes the data transfer between the services into account in order to prevent scheduling allocations that eventually increase the workflow's makespan due to unnecessary or disadvantageous data transfers. Furthermore, a multi-objective scheduling algorithm that is based on a genetic algorithm is able to additionally consider cost, in a way that a user can define her own preferences rising from optimized execution times of a workflow and minimized costs. Possible communication errors are automatically detected and, according to certain constraints, corrected. Adaptation of communication: The presented request/response aspects allow to weave functionality into the communication of web services. By defining a pointcut language that only relies on the exchanged documents, the implementation of services must neither be known nor be available. The weaving process itself is modeled using web services. In this way, the concept of request/response aspects is naturally embedded into a service-oriented architecture

Explainable Artificial Intelligence (XAI): What we know and what is left to attain Trustworthy Artificial Intelligence

This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (No. 2021R1A2C1011198) , (Institute for Information & communications Technology Planning & Evaluation) (IITP) grant funded by the Korea government (MSIT) under the ICT Creative Consilience Program (IITP-2021-2020-0-01821) , and AI Platform to Fully Adapt and Reflect Privacy-Policy Changes (No. 2022-0-00688).Artificial intelligence (AI) is currently being utilized in a wide range of sophisticated applications, but the outcomes of many AI models are challenging to comprehend and trust due to their black-box nature. Usually, it is essential to understand the reasoning behind an AI mode ľs decision-making. Thus, the need for eXplainable AI (XAI) methods for improving trust in AI models has arisen. XAI has become a popular research subject within the AI field in recent years. Existing survey papers have tackled the concepts of XAI, its general terms, and post-hoc explainability methods but there have not been any reviews that have looked at the assessment methods, available tools, XAI datasets, and other related aspects. Therefore, in this comprehensive study, we provide readers with an overview of the current research and trends in this rapidly emerging area with a case study example. The study starts by explaining the background of XAI, common definitions, and summarizing recently proposed techniques in XAI for supervised machine learning. The review divides XAI techniques into four axes using a hierarchical categorization system: (i) data explainability, (ii) model explainability, (iii) post-hoc explainability, and (iv) assessment of explanations. We also introduce available evaluation metrics as well as open-source packages and datasets with future research directions. Then, the significance of explainability in terms of legal demands, user viewpoints, and application orientation is outlined, termed as XAI concerns. This paper advocates for tailoring explanation content to specific user types. An examination of XAI techniques and evaluation was conducted by looking at 410 critical articles, published between January 2016 and October 2022, in reputed journals and using a wide range of research databases as a source of information. The article is aimed at XAI researchers who are interested in making their AI models more trustworthy, as well as towards researchers from other disciplines who are looking for effective XAI methods to complete tasks with confidence while communicating meaning from data.National Research Foundation of Korea Ministry of Science, ICT & Future Planning, Republic of Korea Ministry of Science & ICT (MSIT), Republic of Korea 2021R1A2C1011198Institute for Information amp; communications Technology Planning amp; Evaluation) (IITP) - Korea government (MSIT) under the ICT Creative Consilience Program IITP-2021-2020-0-01821AI Platform to Fully Adapt and Reflect Privacy-Policy Changes2022-0-0068

Urban Informatics

This open access book is the first to systematically introduce the principles of urban informatics and its application to every aspect of the city that involves its functioning, control, management, and future planning. It introduces new models and tools being developed to understand and implement these technologies that enable cities to function more efficiently – to become ‘smart’ and ‘sustainable’. The smart city has quickly emerged as computers have become ever smaller to the point where they can be embedded into the very fabric of the city, as well as being central to new ways in which the population can communicate and act. When cities are wired in this way, they have the potential to become sentient and responsive, generating massive streams of ‘big’ data in real time as well as providing immense opportunities for extracting new forms of urban data through crowdsourcing. This book offers a comprehensive review of the methods that form the core of urban informatics from various kinds of urban remote sensing to new approaches to machine learning and statistical modelling. It provides a detailed technical introduction to the wide array of tools information scientists need to develop the key urban analytics that are fundamental to learning about the smart city, and it outlines ways in which these tools can be used to inform design and policy so that cities can become more efficient with a greater concern for environment and equity

Urban Informatics

This open access book is the first to systematically introduce the principles of urban informatics and its application to every aspect of the city that involves its functioning, control, management, and future planning. It introduces new models and tools being developed to understand and implement these technologies that enable cities to function more efficiently – to become ‘smart’ and ‘sustainable’. The smart city has quickly emerged as computers have become ever smaller to the point where they can be embedded into the very fabric of the city, as well as being central to new ways in which the population can communicate and act. When cities are wired in this way, they have the potential to become sentient and responsive, generating massive streams of ‘big’ data in real time as well as providing immense opportunities for extracting new forms of urban data through crowdsourcing. This book offers a comprehensive review of the methods that form the core of urban informatics from various kinds of urban remote sensing to new approaches to machine learning and statistical modelling. It provides a detailed technical introduction to the wide array of tools information scientists need to develop the key urban analytics that are fundamental to learning about the smart city, and it outlines ways in which these tools can be used to inform design and policy so that cities can become more efficient with a greater concern for environment and equity