XML Security in Certificate Management - XML Certificator

The trend of rapid growing use of XML format in data/document management system reveals that security measures should be urgently considered into next generation's data/document systems. This paper presents a new certificate management system developed on the basis of XML security mechanisms. The system is supported by the theories of XML security as well as Object oriented technology and database. Finally it has been successfully implemented in using C&#, SQL, XML signature and XML encryption. An implementation metrics is evidently presented

Blood glucose monitoring in children and adolescents with Type 1 Diabetes Mellitus

Aim: The aims of this review are to explore and quantify the importance of blood glucose monitoring on glycaemic control in children and adolescents with Type 1 Diabetes Mellitus (T1DM). Methods: A literature search of the major bibliographic databases found 11 observational studies which met the inclusion criteria of this review. Results: 9 of the 11 papers found a significant link between self-monitoring of blood glucose (SMBG) frequency and HbA1c reduction, with SMBG monitoring 4 times daily leading to a further reduction in HbA1c of 1% compared to once daily monitoring. Frequent SMBG was correlated to higher social status, higher self-efficacy and increased parental involvement and was a sign of better global self-care behaviour. It was also noted that frequent SMBG leads to improved glycaemic control only if patients are taught what to do with the results and if they have an insulin regimen that allows for adjustment of insulin doses in response to blood glucose values. Conclusion: Frequent SMBG monitoring is an important part of diabetes self-management in children and adolescents with T1DM because it results in a significant reduction in HbA1c. In the long-term this will lead to a reduction in the late complications of T1DM. Providing children and adolescents with T1DM in Malta with an adequate supply of glucose test strips should serve as an incentive for them to check their blood glucose regularly.peer-reviewe

Interoperability, Trust Based Information Sharing Protocol and Security: Digital Government Key Issues

Improved interoperability between public and private organizations is of key significance to make digital government newest triumphant. Digital Government interoperability, information sharing protocol and security are measured the key issue for achieving a refined stage of digital government. Flawless interoperability is essential to share the information between diverse and merely dispersed organisations in several network environments by using computer based tools. Digital government must ensure security for its information systems, including computers and networks for providing better service to the citizens. Governments around the world are increasingly revolving to information sharing and integration for solving problems in programs and policy areas. Evils of global worry such as syndrome discovery and manage, terror campaign, immigration and border control, prohibited drug trafficking, and more demand information sharing, harmonization and cooperation amid government agencies within a country and across national borders. A number of daunting challenges survive to the progress of an efficient information sharing protocol. A secure and trusted information-sharing protocol is required to enable users to interact and share information easily and perfectly across many diverse networks and databases globally.Comment: 20 page

Door-to-balloon time in primary percutaneous coronary intervention for patients with ST-Segment Elevation Myocardial Infarction

Introduction: Over the past years Primary Percutaneous Coronary Intervention (PCI) has emerged as an effective treatment strategy for acute ST-Elevation Myocardial Infarction (STEMI).1 The survival rate with Primary PCI however is dependent on the time to treatment,2 thus, given the time dependency of survival in patient with STEMI undergoing Primary PCI, the American College of Cardiology and American Heart Association (ACC/AHA) in their management guidelines of acute myocardial infarction also endorsed by European Society of Cardiology (ESC) have established a door- to-balloon time of 90 minutes as a gold standard for Primary PCI.4 The aim of this audit is to measure and compare this key performance measurement for quality of care of patients with STEMI in the Maltese Islands. Methods: This audit was conducted at the only PCI-capable hospital in Malta – Mater Dei Hospital. All the patients coming in through the Accident and Emergency Department with an ST-elevation Myocardial Infarction or a new onset Left Bundle Branch Block (LBBB), thus eligible for a Primary PCI, were included in this audit. This was a prospective audit between January 2012 and December 2012 and using a proforma, data was collected primarily to map out the Door-to-Ballon times for Primary PCI during that period. This data was also used to pinpoint areas were time delays occur when dealing with STEMI cases. Door-to-Balloon times from pre-hospital diagnosis of STEMI using the MRX was also audited and compared to times of in-hospital STEMI diagnosis. Results: During the 12 months duration of the audit, 157 patients were recorded in the CathLab Database as having had an Emergency Primary PCI. Recorded in the audit were 135 patients of which 123 were STEMI patients eligible for a Primary PCI and 12 STEMI patients not eligible for Primary PCI and thus not included in the audit. The Mean Door-to- Balloon times of all 123 patients was found to be 101.45 minutes. Data analysis showed that the times during 'Office Hours' (8am to 5pm) were statistically significantly less than those of 'After hours' (5pm to 8am) (N=123, p<0.001) and those with a Door-to- Balloon time of more than 90 minutes, data analysis showed the number of such cases were statistically significantly less during 'Office Hours' (N=36, p=0.02). With pre-hospital ECG diagnosis of STEMI, data analysis showed that with MRX, Door-to-Ballon times are significantly less when compared to those during 'Office Hours' and 'After Hours' (N=57, p=0.003 and N=66, p<0.001 respectively). Conclusion: From the results obtained, local achievement to remain well within the standards suggested by the ACC/AHA and ESC of Primary PCI ? 90 minutes for STEMI was not reached, however several factors contributing to delays and strategies to minimize delay were pointed out in order to further improve the local practice and thus lowering mortality rates associated with STEMI.peer-reviewe