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

Classification of Normal and Crackles Respiratory Sounds into Healthy and Lung Cancer Groups

Lung cancer is the most common cancer worldwide and the third most common cancer in Malaysia. Due to its high prevalence worldwide and in Malaysia, it is an utmost importance to have the disease detected at an early stage which would result in a higher chance of cure and possibly better survival. The current methods used for lung cancer screening might not be simple, inexpensive and safe and not readily accessible in outpatient clinics. In this paper, we present the classification of normal and crackles sounds acquired from 20 healthy and 23 lung cancer patients, respectively using Artificial Neural Network. Firstly, the sounds signals were decomposed into seven different frequency bands using Discrete Wavelet Transform (DWT) based on two different mother wavelets namely Daubechies 7 (db7) and Haar. Secondly, mean, standard deviation and maximum PSD of the detail coefficients for five frequency bands (D3, D4, D5, D6, and D7) were calculated as features. Fifteen features were used as input to the ANN classifier. The results of classification show that db7 based performed better than Haar with perfect 100% sensitivity, specificity and accuracy for testing and validation stages when using 15 nodes at the hidden layer. While for Haar, only testing stage shows the perfect 100% for sensitivity, specificity, and accuracy when using 10 nodes at the hidden layer

Recent Advances in Signal Processing

The signal processing task is a very critical issue in the majority of new technological inventions and challenges in a variety of applications in both science and engineering fields. Classical signal processing techniques have largely worked with mathematical models that are linear, local, stationary, and Gaussian. They have always favored closed-form tractability over real-world accuracy. These constraints were imposed by the lack of powerful computing tools. During the last few decades, signal processing theories, developments, and applications have matured rapidly and now include tools from many areas of mathematics, computer science, physics, and engineering. This book is targeted primarily toward both students and researchers who want to be exposed to a wide variety of signal processing techniques and algorithms. It includes 27 chapters that can be categorized into five different areas depending on the application at hand. These five categories are ordered to address image processing, speech processing, communication systems, time-series analysis, and educational packages respectively. The book has the advantage of providing a collection of applications that are completely independent and self-contained; thus, the interested reader can choose any chapter and skip to another without losing continuity

Digital Watermarking for Verification of Perception-based Integrity of Audio Data

In certain application fields digital audio recordings contain sensitive content. Examples are historical archival material in public archives that preserve our cultural heritage, or digital evidence in the context of law enforcement and civil proceedings. Because of the powerful capabilities of modern editing tools for multimedia such material is vulnerable to doctoring of the content and forgery of its origin with malicious intent. Also inadvertent data modification and mistaken origin can be caused by human error. Hence, the credibility and provenience in terms of an unadulterated and genuine state of such audio content and the confidence about its origin are critical factors. To address this issue, this PhD thesis proposes a mechanism for verifying the integrity and authenticity of digital sound recordings. It is designed and implemented to be insensitive to common post-processing operations of the audio data that influence the subjective acoustic perception only marginally (if at all). Examples of such operations include lossy compression that maintains a high sound quality of the audio media, or lossless format conversions. It is the objective to avoid de facto false alarms that would be expectedly observable in standard crypto-based authentication protocols in the presence of these legitimate post-processing. For achieving this, a feasible combination of the techniques of digital watermarking and audio-specific hashing is investigated. At first, a suitable secret-key dependent audio hashing algorithm is developed. It incorporates and enhances so-called audio fingerprinting technology from the state of the art in contentbased audio identification. The presented algorithm (denoted as ”rMAC” message authentication code) allows ”perception-based” verification of integrity. This means classifying integrity breaches as such not before they become audible. As another objective, this rMAC is embedded and stored silently inside the audio media by means of audio watermarking technology. This approach allows maintaining the authentication code across the above-mentioned admissible post-processing operations and making it available for integrity verification at a later date. For this, an existent secret-key ependent audio watermarking algorithm is used and enhanced in this thesis work. To some extent, the dependency of the rMAC and of the watermarking processing from a secret key also allows authenticating the origin of a protected audio. To elaborate on this security aspect, this work also estimates the brute-force efforts of an adversary attacking this combined rMAC-watermarking approach. The experimental results show that the proposed method provides a good distinction and classification performance of authentic versus doctored audio content. It also allows the temporal localization of audible data modification within a protected audio file. The experimental evaluation finally provides recommendations about technical configuration settings of the combined watermarking-hashing approach. Beyond the main topic of perception-based data integrity and data authenticity for audio, this PhD work provides new general findings in the fields of audio fingerprinting and digital watermarking. The main contributions of this PhD were published and presented mainly at conferences about multimedia security. These publications were cited by a number of other authors and hence had some impact on their works

Journal of Telecommunications and Information Technology, 2014, nr 2

kwartalni

Applications of MATLAB in Science and Engineering

The book consists of 24 chapters illustrating a wide range of areas where MATLAB tools are applied. These areas include mathematics, physics, chemistry and chemical engineering, mechanical engineering, biological (molecular biology) and medical sciences, communication and control systems, digital signal, image and video processing, system modeling and simulation. Many interesting problems have been included throughout the book, and its contents will be beneficial for students and professionals in wide areas of interest

ECG Analysis-Based Cardiac Disease Prediction Using Signal Feature Selection with Extraction Based on AI Techniques

ECG (Electrocardiogram) performs classification using a machine learning model for processing different features in the ECG signal. The electrical activity of the heart is computed with the ECG signal with machine learning library. The key issue in the handling of ECG signals is an estimation of irregularities to evaluate the health status of patients. The ECG signal evaluate the impulse waveform for the specialized tissues in the cardiac heart diseases. However, the ECG signal comprises of the different difficulties associated with waveform estimation to derive certain features. Through machine learning (ML) model the input features are computed with input ECG signals. In this paper, proposed a Noise QRS Feature to evaluate the features in the ECG signals for the effective classification. The Noise QRS Feature model computes the ECG signal features of the waveform sequences.  Initially, the signal is pre-processed with the Finite Impulse response (FIR) filter for the analysis of ECG signal. The features in the ECG signal are processed and computed with the QRS signal responses in the ECG signal. The Noise QRS Feature evaluate the ECG signal with the kNN for the estimation and classification of features in the ECG signals. The performance of the proposed Noise QRS Feature features are comparatively examined with the Discrete Wavelet Transform (DWT), Dual-Tree Complex Wavelet Transforms (DTCWT) and Discrete Orthonormal Stockwell Transform (DOST) and the machine learning model Cascade Feed Forward Neural Network (CFNN), Feed Forward Neural Network (FFNN). Simulation analysis expressed that the proposed Noise QRS Feature exhibits a higher classification accuracy of 99% which is ~6 – 7% higher than the conventional classifier model

MediaSync: Handbook on Multimedia Synchronization

This book provides an approachable overview of the most recent advances in the fascinating field of media synchronization (mediasync), gathering contributions from the most representative and influential experts. Understanding the challenges of this field in the current multi-sensory, multi-device, and multi-protocol world is not an easy task. The book revisits the foundations of mediasync, including theoretical frameworks and models, highlights ongoing research efforts, like hybrid broadband broadcast (HBB) delivery and users' perception modeling (i.e., Quality of Experience or QoE), and paves the way for the future (e.g., towards the deployment of multi-sensory and ultra-realistic experiences). Although many advances around mediasync have been devised and deployed, this area of research is getting renewed attention to overcome remaining challenges in the next-generation (heterogeneous and ubiquitous) media ecosystem. Given the significant advances in this research area, its current relevance and the multiple disciplines it involves, the availability of a reference book on mediasync becomes necessary. This book fills the gap in this context. In particular, it addresses key aspects and reviews the most relevant contributions within the mediasync research space, from different perspectives. Mediasync: Handbook on Multimedia Synchronization is the perfect companion for scholars and practitioners that want to acquire strong knowledge about this research area, and also approach the challenges behind ensuring the best mediated experiences, by providing the adequate synchronization between the media elements that constitute these experiences