A secure and lightweight drones-access protocol for smart city surveillance

The rising popularity of ICT and the Internet has enabled Unmanned Aerial Vehicle (UAV) to offer advantageous assistance to Vehicular Ad-hoc Network (VANET), realizing a relay node's role among the disconnected segments in the road. In this scenario, the communication is done between Vehicles to UAVs (V2U), subsequently transforming into a UAV-assisted VANET. UAV-assisted VANET allows users to access real-time data, especially the monitoring data in smart cities using current mobile networks. Nevertheless, due to the open nature of communication infrastructure, the high mobility of vehicles along with the security and privacy constraints are the significant concerns of UAV-assisted VANET. In these scenarios, Deep Learning Algorithms (DLA) could play an effective role in the security, privacy, and routing issues of UAV-assisted VANET. Keeping this in mind, we have devised a DLA-based key-exchange protocol for UAV-assisted VANET. The proposed protocol extends the scalability and uses secure bitwise XOR operations, one-way hash functions, including user's biometric verification when users and drones are mutually authenticated. The proposed protocol can resist many well-known security attacks and provides formal and informal security under the Random Oracle Model (ROM). The security comparison shows that the proposed protocol outperforms the security performance in terms of running time cost and communication cost and has effective security features compared to other related protocols

Causes of Mortality for Indonesian Hajj Pilgrims: Comparison between Routine Death Certificate and Verbal Autopsy Findings

10.1371/journal.pone.0073243PLoS ONE88-POLN

SPARC 2018 Internationalisation and collaboration : Salford postgraduate annual research conference book of abstracts

Welcome to the Book of Abstracts for the 2018 SPARC conference. This year we not only celebrate the work of our PGRs but also the launch of our Doctoral School, which makes this year’s conference extra special. Once again we have received a tremendous contribution from our postgraduate research community; with over 100 presenters, the conference truly showcases a vibrant PGR community at Salford. These abstracts provide a taster of the research strengths of their works, and provide delegates with a reference point for networking and initiating critical debate. With such wide-ranging topics being showcased, we encourage you to take up this great opportunity to engage with researchers working in different subject areas from your own. To meet global challenges, high impact research inevitably requires interdisciplinary collaboration. This is recognised by all major research funders. Therefore engaging with the work of others and forging collaborations across subject areas is an essential skill for the next generation of researchers

Dapsone‐ and nitroso dapsone‐specific activation of T cells from hypersensitive patients expressing the risk allele HLA‐B*13:01

BACKGROUND:Research into drug hypersensitivity associated with expression of specific HLA alleles has focussed on the interaction between parent drug and the HLA with no attention given to reactive metabolites. For this reason, we have studied HLA-B*13:01-linked dapsone hypersensitivity to (1) explore whether the parent drug and/or nitroso metabolite activates T-cells and (2) determine whether HLA-B*13:01 is involved in the response. METHODS:PBMC from 6 patients were cultured with dapsone and nitroso dapsone and proliferative responses and IFN-γ release were measured. Dapsone- and nitroso dapsone-specific T-cell clones were generated and phenotype, function, HLA allele restriction and cross-reactivity assessed. Dapsone intermediates were characterized by mass spectrometry. RESULTS:PBMC from 6 patients and cloned T-cells proliferated and secreted Th1/2/22 cytokines when stimulated with dapsone (clones: n=395; 80% CD4+ CXCR3hi CCR4hi , 20% CD8+CXCR3hi CCR4hi CCR6hi CCR9hi CCR10hi ) and nitroso dapsone (clones: n=399; 78% CD4+, 22% CD8+ with same chemokine receptor profile). CD4+ and CD8+ clones were HLA-class II and class I restricted, respectively, and displayed three patterns of reactivity: compound-specific, weakly crossreactive and strongly cross reactive. Nitroso dapsone formed dimers in culture and was reduced to dapsone, providing a rationale for the crossreactivity. T-cell responses to nitroso dapsone were dependent on the formation of a cysteine-modified protein adduct, while dapsone interacted in a labile manner with antigen presenting cells. CD8+ clones displayed an HLA-B*13:01-restricted pattern of activation. CONCLUSION:These studies describe the phenotype and function of dapsone- and nitroso dapsone-responsive CD4+ and CD8+ T-cells from hypersensitive patients. Discovery of HLA-B*13:01-restricted CD8+ T-cell responses indicates that drugs and their reactive metabolites participate in HLA allele-linked forms of hypersensitivity. This article is protected by copyright. All rights reserved

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Maternal and neonatal outcomes of placenta previa and placenta accreta: three years of experience with a two-consultant approach

Gamal A Kassem,1 Ali K Alzahrani21Department of Obstetrics and Gynecology, 2Neonatal Intensive Care Unit, King Abdul-Aziz Specialist Hospital, Taif, Kingdom of Saudi ArabiaObjective: The aim of this retrospective cohort study was to evaluate maternal and neonatal outcomes in patients with placenta previa (PP) and placenta accreta (PA).Methods: The study population comprised all patients who had a cesarean section for PP and PA at a tertiary referral hospital in Taif, Kingdom of Saudi Arabia, from December 2009 to December 2012. Maternal and neonatal data were obtained from medical records and the hospital database system. PA cases were managed by a multispeciality team, including two obstetric consultants.Results: In total, 122 patients with PP were identified, with PA found in 25 cases. The median intraoperative blood loss in cases of PA was 2,000 (mean 3,000) mL, with a loss of &ge;2,000 mL occurring in 72%, and &ge;5,000 mL in 20%. The median packed red blood cell transfusion requirement was 6 (mean 7.7) units, and 28% received &ge;10 units. Fetal growth restriction was diagnosed in two cases with known maternal medical disorders. Four cases (3.3%) were diagnosed as small for gestational age. The mean birth weight of the neonates was at the 10th&ndash;50th percentile according to Hadlock fetal growth charts.Conclusion: The presence of a second obstetric consultant among the multispeciality team during surgery for PA was associated with a reduction in blood loss and a decreased need for large-volume blood transfusion. The rate of fetal growth restriction/small for gestational age in PP was average, but the babies were relatively small (level 2 evidence).Keywords: placenta previa, placenta accreta, maternal outcome, neonatal outcom