Dynamic reciprocal authentication protocol for mobile cloud computing

A combination of mobile and cloud computing delivers many advantages such as mobility, resources, and accessibility through seamless data transmission via the Internet anywhere at any time. However, data transmission through vulnerable channels poses security threats such as man-in-the-middle, playback, impersonation, and asynchronization attacks. To address these threats, we define an explicit security model that can precisely measure the practical capabilities of an adversary. A systematic methodology consisting of 16 evaluation criteria is used for comparative evaluation, thereby leading other approaches to be evaluated through a common scale. Finally, we propose a dynamic reciprocal authentication protocol to secure data transmission in mobile cloud computing (MCC). In particular, our proposed protocol develops a secure reciprocal authentication method, which is free of Diffie–Hellman limitations, and has immunity against basic or sophisticated known attacks. The protocol utilizes multifactor authentication of usernames, passwords, and a one-time password (OTP). The OTP is automatically generated and regularly updated for every connection. The proposed protocol is implemented and tested using Java to demonstrate its efficiency in authenticating communications and securing data transmitted in the MCC environment. Results of the evaluation process indicate that compared with the existing works, the proposed protocol possesses obvious capabilities in security and in communication and computation costs

Measurement of normal optic nerve for Sudanese pediatric using magnetic resonance imaging

Background: Much congenital and intracranial pathology may affect optic nerve (ON) and caused increased or decreased in size, so the measurement is crucial and aiding in diagnosed of some neurogenic and endocrine disorders. The aim of this study was to measure the normal ON length and diameter by magnetic resonance imaging among pediatric at Khartoum state Sudan.Methods: This was descriptive, cross section study,  done in 100 Sudanese pediatrics with age from 1 month to 15 years came to Magnetic resonance imaging (MRI) department for MRI brain at three hospitals in Khartoum state  (Al-Amal national hospital, Al-Zaitona hospital and Modern Medical Center) during the period from December 2019 to March 2020, all of patients had no pathological or medical condition that may affect the orbits and optic nerve (OON), any child with and medical condition or pathology related to orbits excluded from study sampling. The data were collected by data collection sheet designed especially for this study then analyzed.Results: The study found that the mean diameter of ON was 2.06±0.44 mm, the mean length of right ON was 31.54±4.11 mm, there is no significant different in measurement between males and females (p>0.05), there was strong significant correlation between ON length and diameter with children age (r=0.592**, 0.654**, p<0.001 respectively).Conclusions: The study concluded that there was strong correlation between right and left ON diameter and length with age

Evaluation of the knowledge and practices of pregnant Yemeni Women regarding teratogens

Purpose: To investigate the knowledge and practice of pregnant women with regards to teratogens.Methods: A month-long cross-sectional study was carried out among 150 pregnant women selected from four Motherhood and Child Healthcare Centers (MCHCs) in Mukalla District of Yemen. Data collection was conducted during face-to-face interviews using a questionnaire. Descriptive and simple regression analyses were used.Results: Of the 150 pregnant women who participated in the study, 95.3 % of the pregnant women were &lt; 36 years old, 7.4 % had children with congenital malformations, 62 % indicated that they had heard about folic acid; however, only 16.6 % knew the significance of folic acid. Regarding toxoplasmosis, 94.7 % indicated that they had heard about toxoplasmosis, and 76 % knew about the serious consequences of the disease (congenital malformation and abortion) during pregnancy. Based on simple regression analysis, the results indicate that education and parity, irrespective of age or income level, were the major factors determining better knowledge and practices in pregnancy with regards to toxoplasmosis.Conclusion: Knowledge of folic acid deficiency among pregnant women in Mukalla District of Yemen is relatively low. Furthermore, preventive practices to avoid folic acid deficiency are minimal.Keywords: Knowledge, Practices, Teratogens, Pregnant Yemeni women, Folic acid deficienc

Patient attitudes towards medical students at Damascus University teaching hospitals

Background: The cooperation of patients and their consent to involve medical students in their care is vital to clinical education, but large numbers of students and lack of experience as well as loss of privacy may evoke negative attitudes of patients, which may sometimes adversely affect the clinical teaching environment. This study aimed to explore the attitudes of patients towards medical students at Damascus University hospitals, and to explore the determinants of those attitudes thus discussing possible implications applicable to clinical teaching. Methods: This cross-sectional study was conducted at three teaching hospitals affiliated to the Faculty of Medicine at Damascus University. Four hundred patients were interviewed between March and April 2011 by a trained sociologist using a structured questionnaire. Results: Of the patients interviewed, 67.8 % approved the presence of medical students during the medical consultation and 58.2 % of them felt comfortable with the presence of students, especially among patients with better socio-economic characteristics. 81.5 % of the patients agreed to be examined by students in the presence of the supervisor, while 40.2 % gave agreement even in the absence of the supervisor. Privacy was the most important factor in the patients ’ reticence towards examination by the students, whilst the relative safety and comfort if a supervisor was available determined patients ’ agreement

Correct use of non-indexed eGFR for drug dosing and renal drug-related problems at hospital admission

PURPOSE Two to seven percent of the German adult population has a renal impairment (RI) with an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2. This often remains unrecognized and adjustment of drug therapy is lacking. To determine renal function in clinical routine, the CKD-EPI equation is used to calculate an indexed eGFR (ml/min/1.73m2). For drug dosing, it has to be individualized to a non-indexed eGFR (ml/min) by the patient's body surface area. Here, we investigated the number of patients admitted to urological wards of a teaching hospital with RI between July and December 2016. Additionally, we correctly used the eGFRnon-indexed for drug and dosage adjustments and to analyse the use of renal risk drugs (RRD) and renal drug-related problems (rDRP). METHODS In a retrospective observational study, urological patients with pharmacist-led medication reconciliation at hospital admission and eGFRindexed (CKD-EPI) of 15-59 ml/min/1.73m2 were identified. Indexed eGFR (ml/min/1.73m2) was recalculated with body surface area to non-indexed eGFR (ml/min) for correct drug dosing. Medication at admission was reviewed for RRD and based on the eGFRnon-indexed for rDRP, e.g. inappropriate dose or contraindication. RESULTS Of 1320 screened patients, 270 (20.5%) presented with an eGFRindexed of 15–59 ml/min/1.73m2. After readjustment, 203 (15.4%) patients had an eGFRnon-indexed of 15–59 ml/min. Of these, 190 (93.6%) used ≥ 1 drugs at admission with 660 of 1209 (54.7%) drugs classified as RRD. At least one rDRP was identified in 115 (60.5%) patients concerning 264 (21.8%) drugs. CONCLUSION Renal impairment is a common risk factor for medication safety in urologic patients admitted to a hospital. Considerable shifts were seen in eGFR-categories when correctly calculating eGFRnon-indexed for drug dosing purposes. The fact that more than half of the study patients showed rDRP at hospital admission underlines the need to consider this risk factor appropriately

EGCG Enhances the Therapeutic Potential of Gemcitabine and CP690550 by Inhibiting STAT3 Signaling Pathway in Human Pancreatic Cancer

Background: Signal Transducer and Activator of Transcription 3 (STAT3) is an oncogene, which promotes cell survival, proliferation, motility and progression in cancer cells. Targeting STAT3 signaling may lead to the development of novel therapeutic approaches for human cancers. Here, we examined the effects of epigallocathechin gallate (EGCG) on STAT3 signaling in pancreatic cancer cells, and assessed the therapeutic potential of EGCG with gemcitabine or JAK3 inhibitor CP690550 (Tasocitinib) for the treatment and/or prevention of pancreatic cancer. Methodology/Principal Findings: Cell viability and apoptosis were measured by XTT assay and TUNEL staining, respectively. Gene and protein expressions were measured by qRT-PCR and Western blot analysis, respectively. The results revealed that EGCG inhibited the expression of phospho and total JAK3 and STAT3, STAT3 transcription and activation, and the expression of STAT3-regulated genes, resulting in the inhibition of cell motility, migration and invasion, and the induction of caspase-3 and PARP cleavage. The inhibition of STAT3 enhanced the inhibitory effects of EGCG on cell motility and viability. Additionally, gemcitabine and CP690550 alone inhibited STAT3 target genes and synergized with EGCG to inhibit cell viability and induce apoptosis in pancreatic cancer cells. Conclusions/Significance: Overall, these results suggest that EGCG suppresses the growth, invasion and migration of pancreatic cancer cells, and induces apoptosis by interfering with the STAT3 signaling pathway. Moreover, EGCG furthe

Galiellalactone Inhibits Stem Cell-Like ALDH-Positive Prostate Cancer Cells

Galiellalactone is a potent and specific inhibitor of STAT3 signaling which has been shown to possess growth inhibitory effects on prostate cancer cells expressing active STAT3. In this study we aimed to investigate the effect of galiellalactone on prostate cancer stem cell-like cells. We explored the expression of aldehyde dehydrogenase (ALDH) as a marker for cancer stem cell-like cells in different human prostate cancer cell lines and the effects of galiellalactone on ALDH expressing (ALDH+) prostate cancer cells. ALDH+ subpopulations were detected and isolated from the human prostate cancer cell lines DU145 and long-term IL-6 stimulated LNCaP cells using ALDEFLUOR® assay and flow cytometry. In contrast to ALDH− cells, ALDH+ prostate cancer cells showed cancer stem cell-like characteristics such as increased self-renewing and colony forming capacity and tumorigenicity. In addition, ALDH+ cells showed an increased expression of putative prostate cancer stem cell markers (CD44 and integrin α2β1). Furthermore, ALDH+ cells expressed phosphorylated STAT3. Galiellalactone treatment decreased the proportion of ALDH+ prostate cancer cells and induced apoptosis of ALDH+ cells. The gene expression of ALDH1A1 was downregulated in vivo in galiellalactone treated DU145 xenografts. These findings emphasize that targeting the STAT3 pathway in prostate cancer cells, including prostate cancer stem cell-like cells, is a promising therapeutic approach and that galiellalactone is an interesting compound for the development of future prostate cancer drugs

Eradication of Metastatic Renal Cell Carcinoma after Adenovirus-Encoded TNF-Related Apoptosis-Inducing Ligand (TRAIL)/CpG Immunotherapy

Despite evidence that antitumor immunity can be protective against renal cell carcinoma (RCC), few patients respond objectively to immunotherapy and the disease is fatal once metastases develop. We asked to what extent combinatorial immunotherapy with Adenovirus-encoded murine TNF-related apoptosis-inducing ligand (Ad5mTRAIL) plus CpG oligonucleotide, given at the primary tumor site, would prove efficacious against metastatic murine RCC. To quantitate primary renal and metastatic tumor growth in mice, we developed a luciferase-expressing Renca cell line, and monitored tumor burdens via bioluminescent imaging. Orthotopic tumor challenge gave rise to aggressive primary tumors and lung metastases that were detectable by day 7. Intra-renal administration of Ad5mTRAIL+CpG on day 7 led to an influx of effector phenotype CD4 and CD8 T cells into the kidney by day 12 and regression of established primary renal tumors. Intra-renal immunotherapy also led to systemic immune responses characterized by splenomegaly, elevated serum IgG levels, increased CD4 and CD8 T cell infiltration into the lungs, and elimination of metastatic lung tumors. Tumor regression was primarily dependent upon CD8 T cells and resulted in prolonged survival of treated mice. Thus, local administration of Ad5mTRAIL+CpG at the primary tumor site can initiate CD8-dependent systemic immunity that is sufficient to cause regression of metastatic lung tumors. A similar approach may prove beneficial for patients with metastatic RCC

Strategies to reengage patients lost to follow up in HIV care in high income countries, a scoping review

Background: Despite remarkable achievements in antiretroviral therapy (ART), losses to follow-up (LTFU) might prevent the long-term success of HIV treatment and might delay the achievement of the 90-90-90 objectives. This scoping review is aimed at the description and analysis of the strategies used in high-income countries to reengage LTFU in HIV care, their implementation and impact. Methods: A scoping review was done following Arksey & O'Malley's methodological framework and recommendations from Joanna Briggs Institute. Peer reviewed articles were searched for in Pubmed, Scopus and Web of Science; and grey literature was searched for in Google and other sources of information. Documents were charted according to the information presented on LTFU, the reengagement procedures used in HIV units in high-income countries, published during the last 15 years. In addition, bibliographies of chosen articles were reviewed for additional articles. Results: Twenty-eight documents were finally included, over 80% of them published in the United States later than 2015. Database searches, phone calls and/or mail contacts were the most common strategies used to locate and track LTFU, while motivational interviews and strengths-based techniques were used most often during reengagement visits. Outcomes like tracing activities efficacy, rates of reengagement and viral load reduction were reported as outcome measures. Conclusions: This review shows a recent and growing trend in developing and implementing patient reengagement strategies in HIV care. However, most of these strategies have been implemented in the United States and little information is available for other high-income countries. The procedures used to trace and contact LTFU are similar across reviewed studies, but their impact and sustainability are widely different depending on the country studied