SCBC: Smart city monitoring with blockchain using Internet of Things for and neuro fuzzy procedures.

The security of the Internet of Things (IoT) is crucial in various application platforms, such as the smart city monitoring system, which encompasses comprehensive monitoring of various conditions. Therefore, this study conducts an analysis on the utilization of blockchain technology for the purpose of monitoring Internet of Things (IoT) systems. The analysis is carried out by employing parametric objective functions. In the context of the Internet of Things (IoT), it is imperative to establish well-defined intervals for job execution, ensuring that the completion status of each action is promptly monitored and assessed. The major significance of proposed method is to integrate a blockchain technique with neuro-fuzzy algorithm thereby improving the security of data processing units in all smart city applications. As the entire process is carried out with IoT the security of data in both processing and storage units are not secured therefore confidence level of monitoring units are maximized at each state. Due to the integration process the proposed system model is implemented with minimum energy conservation where 93% of tasks are completed with improved security for about 90%

A smart decentralized identifiable distributed ledger technology‐based blockchain (DIDLT‐BC) model for cloud‐IoT security

The most important and difficult challenge the digital society has recently faced is ensuring data privacy and security in cloud‐based Internet of Things (IoT) technologies. As a result, many researchers believe that the blockchain's Distributed Ledger Technology (DLT) is a good choice for various clever applications. Nevertheless, it encountered constraints and difficulties with elevated computing expenses, temporal demands, operational intricacy, and diminished security. Therefore, the proposed work aims to develop a Decentralized Identifiable Distributed Ledger Technology‐Blockchain (DIDLT‐BC) framework that is intelligent and effective, requiring the least amount of computing complexity to ensure cloud IoT system safety. In this case, the Rabin algorithm produces the digital signature needed to start the transaction. The public and private keys are then created to verify the transactions. The block is then built using the DIDLT model, which includes the block header information, hash code, timestamp, nonce message, and transaction list. The primary purpose of the Blockchain Consent Algorithm (BCA) is to find solutions for numerous unreliable nodes with varying hash values. The novel contribution of this work is to incorporate the operations of Rabin digital data signature generation, DIDLT‐based blockchain construction, and BCA algorithms for ensuring overall data security in IoT networks. With proper digital signature generation, key generation, blockchain construction and validation operations, secured data storage and retrieval are enabled in the cloud‐IoT systems. By using this integrated DIDLT‐BCA model, the security performance of the proposed system is greatly improved with 98% security, less execution time of up to 150 ms, and reduced mining time of up to 0.98 s

Alterations in Antioxidant Defense System in the Plasma of Female Khat Chewers of Thamar City, Yemen

Abstract * Corresponding author. e-mail: [email protected]. * Abbreviations used: BChE, Butyrylcholinesterase; GSH, Reduced glutathione; T-SH, Total thiols; OPs, Organophosphate compounds; CAT, Catalase Chewing Khat leaves (Catha edulis) is highly prevalent in Yemen and East African countries. Unfortunately, farmers use to apply pesticide for the better product of Khat. The present study has been designed to investigate the activity of plasma butyrylcholinesterase (BChE) and to assess the antioxidant defense system in the plasma of female Khat chewers in Thamar city, Yemen. Plasma of twenty female Khat chewers and twenty controls (non Khat chewers) were prepared and the activities of BChE and catalase (CAT) were estimated along with the measuring levels of reduced glutathione, total thiols and cholesterol. At biochemical level a significant decrease in the activities of BChE and CAT were observed in the plasma of female Khat chewers (P < 0.05) concomitant with reductions in the levels of reduced glutathione and total thiols (P < 0.05) as compared to non Khat chewers. This alterations on the antioxidants resulted in decrease of plasma cholesterol in Khat chewers group (P < 0.05). The present data show that the production of oxidants which are responsible for reduction in antioxidant defense system might be due to chewing Khat plant with more attention to the pesticide applied to the plant

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Time for a paradigm shift in shared decision-making in trauma and emergency surgery? Results from an international survey

BackgroundShared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons.MethodsGrounding on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society's website, and shared on the society's Twitter profile.ResultsA total of 650 trauma and emergency surgeons from 71 countries in five continents participated in the initiative. Less than half of the surgeons understood SDM, and 30% still saw the value in exclusively engaging multidisciplinary provider teams without involving the patient. Several barriers to effectively partnering with the patient in the decision-making process were identified, such as the lack of time and the need to concentrate on making medical teams work smoothly.DiscussionOur investigation underlines how only a minority of trauma and emergency surgeons understand SDM, and perhaps, the value of SDM is not fully accepted in trauma and emergency situations. The inclusion of SDM practices in clinical guidelines may represent the most feasible and advocated solutions

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population