M-ATTEMPT: A New Energy-Efficient Routing Protocol for Wireless Body Area Sensor Networks

In this paper, we propose a new routing protocol for heterogeneous Wireless Body Area Sensor Networks (WBASNs); Mobility-supporting Adaptive Threshold-based Thermal-aware Energy-efficientMulti-hop ProTocol (M-ATTEMPT). A prototype is defined for employing heterogeneous sensors on human body. Direct communication is used for real-time traffic (critical data) or on-demand data while Multi-hop communication is used for normal data delivery. One of the prime challenges in WBASNs is sensing of the heat generated by the implanted sensor nodes. The proposed routing algorithm is thermal-aware which senses the link Hot-spot and routes the data away from these links. Continuous mobility of human body causes disconnection between previous established links. So, mobility support and energy-management is introduced to overcome the problem. Linear Programming (LP) model for maximum information extraction and minimum energy consumption is presented in this study. MATLAB simulations of proposed routing algorithm are performed for lifetime and successful packet delivery in comparison with Multi-hop communication. The results show that the proposed routing algorithm has less energy consumption and more reliable as compared to Multi-hop communication.Comment: arXiv admin note: substantial text overlap with arXiv:1208.609

Pulmonary rehabilitation and cardiovascular risk in COPD: a systematic review

Introduction: Pulmonary Rehabilitation (PR) is an effective intervention in COPD however the value of PR in reducing cardiovascular risk in COPD (measured by aortic pulse wave velocity, aPWV) is unclear and there is no existing systematic review. Objectives: To conduct a systematic review examining whether PR results in alteration of CV risk in COPD (as measured by aPWV). Methods: An electronic systematic search concordant with PRISMA guidelines was conducted. The search was complete to the 27th of May 2017. Six databases were examined: Embase, Medline, AMED, Web of Science, Cochrane clinical trials, and CINAHL. Results: This study generated 767 initial matches, which were filtered using inclusion/exclusion criteria. Three studies (201 COPD participants) were included. Our analysis does not confirm that PR affects aPWV but studies were heterogeneous. Conclusion: There is currently insufficient information on the effect of PR on reducing CV risk in COPD. Therefore controversy remains, with the possibility that there might be some subjects who benefit and others who might experience an increase in CV risk in response to PR. These results will be of value to those interested in gaining a better understanding of the benefits of PR on CV risk in COPD

Risk-driven revision of requirements models

© 2016 ACM.Requirements incompleteness is often the result of unanticipated adverse conditions which prevent the software and its environment from behaving as expected. These conditions represent risks that can cause severe software failures. The identification and resolution of such risks is therefore a crucial step towards requirements completeness. Obstacle analysis is a goal-driven form of risk analysis that aims at detecting missing conditions that can obstruct goals from being satisfied in a given domain, and resolving them. This paper proposes an approach for automatically revising goals that may be under-specified or (partially) wrong to resolve obstructions in a given domain. The approach deploys a learning-based revision methodology in which obstructed goals in a goal model are iteratively revised from traces exemplifying obstruction and non-obstruction occurrences. Our revision methodology computes domain-consistent, obstruction-free revisions that are automatically propagated to other goals in the model in order to preserve the correctness of goal models whilst guaranteeing minimal change to the original model. We present the formal foundations of our learning-based approach, and show that it preserves the properties of our formal framework. We validate it against the benchmarking case study of the London Ambulance Service

Computational alignment of goals and scenarios for complex systems

The purpose of requirements validation is to determine whether a large requirements set will lead to the achievement of system-related goals under different conditions - a task that needs automation if it is to be performed quickly and accurately. One reason for the current lack of software tools to undertake such validation is the absence of the computational mechanisms needed to associate scenario, system specification and goal analysis tools. Therefore, in this paper, we report first research experiments in developing these new capabilities, and demonstrate them with a non-trivial example associated with a Rolls Royce aircraft engine software component

Healthcare providers’ attitudes, beliefs and barriers to pulmonary rehabilitation for patients with chronic obstructive pulmonary disease in Saudi Arabia: a cross-sectional study

Objectives: To assess the attitude of healthcare providers (HCPs) towards the delivering of pulmonary rehabilitation (PR) to patients with chronic obstructive pulmonary disease (COPD) and identify factors and barriers that might influence referral. Design: A cross-sectional online survey consisting of nine multiple-choice questions. Settings: Saudi Arabia. Participants: 980 HCPs including nurses, respiratory therapists (RT) and physiotherapists. Primary outcome measures: HCPs attitudes towards and expectations of the delivery of PR to COPD patients and the identification of factors and barriers that might influence referral in Saudi Arabia. Results: Overall, 980 HCPs, 53.1% of whom were men, completed the survey. Nurses accounted for 40.1% of the total sample size, and RTs and physiotherapists accounted for 32.1% and 16.5%, respectively. The majority of HCPs strongly agreed that PR would improve exercise capacity 589 (60.1%), health-related quality of life 571 (58.3%), and disease self-management in patients with COPD 589 (60.1%). Moreover, the in-hospital supervised PR programme was the preferred method of delivering PR, according to 374 (38.16%) HCPs. Around 85% of HCPs perceived information about COPD, followed by smoking cessation 787 (80.3%) as essential components of PR besides the exercise component. The most common patient-related factor that strongly influenced referral decisions was ‘mobility affected by breathlessness’ (64%), while the ‘availability of PR centres’ (61%), the ‘lack of trained HCPs’ (52%) and the ‘lack of authority to refer patients’ (44%) were the most common barriers to referral. Conclusion: PR is perceived as an effective management strategy for patients with COPD. A supervised hospital-based programme is the preferred method of delivering PR, with information about COPD and smoking cessation considered essential components of PR besides the exercise component. A lack of PR centres, well-trained staff and the authority to refer patients were major barriers to referring patients with COPD. Further research is needed to confirm HCP perceptions of patient-related barriers

Intrusion Detection Systems Based on Artificial Intelligence Techniques in Wireless Sensor Networks

[EN] Intrusion detection system (IDS) is regarded as the second line of defense against network anomalies and threats. IDS plays an important role in network security. There are many techniques which are used to design IDSs for specific scenario and applications. Artificial intelligence techniques are widely used for threats detection. This paper presents a critical study on genetic algorithm, artificial immune, and artificial neural network (ANN) based IDSs techniques used in wireless sensor network (WSN)The authors extend their appreciation to the Distinguished Scientist Fellowship Program(DSFP) at King Saud University for funding this research.Alrajeh, NA.; Lloret, J. (2013). Intrusion Detection Systems Based on Artificial Intelligence Techniques in Wireless Sensor Networks. International Journal of Distributed Sensor Networks. 2013(351047):1-6. https://doi.org/10.1155/2013/351047S16201335104

Global Current Practices of Ventilatory Support Management in COVID-19 Patients: An International Survey

Background: As the global outbreak of COVID-19 continues to ravage the world, it is important to understand how frontline clinicians manage ventilatory support and the various limiting factors. / Methods: An online survey composed of 32 questions was developed and validated by an international expert panel. / Results: Overall, 502 respondents from 40 countries across six continents completed the survey. The mean number (±SD) of ICU beds was 64 ± 84. The most popular initial diagnostic tools used for treatment initiation were arterial blood gas (48%) and clinical presentation (37.5%), while the national COVID-19 guidelines were the most used (61.2%). High flow nasal cannula (HFNC) (53.8%), non-invasive ventilation (NIV) (47%), and invasive mechanical ventilation (IMV) (92%) were mostly used for mild, moderate, and severe COVID-19 cases, respectively. However, only 38.8%, 56.6% and 82.9% of the respondents had standard protocols for HFNC, NIV, and IMV, respectively. The most frequently used modes of IMV and NIV were volume control (VC) (36.1%) and continuous positive airway pressure/pressure support (CPAP/PS) (40.6%). About 54% of the respondents did not adhere to the recommended, regular ventilator check interval. The majority of the respondents (85.7%) used proning with IMV, with 48.4% using it for 12– 16 hours, and 46.2% had tried awake proning in combination with HFNC or NIV. Increased staff workload (45.02%), lack of trained staff (44.22%) and shortage of personal protective equipment (PPE) (42.63%) were the main barriers to COVID-19 management. / Conclusion: Our results show that general clinical practices involving ventilatory support were highly heterogeneous, with limited use of standard protocols and most frontline clinicians depending on isolated and varied management guidelines. We found increased staff workload, lack of trained staff and shortage of PPE to be the main limiting factors affecting global COVID-19 ventilatory support management

Pulmonary rehabilitation, physical activity and aortic stiffness in COPD

BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) have elevated cardiovascular risk, and cardiovascular disease is a major cause of death in COPD. The current literature indicates that changes in cardiovascular risk during pulmonary rehabilitation (assessed using aortic stiffness) are heterogeneous suggesting that there may be sub-groups of patients who do and do not benefit. OBJECTIVES: To investigate the characteristics of COPD patients who do and do not experience aortic stiffness reduction during pulmonary rehabilitation, examine how changes relate to physical activity and exercise capacity, and assess whether changes in aortic stiffness are maintained at 6 weeks following rehabilitation. METHODS: We prospectively measured arterial stiffness (aortic pulse-wave velocity), exercise capacity (Incremental Shuttle Walk Test) and physical activity (daily step count) in 92 COPD patients who started a six week pulmonary rehabilitation programme, 54 of whom completed rehabilitation, and 29 of whom were re-assessed six weeks later. RESULTS: Whilst on average there was no influence of pulmonary rehabilitation on aortic stiffness (pre- vs. post pulse-wave velocity 11.3 vs. 11.1 m/s p = 0.34), 56% patients responded with a significant reduction in aortic stiffness. Change in aortic stiffness (absolute and/or percentage) during rehabilitation was associated with both increased physical activity (rho = - 0.30, p = 0.042) and change in exercise capacity (rho = - 0.32, p = 0.02), but in multivariable analysis most closely with physical activity. 92% of the responders who attended maintained this response six weeks later. CONCLUSION: Elevated aortic stiffness in COPD is potentially modifiable in a subgroup of patients during pulmonary rehabilitation and is associated with increased physical activity. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03003208. Registered 26/12/ 2016