13 research outputs found
A low-complexity Edward-Curve point multiplication architecture
The Binary Edwards Curves (BEC) are becoming more and more important, as compared
to other forms of elliptic curves, thanks to their faster operations and resistance against side channel
attacks. This work provides a low-complexity architecture for point multiplication computations
using BEC over GF(2
233). There are three major contributions in this article. The first contribution
is the reduction of instruction-level complexity for unified point addition and point doubling laws
by eliminating multiple operations in a single instruction format. The second contribution is the
optimization of hardware resources by minimizing the number of required storage elements. Finally,
the third contribution is to reduce the number of required clock cycles by incorporating a 32-bit finite
field digit-parallel multiplier in the datapath. As a result, the achieved throughput over area ratio over
GF(2
233) on Virtex-4, Virtex-5, Virtex-6 and Virtex-7 Xilinx FPGA (Field Programmable Gate Array)
devices are 2.29, 19.49, 21.5 and 20.82, respectively. Furthermore, on the Virtex-7 device, the required
computation time for one point multiplication operation is 18 Āµs, while the power consumption is
266 mW. This reveals that the proposed architecture is best suited for those applications where the
optimization of both area and throughput parameters are required at the same time
Evaluation of health workforce competence in maternal and neonatal issues in public health sector of Pakistan: an Assessment of their training needs
<p>Abstract</p> <p>Background</p> <p>More than 450 newborns die every hour worldwide, before they reach the age of four weeks (neonatal period) and over 500,000 women die from complications related to childbirth. The major direct causes of neonatal death are infections (36%), Prematurity (28%) and Asphyxia (23%). Pakistan has one of the highest perinatal and neonatal mortality rates in the region and contributes significantly to global neonatal mortality. The high mortality rates are partially attributable to scarcity of trained skilled birth attendants and paucity of resources. Empowerment of health care providers with adequate knowledge and skills can serve as instrument of change.</p> <p>Methods</p> <p>We carried out training needs assessment analysis in the public health sector of Pakistan to recognize gaps in the processes and quality of MNCH care provided. An assessment of Knowledge, Attitude, and Practices of Health Care Providers on key aspects was evaluated through a standardized pragmatic approach. Meticulously designed tools were tested on three tiers of health care personnel providing MNCH in the community and across the public health care system. The Lady Health Workers (LHWs) form the first tier of trained cadre that provides MNCH at primary care level (BHU) and in the community. The Lady Health Visitor (LHVs), Nurses, midwives) cadre follow next and provide facility based MNCH care at secondary and tertiary level (RHCs, Taluka/Tehsil, and DHQ Hospitals). The physician/doctor is the specialized cadre that forms the third tier of health care providers positioned in secondary and tertiary care hospitals (Taluka/Tehsil and DHQ Hospitals). The evaluation tools were designed to provide quantitative estimates across various domains of knowledge and skills. A priori thresholds were established for performance rating.</p> <p>Results</p> <p>The performance of LHWs in knowledge of MNCH was good with 30% scoring more than 70%. The Medical officers (MOs), in comparison, performed poorly in their knowledge of MNCH with only 6% scoring more than 70%. All three cadres of health care providers performed poorly in the resuscitation skill and only 50% were able to demonstrate steps of immediate newborn care. The MOs performed far better in counselling skills compare to the LHWs. Only 50 per cent of LHWs could secure competency scale in this critical component of skills assessment.</p> <p>Conclusions</p> <p>All three cadres of health care providers performed well below competency levels for MNCH knowledge and skills. Standardized training and counselling modules, tailored to the needs and resources at district level need to be developed and implemented. This evaluation highlighted the need for periodic assessment of health worker training and skills to address gaps and develop targeted continuing education modules. To achieve MDG4 and 5 goals, it is imperative that such deficiencies are identified and addressed.</p
Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial
SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65Ā·3 years (SD 15Ā·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0Ā·97, 95% CI 0Ā·87ā1Ā·07; p=0Ā·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1Ā·04, 95% CI 0Ā·98ā1Ā·10; p=0Ā·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0Ā·95, 95% CI 0Ā·87ā1Ā·03; p=0Ā·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication
An Efficient Elliptic-Curve Point Multiplication Architecture for High-Speed Cryptographic Applications
This work presents an efficient high-speed hardware architecture for point multiplication (PM) computation of Elliptic-curve cryptography using binary fields over GF(2163) and GF(2571). The efficiency is achieved by reducing: (1) the time required for one PM computation and (2) the total number of required clock cycles. The required computational time for one PM computation is reduced by incorporating two modular multipliers (connected in parallel), a serially connected adder after multipliers and two serially connected squarer units (one after the first multiplier and another after the adder). To optimize the total number of required clock cycles, the point addition and point double instructions for PM computation of the Montgomery algorithm are re-structured. The implementation results after place-and-route over GF(2163) and GF(2571) on a Xilinx Virtex-7 FPGA device reveal that the proposed high-speed architecture is well-suited for the network-related applications, where millions of heterogeneous devices want to connect with the unsecured internet to reach an acceptable performance
A Hybrid Approach for Efficient and Secure Point Multiplication on Binary Edwards Curves
The focus of this article is to present a novel crypto-accelerator architecture for a resource-constrained embedded system that utilizes elliptic curve cryptography (ECC). The architecture is built around Binary Edwards curves (BEC) to provide resistance against simple power analysis (SPA) attacks. Furthermore, the proposed architecture incorporates several optimizations to achieve efficient hardware resource utilization for the point multiplication process over GF(2m). This includes the use of a Montgomery radix-2 multiplier and the projective coordinate hybrid algorithm (combination of Montgomery ladder and double and add algorithm) for scalar multiplication. A two-stage pipelined architecture is employed to enhance throughput. The design is modeled in Verilog HDL and verified using Vivado and ISE design suites from Xilinx. The obtained results demonstrate that the proposed BEC accelerator offers significant performance improvements compared to existing solutions. The obtained throughput over area ratio for GF(2233) on Virtex-4, Virtex-5, Virtex-6, and Virtex-7 Xilinx FPGAs are 9.43, 14.39, 26.14, and 28.79, respectively. The computation time required for a single point multiplication operation on the Virtex-7 device is 19.61 Āµs. These findings indicate that the proposed architecture has the potential to address the challenges posed by resource-constrained embedded systems that require high throughput and efficient use of available resources
A dynamic framework for internet-based network time protocol
Time synchronization is vital for accurate data collection and processing in sensor networks. Sensors in these networks often operate under fluctuating conditions. However, an accurate timekeeping mechanism is critical even in varying network conditions. Consequently, a synchronization method is required in sensor networks to ensure reliable timekeeping for correlating data accurately across the network. In this research, we present a novel dynamic NTP (Network Time Protocol) algorithm that significantly enhances the precision and reliability of the generalized NTP protocol. It incorporates a dynamic mechanism to determine the Round-Trip Time (RTT), which allows accurate timekeeping even in varying network conditions. The proposed approach has been implemented on an FPGA and a comprehensive performance analysis has been made, comparing three distinct NTP methods: dynamic NTP (DNTP), static NTP (SNTP), and GPS-based NTP (GNTP). As a result, key performance metrics such as variance, standard deviation, mean, and median accuracy have been evaluated. Our findings demonstrate that DNTP is markedly superior in dynamic network scenarios, a common characteristic in sensor networks. This adaptability is important for sensors installed in time-critical networks, such as real-time industrial IoTs, where precise and reliable time synchronization is necessary
Characteristics and gel properties of gelatin from goat skin as affected by spray drying
Improvement of perinatal and newborn care in rural Pakistan through community-based strategies: a cluster-randomised effectiveness trial.
BACKGROUND: Newborn deaths account for 57% of deaths in children younger than 5 years in Pakistan. Although a large programme of trained lady health workers (LHWs) exists, the effectiveness of this training on newborn outcomes has not been studied. We aimed to evaluate the effectiveness of a community-based intervention package, principally delivered through LHWs working with traditional birth attendants and community health committees, for reduction of perinatal and neonatal mortality in a rural district of Pakistan. METHODS: We undertook a cluster randomised trial between February, 2006, and March, 2008, in Hala and Matiari subdistricts, Pakistan. Catchment areas of primary care facilities and all affiliated LHWs were used to define clusters, which were allocated to intervention and control groups by restricted, stratified randomisation. The intervention package delivered by LHWs through group sessions consisted of promotion of antenatal care and maternal health education, use of clean delivery kits, facility births, immediate newborn care, identification of danger signs, and promotion of careseeking; control clusters received routine care. Independent data collectors undertook quarterly household surveillance to capture data for births, deaths, and household practices related to maternal and newborn care. Data collectors were masked to cluster allocation; those analysing data were not. The primary outcome was perinatal and all-cause neonatal mortality. Analysis was by intention to treat. This trial is registered, ISRCTN16247511. FINDINGS: 16 clusters were assigned to intervention (23,353 households, 12,391 total births) and control groups (23,768 households, 11,443 total births). LHWs in the intervention clusters were able to undertake 4428 (63%) of 7084 planned group sessions, but were only able to visit 2943 neonates (24%) of a total 12,028 livebirths in their catchment villages. Stillbirths were reduced in intervention clusters (39Ā·1 stillbirths per 1000 total births) compared with control (48Ā·7 per 1000; risk ratio [RR] 0Ā·79, 95% CI 0Ā·68-0Ā·92; p=0Ā·006). The neonatal mortality rate was 43Ā·0 deaths per 1000 livebirths in intervention clusters compared with 49Ā·1 per 1000 in control groups (RR 0Ā·85, 0Ā·76-0Ā·96; p=0Ā·02). INTERPRETATION: Our results support the scale-up of preventive and promotive maternal and newborn interventions through community health workers and emphasise the need for attention to issues of programme management and coverage for such initiatives to achieve maximum potential. FUNDING: WHO; Saving Newborn Lives Program of Save the Children USA, funded by the Bill & Melinda Gates Foundation