An anonymous device to device access control based on secure certificate for internet of medical things systems: an anonymous D2D access control scheme for IoMT

The Internet of Medical Things (IoMT) is structured upon both the sensing and communication infrastructure and computation facilities. The IoMT provides the convenient and cheapest ways for healthcare by aiding the remote access to the patients’ physiological data and using machine learning techniques for help in diagnosis. The communication delays in IoMT can be very harmful to healthcare. Device to device (D2D) secure communication is a vital area that can reduce communication delays; otherwise, caused due to the mediation of a third party. To substantiate a secure D2D communication framework, some schemes were recently proposed to secure D2D based communication infrastructure suitable for IoMT-based environments. However, the insecurities of some schemes against device physical capture attack and non-provision of anonymity along with related attacks are evident from the literature. This calls for a D2D secure access control system for realizing sustainable smart healthcare. In this article, using elliptic curve cryptography, a certificate based D2D access control scheme for IoMT systems (D2DAC-IoMT) is proposed. The security of the proposed D2DAC-IoMT is substantiated through formal and informal methods. Moreover, the performance analysis affirms that the proposed scheme provides a good trade-off between security and efficiency compared with some recent schemes

The P.F.C. sigma RP-F TKA designed for improved performance: a matched-pair study

The press fit condylar P.F.C. Sigma RP-F (rotating-platform, high flexion) knee is designed to provide a range of motion (ROM) of 155 degrees without compromising wear, polyethylene contact stresses, patellofemoral tracking, or stability. The first 50 TKA surgeries using the Sigma RP-F knee performed at the author's institution were matched to 50 rotating-platform knees for age, sex, body mass index, preoperative diagnosis, duration of follow-up, and preoperative ROM to determine the effect of design on postoperative ROM. The mean increase in active ROM in the Sigma RP-F group was 17 degrees, compared with 6 degrees in the rotating-platform group (P =.0011). The mean increase in active ROM in patients who had less than 120 degrees of preoperative motion was 27 degrees in the Sigma RP-F group, compared with 16 degrees in the rotating-platform group (P = .006). With the new P.F.C. Sigma RP-F design, greater ROM can be achieved independent of preoperative ROM

A three-dimensional clustered peer-to-peer overlay protocol for mobile ad hoc networks

Peer-to-peer (P2P) computing involves exchanging resources and files by computers connected through a network rather than a central server. In P2P, over mobile ad hoc networks (MANETs), the fundamental necessity is the linkage of the overlay participating peers (OPPs) for the efficient operation of the DHT-based P2P overlay protocol over MANETs. This necessity becomes more critical in a high mobility environment. Due to the high mobility of OPPs, the topology of the P2P overlay is altered continuously. Consequently, the efficiency of DHT-based P2P overlay protocol over MANETs greatly decreases due to the increased lookup latency, maintenance, computational, and control overheads. In the current research, a novel three-dimensional clustered overlay P2P protocol, i.e., 3DCOP, is suggested to cope with the identified issues. Simulation results depict that 3DCOP performs better in routing overhead, false-negative ratio, path-stretch ratio, and file discovery delay in the high mobility environment over MANETs

Synovial fluid calprotectin in diagnosing periprosthetic joint infection: A meta-analysis

Purpose Periprosthetic joint infection (PJI) is one of the most debilitating complications following joint replacement surgery. Synovial biomarkers, such as Calprotectin, have become valuable in the diagnosis of PJI. This meta-analysis aimed to investigate the role of synovial Calprotectin as a diagnostic test in PJI. Methods This meta-analysis was conducted with adherence to PRISMA guidelines. PubMed, Cochrane, Web of Science, and Google Scholar were searched until February 2022. Inclusion criteria were as follows: all studies in which the patients with joint replacements were evaluated for PJI; synovial Calprotectin was the biomarker of choice to diagnose PJI; standardized guidelines were used as the gold standard for the diagnosis; and a comparison between the guidelines and Calprotectin results was made. Diagnostic parameters such as sensitivity, specificity, diagnostic odds ratio (DOR), positive predictive value, negative predictive value, and area under the curve (AUC) were calculated for the included studies to evaluate synovial Calprotectin for PJI diagnosis. Results The total number of the included patients was 618 from eight studies. The pooled sensitivity, specificity, and diagnostic odds ratio of Calprotectin test were 92% (95%CI: 84%-98%), 93% (95%CI: 84%-99%), and 187.61 (95%CI: 20.21–1741.18), respectively. The results showed that the negative and positive likelihood ratios of the Calprotectin test were 0.07 (95%CI: 0.02–0.22) and 9.91 (95%CI: 4.11–23.93), respectively. The SROC showed that the area under the curve for Calprotectin test was 0.935. Conclusion Synovial Calprotectin is a valuable biomarker as it provides a reliable and rapid diagnosis of PJI. It has the potential to be used in clinical practice due to its high sensitivity and specificity that are comparable to the other utilized biomarkers. Another advantage is its low cost relative to other biomarkers.Other Information Published in: International Orthopaedics License: https://creativecommons.org/licenses/by/4.0See article on publisher's website: http://dx.doi.org/10.1007/s00264-022-05357-6</p