IoT: the internal and external threat

John Curry, Senior Lecturer in Computing at Bath Spa University, and Nick Drage, a specialist in cyber security, discuss what CISOs should be doing about the security threats emanating from the internet of things

A survey of patient contact shielding in dental teaching hospitals in the UK

A high volume of dental imaging is carried out each year. In the UK, guidance on the use of patient contact shielding for these investigations is published by the British Institute of Radiology (BIR) and in a document jointly produced by the Faculty of General Dental Practice and Public Health England (FGDP/PHE). Both these sources of guidance have been updated recently and patient contact shielding is no longer recommended for most imaging settings in dental radiology. It is unclear whether radiology departments at dental teaching hospitals in the UK are aware of these sources of guidance, and how this relates to clinical practice within these departments. A survey was carried out exploring the awareness of current guidelines and clinical practice at dental teaching hospitals in the UK. The survey was sent to a representative at 17 different dental teaching hospital radiology departments. Responses were received from 11 departments. The range of intra-oral and extra-oral imaging carried out at these departments was comparable. Ten departments were aware of the existence of national guidelines for patient contact shielding, however only four were specifically aware of the recent BIR guidelines and only four were specifically aware of the FGDP/PHE guidelines. No department was aware of both sets of guidelines. No departments used thyroid protection for bitewing, periapical, lower 45 degree occlusal, panoramic or lateral cephalometric radiographs. Six departments sometimes or always used thyroid protection for upper standard occlusal imaging. Two departments used thyroid protection for cone beam CT imaging. No departments routinely used lead aprons on patients for dental imaging. In conclusion, radiology departments at dental teaching hospitals in the UK do not use patient contact shielding for most imaging situations in dental radiology. There is mixed awareness of current national guidelines, but the reported clinical practice aligns well with the current guidelines

Desensitization protocol enabling pediatric crossmatch-positive renal transplantation: successful HLA-antibody-incompatible renal transplantation of two highly sensitized children

BACKGROUND: Renal transplantation improves quality of life (QoL) and survival in children requiring renal replacement therapy (RRT). Sensitization with development of a broad-spectrum of anti-HLA antibodies as a result of previous transplantation or after receiving blood products is an increasing problem. There are no published reports of desensitization protocols in children allowing renal transplantation from HLA-antibody-incompatible living donors. METHODS: We adopted our well-established adult desensitization protocol for this purpose and undertook HLA antibody-incompatible living donor renal transplants in two children: a 14-year-old girl and a 13-year-old boy. RESULTS: After 2 and 1.5 years of follow-up, respectively, both patients have stable renal allograft function despite a rise in donor-specific antibodies in one case. CONCLUSIONS: HLA-incompatible transplantation should be considered in selected cases for sensitized children

A longitudinal interpretative phenomenological analysis of the process of kidney recipients’ resolution of complex ambiguities within relationships with their living donors

Much previous research into living kidney donation has focused on the decision making of the donor, despite evidence suggesting this may be a more psychologically challenging time for the recipient. This longitudinal study explores the experiences of four recipients of kidneys from living donors throughout the transplant process. Transcripts were analysed using Interpretative Phenomenological Analysis (IPA). Three themes arose from the data, which were: Changing perceptions of relationships with kidney donors; Upbeat, temporal strategies for remaining positive; and Journey of the self. Findings from the first theme are presented in detail here. It was found that each participants’ relationship with their donor grew and developed in different ways, presenting their own complex challenges in terms of developing relationships and ambiguity around the decision to use the chosen donor

A pitfall in the reconstruction of fibre ODFs using spherical deconvolution of diffusion MRI data

Diffusion weighted ( DW ) MRI facilitates non-invasive quantification of tissue microstructure and, in combination with appropriate signal processing, three-dimensional estimates of fibrous orientation. In recent years, attention has shifted from the diffusion tensor model, which assumes a unimodal Gaussian diffusion displacement profile to recover fibre orientation ( with various well-documented limitations ), towards more complex high angular resolution diffusion imaging ( HARDI ) analysis techniques. Spherical deconvolution ( SD ) approaches assume that the fibre orientation density function ( fODF ) within a voxel can be obtained by deconvolving a ‘common’ single fibre response function from the observed set of DW signals. In practice, this common response function is not known a priori and thus an estimated fibre response must be used. Here the establishment of this single-fibre response function is referred to as ‘calibration’. This work examines the vulnerability of two different SD approaches to inappropriate response function calibration: ( 1 ) constrained spherical harmonic deconvolution ( CSHD )—a technique that exploits spherical harmonic basis sets and ( 2 ) damped Richardson–Lucy ( dRL ) deconvolution—a technique based on the standard Richardson–Lucy deconvolution. Through simulations, the impact of a discrepancy between the calibrated diffusion profiles and the observed ( ‘Target’ ) DW-signals in both single and crossing-fibre configurations was investigated. The results show that CSHD produces spurious fODF peaks ( consistent with well known ringing artefacts ) as the discrepancy between calibration and target response increases, while dRL demonstrates a lower over-all sensitivity to miscalibration ( with a calibration response function for a highly anisotropic fibre being optimal ). However, dRL demonstrates a reduced ability to resolve low anisotropy crossing-fibres compared to CSHD. It is concluded that the range and spatial-distribution of expected single-fibre anisotropies within an image must be carefully considered to ensure selection of the appropriate algorithm, parameters and calibration. Failure to choose the calibration response function carefully may severely impact the quality of any resultant tractography

Mapping spatial dimensions of Wilderness recreation outcomes: a study of overnight users

Grand Teton National Park (GRTE) is a popular mountain recreation destination which, like many National Park Service (NPS) units, has experienced a significant increase in visitation in recent years, with total visits increasing by 27% between 2014 and 2017 (NPS 2020). Particularly popular within GRTE is the String and Leigh Lakes (SLL) area, which is a favoured alpine destination for numerous day-use recreation activities and also an important starting point for backcountry and overnight recreational users within GRTE’s Recommended Wilderness. To better understand the visitor experience of overnight backcountry recreationists in the SLL area, data were collected using novel public participatory geographic information systems (PPGIS) during the summer of 2018. PPGIS data were used to identify the locations in which overnight recreationists experienced positive and negative recreation outcomes. Results indicate that they experience more positive outcomes within the Recommended Wilderness, away from high-density, trailhead-proximate areas outside the Recommended Wilderness. Findings also indicate that overnight users experience crowding and conflict more outside of the Recommended Wilderness than elsewhere on their backcountry trip. While this may seem intuitive, these are some of the first empirical results spatially contextualizing backcountry visitor outcomes in a popular national park. The findings thus provide managers with a visitor experience baseline that can be monitored and adaptively managed in the future

Measurement of geologic nitrogen using mass spectrometry, colorimetry, and a newly adapted fluorometry technique

Long viewed as a mostly noble, atmospheric species, recent work demonstrates that nitrogen in fact cycles throughout the Earth system, including the atmosphere, biosphere, oceans, and solid Earth. Despite this new-found behaviour, more thorough investigation of N in geologic materials is limited due to its low concentration (one to tens of parts per million) and difficulty in analysis. In addition, N can exist in multiple species (NO3−, NH4+, N2, organic N), and determining which species is actually quantified can be difficult. In rocks and minerals, NH4+ is the most stable form of N over geologic timescales. As such, techniques designed to measure NH4+ can be particularly useful.We measured a number of geochemical rock standards using three different techniques: elemental analyzer (EA) mass spectrometry, colorimetry, and fluorometry. The fluorometry approach is a novel adaptation of a technique commonly used in biologic science, applied herein to geologic NH4+. Briefly, NH4+ can be quantified by HF dissolution, neutralization, addition of a fluorescing reagent, and analysis on a standard fluorometer. We reproduce published values for several rock standards (BCR-2, BHVO-2, and G-2), especially if an additional distillation step is performed. While it is difficult to assess the quality of each method, due to lack of international geologic N standards, fluorometry appears better suited to analyzing mineral-bound NH4+ than EA mass spectrometry and is a simpler, quicker alternative to colorimetry.To demonstrate a potential application of fluorometry, we calculated a continental crust N budget based on new measurements. We used glacial tills as a proxy for upper crust and analyzed several poorly constrained rock types (volcanics, mid-crustal xenoliths) to determine that the continental crust contains  ∼  2  ×  1018 kg N. This estimate is consistent with recent budget estimates and shows that fluorometry is appropriate for large-scale questions where high sample throughput is helpful.Lastly, we report the first δ15N values of six rock standards: BCR-2 (1. 05  ±  0. 4 ‰), BHVO-2 (−0. 3  ±  0. 2 ‰), G-2 (1. 23  ±  1. 32 ‰), LKSD-4 (3. 59  ±  0. 1 ‰), Till-4 (6. 33  ±  0. 1 ‰), and SY-4 (2. 13  ±  0. 5 ‰). The need for international geologic N standards is crucial for further investigation of the Earth system N cycle, and we suggest that existing rock standards may be suited to this need

The impact of time to death in donors after circulatory death on recipient outcome in simultaneous pancreas-kidney transplantation

\ua9 2024 The AuthorsThe time to arrest donors after circulatory death is unpredictable and can vary. This leads to variable periods of warm ischemic damage prior to pancreas transplantation. There is little evidence supporting procurement team stand-down times based on donor time to death (TTD). We examined what impact TTD had on pancreas graft outcomes following donors after circulatory death (DCD) simultaneous pancreas-kidney transplantation. Data were extracted from the UK transplant registry from 2014 to 2022. Predictors of graft loss were evaluated using a Cox proportional hazards model. Adjusted restricted cubic spline models were generated to further delineate the relationship between TTD and outcome. Three-hundred-and-seventy-five DCD simultaneous kidney-pancreas transplant recipients were included. Increasing TTD was not associated with graft survival (adjusted hazard ratio HR 0.98, 95% confidence interval 0.68-1.41, P = .901). Increasing asystolic time worsened graft survival (adjusted hazard ratio 2.51, 95% confidence interval 1.16-5.43, P = .020). Restricted cubic spline modeling revealed a nonlinear relationship between asystolic time and graft survival and no relationship between TTD and graft survival. We found no evidence that TTD impacts pancreas graft survival after DCD simultaneous pancreas-kidney transplantation; however, increasing asystolic time was a significant predictor of graft loss. Procurement teams should attempt to minimize asystolic time to optimize pancreas graft survival rather than focus on the duration of TTD

Detailing patient specific modelling to aid clinical decision-making

The anatomy of the craniofacial skeleton has been described through the aid of dissection identifying hard and soft tissue structures. Although the macro and microscopic investigation of internal facial tissues have provided invaluable information on constitution of the tissues it is important to inspect and model facial tissues in the living individual. Detailing the form and function of facial tissues will be invaluable in clinical diagnoses and planned corrective surgical interventions such as management of facial palsies and craniofacial disharmony/anomalies. Recent advances in lower-cost, non-invasive imaging and computing power (surface scanning, Cone Beam Computerized Tomography (CBCT) and Magnetic Resonance (MRI)) has enabled the ability to capture and process surface and internal structures to a high resolution. The three-dimensional surface facial capture has enabled characterization of facial features all of which will influence subtleties in facial movement and surgical planning. This chapter will describe the factors that influence facial morphology in terms of gender and age differences, facial movement—surface and underlying structures, modeling based on average structures, orientation of facial muscle fibers, biomechanics of movement—proof of principle and surgical intervention

MARCO variants are associated with phagocytosis, pulmonary tuberculosis susceptibility and Beijing lineage

Macrophage receptor with collagenous structure (MARCO) has an important role in the phagocytosis of Mycobacterium tuberculosis (M. tuberculosis). We hypothesized that MARCO polymorphisms are associated with phagocytosis, tuberculosis (TB) disease susceptibility and presentation, and infecting lineage. We used a human cellular model to examine how MARCO genotype mediates the immune response; a case-control study to investigate tuberculosis host genetic susceptibility; and a host-pathogen genetic analysis to study host-pathogen interactions. Two MARCO heterozygous (AG) genotypes (single-nucleotide polymorphisms rs2278589 and rs6751745) were associated with impaired phagocytosis of M. tuberculosis trehalose 6,6'-dimycolate-cord factor and β-glucan-coated beads in macrophages. The heterozygous genotypes of rs2278589 and rs6751745 were also associated with increased risk of pulmonary TB (PTB; rs2278589, P=0.001, odds ratio (OR)=1.6; rs6751745, P=0.009, OR=1.4), and with severe chest X-ray abnormalities (P=0.007, OR=1.6). These two genotypes were also associated with the Beijing lineage (rs2278589, P=0.001, OR=1.7; rs6751745, P=0.01, OR=1.5). Together, these results suggest that MARCO polymorphisms may regulate phagocytosis of M. tuberculosis and susceptibility and severity of PTB. They also suggest MARCO genotype and Beijing strains may interact to increase the risk of PT