Point - to - Point Virtual Private Network Based on IP Filtering and Rijndael Encryption Algorithm

The Rijndael algorithm was chosen to take advantage of its features and add recent technology to increase the confidentiality and security for the transfer of sensitive data on some important institutions. Rijndael algorithm (Advance Encryption Standard) is the Encryption of Symmetric Key, each one of the keys has size of 128 bit. Each round consists of several processing steps; one of them is depend on the encryption key. Therefore NEDRO program has been designed depending on Rijndael algorithm and updated by adding the key (Initialization Vector), in addition to taking into consideration the possibilities that could face the process of transmission of data between   two sides. Finally NEDRO program has implemented and tested practically between two points (User making encryption and Host making decryption or Host making encryption and User making decryption at the same time ) Keywords : Cryptography , Rijndael (AES) ,Data Security , Encryption , Decryptio

UX Evaluation of Video Streaming Application with Teenage Users

Studies show that YouTube (a video streaming application) is the third most frequently visited website globally. It was created for users to search for, watch and share video online. Statistics show that YouTube runs in more than 88 countries and support 76 different languages and this covers about 95% of Internet population worldwide. Hence, a usability study for a specific class of users such as teenagers for such a top-rated web application with very high user loyalty is necessary. In this study, the authors focused on YouTube website usability for Malaysian teenagers that are currently schooling in a boarding school with limited Internet access. The usability study was carried out in a controlled laboratory environment with devices and software like MacBook, LCD Monitor, and WhatPulse heat map tracker. The usability evaluation was done using the following usability metrics: ease of use, usefulness, learnability, and users’ satisfaction. Data was collected using a combination of video recordings, mouse, keyboard heat map and questionnaires. The outcome shows that most of the respondents only use YouTube for watching the video and do not give attention to other features in the application while doing that. In addition, the study reveals that first-time users encounter some difficulties using the application, but however do catch up within a short while. The study further shows that YouTube application is efficient, satisfying, useful, and learnable. Some observed issues with the application were highlighted and useful remedying suggestions for improvement were proffered

Innovation readiness in public sector service delivery: An exploration

We set out in this study to examine the mechanisms (specific knowledge management practices) required to operationalize service innovation readiness within public sector service delivery. Data is obtained from 150 service delivery managers drawn from public sector service organizations within the emirate of Sharjah. Sampling is undertaking utilizing a 38 factor knowledge management-focused service innovation readiness questionnaire developed from the literature. Analysis of the data is via variable ranking and multidimensional scaling (MDS). The findings of the study suggest the existence of four knowledge management-based imperatives which are construed as managerial mechanisms for public sector service innovation readiness. These are (i) ‘Knowledge core competence’ (knowledge as a key strategic asset) (ii) ‘Organizational structure’ (internal patterns of organizational communication, authority and relationships) (iii) ‘Responsiveness to change’ (propensity to engage in both purposeful and timely behavioral change in response to modulating stimuli), and (iv) ‘Innovativeness’ (relative earliness in adopting innovation). The findings lead to a service innovation readiness typology which is oriented towards ensuring that public sector entities are able to effectively and efficiently deliver innovative services that meet both operational mandates and national visions of service expectations

Evaluating the Impact of a Collaborative Care Model in Diabetes Management in a Primary Healthcare Setting in Qatar Using Real-World Data

Objectives: To evaluate the impact of Collaborative Care Model (CCM) on diabetes-related outcomes among patients with diabetes attending a primary care setting. Methods: A multiple-time series, retrospective, observational study with a control group among patients with diabetes followed-up at Qatar Petroleum Diabetes Clinic. The impact of CCM on glycemic control, blood pressure, lipid profile, and anthropometrics was evaluated at baseline and up to 17 months of follow-up. Quantitative data were analyzed descriptively and inferentially using SPSS. Results: CCM significantly improved (p<0.05) the mean values (baseline vs. 17 months) of glycated hemoglobin A1c (6.9% vs. 6.5%), random blood glucose (194.38 mg/dL vs. 141.23 mg/dL), low-density lipoprotein cholesterol (3.7 mmol/L vs. 2.8 mmol/L), total cholesterol (5.43 mmol/L vs. 4.34 mmol/L), weight (78.52 Kg vs. 77.85 Kg), and body mass index (30.41 Kg/m2 vs. 30.17 Kg/m2) over 17-months within the intervention group; whereas, no significant changes occurred within the control group. Similarly, the between group comparisons demonstrated the superiority of CCM over usual care in improving several clinical outcomes. Conclusion: Inefficiencies in delivering diabetes care can be circumvented by the integration of CCM. The implementation of CCM in a primary healthcare setting improved several diabetes-related outcomes over 17-months

Hepatobiliary manifestations following two-stages elective laparoscopic restorative proctocolectomy for patients with ulcerative colitis: A prospective observational study

BACKGROUNDHepatobiliary manifestations occur in ulcerative colitis (UC) patients. The effect of laparoscopic restorative proctocolectomy (LRP) with ileal pouch anal anastomosis (IPAA) on hepatobiliary manifestations is debated.AIMTo evaluate hepatobiliary changes after two-stages elective laparoscopic restorative proctocolectomy for patients with UC.METHODSBetween June 2013 and June 2018, 167 patients with hepatobiliary symptoms underwent two-stage elective LRP for UC in a prospective observational study. Patients with UC and having at least one hepatobiliary manifestation who underwent LRP with IPAA were included in the study. The patients were followed up for four years to assess the outcomes of hepatobiliary manifestations.RESULTSThe patients' mean age was 36 +/- 8 years, and males predominated (67.1%). The most common hepatobiliary diagnostic method was liver biopsy (85.6%), followed by Magnetic resonance cholangiopancreatography (63.5%), Antineutrophil cytoplasmic antibodies (62.5%), abdominal ultrasonography (35.9%), and Endoscopic retrograde cholangiopancreatography (6%). The most common hepatobiliary symptom was Primary sclerosing cholangitis (PSC) (62.3%), followed by fatty liver (16.8%) and gallbladder stone (10.2%). 66.4% of patients showed a stable course after surgery. Progressive or regressive courses occurred in 16.8% of each. Mortality was 6%, and recurrence or progression of symptoms required surgery for 15%. Most PSC patients (87.5%) had a stable course, and only 12.5% became worse. Two-thirds (64.3%) of fatty liver patients showed a regressive course, while one-third (35.7%) showed a stable course. Survival rates were 98.8%, 97%, 95.8%, and 94% at 12 mo, 24 mo, 36 mo, and at the end of the follow-up.CONCLUSIONIn patients with UC who had LRP, there is a positive impact on hepatobiliary disease. It caused an improvement in PSC and fatty liver disease. The most prevalent unchanged course was PSC, while the most common improvement was fatty liver disease

Intraoperative endomanometric laparoscopic Nissen fundoplication improves postoperative outcomes in large sliding hiatus hernia with severe gastroesophageal reflux disease. A retrospective cohort study

Background: Laparoscopic Nissen Fundoplication (LNF) is the gold standard surgical intervention for gastroesophageal reflux disease (GERD). LNF can be followed by recurrent symptoms or complications affecting patient satisfaction. The aim of this study is to assess the value of the intraoperative endomanometric evaluation of esophagogastric competence and pressure combined with LNF in patients with large sliding hiatus hernia (&gt; 5&nbsp;cm) with severe GERD (DeMeester score &gt;100). Materials and methods: This is a retrospective, multicenter cohort study. Baseline characteristics, postoperative dysphagia and gas bloat syndrome, recurrent symptoms, and satisfaction were collected from a prospectively maintained database. Outcomes analyzed included recurrent reflux symptoms, postoperative side effects, and satisfaction with surgery. Results: 360 patients were stratified into endomanometric LNF (180 patients, LNF+) and LNF alone (180 patients, LNF). Recurrent heartburn (3.9% vs. 8.3%) and recurrent regurgitation (2.2% vs. 5%) showed a lower incidence in the LNF+ group (P=0.012). Postoperative score III recurrent heartburn and score III regurgitations occurred in 0% vs. 3.3% and 0% vs. 2.8% cases in the LNF+ and LNF groups, respectively (P=0.005). Postoperative persistent dysphagia and gas bloat syndrome occurred in 1.75% vs. 5.6% and 0% vs. 3.9% of patients (P=0.001). Score III postoperative persistent dysphagia was 0% vs. 2.8% in the two groups (P=0.007). There was no redo surgery for dysphagia after LNF+. Patient satisfaction at the end of the study was 93.3% vs. 86.7% in both cohorts, respectively (P=0.05). Conclusions: Intraoperative high-resolution manometry (HRM) and endoscopic were feasible in all patients, and the outcomes were favorable from an effectiveness and safety standpoint

Cardiovascular risk factors and clinical outcomes of patients hospitalized with COVID-19 pneumonia in Somalia

Background: Coronavirus disease-2019 (COVID-19) is a potentially life-threatening illness with no established treatment. Cardiovascular risk factors (CRFs) exacerbate COVID-19 morbidity and mortality. Objective: To determine the prevalence of CRF and clinical outcomes of patients hospitalized with COVID-19 in a tertiary hospital in Somalia. Methods: We reviewed the medical records of patients aged 18 years or older with a real-time polymerase chain reaction (RT-PCR)–confirmed COVID-19 hospitalized at the De Martino Hospital in Mogadishu, Somalia, between March and July 2020. Results: We enrolled 230 participants; 159 (69.1%) males, median age was 56 (41–66) years. In-hospital mortality was 19.6% (n = 45); 77.8% in the intensive care unit (ICU) compared with 22.2%, in the general wards (p < 0.001). Age ⩾ 40 years [odds ratio (OR): 3.6, 95% confidence interval (CI): 1.2–10.6, p = 0.020], chronic heart disease (OR: 9.3, 95% CI: 2.2–38.9, p = 0.002), and diabetes mellitus (OR: 3.2, 95% CI: 1.6–6.2, p < 0.001) were associated with increased odds of mortality. Forty-three (18.7%) participants required ICU admission. Age ⩾ 40 years (OR: 7.5, 95% CI: 1.7–32.1, p = 0.007), diabetes mellitus (OR: 3.2, 95% CI: 1.6–6.3, p < 0.001), and hypertension (OR: 2.5, 95% CI: 1.2–5.2, p = 0.014) were associated with ICU admission. For every additional CRF, the odds of admission into the ICU increased threefold (OR: 2.7, 95% CI: 1.2–5.2, p < 0.001), while the odds of dying increased twofold (OR: 2.1, 95% CI: 1.3–3.2, p < 0.001). Conclusions: We report a very high prevalence of CRF among patients hospitalized with COVID-19 in Somalia. Mortality rates were unacceptably high, particularly among those with advanced age, underlying chronic heart disease, and diabetes