Intelligent control and security of fog resources in healthcare systems via a cognitive fog model

There have been significant advances in the field of Internet of Things (IoT) recently, which have not always considered security or data security concerns: A high degree of security is required when considering the sharing of medical data over networks. In most IoT-based systems, especially those within smart-homes and smart-cities, there is a bridging point (fog computing) between a sensor network and the Internet which often just performs basic functions such as translating between the protocols used in the Internet and sensor networks, as well as small amounts of data processing. The fog nodes can have useful knowledge and potential for constructive security and control over both the sensor network and the data transmitted over the Internet. Smart healthcare services utilise such networks of IoT systems. It is therefore vital that medical data emanating from IoT systems is highly secure, to prevent fraudulent use, whilst maintaining quality of service providing assured, verified and complete data. In this paper, we examine the development of a Cognitive Fog (CF) model, for secure, smart healthcare services, that is able to make decisions such as opting-in and opting-out from running processes and invoking new processes when required, and providing security for the operational processes within the fog system. Overall, the proposed ensemble security model performed better in terms of Accuracy Rate, Detection Rate, and a lower False Positive Rate (standard intrusion detection measurements) than three base classifiers (K-NN, DBSCAN and DT) using a standard security dataset (NSL-KDD)

Postgraduate ethics training programs: a systematic scoping review

BACKGROUND: Molding competent clinicians capable of applying ethics principles in their practice is a challenging task, compounded by wide variations in the teaching and assessment of ethics in the postgraduate setting. Despite these differences, ethics training programs should recognise that the transition from medical students to healthcare professionals entails a longitudinal process where ethics knowledge, skills and identity continue to build and deepen over time with clinical exposure. A systematic scoping review is proposed to analyse current postgraduate medical ethics training and assessment programs in peer-reviewed literature to guide the development of a local physician training curriculum. METHODS: With a constructivist perspective and relativist lens, this systematic scoping review on postgraduate medical ethics training and assessment will adopt the Systematic Evidence Based Approach (SEBA) to create a transparent and reproducible review. RESULTS: The first search involving the teaching of ethics yielded 7669 abstracts with 573 full text articles evaluated and 66 articles included. The second search involving the assessment of ethics identified 9919 abstracts with 333 full text articles reviewed and 29 articles included. The themes identified from the two searches were the goals and objectives, content, pedagogy, enabling and limiting factors of teaching ethics and assessment modalities used. Despite inherent disparities in ethics training programs, they provide a platform for learners to apply knowledge, translating it to skill and eventually becoming part of the identity of the learner. Illustrating the longitudinal nature of ethics training, the spiral curriculum seamlessly integrates and fortifies prevailing ethical knowledge acquired in medical school with the layering of new specialty, clinical and research specific content in professional practice. Various assessment methods are employed with special mention of portfolios as a longitudinal assessment modality that showcase the impact of ethics training on the development of professional identity formation (PIF). CONCLUSIONS: Our systematic scoping review has elicited key learning points in the teaching and assessment of ethics in the postgraduate setting. However, more research needs to be done on establishing Entrustable Professional Activities (EPA)s in ethics, with further exploration of the use of portfolios and key factors influencing its design, implementation and assessment of PIF and micro-credentialling in ethics practice. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12909-021-02644-5

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

SIERRA: a visual query interface for property graphs

Graph Database Management Systems(DBMS) are the fastest growing category of DBMS used by developers. Graph DBMSs are much better suited to solve problems dealing with connected data than traditional RDBMSs. Hence, they are widely used in domains such as Fraud Detection & Analytics, Recommendation Engines and Social Media Networks. However, working with Graph DBMSs requires users to pick up a new querying language, with Cypher being the most predominant graph querying language. Moreover, graph query languages are created with expert users in mind (eg. developers and data scientists) making it hard to non-expert users to utilise graph databases fully. Therefore, our project’s aim is to provide an intuitive and novel graphical user interface (GUI), named SIERRA, that allows the creation of rich and complex graph queries for graph databases. SIERRA employs the use of a unique node-link diagram, allowing users to draw nodes and connections and transform them into Cypher queries.Bachelor of Engineering (Computer Science

COVID-19 post-vaccination lymphadenopathy: Report of cytological findings from fine needle aspiration biopsy

10.1002/dc.24863DIAGNOSTIC CYTOPATHOLOGY4912E467-E47

A Proposed ASEAN Disaster Response, Training and Logistic Centre Enhancing Regional Governance in Disaster Management

Response, Training, Logistics, Southeast Asia, Disaster management, Disaster relief, N25, O54,

Collagen intrafibrillar mineralization as a result of the balance between osmotic equilibrium and electroneutrality

Mineralization of fibrillar collagen with biomimetic process-directing agents has enabled scientists to gain insight into the potential mechanisms involved in intrafibrillar mineralization. Here, by using polycation- and polyanion-directed intrafibrillar mineralization, we challenge the popular paradigm that electrostatic attraction is solely responsible for polyelectrolyte-directed intrafibrillar mineralization. As there is no difference when a polycationic or a polyanionic electrolyte is used to direct collagen mineralization, we argue that additional types of long-range non-electrostatic interaction are responsible for intrafibrillar mineralization. Molecular dynamics simulations of collagen structures in the presence of extrafibrillar polyelectrolytes show that the outward movement of ions and intrafibrillar water through the collagen surface occurs irrespective of the charges of polyelectrolytes, resulting in the experimentally verifiable contraction of the collagen structures. The need to balance electroneutrality and osmotic equilibrium simultaneously to establish Gibbs-Donnan equilibrium in a polyelectrolyte-directed mineralization system establishes a new model for collagen intrafibrillar mineralization that supplements existing collagen mineralization mechanisms

With/Out Water: Architecture within a water-food nexus in Khulna, Bangladesh

The studio on architecture within a water-food nexus in Khulna, Bangladesh, explores the territorial, spatial, socio-economic and material interrelation of water, food production and urbanisation that are seen as the core of multi-level challenges faced especially by the disadvantaged communities of Khulna. There as in many parts of Bangladesh and South Asia, this nexus has gotten out of balance due to the combined effects of rapid urbanisation, internal as well as international migration and global capitalism, increasing environmental stress and impacting on agriculture and work. The situation in Khulna is further aggravated by the irreversible alterations to the delicate system of ponds, canals and elevated grounds that for centuries, formed a resilient base for water use, food production and settlement in this ‘sponge city’. Architectural design is seen as a way to propose sustainable alternatives for Khulna and beyond. The studio will explore the material economy both with regard to the production of food and building materials allows to tackle resource scarcity and waste problems, sanitation and food production and re-value renewable forms of building and energy materials. Water is thereby investigated at material, tectonic, architectural and urban scales. The studio will apply an urban metabolism approach to quantify stocks and flows of material and energy with particular focus on those materials competing for food production, building materials and waste. Students will formulate a design hypothesis in the form of a short written statement supported by maps and diagrams. The preliminary research on water and tectonic systems will lead to a series of architectural elements forming a joint catalogue of approaches to the topic. These contain prototypical codes identifying input parameters, transformation rules and expected output of the architectural elements. This leads to a parametric definition that can be deployed on the site to generate spatial and tectonic diagrams. Prior knowledge of Grasshopper is not a pre-requisite as all necessary skills will be taught in class. The aim is to produce scalable hybrid water-food-architecture design projects. The students will choose their own programme, building typology and tectonic system according to their research findings, design hypothesis as well as their conceptual and parametric architectural elements